Lithium dilution cardiac output measurements in isoflurane-anaesthetised goats: Jugular versus cephalic lithium chloride administration.

The administration of lithium chloride (LiCl) for cardiac output (CO) measurement via a peripheral instead of a central vein has been described previously as a valid alternative route in pigs and dogs. The aim of the study was to compare CO measurements after administration of LiCl using two peripheral veins, cephalic or jugular, in goats. Ten adult, female, experimental goats undergoing bilateral stifle arthrotomy were recruited for the study. Paired CO measurements were taken two minutes apart during stable conditions in isoflurane-anaesthetised goats. Forty-two paired CO measurements were taken in total, and the median (range) of paired CO measurement per goat were 4.5 (3-6). The mean (SD) CO using the cephalic and jugular vein for injection of LiCl was 5.28 (1.29) L min-1 and 5.20 (1.24) L min-1 respectively. The Bland-Altman analysis showed an acceptable agreement with a mean bias of 1.33% with limits of agreement (LoA) of -18.43 to 21.09%. The percentage of error was 25%. The four-quadrant plot analysis showed a poor agreement (71%) between the two routes. The polar plot showed a poor trending ability. An 86% inclusion rate (18/21 points) was reached with a ± 35° radial sector size. The findings revealed that the agreement between the two routes is not as precise as the authors expected, however the results are comparable with studies published previously.

A European snapshot of psychosocial characteristics and patients' perspectives of faecal incontinence-do they correlate with current scoring systems?

PURPOSE: To compare the current clinical scoring systems used to quantify the severity of symptoms of faecal incontinence (FI) to patients' subjective scoring of parameters of psychosocial well-being. METHODS: Patients referred to six European centres for investigation or treatment of symptoms of FI between June 2017 and September 2019 completed a questionnaire that captured patient demographics, incontinence symptoms using St. Mark's Incontinence score (SMIS) and ICIQ-B, psychological well-being (HADS, Hospital Anxiety and Depression Scale), and social interaction (a three-item loneliness scale). RESULTS: Three hundred eighteen patients completed questionnaires (62 men, mean age 58.7). Sixty percent of the respondents were aged under 65. Median SMIS was 15 (11-18), ICIQ-B bowel pattern was 8 (6-11) and bowel control was 17 (13-22), similar across all demographic groups; however, younger patients were more likely to experience symptoms of depression and anxiety (HADS score > 10, 65.2% of patients age < 65 vs 54.9% of those ages > = 65, p = 0.03) with lower quality of life (ICIQ-B QoL, median score 19 (14-23)) vs age > = 65 (16 (11-21) (p < 0.005)). On loneliness score 25.5% reported often feeling isolated from others. One of the most significant concerns by patients was the fear and embarrassment related to unpredictable episodes of incontinence. CONCLUSION: The SMIS remains a useful tool for quantifying incontinence symptoms but may underestimate the psychosocial morbidity associated with unpredictable episodes of incontinence. Interventions aimed at decreasing anxiety and to address feelings of disgust may be helpful for a significant number of patients requiring treatment for FI.

Use of adrenaline continuous infusion to treat hypotension during general anaesthesia in a cow and a calf.

BACKGROUND: Hypotension is one of the most common complications observed during inhalation anaesthesia in veterinary patients. Treatment of hypotension in cattle is more challenging than in other species, owing to the limited number of drugs licensed in food producing animals. The use of adrenaline as an infusion to support blood pressure has not been described previously in bovines. CASE PRESENTATION: A cow and a calf presented to University College Dublin Veterinary Hospital for bilateral mandibular fracture repair and bladder rupture repair respectively, developed severe anaesthetic related hypotension unresponsive to conventional treatments. In both cases an adrenaline infusion was started and slowly increased to effect, with infusion rates ranging from 0.01 to 0.25 µg/kg/min. Blood pressure increased as the adrenaline infusion rate increased, but clinically significant improvements in blood pressure were only observed with infusion rates exceeding 0.05 µg/kg/min. The side effect observed with adrenaline infusion was an increase in plasma lactate levels in both cases. Both animals were euthanised due to non-anaesthetic related complications. CONCLUSIONS: Maintenance of normotension is important during bovine anaesthesia to prevent the development of post-anaesthetic complications. In the cases described here, adrenaline was effective as an additional treatment of anaesthetic related hypotension. Further research is required to establish the recommended infusion rates, cardiovascular effects and possible side effects of adrenaline infusion administration as a treatment for hypotension in bovines.

Dieta baja en grasas tras colecistectomía: ¿se debería recomendar de forma sistemática? / Low-fat diet after cholecystectomy: Should it be systematically recommended?

Introducción: A pesar de la falta de evidencia, tradicionalmente se ha recomendado seguir una dieta baja en grasas tras la colecistectomía. El objetivo principal fue analizar la correlación potencial entre los síntomas postoperatorios y el tipo de dieta tras la colecistectomía. Métodos: Los síntomas fueron evaluados de forma prospectiva mediante el cuestionario Gastrointestinal Quality of Life Index (GIQLI) antes de la intervención, al mes y 6 meses después de la colecistectomía en 83 pacientes operados en nuestro centro. Los pacientes completaron un cuestionario sobre su dieta y fueron clasificados en 4 grupos de acuerdo a la cantidad de grasa ingerida. Las diferencias en la puntuación GIQLI dependiendo del tipo de dieta se evaluaron en el tiempo. Resultados: La puntuación GIQLI total y varias dimensiones aumentaron significativamente tras la cirugía respecto al valor basal, independientemente de la ingesta de grasa en la dieta. Entre los síntomas evaluados por el GIQLI, la diarrea y la urgencia defecatoria empeoraron mientras que el estreñimiento mejoró. Más del 50% de los pacientes experimentaron cambios en el ritmo deposicional después de la cirugía, que fueron persistentes durante 6 meses en el 23% de los casos. Conclusiones: La dieta baja en grasas no parece influir en la mejoría de los síntomas tras la colecistectomía. No obstante, los resultados de un estudio aleatorizado que se está realizando en nuestro centro contribuirán a confirmar los resultados de este estudio prospectivo

Introduction: Even though evidence is lacking, a low-fat diet has been traditionally recommended after cholecystectomy. The main aim of this study was to assess the potential correlation between postoperative symptoms and type of diet after cholecystectomy. Methods: Symptoms were prospectively assessed by the Gastrointestinal Quality of Life Index (GIQLI) score at baseline, one month and 6 months after cholecystectomy in 83 patients operated on at our institution. Patients completed a questionnaire about their diet and were classified into 4 groups according to the amount of fat intake. Differences in the GIQLI score depending on the type of diet were assessed over time. Results: The overall GIQLI score and most subdomains significantly increased after surgery compared to baseline, regardless of the intake of dietary fat. Constipation improved after cholecystectomy compared to baseline, whereas diarrhea and bowel urgency got worse. More than 50% of patients experienced a change in their bowel habit after surgery, which persisted 6 months later in 23% of cases. Conclusions: A low fat diet does not seem to have an influence on the improvement of symptoms after cholecystectomy. However, a randomized study is ongoing at our institution to confirm the results of this prospective study

Low-fat diet after cholecystectomy: Should it be systematically recommended? / Dieta baja en grasas tras colecistectomía: ¿se debería recomendar de forma sistemática?

INTRODUCTION: Even though evidence is lacking, a low-fat diet has been traditionally recommended after cholecystectomy. The main aim of this study was to assess the potential correlation between postoperative symptoms and type of diet after cholecystectomy. METHODS: Symptoms were prospectively assessed by the Gastrointestinal Quality of Life Index (GIQLI) score at baseline, one month and 6 months after cholecystectomy in 83 patients operated on at our institution. Patients completed a questionnaire about their diet and were classified into 4 groups according to the amount of fat intake. Differences in the GIQLI score depending on the type of diet were assessed over time. RESULTS: The overall GIQLI score and most subdomains significantly increased after surgery compared to baseline, regardless of the intake of dietary fat. Constipation improved after cholecystectomy compared to baseline, whereas diarrhea and bowel urgency got worse. More than 50% of patients experienced a change in their bowel habit after surgery, which persisted 6 months later in 23% of cases. CONCLUSIONS: A low fat diet does not seem to have an influence on the improvement of symptoms after cholecystectomy. However, a randomized study is ongoing at our institution to confirm the results of this prospective study.

Dermal absorption and short-term biological impact in hairless mice from sunscreens containing zinc oxide nano- or larger particles.

Previous studies have shown no, or very limited, skin penetration of metal oxide nanoparticles following topical application of sunscreens, yet concerns remain about their safety compared to larger particles. Here, we assessed the comparative dermal absorption of a traceable form of Zn ((68)Zn) from (68)ZnO nano-sized and larger particles in sunscreens. Sunscreens were applied to the backs of virgin or pregnant hairless mice over four days. Control groups received topical applications of the sunscreen formulation containing no ZnO particles, or no treatment. Major organs were assessed for changes in (68)Zn/(64)Zn ratios, (68)Zn tracer and total Zn concentrations. Short-term biological impact was assessed by measuring levels of serum amyloid A in blood, and by performing whole-genome transcriptional profiling on livers from each group. Increased concentrations of (68)Zn tracer were detected in internal organs of mice receiving topical applications of (68)ZnO (nano-sized and larger particles), as well as in fetal livers from treated dams, compared with controls. Furthermore, concentrations of (68)Zn in organs of virgin mice treated with sunscreen containing (68)ZnO nanoparticles were found to be significantly higher than in mice treated with sunscreen containing larger (68)ZnO particles. However, no ZnO-mediated change in total Zn concentration in any of the major organs was observed. Thus, despite (68)Zn absorption, which may have been in the form of soluble (68)Zn species or (68)ZnO particles (not known), Zn homeostasis was largely maintained, and the presence of ZnO particles in sunscreen did not elicit an adverse biological response in the mice following short-term topical applications.

Staphylococcus lugdunensis: características clínicas, microbiológicas y sensibilidad antibiótica de 27 casos / Staphylococcus lugdunensis: clinical features, microbiology and antimicrobial susceptibility of 27 cases

Introducción. Staphylococcus lugdunensis es un estafilococo coagulasa negativo (SCN) con características microbiológicas, clínicas, de virulencia y de sensibilidad a antimicrobianos que le hacen ser una especie claramente diferente de otras especies de estafilococos coagulasa negativos. Presentamos las características clínico microbiológicas de S.lugdunensis aislados en 27 enfermos de nuestro hospital. Material y métodos. Se estudiaron los aislamientos de Staphylococcus lugdunensis del año 2004 al 2011. La identificación y antibiograma se realizó por el sistema MicroScan (Siemens). Se revisaron las historias clínicas de los pacientes con aislamientos de S. lugdunensis. Resultados. Se obtuvieron 27 aislamientos de S. lugdunensis procedentes de: abscesos (9), heridas (9), líquido articular (3), sangre (2), líquido peritoneal (1), exudado ótico (1), exudado nasal (1), orina (1). En 20 casos el cultivo fue puro y en 7 mixto. En 8 casos (30%) las muestras procedían de Ginecología, 6 (22%) de Traumatología, 5 (19%) de Cirugía, 3 (11%) de Medicina interna, 2 (7%) de Pediatría, 3 (11%) de otros servicios. En 15 casos (55,5%) existían antecedentes de cirugía o traumatismo reciente. Fueron sensibles a la penicilina 20 (74%) y no hubo ninguna cepa resistente a oxacilina. Conclusiones. S. lugdunensis se ha aislado mayoritariamente en infecciones de piel y tejidos blandos, y en infecciones de heridas post-quirúrgicas. Se ha aislado en cultivo puro en el 74% (20/27) de los casos. Es importante la correcta identificación de S. lugdunensis para evitar que sea descartado como simple estafilococo coagulasa negativo, lo que nos permitirá tener un mejor conocimiento de las infecciones causadas por este microorganismo (AU)

Introduction. Staphylococcus lugdunensis is a coagulase-negative staphylococcus (CNS) with microbiological characteristics, clinical virulence and antimicrobial susceptibility testing, which makes it a distinctly different species from other coagulase-negative staphylococcus species. We present the microbiological and clinical characteristics of 27 S.lugdunensis isolates in patients of our hospital. Material and methods. Staphylococcus lugdunensis isolates collected in our hospital from 2004 to 2011 were studied. Identification and susceptibility testing were performed using the MicroScan (Siemens) system. The clinical records of patients with S.lugdunensis were reviewed. Results. A total of 27 isolates of S.lugdunensis were obtained from the following sources: abscesses (8), wounds (8), joint fluid (3), blood (2), peritoneal fluid (1), ear exudate (1), nasal discharge (1), and urine (1). In 22 cases the culture was pure and in 5 cases mixed. Samples came from Gynaecology in 8 cases (30%), Traumatology in 6 (22%), Surgery in 5 (19%), Internal Medicine in 3 (11%), Paediatrics in 2 (7%), and 3 (11%) from other departments. Just over half (15 cases, 55.5%) had a history of recent surgery or trauma. A total of 20 (74%) were sensitive to penicillin, and none of the isolates was resistant to oxacillin. Conclusions. S. lugdunensis has been isolated mainly in skin and soft tissue infections, as well as in surgical wounds. The microorganism was obtained in pure culture in 20 cases (74%). The proper identification of S.lugdunensis is important in order to avoid being ruled out as simple coagulase-negative staphylococci, and to give us a better understanding of infections caused by this microorganism(AU)