Asociación de fascioliasis con el estado nutricional y coinfección enteroparasitaria en niños / Association of fascioliasis to nutritional status and enteroparasite coinfection in children

Introducción: La fascioliasis es causada por el trematodo Fasciola hepatica que afecta a animales herbívoros, omnívoros y al humano. Los niños de edad escolar son los más afectados y el órgano más dañado es el hígado. Este parásito requiere de reservorio y huésped intermediario para completar su ciclo biológico. Objetivo: Determinar la asociación de la fascioliasis con el estado nutricional y coinfección enteroparasitaria en niños. Métodos: La investigación se realizó entre septiembre de 2016 y abril de 2017 en el distrito de Santa María de Chicmo, región Apurímac. El estudio fue analítico de corte transversal. La población de niños de 6 a 16 años estuvo constituida por 2 172 individuos. El tamaño de muestra fue de 435 niños y se determinó mediante un muestreo simple al azar. Además, para que el muestreo fuera más eficiente se distribuyó el tamaño total de la muestra entre los estratos I.E. Primaria e I.E. Secundaria, para un resultado de 209 y 226 muestras, respectivamente. Sin embargo, se logró tomar 493 muestras coprológicas y serológicas repartidas proporcionalmente entre la totalidad de 23 instituciones educativas. Resultados: La prevalencia de fascioliasis fue de 5,3 por ciento (26/493; IC95 por ciento =3,2-7,4). Las instituciones educativas con mayor prevalencia fueron: Taramba con 17,2 por ciento (5/29; IC95 por ciento = 5,9-35,8), Libertadores de América con 16,1 por ciento (5/31; IC95 por ciento = 5,5-33,7), Mariano Melgar con 15 por ciento (3/20; IC95 por ciento = 3,2-37,9) y Nuestra Señora de Guadalupe con 10,8 por ciento (4/37; IC95 por ciento = 3-25,4). No se encontró asociación de fascioliasis con la valoración nutricional antropométrica ni con la coinfección enteroparasitaria en niños (p˃ 0,05). Conclusiones: La fascioliasis no estaría afectando el estado nutricional de los niños; asimismo, los signos clínicos, atribuidos a fascioliasis, corresponderían también a la alta presentación de parásitos entéricos(AU)

Introduction: Fascioliasis is caused by the trematode Fasciola hepatica and affects herbivorous and omnivorous animals as well as humans. Schoolchildren are the most affected group, and the organ most commonly targeted is the liver. This parasite requires an intermediate reservoir and host to complete its biological cycle. Objective: Determine the association of fascioliasis to nutritional status and enteroparasite coinfection in children. Methods: An analytical cross-sectional study was conducted from September 2016 to April 2017 in the district of Santa María de Chicmo, Apurímac Region. The child population aged 6-16 years was composed of 2 172 individuals. The sample size was 435 children, and it was determined by simple random sampling. Additionally, in order for the sampling to be more efficient, the total sample size was distributed between the strata Primary E.I. and Secondary E.I., for 209 and 226 samples, respectively. However, 493 coprological and serological samples were proportionally taken from the total 23 educational institutions. Results: Prevalence of fascioliasis was 5.3 percent (26/493; CI95 percent=3.2-7.4). The educational institutions with the highest prevalence were Taramba with 17.2 percent (5/29; CI95 percent= 5.9-35.8), Libertadores de América with 16.1 percent (5/31; CI95 percent= 5.5-33.7), Mariano Melgar with 15 percent (3/20; CI95 percent= 3.2-37.9) and Nuestra Señora de Guadalupe with 10.8 percent (4/37; CI95 percent= 3-25.4). No association was found between fascioliasis and nutritional anthropometric assessment or enteroparasite coinfection in children (p˃ 0.05). Conclusions: Fascioliasis was not found to affect the nutritional status of children. On the other hand, the clinical signs attributed to fascioliasis also correspond to the high presentation of enteric parasites(AU)

Detection of Contagious Caprine Pleuropneumonia and Concurrent Diseases in Outbreaks Presenting with Respiratory Signs in Small Ruminants in Tanzania

Aims: To establish the prevalence and concurrent diseases in outbreaks presenting with respiratory signs, major associated clinical signs and postmortem lesions and proportions of those diseases in clinically and autopsied small ruminants for a proper diagnosis and control strategies.Study Design: Purposive outbreaks investigation.Place and Duration of Study: Department of Global Health, School of Life Science and Bio Engineering (LiSBE), Nelson Mandela Institution of Science and Technology (NM-AIST) between September 2016 and December 2018.Methodology:We included investigations of outbreaks of diseases presenting with respiratory signs in small ruminants reported from five agro-ecological zones in Tanzania. Small ruminats with clinical signs or postmortem lesions suggestive of respiratory involvement were subjected to clinical or postmortem examination. Samples from all examined animals were tested in the laboratory using conventional polymerase chain reaction (PCR) to confirm the tentative diagnosis.Results: A total of 205 small ruminats were examined and tested, of these 72.2% and 20.8% were goats and sheep respectively. In goats, 79.1% (117/148) and sheep, 28.1% (16/57) were confirmed to have concurrent infections, and pneumonic pasteurellosis and peste des petits ruminants (PPR) for goats, and PPR for sheep being mostly involved diseases. Contagious caprine pleuropneumonia (CCPP) was detected in 16.1% (n=205) of the animals, and was significantly high in goats (p=0.003, OR=7.3) than sheep. Pneumonic mannheimiosis (prevalence = 9.3%) was less likely toaffect goats than sheep (p=0.047, OR=0.38). In goats (n=148), detection of all diseases was significantly (p<0.05) low in clinically examined animals except pneumonic pasteurellosis and PPR, (p =0.056, OR=2.1) and (p=0.096, OR=2.15) respectively, though the difference was not significant. In sheep (n=57), CCPP was significantly (p=0.005, OR=0.17) more likely to be detected in clinically examined animals.Conclusion: In investigations of outbreaks presenting with respiratory signs in small ruminants, it is important to consider concurrent infections in the interventions and control strategies to be deployed, which may include development and use of multivalent vaccines.

Clinical and Bacteriologic profile of Neonatal Sepsis in a tertiary care hospital: A 5-year review

Background@#Neonatal sepsis, a clinical syndrome characterized by non-specific signs and symptoms, is the most common cause of neonatal mortality and morbidity. It is classified into early or late-onset depending on the onset of symptoms, if within the first 72 hours or later. Early onset sepsis (EOS) occurs due to ascending infection following rupture of membranes or during passage through an infected birth canal. Late onset sepsis (LOS) can be nosocomial or community-acquired. A high index of suspicion and timely and judicious use of antibiotics are needed to achieve good outcomes. @*Objective@#This study looked into the clinical and bacteriologic profile of neonatal sepsis in a tertiary care hospital from January 2013 to December 2017. @*Methodology@#This was a retrospective observational study. Data on maternal risk factors, mode of delivery, gestational age, birth weight, birth setting, clinical manifestations, and blood culture and sensitivity were gathered. Descriptive statistics was used to analyze the data.@*Results@#Majority of cases were late onset sepsis with an equal distribution in those born via normal spontaneous delivery (NSD) and cesarean section (CS). There were more culture- positives in low birth weight (LBW) infants and those not delivered within a hospital. The most common maternal risk factor was UTI. Majority of culture-positive newborns presented with respiratory distress, poor feeding, fever, and irritability with respiratory distress being the most common manifestation for both EOS and LOS. Predominant isolates were CONS, E. coli and Klebsiella sp. Both E. coli and Klebsiella were resistant to both first-line empiric antibiotics – ampicillin and gentamicin but highly sensitive to piperacillin-tazobactam and imipenem.@*Conclusion@#Clinical signs and symptoms of neonatal sepsis are non-specific. The presence of respiratory distress, fever, poor feeding, and irritability together with other risk factors should raise suspicion for sepsis and prompt investigation and treatment. Predominant isolates seen were CONS, E. coli and Klebsiella sp. with resistance to first-line empiric antibiotics.

Etiopathology and Haematobiochemical Alteration in the Anaemic Dogs of in and Around Anand Region, Gujarat

The present research work was undertaken to assess the etiopathology and haematobiochemical alterations in anemic dogs of Anand region, Gujarat irrespective of their age, sex and breed. Total 78 dogs were screened for anemia and blood samples were collected from a 51 anemic dogs of Anand region of Gujarat to identify etiopathology and haematobiochemical parameters alterations. Statistical analysis, interpretation, different etiology and comparison of haematobiochemical alteration with scientific literature were carried out to understand pathophysiology of disease. Amongst 78 of 51 dogs, incidence of anemia was recoded 65.38 per cent in which highest was due to liver disorders (23.53%). Incidence of anemia was observed higher in in adult group (58.83%) as well as in male (52.94%). Most clinical variants of anemic dogs showed pale mucous membrane (86.27%), hypothermia (68.63%), tachycardia (70.59%), tachypnea (74.51%) and increased capillary refilling time (64.71%). Haematological indices of anemic dogs revealed Hb, TEC, PCV, MCH, MCHC and MCV decreased significantly (p<0.01), whereas TLC increased significantly (p<0.05) as compare to healthy dogs. Serum biochemistry revealed significantly (p<0.01) increased BUN, Creatinine, Glucose, AST and ALT levels as well as decreased in total protein level in anemic case as compare to healthy ones. Different etiological factors for developing in anemia in dogs as well as hematobiochemical alterations are mentioned, which will be useful for further detailed investigations and therapeutic management

Experimental infection by Anaplasma marginale in buffaloes and cattle: clinical, hematological, molecular and pathological aspects / Infecção experimental de Anaplasma marginale em búfalos e bovinos: aspectos clínicos, hematológicos, moleculares e patológicos

The study aimed to evaluate and compare the clinical, laboratory and pathological aspects of buffalo and bovine experimentally infected with AmRio 2 strain of Anaplasma marginale. Four Murrah buffaloes and four crossbred cattle were used in the experiment, which two animals of each species were splenectomized. Strain AmRio 2 of A. marginale was inoculated in all experimental animals. Clinical exams, Packed Cell Volume (PCV), blood counts, blood smears, rickettsemia, necropsy and histopathology were performed in all cases. Semi-Nested-PCR (snPCR) for the msp5 and snPCR for the msp1α target gene for identification of A. marginale in blood samples from animals was done. From positive samples for msp1α snPCR, samples were analyzed for the amino acid sequences of this gene. Two splenectomized cattle presented apathy, pale mucous membranes, jaundice, hyperthermia, and severe anemia. The remaining experimental animals did not show clinical signs. The rickettsemia in all animals was less than 1%. The mean PCV of the splenectomized cattle was below 20% at two-time points after infection. On the blood count, the main changes were observed in splenectomized calves and were characterized by a decrease in red blood cells, hemoglobin, PCV and platelets (p <0.05). All animals presented leukocyte elevation by increased lymphocytes, however, with no significant difference. The average prepatent period was two days in all the animals. The average incubation period in cattle that became ill was 25.5 days, and death occurred, on average, 63 days after inoculation of the strain. The necropsy findings were characterized by pale carcass, ascites, enlarged liver, distended gallbladder, and thick bile. Histopathological findings included infiltration of macrophages and lymphocytes in various organs, hepatic sinusoidal dilatation, and necrosis of the large intestine. In snPCR for the msp5 gene, 100% of the animals were positive in at least one evaluation. And in the snPCR for the infection of the msp1α target gene was also found in all animals in at least one sample evaluated. However, sequencing revealed only five animals, including the bovine which died, with a similarity of the amino acid sequences with AmRio 2 strain of A. marginale. It is concluded that the splenectomized cattle died due to anaplasmosis caused by the inoculated strain and the buffalo were more resistant compared to cattle. Buffaloes can be an alternative to cattle rearing in areas with a high occurrence of clinical cases of anaplasmosis.(AU)

O estudo teve como objetivo avaliar e comparar os aspectos clínicos, laboratoriais e patológicos de búfalos e bovinos infectados experimentalmente com estirpe AmRio 2 de Anaplasma marginale. Para isso, foram utilizados quatro bubalinos Murrah e quatro bovinos mestiços, sendo dois animais de cada espécie, esplenectomizados. Estirpe AmRio 2 de A. marginale foi inoculada em todos os animais. Foram realizados exames clínicos, hematócrito, hemograma, esfregaço sanguíneo com avaliação de riquetsemia, necropsia e histopatologia, além de, Semi-Nested-PCR (snPCR) para o gene alvo msp5 e snPCR para o gene alvo msp1α para identificação de A. marginale nas amostras de sangue dos ruminantes. A partir das amostras positivas na snPCR msp1α, foram selecionadas amostras para análise das sequências de aminoácidos deste gene. Dois bovinos esplenectomizados apresentaram apatia, mucosas pálidas, icterícia, hipertermia e anemia severa. O restante dos animais não apresentou sintomatologia clínica. A riquetsemia em todos os animais foi menor que 1%. A média do hematócrito dos bovinos esplenectomizados esteve abaixo de 20% em dois momentos após infecção. Ao hemograma, as principais alterações observadas foram nos bovinos esplenectomizados e caracterizaram-se por redução de hemácias, hemoglobina, hematócrito e plaquetas (p<0,05). Todos os animais apresentaram elevação de leucócitos por aumento de linfócitos, porém, sem diferença significativa. O período pré-patente médio foi de dois dias em todos os animais. O período de incubação médio nos bovinos que adoeceram foi de 25,5 dias e estes morreram em média 63 dias após inoculação da estirpe. Os achados de necropsia caracterizaram-se por carcaça pálida, ascite, aumento de volume do fígado, vesícula biliar distendida e bile espessa. À histopatologia, verificou-se infiltração de macrófagos e linfócitos em diversos órgãos, dilatação dos sinusoides hepáticos e necrose do intestino grosso. A snPCR para o gene msp5, revelou 100% dos animais positivos em pelo menos um momento de avaliação. E na snPCR para o gene alvo msp1α também verificou-se infecção em todos os animais em pelo menos uma amostra avaliada. Entretanto, o sequenciamento revelou apenas cinco animais, incluindo os bovinos que morreram, com similaridade das sequências de aminoácidos com estirpe AmRio 2 de A. marginale. Conclui-se que os bovinos esplenectomizados morreram em virtude de anaplasmose provocada pela estirpe inoculada e os bubalinos foram mais resistentes em comparação aos bovinos. Finalmente, os búfalos podem ser uma alternativa à criação de bovinos em áreas com alta ocorrência de casos clínicos de anaplasmose.(AU)

Evaluating diagnostic value of clinical symptoms and signs for chronic sinusitis by CT-scan in patients admitted to Ardabil city hospital, Iran

Background: Chronic rhinosinusitis (CRS) refers to inflammatory nasal and para nasal sinuses which last at least 12 weeks. Despite its high prevalence, it is not easy to diagnose, and clinical criteria and simple radiographs are not so sensitive. The aim of this study was to investigate the diagnostic value of clinical symptoms and signs for chronic sinusitis by Ct-scan in patients admitted to Ardabil city hospital, Iran.Methods: This descriptive cross-sectional study has been done on 83 patients with CRS symptoms who referred to ENT of Ardabil city hospital. The necessary checklist included information such as age, gender, clinical symptoms and CT scan findings were completed and analyzed by statistical methods in SPSS version 21.Results: Of all 83 patients, 55.4% were female and most of patients were in age group 30-39 years with 30.1%. Of all patients, 29 (35%) had positive findings in CT scan of which 72.4% were female. The highest rate of sinus involvement was in the ethmoid sinus. The highest positive predicted value was for nose congestion with OR=2.26 and the lowest was for facial pain and toothache each with OR=0.1.Conclusions: In general, clinical symptoms have a small predictive value in the diagnosis of sinusitis and should be evaluated with CT scan findings (15.7%).

Avaliação de IFN-γ e IL-10 em cães naturalmente infectados com Leishmania (Leishmania) chagasi com e sem manifestações clínicas / Evaluation of INF-γ and IL-10 in dogs naturally infected by Leishmania (Leishmania) chagasi with and without clinic events

As leishmanioses têm como agentes etiológicos parasitas intracelulares obrigatórios pertencentes ao gênero Leishmania capazes de infectar diferentes espécies de mamíferos e nestes se reproduzirem dentro do sistema fagocítico mononuclear. Os cães domésticos são os principais responsáveis pela manutenção da cadeia epidemiológica da doença, podendo apresentar uma grande variedade de perfis clínicos, desde aparentemente sadios a severamente acometidos. Avaliou-se a expressão das citocinas de cães naturalmente infectados com Leishmania (Leishmania) chagasi. Foram coletadas 50 amostras, sendo 20 de animais positivos e sintomáticos para Leishmaniose Visceral Canina (LVC), 20 de animais positivos e assintomáticos e 10 de animais sabidamente negativos para a LVC. As amostras foram analisadas pelo teste imunocromatográfico rápido Dual Path Platform (DPP/Biomanguinhos®) e pelo ELISA (EIE/Biomanguinhos®) indireto para detecção de anticorpos anti-Leishmania. Após as confirmações dos testes, foi realizado o ELISA de captura (R & D Systems) para quantificação das citocinas IL-10 e IFN-γ. Houve diferença estatística entre os grupos observando um aumento nos níveis de IFN-γ nos animais assintomáticos e um aumento de IL-10 nos sintomáticos.(AU)

Leishmaniasis has as obligatory intracellular parasitic etiological agents belonging to the genus Leishmania capable of infecting different species of mammals and reproducing them within the mononuclear phagocytic system. Domestic dogs are the main responsible for maintaining the epidemiological chain of the disease, presenting a wide variety of clinical profiles, from apparently healthy to severely affected. The expression of the cytokines from dogs naturally infected with Leishmania (Leishmania) chagasi was evaluated. Blood samples were collected from 50 animals, 20 from positive and symptomatic dogs for Leishmaniasis Canine (CVL), 20 from positive asymptomatic animals and 10 negative. Samples were analyzed by immunochromatographic test Dual Path Platform (DPP/Biomanguinhos®) and by indirect ELISA (EIE/Biomanguinhos®) for detection of anti-Leishmania antibodies. There was statistical difference between the groups observing an increase in IFN-γ levels in asymptomatic animals and an IL-10 increase in symptomatic.(AU)

Clinical signs in cornea and ocular surface

A careful examination of cornea and ocular surface eliciting the basic signs will help a clinician toward an accurate diagnosis. Flipping the upper lid or pulling the lower lid to look at the inferior fornix may help to pick up any subtle clinical sign. Meticulous documentation by diffuse and slit view will help in following up the disease. Eyelids and ocular surface are evaluated externally and by slit lamp. Slit-lamp examination with the use of the stains such as fluorescein, rose bengal, or lissamine green provides extensive knowledge about the ocular surface. Tests of tear production are also detailed herein. This review is intended to help the eye practitioners in eliciting common clinical signs seen in cornea and ocular surface diseases.

Tetanus in horses: an overview of 70 cases / Tétano em equinos: um panorama de 70 casos

Tetanus is characterized by high case fatality rates in horses. Comprehensive case series studies involving equine tetanus from different geographic areas enable the evaluation of prognosis, efficacy of treatment, and control measures. We retrospectively investigated some selected epidemiological data (breed, age, gender, use of the horses, history of vaccination, seasonality, presence of wound/history of surgical procedures, clinical outcomes) and main clinical aspects (clinical signs, incubation period, length of hospitalization, and period between onset signs and hospitalization) in 70 cases of equine tetanus over 1990-2015, with emphasis in the association between these data and the clinical outcomes. High mortality rate (72.9%) was observed in this study. Forty (57.1%) horses presented history of wounds or surgical procedures related with tetanus, represented mainly by lesions in the hind limbs (42.5%), front limbs (15.0%), umbilical infections (7.1%), castration (4.3%), and face wounds (4.3%). Hyperesthesia, limb spasticity, cervical stiffness, tetanic spasms, and restriction of jaw movement were the main consistent clinical signs. Besides no statistical association, all the horses with umbilical infections, wounds in face, prolonged recumbency, sweating, dysphagia/aphagia died, and together with delay between onset of first clinical signs and prompt veterinary assistance (< 5 days) were considered indicative of poor prognosis; whereas there was a significant association (p=0.001) between survival and length of hospitalization > 7 days, seemed as an evidence of good prognosis. The high mortality rate of tetanus, even in horses under specific treatment, highlight the need for early diagnosis, prompt veterinary assistance, and establishment of prophylatic measures in equine farms.(AU)

Tétano é caracterizado por elevada mortalidade em equinos. Estudos envolvendo séries de casos da doença provenientes de diferentes áreas geográficas possibilitam avaliar o prognóstico, eficácia do tratamento e ações de controle. Foram avaliados, retrospectivamente, os principais achados epidemiológicos (raça, idade, sexo, uso dos equinos, história de vacinação, sazonalidade, presença de lesões/histórico de procedimentos cirúrgicos e evolução dos casos) e aspectos clínicos (sinais clínicos, período de incubação, tempo de hospitalização e período entre início dos sinais e hospitalização) em 70 casos de tétano em equinos atendidos entre 1990 e 2015, com ênfase na associação entre os dados clínico-epidemiológicos e a evolução dos casos (mortalidade). Foi observada alta mortalidade (72,9%) nos equinos. Do total de equinos, 57,1% apresentavam lesões ou histórico de procedimentos cirúrgicos relacionados com tétano, representados principalmente por lesões em membros posteriores (42,5%), membros anteriores (15,0%), infecções umbilicais (7,1%), castração (4,3%) e lesões de face (4,3%). Hiperestesia, espasticidade dos membros, rigidez de pescoço, espasmos tetânicos e restrição aos movimentos de mandíbula foram os principais sinais clínicos observados. Apesar da ausência de significância estatística, todos os animais com presença de infecções umbilicais, lesões na face, decúbito prolongado, sudorese e disfagia/afagia evoluíram para óbito e, associado ao início dos sinais clínicos e a demora no atendimento (< 5 dias), foram considerados indicativos de prognóstico reservado. Em contraste, foi observada associação significante (p=0,001) entre a sobrevivência dos animais e o tempo de hospitalização maior que 7 dias, considerado uma indicação de bom prognóstico. A elevada mortalidade do tétano, mesmo em equinos tratados, enfatiza a necessidade do diagnóstico precoce, do rápido atendimento veterinário e adoção de medidas profiláticas nos criatórios.(AU)

Evaluation of Risk Factors Associated with Venous Thromboembolism in the Lebanese Population

Background: Venous thromboembolism (VTE) is a multifactorial disease with a preventable characteristic. The knowledge of its predictive risk factors will help in preventing it. Therefore, the aim of this study is to assess the predictive risk factors of VTE in the Lebanese population so that effective recommendations can be drawn out. Methodology: A retrospective case-control study was carried between the periods of March till June 2017 in two tertiary care hospitals in Beirut-Lebanon. Patients with a confirmed official diagnosis of VTE between the period going from 2008 till 2016 were taken as cases. Each case was randomly matched with 2 hospitalized controls. Questionnaires concerning VTE risk factors and symptoms were filled. Data were then entered into SPSS version 21 to explore the association between the risk factors and VTE. Bi-variate and multivariate logistic regression were done and a p-value less than 0.05 was considered. Results: 430 patients were included in our study. Among these, 140 were cases of deep vein thrombosis and/or pulmonary embolism and 290 were matched controls. The results of the bi-variate analysis was significant for history of VTE, active cancer, general surgery, thrombophilia, immobility, active/recent pneumonia, trauma, and hormone replacement therapy/contraceptives use (p-value<0.001). It was also significant for history of coronary artery disease/myocardial infarction (p-value=0.018), neurological disease (p-value=0.001), stroke (p-value=0.033) liver diseases and varicose veins (p-value=0.045) and spinal cord injury (p-value=0.034). In multivariate analysis, the probability of VTE was significant for: VTE history (OR=32.8; p-value<0.001), thrombophilia (OR=25.4; p-value<0.001), major trauma (OR=11.5; p-value<0.001), general surgery (OR=10.2; p-value<0.001), immobility (OR=6.9; p-value=0.003), history of stroke (OR=6.8; p-value=0.001), serious liver disease (OR=6.5; p-value=0.016), cancer (OR=5; p-value<0.001), central venous catheter or pacemaker implantation (OR=4.4; p-value=0.025), active/recent pneumonia (OR=3.2; p-value=0.023), neurological disorders (OR=3; p-value =0.047), coronary artery disease/myocardial infarction (OR=2.3; p-value=0.017) and chronic lung diseases (OR= 2.2; p-value=0.033). There was a lack of testing for thrombophilia in the Lebanese hospitals. Conclusion: The knowledge of these causative risk factors and their influence on VTE is crucial to initiate awareness in the population and strict prophylactic procedures for hospitalized patients. Furthermore, physicians must be more aware of the possible thrombophilic factors behind VTE cases by searching through thrombophilia testing. Larger studies must be done to investigate risk factors not detected in this study in order to further generalize the results.

Quantificação da IL-10 e do INF-γ em cães com ou sem sinais clínicos de infecção com Leishmania (Leishmania) chagasi / Quantification of IL-10 and IFN-γ in dogs with or without clinical signs of Leishmania (Leishmania) chagasi infection

As leishmanioses compreendem um complexo de doenças causadas por parasitos intracelulares obrigatórios pertencentes ao gênero Leishmania. Consideradas como importante problema de saúde pública, sendo os cães domésticos os principais responsáveis pela manutenção da cadeia epidemiológica da doença, estima-se que mais da metade dos cães infectados não manifestam sinais clínicos da enfermidade. Avaliou-se o perfil de IL-10 e INF- γ de cães naturalmente infectados com Leishmania (Leishmania) chagasi no município de São Luís-MA. Foram coletadas 50 amostras, sendo 20 de animais positivos e sintomáticos para Leishmaniose Visceral Canina (LVC), 20 de animais positivos e assintomáticos e 10 de animais sabidamente negativos para a LVC. As amostras foram analisadas pelo teste imunocromatográfico rápido Dual Path Platform (DPP/Biomanguinhos®) e pelo ELISA (EIE/Biomanguinhos®) indireto para detecção de anticorpos anti-Leishmania. Após as confirmações dos testes, foi realizado o ELISA de captura para quantificação das citocinas IL-10 e INF-γ através do kit Milliplex MAP. Houve diferença estatística entre os grupos, observando um aumento de IL-10 em soros de cães sintomáticos para LVC, comparado com o grupo de animais assintomáticos, sugerindo que animais com essa expressão de IL-10 podem estar associados à susceptibilidade a doença. Assim como o aumento dos níveis de INF-γ observados em cães assintomáticos, comparado com o grupo de cães sintomáticos, poderiam estar relacionados à cronicidade da doença.(AU)

Leishmaniasis comprise a complex of diseases caused by intracellular mandatory parasites belonging to the genus Leishmania. Considered as an important public health problem, and domestic dogs are primarily responsible for maintaining the epidemiological chain of the disease, it is estimated that more than the half of the dogs infected do not show clinical signs of the disease. The profile of IL-10 and IFN-γ dogs naturally infected with Leishmania (Leishmania) chagasi in São Luís/MA was evaluated. Blood samples were collected from 50 animals, 20 from positive and symptomatic dogs for leishmaniasis canine (CVL), 20 from positive asymptomatic animals and 10 negative. Samples were analyzed by immunochromatographic test Dual Path Platform (DPP/Biomanguinhos®) and by indirect ELISA (EIE/Biomanguinhos®) for detection of anti-Leishmania antibodies. After the confirmation of the tests, the capture ELISA was performed for quantification of IL-10 and IFN-γ cytokines through the Milliplex MAP kit. There was a statistical difference between the groups, observing an increase of IL-10 in blood of symptomatic dogs for CVL, compared to the group of asymptomatic animals, suggesting that animals with this expression of IL-10 may be associated with susceptibility to disease. As well as the increase in IFN-γ levels in asymptomatic dogs, compared to the symptomatic dog group, could be related to chronicity of the disease.(AU)

Relationship between clinical symptomatology on the isolation of Salmonella Gallinarum of japanese quail (Coturnix coturnix) / Relação entre a sintomatologia clínica no isolamento de Salmonella Gallinarum de codornas japonesas (Coturnix coturnix)

Salmonella Gallinarum is capable of causing high mortality in birds of the order Galliformes. This study aimed to relate the presence of clinical signs with the recovery of Salmonella Gallinarum from organs and c loacal swabs of Japanese quails (Coturnix coturnix) experimentally infected. A total of 70 female quails were housed in a pair per cage and divided in two groups (IG: quails inoculated with 1.5x106 CFU of Salmonella Gallinarum Nalr/mL and CG: control group). After the inoculation, birds were evaluated three times a day to verify the presence of clinical signs. Birds that presented ruffled feathers, eyes closed and remained quiet in the cage were removed for euthanasia, as well as the same number of birds from the inoculated groups that presented no clinical signs and from the control group. Cloacal swabbing was performed following euthanasia for the sampling of liver, spleen, caeca, ovarian follicles and lung for microbiological procedure. Quails with clinical signs and quails found dead presented positivity of 100%. While inoculated quails with no clinical signs presented a lower positivity (38.5%). Therefore, quails with septicemia caused by SG present clinical signs of the disease and the pathogen can be isolated and quantified in the organs.(AU)

Salmonella Gallinarum pode causar alta mortalidade em aves da ordem Galliformes. Objetivou-se neste estudo relacionar a presença de sinais clínicos com a recuperação de Salmonella Gallinarum de órgãos e swabs cloacais de codornas japonesas (Coturnix coturnix) experimentalmente infectadas. Um total de 70 codornas fêmeas foram alojadas em par por gaiola e divididas em dois grupos (IG: codornas inoculadas com 1,5x106 UFC de Salmonella Gallinarum Nalr / mL e CG: grupo controle). Após a inoculação, as aves foram avaliadas três vezes ao dia para se verificar a presença de sinais clínicos. As aves que se apresentaram com penas eriçadas, olhos fechados e permaneciam imóveis na gaiola foram removidas para a eutanásia, assim como o mesmo número de aves dos grupos inoculados que não apresentaram sinais clínicos e do grupo controle. O swab cloacal foi realizado após a eutanásia para a amostragem de fígado, baço, ceco, folículos ovarianos e pulmão para procedimento microbiológico. As codornas com sinais clínicos e as encontradas mortas apresentaram positividade de 100%, enquanto as codornas inoculadas sem sinais clínicos apresentaram menor positividade (38,5%). Portanto, codornas com septicemia causada por SG apresentam sinais clínicos da doença e o patógeno pode ser isolado e quantificado em diversos órgãos.(AU)

Aspectos clínicos e laboratoriais do complexo gengivite-estomatite em gatos domés / Clinic and laboratorial profile of Gingivostomatitis Complex in domestic cats

Foram incluídos 76 gatos domésticos com diferentes graus (I a IV) de lesões em cavidade oral, os quais foram avaliados clinicamente e tiveram coletadas amostras de sangue e suabes da cavidade oral. A maioria dos gatos portadores de CGE eram machos, castrados, adultos, sem raça definida e com estilo de vida confinado. Os sinais clínicos observados e associados à gravidade da inflamação na cavidade oral foram halitose (98,7%); ptialismo (22,4%); hemorragia bucal (9,2%) e úlcera na parte superior dos lábios (2,6%); desconforto à manipulação da cavidade oral (44,7%) e perda dentária (55,3%). A maioria dos gatos avaliados foi classificada no grau II (43,4%). Não se observou diferença significativa nos resultados do eritrograma dos gatos portadores de CGE, independentemente da gravidade das lesões e da sintomatologia clínica. Entretanto, observou-se neutrofilia (21,1%) e aumento de proteínas plasmáticas totais (47,3%), na maioria dos animais de grau II, sugerindo que esses parâmetros laboratoriais, quando aumentados, possam estar associados a graus menos graves de CGE. A análise das lâminas de citologia da cavidade oral dos gatos demonstrou que a presença de Simonsiella spp. foi mais frequente nos animais incluídos no grau IV, entretanto não é possível afirmar que essa bactéria esteja relacionada à gravidade das lesões.(AU)

Seventy six domestic cats classified with different scores (I to IV) of oral lesions have been included in the study, being clinically examined and having blood samples and oral cavity swabs collected. Most cats diagnosed with Gingivostomatitis Complex (GSC) were male, neutered, adult, DSH, and lived confined. Clinical signs observed and related to the severity of mouth inflammation were halitosis (98.7%), ptyalism (22.4%), oral hemorrhage (9.2%), and upper lip ulcers (2.6%); discomfort during mouth examination (44.7%) and tooth loss (55,3%). Most cats have been classified as score II (43.4%). The red blood cell count showed no significant statistical difference regardless the different scores of oral lesions and clinical symptoms. However, the leukogram showed neutrophilia (21.1%) and plasmatic proteins had an increased level (47.3%), in most of the animals classified as score II, suggesting that these parameters, when increased, may be associated to less severe GSC scores. Oral cavity microscope slides analysis showed that Simonsiella spp. have been more frequent in the cytology of the score IV animals, however, it does not allow us to correlate the presence of the bacteria with the severity lesions degree.(AU)

Seventy six domestic cats classified with different scores (I to IV) of oral lesions have been included in the study, being clinically examined and having blood samples and oral cavity swabs collected. Most cats diagnosed with Gingivostomatitis Complex (GSC) were male, neutered, adult, DSH, and lived confined. Clinical signs observed and related to the severity of mouth inflammation were halitosis (98.7%), ptyalism (22.4%), oral hemorrhage (9.2%), and upper lip ulcers (2.6%); discomfort during mouth examination (44.7%) and tooth loss (55,3%). Most cats have been classified as score II (43.4%). The red blood cell count showed no significant statistical difference regardless the different scores of oral lesions and clinical symptoms. However, the leukogram showed neutrophilia (21.1%) and plasmatic proteins had an increased level (47.3%), in most of the animals classified as score II, suggesting that these parameters, when increased, may be associated to less severe GSC scores. Oral cavity microscope slides analysis showed that Simonsiella spp. have been more frequent in the cytology of the score IV animals, however, it does not allow us to correlate the presence of the bacteria with the severity lesions degree.(AU)

Scoring clinical signs can help diagnose canine visceral leishmaniasis in a highly endemic area in Brazil

Canine visceral leishmaniasis (CVL) diagnosis is still a challenge in endemic areas with limited diagnostic resources. This study proposes a score with the potential to distinguish positive CVL cases from negative ones. We studied 265 dogs that tested positive for CVL on ELISA and parasitological tests. A score ranging between 0 and 19 was recorded on the basis of clinical signs. Dogs with CVL had an overall higher positivity of the majority of clinical signs than did dogs without CVL or with ehrlichiosis. Clinical signs such as enlarged lymph nodes (83.93%), muzzle/ear lesions (55.36%), nutritional status (51.79%), bristle condition (57.14%), pale mucosal colour (48.21%), onychogryphosis (58.93%), skin lesion (39.28%), bleeding (12.50%), muzzle depigmentation (41.07%), alopecia (39.29%), blepharitis (21.43%), and keratoconjunctivitis (42.86%) were more frequent in dogs with CVL than in dogs with ehrlichiosis or without CVL. Moreover, the clinical score increased according to the positivity of all diagnostic tests (ELISA, p < 0.001; parasite culture, p = 0.0021; and smear, p = 0.0003). Onychogryphosis (long nails) [odds ratio (OR): 3.529; 95% confidence interval (CI): 1.832-6.796; p < 0.001], muzzle depigmentation (OR: 4.651; 95% CI: 2.218-9.750; p < 0.001), and keratoconjunctivitis (OR: 5.400; 95% CI: 2.549-11.441; p < 0.001) were highly associated with CVL. Interestingly, a score cut-off value ≥ 6 had an area under the curve of 0.717 (p < 0.0001), sensitivity of 60.71%, and specificity of 73.64% for CVL diagnosis. The clinical sign-based score for CVL diagnosis suggested herein can help veterinarians reliably identify dogs with CVL in endemic areas with limited diagnostic resources.

Investigation of the clinical and histopathological features of double pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the differences of clinical signs and pathological structure of unilateral nasal pterygium and unilateral double pterygium.METHODS:Retrospective study.Totally 11 unilateral nasal pterygium and 11 unilateral double pterygium were collected to observe the size of the tissue area, the classification of blood vessels, the transparency and the break-up time of tear film.The 11 surgically excised double pterygia (11 eyes) and 6 samples of normal conjunctiva were collected for the study.With 40g/L paraformaldehyde fixation, paraffin sections were stained with Haematoxylin-Eosin, to observe the differences with nasal and temporal pathology under light microscope.RESULTS:In unilateral double pterygium, the tear break-up time was significantly shorter than that of unilateral nasal pterygium (t=3.410, P=0.003).In unilateral nasal pterygium, there was a significant negative correlation between tear film break-up time and tissue size(r=-0.927, P<0.01) and transparency(r=-0.764,P<0.01).In unilateral double pterygium, the tear break-up time was significantly negatively correlated with the growth time (r=-0.661, P<0.05), tissue size (r=-0.775, P<0.01) and transparency (r=-0.671,P<0.05).In unilateral double pterygium, compared with the temporal side, the quantity of the layers of corneal epithelial cells (t=-7.351, P<0.05), vessels (t=-7.400, P<0.05) and inflammatory cells (t=-7.481, P<0.05) increased.CONCLUSION:Compared with unilateral nasal pterygium, the tear film break-up time of unilateral double pterygium was poor.In unilateral double pterygium, with high activity, the degree of proliferation of squamous epithelium, hyperplasia and inflammatory reaction are significantly higher than those of the temporal side.

Repetitive ultrasonographic assessment of adrenal size and shape changes: a clue for an asymptomatic sex hormone-secreting adenoma

Diagnosis of an adrenal tumor without typical clinical signs related to hyperadrenocorticism and elevated alkaline phosphatase is challenging. This report describes a sex hormone-secreting adrenal tumor in a 10-year-old castrated male Shih Tzu evaluated through repetitive ultrasonographic examination. An adrenocorticotropic hormone stimulation test revealed elevated concentrations of androstenedione and 17-hydroxyprogesterone but a normal cortisol concentration. A mass was surgically excised and adenoma was diagnosed histopathologically. In the present case, adrenal tumor was strongly suspected based on a gradual increase in adrenal size and a change from peanut shape to an irregular mass on repetitive ultrasonography. Repetitive ultrasonographic examination of the adrenal gland is recommended when an abnormal ultrasonographic appearance of adrenal gland is identified, even in an asymptomatic dog.

Outcomes of E learning in a clinical context

Background: E learning refers to the use of Internet technologies to deliver a broad array of solutions that enhance knowledge and performance. It is more often used by medical educators in basic science courses than in a clinical evaluation. Materials and methods: An observational study was carried out in the Department of General Surgery among undergraduate medical students to know the impact of e-learning in the acquisition of clinical skills required during evaluation of an inguinoscrotal swelling. A total of 60students were divided into two groups of 30 each. Group A students were trained by conducting bed side clinics on patients while students from Group B were trained using You tube videos. Results: At the end of these sessions, all the students were assessed by Objective Structured Clinical Examination on patients presenting with inguinoscrotal swelling with a check list. Out of 20 marks students from group A had a mean of 16.4 and the mean in the E learning group was 14.1 and the P value was .004 which was statistically significant. Conclusion: E learning by using videos cannot substitute traditional bed side teaching but it can impart basic clinical skills to a certain extent in a resource constrained situation

Symptoms and Response to Treatment with Diminazene Aceturate and Mebendazole in Dogs Infected with Single Trypanosoma congolense, Ancylostoma caninum and Combination of Trypanosoma congolense and Ancylostoma caninum.

The economic losses associated with diseases caused by Trypanosoma congolense and the devastating effect of Ancylostoma caninum (A. caninum) in dogs’ necessitated the present study. Sixteen dogs grouped into 4 of 4 members each were used in the study. GROUP I was uninfected dogs (control), GROUP II was infected with Trypanosoma congolense (T. congolense) infection, GROUP III was mixed infections of Trypanosoma congolense and Ancylostoma caninum (T. congolense /A. caninum) and GPIV was infected with Ancylostoma caninum. At first Ancylostoma caninum infection was done on GPIII and GPIV. Two weeks later T. congolense infections was done on GPII and superimposed on GPIII. Three weeks post trypanosome infection; GPII and GPIII were treated with diminazene aceturate. Mebendazole was used on GPIII and GPIV and treatment repeated 2 weeks later. The prepatent period of T. congolense infection was 14.00±1.40 days in single infection and 9.00±1.10 days in conjunct infection of T. congolense and A. caninum. Persistent parasitaemia resulted in repeated treatment with diminazene aceturate at 7 mg/kg and mebendazole at 100mg twice daily for 3 days. The predominant signs revealed include; lethargy, vomition, enlargement of popliteal lymphnodes, pyrexia, oedema of fore and hind limbs and ocular discharges, anaemia, and slight emaciation. The symptoms were more severe in GPIII compared to GPII and GPIV. The egg per gram of faeces (EPG) in (GPIV) was significantly higher than the conjunct infection (GPIII). Treatment only slightly improved clinical manifestations. In conclusion, conjunct infections of T. congolense / A. caninum would result to more severe disease condition than in single infection of either disease in dogs. The severity of symptoms of the diseases were more in conjunct T. congolense / A. caninum as evidenced by high mortality compared with the single infections. Therefore symptoms of the diseases could serve as a surrogate diagnostic tool in diagnosis and vigorous treatment of infected dogs.

Clinical Effects of Mixed Infection of Trypanosomes and Ancylostoma caninum in Dogs and Treatment with Diminazene and Mebendazole (Nigeria).

The socio-economic importance of trypanosomosis and ancylostomosis in both humans and animal necessitated the investigation of the clinical signs of single and conjunct infection of both parasites in dogs. Sixteen dogs grouped into 4 of 4 members each were used in the study. GROUP I was uninfected dogs (control), GROUP II was infected with Ancylostoma caninum GROUP III was infected with Trypanosoma brucei (T. brucei), GROUP IV was mixed infections of Trypanosoma brucei and Ancylostoma caninum (T. brucei/A. caninum). Post acclimatization, Ancylostoma caninum infection was done on GPII and GPIV. Two weeks later Trypanosoma brucei infections was done on GPIII and superimposed on GPIV. Three weeks post trypanosome infection; GPIII and GPIV were treated with 7 mg/kg diminazene aceturate (Veribin®, CEVA Sante Animale- La Ballasteiére 33501 Libourne Cedex, France) x intramuscularly x once. Mebendazole (Vermin®, Janssen-Cilag Ltd 50 - 100 Holmers Farm Way, High Wycombe, Bucks, HP12 4EG UK) at 100 mg x per os twice daily for 3 days was used only on GPII and GPIV and a repeat treatment given 2 weeks later. Prepatent period of T. brucei infection was 5.00±1.30 days in single infection and 3.00±1.40 days in conjunct infection of T. brucei and A. caninum. Persistent parasitaemia resulted in repeated treatment with diminazene aceturate at 7 mg/kg and mebendazole at 100 mg twice daily for 3 days. The predominant signs revealed include; fluctuation in weight, lethargy, vomition, enlargement of popliteal lymphnodes, pyrexia, oedema of lower jaw and ocular discharges, enlarged abdomen, anaemia, cornea opacity and slight emaciation. The clinical signs were most severe in GPIV compared to GPIII. The egg per gram of faeces (EPG) in GPII was significantly higher than the mixed infection (GPIV). Treatment only slightly improved clinical manifestations. In conclusion, most signs shown were consistent with trypanosomosis in dogs except abdominal enlargement which is a complication of A. caninum. Clinical signs therefore could serve as a diagnostic tool in the treatment of both conditions in dogs.

Fatal Human herpesvirus 1 (HHV-1) infection in captive marmosets (Callithrix jacchus and Callithrix penicillata) in Brazil: clinical and pathological characterization / Infecção fatal por Herpesvirus simplex Tipo 1 (HHV-1) em saguis de cativeiro (Callithrix jacchus and Callithrix penicillata) no Brasil: caracterização clínica e patológica

Fatal Human herpesvirus 1 (HHV-1) was diagnosed in 12 captive marmosets (Callithrix jacchus and Callithrix penicillata) from metropolitan region of São Paulo, São Paulo State. Clinical signs were variable among the cases, but most affected marmosets presented signs associated with viral epithelial replication: oral, lingual and facial skin ulcers and hypersalivation, and viral replication in the central nervous system: prostration, seizure and aggressive behavior. Consistent microscopic findings were diffuse mild to severe nonsuppurative necrotizing meningoencephalitis with gliosis, vasculitis and neuronal necrosis. Additionally, in the brain, oral cavity, skin, adrenal gland and myoenteric plexus intranuclear inclusion bodies were present. Immunohistochemistry confirmed the presence of the HHV-1 antigen in association with lesions in the brain, oral and lingual mucosa, facial skin, adrenal gland and myoenteric plexus. HHV-1-specific polymerase chain reaction (PCR) analysis of the brain was carried out and the virus was detected in 7/8 infected marmosets. It is concluded that HHV-1 causes widespread fatal infection in marmosets.(AU)

Infecção fatal por Herpesvirus simplex Tipo 1 (HHV-1) foi diagnosticada em 12 saguis de cativeiro (Callithrix jacchus e Callithrix penicillata) provenientes da região metropolitana de São Paulo, Estado de São Paulo. Os sinais clínicos foram variáveis entres os casos, no entanto, a maioria dos saguis afetados apresentavam sinais associados à replicação viral em epitélios: úlceras na cavidade oral, língua e pele da face e hipersalivação; e no sistema nervoso central: prostração, convulsão e comportamento agressivo. Histologicamente, o principal achado foi meningoencefalite necrosante não supurativa difusa, leve a acentuada com gliose, vasculite e necrose neuronal. Inclusões intranucleares também foram observadas em encéfalo, cavidade oral, pele, glândula adrenal e plexo mioentérico. A imuno-histoquímica anti-HHV-1 confirmou a presença do antígeno viral em associação às lesões em encéfalo, mucosa oral e lingual, pele da face, glândula adrenal e plexo mioentérico. Em 7/8 saguis infectados foi detectada a presença de HHV-1 por reação em cadeia da polimerase (PCR) a partir de amostras de encéfalo. Conclui-se que HHV-1 causa uma infecção disseminada e fatal em saguis.(AU)