Vitamin nutrition in patients with chronic renal failure and dietary manipulation

(1) Vitamin abnormalities in patients with CRF are frequent and appear early even with mild renal failure; (2) early supplementation with water-soluble vitamins should be given to patients on low-protein diets--the amount of the supplementation, however, remains to be determined; (3) fat-soluble vitamin supplements (A and E) should be avoided and their dietary intake limited, and (4) it is obvious that vitamin nutrition in patients with CRF requires further investigation.

Anaplasma phagocytophilum in questing Ixodes ricinus ticks from Romania

Granulocytic anaplasmosis is a common vector-borne disease of humans and animals with natural transmission cycle that involves tick vectors, among which Ixodes ricinus is the most important. The present paper reports the prevalence and geographical distribution of A. phagocytophilum in 10,438 questing Ixodes ricinus ticks collected at 113 locations from 40 counties of Romania. The unfed ticks were examined for the presence of A. phagocytophilum by PCR targeting a portion of ankA gene. The overall prevalence of infection was 3.42%, with local prevalences ranging between 0.29% and 22.45%, with an average prevalence of 5.39% in the infected localities. The infection with A. phagocytophilum was detected in 72 out of 113 localities and in 34 out of 40 counties. The highest prevalence was recorded in females followed by males and nymphs. The results and the distribution model have shown a large distribution of A. phagocytophilum, covering Romania's entire territory. This study is the first large scale survey of the presence of A. phagocytophilum in questing I. ricinus ticks from Romania.

Further spreading of canine oriental eyeworm in Europe: first report of Thelazia callipaeda in Romania

BACKGROUND

Despite the increasing number of reports of autochthonous cases of ocular thelaziosis in dogs in several European countries, and the evident emergence of human cases, the distribution and spreading potential of this parasite is far for being fully known. In Romania, despite intensive surveillance performed over recent years on the typical hosts of T. callipaeda, the parasite has not been found until now.

METHODS

In October 2014 a German Shepherd was presented for consultation to a private veterinary practice from western Romania with a history of unilateral chronic conjunctivitis. Following a close examination of the affected eye, nematodes were noticed in the conjunctival sac. The specimens collected were used for morphological examination (light microscopy) and molecular analysis (amplification of the cytochrome c oxidase subunit 1 gene, followed by sequencing).

RESULTS

Thirteen nematodes were collected, all identified morphologically as T. callipaeda. The history of the dog revealed no travel outside Romania, and during the last year, not even outside the home locality. The BLAST analysis of our sequence showed a 100% similarity T. callipaeda haplotype h1.

CONCLUSIONS

This is the first report of T. callipaeda in Romania, which we consider to be with autochthonous transmission. These findings confirm the spreading trend of T callipaeda and the increased risk of emerging vector-borne zoonoses.

Further spreading of canine oriental eyeworm in Europe: first report of Thelazia callipaeda in Romania

BACKGROUND

Despite the increasing number of reports of autochthonous cases of ocular thelaziosis in dogs in several European countries, and the evident emergence of human cases, the distribution and spreading potential of this parasite is far for being fully known. In Romania, despite intensive surveillance performed over recent years on the typical hosts of T. callipaeda, the parasite has not been found until now.

METHODS

In October 2014 a German Shepherd was presented for consultation to a private veterinary practice from western Romania with a history of unilateral chronic conjunctivitis. Following a close examination of the affected eye, nematodes were noticed in the conjunctival sac. The specimens collected were used for morphological examination (light microscopy) and molecular analysis (amplification of the cytochrome c oxidase subunit 1 gene, followed by sequencing).

RESULTS

Thirteen nematodes were collected, all identified morphologically as T. callipaeda. The history of the dog revealed no travel outside Romania, and during the last year, not even outside the home locality. The BLAST analysis of our sequence showed a 100% similarity T. callipaeda haplotype h1.

CONCLUSIONS

This is the first report of T. callipaeda in Romania, which we consider to be with autochthonous transmission. These findings confirm the spreading trend of T callipaeda and the increased risk of emerging vector-borne zoonoses.

Current surveys on the prevalence and distribution of Dirofilaria spp. and Acanthocheilonema reconditum infections in dogs in Romania

During the last decades, Dirofilaria spp. infection in European dogs has rapidly spread from historically endemic areas towards eastern and northeastern countries, but little or no information is available from these geographical regions. The present study provides a picture of filarial infections in dogs from Romania and compares two tests for the diagnosis of Dirofilaria immitis. From July 2010 to March 2011, blood samples were collected from 390 dogs from nine counties of Romania and serological SNAP tests were performed for the detection of D. immitis antigen. The remaining blood clots were subsequently used for DNA extraction followed by multiplex PCR for assessing filarioid species diversity (i.e. D. immitis, Dirofilaria repens and Acanthocheilonema reconditum). Based on molecular detection, an overall prevalence of 6.92 % (n = 27; 95 % confidence interval (CI) 4.70-10.03 %) for D. repens, 6.15 % (n = 24; 95 % CI 4.07-9.14 %) for D. immitis and 2.05 % (n = 8; 95 % CI 0.96-4.16 %) for A. reconditum was recorded, with significant variations according to sampling areas. Coinfections of D. immitis and D. repens were recorded in 23.91 % (n = 11) positive dogs. A slightly higher prevalence for D. immitis was detected at the SNAP test (n = 28, 7.17 %; 95 % CI 4.91-10.33 %), but this difference was not statistically significant (p = 0.66). However, only 53.57 % (n = 15) of antigen-positive dogs were confirmed by PCR, while other dogs (n = 9) PCR positive for D. immitis were negative at the serology. The present study shows that Dirofilaria species are endemic in the southern and southeastern areas of Romania, This article also provides, for the first time, an epidemiological picture of the distribution of A. reconditum in Romania.

Immunosuppressive switch to sirolimus in renal dysfunction after liver transplantation

OBJECTIVE

Nephrotoxicity is a serious adverse effect after liver transplantation often related to calcineurin inhibitors (CNI) with a incidence of 18.1% at 5 years. Sirolimus (SRL) is a new immunosuppressive drug that was introduced into solid organ transplant management in 1999. Herein we have performed a retrospective review of patients who developed renal insufficiency owing to CNI therapy after orthotopic liver transplantation (OLT).

MATERIALS AND METHODS

Thirty-one patients were switched to SRL monotherapy because of nephrotoxicity as evidenced by serum creatinine levels (SCr) > 1.8 mg/dL and estimated glomerular filtration rates (eGFR) < 45 mL/min/1.73 m(2). The dosage was adjusted to achieve trough levels between 8 and 10 ng/mL.

RESULTS

The patients were followed for a mean of 52 months (range 2-88 months) after OLT. Mean follow-up after the switch was 27.5 months (range, 2-71.2 months). Immunosuppression was switched after a mean of 35.2 months (range, 0.2-43.4 months). Renal function was significantly improved, as shown by the improved SCr, urea, and eGFR after the switch.

CONCLUSIONS

CNIs may be associated with significant nephrotoxicity and chronic kidney damage. Patients who develop renal dysfunction after OLT may be successfully treated by an early switch from CNIs to SRL, stopping the progression toward chronic renal damage and preserving allograft survival.

Rhipicephalus rossicus and not R. sanguineus is the dominant tick species of dogs in the wetlands of the Danube Delta, Romania

Changes in the distribution of tick species are among the major causes for the increase in prevalence of zoonotic diseases worldwide, with tick-borne diseases' prevalence showing an emerging pattern. One of these ticks, Rhipicephalus rossicus, which is reported occasionally from humans, seems to be particularly interesting because of its demonstrated vectorial role for zoonotic pathogens like Francisella tularensis, Coxiella burnetii, or CCHF and West Nile viruses. Here we report a case of dominant occurrence of R. rossicus on household dogs in the wetlands of Eastern Europe (Romania). Ticks were collected from dogs in 5 distinct locations, with 1068 ticks of 6 species found. R. rossicus had a dominant occurrence in dogs in all but one location, accounting for 87.1% of all ticks (32.3-95.3% in different locations). Until this study, Rhipicephalus sanguineus was considered as the only important tick species on dogs in south-temperate regions of Europe, as well in Romania. The dominant presence of R. rossicus in dogs, its vectorial competence and broad host spectrum (including humans), make this tick species an important candidate for further analysis and highlight the paucity of our knowledge on disease vectors in this region of Europe.

First report of Cercopithifilaria spp. in dogs from Eastern Europe with an overview of their geographic distribution in Europe

Dogs in Europe may be parasitized by a variety of species of filarioids. While some species have been studied for decades, others have been only recently reported, and their range of distribution is still unknown. The present study was aimed to investigate the occurrence of Cercopithifilaria spp., whose microfilariae reside in the dermis and are transmitted by Rhipicephalus sanguineus s.l. ticks, in a dog population from Romania and to present the current knowledge of their distribution in Europe. Sampling was performed in a rural locality from Danube Delta region of Romania, location chosen due to the presence of the only known vector for these species. Skin samples were collected from 39 dogs. The samples were tested for the presence of Cercopithifilaria spp. by PCR methods. One animal (2.56%) was positive, and the amplified sequence showed a 100% similarity to Cercopithifilaria bainae. This study reports C. bainae for the first time in Eastern Europe, extending the known range of the genus in Europe.