Natural coinfection by Streptococcus agalactiae and Francisella noatunensis subsp. orientalis in farmed Nile tilapia (Oreochromis niloticus L.).

Streptococcus agalactiae and Francisella noatunensis subsp. orientalis (Fno) are important pathogens for farm-raised tilapia worldwide. There are no reports of coinfection caused by S. agalactiae and Fno in fish. This study aimed to determine the aetiology of atypical mortalities in a cage farm of Nile tilapia and to characterize the genetic diversity of the isolates. Fifty-two fish were sampled and subjected to parasitological and bacteriological examination. The S. agalactiae and Fno isolates were genotyped using MLST and REP-PCR, respectively. Whole-genome sequencing was performed to confirm the MLST results. Seven fish were shown coinfected by S. agalactiae and Fno. Chronic hypoxia and a reduction in the water temperature were determined as risk factors for coinfection. Fno isolates were shown clonally related in REP-PCR. The MLST analysis revealed that the S. agalactiae isolates from seven coinfected fish were negative for the glcK gene; however, these were determined to be members of clonal complex CC-552. This is the first description of coinfection by S. agalactiae and Fno in farm-raised Nile tilapia. The coinfection was predisposed by chronic hypoxia and was caused by the main genotypes of S. agalactiae and Fno reported in Brazil. Finally, a new S. agalactiae genotype with glcK gene partially deleted was described.

Whole-Genome Sequence of Francisella noatunensis subsp. orientalis Strain FNO01 Isolated from Diseased Nile Tilapia in Brazil.

This paper describes the complete genome sequence of Francisella noatunensis subsp. orientalis strain FNO01, which was isolated during the first outbreak of francisellosis in cultured Nile tilapia in Brazil. The genome is composed of a circular chromosome with 1,859,830 bp and a G+C content of ~32%.

Complete Genome Sequences of Fish Pathogenic Weissella ceti Strains WS74 and WS105.

We describe here the genome sequencing and annotation of Weissella ceti strains WS74 and WS105, isolated from diseased rainbow trout in Brazil. The two genomes were sequenced with an Ion Torrent personal genome machine (PGM) using a fragment library. The genomes of strains WS74 and WS105 consist of circular chromosomes 1,389,513 bp and 1,390,396 bp long, respectively, both presenting a G+C content of 40.75%.

Whole-Genome Sequence of Weissella ceti Strain WS08, Isolated from Diseased Rainbow Trout in Brazil.

We report here the complete genome sequence of Weissella ceti strain WS08, an emerging pathogen to farm-raised rainbow trout. The genome of strain WS08 is composed of a circular chromosome with 1,355,853 bp and a G+C content of 40.78%.

Ultrasound-guided injection of the maxillary nerve in the horse.

REASONS FOR PERFORMING STUDY: Infiltration of the equine maxillary nerve with local anaesthetic can be useful for both diagnostic and surgical procedures. The deep location and proximity of the nerve to surrounding vascular and orbital structures make an accurate, complication-free injection a challenge using traditional techniques reliant upon surface anatomical landmarks. OBJECTIVES: To develop an ultrasound-guided injection technique of the maxillary nerve in equine cadavers and to evaluate its efficacy and potential for complications in vivo. STUDY DESIGN: Descriptive cadaver anatomical and clinical study. METHODS: The relevant anatomy of the pterygopalatine fossa was reviewed in 6 cadaver heads from mature horses of a range of ages, breeds and genders. In an additional 13 cadaver heads, ultrasound-guided injection of 0.2 ml New Methylene Blue dye was performed on both left and right maxillary nerves (n = 26 attempts) in the pterygopalatine fossa. An independent observer dissected the area and recorded the number of times that dye successfully contacted the nerve, along with inadvertent penetration of other structures. The procedure was then performed on 8 clinical cases undergoing a variety of standing surgical procedures on the head. RESULTS: Dye was successfully deposited in contact with the nerve during all attempts on cadaver heads, with no penetration of the orbital cone, deep facial vein and maxillary artery or associated branches. In a single cadaver, a unilateral gas artefact in the masseter muscle prohibited an injection attempt. Analgesia of the maxillary nerve was achieved in <15 min in all clinical cases, with complete loss of ipsilateral cutaneous sensation over the rostral face. No gross or ultrasonographic abnormalities were detected following the procedure. CONCLUSIONS: Using ultrasonographic landmarks of the pterygopalatine fossa, local anaesthetic can be deposited around the maxillary nerve without the inadvertent penetration of adjacent vital structures. POTENTIAL RELEVANCE: The technique allows for vascular structures to be visualised and avoided, which is currently not possible using traditional blind approaches.

Cervical vertebral canal endoscopy in a horse with cervical vertebral stenotic myelopathy.

A 3-year-old Thoroughbred gelding presented with a history of neurological signs, including incoordination in his hindlimbs, of about 7 months' duration. On initial examination, the horse exhibited ataxia and paresis in all limbs with more severe deficits in the hindlimbs. Cervical radiographs displayed severe osteoarthritis of the articular processes between C5 and C6. On subsequent cervical myelography the dorsal contrast column was reduced by 90% at the level of the intervertebral space between C5 and C6. Cervical vertebral canal endoscopy, including epidural (epiduroscopy) and subarachnoid endoscopy (myeloscopy), was performed under general anaesthesia. A substantial narrowing of the subarachnoid space at the level between C6 and C7 was seen during myeloscopy, while no compression was apparent between C5 and C6. Epiduroscopy showed no abnormalities. After completion of the procedure, the horse was subjected to euthanasia and the cervical spinal cord submitted for histopathological examination. Severe myelin and axon degeneration of the white matter was diagnosed at the level of the intervertebral space between C6 and C7, with Wallerian degeneration cranially and caudally, indicating chronic spinal cord compression at this site. Myeloscopy was successfully used to identify the site of spinal cord compression in a horse with cervical vertebral stenotic myelopathy, while myelography results were misleading.

Cervical vertebral canal endoscopy in the horse: intra- and post operative observations.

REASONS FOR PERFORMING STUDY: Despite modern medical diagnostic imaging, it is not possible to identify reliably the exact location of spinal cord compression in horses with cervical vertebral stenotic myelopathy (CVSM). Vertebral canal endoscopy has been successfully used in man and a technique for cervical vertebral canal endoscopy (CVCE) has been described in equine cadavers. OBJECTIVE: To determine the feasibility and safety of CVCE in healthy mature horses. METHODS: Six healthy mature horses were anaesthetised. A flexible videoendoscope was subsequently introduced via the atlanto-occipital space into the epidural space (epiduroscopy, Horses 1-3) or the subarachnoid space (myeloscopy, Horses 4-6) and advanced to the 8th cervical nerve. Neurological examinations were performed after surgery and lumbosacral cerebrospinal fluid (CSF) analysed in horses that had undergone myeloscopy. RESULTS: All procedures were completed successfully and all horses recovered from anaesthesia. Anatomical structures in the epidural space (including the dura mater, nerve roots, fat and blood vessels) and subarachnoid space (including the spinal cord, blood vessels, arachnoid trabeculations, nerve roots and the external branch of the accessory nerve) were identified. During epiduroscopy, a significant increase in mean arterial pressure was recognised, when repeated injections of electrolyte solution into the epidural space were performed. In one horse of the myeloscopy group, subarachnoid haemorrhage and air occurred, resulting in transient post operative ataxia and muscle fasciculations. No complications during or after myeloscopy were observed in the other horses. CSF analysis indicated mild inflammation on Day 7 with values approaching normal 21 days after surgery. CONCLUSIONS: Endoscopic examination of the epidural and subarachnoid space from the atlanto-occipital space to the 8th cervical nerve is possible and can be safely performed in healthy horses. POTENTIAL RELEVANCE: Cervical vertebral canal endoscopy might allow accurate identification of the compression site in horses with CVSM and aid diagnosis of other lesions within the cervical vertebral canal.

Endoscopic anatomy of the cervical vertebral canal in the horse: a cadaver study.

REASON FOR PERFORMING STUDY: Localisation of spinal cord compression in horses with cervical vertebral stenotic myelopathy is inexact. Vertebral canal endoscopy has been used in man to localise spinal cord lesions and has the potential to become a useful diagnostic technique in horses. OBJECTIVE: To establish a surgical approach via the atlanto-occipital space to the cervical vertebral canal in equine cadavers and describe the endoscopic anatomy of the cervical epidural and subarachnoid spaces. METHODS: The cadavers of 25 mature horses were used to assess 3 surgical methods to approach the cervical vertebral canal, including 2 minimally invasive and one open technique. Once the approach had been made, a flexible videoendoscope was inserted into the epidural space (epiduroscopy) or the subarachnoid space (myeloscopy) and advanced caudally until the intervertebral space between C7 and T1 was reached. RESULTS: The epidural and subarachnoid spaces could not be accessed reliably using the minimally invasive techniques. Furthermore, damage to the nervous tissues was a frequent complication with these procedures. The open approach allowed successful insertion of the videoendoscope into the epidural and subarachnoid spaces in all horses and no inadvertent damage was observed. Anatomical structures that could be seen in the epidural space included the dura mater, nerve roots, fat and the ventral internal vertebral venous plexus. In the subarachnoid space, the spinal cord, nerve roots, blood vessels, denticulate ligaments and external branch of the accessory nerve were seen. CONCLUSIONS: Using the open approach, epiduroscopy and myeloscopy over the entire length of the cervical vertebral canal are possible in the mature horse. POTENTIAL RELEVANCE: Cervical vertebral canal endoscopy may become a valuable tool to localise the site of spinal cord injury in horses with cervical vertebral stenotic myelopathy and could aid in the diagnosis of other diseases of the cervical spinal cord.

Detection of Treponema pallidum sp pallidum DNA in latent syphilis.

In this study, polymerase chain reaction (PCR) techniques were used to detect Treponema pallidum DNA in samples from patients with latent syphilis. Sixty-nine patients with latent syphilis and 18 with treated syphilis were included. Whole blood, plasma, sera and ear scrapings, totalling 235 samples from patients with latent syphilis, were obtained. Three PCR assays (47-PCR, polA-PCR and M-PCR assays) were performed. The 47-PCR yielded the highest number of positive samples -92/235 (39.1%), followed by M-PCR -90/235 (38.3%) and polA-PCR -73/235 (31.1%). Ear scrapings presented the highest number of positives (47/84 -56%), followed by plasma samples (36/84 -42.9%), whole blood (32/84 -38.1%) and sera (21/84 -25%). In conclusion, we have confirmed that T. pallidum can be found in blood of patients with latent syphilis. The 47-PCR technique was found to be the most sensitive, whereas ear lobe scrapings seem to be the best specimen for detection of T. pallidum DNA in latent syphilis.

Taxis but not private cars are mite allergen reservoirs in Brazil.

Indoor allergens are major causative agents in allergic disease development. Besides homes, public transport vehicles have been considered important mite and pet allergen reservoirs. Our recent studies on allergen exposure in automobiles showed that different allergen levels are found in private cars versus taxis. We quantified group 1 Dermatophagoides spp. (Der 1), Felis domesticus (Fel d 1), and Canis familiaris (Can f 1) allergen levels by ELISA in dust samples from 60 taxi and 60 private car upholstered seats. Mean levels of Der 1 and Fel d 1 were significantly higher in taxis than private cars. A significantly higher percentage of taxis (42%) harboring sensitizing levels of Der 1 compared to private cars (5%) was also found. In spite of the low mean Fel d 1 levels, comparison of the percentage of vehicles with moderate Fel d 1 levels showed a significant difference between taxis and private cars (43% vs. 20%). On the other hand, mean Can f 1 levels were significantly higher in private cars compared to taxis concomitant with a significantly higher percentage of private cars containing moderate Can f 1 levels than taxis (53% vs. 28%). We conclude that upholstered seats from Brazilian taxis but not private cars constitute an important mite allergen reservoir. Thus, additional effective measures for the reduction of allergen exposure in vehicles within the global allergen avoidance strategy should also be routinely accomplished to minimize the induction of sensitization and symptoms in allergic patients.

Sewage outfall plume dispersion observations with an autonomous underwater vehicle.

This work represents one of the first successful applications of Autonomous Underwater Vehicles (AUVs) for interdisciplinary coastal research. A monitoring mission to study the shape and estimate the initial dilution of the S. Jacinto sewage outfall plume using an AUV was performed on July 2002. An efficient sampling strategy enabling greater improvements in spatial and temporal range of detection demonstrated that the sewage effluent plume can be clearly traced using naturally occurring tracers in the wastewater. The outfall plume was found at the surface highly influenced by the weak stratification and low currents. Dilution varying with distance downstream was estimated from the plume rise over the outfall diffuser until a nearly constant value of 130:1, 60 m from the diffuser, indicating the near field end. Our results demonstrate that AUVs can provide high-quality measurements of physical properties of effluent plumes in a very effective manner and valuable considerations about the initial mixing processes under real oceanic conditions can be further investigated.

[Recreational activities for parents of risk babies: experience at the Clinics Hospital of Ribeirao Preto]. / Lazer para pais de bebês de risco: a experiência junto ao Hospital das Clínicas de Ribeirão Preto.

The nursing team at the University of São Paulo Hospital has implemented actions directed to parents, such as support groups, training for hospital discharge and their involvement in the progressive care to their children. Aiming at expanding such care, the authors have implemented a support program involving ludic and recreational activities with the parents of hospitalized preterm babies under risk. The account of this experience is the object of this work. The interventions were performed by a group of nursing students who gather with the parents weekly for a period of two hours and develop group-dynamics techniques; leisure activities; creativity workshops involving manual work and discussions on themes concerning personal and environmental hygiene. Through these new care strategies directed to parents, the authors expect to contribute to the process of construction of more integral and humanized care in the area of neonatology by focusing on the family.

[Double origin of anterior descending artery--from the left and right coronary arteries--associated with anomalous origin of the circumflex artery]. / Dupla origem do ramo descendente anterior--das coronárias esquerda e direita--associada a origem anômala à direita do ramo circunflexo.

A 65 year-old white man, with typical angina pectoris, underwent coronary angiography that showed dual left anterior descending artery (LAD), originating from the right coronary artery (RCA), associated with anomalous origin of the left circumflex artery (LCX) also from the RCA. This an extremely rare coronary artery anomaly and, it is the first case reported, so far. This rareness and clinical significance are emphasized.

A new optimization based approach to experimental combination chemotherapy.

A new approach towards the design of optimal multiple drug experimental cancer chemotherapy is presented. Once an adequate model is specified, an optimization procedure is used in order to achieve an optimal compromise between after treatment tumor size and toxic effects on healthy tissues. In our approach we consider a model including cancer cell population growth and pharmacokinetic dynamics. These elements of the model are essential in order to allow less empirical relationships between multiple drug delivery policies, and their effects on cancer and normal cells. The desired multiple drug dosage schedule is computed by minimizing a customizable cost function subject to dynamic constraints expressed by the model. However, this additional dynamic wealth increases the complexity of the problem which, in general, cannot be solved in a closed form. Therefore, we propose an iterative optimization algorithm of the projected gradient type where the Maximum Principle of Pontryagin is used to select the optimal control policy.