A novel approach to improving efficiency and cost saving in preoperative blood preparation.

BACKGROUND: Preoperative ordering of blood products has been an area of optimization due to considerable variability among physicians; overpreparation can lead to extra costs and underpreparation of blood can potentially compromise patient safety. STUDY DESIGN AND METHODS: We examined the potential cost savings of extending the storage interval of a presurgical type-and-screen sample from 7 to 14 days, thereby reducing the need for a new specimen on the day of surgery. RESULTS: Sensitivity analysis showed annual cost savings for our institution to be an estimated $38,770 ($22,420-$73,120). CONCLUSION: These results are even more robust when incorporating the additional potential savings from improved operating room efficiency.

The relationship between secretory patterns of gonadotrophic hormones and the attainment of puberty in bull and heifer calves born early or late during the spring calving season.

It was suggested that an early increase in gonadotrophin secretion in calves aged between 6 and 24 weeks might be critical for initiating developmental changes culminating in puberty. An early rise in luteinizing hormone (LH) release appears to be caused by an increase in LH pulse frequency in bull calves and by an increase in LH pulse amplitude in heifer calves. Previously we have found differences in the characteristics of the LH rise between prepubertal beef calves born in spring or fall; however, age at puberty was not affected by season of birth. Here we report the LH/FSH secretory patterns in prepubertal bull and heifer calves (Hereford x Charolais), born in March or April, respectively (i.e., early or late during the spring calving season; six animals of each sex born at each time). The bull calves of both groups reached puberty (defined as an attainment of scrotal circumference of >or=28 cm) at 43.2+/-1.3 weeks of age (P>0.05). Age at puberty for March- and April-born heifer calves (defined as the age at which serum progesterone concentrations first exceeded 0.4 ng/ml) averaged 56.0+/-1.4 weeks (P>0.05). Based on blood samples taken weekly from birth to 26 weeks of age, and then every other week until puberty, bull calves born in March exceeded April-born bull calves in mean serum LH concentrations at 6, 10 and 12 weeks of age (P<0.05). Mean FSH concentrations were greater (P<0.05) in March-born compared to April-born bull calves from 34 to 32 weeks before puberty. Mean serum LH (at 40, 42 and 56 weeks) and FSH concentrations (at 2, 10, 20, 22-26, 30 and 56 weeks of age) were greater (P<0.05) in heifer calves born in April than March. On the basis of frequent blood sampling (every 12 min for 10 h), heifer calves born in April exceeded March-born animals in mean LH and FSH concentrations, at 5 and 25 weeks, and LH pulse frequency, at 5, 10 and 25 weeks of age (P<0.05). None of the parameters of LH secretion (i.e., mean concentrations of LH, LH pulse frequency and amplitude based on frequent blood collection) differed between March- and April-born bull calves in this study (P>0.05). In summary, March-born bull calves had greater mean serum LH and FSH concentrations prior to 24 weeks of age than April-born calves. April-born heifer calves had greater mean serum concentrations of LH and FSH but this difference was not confined to the early postnatal period. Although there were significant differences in absolute amounts of LH secreted, there were no differences in the frequency of LH secretory pulses amongst March- and April-born bull calves and no differences in LH pulse amplitude in heifer calves born in March or April. As these particular parameters of LH secretion, as well as age at puberty, are not affected by the time or season of birth, they may be primary hormonal cues governing sexual development in bulls and heifers, respectively.

Effects of a 6-day treatment with medroxyprogesterone acetate after prostaglandin F2 alpha-induced luteolysis at midcycle on antral follicular development and ovulation rate in nonprolific Western white-faced ewes.

Medroxyprogesterone acetate (MAP) from intravaginal sponges prolongs the lifespan of large ovarian follicles when administered after prostaglandin F2alpha (PGF2alpha)-induced luteolysis early in the luteal phase of ewes. The present study was designed to determine whether a PGF2alpha/MAP treatment applied at midcycle would alter the pattern of antral follicle growth and increase ovulation rate in nonprolific ewes. A single injection of PGF2alpha (15 mg, i.m.) was given, and an intravaginal MAP (60 mg) sponge was inserted for 6 days, on approximately Day 8 after ovulation, in 7 (experiment 1), 8 (experiment 2) or 11 (experiment 3) ultrasonographically monitored, cycling Western white-faced ewes; seven ewes (experiment 1) served as untreated controls. Blood samples were collected each day and also every 12 min for 6 h, halfway through the period of treatment with MAP (experiment 1), or every 4 h, from 1 day before to 1 day after sponging (experiment 2). Seventeen of 26 treated ewes (experiment 1, n = 6; experiment 2, n = 5; experiment 3, n = 6) ovulated 1 to 6 days after PGF2alpha, but this did not affect the emergence of ensuing follicular waves (experiments 1 and 2). These ovulations, confirmed by laparotomy and histological examinations of the ovaries (experiment 3), were not preceded by an increase in LH/FSH secretion and did not result in corpora lutea, as evidenced by transrectal ultrasonography and RIA of serum progesterone (experiments 1 and 2). Following the removal of MAP sponges, the mean ovulation rate was 3.1 +/- 0.4 in treated ewes and 2.0 +/- 0.3 in control ewes (experiment 1; P < 0.05). In experiments 1 and 2, the ovulation rate after treatment (3.1 +/- 0.4 and 2.8 +/- 0.4) was also greater than the pretreatment rate (1.9 +/- 0.3 and 1.9 +/- 0.1, respectively). Ovulations of follicles from two consecutive waves before ovulation were seen in five treated but only in two control ewes (experiment 1), and in seven ewes in experiment 2. There were no significant differences between the MAP-treated and control ewes in mean daily serum concentrations of FSH and estradiol, and no differences in the parameters of LH/FSH secretion, based on frequent blood sampling. Treatment of nonprolific Western white-faced ewes with PGF2alpha and MAP at midcycle changed follicular dynamics and increased ovulation rate by approximately 50%. These effects of MAP, in the absence of luteal progesterone, may not be mediated by changes in gonadotropin secretion.

Effects of delayed serum separation and long-term storage on the measurement of thyroid hormones in equine blood samples.

Studies were conducted to determine the effects of delaying the separation of serum from the clot and of long-term storage of serum samples on the measurement of thyroid hormones in blood from horses using a fluorescence polarization immunoassay. The measured concentrations of T3 and T4 were not affected by leaving serum on the clot for as long as 24 hours at room temperatures. Storage of serum for 19 to 22 months at -20 degrees C resulted in significant increases of measured T4, but not T3. These studies support previous work demonstrating that thyroid hormones are resistant to degradation, immunologically stable, and reasonably insensitive to potential problems of routine specimen handling when measured with an immunoassay.