ABSTRACT
Tuberculosis is emerging/re-emerging in captive elephant populations, where it causes morbidity and deaths, although no case of TB in wild African elephants has been reported. In this paper we report the first case of fatal TB in an African elephant in the wild. The infection with Mycobacterium tuberculosis was confirmed by post-mortem and histological examinations of a female sub-adult elephant aged >12 years that died in Tsavo East National Park, Kenya, while under treatment. This case is unique in that during its lifetime the elephant had contact with both humans and wild elephants. The source of the infection was unclear because the elephant could have acquired the infection in the orphanage or in the wild. However, our results show that wild elephants can maintain human TB in the wild and that the infection can be fatal.
Subject(s)
Animals, Wild , Elephants , Mycobacterium tuberculosis/isolation & purification , Tuberculosis/veterinary , Animals , Fatal Outcome , Female , Kenya , Tuberculosis/diagnosisABSTRACT
This study was performed to determine if a simulated legal deposition increases emergency medicine (EM) residents' knowledge, self-confidence, and understanding of a legal deposition. This prospective study included a convenience sample of EM 1-3 residents. A knowledge and a self-assessment pretest were given, followed by a didactic session moderated by local attorneys, followed by knowledge and a self-assessment posttest. The total time involved was 2 hours. The mean score on the knowledge pretest was 4.5 and 5.25 on the posttest. Using a paired t-test, the authors found this difference to be statistically significant. (P < 0.01) Using Hotelling's T2 test, the authors compared presimulation and postsimulation self-assessment questions. The results revealed that there was a difference between these scores (P < 0.001). Participants in the deposition significantly improved their self-assessment ranking and knowledge inventory test scores by participating in a simulated legal deposition.
Subject(s)
Emergency Medicine/education , Emergency Medicine/legislation & jurisprudence , Emergency Service, Hospital/legislation & jurisprudence , Internship and Residency , Liability, Legal , Adult , Clinical Competence , Education, Medical, Graduate , Educational Measurement , Female , Humans , Male , Prospective Studies , Sampling Studies , Surveys and Questionnaires , United StatesABSTRACT
Laboratory culture results, dating back to 1960, were reviewed at the Veterans Administration Medical Center in Oklahoma City. Nontuberculous mycobacterial incidence increased substantially during the 21-year period as tuberculosis incidence decreased. Nontuberculous mycobacteria were found to represent 13.7% of all mycobacterial isolates, with Mycobacterium kansasii and M intracellulare-avium complex the predominant species. When the dates of first positive cultures were evaluated, a significant month-to-month variation was found in M tuberculosis but not nontuberculous mycobacteria, suggesting a different mode of transmission for the two. There was no significant difference in the racial distribution or age of individuals with nontuberculous mycobacteria.
