Chagas disease is a parasitic infection with high re-emergence rates in some Amazon regions. The main vectors of Trypanosoma cruzi are haematophagous insects, the triatomines. Only a few reports are available about the occurrence of these wild vectors and their contact with the inhabitants of the riverside regions of the Amazon. This study describes the unusual behaviour of the triatomines that have invaded the homes of the residents of Abaetetuba, the city that has the second highest number of cases of Chagas disease.
Two cross-sectional studies were conducted using sero-epidemiological surveys of the inhabitants of Abaetetuba with registered triatomine home invasions. The frequencies of the variables of interest were analysed using Epi Info version 7.2.
In 2014 and 2017, 145 persons registered home invasions of triatomines in their domiciles and 16.55% reported having been bitten by insects. selleck kinase inhibitor The environmental features described indicated potential conditions for the persistence of the parasite's life cycle. Of the enrolled inhabitants, 0.47% were positive for immunoglobulin G anti-T. cruzi antibodies.
Home invasions of triatomines were confirmed in two periods, with a description of unusual behaviour for the genus Rhodnius. The use of serological surveillance in human populations at risk of this occurrence may constitute a new tool for the early detection of silent infections.
Home invasions of triatomines were confirmed in two periods, with a description of unusual behaviour for the genus Rhodnius. The use of serological surveillance in human populations at risk of this occurrence may constitute a new tool for the early detection of silent infections.
Previous work on sickness absence has shown that conversations about return to work can be challenging. The perception of competing interests and multiple stakeholders in the return to work process may also complicate and erode trust, further impacting health and well-being.
This study aims to explore the themes arising from the experiences of physicians and patients on the impact of health and return to work. The goal was to use these results to develop a Medical Readers' Theatre workshop focusing on negotiating challenging return to work scenarios to serve as an educational support for stakeholders.
Semi-structured interviews were conducted with 19 physicians and 15 patients from the Canadian Maritime Provinces on their experiences in return to work following an injury or illness. Interviews were recorded, transcribed and thematically analysed. Using the emergent themes, an educational workshop in the modality of Readers' Theatre was developed.
The findings confirm there are multiple stakeholders involved in the return to work process and the factors influencing successful return are not always medically related. Six recurring themes were identified for the patient group and five for the physicians', allowing the development of storylines and four return to work scenarios. The scenarios have been used in teaching sessions.
The themes reinforced that challenges in return to work are not always medical in nature. This Readers' Theatre adopts perspectives of patients, physicians and other stakeholders whilst focusing on return to work with the goal of providing engagement in reflective and purposeful discussion.
The themes reinforced that challenges in return to work are not always medical in nature. This Readers' Theatre adopts perspectives of patients, physicians and other stakeholders whilst focusing on return to work with the goal of providing engagement in reflective and purposeful discussion.
The evolution of vitamin D status across pregnancy trimesters and its association with prepregnancy body mass index (ppBMI; in kg/m2) remain unclear.
We aimed to 1) assess trimester-specific serum total 25-hydroxyvitamin D [25(OH)D] concentrations, 2) compare those concentrations between ppBMI categories, and 3) examine associations between 25(OH)D concentrations, ppBMI, and vitamin D intake.
As part of a prospective cohort study, 79 pregnant women with a mean age of 32.1 y and ppBMI of 25.7kg/m2 were recruited in their first trimester (average 9.3 weeks of gestation). Each trimester, vitamin D intake was assessed by 3 Web-based 24-h recalls and a Web questionnaire on supplement use. Serum total 25(OH)D was measured by LC-tandem MS. Repeated-measures ANOVA was performed to assess the evolution of 25(OH)D concentrations across trimesters of pregnancy and comparisons of 25(OH)D concentrations between ppBMI categories were assessed by 1-factor ANOVAs. Stepwise regression analyses were used to identify deteuse of a multivitamin across pregnancy.
There was an increase in serum total 25(OH)D concentrations across trimesters, independent of ppBMI, seasonal variation, and vitamin D intake from supplements. Almost all women had serum total 25(OH)D concentrations over the 40- and 50-nmol/L thresholds, thus our study supports the prenatal use of a multivitamin across pregnancy.Antibiotic resistance often generates defects in bacterial growth called fitness cost. Understanding the causes of this cost is of paramount importance, as it is one of the main determinants of the prevalence of resistances upon reducing antibiotics use. Here we show that the fitness costs of antibiotic resistance mutations that affect transcription and translation in Escherichia coli strongly correlate with DNA breaks, which are generated via transcription-translation uncoupling, increased formation of RNA-DNA hybrids (R-loops) and elevated replication-transcription conflicts. We also demonstrated that the mechanisms generating DNA breaks are repeatedly targeted by compensatory evolution, and that DNA breaks and the cost of resistance can be increased by targeting the RNase HI, which specifically degrades R-loops. We further show that the DNA damage and thus the fitness cost caused by lack of RNase HI function drive resistant clones to extinction in populations with high initial frequency of resistance, both in laboratory conditions and in a mouse model of gut colonization. Thus, RNase HI provides a target specific against resistant bacteria, which we validate using a repurposed drug. In summary, we revealed key mechanisms underlying the fitness cost of antibiotic resistance mutations that can be exploited to specifically eliminate resistant bacteria.selleck kinase inhibitor
Top comments (0)