Cardiac Truncus Arteriosus in an Eastern Black Rhinoceros (Diceros bicornis michaeli).

This case report describes congenital truncus arteriosus in a 1-month-old Eastern black rhinoceros (Diceros bicornis michaeli). From the first day of life the animal was underweight and from the 22nd day of life displayed respiratory signs that exacerbated with time leading eventually to collapse and death. Post-mortem examination revealed a single truncus arteriosus originating from the right ventricle leading to two separated pulmonary arteries and the aorta, with the ventricular septum showing a focal communicating defect. Based on the gross examination and current human classifications, the truncus arteriosus was classified as type III or A2. This is the first description of persistent truncus arteriosus in an Eastern black rhinoceros.

Echinococcus and Taenia spp. from captive mammals in the United Kingdom.

Taeniid tapeworms which include Echinococcus and Taenia spp. are obligatory parasites of mammals with pathogenicity usually related to the larval stages of the life cycle. Two species (or genotypes) of Echinococcus, E. granulosus sensu stricto and E. equinus, as well as several Taenia spp. are endemic in the UK. Here we report on the occurrence of larval cystic stages of Echinococcus and Taenia spp. in captive mammals in the UK. Using molecular techniques we have identified E. granulosus (G1 genotype) in a guenon monkey and a Philippine spotted deer; E. equinus in a zebra and a lemur; E. ortleppi in a Philippine spotted deer; E. multilocularis in a macaque monkey and Taenia polyacantha in jumping rats. To the best of our knowledge this is the first report of E. multilocularis in a captive primate translocated to the UK. As far as we know these are the first reports of E. equinus in a primate (lemur) and in a zebra; as well as E. granulosus (G1 genotype) and E. ortleppi in a cervid translocated to the UK. These infections and implications of the potential establishment of exotic species of cestodes are discussed.

General versus spinal/epidural anaesthesia for surgery for hip fractures in adults.

BACKGROUND: The majority of hip fracture patients are treated surgically, requiring anaesthesia. OBJECTIVES: To compare different types of anaesthesia for surgical repair of hip fractures (proximal femoral fractures) in adults. This is primarily regional (spinal or epidural) anaesthesia versus inhalation general anaesthesia, but also includes ketamine anaesthesia versus inhalation general anaesthesia. SEARCH STRATEGY: We searched the Cochrane Musculoskeletal Injuries Group trials register, Medline, selected orthopaedic and anaesthetic journals and conference proceedings, and reference lists of relevant articles. Date of the most recent search: August 1999. SELECTION CRITERIA: Randomised and quasi-randomised trials comparing different methods of anaesthesia for hip fracture surgery in skeletally mature persons. Trials comparing the use of local nerve blocks are not considered in this review. Neither are trials using different types of drugs or techniques with one type of anaesthesia. The primary outcome was mortality. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality, using a nine item scale, and extracted data. The other two reviewers independently checked these results. Wherever appropriate and possible, results were pooled. MAIN RESULTS: Sixteen trials, involving 2191 patients, which compared regional anaesthesia with general anaesthesia, were included. All trials had methodological flaws. Regional anaesthesia was associated with a decreased mortality at one month (53/781(6.8%) versus 78/826(9.4%)) of borderline statistical significance (relative risk 0.72, 95% confidence interval 0.51 to 1.00)). The results for three month mortality were not statistically significant, although the confidence interval does not exclude the possibility of a clinically relevant reduction (86/726 (11.8%) versus 98/765 (12.8%), relative risk 0.92, 95% confidence interval 0.71 to 1.21). The reduced numbers at one year, coming exclusively from two studies, preclude any useful conclusions for long term mortality (80/354 (22.6%) versus 78/372 (21.0%), relative risk 1.07, 95% confidence interval 0.82 to 1.41). Regional anaesthesia was associated with a tendency to a longer operation (weighted mean difference 4.8 minutes, 95% confidence interval 1.1 to 8.6 minutes), and a reduced risk of deep venous thrombosis (39/129 (30%) versus 61/37(76%); relative risk 0.64, 95% confidence interval 0.48 to 0.86), although this conclusion is insecure due to possible selection bias in the subgroups in whom this outcome was measured. No other statistically significant differences in outcome were identified. There was insufficient evidence to draw any conclusions from a further two included trials, involving a total of 100 patients, which compared other types of anaesthesia. REVIEWER'S CONCLUSIONS: Regional anaesthesia and general anaesthesia appear to produce comparable results for most of the outcomes studied. Regional anaesthesia may reduce short-term mortality but no conclusions can be drawn for longer term mortality.

Anticholinesterase activity of the unsymmetric bisquaternary 6-aminoquinoline salt NSC-176319.

The anticholinesterase activity of the unsymmetric bisquaternary 6-aminoquinoline salt NSC-176319 (QB) was studied in vitro. QB proved to be a noncompetitive inhibitor of both acetylcholinesterase (or true cholinesterase) and butyrylcholinesterase (or pseudocholinesterase) having a KI = 0.5 X 10(-6) M for acetylcholinesterase and 1.5 X 10(-6) M for butyrylcholinesterase. Further, QB inhibited esterase activity of murine plasma in a noncompetitive manner (KI = 4.2 X 10(-6) M). The inhibition was instantaneous in onset and did not diminish with prolonged incubation of the drug and enzyme. All mice treated intravenously with 2 mg QB/kg died within 5 min. Prior to death, mice developed severe parasympathomimetic effects and convulsions. Although the parasympathomimetic effects were diminished by atropine sulfate pretreatment, death could only be prevented by barbiturate anesthesia.

An investigation into disordered adolescents by means of the Brook Reaction Test.

Three groups of psychologically disordered male adolescents were matched with controls for age and intelligence, on a one-to-one basis. Group a (n = 83) comprised delinquents, this designation being determined by a history of at least one court conviction. All of these were in borstals or approved schools. Group b (n = 65) were delinquent-and-disturbed: these too had had at least one court conviction and, in addition, they were having psychiatric treatment. Members of group b were also in institutions: these included psychiatric hospitals and prisons, as well as borstals and approved schools. Group c (n = 41) consisted of 'disturbed-only' youths: they had had no convictions but were receiving psychiatric treatment. Each group covered a very wide range of intelligence. All the subjects took the Brook Reaction Test, the aim of the inquiry being to ascertain whether this test differentiates (scored blind) between the experimental groups and their controls. Significant differentiation was found on the following Brook indices: (1) Number of points gained on questionable responses; (2) type of questionable response given; (3) sexual responses; (4) pattern of interests. In all six groups richness of interests proved to be associated with high intelligence.