This Week in Parasitism
TWiP is a podcast about the tiny creatures that live in and on us.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPniks solve the case of the Man With AIDS, and explore how secretion of extracellular vesicles influences the social motility of Trypanosoma brucei.

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Case Study for TWiP 130

Back in Peru. 24 yo female seen in ER, lives in rural area outside of big city, adobe house in highlands, thatched roof, dirt floor, 3000 meters. Quite ill with skin lesion for 48 h. 2 days before was pulling on pjs, felt sharp sudden pain in right upper leg. Next day found small living creature in pajamas, inguinal region. Developed red lesion, enlarged, developed black central dot. Then begins vomiting, comes to hospital. No fever, breathing fast 20, hr 70, bp 160/10, on exam see in right inguinal region an enlarging, necrotic area 1-2 cm, starting to look sick. Whites at 26000, left shift, 200 platelets, eosinophils 4%, bilirubin 3.5, creatinine 4.9 (going into renal failure, not making much urine). Hematocrit 14, BUN 59.7, CPK 227, RBCs and leukocytes in urine. No health problems, no surgeries, first interaction with health system. No toxic habit. Brings in the small creature!

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP130.mp3
Category:Science -- posted at: 11:04am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiP Masters solve the case of the Australian Wildlife Carer, and review evidence that nodding syndrome may be caused by an autoimmune reaction to the parasitic worm that causes river blindness.

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This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free with your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip.

Case Study for TWiP 129

Young male in 30s, presents to ER with male partner, NY area, chief complaint over 1 month significant diarrhea, watery, non bloody. Abdominal cramping. Feels poorly, low energy, fever. Some vomiting, lost noticeable amount of weight, can’t stay hydrated. Past: AIDS positive, not on meds, last CD4 <50, viral load elevated and uncontrolled. Non contributory family history, no meds. Social history: had worked in office, can no longer; lives with male partner; occasional alcohol, no pets, no other significant exposures. Partner also AIDS, also not on therapy. Physical: febrile, 38.5C, 115 bp, 95/65, 18 resp, thin male, clearly uncomfortable. Oral thrush in buccal mucosa. No subungual saliva. Lungs clear, abdomen diffusely tender, increased bowel sounds. Labs: elevated creatinine, BUN, decreased sodium, elevated WBC count with significant eosinophilia. No pets or houseplants. 

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP129.mp3
Category:Science -- posted at: 2:00pm PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPerati solve the case of the Man Who Sat in Feces, and discuss a study on how Dickson's favorite parasite induces the formation of a collagen capsule.

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This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free with your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip.

Case Study for TWiP 128

Daniel doesn’t expect anyone to get this. From Australia, 80 yo retired teacher from Atherton, northheast Australia, presents to clinic with generalized weakness, concern of chronic lyme or Q fever. Seen by neurologist, concern about motor neuron disease. 18 months of illness, insidious onset of limb (arms and legs) weakness. No issues with speaking, swallowing or breathing; no weight loss; no fever, sweat, chill. History of osteoarthritis, joint replacements; myocarditis; vertigo; allergic to pen and dox. Father, rhematoid arthritis, brother colon cancer. On a number of medications. Does extensive travel, when not traveling, is a volunteer carer in Australia (abandoned wildlife), over the past three years. Lives with husband. Marsupials, hand feeds puggles and juvenile spiny anteaters, has pet cockatoo. No history of polio, HIV negative. Neuro exam: diffuse non tender muscle with no rash. Normal upper and lower limb tone, strength is symmetrically reduced proximally. Reflexes good at knees, normal sensation to all modalities. Normal cranial nerve exam. Test results: has eosinophilia, elevated muscle enzymes, EMG shows myopathic changes, nerve conduction normal. Stop statin therapy, no change. This is a rare parasite.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP128.mp3
Category:Science -- posted at: 7:56am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPsters solve the case of the Peace Corps Volunteer with a Liver Lesion, and discuss the dependence of Leishmania survival on the gut microbiome of the sandfly.

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This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free with your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip.

Case Study for TWiP 127

The last of our trio for the Peace Corp, an eosinophilia case. 29 yo pc volunteer in Rwanda, male, 3 weeks of feeling poorly. Starts with rash on lower back and upper legs, maculopapular rash. Fatigue later, cough, then diarrhea, 51% eosinophils (9000). No significant exposure to fresh water. Stool sent for oandp. Said sat down and got something on behind, realized later was feces, this was where rash developed. OandP seeing larva in stool. HIV neg, no med issue, no surgeries, no Kava. 

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP127.mp3
Category:Science -- posted at: 4:47am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiP Trinity solve the case of the Peace Corps volunteer with diarrhea, and reveal how immunizing against a virus ameliorates exacerbated leishmaniasis.

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This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free - WITH FREE SHIPPING - by going to blueapron.com/twip.

Case Study for TWiP 126

Another Peace Corps volunteer in Fiji. 24 yo male, several days of fever, headache, dry cough, rash. Feels poorly, starts diarrhea. No blood or mucus, no vomiting but abdominal discomfort. Heart rate over 100. At private nearby hospital for evaluation: no prior med probs or surgeries. Social history: MSM, not always protected, drinks every weekend. Home blown away by cyclone. Alcohol: drinks beer, a lot. White rice, split peas, bread diet. Fan of cava, also drank unfiltered water. He is admitted, continues to feel poorly. Continued fevers, localized abdominal pain RUQ. On exam he has tender palpable liver, elevated WBC 17.8, eosinopenia, 0 cells. AST/ALT slightly above normal. Dengue, chick, lepto, blood all negative. Ultrasound of liver: shows 8x8 cm mixed echogenic lesion in right lobe. HIV negative. 

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP126.mp3
Category:Science -- posted at: 8:22am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPonderers solve the case of the Timber Worker with Severe Shaking Chills, and describe an experimental malaria vaccine comprising attenuated sporozoites produced by genetic engineering.

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This episode of TWiP is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free - WITH FREE SHIPPING - by going to blueapron.com/twip.

Case Study for TWiP 125

Thanks to the Peace Corps - 24 yo female serving in Cameroon, teaching English and science at local school. Been in country 5 months, first 3 lived with host family, now in own home in community with electricity, 12 hr from Yaounde, capital. Reports intermittent diarrhea, loose stools, abdominal discomfort. No prior problems, no problems in family. No meds. No drinking or smoking. Lots of animals present, roam into class. Eating all local fare, cooks some, or buy locally. Eats fish, vegetables, no fish. Sleeps in house with mosquito nets. Not sexually active, AIDS negative. Young kids at school 6-12 yo, 20 in room. Does not eat at school. Not clear if water is treated. Not on antimalarials. Going on for a few a few weeks. No fever, no rash.

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP125.mp3
Category:Science -- posted at: 11:42am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The prolific podcast-shedding Hosts solve the case of the Global Health Intern with a snakelike lesion on her foot, and reveal the role of a single-stranded DNA binding protein in differentiation of trypanosomes.

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Case Study for TWiP 124

28 yo male from referral hospital near thai-burma border. Fever and chills 2 days, feels poorly, small amount of dark urine. Severe shaking chills, 1x per day, no rash. No diarrhea, difficulty breathing. Seen by local health care volunteer, went to hospital then tertiary hospital in Bangkok. Exposure history to pigs, dogs, insects, etc. Involved in timber industry and farming, sleeping out at night with no cover, clothes and sandals. No meds. Not married, family lives with him. Family is fine. Sleep in dwelling but no screens. No toxic habits, HIV negative, sexually active but not brothels. High fever, low bp, rapid heart rate, breathing rapidly, scleral icterus, dry mucus membranes, neck supple, lungs clear. 2/6 systolic murmur. Abdomen soft but tender, enlarged liver and spleen. Many cuts, bruises, bug bites. Labs: low platelets, low hematocrit, low glucose. Blood smear: abnormal, 5-10% infected RBCs with multiple band forms. 

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP124.mp3
Category:Science -- posted at: 5:31pm PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPanorama solve the case of the Dutch Woman with Wormy Objects in Her Stool, dissect a study on cytoadhesion of malaria infected red blood cells, and introduce Parasitology Superheroes.

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This episode is sponsored by CuriosityStreama subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

Case Study for TWiP 123

Nurse in early 20s, recent grad, decides to spend year in global health internship in western DR/Haitian border. On her foot has skin issue: told is fungal infection, using antifungal cream, is getting worse. Several days, only on one foot. Healthy, no past med/surg/allergies, no meds, no HIV, lives with local family. Daughter, wife, husband, cat. No toxic habits. Originally from US, swims, walks barefoot to and from, shoes off in house. Easts local food, exposure to dogs, cats, sister. Very itchy, but not open; rash area is raised. Blistery in certain areas, involves different areas in different days, snakelike. 

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP123.mp3
Category:Science -- posted at: 3:15pm PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPniks docs solve the case of the Female from Peru with Epistaxis, and discuss the effect of community deworming on immunosuppression.

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Links for this episode:

  • Community deworming and immune hyporesponsiveness (PNAS)
  • Paul C. Beaver (onetwo)
  • Photo by Oscar Adam Oscarson
  • Letters read on TWiP 122

This episode is sponsored by CuriosityStreama subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

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Case Study for TWiP 122
First of a series of cases with a theme, a 23 yo female international aid worker, chief complaint of diarrhea. Dutch descent, born in US, been in rural area of western DR, close to Haitian border. It’s been raining, houses have tin roofs, other flat concrete, rainwater pours off. Child comes by with mangoes, she buys one, washes it in rain water from the roof. Bites open mango, peels it, eats mango. The same night she is not feeling well, loose stools, abdominal discomfort. Next day, goes with group to border town; then has full fledged diarrhea. Looks into toilet, sees white objects 1 cm in length on stool, and they are moving. Uniform width, thinner than long, wormy looking. Has been participating in other activities in this area, swims in local river, walks barefoot, eating lot of local foods. Lunch: rice, beans, cooked meat, avocado. Dinner, yucca, fried salami, etc. Healthy before, no family history, not on meds, living with one of local families, no toxic habits. Dogs, cats, pigs, chickens around. One month earlier, cat in family home had kittens, she played with them. Very excited about that. Local physician contacted, he treats her. 

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP122.mp3
Category:Science -- posted at: 1:23pm PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPanosome docs solve the case of the Mali Man with Profuse Diarrhea, and review the presence of Trypanosoma cruzi in vectors, canids, and humans along the Texas-Mexico border.

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This episode is sponsored by CuriosityStreama subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

Case Study for TWiP 121

Back to Peru. 55 yo female from highland central valley area near Cuzco. Works in farming, no prior skin lesions but has multiple hypopigmented scars on exposed extremities (trauma during working), now reports many years of bloody nasal discharge. Seen in Lima by Daniel in outpatient clinic. No other medical problems, no surgeries, no allergies, everyone in family fine, husband and kids. Still working. No travel except to see doctor. Exam in right nare: ulcerated lesion inside nose, muco-cutaneous lesion. Simple test will decide. No anemia, no fever. Not eosinophilic, labs normal, HIV negative.

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP121.mp3
Category:Science -- posted at: 6:48am PDT

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

The TWiP triumvirate solve the case of the Thai Woman with Facial Swelling, and explain how Th17 T cells protect against the intracellular parasite Trypanosoma cruzi.

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This episode is sponsored by CuriosityStreama subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

Case Study for TWiP 120

A 48 yo man from Mali comes to hospital ER in Washington Heights in NY with profuse watery diarrhea. Born in Mali, came to US at 18, working in US as long haul truck driver for 30 y, frequently visits Mali, recently to attend his father’s funeral. Got symptoms one week after return (was there for 3 weeks). 3 liters diarrhea/day. No past med/surg history, not seen doctor in long time. No allergies. Unknown what father died of, Mother in Mali is ok. No medications. Some alcohol, marijuana use. Does report that has exposure to professional female sex workers, no condoms. Temp of 39 C, bp down 80/40, heart over 110, rapid breathing high 20s, cachectic. Wasted. Fungating lesion perianally. Undergoes HIV testing, clade B. T cells <100. 

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP120.mp3
Category:Science -- posted at: 6:56pm PDT

Hosts: Vincent Racaniello and Daniel Griffin

Vincent and Daniel solve the case of the Family with Eosinophilia, and discuss HIV-1 infection and genome integration in the blood fluke Schistosoma mansoni.

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Links for this episode:

This episode is sponsored by CuriosityStreama subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

This episode is also sponsored by Drobo, a family of safe, expandable, yet simple to use storage arrays. Drobos are designed to protect your important data forever. Visit www.drobo.com to learn more.

Case Study for TWiP 119

This one will be kinder and gentler case. Back in Thailand but could be in several places. 25 yo Thai woman from Bangkok, to hospital, chief complaint facial swelling. Eats typical Thai diet (see previous episodes!) Som tum, etc fish that is not cooked. Migratory - moves around face. Not tender, but mild itchiness. For about a week, no pain. Healthy, no past med/surg history, family all fine. HIV negative, no drugs, no travel. On examination, has swelling on right side, 3-4 cm raised, little redness, firm, does not feel like fluid filled. No fever, no GI problems, no bloods. WBC up, eosinophils up. 

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP119.mp3
Category:Science -- posted at: 1:54pm PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPinella solve the case of the Woman from Guinea, and describe the use of CRISPR/Cas9 to identify essential apicomplexan genes.

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This episode is sponsored by CuriosityStreama subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

This episode is also sponsored by Drobo, a family of safe, expandable, yet simple to use storage arrays. Drobos are designed to protect your important data forever. Visit www.drobo.com to learn more.

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Case Study for TWiP 118

Little bit of a twist - a human family with eosinophilia. Conveyed by good friend/colleague ID physician. Australia, NSW, 45 yo Dad, having problem with mild abdominal distention. Seen by doc in Sydney, CBC shows eosinophil count of 10,500. Wife of same age reports feeling fine, but gets CBC and also shows eosinophils of 5,200. Two daughters, 17 and 19, no symptoms, bloods: 900 and normal eosinophils. One week prior to dads symptoms, sister in law came (also in NSW) and stayed, developed severe diarrhea, discomfort, bloating, weight loss, eosinohils 4,700. Eat raw fish (not known if fresh or salt) purchased at local markets. No overseas travel or out of urban environment. No pets, no home grown foods. Went back to previous labs and found normal eosinophil levels. Full workup for strongyloides, all negative. No HIV. No toxic habits, no remarkable medical history.

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP118.mp3
Category:Science -- posted at: 11:00am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The parasite prophets solve the case of the Thai Man with Abdominal Distention, and discuss the finding that metastatic leishmaniasis dependent on a virus can be prevented by blocking IL-17A.

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This episode is sponsored by CuriosityStreama subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

This episode is also sponsored by Drobo, a family of safe, expandable, yet simple to use storage arrays. Drobos are designed to protect your important data forever. Visit www.drobo.com to learn more.

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Case Study for TWiP 117

Woman 66 yo born in Guinea, grew up the moved to US past 10 years, just retired. Lives in Washington Heights. Mother having issues in Guinea, so went back for 3 months in 2016. Just came back a week ago, reporting headache, fever, feeling poorly. Staying in big city, with Mom (80s). Has own private toilet in nice home. No screens or bednets. Married for 40 years, recently divorces. Has had 10 children. Not sexually active. Starts with high fever, breaks, then 2 days later another for several hours, goes to ER. Given Ebola screening questions, negative, do some blood work, send her back out. 2-3 days later high fever, double vision, headache, comes to Columbia ER. No diarrhea, no urination discomfort. Has backache, feels that mouth is dry. Was admitted. Past med history: high bp, cholesterol, diabetes; not overweight; appendix out; has unknown reaction to novocaine. No smoking, drinking. Physical: 39.4 temp, 14-16 breath rate, heart rate over 100, rapid heartbeat, 2/6 systolic murmur with radiation to left carotid (flow murmur). No jugular venous distention. Abdomen right upper quadrant: slight enlargement of liver, not tender, can palpate spleen tip in left upper quadrant, slightly enlarged spleen. Normal bowel sounds, no rash. Blood: elevated white count, bands 9%. 0.1 eosinophils, platelets 79, hemoglobin 11. Bilirubin 1.5, bicarb 20, chest xray clear. Red cells: small, 79.4 mcv. Animals: don’t like animals! In middle of rainy season. Likes to walk outside in rain during day. No cats to keep out rodents. Food: all food is prepared in home. Eats all favorite foods: rice. No sick contacts, no exposure to health care setting, no bug bites. 

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP117.mp3
Category:Science -- posted at: 1:37pm PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPtoids solve the case of the Thai Fisherman with Chronic Diarrhea, and reveal a potential new drug for treatment of leishmaniasis, Chagas diseases, and sleeping sickness.

Links for this episode:

This episode is sponsored by CuriosityStreama subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

This episode is also sponsored by Drobo, a family of safe, expandable, yet simple to use storage arrays. Drobos are designed to protect your important data forever. Visit www.drobo.com to learn more.

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Case Study for TWiP 116

This week's case involves no math. 36 year old Thai man from the northeast part of the country. Comes in with abdominal distention. Eats a normal Thai diet - Som Tam, Koi Pla, lots of rice. Feels well, came in because he is getting yellowing of skin and whites of eyes - jaundiced. Previously healthy, no prior med prob or surgery. No diseases running in family. Fisherman in the northeast (freshwater). Wife and many children, monogamous, HIV negative. Lives in jungle area, near river, many dogs, chickens, monkeys, goats, cows, pigs. Bathroom is outside. No fever, thin. Distention going on for months. Getting bigger. Exam: jaundiced, has large palpable non-tender mass below liver on his right side. No enlarged liver or spleen. No travel. 

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP116.mp3
Category:Science -- posted at: 5:05pm PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPlets solve the sad case of the Boy Who Went Swimming, and explain why the tomato is resistant to the plant parasite Cuscuta.

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This episode is sponsored by CuriosityStreama subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

This episode is also sponsored by Drobo, a family of safe, expandable, yet simple to use storage arrays. Drobos are designed to protect your important data forever. Visit www.drobo.com to learn more.

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Case Study for TWiP 115

This week's case is more challenging, but with a better outcome than last time. Thailand: 32 year old Thai man from southern coastal part of country, comes to ID hospital in Bangkok with two months of watery diarrhea. Rapid onset. Looks emaciated, protuberant belly. Ten times per day, has trouble flushing feces in toilet, floats. Eats normal fare, boat noodles, fish, rice, vegetables. Som tam - fish sauce from raw fish. Also with salted crab, not well cooked. No unusual past med history, healthy fisherman, no medication. Married with kids, everyone healthy. No bad habits. Monogamous. HIV negative. Liver, spleen not enlarged. Abdominal xray with contrast: loss of villi. Good appetite. No abdominal pain. Too weak to work. No vomiting.

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP115.mp3
Category:Science -- posted at: 7:27am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiP troika solve the case of the Female from the Bronx, and reveal how feeding on different plants affects mosquito capacity to transmit malaria.

Links for this episode:

This episode is sponsored by CuriosityStreama subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

This episode is also sponsored by Drobo, a family of safe, expandable, yet simple to use storage arrays. Drobos are designed to protect your important data forever. Visit www.drobo.com to learn more.

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Case Study for TWiP 114

12 year old boy brought to hospital ER by parents with severe headache, stiff neck, fever, decreased alertness. No rashes. Has been healthy with no prior medical problems. No one else in family is ill. In summer, boy has been engaged in usual summertime activities: soccer, swimming in warm freshwater, playing outside. Undergoes lumbar puncture for CSF: start on meningitis treatment. No surgeries, no allergies. Not on any meds. Lives with Mom, Dad, few brothers. No substance abuse. Not a geographically limited illness. Has had bug bites - lots of mosquito bites. Dogs around as well. Symptoms began a day or two before hospital visit. Eats whatever family eats, food is cooked. Exam: 39.4C, bp low, heart rate up, resp up, decreased responsiveness, stiff neck, looks ill. WBC elevated, neutrophil predominant, eosinopenia. CSF glucose low, cells increased, no bacteria, fungi, acid fast bacilli on stain. CT scan, diffuse swelling of brain. Doing poorly, not a good outcome.

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP114.mp3
Category:Science -- posted at: 2:24pm PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

Guest: Jason Zucker

The TWiP ternion solve the case of the Man from Mexico, and discuss a transgenic toxoplasma vaccine for chickens using Eimeria tenella.

Links for this episode:

  • Transgenic Eimeria as a toxoplasma vaccine (Sci Rep)
  • Image shows cysticercus of T. solium in brain (Parasitic Diseases, 5th Ed)
  • Letters read on TWiP 113

This episode is sponsored by CuriosityStreama subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

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Case Study for TWiP 113

22 yo female comes to clinic in Bronx, reports one week of vaginal discharge and itching. Looks bad, yellowish. Sexually active with boyfriend. He has no symptoms. Some discomfort on urination. Healthy, no prior surgeries, no allergies. Mother with diabetes, father has high bp. Takes oral contraceptive pills. Not employed, lives with mother and sisters. Substance abuse: some on occasion, marijuana and alcohol, no i.v. No pets. Diet: lot of fast food. Physical exam: slightly heavy, normal but vaginal exam: discharge, thick, slight yellow light green color, no strong odor, some redness to vaginal walls, no changes to cervix. 2 weeks from last menstrual period. 

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Direct download: TWiP113.mp3
Category:Science -- posted at: 8:07am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiP trio solve the case of the Woman from Washington Heights, and reveal how helminth infection protects mice deficient in the Crohn's disease gene NOD2 from intestinal disease by inhibiting colonization with an inflammatory bacterial species.

 

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Case Study for TWiP 112

A case here at CUMC, 59 yo male, past medical history of childhood polio, presents with worsening lower extremity weakness, bowel and urinary incontinence. 2 year before worsening back pain, weakness, could not work. Cannot walk up one flight of stairs since 1 month; 1 week prior to admission had fever, no headaches, diarrhea, cough, or any other symptoms. Splits time between Washington Heights and Mexico. Construction worker. Rural town in southern Mexico, 10 months of the year. Worked in the corn growing area. Has been exposed to bugs. Stopped working in cornfields 20 years ago. Has son and daughter, visits them. Lives with wife, stays in Mexico, she is fine. HIV negative. Eats home prepared foods, no dietary restrictions. Physical exam: not febrile, vital signs all good, neurological: upper strength good, weakness in hip flexors, ⅗; quadriceps, but ⅕ in lower extremities ⅖ in right. Sensory has decreased as well. Possibly spinal lesion. Labs: elevated glucose, ESR 33, CRP 2.2, whites 8, 30.6 hematocrit, guaiac negative. Imaging: MRI of spine shows normal vertebrae, T9/10 inflammation of spinal cord, mass lesion, compromise of canal. Brain MRI: hydrocephalus. Problem with recirculation of CSF. 

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Direct download: TWiP112.mp3
Category:Science -- posted at: 12:26am PDT

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

The TWiP trio solve the case of the bug bites all in a row, and talk about a secreted Toxoplasma protein that is central to the parasite's manipulation of host cells.

 

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Case Study for TWiP 111

82 yo woman living in Washington Heights NYC 10 days of watery diarrhea, not smelly, does not float. Wakes her up at night. No fever, sweats at night. Losing some weight, appetite. No recent travel. Born in DR early 1930s, moved to US age 30. Sometimes goes back but not for several years. Springtime. Lives with extended family, only one sick. Eats whole assortment of cooked foods, rice, beans, fresh fruits. Drinks tap water. Not working. No pets. Stays mostly inside. History of reflux, high blood pressure, cognitive decline, diagnosed with temporal giant cell arteritis. Put on prednisone, doing better. Has had gall bladder removed. HIV negative. Extended family works in city, no taxi drivers. Belly uncomfortable for >week. Temp 38.1, BP 116/78, HR 105, breathing 12/min. Exam: looks ill, has diffusely tender abdomen, decreased bowel sounds. Liver, spleen not enlarged. Oriented. Has rash on abdomen: odd patchy distribution, looks like multiple thumbprints, front of belly, extending from umbilicus. White count 8, 78 polys, 14 lymphs, 4 mono, 1 eosinophil. Sodium 129, BUN 15, Creat 0.6. Urine histoplasma negative, TB test negative.

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Direct download: TWiP111.mp3
Category:Science -- posted at: 9:08am PDT

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

Guest: Paul Calle

The TWiP trio visit the Bronx Zoo where Paul solves the case of the Four Year Old with Pulmonary Edema, and talks about his career as the Chief Veterinarian and Director of the Zoological Health program for the Wildlife Conservation Society.

 

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Case Study for TWiP 110

This week's case involves humans. Young woman, 40s, concerned about bug bites. Several weeks ago her 13 year old daughter woke up in morning, reported bug bites. Several small, red, raised itchy areas, 3-4 in a line, just above belt line. They go on vacation in Europe, no problems. Upon return, several weeks later the Mother woke up with a similar pattern. Then second daughter has the same problem. Family lives in NY metropolitan area, which is an epicenter for this problem. Always on trunk, not on arms or legs. No travel before the first daughter's bug bites. Husband does not report any problems. Family spends a lot of time outdoors, live in suburban wooden area.

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Direct download: TWiP110.mp3
Category:Science -- posted at: 2:11pm PDT

Hosts: Vincent Racaniello and Daniel Griffin

Guest: Paul

Daniel and Vincent solve the case of the Truck Driver from India, discuss why parasites resistant to an antimalarial drug are not transmitted by mosquitoes, and introduce Paul who presents a new case study.

 

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Direct download: TWiP109.mp3
Category:Science -- posted at: 5:40pm PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The case of the Man from Assam is solved, and phagocytosis of Leishmania by B-1 cells is brought to you by the Three Twipeteers on this episode of TWiP.

 

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This episode is sponsored by ASM Agar Art Contest and ASM Microbe 2016

Case study for TWiP 108

Todays case is a 26 yo male longhaul truck driver from northern tiger country of India. Comes into hospital at end of rainy season with 6 days of fever, chills, muscle aches, small loose stools, vomiting, trouble breathing, cough, decreased urine output. Lives in mud hut with coconut leaf roof. No one else in family  is sick (wife, two children). Significant animal and insect exposure (dogs, cows, monkeys). Got sick after coming home from a trip up north. No significant medical probs, no surgery. Really sick. Pain everywhere. Occasionally drinks palm wine. Some yellowing of eyes. Has lost a little weight. Ketonic breath. Exam: 39 fever, bp 100/71, 126 heart rate, 24 resp rate. Looks distressed, not fully sharp. Nothing focal on lung exam. Belly tender, esp upper right, spleen enlarged. Liver is tender but not enlarged. Some labs: bun elevated 102, creatinine elevated, Hg decreased 11, platelets 9000 (down), white count 10.3 no eosinophils. LDH 8000 AST/ALT normal, bilirubin 21. Never been this sick.

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Direct download: TWiP108.mp3
Category:Science -- posted at: 6:49am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPtastic trio solves the case of the Surfer from Switzerland, and reveal how taste-chemosensory tuft cells in the gut regulate immune responses to parasites.

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This episode is sponsored by ASM Agar Art Contest and ASM Microbe 2016

 Case study for TWiP 107

Todays case is a fun case about a 45 year old gentleman from Assam India, with sixteen years of fever, abdominal pain, darkening of skin, yellowing of eyes. Farmer, does not have much energy. Works barefoot in fields. Fever occurs every other day. Prior medical problems, nothing out of the ordinary. No surgeries, no meds, has never seen physician. Married, kids, no extramarital affairs, HIV negative, eats mostly cooked vegetables. Lives in concrete house, no screens, mosquito netting. Other people in area have similar problems. Water comes from pump, fill plastic jugs. Been in Assam sick his whole life, finally came to regional med center for evaluation. Underweight. No pets. Dogs around, avoids dogs. Cows, monkeys are around. Fair appetite. Exam: febrile, in face can see darkening which is increasing, also extremities. Whites of eyes are yellow (jaundiced). Striking is has a very large liver, spleen. Elevated bilirubin. Some increased liver enzymes. No physical scarring or lesions.

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Direct download: TWiP107.mp3
Category:Science -- posted at: 8:45am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiP triumvirate solves the case of the Missionary in Kenya, and review the finding of a soldier caste in flatworms that parasitize snails.

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This episode is sponsored by ASM Agar Art Contest

 Case study for TWiP 106

This week's case comes from an ophthalmologist colleague Florian in Switzerland. Swiss female, early 20s, returns after surfing vacation in northern Africa. Accommodations were rustic, lots of animal and insect exposure, right on the beach. No screens. Had loose stools there, now left eye is bothering her, eyelid swollen, eye red. This happened after return. Thinks she has seen things moving around in her eye. Opthalmologist gave eyedrops, now looking for second opinion. Healthy, no med/surg/allergies, no meds, student lives alone, occasional alcohol. No AIDS. Surfing in Morocco. Lots of insect bites. Little tiny things moving around in eye, on surface when she looks in mirror. All blood work was negative. Florian inspects her eye, surprised to see several tiny mobile objects, headed towards lacrymal ducts. Is able to grab one, about 1 mm long, plucks three off.

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Direct download: TWiP106.mp3
Category:Science -- posted at: 10:07am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPanosomes solve the case of the Young Man from Anchorage, and discuss how cestode parasites increase the resistance of brine shrimp to arsenic toxicity.

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 Case study for TWiP 105

This week's case involves a 32 yo male with several concerns. Spent 6 weeks doing religious missionary work in Kenya, performed baptisms in Lake Victoria.Waist deep in water, no shoes. Took malaria drugs, ate lots of interesting foods: cichlids, ugali, corn based food, flavored with greens; stew with some sort of meat, beef and goat. Five weeks after return developed rash with fever, shortness of breath. Three of four friends who were with him in Kenya reported similar symptoms. The fourth who did not get sick did not go in water, nor did he eat very much. No medical/surgical history, no drugs. Had some sexual activity while there. Elevated white count, 70% eosinophils. Chest CT shows nodules in lungs. Doc told him, allergy, you will be fine. The water he went into is near a village, there are rodents nearby, and a runoff.

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Direct download: TWiP105.mp3
Category:Science -- posted at: 7:45am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

Guest: Michael Libman

Michael returns to help the TWiP trio solve the case of the Delusional African Expatriate, and discuss the association of natural and induced antibodies in mice with differential susceptibility to secondary cystic echinococcosis.

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 Case study for TWiP 104

This week's case involves a young man in his thirties, admitted in hospital in Anchorage AK in early June. Chief complaint, severe muscle pain and tenderness. Usually healthy guy, 1 week ago had bad case of diarrhea with belly pain and vomiting, lasted a full week. Now has fever. Concerned because wife now is having diarrhea. Unremarkable history, unknown family history. HIV negative. All childhood vaccinations. Does not eat raw meat. No meds, does seasonal work, social drinker. Came back from successful hunt, got a black bear. Dressed in field, cooked at home really well. Wife also ate bear meat. Bear meat is in freezer. No vegetables. Also eats salmon which he caught the previous season, then frozen. Drinks water from the stream when he hunts. Physical exam: hot, 38.5, bp 115/75, pulse 105, breathing comfortably. Anxious, swelling around both eyes. Sclera not noted. Labs: WBC elevated 14,000, 30% eosinophils; chemistries fine; muscle enzymes LDH, CK elevated.

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Direct download: TWiP104.mp3
Category:Science -- posted at: 6:05am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

Guest: Michael Libman

The TWiP-scholars solve the case of the Housewife from Kolkata, discuss mutations in the IL17 gene associated with cerebral malaria, and hear a case presentation from guest Michael Libman.

 

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 Case study for TWiP 103

This week's case concerns a 42 yo male, refugee in Canada, from DRC, former Zaire, where there is unending civil war. Upper middle class, professor of French at university. Had been imprisoned, tortured, lived in jungle for a few years, reached refugee camp in Tanzania, moved to Canada. Came to health care system 15 months after arrived. Was sent to psych, unstable emotionally, delusions, hallucinations, depression, post traumatic issues. Was under psych care for ~1 yr, did not improve, became worse. Sent to hospital. History: talked about having minor injury, hurt lower back, pain there bothering him. Some anemia (normochromic), basic hem/chem/urine/liver nothing remarkable. Physical exam, nothing remarkable. HIV negative. Some evidence for chronic inflammatory condition: sed rate 60 (elevated), had diffuse increase in IgG, IgM. Developed some low level autoantibodies; anti-nuclear, p-anka, anti-neutrophil cytoplasmic antibodies. Slightly elevated fever for a few days, then few days or week with no fever. No eosinophilia. Radiology: on CT did have some mediastinal, aortic, axillae, lymphadenopathy. Prob screened in Africa for malaria and treated; prob also got ivermectin. Also got head MRI: not completely normal, classic nonspecific midbrain abnormality. Diffuse mild edema. Weight loss remarkable. No visual problems.

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Direct download: TWiP103.mp3
Category:Science -- posted at: 7:42am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPyzoites solve the case of the Uncommon Parasite, and discuss the role of eosinophils in promoting the growth of Trichinella in skeletal muscle.

 

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 Case study for TWiP 102

This week's case involves a 24 yo housewife, from a village outside of Calcutta. Comes into a tertiary care hosp, 6 months coughing up blood, fever, no weight loss. Drinks rainwater, milks her cow. Dogs everywhere, no livestock except cows. Eats meat, well cooked. No extramarital encounters. Husband well. 4 children. Cistern for drinking water is covered.  No health issues. Reports salty, clear mucus. No blood in stool, no changes in stool. Exam: looks healthy, lungs clear. Lab tests: White count of 9000, 12% eosinophils (elevated). So she has eosinophilia. Chest X-ray and CT: lesion on left side in xray. CT: shows 4 cm cavity, with air pocket on left side, mid-lung. HIV negative. Dusty soil, birds.

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Direct download: TWiP102.mp3
Category:Science -- posted at: 9:36am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The doctors TWiP solve the case of the Woman with White Worms, and explain the role of a secreted growth factor from a carcinogenic parasite in wound healing and angiogenesis.

 

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Listener Pick

Ramon - Ancient Rome was infested with parasites

Case study for TWiP 101

This week's case involves an uncommon parasite. Young girl, <10 y, brought in by parents from rural area to regional hospital with fever, diarrhea for 2 weeks. No blood in stool. Parents: few weeks prior to problems, young girls went with family on wild pig hunting trip. With guns. Girl did consume pig on trip, all meat was very well cooked. Was involved with preparation of meat with Mother only. No one else got sick. No surgery, no allergies. Both parents have diabetes. Has four brothers. Some weight loss. This is outside the US. Physical exam: low grade fever, diffuse mild abdominal discomfort, slight microcytic anemia, size of cells is slightly smaller than normal. WBC: normal, except no eosinophils. Blood cultures negative. Stool examination is where we get our answer.

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Direct download: TWiP101.mp3
Category:Science -- posted at: 5:42am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiP trifecta solves the case of the Woman from Bolivia with Belly Pain, and discuss a method for population modification of malaria mosquitoes using a Cas9-mediated driver gene.

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Case study for TWiP 100

This week's case is a 27 yo female, native NY, referred to outpatient at CU after seeing OBGYN, told had seen worms in stool and underwear. Inch or two in length, pale white, round, moving, 2-3 weeks of constant abdominal bloating. Sexually active. No particular diet. Travel: works for NGO, refugee camp in Ethiopian-Sudan border, southern Sudan. Last visit month ago. Noticed worms when she got back from last trip. Eats what local people eat. Raw food popular there: kitfo, raw steak tartare, with melted butter. Made from local beef. Did not take malaria prophylaxis, did not avoid local water, does wear sandals. College graduate. Nothing remarkable in family. CBC, liver, metabolic: all normal. Stool not normal: loose, no mucus or blood.

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Direct download: TWiP100.mp3
Category:Science -- posted at: 9:16am PDT

The TWiP trifecta solves the case of the Professor Who Went to Brazil, and discuss an amazing case of a tapeworm that turned into a tumor in an AIDS patient.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

 

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Case study for TWiP 99

This week's case is a 53 yo woman visiting family in US, comes in with intense belly pain, right upper part of belly. Has become strict vegetarian after having breast cancer, on raw vegetable diet (carrots, collect plants in local markets). From Bolivia. Lives in agricultural area, avoids sheep, fearful of dogs. Housekeeper. Married, lives with husband. Noticed pain when came to US. Breast cancer: localized, removed lesion, no therapy, months ago. No allergies, family healthy. No insect bites, lives in concrete house. Physical exam: not febrile, right upper quadrant is very tender, some liver enlargement. CBC: 10,000 white count, mostly eosinophils, liver function: AST, ALT, AlkPhos all normal. Neuro exam: normal. Five months before this diet, she did have normal diet. Some meat, drank milk.

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TWiP is a MicrobeTV production

Direct download: TWiP099.mp3
Category:Science -- posted at: 11:59am PDT

The TWiP-lets reveal Balamuthia infection in the Children from Peru, and discuss resistance to pyrethroids revealed by RNA sequencing of Anopheles mosquitoes.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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Case study for TWiP 98

This week's case is a Professor clinician, teacher, researcher.  In his 50s, he presents with lesion on big toe, anterior portion, tip, nodular. No surrounding redness, area is itchy. Has a small central black area the size of pencil tip, concerned because feels is getting larger over last week. Spooky. Travels, last in Brasil, had been for a few weeks, noticed toe issue a week after returned. Spent time on beach, but wore flip flops. Different types of beaches, crowded and not crowded. Went with wife. Healthy man, no prior medical problems.

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Direct download: TWiP098.mp3
Category:Science -- posted at: 7:02pm PDT

The paratenic hosts reveal a case of scabies in the Traveling Salesman, and discuss a role for natural antibody in protection from infection with Plasmodium.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

 

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Case study for TWiP 97

Daniel has two cases this week. Two people with similar presentations. A 12 yo girl in Peru presented for care with painless dark brown area on right knee. Has brothers and sisters, often play together. No trauma, but area is expanding. Months later develops cognitive changes. Second case is a 5 yo boy from the coastal region of Peru brought in by Mother, has red swollen area on face. Mom says while playing scratched nose, swelling right cheek, eye, nasal obstruction, no response to antibiotics. MRI of both show infiltrating process. Girl, left side of brain, middle cerebral artery territory. Boy in frontal region, midline area. Thus both skin lesions associated with infiltrating process in brain. Came into clinic months after lesions started, and lesions still present.

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Direct download: TWiP097.mp3
Category:Science -- posted at: 8:38pm PDT

The TWiPanosomes solve the case about the Young Woman who Went to Belize, and relate how sandfly saliva skews the immune response and increases risk of cutaneous leishmaniasis.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

 

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Case study for TWiP 96

Daniel's patient for this week is male patient referred for consultation by OB-GYN: his wife is pregnant, has been admitted and is about the give birth. It is her first pregnancy. There are concerns about the husband's skin problem and whether it is a threat to his pregnant wife. No lesions on woman, husband recently developed itchy skin problem on his hands. Bilateral. Small papules on webs of fingers, brown lines, blood clots at ends, has clearly scratched the lesions. Skin between fingers is involved. Travels, often stays in cheap hotels. Beds not clean. Last trip 1 month before symptoms.  Midwest travel. Family history of heart disease. Sales occupation. No animal exposure. Travels to medium to large cities. 

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Direct download: TWiP096.mp3
Category:Science -- posted at: 5:52am PDT

Vincent, Dickson, and Daniel solve the case about the 33 year old Chinese male with watery diarrhea, and discuss whether arsenic in drinking water might lead to treatment failures for Leishmania infections.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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This episode is sponsored by ASMGAP.

Case study for TWiP 95

Daniel's patient for this week is a 28 yo single female, returns from beach vacation with new boyfriend. Two weeks in Central America (Belize). Often found secluded beaches. Good health, noticed upon her return had small nodules/papules on front of thighs. Thought were insect bites, became very itchy. Noticed serpiginous red lines forming, radiating out from bumps. Felt things moving in her skin. Benadryl did not help. Daniel say something similar occurs in Lima. Healthy, no allergies, surgeries, no relevant family history, using barrier contraception, sexually active. Only drinks alcohol socially. Boyfriend did not report symptoms. She did lie on sand, used thin fabric. Stayed in hotel. There were wild dogs on beach. During her stay she ate ceviche. No intestinal symptoms.

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Direct download: TWiP095.mp3
Category:Science -- posted at: 6:44pm PDT

Vincent, Dickson, and Daniel solve the case about the man from El Salvador, discuss the use of tyrosine kinase inhibitors to treat onchocerciasis and filariasis.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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Case study for TWiP 94

Daniel's patient was seen in the clinic. He is a 33 yo chinese male, from Chinatown NYC, for several months on and off has had watery diarrhea, headaches. Tried reflexology, chiropractic therapy, with no results. Has traveled quite a bit, been in Chile (was there a few months before). Came to US when young. Grew up in the US. In Chile, has had many sexual partners, >50, of both sexes, also has done many drugs. Two years ago was diagnosed with chronic HIV, CD4 count 685, on ARVs triple therapy, virus loads are well controlled. Has had syphilis, nose job, no medication allergies. Lives with family. On exam, afebrile, looks well. Symptom onset a few months after last Chile visit. Is an addventurous eater.

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Direct download: TWiP094.mp3
Category:Science -- posted at: 6:45am PDT

Vincent, Dickson, and Daniel solve their fishy tale, and present a new case study for your consumption.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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Case study for TWiP 92

 

April 2015 a 177 lb 5ft10in 39 yo man seen as outpatient in ID clinic, reports 2 y ago had issues with constipation on and off; throat hurts; feels closing when lies down. For several years has had skin irritation on upper chest and arms. Tried to donate blood, was rejected, told to see doctor.

Emigrated to US from El Salvador 2002, married, reports no extramarital sex, smokes 2-3 cigs/day, now quit; had drinking issue in past, no more; was agricultural worker in rural part of El Salvador; has history of asthma, on a number of medicines, including steriod nasal spray, inhaler, no visual problems, healthy appearing, not allergic to medicines. Family history: mother heart attack and diabetes; father peptic ulcer disease.

 

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Direct download: TWiP093.mp3
Category:Science -- posted at: 6:57am PDT

Vincent, Dickson, and Daniel discuss how fluctuation in the price of guinea pig food could help transmission of the agent of Chagas disease, and present a new case study for your consumption.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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  • Ascaris on TWiP 21
  • Ascaris lumbricoides life cycle (jpg)
  • Child with distended abdomen due to Ascaris (jpg)
  • Bottlenecks and Chagas disease (Proc Biol Soc)
  • Letters read on TWiP 92

Case study for TWiP 92

A 20 yo Japanese female student went to the emergency room with severe abdominal pain. nausea, had vomited. Had just enjoyed homemade sushi an hour or two previuosly. She prepared the sushi: rice, salmon, tuna rolls. Salmon was local, caught by boyfriend. Tuna from store, sushi grade. No past medical history, mother with anemia. Takes oral contraceptives. No toxic habits. No travel. Monogamous. Temp 100.2, bp 140/90, hr high 90s, breathing upper teens. Physical exam normal except appears distressed in pain, belly extended, tender in left upper quadrant. Friends ate sushi but no one else got sick. All guests ate both types of fish.

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Direct download: TWiP092.mp3
Category:Science -- posted at: 5:44am PDT

Vincent, Dickson, and Daniel review how Viagra might be used to block transmission of Plasmodium falciparum, and introduce a new case study.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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Direct download: TWiP091.mp3
Category:Science -- posted at: 5:26am PDT

Vincent, Dickson, and Daniel discuss identification of an erythrocyte protein essential for invasion of Plasmodium falciparum, and introduce a new case study.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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Direct download: TWiP090.mp3
Category:Science -- posted at: 8:38am PDT

Vincent, Dickson, and Daniel reveal last week's case study and introduce a new one concerning a patient who traveled to Belize.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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Direct download: TWiP089.mp3
Category:Science -- posted at: 8:40am PDT

Vincent, Dickson, and Daniel discuss how a secreted protein from the protozoan parasite Theileria transforms its host cells via a cellular proto-oncogene.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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Direct download: TWiP088.mp3
Category:Science -- posted at: 7:57am PDT

Vincent, Dickson, and Daniel review new insight into antigenic variation in trypanosomes, reveal the difficult solution to the last case study, and present another mystery for your solving.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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Direct download: TWiP087.mp3
Category:Science -- posted at: 8:55am PDT

Vincent, Dickson, and Daniel discuss how filarial infection modulates the immune response to mycobacterial infection, and reveal a new case study.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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Direct download: TWiP086.mp3
Category:Science -- posted at: 6:18am PDT

Vincent, Dickson, and Daniel explain how trypanolytic factor forms membrane channels to lyse trypanosomes, and present a new case study.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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Direct download: TWiP085.mp3
Category:Science -- posted at: 7:17am PDT

Vincent, Dickson, and Daniel consider the delivery of anti-trypanosome nanobodies to the tsetse fly via a bacterial symbiont, and present a new case study.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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Direct download: TWiP084.mp3
Category:Science -- posted at: 7:12am PDT

Vincent, Dickson, and Daniel present a new case study, and discuss the effect of chronic malaria infection on wild warbler life span and telomere degradation.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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Direct download: TWiP083.mp3
Category:Science -- posted at: 4:59pm PDT

Vincent, Dickson, and Daniel solve last week's case study, present a new one, and reveal how secreted proteins from a helminth prevent diabetes in mice.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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Direct download: TWiP082.mp3
Category:Science -- posted at: 9:42am PDT

Vincent, Dickson, and Daniel provide the solution to last week's case study, present a new one, and discuss how immune suppression by nematodes increases tuberculosis fatality in African buffalo.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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Direct download: TWiP081.mp3
Category:Science -- posted at: 10:15am PDT

 Vincent and Dickson welcome new TWiP host Daniel to discuss the association of a new Mycoplasma with Trichomoniasis, and to introduce a new feature to the show, a case study.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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Direct download: TWiP080.mp3
Category:Science -- posted at: 6:15pm PDT

Vincent and Dickson discuss the spread of P. knowlesi in Malaysia, and how Leishmania parasites protect the sandfly gut from bacterial infection.

Hosts: Vincent Racaniello and Dickson Despommier

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Direct download: TWiP079.mp3
Category:Science -- posted at: 7:30am PDT

Vincent and Dickson discuss how malaria parasites induce odors in their rodent hosts that attract mosquitoes.

Hosts: Vincent Racaniello and Dickson Despommier

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Direct download: TWiP078.mp3
Category:Science -- posted at: 5:23pm PDT

Vincent and Dickson discuss the exchange of messenger RNAs between a parasitic plant and its hosts.

Hosts: Vincent Racaniello and Dickson Despommier

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Direct download: TWiP077.mp3
Category:Science -- posted at: 7:25am PDT

Vincent and Dickson discuss how infection of mice with helminths induces cytokines that reactivate a latent gamma-herpesvirus.

Hosts: Vincent Racaniello and Dickson Despommier

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Direct download: TWiP076.mp3
Category:Science -- posted at: 1:25pm PDT

Bobbi Pritt joins Vincent and Dickson to talk about directing a clinical parasitology laboratory and her weekly case reports at Creepy Dreadful Wonderful Parasites.

Hosts: Vincent Racaniello and Dickson Despommier

Guest: Bobbi Pritt

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Direct download: TWiP075.mp3
Category:Science -- posted at: 8:58am PDT

Vincent and Dickson review a novel malaria vaccine candidate comprising a parasite protein involved in egress from red blood cells.

Hosts: Vincent Racaniello and Dickson Despommier

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Direct download: TWiP074.mp3
Category:Science -- posted at: 6:20am PDT

Vincent and Dickson discuss how nibbling of human cells by Entamoeba histolytica, a process called amoebic trogocytosis, contributes to cell killing and tissue invasion.

Hosts: Vincent Racaniello and Dickson Despommier

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Direct download: TWiP073.mp3
Category:Science -- posted at: 8:19am PDT

Vincent and Dickson discuss five ways that helminths manipulate host tissues to survive.

Hosts: Vincent Racaniello and Dickson Despommier

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Direct download: TWiP072.mp3
Category:Science -- posted at: 6:37am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson review the finding that urocanic acid in the skin is a chemoattractant for the parasitic nematode Strongyloides stercoralis.

Download TWiP #71 (60 MB .mp3, 84 minutes).

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Direct download: TWiP071.mp3
Category:Science -- posted at: 8:46am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson discuss the finding of Gnathostoma nematodes in Asian swamp eels from US live markets and wild populations.

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Direct download: TWiP070.mp3
Category:Science -- posted at: 1:25pm PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson discuss an increase in the altitude of malaria distribution in warmer years in the highlands of Colombia and Ethiopia.

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Direct download: TWiP069.mp3
Category:Science -- posted at: 5:56am PDT

Hosts: Vincent Racaniello Dickson Despommier, and Sagi Shapira

Vincent, Dickson, and Sagi discuss evidence that the pathogen Trypanosoma brucei undergoes meiosis and sexual reproduction.

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Direct download: TWiP068.mp3
Category:Science -- posted at: 6:41am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson explain the genetic and molecular basis of drug resistance in Schistosoma mansonii.

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Direct download: TWiP067.mp3
Category:Science -- posted at: 9:10am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson discuss reversible inhibitors of cruzipain as new drugs for treating Chagas disease.

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Direct download: TWiP066.mp3
Category:Science -- posted at: 10:53am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson consider the effects of climate change on parasitic diseases.

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Dickson's Pick

Neglected by Shelly Xie (YouTube)

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Direct download: TWiP065.mp3
Category:Science -- posted at: 6:42am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson review three novel approaches to antimalarial chemotherapy.

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Direct download: TWiP64.mp3
Category:Science -- posted at: 1:54pm PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson discuss evidence that the malaria parasite originated in gorillas.

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Direct download: TWiP063.mp3
Category:Science -- posted at: 5:27pm PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson discuss the high diversity of malaria parasites in West African bats, and a vaccine against hookworm.

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Direct download: TWiP062.mp3
Category:Science -- posted at: 6:10pm PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson review examples of paleoparasitology, the detection of parasites in archaeological material.

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Direct download: TWiP061.mp3
Category:Science -- posted at: 7:35am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson discuss how infection with Toxoplasma gondii causes mice to lose their aversion to cat urine, even after the parasites have been cleared.

Links for this episode:

Listener Pick

Blaine - The Worm Within

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Direct download: TWiP060.mp3
Category:Science -- posted at: 1:07pm PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson update the multistate outbreak of cyclosporiasis, discuss the avian malaria parasite P. lophurae, and review protection against malaria by intravenous immunization with a nonreplicating sporozoite vaccine.

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Direct download: TWiP059.mp3
Category:Science -- posted at: 8:38am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Guest: Cali Despommier

Vincent and Dickson update the multistate outbreak of cyclosporiasis, and Dickson reads a chapter from his new book.

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Direct download: TWiP058.mp3
Category:Science -- posted at: 7:28pm PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson review a multistate outbreak of cyclosporiasis caused by the single-celled coccidian parasite Cyclospora cayetanensis.

The day after recording this episode, ProMedMail reported that the outbreak of cyclosporiasis had spread to Texas.

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Direct download: TWiP057.mp3
Category:general -- posted at: 8:35am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson discuss Myxobolus cerebralis, the parasite that causes whirling disease of salmonids.

Links for this episode:

Listener Pick

Amanda - Pandemic: On the Brink

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Direct download: TWiP056.mp3
Category:Science -- posted at: 5:47am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson reveal how invasive harlequin ladybirds use biological weapons against their competitors.

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Dickson's Pick

An Inordinate Fondess for Beetles by Arthur V. Evans, Charles L. Bellamy

Listener Pick

Jessie - Pandemic, the board game

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Direct download: TWiP055.mp3
Category:Science -- posted at: 7:59am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson consider a case history of a young man with Blastocystis hominis - is it causing his disease?

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Direct download: TWiP054.mp3
Category:Science -- posted at: 9:35am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson discuss the finding that immunity to a sandfly salivary protein protects against fatal visceral leishmaniasis in hamsters.

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Direct download: TWiP053.mp3
Category:Science -- posted at: 3:02pm PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson review the life cycle and pathogenesis of the giant kidney worm, Dioctophyme renale.

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Direct download: TWiP052.mp3
Category:Science -- posted at: 12:46pm PDT

Hosts: Vincent Racaniello and Dickson Despommier

Guest: Anthony A. James

Special guest Anthony A. James joins Vincent and Dickson to discuss how mosquitoes can be genetically modified to control infectious diseases.

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Contact

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Direct download: TWiP051.mp3
Category:Science -- posted at: 7:48am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson reveal how malaria parasites avoid lysis by complement in the mosquito.

Links for this episode:

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Direct download: TWiP050.mp3
Category:Science -- posted at: 6:44am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson discuss innate immune sensing of Toxoplasma gondii in mice, and heme metabolism in protozoan parasites.

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Direct download: TWiP049.mp3
Category:Science -- posted at: 7:50am PDT

Hosts: Vincent RacanielloDickson Despommier, and Josef Sabo

Vincent, Dickson, and Josef discuss tetraspanins on the surface of schistosomes as vaccine candidates and immune evasion proteins.

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Direct download: TWiP048.mp3
Category:Science -- posted at: 3:48pm PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson review evidence that a virus of the protozoan parasite Trichomonas vaginalis may exacerbate disease.

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Direct download: TWiP047.mp3
Category:Science -- posted at: 7:20am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson meet with Judith Straimer and Marcus Lee to discuss their method for site-specific genome editing in Plasmodium falciparumusing zinc finger nucleases.

Right-click to download TWiP #46 (46 MB .mp3, 64 minutes).

Links for this episode:

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Direct download: TWiP046.mp3
Category:general -- posted at: 6:52am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson discuss Toxoplasma biology with Stanford University Professor John Boothroyd.

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Direct download: TWiP045.mp3
Category:Science -- posted at: 5:34pm PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson explain how a nematode manipulates cricket behavior and alters the food web of a stream.

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Direct download: TWiP044.mp3
Category:Science -- posted at: 3:31pm PDT

Vincent and Dickson review how sickle cell microRNAs contribute to malaria resistance, and inhibition of innate immune responses by an enzyme from trypanosomes.

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Direct download: TWiP043.mp3
Category:Science -- posted at: 7:38am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson answer listener emails about Leishmania, dual infection of vectors, tapeworms, liver flukes, toxoplasmosis, and much more.

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Direct download: TWiP042.mp3
Category:Science -- posted at: 1:40pm PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson review medically important arthropods.

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Direct download: TWiP041.mp3
Category:Science -- posted at: 6:43pm PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson discuss loaiasis caused by the filarial nematode Loa loa.

Right-click to download TWiP #40 (52 MB .mp3, 73 minutes).

Links for this episode:

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Direct download: TWiP040.mp3
Category:Science -- posted at: 5:58pm PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson review the biology and pathogenesis of the amoebae Naegleria fowlerii and Acanthamoeba castellani.

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Direct download: TWiP039.mp3
Category:Science -- posted at: 11:05am PDT

Hosts: Vincent Racaniello and Dickson Despommier

Vincent and Dickson tackle the backlog of listener email, then consider the life cycle and pathogenesis of Trichomonas vaginalis, the flagellated protozoan transmitted by sexual contact.

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Direct download: TWiP038.mp3
Category:Science -- posted at: 6:53pm PDT

Vincent and Dickson discuss the life cycle and pathogenesis of Dracunculus medinensis, the filarial nematode that causes dracunculiasis, or Guinea worm disease.

Links for this episode:

Direct download: TWiP037.mp3
Category:Science -- posted at: 12:49pm PDT

Vincent and Dickson review how gut bacteria help establish T. muris in the large intestine of mice.

Direct download: TWiP036.mp3
Category:Science -- posted at: 8:09am PDT

Vincent and Dickson discuss control of malaria with their Columbia University colleague David Fidock.

Direct download: TWiP35.mp3
Category:Science -- posted at: 6:36pm PDT

Vincent and Dickson discuss control of malaria and filariasis with the bacterial endosymbiont Wolbachia.

Direct download: TWiP034.mp3
Category:Science -- posted at: 10:57am PDT

Vincent and Dickson review an in silico pipeline for identifying molecular mimicry candidate proteins in the genomes of parasites, and catch up on listener email.

Direct download: TWiP033.mp3
Category:Science -- posted at: 8:40am PDT

Vincent and Dickson discuss immune evasion by the cruzain protease of T. cruzi, and novel tetraspanin antigens of S. japonicum.

Direct download: TWiP032.mp3
Category:Science -- posted at: 1:41pm PDT

Vincent and Dickson discuss the promising results of a phase III trial of a malaria vaccine in African children.

Direct download: TWiP031.mp3
Category:Science -- posted at: 6:17pm PDT