Vertical transmission and pathological findings in the mother, the placenta and the offspring, during first and last thirds of gestation in a mouse model of congenital toxoplasmosis.

We performed a study of congenital toxoplasmosis of the first and third gestation periods in mice, and determined its effects on the embryos/fetuses, the placentae and the maternal organs. We infected pregnant BALB/c mice by i.v. injection of 2.5--10.0 × 106 tachyzoites of the ME49 T. gondii strain and euthanized them 72 h later. The tissues were analyzed by histopathology, immunohistochemistry and parasite-specific qPCR. Infections with the lowest dose induced remarkably different changes in the two thirds: a) all doses diminished the number of products/litter, the lowest dose only by 14%; but most embryos still visible were degenerated in the case of the first period, while the fetuses of the last third were perfectly preserved; b) the transmission rate in the first third was relatively high, but with a very low parasite burden; c) with the lowest dose, strong vascular changes (congestion, thrombosis and hemorrhage) predominated in the placentas of the first period, while they were absent in the last third; d) necrosis caused by T. gondii to maternal organs was much stronger during the last gestation period than in the first. Our results suggest that the vascular alterations at the placenta of the first third of pregnancy prevent embryo from large parasite burden, but provoke its death by starvation. In the last gestation period, there was poor control of parasite dissemination to the placenta and the fetus, but there was greater capacity of the product to defend itself from T. gondii.

Early childhood caries, salivary and microbiological aspects among 3- to 4-year-old children in Cali, Colombia.

AIM: To investigate the presence of early childhood caries (ECC) in relation to plaque index, colony-forming units of Streptococcus mutans (S. mutans) and Lactobacillus spp., pH and salivary buffer capacity in day-care pre-schooler's aged 3-4 years old in Cali, Colombia, 2016. METHODS: Caries prevalence was determined in 124 children using the International Caries Detection and Assessment System and plaque index. In addition, a non-stimulated saliva sample was obtained to determine its pH, and buffer capacity. RESULTS: 55.65% of the children had ECC. The mean decayed-missing-filled teeth index was 2.94 ± 4.26. The absence or presence of ECC, compared to the median plaque index showed statistically significant differences (p < 0.05). There was not an association between ECC and S. mutans, Lactobacillus spp. colonies, pH and buffer capacity of saliva. CONCLUSIONS: This study reported association between ECC and the increasing amount of bacterial plaque. Other important biological risk factors were not associated with ECC. Regular tooth cleaning can be the most important public health measure to control ECC in day-care children.

Effect of marine by-product meals on hen egg production parameters, yolk lipid composition and sensory quality.

The effect of including 5% marine by-product meals in feeds of laying hens on egg production, composition and sensory characteristics was tested. Marine by-product meals were prepared using two methods: (i) cooking (100°C/10 min) followed by drying (60°C/24 hr) or (ii) grinding followed by drying. The raw materials used for meal production were scallop or squid viscera, shrimp heads or whole mackerel. A total of 108 laying hens were allocated to nine diet treatments; one control diet (corn and soya bean based) and eight experimental diets, containing 95% of the control feed and 5% of the experimental meal for three weeks. Daily intake was higher in hens fed the dried mackerel and cooked shrimp meals. All the experimental treatments showed significantly higher concentration of n-3 HUFA in yolk reserves and phospholipids compared to the control (0.12-0.13 g per 100 g), especially those with scallop or squid prepared by both methods (0.53-0.95 g per 100 g). Scallop, squid and shrimp meal inclusion in the feed produced eggs with more astaxanthin (0.22 mg per 100 g) while this carotenoid was absent in the control and mackerel treatments. Visual evaluation of raw yolk colour increased with the inclusion of marine by-product meals with higher values in hens fed shrimp heads (13), followed by scallop viscera (11), squid viscera (9), and with similar values for mackerel and control (4). The taste, aroma, texture and colour of cooked eggs from different treatments were not statically different when evaluated by a panel of 60 untrained people. These results suggest that meals from marine by-products are a better alternative for improving egg yolk composition by increasing n-3 HUFA when compared to fishmeal as they also increase astaxanthin and yolk pigmentation without affecting egg sensory characteristics.

Is Toxoplasma gondii type related to clinical outcome in human congenital infection? Systematic and critical review.

In human congenital toxoplasmosis the effects of parasite burden and pregnancy time at infection on clinical outcome are well known, but there is controversy regarding the role of Toxoplasma gondii type. Through a systematic review of the literature, we aimed to discern if T. gondii type has a role on clinical outcome in human congenital toxoplasmosis. We built up a database of congenital toxoplasmosis from reports of cases, case series and screening-based cohorts, which had information about parasite type, gestation time at maternal infection and/or clinical outcome in the product. Then, we obtained frequencies for loci used to genotype geographical origin of cases and types found. Also, odds ratios were calculated for association between time of maternal infection or parasite type on outcome. Type II parasites were the most common in Europe, Asia and Africa, while in America there were mainly atypical strains. More newborns with clinical problems were born from mothers infected during the first half of gestation than from those acquiring the parasite after week 24, regardless of parasite genotype (92.9 vs. 16.1 %, OR = 67.9, CI95 25.4-181.6). Type I and atypical parasites were associated with clinical problems as opposed to types II and III, regardless of pregnancy period at infection (86.9 vs. 72.9 %, OR = 2.47, CI95 1.1-5.4). A significant and remarkable tendency of type I parasites to be present during early pregnancy was also observed (94.4 vs. 5.6 %, P < 0.009). In addition to parasite burden and period of gestation, T. gondii genotype seems involved in CT clinical outcome.

Mouse model of congenital infection with a non-virulent Toxoplasma gondii strain: Vertical transmission, "sterile" fetal damage, or both?

Congenital transmission of Toxoplasma gondii may occur if the mother gets infected for the first time while pregnant. The risk of mother-to-child transmission depends on the gestation trimester at infection, being lowest in the first and highest in the last. Conversely, fetal damage is frequent and more severe at the beginning of pregnancy. The objective of this study was to evaluate congenital transmission and pathological aspects in the placenta and the fetus using a mouse model of congenital infection of the second gestation third. Forty-five female BALB/c mice were infected intravenously with 2.5-10.0 × 10(6) tachyzoites of the ME49 strain at middle gestation. Samples of maternal spleen and fetal/placental units were taken 72 h later. We determined parasite load and vertical transmission by qPCR, as well as damage macroscopically and by histopathology. With the lowest dose, 18% of the fetuses were infected. Also, 40% of fetuses/litter were altered, while this value was 10% in the control group (P < 0.05). These results are similar to those described in humans in terms of vertical transmission and fetal damage during the second third of gestation. The maternal spleen had 10-1000 times more tachyzoites than the placenta, and the later retained 90-99% of the parasites that could reach the fetus. Nevertheless, we found resorptions, abortions or fetal tissue damage in the presence but also in the absence of parasites. Our data indicate a strong protective effect of maternal organs and the placenta against fetal infection, but extensive damage of the later may led to resorption or abortion without vertical transmission.

Diagnosis and treatment of primary lymphedema. Consensus document of the International Union of Phlebology (IUP)-2013.

Primary lymphedema can be managed effectively as a form of chronic lymphedema by a sequenced and targeted treatment and management program based around a combination of Decongestive Lymphatic Therapy (DLT) with compression therapy, when the latter is desired as an adjunct to DLT. Treatment in the maintenance phase should include compression garments, self-management, including self-massage, meticulous personal hygiene and skin care, in addition to lymphtransport-promoting excercises and activities, and, if desired, pneumatic compression therapy applied in the home. When conservative treatment fails, or gives sub-optimal outcomes, the management of primary lymphedema can be improved, where appropriate, with the proper addition of surgical interventions, either reconstructive or ablative. These two surgical therapies can be more effective when fully integrated with manual lymphatic drainage (MLD)-based DLT postoperatively. Compliance with a long-term commitment to MLD/DLT and particularly compression postoperatively is a critical factor in determining the success of any new treatment strategy involving either reconstructive or palliative surgery. The future of management of primary lymphedema has never been brighter with the new prospect of gene-and perhaps stem-cell oriented management.

Diagnosis and treatment of primary lymphedema. Consensus document of the International Union of Phlebology (IUP)-2009.

Primary lymphedema can be managed safely as one of the chronic lymphedemas by a proper combination of DLT with compression therapy. Treatment in the maintenance phase should include compression garments, self management including the compression therapy, self massage and meticulous personal hygiene and skin care in addition to lymph-transport promoting excercises. The management of primary lymphedema can be further improved with proper addition of surgical therapy either reconstructive or ablative. These two surgical therapies can be effective only when fully integrated with MLD-based DLT postoperatively. Compliance with a long-term commitment of DLT postoperatively is the most critical factor determining the success of any new treatment strategy with either reconstructive or palliative surgery. The future of management of primary lymphedema caused by truncular lymphatic malformation has never been brighter with the new prospect of gene-oriented management.

Primary lymphoedema and lymphatic malformation: are they the two sides of the same coin?

OBJECTIVES: To clear the confusion regarding the relationship between the 'primary lymphoedema' and (truncular) lymphatic malformation (LM); the latter is one of congenital vascular malformations. MATERIALS & METHODS: A literature review was carried out on the primary lymphoedema either existing as an independent LM lesion or as a component of the Klippel-Trenaunay syndrome. RESULTS: The review was able to provide a contemporary guide/conclusion on the definition and classification, clinical evaluation and clinical management regarding conservative (physical) therapy, reconstructive surgical therapy and ablative/excisional surgical therapy, for the primary lymphoedema as an LM. CONCLUSIONS: Primary lymphoedema can be considered as 'congenital' since its majority represents a clinical manifestation of the truncular type of LM arising during the later stages of lymphangiogenesis. Such embryological staging information of the LM is critical for proper management of the primary lymphoedema when it exists with other congenital vascular malformations (Klippel-Trenaunay syndrome). 2. Basic non-invasive to minimally invasive tests will provide an adequate diagnosis and lead to the correct multidisciplinary, specifically targeted and sequenced treatment strategy. 3. The mainstay of current management of the primary lymphoedema/truncular LM is complex decongestive therapy; and the reconstructive as well as ablative surgical therapy remain adjunctive therapies at best.

Extension model of lactation curves to evaluate the effect of the recombinant bovine somatotropin on milk yield in Holstein cows / Modelo de extensão de curvas de lactação para avaliar o efeito da somatotropina bovina recombinante sobre a produção de leite em vacas Holstein

An extension model of lactation curves was used to determine the effect of recombinant bovine somatotropin (bST-r) on milk yield in Holstein dairy cattle. This model use the fitted values obtained by the Wood model, and was tested on the records of 66 cows. The milk yield predicted with the extension model and the observed yield were compared and no significant differences were observed (P>0.05). Once the extension model was validated, the milk yield tests of 199 cows were used. The cows received bST-r 500mg by subcutaneous injections. The injections were applied after 100 days in milk at 14-day intervals (seven injections). The observed milk yield was compared with the yield expected by the extension model. An increase of 5.3 percent was observed in milk yield in response to the bST-r. This increase is lower than that reported in the literature in response to the growth hormone in dairy cattle. It is concluded that extension model used in the present work is reliable for extending the lactation curve in Holstein cows, and the increase in milk yield in response to the application of bST-r, determined in the same animal using the extension model, was lower than that reported by other authors.

Um modelo de extensão de curvas de lactância foi utilizado para determinar o efeito da somatotropina bovina recombinante (bST-r) sobre a produção de leite em vacas Holstein. Este modelo, que utiliza os valores ajustados obtidos pelo modelo de Wood, foi testato nos registros de 66 vacas. A produção de leite predita com o modelo de extensão e a produção observada foram comparadas e não se observaram diferenças significativas (P>0,05). Uma vez validado o modelo de extensão, utilizaram-se os controles de produção de leite (de cada 15 dias) de 199 vacas. As vacas receberam injeções de 500mg de bST-r via subcutânea. As injeções fora aplicadas a partir dos 100 dias de lactação a intervalos de 14 dias (sete injeções). A produção de leite observada foi comparada com a produção esperada com o modelo de extensão. Observou-se um incremento de 5,3 por cento na produção de leite em resposta à bST-r. Este incremento foi menor que o relatado na literatura em resposta ao hormônio do crescimento em vacas leiteiras. O modelo de extensão usado é confiável para estender a curva de lactação na vaca Holstein, e o aumento do rendimento de leite em resposta à aplicação de bST-r, determinado no mesmo animal usando o modelo de extensão, foi inferior ao observado por outros autores.

Components of (co)variance of the days open in Siboney dairy cows / Componentes de (co)variância dos dias vazios em vacas leiteiras Siboney

The records of 63,406 calvings of Siboney dairy cows (5/8 Holstein 3/8 Cuban Zebu) were used to estimate the components of covariance of the days open (DO). Five models were used: of repeatability; univariate; bivariate; of random regression with Legendre polynomials and the parity number as predicting variable; and a model of random regression with Legendre polynomials and heterogeneity of the residual variance. The heritability obtained with the univariate model was 0.09 in the first calving and decreased to 0.05 in the fifth. A higher estimate of heritability (0.12) was obtained with the repeatability model. When the model of random regression with heterogeneity of the residual variance was used, the heritability was higher than the values estimated with the previous models. The genetic correlations among the DO in different calvings, estimated with the models of random regression with and without heterogeneity of the residual variance, were close to 1.0. It is concluded that the estimates of heritability increased with the use of the random regression models. The genetic correlations among the DO of different calvings indicated that in the first three, the DO are regulated for the most part by the same genes.

Os registros de 63.406 partos de vacas Siboney (5/8 Holstein 3/8 Cebu de Cuba) foram utilizados para estimar os componentes de (co)variância de dias vazios (DV). Utilizaram-se cinco modelos: de repetitividade; univariado; bivariado; de regressão aleatória com polinômios de Legendre e número de partos como variável preditiva; e de regressão aleatória com polinômios de Legendre e heterogeneidade da variância residual. A herdabilidade obtida com o modelo univariado foi de 0,09 no primeiro e diminuiu a 0,05 no quinto parto. Uma estimativa de herdabilidade mais alta (0,12) foi obtida com o modelo de repetitividade. Quando foi usado o modelo de regressão aleatória com heterogeneidade da variância residual a herdabilidade foi superior aos valores estimados com os modelos anteriores. As correlações genéticas entre os DV em distintos partos, estimadas com os modelos de regressão aleatória com e sem heterogeneidade da variância residual, foram próximos a 1,0. Concluiu-se que as estimativas de herdabilidade foram incrementadas com o uso dos modelos de regressão aleatória. As correlações genéticas entre os DV de diferentes partos indicaram que, nos três primeiros, os DV são regulados na sua maior proporção pelos mesmos genes.

Endovascular management of takayasu arteritis: is it a durable option?

Interim outcome of endovascular management of Takayasu arteritis (TA) was determined retrospectively to assess the efficacy of angioplasty and/or stenting in 24 patients with 35 lesions in the chronic inactive stage. The renal (n=16), subclavian/innominate (n=11), and carotid (n=5) arteries and abdominal aorta (n=3) were treated. Twenty-six lesions achieved excellent to good target lesion revascularization with no residual or only minimal residual stenosis, whereas five had a moderate result. Thirty lesions achieved satisfactory hemodynamic correction. Restenosis was observed in 8 lesions treated with angioplasty alone (n=18) and in 3 lesions treated with angioplasty and stenting (n=17). All recurrent stenoses underwent successful reintervention without significant complication. Treatment of inactive stage TA lesions with angioplasty alone or with angioplasty and stenting results in excellent to good clinical improvement in the majority of patients (follow-up at 46.8 months). Endovascular therapy is a durable treatment option in patients with chronic inactive stage TA.

The neuroimmunoendocrine network in the complex host-parasite relationship during murine cysticercosis.

We review here the role that sex steroids play in experimental intraperitoneal Taenia crassiceps cysticercosis of male and female BalbC/AnN mice. Briefly, estrogens favour and androgens hinder the reproduction of cysticerci by at least two main mechanisms: 1) through estradiol tilting the TH2/TH1 immune system balance towards parasite-permissive TH2 response,which is IL-6 dependent mediating P450-aromatase over expression, shunting testosterone towards estradiol and thus creating a positive feed-back loop which progressively favours TH2 response, blocking in turns TH1 and furthers parasite growth; and 2) estrogens and androgens acting directly upon the cysticercus reproductive system, favoring or hindering, respectively, its asexual reproduction. Later infection, when parasite loads are for milliars, male mice become estrogenized, deandrogenized and diminish their copulative, aggressive and social behaviors in association with P450-aromatase testis overexpression. Changes in c-fos expression in different areas of the infected mice brain point to the additional connection of the central nervous system with the infection driven events, which senses and perhaps reacts to infection with behavioral changes. This complex immune-neuro-endocrine network management of parasite loads in murine cysticercosis, and its physiological and behavioral consequences upon the host, may be operative in other infections of mammals. Such complexity may also help to explain the often conflicting results, observed between infections with respect to the role of the host sex, and hints to other avenues of research and strategies for their treatment and control.

Quality assurance, benchmarking, assessment and mutual international recognition of qualifications.

The aim of this report is to provide guidance to assist in the international convergence of quality assurance, benchmarking and assessment systems to improve dental education. Proposals are developed for mutual recognition of qualifications, to aid international movement and exchange of staff and students including and supporting developing countries. Quality assurance is the responsibility of all staff involved in dental education and involves three levels: internal, institutional and external. Benchmarking information provides a subject framework. Benchmarks are useful for a variety of purposes including design and validation of programmes, examination and review; they can also strengthen the accreditation process undertaken by professional and statutory bodies. Benchmark information can be used by institutions as part of their programme approval process, to set degree standards. The standards should be developed by the dental academic community through formal groups of experts. Assessment outcomes of student learning are a measure of the quality of the learning programme. The goal of an effective assessment strategy should be that it provides the starting point for students to adopt a positive approach to effective and competent practice, reflective and lifelong learning. All assessment methods should be evidence based or based upon research. Mutual recognition of professional qualifications means that qualifications gained in one country (the home country) are recognized in another country (the host country). It empowers movement of skilled workers, which can help resolve skills shortages within participating countries. These proposals are not intended to be either exhaustive or prescriptive; they are purely for guidance and derived from the identification of what is perceived to be 'best practice'.

Tamoxifen treatment induces protection in murine cysticercosis.

Administration of tamoxifen (an antiestrogen) produced an 80% parasite load reduction in female mice, and a weaker effect of 50% in male mice. This protective effect was associated in both sexes, with an increase in the mRNA levels of interleukin (IL)-2 (a cytokine associated with protection against cysticerci) and IL-4 (no effect on infection). tamoxifen treatment modified 17-beta estradiol production in females, whereas serum testosterone was not affected. However, the expression of the 2 types of estrogen receptor (ER), i.e., ER-alpha and ER-beta, in the spleen of infected mice of both sexes, was decreased by tamoxifen treatment. In vitro, treatment of Taenia crassiceps with tamoxifen reduced reproduction and loss of motility. These results indicate that tamoxifen treatment is a new therapeutic possibility to treat cysticercosis, because it can act at both ends of the host-parasite relationship, i.e., by increasing the cellular immune response protective against the parasite and by directly affecting the parasite's reproduction and survival.

Primary chronic venous disorders.

Primary chronic venous disorders, which according to the CEAP classification are those not associated with an identifiable mechanism of venous dysfunction, are among the most common in Western populations. Varicose veins without skin changes are present in about 20% of the population while active ulcers may be present in as many as 0.5%. Primary venous disorders are thought to arise from intrinsic structural and biochemical abnormalities of the vein wall. Advanced cases may be associated with skin changes and ulceration arising from extravasation of macromolecules and red blood cells leading to endothelial cell activation, leukocyte diapedesis, and altered tissue remodeling with intense collagen deposition. Laboratory evaluation of patients with primary venous disorders includes venous duplex ultrasonography performed in the upright position, occasionally supplemented with plethysmography and, when deep venous reconstruction is contemplated, ascending and descending venography. Primary venous disease is most often associated with truncal saphenous insufficiency. Although historically treated with stripping of the saphenous vein and interruption and removal of major tributary and perforating veins, a variety of endovenous techniques are now available to ablate the saphenous veins and have generally been demonstrated to be safe and less morbid than traditional procedures. Sclerotherapy also has an important role in the management of telangiectasias; primary, residual, or recurrent varicosities without connection to incompetent venous trunks; and congenital venous malformations. The introduction of ultrasound guided foam sclerotherapy has broadened potential indications to include treatment of the main saphenous trunks, varicose tributaries, and perforating veins. Surgical repair of incompetent deep venous valves has been reported to be an effective procedure in nonrandomized series, but appropriate case selection is critical to successful outcomes.