Helminth Microbiomes - A Hidden Treasure Trove?

There is increasing attention on the complex interactions occurring between gastrointestinal parasitic helminths and the microbial flora (microbiota) inhabiting the host gut. However, little is known about the occurrence, structure, and function of microbial populations residing within parasite organs and tissues. In this article, we argue that an in-depth understanding of the interplay between parasites and their microbiomes may significantly enhance current knowledge of parasite biology and physiology, and may lead to the discovery of entirely novel, anthelmintic-independent interventions against parasites and parasitic diseases.

The relationships between faecal egg counts and gut microbial composition in UK Thoroughbreds infected by cyathostomins.

A growing body of evidence, particularly in humans and rodents, supports the existence of a complex network of interactions occurring between gastrointestinal (GI) helminth parasites and the gut commensal bacteria, with substantial effects on both host immunity and metabolic potential. However, little is known of the fundamental biology of such interactions in other animal species; nonetheless, given the considerable economic losses associated with GI parasites, particularly in livestock and equines, as well as the global threat of emerging anthelmintic resistance, further explorations of the complexities of host-helminth-microbiota interactions in these species are needed. This study characterises the composition of the equine gut commensal flora associated with the presence, in faecal samples, of low (Clow) and high (Chigh) numbers of eggs of an important group of GI parasites (i.e. the cyathostomins), prior to and following anthelmintic treatment. High-throughput sequencing of bacterial 16S rRNA amplicons and associated bioinformatics and statistical analyses of sequence data revealed strong clustering according to faecal egg counts (P = 0.003). A trend towards increased populations of Methanomicrobia (class) and Dehalobacterium (genus) was observed in Clow in comparison with Chigh. Anthelmintic treatment in Chigh was associated with a significant reduction of the bacterial Phylum TM7 14 days post-ivermectin administration, as well as a transient expansion of Adlercreutzia spp. at 2 days post-treatment. This study provides a first known insight into the discovery of the intimate mechanisms governing host-parasite-microbiota interactions in equines, and sets a basis for the development of novel, biology-based intervention strategies against equine GI helminths based on the manipulation of the commensal gut flora.

Incisional hernia repair: a mechanical approach.

Fifty incisional hernias were managed by excision of all scar tissue and approproximation of the abdominal wall using continuous doubled nylon inserted with a generous suture length: wound length ratio. There were no major recurrences and only 4 minor ones. The method is theoretically sound and should be more widely used.

The burst abdominal wound: a mechanical approach.

The burst abdominal wound has a mechanical cause. It is the results of suture breaking, knot slipping, the intact suture cutting out of the tissues or protrusion of gut or omentum between stitches. Measurements of abdominal girth and the xiphoid-pubis distance before and during abdominal distension show that a wound may lengthen by 30 per cent if distension occurs. An adequate reserve of suture length in the wound is necessary to allow this lengthening to occur and to ensure a minimal resulting rise in tension between the sutures and the tissues. Three variables present in every continuous wound closure--the suture length inserted, the wound fasical length and the number of stitches--determine the stitch interval and the size of the tissue bite, which are the two vital factors in wound strength under the surgeon's control. These variables may be expressed by the ratio of the length of suture (SL) inserted to the wound length (WL), the ratio SL:WL. Analytical and clinical evidence is presented to show that: 1. Deep wound disruption (evisceration and ventral hernia) is associated with the use of an SL: WL ratio of 2: 1 or less-the lower the ratio, the greater is the risk of a burst wound. 2. Wound disruption because of cutting out of sutures can be prevented by the use of non-absorbable continuous sutures at 1-cm intervals and an SL:WL ratio of 4:1 or more.