A set of new and cross-amplifying microsatellite loci for conservation genetics of the endangered stone crayfish (Austropotamobius torrentium)

Like other indigenous crayfish species in Europe, the stone crayfish (Austropotamobius torrentium) is endangered due to habitat degradation, competition with invasive American crayfish and a deadly disease (crayfish plague) vectored by these invaders. To study the genetic diversity and connectivity of the remnant stone crayfish populations, eight new microsatellite loci were developed and supplemented by four cross-amplifying loci developed for related species. These twelve loci were tested for polymorphism in 130 stone crayfish from five streams in Switzerland. Variability was low with 1–7 alleles per locus, but the markers revealed strong genetic differentiation among streams. Use of these microsatellites will provide important information for the conservation and management of this endangered species.     

Increased anterior chamber penetration of topical levofloxacin 0.5% after pulsed dosing in cataract patients

Purpose: This study aimed to investigate the rise in aqueous humour (AH) levels of levofloxacin after a specific perioperative pulsed topical drop regimen. Methods: Thirty patients undergoing phacoemulsification surgery were administered two preoperative drops of levofloxacin 0.5%, 30 mins apart, and three pulsed drops postoperatively, 5 mins apart. Aqueous humour levels of levofloxacin were measured at the start of surgery and from 5 mins to 90 mins after the last postoperative drop. Samples from individual patients were collected at the time of surgery and at one additional sampling interval by aqueous tap, and analysed using a high‐performance liquid chromatography assay. Results: Aqueous humour levels of levofloxacin continued to rise gradually, reaching a mean peak level (C_max) of 4.4 μg/ml (± 2.5) at 60 mins after the last postoperative drop was administered. This level exceeded the minimum inhibitory concentration of common ocular pathogens at least fourfold. At 90 mins after the last drop, mean AH levels remained > 3 μg/ml. Conclusions: This is the first study to measure AH levels of levofloxacin after postoperative pulsed dosing in humans. Higher AH levels were found than in previously reported studies in which only preoperative drops were given and levels were measured at the time of surgery. Levels of levofloxacin continued to rise for 60 mins after administration of the last postoperative drop, demonstrating that delivery and maintenance of effective antibiotic levels may be achievable with alternative dosing schedules.     

Mental Disorders in Self-Cutting Adolescents

PurposeSelf-cutting as a form of self-harm is common in general population adolescents. The aim of this study was to investigate the prevalence of mental disorders and associated factors among self-cutting community-dwelling adolescents.MethodsA sample of adolescents who reported current self-cutting (n = 80) was drawn from a large sample of community adolescents (n = 4205). Of these 80 individuals, 44 consented to further detailed assessment. An age- and gender-matched control subject was selected for each study subject. Data collection included Structured Clinical Interviews for DSM-IV-TR, the Beck Depression Inventory, the Alcohol Use Disorders Identification Test (AUDIT), and the Youth Self-Report for adolescents aged 11–18 years (YSR).ResultsMajor depressive disorder (63% vs. 5%), anxiety disorders (37% vs. 12%), and eating disorders (15% vs. 0%) were more common among self-cutting girls (n = 41) than among controls. None of the self-cutting boys (n = 3) had a DSM-IV-TR Axis I mental disorder. In multivariate model, the presence of major depressive disorder, the AUDIT score and the YSR internalizing subscale score were the factors that were independently associated with the presence of self-cutting in girls.ConclusionsMajor depressive disorder, signs of alcohol misuse, and internalizing behavior strongly associate with self-cutting in community-dwelling adolescents, especially in girls.     

Early prednisone therapy in Henoch-Schönlein purpura: a randomized, double-blind, placebo-controlled trial

OBJECTIVE: To evaluate the efficacy of early prednisone therapy in preventing renal and treating extrarenal and renal symptoms in Henoch-Sch?nlein purpura (HSP) in a placebo-controlled trial. STUDY DESIGN: A total of 171 patients (84 treated with prednisone and 87 receiving placebo) were included and followed up for 6 months. The endpoints were renal involvement at 1, 3, and 6 months and healing of extrarenal symptoms. The analyses were performed on an intent-to-treat basis. RESULTS: Prednisone (1 mg/kg/day for 2 weeks, with weaning over the subsequent 2 weeks) was effective in reducing the intensity of abdominal pain (pain score, 2.5 vs 4.8; P = .029) and joint pain (4.6 vs 7.3; P = .030). Prednisone did not prevent the development of renal symptoms but was effective in treating them; renal symptoms resolved in 61% of the prednisone patients after treatment, compared with 34% of the placebo patients (difference = 27%; 95% confidence interval = 3% to 47%; P = .024). CONCLUSIONS: The general use of prednisone in HSP is not supported, but patients with disturbing symptoms may benefit from early treatment, because prednisone reduces extrarenal symptoms and is effective in altering (but not preventing) the course of renal involvement.     

Intra- and inter-individual variation of BIS-index? and Entropy? during controlled sedation with midazolam/remifentanil and dexmedetomidine/remifentanil in healthy volunteers: an interventional study

Introduction

We studied intra-individual and inter-individual variability of two online sedation monitors, BIS^® and Entropy^®, in volunteers under sedation.

Methods

Ten healthy volunteers were sedated in a stepwise manner with doses of either midazolam and remifentanil or dexmedetomidine and remifentanil. One week later the procedure was repeated with the remaining drug combination. The doses were adjusted to achieve three different sedation levels (Ramsay Scores 2, 3 and 4) and controlled by a computer-driven drug-delivery system to maintain stable plasma concentrations of the drugs. At each level of sedation, BIS^® and Entropy^® (response entropy and state entropy) values were recorded for 20 minutes. Baseline recordings were obtained before the sedative medications were administered.

Results

Both inter-individual and intra-individual variability increased as the sedation level deepened. Entropy^® values showed greater variability than BIS^® values, and the variability was greater during dexmedetomidine/remifentanil sedation than during midazolam/remifentanil sedation.

Conclusions

The large intra-individual and inter-individual variability of BIS^® and Entropy^® values in sedated volunteers makes the determination of sedation levels by processed electroencephalogram (EEG) variables impossible. Reports in the literature which draw conclusions based on processed EEG variables obtained from sedated intensive care unit (ICU) patients may be inaccurate due to this variability.

Trial registration

clinicaltrials.gov Nr. {"type":"clinical-trial","attrs":{"text":"NCT00641563","term_id":"NCT00641563"}}NCT00641563.     

Hemodynamic variables and mortality in cardiogenic shock: a retrospective cohort study

Introduction  

Despite the key role of hemodynamic goals, there are few data addressing the question as to which hemodynamic variables are associated with outcome or should be targeted in cardiogenic shock patients. The aim of this study was to investigate the association between hemodynamic variables and cardiogenic shock mortality.     

Intra- and inter-individual variation of BIS-index® and Entropy® during controlled sedation with midazolam/remifentanil and dexmedetomidine/remifentanil in healthy volunteers: an interventional study

Introduction

We studied intra-individual and inter-individual variability of two online sedation monitors, BIS^® and Entropy^®, in volunteers under sedation.

Methods

Ten healthy volunteers were sedated in a stepwise manner with doses of either midazolam and remifentanil or dexmedetomidine and remifentanil. One week later the procedure was repeated with the remaining drug combination. The doses were adjusted to achieve three different sedation levels (Ramsay Scores 2, 3 and 4) and controlled by a computer-driven drug-delivery system to maintain stable plasma concentrations of the drugs. At each level of sedation, BIS^® and Entropy^® (response entropy and state entropy) values were recorded for 20 minutes. Baseline recordings were obtained before the sedative medications were administered.

Results

Both inter-individual and intra-individual variability increased as the sedation level deepened. Entropy^® values showed greater variability than BIS^® values, and the variability was greater during dexmedetomidine/remifentanil sedation than during midazolam/remifentanil sedation.

Conclusions

The large intra-individual and inter-individual variability of BIS^® and Entropy^® values in sedated volunteers makes the determination of sedation levels by processed electroencephalogram (EEG) variables impossible. Reports in the literature which draw conclusions based on processed EEG variables obtained from sedated intensive care unit (ICU) patients may be inaccurate due to this variability.

Trial registration

clinicaltrials.gov Nr. NCT00641563.     

Effect of fluid resuscitation on mortality and organ function in experimental sepsis models

Introduction

Several recent studies have shown that a positive fluid balance in critical illness is associated with worse outcome. We tested the effects of moderate vs. high-volume resuscitation strategies on mortality, systemic and regional blood flows, mitochondrial respiration, and organ function in two experimental sepsis models.

Methods

48 pigs were randomized to continuous endotoxin infusion, fecal peritonitis, and a control group (n = 16 each), and each group further to two different basal rates of volume supply for 24 hours [moderate-volume (10 ml/kg/h, Ringer's lactate, n = 8); high-volume (15 + 5 ml/kg/h, Ringer's lactate and hydroxyethyl starch (HES), n = 8)], both supplemented by additional volume boli, as guided by urinary output, filling pressures, and responses in stroke volume. Systemic and regional hemodynamics were measured and tissue specimens taken for mitochondrial function assessment and histological analysis.

Results

Mortality in high-volume groups was 87% (peritonitis), 75% (endotoxemia), and 13% (controls). In moderate-volume groups mortality was 50% (peritonitis), 13% (endotoxemia) and 0% (controls). Both septic groups became hyperdynamic. While neither sepsis nor volume resuscitation strategy was associated with altered hepatic or muscle mitochondrial complex I- and II-dependent respiration, non-survivors had lower hepatic complex II-dependent respiratory control ratios (2.6 +/- 0.7, vs. 3.3 +/- 0.9 in survivors; P = 0.01). Histology revealed moderate damage in all organs, colloid plaques in lung tissue of high-volume groups, and severe kidney damage in endotoxin high-volume animals.

Conclusions

High-volume resuscitation including HES in experimental peritonitis and endotoxemia increased mortality despite better initial hemodynamic stability. This suggests that the strategy of early fluid management influences outcome in sepsis. The high mortality was not associated with reduced mitochondrial complex I- or II-dependent muscle and hepatic respiration.