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Pesquisa : B03.353.688 [Categoria DeCS]
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[PMID]:28976997
[Au] Autor:Kang C; Zhang Q; Zhu W; Cai C; Sun X; Jin M
[Ad] Endereço:Unit of Animal Infectious Diseases, State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, Hubei, P.R. China.
[Ti] Título:Transcription analysis of the responses of porcine heart to Erysipelothrix rhusiopathiae.
[So] Source:PLoS One;12(10):e0185548, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Erysipelothrix rhusiopathiae (E. rhusiopathiae) is the causative agent of swine erysipelas. This microbe has caused great economic losses in China and in other countries. In this study, high-throughput cDNA microarray assays were employed to evaluate the host responses of porcine heart to E. rhusiopathiae and to gain additional insights into its pathogenesis. A total of 394 DE transcripts were detected in the active virulent E. rhusiopathiae infection group compared with the PBS group at 4 days post-infection. Moreover, 262 transcripts were upregulated and 132 transcripts were downregulated. Differentially expressed genes were involved in many vital functional classes, including inflammatory and immune responses, signal transduction, apoptosis, transport, protein phosphorylation and dephosphorylation, metabolic processes, chemotaxis, cell adhesion, and innate immune responses. Pathway analysis demonstrated that the most significant pathways were Chemokine signaling pathway, NF-kappa B signaling pathway, TLR pathway, CAMs, systemic lupus erythematosus, chemokine signaling pathway, Cytokine-cytokine receptor interaction, PI3K-Akt signaling pathway, Phagosome, HTLV-I infection, Measles, Rheumatoid arthritis and natural-killer-cell-mediated cytotoxicity. The reliability of our microarray data was verified by performing quantitative real-time PCR. This study is the first to document the response of piglet heart to E. rhusiopathiae infection. The observed gene expression profile could help screen potential host agents that can reduce the prevalence of E. rhusiopathiae. The profile might also provide insights into the underlying pathological changes that occur in pigs infected with E. rhusiopathiae.
[Mh] Termos MeSH primário: Erysipelothrix/isolamento & purificação
Coração/fisiologia
Miocárdio/metabolismo
Transcrição Genética
[Mh] Termos MeSH secundário: Animais
Erysipelothrix/patogenicidade
Coração/microbiologia
NF-kappa B/metabolismo
Análise de Sequência com Séries de Oligonucleotídeos
Fosforilação
Suínos
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (NF-kappa B)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171005
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185548


  2 / 724 MEDLINE  
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[PMID]:28720292
[Au] Autor:McNeil M; Gerber PF; Thomson J; Williamson S; Opriessnig T
[Ad] Endereço:The Roslin Institute and The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, Scotland, United Kingdom.
[Ti] Título:Serotypes and Spa types of Erysipelothrix rhusiopathiae isolates from British pigs (1987 to 2015).
[So] Source:Vet J;225:13-15, 2017 Jul.
[Is] ISSN:1532-2971
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Erysipelothrix spp. cause a range of clinical signs in pigs and at least 28 different Erysipelothrix spp. serotypes have been identified. In this study, 128 isolates of Erysipelothrix spp. from pigs in Great Britain from 1987 to 2015 were characterised by serotyping and multiplex real time PCR assays targeting the surface protective antigen (Spa) and the main genotypes (Erysipelothrix rhusiopathiae, Erysipelothrix tonsillarum and Erysipelothrix spp. strain 2). All 128 British isolates were characterised as E. rhusiopathiae and were classified as serotypes 1a (n=21), 1b (n=17), 2 (n=75), 5 (n=2), 9 (n=2), 10 (n=2), 11 (n=4) and 15 (n=1), while four isolates were untypeable. All isolates were positive for the spa A gene. Serotypes 1a, 1b and 2 constituted 88.3% of the isolates; current serotype 2 based vaccines should protect against these isolates.
[Mh] Termos MeSH primário: Infecções por Erysipelothrix/microbiologia
Erysipelothrix/classificação
Sorogrupo
Doenças dos Suínos/microbiologia
[Mh] Termos MeSH secundário: Animais
Antígenos de Bactérias/imunologia
Vacinas Bacterianas/uso terapêutico
Erysipelothrix/genética
Erysipelothrix/imunologia
Infecções por Erysipelothrix/prevenção & controle
Genótipo
Reação em Cadeia da Polimerase em Tempo Real/veterinária
Sorotipagem/veterinária
Sus scrofa/microbiologia
Suínos
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antigens, Bacterial); 0 (Bacterial Vaccines)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170720
[St] Status:MEDLINE


  3 / 724 MEDLINE  
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[PMID]:28355191
[Au] Autor:Dolgin E
[Ti] Título:Climate change: As the ice melts.
[So] Source:Nature;543(7647):S54-S55, 2017 03 29.
[Is] ISSN:1476-4687
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Animais Selvagens
Beluga/parasitologia
Borrelia burgdorferi/isolamento & purificação
Erysipelothrix/isolamento & purificação
Aquecimento Global/estatística & dados numéricos
Toxoplasma/isolamento & purificação
Zoonoses/epidemiologia
[Mh] Termos MeSH secundário: Animais
Animais Selvagens/microbiologia
Animais Selvagens/parasitologia
Animais Selvagens/virologia
Regiões Árticas/epidemiologia
Canadá/epidemiologia
Dieta
Encefalite Transmitida por Carrapatos/epidemiologia
Encefalite Transmitida por Carrapatos/virologia
Seres Humanos
Camada de Gelo
Incidência
Índios Norte-Americanos
Doença de Lyme/epidemiologia
Doença de Lyme/microbiologia
Saúde Pública/métodos
Saúde Pública/tendências
Sibéria/epidemiologia
Toxoplasma/genética
Toxoplasmose/epidemiologia
Toxoplasmose/parasitologia
Toxoplasmose/prevenção & controle
Incerteza
Zoonoses/parasitologia
Zoonoses/prevenção & controle
Zoonoses/transmissão
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170808
[Lr] Data última revisão:
170808
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170330
[St] Status:MEDLINE
[do] DOI:10.1038/543S54a


  4 / 724 MEDLINE  
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[PMID]:28327178
[Au] Autor:Zhu W; Zhang Q; Li J; Wei Y; Cai C; Liu L; Xu Z; Jin M
[Ad] Endereço:Animal Infectious Disease Unit, National State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, China.
[Ti] Título:Glyceraldehyde-3-phosphate dehydrogenase acts as an adhesin in Erysipelothrix rhusiopathiae adhesion to porcine endothelial cells and as a receptor in recruitment of host fibronectin and plasminogen.
[So] Source:Vet Res;48(1):16, 2017 Mar 21.
[Is] ISSN:1297-9716
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Erysipelothrix rhusiopathiae is the causative agent of animal erysipelas and human erysipeloid. Previous studies suggested glyceraldehyde 3-phosphate dehydrogenase (GAPDH) plays a role in the pathogenesis of E. rhusiopathiae infection. We studied E. rhusiopathiae GAPDH interactions with pig vascular endothelial cells, fibronectin, and plasminogen. Recombinant GAPDH (rGAPDH) was successfully obtained, and it was shown that it plays a role in E. rhusiopathiae adhesion to pig vascular endothelial cells. Moreover, rGAPDH could bind fibronectin and plasminogen in a dose-dependent manner. To our knowledge, this is the first study demonstrating that a moonlighting protein plays a role in pathogenesis of E. rhusiopathiae infections.
[Mh] Termos MeSH primário: Aderência Bacteriana
Células Endoteliais/microbiologia
Infecções por Erysipelothrix/microbiologia
Erysipelothrix
Fibronectinas/metabolismo
Gliceraldeído-3-Fosfato Desidrogenases/metabolismo
Plasminogênio/metabolismo
Doenças dos Suínos/microbiologia
[Mh] Termos MeSH secundário: Animais
Citometria de Fluxo/veterinária
Suínos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fibronectins); 9001-91-6 (Plasminogen); EC 1.2.1.- (Glyceraldehyde-3-Phosphate Dehydrogenases)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE
[do] DOI:10.1186/s13567-017-0421-x


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[PMID]:28250289
[Au] Autor:Shiraiwa K; Ogawa Y; Nishikawa S; Kusumoto M; Eguchi M; Shimoji Y
[Ad] Endereço:National Institute of Animal Health, National Agriculture and Food Research Organization, 3-1-5 Kannondai, Tsukuba, Ibaraki 305-0856, Japan.
[Ti] Título:Single nucleotide polymorphism genotyping of Erysipelothrix rhusiopathiae isolates from pigs affected with chronic erysipelas in Japan.
[So] Source:J Vet Med Sci;79(4):699-701, 2017 Apr 05.
[Is] ISSN:1347-7439
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:Over the past decades, Erysipelothrix rhusiopathiae strains displaying similar phenotypic and genetic profiles of the attenuated, acriflavine-resistant E. rhusiopathiae Koganei 65-0.15 strain (serovar 1a) have been frequently isolated from pigs affected with chronic erysipelas in Japan. In this study, using the conventional PCR assay that was designed to detect strain-specific single nucleotide polymorphism (SNP) sites found in the genome of the vaccine strain, we analyzed E. rhusiopathiae isolates from pigs with chronic disease in farms where the Koganei vaccine was used. Out of a total of 155 isolates, 101 isolates (65.2%) were determined to be the vaccine strain by SNP-based PCR. Among the 101 PCR-positive isolates, four isolates were found to be sensitive to acriflavine.
[Mh] Termos MeSH primário: Vacinas Bacterianas/genética
Erisipela/veterinária
Erysipelothrix/genética
Polimorfismo de Nucleotídeo Único
Doenças dos Suínos/microbiologia
[Mh] Termos MeSH secundário: Animais
Doença Crônica
Erisipela/epidemiologia
Erisipela/microbiologia
Genótipo
Japão/epidemiologia
Reação em Cadeia da Polimerase/métodos
Reação em Cadeia da Polimerase/veterinária
Suínos
Doenças dos Suínos/epidemiologia
Vacinas Atenuadas/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bacterial Vaccines); 0 (Vaccines, Attenuated)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE
[do] DOI:10.1292/jvms.17-0040


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[PMID]:28206705
[Au] Autor:Tan EM; Marcelin JR; Adeel N; Lewis RJ; Enzler MJ; Tosh PK
[Ad] Endereço:Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA.
[Ti] Título:Erysipelothrix rhusiopathiae bloodstream infection - A 22-year experience at Mayo Clinic, Minnesota.
[So] Source:Zoonoses Public Health;64(7):e65-e72, 2017 Nov.
[Is] ISSN:1863-2378
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Erysipelothrix rhusiopathiae is a facultatively anaerobic Gram-positive bacillus found mostly in swine, fish and sheep. E. rhusiopathiae classically causes cutaneous eruptions in butchers, fish handlers and veterinarians. Based solely on case reports, 90% of E. rhusiopathiae bloodstream infections (BSI) have been associated with infective endocarditis (IE). To assess the true frequency of IE in E. rhusiopathiae BSI as well as other clinical associations, we performed a retrospective cohort analysis of E. rhusiopathiae BSI at Mayo Clinic. This is a single-centre, retrospective study conducted between 1/1/1994 and 20/6/2016 at Mayo Clinic in Rochester, MN. Medical records were reviewed for demographics, E. rhusiopathiae BSI, anti-microbial susceptibilities, incidence of IE, patient comorbidities, intensive care unit (ICU) admission and duration of antibiotics. Five cases of E. rhusiopathiae BSI were identified. Risk factors included animal exposures, immunosuppression, diabetes and kidney disease. All cases involved penicillin-sensitive strains and high-grade BSI. Four cases showed no signs of IE on transesophageal echocardiogram. All patients recovered fully with intravenous antibiotics. Our retrospective review illustrates that E. rhusiopathiae can cause invasive BSI in the absence of IE and that the previously reported 90% association between BSI and IE may be overestimated due to reporting bias. E. rhusiopathiae should be suspected in any patient with Gram-positive bacilli in blood cultures and the aforementioned risk factors. A limitation of our study was the low sample size, and future studies may involve multicentre collaborations and the use of polymerase chain reaction (PCR) or serologic testing to increase the number of diagnoses..
[Mh] Termos MeSH primário: Bacteriemia/microbiologia
Infecções por Erysipelothrix/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Animais
Bacteriemia/epidemiologia
Erysipelothrix
Feminino
Seres Humanos
Masculino
Meia-Idade
Minnesota
Estudos Retrospectivos
Zoonoses
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170217
[St] Status:MEDLINE
[do] DOI:10.1111/zph.12348


  7 / 724 MEDLINE  
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[PMID]:28110776
[Au] Autor:Zhu W; Wu C; Kang C; Cai C; Jin M
[Ad] Endereço:Animal Infectious Disease Unit, National State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, China; College of Animal Science and Veterinary Medicine, Huazhong Agricultural University, Wuhan, China.
[Ti] Título:Development of a duplex PCR for rapid detection and differentiation of Erysipelothrix rhusiopathiae vaccine strains and wild type strains.
[So] Source:Vet Microbiol;199:108-110, 2017 Feb.
[Is] ISSN:1873-2542
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:The differentiation of vaccine strains from wild type strains is important for disease control. A duplex PCR for rapid detection and differentiation of Erysipelothrix rhusiopathiae vaccine strains and wild type strains was developed based on the DNA polymerase IV gene. This duplex PCR was sensitive and specific. The detection results were coincident with that of a single nucleotide polymorphisms based PCR but the detection process was more rapid. In conclusion, this duplex PCR was a useful tool for Erysipelothrix rhusiopathiae infections' differential diagnosis in China.
[Mh] Termos MeSH primário: Infecções por Erysipelothrix/microbiologia
Erysipelothrix/classificação
Erysipelothrix/genética
Tipagem Molecular/veterinária
Reação em Cadeia da Polimerase/veterinária
[Mh] Termos MeSH secundário: Vacinas Bacterianas/microbiologia
China
DNA Polimerase beta/genética
DNA Bacteriano/genética
Infecções por Erysipelothrix/diagnóstico
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bacterial Vaccines); 0 (DNA, Bacterial); EC 2.7.7.- (DNA Polymerase beta)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170227
[Lr] Data última revisão:
170227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170124
[St] Status:MEDLINE


  8 / 724 MEDLINE  
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[PMID]:28056818
[Au] Autor:Hofseth K; Dalen H; Kibsgaard L; Nebb S; Kümmel A; Mehl A
[Ad] Endereço:Department of Orthopedic Surgery, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
[Ti] Título:Infectious tenosynovitis with bloodstream infection caused by Erysipelothrix rhusiopathiae, a case report on an occupational pathogen.
[So] Source:BMC Infect Dis;17(1):12, 2017 Jan 05.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Erysipelothrix rhusiopathiae is an established animal pathogen, which may cause infections in humans. It is a gram-positive rod and found in the tonsils or the digestive tracts of animals. The bacterium is occupationally related, as usually only people with frequent animal contacts are infected. We report a case of a patient who was admitted with an infectious tenosynovitis with bloodstream infection due to E. rhusiopathiae, and to our knowledge, this is the first report of a tenosynovitis with systemic manifestation associated with this bacterium. CASE PRESENTATION: A 52-year old Norwegian man, who worked with transportation of swine cadavers, was admitted to the local hospital with sepsis and unknown focus of infection. A few days earlier he had an injury to the skin of one of his fingers that later proved to be infected with E. rhusiopathiae. There were no other causes for his symptoms than the infectious tenosynovitis with systemic manifestation. The infection resolved on treatment with antibiotics and surgery. A transoesophageal echocardiogram was performed to exclude endocarditis, which may be associated with this pathogen. CONCLUSIONS: This case report highlights the importance of clinicians being aware of this bacterium, and we describe risk factors for infection, differences in the clinical manifestations of the disease, challenges with diagnosing the bacterium and adverse effects of immunosuppressive drugs. Recommended treatment is appropriate antibiotic therapy and adequate debridement and surgical drainage of the tendon sheath.
[Mh] Termos MeSH primário: Bacteriemia/microbiologia
Infecções por Erysipelothrix/diagnóstico
Erysipelothrix/isolamento & purificação
Doenças Profissionais/diagnóstico
Tenossinovite/microbiologia
[Mh] Termos MeSH secundário: Animais
Antibacterianos/uso terapêutico
Endocardite/tratamento farmacológico
Endocardite/microbiologia
Infecções por Erysipelothrix/sangue
Seres Humanos
Masculino
Meia-Idade
Doenças Profissionais/microbiologia
Fatores de Risco
Suínos
Doenças dos Suínos/microbiologia
Tenossinovite/sangue
Zoonoses/diagnóstico
Zoonoses/microbiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170705
[Lr] Data última revisão:
170705
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170107
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-016-2102-1


  9 / 724 MEDLINE  
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[PMID]:27821381
[Au] Autor:Capucchio MT; Lanteri G; Marino F; Biasibetti E; Reale S; Guarda F; Macrì B
[Ad] Endereço:Department of Veterinary Sciences, University of Turin, Grugliasco, Italy.
[Ti] Título:Myocardial infarctions due to Erysipelotrix rhusiopathiae infection in an adult sheep.
[So] Source:Schweiz Arch Tierheilkd;158(11):765-767, 2016 Nov.
[Is] ISSN:0036-7281
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Mh] Termos MeSH primário: Infecções por Erysipelothrix/fisiopatologia
Erysipelothrix/isolamento & purificação
Infarto do Miocárdio/veterinária
Doenças dos Ovinos/microbiologia
Doenças dos Ovinos/fisiopatologia
[Mh] Termos MeSH secundário: Animais
Infecções por Erysipelothrix/microbiologia
Feminino
Infarto do Miocárdio/etiologia
Infarto do Miocárdio/microbiologia
Ovinos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170214
[Lr] Data última revisão:
170214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161109
[St] Status:MEDLINE


  10 / 724 MEDLINE  
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[PMID]:27786163
[Au] Autor:Nollens HH; Giménez-Lirola LG; Robeck TR; Schmitt TL; DiRocco S; Opriessnig T
[Ad] Endereço:Veterinary Services Department, SeaWorld of San Diego, 500 SeaWorld Drive, San Diego, CA 92109, USA.
[Ti] Título:Evaluation of anti-Erysipelothrix rhusiopathiae IgG response in bottlenose dolphins Tursiops truncatus to a commercial pig vaccine.
[So] Source:Dis Aquat Organ;121(3):249-256, 2016 10 27.
[Is] ISSN:0177-5103
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Erysipelothrix rhusiopathiae is the causative agent of erysipeloid in humans and of erysipelas in various animals, including bottlenose dolphins Tursiops truncatus, in which an infection has the potential to cause peracute septicemia and death. The purpose of this study was to evaluate the efficacy of using an off-label porcine (ER BAC PLUS®, Zoetis) E. rhusiopathiae bactrin in a bottlenose dolphin vaccination program by determining the anti-E. rhusiopathiae antibody levels in vaccinated dolphins over a 10 yr period. Serum samples (n = 88) were analyzed using a modified fluorescent microbead immunoassay from 54 dolphins, including 3 individuals with no history of vaccination and 51 dolphins with an average of 5 vaccinations, 3 of which had previously recovered from a natural E. rhusiopathiae infection. A mean 311-fold increase in the immunoglobulin G (IgG) antibody index was measured in a subsample of 10 dolphins 14 d after the first booster vaccination. Serum IgG antibody titers were influenced by number of vaccines received (r2 = 0.47, p < 0.05) but not by age, gender, history of natural infection, adverse vaccine reaction, vaccination interval or time since last vaccination. The commercial pig bacterin was deemed effective in generating humoral immunity against E. rhusiopathiae in dolphins. However, since the probability of an adverse reaction toward the vaccine was moderately correlated (p = 0.07, r2 = 0.1) with number of vaccines administered, more research is needed to determine the optimal vaccination interval.
[Mh] Termos MeSH primário: Anticorpos Antibacterianos/sangue
Vacinas Bacterianas/imunologia
Golfinho Nariz-de-Garrafa
Infecções por Erysipelothrix/prevenção & controle
Erysipelothrix/imunologia
Imunoglobulina G/sangue
[Mh] Termos MeSH secundário: Animais
Infecções por Erysipelothrix/sangue
Infecções por Erysipelothrix/microbiologia
Feminino
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antibodies, Bacterial); 0 (Bacterial Vaccines); 0 (Immunoglobulin G)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170622
[Lr] Data última revisão:
170622
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161028
[St] Status:MEDLINE



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