Molecular survey of Piroplasmida, Hepatozoon spp. and Anaplasmataceae in anemic and thrombocytopenic dogs from Uruguay.

Canine tick-borne diseases, such as babesiosis, rangeliosis, hepatozoonosis, anaplasmosis and ehrlichiosis, are of veterinarian relevance, causing mild or severe clinical cases that can lead to the death of the dog. The aim of this study was detecting tick-borne protozoan and rickettsial infections in dogs with anemia and/or thrombocytopenia in Uruguay. A total of 803 domestic dogs were evaluated, and 10% were found positive (detected by PCR) at least for one hemoparasite. Sequence analysis confirmed the presence of four hemoprotozoan species: Rangelia vitalii, Babesia vogeli, Hepatozoon canis and Hepatozoon americanum, and the rickettsial Anaplasma platys. The most detected hemoparasite was R. vitalii, followed by H. canis and A. platys. This is the first report of B. vogeli in Uruguay and the second report of H. americanum in dogs from South America. The results highlight the importance for veterinarians to include hemoparasitic diseases in their differential diagnosis of agents causing anemia and thrombocytopenia.

Molecular screening of tick-borne microorganisms in ticks from rural areas of Panama, with the first record of Ehrlichia minasensis in Rhipicephalus microplus from Central America.

During a molecular screening of rickettsial, borrelial and protozoal agents in ticks from rural areas of Panama, we detected DNA of Rickettsia amblyommatis in four Amblyomma mixtum collected from horses in a locality in Los Santos province. Ehrlichia minasensis and Anaplasma marginale were identified from three and two Rhipicephalus microplus, respectively, collected on cows from Chiriqui province. No DNA from other tick-borne agents was found. These results increase the information of R. amblyommatis and A. marginale in Panama, and also mark the first record of E. minasensis in Central America.

Molecular pathways and nutrigenomic review of insulin resistance development in gestational diabetes mellitus.

Gestational diabetes mellitus is a condition marked by raised blood sugar levels and insulin resistance that usually occurs during the second or third trimester of pregnancy. According to the World Health Organization, hyperglycemia affects 16.9% of pregnancies worldwide. Dietary changes are the primarily alternative treatment for gestational diabetes mellitus. This paper aims to perform an exhaustive overview of the interaction between diet, gene expression, and the metabolic pathways related to insulin resistance. The intake of foods rich in carbohydrates can influence the gene expression of glycolysis, as well as foods rich in fat, can disrupt the beta-oxidation and ketogenesis pathways. Furthermore, vitamins and minerals are related to inflammatory processes regulated by the TLR4/NF-κB and one carbon metabolic pathways. We indicate that diet regulated gene expression of PPARα, NOS, CREB3L3, IRS, and CPT I, altering cellular physiological mechanisms and thus increasing or decreasing the risk of gestational diabetes. The alteration of gene expression can cause inflammation, inhibition of fatty acid transport, or on the contrary help in the modulation of ketogenesis, improve insulin sensitivity, attenuate the effects of glucotoxicity, and others. Therefore, it is critical to comprehend the metabolic changes of pregnant women with gestational diabetes mellitus, to determine nutrients that help in the prevention and treatment of insulin resistance and its long-term consequences.

Novel Anaplasma (Rickettsiales: Anaplasmataceae) strain and Hepatozoon sp. cf. H. procyonis (Apicomplexa, Hepatozoidae) detected in Procyon cancrivorus (Carnivora, Procyonidae) from Argentina, with note of tick-host association.

The aim of this work is to report the first detection of Procyon cancrivorus naturally co-infected with Hepatozoon sp. cf. H. procyonis and a novel Anaplasma strain from South America and potential vector tick species associated. On August 30, 2016, a specimen of P. cancrivorus was found dead on the route in Chaco province, Argentina. A tick and a blood sample by cardiac puncture was collected from the specimen. DNA was extracted from blood sample and the tick was morphological identity as a female of Amblyomma ovale. Molecular detection of Anaplasmataceae family and Hepatozoon spp. agents was performed targeting two different loci: 16 S rRNA and 18 S rRNA gene. The phylogenetic analyses show that the Anaplasma sp. strain detected in P. cancrivorus in this study is similar to Anaplasma sp. strains previously detected in Nasua nasua and A. ovale from Brazil. Furthermore, Hepatozoon sp. of the H. procyonis group was amplified that is phylogenetically closely related to H. procyonis reported in N. nasua from Brazil. Since it was not exactly the same as the latter, it was decided to name at Hepatozoon sp. cf. H. procyonis. It is possible that, this potential new species of Anaplasma would be specific for Procyonidae family and there are two species of Hepatozoon linked to this family in South America. These results added to other published studies suggest that A. ovale could be a potential vector both for the new potential strain of Anaplasma and for the Hepatazoon sp. of the H. procyonis group.

Vaccines for the common cold.

BACKGROUND: The common cold is a spontaneously remitting infection of the upper respiratory tract, characterised by a runny nose, nasal congestion, sneezing, cough, malaise, sore throat, and fever (usually < 37.8 ºC). Whilst the common cold is generally not harmful, it is a cause of economic burden due to school and work absenteeism. In the United States, economic loss due to the common cold is estimated at more than USD 40 billion per year, including an estimate of 70 million workdays missed by employees, 189 million school days missed by children, and 126 million workdays missed by parents caring for children with a cold. Additionally, data from Europe show that the total cost per episode may be up to EUR 1102. There is also a large expenditure due to inappropriate antimicrobial prescription. Vaccine development for the common cold has been difficult due to antigenic variability of the common cold viruses; even bacteria can act as infective agents. Uncertainty remains regarding the efficacy and safety of interventions for preventing the common cold in healthy people, thus we performed an update of this Cochrane Review, which was first published in 2011 and updated in 2013 and 2017. OBJECTIVES: To assess the clinical effectiveness and safety of vaccines for preventing the common cold in healthy people. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (April 2022), MEDLINE (1948 to April 2022), Embase (1974 to April 2022), CINAHL (1981 to April 2022), and LILACS (1982 to April 2022). We also searched three trials registers for ongoing studies, and four websites for additional trials (April 2022). We did not impose any language or date restrictions. SELECTION CRITERIA: Randomised controlled trials (RCTs) of any virus vaccine compared with placebo to prevent the common cold in healthy people. DATA COLLECTION AND ANALYSIS: We used Cochrane's Screen4Me workflow to assess the initial search results. Four review authors independently performed title and abstract screening to identify potentially relevant studies. We retrieved the full-text articles for those studies deemed potentially relevant, and the review authors independently screened the full-text reports for inclusion in the review, recording reasons for exclusion of the excluded studies. Any disagreements were resolved by discussion or by consulting a third review author when needed. Two review authors independently collected data on a data extraction form, resolving any disagreements by consensus or by involving a third review author. We double-checked data transferred into Review Manager 5 software. Three review authors independently assessed risk of bias using RoB 1 tool as outlined in the Cochrane Handbook for Systematic Reviews of Interventions. We carried out statistical analysis using Review Manager 5. We did not conduct a meta-analysis, and we did not assess publication bias. We used GRADEpro GDT software to assess the certainty of the evidence and to create a summary of findings table.  MAIN RESULTS: We did not identify any new RCTs for inclusion in this update. This review includes one RCT conducted in 1965 with an overall high risk of bias. The RCT included 2307 healthy young men in a military facility, all of whom were included in the analyses, and compared the effect of three adenovirus vaccines (live, inactivated type 4, and inactivated type 4 and 7) against a placebo (injection of physiological saline or gelatin capsule). There were 13 (1.14%) events in 1139 participants in the vaccine group, and 14 (1.19%) events in 1168 participants in the placebo group. Overall, we do not know if there is a difference between the adenovirus vaccine and placebo in reducing the incidence of the common cold (risk ratio 0.95, 95% confidence interval 0.45 to 2.02; very low-certainty evidence). Furthermore, no difference in adverse events when comparing live vaccine preparation with placebo was reported. We downgraded the certainty of the evidence to very low due to unclear risk of bias, indirectness because the population of this study was only young men, and imprecision because confidence intervals were wide and the number of events was low. The included study did not assess vaccine-related or all-cause mortality.  AUTHORS' CONCLUSIONS: This Cochrane Review was based on one study with very low-certainty evidence, which showed that there may be no difference between the adenovirus vaccine and placebo in reducing the incidence of the common cold. We identified a need for well-designed, adequately powered RCTs to investigate vaccines for the common cold in healthy people. Future trials on interventions for preventing the common cold should assess a variety of virus vaccines for this condition, and should measure such outcomes as common cold incidence, vaccine safety, and mortality (all-cause and related to the vaccine).

An Hepatozoon americanum-like protozoan in crab-eating (Cerdocyon thous) and grey pampean (Lycalopex gymnocercus) foxes from Uruguay.

In South America, apicomplexan parasites of the genus Hepatozoon have been sporadically detected in mammals. Previous studies in wild canids from Brazil and Argentina demonstrated infections by species genetically related to Hepatozoon americanum. The aim of the present work was to detect the presence of Hepatozoon in road-killed foxes encountered in Uruguayan highways. Blood samples from 45 crab-eating (Cerdocyon thous) and 32 grey pampean (Lycalopex gymnocercus) foxes were analyzed by PCR for Hepatozoon 18S rRNA gene. Eight foxes (10.4%) were found to be infected with an H. americanum-like protozoan, an Hepatozoon closely related to H. americanum. Bayesian and maximum-likelihood phylogenetic analyses revealed that the sequences obtained in this study cluster with H. americanum from the United States, and with an H. americanum-like species from dog and foxes from Brazil and Argentina. In the Unites States, H. americanum causes severe disease in dogs. In addition to this, an increasing habitat overlap between dogs and foxes makes the presence of H. americanum-like protozoan in foxes acquires veterinary relevance. This work represents the first report of L. gymnocercus infected with an H. americanum-like protozoan, and of wild canids infected with Hepatozoon in Uruguay.

Ixodes tropicalis (Acari: Ixodidae) infesting a human and molecular detection of Rickettsia bellii, Colombia. / Infestación de Ixodes tropicalis (Acari: Ixodidae) en un humano y detección molecular de Rickettsia bellii, Colombia

INTRODUCTION: Ixodes tropicalis is a little-known tick species reported parasitizing wild rodents only in Colombia and Perú. OBJECTIVE: To report a case of I. tropicalis infesting a human in the south of the metropolitan area of the Valle de Aburrá, Antioquia, Colombia, and to report the molecular detection of Rickettsia bellii in this species. MATERIALS AND METHODS: The tick was identified using a morphological key and sequencing of tick mitochondrial 16S rRNA. Additionally, bacterial and protozoa pathogens were evaluated using PCR for the detection of Rickettsia spp., family Anaplasmataceae, Borrelia spp., and piroplasmid. RESULTS: We identified the tick as an I. tropicalis female according to Kohls, 1956, description and to partial 16S rRNA sequences showing a minimum of 5% divergencies compared to Ixodes sequences. We also detected the gltA gene of R. bellii in the tick with 99.87% of identity. CONCLUSION: This is the first report in Colombia of a species of the Ixodes genus parasitizing a human and the first report of the detection of R. bellii in this tick species.

Introducción. Ixodes tropicalis es una especie de garrapata poco conocida que se había reportado parasitando únicamente roedores silvestres en Colombia y Perú. Objetivo. Reportar un caso de infestación por I. tropicalis en un ser humano del sur del área metropolitana del Valle de Aburrá (Antioquia) y reportar la detección molecular de Rickettsia bellii en esta especie. Materiales y métodos. La garrapata se identificó usando claves morfológicas y mediante la secuenciación de su gen 16S ARNr mitocondrial. Además, se evaluó la presencia de agentes patógenos bacterianos y protozoos usando PCR para la detección de Rickettsia spp., la familia Anaplasmataceae, Borrelia spp. y piroplásmidos. Resultados. La garrapata se identificó como una hembra de I. tropicalis, según la descripción de Kohls, 1956, y la secuencia parcial del gen 16S ARNr, la cual mostró una divergencia de mínimo 5 % en la comparación con las secuencias de Ixodes. Además, se detectó el gen gltA de R. bellii en esta garrapata con una similitud del 99,87 %. Conclusión. Este es el primer reporte en Colombia de una especie del género Ixodes parasitando a un humano y el primer reporte de la detección de R. bellii en esta especie de garrapata.

Rangelia vitalii in free-living crab-eating foxes (Cerdocyon thous) in Uruguay.

Rangelia vitalii is a protozoan parasite that causes a hemorrhagic and hemolytic disease in dogs known as rangeliosis. Current reports of the disease are concentrated in the southern and southeastern regions of Brazil, as well as in Uruguay, Argentina, and Paraguay, and mainly concern domestic dogs. South American wild canids, such as the crab-eating fox (Cerdocyon thous), the pampas fox (Lycalopex gymnocercus), and the maned wolf (Chrysocyon brachyurus) may also be affected, although existing reports are restricted to Brazil. The present study aimed to detect R. vitalii parasitism in the Uruguayan wild fox population. DNA extracted from the blood and/or spleen samples of road-killed C. thous and L. gymnocercus found in northern Uruguay were subjected to polymerase chain reaction (PCR) to amplify a 551-bp fragment of the Rangelia 18S rRNA gene. A total of 62 wild canids, including 38 C. thous and 24L. gymnocercus, were analyzed. Five crab-eating fox samples (13.2%) were positive for R. vitalii, with 99.5-100% identity between the sequences. All samples from pampas fox tested negative for R. vitalii. When compared with the R. vitalii sequences available in GenBank, a similarity of 98.9-100% was revealed. Molecular analysis results suggest that R. vitalii is circulating in the crab-eating fox population in Uruguay; however, its veterinary relevance for these foxes remains unknown.

Molecular characterization of novel Ehrlichia genotypes in Ixodes auritulus from Uruguay.

Ehrlichia are small intracellular Gram-negative bacteria transmitted by ticks. These microorganisms cause ehrlichiosis, a complex of life-threatening emerging zoonoses and diseases of global veterinary relevance. The aim of this study was to investigate the presence of Ehrlichia in free-living Ixodes auritulus collected in Uruguay. Ticks were collected from vegetation in five localities from the southeast and northeast of the country between 2014 and 2017. Detection of Ehrlichia DNA was performed in pools of adults or nymphs grouped according to the collection site and date. A total of 1,548 I. auritulus ticks were collected in four of the five locations sampled. Fragments of three loci (16S rRNA, dsb and groEL) were obtained by PCR, and phylogenies inferred using Bayesian inference analysis for each gene independently. DNA of Ehrlichia spp. was found in 15 out of 42 tick pools. Based on the topology of the phylogenetic trees, our sequences represent two novel genotypes for the genus named as Ehrlichia sp. Serrana and Ehrlichia sp. Laguna Negra. Both genotypes were closely related to Ehrlichia sp. Magellanica, a species detected in Ixodes uriae and Magellanic penguins. Considering that all stages of I. auritulus and I. uriae are parasites of birds, their phylogenetic relationships, and common eco-epidemiological profiles, it is reasonable to state that these genotypes of Ehrlichia spp. may represent a natural group likely associated with birds. Our results constitute the first characterization of Ehrlichia spp. in Uruguay. Future studies on birds reported as hosts for I. auritulus are needed to further understand the epidemiological cycles of both Ehrlichia genotypes in the country. Finally, I. auritulus does not feed on humans, so the two Ehrlichia species reported herein might have no implications in human health.

Molecular screening for tick-borne bacteria and hematozoa in Ixodes cf. boliviensis and Ixodes tapirus (Ixodida: Ixodidae) from western highlands of Panama.

The first molecular screening for Rickettsia, Anaplasma, Ehrlichia, Borrelia, Babesia and Hepatozoon was carried out in questing Ixodes cf. boliviensis and Ixodes tapirus from Talamanca Mountains, Panama, using specific primers, sequencing and phylogeny. Phylogenetic analyses for the microorganisms in Ixodes cf. boliviensis confirmed the presence of Rickettsia sp. strain IbR/CRC endosymbiont (26/27 ticks), three genotypes of the Borrelia burgdorferi (sensu lato) complex (4/27 ticks), Babesia odocoilei (1/27 ticks), and Hepatozoon sp. (2/27 ticks), tentatively designated Hepatozoon sp. strain Chiriquensis. Phylogenetic analyses for the microorganisms in I. tapirus revealed an undescribed Rickettsia sp., tentatively designated Rickettsia sp. strain Itapirus LQ (6/6 ticks), and Anaplasma phagocytophilum (2/6 ticks). To the best of our knowledge, this is the first report of B. burgdorferi (s.l.) complex, A. phagocytophilum, B. odocoilei, and Hepatozoon sp. in Ixodes ticks from Central America, and also the first detection of Rickettsia spp. in Ixodes species in Panama. In light of the importance of these findings, further studies are needed focusing on the role of I. tapirus and I. cf. boliviensis as vectors, and the vertebrates acting as reservoirs.

Detection of a putative novel genotype of Anaplasma in gray-brocket deer (Mazama gouazoubira) from Uruguay.

Anaplasmataceae includes the genera Anaplasma, Ehrlichia, Neorickettsia and Wolbachia, comprising a group of obligate intracellular bacteria. The genus Anaplasma has pathogenic species transmitted by ticks of veterinary and human health importance. Wild ungulates such as deer represent important reservoirs and amplifiers of Anaplasmataceae. The interaction between deer and domestic ruminants represents a serious problem due to the transmission of these pathogens through their ectoparasites. In the present study, we investigated the presence of Anaplasmataceae organisms in blood, tissues and tick samples of a gray-brocket deer (Mazama gouazoubira). The specimen was found dead in a farm in northeast Uruguay. PCRs targeting partial regions of 16S rRNA and groESL genes were carried out for Anaplasmataceae DNA detection. Moreover, several ectoparasites were identified: the chewing louse Tricholipeurus albimarginatus, the Neotropical deer louse fly Lipoptena mazamae, and the ticks Haemaphysalis juxtakochi and Rhipicephalus microplus. A consensus sequence of 1274 bp of 16S rRNA was generated for Anaplasma sp. from the M. gouazoubira blood sample. All ticks analysed by PCR assays were negative. No band was detected in any of the samples after PCR targeting groESL gene. Phylogenetic analysis using 16S rRNA partial gene sequences, clustered the putative novel genotype sequence obtained in this study, named Anaplasma sp. genotype Mazama-Uruguay, along with Anaplasma sp. detected in Mazama sp., Mazama americana and Mazama bororo, all deer species from Brazil. Furthermore, this cluster showed to be closely related to Anaplasma bovis sequences obtained from various ruminants and other mammals from several parts of the world. The pathogenicity as well as its infecting potential to other cervids or domestic ruminants is currently unknown. Further studies should be performed in order to characterize this novel species, especially targeting other genes.

A novel Ehrlichia strain (Rickettsiales: Anaplasmataceae) detected in Amblyomma triste (Acari: Ixodidae), a tick species of public health importance in the Southern Cone of America.

The aim of this work was to report the detection of a putative novel Ehrlichia strain associated with the tick Amblyomma triste. Free-living adult ticks determined as A. triste were collected by drag-sampling in Argentina and Uruguay. Molecular detection of Ehrlichia agents was performed targeting three different loci: 16S rRNA gene, dsb gene and a fragment of groESL heat shock operon. In total, 164 adults of A. triste (38 from INTA E.E.A Delta del Paraná in Argentina and 126 from Toledo Chico in Uruguay) were analyzed. One tick (0.6%) collected in INTA E.E.A. Delta del Paraná (Argentina) was positive. The phylogenetic analyses show that the Ehrlichia strain found in this study (named Ehrlichia sp. strain Delta) represents an independent lineage within the genus Ehrlichia, close to E. chaffeensis and E. muris. This is also the first report of an Ehrlichia agent infecting the tick A. triste. The medical and veterinary significance of Ehrlichia sp. strain Delta remains to be demonstrated. However, it is important to mention that adults of A. triste are aggressive to humans and domestic mammals. Therefore, the potential role of A. triste in the transmission of Ehrlichia agents to humans or domestic animals across its distributional range should be highlighted, even more considering that Ehrlichia sp. strain Delta is phylogenetically related to the zoonotic E. chaffeensis, which is recognized as pathogenic to both humans and animals.

First detection of "Candidatus Rickettsia wissemanii" in Ornithodoros hasei (Schulze, 1935) (Acari: Argasidae) from Argentina.

The aim of this study was to assess the presence of Rickettsia in soft ticks (Acari: Argasidae) collected from insectivorous bats (Chiroptera) in Santa Fe province, Argentina. First, a subset of ticks were mounted in Hoyer's medium to be determined by morphological characters and then confirmed by sequencing the mitochondrial 16S rRNA gene. Also ticks were processed by PCR assays using primers CS-78 and CS-323, which amplify a fragment of the Rickettsia spp. gltA gene. Positive ticks were subjected to a second PCR round with primers Rr190.70p and Rr190.701n of the spotted fever group rickettsiae ompA gene. A phylogenetic analysis was performed with Maximum-likelihood method, and the best fitting substitution models were determined with the Akaike Information Criterion. Five bats of the species Eptesicus diminutus Osgood, 1915, Eptesicus furinalis (d'Orbigny and Gervais, 1847), Eptesicus spp. (Vespertilionidae), and Molossops temminckii Burmeister, 1854 (Molossidae) were parasitized with Ornithodoros hasei (Schulze, 1935) larvae. One E. diminutus ticks' tested positive to "Candidatus Rickettsia wissemanii", a spotted fever group rickettsiae. The association O. hasei -"Ca. R. wissemanii" detected in this study represents the first evidence of a Rickettsia in Ornithodoros ticks in Argentina and the third report of this association in America. Also, this finding constitutes the first record of "Ca. R. wissemanii" in Argentina. Finally, we found for the first time the insectivorous bats E. diminutus and E. furinalis parasitized with O. hasei larvae. These findings add two new hosts and a new location, the southernmost recorded to date, for O. hasei.

Referencias de peso, estatura e índice de masa corporal para niñas y niños ecuatorianos de 5 a 19 años de edad / Growth references for weight, height, and body mass index for Ecuadorian children and adolescents aged 5-19 years

Introducción. La evaluación del crecimiento durante la infancia y la adolescencia es un componente fundamental de la atención de salud en todos sus niveles, pues es parte del diagnóstico nutricional y permite la detección oportuna de patologías relacionadas. Ecuador, al no disponer de referencias nacionales de crecimiento, ha adoptado los estándares internacionales de la Organización Mundial de la Salud. El objetivo de este estudio fue construir referencias nacionales de peso, estatura e índice de masa corporal para niños, niñas y adolescentes.Métodos. Se investigaron escolares y adolescentes ecuatorianos entre 5 y 19 años de edad durante 1999 y 2012. Los centilos 3, 10, 25, 50, 75, 90 y 97 de peso, talla e índice de masa corporal fueron estimados por el método LMS para datos transversales, que utiliza la transformación Box-Cox para normalizar la distribución de los datos a cada edad.Resultados. Participaron 5934 sujetos sanos (2788 niños y 3146 niñas). Los niños pesaban más y eran más altos que las niñas. En todos los casos, los valores mostraron un aumento creciente conforme la edad avanzaba. A los 18 años, las diferencias entre sexos promediaron 8 kg y 12,5 cm.Conclusión. Las tablas y curvas producto de este estudio constituyen la primera referencia descriptiva del crecimiento de niños ecuatorianos de 5-19 años. Son un importante instrumento de evaluación nutricional. Su implementación en la atención primaria de salud permitirá complementar el diagnóstico nutricional que, tradicionalmente, se realiza sobre la base de los estándares internacionales de la Organización Mundial de la Salud.

Introduction. The assessment of growth during childhood and adolescence is a critical component of health care at all levels, but it is also part of nutritional status diagnosis and the timely detection of related conditions. Ecuador lacks national growth references, so it has decided to adopt the international standards proposed by the World Health Organization. The objective of this study was to develop national references for weight, height, and body mass index for children and adolescents.Methods. Ecuadorian schoolchildren and adolescents aged 5-19 years were studied between 1999 and 2012. The LMS method for cross-sectional data, which uses the Box-Cox transformation to normalize data distribution at each age, was applied to estimate the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th centiles for weight, height, and body mass index.Results. A total of 5934 healthy subjects (2788 boys and 3146 girls) participated. Boys were heavier and taller than girls. In all cases, values increased with age. At 18 years old, the differences between sexes averaged 8 kg and 12.5 cm.Conclusion. The tables and curves obtained with this study are the first descriptive growth references for Ecuadorian children and adolescents aged 5-19 years. They are relevant for nutritional assessment. Their use at the primary level of care will aid in nutritional status diagnosis, which has traditionally been done based on the World Health Organization's international standards.

Growth references for weight, height, and body mass index for Ecuadorian children and adolescents aged 5-19 years. / Referencias de peso, estatura e índice de masa corporal para niñas y niños ecuatorianos de 5 a 19 años de edad.

INTRODUCTION: The assessment of growth during childhood and adolescence is a critical component of health care at all levels, but it is also part of nutritional status diagnosis and the timely detection of related conditions. Ecuador lacks national growth references, so it has decided to adopt the international standards proposed by the World Health Organization. The objective of this study was to develop national references for weight, height, and body mass index for children and adolescents. METHODS: Ecuadorian schoolchildren and adolescents aged 5-19 years were studied between 1999 and 2012. The LMS method for cross-sectional data, which uses the Box-Cox transformation to normalize data distribution at each age, was applied to estimate the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th centiles for weight, height, and body mass index. RESULTS: A total of 5934 healthy subjects (2788 boys and 3146 girls) participated. Boys were heavier and taller than girls. In all cases, values increased with age. At 18 years old, the differences between sexes averaged 8 kg and 12.5 cm. CONCLUSION: The tables and curves obtained with this study are the first descriptive growth references for Ecuadorian children and adolescents aged 5-19 years. They are relevant for nutritional assessment. Their use at the primary level of care will aid in nutritional status diagnosis, which has traditionally been done based on the World Health Organization's international standards.

Introducción. La evaluación del crecimiento durante la infancia y la adolescencia es un componente fundamental de la atención de salud en todos sus niveles, pues es parte del diagnóstico nutricional y permite la detección oportuna de patologías relacionadas. Ecuador, al no disponer de referencias nacionales de crecimiento, ha adoptado los estándares internacionales de la Organización Mundial de la Salud. El objetivo de este estudio fue construir referencias nacionales de peso, estatura e índice de masa corporal para niños, niñas y adolescentes. Métodos. Se investigaron escolares y adolescentes ecuatorianos entre 5 y 19 años de edad durante 1999 y 2012. Los centilos 3, 10, 25, 50, 75, 90 y 97 de peso, talla e índice de masa corporal fueron estimados por el método LMS para datos transversales, que utiliza la transformación Box- Cox para normalizar la distribución de los datos a cada edad. Resultados. Participaron 5934 sujetos sanos (2788 niños y 3146 niñas). Los niños pesaban más y eran más altos que las niñas. En todos los casos, los valores mostraron un aumento creciente conforme la edad avanzaba. A los 18 años, las diferencias entre sexos promediaron 8 kg y 12,5 cm. Conclusión. Las tablas y curvas producto de este estudio constituyen la primera referencia descriptiva del crecimiento de niños ecuatorianos de 5-19 años. Son un importante instrumento de evaluación nutricional. Su implementación en la atención primaria de salud permitirá complementar el diagnóstico nutricional que, tradicionalmente, se realiza sobre la base de los estándares internacionales de la Organización Mundial de la Salud.

Phylogenetic analysis of Hepatozoon spp. (Apicomplexa: Hepatozoidae) infecting Philodryas patagoniensis (Serpentes: Dipsadidae) in Uruguay.

The purpose of this study was to perform a phylogenetic analysis of Hepatozoon spp. infecting Philodryas patagoniensis in Uruguay. Twenty-five road-killed specimens of P. patagoniensis from ten departments were obtained. Samples of blood and/or heart tissue were taken. Polymerase chain reaction (PCR) assay was carried out amplifying a specific target region of the 18S rRNA gene of Hepatozoon spp. Eighteen out of twenty-five samples were positive to Hepatozoon spp., which gave an overall prevalence of 72%. Phylogenetic analyses with the obtained sequences were carried out to determine the relationship with closely related species found in the region. The results revealed that samples were split into two clades with a high bootstrap support. Clade I was formed with Hepatozoon spp. sequences obtained in this study from P. patagoniensis, Hepatozoon cuestensis from Crotalus durissus terrificus and Hepatozoon musa from Philodryas nattereri, and Hepatozoon spp. retrieved from Cerdocyon thous, Hemidactylus mabouia, and Phyllopezus pollicaris from Brazil, respectively. Clade II was grouped with Hepatozoon cevapii and Hepatozoon massardii, both species described for C. d. terrificus from Brazil. This is the first report of Hepatozoon spp. in snakes from Uruguay.

Borrelia burgdorferi sensu lato infecting Ixodes auritulus ticks in Uruguay.

In the southern cone of South America different haplotypes of Borrelia burgdorferi sensu lato (Bbsl) have been detected in Ixodes spp. from Argentina, southern Brazil, Chile, and Uruguay. So far, Lyme borreliosis has not been diagnosed in Uruguay and the medical relevance of the genus Ixodes in South America is uncertain. However, the growing number of new genospecies of Bbsl in the southern cone region and the scarce information about its pathogenicity, reservoirs and vectors, highlights the importance of further studies about spirochetes present in Uruguay and the region. The aim of this study was to determine the presence of Bbsl in Ixodes auritulus ticks collected from birds and vegetation in two localities of southeastern Uruguay. In total 306 I. auritulus were collected from 392 passerine birds sampled and 1110 ticks were collected by flagging in vegetation. Nymphs and females were analyzed for Borrelia spp. by PCR targeting the flagellin (fla) gene and the rrfA-rrlB intergenic spacer region (IGS). The phylogenetic analysis of Borrelia spp. positive samples from passerine birds and vegetation revealed the presence of four fla haplotypes that form a clade within the Bbsl complex. They were closely related to isolates of Borrelia sp. detected in I. auritulus from Argentina and Canada.

An autochthonous confirmed case of Rickettsia parkeri rickettsiosis in Uruguay.

Rickettsia parkeri, a member of the spotted fever group (SFG) rickettsiae, was first confirmed as an etiological agent of human rickettsiosis in 2004. Nearly all cases are characterized by an inoculation eschar, and no fatalities have been reported. In Uruguay, probable human cases of R. parkeri infection (confused initially with R. conorii infection) have been described since 1990 using the clinical name "cutaneous-ganglionar" rickettsiosis. This is the only tick-borne rickettsiosis reported in the country. A single case of R. parkeri rickettsiosis has been confirmed by molecular and serological testing in a Spanish traveler returning from Uruguay. We report the first autochthonous human R. parkeri infection, confirmed by molecular testing in Uruguay.

Molecular evidence of Babesia species in Procyon cancrivorus (Carnivora, Procyonidae) in Uruguay.

The crab-eating raccoon (Procyon cancrivorus) is a carnivore widely distributed from southern Central America to all South American countries except Chile. In the Southern cone of America, P. cancrivorus has been found parasitized by several Amblyomma spp. Particularly, in Uruguay, A. aureolatum is the only tick found in this wild carnivore. Piroplasmid hemoparasites were found in Procyon lotor from North America and Japan. In this work, molecular evidence Babesia sp. DNA was found in blood and tissues from road-killed P. cancrivorus from different locations in Uruguay. PCRs targeting 18S rRNA gene were carried out. Subsequently, the obtained amplicons were sequenced and full-length sequences was assembled. A phylogenetic tree was constructed and revealed that the Babesia sp. found in this work clustered with other 18sRNA sequences of Babesia spp. obtained from P. lotor from Japan and USA, along with Babesia spp. of maned wolf and I. ovatus. This is the first report of molecular evidence of Babesia sp. parasitizing P. cancrivorus.

Vaccines for the common cold.

BACKGROUND: The common cold is a spontaneously remitting infection of the upper respiratory tract, characterised by a runny nose, nasal congestion, sneezing, cough, malaise, sore throat, and fever (usually < 37.8º C). The widespread morbidity caused by the common cold worldwide is related to its ubiquitousness rather than its severity. The development of vaccines for the common cold has been difficult because of antigenic variability of the common cold virus and the indistinguishable multiple other viruses and even bacteria acting as infective agents. There is uncertainty regarding the efficacy and safety of interventions for preventing the common cold in healthy people. This is an update of a Cochrane review first published in 2011 and previously updated in 2013. OBJECTIVES: To assess the clinical effectiveness and safety of vaccines for preventing the common cold in healthy people. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (September 2016), MEDLINE (1948 to September 2016), Embase (1974 to September 2016), CINAHL (1981 to September 2016), and LILACS (1982 to September 2016). We also searched three trials registers for ongoing studies and four websites for additional trials (February 2017). We included no language or date restrictions. SELECTION CRITERIA: Randomised controlled trials (RCTs) of any virus vaccines compared with placebo to prevent the common cold in healthy people. DATA COLLECTION AND ANALYSIS: Two review authors independently evaluated methodological quality and extracted trial data. We resolved disagreements by discussion or by consulting a third review author. MAIN RESULTS: We found no additional RCTs for inclusion in this update. This review includes one RCT dating from the 1960s with an overall high risk of bias. The RCT included 2307 healthy participants, all of whom were included in analyses. This trial compared the effect of an adenovirus vaccine against placebo. No statistically significant difference in common cold incidence was found: there were 13 (1.14%) events in 1139 participants in the vaccines group and 14 (1.19%) events in 1168 participants in the placebo group (risk ratio 0.95, 95% confidence interval 0.45 to 2.02; P = 0.90). No adverse events related to the live vaccine were reported. The quality of the evidence was low due to limitations in methodological quality and a wide 95% confidence interval. AUTHORS' CONCLUSIONS: This Cochrane Review was based on one study with low-quality evidence. We found no conclusive results to support the use of vaccines for preventing the common cold in healthy people compared with placebo. We identified a need for well-designed, adequately powered RCTs to investigate vaccines for the common cold in healthy people. Any future trials on medical treatments for preventing the common cold should assess a variety of virus vaccines for this condition. Outcome measures should include common cold incidence, vaccine safety, and mortality related to the vaccine.