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Anthropogenic habitat modification can lead to chronic stress in wildlife. This can result in immunosuppression and higher disease prevalence. Chronically stressed individuals typically have elevated baseline GCs and decreased body condition. GCs are called FGMs when excreted in feces and can be used to noninvasively evaluate stress in free-ranging wildlife. In the deer mouse (Peromyscus maniculatus)–SNV system, SNV prevalence is higher in deer mice at peridomestic settings, which are human-modified habitats. This is problematic because SNV causes a fatal disease in humans, and thus the higher SNV prevalence may lead to higher risk of infection for humans. In our study, we hypothesized that SNV prevalence would be higher in deer mice at human-modified habitats due to chronic stress. To test our hypothesis, we compared two stress measures (i.e., baseline FGMs and body condition scores) in deer mice from one peridomestic and one sylvan grid over 2 months. Captured deer mice were tagged, weighed, sexed and sampled for feces and blood and were evaluated for reproductive status and body condition before release. Blood samples were analysed for SNV antibodies, and fecal samples were evaluated for FGMs. We found higher deer mouse numbers at the sylvan grid. There were no differences in baseline FGM levels between peridomestic and sylvan populations. However, peridomestic deer mice had overall lower body condition. Given the low SNV prevalence across both grids, we were unable to examine potential correlations between SNV prevalence and chronic stress. Regardless, we conclude that deer mice at human-modified habitats may not be chronically stressed, which may suggest that higher SNV prevalence at peridomestic settings may not be the result of chronic stress. Although we did find that peridomestic deer mice had lower body condition, this may not have been related to chronic stress because there were no differences in baseline FGMs. Longer studies with more site replication are needed to validate and expand on our findings. Our preliminary study adds to the existing body of knowledge that examines relationships between stress physiology and disease prevalence in human-modified environments.

OBJECTIVE To estimate the prevalence of Anaplasma marginale, the causative agent of bovine anaplasmosis, in beef herds from Ohio; evaluate farm identity and animal age as risk factors; and examine serologic cross-reactivity with Anaplasma phagocytophilum, an emerging disease agent. ANIMALS 4 beef cattle herds (n = 327) sampled between December 2020 and December 2021. PROCEDURES To address the broader investigation of characterizing Anaplasma spp and genotypes in Ohio, herds with a history of clinical anaplasmosis were targeted. Blood was screened for antibodies to Anaplasma spp using a competitive enzyme-linked immunosorbent assay with seropositive samples tested for A marginale using real-time PCR. If negative, samples were also tested for A phagocytophilum. RESULTS We estimated a statewide molecular prevalence of 38.53% (95% CI, 33.26% to 43.81%), with some farms exhibiting higher prevalence than others (19.40% to 56.86%). Accounting for farm identity, the odds of an animal becoming infected increased by 1.41 (95% CI, 1.28 to 1.58) for every year in age. Forty-four animals tested seropositive but PCR negative for A marginale. Out of these, 2 tested positive for A phagocytophilum. CLINICAL RELEVANCE Our study was the first to report prevalence estimates for bovine anaplasmosis in Ohio. Although prevalence was higher than other states, this is most likely due to our sampling approach. Our results suggested that older animals are more likely to be infected with A marginale, and when animals are instead infected with A phagocytophilum, serology alone can be misleading wherever the 2 species co-occur. Our study can guide wider epidemiological studies for informing management in Ohio.

Introduction: High-quality evidence regarding the use of endovascular treatment (EVT) in patients with acute basilar artery occlusion (BAO) has been provided by recently completed randomized controlled clinical trials (RCTs). Methods: We conducted a systematic review and meta-analysis including all available RCTs that investigated efficacy and safety of EVT in addition to best medical treatment (BMT) versus BMT alone for BAO. The random-effects model was used, while the fragility index (FI) was calculated for dichotomous outcomes of interest. Results: Four RCTs were included comprising a total of 988 patients with acute BAO (mean age: 65.6 years, 70% men, median NIHSS: 24, 39% pretreatment with intravenous thrombolysis). EVT was related to higher likelihood of good functional outcome (RR: 1.54; 95% CI: 1.16–2.05; I2 = 60%), functional independence (RR: 1.83; 95% CI: 1.08–3.08; I2 = 79%) and reduced disability at 3 months (adjusted common OR: 1.96; 95% CI: 1.26–3.05; I2 = 59%) compared to BMT alone. Despite that EVT was associated with a higher risk for symptomatic intracranial hemorrhage (RR: 7.78; 95% CI: 2.36–25.61; I2 = 0%) and any intracranial hemorrhage (RR: 2.85; 95% CI: 1.50–5.44; I2 = 16%), mortality at 3 months was lower among patients that received EVT plus BMT versus BMT alone (RR: 0.76; 95% CI: 0.65–0.89; I2 = 0%). However, sufficient robustness was not evident in any of the reported associations (FI < 10) including the overall effect regarding the primary outcome. The former associations were predominantly driven by RCTs with recruitment limited in China. Conclusions: EVT combined with BMT is associated with a higher likelihood of achieving good functional outcomes and a lower risk of death at 3 months compared to BMT alone, despite the higher risk of sICH. An individual-patient data meta-analysis is warranted to uncover and adjust for potential sources of heterogeneity and to provide further insight.

Objective: We report that lumbar puncture (LP) with removal of cerebrospinal fluid (CSF) induced rebound intracranial hypertension with increased papilledema as monitored by optical coherence tomography (OCT). Background: Severe papilledema causes visual field loss and central vision damage if untreated. Fundoscopy is a key to diagnose papilledema, but is not sensitive enough to monitor therapeutic effects. Methods: OCT was applied to follow a 24-year-old woman with headache, visual dysfunction, severe bilateral papilledema, and elevated CSF opening pressure. She was first treated with serial LP, which led to symptom deterioration, increased CSF pressure, and increased the retinal nerve fiber layer (RNFL) thickness. She was then successfully treated with acetazolamide and furosemide. Results: OCT showed reduction of RNFL thickness directly after LP with CSF removal, accompanied with reduced CSF pressure. Increased RNFL thickness accompanied with worsened headache, visual dysfunction, and increased CSF pressure was observed on the next day after LP. Less than 24 h after start of medication, the symptoms had reversed and RNFL thickness was reduced. The patient was symptom-free 2 weeks after starting on medical treatment. Papilledema had vanished on fundoscopy 6 weeks after the therapy, and RNFL thickness was normalized at 3 months of follow-up. Conclusion: This case provides evidence that OCT is an objective and sensitive tool to monitor papilledema and its response to therapy, and thereby important to help in correct clinical decision-making.

Ecological and environmental factors can influence the transmission of infectious diseases. They can accomplish this via effects on host susceptibility and exposure to infection, which are governed by host physiology and behavior, respectively. To better inform disease control, more information is needed about how extrinsic factors affect physiological and behavioral processes that determine transmission. We investigated how heterospecific competitors and seasonality may influence host susceptibility and intraspecific contact rates using a directly transmitted disease system, the North American deer mouse (Peromyscus maniculatus)—Sin Nombre hantavirus (SNV) system. In grasslands of western Montana, USA, deer mice compete with dominant voles (Microtus spp.) and shrews (Sorex spp.) and experience a seasonal temperate climate. Higher SNV transmission occurs primarily during spring/summer, when changes in physiology and behavior may serve as influential contributors. We hypothesized that (1) voles, and to a lesser extent shrews, will induce chronic stress, suppress immunity, and may change contact rates of deer mice; and (2) during spring/summer, deer mice may experience chronic stress, suppressed immunity, and higher contact rates, which may help explain the reported seasonality in SNV transmission. Over two years, we trapped small mammals at four grids in western Montana. Deer mice were sampled for feces and blood and evaluated for scar numbers, demography, and body condition scores (BCSs). We evaluated stress physiology with fecal corticosterone metabolites (FCMs), neutrophil/lymphocyte (N/L) ratios and BCSs, immunity with white blood cell (WBC) counts, and contact rates with scar numbers. We found that shrew density was negatively associated with stress response FCMs, suggestive of chronic stress. Additionally, although complex interactions existed, shrew and vole densities were negatively associated with BCSs, but differentially with scar numbers. N/L ratios were higher in spring/summer, whereas WBC counts were lower in summer, suggestive of chronic stress and suppressed immunity, respectively. Our results suggest that (1) heterospecific competitors may differentially influence disease transmission via stress physiology and contact rates, and that (2) chronic stress, suppressed immunity, and higher contact rates may help explain why higher SNV transmission has been previously reported during spring/summer in Montana. Our findings may extend to other directly transmitted disease systems.

The "Cort-Fitness" hypothesis predicts a negative relationship between baseline glucocorticoids (GCs) and fitness, although evidence for this hypothesis remains mixed. Such ambiguity could partially exist because blood GCs, typically used in field studies, can fluctuate too rapidly to measure accurately, while the relationship between GCs and trappability is often neglected. Here, by addressing these factors, we examined relationships between GC measures and survival of North American deermice (Peromyscus maniculatus; hereafter deermice) as a model system. To do this, we used more stable GC measures, including the integrated measures of baseline and stress response fecal corticosterone metabolites (FCMs), and downstream measures of neutrophil/lymphocyte ratio (N/L ratio), and body condition score (BCS), to characterize their relationships with survival and trappability. Over two years, deermice were live-trapped monthly, evaluated for BCS, and sampled for feces and blood. Stress response FCMs were evaluated only at first capture. Mark-recapture models, with GC measures as predictors of either survival or trappability, were compared to identify top models. We found that stress response FCMs negatively predicted trappability, and weaker evidence that BCS positively predicted survival. Although the latter provides some support for the "Cort-Fitness" hypothesis, there was no support when using integrated measures. Instead, our findings suggest that deermice with a lower adrenocortical response (i.e. stress response FCMs) were more likely to be captured. Therefore, GC-trappability relationships must be investigated in field studies to avoid linking the wrong GC profile to fitness, and physiological measures other than blood GCs may be useful for detecting GC-fitness patterns.

Idiopathic normal pressure hydrocephalus (iNPH) is a gradually progressive disease affecting the elderly population. The diagnosis of probable iNPH is based on clinical history, physical findings, brain imaging. INPH involves non-obstructive enlargement of the cerebral ventricles combined with one or more symptoms of cognitive decline, impaired gait and balance, and urinary urgency. Our case describes an unusual coexistence of radiological and clinical iNPH symptoms with paroxysmal paraparesis.

Background The cerebrospinal fluid tap test (CSF TT) is used for selecting shunt surgery candidates in idiopathic normal pressure hydrocephalus (iNPH). Variations in performance, and different outcome measures and cut-off levels in previous research on the CSF TT make comparison of accuracy difficult between studies. We aimed to evaluate the CSF TT, by using the Hellström iNPH scale for shunted iNPH patients with a standardized method. Methods One hundred thirty-two shunt operated iNPH patients were retrospectively included in this study. The gait and balance domains in the iNPH scale were used as outcome measures for the CSF TT and the total iNPH scale score as postoperatively outcome. To identify responders a cut-off level ≥ 5 points was used. Differences between responders and non-responders to the CSF TT, as well as the sensitivity, specificity, positive and negative predictive values, accuracy and correlations between outcomes of the CSF TT and postoperatively were calculated. Results In the gait domain, there were 62.9% responders and correspondingly 42.7 % in the balance domain of the CSF TT. CSF TT responders had significantly better outcomes in both the gait and balance domains but not in the neuropsychology or continence domains postoperatively. The sensitivity and specificity of the CSF TT and the outcome of the total iNPH scale score postoperatively were 67.6% and 53.3% for gait and 47.5% and 73.3% for balance. For age ≥ 80 years, the sensitivity and specificity for gait were 52.2% and 60.0%, and for age ≤ 80 years 72.2% and 50.0%. Gait as an outcome measure for both the CSF TT and postoperatively had the highest sensitivity, (73.2%) and specificity (65.7%) for all ages. Conclusions The CSF TT, with Hellström´s iNPH scale as the outcome measure, has clear limitations in predicting postoperative results. The gait domain may be used to detect changes of outcomes in gait, but the balance domain is too insensitive to use as an assessment for the CSF TT. The value of the CFS TT for patients over 80 years of age appears to be even lower. Differential diagnostic considerations together with radiological assessments remain cornerstones in selecting eligible shunt responders.

Background Although there may theoretically be a disturbance in the eye or the visual pathways due to abnormal cerebrospinal fluid (CSF) dynamics in idiopathic normal pressure hydrocephalus (iNPH), it has not been studied systemically. Optical coherence tomography (OCT) is a noninvasive, reproducible procedure for quantitative and qualitative analysis of retinal morphology. Methods OCT was used to study the eye fundus before and after a CSF tap test in patients with iNPH compared with healthy individuals (HIs). Twelve patients with iNPH (6 females and 6 males) with a median age of 76 years (64–84 years) and 21 HIs (11 females and 10 males) with a median age of 73 years (64–79 years) were included. The patients underwent neurological, cognitive, and physiotherapeutic evaluation. Brain magnetic resonance imaging, CSF tap test via lumbar puncture, and subsequently CSF analysis were performed. OCT was performed before and after CSF removal. HIs underwent OCT once. Results The patients had significantly reduced retinal ganglion cell layer thickness 71 μm (56–81 μm) compared with the HIs, 79.5 μm (72–90 μm) (P = 0.001), but no significant changes were observed before or after the CSF tap test. All patients improved in motor function in a 10-m walk test after the CSF tap test. The median CSF pressure was 15 and 1 cm H2O, respectively, before and after lumbar puncture with removal of median 43.5 mL CSF. Conclusions This pilot study shows OCT findings that differ from HIs and implies a rational for becoming a valuable tool in the diagnosis of iNPH. Further studies are warranted to elucidate the pathology of the retina in iNPH.

Stress physiology is commonly employed in studies of wildlife ecology and conservation. Accordingly, we need robust and suitable methods to measure stress physiology in the field. Fecal cortisol/corticosterone metabolites (FCMs) are now increasingly being used to non-invasively evaluate adrenocortical activity, a measure of stress physiology. However, immunoassays that measure FCMs must be appropriately validated prior to their use and factors that can influence FCMs, such as trap-induced stress, must be considered. Deermice (Peromyscus maniculatus) are widely used in scientific studies so that developing methods that appropriately measure their adrenocortical activity is critical. In the laboratory, we tested the suitability of two enzyme immunoassays (EIAs, a corticosterone EIA, and a group-specific 5&alpha, pregnane-3&beta, 11&beta, 21-triol-20-one EIA) in deermice by challenging individuals with dexamethasone and adrenocorticotropic hormone (ACTH). We found that dexamethasone suppressed FCM levels within ~10 h post injection whereas ACTH increased FCM levels within ~2&nbsp, h post injection. In the field, we found that FCM levels generally increased with more time in trap confinement when using both EIAs. Although we acknowledge low sample sizes (N = 4), our results validated the two EIAs for use with FCMs from deermice.

We generated reference ranges for seasonal leukocyte differential counts of the free-ranging deermouse (

Idiopathic normal pressure hydrocephalus (iNPH) is a disorder with unclear pathophysiology. The diagnosis of iNPH is challenging due to its radiological similarity with other neurodegenerative diseases and ischemic subcortical white matter changes. By using Diffusion Tensor Imaging (DTI) we explored differences in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) in iNPH patients (before and after a shunt surgery) and healthy individuals (HI) and we correlated the clinical results with DTI parameters. Thirteen consecutive iNPH-patients underwent a pre- and post-operative clinical work-up: 10 m walk time (w10mt) steps (w10ms), TUG-time (TUGt) and steps (TUGs); for cognitive function MMSE. Nine HI were included. DTI was performed before and 3 months after surgery, HI underwent DTI once. DTI differences analyzed by manually placing 12 regions-of-interest. In patients motor and balance function improved significantly after surgery (p = 0.01, p = 0.025). Higher nearly significant FA values found in the patients vs HI pre-operatively in the thalamus (p = 0.07) accompanied by an almost significant lower ADC (p = 0.08). Significantly FA and ADC-values were found between patients and HI in FWM (p = 0.02, p = 0.001) and almost significant (p = 0.057) pre- vs postoperatively. Postoperatively we found a trend towards the HIs FA values and a strong significant negative correlation between FA changes vs. gait results in the FWM (r = -0.7, p = 0.008). Our study gives a clear indication of an ongoing pathological process in the periventricular white matter, especially in the thalamus and in the frontal white matter supporting the hypothesis of a shunt reversible thalamo-cortical circuit dysfunction in iNPH.

Idiopathic normal pressure hydrocephalus (iNPH) is a disorder with unclear pathophysiology. The diagnosis of iNPH is challenging due to its radiological similarity with other neurodegenerative diseases and ischemic subcortical white matter changes. By using Diffusion Tensor Imaging (DTI) we explored differences in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) in iNPH patients (before and after a shunt surgery) and healthy individuals (HI) and we correlated the clinical results with DTI parameters. Thirteen consecutive iNPH-patients underwent a pre- and post-operative clinical work-up: 10 m walk time (w10mt) steps (w10ms), TUG-time (TUGt) and steps (TUGs); for cognitive function MMSE. Nine HI were included. DTI was performed before and 3 months after surgery, HI underwent DTI once. DTI differences analyzed by manually placing 12 regions-of-interest. In patients motor and balance function improved significantly after surgery (p = 0.01, p = 0.025). Higher nearly significant FA values found in the patients vs HI pre-operatively in the thalamus (p = 0.07) accompanied by an almost significant lower ADC (p = 0.08). Significantly FA and ADC-values were found between patients and HI in FWM (p = 0.02, p = 0.001) and almost significant (p = 0.057) pre- vs postoperatively. Postoperatively we found a trend towards the HIs FA values and a strong significant negative correlation between FA changes vs. gait results in the FWM (r = −0.7, p = 0.008). Our study gives a clear indication of an ongoing pathological process in the periventricular white matter, especially in the thalamus and in the frontal white matter supporting the hypothesis of a shunt reversible thalamo-cortical circuit dysfunction in iNPH.

Heavy metal contamination of the environment remains a critical issue. Lead and mercury exposure, particularly, can affect avian health. Bald eagles (Haliaeetus leucocephalus) ingest these metals through their diets. Lead and mercury prevalence were examined in bald eagles from three mid-Atlantic US states between 2004 and 2013. Blood samples were analyzed using atomic absorption spectrometry. Wilcoxon score tests were used to detect differences in lead and mercury over time. Counties of origin for birds with clinically significant metal levels were identified. There were no temporal trends found in lead and mercury prevalence. Eagles with clinically significant lead levels (>0.6 ppm) originated from near Chesapeake and Delaware bays, but most birds with clinically significant mercury levels (>1 ppm) originated from near Delaware and Barnegat bays. These findings indicate that lead and mercury contamination persists in this region and that routine sampling of bald eagles is a useful monitoring tool.

Article impact statement: Parasite-induced shifts in host microbiota that lead to parasite resistance or tolerance may have unintended consequences for host fitness.

Background and purpose We previously reported that certain optical coherence tomography (OCT) measures were sensitive and reliable in identifying idiopathic intracranial hypertension (IIH). This prospective study aimed to define OCT measures that allow differentiation of IIH with and without papilledema, thereby helping clinical decision-making. Methods Eight patients with IIH with papilledema, nine without papilledema and 19 with other neurological diseases were included. OCT measures were obtained before lumbar puncture and within 2 h, 1, 3 and 6 months after lumbar puncture with cerebrospinal fluid (CSF) removal. Results All patients with papilledema had increased retinal nerve fiber layer (RNFL) thickness and elevated CSF pressure. All patients without papilledema had normal RNFL but elevated CSF pressure. After CSF removal, reduced RNFL thickness was registered in all eight patients with IIH with papilledema. No significant change in RNFL thickness after CSF removal was observed in IIH without papilledema or in patients with other neurological diseases, although reduced CSF pressure was documented. RNFL thickness tended to be normal in patients with IIH with papilledema at 3-6 months after CSF removal. All patients with IIH showed increased rim area and rim thickness, but reduced optic cup volume regardless of RNFL thickness or papilledema. Conclusions Retinal nerve fiber layer thickness is sensitive for monitoring acute IIH and evaluating treatment effect. Increased rim area and rim thickness and decreased optic cup volume are reliable parameters that indicate persistently increased CSF pressure and risk of relapse. OCT measures are sensitive and reliable for diagnosing subtle IIH even in the absence of papilledema.

Tick-borne encephalitis, caused by the tick-borne virus (TBEV), is endemic in central, eastern, and northern Europe eastwards through Russian Siberia and China. For the year 2009, the highest incidence in Scandinavian countries was in Sweden. The clinical symptoms have a wide spectrum. We report a unique case of clinical symptoms and radiological findings compatible with a stroke-like inflammatory lesion in the thalamus, suggesting microangiopathy from TBEV. Our case shows that TBEV could be a possible cause of stroke-like lesions.

Background: The pathogenesis of iNPH is inadequately known. Small vessel disease seems to play an important role but the link to a disturbed CSF dynamic is not described. The familial presentation of idiopathic normal pressure hydrocephalus is extremely rare. Nonetheless, the last years the disclosure of familial occurrence seems to be of interest. The increasing reports on familial iNPH indicate a potential genetic component. Except from iNPH and secondary NPH a third form of NPH, familial NPH, is being widely recognized.

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The pathogenesis of idiopathic normal pressure hydrocephalus (iNPH) takes place in structures close to the cerebral ventricular system. Suprachiasmatic nucleus (SCN), situated close to the third ventricle, is involved in circadian rhythm. Diurnal disturbances are well-known in demented patients. The cognitive decline in iNPH is potentially reversible after a shunt operation. Diurnal rhythm has never been studied in iNPH. We hypothesize that there is a disturbance of circadian rhythm in iNPH-patients and the aim was to study any changes of the diurnal rhythm (mesor and circadian period) as well as any changes of the diurnal amplitude and acrophase of the activity in iNPH-patients before and after a shunt operation.Twenty consecutive iNPH-patients fulfilling the criteria of the American iNPH-guidelines, 9 males and 11 females, mean age 73 (49-81) years were included. The patients underwent a pre-operative clinical work-up including 10m walk time (w10mt) steps (w10ms), TUG-time (TUGt) and steps (TUGs) and for cognitive function an MMSE score was measured. In order to receive circadian rhythm data actigraphic recordings were performed using the SenseWear 2 (BodyMedia Inc Pittsburgh, PA, USA) actigraph. Cosinor analyses of accelerometry data were performed in "R" using non-linear regression with Levenburg- Marquardt estimation. Pre- and post-operative data regarding mesor, amplitude and circadian period were compared using Wilcoxon-Mann-Whitney test for paired data.Twenty patients were evaluated before and three month post-operatively. Motor function (w10mt, w10ms, TUGt, TUGs) was significantly improved while MMSE was not significantly changed. Actigraphic measurements (mesor, amplitude and circadian period) showed no significant changes after shunt operation.This is the first systematic study of circadian rhythm in iNPH-patients. We found no significant changes in circadian rhythm after shunt surgery. The conceptual idea of diurnal rhythm changes in hydrocephalus is still interesting from a theoretical standpoint and warrants further studies that could include a combination of better designed actigraphic studies in combination with neuroendocrine markers and imaging methods.

Carpal tunnel syndrome (CTS) is a clinical disorder resulting from the compression of the median nerve. The available evidence regarding the association between computer use and CTS is controversial. There is some evidence that computer mouse or keyboard work, or both are associated with the development of CTS. Despite the availability of pressure measurements in the carpal tunnel during computer work (exposure to keyboard or mouse) there are no available data to support a direct effect of the increased intracarpal canal pressure on the median nerve. This study presents an attempt to simulate the direct effects of computer work on the whole carpal area section using finite element analysis. A finite element mesh was produced from computerized tomography scans of the carpal area, involving all tissues present in the carpal tunnel. Two loading scenarios were applied on these models based on biomechanical data measured during computer work. It was found that mouse work can produce large deformation fields on the median nerve region. Also, the high stressing effect of the carpal ligament was verified. Keyboard work produced considerable and heterogeneous elongations along the longitudinal axis of the median nerve. Our study provides evidence that increased intracarpal canal pressures caused by awkward wrist postures imposed during computer work were associated directly with deformation of the median nerve. Despite the limitations of the present study the findings could be considered as a contribution to the understanding of the development of CTS due to exposure to computer work.

Wild birds commonly are presented with trauma at wildlife clinics and rehabilitation centers. Trauma can affect multiple body systems including the nervous system. Since specific diagnosis of nervous system injuries is more difficult compared to other body system injuries and may require advanced imaging, individuals often are treated symptomatically. This retrospective study focused on wild birds that presented with primary neurologic signs after a confirmed or presumed impact injury (vehicular trauma, window collision, or wire strike). The case outcomes, mean number of days in rehabilitation prior to release, and most commonly affected species were identified from data collected by Tri–State Bird Rescue and Research, Inc., (TSBRR) over 10 years. Further studies could be done to investigate the influence of species, type and severity of neurologic signs, and different treatment modalities on case outcomes and duration of treatment.

There is some evidence that municipal waste collectors are at risk of Hepatitis B virus infection (HBV). Published information on risk of Hepatitis C Virus (HCV) infection among waste collectors is scant. We aimed to investigate the prevalence and possible risk factors of HBV and HCV infections among waste collectors in a municipality of the broader region of Attica, Greece. A cross-sectional sero-prevalence study was conducted in a municipality of the broader region of Attica, Greece. Fifty waste collectors participated in the study (response rate: 95%). The group of municipal waste collectors was compared to a convenient sample of white collar employees not exposed to waste (No 83). Waste collectors recorded a significantly higher prevalence of hepatitis B virus infection (anti-HBc positivity) in comparison to the reference group (15% vs. 2.5%, respectively; p .001). Waste collectors who reported frequent exposure to needle-stick injuries had higher risk of HBV infection (RR 8.28; 95% CI 1.076-63.79; p 0.033). Only one municipal waste collector was anti-HCV positive. Our study corroborates previous results of an increased prevalence of Hepatitis B infection among municipal waste collectors. In addition we found that needle stick injuries were associated with the risk of HBV infection. By contrast, HCV infection does not seem to represent a significant occupational hazard among waste collectors. Vaccination against HBV among municipal solid waste collectors and promotion and use of safer methods for the collection of non-hospital medical waste could represent potential measures for the prevention of Hepatitis B Virus infection among municipal waste collectors.

Background Contradictory reports have been published regarding the association of Carpal Tunnel Syndrome (CTS) and the use of computer keyboard. Previous studies did not take into account the cumulative exposure to keyboard strokes among computer workers. The aim of the present study was to investigate the association between cumulative keyboard use (keyboard strokes) and CTS. Methods Employees (461) from a Governmental data entry & processing unit agreed to participate (response rate: 84.1 %) in a cross-sectional study. Α questionnaire was distributed to the participants to obtain information on socio-demographics and risk factors for CTS. The participants were examined for signs and symptoms related to CTS and were asked if they had previous history or surgery for CTS. The cumulative amount of the keyboard strokes per worker per year was calculated by the use of payroll’s registry. Two case definitions for CTS were used. The first included subjects with personal history/surgery for CTS while the second included subjects that belonged to the first case definition plus those participants were identified through clinical examination. Results Multivariate analysis used for both case definitions, indicated that those employees with high cumulative exposure to keyboard strokes were at increased risk of CTS (case definition A: OR = 2.23;95 % CI = 1.09-4.52 and case definition B: OR = 2.41; 95%CI = 1.36-4.25). A dose response pattern between cumulative exposure to keyboard strokes and CTS has been revealed (p Conclusions The present study indicated a possible association between cumulative exposure to keyboard strokes and development of CTS. Cumulative exposure to key-board strokes would be taken into account as an exposure indicator regarding exposure assessment of computer workers. Further research is needed in order to test the results of the current study and assess causality between cumulative keyboard strokes and development of CT.