Explore the vast range of titles available.

Wolff–Parkinson–White syndrome, though previously diagnosed and without prior arrhythmic events, may remain clinically quiescent until atrial fibrillation with rapid antegrade conduction over an accessory pathway precipitates a potentially life threatening arrhythmia. We present a teaching case of a 46-year-old man who developed abrupt onset wide-complex tachycardia with ventricular rates exceeding 280 beats per minute on postoperative day three following thoracic surgery. Electrocardiography demonstrated an irregularly irregular rhythm with marked beat-to beat QRS variability and very short RR intervals, favoring atrial fibrillation with preexcitation rather than ventricular tachycardia or rate-related aberrancy. This case is used to illustrate key electrocardiographic features that distinguish pre-excited atrial fibrillation from other causes of wide-complex tachycardia and to review evidence based management principles in hemodynamically stable patients, including the selection of therapies that target accessory pathway conduction while avoiding atrioventricular nodal blockade.

Background Wolff-Parkinson-White (WPW) syndrome is a congenital abnormality of the cardiac conduction system characterized by the presence of an accessory pathway, which can predispose affected individuals to supraventricular tachycardia (SVT), atrial fibrillation, ventricular fibrillation, and sudden cardiac death. Despite its clinical significance, WPW syndrome is often underdiagnosed, particularly in resource-limited settings where cardiac arrhythmias may be misattributed to other conditions. Case presentation We report an eight-year-old Nigerian girl with WPW syndrome who was repeatedly misdiagnosed and managed for malaria over four years before an accurate diagnosis was established. She presented with recurrent episodes of chest discomfort, generalized weakness, nausea, and near-syncope. Each episode was treated as malaria, and symptoms resolved following treatment. During the most recent episode of the symptoms, she received care in a tertiary centre where SVT was identified following an electrocardiogram (ECG), heart rate was persistently about 250 beats per minute. Initial pharmacologic intervention with intravenous amiodarone was ineffective, necessitating external cardioversion to restore normal sinus rhythm. A post-recovery ECG confirmed a Wolf Parkinson White pattern. Conclusion WPW syndrome remains a diagnostic challenge in paediatric populations, where it can masquerade varying diseases, resulting in misdiagnosis. This case underscores the importance of a high index of suspicion for cardiac arrhythmias in children presenting with unexplained recurrent symptoms. Early recognition and appropriate intervention are crucial in preventing life-threatening complications associated with WPW syndrome. Increased awareness among healthcare providers can lead to improved diagnostic accuracy and better patient outcomes.

Since its emergence in the 1990s, White Spot Disease (WSD) has had major economic and societal impact in the crustacean aquaculture sector. Over the years shrimp farming alone has experienced billion dollar losses through WSD. The disease is caused by the White Spot Syndrome Virus (WSSV), a large dsDNA virus and the only member of the Nimaviridae family. Susceptibility to WSSV in a wide range of crustacean hosts makes it a major risk factor in the translocation of live animals and in commodity products. Currently there are no effective treatments for this disease. Understanding the molecular basis of disease processes has contributed significantly to the treatment of many human and animal pathogens, and with a similar aim considerable efforts have been directed towards understanding host–pathogen molecular interactions for WSD. Work on the molecular mechanisms of pathogenesis in aquatic crustaceans has been restricted by a lack of sequenced and annotated genomes for host species. Nevertheless, some of the key host–pathogen interactions have been established: between viral envelope proteins and host cell receptors at initiation of infection, involvement of various immune system pathways in response to WSSV, and the roles of various host and virus miRNAs in mitigation or progression of disease. Despite these advances, many fundamental knowledge gaps remain; for example, the roles of the majority of WSSV proteins are still unknown. In this review we assess current knowledge of how WSSV infects and replicates in its host, and critique strategies for WSD treatment.

Arrhythmia induction and identifying the functional characteristics of accessory pathways in Wolff‐Parkinson‐White (WPW) syndrome typically requires an invasive electrophysiological study. This case reports a 13‐year‐old boy with a five‐year history of paroxysmal palpitations, where transesophageal atrial pacing (TEAP) was used to identify accessory pathways. TEAP revealed multiple tachycardia forms, differentiating orthodromic atrioventricular reentrant tachycardia with narrow and wide QRS complexes. EPS confirmed two pathways, diagnosing WPW syndrome. TEAP effectively assessed accessory pathways' functional characteristics and their roles in tachycardia, showcasing its potential as a minimally invasive diagnostic tool for this condition. A 13‐year‐old boy has experienced intermittent paroxysmal palpitations for 5 years. Finally, tachycardia was induced through transesophageal atrial pacing, and an in‐depth analysis of the mechanism of tachycardia was conducted. The diagnostic results from transesophageal atrial pacing were fully consistent with those from intracardiac electrophysiological examination.

Many asymptomatic patients with a Wolff–Parkinson–White pattern on the electrocardiogram are at low risk for arrhythmias. However, younger asymptomatic patients with inducible arrhythmias may be at higher risk. This study found that prophylactic catheter ablation of accessory pathways in such patients greatly reduced the risk of arrhythmias. Prophylactic ablation in asymptomatic patients. Sudden death from cardiac causes in a healthy young person is a tragic event. Although ventricular fibrillation can be the presenting arrhythmia in asymptomatic patients with a Wolff–Parkinson–White electrocardiographic pattern, invasive electrophysiological testing for risk stratification and catheter ablation are not routinely recommended. 1 We recently reported that a particular subgroup of asymptomatic patients may be at risk for an arrhythmic event during follow-up. 2 We also demonstrated the value of electrophysiological testing for stratifying asymptomatic patients into high- and low-risk groups. In the present trial, we tested the hypothesis that prophylactic accessory-pathway ablation performed at the time of the initial electrophysiological . . .

Some children with asymptomatic Wolff–Parkinson–White syndrome are at high risk for tachyarrhythmias and sudden death. These children can be identified because they have inducible tachyarrhythmias on electrophysiological testing. This randomized clinical trial found that such children benefit from radiofrequency catheter ablation of accessory conduction pathways. The results of this study will change the management of high-risk asymptomatic Wolff–Parkinson–White in children. Natural-history studies in children with the Wolff–Parkinson–White syndrome have been limited by short follow-up, small sample size, and selection bias. 1 – 4 Although the incidence of sudden death in children with the Wolff–Parkinson–White is unclear, 5 the lifetime incidence is estimated to be about 3 to 4 percent. 6 – 8 Ventricular fibrillation can be the presenting arrhythmia, and the consequences of a “missed” sudden death in children are devastating. 4 , 9 – 11 Recently, it was reported that high-risk, asymptomatic ventricular preexcitation is associated with a poor prognosis. 12 Prophylactic ablation improves outcome in high-risk adult patients, 13 emphasizing the need to readdress guidelines in this setting. . . .

Rapid, sensitive, point-of-care diagnostics are critical for managing infectious diseases. Here we adapt the CRISPR-based SHERLOCK method to develop a rapid, accurate, single copy detection assay for White Spot Syndrome Virus, the most devastating virus impacting global shrimp aquaculture. Further, we combine paper matrix nucleic acid extraction and lateral flow colorimetric reporting to create a fully field-deployable, next-generation diagnostic with potential to transform veterinary pathology, disease ecology, and animal production.

Shrimp white spot disease (WSD), which is caused by white spot syndrome virus (WSSV), is one of the world's most serious shrimp diseases. Our objective in this study was to use an immunomagnetic reduction (IMR) assay to develop a highly sensitive, automatic WSSV detection platform targeted against ICP11 (the most highly expressed WSSV protein). After characterizing the magnetic reagents (Fe3O4 magnetic nanoparticles coated with anti ICP11), the detection limit for ICP11 protein using IMR was approximately 2 x 10(-3) ng/ml, and the linear dynamic range of the assay was 0.1~1 x 10(6) ng/ml. In assays of ICP11 protein in pleopod protein lysates from healthy and WSSV-infected shrimp, IMR signals were successfully detected from shrimp with low WSSV genome copy numbers. We concluded that this IMR assay targeting ICP11 has potential for detecting the WSSV.

White Spot Syndrome Virus (WSSV) is one of the most devastating viral pathogens affecting shrimp, causing severe economic losses to the global farmed shrimp trade. The globalization of live shrimp trade and waterborne transmission have facilitated the rapid spread of WSSV across major shrimp-producing countries since its initial emergence. The present review gives an updated account of WSSV biology, pathology, transmission dynamics, and recent developments in control measures. The virus, a double-stranded DNA virus of the Nimaviridae family, utilizes advanced immune evasion strategies, resulting in severe mortality. Shrimp lack adaptive immunity and hence rely predominantly on innate immunity, which is insufficient to mount an effective response against severe infections. Traditional disease control measures such as augmented biosecurity, selective breeding, and immunostimulants have, despite extensive research, achieved only limited success. New biotechnological tools such as RNA interference, CRISPR-Cas gene editing, and nanotechnology offer tremendous potential for disease mitigation. In parallel, the development of DNA and RNA vaccines targeting WSSV structural proteins, such as VP28, holds significant promise for stimulating the shrimp immune system. This review highlights the urgent need for a convergent approach to sustainable disease management in global shrimp aquaculture, with interdisciplinarity playing a pivotal role in shaping the future of WSSV control.

White spot syndrome virus (WSSV) is a very large dsDNA virus. The accepted shape of the WSSV virion has been as ellipsoidal, with a tail-like extension. However, due to the scarcity of reliable references, the pathogenesis and morphogenesis of WSSV are not well understood. Here, we used transmission electron microscopy (TEM) and cryogenic electron microscopy (Cryo-EM) to address some knowledge gaps. We concluded that mature WSSV virions with a stout oval-like shape do not have tail-like extensions. Furthermore, there were two distinct ends in WSSV nucleocapsids: a portal cap and a closed base. A C14 symmetric structure of the WSSV nucleocapsid was also proposed, according to our Cryo-EM map. Immunoelectron microscopy (IEM) revealed that VP664 proteins, the main components of the 14 assembly units, form a ring-like architecture. Moreover, WSSV nucleocapsids were also observed to undergo unique helical dissociation. Based on these new results, we propose a novel morphogenetic pathway of WSSV.