Our population-based study found that abnormal placentation is the main indication for peripartum hysterectomy. The most important step in prevention of major postpartum hemorrhage is recognizing and assessing women's risk, although even perfect management of hemorrhage cannot always prevent surgery.
The objective of this retrospective study was to compare the efficacy of azithromycin-rifampin, clarithromycin-rifampin, and erythromycin-rifampin for the treatment of pneumonia caused by Rhodococcus equi in foals. Eighty-one foals with naturally acquired pneumonia caused by R. equi were included in the study. Information on age, sex, breed, physical examination findings, laboratory testing, and thoracic radiography was abstracted from each medical record. Foals were divided in 3 groups based on the antimicrobial agent selected for therapy. Short-term (discharge from the hospital) and long-term (apparently healthy as a yearling) success rates, days of hospitalization, days with fever, days with tachypnea, and percentage of radiographic improvement were compared among groups. Foals treated with clarithromycin-rifampin had significantly (P = .02) higher odds of overall short-term (odds ratio [OR] = 12.2) and long-term (OR = 20.6) treatment success and significantly fewer days with fever than foals treated with erythromycin-rifampin. Foals treated with clarithromycin-rifampin had a significantly (P = .03) higher percentage of radiographic improvement and a tendency (P = .06) toward higher odds of overall short-term (OR = 8.1) and long-term (OR = 11.8) treatment success compared to foals treated with azithromycin-rifampin. Among foals with severe radiographic lesions, the success rates of foals treated with clarithromycin-rifampin both short-term (88%) and long-term (83%) were significantly (P = .02) higher than that of foals treated with azithromycin-rifampin (0%). For each treatment group, the only reported adverse effect was diarrhea that was mild and self-limiting in most cases. The combination clarithromycin-rifampin is superior to azithromycin-rifampin or erythromycin-rifampin for the treatment of pneumonia caused by R. equi in foals in a referral population.
Three-dimensional elements, with refractive index distribution structured at sub-wavelength scale, provide an expansive optical design space that can be harnessed for demonstrating multi-functional free-space optical devices. Here we present 3D dielectric elements, designed to be placed on top of the pixels of image sensors, that sort and focus light based on its color and polarization with efficiency significantly surpassing 2D absorptive and diffractive filters. The devices are designed via iterative gradient-based optimization to account for multiple target functions while ensuring compatibility with existing nanofabrication processes, and experimentally validated using a scaled device that operates at microwave frequencies. This approach combines arbitrary functions into a single compact element even where there is no known equivalent in bulk optics, enabling novel integrated photonic applications.
The normal sonographic appearance of the stomach in various degrees of distension, the duodenum, the small intestine, and the large intestine was determined in awake and sedated cats. The mean stomach rugal fold thickness was 4.38 mm, and the interrugal thickness was 2.03 mm. No significant difference in stomach wall thickness was seen when the stomach was empty, half full, or full. The duodenal wall thickness was significantly greater than other parts of the small intestine, and this difference was accentuated by sedation (awake mean 2.4 mm; sedated mean 2.71 mm). The mean small intestinal wall thickness was 2.1 mm, and the mean colonic wall thickness was 1.67 mm. The five characteristic sonographic layers similar to that seen in the gastrointestinal tract of other species were routinely identified at all regions of the feline gastrointestinal tract.
In humans the dural tail is a sign seen on contrast enhanced T1 weighted magnetic resonance images. This finding is considered specific for meningioma. The purpose of this study was to determine how often the dural tail occurs in cats and dogs and whether it is a specific sign for meningiomas in these species. MR examinations for eighteen dogs and four cats with proven diagnoses were reviewed. Diagnoses included ten meningiomas (seven dogs and three cats), three gliomas, two pituitary tumors, single examples of two other tumor types and five patients with mass lesions due to inflammatory disease. Contrast enhanced T1 weighted images were evaluated independently by three of the authors for the presence of a dural tail, without knowledge of the diagnoses. The results were compared to the diagnosis for each patient and the performance of individual reviewers compared. When their results were averaged, the reviewers reported the presence of a dural tail in 6 of 10 (60%) meningiomas, although detection varied between observers from 40% to 80%. Each reviewer had one false positive result, two reported a dural tail with a chromophobe adenocarcinoma and one with a toxoplasma meningoencephalitis. When a dural tail is seen an associated mass is most likely a meningioma. It is uncertain whether the dural tail represents neoplastic infiltration beyond the margins of the meningioma. This should be considered when planning treatment.
P-glycoprotein (P-gp), the product of ABCB1 gene, is thought to play a role in the biliary excretion of a variety of drugs, but specific studies in dogs have not been performed. Because a number of endogenous (ABCB1 polymorphisms) and exogenous (pharmacological P-gp inhibition) factors can interfere with normal P-gp function, a better understanding of P-gp's role in biliary drug excretion is crucial in preventing adverse drug reactions and drug-drug interactions in dogs. The objectives of this study were to compare biliary excretion of technetium-99m-sestamibi ((99m)Tc-MIBI), a radio-labelled P-gp substrate, in wild-type dogs (ABCB1 wild/wild), and dogs with intrinsic and extrinsic deficiencies in P-gp function. Dogs with intrinsic P-gp deficiency included ABCB1 mut/mut dogs, and dogs with presumed intermediate P-gp phenotype (ABCB1 mut/wild). Dogs with extrinsic P-gp deficiency were considered to be ABCB1 wild/wild dogs treated with the P-gp inhibitor ketoconazole (5 mg/kg PO q12h x 9 doses). Results from this study indicate that ABCB1 mut/mut dogs have significantly decreased biliary excretion of (99m)Tc-MIBI compared with ABCB1 wild/wild dogs. Treatment with ketoconazole significantly decreased biliary excretion of (99m)Tc-MIBI in ABCB1 wild/wild dogs. P-gp appears to play an important role in the biliary excretion of (99m)Tc-MIBI in dogs. It is likely that concurrent administration of a P-gp inhibitor such as ketoconazole will decrease P-gp-mediated biliary excretion of other substrate drugs as well.
Pythiosis is a chronic pyogranulomatous infection of the gastrointestinal tract or skin caused by the water borne pathogen Pythium insidiosum. The ultrasonographic features of nine dogs with gastrointestinal pythiosis are reported. The stomach, duodenum, jejunum or colon were affected. All dogs had thickening of the gastrointestinal wall and areas with obliteration of the normal layered appearance. In one dog an eccentric mass was found arising from the serosal surface of the wall of the colon with mild diffuse wall thickening. Regional lymph node enlargement was seen in seven of the nine dogs. One dog had invasion of the pancreas and signs compatible with extrahepatic biliary obstruction. When compared to previous reports of gastrointestinal neoplasia, the features of wall thickening, loss of layering and regional lymphadenopathy are not considered specific for gastrointestinal pythiosis. Histological examination of tissue specimens is required for diagnosis.
We previously reported that allogeneic, intraperitoneally administered “Neo-Islets,” composed of cultured pancreatic islet cells co-aggregated with high numbers of immunoprotective and cytoprotective Adipose-derived Stem Cells, reestablished, through omental engraftment, redifferentiation and splenic and omental up-regulation of regulatory T-cells, normoglycemia in autoimmune Type-1 Diabetic Non-Obese Diabetic (NOD) mice without the use of immunosuppressive agents or encapsulation devices. Based on these observations, we are currently testing this Neo-Islet technology in an FDA guided pilot study (INAD 012–776) in insulin-dependent, spontaneously diabetic pet dogs by ultrasound-guided, intraperitoneal administration of 2x10e5 Neo-Islets/kilogram body weight to metabolically controlled (blood glucose, triglycerides, thyroid and adrenal functions) and sedated animals. We report here interim observations on the first 4 canine Neo-Islet-treated, insulin-dependent pet dogs that are now in the early to intermediate-term follow-up phase of the planned 3 year study (> 6 months post treatment). Current results from this translational study indicate that in dogs, Neo-Islets appear to engraft, redifferentiate and physiologically produce insulin, and are rejected by neither auto- nor allo-immune responses, as evidenced by (a) an absent IgG response to the allogeneic cells contained in the administered Neo-Islets, and (b) progressively improved glycemic control that achieves up to a 50% reduction in daily insulin needs paralleled by a statistically significant decrease in serum glucose concentrations. This is accomplished without the use of anti-rejection drugs or encapsulation devices. No adverse or serious adverse events related to the Neo-Islet administration have been observed to date. We conclude that this minimally invasive therapy has significant translational relevance to veterinary and clinical Type 1 diabetes mellitus by achieving complete and at this point partial glycemic control in two species, i.e., diabetic mice and dogs, respectively.
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