Brucella ceti infection in harbor porpoise (Phocoena phocoena).

We describe Brucella sp. infection and associated lesions in a harbor porpoise (Phocoena phocoena) found on the coast of Belgium. The infection was diagnosed by immunohistochemistry, transmission electron microscopy, and bacteriology, and the organism was identified as B. ceti. The infection's location in the porpoise raises questions of abortion and zoonotic risks.

[Public access defibrillation]. / Ombres et lumières de l'accès public a la défibrillation.

Placement of automated external defibrillators (AED) in public facilities and training of the lay persons in basic life support-defibrillation (BLS-D) was recommended by the American Heart Association for the treatment of out-of-hospital cardiac arrest (OHCA). Immediate use of AED result in increase of survival to hospital discharge. Many observation and much less randomized trials describe clinical efficacy of this approach. However, "negative" trials have also been published and some recent data suggest that public access defibrillation (PAD) will have a minimal impact on population survival. In this article various PAD strategies were briefly reviewed. In our opinion installation of AED in public places should be based on the long-term study of local OHCA demography and preceded by widespread BLS training of lay population.

Intravascular volume monitoring and extravascular lung water in septic patients with pulmonary edema.

OBJECTIVE: To evaluate whether different indicators using for guiding volume expansion are valuable tools to assess edematous lung injury in patients with septic shock. DESIGN AND SETTING: Prospective observational clinical study in a university intensive care unit. PATIENTS: Sixteen consecutive mechanically ventilated patients developing septic shock with evidence of pulmonary edema on chest radiograph and severe hypoxemia (PaO(2)/FIO(2) <250 mmHg). MEASUREMENTS AND RESULTS: A pulmonary artery catheter was used for the measurement of cardiac index (CI), central venous pressure (CVP), and pulmonary artery occlusion pressure (PAOP). A fiberoptic catheter was placed in the descending aorta. Measurements of extravascular lung water index (EVLWI), intrathoracic blood volume index (ITBVI), and total end-diastolic volume index (TEDVI) were obtained using the thermal dye dilution technique. Measurements were taken just after placement of catheters and 24 h later. Fluid balance was also estimated within the first 24 h. TEDVI and ITBVI were significantly correlated with EVLWI, but not CVP and PAOP. Analysis of 24-h changes showed that the changes in TEDVI and in ITBVI reflected the change in EVLWI, whereas PAOP, CVP, and fluid balance did not. CONCLUSIONS: Volume variables (TEDVI, ITBVI) are more useful indicators than pressure variables (CVP, PAOP) for assessment of EVLWI in septic patients with pulmonary edema.

Twenty years of Belgian North Sea aerial surveillance: a quantitative analysis of results confirms effectiveness of international oil pollution legislation.

Over the years many policy measures have been taken to prevent illegal oil discharges from ships, like the MARPOL 73/78 Convention (1983) and the Bonn Agreement (1969/1983). However, the number of discharges remained high, leading to chronic oiling of seabirds and sensitive coastlines, therefore further measures were taken. The aim of this study is to quantify the effectiveness of two key legislative regulations: the IMO-designation of the North Sea as MARPOL Special Area which took effect in 1999, and the adoption of the EU Directive on Port Reception Facilities in 2000. Under study is the heavily navigated Belgian Surveillance Area, monitored since 1991, characterised by shallow waters with ecologically important sandbanks. The aerial surveillance data from 1991 to 2010 show a stepwise decrease in ship-source oil pollution. Three time periods can be distinguished with two turning points coinciding with the actual implementation of these key legislative measures, confirming their effectiveness.