Effects of intravenous administration of polymyxin B in neonatal foals with experimental endotoxemia

Objective—To evaluate the effect of IV administration of polymyxin B on clinical and serum biochemical variables in foals with experimental endotoxemia. Design—Prospective experimental study. Animals—14 healthy neonatal foals. Procedures—Foals were randomly assigned to a treatment or control group and were administered a single dose of lipopolysaccharide (0.5 μg/kg [0.23 μg/lb]) IV over 30 minutes. The treatment group received polymyxin B (6,000 U/kg [2,727 U/lb], IV) immediately after completion of lipopolysaccharide infusion; the control group was administered an equal volume of saline (0.9% NaCl) solution. Subsequent doses of polymyxin B or saline solution were administered IV at 8 and 16 hours. Blood was collected at various time points, and outcome variables, including heart rate, respiratory rate, rectal temperature, attitude score, WBC count, neutrophil count, lymphocyte count, monocyte count, platelet count, Hct, blood lactate concentration, blood glucose concentration, serum tumor necrosis factor-α concentration, and plasma thromboxane B2 concentration, were measured. Urine was collected prior to and after experimentation to determine whether nephrotoxicosis was associated with treatment. Results—The treatment group had significantly lower blood lactate concentration and serum tumor necrosis factor-α and plasma thromboxane B2 concentrations and had higher blood glucose concentrations and better attitude scores, compared with the control group, at various time points during the study. No other significant differences and no evidence of overt nephrotoxicosis were detected. Conclusions and Clinical Relevance—Administration of polymyxin B IV in healthy neonatal foals challenged with lipopolysaccharide attenuated some clinical and serum biochemical derangements associated with endotoxemia

Impact of Covid-19 on attendances for a 1st episode of reduced fetal movements: A retrospective observational study.

BACKGROUND: Prior studies have demonstrated an increased stillbirth rate. It was suggested that the COVID-19 pandemic may have impacted on attendances for reduced fetal movements. Thus, we sought to ascertain the impact of the pandemic on attendances for reduced fetal movements (RFM) in our unit, ultrasound provision for reduced fetal movements, and the stillbirth rate. METHODS: This was a single site retrospective cohort study involving all women complaining of a 1st episode of reduced fetal movements between 01/03/2020-30/04/2020 (COVID) to 01/03/2019-30/04/2019 (Pre-COVID). Data were retrieved from computerised hospital records and statistical analyses were performed using GraphPad Prism and SPSS. RESULTS: 22% (179/810) of women presented with a 1st episode of reduced fetal movements Pre-COVID compared to 18% (145/803) during COVID (p = 0.047). Primiparous women were significantly over-represented in this population with a 1.4-fold increase in attendances during COVID (67% vs 48%, p = 0.0005). Neither the total stillbirth rate nor the stillbirth rate amongst women who presented with reduced fetal movements changed during COVID. Ultrasound provision was not impacted by COVID with 95% of the scans performed according to local guidelines, compared to Pre-COVID (74%, p = 0.0001). CONCLUSIONS: There is a significant decrease in 1st attendances for reduced fetal movements during COVID-19 pandemic. Primiparous women were 1.4 times more likely to attend with RFM. Women should be reassured that COVID-19 has not resulted in a decreased provision of care for RFM, and has not impacted on the stillbirth rate

Clinical and Immunomodulating Effects of Ketamine in Horses with Experimental Endotoxemia

Background:  Ketamine has immunomodulating effects both in vitro and in vivo during experimental endotoxemia in humans, rodents, and dogs. Hypothesis:  Subanesthetic doses of ketamine will attenuate the clinical and immunologic responses to experimental endotoxemia in horses. Animals:  Nineteen healthy mares of various breeds. Methods:  Experimental study. Horses were randomized into 2 groups: ketamine-treated horses (KET; n = 9) and saline-treated horses (SAL; n = 10). Both groups received 30 ng/kg of lipopolysaccharide (LPS, Escherichia coli, O55:B5) 1 hour after the start of a continuous rate infusion (CRI) of racemic ketamine (KET) or physiologic saline (SAL). Clinical and hematological responses were documented and plasma concentrations of tumor necrosis factor-α (TNF-α) and thromboxane B2 (TXB2) were quantified. Results:  All horses safely completed the study. The KET group exhibited transient excitation during the ketamine loading infusion (P \u3c .05) and 1 hour after discontinuation of administration (P \u3c .05). Neutrophilic leukocytosis was greater in the KET group 8 and 24 hours after administration of LPS (P \u3c .05). Minor perturbations of plasma biochemistry results were considered clinically insignificant. Plasma TNF-α and TXB2 production peaked 1.5 and 1 hours, respectively, after administration of LPS in both groups, but a significant difference between treatment groups was not demonstrated. Conclusions and Clinical Importance:  A subanesthetic ketamine CRI is well tolerated by horses. A significant effect on the clinical or immunologic response to LPS administration, as assessed by clinical observation, hematological parameters, and TNF-α and TXB2production, was not identified in healthy horses with the subanesthetic dose of racemic ketamine utilized in this study

Efficacy of perioperative cefuroxime as a prophylactic antibiotic in women requiring caesarean section : a systematic review

Intravenous (IV) Cefuroxime (CFX) is widely used in Caesarean Section (CS) as a prophylactic antibiotic. The objective of this systematic review to compare CFX concentration in maternal blood and adipose tissue with the incidence of surgical site infection (SSI) following IV CFX in non-obese and obese women undergoing CS. A search in Medline, EMBASE, Cochrane, Web of Science, CINHAL Plus, Scopus and Google Scholar was conducted without language or date restrictions. Published articles or abstracts reporting CFX concentration or rates of SSI following CFX IV administration in adult women requiring CS were included. Studies were screened by title and abstract. Quality of studies was assessed via the ClinPK Statement checklist (Pharmacokinetics studies), or Joanna Briggs Institute Critical Appraisal Tools (SSI studies). The Cochrane Effective Practice and Organisation of Care checklist evaluated the risk of bias (SSI studies). There were no studies evaluating CFX concentrations in obese women undergoing CS. For non-obese women, CFX plasma concentrations ranged from 9.85 to 95.25 mg/L within 30–60 min of administration (1500 mg dose; 4 articles, n = 108 women). Plasma CFX concentrations were above the minimum inhibitory concentration (8 mg/L) for up to 3 h post-dose. No studies reported on CFX concentration in adipose tissue. Reported rates of SSI were 4.7% and 6.8% after administration of a single 1500 mg dose of CFX administrated after cord clamping (n = 144 women). There is limited data on pharmacokinetics of CFX for CS. There were no studies that reported CFX concentrations or SSI in obese women

\u3ci\u3eUncle Tom’s Cabin\u3c/i\u3e in \u3ci\u3eThe National Era\u3c/i\u3e: Commentary on Chapter 1 and 2

In the first chapter of Uncle Tom’s Cabin, Stowe warns her readers that the “indulgence” of slave owners and the “affectionate loyalty” of the slaves themselves towards their masters have misled some observers to believe the “poetic legend” of slavery as a benevolent “patriarchal institution.” She does not deny the genuineness of these emotions, but she warns that “the shadow of a Law” makes a mockery of the human relationships that develop between masters and slaves: “So long as the law considers all these human beings, with beating hearts and living affections, only as so many things belonging to a master—so long as the failure, or misfortune, or imprudence, or death, of the kindest owner, may cause them any day to exchange a life of kind protection and indulgence for one of hopeless misery and toil, so long it is impossible to make anything beautiful or desirable in the best regulated administration of slavery.” We begin the novel, then, in what seems to be the model benevolent Shelby plantation in Kentucky, not the cruel Legree plantation in Louisiana, where the novel ends. Nevertheless, the “shadow of the law,” in the form of Mr. Shelby’s obligation to pay his debts, endangers the residents of the Shelby plantation. Stowe derived her portrait of slavery primarily from reading, not from direct experience and observation in the slave states of the South. She describes Eliza Harris as “not a fancy sketch, but taken from a remembrance, as we saw her years ago in Kentucky”—that is, during Stowe’s one brief trip South of the Mason-Dixon line during her years living in Cincinnati. Some white Southerners attacked Stowe for this lack of direct knowledge of the South and slavery. However, as historian William R. Taylor observed fifty years ago, what troubled them the most about Uncle Tom’s Cabin was not that she attacked their point of view, but that she understood it too well. As Taylor explains, beginning in the 1830s white Southerners invented the legend of “plantation paternalism,” “the image of sunshine and happiness around the plantation home,” to “justif[y] their peculiar institution to themselves and to others.”[1] Stowe only “[took] the Southerner at his word”: she did “not…deny the Southern defense of slavery but…suggested that it was inadequate, even if its claims were allowed.” Stowe set out to show, Taylor explains, that “kindness, generosity and affection provided no assurance against cruelty and brutality” and that “a slave could love his master and mistress and still wish to be free.”[2

Transparent air filter for high-efficiency PM2.5 capture

Particulate matter (PM) pollution has raised serious concerns for public health. Although outdoor individual protection could be achieved by facial masks, indoor air usually relies on expensive and energy-intensive air-filtering devices. Here, we introduce a transparent air filter for indoor air protection through windows that uses natural passive ventilation to effectively protect the indoor air quality. By controlling the surface chemistry to enable strong PM adhesion and also the microstructure of the air filters to increase the capture possibilities, we achieve transparent, high air flow and highly effective air filters of similar to 90% transparency with >95.00% removal of PM2.5 under extreme hazardous air-quality conditions (PM2.5 mass concentration >250 mu g m(-3)). A field test in Beijing shows that the polyacrylonitrile transparent air filter has the best PM2.5 removal efficiency of 98.69% at high transmittance of similar to 77% during haze occurrence.open

Samba II PCR testing for COVID-19 in pregnant women: a retrospective cohort study and literature review.

BACKGROUND: Asymptomatic carriage of COVID-19 in pregnant women has been reported and could lead to outbreaks in maternity units. We sought to ascertain the impact of rapid isothernal nucleic acid based testing for COVID-19 in an unselected cohort of pregnant women attending our maternity unit. We also assessed the correlation between community prevalence and asymptomatic carriage. METHODS: Data for the retrospective cohort study were collected from a large UK tertiary maternity unit over a 4-week period using computerised hospital records. Literature searches were performed across multiple repositories. COVID-19 prevalence was extracted from online repositories. RESULTS: Nasopharyngeal and oropharyngeal swabs were obtained from 457/465 (98%) women during the study period. The median turnaround time for results was 5.3 h (interquartile range (IQR) 2.6-8.9 h), with 92% of the results returned within 24 h. In our cohort, only one woman tested positive, giving a screen positive rate of 0.22% (1/457; 95% CI: 0.04-1.23%). One woman who tested negative developed a fever postnatally following discharge but was lost to follow-up. From our literature review, we did not find any correlation between asymptomatic carriage in pregnant women and the reported regional prevalence of COVID-19. CONCLUSIONS: Testing using the SAMBA-II machine was acceptable to the vast majority of pregnant women requiring admission and had a low turnaround time. Asymptomatic carriage is low, but not correlated to community prevalence rates. Screening pregnant women on admission will remain an important component in order to minimise nosocomial infection

Impact of carprofen administration on stress and nociception responses of calves to cautery dehorning

Citation: Stock, M. L., Barth, L. A., Van Engen, N. K., Millman, S. T., Gehring, R., Wang, C., . . . Coetzee, J. F. (2016). Impact of carprofen administration on stress and nociception responses of calves to cautery dehorning. Journal of Animal Science, 94(2), 542-555. doi:10.2527/jas2015-9510The objective of this study was to investigate the effects of carprofen administered immediately before cautery dehorning on nociception and stress. Forty Holstein calves aged approximately 6 to 8 wk old were either placebo treated and sham dehorned (n = 10) or cautery dehorned following administration of carprofen (1.4 mg/kg) subcutaneously (n = 10) or orally (n = 10) or a subcutaneous and oral placebo (n = 10) in a randomized, controlled trial. All animals were given a cornual nerve block using lidocaine before dehorning. Response variables including mechanical nociception threshold, ocular temperature, heart rate, and respiratory rate were measured before and following cautery dehorning for 96 h. Blood samples were also collected over 96 h following dehorning and analyzed for plasma cortisol and substance P concentrations by RIA. Plasma carprofen concentration and ex vivo PGE2 concentrations were also determined for this time period. Average daily gain was calculated for 7 d after dehorning. Data were analyzed using a linear mixed effects model with repeated measures, controlling for baseline values by their inclusion as a covariate in addition to planned contrasts. Dehorning was associated with decreased nociception thresholds throughout the study and a stress response immediately after dehorning, following the loss of local anesthesia, and 48 h after dehorning compared with sham-dehorned calves. Carprofen was well absorbed after administration and reached concentrations that inhibited ex vivo PGE2 concentrations for 72 h (subcutaneous) and 96 h (oral) compared with placebo-treated calves (P < 0.05). Carprofen-treated calves tended to be less sensitive (P = 0.097) to nociceptive threshold tests. Overall, at the dosing regimen studied, the effect of carprofen on sensitivity and stress following cautery dehorning was minimal. Consideration of route of administration and dose determination studies may be warranted

Timing of tracheostomy as a determinant of weaning success in critically ill patients: a retrospective study

INTRODUCTION: Tracheostomy is frequently performed in critically ill patients for prolonged intubation. However, the optimal timing of tracheostomy, and its impact on weaning from mechanical ventilation and outcomes in critically ill patients who require mechanical ventilation remain controversial. METHODS: The medical records of patients who underwent tracheostomy in the medical intensive care unit (ICU) of a tertiary medical centre from July 1998 to June 2001 were reviewed. Clinical characteristics, length of stay in the ICU, rates of post-tracheostomy pneumonia, weaning from mechanical ventilation and mortality rates were analyzed. RESULTS: A total of 163 patients (93 men and 70 women) were included; their mean age was 70 years. Patients were classified into two groups: successful weaning (n = 78) and failure to wean (n = 85). Shorter intubation periods (P = 0.02), length of ICU stay (P = 0.001) and post-tracheostomy ICU stay (P = 0.005) were noted in patients in the successful weaning group. Patients who underwent tracheostomy more than 3 weeks after intubation had higher ICU mortality rates and rates of weaning failure. The length of intubation correlated with the length of ICU stay in the successful weaning group (r = 0.70; P < 0.001). Multivariate analysis revealed that tracheostomy after 3 weeks of intubation, poor oxygenation before tracheostomy (arterial oxygen tension/fractional inspired oxygen ratio <250) and occurrence of nosocomial pneumonia after tracheostomy were independent predictors of weaning failure. CONCLUSION: The study suggests that tracheostomy after 21 days of intubation is associated with a higher rate of failure to wean from mechanical ventilation, longer ICU stay and higher ICU mortality

Age-related changes in murine myometrial transcript profile are mediated by exposure to the female sex hormones.

In humans, the risk of operative first delivery increases linearly with maternal age. We previously hypothesized that prolonged, cyclical, prepregnancy exposure to estrogen and progesterone contributes to uterine aging. Here, we test this hypothesis. Myometrium was obtained from four groups of virgin mice: (i) 10- to 12-week- and 28- to 30-week-old mice; (ii) 10- to 12-week- and 38- to 40-week-old mice; (iii) 38-week-old mice that had an ovariectomy or sham operation early in life; (iv) 38-week-old mice that had been treated with progesterone or vehicle containing implants from 8 to 36 weeks. Transcript profiling was carried out using Affymetrix Gene ST 1.1 arrays, and data were normalized. We identified 60 differentially regulated transcripts associated with advancing age (group 1). We validated these changes in group 2 (P for overlap = 5.8 × 10(-46) ). Early ovariectomy prevented the age-related changes in myometrial transcript profile. Similarly, progesterone-mediated long-term ovarian suppression prevented the age-related changes in myometrial transcript profile. Interferon regulatory factor 7 (Irf7) mRNA was regulated by age and hormonal exposure, and was identified as a predicted regulator of the other differentially expressed transcripts by both promoter sequence and canonical pathway activation analysis (P = 8.47 × 10(-5) and P < 10(-10) , respectively). Immunohistochemistry demonstrated IRF7 in both mouse and human myometrium. We conclude the following: (i) Myometrial aging in mice is associated with reproducible changes in transcript profile; (ii) these changes can be prevented by interventions which inhibit cyclical changes in the female sex hormones; and (iii) IRF7 may be an important regulator of myometrial function and aging.This work was supported by the NIHR Cambridge Comprehensive Biomedical Research Centre, Addenbrooke's Charitable Trust and the Evelyn Trust.This is the final version of the article. It first appeared from Wiley via http://dx.doi.org/10.1111/acel.1240