A New Genus and Two New Species of Unarmed Hymenolepidid Cestodes (Cestoda: Hymenolepididae) from Geomyid Rodents in Mexico and Costa Rica

Two new cestodes of the family Hymenolepididae are described from two species of rodents of the family Geomyidae collected in Mexico and Costa Rica. One new species of Hymenolepis is described from Cratogeomys planiceps Merriam 1895 from near Toluca, Mexico and another that we allocate to a new genus is described from Heterogeomys heterodus (Peters, 1865) from near Irazú Volcano, Costa Rica. Hymenolepis s. str. includes those Hymenolepididae with an apical organ, with no hooks on suckers or apical organ, and three testes. Hobergia irazuensis n. gen., n. sp. includes a hymenolepidid with an apical organ, unarmed scolex, small pockets termed foveolae, in which the suckers completely retract, and extremely bi-lobed ovary. Multivariate morphometric analysis showed good separation of these species from all other hymenolepidids possessing an apical organ and lacking a well developed rostellum and rostellar hooks in the Nearctic and Neotropical regions

Distribution and Abundance of Host-seeking Culex Species at Three Proximate Locations with Different Levels of West Nile Virus Activity

Culex species were monitored at three proximate sites with historically different West Nile virus (WNV) activities. The site with human WNV transmission (epidemic) had the lowest abundance of the putative bridge vectors, Culex pipiens and Cx. salinarius. The site with horse cases but not human cases (epizootic) had the highest percent composition of Cx. salinarius, whereas the site with WNV-positive birds only (enzootic) had the highest Cx. pipiens abundance and percent composition. A total of 29 WNV-positive Culex pools were collected at the enzootic site, 17 at the epidemic site, and 14 at the epizootic site. Published models of human risk using Cx. pipiens and Cx. salinarius as the primary bridge vectors did not explain WNV activity at our sites. Other variables, such as additional vector species, environmental components, and socioeconomic factors, need to be examined to explain the observed patterns of WNV epidemic activity

Intra- and interspecies interactions between prion proteins and effects of mutations and polymorphisms

Recently, crystallization of the prion protein in a dimeric form was reported. Here we show that native soluble homogenous FLAG-tagged prion proteins from hamster, man and cattle expressed in the baculovirus system are predominantly dimeric. The PrP/PrP interaction was confirmed in Semliki Forest virus-RNA transfected BHK cells co-expressing FLAG- and oligohistidine-tagged human PrP. The yeast two-hybrid system identified the octarepeat region and the C-terminal structured domain (aa90-aa230) of PrP as PrP/PrP interaction domains. Additional octarepeats identified in patients suffering from fCJD reduced (wtPrP versus PrP+90R) and completely abolished (PrP+90R versus PrP+90R) the PrP/PrP interaction in the yeast two-hybrid system. In contrast, the Met/Val polymorphism (aa129), the GSS mutation Pro102Leu and the FFI mutation Asp178Asn did not affect PrP/PrP interactions. Proof of interactions between human or sheep and bovine PrP, and sheep and human PrP, as well as lack of interactions between human or bovine PrP and hamster PrP suggest that interspecies PrP interaction studies in the yeast two-hybrid system may serve as a rapid pre-assay to investigate species barriers in prion diseases

A New Genus and Two New Species of Unarmed Hymenolepidid Cestodes (Cestoda: Hymenolepididae) from Geomyid Rodents in Mexico and Costa Rica

Two new cestodes of the family Hymenolepididae are described from two species of rodents of the family Geomyidae collected in Mexico and Costa Rica. One new species of Hymenolepis is described from Cratogeomys planiceps Merriam 1895 from near Toluca, Mexico and another that we allocate to a new genus is described from Heterogeomys heterodus (Peters, 1865) from near Irazú Volcano, Costa Rica. Hymenolepis s. str. includes those Hymenolepididae with an apical organ, with no hooks on suckers or apical organ, and three testes. Hobergia irazuensis n. gen., n. sp. includes a hymenolepidid with an apical organ, unarmed scolex, small pockets termed foveolae, in which the suckers completely retract, and extremely bi-lobed ovary. Multivariate morphometric analysis showed good separation of these species from all other hymenolepidids possessing an apical organ and lacking a well developed rostellum and rostellar hooks in the Nearctic and Neotropical regions

Quantitative sensory testing in children with sickle cell disease: additional insights and future possibilities.

Quantitative sensory testing (QST) is used in a variety of pain disorders to characterize pain and predict prognosis and response to specific therapies. In this study, we aimed to confirm results in the literature documenting altered QST thresholds in sickle cell disease (SCD) and assess the test-retest reliability of results over time. Fifty-seven SCD and 60 control subjects aged 8-20 years underwent heat and cold detection and pain threshold testing using a Medoc TSAII. Participants were tested at baseline and 3 months; SCD subjects were additionally tested at 6 months. An important facet of our study was the development and use of a novel QST modelling approach, allowing us to model all data together across modalities. We have not demonstrated significant differences in thermal thresholds between subjects with SCD and controls. Thermal thresholds were consistent over a 3- to 6-month period. Subjects on whom hydroxycarbamide (HC) was initiated shortly before or after baseline testing (new HC users) exhibited progressive decreases in thermal sensitivity from baseline to 6 months, suggesting that thermal testing may be sensitive to effective therapy to prevent vasoocclusive pain. These findings inform the use of QST as an endpoint in the evaluation of preventative pain therapies

Design, Implementation, and Evaluation of a Pharmacist-Led Outpatient Benzodiazepine-Tapering Clinic

Background Benzodiazepines are commonly used among older adults, despite well-known risks. Clinical pharmacists can lead tapering efforts, leveraging their clinical expertise and relieving time-pressured primary care providers. Objectives The objective of this study is to describe the design, implementation, and evaluation of an outpatient pharmacist-led benzodiazepine-tapering clinic. Practice description The clinic is based within a community medical group associated with a large academic health system in Los Angeles, California. Practice innovation The clinic is staffed by clinical pharmacists and supervised by a psychiatrist. The initial visit consists of patient education, design of patient-driven tapering schedule, and medical history review. Follow-up phone/video visits are used to monitor withdrawal symptoms and provide support. Evaluation methods We used chart review to assess tapering status among those enrolled in the tapering clinic versus those who did not enroll. We compared outcomes across the 2 groups using bivariate statistics. Results From March 2017 to May 2019, 176 patients were referred to the clinic; 17 were deemed ineligible. Of the 159 patients contacted, 62 patients enrolled in the clinic; 97 patients did not enroll. Among patients in the clinic, 13 (27%) of patients were tapered down, 29 (60%) completely tapered off, 6 (13%) were unable to taper, and 14 (23%) were in the process of tapering. In contrast, among patients who did not enroll, 3 (4%) of patients were tapered down, 15 (20%) completely tapered off, 57 (76%) were unable to taper, and 22 (22%) were in the process of tapering. Ninety percent of patients had at least some benzodiazepine tapering when enrolled in the clinic compared to 41% among not enrolled in the clinic (P\u3c0.001). Conclusion A pharmacist-led benzodiazepine-tapering clinic can be an effective way to engage patients motivated to taper down. Lessons learned include the importance of ensuring referring providers adequately counsel patients prior to referral