Lyme disease: modern approaches to treatment and prevention (based on international recommendations of 2020)

Lyme disease (LD) or tick-borne borreliosis affects thousands of people every year in different regions of the world, primarily in the United States and Europe. Given the great social and medical importance of this problem, an updated version of the clinical guidelines for the prevention, diagnosis and treatment of PD was published in November 2020 by a committee of experts of the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN) and the American College of Rheumatology (ACR). This article discusses the main issues of the use of antibacterial drugs in LD. The most commonly used medications are doxycycline, amoxicillin, cefuroxime axetil, and ceftriaxone. Patients with erythema migrans receive appropriate antibiotics for 7–14 days, depending on the medication used. In case of other clinical manifestations of LD, the duration of treatment is extended to 14–28 days. Antibiotic prophylaxis is carried out using a single oral dose of 200 mg doxycycline for adults and 4.4 mg/kg (with a maximum of 200 mg) for children. This treatment scheme is highly efficient, easy to administer, and has a relatively low risk of adverse events.

Snake Venom Proteomics of Samar Cobra (Naja samarensis) from the Southern Philippines: Short Alpha-Neurotoxins as the Dominant Lethal Component Weakly Cross-Neutralized by the Philippine Cobra Antivenom

The Samar Cobra, Naja samarensis, is endemic to the southern Philippines and is a WHO-listed Category 1 venomous snake species of medical importance. Envenomation caused by N. samarensis results in neurotoxicity, while there is no species-specific antivenom available for its treatment. The composition and neutralization of N. samarensis venom remain largely unknown to date. This study thus aimed to investigate the venom proteome of N. samarensis for a comprehensive profiling of the venom composition, and to examine the immunorecognition as well as neutralization of its toxins by a hetero-specific antivenom. Applying C18 reverse-phase high-performance liquid chromatography (RP-HPLC) and tandem mass spectrometry (LC-MS/MS), three-finger toxins (3FTx) were shown to dominate the venom proteome by 90.48% of total venom proteins. Other proteins in the venom comprised snake venom metalloproteinases, phospholipases A2, cysteine-rich secretory proteins, venom nerve growth factors, L-amino acid oxidases and vespryn, which were present at much lower abundances. Among all, short-chain alpha-neurotoxins (SαNTX) were the most highly expressed toxin within 3FTx family, constituting 65.87% of the total venom proteins. The SαNTX is the sole neurotoxic component of the venom and has an intravenous median lethal dose (LD50) of 0.18 μg/g in mice. The high abundance and low LD50 support the potent lethal activity of N. samarensis venom. The hetero-specific antivenom, Philippine Cobra Antivenom (PCAV, raised against Naja philippinensis) were immunoreactive toward the venom and its protein fractions, including the principal SαNTX. In efficacy study, PCAV was able to cross-neutralize the lethality of SαNTX albeit the effect was weak with a low potency of 0.20 mg/ml (defined as the amount of toxin completely neutralized per milliliter of the antivenom). With a volume of 5 ml, each vial of PCAV may cross-neutralize approximately 1 mg of the toxin in vivo. The findings support the potential para-specific use of PCAV in treating envenomation caused by N. samarensis while underscoring the need to improve the potency of its neutralization activity, especially against the highly lethal alpha-neurotoxins.

Bitis arietans Snake Venom and Kn-Ba, a Snake Venom Serine Protease, Induce the Production of Inflammatory Mediators in THP-1 Macrophages

Bitis arietans is a snake of medical importance found throughout sub-Saharan Africa and in savannas and pastures of Morocco and western Arabia. The effects of its venom are characterized by local and systemic alterations, such as inflammation and cardiovascular and hemostatic disturbances, which can lead to victims’ death or permanent disability. To better characterize the inflammatory process induced by this snake’s venom, the participation of eicosanoids and PAF (platelet- activating factor) in this response were demonstrated in a previous study. In addition, edema and early increased vascular permeability followed by an accumulation of polymorphonuclear (PMN) cells in the peritoneal cavity were accompanied by the production of the eicosanoids LTB4, LTC4, TXB2, and PGE2, and local and systemic production of IL-6 and MCP-1. In this context, the present study focused on the identification of inflammatory mediators produced by human macrophages derived from THP-1 cells in response to Bitis arietans venom (BaV), and Kn-Ba, a serine protease purified from this venom. Here, we show that Kn-Ba, and even the less intensive BaV, induced the production of the cytokine TNF and the chemokines RANTES and IL-8. Only Kn-Ba was able to induce the production of IL-6, MCP-1, and IP-10, whereas PGE2 was produced only in response to BaV. Finally, the release of IL-1β in culture supernatants suggests the activation of the inflammasomes by the venom of Bitis arietans and by Kn-Ba, which will be investigated in more detail in future studies.

Sealworm Nematode Pseudoterranova decipiens (Krabbe, 1878) Gibson, 1983 (Nematoda: Rhabditida: Anisakidae)

Contents: Introduction – Synonymy – Distribution – Description – Life Cycle and Biology – Hosts – Medical Importance – Economic Importance – Management – Selected References. Also published on the Featured Creatures website at http://entnemdept.ufl.edu/Creatures/NEMATODE/Pseudoterranova_decipiens_sealworm_nematode.htm

A systematic approach to the disclosure of genomic findings in clinical practice and research: a proposed framework with colored matrix and decision-making pathways

Background Whether and how to disclose genomic findings obtained in the course of genomic clinical practice and medical research has been a controversial global bioethical issue over the past two decades. Although several recommendations and judgment tools for the disclosure of genomic findings have been proposed, none are sufficiently systematic or inclusive or even consistent with each other. In order to approach the disclosure/non-disclosure practice in an ethical manner, optimal and easy-to-use tools for supporting the judgment of physicians/researchers in genomic medicine are necessary. Methods The bioethics literature on this topic was analyzed to parse and deconstruct the somewhat overlapping and therefore ill-defined key concepts of genomic findings, such as incidental, primary, secondary, and other findings. Based on the deconstruction and conceptual analyses of these findings, we then defined key parameters from which to identify the strength of duty to disclose (SDD) for a genomic finding. These analyses were then applied to develop a framework with the SDD matrix and systematic decision-making pathways for the disclosure of genomic findings. Results The following six major parameters (axes), along with sub-axes, were identified: Axis 1 (settings and institutions where findings emerge); Axis 2 (presence or absence of intention and anticipatability in discovery); Axis 3 (maximal actionability at the time of discovery); Axis 4 (net medical importance); Axis 5 (expertise of treating physician/researcher); and Axis 6 (preferences of individual patients/research subjects for disclosure). For Axes 1 to 4, a colored SDD matrix for genomic findings was developed in which levels of obligation for disclosing a finding can be categorized. For Axes 5 and 6, systematic decision-making pathways were developed via the SDD matrix. Conclusion We analyzed the SDD of genomic findings and developed subsequent systematic decision-making pathways of whether and how to disclose genomic findings to patients/research subjects and their relatives in an ethical manner. Our comprehensive framework may help physicians and researchers in genomic medicine make consistent ethical judgments regarding the disclosure of genomic findings.

Report of erucism caused by Automeris egeus Cramer (Lepidoptera: Saturniidae) and a brief update on caterpillar envenomation in Brazil

We report a case of erucism provoked by the Automeris egeus Cramer caterpillar and update the distribution of caterpillar poisoning in Brazil, showing the regions with the highest incidence rates. We also correlated the incidence rate with anthropic impact rates in all Brazilian municipalities, taking as a reference the Human Footprint Index. The victim presented erucism, burning pain, itching, and local hyperthermia. The highest incidence rates were in southern Brazil. We suggest including A. egeus in the Brazilian list of animals with medical importance, and that Brazilian Ministry of Health indicates the genus of the animals involved in envenomation events on its platform.

NEW RECORD OF LIPOPTENA MAZAMAE (RONDANI, 1878) AS A MAZAMA GOUAZOUBIRA (FISCHER, 1814) PARASITE IN SOUTHERN BRAZIL

Louse flies (Lipoptena mazamae) are important Gray brocket deer (Mazama gouazoubira) parasites, and can be found in large numbers in this mammal. Their distribution is known for just a few locations, and because of this, it is so important to report new records of this association. To contribute with knowledge concerning this parasitism relationship, a record of this fly species parasitizing a deer individual in southern Brazil is reported herein. Such records are paramount, as L. mazamae displays both zoonotic and medical importance, due to the potential propagation of etiological agents that cause diseases. Moreover, as far as we know, this study is only the fifth study that reports this association worldwide, indicating its relevance. It is very important to perform studies as these, because we may contribute to new records of this association of parasitism, therefore, we contribute to alert authorities to the possible association of these parasites with diseases that may pose problems for human and other animal health. Moscas da família Hipoboscidae (Lipoptena mazamae) são parasitos muito importantes do veado-catingueiro (Mazama gouazoubira), podendo ser encontrados em uma considerável abundância nesse mamífero. Sua distribuição é conhecida em apenas alguns locais, e, por causa disso, é muito importante reportar novos registros dessa associação de parasitismo. Para contribuir com o conhecimento dessa associação, é reportado aqui um novo registro dessa mosca parasitando um indivíduo de veado-catingueiro. Esses registros se destacam, pois L. mazamae possui importância médica e veterinária, devido ao seu potencial de veicular agentes etiológicos causadores de doenças. Além disso, depois de nossas pesquisas, concluímos que este é apenas o quinto estudo reportando essa associação no mundo, indicando, portanto, sua relevância. Estudos como este são relevantes, pois contribuem com novos registros dessa associação de parasitismo, e, portanto, pode-se também servir como alerta às autoridades para a possível associação desses parasitos com doenças que podem causar danos à saúde humana e de outros animais.

NUTRITIONAL AND BIOACTIVE ANALYSIS OF EXTRACTED SOYBEAN AND FISH OIL

Extensive literature abounds that applauds the importance of fish and soybean oils to human functioning. Evidence suggests that fish and soybean oil constitute a significant public and medical importance to human existence. Numerous authors have emphasized the health benefits of oils. The current research aimed to produce and analyze the nutritional and bioactive constituents of fish and soybean oil widely used in Nigeria. The samples were extracted from fish and soybean seeds using the standard procedures described in the literature. Thirty liters of the oils were removed from the samples, respectively. The nutritional contents and other properties were determined. The study provided insight into the nutritional composition of fish oil and soybean oil. The findings and recommendations are discussed.

Xenomonitoring of trypanosome infectivity in Tse tse flies from Kagarko Local Government Area, Kaduna State Nigeria

Trypanosomiasis is a re-emerging neglected tropical disease, afflicting domestic, wild animals and humans. In this study, the tsetse fly infectivity and species composition of Trypanosoma species were determined in Kagarko Local Government Area, Kaduna State Nigeria using entomological protocol. The tsetse flies were sampled using standard biconical traps and the flies collected were dissected for trypanosome using microscopy as well as expression of tsetse antigen 5 (TAg 5) using molecular tools. Forty seven (47) tsetse flies were collected over a period of four months, of which 13 (34.21%) were infected with Trypanosoma spp. The species of trypanosome identified include T. vivax 7(53.85%), T. congolense 5(38.46%) and T. brucei 1(7.69%), while expression of TAg 5 was observed in four of the examined flies. The presence of the flies with trypanosome of veterinary and medical importance demonstrate the risk of transmission of trypanosomiasis in the study area.