Epidemiology of tick‐borne pathogens in the semi‐arid and the arid agro‐ecological zones of Punjab province,Pakistan

Tick‐borne diseases (TBDs) have a large impact on animal health and the livelihood of livestock owners, particularly in developing countries. Although climatic and ecological conditions in Pakistan may favour the transmission of tick‐borne pathogens (TBPs), only a few systematic studies have been carried out on TBPs and the diseases that they cause in this country. To improve our understanding of the distribution of TBPs, 3,807 ticks were collected from ruminants (n = 369) on 108 livestock farms (semi‐arid zone = 36, arid zone = 72) in Punjab Province. After morphological identification ticks were pooled into 405 pools (Hyalomma anatolicum = 300, Rhipicephalus microplus = 89, Hyalomma dromedarii = 9, Rhipicephalus turanicus = 7) based on their species, locality of collection, and the host. DNA from each pool was screened by a Reverse Line Blot (RLB) hybridization assay for the presence of Anaplasma, Ehrlichia, Rickettsia, Babesia, and Theileria species. DNA from at least one TBP was found in 142 (35.1%) pools. Among the positive pools, 91 (64.1%) had a mixed infection with two or more TBPs, whereas 51 (35.9%) pools were infected with a single TBP. The detected pathogens not only included species that were known to be endemic in Pakistan, such as Theileria annulata (6.7%), Theileria orientalis (3.5%), Anaplasma marginale (5.7%), Anaplasma centrale (2.7%), Anaplasma ovis (1.5%), Babesia bigemina (0.7%), and Babesia bovis (0.2%), but also several TBPs that had not been reported to occur in Pakistan before. This included Ehrlichia minasensis (3.2%), an Anaplasma platys‐like organism (1.2%), Babesia occultans (0.2%), and Rickettsia massiliae (0.2%), as well as two previously uncharacterized species: Ehrlichia sp. Multan (18.0%) and Anaplasma sp. (BL099‐6) (2.22%). The pathogenicity of these novel species remains to be examined. This study shows that a much broader spectrum of TBPs is present in Pakistan than previously thought, including several zoonotic pathogens.     

Effect of cholinergic crisis on the potency of different emergency anaesthesia protocols in soman-poisoned rats

Background: In a military or terrorist scenario, combination of organophosphorus compounds (OP) poisoning with physical trauma requiring surgical treatment and thus general anaesthesia are possible. Previous in vitro studies showed an altered potency of relevant anaesthetics during cholinergic crisis. Hence, it is not clear, which anaesthetics are suitable to achieve the necessary stage of surgical anaesthesia in OP poisoning.

Methods: In the present study, different anaesthetic regimens (ketamine-midazolam, propofol-fentanyl, thiopental-fentanyl), relevant in military emergency medicine, were examined in soman-poisoned rats. Clinical signs and cardiovascular variables were recorded continuously. Blood samples for acetylcholinesterase (AChE) activity were drawn. After euthanasia or death of the animals, brain and diaphragm were collected for cholinesterase assays.

Results: Propofol-fentanyl and thiopental-fentanyl resulted in surgical anaesthesia throughout the experiments. With ketamine-midazolam, surgical anaesthesia without respiratory impairment could not be achieved in pilot experiments (no soman challenge) and was therefore not included in the study. Soman-poisoned and control animals required a comparable amount of propofol-fentanyl or thiopental-fentanyl. In combination with atropine, significantly less propofol was needed. Survival rate was higher with thiopental compared to propofol. Atropine improved survival in both groups. Blood and tissue AChE activities were strongly inhibited after soman administration with and without atropine treatment.

Discussion: The current in vivo study did not confirm concerns of altered potency of existing anaesthetic protocols for the application of propofol or thiopental with fentanyl due to soman poisoning. Despite severe cholinergic crisis, sufficient anaesthetic depth could be achieved in all animals.

Conclusion: Further experiments in in vivo models closer to human pharmaco- and toxicokinetics (e.g., swine) are required for confirmation of the initial findings and for improving extrapolation to humans.     

Hair hormones in male youth with internet gaming disorder

Objectives: Internet gaming disorder (IGD) is associated with altered physiological reactivity to psychosocial stress. Findings from a previous study on alterations of basal hypothalamic–pituitary–adrenal (HPA) axis functioning, indexed by differences in hair hormone levels (i.e., cortisol) in IGD patients compared to matched controls, were limited by a small sample size.

Methods: Following the protocol of the previous study, male patients with IGD (n?=?31) and controls (n?=?31) matched for age, educational status and smoking were recruited. Sociodemographic and clinical characteristics were assessed using structured interviews and self-reports. Hair samples were taken for the analysis of cortisol, cortisone, testosterone, progesterone, dehydroepiandrosterone (DHEA), and corticosterone.

Results: Groups showed no significant differences on cortisol (d?=??0.10, 95%CI (?0.60; 0.40)), cortisone (d?=??0.10, 95%CI (?0.60; 0.40)), testosterone (d?=??0.00, 95%CI (?0.51; 0.51)), progesterone (d?=??0.46, 95%CI (?0.96; 0.05)), DHEA (d?=??0.04, 95%CI (?0.54; 0.47)) or corticosterone (d?=??0.19, 95%CI (?0.69; 0.32)). Associations between hair hormone concentrations, symptom severity and sociodemographic variables were weak and did not survive correction for multiple testing.

Conclusions: Unlike other psychiatric disorders, effects of IGD and associated psychopathology on basal HPA axis functioning, indexed by hair hormone levels, are negligible. Future studies need to rule out potential effects of sex, age and long-term pathology on these findings.     

Skillstraining und Simulation in der orthopädischen und unfallchirurgischen Facharztweiterbildung

Die Unfallchirurgie - Nach 6‑jähriger Vorbereitung ist vom Deutschen Ärztetag im Mai 2018 die novellierte Musterweiterbildungsordnung verabschiedet worden. Ziel der Novelle ist die...     

Influence of executive functions on the self-reported health-related quality of life of children with ADHD

Quality of Life Research - ADHD is regarded as a neurodevelopmental disorder associated with deficits in executive functions (EF). The presence of these deficits is associated with increased...     

Akute Luftnot nach Tauchgang

Notfall + Rettungsmedizin - Nach einem Tauchgang klagt ein 55-jähriger männlicher Patient über akute Luftnot. Ein fulminantes Lungenödem wird festgestellt, welches eine...