Activity pattern of Tityus serrulatus (Scorpiones: Buthidae) in an urban area in the state of São Paulo, Brazil.

Tityus serrulatus Lutz & Mello (Scorpiones: Buthidae) is a scorpion endemic to Brazil adapted to synanthropic life, colonising and proliferating in the most populous urban areas in the country. Here, we evaluated its activity pattern in an urban cemetery in the municipality of Americana, state of São Paulo, Brazil. Additionally, we tested the effects of species reproduction and climatic seasons on the activity pattern. The Saudade Municipal Cemetery was sampled between 17:00 and 22:00 h during 455 nights from April 2006 to December 2013. The circular mean and the peak of activity were quantified for the total number of specimens, and for specimens with and without broods. Activity patterns were inferred using a rosette diagram. Circular analysis of variance was used to investigate if activity patterns changed across climatic seasons (wet and dry seasons). A total of 25,969 records (467 specimens with broods) were obtained in the field. The circular mean varied between 19:44 and 19:48 h, and the peak of activity occurred between 18:00 and 20:00 h for all groups. Peaks of activity differed from that recorded under laboratory conditions (between 21:00 and 23:00 h). Activity patterns did not differ for specimens with broods, suggesting that the reproductive condition does not alter the species activity pattern. The activity pattern differed between wet and dry seasons for all specimens and specimens without broods, but differences were small and probably biologically irrelevant, probably because the species tolerates a wide variation in abiotic conditions. Deepening the knowledge of the behaviour activity of T. serrulatus can have practical applications for health surveillance agencies, aiming to increase the effectiveness of scorpion control in urban areas.

Tityus serrulatus Lutz & Mello (Scorpiones: Buthidae) é um escorpião endêmico do Brasil adaptado à vida sinantrópica, colonizando e proliferando nas áreas urbanas mais populosas do país. Aqui avaliamos seu padrão de atividade em um cemitério urbano no município de Americana, estado de São Paulo, Brasil. Adicionalmente, testamos os efeitos da reprodução da espécie e das estações climáticas sobre o padrão de atividade. O Cemitério Municipal da Saudade foi amostrado entre 17:00 h e 22:00 h durante 455 noites, de abril de 2006 a dezembro de 2013. A média circular e o pico de atividade foram quantificados para o número total de espécimes, espécimes com e sem ninhadas. Os padrões de atividade foram inferidos usando um diagrama de roseta. Análises de variância circular foram utilizadas para investigar se os padrões de atividade mudavam com as estações climáticas (estações chuvosa e seca). Um total de 25.969 registros (467 espécimes com ninhadas) foram obtidos em campo. A média circular variou entre 19:44 h e 19:48 h e o pico de atividade ocorreu entre 18:00 h e 20:00 h para todos os grupos. Os picos de atividade diferiram dos registados em condições de laboratório (entre 21:00 h e 23:00 h). Os padrões de atividade não diferiram para os espécimes com ninhadas, sugerindo que a condição reprodutiva não altera o padrão de atividade da espécie. O padrão de atividade diferiu entre as estações chuvosa e seca para todos os espécimes e os espécimes sem ninhadas, mas as diferenças foram pequenas e provavelmente biologicamente irrelevantes, provavelmente porque a espécie tolera uma grande variação nas condições abióticas. Preencher lacunas sobre o comportamento de T. serrulatus pode ter aplicações práticas para órgãos de vigilância sanitária, visando aumentar a eficácia do controle de escorpiões em áreas urbanas.

Spatial Analysis in Areas with High Occurrence of Accidents Caused by Tityus serrulatus and Tityus bahiensis (Scorpiones: Buthidae) in Brazil.

INTRODUCTION: In Brazil, scorpion stings are recorded in high numbers with an increasing epidemiological situation in most municipalities. In the present study, data between 1998 and 2018 in Americana, São Paulo, were analyzed. METHODS: In total, 4122 records on scorpion stings were georeferenced using a Garmin eTREX 30X global positioning system device, with WGS84 datum projection and Universal Transverse Mercator zone 23S. Multiple Poisson regression was used to explore the relationship between the incidence rates of stings and urban planning areas (UPAs). Eight quantitative variables were used to establish the environmental and anthropic characterization of UPAs associated or not associated with scorpionism. A spatial analysis was performed for geoprocessing maps of Americana using spatial statistics tools (optimized hotspot analysis and kernel density function) from cartographic clusters in the ArcMap software, version 10.5. RESULTS: The optimized hotspot analysis tool identified spatial clusters with high values of the incidence of scorpion stings in the surroundings of all UPAs in the municipality. The estimation of the kernel function of event intensity showed a wide distribution of stings across the area of the entire municipal territory, with UPA-02 and UPA-06 exhibiting the highest occurrence of scorpion stings. Six significant hotspots were established as highest-event-density areas (with occurrences of 160-270) and were contiguous to 4 environmental protection areas, located in more peripheral regions, and to 2 municipal cemeteries, which were located in urban central areas. CONCLUSIONS: This analysis showed that the risk of scorpion stings in different Americana's UPAs has increased occurrence and incidence intensity.

Scorpionicidal activity of secondary metabolites from Paecilomyces sp. CMAA1686 against Tityus serrulatus.

INTRODUCTION: Urban pests pose enormous risks to human health. Control initiatives are carried out in regions of high infestation and incidence of accidents caused by scorpions OBJECTIVE: In this study, we aimed to analyze the anti-scorpionic activity of fungal isolates obtained from a cemetery in Brazil. MATERIALS AND METHODS: A total of thirteen fungi were subjected to a bioassay test against Tityus serrulatus, and the two isolates with the highest scorpionicidal activity were selected for molecular identification through sequencing of the ITS DNA hypervariable region and large-scale cultivation on liquid medium for secondary metabolite extraction. The crude extracts were partitioned by solid-phase extraction, and the resulting purified extracts were tested for anti-scorpionic activity. The extracts from one of the isolates presented better results and were submitted to UPLC-MS/MS. The metabolomics data were submitted to GNPS website for Molecular Networking and MASST searches. We also performed a MolNetEnhancer analysis to identify the chemical classes of the molecules found in the samples. RESULTS: The most promising fungal isolate was identified as Paecilomyces sp. CMAA1686 which has 98% of similarity to Paecilomyces formosus. The sub-fractions C and D had the best activity against the scorpions (54 and 32% mortality, respectively). Molecular Networking and MolNetEnhancer revealed a range of molecular classes in our extracts that are known to include bioactive metabolites from Paecilomyces species. CONCLUSIONS: The scorpionicidal activity of Paecilomyces sp. CMAA1686 and its secondary metabolites may provide new alternative compounds for biological and chemical control of scorpions from the species T. serrulatus. Paecilomyces sp. CMAA1686 is an isolate that has great potential for isolation of secondary metabolites.

SHORTEN PREOPERATIVE FASTING AND INTRODUCING EARLY EATING ASSISTANCE IN RECOVERY AFTER GASTROJEJUNAL BYPASS?

RATIONAL: The metabolic response to surgical trauma is enhanced by prolonged preoperative fasting, contributing to increased insulin resistance. This manifestation is more intense on the 1st and 2nd postoperative days and is directly proportional to the size of the operation. AIM: To compare whether preoperative fasting abbreviation and early postoperative refeeding associated with intraoperative and postoperative fluid restriction interfere in the evolution of patients undergoing gastrojejunal bypass. METHODS: Eighty patients indicated for Roux-en-Y gastrojejunal bypass were selected. They were randomly divided into two groups: Ringer Lactate (RL) group, who underwent a 6 hours solids fasting, with the administration of 50 g of maltodextrin in 100 ml of mineral water 2 hours before the beginning of anesthesia; and Physiologic Solution (PS) group, who underwent a 12 hours solids and liquids fasting. Anesthesia was standardized for both groups. During the surgical procedure, 1500 ml of ringer lactate solution was administered in the RL and 2500 ml of physiological solution (0.9% sodium chloride) in the PS. In both groups, the occurrence of bronchoaspiration was analyzed during intubation, and the residual gastric volume was measured after opening the abdominal cavity. In the postoperative period in Group RL, patients started a liquid diet 24 hours after the end of the operative procedure; whilst for PS group, fasting was maintained for the first 24 hours, it was prescripted 2000 ml of physiological solution and a restricted liquid diet after 36 hours. Each patient underwent CPK, insulin, sodium, potassium, urea, creatinine, PaCO2, pH and bicarbonate dosage in the immediate postoperative period, and 48 hours later, the exams were repeated. RESULTS: There were no episodes of bronchoaspiration and gastrojejunal fistulas in either group. In the analysis of the residual gastric volume of the PS and RL groups, the mean volumes were respectively 16.5 and 8.8, which shows statistical significance between the groups. In laboratory tests, there was no difference between groups in sodium; PS group showed a higher level of serum potassium (p=0.029); whilst RL group showed a higher urea and creatinine values; CPK values were even for both; PS group demonstrated a higher insulin level; pH was higher in PS group; sodium bicarbonate showed a significant difference at all times; PaCO2 values in RL group was higher than in PS. In the analysis of the incidence of nausea and flatus, no statistical significance was observed between the groups. CONCLUSIONS: The abbreviation of preoperative fasting and early postoperative refeeding of Roux-en-Y gastrojejunal bypass with the application of ERAS or ACERTO Project accelerated the patient's recovery, reducing residual gastric volume and insulin level, and do not predispose to complications.

Small mammals, ticks and rickettsiae in natural and human-modified landscapes: Diversity and occurrence of Brazilian spotted fever in Brazil.

We studied communities of small mammals and their ticks in endemic (E) and non-endemic (NE) areas for Brazilian spotted fever (BSF), aiming to infer if diversity parameters of parasites and hosts could be related to occurrence and prevalence of rickettsial infection, especially Rickettsia rickettsii. We compared E and NE areas in human-modified landscapes (HMLs) and natural areas (BIO) with no report of BSF cases. Composition and equitability were important components of diversity explaining differences among areas. The marsupial Didelphis albiventris was dominant in HMLs, but not in natural areas, and this opossum was the main host for the tick Amblyomma sculptum, principal vector of R. rickettsii, especially in E areas. Communities of ticks were dominated by A. sculptum, followed by Amblyomma dubitatum in E areas. In NE areas, this dominance was inverted, with more A. dubitatum than A. sculptum infesting small mammals, but the numbers of ticks were much lower than in E areas. Composition and abundance of ticks in natural areas were very dissimilar from HMLs, with the lowest tick burdens. Didelphis albiventris in E areas presented higher seroprevalence and endpoint titres against R. rickettsii than in other areas. At least three Rickettsia species, non-pathogenic to humans, were detected in natural areas (Rickettsia bellii, Rickettsia amblyommatis and 'Candidatus Rickettsia andeanae'), and only one non-pathogenic species in HMLs (R. bellii). Our results suggest that higher diversity of ticks, hosts and rickettsiae could be relevant factors in buffering the effect in BSF occurrence. Particularly for D. albiventris, its importance has to be quantified in further studies considering the epidemiological scenario of BSF.

CAN STATURE, ABDOMINAL PERIMETER AND BMI INDEX PREDICT POSSIBLE CARDIOMETABOLIC RISKS IN FUTURE OBESITY?

BACKGROUND: Obesity changes the anatomy of the patient. In addition to the aesthetic change, the high percentage of fat determines evident functional changes. Anthropometric normality in measuring abdominal circumference and height can serve as a basis for measuring cardiometabolic risks of obesity. AIM: To verify if it is possible to determine parameters of normality between waist and height in people with normal BMI and fat percentages, to serve as a basis for assessing risks for obesity comorbidities. METHODS: A sample of 454 individuals with BMI and percentages of fat considered within the normal range was extracted. It was divided into age groups for both men and women between 18 and 25; 26 to 35; 36 to 45; 46 to 55; 56 to 65. A total of 249 men and 205 women were included. RESULTS: Regarding the percentage of height as a measure of the abdominal perimeter, the total female sample had an average of 44.2±1.1% and the male 45.3%+1.5. For women, this percentage determined the equation of the waist-height ratio represented by X=(age+217) / 5.875, and for men X=(age+190.89) / 5.2222. "X" represents the percentage of the height measurement so that the individual falls into the category of adequate percentage of fat and BMI. CONCLUSION: Between the stature of adult men and women with normal fat percentage and BMI, there is a common numerical relationship, with is on average 44% for women and 45% for men.

Habitat selection in natural and human-modified landscapes by capybaras (Hydrochoerus hydrochaeris), an important host for Amblyomma sculptum ticks.

Human activities are changing landscape structure and function globally, affecting wildlife space use, and ultimately increasing human-wildlife conflicts and zoonotic disease spread. Capybaras (Hydrochoerus hydrochaeris) are linked to conflicts in human-modified landscapes (e.g. crop damage, vehicle collision), as well as the spread and amplification of Brazilian spotted fever (BSF), the most human-lethal tick-borne disease in the world. Even though it is essential to understand the link between capybaras, ticks and BSF, many knowledge gaps still exist regarding the effects of human disturbance in capybara space use. Here, we analyzed diurnal and nocturnal habitat selection strategies of capybaras across natural and human-modified landscapes using resource selection functions (RSF). Selection for forested habitats was higher across human-modified landscapes, mainly during day- periods, when compared to natural landscapes. Across natural landscapes, capybaras avoided forests during both day- and night periods. Water was consistently selected across both landscapes, during day- and nighttime. Distance to water was also the most important variable in predicting capybara habitat selection across natural landscapes. Capybaras showed slightly higher preferences for areas near grasses/shrubs across natural landscapes, and distance to grasses/shrubs was the most important variable in predicting capybara habitat selection across human-modified landscapes. Our results demonstrate human-driven variation in habitat selection strategies by capybaras. This behavioral adjustment across human-modified landscapes may be related to increases in A. sculptum density, ultimately affecting BSF.

Epidemiology of capybara-associated Brazilian spotted fever.

BACKGROUND: Brazilian spotted fever (BSF), caused by the bacterium Rickettsia rickettsii, has been associated with the transmission by the tick Amblyomma sculptum, and one of its main hosts, the capybara (Hydrochoerus hydrochaeris). METHODS: During 2015-2019, we captured capybaras and ticks in seven highly anthropic areas of São Paulo state (three endemic and four nonendemic for BSF) and in two natural areas of the Pantanal biome, all with established populations of capybaras. RESULTS: The BSF-endemic areas were characterized by much higher tick burdens on both capybaras and in the environment, when compared to the BSF-nonendemic areas. Only two tick species (A. sculptum and Amblyomma dubitatum) were found in the anthropic areas; however, with a great predominance of A. sculptum (≈90% of all ticks) in the endemic areas, in contrast to a slight predominance of A. dubitatum (≈60%) in the nonendemic areas. Tick species richness was higher in the natural areas, where six species were found, albeit with a predominance of A. sculptum (≈95% of all ticks) and environmental tick burdens much lower than in the anthropic areas. The BSF-endemic areas were characterized by overgrowth populations of A. sculptum that were sustained chiefly by capybaras, and decreased populations of A. dubitatum. In contrast, the BSF-nonendemic areas with landscape similar to the endemic areas differed by having lower tick burdens and a slight predominance of A. dubitatum over A.sculptum, both sustained chiefly by capybaras. While multiple medium- to large-sized mammals have been incriminated as important hosts for A. sculptum in the natural areas, the capybara was the only important host for this tick in the anthropic areas. CONCLUSIONS: The uneven distribution of R. rickettsii infection among A. sculptum populations in highly anthropic areas of São Paulo state could be related to the tick population size and its proportion to sympatric A. dubitatum populations.

Evaluation of an association of alpha-cypermethrin and flufenoxuron for tick control in an area at risk of Brazilian spotted fever.

Brazilian spotted fever (BSF) is an endemic anthropozoonosis caused by Gram-negative bacteria (Rickettsia rickettsii) that is associated with the risk of human infection by ticks. In the city of Americana, São Paulo (SP), Brazil, there were 12 cases (67% lethal) between 2004 and 2015. This study evaluated the effectiveness of control over tick infestations in an area at risk of BSF, in a field trial on an association of alpha-cypermethrin (3%) and flufenoxuron (3%) (Tenopa®) conducted in Americana. The infestation levels of the target species (Amblyomma sculptum and Amblyomma dubitatum) in the field trial were evaluated through acarological surveys (CO2 traps) on days 0, 22, 43 and 62 after treatment, both in the treatment area and in a control area. In the treatment area, the insecticide formulation was applied using a motorized sprayer, at the dosage of 80mL/10L of water per 200m2. These surveys in the treatment area showed that there were reductions in the infestation levels of the adult stage on days 22 (33%), 43 (87%) and 62 (70%) and immature stages (nymphs and larvae) on days 22 (54%), 43 (87%) and 62 (97%), in relation to day zero and to infestation levels in the control area. This study demonstrated that the product applied was effective for reducing the environmental infestation of ticks and that this effect persisted two months after a single application in areas of proven risk of BSF.

Shorten preoperative fasting and introducing early eating assistance in recovery after gastrojejunal bypass? / Abreviar jejum pré-operatório e introduzir alimentação precoce auxiliam na recuperação após bypass gastrojejunal?

ABSTRACT Rational: The metabolic response to surgical trauma is enhanced by prolonged preoperative fasting, contributing to increased insulin resistance. This manifestation is more intense on the 1st and 2nd postoperative days and is directly proportional to the size of the operation. Aim: To compare whether preoperative fasting abbreviation and early postoperative refeeding associated with intraoperative and postoperative fluid restriction interfere in the evolution of patients undergoing gastrojejunal bypass. Methods: Eighty patients indicated for Roux-en-Y gastrojejunal bypass were selected. They were randomly divided into two groups: Ringer Lactate (RL) group, who underwent a 6 hours solids fasting, with the administration of 50 g of maltodextrin in 100 ml of mineral water 2 hours before the beginning of anesthesia; and Physiologic Solution (PS) group, who underwent a 12 hours solids and liquids fasting. Anesthesia was standardized for both groups. During the surgical procedure, 1500 ml of ringer lactate solution was administered in the RL and 2500 ml of physiological solution (0.9% sodium chloride) in the PS. In both groups, the occurrence of bronchoaspiration was analyzed during intubation, and the residual gastric volume was measured after opening the abdominal cavity. In the postoperative period in Group RL, patients started a liquid diet 24 hours after the end of the operative procedure; whilst for PS group, fasting was maintained for the first 24 hours, it was prescripted 2000 ml of physiological solution and a restricted liquid diet after 36 hours. Each patient underwent CPK, insulin, sodium, potassium, urea, creatinine, PaCO2, pH and bicarbonate dosage in the immediate postoperative period, and 48 hours later, the exams were repeated. Results: There were no episodes of bronchoaspiration and gastrojejunal fistulas in either group. In the analysis of the residual gastric volume of the PS and RL groups, the mean volumes were respectively 16.5 and 8.8, which shows statistical significance between the groups. In laboratory tests, there was no difference between groups in sodium; PS group showed a higher level of serum potassium (p=0.029); whilst RL group showed a higher urea and creatinine values; CPK values were even for both; PS group demonstrated a higher insulin level; pH was higher in PS group; sodium bicarbonate showed a significant difference at all times; PaCO2 values in RL group was higher than in PS. In the analysis of the incidence of nausea and flatus, no statistical significance was observed between the groups. Conclusions: The abbreviation of preoperative fasting and early postoperative refeeding of Roux-en-Y gastrojejunal bypass with the application of ERAS or ACERTO Project accelerated the patient's recovery, reducing residual gastric volume and insulin level, and do not predispose to complications.

RESUMO Racional: A resposta metabólica ao trauma cirúrgico é potencializada pelo jejum pré-operatório prolongado que contribui para o aumento da resistência à insulina. Esta manifestação é mais intensa no 1º e 2º dias de pós-operatório e é diretamente proporcional ao porte da operação. Objetivo: Comparar se a abreviação do jejum pré-operatório e a realimentação precoce no pós-operatório associado à restrição hídrica no trans e pós-operatório interferem na evolução dos pacientes submetidos ao bypass gastrojejunal. Métodos: Foram recrutados 80 pacientes indicados ao bypass gastrojejunal em Y-de-Roux. Eles foram distribuídos randomicamente em dois grupos: ringer lactato (RL) que fizeram jejum de 6 h para sólidos, administrando 50 g de maltodextrina em 100 ml de água mineral 2 h antes do início da anestesia e de soro fisiológico (SF) que fizeram jejum de 12 h para sólidos e líquidos. A anestesia foi padronizada para os dois grupos. Durante o procedimento operatório no RL foi administrado 1500 ml solução de ringer lactato e no SF 2500 ml de soro fisiológico (0,9% de cloreto de sódio). Em ambos os grupos foram analisados durante a intubação a ocorrência ou não de bronco-aspiração e mensurado o volume gástrico residual após abertura da cavidade abdominal. No pós-operatório do Grupo RL, os pacientes iniciaram dieta liquida após 24 h do término do procedimento operatório; no Grupo SF foi mantido jejum nas primeiras 24 h, prescrição de 2000 ml de soro fisiológico e início da dieta líquida restrita com 36 h. Cada paciente realizou no pós-operatório imediato, ainda na sala de cirurgia, a dosagem de CPK, insulina, sódio, potássio, ureia, creatinina, PaCO2, pH e bicarbonato e em 48 h repetiu-se a coleta destes exames. Resultados: Não houve episódios de broncoaspiração e fístulas gastrojejunais em ambos os grupos. Na análise do volume residual gástrico dos grupos SF e RL, as médias de volume foram respectivamente 16,5 e 8,8 apresentando significância estatística entre os grupos. Nos exames laboratoriais não houve diferença entre os grupos no sódio; nível sérico de potássio no SF foi maior (p=0,029); ureia e creatinina maiores no RL; CPK não apresentou diferenças; insulina no grupo SF foram maiores; pH foi maior no SF; bicarbonato de sódio evidenciou diferença significativa em todos o momentos; PaCO2 no RL foi maior. Na análise de incidência de náusea e flatos não foram observados significância estatística entre os grupos. Conclusões: A abreviação do jejum pré-operatório e a realimentação precoce no pós-operatório de bypass gastrojejunal em Y-de-Roux com a aplicação de programas como ERAS ou Projeto Acerto aceleram a recuperação do paciente, diminuindo o volume gástrico residual e o nível de insulina, e não predispõem complicações.

Modeling of spatial distribution for scorpions of medical importance in the São Paulo State, Brazil.

AIM: In this work, we aimed to develop maps of modeling geographic distribution correlating to environmental suitability for the two species of scorpions of medical importance at São Paulo State and to develop spatial configuration parameters for epidemiological surveillance of these species of venomous animals. MATERIALS AND METHODS: In this study, 54 georeferenced points for Tityus serrulatus and 86 points for Tityus bahiensis and eight environmental indicators, were used to generate species distribution models in Maxent (maximum entropy modeling of species geographic distributions) version 3.3.3k using 70% of data for training (n=38 to T. serrulatus and n=60 to T. bahiensis) and 30% to test the models (n=16 for T. serrulatus and n=26 for T. bahiensis). The logistic threshold used to cut models in converting the continuous probability model into a binary model was the "maximum test sensitivity plus specificity," provided by Maxent, with results of 0.4143 to T. serrulatus and of 0.3401 to T. bahiensis. The models were evaluated by the area under the curve (AUC), using the omission error and the binomial probability. With the data generated by Maxent, distribution maps were produced using the "ESRI(®) ArcGIS 10.2.2 for Desktop" software. RESULTS: The models had high predictive success (AUC=0.7698±0.0533, omission error=0.2467 and p<0.001 for T. serrulatus and AUC=0.8205±0.0390, omission error=0.1917 and p<0.001 for T. bahiensis) and the resultant maps showed a high environmental suitability in the north, central, and southeast of the state, confirming the increasing spread of these species. The environmental variables that mostly contributed to the scorpions species distribution model were rain precipitation (28.9%) and tree cover (28.2%) for the T. serrulatus and temperature (45.8%) and thermal amplitude (12.6%) for the T. bahiensis. CONCLUSION: The distribution model of these species of medical importance scorpions in São Paulo State revealed a higher environmental suitability of these species in the regions north, central, and southeast of the state, warning to emergencies actions for prevention and surveillance from scorpion stings in several counties. There is also a need to best conservation strategies related to neighboring territories, with the implementation of new environmental protected areas and measures of spread control of these species in urban areas of several counties.

Aspectos clínico-epidemiológicos de um cluster de febre maculosa brasileira, ocorrido no município de Americana, São Paulo, Brasil, 2018 / Clinical and epidemiological aspects of a cluster of brazilian spotted fever, which occurred in the city of Americana, São Paulo, Brazil, 2018

Objetivos: descrever os principais aspectos clínicos, laboratoriais e epidemiológicos relacionados à ocorrência de um cluster de febre maculosa brasileira (FMB) na cidade de Americana/SP, em 2018. Métodos: realizou-se uma análise descritiva baseada na revisão das informações constantes nos registros do Sistema de Informação de Agravos de Notificação ­ SINAN e nos relatórios de investigações epidemiológicas obtidos junto ao banco de dados da Unidade de Vigilância em Saúde Municipal. Resultados: esse cluster ocorreu em um fragmento de mata ciliar situado na confluência dos rios Atibaia e Jaguari, entre os dias 21/4/2018 e 31/5/2018. Durante esse período, ocorreram 15 casos positivos de FMB, com registro de 11 óbitos, atingindo uma taxa de letalidade de 73%. O sexo masculino representou 93% dos pacientes, e a faixa etária mais afetada foi a de indivíduos acima dos 30 anos (67%), seguindo-se o percentual de 13% para as faixas de 1 a 4 e 5 a 9 anos, e 7% para pessoas de 20 a 29 anos. Os principais sinais clínicos observados foram febre (100%); cefaléia (80%) e mialgia (73,33%). Conclusão: foi possível delinear o perfil epidemiológico dos indivíduos a serem alcançados nas campanhas de educação em saúde, com enfoque para medidas preventivas visando à redução de frequência nas áreas de risco para parasitismo humano por carrapatos vetores da FMB.

Objective: describe the main clinical, laboratory and epidemiological aspects related to the occurrence of a cluster of brazilian spotted fever (FMB) in the city of Americana/SP, in 2018. Methods: A descriptive analysis was performed based on the review of the information contained in the records of the Notification Disease Information System (SINAN) and in the reports of epidemiological investigation obtained from the Municipal Health Surveillance Unit database. Results: This cluster occurred in a riparian forest fragment located at the confluence of the Atibaia and Jaguari rivers, between 04/21/2018 and 05/31/2018. During this period there were 15 positive cases of BSF, with a record of 11 deaths, reaching a lethality rate of 73%. Males represented 93% of the patients and the most affected age group was that of individuals over 30 years old (67%), followed by 13% for the age groups 01 to 04 and 05 to 09 years old, and 7 % for people from 20 to 29 years old. The main clinical signs observed were fever (100,00%); headache (80,00%) and myalgia (73,33%). Conclusion: It was possible to outline an epidemiological profile of individuals to be reached in health education campaigns, with a focus on preventive measures aimed at reducing frequency in areas at risk for human parasitism by BSF vector ticks.

Tick-borne infections in human and animal population worldwide.

The abundance and activity of ectoparasites and its hosts are affected by various abiotic factors, such as climate and other organisms (predators, pathogens and competitors) presenting thus multiples forms of association (obligate to facultative, permanent to intermittent and superficial to subcutaneous) developed during long co-evolving processes. Ticks are ectoparasites widespread globally and its eco epidemiology are closely related to the environmental conditions. They are obligatory hematophagous ectoparasites and responsible as vectors or reservoirs at the transmission of pathogenic fungi, protozoa, viruses, rickettsia and others bacteria during their feeding process on the hosts. Ticks constitute the second vector group that transmit the major number of pathogens to humans and play a role primary for animals in the process of diseases transmission. Many studies on bioecology of ticks, considering the information related to their population dynamics, to the host and the environment, comes possible the application and efficiency of tick control measures in the prevention programs of vector-borne diseases. In this review were considered some taxonomic, morphological, epidemiological and clinical fundamental aspects related to the tick-borne infections that affect human and animal populations.

Epidemiological surveillance of capybaras and ticks on warning area for Brazilian spotted fever.

AIM: The vulnerability of tropical developing countries to the emerging disease constitutes a critical phenomenon in which the invasion of wild niches by human hosts, contributes to expansion of zoonotic diseases, such as the Brazilian spotted fever (BSF). This study performed a diagnosis of species occurrence of their hosts (Hydrochoerus hydrochaeris) and vectors (Amblyomma sculptum and Amblyomma dubitatum) on the warning area for this reemerging disease in Brazil. MATERIALS AND METHODS: The study was conducted in a warning area for BSF in the city of Americana, São Paulo state. The occurrence of capybaras was registered by use of binoculars and GPS equipment and 24 acarological researches were performed through 180 CO2 traps. Samples of adult ticks were dissected for salivary glands removal, DNA extraction, and evaluation by polymerase chain reaction (PCR) being tested by initial gltA-PCR, ompA-PCR, and Rickettsia bellii-specific PCR, with the positive samples subjected to sequencing. RESULTS: Eleven clusters of capybaras (total of 71 individuals), were observed along the riparian of Ribeirão Quilombo and 7,114 specimens of A. sculptum and 7,198 specimens of A. dubitatum were collected in this same area. About 568 samples of adult ticks were dissected for salivary glands removal, DNA extraction and evaluation by gltA-PCR, with results of 1.94% (11/568) of positive samples. Results for the initial gltA-PCR indicated none positive sample to Rickettsia species into A. sculptum and 11 positive samples to A. dubitatum. These samples were negative to the ompA-PCR and positive to the Rickettsia bellii-specific PCR protocol and subjected to DNA sequencing, whose result indicated 100% similarity to Rickettsia bellii. The distribution of tick species A. sculptum and A. dubitatum was configured regarding to the biotic potential of the riparian areas, measuring the risks for BSF in peri-urban areas of Americana. CONCLUSION: These results confirmed a status of epidemiological warning with a strong association of the amplifiers hosts of Rickettsia and tick vectors for the transmission of BSF to humans in this region.

Can stature, abdominal perimeter and bmi index predict possible cardiometabolic risks in future obesity? / Pode índice com estatura, perímetro abdominal e imc predizer possíveis riscos cardiometabólicos em futura obesidade?

ABSTRACT Background: Obesity changes the anatomy of the patient. In addition to the aesthetic change, the high percentage of fat determines evident functional changes. Anthropometric normality in measuring abdominal circumference and height can serve as a basis for measuring cardiometabolic risks of obesity. Aim: To verify if it is possible to determine parameters of normality between waist and height in people with normal BMI and fat percentages, to serve as a basis for assessing risks for obesity comorbidities. Methods: A sample of 454 individuals with BMI and percentages of fat considered within the normal range was extracted. It was divided into age groups for both men and women between 18 and 25; 26 to 35; 36 to 45; 46 to 55; 56 to 65. A total of 249 men and 205 women were included. Results: Regarding the percentage of height as a measure of the abdominal perimeter, the total female sample had an average of 44.2±1.1% and the male 45.3%+1.5. For women, this percentage determined the equation of the waist-height ratio represented by X=(age+217) / 5.875, and for men X=(age+190.89) / 5.2222. "X" represents the percentage of the height measurement so that the individual falls into the category of adequate percentage of fat and BMI. Conclusion: Between the stature of adult men and women with normal fat percentage and BMI, there is a common numerical relationship, with is on average 44% for women and 45% for men.

RESUMO Racional: A obesidade modifica a anatomia de seu portador. Além da mudança estética o alto percentual de gordura determina evidentes alterações funcionais. A normalidade antropométrica na mensuração do perímetro abdominal e estatura pode servir de base na mensuração dos riscos cardiometabólicos da obesidade. Objetivo: Verificar se é possível determinar parâmetros de normalidade entre cintura e estatura em pessoas que apresentem IMC e percentuais de gordura normais, para servir de base na avaliação de riscos para co-morbidades da obesidade. Métodos: Foi extraída amostra de 454 indivíduos com IMC e percentuais de gordura considerados dentro da normalidade. Ela foi dividida em faixas de idade tanto para homens como para mulheres entre 18 a 25; 26 a 35; 36 a 45; 46 a 55; 56 a 65. Totalizou 249 homens e 205 mulheres. Resultados: Em relação ao percentual da estatura como medida do perímetro abdominal, a amostra total feminina apresentou média de 44,2±1,1% e a masculina 45,3%+1,5. Para as mulheres este percentual determinou a equação da relação cintura-estatura representado por X=(idade+217)/5,875, e para homens X= (idade+190,89) /5,2222. "X" representa o percentual da medida da estatura para que o indivíduo se enquadre na categoria de adequados percentual de gordura e IMC. Conclusão: Entre a estatura de homens e mulheres adultos possuidores de percentuais de gordura e IMC normais, existe relação numérica comum, sendo em média 44% para mulheres e 45% para homens.

Avaliação da mobilidade de escorpiões Tityus serrulatus em área de infestação urbana de Americana, São Paulo, Brasil / Evaluation of the mobility of scorpions Tityus serrulatus in urban infestation area of Americana, São Paulo, Brazil

Introdução: A avaliação da dispersão e das modificações de habitat das espécies de escorpiões de importância médica acrescentam importantes informações sobre sua ocorrência em áreas urbanas. Objetivo: A mobilidade da espécie Tityus serrulatus foi avaliada em focos de infestação de áreas antropizadas do município de Americana, Estado de São Paulo. Métodos: Os espécimes foram capturados em um cemitério municipal, sendo individualmente marcados, em quatro grupos de 200 indivíduos, com cores diferenciadas. Posteriormente, foram soltos no centro da respectiva área em que foram capturados, sem controle individual. Foram realizadas varreduras periódicas em uma área circular, com raio de leitura estabelecido a cada 4 metros, havendo o registro de localização dos animais marcados que foram recapturados. Os dados experimentais foram coletados no período de agosto de 2014 a novembro de 2016, durante 28 meses de atividades (359 horas de observação). As recapturas dos espécimes foram realizadas em período diurno, no primeiro ano (221 horas), por meio da inspeção de 5.021 sepulturas e em período noturno no segundo ano (138 horas), com 3.053 sepulturas vistoriadas. Resultados: Foram evidenciadas, uma distância mínima de 2,13 metros no 1º dia de leitura e uma distância máxima de 29,34 metros no 68º dia de leitura, em foco de infestação urbana. Conclusão: Os resultados obtidos neste experimento contribuem para um melhor entendimento da dispersão de T. serrulatus em áreas urbanas, visando o controle e a prevenção de riscos de acidentes junto à população, com enfoque nas estratégias de controle químico dessa espécie.(AU)

Introduction: The assessment of the dispersion and habitat modifications of the species of scorpions of medical importance adds important information about their occurrence in urban areas. Objective: The mobility of the species Tityus serrulatus was evaluated in outbreaks of infestation of anthropic areas of the city of Americana, state of São Paulo, Brazil. Methods: The specimens were captured in a municipal cemetery and individually marked in four groups of 200 individuals with different colors. Later on, they were released in the centroid of the respective area in which they were captured, without individual control. Periodic sweeps were performed in a circular area, with a radius established every 4 meters, with the record of the location of the recaptured tagged animals. The experimental data were collected from August 2014 to November 2016, during 28 months of activities (359 observation hours). Sample recaptures were carried out in the first year (221 hours) through the inspection of 5,021 graves and at night in the second year (138 hours), with 3,053 graves inspected. Results: A minimum distance of 2.13 meters on the 1st day of reading and a maximum distance of 29.34 meters on the 68th day of reading were registered, in a focus area of urban infestation. Conclusion: The results obtained in this experiment contribute to a better understanding of the dispersal of T. serrulatus in urban areas, aiming at the control and prevention of risk of accidents for the population, focusing on the strategies of chemical control of this species.(AU)

Environmental infestation and rickettsial infection in ticks in an area endemic for Brazilian spotted fever.

Brazilian spotted fever (BSF), caused by Rickettsia rickettsii, is endemic in the municipality of Americana, southeastern Brazil, where the disease is transmitted by the tick Amblyomma cajennense. This study evaluated the tick fauna and rickettsial infection in free-living ticks that were captured monthly using dry ice traps in areas endemic for BSF in Americana, from July 2009 to June 2010. Two tick species were captured: A. cajennense (6,122 larvae; 4,265 nymphs; 2,355 adults) and Amblyomma dubitatum (7,814 larvae; 3,364 nymphs; 1,193 adults). The immature stages of A. cajennense and A. dubitatum had similar distribution through the 12-month period, with larvae of both species collected in highest numbers between April and July, and nymphs between June and October. The highest numbers of A. cajennense adults were collected between October and December, whereas A. dubitatum adults were collected in relatively similar numbers throughout the 12-month period. Rickettsial infection was evaluated by means of PCR in 1,157 A. cajennense and 1,040 A. dubitatum ticks; only 41 (3.9%) A. dubitatum were found to be infected by Rickettsia bellii. The present study showed that the areas of Americana that are endemic for BSF are characterized by high environmental burdens of A. cajennense and A. dubitatum.

Environmental infestation and rickettsial infection in ticks in an area endemic for brazilian spotted fever / Infestação ambiental e infecção por rickéttsias em carrapatos de área endêmica para Febre Maculosa Brasileira

Brazilian spotted fever (BSF), caused by Rickettsia rickettsii, is endemic in the municipality of Americana, southeastern Brazil, where the disease is transmitted by the tick Amblyomma cajennense. This study evaluated the tick fauna and rickettsial infection in free-living ticks that were captured monthly using dry ice traps in areas endemic for BSF in Americana, from July 2009 to June 2010. Two tick species were captured: A. cajennense (6,122 larvae; 4,265 nymphs; 2,355 adults) and Amblyomma dubitatum (7,814 larvae; 3,364 nymphs; 1,193 adults). The immature stages of A. cajennense and A. dubitatum had similar distribution through the 12-month period, with larvae of both species collected in highest numbers between April and July, and nymphs between June and October. The highest numbers of A. cajennense adults were collected between October and December, whereas A. dubitatum adults were collected in relatively similar numbers throughout the 12-month period. Rickettsial infection was evaluated by means of PCR in 1,157 A. cajennense and 1,040 A. dubitatum ticks; only 41 (3.9%) A. dubitatum were found to be infected by Rickettsia bellii. The present study showed that the areas of Americana that are endemic for BSF are characterized by high environmental burdens of A. cajennense and A. dubitatum.

A Febre Maculosa Brasileira (FMB) é uma antropozoonose endêmica no município de Americana/SP, causada pela bactéria Rickettsia rickettsii e transmitida pelo carrapato Amblyomma cajennense. Este estudo avaliou a fauna de carrapatos e a infecção por riquétsias em carrapatos de vida livre capturados mensalmente com armadilhas de CO2, em áreas de risco para FMB de Americana, de julho de 2009 a junho de 2010. Duas espécies foram capturadas, A. cajennense (6.122 larvas; 4.265 ninfas; 2.355 adultos) e Amblyomma dubitatum (7.814 larvas; 3.364 ninfas; 1.193 adultos). Os estágios imaturos de A. cajennense e A. dubitatum apresentaram uma distribuição anual semelhante, com larvas de ambas as espécies sendo coletadas em maior número no período de abril a julho e ninfas de junho a outubro. Maior número de adultos de A. cajennense foi coletado de outubro a dezembro, enquanto que os adultos de A. dubitatum foram coletados em número relativamente semelhante durante todo o ano. A infecção por Rickettsia foi avaliada pela PCR em 1157 carrapatos A. cajennense e 1040 A. dubitatum, com apenas 41 (3,9%) A. dubitatum infectados com Rickettsia bellii. Este estudo demonstrou que as áreas de risco para FMB de Americana são caracterizadas por elevadas infestações ambientais de A. cajennense e A. dubitatum.