Subgingival microbiota of dogs with healthy gingiva or early periodontal disease from different geographical locations.

BACKGROUND: Periodontal disease is the most common oral disease of dogs worldwide and results from a complex interplay between plaque bacteria, the host and environmental factors. Recent studies have enhanced our understanding of the associations between the plaque microbiota and canine periodontal disease. These studies, however, were limited in their geographical reach. Thus associations between the canine oral microbiota and geographical location were investigated by determining the composition of subgingival plaque samples from 587 dogs residing in the United Kingdom (UK), United States of America (USA), China and Thailand using 454-pyrosequencing. RESULTS: After quality filtering 6,944,757 sequence reads were obtained and clustering of these at ≥98% sequence resulted in 280 operational taxonomic units (OTUs) following exclusion of rare OTUs (present at < 0.05% in all four countries). The subgingival plaque from dog populations located in the UK, USA, China and Thailand had a similar composition although the abundance of certain taxa varied significantly among geographical locations. Exploration of the effect of clinical status and age revealed a marked similarity among the bacteria associated with increased age and those associated with gingivitis: Young dogs and those with no gingivitis were dominated by taxa from the phyla Bacteroidetes and Proteobacteria whereas older dogs and those with moderate gingivitis were dominated by members of the Firmicutes. The plaque microbiota of small breed dogs was found to significantly differ to medium and large breeds and was dominated by species belonging to the Firmicutes. CONCLUSIONS: The bacterial associations with health, gingivitis and periodontitis were conserved across dogs from the UK, USA, China and Thailand. These bacterial signatures of periodontal health and disease have potential as biomarkers for disease detection.

Fascial layers influence the spread of injectate during ultrasound-guided infraclavicular brachial plexus block: a cadaver study.

BACKGROUND: Fascial layers of the neurovascular sheath containing the brachial plexus influence distribution of local anaesthetic, hence increasing the risk of block failure when performing infraclavicular brachial plexus block (ICB). METHODS: Ultrasound-guided infraclavicular brachial plexus block was performed on cadavers using a single injection technique with dye (20-30 ml). After injection, we carried out consecutive dissection of the neurovascular bundle to study dye injectate spread and identify the presence of fascial layers. Ultrasound video images (scout scan and injection) and recordings of dissections were evaluated by independent experts (regional anaesthetists and anatomists). RESULTS: Well defined fascial layers were identified at dissection in seven out of 12 infraclavicular spaces studied. These fascial layers impeded the spread of dye injectate substantially in six cases and partially in one case. No fascial layers were identified at dissection in five cases, in each of which the spread of injectate was complete throughout the neurovascular bundle. The sensitivity and specificity of ultrasonography and haptic sensation for detection of fascial layers were poor. CONCLUSIONS: When fascial layers are present in the neurovascular sheath, they impede the spread of injectate during infraclavicular brachial plexus block. Ultrasound detection of these fascial layers is unreliable in cadavers. These findings support the use of greater volumes of injectate or a multiple injection technique when performing this block.

Effectiveness of CHA2DS2-VASc based decision support on stroke prevention in atrial fibrillation: A cluster randomised trial in general practice.

BACKGROUND: Guidelines on atrial fibrillation (AF) recommend the CHA2DS2-VASc rule for anticoagulant decision-making, but underuse exists. We studied the impact of an automated decision support on stroke prevention in patients with AF in a cluster randomised trial in general practice. METHODS: Intervention practices were provided with a CHA2DS2-VASc based anticoagulant treatment recommendation. Reference practices provided care as usual. The primary outcome was incidence of ischaemic stroke, transient ischaemic attack (TIA) and/or thromboembolism (TE). Secondary outcomes were bleeding and the proportion of patients on guideline recommended anticoagulant treatment. RESULTS: In total, 1129 AF patients were included in the 19 intervention practices and 1226 AF patients in the 19 reference practices. The median age was 77 (interquartile range (IQR) 68-75) years, the median CHA2DS2-VASc score was 3.0 (IQR 2.0-5.0). Underuse of anticoagulants in patients with CHA2DS2-VASc score ≥ 2 was 6.6%. After a median follow-up of 2.7 years (IQR 2.3-3.0), the incidence rate per 100 person-years of ischaemic stroke/TIA/TE was 1.96 in the intervention group and 1.42 in the reference group (hazard ratio (HR) 1.3, 95% C.I. 0.8-2.1). No difference was observed in the rate of bleeding (0.79 versus 0.82), or in the underuse (7.2% versus 8.2%) or overuse (8.0% versus 7.9%) of anticoagulation. CONCLUSIONS: In this study in patients with AF in general practice, underuse of anticoagulants was relatively low. Providing practitioners with CHA2DS2-VASc based decision support did not result in a reduction in stroke incidence, affect bleeding risk or anticoagulant over- or underuse.

The application of high-pressure treatment in the reduction of phosphate levels in breakfast sausages.

This study investigated effects of high pressure (HP) treatment of pork meat at 150 or 300 MPa for 5 min before manufacturing sausages on the reduction of phosphate levels and compared to sausages manufactured with untreated pork meat (control sausages). Improvement in perceived saltiness, juiciness and overall flavour was observed in sausages manufactured using HP-treated meat at 150 MPa and 0% phosphate, compared to control sausages. Sausages manufactured using meat HP-treated at 150 MPa and 0.25% phosphate (P<0.05) improved hardness of sausages. HP-treated meat at 300 MPa and 0% phosphate decreased juiciness and adhesiveness, while at 0.25% phosphate, adversely affected emulsion stability and sensory attributes. HP treatment did not affect significantly the lightness of the sausages; however, elimination of phosphate reduced (P<0.05) the yellowness, while HP treatment at 150 MPa with 0.25 or 0.5% phosphate increased (P<0.05) redness. HP reatment at 150 MPa has potential for reducing phosphate levels in sausages without significant changes in their functionality and improved acceptability.

Impact of pig slurry amendments on phosphorus, suspended sediment and metal losses in laboratory runoff boxes under simulated rainfall.

Losses of phosphorus (P) when pig slurry applications to land are followed by a rainfall event or losses from soils with high P contents can contribute to eutrophication of receiving waters. The addition of amendments to pig slurry spread on high P Index soils may reduce P and suspended sediment (SS) losses. This hypothesis was tested at laboratory-scale using runoff boxes under simulated rainfall conditions. Intact grassed soil samples, 100 cm-long, 22.5 cm-wide and 5 cm-deep, were placed in runoff boxes and pig slurry or amended pig slurry was applied to the soil surface. The amendments examined were: (1) commercial grade liquid alum (8% Al(2)O(3)) applied at a rate of 0.88:1 [Al:total phosphorus (TP)] (2) commercial-grade liquid ferric chloride (38% FeCl(3)) applied at a rate of 0.89:1 [Fe:TP] and (3) commercial-grade liquid poly-aluminium chloride (PAC) (10% Al(2)O(3)) applied at a rate of 0.72:1 [Al:TP]. The grassed soil was then subjected to three rainfall events (10.3 ± 0.15 mm h(-1)) at time intervals of 48, 72, and 96 h following slurry application. Each sod received rainfall on 3 occasions. Results across three rainfall events showed that for the control treatment, the average flow weighted mean concentration (FWMC) of TP was 0.61 mg L(-1), of which 31% was particulate phosphorus (PP), and the average FWMC of SS was 38.1 mg L(-1). For the slurry treatment, there was an average FWMC of 2.2 mg TP L(-1), 47% of which was PP, and the average FWMC of SS was 71.5 mg L(-1). Ranked in order of effectiveness from best to worst, PAC reduced the average FWMC of TP to 0.64 mg L(-1) (42% PP), FeCl(3) reduced TP to 0.91 mg L(-1) (52% PP) and alum reduced TP to 1.08 mg L(-1) (56% PP). The amendments were in the same order when ranked for effectiveness at reducing SS: PAC (74%), FeCl(3) (66%) and alum (39%). Total phosphorus levels in runoff plots receiving amended slurry remained above those from soil only, indicating that, although incidental losses could be mitigated by chemical amendment, chronic losses from the high P index soil in the current study could not be reduced.

The performance of constructed wetlands treating primary, secondary and dairy soiled water in Ireland (a review).

In Ireland, no database detailing the design, influent loading rates or performance of constructed wetlands (CWs) exists. On account of this, they are designed without any protocol based on empirical data. The aim of this paper was to provide the first published data on the performance of free-water surface flow (FWSF) CWs treating primary and secondary-treated municipal wastewater, and agricultural dairy soiled water (DSW) in Ireland. In total, the performance of thirty-four FWSF CWs, comprising fourteen CWs treating primary-treated municipal wastewater, thirteen CWs treating secondary-treated municipal wastewater, and seven CWs treating DSW, were examined. In most CWs, good organic, suspended solids (SS) and nutrient removal was measured. At an average organic loading rate (OLR) of 10 and 9 g biochemical oxygen demand (BOD) m(-2) d(-1), CWs treating primary and secondary wastewater removed 95 and 84% of influent BOD. Constructed wetlands treating DSW had an average BOD removal of 98%. At average SS loading rates of 6 and 14 g m(-2) d(-1), CWs treating primary and secondary wastewater had a 96 and an 82% reduction, and produced a final effluent with a concentration of 14 and 13 mg L(-1). Constructed wetlands treating DSW produced a final effluent of 34 mg L(-1) (94% reduction). Similar to other studies, all CWs examined had variable performance in ammonium-N (NH(4)(+)-N) removal, with average removals varying between 37% (for CWs treating secondary wastewater) and 88% (for CWs treating DSW). Variable ortho-phosphorus (PO(4)(3-)-P) removal was attributable to different durations of operation, media types and loading rates.

Causes of morbilliform rash in a highly immunised English population.

AIMS: To determine the causes of morbilliform rash and fever in a population with high vaccination coverage for measles and rubella. METHODS: Comprehensive laboratory investigation additional to routine oral fluid testing of children presenting to primary care physicians in East Anglia, England. RESULTS: Laboratory confirmation of infection was obtained in 93 (48%) of 195 children: parvovirus B19 in 34 (17%); group A streptococcus in 30 (15%); human herpesvirus type 6 in 11 (6%); enterovirus in nine (5%); adenovirus in seven (4%); and group C streptococcus in six (3%) (four individuals tested positive for two agents). None had measles or rubella. CONCLUSIONS: Oral fluid testing to cover infections additional to measles and rubella aids clinical management and is likely to maintain uptake of testing, which is essential for measles and rubella surveillance in highly immunised low incidence populations.