Infecção natural pelo Trypanosoma cruzi em cães de áreas endêmicas da República Argentina

The population dynamics and the prevalence of chagasic infection of 352 dogs living in 108 rural houses infested by triatomines were studied. The region was divided into three sections according to increasing distances to an urban area. Each animal was identified by means of its particular characteristics and built, and its owners gave information about its habits. By means of xenodiagnosis, serology and ECG studies, prevalences of infection, parasitological-serological correlation, percentage of altered electrocardiographic outlines and percentage of houses with parasitemic dogs, were determined. The rural area showed a characteristic T. cruzi infection pattern and differences in the canine population parameters with respect to the other areas were observed: a higher proportion of puppies than adult dogs, a more sedentary population, higher prevalences of infection, as measured by xenodiagnosis, in dogs, and the highest proportion of bedroom insects infected with T. cruzi. It is assumed that the sedentary characteristics of the human population in that rural area impinge in the blood offer to the triatomine population, and the high percentage of parasitemic dogs of the area, contribute to the rise of "kissing ougs" infected with T. cruzi found in bedrooms.Estudou-se a dinâmica populacional e a prevalência de infecção chagásica de 352 cães vivendo em 108 moradias rurais infestadas por triato-míneos. A área foi dividida em três setores de acordo com suas crescentes distâncias em relação a um povoado urbano. Cada animal foi identificado mediante suas características particulares, e seus donos deram informações a respeito de seus hábitos. As prevalências de infecção foram determinadas por sorologia, correlação parasitológica-sorológica, percentual de traçados eletrocardiográficos alterados e o percentual de moradias com cães parasitados. A área rural mostrou um padrão característico de infecção por T. cruzi e observaram-se diferenças nos parâmetros de população canina em relação às restantes áreas: maior proporção de filhotes, maior população humana e canina sedentárias, maiores prevalências de infecção por xenodiagnóstico em cães e maior proporção de barbeiros infectados com T. cruzi nos cômodos da casa. Supõe-se que as características sedentárias da população humana desta área rural é fundamental para a oferta de sangue para as populações triatomíneas, e a elevada porcentagem de cães parasitêmicos dessa área contribui para o aumento de barbeiros infectados com T. cruzi encontrados nos quartos de dormir

Leishmaniasis visceral: senderos que confluyen, se bifurcan

Urban visceral leishmaniasis is an emerging zoonosis in Argentina. In the Americas the disease is produced by Leishmania infantum, with dogs as the primary reservoir and phlebotomine sandflies as the vectors. This article presents the experience acquired by professionals from the National Leishmaniasis Program in Argentina as visceral leishmaniasis has emerged and spread, especially in clinical and laboratory diagnosis, disease treatment, vector biology, reservoir management, and conflicts regarding recommendations for infected dogs. Early detection and treatment, along with decentralized and horizontal strategies, will contribute to the decrease in morbidity and mortality associated with visceral leishmaniasis. Control over the transmission and spread of the disease requires integral environmental management and responsible dog ownership. The interests and discourses put into conflict by visceral leishmaniasis are discussed in the framework of the human-dog relationship, and the search for a consensus-based risk discourse is proposed.La leishmaniasis visceral urbana es una zoonosis emergente en Argentina. En América es producida por Leishmania infantum, con el perro como reservorio principal e insectos flebotomíneos como vectores. En este artículo se presenta el conocimiento acumulado a partir de su emergencia y dispersión en el país, por los referentes del Programa Nacional de Leishmaniasis, en el diagnóstico clínico y de laboratorio, tratamiento, biología de vectores, manejo de reservorio, y el conflicto generado con las acciones recomendadas en relación con los perros infectados. La detección temprana y el tratamiento precoz, con estrategias descentralizadas y horizontales, contribuirán a disminuir la morbimortalidad asociada a la leishmaniasis visceral. El control de su transmisión y dispersión requiere de un manejo ambiental integral y la tenencia responsable de perros. Se discuten los intereses y discursos en conflicto generados por la leishmaniasis visceral en el marco de la relación humano-perro, proponiendo la búsqueda de un discurso consensuado de riesgo

Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization.

The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (LQTS). Using a genome-wide association and replication study in up to 100,000 individuals, we identified 35 common variant loci associated with QT interval that collectively explain ∼8-10% of QT-interval variation and highlight the importance of calcium regulation in myocardial repolarization. Rare variant analysis of 6 new QT interval-associated loci in 298 unrelated probands with LQTS identified coding variants not found in controls but of uncertain causality and therefore requiring validation. Several newly identified loci encode proteins that physically interact with other recognized repolarization proteins. Our integration of common variant association, expression and orthogonal protein-protein interaction screens provides new insights into cardiac electrophysiology and identifies new candidate genes for ventricular arrhythmias, LQTS and SCD

Natural Trypanosoma cruzi infection in dogs of endemic areas of the Argentine Republic

The population dynamics and the prevalence of chagasic infection of 352 dogs living in 108 rural houses infested by triatomines were studied. The region was divided into three sections according to increasing distances to an urban area. Each animal was identified by means of its particular characteristics and built, and its owners gave information about its habits. By means of xenodiagnosis, serology and ECG studies, prevalences of infection, parasitological-serological correlation, percentage of altered electrocardiographic outlines and percentage of houses with parasitemic dogs, were determined. The rural area showed a characteristic T. cruzi infection pattern and differences in the canine population parameters with respect to the other areas were observed: a higher proportion of puppies than adult dogs, a more sedentary population, higher prevalences of infection, as measured by xenodiagnosis, in dogs, and the highest proportion of bedroom insects infected with T. cruzi. It is assumed that the sedentary characteristics of the human population in that rural area impinge in the blood offer to the triatomine population, and the high percentage of parasitemic dogs of the area, contribute to the rise of "kissing ougs" infected with T. cruzi found in bedrooms

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Natural Trypanosoma cruzi infection in dogs of endemic areas of the Argentine Republic

The population dynamics and the prevalence of chagasic infection of 352 dogs living in 108 rural houses infested by triatomines were studied. The region was divided into three sections according to increasing distances to an urban area. Each animal was identified by means of its particular characteristics and built, and its owners gave information about its habits. By means of xenodiagnosis, serology and ECG studies, prevalences of infection, parasitological-serological correlation, percentage of altered electrocardiographic outlines and percentage of houses with parasitemic dogs, were determined. The rural area showed a characteristic T. cruzi infection pattern and differences in the canine population parameters with respect to the other areas were observed: a higher proportion of puppies than adult dogs, a more sedentary population, higher prevalences of infection, as measured by xenodiagnosis, in dogs, and the highest proportion of bedroom insects infected with T. cruzi. It is assumed that the sedentary characteristics of the human population in that rural area impinge in the blood offer to the triatomine population, and the high percentage of parasitemic dogs of the area, contribute to the rise of "kissing ougs" infected with T. cruzi found in bedrooms

A atividade da azitromicina contra a Leishmania (Viannia) braziliensise a Leishmania (Leishmania) amazonensis no modelogolden hamster

Fil: Sinagra, Angel. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Parasitología; Argentina.Fil: Luna, Concepción. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Parasitología; Argentina.Fil: Abraham, David. Thomas Jefferson University. Department of Microbiology and Immunology; Estados Unidos.Fil: Riarte, Adelina. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Parasitología Dr. Mario Fatala Chaben; Argentina.Fil: Iannella, María del Carmen. Universidad de Buenos Aires. Departamento de Matemática; Argentina.Fil: Krolewiecki, Alejandro J. Fundación Huésped. Área de Investigaciones Clínicas; Argentina.New therapeutic alternatives against leishmaniasis remain a priority. The activity of azithromycin against Leishmania(Leishmania) major has been previously demonstrated. Different responses among species of Leishmaniamake species-specific drug screening necessary. The activity of azithromycin against Leishmania (Viannia) braziliensisand Leishmania (Leishmania) amazonensiswas evaluated in golden hamsters infected through footpad injections of metacyclic promastigotes, and compared with untreated controls and animals treated with meglumine antimoniate. Footpad thickness, lesion cultures and dissemination sites were analyzed. Treatment of golden hamsters with oral azithromycin at 450mg/kg had no activity against infections with Leishmania (Leishmania) amazonensis. For infections due to Leishmania (Viannia) braziliensis, azithromycin demonstrated significant activity relative to untreated controls, but inferior to meglumine antimoniate, for controlling lesion size. Neither drug was able to totally eliminate parasites from the lesions. It was concluded that azithromycin has activity against Leishmania (Viannia) braziliensisbut not against Leishmania (Leishmania) amazonensisin this model

A atividade da azitromicina contra a Leishmania (Viannia) braziliensise a Leishmania (Leishmania) amazonensis no modelogolden hamster

Fil: Sinagra, Angel. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Parasitología; Argentina.Fil: Luna, Concepción. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Parasitología; Argentina.Fil: Abraham, David. Thomas Jefferson University. Department of Microbiology and Immunology; Estados Unidos.Fil: Riarte, Adelina. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Parasitología Dr. Mario Fatala Chaben; Argentina.Fil: Iannella, María del Carmen. Universidad de Buenos Aires. Departamento de Matemática; Argentina.Fil: Krolewiecki, Alejandro J. Fundación Huésped. Área de Investigaciones Clínicas; Argentina.New therapeutic alternatives against leishmaniasis remain a priority. The activity of azithromycin against Leishmania(Leishmania) major has been previously demonstrated. Different responses among species of Leishmaniamake species-specific drug screening necessary. The activity of azithromycin against Leishmania (Viannia) braziliensisand Leishmania (Leishmania) amazonensiswas evaluated in golden hamsters infected through footpad injections of metacyclic promastigotes, and compared with untreated controls and animals treated with meglumine antimoniate. Footpad thickness, lesion cultures and dissemination sites were analyzed. Treatment of golden hamsters with oral azithromycin at 450mg/kg had no activity against infections with Leishmania (Leishmania) amazonensis. For infections due to Leishmania (Viannia) braziliensis, azithromycin demonstrated significant activity relative to untreated controls, but inferior to meglumine antimoniate, for controlling lesion size. Neither drug was able to totally eliminate parasites from the lesions. It was concluded that azithromycin has activity against Leishmania (Viannia) braziliensisbut not against Leishmania (Leishmania) amazonensisin this model

Tegumentary leishmaniasis outbreak in Bella Vista City, Corrientes, Argentina during 2003

Bella Vista City, Corrientes, Argentina, reported an epidemic outbreak of tegumentary leishmaniasis during 2003. The mean age of the 31 cases was 25.0 ± 13.7 years old, with a sex ratio male:female 1.8, and without mucosal involvement. They clustered in two contiguous neighbourhoods, 96% in the periurban border and 4% in the peripheral outskirts. The transmission peak was estimated to have occurred during April 2003. Four species (3608 sand flies) were captured in nine sites: Lutzomyia neivai (90.1%), Lu. pessoai (8.9%), Lu. migonei (0.8 %), and Brumptomyia avellari (0.2 %). The outskirts/rural capture ratio of Lu. neivai was up to 3, and the outskirts/periurban up to 200. Therefore, the 'urban' transmission in this southernmost known focus is still an ecotone-border associated risk. The changes in human distribution or activities, patches of the secondary vegetation, periurban streams, rainfall of the previous year, and river period floods could all contribute to 'urban' outbreaks in the region. Tegumentary leishmaniasis risk should be assessed for any project that involves changes in land use throughout an endemic area

Tegumentary leishmaniasis outbreak in Bella Vista City, Corrientes, Argentina during 2003

Fil: Salomón, Oscar Daniel. ANLIS Dr.C.G.Malbrán. Centro Nacional de Diagnóstico e Investigación en Endemo-Epidemias; Argentina.Fil: Sosa-Estani, Sergio. Fil: Salomón, Oscar Daniel. ANLIS Dr.C.G.Malbrán. Centro Nacional de Diagnóstico e Investigación en Endemo-Epidemias; Argentina.Fil: Ramos, Karina. Ministerio de Salud Pública, Corrientes; Argentina.Fil: Orellano, Pablo Wenceslao. Ministerio de Salud y Ambiente, Buenos Aires; Argentina.Fil: Sanguesa, Gustavo. Ministerio de Salud y Ambiente, Buenos Aires; Argentina.Fil: Fernández, Gustavo. Ministerio de Salud Pública, Corrientes; Argentina.Fil: Sinagra, Angel. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Parasitología Dr. Mario Fatala Chaben; Argentina.Fil: Rapasciolli, Guillermo. Hospital de Bella Vista; Argentina.Bella Vista City, Corrientes, Argentina, reported an epidemic outbreak of tegumentary leishmaniasis during 2003. The mean age of the 31 cases was 25.0 ± 13.7 years old, with a sex ratio male:female 1.8, and without mucosal involvement. They clustered in two contiguous neighbourhoods, 96% in the periurban border and 4% in the peripheral outskirts. The transmission peak was estimated to have occurred during April 2003. Four species (3608 sand flies) were captured in nine sites: Lutzomyia neivai (90.1%), Lu. pessoai (8.9%), Lu. migonei (0.8 %), and Brumptomyia avellari (0.2 %). The outskirts/rural capture ratio of Lu. neivaiwas up to 3, and the outskirts/periurban up to 200. Therefore, the ëurbaní transmission in this southernmost known focus is still an ecotone-border associ-ated risk. The changes in human distribution or activities, patches of the secondary vegetation, periurban streams, rainfall of the previous year, and river period floods could all contribute to ëurbaní outbreaks in the region. Tegumentary leishmaniasis risk should be assessed for any project that involves changes in land use throughout an endemic area