Molecular detection of Rickettsia rickettsii, Ehrlichia canis and Rangelia vitalli in Rhipicephalus sanguineus senso latu collected from dogs in Brazil / [Detecção molecular de Rickettsia rickettsii, Ehrlichia canis e Rangelia vitalli em Rhipicephalus sanguineus sensu lato coletados de cães no Brasil]

ABSTRACT This study evaluated by molecular methods the presence of major canine tick-borne agents in ticks infesting domestic dogs of a hospital population in a neglected area of the southern zone of the São Paulo Metropolitan region, which is characterized by an extensive urban area surrounded and interspersed by forest remnants of the original Atlantic rainforest. During 2017, 106 tick specimens - 71 adults and 33 nymphs of Rhipicephalus sanguineus sensu lato (s.l.), and two adults of Amblyomma aureolatum - were collected from 41 dogs that were attended in a Veterinary Teaching Hospital in São Paulo City, Brazil. By molecular analyses, 4.2% (3/71) of the R. sanguineus s.l. adult ticks contained the bacterium Rickettsia rickettsii, 2.8% (2/71) contained the bacterium Ehrlichia canis, and 4.2% (3/71) contained the protozoan Rangelia vitalii. These results indicate that domestic dogs of the southern zone of the São Paulo metropolitan region might be exposed to three of the major tick-borne agents affecting dogs in Brazil, R. rickettsii, E. canis and R. vitalii. In addition, the findings reinforce the circulation of the human pathogen R. rickettsii in the study area in a likely enzootic cycle involving dogs and R. sanguineus ticks.

RESUMO Este estudo avaliou, por métodos moleculares, a presença dos principais agentes etiológicos de doenças caninas transmitidas por carrapatos que infestam cães domésticos de uma população hospitalar, em uma área negligenciada da zona sul da região metropolitana de São Paulo, caracterizada por uma extensa área urbana circundada e intercalada por remanescentes florestais de Mata Atlântica. Durante o ano de 2017, 106 espécimes de carrapatos - 71 adultos e 33 ninfas de Rhipicephalus sanguineus sensu lato (s.l.), e dois adultos de Amblyomma aureolatum - foram coletados de 41 cães atendidos em um Hospital Veterinário Universitário da cidade de São Paulo, Brasil. Por análises moleculares, 4,2% (3/71) de R. sanguineus s.l. adultos continham a bactéria Rickettsia rickettsii, 2,8% (2/71) continham a bactéria Ehrlichia canis e 4,2% (3/71) continham o protozoário Rangelia vitalii. Esses resultados indicam que cães domésticos da zona sul da região metropolitana de São Paulo podem estar expostos a três dos principais agentes carrapatos que afetam cães no Brasil, R. rickettsii, E. canis e R. vitalii. Além disso, os achados reforçam a circulação do patógeno humano R. rickettsii na área de estudo, em um provável ciclo enzoótico envolvendo cães e carrapatos R. sanguineus.

Detecção de anticorpos anti-Rickettsia rickettsii em cães residentes em área negligenciada no município de São Paulo, SP, Brasil / [Detection of anti-Rickettsia rickettsii antibodies in dogs living in a neglected area in São Paulo, SP, Brazil]

A febre maculosa brasileira (FMB), descrita inicialmente nos Estados Unidos como febre maculosa das Montanhas Rochosas, é uma antropozoonose relatada apenas no continente americano e causada pela bactéria Rickettsia rickettsii. No Brasil a transmissão ocorre sobretudo pela picada de carrapatos do gênero Amblyomma spp. A doença foi inicialmente descrita como de transmissão em áreas rurais e silvestres, no entanto áreas periurbanas e urbanas vêm apresentando casos, principalmente relacionados com a presença de humanos residindo em pequenos fragmentos de mata ciliar. O presente estudo teve por objetivo elucidar a dispersão da FMB nas proximidades dos reservatórios Guarapiranga e Billings, na cidade de São Paulo, SP. Para tanto, a presença de anticorpos anti-R. rickettsii, Rickettsia parkeri e Rickettsia bellii foi avaliada em cães atendidos nas campanhas de esterilização cirúrgica e residentes ao redor dos reservatórios. Foram coletadas amostras de 393 cães, e as amostras de soro foram analisadas pela reação de imunofluorescência indireta (RIFI), com ponto de corte de 1:64. Os títulos para R. rickettsii variaram de 256 a 4096, com positividade de 3,3% (13/393); para R. bellii, de 128 a 1024 e 4,1% (16/393) de positivos, e um único animal (0,25%) foi soropositivo para R. parkeri, com título de 128. Os achados permitem concluir que a região de estudo apresenta condições de se tornar uma possível área com casos de FMB, pois comporta fragmentação de Mata Atlântica, condições essas ideais para a manutenção do vetor do gênero Amblyomma já descrito na região, bem como para a presença da Rickettsia rickettsii circulante entre os cães, confirmada pela existência de anticorpos. Condutas referentes à conscientização da população por meio de trabalhos educacionais devem ser implantadas para a prevenção da doença na população da área.(AU)

Brazilian Spotted Fever (BSF), initially described in the United States as Rocky Mountain Spotted Fever, is an anthropozoonosis reported only in the Americas and caused by the bacterium Rickettsia rickettsii. In Brazil, transmission occurs mainly through tick bites of the genus Amblyomma spp. The disease was initially described as transmission of rural and wild areas; however, peri-urban and urban areas have been presenting cases, mainly related to the presence of humans residing in small fragments of riparian forest. The present study aimed to elucidate the dispersal of BSF near the Guarapiranga and Billings Reservoirs, in the city of São Paulo, SP. The presence of anti-R. rickettsii, Rickettsia parkeri and Rickettsia bellii antibodies were evaluated in dogs treated in surgical sterilization campaigns and residents around the Reservoirs. Samples were collected from 393 dogs and serum samples were analyzed by indirect immunofluorescence reaction (RIFI) with a cutoff of 1:64. The titles for R. rickettsii varied from 256 to 4096 with a positivity of 3.3% (13/393); for R. bellii from 128 to 1024 and 4.1% (16/393) of positive and a single animal (0.25%) was seropositive for R. parkeri with a titre of 128. The findings allow us to conclude that the study region has conditions to become a possible area with BSF cases, as it involves Atlantic Forest, ideal conditions for the maintenance of the vector of the genus Amblyomma already described in the region and the presence of circulating Rickettsia rickettsii among dogs, confirmed by the presence of antibodies. Conducts regarding the awareness of the population through educational work should be implemented to prevent the disease in the population of the area.(AU)

Esophageal motility patterns are altered in older adult patients. / Los patrones de motilidad esofágica están alterados en pacientes adultos mayores.

INTRODUCTION AND AIMS: Since the 1960s, several studies have shown the effect of aging on esophageal motility, with inconsistent results. The aim of the present study was to evaluate the manometric results in older adult patients (=60 years of age) with an esophageal disorder and compare them with adults under 60 years of age. MATERIALS AND METHODS: A cross-sectional, retrospective study was conducted that included a sample of 1,175 patients (936 older adults and 239 non-older adults). The patients were evaluated and compared with respect to (i) sex, (ii) main complaint for which esophageal manometry was indicated, (iii) comorbidities, (iv) current medications, (v) smoking, and (vi) manometry results. RESULTS: Patient age ranged from 19 to 92 years (women made up 76.5% of the older adults and 72.8% of the non-older adults). Normal lower esophageal sphincter relaxation and normal peristalsis were more frequent in the non-older patient group (91.1% vs. 84.8% and 87.4% vs. 76%, respectively). The manometry results for the non-older adults vs. the older adults, respectively, were: achalasia (2.9% vs. 5.9%); hypercontractile disorder (9.2% vs. 10.4%); hypocontractile disorder (38.5% vs. 47.6%); and normal values (49.4% vs. 36.1%). After excluding the variables that could change esophageal motility, the results revealed significant differences between the two study groups. CONCLUSIONS: Esophageal manometry demonstrated statistically significant differences between the older adult and non-older adult study population evaluated.

Randomised clinical trial: daily pantoprazole magnesium 40 mg vs. esomeprazole 40 mg for gastro-oesophageal reflux disease, assessed by endoscopy and symptoms.

BACKGROUND: Pantoprazole magnesium (pantoprazole-Mg) may display extended inhibition of the proton pump with the potential for improved clinical efficacy in gastro-oesophageal reflux disease (GERD). AIM: To compare the efficacy of pantoprazole-Mg and esomeprazole in GERD. METHODS: Gastro-oesophageal reflux disease (Los Angeles grades A-D) patients were randomised to 4 weeks of treatment with pantoprazole-Mg (n = 290) or esomeprazole (n = 288), both 40 mg once daily, in this multicentre (14 Brazilian sites in 9 cities), double-blind study, with an additional 4 weeks' treatment in nonresponding patients. Severity of oesophagitis (at endoscopy) and GERD-related symptoms (ReQuest-GI) were assessed. The primary end point was the proportion of patients in complete remission (ReQuest-GI score <1.73 plus endoscopic healing) at week 4. RESULTS: Complete remission occurred in 61% of patients in each treatment group at 4 weeks (primary endpoint) and in 81% and 79% of patients in the pantoprazole-Mg and esomeprazole groups at 8 weeks, with no significant differences. Mucosal healing rates were high and not significantly different. At 8 weeks, symptom relief with pantoprazole-Mg was significantly greater than that with esomeprazole (91.6% vs. 86.0%, P = 0.0370) because of continued improvement in symptoms with pantoprazole-Mg from week 4 to week 8 (P = 0.0206). CONCLUSIONS: Pantoprazole-Mg 40 mg was at least as effective as esomeprazole 40 mg for complete remission and the mucosal healing rate was high. Symptom relief with pantoprazole-Mg continued to improve from 4 to 8 weeks and was greater than that with esomeprazole at week 8, suggesting an extended period of treatment effect (ClinicalTrials.gov identifier: NCT01132638).

Antibodies against rickettsiae from spotted fever groups in horses from two mesoregions in the state of Santa Catarina, Brazil / Anticorpos contra rickettsias do grupo da febre maculosa em equinos de duas mesorregiões de Santa Catarina, Brasil

Bacteria of the Rickettsia genus are agents of Brazilian Spotted Fever (BSF), a zoonotic disease which is difficult to diagnose, evolves quickly and can result in death. Antibodies against Rickettsia spp. in horses were studied, by means of Indirect Immunofluorescence Assay (IFAT ≥64), in 150 blood samples taken from animals in two Santa Catarina mesoregions (Planalto Serrano and Vale do Itajaí). The overall occurrence of Rickettsia spp. antibodies in horses was 18.66%, with cross-reactivity occurring in all positive samples for at least two of the species tested. Separately, according to the species, 25 (16.66%) samples were positive for R. rickettsii, 15 (10%) for R. parkeri, 22 (14.66%) for R. amblyommii, 23 (15.33%) for R. rhipicephali, 16 (10.66%) for R. bellii and 19 (12.66%) for R. felis. Only two animals resulted in a conclusive serodiagnosis, one for R. bellii and the other for R. rickettsii, at maximum dilutions of 1:4096 and 1:512, respectively. The occurrence of antibodies against Rickettsia spp. in horses from two mesoregions in the state of Santa Catarina indicates the movement of BSF agents in these sentinel animals and confirms the importance of studying spotted fever in the state of Santa Catarina.

Bactérias do gênero Rickettsia são agentes da Febre Maculosa Brasileira (FMB), uma doença zoonótica, de difícil diagnóstico, rápida evolução e que pode levar o indivíduo à morte. Anticorpos contra Rickettsia spp. em equinos foram pesquisados, por meio da Reação de Imunofluorescência Indireta (RIFI≥64), em 150 amostras de sangue colhidas de animais em duas mesorregiões de Santa Catarina (Planalto Serrano e Vale do Itajaí). A ocorrência de anticorpos contra Rickettsia spp. observada em equinos de duas mesorregiões de Santa Catarina foi de 18,66%, ocorrendo reações cruzadas em todas as amostras positivas para, no mínimo, duas das espécies testadas. Isoladamente, de acordo com as espécies, 25 (16,66%) amostras foram positivas para R. rickettsii, 15 (10%) para R. parkeri, 22 (14,66%) para R. amblyommii, 23 (15,33%) para R. rhipicephali, 16 (10,66%) para R. bellii e 19 (12,66%) para R. felis. Somente dois animais resultaram em um sorodiagnóstico conclusivo, um para Rickettsia bellii e outro para R. rickettsii, nas diluições máximas de 1:4096 e 1:512, respectivamente. A ocorrência de anticorpos contra Rickettsia spp. em equinos de duas mesorregiões de Santa Catarina indica a circulação de agentes da FMB nestes animais sentinela e ratificam a importância do estudo da febre maculosa no estado de Santa Catarina.

Antibodies against rickettsiae from spotted fever groups in horses from two mesoregions in the state of Santa Catarina, Brazil / Anticorpos contra rickettsias do grupo da febre maculosa em equinos de duas mesorregiões de Santa Catarina, Brasil

Bacteria of the Rickettsia genus are agents of Brazilian Spotted Fever (BSF), a zoonotic disease which is difficult to diagnose, evolves quickly and can result in death. Antibodies against Rickettsia spp. in horses were studied, by means of Indirect Immunofluorescence Assay (IFAT ≥64), in 150 blood samples taken from animals in two Santa Catarina mesoregions (Planalto Serrano and Vale do Itajaí). The overall occurrence of Rickettsia spp. antibodies in horses was 18.66%, with cross-reactivity occurring in all positive samples for at least two of the species tested. Separately, according to the species, 25 (16.66%) samples were positive for R. rickettsii, 15 (10%) for R. parkeri, 22 (14.66%) for R. amblyommii, 23 (15.33%) for R. rhipicephali, 16 (10.66%) for R. bellii and 19 (12.66%) for R. felis. Only two animals resulted in a conclusive serodiagnosis, one for R. bellii and the other for R. rickettsii, at maximum dilutions of 1:4096 and 1:512, respectively. The occurrence of antibodies against Rickettsia spp. in horses from two mesoregions in the state of Santa Catarina indicates the movement of BSF agents in these sentinel animals and confirms the importance of studying spotted fever in the state of Santa Catarina.(AU)

Bactérias do gênero Rickettsia são agentes da Febre Maculosa Brasileira (FMB), uma doença zoonótica, de difícil diagnóstico, rápida evolução e que pode levar o indivíduo à morte. Anticorpos contra Rickettsia spp. em equinos foram pesquisados, por meio da Reação de Imunofluorescência Indireta (RIFI≥64), em 150 amostras de sangue colhidas de animais em duas mesorregiões de Santa Catarina (Planalto Serrano e Vale do Itajaí). A ocorrência de anticorpos contra Rickettsia spp. observada em equinos de duas mesorregiões de Santa Catarina foi de 18,66%, ocorrendo reações cruzadas em todas as amostras positivas para, no mínimo, duas das espécies testadas. Isoladamente, de acordo com as espécies, 25 (16,66%) amostras foram positivas para R. rickettsii, 15 (10%) para R. parkeri, 22 (14,66%) para R. amblyommii, 23 (15,33%) para R. rhipicephali, 16 (10,66%) para R. bellii e 19 (12,66%) para R. felis. Somente dois animais resultaram em um sorodiagnóstico conclusivo, um para Rickettsia bellii e outro para R. rickettsii, nas diluições máximas de 1:4096 e 1:512, respectivamente. A ocorrência de anticorpos contra Rickettsia spp. em equinos de duas mesorregiões de Santa Catarina indica a circulação de agentes da FMB nestes animais sentinela e ratificam a importância do estudo da febre maculosa no estado de Santa Catarina.(AU)

Comparative evaluation of infected and noninfected Amblyomma triste ticks with Rickettsia parkeri, the agent of an emerging rickettsiosis in the New World.

The distribution of Rickettsia parkeri in South America has been associated with Amblyomma triste ticks. The present study evaluated under laboratory conditions two colonies of A. triste: one started from engorged females that were naturally infected by R. parkeri (designated as infected group); the other started from noninfected females (designated as control group). Both colonies were reared in parallel for five consecutive generations. Tick-naïve domestic rabbits were used for feeding of each tick stage and generation. R. parkeri was preserved by transstadial maintenance and transovarial transmission in A. triste ticks for five consecutive generations, because all tested larvae, nymphs, and adults from the infected group were shown by PCR to contain rickettsial DNA. All rabbits infested by larvae, nymphs, and adults from the infected group seroconverted, indicating that these tick stages were all vector competent for R. parkeri. Expressive differences in mortality rates were observed between engorged nymphs from the infected and control groups, as indicated by 65.9% and 92.4% molting success, respectively. Our results indicate that A. triste can act as a natural reservoir for R. parkeri. However, due to deleterious effect caused by R. parkeri on engorged nymphs, amplifier vertebrate hosts might be necessary for natural long-term maintenance of R. parkeri in A. triste.

Epidemiology of Brazilian spotted fever in the Atlantic Forest, state of São Paulo, Brazil

The tick-borne bacterium Rickettsia rickettsii is the a etiological agent of Brazilian spotted fever (BSF). The present study evaluated tick infestations on wild and domestic animals, and the rickettsial infection in these animals and their ticks in 7 forest areas adjacent to human communities in the São Paulo Metropolitan Area (SPMA). The results were compared to ecological traits of each sampled area. Two main tick species, Amblyomma aureolatum and Rhipicephalus sanguineus, were collected from dogs. The major ticks found on small mammals and birds were Ixodes loricatus and Amblyomma longirostre, respectively. Both anti-R. rickettsii antibodies and R. rickettsii-infected ticks were detected on dogs from only 2 areas in the southern part of the SPMA, which were considered to be endemic for BSF; the remaining 5 areas were considered to be non endemic. Ecologically, the BSF-endemic areas clearly differed from the non-endemic areas by the presence of significantly more degraded forest patches in the former. The present results corroborate historical observations that have indicated that all human cases of BSF in the SPMA were contracted in the southern part of this metropolitan area. However, not all forest patches in the southern part of the SPMA were shown to be associated with BSF endemism...

Low levels of adherence with proton pump inhibitor therapy contribute to therapeutic failure in gastroesophageal reflux disease.

To assess adherence to proton pump inhibitor (PPI) treatment and associated variables in patients with gastroesophageal reflux disease (GERD). Cross-sectional and prospective comprising 240 consecutive adult patients, diagnosed with GERD for whom continuous use of standard or double dose of omeprazole had been prescribed. Patients were ranked as ne-GERD (162: 67.5%) or e-GERD classified according to the Los Angeles classification as A (48:20.0%), B (21:8.6%), C (1:0.5%), D (1:0.5%), and Barrett's esophagus (7:2.9%). The Morisky questionnaire was applied to assess adherence to therapy and a GERD questionnaire to assess symptoms and their impact. Adherence was correlated with demographics, cotherapies, comorbidities, treatment duration, symptoms scores, endoscopic findings, and patient awareness of their disease. 126 patients (52.5%) exhibited high level of adherence and 114 (47.5%) low level. Youngers (P= 0.002) or married (O.R. 2.41, P= 0.03 vs. widowers) patients had lower levels of adherence; symptomatic patients exhibited lower adherence (P= 0.02). All other variables studied had no influence on adherence. Patients with GERD attending a tertiary referral hospital in São Paulo exhibited a high rate of low adherence to the prescribed PPI therapy that may play a role in the therapy failure. Age <60 years, marital status and being symptomatic were risk factors for low adherence.

Rickettsial infections of dogs, horses and ticks in Juiz de Fora, southeastern Brazil, and isolation of Rickettsia rickettsii from Rhipicephalus sanguineus ticks.

The present study was performed in an area endemic for Brazilian spotted fever (BSF) in Juiz de Fora, state of Minas Gerais, Brazil, during the years 2007 and 2008, when fatal cases of BSF (caused by Rickettsia rickettsii) were reported. Adult ticks (Acari: Ixodidae) identified as Rhipicephalus sanguineus (Latreille) and Amblyomma cajennense (Fabricius) were collected from dogs and horses, respectively, and tested by polymerase chain reaction (PCR). Overall, 13.1% of the Rh. sanguineus ticks and none of the A. cajennense were found to be infected with R. rickettsii. Two isolates of R. rickettsii were successfully established in Vero cell culture from two Rh. sanguineus ticks. An indirect immunofluorescence assay (IFA) using R. rickettsii antigens detected blood serological reaction to R. rickettsii in 67.9% (53/78) of dogs and 41.0% (16/39) of horses living in the study area. Larval offspring from two Rh. sanguineus engorged females, naturally infected by R. rickettsii, were reared to adult stage in the laboratory. All active stages (larvae, nymphs, adults) remained 100% infected by R. rickettsii, which was efficiently transmitted to naïve rabbits. Overall, the results of the present study indicate a potential risk for transmission of R. rickettsii to humans by Rh. sanguineus, an occurrence yet to be documented in Brazil.

Prevalência de anticorpos anti-Rickettsia spp. em cães da cidade de Belo Horizonte, MG / Prevalence of antibodies anti-Rickettsia in dogs from Belo Horizonte, MG, Brazil

A cross-sectional study was conducted to determine the seroprevalence of anti-Rickettsia spp. in dogs from Belo Horizonte, MG. For this purpose, serum samples from 453 dogs were collected during the rabies vaccination campaign and tested by the indirect immunofluorescence assay (IFA) using five antigens: Rickettsia bellii, Rickettsia amblyommii, Rickettsia rickettsii, Rickettsia parkeri, and Rickettsia felis. The endpoint titer reacting with each antigen was determined and serum was considered positive if it reacted at the 1:64 dilution. Serum showing titer for a Rickettsia species at least four-fold higher than that observed for any other Rickettsia species was considered homologous to the first Rickettsia species. Only three (0.66%) dogs reacted positively to at least one Rickettsia species and one serum showed to be homologous to R. rickettsii. These results showed a low prevalence of antibodies anti-Rickettsia spp. in dogs from Belo Horizonte city. However, other serosurvey needs to be performed for surveillance of the endemic status of the disease in the municipal district.

Prevalência de anticorpos anti-Rickettsia spp. em cães da cidade de Belo Horizonte, MG / Prevalence of antibodies anti-Rickettsia in dogs from Belo Horizonte, MG, Brazil

A cross-sectional study was conducted to determine the seroprevalence of anti-Rickettsia spp. in dogs from Belo Horizonte, MG. For this purpose, serum samples from 453 dogs were collected during the rabies vaccination campaign and tested by the indirect immunofluorescence assay (IFA) using five antigens: Rickettsia bellii, Rickettsia amblyommii, Rickettsia rickettsii, Rickettsia parkeri, and Rickettsia felis. The endpoint titer reacting with each antigen was determined and serum was considered positive if it reacted at the 1:64 dilution. Serum showing titer for a Rickettsia species at least four-fold higher than that observed for any other Rickettsia species was considered homologous to the first Rickettsia species. Only three (0.66%) dogs reacted positively to at least one Rickettsia species and one serum showed to be homologous to R. rickettsii. These results showed a low prevalence of antibodies anti-Rickettsia spp. in dogs from Belo Horizonte city. However, other serosurvey needs to be performed for surveillance of the endemic status of the disease in the municipal district.(AU)

Experimental infection of capybaras Hydrochoerus hydrochaeris by Rickettsia rickettsii and evaluation of the transmission of the infection to ticks Amblyomma cajennense

The present study evaluated the infection of capybaras (Hydrochoerus hydrochaeris) by Rickettsia rickettsii and their role as amplifier hosts for horizontal transmission of R. rickettsii to Amblyomma cajennense ticks. Two groups of two capybaras each were evaluated: on day 0, group 1 (G1) was infested by R. rickettsii-infected ticks, and group 2 (G2) was inoculated intraperitoneally with R. rickettsii. Two additional groups were control groups, not exposed to R. rickettsii, being CG1 group the control of G1, and CG2 group the control of G2. Capybara rectal temperature was measured daily. Blood samples were collected every 3 days during 30 days, and used to (i) inoculate guinea pigs intraperitoneally; (ii) DNA extraction followed by real-time PCR targeting the rickettsial gene gltA; (iii) hematology; (iv) detection of R. rickettsii-reactive antibodies by indirect immunofluorescence assay (IFA). Blood was also collected from G1 capybaras every approximately 10-30 days till the 146th day, to be tested by serology. Capybaras were infested by uninfected A. cajennense nymphs from the 3rd to the 18th day. Engorged nymphs were collected, allowed to molt to adults in an incubator. Thereafter, the subsequent flat ticks were tested by PCR. All G1 and G2 capybaras became infected by R. rickettsii, as demonstrated by guinea pig inoculation and seroconversion, but they showed no fever...

New Epidemiological Data on Brazilian Spotted Feverin an Endemic Area of the State of São Paulo, Brazil

The present work evaluated rickettsial infection in dogs and their ticks in an area endemic for Brazilian spotted fever (BSF) in the metropolitan area of São Paulo, Brazil, where the tick Amblyomma aureolatum was presumed to be the vector of the disease. Ticks were collected on dogs from 185 houses, encompassing single infestations by Rhipicephalus sanguineus, Amblyomma aureolatum, Amblyomma longirostre, or Amblyomma sp. in dogs from 60 (32.4%), 77 (41.6%), 2 (1.1%), and 25 (13.5%) houses, respectively; 19 (10.3%) houses had dogs with mixed infestations by R. sanguineus and A. aureolatum; 1 (0.5%) house had dogs with infestations by A. aureolatum and A. longirostre; and 1 (0.5%) house had dogs with infestations by R. sanguineus and Amblyomma sp.Overall, A. aureolatum was present in dogs from 97 (52.4%) houses, and R. sanguineus in dogs from 80 (43.2%) houses. A total of 287 ticks (130 A. aureolatum and 157 R. sanguineus) infesting dogs from 98 houses were selected for testing by polymerase chain reaction (PCR) targeting rickettsial genes...

Dietary habits, ethanol and tobacco consumption as predictive factors in the development of esophageal carcinoma in patients with head and neck neoplasms.

Patients with primary head and neck cancers have a higher risk of developing esophageal cancer. The aim of this study was to investigate esophageal cancer prevalence, its risk factors (ethanol and tobacco consumption) and dietary habits in patients with head and neck cancer. Three hundred and twenty-six adults with primary head and neck cancer were followed by a retrospective observational study in a general university hospital in Sao Paulo, Brazil. Flexible videoendoscopy with lugol chromoscopy was the method used to investigate esophageal cancer prevalence. All subjects were interviewed face-to-face, revealing detailed information about their tobacco and alcohol use, as well as their dietary habits. Thirty-six patients with esophageal cancer were diagnosed and the overall prevalence rate was 11.04%. Patients who developed second esophageal tumors had the following characteristics: earlier age of initial ethanol consumption (P < 0.05), longer duration period of ethanol consumption (P < 0.05) and higher weekly consumption rate (P < 0.05). There was an increased risk of esophageal carcinoma in those patients who both smoked and drank (P < 0.05). There was no association between carcinoma of the esophagus and dietary habits in patients who developed esophageal neoplasms, compared with those who did not. Prevalence rate of esophageal neoplasms was 11.04% in patients with head and neck carcinoma, whose ethanol consumption was associated with esophageal cancer. There was an increased risk between ethanol and tobacco consumption and esophageal carcinoma development. On the other hand, there was no association regarding dietary habits between patients who developed esophageal cancer and those who did not.

Larvas de nematóides de importância zoonótica encontradas em traíras (Hoplias malabaricus bloch, 1794) no município de Santo Antonio do Leverger, MT / Nematode larvae with zoonotical importance found in trairas (Hoplias malabaricus) in Santo Antonio do Leverger, Mato Grosso, Brazil

In order to investigate the prevalence of nematode larvae with zoonotical importance in trairas (Hoplias malabaricus), necropsy exams were done 30 specimes from Santo Antonio do Leverger, Mato Grosso, Brazil. These fishes were collected during drought time and two different nematodes larvae were found - Contracaecum sp. and Eustrongylides sp. - presenting the following prevalence: Contracaecum sp., 73 percent and Eustrongylides sp., 33 percent.

Larvas de nematóides de importância zoonótica encontradas em traíras (Hoplias malabaricus bloch, 1794) no município de Santo Antonio do Leverger, MT / Nematode larvae with zoonotical importance found in trairas (Hoplias malabaricus) in Santo Antonio do Leverger, Mato Grosso, Brazil

In order to investigate the prevalence of nematode larvae with zoonotical importance in trairas (Hoplias malabaricus), necropsy exams were done 30 specimes from Santo Antonio do Leverger, Mato Grosso, Brazil. These fishes were collected during drought time and two different nematodes larvae were found - Contracaecum sp. and Eustrongylides sp. - presenting the following prevalence: Contracaecum sp., 73 percent and Eustrongylides sp., 33 percent.(AU)

Evaluation of health-related quality of life in gastroesophageal reflux disease patients before and after treatment with pantoprazole.

Gastrooesophageal reflux disease (GERD) is highly prevalent in the Western world but its true population prevalence is difficult to estimate without a validated instrument to detect it. The evaluation of health-related quality of life (HRQoL) is an useful tool in this assessment. The aims of this study are to translate and validate a GERD specific HRQoL questionnaire and evaluate HRQoL in a Brazilian population before and after GERD treatment. GERD patients with typical symptoms and Los Angeles Classes A to C esophagitis were included in the study. Two HRQoL questionnaires and upper digestive endoscopy were performed before and after 6 weeks treatment with pantoprazole 40 mg/day followed by 80 mg/day for another 8 weeks if healing did not occur. A generic (SF-36) and one disease-specific questionnaire (GERD score) were used. The latter was translated and validated for Brazilian Portuguese. From January 2002 to December 2003, 100 patients were enrolled. Of these, 78 patients were evaluated in a per protocol analysis (35 men, mean age: 40 years). The translated questionnaire (Brazilian GERD Score, BGERDS) demonstrated adequate psychometric properties (validity, responsiveness and reliability). SF-36 and BGERDS domains significantly improved after treatment (P < 0.01 and P < 0.001 respectively). The BGERDS was shown to be valid and reliable. Patients with esophagitis showed an impaired HRQoL that improved or normalized after treatment with pantoprazole.

Reduction of abdominal pressure in patients with ascites reduces gastroesophageal reflux.

The effect of the reduction of intra-abdominal pressure on the lower esophageal sphincter pressure (LESP) and the 24-hour pH monitoring were studied in 16 patients with ascites before and after paracentesis. LESP did not change (P > 0.05) with the reduction of intra-abdominal pressure (before paracentesis: 17.48 mmHg and postparacentesis: 18.67 mmHg). The results were divided into two groups according to the achieved reduction in intra-abdominal pressure group A were those in who the reduction was greater than 70% and B consisted of those a reduction of less than 70%. LESP did not change even when results for each group were considered separately (P > 0.05): group A (before: 15.60 mmHg; after: 18.09 mmHg); group B (before: 23.09 mmHg; after: 20.40 mmHg). However the 24-h pH monitoring showed pathological reflux in patients with ascites that was reduced with the paracentesis (P < 0.05; total number of reflux episodes before paracentesis was 520.26, and after, 136.26). All pH-monitoring parameters were statistically different (P < 0.05) before and after the reduction of intra-abdominal pressure for group A but not for group B. LESP does not change significantly (P > 0.05) when the intra-abdominal pressure is significantly reduced (P < 0.05). Patients with ascites showed gastroesophageal reflux. Intra-abdominal pressure reduction greater than 70% lead to a significant reduction in gastroesophageal reflux.