[Microbiology of infections caused by dog and cat bites: A review]. / Microbiología de las infecciones causadas por mordeduras de perros y gatos en personas: Una revisión.

BACKGROUND: Bites caused by pets constitute 5% of the traumatic injuries registered in the emergency services. AIM: To know the main infectious agents present in dog and cat bites, both individually and jointly, in humans, as well as the predisposing factors that favor infection and its spread. METHODS: A bibliographic search was carried out in PubMed with the following search strategy: (("Bites, Human" [Mesh]) OR "Bites and Stings" [Mesh]) AND "Infection" [Mesh]. Twenty-four papers were included in the qualitative synthesis written in English or Spanish, clinical or descriptive cases and published between 2000 and 2019. RESULTS: Most frequently isolated species were Capnocytophaga canimorsus in dogs and Pasteurella multocida in cats. The existence of comorbidities in the individual, the bite on the hand, or the presence of signs of alteration of the general state of the bitten individual were considered as risk factors for the development of infection after the bite. CONCLUSIONS: All patients with animal bites should receive medical assistance, and the administration of an antibiotic prophylaxis regimen should be considered to reduce the risk of septic shock. Besides, it is important to advise the microbiology laboratory of the nature of the clinical samples obtained in order to reach the best etiological diagnosis.

Acute kidney injury caused by venomous animals: inflammatory mechanisms.

Either bites or stings of venomous animals comprise relevant public health problems in tropical countries. Acute kidney injury (AKI) induced by animal toxins is related to worse prognostic and outcomes. Being one the most important pathways to induce AKI following envenoming due to animal toxins, inflammation is an essential biological response that eliminates pathogenic bacteria and repairs tissue after injury. However, direct nephrotoxicity (i.e. apoptotic and necrotic mechanisms of toxins), pigmenturia (i.e. rhabdomyolysis and hemolysis), anaphylactic reactions, and coagulopathies could contribute to the renal injury. All these mechanisms are closely integrated, but inflammation is a distinct process. Hence, it is important to improve our understanding on inflammation mechanisms of these syndromes to provide a promising outlook to reduce morbidity and mortality. This literature review highlights the main scientific evidence of acute kidney injury induced by bites or stings from venomous animals and their inflammatory mechanisms. It included observational, cross-sectional, case-control and cohort human studies available up to December 2019. Descriptors were used according to Medical Subject Headings (MeSH), namely: "Acute kidney injury" or "Venom" and "Inflammation" on Medline/Pubmed and Google Scholar; "Kidney disease" or "Acute kidney injury" on Lilacs and SciELO. The present review evidenced that, among the described forms of renal inflammation, it can occur either directly or indirectly on renal cells by means of intravascular, systemic and endothelial hemolysis, activation of inflammatory pathway, as well as direct action of venom cytotoxic components on kidney structures.

Microbiología de las infecciones causadas por mordeduras de perros y gatos en personas: una revisión / Microbiology of infections caused by dog and cat bites: a review

INTRODUCCIÓN: Las mordeduras causadas por animales de compañía constituyen el 5% de las heridas traumáticas registradas en los servicios de urgencias. OBJETIVO: Conocer los principales agentes infecciosos presentes en las mordeduras provocadas por perros y gatos, tanto de forma individual como conjunta; así como los factores que favorecen la infección. METODOLOGÍA: Se realizó una búsqueda bibliográfica en Pub-Med con la siguiente estrategia de búsqueda: (("Bites, Human"[Mesh]) OR "Bites and Stings"[Mesh]) AND "Infection"[Mesh]. Se incluyeron 24 trabajos en la síntesis cualitativa escritos en lengua inglesa o española, casos clínicos o descriptivos y publicados entre los años 2000 y 2019. RESULTADOS: Las especies más frecuentemente aisladas fueron Capnocytophaga canimorsus en perros y Pasteurella multocida en gatos. La existencia de comorbilidades en el individuo, la mordedura en la mano, o la presencia de signos de alteración del estado general del individuo mordido fueron considerados como factores de riesgo para el desarrollo de la infección tras la mordedura. CONCLUSIONES: Todos los afectados por mordeduras animales deben recibir asistencia médica y considerar la administración de una pauta de profilaxis antimicrobiana con el fin de reducir el riesgo de shock séptico. Por otro lado, es importante advertir al laboratorio de microbiología de la naturaleza de las muestras clínicas obtenidas para alcanzar el mejor diagnóstico etiológico.

BACKGROUND: Bites caused by pets constitute 5% of the traumatic injuries registered in the emergency services. AIM: To know the main infectious agents present in dog and cat bites, both individually and jointly, in humans, as well as the predisposing factors that favor infection and its spread. METHODS: A bibliographic search was carried out in PubMed with the following search strategy: (("Bites, Human" [Mesh]) OR "Bites and Stings" [Mesh]) AND "Infection" [Mesh]. Twenty-four papers were included in the qualitative synthesis written in English or Spanish, clinical or descriptive cases and published between 2000 and 2019. Results: Most frequently isolated species were Capnocytophaga canimorsus in dogs and Pasteurella multocida in cats. The existence of comorbidities in the individual, the bite on the hand, or the presence of signs of alteration of the general state of the bitten individual were considered as risk factors for the development of infection after the bite. CONCLUSIONS: All patients with animal bites should receive medical assistance, and the administration of an antibiotic prophylaxis regimen should be considered to reduce the risk of septic shock. Besides, it is important to advise the microbiology laboratory of the nature of the clinical samples obtained in order to reach the best etiological diagnosis.

Epidemiological, humanistic and economic burden of dog-mediated rabies in India: a systematic review protocol.

Background: Rabies is a neglected zoonotic disease. It is transmitted through the bite of a rabid animal and dog bites are responsible for around 95% of human cases. The disease is almost always fatal after the onset of symptoms. It is an endemic and major public health problem in India with one-third of the global deaths reported from this country. Protocol: This systematic review aims to estimate the epidemiological, humanistic and economic burden of dog-mediated rabies in India. Initially the existence of controlled descriptors in MeSH terms (such as 'Epidemiology', 'Rabies', 'Cost', 'Dog bite', 'Quality of Life', 'India' etc), and their synonyms (key words) was identified in MEDLINE, and were later combined with Boolean operators 'AND' and 'OR' to develop a detailed search strategy. Two independent reviewers will screen the titles and abstracts and select the studies as per the inclusion criteria. The selected studies will be assessed for their quality and risk of bias. Data will be extracted using standardized data extraction tools and will be synthesized for analysis. Disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer. Discussion: This systematic review will be performed to critically examine relevant literature and report the epidemiological, humanistic and economic burden of dog-mediated rabies in Indian context. The findings will help in estimation of burden of the disease in India and expected to contribute in policy making and planning of the program and interventions in the country. Protocol registration: PROSPERO ID: CRD4202021326.

Acute kidney injury caused by venomous animals: inflammatory mechanisms

Abstract Either bites or stings of venomous animals comprise relevant public health problems in tropical countries. Acute kidney injury (AKI) induced by animal toxins is related to worse prognostic and outcomes. Being one the most important pathways to induce AKI following envenoming due to animal toxins, inflammation is an essential biological response that eliminates pathogenic bacteria and repairs tissue after injury. However, direct nephrotoxicity (i.e. apoptotic and necrotic mechanisms of toxins), pigmenturia (i.e. rhabdomyolysis and hemolysis), anaphylactic reactions, and coagulopathies could contribute to the renal injury. All these mechanisms are closely integrated, but inflammation is a distinct process. Hence, it is important to improve our understanding on inflammation mechanisms of these syndromes to provide a promising outlook to reduce morbidity and mortality. This literature review highlights the main scientific evidence of acute kidney injury induced by bites or stings from venomous animals and their inflammatory mechanisms. It included observational, cross-sectional, case-control and cohort human studies available up to December 2019. Descriptors were used according to Medical Subject Headings (MeSH), namely: Acute kidney injury or Venom and Inflammation on Medline/Pubmed and Google Scholar; Kidney disease or Acute kidney injury on Lilacs and SciELO. The present review evidenced that, among the described forms of renal inflammation, it can occur either directly or indirectly on renal cells by means of intravascular, systemic and endothelial hemolysis, activation of inflammatory pathway, as well as direct action of venom cytotoxic components on kidney structures.

The kiss of (cell) death: can venom-induced immune response contribute to dermal necrosis following arthropod envenomations?

Introduction: Snakes, insects, arachnids and myriapods have been linked to necrosis following envenomation. However, the pathways involved in arthropod venom-induced necrosis remain a highly controversial topic among toxinologists, clinicians and the public. On the one hand, clinicians report on alleged envenomations based on symptoms and the victims' information. On the other hand, toxinologists and zoologists argue that symptoms are incompatible with the known venom activity of target species. This review draws from the literature on arthropod envenomations, snakebite, and inflammatory processes to suggest that envenomation by a range of organisms might trigger an intense inflammatory cascade that ultimately lead to necrosis. If confirmed, these processes would have important implications for the treatment of venom-induced necrosis. Objectives: To describe two inflammatory pathways of regulated necrosis, tumour necrosis factor (necroptosis) and Neutrophil Extracellular Traps (NETosis); to discuss existing knowledge about snake venom and arachnid-induced necrosis demonstrating the involvement of tumour necrosis factor and neutrophils in the development of tissue necrosis following envenomation and to contribute to the understanding of venom-induced necrosis by arthropods and provide clinicians with an insight into little known inflammatory processes which may occur post envenomation. Methods: ISI Web of Science databases were searched using the terms "spider bite necrosis", "arthropod envenomation necrosis", "venom necrosis", "venom immune response", "loxoscelism", "arachnidism", "necroptosis venom", "necroptosis dermatitis", "tumour necrosis factor TNF venom", "scorpionism", "scolopendrism", "centipede necrosis", "NETosis venom", "NETosis necrosis". Searches produced 1737 non-duplicate citations of which 74 were considered relevant to this manuscript. Non-peer-reviewed sources or absence of voucher material identifying the organism were excluded. What is necrosis? Necrosis is the breakdown of cell membrane integrity followed by inflowing extracellular fluid, organelle swelling and the release of proteolytic enzymes into the cytosol. Necrosis was historically considered an unregulated process; however, recent studies demonstrate that necrosis can also be a programmed event resulting from a controlled immune response (necroptosis). Tumour necrosis factor and the necroptosis pathway: Tumour necrosis factor is a pro-inflammatory cytokine involved in regulating immune response, inflammation and cell death/survival. The pro-inflammatory cytokine TNF-α participates in the development of necrosis after envenomation by vipers. Treatment with TNF-α-antibodies may significantly reduce the manifestation of necrosis. Neutrophil Extracellular Traps and the NETosis pathway: The process by which neutrophils discharge a mesh of DNA strands in the extracellular matrix to entangle ("trap") pathogens, preventing them from disseminating. Neutrophil Extracellular Traps have been recently described as important in venom-induced necrosis. Trapped venom accumulates at the bite site, resulting in significant localized necrosis. Arthropod venom driving necrosis: Insects, myriapods and arachnids can induce necrosis following envenomation. So far, the processes involved have only been investigated in two arachnids: Loxosceles spp. (recluse spiders) and Hemiscorpius lepturus (scorpion). Loxosceles venom contains phospholipases D which hydrolyse sphingomyelin, resulting in lysis of muscle fibers. Subsequently liberated ceramides act as intermediaries that regulate TNF-α and recruit neutrophils. Experiments show that immune-deficient mice injected with Loxosceles venom experience less venom-induced inflammatory response and survive longer than control mice. Necrosis following Hemiscorpius lepturus stings correlates with elevated concentrations of TNF-α. These observations suggest that necrosis may be indirectly triggered or worsened by pathways of regulated necrosis in addition to necrotic venom compounds. Conclusions: Envenomation often induce an intense inflammatory cascade, which under certain circumstances may produce necrotic lesions independently from direct venom activity. This could explain the inconsistent and circumstantial occurrence of necrosis following envenomation by a range of organisms. Future research should focus on identifying pathways to regulated necrosis following envenomation and determining more efficient ways to manage inflammation. We suggest that clinicians should consider the victim's immune response as an integral part of the envenomation syndrome.

La pérdida de la percepción al riesgo de zoonosis y la figura del perro comunitario / Loss of risk perception to zoonoses and the figure of community dog

Resumen Los perros son causantes de zoonosis y lesiones; en especial, si aceptamos como normales conductas peligrosas; perdiendo la percepción al riesgo a enfermar. El objetivo de este manuscrito fue demostrar, que la presencia de perros vagos y comunitarios, es un peligro para la salud y seguridad pública, a través de información epidemiológica que sustenta la medida de evitar su libre circulación. La agresividad de los perros regula sus relaciones sociales a través de sumisión o dominancia; características de difícil reconocimiento para la población humana. En Chile, 327.150 personas resultaron mordidas por perros, entre los años 2003-2012, con un costo de U$22,7 a U$177,9 millones; además de los U$3,13 millones por intervenir quirúrgicamente 767 sujetos humanos de hidatidosis durante el año 2012. Sin embargo, la zoonosis más temida es la rabia, dado el resultado mortal de ésta. No se debe tolerar la presencia de perros vagos y comunitarios en las calles, medida que debe tener un sustento técnico de salud y seguridad pública; debido a que la población ha perdido la capacidad de percibir el riesgo de contraer enfermedades zoonóticas, de altos costos para el sistema asistencial; sin considerar el desmedro económico al núcleo familiar y el daño psicológico a los afectados.

Dogs may cause zoonoses and damages; especially when we accept as normal some dangerous behavior, losing the perception of disease risk. The purpose of this review was to demonstrate that the presence of stray dogs as well as community dogs, are public health hazard. Through sustainable epidemiological information, we believe this measure could prevent it from spreading. Dog's aggressiveness regulates its social relationships through submission or dominance; those characteristics are difficult to be recognized by human population. In Chile, 327.150 people were bitten by dogs, between years 2003 and 2012 with a cost of USD$22.7 to USD$177,9 million in addition to the USD$3,13 million for the surgical intervention of 767 human subjects of Hydatidosis during 2012. However zoonosis more dangerous is Rabies with death results. As a conclusion we state that the presence of stray and community dogs in the streets cannot be tolerated. This measure must have a sustainable technical of Health and Public safety because population have lost its ability of recognize the risk of contracting zoonotic diseases, with high costs for the health care system, besides the economical decline and psychological damage to the affected individuals.

The effect of alphacypermethrin-treated mesh protection against African horse sickness virus vectors on jet stall microclimate, clinical variables and faecal glucocorticoid metabolites of horses.

BACKGROUND: African horse sickness (AHS) is of importance to health and international trade in horses worldwide. During export from and transit through AHS endemic countries or zones, physical and chemical measures to protect horses from the vectors of AHS virus (AHSV) are recommended by the World Organization for Animal Health. Protection of containerized air transport systems for horses (jet stalls) with alphacypermethrin insecticide-treated high density polyethylene mesh is effective in reducing the Culicoides midge vector attack rate. In order to determine the effect of this mesh on jet stall ventilation and horse welfare under temperate climatic conditions, jet stall microclimate, clinical variables and faecal glucocorticoid metabolite (FGM) levels of 12 horses were monitored during overnight housing in either a treated or untreated stall in two blocks of a 2 × 3 randomized crossover design. RESULTS: Temperature difference between the treated stall and outside was significantly higher than the difference between the untreated stall and outside at 1/15 time points only (P = 0.045, r = 0.70). Relative humidity (RH) difference between the treated stall and outside did not differ from the untreated stall and outside. Temperature and RH in the treated stall were highly and significantly correlated with outside temperature (r = 0.96, P < 0.001) and RH (r = 0.95, P < 0.001), respectively. No significant differences were detected between rectal temperatures, pulse and respiratory rates of horses in the treated stall compared to the untreated stall. Mean FGM concentrations for horses housed in the treated stall peaked earlier (24 h) and at a higher concentration than horses housed in the untreated stall (48 h), but were not significantly different from baseline. No significant difference was detected in FGM concentrations when the treated and untreated stall groups were compared at individual time points up to 72 h after exiting the jet stall. CONCLUSIONS: Alphacypermethrin-treated HDPE mesh could be used under temperate climatic conditions to protect horses in jet stalls against AHSV vectors, without compromising jet stall microclimate and horse welfare.

MosqTent: An individual portable protective double-chamber mosquito trap for anthropophilic mosquitoes.

Here, we describe the development of the MosqTent, an innovative double-chamber mosquito trap in which a human being attracts mosquitoes while is protected from being bitten within the inner chamber of the trap, while mosquitoes are lured to enter an outer chamber where they are trapped. The MosqTent previously collected an average of 3,000 anophelines/man-hour compared to 240 anophelines/man-hour for the human landing catch (HLC), thereby providing high numbers of human host-seeking mosquitoes while protecting the collector from mosquito bites. The MosqTent performed well by collecting a high number of specimens of Anopheles marajoara, a local vector and anthropophilic mosquito species present in high density, but not so well in collecting An. darlingi, an anthropophilic mosquito species considered the main vector in Brazil but is present in low-density conditions in the area. The HLC showed a higher efficiency in collecting An. darlingi in these low-density conditions. The MosqTent is light (<1 kg), portable (comes as a bag with two handles), flexible (can be used with other attractants), adaptable (can be deployed in a variety of environmental settings and weather conditions), and it can be used in the intra-, peri-, and in the extradomicile. Also, the MosqTent collected similar portions of parous females and anthropophilic mosquito species and collects specimens suitable for downstream analysis. Further developments may include testing for other fabric colors, different mesh sizes and dimensions for other hematophagous insects and conditions, additional chemical mosquito attractants, and even the replacement of the human attractant in favor of other attractants. MosqTent modifications that would allow the trap to be applied as a vector control tool with killing action could also be explored.

Treatment of a perforating thoracic bite wound in a dog with negative pressure wound therapy.

CASE DESCRIPTION A 4-year-old male Dachshund was examined following a bite attack that had occurred 5 days previously. The dog had acutely deteriorated despite IV antimicrobial treatment and fluid therapy. CLINICAL FINDINGS On initial examination, the patient was recumbent with signs of septic shock and a flail chest. Three penetrating wounds in the left thoracic wall with malodorous discharge were evident. The animal trauma triage score was 8 out of 18. Thoracic and abdominal radiography revealed displaced fractures of the left seventh, eighth, and ninth ribs and extensive subcutaneous emphysema. Additionally, a marked diffuse bronchointerstitial pattern, areas of alveolar pattern, and pneumothorax were present bilaterally. TREATMENT AND OUTCOME Open surgical debridement with left lateral lung lobectomy and resection of portions of the left thoracic wall were performed. Extensive soft tissue loss precluded primary reconstruction. The defect was stabilized with a polypropylene mesh implant, and negative pressure wound therapy (NPWT) at -100 mm Hg was initiated. Microbial culture and susceptibility testing of tissue samples indicated the presence of multidrug-resistant Staphylococcus pseudintermedius. The NPWT dressing was changed 2, 5, and 7 days after surgery. Treatment was well tolerated, and the mesh was completely covered with granulation tissue 10 days after surgery. On follow-up 5, 7, 12, and 19 months after surgery, the dog was clinically normal with no apparent complications. CLINICAL RELEVANCE Findings suggested that NPWT may be a valuable adjunct when treating small animal patients with severe thoracic trauma.

Negative pressure wound therapy with instillation for body wall reconstruction using an artificial mesh in a Dachshund.

CASE REPORT: A 4-year-old spayed female Dachshund was presented in shock, displaying multiple haematomas and puncture wounds along the left abdominal wall and ventral aspect of the abdomen after being attacked by another dog. A defect of the left lateral body wall was palpated. Surgery revealed a massive body wall defect and concurrent injury of the intestines. Surgical debridement was performed and the injured portion of the jejunum was resected. The abdominal wall was reconstructed using a polypropylene mesh. Negative pressure wound therapy (NPWT) with instillation of 0.04% polyhexanide (-125 mmHg, instillation interval of 2 h, duration 20 min) was started. Microbial culture after reconstruction of the defect and before application of the NPWTi dressing revealed multiresistant Staphylococcus pseudintermedius. The NPWT dressing was changed on days 2, 5 and 7. Microbial cultures obtained at the first two dressing changes were negative. Therapy was well tolerated and the mesh was completely covered by granulation tissue after 10 days, when the wound was surgically closed. CONCLUSION: Bite wounds frequently result in massive, contaminated defects with impaired perfusion, and reconstruction using foreign material carries the risk of biofilm formation and infection. Instillation therapy may provide an alternative for bacterial clearance and fast integration of the mesh.

Efficacy of alphacypermethrin-treated high density polyethylene mesh applied to jet stalls housing horses against Culicoides biting midges in South Africa.

The efficacy of alphacypermethrin-treated high density polyethylene (HDPE) mesh applied to jet stalls against Culicoides biting midges (Diptera: Ceratopogonidae) was determined by mechanical aspiration of midges from horses and using Onderstepoort 220 V downdraught black light traps in four blocks of a 3 × 2 randomised design under South African field conditions. The alphacypermethrin-treated HDPE mesh applied to the stall significantly (P = 0.008) reduced the number of Culicoides midges, predominantly Culicoides (Avaritia) imicola Kieffer, mechanically aspirated from horses housed in the stall. The mesh reduced the Culicoides midge attack rate in the treated stall compared to the untreated stall and a sentinel horse by 6 times and 14 times, respectively. The number of Culicoides midges and C. imicola collected in light traps from the untreated and alphacypermethrin HDPE mesh-treated stalls did not differ significantly (P = 0.82). Alphacypermethrin-treated HDPE mesh could be used to reduce exposure of horses in jet stalls to Culicoides midges, specifically C. imicola, and the risk of midge-borne Orbivirus transmission.

Trauma mamario por mordedura de caballo: Reporte de caso / Breast injury due to horse bite: Case report

Objetivo: presentar un caso de trauma mamario por mordedura de caballo en una mujer y revisar el manejo de este tipo de accidentes. Materiales y métodos: se presenta un caso de trauma mamario izquierdo por mordedura de equino, de 10 días de evolución, en una mujer de 43 años de edad atendida en una institución de primer nivel de complejidad, posteriormente remitida para estudio imaginológico y manejo a una institución de tercer nivel de complejidad. Se realizó una búsqueda de la información en las bases de datos SciELO y PubMed con la terminología MeSH “Bite horsebreast trauma”, y en español “trauma mamario por mordedura de equino”. Conclusiones: los traumatismos mamarios por mordedura de caballo son infrecuentes y pueden acompañarse de lesiones que van desde laceraciones, equimosis, hematomas, amputación de la glándula mamaria y complicaciones sistémicas de tipo infeccioso, así como secuelas severas de tipo funcional y estético. Es indispensable adoptar medidas preventivas generales y manejar secuencialmente el caso como se recomienda en el presente reporte.

Objective: To present a case of female breast trauma due to horse bite and review the management of this type of injury. Materials and methods: Case presentation of left beast injury caused by horse bite in a 43 year-old woman who came to a first level institution 10 days after the accident, and was then referred for imaging studies and management to a level 3 complexity institution. A search was conducted in the SciELO and PubMed databases using MeSH terms “Bite horse breast Trauma” in English and “mammary trauma due to equine bite” in Spanish. Conclusions: Breast injury due to horse bite is infrequent and may be accompanied by lesions ranging from lacerations to bruising, hematomas, mammary gland amputation and infectious systemic complications, as well as severe functional and cosmetic sequelae. It is of the utmost importance to adopt general preventive measures and treat the case sequentially as recommended in this report.

Evaluation of commercial products for personal protection against mosquitoes.

Human landing catch studies were conducted in a semi-field setting to determine the efficacy of seven commercial products used for personal protection against mosquitoes. Experiments were conducted in two empty, insecticide free, mesh-enclosed greenhouses, in Israel, with either 1500 Aedes albopictus or 1500 Culex pipiens released on consecutive study nights. The products tested in this study were the OFF!(®) Clip-On™ Mosquito Repellent (Metofluthrin 31.2%) and the Terminix(®) ALLCLEAR(®) Sidekick Mosquito Repeller (Cinnamon oil 10.5%; Eugenol 13%; Geranium oil 21%; Peppermint 5.3%; Lemongrass oil 2.6%), which are personal diffusers; Super Band™ Wristband (22% Citronella oil) and the PIC(®) Citronella Plus Wristband (Geraniol 15%; Lemongrass oil 5%, Citronella oil 1%); the Sonic Insect Repeller Keychain; the Mosquito Guard Patch (Oil of Lemon Eucalyptus 80mg), an adhesive-backed sticker for use on textiles; and the Mosquito Patch (vitamin B1 300mg), a transdermal patch. It was determined that the sticker, transdermal patch, wristbands and sonic device did not provide significant protection to volunteers compared with the mosquito attack rate on control volunteers who were not wearing a repellent device. The personal diffusers: - OFF!(®) Clip-On™ and Terminix(®) ALLCLEAR(®) Sidekick - provided superior protection compared with all other devices in this study. These diffusers reduced biting on the arms of volunteers by 96.28% and 95.26% respectively, for Ae. albopictus, and by 94.94% and 92.15% respectively, for Cx. pipiens. In a second trial conducted to compare these devices directly, biting was reduced by the OFF!(®) Clip-On™ and the Terminix(®) ALLCLEAR(®) by 87.55% and 92.83%, respectively, for Ae. albopictus, and by 97.22% and 94.14%, respectively, for Cx. pipiens. There was no significant difference between the performances of the two diffusers for each species.

Piranha attacks in dammed streams used for human recreation in the State of São Paulo, Brazil.

In recent years, attacks by piranhas have become a common problem in dammed portions of rivers and streams in the State of Sao Paulo, Southeastern Brazil. In two outbreaks recorded in two neighboring counties in the Northwest region of the state, 74 bathers were bitten. Only one bite per person was recorded during a short period of the year. The bites were related to parental care and/or defense of spawning territory, which confirms previous studies and demystify the attacks by these legendary fish, as they are perceived by most people. Placement of fine mesh nets and removal of aquatic vegetation stopped the attacks.

Piranha attacks in dammed streams used for human recreation in the State of São Paulo, Brazil / Ataques de piranhas em riachos represados usados para atividades de lazer, no Estado de São Paulo

In recent years, attacks by piranhas have become a common problem in dammed portions of rivers and streams in the State of Sao Paulo, Southeastern Brazil. In two outbreaks recorded in two neighboring counties in the Northwest region of the state, 74 bathers were bitten. Only one bite per person was recorded during a short period of the year. The bites were related to parental care and/or defense of spawning territory, which confirms previous studies and demystify the attacks by these legendary fish, as they are perceived by most people. Placement of fine mesh nets and removal of aquatic vegetation stopped the attacks.

Ataques por piranhas vêm se tornando um problema comum em trechos represados de rios e córregos no estado de São Paulo, Sudeste do Brasil. Em dois surtos ocorridos em dois municípios vizinhos no noroeste do estado, 74 banhistas foram mordidos. Uma mordida por pessoa foi registrada, em curto período do ano. As mordidas estão relacionadas a cuidado parental e/ou defesa do território de desova, o que reforça estudos anteriores e desmistifica os ataques por este peixe lendário, da maneira como são popularmente percebidos. A colocação de redes de malha fina e a remoção de vegetação aquática cessaram os ataques.

Managing insecticide resistance in malaria vectors by combining carbamate-treated plastic wall sheeting and pyrethroid-treated bed nets.

BACKGROUND: Pyrethroid resistance is now widespread in Anopheles gambiae, the major vector for malaria in sub-Saharan Africa. This resistance may compromise malaria vector control strategies that are currently in use in endemic areas. In this context, a new tool for management of resistant mosquitoes based on the combination of a pyrethroid-treated bed net and carbamate-treated plastic sheeting was developed. METHODS: In the laboratory, the insecticidal activity and wash resistance of four carbamate-treated materials: a cotton/polyester blend, a polyvinyl chloride tarpaulin, a cotton/polyester blend covered on one side with polyurethane, and a mesh of polypropylene fibres was tested. These materials were treated with bendiocarb at 100 mg/m(2) and 200 mg/m(2) with and without a binding resin to find the best combination for field studies. Secondly, experimental hut trials were performed in southern Benin to test the efficacy of the combined use of a pyrethroid-treated bed net and the carbamate-treated material that was the most wash-resistant against wild populations of pyrethroid-resistant An. gambiae and Culex quinquefasciatus. RESULTS: Material made of polypropylene mesh (PPW) provided the best wash resistance (up to 10 washes), regardless of the insecticide dose, the type of washing, or the presence or absence of the binding resin. The experimental hut trial showed that the combination of carbamate-treated PPW and a pyrethroid-treated bed net was extremely effective in terms of mortality and inhibition of blood feeding of pyrethroid-resistant An. gambiae. This efficacy was found to be proportional to the total surface of the walls. This combination showed a moderate effect against wild populations of Cx. quinquefasciatus, which were strongly resistant to pyrethroid. CONCLUSION: These preliminary results should be confirmed, including evaluation of entomological, parasitological, and clinical parameters. Selective pressure on resistance mechanisms within the vector population, effects on other pest insects, and the acceptability of this management strategy in the community also need to be evaluated.

Evaluation of a mass distribution programme for fine-mesh impregnated bednets against visceral leishmaniasis in eastern Sudan.

During an epidemic of visceral leishmaniasis (VL) in eastern Sudan, Médecins Sans Frontières distributed 357,000 insecticide-treated bednets (ITN) to 155 affected villages between May 1999 and March 2001. To estimate the protective effect of the ITN, we evaluated coverage and use of ITN, and analysed VL incidence by village from March 1996 to June 2002. We provided ITN to 94% of the individuals >5 years old. Two years later, 44% (95% CI 39-48%) of nets were reasonably intact. Because ITN were mainly used as protection against nuisance mosquitoes, bednet use during the VL transmission season ranged from <10% during the hot dry months to 55% during the beginning of the rainy season. ITN were put up from 9 to 11 p.m., leaving children unprotected during a significant period of sandfly-biting hours after sunset. Regression analysis of incidence data from 114 villages demonstrated a significant reduction of VL by village and month following ITN provision. The greatest effect was 17-20 months post-intervention, with VL cases reduced by 59% (95% CI: 25-78%). An estimated 1060 VL cases were prevented between June 1999 and January 2001, a mean protective effect of 27%. Although results need to be interpreted with caution, this analysis indicates a potentially strong reduction in VL incidence following a community distribution of ITN. The effectiveness of ITN depends on behavioural factors, which differ between communities.

The omentum-polypropylene sandwich technique: an attractive method to repair large abdominal-wall defects in the presence of contamination or infection.

BACKGROUND: Repair of abdominal wall defects in the presence of contamination or infection continues to be a significant problem for surgeons. The loss of tissue warrants reinforcement of the abdominal wall, preferably by autologous material. However, autologous repair often requires extensive operations that carry a high morbidity. Moreover, the lack of sufficient fascia may be so extensive that insertion of a prosthetic material is inevitable. Polypropylene (PP) is the most appropriate material to use under these circumstances, but without coverage, the mesh will wrinkle and ultimately be extruded. The present report describes an alternative technique for repair of heavily contaminated abdominal-wall defects. PATIENTS: Two patients with a very large heavily contaminated abdominal wall defect due to necrotizing fasciitis in one patient and a lion's bite in the other were treated with the omental sandwich technique. After radical debridement, resulting in a full thickness loss of the abdominal wall, the peritoneum was restored using absorbable polyglactin mesh. The fascial defect was bridged with a PP mesh that was fixed to the adjacent myoaponeurosis and covered with a pedicled omental flap. In both patients the omentum was covered with a split skin. RESULTS: Wound healing in both patients was without complications. Both patients had a sufficient abdominal wall, without signs of herniation after a follow up of 4 and 30 months, respectively. CONCLUSION: The omental sandwich technique is an attractive method to repair large abdominal wall defects in the presence of contamination or overt infection.

Physical defeat reduces the sensitivity of murine splenocytes to the suppressive effects of corticosterone.

Social disruption (SDR) in male mice reduces the sensitivity of their splenocytes to the actions of glucocorticoids. To determine whether physical defeat is necessary for the development of this reduced sensitivity, a modification of the SDR paradigm was employed in which mice were exposed to fighting conspecifics in the presence or absence of physical contact. This was accomplished by dividing a cage of 5 resident male C57BL/6 mice in half with a wire mesh partition so that 2 of the mice in the cage (SDR Physical Contact mice) fought and were defeated by an aggressive male C57BL/6 intruder that was placed into the cage for 2h for up to 6 days, while the remaining 3 resident mice (SDR Sensory Contact mice) were on the opposite side of the partition and thus prevented from physically interacting with the intruder. Although both the SDR Physical Contact and the SDR Sensory Contact mice had significantly elevated corticosterone levels and displayed submissive postures toward the intruder, only the SDR Physical Contact animals developed functional glucocorticoid resistance. The viability of LPS-stimulated splenocytes cultured from the SDR Physical Contact mice was not affected by pharmacological doses of corticosterone, whereas splenocyte viability was significantly reduced by corticosterone in cultured cells from SDR Sensory Contact and control mice. This study indicates that exposure to a stressful environment in the absence of physical attack does not reduce the sensitivity of murine splenocytes to the suppressive effects of corticosterone.