Venom phenotype conservation suggests integrated specialization in a lizard-eating snake.

Biological specialization reduces the size of niche space while increasing efficiency in the use of available resources. Specialization often leads to phenotypic changes via natural selection aligning with niche space constraints. Commonly observed changes are in size, shape, behavior, and traits associated with feeding. One often selected trait for dietary specialization is venom, which, in snakes, often shows variation dependent on diet across and within species. The Neotropical Blunt-headed Treesnake (Imantodes cenchoa) is a highly specialized, rear-fanged, arboreal, lizard hunter that displays a long thin body, enlarged eyes, and a large Duvernoy's gland. However, toxin characterization of I. cenchoa has never been completed. Here, we use RNA-seq and mass spectrometry to assemble, annotate, and analyze the venom gland transcriptomes of four I. cenchoa from across their range. We find a lack of significant venom variation at the sequence and expression levels, suggesting venom conservation across the species. We propose this conservation provides evidence of a specialized venom repertoire, adapted to maximize efficiency of capturing and processing lizards. Importantly, this study provides the most complete venom gland transcriptomes of I. cenchoa and evidence of venom specialization in a rear-fanged snake, giving insight into selective pressures of venom across all snake species.

Peripartum cardiomyopathy: a review of current literature.

Peripartum cardiomyopathy (PPCM) is systolic heart failure in a woman who is pregnant or in the early postpartum period. There are multiple theories regarding the pathophysiology of this disease, and it is suspected the true cause is a combination of these theories. Presenting symptoms are similar to that of systolic heart failure from other causes and must be carefully differentiated from normal changes that occur during pregnancy. PPCM may progress to chronic heart failure and result in various complications if not treated early. This paper offers a comprehensive review of currently accepted pathophysiologic theories, major signs and symptoms, possible complications and treatments of PPCM.

Peripartum cardiomyopathy is a heart disorder that involves decreased blood flow from the aorta to the rest of the body. This can occur during pregnancy, or shortly thereafter. The major symptoms are shortness of breath (especially at night), severe leg swelling and persistent cough. Some of these symptoms may also be present in normal, healthy pregnancies, so it is important for the patient to inform their doctor of any personal or family history of cardiac conditions prior to or within pregnancy. There are treatments that are used to improve symptoms; however, many medications that are normally used for cardiomyopathy outside of pregnancy are dangerous for the fetus; and therefore must be avoided. While many cases of peripartum cardiomyopathy resolve spontaneously after delivery, some patients require longer and more intense treatment. Patients with a history of this heart condition should talk with their doctor before deciding to get pregnant again, as recurrence is common and potentially life threatening. It is possible to have a normal, healthy vaginal delivery even with this condition, but in severe cases a c-section may be the safest option for the patient and her child.

Combating Diagnostic Delay of Endometriosis in Adolescents via Educational Awareness: A Systematic Review.

Endometriosis occurs in approximately 10% of adult women worldwide; however, it is commonly under- or misdiagnosed in adolescents. The purpose of this study was to analyze existing scientific literature for reasons for diagnostic delay of endometriosis and to determine how education regarding endometriosis could be improved. An integrative review was conducted based on articles published between December 1980 and December 2020. Suitable articles were identified from the MEDLINE/PubMed databases, using relevant terms. Eligible studies included discussion on potential causes of diagnostic delay of endometriosis in the adolescent population. Data were extracted from eligible publications and qualitative synthesis was used. The 27 articles included in the study revealed several primary reasons for the delay, such as a physician and/or patient knowledge gap, normalization by physician and patient, lack of research, and physician resistance. Strategies to lessen diagnostic delay of endometriosis in adolescents must include integrated actions by educators and healthcare providers to improve health literacy and awareness of common causes of pelvic pain in this age group.