Uma análise dos principais diagnósticos de Sars-cov-2 disponíveis no Brasil: uma revisão de literatura / Diagnosis and main types of coronavirus in humans: a narrative review / Diagnóstico y principales tipos de coronavirus en humanos: una revisión narrativa

Introdução: Com a emergência do SARS-CoV-2 foi disponibilizado uma grande quantidade de ferramentas de diagnóstico. Neste contexto, a falta de vacina, de tratamento e o grande número de casos graves e morte, possibilitou a aprovação emergencial de diversos testes, que ainda necessitam de estudos populacionais para seu registro definitivo. Objetivo: Realizar uma revisão de literatura para avaliar as metodologias de diagnóstico disponíveis no Brasil, de acordo com a realidade local de saúde, explorando o momento epidemiológico a complexidade do teste e a finalidade da sua aplicação. Metodologia: Trata-se de um estudo bibliográfico, descritivo do tipo revisão de literatura. Foram utilizadas as seguintes bases de dados científicos para buscas: PUBMED, MEDLINE, LILACS E COCHRANE LIBRARY, através de descritores selecionados na plataforma DECS. Resultados: O cenário de diversos ensaios, baseados em diferentes metodologias, como os testes baseados em RNA viral, em detecção de antígenos virais ou de anticorpos, associados ao conhecimento da história natural do vírus, possibilita uma análise crítica do melhor diagnóstico de acordo com a clínica do paciente, os epidemiológicos, o objetivo do diagnóstico e a acurácia do ensaio. Atualmente, há mudança no padrão imunológico da população e a descrição de tipos e subtipos de SARS-CoV-2 com mudanças gênicas, que podem levar a mudanças na acurácia diagnóstica ou a re-emergência em surtos de doença grave. Conclusão: Ainda é incerto o caminho evolutivo da história natural da Covid-19 e os ensaios diagnósticos estão em diferentes estágios de desenvolvimento, validação e produção e cada tipo de teste tem suas próprias vantagens e desvantagens distintas inerentes a plataforma tecnológica de origem e uma combinação de tipos de testes usados em momentos diferentes pode ser útil para a condução clínica dos pacientes e no controle da pandemia por SARS-CoV-2.

Introduction: With the emergence of SARS-CoV-2, a large number of diagnostic tools were made available. In this context, the lack of vaccine, treatment and the large number of severe cases and death, allowed the emergency approval of several tests, which still require population studies for their definitive registration. Objective: To carry out a literature review to evaluate the diagnostic methodologies available in Brazil, according to the local health reality, exploring the epidemiological moment, the complexity of the test and the purpose of its application. Methodology: This is a bibliographic, descriptive study of the literature review type. The following scientific databases were used for searches: PUBMED, MEDLINE, LILACS AND COCHRANE LIBRARY, through selected descriptors on the DECS platform. Results: The scenario of several tests, based on different methodologies, such as tests based on viral RNA, on detection of viral antigens or antibodies, associated with knowledge of the natural history of the virus, allows a critical analysis of the best diagnosis according to the patient's clinical, epidemiological, diagnostic objective and assay accuracy. Currently, there is a change in the immune pattern of the population and the description of types and subtypes of SARS-CoV-2 with genetic changes, which can lead to changes in diagnostic accuracy or the re-emergence in outbreaks of severe disease. Conclusion: The evolutionary path of the natural history of Covid-19 is still uncertain and diagnostic assays are at different stages of development, validation and production and each type of test has its own distinct advantages and disadvantages inherent in the technology platform of origin and a combination of types of tests used at different times can be useful for the clinical management of patients and in the control of the SARS-CoV-2 pandemic.

Introducción: Con la aparición del SARS-CoV-2, se dispuso de un gran número de herramientas diagnósticas. En este contexto, la falta de vacuna, tratamiento y el gran número de casos graves y muerte, permitieron la aprobación de urgencia de varias pruebas, que aún requieren estudios poblacionales para su registro definitivo. Objetivo: Realizar una revisión bibliográfica para evaluar las metodologías diagnósticas disponibles en Brasil, de acuerdo con la realidad sanitaria local, explorando el momento epidemiológico, la complejidad de la prueba y la finalidad de su aplicación. Metodología: Se trata de un estudio bibliográfico, descriptivo, del tipo revisión de literatura. Para las búsquedas se utilizaron las siguientes bases de datos científicas PUBMED, MEDLINE, LILACS Y COCHRANE LIBRARY, a través de descriptores seleccionados en la plataforma DECS. Resultados: El escenario de varias pruebas, basadas en diferentes metodologías, como pruebas basadas en el ARN viral, en la detección de antígenos virales o anticuerpos, asociado al conocimiento de la historia natural del virus, permite un análisis crítico del mejor diagnóstico de acuerdo con la clínica del paciente, epidemiológica, objetivo diagnóstico y precisión de la prueba. Actualmente, hay un cambio en el patrón inmunológico de la población y la descripción de tipos y subtipos de SARS-CoV-2 con cambios genéticos, que pueden conducir a cambios en la precisión diagnóstica o la reaparición en brotes de enfermedad grave. Conclusiones: El camino evolutivo de la historia natural del Covid-19 es aún incierto y los ensayos de diagnóstico se encuentran en diferentes etapas de desarrollo, validación y producción y cada tipo de prueba tiene sus propias ventajas y desventajas distintas inherentes a la plataforma tecnológica de origen y una combinación de tipos de pruebas utilizadas en diferentes momentos puede ser útil para el manejo clínico de los pacientes y en el control de la pandemia de SARS- CoV-2.

Epidemiological aspects of the occurrence of anti-Sarcocystis spp. andanti-Toxoplasma gondii antibodies in dogs in the Northern region of Brazil / Aspectos epidemiológicos da ocorrência de anticorpos anti-Sarcocystisspp. e anti-Toxoplasma gondii em cães da região norte do Brasil

We conducted aseroepidemiological study on the occurrence of anti-Sarcocystisspp. and anti-Toxoplasma gondii antibodies in dogs from family farming properties in the municipality of Ji-Paraná, Rondônia.Blood samples were collected from apparently healthy dogs between September 2012 and November 2013. In total, 181 blood serum samples were analyzed using an indirect immunofluorescence assay, among which 57 (31.49%) and 20 (11.04%) were positive for anti-T. gondii and anti-Sarcocystis spp., respectively. Statistical analyses showed that the type of food fed to the dogs was associated with the occurrence of anti-Sarcocystisspp. antibodies. In contrast, age and access to bovine carcasses were the risk factors for anti-T. gondii.The high occurrence of seropositive dogs for Sarcocystis spp. and T. gondii evidences the wide distribution of these agents in the studied area, possibly due to human and animal exposure to these protozoan species. In addition, anti-T. gondii antibodies were directly proportional to dog age. The increase in the number of positive animals with age was statistically significant. Furthermore, high antibody titers (up to 800) against Sarcocystis spp. in dogs suggest the possibility of recent exposure, in addition to environmental contamination by oocysts/sporocysts eliminated by the feces of these animals.

Conduzimos um estudo soroepidemiológico sobre a ocorrência de anticorpos anti- Sarcocystis spp. e anti-Toxoplasma gondiiem cães de propriedades de agricultura familiar no município de Ji-Paraná, Rondônia. Amostras de sangue foram coletadas de cães aparentemente saudáveis, entre setembro de 2012 e novembro de 2013. Ao todo, foram analisados 181 soros sanguíneos por meio do ensaio de imunofluorescência indireta, sendo positivas 57 (31,49%) e 20 (11,04%) amostras para anticorpos anti-T. gondii e anti-Sarcocystis spp., respectivamente. As análises estatísticas demonstraram que o tipo de alimentação fornecida aos cães esteve associado à ocorrência de anticorpos anti-Sarcocystis spp. Em contraste a idade e o acesso à carcaça bovina foram fatores de risco para a presença de anticorpos anti-T. gondii. A alta ocorrência de cães soropositivos para Sarcocystis spp. e T. gondii evidencia a ampla distribuição desses agentes na área estudada, possivelmente devido à exposição humana e animal a essas espécies de protozoários. Além disso, o resultado dos anticorpos anti-T. gondii relacionados a idade do cão mostraram diferença estatística, com aumento significativo no número de animais positivos com a idade. Além disso, altos títulos de anticorpos (até 800) contra Sarcocystis spp. em cães sugerem a possibilidade de exposição recente, além da contaminação ambiental por oocistos/esporocistos eliminados pelas fezes desses animais.

Correlación entre dos metodologías para la medición de anticuerpos contra la proteína spike del coronavirus del Síndrome Respiratorio Agudo Grave 2 / Correlation between two methodologies for the measurement of antibodies against the spike protein of coronavirus of the Severe Acute Respiratory Syndrome 2

Resumen El coronavirus del Síndrome Respiratorio Agudo Grave 2 (SARS-CoV-2) posee diversas proteínas estructurales que incluyen la proteína spike (S), principal blanco de las vacunas actuales. Existen diversas metodologías para la medición de anticuerpos contra ésta que brindan información acerca de la respuesta inmune frente a la vacunación. El objetivo de este trabajo fue determinar la correlación entre quimioluminiscencia (CLIA) y enzimoinmunoanálisis de adsorción (ELISA) para la medición de anticuerpos IgG anti-proteína S (IgG anti-S). Se recolectaron resultados serológicos de 169 individuos y se determinaron los niveles de anticuerpos por ambas metodologías. Del total de muestras, 106 arrojaron un resultado positivo por ambas metodologías y 15 resultaron discordantes (CLIA+, ELISA-), con índice Kappa de 0,80. La correlación entre ambas metodologías fue buena. Este estudio podría aportar al manejo y seguimiento de la población vacunada, con la finalidad de obtener un valor de corte para evaluar la aplicación de una dosis adicional.

Abstract Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has several structural proteins including the spike (S) protein, which is the main target of current vaccines. There are various methodologies for the measurement of antibodies against it that provide information about the immune response to vaccination. The objective of this study was to determine the correlation between chemiluminescence (CLIA) and enzyme-linked immunoassay (ELISA) for the measurement of IgG anti-S protein (IgG anti-S) antibodies. Serological results were collected from 169 individuals and antibody levels were determined by both methodologies. Out of the total samples, 106 were positive by both methodologies and 15 were discordant (CLIA+, ELISA-), with a Kappa index of 0.80. The correlation between both methodologies was good. This study could contribute to the management and follow-up of the vaccinated population, in order to obtain a cut-off value to evaluate the application of an additional dose.

Resumo O coronavírus da Síndrome Respiratória Aguda Grave 2 (SARS-CoV-2) possui várias proteínas estruturais, incluindo a proteína spike (S), principal alvo das vacinas atuais. Existem várias metodologias para medir anticorpos contra ela que fornecem informações sobre a resposta imune diante da vacinação. O objetivo deste trabalho foi determinar a correlação entre quimioluminescência (CLIA) e enzimoimunoanálise de absorção (ELISA) para a medição de anticorpos IgG anti-proteína S (IgG anti-S). Foram coletados resultados sorológicos de 169 indivíduos e os níveis de anticorpos foram determinados por ambas as metodologias. Do total de amostras, 106 deram resultados positivos nas duas metodologias e 15 foram discordantes (CLIA+, ELISA-), com índice Kappa de 0,80. A correlação entre as duas metodologias foi boa. Este estudo poderia contribuir para a gestão e seguimento da população vacinada, visando a obter um valor de corte para avaliar a aplicação de uma dose adicional.

Evaluación de los niveles de anticuerpos para COVID-19 en pacientes que concurrieron a un laboratorio de la Ciudad Autónoma de Buenos Aires / Evaluation of antibody levels for COVID-19 patients who attended a laboratory in Buenos Aires city

Resumen A fines de 2019 se describieron en China los primeros casos de neumonía asociada a SARS-CoV-2. La OMS la llamó COVID-19 y declaró emergencia sanitaria internacional en enero de 2020, ante la rápida diseminación de la infección a nivel mundial. En la Argentina los primeros casos se detectaron en marzo de 2020 y casi inmediatamente comenzaron a utilizarse métodos directos para detección de SARS-CoV-2 (RT PCR, LAMP, entre otros). Los métodos para detección de anticuerpos fueron aprobados posteriormente y no son de elección para realizar el diagnóstico de la enfermedad. En este laboratorio estos últimos comenzaron a utilizarse durante la primera ola de COVID-19 y con estos datos se realizó un estudio observacional retrospectivo de una serie de pacientes con resultados de anticuerpos IgG positivos. Se calculó la tasa de notificación al Sistema Integrado de Información Sanitaria Argentino (SISA) y se evaluaron los niveles de anticuerpos, agrupándolos de acuerdo a: si estaban notificados y si tenían resultado de RT PCR/LAMP, los síntomas presentados y el tiempo transcurrido post RT PCR/LAMP. No fue posible demostrar diferencias entre los pacientes con RT PCR/LAMP detectable y no detectable, tampoco con el tipo de síntomas declarados ni con respecto a los días transcurridos posinfección. Sin embargo, se observó que existía una diferencia significativa entre el grupo de pacientes notificados y no notificados y una alta tasa de pacientes con anticuerpos positivos que no fueron declarados en SISA, por lo que su detección podría considerarse como marcador subrogante de contacto cuando no fuera posible arribar al diagnóstico por métodos moleculares.

Abstract At the end of 2019 the first cases of SARS-CoV-2-associated pneumonia were reported in China. Consequently, the World Health Organization (WHO) named it COVID-19 and in January 2020, it declared the international health emergency due to the worldwide rapid spread of the infection. The first cases in Argentina were detected in early March 2020. Molecular tests like RT PCR and LAMP were immediately used. Serological tests for antibody detection were approved a few months later; however, these are still not the preferred evidiagnostic method for the disease. In our laboratory, the latter began to be used during the first wave of COVID-19. With the results obtained in that moment, an observational retrospective study in a cohort of patients who came voluntarily to test for SARS-CoV-2 IgG antibodies and whose results were positive was performed. The notification rate to the Argentine Integrated System for Health Information (SISA for its acronym in Spanish) was calculated and antibody levels were evaluated, clustering them according to the following facts: if the event had been notified to the SISA and if they had a previous RT PCR/LAMP result, the symptoms experienced by these patients and the time elapsed between RT PCR/LAMP and antibody test results. It was not possible to demonstrate differences between patients with detectable and undetectable RT PCR/LAMP, neither with the type of declared symptoms nor with respect to the days elapsed post-infection. However, it was found that there was a significant difference between notified and non-notified patients, and a high rate of non-notified patients with positive antibodies. Therefore, antibodies level might be considered as a surrogate marker of SARS-CoV-2 contact when a diagnosis through molecular methods is not available.

Resumo No final de 2019 foram reportados na China os primeiros casos de pneumonia associados a SARS-CoV-2. A Organização Mundial da Saúde (OMS) chamou-a de COVID-19 e declarou emergência sanitária internacional em janeiro de 2020, frente à rápida disseminação da infecção em nível mundial. Na Argentina os primeiros casos foram detectados no início de março de 2020 e de forma quase imediata, começaram a ser utilizados métodos diretos para detectar SARS-CoV-2 (RT PCR, LAMP, entre outros). Os métodos para detectar anticorpos foram posteriormente aprovados e não são de eleição para realizar o diagnóstico da doença. Em nosso laboratório, a utilização destes últimos começou durante a primeira onda de COVID-19 e com os resultados obtidos nesse momento foi realizado um estudo observacional retrospectivo de uma série de pacientes com resultados de anticorpos IgG positivos. Foi calculada a taxa de notificação ao Sistema Integrado de Informação em Saúde da Argentina (SISA) e foram avaliados os níveis de anticorpos agrupando- os de acordo a: se estavam notificados e se eles tinham resultado de RT PCR/LAMP, os sintomas apresentados e o tempo decorrido pós RT PCR/LAMP. Não foi possível demonstrar diferenças entre pacientes com RT PCR/LAMP detectável e não detectável, nem com o tipo de sintomas declarados nem com relação aos dias decorridos após a infecção. No entanto, verificou-se que existia uma diferença significativa entre o grupo de pacientes notificados e não notificados, e uma alta taxa de pacientes com anticorpos positivos que não foram declarados no SISA, portanto, sua detecção poderia ser considerada como um marcador substituto de contato quando não fosse possível chegar ao diagnóstico por métodos moleculares.

Manifestaciones pulmonares al diagnóstico de 170 pacientes con vasculitis asociadas a anticuerpos anticitoplasma de neutrófilos: cohorte retrospectiva de un centro universitario / Pulmonary manifestations at the diagnosis of 170 patients with vasculitis associated with anticytoplasmic neutrophil antibodies: retrospective cohort of a university center

INTRODUCCIÓN: Las Vasculitis Asociadas a Anticuerpos Anticitoplasma de Neutrófilos (VAA) son infrecuentes, pero de amplio espectro de presentación. Si bien el consenso de clasificación de Chapel Hill del año 2012, sigue vigente, la tendencia actual es clasificarlas de acuerdo al marcador inmunológico: anti-Proteinasa 3 (PR3) o anti-mieloperoxidasa (MPO). Las manifestaciones pulmonares clásicas son la hemorragia alveolar y los nódulos pulmonares. En los últimos 10 años se ha descrito la enfermedad pulmonar difusa (EPD). Los estudios epidemiológicos son escasos, y suelen representar en su mayoría poblaciones norteamericanas o europeas. El objetivo es describir las características del compromiso pulmonar al debut en VAA en un centro universitario. PACIENTES Y MÉTODO: De un total de 190 pacientes con diagnóstico de VAA se incluyeron 170 en seguimiento en nuestro centro. Se revisaron aspectos clínicos, demográficos, laboratorio e imagenológicos de los pacientes incluidos. RESULTADOS: De los 170 pacientes, 112 (65,88%) presentaron compromiso pulmonar. 106 (94,64%) de los pacientes fueron anticuerpos anti citoplasma de neutrófilos (ANCA) positivos; de estos, 56 (53,27%) MPO (+) y 39 (36,45%) PR-3 (+). Un tercio de los pacientes de ambos grupos presentó hemorragia alveolar. En los pacientes MPO (+) predomina la EPD (53,5%) y en PR-3 (+) los nódulos pulmonares (69,23%). Destaca la baja frecuencia de patología obstructiva asociada. CONCLUSIONES: El compromiso pulmonar en las VAA es prevalente y heterogéneo. En nuestra serie, destaca la frecuencia de EPD en VAA MPO (+), lo que releva la importancia del estudio con ANCA en paciente con diagnóstico y seguimiento por EPD.

INTRODUCTION: Antineutrophil Cytoplasmic Antibodies (ANCA) associated vasculitis (AAV) are uncommon, but of broad spectrum of presentation. Although the 2012 Chapel Hill classification consensus remains valid, the current trend is to classify them according to the immunological marker: anti-Proteinase 3 antibody (PR-3) or anti-Myeloperoxidase antibody (MPO). The classic pulmonary manifestations are alveolar hemorrhage and pulmonary nodules. Interstitial lung disease (ILD) has been described in the last 10 years. Epidemiological studies are scarce, and they usually represent mostly North American or European populations. The objective is to describe the characteristics of lung involvement upon debut in AAV in a university center. PATIENTS AND METHODS: Of a total of 190 patients diagnosed with AAV, 170 were included in follow-up at our center. Clinical, demographic, laboratory and imaging aspects of the included patients were reviewed. RESULTS: Of the 170 patients, 112 (65.88%) had lung involvement. 106 (94.64%) of the patients were ANCA (+); of these, 56 (53.27%) MPO (+) and 39 (36.45%) PR-3 (+). One third of the patients in both groups had alveolar hemorrhage. In MPO (+) patients, ILD predominates (53.5%) and in PR-3 (+) pulmonary nodules (69.23%). The low frequency of associated obstructive pathology stands out. CONCLUSIONS: Pulmonary manifestations in AAVs are frequent and heterogeneous. Locally, the association of ILD and AAV MPO (+) stands out, which highlights the importance of ANCA study in patients with diagnosis and follow-up by ILD.

Enzyme-linked immunosorbent assay (ELISA) for detection of IgY Anti-Borrelia anserina antibodies in Gallus gallus domesticus / Ensaio de imunoadsorção enzimático (ELISA) indireto para detecção de anticorpos IgY Anti-Borreliaanserina em Gallus gallus domesticus

This study aimed to promote the standardization of an indirect, enzyme-linked immunosorbent assay (ELISA) for the serological detection of B. anserina in Gallus gallusdomesticus. An aliquoted sera from vaccinated chicken with B. anserina antigen (GI), experimental infected chickens with B. anserina (GII) and rustic poultry rearing of G. gallus (GIII) were tested with in-house ELISA developed to detect serum antibodies against B. anserina in G. gallus domesticus. On average, the experimentally infected chickens became positive at 9 DPI a mean ± standard deviation (SD) ODI value of 163.11 ± 70.65. The highest observed Optical Density Index (ODI) was 372.54 ± 132.39, at 26 DPI, and the highest overall ODI value was 626.51. The vaccinated chickens became positive between 8 and 10 DPV, with an ODI of 245.59 at 10 DPV, with an overall maximum ODI of 543.13. A total of 108 blood samples were collected from poultry raised on rustic farms. Of the total samples collected, 58.33% (63/108) were considered positive for B. anserina. The maximum ODI found among these rustic chickens was 283.24. This stardardization provided a sensitivity and specificity of 100%.

Este estudo teve como objetivo promover a padronização de um ensaio imunoenzimático indireto (ELISA) para a detecção sorológica de Borrelia anserina em Gallus gallus domesticus. Um frango vacinado com antígeno de B. anserina (GI), frangos infectados experimentalmente com B. anserina (GII) e frangos criados de forma rústica (GIII) foram testados com ELISA indireto in house desenvolvido para a detecção sorológica contra B. anserina em G. gallus domesticus. Em média, os frangos infectados experimentalmente tornaram-se positivos aos 9º dia pós-inoculação (DPI), um valor do índice de densidade óptica (ODI) médio ± desvio padrão (SD) de 163,11 ± 70,65. O maior ODI observado foi 372,54 ± 132,39, em 26ºDPI, e o maior valor geral de ODI foi 626,51. Os frangos vacinados tornaram-se positivos entre 8º e 10° DPV, com um ODI de 245,59 a 10 DPV, com um ODI máximo geral de 543,13. Um total de 108 amostras de sangue foram coletadas de aves criadas em fazendas rústicas. Do total de amostras coletadas, 58,33% (63/108) foram consideradas positivas para B. anserina. O ODI máximo encontrado entre essas galinhas rústicas foi 283,24. Essa padronização proporcionou sensibilidade e especificidade de 100%.

Serum prevalence of anti-Trypanosoma vivax antibodies in cattle in Tapira-MG, Brazil / Soroprevalência de anticorpos anti-Trypanosoma vivaxem bovinos em Tapira-MG, Brasil

Trypanosoma vivax is considered the most important pathogenic Trypanosoma for cattle and causes great damage to the dairy and beef cattle industries. This study aimed to evaluate the prevalence of anti-T. vivax antibodies in dairy cattle from the municipality of Tapira, located in the Alto Paranaíba region, Minas Gerais, Brazil. The 74 blood serum samples from dairy cattle were analyzed using an indirect immunofluorescence reaction. The seroprevalence was 82.4 % (61/74), and the highest incidence observed can be correlated with the transit of untested animals, the presence of vectors, and needle sharing by owners. The data allowed defining Tapira as an area of expansion of T. vivax epizootic infections in the state of Minas Gerais.

O Trypanosoma vivax é considerado o mais importante trypanosoma patogênico para bovinos e causa grandes prejuízos na pecuária de corte e leite. Este estudo teve como objetivo avaliar a prevalência anticorpos de anti-Trypanosoma vivax em bovinos leiteiros do município de Tapira, localizado na região do Alto Paranaíba, Minas Gerais, Brasil. As 74 amostras de soro sanguíneo de bovinos leiteiros foram analisadas por meio de reação de imunofluorescência indireta. A soroprevalência foi de 82,4% (61/74), que pode estar relacionada ao trânsito de animais não testados, presença de vetores e compartilhamento de agulhas pelos proprietários. Os dados permitiram definir Tapira como uma área de expansão das infecções epizoóticas por Trypanosoma vivax no estado de Minas Gerais.

Biomarcadores en tuberculosis / Biomarkers in tuberculosis

Resumen Los métodos diagnósticos clásicos para la tuberculosis son de baja sensibilidad o son muy lentos en la obtención de resultados (baciloscopía, cultivo de Koch). De ahí nace la necesidad de nuevos métodos diagnósticos para esta enfermedad. Los biomarcadores surgen como una opción a esta problemática, con un buen rendimiento diagnóstico, costo y accesibilidad. Ellos permiten identificar la respuesta inflamatoria y/o metabólica del huésped, extrapolando la presencia de Mycobacterium tuberculosis; o identifican moléculas propias del patógeno. En la presente revisión se describen biomarcadores que presentan un buen rendimiento diagnóstico basados en metodologías de investigación de alto nivel (estudio de cohortes, prospectivos, muestreo consecutivo o aleatorizado, comparación de rendimiento diagnóstico frente a cultivo). Es necesario el desarrollo de estas nuevas técnicas con el fin de realizar el diagnóstico precoz de la enfermedad y lograr así su tan ansiada eliminación.

The classical laboratory diagnostic methods for tuberculosis have a low sensitivity or take a long time to know their results. New methods are underway. Biomarkers are a good option to improve our diagnostic approach to this disease. They have good performance, low cost and accessibility. They identify a patient's inflammatory or metabolic response to Mycobacterium Tuberculosis or identifies molecules that are typical of the pathogen. In this paper we sum up the biomarkers with a good diag-nostic performance described in well design investigations. Early diagnosis with these new techniques should contribute to the elimination of the disease.

Seroprevalencia de anticuerpos anti-Leptospira spp. en estudiantes de Medicina Veterinaria y Zootecnia de la Costa Grande de Guerrero, México / Seroprevalence of anti-Leptospira spp. antibodies among Veterinary Medicine and Zootechnics students from Costa Grande of Guerrero, Mexico

Introducción: La leptospirosis humana es una enfermedad zoonótica con manifestaciones clínicas inespecíficas (cefalea y mialgia), las cuales pueden confundirse con otras enfermedades febriles como: gripe, malaria, dengue, fiebre amarilla, hepatitis vírica y rickettsiosis. Objetivo: Determinar la prevalencia de anticuerpos anti-Leptospira en estudiantes de la carrera de Medicina Veterinaria y Zootecnia de la Costa Grande de Guerrero. Métodos: Se aplicó un cuestionario a los estudiantes de la Escuela Superior de Medicina Veterinaria y Zootecnia No. 3 con la finalidad de conocer algunos factores de riesgo asociados a la presencia de anticuerpos anti-Leptospira spp. La determinación de anticuerpos anti-Leptospira y la identificación de las serovariedades se realizaron con la técnica de microaglutinación. Se consideró un suero positivo cuando se observó una aglutinación en una dilución igual o mayor a 1:100. Resultados: En el estudio la seroprevalencia de anticuerpos anti-Leptospira spp. fue de 12,1 por ciento (8/66). Se detectaron anticuerpos a 8 serovariedades de Leptospira spp. El 62,5 por ciento (5/8) de los sueros presentó más de una serovariedad. Las serovariedades y frecuencia fueron icterohaemorrhagiae 25 por ciento (4/16), hardjo 18,8 por ciento (3/16), pyrogenes 18,8 por ciento (3/16), pomona 12,5 por ciento (2/16), canicola 6,2 por ciento (1/16) wolffi 6,2 por ciento (1/16) tarassovi 6,2 por ciento (1/16) y bratislava 6,2 por ciento (1/16). Los factores de riesgo estudiados no se relacionaron con la presencia de anticuerpos anti-Leptospira. Conclusiones: En el presente estudio se encontraron anticuerpos a Leptospira spp. en estudiantes de Medicina Veterinaria y Zootecnia. Por tanto, es pertinente proporcionar información a los estudiantes para prevenir el contacto con el agente causal de la leptospirosis(AU)

Introduction: Human leptospirosis is a zoonotic disease of unspecific clinical manifestations (headache and myalgia) which may be confused with those of other febrile diseases, such as influenza, malaria, dengue, yellow fever, viral hepatitis and rickettsiosis. Objective: Determine the prevalence of anti-Leptospira antibodies among Veterinary Medicine and Zootechnics students from Costa Grande de Guerrero. Methods: A questionnaire was applied to students from the Higher Education Veterinary Medicine and Zootechnics School No. 3 to obtain information about risk factors associated to the presence of anti-Leptospira spp. antibodies. Microagglutination technique was used to determine anti-Leptospira antibodies and identify serovars. A serum sample was considered positive when agglutination was observed at a dilution equal to or greater than 1:100. Results: Seroprevalence of anti-Leptospira spp. antibodies was found to be 12.1 percent (8/66). Antibodies were detected for 8 serovars of Leptospira spp. Of the serum samples analyzed, 62.5 percent (5/8) contained more than one serovar. The serovars and their frequency were the following: icterohaemorrhagiae 25 percent (4/16), hardjo 18.8 percent (3/16), pyrogenes 18.8 percent (3/16), pomona 12.5 percent (2/16), canicola 6.2 percent (1/16), wolffi 6.2 percent (1/16), tarassovi 6.2 percent (1/16) and bratislava 6.2 percent (1/16). The risk factors studied were not related to the presence of anti-Leptospira antibodies. Conclusions: Leptospira spp. antibodies were found in Veterinary Medicine and Zootechnics students. It is therefore advisable to provide students with the information required to prevent contact with the causative agent of leptospirosis(AU)

Mielitis longitudinal extensa de presentación muy tardía: Una entidad del espectro de la neuromielitis óptica / Extensive longitudinal myelitis of very late presentation. An entity of the spectrum of optic neuromyelitis

Las enfermedades del espectro neuromielitis óptica son trastornos inflamatorios del sistema nervioso central caracterizados por una grave desmielinización y daño axonal inmunomediado que afecta principalmente a los nervios ópticos y médula espinal. Suelen presentars e en edades tempranas, aunque existen algunas comunicaciones en la literatura de pacientes con presentaciones tardías. Presentamos el caso de una mujer de 78 años que consultó por un cuadro de paraparesia grave, trastornos sensitivos y retención urinaria. Se realizó una resonancia magnética de columna cervicodorsal que evidenció una lesión medular longitudinal extensa. Se descartaron otras causas secundarias, basadas en la clínica y en resultados de laboratorio. El dosaje de anticuerpos anti-acuaporina 4 resultó positivo. Se indicó tratamiento con glucocorticoides a altas dosis y plasmaféresis, y mantenimiento con rituximab, obteniendo escasa respuesta clínica. En pacientes con lesiones medulares extensas se deben contemplar múltiples diagnósticos diferenciales según la presentación clínica, hallazgos mediante estudios por imágenes y epidemiología. Asimismo, debe incluir la búsqueda de anticuerpos anti-acuaporina 4 y contra la glicoproteína de la mielina del oligodendrocito, ya que el pronóstico funcional de estos pacientes suele ser desfavorable debido al gran componente destructivo de las lesiones. En consecuencia, el tratamiento temprano es fundamental a fin de limitar el daño agudo y prevenir futuras recaídas, lo cual es especialmente importante en presentaciones tardías de esta entidad debido a la escasa reserva funcional y baja capacidad de remielinización.

Optic neuromyelitis spectrum diseases are inflammatory disorders of the central nervous system characterized by severe demyelination and immunomediated axonal damage that mainly affects the optic nerves and spinal cord. They usually appear at an early age, although there are some reports in the literature of patients with late presentations. We present the case of a 78-year-old woman who consulted for severe paraparesis, sensory disorders, and urinary retention. An MRI of the cervicodorsal spine was performed, showing extensive longitudinal spinal injury. Secondary causes based on clinical observations and laboratory studies were ruled out. The dosage of anti-aquaporin 4 antibodies was positive. Acute treatment with high-dose glucocorticoids and plasmapheresis was indicated, and maintenance with rituximab, obtaining little clinical response. In patients with extensive spinal injuries, multiple differential diagnoses should be considered according to the clinical presentation, findings through imaging studies and epidemiology. Likewise, it should include the search for anti-aquaporin 4 antibodies and against the oligodendrocyte myelin glycoprotein, since the functional prognosis of these patients is usually unfavourable due to the large destructive component of the lesions. Consequently, early treatment is essential in order to limit acute damage and prevent future relapses, which is especially important in late presentations of this entity due to the low functional reserve and low remyelination capacity.

Prevalence of red blood cell alloimmunization in multiply transfused patients

Introduction: To analyze the prevalence of alloantibodies in multiply transfused patients. Methods: This study was a retrospective, exploratory and descriptive study with a quantitative approach. The study sample comprised 185 patients transfused at a referral service in the city of Passo Fundo, Rio Grande do Sul, from January 2016 to February 2018. Results: Overall, the antibodies identified were as follows: anti-E in 47 patients (18%), anti-D and anti-K in 28 patients each (11%), anti-C in 21 patients (8.1%), and inconclusive antibody results in 23 patients (8.9%). Females were a majority (55.7%), mean age was 48.8 years and mean quantity of blood transfused was 7.2 bags. Cardiovascular disorders were the most common comorbidities, in 39 patients (21.2%), followed by oncological disorders, in 38 patients (18.4%). Conclusion: Alloimmunization is an important and frequent clinical condition that increases the risk of hemolytic reactions and is associated with significant patient morbidity and mortality. (AU)

Evaluation of the Th17 pathway in psoriasis and geographic tongue

Abstract Background: Psoriasis is a skin-articular disease with unclear etiopathogenesis. It has been suggested that the disease is immune-mediated by T-lymphocytes, predominantly Th17 cells. Similar to psoriasis, geographic tongue is an inflammatory disease with participation of Th17 cells and direct correlation with psoriasis. Objective: To investigate and compare the inflammatory responses and the Th17 pathway in psoriasis and geographic tongue. Methods: This was a cross-sectional study with 46 participants that were categorized into three groups: (A) patients with psoriasis vulgaris; (B) patients with geographic tongue and psoriasis; (C) patients with geographic tongue without psoriasis. All patients underwent physical examination, and a skin and oral biopsy for histopathological examination and immunohistochemical analysis with anti-IL6, anti-IL17, and anti-IL23 antibodies. Results: Histological analysis of all lesions showed mononuclear inflammatory infiltrate. However, moderate intensity was prevalent for the patients with geographic tongue and psoriasis and geographic tongue groups. Immunopositivity for the antibodies anti-IL6, anti-IL17, and anti-IL23 revealed cytoplasmic staining, mainly basal and parabasal, in both psoriasis and geographic tongue. Regarding IL-6, in patients with geographic tongue and psoriasis cases the staining was stronger than in patients with geographic tongue without psoriasis cases. IL-17 evidenced more pronounced and extensive staining when compared to the other analyzed interleukins. IL-23 presented similar immunopositivity for both geographic tongue and psoriasis, demonstrating that the neutrophils recruited into the epithelium were stained. Study limitation: This study was limited by the number of cases. Conclusion: The inflammatory process and immunostaining of IL-6, IL-17, and IL-23 were similar in geographic tongue and psoriasis, suggesting the existence of a type of geographic tongue that represents an oral manifestation of psoriasis.

Utilidad de la determinación de anticuerpos en el diagnóstico de las enfermedades reumáticas / Usefulness of the determination of antibodies in the diagnosis of rheumatic diseases

Introducción: las enfermedades reumáticas son consideradas como una de las principales causas de discapacidad y de disminución de la percepción de calidad de vida relacionada con la salud. El daño articular y sistémico que producen conduce a un deterioro progresivo y crónico del cuerpo humano, de ahí que se hace necesario contar con herramientas diagnosticas que faciliten la sospecha clínica y el diagnóstico definitivo de la enfermedad. Objetivo: describir las bondades de la determinación de los anticuerpos circulantes en el diagnóstico de las enfermedades reumáticas. Métodos: se realizó una búsqueda en distintos sitios web para identificar artículos relacionados con la temática de estudio y que puedan publicados en los últimos cinco años. Resultados: se encontraron un total de 129 artículos, los cuales fueron revisados para conocer cuál es el papel que desempeñan los marcadores inmunológicos el diagnóstico de las enfermedades reumáticas. Las revistas que mayor número de artículos aportaron fueron la Revista Cubana de Reumatología (28,76 por ciento), la Revista Colombiana de Reumatología y la revista Reumatología Clínica (22,37 por ciento)). La búsqueda se realizó en sitios como Scopus, Latindex, Redalyc, ICE Web of Ciencie y Lilacs. Conclusiones: los marcadores inmunológicos representan una ayuda considerable para los profesionales de la salud en su afán de realizar el diagnóstico oportuno y precoz de las enfermedades reumáticas. Conjuntamente con las manifestaciones clínicas y los demás hallazgos de laboratorio, constituyen los pilares del diagnóstico de estas afecciones(AU)

Introduction : rheumatic diseases are considered one of the main causes of disability and decrease in the perception of quality of life related to health. The joint and systemic damage they cause leads to a progressive and chronic deterioration of the human body, which is why it is necessary to have diagnostic tools that facilitate clinical suspicion and the definitive diagnosis of the disease. Objective: describe the benefits of the determination of circulating antibodies in the diagnosis of rheumatic diseases. Methodology: a search was carried out in different websites to identify articles related to the topic of study and that could be published in the last five years. Results: a total of 129 articles were found, which were reviewed to determine the role of immunological markers in the diagnosis of rheumatic diseases. The journals that contributed the most articles were the Cuban Journal of Rheumatology (28.76 percent), the Colombian Journal of Rheumatology and the Clinical Rheumatology journal (22.37 percent). The search was carried out in sites such as Scopus, Latindex, Redalyc, ICE Web of Science and Lilacs. Conclusions: the immunological markers represent a considerable help for the health professionals in their desire to make the opportune and early diagnosis of the rheumatic diseases. Together with clinical manifestations and other laboratory findings, they are the cornerstones of the diagnosis of these conditions(AU)

Encefalopatía asociada a enfermedad tiroídea, un diagnóstico a tener en mente / Encephalopathy associated with thyroid disease, a diagnosis to take into account

Mujer de 54 años con antecedentes de Hipertensión arterial e Hipotiroidismo. Historia de aproximadamente 3 meses de evolución caracterizado al inicio por ánimo bajo, cambios en el comportamiento con aparición progresiva de conductas extraña, ideas delirantes y alucinaciones visuales y auditivas, junto con disminución en requerimientos de hormonas tiroídeas hasta la suspensión. Consulta en varios centros donde se cataloga como Trastorno depresivo severo con síntomas psicóticos, Síndrome confusional, Síndrome Psicótico. En este contexto se pesquisa Hipertiroidismo con títulos elevados de Anticuerpos Antitiroídeos e inicia tratamiento con Metimazol y Betabloqueo. Tras extenso estudio que descartan causas infecciosas, neoplásicas y autoinmunes; se inicia tratamiento con pulsos de Metilprednisolona con excelente y rápida respuesta clínica, la cual mantiene durante el curso del seguimiento con dosis decrecientes de corticoides.

A 54-year-old woman with a history of arterial hypertension and hypothyroidism. History of approximately 3 months of evolution characterized at the beginning by low mood, changes in behavior with progressive appearance of bizarre behaviors, delusional ideas and visual and auditory hallucinations. Consultation in several centers where it is classified as severe Depressive disorder with psychotic symptoms, Confusional syndrome, Psychotic syndrome. Hyperthyroidism is investigated with high titers of Antithyroid Antibodies and initiates treatment with Methimazole and Betablock. After extensive study that ruled out infectious, neoplastic and autoimmune causes; Treatment with Methylprednisolone pulses is initiated with excellent and rapid clinical response, which is maintained during the course of follow-up with decreasing doses of corticosteroid.

Diagnostic validity of biomarkers in Parkinson's Disease: systematic review and meta-analysis / Validad diagnóstica de biomarcadores en la enfermedad de Parkinson: una revisión sistemática y metaanálisis / Validade diagnóstica de biomarcadores na doença de Parkinson: revisão sistemática e meta-análise

ABSTRACT Objective: To identify biomarkers for Parkinson's disease, cerebrospinal fluid, blood, saliva, and urine. Method: The studies were collected from the Cochrane, LILACS, PubMed, SCOPUS, WEB OF SCIENCE, OpenGrey, ProQuest and Google Scholar databases starting from May 3, 2016 and updated on March 20, 2017. Twenty-two studies were evaluated, by the Quality Assessment Tool for Diagnostic Accuracy Studies and Review Manager 5.3. Results: Evidence shows that serum antibodies can be used as highly specific and accurate biomarkers for the diagnosis of Parkinson's disease at the outset. Biomarkers in the cerebrospinal fluid are related to increased motor severity, postural instability, gait abnormality, and cognitive impairment. Conclusion: Serum and cerebrospinal antibodies can be used as diagnostic biomarkers at the onset of the disease.

RESUMEN Objetivo: Identificar los biomarcadores para la enfermedad de Parkinson, el líquido cefalorraquídeo, la sangre, la saliva y la orina. Método: Los estudios fueron recolectados en las bases de datos Cochrane, LILACS, PubMed, SCOPUS, WEB OF SCIENCE, OpenGrey, ProQuest y Google Scholar, a partir del 3 de mayo de 2016 y actualizados el 20 de marzo de 2017. Se seleccionaron 22 estudios, evaluados por la Quality Assessment Tool for Diagnostic Accuracy Studies y el Review Manager 5.3. Resultados: La evidencia muestra que los anticuerpos séricos pueden ser utilizados como biomarcadores altamente específicos y precisos para el diagnóstico de la enfermedad de Parkinson en su inicio. Los biomarcadores en el líquido cefalorraquídeo están relacionados con el aumento de la severidad motora, la inestabilidad postural, el disturbio de la marcha y la declinación cognitiva. Conclusión: Los anticuerpos séricos y cefalorraquídeos pueden utilizarse como biomarcadores de diagnóstico al inicio de la enfermedad.

RESUMO Objetivo: Identificar os biomarcadores para a doença de Parkinson, no líquido cefalorraquidiano, sangue, saliva e urina. Método: Os estudos foram coletados nas bases de dados Cochrane, LILACS, PubMed, SCOPUS, WEB OF SCIENCE, OpenGrey, ProQuest e Google Scholar, a partir de 3 de maio de 2016 e atualizados em 20 de março de 2017. Foram selecionados 22 estudos, avaliados pelo Quality Assessment Tool for Diagnostic Accuracy Studies e o Review Manager 5.3. Resultados: A evidência mostra que os anticorpos séricos podem ser usados como biomarcadores altamente específicos e precisos para o diagnóstico da doença de Parkinson em seu início. Os biomarcadores no líquido cefalorraquidiano estão relacionados ao aumento da severidade motora, à instabilidade postural, ao distúrbio da marcha e ao declínio cognitivo. Conclusão: Os anticorpos séricos e cefalorraquidianos podem ser utilizados como biomarcadores de diagnóstico no início da doença.

Clinical and immunological characteristics of patients with systemic lupus erythematosus in Tibet plateau, China / 北京大学学报(医学版)

OBJECTIVE@#To describe the clinical, immunological characteristics and organ involvement of patients with systemic lupus erythematosus (SLE) in Tibet plateau, China.@*METHODS@#We retrospectively investigated 70 patients admitted in the Tibet Autonomous Region People's Hospital between May 2014 and April 2016. In the study, 120 hospitalized patients with SLE from the Department of Rheumatology and Immunology of the Peking University People's Hospital were randomly selected as the control (plain) group. The major organ involvement, clinical and immunological characteristics were compared between the two groups.@*RESULTS@#The female to male ratio of Tibet plateau group was 10.7, while the corresponding ratio of plain group was 11.0. The mean age at disease diagnosis was (32.21±11.40) and (35.38±13.25) years, respectively. the most common initial manifestations of SLE were arthritis (78.6%), alopecia (55.7%) and malar rash (48.6%) in Tibet plateau group, the prevalence of arthritis and alopecia was significantly higher than in plain group (P<0.05). The incidence of neuropsychiatric and kidney involvement was significantly lower in Tibet plateau group compared with plain group (P<0.05). As for the serological manifestations, the positivity of anti-double-stranded DNA (dsDNA) (57.1%), anti-Smith (Sm) antibody (55.7%), anti-Sjögren syndrome A (SSA) antibody (72.3%), anti-Sjögren syndrome B (SSB) antibody (41.4%) and anti-u1-ribosenuclear protein (u1RNP) antibody (45.7%) was significantly higher in Tibet plateau group (P<0.05). While the incidence of low serum complement C3 (61.4%), C4 (38.6%) less frequent in Tibet plateau group. Mean SLE disease activity index (SLEDAI) score was similar in the Tibet plateau group (12.18±5.58) and plain group (12.69±7.28). Moreover, there were 13 (18.6%) SLE patients suffering from tuberculosis and 7 (10%) SLE patients infected with hepatitis B virus in Tibet plateau group. The number of recent-onset SLE patients with lower 25-dihydroxy-vitamin D3 (25-OH-VD3) in Tibet plateau group was fewer than that in the plain group (76.7% vs. 90.0%, P=0.046). Serum 25-OH-VD3 levels in Tibet plateau plateau group were (31.14±18.74) nmol/L, those in plain group were (26.91±14.27) nmol/L, and the difference was not significant.@*CONCLUSION@#The age, gender and SLEDAI scores in Tibet plateau group was similar to those in plain group. But there are significant differences in clinical manifestations, distributions of antibodies and immunological changes between Tibet plateau group and plain group. The patients with lower serum 25-OH-VD3 levels were more in plain group than in Tibet plateau group, while there was no significant difference in the 25-OH-VD3 level between the two groups.

Valor diagnóstico de las proteínas uPAR en sangre para el cáncer gástrico en Guatemala / Diagnostic value of blood uPAR proteins for gastric cancer in Guatemala

El cáncer gástrico es la neoplasia más frecuente del tubo digestivo, Guatemala posee altas tasas de incidencia y mortalidad. Helicobacter pylori se ha identificado como un carcinógeno gástrico, especialmente si la infección es por cepas que expresen factor de virulencia CagA, asociado a lesiones atróficas y precancerosas. Reportes previos indican que el análisis de biopsias gástricas en pacientes positivos para H. pylori, muestran un incremento de la expresión del activador del plasminógeno uroquinasa (uPA) y su receptor (uPAR). El presente estudio tuvo como objetivo determinar el valor diagnóstico de uPAR en sangre como marcador de cáncer gástrico en Guatemala y la asociación de uPAR con la infección por de H. pylori. Se tomaron muestras sanguíneas de pacientes diagnosticados con cáncer gástrico (n = 68) y controles sanos apareados por edad y sexo (n = 136) en cuatro instituciones de la ciudad de Guatemala, se determinó uPAR e IgG anti H. pylori por metodología Elisa. Los niveles de uPAR en pacientes con cáncer estaban significativamente elevados (p < .001), no se encontró diferencia por edad, sexo, apariencia macroscópica o microscópica del tumor. El cáncer gástrico se asoció significativamente a H. pylori (p = .03). El coeficiente de correlación biserial indica una relación negativa débil (rb = -0.01, p = .443) entre uPAR y H. pylori. Las curvas ROC en uPAR reportaron alta precisión (área bajo la curva = .80) para identificar cáncer gástrico. Estos resultados sugieren que los niveles séricos de uPAR pueden tener valor en el diagnóstico cáncer gástrico.

Gastric cancer is the most frequent neoplasm of the digestive tract, Guatemala has high incidence and mortality rates. Helicobacter pylori has been identified as a gastric carcinogen, especially if the infection is by strains expressing virulence factor CagA which is associated with atrophic and precancerous lesions. Previous reports indicate that gastric biopsy analyses in H. pylori positive patients show increased expression of urokinase plasminogen activator (uPA) and its receptor (uPAR). The present study aimed to determine the diagnostic value of uPAR in blood as a marker of gastric cancer in Guatemala and the association of uPAR with infection by of H. pylori. Blood samples were collected from patients diagnosed with gastric cancer (n = 68) and healthy controls matched by age and sex (n = 136) at four institutions in Guatemala City and analyzed for uPAR and anti-H. pylori IgG. uPAR levels in cancer patients were found to be significantly elevated (p <.001), but were not influenced by age, sex, macroscopic or microscopic appearance of the tumor. Gastric cancer was significantly associated with H. pylori (p = .03). The serial correlation analysis used to determine the correlation of uPAR with H. pylori showed that there is a non-significant weak negative Pearson's correlation coefficient (r = -0.01, p = .443) between both. The ROC curves for uPAR indicated high precision (AUC = 0.80) for detection of gastric cancer. These results suggest that serum uPAR levels may be valuable in the diagnosis of gastric cancer.

Tristeza Parasitária em bovinos do semiárido pernambucano / Cattle Tick Fever in semi-arid of Pernambuco

Este estudo objetivou determinar a soroprevalência da Babesiose e Anaplasmose em bovinos dos municípios de Ouricuri e Petrolina, estado de Pernambuco, Brasil; e definir os possíveis fatores de risco para a ocorrência dessas doenças. Amostras de sangue foram coletadas para realização de teste sorológico por Imunofluorescência Indireta (RIFI). Questionários epidemiológicos sanitários foram aplicados aos produtores com o objetivo de identificar possíveis fatores de risco. Carrapatos foram coletados, identificados e testados por Reação em Cadeia da Polimerase (PCR) para o diagnóstico da infecção por Anaplasma marginale, Babesia bigemina e Babaesia bovis. O estudo foi conduzido com 861 bovinos, sendo 468 de Petrolina e 393 de Ouricuri. A soroprevalência de A. marginale, B. bigemina e B. bovis em Petrolina foi de 35,0% (164/468), 35,9% (168/468) e 32,3% (151/468), respectivamente; e em Ouricuri foi de 45,5% (179/393), 38,6% (152/393) e 54,9% (216/393), respectivamente. A co-infecção por Anaplasma spp. e Babesia spp. foi observada em 31,6% e 32,1% de amostras de Petrolina e Ouricuri, respectivamente. A detecção de DNA de Babesia spp. por PCR foi possível em 5,8% (8/137) carrapatos, dos quais em 62,5 % (5/8) foi detectada posteriormente infecção por B. bovis, e em 23,3% (32/137) por A. marginale. A presença de carrapatos, o uso de acaricidas, idade, raça, e o município de residência dos animais foram identificados como fatores de risco para TPB pela análise univariável e multivariável. Este estudo permitiu caracterizar os municípios estudados como de instabilidade enzoótica para esses hemoparasitos, e consequentemente, alertar para adoção de medidas adequadas de controle e realização de novos estudos.(AU)

This study aimed to determine the seroprevalence of Babesiosis and Anaplasmosis in cattle from the municipalities of Ouricuri and Petrolina, state of Pernambuco, Brazil, and to define the risk factors for the occurrence of the diseases. Blood samples were collected for serologic testing by Indirect Immunofluorescence Assay (IFA). Sanitary epidemiological questionnaires were applied to the producers aiming to identify possible risk factors. Ticks were collected, identified and tested by Polymerase Chain Reaction (PCR) for the diagnosis of infection by Anaplasma marginale, Babesia bigemina and Babesia bovis. The study was conducted with 861 cattle, being 468 in Petrolina and 393 in Ouricuri. The seroprevalence of A. marginale, B. bigemina and B. bovis in Petrolina was of 35.0% (164/468), 35.9% (168/468) and 32.3% (151/468), respectively; and in Ouricuri was 45.5% (179/393), 38.6% (152/393), and 54.9% (216/393), respectively. Co-infection for Anaplasma spp. and Babesia spp. was observed in 31.6% and 32.1% samples of Petrolina and Ouricuri, respectively. The detection of DNA of Babesia spp. by PCR was possible in 5.8% (8/137) ticks; which 62.5% (5/8) was detected later infection with B. bovis; and 23.3% (32/137) with A. marginale. The presence of ticks, the use of acaricide, age, race, and county of residence of the animals were identified as risk factors for TBD by univariate analysis and multivariate. This study allowed the characterization of the municipalities studied as enzootic instability areas for these hemoparasitic, and consequently alert for adoption of adequate control measures and new studies.(AU)

Tristeza Parasitária em bovinos do semiárido pernambucano / Cattle Tick Fever in semi-arid of Pernambuco

This study aimed to determine the seroprevalence of Babesiosis and Anaplasmosis in cattle from the municipalities of Ouricuri and Petrolina, state of Pernambuco, Brazil, and to define the risk factors for the occurrence of the diseases. Blood samples were collected for serologic testing by Indirect Immunofluorescence Assay (IFA). Sanitary epidemiological questionnaires were applied to the producers aiming to identify possible risk factors. Ticks were collected, identified and tested by Polymerase Chain Reaction (PCR) for the diagnosis of infection by Anaplasma marginale, Babesia bigemina and Babesia bovis. The study was conducted with 861 cattle, being 468 in Petrolina and 393 in Ouricuri. The seroprevalence of A. marginale, B. bigemina and B. bovis in Petrolina was of 35.0% (164/468), 35.9% (168/468) and 32.3% (151/468), respectively; and in Ouricuri was 45.5% (179/393), 38.6% (152/393), and 54.9% (216/393), respectively. Co-infection for Anaplasma spp. and Babesia spp. was observed in 31.6% and 32.1% samples of Petrolina and Ouricuri, respectively. The detection of DNA of Babesia spp. by PCR was possible in 5.8% (8/137) ticks; which 62.5% (5/8) was detected later infection with B. bovis; and 23.3% (32/137) with A. marginale. The presence of ticks, the use of acaricide, age, race, and county of residence of the animals were identified as risk factors for TBD by univariate analysis and multivariate. This study allowed the characterization of the municipalities studied as enzootic instability areas for these hemoparasitic, and consequently alert for adoption of adequate control measures and new studies.

Este estudo objetivou determinar a soroprevalência da Babesiose e Anaplasmose em bovinos dos municípios de Ouricuri e Petrolina, estado de Pernambuco, Brasil; e definir os possíveis fatores de risco para a ocorrência dessas doenças. Amostras de sangue foram coletadas para realização de teste sorológico por Imunofluorescência Indireta (RIFI). Questionários epidemiológicos sanitários foram aplicados aos produtores com o objetivo de identificar possíveis fatores de risco. Carrapatos foram coletados, identificados e testados por Reação em Cadeia da Polimerase (PCR) para o diagnóstico da infecção por Anaplasma marginale, Babesia bigemina e Babaesia bovis. O estudo foi conduzido com 861 bovinos, sendo 468 de Petrolina e 393 de Ouricuri. A soroprevalência de A. marginale, B. bigemina e B. bovis em Petrolina foi de 35,0% (164/468), 35,9% (168/468) e 32,3% (151/468), respectivamente; e em Ouricuri foi de 45,5% (179/393), 38,6% (152/393) e 54,9% (216/393), respectivamente. A co-infecção por Anaplasma spp. e Babesia spp. foi observada em 31,6% e 32,1% de amostras de Petrolina e Ouricuri, respectivamente. A detecção de DNA de Babesia spp. por PCR foi possível em 5,8% (8/137) carrapatos, dos quais em 62,5 % (5/8) foi detectada posteriormente infecção por B. bovis, e em 23,3% (32/137) por A. marginale. A presença de carrapatos, o uso de acaricidas, idade, raça, e o município de residência dos animais foram identificados como fatores de risco para TPB pela análise univariável e multivariável. Este estudo permitiu caracterizar os municípios estudados como de instabilidade enzoótica para esses hemoparasitos, e consequentemente, alertar para adoção de medidas adequadas de controle e realização de novos estudos.

Occurrence of antibodies to Toxoplasma gondii in scavenging black vultures (Coragyps atratus) in Brazil / Ocorrência de anticorpos anti-Toxoplasma gondii em urubus (Coragyps atratus) do Brasil

This is the first report of Toxoplasma gondii infection in black vultures (Coragyps atratus), which are obligate scavengers found throughout the Americas. Serum samples from 121 wild black vultures caught in urban areas of the city of São Paulo, Brazil, were tested for the presence of T. gondii antibodies using the modified agglutination test (MAT; cutoff point 1:5). T. gondii antibodies were found in 16 birds (13.2%), with titers of 1:5 (6 birds), 1:10 (8 birds), and 1:20 (2 birds).(AU)

Este é o primeiro relato de infecção por Toxoplasma gondii em urubus (Coragyps atratus) que são aves carniceiras obrigatórias, encontradas no continente americano. Amostras de soro de 121 urubus, capturados em área urbana da cidade de São Paulo, Brasil, foram testadas quanto à presença de anticorpos anti-T. gondii pelo teste de aglutinação modificada (MAT, ponto de corte de 1:5). Anticorpos foram encontrados em 16 (13,2%) aves com títulos de 1:5 (6 aves), 1:10 (8 aves) e 1:20 (2 aves).(AU)