Kidney Injury Molecule-1 in the detection of early kidney injury in dogs with leptospirosis.

Renal damage, a common feature in canine leptospirosis, ranges from a subclinical affection to kidney dysfunction and death. Chances of recovery can be improved by early intervention. However, traditional biomarkers (serum urea and creatinine) have limited relevance for precocity. Kidney Injury Molecule-1 (KIM-1) is a transmembrane protein upregulated in early stages of tubular injury. This study evaluated the use of urinary KIM-1 to detect early renal injury in naturally occurring canine leptospirosis. This exploratory research included 30 dogs divided into two groups: (1) dogs with leptospirosis (n = 25) and (2) healthy dogs (n = 5). Leptospira sp. infection was diagnosed through urine PCR and/or direct bacteriologic culture and/or serology (single MAT titters ≥800). Additionally, stage of infection was further characterized in acute and subacute phases based on the onset of clinical symptoms from 3 to 7 days. Urinary KIM-1 (uKIM-1) concentrations were measured in both groups with a commercial canine ELISA kit. uKIM-1 levels were statistically different (P < 0.01) between the studied groups, especially in non-azotemic dogs (P = 0.0042). The biomarker showed 88 % sensibility to diagnosis of kidney injury at> 1.49 ng/mL cut-off. Urine KIM-1 was negatively correlated with urine specific gravity (USG) but accompanied histopathological evidence of renal degeneration, necrosis and regeneration processes, extending information on kidney health. Measurement of KIM-1 in the urine of canine patients was able to detect naturally occurring acute and subacute leptospirosis accompanied by tubular injury in early non-azotemic infections.

Prevalence of Diarrheagenic Escherichia coli (DEC) and Salmonella spp. with zoonotic potential in urban rats in Salvador, Brazil.

Studies evaluating the occurrence of enteropathogenic bacteria in urban rats (Rattus spp.) are scarce worldwide, specifically in the urban environments of tropical countries. This study aims to estimate the prevalence of diarrhoeagenic Escherichia coli (DEC) and Salmonella spp. with zoonotic potential in urban slum environments. We trapped rats between April and June 2018 in Salvador, Brazil. We collected rectal swabs from Rattus spp., and cultured for E. coli and Salmonella spp., and screened E. coli isolates by polymerase chain reaction to identify pathotypes. E. coli were found in 70% of Rattus norvegicus and were found in four Rattus rattus. DEC were isolated in 31.3% of the 67 brown rats (R. norvegicus). The pathotypes detected more frequently were shiga toxin E. coli in 11.9%, followed by atypical enteropathogenic E. coli in 10.4% and enteroinvasive E. coli in 4.5%. From the five black rats (R. rattus), two presented DEC. Salmonella enterica was found in only one (1.4%) of 67 R. norvegicus. Our findings indicate that both R. norvegicus and R. rattus are host of DEC and, at lower prevalence, S. enterica, highlighting the importance of rodents as potential sources of pathogenic agents for humans.

Prediction of lithium response using clinical data.

OBJECTIVE: Promptly establishing maintenance therapy could reduce morbidity and mortality in patients with bipolar disorder. Using a machine learning approach, we sought to evaluate whether lithium responsiveness (LR) is predictable using clinical markers. METHOD: Our data are the largest existing sample of direct interview-based clinical data from lithium-treated patients (n = 1266, 34.7% responders), collected across seven sites, internationally. We trained a random forest model to classify LR-as defined by the previously validated Alda scale-against 180 clinical predictors. RESULTS: Under appropriate cross-validation procedures, LR was predictable in the pooled sample with an area under the receiver operating characteristic curve of 0.80 (95% CI 0.78-0.82) and a Cohen kappa of 0.46 (0.4-0.51). The model demonstrated a particularly low false-positive rate (specificity 0.91 [0.88-0.92]). Features related to clinical course and the absence of rapid cycling appeared consistently informative. CONCLUSION: Clinical data can inform out-of-sample LR prediction to a potentially clinically relevant degree. Despite the relevance of clinical course and the absence of rapid cycling, there was substantial between-site heterogeneity with respect to feature importance. Future work must focus on improving classification of true positives, better characterizing between- and within-site heterogeneity, and further testing such models on new external datasets.

Is vegetation an indicator for evaluating the impact of tourism on the conservation status of Mediterranean coastal dunes?

Mediterranean coastal dunes are threatened by several factors; particularly, tourism causes modifications to the vegetation and the disappearance of endemic species. Understanding the dunes' conservation status is crucial for preserving these vulnerable environments through appropriate management strategies. This study was conducted on 17 Sardinian coastal dunes, with different levels of touristic pressure. We focused on endemic plant species and developed a new endemicity index (EI). Our study aimed: 1) to assess the conservation status by applying the diversity indices; 2) to verify if the study sites would reveal a general pattern based on different degrees of human disturbance and 3) to test the effectiveness of the EI index. Four m2 plots (2 × 2 m) were placed along orthogonal transects to the coastline (446 plots in total), in which all plant species were identified, and their relative abundance was estimated. We found significant differences among the sites for Hdune and EI values but no statistically significant differences in the N values. The EI showed the high naturalistic value of Sardinian coastal dunes and allowed us to distinguish the sites with higher anthropic pressure. We found significant differences in the indices among the degrees of human disturbance in the coastal systems. The Hdune values were positively related to a medium level of human disturbance, and the EI allowed us to distinguish the sites with varying levels of human disturbance, although it differentiated better those with the highest anthropic pressure. A medium level of human disturbance was positively related to the plant richness and cover, and human trampling could be tolerated by psammophilous vascular plants. Results showed a satisfactory conservation status of Sardinian dune systems and highlighted diversity indices as valuable support for implementing a conservation strategy, compatible with the tourism purposes and the integrated management of the Mediterranean coastal dune systems.

Characteristics of depressive and bipolar disorder patients with mixed features.

OBJECTIVE: To assess differences between subjects with vs. without mixed features in major affective disorders. METHODS: In 3099 out-patient subjects with DSM-5 major depressive disorder (MDD, n = 1921) or bipolar disorders (BD, n = 1178), we compared those with (Mx) vs. without (Non-Mx) mixed features (agitated-irritable depression or dysphoric [hypo]mania) in an index episode. RESULTS: Prevalence of Mx averaged 21.9% [CI: 20.5-23.4] overall, ranking: BD-II > BD-I > MDD, and in BD depression ≥ [hypo]mania > MDD. Mx subjects were significantly more likely than Non-Mx cases to (i) have other mixed episodes, (ii) have higher irritable and agitated ratings, (iii) have more substance abuse, (iv) switch into mixed episodes, (v) have more suicide attempts and higher suicidal ratings, (vi) change diagnosis from depression to BD, (vii) have higher hypomania scores when depressed or depression scores when [hypo]manic, (viii) be unmarried or separated with fewer children and siblings, (ix) be diagnosed more with BD than MDD, (x) be unemployed, (xi) have BD, suicide and divorce among first-degree relatives, (xii) be female, (xiii) be younger at illness-onset. Both BD and MDD Mx subjects also received antidepressants less, but antipsychotics and mood-stabilizers more, alone and in combination with antidepressants. CONCLUSIONS: Mood disorder subjects with agitated-irritable depression or dysphoric [hypo]mania differed from those without such mixed features, including having a less favorable clinical course and repeated mixed episodes. They may represent a distinct and prevalent, syndromal clinical subtype with prognostic and therapeutic significance.

Age at menarche predicts age at onset of major affective and anxiety disorders.

BACKGROUND: Menarche age has been associated inconsistently with the occurrence, timing or severity of major depressive disorder (MDD), but rarely studied in women with bipolar (BDs) or anxiety disorders. METHODS: We investigated women patients at a Sardinian mood disorder center for associations of age at menarche with age at illness onset for major affective or anxiety disorders, year of birth, and other selected factors, using bivariate comparisons and multivariate regression modeling. RESULTS: Among women (n=1139) with DSM-IV MDD (n=557), BD-I (n=223), BD-II (n=178), or anxiety disorders (n=181), born in 1904-1998, of mean age 42.9 years, menarche age averaged 12.8 [CI: 12.7-12.9] years. Illness onset age averaged 30.9 [30.1-31.8] years, ranking: BD-I, 25.8; anxiety disorders, 28.0; BD-II, 30.3; MDD, 34.1 years. Menarche age declined secularly over birth years, and was associated with younger illness-onset, having no or fewer siblings, more psychiatrically ill first-degree relatives, living in rural environments, being suicidal, substance abuse, and being unemployed. Earlier menarche and earlier illness-onset were significantly associated for onset age groups of ≤ 20, 20-39, and > 40 years. Menarche age versus diagnosis ranked: BD-II

[Qualitative research about euthanasia concept, between Spanish doctors]. / Investigación cualitativa sobre el concepto de eutanasia, entre médicos españoles.

BACKGROUND AND OBJECTIVES: The decriminalisation of euthanasia and assisted medical suicide has generated a continuous debate. The terminological confusion is one of the main difficulties in obtaining medical practice consensus. The objective of this study was to determine whether the terms of Euthanasia and physician assisted suicide are used with the same meaning by doctors in Extremadura (Spain). MATERIAL AND METHOD: A qualitative study was conducted using two focus groups in which doctors from different specialties who attended a large number of terminal patients participated. No other focus group was required due to saturation. The sessions were tape recorded and transcribed by two experts in qualitative methodology. Atlas.ti software was used for the analysis. We were advised by the "Health Care at the end of life" Group of the Organizacion Médica Colegial of Spain. RESULTS: Terminological confusion was verified in: 1) The mixture of etymological, functional and social concepts, 2) the term Passive Euthanasia, 3) the association between euthanasia and physician assisted suicide, 4) the confusion with the equivalent "wish to hasten death", and 5) the difficulty of differentiating sedation with Euthanasia. There was consensus on some aspects: a) Full voluntariness, b) the condition of terminal illness, and c) the condition of unbearable symptoms. CONCLUSIONS: Conceptual variability persists in relation to the concept of Euthanasia, and is particularly noticeable in the persistence of the concept of passive euthanasia. It would be desirable to achieve a common language to assign a precise meaning to these words to help doctors in their professional practice.

Comparison of psychotic bipolar disorder, schizoaffective disorder, and schizophrenia: an international, multisite study.

OBJECTIVE: Nosological distinctions among schizoaffective disorder (SA), bipolar I disorder with psychotic features (BDp), and schizophrenia (SZ) remain unresolved. METHOD: We compared 2269 subjects with psychotic features in DSM-IV-TR diagnoses (1435 BDp, 463 SZ, 371 SA) from 8 collaborating international sites, by 12 sociodemographic and clinical measures, all between diagnostic pairs. RESULTS: In bivariate comparisons, SA was consistently intermediate between BDp and SZ for 11/12 features (except onset stressors), and SZ vs. BDp differed in all 12 factors. SA differed from both BDp and SZ in 9/12 factors: SA and BDp were similar in education and suicidal ideation or acts; SA and SZ were similar in education, onset stressors, and substance abuse. Meta-analytic comparisons of diagnostic pairs for 10 categorical factors indicated similar differences of SA from both SZ and BDp. Multivariate modeling indicated significantly independent differences between BDp and SZ (8 factors), SA vs. SZ (5), and BDp vs. SA (3). Measurement variance was similar for all diagnoses. CONCLUSION: SA was consistently intermediate between BDp and SZ. The three diagnostic groups ranked: BDp > SA > SZ related to lesser morbidity or disability. The findings are not consistent with a dyadic Kraepelinian categorization, although the considerable overlap among the three DSM-IV diagnostic groups indicates uncertain boundaries if they represent distinct disorders.

Cardiovascular responses during free-diving in the sea.

Cardiac output has never been assessed during free-diving diving in the sea. Knowledge of human diving response in this setting is therefore scarce. 3 immersions were performed by 7 divers: at depths of 10 m, 20 m and 30 m. Each test consisted of 3 apnea phases: descent, static and ascent. An impedance cardiograph provided data on stroke volume, heart rate and cardiac output. Mean blood pressure, arterial O2 saturation and blood lactate values were also collected. Starting from a resting value of 4.5±1.6 L∙min(-1), cardiac output at 10 m showed an increase up to 7.1±2.2 L∙min(-1) (p<0.01) during the descent, while conditions during the static and ascent phases remained unchanged. At 20 m cardiac output values were 7.3±2.4 L∙min(-1) and 6.7(±1).2 L∙min(-1) during ascent and descent, respectively (p<0.01), and 4.3±0.9 L∙min(-1) during static phase. At 30 m cardiac output values were 6.5±1.8 L∙min(-1) and 7.5±2 L∙min(-1) during descent and ascent, respectively (p<0.01), and 4.7±2.1 L∙min(-1) during static phase. Arterial O2 saturation decreased with increasing dive depth, reaching 91.1±3.4% (p<0.001 vs. rest) upon emergence from a depth of 30 m. Blood lactate values increased to 4.1±1.2 mmol∙L(-1) at the end of the 30 m dive (p<0.001 vs. rest). Results seem to suggest that simultaneous activation of exercise and diving response could lead to an absence of cardiac output reduction aimed at an oxygen-conserving effect.

First isolation of Leptospira noguchii serogroups Panama and Autumnalis from cattle.

Prevention and control of leptospirosis are based on the knowledge of locally circulating strains. Thus, efforts to obtain local isolates are paramount to the epidemiological understanding of leptospirosis. We report and discuss here the first isolation of members of serogroups Autumnalis and Panama from cattle, both belonging to Leptospira noguchii species. Urine samples (n = 167) were collected directly by puncture of the bladder from randomly selected cows from a slaughterhouse in Rio de Janeiro, Brazil, for bacteriological culture. Isolates were characterized by serogrouping and sequencing (rrs and secY genes). Overall, 10/167 positive urine samples (6%) were obtained. Sequencing of amplicons targeting for both rrs and secY genes identified two of them (2013_U73 and 2013_U232) as L. noguchii. Serogrouping of those strains indicated that 2013_U73 belonged to the Panama serogroup (titre 1600), and 2013_U232 to the Autumnalis serogroup (titre 12800). Both Panama and Autumnalis are known agents of incidental leptospirosis in cattle. This group of leptospires could be particularly important in tropical countries. This is the first report of members of serogroups Autumnalis and Panama belonging to L. noguchii species from cattle. Although related to previously reported strains, these isolates have been shown to be genetically diverse from them.

Human and entomological surveillance of Toscana virus in the Emilia-Romagna region, Italy, 2010 to 2012.

Toscana virus (TOSV), transmitted by phlebotomine sandflies, is recognised as one of the most important causes of viral meningitis in summer in Mediterranean countries. A surveillance plan based on both human and entomological surveys was started in 2010 in the Emilia-Romagna region, Italy. Clinical samples from patients with neurological manifestations were collected during 2010 to 2012. The surveillance protocol was improved during these years, allowing the detection of 65 human infections. Most of these infections were recorded in hilly areas, where sandflies reach the highest density. Entomological sampling around the homes of the patients resulted in a low number of captured sandflies, while later sampling in a hilly area with high number of human cases (n=21) resulted in a larger number of captured sandflies. Using this approach, 25,653 sandflies were sampled, of which there were 21,157 females, which were sorted into 287 pools. TOSV RNA was detected by real-time PCR in 33 of the pools. The results highlighted the role of Phlebotomus perfiliewi as the main vector of TOSV and a potential link between vector density and virus circulation. This integrated system shows that an interdisciplinary approach improves the sensitiveness and effectiveness of health surveillance.

Sprint vs. intermittent training in young female basketball players.

AIM: This study aimed at comparing the effects of intermittent and repeated sprint ability training on physiological variables. METHODS: Sixteen young female basketball players were randomly allocated to intermittent training (IT=8) or repeated sprint ability training (RST=8) groups. The following outcomes were measured at baseline and after 6 weeks of training: Yo-Yo intermittent recovery (Yo-Yo) and repeated sprint ability (RSA) tests. RESULTS: For all the variables investigated the effect of training type showed a different trend respect at current knowledge. In the RSA, best time (BT) was a significant main effect of training time (pre- vs. post-) (P<0.0001), and of the interaction training type/time (P=0.03). The RST showed a decrease in BT of 3.1% (P=0.005) while the IT showed a decrease of 6.2% (P<0.0001). In the IT there was a significant main effect of time for the total distance with an increment of 26.9%, and a significant main effect of time in the final speed with an increment of 1.23%. CONCLUSION: These findings suggest that the two training methods used in this study can be an effective training strategy for inducing anaerobic and basketball-specific training schedules. Besides, even when IT training is not done at very high speed, it can increase the maximum speed of the RSA.

A new species of Ituglanis representing the southernmost record of the genus, with comments on phylogenetic relationships (Teleostei: Siluriformes: Trichomycteridae).

Ituglanis australis new species, is described from tributaries of the Laguna dos Patos and Río Uruguay, in Brazil and Uruguay. This represents the southernmost record of the genus and the first occurrence of a species of Ituglanis in those systems. It is distinguished from all its congeners, except Ituglanis parahybae and Ituglanis cahyensis, by its body pigmentation with three well-defined dark brown stripes running along each flank. Ituglanis australis differs from I. parahybae and I. cahyensis in the pectoral- and pelvic-fin ray counts, the pattern of the cephalic laterosensory system and the number of dorsal-fin basal radials. The new species, as well as several other examined congeners, has the levator internus IV muscle attached to the dorsal face of the posttemporo-supracleithrum; a condition that corroborates the inclusion of Ituglanis into a large trichomycterine clade that also includes Bullockia, Hatcheria, Scleronema and several species of Trichomycterus. Previous proposals of the affinities within Ituglanis are reviewed and, despite some advances, the phylogenetic relationships among species of the genus remain largely unknown.

Measurement of pulmonary gas exchange variables and lactic anaerobic capacity during field testing in elite indoor football players.

AIM: The aims of this study were: 1) to examine the gas exchange responses of elite indoor football players to a repeated sprint ability (RSA) test; and 2) to verify whether or not the excess of carbon dioxide production (CO2excess) correlates with blood lactate accumulation during RSA field testing. METHODS: Eleven elite male indoor football players were recruited. A preliminary incremental exercise test on a treadmill was performed to elicit V'O2max. Then, participants underwent an RSA test consisting in a shuttle running through a course with various changes of direction while wearing a portable gas analyzer able to provide values of oxygen uptake, carbon dioxide production, and CO2excess. BLa concentrations during recovery were also measured. RESULTS: The main results were that: 1) during the RSA test subjects did not reached the V'O2max level achieved in the preliminary test; 2) during the RSA test BLa levels were higher compared with the preliminary test; 3) the peak BLa concentration during recovery was significantly correlated with the average CO2excess CONCLUSION: It was concluded that the RSA test did not appear to be useful to elicit V'O2max. Rather, it seemed suitable to recruit subjects' lactic anaerobic capacity. Moreover, CO2excess appeared suitable for qualitatively estimate BLa accumulation during field testing.

Conjunctival flora, Schirmer's tear test, intraocular pressure, and conjunctival cytology in neotropical primates from Salvador, Brazil.

BACKGROUND: This study aimed to establish reference values for selected ophthalmic diagnostic tests in healthy neotropical primates from Salvador, Brazil. METHODS: A total of 73 intact adults, including Callithrix jacchus (n = 31), Callithrix penicillata (n = 8), Cebus sp. (n = 22), and Cebus xanthosternos (n = 9) were used to evaluate the normal conjunctival bacterial flora. Cebus xanthosternos (n = 12) were used to evaluate tear production with Schirmer's tear test (STT), intraocular pressure (IOP), and conjunctival cytology. RESULTS: For all animals evaluated, Gram-positive bacteria were predominant. Results of the diagnostic tests in Cebus xanthosternos were as follows: STT: 14.92 ± 5.46 mm/minutes, IOP: 19.62 ± 4.57 mmHg, and conjunctival cytology revealed intermediate squamous epithelial cells in great quantities. CONCLUSIONS: These ophthalmic reference values will be particularly useful to diagnose discrete or unusual pathological changes in the neotropical primates eye.

Kinetic pathways of sphere-to-cylinder transition in diblock copolymer melt under electric field.

Phase transition from body-centered-cubic spheres to cylinders in a diblock copolymer melt under an external electric field is investigated by means of real-space dynamical self-consistent field theory. Different phase transition kinetic pathways and different cylindrical domains arrangements of the final phase are observed depending on the strength and direction of the applied electric field. Various transient states have been identified depending on the electric field being applied along [111], [100], and [110] directions. The electric field should be above a certain threshold value in order the transition to occur. A "dynamic critical exponent" of the transition is found to be about 3/2, consistent with other order-order transitions in diblock copolymers under electric field.

Assessment of circulatory adjustments during underwater apnoea in elite divers by means of a portable device.

AIM: Considering that sympathetic activation is induced by exercise, it is reasonable to assume that hemodynamic adjustments to exercise act in opposition to those elicited by the diving response. However, cardiovascular measurements have never been performed during underwater dynamic apnoea (DA), and this hypothesis remains speculative. METHODS: Data concerning heart rate (HR), stroke volume (SV) and cardiac output (CO) during static apnoea (SA) and DA were collected from 12 elite divers by means of an impedance cardiograph adapted to the underwater environment. Mean arterial pressure (MBP), systemic vascular resistance (SVR) and arterial oxygen saturation (SaO(2)) were also assessed. Five trials were performed by the divers: head-out immersion during normal breathing (test A); 3 min of SA immersed at the surface (B) and at 3 m depth (C); DA till exhaustion immersed at the surface (D) and at 3 m depth (E). RESULTS: Both B and C conditions led to bradycardia (-17%) compared to A and also induced a decrement in SV (-8%) and in CO (-25%), while MBP was maintained because of an increase in SVR. A significant MBP increment (+11%) was detected only during tests D and E, when a SaO(2) drop was also present, whereas HR, SV and CO remained unchanged. CONCLUSION: We concluded that typical diving response was present only during SA, while sympathetic activation was induced by exercise during DA, which partially obscured the effects of the diving response.

Rediscovery and redescription of the unusual subterranean characiform Stygichthys typhlops, with notes on its life history.

The rediscovery of the enigmatic subterranean characiform Stygichthys typhlops is reported almost a half-century after the collection of the holotype, the only specimen previously known. Thirty-four specimens were collected in two shallow hand-dug wells at the region of the type locality, c. 13 km south-west of the town of Jaíba, Minas Gerais, Brazil. These specimens provide new information on the morphology of this species, and for the first time on its life history. The conservation status of S. typhlops is discussed. The species is severely threatened by habitat loss caused by exploitation of the aquifer.

Cáncer de pulmón y enfermedad pulmonar obstructiva crónica al final de la vida / Chronic obstructive pulmonary disease and lung cancer at the end of life

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Field studies on Culicoides (Diptera: Ceratopogonidae) activity and response to deltamethrin applications to sheep in northeastern Spain.

An enclosure trapping experiment compared numbers and engorgement of Culicoides spp. taken from treated sheep (7.5% deltamethrin) to Culicoides from untreated sheep. Attack rates were low (0.2/min), but 58% of Culicoides obsoletus s.l. and 67% of Culicoides parroti Kieffer engorged on untreated sheep, and no engorgement occurred on treated sheep on 0 and 4 d posttreatment. A UV light trap in a livestock barn collected eight Culicoides spp. (510 individuals), dominated by C. obsoletus (Meigen) (68%), Culicoides imicola Kieffer (19%), Culicoides circumscriptus Kieffer (8%), and Culicoides alazanicus Dzhafarov (4%). A more powerful but nonattractive fan trap collected five species (121 individuals) dominated by C. obsoletus (48%), C. imicola (36%), C. alazanicus (8%), and C. circumscriptus (7%). Parity of C. obsoletus and C. imicola did not vary between the light and fan traps. Engorged Culicoides in the barn (33 C. obsoletus and three C. imicola) had fed on sheep or goats (precipitin test).