ABSTRACT
INTRODUCTION: Rheumatic heart disease (RHD), a sequela of acute rheumatic fever (ARF), affects 40.5 million people worldwide. The burden of disease disproportionately falls on low- and middle-income countries (LMIC) and sub-populations within high-income countries (HIC). Advances have been made in earlier detection of RHD, though several barriers to ideal management persist. AREAS COVERED: This article reviews the current burden of RHD, highlighting the disparate impact of disease. It also reviews the clinical and echocardiographic presentation of RHD, as some may present in late stages of disease with associated complications. Finally, we review the advances which have been made in echocardiographic screening to detect latent RHD, highlighting the challenges which remain regarding secondary prophylaxis management and uncertainty of best practices for treatment of latent RHD. EXPERT OPINION: Advances in technology and validation of portable echocardiography have made screening and identifying latent RHD feasible in the most burdened regions. However, uncertainty remains around best management of those with latent RHD and best methods to ensure ideal secondary prophylaxis for RHD. Research regarding latent RHD management, as well as continued work on innovative solutions (such as group A streptococcal vaccine), are promising as efforts to improve outcomes of this preventable disease persist.
Subject(s)
Rheumatic Fever , Rheumatic Heart Disease , Echocardiography , Humans , Mass Screening , Rheumatic Fever/diagnosis , Rheumatic Fever/epidemiology , Rheumatic Fever/prevention & control , Rheumatic Heart Disease/diagnosis , Rheumatic Heart Disease/epidemiology , Rheumatic Heart Disease/prevention & control , Secondary PreventionABSTRACT
In this paper we describe a new species of Adelius (Braconidae, Cheloninae) from the Afrotropical region, the first record of the genus for Angola, and a significant extension of its geographical distribution.
Subject(s)
Hymenoptera , Wasps , AnimalsABSTRACT
Mitral regurgitation (MR) is a major complication of the percutaneous mitral valvuloplasty (PMV). Despite high technical expertise and cumulative experience with the procedure, the incidence rate of severe MR has not decreased. Although some of MR can be anticipated by echocardiographic analysis; leaflet tearing, which leads to the most dreaded type of MR, remains unpredictable. Irregular valvular collagen remodeling is likely to compromise tissue architecture and increase the tearing risk during PMV balloon inflation. In this study, we evaluated histological and molecular characteristics of excised mitral valves from patients with rheumatic mitral stenosis (MS) who underwent emergency surgery after PMV due to severe MR caused by leaflet tear. Those findings were compared with patients who underwent elective mitral valve replacement surgery owing to severe MS, in whom PMV was not indicated. In vitro assay using peripheral blood mononuclear cells was performed to better understand the impact of the cellular and molecular alterations identified in leaflet tear mitral valve specimens. Our analysis showed that focal infiltration of inflammatory cells contributes to accumulation of MMP-1 and IFN-γ in valve leaflets. Moreover, we showed that IFN-γ increase the expression of MMP-1 in CD14+ cells (monocytes) in vitro. Thus, inflammatory cells contribute to unevenly remodel collagen resulting in variable thickening causing abnormalities in leaflet architecture making them more susceptible to laceration.
ABSTRACT
The genus Coelinius (Hymenoptera: Braconidae: Alysiinae) is reported for the first time from Brazil and the Neotropical region. The genus occurs in southeastern Brazil, in the states of Minas Gerais, Rio de Janeiro and São Paulo. Four new species of Coelinius are described and illustrated: C. canastra sp. nov, C. itamonte sp. nov., C. kali sp. nov. and C. lux sp. nov.
Subject(s)
Chenopodiaceae , Hymenoptera , Animals , Brazil , PoaceaeABSTRACT
The genera Ecclitura Kokujev and Streblocera Westwood are reported for the first time from Brazil. Three new species of the subfamily Euphorinae are described and illustrated: Ecclitura shawi sp. n., Marshiella tupi sp. n. and Streblocera brasiliana sp. n. These species are restricted to Atlantic forest remnants in southeastern Brazil.
Subject(s)
Hymenoptera , Animals , BrazilABSTRACT
The genus Leptodrepana Shaw was described in 1983, but prior to the current study only one Neotropical species had been described from Mexico and none were named from Costa Rica. In this paper twenty-four new species are described and named from Costa Rica: L. alexisae Dadelahi & Shaw, sp. n., L. atalanta Dadelahi & Shaw, sp. n., L. conda Dadelahi & Shaw, sp. n., L. conleyae Dadelahi & Shaw, sp. n., L. demeter Dadelahi & Shaw, sp. n., L. eckerti Dadelahi & Shaw, sp. n., L. gauldilox Dadelahi & Shaw, sp. n., L. hansoni Dadelahi & Shaw, sp. n., L. kimbrellae Dadelahi & Shaw, sp. n., L. lorenae Dadelahi & Shaw, sp. n., L. munjuanae Dadelahi & Shaw, sp. n., L. ninae Dadelahi & Shaw, sp. n., L. pamelabbas Dadelahi & Shaw, sp. n., L. ronnae Dadelahi & Shaw, sp. n., L. rosanadana Dadelahi & Shaw, sp. n., L. schuttei Dadelahi & Shaw, sp. n., L. scottshawi Dadelahi, sp. n., L. shriekae Dadelahi & Shaw, sp. n., L. sohailae Dadelahi & Shaw, sp. n., L. sorayae Dadelahi & Shaw, sp. n., L. soussanae Dadelahi & Shaw, sp. n., L. stasia Dadelahi & Shaw, sp. n., L. strategeri Dadelahi & Shaw, sp. n., and L. thema Dadelahi & Shaw, sp. n. A key to Costa Rican species of Leptodrepana is provided. The flagellum of all female Leptodrepana described in this work is reduced to only 17 flagellomeres. This character state is also found in two North American species described by Shaw (1983), L. opuntiae Shaw and L. oriens Shaw. It is hypothesized that a female antenna with 17 flagellomeres is a synapomorphy for a species-group comprising all the Costa Rican Leptodrepana species as well as two of the Mexican and North American species, L. opuntiae and L. oriens.
ABSTRACT
This paper provides the first taxonomic revision for the euphorine genus Centistes from a Neotropical country. Twenty-three new species are described: C. achterbergi sp. n., C. acuticaudatus sp. n., C. auricephalus sp. n., C. auristigma sp. n., C. bicaudatus sp. n., C. cabecares sp. n., C. cartagoensis sp. n., C. chorotegus sp. n., C. compactus sp. n., C. curvicaudatus sp. n., C. gauldi sp. n., C. hansoni sp. n., C. hirsutus sp. n., C. janzeni sp. n., C. laticaudatus sp. n., C. longicaudatus sp. n., C. marshi sp. n., C. muertensis sp. n., C. ornamentum sp. n., C. pilosus sp. n., C. puntarenensis sp. n., C. sergeyi sp. n., C. zurquiensis sp. n. A taxonomic key, including the two previously described species, C. epicaeri Muesebeck and C. gasseni Shaw, is presented. As a whole, the Centistes exhibit their highest diversity in the premontane cloud forests.
Subject(s)
Wasps/classification , Animal Distribution , Animal Structures/anatomy & histology , Animal Structures/growth & development , Animals , Body Size , Costa Rica , Ecosystem , Female , Male , Organ Size , Wasps/anatomy & histology , Wasps/growth & developmentABSTRACT
Meteorus Haliday, 1835 (Hymenoptera: Braconidae) is a cosmopolitan genus with around 340 species described, all koinobiont endoparasitoids of Coleoptera or Lepidoptera larvae, and several of its hosts are pest insects. Previously to this work only two species were described from Brazil, M. eaclidis Muesebeck and M. townsendi Muesebeck. Five new species of Meteorus are here described: M. atlanticus n. sp., M. ferruginosus n. sp., M. itatiaiensis n. sp., M. monoceros n. sp., and M. strigatus n. sp. Three species are recorded for the first time from Brazil: M. jerodi Aguirre & Shaw, M. laphygmae Viereck and M. megalops Zitani.
Subject(s)
Hymenoptera/classification , Animal Distribution , Animal Structures/anatomy & histology , Animal Structures/growth & development , Animals , Body Size , Brazil , Female , Hymenoptera/anatomy & histology , Hymenoptera/growth & development , Male , Organ SizeABSTRACT
A comprehensive key for 75 species of Meteorus distributed across 15 Neotropical countries is presented. Eleven new species from Bolivia, Costa Rica and Ecuador are described: Meteorusalbistigma, Meteoruscarolae, Meteoruseurysaccavorus, Meteorusfallacavus, Meteorusflavistigma, Meteorushaimowitzi, Meteorusmagnoculus, Meteorusmartinezi, Meteorusmicrocavus, Meteorusnoctuivorus and Meteorusorion. Expanded range distributions are recorded for Meteorusandreae, Meteorusfarallonensis, Meteorusguineverae, Meteorusjerodi, Meteoruskraussi, Meteoruspapiliovorus and Meteorusquimbayensis. The host of Meteorusjerodi is reported for the first time: a noctuid larva feeding on Asteraceae. Meteoruspapiliovorus is recorded attacking Papilionidae larvae in Ecuador, therefore displaying a similar host family preference as formerly documented from Costa Rica and Colombia.
