Downsized: gray whales using an alternative foraging ground have smaller morphology

Describing individual morphology and growth is key for identifying ecological niches and monitoring the health and fitness of populations. Eastern North Pacific ((ENP), approximately 16 650 individuals) gray whales primarily feed in the Arctic/sub-Arctic regions, while a small subgroup called the Pacific Coast Feeding Group (PCFG, approximately 212 individuals) instead feeds between northern California, USA and British Columbia, Canada. Evidence suggests PCFG whales have lower body condition than ENP whales. Here we investigate morphological differences (length, skull, and fluke span) and compare length-at-age growth curves between ENP and PCFG whales. We use ENP gray whale length-at-age data comprised of strandings, whaling, and aerial photogrammetry (1926-1997) for comparison to data from PCFG whales collected through non-invasive techniques (2016-2022) to estimate age (photo identification) and length (drone-based photogrammetry). We use Bayesian methods to incorporate uncertainty associated with morphological measurements (manual and photogrammetric) and age estimates. We find that while PCFG and ENP whales have similar growth rates, PCFG whales reach smaller asymptotic lengths. Additionally, PCFG whales have relatively smaller skulls and flukes than ENP whales. These findings represent a striking example of morphological adaptation that may facilitate PCFG whales accessing a foraging niche distinct from the Arctic foraging grounds of the broader ENP population.

Molecular characterization of thioester-containing proteins in Biomphalaria glabrata and their differential gene expression upon Schistosoma mansoni exposure

Schistosomiasis is a disease caused by trematode parasites of the genus Schistosoma that affects approximately 200 million people worldwide. Schistosomiasis has been a persistent problem in endemic areas as there is no vaccine available, currently used anti-helmintic medications do not prevent reinfection, and most concerning, drug resistance has been documented in laboratory and field isolates. Thus, alternative approaches to curtail this human disease are warranted. Understanding the immunobiology of the obligate intermediate host of these parasites, which include the freshwater snail Biomphalaria glabrata, may facilitate the development of novel methods to stop or reduce transmission to humans. Molecules from the thioester-containing protein (TEP) superfamily have been shown to be involved in immunological functions in many animals including corals and humans. In this study we identified, characterized, and compared TEP transcripts and their expression upon S. mansoni exposure in resistant and susceptible strains of B. glabrata snails. Results showed the expression of 11 unique TEPs in B. glabrata snails. These transcripts present high sequence identity at the nucleotide and putative amino acid levels between susceptible and resistant strains. Further analysis revealed differences in several TEPs’ constitutive expression levels between resistant and susceptible snail strains, with C3-1, C3-3, and CD109 having higher constitutive expression levels in the resistant (BS90) strain, whereas C3-2 and TEP-1 showed higher constitutive expression levels in the susceptible (NMRI) strain. Furthermore, TEP-specific response to S. mansoni miracidia exposure reiterated their differential expression, with resistant snails upregulating the expression of both TEP-4 and TEP-3 at 2 h and 48 h post-exposure, respectively. Further understanding the diverse TEP genes and their functions in invertebrate animal vectors will not only expand our knowledge in regard to this ancient family of immune proteins, but also offer the opportunity to identify novel molecular targets that could aid in the efforts to develop control methods to reduce schistosomiasis transmission.

[Chronic Right Ventricular Failure Revealing a Large Compressive Hydatid Cyst at the Cardiology Department of the Aristide le Dantec Hospital (Dakar, Senegal)]

Hydatidosis, an anthropozoonosis caused by the development of the Echinococcus granulosus larva in human, is a parasitic infection that is endemic in many countries. Pericardial localization in the absence of other cardiac involvement is extremely rare. Its spontaneous evolution is serious because of the risk of rupture. We report the case of a 65-year-old patient, who received limb edema that had been going on for 4 months, and in whom the physical examination noted a 3/6 tricuspid regurgitation and a right heart failure syndrome. Transthoracic echocardiography revealed an intra-pericardial mass whose contents appeared fluid with hyperechogenic area. It measured 86x61 mm and significantly compressed the straight cavities. Thoracic computed tomography showed an appearance in favor of an aged intrapericardic hydatid cyst (GHARBI V) with mass effect on the right cavities. The hydatid serology was negative. The patient did not accept the surgical cure. She had been put on albendazole and diuretic treatment. Fatal outcome was reported after two-month follow-up.

P1586Research network in Africa (RNA): antihypertensive drugs strategies in 12 African countries

Background

High Blood Pressure is the worldwide leading global burden of disease risk factor. In Sub-Saharan Africa, the number of adults with raised blood pressure has alarmingly increased from 0.59 to 1.13 billion between 1975 and 2015. Blood pressure-lowering medicines are cornerstone of cardiovascular risk reduction. Data on management of anti-hypertensive drugs in sub-Saharan Africa are squarce.

Purpose

Our study aims to describe antihypertensive drugs strategies in Africa.

Methods

We conducted a cross-sectional survey in urban clinics during outpatient consultation specialized in hypertension cardiology departments of 29 medical centers from 17 cities across 12 African countries (Benin, Cameroon, Congo, Democratic Republic of Congo, Gabon, Guinea, Ivory Coast, Mauritania, Mozambic, Niger, Senegal, Togo). Data were collected on demographics, treatment and standardized BP measures were made among the hypertensive patients attending the clinics. Country income was retrieved from the World Bank database. All analyses were performed through scripts developed in the R software (3.4.1 (2017–06–30)).

Results

A total of 2198 hypertensive patients (58.4±11.8 years; 39.9% male) were included. Among whom 2123 (96.6%) had at least one antihypertensive drug. Overall, 30.8% (n=653) received monotherapy and calcium-channel blockers (49.6%) were the most common monotherapy prescribed follow by diuretics (18.7%). Two-drug strategies were prescribed for 927 patients (43.6%). Diuretics and Angiotensin-converting enzyme inhibitors was the combination most frequently prescribed (33.7%). Combination of three drugs or more was used in 25.6% (n=543) of patients. The proportion of drugs strategies differed significantly according to countries (p<0.001), monotherapy ranged from 12.7% in Niger to 47.1% in Democratic Republic of the Congo (figure). Furthermore we observed a significantly difference of strategies between low and middle income countries (55.3% and 44.7% of monotherapy respectively) (p<0.001). According to hypertension grades 1, 2 and 3, the proportion of three-drugs or more combination was 25%, 28% and 34% in middle-income and lower in low-income countries (18%, 19% and 25%). Furthermore, Grade 3 hypertension in low income countries was still treated with monotherapy (36%) instead of 19% in middle income countries (p<0.01).

Antihypertensive strategies by country

Conclusion

Our study described antihypertensive drugs use across 12 sub-Saharan countries, and identified disparities specific to the income context. Inequity in access to drugs combination is a serious barrier to tackle the burden of hypertension in Africa.

[Skin Leishmaniosis : Epidemiological And Clinical-Biological Study In Two Public Hospitals In Nouakchott]

Many cases of cutaneous leishmaniasis are observed during hospital consultations in Nouakchott. The objective of our study is to collect all cases of cutaneous leishmaniasis in Nouakchott and to study its epidemiological and clinico-biological characteristics.

METHOD

This is a prospective multicenter descriptive study conducted in two specialized hospital departments in Nouakchott from September 1st, 2016 to the end of October 2017. All patients with suspicious lesions of cutaneous leishmaniasis during this period were selected. Parasitological skin sampling, PCR and histology have been performed to patients.

RESULTS

Twenty one out of 9000 patients were diagnosed during the study period, with an average age of 23 years (ranging from 3 to 70 years). A male predominance was noted with a sex ratio of 2/1. The most frequent locations are the discovered parts of the body (the 4 members). The ulcero-crusty form is encountered in 2/3 of the cases. L. major is more frequently identified (61.9%) followed by L infantum in 23.8% of cases. Meglume Antimoniate was administered intralesionally in 57.1% of patients. In Nouakchott, cutaneous leishmaniasis is not uncommon. The cases observed are related to an origin or a stay in the southern regions.

Non-tubercular caseous adenopathy in Senegal

The authors report the case of a 22-year-old man referred seven months after the onset of papulo-nodular skin lesions, lymphadenopathy, splenomegaly and hepatomegaly. Mycologic and histologic examination of skin lesions enabled the diagnosis of African histoplasmosis, by Histoplasma capsulatum var duboisii. The lymph nodes were caseous. The culture in Lowenstein-Jensen medium was negative.

[Prevalence of cardiovascular risk factors in semi-rural area in Senegal]

OBJECTIVES

We aim to determine the prevalence of cardiovascular risk factors in the semi-rural population of the community of Gueoul in Senegal.

PATIENTS AND METHOD

This is a cross-sectional, observational and descriptive study. We conducted an exhaustive survey in 2012 according to the STEPS wise approach of the world health organization against Senegalese aged of 35 years and over who resided for at least 6 months in semi-rural area in the community of Gueoul. Pregnant women were excluded. Classical cardiovascular risk factors were collected and data analyzed using SPSS 18.0 software. The significance level was agreed for a value of P<0.05.

RESULTS

We examined 1411 subjects (1052 women) with a mean age of 48.5±12.68 years. The main cardiovascular risk factors were dyslipidemia (61,1%), physical inactivity (56.2%), abdominal obesity according to the International Diabetes Federation (53.9%), hypertension (46.4%), global obesity (13%), diabetes (7.2%) and smoking (2.5%). Hypertension was significantly associated with diabetes (P=0.001), abdominal obesity (P=0.001) and global obesity (P=0.0001). Sedentarity (P=0.001), global obesity (P=0.0001) and hypertension (P=0.001) were more frequent in women.

CONCLUSION

Cardiovascular risk factors are frequent and often associated in semi-rural area of Senegal, particularly in women. This condition should lead to develop prevention strategies of cardiovascular complications.

[Ambulatory Blood Pressure Measurement's Reults And Indications At Cadiology Department At Hôpital Aristide Le Dantec]

High blood pressure (HTA) is a public health problem. It affects more than one billion people around the world, more than a quarter of the world's population. In recent years the ABPM (Ambulatory Blood Pressure Measurement) has become a valuable and widely used tool for the diagnosis and management of hypertension. The aims of this study were to determine the indications of MAPA to the cardiology department of Aristide le Dantec Hospital; to determine the results and to evaluate the blood pressure profile of our patients.

METHODS

We carried out a retrospective study, over 37 months from December 2010 to December 2013 covering all the results of the ABPMs recorded during this period. Was included any patient over 18 years of age with an ABPM. All ABPMs with less than 50 good measures per 24 hours were not included.

RESULTS

A total of 204 MAPA results were included of a total of 307. The mean age was 49.6 ± 11.5 years with extremes of 25 years and 78 years. The sex ratio was 1.5 in favour of women. Indications were dominated by labile HTA (34.8%); masked HTA (27.9%) and suspicious of the white coat effect (12.3%). The analysis of the results showed that MAPA was normal in 49.5%. The white coat effect was found in 32% (65 patients) of ABPM. In patients with abnormal ABPM, permanent systolic-diastolic hypertension predominated (57%). HTA masked was noted in 25.7% of our patients and HTA white coat was found in 3.8% of cases. In the hypertensive patients treated, MAPA revealed a poor blood pressure balance in 42.1%. Among the HTA prognostic factors we noted32.4% of patients were "Non Dippers", a pulse pressure greater than or equal to 60 mmHg in 59%.

CONCLUSION

The use of this exploration is an important aid to practitioners in the diagnostic, therapeutic and prognosis phase of the management of hypertension. It should become more important as it provides better information on the blood pressure profile for the patients.

Cardiac magnetic resonance imaging-indeterminate/negative cardiac sarcoidosis revealed by 18F-fluorodeoxyglucose-positron emission tomography: two case reports and a review of the literature

Background

Sarcoidosis is an inflammatory disorder of immune dysregulation characterized by non-caseating granulomas that can affect any organ. Cardiac sarcoidosis is an under-recognized entity that has a heterogeneous presentation and may occur independently or with any severity of systemic disease. Diagnosing cardiac sarcoidosis remains problematic with endomyocardial biopsies associated with a high risk of complications. Several diagnostic algorithms are currently available that rely on histopathology or clinical and radiological measures. The dominant mode of diagnostic imaging to date for cardiac sarcoidosis has been cardiac magnetic resonance imaging with gadolinium enhancement.

Case presentations

We report the cases of two adult patients: case 1, a 50-year-old white man who presented with severe congestive cardiac failure; and case 2, a 37-year-old white woman who presented with complete heart block. Both patients had a background of untreated pulmonary sarcoidosis. Cardiac magnetic resonance imaging did not show evidence of sarcoidosis in either patient and both proceeded to ¹⁸F-fluorodeoxyglucose-positron emission tomography scans that were highly suggestive of cardiac sarcoidosis. Both patients were systemically immunosuppressed with orally administered prednisone and methotrexate and had subsequent improvement by clinical and nuclear medicine imaging measures.

Conclusions

Current consensus guidelines recommend all patients with sarcoidosis undergo screening for occult cardiac disease, with thorough history and examination, electrocardiogram, and transthoracic echocardiogram. If any abnormalities are detected, advanced cardiac imaging should follow. While cardiac magnetic resonance imaging identifies the majority of cardiac sarcoidosis, early disease may not be detected. These cases demonstrate ¹⁸F-fluorodeoxyglucose-positron emission tomography is warranted following an indeterminate or normal cardiac magnetic resonance imaging if clinical suspicion remains high. Unidentified and untreated cardiac sarcoidosis risks significant morbidity and mortality, but early detection can facilitate disease-modifying immunosuppression and cardiac-specific interventions.