Demonstration of the metaphylactic use of gamithromycin against bacterial pathogens associated with bovine respiratory disease in a multicentre farm trial.

On five commercial cattle rearing sites across Europe, a total of 802 young cattle at high risk of developing bovine respiratory disease (BRD) associated with the bacterial pathogens Mannheimia haemolytica or Pasteurella multocida and/or Mycoplasma bovis were enrolled into a multicentre, controlled field trial. Half were treated with a single dose of gamithromycin at 6 mg/kg bodyweight by subcutaneous injection and half received an injection of a saline placebo as the control. All animals were observed daily for 14 days for signs of BRD as defined by set criteria. The proportion of metaphylactic preventive treatment successes, defined as animals surviving to day 14 without signs of BRD, in the gamithromycin-treated group (86 per cent) was significantly (P=0.0012) higher than in the saline-treated controls (61 per cent). Morbidity among the treated animals was reduced by 64 per cent compared with the controls.

In situ kinetics study of the accelerated aging of poly(ethylene oxide) using PhotoDSC.

PhotoDSC has been applied to follow the global kinetics of chain scissions resulting from the UV light irradiation or from the thermal degradation of a high molecular weight PEO (4 x 10(6) g x mol(-1)). Infrared spectroscopy, XRD measurements and rheology experiments were performed to evidence the occurrence of chain scissions. Melting energy was used as a tool to quantify the extent of the degradation. It was found that the chain scissions reaction follows a first-order kinetic law for both photo and thermal degradation. The activation energies were found identical in both cases (41 kJ x mol(-1)), whereas the degradation rate was higher in the case of UV irradiation than in the case of thermoageing.

Corticosterone and fear behaviour in white and brown caged laying hens.

Physiological and behavioural measures of stress in caged hens on a commercial farm were compared between White Leghorn and brown Hyline strains, and between three tiers of cages. Blood and faecal samples were collected from undisturbed birds for corticosterone measurements. Plasma corticosterone responses to a stressor were measured by the collection of blood samples after 15, 30, and 60 min of a handling stressor. Tonic immobility and novel object tests were used to measure fear behaviour. Plasma corticosterone in undisturbed hens and faecal corticosterone did not differ between White Leghorn and brown Hyline hens, whereas the plasma corticosterone response to a handling stressor was greater in White Leghorns. The duration of tonic immobility, latency to first head movement and number of head movements in tonic immobility tests were greater in white than brown birds, whereas the number of inductions was less for tonic immobility tests. There were no differences between the strains in their responses to a novel object. There were no differences between tiers in plasma corticosterone or corticosterone responses or tonic immobility responses, and no consistent differences in responses of birds to a novel object. This is the first study in which plasma and faecal corticosterone concentrations and fear behaviour have been measured together in laying hens, and the first description of plasma corticosterone responses to handling over 60 min for caged laying hens on a commercial farm. The study has shown the value of measuring endocrine and behavioural variables together to provide objective data on characteristics of different strains of hens.

Comparison of 99mTc-DTPA and urea for measuring cefepime concentrations in epithelial lining fluid.

The efficacy of antimicrobial agents against pulmonary infections depends on their local concentrations in the lung. The aims of the present study were to: 1) compare technetium-99m diethylenetriaminepenta-acetic acid (99mTc-DTPA) and urea as markers of epithelial lining fluid (ELF) dilution for measuring ELF concentrations of pharmaceuticals; 2) quantify ELF cefepime concentrations in normal and injured lung; and 3) measure the increase in permeability to cefepime following oleic acid-induced acute lung injury. A modified bronchoalveolar lavage technique, based on equilibration of infused 99mTc-DTPA, was used to measure ELF volume. Cefepime was administered intravenously at steady plasma levels. Six serial bronchoalveolar lavages were performed 5 h after the beginning of infusion. ELF to plasma cefepime concentration ratios were 95 +/- 17 and 100 +/- 14.5% in normal and injured lung respectively. When urea was used as marker, cefepime concentration ratios were underestimated at 16.4 +/- 2.7 and 73.9 +/- 8.4% respectively. Cefepime blood/ airspace clearance increased from 3.8 +/- 0.7 micro x min(-1) in controls to 39.8 +/- 4.9 microL x min(-1) in acute lung injury. It was concluded that: 1) cefepime concentrations in epithelial lining fluid were in equilibrium with those in plasma in both normal and injured lung after 5 h at steady plasma concentrations; 2) epithelial lining fluid cefepime concentration by the urea method was much less underestimated in injured versus normal lung; and 3) acute lung injury induces a 10-fold elevation of cefepime blood/airspace clearance.

Nadroparin in the prevention of deep vein thrombosis in acute decompensated COPD. The Association of Non-University Affiliated Intensive Care Specialist Physicians of France.

Low molecular weight heparins are as effective as unfractionated heparin in deep-vein thrombosis (DVT) prophylaxis for major surgery. However, there is no evidence nor consensus for prophylaxis in medical patients. We compared the efficacy and safety of nadroparin calcium (nadroparin) with placebo in medical patients at high risk of DVT. A total of 223 patients mechanically ventilated for acute, decompensated chronic obstructive pulmonary disease, were randomized to treatment with subcutaneous nadroparin adjusted for body weight (0.4 ml, i.e., 3,800 AXa IU, or 0.6 ml, i.e., 5,700 AXa IU) or placebo. The average duration of treatment was 11 d. The incidence of DVT in patients receiving nadroparin was significantly lower than that in patients receiving placebo (15.5 versus 28.2%; p = 0.045). Although the incidence of adverse events was high in both groups, there were no significant differences between nadroparin and placebo for total adverse events (46.3 versus 39.8%; p = 0.33), serious adverse events (25.0 versus 19.5%; p = 0.32), or those resulting in early permanent discontinuation of treatment (12.0 versus 8.8%; p = 0.44). The most common adverse event was hemorrhage. There was the same number of deaths in both treatment groups. Subcutaneous nadroparin resulted in 45% decrease in incidence of DVT compared with placebo.

[Rearrangement of an emergency department. Reflections on a structure]. / Réaménagement d'un service d'urgences. Réflexion sur une structure.

Since 1986, a new conception of the emergency department in the hospital of Saint-Denis comes out. It would adapt with a greater efficiency plan to the needs and has entailed a sudden awareness, reflections and critical analysis of the situation. The disposition of the emergency ward, the formal procedures that prevailed over the act of care and the deficiency of the first global relationship with the patient were impediments to the mission of emergency department. A new department that gathers both reception and emergency duties was inaugurated in May 1987. It puts three aims in concrete form: to make the emergency ward more functional, to improve quality and capacities of reception and to improve the medical act.

[Staphylococcus aureus endocarditis]. / Les endocardites à Staphylococcus aureus.

Among 409 cases of bacterial endocarditis (BE) observed from 1972 to 1985, 142 were caused by Staphylococcus aureus. Of these 142 cases, 59 affected native valves of the left heart (left BE), 47 affected native valves of the right heart (right BE) (including 36 drug-addicts), and 36 involved prosthetic valves (BEP) and were associated with mediastinitis in 11 cases. Symptoms were acute in 122 cases and subacute in 2 cases. 91 of the BE on native valves were primary (86%). Cutaneous manifestations were present in 38 cases (27%). Of the 67 patients who died (47%), 28/59 had left BE (47%), 7/47 had right BE (15%) (including 2 drug addicts) and 32/36 had BEP (86%); all differences were statistically significant. Complications consisted of: heart failure in 78 cases (55%), including 40 cases of left BE, 8 cases of right BE and 30 cases of BEP; systemic peripheral embolism in 29 cases (left BE 17, BEP 12) and neurological accidents in 58 cases (left BE 34, right BE 24). Thirty of these accidents occurred before the 4th day (left BE 13, BEP 17). Documented neurological accidents included cerebral haemorrhage (13 cases), cerebral infarction (14 cases) and cerebral abscess (4 cases); 4 of the 12 patients who underwent arteriography were found to have one or several aneurysms. Thirty-nine of these 58 patients died, death being directly due to a neurological cause in 20 cases (left BE 10, right BE 10).(ABSTRACT TRUNCATED AT 250 WORDS)

[Chronic endocarditis on valve prosthesis. 6 cases]. / Endocardites chroniques sur prothèse valvulaire. Six observations.

Six cases of chronic endocarditis (more than 1 year duration) have been extracted from a series of 72 cases of endocarditis (delayed in 49) associated with intracardiac prosthesis observed over a 15-year period. In these 6 cases endocarditis developed 6 months to 2 years after valve replacement. The prosthetic material included 3 Starr-Edward's valves, 2 Hancock's valves and 1 intracardiac patch. The micro-organism isolated were Streptococcus in 3 cases, Serratia and Corynebacterium in 1 case each. The 18-month to 5-year course of the disease was marked by 2 to 5 relapses separated by long periods of apyrexia. The most significant complications were dysimmune syndrome (5 cases), embolic accidents (2 cases) and prosthesis disinsertion (4 cases). Five patients benefited from antibiotic therapy; 4 were operated upon with recurrent disinsertion in 2 cases. Two patients died, one of repeated disinsertion, the other of myocardial dysfunction. Bacteriostatic antibiotics were administered continuously to 3 patients whose endocarditis persisted or relapsed, with satisfactory results in two cases followed-up for more than 2 years.

[Acute rhabdomyolysis in alcoholic patients]. / Rhabdomyolyse aiguë chez des malades alcooliques.

Six episodes of acute rhabdomyolysis were observed within a two-year period in 5 male adult alcoholic patients hospitalised in a hepatology intensive care unit. Painful muscle swelling was discrete of absent in 4 of the 5 patients. Acute rhabdomyolysis was preceded by grand mal seizures in 4 patients, delirium tremens in 1 and high fever with shivers in 3. All cases were rapidly diagnosed on the finding of very high serum creatinine phosphokinase levels. One patient developed acute respiratory failure and recovered after prolonged mechanical ventilation. Three patients had acute renal failure with severe hyperkalemia in one but none required dialysis. Three patients died within 2 to 6 days of the diagnosis, but the deaths were not directly related to rhabdomyolysis. It would appear that in alcoholic patients: the prevalence of rhabdomyolysis is probably underestimated; any muscular hyperactivity as seen in seizures, delirium tremens and prolonged shivers may be a precipitating factor; the condition is easily diagnosed by measuring serum creatinine kinase activity; some cases of acute renal failure in patients with alcoholic cirrhosis might be explained by acute rhabdomyolysis with minimal symptoms.

[Normal values of the main stool constituents from age 1 year to puberty (author's transl)]. / Valeurs normales des principaux constituants des selles de un an à la puberté.

The daily excretions of the main stool constituents have been measured during 97 balance periods performed in 73 children aged 1 to 17 years and whose digestive functions could be considered as normal. From 1 to 2, 2 to 6, and 6 to 17 years of age, the following values (mean and range) have been obtained: expressed in g/day, for stool wet weight: 61 (33-112), 79 (19-157), 76 (22-166); for nitrogen: 0.49 (0.26-1.06), 0.74 (0.3-2.13), 0.83 (0.3-1.52); for fat: 2 (1-3.6), 1.9 (0.9-3.2), 1.8 (0.6-4.5); expressed in mmol/day for volatile acids: 10.1 (5.2-18), 13.7 (1.8-23.7), 10.1 (3.5-27.5); for Na+ : 0.7 (0.3-1.2), 1 (0.1-3.2), 1.1 (0.1-4); for K+ : 4.4 (3-6.7), 5.1 (1.7-10.4), 5.9 (1.6-11). Only wet weight and nitrogen vary significantly from the first to the second period of age (p less than 0.05 and less 0.01 respectively). Wet weight is highly correlated with volatile acid excretion (p less than 0.001) but weakly linked to fecal fat which implies that the measurement of the percentage of fat in fresh stools is not a correct estimate of their absorption.