Possible respiratory infection due to Aspergillus in workers from swineries and poultries

Recent epidemiologic studies clearly outline the link between fungal sensibilization and exarcebations of asthma, leading to increased morbidity and mortality. Amongst the filamentous fungi, Aspergillus scpecies have been strongly linked with exarcebations of asthma and other respiratory allergic diseases. Particles of approximately 1 to 4 pm are deposited in the lower respiratory tract. Therefore, conidia of A. fumigatus are small enough to traverse the terminal respiratory airways and reach the pulmonary alveoli, whereas the larger conidia of some other Aspergillus species, such as A. flavus and A. niger, tend to be deposited in the paranasal sinuses and upper airways. Exposute to environmental fungal spores has been associated with worsening asthma symptoms, lung function, hospital admissions and asthma-related deaths.

Approaches to tuberculosis mucosal vaccine development using nanoparticles and microparticles: a review

Next-generation vaccines for tuberculosis should be designed to prevent the infection and to achieve sterile eradication of Mycobacterium tuberculosis. Mucosal vaccination is a needle-free vaccine strategy that provides protective immunity against pathogenic bacteria and viruses in both mucosal and systemic compartments, being a promising alternative to current tuberculosis vaccines. Micro and nanoparticles have shown great potential as delivery systems for mucosal vaccines. In this review, the immunological principles underlying mucosal vaccine development will be discussed, and the application of mucosal adjuvants and delivery systems to the enhancement of protective immune responses at mucosal surfaces will be reviewed, in particular those envisioned for oral and nasal routes of administration. An overview of the essential vaccine candidates for tuberculosis in clinical trials will be provided, with special emphasis on the potential different antigens and immunization regimens.

The efficiency of urine dipsticks for the diagnosis of urinary tract infection

Urinary tract infection (UTI) is one of the most prevalent pathologies in developed countries, particularly in women, characterized by the presence of bacterial growth in any part of the urinary system. Currently, urine culture is considered the gold standard method for the diagnosis of UTI. However, this method has several disadvantages including the time necessary for obtaining the results and the associated high costs. Therefore, it is important to evaluate new efficient and valuable methods for the diagnosis of these infections. Objectives: Presently, dipsticks are considered a possible valuable alternative to urine culture. This method has very low costs associated and the results can be obtained in few minutes. Here we aim to compare the sensibility, specificity, predictive value of a positive test and a negative test of both methods in order to determine the efficiency of the test strips method and also to characterize the microorganism more frequently isolated.

Unusual cause for smoldering dysphagia

A 30-year-old black woman presented with heartburn and odynophagia. She had a 2-year history of Behçet’s disease and systemic lupus erythematosus and had been treated with colchicine, hydroxychloroquine, and sucralfate. Odynophagia was not related to the presence of oral ulcers as they were painless and when they were in remission the patient would still intermittently complain of substernal pain. The patient underwent upper digestive endoscopy that revealed only small mucosal irregularities in the upper third of the esophagus. Biopsies of these segments showed marked acanthosis and papillomatosis of the squamous epithelium as well as intense lymphoplasmacytic infiltrate with an increased number of intraepithelial lymphocytes (IEL). There were neither granulocytes nor signs of viral infection. The endoscopic findings were then attributed to regenerative changes of the epithelium and the patient was started on a proton pump inhibitor (PPI), assuming gastroesophageal reflux disease (GERD). During the following years there were flare-ups of rheumatologic disease activity due to the patient’s lack of adherence to therapy. However, there was no correlation of the patient’s maintained (although scarce) complaints of transitory dysphagia and substernal pain.