Anaemia, iron status and vitamin A deficiency among adolescent refugees in Kenya and Nepal

OBJECTIVE: To investigate the prevalence of anaemia (haemoglobin<11.0 to 13.0 g dl(-1) depending on age and sex group), iron deficiency (transferrin receptor concentration>8.3 microg ml(-1)) and vitamin A deficiency (serum retinol <0.7 micromol l(-1)) in adolescent refugees. DESIGN: Cross-sectional surveys. SETTING: Kakuma refugee camp in Kenya and seven refugee camps in Nepal. SUBJECTS: Adolescent refugee residents in these camps. RESULTS: Anaemia was present in 46% (95% confidence interval (CI): 42-51) of adolescents in Kenya and in 24% (95% CI: 20-28) of adolescents in Nepal. The sensitivity of palmar pallor in detecting anaemia was 21%. In addition, 43% (95% CI: 36-50) and 53% (95% CI: 46-61) of adolescents in Kenya and Nepal, respectively, had iron deficiency. In both surveys, anaemia occurred more commonly among adolescents with iron deficiency. Vitamin A deficiency was found in 15% (95% CI: 10-20) of adolescents in Kenya and 30% (95% CI: 24-37) of adolescents in Nepal. Night blindness was not more common in adolescents with vitamin A deficiency than in those without vitamin A deficiency. In Kenya, one of the seven adolescents with Bitot's spots had vitamin A deficiency. CONCLUSIONS: Anaemia, iron deficiency and vitamin A deficiency are common among adolescents in refugee populations. Such adolescents need to increase intakes of these nutrients; however, the lack of routine access makes programmes targeting adolescents difficult. Adolescent refugees should be considered for assessment along with other at-risk groups in displaced populations.     

A preliminary study on the suitability of Cervidil to induce cervical dilation for artificial insemination in ewes

The aim of this study was to evaluate the efficacy of Cervidil^®, a prostaglandin E₂ (PgE₂)-releasing vaginal insert used for induction of cervical ripening and labour in women, to enhance the ease of transcervical artificial insemination (TCAI) in anestrous ewes (June). It was hypothesized that the use of Cervidil^® prior to AI would cause dilation of the cervix, and thus alleviate the difficulty associated with traversing the cervix for semen deposition in sheep. Cervidil^® was inserted 12 h before insemination in six Rideau-Arcott ewes; six ewes served as untreated controls.Semen was deposited into the uterus of all six treated ewes but TCAI was possible only in four of the six control ewes. It can be concluded that Cervidil^® facilitated transcervical semen deposition in anestrous ewes. The treatment with Cervidil^® has the promise of a technique to improve transcervical AI and to enable non-invasive embryo transfer procedures in sheep.     

Azotemia and mortality among Babesia microti-like infected dogs

Babesia microti-like piroplasms are a recently recognized cause of illness in dogs in northwest Spain. Our objective was to describe the clinical characteristics and investigate the risk factors for azotemia and death among 58 B microti-like infected dogs. Twenty-one of the 58 (36%) dogs were azotemic at the time that the infection was diagnosed. The case fatality rate during the following week was 22%. Dogs with azotemia at the time of diagnosis were 10 times (95% CI, 3.26-28.8) more likely to die during the following week. Azotemia was the main cause of death for B microti-like infected dogs (attributable fraction = 90%). Severe anemia was present in 45 of the 58 (78%) dogs. Azotemic dogs also presented with hyperphosphatemia, hypoalbuminemia, hypercholesterolemia, proteinuria, and high urine protein: creatinine ratios, suggesting a glomerular component to the disease. Age was the only factor significantly associated with the risk of azotemia (P = .042): on average, a 4-year age increase doubled the risk of an infected dog being azotemic. The only factor significantly associated with mortality was azotemia (P = .001). We concluded that B microti-like infection is associated with a high risk of azotemia and mortality.     

Dynamics and determinants of Quercus alba seedling success following savanna encroachment and restoration

The scattered tree layer that defines savannas is important for structuring the understory community and determining patterns of overstory recruitment. However, encroachment by woody plants has altered overstory tree densities and regeneration dynamics. We characterized seedling success of the savanna-forming species Quercus alba within Midwestern (USA) oak savannas that had been degraded by encroachment (control; n = 4) or experimentally restored by removal of encroaching woody vegetation (treatment; n = 4). In early 2004, 981 seedlings were transplanted along transects radiating from tree boles of overstory Q. alba trees to inter-canopy gaps and monitored for three growing seasons. Seedlings in restored sites had greater survival (>2×), height growth (by >50%), and basal diameter growth (by >20%). In general, seedling survival and growth parameters increased with distance from overstory trees and were greatest in inter-canopy gaps of restored sites. By the final growing season (2006), the seedling survival-by-distance from tree correlation was stronger in control (r² = 0.25) than treatment sites (r² = 0.18), due to relatively uniform (and greater) survival at all distances from trees in treatment sites. In 2006, growth parameters (seedling height, diameter, Δ height, Δ diameter, and # leaves) were significantly (and more strongly) positively correlated with distance from trees in treatment sites. However, seedling herbivory was also greater after treatment and increased with distance from overstory trees. To understand seedling/microenvironment relationships, we created logistic (survival) and linear regression models (Δ height, Δ basal diameter, # leaves in 2006). Control seedling models had consistently greater predictive power and included more variables, suggesting that savanna restoration may decouple seedlings from their microenvironments, potentially by decreasing competition for limiting resources. Encroachment of the savannas in this study is limiting regeneration of Q. alba, suggesting substantially altered regeneration dynamics from those under which these savannas originally formed. Initial responses from our test of restoration, however, were promising and mechanical encroachment removal may be a means to promote overstory regeneration of this species. Finally, the savannas in this study appear inherently unstable and a scattered canopy tree configuration is unlikely to persist without regular disturbance, even in the restoration sites. Repeated mechanical thinning treatments with selected retention of recruiting Q. alba individuals or reintroduction of understory fire or grazing animals may be potential mechanisms for promoting long-term persistence of savannas at these sites.     

Assessing the influence of mechanical ventilation on blood gases and blood pressure in rattlesnakes

ObjectiveTo characterize the impact of mechanical positive pressure ventilation on heart rate (HR), arterial blood pressure, blood gases, lactate, glucose, sodium, potassium and calcium concentrations in rattlesnakes during anesthesia and the subsequent recovery period.Study designProspective, randomized trial.AnimalsTwenty one fasted adult South American rattlesnakes (Crotalus durissus terrificus).MethodsSnakes were anesthetized with propofol (15 mg kg⁻¹) intravenously, endotracheally intubated and assigned to one of four ventilation regimens: Spontaneous ventilation, or mechanical ventilation at a tidal volume of 30 mL kg⁻¹ at 1 breath every 90 seconds, 5 breaths minute⁻¹, or 15 breaths minute⁻¹. Arterial blood was collected from indwelling catheters at 30, 40, and 60 minutes and 2, 6, and 24 hours following induction of anesthesia and analyzed for pH, PaO₂, PaCO₂, and selected variables. Mean arterial blood pressure (MAP) and HR were recorded at 30, 40, 60 minutes and 24 hours.ResultsSpontaneous ventilation and 1 breath every 90 seconds resulted in a mild hypercapnia (PaCO₂ 22.4 ± 4.3 mmHg [3.0 ± 0.6 kPa] and 24.5 ± 1.6 mmHg [3.3 ± 0.2 kPa], respectively), 5 breaths minute⁻¹ resulted in normocapnia (14.2 ± 2.7 mmHg [1.9 ± 0.4 kPa]), while 15 breaths minute⁻¹ caused marked hypocapnia (8.2 ± 2.5 mmHg [1.1 ± 0.3 kPa]). Following recovery, blood gases of the four groups were similar from 2 hours. Anesthesia, independent of ventilation was associated with significantly elevated glucose, lactate and potassium concentrations compared to values at 24 hours (p < 0.0001). MAP increased significantly with increasing ventilation frequency (p < 0.001). HR did not vary among regimens.Conclusions and clinical relevanceMechanical ventilation had a profound impact on blood gases and blood pressure. The results support the use of mechanical ventilation with a frequency of 1–2 breaths minute⁻¹ at a tidal volume of 30 mL kg⁻¹ during anesthesia in fasted snakes.     

Treatment of equine glaucoma by transscleral neodymium:yttrium aluminum garnet laser cyclophotocoagulation: a retrospective study of 23 eyes of 16 horses

Contact neodymium:yttrium aluminum garnet (Nd:YAG) laser transscleral cyclophotocoagulation (TSCP) was performed on 23 eyes of 16 horses for treatment of glaucoma. The mean highest preoperative IOP was 51 ± 17 mmHg. Follow-up evaluation was available for 19 eyes 1 day after surgery, 14 eyes from 1 to 2 weeks, 16 eyes from 4 to 6 weeks, 9 eyes from 12 to 16 weeks, and 10 eyes greater than 20 weeks after laser treatment. The mean intraocular pressure (IOP) the day following surgery was 34 ± 13 mmHg. The mean IOP for each follow-up period was: one to two weeks postoperative, 23 ± 9 mmHg; four to six weeks, 24 ± 7 mmHg; 12–16 weeks, 28 ± 10 mmHg; and  20 weeks, 22 ± 9 mmHg. IOP measurements were significantly different from pretreatment values for all follow-up intervals except for weeks 12–16 ( P < 0.05). Treatment success was defined as maintenance of IOP < 30 mmHg. Treatment success was achieved in 93%, 88%, 78%, and 70% of the treated eyes at the 1–2 weeks, 4–6 weeks, 12–16 weeks, and the  20 weeks re-evaluation, respectively. No significant difference was found between the number of eyes visual at presentation (52.2%) and visual at 20 weeks (60%). The most common laser complications were conjunctival hyperemia (21.7%) and corneal ulcers (13.0%). Results of this study indicate that Nd:YAG TSCP is an effective method of controlling IOP and preserving vision in horses with glaucoma. An effective Nd:YAG laser protocol for TSCP in the equine glaucomatous eye is a power setting of 11 W, duration of 0.4 s, applied 5 mm posterior to the limbus at 60 sites, resulting in a total energy dose of 264 J.     

Administering dental nerve blocks

Dental nerve blocks provide excellent pain management for many oral procedures. They are easy and inexpensive to perform, provide a rapid onset of action, and work in concert with anesthetic and other analgesic modalities. This article explains how to administer various dental nerve blocks and discusses the indications and precautions associated with their use.     

Atmospheric Mercury Fluxes in a Southern Boreal Forest and Wetland

Total gaseous mercury (TGM) fluxes from the forest floor and a boreal wetland were measured by a flux chamber technique coupled with an automatic mercury vapour analyser. The fluxes were measured at three sampling sites in southern Finland, 61°14′ N, 25°04′ E in summer 2007, with additionally in situ TGM concentrations in the air at one of the sites and mercury bulk deposition at another. Most of the flux data were collected during the daytime. At one of the sites, diurnal flux behaviour was studied, and a clear cycle with an afternoon maximum and a night minimum was observed. The highest emissions (up to 3.5 ng m⁻² h⁻¹) were observed at the forest floor site having a moss and grass cover. At the wetland and litter-rich forest floor sites, the emissions were below 1 ng m⁻² h⁻¹ and sometimes negative (down to −1.0 ng m⁻² h⁻¹), indicating mercury uptake. The measured average fluxes in August were 0.9 ± 1.1 and 0.2 ± 0.3 ng m⁻² h⁻¹ for the forest floor sites and wetland sites, respectively. The flux data were compared with the mercury bulk deposition, which proved to be of the same magnitude, but opposite in sign. At the mossy forest floor site, the extrapolated TGM emissions were 130% of the Hg deposition in August 2007. Comparison with other studies showed that the fluxes in background areas are relatively uniform, regardless of measurement site location and method used. Airborne TGM remained at the background level during the study, with an average value of 1.3 ± 0.2 ng m⁻³; it frequently showed a diurnal cycle pattern.