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Body temperature is one of the key vital signs for determining a disease's severity, as it reflects the thermal energy generated by an individual's metabolism. Since the first study on the relationship between body temperature and diseases by Carl Reinhold August Wunderlich at the end of the 19th century, various forms of thermometers have been developed to measure body temperature. Traditionally, methods for measuring temperature can be invasive, semi-invasive, and non-invasive. In recent years, great technological advances have reduced the cost of thermographic cameras, which allowed extending their use. Thermal cameras capture the infrared radiation of the electromagnetic spectrum and process the images to represent the temperature of the object under study through a range of colors, where each color and its hue indicate a previously established temperature. Currently, cameras have a sensitivity that allows them to detect changes in temperature as small as 0.01 °C. Along with its use in other areas of medicine, thermography has been used at the ocular level for more than 50 years. In healthy subjects, the literature reports that the average corneal temperature ranges from 32.9 to 36 °C. One of the possible sources of variability in normal values is age, and other possible sources of variation are gender and external temperature. In addition to the evaluation of healthy subjects, thermography has been used to evaluate its usefulness in various eye diseases, such as Graves' orbitopathy, and tear duct obstruction for orbital diseases. The ocular surface is the most studied area. Ocular surface temperature is influenced by multiple conditions, one of the most studied being dry eye; other diseases studied include allergic conjunctivitis and pterygium as well as systemic diseases such as carotid artery stenosis. Among the corneal diseases studied are keratoconus, infectious keratitis, corneal graft rejection, the use of scleral or soft contact lenses, and the response to refractive or cataract surgery. Other diseases where thermographic features have been reported are glaucoma, diabetic retinopathy, age-related macular degeneration, retinal vascular occlusions, intraocular tumors as well as scleritis, and other inflammatory eye diseases.

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Candida auris is responsible for hospital outbreaks worldwide. Some C. auris isolates may show concomitant resistance to azoles, echinocandins, and polyenes, thereby possibly leaving clinicians with few therapeutic options. In addition, this multi-drug-resistant yeast is difficult to identify with conventional methods and has the ability to persist on environmental surfaces causing hospital-acquired infections. The development of new treatment options and tools for identification is critical to control, prevent, and establish an early diagnosis of this emerging pathogen. The aim of this study was to perform a critical patent review to explore and identify the latest advances in therapeutic strategies as well as diagnostic methods for C. auris. A total of 19 patents were identified for a preliminary assessment from the Espacenet database. Three patents were excluded as they were out of focus for this review according to their abstract and/or description. The final selection covered 16 patents, which were surveyed by country, year and classified as treatment or diagnostic methods for C. auris. As noted in the patent reading, in recent years, the interest of academic, government and industry sectors have shown an increasing tendency focused on research and development of new therapeutic molecules and diagnostic methods to combat this emerging pathogen.

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The spread of anthelmintic resistance (AR) in nematode populations threatens the viability of sheep production systems worldwide, and warrants the adoption of sensitive, practical, and standardized tests to detect AR. The aim of this study was to characterize the replacement of an Haemonchus contortus population resistant to benzimidazoles (BZDs) by a susceptible one, by means of both phenotypic and genotypic techniques. Phenotypic methods to assess BZD resistance included in vivo tests, such as the fecal egg count reduction test (FECRT), and in vitro tests, such as the egg hatch assay (EHA). Additionally, genotypification of polymorphisms associated with BZD resistance by sequencing a fragment of the isotype 1 ß-tubulin gene was carried out. The initial, BZD-resistant population (initial Balcarce population) exhibited an egg count reduction (ECR) of 59.3%. Following refugium replacement, the final population (final Balcarce population) exhibited an ECR of 95.2%. For the initial Balcarce population, the median effective dose (ED50) for the EHA was 0.607 µg thiabendazole (TBZ)/mL, with a rate of eclosion at a discriminating dose (EDD) of 0.1 µg TBZ/mL of 76.73%. For the final Balcarce population, ED50 was 0.02 µg TBZ/mL, and EDD was 1.97%. In the initial population, 93% of the analyzed individuals exhibited genotypic combinations associated with BZD resistance (53% Phe/Phe167-Tyr/Tyr200, 37% Phe/Tyr167-Phe/Tyr200, and 3% Phe/Tyr167-Glu/Leu198). Conversely, no combination associated with resistance was found in individuals from the final population. All of the tests were useful for detecting AR to BZDs. The results from the genetic and phenotypical studies were consistent, and the resulting information greatly aided in interpreting the outcomes of the population replacement and the potential impact of this strategy on management of AR.

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Leptospirosis is poorly studied in small ruminants raised in field semiarid conditions. In this study we compared serological, bacteriological and molecular diagnostic methods in ewes maintained in field Brazilian semiarid conditions. Blood, vaginal fluid and urine samples were collected from 60 Morada Nova ewes raised in a semi-intensive system in the Brazilian semiarid. Diagnostic tests performed were microscopic agglutination test (MAT), polymerase chain reaction (PCR) and bacterial isolation. Anti-Leptospira sp. antibodies were found in eight (13.33%) animals analyzed by MAT at reciprocal titer 25 (cut-off 25), while Leptospira sp. DNA was detected in urine or vaginal fluid of 56 animals (93.33%). There was growth of leptospires in 10 urine cultures and in 11 vaginal fluid cultures, however, two of urine (2/60-3.33%) and eight cultures of vaginal fluid (8/60-13.33%) were confirmed by PCR. Two samples of vaginal fluid (one of each animal) were submitted to sequencing demonstrating 99% similarity with L. santarosai and L. interrogans. The highest MAT sensitivities were obtained with reciprocal titer 25 (cut-off 25) compared to 50 and 100. The performance of different diagnostic techniques for leptospirosis in ewes raised in field semiarid conditions allowed a better evaluation of the herd, as well as made it possible to identify carrier animals. Genital route may be important for efficient transmission and without dependence on environmental factors in ewes from semiarid, as well as it's highlighted that titer 1:25 in serology was more efficient, indicating its use in ewes in field semiarid conditions.

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Introducción: Las membranopatías son anemias hemolíticas hereditarias debidas a anomalías cualitativas o deficiencias cuantitativas de las proteínas del citoesqueleto del glóbulo rojo. Objetivo: Actualizar el diagnóstico de las membranopatías con la inclusión de las últimas recomendaciones del comité de grupos de expertos a nivel nacional e internacional. Métodos: Se realizó una revisión de la literatura en inglés y español, a través del sitio web PubMed y el motor de búsqueda Google académico, de artículos publicados en los últimos cinco años. Análisis y síntesis de la información: Las enfermedades de mayor interés clínico son: la esferocitosis, la eliptocitosis y la estomatocitosis hereditaria. Estas en general se heredan con carácter autosómico dominante pero existen formas que se transmiten con carácter recesivo, sin descartar posible mutación de novo. Para su diagnóstico se utilizan pruebas que incluyen el estudio de la morfología de los glóbulos rojos, la fragilidad osmótica, la lisis de glicerol acidificado, la criohemólisis hipertónica, la prueba de unión a la eosina-5'-maleimida por citometría de flujo, la electroforesis en gel de poliacrilamida con dodecilsulfato sódico y la ectacitometría. Conclusiones: Las membranopatías pueden sospecharse de manera preliminar teniendo en cuenta algunas alteraciones de la morfología eritrocitaria, aunque el diagnóstico se basa en estudios familiares y otros de carácter confirmatorio de la enfermedad, como los estudios moleculares. Los profesionales de la salud que atienden a pacientes jóvenes con anemia deben considerar la posibilidad de una anemia hemolítica por trastornos de la membrana eritrocitaria(AU)

ABSTRACT Introduction: Membranopathies are inherited hemolytic anemias due to qualitative abnormalities or quantitative deficiencies of red blood cell cytoskeletal proteins. Objective: to update the diagnosis of membranopathies with the inclusion of the latest recommendations from the committee of expert groups at the national and international level. Methods: A review of the literature in English and Spanish was carried out, through the PubMed website and the academic search engine Google, in articles published in the last five years. Analysis and synthesis of information: The diseases of greatest clinical interest are: spherocytocis, elliptocytosis and hereditary stomatocytosis. These are generally inherited with an autosomal dominant character but there are forms that are transmitted recessively, without ruling out a possible de novo mutation. For its diagnosis, tests are used that include the study of red blood cell morphology, osmotic fragility, acidified glycerol lysis, hypertonic cryohemolysis, eosin-5'-maleimide binding test by flow cytometry, sodium dodecyl sulfate polyacrylamide gel electrophoresis and ectacytometry. Conclusions: Membranopathies can be preliminarily suspected taking into account some alterations in erythrocyte morphology, although the diagnosis is based on family studies and others confirming the disease, such as molecular studies. Healthcare professionals caring for young patients with anemia should consider the possibility of hemolytic anemia due to red cell membrane disorders(AU)

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Despite its reduced sensitivity, sputum smear microscopy (SSM) remains the main diagnostic test for detecting tuberculosis in many parts of the world. A new diagnostic technique, the magnetic nanoparticle-based colorimetric biosensing assay (NCBA) was optimized by evaluating different concentrations of glycan-functionalized magnetic nanoparticles (GMNP) and Tween 80 to improve the acid-fast bacilli (AFB) count. Comparative analysis was performed on 225 sputum smears: 30 with SSM, 107 with NCBA at different GMNP concentrations, and 88 with NCBA-Tween 80 at various concentrations and incubation times. AFB quantification was performed by adding the total number of AFB in all fields per smear and classified according to standard guidelines (scanty, 1+, 2+ and 3+). Smears by NCBA with low GMNP concentrations (≤1.5 mg/mL) showed higher AFB quantification compared to SSM. Cell enrichment of sputum samples by combining NCBA-GMNP, incubated with Tween 80 (5%) for three minutes, improved capture efficiency and increased AFB detection up to 445% over SSM. NCBA with Tween 80 offers the opportunity to improve TB diagnostics, mainly in paucibacillary cases. As this method provides biosafety with a simple and inexpensive methodology that obtains results in a short time, it might be considered as a point-of-care TB diagnostic method in regions where resources are limited.

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OBJECTIVES: Disseminated histoplasmosis is a major killer of HIV-infected persons in Latin America. Antigen detection, fungal culture and Polymerase Chain Reaction are often not available, but cytology and histology are present in most hospitals and may offer a diagnostic alternative. In this study, we review 34 years of clinical experience to describe the roles of cytology and histology in diagnosing disseminated histoplasmosis. METHODS: Retrospective multicentric study of 349 patients between 1 January 1981 and 1 October 2014 with confirmed disseminated histoplasmosis. RESULTS: Around 32/214 (14.9%) of samples were screened using cytopathology, as were 10/101 (9.9%) bronchoalveolar lavage samples and 5/61 (8.2%) of spinal fluid samples. The samples most commonly sent to pathology were liver biopsies, lower digestive tract and lymphnode biopsies; the greatest proportion of positive results were found in lower digestive tract (43/59 (72.9%) positives), lymph node (39/63 (66.1%)), and liver (38/75 (50.7%)) samples. Overall, 97.2% of bone marrow and 97% of bronchoalveolar lavage samples were directly examined by a mycologist. Positive direct examination was independently associated with death (aHR = 1.5 (95%CI = 1-2.2)). CONCLUSIONS: Opportunities for a rapid diagnosis were regularly missed, notably for bone marrow samples, which could have been examined using staining methods complementary to those of the mycologist.

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Male infertility accounts for about 30% of the causes of couple infertility and has become a public health concern. Male infertility may be caused by several factors occurring in isolation or association with several complex syndromes. Despite the importance of semen analysis in the initial investigation of infertility, it has been estimated that 15% of infertile men present normal sperm, a proportion that calls for additional tests to further investigate cases of infertility and accurately determine the factors that alter ejaculate quality. In addition to semen analysis parameters, genetics has been drawing attention. The incorporation of genetic diagnostic methods in the routine practice of andrology laboratories is an important step to further improve assisted reproductive technologies. The present study described the current status of the main methods used in male infertility investigation.

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COVID-19 and arboviruses (ARBOD) epidemics co-occurrence is a great concern. In tropical and subtropical regions, ARBOD diseases such as chikungunya, dengue, and Zika are frequent. In both COVID-19 and ARBOD cases, an accurate diagnosis of infected patients is crucial to promote adequate treatment and isolation measures in COVID-19 cases. Overlap of clinical symptoms and laboratory parameters between COVID-19 and ARBOD present themselves as an extra challenge during diagnosis. COVID-19 diagnosis is mainly performed by quantitative reverse polymerase chain reaction (RT-qPCR), while ARBOD diagnosis is performed by serology, detection of antigen or antibody, and molecular diagnosis. In this review, the epidemiologic profile of arboviruses and SARS-CoV-2 is analyzed, and potential risks of symptom overlap is addressed. The implementation of an analytical platform based on infrared (IR) spectroscopy, MALDI-TOF mass spectrometry, and RT-qPCR is discussed as an efficient strategy for a fast, robust, reliable, and cost-effective diagnosis system even during the co-occurrence of virus outbreaks. The spectral data of IR spectroscopy and MALDI-TOF MS obtained from COVID-19 infected and recovered patients can be used to build up an integrated spectral database. This approach can enable us to determine quickly the groups that have been exposed and have recovered from COVID-19 or ARBOD, avoiding misdiagnoses.

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A novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak has become a global ongoing pandemic. This pandemic represents a great work risk for all health professionals, it includes dental professionals who are in constant contact with saliva, which represents one of the main routes of transmission of the disease. This is due to the fact that a wide variety of oral tissues and cells are susceptible to infection by SARS-CoV-2 and that they express the ACE2 receptor, which is the main route of entry of the virus into cells, as well as the proteins TMPRSS and furin that contributes to the binding of the virus to the host cells. According to recent studies, some of the oral cells most susceptible to infection by SARS-CoV-2 are the epithelial cells of the salivary glands. This explains the presence of the virus in the saliva of infected patients and provides scientific evidence that supports the use of saliva as a biofluid that offers the opportunity to develop new detection and diagnostic techniques. This is because saliva is much easier to collect compared to nasopharyngeal swab. However, the presence of the virus in saliva, also represents a great source of transmission, since the main form of infection is through microscopic drops that are generated when infected people cough or sneeze. Likewise, health professionals, such as dentists are exposed to contagion through saliva. The objective of this review article is to provide a perspective on the main cells and tissues that can be affected by the virus, the risk of contagion that the presence of the virus in saliva represents for dentists; and the new techniques developed from saliva samples for the diagnosis and surveillance of SARS-CoV-2 infection. This review is expected to contribute to the knowledge of oral health professionals about the risk of saliva in the spread of SARS-CoV-2, but also its advantages as a diagnostic tool for pandemic control. In conclusion, the authors can mention that information that provides more scientific evidence of the mechanisms of infection of the coronavirus in oral cells and tissues is being published continually. This also explains the presence of the virus in the saliva of infected people and the risk of contagion that this means. It also provides scientific evidence of the use of saliva as a biofluid for the detection, diagnosis, monitoring, and control of the spread of the virus.

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Proper plant nutrition is critical to increasing the yield of bananas. The objective was to establish the potential nutrient-response curves and sufficiency ranges using the boundary line approach (BLA) and the method proposed by Kenworthy (MK) to assess the nutritional status of ‘Prata-Anã bananas cultivated under two environmental conditions. The study was carried out using a database comprising leaf nutrient concentrations and banana yields grown at Missão Velha, Ceará, and Ponto Novo, Bahia, Brazil. The reference population consisted of high-yielding plants with yields greater than the mean yield plus 0.5 standard deviation. The database was divided into two datasets. One contained 253 leaf analysis results and a reference population with a mean yield greater than 39.81 t ha−1 yr−1 at Missão Velha. The other contained 147 samples and a reference population with a mean yield greater than 41.69 t ha−1 yr−1 at Ponto Novo. The sufficiency ranges obtained by the BLA for ‘Prata-Anã banana in Bahia and Ceará, respectively, are: a) for macronutrients (g kg−1): N (19.3-22.0) and (19.9-22.1); P (1.4-2.0) and (1.4-1.6); K (22.6-32.2) and (24.0-31.3); Ca (4.6-6.5) and (5.3-5.8); Mg (1.8-2.6) and (2.1-2.7); S (1.3-2.0) and (1.3-1.5); b) for micronutrients (mg kg−1): B (8.4-13.0) and (13.7-16.4); Cu (5.6-8.4) and (4.4-5.2); Fe (54.2-77.6) and (39.0-55.0); Mn (140.1-222.8) and (64.0-91.0); Zn (13.5-18.3) and (12.4-14.5). The sufficiency ranges obtained by the BLA are more assertive when assessing the nutritional status for ‘Prata-Anã banana.(AU)

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ABSTRACT: Proper plant nutrition is critical to increasing the yield of bananas. The objective was to establish the potential nutrient-response curves and sufficiency ranges using the boundary line approach (BLA) and the method proposed by Kenworthy (MK) to assess the nutritional status of Prata-Anã bananas cultivated under two environmental conditions. The study was carried out using a database comprising leaf nutrient concentrations and banana yields grown at Missão Velha, Ceará, and Ponto Novo, Bahia, Brazil. The reference population consisted of high-yielding plants with yields greater than the mean yield plus 0.5 standard deviation. The database was divided into two datasets. One contained 253 leaf analysis results and a reference population with a mean yield greater than 39.81 t ha1 yr1 at Missão Velha. The other contained 147 samples and a reference population with a mean yield greater than 41.69 t ha1 yr1 at Ponto Novo. The sufficiency ranges obtained by the BLA for Prata-Anã banana in Bahia and Ceará, respectively, are: a) for macronutrients (g kg1): N (19.3-22.0) and (19.9-22.1); P (1.4-2.0) and (1.4-1.6); K (22.6-32.2) and (24.0-31.3); Ca (4.6-6.5) and (5.3-5.8); Mg (1.8-2.6) and (2.1-2.7); S (1.3-2.0) and (1.3-1.5); b) for micronutrients (mg kg1): B (8.4-13.0) and (13.7-16.4); Cu (5.6-8.4) and (4.4-5.2); Fe (54.2-77.6) and (39.0-55.0); Mn (140.1-222.8) and (64.0-91.0); Zn (13.5-18.3) and (12.4-14.5). The sufficiency ranges obtained by the BLA are more assertive when assessing the nutritional status for Prata-Anã banana.

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Proper plant nutrition is critical to increasing the yield of bananas. The objective was to establish the potential nutrient-response curves and sufficiency ranges using the boundary line approach (BLA) and the method proposed by Kenworthy (MK) to assess the nutritional status of ‘Prata-An㒠bananas cultivated under two environmental conditions. The study was carried out using a database comprising leaf nutrient concentrations and banana yields grown at Missão Velha, Ceará, and Ponto Novo, Bahia, Brazil. The reference population consisted of high-yielding plants with yields greater than the mean yield plus 0.5 standard deviation. The database was divided into two datasets. One contained 253 leaf analysis results and a reference population with a mean yield greater than 39.81 t ha−1 yr−1 at Missão Velha. The other contained 147 samples and a reference population with a mean yield greater than 41.69 t ha−1 yr−1 at Ponto Novo. The sufficiency ranges obtained by the BLA for ‘Prata-An㒠banana in Bahia and Ceará, respectively, are: a) for macronutrients (g kg−1): N (19.3-22.0) and (19.9-22.1); P (1.4-2.0) and (1.4-1.6); K (22.6-32.2) and (24.0-31.3); Ca (4.6-6.5) and (5.3-5.8); Mg (1.8-2.6) and (2.1-2.7); S (1.3-2.0) and (1.3-1.5); b) for micronutrients (mg kg−1): B (8.4-13.0) and (13.7-16.4); Cu (5.6-8.4) and (4.4-5.2); Fe (54.2-77.6) and (39.0-55.0); Mn (140.1-222.8) and (64.0-91.0); Zn (13.5-18.3) and (12.4-14.5). The sufficiency ranges obtained by the BLA are more assertive when assessing the nutritional status for ‘Prata-An㒠banana.

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BACKGROUND: The treatment of choice for advanced non-small cell lung cancer is selected according to the presence of specific alterations. Patients should undergo molecular testing for relevant modifications and the mutational status of EGFR and translocation of ALK and ROS1 are commonly tested to offer the best intervention. In addition, the tests costs should also be taken in consideration. Therefore, this work was performed in order to evaluate the cost-effectiveness of a unique exam using NGS (next generation sequencing) versus other routinely used tests which involve RT-PCR and FISH. METHODS: The target population was NSCLC, adenocarcinoma, and candidates to first-line therapy. Two strategies were undertaken, strategy 1 corresponded to sequential tests with EGFR RT-PCR, then FISH for ALK and ROS1. Strategy 2 differed from 1 in that ALK and ROS1 translocation testing were performed simultaneously by FISH. Strategy 3 considered single test next-generation sequencing, a platform that includes EGFR, ALK and ROS1 genes. A decision tree analysis was used to model genetic testing options. From the test results, a microsimulation model was nested to estimate survival outcomes and costs of therapeutic options. RESULTS: The use of NGS added 24% extra true cases as well as extra costs attributed to the molecular testing. The ICER comparing NGS with sequential tests was US$ 3479.11/correct case detected. The NGS improved a slight gain in life years and QALYs. CONCLUSION: Our results indicated that, although precise, the molecular diagnosis by NGS of patients with advanced stage NSCLC adenocarcinoma histology was not cost-effective in terms of quality-adjusted life years from the perspective of the Brazilian supplementary health system.

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The objectives of this study were to characterize the endometritis induced in mares using color Doppler ultrasonography and traditional exams. Experiment 1. Mares (n=20) were submitted to intrauterine inoculation with Escherichia coli. Uterine evaluation was performed at M0 and M1. Experiment 2. Animals were divided into two groups: control group (n=10), and treated group (n=10) using phytotherapeutic solution. In both groups, the uterine evaluation was performed at time T1, T2, and T3. Experiment 3: Uterine evaluation was compared after antibiotic therapy, phytotherapy, and M0. For statistical analysis, the Tukey test, t Student, and Anova test were applied. Experiment 1. The mean values of vascularization at M1 were significantly higher than those obtained at M0 (P<0.05). Bacterial growth was observed in all samples collected. Experiment 2. The mean value of vascularization at time T1 in both groups was significantly higher (P<0.05) compared to M2 and M3. Experiment 3. After antibiotic therapy, the vascularization of the body and uterine horns was not equivalent to the vascularization presented at M0. We can conclude that it was not possible to correlate results obtained by color Doppler ultrasonography with the traditional findings for the diagnosis of endometritis.(AU)

Os objetivos deste estudo foram caracterizar a endometrite induzida em éguas utilizando-se a ultrassonografia com Doppler colorido e exames tradicionais. Experimento 1: as éguas (n=20) foram submetidas à inoculação intrauterina com Escherichia coli. A avaliação uterina foi realizada em M0 e M1. Experimento 2: os animais foram divididos em dois grupos: grupo controle (n=10) e grupo tratado (n=10), sendo usada solução fitoterápica. Nos dois grupos, a avaliação uterina ocorreu nos momentos T1, T2 e T3. Experimento 3: a avaliação uterina foi comparada após antibioticoterapia, fitoterapia e M0. Para análise estatística, foram aplicados os testes de Tukey, t de Student e ANOVA. Experimento 1: os valores médios de vascularização em M1 foram significativamente maiores que os obtidos no M0 (P<0,05). Houve crescimento bacteriano em todas as amostras coletadas. Experimento 2: o valor médio da vascularização no tempo T1 nos dois grupos foi significativamente maior (P<0,05) do que o obtido em M2 e M3. Experimento 3: após antibioticoterapia, a vascularização do corpo e dos cornos uterinos não era equivalente à vascularização apresentada em M0. Pode-se concluir que não foi possível correlacionar os resultados obtidos pela ultrassonografia com Doppler colorido com os achados tradicionais para o diagnóstico de endometrite.(AU)

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Leishmaniasis is a neglected zoonotic disease caused by a variety of pathogenic Leishmania species. In the New World, especially in Brazil, visceral leishmaniasis (VL) is caused by Leishmania infantum. The pathogen can infect several animal species including dogs, foxes, rodents, primates, felines, equines and humans. Dogs act as the primary domestic reservoirs. This study aimed to use polymerase chain reaction (PCR) for detecting Leishmania infection in horses living in a canine visceral leishmaniasis (CVL) endemic region. DNA samples from horse peripheral blood were used to perform PCR. Templates were amplified using primers for the kinetoplast DNA (kDNA) minicircles, which were able to detect different species of Leishmania. In addition, primers for internal transcribed spacer (ITS) of ribosomal DNA were used for detection of Trypanosomatidae sp. Amongst the 75 (39%) positive PCR samples from total 192 samples, 21 samples were positive for kDNA and 63 samples were positive for either ITS, ITS1, or ITS2 gene markers. The kDNA PCR and sequencing allowed the detection of L. infantum in horse blood samples. To our knowledge, this is the first report of equine infection with L. infantum in Southern Brazil. These results proved that L. infantum could also infect horses in addition to humans and dogs, as well as in European countries. This conclusion emphasizes the urgent need to follow up investigation of the infection in these animals.(AU)

A leishmaniose é uma doença zoonótica negligenciada, causada por uma diversidade de espécies patogênicas de Leishmania. No Novo Mundo, especialmente no Brasil, a leishmaniose visceral é causada pelo protozoário Leishmania infantum. A infecção acomete várias espécies animais (cães, raposas, roedores, primatas, felinos, equinos) e humanos e o cão é o principal reservatório doméstico. Este estudo teve como objetivo utilizar a reação em cadeia da polimerase (PCR) para detectar a infecção por Leishmania sp. em cavalos que vivem em uma região endêmica para leishmaniose visceral canina (LVC). Amostras de DNA do sangue periférico de equinos foram utilizadas para extração de DNA e PCR. As amplificações foram realizadas utilizando-se marcadores para a região do DNA do cinetoplasto (kDNA), que são capazes de detectar diferentes espécies de Leishmania sp. e a região dos espaçadores internos transcritos (ITS) do DNA ribossomal para detecção da família Trypanosomatidae. Dentre os 192 animais testados, 75 (39%) amostras foram positivas no PCR, 21 amostras foram positivas para PCR kDNA e 63 para os genes ITS, ITS1 e ITS2. O sequenciamento dos amplicons permitiu detectar L. infantum em amostras de sangue periférico de equinos. Este foi o primeiro relato de infecção por L. infantum no sul do Brasil na espécie equina. Os resultados demonstram que, assim como nos países europeus, a infecção foi detectada em equinos após ter sido identificada em seres humanos e cães, o que indica a urgência em acompanhar a investigação da infecção nessa espécie animal.(AU)

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Leishmaniasis is a neglected zoonotic disease caused by a variety of pathogenic Leishmania species. In the New World, especially in Brazil, visceral leishmaniasis (VL) is caused by Leishmania infantum. The pathogen can infect several animal species including dogs, foxes, rodents, primates, felines, equines and humans. Dogs act as the primary domestic reservoirs. This study aimed to use polymerase chain reaction (PCR) for detecting Leishmania infection in horses living in a canine visceral leishmaniasis (CVL) endemic region. DNA samples from horse peripheral blood were used to perform PCR. Templates were amplified using primers for the kinetoplast DNA (kDNA) minicircles, which were able to detect different species of Leishmania. In addition, primers for internal transcribed spacer (ITS) of ribosomal DNA were used for detection of Trypanosomatidae sp. Amongst the 75 (39%) positive PCR samples from total 192 samples, 21 samples were positive for kDNA and 63 samples were positive for either ITS, ITS1, or ITS2 gene markers. The kDNA PCR and sequencing allowed the detection of L. infantum in horse blood samples. To our knowledge, this is the first report of equine infection with L. infantum in Southern Brazil. These results proved that L. infantum could also infect horses in addition to humans and dogs, as well as in European countries. This conclusion emphasizes the urgent need to follow up investigation of the infection in these animals.

A leishmaniose é uma doença zoonótica negligenciada, causada por uma diversidade de espécies patogênicas de Leishmania. No Novo Mundo, especialmente no Brasil, a leishmaniose visceral é causada pelo protozoário Leishmania infantum. A infecção acomete várias espécies animais (cães, raposas, roedores, primatas, felinos, equinos) e humanos e o cão é o principal reservatório doméstico. Este estudo teve como objetivo utilizar a reação em cadeia da polimerase (PCR) para detectar a infecção por Leishmania sp. em cavalos que vivem em uma região endêmica para leishmaniose visceral canina (LVC). Amostras de DNA do sangue periférico de equinos foram utilizadas para extração de DNA e PCR. As amplificações foram realizadas utilizando-se marcadores para a região do DNA do cinetoplasto (kDNA), que são capazes de detectar diferentes espécies de Leishmania sp. e a região dos espaçadores internos transcritos (ITS) do DNA ribossomal para detecção da família Trypanosomatidae. Dentre os 192 animais testados, 75 (39%) amostras foram positivas no PCR, 21 amostras foram positivas para PCR kDNA e 63 para os genes ITS, ITS1 e ITS2. O sequenciamento dos amplicons permitiu detectar L. infantum em amostras de sangue periférico de equinos. Este foi o primeiro relato de infecção por L. infantum no sul do Brasil na espécie equina. Os resultados demonstram que, assim como nos países europeus, a infecção foi detectada em equinos após ter sido identificada em seres humanos e cães, o que indica a urgência em acompanhar a investigação da infecção nessa espécie animal.

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ABSTRACT Chagas disease (CD) is a neglected endemic disease. Its classic form of transmission occurs through hematophagous triatomine insects. Its classic form of transmission occurs through hematophagous triatomine insects. There are cases of the disease in non-endemic regions that occur through alternative transmissions, as this possibility also exists. The aim of this study was to report a case among members of a same family (born and resident in Taquarituba, São Paulo, Brazil) diagnosed with CD. The family matriarch lived in a mud house in the countryside and reported contact with the triatomine during childhood. Two grown-up children are also seroreactive; both reported not having contact with the insect as children. Medical record analyzes and new laboratory tests were performed. Clinical history and recent tests have confirmed positivity for CD in the matriarch and her grown-up children. Parasitological techniques have shown negative results, evidencing that they are in the chronic form of the disease. Congenital transmission may have occurred between them, as well as the possibility of vector transmission by secondary species cannot be ruled out, since the patients come from a municipality considered endemic for CD in the past.

RESUMEN La enfermedadde Chagas (EC) es una infección endémica que ha sido descuidada. Su forma clásica de transmisión ocurre mediante insectos triatominos hematófagos. Hay casos de la enfermedad en regiones no endémicas que ocurrieron por vías alternativas de transmisión, puesto que también hay esa posibilidad. El objetivo de este estudio fue reportar un caso de miembros de una misma familia diagnosticados con EC. La matriarca de la familia vivía en una casa hecha de barro en la zona ruraly reportó contacto con el triatomino en su infancia. Dos hijosson también sero-reactivos, pero no reportaron contacto con el insecto cuando eran ninos. Se hicieron análisis de historial médico y nuevaspruebas de laboratorio. El histórico clínico y laspruebas recientes confirmaran la positividad para EC, tanto en la madre como en los hijos. Las técnicasparasitológicas demostraron resultados negativos, comprobando la forma crónica de la enfermedad. Transmisión congénitapuede haber ocurrido entre ellos, así como no se puede descartar la posibilidad de ocurrencia de transmisión vectorial por especies secundarias, ya que los pacientes proceden de un municipio que fue considerado endémico para EC en el pasado.

RESUMO A doença de Chagas (DC) é uma enfermidade endêmica negligenciada. Sua forma clássica de transmissão ocorre por meio de insetos triatomíneos hematófagos. Há casos da doença em regiões não endêmicas ocorridos por transmissões alternativas, uma vez que também existe essa possibilidade. O objetivo deste estudo foi relatar um caso de membros da mesma família (natural e residente em Taquarituba, São Paulo, Brasil) diagnosticados com DC. A matriarca da família morava em uma casa de barro na zona rural e relatou contato com o triatomíneo na infância. Dois filhos também são sororreagentes; ambos relataram não terem tido contato com o inseto quando crianças. Análises de prontuário e novos testes laboratoriais foram feitos. O histórico clínico e os recentes exames confirmaram a positividade para DC, tanto na mãe quanto nos filhos. As técnicas parasitológicas demonstraram resultados negativos, constatando forma crônica da doença. Transmissão congênita pode ter ocorrido entre eles, assim como também não se pode descartar a possibilidade de ocorrência de transmissão vetorial por espécies secundárias, visto que os pacientes são oriundos de um município considerado endêmico para DC no passado.

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Introduction. Nosocomial transmission of Mycobacterium tuberculosis is an important health issue and the detection of tuberculosis (TB) cases is the main tool for controlling this disease.Aim. We aimed to assess the possible occurrence of nosocomial transmission of M. tuberculosis in a reference hospital for HIV/AIDS patients and evaluate both the performance of the Xpert MTB/RIF (Xpert) platform and drug resistance profiles.Methodology. We evaluated the performance of the Xpert platform. Samples that tested positive on the BACTEC MGIT 320 (MGIT320) platform were submitted for genotyping and drug susceptibility testing.Results. In this study, pulmonary and extrapulmonary samples from 407 patients were evaluated, and among these, 15.5 % were diagnosed with TB by the MGIT320 platform, with a TB/HIV coinfection rate of 52.4 %. The Xpert platform gave positive results for TB for 11 samples with negative results on the MGIT320 platform. In the genotyping results, 53.3 % of the strains clustered; of these strains, half were in two of the four clusters formed, and the patients had visited the hospital on the same day. Drug resistance was observed in 11.7 % of the strains.Conclusion. Putative nosocomial transmission of M. tuberculosis was detected, showing that genotyping is a powerful approach for understanding the dynamics of M. tuberculosis transmission, especially in a high-burden TB and HIV landscape.

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Resumen La ehrlichiosis es una enfermedad transmitida por la picadura de garrapatas que afecta a perros y humanos, causada por las especies Ehrlichia canis y E. chaffeensis, respectivamente. Estas bacterias son gramnegativas, intracelulares obligadas, de aspecto cocoide a pleomorfo, que infectan los monocitos y desencadenan síntomas como fiebre elevada, anorexia, trombocitopenia, hemorragias, anemia y problemas graves como esplenomegalia, hepatomegalia y meningitis. Para diagnosticar esta enfermedad existen diversos métodos, entre los que se encuentran los hematológicos que evalúan la morfología de los monocitos en búsqueda de mórulas y la serología, que incluye la búsqueda de anticuerpos anti-Ehrlichia, pero que se encuentra limitado debido a la reactividad cruzada que presenta. Por otra parte, el cultivo de especies de Ehrlichia ha resultado ser un método efectivo para la obtención de antígenos y así desarrollar ensayos por inmunofluorescencia indirecta (IFI). El método por reacción de polimerasa en cadena ofrece un diagnóstico definitivo por tener una mayor sensibilidad y especificidad que los otros métodos, al haberse desarrollado cebadores género-específicos, así como especie-específicos. En esta revisión, se discutirán los diversos métodos aplicados al diagnóstico de esta enfermedad, así como las ventajas y desventajas que estos presentan.

Ehrlichiosis is a disease transmitted by tick's bite that affect dogs and humans caused by the species Ehrlichia canis and E. chaffeensis, respectively. These bacteria are obligated intracellular gram negatives, with a cocoid to pleomorph aspect and can infect monocytes and trigger symptoms such as high fever, anorexia, thrombocytopenia, hemorrhages, anemia, and some serious problems such as splenomegaly, hepatomegaly and meningitis. There are several diagnostic tests for ehrlichiosis such as the hematological ones that evaluate the morphology of the monocytes in search of morulae; serological tests that includes the search of anti-Ehrlichia antibodies, although they might be limited due to cross reaction with other species. In other hand, the culture of Ehrlichia species is an effective method to obtain antigens and even develop indirect immunofluorescence assays (IFA). The polymerase chain reaction offers a definitive diagnosis associated to the use of genus-specific and species-specific primers, as well as its increased sensibility and specificity, compared to the others methods. Thus, in this review, we will discuss various methods applied to the diagnosis of this disease, as well as the advantages and disadvantages that these present.

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