Prevalence of Shiga toxin-producing Escherichia coli and Salmonellae and some associated hematologic and biochemical profile alterations in lambs.

Lamb enteritis constitutes an economic burden on sheep production worldwide. We aimed to estimate the prevalence of Shiga toxin-producing Escherichia coli (STEC) and Salmonellae among diarrheic lambs at Kafrelsheikh Governorate, Egypt and to detect the associated clinical, hematologic, biochemical, and antioxidant parameters. Fifty diarrheic and twenty apparently healthy control lambs were examined clinically, and hematologically. Diarrheic lambs had a significant elevated body temperature, respiratory and pulse rate, most of hemogram para-meters, total proteins and albumin, oxidative stress markers malonaldiahyde and nitric oxide levels, liver enzymes, urea and creatinine than control group. On the other hand, these diarrheic lambs had significant reduction in total leukocyte count and lymphocytes, antioxidant biomarkers super oxide dismutase activities and reduced glutathione than control lambs. E. coli and Salmonella spp. were isolated from 32.00% and 16.00% of diseased lambs, respectively. Serotyping and biochemical tests of examined samples identified 16 E. coli isolates belonged to 10 different serotypes; O6, O8, O26:H11, O75, O84:H21, O103:H2, O114:H4, O121:H7, O128:H2 and O163:H2. All isolates are STEC as they harbor either Shiga-toxin 1 or Shiga-toxin 2 genes or both. One isolate carries intimin gene (eaeA) and classified as EHEC; O26:H11. The obtained nine isolates of Salmonella carry enterotoxin (Stn) genes, eight of them carry hyper-invasive locus (hilA) gene, all isolates belonged to six serotypes; S. Enteritidis, S. Heidelberg, S. Tsevie, S. Typhimurium, S. Essen, and S. Infantis. Lamb diarrhea was prevalent in the studied area and might constitute a veterinary and public health threat. Alteration in hemato-biochemical para-meters and oxidative-anti-oxidant balance could help adopt appropriate treatment regimens.

Current Status of Training and Certification for Congenital Heart Surgery Around the World: Proceedings of the Meetings of the Global Council on Education for Congenital Heart Surgery of the World Society for Pediatric and Congenital Heart Surgery.

The optimal training of the highly specialized congenital heart surgeon is a long and complex process, which is a significant challenge in most parts of the world. The World Society for Pediatric and Congenital Heart Surgery (WSPCHS) has established the Global Council on Education for Congenital Heart Surgery as a nonprofit organization with the goal of assessing current training and certification and ultimately establishing standardized criteria for the training, evaluation, and certification of congenital heart surgeons around the world. The Global Council and the WSPCHS have reviewed the present status of training and certification for congenital cardiac surgery around the world. There is currently lack of consensus and standardized criteria for training in congenital heart surgery, with significant disparity between continents and countries. This represents significant obstacles to international job mobility of competent congenital heart surgeons and to the efforts to improve the quality of care for patients with Congenital Heart Disease worldwide. The purpose of this article is to summarize and document the present state of training and certification in congenital heart surgery around the world.

Inhaled foreign bodies: presentation, management and value of history and plain chest radiography in delayed presentation.

OBJECTIVE: To assess the clinical and management aspects of tracheobronchial foreign body (FB) in children and adults; to judge the influence of the operator's experience on the outcome of the procedure and to evaluate the factors associated with delayed diagnosis of FB aspiration (FBA) in children; and to compare clinical, radiologic and bronchoscopic findings in the patients with suspected FB inhalation (FBI). STUDY DESIGN AND SETTING: Retrospective review of a 10-year experience (from 1995 to 2005), involving a 1512-bed Mansoura university hospital and a 184-bed Mansoura emergency hospital. MATERIAL AND METHODS: Three thousand three hundred patients underwent rigid bronchoscopy for suspected FBI between 1995 and 2005 in Mansoura, Egypt. The data were analyzed in 3 groups: the patients with negative bronchoscopy for FBI (group 1), early (group 2), and delayed diagnosis (group 3). Foreign body was removed using the rigid bronchoscope with or without using the extracting forceps (Egyptian novel technique; Sersar technique). RESULTS: The penetration syndrome and decreased breath sounds were determined in a significantly higher number of the patients with FBI. The plain chest radiography revealed radiopaque foreign bodies (FBs) in 23.56% of all patients with FBI. Pneumonia and atelectasis were more common in the groups with negative bronchoscopy and with delayed diagnosis (P < 0.01). The FBs were mostly of vegetable origin, such as seeds and peanuts. The Egyptian novel (Sersar) technique was used since 2004 April in 100 cases (4.62%) with a history of FBI (pins and or small rounded materials). It was successful in 73 cases of nonimpacted inhaled pins. CONCLUSIONS: Bronchoscopy is indicated on appropriate history and on suspicion. To prevent delayed diagnosis, characteristic symptoms, and clinical and radiologic signs of FBI should be checked in all suspected cases. Because clinical and radiologic findings of FBI in delayed cases may mimic other disorders, the clinician must be aware of the likelihood of FBI. EBM RATING: C-4.

Unilateral Emphysema in Infancy, a Rare Presentation of Aberrant Bronchial Artery: Case Report and Review of Literature.

Aberrant bronchial arteries are rarely seen and may originate from various vascular structures. Hemoptysis is the most common clinical presentation of cases with anomalous bronchial artery. We report a case of a 1-month-old infant presented with respiratory distress and left lung emphysema. Radiologic investigations and bronchoscopy revealed that the cause is an aberrant left bronchial artery compressing the left main bronchus. Surgical division of the aberrant vessel was performed with gradual improvement of the emphysema and respiratory distress. Unilateral emphysema due to vascular compression was previously reported. However, to the best of our knowledge, this is the first reported case of aberrant bronchial artery presenting with external compression of a main bronchus and unilateral emphysema. Also, this is the youngest reported case with an aberrant bronchial artery.