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Bird wings vary in size and morphology in terms of both size and number of feathers and the underlying skeletal anatomy. The number of primary remiges does not seem to vary much between bird species but, by contrast, the number of secondary remiges is reported to range between 6 and 40 depending on bird size. Given that the primaries are attached to the manus, and the secondaries are attached to the ulna, it was predicted that as bone lengths increased with increasing size of the bird, then feather count would increase. Data were collected for 268 species from 25 different orders, and phylogenetically controlled analysis explored the allometry between feather count and bone size. The number of primaries was typically 10 or 11 and did not vary with manus size. By contrast, the number of secondaries increased with ulna length, but only in some orders. For example, in Gruiformes, the number of secondary feathers increased concomitantly with ulna length but despite a two orders of magnitude range in body mass, almost all species in the Passeriformes had nine secondary remiges. It is unclear why, for instance, species with an ulna length of 70 mm can have between 9 and 24 secondaries depending on their order. This variation in secondary feather number can be added to variation in relative wing bone lengths, flight feather lengths, flight feather mechanical properties, and flight feather vane densities as another potential mechanism of adaptation to flight requirements. The apparent constraint of wingspan is scaling as approximately body mass1/3. Further research is needed to explore whether changes in secondary feather number relative to ulna length are accompanied by changes in feather vane width or the overlap of adjacent feathers and how this relates to wing aerodynamics. [ABSTRACT FROM AUTHOR]

Background: Early diagnosis and treatment are associated with an improved prognosis in blastomycosis. The diagnosis of blastomycosis may be missed by cytology, histopathology, culture, or serology. An enzyme immunoassay (EIA) for detection of Blastomyces dermatitidis galactomannan antigen in body fluids has been used for rapid diagnosis of blastomycosis in humans. Hypothesis: Measurement of Blastomyces antigen in urine or serum by the MVista Blastomyces antigen EIA is more sensitive than measurement of anti- Blastomyces antibodies for diagnosis of blastomycosis in dogs. Methods: Serum and urine samples from 46 dogs with confirmed blastomycosis were tested for Blastomyces antigen and serum was tested for anti- Blastomyces antibodies. Results: The sensitivity for the detection of antigen in urine was 93.5% and it was 87.0% in serum. The sensitivity of antibody detection by agar gel immunodiffusion (AGID) was 17.4% and it was 76.1% by EIA. Antigen and antibody decreased during itraconazole treatment. Conclusions and Clinical Importance: Antigen detection is a more sensitive test for diagnosis of blastomycosis than antibody testing by AGID, the only commercially available method. Antigen concentrations decreased with treatment. [ABSTRACT FROM AUTHOR]

False-positive Histoplasma antigen results were identified in two patients who received rabbit antithymocyte globulin (ATG, Thymoglobulin®) to prevent allograft rejection. To determine the prevalence of false-positive results following the administration of Thymoglobulin®, sequential specimens were tested from a cohort of transplant recipients. Of 107 such patients, 17 (15.9%) demonstrated false-positive tests for Histoplasma antigenemia. False antigenemia peaked at 2–4 weeks after ATG administration and cleared over the next few months. Physicians should be aware of the potential for false-positive results in specimens from patients who have received ATG. [ABSTRACT FROM AUTHOR]

Both acute and chronic ethanol consumption may cause esophageal dysmotility. In order to systematically evaluate the effect of ethanol on esophageal motility, we studied esophageal motility in 13 healthy subjects before and following acute intravenous administration of 0.8 g/kg ethanol and in chronic alcoholics within 6 hr of their last drink ( n= 6) and following 24 to 48 hr of abstinence when signs of withdrawal were present ( n= 13). Withdrawing alcoholics were also restudied after intravenous administration of 0.8 g/kg ethanol. Ethanol transiently decreased lower esophageal sphincter pressure (LESP) and inhibited LES relaxation in all control subjects; this inhibitory effect of ethanol on LESP in alcoholics was significantly less, indicating the development of tolerance. Ethanol moderately decreased esophageal contraction amplitude (ECA) in 10 of 13 controls and prolonged duration of contractions in all but had no effect on velocity of esophageal contractions. In contrast, ECA was significantly elevated in both groups of alcoholics, but this was significantly more marked in withdrawing alcoholics. Ethanol infusion returned ECA toward normal values in withdrawing alcoholics. Abnormal motility was noted in three intoxicated alcoholics and 10 (77%) withdrawing alcoholics. This included nutcracker esophagus in five and hypertensive LES in two. These data indicated that (1) esophageal motor dysfunction is common in alcoholics; (2) acute ethanol administration decreases LESP and esophageal contraction amplitude, whereas chronic ethanol consumption and withdrawal from ethanol increases ECA. This suggests development of a compensatory mechanism in chronic alcoholics leading to high pressure esophageal contractions during withdrawal. [ABSTRACT FROM AUTHOR]

False-positive Histoplasma antigenemia was reported in solid organ allograft recipients who had received rabbit anti-thymocyte globulin (RATG, RATG®) caused by human anti-rabbit antibodies (HARA). A second-generation Histoplasma antigen detection assay was developed to overcome false positivity caused by HARA. With the second-generation assay, false-positive results were eliminated in 18 of 19 cases without reduction in the sensitivity in patients with histoplasmosis. In fact, sensitivity for detection of antigenuria in patients with acquired immunodeficiency syndrome and disseminated histoplasmosis was higher in the second-generation assay. Physicians should be aware of the potential for false-positive results in sandwich immunoassays in specimens from patients who have received RATG. [ABSTRACT FROM AUTHOR]

The article focuses on a study conducted by researchers Steven C. Marcus and Michael Durkin on the impact of stimulant medications on the academic performance of youth with attention-deficit/hyperactivity disorder (ADHD). It mentions the methodology of the study and discusses its results, published in the "Journal of the American Academy of Child and Adolescent Psychiatry," which showed greater effects of stimulant adherence on academic performance in ADHD students.

Examines the infant feeding practices among mothers of very low birth weight (VLBW) infants in the United States. Review of birth chart on neonatal characteristics; Influence of maternal verbal IQ and social class on expressed milk feeding; Effect of sociodemographic factors on feeding practices of VLBW infants.

Aim: Duration of untreated psychosis in early schizophrenia impacts long-term outcomes. Because long-acting injectable (LAI) antipsychotic drugs improve adherence in early-stage patients, they could reduce additional time in uncontrolled psychosis (TUP) during the critical period of the illness. However, the long-term benefit of early LAI use over oral formulations has not been quantified. This study explores the potential magnitude of the benefit with a simulation approach., Methods: A microsimulation models the effects of 11 treatment pathways reflecting alternative decisions on whether and when LAI agents are used during a "calibration phase" that starts at treatment entry and lasts until the end of the 3-year critical period. Treatment failure prolongs time in psychosis. Long-term outcomes are predicted over the ensuing 7-year period as a function of TUP., Results: An "early LAI" pathway where LAI treatment follows the second oral treatment failure is compared to an oral-only pathway. Under these pathways, 69% and 46% of patients, respectively, are estimated to exit the calibration phase with adequate symptom control (total positive and negative syndrome scale score below 68). Relative to the oral-only pathway, the early LAI pathway is predicted to increase competitive employment by 39% (25% vs 18%) and independent or family living by 22% (71% vs 58%), and to decrease receipt of disability benefits by 36% (42% vs 66%) and hospital admissions per 1000 patient-years by 15% (249% vs 294%)., Conclusions: While these simulation results need to be confirmed empirically, they suggest that earlier use of LAI antipsychotics can meaningfully improve patient outcomes., (© 2018 John Wiley & Sons Australia, Ltd.)

The National Venous Thromboembolism Prevention Programme was launched in England, in 2010. Its central objective was to reduce morbidity and mortality from preventable deep vein thrombosis and pulmonary embolism through introduction of a comprehensive systematic approach. The cornerstone of the programme was the introduction of mandatory documented risk assessment for venous thromboembolism, supported by national thromboprophylaxis guidance. Despite widespread uptake of risk assessment, measuring the impact of the national programme on outcomes has proved challenging. The aim of this paper is to review the implementation and outcomes of the national programme., (© 2017 John Wiley & Sons Ltd.)

Antifungal catheter lock therapy (AfLT) with liposomal amphotericin B has been used in the treatment of pediatric central line infections caused by Candida species; however, reports describing the use of liposomal amphotericin B lock therapy in the adult hemodialysis patient population are lacking. Management of central line-associated candidemia with systemic therapy alone is often challenging due to the propensity of Candida species to form biofilms on foreign bodies. We describe a 64-year-old woman who was receiving hemodialysis 3 times/week and was hospitalized with persistent fungemia. Despite receiving intravenous micafungin, she had multiple positive blood cultures for Candida albicans, which finally cleared after 7 days. Her double-lumen catheter was considered the most likely nidus of infection. Although catheter removal would have been preferred, this was not possible given her vasculopathy, history of multiple bloodstream infections, and lack of other available sites for vascular access. Catheter exchange was performed, and liposomal amphotericin B AfLT was administered in combination with intravenous micafungin for a total of 6 days. During this time, the patient experienced no discernible adverse effects secondary to AfLT. At discharge, AfLT was discontinued, and intravenous micafungin was changed to oral fluconazole. After 6 months of treatment, the patient remained culture negative and maintained her dialysis access. To our knowledge, this is the first case report of liposomal amphotericin B catheter lock therapy used to manage a persistent C. albicans bloodstream infection in an adult receiving hemodialysis. AfLT is a novel concept for treating catheter-associated fungal infections. Liposomal amphotericin B was chosen based on its favorable in vitro activity against Candida species biofilms in catheter lock environments. We identified several barriers to implementing AfLT, and these issues may prohibit the use of AfLT. This case report illustrates the benefits and challenges of managing catheter-associated fungal infections with AfLT. Further study is required to examine the efficacy, safety, and feasibility of this approach., (© 2014 Pharmacotherapy Publications, Inc.)