Fatal Systemic Toxoplasma gondii Infection in a Red Squirrel (Sciurus vulgaris), a Swinhoe's Striped Squirrel (Tamiops swinhoei) and a New World Porcupine (Erethizontidae sp.).

Toxoplasmosis is a parasitic disease that affects man and animals worldwide. The primary hosts and major reservoir for Toxoplasma gondii are felids and the intermediate hosts are most warm-blooded animals including man. This report describes fatal toxoplasmosis in three different rodent species in Germany: a female red squirrel (Sciurus vulgaris) and a male Swinhoe's striped squirrel (Tamiops swinhoei), both kept as pets, and a female New World porcupine (Erethizontidae sp.) from a zoo. All three animals had multifocal necrotizing hepatitis. Additional findings included lymphohistiocytic and necrotizing myocarditis in the New World porcupine and the Swinhoe's striped squirrel, lymphohistiocytic encephalomyelitis in the New World porcupine and suppurative lymphadenitis in the red squirrel. Numerous tachyzoites were identified associated with the lesions. The diagnosis was confirmed by Toxoplasma. gondii immunohistochemistry and electron microscopy. This is the first report of toxoplasmosis in a New World porcupine and a Swinhoe's striped squirrel.

Predicting the severity of fetal anemia using time-domain measurement of volume flow in the fetal aorta.

OBJECTIVES: To assess the value of fetal aortic time-domain measurement of volume flow (using color velocity imaging quantification (CVI-Q)) in predicting the severity of fetal anemia. METHODS: This was a prospective observational study, in which 24 pregnant women with suspected fetal anemia due to rising anti-red blood cell antibody titers underwent cordocentesis. The fetal aortic time-domain volume flow was measured before fetal blood sampling for fetal hemoglobin investigation. We examined the correlation between increased fetal aortic time-domain volume flow (>2 SD for gestational age) and fetal anemia (hemoglobin level <2 SD for gestational age). RESULTS: Seventeen fetuses had anemia, and seven had normal hemoglobin. There was a strong correlation between the increase in fetal aortic time-domain volume flow and the drop in hemoglobin value (r = 0.81; P < 0.01). The sensitivity of this technique to predict fetal anemia was 81.3% and the specificity was 71.4%. The mean increase over time in aortic CVI-Q in anemic fetuses was 323.2 mL/min (95% CI, 200.1 to 446.4) compared with 86.9 mL/min (95% CI, -17.7 to 191.5) in the non-anemic group (P = 0.004). CONCLUSION: Fetal aortic time-domain measurement of volume flow is significantly increased in cases of fetal anemia due to red-cell alloimmunization. These findings can be used to improve the sensitivity, specificity and positive predictive value of the non-invasive techniques used to predict fetal anemia, and may help in the selection of pregnancies that require cordocentesis and transfusion.

Time domain measurement of blood flow in the human fetal aorta during normal pregnancy.

OBJECTIVE: To evaluate blood-volume flow-rate measurement in the fetal descending thoracic aorta using a non-invasive, non-Doppler, ultrasound technique. METHODS: This was a cross-sectional, observational study. Volume flow measurements were obtained from the descending thoracic aorta in 59 human fetuses between 20 and 40 weeks' gestation. These were uncomplicated pregnancies that resulted in the live births of appropriately grown infants. The measurements were obtained using a time domain processing technique: color velocity imaging quantification (CVI-Q). RESULTS: The blood-volume flow rate increased consistently from the second trimester until term. The mean values ranged between 100 mL/min at 20 weeks' gestation and approximately 350 mL/min at term. The normalized (weight-adjusted) volume flow rates decreased with increasing gestation, from a maximum of 626 mL/min/kg at 23 weeks to a minimum of 45.6 mL/min/kg at 37 weeks. CONCLUSIONS: The regular measurement of blood-volume flow in the descending fetal thoracic aorta is feasible using CVI-Q. Although there is a considerable learning curve, with adequate training there are potential clinical applications for this non-Doppler technique. However, limitations exist with the currently available technology for clinical use in fetal vascular studies.

The value of uterine artery Doppler in the prediction of uteroplacental complications in multiparous women.

OBJECTIVE: To investigate the value of second-trimester uterine artery Doppler in the prediction of complications resulting from uteroplacental insufficiency in low- and high-risk multiparous women. METHODS: Color flow pulsed Doppler imaging of both uterine arteries at 20 weeks' gestation was performed on 628 multiparous women; 458 of them had no known risk factors and 170 had clinically identifiable high-risk factors at booking. An abnormal result was defined as bilateral notches and a mean resistance index (RI) >/= 0.55 (50th centile) or unilateral notches and a mean RI >/= 0.65 (80th centile). The main outcome measure was adverse pregnancy outcome defined as any case of pre-eclampsia, small-for-gestational age birth weight (< 5th centile), placental abruption, stillbirth or early neonatal death. RESULTS: There was an adverse outcome in 30 women (6.6%) in the low-risk group and 48 (28.2%) women in the high-risk group. In the high-risk group the sensitivity to predict adverse pregnancy outcome in screen-positive women was 81.4% for a specificity of 89.0%, a positive predictive value of 71.4% and a negative predictive value of 93.4%. Normal Doppler studies in the high-risk group conferred a risk of adverse perinatal outcome of 6.6%, similar to the risk of adverse outcome in the low-risk population (6.6%). In the low-risk group the sensitivity for an adverse outcome in screen-positive women was 33.3% for a specificity of 92.8% and a positive predictive value of 24.4%. CONCLUSION: In high-risk multiparous women, persistent bilateral notches with mean RI >/= 0.55 and unilateral notches with mean RI >/= 0.65 at 20 weeks' gestation identifies the vast majority of women who will subsequently develop complications secondary to uteroplacental insufficiency. Normal uterine artery Doppler studies in these women confers a risk of adverse outcome similar to that of women with an uncomplicated obstetric history. In low-risk women, the screening efficacy of uterine artery Doppler for adverse perinatal outcome is poor and does not justify routine screening.

First Report of Cucurbit Aphid-borne Yellows Luteovirus in Lebanon.

Recently, Lecoq et al (1992) reported a new yellowing disease of cucurbits in France caused by cucurbit aphid-borne yellows luteovirus (CABYV) (1). Yellowing of older leaves of cucurbits has been observed in Lebanon for the past few years. Transmission tests showed that the disease incitant could be transmitted by Aphis gossypii in a persistent, circulative manner from muskmelon plants (Cucumis melo) to cucumber (C. sativus), muskmelon (C. melo), and squash (Cucurbita pepo) plants. Extracts from these plants reacted positively in enzyme-linked immunosorbent assays (ELISAs) with an antiserum prepared to a French isolate of CABYV. Surveys conducted in 1995 and 1996 showed that CABYV was widely distributed in the major cucurbit-growing areas along the Lebanese coast from north to south, and in the Beqaa plain. It was detected year round, alone or in mixed infections with mosaic-inducing viruses. The highest frequencies were recorded between May and October. CABYV and zucchini yellow mosaic potyvirus (ZYMV) were the most commonly detected viruses in outdoor cucurbits, including squash, cucumber, and melon. However, in protected cultivations (plastic tunnels), only a small proportion of cucumber plants showing similar yellowing symptoms reacted positively with CABYV antiserum in ELISAs, suggesting another cause to account for these symptoms. Reference: (1) H. Lecoq et al. Plant Pathol. 41:479, 1992.