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Aims Integrated Care Pathways (ICPs) are management plans that indicate the sequence and timing of the optimal treatment for individuals with a given disorder. The treatment of diabetic ketoacidosis (DKA) before and after the implementation of an ICP in a teaching hospital was examined. Methods Twenty-seven episodes of DKA were identified during the 13-month control period and 22 in the 13 months following implementation of the ICP. Case notes were reviewed and relevant clinical data extracted. Results The introduction of the ICP was associated with a reduction in the time taken to initiate intravenous fluid [45.0 (5–225) min to 37.5 (0–135) min; P = 0.01]. Time taken to initiate insulin infusion was also reduced [60.0 (5–755) min to 37.5 (0–175) min; P = 0.02]. The proportion of patients commenced on intravenous insulin within 60 min increased from 48 to 77% ( P = 0.04). In addition, there was a reduction in the prescription of antibiotics (48–18%; P = 0.028) and low molecular weight heparin (59–5%; P < 0.001). Length of stay was not affected. Conclusion The ICP significantly improved key areas in the management of DKA, although there remains room for further improvements. [ABSTRACT FROM AUTHOR]

Summary The objective of the present study was to examine the effect of signalment, body size and diet on plasma taurine and whole blood taurine concentrations. A total of 131 normal dogs consuming commercially prepared dog food had blood drawn 3–5 h post-prandially to be analysed for plasma amino acids and whole blood taurine. Body weight and morphometric measurements of each dog were taken. Plasma and whole blood taurine concentrations were 77 ± 2.1 nmol/ml (mean ± SEM) and 266 ± 5.1 nmol/ml (mean ± SEM), respectively. No effect of age, sex, body weight, body size, or diet was seen on plasma and whole blood taurine concentrations. Mean whole blood taurine concentrations were lower in dogs fed diets containing whole grain rice, rice bran or barley. The lowest whole blood concentrations were seen in dogs fed lamb or lamb meal and rice diets. Plasma methionine and cysteine concentrations were lower in dogs fed diets with animal meals or turkey, and whole grain rice, rice bran or barley. Fifteen of 131 dogs had plasma taurine concentrations lower than, or equal, to the previously reported lowest mean food-deprived plasma taurine concentration in normal dogs of 49 ± 5 nmol/ml (mean ± SEM) (Elliott et al., 2000). These findings support the theory that taurine deficiency in dogs may be related to the consumption of certain dietary ingredients. Scientific and clinical evidence supports the hypothesis that dilated cardiomyopathy is associated with low blood taurine concentration in dogs; therefore, further work is indicated to determine the mechanism by which diet can affect taurine status in dogs. [ABSTRACT FROM AUTHOR]

The objective of the present study was to examine the interaction between graded levels of leucine and dietary crude protein. Dose–response curves were generated using four 3 × 3 Latin squares (two dogs/square). Each square represented one of two concentrations of crude protein (140 or 280 g/kg diet) and one of two combinations of three concentrations of leucine (5.0, 7.0 and 9.0 g/kg diet or 9.0, 11 and 13 g/kg diet). An additional experiment was performed by feeding crude protein at 210 g/kg diet with either 7.0 or 11 g leucine/kg diet. Weight gain, food intake, nitrogen retention, plasma albumin and plasma amino acids were measured. The requirement was determined to be the minimum leucine concentration required to maximize weight gain and nitrogen retention. For 8–14-week-old male Beagle dogs, 140 g crude protein/kg diet in a diet containing 18 kJ metabolizable energy/g does not appear to support maximal growth. The leucine requirement was not affected by doubling the dietary crude protein level from 140 to 280 g/kg diet. From these results, the leucine requirement of 8–14-week-old Beagle dogs appears to be 11 g leucine/kg diet independent of the level of dietary crude protein, whereas dogs over 14 weeks require only 7 g leucine/kg diet for maximal nitrogen retention. [ABSTRACT FROM AUTHOR]

An experimental design was used to examine the effects of interviewer gender and (mis)understanding on physiological stress (i.e., cortisol). A total of 103 undergraduate students wrote about a recent social conflict and then discussed that conflict with either a male or a female interviewer. During these discussions, the interviewer displayed verbal and nonverbal cues of (mis)understanding toward the participants. Participants' cortisol was assessed four times throughout the study. Results from a 2 × 2 × 4 mixed‐model analysis of variance demonstrated an interaction between the gender of the interviewer, understanding condition, and time such that cortisol decreased the most over time when the interviewer used cues of understanding that matched stereotypical expectations for the interviewers' gender (i.e., when women were understanding and men were misunderstanding). [ABSTRACT FROM AUTHOR]

Jack pine (Pinus banksiana Lamb.) seedlings were inoculated with either one of the ectomycorrhizal (ECM) fungi, Laccaria bicolor (Miare) Orton or Pisolithus tinctorius (Pers.) Coker and Couch, and grown for 16 weeks in a growth chamber along with non-ECM controls. Five enzymes involved with the assimilation of nitrogen or the synthesis of amino acids were measured in the 3 jack pine root systems as well as in the pure fungal cultures. Pisolithus tinctorius in pure cultures. Pisolithus tinctorius in pure culture had no detectable activity of nitrate reductase (NR, EC 1.6.6.1), glutamate dehydrogenase (GDH, EC 1.4.1.2), glutamate oxoglutarate aminotransferase (GOGAT, EC 1.4.1.13) but did have some glutamine synthetase (GS, EC 6.3.1.2) activity. Laccaria bicolor in pure culture had no NR activity, small levels of GDCO activity, and high GS, GDH and GOGAT activity. The high levels of enzymatic activity present in L. bicolor indicate that it may play a greater role in the nitrogen metabolism of its host plant than P. tinctorius. ECM infection clearly altered the enzymatic activity in jack pine roots but the nature of these changes depended on the fungal associate. Non-ECM root systems had higher specific activities than ECM root systems for NR, GS, GDH and GDCO but GOGAT activities were the same for both the ECM and non-ECM roots. Root systems infected with L. bicolor had significantly greater NR and GDCO activity than those infected with P. tinctorius. Differences in the GS activity of the two fungi in pure culture corresponded to the GS activity of jack pine roots in symbiotic association with these fungi. While the free amino acids profiles in foots were significantly affected by ECM infection, the profile of free amino acids exported to the stem was the same for all treatments. High asparagines and low glutamine in roots infected with P. tinctorius indicates that asparagines synthetase (EC x.x.x.x) activity should be higher within this symbiotic association than in the L. bicolor association or in the non-mycorrhizal roots. [ABSTRACT FROM AUTHOR]