MRI is the most effective initial diagnostic study for osteomyelitis of the foot in diabetic patients

What is the best initial diagnostic study that should be used for a suspected osteomyelitis diagnosis? A critical review and clinical application of: Kapoor A, Page S, LaValley M, Gale DR, Felson DT. Magnetic resonance imaging for diagnosing foot osteomyelitis: a meta-analysis. Arch Intern Med. 2007;167(2):125-132. doi:10.1001/archinte.167.2.125

From the editors

Welcome to the inaugural issue of Clinical Research in Practice: The Journal of Team Hippocrates

A study on the bacteria of dog bite wounds in dogs and their susceptibility to antimicrobials

To investigate the bacterial composition of infected and non-infected dog bite wounds (DBW), a prospective study was performed on dogs with various grades of bite wounds presenting at the Onderstepoort Veterinary Academic Hospital, University of Pretoria, and a nearby animal shelter. Fifty dogs with bite wounds inflicted within the previous 72 hours were selected. This represented 104 wounds. Wounds were clinically graded according to severity. Swabs were collected from all wounds for bacterial culture and cytology. Infection was diagnosed if 2 of the following 3 criteria were met: macroscopic purulence, microscopic presence of phagocytosed bacteria, or pyrexia. Non-infected wounds were either classed as sterile (established by culture) or contaminated (culture positive but bacteria not phagocytosed on cytology). To determine the origin of the bacteria, swabs were collected from the skin near the wounds and gingiva of 15 bite victims. All swabs were cultured aerobically and anaerobically and all aerobic cultures were evaluated for antimicrobial susceptibility using the Kirby Bauer disk diffusion test. The victims were predominately male, uncastrated, small-breed dogs. Of the 104 wounds studied, 21 were judged to be infected and 83 non-infected. Infected wounds were significantly more likely to culture positive (Fisher's exact test: p = 0.02). Sixteen per cent of wounds did not culture bacteria, 67% grew aerobes only, 1% anaerobes only and 67% a mixture of aerobes and anaerobes. A total of 213 isolates were cultured representing a mean of 2 isolates per wound. Of the aerobe species cultured, 22%, 19% and 17% belonged to the genera of Pasteurella, Streptococcus and Staphylococcus respectively. The species of Pasteurella multocida (66%) and Staphylococcus intermedius (70%) were predominant. Pasteurella canis and pyogenic streptococci were common in infected wounds, whereas Bacillus spp., Actinomyces spp. and oral streptococci were usually found in contaminated wounds. Three anaerobic genera were cultured, namely, Prevotella, Clostridium and Peptostreptococcus, and were usually associated with wounds with dead space. This study also describes the first documented case of Capnocytophaga canimorsus in an infected dog bite wound. Notably clinical and cytological assessment was capable of establishing whether antimicrobials were required or not. Although no single antimicrobials was considered to be effective against all the bacteria, amoxycillin plus clavulanic acid, 1st and 3rd generation cephalosporins, ampicillin or amoxycillin and potentiated sulphonamides gave the best in vitro sensitivity results.Dissertation (MMedVet(Surgery) Small Animal Surgery)--University of Pretoria, 2007.Companion Animal Clinical Studiesunrestricte

Identification and Antibiotic Susceptibility Pattern of Enterobacteriaceae Isolated from Gecko (Hemidactylus frenatus)

Diseases and infections which are naturally transmitted between animals and humans are of major concern worldwide. Geckos (Hemidactylus frenatus) are known to be potential reservoirs of many zoonotic enteropathogens. This study was designed to isolate, identify, and evaluate the antibiotic susceptibility pattern of Enterobacteriaceae from Geckos. Using standard microbiological procedures, bacteria were isolated from 138 intestinal samples of Hemidactylus frenatus collected from different sampling sites. A total of 20 bacterial species of 9 different genera were identified using automated Colorimetry VITEK 2 system. The percentage occurrences were Enterobacter aerogenes (35%), Proteus mirabilis (15%), Salmonella ser paratyphi B (10%), Serratia fonticola (10%), Enterobacter kobei (10%), Raoultella ornithinolytica (5%), Sphingomonas paucimobilis (5%), Acinetobacter baumannii, (5%) and Burkholderia cepacia (5%). Results obtained from the antibiotic susceptibility pattern according to CLSI guidelines revealed that all the 20 bacterial species have varying rate of resistance with 20 (100%) showing resistance to Ciprofloxacin (CPX), 20 (100%) Pefloxacin (PEF), 19 (95%), Augmentin (AU), 11 (55%) Cotrimoxazole (CXT), 10 (50%) Streptomycin (S), 9 (45%) Chloramphenicol (CH), 6 (30%) Gentamycin (CN), 3 (15%) Ofloxacin (OFX). This study revealed that Enterobacteriaceae in the intestine of Geckos are multidrug resistant and are potentially harmful when in contact directly or indirectly with humans. It becomes important to educate people on the importance of personal hygiene in order to eradicate Geckos from our environment

Mixing along the Red Giant Branch in Metal-poor Field Stars

We have determined Li, C, N, O, Na, and Fe abundances, and 12C/13C isotopic ratios for a sample of 62 field metal-poor stars (plus 43 taken from the literature). This large sample was used to show that small mass lower-RGB stars (i.e., fainter than the RGB bump) have abundances of light elements in agreement with theoretical predictions from classical evolutionary models. A second, distinct mixing episode occurs just after the RGB bump, reaching regions of incomplete CNO burning. No O-Na anticorrelation, as observed in globular cluster stars, is found in field stars. This means that the mixing episode is not deep enough to reach regions where ON-burning occurs.Comment: 6 pages, 3 encapsulated figures, LateX, uses crckapb.sty; invited talk, in "The Chemical Evolution of the Milky Way: Stars vs Clusters, Vulcano (Italy), 20-24 September 1999, F. Matteucci and F. Giovannelli eds, Kluwer, in pres

Precision Measurement of the Proton and Deuteron Spin Structure Functions g2 and Asymmetries A2

We have measured the spin structure functions g2p and g2d and the virtual photon asymmetries A2p and A2d over the kinematic range 0.02 < x < 0.8 and 0.7 < Q^2 < 20 GeV^2 by scattering 29.1 and 32.3 GeV longitudinally polarized electrons from transversely polarized NH3 and 6LiD targets. Our measured g2 approximately follows the twist-2 Wandzura-Wilczek calculation. The twist-3 reduced matrix elements d2p and d2n are less than two standard deviations from zero. The data are inconsistent with the Burkhardt-Cottingham sum rule if there is no pathological behavior as x->0. The Efremov-Leader-Teryaev integral is consistent with zero within our measured kinematic range. The absolute value of A2 is significantly smaller than the sqrt[R(1+A1)/2] limit.Comment: 12 pages, 4 figures, 2 table

A real quaternion spherical ensemble of random matrices

One can identify a tripartite classification of random matrix ensembles into geometrical universality classes corresponding to the plane, the sphere and the anti-sphere. The plane is identified with Ginibre-type (iid) matrices and the anti-sphere with truncations of unitary matrices. This paper focusses on an ensemble corresponding to the sphere: matrices of the form \bY= \bA^{-1} \bB, where \bA and \bB are independent $N\times N$ matrices with iid standard Gaussian real quaternion entries. By applying techniques similar to those used for the analogous complex and real spherical ensembles, the eigenvalue jpdf and correlation functions are calculated. This completes the exploration of spherical matrices using the traditional Dyson indices $\beta=1,2,4$. We find that the eigenvalue density (after stereographic projection onto the sphere) has a depletion of eigenvalues along a ring corresponding to the real axis, with reflective symmetry about this ring. However, in the limit of large matrix dimension, this eigenvalue density approaches that of the corresponding complex ensemble, a density which is uniform on the sphere. This result is in keeping with the spherical law (analogous to the circular law for iid matrices), which states that for matrices having the spherical structure \bY= \bA^{-1} \bB, where \bA and \bB are independent, iid matrices the (stereographically projected) eigenvalue density tends to uniformity on the sphere.Comment: 25 pages, 3 figures. Added another citation in version

Impacts of Climate Change on indirect human exposure to pathogens and chemicals from agriculture

Objective: Climate change is likely to affect the nature of pathogens and chemicals in the environment and their fate and transport. Future risks of pathogens and chemicals could therefore be very different from those of today. In this review, we assess the implications of climate change for changes in human exposures to pathogens and chemicals in agricultural systems in the United Kingdom and discuss the subsequent effects on health impacts. Data sources: In this review, we used expert input and considered literature on climate change ; health effects resulting from exposure to pathogens and chemicals arising from agriculture ; inputs of chemicals and pathogens to agricultural systems ; and human exposure pathways for pathogens and chemicals in agricultural systems. Data synthesis: We established the current evidence base for health effects of chemicals and pathogens in the agricultural environment ; determined the potential implications of climate change on chemical and pathogen inputs in agricultural systems ; and explored the effects of climate change on environmental transport and fate of different contaminant types. We combined these data to assess the implications of climate change in terms of indirect human exposure to pathogens and chemicals in agricultural systems. We then developed recommendations on future research and policy changes to manage any adverse increases in risks. Conclusions: Overall, climate change is likely to increase human exposures to agricultural contaminants. The magnitude of the increases will be highly dependent on the contaminant type. Risks from many pathogens and particulate and particle-associated contaminants could increase significantly. These increases in exposure can, however, be managed for the most part through targeted research and policy changes

Environment and Rural Affairs Monitoring & Modelling Programme – ERAMMP Report-26: ‘Quick Start’ Agricultural Small Sectors Modelling.

The potential impact of Brexit on the farming sector and wider environment is just one of the many challenges facing the Welsh Government. There are a range of decision and modelling tools which can be used to explore potential outcomes and the areas at risk where the environmental regulatory floor needs to be enhanced or social transition programmes put in place. To meet this challenge in Wales, a partnership between the Welsh Government, their stakeholders and a consortium of research organisations led by the UK Centre for Ecology and Hydrology (UKCEH) was formed. This partnership, called ERAMMP, (https://erammp.wales/en) combined expert knowledge and a range of decision and modelling tools to examine potential changes in agricultural land use that might result from Brexit, and to explore potential benefits of new land management options

Measurements of the Q2Q^2-Dependence of the Proton and Neutron Spin Structure Functions g1p and g1n

The structure functions g1p and g1n have been measured over the range 0.014 < x < 0.9 and 1 < Q2 < 40 GeV2 using deep-inelastic scattering of 48 GeV longitudinally polarized electrons from polarized protons and deuterons. We find that the Q2 dependence of g1p (g1n) at fixed x is very similar to that of the spin-averaged structure function F1p (F1n). From a NLO QCD fit to all available data we find $\Gamma_1^p - \Gamma_1^n =0.176 \pm 0.003 \pm 0.007$ at Q2=5 GeV2, in agreement with the Bjorken sum rule prediction of 0.182 \pm 0.005.Comment: 17 pages, 3 figures. Submitted to Physics Letters