Anthropogenic debris in the digestive tract of a southern right whale (Eubalaena australis) stranded in Golfo Nuevo, Argentina.

Over the past fifty years, interactions between anthropogenic debris and a wide range of marine species have increased. In cetaceans, the most frequent interactions have occurred through ingestion and/or entanglement, with results ranging from minor injuries to death in affected animals. While debris ingestion is widely documented in odontocetes, records are scarcer in mysticetes. This study describes the finding of plastic litter in the digestive tract of a southern right whale (Eubalaena australis) juvenile male, which was found dead on the shores of Golfo Nuevo, Chubut, Argentina in 2014. During the examination of intestinal contents, anthropogenic waste was found and classified as macro-debris (25 mm-1 m). Although this whale likely died of causes not related to this finding, it is the first record of anthropogenic debris ingestion for this species. This event adds information about the potential impact of human-made debris on a variety of aquatic species and ecosystems.

Flu vaccine coverage for recommended populations in France.

OBJECTIVES: To estimate the size of the populations targeted by the French recommendations of the High Council for Public Health (French acronym HCSP) regarding vaccination against seasonal flu and to estimate vaccination coverage rates in these populations. PATIENTS AND METHODS: The analysis was conducted on a representative sample of patients retrieved from the French Health Insurance databases during three influenza seasons (2012-2013, 2013-2014, 2014-2015). Patients targeted by the influenza vaccination recommendations were identified based on their sociodemographic characteristics and disease identification algorithms during each season. Vaccine coverage rates were estimated based on reimbursed influenza vaccines. Results were extrapolated using indirect standardization to the overall French population. RESULTS: Populations targeted by the recommendations were estimated after extrapolation to 17.6, 17.8, and 18.0 million for the 2012-13, 2013-14, and 2014-15 influenza seasons, respectively. The vaccination coverage rates in these target populations were respectively estimated at 32.1%, 31.9%, and 32.1%; i.e. 44.2%, 43.1%, and 42.7% for individuals aged ≥65 years and 12.9%, 13.2%, and 13.7% for individuals ˂65 years of age presenting a risk justifying vaccination. CONCLUSIONS: Immunization coverage against influenza in France remains well below the target of 75% set by the World Health Organization. Multiple strategies combining communication, education, access program, and professional engagement could be implemented to improve this situation.

Wildlife conservation status and disease trends: ten years of reports to the Worldwide Monitoring System for Wild Animal Diseases.

Disease is an increasingly recognised threat to wild animal populations and the conservation of endangered species. The World Organisation for Animal Health (OIE) Worldwide Monitoring System for Wild Animal Diseases (WAHIS-Wild) serves as the main global information portal for wildlife disease events, compiled via voluntary reporting by countries on non-OIE-listed diseases. The first decade of reports to WAHIS-Wild were analysed to identify trends and examine their relevance for conservation. Between 2008 and 2018, a total of 4,229 wildlife disease events were reported, with the majority from the European continent. When standardised for nomenclature changes, 54 unique previous or current non-OIE-listed diseases were reported. The most common disease events (collectively representing > 50% of reports) were chemical poisoning (12.5% of events reported), infection with low pathogenic avian influenza viruses (11.9%), infection with Salmonella enterica (10.8%), infection with Pasteurella spp. (8.4%) and infection with Trichomonas spp. in birds and reptiles (7.5%). Reports indicated disease in 501 unique species, 19.2% of which are listed as endangered species based on the International Union for Conservation of Nature (IUCN) Red List of Threatened Species, and 30.7% of which are protected under the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). The findings suggest reporting gaps, including likely geographical area and other biases. More systematic reporting of wildlife disease and use of this information in biodiversity assessment and decision-making would result in better animal health and conservation coordination in a One Health context.

Les maladies constituent une menace dont l'importance sur les populations d'animaux sauvages et la conservation des espèces menacées est de plus en plus reconnue. Le Système mondial de suivi des maladies des animaux sauvages (WAHIS-Wild) de l'Organisation mondiale de la santé animale (OIE) est le principal portail mondial d'information sur les événements sanitaires affectant la faune sauvage. Il s'appuie sur les informations notifiées de manière volontaire par les pays concernant les maladies non listées par l'OIE. Les auteurs présentent les résultats d'une analyse des rapports notifiés à WAHIS-Wild au cours de ses dix premières années d'existence réalisée dans le but de relever les tendances et d'examiner leur pertinence pour la conservation de la faune. Entre 2008 et 2018, au total 4 229 événements sanitaires affectant la faune sauvage ont été notifiés, dont la majorité par des pays européens. Une fois normalisées pour tenir compte de la nouvelle nomenclature, les notifications couvraient 54 maladies individuelles anciennes ou actuelles non listées par l'OIE. Les événements sanitaires les plus fréquents (représentant collectivement plus de 50 % des rapports) concernaient des intoxications par des agents chimiques (12,5 % des événements notifiés), des infections par des virus faiblement pathogènes de l'influenza aviaire (11,9 %), des infections à Salmonella enterica (10,8 %), des infections à Pasteurella spp. (8,4 %) et des infections à Trichomonas spp. chez les oiseaux et les reptiles (7,5 %). Les rapports rendaient compte de la présence de maladies chez 501 espèces, dont 19,2 % sont inscrites sur la Liste rouge des espèces menacées de l'Union internationale pour la conservation de la nature (UICN) dans la catégorie des espèces menacées d'extinction, et dont 30,7 % sont protégées au titre de la Convention sur le commerce international des espèces de faune et de flore sauvages menacées d'extinction (CITES). Les résultats de cette analyse laissent penser qu'il existe un déficit d'information, y compris par aires géographiques, parmi d'autres biais. Une notification plus systématique des maladies des animaux sauvages et le recours à ces informations lors des évaluations de la biodiversité et des prises de décision se traduiraient par une meilleure coordination entre la santé animale et la conservation de la faune, dans un contexte Une seule santé.

Cada vez está más aceptado que las enfermedades son una posible amenaza para las poblaciones de animales silvestres y la conservación de especies en peligro. El «Sistema mundial de seguimiento de las enfermedades de los animales salvajes¼ (WAHIS-Wild ) de la Organización Mundial de Sanidad Animal (OIE) constituye el más importante portal mundial de información sobre eventos de enfermedad en la fauna silvestre, compilada a partir de los informes que voluntariamente envían los países sobre enfermedades no incluidas en la lista de la OIE. En este estudio se analizaron las notificaciones recibidas durante el primer decenio de WAHIS-Wild con el objetivo de determinar tendencias y examinar su relevancia para la conservación. De 2008 a 2018, se notificaron en total 4.229 eventos de enfermedad en animales silvestres, la mayoría de ellos en el continente europeo. Las notificaciones, una vez uniformizada la nomenclatura para descartar sinonimias, cubrían 54 enfermedades anteriores o actuales no inscritas en la lista de la OIE. Las enfermedades más comunes (que en conjunto suponen más del 50% de los informes) fueron las intoxicaciones por productos químicos (un 12,5% de los episodios notificados), infecciones por virus de influenza aviar de baja patogenicidad (un 11,9%), infecciones por Salmonella enterica (un 10,8%), infección por Pasteurella spp. (un 8,4%) e infecciones de aves y reptiles por Trichomonas spp. (un 7,5%). Los informes dan cuenta de enfermedades en 501 especies distintas, de las cuales, el 19,2% están en riesgo de extinción según la Lista Roja de Especies Amenazadas de la Unión Internacional para la Conservación de la Naturaleza (UICN), y el 30,7% están protegidas por la Convención sobre el Comercio Internacional de Especies Amenazadas de Fauna y Flora Silvestres (CITES). Los resultados sugieren la existencia de vacíos de información, como por ejemplo, por área geográfica, entre otros sesgos. Una notificación más sistemática de las enfermedades de los animales silvestres y un uso de esta información en evaluaciones de la biodiversidad y en la toma de decisiones permitiría una mayor coordinación en materia de sanidad y conservación, en un contexto de «Una sola salud¼.

Proposed attributes of national wildlife health programmes.

Wildlife health is important for conservation, healthy ecosystems, sustainable development and biosecurity. It presents unique challenges for national programme governance and delivery because wildlife health not only crosses jurisdictional responsibilities and authorities but also inherently spans multiple sectors of expertise. The World Organisation for Animal Health (OIE) encourages its Members to have wildlife disease monitoring and notification systems. Where national wildlife health surveillance programmes do exist, they vary in scope and size. Evidence-based guidance is lacking on the critical functions and roles needed to meet the OIE's recommendations and other expectations of a national programme. A literature review and consultation with national wildlife health programme leaders identified five key attributes of national programmes: 1) being knowledge and science based; 2) fostering cross-nation equivalence and harmonisation; 3) developing partnerships and national coordination; 4) providing leadership and administration of national efforts; and 5) capacity development. Proposed core purposes include: 1) establishment and communication of the national wildlife health status; 2) leading national planning; 3) centralising information and expertise; 4) developing national networks leading to harmonisation and collaborations; 5) developing wildlife health workforces; and 6) centralising administration and management of national programmes. A national wildlife health programme should aim to identify, effectively communicate and manage the risk to or from a country's wildlife populations. It should generate the appropriate knowledge required to improve the effectiveness of wildlife policies and systems, including identifying and assessing emerging priorities, thus facilitating early warning, preparedness and preventive actions.

La santé de la faune sauvage a un impact important sur la préservation des espèces et d'écosystèmes sains, sur le développement durable et sur la biosécurité. Les défis sont nombreux et complexes pour les programmes nationaux de gouvernance et de mise en oeuvre car les responsabilités et les compétences juridictionnelles sont croisées et les secteurs d'expertise sont multiples. L'Organisation mondiale de la santé animale (OIE) encourage ses Membres à mettre en place des systèmes de notification et de surveillance des maladies de la faune sauvage. Les programmes existants sont de tailles et de compétences variables et les orientations prises concernant les fonctions indispensables pour répondre aux recommandations de l'OIE et à ce qui est attendu d'un programme national ne sont pas toujours déterminées sur une base scientifique. Une revue de la littérature et des consultations auprès de responsables des programmes nationaux de santé de la faune sauvage ont permis d'identifier cinq attributs à proposer pour ces programmes nationaux. Ces programmes doivent :1) fonctionner sur la base de données scientifiques ; 2) favoriser l'équivalence et l'harmonisation transnationales ; 3) développer des partenariats et une coordination à l'échelle nationale ; 4) encadrer et administrer les efforts nationaux ; et 5) assurer le renforcement des capacités. Les missions essentielles sont : 1) déterminer et rendre publique la situation sanitaire de la faune sauvage dans le pays ; 2) encadrer le plan national ; 3) centraliser l'information et l'expertise ; 4) développer les réseaux nationaux d'harmonisation et de collaboration ; 5) former des personnels compétents dans le domaine de la faune sauvage ; et 6) centraliser l'administration et la gestion des programmes nationaux. Les objectifs d'un programme national de santé de la faune sauvage sont d'identifier, de rendre publics et de gérer les risques pour les populations d'animaux sauvages ainsi que les risques générés par ces mêmes populations. Ces programmes doivent promouvoir les connaissances nécessaires pour améliorer l'efficacité des politiques et des systèmes applicables à la faune sauvage, en particulier l'identification et l'évaluation des nouvelles priorités afin de faciliter la mise en oeuvre de systèmes d'alerte précoce, de préparation aux urgences et d'action préventive.

La salud de los animales silvestres, tan importante para la conservación del medio, el buen funcionamiento de los ecosistemas, el desarrollo sostenible y la seguridad biológica, presenta singulares dificultades desde el punto de vista de la gobernanza y aplicación de programas nacionales, dado que la fauna silvestre no solo toca a múltiples responsabilidades y atribuciones jurisdiccionales sino que, por su propia naturaleza, convoca a una plétora de especialidades técnicas. La Organización Mundial de Sanidad Animal (OIE) alienta a sus Miembros a que se doten de sistemas de vigilancia y notificación de enfermedades de la fauna silvestre. Allí donde existen, los programas nacionales en la materia son muy variopintos en cuanto a sus dimensiones y alcance. Faltan pautas científicamente sólidas sobre las funciones y atribuciones básicas que se requieren para cumplir las recomendaciones de la OIE y otras expectativas a las que pueda responder un programa nacional. Tras efectuar un estudio bibliográfico y consultar a los directivos de programas nacionales en la materia, los autores determinaron cinco atributos clave que debe reunir todo programa nacional: 1) estar basado en el saber y la ciencia; 2) favorecer la equivalencia y la armonización entre naciones; 3) crear alianzas y mecanismos de coordinación nacional; 4) encabezar y administrar las actividades a escala nacional; y 5) desarrollar los medios de acción del país. Los objetivos básicos propuestos son: 1) determinar y dar a conocer la situación sanitaria de la fauna silvestre del país; 2) dirigir las labores de planificación a escala nacional; 3) centralizar la información y las competencias especializadas; 4) instituir redes nacionales que propicien la armonización y las iniciativas de colaboración; 5) desarrollar los recursos humanos dedicados a la sanidad de la fauna silvestre; y 6) centralizar la gestión y administración de los programas nacionales. Todo programa nacional de sanidad de la fauna silvestre debe responder a la finalidad de detectar, comunicar eficazmente y gestionar los riesgos que amenacen a las poblaciones de animales silvestres del país o que provengan de ellas. A tal efecto debe generar el conocimiento adecuado y necesario para conferir más eficacia a las políticas y sistemas tocantes a la fauna silvestre, lo que supone, entre otras cosas, determinar y evaluar las nuevas prioridades, facilitando con ello la alerta anticipada y las labores de preparación y prevención.

Estimating the cost-effectiveness profile of a universal vaccination programme with a nine-valent HPV vaccine in Austria.

BACKGROUND: HPV is a major cancer-causing factor in both sexes in the cervix, vulva, vagina, anus, penis, oropharynx as well as the causal factor in other diseases such as genital warts and recurrent respiratory papillomatis. In the context of the arrival of a nonavalent HPV vaccine (6/11/16/18/31/33/45/52/58), this analysis aims to estimate the public health impact and the incremental cost-effectiveness of a universal (girls and boys) vaccination program with a nonavalent HPV vaccine as compared to the current universal vaccination program with a quadrivalent HPV vaccine (6/11/16/18), in Austria. METHOD: A dynamic transmission model including a wide range of health and cost outcomes related to cervical, anal, vulvar, vaginal diseases and genital warts was calibrated to Austrian epidemiological data. The clinical impact due to the 5 new types was included for cervical and anal diseases outcomes only. In the base case, a two-dose schedule, lifelong vaccine type-specific protection and a vaccination coverage rate of 60% and 40% for girls and boys respectively for the 9-year old cohorts were assumed. A cost-effectiveness threshold of €30,000/QALY-gained was considered. RESULTS: Universal vaccination with the nonavalent vaccine was shown to reduce the incidence of HPV16/18/31/33/45/52/58 -related cervical cancer by 92%, the related CIN2/3 cases by 96% and anal cancer by 83% and 76% respectively in females and males after 100 years, relative to 75%, 76%, 80% and 74% with the quadrivalent vaccine, respectively. Furthermore, the nonavalent vaccine was projected to prevent an additional 14,893 cases of CIN2/3 and 2544 cases of cervical cancer, over 100 years. Depending on the vaccine price, the strategy was shown to be from cost-saving to cost-effective. CONCLUSION: The present evaluation showed that vaccinating 60% of girls and 40% of boys aged 9 in Austria with a 9-valent vaccine will substantially reduce the incidence of cervical cancer, CIN and anal cancer compared to the existing strategy. The vaccination strategies performed with the 9-valent vaccine in the current study were all found to be cost-effective compared to the current quadrivalent vaccination strategy by considering a cost-effectiveness threshold of 30,000€/QALY gained.

Costs of dengue in three French territories of the Americas: an analysis of the hospital medical information system (PMSI) database.

BACKGROUND: Dengue is a major emerging public health concern in tropical and subtropical countries. Severe dengue can lead to hospitalisation and death. This study was performed to assess the economic burden of hospitalisations for dengue from 2007 to 2011 in three French territories of the Americas where dengue is endemic (French Guiana, Martinique and Guadeloupe). METHODS: Data on dengue-associated hospitalisations were extracted from the French national hospital administrative database, Programme de Médicalisation des Systèmes d'Information (PMSI). The numbers of stays and the corresponding number of hospitalised patients were determined using disease-specific ICD-10 codes. Associated hospital costs were estimated from the payer perspective, using French official tariffs. RESULTS: Overall, 4183 patients (mean age 32 years; 51 % male) were hospitalised for dengue, corresponding to 4574 hospital stays. In nearly all hospital stays (98 %; 4471), the illness was medically managed and the mean length of stay was 4.3 days. The mean cost per stay was €2522, corresponding to a total hospital cost of €11.5 million over the 5 years assessed. The majority of hospitalisations (80 % of patients) and associated costs (75 % of total hospital costs) were incurred during two epidemics. CONCLUSION: Severe dengue is associated with significant hospital costs that escalate during outbreaks.

Organochlorine pesticides and PCBs in Southern Right Whales (Eubalaena australis) breeding at Península Valdés, Argentina.

Organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) were assessed in blubber from 35 dead Southern Right Whales (SRW - Eubalaena australis) stranded at Península Valdés, Argentina. The life cycle includes a feeding period in high productivity areas of the South West Atlantic and a reproductive period in coastal template waters of Argentina. Organochlorine pesticides showed higher concentrations (22.6±13.8 ng·g(-1)ww) than PCBs (7.5±10 ng·g(-1)ww). Among pesticides, HCHs, DDTs, endosulfans, dieldrin, chlordans, heptachlor epoxide, and trans-nonachlor were detected. p,p'-DDE and p,p'-DDT were present in 69% and 26% of samples, respectively. p,p'-DDT/p,p'-DDE ratio showed low values (<0.33) as a result of aged DDT inputs. However, the occurrence of only p,p'-DDT in some samples suggests a recent pesticide input. α-HCH/γ-HCH ratio (

Relating diving behavior and antioxidant status: Insights from oxidative stress biomarkers in the blood of two distinct divers, Mirounga leonina and Arctocephalus australis.

Pinnipeds rely upon diving to perform essential activities, including foraging. As pulmonated animals, oxygen privation experienced during submergence represents a considerable challenge both physiologically and biochemically. Routine exposure to hypoxia and the rapid transitions between ischemia/reperfusion of tissues leads to extremely high reactive oxygen species (ROS) production, which must be opposed by antioxidant defenses to avoid oxidative stress. The diving behaviors and capabilities of pinnipeds are very diverse, resulting in distinct metabolic responses among species. To assess whether these characteristics reflect the antioxidant status of two marine diving mammals with distinct diving capacities, oxidative stress biomarkers were measured in the blood of Arctocephalus australis (n=11) and Mirounga leonina (n=12). All of the biomarkers analyzed in M. leonina were significantly higher than those of A. australis, suggesting that higher antioxidant content is needed to counteract the high ROS production associated with the long submergence times (24.3±5.6min) of this species, which are nearly ten times greater than those of A. australis (2.8±0.5min). Thus, the constitutive antioxidant defenses of both species are of distinct magnitudes due to their inherent diving capacity.

Stakeholders in One Health.

The stakeholders in One Health include the ultimate beneficiaries (i.e. animals, people and the environment) and the organisations that work to protect them (i.e. research institutes, government ministries, international organisations and professional bodies). However, identifying these stakeholders who will contribute to One Health activities and develop solutions to complex health problems can be difficult, as these problems often affect all sectors of society. In addition, evolving concepts about health and its dependence on environmental resilience necessitate the inclusion of ministries, organisations and disciplines that may not have been traditionally considered to be related to health. The multilateral organisations with greatest responsibilities in the global health arena have recognised that the best way to protect health security and promote overall global well-being is to work together across disciplinary and jurisdictional boundaries. Permanent regional networks and ad hoc networks created to tackle specific issues (both of which require donor investment) are also facilitating improved disease surveillance and collaborative approaches to synchronised interventions across country borders. These networks necessarily involve the key ministries for One Health, those of health, agriculture/livestock, and natural resources/environment. Ministries play a critical role in the formulation and implementation of policies for the promotion of health and disease control. They contribute to all stages of the One Heath process, as do universities, which engage by generating knowledge and capacity through teaching, research and extension services. Similarly, non-governmental organisations have a key role in stewardship; resource mobilisation; generation of knowledge; capacity development; intervention design; and implementation. Finally, communities, including rural and indigenous peoples, particularly those that are in close proximity to natural areas, are at the heart of the One Health concept.

[Inter-individual and intra-individual pharmacokinetic variability during teicoplanin therapy in geriatric patients]. / Variabilité pharmacocinétique inter- et intra-individuelle lors de traitements par teicoplanine chez les sujets âgés.

OBJECTIVES: The authors had for aim to assess the inter- and intra-individual variability of teicoplanin pharmacokinetic parameters in geriatric patients. METHODS: A cohort of 90 geriatric patients, treated with teicoplanin, was used to build two models describing the pharmacokinetics of teicoplanin, at the beginning and at the end of treatment respectively. RESULTS: The inter- and intra-individual variability of parameters were important as shown respectively by the coefficients of variation of pharmacokinetic parameters ranging from 125 to 694% and the half-life change during the treatment (by a factor of three to more than 30) for 60% of patients. CONCLUSIONS: The results revealed that elderly patients presented significant variability, which was only partly explained by the renal function. Therapeutic monitoring of teicoplanin in geriatric patients should be undertaken at the end of the loading dose and repeatedly during the maintenance phase to prevent over- or underexposure.

Guidelines for aminoglycoside use and applicability to geriatric patients.

OBJECTIVES: The authors had for objective to evaluate the applicability of AFSSAPS guidelines for aminoglycoside use to geriatric patients. METHODS: Theoretical doses and dosing regimens allowing reaching target concentrations in this population were calculated by applying a pharmacokinetic model to 30 geriatric patients treated by amikacin. RESULTS: The dose allowing reaching a maximum concentration of 60 mg/L was 1.217 mg on average. The time required to reach a blood concentration lower than or equal to 2.5mg/L was 62.5±70.4 hours. Forty-six percent of patients had a trough concentration greater than 2.5 mg/L, 48 hours after administration. For these patients, the time between critical minimum inhibitory concentration (MIC) and toxicity threshold concentration was 21.9±14.9 hours. CONCLUSION: Reaching a target concentration can be problematic in geriatric patients. It is frequently necessary to use dosing intervals greater than 48 hours. The effectiveness and safety of these regimens remain uncertain.

[Practical application of the charter of pharmaceutical sales visit]. / Application pratique de la charte de la visite médicale.

BACKGROUND: Visits from pharmaceutical representatives are controlled in France by regulations, but also by a Charter of good practice. The goal of this study was to measure compliance to the conditions of this charter by participating pharmaceutical companies. MATERIAL AND METHODS: An assessment grid was drafted to determine compliance to interdictions and obligations concerning the information provided during visits from pharmaceutical representatives. RESULTS: We studied 20 visits from pharmaceutical representatives. All of the documents and obligatory information were only provided in 5% of cases. During 80% of these meetings, the pharmaceutical representatives made a comparison with competitor's drugs, which was associated with negative remarks in 44% of cases. The pharmaceutical representatives promoted cases of use outside those, which had received marketing approval in 35%. Gifts or samples were offered at the end of these meetings in 20% of cases. Prohibited practices were observed in a total of 85% of cases. DISCUSSION: This study shows that meetings are respected by pharmaceutical representatives in terms of regulations related to donations. In opposite, there is a very low compliance concerning the proper use of the drug, whether to provide official documentation, to give information respectful of other pharmaceutical companies or to promote the proper use. CONCLUSION: Our results suggest that, at present hospital visits by pharmaceutical representatives do not respect the commitments made by the pharmaceutical industry, and do not make it possible to ensure that honest information is provided to favor the proper use of drugs.

[Relationship between benzodiazepines use and falls in the elderly: a multicenter study in three geriatric centers of a university hospital]. / Relation entre consommation de benzodiazépines et chutes en gériatrie : étude multicentrique dans trois établissements gériatriques d'un CHU.

INTRODUCTION: Benzodiazepines are widely used in the elderly, but may induce potentially severe iatrogenic events like falls. The analysis of their use is difficult because of the numerous molecules and dosages available. The aim of the present study is to build a tool to monitor their consumption and to evaluate the relation between this consumption and patient's falls reported in three geriatric institutions. METHODS: Conversion coefficients found in the literature allowed the expression of benzodiazepine action with a unique comparator: diazepam. Benzodiazepine consumption observed during 20 consecutive months was collected and weighted by hospital activity. A correlation between benzodiazepine consumption and the number of falls reported during the same period was researched. RESULTS: Benzodiazepine consumption expressed in milligrams of diazepam-equivalent per hospitalization day is significantly linked to the number of falls expressed during the same period (R=0.63; p<0.01). However, no statistical bound was found between monthly falls variations and monthly benzodiazepine consumption variations. These results corroborate others published studies: benzodiazepine consumptions are statistically linked to falls, but the reduction of this consumption is of poor predictive value, maybe because of the multifactorial nature of falls. DISCUSSION AND CONCLUSION: The expression of benzodiazepine consumption in diazepam-equivalent enables one to estimate the general exposition of patients and to compare the use of each molecule. The statistical link between this indicator and a major iatrogenic event like falls makes it a tool worth interest for both clinicians and pharmacists.

Assessment of sodium hyaluronate gel as vehicle for intracameral delivery of cefuroxime in endophthalmitis prophylaxis.

Sodium cefuroxime is a second-generation cephalosporin widely used at 10mg/mL for endophthalmitis prophylaxis after cataract surgery. Sodium cefuroxime solution is usually conditioned in pre-filled syringes then frozen for storage. In the present study, 0.2% sodium hyaluronate gel, natural extracellular polymer used in wound healing, was compared to conventional saline solution (0.9% sodium chloride) as drug delivery systems for cefuroxime loading in pre-filled syringes. Therefore, the temperature (4 and 25 degrees C) and time of storage (up to 21 days) varied in order to appreciate both cefuroxime and vehicle stability. Furthermore, the kinetics of drug release from both hyaluronate gel and saline solution were compared since in vitro sets of dialysis experiments. Results indicated that cefuroxime loaded in either saline solution or hyaluronate hydrogel was found stable in pre-filled syringes stored at 4 degrees C for 21 days, whereas cefuroxime degradations products appeared from the 2nd day of storage at 25 degrees C. Both drug delivery systems were found bioequivalent, although statistically slower cefuroxime dialysis was evidenced by using sodium hyaluronate vehicle. Noteworthy, cefuroxime concentration in drug delivery systems during dialysis experiment remained greater than the minimum inhibitory concentrations reported for resistant strains. In conclusion, the present stability and release study confirmed that sodium hyaluronate hydrogel is a promising vehicle for cefuroxime intracameral delivery in endophthalmitis prophylaxis.

Evaluation of the health of free-ranging greater rheas (Rhea americana) in Argentina.

The health of 22 free-ranging adult rheas (Rhea americana) examined and sampled during a translocation/reintroduction project and six juvenile rheas kept in semicaptivity was investigated, and details of their haematology and plasma biochemistry are presented. Serological testing for antibodies to infectious agents was negative for infectious laryngotracheitis, avian adenovirus, avian influenza, avian reovirus, infectious bursal disease, infectious bronchitis virus, paramyxovirus types 1, 2, and 3, fowlpox and Salmonella Pullorum. Antibodies to Chlamydophila species were found in 25 of 27 of the birds, and 22 of 25 had antibodies to Aspergillus species. Ova of gastrointestinal nematodes of the genus Capillaria were identified, and the anoplocephalid cestode Monoecocestus cf rheiphilus was identified in R americana for the first time.

GABRA6 gene polymorphism and an attenuated stress response.

The glucocorticoid component of the stress response has been the subject of intense scientific scrutiny because of the wide ranging pathological consequences resulting from excess glucocorticoid exposure, including mood and anxiety disorders, and cognitive impairment. Exposure to stress activates the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic adrenomedullary system, which are regulated by neuronal pathways, including the inhibitory GABAergic (gamma-aminobutyric acid) system. Approximately 60% of the variance in glucocorticod levels may be attributable to genetic individual differences. In the present study, 56 healthy subjects underwent genotyping to determine the influence of the T1521C single nucleotide polymorphism (SNP) in the GABA(A)alpha6 receptor subunit gene (GABRA6) on the hormonal and autonomic responses to psychological stress induced by the Trier Social Stress Test (TSST). Adrenocorticotropin (ACTH), cortisol, diastolic blood pressure, and mean blood pressure responses to the TSST were significantly greater in subjects homozygous for the T allele or heterozygous compared to subjects homozygous for the C allele. Behavioral data was collected employing the Revised NEO Personality Inventory (NEO PI-R); subjects homozygous for the C allele scored significantly lower on the Extraversion factor compared to subjects homozygous for the T allele or heterozygous. These results suggest that the T1521C polymorphism in the GABRA6 gene is associated with specific personality characteristics as well as a marked attenuation in hormonal and blood pressure responses to psychological stress.

Internal parasites of free-ranging guanacos from Patagonia.

In the winter of 2000, a greater than 80% reduction in the guanaco population located in Cabo Dos Bahi;as Wildlife Reserve, Chubut, Argentina, was evident due to massive mortality attributed to starvation. Twelve guanacos were necropsied and samples were analyzed at the Parasitology Laboratory of Facultad de Ciencias Veterinarias, Universidad Nacional del Litoral. Fecal analysis revealed developmental stages of Nematodirus sp., Marshallagia sp., Trichuris sp. and Eimeria spp. Histopathological analysis showed the presence of Sarcocystis sp. in muscle and fascia cysts. Other parasites recovered included Dictyocaulus filaria, Trichuris tenuis and Moniezia expansa. Of these, D. filaria and M. expansa possibly reflect interactions with domestic sheep. This is the first time that T. tenuis has been reported in guanacos.

Comparison between the antioxidant status of terrestrial and diving mammals.

Many diving mammals are known for their ability to deal with nitrogen supersaturation and to tolerate apnea for extended periods. They are all characterized by high oxygen-carrying capacity in blood together with high oxygen storage in their muscle mass due to large myoglobin concentrations. The above properties theoretically also imply a high tissue antioxidant defenses (AD) to counteract reactive oxygen species (ROS) generation associated with the rapid transition from apnea to reoxygenation. Different enzymatic (superoxide dismutase, catalase, glutathione reductase, glutathione peroxidase, and glutathione S-transferase), and non-enzymatic (levels of glutathione) AD as well as cellular damage (thiobarbituric acid-reactive substances contents, as a measure of lipoperoxidation) were measured in blood samples obtained from anesthetized animals, and also in blood obtained from recently dead diving mammals, and compared to some terrestrial mammals (n=5 in both groups). The results confirmed that diving mammals have, in general, higher antioxidant status compared to non-diving mammals. Apparently, to avoid exposure of tissues to changing high oxygen levels, and therefore to avoid an oxidative stress condition related to antioxidant consumption and increased ROS generation, diving mammals possess constitutive high levels of antioxidants in tissues. These data are in agreement with short-term AD adaptations related to torpor and to animals that experience large daily changes in oxygen consumption. These data are similar to the long-term adaptations of animals that undergo hibernation, estivation, freezing-thawing and dehydration-rehydration processes. In summary, animals that routinely face high changes in oxygen availability and/or consumption seem to show a general strategy to prevent oxidative damage by having either appropriate high constitutive AD and/or the ability to undergo arrested states, where depressed metabolic rates minimize the oxidative challenge.