Intermittent heparinised saline flushes for maintaining indwelling peripheral and central intravenous catheters in diabetic dogs

Intermittent low-dose heparinised saline flushes were found to be efficacious for maintaining patency of indwelling peripheral and central intravenous catheters in diabetic dogs. The catheters were flushed with 1 mL of 1 U/mL heparinised saline every two hours immediately following blood sample collection, or every 12 hours when not being used for sampling. Central catheters were flushed with saline solution first to clear the line before instillation of the heparinised saline. Patency of 54/57 (95%) of the peripheral catheters and 30/32 (94%) of the central catheters was achieved for up to 36 hours and five days, respectively. No phlebitis, or local or systemic infections were observed and, in each case, catheter failure was attributable to obstruction or extravasation. It is unlikely that there will be any contraindications to this flushing technique and its introduction may improve intravenous catheter survival and reduce catheter-associated complications in hospitalised dogs.

Increase in prevalence of nosocomial non-Candida albicans candidaemia and the association of Candida krusei with fluconazole use

Candida is an important nosocomial pathogen. This study was undertaken to provide information on the rate of candidaemia, to define the risks for candidaemia and to describe and account for the epidemiology of candidaemia at our institution between 1992 and 1999. The overall rate was 0.052 per 1000 patient days and 0.27 per 1000 discharges. The major risks for candidaemia were colonization at a non-sterile site (OR 3.85, 95%CI 1.80-9.09), total parenteral nutrition (TPN) in the absence of neutropenia (OR 11.8, 95%CI 4.5-35.4, P

Dietary chromium tripicolinate supplementation reduces glucose concentrations and improves glucose tolerance in normal-weight cats

The effect of dietary chromium supplementation on glucose and insulin metabolism in healthy, non-obese cats was evaluated. Thirty-two cats were randomly divided into four groups and fed experimental diets consisting of a standard diet with 0 ppb (control), 150 ppb, 300 ppb, or 600 ppb added chromium as chromium tripicolinate. Intravenous glucose tolerance, insulin tolerance and insulin sensitivity tests with minimal model analysis were performed before and after 6 weeks of feeding the test diets. During the glucose tolerance test, glucose concentrations, area under the glucose concentration-time curve, and glucose half-life (300 ppb only), were significantly lower after the trial in cats supplemented with 300 ppb and 600 ppb chromium, compared with values before the trial. Fasting glucose concentrations measured on a different day in the biochemistry profile were also significantly lower after supplementation with 600 ppb chromium. There were no significant differences in insulin concentrations or indices in either the glucose or insulin tolerance tests following chromium supplementation, nor were there any differences between groups before or after the dietary trial. Importantly, this study has shown a small but significant, dose-dependent improvement in glucose tolerance in healthy, non-obese cats supplemented with dietary chromium. Further long-term studies are warranted to determine if the addition of chromium to feline diets is advantageous. Cats most likely to benefit are those with glucose intolerance and insulin resistance from lack of exercise, obesity and old age. Healthy cats at risk of glucose intolerance and diabetes from underlying low insulin sensitivity or genetic factors may also benefit from long-term chromium supplementation. (C) 2002 ESFM and AAFP.

Lysine requirements of pre-lay broiler breeder pullets: Determination by indicator amino acid oxidation

The indicator amino acid oxidation (IAAO) method allows the determination of amino acid requirements under conditions of low growth rate as found in pre-laying broiler breeder pullets. Cobb 500 breeder pullets (20 wk old; 2290 +/- 280 g, n = 4) were adapted (6 d) to a pelleted, purified control diet containing all nutrients at greater than or equal to 110% of NRC recommendations. After recovery from surgery for implantation of a jugular catheter, each bird was fed, in random order, test diets containing one of nine levels of lysine (0.48, 0.96, 1.92, 2.88, 3.84, 4.80, 7.68, 9.60 and 14.40 g/kg of diet). Indicator oxidation was determined during 4-h primed (74 kBq/kg body), constant infusions (44 kBq (.) h(-1) (.) kg body(-1)) of L-[1-C-14]phenylalanine. Using the breakpoint of a one-slope broken-line model, the lysine requirement was determined to be 4.88 +/- 0.96 g/kg of diet or 366 +/- 72 mg (.) hen(-1) (.) d(-1) with an upper 95% Cl of 6.40 g/kg of diet or 480 mg (.) hen(-1) (.) d(-1). IAAO allows determination of individual bird amino acid requirements for specific ages and types of birds over short periods of time and enables more accurate broiler breeder pullet diet formulation.

Gastroschisis: determinants of neonatal outcome

This retrospective study elicits information regarding the dependence of neonatal outcome in gastroschisis upon: (1) the mode of delivery, (2) place of birth, (3) time for birth to surgery, (4) method of closure, (5) time from operation to commencement of first enteral feeds. The neonatal intensive care database from five major tertiary centres was used to identify 181 neonates with gastroschisis from 1990 to 2000. There were 8 deaths. There were no significant differences in outcome for infants delivered vaginally (102) versus Caesarean section (79), those born near the tertiary centre (133) as compared to infants born away (48), ones operated within 7 hours (125) compared with those operated after 7 hours (56), with delayed closure (30) versus primary closure (151). Neonates fed within 10 days of operation (85) had significantly lower incidence of sepsis, duration of TPN and hospital stay when compared to those fed after 10 days (96). Early commencement of feeds decreases the incidence of sepsis, duration of total parenteral nutrition (TPN) and hospital stay. Place of delivery, mode of delivery, time to surgery and type of closure do not influence neonatal outcome.

Factors predictive of intravenous fluid administration errors in Australian surgical care wards

Background: Intravenous (IV) fluid administration is an integral component of clinical care. Errors in administration can cause detrimental patient outcomes and increase healthcare costs, although little is known about medication administration errors associated with continuous IV infusions. Objectives: ( 1) To ascertain the prevalence of medication administration errors for continuous IV infusions and identify the variables that caused them. ( 2) To quantify the probability of errors by fitting a logistic regression model to the data. Methods: A prospective study was conducted on three surgical wards at a teaching hospital in Australia. All study participants received continuous infusions of IV fluids. Parenteral nutrition and non-electrolyte containing intermittent drug infusions ( such as antibiotics) were excluded. Medication administration errors and contributing variables were documented using a direct observational approach. Results: Six hundred and eighty seven observations were made, with 124 (18.0%) having at least one medication administration error. The most common error observed was wrong administration rate. The median deviation from the prescribed rate was 247 ml/h (interquartile range 275 to + 33.8 ml/ h). Errors were more likely to occur if an IV infusion control device was not used and as the duration of the infusion increased. Conclusions: Administration errors involving continuous IV infusions occur frequently. They could be reduced by more common use of IV infusion control devices and regular checking of administration rates.

Nutritional status and energy expenditure in children pre-bone-marrow-transplant

The aims of this study were to establish the nutritional status of children pre- BMT and to determine whether predictive methods of assessing nutritional status and resting energy expenditure ( REE) are accurate in this population. We analysed the body cell mass ( BCM) ( n = 26) and REE ( n = 24) in children undergoing BMT. BCM was adjusted for height ( BCM/ HTp) and expressed as a Z score to represent nutritional status. To determine whether body mass index ( BMI) was indicative of nutritional status in children undergoing BMT, BMI Z scores were compared to the reference method of BCM/ HTp Z scores. Schofield predictive equations of basal metabolic rate ( BMR) were compared to measured REE to evaluate the accuracy of the predictive equations. The mean BCM/ HTp Z score for the subject population was -1.09 +/- 1.28. There was no significant relationship between BCM/ HTp Z score and BMI Z score ( r = 0.34; P > 0.05); however there was minimal difference between measured REE and predicted BMR ( bias = -11 +/- 149 kcal/ day). The results of this study demonstrate that children undergoing BMT may have suboptimal nutritional status and that BMI is not an accurate indication of nutritional status in this population. However, Schofield equations were found to be suitable for representing REE in children pre- BMT.

Mineral nutrition and plant morphogenesis

Plant morphogenesis in vitro can be achieved via two pathways, somatic embryogenesis or organogenesis. Relationships between the culture medium and explant leading to morphogenesis are complex and, despite extensive study, remain poorly understood. Primarily the composition and ratio of plant growth regulators are manipulated to optimize the, quality and numbers of embryos or organs initiated. However, many species and varieties do not respond to this classical approach and require further optimization by the variation of other chemical or physical factors. Mineral nutrients form a significant component of culture media but are often overlooked as possible morphogenic elicitors. The combination of minerals for a particular plant species and developmental pathway are usually determined by the empirical manipulation of one or a combination of existing published formulations. Often only one medium type is used for the duration of culture even though this formulation may not be optimal for the different stages of explant growth and development. Furthermore, mineral studies have often focused on growth rather than morphogenesis with very little known of the relationships between mineral uptake and morphogenesis. This article examines the present knowledge of the main effects that mineral nutrients have on plant morphogenesis in vitro. In particular, the dynamics of nitrogen, phosphorus, and calcium supply during development are discussed.

Electronic nose evaluation of onion headspace volatiles and bulb quality as affected by nitrogen, sulphur and soil type

Edaphic factors affect the quality of onions (Allium cepa). Two experiments were carried out in the field and glasshouse to investigate the effects of N (field: 0, 120 kg ha(-1); glasshouse: 0, 108 kg ha(-1)), S (field: 0, 20 kg ha(-1); glasshouse: 0, 4.35 kg ha(-1)) and soil type (clay, sandy loam) on onion quality. A conducting polymer sensor electronic nose (E-nose) was used to classify onion headspace volatiles. Relative changes in the E-nose sensor resistance ratio (%dR/R) were reduced following N and S fertilisation. A 2D Principal Component Analysis (PCA) of the E-nose data sets accounted for c. 100% of the variations in onion headspace volatiles in both experiments. For the field experiment, E-nose data set clusters for headspace volatiles for no N-added onions overlapped (D-2 = 1.0) irrespective of S treatment. Headspace volatiles of N-fertilised onions for the glasshouse sandy loam also overlapped (D-2 = 1.1) irrespective of S treatment as compared with distinct separations among clusters for the clay soil. N fertilisation significantly (P < 0.01) reduced onion bulb pyruvic acid concentration (flavour) in both experiments. S fertilisation increased pyruvic acid concentration significantly (P < 0.01) in the glasshouse experiment, especially for the clay soil, but had no effect on pyruvic acid concentration in the field. N and S fertilisation significantly (P < 0.01) increased lachrymatory potency (pungency), but reduced total soluble solids (TSS) content in the field experiment. In the glasshouse experiment, N and S had no effect on TSS. TSS content was increased on the clay by 1.2-fold as compared with the sandy loam. Onion tissue N:water-soluble SO42- ratios of between five and eight were associated with greater %dR/R and pyruvic acid concentration values. N did not affect inner bulb tissue microbial load. In contrast, S fertilisation reduced inner bulb tissue microbial load by 80% in the field experiment and between 27% (sandy loam) and 92% (clay) in the glasshouse experiment. Overall, onion bulb quality discriminated by the E-nose responded to N, S and soil type treatments, and reflected their interactions. However, the conventional analytical and sensory measures of onion quality did not correlate with %dR/R.

Quality of life changes following peripheral blood stem cell transplantation and participation in a mixed-type, moderate-intensity, exercise program

The purpose of this investigation was to evaluate the impact of undertaking peripheral blood stem cell transplantation (PBST) on quality of life (QoL), and to determine the effect of participating in a mixed-type, moderate-intensity exercise program on QoL. It was also an objective to determine the relationship between peak aerobic capacity and QoL in PBST patients. QoL was assessed via the CARES questionnaire and peak aerobic capacity by a maximal graded treadmill test, pretransplant (PI), post transplant (PII) and following a 12-week intervention period (PIII). At PII, 12 patients were divided equally into a control or exercise intervention group. Undergoing a PBST was associated with a statistically but not clinically significant decline in QoL (P < 0.05). Following the intervention, exercising patients demonstrated an improved QoL when compared with pretransplant ratings (P < 0.01) and nonexercising transplant patients (P < 0.05). Moreover, peak aerobic capacity and QoL were correlated (P < 0.05). The findings demonstrated that exercise participation following oncology treatment is associated with a reduction in the number and severity of endorsed problems, which in turn leads to improvements in global, physical and psychosocial QoL. Furthermore, a relationship between fitness and QoL exists, with those experiencing higher levels of fitness also demonstrating higher QoL.

Evaluation of eight spring onion genotypes, sulphur nutrition and soil-type effects with an electronic nose

Genotype, sulphur (S) nutrition and soil-type effects on spring onion quality were assessed using a 32-conducting polymer sensor E-nose. Relative changes in sensor resistance ratio (% dR/R) varied among eight spring onion genotypes. The % dR/R was reduced by S application in four of the eight genotypes. For the other four genotypes, S application gave no change in % dR/R in three, and increased % dR/R in the other. E-nose classification of headspace volatiles by a two-dimensional principal component analysis (PCA) plot for spring onion genotypes differed for S fertilisation vs. no S fertilisation. Headspace volatiles data set clusters for cv. 'White Lisbon' grown on clay or on sandy loam overlapped when 2.9 [Mahalanobis distance value (D2) = 1.6], or 5.8-(D2 = 0.3) kg S ha-1 was added. In contrast, clear separation (D2 = 7.5) was recorded for headspace volatile clusters for 0 kg S hd-1 on clay vs. sandy loam. Addition of 5.8 kg S ha-1 increased pyruvic acid content (mmole g-1 fresh weight) by 1.7-fold on average across the eight genotypes. However, increased S from 2.9 to 5.8 kg ha-1 did not significantly (P > 0.05) influence % dR/R, % dry matter (DM) or total soluble solids (TSS) contents, but significantly (P < 0.05) increased pyruvic acid content. TSS was significantly (P < 0.05) reduced by S addition, while % DM was unaffected. In conclusion, the 32-conducting polymer E-nose discerned differences in spring onion quality that were attributable to genotype and to variations in growing conditions as shown by the significant (P < 0.05) interaction effects for % dR/R.

Quality of Reporting of Observational Longitudinal Research

Observational longitudinal research is particularly useful for assessing etiology and prognosis and for providing evidence for clinical decision making. However, there are no structured reporting requirements for studies of this design to assist authors, editors, and readers. The authors developed and tested a checklist of criteria related to threats to the internal and external validity of observational longitudinal studies. The checklist criteria concerned recruitment, data collection, biases, and data analysis and descriptive issues relevant to study rationale, study population, and generalizability. Two raters independently assessed 49 randomly selected articles describing stroke research published from 1999 to 2003 in six journals: American Journal of Epidemiology, Journal of Epidemiology and Community Health, Stroke, Annals of Neurology, Archives of Physical Medicine and Rehabilitation, and American Journal of Physical Medicine and Rehabilitation. On average, 17 of the 33 checklist criteria were reported. Criteria describing the study design were better reported than those related to internal validity. No relation was found between study type (etiologic or prognostic) or word count and quality of reporting. A flow diagram for summarizing participant flow through a study was developed. Editors and authors should consider using a checklist and flow diagram when reporting on observational longitudinal research.