Made available in DSpace on 2014-06-11T19:27:18Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-12-18Bitstream added on 2014-06-13T18:55:52Z : No. of bitstreams: 1 silva_dc_me_araca.pdf: 457686 bytes, checksum: 955900a36656c74b3d4e888ce706efe1 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Devido à carência de informações relacionadas à epidemiologia da infecção por Cryptosporidium spp. em passeriformes, neste trabalho objetivou-se determinar a periodicidade da eliminação fecal de oocistos de Cryptosporidium, os sinais clínicos, a presença de mortalidade, e a caracterização molecular desse coccídio. Foram colhidas 480 amostras de fezes, provenientes de 40 aves, sendo 372 amostras de 31 aves adultas e 108 amostras de nove filhotes até 12 semanas de vida, com periodicidade mensal, no período de setembro de 2007 a setembro de 2008, com exceção do mês de abril. As aves estavam alojadas em cinco criatórios, com criação de bicudo (Oryzoborus maximiliani), curió (Oryzoborus angolensis), azulão (Passerina brissonii) e coleira do brejo (Sporophila collaris). As amostras foram conservadas em bicromato de potássio 2,5%, a 4ºC, até o processamento. Os oocistos foram purificados por centrífugo-flutuação em solução de Sheather, seguindo-se a extração do DNA genômico dos oocistos e a classificação molecular, por meio da reação em cadeia de polimerase-nested, para amplificação de fragmentos da subunidade 18S do gene do RNA ribossômico. Eliminação fecal intermitente de Cryptosporidium spp. foi observada em 91 (24,5%) amostras de aves adultas, com maior ocorrência nos períodos que se aproximam dos períodos de muda de penas e de reprodução das aves e em 14 amostras (13%) de aves jovens. O sequenciamento dos fragmentos de DNA amplificados possibilitou a identificação de somente Cryptosporidium galli. Embora em todos os criatórios houvesse aves positivas para C. galli, a presença de morbidade ou mortalidade foi observada em aves de somente um criatório, e estava associada à infecção concomitante com Escherichia coli e Isospora spp..Este é o primeiro relato de infecção por C. galli em P. brissonii, O. maximiliani e S. collaris / Due to the lack of information related to the epidemiology of Cryptosporidium infection in passerine birds, this study aimed to determine the frequency of fecal shedding of Cryptosporidium spp. oocysts, after natural infection, the clinical signs and the presence of mortality, and accomplish its molecular characterization. Four hundred and eighty fecal samples were collected from 40 birds, 372 samples from 31 adult birds and 108 samples from young birds (up to 12 months old), housed in five herds, monthly, from September 2007 to September 2008, with the exception of the April. The birds were originated from flocks were the following species were herd: great-billed seed-finch (Oryzoborus maximiliani), lesser seed-finch (Oryzoborus angolensis), ultramarine grosbeak (Passerina brissonii) and rusty-collared seedeater (Sporophila collaris). The samples were preserved in 2.5% potassium dichromate 2.5% at 4°C, until processing. The oocysts were purified by centrifugal flotation in Sheather solution, followed by genomic DNA extraction from oocysts and molecular characterization using the nested polymerase chain reaction for amplification of fragments of the 18S subunit ribosomal RNA gene. Intermittent fecal shedding of Cryptosporidium spp. was observed in 91 (24.5%) samples from adult birds, with more frequent in periods approaching the periods of moulting and reproduction of birds and 14 samples (13%) of young birds.The sequencing of the amplified fragments allowed the identification of Cryptosporidium galli. Although all the aviaries had birds positive for C. galli, morbidity or mortality was observed in birds from only one aviary, and was associated to concomitant infection with Escherichia coli and Isospora sp. This is the first report of infection by C. galli in Oryzoborus maximiliani, Passerina brissonii, and Sporophila collaris

Orientador: Marcelo Vasconcelos Meireles / Banca: Valéria Marçal Félix de Lima / Banca: Rodrigo Martins Soares / Resumo: Devido à carência de informações relacionadas à epidemiologia da infecção por Cryptosporidium spp. em passeriformes, neste trabalho objetivou-se determinar a periodicidade da eliminação fecal de oocistos de Cryptosporidium, os sinais clínicos, a presença de mortalidade, e a caracterização molecular desse coccídio. Foram colhidas 480 amostras de fezes, provenientes de 40 aves, sendo 372 amostras de 31 aves adultas e 108 amostras de nove filhotes até 12 semanas de vida, com periodicidade mensal, no período de setembro de 2007 a setembro de 2008, com exceção do mês de abril. As aves estavam alojadas em cinco criatórios, com criação de bicudo (Oryzoborus maximiliani), curió (Oryzoborus angolensis), azulão (Passerina brissonii) e coleira do brejo (Sporophila collaris). As amostras foram conservadas em bicromato de potássio 2,5%, a 4ºC, até o processamento. Os oocistos foram purificados por centrífugo-flutuação em solução de Sheather, seguindo-se a extração do DNA genômico dos oocistos e a classificação molecular, por meio da reação em cadeia de polimerase-nested, para amplificação de fragmentos da subunidade 18S do gene do RNA ribossômico. Eliminação fecal intermitente de Cryptosporidium spp. foi observada em 91 (24,5%) amostras de aves adultas, com maior ocorrência nos períodos que se aproximam dos períodos de muda de penas e de reprodução das aves e em 14 amostras (13%) de aves jovens. O sequenciamento dos fragmentos de DNA amplificados possibilitou a identificação de somente Cryptosporidium galli. Embora em todos os criatórios houvesse aves positivas para C. galli, a presença de morbidade ou mortalidade foi observada em aves de somente um criatório, e estava associada à infecção concomitante com Escherichia coli e Isospora spp..Este é o primeiro relato de infecção por C. galli em P. brissonii, O. maximiliani e S. collaris / Abstract: Due to the lack of information related to the epidemiology of Cryptosporidium infection in passerine birds, this study aimed to determine the frequency of fecal shedding of Cryptosporidium spp. oocysts, after natural infection, the clinical signs and the presence of mortality, and accomplish its molecular characterization. Four hundred and eighty fecal samples were collected from 40 birds, 372 samples from 31 adult birds and 108 samples from young birds (up to 12 months old), housed in five herds, monthly, from September 2007 to September 2008, with the exception of the April. The birds were originated from flocks were the following species were herd: great-billed seed-finch (Oryzoborus maximiliani), lesser seed-finch (Oryzoborus angolensis), ultramarine grosbeak (Passerina brissonii) and rusty-collared seedeater (Sporophila collaris). The samples were preserved in 2.5% potassium dichromate 2.5% at 4°C, until processing. The oocysts were purified by centrifugal flotation in Sheather solution, followed by genomic DNA extraction from oocysts and molecular characterization using the nested polymerase chain reaction for amplification of fragments of the 18S subunit ribosomal RNA gene. Intermittent fecal shedding of Cryptosporidium spp. was observed in 91 (24.5%) samples from adult birds, with more frequent in periods approaching the periods of moulting and reproduction of birds and 14 samples (13%) of young birds.The sequencing of the amplified fragments allowed the identification of Cryptosporidium galli. Although all the aviaries had birds positive for C. galli, morbidity or mortality was observed in birds from only one aviary, and was associated to concomitant infection with Escherichia coli and Isospora sp. This is the first report of infection by C. galli in Oryzoborus maximiliani, Passerina brissonii, and Sporophila collaris / Mestre

Magister Artium (Development Studies) - MA(DVS) / Tuberculosis (TB) infection is present in many people but it is sometimes latent until one’s immune system is compromised. As such, it increasingly manifests in people, especially those whose immune system has been compromised by e.g. HIV, as an opportunistic disease. TB is thus closely interlinked with HIV and efforts to eradicate TB have been integrated with the fight against HIV in South Africa. The study revealed that factors such as poverty and stigma - be it enacted or perceived - has an impact on how people with TB deal with the burden of having the disease. Using qualitative research as the choice of methodology and collecting data using observations, in-depth interviews and structured interviews among 18 participants the study focused on the ways in which people understand TB in an area that is known to have high HIV prevalence. The researcher explored people’s experiences with TB and investigated their understanding of the disease as well as explored how people on Directly Observed Treatment Strategy (DOTS) make sense of and interact with this programme in Gugulethu Township. During the study it emerged that people have significant understanding of TB and its symptoms but their initial reaction to those symptoms is selfmedication and this results in delayed treatment seeking. TB is stigmatised in Gugulethu despite some people acknowledging that the environment itself is partly to blame for the rapid spread of the disease. The study revealed that there is good healthcare provision in Gugulethu and it is accessible but the burden of suffering from TB is a difficult one that requires family support, financial support and good relations with clinic and hospital staff in order for one to adhere to treatment and recover from TB.

No description available.

A cross-sectional survey was conducted in four areas in the communal area of Gweru District in the Midlands Province, Zimbabwe. The study was conducted at Mkoba, Mangwande, Chiwundura and Nsukamini. The objective of the study was to determine the prevalence of nematode infection in communal goats in Gweru District, and whether or not the prevalence was related to age, sex, breed or the season. The study was important as it would help in evaluating current strategies used in nematode control and designing low cost control strategies. One hundred and ninety-eight (198) communal goats made up of 49 males and 149 females ranging in age from one month to over twelve months were sampled. Of these, 100 were sampled during the wet season and the remaining 98 during the dry season. One hundred and fifteen (115) or 58% had significant egg counts per gram (epg) of faeces. Among the goats that had significant epg, 31 were males and 84 were females. All age groups were affected. The most common parasites encountered were Haemonchus, Trichostrongylus, Teladorsagia and Oesophagostomum. Haemonchus was the dominant species during the wet season. The proportion of goats that had a significant EPG during the wet season was significantly higher than during the dry season (X2=5.311; P≤0.05). There was no statistical significant difference in prevalence among the different age groups (X2=1.270; P≤0.05) and between males and females (X2=0.696; P≤0.05). Copyright / Dissertation (MSc (Veterinary Tropical Diseases))--University of Pretoria, 2009. / Veterinary Tropical Diseases / unrestricted

Manabu Morishima, Akira Marui, Shigeki Yanagi, Takamasa Nomura, Naoki Nakajima, Suong-Hyu Hyon, Tadashi Ikeda, and Ryuzo Sakata. Sustained release of vancomycin from a new biodegradable glue to prevent methicillin-resistant Staphylococcus aureus graft infection. Interact CardioVasc Thorac Surg (2010) 11(1): 52-55 doi:10.1510/icvts.2010.232447 / 京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第17856号 / 医博第3825号 / 新制||医||1000(附属図書館) / 30676 / 京都大学大学院医学研究科医学専攻 / (主査)教授 一山 智, 教授 伊達 洋至, 教授 鈴木 茂彦 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Abstract available in the Journal of Investigative Medicine.

Spirocerca lupi (S. lupi) is a nematode that infects the dog’s oesophagus resulting in an inflammatory fibroblastic nodule that progresses to a sarcoma in approximately 25% of cases. Inflammation, coagulation and cancer are exquisitely intertwined and inflammatory changes are known to lead to coagulation abnormalities. The nature and degree of haemostatic alterations in canine spirocercosis are unknown. Evidence of inflammation in dogs with clinical spirocercosis is provided by pyrexia, leucocytosis, increased serum interleukin 8 and C-reactive protein as well as severe inflammatory infiltrates on histopathology of nodules. This study aimed to determine if haemostatic abnormalities exist in canine spirocercosis, and hypothesised that the severity of abnormalities could be used to differentiate non-neoplastic from neoplastic spirocercosis. Thirty-nine client-owned S. lupi-infected dogs and 15 healthy age- and sex-matched control dogs were included in this study. Blood samples were collected at the time of diagnosis. A complete blood count, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen concentration, antithrombin (AT) activity, D-dimer concentration and thromboelastography (TEG) analysis were performed. Hypercoagulability was based on the maximum amplitude (MA) value derived from TEG. Inflammatory parameters were also determined and included C-reactive protein (CRP) and fibrinogen concentrations. The S lupi-infected dogs were divided into a non-neoplastic group (n=24) and a neoplastic group (n=15). Data were compared using the Kruskal-Wallis Test and Dunn’s multiple comparisons applied post-hoc. Correlation was determined using Spearman’s correlation. Hypercoagulabilty was found in the neoplastic and non-neoplastic spirocercosis cases. In addition, the neoplastic group was significantly more hypercoagulable than the non-neoplastic group, and the non-neoplastic group was significantly more hypercoagulable than the control group. The median fibrinogen concentration was significantly higher in the neoplastic group compared to the non-neoplastic group, but there was no significant difference between the non-neoplastic and control group. The median CRP concentration was significantly higher in the neoplastic group compared to the non-neoplastic group, with no significant difference between the non-neoplastic and control group. Compared to the control group the median AT activity was significantly decreased in both the non-neoplastic and neoplastic groups. No significant difference was found between the infected groups. Across the non-neoplastic and neoplastic groups, MA showed positive linear correlation with CRP and fibrinogen. The study showed that spirocercosis is associated with a hypercoagulable state that becomes progressively more severe with neoplastic transformation. Overlap did exist between the median MA values of the non-neoplastic and neoplastic groups, but an MA of >76 mm provided a specificity of 96% and sensitivity of 73% for the differentiation of disease state. Thromboelastography might therefore be used as an adjunctive assay to support the suspicion of neoplastic transformation of the oesophageal nodule as well as to determine the overall haemostatic status of the patient. The MA correlated positively with the indicators of inflammation (CRP&fibrinogen) supporting the hypothesis that an inflammatory state induced by the S. lupi nodule is at least partly responsible for the hypercoagulability. The link between inflammation, coagulation and neoplastic transformation in spirocercosis warrants further investigation to elucidate the exact factors resulting in the hypercoagulable state, whether clinically relevant complications develop and whether or not specific therapy should be instituted to prevent thrombotic sequelae. / Dissertation (MMedVet)--University of Pretoria, 2012. / Companion Animal Clinical Studies / unrestricted

Prosthetic joint infection with Mycobacterium tuberculosis usually involves the hips or knees and can result from either local reactivation, or less often from hematogenous spread. Predisposing conditions include rheumatoid arthritis, chronic steroid use and pulmonary diseases. The most common symptom at presentation is pain, and the most common physical finding is joint swelling and/or a draining sinus tract. The sedimentation rate is helpful when elevated but is nonspecific, and initial skin testing is only helpful when positive. The diagnosis depends on culture and histologic examination of tissue. Removal of the joint combined with oral antituberculous treatment is necessary when the infection is discovered greater than six weeks post joint replacement. Early diagnosis leads to decreased morbidity. Tuberculous infection of prosthetic joints is a rare disease and its diagnosis depends on a high degree of clinical suspicion.

Introducción: Diferentes escalas de predicción diagnóstica se vienen recomendando y aplicando en diferentes departamentos de emergencia para predecir ciertos resultados de salud, los cuales pueden apoyar y/o mejorar el manejo de pacientes graves. Entre los más empleados están el qSOFA (quickly- Sepsis-related Organ Failure Assessment), una escala validada por el consenso de sepsis-3; la escala inglesa NEWS (National Early Warning Score) y la escala APACHE II (. Sin embargo, en nuestro medio no se ha evaluado su uso y performance en un servicio de emergencia. Objetivo: Valorar el desempeño diagnóstico de las escalas qSOFA, NEWS y APACHE-II en el departamento de emergencia en el Hospital Edgardo Rebagliati Martins (HNERM). Métodos: Estudio de cohorte retrospectivo realizado en un hospital de alta complejidad. La población de estudio comprendió las admisiones al departamento de emergencia en pacientes con sospecha de sepsis. Asimismo, usando tres escalas: qSOFA, NEWS y APACHE II se calculó la exactitud de la predicción diagnóstica comparándolas entre ellas. Resultados: Se incluyeron 112 pacientes, de los cuales fallecieron 16 (14.29 %). Para predecir mortalidad dentro del hospital, se hallaron áreas bajo las curvas (AUC) para las diferentes escalas. APACHE II ≥17 tuvo una sensibilidad de 87.5% y una especificidad de 78.13% (IC 95%: 0.84 - 0.96) con un AUC de 0.9, qSOFA ≥2 con una sensibilidad de 81.25% y especificidad de 68.75% (IC 95%: 0.63 - 0.87) con un AUC de 0.75 y NEWs ≥7 con una sensibilidad de 62.5% y especificidad de 78.13% (IC 95%: 0.56 - 0.86) con un AUC de 0.71. Conclusiones: Las escalas de puntaje qSOFA, NEWS y APACHE II, son adecuados para la predicción diagnóstica de mortalidad en pacientes con diagnóstico de sepsis y es pertinente su uso en los distintos hospitales del Perú. / Introduction: Different scales of diagnostic prediction are being recommended and applied in different emergency departments to predict certain health outcomes, which can support and / or improve the management of serious patients. Among the most used are the qSOFA (quickly- Sepsis-related Organ Failure Assessment), a scale validated by the sepsis-3 consensus; and the English scale NEWS (National Early Warning Score). However, in our environment, its use and performance have not been evaluated in an emergency service. Objective: To assess the diagnostic performance of the qSOFA, NEWS and APACHE-II scales in the emergency department at the Edgardo Rebagliati Martins Hospital (HNERM). Methods: Retrospective cohort study conducted in a high complexity hospital. The study population included admissions to the emergency department in patients with suspected sepsis. Also, using three scales: qSOFA, NEWS and APACHE II, the accuracy of the prediction was calculated by comparing them. Results: 112 patients were included, of whom 16 died (14.29%). To predict mortality within the hospital, areas under the curves (AUC) were found for the different scales. APACHE II ≥17 had a sensitivity of 87.5% and a specificity of 78.13% (95% CI: 0.84-0.96) with an AUC of 0.9, qSOFA ≥2 with a sensitivity of 81.25% and specificity of 68.75% (95% CI: 0.63 - 0.87) with an AUC of 0.75 and NEWs ≥7 with a sensitivity of 62.5% and specificity of 78.13% (95% CI: 0.56 - 0.86) with an AUC of 0.71. Conclusions: The qSOFA, NEWS and APACHE II score scales are suitable for the diagnostic prediction of mortality in patients diagnosed with sepsis and their use in the different hospitals in Peru is pertinent. / Tesis