[Survey on the use of antibiotics in exotic pets among Swiss veterinarians]. / Umfrage bei Schweizer Tierärzte/-innen über den Einsatz von Antibiotika bei exotischen Heimtieren.

INTRODUCTION: Monitoring programs and guidelines on the use of antibiotics and antibiotic resistance in human and veterinary medicine have been developed worldwide to promote the prudent use of antibiotics in recent years. However, such information on the use of antibiotics in exotic pets is absent. This fact must be taken into account, since the number of exotic pet patients is constantly increasing and the administration of antibiotics is particular challenging due to the diversity of species and the differences in physiology. The present study reports the results of a survey of frequently used antibiotics and the criteria of antibiotic usage in exotic pets (rabbits, rodents, birds and reptiles) among Swiss veterinarians. These data should form the basis for the development of antibiotic usage guidelines in exotic pets. A total of 61 veterinarians returned the questionnaire. The most important decision-making criteria for antibiotic treatment and antibiotic selection were clinical symptoms (55/59, 93% for antibiotic treatment and 40/59, 68% for antibiotic selection), experience (41/59, 69% and 36/59, 61%, respectively) and textbooks (39/59, 66% and 40/59, 68%). The most important decision-making criteria for dosage and duration of therapy were textbooks (59/59, 100%) and experience (31/59, 53%). The use of a microbial culture was used as a decision criterion for both antibiotic treatment and antibiotic selection by 39% of the participants, sensitivity testing was chosen as a decision criterion by 37% for antibiotic treatment and by 46% for antibiotic selection. Fluoroquinolones were used most frequently, 46/56 (82% of the participants) for rabbits, 49/57 (86%) for rodents, 36/37 (97%) for reptiles and 38/46 (83%) for birds. The vast majority of veterinarians (57/58, 98%) would consult a guide for the use of antibiotics. The frequent use of critical antibiotics in exotic pets underscores the need for a guide to the prudent use of antibiotics. The positive influence of such guidelines has already been proven in dogs and cats.

INTRODUCTION: Pour promouvoir une utilisation prudente des antibiotiques, des programmes de surveillance et des lignes directrices sur l'utilisation des antibiotiques et la résistance aux antibiotiques en médecine humaine et vétérinaire ont été élaborés dans le monde entier ces dernières années. Cependant, il n'existe actuellement aucune information de ce type en ce qui concerne les nouveaux animaux de compagnie ainsi que des informations exhaustives sur l'utilisation d'antibiotiques dans la pratique vétérinaire. Ce fait doit être pris en compte, d'autant plus que le nombre d'nouveaux animaux de compagnie est en constante augmentation dans la patientèle et que l'administration d'antibiotiques est un défi particulier en raison de la diversité des espèces et des différences de physiologie. Dans la présente étude, une enquête a été menée pour avoir un aperçu des antibiotiques fréquemment utilisés et de leurs critères d'utilisation chez les nouveaux animaux de compagnie (lapins, rongeurs, oiseaux et reptiles) auprès de vétérinaires suisses. Ces données sont destinées à servir de base à l'élaboration d'un guide sur les antibiotiques pour les animaux exotiques. Au total 61 vétérinaires ont répondu au questionnaire. Les critères de décision les plus importants pour le traitement antibiotique et la sélection d'un antibiotique étaient les symptômes (55/59, 93% pour le traitement antibiotique et 40/59, 68% pour la sélection de l'antibiotique), l'expérience (41/59, 69% et 36/59, 61%, respectivement) et la littérature spécialisée (39/59, 66% et 40/59, 68%). Les critères de décision les plus importants pour e dosage et la durée du traitement étaient la littérature spécialisée (59/59, 100%) et l'expérience (31/59, 53%). L'utilisation d'une culture bactériologique a été donnée par 39% des participants comme critère de décision à la fois pour le traitement antibiotique et le choix de l'antibiotique et un antibiogramme a été choisi par 37% comme critère de décision pour le traitement antibiotique et 46% pour le choix de l'antibiotique. Il a été constaté que les fluoroquinolones sont utilisées le plus fréquemment, chez 46/56 (82% des participants) pour les lapins, 49/57 (86%) pour les rongeurs, 36/37 (97%) pour les reptiles et 38/46 (83%) pour les oiseaux. La grande majorité des vétérinaires (57/58, 98%) a déclaré qu'ils consulteraient un guide pour l'utilisation des antibiotiques. L'utilisation fréquente d'antibiotiques critiques chez les nouveaux animaux de compagnie souligne la nécessité d'un guide sur l'utilisation prudente des antibiotiques. L'influence positive de ces recommandations a déjà été prouvée pour les chiens et les chats.

Cloning of the rat ADAMTS-1 gene and its down regulation in endothelial cells in cirrhotic rats.

AIMS: This study was undertaken in order to identify genes which are regulated during the process of liver fibrosis. METHODS: The differential display method and RNA from rat endothelial cells before and after induction of cirrhosis were used. RESULTS: A 496 bp fragment, which was down regulated in liver endothelial cells from a cirrhotic animal, was cloned. The cloned fragment showed a 95% homology with the newly cloned mouse ADAMTS-1 gene (a disintegrin and metalloproteinase with thrombospondin motifs), which is implicated in inflammation. The fragment was found to span the 3' of exon 6, the whole exon 7 and the 5' of exon 8. Sequencing of the entire coding region of the rat gene showed a 94% homology at the nucleic acid level and 96% homology at the amino acid level. The sequences responsible for the function of the protein were conserved. Northern blot analysis, using the cloned fragment as a probe, confirmed the finding that the gene was down-regulated in endothelial cells derived from livers of cirrhotic animals. In situ PCR analysis localised the ADAMTS-1 gene in the liver endothelial cells from normal animals. CONCLUSIONS: Regulation of the expression of genes which belong to the metalloproteinase family in liver endothelial cells might be important in the development of liver cirrhosis.

Intraportal administration of glyceryl trinitrate or nitroprusside exerts more systemic than intrahepatic effects in anaesthetised cirrhotic rats.

BACKGROUND/AIMS: Increased intrahepatic vascular tone can be pharmacologically manipulated in isolated cirrhotic livers. Intrahepatic endothelial dysfunction may lead to a decreased production of the potent endogenous vasodilator nitric oxide in cirrhotic livers. The aims of the study were to determine whether portal pressure can be lowered in vivo by injecting nitric oxide donors glyceryl trinitrate or nitroprusside directly in the portal vein and whether this is related to a decrease in intrahepatic resistance. METHODS: In anaesthetised CCl4 cirrhotic rats, intraportal doses of glyceryl trinitrate 0.5, 1 or 5 microg/kg/ min or nitroprusside 1, 5 or 10 microg/kg/min did not decrease portal pressure but only arterial pressure. Systemic and splanchnic haemodynamics were measured before and during 15 min intraportal infusion of glyceryl trinitrate 10 microg/kg/min or nitroprusside 20 microg/kg/min. RESULTS: Glyceryl trinitrate decreased portal pressure from 14.0+/-1.1 to 11.8+/-1.4 mm Hg, splanchnic perfusion pressure from 102+/-10 to 74+/-5 mm Hg and portal sinusoidal flow from 2.11+/-0.38 to 1.70+/-0.35 ml/min/g liver (all p<0.05). Nitroprusside did not decrease portal pressure significantly but led to a reduction of the splanchnic perfusion pressure (104+/-9 to 66+/-7 mm Hg) and the portal sinusoidal flow (2.39+/-0.50 to 1.77+/-0.31 ml/min/g liver; all p<0.05). Portal sinusoidal resistance was not altered by either drug. CONCLUSIONS: Intraportal infusion of nitric oxide donors decreased arterial pressure more than portal pressure. Portal sinusoidal resistance remained unaffected, but the liver parenchyma became less perfused with high doses. The systemic effects of nitric oxide donating drugs prevailed.

[Permeability pulmonary edema in pheochromocytoma]. / Permeabilitäts-Lungenödem bei Phäochromozytom.

We describe two patients with pheochromocytoma who developed pulmonary edema of rapid onset. The edema occurred spontaneously in the first case and during surgery for the tumor in the second patient. Since left ventricular function was normal in both patients and the protein content of the edema fluid was elevated in one patient, the conditions involved were permeability edemas.

Reduction of systemic fungal infections in patients with hematological malignancies, neutropenia, and prolonged fever by early amphotericin B therapy.

A rate on autopsy of up to 30% systemic fungal infections and difficulties in diagnosing systemic mycosis antemortem have led to the empiric use of amphotericin B in patients with hematological malignancies, prolonged fever, and neutropenia. Routine empiric antifungal treatment was initiated in our institution in 1982. Amphotericin B was given to granulocytopenic patients with hematological malignancies with (a) unremitting fever after 48-72 h of antibiotic treatment, (b) recurrent fever during antibiotic treatment, or (c) with newly detected pulmonary infiltrates, sinusitis, skin and retinal lesions suggestive of a fungal infection. With this approach the rate of systemic fungal infections decreased significantly from 10% (27 of 270 patients; 1973-1981) to 4% (6 of 153 patients; 1982-1986, P less than 0.02). The reduction of systemic fungal infections was most prominent in patients with acute myelogenous leukemia, where its proportion decreased from 16% (16 of 98 patients; 1973-1981) to 4% (2 of 50 patients; 1982-1986, P less than 0.023). Our data support the hypothesis that the incidence of systemic fungal infections in patients with hematological malignancies and especially in acute myelogenous leukemia can be reduced significantly by empirical treatment with amphotericin B.

[Hematologic complications in infectious mononucleosis]. / Hämatologische Komplikationen bei Mononucleosis infectiosa.

In three patients with infectious mononucleosis the disease was severely complicated by, respectively, aplastic anemia, consumptive thrombocytopenia and hemolytic anemia with acute renal failure. In contrast to the regularly recurring basic signs and symptoms of the illness, serious complications occur in less than 1% of all patients. Changes in the immunologic system seem to play an important role in hematologic and other complications, as well as in the occasionally fatal Epstein-Barr virus infection. Pathophysiological, and particularly immunologic mechanisms, and possible therapy are discussed with reference to case reports of patients with similar clinical courses and the literature on infectious mononucleosis.

Pseudomonas cepacia bacteraemia due to intrinsic contamination of an anaesthetic. Bacteriological and serological observations.

In November-December 1977 an epidemic of bacteraemia due to P. cepacia was observed in Odense, Denmark (nine patients), and in Nijmegen, Holland (seven patients). All patients recovered. The epidemic was traced to intrinsic contamination of two batches of the anaesthetic fentanyl. All isolates from the patients and from the two batches belonged to the same biotype, had identical sensitivity patterns, and identical antigens. The P. cepacia strain differed from stock strains in being able to grow in two passages in methyl-p-hydroxi-benzoate, 0.5 mg/ml, which promoted the growth of the microorganism: inocula of 2-20 cfu were sufficient to initiate growth in the drug or preservative. These facts indicate the inadvisability of using p-hydroxi-benzoates as preservatives in vials. The strain was inhibited at temperatures above 38.5 degrees C, corresponding to the recovery of the patients after a period with fever above 39 degrees C. Fourteen out of 15 patients examined had agglutinin titres greater than or equal to 320, while 36 blood donors had titres less than 40. Of 12 patients with postoperative fever in the same period whose blood cultures did not yield P. cepacia, three had titres greater than 320.