Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.318
Filtrar
1.
Medicine (Baltimore) ; 100(4): e24492, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33530269

RESUMO

INTRODUCTION: Multiple wasp stings is an emergency result from systemic reactions to the toxin with a wide range of manifestations, and we presented 2 patients with distinct clinical and transcriptomic findings. PATIENT CONCERNS: Two patients without systemic disease presented with nearly 90 painful papules after attacked by a swarm of wasps (Vespa basalis). DIAGNOSIS: Patient 1 was a 44-year-old healthy male whose clinical manifestations mainly comprised hemolysis, hepatic injury, rhabdomyolysis, and acute kidney injury. Patient 2 was a 49-year-old healthy female who presented with severe acute respiratory distress syndrome (ARDS) in addition to certain clinical manifestations that were also found in patient 1. We used ribo- nucleic acid sequencing (RNA-Seq) to characterize the inflammatory responses of 2 patients with distinct clinical manifestations after multiple wasp stings. INTERVENTIONS: Both 2 patients received 5 sessions of plasmapheresis, and patient-1 further received mechanical ventilation for 8 days as well as 8 sessions of hemodialysis until day 17. OUTCOMES: Both patients recovered uneventfully after the aforementioned management. We used RNA-Seq to demonstrate a largely regulated neutrophil-predominated immune response in patient 1. In patient 2, we found a profound neutrophilc response on week 1 and a robust neutrophilic as well as pro-inflammatory responses on week 2. Furthermore, we found increased expression of signals that were associated with renal system process on week 2. CONCLUSION: In conclusion, we report 2 patients who manifested with shared and distinct presentations after an attack by the same swarm of wasps. Both patients had hemolysis, rhabdomyolysis, hepatic injury and acute kidney injury, and 1 patient had ARDS. The whole transcriptomic analyses were consistent with the distinct clinical manifestation, and these results suggest the potential of RNA-Sequencing to disentangle complex inflammatory responses in patients with multiple wasp stings. Plasmapheresis and corticosteroid were administered to both patients and case 2 also underwent 8 sessions of hemodialysis.


Assuntos
Mordeduras e Picadas de Insetos/complicações , Venenos de Vespas/efeitos adversos , Lesão Renal Aguda/etiologia , Corticosteroides/uso terapêutico , Adulto , Animais , Feminino , Humanos , Mordeduras e Picadas de Insetos/imunologia , Mordeduras e Picadas de Insetos/terapia , Masculino , Pessoa de Meia-Idade , Plasmaferese , Rabdomiólise/etiologia , Resultado do Tratamento , Venenos de Vespas/imunologia , Vespas
2.
Artigo em Inglês | MEDLINE | ID: mdl-33466336

RESUMO

Anaphylaxis is a severe, potentially life-threatening systemic hypersensitivity reaction that is still rarely diagnosed. For safety reasons, patients should visit an allergologist to identify potential causes and cofactors of this reaction. This paper presents the analysis of data from the Anaphylaxis Registry gathered over ten years at the Allergy Clinic, Pomeranian Medical University (PMU). A questionnaire-based survey was used for patients visiting the Allergy Clinic to identify potential augmentation factors/comorbidities and/or cofactors of anaphylaxis in patients with a history of moderate to severe anaphylaxis. The registry comprised patients with grade II or higher anaphylaxis. The gathered data concerned chronic comorbidities (cardiovascular diseases, respiratory diseases, and others), recurrence of anaphylaxis, and potential cofactors in anaphylaxis. In the analyzed group, the incidence rate of anaphylaxis was the highest for women aged 19-60 years. Most common comorbidities in patients with moderate to severe anaphylaxis included: cardiovascular diseases, respiratory tract diseases, features of atopy, and thyroid diseases. More than 30% of drug-induced reactions were anaphylactic reactions due to the re-exposure to the same drug, which points to the need for educational initiatives in this area. The incidence rate of anaphylaxis induced by Hymenoptera stings was comparable in patients who had a previous generalized reaction and those who had good tolerance to the previous sting. It is important to take these cofactors into consideration when evaluating patients with anaphylaxis as they may play a role in future anaphylactic reactions.


Assuntos
Anafilaxia , Comorbidade , Hipersensibilidade a Drogas/epidemiologia , Mordeduras e Picadas de Insetos/epidemiologia , Adolescente , Adulto , Anafilaxia/epidemiologia , Anafilaxia/etiologia , Animais , Criança , Pré-Escolar , Feminino , Humanos , Himenópteros , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Sistema de Registros , Adulto Jovem
4.
Rev Soc Bras Med Trop ; 54: e20200319, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33338119

RESUMO

Bee venom is a natural toxin composed of several peptides. Massive envenoming causes severe local and systemic reactions. We report two cases of severe bee envenomation, of which one was fatal. We also describe clinical characteristics and immune markers. Both victims suffered from respiratory distress, renal failure, rhabdomyolysis, and shock. They required invasive mechanical ventilation, vasoactive drugs, and renal replacement therapy. Moreover, serum levels of chemokines, cytokines, and cell-free circulating nucleic acids demonstrated an intense inflammatory process. Massive envenoming produced systemic injury in the victims, with an uncontrolled inflammatory response, and a more significant chemotactic response in the fatal case.


Assuntos
Venenos de Abelha , Mordeduras e Picadas de Insetos , Rabdomiólise , Animais , Abelhas , Biomarcadores , Brasil , Mordeduras e Picadas de Insetos/complicações , Rabdomiólise/diagnóstico , Rabdomiólise/etiologia
5.
Vaccimonitor (La Habana, Print) ; 29(3)sept.-dic. 2020. tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1139856

RESUMO

La alergia al veneno de abejas provoca reacciones de leves a severas con compromiso para la vida. La inmunoterapia con veneno de himenópteros es un tratamiento eficaz y protege a los pacientes alérgicos de sufrir reacciones sistémicas ante nuevas picaduras. Nos propusimos caracterizar los pacientes alérgicos a picaduras de abeja que reciben inmunoterapia. Se realizó un estudio observacional descriptivo de corte longitudinal en pacientes alérgicos a las picaduras de abeja tratados con inmunoterapia de extracto de abeja en el Hospital Universitario General Calixto García de La Habana, Cuba. La muestra fue de 17 pacientes que cumplieron los criterios de inclusión. Usamos técnicas de estadística descriptiva: promedio, probabilidad y puntaje estandarizado, así como técnicas de estadística inferencial tales como Chi cuadrado, verificando asociación significativa entre las variables; el nivel de significación empleado fue del 5 por ciento (p˂0,05). La tercera década de la vida fue la edad promedio de los pacientes. Se observó predominio del sexo masculino y residencia en zona urbana. Alrededor de la mitad de los pacientes tenían rinitis y antecedentes familiares de asma. Todos los pacientes tuvieron reacciones locales, la mayoría se re-expusieron a la picadura; de ellos, solo el 20 por ciento presentaron reacciones alérgicas sistémicas después de la inmunoterapia. Se concluye que la reactividad cutánea al extracto de abeja se redujo con el tratamiento de inmunoterapia(AU)


Allergy to bee venom may cause from mild to severe reactions threatening the patient´s life. Immunotherapy with hymenopter venom is an effective treatment that can protect allergic patients from suffering systemic reactions to new stings. The aim of this study was to characterize allergic patients to bee sting that receive immunotherapy. A descriptive longitudinal observational study was carried out in allergic patients to bee sting receiving immunotherapy with bee extracts in the University Hospital General Calixto García, Havana, Cuba. A sample of 17 patients with inclusion criteria was analyzed. Descriptive statistical techniques were used: mean, probability, standardized score, as well as, inferential statistic techniques such as the Chi square; verifying significant association between variables. The level of signification was 5 percent (p˂0.05). The third decade of life was the average age of the patients in this study; male sex and, urban residents were predominant. Around half of the patients had rhinitis and family history of asthma. All patients had local reactions; most of the patients were re-exposed to stings. Only 20 percent of patients reported systemic allergic reaction after immunotherapy. Skin reactivity to bee extract was reduced with the immunotherapy(AU)


Assuntos
Humanos , Venenos de Abelha , Abelhas , Hipersensibilidade/tratamento farmacológico , Mordeduras e Picadas de Insetos/terapia , Vacinas
6.
PLoS Negl Trop Dis ; 14(12): e0009015, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33370305

RESUMO

Trypanosoma rangeli is a non-pathogenic protozoan parasite that infects mammals, including humans, in Chagas disease-endemic areas of South and Central America. The parasite is transmitted to a mammalian host when an infected triatomine injects metacyclic trypomastigotes into the host's skin during a bloodmeal. Infected mammals behave as parasite reservoirs for several months and despite intensive research, some major aspects of T. rangeli-vertebrate interactions are still poorly understood. In particular, many questions still remain unanswered, e.g. parasite survival and development inside vertebrates, as no parasite multiplication sites have yet been identified. The present study used an insect bite transmission strategy to investigate whether the vector inoculation spot in the skin behave as a parasite-replication site. Histological data from the skin identified extracellular parasites in the dermis and hypodermis of infected mice in the first 24 hours post-infection, as well as the presence of inflammatory infiltrates in a period of up to 7 days. However, qPCR analyses demonstrated that T. rangeli is eliminated from the skin after 7 days of infection despite being still consistently found on circulating blood and secondary lymphoid tissues for up to 30 days post-infection. Interestingly, significant numbers of parasites were found in the spleen and mesenteric lymph nodes of infected mice during different periods of infection and steady basal numbers of flagellates are maintained in the host's bloodstream, which might behave as a transmission source to insect vectors. The presence of parasites in the spleen was confirmed by fluorescent photomicrography of free and cell-associated T. rangeli forms. Altogether our results suggest that this organ could possibly behave as a T. rangeli maintenance hotspot in vertebrates.


Assuntos
Doença de Chagas/transmissão , Linfonodos/parasitologia , Pele/parasitologia , Baço/parasitologia , Trypanosoma rangeli/isolamento & purificação , Animais , América Central/epidemiologia , Doença de Chagas/epidemiologia , Modelos Animais de Doenças , Interações Hospedeiro-Parasita , Humanos , Mordeduras e Picadas de Insetos/parasitologia , Insetos Vetores/parasitologia , Camundongos , Rhodnius/parasitologia , Sepse/parasitologia , América do Sul/epidemiologia
7.
PLoS One ; 15(10): e0239728, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33048941

RESUMO

INTRODUCTION: School-aged children become a highly vulnerable group for malaria, yet they are less likely to use malaria prevention interventions. Previous studies exploring perception on cause of malaria mainly focused on pregnant mothers or parents of children under age five years. Exploring parent's perception on cause of malaria and their experiences on the prevention of malaria and associated challenges among school-aged children is important to develop a malaria prevention education package for school-aged children to reduce malaria and malaria related morbidities among school-aged children. METHODS: A descriptive qualitative study is conducted in Kutcha district by recruiting 19 parents of school-aged children for semi-structured interviews, 6 key informants and 6 focus group discussion which consists of parents, health development army and health extension workers. A semi-structured interview guide is used to guide the interview process. The collected data is analyzed thematically with a focus on the three major areas of concern: perceived cause of malaria, experience of malaria prevention and challenges of bed net use for prevention of malaria. RESULTS: Five causes of malaria were identified, namely hunger, mosquito bite, exposure to hot sunshine, poor sanitation and hygiene and eating some sweet foods and unripe maize. Participants perceived that eating sweet foods and unripe maize lead to enlargement of the spleen that ends in malaria while poor hygiene and sanitation leads to either development of the ova of mosquito and the landing of the housefly to contaminate food for consumption. The experiences of malaria prevention were largely influenced by their perceived cause of malaria. The malaria prevention measures undertaken by parents were vectors control measures, homemade herbal remedies and restricting children from eating sweet foods. The challenges of malaria prevention by using bed nets were related to a negative attitude, sleeping behaviors of children; use of bed nets for unintended purposes, shortage of bed nets and delays in the distribution of bed nets. CONCLUSION: There were misconceptions about the cause of malaria and associated experiences of malaria prevention. Control of malaria among school-aged children need health education targeting the challenges and correcting identified misconceptions by parents in Kutcha district and in other similar settings.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde/etnologia , Malária/prevenção & controle , Pais/psicologia , Adulto , Etiópia/epidemiologia , Feminino , Grupos Focais , Educação em Saúde , Humanos , Mordeduras e Picadas de Insetos , Mosquiteiros Tratados com Inseticida , Malária/etiologia , Masculino , Controle de Mosquitos/métodos , Pais/educação , Pesquisa Qualitativa
8.
An Bras Dermatol ; 95(6): 724-727, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33012570

RESUMO

Insect bites and bite wounds are quite common and most often have mild repercussions in humans. Statistics on the incidence of accidents caused by insects are not available, and the skin reactions after the bites are not always known. The authors present two cases of patients with hemorrhagic blisters on their hands after tabanidae bites and discuss the factors that cause the problem and the importance of the differential diagnosis of blisters with hemorrhagic content on human skin.


Assuntos
Mordeduras e Picadas de Insetos , Prurigo , Dermatopatias Vesiculobolhosas , Alérgenos , Humanos , Mordeduras e Picadas de Insetos/complicações , Mordeduras e Picadas de Insetos/diagnóstico , Pele
9.
Toxicon ; 187: 279-284, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33035564

RESUMO

A survey on 5115 beekeepers and 121 patients treated with bee venom by an apitherapy clinic in the Hubei province, the epicenter of COVID-19 in China, reported that none of the beekeepers developed symptoms associated with COVID-19, the new and devastating pandemic. The hypothesis that immunity to bee venom could have a preventive effect was expressed and the authors of the Chinese survey suggested that the next step should be animal experiments on monkeys. We believed that before starting such studies, a second independent survey should verify the findings and define the hypothesis more clearly. Thus we asked all German beekeepers to complete an assessment form which would summarize their experiences with COVID-19. In contrast to the Chinese study we found that two beekeepers had died from a SARS-CoV-2 infection and forty-five were affected. The reaction to bee stings (none; mild swelling; severe swelling) correlated with the perceived severity of the SARS-CoV-2-infection-associated symptoms - exhaustion and sore throat. Beekeepers comorbidity correlated with problems with breathing at rest, fever, and diarrhea. Our results did not confirm the findings of the Chinese study. However, since the antiviral effects of bee venom have been found in several studies, we cannot exclude that there could be a direct preventive or alleviating effect when bee venom is administered during the infection.


Assuntos
Venenos de Abelha/toxicidade , Abelhas/fisiologia , Betacoronavirus/imunologia , Infecções por Coronavirus/imunologia , Mordeduras e Picadas de Insetos , Exposição Ocupacional/efeitos adversos , Pneumonia Viral/imunologia , Adulto , Idoso , Criação de Animais Domésticos , Animais , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Fatores de Risco
10.
PLoS Negl Trop Dis ; 14(9): e0008527, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32898136

RESUMO

BACKGROUND: Zika virus (ZIKV) emerged in the Pacific Ocean and subsequently caused a dramatic Pan-American epidemic after its first appearance in the Northeast region of Brazil in 2015. The virus is transmitted by Aedes mosquitoes. We evaluated the role of temperature and infectious doses of ZIKV in vector competence of Brazilian populations of Ae. aegypti and Ae. albopictus. METHODOLOGY/PRINCIPAL FINDINGS: Two Ae. aegypti (Rio de Janeiro and Natal) and two Ae. albopictus (Rio de Janeiro and Manaus) populations were orally challenged with five viral doses (102 to 106 PFU / ml) of a ZIKV strain (Asian genotype) isolated in Northeastern Brazil, and incubated for 14 and 21 days in temperatures mimicking the spring-summer (28°C) and winter-autumn (22°C) mean values in Brazil. Detection of viral particles in the body, head and saliva samples was done by plaque assays in cell culture for determining the infection, dissemination and transmission rates, respectively. Compared with 28°C, at 22°C, transmission rates were significantly lower for both Ae. aegypti populations, and Ae. albopictus were not able to transmit the virus. Ae. albopictus showed low transmission rates even when challenged with the highest viral dose, while both Ae. aegypti populations presented higher of infection, dissemination and transmission rates than Ae. albopictus. Ae. aegypti showed higher transmission efficiency when taking virus doses of 105 and 106 PFU/mL following incubation at 28°C; both Ae. aegypti and Ae. albopictus were unable to transmit ZIKV with virus doses of 102 and 103 PFU/mL, regardless the incubation temperature. CONCLUSIONS/SIGNIFICANCE: The ingested viral dose and incubation temperature were significant predictors of the proportion of mosquito's biting becoming infectious. Ae. aegypti and Ae. albopictus have the ability to transmit ZIKV when incubated at 28°C. However Brazilian populations of Ae. aegypti exhibit a much higher transmission potential for ZIKV than Ae. albopictus regardless the combination of infection dose and incubation temperature.


Assuntos
Aedes/virologia , Saliva/virologia , Infecção por Zika virus/transmissão , Animais , Brasil , Mordeduras e Picadas de Insetos/virologia , Mosquitos Vetores/virologia , Estações do Ano , Temperatura , Distribuição Tecidual , Carga Viral , Zika virus
11.
Clin Ter ; 171(5): e369-e370, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32901775

RESUMO

Skin findings are common among patients with hematological malignancies and are thought to be expressions of a reactive spectrum peculiar to immunosuppressed patients with an unclear pathogenesis. Eosinophilic panniculitis is a reaction pattern defined by single or multiple lesions consisting in nodules and plaques, and sometimes in papules and pustules, characteristically associated to hematological neoplasms or to a series of benign conditions such as arthropod bites. We report a case of eosinophilic panniculitis occurring in a 77-year-old woman with chronic lymphocytic leukemia. Our case is remarkable as the histology of panniculitis was associated with a clinical evidence of dermal papules and a history of insect bites.


Assuntos
Eosinófilos , Mordeduras e Picadas de Insetos/complicações , Leucemia Linfocítica Crônica de Células B/complicações , Paniculite/etiologia , Idoso , Animais , Feminino , Humanos , Leucemia Linfocítica Crônica de Células B/patologia , Paniculite/complicações
12.
PLoS Negl Trop Dis ; 14(9): e0008712, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32970687

RESUMO

BACKGROUND: Several studies addressed changes on the insect vector behavior due to parasite infection, but little is known for triatomine bugs, vectors of Trypanosoma cruzi, the etiological agent of Chagas disease. We assessed infection rates and metacyclogenesis of T. cruzi (TcVI) in fifth-instar nymphs of Triatoma rubrovaria comparing with the primary vector Triatoma infestans. Also, biological parameters related to feeding-excretion behavior were evaluated aiming to identify which variables are most influenced by T. cruzi infection. METHODOLOGY/PRINCIPAL FINDINGS: Fifth-instar nymphs of T. rubrovaria and T. infestans were fed on mice infected with T. cruzi (TcVI). We compared the presence and the number of parasite evolutive forms in excreta of both triatomine species at 30, 60 and 90 days post-infection (dpi) with traditional statistical analyses. Moreover, both species were analyzed through generalized linear models and multinomial logistic regression hypotheses for seven behavioral parameters related to host-seeking and feeding-excretion. Triatoma rubrovaria and T. infestans had similar overall infection and metacyclogenesis rates of T. cruzi TcVI in laboratory conditions. Regarding vector behavior, we confirmed that the triatomine's tendency is to move away from the bite region after a blood meal, probably to avoid being noticed by the vertebrate host. Interspecific differences were observed on the volume of blood ingested and on the proportion of individuals that excreted after the blood meal, revealing the higher feeding efficiency and dejection rates of T. infestans. The amount of ingested blood and the bite behavior of T. rubrovaria seems to be influenced by TcVI infection. Infected specimens tended to ingest ~25% more blood and to bite more the head of the host. Noteworthy, in two occasions, kleptohematophagy and coprophagy behaviors were also observed in T. rubrovaria. CONCLUSIONS/SIGNIFICANCE: Laboratory infections revealed similar rate of T. cruzi TcVI trypomatigotes in excreta of T. rubrovaria and T. infestans, one of the most epidemiological important vectors of T. cruzi. Therefore, TcVI DTU was able to complete its life cycle in T. rubrovaria under laboratory conditions, and this infection changed the feeding behavior of T. rubrovaria. Considering these results, T. rubrovaria must be kept under constant entomological surveillance in Rio Grande do Sul, Brazil.


Assuntos
Comportamento Alimentar , Insetos Vetores/fisiologia , Insetos Vetores/parasitologia , Triatoma/fisiologia , Triatoma/parasitologia , Trypanosoma cruzi/fisiologia , Animais , Brasil , Doença de Chagas/transmissão , Modelos Animais de Doenças , Interações Hospedeiro-Parasita , Mordeduras e Picadas de Insetos , Modelos Logísticos , Camundongos , Ninfa , Eliminação Renal , Trypanosoma cruzi/patogenicidade
13.
Am J Trop Med Hyg ; 103(4): 1487-1489, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32748771

RESUMO

A collaborative investigation was initiated in rural coastal South Carolina in response to a reported triatomine bite. The eastern conenose bug, Triatoma sanguisuga, was identified and tested for Trypanosoma cruzi. The insect was negative by PCR, and no additional triatomines were found in the vicinity of the home. This is the first published report of a bite from T. sanguisuga in South Carolina despite the fact that triatomine vectors have been documented in the state since the 1850s, and specimens have been collected from homes in the past. Sylvatic T. cruzi reservoirs are common throughout the southeastern United States, and this case brings to light the possibility of human contact with infected triatomines in the state of South Carolina for public health and clinical and entomology professionals.


Assuntos
Doença de Chagas/transmissão , Mordeduras e Picadas de Insetos , Triatoma/classificação , Trypanosoma cruzi/isolamento & purificação , Animais , Feminino , Humanos , Insetos Vetores , Pessoa de Meia-Idade , South Carolina
14.
Proc Biol Sci ; 287(1933): 20201521, 2020 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-32811316

RESUMO

Of all hypotheses advanced for why zebras have stripes, avoidance of biting fly attack receives by far the most support, yet the mechanisms by which stripes thwart landings are not yet understood. A logical and popular hypothesis is that stripes interfere with optic flow patterns needed by flying insects to execute controlled landings. This could occur through disrupting the radial symmetry of optic flow via the aperture effect (i.e. generation of false motion cues by straight edges), or through spatio-temporal aliasing (i.e. misregistration of repeated features) of evenly spaced stripes. By recording and reconstructing tabanid fly behaviour around horses wearing differently patterned rugs, we could tease out these hypotheses using realistic target stimuli. We found that flies avoided landing on, flew faster near, and did not approach as close to striped and checked rugs compared to grey. Our observations that flies avoided checked patterns in a similar way to stripes refutes the hypothesis that stripes disrupt optic flow via the aperture effect, which critically demands parallel striped patterns. Our data narrow the menu of fly-equid visual interactions that form the basis for the extraordinary colouration of zebras.


Assuntos
Dípteros , Pigmentação , Animais , Cor , Sinais (Psicologia) , Voo Animal , Mordeduras e Picadas de Insetos
16.
Aust Vet J ; 98(8): 411-416, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32761617

RESUMO

OBJECTIVE: To assess the efficacy of an herbal spray combining various essential oils, with a claim of mast cell stabilisation, antipruritic, anti-inflammatory, and insect repellent effects on the clinical presentation of insect bite hypersensitivity (IBH) in horses. DESIGN: Double-blinded, placebo-controlled, randomised, cross-over clinical trial. METHODS: Twenty adult horses with clinical IBH were treated with a daily application of herbal spray or placebo for 28 days in a randomised, cross-over fashion, separated by a>28-day washout period. Horses were examined and scored prior to and after the completion of each treatment. Histopathology was performed on four horses. Owners kept daily diaries of observations. RESULTS: The herbal spray significantly reduced the severity of all assessed parameters (pruritus, excoriations, lichenification and alopecia; P < 0.05) compared with baseline values (pretreatment) and with placebo. Owners reported improvement of pruritus in 19/20 horses (95%) with complete resolution in 17 horses (85%) following treatment. Skin biopsies showed resolution of orthokeratosis in 4/4 horses, reduced thickness of the stratum spinosum in 2/4 horses and complete resolution of histopathological abnormalities in 1/4 horses after treatment, compared with either no change or deterioration of histopathologic lesions after placebo. No side effects were observed. CONCLUSIONS: The tested herbal spray may be an effective treatment for the management of equine IBH.


Assuntos
Ceratopogonidae , Doenças dos Cavalos , Hipersensibilidade/veterinária , Mordeduras e Picadas de Insetos/veterinária , Óleos Voláteis , Animais , Cavalos
17.
Artigo em Inglês | MEDLINE | ID: mdl-32854269

RESUMO

BACKGROUND: Hymenopteran stings are the most common animal insult injury encountered in the emergency department. With increasing global spread of imported fire ants in recent decades, the rate of Formicidae assault has become a serious problem in many countries. Formicidae-associated injuries gradually increased in Taiwan in recent decades and became the second most common arthropod assault injury in our ED. The present study aimed at comparing the clinical characteristics of Formicidae sting patients with those of the most serious and common group, Vespidae sting patients, in an emergency department (ED) in Taiwan. METHODS: This retrospective study included patients who were admitted between 2015 to 2018 to the ED in a local teaching hospital in Taiwan after a Vespidae or Formicidae sting. Cases with anaphylactic reaction were further compared. RESULTS: We reviewed the records of 881 subjects (503 males, 378 females; mean age, 49.09 ± 17.62 years) who visited our emergency department due to Vespidae or Formicidae stings. A total of 538 (61.1%) were categorized into the Vespidae group, and 343 (38.9%) were sorted into the Formicidae group. The Formicidae group had a longer ED length of stay (79.15 ± 92.30 vs. 108.00 ± 96.50 min, p < 0.01), but the Vespidae group had more cases that required hospitalization (1.9% vs. 0.3%, p = 0.04). Antihistamines (76.8% vs. 80.2%, p < 0.01) were more frequently used in the Formicidae group, while analgesics were more frequently used in the Vespidae group (38.1% vs. 12.5%, p < 0.01). The Vespidae group had more local reactions, and the Formicidae group had more extreme, systemic, or anaphylactic allergic reactions. Creatine kinase was significantly higher in the Vespidae group with an anaphylactic reaction. Sting frequency in both groups exhibited the same positive associations with average temperature of the month and weekend days. CONCLUSION: Formicidae sting patients presented to the ED with higher rate allergic reactions and spent more time in the ED than Vespidae sting patients. However, Vespidae sting patients had more complications and higher rates of admission, especially with anaphylactic reaction. Laboratory data, especially creatine kinase data, were more valuable to check in Vespidae sting patients with an anaphylactic reaction in the ED. Both groups exhibited positive correlations with temperature and a higher rate on weekend days.


Assuntos
Venenos de Formiga/efeitos adversos , Formigas , Serviço Hospitalar de Emergência/estatística & dados numéricos , Antagonistas dos Receptores Histamínicos/uso terapêutico , Mordeduras e Picadas de Insetos/tratamento farmacológico , Venenos de Vespas/efeitos adversos , Vespas , Adulto , Idoso , Anafilaxia/complicações , Anafilaxia/tratamento farmacológico , Animais , Venenos de Formiga/imunologia , Feminino , Humanos , Mordeduras e Picadas de Insetos/complicações , Mordeduras e Picadas de Insetos/epidemiologia , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taiwan/epidemiologia , Resultado do Tratamento , Venenos de Vespas/imunologia
19.
PLoS One ; 15(6): e0233840, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555601

RESUMO

BACKGROUND: Immunization with radiation-attenuated sporozoites (RAS) by mosquito bite provides >90% sterile protection against Plasmodium falciparum (Pf) malaria in humans. RAS invade hepatocytes but do not replicate. CD8+ T cells recognizing parasite-derived peptides on the surface of infected hepatocytes are likely the primary protective mechanism. We conducted a randomized clinical trial of RAS immunization to assess safety, to achieve 50% vaccine efficacy (VE) against controlled human malaria infection (CHMI), and to generate reagents from protected and non-protected subjects for future identification of protective immune mechanisms and antigens. METHODS: Two cohorts (Cohort 1 and Cohort 2) of healthy, malaria-naïve, non-pregnant adults age 18-50 received five monthly immunizations with infected (true-immunized, n = 21) or non-infected (mock-immunized, n = 5) mosquito bites and underwent homologous CHMI at 3 weeks. Immunization parameters were selected for 50% protection based on prior clinical data. Leukapheresis was done to collect plasma and peripheral blood mononuclear cells. RESULTS: Adverse event rates were similar in true- and mock-immunized subjects. Two true- and two mock-immunized subjects developed large local reactions likely caused by mosquito salivary gland antigens. In Cohort 1, 11 subjects received 810-1235 infected bites; 6/11 (55%) were protected against CHMI vs. 0/3 mock-immunized and 0/6 infectivity controls (VE 55%). In Cohort 2, 10 subjects received 839-1131 infected bites with a higher first dose and a reduced fifth dose; 9/10 (90%) were protected vs. 0/2 mock-immunized and 0/6 controls (VE 90%). Three/3 (100%) protected subjects administered three booster immunizations were protected against repeat CHMI vs. 0/6 controls (VE 100%). Cohort 2 uniquely showed a significant rise in IFN-γ responses after the third and fifth immunizations and higher antibody responses to CSP. CONCLUSIONS: PfRAS were generally safe and well tolerated. Cohort 2 had a higher first dose, reduced final dose, higher antibody responses to CSP and significant rise of IFN-γ responses after the third and fifth immunizations. Whether any of these factors contributed to increased protection in Cohort 2 requires further investigation. A cryobank of sera and cells from protected and non-protected individuals was generated for future immunological studies and antigen discovery. TRIAL REGISTRATION: ClinicalTrials.gov NCT01994525.


Assuntos
Mordeduras e Picadas de Insetos/imunologia , Malária/prevenção & controle , Esporozoítos/imunologia , Vacinação/métodos , Vacinas Atenuadas/efeitos adversos , Adulto , Animais , Anopheles/parasitologia , Anopheles/fisiologia , Feminino , Raios gama , Humanos , Malária/imunologia , Masculino , Pessoa de Meia-Idade , Mosquitos Vetores/parasitologia , Mosquitos Vetores/fisiologia , Plasmodium falciparum/crescimento & desenvolvimento , Plasmodium falciparum/imunologia , Plasmodium falciparum/patogenicidade , Proteínas de Protozoários/imunologia , Esporozoítos/patogenicidade , Esporozoítos/efeitos da radiação , Vacinação/efeitos adversos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA