Bone and joint infections due to melioidosis; diagnostic and management strategies to optimise outcomes.

Background: Melioidosis, a life-threatening infection caused by the gram negative bacterium Burkholderia pseudomallei, can involve almost any organ. Bone and joint infections (BJI) are a recognised, but incompletely defined, manifestation of melioidosis that are associated with significant morbidity and mortality in resource-limited settings.

Methodology/principal Findings: We identified all individuals with BJI due to B.

Antimicrobial Volatiles of the Insect Pathogen .

Fungal volatile organic compounds (VOCs) represent promising candidates for biopesticide fumigants to control crop pests and pathogens. Herein, VOCs produced using three strains of the entomopathogenic fungus were identified via GC-MS and screened for antimicrobial activity. The VOC profiles varied with fungal strain, development state (mycelium, spores) and culture conditions.

Breathlessness and cough in the acute setting.

The symptom of breathlessness is well recognized as part of the presentation of a wide range of medical conditions. It can be a manifestation of a life-threatening emergency. In acute medical settings, the priority is to quickly recognize patients who are critically unwell and require emergency treatment.

Effects of route of administration on oxytocin-induced changes in regional cerebral blood flow in humans.

Could nose-to-brain pathways mediate the effects of peptides such as oxytocin (OT) on brain physiology when delivered intranasally? We address this question by contrasting two methods of intranasal administration (a standard nasal spray, and a nebulizer expected to improve OT deposition in nasal areas putatively involved in direct nose-to-brain transport) to intravenous administration in terms of effects on regional cerebral blood flow during two hours post-dosing. We demonstrate that OT-induced decreases in amygdala perfusion, a key hub of the OT central circuitry, are explained entirely by OT increases in systemic circulation following both intranasal and intravenous OT administration. Yet we also provide robust evidence confirming the validity of the intranasal route to target specific brain regions.

Predicting Amputation and Multiple Debridements in Tooth Knuckle Injuries.

Background: Tooth knuckle injuries can be expensive to treat and may necessitate amputation in some cases. Several limitations exist in the literature regarding our knowledge around the factors predicting amputation and the need for multiple debridements in treating this injury.

Methods: A historic cohort study of 321 patients treated for tooth knuckle injuries was undertaken.

A combined randomised and observational study of surgery for fractures in the distal radius in the elderly (CROSSFIRE)-a study protocol.

Unlabelled: Fractures of the distal radius are common and occur in all age groups. The incidence is high in older populations due to osteoporosis and increased falls risk. Considerable practice variation exists in the management of distal radius fractures in older patients ranging from closed reduction with cast immobilisation to open reduction with plate fixation.

Predicting serious complications and high cost of treatment of tooth-knuckle injuries: a systematic literature review.

Purpose: The tooth-knuckle injury (TKI) is a serious and potentially costly injury seen in orthopaedic practice. The aim was to conduct a systematic literature review on the factors associated with serious complications and high treatment costs in tooth-knuckle injuries.

Methods: MEDLINE, Scopus and CINAHL were used as the literature sources.

PCB pollution continues to impact populations of orcas and other dolphins in European waters.

Organochlorine (OC) pesticides and the more persistent polychlorinated biphenyls (PCBs) have well-established dose-dependent toxicities to birds, fish and mammals in experimental studies, but the actual impact of OC pollutants on European marine top predators remains unknown. Here we show that several cetacean species have very high mean blubber PCB concentrations likely to cause population declines and suppress population recovery. In a large pan-European meta-analysis of stranded (n = 929) or biopsied (n = 152) cetaceans, three out of four species:- striped dolphins (SDs), bottlenose dolphins (BNDs) and killer whales (KWs) had mean PCB levels that markedly exceeded all known marine mammal PCB toxicity thresholds.

Volar dislocation of the index, middle, and ring carpometacarpal joints: a review.

Dislocation of the index, middle, and ring carpometacarpal joints is an extremely rare injury pattern, with a paucity of published cases. We reviewed the literature and analyzed our own experience to familiarize clinicians with this rare condition through discussion of its clinical presentation, diagnostic considerations, and management. We present the rare case of volar-radial dislocation of the index, middle, and ring carpometacarpal joints in a 61-year-old woman.

Treatment of distal radial fractures with the DVR-A plate--the early Bristol experience.

Aim: The aim of the study was to assess how adequately distal radial fracture reduction was reproduced and maintained with the distal volar radius anatomic DVR-A (Biomet, Inc) locking plate.

Methods: We looked at a consecutive series of 111 patients treated with the DVR-A plate at our institution from 2007-2010. The preoperative, intra-operative, and postoperative films were reviewed.

What caused the UK's largest common dolphin (Delphinus delphis) mass stranding event?

On 9 June 2008, the UK's largest mass stranding event (MSE) of short-beaked common dolphins (Delphinus delphis) occurred in Falmouth Bay, Cornwall. At least 26 dolphins died, and a similar number was refloated/herded back to sea. On necropsy, all dolphins were in good nutritive status with empty stomachs and no evidence of known infectious disease or acute physical injury.

Seasonal abundance and epidemiological indices of potential plague vectors Dinopsyllus lypusus (Siphonaptera: Hystrichopsyllidae) and Ctenophthalmus calceatus (Siphonaptera: Ctenophthalmidae) on rodents captured from three habitat types of Hatcliffe and Dzivarasekwa suburbs of Harare, Zimbabwe.

The seasonal abundance of Dinopsyllus lypusus Jordan and Rothschild and Ctenophthalmus calceatus Waterson (potential vectors of plague in southern Africa) were studied on rodent hosts captured in selected habitat types of two periurban suburbs of Harare, Zimbabwe. Removal trapping was used to capture the rodents, from which fleas were collected and identified. Prevalence (proportion of animals infested) and specific flea index (SFI = number of fleas per animal) were calculated for each species of rodent host.

Is fixation failure after plate fixation of the symphysis pubis clinically important?

Background: Plate fixation is a recognized treatment for pelvic ring injuries involving disruption of the pubic symphysis. Although fixation failure is well known, it is unclear whether early or late fixation failure is clinically important.

Questions/purposes: We therefore determined (1) the incidence and mode of failure of anterior plate fixation for traumatic pubic symphysis disruption; (2) whether failure of fixation was associated with the types of pelvic ring injury or pelvic fixation used; (3) the complications, including the requirement for reoperation or hardware removal; and (4) whether radiographic followup of greater than 1 year alters subsequent management.

Contaminants in cetaceans from UK waters: status as assessed within the Cetacean Strandings Investigation Programme from 1990 to 2008.

Since 1990, tissue samples from UK-stranded and -bycaught cetaceans have been available for study of contaminant burdens. These have been used to study spatial and temporal trends in concentrations in UK waters, and to investigate potential associations between contaminants and health status. We describe the current status of cetaceans (primarily harbour porpoises, Phocoena phocoena) in UK waters in relation to pollution.

Seasonal abundance of plague vector Xenopsylla brasiliensis from rodents captured in three habitat types of periurban suburbs of Harare, Zimbabwe.

The study was aimed at determining the seasonal abundance of Xenopsylla brasiliensis, an important vector of plague in Zimbabwe, from rodent hosts captured in selected habitat types of two periurban suburbs of Harare, Zimbabwe. The removal-trapping method was used to capture the rodents, from which fleas were collected and identified. Percentage incidence index (PII) and specific flea index (SFI) were calculated for X.

Postmortem evidence of interactions of bottlenose dolphins (Tursiops truncatus) with other dolphin species in south-west England.

Reports of violent interactions between bottlenose dolphins (Tursiops truncatus) and harbour porpoises (Phocoena phocoena) in the coastal waters of the UK are well documented. Examination of stranded cetaceans by the Cornwall Wildlife Trust Marine Strandings Network and the UK Cetacean Strandings Investigation Programme has indicated that seven animals, of four other species, found stranded in south-west England, had pathology consistent with bottlenose dolphin interaction, including two juvenile and two adult common dolphins (Delphinus delphis), one juvenile pilot whale (Globicephala melas), one juvenile Risso's dolphin (Grampus griseus) and one adult striped dolphin (Stenella coeruleoalba). Although recorded traumatic lesions were often not as severe as those found in harbour porpoises, it is probable that the interactions did contribute to stranding and/or death in all four of the juvenile animals examined.

Beware of glenoid dysplasia mimicking bone trauma in the injured shoulder.

The term 'primary glenoid dysplasia' is used to describe a rare developmental abnormality of the shoulder. The symptomatic presentation of glenoid dysplasia has two definite age-related peaks. The first peak is in adolescents and young adults; they generally present with symptoms of instability related to high levels of activity.

Arthritis progression after patellofemoral joint replacement.

Progressive symptomatic tibiofemoral osteoarthritis (OA) following patellofemoral joint replacement (PFJR) may necessitate revision to total knee arthroplasty. This study was designed to quantify this problem in a prospective series of 103 consecutive patients who underwent PFJRs undertaken at our institution. At a mean follow-up of 7.

Revision of an acetabular liner has a high risk of dislocation.

Polyethylene liners of modular acetabular components wear sometimes need to be replaced, despite the metal shell being well fixed. Replacing the liner is a relatively simple procedure, but very little is known of the outcome of revision. We prospectively followed up 1126 Harris-Galante I metal-backed, uncemented components for between nine and 19 years.

Embryonic and larval respiration in the arboreal foam nests of the African frog Chiromantis xerampelina.

In Zimbabwe, female Chiromantis xerampelina construct spherical foam nests that are suspended above temporary water. The nests average 624 ml in volume and contain 854 eggs. The 1.

Systematic study of human alpha beta T cell receptor V segments shows allelic variations resulting in a large number of distinct T cell receptor haplotypes.

The variation of the alpha beta T cell receptor (TCR) results mainly from rearrangements of germ-line V, D and J elements combined with the processes of N- and P-region addition. In addition to this extensive diversity, diallelic polymorphism is also recognized in V regions of beta loci. Four such polymorphisms have previously been defined, but the full extent of such variation has not yet been established.