High-Dose Celecoxib for Pain After Pediatric Tonsillectomy: A Randomized Controlled Trial.

OBJECTIVE: Pediatric tonsillectomy causes significant postoperative pain. Newer nonsteroidal anti-inflammatory drugs such as celecoxib control pain without increasing bleeding risk, but in prior studies provided only modest pain reduction at standard doses. We aimed to determine if high-dose celecoxib (double the usual pediatric dose) is effective for pain, without increasing bleeding or other risks. STUDY DESIGN: Randomized double-blind trial. SETTING: Pediatric tertiary center. METHODS: Children aged 3 to 11 years undergoing total tonsillectomy were randomized to receive celecoxib (6 mg/kg/dose) or placebo, twice daily, for up to 10 days. All cases were supplemented with acetaminophen and oxycodone as needed. All participants and personnel were blinded to treatment group. Subjects recorded coanalgesic consumption, pain, diet, and activity. RESULTS: The celecoxib group (n = 68) consumed 0.72 mg/kg of oxycodone, as compared with 1.12 mg/kg in the placebo group (n = 62), a 36% difference that was not significant. However, multivariate analysis by treatment group, separate from pain levels, confirmed that this reduction was due to celecoxib treatment (P = .03). In subjects with more prolonged pain (n = 88), celecoxib reduced consumption by 52% (P = .02). Celecoxib showed greater benefit for subjects in the prolonged pain group than for those in the lesser pain group (P = .006). Incidence of adverse events was similar between groups. Minor hemorrhage occurred in 4.6% (5 placebo, 3 celecoxib). CONCLUSION: High-dose celecoxib is effective in controlling pain after tonsillectomy, with no adverse effects in this relatively small sample. It reduces narcotic consumption, and its impact appears greater in children with higher degrees of pain. Celecoxib can be considered an effective alternative to ibuprofen after tonsillectomy. This trial was registered at ClinicalTrials.gov: NCT02934191.

Complete replacement of soybean meal with black soldier fly larvae meal in feeding program for broiler chickens from placement through to 49 days of age reduced growth performance and altered organs morphology.

Black soldier fly larvae meal (BSFLM) is characterized with good nutritional and functional attributes. However, there is limited data on inclusion of BSFLM in broiler chicken rations from placement through to market weight. Therefore, we examined growth and organ responses of partial to complete replacement of soybean meal (SBM) with BSFLM in a practical feeding program. A total of 1,152 d-old male Ross × Ross 708 chicks were allocated to 48 pens and assigned one of six diets (n = 8). The diets were: a basal corn-SBM diet (0%BSFLM), 4 diets in which SBM in 0%BSFLM was replaced with BSFLM at 12.5, 25, 50, and 100% and a final diet (0 + AGP) in which 0%BSFLM was treated with coccidiostat (70 mg Narasin/kg) and antibiotic (55 mg Bacitracin Methylene Disalicylate/kg). For energy fortification, soy oil was used for 0%BSFLM diets and black soldier fly oil in the other diets. Body weight, feed intake (FI), BW gain (BWG), and mortality-corrected feed conversion ratio (FCR) were reported. Organ weights were recorded on d 24 and 49. On d 10, birds fed diets 12.5, 25, and 0 + AGP had higher BWG than birds fed diets 0, 50, and 100 (P < 0.01), and birds fed diet 100 had lower BWG than birds fed diets 0 or 50 (P < 0.01). Birds fed diets 50 and 100 had lower BWG than birds fed all other diets on d 24 and 49 (P < 0.05). Overall (d 0-49), BSFLM linearly (P < 0.01) decreased BW, BWG, and FI and increased FCR and mortality. The overall BWG of 50 and 100% BSFLM birds was 92 and 81% of birds fed 0%BSFLM, repectively and coresponding overall FI was 96 and 90%. An increase in gizzard, small intestine, pancreas, and liver relative weights were observed with increasing BSFLM inclusion (P < 0.01). The data indicated that lower levels of BSFLM could provide some growth-promoting effects commensurate to antibiotics in the starter phase. However, replacing SBM with greater amounts (≥50) of BSFLM reduced growth and increased organ size.

Molecular diversity of methanogens in fecal samples from captive Sumatran orangutans (Pongo abelii).

Methane emissions have been previously detected from orangutans, but characterization of the diversity of methanogens in this species has yet to be completed. This preliminary study identified methanogen producing microorganims, also called methanogens, present in the feces from a colony of captive Sumatran orangutans at the Perth Zoo. All animals were housed in the same enclosure and were fed primarily a frugivorous diet. Methanogens were detected using a 16S rRNA gene clone library. A total of 207 clones were examined, revealing 37 different methanogen 16S rRNA sequences, or phylotypes. Of these, 31 phylotypes represented by 170 clones had 96.4-100% sequence identity to Methanosphaera stadtmanae, four phylotypes (32 clones) had 95.1-100% sequence identity to Methanobrevibacter smithii, while two phylotypes (five clones) had 95.9-97.7% sequence identity to Methanobacterium beijingense. Overall, five possible new species were identified from the clone library. This represents the first report of Msp. stadtmanae, a methanol utilizer, as the most predominant methanogen in the gastrointestinal tract of animals. This is likely due to the increased availability of methanol from the highly frugivorous diet of the orangutans. Further studies are warranted to properly assess the effects of frugivorous diets on the methanogen population.