Occurrence and risk factors of Coxiella burnetii in domestic ruminants in Lebanon.

Coxiella burnetii causes diseases in humans (Q fever) and animals, domestic ruminants playing a major role in the epidemiology of the infection. Information on C. burnetii infection in Lebanon is scanty. In order to assess the prevalence of C. burnetii infection in ruminants, a cross-sectional study was undertaken in 2014. A total of 1633 sera from ruminants (865 cattle, 384 sheep and 384 goats) from 429 farms (173 cattle, 128 sheep and 128 goats), in seven provinces of Lebanon were randomly selected and assayed for the presence of antibodies. 39.86% of farms (95% CI: 35.23-44.56) resulted positive. The seroprevalence was 30.63% in Cattle-farms, 46.88% in sheep-farms and 45.31% in goat-farms. Milk samples collected from 282 seropositive animals (86 cows, 93 sheep and 103 goats) from 171 positive farms were tested by a high sensitive Real-Time PCR targeted to the IS1111 transposon of C. burnetii. The overall prevalence in farms was estimated to be 14.04%. Cattle-, sheep- and goat farm prevalence rates were 15.09%, 10% and 17.24%, respectively. The findings of the study show that C. burnetii prevalence in Lebanese domestic ruminants is related to animal species and farming practices. Indeed, the mixed herds with sheep (p < 0.01), the presence of common lambing/kidding areas (p < 0.001) in farms where the use of disinfectants was not a routine practice (p < 0.05) were identified as important risk factors. The results of the study provide baseline information for setting up herd management and public health measures for the prevention and control of Q fever in Lebanon.

Analysis of seroprevalence against Coxiella burnetii in a sample of farm workers in Western Sicily.

INTRODUCTION AND OBJECTIVE: Little is known about the development of chronic Q fever caused by Coxiella burnetii in occupational risk groups and in the general population in Italy, as well as in many countries in the world. The aim of this study was to highlight the presence of the infection in a sample of workers operating outdoors (but not directly in contact with animals), in three provinces of western Sicily, in order to detect the human seroprevalence and compare the obtained data with those found in animals raised in the same territory. MATERIALS AND METHODS: The study included 126 generic seasonal agricultural workers (labourers), 84 male and 42 female; none of whom were aware of any previous contact with Coxiella burnetii. Their immunologic status against Coxiella burnetii was tested through research and titration of both phases I and II specific antibodies (IgG) with an indirect immunofluorescence assay, using anti-antibodies labeled with fluorescein isothiocyanate. All data were statistically analyzed, comparing all positive results from the three provinces through variance analysis, and then comparing human results with those obtained from animals raised in the considered areas, specifically, 1,511 cows, 46 of which were found positive (3.04%), and 3,391 sheep, 548 of which were found positive (16.16%). RESULTS: Anti-Coxiella antibodies were found in nine of 42 females sampled (21.4%; 95%CI=[9.0-33.8]) and 21 of 84 males sampled (25.0%; 95%CI=[15.7-34.3]). 60% (18 of 30; 95%CI=[42.5-77.5]) of seropositive samples were positive either for Phase I antigen or for both Phase I and II antigens, representing cases of chronic infection. Applying Spearman's rank correlation, the percentage of seropositive humans was significantly correlated with that observed for sheep (r=1.00; p<0.001), but not for cows (r=-0.5; p=0.667). CONCLUSIONS: The results obtained, although based on a small sample, suggest that the disease is present in the territory of Western Sicily, both in animals and in humans. A closer collaboration between doctors and veterinarians is therefore necessary to fight against the spread of the infection.

Response of LaBr3(Ce) scintillators to 2.5 MeV fusion neutrons.

Measurements of the response of LaBr3(Ce) to 2.5 MeV neutrons have been carried out at the Frascati Neutron Generator and at tokamak facilities with deuterium plasmas. The observed spectrum has been interpreted by means of a Monte Carlo model. It is found that the main contributor to the measured response is neutron inelastic scattering on (79)Br, (81)Br, and (139)La. An extrapolation of the count rate response to 14 MeV neutrons from deuterium-tritium plasmas is also presented. The results are of relevance for the design of γ-ray diagnostics of fusion burning plasmas.

An evaluation of the capability of existing and novel serodiagnostic methods for porcine brucellosis to reduce false positive serological reactions.

Porcine brucellosis is a zoonotic disease of truly global significance because even in countries without the disease the occurrence of false positive serological reactions (FPSRs) creates significant problems. Statutory diagnostic testing is required in many disease free countries or regions and is often a prerequisite for the movement of live animals. Currently this testing is dependent almost entirely on serological assays and these may result in a significant number of FPSRs. The aim of this study was to examine existing and novel serodiagnostic assays to evaluate their diagnostic sensitivity and resilience to FPSRs. The existing assays evaluated were the RBT, smooth lipopolysaccharide (sLPS) indirect (i) ELISA, sLPS competitive (c) ELISA, and the FPA. The novel assays evaluated were the sLPS TR-FRET assay, a rough (r) LPS iELISA, a recombinant protein BP26 iELISA and a cytoplasmic protein extract (Brucellergene™) iELISA. Four populations of sera were evaluated: those from Brucella suis infected swine (n=34), randomly selected samples from non-infected swine (n=161), sera from non-infected swine within herds exhibiting FPSRs (n=132) and sera from swine experimentally infected with Yersinia enterocolitica O:9 (n=4). The results show that all the assays dependent on the sLPS O-polysaccharide (OPS) for their sensitivity (the RBT, sLPS ELISAs, FPA and the sLPS TR-FRET) had significantly reduced diagnostic specificity when applied to the FPSR population, the RBT being most affected. Of the two rapid homogeneous assays, the TR-FRET was diagnostically superior to the FPA in this study. Neither of the protein based iELISAs demonstrated sufficient diagnostic sensitivity to resolve the FPSRs. The rLPS iELISA showed no cross reaction with the FPSRs and had diagnostic sensitivity similar to that of the OPS based assays.

Expansion of intracellular IFN-γ positive lymphocytes during Mycoplasma agalactiae infection in sheep.

A method to assess the expansion of antigen-specific intracellular IFN-γ positive T cell subsets during the infection will be helpful for a better understanding of mycoplasmal infections physiopathology in the sheep. We analysed the percentage of antigen-specific lymphocytes positive for intracellular IFN-γ during the infection of sheep with Mycoplasma agalactiae by culturing peripheral blood mononuclear cells of infected or uninfected animals with irradiated M. agalactiae. The expansion of antigen-specific IFN-γ positive lymphocytes in infected sheep was initially sustained by CD4(+) T cells at day 15 after infection, when antigen specific IgG start to be detectable, followed by CD8/IFN-γ double positive cells. γδ T-cells were not expanded at any time point analysed. IFNγ(+) T cells disappear 60 days after infection, suggesting that antigen specific IFNγ(+) T cells, mainly detected in the early phase of the disease, could be useful to understand the role of cell-mediated immunity during M. agalactiae infection.

Pneumothorax in the Emergency Room: personal caseload.

The aim of this study was to collect information on the incidence, pathophysiology, treatment and mortality of pneumothorax in the Emergency Room. Pneumothorax is classified as spontaneous (primary, secondary or catamenial) or traumatic (iatrogenic or secondary to a blunt or penetrating chest injury). Between January 2007 and December 2009, 102 patients with pneumothorax were seen in our Emergency Room. Their records were examined and their data collected retrospectively. The type and side of the pneumothorax and age, sex, incidence and mortality were analyzed. The cases, involving 93 males and 9 females, broke down as follows: 68 spontaneous (66.7%), 33 traumatic (32.3%) and one iatrogenic (0.98%). The mean age was 47.3 (range 12-99); the incidence was 0.10%. There were no deaths due to pneumothorax in the Emergency Room. Traumatic pneumothorax was associated with blunt chest trauma, pleural effusion, hemothorax, cranial trauma, fractured collarbone, upper and lower limb fracture, pelvic fracture, vertebral and spinal trauma, sternum fracture and abdominal trauma. Pneumothorax is a common clinical problem. A multidisciplinary approach is essential to reduce the risk of morbidity and mortality. The incidence of pneumothorax in the Emergency Room was similar to that reported in the literature, while mortality data cannot be compared due to the lack of published studies.

What do we know about risk factors for infection in humans with Toxoplasma gondii and how can we prevent infections?

Fourteen case-control studies evaluating the importance of different risk factors for infection of humans with Toxoplasma gondii were identified. Surprisingly, up to two-thirds of infections could not be explained by risk factors such as consuming raw or undercooked meat or poor kitchen hygiene. Few studies reported population attributable risk, and when reported, it was low. Protocols including questionnaires used for collecting data, age and socio-economic groups studied, and sample sizes varied among studies. There is a need for carefully planned, case-control studies to identify sources of infection with T. gondii in humans. New risk factors, such as the manufacture of organic meat, and possible ways to sterilize meat to inactivate T. gondii tissue cysts are discussed.

Risk factors for toxoplasmosis in pigs bred in Sicily, Southern Italy.

The aim of the study was to determine the seroprevalence of Toxoplasma gondii infection in pigs raised and slaughtered in Sicily, Southern Italy, and to evaluate the risk factors associated with the infection. Samples were collected in seven slaughterhouses and on-site on 274 raising farms across Sicily, in the period from January 2006 until March 2007. For each sampled pig born and raised in Sicily, information was obtained on gender, age, origin, final destination of meat and farm management. Data on the farm included: farming type, presence of cats and dogs, rodent control by rodenticides, cleaning methods, water supply, altitude and herd size.T. gondii-specific antibodies were detected using a commercial Enzyme-Linked Immunosorbent Assay (Institut Pourquier, France).Antibodies against T. gondii were found in 16.3% of Sicilian pigs. The lowest seroprevalence, 7%, was found in the age group 5-7 months (market pig) and the highest, 19%, in the age group >24 months. Risk factors for seropositivity were: age 11-24 months compared to younger (OR 5.62; CI 1.52-20.8); farrow-to-finish farming type (OR 6.85; CI 1.87-25.01) compared to finishing and farrow-to-breed type; less than 50 pigs on the farm (OR 6.8; CI 1.76-26.2); no use of rodenticides (OR 2.71; CI 1.10-6.64), use of water coming from private sources (especially wells; OR 2.8; CI 1.03-7.72).Pigs raised in Sicily shows a high prevalence of antibodies against T. gondii. Pre-harvesting interventions to lower the risk of locally produced meat consumption for consumers should point as soon as possible to increase hygienic condition on the farm, by carefully removing waste with automatic cleaning and reducing biohazard by rodent control. Consumers must receive information on the correct handling and cooking locally produced pork meat derivatives.

Toxoplasma gondii infections in sheep in Sicily, southern Italy.

The aim of the study was to determine the burden of Toxoplasma gondii-infections in sheep in Sicily, southern Italy and the risk factors for infection. Sera from 1961 sheep were collected just before slaughtering from 62 farms located in 8 out of 9 Sicilian administrative districts. The sera were analysed for Toxoplasma-specific IgG antibodies using commercially available enzyme-linked immunosorbent assay. Sheep less than 4 weeks old were further analysed by ELISA for Toxoplasma-specific IgM-antibodies. Data on farm size and location were obtained from slaughterhouse sanitary reports and through structured telephone interviews of the veterinary officers from public health districts. The overall seroprevalence of Toxoplasma-specific IgG-antibodies were 49.9% (937/1876) by ELISA. Eighty-seven (54/62) percent of the farms had at least one Toxoplasma-positive animal. All the farms fed the animals outdoor on pasture and only one was claiming organic farming. Having cats on the farm, age of the animals, farm size and the use of surface water sources for drinking were all significantly associated with T. gondii-infected animals on the farm. T. gondii infection in mutton used for human consumption is very prevalent, and eating unprocessed sheep and lamb meat has a high risk of transmitting infections to humans. The presence of cats on the farm, farm size and using surface water as drinking water for the animals were risk factors for infection in sheep, with age as a significant confounder.

"Stents" ureterales: una forma de fijación simplificada / Ureteral stents: A simplified fixation approach

Los"stends" ureterales son más utilizados en los reimplantes ureterales con modelaje, en aquellos con dificultades técnicas, en reoperaciones y eventualmente en pieloplastías. De enero de 1995 a junio de 1998 utilizamos "stents"ureterales en 40 niños. 29 sometido a reimplantes vesicoureterales, 10 a pieloplastías y una ureteroplastía. Las extremidades de los stents en los reimplantes permanecieron en la vejiga y fueron fijados a la cistotomía o a la sonda uretral y en la pieloplastías o en la ureteroplastía fueron fijados a la sonda de nefrostomía. Los stents fueron retirados ambulatoriamente, juntamente con la sonda a la que estaban fijados, 7 a 12 días despues de la operación. No hubo complicaciones, el tiempo medio de internación disminuyó de 6 a 3 días. El procedimiento resultó eficaz, facilitó el trabajo médico, permitió mayor confort y movilidad a los pacientes

"Stents" ureterales: una forma de fijación simplificada / Ureteral stents: A simplified fixation approach

Los"stends" ureterales son más utilizados en los reimplantes ureterales con modelaje, en aquellos con dificultades técnicas, en reoperaciones y eventualmente en pieloplastías. De enero de 1995 a junio de 1998 utilizamos "stents"ureterales en 40 niños. 29 sometido a reimplantes vesicoureterales, 10 a pieloplastías y una ureteroplastía. Las extremidades de los stents en los reimplantes permanecieron en la vejiga y fueron fijados a la cistotomía o a la sonda uretral y en la pieloplastías o en la ureteroplastía fueron fijados a la sonda de nefrostomía. Los stents fueron retirados ambulatoriamente, juntamente con la sonda a la que estaban fijados, 7 a 12 días despues de la operación. No hubo complicaciones, el tiempo medio de internación disminuyó de 6 a 3 días. El procedimiento resultó eficaz, facilitó el trabajo médico, permitió mayor confort y movilidad a los pacientes

Asbestos bodies in bronchoalveolar lavage fluid and sputum.

The aim of the study was to determine the concordance of asbestos body (AB) detection in sputum and bronchoalveolar lavage fluid (BALF). AB were detected in the BALF of 110 former or current asbestos workers with medium weak exposure level and, for 65 subjects, in sputum. Several spontaneous sputum samples were taken from each subject. AB prevalence in BALF was rather low (48.2%) especially in subjects with former chrysotile exposure (32.5%). AB prevalence was lower in smokers (40.9%) and ex-smokers (40.7%) than in non-smokers (68.7%). In the sub-group, who underwent both sputum and BALF examination, the concordance of AB detection was observed only in 56.8% of the cases. Neither of the two methods had significant prevalence over the other but were complementary, as both are useful in increasing the probability of AB detection.

Relationship between asbestos bodies in sputum and the number of specimens.

OBJECTIVES: This study investigated the relationship between asbestos body identification and the number of sputum specimens obtained from each subject. METHODS: The presence of asbestos bodies in sputum was studied in 142 asbestos workers with former low-exposure levels; the number of specimens collected during 1-3 weeks varied from 2 to more than 4. Furthermore the persistence of asbestos bodies in the sputum of 15 asbestos workers was studied during a long-time follow-up. RESULTS: Asbestos bodies were present in at least 1 specimen in 44.4% of the 142 subjects. The cumulative percentage of asbestos body presence increased linearly, from 20% to 68%, as the number of specimens increased. CONCLUSIONS: Five specimens did not seem to be sufficient to obtain satisfactory sensitivity in a group with low exposure to asbestos. Neither the type of exposure (to chrysotile only or to chrysotile plus amphibole) nor the presence of an asbestos-related disease clearly influenced the probability of finding asbestos bodies.

Asbestos bodies in sputum of asbestos exposed workers.

The prevalence of asbestos bodies (AB) in sputum was studied in a group of 220 former or current asbestos workers, who came under observation because of a claim for compensation and who had, in most cases, high levels of exposure. Only one sputum specimen was obtained from each subject. The overall AB prevalence was 34%; it was 24.5% among workers exposed to chrysotile only, and 42% among workers also exposed to amphiboles, thus showing a statistically significant difference. No significant differences were found in AB prevalence either between current asbestos workers and former workers or between asbestosis cases and those without asbestosis. AB prevalence among current smokers was significantly lower than that observed among non-smokers and ex-smokers pooled together. The highest AB prevalence was found among currently exposed textile workers (65.7%), especially in male subjects (66.7%). As the exposure of these groups was heavy and included amphiboles, it may be concluded that although AB counts are highly specific they have low sensitivity.