Mastitis outcomes on pre-ovulatory follicle diameter, estradiol concentrations, subsequent luteal profiles and conception rate in Buffaloes.

The objectives of this study was to investigate the outcome of mastitis, in its clinical or subclinical forms, on the mean diameter of pre-ovulatory follicle (POF), plasma estradiol concentration on the day of estrus, subsequent luteal profile and subsequent conception rate in buffaloes. Sixty dairy buffalo (Bubalus bubalus) conducted in this study were divided into three groups {healthy (H), n=20; subclinical mastitis (SCM), n=18; and clinical mastitis (CM), n=22}. Ultrasonography of ovaries revealed that mean diameter of POF was larger (P<0.05) in H buffalo (14.35mm) compared to SCM (12.40mm) and CM (10.25mm). Also, plasma estradiol concentration on the day of estrus was higher (P<0.05) in H buffalo compared to SCM and CM counterparts; 34.95 vs. 32.87 and 27.50pg/ml, respectively. Besides, positive correlation was observed between the POF diameter with plasma estradiol concentration in H, SCM and CM buffaloes (r=0.64, 0.74, 0.72 respectively, P<0.05). Moreover, positive correlations (P<0.01) were found on days 9, 12, 16, and 21 post-ovulation between POF diameter and luteal profile. Thus, the conception rate in H buffalo was higher (P<0.05) compared with SCM and CM counterparts; 55% vs. 38.89 and 18.18%, respectively. In conclusion, mastitis in its clinical or subclinical forms disrupts the functioning of the pre-ovulatory follicle on the day of estrus, associated with low follicular estradiol production, resulting in suppression to subsequent luteal profile leading to substantial decrease in pregnancy consequence of buffaloes.

Effect of mastitis on luteal function and pregnancy rates in buffaloes.

The aim of this study was to investigate the effects of mastitis on CL development and function and pregnancy rate in buffaloes. Sixty-six buffaloes (Bubalus bubalus) reared in a commercial farm at El-Beheira governorate, north of Egypt were used in this study. According to the visual observation of milk, physical examination of the udder and actual somatic cell count in milk, buffalo cows were divided into three groups: without mastitis (W), n = 23; subclinical mastitis (SC), n = 18; and clinical mastitis (C), n = 25. All buffalo cows were synchronized by double dose of PGF2α (11-day interval) and inseminated by frozen-thawed semen of fertile bull. Mean CL diameter was ultrasonically examined on Days 5, 9, 12, 16, 21, and 25 after artificial insemination (AI). Blood samples were taken on the days of ultrasonography for progesterone (P4) assay. Results indicated that pregnancy rates were lower (P < 0.05) in C (28.00%) and SC (55.56%) compared with W (69.57%) on Day 25 after first AI. Pregnancy rates reduced to 60.87%, 44.45%, and 16.00% in W, SC, and C, respectively, at Day 45 after insemination. Thus, the embryonic loss was 8.7%, 11.11%, and 12.00 % in W, SC, and C cows, respectively. Pregnancy rates decreased between 44.32% and 50.51% when mastitis occurred during Day -15 before to Day +30 after AI, compared with 59.22% in the uninfected cows. The diameter of CL was greater (P < 0.05) in W than SC and C cows starting at Day 9 postbreeding onward. Likewise, P4 concentrations on Days 9 through 25 after AI were greater (P < 0.05) in W cows as compared to SC and C cows. Positive correlations (P < 0.01) were found on Days 5, 9, 12, 16, 21, and 25 after AI between CL diameter and P4 concentrations. Similar trend was found among CL diameter, P4 concentrations, and pregnancy rate. Accordingly, incidence of mastitis revealed suppression to both CL diameter and function leading to significant reduction in pregnancy outcome of buffalo cows.

Pneumothoraces Post Mechanical Cardiopulmonary Resuscitation: A Case Series.

The incidence of pneumothoraces with automated cardiopulmonary resuscitation (CPR) is unknown. Herein, we present 4 cases of pneumothoraces occurring in the setting of automated mechanical CPR (AM-CPR) in a 2-month period since incorporating mechanical devices into our resuscitation program. Two of the cases were in-hospital cardiac arrests, whereas the other 2 were out-of-hospital cardiac arrests. The Life-Stat 1008 device was utilized for AM-CPR in all cases. All cases demonstrated confirmed pneumothoraces on post-resuscitation imaging. Several factors may have contributed to the observed pneumothoraces. Two of the cases presented with obstructive lung disease, whereas the other 2 had underlying malignancy. Suboptimal positioning and failure to secure the included shoulder straps could have led to migration of the piston over the ribs. Further study is needed to determine the incidence of complications for all FDA-approved AM-CPR devices compared with manual chest compressions.

Respiratory source control versus receiver protection: impact of facemask fit.

BACKGROUND: Placing a surgical mask on an infected patient (respiratory source control) may offer a health-care worker (HCW) more protection than donning an N95 respirator (receiver protection). This observation was made in an in vitro study that used hard, nondeformable faces, and the lack of proper N95 fit may have accounted for the observed results. In the present study, we test the effects of fit on respiratory source control protection, using a soft, deformable mannequin head. METHODS: Resusci Anne CPR mannequin heads were placed in a chamber allowing 6 air exchanges/hr (14 cubic feet per minute), to simulate an infected patient (source) and an HCW (receiver). The heads were ventilated with a tidal breathing pattern. The source exhaled radioactive aerosols, and a filter was attached to the receiver to quantify inhaled exposure. N95 respirators and surgical masks were tested on both heads. The degree of protection was expressed by calculating the reduction in exposure expressed as a simulated workplace protection factor (sWPF; the ratio of exposure with mask to exposure without mask) compared statistically using confidence intervals. RESULTS: Use of the Resusci Anne heads resulted in improved fit, with higher sWPF than previously reported, for example, for source N95 mask combinations (7,174 vs. 317) as well as receiver (7.53 vs. 1.37). Masks placed on the receiver provided minimal exposure protection (sWPF range 0.99-7.53), except when sealed with Vaseline (sWPF 63.1). Any mask applied to the source mannequin resulted in significant reductions in exposure (sWPF range 214-17,038). CONCLUSION: Improved fit significantly enhanced the effects of source control protection. A Vaseline-sealed N95 respirator on the receiver offered less protection when compared with any mask on the source. Respiratory source control can offer more protection to HCW and potentially decrease the spread of aerosolized infections.

Blow-by as potential therapy for uncooperative children: an in-vitro study.

BACKGROUND: Blow-by, a common form of nebulizer therapy, in which the device is held away from a child's face, has been dismissed as ineffective because studies have demonstrated incremental aerosol drop-off with increasing distances from the face. Many of these studies do not take into account differences among nebulizer systems. Using common, commercially available nebulizer systems, we defined the interaction of system components (nebulizer type, face mask configuration, and compressor characteristics) on aerosol delivery with and without blow-by. METHODS: A pediatric model consisting of a ventilated mannequin fitted with a filter (inhaled mass), and 3 commercial nebulizer/compressor/face mask systems (Pari Sprint, Respironics Sidestream, and Salter 8900) were used to nebulize budesonide (1.0 mg/2 mL) at 0, 2, and 4 cm from the face. Inhaled mass and the deposition on face, eyes, and mask were measured using high-performance liquid chromatography and reported as a percent of nebulizer charge. RESULTS: At 0 cm, inhaled mass for the Pari, Respironics, and Salter systems was 5.33%, 1.14%, and 3.50%, respectively; at 4 cm from the face, inhaled mass decreased to 1.83%, 0.13%, and 1.14%. Facial (1.12%, 0.63%, and 2.94%) and eye (0.35%, 0.12%, and 0.68%) deposition varied significantly. Pari compressor/nebulizer flow rate was lower than Respironics and Salter (3.5 L/min vs 5.7 L/min and 5.9 L/min), resulting in longer run time (7.7 min vs 4.0 min and 5.3 min). CONCLUSIONS: At 4 cm, the Pari system delivered more drug than Respironics at 0 cm, suggesting adequate therapy during blow-by for some systems. Our results indicate that pediatric aerosol delivery is a strong function of the nebulizer system as a whole, and not simply a function of blow-by distance from the face or nebulizer efficiency. In uncooperative children, blow-by can be an effective means of drug delivery with the appropriate nebulizer system.