Molecular evidence for trans-stadial transmission of Anaplasma platys by Rhipicephalus sanguineus sensu lato under field conditions

This study investigated the transmission of Anaplasma platys by Rhipicephalus sanguineus sensu lato (Ixodida: Ixodidae). Engorged nymphs (n = 404) removed from A. platys-infected dogs were incubated at 28 °C until moulting. Unfed adults were obtained and divided into 48 pools. Unfed ticks collected from the grounds of the dog shelter, comprising 1800 larvae (n = 18 pools), 3100 nymphs (n = 62 pools) and 85 adults (n = 10 pools, including three male and seven female pools) were sorted into 90 pools. All pools were screened by polymerase chain reaction for the 16S rRNA gene of A. platys. Of 48 pools of unfed adults obtained from engorged nymphs, 12 were positive for A. platys; the infection rate maximum likelihood estimate (MLE) was 3.36 [95% confidence interval (CI) 1.84-5.68]. Anaplasma platys was detected in five of 23 male pools (MLE 2.82, 95% CI 1.06-6.20) and seven of 25 female pools (MLE 3.83, 95% CI 1.72-7.57). Of seven pools of unfed adult females collected from the shelter grounds, one was positive for A. platys (MLE 1.74, 95% CI 0.11-8.22). Among 62 unfed nymph pools, eight were infected with A. platys (MLE 0.27, 95% CI 0.13-0.52). No A. platys DNA was detected in the larva pools. The present results reveal molecular evidence for the trans-stadial transmission of A. platys by R. sanguineus s.l.

Molecular survey of haemoplasmas in shelter dogs and associations with Rhipicephalus sanguineus sensu lato

This study aimed to assess the occurrence of canine haemoplasma infection in domestic dogs and its possible trans-stadial transmission by Rhipicephalus sanguineus sensu lato (Ixodida: Ixodidae) in shelter dogs in Diyarbakır Province in southeast Turkey. Blood samples (n = 282) collected from domestic dogs were analysed by polymerase chain reaction (PCR) for the presence of canine haemoplasma. Fully engorged nymphs (n = 204) were removed from dogs that were positive for canine haemoplasma by PCR and maintained in an incubator at 28 °C for moulting. Unfed ticks (n = 2185) comprising 2100 nymphs and 85 adults collected from the grounds of the same shelter were also screened. Of 282 dogs, 108 [38.3%, 95% confidence interval (CI) 32.6-44.2] were PCR-positive for canine haemoplasmas. Mycoplasma haemocanis (Mhc) infection (26.2%, 95% CI 21.2-31.8) was observed in a significantly higher number of dogs than was Candidatus Mycoplasma haematoparvum (CMhp) infection (6.7%, 95% CI 4.1-10.3). Co-infections were seen in 15 (5.3%, 95% CI 3.0-8.6) dogs. None of the tick specimens examined were found to be positive for haemoplasma. Partial sequences of the 16S ribosomal RNA (rRNA) gene shared 99-100% identity with the corresponding published sequences for Mhc and CMhp. The present results revealed no trans-stadial transmission of canine haemoplasma species by R. sanguineus s.l. in field conditions.

Transstadial Transmission of Hepatozoon canis by Rhipicephalus sanguineus (Acari: Ixodidae) in Field Conditions

This study investigated possible transovarial and transstadial transmission of Hepatozoon canis by Rhipicephalus sanguineus (Latreille) ticks collected from naturally infected dogs in a municipal dog shelter and the grounds of the shelter. Four hundred sixty-five engorged nymphs were collected from 16 stray dogs that were found to be infected with H. canis by blood smear and PCR analyses and maintained in an incubator at 28 °C for moulting. Four hundred eighteen nymphs moulted to adults 14-16 d post collection. Unfed ticks from the shelter grounds comprised 1,500 larvae, 2,100 nymphs, and 85 adults; were sorted according to origin, developmental stage, and sex into 117 pools; and screened by 18S rRNA PCR for Hepatozoon infection. Of 60 adult tick pools examined, 51 were infected with H. canis. The overall maximum likelihood estimate (MLE) of infection rate was calculated as 21.0% (CI 15.80-28.21). Hepatozoon canis was detected in 31 out of 33 female pools (MLE 26.96%, CI 17.64-44.33) and 20 out of 27 male pools (MLE 14.82%, CI 20.15-46.41). Among 42 unfed nymph pools collected from the shelter, 26 were infected with H. canis, and MLE of infection was calculated as 1.9% (CI 1.25-2.77). No H. canis DNA was detected in any of the gDNA pools consisting of larva specimens. Partial sequences of the 18S rRNA gene shared 99-100% similarity with the corresponding H. canis isolates. Our results revealed the transstadial transmission of H. canis by R. sanguineus, both from larva to nymph and from nymph to adult, in field conditions. However, there were no evidence of transovarial transmission.

Molecular and Parasitological Survey of Ovine Piroplasmosis, Including the First Report of Theileria annulata (Apicomplexa: Theileridae) in Sheep and Goats from Turkey

Blood and tick samples were collected from 333 apparently healthy sheep and 257 goats as well as 10 sheep exhibiting clinical signs of babesiosis in Adana, Gaziantep, and Adiyaman Provinces in southern Turkey. Fully engorged female ticks were selected and maintained in an incubator until they oviposited. The tick carcasses and their egg masses were examined. Piroplasms compatible with Babesia spp. and Theileria spp. were observed in both symptomatic and asymptomatic small ruminants. Genomic DNA isolates from blood of ovine, tick samples, and egg masses were screened for piroplasms by utilizing 18S rRNA polymerase chain reaction and reverse line blotting (RLB) assays. Parasitemia ranged from 0.01% to 5.6% of erythrocytes in clinical cases. RLB showed positivity in 239 (40.5%) of the sampled apparently healthy sheep and goats and revealed the presence of three Theileria and one Babesia species. Theileria ovis was the most prevalent (35.4%), followed by Babesia ovis (5.4%), Theileria annulata (3.9%), and Theileria sp. MK (0.3%). Thirty-two small ruminants infected with T. ovis were also infected with B. ovis One animal infected with T. ovis was also infected with Theileria sp. MK. Ticks were identified as Rhipicephalus bursa, Rhipicephalus turanicus, Hyalomma excavatum, Haemaphysalis parva, and Hyalomma anatolicum Egg masses of two female R. bursa carcasses were infected with B. ovis This is the first report of theileriosis caused by T. annulata in sheep and goats in Turkey.

Long-term follow-up and quality of life after robot assisted sacrohysteropexy

OBJECTIVE

The aim of this study is to investigate the effect of robot assisted laparoscopic sacrohysteropexy (RALS), with preservation of the uterus, in patients with pelvic organ prolapse on short and long term outcome. We report on (anatomical) status of the prolaps and the associated health related quality of life of women treated with RALS before and five years after surgery.

STUDY DESIGN

A prospective cohort study in a teaching hospital in The Netherlands was performed. Quality of life was assessed pre-operative, post-operative and five years after RALS using the UDI/IIQ validated self-questionnaire designed for Dutch-speaking patients. Clinical and operative data were prospectively collected up to five years. Statistical analysis of categorical data was performed with the paired T-test. Descriptive statistics were computed with the use of standard methods for means, median and proportions.

RESULTS

Hundred women with utero vaginal prolapse were treated with RALS with preservation of the uterus. The overall success rate of pelvic organ prolapse (POP) was 89.2%. After surgery the quality of life improved (P<0.05) Overall health status, based on a 0-100% visual analogue scale (VAS), improved from 72.6% pre-operative to 82.2% six weeks postoperative (P<0.05). Postoperative patients experienced less feelings of nervousness (P=0.01), shame (P<0.05) and frustration (P<0.05). The positive effects on these feelings remained present after five years. The learning curve shows a decrease in operating time with gained experience.

CONCLUSION

RALS has proven to be a safe and effective treatment for uterine preserving surgery in cases of pelvic organ prolapse. The long term anatomical outcomes and quality of life after RALS compare favorably with laparoscopic and open hysteropexy.

Molecular and Parasitological Survey of Bovine Piroplasms in the Black Sea Region, Including the First Report of Babesiosis Associated with Babesia divergens in Turkey

Clinical cases of babesiosis were evaluated, and the frequency of bovine Babesia and Theileria parasites was determined in cattle. Blood samples and thin blood smears were collected from 23 cattle exhibiting clinical signs of babesiosis. In addition, tick and blood samples were collected from 100 apparently healthy cattle cograzing from the same area. Egg masses obtained from fully engorged female ticks were included. DNA isolated from blood and tick samples was screened for Babesia and Theileria by reverse line blot assay. Piroplasms compatible with Babesia spp. were observed microscopically for symptomatic cattle as circular, oval, elongated, or pear-shaped bodies. Parasitemia ranged from 0.08 to 0.9% for Babesia bovis, 2.5 to 15.4% for Babesia bigemina, and 7.4% for Babesia divergens. Reverse line blot showed positivity in 13 (13%) of the sampled clinically normal cattle and revealed the presence of three Babesia species. Babesia bovis was the most prevalent (9/100, 9%), followed by Babesia occultans (3/100, 3%) and B. bigemina (1/100, 1%). One animal infected with B. bigemina was also infected with B. bovis. The single animal infected with B. divergens showed symptoms of babesiosis. Ticks were identified as Rhipicephalus annulatus, Rhipicephalus turanicus, and Ixodes ricinus. One female R. annulatus and its egg mass were infected with B. bigemina. Neither Theileria annulata nor Theileria buffeli/orientalis infections were observed in cattle or ticks. This is the first report of clinical babesiosis caused by B. divergens in cattle from Turkey.

Application of the Reverse Line Blot Assay for the Molecular Detection of Theileria and Babesia sp. in Sheep and Goat Blood Samples from Pakistan

BACKGROUND

The present study was designed to detect the presence of tick-borne parasites (Theileria and Babesia spp.) in 196 blood samples collected from apparently healthy sheep and goats from two provinces, Punjab and Khyber Pukhtoon Khwa, in Pakistan.

METHODS

Reverse line blot (RLB) assay was applied for the parasitic detection by the amplification of hypervariable V4 region of the 18S ribosomal RNA (rRNA) gene. A membrane with covalently linked generic and species specific oligonucleotide probes was used for the hybridization of amplified PCR products.

RESULTS

Parasites were detected in 16% of the ruminant blood samples under study. Two Theileria species, T. lestoquardi and T. ovis, were identified in samples. 25, of the total 32, infected animals were from Khyber Pukhtoon Khwa.

CONCLUSION

Sheep were more prone to tick borne haemoprotozans as 81% infected samples were sheep as compared to 19% goats (P > 0.001). Risk factor analysis revealed that male (P = 0.03), animals infested by ticks (P = 0.03) and herd composed of sheep only (P = 0.001) were more infected by blood parasites.

A study on the determination of risk factors associated with babesiosis and prevalence of Babesia sp., by PCR amplification, in small ruminants from Southern Punjab (Pakistan)

Babesiosis is a parasitic infection due to the multiplication of tick borne parasite, Babesia sp., in erythrocytes of host, which includes a wide variety of vertebrates including small ruminants causing decreased livestock output and hence economic losses. The objective of the present study was to establish a PCR based method for the detection of Babesia sp. in small ruminant population in Southern Punjab and to determine the risk factors involve in the spread of babesiosis. A total of 107 blood samples were collected from 40 sheep and 67 goats in seven districts of Southern Punjab from randomly selected herds. Data on the characteristics of the animals and the herd were collected through questionnaires. 36 blood samples (34% of total) produced the DNA fragment specific for 18S rRNA gene of Babesia sp., by PCR amplification, of which 20 were sheep and 16 were goats. Samples from all seven district contained Babesia positive samples and prevalence varied between 18 to 68%. It was observed that male animals (P = 0.009) and young animals under one year of age (P = 0.01) were more prone to the parasite. It was observed that herds consist of more than 15 animals (P = 0.007), composed of mixed species of small ruminants (P = 0.022), associated with dogs (P = 0.003) and dogs having ticks on their bodies (P = 0.011) were among the major risk factors for the spread of babesiosis in small ruminants.

Molecular identification of ovine Theileria species by a new PCR-RFLP method

Theileria spp. infect wild and domestic ruminants in the tropical and subtropical regions of the world. Two species, T. lestoquardi and T. ovis, are suspected to cause ovine theileriosis in Iran. The epidemiological aspects of ovine theileriosis in Iran are poorly understood, and further investigations by sensitive and precise techniques are required. In this study, the use of a nested PCR for amplification of a fragment of the 18S ribosomal DNA from virtually all species of Theileria is described. For differentiation of various Theileria spp. a RFLP assay was developed as a diagnostic tool enabling direct, concurrent, highly specific and sensitive identification of Theileria spp. The sensitivity of the nested PCR for Theileria species was 10(-5)% parasitemia. Restriction fragment length polymorphism (RFLP) of the PCR products allowed differentiation between three different Theileria species (T. annulata, T. lestoquardi and T. ovis) and seems to be useful for differentiation of other species such as T. separata and Theileria spp. china. From 100 field blood samples obtained from sheep in East and South-East Iran, 56% were positive for Theileria spp. by nested-PCR compared with 21% by microscopic examination. Out of 56 positive samples, 12.5% (7/56) were positive for T. ovis and 87/5% (49/56) were positive for T. lestoquardi. This is the first report in which T. ovis has been detected in Iran using molecular identification techniques.

Separation of adult bone marrow mononuclear cells using the automated closed separation system Sepax

BACKGROUND

The Düsseldorf-based cardiologist Professor Strauer was the first to present a therapeutic concept for the repair of acute infarcted myocardium in 2001: the autologous intracoronary transplantation of unfractionated human bone marrow (BM) mononuclear cells (MNC). The Division of Cardiology, Pneumology and Angiology, University of Duesseldorf Medical School, Duesseldorf, Germany, was also able to show the regenerative potential of BM stem cell transplantation in patients with chronic heart disease (CHD) and peripheral arterial disease (PAD). In the mean time, several clinical trials have been set up worldwide, predominantly by using MNC isolated manually from BM aspirates via density-gradient centrifugation; 374 patients have been treated here with unselected BM MNC since 2001. Altogether 217 BM aspirates have been processed manually. In order to maintain the high standards required for cellular therapeutics, the Sepax cell-separation system was implemented into routine BM processing in 2006. The closed Sepax system provides a reproducible MNC isolation method, and 157 BM samples have been processed with the Sepax device. The results of manual MNC isolation were compared with the Sepax-mediated MNC isolation.

METHODS

The manual Ficoll separation method was compared with the Sepax density gradient-based separation (DGBS) protocol using Ficoll with the kit CS-900 and the Sepax S-100 main processing unit from Biosafe.

RESULTS

Nucleated cell and MNC recovery were significantly higher after Sepax processing (P<0.0001) whereas no significance was found for red blood cell depletion.

DISCUSSION

The Sepax cell-separation system is a time-saving method providing clinical-grade MNC isolated automatically from human BM by Ficoll density centrifugation.

The perceived role of Islam in immigrant Muslim medical practice within the USA: an exploratory qualitative study

BACKGROUND

Islam and Muslims are underrepresented in the medical literature and the influence of physician's cultural beliefs and religious values upon the clinical encounter has been understudied.

OBJECTIVE

To elicit the perceived influence of Islam upon the practice patterns of immigrant Muslim physicians in the USA.

DESIGN

Ten face-to-face, in-depth, semistructured interviews with Muslim physicians from various backgrounds and specialties trained outside the USA and practising within the the country. Data were analysed according to the conventions of qualitative research using a modified grounded-theory approach.

RESULTS

There were a variety of views on the role of Islam in medical practice. Several themes emerged from our interviews: (1) a trend to view Islam as enhancing virtuous professional behaviour; (2) the perception of Islam as influencing the scope of medical practice through setting boundaries on career choices, defining acceptable medical procedures and shaping social interactions with physician peers; (3) a perceived need for Islamic religious experts within Islamic medical ethical deliberation.

LIMITATIONS

This is a pilot study intended to yield themes and hypotheses for further investigation and is not meant to fully characterise Muslim physicians at large.

CONCLUSIONS

Immigrant Muslim physicians practising within the USA perceive Islam to play a variable role within their clinical practice, from influencing interpersonal relations and character development to affecting specialty choice and procedures performed. Areas of ethical challenges identified include catering to populations with lifestyles at odds with Islamic teachings, end-of-life care and maintaining a faith identity within the culture of medicine. Further study of the interplay between Islam and Muslim medical practice and the manner and degree to which Islamic values and law inform ethical decision-making is needed.

Detection of Babesia ovis by PCR in Rhipicephalus bursa collected from naturally infested sheep and goats

Polymerase chain reaction (PCR) was used to assess the presence and the frequency of Babesia ovis infection in the adult Rhipicephalus bursa and their hosts in Elazig province located in eastern Turkey. Tick and blood samples were collected from 32 sheep and 28 goats of four selected herds. A total of 226 R. bursa were randomly selected from the collected ticks and their salivary glands were dissected out in 0.85% saline under stereo microscope. DNA amplification method revealed that the frequency of B. ovis infections in the ticks and the small ruminants were 16.37% (37/226) and 6.66% (4/60), respectively. Three positive products, two of which were from the salivary glands of R. bursa and the other from sheep blood were purified from agarose gel and sequenced. The results showed that nucleotide sequences were identical to the previously reported nucleotide sequences of B. ovis. It is concluded that R. bursa might play an important role in the field as a natural vector of the parasite.

PCR-based detection of Theileria ovis in Rhipicephalus bursa adult ticks

Tick-borne diseases in ruminants are common in tropical and subtropical regions and lead to meat and milk production losses. In this study, polymerase chain reaction (PCR) was used to assess the presence of Theileria ovis in Rhipicephalus bursa ticks. We have demonstrated that the PCR enabled detection of T. ovis in field isolates of R. bursa collected from naturally infested sheep and goats in eastern Turkey. The sampling was done in spring season (between May and June 2004). A total of 420 R. bursa were collected and randomly selected 192 number of them (97 female and 95 male) were dissected. Primers specific for 520 bp fragments small subunit ribosomal RNA (ssu rRNA) gene of T. ovis amplified products from 37 of the 192 (19.27%) samples. The parasite was detected in 17 (17.52%) female and in 20 (21.05%) male ticks. Two T. ovis amplicons from the tick samples were purified and sequenced. The resulting sequences were identical to the nucleotide sequence of the Turkish sheep strain of T. ovis. These results showed that R. bursa might play an important role in the field as a natural vector of T. ovis.

Prevalence and distribution of tropical theileriosis in eastern Turkey

This study was carried out to determine the prevalence and distribution of tropical theileriosis in cattle in eastern Turkey by microscopical, serological and molecular methods. A total of 1561 whole blood, 1505 serum and 1483 blood smear samples were collected from cattle of various breeds and ages in 11 towns of Eastern Turkey. Theileria annulata piroplasm DNA extracted from cattle blood was amplified by polymerase chain reaction (PCR) using species-specific primers. Serum antibodies against T. annulata were investigated by indirect fluorescence antibody test (IFAT). Blood smears were examined for Theileria piroplasms by microscopical examination (ME). In the examination of DNA extracted from 1561 blood samples, an amplicon with the size of 721bp was obtained in 37.8% (590/1561) of these samples. Serum antibodies against T. annulata and piroplasm of Theileria spp. were detected in 34.9% (526/1505) and 19.7% (293/1483) of the samples, respectively. The differences between ME and PCR results and between ME and IFAT results were statistically significant (P < 0.05). In contrast, there was no significant difference between the PCR and IFAT results. A total of 179 ticks (136 female; 43 male) belonging to Hyalomma spp. were collected from cattle from three towns. Ticks were identified to be Hyalomma anatolicum anatolicum on the basis of morphological features.

Cattle infestation by Hyalomma ticks and prevalence of Theileria in Hyalomma species in the east of Turkey

A total of 2388 cattle and 442 shelters, from two provinces (Elazig and Malatya) endemic for tropical theileriosis in the east of Turkey, were studied for Hyalomma tick populations from July 1993 to July 1995 in Elazig and from May 1998 to January 1999 in Malatya. Four thousand five hundred and eighty one of 7455 Hyalomma ticks were collected from cattle, the other ticks (2874) were collected from shelters. All of the ticks collected from shelters were Hyalomma anatolicum anatolicum. Two thousand eight hundred and ninety five (63.1%) of 4581 Hyalomma ticks collected from cattle were H.a. anatolicum. 23.8% (1047/4581), 11.7% (536/4581) and 0.6% (3/4581) of Hyalomma ticks were Hyalomma anatolicum excavatum, Hyalomma detritum and Hyalomma marginatum marginatum, respectively. A total of 5909 Hyalomma adult ticks collected from cattle (3362/5909) and shelters (2447/5909) were dissected and salivary glands were stained with Methylgreen/Pyronin method. Thousand one hundred and fifty (46.9%) of 2447 H.a. anatolicum collected from shelters and 412 (19.1%) of 2147 H.a. anatolicum collected from cattle were positive for Theileria infection. Twenty (2.4%) of 820 H.a. excavatum and 23 (4.6%) of 495 H. detritum collected from cattle were positive. The mean number of infected acini per infected male and female ticks collected from cattle were 11.3 and 22.4 in H.a. anatolicum, 4 and 6.8 in H.a. excavatum, 17.9 and 18.3 in H. detritum, respectively. In H.a. anatolicum collected from shelters, the above rates were 11.8 and 17.6 in male and female ticks, respectively. The prevalence and intensity of Theileria infection was greater in female ticks than in males.

In vivo quantification of muscle damage in dogs after intramuscular administration of drugs

Intramuscular injections of a vitamin B preparation, imidocarb, imidocarb+lidocaine, and a preparation of salts of fatty acids produced significant increases in plasma creatine kinase activity in groups of five to six dogs. Activities peaked between 3 and 8 h, and were as high as 23 times base values with the fatty acid salts preparation. Quantification of the equivalent muscle damage gave means of 0.04, 0.25, 0.23 and 0.30 g kg-1 body weight, respectively, for each of the above preparations.

Disposition of creatine kinase activity in dog plasma following intravenous and intramuscular injection of skeletal muscle homogenates

The fate of skeletal muscle-derived creatine kinase (CK) was investigated in six dogs. After i.m. and i.v. injections of 3000 g and 105,000 g supernatants of dog muscle homogenates, plasma CK activity was measured up to 48 h. There was no significant difference in pharmacokinetic parameters dependent on the type of supernatant injected. After i.v. injection, the volume of distribution of CK was equal to the plasma volume, CK clearance was relatively low (about 0.5 mL/kg/min) and its terminal half-life of elimination was about 2.5 h. After i.m. injection, the CK terminal half-life was about 6.5 h, demonstrating a flip-flop mechanism, i.e. a limiting absorption process from the site of injection. Bioavailability after i.m. injection was about 65%, and the rate of absorption from muscle injection site was relatively slow: peak activity occurred at the second hour post administration, and most CK activity had been absorbed by 24 h. These pharmacokinetic parameters can be used as a basis for a minimally invasive means of quantitating muscle damage either after intramuscular drug administration or in canine sports medicine.

Creatine kinase in dog plasma: preanalytical factors of variation, reference values and diagnostic significance

In the dog, plasma creatine kinase (CK) activity was stable up to one week at +4 degrees C and one month at -20 degrees C. Activity was higher in serum than in plasma due to interference by CK from the platelets. The reference values were determined in 232 dogs using the IFCC recommended method. There was a significant decrease in activity with age but no effect of sex. In adults, plasma CK exhibited a log-normal distribution ranging from 20 to 104 U per litre. In 510 dogs with various diseases, the overall sensitivity and specificity of CK determination were 40 per cent and 98 per cent, respectively. The numerous false negatives could result from the relatively short half-life of the enzyme, while the false positives could be due to secondary muscle damage.

Creatine kinase in the dog: a review

In the dog, creatine kinase (CK) is mostly present in the skeletal muscles, myocardium, brain and intestine. The MM isoenzyme predominates in muscles and myocardium. In plasma, reference values depend on the technique used and CK-MB accounts for about 30-45% of total CK activity. Sex has no influence on plasma CK activity, which is higher in young dogs than in adults. Plasma CK is elevated after physical exercise. After its release from the cells, CK reaches the plasma mostly via the lymphatic route and then remains in the plasma compartment. It is rapidly cleared with a half-life of about 2 hours. Muscle diseases are the main source of plasma CK elevations: inherited myopathies, malignant hyperthermia, hypothyroidism, vitamin E-selenium deficiency, prolonged decubitus, intramuscular injections, surgery, etc. Plasma CK is also increased in experimental myocardial infarction, for which the dog is an interesting model, allowing quantification of the damage by measuring the total CK activity released.