Bovine cryptosporidiosis: impact, host-parasite interaction and control strategies

International audienceAbstractGastrointestinal disease caused by the apicomplexan parasite Cryptosporidium parvum is one of the most important diseases of young ruminant livestock, particularly neonatal calves. Infected animals may suffer from profuse watery diarrhoea, dehydration and in severe cases death can occur. At present, effective therapeutic and preventative measures are not available and a better understanding of the host–pathogen interactions is required. Cryptosporidium parvum is also an important zoonotic pathogen causing severe disease in people, with young children being particularly vulnerable. Our knowledge of the immune responses induced by Cryptosporidium parasites in clinically relevant hosts is very limited. This review discusses the impact of bovine cryptosporidiosis and describes how a thorough understanding of the host–pathogen interactions may help to identify novel prevention and control strategies

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

The sick body is not associated with the sicker eye

Introduction: Systemic diseases such as hypertension and diabetes mellitus (DM) have been identified as the risk factor for glaucoma. However, there is minimal knowledge on the impact of systemic diseases on severity of glaucoma. This study aimed to determine the association between systemic disease and systemic treatment and severity of glaucoma. Materials and Methods: A cross-sectional study was conducted involving 298 primary open-angle glaucoma (POAG; 169 high tension glaucoma (HTG) and 129 normal tension glaucoma (NTG)) patients presented at the eye clinic of two tertiary hospitals in Malaysia between March and August 2012. The severity of POAG was based on Hodapp-Parrish-Anderson′(HODAPP) classification on Humphrey visual field 24-2 analysis. Only the right eye was selected when both eyes were eligible. Systemic diseases and treatment were retrieved from medical record or traced from the private practitioner or health clinic. Results: Systemic hypertension was the commonest systemic disease (56.4%) among POAG. There was no significant association between systemic diseases and severity of POAG. More than two systemic diseases were found in43.8% of patients with mild glaucoma. There was also no significant association of systemic treatment such as systemic antihypertensive drugs with severity of glaucoma. Conclusion: Systemic diseases such as systemic hypertension are not associated with severity of POAG. In fact, the presence of systemic disease (sick body) may lead to early detection of glaucoma (sick eye).′Sick body′ may prevent ′sicker eye′