bluuebunny/crossref_metadata_2025 huggingface dataset:
FEOCROMOCITOMA EM PEQUENOS ANIMAIS
Authors: Mendes de Queiroz Deborah Luiza , Guedes Arruda Giselle Nogueira , Alves Lourenço Paulo Victor , Diógenes Yara Pereira , Dos Santos Maressa Holanda , Rodrigues Cabral Leonardo Alves , Correia costa Paula Priscila
Published: September 2018

O feocromocitoma é uma neoplasia endócrina rara, do sistema nervoso simpático, com origem nas células cromafins da medula adrenal e produtor de catecolaminas. O diagnóstico ante mortem é complexo e raro, exigindo um alto índice de suspeita por parte dos médicos veterinários, devido à natureza paroxística e inespecífica dos sinais clínicos assim como à presença de doenças concomitantes e ainda carência de meios de diagnóstico específicos e sensíveis em cães. Como resultado de potenciais consequências fatais, o diagnóstico precoce é essencial de forma a garantir qualquer possibilidade de sobrevivência do animal. Essa neoplasia pode se apresentar de maneira unilaterais ou bilaterais, funcionais ou não-funcionais, de carácter benigno ou maligno. Nos cães, as maiorias destes tumores apresentam-se unilaterais, e apenas cerca de 10% são bilaterais. Os sinais clínicos associados aos feocromocitomas resultam do excesso de catecolaminas libertadas, do efeito de massa e invasão local pelo tumor e da presença de metástases, sendo o excesso de secreção de catecolaminas o principal responsável pelo quadro clínico. Cerca de 50% dos cães afetados permanecem assintomáticos, sendo que, nestes pacientes, o diagnóstico ocorre de forma acidental durante a necrópsia, durante a exploração de outras afeções ou durante uma intervenção cirúrgica.
USO DE MEDICAMENTOS HOMEOPÁTICOS NA PODODERMATITE EM OVINOS DA RAÇA SANTA INÊS – RELATO DE CASO
Authors: Jesus Renan Almeida de , Bergo Danilo , Rodrigues Fernanda Lourenço , Sabec Giuliana Zardeto , Marcusso Paulo Fernandes
Published: September 2018

O relato de caso teve como objetivo demonstrar o efeito do uso de medicamentos homeopáticos no tratamento da pododermatite de ovinos da raça Santa Inês. A pododermatite é uma doença infecciosa causada principalmente pelas bactérias Dichelobacter nodosus e Fusobacterium necrophorum, que pode provocar lesões na camada córnea do casco, causando problemas como infecções secundárias e dificuldade de locomoção caracterizada por claudicação. Em um rebanho de 119 ovinos da raça Santa Inês, foram tratados 12 animais que apresentavam claudicação e características inflamatórias. O tratamento consistiu em 20 gramas diárias de medicamento homeopático (composto por Arnica montana, Graphites, Mercurius solubilis, Scilla maritima e Thuya occidentalis) fornecido na alimentação, que foi utilizada na proporção de 1,5% do peso vivo do animal durante 60 dias, com análise dos resultados após 30 e 60 dias do início do tratamento. Dos 12 animais tratados, 1 (8,33%) não obteve melhora clínica e foi destinado ao descarte por escolha do proprietário, 1 (8,33%) ainda apresentava características inflamatórias ao término do tratamento, contudo a classificação passou de grave para leve aos60 dias, e 10 (83,34%) animais que inicialmente apresentavam grau grave obtiveram melhora clínica e ausência total de claudicação. Com base nos dados alcançados, o tratamento homeopático parece apresentar melhora na claudicação e no tratamento de pododermatite.
CARACTERÍSTICAS MICROBIOLÓGICAS E FÍSICO-QUÍMICAS DA CARNE DE SOL COMERCIALIZADA
Authors: Nascimento Leniza Luiza Oliveira , Oliveira Dérick Gustavo Silva , Silva Maria Eliuma Pereira , Barbosa Victor Augusto Araújo , Cardoso Filho Francisco Chagas , Albuquerque Waleska Ferreira de
Published: September 2018

A pesquisa objetivou avaliar a qualidade microbiológica e físico-química da carne de sol comercializadas nos frigoríficos em Teresina, Piauí. Foram analisadas 20 amostras de carne de sol de dezembro de 2013 a fevereiro de 2014 quantificando bactérias aeróbias mesófilas, coliformes a 35°C e 45°C, estafilococos coagulase positiva e a presença de Salmonella, verificando se acatava aos padrões microbiológicos da RDC n°12/2001. Para análises físico-químicas verificou-se o pH, teor de umidade pelo método da estufa, teor de cinzas e o teor de cloreto sódio seguindo as normas do Instituto Adolfo Lutz. Quanto à presença de coliformes a 35°C, 50% das amostras apresentaram contaminação máxima e para os coliformes 45°C, 60% amostras eram inapropriadas. Contagem de bactérias aeróbias mesófilas variou de 4,5. 103 UFC/g a 8,9. 105 UFC/g. Para contagem de estafilococos coagulase positivo 70% das amostras contrariaram a RDC n°12, e para pesquisa de Salmonella 20% são inaceitável pela legislação. A média do pH  foi de 5,8, do teor de umidade foi 57,64%, do teor de cinza 7,9%, e do teor de cloreto sódio foi de 6,48%. As carnes de sol foram consideradas inapropriadas para consumo e a combinação dos fatores físico-químicos foram insuficientes para produção de um alimento seguro.
AVALIAÇÃO DA RESPOSTA CICATRICIAL À APLICAÇÃO DÉRMICA DE SCAFFOLD A BASE DE AMIDO ADITIVADO EM FERIDAS CIRÚRGICAS DE ORYCTOLAGUS CUNICULUS EM MODELO EXPERIMENTAL
Authors: Olsson Débora Cristina , Schiochet Gisele , Ampessan Jonathan , Rossi Kauê , Albrecht Rafael , Vieira Francieli , Locatelli Gabriela Maria , Albring Caren Lis , Gabriel Mateus , Schwertz Claiton , Mendes Ricardo Evandro , Fronza Nei , Vargas Junior Alvaro
Published: September 2018

O presente estudo teve por objetivo desenvolver e investigar experimentalmente as potencialidades de aplicação de bioadesivo a base de amido aditivado, como sistema patches transdérmico e intradérmico epitelial, em formato de filme monolaminar tubular, visando à ação futura para administração de anti-inflamatórios, antimicrobianos e atuação terapêutica. Foram utilizados 20 coelhos machos e fêmeas, da raça Nova Zelândia, adultos, separados em quatro grupos com cinco animais que passaram por cirurgia para realização de defeito dérmico. O grupo GA e o grupo GB (controle dérmico e intradérmico negativos respectivamente) não receberam biomaterial na ferida. Os animais do grupo GC receberam o biofilme adesivo de forma dérmica que foi suturado sobre a ferida e o grupo GD, recebeu o biofilme adesivo de forma intradérmica. Aos sete e 14 dias de pós-operatório os animais foram anestesiados novamente para criação do defeito para biópsia. A análise estatística da planimetria foi conduzida a partir da média dos grupos, utilizando-se o teste de Tukey a significância de 1%, através do software computacional estatístico SAS®.  A pesquisa demonstrou que o biofilme utilizado até sete dias reduz o processo inflamatório e estimula a neoangiogênse.
EFEITOS DE ONDAS ULTRASSÔNICAS E ÁCIDOS GRAXOS ESSENCIAIS NA CICATRIZAÇÃO DE MÚSCULO GASTROCNÊMIO DE RATOS WISTAR
Authors: Olsson Débora Cristina , Do Amaral Andressa Dias , Tibola Rafael Teis , Locatelli Gabriela Maria , Vieira Francieli Jaqueline , Rossi Kaue , Albring Caren Lis , Marchezan Manoela Piva , Stedille Fernanda , Moreira Marina Prazeres , Albrecht Rafael , Mendes Ricardo Evandro
Published: September 2018

Para avaliar a cicatrização de feridas do músculo gastrocnêmio de ratos submetidos à lesão iatrogênica, utilizou-se a terapia com ultra-som terapêutico (UST) e fonoforese no modo pulsado com óleo cicatrizante composto por ácidos graxos essenciais (AGE) . Foram utilizadas 64 ratas, separadas em quatro grupos experimentais com 16 animais por grupo. A cicatrização do músculo gastrocnêmio foi avaliada por esteriometria, sendo considerada a proporção volumétrica dos constituintes tissulares e celulares de amostras obtidos por biópsia às 24, 48, 96 e 144horas de pós-operatório. Vinte e quatro horas após a intervenção cirúrgica iniciou-se a aplicação de UST, fonoforese, e AGE nos grupos distintos sobre a ferida. Os resultados obtidos com a aplicação de UST no modo pulsado e em função fonoforese às 144horas mostraram menor proporção volumétrica de células polimorfonucleares (PMN) e o grupo que recebeu fonoforese apresentou maior proporção de fibroblastos. Esses resultados sugerem que a modalidade fonoforese auxilia na cicatrização de feridas musculares.
RINOSPORIDIOSE EM EQUINO - RELATO DE CASO
Authors: Savioli de Almeida Sampaio Augusto José , Frederico Rodrigues Loureiro Bracarense Ana Paula , Nesi Maria Flávia
Published: September 2018

A rinosporidiose é uma infecção de natureza crônica causada pelo agente etiológico Rinosporidium seeberi. Afeta predominantemente narinas e nasofaringe e é responsável pela formação de nódulos granulomatosos. Os principais sinais clínicos são secreção nasal, ruídos respiratórios e dificuldade respiratória por obstrução. O presente trabalho tem como objetivo relatar um caso de rinosporidiose em um equino macho, adulto com 7 anos de idade, sem raça definida e destinado ao serviço de patrulhamento urbano. O diagnóstico foi estabelecido pelos sinais clínicos e confirmado através do exame histopatológico. O tratamento de escolha foi a excisão cirúrgica da massa granulomatosa seguida pela termocauterização da sua base, apresentando ótimo resultado. Pode-se concluir que casos suspeitos devem ser estudados com a finalidade de identificar o agente causal para estabelecer o correto diagnóstico e dessa forma determinar um tratamento adequado, eficaz e assegurar um prognóstico convicto.
QUALIDADE MICROBIOLÓGICA DE RICOTAS PROVENIENTES DE UM LATICÍNIO LOCALIZADO NO SUL DE MINAS GERAIS
Authors: Da Silva Fernandes Meg , Fujimoto Graciela , Kabuki Dirce Yorika , Kuaye Arnaldo Yoshiteru
Published: September 2018

Neste trabalho avaliou-se a adequação de amostras de ricota provenientes de um laticínio localizado no sul de Minas Gerais aos padrões microbiológicos fixados pela RDC n°12/2001 da ANVISA, complementado pela avaliação da potabilidade da água de processo utilizada na indústria de laticínios. Foram realizadas análises microbiológicas de Salmonella sp., Listeria monocytogenes, coliformes a 45 °C e estafilococos coagulase positiva e negativa em 15 amostras de ricota. Complementarmente, um total de 3 amostras de água utilizada na planta de processo foi avaliado quanto à contagem de  coliformes totais, termotolerantes e bactérias heterotróficas. Os resultados revelaram que 13% (2/15) das amostras de ricota estavam em desacordo com os padrões para contagem de estafilococos coagulase positiva e 13 amostras (87%) apresentaram contagens de estafilococos coagulase negativa entre 5,9 x 104 e 4,9 x 106 UFC/g. Em nenhuma das amostras foi detectada a presença de Salmonella sp., L. monocytogenes e a contagem de coliformes termotolerantes foi <3 NMP/g. Das 3 amostras de água analisadas, 1 (33%) estava fora dos padrões de potabilidade preconizados pela legislação. Os resultados evidenciaram possíveis deficiências na aplicação das boas práticas de fabricação e, portanto, a consequente necessidade de medidas corretivas para o controle da inocuidade das ricotas produzidas.
CONDIÇÕES DE RISCO DE PARASITISMO POR DIOCTOPHYME RENALE EM CÃES NO MUNICÍPIO DE URUGUAIANA – CONTRIBUIÇÃO DO MÉDICO VETERINÁRIO NA SAÚDE PÚBLICA
Authors: Dill Susane Werle , Mistieri de Arruda Maria Lígia , Rios Lima Machado Ingrid
Published: September 2018

O objetivo foi realizar um levantamento de cães atendidos no setor de Diagnóstico por Imagem do Hospital Universitário Veterinário da UNIPAMPA e selecionar pacientes diagnosticados com dioctofimatose. Realizou-se levantamento documental com a e coleta de dados dos prontuários durante os anos de 2015 a 2017. As informações coletadas eram: método diagnóstico, sinais clínicos, localização do(s) parasita(s), idade, gênero, contato com outros cães, controle parasitário, tipo de alimentação e endereço. O endereço foi avaliado quanto à proximidade do rio Uruguai e áreas de alagamento. Realizou-se avaliação dos locais, buscando caracterizar condições de risco de exposição ao parasita, como: presença de animais errantes, rios/canais fluviais, lixo em vias públicas, saneamento básico, pavimentação e áreas alagadas. Os dados foram descritos e analisados por distribuição de percentagem. Entre os anos de 2015 e 2017, treze (1,75%) cães apresentaram imagens compatíveis com dioctofimatose. Em relação ao gênero dos cães, 69% eram machos, a maioria dos tutores (54%) informou que os animais tinham livre acesso a rua, outros 23% permaneciam dentro do quintal e 85% dos cães apresentava contato com outros cães. Um animal reside nas proximidades de um canal de água, 89% dos locais tinham lixo em vias públicas e 85% apresentavam cães errantes. O potencial hídrico, presença de lixo nas ruas e esgoto a céu aberto, associados a hábitos de alimentação e manejo semidomiciliar dos cães contribuem para a ocorrência do parasitismo em bairros distantes das encostas do Rio Uruguai. Maiores esclarecimentos quanto à perpetuação do clico do parasita são necessários em diferentes populações caninas do município de Uruguaiana.
SUBLUXAÇÃO ATLANTOAXIAL CONGÊNITA EM CÃO SUBMETIDO A TRATAMENTO CONSERVATIVO – RELATO DE CASO
Authors: Dos Santos Douglas Evandro , Vasques Gabriela Maria Benedetti , Fiorato Camila André , Leal Leonardo Martins
Published: September 2018

A subluxação atlantoaxial ou instabilidade atlantoaxial, é uma afecção articular onde ocorre o deslocamento dorsal do áxis (C2) em relação ao atlas (C1) levando a uma compressão da medula espinhal, podendo ser de forma congênita ou adquirida. Os cães acometidos apresentam sinais clínicos relacionados ao nervo motor superior (NMS) como consequência da compressão medular cervical, tendo curso agudo ou crônico, intermitentes ou não. O diagnóstico é realizado através da avaliação dos sinais neurológicos, exame clínico e exames de imagem. O tratamento pode ser médico, com o repouso, uso de colar cervical e utilização de analgésicos e anti-inflamatórios ou cirúrgico, visando a redução e estabilização permanente da articulação e eliminar a compressão medular. Este trabalho tem como objetivo relatar o atendimento a um canídeo, fêmea, sem raça definida, com 6 meses de idade e 6 kg, atendido no hospital veterinário do Centro Universitário Ingá, apresentando cervicalgia, relutância ao movimento de cabeça e pescoço, ataxia, quedas ao locomover-se e paresia de membros posteriores de curso agudo, tendo início a aproximadamente 2 dias tendo sido, através do exame radiográfico diagnosticada com Subluxação atlantoaxial congênita, tendo sido instituído tratamento conservativo com uso de colar cervico torácico e repouso em canil, tendo sido prescrito cloridrato de tramadol, dipirona, meloxicam e ranitidina, obtendo-se resposta satisfatória ao quadro, sem qualquer sinal recidiva durante 6 meses de acompanhamento.
Pilot Study Assessing the Impact of Bereavement Support on Families of Deceased Intensive Care Unit Patients
Authors: McAdam Jennifer L. , Puntillo Kathleen
Published: September 2018

Background

Family members of patients who die in an intensive care unit (ICU) may experience negative outcomes. However, few studies have assessed the effectiveness of bereavement care for families.

Objective

To evaluate the effectiveness of bereavement follow-up on family members’ anxiety, depression, posttraumatic stress, prolonged grief, and satisfaction with care.

Methods

A cross-sectional, prospective pilot study of 40 family members of patients who died in 2 tertiary care ICUs. Those in the medical-surgical ICU received bereavement follow-up (bereavement group); those in the cardiac ICU received standard care (nonbereavement group). Both groups completed surveys 13 months after the death. Surveys included the Hospital Anxiety and Depression Scale, Impact of Event Scale-Revised, Family Satisfaction With Care in the Intensive Care Unit, Prolonged Grief Disorder, and a bereavement survey.

Results

Of 30 family members in the bereavement group and 10 in the nonbereavement group, most were female and spouses, with a mean (SD) age of 60.1 (13.3) years. Significantly more participants in the nonbereavement group than in the bereavement group had prolonged grief. Posttraumatic stress, anxiety, depression, and satisfaction with care were not significantly different in the 2 groups. However, overall posttraumatic stress scores were higher in the nonbereavement group than the bereavement group, indicating a higher risk of posttraumatic stress disorder.

Conclusions

Bereavement follow-up after an ICU death reduced family members’ prolonged grief and may also reduce their risk of posttraumatic stress disorder. This type of support did not have a measurable effect on depression or satisfaction with ICU care.
The ‘Frail Researcher’ in dialogue with existential phenomenology: The threat of empiricism within the quest for sound methodology in practical theological research
Authors: Louw Daniël J.
Published: September 2018

Within an academic environment and context of higher education, the question of disciplinary differentiation and research methodology are burning issues to adhere to the quest for scientific and sound epistemological based knowledge. While dealing with the dual tension: wisdom (sapientia) and reason (scientia), it is difficult for practical theology to identify and maintain its theological character. Under the pressure of human sciences, research in practical theology tends to turn to phenomenology so to gain clarity on the philosophical framework or paradigm for performing research projects in a systematic and methodological way. In this regard, existential phenomenology probes into the meta-realm of meaning-giving; it describes the frailty of life in terms of being (Dasein) as exposed to anxiety, dread, despair and fear of death. Due to the demand for empirical research, the threat of empiricism and the danger of Platonification (the ‘causation trap’) is discussed. To maintain both its spiritual-theological character (ministerial and ecclesial context), and its relevancy for the dynamics of life events (contextuality), a ‘spiritual empiricism’ is proposed by means of a praxis of practical theological verbing, namely understanding and interpreting, communicating and verbalising, acting, hoping, imagining, seeing, beautifying and living. It is argued that the notion ‘praxis of God’ could serve as theological paradigm in theory formation. The passio Dei is both a spiritual matter and existential-experiential entity within the encounter of God–human beings. It refers to both the reason or logic of God (ḥesed) and the wisdom of grace (compassion).
RISK MAPPING OF VISCERAL LEISHMANIASIS: THE ROLE OF LOCAL VARIATION IN RAINFALL AND ALTITUDE ON THE PRESENCE AND INCIDENCE OF KALA-AZAR IN EASTERN SUDAN
Authors: ELNAIEM DIA-ELDIN A. , SCHORSCHER JUDITH , BENDALL ANNA , OBSOMER VALÉRIE , OSMAN MAHA E. , MEKKAWI ABDELRAFIE M. , CONNOR STEPHEN J. , ASHFORD RICHARD W. , THOMSON MADELEINE C.
Published: September 2018

Visceral leishmaniasis (VL) is a vector-borne disease highly influenced by environmental factors. A model was developed for mapping the distribution and incidence of VL in Gedaref State, eastern Sudan, in relation to different environmental factors. Geographical information systems (GIS) were used to extract and map regression results for environmental variables of 190 villages in Gedaref State, including rainfall, vegetation status, soil type, altitude, distance from river, topography, wetness indexes, and average rainfall estimates. VL incidence in each village was calculated from hospital records. By use of logistic and linear multivariate regression analyses, models were developed to determine which environmental factors explain variability in VL presence and incidence. We found that average rainfall and the altitude were the best predictors of VL incidence. The resulting models were mapped by GIS software predicting both VL presence or absence and incidence at any locality in Gedaref State. The results are discussed in relation to VL control.
SHORT REPORT: ANCYLOSTOMA CEYLANICUM: EXSHEATHMENT IS NOT REQUIRED FOR SUCCESSFUL CRYOPRESERVATION OF THIRD STAGE HOOKWORM LARVAE
Authors: DUARTE JOHN , HARRISON LISA M. , CAPPELLO MICHAEL
Published: September 2018

Third-stage larvae (L3) of the human hookworm parasite Ancylostoma ceylanicum were cultured from the feces of infected hamsters and frozen for up to 100 days in liquid nitrogen. Upon thawing, viable larvae were recovered and used to inoculate naive hamsters. The larvae recovered from this second group of hamsters were used to inoculate a third group of naive animals, which demonstrated that the originally frozen larvae were successfully maintained for two full generations following thawing. These data suggest that exsheathment, which has previously been reported to be essential for successful cryopreservation, is not necessary for recovery of viable, infectious A. ceylanicum L3.
GENERATION AND CHARACTERIZATION OF CDNA CLONES FROM SARCOPTES SCABIEI VAR. HOMINIS FOR AN EXPRESSED SEQUENCE TAG LIBRARY: IDENTIFICATION OF HOMOLOGUES OF HOUSE DUST MITE ALLERGENS
Authors: FISCHER KATJA , HOLT DEBORAH C. , HARUMAL PEARLY , CURRIE BART J. , WALTON SHELLEY F. , KEMP DAVID J.
Published: September 2018

Molecular studies on scabies, a disease of considerable human and veterinary significance, have been limited because of the difficulty of obtaining the causative organism Sarcoptes scabiei, the “itch mite.” We have used skin from the bedding of crusted scabies patients as a source of mites for the construction of libraries of cDNAs from S. scabiei var. hominis in the bacteriophage λ vector λZAP express. Sequences of 145 clones established that the libraries predominantly contain sequences from S. scabiei, enabling a major sequencing program to begin. Among those sequenced to date, cDNAs encoding S. scabiei homologues of 3 house dust mite allergens—the M-177 apolipoprotein, glutathione S-transferase, and paramyosin—were identified. The availability of cDNA libraries from S. scabiei var. hominis and S. scabiei var. vulpes and the emerging public sequence databases from both opens up new possibilities in scabies research.
EFFECTS OF PERMETHRIN-TREATED BED NETS ON IMMUNITY TO MALARIA IN WESTERN KENYA II. ANTIBODY RESPONSES IN YOUNG CHILDREN IN AN AREA OF INTENSE MALARIA TRANSMISSION
Authors: KARIUKI SIMON K. , LAL ALTAF A. , TERLOUW DIANNE J. , TER KUILE FEIKO O. , ONG’ECHA JOHN M. O. , PHILLIPS-HOWARD PENELOPE A. , ORAGO ALLOYS S. S. , KOLCZAK MARGARETTE S. , HAWLEY WILLIAM A. , NAHLEN BERNARD L. , SHI YA PING
Published: September 2018

As part of a large community-based trial on the impact of insecticide (permethrin)-treated bed nets (ITNs) on childhood morbidity and mortality in an area of intense perennial malaria transmission in western Kenya, we assessed the effects of ITNs on malaria-specific humoral responses in young children. The IgG responses to Plasmodium falciparum pre-erythrocytic antigens circumsporozoite protein (CSP) and liver stage antigen-1 (LSA-1) and the blood stage antigen merozoite surface protein-1 (MSP-119 kD) in children less than three years old were investigated during a series of cross-sectional surveys. At 14 and 22 months after the introduction of ITNs, the frequencies and levels of IgG to CSP and LSA-1 were significantly lower in children from ITN villages than in children from control villages (P < 0.001). In contrast, the prevalence of IgG to MSP-1 was significantly higher in children from ITN villages at 14 months (P = 0.0069), but not at 22 months. Our results show that decreased exposure by ITNs reduces IgG responses to pre-erythrocytic antigens, but there was no evidence that two years of ITN use compromises IgG responses to blood stage antigens in these young children in this malaria holoendemic area.
COMMUNITY-WIDE EFFECTS OF PERMETHRIN-TREATED BED NETS ON CHILD MORTALITY AND MALARIA MORBIDITY IN WESTERN KENYA
Authors: HAWLEY WILLIAM A. , PHILLIPS-HOWARD PENELOPE A. , TER KUILE FEIKO O. , TERLOUW DIANNE J. , VULULE JOHN M. , OMBOK MAURICE , NAHLEN BERNARD L. , GIMNIG JOHN E. , KARIUKI SIMON K. , KOLCZAK MARGARETTE S. , HIGHTOWER ALLEN W.
Published: September 2018

Spatial analyses of the effect of insecticide (permethrin)-treated bed nets (ITNs) on nearby households both with and without ITNs was performed in the context of a large-scale, group-randomized, controlled mortality trial in Asembo, western Kenya. Results illustrate a protective effect of ITNs on compounds lacking ITNs located within 300 meters of compounds with ITNs for child mortality, moderate anemia, high-density parasitemia, and hemoglobin levels. This community effect on nearby compounds without nets is approximately as strong as the effect observed within villages with ITNs. This implies that in areas with intense malaria transmission with high ITN coverage, the primary effect of insecticide-treated nets is via area-wide effects on the mosquito population and not, as commonly supposed, by simple imposition of a physical barrier protecting individuals from biting. The strength of the community effect depended upon the proportion of nearby compounds with treated nets. To maximize their public health impact, high coverage with treated nets is essential.
COMPARATIVE EFFICACY OF AMINOQUINOLINE-ANTIFOLATE COMBINATIONS FOR THE TREATMENT OF UNCOMPLICATED FALCIPARUM MALARIA IN KAMPALA, UGANDA
Authors: GASASIRA ANNE F. , DORSEY GRANT , NZARUBARA BRIDGET , STAEDKE SARAH G. , NASSALI ANNETTE , ROSENTHAL PHILIP J. , KAMYA MOSES R.
Published: September 2018

Resistance to chloroquine (CQ) requires its replacement as first-line therapy for uncomplicated malaria in much of Africa. Combination therapy may improve efficacy and delay the selection of resistant malaria parasites. Combinations of sulfadoxine-pyrimethamine (SP) with 4-aminoquinolines offer affordable and available alternatives to CQ. We conducted a randomized, single-blinded trial to compare the efficacy of SP monotherapy with combinations of SP and either CQ or amodiaquine (AQ) for the treatment of uncomplicated falciparum malaria in patients over 6 months of age in Kampala, Uganda. Of the 448 patients enrolled, 428 (95%) completed follow-up. Clinical treatment failure after 14 days occurred in 21/140 (15.0%, 95% CI 9.5–22.0%) SP-treated, 11/152 (7.2%, 95% CI 3.7–12.6%) SP/CQ-treated, and 0/136 (0%, 95% CI 0–2.7%) SP/AQ-treated patients. Combination therapies were safe and offered superior efficacy to SP monotherapy. SP/AQ was the most efficacious. This low-cost combination regimen may provide an optimal alternative to CQ for the treatment of uncomplicated malaria in Uganda.
DISTINGUISHING RECRUDESCENCE FROM REINFECTION IN A LONGITUDINAL ANTIMALARIAL DRUG EFFICACY STUDY: COMPARISON OF RESULTS BASED ON GENOTYPING OF MSP-1, MSP-2, AND GLURP
Authors: CATTAMANCHI ADITHYA , KYABAYINZE DANIEL , HUBBARD ALAN , ROSENTHAL PHILIP J. , DORSEY GRANT
Published: September 2018

Genotyping frequently is used to distinguish recrudescent from new infections in antimalarial drug efficacy trials, but methodology and interpretation of results have not been standardized. We compared the utility of polymorphisms within 3 Plasmodium falciparum genes during a longitudinal trial in Kampala, Uganda. Merozoite surface protein-1 (msp-1) and merozoite surface protein-2 (msp-2) revealed greater diversity than glutamate-rich protein. Genotypes based on msp-1, msp-2, and all 3 genes combined were compared for 394 initial and subsequent isolates. Classification of most episodes as due to recrudescence or reinfection was straightforward. In 24% (msp-1), 16% (msp-2), and 62% (3 genes combined) of samples, subsequent episodes contained identical and new alleles, however. Our analysis suggested that such episodes should be classified as reinfections and not recrudescence. Comparing the 3 studied genes, msp-2 results were most accurate, and analysis of this single gene effectively distinguished recrudescence from reinfection in our study population.
ASSOCIATION OF PLASMODIUM FALCIPARUM CHLOROQUINE RESISTANCE TRANSPORTER VARIANT T76 WITH AGE-RELATED PLASMA CHLOROQUINE LEVELS
Authors: MAY JÜRGEN , MEYER CHRISTIAN G.
Published: September 2018

The mutation leading to the substitution of a threonine (T76) for a lysine at position 76 of the Plasmodium falciparum chloroquine resistance transporter (PfCRT) was genotyped in 100 Nigerian children with asymptomatic parasitemia. Isolates containing both pfcrt variants were found to harbor higher numbers of parasite clones (P < 0.002). The prevalence of the pfcrt T76 variant decreased with age (P < 0.0001) and increased with blood levels of chloroquine (CQ) (P < 0.0001). Whereas the K76 allele was more frequent in individuals without detectable plasma CQ levels (79.7%), only the pfcrt T76 variant was observed in children with CQ levels > 150 nmol/L. In individuals without detectable plasma CQ, the proportion of those with pfcrt T76 decreased from 60% in children < 2 years old to 23.5% in children ≥ 6 years old (P < 0.01). The association of actual blood levels of CQ and the occurrence of pfcrt T76 underlines that the pfcrt T76 variant is in fact the mediator of CQ resistance.
RECRUDESCENCE IN ARTESUNATE-TREATED PATIENTS WITH FALCIPARUM MALARIA IS DEPENDENT ON PARASITE BURDEN NOT ON PARASITE FACTORS
Authors: ITTARAT WANIDA , PICKARD AMY L. , RATTANASINGANCHAN PANTHIP , WILAIRATANA POLRAT , LOOAREESUWAN SORNCHAI , EMERY KATHRYN , LOW JONATHAN , UDOMSANGPETCH RACHANEE , MESHNICK STEVEN R.
Published: September 2018

Artemisinin derivatives are first-line antimalarial drugs in Thailand. No firm evidence of clinically relevant artemisinin resistance exists. When used as monotherapy, artesunate has been associated with a high treatment failure (recrudescence) rate, which could be due to low-level artemisinin resistance. To understand the causes of recrudescence, we retrospectively studied a cohort of 104 malaria patients treated with artesunate monotherapy, 32 of whom recrudesced. There was no difference in in vitro artesunate sensitivities between 6 nonrecrudescent isolates and 16 paired admission and recrudescent isolates. Paired admission and recrudescent isolates from 10 patients were genotyped; only 3 had pfmdr1 mutations. Patients with admission parasitemias >10,000 per μl had a 9-fold higher likelihood of recrudescence (adjusted odds ratio) compared with patients with lower parasitemias. This study suggests (1) recrudescence after treatment with artesunate is not the result of inherent parasite resistance, and (2) admission parasitemia may be useful in choosing therapeutic options.
THE HOUSEHOLD-LEVEL ECONOMICS OF USING PERMETHRIN-TREATED BED NETS TO PREVENT MALARIA IN CHILDREN LESS THAN FIVE YEARS OF AGE
Authors: MELTZER MARTIN I. , TERLOUW DIANNE J. , KOLCZAK MARGARETTE S. , ODHACHA AMOS , TER KUILE FEIKO O. , VULULE JOHN M. , ALAII JANE A. , NAHLEN BERNARD L. , HAWLEY WILLIAM A. , PHILLIPS-HOWARD PENELOPE A.
Published: September 2018

We measured the two-week household-level economic impact of insecticide (permethrin)-treated bed nets (ITNs) used to prevent malaria among children less than five years of age in Asembo, Kenya. The ITNs induced a two-week reduction of 15 Kenyan shillings (KSH) (U.S. $0.25; P < 0.0001) in health care expenditures, but a statistically insignificant 0.5 day (P = 0.280) reduction in household time lost due to caring for sick children. The equivalent annual threshold cost was estimated at U.S. $6.50 (95% confidence interval = 3.12–9.86). If the actual purchase price and maintenance costs of ITNs were greater than this threshold, then households would pay more than they would save (and vice-versa). Both seasonal effects and number of children per household had larger impacts than ITNs on health care expenditures and time lost from household activities. Health care expenditures by a household without ITNs and one child were only 32 KSH per two weeks (U.S. $0.50; P = 0.002), leaving little opportunity for household-level, ITN-induced direct savings. The widespread adoption of the ITNs will therefore probably require a subsidy.
THE COST-EFFECTIVENESS OF PERMETHRIN-TREATED BED NETS IN AN AREA OF INTENSE MALARIA TRANSMISSION IN WESTERN KENYA
Authors: WISEMAN VIRGINIA , HAWLEY WILLIAM A. , TER KUILE FEIKO O. , PHILLIPS-HOWARD PENELOPE A. , VULULE JOHN M. , NAHLEN BERNARD L. , MILLS J.
Published: September 2018

This study compared the costs and effects of insecticide (permethrin)-treated bed net (ITN) use in children less than five years of age in an area of intense, perennial malaria transmission in western Kenya. The data were derived from a group-randomized controlled trial of ITNs conducted between 1996 and 1999. The annual net cost per life-year gained was U.S. $34 and the net annual cost per all-cause sick child clinic visit averted was U.S. $49. After taking into account a community effect (protection from malaria afforded to non-ITN users who lived within 300 meters from users) these estimates decreased to U.S. $25 and U.S. $38, respectively. This study provides further evidence that ITNs are a highly cost-effective use of scarce health care resources.
IMPLICATIONS OF THE WESTERN KENYA PERMETHRIN-TREATED BED NET STUDY FOR POLICY, PROGRAM IMPLEMENTATION, AND FUTURE RESEARCH
Authors: HAWLEY WILLIAM A. , TER KUILE FEIKO O. , STEKETEE RICHARD S. , NAHLEN BERNARD L. , TERLOUW DIANNE J. , GIMNIG JOHN E. , SHI YA PING , VULULE JOHN M. , ALAII JANE A. , HIGHTOWER ALLEN W. , KOLCZAK MARGARETTE S. , KARIUKI SIMON K. , PHILLIPS-HOWARD PENELOPE A.
Published: September 2018

The fifth, and probably last, large-scale, group-randomized, controlled trial of insecticide (permethrin)-treated bed nets (ITNs) showed that ITNs are efficacious in reducing all-cause post-neonatal mortality in an area of intense, perennial malaria transmission. The trial helped to define pregnant women and infants as target groups for this intervention in high transmission settings. High population coverage with ITNs in both target and non-target groups may be critical to enhance health and survival in pregnant women and infants. The proportion of households with ITNs (coverage), the proportion of individuals properly deploying ITNs each night (adherence), and the proportion of nets properly treated with insecticide (treatment) are the three key determinants of effectiveness of large-scale ITN programs. These three simple outcomes should serve as the basis for program objectives and monitoring and evaluation efforts. Coverage effects and economic analysis support the proposition that ITNs may be viewed as a public good, worthy of public support. Research should continue to improve the intervention tools (the net, the insecticide, and methods for durable treatment and re-treatment) and their deployment.
NORMAL RIBOFLAVIN STATUS IN MALARIA PATIENTS IN GABON
Authors: TRAUNMÜLLER FRIEDERIKE , RAMHARTER MICHAEL , LAGLER HEIMO , THALHAMMER FLORIAN , KREMSNER PETER G. , GRANINGER WOLFGANG , WINKLER STEFAN
Published: September 2018

Previous publications reported commonly the occurrence of riboflavin deficiency and a positive correlation between riboflavin status and parasitemia in patients with Plasmodium falciparum malaria. In these studies, riboflavin status was determined by erythrocyte glutathione reductase activation coefficients (EGRACs). Inherited low erythrocyte glutathione reductase activity is highly prevalent in malarial regions, however. To rule out falsely diagnosed riboflavin deficiency in affected patients, we conducted an investigation using a high-performance liquid chromatography method (HPLC) instead of the EGRAC method. In 29 infants (age range, 1–5 years), 22 schoolchildren (age range, 6–12 years), and 33 adolescents and adults (age range, 13–74 years) from Lambaréné, Gabon, with acute P. falciparum malaria, plasma concentrations of riboflavin, flavin mononucleotide (FMN), and flavin adenine dinucleotide (FAD) were measured by HPLC. Results were correlated with parasite densities. Profiles of plasma concentrations of all 3 flavin compounds were within the normal range in all patients. Concentrations of free riboflavin were not different between the 3 age groups. In adolescents and adults, FMN and FAD concentrations were higher than in infants (P = 0.002 and P = 0.001) and schoolchildren (P = 0.003 and P = 0.002). Comparing children with hyperparasitemic and uncomplicated malaria, no difference in the concentrations of either flavin compound was found. Neither the concentrations of free riboflavin nor the concentrations of one of the flavin nucleotides correlated with parasitemia within subgroups of age or of children with uncomplicated and hyperparasitemic malaria. Our data indicate that nutritional riboflavin deficiency might have been overestimated in previous malaria studies and do not support a relationship between flavin concentrations and parasitemia in P. falciparum malaria.
LOW ORAL RECEPTIVITY FOR DENGUE TYPE 2 VIRUSES OF AEDES ALBOPICTUS FROM SOUTHEAST ASIA COMPARED WITH THAT OF AEDES AEGYPTI
Authors: VAZEILLE MARIE , ROSEN LEON , MOUSSON LAURENCE , FAILLOUX ANNA-BELLA
Published: September 2018

Dengue hemorrhagic fever has been a major health problem in Asia since the 1950s. During this period, the former principal vector of dengue viruses in Asia, Aedes albopictus, was replaced by Aedes aegypti in most major cities of the area. Ae. aegypti is now considered the main vector of dengue viruses in Asia. Surprisingly, however, this mosquito has been described as having a relatively low oral receptivity for dengue viruses compared with Ae. albopictus. In the present study, we compared the relative oral receptivities of Ae. aegypti and Ae. albopictus collected in southeast Asia from both sympatric and allopatric breeding sites. In all instances, the oral receptivity of Ae. aegypti to the dengue type 2 virus used was significantly higher than that of Ae. albopictus. We also compared the relative oral receptivity of Ae. aegypti and Ae. albopictus for two other low-passage strains of dengue 2. In all instances, Ae. aegypti was significantly more receptive than Ae. albopictus. It should be noted, however, that the difference was found only for Ae. albopictus recently collected from the field (Ta Promh strain, Cambodia, 2001) and not for an Ae. albopictus strain that had been colonized for many years (Oahu strain, Hawaii, 1971). We also observed a significant increase in the infection rate of Ae. albopictus of the Ta Promh strain with increasing generations in the laboratory. These observations demonstrate the importance of considering the colonization history of mosquitoes when assessing their susceptibility to infection with dengue viruses and, perhaps, other arboviruses.
DENGUE AND ITS VECTORS IN THAILAND: CALCULATED TRANSMISSION RISK FROM TOTAL PUPAL COUNTS OF AEDES AEGYPTI AND ASSOCIATION OF WING-LENGTH MEASUREMENTS WITH ASPECTS OF THE LARVAL HABITAT
Authors: STRICKMAN DANIEL , KITTAYAPONG PATTAMAPORN
Published: September 2018

Working in a village dengue focus in Chachoengsao Province, Thailand, aedine mosquito larvae and pupae were counted in all containers of 10 houses per month. The wings of female Aedes aegypti (L.) emerging from pupae were measured. Number of pupae and size of emerging females increased in containers with qualities that favored availability of larval food sources (e.g., uncovered containers). The small size of most mosquitoes compared with those raised in the laboratory indicated that the larval population as a whole was under nutritional stress. Applying the number of pupae per house and measurement of air and water temperature with an existing model, the risk of dengue transmission was greatest in May and June. The estimated number of female Ae. aegypti per house was well above the threshold for increasing transmission in all months but December through February. A phased approach to sampling immature aedine mosquitoes in Thailand is proposed, which would consist of routine surveillance of larval index and occasional total counts with measurement of wing size. Such a system would combine the benefits of the simple application of larval surveillance with the valuable data gathered from pupal counts and wing measurements.
LIMITED POTENTIAL FOR MOSQUITO TRANSMISSION OF GENETICALLY ENGINEERED, LIVE-ATTENUATED WESTERN EQUINE ENCEPHALITIS VIRUS VACCINE CANDIDATES
Authors: TURELL MICHAEL J. , O’GUINN MONICA L. , PARKER MICHAEL D.
Published: September 2018

Specific mutations associated with attenuation of Venezuelan equine encephalitis (VEE) virus in rodent models were identified during efforts to develop an improved VEE vaccine. Analogous mutations were produced in full-length cDNA clones of the Cba 87 strain of western equine encephalitis (WEE) virus by site-directed mutagenesis in an attempt to develop an improved WEE vaccine. Isogenic viral strains with these mutations were recovered after transfection of baby hamster kidney cells with infectious RNA. We evaluated two of these strains (WE2102 and WE2130) for their ability to replicate in and be transmitted by Culex tarsalis, the principal natural vector of WEE virus in the United States. Each of the vaccine candidates contained a deletion of the PE2 furin cleavage site and a secondary mutation in the E1 or E2 glycoprotein. Both of these potential candidates replicated in mosquitoes significantly less efficiently than did either wild-type WEE (Cba 87) virus or the parental clone (WE2000). Likewise, after intrathoracic inoculation, mosquitoes transmitted the vaccine candidate strains significantly less efficiently than they transmitted either the wild-type or the parental clone. One-day-old chickens vaccinated with either of the two vaccine candidates did not become viremic when challenged with virulent WEE virus two weeks later. Mutations that result in less efficient replication in or transmission by mosquitoes should enhance vaccine safety and reduce the possibility of accidental introduction of the vaccine strain to unintentional hosts.
DETECTION OF CRYPTOSPORIDIUM PARVUM AND GIARDIA LAMBLIA CARRIED BY SYNANTHROPIC FLIES BY COMBINED FLUORESCENT IN SITU HYBRIDIZATION AND A MONOCLONAL ANTIBODY
Authors: GRACZYK THADDEUS K. , GRIMES BARBARA H. , KNIGHT RONALD , DA SILVA ALEXANDRE J. , PIENIAZEK NORMAN J. , VEAL DUNCAN A.
Published: September 2018

Wild-caught synanthropic flies were tested for the presence of Cryptosporidium parvum and Giardia lamblia on their exoskeletons and in their digestive tracks by fluorescent in situ hybridization and fluorescein isothiocyanate (FITC)–conjugated monoclonal antibody (MAb) against Cryptosporidium and Giardia cell wall epitopes. The levels of C. parvum were positively correlated with the levels of G. lamblia, indicating a common source of contamination. The majority of oocysts and cysts were potentially viable (C. parvum = 80% and G. lamblia = 69%). More G. lamblia cysts occurred on the exoskeleton of the flies than within the digestive tracts; the opposite relationship was observed for C. parvum. No genotype other than C. parvum G2 was found to be associated with flies. Because filth flies carry viable C. parvum oocysts and G. lamblia cysts acquired naturally from unhygienic sources, they can be involved in the epidemiology of cryptosporidiosis and giardiasis. Fluorescent oligonucleotide probes used together with FITC–conjugated MAb represent a convenient and cost-effective technique for rapid and specific identification of human-infectious species of Cryptosporidium and Giardia mechanically transported by flies, and for the assessment of the viability of these pathogens.
ASSOCIATION AND EPIDEMIOLOGIC FEATURES OF TRYPANOSOMA CRUZI AND HUMAN T CELL LYMPHOTROPIC A VIRUS TYPE II IN INHABITANTS OF THE PARAGUAYAN GRAN CHACO
Authors: FERRER JORGE F. , ESTEBAN EDUARDO , MURUA ALICIA , GUTIERREZ SILVINA , DUBE SYAMALIMA , POIESZ BERNARD , FELDMAN LEONARDO , BASOMBRIO MIGUEL A. , GALLIGAN DAVID
Published: September 2018

Serologic evidence of Trypanosoma cruzi infection was demonstrated in 43.5% of 519 Paleoamerindians and in only 2.5% of 161 non-Indians (Mennonites of German descent and Paraguayans of Spanish descent) inhabiting an area of western Paraguay that belongs to the Gran Chaco territory. These people ranged in age between two and 80 years. All were also tested for infection with the human T cell lymphotropic virus type II (HTLV-II). The prevalence of HTLV-II infection was 22.1% in Indians and 3.7% in non-Indians. As determined by a multivariate logistic regression analysis that controlled for relevant confounders, an HTLV-II-infected individual was 2.28 times more likely to be seropositive for T. cruzi than an HTLV-II negative. Possible explanations for this finding are discussed. The difference in T. cruzi prevalence between Indians and non-Indians was associated with differences between these groups in exposure to known risk factors for infection with the parasite. There were significant differences in the seroprevalence of T. cruzi among the two predominant Indian groups, even when they inhabited communities that were close to each other. These differences were associated with differences in the prevalence of HTLV-II infection but not with differences in exposure to known risk factors for T. cruzi infection. Infection with T. cruzi increased with age, was greater in males than in females, and clustered in families.
MORPHOLOGIC AND FUNCTIONAL CHARACTERIZATION OF CHAGASIC HEART DISEASE IN NON-HUMAN PRIMATES
Authors: ZABALGOITIA MIGUEL , VENTURA JAIME , ANDERSON LORI , CAREY K.D. , WILLIAMS JEFF T. , VANDEBERG JOHN L.
Published: September 2018

Chagasic heart disease has been documented in non-human primates, but noninvasive characterization of systolic and diastolic function has not been previously reported. Seventeen seropositive (12 females; mean age, 20) and 13 age- and gender-matched seronegative baboons underwent Doppler echocardiography. Systolic function indices included left ventricular (LV) fractional shortening (FS %), velocity of circumferential fiber shortening (VCF, circ/sec), LV mass index, and left and right ventricular ejection fractions (RVEF %). Diastolic function indices included transmitral E-wave, A-wave, E/A ratio, E-deceleration time, and isovolumic relaxation time. Twelve-lead electrocardiographic (ECG) recordings were obtained. There were no significant differences between groups for body size or blood pressure. Seropositive and seronegative groups revealed diffuse non-specific T wave changes precluding differentiation; however, tall “P” waves were seen in four seropositive and two seronegative baboons. Four of the 17 (24%) seropositive baboons had decreased FS (25 ± 8% versus 40 ± 5%, P < 0.005) and VCF (1.05 ± 0.36 circ/sec versus 1.84 ± 0.23 circ/sec, P < 0.0001), prolonged isovolumic relaxation time (71 ± 16 msec versus 55 ± 9 msec, P < 0.02), and reduced RVEF (44 ± 9% versus 54 ± 4%, P < 0.05), as compared with the other seropositive baboons. We conclude that chagasic heart disease is present in 24% of the naturally infected baboons in this study. ECG evidence of right atrial enlargement was more common in the seropositive animals. There were systolic and diastolic abnormalities of both ventricles. The LV systolic dysfunction may be segmental or diffuse.
CIGUATERA POISONING IN VANUATU
Authors: GOODMAN ANNA , WILLIAMS THOMAS N. , MAITLAND KATHRYN
Published: September 2018

Ciguatera poisoning is endemic in many tropical and subtropical countries. We conducted a retrospective study of admissions to two hospitals on the islands of Vanuatu in the southwestern Pacific region. We estimated the annual hospital admission rate for fish poisoning to be 65 (95% confidence interval [CI] = 55–75)/100,000 population on the island of Santo and 29 (95% CI = 19–43)/100,000 population on the island of Ambae. Hospital admission was more common in males 20–29 years old. Death was a rare complication. In the face of increases in both tourism and in the global trade in tropical and exotic fish, physicians in both endemic and non-endemic areas should be familiar with the epidemiology and clinical features of this important condition.
SHORT REPORT: VARIATION IN THE 56-KD TYPE-SPECIFIC ANTIGEN GENE OF ORIENTIA TSUTSUGAMUSHI ISOLATED FROM PATIENTS IN THAILAND
Authors: KOLLARS THOMAS M. , BODHIDATTA DHARADIDA , PHULSUKSOMBATI DUANGPORN , TIPPAYACHAI BOURSARAPORN , COLEMAN RUSSELL E.
Published: September 2018

The sequences of a 300-base pair region of the 56-kD type-specific antigen gene from 12 Orientia tsutsugamushi isolates from Thailand were compared with isolates from other regions in Asia. A high degree of heterogeneity was found among the 12 Thai isolates, with the C3 strain most commonly found. The abundance of the C3 strain of O. tsutsugamushi is of particular concern because doxycycline and chloramphenicol resistance have previously been reported in this strain.