Study of wound healing in rat skin treated with extract of Hedera helix, L / Estudo da cura de feridas na pele de rato tratada com extrato de Hedera helix, L

The Hera (Hedera helix L) is part of the ARALIACEAE family, is included in the group of plants that produce saponins, has antifungal action, is hypocholesterolemic, has anti-inflammatory activity, is expectorant, antispasmodic and purifying. It was evaluated, by histological studies, the wound healing action of the extract of Hera leaves on skin wounds, as well as changes in the epithelial tissue and wound healing period. 75 Wistar rats were used and divided into five groups, according to the treatment: negative control (PBS), Hera 10 mg/ml, Hera 30 mg/ml, Hera 50 mg/ml and the positive control (Nebacetin). The animals were anesthetized and undergone through a cut of 4 cm in the dorsal region, exposing their muscle fascias. Right after, daily, the suitable substance to each group was applied in the lesion. After periods of 3, 7, 14, 21 days after the surgery, the animals were killed to collect fragments of the lesion. The material was prepared in stained slides with HE and toluidine blue for histologic analysis. The results showed that at day 14 of treatment, the animals under effect of 30 mg/ml and 50 mg/ml of Hera extract did not present edema. It was also observed a reduction in vascular congestion in the Hera of 30 mg/ml, Hera 50 mg/ml and Nebacetin groups compared to the other groups analyzed. All groups treated with Hera extract showed a reduction of inflammatory cells in day 14 post-lesion, besides the increase of fibroblast this period, showing acceleration in the chronicity of the lesion. Regarding the number of mast cells, a significant increase in the early lesion, in the 3 and 7 days periods was observed, in Hera 50 mg/ml and 30 mg/ml groups, respectively. According to the results, the Hera extract, especially at concentrations of 30 mg/ml and 50 mg/ml accelerated the healing process; based on the decreased permanence period of the edema and congestion of the vessels, as well as changes in the number of cells related to inflammation of lesions.

Early Lesion of Post-Primary Tuberculosis: Subclinical Driver of Disease and Target for Vaccines and Host-Directed Therapies

The characteristic lesion of primary tuberculosis is the granuloma as is widely studied in human tissues and animal models. Post-primary tuberculosis is different. It develops only in human lungs and begins as a prolonged subclinical obstructive lobular pneumonia that slowly accumulates mycobacterial antigens and host lipids in alveolar macrophages with nearby highly sensitized T cells. After several months, the lesions undergo necrosis to produce a mass of caseous pneumonia large enough to fragment and be coughed out to produce a cavity or be retained as the focus of a post-primary granuloma. Bacteria grow massively on the cavity wall where they can be coughed out to infect new people. Here we extend these findings with the demonstration of secreted mycobacterial antigens, but not acid fast bacilli (AFB) of M. tuberculosis in the cytoplasm of ciliated bronchiolar epithelium and alveolar pneumocytes in association with elements of the programmed death ligand 1 (PD-L1), cyclo-oxygenase (COX)-2, and fatty acid synthase (FAS) pathways in the early lesion. This suggests that M. tuberculosis uses its secreted antigens to coordinate prolonged subclinical development of the early lesions in preparation for a necrotizing reaction sufficient to produce a cavity, post-primary granulomas, and fibrocaseous disease.

Early Lesion of Post-Primary Tuberculosis: Subclinical Driver of Disease and Target for Vaccines and Host-directed Therapies.

The characteristic lesion of primary tuberculosis is the granuloma as is widely studied in human tissues and animal models. Post-primary tuberculosis is different. It develops only in human lungs and begins as a prolonged subclinical obstructive lobular pneumonia that slowly accumulates mycobacterial antigens and host lipids in alveolar macrophages with nearby highly sensitized T cells. After several months, the lesions undergo necrosis to produce a mass of caseous pneumonia large enough to fragment and be coughed out to produce a cavity or be retained as the focus of a post-primary granuloma. Here we extend these findings with the demonstration of mycobacterial antigen, but not AFB, of M. tuberculosis in the cytoplasm of ciliated bronchiolar epithelium and alveolar pneumocytes in association with elements of the programmed death ligand 1 (PD-L1), cyclo-oxygenase (COX)-2, and fatty acid synthase (FAS) pathways in the early lesion. This suggests that M. tuberculosis uses its secreted antigens to coordinate prolonged subclinical development of the early le-sions in preparation for a necrotizing reaction sufficient to produce a cavity, post-primary granulomas and fibrocaseous disease.

Early Lesion of Post-Primary Tuberculosis: Subclinical Driver of Disease and Target for Vaccines and Host-directed Therapies

The characteristic lesion of primary tuberculosis is the granuloma as is widely studied in human tissues and animal models. Post-primary tuberculosis is different. It develops only in human lungs and begins as a prolonged subclinical obstructive lobular pneumonia that slowly accumulates mycobacterial antigens and host lipids in alveolar macrophages with nearby highly sensitized T cells. After several months, the lesions under necrosis to produce a mass of caseous pneumonia large enough to fragment and be coughed out to produce a cavity or be retained as the focus of a post-primary granuloma. Here we extend these findings with the demonstration of mycobacterial antigen, but not AFB, of M. tuberculosis in the cytoplasm of ciliated bronchiolar epithelium and alveolar pneumocytes in association with elements of the programmed death ligand 1 (PD-L1), cyclo-oxygenase (COX)-2, and fatty acid synthase (FAS) pathways in the early lesion. This suggests that M. tuberculosis use its secreted antigens to coordinate prolonged subclinical development of the early lesions in preparation for a necrotizing reaction sufficient to produce a cavity, post-primary granulomas and fibrocaseous disease

POST COVID ORAL MUCORMYCOSIS AN EARLY LESION ON THE PALATE: A CASE REPORT

Covid-19 is an infection caused by severe acute respiratory syndrome coronavirus-2. During second wave in India a serious fungal infection known as black fungus, mucormycosis has been increasingly found in covid -19 recovered patients. It causes necrosis in the head and neck region including nose, paransal sinuses, orbits and facial bones and intracranial spread. If not diagnosed early this disease progresses rapidly causing high mortality and high morbidity. A case of 60 year old female patient of post covid home isolation with very mild symptoms only of red lesion on the palate. We are presenting this rare case for its clinical ndings and awareness.

SAUNet++: An automatic segmentation model of COVID-19 lesion from CT slices

The coronavirus disease 2019 (COVID-19) epidemic has spread worldwide and the healthcare system is in crisis. Accurate, automated and rapid segmentation of COVID-19 lesion in computed tomography (CT) images can help doctors diagnose and provide prognostic information. However, the variety of lesions and small regions of early lesion complicate their segmentation. To solve these problems, we propose a new SAUNet++ model with squeeze excitation residual (SER) module and atrous spatial pyramid pooling (ASPP) module. The SER module can assign more weights to more important channels and mitigate the problem of gradient disappearance, the ASPP module can obtain context information by atrous convolution using various sampling rates. In addition, the generalized dice loss (GDL) can reduce the correlation between lesion size and dice loss, and is introduced to solve the problem of small regions segmentation. We collected multinational CT scan data from China, Italy and Russia and conducted extensive experiments. In the experiments, SAUNet++ and GDL were compared to advanced segmentation models and popular loss functions, respectively. The experimental results demonstrated that our methods can effectively improve the accuracy of COVID-19 lesion segmentation on the dice similarity coefficient (our: 87.38% VS U-Net++: 86.08%), sensitivity (our: 93.28% VS U-Net++: 89.85%) and hausdorff distance (our: 19.99mm VS U-Net++: 27.69mm), respectively.

Fluid-Attenuated Inversion Recovery Hyperintense Ischemic Stroke Predicts Less Favorable 90-Day Outcome after Intravenous Thrombolysis

<b><i>Introduction:</i></b> The absence of an ischemic lesion on MRI fluid-attenuated inversion recovery (FLAIR) is helpful in predicting stroke onset within 4.5 h. However, some ischemic strokes become visible on FLAIR within 4.5 h. We hypothesized that the early lesion visibility on FLAIR may predict stroke outcome 90 days after intravenous (IV) thrombolysis, independent of time. <b><i>Materials and Methods:</i></b> We analyzed data from acute ischemic stroke patients presenting over the last 10 years who were screened with MRI and treated with IV thrombolysis within 4.5 h from onset. Three independent readers assessed whether ischemic lesions seen on diffusion-weighted imaging were also FLAIR positive based on visual inspection. Multivariable regression analyses were used to obtain an adjusted odds ratio of favorable clinical and radiological outcomes based on FLAIR positivity. <b><i>Results:</i></b> Of 297 ischemic stroke patients, 25% had lesion visibility on initial FLAIR. The interrater agreement for the FLAIR positivity assessment was 84% (<i>κ</i> = 0.604, 95% CI: 0.557–0.652). Patients with FLAIR-positive lesions had more right hemispheric strokes (57 vs. 41%, <i>p</i> = 0.045), were imaged later (129 vs. 104 min, <i>p</i> = 0.036), and had less frequent favorable 90-day functional outcome (49 vs. 63%, <i>p</i> = 0.028), less frequent early neurologic improvement (30 vs. 58%, <i>p</i> = 0.001), and more frequent contrast extravasation to the cerebrospinal fluid space (44 vs. 26%, <i>p</i> = 0.008). <b><i>Conclusions:</i></b> Early development of stroke lesion on FLAIR within 4.5 h of onset is associated with reduced likelihood of favorable 90-day outcome after IV thrombolysis.

Early Lesion of Post-Primary Tuberculosis: Subclinical Driver of Disease and Target for Vaccines and Hostdirected Therapies

Research on the pathogenesis of tuberculosis in recent years has focused largely on the granulomatous stage of primary tuberculosis. However, post-primary tuberculosis that accounts for 80% of clinical disease is seldom studied because of the paucity of animal models and human tissues. The early lesion of post-primary tuberculosis is a subclinical obstructive lobular pneumonia that develops asymptomatically for months accumulating secreted mycobacterial antigens in alveolar macrophages and highly sensitized T cells before onset of clinical disease. Here we demonstrate antigen of M. tuberculosis in the cytoplasm of ciliated bronchiolar epithelium and alveolar pneumocytes in association with elements of the programmed death ligand 1 (PD-L1), cyclo-oxygenase (COX)-2, and fatty acid synthase (FAS) pathways in the early lesion. This suggests a new synthesis of the pathogenesis of post-primary tuberculosis in which M. tuberculosis use its secreted antigens and cord factor to direct prolonged subclinical development of the early lesions in preparation for a sudden necrotizing reaction sufficient to produce a cavity and/or granulomas. Available evidence indicates that most successful human and animal vaccines and host directed therapies of post-primary tuberculosis target the early lesion, not granulomas. Recognition of this will facilitate design and evaluation of improved vaccines and therapies for tuberculosis.