Postepizootic Persistence of Asymptomatic Mycoplasma conjunctivae Infection in Iberian Ibex

ABSTRACT The susceptibility of the Iberian ibex (Capra pyrenaica) to Mycoplasma conjunctivae ocular infection and the changes in their interaction over time were studied in terms of clinical outcome, molecular detection, and IgG immune response in a captive population that underwent a severe infectious keratoconjunctivitis (IKC) outbreak. Mycoplasma conjunctivae was detected in the Iberian ibex, coinciding with the IKC outbreak. Its prevalence had a decreasing trend in 2013 that was consistent with the clinical resolution (August, 35.4%; September, 8.7%; November, 4.3%). Infections without clinical outcome were, however, still detected in the last handling in November. Sequencing and cluster analyses of the M. conjunctivae strains found 1 year later in the ibex population confirmed the persistence of the same strain lineage that caused the IKC outbreak but with a high prevalence (75.3%) of mostly asymptomatic infections and with lower DNA load of M. conjunctivae in the eyes (mean quantitative PCR [qPCR] cycle threshold [CT ], 36.1 versus 20.3 in severe IKC). Significant age-related differences of M. conjunctivae prevalence were observed only under IKC epizootic conditions. No substantial effect of systemic IgG on M. conjunctivae DNA in the eye was evidenced with a linear mixed-models selection, which indicated that systemic IgG does not necessarily drive the resolution of M. conjunctivae infection and does not explain the epidemiological changes observed. The results show how both epidemiological scenarios, i.e., severe IKC outbreak and mostly asymptomatic infections, can consecutively occur by entailing mycoplasma persistence. IMPORTANCE Mycoplasma infections are reported in a wide range of epidemiological scenarios that involve severe disease to asymptomatic infections. This study allows a better understanding of the transition between two different Mycoplasma conjunctivae epidemiological scenarios described in wild host populations and highlights the ability of M. conjunctivae to adapt, persist, and establish diverse interactions with its hosts. The proportion of asymptomatic and clinical M. conjunctivae infections in a host population may not be regarded only in response to intrinsic host species traits (i.e., susceptibility) but also to a specific host-pathogen interaction, which in turn influences the infection dynamics. Both epidemic infectious keratoconjunctivitis and a high prevalence of asymptomatic M. conjunctivae infections may occur in the same host population, depending on the circulation of M. conjunctivae, its maintenance, and the progression of the host-pathogen interactions.

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Anaplasma marginale Superinfection Attributable to Pathogen Strains with Distinct Genomic Backgrounds

Infection and Immunity ◽

10.1128/iai.02537-14 ◽

2014 ◽

Vol 82 (12) ◽

pp. 5286-5292 ◽

Cited By ~ 11

Author(s):

Eduardo Vallejo Esquerra ◽

David R. Herndon ◽

Francisco Alpirez Mendoza ◽

Juan Mosqueda ◽

Guy H. Palmer

Keyword(s):

High Throughput Sequencing ◽

Anaplasma Marginale ◽

Host Population ◽

Content Type ◽

Tropical Regions ◽

Disease Epidemiology ◽

Infectious Disease Epidemiology ◽

Perfect Sequence ◽

Significant Difference ◽

High Prevalence

ABSTRACTStrain superinfection occurs when a second pathogen strain infects a host already infected with a primary strain. The selective pressures that drive strain divergence, which underlies superinfection, and allow penetration of a new strain into a host population are critical knowledge gaps relevant to shifts in infectious disease epidemiology. In regions of endemicity with a high prevalence of infection, broad population immunity develops againstAnaplasma marginale, a highly antigenically variant rickettsial pathogen, and creates strong selective pressure for emergence of and superinfection with strains that differ in their Msp2 variant repertoires. The strains may emerge either bymsp2locus duplication and allelic divergence on an existing genomic background or by introduction of a strain with a differentmsp2allelic repertoire on a distinct genomic background. To answer this question, we developed a multilocus typing assay based on high-throughput sequencing of non-msp2target loci to distinguish among strains with different genomic backgrounds. The technical error level was statistically defined based on the percentage of perfect sequence matches of clones of each target locus and validated using experimental single strains and strain pairs. Testing ofA. marginale-positive samples from tropical regions whereA. marginaleinfection is endemic identified individual infections that contained unique alleles for all five targeted loci. The data revealed a highly significant difference in the number of strains per animal in the tropical regions compared to infections in temperate regions and strongly supported the hypothesis that transmission of genomically distinctA. marginalestrains predominates in high-prevalence areas of endemicity.

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Molecular Epidemiology of Mycoplasma conjunctivae in Caprinae: Transmission across Species in Natural Outbreaks

Applied and Environmental Microbiology ◽

10.1128/aem.69.4.1913-1919.2003 ◽

2003 ◽

Vol 69 (4) ◽

pp. 1913-1919 ◽

Cited By ~ 26

Author(s):

Luc Belloy ◽

Martin Janovsky ◽

Edy M. Vilei ◽

Paola Pilo ◽

Marco Giacometti ◽

...

Keyword(s):

Variable Domain ◽

Clinical Samples ◽

Ocular Infection ◽

European Alps ◽

Sequence Determination ◽

Molecular Method ◽

Infectious Keratoconjunctivitis ◽

Mycoplasma Conjunctivae ◽

Different Strains

ABSTRACT Mycoplasma conjunctivae is the etiological agent of infectious keratoconjunctivitis, a highly contagious ocular infection that affects both domestic and wild Caprinae species in the European Alps. In order to study the transmission and spread of M. conjunctivae across domestic and wild Caprinae populations, we developed a molecular method for subtyping and identifying strains of M. conjunctivae. This method is based on DNA sequence determination of a variable domain within the gene lppS, a gene that encodes an antigenic lipoprotein of M. conjunctivae. This domain of lppS shows variations among different strains but remains constant upon generations of individual strains on growth medium and thus allows identification of individual strains and estimation of their phylogenetic intercorrelations. The variable domain of lppS is amplified by PCR using primers that match conserved sequences of lppS flanking it. Sequence analysis of the amplified fragment enables fine subtyping of M. conjunctivae strains. The method is applicable both to isolated strains and to clinical samples directly without requiring the cultivation of the strain. Using this method, we show that M. conjunctivae was transmitted between domestic and wild animals that were grazing in proximate pastures. Certain animals also presented infections with two different strains simultaneously.

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Infectious keratoconjunctivitis and occurrence ofMycoplasma conjunctivaeand Chlamydiaceae in small domestic ruminants from Central Karakoram, Pakistan

Veterinary Record ◽

10.1136/vr.103948 ◽

2017 ◽

Vol 181 (9) ◽

pp. 237-237 ◽

Cited By ~ 3

Author(s):

Xavier Fernández-Aguilar ◽

Luca Rossi ◽

Óscar Cabezón ◽

Andrea Giorgino ◽

Isis Victoriano Llopis ◽

...

Keyword(s):

National Park ◽

Case Control Study ◽

Ocular Infection ◽

Remote Communities ◽

Cross Sectional ◽

Widespread Occurrence ◽

Domestic Ruminants ◽

Infectious Keratoconjunctivitis ◽

Mycoplasma Conjunctivae ◽

Control Study

Infectious keratoconjunctivitis (IKC) is a contagious eye disease primarily caused byMycoplasma conjunctivaein domestic and wild Caprinae.Chlamydophilaspecies have also been detected in ruminants with IKC. The objectives of this study are to investigate the ocular infection ofM. conjunctivaeand Chlamydiaceae and assess its interaction in relation to IKC in sheep and goats from remote communities around the Central Karakoram National Park in Pakistan, performing a combination of cross-sectional and case–control study design. Mostly asymptomatic and endemic infections ofM. conjunctivaeand Chlamydiaceae were found in sheep (19.3 per cent and 4.5 per cent, respectively) and goats (9.5 per cent and 1.9 per cent, respectively) from all communities, assessed by qPCR. Prevalence significantly differed between species only forM. conjunctivae(P=0.0184), which was also more prevalent in younger sheep (P<0.01).Chlamydophila pecorumwas identified by sequencing and was related with IKC only when coinfection withM. conjunctivaeoccurred, which suggest a synergic interaction. Cluster analysis ofM. conjunctivaestrains revealed higher diversity of strains than expected, evidenced interspecific transmission and suggested a higher local livestock trade than previously assumed. These results highlight the widespread occurrence ofM conjunctivaein sheep worldwide and its implications for wildlife should be assessed from a conservation perspective.

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Gamma knife radiosurgery for craniopharyngiomas

Journal of Neurosurgery ◽

10.3171/jns.2000.93.supplement_3.0047 ◽

2000 ◽

Vol 93 (supplement_3) ◽

pp. 47-56 ◽

Cited By ~ 107

Author(s):

Wen-Yuh Chung ◽

David Hung-Chi Pan ◽

Cheng-Ying Shiau ◽

Wan-Yuo Guo ◽

Ling-Wei Wang

Keyword(s):

Clinical Outcome ◽

Gamma Knife ◽

Tumor Volume ◽

Gamma Knife Radiosurgery ◽

Tumor Control ◽

Content Type ◽

Stereotactic Aspiration ◽

Cystic Component ◽

The Mean ◽

Fine Print

Object. The goal of this study was to elucidate the role of gamma knife radiosurgery (GKS) and adjuvant stereotactic procedures by assessing the outcome of 31 consecutive patients harboring craniopharyngiomas treated between March 1993 and December 1999. Methods. There were 31 consecutive patients with craniopharyngiomas: 18 were men and 13 were women. The mean age was 32 years (range 3–69 years). The mean tumor volume was 9 cm3 (range 0.3–28 cm3). The prescription dose to the tumor margin varied from 9.5 to 16 Gy. The visual pathways received 8 Gy or less. Three patients underwent stereotactic aspiration to decompress the cystic component before GKS. The tumor response was classified by percentage reduction of tumor volume as calculated based on magnetic resonance imaging studies. Clinical outcome was evaluated according to improvement and dependence on replacement therapy. An initial postoperative volume increase with enlargement of a cystic component was found in three patients. They were treated by adjuvant stereotactic aspiration and/or Ommaya reservoir implantation. Tumor control was achieved in 87% of patients and 84% had fair to excellent clinical outcome in an average follow-up period of 36 months. Treatment failure due to uncontrolled tumor progression was seen in four patients at 26, 33, 49, and 55 months, respectively, after GKS. Only one patient was found to have a mildly restricted visual field; no additional endocrinological impairment or neurological deterioration could be attributed to the treatment. There was no treatment-related mortality. Conclusions. Multimodality management of patients with craniopharyngiomas seemed to provide a better quality of patient survival and greater long-term tumor control. It is suggested that GKS accompanied by adjuvant stereotactic procedures should be used as an alternative in treating recurrent or residual craniopharyngiomas if further microsurgical excision cannot promise a cure.

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Touring for peace: the role of dual-narrative tours in creating transnational activists

International Journal of Tourism Cities ◽

10.1108/ijtc-12-2017-0092 ◽

2019 ◽

Vol 5 (2) ◽

pp. 200-218 ◽

Cited By ~ 1

Author(s):

Emily Maureen Schneider

Keyword(s):

Attitude Change ◽

Past Research ◽

Host Population ◽

Contact Hypothesis ◽

Racial Groups ◽

Content Type ◽

Governmental Organizations ◽

Non Governmental Organizations ◽

Peace And Justice

Purpose Scholarship on the contact hypothesis and peacebuilding suggests that contact with marginalized ethnic and racial groups may reduce prejudice and improve opportunities for conflict resolution. Through a study of dual-narrative tours to Israel/Palestine, the purpose of this paper is to address two areas of the debate surrounding this approach to social change. First, past research on the effectiveness of contact-based tourism as a method to change attitudes is inconclusive. Travel to a foreign country has been shown to both improve and worsen tourists’ perceptions of a host population. Second, few scholars have attempted to link contact-based changes in attitudes to activism. Design/methodology/approach Through an analysis of 218 post-tour surveys, this study examines the role of dual-narrative tours in sparking attitude change that may facilitate involvement in peace and justice activism. Surveys were collected from the leading “dual-narrative” tour company in the region, MEJDI. Dual-narrative tours uniquely expose mainstream tourists in Israel/Palestine to Palestinian perspectives that are typically absent from the majority of tours to the region. This case study of dual-narrative tours therefore provides a unique opportunity to address the self-selecting bias, as identified by contact hypothesis and tourism scholars, in order to understand the potential impacts of exposure to marginalized narratives. Findings The findings of this study suggest that while these tours tend to engender increased support for Palestinians over Israelis, their most salient function appears to be the cultivation of empathy for “both sides” of the conflict. Similarly, dual-narrative tours often prompt visitors to understand the conflict to be more complex than they previously thought. In terms of activism, tourists tend to prioritize education-based initiatives in their plans for post-tour political engagement. In addition, a large number of participants articulated commitments to support joint Israeli–Palestinian non-governmental organizations and to try to influence US foreign policy to be more equitable. Originality/value These findings complicate debates within the scholarship on peacebuilding as well as within movements for social justice in Israel/Palestine. While programs that equate Israeli and Palestinian perspectives are often criticized for reinforcing the status quo, dual-narrative tours appear to facilitate nuance and universalism while also shifting tourists toward greater identification with an oppressed population. Together, these findings shed light on the ability of tourism to facilitate positive attitude change about a previously stigmatized racial/ethnic group, as well as the power of contact and exposure to marginalized narratives to inspire peace and justice activism.

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A new endoscopic technique to decompress lumbar nerve roots affected by spondylolysis

Journal of Neurosurgery Spine ◽

10.3171/spi.2003.98.3.0290 ◽

2003 ◽

Vol 98 (3) ◽

pp. 290-293 ◽

Cited By ~ 8

Author(s):

Koichi Sairyo ◽

Shinsuke Katoh ◽

Tadanori Sakamaki ◽

Shinji Komatsubara ◽

Natsuo Yasui

Keyword(s):

Clinical Outcome ◽

Nerve Root ◽

Clinical Results ◽

Skin Incision ◽

Endoscopic Technique ◽

Spinal Instability ◽

Nerve Roots ◽

Content Type ◽

Proximal Stump

✓ The authors describe a new endoscopic technique to decompress lumbar nerve roots affected by spondylolysis. Short-term clinical outcome was evaluated. Surgery-related indications were: 1) radiculopathy without low-back pain; 2) no spinal instability demonstrated on dynamic radiographs; and 3) age older than 40 years. Seven patients, four men and three women, fulfilled these criteria and underwent endoscopic decompressive surgery. Their mean age was 60.9 years (range 42–70 years). No subluxation was present in four patients, whereas Meyerding Grade I slippage was demonstrated in three. For endoscopic decompression, a skin incision of 16 to 18 mm in length was made, and fenestration was performed to identify the affected nerve root. The proximal stump of the ragged edge of the spondylotic lesion, and the fibrocartilaginous mass compressing the nerve root were removed. The follow-up period ranged from 6 to 22 months (mean 11.7 months). Clinical outcome was evaluated using Gill criteria; in three patients the outcome was excellent, and in four it was good. This new endoscopic technique was useful in the decompression of nerve roots affected by spondylolysis, the technique was minimally invasive, and the clinical results were acceptable.

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Population Pharmacokinetics and Pharmacodynamics of Levofloxacin in Acutely Hospitalized Older Patients with Various Degrees of Renal Function

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.02134-16 ◽

2016 ◽

Vol 61 (3) ◽

Cited By ~ 4

Author(s):

Pier Giorgio Cojutti ◽

Virginia Ramos-Martin ◽

Isabella Schiavon ◽

Paolo Rossi ◽

Massimo Baraldo ◽

...

Keyword(s):

Renal Function ◽

Clinical Outcome ◽

Creatinine Clearance ◽

Population Pharmacokinetics ◽

Older Patients ◽

Classification And Regression Tree ◽

Therapeutic Drug ◽

Time Curve ◽

Content Type ◽

Cart Analysis

ABSTRACT A retrospective study was conducted in a large sample of acutely hospitalized older patients who underwent therapeutic drug monitoring during levofloxacin treatment. The aim was to assess the population pharmacokinetics (popPK) and pharmacodynamics of levofloxacin among older patients. PopPK and Monte Carlo simulation were performed to define the permissible doses in older patients according to various degrees of renal function. Classification and regression tree (CART) analysis was used to detect the cutoff 24-hour area under the concentration-time curve (AUC24)/MIC ratio that best correlated with the clinical outcome. The probability of target attainment (PTA) of this value was calculated against different pathogens. A total of 168 patients were included, and 330 trough and 239 peak concentrations were used for the popPK analysis. Creatinine clearance (CrCL) was the only covariate that improved the model fit (levofloxacin CL = 0.399 + 0.051 × CrCLCKD-EPI [creatinine clearance estimated by means of the chronic kidney disease epidemiology]). Drug doses ranged between 500 mg every 48 h and 500 mg every 12 h in relation to different renal functions. The identified cutoff AUC24/MIC ratio (≥95.7) was the only covariate that correlated with a favorable clinical outcome in multivariate regression analysis (odds ratio [OR], 20.85; 95% confidence interval [CI], 1.56 to 186.73). PTAs were optimal (>80%) against Escherichia coli and Haemophilus influenzae, borderline against Staphylococcus aureus, and suboptimal against Pseudomonas aeruginosa. The levofloxacin doses defined in our study may be effective for the treatment of infections due to bacterial pathogens, with an MIC of ≤0.5 mg/liter in older patients with various degrees of renal function, while minimizing the toxicity risk. Conversely, the addition of another active antimicrobial should be considered whenever treating infections caused by less susceptible pathogens.

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Safety of transforaminal lumbar interbody fusion and intervertebral recombinant human bone morphogenetic protein—2

Journal of Neurosurgery Spine ◽

10.3171/spi.2005.3.6.0436 ◽

2005 ◽

Vol 3 (6) ◽

pp. 436-443 ◽

Cited By ~ 137

Author(s):

Alan T. Villavicencio ◽

Sigita Burneikiene ◽

E. Lee Nelson ◽

Ketan R. Bulsara ◽

Mark Favors ◽

...

Keyword(s):

Clinical Outcome ◽

Minimally Invasive ◽

Interbody Fusion ◽

Transforaminal Lumbar Interbody Fusion ◽

Bone Morphogenetic Protein 2 ◽

Content Type ◽

Morphogenetic Protein ◽

Human Bone Morphogenetic Protein ◽

Recombinant Human Bone ◽

Fine Print

Object. Recombinant human bone morphogenetic protein—2 (rhBMP-2) is being increasingly used for spinal fusion. There are few data regarding its clinical safety, effectiveness, and clinical outcome when applied on an absorbable collagen sponge (ACS) in conjunction with allograft for transforaminal lumbar interbody fusion (TLIF). Methods. Seventy-four consecutive patients undergoing TLIF for degenerative disc disease were divided into five groups depending on whether the patient underwent a minimally invasive or open approach, as well as the number of spinal levels surgically treated. Surgery-related data, fusion results, complications, and clinical outcome were evaluated. The mean follow-up duration was 20.6 months (range 14–28 months). The radiographic fusion rate was 100% at 12 and 24 months after the surgery. No bone overgrowth or other complications related to BMP use were demonstrated. Conclusions. Analysis of the results demonstrated that TLIF combined with a BMP-2—soaked ACS is a feasible, effective, and safe method to promote lumbar fusion. There were no significant intergroup differences in clinical outcome between patients who underwent open compared with minimally invasive procedures. Patient satisfaction rates, however, were higher in the minimally invasive procedure group. The efficacy of BMP-2 was not dependent on which approach was used or the number of spinal levels that were treated.

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Deliberate basilar or vertebral artery occlusion in the treatment of intracranial aneurysms

Journal of Neurosurgery ◽

10.3171/jns.1993.79.2.0161 ◽

1993 ◽

Vol 79 (2) ◽

pp. 161-173 ◽

Cited By ~ 240

Author(s):

Gary K. Steinberg ◽

Charles G. Drake ◽

Sydney J. Peerless

Keyword(s):

Clinical Outcome ◽

Vertebral Artery ◽

Brain Stem ◽

Intracranial Aneurysms ◽

Artery Occlusion ◽

Neurological Deterioration ◽

Content Type ◽

Vertebrobasilar Junction ◽

Aneurysm Thrombosis ◽

Fine Print

✓ Deliberate occlusion of the basilar or vertebral arteries was performed in 201 patients with intracranial aneurysms, where the aneurysmal neck could not be clipped directly. The aneurysms arose from the basilar apex in 83 cases, the basilar trunk in 46, the vertebrobasilar junction in 35, and the vertebral artery in 37; 87% of the aneurysms were classified as giant lesions (> 2.5 cm). There were 85 upper basilar occlusions, 41 lower basilar occlusions, 29 bilateral vertebral occlusions, and 48 unilateral vertebral artery occlusions. The clinical follow-up period varied from 1 to 23 years, with a mean of 9.5 years. Overall long-term results were excellent in 68% of the patients, good in 5%, and poor in 3%; 24% died. Clinical outcome varied according to aneurysm site; excellent or good results were achieved in 64% of the patients with basilar apex, 76% with basilar trunk, 74% with vertebrobasilar junction, and 87% with vertebral artery aneurysms. Clinical outcome also varied depending on preoperative grade: 86% of the patients with an excellent presenting grade achieved excellent results. The size of the posterior communicating arteries was a good predictor of tolerance to basilar artery occlusion (p < 0.05). Successful aneurysm thrombosis was achieved in 78% of the patients. The neurological status in 26 patients (13%) deteriorated due to vertebrobasilar ischemia occurring within the 1st postoperative week, and thrombosis or embolism was implicated much more frequently than hemodynamic insufficiency. Subarachnoid hemorrhage (SAH) in 14 patients, vasospasm in five patients, and surgical trauma in seven patients accounted for additional morbidity in the 1st month following operation; however, many of these patients ultimately made an excellent recovery. Late vertebrobasilar ischemic complications or neurological deterioration from persistent mass effect occurred in 4% of patients with successful aneurysm thrombosis 6 weeks to 18 months after arterial ligation. Among the 43 patients with incompletely thrombosed aneurysms, 67% developed early or late neurological deterioration from SAH, progressive brain-stem compression, or brain-stem stroke, with 86% of the complications proving fatal.

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