Use of Tubo-Ovarian Ligation Via Colpotomy as A Potential Method for Sterilization in Mares.

The goal of this study was to develop a safe, effective, and economical method for permanent sterilization of mares based upon tubo-ovarian ligation performed via colpotomy. In this study, we evaluated the application of a nylon cable tie (zip-tie) to the ovarian pedicle and oviduct of mares to induce ovarian ischemia and tubal ligation without removal of ovaries. Initially, efficiency of zip-ties on the ovarian pedicle was tested in vitro and in vivo. Based on the absence of leakage through the zip-tie ligated vessels in anatomic specimens, we confirmed the potential efficacy of the technique. Next, ligation of the ovarian pedicle via a standing colpotomy was conducted in five mares. Although the surgical procedure in these mares appeared to be quick and efficient, all five mares were noted to develop ovarian adhesions to surrounding abdominal viscera in either one or both ovaries postoperatively. Ovarian ischemia led to loss of ovarian activity based upon ultrasound examination, which was confirmed by a low plasma progesterone concentration in four of the five mares. During the postoperative period, four mares demonstrated clinical signs related to the ovarian adhesions and were euthanized. The postoperative complications associated with ovarian adhesions to abdominal viscera presented significant challenges, limiting the success of this study. While this technique resulted in ovarian ischemia and atrophy in four out of the five mares, we were unable to assess long-term effects on the health and reproduction of the mares due to the ovarian adhesions to the surrounding tissues and the potential for secondary complications. Although technically feasible, tubo-ovarian ligation via colpotomy does not appear to be a viable option for sterilization of mares using the described technique due to ovarian adhesions post procedure.

Ceftriaxone and cefazolin attenuate the cue-primed reinstatement of alcohol-seeking.

Alcohol consumption and the reinstatement of alcohol-seeking rely on glutamate and GABA transmission. Modulating these neurotransmitters may be a viable treatment strategy to prevent alcohol relapse. N-acetylcysteine (NAC) and the antibiotic ceftriaxone (CEF) alter the glial reuptake and release of glutamate while the antibiotic cefazolin (CEFAZ) modulates GABA signaling without affecting glutamate. Here, we used the extinction-reinstatement model of relapse to test the ability of these compounds to attenuate the reinstatement of alcohol-seeking. Male Sprague-Dawley rats were trained to self-administer 20% (v/v) alcohol in the home cage using an intermittent schedule (24 h on, 24 h off) for 12 sessions. Subsequently, animals self-administered alcohol during daily 45-min operant sessions for 26 sessions, followed by extinction training. We tested whether chronic administration of NAC, CEF, or CEFAZ attenuated the cue-primed reinstatement of alcohol-seeking. CEF and CEFAZ attenuated cue-primed reinstatement of alcohol-seeking while NAC had no effect. We subsequently investigated whether CEF and CEFAZ alter the self-administration of sucrose and chow pellets and if CEFAZ attenuates the reinstatement of cocaine-seeking. The operant self-administration of regular chow and sucrose was not altered by either CEF or CEFAZ. CEFAZ had no effect on cocaine reinstatement, a behavior that has been strongly tied to altered glutamate homeostasis in the nucleus accumbens. Thus the ability of CEFAZ to attenuate alcohol reinstatement likely does not involve the glial modulation of glutamate levels. The dampening of GABA transmission may be a common mechanism of action of cefazolin and ceftriaxone.

Patient attitudes toward mobile phone-based health monitoring: questionnaire study among kidney transplant recipients.

BACKGROUND: Mobile phone based remote monitoring of medication adherence and physiological parameters has the potential of improving long-term graft outcomes in the recipients of kidney transplants. This technology is promising as it is relatively inexpensive, can include intuitive software and may offer the ability to conduct close patient monitoring in a non-intrusive manner. This includes the optimal management of comorbidities such as hypertension and diabetes. There is, however, a lack of data assessing the attitudes of renal transplant recipients toward this technology, especially among ethnic minorities. OBJECTIVE: To assess the attitudes of renal transplant recipients toward mobile phone based remote monitoring and management of their medical regimen; and to identify demographic or clinical characteristics that impact on this attitude. METHODS: After a 10 minute demonstration of a prototype mobile phone based monitoring system, a 10 item questionnaire regarding attitude toward remote monitoring and the technology was administered to the participants, along with the 10 item Perceived Stress Scale and the 7 item Morisky Medication Adherence Scale. RESULTS: Between February and April 2012, a total of 99 renal transplant recipients were identified and agreed to participate in the survey. The results of the survey indicate that while 90% (87/97) of respondents own a mobile phone, only 7% (7/98) had any prior knowledge of mobile phone based remote monitoring. Despite this, the majority of respondents, 79% (78/99), reported a positive attitude toward the use of a prototype system if it came at no cost to themselves. Blacks were more likely than whites to own smartphones (43.1%, 28/65 vs 20.6%, 7/34; P=.03) and held a more positive attitude toward free use of the prototype system than whites (4.25±0.88 vs 3.76±1.07; P=.02). CONCLUSIONS: The data demonstrates that kidney transplant recipients have a positive overall attitude toward mobile phone based health technology (mHealth). Additionally, the data demonstrates that most kidney transplant recipients own and are comfortable using mobile phones and that many of these patients already own and use smart mobile phones. The respondents felt that mHealth offers an opportunity for improved self-efficacy and improved provider driven medical management. Respondents were comfortable with the idea of being monitored using mobile technology and are confident that their privacy can be protected. The small subset of kidney transplant recipients who are less interested in mHealth may be less technologically adept as reflected by their lower mobile phone ownership rates. As a whole, kidney transplant recipients are receptive to the technology and believe in its utility.