Carriage of pathogenic Leptospira in carnivores at the wild/domestic interface.

The carriage of pathogenic Leptospira was investigated by PCR in 51 wild carnivores, 20 domestic dogs with outdoor access, and 27 free-roaming domestic cats sampled in periurban Barcelona (NE Spain). Overall prevalence was 7.7%, with DNA confirmed in 3/30 common genets (Genetta genetta) (serovars Icterohaemorraghiae and Sejröe), 1/9 red foxes (Vulpes vulpes) (Canicola) and 2/27 cats (Icterohaemorraghiae). Though most of the dogs were vaccinated against Leptospira, DNA of the serovar Canicola was detected in the urine of 25% of the vaccinated animals, and the serovar Icterohaemorraghiae in one non-vaccinated dog.

Risk factors of Leptospira infection in Mediterranean periurban micromammals.

Urbanization of natural areas can change abiotic factors, providing artificial sources of humidity in summer and decreasing variation of temperatures in winter. Our study aimed at document risk factors of infection in mammal reservoirs of pathogenic Leptospira in the human/wildlife interface of a large metropolitan area. We hypothesize that survival of Leptospira and thus their prevalence in animal reservoirs should be higher in residential areas than in natural habitats, especially after the hot, dry Mediterranean summers. We established the prevalence of Leptospira spp. and identified the serovars in 353 urine samples from micromammals (chiefly the wood mouse Apodemus sylvaticus, n = 266) using direct immunofluorescence and PCR. Animals were captured in spring and autumn, 2011-2012, in two natural parks and two adjacent residential areas in periurban Barcelona (NE Spain). Overall observed prevalence of infection was 11%, ranking between 8% and 13% in the better represented host species. We observed marked differences between seasons; the probability of finding a micromammal infected in spring was three times greater than in autumn (almost four times for wood mouse). Prevalence was not related with type of habitat, micromammal relative abundance or sex of the animal. Three Leptospira species were confirmed: Leptospira interrogans (47% of cases), Leptospira borgpetersenii (41%) and Leptospira kirschneri (12%). The serovars most commonly detected were those typically hosted by rodents, and serovars Ballum and Icterohemorrhagiae were the only ones found in autumn. People living in periurban Barcelona and those visiting the natural areas of the metropolitan area face hazard of infection with rodent-borne Leptospira, especially during spring.

Serum tryptase concentrations in beekeepers with and without Hymenoptera venom allergy.

BACKGROUND: Increased tryptase concentrations are a risk marker for the severity of reactions to Hymenoptera stings or venom immunotherapy OBJECTIVE: To investigate serum tryptase concentrations in beekeepers with and without Hymenoptera venom allergy (HVA). METHODS: Serum tryptase concentrations were measured in adult patients with HVA (n = 91, 37 of whom were beekeepers), beekeepers without HVA (n = 152), and control individuals from the general adult population (n = 246). RESULTS: Multivariate analyses revealed that serum tryptase levels were positively associated with beekeeping activities (P < .001) and HVA (P < .001). Tryptase levels were also positively associated with age (P < .001) and male'sex (P = .02), and negatively associated with alcoho consumption (P = .002). CONCLUSIONS: Beekeeping and HVA are independently associated with increased concentrations of serum tryptase.

Rotura traqueal postintubación de instauración clínica tardía. Breve revisión etiopatológica y del tratamiento / Delayed iatrogenic tracheal post-intubation rupture: a short review of the aetiopathology and treatment

La rotura traqueal iatrogénica es una complicación rara con elevada morbimortalidad. La intubación orotraqueal es su principal causa y su origen multifactorial. El diagnóstico de sospecha se fundamenta en la aparición de signos y síntomas inespecíficos, aunque altamente sugestivos como enfisema subcutáneo, neumotórax, insuficiencia respiratoria o hemoptisis. El diagnóstico de confirmación exige la realización de una exploración mediante broncoscopia. La reparación quirúrgica ha sido tradicionalmente el tratamiento de elección, aunque la tendencia actual es el tratamiento conservador(AU)

Iatrogenic tracheal rupture is a rare complication with a high morbidity and mortality. Tracheal intubation is the main cause and its origin is multifactorial. The diagnosis is based on non-specific but highly suggestive signs and symptoms, such as subcutaneous emphysema, pneumothorax, respiratory distress, or haemoptysis. Confirmation of the diagnosis requires an examination by bronchoscopy. Surgical repair has traditionally been the treatment of choice although the current trend is conservative management(AU)

Serum Tryptase Concentrations in Beekeepers With and Without Hymenoptera Venom Allergy

Antecedentes: Los niveles séricos elevados de triptasa son un marcador de gravedad de las reacciones a las picaduras de himenópteros y de las reacciones a la inmunoterapia específica. Objetivo: Investigar los niveles séricos de triptasa en apicultores alérgicos y no alérgicos al veneno de himenópteros. Métodos: Se determinó la triptasa sérica en pacientes adultos con alergia al veneno de himenópteros (n=91, 37 de los cuales eran apicultores), apicultores sin alergia al veneno de himenópteros (n=152), y en controles de una población general adulta (n=246). Resultados: En los análisis multivariante, se observó que las concentraciones de triptasa sérica estaban positivamente asociadas con el hecho de ser apicultor (P<.001) y con el hecho de ser alérgico al veneno de himenópteros (P<.001). Los niveles de triptasa sérica también se asociaron positivamente con la edad (P<.001) y el sexo masculino (P=.02), y negativamente con el consumo de alcohol (P=.002). Conclusiones: La apicultura y la alergia al veneno de himenópteros se asocian independientemente con concentraciones elevadas de triptasa sérica (AU)

Background: Increased tryptase concentrations are a risk marker for the severity of reactions to Hymenoptera stings or venom immunotherapy. Objective: To investigate serum tryptase concentrations in beekeepers with and without Hymenoptera venom allergy (HVA). Methods: Serum tryptase concentrations were measured in adult patients with HVA (n=91, 37 of whom were beekeepers), beekeepers without HVA (n=152), and control individuals from the general adult population (n=246). Results: Multivariate analyses revealed that serum tryptase levels were positively associated with beekeeping activities (P<.001) and HVA (P<.001). Tryptase levels were also positively associated with age (P<.001) and male sex (P=.02), and negatively associated with alcohol consumption (P=.002). Conclusions: Beekeeping and HVA are independently associated with increased concentrations of serum tryptase (AU)

[Delayed iatrogenic tracheal post-intubation rupture. A short review of the aetiopathology and treatment]. / Rotura traqueal postintubación de instauración clínica tardía. Breve revisión etiopatológica y del tratamiento.

Iatrogenic tracheal rupture is a rare complication with a high morbidity and mortality. Tracheal intubation is the main cause and its origin is multifactorial. The diagnosis is based on non-specific but highly suggestive signs and symptoms, such as subcutaneous emphysema, pneumothorax, respiratory distress, or haemoptysis. Confirmation of the diagnosis requires an examination by bronchoscopy. Surgical repair has traditionally been the treatment of choice although the current trend is conservative management.

Determinants of serum tryptase in a general population: the relationship of serum tryptase to obesity and asthma.

BACKGROUND: Recent studies indicate that mast cells are more abundant in the obese state. Total serum tryptase (ST) is a marker of mast cell numbers or activity. Since obesity and asthma have been consistently linked in epidemiological studies, a possible higher mast cell activity in obesity could be a factor between the two conditions. The aim of this study was to investigate determinants of ST and whether a potential association between obesity and allergic respiratory disease would be influenced by levels of ST in obese persons. METHODS: Measurements of ST (ImmunoCAP Tryptase assay), atopy (skin prick test reactivity), methacholine bronchial hyperresponsiveness (BHR), body mass index (BMI) and serum lipids were performed in a general population of 1,216 persons aged 15-69 years. RESULTS: ST increased significantly with increasing BMI. The median ST level increased from 3.3 µg/l in persons with BMI <25 to 4.4 µg/l in persons with BMI >30, p < 0.0001. Age (p < 0.0001), male sex (p = 0.0009) and smoking (p = 0.022) were positively associated with ST, whereas alcohol consumption (p = 0.005) was inversely associated with ST. ST was not associated with atopy, symptoms of allergic respiratory disease or BHR. A positive association between symptoms of allergic respiratory disease and obesity (OR = 1.98, 95% CI = 1.25-3.14) was not influenced by obesity-related differences in ST. CONCLUSIONS: Increasing BMI was significantly associated with increasing ST and the prevalence of symptoms of allergic respiratory disease. However, mast cell activity/burden (assessed by ST levels) did not influence the association between BMI and asthma/rhinitis symptoms.

Use of a crude extract or purified antigen from first-instar cattle grubs, Hypoderma lineatum, for the detection of anti-Hypoderma antibodies in free-ranging cervids from southern Spain.

During the 2003-2005 hunting seasons, a total of 120 Cervidae, including 39 red deer (Cervus elaphus hispanicus) and 81 fallow deer (Dama dama), were examined for subcutaneous myiasis. Animals were shot from January to June in southern Spain. Specific antibodies against Hypodermatinae (Diptera: Oestridae) were detected by indirect enzyme-linked immunosorbent assay (iELISA) using a crude larval extract (CLE) and a purified antigen [hypodermin C (HC)] obtained from first instars of Hypoderma lineatum (De Villers) (Diptera: Oestridae). Hypoderma actaeon Brauer was the only species detected in this study, which represents the first confirmation of this species in fallow deer from Spain. The overall prevalence of animals presenting subcutaneous larvae (14.2%) was considerably lower than the prevalences determined by iELISA with CLE (43.3%) and HC (40.0%). Red deer showed a higher prevalence of Hypoderma than fallow deer. The concordance between larval examination during the hunting season and iELISA using both antigens was low, whereas the concordance between the CLE and HC ELISAs was good. Larval antigens obtained from H. lineatum constitute a good tool for the diagnosis of H. actaeon in Cervidae, especially when the hunting season does not coincide with the maximum presence of larvae on the back.

Improvement of renal function after conversion to mycophenolate mofetil combined with low-level calcineurin inhibitor in liver transplant recipients with chronic renal dysfunction.

INTRODUCTION: Calcineurin inhibitors (CNI) are the main pathogenic factors for renal dysfunction in solid organ transplant recipients. Introduction of non-nephrotoxic immunosuppressive drugs, such as mycophenolate mofetil (MMF), may allow discontinuation or reduction of CNI treatment, thereby improving renal function. The aim of this study was to assess the feasibility, efficacy and safety of MMF introduction and CNI dosage reduction in the maintenance immunosuppressive protocol to improve renal function in liver transplant recipients with chronic renal dysfunction. PATIENTS AND METHODS: We prospectively included 88 liver transplant recipients including 74 men and an overall mean age of 58.8 +/- 10.3 years who all displayed chronic renal dysfunction (creatinine >1.4 mg/dL) and proteinuria <1 g/d. They were subdivided into 3 groups according to the basal creatinine value 1.4-1.7 mg/dL (group I; n = 41); 1.8-2.0 mg/dL (group II; n = 28); and >2 mg/dL (group III; n = 19). MMF was initiated at 1.5-2.0 g/d. Reduction of tacrolimus or cyclosporine dosage was performed to achieve respective target trough levels of <5 ng/mL or <50 ng/mL. We performed periodic determinations of arterial pressure, liver function tests, serum creatinine, blood cells count, CNI levels, and proteinuria. RESULTS: Creatinine values after conversion were 1.4 +/- 0.5 mg/dL in the overall group. Improvement of renal function was more frequent among groups I (80.4%) and II (92.8%) versus III (73.6%). Normalization of creatinine values was more frequent in group I (68.2%) with respect to cohorts II (21.4%) and III (10.5%). Rejection was not detected. CONCLUSION: Application of an immunosuppressive protocol with MMF and low-level CNI in liver transplant recipients with chronic renal dysfunction was associated with improvement or normalization of creatinine, without an increased risk of rejection. Early conversion is needed to achieve the best results.

Double (honeybee and wasp) immunoglobulin E reactivity in patients allergic to Hymenoptera venom: the role of cross-reactive carbohydrates and alcohol consumption.

BACKGROUND: Immunoglobulin (Ig) E-mediated sensitization to N-glycans (cross-reactive carbohydrate determinants, CCDs) may induce double IgE reactivity to honeybee venom (HBV) and yellow jacket venom (YJV) in patients who are monosensitized to either of these venoms. Alcohol consumption is associated with increased IgE levels and possibly with sensitization to CCDs in the general population. OBJECTIVES: This study investigated the factors associated with double (HBV and YJV) IgE reactivity in patients who are allergic to Hymenoptera venom, and in particular, alcohol consumption. METHODS: Ninety-one patients with Hymenoptera allergy (68 to HBV, 19 to YJV, and 4 to both venoms) were studied. Determinations included a multiallergen IgE test and IgE to HBV, YJV, natural (glycosylated) HBV phospholipase-A2 (nPLA2), recombinant (nonglycosylated) HBV phospholipase-A2 (rPLA2), MUXF (the N-glycan from bromelain), natural (glycosylated) rubber latex, total IgE. Double reactivity was defined as an IgE level > 0.35 kU(A)/L to HBV and YJV. RESULTS: Double reactivity was observed in 28/87 (32%) clinically monosensitized patients. Double reactivity was associated with high levels of total IgE, MUXF-specific IgE, nPLA2-specific IgE, latex-specific IgE, and false-positive results in the multiallergen IgE test, but not with rPLA2-specific IgE. Alcohol consumption was associated with double reactivity and with high levels of IgE to glycosylated allergens after adjusting for confounders in the multivariate analysis. CONCLUSIONS: Sensitization to CCDs and clinically irrelevant double (honeybee and wasp) IgE reactivity are common among Hymenoptera venom-allergic patients who drink alcohol. A simple questionnaire about alcohol consumption could be useful when interpreting levels of specific IgE in these patients.

Immunoglobulin-E reactivity to a glycosylated food allergen (peanuts) due to interference with cross-reactive carbohydrate determinants in heavy drinkers.

BACKGROUND: N-glycans in plant and invertebrate glycoproteins can induce extensive IgE cross-reactivity therefore limiting the specificity of in vitro allergy tests. IgE sensitization to N-glycans (cross-reactive carbohydrate determinants, CCDs) may be increased in heavy drinkers, who therefore show IgE reactivity to aeroallergens, latex, and Hymenoptera venoms. The peanut, a CCD-bearing allergen, is the leading cause of severe food allergic reactions in many populations. AIM OF THE STUDY: To investigate the potential interference of CCDs with determinations of IgE to peanuts in heavy drinkers. METHODS: We determined IgE to peanuts and IgE to a CCD marker (MUXF(3), the N-glycan from bromelain) in 41 heavy drinkers admitted to the hospital and 54 healthy controls. None of the participants reported symptoms of peanut allergy. In cases with positive (>or=0.35 kU/l) IgE to peanuts, we performed inhibition assays with a neoglycoprotein consisting of MUXF(3) molecules coupled to bovine serum albumin (MUXF(3)-BSA) and a similar neoglycoprotein lacking xylose and fucose (MM-BSA). In the same cases, we screened for IgE to a panel of recombinant nonglycosylated peanut allergens. SDS-PAGE immunoblotting and inhibition assays were performed in selected cases. RESULTS: The prevalence of positive IgE to peanuts was 22 and 3.7% in heavy drinkers and healthy controls, respectively (p < 0.001). Peanut-IgE positivity was closely related to the presence of IgE to CCDs. In most (8/9) heavy drinkers with positive IgE to peanuts, reactivity was inhibited by preincubation with MUXF(3)-BSA, but not with MM-BSA. IgE binding to multiple bands on immunoblotting studies was also inhibited by MUXF(3)-BSA preincubation. IgE to nonglycosylated recombinant peanut allergens was uniformly negative. CONCLUSION: Heavy drinking is associated with clinically asymptomatic IgE reactivity to peanuts, a relevant food allergen, in relation to CCD interference.

Epidemiology of Mycoplasma agalactiae infection in free-ranging Spanish ibex (Capra pyrenaica) in Andalusia, southern Spain.

Mycoplasma agalactiae is the main causal agent of contagious agalactia syndrome in Spain. It is a severe disease of small ruminants, endemic in Mediterranean countries, that is characterized by mastitis, arthritis, and keratoconjunctivitis. This paper investigates the temporal, spatial, and host-related factors in the distribution of M. agalactiae infection from October 1996 to November 1998 and March 2002 to May 2003 in Spanish ibex (Capra pyrenaica) populations from Andalusia, in southern Spain. The predisposing factors to infection among previously selected factors (year of sampling, climatic season, geographic origin according to province, mountain range and metapopulation, sex, year of life, presence of scabies, and phase of the reproductive cycle) were established. We collected conjunctival and ear-canal swabs from 411 free-ranging ibexes. The frequency of infected ibexes was 11.2%. The peak frequency of infection occurred in 1998 and in summer. Granada was the province with greatest risk (odds ratio = 2.6) of carriers (18.8% infected). The predisposing factors were sex (females), age (young animals), and metapopulation (Sierra Nevada). We identified a higher number of infected ibexes in the metapopulation "Sierra Nevada" (34/ 256) and significant differences among the three established metapopulations (P<0.01). Mycoplasma agalactiae infection represents a risk for population density and maintenance of these wild populations; infections can result in blindness, malnutrition, and polyarthritis leading to numerous deaths.

[Antineutrophil cytoplasmic antibodies in nonvasculitis diseases: clinical correlates and target antigens]. / Anticuerpos anticitoplasma de neutrófilo en enfermedades distintas a las vasculitis idiopáticas: correlaciones clínicas y especificidades antigénicas.

The value of antineutrophil cytoplasmic antibodies (ANCA) in the diagnosis of several types of idiopathic vasculitis has been well-documented: In these diseases the ANCA show two classical immunofluorescence patterns, C-ANCA and P-ANCA, which have antigen specificity for the myeloperoxidase and proteinase 3, respectively. However, the appearance of ANCA in very different diseases other than the mentioned vasculitis, has been documented in recent years. In these diseases, the ANCA generally have atypical immunofluorescence patterns and are directed against neutrophil antigens that are different from the previous two, their clinical value still being under debate.

Anticuerpos anticitoplasma de neutrófilo en enfermedades distintas a las vasculitis idiopáticas: correlaciones clínicas y especificidades antigénicas / Antineutrophil cytoplasmic antibodies in nonvasculitis diseases: clinical correlates and target antigens

Es bien conocido el valor de los anticuerpos anticitoplasma de neutrófilo (ANCA) en el diagnóstico de varios tipos de vasculitis idiopáticas. En estas enfermedades estos autoanticuerpos muestran dos patrones clásicos de inmunofluorescencia, C-ANCA y P-ANCA, que poseen, respectivamente, especificidad antigénica por la proteinasa 3 y la mieloperoxidasa. Sin embargo, en los últimos años se ha documentado la aparición de ANCA en muy diversas patologías distintas a las mencionadas vasculitis. En estas enfermedades los ANCA suelen mostrar patrones atípicos por inmunofluorescencia e ir dirigidos a antígenos neutrofílicos distintos de los dos anteriores, estando su valor clínico aún sujeto a debate (AU)

The value of antineutrophil cytoplasmic antibodies (ANCA) in the diagnosis of several types of idiopathic vasculitis has been well-documented: In these diseases the ANCA show two classical immunofluorescence patterns, C-ANCA and P-ANCA, which have antigen specificity for the myeloperoxidase and proteinase 3, respectively. However, the appearance of ANCA in very different diseases other than the mentioned vasculitis, has been documented in recent years. In these diseases, the ANCA generally have atypical immunofluorescence patterns and are directed against neutrophil antigens that are different from the previous two, their clinical value still being under debate (AU)

Antibodies to Mycobacterium bovis in wild carnivores from Doñana National Park (Spain).

We conducted a retrospective serologic survey for antibodies against the MPB70 protein of Mycobacterium bovis in wild carnivores from Doñana National Park (southwestern Spain). Serum samples from 118 red foxes (Vulpes vulpes), 39 Iberian lynx (Lynx pardinus), 31 Eurasian badgers (Meles meles), five Egyptian mongoose (Herpestes ichneumon), four European genet (Genetta genetta), and one Eurasian otter (Lutra lutra) were analyzed using an indirect competitive enzyme-linked immunoassay. Antibodies against the MPB70 protein of M. bovis were detected in seven badgers, five foxes, and one lynx. The frequency of positive animals was significantly higher in badger (23%) than in lynx (3%) and fox (4%). Antibodies were not detected in other species. Annual antibody frequency peaked at 38% in badgers and 11% for red fox. These species may contribute to persistence of bovine tuberculosis in Doñana.

Bovine tuberculosis in a free ranging red fox (Vulpes vulpes) from Doñana National Park (Spain).

During 1997 and 1998, a survey of Iberian carnivores was conducted to study the epidemiology of bovine tuberculosis in the Doñana National Park and surrounding areas in southwestern Spain. Post-mortem examinations were done on seven red foxes (Vulpes vulpes), two Egyptian mongoose (Herpestes ichneumon), one weasel (Mustela nivalis), two genets (Genetta genetta), one Iberian lynx (Lynx pardinus), one Eurasian badger (Meles meles), and two polecats (Mustela putorius). Lesions suggestive of bovine tuberculosis were not detected but, in culture, Mycobacterium bovis was isolated from the retropharyngeal lymph nodes of one adult male red fox. This is the first report of M. bovis infection in red fox in Spain.

The translation into Spanish of the OIE Manual of diagnostic tests and vaccines for terrestrial animals (mammals, birds and bees): problems, solutions and conclusions.

In order to carry out the translation into Spanish of the Manual of diagnostic tests and vaccines for terrestrial animals (mammals, birds and bees) ensuring full scientific and linguistic accuracy, its authors relied on coordination between three types of experts: linguistic, translational and veterinary. In this paper the planning, execution and quality control of such work, which was undertaken with the support and guarantee of the World Organisation for Animal Health (OIE), is reported. In the conclusions the authors describe what they view as necessary guidelines for the OIE to apply in the future regarding its linguistic policy. The working methodology reported in connection with the translation of the Terrestrial Manual into Spanish will be useful for the translation of the Terrestrial Manual or other texts into languages other than Spanish, whether or not they are among the official languages of the OIE.