Gizzard nematodes of Canada geese wintering in southern Illinois

Gizzards from 64 hunter-shot Canada geese (Branta canadensis) were collected in southern Illinois (USA) in December 1991 and January 1992 to determine the prevalence and intensity of gizzard nematodes. Three species of gizzard nematodes were recovered: Amidostomum anseris, Amidostomum spatulatum, and Epomidiostomum crami. The prevalence of infection was 98%. Mean intensity was 17.8 nematodes per host and was significantly greater for immature geese (40.3 nematodes/host) than for adult geese (10.9 nematodes/host). The intensity of both A. anseris and E. crami was greater in immature geese, but even the most heavily infected birds did not display serious lesions. Despite a dramatic increase in the population of geese, mean intensity in adult geese was similar to mean intensity reported from earlier studies at the same site. Mean intensity in immature geese in 1991 and 1992 was greater than in earlier studies.

Efficacy of magnesium citrate cathartic in pediatric toxic ingestions

STUDY OBJECTIVE

To investigate the efficacy of magnesium citrate in reducing gastrointestinal transit time of activated charcoal in children.

DESIGN

A prospective, randomized, clinical comparison of four magnesium doses.

SETTING

Urban children's hospital emergency department.

PARTICIPANTS

Children aged 1 month to 6 years who presented for management of an acute toxic ingestion.

INTERVENTION

Each child received 1 g/kg activated charcoal combined with a randomly assigned dose of a 6% solution of magnesium citrate: 0 mL/kg, 4 mL/kg (standard recommended dose), 6 mL/kg, or 8 mL/kg. The primary outcome measure was the interval to first activated charcoal-containing stool, which was determined by follow-up telephone call or review of the medical record.

RESULTS

Sixty-four children were enrolled. Median times to first charcoal stool were 19.5 hours (0 mL/kg), 13.0 hours (4 mL/kg), 14.0 hours (6 mL/kg), and 12.0 hours (8 mL/kg). Intergroup differences were significant by Kruskal-Wallis analysis of variance (P = .0035).

CONCLUSION

Magnesium citrate reduces gastrointestinal transit times of activated charcoal stools when administered to children who receive activated charcoal for a toxic ingestion. Further study is needed to determine the clinical value of this reduction.

Parasites of cottontail rabbits of southern Illinois

Fifteen species of parasites including Haemaphysalis leporispalustris, Ixodes dentatus, Amblyomma americanum, Cediopsylla simplex, Odontopsyllus multispinosus, Cuterebra sp., Obeliscoides cuniculi, Trichostrongylus calcaratus, Trichostrongylus affinis, Longistriata noviberiae, Dermatoxys veligera, Trichuris sp., Mosgovoyia sp., Taenia pisiformis, and Hasstilesia tricolor as well as coccidia oocysts were collected from 96 cottontail rabbits (Sylvilagus floridanus) confined to a pen in southern Illinois in 1983 and 1984. The diversity of parasites and the intensities of infections were similar to published reports on free-ranging populations. Most variations in parasite abundances were attributable to season. Few lesions were seen in association with parasitism.

Iron absorption from chewable vitamins with iron versus iron tablets: implications for toxicity

The medical literature contains few, if any, reports of severe iron (Fe) poisonings from ingestion of chewable multivitamins with iron. One possible explanation for this observation is that iron from multivitamins is more poorly absorbed than iron from iron tablets. To compare iron absorption from multivitamins with iron absorption from ferrous fumarate tablets, male adult volunteers were given 6 mg of elemental Fe/kg body weight as chewable multivitamins with iron or as crushed ferrous fumarate tablets in a crossover study. Serum Fe and total iron binding capacity (TIBC) were determined prior to administration of the tablets and one, two, four, and six hours after ingestion. Statistical analyses demonstrated increased and more rapid absorption of Fe from the multivitamin preparation. These results suggest that iron is well absorbed from chewable multivitamins with iron and should theoretically have the potential for producing serious toxicity when taken in overdose. The reasons that such toxicity is not commonly seen clinically are discussed, and a plan for further investigation of this issue is proposed.

Prevalence of spindle cell sarcomas among wild Canada geese from southern Illinois

Over a 6-yr period, two cases of neoplastic disease were diagnosed among 1,272 wild Canada geese (Branta canadensis interior) collected in Illinois (USA), Wisconsin (USA), and Ontario, Canada. One juvenile goose of each sex was involved. In both cases > 35 discrete masses were observed subdermally, intramuscularly, and within the body cavity. The tumors, diagnosed as spindle cell sarcomas, are among the most commonly observed neoplasms in free-living North American waterfowl. Based on our data, we suggest that these neoplasms occur with extremely low prevalence (0.002%) in free-living Canada geese.

The OPQ: a proposed instrument for predicting poisoning accident recurrence in young children

A 26-item self-report questionnaire for parents/guardians was constructed for potential use with first-exposure childhood poisoning victims to predict high risk for subsequent poisoning episodes. Data were obtained from 185 subjects served by 1 of 5 US regional poison control centers. The resulting device was labeled the OPQ. Its retrospective validity (R = 0.71) and test-retest reliability (0.81) are viewed as sufficient. The test itself, with accompanying scoring key and norms, are provided here in the hope that other clinicians and researchers will join in subjecting the OPQ to prospective validity studies and other forms of Scale refinement.

Correlates of medical compliance among hemophilic boys

Twenty-nine males with hemophilia completed the Medical Compliance Incomplete Stories Test (M-CIST), and their scores were correlated with health care professionals' ratings of four aspects of medical compliance, along with measures of possible moderating variables. The results indicated that significant associations were found between most of the M-CIST category scores, particularly the Compliance/coping subscale, and the health care specialists' ratings of how well the children exhibited compliant responses to bleeding episodes, and inverse associations with the incidence of monthly bleeding episodes. The findings suggested that the M-CIST continues to demonstrate promise as an instrument to be used in studies of compliance among pediatric chronic illness patients.

Further observations on estrus and ovulation in woodchucks (Marmota monax) in captivity

The woodchuck is a seasonally breeding sciurid rodent. Female woodchucks are monoestrous and, when isolated from males, remain in a prolonged period of estrus characterized by a clear predominance of cornified cells in the vaginal smear. This study was designed to characterize relationships between the degree of vaginal cornification and sexual receptivity, and to study ovulation and related phenomena of this species in captivity. Fourteen individually caged adult females, maintained under standard laboratory conditions for 9-23 mo, were used in this investigation. Females exhibiting predominantly (67-97%) cornified smears were always receptive, regardless of the time interval from the onset of estrus, and mated within 24 h of pairing. Mated females allowed to complete pregnancy gave birth to live pups 30-32 days later. Litter size ranged from 3-7 pups. Serum progesterone (P) levels increased to approximately 2 ng/ml during the first week of pregnancy and greater than 5 ng/ml during the second and third weeks of pregnancy. Serum estradiol (E2) levels were elevated during the first week of pregnancy and began to decline thereafter. Examination of ovarian serial sections revealed that ovulation took place between 20 and 32 h after copulation. Serum levels increased significantly (4-fold) after ovulation (1.2 +/- 0.3 vs. 0.3 +/- 0.01 ng/ml). However, the circulating levels of E2 remained unchanged between the periods before (53 +/- 1 pg/ml) and after ovulation (60 +/- 3 pg/ml). Ovulation was not simultaneous in all mature follicles.(ABSTRACT TRUNCATED AT 250 WORDS)

Multiple-dose sodium polystyrene sulfonate in lithium intoxication: an animal model

Previous work in our laboratory has demonstrated that sodium polystyrene sulfonate (SPS) significantly lowered serum lithium (Li) concentrations when administered in a single oral dose after an oral dose of lithium in a mouse model. The present study was designed to determine whether: 1) repetitive doses of SPS are effective in lowering serum lithium concentrations, 2) the effect of SPS on lithium concentration is dose related and 3) SPS enhances the elimination of lithium. Mice (N = 144) were given orogastric LiCl (250 mg/kg) and then divided into 4 groups: Controls received water 0, 30, 90, 180, and 360 min. after LiCl; the Full-Dose SPS Group received SPS (5 g/kg/dose) at equivalent times; the Half-Dose SPS Group received SPS (2.5 g/kg/dose) at the same times; and the Elimination Group received water at 0 and 30 min. after LiCl and SPS at 90, 180 and 360 min. after LiCl. Subgroups of each group were sacrificed at 1, 2, 4 and 8 hr post-treatment and serum analyzed for lithium concentrations. Statistical analyses revealed that, when compared to Controls: 1) SPS significantly lowered serum lithium concentrations; 2) this effect was dose-related; 3) repetitive dosing of SPS appears to enhance the elimination of lithium.

Care of elderly patients with a fractured neck of femur

This survey was designed to compare the clinical management of elderly patients admitted to hospitals with a hip fracture, with the recommendations in the recent Royal College of Physicians report "Fractured Neck of Femur". The results highlight large discrepancies between the 'ideal' clinical management as recommended, and that which occurs in practice. Particular concerns include the lack of experienced medical supervision provided for patients perioperatively, the high proportion of junior anaesthetic and surgical staff performing the operation, and the widespread poor rehabilitation facilities. These findings suggest that, unless the quality of clinical care for such patients is vastly improved, the predicted exponential rise in the number of elderly people sustaining a hip fracture will create a heavy burden on scarce National Health Service resources.

Reinitiation of spermatogenesis by exogenous gonadotropins in a seasonal breeder, the woodchuck (Marmota monax), during gonadal inactivity

The present study was undertaken (1) to document structural and functional changes in the testes of seasonally breeding woodchuck during active and inactive states of spermatogenesis and (2) to evaluate the ability of exogenous gonadotropins to reinitiate spermatogenesis outside the breeding season. During seasonal gonadal inactivity, there were significant (P less than 0.05) reductions in volumes of several testicular features (testis, seminiferous tubules, tubular lumen, interstitial tissue, individual Leydig cells, Leydig cell nuclei, and Leydig cell cytoplasm) as compared with gonadally active animals. The diameter of the seminiferous tubules was decreased by 26%, and Leydig cell numbers also declined in the regressed testes. These changes were accompanied by a decline in testosterone (T) levels in both plasma and testis, and reduction in epithelial height of accessory reproductive organs. A hormonal regimen was developed that would reinitiate spermatogenesis in captive, sexually quiescent woodchucks. A combination of PMSG and hCG markedly stimulated testicular growth and function and restored spermatogenesis qualitatively. Quantitatively normal spermatogenesis was restored in 2 of 6 treated males. Morphometric analyses revealed substantial increases in seminiferous tubular diameter and in the volume of seminiferous tubules, tubular lumen, total Leydig cells, and individual Leydig cells in the hormone-treated animals. These increased values corresponded to 99, 75, 68, 51, and 200%, respectively, of the values measured in naturally active woodchucks. Leydig cell numbers, however, remained unchanged and approximated only 31% of the number found in naturally active testes. Hormonal stimulation also resulted in a significant rise in serum T as well as in the total content of testicular T, and a marked increase in epithelial height in various accessory reproductive glands. The most effective hormonal protocol for stimulating spermatogenesis was treatment with 12.5 IU of PMSG twice a week for 4 weeks followed by 12.5 IU of PMSG + 25 IU of hCG twice a week for 4 weeks.

Screening for vertebral osteoporosis using individual risk factors. The Multicentre Vertebral Fracture Study Group

Osteoporosis is a major cause of ill health in postmenopausal women. Several risk factors for osteoporosis have been identified, and they have been widely recommended as a means of identifying subgroups of postmenopausal women who might benefit from prophylaxis and therapy. Evidence to support this use of risk factors is currently lacking, however. We have constructed and evaluated a profile of putative risk factors as a means of identifying women attending general practitioners who have sustained vertebral fractures. The overall prevalence of vertebral fractures in the 1012 women (mean age 64.4 years) studied was 7.8%. Women who had sustained vertebral fractures in this population were significantly (p less than 0.05) older and shorter than those without fractures. They reported a significantly (p less than 0.05) earlier menopause, lower parity and a greater prevalence of hyperthyroidism. However, the best screening instrument devised was not sufficiently predictive to warrant widespread use.

Monitoring cyanide and thiocyanate concentrations during infusion of sodium nitroprusside in children

Over a 19-month period, all requests for blood cyanide and/or serum thiocyanate concentrations to the Clinical Laboratory of The Children's Hospital, Boston, were reviewed in order to determine how physicians screen for nitroprusside-related toxicity. During that period, 52 patients receiving nitroprusside were monitored for cyanide and/or thiocyanate toxicity. Overall, there were 62 cyanide and 86 thiocyanate determinations. None of the thiocyanate determinations and five of the cyanide concentrations were within the toxic range as established by the reference laboratory, and no patient displayed signs or symptoms of toxicity which could not also be explained by their underlying illness. Our findings suggest that while physicians are concerned with nitroprusside toxicity in children, there exists no apparent consensus as to how to monitor for this toxicity. The results also indicate that the relationship between blood cyanide or serum thiocyanate concentrations and clinical evidence of toxicity is not straightforward and requires further delineation.

Hematology and serum chemistry of cottontail rabbits of southern Illinois

In 1983 and 1984 blood was collected from 79 cottontail rabbits (Sylvilagus floridanus) confined to an outdoor enclosure in southern Illinois to establish reference values for hematology and serum chemistry. Packed cell volume, sodium, potassium, chloride, glucose, calcium, carbon dioxide, blood urea nitrogen, creatinine, uric acid, cholesterol, albumin, bilirubin, alkaline phosphatase, aspartate transaminase, alanine aminotransaminase, total protein, albumin/globulin ratio, and osmolality were measured. Sex and age (adult versus juvenile) of rabbit as well as season (June to September versus October to May) and method of capture (trap versus shot) variously affected most hematology and serum chemistry variables.

HIV infection of human gastrointestinal submucosal cells: an in vitro model that mimics Kaposi's sarcoma

Infection of human gastrointestinal submucosal mesenchymal cells with HIV-1 led to cell populations with abnormal growth properties, increased synthesis of endothelial cell and angioblast markers, and release of angiogenic factors. This system may be the first in vitro model for HIV-induced Kaposi's sarcoma.

The estrous cycle of captive woodchucks (Marmota monax)

Changes in vaginal cytology were assessed and correlated with temporal changes in circulating concentrations of progesterone (P) and estradiol-17 beta (E2) during the breeding season (February to March) in a seasonally breeding rodent, the woodchuck (Marmota monax). Ten individually caged adult females, maintained under laboratory conditions for 3-11 mo, were studied. Vaginal smears were taken each morning for 2 consecutive months beginning 1 February 1990. Seven of 10 females exhibited readily identifiable estrus, characterized by a clear predominance (83%) of cornified cells. The earliest estrous smear was recorded on 3 February and the latest on 12 March. These animals were monoestrous and remained in a prolonged estrous period during their brief breeding season. The average duration of estrus was 18.1 +/- 2.1 days, ranging from 12-27 days. Levels of P and E2 were determined in serum samples taken before, during, and after estrus from 7 females who exhibited estrus. No changes in the circulating levels of P were apparent during the estrous cycle. However, there was a consistent pattern of estradiol secretion characterized by elevated levels of E2 before and during estrus, followed by a significant (p less than 0.05) decline in E2 levels one week after the end of estrus. Elevated levels of E2 preceded and coincided with maximal degree of vaginal cornification. Thus, the termination, but not the onset, of estrus in woodchucks reflected closely the temporal pattern of changes in serum E2 levels during the breeding season.

The adsorption of salicylates by a milk chocolate-charcoal mixture

STUDY OBJECTIVE

To evaluate the adsorptive capacity of a milk chocolate-charcoal mixture to aspirin, compared with superactivated charcoal and conventional activated charcoal.

DESIGN

A prospective, randomized, crossover study.

SETTING

The Massachusetts Poison Control Center office in The Children's Hospital, Boston.

TYPE OF PARTICIPANTS

Six healthy adult volunteers with no known allergies to aspirin or chocolate, bleeding disorders, or peptic ulcer disease.

INTERVENTIONS

Each participant ingested 975 mg of crushed aspirin on separate days, followed by either water; 10 g milk chocolate-charcoal mixture; 10 g SuperChar Liquid; or 10 g Actidose Aqua activated charcoal. Total serum salicylate concentrations were determined by high-performance liquid chromatography at zero, one, two, four, eight, and 24 hours after ingestion.

MEASUREMENTS AND MAIN RESULTS

Neuman-Keuls analysis was used to measure time-to-peak concentration, which was reduced by SuperChar Liquid, 67%; milk chocolate-charcoal mixture, 106%; and activated charcoal, 56%. Aspirin absorption was calculated using Neuman-Keuls analysis to measure area under the concentration-time curve. Total aspirin absorption was reduced by SuperChar, 67%; milk chocolate-charcoal mixture, 50%; and activated charcoal, 2%. There was no difference in serum salicylate concentrations between SuperChar and milk chocolate-charcoal mixture at all time intervals. Also, all serum salicylate concentrations with milk chocolate-charcoal mixture were consistently lower than with activated charcoal.

CONCLUSION

Although the formulation of milk chocolate with activated charcoal reduces its adsorptive capacity compared with superactivated charcoal, it is still able to bind aspirin effectively and is superior to conventional activated charcoal. Further research may improve the binding and palatability of milk chocolate-charcoal mixture, especially for home use.

Seasonal variations in circulating levels of progesterone and estradiol in unmated adult female woodchucks (Marmota monax) in captivity

The annual profile of serum levels of progesterone (P) and estradiol-17 beta (E2) was characterized in a seasonally breeding rodent, the woodchuck (Marmota monax). Hormonal levels were determined in serum samples taken at weekly or biweekly intervals from unmated female woodchucks maintained all year indoors under controlled conditions of photoperiod and temperature. Annual fluctuations included a rise of E2 levels during late January through February, followed by a modest increase in plasma P concentrations by late March, the latter attaining peak values during April and May. A temporal dissociation of peak values of circulating levels of P and E2 during the annual reproductive cycle was also detected. The timing of changes in serum levels of P and E2 in these captive woodchucks corresponded to reproductive events during the normal breeding season of the woodchuck in the southern part of its range.

Serum magnesium concentrations after repetitive magnesium cathartic administration

Severe hypermagnesemia has been reported by several authors after multiple doses of magnesium-containing cathartic are administered during management of a toxic ingestion. To evaluate the frequency and magnitude of serum magnesium elevations after the use of repetitive magnesium catharsis, we prospectively evaluated 102 patients who received multiple doses of magnesium citrate as a part of treatment of an overdose. Commonly ingested substances for which repetitive cathartic was administered were tricyclic antidepressants in 47%, aspirin in 17%, and phenytoin in 10%. For each case, serial electrolytes, blood urea nitrogen, creatinine, calcium and magnesium were obtained. Mean initial serum magnesium concentration was 1.8 +/- .03 mEq/L. After a mean 960 mL of magnesium citrate (9.22 g magnesium), final mean serum magnesium concentration was 2.5 +/- .05 mEq/L. Forty-seven patients (47%) developed an elevated (greater than 2.4 mEq/L) serum magnesium concentration, with 12 greater than 3.0 mEq/L. No correlation was found between total quantity of magnesium citrate administered and the increment in serum magnesium concentration. Our data indicate that serum magnesium concentrations consistently rise after repetitive magnesium citrate use. However, the magnitude of this rise appears modest. The elevation in serum magnesium concentration does not correlate with the quantity of magnesium administered. We conclude that with close monitoring, repetitive magnesium citrate can be administered without inducing severe hypermagnesemia (serum magnesium concentration greater than 5.0 mEq/L).