A health survey of the reef forming scleractinian cold-water corals Lophelia pertusa and Madrepora oculata in a remote submarine canyon on the European continental margin, NE Atlantic.

Monitoring of cold-water corals (CWCs) for pathogens and diseases is limited due to the environment, protected nature of the corals and their habitat and as well as the challenging and sampling effort required. It is recognised that environmental factors such as temperature and pH can expedite the ability of pathogens to cause diseases in cold-water corals therefore the characterisation of pathogen diversity, prevalence and associated pathologies is essential. The present study combined histology and polymerase chain reaction (PCR) diagnostic techniques to screen for two significant pathogen groups (bacteria of the genus Vibrio and the protozoan Haplosporidia) in the dominant NE Atlantic deep-water framework corals Lophelia pertusa (13 colonies) and Madrepora oculata (2 colonies) at three sampling locations (canyon head, south branch and the flank) in the Porcupine Bank Canyon (PBC), NE Atlantic. One M. oculata colony and four L. pertusa colonies were collected from both the canyon flank and the south branch whilst five L. pertusa colonies were collected from the canyon head. No pathogens were detected in the M. oculata samples. Neither histology nor PCR detected Vibrio spp. in L. pertusa, although Illumina technology used in this study to profile the CWCs microbiome, detected V. shilonii (0.03%) in a single L. pertusa individual, from the canyon head, that had also been screened in this study. A macroborer was observed at a prevalence of 0.07% at the canyon head only. Rickettsiales-like organisms (RLOs) were visualised with an overall prevalence of 40% and with a low intensity of 1 to 4 (RLO) colonies per individual polyp by histology. L. pertusa from the PBC canyon head had an RLO prevalence of 13.3% with the highest detection of 26.7% recorded in the south branch corals. Similarly, unidentified cells observed in L. pertusa from the south branch (20%) were more common than those observed in L. pertusa from the canyon head (6.7%). No RLOs or unidentified cells were observed in corals from the flank. Mean particulate organic matter concentration is highest in the south branch (2,612 µg l-1) followed by the canyon head (1,065 µg l-1) and lowest at the canyon flank (494 µg l-1). Although the route of pathogen entry and the impact of RLO infection on L. pertusa is unclear, particulate availability and the feeding strategies employed by the scleractinian corals may be influencing their exposure to pathogens. The absence of a pathogen in M. oculata may be attributed to the smaller number of colonies screened or the narrower diet in M. oculata compared to the unrestricted diet exhibited in L. pertusa, if ingestion is a route of entry for pathogen groups. The findings of this study also shed some light on how environmental conditions experienced by deep sea organisms and their life strategies may be limiting pathogen diversity and prevalence.

Accumulation of marine litter in cold-water coral habitats: A comparative study of two Irish Special Areas of Conservation, NE Atlantic.

Cold-water corals (CWCs) have come under threat from anthropogenic activities such as fishing despite their ecological significance as biodiversity hotspots and as such are being protected in Europe under the EU Habitats Directive with some designated as Special Areas of Conservation (SACs). This study maps the distribution and sources of marine litter in CWC habitats in two SACs on the Irish margin. Data were collected with remotely operated vehicle in the SACs. The density, abundance and composition of litter were assessed, with differences observed between the two sites. The regional morphology influences the distribution of litter in the SACs, with CWC reefs and rock exposures trapping more marine litter. Fishing gear (80.7%) and plastics (55.1%) were commonly found. The observed fisheries-derived litter in the SACs exceed global averages of 10-20% fishing gear, suggesting the SACs appear to offer limited protection to the coral habitats with respect to marine litter.

Competing barnacle species with a time dependent reproduction rate.

A simple competition model with time varying periodic coefficients, in which two species use different reproduction strategies, is explored in this paper. The two species considered comprise a native species which reproduces once a year over a short time period and an invasive species which is capable of reproducing throughout the entire year. A monotonicity property of the model is instrumental for its analysis. The model reveals that the time difference between the peak of reproduction for the two species is a critical factor in determining the outcome of competition between these species. The impact of climate change and an anthropogenic disturbance, comprising the creation of additional substrate, is also investigated using a modified model. The results of this paper describe how climate change will favour the invasive species by reducing the time period between the reproductive peaks of the two species and how the addition of new substrates is likely to endanger a small population of either of the two species, depending on the timing of the introduction of the substrates.

A health status survey of clams, Mya arenaria and Ensis siliqua, in the Irish Sea.

The soft shell clam, Mya arenaria, and the razor clam, Ensis siliqua, are widely distributed in Irish waters. Though the reproductive biology and other aspects of the physiology of these species has been previously investigated, little or no data are currently available on their health status. As this knowledge is essential for correct management of a species, M. arenaria and E. siliqua were examined to assess their current health status using histological and molecular methods, over a period of sixteen months. No pathogens or disease were observed in M. arenaria, and low incidences of Prokaryote inclusions, trematode parasites, Nematopsis spp. and eosinophilic bodies were recorded in razor clams for the first time in Northern European waters.

Practical applications of digital tomosynthesis of the chest.

Digital tomosynthesis is a radiographic technique that generates a number of coronal raw images of a patient from a single pass of the x-ray tube. Tomosynthesis provides some of the tomographic benefits of computed tomography (CT), but at a much lower dose of radiation and cost when compared to CT. This review illustrates the range of practical applications of digital tomosynthesis of the chest.

Influence of disseminated neoplasia, trematode infections and gametogenesis on surfacing and mortality in the cockle Cerastoderma edule.

Cerastoderma edule is a widely distributed bivalve mollusc, commercially exploited throughout Europe and is also an important food source for birds and crustaceans. Recently, mass surfacing and mortalities of cockles have been observed and reported at sites in Ireland and elsewhere, particularly in the summer months. One such site is Flaxfort Strand, Courtmacsherry Bay, County Cork, Ireland, an important feeding area used by many seabirds during the summer months. For the past few years large numbers of surfaced cockles have been observed at the site in a moribund condition. Samples of cockles from this area were collected over the summer months and their health status assessed. Cockles that had surfaced (moribund) and those still buried in the sediment were quantified and screened: sex, gonadal maturity and size class of cockles were also determined. Disseminated neoplasia and trematodes were observed in screened cockles. The most significant finding during the study was that mortalities and surfacing of cockles was related to a greater incidence of disseminated neoplasia. No neoplasia was observed in the smallest and largest size classes. There was a significantly higher prevalence of neoplasia in moribund cockles than in buried cockles, whereas in both groups a similar concentration of trematode metacercariae was observed in the screened tissues. Also, most of the cockles that had surfaced were either in the process of spawning or were spent. Overall a much larger percentage of moribund cockles exhibited both trematode infections plus neoplasia compared with buried cockles. A combination of the presence of neoplasia and trematodes, along with stress related to spawning, may immunocompromise the cockless, causing the animals to surface and become moribund.

Imaging of illicit drug use.

Illicit drug abuse is a continuing menace of epidemic proportions associated with serious medical and social problems. Drug abuse can have a wide variety of presentations some of which can be life-threatening. The clinical diagnosis can be challenging as the history is usually limited or absent. Radiologists need to be familiar with varied imaging presentations and the related complications of illicit drug abuse to ensure correct diagnosis and appropriate timely treatment. This review will illustrate the imaging spectrum of illicit drug abuse involving several organ systems and also discuss the pathophysiological consequences of drug abuse.

Temporal variation of Meiogymnophallus minutus infections in the first and second intermediate host.

In order to study seasonal patterns of Meiogymnophallus minutus infections in its intermediate hosts, bivalve samples were collected monthly between April 2008 and March 2009 from a high intertidal flat at Courtmacsherry Bay, Ireland. Infection rates in the first intermediate host Scrobicularia plana did not fluctuate significantly with season. Completely developed M. minutus cercariae appeared in daughter sporocysts from June and prevailed from July to October, indicating that transmission of M. minutus from its first to its second intermediate host is confined to this period of the year. All analysed individuals of the second intermediate host Cerastoderma edule were found to be infected with metacercariae. Infection levels significantly increased in September, suggesting recent cercarial invasions. Throughout the year, the majority of metacercariae were hyperinfected by the pathogenic microsporidian Unikaryon legeri. Spreading of hyperinfections was confined to spring and summer. Newly settled metacercariae were not affected by hyperparasitism and presumably retained their infectivity for half a year. Our findings suggest that the spreading of hyperinfections is correlated with higher water temperatures and that the entire metacercarial population has to rebuild every year as a consequence of hyperparasite-induced mortality.

Infection of Mytilus edulis by the trematode Echinostephilla patellae (Digenea: Philophthalmidae).

The blue mussel Mytilus edulis is described as second intermediate host for Echinostephilla patellae from the common limpet Patella vulgata. Mussels were infected with metacercariae of E. patellae under laboratory conditions. Average infection rates increased with increasing temperature, whereas numbers of cercariae, to which individual mussels were exposed, had no effect on relative infection success. The round to slightly oval metacercariae with an average cyst diameter of 208 microm (range 186-243 microm) encysted exclusively in the foot tissue of M. edulis. Morphologically similar metacercariae were found in naturally infected mussels at sites where parasitized P. vulgata and M. edulis are sympatric. This is the first report of E. patellae in blue mussels. The detection of M. edulis being a second intermediate host is of particular interest with regard to the abundance of the parasite and host organisms in intertidal rocky shore ecosystems. The potential role of the common limpet P. vulgata as an alternative secondary host is discussed.

Quality of stroke care at an Irish Regional General Hospital and Stroke Rehabilitation Unit.

BACKGROUND: Robust international data support the effectiveness of stroke unit (SU) care. Despite this, most stroke care in Ireland are provided outside of this setting. Limited data currently exist on the quality of care provided. AIM: The aim of this study is to examine the quality of care for patients with stroke in two care settings-Regional General Hospital (RGH) and Stroke Rehabilitation Unit (SRU). METHODS: A retrospective analysis of the stroke records of consecutive patients admitted to the SRU between May-November 2002 and April-November 2004 was performed applying the UK National Sentinel Audit of Stroke (NSAS) tool. RESULTS: The results of the study reveal that while SRU processes of care was 74% compliant with standards; compliance with stroke service organisational standards was only 15 and 43% in the RGH and SRU, respectively. CONCLUSION: The quality of stroke care in our area is deficient. Comprehensive reorganisation of stroke services is imperative.

Stroke unit care: recurrence, mortality and institutionalisation rates-a four year follow-up study.

BACKGROUND: he benefits of stroke unit care in terms of reducing mortality, morbidity and the need for institutional care in the short term are clear. Less evidence exists of its longer term benefits. AIM: The aim of this study was to measure the rates of mortality, institutionalisation and stroke recurrence over a4-year period following stroke unit care. METHODS: Discharge and 4-year follow-up data were examined on all patients admitted to the Stroke Rehabilitation Unit between September 2000 and August 2002. There results were compared with previously published data. RESULTS: After 4 years 8% of patients had sustained are current stroke, 40% were deceased and 40% were in institutional care. CONCLUSIONS: Compared to international data care at our unit appears to be associated with a lower rate of recurrent stroke and mortality but a higher institutionalisation rate after 4 years. The reasons for this are unclear.

Intramural haematoma of the oesophagus presenting as an unusual complication of endotracheal intubation.

Intramural haematoma of the oesophagus is an uncommon and under-recognized condition. It may mimic other causes of chest pain, haematemesis, or dysphagia, and hence pose a diagnostic challenge. We report a case of an unusual presentation of intramural haematoma of the oesophagus occurring as a presumed complication of endotracheal intubation. It was disguised as acute onset post-operative chest pain, and resolved with conservative management. Awareness of this uncommon complication is important to allow rapid and timely diagnosis and management. We review the literature, causes and imaging features of this condition.

Impacts of microcystins on the feeding behaviour and energy balance of zebra mussels, Dreissena polymorpha: a bioenergetics approach.

Microcystins are produced by bloom-forming cyanobacteria and pose significant health and ecological problems. To investigate the impacts of these biotoxins on the physiology of the zebra mussels, Dreissena polymorpha, a series of short-term feeding experiments were conducted in the laboratory. We used five microalgal diets consisting of single-cell suspensions of the green algae, Chlorella vulgaris, the diatom, Asterionella formosa, the cryptophyte, Cryptomonas sp. and two strains of the toxic cyanobacterium, Microcystis aeruginosa (strains CCAP 1450/06 and CCAP 1450/10). A sixth diet was a mixture of the diatom and the CCAP 1450/10 cyanobacterial strain. The low-toxicity strain CCAP 1450/06 contained 7.4 microg l(-1) of the MC-LR variant while the very toxic strain CCAP 1450/10 contained 23.8 microg l(-1) of MC-LR and 82.9 microg l(-1) of MC-LF. A flow-through system was designed to measure the following feeding parameters: clearance, filtration, ingestion and absorption rates. Ultimately the scope for growth (SFG) was determined as a net energy balance. We observed that mussels cleared the cyanobacterial species containing MC-LF (mean+/-95% confidence interval) at a significant lower rate (498+/-82 ml h(-1) g(-1) for the single cell suspension and 663+/-100 ml h(-1) g(-1) for the mixture diet) than all of the non-toxic species and the cyanobacterium containing MC-LR (all above 1l h(-1) g(-1)). The same pattern was observed with all the feeding parameters, particularly absorption rates. Furthermore, MC-LF caused an acute irritant response manifested by the production of 'pseudodiarrhoea', unusually fluid pseudofaeces, rich in mucus and MC-LF-producing Microcystis cells, ejected through the pedal gape of the mussels. This overall response therefore demonstrates selective rejection of MC-LF-producing cyanobacteria by zebra mussels, enhancing the presence of the very toxic MC-LF-producing M. aeruginosa in mixed cyanobacterial blooms and in the benthos. Finally, we observed that the SFG (mean+/-95% confidence interval) of mussels feeding on M. aeruginosa containing MC-LF was significantly lower (34.0+/-18.8 J h(-1) g(-1) for the single cell suspension and 83.1+/-53.0 J h(-1) g(-1) for the mixture diet) than for mussels ingesting non-toxic diets, except for C. vulgaris (all above 200 J h(-1)g(-1)). This reveals a sublethal, stressful effect of microcystins (particularly MC-LF) on the feeding behaviour and energy balance of the zebra mussel.

Stroke unit care is superior to general rehabilitation unit care.

Robust evidence exists for the efficacy of stroke units in improving stroke outcome. To date no Irish and little international data exist comparing stroke unit and general rehabilitation unit care. 207 patients admitted to a stroke unit (136--65.7%) and a general rehabilitation unit (71--34%) in the Mid-Western region from September 2000-August 2002 were included in the study. There was no difference in patient age, gender or admission criteria between the units. The stroke unit was associated with a shorter length of stay (mean 21 versus 33 days, p < 0.01) and a higher rate of home discharge (50% versus 38%, p < 0.01). Patient survival at discharge (86% versus 70.4%, p < 0.01), 3 months (84.5% versus. 69.5%, p < 0.01) and 6 months (81% versus. 66%, p < 0.01) post-admission was better among stroke unit patients.

Pineapple juice as a negative oral contrast agent in magnetic resonance cholangiopancreatography: a preliminary evaluation.

The quality of magnetic resonance cholangiopancreatography (MRCP) images is frequently degraded by high signal from the gastrointestinal tract. The aim of this study is to evaluate pineapple juice (PJ) as an oral negative contrast agent in MRCP. Preliminary in vitro evaluation demonstrated that PJ shortened T(2) relaxation time and hence decreased T(2) signal intensity on a standard MRCP sequence to a similar degree to a commercially available negative contrast agent (ferumoxsil). Electrothermal atomic absorption spectrometry assay demonstrated a high manganese concentration in PJ of 2.76 mg dl(-1), which is likely to be responsible for its T(2) imaging properties. MRCP was subsequently performed in 10 healthy volunteers, before and at 15 min and 30 min following ingestion of 400 ml of PJ. Images were assessed blindly by two Consultant Radiologists using a standard grading technique based on contrast effect (degree of suppression of bowel signal), and image effect (diagnostic quality). There were statistically significant improvements in contrast and image effect between pre and post PJ images. There was particularly significant improvement in visualization of the pancreatic duct, but no significant difference between 15 min and 30 min post PJ images. Visualization of the ampulla, common bile duct, common hepatic and central intrahepatic ducts were also significantly improved at 15 min following PJ. Our results demonstrate that PJ, may be used as an alternative to commercially available negative oral contrast agent in MRCP.

Isolated cervical intramedullary sarcoidosis--a histological surprise.

We present a case of cervical intramedullary sarcoidosis. A 56 year old woman presented with progressive paraesthesia affecting the lower limbs. MRI revealed an intramedullar lesion from C4-C7. A laminectomy and subtotal resection was carried out for this presumed intramedullary tumour. Pathology revealed this to be a granulomatous lesion with features indicative of sarcoidosis. Postoperatively, there was no change in her neurological function and her symptoms improved with steroid therapy.

Endovascular embolization of varicoceles: resorption of tungsten coils in the spermatic vein.

PURPOSE: To investigate whether resorption of tungsten coils occurs in patients with varicoceles treated by endovascular embolization of the spermatic vein. METHODS: Patients who had previously had varicocele embolization were requested by letter to attend the radiology department. Blood levels of tungsten were compared with a group of controls. Fluoroscopic images of the coils were taken and compared with those obtained during the original procedures. RESULTS: Nineteen patients attended, whose procedure had been done 19-57 months previously (mean 40 months). Blood levels of tungsten were raised in 18 patients compared with the controls. Radiographic evidence of loss of substance of the coils was seen in four patients. CONCLUSION: Tungsten coil resorption occurs in varicocele embolization. In view of the unknown long-term effects of raised blood tungsten levels and the availability of alternative embolization agents, we feel that it is unwise to persist in the use of tungsten coils in this application.