Urinary calculi in larvae of striped trumpeter, Latris lineata.

Urinary calculi are observed in some cultured marine fish larvae and may negatively impact larval health and survival. This study assessed urinary calculi in striped trumpeter Latris lineata larvae from hatching to 28 days post-hatching (dph). The prevalence of urinary calculi was variable over time and ranged from 15% to 50%, whereas the average size of calculi increased with larval age. Urinary calculi were semi-translucent, light cream to white colour with irregular morphology and a uniform internal structure. The calculi resulted in pressure atrophy causing a distended epithelium of the urinary bladder of fish with calculi. The calculi were predominantly formed of calcium hydrogen phosphate (CaHPO4 ). Routine assessment of the prevalence of urinary calculi in marine fish larvae is recommended, along with other parameters, to monitor larval quality and inform hatchery management actions.

Senior student goal setting during subinternship: a mixed-methods study.

BACKGROUND: New developments in Subinternship curricula attempt to establish self-directed learning skills that will translate into the 1st year of residency. However, we know little about how well senior medical students' self-directed learning goals match with what is expected of them in residency. PURPOSES: We designed a mixed-methods study to examine the goals set by senior students at Georgia Health Sciences University on Pediatric Subinternship and to determine how those goals relate to the 6 Accreditation Council for Graduate Medical Education (ACGME) competencies. METHODS: We used an iterative process to categorize self-directed learning goals on Pediatric Subinternships (n=188 goals generated by 57 senior students) by (a) the 6 ACGME competencies and (b) general or specific goals. We used tests of association and multivariate modeling to compare goal categories by clinical site and time of year. RESULTS: There were 56.3% of goals addressing patient care. Professionalism and systems-based practice goals were rare. Of the goals, 72% were general, but goals written by students at the newborn nursery and neonatal intensive care unit sites were significantly more likely to be specific than goals written by students on the general inpatient subinternship. CONCLUSIONS: The overwhelming majority of senior medical student goals on a Pediatric Subinternship are general and related to patient care. Students may need assistance with developing more specific goals in all 6 competencies. Our findings suggest that understanding and incorporating students' learning goals may be important for enhancing the potential effectiveness of transition-to-residence curricula.

Conocimiento actual de las hormonas reguladoras de la ingestión de alimentos en la especie porcina / Current knowledge of the regulatory hormones in food intake in swine

Este trabajo es una revisión de los estudios realizados en la especie porcina sobre el comportamiento de la insulina, leptina y grelina, y su implicación en la regulación de la ingestión de alimentos. Desde el punto de vista productivo es de gran interés por constituir una fuente de información importante para conocer el estado metabólico y energético del animal. Los animales, durante su crecimiento y a lo largo de su vida productiva, pasan por diferentes etapas con necesidades específicas que deben ser cubiertas mediante el aporte de nutrientes a través de la alimentación. La salud de los animales dependen de la habilidad del cuerpo para regular de forma adecuada el equilibrio entre las necesidades y los aportes, y este equilibrio está regulado por del sistema nervioso central mediante señales neuronales o la liberación de hormonas. Las hormonas implicadas en la ingestión de alimentos, es decir, aquellas que ejercen un papel regulador sobre el apetito o la saciedad, pueden clasificarse en orexigénica o anorexigénias según su capacidad de estimular o inhibir, respectivamente, el consumo de alimentos. La grelina, también llamada hormona del hambre, es la principal hormona orexigénica, es producida principalmente en el estómago en respuesta al hambre y la inanición. Durante el ayuno, o en estados energéticos insuficientes eleva sus niveles en sangre y tras la alimentación recupera los niveles basales. Entre las hormonas anorexigénicas destaca la leptina secretada principalmente por las células del tejido adiposo, cuya función primordial es la regulación de la ingestión de alimentos y del gasto energético, a largo plazo, para mantener las reservas corporales, de manera que, cuando un individuo está en balance energético positivo los niveles de leptina aumentan presentando un estado de saciedad que provoca la disminución en el consumo alimentos y/o apetito. Además, tras la ingestión de alimento, se secreta insulina, que es la principal hormona encargada de regular la glucemia y esta implicada en la regulación del apetito por interactuar con otras hormonas. Aunque estas hormonas han sido ampliamente estudiadas en la especie humana y roedores, es de esperar que en las próximas décadas su estudio se extienda a todos las especies domésticas (AU)

This paper is a review about research of insulin, leptin and ghrelin in pigs and their implications in regulation of appetite. Their study could be very important in animal production as they are a source of important information to know metabolic and energetic states of animals. The animals during their growth have different states with their own needs which should be covered with the nutrients intake. The balance between needs and feed nutrient inputs are regulated by central neuronal system through hormones. The hormones involved in feed intake are orexigenic or anorexigenic according their capacity to activate or inhibit feed intake. The most important orexigenic hormone is the ghrelin, which is a «hunger hormone» is high in the fasting state and decreases in serum after feed intake. Leptin, anorexigenic hormone, is thought to be a satiety factor that regulates body weight through modulation of feeding behaviour and energy expenditure and it is directly related to the animals’ adiposity degree. Insulin, besides regulating blood glucose levels, is involved in food intake by interacting with other hormones. However, these actions are affected by many factors as the feeding pattern, the diet composition or the productive stage of swine (AU)

Effect of crude glycerin on feed manufacturing, growth performance, plasma metabolites, and nutrient digestibility of growing-finishing pigs.

Three experiments were conducted to determine the effects of dietary addition of crude glycerin on pellet production efficiency and to evaluate its effect on growth performance and digestibility in growing-finishing pigs. Three dietary treatments were created by addition of 0, 2.5, or 5% crude glycerin to barley-soybean meal-based diet, and 4 batches of each dietary treatment (2 each for grower and finisher diets) were prepared. In the manufacturing process, crude glycerin supplementation linearly increased the feeder speed and production rate (P < 0.05), resulting in a 20 to 29% improvement in the feed production rate compared with the control. Production efficiency (kg/kWh) increased linearly (P < 0.05) as the level of crude glycerin in feed increased. A growth experiment was performed with 240 barrows (30 ± 1 kg initial BW) using a 2-phase feeding program over a 12-wk period with 4 pens per treatment and 20 pigs per pen. On the last day of the growth experiment, blood samples were collected to determine circulating glucose, fructosamine, and IGF-1 concentrations. Overall growth performance was not affected (P > 0.05) by dietary treatment, and there was no effect (P > 0.05) of dietary treatment on any plasma metabolite measured. A digestibility experiment involving 9 male pigs housed in metabolic cages was used to determine the coefficients of apparent fecal digestibility and N and mineral balances. Pigs were assigned to 1 of the 3 diets in each feeding period using a 3 × 3 Latin square arrangement of treatments (43 ± 3 and 74 ± 3 kg initial BW in the growing and finishing periods, respectively). In both feeding periods, fecal digestibility of OM and ether extract were affected by dietary treatment, increasing linearly (P < 0.05) with increasing crude glycerin levels. However, neither CP digestibility nor N retention was affected by the glycerin content in either the growing or finishing period. Digestibilities and balance of Ca and P showed opposite tendencies with the variations in crude glycerin content, which either decreased or increased depending on the feeding period. In conclusion, adding crude glycerin to the diet before pelleting improved feed mill production efficiency. The addition of crude glycerin up to 5% in the diet of growing-finishing pigs had no effect on growth performance, blood metabolites, nutrient digestibility, and N balance, but more studies are needed to determine how crude glycerin affects mineral metabolism and balance.

Vaginal misoprostol 800 microg every 12 h for second-trimester abortion.

The objective of the study was to evaluate the efficacy and safety of 800 microg misoprostol every 12 h, up to three doses, for pharmacological second-trimester abortion. The misoprostol doses were always administered by doctors into the vagina. Two-hundred and sixty-nine women with gestations within 12 and 20 weeks were recruited into the study. The main outcomes measured were successful abortion (passage of fetus and placenta without surgery), side effects and mean drop in hemoglobin, vaginal bleeding and mean time of return of menstruation. Complete abortion occurred in 245/269 (91.1%, 95% confidence interval 87-94%) patients. Vaginal bleeding lasted 15.7 +/- 4.1 days. The mean drop in hemoglobin, calculated 24 h after abortion, were statistically significant (p = 0.0001), as also was the mean hemoglobin measured 14 days after abortion, but without clinical relevance. According to the results obtained, 800 microg of misoprostol administered every 12 h, up to a maximum of three doses, could be a valid method for abortion within 12 and 20 weeks of gestation.

Synergistic activity of the novel des-fluoro(6) quinolone, garenoxacin (BMS-284756), in combination with other antimicrobial agents against Pseudomonas aeruginosa and related species.

Non-fermentative Gram-negative bacteria (Pseudomonas aeruginosa, Burkholderia cepacia, Stenotrophomonas maltophilia and Acinetobacter spp.) are intrinsically less susceptible to many antimicrobial agents. Two-drug combinations have been used to treat infections caused by less susceptible pathogens. In this study, the antibacterial activity of garenoxacin (GARX) with non-quinolones was examined. The non-quinolones evaluated were cefepime (CEPI), imipenem (IMIP), aztreonam (AZTR), piperacillin-tazobactam (PIPC/TZ), amikacin (AMK), ceftazidime (CTAZ), trimethoprim-sulphamethoxazole (TMP/SMX) and ticarcillin-clavulanate (TICC/CA). Synergism was determined by time-kill analysis using GARX (at 2 x its MIC, not to exceed 4 mg/l) and the second drug (at 1 x MIC, not to exceed its susceptible MIC breakpoint), and is defined as > or = 2 log(10) enhanced killing at 24 h with the combination. Partial synergy is defined as > or = 1.5 log(10) but < 2 log(10) enhanced killing with the drug combination. Synergy/partial synergy was observed most often with GARX plus: CEPI, AZTR, PIPC/TZ, IMIP (five strains each) or AMK (four strains) vs. eight P. aeruginosa; CTAZ, AZTR (five strains each) vs. six B. cepacia; TICC/CA (six strains), CEPI, CTAZ or AMK (five strains each) vs. eight S. maltophilia; and CEPI, AMK (three strains each) or CTAZ, TICC/CA (two strains each) vs. four Acinetobacter spp. In conclusion, synergistic killing was observed frequently with GARX plus a non-quinolone bactericidal agents against non-fermentative Gram-negative bacteria, including strains intermediately susceptible/resistant to one or both agents.

Phenotypic study by numerical taxonomy of strains belonging to the genus Aeromonas.

AIMS: This study was undertaken to cluster and identify a large collection of Aeromonas strains. METHODS AND RESULTS: Numerical taxonomy was used to analyse phenotypic data obtained on 54 new isolates taken from water, fish, snails, sputum and 99 type and reference strains. Each strain was tested for 121 characters but only the data for 71 were analysed using the 'SSM' and 'SJ' coefficients, and the UPGMA clustering algorithm. At SJ values of > or = 81.6% the strains clustered into 22 phenons which were identified as Aer. jandaei, Aer. hydrophila, Aer. encheleia, Aer. veronii biogroup veronii, Aer. trota, Aer. caviae, Aer. eucrenophila, Aer. ichthiosmia, Aer. sobria, Aer. allosaccharophila, Aer. media, Aer. schubertii and Aer. salmonicida. The species Aer. veronii biogroup sobria was represented by several clusters which formed two phenotypic cores, the first related to reference strain CECT 4246 and the second related to CECT 4835. A good correlation was generally observed among this phenotypic clustering and previous genomic and phylogenetic data. In addition, three new phenotypic groups were found, which may represent new Aeromonas species. CONCLUSIONS: The phenetic approach was found to be a necessary tool to delimitate and identify the Aeromonas species. SIGNIFICANCE AND IMPACT OF THE STUDY: Valuable traits for identifying Aeromonas as well as the possible existence of new Aeromonas species or biotypes are indicated.

Synergistic activities of gatifloxacin in combination with other antimicrobial agents against Pseudomonas aeruginosa and related species.

Drug combinations have been used to treat serious infections caused by Pseudomonas, Burkholderia, Stenotrophomonas, and Acinetobacter. In this study, the combined drug effects of gatifloxacin (GAT) and nonquinolones were determined by time-kill analysis at clinically achievable drug concentrations. Synergy (>or=2 log(10)-enhanced killing at 24 h) was observed with GAT plus amikacin or a beta-lactam against 50 to 75% of strains, including strains nonsusceptible to one or both drugs.

Comparative killing kinetics of the novel des-fluoro(6) quinolone BMS-284756, fluoroquinolones, vancomycin and beta-lactams.

The primary bactericidal classes used therapeutically as single agents, are the quinolones and the cell-wall active agents. In this study, their rates of killing were compared. The des-fluoro(6) quinolone BMS-284756 (T-3811ME), fluoroquinolones (trovafloxacin, levofloxacin) and cell wall-active agents (beta-lactams, vancomycin) were evaluated against Enterobacteriaceae, Staphylococcus aureus, streptococci, and Enterococcus faecalis. Time-kill analysis was done at 10x the MIC, using Mueller-Hinton broth (supplemented with 7% lysed horse blood for Streptococcus pneumoniae and the viridans streptococci), or Brain Heart Infusion broth for beta-haemolytic streptococci. Using a 3-log(10) decrease in viable count as an index of bactericidal activity, BMS-284756 and the fluoroquinolones killed Enterobacteriaceae rapidly, requiring < 2 h versus > or =6 h for beta-lactams. The staphylococcal cell counts generally decreased more rapidly with quinolone exposure, compared with those treated with vancomycin or the beta-lactams. The antimicrobial agents killed streptococci and enterococci more slowly, requiring > 6 h to decrease the viable count by 99.9%. In summary, BMS-284756 killing rates are similar to those of recent fluoroquinolones and are bacterial group-dependent. Overall, the quinolones are more rapidly bactericidal than vancomycin and the beta-lactam antibiotics.

Correlation between genotype and phenotypic categorization of staphylococci based on methicillin susceptibility and resistance.

Positive correlation between methicillin and oxacillin susceptibility test results and the detection of the mecA gene was observed for Staphylococcus aureus, S. epidermidis, and S. haemolyticus as well as among mecA(+) strains of other species of coagulase-negative staphylococci (CNS). However, at least 50% of the mecA-negative strains of these other species of CNS were falsely classified as methicillin and oxacillin resistant.

Activity of gatifloxacin and ciprofloxacin in combination with other antimicrobial agents.

The influence of non-quinolone antimicrobial agents on the antibacterial activities of gatifloxacin and ciprofloxacin was determined using chequerboard, fractional inhibitory concentration, (FIC) and time-kill analysis methods. In the chequerboard method, the quinolones were tested in combination with ten antimicrobial agents (macrolides, aminoglycosides, beta-lactams, vancomycin, rifampicin and chloramphenicol) against five bacterial strains (one strain each of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecalis and Streptococcus pneumoniae). In no incidence was antagonism (FIC > or = 4) or synergy (FIC < or = 0.5) observed; all dual drug combinations involving gatifloxacin or ciprofloxacin showed additivity/indifference (FIC > 0.5, < 4). By time-kill analysis, the strains were tested at a quinolone concentration equal to 8 x MIC in combination with a second antibiotic at 0.5xits MIC. These combinations killed non-enterococcal strains at rates similar to those with quinolones alone. However, rifampicin and chloramphenicol were often antagonistic (100-fold lesser killing) to the lethal action of gatifloxacin and ciprofloxacin against E. faecalis. These findings indicate that, with the exception of E. faecalis, the antibacterial activities of quinolones are generally additive/indifferent to those of other antimicrobial agents.

Oral versus vaginal misoprostol for cervical priming in first-trimester abortion: a randomized trial.

The objective of this study was to compare the oral and vaginal administration of misoprostol for cervical priming before surgical abortion up to 63 days' gestation. A total of 900 pregnant women, with ages ranging from 18 to 42 years, who asked for pregnancy termination, were included in this study. Women were randomly allocated to one of the following groups: oral administration of 400 microg misoprostol, 8 h before aspiration; and vaginal self-administration of 400 microg misoprostol, 4 h before aspiration. During admission, all subjects were checked on a 15-min basis. The preoperative cervical dilatation achieved was the main outcome assessed. The cervix was dilated (Hegar > or = 8) in 348 (78%) subjects from the oral treatment group and in 391 (87%) women from the vaginal treatment group; this difference was statistically significant (p = 0.0004). The mean dilatation achieved in the oral treatment group was 8.1 mm (SD 1.6 mm) and it was 8.5 mm (SD 1.5 mm) in the vaginal treatment group; this difference was statistically significant (p = 0.0001). The frequencies of side-effects such as nausea, vomiting, diarrhea and chills reported by women from the vaginal misoprostol group were 10, 8, 18 and 4 times lower, respectively, than those reported by subjects from the oral misoprostol group. In conclusion, vaginal self-administration of misoprostol was the best administration route, as it obtained the same or greater priming effectiveness of the cervix in half the time with a much lower frequency of side-effects.

Susceptibility of bacterial isolates to gatifloxacin and ciprofloxacin from clinical trials 1997-1998.

MICs of gatifloxacin and ciprofloxacin against 3482 pre-treatment, clinical trial isolates collected during 1997-1998 are reported. These data suggested that gatifloxacin was four- to eight-fold more active than ciprofloxacin against Gram-positive bacteria, with gatifloxacin MIC(90)s < or = 0.33 mg/l against Staphylococcus aureus and Streptococcus pneumoniae, and < or = 1.0 mg/l versus viridans streptococci and Enterococcus faecalis. Both quinolones had similar MIC(90)s versus Enterobacteriaceae (generally < or = 0.38 mg/l, except 0. 7-0.8 mg/l for Citrobacter freundii) and Pseudomonas aeruginosa ( approximately 8 mg/l). A total of 78% P. aeruginosa had gatifloxacin MICs < or = 2 mg/l. Gatifloxacin was more active than ciprofloxacin against Acinetobacter species and non-P. aeruginosa pseudomonads. Both had exceptional activity versus Haemophilus spp, Moraxella catarrhalis and Neisseria gonorrhoeae. In summary, compared to ciprofloxacin, gatifloxacin had improved activity against Gram-positive bacteria and comparable activity against Gram-negative bacteria.

Antibacterial spectrum of a novel des-fluoro(6) quinolone, BMS-284756.

The in vitro spectrum of a novel des-fluoro(6) quinolone, BMS-284756, was compared with those of five fluoroquinolones (trovafloxacin, moxifloxacin, levofloxacin, ofloxacin, and ciprofloxacin). BMS-284756 was among the most active and often was the most active quinolone against staphylococci (including methicillin-resistant strains), streptococci, pneumococci (including ciprofloxacin-nonsusceptible and penicillin-resistant strains), and Enterococcus faecalis. BMS-284756 inhibited approximately 60 to approximately 70% of the Enterococcus faecium (including vancomycin-resistant) strains and 90 to 100% of the Enterobacteriaceae strains and gastroenteric bacillary pathogens at the anticipated MIC susceptible breakpoint (

Comparative killing rates of fluoroquinolones and cell wall-active agents.

Killing rates of fluoroquinolones, beta-lactams, and vancomycin were compared against Enterobacteriaceae, Staphylococcus aureus, pneumococci, streptococci, and Enterococcus faecalis. The times required for fluoroquinolones to decrease viability by 3 log(10) were 1.5 h for Enterobacteriaceae, 4 to 6 h for staphylococci, and >/=6 h for streptococci and enterococci. Thus, the rate of killing by fluoroquinolones is organism group dependent; overall, they killed more rapidly than beta-lactams and vancomycin.

Vaginal misoprostol for early second-trimester abortion.

OBJECTIVES: To demonstrate the effectiveness and safety of misoprostol without the need of postexpulsion systematic curettage in early second-trimester abortions, i.e. at 13-15 weeks' gestation. METHODS: A group of 151 women, with gestations from 85 to 105 days, received 800 micrograms of vaginal misoprostol every 25 h for a maximum of three doses, without having postexpulsion systematic preventive curettage performed. Outcome measures included successful abortion (complete abortion without requiring a surgical procedure), side-effects, mean expulsion time and mean time of vaginal bleeding. RESULTS: Complete abortion occurred in 121/151 subjects (80%; 95% confidence interval, 78-87%). The decrease in hemoglobin was statistically significant (p = 0.0001), but without clinical relevance (11.8 mg/dl (SD, 0.9) before treatment and 11.4 mg/dl (SD, 1.0) afterwards. No statistically significant differences were found between the success rate and any of the women's characteristics. Vaginal bleeding lasted 6 +/- 3 days, spotting 6 +/- 3 days, and total bleeding 12 +/- 5 days (median, 11 days; range, 1-29). CONCLUSIONS: The acceptable expulsion time in 80% of the cases, the fact that postabortion systematic curettage was not needed, the clinically insignificant hemoglobin loss and the abortion rate obtained, show that misoprostol by vaginal administration may be an alternative for interrupting gestation in the early second trimester of pregnancy.

Squamous cell carcinoma complicating perianal hidradenitis suppurativa.

Hidradenitis suppurativa or Verneuil's disease is usually a chronic, recurrent, suppurative and cicatricial disorder. It most often affects the skin of the axillae, groins and perineum, and less commonly the buttocks and upper thighs. A squamous cell carcinoma located in the hidradenitis-affected area is a rare complication. We present a review of the twenty-six published cases adding one of our own.

Sharing of MHC haplotypes among apparently unrelated patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.

From the study of HLA, complement, and glyoxalase I alleles in 82 Venezuelan individuals belonging to 19 families of mixed ethnic origin having 20 affected newborns with salt-wasting congenital adrenal hyperplasia due to 21-hydroxylase (21-OH) deficiency, a total of 38 disease haplotypes and 53 nondisease haplotypes were found. Of the pathological haplotypes 47% were found to share the HLA-B39 or -Bw62 specificities, 55% of them in combination with the BFS, C2C, C4A4, C4B2 (SC42) complotype. The frequencies of HLA-B39 and -Bw62 among the affected haplotypes were 29 and 18% as compared with 6 and 0% among the nondisease haplotypes of the same families. Statistical associations (P less than 0.01) with salt-wasting adrenal hyperplasia were found with the SC42 complotype and with the combination SC42, HLA-B39. These results are markedly different from those reported in the literature which show an "association" at the population level among many Caucasoid samples of HLA-Bw47 and the extended haplotype (HLA-Bw47, DR7,FC91,0) with the salt-wasting form of the disease. Furthermore, four of the unrelated patients reported here were homozygous for all the major histocompatibility complex loci tested, while three others were homozygous for at least two HLA loci. Analysis of the geographical origin of the grandparents indicated clustering of the deficiency carrier HLA haplotypes. This observation, together with the fact that there is an excess of homozygotes among the patients in Venezuela, strongly suggests that salt-wasting 21-OH deficiency congenital adrenal hyperplasia is mostly the result of a founder effect of relatively hyperplasia is mostly the result of a founder effect identity by descent of a few abnormal alleles at the 21-OHB locus in most cases. The mutation marked by HLA-Bw47 was not observed in this population.