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In the years since this judgment cheap 1mg tolterodine, considerable effort has been expended attempting to regulate the custodial interview to minimize the risk of false confessions while preserving the value of interrogation as a means of solving crime generic tolterodine 4 mg with amex. In this section cheap tolterodine 4 mg otc, the important psychological aspects of interrogation and confession are considered and the role the forensic physician can play in ensuring that suspects are fit to be interviewed is discussed quality 1 mg tolterodine. Police Interview Techniques Numerous American manuals detail the way in which coercive and manip- ulative interrogation techniques can be employed by police officers to obtain a confession (40 purchase tolterodine 2mg free shipping,41), with similar techniques being advocated by Walkley (42) in the first such manual written for British officers. The authors of these manuals propound various highly effective methods for breaking down a suspect’s resis- tance while justifying a certain amount of pressure, deception, persuasion, and manipulation as necessary for the “truth” to be revealed. Walkley acknowledges that “if an interviewer wrongly assesses the truth-teller as a lie-teller he may subject that suspect to questioning of a type which induces a false confession. Although studies in the United Kingdom have suggested that coercive interview techniques are employed less frequently than in the past, manipulative and persuasive tactics continue to be used, particularly in relation to more serious crimes (43,44). Care of Detainees 217 Interrogators are encouraged to look for nonverbal signs of anxiety, which are often assumed to indicate deception. Innocent suspects may be anxious because they are erroneously being accused of being guilty, because of wor- ries about what is going to happen to them while in custody, and possibly because of concerns that the police may discover some previous transgres- sion. Furthermore, there are three aspects of a police interview that are likely to be as stressful to the innocent as to the guilty: the stress caused by the physical environment in the police station, the stress of being isolated from family and friends, and the stress caused by the suspect’s submission to authority. All these factors can markedly impair the performance of a suspect during an interview. Indeed, American research has suggested that for most suspects, interrogations are likely to be so stressful that they may impair their judgment on such crucial matters as the exercise of legal rights (45). Given the interview techniques employed by the police and the stresses interrogation places on the accused, there is little wonder that false confes- sions are occasionally made to the police. False Confessions During the last two decades, the United Kingdom has witnessed several well-publicized miscarriages of justice in which the convictions depended heavily on admissions and confessions made to the police that were subse- quently shown to be untrue (46–48). In reviewing 70 wrongful imprisonments that occurred between 1950 and 1970, Brandon and Davies (49) found that false confessions were second only to incorrect identification evidence as the most common cause of wrongful conviction. More recently, in 1994, Justice (50) identified 89 cases in which an alleged miscarriage of justice rested on a disputed confession. Thus, it is clear that people can and do make false and misleading admissions against their own interest. There is no single reason why people falsely confess to crimes they have not committed. Indeed, such confessions usually result from a combination of factors unique to the individual case. These categories are voluntary, accommodating-compliant, coerced-com- pliant, and coerced-internalized. Voluntary False Confessions Voluntary false confessions are offered by individuals without any exter- nal pressure from the police. Commonly, the individuals go voluntarily to the police to confess to a crime they may have read about in the press or seen reported on television. Often, they do so out of a morbid desire for notoriety because the individual seemingly has a pathological desire to become infa- mous, even at the risk of facing possible imprisonment. Alternatively, a voluntary false confession may result from the individual’s unconscious need to expiate guilty feelings through receiving pun- ishment. The guilt may concern real or imagined past transgressions or, occa- sionally, may be part of the constant feeling of guilt felt by some individuals with a poor self-image and high levels of trait anxiety. By contrast, some people making this type of confession do so because they are unable to distinguish between fact and fantasy. Such individuals are unable to differentiate between real events and events that originate in their thinking, imagination, or planning. Such a breakdown in reality monitoring is normally associated with major psychiatric illness, such as schizophrenia. Occasionally, people may volunteer a false confession to assist or protect the real culprit. Gudjonsson (52) highlights some evidence that confessing to crimes to protect others may be particularly common in juvenile delinquents. Finally, Shepherd (53) identifies a subset of individuals who falsely con- fess to crimes to preempt further investigation of a more serious crime. Accommodating-Compliant False Confessions Expanding on the original three distinct categories of false confession, Shepherd recognizes a group of people for whom acquiescing with the police is more important than contradicting police assertions about what happened. In such circumstances, a false confession arises from a strong need for approval and to be liked. Police conduct is noncoercive, although it does involve the use of leading questions sufficiently obvious to suggest to the suspect what answers the police want to hear. People at all intellectual levels are at risk of behaving in this manner, with those who are excessively compliant being at greatest risk.

They also 1 time per week or less found that people who ate beef four or more times a week 1 purchase 4mg tolterodine with mastercard. Those with low levels of vitamin D have a two- to threefold Avoid the sun and don’t take 2 tolterodine 2mg without prescription. Women who took a folic-acid- For 14 years or more containing multivitamin for 5 to 14 years were about 20% less likely 0 buy 1mg tolterodine free shipping. Vegetables in the brassica family 1 mg tolterodine fast delivery, including cabbages tolterodine 2 mg cheap, Protective effect against lung, stomach, colon and rectal cancers have kale, broccoli, brussels sprouts, 0. Garlic consumption of >20 g Garlic consumption reduces colorectal cancer risk to 0. Remember that if a factor does not apply to you, then enter a 1 in the “Score” column. Indicate the result here: Total score (section 1) = ____ divided by 14 = ____ Repeat that process for Section 2, only this time divide the result by 16. Total score (section 2) = ____ divided by 16 = ____ Now take those two results and multiply them together. For additional and more specific recommendations for preventing breast or prostate cancer, please go to the chapter “Breast Cancer (Prevention),” or the chapter “Prostate Cancer (Prevention). After finding that the incidence of colon cancer was nearly three times higher in New York than in New Mexico, the Garland brothers hypothesized that lack of sun exposure (resulting in a lack of vitamin D) played a role. While his assertion is controversial, the research is very clear that vitamin D deficiency dramatically increases risk of many cancers, especially breast and colon. Screening is especially important for people who have certain risk factors, such as a family history of certain cancers or exposure to environmental toxins. The major benefit with regular screening examinations by a health care professional is that it can lead to early detection of cancer. Screening-accessible cancers—especially cancers of the breast, colon, rectum, cervix, prostate, testicles, oral cavity, and skin—account for about half of all new cancer cases. In general, the earlier a cancer is discovered, the more likely it is that treatment will be successful. Self-examination for cancers of the breast and skin may also result in detection of tumors at earlier stages. This exam should include health counseling and, depending on a person’s age and gender, might include related examinations for cancers of the thyroid, oral cavity, skin, lymph nodes, and testes or ovaries, as well as for some checkup nonmalignant diseases. Beginning at age 50, men and women should follow one of the examination schedules below: • A fecal occult blood test every year and a flexible sigmoidoscopy every 5 years Colon • A colonoscopy every 10 years and • A double-contrast barium enema every 5 to 10 years rectum A digital rectal exam should be done at the same time as sigmoidoscopy, colonoscopy, or double-contrast barium enema. People who have a family history of colon cancer should talk with a doctor about a different testing schedule. Men in high-risk groups, such as blacks and those with a strong familial predisposition (i. Cervix: All women who are or have been sexually active or who are 18 and older should have an annual Pap test and pelvic examination. After three or more consecutive satisfactory examinations with normal findings, the Pap test may Uterus be performed less frequently. Endometrium: Women with a family history of cancer of the uterus should have a sample of endometrial tissue examined when menopause begins. Detoxification and Internal Cleansing Introduction Have you ever noticed that many people treat their cars better than their bodies? They wouldn’t dream of ignoring a warning light on the dash letting them know that it is time to change the oil, but they often ignore the telltale signs that their body is in dire need of cleanup or critical support. If you answer yes to any of them, you definitely need to pay attention to detoxification. Is improving detoxification really an effective solution to help with all of these symptoms? Once the body’s detoxification system becomes overloaded, toxic metabolites accumulate, and we become progressively more sensitive to other chemicals, some of which are not normally toxic. The concepts of internal cleansing and detoxifying have been around for quite some time. In modern times, as society has increasingly been exposed to toxic compounds in air, water, and food, it has become apparent that an individual’s ability to detoxify substances to which he or she is exposed is of critical importance for overall health. When you reduce the toxic load on the body and give the body proper nutritional support, in most cases these bothersome symptoms will disappear. Even more important, by addressing these warning signs now we can ensure better long-term health and avoid the progression of minor problems to more serious conditions. A toxin is defined as any compound that has a detrimental effect of cell function or structure. Our modern environment seriously overloads the liver, resulting in increased levels of circulating toxins in the blood, which damage most of our body’s systems.

One of the main attractions and places of natural uniqueness in Hungary is Hortobágy National Park tolterodine 2 mg low price, known as “puszta" (“plain”) buy generic tolterodine 1 mg, which begins just in the outskirts of Debrecen purchase 1mg tolterodine. This is the authentic Hungarian Plain without any notable elevations discount tolterodine 1mg online, with unique flora and fauna tolterodine 4 mg low price, natural phenomena (e. The region is unmatched in Europe, no matter whether one considers its natural endowments or its historic and ethnographic traditions. A very lovely part of Debrecen is the “Nagyerdő” (“The Great Forest”), which is a popular holiday resort. Besides a number of cultural and tourist establishments, luxurious thermal baths and spas, Nagyerdő accommodates the University campus too. The history of higher education in Debrecen goes back to the 16th century when the College of the Reformed Church was established. It was in the year of the millennium of the establishment of Hungary (1896) when the foundation of the present University was decided. The University of Debrecen was established in 1912, initially having four faculties (Faculties of Arts, Law, Medicine and Theology). The educational activity at the University started in 1924, although the construction of the whole University was completed only in 1932. In 1951 the Faculty of Medicine became a self-contained, independent Medical University for training medical doctors. As a further development the University Medical School established the Health College of Nyíregyháza in 1991. In 1993, as part of a nationwide program, the University was given the rights to issue scientific qualifications and new Ph. The Faculty of Public Health was established in 1999, while the Faculty of Dentistry was founded in the academic year 2000/2001. In the ‘70s, the Theoretical Building and the new building of Dentistry were completed. The second phase of development was the establishment of the new Dialysis Center and the Cardiac Surgery Unit in the early ‘90s. The Life Science Building and a new library (with lecture halls, reading rooms and 200 computer terminals freely available for the students) were completed in 2006. The Medical School of the University of Debrecen celebrated the 90th anniversary of its foundation in October 2008 with a highly successful international scientific conference. Education at the University of Debrecen Debrecen, the second largest city of Hungary, is situated in Eastern Hungary. The Hungarian Government gives major priorities to the higher education of health sciences in its higher education policy. One of these priorities is to increase the ratio of college level training forms within the Hungarian higher education system. The governmental policy wishes to implement conditions in which the whole health science education system is built vertically from the lowest (post-secondary or certificate) to the highest (PhD-training) levels. In fact, this governmental policy was the reason behind the establishment of the new Health Science Education Center within the Federation of Debrecen Universities, based partially on the intellectual resources of the University of Debrecen Medical and Health Science Center. The new programs – with specialized training for paramedics – will help to correct the balance of the Hungarian labor-market that became rather unsettled in the past few decades. The Act of Higher Education (1993) has restored the rights of the medical universities to award postgraduate degrees and residency, and permission was also given to license Physicians’ procedures. This kind of training required a new structure, a new administrative apparatus, and a suitable training center. The introduction of the credit system, starting in September 2003, has been mandatory in every Hungarian university, helping the quantitative and qualitative evaluation of the students’ achievements. Admission requirements for Hungarian students are defined at national level, and they are applicable for every student wishing to be enrolled into the Medicine or Dentistry programs. International students must pass an entrance exam in biology and (depending on their preference) in physics or chemistry. In some special cases it may be possible for the candidates to apply for transfer to higher years on the basis of their previous studies and achievements. Entrance for certain courses of the Health College is also possible on the basis of a special evaluation (scoring) and an entrance interview. The total number of contact hours in medical education is over 5,500, which can be divided into three main parts: basic theoretical training (1st and 2nd year), pre-clinical subjects (3rd year) and clinical subjects (4th and 5th year) followed by the internship (6th year). The proportion of the theoretical and practical classes is 30% to 70%; whereas the students/instructors ratio is about 8/1. The first two years of dentistry education are similar to the medicine program, but the former contains a basic dental training that is followed by a three-year-long pre-clinical and clinical training. Besides the medicine and dentistry programs, there are several other courses also available, including molecular biology. The Medicine program delivered in English and intended for international students was commenced in 1987; whereas the Dentistry and Pharmacy programs for international students started in 2000 and 2004, respectively. The curriculum of the English language Medicine program meets all the requirements prescribed by the European medical curriculum, which was outlined in 1993 by the Association of Medical Schools in Europe.

The only were effectively treated for 14 days with medicated reported case of human chlamydiosis from free-rang- food containing 500 ppm (budgerigars=250 ppm) en- ing birds involved the Northern Fulmar on the Faroe rofloxacin cheap tolterodine 4 mg visa. Pigeon strains of chlamydia are considered treatment until four to five weeks after the end of less virulent for humans discount tolterodine 2 mg free shipping. Complete elimination of chlamydia from a quarantined group of Human infections are characterized by flu-like clini- 196 Senegal Parrots was reached only after substitut- cal signs including a high fever order tolterodine 4mg, severe headaches cheap tolterodine 2mg visa, ing their normal mixed food with medicated corn con- chills buy cheap tolterodine 2mg on line, shortness of breath and general debilitation. Control Chronic manifestations can be arteritis, cardiovascu- Persistent, probably life-long, infections require new lar insufficiencies and thrombophlebitis including in- ideas on control. Treatment with doxy- mulated and concentrate on clinically sick and sero- cycline is recommended for three weeks. Seronegative birds should not be increase in titer should not be expected to occur in treated. Imagen Chlamydia Test kit, Röhm Pharma, Darmstadt, Chlamydiosis is a reportable disease in the United Germany States because of its potential as a zoonotic agent. J Gen Mi- Chlamydia psittaciin Zellkulturen - breitung verschiedener Erkrankun- 44. Immunsystems auf die Abwehr einer Verwendbarkeit in der Chlamydiendi- truches (Struthio camelus) de parc 3. Gerbermann H, et al: Excretion of tion and isolation attempts for detect- cher, 1992, pp 282-283. European avian Chlamydia psittaci chlamyia and kinetics of the antibod- ing Chlamydia psittaciinfections of 39. Avian Dis 29:873- Nachweisverfahren fürChlamydia clonal antibodies in an microim- with doxycycline. In Gyl- hrungsstadium in Abstrichen, Organ ternat Symp World Assoc Vet Lab Di- 153. Gerbermann H, et al: Chlamydiose Verlag Eugen Ulmer Stuttgart, 1987, Giessen, 1989. Lindenstruth H: [Field study of budg- lated antigen from a coccoid bacte- und Alternative der Diagnose und 28. Gylstorff I, et al: Vergleichende Unter- ies and various parrots using Baytril rium. Prakt Tierärzt 72:521- suchungen zur Psittakose- for prevention and therapy after im- 39:117-126, 1956. Auflage, Georg Thieme Verlag, 1969, funde aus einer größeren Greifvogel- sprüfung verschiedener Arzneimittel 41. J vet med B 37:739-748, bei unterschiedlichen Applikations- caged pet bird improvement program. Zeh C: Behandlungsversuche bei and control of psittacosis in the Wschr 97:91-99, 1984. Like bacterial- and viral-induced dis- C H A P T E R F eases, the clinical features of a fungal infec- tion may be influenced by stress factors and the age and condition of the patient. Candidiasis is fre- quently associated with gastrointestinal problems in neonates. Aspergillosis continues to be an important respiratory disease in psittacine species, zoo species and raptors. Improved preventive techniques and 35 therapeutic regimes have enhanced the practitio- ner’s ability to deal with common fungal pathogens. However, many clinical reports detail the effects of less commonly diagnosed fungal pathogens about which relatively little is known. Current interest in avian pathology has resulted in the identification of disease conditions that were unrecognized in the past. Reducing stress, maintaining a healthy environ- ment, carefully limiting the use of antibiotics and reducing exposure to fungal organisms are important in preventing these diseases. How- ever, several reports also indicate that in some young birds, the proventriculus or ventriculus can be the Candidiasis primary site of yeast replication in the absence of crop lesions. The clinician should be ance produced by multiple tag-like plaques of mucosa reminded that this terminology is a summation of a 52 and inflammatory cells (Figure 35. Candida albicans is a common environmental organ- Candida lesions in the oral cavity are recognized by ism and may be a normal inhabitant of the avian the appearance of white plaques covered by a tena- digestive tract. Yeast infections in mals are thought to develop spontaneous primary ratites have been associated with extensive necrosis candidiasis possibly because of an immature immune of the upper beak. Neonatal cockatiels are thought to be Although less frequent, candida infections may also especially prone to primary candidiasis. Yeast infections affecting the cloaca and vent of turkeys and geese Pathogenesis and Incubation have been reported. Chronic or systemic infections may result in septate hyphae and repro- ductive chlamydospores that can be demonstrated by histologic examination.

Debilitated birds may benefit priate antimicrobials if bacterial or fungal infections from intravenous or intraosseous fluids and one dose are suspected cheap tolterodine 2 mg on-line. Parenteral admini- hexidine reduces local bacterial levels in cases of stration of a bacteriocidal antibiotic with a broad ingluvitis purchase tolterodine 1 mg with mastercard. Diarrhea in birds is clinically recognized by un- formed feces cheap tolterodine 4 mg line, often in association with an increase in Cloacal Prolapse the fluid portion of the dropping (see Color 8) generic tolterodine 2 mg without a prescription. Stools Prolapse of the cloacal mucosa is associated with may “normally” be loose from stress discount tolterodine 1mg with mastercard, excitement, masses within the cloaca, neurogenic problems or over-consumption of dairy products and ingestion of conditions causing tenesmus (eg, enteritis, cloacitis foods with a high water content (vegetables and or egg-binding). Pathologic diarrhea usually results from bac- terial, viral, fungal, chlamydial or parasitic gastroen- A prolapsed cloaca may not be immediately apparent teritis. Abdominal palpa- tient with diarrhea includes gram-negative enteritis, tion for a mass and checking for prolapse of the hep-atopathy, chlamydial infection and heavy metal ureters or uterus should be a priority during the toxicity. An Physical examination of the bird with diarrhea irregular, “raspberry-like” appearance of the mucosa should begin with careful evaluation of the hydration suggests cloacal papillomatosis (see Color 19). Melena may be noted with problems of the the bird relaxed under isoflurane anesthesia. It is important to treat any possible underlying cause of pro- lapse such as hypocalcemia or other nutritional or metabolic problems. Liver Disease As in mammals, liver disease is often difficult to diagnose and characterize in birds (see Chapter 20). Clinical signs of hepatitis are often nonspe- cific, including lethargy, inappe- tence, polyuria, polydipsia, diarrhea and ascites. The presence of yellow or green urates is an indicator of probable liver disease (see Color 8). On physical ble or, particularly in passerine examination, an accumulation of excrement was noted in the pericloacal area and on the birds, may be visible through the tail feathers. A tentative diagnosis of papillomatosis was made by identifying small, pink nodules on the cloacal mucosa (courtesy of Elizabeth Hillyer). The basic database for suspected hepatitis includes a complete blood ual massage of the caudal abdominal and cloacal count, serum biochemistry profile, bile acids, fecal regions promotes fecal evacuation. Parenteral fluid Gram’s stain, fecal culture, cytology of the abdominal therapy and treatment for septic shock should be fluid, whole body radiographs and chlamydial test- used in these cases. A complete examination of the cloacal area must be While laboratory tests are pending, treatment for performed. In larger birds, a vaginal speculum and suspected liver disease includes basic supportive strong light source permit examination deep into the care, broad-spectrum antibiotics, oral lactulose and cloacal region. Doxycy- fecal wet mount, Gram’s stain, culture and radio- cline is the drug of choice for chlamydiosis. If cloacal papillomatosis is suspected, tissue dazole, cephalosporins and the penicillins are the excision with biopsy is necessary to confirm the diag- antibacterials of choice for small mammal hepatic nosis. Investigations to determine the best anti- not require a purse-string suture preoperatively. Solitary tumors should Primary pancreatitis is seldom diagnosed in birds, be biopsied by excision if possible. The tissues should be flushed with Acute pancreatic necrosis in an Umbrella Cockatoo38 saline and covered with a sterile lubricating jelly or and pancreatic atrophy in a Blue and Gold Macaw40 ointment. The underlying cause was not depending on the individual bird and the clinician’s found in these two birds; however, it was speculated preferences. Retention sutures may complicate the that obesity and a high-fat diet contributed to disease prolapse by exacerbating straining and should be in the cockatoo. If a retention suture is placed, it must not interfere with evacuation of the Clinical signs of pancreatitis may include inappe- cloaca. Medullary bone forma- exocrine insufficiency results in polyphagia, weight tion, also termed hyperostosis or osteomyelos- loss and bulky, pale droppings (see Color 8). In cases of acute pancreatitis, a radiograph may demonstrate a hazy Occasionally, the presence of an egg with a non-calci- or fluid-filled abdomen. Initial treatment should in- fied shell may be difficult to distinguish radiographi- clude aggressive parenteral fluid therapy and broad- cally from egg-related peritonitis or an abdominal spectrum antibiotics. In this case, a repeat radiograph approxi- ticosteroid may be beneficial in some birds. Plant mately one hour after the administration of barium enzymes (rather than canine pancreatic enzymes) may aid in localizing internal structures. An alterna- can be added to the tube-feeding formula to help with tive is to administer supportive care, calcium, vita- digestion (see Chapter 18). Vitamin E and selenium mins and antibiotics, and then to repeat the radio- should also be given, and the bird tested for zinc graph one to two days later, assuming that an egg toxicosis. Uterine rupture is possible, and will negate this last assumption (see Chapter 41).

Fractures of the phalanges cheap 1mg tolterodine with visa, fractures of the ated with diarrhea 1 mg tolterodine fast delivery, or more frequently cheap tolterodine 4mg on-line, with tenes- distal metaphysis of the tarsometatarsus and luxa- mus due to constipation discount 2mg tolterodine fast delivery. Treatment of the prolapse is tions of the metatarsal-phalangeal or interpha- similar to methods used in other birds tolterodine 4mg for sale, but the initi- langeal joints can be stabilized with fiberglass casts, ating cause must be addressed to prevent recurrence to which most ratites readily adapt. Intussusception is caused by hyper- motility and gastrointestinal tract irritation and is Wing fractures in ostriches frequently occur secon- often the result of an abrupt dietary change, espe- dary to improper restraint. Overweight yearlings that are subjected to physical stress are most commonly affected. Degenerative Myopathy A large percentage of the young ostriches, rheas and emus submitted for necropsy have evidence of degen- erative myopathy, with the majority of affected birds being less than six months of age. In birds, several etiologies for degenerative myopathy have been re- ported, including capture myopathy, selenium or vi- tamin E deficiency, furazolidone and ionophore toxic- ity. White foci and streaks in the myocardium and muscles of the hind limbs and myo- cyte degeneration with infiltration of macrophages and early calcification may be noted in birds that die several days after transport. These compounds may be contributing in an emu with a valgus deformity of the tibiotarsal bone. Frac- tures of the leg are relatively easy to repair surgically, but are factors in the development of degenerative rarely successful long-term because of problems in managing these myopathy, and ratite producers should avoid the use large, fractious, bipedal patients (courtesy of Louise Bauck). The author prefers a closed reduction and In the southern United States, pastures may contain fixation technique. A small diameter pin may enter the shrubs or trees of coffee senna (Cassia occiden- the distal caudal surface of the humeral shaft and be talis or Cassia obtusifolia). In ruminants, ingestion advanced through the fracture site into the proximal of these beans may cause diarrhea, weakness, gait fragment. Alternatively, the pin may enter the proxi- abnormalities, recumbency and muscular lesions mal fragment at the fracture site, be advanced proxi- consistent with degenerative myopathy. The wing is then taped to the exposure to this toxic plant should be considered in body for a period of six weeks to provide rotational cases of acute myocyte degeneration. Some authors believe that capture myopathy, which Ruptured Aorta has been described in ratites with some frequency, is simply the acute manifestation of a chronic subclini- Ostriches are prone to spontaneous rupture of the cal deficiency of selenium or vitamin E. These are most often located at tive myopathy appears to be primarily a disease of the aortic arch, but ruptures in the caudal aorta have young ratites and higher levels of vitamin E may be also been described. Normal liver selenium levels are not available for Lymphoma was diagnosed in a three-year-old female ratites but levels below 0. Ultrasonogra- of ratite neonates with clinical or histologic lesions phy of the abdomen revealed an enlarged oviduct and suggestive of degenerative myopathy. Abnormal clinical pathology results included a marked leukocytosis Additional investigations to determine the normal (160,000), lymphocytosis (95%), hyperproteinemia serum and organ levels of selenium and vitamin E (6. The transmission of viruses from paddock to and is generally effective in early cases. One author paddock or from farm to farm should be prevented has suggested the parenteral administration of 3. Optimum nutrition, environ- weight at two days of age, then weekly thereafter for 43 mental conditions and reduced stress will ensure a total of three injections. The latter has a low thera- Newcastle disease was the only disease of viral etiol- peutic index and can readily reach a toxic level. Recent chick with clinical signs suggestive of degenerative international interest in ostrich production, particu- myopathy that was treated with this regime died larly in the United States and Israel, has prompted despite therapy and had histologic lesions suggestive further viral investigations. Liver selenium levels in this bird been detected in ratites by virus isolation or electron were 3. The toxic liver selenium level in 46 microscopy, but the clinical relevance of most of these poultry is considered 4. Newcastle disease virus, coro- A safer treatment regimen may be to use injectable navirus, reovirus, influenzavirus and togavirus have been associated with specific diseases. Lesions included dilation of the flora for ratites has not been established, the birds proventriculus, nutritional osteodystrophy and de- are terrestrial; thus, ample gram-negative bacteria generative myopathy. Avian influenza was associated with high levels of Co m mo n p a th o ge n s in clu de Pseudomonas, mortality among ostriches in South Africa. Clinical Klebsiella, Proteus, Salmonella and Campylobacter signs in affected birds included respiratory signs, spp. Although ostriches up to 14 months of age and is frequently misrepresented as the cause of have been shown to be affected, morbidity is greatest mortality in ostrich chicks (Color 48. Mortality may enteritis is a common disorder in ratites of all ages reach 80% in hatchlings and is complicated by secon- and is often associated with the excessive consump- dary bacterial and nutritional problems. Botulism, clini- teristic postmortem findings include fibrinous air cally characterized by paralysis and death, has his- sacculitis, mucoid sinusitis, multifocal hepatic ne- torically been a significant industry problem in adult crosis, splenomegaly and nephritis. Fowlpox infections are well documented in os- Tuberculosis is a common finding in adult ostriches. Morbidity been described in three- to six-week-old birds pre- may be high but mortality is low. A commercial sented with acute weight loss, lethargy and bilater- fowlpox vaccine administered at 10 to 14 days of age ally symmetrical distal limb edema.