Ecological links between water storage behaviors and Aedes aegypti production: implications for dengue vector control in variable climates

Understanding linkages between household behavior and Aedes aegypti (L.) larval ecology is essential for community-based dengue mitigation. Here we associate water storage behaviors with the rate of A. aegypti pupal production in three dengue-endemic Colombian cities with different mean temperatures. Qualitative, semi-structured interviews and pupal counts were conducted over a 7-15-day period in 235 households containing a water storage vessel infested with larvae. Emptying vessels more often than every 7 days strongly reduced pupal production in all three cities. Emptying every 7-15 days reduced production by a similar magnitude as emptying <7 days in Armenia (21.9 degrees C), has a threefold smaller reduction as compared to <7 days in Bucaramanga (23.9 degrees C), and did not reduce production in Barranquilla (29.0 degrees C). Lidding vessels reduced mosquito production and was most feasible in Barranquilla because of container structure. Vessel emptying strongly correlated with usage in Barranquilla, where many households stored water in case of interruptions in piped service rather than for regular use. In the cooler cities, >90% of households regularly used stored water for washing clothes, generating a weaker correlation between emptying and usage. Emptying was less frequent in the households surveyed in the dry season in all three cities. These results show that A. aegypti production and human behaviors are coupled in a temperature-dependent manner. In addition to biological effects on aquatic stages, climate change may impact A. aegypti production through human behavioral adaptations. Vector control programs should account for geographic variation in temperature and water usage behaviors in designing targeted interventions.

Genotype and phenotype correlations in diabetic patients in Uruguay

To differentiate among different types of diabetes is becoming an increasingly challenging task. We investigated whether the patient's genetic profile is useful to identify the particular type of diabetes, to determine the corresponding hyperglycemia pathogenesis and treat accordingly. Three hundred and thirty-eight diabetic patients, diagnosed according to American Diabetes Association criteria, were recruited from 2004 to 2008 in diabetes health reference centers. We analyzed the major gene for type 1 diabetes susceptibility (HLA DQ/DR). In order to improve our understanding of the pathogenesis of the resulting hyperglycemia and to implement a more adequate treatment for the patients, we reclassified our sample according to the presence or absence of the genetic markers. We found that a higher percentage of people than expected have immunological disease, independent of their phenotype, with a relative risk of 4.62 (95% confidence interval). This methodology allowed us to establish an association between the genotype and its resulting phenotype. We found significant differences; the phenotypic classification did not reflect immunological disease based on genotype. Moreover, when we examined markers, body mass index and age of onset, we found that many people have an intermediate phenotype between type 1 and type 2. This genetic data can help provide an accurate definition of the disease and would therefore provide the physician a better possibility of providing adequate treatment.

Francisella sp., an emerging pathogen of tilapia, Oreochromis niloticus (L.), in Costa Rica

Francisella sp. is an emergent bacterial pathogen that causes acute to chronic disease in warm and cold water cultured and wild fish species. During the past 3 years, the bacterium has been detected in tilapia, Oreochromis niloticus, cultured in Costa Rica. Infected fish presented non-specific clinical signs, such as erratic swimming, anorexia, anaemia, exophthalmia and high mortality. Upon macroscopic and microscopic examination, several internal organs (mainly spleen and kidney) were enlarged and contained white nodules. Histological examination revealed the presence of multifocal granulomatous lesions, with the presence of numerous small, pleomorphic, cocco-bacilli. The bacteria were isolated from infected tilapia on selective media and grown on several media with and without antibiotics. Specific PCR primers to the Francisella genus were used to confirm the preliminary diagnoses. In comparison with several bacterial 16S rRNA sequences, our isolate was found to share 99% identity with other Fransicella spp. isolated from fish, and more than 97% identity to the human pathogen Francisella tularensis. Koch's postulates were fulfilled after experimental intraperitoneal and gill exposure challenges.

In situ estrogen metabolism in proliferative endometria from untreated women with polycystic ovarian syndrome with and without endometrial hyperplasia

The aim of the present investigation was to study whether the endocrinological status of women bearing polycystic ovarian syndrome (PCOS) affects the endometrial in situ steroid metabolism. For this purpose, we evaluated the mRNA levels (RT-PCR), and the activity of steroid metabolic enzymes: P450 aromatase, steroid sulfatase (STS), estrogen sulfotransferase (EST) and 17beta-hydroxysteroid dehydrogenase (17beta-HSD) in 23 samples of normal endometria (CE), 18 PCOS endometria without treatment (PCOSE), 10 specimens from PCOS women with endometrial hyperplasia (HPCOSE), and 7 endometria from patients with endometrial hyperplasia not associated to PCOS (EH). The data showed lower levels of STS mRNA for PCOSE and HPCOSE (p<0.05, p<0.01, respectively) and of EST for HPCOSE and EH compared to control (p<0.05). However, higher levels for EST mRNA were obtained in PCOSE (p<0.05) versus CE. The mRNA and protein levels for P450 aromatase were undetectable in all analyzed endometria. The relationship between the activities of STS and EST was lower in PCOSE and HPCOSE (p<0.05) versus CE. The ratio between the mRNA from 17beta-HSD type 1/type 2 was higher in PCOSE (p<0.05), whereas, a diminution in the 17beta-HSD type 2 activity was observed in PCOSE (p<0.05). These results indicate that the activity of enzymes related to the steroid metabolism in analyzed PCOSE differ from those found in the CE. Consequently, PCOSE may present an in situ deregulation of the steroid metabolism.

Improving prevention in primary care: evaluating the effectiveness of outreach facilitation

BACKGROUND

Out reach facilitation is designed to promote uptake of evidence-based guidelines. There is evidence indicating that outreach facilitation can be effective in improving implementation of preventive care in GPs' offices. In this trial, we test a modified version of an outreach facilitation intervention.

OBJECTIVE

To evaluate whether a comprehensive preventive intervention program using outreach facilitators improves preventive care delivery.

DESIGN

Match-paired, cluster-randomized controlled trial.

SETTING

Fee-for-service primary care practices in Eastern Ontario, Canada, at a time of physician shortage.

PARTICIPANTS

Volunteer sample of 54 primary care practices.

MAIN OUTCOME MEASURES

Mean difference between trial arms in practices' delivery of preventive manoeuvres, measured by preventive performance indices estimated from chart reviews and patient survey data.

RESULTS

No difference was detected between the trial's arms for the primary outcome's overall prevention index [2.0%; 95% confidence interval (CI) -3.2 to 7.3; P = 0.44]. A small significant difference between the arms was detected for the secondary outcome's overall prevention index (2.8%; 95% CI 0.7-4.8; P = 0.01).

CONCLUSION

In contrast to similar facilitation trials, this outreach facilitation program did not produce improvements in the delivery of preventive care. This lack of effect may be due to differences in the intervention and context, or the practice's limited capacity to change. Our intervention simultaneously facilitated a high number of manoeuvres, blinded facilitators and physicians to the targeted tests and had a relatively short intervention period and large number of practices assigned per facilitator. Changes in the primary care service model in Ontario at the time of the trial could have also washed out the intervention effect.

Genetic and virulence characterization of Flavobacterium columnare from channel catfish (Ictalurus punctatus)

AIM

To develop a method for conducting pulsed-field gel electrophoresis (PFGE) on Flavobacterium columnare, to use PFGE to characterize F. columnare channel catfish isolates, and to determine whether variation in pathogenic potential exists in F. columnare isolates from channel catfish.

METHODS AND RESULTS

On the basis of PFGE-derived profiles, similarity dendrograms constructed for more than 30 F. columnare isolates showed two major genetic groups with more than 60% similarity. Channel catfish fingerlings challenged with PFGE group A isolates by bath immersion had significantly higher average mortalities (>60%) than fish challenged with PFGE group B isolates (<9%). However, abrasion and skin mucus removal made channel catfish fingerlings susceptible to disease caused by group B isolates following immersion exposure.

CONCLUSION

Our results suggest that two genetic divisions of F. columnare channel catfish isolates exist, and that isolates in PFGE group A isolates tend to be more pathogenic to immunocompetent channel catfish fingerlings than PFGE group B isolates.

SIGNIFICANCE AND IMPACT OF THE STUDY

PFGE is a potentially useful tool for determining whether F. columnare isolates are more likely to be primary or secondary pathogens. Pathogenesis research for columnaris disease in catfish should focus on pathogenic isolates from PFGE group A.

Impact of feeding and rearing systems of Iberian pigs on volatile profile and sensory characteristics of dry-cured loin

The effect of growing pigs on free-range (FR) or in confinement with three different diets [acorn (A), acorn and grass (A-G) and formulated diet (FD)] on composition, volatile profile and sensory characteristics of dry-cured loin was studied. The FR, A and A-G diets, in comparison with FD, induce a higher α- and γ-tocopherol concentration, which limits the TBARs values at 24h of air exposure. Sixty volatile compounds were identified in the headspace, including 14 aldehydes, 10 hydrocarbons, eight alcohols, five ketones, four furans, four pyrazines, four sulphur compounds, three acids, three esters, three phenols, one pyridine and one pyrrole. Volatiles from amino acid catabolism stressed the difference among batches FR being the batch with the highest level of these compounds. Products from FD showed the lowest fat content and L(∗) value. FR loins obtained the highest scores for appearance, odour and flavour in the rank order test sensory analysis.

A piscirickettsiosis-like syndrome in cultured Nile tilapia in Latin America with Francisella spp. as the pathogenic agent

In 2004, cultured Nile tilapia Oreochromis niloticus in several Latin America farms began to succumb to a disease similar to the piscirickettsiosis-like syndrome previously reported in tilapia in Taiwan and the United States. Mortality increased during 2005; reductions in tilapia biomass ranged from 5% to 80% in individual ponds and averaged 50% overall. All ages of fish have been involved. Clinical signs include lethargy, loss of appetite, petechia, exophthalmia, and abnormal swimming behavior. Gross lesions have included splenomegaly, renomegaly, and numerous white nodules observed in the spleen, kidney, testes, heart, ovaries, and occasionally the liver. A previously unreported black granulomatous lesion was reported in up to 30% of the fillets. Histologically, granulomatous infiltrates were observed in the kidney, spleen, liver, testes, ovary, and choroid gland, and rarely in the brain and heart. A small pleomorphic bacterium was observed in Giemsa-stained blood smears and spleen imprints. The bacterium did not grow on standard microbiological media and has not been isolated in cell culture. We obtained a near-complete 16S ribosomal DNA sequence with high similarity to Francisella spp. sequences previously identified in tilapias Oreochromis spp. (Taiwan), Atlantic cod Gadus morhua (Norway), and three-line grunts Parapristipoma trilineatum (Japan).

Three-dimensional ultrasound in the prenatal diagnosis of cleidocranial dysplasia associated with B-cell immunodeficiency

A patient with a singleton pregnancy was referred for three-dimensional ultrasonography (3DUS) at 18 + 3 weeks for suspected hypomineralization of the skull bones and absence of the nasal bones. Three-dimensional rendered images of the fetal skull revealed widening of the coronal sutures, absence of the squamous portion of the temporal bone, and absence of the occipital bone, except for two areas of ossification. In addition, a fractured right clavicle was identified. The remainder of the fetal anatomy was normal and biometry was appropriate for gestational age. Genetic amniocentesis revealed a 46,XX fetal karyotype. Family history was positive for a 5-year-old sibling with an open anterior fontanelle. Cleidocranial dysplasia was suspected. A female neonate was delivered by elective repeat Cesarean section at 40 + 3 weeks of gestation without complications and discharged home 3 days after delivery. Prenatal diagnosis was confirmed by physical and radiological evaluation. The infant died at 8 weeks of age due to respiratory syncytial virus pneumonia secondary to B-cell deficiency. RUNX2 mutations were not detected by molecular analysis. There are three relevant aspects to this case: (1) clear visualization of the widened fontanelles and hypomineralized occipital bones was possible with the use of 3DUS; (2) a clavicular fracture was identified in utero with combined high-resolution two-dimensional and 3DUS; and (3) although absence of the nasal bones is most commonly observed in fetuses with chromosomal disorders (e.g. trisomy 21 and trisomy 18), a careful examination of the skeleton should be considered in fetuses with absent nasal bones and a normal karyotype.

Monthly variation of fertility and oestrus frequency in crossbred dual-purpose cows in three agroecological areas of the South American tropics

The aim of this study was to examine the monthly variation of the first service conception (FSC) and oestrus frequency (OF) from 8308 artificial inseminations (AI) of 2960 crossbred dual-purpose cows on three commercial farms with improved management located in the Maracaibo Lake Basin, Venezuela. The effects of month of the year, agroecological area (from dry tropical forest to sub-humid tropical forest on the three farms), predominant breed (BT, Bos taurus; BI, Bos indicus), and season (December-April; May-August; and September-November) were considered. Data were analysed using logistic regression (FSC) and GLM (OF) from SAS. The mean FSC was 55.4% overall and 48.7%, 57.0% and 58.3% for farms A, B and C, respectively (p < 0.01). Within the three agroecological areas (farms A, B and C), the FSC was highest during the cooler and drier months of the year (season 1), while the lowest FSC was obtained during the months of highest rainfall and humidity (season 3) (53.3% vs. 37.4%; 58.5% vs. 49.0% and 63.0% vs. 52.3% on farms A, B, C, respectively; p < 0.01). In the three studied farms, OF was higher during the first 4 months of the year; with a diminishing trend towards the end of the year (p < 0.05). In general, BI cows had a higher FSC than BT cows, especially during the second half of the year, when environmental conditions were characterized by higher rainfall and humidity with lower wind velocity (58.8%a, 55.5%b and 46.4%c in season 1, 2 and 3 respectively; a,b,c p < 0.01).

Epidemiology of transfusion-transmitted infections among multi-transfused patients in seven hospitals in Peru

BACKGROUND

Transfusion-transmitted infections (TTIs) constitute a major health problem worldwide where routine screening of blood or blood products is improperly done, and where non-medical injecting medications and/or drug use are prevalent. Prevalence and risk factors vary by geographic location and by the specific TTI (including HIV-1, HBV, HCV and HTLV-I).

OBJECTIVE

To determine the prevalence and risk factors associated with TTIs among a sample of multi-transfused adult patients in Peru.

STUDY DESIGN

A cross-sectional multi-center study was conducted across seven major hospitals in Peru from February 2003 to September 2004. Self-reported behavior information (medical procedures, number of sexual partners, and drug use history) was analyzed, along with a review of exposure history from hospital medical records. Prevalences were calculated by TTI for different exposures, along with unadjusted and adjusted odds ratios for infection risk.

RESULTS

Overall, 192 (54.7%) of 351 multi-transfused patients were found infected with one or more TTIs. Number of transfusion units, years of transfusion history (6 or more), and number of treatment facilities (2 or more) were associated with HCV infection. Hemodialysis history was a common risk factor associated with HBV, HCV and HTLV-I infection. HIV infection was associated only with total number of transfusion units received.

CONCLUSIONS

High prevalences of HBV and HCV infection were found among Peruvian multi-transfused patients and were associated with a past history and number of blood transfusions, as well as with past hemodialysis procedures. TTIs continue to represent a significant public health problem in Peru. Continued vigilant attention to blood safety procedures, including universal screening and health care provider education, is recommended.

[Ion channels that are sensitive to the extracellular concentration of protons: their structure, function, pharmacology and pathophysiology]

AIM

Acid sensing ion channels (ASIC) members of the ENaC degenerine channel family, have been shown to participate in various sensorial pathways including nociception, also they have been shown to participate in synaptic transmission, learning and memory processes and in the physiopathology of the ischemic stroke.

DEVELOPMENT

The proton concentration in the organism is strictly regulated by distinct buffer systems. Drastic changes of pH are generated only by pathological conditions as is the ischemia; however, some physiological processes may produce local changes in the extracellular pH. Recently, a new family of proton receptors known as ASIC has been cloned. These are ionic channels inactivated at physiological pH (7.4) and activated with a pH fall (increase in H+ concentration). ASICs are permeable to sodium ions and in a lesser degree to calcium ions, activation of these channels leads to an increase in cell excitability. The ASICs are distributed widely in the central and peripheral nervous system, and in specialized epithelia. In the past few years they have become a focus of interest due to its role in nociception, taste perception, long term potentation and the physiopathology of ischemic stroke.

CONCLUSIONS

In this review we address the most relevant molecular, physiological and pharmacological aspects of the ASICs, its participation in some pathological process, and the perspectives of basic and clinic investigation in this arising research field.

A mathematical model of the response of semicircular canal and otolith to head rotation under gravity

The mathematical model of the system composed of two sensors: semicircular canal and sacculus, is presented. The system is described by three series of blocks: biomechanical block, mechanoelectrical transduction mechanism and hair cell ionic currents and membrane potential dynamics. The response of the aforecited system to various stimuli (head rotation under gravity and falling) was investigated. The identification of the model parameters was fulfilled for the experimental data, obtained for the axolotle (Ambystoma tigrinum) in Institute of Physiology, Autonomous University of Puebla, Mexico. The comparative analysis of canal and sacculus membrane potential was realized.