User:Gloria Andrea/sandbox

The lead section is easy to understand. Also, The article has neutral content. On the other hand, I think that the article will be more complete with more reliable sources. Also, I'm according to Peter Southwood, about the mouth to nose variant that is excluded by title.

Peer Review
Mouth-to-mouth resuscitation

Five elements:

• A lead section that is easy to understand

• A clear structure

• Balance coverage

• Neutral content

• Reliable sourses

Lead

I feel satified that I know the importance topic?

Does the lead reflect the most importan information?

Does the lead give more weight to certain parts of the article over others? Is anything missing? Is aniything redundant?

Ask yourself:

Are the sections organized well?

Minority viewpoints and positions

Is each section's lenght equal to its importance to the article's subject? are there sections in the article that seem unnecesary? Is anything off-topic?

Does the article draw conclusions?

Are there anu words of phrasses thar don't feel neutral?

Does the article focus too much on negative or positive information?

Reliable sourses

Are most staments in the article connected to a reliable sourse such as texbooks, journal articles? Or do they rely on blogs or self-published autors?

Are there a lot of statements attrivuted to one or two sourses? If so, it may lead to an unbalance article, or one that leans too heavily into single point od view.

Are ther any unsoursced staments in the article?

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Toxocariasis
Toxocariasis is an illness of humans caused by larvae (immature worms) of either the dog roundworm (Toxocara canis), the cat roundworm (Toxocara cati) or the fox roundworm (Toxocara canis).

Toxocariasis is often called visceral larva migrans (VLM). "Toxocariasis can manifiest in three ways; visceral larva mirans results from larvae migrating to mayor organs includin the brain, lungs, and liver, causing a variety of signs and symptoms (ussually in yung children) including eosinophilia, abdominal pain, headache, cognitive and behavvioral disturbances, pneumonitis, hepatitis with hepatomegaly, while ocular toxocariasis more commonly occurs in older children ande results from larvae migrating to the eye and can cause irreversible vision loss. COnvert toxocariasis, the most difficult from to diagnose, is believed to be cuased by chronic expouse and can manifest as eosinophilia as eosinophilia with cognitive disturbances, or nospecific symtoms that resemble asthma, coughing and wheezing"

Depending on geographic location, degree of eosinophilia, eye and/or pulmonary signs, the terms ocular larva migrans (OLM), Weingarten's disease, Frimodt-Møller's syndrome, and eosinophilic pseudoleukemia

Humans normally become infected by ingestion of embryonated eggs (each containing a fully developed second stage larva, L2) from contaminated sources (soil, undercooked meat, fresh or unwashed vegetables.)

'' 2. Markell, Edward K. and Marietta Voge. Markell and Voge’s Medical Parasitology. 9th ed. St. Louis: Saunders Elsevier, 2006 ''

Other terms sometimes or rarely used include nematode ophthalmitis, toxocaral disease, toxocarose, and covert toxocariasis.

Toxocara canis and Toxocara cati are perhaps the most ubiquitous gastrointestinal worms (helminths) of domestic dogs, cats, and foxes. There are many 'accidental' or paratenic hosts including humans, birds, pigs, rodents, goats, monkeys, and rabbits. In paratenic hosts, the larvae never mature and remain at the L2 stage.

''3. Despommier D. (2003). "Toxocariasis: clinical aspects, epidemiology, medical ecology, and molecular aspects". Clin Microbiol Rev. 16 (2): 265–272. doi:10.1128/CMR.16.2.265-272.2003''

There are three main syndromes: visceral larva migrans (VLM), which encompasses diseases associated with major organs; covert toxocariasis, which is a milder version of VLM; and ocular larva migrans (OLM), in which pathological effects on the host are restricted to the eye and the optic nerve.

Signs and symptoms
'' 2. Markell, Edward K. and Marietta Voge. Markell and Voge’s Medical Parasitology. 9th ed. St. Louis: Saunders Elsevier, 2006 ''

When symptoms do occur, they are the result of migration of second stage Toxocara larvae through the body.

VLM is primarily diagnosed in young children, because they are more prone to exposure and ingestion of infective eggs.

Many objects and surfaces can become contaminated with infectious Toxocara eggs.

Sometimes the subcutaneous migration tracks of the larvae can be seen.

Ocular granulomas resulting from OLM are frequently misdiagnosed as retinoblastomas.

Approximately 50% of puppies and 20% of adult dogs are infected with T. canis.

5. Medscape

Physiological reactions to Toxocara infection depend on the host's immune response and the parasitic load. https://emedicine.medscape.com/article/229855-overview

Most cases of Toxocara infection are asymptomatic, especially in adults. 6 y 7

Symptoms depend on the organ(s) affected

Patients can present with pallor, fatigue, weight loss, anorexia, fever, headache, skin rash, cough, asthma, chest tightness, increased irritability, abdominal pain, nausea, and vomiting. 2

Covert toxocariasis is the least serious of the three syndromes and is believed to be due to chronic exposure. Signs and symptoms of covert toxocariasis are coughing, fever, abdominal pain, headaches, and changes in behavior and ability to sleep. 8

Upon medical examination, wheezing, hepatomegaly, and lymphadenitis are often noted.

Toxocara infection commonly resolves itself within weeks, but chronic eosinophilia may result.

Second stage larvae hatch from these eggs and are approximately 0.5mm long and 0.02mm wide.

6. 7.cdc

Most cases of Toxocara infection are asymptomatic, especially in adults. 5,6

High parasitic loads or repeated infection can lead to visceral larva migrans (VLM).

In VLM, larvae migration incites inflammation of internal organs and sometimes the central nervous system.5

Humans can also contaminate foods by not washing their hands before eating 5

Dogs and foxes are the reservoir for Toxocara canis, but puppies and cubs pose the greatest risk of spreading the infection to humans. 5

'' 8. Holland, Celia and H.V. Smith. Toxocara: The Enigmatic Parasite. Wallingford, UK and Cambridge, MA: CABI Publishing, 2006. 26 Jan. 2009 ''

Patients are commonly diagnosed with pneumonia, bronchospasms, chronic pulmonary inflammation, hypereosinophilia, hepatomegaly, hypergammaglobulinaemia (IgM, IgG, and IgE classes), leukocytosis, and elevated anti-A and –B isohaemagglutinins 2,4,6

Severe cases have occurred in people who are hypersensitive to allergens; in rare cases, epilepsy, inflammation of the heart, pleural effusion, respiratory failure, and death have resulted from VLM. 5

A light Toxocara burden is thought to induce a low immune response, allowing a larva to enter the host's eye.

Although there have been cases of concurrent OLM and VLM, these are extremely exceptional

Loss of vision occurs over days or weeks

Flies that feed on feces can spread Toxocara eggs to surfaces or foods.

Young children who put contaminated objects in their mouths or eat dirt (pica) are at risk of developing symptoms.

Humans are not the only accidental hosts of Toxocara. Eating undercooked rabbit, chicken, or sheep can lead to infection; encysted larvae in the meat can become reactivated and migrate through a human host, causing toxocariasis. Special attention should be paid to thoroughly cooking giblets and liver to avoid transmission 2

Cats are the reservoir for Toxocara cati.

Flies can act as mechanical vectors for Toxocara, but most infections occur without a vector.

''9 The Merck Veterinary Manual. “Roundworm.” 2008. 26 Jan. 2009''

Ocular larva migrans (OLM) is rare compared with VLM.

'' 10 Review of Optometry Online: Handbook of Ocular Disease Management. "Toxocariasis: Ocular Larva Migrans". 26 Jan. 2009 ''

OLM often occurs in just one eye and from a single larva migrating into and encysting within the orbit. 2

Toxocara damage in the eye is permanent and can result in blindness 5,6

'' 11 Stewart, JM, LD Cubillan, and ET Cunningham, Jr. Prevalence, clinical features, and causes of vision loss among patients with ocular Toxocariasis. Retina. 2005 ''

Other signs and symptoms are red eye, white pupil, fixed pupil, retinal fibrosis, retinal detachment, inflammation of the eye tissues, retinal granulomas, and strabismus. 2,8,10

'' 12 Bassukas, Ioannis D., Georgios Gaitanis, Aikaterini Zioga, Christina Boboyianni, and Christina Stergiopoulou. Febrile “migrating” eosinophilic cellulitis with hepatosplenomegaly: adult Toxocariasis – a case report. Cases Journal 2008 ''

A case study published in 2008 supported the hypothesis that eosinophilic cellulitis may also be caused by infection with Toxocara. In this study, the adult patient presented with eosinophilic cellulitis, hepatosplenomegaly, anemia, and a positive ELISA for T. canis.

'' 13 Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, Division of Parasitic diseases. "Guidelines for Veterinarians: Prevention of Zoonotic Transmission of Ascarids and Hookworms of Dogs and Cats." 27 Sept. 2004 19 Jan. 2009 ''

The incubation period for Toxocara canis and cati eggs depends on temperature and humidity. 2

Under ideal summer conditions, eggs can mature to the infective stage after two weeks outside of a host. 5,8

Transmission of Toxocara to humans is usually through ingestion of infective eggs. 6

These eggs are passed in cat or dog feces, but the defecation habits of dogs cause T. canis transmission to be more common than that of T. cati. 2

Second stage larvae will also hatch in the small intestine of an accidental host, such as a human, after ingestion of infective eggs. The larvae will then migrate through the organs and tissues of the accidental host, most commonly the lungs, liver, eyes, and brain. Since L2 larvae cannot mature in accidental hosts, after this period of migration, Toxocara larvae will encyst as second stage larvae. 2,5

''14 Azam, Dena; Ukpai, Onyinye M.; Said, Ashraf; Abd-Allah, Gamal A.; Morgan, Eric Rene (2012). "Temperature and the development and survival of infective Toxocara canis larvae". Parasitology Research.''

T. canis females, specifically, are capable of producing up to 200,000 eggs a day that require 2–6 weeks minimum up to a couple months before full development into the infectious stage.

As with T. canis, encysted second stage larvae in pregnant or lactating cats become reactivated. However, vertical transmission can only occur through breastfeeding.

'' 15 Gamboa, MI. (December 2005). "Effects of temperature and humidity on the development of eggs of Toxocara canis under laboratory conditions". ''

However, as identified in a case study presented within the journal of helminthology, the second stage of larvae development poses strict vulnerabilities to certain environmental elements.

High temperatures and low moisture levels will quickly degrade the larvae during this stage of growth.

'' 16 Harris-Linton, Megan. The University of Michigan Museum of Zoology: Animal Diversity Web. “Toxocara canis.” 2001. 26 Jan. 2009 ''

Adult T. canis are found only within dogs and foxes and the males are 4–6 cm in length, with a curved posterior end. 4

The males each have spicules and one “tubular testis.”

Females can be as long as 15 cm, with the vulva stretching one third of their bodylength.

The females do not curve at the posterior end. 4

Larvae enter the bloodstream and migrate to the lungs, where they are coughed up and swallowed. The larvae mature into adults within the small intestine of a cat, dog or fox, where mating and egg laying occurs. 8,10,13,16 '' 17 Soskolne, Gayle. The University of Michigan Museum of Zoology: Animal Diversity Web. “Toxocara cati.” 2001. 26 Jan. 2009 ''

Provided sufficient oxygen and moisture availability, Toxocara eggs can remain infectious for years, as their resistant outer shell enables the protection from most environmental threats 5,15,16,17

Both species produce eggs that are brown and pitted. 9, 16,17

T. canis eggs measure 75-90 µm and are spherical in shape, whereas the eggs of T. cati are 65-70 µm in diameter and oblong. 2,16.17

dults of both species have complete digestive systems and three lips, each composed of a dentigerous ridge. 16

T. cati adult females are approximately 10 cm long, while males are typically 6 cm or less. The T. cati adults only occur within cats, and male T. cati are curved at the posterior end.

Transmission to cats and dogs can also occur by ingestion of infected accidental hosts, such as earthworms, cockroaches, rodents, rabbits, chickens, or sheep. 2,8

Eggs are passed in the feces and only become infective after several weeks outside of a host. During this incubation period, molting from first to second (and possibly third) stage larva takes place within the egg. 8

'' 18 Johnstone, Colin. University of Pennsylvania. The Nematodes.24 Jan. 2000 ''

Eggs hatch as second stage larvae in the intestines of the cat, dog or fox host (for consistency, this article will assume that second stage larvae emerge from Toxocara eggs, although there is debate as to whether larvae are truly in their second or third stage of development).

19 Taxonomy Browser". www.ncbi.nlm.nih.gov. Retrieved 14 January 2019.

'' 20 Artem Cheprasov. 2012. Death at the Playground. Guru Magazine. 11. pp. 59-61 ''

T. canis can lay around 200,000 eggs per day.

Both Toxocara canis and Toxocara cati eggs require a several week incubation period in moist, humid, weather, outside a host before becoming infective, so fresh eggs cannot cause toxocariasis. 2.5.13

'' 21 Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, DPDx: Parasites and Health. “Toxocariasis.” 19 Jan. 2009 ''

Infection in most adult dogs is characterized by encysted second stage larvae. However, these larvae can become reactivated in pregnant females and cross the placental barrier to infect the pups. Vertical transmission can also occur through breastmilk. 2,13

Infectious mothers, and puppies under five weeks old, pass eggs in their feces. 13