The prevalence of Giardia infection in dogs and cats, a systematic review and meta-analysis of prevalence studies from stool samples

Giardia has a wide range of host species and is a common cause of diarrhoeal disease in humans and animals. Companion animals are able to transmit a range of zoonotic diseases to their owners including giardiasis, but the size of this risk is not well known. The aim of this study was to analyse giardiasis prevalence rates in dogs and cats worldwide using a systematic search approach. Meta-analysis enabled to describe associations between Giardia prevalence and various confounding factors. Pooled prevalence rates were 15.2% (95% CI 13.8-16.7%) for dogs and 12% (95% CI 9.2-15.3%) for cats. However, there was very high heterogeneity between studies. Meta-regression showed that the diagnostic method used had a major impact on reported prevalence with studies using ELISA, IFA and PCR reporting prevalence rates between 2.6 and 3.7 times greater than studies using microscopy. Conditional negative binomial regression found that symptomatic animals had higher prevalence rates ratios (PRR) than asymptomatic animals 1.61 (95% CI 1.33-1.94) in dogs and 1.94 (95% CI 1.47-2.56) in cats. Giardia was much more prevalent in young animals. For cats >6 months, PRR=0.47 (0.42-0.53) and in dogs of the same age group PRR=0.36 (0.32-0.41). Additionally, dogs kept as pets were less likely to be positive (PRR=0.56 (0.41-0.77)) but any difference in cats was not significant. Faecal excretion of Giardia is common in dogs and slightly less so in cats. However, the exact rates depend on the diagnostic method used, the age and origin of the animal. What risk such endemic colonisation poses to human health is still unclear as it will depend not only on prevalence rates but also on what assemblages are excreted and how people interact with their pets

The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with >80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

Acute inflammatory myelopathies

Inflammatory injury to the spinal cord causes a well-recognized clinical syndrome. Patients typically develop bilateral weakness, usually involving the legs, although the arms may also become affected, in association with a pattern of sensory changes that suggests a spinal cord dermatomal level. Bowel and bladder impairment is also common in many patients. Recognition of the clinical pattern of spinal cord injury should lead clinicians to perform imaging studies to evaluate for compressive etiologies. MRI of the spine is particularly useful in helping visualize intraparenchymal lesions and when these lesions enhance following contrast administration a diagnosis of myelitis is made. Cerebrospinal fluid analysis can also confirm a diagnosis of myelitis when a leukocytosis is present. There are many causes of non-compressive spinal cord injury including infectious, parainfectious, toxic, nutritional, vascular, systemic as well as idiopathic inflammatory etiologies. This review focuses on inflammatory spinal cord injury and its relationships with multiple sclerosis, neuromyelitis optica, acute disseminated encephalomyelitis and systemic collagen vascular and paraneoplastic diseases

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Seismic stratigraphic record of the Amundsen Sea Embayment shelf from pre-glacial to recent times: Evidence for a dynamic West Antarctic ice sheet

Studies of the sedimentary architecture and characteristics of the Antarctic continental margin provide clues about past ice sheet advance-retreat cycles and help improve constraints for paleo-ice dynamic models since early glacial periods. A first seismostratigraphic analysis of the Amundsen Sea Embayment shelf and slope of West Antarctica reveals insights into the structural architecture of the continental margin and shows stages of sediment deposition, erosion and transport reflecting the history from pre-glacial times to early glaciation and to the late Pleistocene glacial-interglacial cycles. The shelf geometry consists of a large pre- and syn-rift basin in the middle shelf region between basement cropping out on the inner shelf and buried basement ridge and highs on the outer shelf. A subordinate basin within the large basin on the mid-shelf may be associated with motion along an early West Antarctic Rift System branch. At least 4 km of pre-glacial strata have been eroded from the present inner shelf and coastal hinterland by glacial processes. Six major sedimentary units (ASS-1 to ASS-6) separated by five major erosional unconformities (ASS-u1 to ASS-u5) are distinguished from bottom to top. Unconformity ASS-u4 results from a major truncational event by glacial advance to the middle and outer shelf, which was followed by several episodes of glacial advance and retreat as observed from smaller-scale truncational unconformities within the units above ASS-u4. Some of the eroded sediments were deposited as a progradional wedge that extends the outer shelf by 25 to 65 km oceanward of the pre-glacial shelf-break. We compare the observed seismic characteristics with those of other Antarctic shelf sequences and assign an Early Cretaceous age to bottom sedimentary unit ASS-1, a Late Cretaceous to Oligocene age to unit ASS-2, an Early to Mid-Miocene age to unit ASS-3, a Mid-Miocene age to unit ASS-4, a Late Miocene to Early Pliocene age to unit ASS-5, and a Pliocene to Pleistocene age to the top unit ASS-6. Buried grounding zone wedges in the upper part of unit ASS-5 on the outer shelf suggest pronounced warming phases and ice sheet retreats during the early Pliocene as observed for the Ross Sea shelf and predicted by paleo-ice sheet models. Our data also reveal that on the middle and outer shelf the flow-path of the Pine Island-Thwaites paleo-ice stream system has remained stationary in the central Pine Island Trough since the earliest glacial advances, which is different from the Ross Sea shelf where glacial troughs shifted more dynamically. This study and its stratigraphic constraints will serve as a basis for future drilling operations required for an improved understanding of processes and mechanisms leading to change in the West Antarctic Ice Sheet, such as the contemporary thinning and grounding line retreat in the Amundsen Sea drainage sector

Molecular characterization of Apis mellifera colonies from Argentina: genotypic admixture associated with ecoclimatic regions and apicultural activities

The European honeybee, Apis mellifera L. (Hymenoptera: Apidae), is considered as a main contributor to pollination of important crops and to honey production. Originally, beekeeping in Argentina was performed in an extended area covering the north and central region of the country and involving A. mellifera of European origin. Later, honeybees of African origin entered South America through Brazil and hybridized with European genetic resources, giving rise to Africanized populations that are characterized by a more aggressive behavior among other unfavorable traits. In this study, a genetic characterization of 396 honeybee colonies from the most important apicultural region of Argentina is presented in order to provide an updated description of population structure and genetic diversity of commercial and feral colonies. Diversity was analyzed using mitochondrial (COI‐COII region) and nuclear (eight microsatellites) markers. Three European (M4, C1, C2J) and three African (A1, A4, A30) haplotypes were detected. European haplotypes were mostly found in commercial apiaries, whereas African haplotypes were detected at high frequencies in feral colonies. Microsatellite data were analyzed to estimate population genetic variability at the province level and to evaluate genetic admixture. A high level of hybridization between Africanized and European honeybees was detected with a significant latitudinal cline from north to south. Extensive population admixture resulted in the definition of four clusters that included both feral and commercial colonies and that are explained not only by geographical distribution and degree of Africanization but also by human influence through beekeeping activities.EEA BalcarceFil: Agra, Marcelo Nicolás. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina. Universidad Nacional de Mar del Plata. Facultad de Ciencias Agrarias; ArgentinaFil: Conte, Claudia Alejandra. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Genética Ewald A. Favret; ArgentinaFil: Corva, Pablo M. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina. Universidad Nacional de Mar del Plata. Facultad de Ciencias Agrarias; ArgentinaFil: Cladera, Jorge Luis. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Genética Ewald A. Favret; ArgentinaFil: Lanzavecchia, Silvia Beatriz. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Genética Ewald A. Favret; ArgentinaFil: Palacio, María Alejandra. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina. Universidad Nacional de Mar del Plata. Facultad de Ciencias Agrarias; Argentin