Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Serological investigation and PCR in detection of pathogenic leptospires in snakes

A detecção de Leptospira pela técnica de PCR não havia sido descrita em serpentes. Este estudo investigou pelo teste de aglutinação microscópica (MAT) e PCR, a presença de anticorpos anti-Leptospira spp. e Leptospira spp., respectivamente, em serpentes peçonhentas e não peçonhentas de vida livre e de cativeiro. As serpentes foram divididas em três grupos para comparação: Grupo 1 (serpentes recém-chegadas da natureza - WS); Grupo 2 (serpentes em regime de cativeiro intensivo -IC) e Grupo 3 (serpentes em regime de cativeiro coletivo semi-extensivo - CC). do total de 147 serpentes estudadas, 52 (35,4%) foram positivas para leptospirose pelo MAT, as quais 8 (15,4%) pertenciam ao Grupo 1 (WS), 34 (65,4%) ao Grupo 2 (IC) e 10 (19,2%) ao Grupo 3 (CC). Das espécies estudadas, a jararaca (Bothrops jararaca) apresentou maior soropositividade (66,7%, N=22/33). O sorovar mais prevalente foi o Hardjo prajtino (88,5%, N=46/52) e os títulos variaram de 100 a 3200. Leptospira interrogans foi revelada por PCR nos rins e no fígado de caiçaca (Bothrops moojeni) e de jararaca-pintada (Bothrops pauloensis), mostrando 100% e 93% de identidade, respectivamente. Futuros estudos devem ser realizados para melhor compreensão do papel das serpentes como reservatório de leptospiras na natureza.Detection of Leptospira by PCR had not yet been described in snakes. This study investigated, by microscopic agglutination test (MAT) and PCR, the presence of antibodies to Leptospira spp. and Leptospira spp., respectively, in venomous and non-venomous wildlife and captivity snakes. All snakes were divided into three groups to be compared: Group 1 (wildlife snakes - WS); Group 2 (snakes in intensive captivity - IC), and Group 3 (collective semi-extensive captivity -CC). of the 147 snakes studied, 52 (35.4%) were positive for leptospirosis by MAT, 8 (15.4%) belonging to Group 1 (WS), 34 (65.4%) to Group 2 (IC) and 10 (19.2%) to Group 3 (CC). Jararaca (Bothrops jararaca) presented the highest average titer (66.7%, N=22/33) among the three group studied, and Hardjo prajtino was the most prevalent serovar (88.5%, N=46/52), with titers varying from 100 to 3200. Leptospira interrogans was revealed by PCR in kidney and liver of caiçaca (Bothrops moojeni) and jararaca-pintada (Bothrops pauloensis), showing 100% and 93% identity respectively. Future studies should be carried out for better understanding of the role of snakes as a reservoir of Leptospira in nature.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Detection of Toxoplasma gondii DNA in the milk of naturally infected ewes

Toxoplasmosis is the major parasitic disease affecting sheep. It is important for veterinary medicine, animal science and public health since it causes reproductive and economic losses in the herd, as well as damaging human health due to consumption of contaminated meat and milk, which can facilitate zoonotic transmission. Detection of Toxoplasma gondii in ovine milk and lack of data in the literature describing differentiation between acute and chronic disease for this species stimulated the elaboration of the present research project. To achieve the aim of this study, the animals were allocated to two groups of 20 ewes each, of which group 1 was composed of animals with positive serology and group 2 with negative serology. Acute and chronic stages of the disease were differentiated by modified direct agglutination test (MAT), in which antigens were fixed with formalin (MAT-AF) and methanol (MAT-AM). The parasite was detected in milk by polymerase chain reaction (PCR), and the molecular identity of the amplified products was confirmed by sequencing. The serological results indicated that sheep had a chronic infection profile. T. gondii DNA was detected in seven milk samples from five seropositive sheep, and twice in milk of two sheep. Sequences of species shared 97-100% identity with T. gondii. These findings allowed the hypothesis that the peripartum period may also lead to the resurgence of tissue T. gondii tachyzoites cysts which can circulate again and be excreted in the milk. This study used sheep naturally infected with T. gondii as a prerequisite for further investigations on the possible participation of this species in toxoplasmosis epidemiology and as a potential transmission route related to consumption of milk from infected sheep. (C) 2010 Elsevier B.V. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP