Ultrasound monitoring to detect embolic phenomena in the inferior vena cava during hip arthroplasty.

INTRODUCTION AND OBJECTIVES: Embolic phenomena frequently occur during hip joint replacement surgery, and may lead to haemodynamic instability in frail patients. Transoesophageal ultrasound monitoring is rarely available in non-cardiac operating theatres, and cannot be performed in awake patients under spinal anaesthesia. The main objectives of this prospective exploratory study were to determine the feasibility of using an alternative ultrasound approach to monitor the inferior vena cava during hip replacement surgery, and to determine the intra and interobserver reliability of the ultrasound findings. METHOD: We conducted a prospective exploratory study in 20 patients undergoing cemented hip arthroplasty in the supine position under spinal anaesthesia and sedation. The inferior vena cava was assessed through a subcostal window at 10 intraoperative time points, and the findings were rated on a qualitative embolism severity scale. The ultrasound images were evaluated by 2 independent observers. RESULTS: An adequate subcostal window was obtained in 90% of cases. Intra- and inter-observer reliability was high (kappa index >0.80, p < 0.001). Nearly all (95%) patients presented some degree of embolism, which was severe in 50% of cases. CONCLUSIONS: Our study suggests that ultrasound assessment of embolic phenomena in the inferior vena cava through a subcostal window is feasible in 90% of cases. The qualitative embolic severity rating scale is highly reproducible and has high intra- and inter-observer reliability.

Different contamination patterns of lineage I and II strains of Listeria monocytogenes in a Spanish broiler abattoir.

The purpose of this study was to determine whether genetically similar or diverse strains of Listeria monocytogenes colonize the environment and carcasses in a single Spanish broiler abattoir over time. The study was composed of 5 surveys over a 1.5-yr period and included the monitoring of cleaning and disinfection procedures. Overall, a total of 212 samples were tested for the presence of L. monocytogenes, and 31% of the samples were found to be positive. Listeria monocytogenes was isolated from carcasses and product contact and noncontact sites in the evisceration and carcass classification areas of the abattoir. A total of 132 L. monocytogenes isolates were characterized by PCR-based serotyping and pulsed-field gel electrophoresis (PFGE) restriction analysis with the endonucleases ApaI and AscI. Molecular serotyping showed that L. monocytogenes isolates were of serotypes 1/2a and 1/2b. Isolates of serotype 1/2b (89.4%) were contaminating carcasses as well as environmental product contact and noncontact sites, whereas isolates of serotype 1/2a (10.6%) were recovered only from environmental product noncontact sites. A relatively low genetic diversity was found in this group of L. monocytogenes isolates from the abbatoir; only 14 different PFGE types (A1 to A14) were obtained. Nine pulsotypes belonging to serotype 1/2b (lineage I) were grouped in only one PFGE genetic cluster, whereas 5 pulsotypes belonging to serotype 1/2a (lineage II) were grouped into 4 PFGE genetic clusters. Two genetically related pulsotypes of serotype 1/2b (A1 and A2, 64.4% of the isolates) predominated and persisted in the abattoir. Our study indicated that a few strains of L. monocytogenes lineage I that were genetically very closely related might be specifically adapted to colonizing the evisceration zone of the abattoir and were predominant on carcasses over 1 yr. On the other hand, a genetically diverse group of lineage II strains were present in the abattoir environment, but never contaminated carcasses.

The development of the diencephalon of the rainbow trout (Salmo gairdneri Richardson). Thalamus and hypothalamus.

This article describes a study of the development of the thalamus and hypothalamus of the rainbow trout from the embryo to the juvenile fish. The areas from which the various nuclei derived are reported together with the order of their appearance, the earliest being the nucleus geniculatus lateralis, the nucleus pretectalis, the nucleus of the torus lateralis hypothalami, the nucleus preglomerulosus and the nucleus diffusus of the lateral lobes, all of were beginning to be distinguishable in 9 mm embryos. The lateral lobes of the hypothalamus developed mainly after hatching, and medial regions generally developed later than lateral areas, though certain periventricular structures appeared very soon. Cell proliferation persisted in 35 mm juveniles, especially in the walls of the lateral and posterior recesses.