Checklist of Helminths of Bats from Mexico and Central America

Based on original data obtained from fieldwork conducted from January 2008 to December 2015 and from previous records from published accounts, an updated checklist of helminth parasites of bats from Mexico and Central America is presented. The checklist has been organized in four ways, first as a helminth-host list in the state of Morelos, second as a helminth-host list with taxonomic and geographic distributional information, third as a bat-helminth list with references, and last, as a summary of the host-helminth association. A total of 105 records and 67 helminth taxa (26 trematodes, 4 cestodes, and 37 nematodes [33 adult and 5 larvae]) in 27 bat species from the families Emballonuridae, Molossidae, Mormoopidae, Natalidae, Phyllostomidae, and Vespertilionidae are presented for Mexico and Central America. Eight species of helminths are unique to Central America and ten species occur in both Mexico and the isthmus. From the helminths recorded in Mexico, 34 helminth species in 19 species of bats are present in the state of Morelos. The helminth diversity represents 58% of the total recorded thus far in Mexico, yet the diversity of bats intensively surveyed for parasites in the country represents roughly 14% of the diversity of chiropterans present. This evidence suggests that these intensive examinations are necessary to complete the helminthological record for bats, especially in areas of high endemism

Chronic coronary syndromes without standard modifiable cardiovascular risk factors and outcomes: the CLARIFY registry

Background and Aims: It has been reported that patients without standard modifiable cardiovascular (CV) risk factors (SMuRFs—diabetes, dyslipidaemia, hypertension, and smoking) presenting with first myocardial infarction (MI), especially women, have a higher in-hospital mortality than patients with risk factors, and possibly a lower long-term risk provided they survive the post-infarct period. This study aims to explore the long-term outcomes of SMuRF-less patients with stable coronary artery disease (CAD). Methods: CLARIFY is an observational cohort of 32 703 outpatients with stable CAD enrolled between 2009 and 2010 in 45 countries. The baseline characteristics and clinical outcomes of patients with and without SMuRFs were compared. The primary outcome was a composite of 5-year CV death or non-fatal MI. Secondary outcomes were 5-year all-cause mortality and major adverse cardiovascular events (MACE—CV death, non-fatal MI, or non-fatal stroke). Results: Among 22 132 patients with complete risk factor and outcome information, 977 (4.4%) were SMuRF-less. Age, sex, and time since CAD diagnosis were similar across groups. SMuRF-less patients had a lower 5-year rate of CV death or non-fatal MI (5.43% [95% CI 4.08–7.19] vs. 7.68% [95% CI 7.30–8.08], P = 0.012), all-cause mortality, and MACE. Similar results were found after adjustments. Clinical event rates increased steadily with the number of SMuRFs. The benefit of SMuRF-less status was particularly pronounced in women. Conclusions: SMuRF-less patients with stable CAD have a substantial but significantly lower 5-year rate of CV death or non-fatal MI than patients with risk factors. The risk of CV outcomes increases steadily with the number of risk factors