Abdominal radiograph usage trends in the setting of constipation: a 10-year experience.

PURPOSE: Limited data are available to guide the use of abdominal radiographs in the setting of constipation, especially in adults. Anecdotally, there has been a recent increase in such examinations. We sought to determine ordering trends for abdominal radiographs ordered to assess constipation, as well as to better understand referring clinician and radiologist opinion on such examinations. METHODS: We conducted a retrospective review of all abdominal radiographs performed between 2004 and 2014 at our institution with a primary indication of constipation. We also surveyed clinicians and radiologists regarding their opinions and practices involving such examinations. RESULTS: Constipation radiograph volume increased by approximately 56% over the 10-year period, while volume of all other abdominal radiographs decreased. Growth was greatest in adult females. Both radiologists and clinicians agree that constipation is a clinical diagnosis and are neutral as to whether radiographs help make the diagnosis. Clinicians somewhat agree that radiographs are helpful in determining management and find quantitation of stool burden within the radiology report helpful. Radiologists tend to find radiographs inaccurate at quantifying stool burden. Clinicians tend to agree that the increasing use of radiographs for constipation is appropriate while radiologists disagree. Education on these trends did not affect the intended future ordering practice of referring clinicians. CONCLUSIONS: Constipation abdominal radiograph volume has disproportionately increased, especially in adult women. Clinicians and radiologists agree that constipation is a clinical diagnosis. Otherwise, the groups tend to have differing opinions on the utility of such examinations. Clinicians indicated no intention to change their ordering practices. Further investigation is needed to better define the role of imaging for this indication, including how the radiologist may best interpret and report such examinations.

Using sex pheromone trapping to explore threats to wheat from Hessian fly (Diptera: Cecidomyiidae) in the Upper Great Plains.

Before embarking on the 5-10 yr effort it can take to transfer plant resistance (R) genes to adapted crop cultivars, a question must be asked: is the pest a sufficient threat to warrant this effort? We used the recently discovered female-produced sex pheromone of the Hessian fly, Mayetiola destructor (Say) (Diptera: Cecidomyiidae),to explore this question for populations in the Upper Great Plains. Methods for pheromone trapping were established and trapping data were used to explore geographic distribution, phenology, and density. The pheromone lure remained attractive for up to 10 d and only attracted male Hessian flies. Traps placed within the crop canopy caught flies but traps placed above the crop canopy did not. Hessian flies were trapped throughout North Dakota starting in the spring and continuing through the summer and autumn. Densities were low in the spring but increased greatly during the early part of the summer, with peak adult emergence taking place at a time (July/August) when spring wheat was being harvested and winter wheat had not yet been planted. In the autumn, adults were found at a time when winter wheat seedlings are growing. The discovery of flies on Conservation Reserve Program land supports the idea that pasture grasses serve as alternate hosts. We conclude that the Hessian fly is a risk to wheat in the Upper Great Plains and predict that global warming and the increasing cultivation of winter wheat will add to this risk.

A reproductive fitness cost associated with Hessian fly (Diptera: Cecidomyiidae) virulence to wheat's H gene-mediated resistance.

We studied whether adaptation of the Hessian fly, Mayetiola destructor (Say) (Diptera: Cecidomyiidae), to plant resistance incurs fitness costs. In this gene-for-gene interaction, adaptation to a single H resistance gene occurs via loss of a single effector encoded by an Avirulence gene. By losing the effector, the adapted larva now survives on the H gene plant, presumably because it evades the plant's H gene-mediated surveillance system. The problem is the Hessian fly larva needs its effectors for colonization. Thus, for adapted individuals, there may be a cost for losing the effector, with this then creating a trade-off between surviving on H-resistant plants and growing on plants that lack H genes. In two different tests, we used wheat lacking H genes to compare the survival and growth of a nonadapted strain to two H-adapted strains. The two adapted strains differed in that one had been selected for adaptation to H9, whereas the other strain had been selected for adaptation to H13. Tests showed that two H-adapted strains were similar to the nonadapted strain in egg-to-adult survival but that they differed in producing adults with smaller wings. By using known relationships between wing length and reproductive potential, we found that losses in wing length underestimate losses in reproductive potential. For example, H9- and H13-adapted females had 9 and 3% wing losses, respectively, but they were estimated to have 32 and 12% losses in egg production. Fitness costs of adaptation will be investigated further via selection experiments comparing Avirulence allele frequencies for Hessian fly populations exposed or not exposed to H genes.

Maintenance of pregnancy in postpartum beef cows that have short-lived corpora lutea.

The first two experiments examined the role of the uterus in low pregnancy rates of beef cows induced to ovulate by early weaning. At 20 to 25 d postpartum, one-half of the cows in Exp. 1 and 2 received a s.c. implant containing 6 mg of norgestomet (NOR) for 9 d (NOR-pretreated) and the remaining cows were untreated controls (CON). Lengths of first postpartum luteal phase after weaning of calves at d 7 after implant insertion were expected to be normal in NOR-pretreated and short in CON cows. In Exp. 1, cows of both groups received an implant containing 3 mg of NOR at d 4 after first estrus and a silastic implant with 15 or 25 mg of NOR at d 7 after first estrus. At 7 d after first estrus, two embryos were transferred into the uterus of each cow and pregnancy was diagnosed by ultrasonography at d 35. Blood samples were collected daily from onset of treatment to d 8 after estrus and then every other day to d 24. Only 4 of 22 cows were pregnant at d 35, concentrations of estradiol (E2) were elevated after luteolysis, and large follicles were present at d 35. In Exp. 2, all cows were injected with 100 mg of progesterone (P4) twice daily from d 4 to 35 after first estrus. Embryos were transferred, pregnancy was diagnosed, and blood samples were collected as in Exp. 1, except blood sampling was continued to d 34.(ABSTRACT TRUNCATED AT 250 WORDS)

The use of X-terminals as clinical workstations.

The Medical Computer Facility at the Fox Chase Cancer Center has installed X-terminals in patient examination rooms and at nursing stations for clinical data access by physicians and nurses. The X-terminals are connected to UNIX operating system RISC processors via Ethernet. The RISC processors communicate with databases on a minicomputer cluster. Simultaneous presentation of textual (e.g., pathology and radiology reports) and graphical (e.g., clinical laboratory results) clinical data is provided under X-Windows. CT and MRI images can also be displayed in windows. Our experiences implementing X-terminal clinical workstations in a production environment will be discussed.

Myo-Inositol transport in Klebsiella aerogenes. scyllo-Inositol, a non-metabolizable substrate for the study of the myo-inositol transport system.

1. Scyllo-Inositol is transported against a concentration gradient by Klebsiella aerogenes, but is not metabolized. 2. The apparent KT of scyllo-inositol is 0.05 X 10(-3) M while that of myo-inositol is 0.23 X 10(-3) M. The V values are respectively 32 and 12 nmol min(-1) mg cells(-1) (dry weight). 3. Both cyclitols bind to the same carrier, since typical competitive inhibition kinetics are observed. 4. Neither phosphoenolpyruvate phosphotransferase nor a periplasmic binding protein seems to be involved in the scyllo-inositol transport system. 5. The induction of the transport system is not repressed by malate, furmarate, citrate, succinate or pyruvate; however, acetate represses the induction. The activity of the transport system is increased when the growth medium is supplemented with adenosine 3':5'-monophosphate.