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Control of ticks.

A number of different acaricides provide highly effective control of tick populations on dogs and cats. These acaricides are formulated as sprays, dips, dusts, or shampoos for use on the animal. Further protection of the animal from reinfestation with ticks can be achieved with the use of acaricide-impregnated flea and tick collars. Some of these acaricides are registered with the EPA for indoor and outdoor use as controls for free-living populations of ticks. Caution should be used when applying these materials. The label directions for the application of the acaricide and disposal of the acaricide containers should always be followed. Removal of underbrush and leaf litter, thinning trees, and frequently mowing grasses help reduce the number of free-living ticks. Any reduction in the amount of wildlife food sources and cover areas potentially decreases populations of ticks and thus reduces the potential of these ticks parasitizing a dog or cat. Application of an acaricide for area-wide control of free-living ticks in the spring, summer, and autumn also reduces the number of ticks. New approaches to area-wide control of ticks by use of acaricides that are focused on controlling the ticks attached to small mammal hosts are discussed. Although research has shown that reductions in tick numbers can be achieved using these methods, acceptance of these methods by regulatory agencies and the public requires further research.

Animals

Surface oximetry. A new method to evaluate intestinal perfusion.

Accepted methods to evaluate intestinal vascularity intraoperatively include standard clinical criteria (SCC), doppler ultrasound (DUS), and intravenous fluorescein (FLF). A combination of methods is often used to overcome disadvantages of individual techniques. Assessment of intestinal vascularity by FLF was compared to SCC, DUS, and pulse oximetry (POX) in segments of intestine demonstrating arterial, venous and arteriovenous occlusion, to determine if POX might supplement the assessment of intestinal vascularity. POX uses a commercially available instrument to assess tissue oxygenation and arterial flow, and is rapid, reproducible, and noninvasive. POX appears to be a superior technique when compared to SCC and DUS.

Animals

Staphylococcus epidermidis biotype 4: epidemiological conclusions from five different typing methods.

There is presently no accepted method for marking individual strains of Staphylococcus epidermidis. Consequently, five parameters for distinguishing such strains were examined and compared for their epidemiological efficacy: biotyping, serotyping, proteinase grouping, aminopeptidase profiles and antibiograms. Both biotyping and proteinase grouping were of limited use in identifying a particular strain, although they were helpful in initially categorizing such strains. Antibiograms were least useful because of similarities in susceptibility patterns among isolates. Serotyping and amino-peptidase profiles provided the best means of identifying an individual strain for epidemiological use. The applicability of these typing methods was demonstrated during a one year epidemiological study at a chronic disease hospital.

Aminopeptidases

Trial of pyrethroid impregnated bednets in an area of Tanzania holoendemic for malaria. Part 1. Operational methods and acceptability.

In five Tanzanian villages, nets impregnated with permethrin or lambdacyhalothrin were given out. The people received them enthusiastically and brought their nets for re-impregnation at six monthly intervals. Bioassays showed that the insecticidal power of permethrin impregnated nets remained adequate for six months unless the nets were washed. Nets with 30 mg lambdacyhalothrin/m2 retained high insecticidal power despite washing, but this dose caused temporary cold-like symptoms in those sleeping under freshly treated dry nets. Methods by which durable bednets might be made affordable by Tanzanian villagers are discussed.

Animals

Single-operator comparison of early and mid-second-trimester amniocentesis.

We sought to determine whether early amniocentesis is a safe and acceptable method of genetic evaluation in early pregnancy. During the 54-month period from September 1986 to February 1991, 300 consecutive early second-trimester amniocenteses were performed transabdominally at 13-14 weeks' gestation and 567 consecutive mid-second-trimester transabdominal amniocenteses were performed at 16-18 weeks. Group assignment was nonrandomized, interoperator-dependent variables were eliminated, and analysis was performed in one cytogenetics laboratory. The median maternal age and indications for the procedure were similar in both groups. There were no significant differences between the early- and mid-second-trimester amniocenteses in failed sampling, ambiguous results, pregnancy loss from 4 weeks after the procedure to 28 weeks' gestation, preterm birth, or perinatal death rate. Pregnancy loss within 4 weeks of amniocentesis was more frequent in early- than in mid-second-trimester amniocenteses. We conclude that early amniocentesis is a safe and acceptable method of genetic evaluation.

Adult

Anterior screw fixation of posteriorly displaced type II odontoid fractures.

Posteriorly displaced Type II odontoid fractures (Type II-P) are difficult to stabilize in an anatomic position with accepted methods of posterior atlantoaxial arthrodesis. Nine patients with Type II-P odontoid fractures with 4 to 15 mm displacement were treated with anterior odontoid screw stabilization. Seven of these patients had associated fractures or defects of the posterior arch of the first cervical vertebra (C1). Atlantoaxial posterior arthrodesis in these patients would not have been possible initially because of the lack of structural integrity of the posterior arch of C1. Two patients, later in the study, had no injury to the ring of C1. The odontoid fractures were stabilized with two 4.0-mm cancellous screws inserted through an anterior approach to the neck under fluoroscopic control with the skin incision at the C5 level. Preoperative reduction of the displaced odontoid process and immediate operative stability of the atlantoaxial complex were obtained in each case. No neurological complications related to the procedure occurred. Two patients died of causes unrelated to their cervical fracture surgery. The 7 patients who survived were followed for a minimum of 6 months. Fracture union and cervical stability were demonstrated in each of the surviving patients, without evidence of screw loosening or loss of fixation. Normal range of motion of the neck was documented at follow-up in all surviving patients. Although this series represents a limited experience with this treatment technique, anterior odontoid screw fixation has significant advantages over accepted methods of cervical stabilization for Type II-P odontoid fractures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Antimicrobial susceptibility testing of anaerobic bacteria.

Antimicrobial therapy of anaerobic infections is usually predicted on the basis of known patterns of susceptibility of anaerobic bacteria to antimicrobial agents rather than on results of in vitro tests of individual isolates. Routine susceptibility testing of anaerobic bacteria is not recommended, but there are instances of serious infection, i.e., endocarditis, or specific infecting organisms, e.g., Bacteroides fragilis, when in vitro testing of the specific infecting organism is indicated. No standard method has yet been accepted. Methods presently recommended are agar dilution or broth dilution tests. Other methods currently being evaluated are agar (disc) diffusion, broth-disc, and simplified broth and agar dilution tests. The advantages and limitations of the various methods are discussed.

Anti-Bacterial Agents

[Value of diagnostic procedures in heart failure].

Strategy for the diagnosis of heart insufficiency is directed to the accomplishment of distinct therapeutic aims. Main factors for diagnostic approaches are pathophysiology and progression of qualitatively and quantitatively different disturbances in cardiac performance. Anamnesis and clinical investigations are irremissible for the evaluation of congestive heart failure. For the detection of noncongestive cardiac insufficiency investigations during exercise are often necessary. Ventriculography ist the standard reference technique for measurement of the systolic and diastolic ventricular functions. For exercise and follow-up investigations non-invasive methods are widely used. Accepted methods are two dimensional and Doppler-echocardiography, quantitative radiocardiography with single-pass bolus technique, and radionuclid-ventriculography. We found a good correlation for the measurement of stroke volume when comparing impedance cardiography with uniplane ventriculography at rest. M-mode echocardiography did not yield sufficiently reliable volumetric data. The new imaging methods, positron emission tomography, magnetic resonance technique, and cine computed tomography are future tools for cardiac output measurements.

Coronary Disease

Method comparison--a different approach.

The commonly accepted method of analysing data from method comparison studies is regression analysis, a method which has limitations. This study illustrates the use of a graphical presentation of data, the difference plot, which can be used as an alternative to least squares regression analysis. The data from comparison studies performed on five methods were analysed both by Deming's regression analysis, with calculation of the correlation coefficient, and by the difference plot. The results show that in most cases much more relevant information was obtained from the difference plot.

Androstenedione

Single catheter technique for accurate cardiac outputs from left ventricle.

We report our experience in cardiac output measurements using a single catheter for left ventricular green dye injection with sampling from the side arm of a femoral artery introducer sheath. This technique is compared to thermal dilution (20 patients) and pulmonary artery green dye injection (20 patients). There were no significant differences between the single catheter left ventricular method and the other two accepted methods for measuring cardiac output.

Cardiac Catheterization

Estimation of transfused red cell survival using an enzyme-linked antiglobulin test.

An enzyme-linked antiglobulin test (ELAT) method was developed to estimate survival of transfused red cells. This procedure is based on a principle analogous to that of the Ashby technique were antigenically distinct red cells are transfused and their survival studied. We compared the ELAT survival to the 51Chromium method (51Cr) in four patients. Three patients with hypoproliferative anemias showed T 1/2 by ELAT of 17.5, 18, and 17 days versus 18.5, 20, and 19 days by the 51Cr method. A fourth patient with traumatic cardiac hemolysis had two studies performed. In this case, the ELAT showed a T 1/2 of 10 and 8.1 days while 51Cr T 1/2 values were 11 and 10.5 days. The ELAT method for measuring red cell survival yielded data which agreed closely with the results of the 51Cr method. Although 51Cr is the accepted method for red cell survival, the ELAT method can be used to estimate transfused red cell survival.

Anemia

Comparison of laser Doppler and Doppler ultrasound in lower limb vascular diagnosis.

This study represents a preliminary investigation into the use of laser Doppler flowmetry in lower limb vascular diagnosis. The method is compared with the accepted method of continuous wave Doppler ultrasound. Fifty-six patients with symptoms of lower limb vascular disease were investigated consecutively and independently using both techniques. In approximately two-thirds of patients the two methods showed broad agreement in their classification of disease severity (correlation coefficient = 0.63, P less than 0.001, n = 41). However, about 30% of those studied had impaired microvascular responses on laser Doppler evaluation with no detectable major vessel disease on continuous wave ultrasound investigation. The results indicate that more information is obtained about a subject's vascular status when results from both methods are combined. Thus laser Doppler flowmetry may be useful adjunct to Doppler ultrasound and segmental pressure measurements in the vascular laboratory.

Adult

Bile acid analysis: methods and problems.

What is the ideal method for analysis of faecal bile acids? Selection of an ideal system for a specific situation requires consideration of several factors, eg the information sought, availability of equipment and time constraints. Each laboratory will select procedures based on these constraints. A situation in which a large number of subjects are to be screened for total bile acid concentration might suggest use of single-day collections, lyophilization prior to homogenization, extraction using the Evrard and Janssen method and quantification by 3 alpha-hydroxysteroid dehydrogenase. However if the ratio of glycine to taurine conjugates and the daily excretion were of interest, separation of subclasses with Lipidex 1000 followed by both gas chromatography (of free bile acids) and HPLC (of conjugated bile acids) would be selected. There is not a best method for all situations. What does the future hold for improving this methodology in order to improve our ability to use faecal bile acid analysis clinically? The biggest problem facing the application of faecal bile acid analysis to clinical situations in the lack of ability to devise a rapid method (24-48 h) which retains the accuracy of current methods. One promising development is the potential application of immunological methods to faecal bile acids. These detection methods have been applied primarily to serum to date but if extraction and/or purification methods could be coupled with this method of quantification, a clinically acceptable method may result.(ABSTRACT TRUNCATED AT 250 WORDS)

Bile Acids and Salts

Single-stage correction of constriction ring syndrome.

The accepted method of treatment for the constricting ring syndrome of the extremities is serial excision and repair with Z-plasties. A series of 4 patients operated upon in different centers by single-stage excision of the ring and multiple Z-plasty repair is presented. In 1 patient there was absence of a major nerve trunk underneath and distal to a constriction ring. None of the patients suffered any significant circulatory embarrassment. This surgical approach is anatomically sound and clinically safe. It should be considered as an alternative method of treatment to the currently accepted procedure.

Amniotic Band Syndrome

Determination of vitamin B12 in gruel by a radioisotope dilution assay.

The results obtained by a radioisotope dilution (RID) method for the determination of vitamin B12 in gruel were compared with those obtained by a standard microbiological assay with Lactobacillus leichmannii. A commercially available RID assay kit was used. A very high correlation between the results from the RID method and the microbiological method was found when the extraction procedure was the same. Digestion with buffer solution at pH 4.6 was shown to be the most suitable extraction method. The RID assay is an acceptable method for routine determinations of vitamin B12 in gruel.

Biological Assay

Assessment of labial salivary gland changes in patients with rheumatoid arthritis by subjective and quantitative methods.

Biopsy of the minor salivary glands is an accepted method in the diagnosis of Sjögren's syndrome, the most characteristic feature being the prominent inflammatory cell infiltration. However, difficulties exist in the early diagnosis of Sjögren's syndrome. The present study was conducted to analyse by subjective and quantitative methods the morphological changes of the salivary glands in patients with rheumatoid arthritis (RA) frequently complicated by Sjögren's syndrome. The subjects of this study were 71 RA patients (mean age 54 +/- 15 years) and their 45 healthy age-matched controls (mean age 60 +/- 14 years). The histologic parameters evaluated were: inflammatory cell infiltration; acinar atrophy; fibrosis, and fatty infiltration. Statistically significant differences between the RA and the control groups were found in all parameters (p less than 0.001) except the fatty infiltration. This indicates that destruction of the salivary glands including fibrosis and acinar atrophy is associated with RA. Only the fatty infiltration seems to be an age-dependent change. All salivary gland biopsies of the RA patients were photographed and evaluated planimetrically, for the same parameters as in the subjective evaluation. An excellent reproducibility between the two methods was found, thus indicating the applicability of the subjective evaluation in the assessment of early salivary gland changes in RA patients.

Adult

A method for correctly setting the rf flip angle.

Currently the accepted method for setting the correct rf power levels to achieve 90 degrees and 180 degrees rf pulses for MR imaging is to peak the echo amplitude of a rf spin-echo sequence. The echo amplitude of this alpha-2 alpha pulse sequence is proportional to sin3 (alpha) and has a relatively broad maximum. Recently another method for setting the rf flip angle by maximizing the ratio of the stimulated echo to the primary echo amplitudes (in a 3 alpha sequence) demonstrated accuracy similar to that of the spin-echo method using a shorter repetition time. We present a new, more sensitive, and more accurate method for setting the correct rf power levels for 90 degrees and 180 degrees rf pulses. In this method, based upon the stimulated echo pulse sequence, we are able to accurately set the rf power to within +/- 0.1 dB by minimizing the signal amplitude of the third spin echo. This null method works for both selective and nonselective rf pulses of flip angle 90 degrees or 180 degrees, allowing the user to accurately adjust the relative amplitudes of the four rf pulse types within a single pulse sequence.

Calibration

A double buffy coat method for red cell removal from ABO-incompatible marrow.

Hemolytic reactions caused by transfusion of ABO-incompatible marrow can be ameliorated by either reduction of isohemagglutinins in the recipient or depletion of incompatible red cells from the harvested marrow. This article describes a rapid and reliable method for removal of incompatible marrow red cells on a blood cell processor using a double buffy coat technique. In five allogeneic bone marrow transplants, the maximum value of transfused incompatible red cells was 8.8 ml. There was no evidence of a hemolytic transfusion reaction in any patient. The median cell recovery for nucleated marrow cells and progenitor cells was 77 and 104 percent, respectively. Engraftment occurred at a median of 13 days (range, 11-21 days) after transplantation. The double buffy coat method of red cell depletion is an acceptable method for processing ABO-incompatible marrow.

ABO Blood-Group System