Neurological examination of clinically healthy pigeons (Columba livia domestica), mute swans (Cygnus olor), common buzzards (Buteo buteo), common kestrels (Falco tinnunculus) and northern goshawks (Accipiter gentilis)

BACKGROUND

A neurological examination is essential for determining the localisation of neurological lesions. However, in avian species, quantitative data regarding the practicability and feasibility of neurological tests are very limited. Therefore, the aim of this study was to establish normative data for the neurological examination of clinically healthy birds of different species.

METHODS

Forty-two domestic and feral pigeons (Columba livia domestica), 42 mute swans (Cygnus olor), 12 common buzzards (Buteo buteo), 24 common kestrels (Falco tinnunculus) and six northern goshawks (Accipiter gentilis) were examined. All birds underwent a predefined neurological examination. Interobserver variations between three examiners were investigated in 11 pigeons and 11 mute swans.

RESULTS

All postural reaction tests, except for the drop and flap reaction in mute swans, provoked a consistent response in pigeons and mute swans, whereas postural reaction tests of the legs in raptors were often not performable. Cranial nerve tests and most of the spinal reflexes revealed variable responses in all birds. The gastrocnemius reflex was not provokable in any bird. Interobserver agreement was almost perfect (Gwet's AC1 coefficient ≥0.81) for 16 of 21 parameters in the examination in pigeons and for 14 of 21 in mute swans.

LIMITATIONS

The inclusion of free-ranging birds, which were not used to handling and for which limited information regarding age, history of previous diseases, etc. was available, may have influenced the results.

CONCLUSION

The normative neurological examination data provided in this study will help improve clinicians' interpretation of neurological examination results in the respective bird species.

Electric Fields in Liquid Water Irradiated with Protons at Ultrahigh Dose Rates

We study the effects of irradiating water with 3 MeV protons at high doses by observing the motion of charged polystyrene beads outside the proton beam. By single-particle tracking, we measure a radial velocity of the order of microns per second. Combining electrokinetic theory with simulations of the beam-generated reaction products and their outward diffusion, we find that the bead motion is due to electrophoresis in the electric field induced by the mobility contrast of cations and anions. This work sheds light on the perturbation of biological systems by high-dose radiations and paves the way for the manipulation of colloid or macromolecular dispersions by radiation-induced diffusiophoresis.

Monte Carlo study of patient and medical staff radiation exposures during interventional cardiology

The aim of this study is to assess the radiation exposure of the patient and the medical staff during interventional cardiology procedures. Realistic exposure scenarios were developed using the adult reference anthropomorphic phantoms adopted by the International Commission on Radiological Protection (ICRP110_Male and ICRP110_Female), and the radiation transport code Geant4 (version 10.3). The calculated equivalent and effective doses were normalised by the simulated Kerma-Area Product (KAP), resulting in two conversion coefficients H_T/KAP and E/KAP. To properly evaluate the risk of exposure, several dose-dependent parameters have been investigated, namely: radiological parameters (tube kilovoltage peak (kVp), type of projection, field size (FOV)), and operator positions. Four projections (AP,PA,LAO25° and RAO25°) were simulated for three X-ray energy spectra (80,100 and 120 kVp) with four different values of FOV (15×15 cm²,20×20 cm²,25×25 cm² and 30×30 cm²). The results showed that the conversion coefficients values increase with increasing tube voltage as well as the FOV size. Recommended projection during the interventional cardiology procedures, whenever possible, should be the PA projection rather than AP projection. The most critical projection for the patient and the main operator is the RAO25° projection and the LAO25° projection respectively. The comparison of our results with the literature data showed good agreement allowing their use in the dosimetric characterization of interventional cardiology procedures.

Microdosimetry in 3D realistic mitochondria phantoms: Geant4 Monte Carlo tracking of 250keV photons in phantoms reconstructed from microscopic images

Mitochondria are considered to be sensitive radiation targets since they control processes vital to the cell's functioning. These organelles are starting to get attention and some studies are investigating the radiation dose inside them. In previous studies, mitochondria are represented as simple ellipsoids inside the cell not taking into consideration the complexity of their shape. In this study, realistic phantoms are built based on deconvolved widefield fluorescent microscopic images of the mitochondrial networks of fibroblast cells. The phantoms are imported into Geant4 as tessellated volumes taking into account the geometrical complexity of these organelles. Irradiation with 250keV photons is performed and the lineal energy is calculated. The lineal energy distributions inside the produced phantoms are compared with those calculated inside simple volumes, a sphere and an ellipsoid, where the effect of the shape and volume is clearly seen on lineal energies.

[Current status of nosocomial infections in the Lebanese Hospital Center, Beirut]

Nosocomial infections are a significant problem and hospitals need to be aware of their nosocomial infection status. This retrospective study aimed to identify nosocomial bacterial infections in patients admitted to the Lebanese Hospital Center from January 2006 to January 2008 and determine the causative micro-organisms, the antibiotic sensitivity of the micro-organisms and evaluate the hospital treatment. In total 96 patients with nosocomial infection were included. Urinary infections were the commonest nosocomial infections (42%) followed by pulmonary infections (28%). Gram-negative bacteria were responsible for 89% of nosocomial infections and staphylococci for 7%, with Escherichia coli and Pseudomonas aeruginosa being the most common (46% and 26% respectively). The organisms were resistant to multiples antibiotics and 18% of the patients were treated with imipenem, 7% with vancomycin, 42% with third-generation cephalosporins and 24% with amikacin. Hospital hygiene measures and antibiotic prescription policies are required to fight nosocomial infections and reduce antibiotic resistance among organisms.

Drug-related problems identified by clinical pharmacist's students and pharmacist's interventions

BACKGROUND

Drug-related problems constitute a major public health problem, because of their consequences on morbidity, mortality and cost.

PATIENTS AND METHODS

A 6-month prospective study was conducted, including hospitalized patients in the internal medicine ward of the University Hospital of Beirut, in order to identify drug-related problems by clinical pharmacist's students participating in routine medical rounds, to assess the characteristics of patients presenting these drug-related problems and to analyze pharmacist's interventions.

RESULTS

Ninety patients presenting drug-related problems were identified. Thirty-two percent were hydro-electrolytic problems and 24% gastrointestinal. Cardiovascular drugs were the most frequently implicated (44%), followed by anticoagulants (17%) and corticosteroids (14%). The most commonly identified drug-related problems were drug interactions (37%), overdosage (28%), non-conformity to guidelines or contra-indications (23%), underdosage (10%) and improper administration (2%). The clinical pharmacist's interventions consisted of dose adjustment (38%), addition drugs (31%), changes in drugs (29%) and optimization of administration (2%).

DISCUSSION AND CONCLUSION

To decrease the risk of drug-related problems, drug treatment requires physicians to abide by prescribing recommendations, notably in elderly patients, as well as pharmacists' effective intervention at all levels. Routine participation of clinical pharmacists in clinical medical rounds facilitates the identification of drug-related problems and may prevent their occurrence.

Road safety engineering: an effective tool in the fight against whiplash injuries

Road safety engineering can play an integral part in the prevention of whiplash injuries. While improvements to vehicle design can reduce the severity of whiplash injuries when a crash occurs, improvements to road safety can prevent whiplash-inducing crashes from occurring in the first place. Whiplash injuries are most commonly associated with rear end crashes. Unfortunately, rear end crashes are also the most common type of crash at urban signalized intersections, where the majority of crashes occur in British Columbia, Canada. The Insurance Corporation of British Columbia (ICBC), through the road improvement program, has been funding road improvements in order to reduce the frequency of collisions at high crash locations in British Columbia. Several road safety engineering countermeasures specifically targeted at rear end collisions have been researched and deployed. These countermeasures include simple and affordable solutions such as signal visibility enhancements, as well as complex and expensive solutions such as intersection geometric upgrades. When appropriately used, these countermeasures have proven to be extremely cost-effective in reducing the frequency of rear end collisions. Widespread application of signal visibility enhancements is now being pursued to further decrease the risk of rear end collisions and whiplash injuries. Costs are the direct cost of the ICBC portion of the investment and benefits are only those associated with reduced insurance claims over a 2-year period.

Three complement-type repeats of the low-density lipoprotein receptor-related protein define a common binding site for RAP, PAI-1, and lactoferrin

The low-density lipoprotein receptor-related protein (LRP) is a 600-kD scavenger receptor that binds a number of protein ligands with high affinity. Although some ligands do not compete with each other, binding of all is uniformly blocked by the 39-kD receptor-associated protein (RAP). RAP is normally found in the endoplasmic reticulum and seems to function as a chaperone for LRP. To identify the binding sites for RAP, lactoferrin, and plasminogen activator inhibitor-1 (PAI-1), a bacterial expression system has been developed to produce soluble LRP fragments spanning residues 783-1399. These residues overlap most of the CNBr fragment containing the second cluster of complement-type repeats (C). Solid phase binding assays show that 125I-RAP binds to fragments containing three successive complement-type repeats: C5-C7. PAI-1 and lactoferrin bind to the same fragments. A fragment containing C5-C7 also blocks uptake and degradation of 125I-RAP by fibroblasts in a concentration-dependent manner. Binding competition experiments show that RAP, PAI-1, and lactoferrin each inhibit the binding of the others, suggesting that at this site in LRP, RAP acts as a competitive, rather than an allosteric, inhibitor of PAI-1 and lactoferrin binding.