James C. Carr, MD, FFR RCSI

• Associate Professor of Radiology and Medicine
• Northwestern University Feinberg School of Medicine
• Director of Cardiovascular Imaging
• Northwestern Memorial Hospital
• Chicago, Illinois

The properties of excitation and conduction largely result from the presence of membranespanning ion conducting pathways and channel gaits that regulate the selective and nonselective conductance of sodium medicine 0031 order 150 mg norpace, potassium 2 medications that help control bleeding discount 150 mg norpace visa, calcium treatment internal hemorrhoids buy norpace 100 mg without a prescription, and chloride across the sarcolemma medicine syringe discount norpace 150mg online. The end-plate potential generates a muscle action potential that spreads away from the neuromuscular junction in all directions over the surface of the myofiber and into its depths via the transverse (T) tubules medicine 853 cheap 100mg norpace with mastercard. The calcium release channels form small "feet" that extend from the terminal cisternae to the T tubules symptoms mercury poisoning order 150 mg norpace overnight delivery. The liberated calcium ions bind to the regulatory protein troponin and release the inhibitory action of the regulatory proteins on the contractile events that lead to sliding of the thin (actin) and thick (myosin) filaments. Voltage-gated channels contain additional voltage-sensing transmembrane domains and are essential for the generation and modification of action potentials. Ligand-gated ion channels are essential for setting myoplasmic calcium concentrations and establishing signal transduction pathways. Abnormal function of these ion channels produces muscle weakness or altered muscle contractions through altered excitability of the sarcolemma. The neuromuscular junction or motor end plate is the synaptic site for chemical transmission of excitation from the presynaptic axon terminal of a motor neuron to the postsynaptic skeletal myofiber (Fig. The position of the neuromuscular junction on a muscle fiber can vary among species, among muscles in a species, and among fibers in a given muscle. Arising from the primary cleft underlying the axon terminal are numerous smaller secondary clefts and complementary folds. The space within the primary and secondary clefts, located between the axon terminal and the postsynaptic sarcolemma, comprises the synaptic cleft. Specialization of the Sarcolemma and Sarcoplasm for Muscular Contraction 461 basal lamina also plays an important role in the development and regeneration of the neuromuscular junction. The arrival of a nerve action potential at the axon terminal results in activation of voltage-gated calcium ion channels in the presynaptic membrane. Voltage-gated potassium channels in the presynaptic membrane close the voltage-gated calcium channels and restore resting membrane potential in the axon. Somewhat deeper within the troughs of the secondary folds are voltage-gated sodium ion channels, which are also present within the sarcolemma throughout nonjunctional regions of the myofiber (Engel, 2004). The T tubules are invaginations of the sarcolemma that tranverse the long axis of the myofiber, and their lumina openly communicate with the extracellular fluid space (Engel, 2004). The sarcoplasmic reticulum functions in the uptake, storage, and release of calcium ions to regulate the concentration of calcium ions in the aqueous sarcoplasm bathing the myofilaments and other organelles. This elevation in calcium ion concentrations initiates contraction through its interaction with the calcium binding proteins such as troponin C and calmodulin, a component of the myosin light chain kinase system (Magleby, 2004). Further details concerning the structures and functions involved in neuromuscular transmission and coupling of excitation to contraction are available elsewhere (Engel, 2004; Magleby, 2004; Martonosi and Pikula, 2003; Numa et al. Muscular Contraction the ability of skeletal muscle to contract is conferred by the elementary contractile unit, the sarcomere (Fig. The sarcomere has three crucial properties: (1) the ability to shorten rapidly and efficiently, (2) the ability to switch on and off in milliseconds, and (3) precision self-assembly and structural regularity. Portions of the myosin molecules (cross-bridges) project from the thick myofilaments and make contact with the thin myofilaments (a). The force for sliding of the myofilaments results from a change in the angle of attachment. Myofilaments and Contractile Proteins Together, myosin, the principal contractile protein component of thick myofilaments, and actin, the principal component of thin myofilaments, account for more than 70% of myofibrillar protein. Lateral projections of the myosin thick myofilaments (myosin cross-bridges) form reactive sites with actin, which cyclically associate and disassociate during contraction and relaxation. The force-generating step for sliding of the filaments past each other results from changes in the angle of the cross-bridge attachments (Fig. Thick Myofilaments and Myosin To understand the physicochemical changes that occur at the cross-bridges, the composition and properties of myosin need to be considered. It is composed of two identical heavy chains (polypeptide chains with an approximate molecular mass of 200kDa) and two pairs of light chains (polypeptide chains with molecular masses ranging from 16 to 27kDa). The two myosin heavy chains are arranged in a double helix to form a long stable tail at one end, and at the other end each heavy chain is folded to form one globular pear-shaped head. The four myosin light chains are contained within the globular heads (two per head) near the junction of the head and neck domains. The composition of myosin heavy chains within sarcomeres varies among species, among individual muscles, and among individual muscle cells. The speed of contraction of these myosin heavy chain isoforms increases in the order listed here. Three additional sarcomeric myosin heavy chain genes (super fast, slow A, and slow B) exist, but their expression is unknown, with the exception of expression of superfast myosin in jaw muscles (Sweeney and Houdusse, 2004). A range of myosin light chain isoforms also exist in skeletal muscle that may affect their function. Skeletal muscle possesses both fast skeletal and slow skeletal muscle isoforms of essential light chains as well as regulatory light chains. Thin Myofilaments and Actin the thin filaments are composed of two F-actin strands arranged in a double helical configuration. The F-actin strands are polymers of the globular protein G-actin, and each G-actin monomer possesses a complementary binding site for the myosin globular head. Structural Proteins the organization of myofilaments within sarcomeres and the organization of myofibrils are supported by a complex cytoskeletal network of intermediate filaments (Wang and Ramirez-Mitchell, 1983). Intermediate filaments, and a number of accessory proteins that form fine filaments, (1) maintain the alignment of myofilaments and sarcomeres, (2) attach and maintain alignment of adjacent myofibrils, (3) attach the sarcomeres of peripheral myofibrils to the sarcolemma, and (4) connect terminal sarcomeres to the sarcolemma at myotendinous junctions. Collectively, the cytoskeletal filaments maintain the structural and functional relationships of the myofilaments and transfer the forces developed by the myofilaments to the sarcolemma. Alignment of Myofilaments, Sarcomeres, and Myofibrils Thick myofilaments are attached to Z lines by small filaments composed of the protein titin (Labeit et al. The titin filaments arise near the M line within the axes of the thick filaments and span the length of the thick filament as well as the I-band region to attach to the Z line. Within the I-band region, the titin filaments provide an elastic attachment to the Z line, which imparts a passive elasticity to sarcomeres. Myosin-binding proteins attach to the thick filaments and titin and appear to serve a structural role as well as a role in myofibrillogenesis. An additional protein, nebulin, forms small filaments that run the length of thin myofilaments and may regulate the length of thin myofilaments. The M line within the sarcomere stabilizes the thick filament lattice by linking neighboring filaments to each other and has an enzymatic role as well. It is composed of creatine kinase, myomesin, and M protein (Craig and Padron, 2004). At the periphery of myofibrils, adjacent Z lines within the same sarcomere are connected by intermediate filaments of desmin. Also, intermediate filaments of desmin encircle the circumference of Z lines and appear to form linkages with Z lines of adjacent myofibrils to aid in the alignment of sarcomeres in register with adjacent myofibrils. Attachment of Myofilaments to the Sarcolemma At the periphery of myofibrils adjacent to the sarcolemma there are riblike attachments (costomeres), which are present on either side of Z lines (Franzini-Armstrong and Horowitz, 2004; Maruyama, 1999). Desmin filaments appear to be anchored to the sarcolemma by a number of adhesion proteins such as vinculin. At myotendinous junctions, the thin myofilaments of the last sarcomere attach to the sarcolemma, which is thrown into numerous villous projections. The thin myofilaments are anchored by the proteins -actinin and vinculin, among others. Growth in the length of muscle fibers occurs at the myotendinous junctions by the addition of new sarcomeres (Griffin et al. Regulatory Proteins Two proteins (tropomyosin and troponin) work in concert with calcium to regulate muscle contraction. Tropomyosin, a fibrous protein, is arranged along the length of the thin filaments, within the grooves of the two F-actin strands. With low sarcoplasmic calcium concentrations (10 7M), tropomyosin molecules block the myosin-binding sites on actin, which prevents the interaction of actin and myosin. With the myosin-binding site on actin exposed, actin and myosin combine and initiate the cyclical changes associated with that interaction. Measurements indicate that each cycle (stroke) shortens a sarcomere by 12 nm (Barden and Mason, 1978). Rigor mortis, the rigid and stiff condition of skeletal muscles that develops following death, involves cessation of the cross-bridge cycle in the post-force-generating step (step 6, Fig. Gross Muscle Coloration the first indication that different muscles had different physiological prosperities arose from the observation that there was variation in muscle coloration not only among species of animals, but also among individual muscles within the same individual. As a result of these differences in coloration, the terms "red" and "white" were introduced to distinguish between muscles of different gross coloration. Red coloration of muscles was subsequently found to be due to the presence of myoglobin and other cytochromes within the myofibers. Numerous biochemical, histochemical, and physiological studies have since been conducted to detail a variety of differences in both the metabolic and contractile properties of "red" and "white" skeletal muscle. Muscular Energetics Muscular contraction results from the transformation of chemical energy into mechanical energy. Chemically, the transformation of energy is associated with the cyclical association and disassociation of the contractile proteins actin and myosin, whereas mechanically the transformation is associated with shortening of sarcomeres, which is achieved by conformational changes of the myosin molecules that result in sliding of the overlapping arrays of thick and thin myofilaments (Fig. In the noncontracting state, actin and myosin are combined at the cross-bridges (step 1, Fig. The globular head of myosin moves to a new location on the thin filament (step 3, Fig. This recombination step between the globular head and actin is controlled by the regulatory proteins troponin and tropomyosin in response to calcium ion concentrations. The force for contraction is generated by movement of the cross-bridge head to a 45 degree angle of attachment (step 5, Fig. Physiological Properties the speed of contraction of red muscles was most often found to be slower than that of white muscles in a variety of animals. In addition, redness of a muscle was associated with the development of tetanus at lower frequencies of stimulation, the development of smaller twitch tensions, and a greater resistance to fatigue. Conversely, white muscles required greater frequencies of stimulation for the development of tetanus, developed larger twitch tensions, and tended to fatigue quickly. From this data, the terminology of slow-contracting or slow-twitch and fast-contracting or fast-twitch muscles evolved. Moreover, because speed of contraction was closely associated with gross muscle coloration, the terms "red" and "white" came to be used interchangeably with "slow" and "fast," respectively. However, there are numerous exceptions to this association of gross coloration with physiological properties of contraction. Motor Units the morphological and functional unit of skeletal muscles is the motor unit (Fig. Motor neurons may differ based on their rates of discharge: (1) phasic motor neurons with a fast discharge rate and (2) tonic motor neurons with a slow discharge rate. In addition, the phasic motor neurons are characterized by shorter after hyperpolarization potentials, faster conduction velocities, and larger axons than the tonic motor neurons. Investigations of these parameters in motor neurons of slow-contracting and fast-contracting muscles indicate that tonic motor neurons, which discharge at rates of 10 to 20 per second, innervate slow-contracting muscles, and phasic motor neurons, which discharge at rates of 30 to 60 per second, innervate fast-contracting muscle. Thus, there are at least two types of motor units, which differ in their physiological properties and type of motor neuron innervation (Eccles et al. Physiological measurements performed on isolated motor units in the cat have revealed two types of fasttwitch motor units and one type of slow-twitch unit (Burke, 1975). All of the slow-twitch units are resistant to fatigue and are therefore designated as S units. The average number of muscle fibers per motor unit in cats ranges from 550 to 650. Immunocytochemical Identification of Myosin Isoforms More recently, immunohistochemical differentiation of fiber types based on antibodies directed against myosin heavy chain isoforms have been used to identify contractile muscle fiber types (Gorza, 1990). Immunohistochemical staining for myosin isoforms reveals that the true number of distinctly identified muscle fiber types supersedes the number recognized by histochemistry alone. Myosin isoforms include neonatal and slow-twitch myosin isoforms as well as five distinct fast-twitch isoforms (Rubenstein and Kelly, 2004). Type 2a, type 2b, and type 2x are the most widely expressed skeletal muscle isoforms in the body with 2 m fibers found in the jaw muscles of carnivores and 2eom in extraocular muscles. Moreover patterns of contractile protein isoforms and enzyme activities recognized in developing or pathological muscles do not correlate with standard histochemically derived fiber types (Linnane et al. Hence, though useful as a screening tool for pathologists and physiologists, histochemical techniques have limitations. Most limb muscles are "mixed" and contain variable proportions of type 1, type 2a, and type 2x myofibers. These fibers presumably represent fibers capable of transitioning between type 1 and type 2 myofibers (Brooke and Kaiser, 1970). In conjunction with electron microscopic observations, the activities of these enzymes have been localized to mitochondria, which are present in abundance in type I fibers. Associated with the large mitochondrial volume of type 1 myofibers are lipid inclusions. Because various intermediate histochemical reactions of myofibers also exist, a classification system that describes type 1, type 2 oxidative, and type 2 glycolytic is often used. Relationships with Functional Properties Each motor unit is homogeneous with respect to its myofiber-type composition. Fast-twitch muscles derive their energy primarily via anaerobic glycogenolysis and glycolysis through the degradation of glycogen and glucose to lactate. Two types of fast-contracting motor units exist; fast-twitch fatigue resistant, corresponding to type 2a fibers, and fast-twitch rapidly fatigable corresponding to type 2x fibers identified histochemically (Burke, 1975). The physiological and histochemical properties and classifications of myofibers are summarized in (Table 15-1) and illustrated in Figure 15-6 and Figure 15-7. In general, the rate of glycogen utilization is greatest with high-intensity anaerobic exercise, whereas low-intensity submaximal exercise results in a lower rate of glycogen utilization and reliance on oxidation of fatty acids as fuel (Kiens, 2006). Under conditions of restricted energy intake or prolonged exercise, amino acids may also serve as energy substrates within skeletal muscle (Rennie et al. Aerobic and Anaerobic Energy Metabolism In general, fast-twitch muscle fibers in the untrained state are biochemically suited to derive energy for contraction by anaerobic glyco(geno)lysis.

Gloves treatment vitiligo effective 100 mg norpace, catch poles medicine quinidine cheap 150 mg norpace, ropes symptoms 10 weeks pregnant order 100 mg norpace overnight delivery, nets treatment centers for alcoholism discount 100 mg norpace overnight delivery, body bags medications interactions generic norpace 100 mg line, holding boxes medications jejunostomy tube cheap norpace 150mg with mastercard, corrals, squeeze chutes, or more sophisticated mechanical holding devices may be required for specific situations (Fig. Use of anesthetics, analgesics, and sedatives is mandatory for the control of pain and distress before potentially painful procedures such as surgery are performed on animals. Use of drugs and "tranquilizer guns," however, is not the panacea to wild-animal restraint. Chemicals used for tranquilization and immobilization, if not correctly handled and delivered, may be dangerous to the target animals and humans (Fig. In addition, during the drug induction phase or during recovery, an unrestrained animal may be subject to increased potential for accidental injury or death including predation. While under the effects of the drug the animal may become hyper- or hypothermic, depending on chemicals used and ambient temperature, it may vomit and aspirate the vomitus, or pregnant females may abort. A darted animal may be able to elude its captors and hide before being completely anesthetized, a particularly acute hazard when chemicals are employed that require administration of an antidote. All of these circumstances and possibilities must be understood and evaluated by the researcher before a chemical is selected as the best method of restraint in a given instance. If chemical restraint is selected, it is imperative for all members of the capture team to have a working knowledge of the chemical or drugs being used, even if they are to be handled and delivered by a veterinarian. It also is the responsibility of researchers to know the effects, side effects, advantages, and disadvantages of the drugs being used, and to have knowledge of such factors as the minimum and maximum induction times and potential for adverse drug reactions. This type of information is necessary to evaluate the danger to target animals, and to humans that might be exposed to the drugs. Searchers should be capable of monitoring the condition of anesthetized animals and be able to apply resuscitative routines in a life-threatening emergency. Information on use of these methods exists in guidelines on acceptable field techniques by various professional societies (See "Professional society guidelines" at the end of this chapter). Guidelines for Proper Care and Use of Wildlife in Field Research 59 Photo by Doug Mader A B Figure 6. Criteria for Marking When answers to the four initial questions lead to a decision to initiate an animal-marking program, researchers must search among a wide array of potential techniques with varying strengths and weaknesses to select the method(s) most suited to their particular project (Nietfeld and others, 1994). Technological and methodological constraints and available resources can vary widely from project to project and will require each researcher to examine each potential marking technique in terms of a standard set of criteria. Specific criteria relate to impacts of marking on the organism, validity of the study, and other constraints such as legal requirements. Evaluation criteria for marking techniques Photo by Milton Friend the following are essential criteria for evaluation of marking techniques: 1. Marks should have minimal effect on the anatomy and physiology of the organism, i. Marks that make an organism more conspicuous must be evaluated carefully to ensure that they neither cause others of the same species to react differently to it than to other conspecifics nor subject it to increased selection by potential predators (unless this is a purpose of the study) (Fig. Marks should be retained for the minimal period required to achieve project goals. Unambiguous marks that are quick and easy to apply should be selected to avoid extensive handling or error potential. The first three criteria focus on the well-being of the organism being studied and the potential for marks to influence research results by affecting the fitness or behavior of the organisms. Criteria 4 and 5 may affect the validity of the research design, and criterion 6 reflects other constraints placed upon the researcher. Violation of any of the first five criteria may result in biased research results, so researchers should specifically address these criteria in any evaluation of research resulting from a sample of marked organisms. Although marks that may be applied to organisms are commonly perceived as passive and visual, markers also Figure 6. Animal Marking Developing means of reliably identifying individual animals to achieve field research objectives often is necessary. In addition to requiring individual identification, researchers may need information on nonconspicuous aspects of physiology or movements, or other aspects of animal ecology that can be determined directly or indirectly through specially designed markers. Consideration for animal marking Before initiating any marking procedure for wild animals, researchers must resolve the following questions to determine whether marking is required and appropriate for the particular situation. Do naturally occurring differences in the morphology of the animals under consideration provide sufficient identification to achieve research objectives? If animals must be physically marked, can a sufficient number of animals be marked in the time available? Are the risks (to both the animal and researcher) associated with capture, handling, and marking, and subsequent well-being, minimal and acceptable in both responsible and scientific contexts? Guidelines for Proper Care and Use of Wildlife in Field Research 61 A B C Figure 6. A vast literature exists of techniques and potential concerns regarding the marking of organisms from insects to whales, and it has been summarized in detail elsewhere (see "Professional society guidelines"; Day and others, 1980; Orlans, 1988). Other Professional and Ethical Considerations Many organisms of interest to wildlife professionals are free-ranging and may be enjoyed by other segments of society in many ways, from observation or photography to har- vest as meat or trophies. Professional ethics dictate that those other potential uses of organisms be considered and accommodated insofar as possible. Wild animals and birds are valued in part because they are wild, and the presence of humancaused marks may detract from that value. Accordingly, shortlived and inconspicuous marks should be selected whenever they can meet the objectives of proposed research. Scientists have an ethical responsibility to attempt to remove collars or other external markers at the conclusion of their research if possible and feasible. Furthermore, professional and ethical considerations dictate that permanent markers that injure or change the appearance of an animal. Housing and Maintenance of Field Sites General Proper care and responsible treatment of incarcerated animals must depend on scientific and professional judgement, on concern for the animal, on knowledge of animal behavior and animal husbandry, and on familiarity with the species. Investigators working with species unfamiliar to them should obtain all pertinent information before confining those animals. It also may be necessary to test and compare several methods of housing to determine the most appropriate one for the well-being of the animal and the purpose of the study. Findings should be part of a permanent record system and animal logbook associated with the study and the maintenance facility. Housing Housing for wild vertebrates should approximate natural conditions as closely as possible. Housing should provide safety and comfort for the animal as well as meet the study objectives. Methods of housing should provide for behavioral needs, safety, adequate exercise and rest, and conditions for the general well-being of the animal. Considerations depend on the animal involved and include isolation or refuge areas, natural materials, dust and water baths, natural foods, sunlight, and fresh air. Housing should incorporate as many aspects of natural living as possible, such as brushy areas for escape, resting cover, shade and protection from environmental elements, a natural stream traversing the pen, rocky areas for hoofed animals that need to wear down their hooves, and social groups of animals kept together. Housing of compatible species in a common pen also will provide for social interaction. Frequency of cleaning should be a compromise between level of cleanliness necessary to prevent disease and amount of stress imposed by cleaning (Fig. In general, housing must be of adequate size to allow for the physical and behavioral needs of the animals, while allowing scientists to collect appropriate data. For many housing situations, the pen can be large and natural, with a smaller internal or attached catch pen to restrain animals for experimental techniques. Pen construction materials must provide for the safety of the animals, as well as prevent the animals from escaping. Materials should be of sufficient durability to last for the intended period of confinement. When longterm confinement (weeks or longer) is necessary, or pens are to be reused, materials with impervious surfaces should be used to facilitate sanitation and minimize the potential for survival of animal pathogens. All animals that are inherently dangerous, are environmentally injurious, or have a propensity for escape require special attention. Mesh size and spacing between fencing materials must be small enough to prevent the head of an animal from extending through the fence. Colored flagging material may be necessary for animals to visualize fencing until they become accustomed to it. Animals should be released into the housing in a calm and unstressed manner so that initial mortality and morbidity from fence encounters are minimal. A small dose of tranquilizer often will reduce the immediate flight response when an animal is released into the housing and may help prevent initial injuries. Once animals have investigated the limits of the housing, injury occurrence is minimized if investigators do not cause undo flight reactions. Adequacy of housing often can be judged on normal behavior patterns, weight gains and growth, survival rates, reproductive success, and physical appearance of the animals involved in the research project. Established guidelines for housing laboratory and farm animals were provided by the Canadian Council on Animal Care (1980, 1984). Additional guidelines for housing requirements of fish, amphibians reptiles, wild birds, and small mammals were reported by the appropriate professional societies and appear in the Animal Welfare Act (see also "Professional society guidelines" at the end of this chapter). Nutrition Nutrition must meet the needs of the animal unless deviations are an approved purpose of the investigation. Researchers are responsible for determining the appropriate nutritional needs of study animals prior to placing them in confinement and for obtaining adequate food supplies to sustain the animals during the period of confinement. Feeding and watering should be under the direct supervision of an individual Guidelines for Proper Care and Use of Wildlife in Field Research 63 Photo by Milton Friend trained and experienced in animal care for the species being maintained. Animal care personnel must be familiar with the animals being studied so abnormalities in appearance and behavior that may be indicative of nutritional deficiencies can be recognized quickly. Transportation General Considerations A variety of vehicles such as conventional motor vehicles, all-terrain vehicles, snow machines, rotary and fixed-wing aircraft, and boats are used to transport wild animals. The species involved, method of transportation selected, and length of time an animal is to be transported are important factors regarding the type of care and conditions of containment required to maintain the animal in a state of well- being (Fig. To the extent possible, selection of transportation vehicles should take into account maintenance of the animal in a comfortable environment. Veterinary assistance may be required to prescribe and administer appropriate tranquilizers or other drugs when conditions of transportation are likely to result in a high level of stress to the animal due to its behavioral and physiological characteristics, restrictions of confinement, engine noise, and rigors of the trip. This can be expedited by proper and adequate planning to assure that transportation vehicles and housing units in appropriate numbers and size are available and ready for use as needed; that food, water, bedding, and other needs to provide for the animals also are available; that individuals involved in the transportation process are trained in the procedures to be used in containment and transportation of the A Figure 6. B 64 Field Manual of Wildlife Diseases: Birds Photos by Julie Langenberg, International Crane Foundation animals; and that all permits, health certificates, and other paperwork have been completed to the extent possible. When interstate movement of animals or shipment by commercial carriers is involved, scheduling of transportation segments to minimize the number of transfers and delays between transfers, having someone involved with the project meet the shipment at each transfer point, and, when appropriate, arranging for prompt clearance of animals by veterinary and customs inspectors can result in major reductions in transit time. For some species, periodic rest periods are required to allow the animals to feed undisturbed. Other species are best transported when they are normally inactive and do not feed. Ventilation within the housing unit and transportation vehicle should provide for adequate air movement to keep animals comfortable and avoid buildup of exhaust gases. Subdued lighting and visual barriers between animals and humans and between animals and their transportation environment should be provided to help keep the animals calm. Fish and Wildlife Service has published rules for the Humane and Healthful Transport of Wild Animals and Birds to the United States (see Fed Reg. Confinement During Shipping Animal containers should be inspected to assure they have no sharp edges, protrusions, or rough surfaces that could cause injury during transport. The floor of shipping containers should allow reasonable footing to prevent falling due to a slippery surface. Also, containers should not have coatings or be constructed of materials that are toxic and could be consumed by the animal through licking or chewing during transportation. In general, housing units of porous materials, such as cardboard boxes, should not be reused; all other containers used to house animals should be suitably disinfected between uses (Fig. That portion of the transportation vehicle used to contain the housing units also should be disinfected. Grouping or separation of animals being transported at the same time should take into consideration the species, age, and other appropriate factors. Direct contact generally should be maintained between females and their dependent young, particularly if abandonment may result (unless the young are to be maintained by some other means). Birds should be isolated in separate cells within the shipping container; if this cannot be done, each individual should have sufficient space to assume normal postures and engage in comfort and maintenance activities unimpeded by other birds (Ad Hoc Committee on the Use of Wild Birds in Research, 1988). Transported animals should be protected from exposure to inclement weather, harsh environmental conditions, and major temperature fluctuations and extremes. Bedding, feed, and water should be provided, as appropriate, and the animals should be observed periodically to determine their state of well-being during transportation. Onsite veterinary assistance may be warranted to monitor animals and to provide life-support assistance should a medical emergency occur during transportation or at the release or field study site. Any animals that die during transit should be removed as soon as practical from the sight and olfactory detection of other animals being transported. These carcasses should be retained for pathological examinations regarding cause of death. Similarly, animals that become severely injured or clinically ill should be removed and responsibly euthanized. Sick animals disposed of in this manner also should be retained for pathological assessments. Determinations of cause of death are needed to assess whether the remaining animals are at risk from pathogens associated with the dead animals. Surgical and Medical Procedures Guidelines for wildlife medical procedures Wildlife field research can involve surgical and medical procedures such as implanting radio transmitters and surgical sex determination in birds. Incorporation of such techniques into a research protocol should follow these guidelines: 1.

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Academic Achievement Profiles of Children with High Functioning Autism and Asperger Syndrome: A Review of the Literature. Academic Achievement and Strategy Instruction to Support the Learning of Children with High-Functioning Autism. Functional Analysis and Treatment of Rumination Using Fixed-Time Delivery of a Flavor Spray. Sociosexuality Education for Persons with Autism Spectrum Disorders Using Principles of Applied Behavior Analysis. Effectiveness of Group Cognitive-Behavioural Treatment for Men with Intellectual Disabilities at Risk of Sexual Offending. Questions on Verbal Behavior and Its Application to Individuals with Autism: An Interview with the Experts. Reduced cognitive control of response inhibition by the anterior cingulate cortex in autism spectrum disorders. Personality disorders in offenders with intellectual disability: a comparison of clinical, forensic and outcome variables and implications for service provision. 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Relationship between adverse effects of antiepileptic drugs, number of coprescribed drugs, and drug load in a large cohort of consecutive patients with drug-refractory epilepsy.

Pigs Mink Rabbits Sheep Species Affected All avian species are susceptible to infection by M medications via ng tube buy norpace 150mg with amex. Recent molecular studies with a limited number of isolates from birds medicine mound texas buy norpace 100 mg visa, humans medicine omeprazole buy norpace 150 mg with amex, and other mammals clearly indicated that M medicine articles buy 150mg norpace amex. It is generally accepted that pigs medicine 5513 buy cheap norpace 100 mg on line, rabbits treatment 2 degree burns norpace 100mg online, and mink are highly susceptible to M. In captivity, turkeys, pheasants, quail, cranes, and certain birds of prey are more commonly infected than waterfowl. However, when avian tuberculosis becomes established, it can be a common and lethal disease in captive waterfowl flocks. Chronic infections exist in some captive nene goose flocks, making these flocks unsuitable donors to supplement the wild population of this endangered species. In free-ranging wild birds, avian tuberculosis is found most often in species that live in close association with domestic stock (sparrows and starlings) and in scavengers (crows and gulls). The prevalence of tuberculosis in free-ranging North American birds has not been determined, although generally less than 1 percent of birds examined at postmortem are affected. Sampling biases due to the limited numbers of speciDeer Cattle Horses Goats Dogs Cats Human Figure 8. Tuberculosis 93 Frequent Common Occasional Chickens Captive reared Free-ranging Partridge/quail Captive reared Free-ranging Cranes Captive reared Free-ranging Pigeons Captive reared Free-ranging Hawks/owls Captive reared Free-ranging Waterfowl Captive reared Free-ranging Pheasants Captive reared Free-ranging Gulls Captive reared Free-ranging Crows Captive reared Free-ranging Turkeys Captive reared Free-ranging Songbirds Captive reared Free-ranging Vultures/buzzards Captive reared Free-ranging Not applicable mens examined preclude extending findings to reflect actual prevalence (Fig. A decade-long study of nearly 12,000 wild birds necropsied in the Netherlands disclosed that 0. Distribution Avian tuberculosis is a ubiquitous and cosmopolitan disease of free-ranging, captive, and domestic birds. The disease is most commonly found in the North Temperate Zone, and, within the United States, the highest infection rates in poultry are in the North Central States. Distribution of this disease in free-ranging wild birds is inferred from birds submitted for necropsy; however, the sampling underrepresents both the geographic distribution and the frequency of infection for individual species. Avian tuberculosis likely exists in small numbers of free-ranging wild birds wherever there are major bird concentrations. Seasonality Seasonal trends of tuberculosis in wild birds have not been documented. The chronic nature of this disease guarantees its presence yearround for both wild and captive birds. Factors that may influence seasonal exposure to tuberculosis in migratory birds are changes in habitat used, food base during the year, and interspecies contacts. Contaminated sewage and wastewater environments containing tubercle bacilli are more likely to be used by waterfowl during fall and winter than during warmer months. Wastewater sites are often closed to hunting, thereby serving as refuge areas, and warm water discharges to these sites maintain open water in subfreezing temperatures, thus inviting ready use by waterfowl. Predatory and scavenger species such as raptors and crows often ingest many different food items during different periods of the year; scavengers, therefore, may be exposed to tuberculosis through contaminated food yearround. Contact between wild birds and poultry and livestock is often restricted to specific periods of the year owing to husbandry practices. Environmental conditions can greatly affect the susceptibility of birds to tuberculosis and the prevalence of tuberculosis in captive birds. Gross Lesions Typical cases of avian tuberculosis in wild birds involve emaciated carcasses with solid-to-soft or crumbly, yellowto-white or grey nodules that are less than 1 millimeter to several centimeters in size and that are deeply embedded in infected organs and tissues. Other birds have died of avian tuberculosis without any obvious clinical signs or external lesions. Advanced disease and clinical signs are seen most often in adult birds because of the chronic, insidious nature of the disease. Infected birds are often emaciated, weak, and lethargic, and they exhibit wasting of the muscles. These signs are similar to those of lead poisoning and other debilitating conditions. Other signs depend on which body system is affected and signs may include diarrhea, lameness, and unthrifty appearance. Darkening and dulling of plumage have been reported in the United Kingdom for wood pigeons infected with tuberculosis, but not for other species. Nodular tuberculosis lesions in internal organs are often grossly similar to those of aspergillosis, and laboratory diagnosis is required to differentiate the two diseases as well as others that produce similar lesions. Sometimes the primary lesions seen at necropsy are enlarged livers and spleens that are so fragile that they easily rupture upon being handled. Most of these cases have livers and spleens with a tan-togreen translucence due to amyloid deposits. Less commonly, in situations where nodules are not formed nor is amyloid deposited, the liver and spleen can be large, pale, and firm. Lesions in the lungs and other areas of the respiratory tract suggest inhalation as the route of exposure. When carcass or tissue submissions to a laboratory are not possible within a short time, tissue preserved in 10 percent buffered formalin solution is useful for diagnostic purposes (see Chapter 2, Specimen Collection and Preservation). Microscopic studies can provide a diagnosis of tuberculosis, although such studies cannot determine the species of Mycobacterium. Because this disease is transmissible to humans, extra care must be taken when handling infected carcasses. Control Tuberculosis is difficult to detect in free-ranging birds despite its broad geographic distribution. Tuberculosis rarely causes a major die-off, and there are no practical nonlethal testing procedures for mobile wild birds. Therefore, there is no focal point and, hence, no method developed for disease control in wild bird populations. By contrast, tuberculosis can cause die-offs in captive flocks, and mortality has been reported in sea ducks and other birds, including chukar partridge and pheasants. Some captive flocks of wild birds have experienced losses of nearly 30 percent or more from tuberculosis. Close monitoring of the health of bird populations - freeranging or captive - is an essential first step toward detecting tuberculosis so that control efforts can be developed and initiated when feasible. Monitoring can best be accomplished by the timely submission of carcasses to disease diagnostic laboratories. Tuberculosis testing of birds maintained in captivity and laboratory analyses of fecal samples from captive and wild flocks also can be used to identify the presence of Diagnosis Typically, tuberculosis is discovered in captive birds during routine investigation of mortality, and in wild birds during carcass examinations associated with die-offs due to other causes. Whole carcasses are preferred, but when a whole carcass cannot be submitted, remove the leg at the hip joint, wrap it in clean aluminum foil, place it in a plastic bag, and freeze it for shipment to a qualified disease diagnostic laboratory. These tests do not detect all infected birds, but the tests are useful for identifying infected flocks. Fecal contamination of the environment is the major means of tuberculosis dissemination; ingestion of the bacterium in contaminated feed and water is the most common means of disease transmission. Because this bacterium can survive outside of the vertebrate host for long time periods in an organic substrate (Fig. Tuberculosis outbreaks in birds have been associated with sewage effluents and discharges from slaughter houses, meat processing plants, and dairies. In one instance, an outbreak occurred in a captive waterfowl flock when contaminated water was sprayed into the enclosure. These events illustrate the importance of disease prevention for addressing tuberculosis in free-ranging and captive wild birds. The use of wastewater for maintaining captive waterfowl and other wild birds is questionable without adequate testing or treatment or both to assure that the wastewater does not contain tubercle bacilli. Also, the use of wetlands for wastewater discharges and the use of wastewater to create wetlands for migratory bird habitat should be carefully considered because of the possible presence of M. Other actions that should be considered include preventing land use that could place tuberculosis-infected swine in close proximity to major wild bird concentrations and not using unexamined chicken and pigeon carcasses as food for raptors being reared in captivity for release into the wild. Infected flocks of captive birds should be destroyed because treatment is ineffective and because not all infected birds will be detected by current testing procedures. Because of the long-term environmental persistence of the tubercle bacilli, additional bird use of the site should be avoided for approximately 2 years. Vegetation removal and turning of the soil several times during this period will facilitate sunlight-induced environmental decay of the bacilli. However, when a major outbreak of tuberculosis occurs in wild birds, the circumstances should be assessed, and limited population reduction should be considered if the remaining population-at-risk is well defined, limited in immediate distribution, and involves species that can withstand this action. Habitat manipulation, such as drainage, and scaring devices, such as propane exploders, can sometimes be used to deny birds use of areas where tuberculosis outbreaks occur. The insidious nature of avian tuberculosis combined with the long environmental persistence of the causative bacterium strongly indicate a need to prevent the establishment of this disease in wild bird populations. When the disease becomes established in free-ranging populations, interspecies transmission and the mobility of free-ranging birds could serve to spread it widely. The continued persistence of avian tuberculosis as a major cause of avian mortality in zoological collections attests to the difficulty of disease control. Tuberculosis 97 Human Health Considerations There are many authenticated cases of M. Avian tuberculosis is generally considered noncontagious from an infected person to an uninfected person. Rats, mice, and other species, including reptiles and turtles, in addition to birds, are sources of fecal discharges of paratyphoid forms of salmonellae. Inhalation of the bacterium during close confinement in high humidity environments such as hatching and brooder operations, direct contact with infected birds and animals, and insects are other demonstrated transmission routes for salmonellosis. Intestinal microflora are an important factor influencing infection and disease by salmonellae in poultry. Very small numbers of salmonellae can cause infection of poultry during the first few weeks of life. Thereafter, the infectious dose becomes progressively higher, apparently because poultry acquire intestinal microflora that protect them against infection even in the presence of a highly salmonella-contaminated environment. This may explain the high prevalence of salmonellosis occasionally found in chicks of some colonial nesting species, such as gulls and terns, and in heron and egret rookeries, but the lower-than-expected infection rates in adult birds from those same colonies. Experimental studies with full-grown herring gulls disclosed a rapid elimination of salmonella bacteria from the intestines of these birds, which suggests that adult herring gulls may be passively, rather than actively, infected and may simply serve as a mechanical transport mechanism for the movement of salmonellae ingested from contaminated environments. Individual infected birds can excrete salmonella bacteria for prolonged periods of time ranging from weeks to months. Prolonged use of sites by birds and high density of individuals at those sites can result in cycles of salmonellosis within those populations. Persistently contaminated environments result from a small percentage of birds which remain as lifelong carriers that intermittently excrete salmonellae into the environment. The environmental persistence of these bacteria is another factor influencing the probability for infections of birds using that site (Table 9. The common practices of using sewage sludge and livestock feces and slurry as fertilizer provide another means for infecting wild birds. Survival periods for salmonellae in cattle slurry samples have been reported to range from 11 to 12 weeks and for months in fields where the slurry has been applied as fertilizer. There are numerous reports of the isolation of salmonellae from rivers and streams as a result of pollution by sewage effluent and slurry runoff from fields. Cause Avian salmonellosis is caused by a group of bacteria of the genus salmonella. Approximately 2,300 different strains of salmonellae have been identified, and these are placed into groupings called "serovars" on the basis of their antigens or substances that induce immune response by the host, such as the production of specific antibody to the antigen. Current taxonomic nomenclature considers the 2,300 different serovars to be variants of two species, Salmonella enterica and S. Readers should be aware of this convention for naming salmonellae because they will find this nomenclature in the current scientific literature. In this chapter, different serovars of salmonellae will be referred to by their previous, less complex nomenclature, such as S. Wild birds have been infected with pullorum disease and fowl typhoid, but wild birds are more commonly infected by the variants of salmonellae that are collectively referred to as paratyphoid forms, of which S. The paratyphoid forms constitute the great majority of salmonellae, and they are becoming increasingly important as causes of illness and death in wild birds (Table 9. Egg transmission and environmental contamination of rearing facilities are of more importance for infecting poultry than are contaminated feeds. For wild Distinct forms of salmonellosis caused by specific variants of salmonellae. Salmonella pullorum Pullorum disease Chickens (primary), turkeys Mortality usually confined to the first 2­3 weeks of age. Characteristic Common name Natural hosts Salmonella gallinarum Fowl typhoid Chickens, turkeys Salmonella typhimurium Salmonellosis Wide range of vertebrates; not restricted to birds. All ages affected; more common in young and often in association with concurrent disease agents. Contaminated environment resulting in ingestion through food and water; egg transmission can also occur. Prevalence varies with species; most common in those species associated with landfills, sewage lagoons, and other waste-disposal sites and those with close associations with livestock and poultry operations. Wide range of species; commonly found in gulls and terns and passerine birds using birdfeeding stations. Also reported in herons, egrets, ducks, geese, cormorants, cranes, owls, eagles, falcons, hawks, and other species. Age susceptibility Generally infects growing and adult birds; disease also infects young due to egg transmission. Transmission Infected hatching eggs followed by spread from infected chicks to uninfected chicks that hatch.

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