High infection rates of Toxoplasma gondii in cattle, sheep and pigs from Israel.

Toxoplasma gondii is an obligate intracellular parasite belonging to the phylum Apicomplexa, which causes the zoonotic disease toxoplasmosis. T. gondii infects almost all warm blood animals. Generally, infected animals are asymptomatic and remain infected for life. Infection of humans occurs by consumption of infected undercooked meat or contaminated vegetables, fruit and water. The aim of this study was to evaluate the prevalence and seroprevalence of T. gondii in livestock in Israel. For the serological screening we investigated the presence of antibodies against T. gondii in sera using the indirect fluorescent antibody test (IFAT). Molecular screening was preformed using conventional PCR and nested PCR for the detection of T. gondii DNA in tissue samples. Serum samples of 249 cattle and 138 sheep were collected from farms. This serological survey showed high seroprevalence with seropositivity of 29 % in cattle and 33 % in sheep. In addition, 526 paired sera and tissue samples from cattle, sheep and pigs were obtained in slaughterhouses. The serological prevalence of T. gondii in healthy animals intended for human consumption was 29.4 % in cattle, 26.1 % in sheep and 8.1 % in pigs. The molecular detection of T. gondii in the tissue samples was 7.5 % in cattle, 7.3 % in sheep and 6.3 % in pigs. Considering the combined positive results from both serological and molecular assays, exposure to or infection with the parasite was present in 26.2 % of the samples (33.8 % in cattle, 30.3 % in sheep, 12.5 % in pigs). The prevalence of T. gondii in pigs was significantly lower compared to that of cattle and sheep (P < 0.001). All PCR positive samples from animals and 12 human positive samples were genotyped using a restriction fragment length polymorphism (PCR-RFLP) method. The results showed the existence of atypical genotypes in the majority of the samples and no correlation between animals and human samples could be determined from this study. Widespread exposure to T. gondii in Israel with the presence of parasite DNA in meat from cattle, sheep and pigs meant for human consumption was found.

How often an isolated cardiac disproportion predicts a coarctation of the aorta? Single center experience and systematic review of the literature.

BACKGROUND: Cardiac disproportion is considered as an indirect sign of coarctation of the aorta (CoA). In this review, we have reassessed the positive predictive value (PPV) of such finding for a postnatal confirmation of CoA. DATA SOURCES: All cases of isolated cardiac disproportion diagnosed in the four-chamber and/or three-vessel/three-vessel and trachea views (right/left sections >1.5) were included. Postnatal cardiac findings were recorded. Additionally, a systematic literature search (PubMed, EMBASE, Cochrane library, and the reference lists of identified articles) regarding the association between antenatally detected cardiac disproportion and postnatal confirmation of CoA was performed. Data from our center were pooled with those derived from the literature. RESULTS: Ten fetuses with isolated cardiac disproportion were selected from our center and 259 from the literature review. CoA was postnatally confirmed in 101/269 (PPV 38%). PPV of antenatal cardiac findings was significantly higher in earlier gestation (23/27, 85% <26+0 weeks versus 11/39, 28%≥26+0 weeks, p < .001). No significant difference was noticed comparing ventricular disproportion with combined ventricular and great vessels disproportion (86/230 versus 15/39, p .89). DISCUSSION: Isolated cardiac disproportion has an overall chance of one in three of heralding a CoA in the neonate. The specificity of these findings is significantly higher in the second trimester.

Is the short axis view of the fetal heart useful in improving the diagnostic accuracy of outlet ventricular septal defects?

OBJECTIVES: Outlet ventricular septal defects (VSDs) are usually suspected on the five-chamber view of the fetal heart; however, postnatal confirmation occurs only in a small number of cases. The aim of this study was to evaluate if the systematic assessment of the short axis view may improve the prediction of prenatally detected outlet VSDs. METHODS: Cases where isolated outlet VSD was suspected on the five-chamber view were assessed by using the short axis scanning plane for confirmation of the defect. Postnatal assessment was performed within 2 weeks from birth at our Paediatric Cardiology Unit. RESULTS: An outlet VSD was suspected at five-chamber view in 23 fetuses. Postnatal confirmation of the VSD occurred in 14 cases where the defect was prenatally detected both on the five chamber and the short axis views. VSDs were not confirmed at postnatal assessment only in two cases where outlet VSD was suspected on both views, whereas all the seven cases with a suspected VSD on the five-chamber view only turned out to be false positives. CONCLUSION: The short axis view of the fetal heart seems useful in confirming the presence of outlet VSDs. © 2016 John Wiley & Sons, Ltd.