Accuracy of the withdrawal reflex for localization of the site of cervical disk herniation in dogs: 35 cases (2004-2007)

OBJECTIVE To evaluate the accuracy of neurologic examination versus magnetic resonance imaging (MRI) in localization of cervical disk herniation and evaluate the usefulness of withdrawal reflex testing in dogs. DESIGN Retrospective case series. ANIMALS 35 client-owned dogs with a single-level cervical disk herniation as determined via MRI. PROCEDURES 1 of 2 board-certified neurologists performed a complete neurologic examination in each dog. Clinical signs of a cervical lesion included evidence of neck pain and tetraparesis. The withdrawal reflex was used for neuroanatomic localization (C1-C5 or C6-T2). Agreement between results of neurologic and MRI examinations was determined. RESULTS Agreement between neurologic and MRI diagnoses was 65.8%. In 11 dogs in which the lesion was clinically localized to the C6-T2 segment on the basis of a decreased withdrawal reflex in the forelimbs, MRI revealed an isolated C1-C5 disk lesion. In 1 dog, in which the lesion was suspected to be at the C1-C5 level, MRI revealed a C6-T2 lesion. Cranial cervical lesions were significantly associated with an incorrect neurologic diagnosis regarding site of the lesion. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that the withdrawal reflex in dogs with cervical disk herniation is not reliable for determining the affected site and that a decreased withdrawal reflex does not always indicate a lesion from C6 to T2.

Leishmaniasis and polyarthritis in the dog

Two cases of polyarthritis in the dog resulting from Leishmania species infection are reviewed. The clinical investigations, laboratory findings and serological tests are summarised. Leishmanial amastigotes were detected in synovial fluid samples of multiple joints with marked inflammatory signs. Diagnosis was made by biopsy of bone marrow, skin and synovial fluid. Both dogs were initially treated with pentavalent sodium stibogluconate. Other causes of canine polyarthritis were excluded.

In vitro activity of clinically implemented β-lactams against Aerococcus urinae: presence of non-susceptible isolates in Switzerland.

We analyzed the in vitro susceptibility to several ?-lactams and vancomycin of 80 Aerococcus urinae isolates col- lected during 2011-2012 in Switzerland. MICs were determined by Etest (bioMérieux) on Müller-Hinton agar with 5% sheep blood and interpreted according to the CLSI and EUCAST criteria set for viridans streptococci. MIC50/90 for penicillin, amoxicillin, ceftriaxone and vancomycin were 0.016/0.064 mg/l, 0.032/0.064 mg/l, 0.125/0.5 mg/l and 0.38/0.5 mg/l, respectively. Three (3.8%) isolates were resistant to ceftriaxone regardless of the criteria used (MICs ?2 mg/l); one of them was also non-susceptible to penicillin (MIC of 0.25 mg/l) according to CLSI. ?-lactam resis- tance in A. urinae is a concern and suggests that more studies are needed to determine the molecular mechanisms of such resistance.

The strength of badenya ties: siblings and social security in old age – the case of urban Burkina Faso

In urban Burkina Faso, siblings play a decisive role in local social security. Badenya, the unity of children of the same mother, compensates in particular for the economic failure of an eldest son no longer in a position to fulfill his familial duties. Although the institution of badenya is strengthened as it increasingly comes into play to help a family avoid social marginalization, it is also overburdened, which makes its future uncertain. This article enhances the anthropological understanding of kinship by focusing on sibling relationships. Findings are based on interviews conducted between 2007 and 2010 with two generations in households in Bobo-Dioulasso and on participant-observation over the course of more than a dozen research stays since 1989.

State-of-the-art of imaging detecting endoleaks post-EVAR with special focus on low-flow endoleaks.

Endovascular aortic repair (EVAR) necessitates lifelong surveillance for the patient, in order to detect complications timely. Endoleaks (ELs) are among the most common complications of EVAR. Especially type II ELs can have a very unpredictable clinical course and this can range from spontaneous sealing to aortic rupture. Subgroups of this type of EL need to be identified in order to make a proper risk stratification. Aim of this review is to describe the existing imaging techniques, including their advantages and disadvantages in the context of post-EVAR surveillance with a particular emphasis on low-flow ELs. Low flow ELs cause pressurization of the aortic aneurysm sac with a low velocity filling, leading to difficulty of detection by routine imaging protocols for EVAR surveillance, e.g. bi- or triphasic multislice computed tomographic angiography, magnetic resonance imaging and contrast enhanced ultrasound. In this article, we review the imaging possibilities of ELs and discuss the different imaging strategies available for depicting low flow ELs.

Outcome of aplastic anaemia in children. A study by the severe aplastic anaemia and paediatric disease working parties of the European group blood and bone marrow transplant.

This study analysed the outcome of 563 Aplastic Anaemia (AA) children aged 0-12 years reported to the Severe Aplastic Anaemia Working Party database of the European Society for Blood and Marrow Transplantation, according to treatment received. Overall survival (OS) after upfront human leucocyte antigen-matched family donor (MFD) haematopoietic stem cell transplantation (HSCT) or immunosuppressive treatment (IST) was 91% vs. 87% (P 0·18). Event-free survival (EFS) after upfront MFD HSCT or IST was 87% vs. 33% (P 0·001). Ninety-one of 167 patients (55%) failed front-line IST and underwent rescue HSCT. The OS of this rescue group was 83% compared with 91% for upfront MFD HSCT patients and 97% for those who did not fail IST up-front (P 0·017). Rejection was 2% for MFD HSCT and HSCT post-IST failure (P 0·73). Acute graft-versus-host disease (GVHD) grade II-IV was 8% in MFD graft vs. 25% for HSCT post-IST failure (P < 0·0001). Chronic GVHD was 6% in MFD HSCT vs. 20% in HSCT post-IST failure (P < 0·0001). MFD HSCT is an excellent therapy for children with AA. IST has a high failure rate, but remains a reasonable first-line choice if MFD HSCT is not available because high OS enables access to HSCT, which is a very good rescue option.

Ancora su Hölderlin e gli scrittori di lingua italiana (da Giosue Carducci a Fabio Pusterla)

A discussion of the long-term “Hölderlinism” of Italian poets, starting from Vigolo’s essay on Hölderlin and the music (1966), moving back to Carducci’s translations, with a critical edition of his version of Hölderlin’s Achill (1874, see the leaf reproduced in the appendix), and concluding with a look at later Italian poets up to Pusterla (2004).

Giorgio Vigolo – Quali musiche suonò Hölderlin? (28 aprile 1966)

Giorgio Vigolo’s lecture Quali musiche suonò Hölderlin? (Which Pieces of Music Did Hölderlin Play?), which the Italian poet held in Rome on April 28th 1966, here edited for the first time, with notes, by Giovanna Cordibella.

Zur Beherzigung für jeden Menschenfreund dem die Bildung und Veredlung der jüdischen Jugend nicht gleichgültig ist, besonders für die Einwohner jüdischer Nation zu Frankfurt am Mayn

Hss. auf d. Titelbl., Sign aus Freimann-Kat.: Jud. Ff. 563

End caps prevent nail migration in elastic stable intramedullary nailing in paediatric femoral fractures: a biomechanical study using synthetic and cadaveric bones.

End caps are intended to prevent nail migration (push-out) in elastic stable intramedullary nailing. The aim of this study was to investigate the force at failure with and without end caps, and whether different insertion angles of nails and end caps would alter that force at failure. Simulated oblique fractures of the diaphysis were created in 15 artificial paediatric femurs. Titanium Elastic Nails with end caps were inserted at angles of 45°, 55° and 65° in five specimens for each angle to create three study groups. Biomechanical testing was performed with axial compression until failure. An identical fracture was created in four small adult cadaveric femurs harvested from two donors (both female, aged 81 and 85 years, height 149 cm and 156 cm, respectively). All femurs were tested without and subsequently with end caps inserted at 45°. In the artificial femurs, maximum force was not significantly different between the three groups (p = 0.613). Push-out force was significantly higher in the cadaveric specimens with the use of end caps by an up to sixfold load increase (830 N, standard deviation (SD) 280 vs 150 N, SD 120, respectively; p = 0.007). These results indicate that the nail and end cap insertion angle can be varied within 20° without altering construct stability and that the risk of elastic stable intramedullary nailing push-out can be effectively reduced by the use of end caps.

Reconstructing 4000 years of mass movement and tsunami history in a deep peri-Alpine lake (Lake Geneva, France-Switzerland)

The study of mass movements in lake sediments provides insights into past natural hazards at historic and prehistoric timescales. Sediments from the deep basin of Lake Geneva reveal a succession of six large-scale (volumes of 22 × 106 to 250 × 106 m3) mass-transport deposits, associated with five mass-movement events within 2600 years (4000 cal bp to 563 ad). The mass-transport deposits result from: (i) lateral slope failures (mass-transport deposit B at 3895 ± 225 cal bp and mass-transport deposits A and C at 3683 ± 128 cal bp); and (ii) Rhône delta collapses (mass-transport deposits D to G dated at 2650 ± 150 cal bp, 2185 ± 85 cal bp, 1920 ± 120 cal bp and 563 ad, respectively). Mass-transport deposits A and C were most probably triggered by an earthquake, whereas the Rhône delta collapses were likely to be due to sediment overload with a rockfall as the external trigger (mass-transport deposit G, the Tauredunum event in 563 ad known from historical records), an earthquake (mass-transport deposit E) or unknown external triggers (mass-transport deposits D and F). Independent of their origin and trigger mechanisms, numerical simulations show that all of these recorded mass-transport deposits are large enough to have generated at least metre-scale tsunamis during mass movement initiation. Since the Tauredunum event in 563 ad, two small-scale (volumes of 1 to 2 × 106 m3) mass-transport deposits (H and I) are present in the seismic record, both of which are associated with small lateral slope failures. Mass-transport deposits H and I might be related to earthquakes in Lausanne/Geneva (possibly) 1322 ad and Aigle 1584 ad, respectively. The sedimentary record of the deep basin of Lake Geneva, in combination with the historical record, show that during the past 3695 years, at least six tsunamis were generated by mass movements, indicating that the tsunami hazard in the Lake Geneva region should not be neglected, although such events are not frequent with a recurrence time of 0·0016 yr−1.

Utility of electrophysiological studies to predict arrhythmic events

AIM To evaluate the prognostic value of electrophysiological stimulation (EPS) in the risk stratification for tachyarrhythmic events and sudden cardiac death (SCD). METHODS We conducted a prospective cohort study and analyzed the long-term follow-up of 265 consecutive patients who underwent programmed ventricular stimulation at the Luzerner Kantonsspital (Lucerne, Switzerland) between October 2003 and April 2012. Patients underwent EPS for SCD risk evaluation because of structural or functional heart disease and/or electrical conduction abnormality and/or after syncope/cardiac arrest. EPS was considered abnormal, if a sustained ventricular tachycardia (VT) was inducible. The primary endpoint of the study was SCD or, in implanted patients, adequate ICD-activation. RESULTS During EPS, sustained VT was induced in 125 patients (47.2%) and non-sustained VT in 60 patients (22.6%); in 80 patients (30.2%) no arrhythmia could be induced. In our cohort, 153 patients (57.7%) underwent ICD implantation after the EPS. During follow-up (mean duration 4.8 ± 2.3 years), a primary endpoint event occurred in 49 patients (18.5%). The area under the receiver operating characteristic curve (AUROC) was 0.593 (95%CI: 0.515-0.670) for a left ventricular ejection fraction (LVEF) < 35% and 0.636 (95%CI: 0.563-0.709) for inducible sustained VT during EPS. The AUROC of EPS was higher in the subgroup of patients with LVEF ≥ 35% (0.681, 95%CI: 0.578-0.785). Cox regression analysis showed that both, sustained VT during EPS (HR: 2.26, 95%CI: 1.22-4.19, P = 0.009) and LVEF < 35% (HR: 2.00, 95%CI: 1.13-3.54, P = 0.018) were independent predictors of primary endpoint events. CONCLUSION EPS provides a benefit in risk stratification for future tachyarrhythmic events and SCD and should especially be considered in patients with LVEF ≥ 35%.

Automatic quality control in clinical (1) H MRSI of brain cancer.

MRSI grids frequently show spectra with poor quality, mainly because of the high sensitivity of MRS to field inhomogeneities. These poor quality spectra are prone to quantification and/or interpretation errors that can have a significant impact on the clinical use of spectroscopic data. Therefore, quality control of the spectra should always precede their clinical use. When performed manually, quality assessment of MRSI spectra is not only a tedious and time-consuming task, but is also affected by human subjectivity. Consequently, automatic, fast and reliable methods for spectral quality assessment are of utmost interest. In this article, we present a new random forest-based method for automatic quality assessment of (1) H MRSI brain spectra, which uses a new set of MRS signal features. The random forest classifier was trained on spectra from 40 MRSI grids that were classified as acceptable or non-acceptable by two expert spectroscopists. To account for the effects of intra-rater reliability, each spectrum was rated for quality three times by each rater. The automatic method classified these spectra with an area under the curve (AUC) of 0.976. Furthermore, in the subset of spectra containing only the cases that were classified every time in the same way by the spectroscopists, an AUC of 0.998 was obtained. Feature importance for the classification was also evaluated. Frequency domain skewness and kurtosis, as well as time domain signal-to-noise ratios (SNRs) in the ranges 50-75 ms and 75-100 ms, were the most important features. Given that the method is able to assess a whole MRSI grid faster than a spectroscopist (approximately 3 s versus approximately 3 min), and without loss of accuracy (agreement between classifier trained with just one session and any of the other labelling sessions, 89.88%; agreement between any two labelling sessions, 89.03%), the authors suggest its implementation in the clinical routine. The method presented in this article was implemented in jMRUI's SpectrIm plugin. Copyright © 2016 John Wiley & Sons, Ltd.