Introduction: Migration of Toxocara canis larvae was investigated in male and female Rattus norvegicus. Methods: Eighteen male and 18 female R. norvegicus were infected with 300 T. canis eggs. Three male and three female rats were euthanized at 3, 7, 10, 15, 30, and 60 days post-infection, and T. canis larvae were recovered by means of organ and tissue digestion. Results: Female rats showed a greater number of larvae in the liver than males. Conclusions: Paratenic host sex influences the migration pattern of T. canis larvae.
Secondary syphilis can have different clinical presentations, with corymbiform rash as its rarest manifestation. The disease is characterized by a central papule surrounded by smaller ones. We report the case of a man who has sex with man with corymbiform syphilis. The patient was subsequently diagnosed with HIV infection, hepatitis B, non-gonococcal urethritis, as well as infection of the central nervous system by treponema. This case not only illustrates a rare presentation of secondary syphilis, but also demonstrates the importance of further investigation of sexually transmitted infections, particularly among at-risk patients.
1933 Introduction: Infection by BK virus in the allo-HSCT setting is associated with the development of HC, which is a major cause of morbidity. There are few studies evaluating the impact of BK virus-associated HC on survival post allo-HSCT. Objectives: To evaluate the incidence of HC by BK virus in patients after allo-HSCT and its impact on survival. Methods: We retrospectively reviewed the medical charts of 107 patients who underwent allo-HSCT at Hospital Israelita Albert Einstein from July 2007 until November 2011. HC was defined by the presence of any degree of unexplained hematuria and positivity for BK virus in a urine sample by quantitative polymerase chain reaction (PCR) assay. CMV reactivation was defined as positivity in the antigenemia assay or greater than 165 copies in a quantitative PCR assay. Three patients were excluded because PCR results for BK virus were inconclusive, with 104 patients being analyzed in the final cohort. Cumulative incidence (CI) of HC, CMV reactivation and acute graft-versus-host disease (GVHD) were estimated taking into account the competing risk of death. Overall survival (OS) was estimated by the Kaplan-Meier method. Gray model was used for regression analysis of factors associated with the development of HC. Hazard ratios (HRs) were estimated by a Cox multivariable proportional hazards model, considering HC, CMV reactivation and acute GVHD as discrete time-varying covariates. Results: Median age was 28 years (range 6 months–76 years), and 60.5% of patients were male. About 37% had high-risk disease (refractory leukemia/lymphoma or 2nd-transplantation). Source of HSCs included matched related donors (37%), 10/10 HLA-matched unrelated donors (24%) and cord blood/haploidentical donors in 39%. The conditioning regimen was myeloablative in 81% of cases. The median follow-up of the whole cohort was 450 days (range 9–1624 days). At 1 year, the cumulative incidence of HC was 30.5% (95% confidence interval [CI] 21.8%–39.7%). The 1-year incidence of CMV reactivation and acute GVHD (all grades) was 57.1% and 39.7%, respectively. In a multivariate analysis taking into account age, sex, risk of disease, source of HSCs, intensity of conditioning, CMV reactivation and acute GVHD, only receiving cells from cord blood/haploidentical donors was associated with an increased incidence of HC (subhazard ratio 4.04, 95% CI 1.31–12.49, p = 0.015). The 1 year-OS of the whole cohort was 55% (95% CI 44–62%). Patients who developed HC had an inferior OS (1 year: 18% vs. 70%; HR= 4.40, p <0.0001; 95% CI 2.37–8.14). In the multivariate Cox analysis for OS, after adjusting for age, sex, disease risk, source of HSCs, intensity of conditioning, CMV reactivation and development of acute GVHD, development of HC was associated with an increased mortality (table). Conclusion: In this cohort, the development of CH was associated with an inferior OS in patients undergoing allogeneic HSCT. Even after adjusting for several variables, including development of acute GVHD and CMV reactivation, HC still remained an important factor associated with decreased survrival. It is possible that HC is not the direct cause of the increased mortality, but is rather a surrogate marker of a state of severe immunosuppression and increased risk of dying in the post-transplant setting. Nonetheless, our results suggest that the development of BK virus-associated HC in allo-HSCT patients is associated with inferior survival and future studies should confirm this finding and seek strategies to prevent this complication. Disclosures: No relevant conflicts of interest to declare.
Background: psoriasis is an in ammatory disease of the skin, characterized by erythematous plaques. It is rather common, affecting 2-4% of the population in western countries. Psoriasis' etiology encompasses both genetic and environmental factors. Evidence suggests that the latter re ect the importance of changes in the microbiome for developing the disease. Thus, it is hypothesized that gut microbiome manipulation may arise as a way of treating psoriasis. However, few trials assessed the use of probiotics in psoriasis, although promising results were detected in small studies.Objectives: to assess the e cacy of adjuvant probiotics (Lactobacillus rhamnosus) in treating plaque psoriasis patients.Design, Setting and Participants: this was a randomized, parallel, placebo-controlled, double-blind trial with two arms: experimental (n=50) and control (n=53). Inclusion of subjects and data gathering lasted from November 2020 to August 2021. Subjects were consecutive plaque psoriasis patients under regular follow-up in the Dermatology unit of a university-a liated, tertiary-referral hospital in São Paulo (Brazil).Eligibility criteria included being over 18 years old, having plaque psoriasis and not having other skin diseases, neoplasms nor systemic in ammatory diseases.Interventions: subjects received standard-of-care plus probiotics (Lactobacillus rhamnosus formula). Controls received standard-of-care plus placebo.Main Outcome Measure: primary outcome was skin lesion improvement as assessed by Psoriasis Area of Severity Index (PASI) at six months. Secondary outcome was quality-of-life as assessed by Dermatology Life Quality Index (DLQI) at six months.Results: regarding within-group analyses, changes in both PASI and DLQI were non-signi cant for the experimental group (mean PASI decreased by 1.58, p=0.105, and mean DLQI increased by 0.05, p=0.873) and signi cant for controls (mean PASI decreased by 1.90, p=0.019, and mean DLQI decreased by 3.33, p=0.031). Between-group analyses returned non-signi cant results (p=0.620).Conclusions: our ndings do not support the hypothesis that gut microbiome modulation via ingestion of Lactobacillus rhamnosusproduces clinical improvement in psoriasis patients. Further research is encouraged.Trial Registration: retrospectively registered at the Brazilian Clinical Trials Registry (RBR-8js7t83) on 08/02/2022.
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