Beware of nonconvulsive seizures in prolonged disorders of consciousness: Long-term EEG monitoring is the key.

OBJECTIVE: Evaluate the prevalence of epileptic seizures (ES) and epileptiform discharges (EDs) in patients with prolonged disorders of consciousness (DOC), and potential influence of amantadine on epilepsy. METHODS: We conducted a retrospective study in 34 patients hospitalized in a DOC care unit for prolonged DOC between 2012 and 2018, who received a long-term EEG monitoring (LTM). We reviewed the prevalence of ES, EDs and nonconvulsive seizures (NCSz), the type of DOC recovery treatment administered, and neurological outcome. RESULTS: LTM was more effective than standard EEGs in detecting EDs (32% vs 21% respectively). Moreover, 12% of the LTM showed NCSz. Among patients with EDs in LTM, 73% showed no EDs in standard EEG recordings, even when performed more than once. The presence of EDs and/or NCSz in LTM was significantly associated with the occurrence of remote clinical epileptic seizures (p = 0.017) but did not influence neurological outcome (p = 1). Amantadine was not associated with higher occurrence of EDs/NCSz or clinical seizures. CONCLUSION: In our prolonged DOC population, LTM showed more pathological results (EDs and NCSz) than standard EEGs, which was significantly associated with remote clinical seizures. SIGNIFICANCE: The use of LTM might be advised to rule out NCSz in patients with prolonged DOC.

Echinococcus multilocularis in red foxes in North Belgium: Prevalence and trends in distribution.

A cross-sectional systematic sampling was carried out during three consecutive winters from 2012 to 2015, to update the knowledge on the fox tapeworm (Echinococcus multilocularis) distribution in the red fox (Vulpes vulpes) in Flanders. Earlier studies reported the low endemicity status of this tapeworm in the northern region of Belgium, in contrast to the south of the country and neighbouring countries. Using a modified Segmental Sedimentation and Counting Technique, followed by PCR-RFLP and sequencing, 923 foxes' intestines were examined for the presence of E. multilocularis. Based on microscopic examination, 38 out of 923 foxes were suspected to be infected with either E. multilocularis or Amoebotaenia spp., of which 19 were molecularly confirmed to be E. multilocularis, 18 were found positive for Amoebotaenia spp. and one was negative. The overall prevalence for E. multilocularis of 2.1% confirms the low endemicity of the fox tapeworm in Flanders. However, in one area in the most eastern part of Flanders (Voeren), neighbouring the Netherlands and Wallonia, a prevalence of 57% (12/21) was observed. Continuous monitoring of the fox tapeworm remains needed to assess spatio-temporal trends in distribution and to assess the risk of this zoonotic infection in Europe. The challenging differential diagnosis of E. multilocularis and Amoebotaenia spp. based on microscopic examination calls for attention.

Occurrence of Taenia species in pigs in slaughterhouses in Phu Tho province, northern Vietnam.

Pigs act as the intermediate hosts of the zoonotic tapeworms Taenia solium and Taenia asiatica, as well as of the non-zoonotic Taenia hydatigena. In Vietnam, human taeniasis and cysticercosis have been reported throughout the country; however, data on porcine cysticercosis are scarce. Our study aimed to estimate the prevalence of Taenia spp. in slaughtered pigs in two districts in Phu Tho, a mountainous province in northern Vietnam from where neurocysticercosis patients commonly originate. The carcasses of 399 pigs from 51 small-scale abattoirs were checked for cysticerci, while tongue, liver, masseter muscles, diaphragm and heart were sliced and examined. Retrieved cysticerci underwent polymerase chain reaction-restriction fragment length polymorphism and sequencing for species confirmation. Blood was also collected to detect antibodies by lentil lectin-purified glycoprotein enzyme-linked immunoelectrotransfer blot (LLGP-EITB) and recombinant T24H antigen (rT24H)-EITB and circulating antigens by B158/B60 Ag-ELISA. In two pigs, T. asiatica cysticerci were found, confirming the presence of the parasite in pigs in Vietnam at a low prevalence (0.5%; 95% exact confidence interval (CI): 0-1.19%). Cysticerci of T. solium were found in none of the pigs, although one serum sample was positive for antibodies in both LLGP-EITB and rT24H-EITB. Furthermore, a high prevalence of T. hydatigena cysticercosis was observed (18.0%; 95% Wilson score CI: 14.6-22.1%). In more than half of the T. hydatigena-positive pigs, circulating antigens were detected by Ag-ELISA, confirming that this test cannot be used to diagnose T. solium cysticercosis in this region. Finally, Spirometra erinaceieuropaei was found in one pig liver. It is the first record of this zoonotic cestode species in pigs in Vietnam. Overall, the findings confirmed the complex epidemiology of Taenia spp. in pigs in Vietnam.

Serological diagnosis of Taenia solium in pigs: No measurable circulating antigens and antibody response following exposure to Taenia saginata oncospheres.

Taenia solium taeniasis/cysticercosis is a zoonosis included in the WHO's list of neglected tropical diseases. Accurate diagnostic tools for humans and pigs are needed to monitor intervention outcomes. Currently used diagnostic tools for porcine cysticercosis all have drawbacks. Serological tests are mainly confronted with problems of specificity. More specifically, circulating antigen detecting tests cross-react with Taenia hydatigena and the possibility of transient antigens as a result of aborted infections is suspected. Furthermore, the hypothesis has been raised that hatched ingested eggs of other Taenia species may lead to a transient antibody response or to the presence of circulating antigen detectable by serological tests used for porcine cysticercosis. Here we describe the results of a study that consisted of oral administration of Taenia saginata eggs to five piglets followed by serological testing during five weeks and necropsy aiming at studying possible cross reactions in serological tests used for porcine cysticercosis. The infectivity of the eggs was verified by in vitro hatching and by experimental infection of a calf. One piglet developed acute respiratory disease and died on day 6 post infection. The remaining four piglets did not show any clinical signs until euthanasia. None of the serum samples from four piglets collected between days 0 and 35 post infection gave a positive reaction in the B158/B60 Ag-ELISA and in a commercial Western blot for antibody detection. In conclusion, this study showed that experimental exposure of four pigs to T. saginata eggs did not result in positive serologies for T. solium. These results may help interpreting serological results in monitoring of T. solium control programmes.

Impact of a trace element supplementation programme on health and performance of cross-breed (Bos indicus x Bos taurus) dairy cattle under tropical farming conditions: a double-blinded randomized field trial.

Small-scale urban dairy farms (n = 16) in and around Jimma, Ethiopia with cross-bred (Bos indicus × Bos taurus) cows were enrolled in a double-blinded intervention study to investigate the effect of a trace element supplementation programme on trace element status and milk concentrations as well as performance [body condition score (BCS), milk yield, leptin], milk composition, antioxidant status (ferric-reducing ability of plasma (FRAP), thiobarbituric acid-reactive substances (TBARS)], blood biochemistry, serum proteins and immune response (antibody titre upon rabies vaccination). The farms were allocated to a (1) placebo or (2) Cu, Zn, Se, Co and I supplementation treatment for 150 d. On days 0 and 120, four lactating cows per farm were sampled for milk and plasma, and on day 150 for serum, following primo-vaccination. Cu deficiency was present in 17% and marginal Se deficiency in 30% of initially sampled cows, while no Zn shortage was detected. Over 120 days, trace element supplementation caused a bigger increase in plasma Se and Cu concentrations, but also a larger decrease of plasma Fe concentrations. A larger increase in milk Se concentrations was observed in the supplemented group, whereas none of the other elements were affected. BCS decreased more over time in the supplemented group. None of the other parameters of performance and antioxidant status nor milk composition or blood biochemistry was affected by treatment. Antibody response to rabies vaccination did not differ between groups, whereas α1-globulins tended to be lower and ß-globulins tended to be higher in the supplemented group. In conclusion, despite improved Cu and Se status and Se concentrations in milk, cows on tropical urban dairy farms did not seem to benefit from trace element supplementation, with respect to the parameters investigated.

A disparate trace element metabolism in zebu (Bos indicus) and crossbred (Bos indicus × Bos taurus) cattle in response to a copper-deficient diet.

Copper deficiency is a commonly diagnosed problem in cattle around the globe. In Jimma, Ethiopia, 8 zebu (Bos indicus) and 8 zebu ×: Holstein Friesian cross (Bos taurus ×: Bos indicus) heifers were used in an 11-wk study to investigate breed type differences and effects of Cu deficiency on concentrations of trace elements in plasma and edible tissues as well as mRNA expression of Cu-related genes. Heifers were fed a grass diet (6.4 ± 0.2 [SEM] mg Cu/kg DM) supplemented with 1 mg Mo/kg DM in wk 1 to 4 and 2 mg Mo/kg DM in wk 5 to 11, with blood samples collected every 2 wk and tissue collection postmortem. Plasma, liver, kidney, and semitendinosus and cardiac muscle were analyzed for Zn, Cu, Fe, Se, Mo, Co, and Mn. Expression of mRNA Cu-related genes was measured in aorta (lysyl oxidase [LOX]), liver (Cu transporting ß-polypeptide [Atp7b], Cu chaperone for superoxide dismutase [CCS], cytochrome c oxidase assembly homolog 17 [Cox17], Cu transporter 1 homolog [Ctr1], and superoxide dismutase 1 [Sod1]), and duodenum (diamine oxidase [DAO] and metallo-thionein-1A [Mt1a]) as well as the Se-related glutathione peroxidase 1 (Gpx1). Zebu cattle maintained initial plasma Cu concentrations just below the threshold value for deficiency, whereas crossbred cattle gradually became severely Cu deficient over time (P < 0.001). In contrast, plasma Zn and Co were greater in zebu cattle at the onset of the trial but became similar to crossbred cattle towards the end of the trial (P < 0.001). Liver Cu (P = 0.002) and Fe (P ≤ 0.001), kidney Se (P < 0.001), and kidney and cardiac muscle Co (P ≤ 0.001) concentrations were greater in zebu than in crossbred cattle. Increased hepatic mRNA expression of the Cu regulatory genes Atp7b, Ctr1 (P = 0.02), CCS (P = 0.03), and Cox17 (P = 0.009) and Cu-related Sod1 (P = 0.001) as well as the Se-related Gpx1 (P ≤ 0.001) were greater in zebu than in crossbred cattle. However, duodenal mRNA expression of DAO (P = 0.8) and Mt1a (P = 0.2) and aortic expression of LOX (P = 0.8) were not different. Both the differences in Cu status indices (plasma and liver concentrations) and hepatic mRNA expression of Cu regulatory genes point to the possibility of a more efficient use of dietary Cu in B. indicus as compared to B. taurus ×: B. indicus cattle resulting in greater sensitivity to Cu deficiency in B. taurus crossbred cattle.