Publications by authors named "Ana Sofia Santos"

35 Publications

Validation of the Personal Social Capital Scale-16 in Portugal: preliminary data on Portuguese and immigrants.

Health Promot Int 2021 Feb 27. Epub 2021 Feb 27.

CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisboa 1649-013, Portugal.

Objectives: The Personal Social Capital Scale 16 (PSCS-16) is a self-report measure used to assess social capital, as a social determinant of health. To guarantee validated measures of this construct, the psychometric properties of the Portuguese version of the PSCS-16 were studied.

Methods: The PSCS-16 comprises 16 items, organized in two scales: bonding and bridging social capital. A convenience sample of 280 participants was collected through an online survey. For construct validity, we used confirmatory factor analysis, and convergent and discriminant validity through the average variance extracted (AVE) and correlations. For reliability, we used: The Spearman-Brown split-half and the omega hierarchical coefficient. Correlations were made between the PSCS-16 and socio-demographic variables.

Results: A first-order model depicting two oblique factors was supported, suggesting the use of the two scales. Evidence of convergent validity was achieved: acceptable AVE and associations between social capital and emotional self-disclosure. For discriminant validity, the AVE values surpassed the squared correlation between bonding and bridging, and associations with sexual health were found to be absent. Reliability was good. Additional correlations: A positive association between the education level and bridging social capital and participants with an immigrant status having more bridging social capital.

Conclusions: Preliminary findings support the Portuguese version of PSCS-16 as suitable to evaluate social capital. Contributions are highlighted: the need to study correlates of social capital, particularly crossing migrations, social capital and mental health; and confirming the structure found by measuring its invariance.
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http://dx.doi.org/10.1093/heapro/daab022DOI Listing
February 2021

Evaluation of dental trauma in inmates of the most highly populated Brazilian prison complex.

Dent Traumatol 2021 Feb 18. Epub 2021 Feb 18.

Federal University of Pernambuco, Recife, Brazil.

Background/aim: Due to the increase in incarceration rates, the prison community has attracted much concern in the recent past. Although people in prison are often socially disadvantaged and vulnerable to a range of health problems, there is a lack of information on the oral health conditions of prisoners. Thus, the aim of this study was to survey the oral problems of a sample of the male incarcerated population of Brazil, focusing on dental trauma.

Material And Methods: The research was undertaken over a three-month period in 2017. It was a cross-sectional study of 756 prisoners of the Curado Prison Complex, located in Recife, PE. Using a previously calibrated examiner, dental trauma was measured with the Andreasen index. Etiology of dental trauma and socio-demographic data were collected with questions developed for this survey. Standard descriptive statistics were used to report frequency estimates. The chi-square test, Fisher's exact test, and Mann-Whitney U-test were used to compare groups. In addition, a binary logistic regression was performed to identify whether the studied variables could predict the occurrence of dental trauma.

Results: The prevalence of dental trauma in the sample was 10.8% and most of the cases (42.7%) occurred due to violent events. A higher frequency of violent etiology was observed in cases that occurred during imprisonment (p = 0.037). Individuals that suffered dental trauma during incarceration were more likely to have been incarcerated for longer periods of time (p = 0.043). The main type of injury found was enamel and dentin fracture without pulp exposure (68%). The most affected tooth was the upper right central incisor (40%).

Conclusion: These results underline the high prevalence of dental trauma experienced by men in prison.
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http://dx.doi.org/10.1111/edt.12670DOI Listing
February 2021

Descriptive Acute Respiratory Distress Syndrome (ARDS) in adults with imported severe Plasmodium falciparum malaria: A 10 year-study in a Portuguese tertiary care hospital.

PLoS One 2020 9;15(7):e0235437. Epub 2020 Jul 9.

Infectious Diseases Department, Centro Hospitalar Universitário São João, Porto, Portugal.

Background: Acute respiratory distress syndrome (ARDS) is a severe complication of malaria that remains largely unstudied. We aim to describe the development of ARDS associated with severe P. falciparum malaria, its management and impact on clinical outcome.

Methods: Retrospective observational study of adult patients admitted with severe P. falciparum malaria in an Intensive Care Unit (ICU) of a tertiary care hospital from Portugal from 2008 to 2018. A multivariate logistic regression analysis was used to identify factors associated with the development of ARDS, defined according to Berlin Criteria. Prognosis was assessed by case-fatality ratio, nosocomial infection and length of stay.

Results: 98 patients were enrolled, of which 32 (33%) developed ARDS, a median of 2 days after starting antimalarial medication (IQR 0-4, range 0-6). Length of stay in ICU and in hospital were significantly longer in patients who developed ARDS: 13 days (IQR 10-18) vs 3 days (IQR 2-5) and 21 days (IQR 15-30.5) vs 7 days (IQR 6-10), respectively. Overall case-fatality ratio in ICU was 4.1% and did not differ between groups. The risk of ARDS development is difficult to establish.

Conclusion: ARDS is a hard to predict late complication of severe malaria. A low threshold for ICU admission and monitoring should be used. Ideally patients should be managed in a centre with experience and access to advanced techniques.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235437PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347120PMC
September 2020

Quantitative Proteomics Identifies Metabolic Pathways Affected by Infection and Blood Feeding in the Sialoproteome of the Vector .

Vaccines (Basel) 2020 Feb 19;8(1). Epub 2020 Feb 19.

Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008 Lisboa, Portugal.

The negative impact of ticks and tick-borne diseases on animals and human health is driving research to discover novel targets affecting both vectors and pathogens. The salivary glands are involved in feeding and pathogen transmission, thus are considered as a compelling target to focus research. In this study, proteomics approach was used to characterize sialoproteome in response to infection and blood feeding. Two potential tick protective antigens were identified and its influence in tick biological parameters and pathogen infection was evaluated. Results demonstrate that the sialoproteome is highly affected by feeding but infection is well tolerated by tick cells. The combination of both stimuli shifts the previous scenario and a more evident pathogen manipulation can be suggested. Knockdown of led to a significative increase of infection in tick salivary glands but a brusque decrease in the progeny, revealing its importance in the cellular response to pathogen infection, which is worth pursuing in future studies. Additionally, an impact in the recovery rate of adults (62%), the egg production efficiency (45.75%), and the hatching rate (88.57 %) was detected. Building knowledge on vector and/or pathogen interplay bridges the identification of protective antigens and the development of novel control strategies.
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http://dx.doi.org/10.3390/vaccines8010091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7157752PMC
February 2020

Genotyping of Coxiella burnetii in sheep and goat abortion samples.

BMC Microbiol 2018 12 4;18(1):204. Epub 2018 Dec 4.

Laboratory of Microbiology and Infectious Diseases, Faculty of Veterinary Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Background: Q fever, caused by Coxiella burnetii, is a zoonosis that presents a worldwide distribution and affects both humans and animals. The route of dispersal of the pathogen by ruminants into the environment usually involves stages of abortion and parturition, nevertheless the agent can, also, be detected in other animal samples. Therefore it is considered as important in terms of proper diagnosis, as well as, for epidemiology and surveillance purposes, to genotype the pathogen. The aim of the current study was to investigate the presence of different genotypes of the agent in animals that had suffered from abortion during a two-year survey in Greece.

Results: Sixty nine tissue samples (37 stomach contents, 11 liver samples, 21 cotyledons) were collected from 59 abortion cases in sheep (N = 45) and goats (N = 14) from 65 farms at eight different areas of Greece. Samples were screened by qPCR and positive ones were further genotyped using a 10-locus multiple loci (ms 1, 3, 7, 12, 20, 21, 22, 26, 30 and 36) variable number of tandem repeat analysis (MLVA) method. Three genotypes were identified in sheep (A, B, C). Samples representing each of the obtained MLVA profile were further used for MST genotyping. Ten spacers (Cox 2, 5, 6, 18, 20, 22, 37, 51, 56 and 57) were amplified. A close relatedness among the identified MLVA genotypes was confirmed since they all belonged to MST group 32.

Conclusions: The current study introduces into the aspect of genotyping of C. burnetii in Greece. Further studies are needed to explore the presence of more genotypes, to associate the genotypes circulating in the animal and tick population with those causing human disease in order to further expand on the epidemiological aspects of the pathogen.
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http://dx.doi.org/10.1186/s12866-018-1353-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280429PMC
December 2018

How Your Power Affects My Impression of You.

Pers Soc Psychol Bull 2019 04 21;45(4):495-509. Epub 2018 Aug 21.

2 Universidade de Lisboa, Portugal.

In the present article, we investigate how a person's power affects the way we infer traits from their behavior. In Experiment 1, our results suggest that, when faced with behavioral descriptions about others, participants infer both positive and negative traits about powerless actors, whereas for powerful and control (power irrelevant) actors, only positive but no negative traits are inferred, an effect we call the benevolence bias. In the second experiment, (a) we replicate this effect, (b) we show that it does not depend on the specific traits used in Experiment 1, and (c) we show that it is also detected when an implicit measure of inferences is used. Experiment 3 further shows that this effect generalizes to a more generic power manipulation. Theoretical explanations for these findings are discussed.
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http://dx.doi.org/10.1177/0146167218788558DOI Listing
April 2019

Detection of Anaplasma phagocytophilum, Candidatus Neoehrlichia sp., Coxiella burnetii and Rickettsia spp. in questing ticks from a recreational park, Portugal.

Ticks Tick Borne Dis 2018 09 26;9(6):1555-1564. Epub 2018 Jul 26.

Centro de Estudos de Vetores e Doenças Infeciosas Dr. Francisco Cambournac, Instituto Nacional de Saúde Doutor Ricardo Jorge (CEVDI-INSA), Av. da Liberdade 5, 2965-575, Águas de Moura, Portugal.

Tick-borne agents with medical relevance have been recorded in Portugal but little is known about their occurrence in urban outdoor leisure areas. This study aimed to investigate ticks and tick-borne agents in three public parks of Lisbon's metropolitan area. A total of 234 questing ticks belonging to eight species were found in Parque Florestal de Monsanto (PFM). Ixodes ventalloi represented 40% of collections. Mitochondrial genes confirmed Ixodes morphological identification, evidencing the intraspecific variability of I. ricinus and particularly I. frontalis populations. Regarding tick-borne agents, Rickettsia massiliae DNA were found in 21 (9.0%) ticks, Coxiella burnetii in 15 (6.4%), Anaplasma phagocytophilum in five (2.1%), an agent closely related to Candidatus Neoehrlichia mikurensis in two (0.9%), Rickettsia sibirica mongolitimonae and Rickettsia monacensis each in one (0.4%). Active enzootic cycles were suggested for these agents by the detection of positives in different time periods. Five tick species were founded with C. burnetii, including I. ventalloi which seems to be a new association record. This tick was also the only species found positive for A. phagocytophilum and the Candidatus Neoehrlichia mikurensis-like agent. Two A. phagocytophilum variants were detected in PFM, one of them representing a potentially new ecotype already found in I. ventalloi from another Portuguese area. To the authors´ knowledge, this is also the first report of such a Candidatus Neoehrlichia mikurensis-like microorganism. These data show an interesting diversity of ticks and tick-borne agents with potential public health relevance in PFM, an urban recreational area commonly frequented by humans and their pets.
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http://dx.doi.org/10.1016/j.ttbdis.2018.07.010DOI Listing
September 2018

Molecular heterogeneity of Rhipicephalus sanguineus sensu lato and screening for Ehrlichia canis in mainland Portugal.

Ticks Tick Borne Dis 2018 09 11;9(6):1383-1390. Epub 2018 Jun 11.

Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisboa, Portugal.

The present study aimed to expand knowledge regarding the molecular characterization of R. sanguineus s.l. in Portugal and to screen for ticks naturally infected with E. canis. A total of 113 R. sanguineus s.l. were collected questing or attached to domestic and wild animals from the 18 administrative regions of mainland Portugal. All the ticks were analyzed for the 16S rRNA and the partial sequences obtained showed high genetic similarities with specimens belonging to the temperate lineage. These sequences revealed eight haplotypes (H1‒H8), with a genetic distance ranging from 0.3% to 1.4%. A convenience sample representing approximately 75% of all the R. sanguineus s.l. ticks collected was tested for the presence of E. canis by qPCR for the dsb gene. No ticks were found to be infected with this pathogen. Accordingly, further studies are required to determine the role of the R. sanguineus s.l. temperate lineage in E. canis maintenance and transmission, as well as to elucidate if a different R. sanguineus s.l. lineage or other tick species act as E. canis vectors for dogs in Portugal.
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http://dx.doi.org/10.1016/j.ttbdis.2018.06.002DOI Listing
September 2018

Off the top of my head: Malleability and stability in natural categories.

Acta Psychol (Amst) 2018 Apr 10;185:104-115. Epub 2018 Feb 10.

CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal.

Previous research has found that category representations are highly malleable knowledge structures, varying widely across different contexts and individuals. However, it has also been found that such malleability does not apply equally to all types of category information. The present research further investigates the representational malleability versus stability of natural taxonomic categories. Using perceptual fluency as means to induce malleability, we explored whether malleability is moderated by the degree of typicality of category information. In the first experiment, we found that fluency-based malleability only occurs for non-typical category information. In follow-up experiments, we investigated the boundary conditions under which such fluency-based malleability occurs. Namely, in Experiment 2, we showed that the effect of fluency on non-typical features disappeared when there is a sensory modality mismatch between study and test phases. Finally, in Experiment 3, we demonstrated that this effect reappears in the modality mismatch condition when participants are given a response deadline. The implications of these findings to current theories of category representation and the perceptual fluency literature are discussed.
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http://dx.doi.org/10.1016/j.actpsy.2018.02.002DOI Listing
April 2018

Gaseous emissions and modification of slurry composition during storage and after field application: Effect of slurry additives and mechanical separation.

J Environ Manage 2017 Sep 10;200:416-422. Epub 2017 Jun 10.

CITAB-Centre for the Research and Technology of Agro-Environment and Biological Sciences, Department of Agronomy, University of Trás-os-Montes and Alto Douro, 5000-801, Vila Real, Portugal.

The aim of the study was to evaluate the impact of slurry treatment by additives (EU200 (EU200), Bio-buster (BB), JASS and sulphuric acid (HSO)) and mechanical separation on the physical-chemical characteristics, gaseous emissions (NH, CH, CO and NO) during anaerobic storage at ∼20 °C (experiment 1) and NH losses after field application (experiment 2). The treatments studied in experiment 1 were: whole slurry (WS), WS+HSO to a pH of 6.0, WS+EU200 and WS+BB. Treatments for experiment 2 were: WS, slurry liquid fraction (LF), composted solid fraction (CSF), LFs treated with BB (LFB), JASS (LFJ), HSO to a pH of 5.5 (LFA) and soil only (control). The results showed an inhibition of the degradation of organic materials (cellulose, hemicellulose, dry matter organic matter and total carbon) in the WS+HSO relative to the WS. When compared to the WS, the WS+HSO increased electrical conductivity, ammonium (NH) and sulphur (S) concentrations whilst reducing slurry pH after storage. The WS+HSO reduced NH volatilization by 69% relative to the WS but had no effect on emissions of CH, CO and NO during storage. Biological additive treatments (WS+EU200 and WS+BB) had no impact on slurry characteristics and gaseous emissions relative to the WS during storage. After field application, the cumulative NH lost in the LF was almost 50% lower than the WS. The losses in the LFA were reduced by 92% relative to the LF. The LFB and LFJ had no impact on NH losses relative to the LF. A significant effect of treatment on NH concentration was found at the top soil layer (0-5 cm) after NH measurements with higher concentrations in the LF treatments relative to the WS. Overall, the use of the above biological additives to decrease pollutant gases and to modify slurry characteristics are questionable. Reducing slurry dry matter through mechanical separation can mitigate NH losses after field application. Slurry acidification can increase the fertilizer value (NH and S) of slurry whilst mitigating the environmental impacts through a decrease in NH losses during storage and after application.
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http://dx.doi.org/10.1016/j.jenvman.2017.06.004DOI Listing
September 2017

The future is now: the impact of present fluency in judgments about the future.

Memory 2018 02 8;26(2):144-153. Epub 2017 Jun 8.

a CICPSI, Faculdade de Psicologia , Universidade de Lisboa , Lisboa , Portugal.

Recent research has emphasised the role of episodic memory in both remembering past events and in envisaging future events. On the other hand, it has been repeatedly shown that judgments about past events are affected by the fluency with which retrieval cues are processed. In this paper we investigate whether perceptual fluency also plays a role in judgments about future events. For this purpose we conducted four experiments. The first experiment replicated recent findings showing that stimuli that are processed fluently tend to be wrongly recognised as having been encountered in the past outside the laboratory walls [Brown, A. S., & Marsh, E. J. (2009). Creating illusions of past encounter through brief exposure. Psychological Science, 20, 534-538. doi: 10.1111/j.1467-9280.2009.02337.x ]. Two follow-up experiments using Brown and Marsh's [(2009). Creating illusions of past encounter through brief exposure. Psychological Science, 20, 534-538. doi: 10.1111/j.1467-9280.2009.02337 ] task tested the influence of perceptual fluency on future judgments. The fourth and last experiment was designed to rule out a potential confounding factor in the two previous experiments. Across experiments, we found that people rely on fluency when making judgments about events that are yet to come. These results suggest that fluency is an equally valid cue for past and future judgments.
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http://dx.doi.org/10.1080/09658211.2017.1335328DOI Listing
February 2018

"To-be-forgotten" statements become less true: Memory processes involved in selection and forgetting lead to truthfulness changes of ambiguous sentences.

Scand J Psychol 2017 Jun 25;58(3):205-210. Epub 2017 Apr 25.

Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013, Lisboa, Portugal.

What happens when people try to forget something? What are the consequences of instructing people to intentionally forget a sentence? Recent studies employing the item-method directed forgetting paradigm have shown that to-be-forgotten (TBF) items are, in a subsequent task, emotionally devaluated relative to to-be-remembered (TBR) items, an aftereffect of memory selection (Vivas, Marful, Panagiotidou & Bajo, 2016). As such, distractor devaluation by attentional selection generalizes to memory selection. In this study, we use the item-method directed forgetting paradigm to test the effects of memory selection and inhibition on truth judgments of ambiguous sentences. We expected the relative standing of an item in the task (i.e., whether it was instructed to be remembered or forgotten) to affect the truthfulness value of that item, making TBF items less valid/truthful than TBR items. As predicted, ambiguous sentences associated with a "Forget" cue were subsequently judged as less true than sentences associated with a "Remember" cue, suggesting that instructions to intentionally forget a statement can produce changes in the validity/truthfulness of that statement. To our knowledge, this is the first study to show an influence of memory processes involved in selection and forgetting on the perceived truthfulness of sentences.
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http://dx.doi.org/10.1111/sjop.12365DOI Listing
June 2017

Prevalence of abacavir-associated hypersensitivity syndrome and HLA-B*5701 allele in a Portuguese HIV-positive population.

Porto Biomed J 2017 Mar-Apr;2(2):59-62. Epub 2017 Feb 4.

Serviço de Imunoalergologia, Centro Hospitalar São João, E.P.E., Porto, Portugal.

Background: Human Immunodeficiency Virus (HIV)-positive patients treated with the antiretroviral drug abacavir (ABC) may develop a potentially fatal ABC-associated hypersensitivity syndrome (ABC-HS), typically characterized by fever, malaise, rash, vomiting/diarrhoea and/or dyspnoea/cough. ABC-HS has been strongly associated with HLA-B*57:01 carriage and screening for this allele is recommended.

Objective: To determine the prevalence of HLA-B*57:01 and to characterize suspected ABC-HS in the adult HIV population from our hospital during a 7-year period.

Methods: Clinical data on patients under ABC treatment from January 2006 to December 2012 were analyzed to search for symptoms of ABC-HS. Reactions of suspected ABC-HS were characterized. HLA-B*57:01 and patch tests (1% and 10% ABC in petrolatum) with readings at 48 h were performed in those without previous testing. From January 2008 routine HLA-B*57:01 screening was implemented.

Results: From January 2006 to December 2007, 186 patients began treatment with ABC (data from 163 were available): 7 (4%) patients stopped ABC for suspected ABC-HS (71% males, median age 45 years) and the median time for onset of the reaction after starting ABC was 7 days. Four of the 7 patients had the HLA-B*57:01 allele and 2 of these 4 had positive patch tests. After HLA-B*57:01 screening implementation (January 2008), 573 patients were evaluated and 35 (6.1%) were HLA-B*57:01 positive; no suspected ABC-HS were observed since then.

Conclusion: Four patients with suspected ABC-HS (of 6 screened) were HLA-B*57:01 positive. No ABC-HS occurred since January 2008, after HLA-B*57:01 screening was implemented.
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http://dx.doi.org/10.1016/j.pbj.2016.12.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6806971PMC
February 2017

Guidelines for the Direct Detection of Anaplasma spp. in Diagnosis and Epidemiological Studies.

Vector Borne Zoonotic Dis 2017 01;17(1):12-22

14 Departments of Pathology and Microbiology and Immunology, University of Maryland , School of Medicine, Baltimore, Maryland.

The genus Anaplasma (Rickettsiales: Anaplasmataceae) comprises obligate intracellular Gram-negative bacteria that are mainly transmitted by ticks, and currently includes six species: Anaplasma bovis, Anaplasma centrale, Anaplasma marginale, Anaplasma phagocytophilum, Anaplasma platys, and Anaplasma ovis. These have long been known as etiological agents of veterinary diseases that affect domestic and wild animals worldwide. A zoonotic role has been recognized for A. phagocytophilum, but other species can also be pathogenic for humans. Anaplasma infections are usually challenging to diagnose, clinically presenting with nonspecific symptoms that vary greatly depending on the agent involved, the affected host, and other factors such as immune status and coinfections. The substantial economic impact associated with livestock infection and the growing number of human cases along with the risk of transfusion-transmitted infections, determines the need for accurate laboratory tests. Because hosts are usually seronegative in the initial phase of infection and serological cross-reactions with several Anaplasma species are observed after seroconversion, direct tests are the best approach for both case definition and epidemiological studies. Blood samples are routinely used for Anaplasma spp. screening, but in persistently infected animals with intermittent or low-level bacteremia, other tissues might be useful. These guidelines have been developed as a direct outcome of the COST action TD1303 EURNEGVEC ("European Network of Neglected Vectors and Vector-Borne Diseases"). They review the direct laboratory tests (microscopy, nucleic acid-based detection and in vitro isolation) currently used for Anaplasma detection in ticks and vertebrates and their application.
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http://dx.doi.org/10.1089/vbz.2016.1960DOI Listing
January 2017

Critical Aspects for Detection of Coxiella burnetii.

Vector Borne Zoonotic Dis 2017 01;17(1):33-41

5 Centre for Vector and Infectious Diseases Research, National Institute of Health Doutor Ricardo Jorge , Águas de Moura, Portugal .

Coxiella burnetii is a globally distributed zoonotic γ-proteobacterium with an obligatory intracellular lifestyle. It is the causative agent of Q fever in humans and of coxiellosis among ruminants, although the agent is also detected in ticks, birds, and various other mammalian species. Requirements for intracellular multiplication together with the necessity for biosafety level 3 facilities restrict the cultivation of C. burnetii to specialized laboratories. Development of a novel medium formulation enabling axenic growth of C. burnetii has facilitated fundamental genetic studies. This review provides critical insights into direct diagnostic methods currently available for C. burnetii. It encompasses molecular detection methods, isolation, and propagation of the bacteria and its genetic characterization. Differentiation of C. burnetii from Coxiella-like organisms is an essential diagnostic prerequisite, particularly when handling and analyzing ticks.
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http://dx.doi.org/10.1089/vbz.2016.1958DOI Listing
January 2017

PCR screening of tick-borne agents in sensitive conservation areas, Southeast Portugal.

Mol Cell Probes 2017 02 25;31:42-45. Epub 2016 Nov 25.

Centro de Estudos de Vectores e Doenças Infecciosas Doutor Francisco Cambournac, Instituto Nacional de Saúde Doutor Ricardo Jorge, Avenida da Liberdade 5, 2965-575 Águas de Moura, Portugal. Electronic address:

The Southeast region of Portugal, particularly the Guadiana valley, is currently the reintroduction territory of Lynx pardinus (Iberian lynx), one of the most endangered felids in the world that is only found in the Iberian Peninsula. Over the last century, populations have declined, placing L. pardinus at extremely high risk of extinction in the wild and relying on reintroduction projects. Among the aspects taken into account in the establishment of new populations is the sanitary status of the selected habitats, especially concerning infectious diseases, including tick-borne pathogens (TBPs). This study presents the results of TBPs survey on ticks collected at sensitive conservation areas of Southeast Portugal. From 2012 to 2014, 231 ticks obtained from vegetation, sympatric domestic and wild animals were submitted for analysis. The presence of Babesia spp., Cytauxzoon spp., Theileria spp., Hepatozoon spp., Anaplasma spp., Ehrlichia spp., Candidatus Neoehrlichia mikurensis, among other Anaplasmataceae, and Coxiella burnetii were investigated by PCR. Six tick species were recorded, Dermacentor marginatus (n = 13/5.6%), Hyalomma lusitanicum (n = 175/75.8%), Ixodes ricinus (n = 4/1.7%), Rhipicephalus bursa (n = 7/3.0%), R. pusillus (n = 21/9.1%) and R. sanguineus sensu lato (n = 11/4.8%). The molecular screening confirmed the presence of two tick-borne pathogens, C. burnetii (N = 34) and Anaplasma platys (N = 1), and one tick-endosymbiont, Candidatus Midichloria mitochondrii (N = 45). The results obtained provide new information on the circulation of ticks and TBPs with potential veterinary importance in Iberian lynx habitat.
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http://dx.doi.org/10.1016/j.mcp.2016.11.005DOI Listing
February 2017

Relationships between body condition score and ultrasound skin-associated subcutaneous fat depth in equids.

Acta Vet Scand 2016 Oct 20;58(Suppl 1):62. Epub 2016 Oct 20.

EUVG-Escola Universitária Vasco da Gama, Campus Universitário, Bloco B, Lordemão, 3020-210, Coimbra, Portugal.

Background: In equids, health and welfare depend on body composition. A growing number of equids are now used as leisure and companion animals, and often found overfeed. The need for a close monitoring of body fatness led to the search for tools allowing a rapid and non-invasive estimation of fatness. This study intends to assess real-time ultrasonography (RTU) usefulness in establishing a relationship between ultrasound measures of subcutaneous fat-plus-skin thickness (SF-Skin) and body condition score (BCS) in horses and donkeys. Forty-three healthy animals (16 donkeys and 27 horses) were used in this study to generate 95 records (RTU and BCS pairs), in multiple RTU sessions for 2 years. Using visual appraisal and palpation, BCS was graded in a 1-9 points scale. Real-time ultrasonography images were taken using a 7.5 MHz linear transducer, placed perpendicular to the backbone, over the 3rd lumbar vertebra. ImageJ was used to measure the SF-Skin on RTU images. The relation between BCS and SF-Skin measurements was tested by linear and polynomial regression analysis.

Results: The BCS values were similar in horses (5.50; from 3 to 8 points) and donkeys (5.14; from 3 to 7 points). The SF-Skin measures show a similar trend (a mean of 7.1 and 7.7 mm in horses and donkeys, respectively). A polynomial regression among BCS and SF-Skin explained 92 and 77 % of the variation in donkeys and horses respectively. The coefficient of determination was considerably higher for the regression developed for donkeys compared with that of horses (R2 = 0.92 vs. 0.77, respectively), which reduced the accuracy of the method in horses. Both the linear and polynomial models tested show a strong relationship among BCS and SF-Skin for donkeys (R2 > 0.91; P < 0.01) and horses (R2 > 0.74; P < 0.01), despite that the extremes for BCS did not existed in our sample.

Conclusions: Our results showed the potential RTU usefulness to monitor body fat in equids. Using a high-frequency transducer and RTU together with image analysis allowed the identification of small SF-skin variations. This report will support further studies on the relationships between SF-Skin and BCS, particularly in extreme BCS scores.
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http://dx.doi.org/10.1186/s13028-016-0243-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5073852PMC
October 2016

Correlations between cresty neck scores and post-mortem nape fat measurements in horses, obtained after photographic image analysis.

Acta Vet Scand 2016 Oct 20;58(Suppl 1):60. Epub 2016 Oct 20.

EUVG-Escola Universitária Vasco da Gama, Campus Universitário, Bloco B, Lordemão, 3020-210, Coimbra, Portugal.

Background: Obesity and emaciation in horses have major detrimental effects on health and morbidity, reproductive failure, work performance or carcass quality. Scoring is a current management tool used to assess and monitor equine body condition due to its simplicity and low cost. However, accurate assessment of obesity remains a challenge, even though a number of approaches have been tested, particularly for research purposes on adiposity. Their merit is usually validated by comparison with standard scoring methods. The overall aim of this study was to establish the correlation between post-mortem nape fat measurements obtained after photographic image analysis and cresty neck score (CNS) in horses. Data were collected from seventeen horses with a hot carcass weight of 165 ± 51 kg. Pre-slaughter CNS measurements were obtained using a six-point scale (from 0 to 5). Image capture was performed post-mortem, in the slaughter line; for each carcass, images of the dorsal and medial views were collected and afterwards transferred to a computer for analysis. After outlining the cresty neck fat, its area, major axis and thickness were determined. Correlation coefficients between nape fat measurements, CNS and carcass fatness were determined.

Results: The horses in the study show similar variation for CNS and hot carcass weight [Coefficient of variation (CV) = 32 and 31 %, respectively], but a high variation for carcass fattening (CV = 41 %). The nape fat area measurement was the parameter exhibiting the greatest variation (CV = 50 %). Correlations established between CNS and the variables tested revealed the existence of moderate to strong correlations among CNS, nape fat measurements, and carcass fatness. The highest correlation coefficients were found between CNS and nape fat thickness (r = 0.882; P < 0.01). The linear regression between CNS and nape fat thickness accounted for 77 % of the recorded variation for nape fat thickness.

Conclusions: The present study showed that there is a strong correlation between horse CNS and post-mortem nape fat measurements or carcass fatness.
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http://dx.doi.org/10.1186/s13028-016-0241-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5073977PMC
October 2016

Notch and Hedgehog in the thymus/parathyroid common primordium: Crosstalk in organ formation.

Dev Biol 2016 10 18;418(2):268-82. Epub 2016 Aug 18.

Instituto de Histologia e Biologia do Desenvolvimento, Faculdade de Medicina da Universidade de Lisboa, Edifício Egas Moniz, Piso 3, Ala C, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal; Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal. Electronic address:

The avian thymus and parathyroids (T/PT) common primordium derives from the endoderm of the third and fourth pharyngeal pouches (3/4PP). The molecular mechanisms that govern T/PT development are not fully understood. Here we study the effects of Notch and Hedgehog (Hh) signalling modulation during common primordium development using in vitro, in vivo and in ovo approaches. The impairment of Notch activity reduced Foxn1/thymus-fated and Gcm2/Pth/parathyroid-fated domains in the 3/4PP and further compromised the development of the parathyroid glands. When Hh signalling was abolished, we observed a reduction in the Gata3/Gcm2- and Lfng-expression domains at the median/anterior and median/posterior territories of the pouches, respectively. In contrast, the Foxn1 expression-domain at the dorsal tip of the pouches expanded ventrally into the Lfng-expression domain. This study offers novel evidence on the role of Notch signalling in T/PT common primordium development, in an Hh-dependent manner.
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http://dx.doi.org/10.1016/j.ydbio.2016.08.012DOI Listing
October 2016

Intraventricular colistin in Gram-negative ventriculoperitoneal shunt infection in two pediatric patients.

Acta Neurochir (Wien) 2015 Dec 22;157(12):2219-20. Epub 2015 Sep 22.

Pediatric Infectious Diseases Unit, Hospital Dona Estefânia, CHLC, Lisbon, Portugal.

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http://dx.doi.org/10.1007/s00701-015-2588-0DOI Listing
December 2015

Q Fever Chronic Osteomyelitis in Two Children.

Pediatr Infect Dis J 2015 Nov;34(11):1269-71

From the *Infecciology Unit, Pediatric Department, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central - Entidade Pública Empresarial, Lisbon, Portugal; †Pediatric Department, Hospital José Joaquim Fernandes - Unidade Local de Saúde do Baixo Alentejo - Beja, Portugal; ‡Centro de Estudos de Vectores e Doenças Infecciosas, Instituto Nacional de Saúde Dr Ricardo Jorge, Águas de Moura, Portugal; and §Orthopedic Unit, Pediatric Cirurgic Departement, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central - Entidade Pública Empresarial, Lisbon, Portugal.

We report 2 cases of chronic Q fever osteomyelitis in 10- and 5-year-old girls who presented with distal right femoral and left parasternal granulomatous osteomyelitis, respectively. Both were treated with ciprofloxacin and rifampin with good response. Q fever osteomyelitis is a challenging diagnosis in children, and the choice of antimicrobial treatment is difficult because of limited available data.
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http://dx.doi.org/10.1097/INF.0000000000000861DOI Listing
November 2015

Stimulus-Response Bindings in the Go/NoGo Task: Effects on the Judged Typicality of Stimuli.

Exp Psychol 2015 1;62(4):264-75. Epub 2015 Jan 1.

1 Faculty of Psychology, University of Lisbon, Portugal.

In the present paper, we explore the notion that judgments of typicality are dependent on the goal-relevancy of exemplars. However, we propose that relevancy can be derived from the response provided to stimulus, through the operation of stimulus-response bindings. Specifically, items associated with selection responses are tagged as "relevant" and will be subsequently judged as more typical of their categories, while stimuli associated with avoidance responses are tagged as "irrelevant" will be judged as less typical of their categories. We test this prediction with a Go-NoGo task with male and female faces. Results showed that (a) faces associated with a selection (Go) response were judged more typical of their gender category than faces associated with an avoidance (NoGo) response, and (b) these effects were more likely to be observed when the context is reactivated. Our results are consistent with the notion that representation of typicality is goal-oriented and contextually dependent.
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http://dx.doi.org/10.1027/1618-3169/a000297DOI Listing
May 2016

Rickettsial infection caused by accidental conjunctival inoculation.

BMJ Case Rep 2015 Jan 7;2015. Epub 2015 Jan 7.

Department of Pediatric, Hospital Dona Estefania, Lisboa, Portugal.

The most common transmission route of tick-borne Rickettsia is through tick bite; nevertheless, other transmission routes should also be considered. We report a case of rickettsial infection in a 15-year-old boy caused by accidental contamination of the conjunctiva through the infected fluid of a crushed engorged tick removed from a dog. Right eye pain, conjunctival hyperaemia with mucopurulent exudate, chemosis and eyelid oedema were the first signs and symptoms. Two days later, the boy developed fever, myalgia, headache, abdominal pain and was vomiting; physical examination showed multiple cervical adenopathies but no rash. He was treated with doxycycline (200 mg/day) for 7 days with progressive resolution of clinical signs. Rickettsial infection was confirmed by immunofluorescence assay with serological seroconversion in two consecutive samples. Rickettsia conorii or Rickettsia massiliae were the possible causal agents since they are the Rickettsia spp found in the Rhipicephalus sanguineus dog tick in Portugal.
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http://dx.doi.org/10.1136/bcr-2014-207029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4289770PMC
January 2015

Primary drug resistance at diagnosis of HIV-1 infection: a Portuguese cohort.

J Int AIDS Soc 2014 2;17(4 Suppl 3):19761. Epub 2014 Nov 2.

Infectious Diseases, Centro Hospitalar São João, Porto, Portugal.

Introduction: Presence of viral mutations conferring resistance to antiretroviral drugs has potential impact on success of antiretroviral therapy (ART). The aim of this study was to describe the prevalence of resistance-associated mutations in HIV-infected patients without prior ART in a Portuguese cohort.

Materials And Methods: Retrospective single-centre study of patients newly diagnosed with HIV-1 infection between 2006 and 2012. Resistance genotyping was obtained with HIV TRUGENE(®) and Viroseq(®) tests and the analysis of drug resistance was based on the Stanford University HIV Drug Resistance Database. Epidemiological data was also gathered. Continuous variables were summarized by mean and standard deviation, whereas categorical variables were presented as proportions. Comparison of proportions was performed with Chi square and Fisher exact test while means were compared with Student test. Statistical significance was assumed when p<0.05. Statistical analysis was performed with SPSS 21.0(®).

Results: Resistance testing was performed in 624 patients. General characteristics of the patients are summarized in Table 1. Mutations were found in 291 (46.6%) patients but resistance-associated mutations were present in 79 (12.7%) patients. Resistances to different drug classes were the following: NNRTIs-resistance in 42 (6.7%) patients; NRTIs-resistance in 19 (3.0%) patients; PIs-resistance in 30 (4.8%) patients. Only 10 (1.6%) patients presented simultaneous resistance-associated mutations to more than one class of drugs. There were no statistical significant differences between the years at which HIV-1 was diagnosed. Also no significant difference in the distribution of the parameters age, sex, CD4-cell count, and viral load, between groups with and without resistance was identified. Resistance-associated mutations were significantly more common in patients with non-B HIV-1 subtypes (15.4% vs 9.8%; p=0.048) and in those presenting with AIDS (18.2% vs 11.1%; p=0.03).

Conclusions: Prevalence of resistance-associated mutations identified in this study was similar to those reported in similar studies from Western Europe. Knowledge about the epidemiology of primary resistance in our country is important in order to improve HIV care.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225256PMC
http://dx.doi.org/10.7448/IAS.17.4.19761DOI Listing
January 2016

Prevention of mother-to-child transmission: experience of a Portuguese centre.

J Int AIDS Soc 2014 2;17(4 Suppl 3):19705. Epub 2014 Nov 2.

Infectious Diseases Service, Centro Hospitalar São João, Porto, Portugal.

Introduction: HIV infection during pregnancy still raises controversial issues. Combined antiretroviral therapy (cART) has been successful in reducing mother-to-child transmission (MTCT). Routine screening in pregnancy and in pre-conception consultation proved to be one of the best methods able to get this treatment on time. We review our experience with pregnant patients with HIV infection.

Materials And Methods: Retrospective and descriptive study. Data obtained from HIV-infected pregnant women from 1999 to 2012 with delivery and subsequent infectious diseases follow-up at our hospital.

Results: We evaluated 136 patients (169 pregnancies), with a total of 147 living newborns (2 twin pregnancies) and 1 stillbirth. Median age at pregnancy was 30 (SD 5.7) years. Four patients were HIV-2 infected and one HIV-1+2 infected. 26 (19.1%) women were HCV co-infected and 6 (4.4%) HBV co-infected; 1 patient has HCV and HBV co-infection. Sexual risk for HIV acquisition was determined in 102 (75%) patients and 31 (22.8%) were intravenous drug users. 33/136 (24.2%) women were diagnosed on routine screening in pregnancy, 4 during delivery and 2 immediately after delivery. 36 (26.4%) patients had an AIDS-defining entity before pregnancy and no new opportunistic infections were diagnosed. ART was used in 157 (92.9%) pregnancies and 15 (9.5%) of them were treated only with NRTIs. At the time of delivery 86/144 (59.7%) patients had undetectable viral load (VL) (25 patients without VL determined), 91.7% of those on ART. 119 (70.4%) had a TCD4 cell count above 200 cells/mm(3). MTCT occurred in 3/147 cases (2%): in one mother HIV-1 infection was diagnosed three weeks before delivery, other immediately after delivery and the third woman started cART (2NRTI+1PI/r) in the second trimester of pregnancy, always adherent and without secondary effects, VL at delivery was 50 copies/mL and elective C-section was performed.

Conclusions: The fact that 24% of patients were diagnosed during pregnancy shows the importance of routine screening to all pregnant women. MTCT occurred in three children, but only one was administered cART for prevention.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225253PMC
http://dx.doi.org/10.7448/IAS.17.4.19705DOI Listing
January 2016

Insights into the regulatory domain of cystathionine Beta-synthase: characterization of six variant proteins.

Hum Mutat 2014 Oct 31;35(10):1195-202. Epub 2014 Jul 31.

Metabolism and Genetics Group, Research Institute for Medicines, Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal; Metabolic Unit, Department of Clinical Chemistry, VU University Medical Centre, Amsterdam, The Netherlands.

Cystathionine beta-synthase (CBS) catalyzes the formation of cystathionine from homocysteine and serine. CBS is allosterically activated by S-adenosylmethionine (SAM), which binds to its C-terminal regulatory domain. Mutations in this domain lead to variants with high residual activity but lacking SAM activation. We characterized six C-terminal CBS variants (p.P427L, p.D444N, p.V449G, p.S500L, p.K523Sfs*18, and p.L540Q). To understand the effect of C-terminal mutations on the functional/structural properties of CBS, we performed dynamic light scattering, differential scanning fluorimetry, limited proteolysis, enzymatic characterization, and determination of SAM-binding affinity. Kinetic data confirm that the enzymatic function of these variants is not impaired. Although lacking SAM activation, the p.P427L and p.S500L were able to bind SAM at a lower extent than the wild type (WT), confirming that SAM binding and activation can be two independent events. At the structural level, the C-terminal variants presented various effects, either showing catalytic core instability and increased susceptibility toward aggregation or presenting with similar or higher stability than the WT. Our study highlights as the common feature to the C-terminal variants an impaired binding of SAM and no increase in enzymatic activity with physiological concentrations of the activator, suggesting the loss of regulation by SAM as a potential pathogenic mechanism.
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http://dx.doi.org/10.1002/humu.22616DOI Listing
October 2014

Medication fall risk in old hospitalized patients: a retrospective study.

Nurse Educ Today 2014 Feb 14;34(2):171-6. Epub 2013 Jun 14.

Catholic University of Portugal, Lisbon, Portugal; European Academy of Nursing Science, United Kingdom. Electronic address:

Background: While the causes of falls in old hospitalized patients are multifactorial, medication has been considered as one of the most significant factors. Given the large impact that this phenomenon has on the lives of the elderly and organizations, it is important to explore such phenomenon in greater depth.

Objective: The objective of this study was to explore the association between medication and falls and the recurrent falls (n≥2), and identify medication related risk for fall in hospitalized patients, in a large acute hospital.

Design: Retrospective and quantitative study from June 2008 to December 2010.

Setting: The study was conducted in a private hospital for acute patients in Lisbon, Portugal.

Participants: The study included a sample of 214 episodes of fall event notifications which occurred in 193 patients.

Methods: The current study was conducted through the "face to face consensus" technique which emerged the treatment groups to investigate. Regarding the data analysis we used Student's t test, ANOVA and Odds Ratio. In the violation of the premises for the use of parametric statistics we used the Kruskal-Wallis test. To assess the fall risk, and the medication-related fall risk, we used the Morse Fall Risk Scale, and the Medication Fall Risk Score.

Results: Patients who received drugs from the therapy group of "Central Nervous System", are 10 times more likely to have fall risk (OR 9. 90, 95% CI 1.6-60.63). Association was found between falls (OR 6.09, 95% CI 1.30-28.54) and its recurrence (OR 3.32, 95% CI 1.61-6.85), among patients receiving haloperidol and receiving tramadol for recurrent falls (OR 3.10, 95% CI 1.59-6.07). In 34% of the patients the medication fall risk score was 6 or higher.

Conclusions: This current study allowed identifying medication-related risk factors for falls, that nurses should consider when prescribing interventions to prevent falls and its recurrence, when patients are admitted to acute care hospitals.
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http://dx.doi.org/10.1016/j.nedt.2013.05.016DOI Listing
February 2014

Genotypic diversity of clinical Coxiella burnetii isolates from Portugal based on MST and MLVA typing.

Int J Med Microbiol 2012 Nov 4;302(6):253-6. Epub 2012 Oct 4.

Centre for Vectors and Infectious Diseases Research Doutor Francisco Cambournac, National Institute of Health Dr. Ricardo Jorge-CEVDI/INSA, Águas de Moura, Portugal.

The temporal and spatial diversity of Coxiella burnetii genotypes associated with human and animal disease in Portugal was analysed using a 6-locus multiple-locus variable-number tandem repeat analysis (MLVA) and a 10-locus multi-spacer sequence typing (MST) panel. Fifteen cultured C. burnetii isolates from 13 Q fever patients and a stillborn goat and 6 additional PCR-positive ruminant tissue samples obtained during 2006-2011 were included in this study. Seven MLVA genotypes (types S-Y) were obtained, including 4 new MLVA types (U, V, W, and X), all corresponding to 3 MST profiles (types 4, 8, and 13) previously reported from France and Spain. MLVA types U-Y, all belonging to MST type 4, were found in acute Q fever patients from the districts of Évora, Faro, Lisbon, and Setúbal. Different MLVA types were associated with goats from Castelo Branco district (S) and chronic Q fever patients from both Castelo Branco and Lisboa districts (S and T), matching with MST types 13 and 8, respectively. In conclusion, a genotypic diversity of C. burnetii consistent with a non-outbreak situation was identified. The involvement of different genotypes in acute and chronic Q fever was found, linking one of the chronic genotypes to goats from the eastern region of the country.
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http://dx.doi.org/10.1016/j.ijmm.2012.08.003DOI Listing
November 2012

Chronic q Fever with no elevation of inflammatory markers: a case report.

Case Rep Med 2012 26;2012:249705. Epub 2012 Jun 26.

Department of Internal Medicine, St. Marta's Hospital, 1169-024 Lisbon, Portugal.

We describe the case of a 55-year-old man with a biological prosthetic aortic valve who suffered from epigastrium and right hypochondrium pain associated with intermittent night sweats. Liver biopsy showed infectious hepatitis pattern without pathognomonic features. Coxiella burnetii serology was suggestive of chronic Q fever, and modified Duke's criteria for endocarditis were also fulfilled. The authors present a brief literature review concerning chronic Q fever, emphasizing absent previous reports of chronic Q fever with hepatitis and endocarditis and no increase in inflammatory markers.
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http://dx.doi.org/10.1155/2012/249705DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3389709PMC
August 2012

Detection of Rickettsia conorii strains in Portuguese dogs (Canis familiaris).

Ticks Tick Borne Dis 2011 Jun 16;2(2):119-22. Epub 2011 Apr 16.

Departamento de Zootecnia, Universidade de Évora, Pólo da Mitra, 7002-554 Évora, Portugal.

This study reports a serological and molecular survey on the spotted fever group Rickettsia found in a group of 51 dogs with suspected tick-borne illness from the south of Portugal. Additionally, a prevalence of IgG antibodies to R. conorii was also estimated in a group of 400 healthy dogs from the same region. In the group of healthy dogs, the immunofluorescence test revealed that 154 (38.5%) of the 400 dogs had IgG antibodies reactive with R. conorii. The highest proportion of dogs (45%) with R. conorii antibodies was found in blood samples collected from October to December. Among the group suspected with tick-borne illness, 35 (62%) dogs showed to be seroreactive (IgG≥128) for antibodies against R. conorii, and the analysis of PCR-positive amplicons revealed that 5 dogs were infected with R. conorii Malish and 2 dogs were infected with R. conorii Israeli tick typhus strain. There was a higher prevalence of antibodies to R. conorii in the group of sick dogs, and the detection of R. conorii DNA in blood samples from this group points to their potential role as a reservoir and sentinel host helping to evaluate and characterize the distribution of circulating rickettsial strains.
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http://dx.doi.org/10.1016/j.ttbdis.2011.03.001DOI Listing
June 2011