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PubMed2026

Applicability of Nanopore-only whole-genome sequencing for Pseudomonas aeruginosa outbreak investigation in the ICU setting: a multicentric study.

UNLABELLED: Pseudomonas aeruginosa outbreaks frequently occur in intensive care units (ICUs). In particular, ICU patients requiring mechanical ventilation are vulnerable to P. aeruginosa ventilator-associated pneumonia, which is associated with high morbidity and mortality. Fast and accurate genotyping during the early stage is crucial to document and manage P. aeruginosa outbreaks at the ICU. In this study, we have evaluated the applicability of Oxford Nanopore whole-genome sequencing (WGS) for outbreak investigation and antimicrobial resistance (AMR) prediction. To evaluate whether a Nanopore-only WGS workflow was able to reproduce Illumina-confirmed transmission clusters, 19 P. aeruginosa isolates from ICUs at UZ Brussels (Belgium) that were previously sequenced with Illumina were sequenced using a Nanopore-only workflow based on the latest V14 chemistry, followed by bioinformatic analysis via BugSeq and MBioSEQ Ridom Typer. Although both bioinformatic platforms showed high concordance between Illumina and Nanopore data, MBioSEQ Ridom Typer yielded the lowest allelic distance (maximum one cgMLST allele), confirming all outbreak clusters. When applying the Nanopore-only workflow to longitudinally collected isolates, low genetic heterogeneity (maximum three cgMLST alleles) was observed between isolates from the same patient. WGS and subsequent outbreak analysis of 65 respiratory P. aeruginosa isolates collected from 38 different ICU patients across six Belgian hospitals during a 9-month period showed no intra- or inter-hospital transmission. When the Nanopore-only WGS data were used to predict AMR, there was high categorical agreement (95%) between AMR genotype and phenotype. These findings highlight the potential of Nanopore WGS as a rapid and accurate tool for outbreak investigation of P. aeruginosa. IMPORTANCE: In recent years, Nanopore sequencing has found its way to clinical laboratories because of its affordability, scalability, and, most importantly, its ability to obtain sequencing results in near-real time. However, despite improved raw read accuracies with the latest generation R10.4.1 flow cells, the question remains whether the achieved accuracy is sufficient for accurate bacterial outbreak investigation, particularly in high-risk settings such as intensive care units (ICUs). In this study, we show that Nanopore-only whole-genome sequencing (WGS) is able to match Illumina-only WGS in terms of accuracy for Pseudomonas aeruginosa outbreak investigation in the ICU setting, although important sequence type-dependent and even strain-specific methylation issues need to be resolved in order to guarantee this accuracy. By providing a fast and accurate workflow for reliable P. aeruginosa outbreak investigation, this study could pave the way for large-scale implementation of Nanopore-only WGS, leading to faster outbreak response times.

Humans↗

PubMed2026

Emergence and persistence of ESBL- and carbapenemase-producing Klebsiella pneumoniae-related species in Barcelona wastewater treatment plants.

The World Health Organization classifies extended-spectrum beta-lactamase (ESBL) and carbapenemase-producing Klebsiella pneumoniae as critical-priority pathogens due to their high incidence, mortality, transmissibility, rapid resistance acquisition, and limited treatment options. Beyond clinical settings, their detection in wastewater treatment plants (WWTPs) provides an opportunity to assess their prevalence, persistence, and circulation within wastewater systems. This study characterized 37 antibiotic-resistant K. pneumoniae-related species strains isolated from two WWTPs in the metropolitan area of Barcelona, analyzing their antimicrobial resistance (AMR) profiles, antimicrobial resistance genes (ARGs), biocide and heavy metal tolerance genes (HMTGs), virulence factor genes (VFGs), biofilm-forming capacity, and conjugation ability. Among them, 70.3% were multidrug-resistant (MDR), and 16.2% were extensively drug-resistant. Whole-genome sequencing revealed diverse ARGs; all strains carried β-lactam resistance genes (14 ESBL and 12 carbapenemase producers), nearly all (96.9%) carried biocide or HMTGs, 64.9% harbored integrases, and all carried VFGs. Core-genome SNP analysis identified closely related strains across sampling periods and treatment stages, suggesting long-term persistence within the wastewater treatment system, despite biological and chemical processes in secondary treatment. Most strains (67.6%) displayed biofilm-forming capacity, and conjugation assays confirmed horizontal gene transfer in five of the seven ESBL-producing strains tested. High-risk clones were predominantly detected in the IFAS secondary treatment stage of the Gavà-Viladecans WWTP. The three strains recovered from the reclaimed water of the Baix Llobregat WWTP were ESBL or carbapenemase producers. Altogether, these results provide genomic and phenotypic evidence of the persistence and circulation of antibiotic-resistant K. pneumoniae-related species within wastewater treatment systems.IMPORTANCEWWTPs are essential for urban sanitation and environmental protection. Understanding how clinically relevant pathogens, such as ESBL and carbapenemase-producing K. pneumoniae-related species strains, behave in these settings may inform public health considerations. Investigating the presence and persistence of high-risk MDR pathogens in WWTPs helps identify circulation of AMR, assess the risk of gene transfer, and evaluate the potential for co-selection with other contaminants. This knowledge supports efforts to improve wastewater treatments, strengthen environmental surveillance, and develop integrated One Health strategies to limit the spread of AMR across human, animal, and environmental sectors.

Wastewater↗

PubMed2026

Molecular characterization of pESI-like megaplasmids in Salmonella Infantis from poultry in Lebanon.

UNLABELLED: Salmonella enterica serovar Infantis has emerged as a globally disseminated multidrug-resistant (MDR) pathogen, largely driven by the spread of the plasmid of emerging Salmonella Infantis (pESI)-like megaplasmid. In our study, we investigated the prevalence, antimicrobial resistance (AMR) phenotypes, and genomic features of S. Infantis isolates collected from poultry farms in Lebanon. A total of 72 isolates were recovered during a nationwide surveillance effort, among which 67 (93%) were MDR based on antimicrobial susceptibility testing (disk diffusion and broth microdilution) results, including resistance to critically important agents such as quinolones, and highly important classes such as tetracyclines and sulfonamides. Whole-genome sequencing was performed on 19 isolates selected through a stratified approach to encompass all identified AMR phenotypes; this analysis revealed a conserved pESI-like backbone together with MDR-associated determinants, including sul1, tet(A), and aadA. Plasmid marker analysis confirmed the presence of pESI in the majority of isolates, with plasmid-associated genes (ardA and trbA) and replicon markers (IncP and IncFIB(pN55391)) among the most prevalent. Comparative plasmid alignments with representative pESI sequences from Italy, Turkey, and the United States revealed strong conservation of the backbone alongside regional variation in AMR gene content. These findings highlight the role of poultry production systems in Lebanon as reservoirs for pESI-like megaplasmids and MDR S. Infantis, underscoring the zoonotic and public health risks posed at the human-animal-environment interface. Strengthened surveillance, antimicrobial stewardship, and biosecurity interventions are urgently needed to mitigate the spread of MDR S. Infantis within agriculture and beyond. IMPORTANCE: The emergence of plasmid of emerging Salmonella Infantis (pESI)-like megaplasmids has transformed Salmonella Infantis into a globally distributed multidrug-resistant (MDR) clone with the capacity to persist in livestock and disseminate resistance genes across ecological boundaries. Our study provides the first genomic characterization of pESI-positive S. Infantis from poultry farms in Lebanon, a region with high antimicrobial usage and limited stewardship frameworks. By integrating phenotypic susceptibility testing and whole-genome sequencing, we demonstrate that Lebanese isolates harbor conserved pESI-like backbone markers together with antimicrobial resistance determinants, aligning them with internationally circulating lineages. Comparative analysis with isolates from Italy, Turkey, and the United States highlights both the evolutionary stability and geographic diversity of pESI. These findings emphasize the urgent need for integrated surveillance and stewardship strategies to curb the spread of MDR S. Infantis and reduce the zoonotic risk at the human-animal-environment interface.

Animals↗

PubMed1992

Effects of amrinone and isoproterenol on mechanoenergetics of blood-perfused rabbit heart.

To compare the effects of amrinone (AMR) and isoproterenol (Iso) on left ventricular contractility and energetics, we assessed Emax (ventricular contractility index) and the relation between oxygen consumption per beat (VO2) and systolic pressure-volume area (PVA, a measure of left ventricular total mechanical energy) in isolated cross-circulated (blood-perfused) rabbit hearts during infusion of AMR or Iso in either a constant-flow (CF) or constant-pressure (CP) perfusion mode. Both Emax and the VO2 intercept of the linear VO2-PVA relation increased significantly during AMRCP (increase in Emax 15% and increase in VO2 intercept 11%), ISOCF (49 and 43%), and ISOCP (55 and 54%) but not during AMRCF. However, neither drug changed the slope of the VO2-PVA relation (reciprocal of contractile efficiency) in either perfusion mode. Furthermore, with both drugs the relation between increases in Emax and the VO2 intercept fell on a single regression line (r = 0.92). We conclude that 1) although the mechanism of action and inotropic potency of the two drugs differ, their effects on cardiac energetic cost are essentially the same, i.e., both drugs increase the nonmechanical oxygen cost in proportion to the increase in contractility without changing contractile efficiency, and 2) a significant portion of the inotropic effect of AMR in the whole ventricle is likely due to increased coronary blood flow, i.e., Gregg's phenomenon.

Amrinone↗

PubMed1989

An artificial myotatic reflex: a potential avenue to fine motor control.

When a striated muscle becomes paralyzed, not only its motor function, but its sensory innervation may be impaired. Methods of rehabilitation have previously focused only on motor innervation, although striated muscles are submitted to self-regulation of length and tension. Indeed, reinnervated muscle may not contract appropriately unless sensory information is available, nor is it known whether sensory receptors are included in the reinnervation process. We hypothesized that the myotatic reflex (MR) would be absent in the event these sensory organs are not reinnervated, and that an artificial myotatic reflex (AMR) would be useful in reestablishing fine motor control. The strap muscles were exposed in six anesthetized rabbits. The MR was verified by stretching an intact sternohyoid muscle. Next, loss of the reflex was documented after the ipsilateral ansa hypoglossi was divided, and a crossover nerve-muscle pedicle (NMP) was brought in from the opposite sternothyroid. After 3 months, the MR was still absent; however, stretch of the contralateral sternohyoid produced a reflex response on the reinnervated side. A strain gauge sutured to the reinnervated muscle was linked to an electronic modulator so that stretch induced electric stimulation of the NMP and contraction (the AMR). We conclude that (1) proprioception is not reestablished in the reinnervated muscle; (2) by contrast, sensory information from the muscle of origin of the NMP is conveyed to the reinnervated side; and (3) the AMR offers promise toward more sophisticated control of paralyzed (i.e., facial, laryngeal) musculature.

Animals↗

PubMed2005

Linking swimming performance, cardiac pumping ability and cardiac anatomy in rainbow trout.

We exploited the inherent individual diversity in swimming performance of rainbow trout Oncorhynchus mykiss to investigate the hypothesis that maximum cardiac performance is linked to active metabolic rate (AMR) and critical swimming speed (U crit). Six hundred juveniles (body mass approximately 150 g) were screened using a swimming challenge of 1.2 m s(-1) to identify 'poor swimmers' and 'good swimmers', i.e. the first and last 60 fish to fatigue, respectively. These 120 fish were individually tagged and then reared in common tanks for 9 months, where they grew at similar rates and achieved a similar body mass of approximately 1100 g. Critical swimming speed (U crit) was then measured individually in tunnel respirometers, with simultaneous recordings of cardiac output via a ventral aortic flow probe. The group of individuals that were screened as poor swimmers remained so, with a significantly (27%) lower U crit than good swimmers [89+/-10 cm s(-1) vs 123+/-5 cm s(-1) (mean +/-s.e.m.), respectively, N = 6], a 19% lower AMR (147+/-12 micromol min(-1) kg(-1) vs 181+/-11 micromol min(-1) kg(-1), respectively), and a 30% lower maximum in vivo cardiac output (47.3+/-4.7 ml min(-1) kg(-1) vs 68.0+/-5.2 ml min(-1) kg(-1), respectively). When cardiac performance was compared with an in situ heart preparation, hearts from poor swimmers had a significantly (26%) lower maximum cardiac output (45.9+/-1.9 ml min(-1) kg(-1) vs 56.4+/-2.3 ml min(-1) kg(-1), respectively) and a 32% lower maximum cardiac power output at a high afterload (3.96+/-0.58 mW g(-1) vs 5.79+/-1.97 mW g(-1), respectively). Cardiac morphology was visualised in vivo by Doppler echography on anaesthetised individual fish and revealed that poor swimmers had a significantly more rounded ventricle (reduced ventricle length to height ratio) compared with good swimmers, which in turn was correlated with fish condition factor. These results provide clear evidence that maximum cardiac performance is linked to AMR and U crit and indicate that a simple screening test can distinguish between rainbow trout with lower active metabolic rate, U crit, maximal cardiac pumping capacity and a more rounded ventricular morphology. These distinguishing traits may have been retained for 9 months despite a common growing environment and growth.

Analysis of Variance↗

PubMed2025

Global genomic and antimicrobial resistance profiling of Neisseria gonorrhoeae: Insights from whole genome sequencing and minimum inhibitory concentration analysis.

BACKGROUND: The rising antimicrobial resistance (AMR) of Neisseria gonorrhoeae is a major global health concern that limits treatment options and complicates disease management. Efflux pump systems and resistance genes are key to bacteria's ability to evade antibiotics. This study examined the genetic and phenotypic resistance landscape using a large dataset of whole-genome sequences to identify key resistance mechanisms, assess efflux pump gene prevalence, and analyze regional variations in Minimum Inhibitory Concentration (MIC) values to inform treatment strategies and public health interventions. METHODS: A total of 38,585 whole-genome sequences of N. gonorrhoeae were analyzed to identify AMR determinants. This study focused on the presence and distribution of efflux pump genes (mtrC, farB, norM, and mtrA) and specific resistance genes, including tet(C) (tetracycline resistance) and aph(3')-Ia (aminoglycoside resistance). The MIC values were assessed for multiple antibiotics to evaluate resistance trends and regional variations, including penicillin, spectinomycin, zoliflodacin, gentamicin, and fluoroquinolones. RESULTS: This analysis revealed widespread resistance to multiple antibiotics. Efflux pump genes (mtrC, farB, norM, and mtrA) were found in nearly all isolates, highlighting their essential roles in resistance and adaptation. The presence of tet(C) and aph (3')-Ia varied across different Gene Presence Patterns, suggesting that regional or therapeutic factors may influence tetracycline and aminoglycoside resistance. High MIC values for penicillin were observed, likely because of blaTEM, a beta-lactamase gene responsible for beta-lactam resistance. Resistance to spectinomycin is also widespread, raising concerns about the diminishing efficacy of this antibiotic. In contrast, zoliflodacin, gentamicin, and fluoroquinolones exhibited relatively low MIC values, indicating their sustained effectiveness against N. gonorrhoeae. DISCUSSION: Efflux pump systems are key to N. gonorrhoeae resistance and adaptability. Regional MIC variations indicate that local antibiotic use shapes resistance patterns. The high resistance to penicillin and spectinomycin highlights the need for alternative treatments, whereas zoliflodacin and fluoroquinolones remain effective but require monitoring. This study emphasizes global AMR surveillance, novel therapies, and targeted antimicrobial stewardship to address multidrug-resistant infections.

Neisseria gonorrhoeae↗

PubMed1998

Derivation of an equation to estimate marrow content of bovine cervical vertebrae.

Marrow content of bovine cervical vertebrae from Choice- and Select-grade carcasses weighing 294 to 343 kg was determined so that a method to monitor the amount of marrow in meat from advanced meat/bone separation machinery and recovery (AMR) systems could be developed. The marrow determination requires cleaning and then ashing bones. Because a large difference in ash content of bone and bone marrow exists and because cartilage content of cervical vertebrae in Choice and Select beef is relatively constant, it was possible to derive the following equation: Weight of marrow = [weight of cartilage (% ash in cartilage - % ash in bone) + % ash in bone (total weight) - (total ash)]/[(% ash in bone - % ash in marrow)]. Constants for ash in fresh bone, marrow, and cartilage were 58.51, .57, and 2.14% with SD of 2.23, .15, and .30%, respectively. A cartilage content of 9.5% along with cervical vertebrae weight and total ash weight were also used to calculate 33.9% marrow in cervical vertebrae. Means for marrow pressed or centrifuged from bovine cervical vertebrae were lower than those obtained from the equation. Therefore, pressing and centrifuging left some marrow in spongy bone. Our ashing method for determining the amount of marrow in whole cervical vertebrae should be useful for determining marrow remaining in cervical vertebrae of bone cakes from AMR systems. Percentage ash in pressed bones is higher and the calculated marrow content is lower when pressed bones are compared to cervical vertebrae that are not pressed. The amount of marrow in whole cervical vertebrae minus the amount left in cervical vertebrae from bone cakes equals the amount in meat from AMR systems.

Analysis of Variance↗

PubMed1986

An analysis of body weights and maturing patterns in western range ewes.

The objectives were to determine the association of maturing patterns with growth rates and body weights and to estimate heritabilities and genetic and phenotypic correlations among these characters of sheep. Records of 1,109 range ewes from the Montana Agricultural Experiment Station Red Bluff Research Ranch at Norris were analyzed. Body weight and degree of maturity of body weight at birth, weaning, 12 mo of age, 18 mo of age and maturity (body weight only), and absolute growth rate (AGR), absolute maturing rate (AMR) and relative growth rate (RGR) over various age intervals were examined. Mature weight, required to calculate degree of maturity and AMR, was estimated by the average of the fall weights taken at 42, 54, 66 and 78 mo of age. Heritability estimates were .53 +/- .12 for mature weight and from .26 to .46 for immature weights. Genetic correlations among body weights at all ages were positive and generally large between immature weights and mature weights. Heritability estimates for degree of maturity ranged from .63 +/- .12 at 12 mo of age to .19 +/- .11 at 30 mo of age, at which time maturity was being approached. Genetic correlations between degree of maturity and body weight at the same age were positive; however, degree of maturity at all ages was negatively correlated with mature weight. Animals more mature at any age or stage during growth tended to be more mature at later stages, to be lighter at maturity, and to grow faster and weigh more up to 12 mo of age. Heritability estimates for AGR, RGR and AMR were moderate to high and were similar for the same age intervals. Selection for any one of the measures of growth rate would tend to expand the shape of the growth curve toward heavier weights and lower degree of maturity for any interval.

Animals↗

PubMedDate not supplied

The effects of high-dose barbiturates on the acoustic reflex and auditory evoked responses. Two case reports.

The effects of high-dose barbiturates (pentobarbital) on the acoustic reflex, and the auditory brainstem (ABR) and middle-latency (AMR) responses, are illustrated with two case reports. Auditory electrophysiologic data were recorded serially during recovery from therapeutic barbiturate coma. ABR latency remained within normal limits in barbiturate coma, but amplitude of the wave I component was abnormally augmented. Contralateral and ipsilateral acoustic reflex activity, and the Pa component of the AMR, were not observed in barbiturate coma, and reappeared with the emergence of brainstem neurologic signs. These findings suggest a fundamental difference in the neurophysiologic substrate of the ABR vs. acoustic reflex and AMR. Possible mechanisms for the differential influence of barbiturates on these three auditory electrophysiologic measures are offered.

Adolescent↗

PubMed2026

Systematic review on genomic insights into antimicrobial resistance in ESKAPE pathogens.

BACKGROUND: Antimicrobial resistance (AMR) is a major global public health threat. ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.) pose a major threat owing to resistance to last-line antibiotics. Genomic surveillance is crucial to understanding global and regional antimicrobial resistance genes (ARGs) in AMR transmission. AIM: This systematic review synthesised global genomic evidence to identify global and region-specific ARGs distribution among ESKAPE pathogens. METHODS: Following PRISMA guidelines, studies published January 2019 to December 2024 were identified from PubMed, Google Scholar, and Web of Science. Eligible studies reported genomic characteristics and resistance patterns of one or more ESKAPE pathogens from any source. RESULTS: Seventy-seven studies were included, with most originating from Asia, followed by Europe and Africa. Clinical isolates predominated K. pneumoniae was the most frequently investigated pathogen, followed by S. aureus, P. aeruginosa, and A. baumannii. The most reported resistance genes were blaCTX-M, blaNDM, and blaSHV. Distinct regional patterns of antimicrobial resistance gene (ARG) distribution were observed, with tetracycline and quinolone resistance genes prevailing in Africa and South America, and blaOXA variants dominating in Asia and Europe. Region-specific ARG patterns were identified through descriptive synthesis and comparative analysis of study-reported frequencies. CONCLUSION: This review provides a synthesised global map of ARG distribution in ESKAPE pathogens, highlighting surveillance gaps in underrepresented regions and non-clinical settings. Addressing these gaps will support targeted genomic surveillance and stewardship programmes. WHAT THIS STUDY ADDS: This study contributes to the body of knowledge by mapping global and regional antimicrobial resistance gene patterns in ESKAPE pathogens, identifying key surveillance gaps and informing targeted AMR monitoring and stewardship strategies.

ESKAPE pathogens↗

PubMedDate not supplied

Endoscopic patterns of primary gastric MALT lymphoma.

Primary low grade B-cell lymphoma of the mucosa associated lymphoid tissue (MALT), is an uncommon malignancy with a prolonged period of localized disease, and a possible transition to a high grade MALT lymphoma. The endoscopic diagnosis is often difficult, because of the various macroscopy patterns. The endoscopic aspects seen in 14 patients diagnosed and treated for primary gastric MALT lymphomas, were reviewed. Four main patterns were recognized: 1/Large ulcerations (n = 6, 42.9%), 2/Polypoid lesion (n = 2, 14.3%), 3/Gastritis with small ulcerations (n = 4, 28.5%), and 4/Atypical mucosal relief (AMR): erythema, nodularity, edematous or infiltrated folds (n = 2, 14.3%). In 10 cases (71%) AMR was associated with another endoscopic pattern. Histologically the tumors were of low grade (n = 11) and high grade (n = 3). On initial endoscopy a diagnosis of malignancy was done in 6 out of the 7 patients (85.7%) with large ulcers and the large polypoid mass; in contrast, an adequate endoscopic diagnosis was made in only 3 out of the 7 patients (42.8%) with ulcerative gastritis, AMR, and the small polypoid lesion. The endoscopic aspect of the latter group, representing 50% of all patients and 63.6% of the group with low grade MALT lymphomas, was indistinguishable from a benign lesion. Therefore it is important to be aware of this entity and perform biopsies in every patients with abnormal endoscopic findings.

Aged↗

PubMed2002

Expression of adrenomedullin and its receptor in lungs of rats with hypoxic pulmonary hypertension.

OBJECTIVE: To investigate the role of adrenomedullin (AM) in the development of hypoxic pulmonary hypertension (HPH), and to assess the expression of AM and adrenomedullin receptor (AMR) in the lungs of rats with HPH. METHODS: We exposed 10 rats to normobaric hypoxic conditions for 3 weeks to establish rat model of pulmonary hypertension; and 10 other rats were used as normoxic controls. Mean pulmonary arterial pressure (mPAP) was measured by a right cardiac catheterization. The thickness of pulmonary arterioles was measured by a computerized image analyzer. We used the reverse transcription-polymerase chain reaction (RT-PCR) to assess the change of expression of AM and AMR in lung of HPH rat model. RESULTS: Compared with the control group, hypoxic rats developed remarkable pulmonary hypertension, increment in the thickness of pulmonary arterioles and right ventricular hypertrophy (P < 0.01). Chronic hypoxia elicited a considerable increment in expression of AM and AMR in the lungs of rats, and the ratio of AM/beta-actin and AMR/beta-actin in lungs of rats treated with hypoxia were significantly higher (P < 0.01). CONCLUSIONS: The AM plays an important role in regulating pulmonary vascular tone and can ameliorate the development of hypoxic pulmonary hypertension in rats.

Adrenomedullin↗

PubMed2003

[Effect of dexamethasone, aminoguanidin, amrinone on oxygen utilization in endotoxin shock rabbits].

OBJECTIVE: To investigate the effect of three kinds of drug with different mechanism, dexamethasone (Dex), aminoguanidin (AG) and amrinone (Amr) on oxygen utilization in endotoxic shock rabbits. METHODS: Thirty-five rabbits were randomly allocated into five groups: operation, lipopolysaccharide (LPS), Dex, Amr and AG. The endotoxin shock was induced by intravenously injecting LPS (400 micro g/kg). The arterial blood gas, mixed venous blood gas and cardiac output were recorded at 30 min after the operation (T(0)), shock status (T), 1 - 6 h after the treatment (T(1)-T(6)). The oxygen delivery (DO(2)), oxygen consumption (VO(2)) and extraction ratio of oxygen (ERO(2)) were calculated. RESULTS: All the parameters in five groups showed no significant differences (P > 0.05) at T(0). Six hours after treatment, rabbits in Dex group presented with significantly improved DO(2) (12.4 +/- 3.1) ml/(kg.min), P < 0.01 and VO(2) (5.1 +/- 1.6) ml/(kg.min), P < 0.05 compared with DO(2) (8.1 +/- 2.4) ml/(kg.min) and VO(2) (2.7 +/- 1.0) ml/(kg.min) in LPS group. Rabbits in AG group showed significantly increased DO(2) (17.0 +/- 2.8) ml/(kg.min) (P < 0.01), (17.2 +/- 2.5) ml/(kg.min) (P < 0.05), compared with (12.2 +/- 2.6), (14.1 +/- 3.8) ml/(kg.min) in LPS group at T(1) and T(2), respectively, but there was no significant difference (11.2 +/- 1.7) ml/(kg.min) (P > 0.05) at T(6). The VO(2) increased significantly, (5.0 +/- 1.0) ml/(kg.min) (P < 0.01) compared with LPS group at T(6). The VO(2) of Amr group was significantly higher than LPS group at T(3) and T(4). At T(6), the DO(2) and VO(2) were (9.5 +/- 1.3) and (4.1 +/- 1.5) ml/(kg.min), respectively, but there was no significant difference compared with LPS group. There was no significant difference in ERO(2) among groups (P > 0.05). CONCLUSION: The dexamethasone, aminoguanidin, amrinone can improve oxygen utilization in endotoxic shock rabbits, especially for dexamethasone and aminoguanidin.

Amrinone↗

PubMed2005

Adaptation for river basins: connecting policy goals to the water resources system.

This paper focuses on a methodology called 'generic adaptation methodology for river basins' (AMR) that provides guidance to water managers seeking: (1) potential adaptation measures to climate change and climate variability, (2) measuring impacts, and (3) evaluating adaptations. The methodology uses basic elements addressed in existing adaptation research and is designed for a participatory setting involving various stakeholders. In AMR, the water resources system is seen as an economic asset that provides 'goods and services' for both humans and ecosystems. The innovative aspect of AMR is that it distinguishes impacts to water management objectives and impacts to the physical state of water resources in a river basin in a relatively simple iterative approach. Both impact types are quantified using indicators. The framework and results are demonstrated for a case study in the Walawe basin (Sri Lanka). It is explained that actually implementing adaptations in policy making can be difficult in trans-boundary river basins as each riparian country has its own policy objectives and hence ways of dealing with adaptation.

Conservation of Natural Resources↗

PubMed1990

[Clinical effect of China-made amrinone in the treatment of refractory congestive heart failure].

Clinical and hemodynamic studies were carried out in 20 patients suffering from refractory congestive heart failure with invasive technique and non-invasive methods such as tolerance exercise test, 24-hour Holter monitoring, etc. Digitalis was then withdrawn and China-made amrinone (AMR) was administered orally for 15 days. All the indices mentioned above were repeated and each patient served as his own control. The results indicate that AMR can improve hemodynamic parameters as well as exercise tolerance. Holter monitoring revealed no significant increase in arrythmogenic potentiality. The total clinical effective rate was 95%. No severe side effects were found except thrombocytopenia observed in 20% of the patients. It is suggested that China-made AMR is effective in treating refractory congestive heart failure.

Adult↗

PubMed1989

Characterization of cytotoxicity and R-plasmid in Salmonella krefeld.

From 1981 to 1984, 254 isolates of Salmonella krefeld were isolated from newborns and infants with acute gastroenteritis in southern Taiwan. All the crude enterotoxin preparations of S. krefeld caused the cytotoxic elongation reaction in Chinese hamster ovary K1 (CHO-K1) cells. Cytotoxic enterotoxin was also produced by S. krefeld inducing Vero cells to round up and appear partially detached from the culture plate. It was noted that S. krefeld showed internalization and multiplication in CHO-K1 cells. S. krefeld exhibited 12 different resistant patterns. And the predominant patterns were found to be resistant to kanamycin and ampicillin (Ka-Amr), and resistant to kanamycin, ampicillin, chloramphenicol and tetracycline (Ka-Am-Cm-Ter). It was found that two distinct plasmids of 34 megadalton (Md) and 120 Md were commonly present in these strains. S. krefeld haboured 34 Md and 120 Md R-plasmid, which conferred resistance to Ka-Amr and Ka-Am-Cm-Ter, respectively. From the resistance transferred patterns, Ka-Amr was the most common resistance among transconjugants. The frequency of transfer of the 34 Md R-plasmid (2.71 x 10(-3) transconjugants/donor cell) from S. krefeld to E. coli K-12 14R525 was 20 times higher than that of the 120 Md R-plasmid (1.48 x 10(-4) transconjugants/donor cell). In analysis of the restriction endonuclease digest of the 34 Md plasmid obtained from different bacterial sources, their specific identical DNA fragment pattern suggested that the outbreak infection due to S. krefeld had a common origin.

Cell Line↗

PubMed1989

From forms to focus. A new teaching model in ambulatory medicine.

We have developed a simple generalizable model of teaching ambulatory medicine that adopts successful elements of inpatient teaching and addresses deficiencies in traditional ambulatory forums. This model combines resident analysis of the patient encounter via a "clinical encounter form" (CEF) with faculty-led ambulatory medicine rounds (AMR). Its objectives are to integrate teaching and quality assessment; be explicit about the relation between the record and the physician's clinical thinking; teach around every patient; focus on selected aspects of a case in limited time; and permit appropriate rounds preparation by faculty. The CEF-AMR model, like inpatient rounds, allows teaching to be focused on real patient issues; all patients are reviewed and quality is assured, and interesting teaching points can be selected, prepared, and discussed efficiently in limited time. It is the "classroom" complement to faculty "bedside" precepting and has made teaching ambulatory medicine feasible, clinically relevant, and well-informed. Perhaps most importantly, the CEF-AMR model encourages self-analysis of clinical decisions and makes explicit the key elements of clinical judgment.

Ambulatory Care↗