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Lin L, Dacal E, Díez N, Carmona C, Martin Ramirez A, Barón Argos L, Bermejo-Peláez D, Caballero C, Cuadrado D, Darias-Plasencia O, García-Villena J, Bakarjiev A, Postigo M, Recalde-Jaramillo E, Flores-Chavez M, Santos A, Ledesma-Carbayo MJ, Rubio JM, Luengo-Oroz M. Edge Artificial Intelligence (AI) for real-time automatic quantification of filariasis in mobile microscopy. PLoS Negl Trop Dis 2024; 18:e0012117. [PMID: 38630833 DOI: 10.1371/journal.pntd.0012117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 03/29/2024] [Indexed: 04/19/2024] Open
Abstract
Filariasis, a neglected tropical disease caused by roundworms, is a significant public health concern in many tropical countries. Microscopic examination of blood samples can detect and differentiate parasite species, but it is time consuming and requires expert microscopists, a resource that is not always available. In this context, artificial intelligence (AI) can assist in the diagnosis of this disease by automatically detecting and differentiating microfilariae. In line with the target product profile for lymphatic filariasis as defined by the World Health Organization, we developed an edge AI system running on a smartphone whose camera is aligned with the ocular of an optical microscope that detects and differentiates filarias species in real time without the internet connection. Our object detection algorithm that uses the Single-Shot Detection (SSD) MobileNet V2 detection model was developed with 115 cases, 85 cases with 1903 fields of view and 3342 labels for model training, and 30 cases with 484 fields of view and 873 labels for model validation before clinical validation, is able to detect microfilarias at 10x magnification and distinguishes four species of them at 40x magnification: Loa loa, Mansonella perstans, Wuchereria bancrofti, and Brugia malayi. We validated our augmented microscopy system in the clinical environment by replicating the diagnostic workflow encompassed examinations at 10x and 40x with the assistance of the AI models analyzing 18 samples with the AI running on a middle range smartphone. It achieved an overall precision of 94.14%, recall of 91.90% and F1 score of 93.01% for the screening algorithm and 95.46%, 97.81% and 96.62% for the species differentiation algorithm respectively. This innovative solution has the potential to support filariasis diagnosis and monitoring, particularly in resource-limited settings where access to expert technicians and laboratory equipment is scarce.
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Affiliation(s)
- Lin Lin
- Spotlab, Madrid, Spain
- Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Claudia Carmona
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III-Madrid, Madrid, Spain
| | - Alexandra Martin Ramirez
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III-Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC) Instituto de Salud Carlos III-Madrid, Madrid, Spain
| | - Lourdes Barón Argos
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III-Madrid, Madrid, Spain
| | | | | | | | | | | | | | | | - Ethan Recalde-Jaramillo
- Spotlab, Madrid, Spain
- Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Flores-Chavez
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III-Madrid, Madrid, Spain
- Fundación Mundo Sano, Madrid, Spain
| | - Andrés Santos
- Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
| | - María Jesús Ledesma-Carbayo
- Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
| | - José M Rubio
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III-Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC) Instituto de Salud Carlos III-Madrid, Madrid, Spain
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Martín Ramírez A, Barón Argos L, Lanza Suárez M, Carmona Rubio C, Pérez-Ayala A, Hisam SR, Rubio JM. Malaria diagnosis using a combined system of a simple and fast extraction method with a lyophilised Dual-LAMP assay in a non-endemic setting. Pathog Glob Health 2024; 118:80-90. [PMID: 37415348 PMCID: PMC10769111 DOI: 10.1080/20477724.2023.2232595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
Abstract
Malaria is a parasitic disease distributed in tropical areas but with a high number of imported cases in non-endemic countries. The most specific and sensitive malaria diagnostic methods are PCR and LAMP. However, both require specific equipment, extraction procedures and a cold chain. This study aims to solve some limitations of LAMP method with the optimization and validation of six LAMP assays, genus and species-specific, using an easy and fast extraction method, the incorporation of a reaction control assay, two ways (Dual) of result reading and reagent lyophilization. The Dual-LAMP assays were validated against the Nested-Multiplex Malaria PCR. A conventional column and saline extraction methods, and the use of lyophilized reaction tubes were also assessed. A new reaction control Dual-LAMP-RC assay was designed. Dual-LAMP-Pspp assay showed no cross-reactivity with other parasites, repeatability and reproducibility of 100%, a significant correlation between parasite concentration and time to amplification and a LoD of 1.22 parasites/µl and 5.82 parasites/µl using column and saline extraction methods, respectively. Sensitivity and specificity of the six Dual-LAMP assays reach values of 100% or close to this, being lower for the Dual-LAMP-Pm. The Dual-LAMP-RC assay worked as expected. Lyophilized Dual-LAMP results were concordant with the reference method. Dual-LAMP malaria assays with the addition of a new reaction control LAMP assay and the use of a fast and easy saline extraction method, provided low limit of detection, no cross-reactivity, and good sensitivity and specificity. Furthermore, the reagent lyophilization and the dual result reading allow their use in most settings.
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Affiliation(s)
- Alexandra Martín Ramírez
- Malaria & Parasitic Emerging Diseases Laboratory. National Microbiology Center, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
- Centro de Investigación Biomédica En Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Lourdes Barón Argos
- Malaria & Parasitic Emerging Diseases Laboratory. National Microbiology Center, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Marta Lanza Suárez
- Malaria & Parasitic Emerging Diseases Laboratory. National Microbiology Center, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Claudia Carmona Rubio
- Malaria & Parasitic Emerging Diseases Laboratory. National Microbiology Center, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Ana Pérez-Ayala
- Department of Clinical Microbiology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Shamilah R. Hisam
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institute of Health, Setia Alam, Selangor, Malaysia
| | - José M. Rubio
- Malaria & Parasitic Emerging Diseases Laboratory. National Microbiology Center, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
- Centro de Investigación Biomédica En Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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Treviño B, Zarzuela F, Oliveira-Souto I, Maturana CR, Serre-Delcor N, Aznar ML, Pou D, Goterris L, Salvador F, Bosch-Nicolau P, Rubio JM, Ruiz E, Molina I, Sulleiro E. Unexpected Loa loa Finding in an Asymptomatic Patient From The Gambia: A Case Report. Open Forum Infect Dis 2023; 10:ofad338. [PMID: 37484898 PMCID: PMC10358219 DOI: 10.1093/ofid/ofad338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/29/2023] [Indexed: 07/25/2023] Open
Abstract
A 17-year-old asymptomatic male from The Gambia presented for a routine health examination after migration to Spain. Laboratory diagnosis confirmed the presence of Loa loa microfilariae. This unusual finding emphasizes the importance of screening in newly arrived migrants and the need of an extended anamnesis including migratory route and previous travels.
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Affiliation(s)
- Begoña Treviño
- Vall d’Hebron-Drassanes International Health Unit, Infectious Diseases Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
- Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain
| | - Francesc Zarzuela
- Vall d’Hebron-Drassanes International Health Unit, Microbiology Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
| | - Inés Oliveira-Souto
- Correspondence: Inés Oliveira-Souto, MD, PhD, Unidad de Salud Internacional Vall d’Hebron-Drassanes, Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d’Hebron, Passeig de la Vall d’Hebron 119-129, 08035 Barcelona, Spain ()
| | - Carles Rubio Maturana
- Vall d’Hebron-Drassanes International Health Unit, Microbiology Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
| | - Núria Serre-Delcor
- Vall d’Hebron-Drassanes International Health Unit, Infectious Diseases Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
- Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain
| | - Maria L Aznar
- Vall d’Hebron-Drassanes International Health Unit, Infectious Diseases Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
- Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain
| | - Diana Pou
- Vall d’Hebron-Drassanes International Health Unit, Infectious Diseases Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
- Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain
| | - Lidia Goterris
- Vall d’Hebron-Drassanes International Health Unit, Microbiology Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
| | - Fernando Salvador
- Vall d’Hebron-Drassanes International Health Unit, Infectious Diseases Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
- Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain
| | - Pau Bosch-Nicolau
- Vall d’Hebron-Drassanes International Health Unit, Infectious Diseases Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
- Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain
| | - José M Rubio
- Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain
- Microbiology National Centre, Carlos III Health Institute, Madrid, Spain
| | - Edurne Ruiz
- Vall d’Hebron-Drassanes International Health Unit, Microbiology Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
| | - Israel Molina
- Vall d’Hebron-Drassanes International Health Unit, Infectious Diseases Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
- Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain
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Morales Martínez KA, Muñoz García C, Figueroa Delgado A, Chávez Güitrón L, Osorio Saravia D, Saavedra Montañez M, Martínez Maya JJ, Rubio JM, Villalobos N. Parasite identification in mullet fish (Mugil curema) from Chautengo Lagoon, Guerrero, Mexico, based on morphology and molecular analysis. Exp Parasitol 2022; 240:108335. [PMID: 35932907 DOI: 10.1016/j.exppara.2022.108335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/01/2022] [Accepted: 07/12/2022] [Indexed: 11/04/2022]
Abstract
Parasite identification is crucial in areas where no sanitary inspection is conducted on fish, especially considering that parasitic zoonoses like anisakiasis and gnathostomiasis can pose a risk for human health. In this study, parasites in mullet fish (Mugil curema) from the Chautengo Lagoon, Guerrero, Mexico, were identified by morphological and molecular methods. A total of 122 specimens weighing 317 ± 51.25 g and 19.3 ± 1.14 cm in length were assessed. Their helminthofauna was classified by measuring internal structures, total length, and maximum width; a morphometric index was also calculated for larval stages. The prevalence of parasitosis in these mullets was 91.8%, with a mean infection intensity of 4.1. The acanthocephalan Floridosentis mugilis was identified by its external and internal structures. The nematodes found were of the Anisakidae family in stage 3 (L3), with a morphology consistent with Contracaecum sp. To determine the species, the ITS ribosomal gene and the mitochondrial genes COX2 and rrnS were molecularly characterized by PCR; then, they were aligned by CLUSTAL W, and a phylogenetic tree was obtained. In this analysis, the sequences were compared with those reported in GenBank. A total of 460 parasites were studied, 283 of which were nematodes (61.5%) and 177 were acanthocephalans (38.5%). The sequences of seven nematodes showed 99% homology with each other, and thus they formed an independent branch within the Contracaecum sp. group. This is the first report identifying Contracaecum multipapillatum in mullet fish in the Chautengo Lagoon, Guerrero.
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Affiliation(s)
- Karla Azucena Morales Martínez
- Universidad Tecnológica de Tecámac UTTEC. Km 37.5 Ctra. Fed. México-Pachuca S/N, C.P. 55740, Col. Sierra Hermosa, Tecámac, Estado de México, Mexico
| | - Carlota Muñoz García
- Parasitology Department. National Microbiology Center, Instituto de Salud Carlos III. Madrid, Ctra. Majadahonda Pozuelo Km 2 Majadahonda, 28220. Madrid, Spain
| | - Alfredo Figueroa Delgado
- Universidad Tecnológica del Mar del Estado de Guerrero. Avenida Universidad S/N, Barra de Tecoanapa, Marquelia, Guerrero, 41937, Mexico
| | - Lorena Chávez Güitrón
- Universidad Tecnológica de Tecámac UTTEC. Km 37.5 Ctra. Fed. México-Pachuca S/N, C.P. 55740, Col. Sierra Hermosa, Tecámac, Estado de México, Mexico
| | - David Osorio Saravia
- Colegio de Ciencias y Humanidades Plantel Oriente. Av. Canal de San Juan Esq. Sur 24, Col. Tepalcates, CDMX, 09210, Mexico
| | - Manuel Saavedra Montañez
- Departamento de Microbiología e Inmunología. Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México. Circuito Exterior S/N, Ciudad Universitaria, CDMX, 04510, Mexico
| | - José Juan Martínez Maya
- Departamento de Medicina Preventiva y Salud Pública. Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México. Circuito Exterior S/N, Ciudad Universitaria, CDMX, 04510, Mexico
| | - José M Rubio
- Parasitology Department. National Microbiology Center, Instituto de Salud Carlos III. Madrid, Ctra. Majadahonda Pozuelo Km 2 Majadahonda, 28220. Madrid, Spain
| | - Nelly Villalobos
- Departamento de Patología. Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México. Circuito Exterior S/N, Ciudad Universitaria, CDMX, 04510, Mexico.
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Martín-Ramírez A, Lanza M, Hisam S, Perez-Ayala A, Rubio JM. Usefulness of a commercial LAMP assay for detection of malaria infection, including Plasmodium knowlesi cases, in returning travelers in Spain. BMC Res Notes 2022; 15:147. [PMID: 35468833 PMCID: PMC9036737 DOI: 10.1186/s13104-022-06037-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/11/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objective
Main malaria diagnosis is based on microscopic examination combined with rapid diagnostic tests. Both methods have low sensitivity and specificity. Loop-mediated isothermal amplification techniques have shown a sensitivity similar to PCR but with lower times of performance. This study aimed to assess a commercial LAMP for the diagnosis of malaria (Alethia® Malaria) against the Nested-Multiplex-Malaria PCR, including the analytical sensitivity and the operational characteristics.
Results
One hundred five samples out of 114 rendered valid results, obtaining 85 positive samples and 18 negative samples with an agreement of 98% compared to the reference method with a sensitivity, specificity and kappa coefficient of 98.84%, 94.74% and 0.94 respectively, with only two discrepant samples. The turnaround time was estimated in 1 h and 30 min, with a cost of 32.67€ per determination. The results showed several advantages of the Alethia® Malaria, as it was easy to perform, minimal training requirement and 40 min run. Moreover, it includes an internal control to avoid false negatives. However, it also showed some limitations such as the need for a specific amplification and detection device, the detection of only Plasmodium spp. and a very high price.
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Soldevila-Matías P, Albajes-Eizagirre A, Radua J, García-Martí G, Rubio JM, Tordesillas-Gutierrez D, Fuentes-Durá I, Solanes A, Fortea L, Oliver D, Sanjuán J. Precuneus and insular hypoactivation during cognitive processing in first-episode psychosis: Systematic review and meta-analysis of fMRI studies. Rev Psiquiatr Salud Ment (Engl Ed) 2022; 15:101-116. [PMID: 35840277 DOI: 10.1016/j.rpsmen.2022.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/09/2020] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The neural correlates of the cognitive dysfunction in first-episode psychosis (FEP) are still unclear. The present review and meta-analysis provide an update of the location of the abnormalities in the fMRI-measured brain response to cognitive processes in individuals with FEP. METHODS Systematic review and voxel-based meta-analysis of cross-sectional fMRI studies comparing neural responses to cognitive tasks between individuals with FEP and healthy controls (HC) according to PRISMA guidelines. RESULTS Twenty-six studies were included, comprising 598 individuals with FEP and 567 HC. Individual studies reported statistically significant hypoactivation in the dorsolateral prefrontal cortex (6 studies), frontal lobe (8 studies), cingulate (6 studies) and insula (5 studies). The meta-analysis showed statistically significant hypoactivation in the left anterior insula, precuneus and bilateral striatum. CONCLUSIONS While the studies tend to highlight frontal hypoactivation during cognitive tasks in FEP, our meta-analytic results show that the left precuneus and insula primarily display aberrant activation in FEP that may be associated with salience attribution to external stimuli and related to deficits in perception and regulation.
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Affiliation(s)
- Pau Soldevila-Matías
- Research Institute of the Hospital Clínic Universitari of Valencia (INCLIVA), Valencia, Spain; Department of Basic Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Anton Albajes-Eizagirre
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Joaquim Radua
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Gracián García-Martí
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Biomedical Engineering Unit/Radiology Department, Quirónsalud Hospital, Spain
| | - José M Rubio
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; The Feinstein Institute, Northwell Health Hospital, New York, USA
| | - Diana Tordesillas-Gutierrez
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; University Hospital Marqués de Valdecilla (IDIVAL), Department of Psychiatry, School of Medicine, University of Cantabria, Spain; Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL, Santander, Cantabria, Spain
| | - Inmaculada Fuentes-Durá
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Aleix Solanes
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Lydia Fortea
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; OASIS Service, South London and the Maudsley NHS Foundation Trust, London, UK
| | - Julio Sanjuán
- Research Institute of the Hospital Clínic Universitari of Valencia (INCLIVA), Valencia, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Psychiatric, University of Valencia, School of Medicine, Valencia, Spain
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Martín-Ramírez A, Lanza-Suárez M, Muñoz-García C, Hisam SR, Perez-Ayala A, Rubio JM. Usefulness of Malachite-Green LAMP for Diagnosis of Plasmodium and Five Human Malaria Species in a Nonendemic Setting. Am J Trop Med Hyg 2022; 106:tpmd211151. [PMID: 35292597 PMCID: PMC9128691 DOI: 10.4269/ajtmh.21-1151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/22/2021] [Indexed: 11/07/2022] Open
Abstract
Molecular methods are necessary to detect low-density malaria infections. The purpose of this study was to assess the diagnostic performance of six malachite-green loop-mediated amplification method (MG-LAMP) assays (MG-LAMP-Pf, MG-LAMP-Pv, MG-LAMP-Po, MG-LAMP-Pm, MG-LAMP-Pk, and MG-LAMP-Pspp) for the species-specific detection of each human Plasmodium, including P. knowlesi, and the Plasmodium genus compared with the nested-multiplex malaria polymerase chain reaction (NM-PCR), using 161 malaria-positive and 274 malaria-negative samples. MG-LAMP-Pspp assay detected the five human Plasmodium species and each species-specific MG-LAMP assay detected only its corresponding species. Sensitivity, specificity, and predictive values of MG-LAMP assays, compared with NM-PCR, were > 90%, except in the case of the MG-LAMP-Pm assay, which dropped to 47%. Limit of detection for MG-LAMP-Pspp assay ranged from 0.1 parasites/µL for P. falciparum to 16.9 parasites/µL for P. malariae samples, and it was similar for the rest of MG-LAMP assays except for the MG-LAMP-Pm assay. Turnaround time was estimated to be 2 hours and 35 minutes for one MG-LAMP assay and 4 hours and 15 minutes if all species-specific MG-LAMP is set up, whereas for the NM-PCR, turnaround time was ∼6 hours and 15 minutes. Costs per determination ranged from 1 to 6 euros for MG-LAMP assays and 5 euros for NM-PCR. Therefore, MG-LAMP assays appear to have good concordance compared with the reference method, except for the MG-LAMP-Pm assay. They can detect low parasitemia and identify malaria species, with lower costs and shorter time to obtain results, and they are suitable tools to be used in endemic and non-endemic countries for malaria detection.
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Affiliation(s)
- Alexandra Martín-Ramírez
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Lanza-Suárez
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - Carlota Muñoz-García
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - Shamilah R. Hisam
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Ana Perez-Ayala
- Department of Clinical Microbiology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - José M. Rubio
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
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Köster PC, Renelies-Hamilton J, Dotras L, Llana M, Vinagre-Izquierdo C, Prakas P, Sneideris D, Dashti A, Bailo B, Lanza M, Jiménez-Mejías A, Muñoz-García C, Muadica AS, González-Barrio D, Rubio JM, Fuentes I, Ponce-Gordo F, Calero-Bernal R, Carmena D. Molecular Detection and Characterization of Intestinal and Blood Parasites in Wild Chimpanzees ( Pan troglodytes verus) in Senegal. Animals (Basel) 2021; 11:ani11113291. [PMID: 34828022 PMCID: PMC8614354 DOI: 10.3390/ani11113291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/02/2021] [Accepted: 11/11/2021] [Indexed: 11/24/2022] Open
Abstract
Simple Summary Western chimpanzees are currently listed as a Critically Endangered subspecies. Human encroachment has taken a toll on this great ape due to fragmented habitat and the exchange of pathogens. This epidemiological study investigated the occurrence and genetic diversity of intestinal and blood parasites in faecal samples from wild chimpanzees living in the Dindefelo Community Nature Reserve, Senegal. We paid special attention to potential human-driven sources of infection and transmission pathways. Potential diarrhoea-causing protist parasites (e.g., Cryptosporidium spp., Giardia duodenalis, Entamoeba histolytica) were detected at low infection rates (and densities) or absent, whereas commensals (Entamoeba dispar) or protist of uncertain pathogenicity (Blastocystis sp.) were far more abundant. We detected Sarcocystis spp. in chimpanzee faeces. Blood protist parasites such as Plasmodium spp. and Trypanosoma brucei spp. (the etiological agents of malaria and sleeping sickness, respectively, in humans) were also found at low prevalences, but microfilariae of the nematode Mansonella perstans were frequently found. Molecular analyses primarily revealed host-adapted species/genotypes and an apparent absence of gastrointestinal clinical manifestations in infected chimpanzees. Zoonotic events of still unknown frequency and directionality may have taken part between wild chimpanzees and humans sharing natural habitats and resources. Abstract Wild chimpanzee populations in West Africa (Pan troglodytes verus) have dramatically decreased as a direct consequence of anthropogenic activities and infectious diseases. Little information is currently available on the epidemiology, pathogenic significance, and zoonotic potential of protist species in wild chimpanzees. This study investigates the occurrence and genetic diversity of intestinal and blood protists as well as filariae in faecal samples (n = 234) from wild chimpanzees in the Dindefelo Community Nature Reserve, Senegal. PCR-based results revealed the presence of intestinal potential pathogens (Sarcocystis spp.: 11.5%; Giardia duodenalis: 2.1%; Cryptosporidium hominis: 0.9%), protist of uncertain pathogenicity (Blastocystis sp.: 5.6%), and commensal species (Entamoeba dispar: 18.4%; Troglodytella abrassarti: 5.6%). Entamoeba histolytica, Enterocytozoon bieneusi, and Balantioides coli were undetected. Blood protists including Plasmodium malariae (0.4%), Trypanosoma brucei (1.3%), and Mansonella perstans (9.8%) were also identified. Sanger sequencing analyses revealed host-adapted genetic variants within Blastocystis, but other parasitic pathogens (C. hominis, P. malariae, T. brucei, M. perstans) have zoonotic potential, suggesting that cross-species transmission between wild chimpanzees and humans is possible in areas where both species overlap. Additionally, we explored potential interactions between intestinal/blood protist species and seasonality and climate variables. Chimpanzees seem to play a more complex role on the epidemiology of pathogenic and commensal protist and nematode species than initially anticipated.
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Affiliation(s)
- Pamela C. Köster
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, 28220 Majadahonda, Spain; (P.C.K.); (A.D.); (B.B.); (M.L.); (A.J.-M.); (C.M.-G.); (A.S.M.); (D.G.-B.); (J.M.R.); (I.F.)
| | - Justinn Renelies-Hamilton
- Section for Ecology and Evolution, Department of Biology, University of Copenhagen, DK-1165 Copenhagen, Denmark;
| | - Laia Dotras
- Jane Goodall Institute Spain and Senegal, Dindefelo Biological Station, Dindefelo, Kedougou, Senegal; (L.D.); (M.L.)
| | - Manuel Llana
- Jane Goodall Institute Spain and Senegal, Dindefelo Biological Station, Dindefelo, Kedougou, Senegal; (L.D.); (M.L.)
| | | | - Petras Prakas
- Nature Research Centre, LT-08412 Vilnius, Lithuania; (P.P.); (D.S.)
| | | | - Alejandro Dashti
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, 28220 Majadahonda, Spain; (P.C.K.); (A.D.); (B.B.); (M.L.); (A.J.-M.); (C.M.-G.); (A.S.M.); (D.G.-B.); (J.M.R.); (I.F.)
| | - Begoña Bailo
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, 28220 Majadahonda, Spain; (P.C.K.); (A.D.); (B.B.); (M.L.); (A.J.-M.); (C.M.-G.); (A.S.M.); (D.G.-B.); (J.M.R.); (I.F.)
| | - Marta Lanza
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, 28220 Majadahonda, Spain; (P.C.K.); (A.D.); (B.B.); (M.L.); (A.J.-M.); (C.M.-G.); (A.S.M.); (D.G.-B.); (J.M.R.); (I.F.)
| | - Alejandra Jiménez-Mejías
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, 28220 Majadahonda, Spain; (P.C.K.); (A.D.); (B.B.); (M.L.); (A.J.-M.); (C.M.-G.); (A.S.M.); (D.G.-B.); (J.M.R.); (I.F.)
| | - Carlota Muñoz-García
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, 28220 Majadahonda, Spain; (P.C.K.); (A.D.); (B.B.); (M.L.); (A.J.-M.); (C.M.-G.); (A.S.M.); (D.G.-B.); (J.M.R.); (I.F.)
| | - Aly S. Muadica
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, 28220 Majadahonda, Spain; (P.C.K.); (A.D.); (B.B.); (M.L.); (A.J.-M.); (C.M.-G.); (A.S.M.); (D.G.-B.); (J.M.R.); (I.F.)
- Departamento de Ciências e Tecnologia, Universidade Licungo, Quelimane 106, Mozambique
| | - David González-Barrio
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, 28220 Majadahonda, Spain; (P.C.K.); (A.D.); (B.B.); (M.L.); (A.J.-M.); (C.M.-G.); (A.S.M.); (D.G.-B.); (J.M.R.); (I.F.)
| | - José M. Rubio
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, 28220 Majadahonda, Spain; (P.C.K.); (A.D.); (B.B.); (M.L.); (A.J.-M.); (C.M.-G.); (A.S.M.); (D.G.-B.); (J.M.R.); (I.F.)
| | - Isabel Fuentes
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, 28220 Majadahonda, Spain; (P.C.K.); (A.D.); (B.B.); (M.L.); (A.J.-M.); (C.M.-G.); (A.S.M.); (D.G.-B.); (J.M.R.); (I.F.)
| | - Francisco Ponce-Gordo
- Department of Microbiology and Parasitology, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Rafael Calero-Bernal
- Salud Veterinaria y Zoonosis (SALUVET), Department of Animal Health, Faculty of Veterinary, Complutense University of Madrid, 28040 Madrid, Spain
- Correspondence: (R.C.-B.); (D.C.)
| | - David Carmena
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, 28220 Majadahonda, Spain; (P.C.K.); (A.D.); (B.B.); (M.L.); (A.J.-M.); (C.M.-G.); (A.S.M.); (D.G.-B.); (J.M.R.); (I.F.)
- Correspondence: (R.C.-B.); (D.C.)
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9
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Ramírez AM, Tang THT, Suárez ML, Fernández AÁ, García CM, Hisam S, Rubio JM. Assessment of Commercial Real-Time PCR Assays for Detection of Malaria Infection in a Non-Endemic Setting. Am J Trop Med Hyg 2021; 105:1732-1737. [PMID: 34662870 DOI: 10.4269/ajtmh.21-0406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/09/2021] [Indexed: 11/07/2022] Open
Abstract
Malaria control and elimination require prompt diagnosis and accurate treatment. Conventional methods such as rapid diagnostic tests (RDTs) and microscopy lack the characteristics to detect low parasitemias, commonly found in asymptomatic parasitemias and/or submicroscopic malaria carriers. On the contrary, molecular methods have higher sensitivity and specificity. This study evaluated the performance of two commercial real-time polymerase chain reaction (PCR) assays, RealStar® Malaria PCR (RealStar-genus) and RealStar Malaria Screen&Type PCR (RealStar-species), compared with the reference Nested Multiplex Malaria PCR, for the detection of the main five Plasmodium species affecting humans. A total of 121 samples were evaluated. Values of sensitivity (98.9% and 97.8%) and specificity (100% and 96.7%) of the RealStar-genus and the RealStar-species assays, respectively, were very good. The limit of detection (LoD) for the RealStar-genus assay showed a mean value of 0.28 parasites/µL with Plasmodium falciparum samples; while, the LoD of the RealStar-species assay ranged from 0.09 parasites/µL for P. vivax to two parasites/µL for P. ovale. The time to complete a diagnosis was established in 4 hours. Our findings showed a very good concordance of both assays compared with the reference method, with a very good analytical sensitivity. RealStar-species assay was able to correctly characterize double and triple infections. Therefore, these RealStar assays have shown to be useful tools in malaria diagnosis in non-endemic countries and even endemic countries, and for malaria control in general, detecting low parasitemias with sensitivity similar to the most sensitive methods as nested PCR, but with lower time to get the results.
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Affiliation(s)
- Alexandra Martín Ramírez
- Malaria and Parasitic Emerging Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | - Thuy Huong Ta Tang
- Malaria and Parasitic Emerging Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain.,NTD Laboratory, Tropical Medicine Center, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Lanza Suárez
- Malaria and Parasitic Emerging Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Álvarez Fernández
- Malaria and Parasitic Emerging Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | - Carlota Muñoz García
- Malaria and Parasitic Emerging Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | - Shamilah Hisam
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institute of Health, Setia Alam, Selangor, Malaysia
| | - José M Rubio
- Malaria and Parasitic Emerging Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
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Abstract
Mansonellosis is caused by three filarial parasite species from the genus Mansonella that commonly produce chronic human microfilaraemias: M. ozzardi, M. perstans and M. streptocerca. The disease is widespread in Africa, the Caribbean and South and Central America, and although it is typically asymptomatic it has been associated with mild pathologies including leg-chills, joint-pains, headaches, fevers, and corneal lesions. No robust mansonellosis disease burden estimates have yet been made and the impact the disease has on blood bank stocks and the monitoring of other filarial diseases is not thought to be of sufficient public health importance to justify dedicated disease management interventions. Mansonellosis´s Ceratopogonidae and Simuliidae vectors are not targeted by other control programmes and because of their small size and out-door biting habits are unlikely to be affected by interventions targeting other disease vectors like mosquitoes. The ivermectin and mebendazole-based mass drug administration (iMDA and mMDA) treatment regimens deployed by the WHO´s Elimination of Neglected Tropical Diseases (ESPEN) programme and its forerunners have, however, likely impacted significantly on the mansonellosis disease burden, principally by reducing the transmission of M. streptocerca in Africa. The increasingly popular plan of using iMDA to control malaria could also affect M. ozzardi parasite prevalence and transmission in Latin America in the future. However, a potentially far greater mansonellosis disease burden impact is likely to come from short-course curative anti-Wolbachia therapeutics, which are presently being developed for onchocerciasis and lymphatic filariasis treatment. Even if the WHO´s ESPEN programme does not choose to deploy these drugs in MDA interventions, they have the potential to dramatically increase the financial and logistical feasibility of effective mansonellosis management. There is, thus, now a fresh and urgent need to better characterise the disease burden and eco-epidemiology of mansonellosis so that effective management programmes can be designed, advocated for and implemented.
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Affiliation(s)
- Thuy-Huong Ta-Tang
- Malaria and NTDs Laboratory, National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain
| | - Sergio L B Luz
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, Amazonas State, Brazil
| | - James L Crainey
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, Amazonas State, Brazil
| | - José M Rubio
- Malaria & Emerging Parasitic Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
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11
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Alvarez-Fernandez A, Bernal MJ, Fradejas I, Martin Ramírez A, Md Yusuf NA, Lanza M, Hisam S, Pérez de Ayala A, Rubio JM. KASP: a genotyping method to rapid identification of resistance in Plasmodium falciparum. Malar J 2021; 20:16. [PMID: 33407529 PMCID: PMC7789257 DOI: 10.1186/s12936-020-03544-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 12/11/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The emergence and spread of anti-malarial resistance continues to hinder malaria control. Plasmodium falciparum, the species that causes most human malaria cases and most deaths, has shown resistance to almost all known anti-malarials. This anti-malarial resistance arises from the development and subsequent expansion of Single Nucleotide Polymorphisms (SNPs) in specific parasite genes. A quick and cheap tool for the detection of drug resistance can be crucial and very useful for use in hospitals and in malaria control programmes. It has been demonstrated in different contexts that genotyping by Kompetitive Allele Specific PCR (KASP), is a simple, fast and economical method that allows a high-precision biallelic characterization of SNPs, hence its possible utility in the study of resistance in P. falciparum. METHODS Three SNPs involved in most cases of resistance to the most widespread anti-malarial treatments have been analysed by PCR plus sequencing and by KASP (C580Y of the Kelch13 gene, Y86N of the Pfmdr1 gene and M133I of the Pfcytb gene). A total of 113 P. falciparum positive samples and 24 negative samples, previously analysed by PCR and sequencing, were selected for this assay. Likewise, the samples were genotyped for the MSP-1 and MSP-2 genes, and the Multiplicity of Infection (MOI) and parasitaemia were measured to observe their possible influence on the KASP method. RESULTS The KASP results showed the same expected mutations and wild type genotypes as the reference method, with few exceptions that correlated with very low parasitaemia samples. In addition, two cases of heterozygotes that had not been detected by sequencing were found. No correlation was found between the MOI or parasitaemia and the KASP values of the sample. The reproducibility of the technique shows no oscillations between repetitions in any of the three SNPs analysed. CONCLUSIONS The KASP assays developed in this study were efficient and versatile for the determination of the Plasmodium genotypes related to resistance. The method is simple, fast, reproducible with low cost in personnel, material and equipment and scalable, being able to core KASP arrays, including numerous SNPs, to complete the main pattern of mutations associated to P. falciparum resistance.
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Affiliation(s)
- Ana Alvarez-Fernandez
- Malaria & Parasitic Emerging Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | - María J Bernal
- Malaria & Parasitic Emerging Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Fradejas
- Department of Clinical Microbiology, Hospital Universitario, 12 de Octubre, Madrid, Spain
| | - Alexandra Martin Ramírez
- Malaria & Parasitic Emerging Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | - Noor Azian Md Yusuf
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institute of Health, Setia Alam, Selangor, Malaysia
| | - Marta Lanza
- Malaria & Parasitic Emerging Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | - Shamilah Hisam
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institute of Health, Setia Alam, Selangor, Malaysia
| | - Ana Pérez de Ayala
- Department of Clinical Microbiology, Hospital Universitario, 12 de Octubre, Madrid, Spain
| | - José M Rubio
- Malaria & Parasitic Emerging Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain.
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12
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Soldevila-Matías P, Albajes-Eizagirre A, Radua J, García-Martí G, Rubio JM, Tordesillas-Gutierrez D, Fuentes-Durá I, Solanes A, Fortea L, Oliver D, Sanjuán J. Precuneus and insular hypoactivation during cognitive processing in first-episode psychosis: Systematic review and meta-analysis of fMRI studies. Rev Psiquiatr Salud Ment (Engl Ed) 2020; 15:S1888-9891(20)30100-2. [PMID: 32988773 DOI: 10.1016/j.rpsm.2020.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/02/2020] [Accepted: 08/09/2020] [Indexed: 01/16/2023]
Abstract
INTRODUCTION The neural correlates of the cognitive dysfunction in first-episode psychosis (FEP) are still unclear. The present review and meta-analysis provide an update of the location of the abnormalities in the fMRI-measured brain response to cognitive processes in individuals with FEP. METHODS Systematic review and voxel-based meta-analysis of cross-sectional fMRI studies comparing neural responses to cognitive tasks between individuals with FEP and healthy controls (HC) according to PRISMA guidelines. RESULTS Twenty-six studies were included, comprising 598 individuals with FEP and 567 HC. Individual studies reported statistically significant hypoactivation in the dorsolateral prefrontal cortex (6 studies), frontal lobe (8 studies), cingulate (6 studies) and insula (5 studies). The meta-analysis showed statistically significant hypoactivation in the left anterior insula, precuneus and bilateral striatum. CONCLUSIONS While the studies tend to highlight frontal hypoactivation during cognitive tasks in FEP, our meta-analytic results show that the left precuneus and insula primarily display aberrant activation in FEP that may be associated with salience attribution to external stimuli and related to deficits in perception and regulation.
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Affiliation(s)
- Pau Soldevila-Matías
- Research Institute of the Hospital Clínic Universitari of Valencia (INCLIVA), Valencia, Spain; Department of Basic Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Anton Albajes-Eizagirre
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Joaquim Radua
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Gracián García-Martí
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Biomedical Engineering Unit/Radiology Department, Quirónsalud Hospital, Spain
| | - José M Rubio
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; The Feinstein Institute, Northwell Health Hospital, New York, USA
| | - Diana Tordesillas-Gutierrez
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; University Hospital Marqués de Valdecilla (IDIVAL), Department of Psychiatry, School of Medicine, University of Cantabria, Spain; Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL, Santander, Cantabria, Spain
| | - Inmaculada Fuentes-Durá
- Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Aleix Solanes
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Lydia Fortea
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; OASIS Service, South London and the Maudsley NHS Foundation Trust, London, UK
| | - Julio Sanjuán
- Research Institute of the Hospital Clínic Universitari of Valencia (INCLIVA), Valencia, Spain; Center for Networking Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Psychiatric, University of Valencia, School of Medicine, Valencia, Spain
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13
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Azcárate IG, Marín-García P, Abad P, Pérez-Benavente S, Paz-Artal E, Reche PA, Fobil JN, Rubio JM, Diez A, Puyet A, Bautista JM. Plasmodium falciparum immunodominant IgG epitopes in subclinical malaria. Sci Rep 2020; 10:9398. [PMID: 32523082 PMCID: PMC7287129 DOI: 10.1038/s41598-020-66384-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 05/18/2020] [Indexed: 01/30/2023] Open
Abstract
Incomplete non-sterile immunity to malaria is attained in endemic regions after recurrent infections by a large percentage of the adult population, who carry the malaria parasite asymptomatically. Although blood-stage Plasmodium falciparum rapidly elicits IgG responses, the target antigens of partially protective and non-protective IgG antibodies as well as the basis for the acquisition of these antibodies remain largely unknown. We performed IgG-immunomics to screen for P. falciparum antigens and to identify epitopes associated with exposure and clinical disease. Sera from malaria cases identified five prevalent antigens recognized by all analyzed patients' IgGs. Epitope mapping of them, using adult and children sera samples from an endemic malaria region in Ghana segregated into patients with positive or negative subclinical detection of P. falciparum, revealed binding specificity for two 20-mer immunodominant antigenic regions within the START-related lipid transfer protein and the protein disulfide isomerase PDI8. These 20-mer epitopes challenged with sera samples from children under 5 years old displayed specific IgG binding in those with detectable parasitemia, even at subclinical level. These results suggest that humoral response against START and PDI8 antigens may be triggered at submicroscopic parasitemia levels in children and may eventually be used to differentially diagnose subclinical malaria in children.
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Affiliation(s)
- Isabel G Azcárate
- Department of Biochemistry and Molecular Biology and Research Institute Hospital 12 de Octubre (Imas12), Universidad Complutense de Madrid, 28040, Madrid, Spain.,Isabel G. Azcárate, Faculty of Health Sciences, Rey Juan Carlos University, Alcorcón, 28922, Madrid, Spain
| | | | - Paloma Abad
- Department of Biochemistry and Molecular Biology and Research Institute Hospital 12 de Octubre (Imas12), Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Susana Pérez-Benavente
- Department of Biochemistry and Molecular Biology and Research Institute Hospital 12 de Octubre (Imas12), Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Estela Paz-Artal
- Immunodeficiency and Transplant Immunology Unit, Research Institute Hospital 12 de Octubre (Imas12), 28041, Madrid, Spain
| | - Pedro A Reche
- Faculty of Medicine, Department of Immunology, Ophthalmology and ORL, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Julius N Fobil
- Department of Biological, Environmental & Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, P.O. Box LG 13, Legon, Ghana
| | - José M Rubio
- Malaria & Emerging Parasitic Diseases Laboratory, National Centre of Microbiology. Instituto de Salud Carlos III, 28220, Majadahonda, Spain
| | - Amalia Diez
- Department of Biochemistry and Molecular Biology and Research Institute Hospital 12 de Octubre (Imas12), Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Antonio Puyet
- Department of Biochemistry and Molecular Biology and Research Institute Hospital 12 de Octubre (Imas12), Universidad Complutense de Madrid, 28040, Madrid, Spain.
| | - José M Bautista
- Department of Biochemistry and Molecular Biology and Research Institute Hospital 12 de Octubre (Imas12), Universidad Complutense de Madrid, 28040, Madrid, Spain.
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Abstract
OBJECTIVE Clozapine is the only approved strategy for treatment-resistant schizophrenia, although it is highly underutilized. We aim to generate practical and actionable evidence-based recommendations for the use of this drug considering prescription barriers. METHOD Narrative review. RESULTS A consistent body of evidence supports the efficacy of clozapine reducing morbidity and mortality in schizophrenia. The main obstacles to its use are the lack of experience by prescribers and perceived treatment burden. Systematic screening of eligibility, utilization of available resources for consultation, developing a professional network with other stakeholders, as well as optimizing how clozapine is presented to patients is discussed. Furthermore, specific evidence-based recommendations for initiation, maintenance, and safety monitoring with clozapine are provided. CONCLUSION Clozapine prescription is one of the areas in psychiatry with the greatest mismatch between efficacy and utilization in clinical practice. Although multiple barriers to the use of clozapine exist, some of these may be overcome by updates of routine clinical practice.
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Affiliation(s)
- J M Rubio
- Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, Glen Oaks, NY, USA.,Feinstein Institute for Medical Research, Northwell Health, Glen Oaks, NY, USA.,The Zucker Hillside Hospital - Northwell Health, Glen Oaks, NY, USA
| | - J M Kane
- Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, Glen Oaks, NY, USA.,Feinstein Institute for Medical Research, Northwell Health, Glen Oaks, NY, USA.,The Zucker Hillside Hospital - Northwell Health, Glen Oaks, NY, USA
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15
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Cabrera JA, Porta Sanchez A, Rubio JM, Macias Y, Salvador-Montanes O, Casado-Alvarez R, Nevado-Medina J, Sanchez-Quintana D. P6014The variable location of the atrioventricular conduction axis. Implications for permanent and safe His bundle pacing. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
The deleterious effects of long-term RV apical pacing have been well recognized. Permament His bundle (HB) pacing has emerged as a promising technique for patients who need ventricular pacing.
Purpose
To describe the anatomy of the HB region and its variations for successfully approaching HB pacing in a safer and more efficient way and to understand selective vs non-selective HB pacing and to avoid permanent damage to it.
Methods
In 57 structurally normal human heart specimens (48 males, 77±7 years) we examined by dissection techniques and histological sections the course of the penetrating and non-branching His bundle in relation with the membranous septum and the tricuspid valve (TV) annulus. We correlated these anatomic findings with a series of angiographic studies in 60 patients (47% males, 45±16 years old) by recording the largest His electrogram sites within the limits of the triangle of Koch (TK) and the plane of the TV.
Results
The membranous septum is divided by the attachment on its right side of the septal leaflet of the tricuspid valve into atrioventricular (AV) and interventricular components. The AV component of the membranous septum forms the anterosuperior apex of the TK and showed in cadaveric hearts variable dimensions in length (4.6±1.5 mm, range 1–9 mm). The AV node becomes the His bundle as the AV conduction axis enters the AV component of the membranous septum and is encircled by the fibrous tissue of the central fibrous body in 100% of hearts with none of them having a “naked” entrance to it. In 30 hearts (53%) the HB penetrates the AV membranous septum at the apex of the TK at the hinge point of the septal leaflet of the TV near its commissure with the anterosuperior leaflet. However in 47% of cases the HB crossed the fibrous tissue of the central fibrous body in a lower position in the medial area of the paraseptal right atrial region of the TK with a mean distance to the AV membranous septum of 4±1.4 mm (range 1.5–8 mm) above and behind the TV annulus. These findings correlate with those obtained in patients in which the site of recording of the largest His bundle deflection does not always coincide with the anterosuperior vertex of the triangle as judged angiographically. In 51% of patients the site of the largest His bundle electrograms was found in the medial area of the triangle above (posterior-inferior) the TV annulus while in 49% of patients the His was recorded at the same level (15%) or below (anterior-inferior) the TV annulus (34% of patients) (figure).
Histology of HB and catheter locations
Conclusions
Knowledge of the marked variability in the location of the AV conduction bundle within the paraseptal right atrial region is crucial for approaching permanent HB pacing. An anterior-inferior and ventricular HB location could yield to restriction of the septal leaflet of the tricuspid valve if a lead is to be deployed in the area.
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Affiliation(s)
- J A Cabrera
- Quiron University Hopsital. European University of Madrid, Madrid, Spain
| | - A Porta Sanchez
- Quironsalud University Hospital. European University of Madrid, Madrid, Spain
| | - J M Rubio
- Foundation Jimenez Diaz, Cardiology, Madrid, Spain
| | - Y Macias
- University of Extremadura, Department of Anatomy and Cell Biology, Badajoz, Spain
| | - O Salvador-Montanes
- Quironsalud University Hospital. European University of Madrid, Madrid, Spain
| | - R Casado-Alvarez
- Quironsalud University Hospital. European University of Madrid, Madrid, Spain
| | - J Nevado-Medina
- University of Extremadura, Department of Anatomy and Cell Biology, Badajoz, Spain
| | - D Sanchez-Quintana
- University of Extremadura, Department of Anatomy and Cell Biology, Badajoz, Spain
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Cabrera JA, Porta-Sanchez A, Nunez Pernas D, Rubio JM, Navarro F, Salvador-Montanes O, Macias Y, Nevado-Medina J, Sanchez-Quintana D. P6015Histological pattern of penetrating His bundle division: implications for atrioventricular conduction damage during and following transcatheter aortic valve implantation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Severe damage to the atrioventricular conduction system is one of the most common complications of transcatheter aortic valve implantation (TAVI) and can be linked to important comorbidity, increased healthcare expense, need for long-term monitoring and pacemaker implantation.
Purpose
To provide a detailed description of the His bundle (HB) arrangement within the left ventricular outflow tract.
Methods
We examined by dissection techniques and histological sections the course of the AV conduction axis (penetrating, non-branching and branching HB) in relation with the membranous and muscular interventricular septum in 57 structurally normal human heart specimens (48 males, 77±7 years)
Results
The AV conduction axis is located along the inferior edge of the membranous septum (MS). The MS is divided into AV and interventricular components and is located at the base of the interleaflet triangle between the right and non-coronary leaflets of the aortic valve. The conduction axis enters the AV component of the MS and is encircled by the fibrous tissue of the central fibrous body to reach the left ventricular outflow tract. The MS showed in cadaveric hearts variable dimensions in length (4.6±1.5 mm) with a range bewteen 1 to 9mm. In 17.5% of specimens the MS length was ≤2 mm. After penetrating the AV membranous septum it has a non-branching component that in 85.5% of cases runs only for a short distance (1–3 mm) along the septal crest before giving rise to the fascicles of the left bundle (LB) on the septal surface (Type A). The most anterior fibers of the LB originate at the end of the branching portion located underneath the inferior edge of the MS. In 5 hearts (9%) the HB division was found before it reached the interventricular MS (Type B) and in 3 cases (5.5%)2–3.5 mm distal to the crest (Type C). 22 hearts (49%) were shown to have a relatively left-sided deviation of the AV bundle with the anterior part of the bundle closely related to the nadir of attachment of the right coronary leaflet of the aortic valve. In the remaining 51% of hearts, the bundle coursed centrally or with a right-sided deviation. The HB measures were (mm, mean±SD (range)): length: 3±0.6 (2–4.5), width: 3.7±1.4 (2.5–5.6), thickness: 1.4±0.5 (0.5–2.2), HB to endocardium: 0.7±0.3 (0.2–1.5).
His bundle position types
Conclusions
A shorter membranous septum length, the variable HB dimensions and the left-sided deviation of the AV conduction axis are extremely relevant anatomic features that are linked to the frequent injury to the HB branch or complete AV block following TAVI.
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Affiliation(s)
- J A Cabrera
- Quironsalud University Hospital. European University of Madrid, Madrid, Spain
| | - A Porta-Sanchez
- Quironsalud University Hospital. European University of Madrid, Madrid, Spain
| | - D Nunez Pernas
- Quironsalud University Hospital. European University of Madrid, Madrid, Spain
| | - J M Rubio
- Foundation Jimenez Diaz, Cardiology, Madrid, Spain
| | - F Navarro
- Foundation Jimenez Diaz, Cardiology, Madrid, Spain
| | - O Salvador-Montanes
- Quironsalud University Hospital. European University of Madrid, Madrid, Spain
| | - Y Macias
- University of Extremadura, Department of Anatomy and Cell Biology, Badajoz, Spain
| | - J Nevado-Medina
- University of Extremadura, Department of Anatomy and Cell Biology, Badajoz, Spain
| | - D Sanchez-Quintana
- University of Extremadura, Department of Anatomy and Cell Biology, Badajoz, Spain
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Cabrera JA, Porta-Sanchez A, Nunez Pernas D, Rubio JM, Navarro F, Salvador-Montanes O, Macias Y, Nevado-Medina J, Sanchez-Quintana D. P2275Left-sided deviation and fibrous-fatty infiltration of the right bundle branch in the elderly: implication for transcatheter aortic valve implantation (TAVI) procedure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Permanent and irreversible damage to the conduction tissue is one of the most common complications of TAVI. Detailed knowledge of the anatomy of the atrioventricular (AV) bundle is crucial to minimize the potential for injury to the His bundle branch block or complete AV block.
Purpose
Preexisting anatomic location and damage of the right bundle branch (RBB) may have important unrecognized clinical implications.
Methods
The myocardial arrangement and the presence of fibrous and fatty tissue infiltration of the AV conduction axis and right bundle branch were examined by dissection techniques and histological sections in 57 structurally normal human heart specimens (48 males, 77±7 years).
Results
The AV conduction axis enters the AV component of the membranous septum and is encircled by the fibrous tissue of the central fibrous body. The AV bundle is divided in a non-branching portion and a branching portion. After a short distance of the non-branching component along the septal crest, the RBB arises at the end of the branching portion of the conduction axis and is located superficially in the muscular ventricular septum. The RBB takes off from the bundle at the level of origin of the superior fascicle of the left bundle, passing then through the thickness of the ventricular septum to emerge beneath the medial papillary muscle of the tricuspid valve. In 22 hearts (49%) in which we found to have a relatively left-sided deviation of the AV bundle in relation to the interventricular membranous septum the RBB runs intramyocardial along the muscular interventricular septum. In the remaining 51% of the hearts the RBB runs subendocardially in the crest of the interventricular muscular septum. We found connective tissue and fatty infiltration along the right bundle branch in 23 hearts (40%) from its origin to its distal part. A significant correlation was found between age and the presence of RBB fibrosis (85% of hearts from individuals with age >80 years). These 2 conditions may make the RBB very vulnerable to self-expanding aortic valves during or after TAVI (figure).
RBB and its critical region
Conclusions
The presence of an intramyocardial location of the RBB with a lef-sided deviation and the fibro-fatty infiltration found in the mayority of senescent hearts are relevant anatomic determinants that may increase the risk of complete AV block following a TAVI procedure.
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Affiliation(s)
- J A Cabrera
- Quironsalud University Hospital. European University of Madrid, Madrid, Spain
| | - A Porta-Sanchez
- Quironsalud University Hospital. European University of Madrid, Madrid, Spain
| | - D Nunez Pernas
- Quironsalud University Hospital. European University of Madrid, Madrid, Spain
| | - J M Rubio
- Foundation Jimenez Diaz, Cardiology, Madrid, Spain
| | - F Navarro
- Foundation Jimenez Diaz, Cardiology, Madrid, Spain
| | - O Salvador-Montanes
- Quironsalud University Hospital. European University of Madrid, Madrid, Spain
| | - Y Macias
- University of Extremadura, Department of Anatomy and Cell Biology, Badajoz, Spain
| | - J Nevado-Medina
- University of Extremadura, Department of Anatomy and Cell Biology, Badajoz, Spain
| | - D Sanchez-Quintana
- University of Extremadura, Department of Anatomy and Cell Biology, Badajoz, Spain
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Renelies-Hamilton J, Noguera-Julian M, Parera M, Paredes R, Pacheco L, Dacal E, Saugar JM, Rubio JM, Poulsen M, Köster PC, Carmena D. Exploring interactions between Blastocystis sp., Strongyloides spp. and the gut microbiomes of wild chimpanzees in Senegal. Infect Genet Evol 2019; 74:104010. [PMID: 31442596 DOI: 10.1016/j.meegid.2019.104010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/02/2019] [Accepted: 08/18/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Gut parasites exert an important influence on the gut microbiome, with many studies focusing on the human gut microbiome. It has, however, undergone severe richness depletion. Hygienic lifestyle, antimicrobial treatments and altered gut homeostasis (e.g., chronic inflammation) reduce gut microbiome richness and also parasite prevalence; which may confound results. Studying species closely related to humans could help overcome this problem by providing insights into the ancestral relationship between humans, their gut microbiome and their gut parasites. Chimpanzees are a particularly promising model as they have similar gut microbiomes to humans and many parasites infect both species. AIMS We study the interaction between gut microbiome and enteric parasites in chimpanzees. Investigating what novel insights a closely related species can reveal when compared to studies on humans. METHODS Using eighty-seven faecal samples from wild western chimpanzees (Pan troglodytes verus) in Senegal, we combine 16S rRNA gene amplicon sequencing for gut microbiome characterization with PCR detection of parasite taxa (Blastocystis sp., Strongyloides spp., Giardia duodenalis, Cryptosporidium spp., Plasmodium spp., Filariae and Trypanosomatidae). We test for differences in gut microbiota ecosystem traits and taxonomical composition between Blastocystis and Strongyloides bearing and non-bearing samples. RESULTS For Blastocystis, twelve differentially abundant taxa (e.g., Methanobrevibacter), including Prevotella and Ruminococcus-Methanobrevibacter enterotype markers, replicate findings in humans. However, several richness indices are lower in Blastocystis carriers, contradicting human studies. This indicates Blastocystis, unlike Strongyloides, is associated to a "poor health" gut microbiome, as does the fact that Faecalibacterium, a bacterium with gut protective traits, is absent in Blastocystis-positive samples. Strongyloides was associated to Alloprevotella and five other taxonomic groups. Each parasite had its unique impact on the gut microbiota indicating parasite-specific niches. Our results suggest that studying the gut microbiomes of wild chimpanzees could help disentangle biological from artefactual associations between gut microbiomes and parasites.
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Affiliation(s)
- Justinn Renelies-Hamilton
- Section for Ecology and Evolution, Department of Biology, University of Copenhagen, Copenhagen, Denmark; Jane Goodall Institute Spain, Station Biologique Fouta Djallon, Dindéfélo, Kédougou, Senegal.
| | - Marc Noguera-Julian
- IrsiCaixa AIDS Research Institute-HIVACAT, Hospital Germans Trias i Pujol, Badalona, Spain; Chair in AIDS and Related Illnesses, Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic - Central University of Catalonia (UVic - UCC), Vic, Spain
| | - Mariona Parera
- IrsiCaixa AIDS Research Institute-HIVACAT, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Roger Paredes
- IrsiCaixa AIDS Research Institute-HIVACAT, Hospital Germans Trias i Pujol, Badalona, Spain; Chair in AIDS and Related Illnesses, Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic - Central University of Catalonia (UVic - UCC), Vic, Spain
| | - Liliana Pacheco
- Jane Goodall Institute Spain, Station Biologique Fouta Djallon, Dindéfélo, Kédougou, Senegal
| | - Elena Dacal
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Spain
| | - José M Saugar
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Spain
| | - José M Rubio
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Spain
| | - Michael Poulsen
- Section for Ecology and Evolution, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Pamela C Köster
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Spain
| | - David Carmena
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Spain
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Sánchez-Borque P, González-Giráldez B, Benezet-Mazuecos J, Miracle A, Crosa J, Rubio JM. Ictal asystole: A condition between neurology and cardiology. Int J Cardiol 2019; 278:104-107. [DOI: 10.1016/j.ijcard.2018.09.087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/03/2018] [Accepted: 09/24/2018] [Indexed: 01/05/2023]
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20
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Garcia Talavera CS, Devesa Arbiol A, Benezet-Mazuecos J, Iglesias JA, De La Vieja JJ, Serrano E, Sanchez-Borque P, Miracle A, Rubio JM. P6623Is ventricular pacing a new predictor for atrial high rate episodes in patients with pacemakers? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | - J A Iglesias
- Foundation Jimenez Diaz, Cardiology, Madrid, Spain
| | | | - E Serrano
- Foundation Jimenez Diaz, Cardiology, Madrid, Spain
| | | | - A Miracle
- Foundation Jimenez Diaz, Cardiology, Madrid, Spain
| | - J M Rubio
- Foundation Jimenez Diaz, Cardiology, Madrid, Spain
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21
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Lopez M, Cortes Garcia M, Rivero AL, Devesa A, Martinez J, Franco JA, Taibo M, Briongos S, Benezet J, Rubio JM. P6289Cardiac resynchronization therapy in elderly patients with chronic kidney disease and low ejection fraction: does it work? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Lopez
- Foundation Jimenez Diaz, Madrid, Spain
| | | | | | - A Devesa
- Foundation Jimenez Diaz, Madrid, Spain
| | | | | | - M Taibo
- Foundation Jimenez Diaz, Madrid, Spain
| | - S Briongos
- University Hospital Infanta Leonor, Cardiology, Madrid, Spain
| | - J Benezet
- Foundation Jimenez Diaz, Madrid, Spain
| | - J M Rubio
- Foundation Jimenez Diaz, Madrid, Spain
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22
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de Jong MR, Hoogerwaard AF, Adiyaman A, Smit JJJ, Ramdat Misier AR, Heeg JE, van Hasselt BAAM, Van Gelder IC, Crijns HJGM, Lozano IF, Toquero Ramos JE, Javier Alzueta F, Ibañez B, Rubio JM, Arribas F, Porres Aracama JM, Brugada J, Mont L, Elvan A. Treatment of atrial fibrillation in patients with enhanced sympathetic tone by pulmonary vein isolation or pulmonary vein isolation and renal artery denervation: clinical background and study design : The ASAF trial: ablation of sympathetic atrial fibrillation. Clin Res Cardiol 2018; 107:539-547. [PMID: 29487995 DOI: 10.1007/s00392-018-1214-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 02/08/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hypertension is an important, modifiable risk factor for the development of atrial fibrillation (AF). Even after pulmonary vein isolation (PVI), 20-40% experience recurrent AF. Animal studies have shown that renal denervation (RDN) reduces AF inducibility. One clinical study with important limitations suggested that RDN additional to PVI could reduce recurrent AF. OBJECTIVE The goal of this multicenter randomized controlled study is to investigate whether RDN added to PVI reduces AF recurrence. METHODS The main end point is the time until first AF recurrence according to EHRA guidelines after a blanking period of 3 months. Assuming a 12-month accrual period and 12 months of follow-up, a power of 0.80, a two-sided alpha of 0.05 and an expected drop-out of 10% per group, 69 patients per group are required. We plan to randomize a total of 138 hypertensive patients with AF and signs of sympathetic overdrive in a 1:1 fashion. Patients should use at least two antihypertensive drugs. Sympathetic overdrive includes obesity, exercise-induced excessive blood pressure (BP) increase, significant white coat hypertension, hospital admission or fever induced AF, tachycardia induced AF and diabetes mellitus. The interventional group will undergo PVI + RDN and the control group will undergo PVI. RESULTS Patients will have follow-up for 1 year, and continuous loop monitoring is advocated. CONCLUSION This randomized, controlled study will elucidate if RDN on top of PVI reduces AF recurrence.
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Affiliation(s)
- Mark R de Jong
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | | | - Ahmet Adiyaman
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | - Jaap Jan J Smit
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | | | - Jan-Evert Heeg
- Department of Internal Medicine, Isala Hospital, Zwolle, The Netherlands
| | | | | | - Harry J G M Crijns
- Department of Cardiology, Maastricht Universitair Medisch Centrum, Maastricht, The Netherlands
| | - Ignacio Fernández Lozano
- Department of Arrhythmia Unit, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Jorge E Toquero Ramos
- Department of Arrhythmia Unit, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - F Javier Alzueta
- Department of Arrhythmia Unit, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Borja Ibañez
- Department of Cardiology, Hospital Fundación Jimenez Díaz, Madrid, Spain
| | - José M Rubio
- Department of Cardiology, Hospital Fundación Jimenez Díaz, Madrid, Spain
| | - Fernando Arribas
- Department of Cardiology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Josep Brugada
- Arrhythmia Unit, Cardiovascular Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Lluís Mont
- Arrhythmia Unit, Cardiovascular Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Arif Elvan
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands.
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Abstract
Mansonellosis is a filarial disease caused by three species of filarial (nematode) parasites (Mansonella perstans, Mansonella streptocerca, and Mansonella ozzardi) that use humans as their main definitive hosts. These parasites are transmitted from person to person by bloodsucking females from two families of flies (Diptera). Biting midges (Ceratopogonidae) transmit all three species of Mansonella, but blackflies (Simuliidae) are also known to play a role in the transmission of M. ozzardi in parts of Latin America. M. perstans and M. streptocerca are endemic in western, eastern, and central Africa, and M. perstans is also present in the neotropical region from equatorial Brazil to the Caribbean coast. M. ozzardi has a patchy distribution in Latin America and the Caribbean. Mansonellosis infections are thought to have little pathogenicity and to be almost always asymptomatic, but occasionally causing itching, joint pains, enlarged lymph glands, and vague abdominal symptoms. In Brazil, M. ozzardi infections are also associated with corneal lesions. Diagnosis is usually performed by detecting microfilariae in peripheral blood or skin without any periodicity. There is no standard treatment at present for mansonellosis. The combination therapy of diethylcarbamazine plus mebendazole for M. perstans microfilaremia is presently one of the most widely used, but the use of ivermectin has also been proven to be very effective against microfilariae. Recently, doxycycline has shown excellent efficacy and safety when used as an antimicrobial against endosymbiotic Wolbachia bacteria harbored by some strains of M. perstans and M. ozzardi. Diethylcarbamazine and ivermectin have been used effectively to treat M. streptocerca infection. There are at present no estimates of the disease burden caused by mansonellosis, and thus its importance to many global health professionals and policy makers is presently limited to how it can interfere with diagnostic tools used in modern filarial disease control and elimination programs aimed at other species of filariae.
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Affiliation(s)
- Thuy-Huong Ta-Tang
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Majadahonda, Spain,
| | - James L Crainey
- Laboratory of Infectious Disease Ecology in the Amazon, Oswaldo Cruz Foundation, Instituto Leônidas e Maria Deane, Manaus, Brazil
| | - Rory J Post
- School of Natural Sciences and Psychology, John Moores University, Liverpool
- Department of Disease Control, Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Sergio Lb Luz
- Laboratory of Infectious Disease Ecology in the Amazon, Oswaldo Cruz Foundation, Instituto Leônidas e Maria Deane, Manaus, Brazil
| | - José M Rubio
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Majadahonda, Spain,
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Rubio JM, Sánchez Borque P, Benezet-Mazuecos J, Miracle Á, del Río A, Farré J. Conversion from wide to narrow QRS complex ventricular tachycardia: What is the mechanism? Pacing Clin Electrophysiol 2017. [DOI: 10.1111/pace.13143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- José M Rubio
- Arrhythmia Unit, Cardiology Department; Fundación Jiménez Díaz - Quirón Salud; Madrid Spain
| | - Pepa Sánchez Borque
- Arrhythmia Unit, Cardiology Department; Fundación Jiménez Díaz - Quirón Salud; Madrid Spain
| | - Juan Benezet-Mazuecos
- Arrhythmia Unit, Cardiology Department; Fundación Jiménez Díaz - Quirón Salud; Madrid Spain
| | - Ángel Miracle
- Arrhythmia Unit, Cardiology Department; Fundación Jiménez Díaz - Quirón Salud; Madrid Spain
| | - Ana del Río
- Arrhythmia Unit, Cardiology Department; Fundación Jiménez Díaz - Quirón Salud; Madrid Spain
| | - Jerónimo Farré
- Arrhythmia Unit, Cardiology Department; Fundación Jiménez Díaz - Quirón Salud; Madrid Spain
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Miguel-Oteo M, Jiram AI, Ta-Tang TH, Lanza M, Hisam S, Rubio JM. Nested multiplex PCR for identification and detection of human Plasmodium species including Plasmodium knowlesi. ASIAN PAC J TROP MED 2017; 10:299-304. [DOI: 10.1016/j.apjtm.2017.03.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 12/12/2016] [Accepted: 01/05/2017] [Indexed: 10/20/2022] Open
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Abdel-Shafi IR, Shoieb EY, Attia SS, Rubio JM, Ta-Tang TH, El-Badry AA. Molecular identification and phylogenetic analysis of Wuchereria bancrofti from human blood samples in Egypt. Parasitol Res 2017; 116:963-970. [DOI: 10.1007/s00436-017-5372-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 01/10/2017] [Indexed: 10/20/2022]
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Abdel-Shafi IR, Shoeib EY, Attia SS, Rubio JM, Edmardash Y, El-Badry AA. MOSQUITO IDENTIFICATION AND MOLECULAR XENOMONITORING OF LYMPHATIC FILARIASIS IN SELECTED ENDEMIC AREAS IN GIZA AND QUALIOUBIYA GOVERNORATES, EGYPT. ACTA ACUST UNITED AC 2016; 46:93-100. [PMID: 27363044 DOI: 10.12816/0026153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Lymphatic filariasis is a vector-borne health problem that has been focally endemic in Egypt for centuries. The chief vectors of transmission are Culicinae species. Control measures in the form of mass drug administration of DEC citrate treatment have been implemented in Nile delta for almost a decade. This study aimed to identify the prevalent mosquito species in endemic areas in Giza and Qualioubiya governorates and to monitor Wuchereria bancrofti infection by detecting the parasite DNA in collected mosquitoes. Adult mosquitoes were collected using light traps hung indoors. Microscopic examination was performed to identify and examine the morphologic characters of mosquitoes. Female Culex mosquitoes were subjected to semi-nested PCR to detect filarial DNA targeting repetitive DNA sequences (pWbl2 repetitive region) specific for W. bancrofti. The results revealed 3 species of mosquitoes Culex pipiens, Culex pusillus and Culex quinquefasciatus with the predominance of Culex pipiens (85.7%). Wuchereria bancrofti DNA was not detected in any of the collected mosquito pools. With progress of elimination programme in Nile Delta, follow up studies with larger sample size are recommended as the predominance of Culex pipiens the main lymphatic filariasis vector remains a risk of transmission in such areas.
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Ta-Tang TH, Luz SLB, Merino FJ, de Fuentes I, López-Vélez R, Almeida TAP, Lanza M, Abrahim CMM, Rubio JM. Atypical Mansonella ozzardi Microfilariae from an Endemic Area of Brazilian Amazonia. Am J Trop Med Hyg 2016; 95:629-32. [PMID: 27402517 DOI: 10.4269/ajtmh.15-0654] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 05/16/2016] [Indexed: 11/07/2022] Open
Abstract
Mansonellosis is endemic in several regions of Africa, the Caribbean, and Latin America. Mansonella ozzardi and Mansonella perstans have been reported in Latin America, including the Amazon region. A morphological and molecular microfilariae study was performed in Pauini (Brazil). Blood samples were collected from 40 individuals, and were analyzed by Giemsa-stained blood film and by two different nested polymerase chain reactions which detect internal transcribed spacer-1 and the major sperm protein gene. By microscopy, 14 of 40 were positive: 11 as M. ozzardi and three as M. perstans-like infections. Both molecular methods detected 19 positive cases as M. ozzardi, including those 14 individuals detected by microscopy, without detectable genetic differences among any of the 19 positive samples. Molecular techniques showed an improvement of mansonellosis diagnosis and may become an effective tool to evaluate the present status of M. ozzardi and M. perstans in Latin America.
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Affiliation(s)
- Thuy-Huong Ta-Tang
- Malaria and Emerging Parasitic Diseases Laboratory, Parasitology Department, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | - Sergio L B Luz
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz (FIOCRUZ) Amazônia, Manaus, Brazil
| | | | - Isabel de Fuentes
- Malaria and Emerging Parasitic Diseases Laboratory, Parasitology Department, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | - Rogelio López-Vélez
- Tropical Medicine and Clinical Parasitology Unit, Infectious Diseases Department, Hospital Ramón y Cajal, Madrid, Spain
| | - Tatiana A P Almeida
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz (FIOCRUZ) Amazônia, Manaus, Brazil
| | - Marta Lanza
- Malaria and Emerging Parasitic Diseases Laboratory, Parasitology Department, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | | | - José M Rubio
- Malaria and Emerging Parasitic Diseases Laboratory, Parasitology Department, National Microbiology Center, Instituto de Salud Carlos III, Madrid, Spain.
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Rubio JM, Jiménez Del Bianco AI, Cervera-Alonso Y, Fernandez-Garcia MD, Lanza M, Ta Tang TH, Sevil Puras F, Blanco L. Vivax malaria in a blood donor in Spain, relapse or a new infection in a malaria non-endemic country? Vox Sang 2015; 110:193-5. [PMID: 26509738 DOI: 10.1111/vox.12352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 09/03/2015] [Accepted: 09/03/2015] [Indexed: 10/22/2022]
Abstract
Malaria is a vectorborne disease caused by protozoan of the genus Plasmodium, which can also be transmitted by the transfusion of infected red blood cells. One year after return from a travel to Honduras, a Spanish traveller developed vivax malaria. Prior to the onset of symptoms, the donor made a donation that tested non-reactive using an immunological test for malaria. Samples from the donor taken before donation and tested by serological and molecular methods were negative but positive at the time of hospital admission. The possible sources of the donors' infection, imported versus locally acquired, are discussed.
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Affiliation(s)
- J M Rubio
- Malaria & Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - A I Jiménez Del Bianco
- Serology and Biochemistry Department, Centro de Hemoterapia de Castilla y León, Valladolid, Spain
| | - Y Cervera-Alonso
- Malaria & Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - M D Fernandez-Garcia
- Malaria & Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain.,European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - M Lanza
- Malaria & Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - T H Ta Tang
- Malaria & Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - F Sevil Puras
- Blood Bank Unit, Santa Barbara Hospital, Soria, Spain
| | - L Blanco
- Serology and Biochemistry Department, Centro de Hemoterapia de Castilla y León, Valladolid, Spain
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Serre N, Franco L, Sulleiro E, Rubio JM, Zarzuela F, Molero F, Tenorio A. Concurrent Infection With Dengue Type 4 and Plasmodium falciparum Acquired in Haiti. J Travel Med 2015. [PMID: 26212051 DOI: 10.1111/jtm.12222] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report one laboratory-confirmed coinfection by dengue type 4 and Plasmodium falciparum imported to Spain from Haiti. Diagnosis was made by real-time polymerase chain reaction (RT-PCR), serology, quantitative buffy coat, and thick blood smear. In areas where both infections are present, diagnosis of both diseases should be considered because a delay in the treatment of malaria could be fatal.
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Affiliation(s)
- Núria Serre
- Department of Infectious Diseases, Tropical Medicine and International Health Unit Drassanes-Vall d'Hebron, Barcelona, Spain
| | - Leticia Franco
- Department of Arbovirus and Imported Viral Diseases, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Elena Sulleiro
- Department of Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - José M Rubio
- Department of Arbovirus and Imported Viral Diseases, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Francesc Zarzuela
- Department of Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Francisca Molero
- Department of Arbovirus and Imported Viral Diseases, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Tenorio
- Department of Arbovirus and Imported Viral Diseases, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
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Sánchez-Borque P, Rubio JM, Benezet-Mazuecos J, Quiñones MA, Farré J. Atrial fibrillation with Wolff-Parkinson-White syndrome in epilepsy: A potentially fatal combination. Seizure 2015; 32:1-3. [PMID: 26552553 DOI: 10.1016/j.seizure.2015.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 08/07/2015] [Accepted: 08/08/2015] [Indexed: 11/18/2022] Open
Affiliation(s)
- P Sánchez-Borque
- The Arrhythmia Unit, Cardiology Department, Fundación Jiménez Díaz - IDC, Madrid, Spain.
| | - J M Rubio
- The Arrhythmia Unit, Cardiology Department, Fundación Jiménez Díaz - IDC, Madrid, Spain
| | - J Benezet-Mazuecos
- The Arrhythmia Unit, Cardiology Department, Fundación Jiménez Díaz - IDC, Madrid, Spain
| | - M A Quiñones
- The Arrhythmia Unit, Cardiology Department, Fundación Jiménez Díaz - IDC, Madrid, Spain
| | - J Farré
- The Arrhythmia Unit, Cardiology Department, Fundación Jiménez Díaz - IDC, Madrid, Spain
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de la Cruz E, Cortés M, Farré J, Palfy J, Ávila P, Hernández I, Romero A, Benezet J, Franco JA, Navas MA, Hernandez JJ, Briongos S, Rubio JM. Comparison of pharmacological treatment alone versus treatment combined with cardiac resynchronization therapy in patients over 75 years. J Interv Card Electrophysiol 2015; 43:13-20. [PMID: 25687979 DOI: 10.1007/s10840-015-9979-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 01/23/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND The role of cardiac resynchronization therapy (CRT) in patients aged ≥75 years is not well established. METHODS We identified 607 patients aged ≥75 years with left ventricular ejection fraction (LVEF) of ≤35 %, of whom 78 met the guidelines for indication of CRT. Based on the decision of the patients or attending cardiologists, 34 patients received a CRT defibrillator (CRT-D). RESULTS The age of patients with a CRT indication was 80 ± 4 years, and 73 % were males. As compared with patients on medical therapy, CRT-D patients were younger (79 ± 3 vs. 83 ± 4, P < 0.001), had lower LVEF (23 ± 7 vs. 27 ± 7 %, P = 0.008) and higher rate of decompensated heart failure episodes (77 vs. 55 %, P = 0.04), were more frequently New York Heart Association (NYHA) class III-IV (53 vs. 25 %, P = 0.01), and were more likely to be on beta-blockers (88 vs. 66 %, P = 0.023), anticoagulants (61 vs. 32 % P = 0.02), and anti-aldosterone drugs (82 vs. 50 %, P = 0.003). After a median follow-up of 26 months, seven patients in the CRT-D group (21 %) and 20 non-CRT patients (46 %) died (hazard ratio (HR) 0.16 [95 % confidence interval (CI) 0.06-0.46]). The end point of mortality or hospitalization was not reduced because of a similar rate of hospitalizations for heart failure of CRT-D patients. Four CRT-D patients (12 %) had received appropriate device therapy, and one had been inappropriately discharged. During follow-up, 44 % of CRT-D patients improved their LVEF by >40 %. CONCLUSION CRT-D is potentially of benefit in terms of mortality in our population; this effect persists after correction for use of beta-blockers. In patients ≥75 years, CRT indications should be similar to those accepted for younger subjects.
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Affiliation(s)
- Elena de la Cruz
- Hospital Universitario Fundación Jiménez Díaz - idcsalud, Universidad Autónoma de Madrid, Madrid, Spain
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Blanco C, Rubio JM, Wall M, Secades-Villa R, Beesdo-Baum K, Wang S. The latent structure and comorbidity patterns of generalized anxiety disorder and major depressive disorder: a national study. Depress Anxiety 2014; 31:214-22. [PMID: 23776155 PMCID: PMC3956045 DOI: 10.1002/da.22139] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 05/09/2013] [Accepted: 05/09/2013] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND There is controversy on whether generalized anxiety disorder (GAD) and major depressive disorder (MDD) constitute the same or separate disorders. This study sought to examine the factor structure of the DSM-IV diagnostic criteria of GAD and MDD and the patterns of comorbidity associated with both disorders. METHODS Data were drawn from the National Epidemiological Survey on Alcohol and Related conditions (NESARC), a representative sample of the adult general population in the United States (N = 43,093). Sociodemographic and psychiatric comorbidity correlates of GAD, MDD, and co-occurring GAD-MDD were obtained. Exploratory and confirmatory factor analyses of the DSM-IV diagnostic criteria for GAD and MDD were conducted, followed by a Multiple Indicators Multiple Causes (MIMIC) model to examine the invariance of the model across several sociodemographic covariates. RESULTS A bifactor model with one general factor underlying all the MDD and GAD diagnostic criteria and another factor with large loadings only for the GAD criteria best represented the latent structure. This model showed excellent fit indices (CFI = 1.00, TLI = 1.00, RMSEA < 0.02), and a high degree of invariance across sociodemographic covariates. The comorbidity patterns of individuals with MDD only (n = 4,885), GAD only (n = 947) and GAD-MDD (n = 810) were clearly distinguishable. CONCLUSIONS The latent structure of the diagnostic criteria of MDD and GAD and their comorbidity patterns suggests that GAD and MDD are closely related but different nosological entities, with distinct latent structures, clinical manifestations, and patterns of comorbidity.
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Affiliation(s)
- Carlos Blanco
- Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY 10032, Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032
| | - José M. Rubio
- Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY 10032
| | - Melanie Wall
- Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY 10032, Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032
| | - Roberto Secades-Villa
- Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY 10032
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Dresden, Germany
| | - Shuai Wang
- Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY 10032
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Ta TH, Hisam S, Lanza M, Jiram AI, Ismail N, Rubio JM. First case of a naturally acquired human infection with Plasmodium cynomolgi. Malar J 2014; 13:68. [PMID: 24564912 PMCID: PMC3937822 DOI: 10.1186/1475-2875-13-68] [Citation(s) in RCA: 183] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 02/18/2014] [Indexed: 11/10/2022] Open
Abstract
Since 1960, a total of seven species of monkey malaria have been reported as transmissible to man by mosquito bite: Plasmodium cynomolgi, Plasmodium brasilianum, Plasmodium eylesi, Plasmodium knowlesi, Plasmodium inui, Plasmodium schwetzi and Plasmodium simium. With the exception of P. knowlesi, none of the other species has been found to infect humans in nature. In this report, it is described the first known case of a naturally acquired P. cynomolgi malaria in humans.The patient was a 39-year-old woman from a malaria-free area with no previous history of malaria or travel to endemic areas. Initially, malaria was diagnosed and identified as Plasmodium malariae/P. knowlesi by microscopy in the Terengganu State Health Department. Thick and thin blood films stained with 10% Giemsa were performed for microscopy examination. Molecular species identification was performed at the Institute for Medical Research (IMR, Malaysia) and in the Malaria & Emerging Parasitic Diseases Laboratory (MAPELAB, Spain) using different nested PCR methods.Microscopic re-examination in the IMR showed characteristics of Plasmodium vivax and was confirmed by a nested PCR assay developed by Snounou et al. Instead, a different PCR assay plus sequencing performed at the MAPELAB confirmed that the patient was infected with P. cynomolgi and not with P. vivax.This is the first report of human P. cynomolgi infection acquired in a natural way, but there might be more undiagnosed or misdiagnosed cases, since P. cynomolgi is morphologically indistinguishable from P. vivax, and one of the most used PCR methods for malaria infection detection may identify a P. cynomolgi infection as P. vivax.Simian Plasmodium species may routinely infect humans in Southeast Asia. New diagnostic methods are necessary to distinguish between the human and monkey malaria species. Further epidemiological studies, incriminating also the mosquito vector(s), must be performed to know the relevance of cynomolgi malaria and its implication on human public health and in the control of human malaria.The zoonotic malaria cannot be ignored in view of increasing interactions between man and wild animals in the process of urbanization.
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Affiliation(s)
| | | | | | | | | | - José M Rubio
- Malaria & Emerging Parasitic Diseases Laboratory, Parasitology Department, National Microbiology Centre, Instituto de Salud Carlos III, Cra, Majadahonda Pozuelo Km, 2, Majadahonda 28220, Madrid, Spain.
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Marcos-Alberca P, Sánchez-Quintana D, Cabrera JA, Farré J, Rubio JM, de Agustín JA, Almería C, Pérez-Isla L, Macaya C. Two-dimensional echocardiographic features of the inferior right atrial isthmus: the role of vestibular thickness in catheter ablation of atrial flutter. Eur Heart J Cardiovasc Imaging 2013; 15:32-40. [PMID: 23751506 DOI: 10.1093/ehjci/jet112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The aim of this study was to examine the feasibility of transthoracic two-dimensional (2D)-echocardiography in defining the cavo-tricuspid isthmus (CTI) anatomy and its value concerning the ease of catheter ablation of isthmic atrial flutter (AF). METHODS CTI analysis was accomplished in 39 cases: 16 necropsy specimens and 23 patients. Sixteen were patients with isthmus-dependent AF and seven controls with other supraventricular re-entrant tachycardias. Two-dimensional transthoracic echocardiography and a right atrium angiogram were performed before radiofrequency catheter ablation (RFCA). RESULTS The measurements of the CTI with angiography were compared with those taken with echocardiography and correlation was excellent (r= 0.91; P < 0.0001). In normal patients, the dimension of the vestibular thickness was successfully compared and validated with the histological examination of the necropsy specimens: histology median 6.8 mm, range 4.4-10.5 vs. echo median 6.2 mm, range 5.4-8.7; P: NS. Vestibular thickness was greater in complex than in simple RFCA (13.6 ± 1.9 mm vs. 10.0 ± 2.3 mm; P = 0.01). When vestibular thickness ≥11.5 mm, the ablation prone to be complex (sensitivity 83.3%, specificity 80%, positive predictive value 71.4%, and negative predictive value 88.9%). CONCLUSIONS Two-dimensional transthoracic echocardiography clearly depicts the inferior isthmus and, displaying the thickness of the tricuspid vestibule, it was related with complexity of the ablation procedure in isthmus-dependent AF.
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Affiliation(s)
- Pedro Marcos-Alberca
- Cardiology Department, Instituto Cardiovascular, Hospital Clínico San Carlos, c/ Prof. Martín Lagos s/n. 28040 Madrid, Spain
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García-Bujalance S, Francisco CNS, Rubio JM, Arribas JR, Gutierrez A. Imported Plasmodium falciparum malaria in HIV-infected patients: a report of two cases. Malar J 2012; 11:136. [PMID: 22540214 PMCID: PMC3358242 DOI: 10.1186/1475-2875-11-136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 04/27/2012] [Indexed: 11/11/2022] Open
Abstract
As HIV becomes a chronic infection, an increasing number of HIV-infected patients are travelling to malaria-endemic areas. Association of malaria with HIV/AIDS can be clinically severe. Severe falciparum malaria is a medical emergency that is associated with a high mortality, even when treated in an Intensive Care Unit. This article describes two cases of HIV-positive patients, who returned from malaria-endemic areas and presented a parasitaemia > 5% of erythrocytes and clinical signs of severe falciparum malaria, both with > 350 CD4 cell count/μl, absence of chemoprophylaxis and successful response. Factors like drug interactions and the possible implication of anti-malarial therapy bioavailability are all especially interesting in HIV-malaria co-infections.
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Affiliation(s)
- Silvia García-Bujalance
- Department of Microbiology and Parasitology, La Paz University Hospital-IdiPAZ, Paseo de la Castellana 261, 28046 Madrid, Spain.
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Rey S, Zuza I, Martínez-Mondéjar B, Rubio JM, Merino FJ. Imported malaria in an area in southern Madrid, 2005-2008. Malar J 2010; 9:290. [PMID: 20961449 PMCID: PMC2972306 DOI: 10.1186/1475-2875-9-290] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Accepted: 10/20/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Spain, malaria cases are mostly due to migrants and travellers returning from endemic areas. The objective of this work was to describe the malaria cases diagnosed at the Severo Ochoa University Hospital (HUSO) in Leganés in the south of the Madrid Region from 2005 to 2008. METHODS Descriptive retrospective study performed at HUSO. Data sources are registries from the Microbiology Department and malaria cases notified to the Preventive Medicine Department. Analysed parameters were: administrative, demographical, related to the stay at the endemic country, clinical, microbiological diagnosis method, pregnancy, treatment and prophylaxis, co-infections, and days of hospital stay. RESULTS Fifty-seven patients diagnosed with malaria were studied. Case distribution per year was 13 in 2005, 15 in 2006, 15 in 2007 and 14 in 2008. Thirty-three patients were female (57.9%) and 24 male (42.1%). Mean age was 27.8 years. Most of the malaria cases were acquired in Nigeria (49.1%) and Equatorial Guinea (32.7%). 29.1% of the patients were immigrants who had arrived recently, and 61.8% acquired malaria when travelling to their countries of origin to visit friends and relatives (VFR). Majority of cases were diagnosed between June and September. Microscopy was positive in 39 cases (68.4%) immunochromatography in 42 (73.7%) and PCR in the 55 cases where performed. Plasmodium falciparum was responsible for 94.7% of the cases. The more frequent symptoms were fever (77.2%), followed by headache and gastrointestinal symptoms (33.3%). Nine cases needed hospital admittance, a pregnant woman, three children, four VFR and an African tourist, but all evolved favourably. Chemoprophylaxis data was known from 55 patients. It was taken correctly in one case (1.8%), in five (9.1%) the prophylaxis was improper while the others 49 (89.1%) cases had not followed any anti-malarial prophylaxis. CONCLUSIONS Children, pregnant women and the VFR have the highest risk to present severe malaria and to need hospital admittance. Another important risk factor for acquiring malaria is incorrect prophylaxis. The first place for malaria acquisition was Nigeria and the main species causing malaria was P. falciparum.
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Affiliation(s)
- Sonia Rey
- Microbiology and Parasitology Department, Severo Ochoa University Hospital, Avda Orellana s/n, Leganés, Madrid, Spain
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Jotty K, Ojeda ML, Nogales F, Rubio JM, Murillo ML, Carreras O. Selenium tissue distribution changes after ethanol exposure during gestation and lactation: selenite as a therapy. Food Chem Toxicol 2009; 47:2484-9. [PMID: 19596040 DOI: 10.1016/j.fct.2009.07.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2009] [Revised: 07/01/2009] [Accepted: 07/06/2009] [Indexed: 01/29/2023]
Abstract
Ethanol consumption affects maternal nutrition and antioxidant status together with the future health of their progeny. Selenium (Se) is a trace element with antioxidant activity; we will study the effect of ethanol in dams on Se bioavailability, antioxidant balance and gestational parameters. We also will study if a Se-supplemented diet (0.5 ppm) administered to ethanol-exposed dams avoids the undesirable effects provoked by ethanol. We have used four experimental groups: control (C); chronic ethanol (A); control+Se (CS) and chronic ethanol+Se (AS). Se levels in serum, urine, faeces, and several tissues were measured by graphite-furnace atomic absorption spectrometry. Serum glutathione peroxidase (GPx) activity was determined by spectrometry. Se bioavailability is altered by ethanol, causing a decrease in Se retention, reducing Se levels in cortex, muscle, mammary gland and salivary gland while elevating Se values in heart, liver and spleen. On the other hand, Se supplementation increases some of these parameters. Serum GPx activity was decreased by ethanol, while a Se-supplemented diet restores these values to those found in controls. We have demonstrated that ethanol decreased Se retention in dams, affecting their tissues' Se deposits, decreasing GPx activity in serum, gestational parameters and the weight of their progeny. Selenite supplementation counteracts these decreasing effects, except in cortex.
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Affiliation(s)
- K Jotty
- Department of Physiology and Zoology, Faculty of Pharmacy, Seville University, 41012 Seville, Spain
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Martínez MA, Puig JG, Mora M, Aragón R, O'Dogherty P, Antón JL, Sánchez-Villares T, Rubio JM, Rosado J, Torres R, Marcos J, Pallardo LF, Banegas JR. Metabolic syndrome: prevalence, associated factors, and C-reactive protein: the MADRIC (MADrid RIesgo Cardiovascular) Study. Metabolism 2008; 57:1232-40. [PMID: 18702949 DOI: 10.1016/j.metabol.2008.04.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2007] [Accepted: 04/23/2008] [Indexed: 12/23/2022]
Abstract
The metabolic syndrome (MS) is defined by the clustering of a number of cardiovascular risk factors. The aims of the present study were to estimate the prevalence of MS in Madrid (Spain) by 2 definitions and to investigate its relationship with several sociodemographic factors and C-reactive protein (CRP) levels. This was a cross-sectional population study, and participants were 1344 subjects aged 31 to 70 years. Clinical evaluation included data on sociodemographic and cardiovascular background, physical examination, fasting glucose, triglycerides, and high-density lipoprotein cholesterol. The CRP levels were determined in a subgroup of 843 subjects. The diagnosis of MS was made according to the 2005 Adult Treatment Panel III (ATP III) and International Diabetes Federation (IDF) definitions. The age- and sex-adjusted prevalence of MS was 24.6% (95% confidence interval [CI], 22.3%-26.9%) using the ATP III definition and 30.9% (95% CI, 28.4%-33.3%) using the International Diabetes Federation definition. The overall agreement rate was 91.5% (kappa = 0.80; 95% CI, 0.76-0.83). Prevalence figures by both definitions were higher in men than in women and increased with age. Male sex, older age, low educational level, and physical inactivity were all determinants of ATP III-defined MS. The presence of MS or any of its components was associated with high CRP levels. In a logistic regression analysis, low educational level and waist circumference were the best predictors for high CRP level. The prevalence of MS in the Madrid region is one of the highest in Europe and confirms the strong Spanish regional variability in this syndrome frequency. Some sociodemographic and lifestyle factors, particularly educational level, are predictors for MS and high CRP levels.
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Affiliation(s)
- Maria A Martínez
- Department of Internal Medicine, Hospital Infanta Sofía, Madrid, Spain.
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Aggarwal MM, Ahammed Z, Angelis ALS, Antonenko V, Arefiev V, Astakhov V, Avdeitchikov V, Awes TC, Baba PVKS, Badyal SK, Bathe S, Batiounia B, Baumann C, Bernier T, Bhalla KB, Bhatia VS, Blume C, Bucher D, Büsching H, Carlén L, Chattopadhyay S, Decowski MP, Delagrange H, Donni P, Majumdar MRD, El Chenawi K, Dubey AK, Enosawa K, Fokin S, Frolov V, Ganti MS, Garpman S, Gavrishchuk O, Geurts FJM, Ghosh TK, Glasow R, Guskov B, Gustafsson HA, Gutbrod HH, Hrivnacova I, Ippolitov M, Kalechofsky H, Kamermans R, Karadjev K, Karpio K, Kolb BW, Kosarev I, Koutcheryaev I, Kugler A, Kulinich P, Kurata M, Lebedev A, Löhner H, Luquin L, Mahapatra DP, Manko V, Martin M, Martínez G, Maximov A, Miake Y, Mishra GC, Mohanty B, Mora MJ, Morrison D, Mukhanova T, Mukhopadhyay DS, Naef H, Nandi BK, Nayak SK, Nayak TK, Nianine A, Nikitine V, Nikolaev S, Nilsson P, Nishimura S, Nomokonov P, Nystrand J, Oskarsson A, Otterlund I, Pavliouk S, Peitzmann T, Peressounko D, Petracek V, Phatak SC, Pinganaud W, Plasil F, Purschke ML, Rak J, Rammler M, Raniwala R, Raniwala S, Rao NK, Retiere F, Reygers K, Roland G, Rosselet L, Roufanov I, Roy C, Rubio JM, Sambyal SS, Santo R, Sato S, Schlagheck H, Schmidt HR, Schutz Y, Shabratova G, Shah TH, Sibiriak I, Siemiarczuk T, Silvermyr D, Sinha BC, Slavine N, Söderström K, Sood G, Sørensen SP, Stankus P, Stefanek G, Steinberg P, Stenlund E, Sumbera M, Svensson T, Tsvetkov A, Tykarski L, V D Pijll EC, V Eijndhoven N, V Nieuwenhuizen GJ, Vinogradov A, Viyogi YP, Vodopianov A, Vörös S, Wysłouch B, Young GR. Suppression of high-p{T} neutral pion production in central Pb+Pb collisions at sqrt[S{NN}]=17.3 GeV relative to p+C and p+Pb collisions. Phys Rev Lett 2008; 100:242301. [PMID: 18643578 DOI: 10.1103/physrevlett.100.242301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2007] [Revised: 05/12/2008] [Indexed: 05/26/2023]
Abstract
Neutral pion transverse momentum spectra were measured in p+C and p+Pb collisions at sqrt[S{NN}]=17.4 GeV at midrapidity (2.3 less than or approximately equal eta{lab} less than or approximately equal 3.0) over the range 0.7 less than or approximately equal p{T} less than or approximately equal 3.5 GeV/c. The spectra are compared to pi{0} spectra measured in Pb+Pb collisions at sqrt[S{NN}]=17.3 GeV in the same experiment. For a wide range of Pb+Pb centralities (N{part} less than or approximately equal 300), the yield of pi{0}'s with p{T} greater than or approximately equal 2 GeV/c is larger than or consistent with the p+C or p+Pb yields scaled with the number of nucleon-nucleon collisions (N{coll}), while for central Pb+Pb collisions with N{part}greater than or approximately equal 350, the pi{0} yield is suppressed.
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Cuadros J, Martín-Rabadán P, Merino FJ, Delgado-Irribarren A, Garcia-Bujalance S, Rubio JM. Malaria diagnosis by NOW ICT and expert microscopy in comparison with multiplex polymerase chain reaction in febrile returned travellers. Eur J Clin Microbiol Infect Dis 2007; 26:671-3. [PMID: 17605054 DOI: 10.1007/s10096-007-0337-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- J Cuadros
- Servicio de Microbiología Clínica, Hospital Príncipe de Asturias, Madrid, Spain.
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Martínez MA, Sancho T, García P, Moreno P, Rubio JM, Palau FJ, Antón JL, Cirujano FJ, Sanz J, Puig JG. Home blood pressure in poorly controlled hypertension: relationship with ambulatory blood pressure and organ damage. Blood Press Monit 2006; 11:207-13. [PMID: 16810031 DOI: 10.1097/01.mbp.0000209073.30708.e1] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES (1) To assess whether home blood pressure measurement is a reliable alternative to ambulatory blood pressure monitoring for the evaluation of treated patients with inadequate blood pressure control at the clinic; and (2) to evaluate the relationship between home blood pressure and several target-organ damage markers. BASIC METHODS A cross-sectional study was performed in 225 treated hypertensive patients with persistently high blood pressure values at the clinic (systolic blood pressure 140 mmHg and/or diastolic blood pressure 90 mmHg). All study participants underwent clinic blood pressure measurement, 24-h ambulatory blood pressure and home blood pressure monitoring. A subgroup of patients underwent the following procedures: carotid echography (n=74), microalbuminuria determination (n=88) and echocardiography (n=43). We defined out-of-clinic normotension as an average ambulatory or home blood pressure less than 135 mmHg (systolic) and 85 mmHg (diastolic). MAIN RESULTS The sensitivity, specificity and positive and negative predictive values of the home blood pressure method for predicting out-of-clinic normotension (with the ambulatory method used as reference), expressed as percentages, were 50, 87, 64 and 79%, respectively. Systolic home blood pressure correlated significantly with left ventricular mass (r=0.33, P<0.05) and microalbuminuria (r=0.24, P<0.05). Similar correlation coefficients were found for systolic ambulatory blood pressure (r=0.32, P<0.05 and r=0.24, P<0.05, respectively). Clinic blood pressure did not correlate with either left ventricular mass or microalbuminuria (r=0.19, P=0.09 and r=0.19, P=0.24, respectively). Diastolic home blood pressure, but not ambulatory blood pressure, correlated negatively with mean carotid intima-media thickness (r=-0.27, P<0.05). CONCLUSION Our results suggest that, in patients with poorly controlled hypertension at the clinic, home blood pressure represents a complementary test rather than an alternative to ambulatory blood pressure, and correlates with several target-organ damage markers.
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Affiliation(s)
- María A Martínez
- Hospital and Primary Care Research Unit, Hospital La Paz, Universidad Autónoma de Madrid, Madrid, Spain.
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Guerra-Neira A, Rubio JM, Royo JR, Ortega JC, Auñón AS, Diaz PB, LLanes AB. Plasmodium diversity in non-malaria individuals from the Bioko Island in Equatorial Guinea (West Central-Africa). Int J Health Geogr 2006; 5:27. [PMID: 16784527 PMCID: PMC1550388 DOI: 10.1186/1476-072x-5-27] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2006] [Accepted: 06/19/2006] [Indexed: 11/10/2022] Open
Abstract
Background In this paper we analyse the Plasmodium sp. prevalence in three villages with different isolation status on the island of Bioko (Equatorial Guinea) where malaria is a hyper-endemic disease. We also describe the genetic diversity of P. falciparum, using several plasmodia proteins as markers which show a high degree of polymorphism (MSP-1 and MSP-2). The results obtained from three different populations are compared in order to establish the impact of human movements and interventions. Methods Plasmodium sp. were analysed in three villages on Bioko Island (Equatorial Guinea), one of which (Southern) is isolated by geographical barriers. The semi-nested multiplex polymerase chain reaction (PCR) technique was used to determine the prevalence of the four human plasmodia species. The genotyping and frequency of P. falciparum populations were determined by PCR assay target polymorphism regions of the merozoite surface proteins 1 and 2 genes (MSP-1 and MSP-2). Results The data obtained show that there are no differences in plasmodia population flow between the Northwest and Eastern regions as regards the prevalence of the different Plasmodium species. The Southern population, on the other hand, shows a minor presence of P. malariae and a higher prevalence of P. ovale, suggesting some kind of transmission isolated from the other two. The P. falciparum genotyping in the different regions points to a considerable allelic diversity in the parasite population on Bioko Island, although this is somewhat higher in the Southern region than the others. There was a correlation between parasitaemia levels and the age of the individual with the multiplicity of infection (MOI). Conclusion Results could be explained by the selection of particular MSP alleles. This would tend to limit diversity in the parasite population and leading up to the extinction of rare alleles. On the other hand, the parasite population in the isolated village has less outside influence and the diversity of P. falciparum is maintained higher. The knowledge of parasite populations and their relationships is necessary to study their implications for control intervention.
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Affiliation(s)
- Ana Guerra-Neira
- Centro de Referencia para el Control de Endemias, Centro Nacional de Medicina Tropical. Instituto de Salud Carlos III, Malabo, Bioko, Equatorial Guinea
| | - José M Rubio
- Servicio de Medicina Tropical. Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Sinesio Delgado 6, Pabellón 13, 28220, Madrid, Spain
| | - Jesús Roche Royo
- Centro de Referencia para el Control de Endemias, Centro Nacional de Medicina Tropical. Instituto de Salud Carlos III, Malabo, Bioko, Equatorial Guinea
| | - Jorge Cano Ortega
- Centro de Referencia para el Control de Endemias, Centro Nacional de Medicina Tropical. Instituto de Salud Carlos III, Malabo, Bioko, Equatorial Guinea
| | - Antonio Sarrión Auñón
- Centro de Referencia para el Control de Endemias, Centro Nacional de Medicina Tropical. Instituto de Salud Carlos III, Malabo, Bioko, Equatorial Guinea
| | - Pedro Berzosa Diaz
- Servicio de Medicina Tropical. Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Sinesio Delgado 6, Pabellón 13, 28220, Madrid, Spain
| | - Agustín Benito LLanes
- Servicio de Medicina Tropical. Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Sinesio Delgado 6, Pabellón 13, 28220, Madrid, Spain
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Gil P, Fernández Guerrero ML, Bayona JF, Rubio JM, de Górgolas M, Granizo JJ, Farré J. Infections of implantable cardioverter-defibrillators: frequency, predisposing factors and clinical significance. Clin Microbiol Infect 2006; 12:533-7. [PMID: 16700701 DOI: 10.1111/j.1469-0691.2006.01434.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The prognosis for patients with ventricular arrhythmias has improved dramatically with the aid of implantable cardioverter-defibrillators (ICDs). Although infection is a serious complication that frequently causes dysfunction and loss of ICDs, the frequency, predisposing risk-factors, and clinical and microbiological features are only partially understood. This study describes a retrospective review of 423 procedures in 278 patients with ICD primary implants and replacements performed at a tertiary-care hospital. Generators were placed in either a pectoral (68%) or abdominal (32%) site, and electrodes were placed transvenously in 97% of the patients. Most (95%) interventions were performed in a one-stage procedure. Infection developed with ten (2.4%) implanted devices. Four cases occurred within 30 days of surgery ('early infections') and six occurred > 1 month after surgery ('late infections'). In univariate analysis, factors associated with the development of an early infection were: two-stage surgery, a sub-costal approach, and abdominal generator placement. In patients with late infections, a significant association was found with trauma or decubitus ulcer in the generator area. Infection presented with local signs without systemic complications. Seven of the ten patients required complete removal of the system.
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Affiliation(s)
- P Gil
- Division of Infectious Diseases, Department of Cardiology, Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, Spain
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Benito-Ruiz J, Rubio JM, Ferreres A, Serra-Renom JM. Steal syndrome of the hand complicating an arteriovenous fistula. Plast Reconstr Surg 2006; 117:1361-3. [PMID: 16582828 DOI: 10.1097/01.prs.0000205576.84070.00] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Sanmillán F, Cabrera JA, Santos-Gallego CG, Pindado J, Rubio JM, Sánchez-Quintana D, López-Farré A, Pérez PP, Farré J. Enalapril prevents electrical and structural remodeling in a canine model of atrial fibrillation: Molecular mechanisms. Heart Rhythm 2005. [DOI: 10.1016/j.hrthm.2005.02.223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Pascual N, Jurado B, Rubio JM, Santos F, Lama R, Cosano A. Respiratory Disorders and Quality of Sleep in Patients on the Waiting List for Lung Transplantation. Transplant Proc 2005; 37:1537-9. [PMID: 15866666 DOI: 10.1016/j.transproceed.2005.02.043] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND The purpose of this study was to assess the quality of sleep and extent of respiratory disorders in patients awaiting lung transplantation as compared with a control group. METHODS From September 2003 to November 2003, 17 clinically stable patients on the waiting list for lung transplantation and 14 healthy controls (with similar age, gender, and body mass index) were studied. Diagnostic polysomnography (PSG) was carried out for all subjects. RESULTS Seventeen patients were included, 15 men and 2 women, aged 51 +/- 14 years. The indication for lung transplantation was emphysema in 7 cases, pulmonary fibrosis in 6, and "other" in 4. Patients awaiting lung transplantation had the following respiratory values: mean FEV1, 1105 mL (34% of predicted); PaO2, 54 mm Hg; and PaCO2, 44 mm Hg. Significant differences were found among the waiting-list patients in terms of predominance of light sleep, wakeful periods, and phase changes per sleep-hour, as compared with the control group. The recording of the respiratory events showed an apnea-hypopnea index of 6.13, sleeping time with SaO2 <90% of 1.80%, and a mean number of significant desaturations (<4%) of 6.38. There were no statistically significant differences with respect to the control group. CONCLUSIONS Poor quality of sleep was observed in patients awaiting lung transplantation as compared with a healthy control group. There was no evidence of more respiratory events or significant desaturations in these patients, probably due to the provision of supplementary oxygen therapy during the PSG.
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Affiliation(s)
- N Pascual
- Department of Respiratory Diseases, University Hospital Reina Sofia, Cordoba, Spain.
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48
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Aggarwal MM, Ahammed Z, Angelis ALS, Antonenko V, Arefiev V, Astakhov V, Avdeitchikov V, Awes TC, Baba PVKS, Badyal SK, Bathe S, Batiounia B, Bernier T, Bhalla KB, Bhatia VS, Blume C, Bucher D, Büsching H, Carlén L, Chattopadhyay S, Decowski MP, Delagrange H, Donni P, Dutta Majumdar MR, el Chenawi K, Dubey AK, Enosawa K, Fokin S, Frolov V, Ganti MS, Garpman S, Gavrishchuk O, Geurts FJM, Ghosh TK, Glasow R, Guskov B, Gustafsson HA, Gutbrod HH, Hrivnacova I, Ippolitov M, Kalechofsky H, Karadjev K, Karpio K, Kolb BW, Kosarev I, Koutcheryaev I, Kugler A, Kulinich P, Kurata M, Lebedev A, Löhner H, Luquin L, Mahapatra DP, Manko V, Martin M, Martínez G, Maximov A, Miake Y, Mishra GC, Mohanty B, Mora MJ, Morrison D, Moukhanova T, Mukhopadhyay DS, Naef H, Nandi BK, Nayak SK, Nayak TK, Nianine A, Nikitine V, Nikolaev S, Nilsson P, Nishimura S, Nomokonov P, Nystrand J, Oskarsson A, Otterlund I, Peitzmann T, Peressounko D, Petracek V, Phatak SC, Pinganaud W, Plasil F, Purschke ML, Rak J, Raniwala R, Raniwala S, Rao NK, Retiere F, Reygers K, Roland G, Rosselet L, Roufanov I, Roy C, Rubio JM, Sambyal SS, Santo R, Sato S, Schlagheck H, Schmidt HR, Schutz Y, Shabratova G, Shah TH, Sibiriak I, Siemiarczuk T, Silvermyr D, Sinha BC, Slavine N, Söderström K, Sood G, Sørensen SP, Stankus P, Stefanek G, Steinberg P, Stenlund E, Sumbera M, Svensson T, Tsvetkov A, Tykarski L, v d Pijll EC, von Eijndhoven N, von Nieuwenhuizen GJ, Vinogradov A, Viyogi YP, Vodopianov A, Vörös S, Wysłouch B, Young GR. Interferometry of direct photons in central 208Pb + 208Pb collisions at 158A GeV. Phys Rev Lett 2004; 93:022301. [PMID: 15323905 DOI: 10.1103/physrevlett.93.022301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2003] [Indexed: 05/24/2023]
Abstract
Two-particle correlations of direct photons were measured in central 208Pb+208Pb collisions at 158A GeV. The invariant interferometric radii were extracted for 100<K(T)<300 MeV/c and compared to radii extracted from charged pion correlations. The yield of soft direct photons, K(T)<300 MeV/c, was extracted from the correlation strength and compared to theoretical calculations.
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Mank R, Wilson MD, Rubio JM, Post RJ. A molecular marker for the identification of Simulium squamosum (Diptera: Simuliidae). Ann Trop Med Parasitol 2004; 98:197-208. [PMID: 15035730 DOI: 10.1179/000349804225003118] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
All except one of the important groups of West African vectors of Onchocerca volvulus that lie within the Simulium damnosum complex can be distinguished from each other using morphological characteristics. The exception is S. squamosum, which overlaps with other species, and this results in significant levels of misidentification. Variation in the untranscribed H3-H4 histone intergenic spacer region of flies of the S. damnosum complex has now been investigated. Although a CAA/CAG microsatellite was found to be hyper-variable and unsuitable for species diagnosis, a 10-bp indel seemed to vary in a species-specific manner. This indel was apparently absent from S. squamosum but present in all of the other species tested (S. damnosum s.s., S. sirbanum, S yahense, S. sanctipauli and S. leonense/konkourense). It should now be possible to identify individual, adult, female S. squamosum from the absence of the indel, using a PCR-based amplification and agarose- or polyacrylamide-gel electrophoresis, thus removing the major barrier to the routine identification of unknown samples.
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Affiliation(s)
- R Mank
- Animal Taxonomy Section, Wageningen University, Binnenhaven 7, 6709 PD Wageningen, The Netherlands
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Cano J, Berzosa PJ, Roche J, Rubio JM, Moyano E, Guerra-Neira A, Brochero H, Mico M, Edú M, Benito A. Malaria vectors in the Bioko Island (Equatorial Guinea): estimation of vector dynamics and transmission intensities. J Med Entomol 2004; 41:158-161. [PMID: 15061273 DOI: 10.1603/0022-2585-41.2.158] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The current study was performed on the Bioko Island (Equatorial Guinea) with the aim of establishing a rapid assessment technique for mapping malaria risk and measuring vector densities. Human bait collection, tent traps, light traps, indoor resting collection, and window exit traps were used to collect Anopheles gambiae s.s. and Anopheles funestus, the two anopheline species involved in malaria transmission in this island. Capture data were used to compare differences in the behavior and vectorial capacity of An. gambiae s.s. and An. funestus. Differences in the two species of mosquitoes were found in relation to the season and trapping methods used. Entomological inoculation rates (EIR) for Plasmodium falciparum were calculated using a polymerase chain reaction (PCR) test with individual anopheline mosquitoes from human bait collections in two villages during the dry and rainy seasons. P. falciparum sporozoites were detected from both dissected heads/thorax and abdomens of both species.
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Affiliation(s)
- J Cano
- Laboratorio de Salud Pública para el Control de Endemias, Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Equatorial Guinea
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