BackgroundZoonotic cutaneous leishmaniasis has long been endemic in Israel. In recent years reported incidence of cutaneous leishmaniasis increased and endemic transmission is being observed in a growing number of communities in regions previously considered free of the disease. Here we report the results of an intensive sand fly study carried out in a new endemic focus of Leishmania major. The main objective was to establish a method and to generate a data set to determine the exposure risk, sand fly populations' dynamics and evaluate the efficacy of an attempt to create "cordon sanitaire" devoid of active jird burrows around the residential area.Methodology/Principal FindingsSand flies were trapped in three fixed reference sites and an additional 52 varying sites. To mark sand flies in the field, sugar solutions containing different food dyes were sprayed on vegetation in five sites. The catch was counted, identified, Leishmania DNA was detected in pooled female samples and the presence of marked specimens was noted. Phlebotomus papatasi, the vector of L. major in the region was the sole Phlebotomus species in the catch. Leishmania major DNA was detected in ~10% of the pooled samples and the highest risk of transmission was in September. Only a few specimens were collected in the residential area while sand fly numbers often exceeded 1,000 per catch in the agricultural fields. The maximal travel distance recorded was 1.91km for females and 1.51km for males. The calculated mean distance traveled (MDT) was 0.75km.ConclusionsThe overall results indicate the presence of dense and mobile sand fly populations in the study area. There seem to be numerous scattered sand fly microsites suitable for development and resting in the agricultural fields. Sand flies apparently moved in all directions, and reached the residential area from the surrounding agricultural fields. The travel distance noted in the current work, supported previous findings that P. papatasi like P. ariasi, can have a relatively long flight range and does not always stay near breeding sites. Following the results, the width of the "cordon sanitaire" in which actions against the reservoir rodents were planned, was extended into the depth of the agricultural fields.

LicoA possesses immunomodulatory effects on H2 O2 , NO, IFN-γ, TNF-α and IL-17 production in cells from EAE mice. It is suggested that LicoA acts on the mechanism of development of EAE by IFN-γ, IL-17 and TNF-α inhibition, modulating the immune response on both Th1 and Th17 cells.

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Introduction: Mild cognitive impairment (MCI) is a prevalent and underdiagnosed condition in chronic kidney disease (CKD), that shares common pathophysiological factors such as chronic inflammation. Objective: To evaluate the association of MCI in CKD stages 1-5 using inflammatory markers and changes by magnetic resonance imaging (MRI). Patients and Methods: Cross-sectional study in adult patients with pre-dialysis CKD. MCI was assessed by the Montreal Cognitive Assessment (MoCA) and the estimated glomerular filtration rate (eGFR) by the Chronic Kidney Disease Epidemiology Collaboration equation. Sociodemographic and clinical data were collected from medical records. The cytokines IL-4, IL-6, IL-17, TNF-α and hs-CRP were determined. Brain MRI was performed in a 1.5 Tesla device, without paramagnetic contrast. A descriptive analysis followed by a comparison of abnormal versus normal MoCA scores among all studied variables. A linear regression analysis was performed using MoCA as a dependent variable, adjusted for confounding factors. Results: Of 111 invited patients, eighty completed the neuropsychological assessment and 56 underwent MRI, and were included in the study. Mean age was 56.3 ± 8.3 years and 51.8% (n = 29) had altered MoCA. When compared to the group with normal MoCA, the group with altered MoCA had higher levels of IL-6 and IL-17. There was no correlation between altered MoCA with eGFR or with MRI abnormalities. Conclusão: MCI assessed by MoCA was prevalent in patients with pre-dialysis CKD, it was associated with inflammation and showed no correlation with MRI changes.

Introdução: Comprometimento cognitivo (CC) é comum no paciente renal crônico, porém pouco avaliado. A anemia e a deficiência de ferro podem contribuir para o CC. Objetivo: avaliar CC e sua associação com alterações no metabolismo do ferro na DRC pré-dialítica. Método: Estudo transversal com 54 pacientes entre 21 e 65 anos avaliados sociodemografica, clínica e laboratorialmente. Realizada triagem cognitiva completa, teste de rastreio de cognição global: Montreal Cognitive Assessment (MoCA), bateria de testes de memória, atenção, velocidade de processamento, fluência verbal e funções executivas, escalas de sono (Escala de Sonolência Diurna de Epworth, Questionário Clínico de Apnéia Obstrutiva do Sono de Berlin(AOS), Questionário de cinco perguntas de sintomas de Pernas Inquietas, depressão (Inventário de depressão de Beck, Mini-Plus para Episódio Depressivo Maior (DSM-IV) e de funcionalidade (Questionário de Atividades Funcionais de Pfeffer). Resultados: AOS esteve presente em 76,9%, pernas inquietas e sonolência diurna (35,2%) e sintomas depressivos (34,7%). O MoCA esteve alterado em 59,3%. Correlação de Pearson entre testes neuropsicológicos e Hemoglobina(Hb), índice de Saturação de Transferrina(IST), ferritina e PCRus, mostrou associação entre MoCA e Hb (r=0,310 e p=0,02). Regressão Linear utilizando três modelos ajustados por variáveis sociodemográficas e IST ou ferritina ou Hb: modelo 1 e 2-escolaridade e depressão se associaram ao MoCA, modelo 3-Hb e depressão se associaram ao MoCA. Conclusão: O nível sérico de Hb e a presença de depressão foram associadas com CC. Níveis mais baixos de ferritina se correlacionaram com o MoCA, enquanto não encontramos associação com os demais marcadores do metabolismo do ferro.