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The thymus is a largely neglected organ but plays a significant role in the regulation of adaptive immune responses. The effect of aging on the thymus and immune senescence is well established, and the resulting inflammaging is found to be implicated in the development of many chronic diseases including atherosclerosis, hypertension and type 2 diabetes. Both aging and diseases of inflammaging are associated with severe COVID-19 disease, and a dysfunctional thymus may be a predisposing factor. In addition, insults on the thymus during childhood may lead to abnormal thymic function and may explain severe COVID-19 disease among younger individuals; therefore, measurement of thymic function may assist COVID-19 care. Those with poor thymic function may be treated prophylactically with convalescent serum or recombinant antibodies, and they may respond better to high-dose or adjuvanted COVID-19 vaccines. Treatments inducing thymic regeneration may improve patients' overall health and may be incorporated in COVID-19 management.Introduction Data on subtotal cholecystectomy (STC) as an alternative to conventional cholecystectomy in difficult surgical situations are limited. This multiaspectual report aims to reduce the STC-specific knowledge gap and inform clinical decision-making strategies. Materials and Methods All 180 patients who underwent STC at a single center between 2011 and 2017 were assessed in this retrospective cohort study. Their outcomes were followed up until March 23, 2018. Six subgroups stratified by surgical setting (elective/nonelective), surgical approach used (open/laparoscopic), and type of STC (reconstituting/fenestrating) were compared. Zasocitinib Results The ratio of conventional to STC procedures was 131. Of the 180 patients, 150 had a history of hospitalization for the acute biliary disease. The proportion of all cholecystectomies that were STC ranged from 1% to 71% between individual surgeons; similarly, laparoscopic STC comprised 0%-97% of all STCs. STC was associated with high intraoperative (n = 19; 10.6%) and short-term postoperative (n = 159; 88.3%) complication rates. There were three significant intraoperative complications-bleeding (n = 8; 4.4%), bile duct injury (n = 7; 3.9%), and intestinal injury (n = 4; 2.2%). The most common postoperative surgical site complications were external bile leak (21%), wound infection (17%), and biloma (10%). Associations between fenestrating STC and the rates of postoperative bile leak and retained gallstones, mainly in the main bile duct, were detected. Conclusions STC-associated perioperative morbidity is significant. There is a substantial investigation burden. Injuries can be avoided when conversion to STC is timely, and its technical variant is correctly selected. The STC rate is a potential key performance indicator monitoring gallbladder surgery practice.
To identify a method for developing antibiograms for use in companion animal private practices (PPs).
Reports (n = 532) of aerobic bacterial culture and antimicrobial susceptibility testing performed between January 1, 2018, and December 31, 2018, at 11 PPs and 1 academic primary care practice (APCP).
Data extracted from reports included patient identification number, laboratory accession number, patient signalment, collection method, body site, and results of bacterial culture and antimicrobial susceptibility testing. A custom antibiogram was then constructed with the help of commonly available software by adapting methods used by human hospitals. Susceptibility patterns of bacteria isolated by PPs and the APCP were compared to identify challenges associated with collating data from multiple laboratories.
4 bacterial species (
, and
) and 3 bacterial groups (Enterobacteriaceae,
spp, and coagulase-positive
spp) met the minimum requirement of ≥ 15 isolates for construction of an antibiogram. For urine samples, 3 bacterial species and 2 bacterial groups met the minimum requirement of ≥ 10 isolates. For samples from skin, 2 bacterial species and 2 bacterial groups met the minimum requirement of ≥ 10 isolates. Patient signalment, sample source, and distribution of bacterial isolates were similar between PP and APCP patients.
Results demonstrated that it was feasible to adapt existing guidelines for developing antibiograms in human medicine to the veterinary outpatient setting. Use of antibiograms could aid in empirical antimicrobial drug selection in a manner that supports antimicrobial stewardship principles.
Results demonstrated that it was feasible to adapt existing guidelines for developing antibiograms in human medicine to the veterinary outpatient setting. Use of antibiograms could aid in empirical antimicrobial drug selection in a manner that supports antimicrobial stewardship principles.
To determine whether plasma uric acid concentration in inland bearded dragons (
) was affected by recent ingestion of a meal of crickets.
12 healthy adult inland bearded dragons.
Food was withheld for 48 hours prior to experiments. Animals (6/group) were randomly assigned to receive a meal of crickets (equivalent to 1% of the animal's body weight; 10 g/kg [4.5 g/lb]; treatment group) or have food withheld for an additional 48 hours (control group). Blood samples were collected for plasma uric acid measurement just before (time 0) and 4, 24, and 48 hours after feeding. Effects of feeding and time on the targeted measurement were assessed by repeated-measures ANOVA.
Mean plasma uric acid concentration for the treatment group was significantly increased from the time 0 value (2.5 ± 1.5 mg/dL) 24 hours following meal ingestion (6.5 ± 1.2 mg/dL), but not at the 4-hour time point, and returned to the time 0 value by the 48-hour time point. No significant changes in plasma uric acid concentration were detected for the control group.
Results suggested food should be withheld for ≥ 48 hours prior to blood collection if inland bearded dragons are used to establish reference intervals for plasma uric acid concentration or if feasible when obtaining samples from these animals for clinical evaluation. Veterinarians should consider the time from last meal consumption when interpreting plasma uric acid concentration for this species and potentially other terrestrial insectivorous and omnivorous lizards.
Results suggested food should be withheld for ≥ 48 hours prior to blood collection if inland bearded dragons are used to establish reference intervals for plasma uric acid concentration or if feasible when obtaining samples from these animals for clinical evaluation. Veterinarians should consider the time from last meal consumption when interpreting plasma uric acid concentration for this species and potentially other terrestrial insectivorous and omnivorous lizards.
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