Phylodynamic analysis of foot-and-mouth disease virus evolution in Mar Chiquita, Argentina.

Foot-and-mouth disease is a highly contagious disease affecting cloven-hoofed animals, resulting in considerable economic losses. Its causal agent is foot-and-mouth disease virus (FMDV), a picornavirus. Due to its error-prone replication and rapid evolution, the transmission and evolutionary dynamics of FMDV can be studied using genomic epidemiological approaches. To analyze FMDV evolution and identify possible transmission routes in an Argentinean region, field samples that tested positive for FMDV by PCR were obtained from 21 farms located in the Mar Chiquita district. Whole FMDV genome sequences were obtained by PCR amplification in seven fragments and sequencing using the Sanger technique. The genome sequences obtained from these samples were then analyzed using phylogenetic, phylogeographic, and evolutionary approaches. Three local transmission clusters were detected among the sampled viruses. The dataset was analyzed using Bayesian phylodynamic methods with appropriate coalescent and relaxed molecular clock models. The estimated mean viral evolutionary rate was 1.17 × 10- 2 substitutions/site/year. No significant differences in the rate of viral evolution were observed between farms with vaccinated animals and those with unvaccinated animals. The most recent common ancestor of the sampled sequences was dated to approximately one month before the first reported case in the outbreak. Virus transmission started in the south of the district and later dispersed to the west, and finally arrived in the east. Different transmission routes among the studied herds, such as non-replicating vectors and close contact contagion (i.e., aerosols), may be responsible for viral spread.

A participatory surveillance of marsh deer (Blastocerus dichotomus) morbidity and mortality in Argentina: first results.

BACKGROUND: In an era of unprecedented socio-ecological changes, managing wildlife health demands high-quality data collection and the engagement of local communities. Blastocerus dichotomus, the largest South American deer, is Vulnerable to extinction mainly due to habitat loss. Diseases have been recognised as a potential threat, and winter mortality has been historically described in marsh deer populations from Argentina. Field difficulties have, however, prevented in-depth studies of their health status. RESULTS: Between May 2014 and April 2017, we investigated marsh deer morbidity and mortality in the two largest populations in Argentina. We collected data by means of a passive surveillance system that involved a network of researchers, field partners (veterinarians, park rangers, and local community), and decision makers. We sampled marsh deer during as well as outside mortality events. A total of 44 marsh deer with different body condition scores were evaluated. We obtained haematology and biochemistry values from animals with good body condition score. Marsh deer with poor body condition had a high burden of the ticks Amblyomma triste and Rhipicephalus microplus. Vector-borne agents such as Theileria cervi, Trypanosoma theileri, Trypanosoma evansi, Ehrlichia chaffeensis, Anaplasma platys, Anaplasma odocoilei, Anaplasma marginale, and Candidatus Anaplasma boleense were also found. Haemonchus spp., Ostertagia spp., and Trichostrongylus spp. were the most frequent gastrointestinal parasites in deer with poor body condition. A Multiple Correspondence Analysis reinforced a possible association of winter period with lower body score condition, high tick loads, infection with E. chaffeensis, and presence of harmful gastrointestinal parasites. CONCLUSIONS: Our approach allowed the establishment of a participatory surveillance network of marsh deer morbidity and mortality in Argentina. We report and analyse the first data obtained opportunistically within the framework of this network, providing information on the infectious and parasitic agents in marsh deer populations. The occurrence of Fasciola hepatica and Leptospira interrogans serovar pyrogenes is reported for the first time in wild marsh deer from Argentina. Our data will be useful to improve the interpretation of future mortality events. The field implementation of a surveillance network is key to a holistic approach to wildlife diseases.

Toxoplasma gondii and Trichinella infections in wild boars (Sus scrofa) from Northeastern Patagonia, Argentina.

Wild boar (Sus scrofa) was introduced in many countries of the world and is recognized as carrier of many infectious diseases. Wild game meat consumption is recognized as a source of transmission of Toxoplasma gondii and Trichinella spp. The aim of the present study was to evaluate the prevalence of antibodies to T. gondii and Trichinella spp. in free-range wild boars in Northeastern Argentine Patagonia. Between 2014 and 2018, 144 blood samples and 423 muscle samples from 423 carcasses were collected. To detect T. gondii IgG, 144 sera were processed by an immunofluorescent antibody test, and to detect anti-Trichinella IgG, 125 sera and 304 muscle juice samples were processed by ELISA. Detection of first stage larvae in muscle was performed by artificial digestion. A total of 423 wild boars muscle samples were negative to Trichinella spp. by artificial digestion. Antibodies to Trichinella spp. were detected in 2.4% (3/125) of serum samples and in 1.64% (5/304) of meat juice samples. Antibodies to T. gondii infection were detected in 12.5% (18/144) of the serum samples. This is the first study to reveal the presence of antibodies to T. gondii in wild boars from Argentina. The present results suggest that consumption of raw or undercooked wild boar meat could represent a potential source risk for toxoplasmosis in humans and that Trichinella spp. is infrequent and/or that it circulates in low burdens among wild boars in Northeastern Patagonia.

Quantitative Risk Assessment of Foot-and-Mouth Disease (FMD) Virus Introduction Into the FMD-Free Zone Without Vaccination of Argentina Through Legal and Illegal Trade of Bone-in Beef and Unvaccinated Susceptible Species.

Argentina is a foot-and-mouth disease (FMD)-free country divided into five zones associated to disparate epidemiological situations and control strategies. Two zones are free from FMD with vaccination and three without vaccination. Quantitative risk assessment was used here to estimate the risk of introduction of FMD virus (FMDV) into the Argentine FMD-free without vaccination zone via legal or illegal trade of bone-in beef and non-vaccinated live animals from the FMD-free zone with vaccination of the country. Because trade of those commodities between those two zones is currently banned in Argentina, the analysis here will help evaluating the impact of relaxing such prohibition in the national regulation and the impact of illegal trade. Results suggest that if the volume of incoming bone-in beef is equal to the volume of deboned beef that enters the non-vaccinating zone, the annual risk of an FMDV introduction to the zone without vaccination will be low (0.0017). Indeed, the risk of introduction per kg trade volume via illegal trade is 6.9 times higher compared to legal trade. Similarly, the annual risk was also low for movement of live sheep and goat (0.0059) and swine (0.007) when the FMDV was assumed to be adapted to bovine and when a serological test was performed prior to movement. The implementation of a serological test to sheep and goat reduces 19 times the risk for FMDV introduction. In conclusion, the risk of introduction of FMDV into the FMD-free zone without vaccination through bone-in beef, sheep, goat, and swine with certain requirements, such as serological testing, is nil. If legal trade was allowed, the incoming risk may even be lower, compared to the current scenario of prohibiting the introduction. Results are likely due to the controls associated to legal trade, and the subsequent reduction of illegal trade. Consequently, results suggest that a policy of incentive and facilitation of good practices may be more effective in preventing FMDV introduction into a free zone than prohibition of trade.

[Evaluation of intima-media thickness in patients with chronic kidney disease not on dialysis: a prospective study of 24 months]. / Avaliacao da espessura medio-intimal em pacientes com doenca renal cronica nao dialitica: estudo prospectivo de 24 meses.

INTRODUCTION: Increased carotid intima-media thickness (IMT) is considered a marker of early-onset atherosclerosis and it seems to predict cardiovascular events in general population. The prognostic value of IMT in patients with early-stage chronic kidney disease (CKD) has not been clearly established. OBJECTIVE: We aimed to evaluate the association between IMT and cardiovascular (CV) events and mortality in CKD patients. METHODS: A cohort of CKD patients in stage 2-4 was evaluated the occurrence of CV events and death in a 24 months follow-up. Laboratory data, carotid ultrasound and coronary computed tomography were performed at baseline. RESULTS: A total of 117 patients (57 ± 11 years-old, 61% male) were evaluated. Mean glomerular filtration rate (eGFR) was 36 ± 17 mL/min, 96% of patients had hypertension, 23% diabetes and 27% were obese. Coronary calcification was found in 48% of the patients, with higher prevalence among CKD stage 4 (p = 0.02). The median value of IMT was 0.6 mm (0.4-0.7 mm). When compared to patients with IMT ≤ 0.6 mm, those with IMT > 0.6 mm were older (p = 0.001), had higher prevalence of male (p = 0.001) and had lower eGFR (p = 0.01). These patients also had higher prevalence of coronary calcification (p = 0.001). During the follow-up, there were no differences in the occurrence of cardiovascular events and deaths between the two groups. CONCLUSION: IMT in early-stage CKD patients was related to coronary calcification, but not with the occurrence of cardiovascular events or death.

Avaliacao da espessura medio-intimal em pacientes com doenca renal cronica nao dialitica: estudo prospectivo de 24 meses / Evaluation of intima-media thickness in patients with chronic kidney disease not on dialysis: a prospective study of 24 month

Introdução: O aumento da espessura média-intimal (EMI) avaliada por ultrassom é um preditor de risco cardiovascular na população geral. Porém, em pacientes com doença renal crônica nos estágios iniciais, essa associação ainda não está bem estabelecida. Objetivo: Avaliar a associação EMI com a ocorrência de eventos cardiovasculares e mortalidade em pacientes nos estágios iniciais da doença renal crônica. Métodos: A análise post hoc de uma coorte de pacientes nos estágios 2-4 da DRC. Foram avaliados dados laboratoriais, ultrassom da artéria carótida e tomografia coronariana no início do estudo e a ocorrência de óbito, em seguimento por 24 meses. Resultados: Um total de 117 pacientes (57 ± 11 anos, 61% sexo masculino) foram avaliados. A taxa de filtração glomerular foi 36 ± 17 mL/min, 96% dos pacientes eram hipertensos, 23% diabéticos e 27% obesos. Calcificação arterial coronariana esteve presente em 48% dos pacientes, sendo mais prevalente em pacientes nos estágios mais avançados da DRC (p = 0,02). EMI foi 0,6 mm (0,4-0,7 mm). Comparado aos pacientes com EMI < 0,6mm, aqueles com EMI ≥ 0,6 mm eram mais velhos (p = 0,001), apresentavam maior prevalência do sexo masculino (p = 0,001), menor taxa de filtração glomerular (p = 0,01) e maior proporção de pacientes com calcificação (p = 0,001). Não foi observada relação entre a espessura média-intimal e a ocorrência de evento cardiovascular e óbito. Conclusão: A espessura médio-intimal em pacientes DRC se associou à calcificação coronariana, mas não à ocorrência de eventos cardiovasculares e óbito, em um seguimento de 24 meses. .

Introduction: Increased carotid intima-media thickness (IMT) is considered a marker of early-onset atherosclerosis and it seems to predict cardiovascular events in general population. The prognostic value of IMT in patients with early-stage chronic kidney disease (CKD) has not been clearly established. Objective: We aimed to evaluate the association between IMT and cardiovascular (CV) events and mortality in CKD patients. Methods: A cohort of CKD patients in stage 2-4 was evaluated the occurrence of CV events and death in a 24 months follow-up. Laboratory data, carotid ultrasound and coronary computed tomography were performed at baseline. Results: A total of 117 patients (57 ± 11 years-old, 61% male) were evaluated. Mean glomerular filtration rate (eGFR) was 36 ± 17 mL/min, 96% of patients had hypertension, 23% diabetes and 27% were obese. Coronary calcification was found in 48% of the patients, with higher prevalence among CKD stage 4 (p = 0.02). The median value of IMT was 0.6 mm (0.4-0.7 mm). When compared to patients with IMT ≤ 0.6 mm, those with IMT > 0.6 mm were older (p = 0.001), had higher prevalence of male (p = 0.001) and had lower eGFR (p = 0.01). These patients also had higher prevalence of coronary calcification (p = 0.001). During the follow-up, there were no differences in the occurrence of cardiovascular events and deaths between the two groups. Conclusion: IMT in early-stage CKD patients was related to coronary calcification, but not with the occurrence of cardiovascular events or death. .

Cariótipo fetal: podemos confiar sempre no seu resultado? / Fetal karyotype: can we always trust its result?

Estudo retrospectivo de seis casos em que houve discrepância entre cariótipo pré-natal e achados pós-natais. Em cinco deles as anomalias cromossômicas que foram encontradas inicialmente pela biópsia de vilosidades coriônicas ou amniocentese não foram compatíveis com resultados posteriores. Já em um caso, o cariótipo inicial normal pela biópsia de vilosidades coriônicas necessitou de novo controle devido ao aparecimento de sinais ultra-sonográficos pré-natais e sinais clínicos pós-natais. Na maioria dos casos a evolução favorável ultra-sonográfica foi o que levantou a dúvida sobre o cariótipo inicial anormal. Quando os achados ultra-sonográficos são discordantes do cariótipo encontrado inicialmente, muita cautela é necessária na interpretação dos resultados e no aconselhamento genético desses casais. O mosaicismo confinado à placenta é uma das principais causas de resultados discordantes. Desta forma, a interpretação do cariótipo fetal depende da correlação com os achados clínicos/ultra-sonográficos pré-natais.

Tratamento de condiloma acuminado com imiquimod em lactente: relato de caso / Treatment of condyloma acuminata with imiquimod in infant: a case report

Objetivo: relatar o tratamento de condiloma acuminado em lactente com o uso de imiquimod. Descrição de caso: um condiloma acuminado extenso em região de grandes e pequenos lábios, vulvar e perianal, em criança de 17 meses, evoluiu de forma insatisfatória sob tratamento local com o ácido tricloroacético a 80 por cento, durante 4 meses / Objective: to report the treatment evolution in an infant with condyloma acuminatum with the application of imiquimod. Case description: an extended condyloma acuminatum in the vaginal labia, vulvae and perianal region, in a 17 months old child, responded insufficiently to local treatment with trichloroacetic acid 80 per cent during a four months old child, responded insufficiently to local treatment...

Morbidade febril puerperal em pacientes infectadas pelo HIV / Puerperal morbidity in HIV-positive women

OBJETIVO: avaliar as taxas de morbidade febril puerperal em pacientes infectadas pelo HIV e sua correlaçäo com a via de parto, duraçäo do trabalho de parto, tempo de rotura de membranas, número de células CD4+ e carga viral do HIV periparto. MÉTODOS: foram incluídas 207 gestantes infectadas pelo HIV, com seguimento pré-natal e parto entre maio de 1997 e dezembro de 2001, sendo 32 submetidas a parto vaginal e 175 a cesárea. Do total de pacientes, 62,8 por cento foram submetidas a cesárea eletiva. A idade média no grupo analisado foi de 27,4 anos, 25,6 por cento eram nulíparas e 26 por cento primíparas, com idade gestacional média de 37,8 semanas no momento do parto. A contagem média de células CD4+ foi de 481 células /mm3 e da carga viral do HIV de 49.100 cópias/mL, ambas no final da gestaçäo. RESULTADOS: a morbidade febril puerperal ocorreu em 34 pacientes, sendo 33 pós-cesárea e 1 pós-parto vaginal. O tipo mais comum de intercorrência infecciosa pós-cesárea foi infecçäo de cicatriz cirúrgica (13 por cento dos casos de infecçäo). Os fatores analisados, como duraçäo do trabalho de parto, tempo de rotura de membranas, contagem de células CD4+ ou carga viral do HIV periparto, näo interferiram na taxa de morbidade febril puerperal. CONCLUSÕES: A incidência de morbidade febril puerperal foi de 16,8 por cento, sendo mais freqüente pós-cesárea (18,9 por cento) que pós-parto vaginal (3,1 por cento). Os demais fatores näo mostraram relaçäo significativa com a taxa de morbidade febril puerperal