Relating land cover and spatial distribution of nephropathia epidemica and Lyme borreliosis in Belgium

Lyme borreliosis (LB) and nephropathia epidemica (NE) are zoonoses resulting from two different transmission mechanisms and the action of two different pathogens: the bacterium Borrelia burgdorferi and the Puumala virus, respectively. The landscape configuration is known to influence the spatial spread of both diseases by affecting vector demography and human exposure to infection. Yet, the connections between landscape and disease have rarely been quantified, thereby hampering the exploitation of land cover data sources to segment areas in function of risk. This study implemented a data-driven approach to relate land cover metrics and an indicator of NE/LB risk at different scales of observation of the landscape. Our results showed the suitability of the modeling approach (r² > 0.75, ρ < 0.001) and highlighted the relevance of the scale of observation in the set of landscape attributes found to influence disease risk as well as common and specific risk factors of NE and LB.

Driving position field study, differences with the whiplash protocol and biomechanics experimental responses

Rear-impact collisions at low speed are a leading cause of economic costs among motor vehicle accidents. Recently, EuroNCAP has incorporated in its protocol the whiplash test, to reproduce a low-speed rear impact. This paper presents a field driving study to assess the potential differences between the EuroNCAP dummy tests and actual drivers in the field, focusing on occupant position and biomechanics experimental results. A total of 182 drivers were randomly selected in two geographical areas in Spain. The driving position of each driver was recorded with a focus on the most relevant measurements for rear impact. Statistical analysis was performed to obtain means, standard deviations and density functions to compare observational seating position with that of the EuroNCAP testing protocol. The observational data showed a similar seatback angle to that used in the EuroNCAP protocol (24° in front of 25° for the protocol), a greater distance between the head vertex and the top of the head restraint (53mm compared to 39.5mm), and less distance between the occipital bone of the head and the headrest (67.9 compared to 89.3mm). Based on these data, 4 dummy tests were conducted using the dummy BioRID IIg. The baseline test was designed to reproduce the dummy position according to EuroNCAP 3.0 whiplash protocol. Three different additional tests were defined to reproduce the actual observed driving position as well as to assess a "worst case" scenario in terms of reduced seatback angle. These variations in initial driver position, comparing the EuroNCAP protocol to the observational study results, were not observed to cause significant differences in the biomechanical values measured in the BioRID IIg, The T1 acceleration was reduced less than 8%, the NIC was increased about 8%, and the NKm presented a reduction of 20%. Reducing the seat angle was observed to be more harmful in terms of NIC.

Percutaneous liver biopsy in children: impact of ultrasonography and spring-loaded biopsy needles

BACKGROUND

Percutaneous liver biopsy is a valued tool of pediatric hepatology. Recent advances in technology have incorporated spring-loaded biopsy needles and ultrasonography in percutaneous liver biopsy.

METHODS

To determine the frequency of complications after liver biopsy and whether variables such as needle selections (Jamshidi, Monopty, or ASAP) and ultrasound guidance could predict complications, medical records were retrospectively reviewed of all patients who underwent percutaneous liver biopsy during a 7-year period. Available data were collected from 123 patients who had undergone a total of 249 percutaneous liver biopsies. All patients with evidence of mild clotting abnormalities (8.83%) received platelets, cryoprecipitate, or fresh-frozen plasma.

RESULTS

There was a 6.83% incidence of overall complications, and a 2.4% incidence of major complications. The mortality rate was 0.4%. Ultrasound localization did not diminish the risk of bleeding during biopsy. There was no significant difference in the change of hematocrit between the aspiration (Jamshidi) and spring-loaded (Monopty) needles. However, in patients less than 5 years of age, the change of hematocrit was significantly higher (P < 0.05) with the 15- or 18-gauge ASAP needle (Microvasive, Quincy, MA, U.S.A.) than with either the Jamshidi (Allegience Healthcare, Columbia, MD, U.S.A.) or Monopty (Bard Technologies, Covington, GA, U.S.A.) needles.

CONCLUSION

Percutaneous liver biopsy is safe, using either aspiration or spring-loaded needles. Ultrasound guidance may not be helpful except in patients who underwent segmental liver transplantation.

Role of biliary phosphatidylcholine in bile acid protection and NSAID injury of the ileal mucosa in rats

BACKGROUND & AIMS

We explored the role of biliary phosphatidylcholine (PC) in protection of the intestinal mucosa against bile salt (BS)-induced intestinal injury and how this property may be blocked by indomethacin (Indo), a nonsteroidal anti-inflammatory drug (NSAID) that is secreted into the bile.

METHODS

We performed in vivo studies in which bile was collected over a 2-hour period after rats were intragastrically administered Indo (25 mg/kg) or an equivalent volume of saline (controls). The bile samples (some of which were supplemented with PC) were then instilled into a loop of distal ileum of anesthetized rats. After a 30-minute exposure period, we measured the hemoglobin concentration of the ileal loop fluid, as an index of bleeding, and mucosal contact angles, as an index of surface hydrophobicity. A similar in vivo experiment was performed in which model bile containing 5 mmol/L each of the BS, sodium deoxycholate, PC, or Indo, alone and in combination, was instilled into ileal loops. In our in vitro test system, human erythrocytes were exposed to the above biliary constituents, and hemolysis was measured spectrophotometrically.

RESULTS

Bile from Indo-pretreated rats decreased the surface hydrophobicity and induced bleeding of ileal loops in comparison with control bile, and both NSAID-induced changes were reversed if PC was added to the bile. Similarly, synthetic BS caused gastrointestinal bleeding, decreased ileal contact angles, and induced erythrocyte hemolysis, all of which were reversed by addition of equimolar PC. This protective role of PC in both the in vivo and in vitro systems was partially blocked by Indo, although the NSAID had no effect on these properties on its own.

CONCLUSIONS

These findings support the hypothesis that PC protects the intestinal mucosa against injurious actions of BS, possibly by forming less toxic mixed micelles. Indo and perhaps other NSAIDs that enter the bile may damage the mucosa, not by a direct action, but by competing for the available protective PC molecules.

Oral rehydration solution therapy in the management of children with rotavirus diarrhea

Rotavirus infections are the most common cause of gastroenteritis among children younger than 3 years of age and are associated with sporadic outbreaks of diarrhea in elderly and immunocompromised patients. Oral rehydration solutions (ORS) are formulated to correct dehydration and acidosis. Currently, ORS do not promote intestinal healing; however, investigators are examining the role of nutrition in promoting intestinal healing. This article reviews the composition of several ORS in human medicine and summarizes our current knowledge of the nutritional treatment of rotavirus diarrhea and intestinal healing.

[Malignant schwannoma of the neck]

Malignant schwannoma (MS) is a tumor of the peripheral nervous system, extremely rare when settled in head and neck. Conversely these two are preferable locations for benign schwannomata. We report a feminine patient, 74-year-old, with a right laterocervical massa, evolving in 3 months, surgically removed and postoperative radiotherapeutic treatment, which remains asymptomatic since one year and a half.

Aesthetic and functional reconstruction with the trapezius osseomyocutaneous flap and dental implants in oral cavity cancer patients

The trapezius osseomyocutaneous flap is the only pedicled flap that is able to transfer vascularized bone for mandibular reconstruction as well as skin for intra-extra oral reconstruction. The trapezius muscle also helps to fill the defect created by the neck dissection and covers the vessels of the neck. This flap has been used in our maxillofacial surgery service during the past 14 years. In spite of having incorporated microvascular flaps in our reconstructive techniques it continues to be one of the flaps we use in selected patients for bone and soft tissue compound defects of the oral cavity. We describe in this article our experience using this flap with dental implants in order to achieve a functional reconstruction. We also discuss when we use this flap for mandibular reconstruction and when a free vascularized flap is used.

Pourfour du Petit syndrome: a case following a traffic accident with severe cranioencephalic trauma

Poufour du Petit syndrome is an extraordinarily unusual clinical condition produced by hyperactivity of the sympathetic cervical chain as a consequence of irritation of these nerves. It causes an ipsilateral mydriasis, which, in patients suffering a head injury as in the case reported here, can confuse the diagnosis and disconcert physicians.