Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Detection of Mycoplasma ovipneumoniae from Goats with Nasal Discharge by Culture and Polymerase Chain Reaction

In this study, the presence of Mycoplasma ovipneumoniae and other mycoplasmas was investigated by culture and PCR in the nasal swab samples of 692 goats with nasal discharges in 44 different flocks in eastern Turkey. The results showed that approximately 41% (18/44) of the flocks and 11% (75/692) of the goats harbored Mycoplasma agents. Among the Mycoplasma species; M. ovipneumoniae was the most prevalent species detected within 29.5% (13/44) of the flocks and 8.1% (56/692) of the goats. Mycoplasma arginini was also detected solely or in combination with M. ovipneumoniae in 18.2% (8/44) of the flocks and 1.9% (13/692) of the goats with nasal discharges. None of the samples were determined to be positive in the M. mycoides cluster and Mycoplasma agalactiae specific PCR analyses. The remaining 12 samples could not be identified at species level. Because the investigation of other agents which may cause respiratory problems such as Mannheimia was beyond the scope of this study, it is not possible to establish strong association between M. ovipneumoniae and disease. However, it may be logical to put forward that this agent might be the main cause of respiratory problems in at least three flocks in which the isolation rates of 50% or higher were obtained

Endemic Contagious Agalactia in Sheep and Goats: Clinical Evaluation, Treatment and Vaccination

KALIN, Recep/0000-0002-9173-9550WOS: 000281923700006In this study, it aimed to evaluate clinical signs of Contagious Agalactia (CA) that had been affecting small ruminants in Kirikkale Province for 1.5 years and to intervene with this endemic CA by administration of enrofloxacin 5 mg kg(-1) for 5 days and a single dose of meloxicam (0.5 mg kg(-1)) to acutely infected animals and by vaccination of the flocks. The study was conducted between July 2007 and December 2008 on a total of 745 animals of 5 different flocks with problems of mastitis, keratoconjunctivitis and arthritis. Clinically determined CA was also confirmed by PCR analysis of milk samples. Arthritis was the most frequently observed clinical sign with a rate of 71.84% in diseased animals. Arthritis was observed either as a single problem or concurrently with mastitis or ocular lesions. The co-existence rate of ocular lesions with mastistis was 2.91% while observing all three lesions concomitantly was the least frequent, 2.91%. Ocular lesions alone was not seen in ewes and goats but co-existed with other signs. Ewes and goats exhibited a higher frequency of mastitis alone with a rate of 45 and 44.83%, respectively compared to other two clinical signs. The treatment protocol mentioned above was successful as the general body condition of the clinically diseased animals was improved and subsequently no incidence of death was observed. Animals gradually recovered from mastititis and conjunctivitis and the severity of keratoconjunctivitis and arthritis was decreased. It also concluded that application of a live CA vaccine twice with a 6 month-interval was quite effective as no case of CA was observed in vaccinated flocks during a 1 year follow-up period

Quercetin protects rat skeletal muscle from ischemia reperfusion injury

In this study, we investigated the potential beneficial effects of quercetin on skeletal muscle ischemia reperfusion injury. Twenty-four Sprague–Dawley type rats were randomly divided into four groups. In the sham group, only gastrocnemius muscle were removed and given no quercetin. In ischemia group, all the femoral artery, vein and collaterals were occluded in the left hindlimb by applying tourniquate under general anaesthesia for three hours but reperfusion was not done. In the Quercetin + Ischemia reperfusion group, quercetin (200 mg kg−1 dose orally) was given during one-week reoperation and later ischemia reperfusion model was done. Finally, gastrocnemius muscle samples were removed to measure biochemical parameters. The biomarkers, MDA levels, SOD, CAT and GPx activities, were evaluated related to skeletal muscle ischemia reperfusion injury. MDA levels reduced and SOD, CAT and GPx activities increased significantly in Quercetin + Ischemia reperfusion group. Results clearly showed that Quercetin have a protective role against oxidative damage induced by ischemia reperfusion in rats. © 2016 Informa UK Limited, trading as Taylor & Francis Group