[Perioperative Atrial Fibrillation].

New atrial fibrillation is a risk factor for increased morbidity and mortality in the perioperative phase. The prevalence and incidence of atrial fibrillation depend on age, previous illnesses and the intercurrent diagnoses in the perioperative phase. Pathomechanisms for both permanent and acute forms of atrial fibrillation relate to electrophysiological, histopathological and other pathophysiological abnormalities.

Use of the internet to enhance infectious disease surveillance and outbreak investigation.

Modernization of electronic communication systems to facilitate infectious disease surveillance and outbreak investigation became a priority after the 2001 anthrax attacks. However, the extent to which communicable disease investigators are using web-based information resources, e-mail notifications, or secure information exchange systems to facilitate surveillance is unknown. To address this question, we conducted a survey in 2004 of state and local communicable disease investigators responsible for infectious disease surveillance and outbreak investigation in three states.

Laryngeal, laryngotracheal, and tracheal masses in cats: 27 cases (1998-2003).

Medical records of 27 cats with masses of the larynx and trachea were examined. Six cats had inflammatory masses, and 21 cats had neoplastic lesions. A definitive diagnosis was reached in 22 cats with a single biopsy.

Effect of venous air embolization on pulmonary microvascular protein permeability.

Objective: An increase in pulmonary lymph flow and lymph protein clearance following pulmonary air embolization has been interpreted as evidence of increased pulmonary microvascular permeability. The authors hypothesized that air embolization does not alter the pulmonary microvascular permeability to protein and that this could be demonstrated by determining the effect of air embolization on the pulmonary solvent drag reflection coefficient (sigma(f)).

Methods: Anesthetized dogs were instrumented with left atrial balloon-tipped catheters, pulmonary lymphatic cannulae, and inferior vena caval catheters.

Duodenal perforation in a cheetah (Acinonyx jubilatus).

An 11-yr-old female cheetah (Acinonyx jubilatus) from a privately owned breeding center for endangered species was referred for evaluation with a history of vomiting and depression of 10 days' duration. After anesthetic induction with tiletamine and zolazepam and anesthetic maintenance with isoflurane, a complete diagnostic workup was performed, including hematology, serum chemistry, and radiography. The clinical diagnosis was septic suppurative inflammation and hemorrhage in the abdomen, consistent with perforation or rupture of the gastrointestinal tract.

Basic determinants of epicardial transudation.

Myocardial edema formation, which has been shown to compromise cardiac function, and increased epicardial transudation (pericardial effusion) have been shown to occur after elevation of myocardial venous and lymphatic outflow pressures. The purposes of this study were to estimate the hydraulic conductance and osmotic reflection coefficient for the epicardium and to determine the effect of coronary sinus hypertension and cardiac lymphatic obstruction on epicardial fluid flux (JV,e/Ae). A Plexiglas hemispheric capsule was attached to the left ventricular epicardial surface of anesthetized dogs.

Regulation of microvascular filtration in the myocardium by interstitial fluid pressure.

We hypothesized that myocardial microvascular filtration rate (Jv) could be manipulated by varying end-diastolic myocardial interstitial hydrostatic (P(int)) pressure. Dogs under general anesthesia were instrumented with intramyocardial capsules to measure P(int) and with prenodal myocardial lymphatic trunk cannulas and superior vena caval balloon-tipped catheters to manipulate myocardial lymph flow. Because, for a given surface area, the lymph-to-plasma protein concentration ration (CL/CP) varies inversely with JV, CL/CP was utilized as an index of changes in JV.

Renal lymphatic function following venous pressure elevation.

The renal lymphatic system plays an important role in removing excess fluid from the kidneys. Unfortunately, the factors influencing lymphatic flow are difficult to measure. We used a simple model to represent renal lymphatics as a single pressure source (PL) pushing lymph through a single resistance (RL).

Presumptive, iatrogenic gastric outflow obstruction associated with prior gastric surgery.

Iatrogenic gastric outflow obstruction in two dogs appeared to be caused by prior gastric surgery. The obstructions were believed to be anatomical rather than functional based on endoscopic examinations. Initially, the dogs had been evaluated and each had received two abdominal surgeries because of gastrointestinal bleeding, vomiting, or both.

Myocardial edema and compromised left ventricular function attributable to dirofilariasis and cardiopulmonary bypass in dogs.

We investigated the relation between left ventricular dysfunction and myocardial edema in dogs with heartworm (Dirofilaria immitis) infection that were undergoing cardiopulmonary bypass. Dogs with and without D immitis were anesthetized by continuous thiopental infusion and were mechanically ventilated. Sonomicrometry crystals were placed on the long and short axes of the left ventricle, and a Millar pressure transducer was placed in the left ventricular chamber.

[Diagnosis and surgical therapy of right-sided colonic diverticulitis].

Diverticulosis of the colon is common in the descending and sigmoid part; the right colon is rarely involved. Inflammation of perforation of a cecal diverticulum is an uncommon condition that mimics acute appendicitis. The correct diagnosis is mostly made after operative exploration.

A cluster of invasive pneumococcal disease in young children in child care.

Objective: To investigate a cluster of invasive pneumococcal disease in children 8 to 26 months of age, using standard microbiological procedures and ribosomal DNA gene-restriction patterns to characterize the outbreak strain.

Design: Outbreak investigation.

Setting: A family child-care home with six children in Baltimore, Md.

Amoxicillin-clavulanate potassium compared with cefaclor for acute otitis media in infants and children.

One hundred thirty-three infants and children with documented acute otitis media (OM) were randomized to receive the oral suspension of either amoxicillin-clavulanate potassium or cefaclor. Beta-lactamase-producing bacteria were found in 10.9 and 14.

Sultamicillin (ampicillin-sulbactam) in the treatment of acute otitis media in children.

Sultamicillin, a dimer of ampicillin and a beta-lactamase-inhibiting agent, sulbactam, was given in oral form to 50 infants and children with acute otitis media. Tympanocentesis was performed on entry into the trial. Beta-lactamase-positive Haemophilus influenzae or Branhamella catarrhalis was isolated from 14 of 73 (19.

Treatment of ampicillin-resistant acute otitis media in the chinchilla.

The efficacy of sulbactam sodium (CP45,899-2) was investigated using the chinchilla animal model of acute otitis media with effusion (AOME). Both ears of 78 chinchillas were inoculated with beta-lactamase-producing nontypable Hemophilus influenzae. Half of the animals were treated with ampicillin sodium alone (group A) and the remaining animals received ampicillin plus sulbactam (group B).

An animal model of acute otitis media consequent to beta-lactamase-producing nontypable Haemophilus influenzae.

A chinchilla model of acute otitis media with effusion consequent to beta-lactamase-producing nontypable Haemophilus influenzae was developed using the method of direct inoculation of 145 colony-forming units (CFU) or 252 CFU of beta-lactamase-producing nontypable H influenzae into the right superior bullae of 40 chinchillas. The course of the disease was documented longitudinally by otomicroscopy, tympanometry, and periodic culturing of the middle ears. Onset of the disease occurred in 100% of the animals between two and six days postinoculation and resolution was complete in all ears by day 36.

Effect of fetal protein malnutrition on the postnatal structure and function of alveolar macrophages.

To test the hypothesis that intrauterine malnutrition may alter ontogeny of the host defense system, an animal model of fetal protein deprivation was developed. Young adult female rats were fed either a deficient (8% protein) diet or a normal (25% protein) diet for 10 days before insemination and throughout gestation. Offspring of the malnourished animals showed significant growth retardation and were hypoproteinemic.

Recurrent pneumococcal otitis media in the chinchilla. A longitudinal study.

To define the relative importance of the local and systemic immune mechanisms in otitis media, middle ear infections were induced in 47 chinchillas by unilateral intrabullar inoculation of Streptococcus pneumoniae type 6A. Bacterial challenges were repeated ipsilaterally or contralaterally several times during the five-month course of the study. The middle ear condition was assessed with the use of otomicroscopy, tympanometry, and direct inspection and culture through a bullar opening.

Pharmacokinetics of cefaclor in chronic middle ear effusions.

Fifty children aged 1 to 13 years with chronic or recurrent otitis media with effusion received a single dose of cefaclor (15 mg/kg body weight) by the oral route 30 minutes to seven hours before the removal of middle ear effusion and insertion of tympanostomy tubes. Serum and middle ear aspirate concentrations of the antibiotic were determined employing a microbiological assay technique by a disk diffusion method. Middle ear specimens were also cultured for aerobic bacteria.