Two different begomovirus species are associated with yellow vein mosaic disease of okra in Sri Lanka.

Yellow vein mosaic disease is the major biotic constraint of okra cultivation in Sri Lanka. Identification and detailed molecular characterization of associated pathogen is needed for effective disease management. The genome of the begomovirus and betasatellite were amplified in symptomatic plant samples using specific degenerate primers. DNA-A genome of twelve isolates representing different locations in Sri Lanka were cloned, sequenced and deposited in GenBank database (Accession No- KX698087- KX698092 and MH455207- MH455212). Size of the complete nucleotide sequences ranged from 2735 to 2786 bp. The genome organization showed characteristics of begomoviruses. The pairwise sequence identity revealed the association of two different begomovirus species. Five of the isolates showed > 91% of sequences identity with Bhendi yellow vein mosaic virus, and the rest of the seven isolates were around 92% of identity with Okra enation leaf curl virus. This is further supported by phylogenetic analysis where both of these group of isolates were in different cluster. Recombination analysis showed the presence of recombinant fragments in the virus isolates associated with okra yellow vein mosaic disease (OYVMD) in Sri Lanka. Attempts to amplify DNA- B were failed in any of the samples tested. However, both type of the begomovirus species associated with betasatellite species, Bhendi yellow vein mosaic betasatellite. The present study has revealed the association of two distinct monopartite begomovirus species, Bhendi yellow vein mosaic virus or Okra enation leaf curl virus, with OYVMD in Sri Lanka.

Initial renal histology and early response predict outcomes of Brazilian lupus nephritis patients.

OBJECTIVE: We analyzed baseline and follow-up characteristics related to poorer renal outcomes in a Brazilian cohort of admixture race patients with lupus nephritis. METHODS: Overall, 280 outpatients with a diagnosis of systemic lupus erythematosus and previous kidney biopsy of lupus nephritis were recruited from August 2015 to December 2018 and had baseline laboratory and histologic data retrospectively analyzed; patients were then followed-up and data were recorded. The main outcome measure was the estimated glomerular filtration rate at last follow-up. Secondary analyses assessed the impact of initial kidney histology and treatment in long-term kidney survival. RESULTS: Median duration of lupus nephritis was 60 months (interquartile range: 27-120); 40 (14.3%) patients presented progressive chronic kidney disease (estimated glomerular filtration rate <30 and ≥10 ml/min/1.73 m2) or end-stage kidney disease at last visit. Adjusted logistic regression analysis showed that class IV lupus nephritis (odds ratio 14.91; 95% confidence interval 1.77-125.99; p = 0.01) and interstitial fibrosis ≥25% at initial biopsy (odds ratio 5.87; 95% confidence interval 1.32-26.16; p = 0.02), lack of complete or partial response at 12 months (odds ratio 16.3; 95% confidence interval 3.74-71.43; p < 0.001), and a second renal flare (odds ratio 4.49; 95% confidence interval 1.10-18.44; p = 0.04) were predictors of progressive chronic kidney disease. In a Kaplan-Meier survival curve we found that class IV lupus nephritis and interstitial fibrosis ≥25% were significantly associated with end-stage kidney disease throughout follow-up (hazard ratio 2.96; 95% confidence interval 1.3-7.0; p = 0.036 and hazard ratio 4.96; 95% confidence interval 1.9-12.9; p < 0.0001, respectively). CONCLUSION: In this large cohort of admixture race patients, class IV lupus nephritis and chronic interstitial damage at initial renal biopsy together with non-response after 1 year of therapy and relapse were associated with worse long-term renal outcomes.

Biofilm contamination of high-touched surfaces in intensive care units: epidemiology and potential impacts.

The aim of this study was to determine the epidemiology (location, microbial load, microbiome, presence/absence of biofilm and pathogens, including ESKAPE-Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species, and antimicrobial susceptibility profiles) of the bacterial contamination on intensive care units (ICUs) surfaces. Fifty-seven high-touched surfaces were collected from adult, paediatric and neonatal ICUs from two large public Brazilian hospitals from central and north regions. Samples (c. 4 cm2 ) were subjected to culture (qualitative), qPCR targeting 16s rRNA gene (microbial load-bacteria per cm2 ), 16s rRNA amplicon sequencing (microbiome analysis) and scanning electron (SEM) or confocal laser scanning microscopy (CLSM) (biofilm presence). Multidrug resistant organisms (MROs) were detected using specific chromogenic agar. The average bacterial load was 1·32 × 104 bacteria per cm2 , container for newborn feeding bottles, stretcher mattress, humidicrib mattress filling and computer keyboards presented the higher bioburden. However, only 45·6% (26/57) were culture-positive, including 4/26 with MROs. ESKAPE organisms were detected in 51·8% of the samples subjected to next-generation sequencing. Viability staining and CLSM demonstrated live bacteria on 76·7% of culture-negative samples. Biofilm was present on all surfaces subjected to microscopy (n = 56), demonstrating that current cleaning practices are suboptimal and reinforcing that MROs are incorporated into hospital surfaces biofilm. SIGNIFICANCE AND IMPACT OF THE STUDY: Contamination of healthcare facilities surfaces has been shown to play a major role in transmission of pathogens. The findings of this study show that dry surface biofilms are widespread and can incorporate pathogens and multidrug-resistant organisms (MROs). Biofilms on highly touched surfaces pose a risk to patients, as dry surface biofilms persist for long period and micro-organisms within biofilm have been shown to be transmitted. This study also provides a better understanding of microbial populations in hospital environments, reinforcing that pathogens and MROs are found incorporated into biofilm, which impacts the difficulty in cleaning/disinfection.

Complex design of surgical instruments as barrier for cleaning effectiveness, favouring biofilm formation.

BACKGROUND: Inadequately reprocessed reusable surgical instruments (RSIs) may harbour infectious agents which may then be transferred to a suitable site for replication. AIM: To determine the cumulative effect of 20 cycles of contamination, cleaning (manual or manual followed by automated) and steam sterilization on high-complex-design RSIs used for orthopaedic surgery. METHODS: New flexible medullary reamers and depth gauges were contaminated by soaking in tryptone soya broth, containing 5% sheep blood and 109 cfu/mL of Staphylococcus aureus (ATCC 25923), for 5 min. To mimic a worse-case scenario, RSIs were dried 7 h and subjected to either (a) rinsing in distilled water, (b) manual cleaning or (c) manual plus automated cleaning (reference standard), and steam sterilization. The contamination, cleaning, and sterilization cycle was repeated 20 times. Adenosine triphosphate (ATP) was measured after cleaning procedures; microbial load and residual protein were measured following the 10th and 20th reprocessing, in triplicate. Scanning electron microscopy (SEM) was used to confirm soil and biofilm presence on the RSIs after the 20th reprocessing. FINDINGS: Manual and manual plus automated cleaning significantly reduced the amount of ATP and protein residues for all RSIs. Viable bacteria were not detected following sterilization. However, SEM detected soil after automated cleaning, and soil, including biofilms, after manual cleaning. CONCLUSION: Soil and/or biofilms were evident on complex-design RSIs following 20 cycles of contamination and reprocessing, even using the reference standard method of cleaning. Although the depth gauges could be disassembled, biological residues and biofilm accumulated in its lumen. The current design of these RSIs prevents removal of all biological soil and this may have an adverse effect on patient outcome.

Effects of condensed tannin from Acacia mearnsii on sheep infected naturally with gastrointestinal helminthes.

The effect of tannins on endoparasite control in hair sheep was investigated using 20 entire lambs of the Santa Inês breed. At the beginning of the experiment these animals were 6-months old and weighed 22.5kg+/-4.7. The treatments used were (10 animals each): GT (animals receiving 18g of Acácia negra containing 18% of condensed tannin/animal/week) and GC (animals not receiving tannin). The experiment lasted 84 days, with animals kept on an Andropogon gayanus pasture. Faeces were collected weekly, with weighing and blood collection carried out fortnightly. At slaughter, the adult worms were harvested for identification and counting. Although the GT animals weighed more than the GC lambs at slaughter, these differences were not significant (P>0.05). In general, the values for haemoglobin, hematocrit, total protein, urea, phosphorus and calcium in the serum were within normal levels and no significant differences between groups were observed. For faecal egg count (FEC), lower values were observed throughout the experiment in the group receiving tannin, but these differences were only significant in the eighth week. There was a lower output of eggs by regression for GT compared with GC (P<0.05). The species identified, in decreasing order of worm count, were: Trichostrongylus colubriformis, Haemonchus contortus, Oesophagostomum columbianum, Cooperia sp., Strongyloides papillosus, Trichuris globulosa and Moniezia expansa. The total worm count and number of each species of worm were lower for GT compared with GC for T. colubriformis and Cooperia sp. (P<0.05). Condensed tannin (CT) from A. negra had an antiparasitic effect, thereby representing an alternative for worm control in sheep.

Effect of hand hygiene and glove use on cleanliness of reusable surgical instruments.

BACKGROUND: During functionality testing and packaging of reusable surgical instruments (RSI) for sterilization, instruments are frequently touched. There is a lack of standards relating to hand hygiene frequency and use of gloves in the sterilizing service unit packing area. AIM: To determine the effect of hand hygiene and glove use on maintenance of RSI cleanliness. METHODS: Following manual and automated cleaning, Halsted-mosquito forceps were assessed for adenosine triphosphate (ATP), protein and microbial contamination after handling with gloved and ungloved but washed hands using an ATP surface swab test, bicinchoninic acid assay, and standard culture plate/broth, respectively. Gram's stain was used to classify the isolates. RSI contamination was assessed immediately following and 1, 2, and 4 h after washing hands. FINDINGS: Packing instruments with hands that had been unwashed for 2 or 4 h resulted in a significant increase in contaminating ATP when compared with all other treatment groups (P < 0.05). There was a significant correlation between the time since washing hands, the amount of ATP (r = 0.93; P ≤ 0.001), and the microbial load (r = 0.83; P ≤ 0.001) contaminating the forceps, where the longer the time the hands remained unwashed the higher the contamination. Significantly more contaminating protein was found on forceps handled with ungloved hands that had not been washed for 2 or 4 h (P < 0.001). CONCLUSION: Critical RSI inspection, assembling, lubricating and packing should be performed using either gloves or within 1 h of washing hands.

Changes in electrovestibular brainstem responses after aminoglycoside intoxication in guinea pigs.

OBJECTIVE: To verify the usefulness of short-latency vestibular responses evoked by a combination of round window electrical stimulation and sinusoidal rotation (electrovestibular brainstem responses; EVBRs) as a new monitoring tool of the vestibular function in animal experiments. METHODS: EVBRs were obtained before, during, and after treatment with aminoglycosides, along with compound action potential (CAP) audiograms. The changes in EVBRs were compared with morphological changes observed by scanning electron microscopy. RESULTS: EVBR amplitudes did not change in the group of guinea pigs treated with amikacin, but markedly decreased in the streptomycin and gentamicin- treated groups. CAP audiograms indicated a significant threshold elevation in the amikacin group, a moderate elevation in the gentamicin group, and no change in the streptomycin group. Under scanning electron microscopy, the loss of the sensory hair cells observed in the cristae ampullares was slight to moderate in the amikacin group, moderate to severe in the streptomycin group, and severe in the gentamicin group. CONCLUSION: EVBRs reflect overall pathological changes undergone by vestibular hair cells, and support the vestibular specificity of EVBRs.

Genome analysis of Agrobacterium tumefaciens: linkage map and genetic features of the left region of the linear chromosome.

In addition to a unique tumor-inducing (Ti) plasmid, the plant pathogenic bacterium Agrobacterium tumefaciens has an unconventional chromosomal organization. Our previous studies on A. tumefaciens MAFF301001 revealed that it possesses a 2 Mb linear and a 2.8 Mb circular chromosome plus a 206.479 kbp Ti plasmid (pTi-SAKURA). In this study, a linkage map for the left half of its linear chromosome covering a 900 kbp region was constructed and the number of potential genes existing in the region was estimated. The linkage map consists of 31 BAC and 8 lambda phage recombinants without any gaps. It confirmed the size and all the structural landmarks indicated in the corresponding region of our previously constructed physical map for the linear chromosome. Sequencing analysis of the end-regions of each linking clone led to the identification of 6 genes and another 27 potential genes or ORFs, including genes and/or gene clusters responsible for homologous recombination (ruvB), trehalose/maltose sugar transport (thuR, thuG) and alanine catabolism (dadR). Two virulence-related gene homologues (attK and celB), previously reported in the circular chromosome of a different strain of A. tumefaciens were found in this region. These findings will provide a ready-to-use linkage map for further functional analysis of the linear chromosome.

[Expectoration of cerebrospinal fluid: an unusual complication of ventriculoperitoneal shunt]. / Expectoraçao de líquido cefalorraqueano: rara complicaçao de derivaçao ventriculoperitoneal.

A child, who had undergone ventriculoperitoneal shunting, presented with repeated episodes of pneumonia and expectoration of CSF. Chest x-ray demonstrated the presence of the shunt catheter in the base of the left lung. In the present case the distal end of the catheter perforated the diaphragm, entering the thoracic cavity through the pleura and penetrating the pulmonary parenchyma. CSF then flowed freely into the alveoli and bronchi and became expectorated during repeated bouts of coughing associated with pneumonia. This respiratory complication disappeared after the removal of the catheter. We theorize that the penetration of the catheter into the thoracic cavity was secondary to its displacement from the iliac fossa to the left infradiaphragmatic space between the spleen and the diaphragm where the intra-abdominal pressure is lowest. The respiratory movements and the hypertension inside the abdomen created a constant friction of the catheter against the diaphragm which was finally perforated, permitting the passage of the peritoneal end of the shunting device into the thoracic cavity and secondary penetration of the lung.

Surgical experience with juvenile nasopharyngeal angiofibroma.

A retrospective analysis was made of 24 cases of nasopharyngeal angiofibroma treated by the ENT Department of the Hospital de Clínicas de Porto Alegre between 1975 and 1989. All the patients were male with an average age of 16. All were treated by surgery alone, with an average peri-operative blood loss of 1,784 ml; pre-operative embolization made no significant difference to the blood loss. No other operative complications were encountered. Five patients (21%) had a recurrence, one of which was intracranial and required further surgery to effect a cure. The average length of follow-up was 19 months. We believe that surgical excision must be the treatment of choice for nasopharyngeal angiofibroma.

Structure of the testate amoebae community in different habitats in a neotropical floodplain.

This study evaluated the differences in composition, abundance and morphology of testate amoebae among different habitats of the same aquatic environment (plankton, aquatic macrophyte and sediment) in the Upper Paraná River floodplain. Triplicate samplings were undertaken monthly at each habitat from April 2007 to March 2008. The structure of the community of testate amoebae was different among the habitats. The species typical for each habitat, according to Indval, were classified by their shell morphology. Arcella species together with Difflugia gramen and Difflugia pseudogramem were more abundant for plankton. Trinema and Phryganella stood out by their abundance and frequency in aquatic macrophytes. Centropyxis was an indicator of sediment. The results indicated a higher frequency of hemispherical and spherical shells in plankton and spherical and elongated shells in aquatic macrophytes. In the sediment, there was a high frequency of elongated species. Our results support the hypothesis that the community of testate amoebae has different structures among the habitats, refuting the idea that the organization of this community in plankton is guided by random events like the resuspension of organisms from the sediment and their displacement from marginal vegetation.

Eficácia dos colírios ciclosporina e tacrolimo no tratamento de ceratoconjuntivite seca em cães / Efficacy of cyclosporine and tacrolimus drops in the treatment of keratoconjunctivitis sicca in dogs

O objetivo deste estudo foi avaliar os efeitos do tacrolimo e da ciclosporina na produção lacrimal de cães com ceratoconjuntivite seca (CCS) durante 90 dias. Para tanto, foram utilizados colírios de tacrolimo 0,02% (TcL) e ciclosporina 0,1% (CsA) em 14 cães com CCS. Os animais foram distribuídos em dois grupos e avaliados antes do início do tratamento (T0) e aos 15 (T1), 30 (T2), 45 (T3), 60 (T4), 75 (T5) e 90 (T6) dias após o início do tratamento. Na avaliação clínica, observou-se maior redução da secreção ocular, da opacidade e do edema corneano e da vascularização conjuntival. no grupo tacrolimo. No teste de Schirmer, verificou-se produção basal de 6(4,07 e 5,86(2,85mm/min no TcL e CsA, respectivamente, com aumento significativo da produção lacrimal em ambos os grupos, contudo houve aumento significativo da produção lacrimal a partir dos 15 dias de tratamento no grupo TcL (17,88(5,51mm/min), mas apenas a partir dos 45 dias no grupo CsA (11,86(4,74mm/min). Conclui-se que o uso do colírio tacrolimo aumentou em 68,83% a produção lacrimal em 90 dias de tratamento, comparado com a ciclosporina (56,82%), além de diminuir as manifestações clínicas inerentes à CCS, quando comparado à terapia com ciclosporina.(AU)

The objective of this study was to evaluate the effects of tacrolimus and cyclosporine on the lacrimal production of dogs with ketaroconjunctivitis sicca (KCS) for 90 days. Tacrolimus 0.02% (TcL) and 0.1% cyclosporine (CsA) eye drops were used in 14 dogs with KCS. The animals were randomly assigned to two groups and evaluated before treatment (T0) and at 15 (T1), 30 (T2), 45 (T3), 60 (T4), 75 (T5) and 90 (T6) days after initiation of treatment. Clinical evaluation showed significant reduction of ocular secretion, corneal opacity and edema and conjunctival vascularization in the tacrolimus group. Schirmer test showed basal lacrimal production of 6(4.07 and 5.86(2.85mm/min for TcL and CsA, respectively, with significant increase in lacrimal production in both groups. There was a significant increase in lacrimal production after 15 days of treatment in the TcL group (17.88(5.51mm/min), but only after 45 days in the CsA group (11.86(4.74mm/min). Tacrolimus drops increased lacrimal production in 68.83% after 90 days of treatment, compared to cyclosporine (56.82%), and also reduced clinical manifestations related to KCS when compared to cyclosporine.(AU)

Toward structural and functional genomics of Agrobacterium tumefaciens: linkage map of the left region of linear chromosome.

Genome of A. tumefaciens contains a linear and a circular chromosome. As an initial step of elucidating the structural and functional genomics of this bacterium, linkage map of the left region of its linear chromosome was constructed. Total genomic libraries of A. tumefaciens MAFF301001 were constructed in BAC vectors namely, pFOS1 and pBeloBAC11. Upon construction of sub-libraries, minimum overlapping clones needed to cover the left region was determined. So far, four contigs have been assembled with a total of 19 overlapping clones. Detailed EcoRI physical map of contig III was constructed and it covers a 110 kb region of the Pme5 fragment of the linear chromosome. Seven end regions of the linking clones were partially sequenced but no gene existence was determined due to low homology.

[Venomous animal accidents in childhood] / Acidentes por animais peçonhentos na infância.

OBJECTIVE: To highlight the importance of venomous animal accidents in childhood. The conducts are based on the proposals of the Ministério da Saúde do Brasil [Ministry of Health of Brazil] to standardize medical care in this kind of accident. This article shows the importance of early clinical diagnosis and assistance.METHODS: Review of international and national literature that includes original articles, official standards and books.RESULTS: Pediatricians may always feel insecure when they have to attend children who had venomous animal accidents because this kind of pathology is not very common. This article tries to offer easy guidelines and describes the main steps to be followed. Besides, peculiar or unusual aspects of these accidents are to be found in the literature referred to in the end of this article. Venomous animal accidents are always more severe in children, therefore resulting in higher mortality and sequelae. We assert that the early antivenom sera is extremely helpful.CONCLUSIONS: The systematization of the assistance may guarantee that the essential steps are followed thus making the assistance itself more effective. This is the purpose of the guidelines presented in this article.