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19600 Targeting the symbionts of Triatominae through paratransgenesis can be done .
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19601 A number of potential vaccines are currently being tested . Vaccination with Trypanosoma rangeli has produced positive results in animal models . More recently , the potential of DNA vaccines for immunotherapy of acute and chronic Chagas disease is being tested by several research groups .
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19602 Blood transfusion was formerly the second @-@ most common mode of transmission for Chagas disease , but the development and implementation of blood bank screening tests has dramatically reduced this risk in the 21st century . Blood donations in all endemic Latin American countries undergo Chagas screening , and ...
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19603 The US FDA has approved two Chagas tests , including one approved in April 2010 , and has published guidelines that recommend testing of all donated blood and tissue products . While these tests are not required in US , an estimated 75 – 90 % of the blood supply is currently tested for Chagas , including all uni...
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19604 = = Management = =
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19605 There are two approaches to treating Chagas disease : antiparasitic treatment , to kill the parasite ; and symptomatic treatment , to manage the symptoms and signs of the infection . Management uniquely involves addressing selective incremental failure of the parasympathetic nervous system . Autonomic disease im...
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19606 = = = Medication = = =
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19607 Antiparasitic treatment is most effective early in the course of infection , but is not limited to cases in the acute phase . Drugs of choice include azole or nitro derivatives , such as benznidazole or nifurtimox . Both agents are limited in their capacity to completely eliminate T. cruzi from the body ( parasi...
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19608 Studies suggest antiparasitic treatment leads to parasitological cure in more than 90 % of infants but only about 60 – 85 % of adults treated in the first year of acute phase Chagas disease . Children aged six to 12 years with chronic disease have a cure rate of about 60 % with benznidazole . While the rate of c...
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19609 Treatment of chronic infection in women prior to or during pregnancy does not appear to reduce the probability the disease will be passed on to the infant . Likewise , it is unclear whether prophylactic treatment of chronic infection is beneficial in persons who will undergo immunosuppression ( for example , org...
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19610 = = = Complications = = =
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19611 In the chronic stage , treatment involves managing the clinical manifestations of the disease . For example , pacemakers and medications for irregular heartbeats , such as the anti @-@ arrhythmia drug amiodarone , may be life saving for some patients with chronic cardiac disease , while surgery may be required f...
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19612 = = Epidemiology = =
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19613 Chagas disease affects 8 to 10 million people living in endemic Latin American countries , with an additional 300 @,@ 000 – 400 @,@ 000 living in nonendemic countries , including Spain and the United States . An estimated 41 @,@ 200 new cases occur annually in endemic countries , and 14 @,@ 400 infants are born ...
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19614 The disease is present in 18 countries on the American continents , ranging from the southern United States to northern Argentina . Chagas exists in two different ecological zones . In the Southern Cone region , the main vector lives in and around human homes . In Central America and Mexico , the main vector spe...
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19615 Although Triatominae bugs feed on them , birds appear to be immune to infection and therefore are not considered to be a T. cruzi reservoir . Even when colonies of insects are eradicated from a house and surrounding domestic animal shelters , they can re @-@ emerge from plants or animals that are part of the anc...
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19616 The primary wildlife reservoirs for Trypanosoma cruzi in the United States include opossums , raccoons , armadillos , squirrels , woodrats , and mice . Opossums are particularly important as reservoirs , because the parasite can complete its life cycle in the anal glands of this animal without having to re @-@ e...
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19617 Studies on raccoons in the Southeast have yielded infection rates ranging from 47 % to as low as 15 @.@ 5 % . Armadillo prevalence studies have been described in Louisiana , and range from a low of 1 @.@ 1 % to 28 @.@ 8 % . Additionally , small rodents , including squirrels , mice , and rats , are important in t...
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19618 Chronic Chagas disease remains a major health problem in many Latin American countries , despite the effectiveness of hygienic and preventive measures , such as eliminating the transmitting insects . However , several landmarks have been achieved in the fight against it in Latin America , including a reduction b...
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19619 Screening of donated blood , blood components , and solid organ donors , as well as donors of cells , tissues , and cell and tissue products for T. cruzi is mandated in all Chagas @-@ endemic countries and has been implemented . Approximately 300 @,@ 000 infected people live in the United States , which is likel...
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19620 = = History = =
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19621 The disease was named after the Brazilian physician and epidemiologist Carlos Chagas , who first described it in 1909 . The disease was not seen as a major public health problem in humans until the 1960s ( the outbreak of Chagas disease in Brazil in the 1920s went widely ignored ) . Dr Chagas discovered that the...
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19622 Chagas named the pathogenic parasite as Trypanosoma cruzi and later that year as Schizotrypanum cruzi , both honoring Oswaldo Cruz , the noted Brazilian physician and epidemiologist who successfully fought epidemics of yellow fever , smallpox , and bubonic plague in Rio de Janeiro and other cities in the beginni...
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19623 In Argentina , the disease is known as mal de Chagas @-@ Mazza , in honor of Salvador Mazza , the Argentine physician who in 1926 began investigating the disease and over the years became the principal researcher of this disease in the country . Mazza produced the first scientific confirmation of the existence o...
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19624 It has been hypothesized that Charles Darwin might have suffered from Chagas disease as a result of a bite of the so @-@ called great black bug of the Pampas ( vinchuca ) ( see Charles Darwin 's illness ) . The episode was reported by Darwin in his diaries of the Voyage of the Beagle as occurring in March 1835 t...
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19625 = = Research = =
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19626 Several experimental treatments have shown promise in animal models . These include inhibitors of oxidosqualene cyclase and squalene synthase , cysteine protease inhibitors , dermaseptins collected from frogs in the genus Phyllomedusa ( P. oreades and P. distincta ) , the sesquiterpene lactone dehydroleucodine (...
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19627 Chagas disease has a serious economic impact on the United States and the world . The cost of treatment in the United States alone , where the disease is not indigenous , is estimated to be $ 900 million annually , which includes hospitalization and medical devices such as pacemakers . The global cost is estimat...
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19628 Megazol in a study seems more active against Chagas than benznidazole but has not been studied in humans . Fexinidazole , an old drug rediscovered for this purpose is being tested in phase 2 clinical trials . A Chagas vaccine ( TcVac3 ) has been found to be effective in mice with plans for studies in dogs . It i...
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19629 = Diamond stingray =
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19630 The diamond stingray ( Dasyatis dipterura ) is a species of stingray in the family Dasyatidae . It is found in the coastal waters of the eastern Pacific Ocean from southern California to northern Chile , and around the Galápagos and Hawaiian Islands . This bottom @-@ dweller generally inhabits sandy or muddy fla...
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19631 When searching for food , diamond stingrays may form groups of up to hundreds of individuals . It is most active at night and preys mainly on burrowing invertebrates and small bony fishes , which are extracted from the bottom via suction or digging . This species is aplacental viviparous : once the embryos exhau...
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19632 = = Taxonomy and phylogeny = =
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19633 In 1880 , the diamond stingray was described twice by three American ichthyologists : as Dasybatus dipterurus by David Starr Jordan and Charles Henry Gilbert in Proceedings of the United States National Museum , and as Trygon brevis by Samuel Garman in Bulletin of the Museum of Comparative Zoology . Jordan and G...
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19634 The species syntypes were collected from San Diego Bay , California . The specific epithet dipterura is derived from the Latin di ( " two " ) , ptero ( " wing " ) , and ura ( " tail " ) , referring to the fin folds on both sides of its tail . Rat @-@ tailed stingray is a former common name for this species . Lis...
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19635 = = Distribution and habitat = =
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19636 The diamond stingray is found in the eastern Pacific Ocean from southern California to northern Chile , as well as around the Galápagos and Hawaiian Islands ; it is very abundant around Baja California and in the Gulf of California . At the northern and southern extremes of its range , it is generally only prese...
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19637 A bottom @-@ dwelling inhabitant of inshore waters , the diamond stingray favors sandy or muddy bottoms , often near rocky reefs or kelp forests . Off southern California , it usually occurs from the intertidal zone to a depth of 7 m ( 23 ft ) during the summer , shifting to depths of 13 – 18 m ( 43 – 59 ft ) du...
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19638 = = Description = =
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19639 The diamond stingray attains a disc width of 1 m ( 3 @.@ 3 ft ) or possibly 1 @.@ 2 m ( 3 @.@ 9 ft ) ; females grow larger than males . Its pectoral fin disc is rhomboid in shape , slightly wider than long , with angular outer corners and subtly convex margins . The snout is blunt @-@ angled and non @-@ projecti...
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19640 The whip @-@ like tail generally measures up to one and half times the length of the disc , and bears one ( more if replacements have grown in ) long , slender , serrated spine on the upper surface , closer to the base than the tip . Behind the spine , there are long dorsal and ventral fin folds that rise gradua...
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19641 = = Biology and ecology = =
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19642 The diamond stingray is most active at night , spending much of the day buried in sand with only its eyes protruding . When foraging for food , it may be solitary but more commonly forms groups numbering up to the hundreds . There is strong segregation by sex and age . This species feeds on crustaceans , mollusc...
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19643 The typical hunting strategy of the diamond stingray is to cruise just above the sea floor , landing atop any prey encountered . It then quickly levers its body up @-@ and @-@ down with its disc , producing negative pressure to extract the prey from its burrow . This ray has also been known to excavate large pit...
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19644 Like other stingrays , the diamond stingray is aplacental viviparous : the embryos are initially nourished by yolk , and later by histotroph ( " uterine milk " , rich in proteins and lipids ) produced by the mother . Only the left ovary and uterus are functional in adult females . Several bays along the Pacific ...
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19645 = = Human interactions = =
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19646 At least one fatality off southern California has resulted from the long , venomous tail spine of the diamond stingray . However , it is not aggressive and will usually flee given the opportunity . This ray is not found off the United States in sufficient numbers to be economically important . Elsewhere in its r...
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19647 In Mexico , the diamond stingray is one of the most important components of Pacific artisanal shark and ray fisheries , comprising around a tenth of the total annual catch . Its significance is likely underestimated , as Mexican fishery reports frequently suffer from misidentifications and a lack of species @-@ ...
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19648 = George Calvert , 1st Baron Baltimore =
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19649 George Calvert , 1st Baron Baltimore ( 1579 – 15 April 1632 ) was an English politician and colonizer . He achieved domestic political success as a Member of Parliament and later Secretary of State under King James I. He lost much of his political power after his support for a failed marriage alliance between Pr...