Premonitory Signs Research Articles

Mapping the susceptibility to sinkholes in coastal areas, based on stratigraphy, geomorphology and geophysics

Sinkholes and land subsidence are among the main coastal geologic hazards. Their occurrence poses a serious threat to the man-made environment, due to the increasing density of population, pipelines and other infrastructures along the coasts, and to the catastrophic nature of the phenomena, which generally occur without any premonitory signs. To assess the potential danger from sinkholes along the coast, it is important to identify and monitor the main factors contributing to the process. This article reports a methodology based on sequential stratigraphic, hydrogeological and geophysical investigations to draw up a susceptibility map of sinkholes in coastal areas. The town of Casalabate situated in the Apulia region (southern Italy), affected by a long history of sinkhole phenomena, is here presented as an example. The approach proposed is based on sequential stratigraphical, geomorphological and geophysical surveys to identify the mechanisms of sinkhole formation and to provide a zonation of the areas in which further sinkhole phenomena may likely occur. Interpretation of the ground penetration radar and electrical tomography profiles has enabled us to identify the potentially most unstable sectors, significantly improving the assessment of the sinkhole susceptibility in the area. The proposed methodology is suitable to be exported in other coastal areas where limestone bedrock is not directly exposed at the surface, but covered by a variable thickness of recent deposits.

Amanitin intoxication in two beef calves in California

Two 2- and 3-month-old beef calves from 2 separate herds, locations, and times were found dead and were submitted to the veterinary diagnostic laboratory for diagnostic work-up. In both cases, no premonitory signs were seen by the owners. Histopathology revealed acute panlobular hepatic necrosis in both calves. In addition, calf A had copper and selenium deficiency, and calf B had oxalate nephrosis, and selenium and zinc deficiencies. Alpha-amanitin was detected in the urine from calf A, and in the liver and rumen contents from calf B using liquid chromatography-mass spectrometry. The cause of panlobular hepatic necrosis and death of both calves was determined to be amanitin toxicosis from ingestion of amanitin-containing mushrooms based on microscopic changes and toxicological analysis of tissues. In cases of sudden death in cows with histopathological findings of panlobular hepatic necrosis, toxicological analysis for amanitin is needed for a definitive diagnosis of poisoning by amanitin-containing mushrooms.

Outbreak of Mortality in Psittacine Birds in a Mixed-Species Aviary Associated With Erysipelothrix rhusiopathiae Infection

Erysipelothrix rhusiopathiae septicemia, associated with an increased mortality of captive psittacines in a mixed-species aviary, was diagnosed by histopathology, Gram staining, bacterial culture and sequencing, immunohistochemistry, and real-time polymerase chain reaction (PCR). Over a period of 23 days with no premonitory signs, 2 rainbow lorikeets and an eclectus parrot died. Of these birds, one lorikeet and the eclectus were submitted for necropsy. The main pathologic findings were thrombosis (2/2), bacterial embolism/thromboembolism (2/2), necrotizing hepatitis (2/2), necrohemorrhagic myocarditis (1/2), fibrinohemorrhagic and heterophilic visceral coelomitis (1/2), submandibular necrosuppurative dermatitis with necrotizing vasculitis and bacterial and fungal thromboembolism (1/2), and locally extensive rhabdomyonecrosis with bacterial embolism (1/2). Intralesional bacteria were positive by Gram staining and immunohistochemistry in both cases. E. rhusiopathiae was isolated by routine bacterial culture from the liver of the lorikeet, which was also positive by real-time PCR. This report is one of the rare descriptions of erysipelas in psittacines, and to the authors' knowledge, it appears to be the first in the described species using immunohistochemistry and real-time PCR on avian paraffin-embedded tissues for the diagnosis.

Epizootic Myocarditis Associated With Encephalomyocarditis Virus in a Group of Rhesus Macaques (Macaca mulatta)

Six cases of fatal myocarditis associated with encephalomyocarditis virus occurred over a 14-month period in a group of outdoor-housed juvenile rhesus macaques. All animals were younger than 3 years of age and died or were euthanized following acute onset of dyspnea or pulmonary effusion (3 of 6) or were found dead without premonitory signs (3 of 6). Gross findings included pulmonary congestion (6 of 6), variable degrees of pleural effusion (4 of 6), multifocal pale tan foci throughout the myocardium (3 of 6), hepatomegaly and hepatic congestion (3 of 6), and pericardial effusion (1 of 6). Histologically, affected myocardium was infiltrated multifocally by lymphoplasmacytic and histiocytic inflammation admixed with necrotic and degenerate myofibers and infrequent mineralization (6 of 6). Pulmonary edema was present in all animals. Encephalomyocarditis virus was confirmed in 6 of 6 hearts by immunohistochemistry, and virus was isolated from one case by polymerase chain reaction. Sequencing of virus isolated from 1 affected animal indicated infection with a novel encephalomyocarditis virus. Encephalomyocarditis virus should be considered as a differential etiology in outbreaks of myocarditis and pulmonary edema in juvenile primates.

High NIHSS Values Predict Impairment of Cardiovascular Autonomic Control

Stroke is frequently associated with autonomic dysfunction, which causes secondary cardiovascular complications. Early diagnosis of autonomic imbalance prevents complications, but it is only available at specialized centers. Widely available surrogate markers are needed. This study tested whether stroke severity, as assessed by National Institutes of Health Stroke Scale (NIHSS) scores, correlates with autonomic dysfunction and thus predicts risk of autonomic complications. In 50 ischemic stroke patients, we assessed NIHSS scores and parameters of autonomic cardiovascular modulation within 24 hours after stroke onset and compared data with that of 32 healthy controls. We correlated NIHSS scores with parameters of total autonomic modulation (total powers of R-R interval [RRI] modulation; RRI standard deviation [RRI-SD], RRI coefficient of variation), parasympathetic modulation (square root of the mean squared differences of successive RRIs, RRI-high-frequency-powers), sympathetic modulation (normalized RRI-low-frequency-powers, blood pressure-low-frequency-powers), the index of sympatho-vagal balance (RRI-LF/HF-ratios), and baroreflex sensitivity. Patients had significantly higher blood pressure and respiration, but lower RRIs, RRI-SDs, RRI coefficient of variation, square root of the mean squared differences of successive RRIs, RRI-low-frequency-powers, RRI-high-frequency-powers, RRI-total powers, and baroreflex sensitivity than did controls. NIHSS scores correlated significantly with normalized RRI-low-frequency-powers and RRI-LF/HF-ratios, and indirectly with RRIs, RRI-SDs, square root of the mean squared differences of successive RRIs, RRI-high-frequency-powers, normalized RRI-high-frequency-powers, RRI-total-powers, and baroreflex sensitivity. Spearman-Rho values ranged from 0.29 to 0.47. Increasing stroke severity was associated with progressive loss of overall autonomic modulation, decline in parasympathetic tone, and baroreflex sensitivity, as well as progressive shift toward sympathetic dominance. All autonomic changes put patients with more severe stroke at increasing risk of cardiovascular complications and poor outcome. NIHSS scores are suited to predict risk of autonomic dysregulation and can be used as premonitory signs of autonomic failure.

Dispharynx nasuta (Nematoda: Acuariidae) Infection Causing Proventricular Lesions and Death in Three Captive Rosellas (Psittaciformes: Psittacidae)

Two adult male Crimson rosellas (Platycercus elegans) and an adult female eastern rosella (Platycercus eximius) were found dead in their cages in a private aviary in March 2009, April 2010, and February 2010, respectively, without premonitory signs. Their postmortem examination showed pectoral muscle atrophy and a distended proventriculus. The proventricular mucosal surface was covered with a gelatinous, whitish material, where a large number of nematode parasites identified as Dispharynx nasuta were present. A histologic examination revealed a hyperplastic mucosa, spirurid nematodes in the mucosal layer and inflammatory mononuclear cells in the lamina propria. This is the first report of a D. nasuta infection associated with proliferative proventriculitis and subsequent death in psittacine birds.

Modelling the rainfall-induced mobilization of a large slope movement in northern Calabria

Two recent phases of mobilization of a large, rainfall-induced debris slide are analysed in terms of relationships between rains and phases of displacement. The first activation at San Rocco (San Benedetto Ullano, Calabria) occurred on 28 January 2009, after extraordinary rains had stricken the region for a couple of months. Detailed geomorphologic field surveys, combined with measurements of superficial displacements at datum points, were performed to properly recognize the evolution of the phenomenon. In addition, a real-time control system of rains and superficial displacements measured at extensometers was implemented, to better analyse the evolution of the phenomenon. In early May 2009, the activity reduced to very slow displacements, persisting in the same condition for the following 8 months. On 1 February 2010, premonitory signs of a new phase of activation were noticed, again following 2 months of extraordinary rainfalls. After few days of further precipitations, the middle sector of the landslide activated since 11 February, disrupting the road network and threatening the major lifelines and some buildings. A hydrological analysis aimed at simulating the dates of activation and the main phases of acceleration of the phenomenon was carried out, by calibrating the empirical model FLaIR against the daily rainfalls and the history of known phases of mobilization since 1970. Calibration allowed to successfully simulate both the cited phases of activity of the San Rocco landslide, by predicting the beginning of the movements as well as the following paroxysmal stages, as testified by the measurements at datum points and extensometers. The set of parameters obtained through calibration reflects the influence of both prolonged antecedent rains, and of high-intensity rainfalls of shorter duration, which slightly preceded the major displacements. Once calibrated the model, a suitable threshold could be defined, by analysing the trend of the mobility function against the history of activations of the considered slope movement, and by excluding false alarms. Accordingly, a reliable tool for predicting the phases of activity of a large slope movement could therefore be obtained.

Origin and distribution of different types of sinkholes in the plain areas of Southern Italy

Sinkholes constitute a significant risk in many karst areas, and may even threat human safety. Collapse sinkholes that occur catastrophically without showing premonitory signs may result in severe economic losses and casualties. In the last years, research on sinkholes and related detrimental effects has significantly increased in Italy, in the aftermath of remarkable events. Aimed at analysing the peculiar conditions which lead to sinkhole occurrence in Southern Italy, a set of cases in the plain areas of Campania, Apulia and Calabria is discussed. The considered regions show a wide variety of environmental conditions. In Campania, the plains are underlain by alluvial deposits with intercalations of volcaniclastic sediments. Sinkholes are generally located along the Tyrrhenian margin of the carbonate massifs or within intramontane Apennine basins. In Apulia, a flat and elongated peninsula, most of the cases occur on calcarenites overlying limestone bedrock along the coast. In Calabria, one of the most seismogenic Italian regions, the surveyed cases seem to be attributable mainly to earthquake-induced liquefaction. The article provides a first glance on the variety of sinkholes in the plain areas of Southern Italy, to highlight the possibility of further subsidence events in the considered regions, as well as in other comparable areas of the country.

Appearance of age-related macular degeneration in vitrectomized and nonvitrectomized eyes: an intraindividual case study

This study analyses the consequences of vitreoretinal traction on the macula and in particular the impact of a vitrectomy on the development of the age-related macular degeneration (ARMD). In this retrospective case study, 42 eyes of 21 subjects were examined. The vitreous of one eye must have been removed by vitrectomy at least 8 years ago. At that point in time, the patients had to be at least 50 years old, with a healthy vitreous body of the other eye and a healthy macula in both eyes. Both eyes were examined using an optical coherence tomography (OCT) scan, B-scan ultrasound, a binocular slit-lamp funduscopy and a fluorescence angiography (FAG) to evaluate the potential development stage of an ARMD and the vitreous status. In the follow-up examination, the patients had an average age of 73.6 years. In 0 of 21 vitrectomized eyes (0%), there were signs for an early ARMD. In 5 of 21 nonvitrectomized eyes (23.8%), we found ARMD-like changes in the angiography and slit-lamp examinations. Of these 21 eyes, five eyes presented persistent attachment of the posterior vitreous cortex to the macula, while 16 eyes showed complete posterior vitreous detachment. All five eyes (100%) with premonitory signs of an ARMD showed persistent attachment of the posterior vitreous to the macula. We demonstrated a positive relationship between a persistent attachment of the posterior vitreous cortex to the macula and early signs of ARMD. Although the precise mechanism of this relationship remains unclear, the role of chronic low-grade inflammation, chronic oxidative and mechanical stress and an increase in VEGF is discussed. Persistent vitreous attachment is likely to be another risk factor for ARMD.

Prevention of Torsade de Pointes in Hospital Settings

Cardiac arrest due to torsade de pointes (TdP) in the acquired form of drug-induced long-QT syndrome (LQTS) is a rare but potentially catastrophic event in hospital settings. Administration of a QT-prolonging drug to a hospitalized population may be more likely to cause TdP than administration of the same drug to an outpatient population, because hospitalized patients often have other risk factors for a proarrhythmic response. For example, hospitalized patients are often elderly people with underlying heart disease who may also have renal or hepatic dysfunction, electrolyte abnormalities, or bradycardia and to whom drugs may be administered rapidly via the intravenous route. In hospital units where patients’ electrocardiograms (ECGs) are monitored continuously, the possibility of TdP may be anticipated by the detection of an increasing QT interval and other premonitory ECG signs of impending arrhythmia. If these ECG harbingers of TdP are recognized, it then becomes possible to discontinue the culprit drug and manage concomitant provocative conditions (eg, hypokalemia, bradyarrhythmias) to reduce the occurrence of cardiac arrest. The purpose of this scientific statement is to raise awareness among those who care for patients in hospital units about the risk, ECG monitoring, and management of drug-induced LQTS. Topics reviewed include the ECG characteristics of TdP and signs of impending arrhythmia, cellular mechanisms of acquired LQTS and current thinking about genetic susceptibility, drugs and drug combinations most likely to cause TdP, risk factors and exacerbating conditions, methods to monitor QT intervals in hospital settings, and immediate management of marked QT prolongation and TdP. The term torsade de pointes was coined by Dessertenne in 1966 as a polymorphic ventricular tachycardia characterized by a pattern of twisting points.1 Several ECG features are characteristic of TdP and are illustrated in Figure 1. First, a change in the amplitude and morphology (twisting) of the QRS …

Toxoplasmosis in Macropodids: A Review

Toxoplasmosis is a well-described disease entity that causes significant morbidity and mortality in both captive and free-ranging macropodids. The clinical presentation of toxoplasmosis in macropodids is variable, which reflects the multiple body systems affected by this disease. Animals may die without exhibiting premonitory signs or after the acute development of nonspecific signs of illness. In more chronic cases, clinical signs include neurologic deficits, blindness, respiratory signs, and, in some cases, diarrhea. Histologic lesions can be extensive and affect the pulmonary parenchyma, cardiac and skeletal muscle, lymph nodes, spleen, gastrointestinal tract, adrenal glands, pancreas, central nervous system, liver, and kidney. An antemortem diagnosis can be challenging, although a range of serologic tests are available. Treatment is frequently unrewarding, although recent evidence suggests that the anti-protozoal drug atovaquone may be effective in treating acute cases and eliminating infection. Attempts to vaccinate macropodids against toxoplasmosis have been unsuccessful, and preventive measures are limited to preventing exposure to sporulated oocysts in the environment.

Polycystic Kidney Disease in the Pygmy Hippopotamus (Hexaprotodon liberiensis)

Polycystic kidney disease (PKD) was diagnosed at necropsy in a captive aged female pygmy hippopotamus (Hexaprotodon liberiensis), which presented with numerous cysts in both kidneys, the liver, and the duodenum and with one single cyst in the pancreas. There were no premonitory clinical signs of a nephropathy observed prior to its death. Similar findings were made in a male cage mate 6 mo later. Both animals had been wild caught. A literature review revealed that another seven cases of PKD have been reported in pygmy hippopotamuses, and an additional screening of records available from the international studbook for the species revealed yet another six cases. In all cases, aged females were affected, and in several instances, affected animals were related to each other. These patterns indicated familiar transmission similar that associated with PKD in humans and other animals. The disease, and especially the presumptive bias in diagnosis toward females, indicated that the male animal of this report was the first case of PKD reported in a male pygmy hippopotamus; thus, further investigation is warranted. The status of the kidneys with respect to PKD should be assessed (including histology) in every deceased pygmy hippopotamus, and whenever possible by ultrasonography in live animals.

Diagnosis of the first cases of scrapie in Poland

This is the first report of cases of scrapie in Poland. The disease was an atypical phenotype, diagnosed in two aged sheep which were found dead. Brainstem samples from both animals were positive on the applied ELISA rapid test, while the confirmatory immunoblot indicated abnormal banding patterns of protease resistant prion protein (PrP(res)). The genotypes of these sheep were ALRQ/ALHQ and ALRQ/ALRR. The absence of premonitory clinical signs, the advanced age of the affected sheep, the higher concentration of PrP(res) in the cerebellum relative to the obex, the unusual banding profile of the prion protein and its relatively low resistance to proteolytic degradation confirmed the diagnosis of atypical scrapie (Nor98-like) in both cases.

Streptococcus suis: An Emerging Human Threat

In the world of Streptococcus, S. suis has been somewhat neglected. Indeed, at this year’s Lancefield International Symposium on Streptococci and Streptococcal Diseases, only one oral presentation was devoted to this pathogen. However, this perception should change, because S. suis is emerging as an important threat to human health. S. suis is an encapsulated Grampositive coccus possessing cell-wall antigens related to Lancefield group D. There are 35 serotypes that have been described on the basis of the composition of the polysaccharide capsule [1]. S. suis infections are considered to be a major problem worldwide in the swine industry. The pathogen’s natural habitat is the upper respiratory tract of pigs, as well as the genital and alimentary tracts [1]. The pig carrier rate is near 100%, and, in the absence of treatment, mortality reaches 20% [2]. The most important clinical feature associated with S. suis infection in pigs is meningitis. In severe cases, pigs are found dead with no premonitory signs. Other manifestations are arthritis, endocarditis, pneumonia, rhinitis, abortion, and vaginitis [1]. Until recently, S. suis disease in humans has been rare [3, 4]. Since the first human case in Denmark in 1968 [5] and before 2005, only 250 S. suis infections were reported in Europe and Asia. However, S. suis recently was identified as the third most common cause of communityacquired bacterial meningitis in Hong Kong, behind S. pneumoniae and Mycobacterium tuberculosis [6], and as the leading cause of adult meningitis in Vietnam [7]. Mysteriously, only 2 cases of S. suis meningitis have been reported in Canada [8, 9], and only 1, very recently, in the United States [10]. Although the epidemiology of S. suis infections in humans remains largely undefined, nearly all cases can be ascribed to either handling or consumption of unprocessed pork meat or to close contact with pigs. Therefore, most infected people are pig farmers, abattoir workers, meat inspectors, butchers, and veterinarian practitioners [4]. In humans, S. suis usually produces a purulent or nonpurulent meningitis. Additionally, endocarditis, cellulitis, peritonitis, rhabdomyolysis, arthritis, spondylodiscitis, pneumonia, uveitis, and endopthalmitis may occur [4, 11, 12]. Both severe infections with shock and a high mortality also have been described [13, 14]. One striking feature of S. suis–related meningitis is the complication of deafness and/or vestibular dysfunction, which occurs at a rate consistently higher than that reported for other meningitis-causing bacteria and which reaches 50% and 65% in Europe and Asia, respectively [11, 12]. Most cases of S. suis infection have been attributed to serotype 2 strains; however, cases due to serotypes 4, 14, and 16 also have been reported [4]. Strains isolated from humans are phenotypically and genotypically similar to those recovered from swine within the same geographical region [15].

Mortalities Associated with Sepsis, Parasitism, and Disseminated Round Cell Neoplasia in Yellow-Lipped Sea Kraits (Laticauda colubrina)

This case series describes multiple mortalities associated with sepsis, neoplasia, and endoparasitism in yellow-lipped sea kraits (Laticauda colubrina) at an exhibit aquarium. Over a 2-yr period, the facility kept 42 L colubrina, of which 38 died and 19 were suitable for necropsy and histopathology. The common clinical syndrome seen in these animals consisted of partial to compete anorexia, increased time spent "hauled-out" on land, intermittent regurgitation, chronic lethargy, and weight loss. Few animals died without premonitory signs. Nutritional support and treatment for presumptive parasitism and sepsis were unsuccessful. The mortality seen in this collection of sea kraits could be placed into three groups; one group of animals (n=9) died of sepsis secondary to necrotizing enteritis or pneumonia; one group (n=6) remained apparently healthy for over 1 yr and then died with multifocal granulomas and sepsis; and the last group (n=3) died as a result of multicentric lymphoid neoplasia with secondary sepsis. The unifying factor in the majority of these cases is the presence of septicemia as the proximate cause of death. Based on the clinical picture, it is presumed that an immunosuppressive event, such as transport, captivity stress, or possible concurrent viral infection, resulted in a septic event and death.

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) in Four Calves

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), or Bland-White-Garland syndrome, is a rare congenital malformation described in children and adults. In this condition, the left coronary artery, which normally originates from the left coronary sinus in the aorta, instead originates from the pulmonary trunk, which results in retrograde flow of blood away from the myocardium into the lower-pressure pulmonary artery. Myocardial hypoxic-ischemic injury results in cardiac dysfunction, failure, and eventually in patient death if not surgically repaired. This report describes gross and microscopic findings in 4 beef calves with ALCAPA. All the calves had a history of being found dead with few or no premonitory signs, 2 shortly after sudden strenuous exercise. Gross necropsy lesions suggestive of heart failure included cardiomegaly with atrial and ventricular dilation and/or ventricular hypertrophy, and hepatomegaly. Dissection of each heart revealed the origin of the left coronary artery arising in the pulmonary trunk above the anterior cusp of the pulmonic valve. No degeneration; mineralization; and fiber loss, with replacement by fibrous connective tissue, predominantly in the left ventricular papillary muscle and the interventricular septum. Changes observed in the liver and lungs, including hepatomegaly, sinusoidal congestion, centrilobular fibrosis, and pulmonary congestion, edema, and intra-alveolar pigment-laden macrophages were consistent with heart failure.

Ulcerative Enterocolitis in Two Goats Associated with Enterotoxin- and beta2 Toxin–Positive Clostridium Perfringens Type D

Enterotoxemia caused by Clostridium perfringens type D in sheep is believed to result from the action of epsilon toxin (ETX). However, the sole role of ETX in the intestinal changes of the acute and chronic forms of enterotoxemia in goats remains controversial, and the synergistic action of other C. perfringens toxins has been suggested previously. The current study examined 2 goats that were found dead without premonitory clinical signs. Gross lesions at necropsy consisted of multifocal fibrinonecrotic enterocolitis, edematous lungs, and excess pleural fluid. Histologically, there were multifocal fibrinonecrotic and ulcerative ileitis and colitis, edema of the colonic serosa, and proteinaceous interstitial edema of the lungs. Clostridium perfringens type D carrying the genes for enterotoxin (CPE) and beta2 toxin (CPB2) was cultured from intestinal content and feces of 1 of 2 goats, while C. perfringens type D CPB2-positive was isolated from the other animal. When multiple colonies of the primary isolations from both animals were tested by Western blot, most of the isolates expressed CPB2, and only a few isolates from the first case expressed CPE. Alpha toxin and ETX were detected in ileal and colonic contents and feces of both animals by antigen capture enzyme-linked immunosorbent assay. CPB2, but not CPE, was identified in the small and large intestines of both goats by immunohistochemistry. These findings indicate that CPB2 may have contributed to the necrotic changes observed in the intestine, possibly assisting ETX transit across the intestinal mucosa.

Occurrence Of Egg Impaction And Peritonitis In A Flock Of Commercial Laying Hens In Damaturu Nigeria

Some reproductive disorders in poultry which include peritonitis, salpingitis and impaction of oviduct are described as ‘egg peritonitis\' (Jordan, 1990). Egg peritonitis can occur as a severe flock problem and when it does it is usually associated with poor management (Jordan, 1990). Flock egg peritonitis outbreaks are often accompanied by cannibalism and vent pecking. Multiple etiologic factors have been ascribed to egg peritonitis problem. However, Escherichia coli is often incriminated as one of the etiologic agents of egg peritonitis (Hofstad et al., 1984) colibacillosis, coligranuloma, Hjarre\'s disease, salphangitis, synovitis, omphilitis and air sac disease in pre- and- laying hens. Other organisms frequently involved are Staphylococci and Streptococci spp (Jordan, 1990). Egg peritonitis and related effects are responsible for major economic losses to poultry industry (Hofstad et al., 1984). Economic losses resulting from mortality and egg losses were recorded in the flock under consideration. These were due to egg peritonitis, impaction and mortality in laying hens which were otherwise in good bodily condition and had full crops. The mortality was sudden with no premonitory signs except when accompanied by cannibalism and vent pecking. In this article clinico-pathological report on egg peritonitis and impaction in flock of commercial laying hens is presented and assessment of causal factors and control measures are highlighted. Keywords : Egg peritonitis, Colisepticemia, Vent pecking, E. coli , Laying hens Nigerian Veterinary Journal Vol. 28 (3) 2007 pp. 56-58

In the aftermath of teenage suicide: A qualitative study of the psychosocial consequences for the surviving family members

BackgroundStudies of family reactions following teenage suicide are hampered by the psychological difficulties of approaching families and recruiting an unbiased sample of study subjects. By using a small but consecutive series of cases, we examined the qualitative aspects of loosing a teenage family member due to suicide. Such an understanding is important for future organisation of proper programs that provide professional support in the grief process.MethodsFrom a large project on teenage unnatural death in northern Sweden 1981–2000 (including 88 suicides), 13 cases from 1995 through 1998 were retrospectively identified and consecutively analysed. Ten families agreed to participate. The open interviews took place 15 to 25 months after the suicide. The information gathered was manually analysed according to a grounded theory model, resulting in allocation of data into one of three domains: post-suicidal reactions, impact on daily living, and families' need for support.ResultsTeenager suicide is a devastating trauma for the surviving family and the lack of sustainable explanations for the suicide is a predominant issue in the grief process. The prolonged social and psychological isolation of the families in grief should be challenged. At the time of the interview, the families were still struggling with explaining why the suicide occurred, especially since most suicides had occurred without overt premonitory signs. The bereaved family members were still profoundly affected by the loss, but all had returned to an ostensibly normal life. Post-suicide support was often badly timed and insufficient, especially for younger siblings.ConclusionFamily doctors can organise a long-term, individually formulated support scheme for the bereaved, including laymen who can play a most significant role in the grief process. There is also a need for better understanding of the families who have lost a teenager whom committed suicide and for the development and testing of treatment schemes for the bereaved family.

Feline heartworm disease: a clinical review.

Feline heartworm disease is caused by the filarial nematode Dirofilaria immitis, and is transmitted by mosquitoes in heartworm-endemic areas worldwide. While dogs are the definitive hosts for this parasite, cats can also be infected, and the overall prevalence in cats is between 5% and 10% of that in dogs in any given area. The spectrum of feline presentations varies from asymptomatic infections to chronic respiratory signs, sometimes accompanied by chronic vomiting to acute death with no premonitory signs. Ante-mortem diagnosis can be challenging and relies on a combination of tests, including antigen and antibody serology, thoracic radiography and echocardiography. As treatment with heartworm adulticidal drugs can be life-threatening and heartworm infection in cats is often self-limiting, infected cats are frequently managed with supportive treatment (corticosteroids, bronchodilators, and anti-emetics). Surgical removal of filariae using extraction devices may be considered in some acute cases where immediate curative treatment is necessary, but filarial breakage during the procedure may result in an acute fatal shock-like reaction. Necropsy findings are mainly pulmonary and include muscular hypertrophy of the pulmonary arteries and arterioles on histopathology. A number of safe and effective macrocytic lactone drugs are available for prophylaxis in cats. These drugs can kill a range of larval and adult life-cycle stage heartworms, which may be advantageous in cases of owner compliance failure or when heartworm infection status is undetermined at the time prophylaxis is commenced. An index of suspicion for feline heartworm disease is warranted in unprotected cats with respiratory signs, and perhaps chronic vomiting, in areas where canine heartworm disease is endemic. Many cats, once diagnosed and with appropriate supportive care and monitoring, will resolve their infection and be free of clinical signs.