Administration Of Antibiotics Research Articles

Method Validation for the Determination of Ciprofloxacin in Lucilia sericata Larvae via Capillary Electrophoresis Combined With Mass Spectrometry.

Substances derived from insects can serve therapeutic functions due to their diverse biological properties. This article focuses on the species Lucilia sericata and the benefits of larval therapy in patients who, due to hospitalization, have developed pressure ulcers and other difficult-to-heal wounds. Larval therapy, also known as maggot debridement therapy, employs sterile fly larvae to treat chronic, non-healing wounds by enzymatically degrading necrotic tissue and decreasing bacterial colonization. The larvae are applied to the wound for a period of 48-72h, during which they effectively clean the wound and stimulate tissue regeneration. This therapeutic approach is particularly efficacious for recalcitrant wounds, such as diabetic foot ulcers and pressure sores, which have not responded to conventional treatments. Larvae may also constitute an alternative material in entomotoxicological studies to detect substances ingested at not only toxic but also therapeutic doses. The present work describes a method for assaying ciprofloxacin in L. sericata larvae using capillary electrophoresis coupled to mass spectrometry. The developed method features high sensitivity with a limit of quantification of 100±0.018ng/mL, as well as accuracy and precision estimated within 87%-103% and 1%-4%, respectively. An application of a simple and fast precipitation of proteins procedure for sample cleaning resulted in a highly satisfactory recovery of the analyte (90%-104%). The method was linear in a range of 100-1000ng/mL with a determination coefficient higher than 0.9973. The method was used to determine ciprofloxacin in larval homogenate after antibiotic administration to the patient at a dose of 500mg twice daily per os during application of the larvae dressing. Ciprofloxacin was shown to distribute from the patient's circulation to the larvae at a concentration of 150ng/mL (750ng/g).

Experimental models of antibiotic exposure and atopic disease.

In addition to numerous clinical studies, research using experimental models have contributed extensive evidence to the link between antibiotic exposure and atopic disease. A number of mouse models of allergy have been developed and used to uncover the specific effects of various microbiota members and perturbations on allergy development. Studies in mice that lack microbes entirely have also demonstrated the various components of the immune system that require microbial exposure. The importance of the early-life period and the mechanisms by which atopy "protective" species identified in human cohorts promote immune development have been elucidated in mice. Finally, non-animal models involving human-derived cells shed light on specific effects of bacteria on human epithelial and immune responses. When considered alongside clinical cohort studies, experimental model systems have provided crucial evidence for the link between the neonatal gut microbiota and allergic disease, immensely supporting the stewardship of antibiotic administration in infants. The following review aims to describe the range of experimental models used for studying factors that affect the relationship between the gut microbiota and allergic disease and summarize key findings that have come from research in animal and in vitro models.

RF pulsed plasma modified composite scaffold for enhanced anti-microbial activity and accelerated wound healing

Infected wounds present significant challenges pertaining to healing and often demand administration of strong antibiotics to patients. Also, drug resistant microbes may alter the physiology of wounds to create biofilms, frequently leading to high morbidity and mortality. In this investigation, a biodegradable, microporous composite agarose-chitosan scaffold was fabricated. Furthermore, its surface was modified with diphenyldiselenide deposition, using low pressure pulsed plasma technology. The optimized plasma parameters, viz. 5ON/15OFF (ms) of plasma pulse rate and 80 min of treatment time resulted in scaffolds having enhanced anti-bacterial activity against gram positive microbes like Staphylococcus (S.) aureus and S. epidermidis. The scaffolds were non-toxic to skin cells, as confirmed by the MTT assay. Cell proliferation through plasma treated and native scaffolds was assessed by culturing primary human dermal fibroblasts (HdaF) and human keratinocytes (HaCaT) and visualizing via confocal microscopy. Moreover, in-vivo rat model confirmed accelerated wound healing with plasma treated scaffold (100 % on day 14), as compared to the native scaffold (100 % on day 16) when compared with over-the-counter (OTC) ointment Betadine (100 % on day 12).

Improving communication during damage control surgery: a survey of adult major trauma centres in England.

Deficiencies in non-technical skills can severely impede the functioning of teams in high-intensity scenarios, such as in damage control surgery for the critically injured trauma patient. Truncated preoperative checklists, modified from the standard World Health Organization preoperative checklist, and situational reporting at intervals during surgery are long-established practices in the military, and are recommended in the National Health Service guidelines on major incidents. These tools allow the multiprofessional team to create a shared mental model of the anaesthetic and operative plan, thereby improving team efficiency. Our aim was to establish whether adult major trauma centres in England are using truncated preoperative checklists and situational reporting for damage control surgery. An online survey was devised and distributed via the national programme of care for trauma in November 2020. Responses were received from all 23 adult major trauma centres in England. Nine centres (39.1%) reported using a truncated preoperative checklist for damage control surgery albeit in a variety of formats. Common components were blood products received and/or available, presence of allergies, tranexamic acid and antibiotic administration, availability of viscoelastic tests, equipment required, availability of cell saver, role allocation and reference to other personnel needed, and discussion of the plan. Twelve centres (52.2%) have formal policies in place for situational reporting. Again, these were in multiple formats but all focused on patient physiology to direct surgical planning. We have identified key components to advanced communication aids for damage control surgery, providing a foundation on which other major trauma centres can build their own versions of these potentially lifesaving tools.

Extended-spectrum beta-laktamase (ESBL) enzyme producing bacteria isolated from rectal swabs of around animals in dairy farms

This study aims to identify bacterial contamination of Klebsiella pneumoniae and Escherichia coli producing Extended Spectrum Beta Lactamase (ESBL) isolated from rectal swabs of local animals on a dairy farm in Deyeng Village, Kediri, East Java. Interviews and observations were conducted with farmers to obtain the required risk factor data (cleanliness of drinking and eating places, drinking water sources, and administration of antibiotics to livestock). The number of samples tested in this study was 34 samples, including 12 chicken samples, 8 goat samples, 5 duck samples, 4 rabbit samples, 3 cat samples and 2 goose samples. Samples were isolated on MCA media + cefotaxime 1 mg/l and isolated again on MCA media without the addition of antibiotics to multiply pure bacterial colonies. The tests carried out to determine the presence of ESBL-producing bacteria are biochemical tests, namely the IMViC test (Indole, Methyl red, Voges-Proskauer, Citrate Utilization), TSIA (Triple Sugar Iron Agar) test, gram staining, and the Double Disk Standard Method test using β-lactam disc antibiotics, namely cefotaxime 30μg, ceftazidime 30μg, and amoxycilline-clavulanate acid 30μg. The results of this research were that 6 samples or 17.6% of ESBL-producing bacteria were identified from poultry groups (chickens, ducks and geese) from dairy farms in Deyeng Village, Kediri Regency, East Java.

Evaluation of Antibiotic Use in Pediatric Patients Hospitalized with Acute Diarrhea as a Result of Clinical Pathway Implementation in Hospital

This study aims to determine the effectiveness of clinical pathway implementation in pediatric patients with acute diarrhea with mild-moderate dehydration on clinical outcomes, length of stay, use of quality and quantity of antibiotics at North Jakarta Teaching Hospital. This study is a quantitative study using a retrospective cohort case study method. The samples in this study were pediatric patients with a diagnosis of acute diarrhea with mild-moderate dehydration who were hospitalized at the North Jakarta Teaching Hospital for the period January-December 2020 and JanuaryDecember 2021 before and after the implementation of the clinical pathway, totaling 274 patients. The data used is secondary data in the form of medical records of pediatric patients with acute diarrhea with mild-moderate dehydration who were hospitalized at the North Jakarta Teaching Hospital. The data that has been collected is then processed and analyzed using the chi-square test. The results showed Qualitative use of antibiotics with the Gyssens method after the application of clinical pathway is better than before the application of clinical pathway. Quantitative antibiotic administration with the DDD method in pediatric patients with acute diarrhea with dehydration before and after the application of clinical pathway the highest was ceftriaxone antibiotics after the application of clinical pathway with DDD/100 patient-days value increased compared to before clinical pathway.

The Use of Dissolvable Synthetic Calcium Impregnated with Antibiotic in Osteoarticular Infection in Patients with Diabetes

The medical management of osteoarticular infections in patients with diabetes continues to be a considerable clinical dilemma because of inadequate blood supply and weakened immune systems. The objective of this study is to assess the effectiveness of dissolvable synthetic pure calcium sulfate beads with antibiotics in the treatment of osteoarticular infections in individuals diagnosed with diabetes mellitus. A retrospective analysis was conducted on 27 patients with diabetes (19 with type II diabetes and 8 with type I diabetes) who were diagnosed with osteoarticular infections and received treatment with locally delivered antibiotic-loaded calcium sulfate beads. The patients were monitored for a duration ranging from 6 months to 2 years, during which the clearance of infection, bone remodeling, and rates of recurrence were evaluated. The evaluation also included an assessment of glycemic control and its influence on infection treatment. The findings revealed a notable decrease in the recurrence of infections, as patients who were given combinations of two antibiotics showed better results in comparison to those who were exclusively treated with one antibiotic. A 92% eradication rate was achieved within the trial group, and patients who had dual-antibiotic treatment did not have any return of illness. Postoperative bone remodeling was shown to take place between 8 and 16 weeks, with faster recovery in individuals who maintained ideal glycemic control (HbA1c < 7%). Only one instance of soft tissue necrosis was documented, indicating minimal consequences. The results validate the use of dissolvable synthetic calcium sulfate as a secure and efficient local antibiotic administration method for controlling osteoarticular infections in patients with diabetes, providing improved infection management and facilitating bone regeneration.

The Incidence and Characteristics of Oral Candidiasis in Patients Hospitalized for SARS-CoV-2 Infection During the Circulation of Alpha, Beta, and Delta Variants

Background: Oral candidiasis has been documented in patients with SARS-CoV-2 infection, with varying prevalence rates across geographic regions and patient demographics. This study aimed to ascertain the incidence, characteristics, and risk factors associated with the development of oral candidiasis in patients hospitalized for SARS-CoV-2 infection in a tertiary infectious diseases hospital in Romania. Methods: A retrospective analysis was conducted on adult patients hospitalized between March 2020 and December 2022 with moderate or severe forms of SARS-CoV-2 infection, for whom a culture of lingual scrapings for Candida spp. was performed. Results: A total of 294 patients were deemed eligible for inclusion in the analysis, with an incidence rate of oral candidiasis of 17.0%. The incidence of oral candidiasis was 4.2 times higher in patients with severe forms of SARS-CoV-2 infection compared to those with moderate forms. Patients with a diagnosis of COVID-19 and oral candidiasis were more likely to receive antibiotics (98.0% vs. 86.1%, p = 0.017) and corticosteroids (100% vs. 83.6%, p = 0.003) than those without oral candidiasis. These findings were associated with a 19% higher relative risk of developing oral candidiasis for patients who received corticosteroid therapy compared to those who did not, and a 13% higher relative risk for those who were administered antibiotics compared to those who were not. The presence of respiratory insufficiency increased the odds of oral candidiasis association 4.7-fold (88.0% vs. 61.1%, p < 0.001). Conclusions: Although the data have been analyzed retrospectively, we have shown that individuals with severe forms of COVID-19 exhibited an elevated risk of developing oral candidiasis. The administration of antibiotics and corticosteroids was identified as a positive predictor for the development of oral candidiasis. The data presented here suggest that a key aspect of the therapeutic management of patients with SARS-CoV-2 infection should include the implementation of preventive measures to minimize the risk of secondary fungal infections.

Preoperative, Intraoperative & Postoperative Concepts to Prevent Infection for Unicompartmental Knee Arthroplasty

Periprosthetic joint infection (PJI) is a complication that occurs in less than 1% of patients after unicompartmental knee arthroplasty (UKA). Though infrequent, it may potentially lead to revision while placing a significant financial burden on the healthcare system. Pre-operative, intra-operative, and postoperative strategies should be implemented to minimize the risk of PJI. Patient optimization prior to surgery can help to identify patients at risk for PJI and also maximize the health of the patient prior to surgery. Intraoperative and postoperative strategies can also mitigate the risk of postoperative infection. This article will summarize the evidence for preoperative, intra-operative, and postoperative strategies to prevent PJI in UKA. This will include topics on malnutrition and obesity, staphylococcus aureus, smoking, human immunodeficiency virus, rheumatoid arthritis, as well as skin preparation, laminar air flow, preoperative antibiotic administration anti-microbial incision drapes, pulsatile lavage, vancomycin powder, wound closure method, thromboprophylactic agents, and closed incisional negative pressure wound therapy dressings.

Investigation of the Impact of Antibiotic Administration on the Preterm Infants' Gut Microbiome Using Next-Generation Sequencing-Based 16S rRNA Gene Analysis.

Background: The human gut microbiota is an extensive population of microorganisms, and it shows significant variations between periods of optimal health and periods of illness. Vancomycin-resistant Enterococcus (VRE) and carbapenem-resistant Klebsiella pneumoniae (CRKP) are both pathogenic agents (BPAs) that can colonize in the gut after dysbiosis of microbiotal composition following antibiotic treatment. Methods: This study aimed to investigate the impact of antibiotics on the microbiotal composition of the gut. For this purpose, the first pass meconiums of 20 patients and the first rectal swabs containing BPAs of the same patients after antibiotic treatment were studied using next-generation sequencing-based 16S rRNA gene analysis. The V1-V9 region of 16S rRNA was sequenced with Oxford Nanopore. Results: Twenty-five phyla were detected in the meconiums, and 12 of them were absent after antibiotic treatment. The four most prevalent phyla in meconiums were Bacillota, Pseudomonadota, Bacteroidota, and Actinomycetota. Only the relative abundance of Pseudomonadota was increased, while a significant decrease was observed in the other three phyla (p < 0.05). A significant decrease was observed in alpha-diversity in rectal swabs containing BPAs versus meconiums (p = 0.00408), whereas an increased variance was observed in beta-diversity in all samples (p < 0.05). As a result of a LEfSe analysis, Pseudomonadota was found to have a higher relative abundance in rectal swabs, and Bacillota was significantly higher in the meconiums of the twins. Conclusions: Our study strongly verified the relationship between the administration of antibiotics, dysbiosis, and colonization of BPAs in the infants' gut microbiota. Further research would be beneficial and needed, comprising the natural development process of the infants' gut microbiota.

Comprehensive evaluation and management of chronic gastritis in a dog: A case report

Gastric ulcer is a significant clinical issue in dogs, with higher prevalence in mature animals and often occurs secondary to systemic diseases such as hepatic or renal disorders, Addison’s disease or shock. This case report highlights a four-and-a-half-year-old intact male Rottweiler presented with persistent vomiting, anorexia, abdominal pain and anemia. Diagnostic imaging, including radiography, ultrasonography and endoscopy, revealed gastric ulceration and the presence of radiopaque lead pellets in the pyloric region of the stomach. Histopathological examination confirmed extensive gastric mucosal damage.Treatment included the elimination of lead, fluid therapy and administration of proton pump inhibitors, antibiotics and mucosal protectants. Incorporating psyllium husk into the diet helped to enhance lead excretion. Follow-up imaging after two weeks showed absence of lead pellets and normal gastric mucosa. This case underscores the importance of comprehensive diagnostic and therapeutic approaches for chronic gastric ulcers in dogs, emphasising the role of multimodal imaging and targeted treatment strategies. Keywords: Dog, gastric ulcers, diagnostics, therapeutics

Salmon-IgM Functionalized-PLGA Nanosystem for Florfenicol Delivery as an Antimicrobial Strategy against Piscirickettsia salmonis.

Salmonid rickettsial septicemia (SRS), caused by Piscirickettsia salmonis, has been the most severe health concern for the Chilean salmon industry. The efforts to control P. salmonis infections have focused on using antibiotics and vaccines. However, infected salmonids exhibit limited responses to the treatments. Here, we developed a poly (D, L-lactide-glycolic acid) (PLGA)-nanosystem functionalized with Atlantic salmon IgM (PLGA-IgM) to specifically deliver florfenicol into infected cells. Polymeric nanoparticles (NPs) were prepared via the double emulsion solvent-evaporation method in the presence of florfenicol. Later, the PLGA-NPs were functionalized with Atlantic salmon IgM through carbodiimide chemistry. The nanosystem showed an average size of ~380-410 nm and a negative surface charge. Further, florfenicol encapsulation efficiency was close to 10%. We evaluated the internalization of the nanosystem and its impact on bacterial load in SHK-1 cells by using confocal microscopy and qPCR. The results suggest that stimulation with the nanosystem elicits a decrease in the bacterial load of P. salmonis when it infects Atlantic salmon macrophages. Overall, the IgM-functionalized PLGA-based nanosystem represents an alternative to the administration of antibiotics in salmon farming, complementing the delivery of antibiotics with the stimulation of the immune response of infected macrophages.

Management of chronic septic nonunion of the femur associated with an extended drug resistant nosocomial germ: a case report

Introduction and Importance: Septic nonunion of long bones poses significant treatment challenges, often necessitating extended hospital stays and multiple surgical interventions. This report details a chronic septic nonunion of the femur, complicated by drug-resistant pathogens, managed through an integrated surgical approach. Case Presentation: A 32-year-old male with a history of infected nonunion and multiple failed surgeries presented with a vast bone defect and osteomyelitis. Treatment involved single-session debridement, bone resection, intramedullary fixation, and trifocal segment bone transport using the Limb Reconstruction System (LRS) and Masquelet technique. After eight months, the patient achieved radiologic and clinical bone healing, regained full ambulation, and resumed work without re-infection over an 18-months follow-up. Clinical Discussion: The management of septic nonunion, particularly with drug-resistant infections, requires a multifaceted approach. This case exemplifies the efficacy of combining radical bone resection, targeted debridement, and advanced reconstructive techniques. The use of antibiotic-impregnated cement beads and bone transport procedures played pivotal roles in the successful outcome. While such procedures can be complex and necessitate vigilant monitoring, they are crucial for improving treatment success and functional recovery. Conclusion: Septic nonunion caused by extended drug-resistant germs of the lower extremity long bones can be managed in a single-session bone resection and debridement, local antibiotic administration, and later bone defect reconstruction.

TREATMENT OF TOOTH AVULSION: A CASE REPORT

Dental trauma (DT) refers to injuries caused by impacts to the teeth and/or the hard and soft tissues within or outside the oral cavity. Among the various types of DT, avulsion, characterized by the complete displacement of the tooth from its socket. The success of treatment depends on timely management and proper professional care during and after reimplantation in preserving the tooth in the oral cavity. This study describes a case report of an avulsion of the upper left central incisor (21) that underwent reimplantation. The patient, a 10-year-old boy, had a history of bicycle fall, presenting with extraoral injuries to the cheek and chin, lip abrasions, and avulsion of tooth 21. The tooth was stored in milk and reimplanted 30 minutes after the accident. Clinical and radiographic examinations showed no bone fractures but revealed mobility of teeth 11 and 12 and avulsion of tooth 21. Treatment included cleaning, repositioning of the avulsed tooth, stabilization with a semi-flexible splint, and administration of antibiotics and analgesics. Endodontic therapy with mechanical instrumentation was successfully initiated after 20 days. This case highlights the importance of proper tooth storage and timing of reimplantation, leading to the restoration of patient’s aesthetics, chewing function, and self-esteem.

Predictors for prolonged and escalated perioperative antibiotic therapy after microvascular head and neck reconstruction: a comprehensive analysis of 446 cases

Literature suggests that intravenous prophylaxis exceeding 48 h offers no additional benefit in preventing surgical site infections (SSI) in patients with microvascular head and neck reconstruction. However, protocols for antibiotic therapy duration post-reconstruction are not standardized. This study identifies factors predicting prolonged intravenous antibiotic use and antibiotic escalation in patients receiving free flap head neck reconstruction. A retrospective analysis of 446 patients receiving free flap reconstruction was conducted, examining predictors for antibiotic therapy > 10 days and postoperative escalation. 111 patients (24.8%) experienced escalation, while 159 patients (35.6%) received prolonged therapy. Multivariate regression analysis revealed predictors for escalation: microvascular bone reconstruction (p = 0.008, OR = 2.0), clinically suspected SSI (p < 0.001, OR = 5.4), culture-positive SSI (p = 0.03, OR = 2.9), extended ICU stay (p = 0.01, OR = 1.1) and hospital-acquired pneumonia (p = 0.01, OR = 5.9). Prolonged therapy was associated with bone reconstruction (p = 0.06, OR = 2.0), preoperative irradiation (p = 0.001, OR = 1.9) and culture-positive SSI (p < 0.001, OR = 3.5). The study concludes that SSIs are a primary factor driving the escalation of perioperative antibiotic use. Clinical suspicion of infection often necessitates escalation, even in the absence of confirmed microbiological evidence. Microvascular bone reconstruction was a significant predictor for both the escalation and extension of antibiotic therapy beyond 10 days. Furthermore, preoperative radiation therapy, hospital-acquired pneumonia, and prolonged ICU stay were associated with an increased likelihood of escalation, resulting in significantly extended antibiotic administration during hospitalization. Antibiotic stewardship programmes must be implemented to reduce postoperative antibiotic administration time.Trial registration The study was registered approved by the local Ethics Committee (Nr: 18-1131-104).

Ongoing transmission of trachoma in low prevalence districts in Mozambique: results from four cross-sectional enhanced impact surveys, 2022

Mozambique is making progress towards elimination of trachoma as a public health problem, but in some districts trachomatous inflammation—follicular (TF) prevalence remains above the 5% elimination threshold despite years of various interventions, including antibiotic mass drug administration. To characterize transmission in four districts, we incorporated testing of ocular infection and serology into routine trachoma impact surveys (TIS) in August 2022. We examined residents aged ≥ 1 year for trachoma and collected information on household water, sanitation, and hygiene. Among children aged 1–9 years, we tested conjunctival swabs for Chlamydia trachomatis nucleic acid and dried blood spots for C. trachomatis antibodies. We modeled age-dependent seroprevalence to estimate seroconversion rate (SCR). We examined 4841 children aged 1–9 years. TF prevalence ranged between 1.1 and 6.0% with three districts below the 5% threshold. PCR-confirmed infection prevalence ranged between 1.1 and 4.8%, and Pgp3 seroprevalence ranged between 8.8 and 24.3%. Pgp3 SCR was 1.9 per 100 children per year in the district with the lowest TF prevalence. Two other districts with TF < 5% had SCR of 5.0 and 4.7. The district with TF ≥ 5% had a SCR of 6.0. This enhanced TIS furthered understanding of transmission in these districts and provides information on additional indicators for monitoring trachoma programs.

Development and Validation of a Machine Learning Model for Early Detection of Untreated Infection.

Early diagnostic uncertainty for infection causes delays in antibiotic administration in infected patients and unnecessary antibiotic administration in noninfected patients. To develop a machine learning model for the early detection of untreated infection (eDENTIFI), with the presence of infection determined by clinician chart review. Three thousand three hundred fifty-seven adult patients hospitalized between 2006 and 2018 at two health systems in Illinois, United States. We validated in 1632 patients in a third Illinois health system using area under the receiver operating characteristic curve (AUC). Using a longitudinal discrete-time format, we trained a gradient boosted machine model to predict untreated infection in the next 6 hours using routinely available patient demographics, vital signs, and laboratory results. eDENTIFI had an AUC of 0.80 (95% CI, 0.79-0.81) in the validation cohort and outperformed the systemic inflammatory response syndrome criteria with an AUC of 0.64 (95% CI, 0.64-0.65; p < 0.001). The most important features were body mass index, age, temperature, and heart rate. Using a threshold with a 47.6% sensitivity, eDENTIFI detected infection a median 2.0 hours (interquartile range, 0.9-5.2 hr) before antimicrobial administration, with a negative predictive value of 93.6%. Antibiotic administration guided by eDENTIFI could have decreased unnecessary IV antibiotic administration in noninfected patients by 10.8% absolute or 46.4% relative percentage points compared with clinicians. eDENTIFI could both decrease the time to antimicrobial administration in infected patients and unnecessary antibiotic administration in noninfected patients. Further prospective validation is needed.

Lameness in Adult Sheep and Goats in Greece: Prevalence, Predictors, Treatment, Importance for Farmers.

The present study refers to an extensive investigation of lameness performed countrywide in Greece, on 325 sheep and 119 goat farms. The specific objectives of this work were to present data on the occurrence of lameness on sheep and goat farms and to identify variables (including variables related to climatic factors) associated with the disorder on the farms. Farms were visited and animals on the farm were assessed for the presence of lameness; further, an interview was carried out with the farmer to obtain information regarding practices applied on the farm. Climatic variables at the location of each farm were derived from NASA research. The within farm prevalence rate varied from 0.0% to 25.0% in sheep flocks and from 0.0% to 30.0% in goat herds. The mean ± standard error (median (interquartile range)) within farm prevalence rate among sheep farms was 1.9% ± 0.2 (0.0% (0.0%)); among goat farms, it was 2.6% ± 0.5% (0.0% (0.0%)). Multivariable analysis for within farm prevalence of lameness revealed three significant predictors in sheep farms: application of vaccination against foot-rot, increased precipitation at the farm location and longer annual grazing period for sheep, and one in goat farms: increased precipitation at the farm location. Treatment of lameness involved mostly administration of antibiotics (on 104 farms); the antibiotics administered most often were lincomycin (on 69 farms) and oxytetracycline (on 33 farms). There was a tendency for higher median within farm prevalence of lameness among farms where no antibiotic administration was practiced. Finally, 6.2% of sheep farmers and 4.2% of goat farmers considered lameness as an important health problem for the animals, specifically the third and fifth most important problem on the respective farms.

Alterations in the Renin-Angiotensin System in Experimental Septic Shock.

To analyze dynamic changes in the renin-angiotensin system (RAS) during septic shock, focusing on angiotensin-converting enzyme (ACE) activity and the balance between angiotensin peptides, using a mass spectrometry method. Experimental septic shock model induced by peritonitis in swine. Experimental Laboratory, Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles. Forty time points from eight mechanically ventilated pigs. Septic shock was induced using intraperitoneal instillation of autologous feces, followed by standardized fluid resuscitation, norepinephrine infusion, antibiotic administration, and peritoneal lavage. The induction of sepsis resulted in a significant increase in plasma renin activity and levels of angiotensin I and II, with a significant decrease in ACE activity observed from 4 hours post-resuscitation and a notable rise in the angiotensin I/angiotensin II ratio at 12 hours. Additionally, a shift toward the angiotensin-(1-7) axis was observed, evidenced by an increased angiotensin-(1-7)/angiotensin II ratio. The study highlighted dynamic shifts in the RAS during septic shock, characterized by reduced circulating ACE activity, elevated angiotensin I/II ratio, and a shift toward the angiotensin-(1-7) axis. These findings suggest an adaptive response within the RAS, potentially offering new insights into sepsis management and therapeutic targets.

Rare huge bilateral adrenal myelolipoma confused with retroperitoneal liposarcoma

IntroductionAdrenal myelolipomas are uncommon benign adrenal tumors, which mostly occur unilaterally. We describe a rare case of giant bilateral adrenal myelolipoma mistaken for retroperitoneal liposarcoma.Case presentationA 49‐year‐old man developed fever, left flank pain, and a large mass in his left abdomen. Plain computed tomography showed a 23‐cm mass with fat‐containing components in the retroperitoneal cavity, suggestive of retroperitoneal liposarcoma. A similar 9‐cm mass was observed in the right adrenal gland, suggesting adrenal metastasis. With a clinical diagnosis of retroperitoneal liposarcoma, we administered preoperative radiation therapy and performed a bilateral tumor resection. On postoperative day 9, a surgical site infection occurred, necessitating incisional drainage and the administration of intravenous antibiotics. The histopathological diagnosis was bilateral myelolipoma of the adrenal glands.ConclusionIn cases of bilateral retroperitoneal tumors with a large fat component, adrenal myelolipoma should be considered in the differential diagnosis to avoid overtreatment.