The effect of isosorbide dinitrate on uterine and ovarian blood flow in cycling and early pregnant mares: A pilot study

Poor uterine perfusion has been proposed as a cause of infertility in mares. The objective of this study was to investigate the effect of isosorbide dinitrate (ISDN), a nitric oxide donor, on uterine and ovarian blood flow resistance during diestrus and early pregnancy in mares. Six Trotter mares, aged 7 to 14 years, were examined daily during the first 11 days of three diestrous periods, and five of those mares were also examined during the first 11 days of two pregnancies. Six mares randomly received a placebo, a low dose (30 mg, ISDN30), or a high dose of ISDN (60 mg, ISDN60) through three nonconsecutive cycles. The treatments were administered orally, every 12 hours from Day 1 to 11 of the cycle (Day 0 = ovulation). Five of the 6 mares received a placebo or 60 mg of ISDN orally every 12 hours from Day 1 to 11 of pregnancy. The mares were short cycled on Day 12 of each trial. Transrectal color Doppler was used to determine blood flow resistance semiquantitatively and expressed as pulsatility index. Mean pulsatility index of both uterine arteries combined and of the dominant (ipsilateral to the CL) ovarian artery was lower (treatment effects: P ≤ 0.01; time effects: P ≤ 0.002) in mares receiving 30 mg or 60 mg of ISDN compared with placebo-treated mares. Blood flow resistance in the dominant ovarian artery was lower in ISDN-treated pregnant mares than in placebo-treated pregnant and cycling mares (treatment effect: P = 0.04; time effect: P = 0.003). Isosorbide dinitrate increases uterine and ovarian perfusion in cycling mares and ovarian perfusion in early pregnant mares. Further studies are needed to investigate these effects in relation to fertility of the mare.

[Long-term effectiveness of psychodynamic outpatient treatment of addiction]

BACKGROUND

The aim of this study is to make an evaluation of the effectiveness of long-term outpatient treatment for addiction on the basis of abstinence, cognitive functions, and changes in personality structure.

METHODS

This is a prospective cohort study of 259 patients with registration of the German core data set "addiction", a 12-month follow-up and neuropsychological testing (personality inventory, intelligence and cognitive functions).

RESULTS

One year after the end of the long-term treatment we see an abstinence rate (DGSS4) of 57.5 %. The most substantial factors in abstinence are the participation in a self-help-group (β = 0.734, p < 0.0001). Known negative predictors such as unemployment (β = - 0.093, p < 0.01) and problematic debts over 15,000 $ (β = - 0.104, p < 0.01 just show a small negative correlation with abstinence. The results seems to indicate that patients have better overall performance and achieve better results in the neuropsychological testing at the end of the rehabilitation. The ideal and self-image may be changed positively. We see also unspecific changes classified by a reduction of the psychological test values regarding conversion symptoms, depressive mood, psychasthenia and social isolation. At the end of the long-term treatment the patients show significantly better cognitive functions and an improvement in their ideals and self-images. Conversion symptoms, depressive mood and reduced values for psychasthenia and social isolation can be decreased.

DISCUSSION

These results of a psycho-dynamic outpatient treatment of addiction seem to show its high effectiveness in terms of abstinence and processing of drug structures. The cognitive functions could increase. This could be determinate of a condition for the conservation and restoration of working capacity. Further studies should differentiate the effect of insight into the dependency structure from the abstinence as an specific or unspecific effect.

Discharge planning, an intervention study - and where to go next?

Background

Process evaluation should be an integral part of randomised controlled trials (RCTs), and this is important in examining complex interventions with a number of active ingredients.

Objective

To analyse effectiveness and effect moderators in a multi-centre RCT of needs-oriented discharge planning vs. treatment as usual (TAU) for high utilisers of mental health care.

Method

From April 2006 to July 2007, 491 adults with high utilisation of mental health care for psychotic disorders gave informed consent to participate in a multi-site RCT at five German psychiatric inpatient services. Subjects allocated to the intervention group were offered a manualised needs-led discharge planning intervention of two 45 minute sessions delivered by a trained study worker. Outcomes (service use, needs, psychopathology, depression, quality of life, direct costs) were assessed at four measurement points during 18-month follow-up. Latent class modelling was used to scrutinise differential effectiveness. Characteristics of subgroups of participants showing variable treatment response will be described.

Results

There was improvement both in the intervention and (TAU) control group but no differential effectiveness of the discharge planning intervention. Only few variables significantly moderated effects. Effect moderators pertained to quality of delivery and intervention dose.

Conclusions

Study results could help to tailor interventions to local conditions and guide future implementation of discharge planning in routine care. Further research should focus on scrutinising study process, ensuring ecological suitability of interventions and on head-to-head comparison studies.

Discharge planning in mental health care: a systematic review of the recent literature

OBJECTIVE

To determine and estimate the efficacy of discharge planning interventions in mental health care from in-patient to out-patient treatment on improving patient outcome, ensuring community tenure, and saving costs.

METHOD

A systematic review and meta-analysis identified studies through an electronic search on the basis of defined inclusion and exclusion criteria and extracted data.

RESULTS

Of eleven studies included, six were randomised controlled trials, three were controlled clinical trials, and two were cohort studies. The discharge planning strategies used varied widely, most were limited to preparation of discharge during in-patient treatment. Pooled risk ratios were 0.66 (95% CI = 0.51 to 0.84; P < 0.001) for hospital readmission rate, and 1.25 (1.07 to 1.47; P < 0.001) for adherence to out-patient treatment. Effect sizes (Hedge's g) were -0.25 (-0.45 to -0.05; P = 0.02) for mental health outcome, and 0.11(-0.05 to 0.28; NS) for quality of life.

CONCLUSION

Discharge planning interventions are effective in reducing rehospitalisation and in improving adherence to aftercare among people with mental disorders.

Beyond Family Burden - the Complexities of Carer Roles

In her talk, Sigrid Steffen will speak about the core aims of EUFAMI in respect to family members and carers. Sigrid will base a lot of her talk around her own personal experience as a carer of a son who was diagnosed with schizophrenia, and she will augment this with experiences of other members of EUFAMI from across Europe. She will elaborate on the stresses and strains under which family members (the carers) come under and will discuss the challenges which carers face on a daily basis.

Her talk will also include a description of a typical ‘journey’ which carers and families travel in the execution of their caring role in an attempt to describe the various feelings and pressures they experience. Sigrid will also discuss what she understands to be the critical needs of carers and the level of support required. In particular Sigrid will concentrate on the stigma which families feel and experience during their lifetime, a aspect which is little understood and appreciated by the wider public. In conclusion, Sigrid will detail some of the work which EUFAMI has been and is involved with and which is related to the subject of her talk.

Conventional carbon dioxide application does not reduce cerebral or myocardial damage in open heart surgery

BACKGROUND

Open heart surgery is associated with a significant risk of cerebral and myocardial dysfunction, which is attributed in part to air embolism from incompletely deaired cardiac chambers. To evaluate the impact of carbon dioxide (CO2) insufflation to the thoracic cavity, a prospective randomized study was designed.

METHODS

A total of 62 elective patients were randomly assigned to CO2 insufflation (group I, n = 31) or control (group II, n = 31). According to the Parsonnet risk score, 16 patients in group I (52%) and 10 patients in group II (32%) were categorized as being at either high risk or extremely high risk.

RESULTS

In group II, perioperative mortality was 16.1% (5 patients); in group I, 1 patient died (ns). Creatine kinase MB isoenzyme, as a marker of myocardial damage, was more elevated in group I after surgery (38.0 +/- 4.1 vs 28.0 +/- 2.1, p = 0.02). Neurocognitive test scores did not reveal significant postoperative differences between groups.

CONCLUSIONS

Although mortality was lower with CO2 insufflation, no benefit could be demonstrated for markers of cardiac ischemic damage or neurocognitive outcome in this high-risk population. As CO2 concentrations in the thoracic cavity did not necessarily reach anticipated levels, our method of application is in question.

Induction of AIDS virus-specific CTL activity in fresh, unstimulated peripheral blood lymphocytes from rhesus macaques vaccinated with a DNA prime/modified vaccinia virus Ankara boost regimen

The observed role of CTL in the containment of AIDS virus replication suggests that an effective HIV vaccine will be required to generate strong CTL responses. Because epitope-based vaccines offer several potential advantages for inducing strong, multispecific CTL responses, we tested the ability of an epitope-based DNA prime/modified vaccinia virus Ankara (MVA) boost vaccine to induce CTL responses against a single SIVgag CTL epitope. As assessed using both 51Cr release assays and tetramer staining of in vitro stimulated PBMC, DNA vaccinations administered to the skin with the gene gun induced and progressively increased p11C, C-->M (CTPYDINQM)-specific CD8+ T lymphocyte responses in six of six Mamu-A*01+ rhesus macaques. Tetramer staining of fresh, unstimulated PBMC from two of the DNA-vaccinated animals indicated that as much as 0.4% of all CD3+/CD8alpha+ T lymphocytes were specific for the SIVgag CTL epitope. Administration of MVA expressing the SIVgag CTL epitope further boosted these responses, such that 0.8-20.0% of CD3+/CD8alpha+ T lymphocytes in fresh, unstimulated PBMC were now Ag specific. Enzyme-linked immunospot assays confirmed this high frequency of Ag-specific cells, and intracellular IFN-gamma staining demonstrated that the majority of these cells produced IFN-gamma after peptide stimulation. Moreover, direct ex vivo SIV-specific cytotoxic activity could be detected in PBMC from five of the six DNA/MVA-vaccinated animals, indicating that this epitope-based DNA prime/MVA boost regimen represents a potent method for inducing high levels of functionally active, Ag-specific CD8+ T lymphocytes in non-human primates.

[Examination of the total protein concentration and gamma-glutamyltransferase (gamma-GT) in calves during the first 14 days of life and their significance for predictions of health status in the first two postnatal weeks]

The objective of the present paper was to examine the development of the total protein concentration in blood serum and the gamma-GT activity in 49 calves in relation to the health status during the first 14 days of life. For this purpose, blood samples were taken immediately after birth of the animals, after 6, 12, 18 and 24 hours and from then onwards once a day with the calves being subject to a thorough clinical examination each time. All calves received pooled colostrum. At the end of the experiment, the calves were subdivided into three groups on the basis of their health status, i.e. control calves, calves with a slight or moderately severe disease and calves suffering from a severe disease. In all three groups the total protein concentration increased significantly after the colostrum intake and decreased slowly from the 2nd day of life onwards. The gamma-GT activity as well increased significantly after the colostrum intake and decreased rapidly after 12th hour of life and progressively in the further course of the experiment. Both parameters varied considerably from one calf to the next and no statistically significant differences in these parameters between the three groups could be found. It can thus be deduced that the total protein concentration in blood serum and the gamma-GT activity do not allow any predictions about the development of the health status during the first 14 days of life to be made.

[On calving in the pasture during the fall (veterinary expert)]

The objective of the following study was a veterinary expert opinion dealing with the evaluation of the pasturing of a cow and her calf during fall with special respect to animal welfare. The legal basis of this expert opinion was the Animal Welfare Act as amended on 1993. It is emphasized that there are no binding legal regulations as to the pasturing of livestock and that, especially because of the increasing public interest in animal welfare matters, the definition of minimal requirements would be desirable.

[Intestinal perforation in a llama mare following rectal palpation (veterinary expert opinion)]

The object of the following study is a veterinary expert opinion about a llama mare. This animal was subjected to a rectal palpation for pregnancy diagnosis during which the rectum was perforated. General guide lines for rectal palpation as well as special characteristics in llamas described in the literature are discussed.

[Non-recognition of a second fetus in a recumbent cow during veterinary obstetrical assistance (expert opinion)]

The objective of the expert opinion presented in this paper is the missing of a second fetus after veterinary obstetrical assistance in a downer cow. The necessity of a thorough examination after obstetrical manipulation is stressed with special reference to problems occurring in recumbent cows. In addition, possible complications after inappropriate removal of retained placental fetal membranes are discussed.

Microgravity effects on sea urchin fertilization and development

Gravity has been a pervasive influence on all living systems and there is convincing evidence to suggest that it alters fertilization and embryogenesis in several developmental systems. Notwithstanding the global importance of gravity on development, it has only been recently possible to begin to design experiments which might directly investigate the specific effects of this vector. The goal of this research program is to explore and understand the effects of gravity on fertilization and early development using sea urchins as a model system. Sea urchin development has several advantages for this project including the feasibility of maintaining and manipulating these cells during spaceflight, the high percentage of normal fertilization and early development, and the abundant knowledge about molecular, biochemical, and cellular events during embryogenesis which permits detailed insights into the mechanism by which gravity might interfere with development. Furthermore, skeletal calcium is deposited into the embryonic spicules within a day of fertilization permitting studies of the effects of gravity on bone calcium deposition.