Dose Optimization of Intravenous Indocyanine Green for Malignant Lung Tumor Localization.

Background: Intravenously administered indocyanine green (ICG) accumulates in lung tumors, facilitating their detection via a fluorescence spectrum measurement. This method aids in identifying tumor locations that are invisible to the naked eye. We aim to determine the optimal ICG dose and administration method for accurate tumor identification during lung resection surgeries, utilizing a novel ICG fluorescence spectroscopy system for precise tumor localization. Materials and Methods: ICG should be dissolved in the provided solution or distilled water and administered intravenously approximately 24 h before surgery, beginning with an initial dose of 0.5 mg/kg. If the tumor detection rate is insufficient, the dose may be gradually increased to a maximum of 5.0 mg/kg to determine the optimal dosage for effective tumor detection. This fluorescence spectroscopy during surgery may reveal additional lesions that remain undetected in preoperative assessments. The primary endpoint includes the correct diagnostic rate of tumor localization. The secondary endpoints include the measurement of the intraoperative ICG fluorescence spectral intensity in lung tumors, the assessment of the operability and safety of intraperitoneal ICG administrations, the measurement of the ICG fluorescence spectral intensity in surgical specimens, the comparison of the spectral intensity in lung tissues during collapse and expansion, the correlation between ICG camera images and fluorescence spectral intensity, and the comparison of fluorescence analysis results with histopathological findings. The trial has been registered in the jRCT Clinical Trials Registry under the code jRCTs011230037. Results and Conclusions: This trial aims to establish an effective methodology for localizing and diagnosing malignant lung tumors, thereby potentially improving surgical outcomes and refining treatment protocols.

Analysis of the characteristics of anticipatory postural adjustments in older adults using smartphones: Association between cognitive and balance functions.

OBJECTIVES: Using smartphones, we aimed to clarify the characteristics of anticipatory postural adjustments (APA) in older adults and examine the relationship between cognitive and balance functions. METHODS: The study participants were 10 young and 13 older adults. An accelerometer built into a smartphone was attached to the lower back (L5) of the participant, and acceleration in the mediolateral direction was measured using a one-leg stance (OLS). As APA features, we analyzed the time to the peak value in the stance direction (peak latency [PL]) and the amount of displacement to the peak value in the stance direction (peak magnitude [PM]). Additionally, the measured PL was divided by PM for each group to obtain the APA ratio (APAr). We investigated the relationship between the APAr and Mini-BESTest subitems. RESULTS: Older adults showed delayed PL and decreased PM levels (p < 0.01). While in the Mini-BESTest sub-items, deductions were most common in the order of dual-task and single-leg standing, and most participants with low APAr scores were degraded in APA of sub-items. The correlation was observed between APAr and both TUG and dual-task cost (DTC) (r= -0.56, r= -0.67). According to the receiver operating characteristic curve, the APAr value was 1.71 in the older age group. CONCLUSIONS: Older adults showed delayed PL and decreased PM, and APAr was associated with cognitive and locomotor functions. By evaluating the APAr at the initiation of movement, it may be possible to distinguish the APA of the older adluts from the possible to the impossible of OLS movement.

Molecular identification of Spirometra infections in companion animals and wildlife in Japan.

Spirometra infections in companion animals and wildlife in Japan have been diagnosed based on the morphology of the adult worms and eggs, and the etiological agent has been mainly ascribed to Spirometra erinaceieuropaei. However, recent studies have revealed that two other species, Spirometra mansoni and Spirometra asiana, coexist in Japan. Spirometra asiana is a new species recently discovered in Japan. Although morphological discrimination between these two species is difficult, molecular identification is useful. Therefore, to understand which species commonly parasitizes companion animals and wildlife in Japan, a preliminary study was performed based on mitochondrial DNA analysis. Eleven adult worms examined were identified as S. mansoni, suggesting that S. mansoni infects companion animals and wildlife commonly than S. asiana in Japan.

Description of Spirometra asiana sp. nov. (Cestoda: Diphyllobothriidae) found in wild boars and hound dogs in Japan.

According to the latest taxonomy of Spirometra species, six species (lineages) have been tentatively classified as valid. These species are Spirometra erinaceieuropaei, S. folium, S. mansoni, undescribed Spirometra sp. 1, and S. decipiens complex 1 and 2. Among these species, the undescribed species was first discovered as plerocercoid larvae in wild boars in Japan and further studies have confirmed that this species is a new taxon belonging to the genus Spirometra. Here, we describe Spirometra asiana sp. nov., which is difficult to distinguish morphologically from known Spirometra species. However, it is genetically easily distinct from other Spirometra species, thus facilitating identification. We also emphasize that S. mansoni and S. asiana, but not S. erinaceieuropaei, are etiological agents that cause human sparganosis and/or spirometrosis in Asia.

Development and evaluation of an immunochromatography-based point-of-care test kit for a rapid diagnosis of human cysticercosis.

Human cysticercosis is a life-threatening zoonotic disease caused by infection with larvae (cysticerci) of the pork tapeworm, Taenia solium. This can affect the nervous system causing chronic headache and intracranial hypertension, potentially leading to epileptic seizures and paralysis. The disease is found in developing countries, especially in Southeast and South Asia, Sub-Saharan Africa, and Central and South America where porcine cysticercosis is endemic and people have a habit of eating undercooked pork. An immunochromatography-based test (ICT) kit, using T. solium cyst fluid as antigen, was manufactured to detect anti-T. solium IgG antibodies in human serum. To evaluate the kit, we used 187 serum samples including 24 from proven/confirmed cysticercosis cases, 133 from cases with other parasitosis and 30 healthy controls. Diagnostic efficiencies were calculated. The sensitivity, specificity, and accuracy were 83.3%, 92.0%, and 90.9%, respectively. Moreover, the ICT was positive before treatment but became negative after treatment, implying that this kit is also useful for follow-up monitoring post-treatment. In conclusion, we have successfully developed and present preliminary evaluation of an easy-to-handle rapid diagnostic tool for human cysticercosis in the form of an ICT platform using as antigen fluid from T. solium cysticerci.

Examination of the correlation between the knee extension angles in the sitting and supine positions measured using ImageJ software: a prospective cross-sectional study.

[Purpose] We aimed to examine the correlation between the knee extension angles in the sitting and supine positions measured using ImageJ software. [Participants and Methods] A total of 50 legs in 25 healthy participants (17 males and 8 females) were included in our study. The knee extension angle was measured in the sitting and supine positions with the participants actively and maximally extending their knee joint on one side. The participants were photographed from the side with their knees centered in the image. Thereafter, the photographs were imported into the ImageJ image processing software to calculate the knee extension angles. [Results] The mean values of the knee extension angles in the sitting and supine positions were 131.5 ± 11.2° and 132.1 ± 12.2°, respectively, with a correlation coefficient of 0.85. No systematic errors were observed, and the minimal detectable change was 12.9°. [Conclusion] The knee extension angle in the sitting position showed a strong correlation with that in the supine position, with no systematic errors observed. Therefore, measurement of the knee extension angle in the sitting position can be an alternative to its measurement in the supine position.

Genetic characterization of Dibothriocephalus latus and Dibothriocephalus dendriticus (Cestoda: Diphyllobothriidae) from Chile based on haplotype analysis using mitochondrial DNA markers.

Dibothriocephalus latus and Dibothriocephalus dendriticus are found throughout the temperate and sub-arctic zones of the northern hemisphere, but they are also found in the southern core countries of South America, Chile and Argentina. Genetic characteristics of D. latus and D. dendriticus from South America have yet to be fully defined. The present study aimed to understand the genetic characteristics of D. latus and D. dendriticus from Chile by haplotype network analysis of mitochondrial cytochrome c oxidase subunit I gene (cox1) and cytochrome b gene (cob), as well as their origins. Dibothriocephalus latus and D. dendriticus plerocercoid larvae were obtained from feral and/or wild salmonids captured in Lake Llanquihue in Región de Los Lagos, and Lake Panguipulli in Región de Los Ríos, located south of central Chile. Haplotype analysis of D. latus revealed that H1 in cox1 and H2 in cob are the key haplotypes common to D. latus across the world, including Chile, and both genes exhibited limited genetic diversity in D. latus. It was assumed that D. latus was brought into South America by European and Russian immigrants in the 19th century as previously reported. In contrast, both the cox1 and cob of D. dendriticus display considerable genetic diversity, with no common haplotypes between D. dendriticus populations from Chile and the northern hemisphere. More intriguingly, two cob haplotypes (H24, H25) detected in Chilean D. dendriticus were closely linked to haplotypes (H30, H31) detected in North American D. dendriticus, strongly implying that D. dendriticus in Chile was brought by piscivorous migrating birds from North America. It has also been estimated that the D. dendriticus from Chile genetically diverged from the D. dendriticus from the northern hemisphere approximately 1.11 million years ago, long before humans migrated to the southern parts of South America.

Successful treatment of a patient with Takayasu's arteritis complicated with Crohn's disease with ustekinumab: A case report.

A 17-year-old woman was referred to our department with fever, general malaise, and weight loss. She was diagnosed with Takayasu arteritis (TAK) and Crohn's disease (CD) following positron emission tomography-computed tomography (PET-CT) and colonoscopy, respectively. Serological human leukocyte antigen (HLA) typing revealed HLA-B52 positivity. Initial treatment with prednisolone (PSL) (0.5 mg/kg) was insufficient; therefore, ustekinumab and 5-aminosalicylic acid were added. This treatment achieved PSL-free remission for both diseases, as confirmed by PET-CT and colonoscopy. Although treatment guidelines for TAK and CD have been previously established, treatment of patients with TAK with coexisting CD is controversial. Our case suggests that ustekinumab has the ability to achieve TAK remission in addition to its therapeutic effect on CD.

Biochemical characterization of mitochondria from adult worms and plerocercoid larvae of Spirometra mansoni shows mixed populations of anaerobic and aerobic mitochondria.

The mitochondria of adult and plerocercoid Spirometra mansoni were characterized in isolated mitochondria and in situ by electron microscopic histochemistry with special attention to the respiratory chain. Although the specific activities of the constituent enzyme complexes of succinate oxidase are fairly similar in adult and plerocercoid mitochondria, those of succinate oxidase and NADH-FRD are approximately 4- and 25-fold higher in adult mitochondria than in plerocercoid mitochondria, respectively. Quinone analysis by high performance liquid chromatography and mass spectrometry showed that adult and plerocercoid mitochondria contained both rhodoquinone-10 and ubiquinone-10 at concentrations of 4.98 and 0.106 nmol mg-1 for adult, and 0.677 and 0.137 nmol mg-1 for plerocercoid, respectively. Inhibition studies on the succinate-oxidase system of adult mitochondria showed that they possessed both cyanide-sensitive and -insensitive succinate oxidases, the latter of which produces hydrogen peroxide. Adult mitochondria, when NADH was used as a substrate, were shown to produce hydrogen peroxide, and the production of hydrogen peroxide decreased to undetectable levels in the presence of fumarate. The specific activities of NADH-fumarate reductase and cytochrome c oxidase were significantly higher in mature proglottids than in immature and gravid proglottids. Isopycnic density-gradient centrifugation analyses and in situ electron microscopic histochemistry revealed that both adult and plerocercoid mitochondria were heterogeneous in terms of respiratory function and physicochemical properties. The physiological significance of adult and plerocercoid mitochondria is discussed in relation to the oxygen tension of their parasitic habitats.

Epibiontic life on intertidal Setaphyes kielensis and S. dentatus (Kinorhyncha, Pycnophyidae) from Sylt, North Sea, Germany, with a description of a new species of Trematosoma (Ciliophora, Acinetidae) and a redescription of Cothurnia buetschlii (Ciliophora, Vaginicolidae).

Specimens of two species of Kinorhyncha, Setaphyes dentatus and S. kielensis, were collected in 1988, 1998, and 2016 at two intertidal sites on the island of Sylt, North Sea, and investigated as preserved material by light microscopy and scanning electron microscopy for their epibionts. One species of Acinetidae (Suctoria), one species of Vaginicolidae (Peritrichia), and two species of bacteria were traced. The most abundant ciliate species with 705 specimens was Trematosoma husselae sp. nov. occurring with 146 specimens on a basibiont, mainly on the ventral side and here especially on segment 1. Cothurnia buetschlii was found as 14 specimens. Trematosoma husselae sp. nov. agreed with T. amphiasci and T. pusilla in the calyciform shape of the lorica and with most species in the general size of the body except for the much larger T. constricta and T. pusilla. The new species could be distinguished from T. amphiasci, T. complatana, T. constricta, T. falcata, T. ovata, and T. pusilla by the short length of its stalk and agreed with T. bocqueti and T. rotunda in this character. Cothurnia buetschlii was redescribed for the first time after the descriptions by Zelinka (1914, 1928).

Dystextia and dystypia due to phonological errors after ischemic stroke: a case report in a Japanese patient.

A 69-year-old Japanese male presented with acute dystextia and dystypia, defined as texting and typing impairments, respectively. His text input speed decreased due to a phonologically incorrect kana flick input on his smartphone. Additionally, dystypia occurred due to phonemic paragraphia of Romaji. Brain MRI revealed a new left lenticulostriate infarction sparing the cerebral cortex. SPECT showed reduced cerebral blood flow in the left inferior precentral frontal gyrus as well as in the infarction area. It was concluded that his abnormal phonological processes resulted from hypoperfusion in the left inferior precentral gyrus that is assumed to be an endpoint of the arcuate fasciculus.

New quantitative evaluation of anticipatory postural adjustments using a smartphone in patients with Parkinson's disease.

OBJECTIVE: To investigate a smartphone-enabled quantitative evaluation of anticipatory postural adjustments (APA) during one-leg stance (OLS) movements among individuals with Parkinson's disease (PD). METHODS: This cross-sectional study included 10 young controls, 10 older individuals, and 13 individuals with PD. A smartphone and accelerometer were attached to the participants' lower back (L5), and the movements of the lower back toward the stance side during OLS were measured. For acceleration, the time to the peak value in the stance direction (peak latency [PL]) and the amount of displacement to the peak value in the stance direction (peak magnitude [PM]) were analyzed as APA characteristics. Additionally, the measured PL was divided by the PM for each group to obtain the APA ratio (APAr) as a new index. RESULTS: Individuals with PD showed a delayed PL and decreased PM (vs. young controls: p = .002 for PL, p < .001 for PM) (vs. older individuals: p = .022 for PL, p = .001 for PM). The APAr clustered the young controls, older individuals, and individuals with PD. According to the receiver operating characteristic curve the APAr value was 0.95, and individuals in the PD group were identified (i.e. area under the curve: 0.98; sensitivity: 85.0%; specificity: 100%). Moreover the APAr was correlated with severity and balance ability in individuals with PD (p = .015 for NFOG-Q, p = .028 for UPDRS, p = .036 for TUG, p = .015 for Mini-BESTest, p = .018 for OLS time). CONCLUSIONS: This smartphone-based evaluation using the APAr index was reflective of disease severity and decreased balance ability among individuals with PD. The facilitation of this measurement can help clinicians and physiotherapists quantitatively evaluate the APA of individuals with PD at laboratories and hospitals as well as in home environments.

Evaluation of total immunoglobulin G and subclass antibodies in an enzyme-linked immunosorbent assay for serodiagnosis of human amebic liver abscess.

Background: Amebic liver abscess (ALA) caused by Entamoeba histolytica is usually diagnosed based on its clinical symptoms, medical imaging abnormalities of the liver, and serological tests, the most common being the enzyme-linked immunosorbent assay (ELISA). For more than three decades, no investigation has evaluated the diagnostic performance of immunoglobulin G (IgG) subclasses in the serodiagnosis of ALA. Herein, we assessed the efficiencies of anti-amebic IgG and IgG subclasses for diagnosing ALA. Methods: A serological ELISA-based test was performed to assess its diagnostic performance using a total of 330 serum samples from ALA patients (n = 14), healthy individuals (n = 40), and patients with other diseases (n = 276). Results: ELISA targeting the total IgG antibody to E. histolytica antigen exhibited 100% sensitivity 95% CI [76.8-100.0] and 97.8% specificity 95% CI [95.5-99.1], whereas the assay targeting IgG1 showed the same sensitivity (100% 95% CI [76.8-100.0]) and a slightly higher specificity (99.1% 95% CI [97.3-99.8]). The other IgG subclasses (IgG2, IgG3, and IgG4) displayed a lower sensitivity and specificity. The sensitivity and specificity did not significantly differ between tests measuring total IgG and IgG1 (Exact McNemar's test; p > 0.05), with a concordance of 98.2%, represented by a Cohen's kappa of 0.83 (p < 0.001), indicating almost perfect agreement. Conclusion: ELISA targeting IgG1 can provide valuable information to clinicians in differentiating ALA from other parasitic diseases, cancers, cirrhosis, and viral hepatitis. However, enzyme-conjugated anti-human total IgG is cheaper than anti-human IgG subclasses. Therefore, we suggest that total IgG-based ELISA is sufficient for the routine serodiagnosis of human ALA and possibly other clinical manifestations of invasive amebiasis.

An Innovative Test for the Rapid Detection of Specific IgG Antibodies in Human Whole-Blood for the Diagnosis of Opisthorchis viverrini Infection.

Chronic human liver fluke infections caused by Opisthorchis viverrini and Clonorchis sinensis can last for decades and cause liver and biliary diseases, including life-threatening pathology prior to cholangiocarcinoma (CCA). CCA generally has a poor prognosis. Serological diagnosis can support parasitological examination in diagnosing disease and screening for the risk of CCA. Here, we present an improved and innovative lateral flow immunochromatographic test (ICT) kit that uses whole-blood samples (WBS) rather than serum to diagnose human opisthorchiasis, which also successfully diagnosed human clonorchiasis. This ICT includes a soluble worm extract of O. viverrini adults and colloidal-gold-labeled conjugates of the IgG antibody to evaluate the diagnostic values with simulated WBS (n = 347). Simulated WBS were obtained by the spiking infection sera with red blood cells. The diagnostic sensitivity, specificity, positive and negative predictive values, and accuracy for detecting opisthorchiasis were 95.5%, 87.0%, 80.5%, 97.2%, and 90.1%, respectively. For clonorchiasis, these findings were 85.7%, 87.0%, 53.6%, 97.2%, and 86.8%, respectively. Combined for both diseases, they were 93.2%, 87.0%, 84.0%, 94.6%, and 89.6%, respectively. The ICT kit can possibly replace the ICT platforms for antibody detection in serum samples in field surveys in remote areas where sophisticated equipment is not available.

Reliability, minimal detectable change and measurement errors in knee extension muscle strength measurement using a hand-held dynamometer in young children.

[Purpose] Few studies have assessed the reliability of muscle strength measurement using a hand-held dynamometer, specifically in Japanese young children. This study aims to investigate the reliability, minimal detectable change and measurement error in knee extension muscle strength measurements in young children using a hand-held dynamometer. [Participants and Methods] The study participants comprised 36 kindergarten-enrolled children of 3-6 years age. An experienced physiotherapist measured their isometric knee extension strength. Appropriate orientation and practices were performed prior to measurement. The same physiotherapist took the muscle measurements twice; and the maximum value was used as the muscle strength value. The measurements were repeated at intervals of approximately 30 min to verify reproducibility. [Results] The initial isometric knee extension strength was 10.6 ± 3.3 kgf and the Intra-class correlation coefficient (1,1) was 0.765. The standard error of measurement was 1.6 kgf and the minimal detectable change was 4.4 kgf. No significant systematic errors were observed. [Conclusion] Isometric knee extension strength measurement using a hand-held dynamometer in young children has good reliability with a low risk of systematic errors.

[Pulmonary Hematoma Likely due to a Contralateral Chest Injury, Requiring Differentiation from Lung Tumor:Report of a Case].

A 23-year-old man was referred to our department for chest abnormal shadow. Computed tomography (CT) of the chest revealed a well-defined 1.2 cm nodule in the S4 segment of the right middle lobe and a well-defined 1.8 cm nodule in the S10 segment of the right lower lobe. The patient was found to have a fracture in the left fifth rib due to the falling accident at playing snowboard, two months before. He was diagnosed with a benign tumor in the right middle lobe and the right lower lobe and was performed surgery. Thoracoscopy revealed a yellowish-brown tumor in the right middle lobe( S4) and a yellow-brown tumor in the right lower lobe( S10). Both lesions were diagnosed as clots by rapid intraoperative pathologic diagnosis. Histopathological diagnosis was an intrapulmonary hematoma.

Recurrent Syncope in a Case with Mediastinal Lymphoma.

An 83-year-old man suddenly lost consciousness, and his blood pressure dropped. Results of blood analysis were within normal range. A chest radiograph showed enlargement of the left mediastinum. Computed tomographic scan of the chest showed a large mass surrounding the left common carotid artery in the left upper mediastinum. Histology revealed a large B-cell lymphoma. A Holter ECG showed transient sinus bradycardia and atrioventricular block. The power spectrum revealed increase in power of high frequency, suggesting that general vagal activity might be related to bradycardia. Evaluation of autonomic system from high frequency and low frequency components may be useful in examining the mechanisms of sudden bradycardia and/or hypotension of unknown origin.

Clarify Sit-to-Stand Muscle Synergy and Tension Changes in Subacute Stroke Rehabilitation by Musculoskeletal Modeling.

Post-stroke patients exhibit distinct muscle activation electromyography (EMG) features in sit-to-stand (STS) due to motor deficiency. Muscle activation amplitude, related to muscle tension and muscle synergy activation levels, is one of the defining EMG features that reflects post-stroke motor functioning and motor impairment. Although some qualitative findings are available, it is not clear if and how muscle activation amplitude-related biomechanical attributes may quantitatively reflect during subacute stroke rehabilitation. To better enable a longitudinal investigation into a patient's muscle activation changes during rehabilitation or an inter-subject comparison, EMG normalization is usually applied. However, current normalization methods using maximum voluntary contraction (MVC) or within-task peak/mean EMG may not be feasible when MVC cannot be obtained from stroke survivors due to motor paralysis and the subject of comparison is EMG amplitude. Here, focusing on the paretic side, we first propose a novel, joint torque-based normalization method that incorporates musculoskeletal modeling, forward dynamics simulation, and mathematical optimization. Next, upon method validation, we apply it to quantify changes in muscle tension and muscle synergy activation levels in STS motor control units for patients in subacute stroke rehabilitation. The novel method was validated against MVC-normalized EMG data from eight healthy participants, and it retained muscle activation amplitude differences for inter- and intra-subject comparisons. The proposed joint torque-based method was also compared with the common static optimization based on squared muscle activation and showed higher simulation accuracy overall. Serial STS measurements were conducted with four post-stroke patients during their subacute rehabilitation stay (137 ± 22 days) in the hospital. Quantitative results of patients suggest that maximum muscle tension and activation level of muscle synergy temporal patterns may reflect the effectiveness of subacute stroke rehabilitation. A quality comparison between muscle synergies computed with the conventional within-task peak/mean EMG normalization and our proposed method showed that the conventional was prone to activation amplitude overestimation and underestimation. The contributed method and findings help recapitulate and understand the post-stroke motor recovery process, which may facilitate developing more effective rehabilitation strategies for future stroke survivors.

Distribution and prevalence of Taenia hydatigena, Taenia multiceps, and Mesocestoides spp. in Mongolian sheepdogs.

Gastrointestinal parasite infections in livestock and companion animals in Mongolia have not been investigated sufficiently. This study aimed to determine the prevalence of cyclophyllid cestodes (Taeniidae and Mesocestoididae) in Mongolian sheepdogs using copro-DNA analysis. Sheepdog fecal samples (n = 1242) were collected from five ecological zones (mountain taiga, forest-steppe, steppe, desert-steppe, and desert) and four geographical regions (Western, Khangai, Central, and Eastern) within 20 of the country's 21 provinces. Among the 1242 samples, 201 (16.2%) tested positive for mitochondrial cytochrome c oxidase subunit 1 (cox1) and ribosomal 12S rRNA encoding genes of cyclophyllid cestodes. Prevalence in the mountain taiga, forest-steppe, steppe, desert-steppe, and desert zones was 29.2%, 15.4%, 15.1%, 20.1%, and 9.1%, respectively. Prevalence in the Western, Khangai, Central, and Eastern regions was 19.9%, 18.6%, 12.1%, and 12.8%, respectively. Taenia hydatigena, Taenia multiceps, and two Mesocestoides species (Mesocestoides sp.1 and Mesocestoides sp.2) were identified. T. hydatigena was found in the samples from all 20 provinces (all five zones and four regions), while T. multiceps was detected in the samples from 19 provinces (all five zones and four regions). Mesocestoides sp.1 infection was detected in the samples from all zones (except desert) and regions; it was detected in 14 provinces. Mesocestoides sp.2 infection was detected in the samples from all zones (except mountain taiga) and regions and found in seven provinces. Cyclophyllidea infection in sheepdogs is highly prevalent across Mongolia, representing a zoonotic risk. Implementation of a surveillance program for sheepdogs and their owners, and the wild animals in all ecological zones should be considered. In addition, control measures, including public awareness campaigns, especially for sheepdog owners, and periodic deworming of sheepdogs are warranted.