ABSTRACT
Animal communication systems evolved in the presence of noise generated by natural sources. Many species can increase the source levels of their sounds to maintain effective communication in elevated noise conditions, i.e. they have a Lombard response. Human activities generate additional noise in the environment creating further challenges for these animals. Male humpback whales are known to adjust the source levels of their songs in response to wind noise, which although variable is always present in the ocean. Our study investigated whether this Lombard response increases when singing males are exposed to additional noise generated by motor vessels. Humpback whale singers were recorded off eastern Australia using a fixed hydrophone array. The source levels of the songs produced while the singers were exposed to varying levels of wind noise and vessel noise were measured. Our results show that, even when vessel noise is dominant, singing males still adjust the source levels of their songs to compensate for the underlying wind noise, and do not further increase their source levels to compensate for the additional noise produced by the vessel. Understanding humpback whales' response to noise is important for developing mitigation policies for anthropogenic activities at sea.
Subject(s)
Humpback Whale , Music , Singing , Animals , Humans , Male , Wind , Sound , Vocalization, AnimalABSTRACT
BACKGROUND: Rotavirus infections of neonatal and older pigs are widely reported. Analysis of rotavirus group C prevalence and diversity has not previously been reported for Australian pig farms. METHODS: Twenty-seven farms with or without diarrhoea present among neonatal or older pigs were enrolled across eastern Australia. Fresh faecal samples were analysed by ELISA for rotavirus and RNA extractions by polyacrylamide gel electrophoresis and RT-PCR for rotavirus. Rotavirus group C samples were genotyped via sequencing. RESULTS AND CONCLUSIONS: Rotavirus infection was diagnosed in pigs on 10 of 19 farms investigated for neonatal diarrhoea, four with group A and six with group C; also among post-weaned (5- to 11-week-old) diarrhoeic pigs on two farms. Neonatal rotavirus group C infections were exclusively noted in piglets less than 1-week-old, consisting of farm infections with a single VP7 genotype (G5 or G6). Infections in post-weaned pigs were associated with multiple VP7 genotypes (G1, G3). This first report of rotavirus group C infections of Australian pigs suggests they may form a limited population of VP7 genotypes.
Subject(s)
Diarrhea/veterinary , Rotavirus Infections/veterinary , Rotavirus/isolation & purification , Swine Diseases/virology , Animals , Animals, Newborn/virology , Australia , Diarrhea/virology , Farms , Feces/virology , Female , Genotype , Rotavirus/genetics , Rotavirus Infections/virology , SwineABSTRACT
In some parts of the world, cyanobacteria are used as a food in the human diet, due to their ready availability. Lake Chad, has long been a traditional site for the collection of Arthrospira fusiformis which is dried and processed at the lake into thin wafers called Dihé for later consumption or is transported to market for sale. However, Dihé purchased from markets in Chad has not been analyzed for known cyanobacterial toxins or assessed for total amino acid content. Since BMAA in traditional foodstuffs of the indigenous Chamorro people of Guam causes neurodegenerative illness, it is important that Dihé from Chad be analyzed for this neurotoxin. BMAA and its isomer AEG were not detected in our analyses, but a further isomer DAB was detected as both a free and bound amino acid, with an increase in the free concentration after acid hydrolysis of this fraction. Microcystins were present in 6 samples at up to 20 µg/g according to UPLC-PDA, although their presence could not be confirmed using PCR for known microcystin synthetic genes. Amino acid analysis of the cyanobacterial material from Chad showed the presence of large amounts of canonical amino acids, suggesting that this may supplement indigenous people on low protein diets, although regular monitoring of the foodstuffs for the presence of cyanotoxins should be performed.
Subject(s)
Amino Acids/analysis , Cyanobacteria Toxins/analysis , Cyanobacteria/chemistry , Food Analysis , Chad , Microcystins/chemistryABSTRACT
For most cetacean species, there is little known about how an individual's physiology influences its behaviour. Humpback whales (Megaptera novaeangliae) are a good candidate to examine such links as they have a well-described distribution and behaviour, can be consistently sampled using remote biopsy systems, and have been the subject of several previous endocrine studies. The objective here was to examine whether a female humpback whale's social state (i.e. escorted by a male or not) is related to her endocrine condition, and whether male dominance ranking is related to testosterone levels. Skin and blubber biopsies were collected from the east and west Australian humpback whale populations in 2010-2016 (nâ¯=â¯252) at multiple times throughout the winter-spring breeding season. Steroid hormones were extracted from blubber and concentrations of progesterone (a marker for pregnancy), testosterone (a marker of male testicular activity) and oestradiol (a potential marker of ovarian activity) measured using enzyme-immunoassays. Principal escorts-the dominant males in mixed sex groups-had significantly higher blubber testosterone levels (mean⯱â¯SE; 1.43⯱â¯0.20â¯ng/g wet weight) than subordinate, secondary escorts (0.69⯱â¯0.06â¯ng/g wet weight). Females that were escorted by males typically possessed elevated blubber oestradiol levels (1.96⯱â¯0.25â¯ng/g wet weight; pâ¯=â¯0.014); few were considered to be pregnant (pâ¯=â¯0.083). 'Unescorted' females displayed characteristically lower blubber oestradiol levels (0.56⯱â¯0.06â¯ng/g wet weight). Together, these results are consistent with 'challenge hypothesis' theory and suggest the existence of associated reproductive patterns in humpback whales.
Subject(s)
Humpback Whale/physiology , Sexual Behavior, Animal/physiology , Adipose Tissue , Animal Migration/physiology , Animals , Australia , Body Constitution/physiology , Female , Hormones/analysis , Hormones/chemistry , Hormones/metabolism , Male , Pregnancy , Reproduction/physiology , Seasons , Skin/chemistry , Skin/metabolism , Testosterone/analysis , Testosterone/metabolismABSTRACT
Blubber and respiratory vapour ('blow') are now commonly used for endocrine studies on cetaceans, primarily because they can be obtained using minimally invasive methods. For many species, these samples have yet to be validated for these purposes. The objective of this study was to examine the performance of blow and blubber hormone monitoring, relative to serum hormone monitoring, for evaluating the reproductive and adrenal condition of captive bottlenose dolphins (Tursiops spp.). Eighteen bottlenose dolphins were sampled five times for serum and blow and twice for blubber throughout a one-year period. Concentrations of progesterone, testosterone, oestradiol and cortisol were measured in each sample type. Hormone levels were examined in relation to dolphin age, sex, reproductive status, season, time of sample collection (morning/afternoon) and collection type (in- or out-of-water sampling). Patterns in hormone levels were similar for serum and blubber. For instance, in both sample types, progesterone levels were significantly higher in pregnant (serum: 34.10⯱â¯8.64â¯ng/mL; blubber: 13.01⯱â¯0.72â¯ng/g) than in non-pregnant females (serum: 0.32⯱â¯0.09â¯ng/mL; blubber: 1.17⯱â¯0.10â¯ng/g). This pattern was not detected in blow, primarily because seawater contamination, nylon sampling materials and variable sample volumes influenced measured concentrations. In addition, the respiratory water content of a blow sample is known to affect measured hormone levels. Two methods were trialled to control for variability in sample volumes and dilution: (1) normalising blow hormone concentrations relative to urea nitrogen levels (a potential endogenous standard), and (2) measuring the relative proportions (i.e. ratios) of blow hormones. These correction measures had little influence on blow hormone results. Further refinement of blow hormone monitoring methods is required before they can be used for reproductive or adrenal assessments of bottlenose dolphins. Blubber, on the other hand, should be a suitable proxy for serum when attempting to classify pregnancy status and male maturity in these species.
Subject(s)
Bottle-Nosed Dolphin/anatomy & histology , Bottle-Nosed Dolphin/metabolism , Breath Tests , Endocrine System/metabolism , Respiration , Animals , Bottle-Nosed Dolphin/blood , Female , Hormones/blood , Male , Models, Statistical , Pregnancy , ReproductionABSTRACT
The unfolded protein response (UPR) is a highly evolutionarily conserved response to endoplasmic reticulum (ER) stress, which functions to return cells to homeostasis or send them into apoptosis, depending on the degree of cellular damage. ß-N-methylamino-L-alanine (L-BMAA) has been shown to induce ER stress in a variety of models and has been linked to several types of neurodegenerative disease including Guamanian amyotrophic lateral sclerosis/Parkinsonism dementia complex (ALS/PDC). L-Serine, an amino acid critical for cellular metabolism and neurological signaling, has been shown to be protective against L-BMAA-induced neurotoxicity in both animal and cell culture models. While the mechanisms of L-BMAA neurotoxicity have been well characterized, less is known about L-serine neuroprotection. We recently reported that L-serine and L-BMAA generate similar differential expression profiles in a human ER stress/UPR array, despite L-serine being neuroprotective and L-BMAA being linked to neurodegenerative disease. Here, we further investigate the mechanism(s) of L-serine-induced UPR dysregulation by examining key genes and proteins in the ER stress/UPR pathways. We report that L-serine selectively increased protein disulfide isomerase (PDI) protein translation, an ER chaperone involved in refolding misfolded proteins, suggesting it may be modulating the UPR to favor recovery from ER stress. This constitutes a new mechanism for L-serine-mediated neuroprotection and has implications for its use as a therapy for neurodegenerative illnesses.
Subject(s)
Endoplasmic Reticulum Stress/drug effects , Neuroprotection/drug effects , Protein Disulfide-Isomerases/metabolism , Serine/pharmacology , Up-Regulation/drug effects , Activating Transcription Factor 4/genetics , Activating Transcription Factor 4/metabolism , Amino Acids, Diamino/pharmacology , Apoptosis/drug effects , Caspase 3/genetics , Caspase 3/metabolism , Cell Line, Tumor , Cell Survival/drug effects , Cyanobacteria Toxins , Humans , L-Lactate Dehydrogenase/metabolism , Nerve Degeneration/chemically induced , Nerve Degeneration/prevention & control , Neuroblastoma/pathology , Protein Disulfide-Isomerases/genetics , RNA, Messenger/metabolism , Signal Transduction/drug effects , X-Box Binding Protein 1/genetics , X-Box Binding Protein 1/metabolismABSTRACT
ß-N-methylamino-L-alanine (L-BMAA) is a neurotoxic non-protein amino acid produced by cyanobacteria. Recently, chronic dietary exposure to L-BMAA was shown to trigger neuropathology in nonhuman primates consistent with Guamanian ALS/PDC, a paralytic disease that afflicts Chamorro villagers who consume traditional food items contaminated with L-BMAA. However, the addition of the naturally occurring amino acid L-serine to the diet of the nonhuman primates resulted in a significant reduction in ALS/PDC neuropathology. L-serine is a dietary amino acid that plays a crucial role in central nervous system development, neuronal signaling, and synaptic plasticity and has been shown to impart neuroprotection from L-BMAA-induced neurotoxicity both in vitro and in vivo. We have previously shown that L-serine prevents the formation of autofluorescent aggregates and death by apoptosis in human cell lines and primary cells. These effects are likely imparted by L-serine blocking incorporation of L-BMAA into proteins hence preventing proteotoxic stress. However, there are likely other mechanisms for L-serine-mediated neuroprotection. Here, we explore the molecular mechanisms of L-serine neuroprotection using a human unfolded protein response real-time PCR array with genes from the ER stress and UPR pathways, and western blotting. We report that L-serine caused the differential expression of many of the same genes as L-BMAA, even though concentrations of L-serine in the culture medium were ten times lower than that of L-BMAA. We propose that L-serine may be functioning as a small proteostasis regulator, in effect altering the cells to quickly respond to a possible oxidative insult, thus favoring a return to homeostasis.
Subject(s)
Endoplasmic Reticulum/drug effects , Gene Expression Regulation, Neoplastic/drug effects , Neuroprotective Agents/pharmacology , Proteostasis/drug effects , Serine/pharmacology , Amino Acids, Diamino/toxicity , Analysis of Variance , Apoptosis/drug effects , Caspase 3/genetics , Caspase 3/metabolism , Cell Line, Tumor , Cyanobacteria Toxins , Dose-Response Relationship, Drug , Endoplasmic Reticulum/metabolism , Endoplasmic Reticulum Stress , Excitatory Amino Acid Agonists/toxicity , Humans , Molecular Chaperones/genetics , Molecular Chaperones/metabolism , Neuroblastoma/pathology , Oligonucleotide Array Sequence Analysis , Protein Folding/drug effects , Proteolysis/drug effects , Transcription Factors/genetics , Transcription Factors/metabolism , Ubiquitination/drug effects , Ubiquitination/geneticsABSTRACT
In human neuroblastoma cell cultures, non-human primates and human beings, L-serine is neuroprotective, acting through a variety of biochemical and molecular mechanisms. Although L-serine is generally classified as a non-essential amino acid, it is probably more appropriate to term it as a "conditional non-essential amino acid" since, under certain circumstances, vertebrates cannot synthesize it in sufficient quantities to meet necessary cellular demands. L-serine is biosynthesized in the mammalian central nervous system from 3-phosphoglycerate and serves as a precursor for the synthesis of the amino acids glycine and cysteine. Physiologically, it has a variety of roles, perhaps most importantly as a phosphorylation site in proteins. Mutations in the metabolic enzymes that synthesize L-serine have been implicated in various human diseases. Dosing of animals with L-serine and human clinical trials investigating the therapeutic effects of L-serine support the FDA's determination that L-serine is generally regarded as safe (GRAS); it also appears to be neuroprotective. We here consider the role of L-serine in neurological disorders and its potential as a therapeutic agent.
Subject(s)
Nervous System Diseases/drug therapy , Neuroprotective Agents/therapeutic use , Serine/therapeutic use , Animals , HumansABSTRACT
Precision measurements of superallowed Fermi ß-decay transitions, particularly for the lightest superallowed emitters ^{10}C and ^{14}O, set stringent limits on possible scalar current contributions to the weak interaction. In the present work, a discrepancy between recent measurements of the ^{10}C half-life is addressed through two high-precision half-life measurements, via γ-ray photopeak and ß counting, that yield consistent results for the ^{10}C half-life of T_{1/2}=19.2969±0.0074 s and T_{1/2}=19.3009±0.0017 s, respectively. The latter is the most precise superallowed ß-decay half-life measurement reported to date and the first to achieve a relative precision below 10^{-4}. A fit to the world superallowed ß-decay data including the ^{10}C half-life measurements reported here yields b_{F}=-0.0018±0.0021 (68% C.L.) for the Fierz interference term and C_{S}/C_{V}=+0.0009±0.0011 for the ratio of the weak scalar to vector couplings assuming left-handed neutrinos.
ABSTRACT
In an on-farm study, 40 weaned piglets aged 3 weeks were vaccinated with Lawsonia intracellularis vaccine orally, IM or IP while a fourth group remained unvaccinated. All vaccinated animals showed increased serum levels of L. intracellularis-specific IgG antibodies, but significantly elevated concentrations of specific IgG, IgA and cytokines were generated in ileal mucosal secretions from the orally and IP vaccinated pigs when examined at 17 days after vaccination.
Subject(s)
Bacterial Vaccines/therapeutic use , Desulfovibrionaceae Infections/veterinary , Lawsonia Bacteria/immunology , Mouth Mucosa/metabolism , Swine Diseases/prevention & control , Animals , Antibodies, Bacterial/immunology , Bacterial Vaccines/immunology , Desulfovibrionaceae Infections/immunology , Desulfovibrionaceae Infections/prevention & control , Immunoglobulin A/immunology , Immunoglobulin G/immunology , Interferon-gamma/metabolism , Interleukin-10/metabolism , Interleukin-6/metabolism , Mouth Mucosa/immunology , Swine , Swine Diseases/immunology , Swine Diseases/microbiology , Transforming Growth Factor beta1/metabolism , Tumor Necrosis Factor-alpha/metabolismABSTRACT
We present the case of a previously well patient who presented to the Emergency Department of a Dublin hospital with a tuberculous infection of his dominant index finger and a very low serum vitamin D level--this has been implicated in both primary and reactivation infections with Mycobacterium Tuberculosis. This case highlights and reviews both the importance of considering non-endemic pathologies in the setting of a patient base of diverse ethnicity, and the emerging importance of vitamin D in the immune response to M. tuberculosis infection. We discuss the relevant literature to highlight the background of this disease process, and the importance of a multidisciplinary approach to these patients.
Subject(s)
Osteomyelitis/microbiology , Tuberculosis, Osteoarticular/blood , Vitamin D/blood , Adult , Humans , Male , Osteomyelitis/drug therapy , Radiography , Tuberculosis, Osteoarticular/diagnostic imaging , Tuberculosis, Osteoarticular/immunology , Vitamin D/immunology , Vitamin D Deficiency/immunologyABSTRACT
While cases of severe kava hepatotoxicity have been reported, studies examining the toxicity of individual kavalactones are limited. The present study examined the in vitro hepatotoxicity of kavain, methysticin and yangonin on human hepatocytes (HepG2) and the possible mechanism(s) involved. Cytotoxicity was assessed using lactate dehydrogenase (LDH) and ethidium bromide (EB) assays. The mode of cell death was analysed with acridine orange/ethidium bromide dual staining with fluorescence microscopy. Glutathione oxidation was measured using the ortho-phthalaldehyde (OPT) fluorescence assay. Kavain had minimal cytotoxicity, methysticin showed moderate concentration-dependent toxicity and yangonin displayed marked toxicity with ~ 40% reduction in viability in the EB assay. Acridine orange/ethidium bromide staining showed the predominant mode of cell death was apoptosis rather than necrosis. No significant changes were observed in glutathione levels, excluding this as the primary mechanism of cell death in this model. Further studies may elucidate the precise apoptotic pathways responsible and whether toxic kavalactone metabolites are involved.
Subject(s)
Apoptosis/drug effects , Lactones/pharmacology , Pyrans/pharmacology , Pyrones/pharmacology , Cell Survival , Glutathione/analysis , Hep G2 Cells , Hepatocytes/drug effects , Humans , L-Lactate Dehydrogenase/analysisABSTRACT
This paper presents an overview of computerised decision support for clinical practice. The concept of computer-interpretable guidelines is introduced in the context of the @neurIST project, which aims at supporting the research and treatment of asymptomatic unruptured cerebral aneurysms by bringing together heterogeneous data, computing and complex processing services. The architecture is generic enough to adapt it to the treatment of other diseases beyond cerebral aneurysms. The paper reviews the generic requirements of the @neurIST system and presents the innovative work in distributing executable clinical guidelines.
Subject(s)
Computer Communication Networks/organization & administration , Computer Systems , Disease Management , Medical Informatics Computing , Chronic Disease , Decision Support Systems, Clinical , Europe , Humans , Practice Guidelines as TopicABSTRACT
BACKGROUND: Sickle cell disease is an inherited genetic disorder characterized by an abnormality of haemoglobin that predisposes to polymerization and consequent deformation ("sickling"). Sickle cell disease can cause episodes of acute severe pain. Chronic pain may also occur. Currently, pain is inadequately managed. OBJECTIVES: The primary aim of the review was to assess the effectiveness of pharmacological analgesic interventions for pain management in sickle cell disease, including the treatment of acute and chronic pain in children and adults. SEARCH STRATEGY: A pre-defined search strategy was used to electronically search the MEDLINE and EMBASE databases. Searches were also conducted on the Cochrane Controlled Trial Register (CCTR) and the Oxford pain randomised controlled trials citation database. The search period covered from January 1965 through to June 2002. Bibliographies of retrieved studies were searched for additional references. No language restriction was used. SELECTION CRITERIA: All randomised controlled trials involving pharmacological treatment of acute or chronic pain in children or adults with sickle cell disease were selected. Patients with haemoglobin SS, haemoglobin S ss thalassaemia and the haemoglobin SC group were included. DATA COLLECTION AND ANALYSIS: Trials were quality rated using the Oxford quality scale. Continuous measures of outcome were combined using weighted mean differences. Overall effect size was calculated with 95% confidence intervals. MAIN RESULTS: Nine randomised controlled trials were identified. All studies involved small numbers of patients with acute sickle cell pain only. Interventions included NSAIDs (versus placebo in four studies; versus strong opioids in one study), strong opioids (oral versus parenteral in one study; morphine versus alternate in one study) and corticosteroids (versus placebo in two studies). Lack of data, small patient numbers, variations in study design and outcome measures limited the review. Due to heterogeneity of methodologies and reporting, it was not possible to perform meaningful meta-analyses. AUTHORS' CONCLUSIONS: There were no studies addressing chronic pain in sickle cell disease. There is limited evidence for analgesic interventions in acute pain crises. Studies have been under-powered. There is not enough data for inter-trial comparisons. In one trial, there was no difference in the efficacy of sustained-release oral versus parenteral morphine, which suggests that oral morphine should be considered for acute pain. Parenteral corticosteroids appear to shorten the period over which analgesics are required and hospital length-of-stay, without producing short-term major adverse effects. More research is needed to improve pain management in sickle cell disease.
Subject(s)
Anemia, Sickle Cell/complications , Pain/drug therapy , Acute Disease , Adrenal Cortex Hormones/therapeutic use , Analgesics, Opioid/therapeutic use , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Chronic Disease , Humans , Pain/etiology , Randomized Controlled Trials as TopicABSTRACT
BACKGROUND: Avascular necrosis of bone is a frequent and severe complication of sickle cell disease and its treatment is not standardised. It is therefore important to gather evidence about the safety and effectiveness of different interventions. OBJECTIVES: To determine the impact of surgery compared to non-surgical management on both the short- and the long-term outcomes (efficacy, safety, and adverse events) for people with sickle cell disease-related avascular necrosis. SEARCH STRATEGY: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group trials register, which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. Additional randomized controlled trials were sought from the reference lists of the trials found and reviews identified by the search strategy. Date of the most recent search: April 2004. SELECTION CRITERIA: All randomized or quasi-randomized controlled trials (published or unpublished). DATA COLLECTION AND ANALYSIS: One ongoing clinical trial has been identified but no data are available for inclusion in the review. MAIN RESULTS: Five trials were identified by the searches. Four trials were not eligible for inclusion and one is an ongoing clinical trial. REVIEWERS' CONCLUSIONS: We were unable to find any evidence from completed randomized controlled trials assessing treatments for avascular necrosis in people with sickle cell disease. We await the results of an ongoing clinical trial to assess the benefits and risks of a surgical approach compared to a non-surgical approach as a means of improving survival and quality of life for people with sickle cell disease-related avascular necrosis of bone.
Subject(s)
Anemia, Sickle Cell/complications , Osteonecrosis/therapy , HumansABSTRACT
INTRODUCTION: The purpose of this study was to identify radiological predictors of early and late instability following conservative treatment of extra-articular distal radius fractures. MATERIALS AND METHODS: An observational study design was employed using patient records and standardized radiological follow-up examinations as data sources. The database at a single institution was used to identify all patients with extra-articular distal radius fractures over the course of 1 year. A total of 71 patients with extra-articular distal radius fractures (50 dorsally displaced, 21 undisplaced) fulfilled the inclusion criteria. Patients were predominantly female (87%) with a pooled mean age of 64.9 years. All patients with displaced extra-articular distal radius fractures underwent closed reduction with subsequent cast immobilization. Undisplaced fractures were simply treated with cast immobilization. The primary outcomes were early (1 week) and late (6 weeks) instability of the fracture. Instability was defined as: (1) dorsal tilt >15 degrees, (2) volar tilt >20 degrees, (3) ulnar variance >4 mm, (4) radial inclination <10 degrees. RESULTS: Degree of radial shortening and volar tilt were predictive of early instability ( p<0.05), with dorsal comminution also approaching statistical significance ( p=0.06). Radial inclination, age, radial shortening, and volar tilt were predictive of late failure ( p<0.05). An unexpected result showed that one-third of undisplaced fractures went on to fail, most of which occurred in those patients over the age of 65 years. CONCLUSION: An awareness of independent predictors of instability in extra-articular distal radius fractures is helpful in anticipating the final alignment outcome.
Subject(s)
Casts, Surgical , Joint Dislocations/epidemiology , Joint Instability/epidemiology , Radius Fractures/therapy , Age Distribution , Aged , Aged, 80 and over , Cohort Studies , Female , Fracture Healing/physiology , Humans , Incidence , Injury Severity Score , Joint Dislocations/diagnostic imaging , Joint Instability/diagnostic imaging , Logistic Models , Male , Middle Aged , Predictive Value of Tests , Probability , Prognosis , Radiography , Radius Fractures/diagnostic imaging , Radius Fractures/physiopathology , Retrospective Studies , Risk Assessment , Sex Distribution , Time Factors , Wrist Injuries/physiopathologyABSTRACT
To assess the utility of humeral shaft fractures as predictors of organ injuries and skeletal injuries in multiply injured patients involved in motor vehicle collisions (MVCs). A prospectively collected database of multiply injured motor vehicle occupants with an Injury Severity Score (ISS) greater than 12 admitted to a level I regional trauma centre during a 102-month period (January 1992 to June 2000) was reviewed to assess skeletal and organ injuries associated with a humeral shaft fracture. The effect of occupant location within the vehicle, the point of collision, and the use of a seat belt restraint was also examined to identify trends in injury patterns. Data from 1070 motor vehicle occupants - 65 with concomitant humeral shaft fractures and 1005 without humeral shaft fractures - revealed that 63% of motor vehicle occupants who sustained humeral fractures were drivers, compared with 77% in the non-humeral fracture group. Those patients who sustained a humeral shaft fracture had a significantly greater number of liver injuries (p = 0.022), forearm/hand fractures (p < 0.001), tibial fractures (p < 0.01) and femoral fractures (p < 0.01) compared with controls. A lateral collision impact showed a trend towards increased splenic and hepatic injuries within the humeral shaft fracture group. The presence of a humeral shaft fracture in a multiply injured patient involved in a MVC is significantly associated with an increased incidence of both upper and lower extremity fractures and liver injury. Moreover, humeral shaft fractures may serve as a predictor of potential intra-abdominal pathology in multiply injured trauma patients involved in MVCs.