Cefazolin Prophylaxis for Total Joint Arthroplasty: Obese Patients Are Frequently Underdosed and at Increased Risk of Periprosthetic Joint Infection

Background One of the most effective prophylactic strategies against periprosthetic joint infection (PJI) is administration of perioperative antibiotics. Many orthopedic surgeons are unaware of the weight-based dosing protocol for cefazolin. This study aimed at elucidating what proportion of patients receiving cefazolin prophylaxis are underdosed and whether this increases the risk of PJI. Methods A retrospective study of 17,393 primary total joint arthroplasties receiving cefazolin as perioperative prophylaxis from 2005 to 2017 was performed. Patients were stratified into 2 groups (underdosed and adequately dosed) based on patient weight and antibiotic dosage. Patients who developed PJI within 1 year following index procedure were identified. A bivariate and multiple logistic regression analyses were performed to control for potential confounders and identify risk factors for PJI. Results The majority of patients weighing greater than 120 kg (95.9%, 944/984) were underdosed. Underdosed patients had a higher rate of PJI at 1 year compared with adequately dosed patients (1.51% vs 0.86%, P = .002). Patients weighing greater than 120 kg had higher 1-year PJI rate than patients weighing less than 120 kg (3.25% vs 0.83%, P < .001). Patients who were underdosed (odds ratio, 1.665; P = .006) with greater comorbidities (odds ratio, 1.259; P < .001) were more likely to develop PJI at 1 year. Conclusion Cefazolin underdosing is common, especially for patients weighing more than 120 kg. Our study reports that underdosed patients were more likely to develop PJI. Orthopedic surgeons should pay attention to the weight-based dosing of antibiotics in the perioperative period to avoid increasing risk of PJI

Pets or Pest: Peritoneal Dialysis-related Peritonitis due to Pasteurella multocida

Pasteurella multocida is a Gram-negative bacteria found in the oropharynx of many domestic animals. P. multocida can cause a variety of human infections, but it remains a rare cause of peritoneal dialysis-related peritonitis. We describe a severe case of peritoneal dialysis-related peritonitis due to P. multocida infection caused by close contact with a cat

Enzymes as Feed Additive to Aid in Responses Against Eimeria Species in Coccidia-Vaccinated Broilers Fed Corn-Soybean Meal Diets with Different Protein Levels

This research aimed to evaluate the effects of adding a combination of exogenous enzymes to starter diets varying in protein content and fed to broilers vaccinated at day of hatch with live oocysts and then challenged with mixed Eimeria spp. Five hundred four 1-d-old male Cobb-500 chickens were distributed in 72 cages. The design consisted of 12 treatments. Three anticoccidial control programs [ionophore (IO), coccidian vaccine (COV), and coccidia-vaccine + enzymes (COV + EC)] were evaluated under 3 CP levels (19, 21, and 23%), and 3 unmedicated-uninfected (UU) negative controls were included for each one of the protein levels. All chickens except those in unmedicated-uninfected negative controls were infected at 17 d of age with a mixed oral inoculum of Eimeria acervulina, Eimeria maxima, and Eimeria tenella. Live performance, lesion scores, oocyst counts, and samples for gut microflora profiles were evaluated 7 d postinfection. Ileal digestibility of amino acids (IDAA) was determined 8 d postinfection. Microbial communities (MC) were analyzed by G + C%, microbial numbers were counted by flow cytometry, and IgA concentrations were measured by ELISA. The lowest CP diets had poorer (P ≤ 0.001) BW gain and feed conversion ratio in the preinfection period. Coccidia-vaccinated broilers had lower performance than the ones fed ionophore diets during pre- and postchallenge periods. Intestinal lesion scores were affected (P ≤ 0.05) by anticoccidial control programs, but responses changed according to gut section. Feed additives or vaccination had no effect (P ≥ 0.05) on IDAA, and diets with 23% CP had the lowest (P ≤ 0.001) IDAA. Coccidial infection had no effect on MC numbers in the ileum but reduced MC numbers in ceca and suppressed ileal IgA production. The COV + EC treatment modulated MC during mixed coccidiosis infection but did not significantly improve chicken performance. Results indicated that feed enzymes may be used to modulate the gut microflora of cocci-vaccinated broiler chickens

Effect of Electrolyte Balance in Low-Protein Diets on Broiler Performance and Tibial Dyschondroplasia Incidence

A proper dietary electrolyte balance (DEB) is essential to ensure an optimum acid-base equilibrium and broiler performance. In low-CP diets, this balance can be affected by reduction of soybean meal and inclusion of high levels of synthetic amino acids. Although, some studies have related low-protein diets supplemented with amino acids and DEB, these relations are not well explained, because some research demonstrates confusion about the deficiency and balance of nutrients. The objective of these experiments was to evaluate the DEB effects of diets with low levels of protein supplemented with amino acids on broiler performance and bone development. Results indicated that DEB and CP content influenced broiler chick performance in the starter and growing periods. There was no significant effect due to the interaction between DEB and CP content for tibial dyschondroplasia incidence (TD) or in bone breaking resistance during the growing period of either experiment. The incidence of TD was reduced with 253 mEq/kg DEB in the starter period

Soil mineral N dynamics beneath mixtures of leaves from legume and fruit trees in Central Amazonian multi-strata agroforests.

Dinâmica do nitrogênio mineral no solo em misturas de folhas de leguminosas arbóreas e de fruteiras em sistemas agroflorestais multiestratificados na Amazônia Central

Chromomagnetism in nuclear matter

Quarks are color charged particles. Due to their motion there is a strong possibility of generation of color magnetic field. It is shown that however hadrons are color singlet particles they may have non-zero color magnetic moment. Due to this color magnetic moment hadrons can show color interaction. In this paper we have studied the chromomagnetic properties of nuclear matter.Comment: 6 pages, 1 figure, accepted for publication in Int. J. Theor. Phy

La enseñanza de las ciencias mediante proyectos didácticos en la Universidad de los Andes - Venezuela

Los paradigmas de la pedagogía científica incorporan estrategias activas, pero, en el trabajo de aula sigue prevaleciendo el modelo pasivo. En contraposición a esto, el presente ensayo describe la experiencia que hemos acumulado desde 1999 con el desarrollo de una metodología denominada Proyectos Didácticos para la Enseñanza de la Ciencia que tiene por finalidad principal aportar diferentes propuestas metodológicas para abordar el trabajo de aula y fuera de ésta, para el caso especial de la enseñanza de las ciencias. Esta estrategia implica la participación activa del estudiante diseñando propuestas prácticas o juegos para el desarrollo de diversos contenidos típicos de la ciencia en el contexto de la formación inicial de docentes en la Universidad de Los Andes

Responding to COVID-19 in social work field education in Australia, New Zealand and the United States

Author(s), Kathryn Hay, "Responding to COVID-19 in social work field education in Australia, New Zealand and the United States". International Social Work pp. 1-14. [2021] Copyright © The author/s. DOI: [10.1177/00208728211048934]. Published source must be acknowledged with citation. Reuse is restricted to non-commercial and no derivative usesPublishe

Requirements of Sodium and Chloride by Leghorn Laying Hens

Sodium and Cl are low-cost nutrients with great influence on feed conversion ratio (FCR), eggshell quality, and excreta moisture. Actual values of dietary requirements of these minerals for commercial laying hens are not well defined. These requirements were reevaluated in a factorial experiment using corn-soybean meal basal diets. No significant influence of Na and Cl levels was observed on egg production (%), egg weight (g), or feed intake (g/d), but levels of these minerals had variable effects on FCR, eggshell quality, and excreta moisture. The optimum requirement of Na changed according to the variable evaluated and level of Cl used