Quantitative analysis of production traits in saltwater crocodiles (Crocodylus porosus): III. juvenile survival.

Mortality records of 1302 juvenile crocodiles were available for analysis. Crocodiles that were slaughtered during this study were treated as censored (n = 2151). Additionally, records from animals that had neither died nor been slaughtered, i.e. were still alive in the production system (n = 1582), were censored at the last date of data collection. There were a total of 3733 censored records. The data were all full-sib records from 29 parental pairs from Janamba Croc Farm (Northern Territory, Australia), collected over nine consecutive years. Data were analysed using an extension of Cox's proportional hazards model to include frailty (random) terms to account for genetic effects. Heritability of log survival time for juvenile crocodile survival was 0.15 (SE 0.04). The probability of a juvenile crocodile surviving to day 400 was estimated to be only 51%. These results are the first to quantify juvenile survival in a captive breeding situation. Also, this is the first heritability estimate of crocodile survival and is a fundamental element in the development of a genetic improvement programme.

Quantitative analysis of production traits in saltwater crocodiles (Crocodylus porosus): IV. number of scale rows.

A total of 3156 scale row records, comprising 1739 full-sibling records from 30 families from Janamba Croc Farm (NT, Australia) and 1417 parent-offspring records from 19 families from Wildlife Management International, Pty Ltd (NT, Australia), collected at each facility using a different method, were analysed using ASReml. The full-sibling heritability estimate for the Janamba data was 0.37 (SE 0.03). The animal model estimate of heritability for the Wildlife Management International (WMI) data, also based predominantly on full-sibling data, was 0.42 (SE 0.04). The counts from three counting methods were evaluated by regression analysis on 100 individuals and were found to be highly correlated. Using the regression relationship, the WMI data were transformed and pooled with the Janamba data to give an animal model heritability estimate of 0.42 (SE 0.04). A multitrait analysis revealed negligible correlations (both phenotypical and genetical) between hatchling size traits and the number of scale rows. There is ample genetic variation to incorporate this trait into a genetic improvement programme for farmed saltwater crocodiles.

Quantitative analysis of production traits in saltwater crocodiles (Crocodylus porosus): II. age at slaughter.

Crocodile morphometric (head, snout-vent and total length) measurements were recorded at three stages during the production chain: hatching, inventory [average age (+/-SE) is 265.1 +/- 0.4 days] and slaughter (average age is 1037.8 +/- 0.4 days). Crocodile skins are used for the manufacture of exclusive leather products, with the most common-sized skin sold having 35-45 cm in belly width. One of the breeding objectives for inclusion into a multitrait genetic improvement programme for saltwater crocodiles is the time taken for a juvenile to reach this size or age at slaughter. A multivariate restricted maximum likelihood analysis provided (co)variance components for estimating the first published genetic parameter estimates for these traits. Heritability (+/-SE) estimates for the traits hatchling snout-vent length, inventory head length and age at slaughter were 0.60 (0.15), 0.59 (0.12) and 0.40 (0.10) respectively. There were strong negative genetic (-0.81 +/- 0.08) and phenotypic (-0.82 +/- 0.02) correlations between age at slaughter and inventory head length.

Quantitative analysis of production traits in saltwater crocodiles (Crocodylus porosus): I. reproduction traits.

Repeatability and phenotypic correlations were estimated for saltwater crocodile reproductive traits. No pedigree information was available to estimate heritability or genetic correlations, because the majority of breeder animals on farms were wild-caught. Moreover, as the age of the female breeders could not be accounted for, egg-size measurements were used as proxies. The reproductive traits investigated were clutch size (total number of eggs laid), number of viable eggs, number of eggs that produced a live, healthy hatchling, hatchability, average snout-vent length of the hatchlings and time of nesting. A second data set was also created comprising binary data of whether or not the female nested. Repeatability estimates ranged from 0.24 to 0.68 for the measurable traits, with phenotypic correlations ranging from -0.15 to 0.86. Repeatability for whether a female nested or not was 0.58 on the underlying scale. Correlations could not be estimated between the measurement and binary traits because of confounding. These estimates are the first published for crocodilian reproduction traits.

Analysis of microsatellites and parentage testing in saltwater crocodiles.

Fifteen microsatellite loci were evaluated in farmed saltwater crocodiles for use in parentage testing. One marker (C391) could not be amplied. For the remaining 14, the number of alleles per locus ranged from two to 16, and the observed heterozygosities ranged from 0.219 to 0.875. The cumulative exclusion probability for all 14 loci was .9988. the 11 loci that showed the greatest level of polymorphism were used for parentage testing, with an exclusion probability of .9980. With these 11 markers on 107 juveniles from 16 known breeding pairs, a 5.6% pedigree error rate was detected. This level of pedigree error, if consistent, could have an impact on the accuracy of gentic parameter and breeding value estimation. The usefulness of these markers was also evaluated for assigning parentage in situations where maternity, paternity, or both may not be known. In these situations, a 2% error in parentage assignment was predicted. It is therefore recommended that more micro-satellite markers be used in these situations. The use of these microsatellite markers will broaden the scope of a breeding program, allowing progeny to be tested from adults maintained in large breeding lagoons for selection as future breeding animals.

Primary varicose veins: altered transcription of VEGF and its receptors (KDR, flt-1, soluble flt-1) with sapheno-femoral junction incompetence.

OBJECTIVE: Loss of regulation of vascular endothelial growth factor (VEGF) production and action disturbs vascular homeostasis leading to pathology. Primary varicose veins (VVs) demonstrate aberrant production/release of VEGF. Our aim was to examine transcription of genes for VEGF (VEGF(121)/VEGF(165)) and its receptors (KDR, flt-1, s.flt-1) in VVs, in relation to underlying venous incompetence. MATERIALS AND METHODS: Samples of varicose (n=83, 18 patients) or normal (n=14, five subjects) great saphenous vein were divided into segments, determined by anatomical position from the sapheno-femoral junction (SFJ). SFJ and segmental incompetence were determined from duplex scans. Gene transcripts were amplified by RT-PCR, analysed by scanning densitometry, and the levels of transcription determined by ratio to control gene GADPH-3 (GAP-3). RESULTS: VEGF(121)/(165), KDR and flt-1 transcription was elevated in VVs overall (p<0.001), and in VVs with an incompetent SFJ (p<0.001), but not when the SFJ was functional; s.flt-1 was unaltered. Notably, gene transcription was unaffected by segmental position, or incompetence. Position below the SFJ correlated with increased transcription of s.flt-1 when the SFJ was incompetent (p<0.04), and s.flt-1 and VEGF(121) when the segment was incompetent (p<0.03). CONCLUSIONS: SFJ incompetence is associated with altered transcription of VEGF and its receptors reflecting an aetiological mechanism or later stage of disease development. Altered VEGF(121) and s.flt-1 transcription may be an early event in varicogenesis.

Integrated care pathways for vascular surgery: an analysis of the first 18 months.

OBJECTIVES: A review of the use of previously described integrated care pathways (ICPs) established for three elective vascular surgical procedures. DESIGN: A retrospective analysis of information gathered prospectively over an initial 18 month period of use of vascular surgical ICPs. SUBJECT: Patients admitted to a single vascular unit for "open" repair of abdominal aortic aneurysm (AAA), carotid endarterectomy, or femoropopliteal bypass grafting. METHODS: An analysis of variance data, length of stay, and costings after the use of ICPs, compared with previous clinical practice. RESULTS: Variance data were gathered for each of the three procedures. Variances of medication prescribing and delays in discharge were common to all procedures. In particular: (i) gastrointestinal complications were more specific to AAA repair and (ii) wound drains were removed a day later than originally proposed after femoropopliteal bypass. Overall, improved efficiency due to use of ICPs reduced the length of stay for all procedures, which was reflected in a potential cost saving of some 25%. CONCLUSION: There are clear benefits to the use of ICPs, resulting in more structured, efficient, and cost effective patient care. Recommended changes to current practice based on variance analysis will require continued audit to sustain this "evidence based" approach.

"Long haul" flight and deep vein thrombosis: a model to help investigate the benefit of aspirin and below-knee compression stockings.

OBJECTIVE: to develop a model simulating factors of "long haul" flight to investigate the relationship with DVT. MATERIALS AND METHODS: volunteers (19 males: 20 females) sat for 6 h in a warm (>25 degrees C), dry environment, limited in movement, consuming alcohol (40 ml of 40% alcohol/hour) and salted foods (300 g). Half of the subjects received 150 mg aspirin and wore especially designed below-knee, compression stockings (Class 1 profile). Changes in full blood counts were recorded, and as an indication of DVT formation, plasma was analysed for D-dimer. Limb swelling was assessed from leg measurements. RESULTS: after 6 h, in controls, there were significant rises in platelet packing (Pct p<0.04), total platelet numbers (p<0.003) and total numbers of white blood cells (WBC's p<0.001). With aspirin plus stockings, there were similar significant rises in total platelet numbers (p<0.002) and total WBC's (p<0.001). In both groups, significant rises were seen in all WBC types (except basophils). Wearing compression stockings prevented calf swelling seen in controls after 6 h (p<0.002). No subject developed a DVT, or a change in levels of D-dimer. CONCLUSION: changes in the cellular components of blood, particularly WBC's, combined with vaso-compression and reduced flow could predispose towards DVT. Aspirin, combined with compression stockings, may provide prophylaxis.

Varicose veins: loss of release of vascular endothelial growth factor and reduced plasma nitric oxide.

OBJECTIVES: To examine the release of vascular endothelial growth factor (VEGF) and nitric oxide (NO) in primary varicose veins (VVs) and normal vein controls following experimentally-induced venous stasis. DESIGN, MATERIALS AND METHODS: Patients with primary VVs (n=21) and control subjects (n=11) were rested supine for 15 min. Blood was collected from both an arm and foot vein. A below-knee cuff was applied and inflated to 90-95 mmHg for 10 min (to prompt venous stasis). Further blood samples were collected from the foot vein. Levels of plasma VEGF and NO were analysed. RESULTS: In control subjects, application of the cuff increased levels of plasma VEGF in the foot (p<0.025). In contrast, in patients with VVs, there was little or no change in these levels of plasma VEGF. Cuff application had little effect on levels of plasma NO in either controls, or those with VVs. When compared to controls however, the levels of plasma NO in all samples with VVs (arm, or foot before, or after, cuff application) were reduced (all, p<0.05). CONCLUSIONS: Loss of VEGF release with experimentally-induced venous stasis, and reduced levels of plasma NO may suggest a mechanism important in the development of primary VVs.

Delivery of low molecular weight heparin for prophylaxis against deep vein thrombosis using a novel, needle-less injection device (J-Tip).

Given daily, low molecular weight (LMW) heparins are established for prophylaxis against deep vein thrombosis (DVT). We describe delivery by a novel, needle-less device that is virtually painless in action. Its use could provide benefits for patients in terms of comfort both psychologically and physically, and for healthcare workers in terms of safety from needle-stick injury. Patients undergoing elective surgery received LMW heparin delivered subcutaneously by either a standard needle and syringe or by the needle-less injection device, J-Tip. Pain was scored at the time of injection and plasma anti-factor Xa levels compared between the two methods of drug delivery 4 h later: 29 patients received LMW heparin delivered by the J-Tip and 31 patients by standard needle and syringe. The J-Tip was significantly more comfortable for the patient as the method of drug delivery (P < 0.001). When delivered by the J-Tip, LMW heparin was equally as efficacious, as plasma anti-factor Xa levels were similar for both methods of delivery (P < 0.42). In summary, delivery of LMW heparin by the J-Tip device was both comfortable and effective. These findings, taken in conjunction with its ease of use and complete freedom from risk of needle-stick injury might encourage further examination and use of this type of product.

Evaluation of a needle-free injection system for local anaesthesia prior to venous cannulation.

We evaluated a single-use, disposable, carbon-dioxide-powered, needleless injector (J-Tip, National Medical Products Inc., CA, USA), which is claimed to deliver a virtually painless, subcutaneous injection. Seventy-two patients undergoing various types of surgery had a large-bore intravenous cannula inserted prior to induction of general anaesthesia. Three minutes beforehand, a subcutaneous injection of 0.3 ml of 1% plain lidocaine was administered. Subjects were randomly allocated to receive the lidocaine either by the needleless injector or from a conventional syringe and a 25 G needle. Pain scores were recorded on injection of the lidocaine and on insertion of the cannula. There was significantly less pain on injection with the needleless injector than with the 25 G needle (p < 0.001) but, surprisingly, there was more pain on cannulation (p < 0. 001). We conclude that the device certainly delivers a less painful subcutaneous injection than a 25 G needle, but perhaps provides less effective skin anaesthesia for venous cannulation at sites where the subcutaneous space is small; its use might be better suited to areas where the subcutaneous space is deeper.

Integrated care pathways for vascular surgery.

OBJECTIVES: a trial of the use of integrated care pathways (ICPs) for elective vascular surgical procedures. DESIGN: a 12-month prospective study, following a multi-disciplinary group construction of current "best practice" ICPs, with changes in practice only occurring following careful audit of results. MATERIALS: patients admitted to a single vascular unit for "open" repair of abdominal aortic aneurysm, carotid endarterectomy or femoropopliteal bypass grafting. METHODS: patients followed ICPs on a daily basis with signatures required to confirm that action had been taken and careful recording of variances from the ICPs. Audit of variance data allowed changes in the ICPs and, hence, provision of the best possible nursing and clinical practice. RESULTS: ICPs were well received by patients and staff. They improved communication, promoted an appreciation of each health group's role in patient care, increased nursing autonomy, reduced calls to junior medical staff, improved patient education and confidence and caused a marked reduction in hospital "length of stay". CONCLUSIONS: ICPs have clear benefits. This study realises that benefits might be maximal for high throughput, high-cost procedures. Successful use of ICPs depends upon "clinical champions" and effective project management. Sufficient resource and training are essential.

Sporting 'groin strains': not always muscular!

A gluteal artery pseudoaneurysm presenting as a 'groin strain' following minor trauma is reported. Diagnosis was made by CT scan and arteriography. Treatment was with superselective catheterization and microcoil embolization.