Experimental transmission of a novel relapsing fever group Borrelia harbored by Ornithodoros octodontus (Ixodida: Argasidae) in Chile.

Tick-borne relapsing fever spirochetes of genus Borrelia thrive in enzootic cycles involving Ornithodoros spp. (Argasidae) mainly, and rodents. The isolation of these spirochetes usually involves a murine model in which ticks are fed and the spirochetes detected in blood several days later. Such an experiment also demonstrates that a given species of tick is competent in the transmission of the bacteria. Here, soft ticks Ornithodoros octodontus were collected in Northern Chile with the objective to experimentally determine its capacity to transmit a Borrelia sp. detected in a previous study. Two Guinea pigs (Cavia porcellus) were used to feed nymphs and adults of O. octodontus and the spirochetes in blood were inspected by dark-field microscopy and nested PCR. Although spirochetes were not seen in blood, DNA was detected in only one animal 11 days after the ticks were fed. Genetic sequences of Borrelia flaB, clpX, pepX, recG, rplB, and uvrA genes retrieved from DNA extraction of positive blood were employed to construct two phylogenetic analyses. On the one hand, the flaB tree showed the Borrelia sp. transmitted by O. octodontus clustering with Borrelia sp. Alcohuaz, which was previously detected in that same tick species. On the other hand, concatenated clpX-pepX-recG-rplB-uvrA demonstrated that the characterized spirochete branches together with "Candidatus Borrelia caatinga", a recently discovered species from Brazil. Based on the genetic profile presented in this study, the name "Candidatus Borrelia octodonta" is proposed for the species transmitted by O. octodontus. The fact that spirochetes were not observed in blood of guinea pigs, may reflect the occurrence of low spirochetemia, which could be explained because the susceptibility of infection varies depending on the rodent species that is used in experimental models. Although the vertebrate reservoir of "Ca. Borrelia octodonta" is still unknown, Octodon degus, a rodent species that is commonly parasitized by O. octodontus, should be a future target to elucidate this issue.

Elevated concentrations of organic and inorganic forms of iron in plant-based diets for channel catfish prevent anemia but damage liver and intestine, respectively, without impacting growth performance.

We compared the effects of using inorganic and organic forms of iron in plant-based diets on catfish performance in a feeding trial with 6-g catfish fingerlings. The objective was to determine whether dietary iron in excess of known requirements negatively affected the fish. Five diets supplemented with 0 (basal), 125, 250 mg Fe/kg of either FeSO4 or iron methionine were formulated. Weight gain, feed conversion ratio, hepatosomatic index, and survival were similar among diets. Plasma and intestine iron concentration was similar among diets. Whole-body total lipid, protein, and dry matter were similar among diets, while ash content was higher in fish fed the basal diet. Total liver iron concentration was higher in fish fed diets supplemented with 250 mg Fe/kg in both iron forms than other diets. Hematological parameters were similar among treatments. Liver necrosis, inflammation, and vacuolization were highest in fish fed the diet supplemented with 250 mg Fe/kg from organic iron, followed by those fed diets with 250 mg Fe/kg from inorganic iron. Inorganic iron-supplemented diets caused more intestinal inflammation (increased inflammatory cells, villi swelling, thicker lamina propria) than the organic iron-supplemented diets or basal diet. Organic iron at 250 mg/kg resulted in a $0.143/kg increase in feed cost. Latent iron deficiency and initial signs of anemia developed in catfish fed the basal diet. Supplemental iron from either form prevented iron deficiency. Organic iron at 125 mg/kg optimized fish performance at a cost comparable to that of fish fed other diets, but without overt negative effects.

Honeybee Cognition as a Tool for Scientific Engagement.

Apis mellifera (honeybees) are a well-established model for the study of learning and cognition. A robust conditioning protocol, the olfactory conditioning of the proboscis extension response (PER), provides a powerful but straightforward method to examine the impact of varying stimuli on learning performance. Herein, we provide a protocol that leverages PER for classroom-based community or student engagement. Specifically, we detail how a class of high school students, as part of the Ryukyu Girls Outreach Program, examined the effects of caffeine and dopamine on learning performance in honeybees. Using a modified version of the PER conditioning protocol, they demonstrated that caffeine, but not dopamine, significantly reduced the number of trials required for a successful conditioning response. In addition to providing an engaging and educational scientific activity, it could be employed, with careful oversight, to garner considerable reliable data examining the effects of varying stimuli on honeybee learning.

[Detection of " Candidatus Rickettsia andeanae" in Rhipicephalus sanguineus sensu stricto (Acari: Ixodidae) from Rapa Nui-Easter Island]. / Detección de " Candidatus Rickettsia andeanae" en Rhipicephalus sanguineus sensu stricto (Acari: Ixodidae) en Rapa Nui-Isla de Pascua.

BACKGROUND: Rickettsioses are vector-borne emerging diseases caused by pathogenic bacteria of the genera Rickettsia and Orientia . Bacteria of these genera have been described in northern and southern Chile, respectively. AIM: To determine the presence of Rickettsia spp. in ticks collected from domestic dog in Rapa Nui-Easter Island, Valparaíso Region. METHODS: 20 stray dogs were sampled during October 2018. Overall, eight adult ticks were collected from seven animals (prevalence: 35%); after morphological identification, were submitted to DNA extraction and amplification and sequencing of the tick mitochondrial 16S DNA gene. The screening for Rickettsia was performed targeting the gltA (citrate synthetase) gene. RESULTS: A phylogenetic analysis confirmed the identity of the ticks as Rhipicephalus sanguineus sensu stricto. In two ticks (25%), we retrieved identical sequences of gltA compatible with " Candidatus Rickettsia andeanae", which formed a monophyletic group with conspecific isolates obtained in Brazil, Chile and Peru. CONCLUSION: This study proves the presence of " Ca . R. andeanae" in R. sanguineus s. s. at Rapa Nui-Easter Island, which also corresponds to the first report of this Rickettsia spp. in R. sanguineus complex for Chile.

Prevalence and morphology of hand eczema in patients with atopic dermatitis.

BACKGROUND: Patients with hand eczema frequently have a history of atopic dermatitis or atopy. No specific morphologic pattern of hand eczema helps distinguish atopic hand eczema from other etiologies. There are few studies of hand eczema prevalence and morphology in a well-defined population of patients with atopic dermatitis. METHODS: We evaluated 777 consecutive patients with atopic dermatitis (diagnosed by standard criteria) for hand involvement. An additional 100 patients had further evaluations, including evaluation of the historical and morphologic characteristics of their hand eczema. RESULTS: The prevalence of hand involvement in patients with active atopic dermatitis was 58.9% (458 of 777 patients). Nail dystrophy was present in 16% (124 of 777) of patients. There was a significant trend toward an increasing prevalence of hand involvement with increasing age. Hand eczema tended to involve primarily the dorsal hand surfaces and the volar wrist. CONCLUSIONS: The hands are frequently involved in patients with active atopic dermatitis and present unique physical, social, and therapeutic challenges for patients. During the evaluation of patients presenting with hand eczema, the involvement of dorsal hand surfaces and the volar wrist may suggest atopic dermatitis as a contributing etiologic factor.

Detección de " Candidatus Rickettsia andeanae" en Rhipicephalus sanguineus sensu stricto (Acari: Ixodidae) en Rapa Nui-Isla de Pascua / Detection of " Candidatus Rickettsia andeanae" in Rhipicephalus sanguineus sensu stricto (Acari: Ixodidae) from Rapa Nui-Easter Island

INTRODUCCIÓN: Las rickettsiosis son enfermedades emergentes transmitidas por vectores artrópodos cuyos agentes etiológicos corresponden a bacterias patógenas del género Rickettsia y Orientia . Bacterias de este género han sido descritas en el norte y sur de Chile. OBJETIVO: Determinar presencia de Rickettsia spp. en garrapatas colectadas a partir de perros domésticos en Rapa Nui-Isla de Pascua, Región de Valparaíso. MÉTODOS: Fueron muestreados 20 perros callejeros durante octubre del año 2018. Se colectaron ocho garrapatas adultas desde siete animales (prevalencia: 35%); luego de su identificación taxonómica fueron sometidas a amplificación y secuenciación del gen ADNm 16S para garrapata y gltA (citrato sintetasa) para Rickettsia . RESULTADOS: Todos los ejemplares de garrapatas adultas correspondieron genéticamente a Rhipicephalus sanguineus sensu stricto lo cual fue confirmado mediante un análisis filogenético. En dos garrapatas (25%) se encontraron secuencias idénticas de gltA compatibles con " Candidatus Rickettsia andeanae", que formaron un clado monofilético con aislados obtenidos en Brasil, Chile y Perú. CONCLUSIÓN: Se documenta la presencia de " Ca. R. andeanae" s. s. en Rapa Nui-Isla de Pascua, asociado por primera vez a garrapatas del complejo R. sanguineus en Chile.

BACKGROUND: Rickettsioses are vector-borne emerging diseases caused by pathogenic bacteria of the genera Rickettsia and Orientia . Bacteria of these genera have been described in northern and southern Chile, respectively. AIM: To determine the presence of Rickettsia spp. in ticks collected from domestic dog in Rapa Nui-Easter Island, Valparaíso Region. METHODS: 20 stray dogs were sampled during October 2018. Overall, eight adult ticks were collected from seven animals (prevalence: 35%); after morphological identification, were submitted to DNA extraction and amplification and sequencing of the tick mitochondrial 16S DNA gene. The screening for Rickettsia was performed targeting the gltA (citrate synthetase) gene. RESULTS: A phylogenetic analysis confirmed the identity of the ticks as Rhipicephalus sanguineus sensu stricto. In two ticks (25%), we retrieved identical sequences of gltA compatible with " Candidatus Rickettsia andeanae", which formed a monophyletic group with conspecific isolates obtained in Brazil, Chile and Peru. CONCLUSION: This study proves the presence of " Ca . R. andeanae" in R. sanguineus s. s. at Rapa Nui-Easter Island, which also corresponds to the first report of this Rickettsia spp. in R. sanguineus complex for Chile.

Effective therapy of childhood atopic dermatitis allays food allergy concerns.

BACKGROUND: Roughly one third of children with atopic dermatitis (AD) have IgE-mediated food allergy. Most parents and pediatricians assume foods also cause the eczema, a focus that diverts proper skin therapy and has negative outcomes including nutritional deficiency, costly referrals, and unnecessary testing. This project investigates the relationship between food allergy and AD, both before and after treatment in an established AD population. During an open trial of topical tacrolimus we observed a decrease in parental food allergy concern during good control of their child's eczema. We tested this observation by follow-up interviews and a questionnaire study to compare parental estimates of food allergy concerns after therapy with concerns before beginning the trial. Study subjects were children 11 years old and younger with AD and suspicion of food allergy. AD and food allergy parameters, pre- and post-treatment, were retrospectively assessed by a questionnaire given to the parents. RESULTS: Twenty-three patients were enrolled: 16 had positive food allergy tests (7 RAST and/or 10 skin prick tests) and 30% had a definite history of immediate IgE reactions to foods. Ninety-five percent of parents felt that food allergy exacerbated their child's AD. Treatment durations were 3 to 45 months. Parental concern of food allergy decreased significantly from 7.7 to 4.0 on a 10 point scale (P < .001). Additionally, estimated food reactions decreased by approximately 80% during 1- and 6-month periods (P = .001). CONCLUSIONS: In this selected university-based childhood AD population, nearly all parents were convinced their child had food allergy and further that the food contributed to the AD. The level of concern about food reactions was significantly decreased and the number of food reactions declined during effective topical therapy. This preliminary assessment of parental perceptions suggests that successful, stable therapy of AD reduces perceived food reactions and allays parental concerns about food allergy. Such therapy may encourage parents to refocus on direct skin care as the primary effort in AD therapy. We conclude that the effect of successful AD treatment on food allergy and food allergy concern are of interest and worthy of further study.

The Zero Acceptance of Pain (ZAP) Quality Improvement Project: evaluation of pain severity, pain interference, global quality of life, and pain-related costs.

The Zero Acceptance of Pain (ZAP) Quality Improvement Project was a multi-site effort to improve the lives of outpatients with cancer pain by enhancing the clinical practice of pain assessment and management. Independent samples of patients completed self-report measures of severity of pain, pain interference, global quality of life, pain treatment satisfaction, general medical treatment satisfaction, pain attitudes, and pain-related medical costs before and after the implementation of ZAP. Results suggested that ZAP decreased the severity of recent pain, decreased interference of pain on daily functioning, and improved satisfaction with pain treatment and attitudes about addiction to opioid medication. Direct medical costs consisting of pain-related hospitalizations, emergency department visits, and physician office visits were greatly reduced. In summary, the findings of this study support the idea that clinic-based efforts to improve the practice of pain management are effective in improving the lives of cancer patients who are experiencing pain.

A Comparison of Clonidine and Buprenorphine in the Outpatient Treatment of Opiate Withdrawal.

The opiate withdrawal syndrome, although not life threatening, is a major obstacle in the treatment of opiate dependence. Over a 12 week period, 124 patients (63% female, 66% African American and mean age 32.6 years) underwent 5 day treatment for opiate withdrawal. Patients treated in the first 6 weeks (n = 69) received clonidine based treatment (0.1 mg every 6 h with one dose received on-site each day and the others taken home), while patients treated in the latter 6 weeks (n = 65) received buprenorphine 0.3 mg IM daily. Both groups received supportive medications for diarrhea, cramps, aches, and nausea, had clonidine patches placed on day 4, and were offered naltrexone upon completion. Based on age, gender, and race the two treatment groups were similar. The completion rate was 75.4% for buprenorphine group and 47.5% for the clonidine group, (p =.001). In conclusion, buprenorphine was superior to clonidine in enabling opiate dependent patients to successfully complete an outpatient detoxification program.

Diagnostic pitfalls in syringocystadenocarcinoma papilliferum: case report and review of the literature.

We report the first case, to our knowledge, of syringocystadenocarcinoma papilliferum with p63-verified squamous differentiation and extensive dermal invasion accompanying in situ components. An 86-year-old woman presented with a neoplasm on the neck, and the intralesional heterogeneity typical of these neoplasms led to an initial diagnosis on needle biopsy favoring squamous cell carcinoma. Excision illustrated diverse morphology, raising a broad differential diagnosis, including more common extracutaneous malignancies, such as breast, gastrointestinal, and ovarian primary tumors. Fortuitous sectioning revealed a focal connection to the skin surface with evidence of apocrine differentiation allowing final diagnosis as syringocystadenocarcinoma papilliferum. Our literature review shows the histologic and immunohistochemical features of syringocystadenocarcinoma papilliferum are not well defined outside of their clear morphologic overlap with syringocystadenoma papilliferum. We describe our findings and diagnostic pitfalls to help pathologists encountering this unusual apocrine neoplasm.

Patterns of care and referral in children with atopic dermatitis and concern for food allergy.

Although many providers believe that up to 30% of atopic dermatitis (AD) is food induced, food challenge studies show that food-induced eczematous reactions are rare. When food allergy is suggested to cause AD, it often leads to allergy testing with a high false-positivity rate, in turn further focusing parents on food allergy. Study subjects were children less than 11 years old with AD and food allergy suspicion. Prior diagnoses, provider, and testing patterns were assessed by questionnaire given to the parents. Thirty-eight patients with AD were enrolled. Most subject's parents suspected food allergy induced AD. Initial skin diagnoses were made by pediatricians (79%) and family practitioners (18%) as eczema. Allergy was suggested by providers as cause for AD in 63% of the present study's patients. Seventy-nine percent had allergy testing. Greater than 90% of parents claimed their children had food allergy and food-induced AD. Sixty-six percent had positive food allergy tests and 37% had definite history of immediate IgE reactions to food. The majority of this population had allergy suggested as causative for eczema by their primary care provider and were subsequently evaluated by allergist and allergy testing. Consensus about the role of food allergy between the different providers of AD in children would result in more effective, efficient, and less costly health care.