Retrospective Study of Intertarsal Joint Inflammation in Avian Species From a Zoological Institution

A retrospective cross-sectional study was performed to measure the prevalence of avian intertarsal inflammation over a 5-year period, identify risk factors, and discuss treatment options. The authors hypothesized that: 1) long-legged birds would be more affected, 2) participation in a bird show would be a significant risk factor, and 3) young animals would be more frequently affected. Thirty-five clinical cases from 9 avian orders were included in the study. Statistical analysis indicated that the orders Ciconiiformes (9/150; 6%, 95% confidence interval [CI]: 3.2-11), Gruiformes (4/132; 3%, 95% CI: 1.2-7.5), and Pelecaniformes (7/152; 2.8%, 95% CI: 1.4-5.6) were significantly more affected than other orders (P < 0.01). Similarly, long-legged birds (21/35) had 9.8 times greater chance (P < 0.001, 95% CI: 4.7-21) of developing the condition compared with other birds. Participation in a free-flight show (22/35) was a significant risk factor (P < 0.001; odds ratio: 7.0, 95% CI: 3.3-15). Mean age at onset of clinical signs was 5.7 years, and being < 2 years-of-age during the study period was not a significant predictor of disease (P = 0.054). The tibial cartilage, a fragile fibrocartilaginous structure, was frequently affected (34%, 12/35). Treatment protocols included anti-inflammatory drugs, analgesic drugs, or both (94%, 33/35), low-level laser therapy (54%, 19/35), joint immobilization (34%, 12/35), intra-articular corticoid injections (20%, 7/35), surgical stabilization (17%, 6/35), physiotherapy (9%, 3/35), intra-articular hyaluronic acid (6%, 2/35) or platelet-rich plasma (3%, 1/35) injections, and chiropractic care (3%, 1/35). Overall recovery rate was 49% (17/35), and the condition was associated with a poor prognosis in chronic cases.

P468 Aspergillosis in a colony of Humboldt penguins (Spheniscus humboldti) under managed care: a clinical and environmental investigation in a French zoological park

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM

 

Objectives

Aspergillosis is an opportunistic fungal infection due to Aspergillus spp., and primarily A. fumigatus. The disease is pervasive in avian populations, especially those under managed care. The incidence and the management of avian aspergillosis can be critically impacted by exposure to high levels of spores via environmental contamination and by strains resistant to azole drugs. The present study aimed at assessing the impact of environmental contamination on the clinical incidence of aspergillosis in penguins managed under human care. ZooParc de Beauval was chosen for the investigations, because this zoological facility hosts a large colony of Humboldt penguin (Spheniscus humboldti) and it is geographically located in the rural countryside of the Loir-et-Cher district, France, surrounded by numerous large crop fields

Material and methods

The fungal contamination in the environment was assessed through three serial sessions of surface sampling in bird nests: all isolates were counted, identified by DNA sequencing, and then systematically screened for resistance mutations and MICs (minimal inhibitory concentrations) elevation for the A. fumigatus strains. In addition, the clinical incidence of aspergillosis was evaluated in the penguin population over a 3-year period. A microsatellite-based analysis tracked A. fumigatus isolates circulation.

Results

Environmental investigations highlighted a substantial increase in the fungal load during the Autumn season (>12-fold vs. the other timepoints) and a large overrepresentation of species belonging to the Aspergillus section Fumigati (ranging from 22.7 to 94.6%) (Fig. 1). Only one cryptic species (A. nishimurae) and one isolate exhibiting resistance mutation (G138S in the cyp51A gene; MIC itraconazole >4 μg/ml) were detected. The overall incidence of aspergillosis was measured at ∼3.4% case-years and was observed mostly in juvenile penguins (Fig. 1). The analysis of microsatellite polymorphism revealed a high level of genetic diversity among A. fumigatus isolates, except for one strain that was largely over-represented during the Autumn sampling session. A limited number of isolate genotypes was collected from clinical cases and from the environment.

Conclusions

Fungal environmental contamination and incidence of aspergillosis in penguins appeared variable depending on seasons, but the rural location of the penguin habitat did not seem to influence the emergence of resistant strains.

pAspergillosis in a colony of Humboldt penguins (Spheniscus humboldti) under managed care: a clinical and environmental investigation in a French zoological park

Aspergillosis is pervasive in bird populations, especially those under human care. Its management can be critically impacted by exposure to high levels of conidia and by resistance to azole drugs. The fungal contamination in the environment of a Humboldt penguin (Spheniscus humboldti) group, housed in a French zoological park next to numerous large crop fields, was assessed through three serial sessions of surface sampling in nests, in 2018-20: all isolates were counted and characterized by sequencing. When identified as A. fumigatus, they were systematically screened for resistance mutations in the cyp51A gene and tested for MICs determination. In the same time, the clinical incidence of aspergillosis was evaluated in the penguin population by the means of systematic necropsy and mycological investigations. A microsatellite-based analysis tracked the circulation of A. fumigatus strains. Environmental investigations highlighted substantial increase of the fungal load during the summer season (>12-fold vs. the other timepoints) and large overrepresentation of species belonging to the Aspergillus section Fumigati, ranging from 22.7 to 94.6% relative prevalence. Only one cryptic species was detected (A. nishimurae), and one isolate exhibited G138S resistance mutation with elevated MICs. The overall incidence of aspergillosis was measured at ∼3.4% case-years, and mostly in juveniles. The analysis of microsatellite polymorphism revealed a high level of genetic diversity among A. fumigatus clinical isolates. In contrast, one environmental strain appeared largely overrepresented during the summer sampling session. In all, the rural location of the zoo did not influence the emergence of resistant strains.

Malignant Melanoma in a Long-legged Buzzard (Buteo rufinus): Characterization of Clinical and Histologic Lesions

A 17-year-old, male long-legged buzzard (Buteo rufinus) presented for acute lethargy and black gelatinous tissue in both nostrils. Despite intensive care, the bird died within 2 days. A postmortem computed tomographic scan of the head revealed a complete obstruction of the rostral infraorbital sinus, later confirmed by necropsy. Postmortem examination also highlighted multifocal, black, infiltrating nodules of various sizes (2 mm to 2 cm in diameter) in almost all internal organs: lungs, heart (pericardium, myocardium, endocardium), kidneys, pancreas, adrenals, muscles, and bones (periosteum and medulla). Histologically, the nodules were composed of anaplastic cells containing abundant melanin pigment, consistent with a disseminated melanoma. Malignant melanomas are aggressive neoplasms frequently reported in mammals but rarely found in avian species. In Accipitridae and Falconidae, only 2 cases have been reported.

Automated analysis of single cells using Laser Tweezers Raman Spectroscopy

In recent years, significant progress has been made into the label-free detection and discrimination of individual cancer cells using Laser Tweezers Raman Spectroscopy (LTRS). However, the majority of examples reported have involved manual trapping of cells, which is time consuming and may lead to different cell lines being analysed in discrete batches. A simple, low-cost microfluidic flow chamber is introduced which allows single cells to be optically trapped and analysed in an automated fashion, greatly reducing the level of operator input required. Two implementations of the flow chamber are discussed here; a basic single-channel device in which the fluid velocity is controlled manually, and a dual-channel device which permits the automated capture and analysis of multiple cell lines with no operator input. Results are presented for the discrimination of live epithelial prostate cells and lymphocytes, together with a consideration of the consequences of traditional 'batch analysis' typically used for LTRS of live cells.

Future directions for the European influenza reference laboratory network in influenza surveillance

By defining strategic objectives for the network of influenza laboratories that have national influenza centre status or national function within European Union Member States, Iceland and Norway, it is possible to align their priorities in undertaking virological surveillance of influenza. This will help maintain and develop the network to meet and adapt to new challenges over the next 3-5 years and underpin a longer-term strategy over 5-10 years. We analysed the key activities undertaken by influenza reference laboratories in Europe and categorised them into a framework of four key strategic objectives areas: enhancing laboratory capability, ensuring laboratory capacity, providing emergency response and translating laboratory data into information for public health action. We make recommendations on the priority areas for future development.

Assessment of validity, reliability, responsiveness and bias of three commonly used patient-reported outcome measures in carpal tunnel syndrome

BACKGROUND

In recent years there has been an increase in the use of self-administered questionnaires to accurately assess intervention outcomes in hand surgery in order to determine the quality of healthcare. This prospective study aims to evaluate and assess the validity, reliability, responsiveness, and bias of a number of outcome measure for Carpal Tunnel Syndrome (CTS) including the disease-specific Boston questionnaires (BQ), and the region-specific Disability of Arm, Shoulder, and Hand (DASH) questionnaires and Manchester Modified Disabilities of the Arm, Shoulder and Hand (M(2)DASH) questionnaires, and comparing the results to Nerve Conduction Studies (NCS).

MATERIALS AND METHODS

Forty-eight patients with clinical signs of CTS confirmed by NCS completed the BQ, DASH and M(2)DASH questionnaire at different time intervals peri-operatively. The scores were analysed to assess validity, reliability, responsiveness, and bias of the questionnaires. Validity analysis for the three questionnaires showed strong positive correlations and there was no age, gender, hand dominance, or side affected bias in the questionnaires.

RESULTS

No significant correlation was obtained between the questionnaires and NCS. Significant results for responsiveness were noted in BQ symptom severity scale only.

CONCLUSION

1. This study ha show n that the BQ, DASH and M(2)DASH questionnaires are valid and reliable outcome measures for CTS. 2. In terms of responsiveness, the DASH and M(2)DASH questionnaires are not as responsive as the BQ scores over the initial post-operative recovery period. 3. We would therefore recommend that the Boston Questionnaire be used to assess early post-operative patient related outcome measures for Carpal Tunnel Syndrome.

Carpal tunnel syndrome: a review of the recent literature

Carpal Tunnel Syndrome (CTS) remains a puzzling and disabling condition present in 3.8% of the general population. CTS is the most well-known and frequent form of median nerve entrapment, and accounts for 90% of all entrapment neuropathies. This review aims to provide an overview of this common condition, with an emphasis on the pathophysiology involved in CTS. The clinical presentation and risk factors associated with CTS are discussed in this paper. Also, the various methods of diagnosis are explored; including nerve conduction studies, ultrasound, and magnetic resonance imaging.

Christiansen filter realized by an odd smooth cylindrical lens

The Christiansen filter that is realized by odd smooth cylindrical lenses is analyzed in detail. Several popular filtering functions are discussed. The corresponding lens profile functions are obtained by an inverse scattering theory, which enables the filter to synthesize a desired prescribed response function. This kind of Christiansen filter has a passband narrower than that of the traditional Christiansen filter. Three Christiansen filters centered at 545 nm with full width at half-maximum of 2 nm are synthesized, and the approach to a better suppression of halos from the main transmission peak of the filters is presented in a systematic way.

Start of the influenza season 2008-9 in Europe - increasing influenza activity moving from West to East dominated by A(H3N2)

The influenza season 2008-9 started in week 49 of 2008 and is so far characterised by influenza virus type A subtype H3N2. Isolates of this subtype that were tested proved susceptible to neuraminidase inhibitors, but resistant to M2 inhibitors. The circulating A(H3N2) viruses are antigenically similar to the component in the current northern hemisphere influenza vaccine.

Start of the influenza season 2008-9 in Europe - increasing influenza activity moving from West to East dominated by A(H3N2)

The influenza season 2008-9 started in week 49 of 2008 and is so far characterised by influenza virus type A subtype H3N2. Isolates of this subtype that were tested proved susceptible to neuraminidase inhibitors, but resistant to M2 inhibitors. The circulating A(H3N2) viruses are antigenically similar to the component in the current northern hemisphere influenza vaccine.

Case studies: orthopaedic surgery in adult patients with haemophilia A with inhibitors

Whilst orthopaedic surgery in haemophilia patients without inhibitors is now relatively common in specialized centres, until recently there have been only a few sporadic instances of surgery having been undertaken on patients with inhibitors. The availability of recombinant activated factor VII (rFVIIa) for haemostatic cover during surgery allows procedures to be performed that previously may not have been considered possible. Complications associated with thrombosis are rare in haemophilia patients with inhibitors, but bleeding complications remain a concern. Globally, experience of performing orthopaedic surgery in these patients is increasing and many successful outcomes have been reported. However, more knowledge relating to the incidence and type of bleeding complications liable to be encountered, together with further information about appropriate rescue treatment, would be valuable. Data relating to long-term follow-up after surgery would be useful, as would a comparison of outcomes between haemophilia patients with and without inhibitors. Optimal dosing regimens for rFVIIa as surgical cover are still to be determined and further information is required relating to the cost effectiveness of rFVIIa in surgery. Further study should address these issues.

Episodic and semantic memory tasks activate different brain regions in Alzheimer disease

OBJECTIVE

To compare brain activity identified by fMRI in subjects with Alzheimer disease (AD) and older healthy controls (HCs) performing an episodic/working memory (EWM) and semantic memory (SM) task.

METHODS

Nine AD (mean age 73.6) and 10 HC (mean age 71.8) subjects underwent an fMRI memory paradigm. Tasks comprised 1) baseline (recognizing a single digit presented for 1 second), 2) SM (addition of two single digits, always producing a single digit answer), and 3) EWM (recall of the previous single digit on the stimulus of the next digit). Each condition was presented in 2-minute blocks with a shorter and longer time interval for the first and second minute within blocks.

RESULTS

Comparing AD and HC subjects, there were no activated brain regions in common for EWM > SM, but left anterior cingulate (Brodmann area [BA] 24, 0, 31, 4) and left medial frontal lobe gyrus (BA 25, -6, 23, -15) were activated by both groups for SM > EWM. Key differences were that for EWM > SM, HC subjects activated the right parahippocampal gyrus, whereas subjects with AD activated the right superior frontal gyrus and left uncus.

CONCLUSIONS

Subjects with Alzheimer disease (AD) recruited brain regions for easier episodic/working memory (EWM) tasks used by healthy controls (HCs) for more difficult EWM tasks. AD subjects recruited brain regions for semantic memory tasks used by HCs for more difficult EWM tasks. The authors propose a functional "memory reserve" model of compensatory recruitment according to task difficulty and underlying neuropathology.

Ethnicity and adolescent deliberate self-harm

The characteristics of all adolescents referred to the psychiatric service of a tertiary hospital following an episode of deliberate self-harm (DSH) were studied. Of 100 adolescents selected over a 3-year period, 64 White and 28 Black adolescents were compared to identify factors associated with DSH in Black adolescents. The main findings were: (1) the referral rate for Black adolescents was in proportion to the community composition; (2) the characteristics of Black and White adolescents referred following DSH were similar for background socio-demographic variables, psychiatric symptoms, circumstances of the attempt and outcome. However, more social stress was reported in the Black group.

Colour blind cricketers and snowballs

OBJECTIVE

To determine whether colour blindness affects batting in professional cricketers.

DESIGN

Comparison of batting averages of colour blind cricketers and those with normal vision.

SETTING

Players on 18 first class county cricket teams.

SUBJECTS

280 of 306 players were tested.

MAIN OUTCOME MEASURES

Results of Isihara colour blindness tests.

RESULTS

Batting average for the colour blind group (12 players) was slightly lower than for players with normal vision (20.88 v 26.31). There was no difference in the number of batsmen and bowlers affected. Batting averages before and after the introduction of the white ball into Sunday League cricket did not differ significantly.

CONCLUSIONS

That batting performance is not significantly impaired by colour blindness suggests that to some extent these players are self selected. Routine testing of cricketers for colour blindness is not recommended.

Immunological and feeding studies on antigens derived from the biting fly, Stomoxys calcitrans

Pairs of rabbits were immunised with three antigenic preparations derived from Stomoxys calcitrans gut, abdominal section and whole flies. Immunoblotting studies demonstrated that a humoral response was mounted against eight antigens from the gut preparation and 12 each from the abdominal and whole fly preparations. In vitro feeding experiments showed higher mortality between Days 4 and 7 in the group of flies which had fed upon blood from rabbits inoculated with the gut derived antigen. This group also produced the lowest percentage of viable eggs (15.5%).

Financial responsibilities and preparation of chief nurse executives

Chief nurse executives face staggering financial responsibility. Findings indicate a variety of processes are used to administer budgets in excess of $14 million. On-the-job experience, instead of formal education, is the major means of acquiring expertise in financial management.

Palmar subluxation of the carpus in rheumatoid disease: a radiological evaluation

The authors present a radiological assessment of palmar subluxation of the carpus in rheumatoid disease. The radiological measurements have been taken with reference to the long axis of the radius, the radiological centres of the lunate and the capitate and expressing their reciprocal distances as a ratio which we have termed the radio-carpal and inter-carpal indices. Using a control group of a 100 serial radiographs of normal wrists it was possible to determine the normal indices and their normal range. A subsequent analysis of 100 rheumatoid wrists enabled them to accurately determine the degree of anterior carpal subluxation, and allowed this form of radio-carpal malalignment to be differentiated from other forms of carpal instability.