Development and characterization of polymorphic microsatellite loci in the Mohave ground squirrel (Xerospermophilus mohavensis)

We characterized 12 polymorphic microsatellite markers for Xerospermophilus mohavensis, the Mohave ground squirrel, in order to contribute to the conservation management of this species. We tested polymorphism in the Cactus Peak population (N = 84) and found that allele number ranged from 4 to 9 with observed and expected heterozygosity ranging from 0.25 to 0.84, respectively. One locus deviated from Hardy–Weinberg expectations. Eleven of the 12 loci are polymorphic in the Mohave ground squirrel’s parapatric sister species, Xerospermophilus tereticaudus, the round-tailed ground squirrel. These loci will be useful in studies of parentage, population genetic structure and interspecific hybridization.     

The use of fibrinogen concentrate to correct hypofibrinogenaemia rapidly during obstetric haemorrhage

Haemorrhage is a common complication of childbirth with 0.65% of deliveries associated with significant (>1500 mL) peripartum blood loss. Hypofibrinogenaemia secondary to dilutional and consumptive coagulopathies can be challenging to correct quickly with conventional blood and plasma therapy. Fibrinogen concentrate offers rapid restoration of fibrinogen levels with a small volume infusion and minimal preparation time. It is effective in treating patients with congenital hypofibrinogenaemia, but there are few reports of its use in association with continuing obstetric haemorrhage. Six cases of obstetric haemorrhage, associated with hypofibrinogenaemia, treated with fibrinogen concentrate in conjunction with platelets, fresh frozen plasma, packed red blood cells, uterotonics and obstetric intervention are described. In all cases, laboratory assessed coagulation was rapidly normalised and severe haemorrhage improved. These cases suggest that fibrinogen concentrate may be an effective addition to conventional treatments for obstetric haemorrhage associated with hypofibrinogenaemia.     

A primary care cardiovascular risk reduction clinic in Canada was more effective and no more expensive than usual on-demand primary care – a randomised controlled trial

The objective of this randomised controlled trial was to compare the effects and expense of three approaches to care (1) proactive cardiovascular risk reduction (CaRR) clinic; (2) nurse telephone calls; or (3) usual care for people with cardiovascular risk factors in a Primary Care, Health Service Organisation (HSO) in Ontario, Canada. Subjects included consenting patients with an identified cardiovascular disease (CVD) risk factor identified from the HSO computerised patient information system in 2004. Patients were excluded if they were mentally incompetent, <18 years of age, in a nursing home, or not English speaking. Of 1570 eligible subjects, 523 (33.3%) verbally declined, 145 (9.2%) could not be contacted, and 249 (15.9%) were not needed. The final sample size was 653 (41.6%), 634 completed the follow-up (97%). The Cardiovascular Risk Score, Health and Social Service Utilisation, Montgomery-Asberg Depression Rating, Billings and Moos Indices of Coping, Personal Resource and Self-Efficacy Questionnaires were measured at baseline and 1-year follow-up by clinical examination and telephone interview. Cardiovascular risk scores were reduced in all treatment groups after 1 year. The proportions of subjects showing reduction in risk score greater than or equal to 10% was greatest in the CaRR group (69.2%) compared with Nurse Phone intervention (57.8%) and Usual Care (59.0%) ( M - H χ² = 4.33, df = 1, P  = 0.037, CaRR-Usual Care). Self-efficacy scores showed the greatest improvements in the CaRR clinic. This effect was achieved with no significant difference in total person per annum costs for direct and indirect health and social service utilisation between all three groups. A CaRR clinic is more effective in reducing CVD risk after 1 year compared with nurse phone intervention and usual care with no additional expense found.     

In vitro interaction of bacteria with polypropylene/ePTFE prostheses.

The infection of an implanted prosthetic material can have serious consequences on the tissue integration of the implant and the scarring process in the host, and may even necessitate replacement of the prosthesis. This study was designed to explore the in vitro effects of Staphylococcus aureus (Sa) and Staphylococcus epidermidis (Se) on polypropylene (PL) and expanded polytetrafluoroethylene (ePTFE) prostheses. Fragments of PL and ePTFE were placed in a medium previously inoculated with Sa, Se or Sa + Se (1 x 10(8) cfu Sa or/and Se). Bacterial effects on the biomaterials were evaluated for 30 days through scanning electron microscopy (SEM). In order to confirm the presence of bacteria on the prostheses, specimens were Gram stained and challenged with an antibody against protein-A (a specific Sa bacterial wall component). In both methods, specimens were examined by light microscopy. The presence of bacteria as microcolonies or biofilms was detected at PL filament cross-over regions after 30 days. Bacterial colonization of the ePTFE fragments was observed in internodal areas, which led to the deformation of prosthetic filaments. The present findings indicate that Sa and Se colonize the cross-over regions of the PL filaments, whereas in ePTFE prostheses, it is the internodal areas which are mostly affected. The latter areas are of difficult access to defence agents.     

An outbreak of Serratia marcescens bacteremia after general anesthesia.

OBJECTIVE: To investigate an outbreak of Serratia marcescens bacteremia among patients after general anesthesia. DESIGN: A case-control study. SETTING: A 304-bed, pediatric teaching hospital. PATIENTS: Twenty-three pediatric patients who developed S. marcescens bacteremia within 2 weeks after general anesthesia between June 15 and September 22, 1999, were compared with 46 age-matched control-patients who had undergone procedures on the same clinical services of the hospital during the same period. RESULTS: Cases were distributed over a wide range of surgical services and were not correlated with exposure to any of the surgical, anesthesia, or nursing staff. Case-patients were significantly more likely than control-patients to have received cefazolin (odds ratio [OR], 11.1; 90% confidence interval [CI90], 1.9 to 24.3) or to have had perioperative placement of a central vascular catheter (OR, 4.2; CI90, 1.2 to 18.8). The timing of the procedures of patients who subsequently developed S. marcescens bacteremia was significantly associated with the shifts of one or more of five operating room technicians (OR, 2.9 to 6.8) who were responsible for preparing intravenous fluids used both to reconstitute perioperatively administered antibiotics and to prime central vascular catheter assemblies. CONCLUSIONS: Our findings are consistent with a pattern of intermittent contamination due to periodic breaches in sterile technique, rather than a point-source of contamination. The unique challenges that such a procedural breakdown presents to an epidemiologic investigation are discussed. This outbreak stresses the importance of providing comprehensive training in antisepsis when multifunctional personnel are incorporated into an operating room work environment.