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OBJECTIVES: We aim to independently assess the validity of the damage index for antiphospholipid syndrome (DIAPS) in thrombotic antiphospholipid syndrome (APS) patients by exploring the prevalence and risk factors of organ damage and evaluating its impact on health-related quality of life (HR-QoL). METHODS: Cross-sectional study including all thrombotic APS patients (Sydney criteria) attending a Portuguese tertiary centre. Damage was assessed using the DIAPS, and HR-QoL using the 3- and 5-level EuroQol HR-QoL (EQ-D5-3L and 5L), and Visual Analogue Scale (VAS) applied via a phone questionnaire. Spearman's correlation between DIAPS and the HR-QoL scales was performed. Risk factors for damage accrual and HR-QoL impairment were explored using univariate and multivariate logistic regression. RESULTS: Among the 108 patients (female, 65.7%; white, 90.7%; primary APS, 75.9%; median disease duration, 6 years), damage (DIAPS≥1) developed in 48.2% of patients (mean ± SD DIAPS, 3.08 ± 1.83). DIAPS's neuropsychiatric domain was the most affected (24.2%), followed by the peripheral vascular domain (20.3%). No clinical, demographic nor laboratory parameters were significantly associated with damage. Regarding HR-QoL, pain/discomfort, anxiety/depression and usual activities domains were the most frequently impaired in both scales. DIAPS's domains correlated similarly with the EQ-5D-3L and 5L scales' individual domains. Female sex, medical disorders, secondary APS and type of presenting thrombosis (arterial) increased the risk of HR-QoL impairment. Total DIAPS was associated with higher odds of mobility, self-care and pain/discomfort impairment in both EQ-5D-3L and 5L scales but lost its independent risk in multivariable analysis. CONCLUSION: This external validation of DIAPS reinforces the ability of the score to correlate with HR-QoL while also highlighting risk factors for HR-QoL impairment other than damage accrual.
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Síndrome Antifosfolípido , Calidad de Vida , Trombosis , Humanos , Síndrome Antifosfolípido/complicaciones , Femenino , Masculino , Adulto , Estudios Transversales , Persona de Mediana Edad , Factores de Riesgo , Trombosis/etiología , Encuestas y Cuestionarios , Portugal/epidemiología , Índice de Severidad de la Enfermedad , Modelos LogísticosRESUMEN
ABSTRACT: Vector-borne diseases are currently one of the biggest public health concerns worldwide. Dogs, being the closest companion animals to humans, are considered the main reservoir of some of these diseases in the urban environment. Therefore, the study of the disease behavior in dogs can help to understand the disease affecting human health. Serological and molecular diagnoses of Babesia vogeli, Rangelia vitalli, Leishmania infantum, and other trypanosomatids, were performed by immunochromatographic and PCR assays, respectively, on dogs in a dog shelter located in an Atlantic Forest fragment near the Billings Dam, São Bernardo do Campo, São Paulo-Brazil. Our molecular diagnostic results showed a high prevalence of Babesia vogeli, at 20.9% (17/81). No other protozoan was detected in any of the tests. Determining the prevalence of major vector-borne diseases is essential to establish preventive and control measures for zoonotic diseases in animals kept in shelters, in order to minimize the impact of vector-borne diseases on animal health.
RESUMO: As doenças transmitidas por vetores são atualmente um dos maiores problemas de saúde pública. Os cães, sendo os animais de companhia mais próximos dos seres humanos, são considerados os principais reservatórios de algumas dessas doenças no ambiente urbano, e o estudo de seu comportamento em cães ajuda a entender a doença como um todo na saúde humana. Diagnósticos sorológicos e moleculares de Babesia vogeli, Rangelia vitalli, Leishmania infantum e outros tripanossomatídeos, em um abrigo para cães localizado em um fragmento da Mata Atlântica próximo à Barragem Billings, São Bernardo do Campo, São Paulo, Brasil. Foram realizadas sorologias e diagnósticos moleculares, no ensaio de PCR foram utilizados marcadores moleculares de oligonucleotídeos específicos para alguns protozoários de importância na saúde animal, como Babesia vogeli, Rangelia vitalli, Leishmania infantum e outros tripanossomatídeos. Nossos resultados de diagnóstico molecular mostraram uma alta prevalência de 20,9% (17/81) de Babesia vogeli. Nenhum outro protozoário foi detectado em nenhum dos testes. A determinação da prevalência das principais doenças transmitidas por vetores é essencial para estabelecer medidas preventivas e de controle de doenças zoonóticas em animais mantidos em abrigos. Essas medidas devem ser propostas para minimizar o impacto de doenças transmitidas por vetores na saúde animal.
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Abstract INTRODUCTION The National Park of Serra das Confusões (NPSC) is a protected area of natural landscape located in Southern Piauí, Brazil, and it is considered as one of the largest and most important protected areas in the Caatinga biome. METHODS The natural occurrences of trypanosomatids from hemocultures on small mammals and cultures from intestinal contents triatomines were detected through molecular diagnoses of blood samples, and phylogenetic relationship analysis of the isolates parasites using the trypanosome barcode (V7V8 SSUrDNA) were realized. RESULTS Only two Galea spixii (8.1%) and six Triatoma brasiliensis (17.6%) were positive by hemoculture, and the isolates parasites were cryopreserved. All the isolates obtained were positioned on the Trypanosoma cruzi DTU TcI branch. CONCLUSIONS Research focused on studying the wild animal fauna in preserved and underexplored environments has made it possible to elucidate indispensable components of different epidemiological chains of diseases with zoonotic potential.
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Animales , Roedores/parasitología , Trypanosoma cruzi/genética , Reservorios de Enfermedades/parasitología , Triatominae/parasitología , Animales Salvajes/parasitología , Marsupiales/parasitología , Filogenia , Roedores/clasificación , Trypanosoma cruzi/aislamiento & purificación , Brasil , Biodiversidad , Parques Recreativos , Genotipo , Marsupiales/clasificaciónRESUMEN
Abstract In this study, we evaluated the ovicidal and larvicidal activity of protein preparations obtained from Cassia fistula L. and Combretum leprosum Mart. leaves on the gastrointestinal parasites of goats. Protein preparations were obtained after the extraction of C. fistula L. and C. leprosum Mart. leaves, followed by protein fractionation (with ammonium sulfate saturation percentages of 30%, 30%-60%, and 60%-90%) and dialysis, which resulted in protein fractions (called F1, F2, and F3, respectively). The fractions were evaluated by egg hatching (the eggs were recovered in stool samples from naturally infected goats) and larval development tests. The results reveled that the inhibition of hatching of eggs caused by the protein fractions of C. fistula (38%) were similar to that of the control drug, thiabendazole. In addition, the fractions of C. fistula caused significant inhibition (61-69%) of larval development also. However, C. leprosum did not reveal significant inhibition of egg hatching and larval development. We conclude that C. fistula L. showed better ovicidal and larvicidal activity against endoparasites.
Resumo Neste estudo, foram avaliadas as atividades ovicida e larvicida de preparações proteicas de Cassia fistula L. e Combretum leprosum Mart. em parasitas gastrointestinais de caprinos. As preparações proteicas foram obtidas por extração das folhas de C. fistula L. e C. leprosum Mart. seguido pelo fracionamento proteico (com porcentagens de saturação de sulfato de amônio de 30%, 30-60%, 60-90%) e diálise, resultando nas frações proteicas (intituladas F1, F2 e F3, respectivamente). As frações foram avaliadas nos testes de eclosão de ovos (os ovos foram recuperados em amostras de fezes de cabras naturalmente infectadas) e de desenvolvimento larvar. Os resultados revelaram que a inibição da eclosão de ovos causada pelas frações proteicas de C. fistula (38%) foi semelhante à do fármaco controle, o tiabendazol. Além disso, as frações de C. fistula também causaram inibição significativa (61-69%) do desenvolvimento larvar. No entanto, C. leprosum não revelou inibição significativa na eclosão dos ovos e no desenvolvimento larvar. Concluiu-se que C. fistula L. mostrou uma melhor atividade ovicida e larvicida contra endoparasitas.