BackgroundUsing data from an observational study in which the effectiveness of a guideline for eradication of methicillin-resistant Staphylococcus aureus (MRSA) carriage was evaluated, we identified variables that were associated with treatment failure.
Summary Coefficients of correlation have been calculated between morphological lesion scores of osteochondrosis that were made on the bones of porcine fore and hind limbs and some carcass characteristics. It was found that carcass length, as well as the relative weights of the hams were significantly correlated with the lesions that were observed in the proximal site of the femur and the medial femoral condyle. Despite these significant correlations, the values of the correlation coefficients were too small to be of any use for selection purposes. This applies the whole animal population, consisting of 6 breeds of pigs. It is shown that the coefficients of correlation between the morphological lesion scores of the femur and the relative weights of the hams in some of the individual breeds were much higher, implying a possibility for the prediction of osteochondrosis based on carcass characteristics.
Background. A multiple intervention targeted to reduce antibiotic prescribing with an educational outreach programme had proven to be effective in a randomized controlled trial in 12 peer review groups, demonstrating 12% less prescriptions for respiratory tract infections. Objective. To assess the effectiveness of a multiple intervention in primary care at a large scale. Methods. A controlled before and after study in 2006 and 2007 was designed. Participants were from general practices within a geographically defined area in the middle region of The Netherlands. Participants were GPs in 141 practices in 25 peer review groups. A control group of GP practices from the same region, matched for type of practice and mean volume of antibiotic prescribing. The multiple intervention consisted of the following elements: (i) group education meeting and communication training; (ii) monitoring and feedback on prescribing behaviour; (iii) group education for GPs and pharmacists assistants and (iv) patient education material. The main outcome measures are as follows: (i) number of antibiotic prescriptions per 1000 patients per GP and (ii) number of second-choice antibiotics, obtained from claims data from the regional health insurance company. The associations between predictors and outcome measurements were assessed by means of a multiple regression analyses. Results. At baseline, the number of antibiotic prescriptions per 1000 patients was slightly higher in the intervention group than in the control group (184 versus 176). In 2007, the number of prescriptions had increased to 232 and 227, respectively, and not differed between intervention and control group. Conclusions. The implementation of an already proven effective multiple intervention strategy at a larger scale showed no reduction of antibiotic prescription rates. The failure might be attributed to a less tight monitoring of intervention and audit. Inserting practical tools in the intervention might be more successful and should be studied.
We evaluated the effectiveness of eradication of methicillin-resistant Staphylococcus aureus (MRSA) carriage in the Netherlands after the introduction of a guideline in 2006. The guideline distinguishes complicated (defined as the presence of MRSA infection, skin lesions, foreign-body material, mupirocin resistance and/or exclusive extranasal carriage) and uncomplicated carriage (not meeting criteria for complicated carriage). Mupirocin nasal ointment and chlorhexidine soap solution are recommended for uncomplicated carriers and the same treatment in combination with two oral antibiotics for complicated carriage. A prospective cohort study was performed in 18 Dutch centres from 1 October 2006 until 1 October 2008. Six hundred and thirteen MRSA carriers underwent one or more decolonization treatments during the study period, mostly after hospital discharge. Decolonization was achieved in 367 (60%) patients with one eradication attempt and ultimately 493 (80%) patients were decolonized, with a median time until decolonization of 10 days (interquartile range 7–43 days). Three hundred and twenty-seven (62%) carriers were treated according to the guideline, which was associated with an absolute increase in treatment success of 20% [from 45% (91/203) to 65% (214/327)]. Sixty percent of MRSA carriers were successfully decolonized after the first eradication attempt and 62% were treated according to the guideline, which was associated with an increased treatment success.
Summary Clinical and pathological data concerning the degree of leg weakness and severity of osteochondral lesions in gilts and barrows have been compared. It became clear that the pathological condition of the distal part of the ulna and the medial femoral condyle of gilts was less severe than that of barrows. The clinical symptoms of leg weakness in gilts also tended to be less severe than those in barrows. Notes Research Institute for Animal Production ‘Schoonoord’, PO Box 501, 3700 AM Zeist, the Netherlands. Dept. Vet. Medicine, State University Utrecht, Utrecht, the Netherlands. Dept. Vet. Pathology, State University Utrecht, Utrecht, the Netherlands.
Summary The experiments demonstrate that the acid‐base status of porcine blood does not change significantly during a six hours’ storage period at 0° C. They further show that the sampling of blood via a vena cava puncture in comparison with sampling via an indwelling ear vein catheter is associated with severe stress that affects the acid‐base statuts of the blood.
In view of long-standing concerns about possible consequences regarding the cardiovascular capacity and adaptability of modern pigs we investigated the proportionality and performance of porcine hearts over a wide range of body weights (25– 225 kg), according to allometric scaling laws. Specifically, we tested the hypothesis that both heart mass (HM) and cardiac output (CO) scale with body mass (M) to the power of 0.75 (HM or CO = a.M0.75), stroke volume (SV), and left ventricular end-diastolic volume (LVEDV) to the power of 1.00. For this purpose, 21 Yorkshire × Landrace pigs were instrumented under anesthesia to measure CO and SV and LVEDV. Subsequently, animals were sacrificed and hearts were excised and weighed and tissue samples of the LV anterior myocardial wall analyzed for collagen content. Using a linear mixed model, the scaling coefficients of the relations between M and CO, SV, HM, and LVEDLV were determined. The 95% confidence intervals of the power-coefficient b for HM were 0.67– 0.88, encompassing the predicted value of 0.75, indicating that HM increased proportionally to M. In contrast, the 95% confidence intervals of power-coefficient b for CO amounted 0.40–0.65, thus failing to encompass the predicted value of 0.75. This was principally due to the lack of proper scaling of SV as the confidence interval of 0.52–0.83 failed to encompass the predicted value of 1.0, which in turn appeared to be due to a lack of scaling of LVEDV as its confidence interval of b values amounted 0.57–0.99, thus failing to encompass the predicted value of 1.0. The increase of HM without a proportional increase of LV volume, was accompanied by a doubling of collagen content in the LV of swine > 150 kg compared to swine < 75 kg (p < 0.05). In conclusion, cardiac geometry and function of modern swine fail to obey allometric scaling laws, likely due to an increased extracellular matrix deposition preventing physiological remodeling during growth.
