Criptosporidiosis y una salud / Cryptosporidiosis and one health

RESUMEN Criptosporidiosis es una enfermedad diarreica (zoonótica) causada por el parásito Cryptosporidium, el cual infecta al intestino. Se producen tanto en el ser humano como en diferentes animales de granja, mascotas y animales silvestres. Se subestima su papel y poco se conoce sobre su epidemiología, debido al escaso interés que suscita y la limitada disponibilidad de métodos de diagnóstico. La salud de las poblaciones tanto humana como animal, están relacionadas con una estrecha interacción de tres factores: el ambiente, los agentes patógenos, y las poblaciones, lo cual determina el estado de salud y enfermedad. El enfoque, conocido como «Una Salud¼, es una estrategia global en crecimiento que se está adoptando por una diversidad de organizaciones y responsables de las políticas en respuesta a la necesidad de enfoques integrados. Este enfoque puede ser relevante para una amplia gama de objetivos mundiales de desarrollo. Cada vez se habla más de salud integral, de salud holística. Parece que somos más conscientes de que la salud no se reduce a algo puramente biológico, sino que afecta a toda la persona. No es sólo ver al enfermo globalmente, es partir de la complejidad del ser humano y del mundo entero atravesado por la vulnerabilidad e interaccionar con la totalidad de los sujetos.(AU)

ABSTRACT Cryptosporidiosis is a diarrheal disease (zoonotic) caused by the parasite Cryptosporidium, which infects the intestine. It occurs in humans and in different pets, farm and wild animals. Its role is underestimated and little is known about its epidemiology, due to the low interest it draws and the limited availability of diagnostic methods. The population health, both human and animal, is related to a close interaction of three factors: the environment, pathogens, and population, which determines the state of health and disease; some of the diseases considered as emerging, that appeared in the last years. The approach, known as "One Health", is a growing global strategy being adopted by a diversity of organizations and policy makers in response to the need for integrated approaches. This approach may be relevant to a wide range of global development goals. There is more and more talk about holistic health. It seems that we are more aware that health is not reduced to something purely biological, but affects the whole person. It is not only seeing the patient globally, it is starting from the complexity of the human being and the whole world crossed by vulnerability and interacting with the totality of the subjects.(AU)

Cryptosporidium spp. em idosos residentes em instituições de longa permanência no sul do Brasil / Cryptosporidium spp. in older adults living in long-term care facilities in southern Brazil

Introdução: A criptosporidiose é uma doença mundial, levando a quadros desde assintomáticos à diarreia grave. O presente estudo teve como objetivo detectar oocistos de Cryptosporidium spp. em idosos residentes em instituições de longa permanência na cidade de Lages, estado de Santa Catarina, Brasil, buscando avaliar a situação da parasitose, relativamente desconhecida na população idosa, foi avaliada por meio de um método diagnóstico fácil e de baixo custo, porém nem sempre realizado na rotina laboratorial. Métodos: Foram coletadas amostras dos exames Parasitológicos de fezes de 93 idosos residentes em instituições de longa permanência no período de setembro a novembro de 2015. Resultados: Os oocistos do protozoário foram detectados pela técnica de Ziehl-Neelsen modificada. A positividade para oocistos de Cryptosporidium spp. foi de 6,45% (6/93). Em relação ao sexo, a positividade foi de 8,9% (4/45) para mulheres e 2,1% (2/48) dos homens. Todos os pacientes tinham idade entre 60 e 70 anos. Em relação à consistência fecal, todas as amostras foram descritas como diarreia. Conclusão: A criptosporidiose é uma infecção parasitária importante e debilitante que afeta os idosos e precisa ser tratada. Os cuidadores devem estar cientes disso, para que tenham cuidados adequados, especialmente de higiene individual e uso de utensílios que podem transmitir a infecção aos demais idosos que residem nessas instituições. (AU)

Introduction: Cryptosporidiosis is a worldwide disease whose characteristics range from absence of symptoms to severe diarrhea. The present study aimed to detect Cryptosporidium spp. oocysts in older adults living in long-term care facilities in the city of Lages, state of Santa Catarina, Brazil. The situation of this parasitosis, which is relatively unknown in the older population, was evaluated using an easy and low-cost diagnostic method, although not always performed in laboratory routine. Methods: Stool samples were obtained from 93 older adults living in long-term care facilities from September to November 2015. Results: Protozoan oocysts were detected by the modified Ziehl-Neelsen technique. Positivity for Cryptosporidium spp. oocysts was 6.45% (6/93). Regarding sex, 8.9% (4/45) of women and 2.1% (2/48) of men were positive. All patients were aged between 60 and 70 years. Regarding fecal consistency, all samples were described as diarrhea. Conclusion: Cryptosporidiosis is an important, debilitating parasitic infection that affects older age and needs to be addressed. Caregivers must be aware of it in order to provide appropriate care, especially in terms of individual hygiene and use of tools that may transmit infection to other older adults living in these facilities. (AU)

Measurement of Elastic Modulus and Vickers Hardness of Surround Bone Implant Using Dynamic Microindentation - Parameters Definition

The clinical performance of dental implants is strongly defined by biomechanical principles. The aim of this study was to quantify the Vicker's hardness (VHN) and elastic modulus (E) surround bone to dental implant in different regions, and to discuss the parameters of dynamic microindantion test. Ten cylindrical implants with morse taper interface (Titamax CM, Neodent; 3.5 mm diameter and 7 mm a height) were inserted in rabbit tibia. The mechanical properties were analyzed using microhardness dynamic indenter with 200 mN load and 15 s penetration time. Seven continuous indentations were made distancing 0.08 mm between each other perpendicularly to the implant-bone interface towards the external surface, at the limit of low (Lp) and high implant profile (Hp). Data were analyzed by Student's t-test (a=0.05) to compare the E and VHN values obtained on both regions. Mean and standard deviation of E (GPa) were: Lp. 16.6 ± 1.7, Hp. 17.0 ± 2.5 and VHN (N/mm2): Lp. 12.6 ± 40.8, Hp. 120.1 ± 43.7. No statistical difference was found between bone mechanical properties of high and low profile of the surround bone to implant, demonstrating that the bone characterization homogeneously is pertinent. Dynamic microindantion method proved to be highly useful in the characterization of the individual peri-implant bone tissue.

O desempenho clínico de implantes dentais é fortemente definido por princípios biomecânicos. Este trabalho objetivou quantificar a Dureza Vickers (VHN) e módulo de elasticidade (E) do osso periimplantar e discutir parâmetros metodológicos de ensaio dinâmico de indentação. Foram utilizados 10 implantes de corpo cilíndrico com interface cone morse, (Titamax CM; Neodent, Curitiba, PR, Brasil), diâmetro de 3.5 mm e altura de 7 mm inseridos em tíbia de coelho recém obtidas após abate dos animais. As propriedades mecânicas foram analisadas usando penetrador dinâmico de microdureza Vickers (CSM Micro-Hardness Tester; CSM Instruments, Peseux, Switzerland) com carga de 200 mN e tempo de penetração de 15s. Foram feitas 7 indentações no osso cortical na base da rosca (Br) e na ponta da rosca (Pr) na direção perpendicular ao implante, com distância entre elas de 0,08 mm perpendicular a interface osso implante em direção a superfície esterna. Os dados foram analisados por meio de teste t-Student (P<0,05). O valores médios e desvio padrão de E (GPa) foram: Br. 16,6 ± 1,7A; Pr. 17,0 ± 2,5A e VHN (N/mm2): Br. 125,6 ± 40,8A; Pr. 120,1 ± 43,7A. Não houve diferença significativa entre as propriedades mecânicas avaliadas no osso na base e na ponta da rosca do implante, demonstrando que a caracterização desta estrutura de forma homogênea em análises computacionais é pertinente. O método de indentação dinâmica mostrou ser altamente útil na caracterização individualizada do tecido ósseo periimplantar.

[ Cryptosporidium ryanae infection commence in Iranian cattle]

Cryptosporidium as an intracellular parasite causes severe diarrhea in calves. Several cases of cryptosporidiosis have been reported in different Iranian regions. The aim of this study was to follow cryptosporidiosis occurrence in cattle husbandries of Semnan city in lran. Fecal samples were collected from 200 cows and calves, stained by modified Ziehl-Neelsen method and the cryptosporidium oocysts' size were determined. While the collected oocysts [n=40] showed a morphology similar to cryptosporidium parvumthey were smaller than this parasite. In this respect, their mean length, width and length to width ratio were 3.44 +/- 0.06 micro m, 3.55 +/- 0.06 micro m and 1.03, respectively. By considering these characteristics and the small size of Cryptosporidium ryanae[as a key characteristic for this species] infection with this species has been suggested. However, further molecular studies would be necessary. The mean prevalence of cryptosporidiosis was 17.5%. However, in diarrheal calves, numbers of positive samples were significantly more than the other cattle. In non diarrheal cases, the infection rate was remarkably higher in cattle when compared with heifers and calves. There was not any relation between number of positive cases and type of husbandry, source of water, base of stable and sex of cattle. However, there was positive correlation between number of infected cattle and quality of basement sanitation, the way of using detergents and number of cattle in husbandry. It can be conclude that cryptosporidium ryanae may affect cattle of husbandries in some Iranian regions as Semnan. Hence, improvement of management and good sanitation of husbandry should be considered as control measures

Acción de distintos coagulantes para la eliminación de Cryptosporidium spp. en el proceso de potabilización del agua / The action of different coagulants to remove Cryptosporidium during the process of water treatment

Cryptosporidium es uno de los microorganismos de mayor interés desde el punto de vista de la Salud Pública y constituye un problema prioritario para las plantas y organismos reguladores de agua. Debido a su pequeño tamaño y a su resistencia a la cloración, la eliminación por el proceso de potabilización es una tarea compleja. En este trabajo se analizó la efectividad de distintos coagulantes utilizados comúnmente en tal proceso para lograr la remoción de los ooquistes. Se trabajó con la prueba de jarras (Jar Test). Se halló que: 1) Los coagulantes con agregado de polímeros coadyuvantes producen remociones de ooquistes superiores a 2 log. 2) Un valor bajo de turbiedad no asegura una remoción óptima de los parásitos. 3) La adición de polielectrolitos al cloruro férrico disminuye la variabilidad tanto en la turbiedad final como en la eliminación de Cryptosporidium.

Cryptosporidium is one of the microorganisms of main concern from the point of view of Public Health, being a priority problem for water treatment plants and water regulatory institutions. Due to its small size and resistance to chlorination, Cryptosporidium removal during the process of drinking water treatmentis a hard task. The effectiveness of different coagulants commonly used in the process of removal of oocysts was analyzed. Thetechnique used was the Jar Test. It was found that: 1) coagulants with the addition of polimeric coadjuvants produce over 2 logs of oocyst removal; 2) a low value in turbidity does not necessarily mean optimal parasite removal, and 3) the addition of polyelectrolites to ferric chloride diminishes variability, both in final turbidity and Cryptosporidium removal.

Testing methods for detection of Cryptosporidium spp in water samples.

A large waterborne outbreak of cryptosporidiosis in Milwaukee, Wisconsin, USA in 1993 prompted a search for ways to prevent large-scale waterborne outbreaks of protozoan parasitoses. Methods for detecting Cryptosporidium parvum play an integral role in strategies that lead to appropriate treatment of surface water, but are criticized because they produce results that are highly variable. The US Environmental Protection Agency developed a set of criteria to evaluate detection methods for protozoan parasites in water. As a consequence, the Agency has had to develop approaches to reducing uncertainty of evaluations. The variability and accuracy of various methods of producing small numbers of Cryptosporidium spp oocysts were tested. The least variable and most accurate method was used to spike seven surface water, and one tap water sample to compare 4 detection methods that had been reported in the literature. The least variable and most accurate method for spiking specified numbers of oocysts into samples was found to be flow cytometry. The most effective of the methods tested for detection in surface, tap and reagent water was solid phase cytometry.

Prevalencia de criptosporidiosis en niños menores de 6 años y su relación con los factores de riesgo / Prevalence of criptosporidiosis in childrens less than 6 years and its relation with the risk factors

Se investigó la presencia de Cryptosporidium en heces de niños menores de 6 años pertenecientes a hogares de cuidado diario de dos sectores: marginal y no marginal de la ciudad de Maracaibo, Estado Zulia, Venezuela. Estudiamos entre los meses de abril y julio de 1954, 54 niños asintomáticos, a quienes le fueron recolectadas tres muestras fecales con un intervalo de 20 días, practicándose: examen al fresco, concentrado y frotis teñido con Ziehl Neelsen modificada. Se comparó la prevalencia en los dos sectores y fueron analizados como posibles factores de riesgo los siguientes hábitos personales como: chupar dedo, llevarse objetos a la boca y antecedentes de diarrea; condiciones de saneamiento en los hogares en letrinas, agua almacenada como fuente de agua y presencia de animales domésticos; y otros: procedencia de los alimentos y agua almacenada para la limpieza de los mismos. Se cuantificó la asociación de Cryptosporidium con otras parasitosis. La prevalencia de cryptosporidiosis durante el primer muestreo de heces en el sector no marginal fue 13,3 por ciento y en el sector marginal 29,1 por ciento durante el segundo muestreo fue 23,3 por ciento y 20,8 por ciento y durante el tercer muestreo fue 6,6 por ciento y 4,1 por ciento. No se evidenció diferencias significativas entre los dos sectores. La estimación del RD indicó que la presencia de infección por Cryptosporidium en los individuos expuestos a los diferentes factores de riesgo osciló entre 1,2 y 4,5 veces más que los no expuestos. Cryptosporidium se encontró asociado a otras especies parasitarias, siendo G.lamblia la más frecuentemente encontrada 53,5 por ciento. La importancia que puede adquirir Cryptosporidium en niños asintomáticos como fuentes de infección para brotes epidémicos en estos centros hace indispensable continuar realizando este tipo de investigaciones

Prevalencia de Cryptosporidium en muestras de materia fecal llevadas a diez laboratorios del Area Metropolitana de Bucaramanga, Colombia

Con la técnica de Kinyoun para Cryptosporodium se estudiaron 1988 muestras de materia fecal llevadas para estudio a diez laboratorios del área metropolitana de Bucaramanga, Colombia. Correspondían a 103 lactantes, 113 preescolares, 201 escolares, 1162 adultos jóvenes, 322 adultos mayores y 87 ancianos; 55.48 por ciento eran mujeres y el 97.94 por ciento vivían en zona urbana. Un 13.93 por ciento pertenecían a personas con diarrea. Se encontraron tres muestras positivas, todas en menores de dos años y con diarrea: 2.91 por ciento de los lactantes y el 4.69 por cientode los lactantes con diarrea. Con esto se confirma la presencia del parásito en el Nororiente colombiano, con una prevalencia similar a la encontrada en otras partes del país