Coprological Survey of Protostrongylid Infections in Antelopes from Souss-Massa National Park (Morocco)

Protostrongylids, small nematode lungworms, are an integral part of the wild ruminant helminth community, which can damage animals' health when they are held in captivity or semi-captive conditions. The Sahelo-Saharan antelope species dorcas gazelle (Gazella dorcas), the scimitar-horned oryx (Oryx dammah), and the addax (Addax nasomacculatus), reintroduced to Souss-Massa National Park in Morocco, could be host to many species of Protostrongylids. This study was conducted from January to July 2015 to identify infecting parasite species, and determine their prevalence and abundance in all three antelope species. A total of 180 individual fecal samples were collected, morphologically examined by the Baermann technique, and molecularly identified by PCR amplification and sequencing of the second internal transcribed spacer region of the rDNA (ITS-2). Two parasite species were found in the three antelope populations: Muellerius capillaris and Neostrongylus linearis. The prevalence scores recorded for M. capillaris were 98.40 % in the addax, 96.70 % in dorcas gazelle, and 28.40 % in the oryx. The prevalence rates of N. linearis were 60 % in the addax, 23.40 % in dorcas gazelle, and 90 % in the oryx. Excreted larvae were quantified by LPG (larvae per gram) counting: for M. capillaris, the LPG mean values were 92.94 in the addax, 133.09 in dorcas gazelle, and 1.48 in the oryx; and for N. linearis, the LPG mean values were 6.02 in the addax, 1.37 in dorcas gazelle, and 32.81 in the oryx. These findings indicate that the three species of antelopes are infected with Muellerius capillaris and Neostrongylus linearis to varying degrees in intensity and prevalence.

Review of Cardiac Involvement in Multisystem Inflammatory Syndrome in Children

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with substantial cardiovascular implications. Although infection with SARS-CoV-2 is usually mild in children, some children later develop a severe inflammatory disease that can have manifestations similar to toxic shock syndrome or Kawasaki disease. This syndrome has been defined by the US Centers for Disease Control and Prevention as multisystem inflammatory syndrome in children. Although the prevalence is unknown, >600 cases have been reported in the literature. Multisystem inflammatory syndrome in children appears to be more common in Black and Hispanic children in the United States. Multisystem inflammatory syndrome in children typically occurs a few weeks after acute infection and the putative etiology is a dysregulated inflammatory response to SARS-CoV-2 infection. Persistent fever and gastrointestinal symptoms are the most common symptoms. Cardiac manifestations are common, including ventricular dysfunction, coronary artery dilation and aneurysms, arrhythmia, and conduction abnormalities. Severe cases can present as vasodilatory or cardiogenic shock requiring fluid resuscitation, inotropic support, and in the most severe cases, mechanical ventilation and extracorporeal membrane oxygenation. Empirical treatments have aimed at reversing the inflammatory response using immunomodulatory medications. Intravenous immunoglobulin, steroids, and other immunomodulatory agents have been used frequently. Most patients recover within days to a couple of weeks and mortality is rare, although the medium- and long-term sequelae, particularly cardiovascular complications, are not yet known. This review describes the published data on multisystem inflammatory syndrome in children, focusing on cardiac complications, and provides clinical considerations for cardiac evaluation and follow-up.

Coronavirus Disease 2019 (COVID-19) Pandemic Implications in Pediatric and Adult Congenital Heart Disease

The corona virus disease -2019 (COVID-19) is a recently described infectious disease caused by the severe acute respiratory syndrome corona virus 2 with significant cardiovascular implications. Given the increased risk for severe COVID-19 observed in adults with underlying cardiac involvement, there is concern that patients with pediatric and congenital heart disease (CHD) may likewise be at increased risk for severe infection. The cardiac manifestations of COVID-19 include myocarditis, arrhythmia and myocardial infarction. Importantly, the pandemic has stretched health care systems and many care team members are at risk for contracting and possibly transmitting the disease which may further impact the care of patients with cardiovascular disease. In this review, we describe the effects of COVID-19 in the pediatric and young adult population and review the cardiovascular involvement in COVID-19 focusing on implications for patients with congenital heart disease in particular.

Some larval morphological characteristics of Camelostrongylus mentulatus and Nematodirus spathiger

Monitoring of gastrointestinal nematode parasites in ruminants (domestic and wild) is often based on fecal examination techniques, looking for excreted eggs and larval forms using morphological keys. These, are more available in domestic ruminants, in which helminths are widely studied, than in wild ruminants.  This study tried to provide certain morphological elements that will help to recognize the L3 larvae of Camelostrongylus mentulatus and Nematodirus spathiger that could parasite either domestic or wild ruminants. For that, we resorted first to the culture of L3 larvae from fecal samples taken from African antelopes, and second by the microscopic characterization of each isolated larval morphological pattern previously identified by sequencing of its internal transcribed spacer (ITS-2) regions of the ribosomal DNA. The results of different microscopic captured images showed that Camelostrongylus mentulatus larva is 16 intestinal cells that measuring approximately 820 µm length, ‎≈ 25 µm wide, and ‎≈ 47 µm for its sheath tail extension and by this be closer to Teladorsagia circumcincta characteristics.  For Nematodirus spathiger, it possesses 8 gut cells and measuring about 1020 µm long, ‎≈ 25 µm wide, and‎ ≈ 143 µm for its sheath tail extension with specific tail appendages. Have done this, we were able to get some clarifications on the morphology of the studied larvae, and we believe thus that this study will contribute to the establishment of morphological identification keys especially for parasitic nematodes of wild ruminants.

Development of a predictive model for drug-associated QT prolongation in the inpatient setting using electronic health record data

PURPOSE

We aimed to construct a dynamic model for predicting severe QT interval prolongation in hospitalized patients using inpatient electronic health record (EHR) data.

METHODS

A retrospective cohort consisting of all adults admitted to 2 large hospitals from January 2012 through October 2013 was established. Thirty-five risk factors for severe QT prolongation (defined as a Bazett's formula-corrected QT interval [QTc] of ≥500 msec or a QTc increase of ≥60 msec from baseline) were operationalized for automated EHR retrieval; upon univariate analyses, 26 factors were retained in models for predicting the 24-hour risk of QT events on hospital day 1 (the Day 1 model) and on hospital days 2-5 (the Days 2-5 model).

RESULTS

A total of 1,672 QT prolongation events occurred over 165,847 days of risk exposure during the study period. C statistics were 0.828 for the Day 1 model and 0.813 for the Days 2-5 model. Patients in the upper 50th percentile of calculated risk scores experienced 755 of 799 QT events (94%) allocated in the Day 1 model and 804 of 873 QT events (92%) allocated in the Days 2-5 model. Among patients in the 90th percentile, the Day 1 and Days 2-5 models captured 351 of 799 (44%) and 362 of 873 (41%) QT events, respectively.

CONCLUSION

The risk models derived from EHR data for all admitted patients had good predictive validity. All risk factors were operationalized from discrete EHR fields to allow full automation for real-time identification of high-risk patients. Further research to test the models in other health systems and evaluate their effectiveness on outcomes and patient care in clinical practice is recommended.

Molecular characterization of cucumber mosaic virus isolates infecting tomato in Hamedan and Tehran provinces of Iran

Here we identified four isolates, MS, 3H, 50A, and 2K of cucumber mosaic virus (CMV) infecting tomato, on the basis of their non-coding intergenic region and a part of the coat protein (CP) sequence in the CMV genomic RNA3. The sequences from the four isolates were compared with other previously characterized isolates of CMV isolated from different plant species across the globe. Sequence comparisons revealed that the two CMV isolates from Hamedan province (MS and 3H) had the highest sequence identity with CMV-G10 (98%), which was previously reported as a severe Hellenic tomato isolate of CMV, while the CMV isolates from Tehran province, including CMV-2K (isolated from Karaj region) and CMV-50A (isolated from Varamin region), had the highest sequence identity with that of CMV-ALF (99%). Phylogenetic analysis of the nucleotide sequences showed that CMV-MS and CMV-3H belong to group IB, while CMV-2K and CMV-50A belong to group IA. This is the first report on the molecular characterization of novel isolates of CMV infecting tomato plants in Iran.