Subclinical effects and fenbendazole treatment of turkey ascaridiasis under simulated field conditions.

Under simulated natural conditions of bird production and parasite challenge, the effects of ascaridiasis and the effectiveness of fenbendazole treatment (6-day regimes in the feed at 16 ppm) were documented. Birds were artificially challenged with ascarid larvae on a daily basis from day 35 to 112, with bird grow out ending on day 119. Experimental groups, on a per pen basis, were infected control, treated with fenbendazole at days 63-69, treated with fenbendazole at days 63-69 and days 91-97, and uninfected control. In the same order as above, and on an experimental group mean bird basis, final weights were 13.34, 13.47, 13.59, and 13.78 kg, average daily gains from day 7 to day 119 were 117.8, 118.9, 120.1, and 121.8 g, and units gained per unit of feed consumed from day 7 to day 119 were 0.337, 0.341, 0.347, and 0.362. Infected control bird mean Ascaridia dissimilis burdens, with all stages combined, ranged from 351.1 on day 63 to 117.2 on day 91, levels seen commonly with naturally infected commercial turkeys. Trial data dearly indicated that moderate A. dissimilis burdens negatively impacted animal performance (average daily gains and feed efficiencies) and that these parasite burdens are effectively removed by fenbendazole treatment.

Cyathostome fecal egg count trends in horses treated with moxidectin, ivermectin or fenbendazole.

Commercial preparations of fenbendazole (Safe-Guard, Intervet), ivermectin (Eqvalan, Merial) or moxidectin (Quest, Fort Dodge) were administered once to horses scheduled for routine parasiticide treatment. In total, 93 horses from six cooperating farms were used in the study. Computer generated, random allocation of horses to treatment group was conducted at each farm. Fecal egg counts were determined for all horses on trial days 0, 56, 84 and 112, with corresponding calendar dates that were unique to each farm. Only strongyle egg counts from animals which were positive at day 0 were used for analysis of variance and comparisons. Counts for the three treatment groups were similar at day 0, moxidectin

Somatostatin receptor scintigraphy: the definitive technique for characterizing vasoactive intestinal peptide-secreting tumors.

Vasoactive intestinal peptide-secreting tumors (VIPomas) are extremely rare and difficult to diagnose. The authors describe a patient who was found to have a VIPoma after 3 years of symptoms. Somatostatin receptor scintigraphy using indium-labeled octreotide localized her tumor and prompted a surgical resection. This is the preferred imaging study for the earliest, most accurate, and cost-effective identification of VIPomas and their metastases.

Blood loss estimation by out-of-hospital emergency care providers.

OBJECTIVES: To evaluate emergency medical technicians' (EMTs') ability to estimate spilled blood volume and to determine whether limited training improves estimate accuracy and whether there is a difference in improvement comparing two different training methods. METHODS: The study design was a single-blinded, clinical model, utilizing EMTs (basic, intermediate, and advanced) from a local commercial ambulance service. Participants estimated the volume of randomly selected volumes of packed red blood cells reconstituted to a normal hematocrit and poured onto three absorbent (carpet) and three nonabsorbent (vinyl) surfaces. Participants were then randomly assigned to one of two teaching groups. The SITEGRP (n = 17) returned to the six testing sites and were told the actual blood volumes. The SLIDE-GRP (n = 16) were taught with slides of six similar blood spill sites. Both groups were provided with suggestions for making volume estimates. The same participants were then retested one month later using the same type of sites and six new blood volumes. RESULTS: Thirty-three participants with an average of 7.5 years of prehospital care experience completed testing on both dates. Mean percent error {[(estimated volume - actual volume)/actual volume] x 100} for all participants decreased from 65%+/-33% initially to 52%+/-20% after retesting (p < 0.05). Mean percent error was 74%+/-41% and 59%+/-20% for the SITEGRP (p < 0.15) initially and after retesting, respectively. Mean percent error was 56%+/-17% and 45%+/-17% for the SLIDEGRP (p < 0.05) initially and after retesting, respectively. CONCLUSION: Prehospital care providers are not accurate at estimating spilled blood volumes. This ability can be improved with limited education. Slides appear to be as effective as viewing actual spill sites.

Correlation between urea reduction rates and serum albumin levels in patients on hemodialysis.

Monthly urea reduction rates and serum albumin levels were measured in 12 dialysis patients during a year when standard hemodialysis was replaced by high efficiency hemodialysis without changing treatment duration. Initially, mean urea reduction rates were 57-58% and mean serum albumin levels were 3.6-3.7 g/dl. Introduction of high efficiency hemodialysis gradually increased mean urea reduction rates to 68-70% (an increase in dialysis delivery of 40%). There was a parallel increase in mean albumin levels by 0.5 g/dl to 4.1-4.2 g/dl two months after the rise in urea reduction rate. Increased insulin administration was necessary to compensate for probable increased caloric intake in diabetic patients. Hemodialysis patients achieve improvement in nutritional status after dialysis delivery is increased using high efficiency hemodialysis without decreasing treatment duration.

Mechanical properties of a light-polymerizing provisional restorative material with and without reinforcement fibers.

Interim restorations are vulnerable to inadvertent fracture during mastication. Autopolymerizing acrylic resins have traditionally been selected for fabrication of provisional restorations. Triad light-polymerizing tooth-colored acrylic resin was recently introduced as an alternative material for this procedure. This material does not contain methyl methacrylate monomer and permits an increased working time. Heavy occlusal forces may initiate cracks within these restorations, and propagation of these cracks may ultimately lead to failure. Various forms of reinforcement fibers are available and are marketed for strengthening dental resins used for provisional restorations. Investigators have demonstrated that the mechanical properties of acrylic resins may be improved with the incorporation of reinforcing fibers, but a published evaluation of fiber-reinforced light-polymerizing provisional restorative materials is lacking. This investigation recorded and compared two mechanical properties of one light-polymerizing provisional restorative material with and without incorporation of vertically and horizontally oriented woven, matted, polyethylene fibers. No significant difference in modulus of rupture was recorded between groups with and without fibers. The mean flexural elastic modulus of the group with the horizontally oriented fibers was significantly greater than the mean flexural elastic modulus of the specimens without incorporated fibers.

Methemoglobinemia and hemolytic anemia after phenazopyridine hydrochloride (Pyridium) administration in end-stage renal disease.

Phenazopyridine is a commonly used urinary tract analgesic. As illustrated by the case we have reported, its use may be complicated by the development of methemoglobinemia and hemolytic anemia, especially in patients with renal insufficiency.

Atrial natriuretic peptide (ANP) is removed by peritoneal dialysis in humans.

Atrial natriuretic peptide (ANP) is a hormone liberated from the heart during atrial stretch (volume overload). In order to determine if ANP levels are altered in patients on continuous ambulatory peritoneal dialysis (CAPD) or affected by the dialysis procedure itself, we measured plasma ANP in patients before and after peritoneal infusion of two liters of 1.5% Dianeal dialysate and in dialysate subsequently drained from these patients. Plasma ANP is elevated in CAPD patients, but is not affected by infusion of dialysate. ANP is cleared from plasma by peritoneal dialysis.

Right atrial thrombus formation following central venous dialysis catheter placement.

Silicone rubber central venous dialysis catheters are used to provide vascular access in acute renal failure patients and in chronic dialysis patients in whom conventional vascular access cannot be achieved or maintained. The use of these catheters is not without hazard. The first reported case of right atrial thrombus formation associated with the use of a double lumen silicone rubber central hemodialysis catheter is described. This patient's course points out another potential complication of this type of vascular access and emphasizes the importance of removing such catheters in a timely fashion when they are no longer required for dialysis.

Severe hyponatremia without severe hypoosmolality following transurethral resection of the prostate (TURP) in end-stage renal disease.

A 55-year-old man on chronic hemodialysis underwent a transurethral resection of the prostate (TURP), during which 3% sorbitol solution was used for urethral irrigation. Following the procedure, he developed symptomatic hyponatremia (serum sodium, 106 mEq/L), but had only mild hypoosmolality (serum osmolality, 269 mosm/kg). The "osmolal gap" was 47 mosm/kg, probably from sorbitol absorbed systemically during the TURP. Hemodialysis raised the serum sodium to 118 mEq/L, and the serum osmolality to 284 mosm/kg, while lowering the osmolal gap to 26 mosm/kg. The presence of severe hyponatremia with only modest hypoosmolality may occur in patients with renal failure following the systemic absorption of hypotonic fluids containing solutes such as sorbitol and mannitol. Hemodialysis offers the advantages of correcting the hyponatremia while removing the unmeasured solute, thus preventing rapid increases in the serum osmolality.

Hepatic infarction in ulcerative colitis during pregnancy.

Acute hepatic failure developed at the time of parturition in a 27-yr-old woman. Liver biopsy demonstrated disseminated hepatic infarctions which were confined to the distal segments of the hepatic microcirculatory units. This episode of hepatic infarction was followed by persistent fever and cutaneous vasculitis, which resolved on prednisone therapy. The diagnosis of ulcerative colitis was made 5 mo after recovery from severe hepatic failure.