Serosurvey of Borrelia in dogs, horses, and humans exposed to ticks in a rural settlement of southern Brazil / Soroprevalência e fatores associados a Borrelia em cães, equinos e humanos expostos a carrapatos em um assentamento rural do sul do Brasil

Abstract The aims of the present study were to serosurvey dogs, horses, and humans highly exposed to tick bites for anti-Borrelia burgdorferi s.l. antibodies, identify tick species present, and determine risk factors associated with seropositivity in a rural settlement of Paraná State, southern Brazil. Eighty-seven residents were sampled, along with their 83 dogs and 18 horses, and individual questionnaires were administered. Immunofluorescence antibody test (IFAT) was performed on serum samples and positive samples were subjected to western blot (WB) analysis. Anti-B. burgdorferi antibodies were found in 4/87 (4.6%) humans, 26/83 (31.3%) dogs, and 7/18 (38.9%) horses by IFAT, with 4/4 humans also positive by WB. Ticks identified were mostly from dogs and included 45/67 Rhipicephalus sanguineus, 21/67 Amblyomma ovale, and 1/67 A. cajennense sensu lato. All (34/34) horse ticks were identified as A. cajennense s.l.. No significant association was found when age, gender, or presence of ticks was correlated to seropositivity to Borrelia sp. In conclusion, although anti-Borrelia antibodies have been found in dogs, horses and their owners from the rural settlement, the lack of isolation, molecular characterization, absence of competent vectors and the low specificity of the commercial WB kit used herein may have impaired risk factor analysis.

Resumo Os objetivos do presente estudo foram realizar um levantamento sorológico de cães, cavalos e humanos altamente expostos a picadas de carrapatos para anticorpos anti-B. burgdorferi s.l., identificar as espécies de carrapatos presentes, e determinar os fatores de risco associados a soropositividade em um assentamento rural do Estado do Paraná, sul do Brasil. Oitenta e sete residentes foram amostrados junto com seus respectivos 83 cães e 118 cavalos e questionários individuais foram aplicados. O teste de imunofluorescência indireta (IFI) foi realizado nas amostras sorológicas e as positivas foram submetidas a análise por western blot (WB). Anticorpos anti-B. burgdorferi foram detectados em 4/87 (4,6%) humanos, 26/83 (31,3%) cães e 7/18 (38,9%) cavalos pela IFI, com 4/4 humanos também positivos pelo WB. Os carrapatos identificados foram em sua maioria de cães e incluíram 45/67 Rhipicephalus sanguineus, 21/67 Amblyomma ovale e 1/67 A. cajennense sensu lato. Todos (34/34) carrapatos dos cavalos foram identificados como A. cajennense s.l.. Não foram observadas diferenças estatísticas entre idade, sexo ou presença de carrapatos e soropositividade para Borrelia sp. Em conclusão, embora anticorpos anti-Borrelia tenham sido encontrados em cães, equinos e seus proprietários do assentamento rural, a ausência de isolamento, caracterização molecular, ausência de vetores competentes e baixa especificidade do kit comercial de WB utilizado podem ter limitado a análise de fatores de risco.

Borrelia burgdorferi sensu lato in humans in a rural area of Paraná State, Brazil

This study describes the detection of Borrelia garinii and Borrelia burgdorferi sensu stricto (s.s.) in Brazilian individuals using PCR and DNA sequencing. Our results suggest that these species are emerging pathogens in this country, and additional studies are necessary to determine the epidemiological characteristics of this disease in Brazil.

First record of Borrelia burgdorferi B31 strain in Dermacentor nitens ticks in the northern region of Parana (Brazil)

The aim of this study was to investigate the presence of DNA of Borrelia burgdorferi sensu lato (s.l.) in ticks that feed on horses used for animal traction in rural Jataizinho, Parana, Brazil. Between February and June 2008, a total of 224 ticks was collected of which 75% were identified as Dermacentor nitens and 25% as Amblyomma cajenense. To amplify B. burgdorferi s.l. DNA, the intergenic space region (ISR) between the 5S (rrf) 23S (rrl) rRNA genes was used as targets for nested-PCR. Two ticks of the D. nitens species were positive for B. burgdorferi s.l. Both species showed a fragment of 184 bp, but the sequencing revealed 99.9% homology with the B. burgdorferi sensu stricto (s.s.) strain B31. These results showed, for the first time, the presence of spirochete DNA infecting ticks that parasitize horses used for animal traction, in the rural municipality mentioned. In conclusion, this study opens up promising prospects for determining the infection rate of B. burgdorferi s.s. genospecies or other species in the equine population, as well as the impact of the infection rate on Lyme disease in the state of Parana.

Propedêutica básica da infertilidade conjugal / Basic propedeutics of conjugal infertility

A infertilidade é um problema que afeta cerca de 10%-20% da população, com incidência variável em todo o mundo. A avaliação do casal infértil é geralmente indicada depois de um ano, tempo em que a maioria dos casais normais teria sido bem sucedida na tentativa de concepção. Algumas investigações são controversas, e, na presença de múltiplos métodos, o custo, a segurança e a conveniência deveriam ajudar a decidir o mais apropriado.

Infertility is a problem affecting approximately 10%-20% of the population with variable incidences across the world. Evaluation of a couple is generally indicated after one year, by which time most normal couples attemptiong conception would have been successful. Some of the investigations are controversial and in the presence of multiple methods of investigating one aspect, the cost, safety, convenience and evidence-base should help in deciding on the appropriate method.

Zoonoses in humans from small rural properties in Jataizinho, Parana, Brazil

The aim of this study was to conduct a serological survey for Lyme diseases, brucellosis, leptospirosis and toxoplasmosis and identify the risk variables related to these zoonoses in humans living in the rural area of Jataizinho, state of Parana, Brazil. A total of 63 rural properties were surveyed. Additionally, 207 serum samples collected from these rural area inhabitants were tested for indirect immunofluorescence (IFI) and western blots (WB) were performed to detect Borrelia burgdorferi (sensu lato); a tamponated acidified antigen test (AAT) and 2-mercaptoethanol (2-ME) were used to detect antibodies of Brucella abortus; the microscopic agglutination test (MAT) was carried out to detect antibodies anti-Leptospira spp. and IFI was used to find antibodies of Toxoplasma gondii. Two of the samples (0.96%) were reactive for Lyme borreliosis, three (1.4%) for brucellosis, 25 (12.1%) for leptospirosis and 143 (69.1%) for toxoplasmosis. Although the town of Jataizinho has a human development index (IDH) that was considered to be average (0.733) in the state of Parana, the low social, economic and cultural conditions of the population from small rural properties have resulted in lack of basic information on animal health and direct or indirect contact with the various species of domestic animals, wildlife and ticks have probably contributed to the prevalence levels found. These results show the need for additional regional studies in order to determine the epidemiological characteristics of these diseases as well as their respective vectors and reservoirs so that effective prophylaxis can be administered in the human population.

Borrelia burgdorferi em cão errante da região noroeste do estado do paraná - relato de caso / Borrelia burgdorferi en perro callejero de la región noroeste del estado de paraná - relato de caso / Borrelia burgdorferi in stray dog the northwest region of the state of paraná - case report

A doença de Lyme é uma enfermidade infecciosa, sistêmica e cosmopolita que acomete diferentes espécies de animais domésticos, silvestres e também o homem. É transmitida por carrapatos sendo provocada pela infecção de bactérias do complexo Borrelia burgdorferi do complexo sensu lato (s.l.). A transmissão das borrélias para o carrapato pode ocorrer de forma transovariana e/ou transestadial e a transmissão no hospedeiro ocorre pela saliva infectada. Os cães são importantes reservatórios de Borrelia burgdorferi, podendo ser isoladas espiroquetas de animais clinicamente sadios. O objetivo deste trabalho foi relatar a presença de anticorpos anti-Borrelia burgdorferi em um cão errante assintomático da região noroeste do estado do Paraná. Foi coletado sangue pela punção da veia jugular externa de um cão que possuía carrapatos fixados no corpo albergado em um abrigo privado localizado na região noroeste do estado do Paraná. Para a pesquisa de anticorpos anti-Borrelia burgdorferi do complexo sensu lato a amostra de soro foi submetida à imunofluorescência indireta (IFI). O resultado demonstrou a presença de anticorpos anti-Borrelia burgdorferi, o que sugere a presença da borreliose de Lyme nesse cão errante e possivelmente a circulação do agente etiológico no referido local.

Lyme disease is an infectious, systemic and cosmopolitan disease affecting different species of domestic and wild animals, as well as humans. It is a tick-borne infection caused by bacteria of the Borrelia burgdorferi of the sensu lato (sl) complex. The transmission of borrelias to the tick may occur by transovarian and/or transestadial route, and the transmission to the host occurs by infected saliva. Dogs are important reservoirs of Borrelia burgdorferi, and spirochetes can be isolated from clinically healthy animals. The aim of this study is to report the presence of anti-Borrelia burgdorferi antibodies in an asymptomatic stray dog in the Northwestern state of Parana. Blood was collected by puncture of the jugular vein of a dog that had ticks attached to its body housed in a private shelter located in the Northwestern region of the state of Parana. For the detection of anti-Borrelia burgdorferi antibodies of the sensu lato complex, the serum sample was subjected to indirect immunofluorescence (IIF). The result showed the presence of anti-Borrelia burgdorferi antibodies suggesting the presence of Lyme disease in the dog and possibly errant movement of the etiologic agent in that location.

La enfermedad de Lyme es infecciosa, sistémica y cosmopolita, que acomete diferentes especies de animales domésticos, silvestres y también el hombre. Es transmitida por garrapatas, siendo provocada por la infección de bacterias del complexo Borrelia burgdorferi del complexo sensu lato (s.1.). La transmisión de las borrelias en la garrapata puede ocurrir de forma transovarial y/o transestadial, y la transmisión ocurre en el hospedero por la saliva infectada. Los perros son importantes reservatorios de Borrelia burgdorferi, pudiendo ser aisladas espiroquetas de animales clínicamente sanos. El objetivo de este estudio fue relatar la presencia de anticuerpos anti-Borrelia burgdorferi en un perro callejero asintomático de la región noroeste del estado de Paraná. Se recolectó sangre por punción de la vena yugular externa de un perro que tenía garrapatas fijadas en el cuerpo, en un abrigo privado localizado en la región noroeste del estado de Paraná. Para la investigación de anticuerpos anti-Borrelia burgdorferi del complexo sensu lato, la muestra de suero fue sometida a la inmunofluorescencia indirecta (IFI). El resultado demostró la presencia de anticuerpos anti-Borrelia burgdorferi, lo que sugiere la presencia de borreliosis de Lyme en este perro callejero y posiblemente la circulación del agente etiológico en el referido local.

A importância da propedêutica em ferimentos tóraco-abdominais à esquerda por arma branca / The importance of propedeutic on left thoracoabdominal region stab wounds

O diafragma pode ser lesado tanto nos traumas contusos quanto nos penetrantes. A incidência de lesão diafragmática nas feridas penetrantes na região tóraco-abdominal esquerda por arma branca varia de 20 a 24. A porcentagem de assintomáticos pode atingir 30 e a lesão, usualmente, é clinicamente despercebida. A maioria dos casos apresenta alterações radiológicas mínimas. A principal complicação é a hérnia estrangulada, que aumenta a taxa de mortalidade de 3 a 7 para 25 a 30 . O alto índice de suposição é o fator mais importante para o diagnóstico. O uso da videolaparoscopia diagnóstica e terapêutica, em casos selecionados, diminuiu o número de laparotomias brancas. A baixa sensibilidade diagnóstica associada à clínica e aos procedimentos radiológicos requer abordagem intervencionista para que as lesões diafragmáticas sejam rapidamente diagnosticadas e evitadas futuras complicações.

Diaphragmatic rupture occurs after blunt or penetrating wound. The incidence of diaphragmatic rupture in patients with penetrating wounds in the left thoracoabdominal area varies from 20 to 24. The rupture is observed in up to 30 of asymptomatic patients and is not usually detected by physical exam. In most cases, radiological investigation shows minimal alterations. The main complication is the strangulated hernia, which rises the mortality rate from 3-7 to 25-30 . A high grade of clinical suspicion is the main contributor to elucidate the diagnostic. The use of diagnostic and therapeutic videolaparoscopy has downsized the number of white laparotomies. Considering the low sensitivity of clinical exam and radiological investigation, an aggressive approach to diagnose diaphragmatic lesions and avoid future complications is recommended.

Pneumoventrículo hipertensivo pós-traumático: relato de caso / Post-traumatic tension pneumoventricle: case report

O pneumoencéfalo, o pneumoventrículo, e a fístula liquórica são complicações degrande morbidade decorrentes do traumatismo cranioencefálico(TCE) , que requeremadequada vigilância neurológica. Este relato apresenta uma vítima de TCE que evoluiucom pneumoencéfalo e pneumoventrículo hipertensivo, associados com fístula liquóricae meningites de repetição. Foi submetida aos tratamentos clínico e cirúrgico, commelhora neurológica.

Pneumocephalus, pneumoventricle and fistula are high morbidity complications caused by traumatic brain injury (TBI), requiring adequate neurological follow. We report a case of a victim of TBI that evolved with pneumocephalus and tension pneumoventricle associ-ated with fistula and repeated meningitis. Subjected to clinical and surgical treatments, the patient progressed favorably, with neurological improvement.