Declining Visceral Leishmaniasis in Malta

Aims: To study visceral leishmaniasis (VL) trends in Malta. Methods: Analysis of epidemiological and clinical trends, a veterinary questionnaire and questioning a canine laboratory testing facility. Results: A decline in VL in the past 25 years (1980-2005) was noted for both paediatric (p<0.001) and adult (p=0.002) populations. No seasonal variation in infection rates was found. Serological testing was reliable and a useful adjunct to bone marrow diagnosis. Treatment with sodium stibogluconate was highly effective and there were no permanent sequelae associated with disease or treatment. Vets are encountering less canine VL with no differences in localities Discussion: The decline in VL was paralleled by a decline in the stray canine reservoir population and by better management of canine infection in both sanctuaries and in domestic settings.peer-reviewe

A resistant case of Kawasaki Disease

Kawasaki disease (KD) is an acute febrile illness of childhood of unknown origin which may cause coronary arteritis and death. The Maltese incidence has been calculated at 3.2/100,000 population 4 years of age, similar to that reported in European communities and far lower than that reported in Asian countries. The use of steroids in this condition remains contentious. We report a resistant case of KD who required two doses of pulsed steroids in addition to standard treatment with aspirin and immunoglobulin.peer-reviewe

Fiscal consolidation in a low inflation environment: pay cuts versus lost jobs

We construct a model of a monetary union to study fiscal consolidation in the Periphery of the euro area, through cuts in public sector wages or hiring when the nominal interest rate is constrained at its lower bound. Consolidation induces a positive wealth effect that increases demand, as well as a reallocation of workers towards the private sector, which together boost private activity. However, in a low inflation environment, demand is suppressed and the private sector is not able to absorb the additional workers. Comparing the two instruments, cuts in public hiring increase unemployment persistently in this environment, while wage cuts reduce it. Regions with higher mobility of labour between the two sectors are able to consolidate more effectively. Price flexibility is also key at the zero lower bound: for a higher degree of price rigidity in the Periphery, consolidation becomes harder to achieve. Consolidations can be self-defeating when the public good is productive, or a complement to private consumption

The waterlogging of floating objects.

We consider the dynamical processes by which a dense, porous object floating in a\ud body of liquid becomes waterlogged and sinks. We first generalize the classic model\ud of capillary rise in a porous medium to present an analytically tractable model of the\ud process, which is valid for objects that are very shallow compared to their horizontal\ud extent. We find an analytical expression for the time taken for the object to sink under\ud this approximation. We use a series of boundary integral simulations to show that\ud decreasing the horizontal extent of the object decreases the time taken to sink. We\ud find that the results of these numerical simulations are in good quantitative agreement\ud with a series of laboratory experiments. Finally, we discuss the implications of our\ud work for pumice fragments, often found floating in open water after a volcanic\ud eruption, occasionally even supporting plant, animal and human remains

The relationship between infecting organisms and underlying structural anomalies in children with urinary tract infections

Introduction: Urinary tract infections (UTIs) are a common cause of morbidity in childhood with potential for renal scarring and reflux nephropathy which can lead to hypertension and end-stage renal failure. Aim: The aim of this study was to investigate the relationship between the infecting organism and any underlying anomalies of the urinary tract which may predispose to the development of infections and which may alter the management of children with UTIs. Methods and results: A total of 72 cases of UTI were recorded retrospectively (in- and outpatients), with ages ranging from 3 days to 48 months (mean 9.5, median 5 months). Fifty seven (79%) of patients had their first reported urinary tract infection under the age of 1 year.. Fifty eight (80.6%) were E. coli infections. These presented at an older age than non-E. coli infections. Investigations were abnormal in 31 (43%) cases. The mean age for first infection in patients with abnormal investigations was 7.7 months (median 2 months), younger than those with no renal tract abnormalities. Organisms other than E. coli were rarely found when no significant abnormalities were detected with investigation by US and MCUG and this was a statistically significant difference (p<0.001). Renal scarring was identified in 10 (13.9%) patients. Discussion: This study confirms that non-E. coli UTI is associated with underlying renal pathology and that early infections with any organism are more likely to be associated with underlying abnormalities. We also outline an algorithm based on the recent NICE 2007 guidelines which will be adopted by the Paediatric Department, Mater Dei Hospital for the investigation of UTI.peer-reviewe

Is the Donnan effect sufficient to explain swelling in brain tissue slices?

Brain tissue swelling is a dangerous consequence of traumatic injury and is associated with raised intracranial pressure and restricted blood flow. We consider the mechanical effects that drive swelling of brain tissue slices in an ionic solution bath, motivated by recent experimental results that showed that the volume change of tissue slices depends on the ionic concentration of the bathing solution. This result was attributed to the presence of large charged molecules that induce ion concentration gradients to ensure electroneutrality (the Donnan effect), leading to osmotic pressures and water accumulation. We use a mathematical triphasic model for soft tissue to characterize the underlying processes that could lead to the volume changes observed experimentally. We suggest that swelling is caused by an osmotic pressure increase driven by both non-permeating solutes released by necrotic cells, in addition to the Donnan effect. Both effects are necessary to explain the dependence of the tissue slice volume on the ionic bath concentration that was observed experimentally

Elastometry of deflated capsules elastic moduli from shape and wrinkle analysis

Elastic capsules, prepared from droplets or bubbles attached to a capillary (as in a pendant drop tensiometer), can be deflated by suction through the capillary. We study this deflation and show that a combined analysis of the shape and wrinkling characteristics enables us to determine the elastic properties in situ. Shape contours are analyzed and fitted using shape equations derived from nonlinear membrane-shell theory to give the elastic modulus, Poisson ratio and stress distribution of the membrane. We include wrinkles, which generically form upon deflation, within the shape analysis. Measuring the wavelength of wrinkles and using the calculated stress distribution gives the bending stiffness of the membrane. We illustrate this method on two very different capsule materials: polymerized octadecyltrichlorosilane (OTS) capsules and hydrophobin (HFBII) coated bubbles. Our results are in agreement with the available rheological data. For hydrophobin coated bubbles the method reveals an interesting nonlinear behavior consistent with the hydrophobin molecules having\ud a rigid core surrounded by a softer shell