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This article describes experiences and lessons learned from the Trusted CI project, funded by the US National Science Foundation (NSF) to serve the community as the NSF Cybersecurity Center of Excellence (CCoE). Trusted CI is an effort to address cybersecurity for the open science community through a single organization that provides leadership, training, consulting, and knowledge to that community. The article describes the experiences and lessons learned of Trusted CI regarding both cybersecurity for open science and managing the process of providing centralized services to a broad and diverse community.

Currently, corn is used to produce more than 85% of the world’s high fructose syrup (HFS). There is a search for alternative HFS substrates because of increased food demand and shrinking economies, especially in the developing world. The sweet potato is a feasible, alternative raw material. This study isomerized a high glucose sweet potato starch syrup (SPSS) and determined its sugar profile, mineral content, and rheological and thermal properties. Rheological and thermal properties were measured using a rheometer and DSC, respectively. Sweet potato starch was hydrolyzed to syrup with a mean fructose content of 7.6±0.4%. The SPSS had significantly higher (P

Background: Rib fractures are common injuries associated with considerable morbidity, long-term disability, and mortality. Early, adequate analgesia is important to mitigate complications such as pneumonia and respiratory failure. Regional anesthesia has been proposed for rib fracture pain control due to its superior side effect profile compared with systemic analgesia. Our objective was to evaluate the effect of emergency physician-performed, ultrasound-guided serratus anterior plane block (SAPB) on pain and respiratory function in emergency department patients with multiple acute rib fractures., Methods: This was a prospective observational cohort study of adult patients at a level 1 trauma center who had two or more acute unilateral rib fractures. Eligible patients received a SAPB if an emergency physician trained in the procedure was available at the time of diagnosis. Primary outcomes were the absolute change in pain scores and percent change in expected incentive spirometry volumes from baseline to 3 hours after rib fracture diagnosis., Results: 38 patients met eligibility criteria, 15 received the SAPB and 23 did not. The SAPB group had a greater decrease in pain scores at 3 hours (-3.7 vs. -0.9; p=0.003) compared with the non-SAPB group. The SAPB group also had an 11% (CI 1.5% to 17%) increase in percent expected spirometry volumes at 3 hours which was significantly better than the non-SAPB group, which had a -3% (CI -9.1% to 2.7%) decrease (p=0.008)., Conclusion: Patients with rib fractures who received SAPB as part of a multimodal pain control strategy had a greater improvement in pain and respiratory function compared with those who did not. Larger trials are indicated to assess the generalizability of these initial findings., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Variability exists in the management of childhood syncope as clinicians balance resource utilization with the need to identify serious diseases. Limited evidence exists regarding the long-term impact of evidence-based guidelines (EBGs) on clinical practices. This study's objective was to measure long-term changes in the management of syncope after implementing a syncope EBG in a single pediatric emergency department following the redistribution of resources to facilitate compliance over time., Methods: We included healthy patients aged 8-22 years, presenting to the pediatric emergency department with syncope between 2009 and 2017. Interrupted time series analysis compared testing rates and length of stay among the pre-EBG, short-term follow-up, and long-term follow-up periods., Results: The study included 1,294 subjects. From the pre-EBG period to the long-term follow-up period, recommended electrocardiogram and urine pregnancy test rose significantly [level change odds ratio (95% confidence interval) 5.56 (1.73-17.91) and 3.15 (1.07-9.32), respectively]. Testing and management not recommended by the EBG decreased significantly, including complete blood count, electrolytes, point-of-care glucose, chest radiograph, and intravenous fluids [level change odds ratio (95% confidence interval) 0.19 (0.09-0.40), 0.15 (0.07-0.32), 0.38 (0.18-0.81), 0.17 (0.06-0.49), and 0.18 (0.08-0.39), respectively]. Length of stay declined significantly. No delayed diagnoses occurred., Conclusions: Sustained improvements in syncope management persisted during long-term follow-up of the EBG despite minimal resources. The EBG was associated with increased focused evaluation and decreased low yield testing. EBGs may be useful tools to influence sustained clinical practices to promote safe, cost-effective, and high-quality care., Competing Interests: The authors have no financial interest to declare in relation to the content of this article., (Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc.)

Objectives: To examine changes in tooth loss and untreated tooth decay among older low-income and higher-income US adults and whether disparities have persisted., Design: Sequential cross-sectional study using nationally representative data., Setting: The 1999 to 2004 and 2011 to 2016 National Health and Nutrition Examination Survey., Participants: Noninstitutionalized US adults, aged 65 years and older (N = 3539 for 1999-2004, and N = 3514 for 2011-2016)., Measurements: Differences in prevalence of tooth loss (having 19 teeth or fewer, 8 teeth or fewer, and no teeth) and untreated decay and mean number of decayed and missing teeth (DMT) between low- and high-income adults 65 years and older in each survey and changes between surveys. Adjusted prevalence and count outcomes were estimated with logistic and negative binomial regression models, respectively. Models controlled for sociodemographic characteristics and smoking status. Reported findings are significant at P < .05., Results: In 2011 to 2016, unadjusted prevalence of having 19 teeth or fewer, 8 teeth or fewer, no teeth, and untreated decay among low-income adults 65 years and older was 50.6%, 42.0%, 28.6%, and 28.6%, respectively. Multivariate analyses indicated that although most tooth loss measures improved between surveys for both income groups, tooth loss among low-income adults remained at almost twice that among higher-income adults. The disparity in untreated decay prevalence in 2011 to 2016, 15.2 percentage points (26.1% vs 10.9% for low vs high income) was twice that in 1999 to 2004, 8.5 percentage points (22.9% vs 14.4% for low vs high income). DMT decreased for both groups, with lower-income adults having about five more affected teeth in both surveys., Conclusion: Tooth loss is decreasing, but differential access to restorative care by income appears to have increased., (Published 2019. This article is a U.S. Government work and is in the public domain in the USA.)

An understanding of population surveillance is important for predoctoral dental students, so they will comprehend the health needs of the population in order to provide needed care and promote overall health. The aim of this study was to teach data mining and surveillance methodologies to dental students and to assess the association between systemic health factors and tooth loss in patients visiting the University of Colorado School of Dental Medicine clinics. The students were calibrated to using the data mining methodologies from the Electronic Health Record (EHR) using a rubric and presentation by a faculty member. The EHR was reviewed for age, gender, race/ethnicity, number of natural teeth present, systemic diseases reported including cardiovascular disease and diabetes, and history of any form of tobacco use. A total of 1,338 patients who visited the clinics in spring 2017 were included in the study; of those, 354 (27%) had <20 teeth. The results showed greater odds of having <20 teeth for those who reported cardiovascular disease (OR=2.1, 95% CI 1.6, 2.7), diabetes (OR=1.7, 95% CI 1.2, 2.3), tobacco use (OR=1.4, 95% CI 1.0, 1.9), and being Hispanic (OR=1.4, 95% CI 1.0, 1.9). After adjusting for age, gender, and ethnicity, the odds of having <20 teeth for patients with tobacco use were found to be twice that of patients with no tobacco use (OR=2.1, 95% CI 1.5, 3.0). Understanding population surveillance could be beneficial in designing evidence-based interventions at the dental school and community levels.

The curriculum for nurse practitioner (NP) students often overlooks the assessment of the oral cavity. In recognition of this, the HEENT (head, eyes, ears, nose, and throat) assessment was expanded to HEENOT (head, ears, eyes, nose, oral, and throat) through integration of an interprofessional educational (IPE) activity developed for University of Colorado NP and dental students. The aim of this study was to assess NP students' perceptions of an IPE activity in which dental faculty and students taught NP students how to conduct an oral exam, recognize oral health pathology, and apply fluoride varnish. Afterwards, the NP students completed an evaluation survey focusing on their thoughts, comfort level, organization, and understanding of the activity. This IPE activity was repeated over four semesters from 2014 to 2017, and significant differences among the semesters were compared. All NP students in the four semesters participated in the activity and the survey: semester one N=25, semester two N=31, semester three N=43, and semester four N=25. In all semesters, NP students reported feeling more confident conducting oral health exams after completion of the IPE activity. Semester four students agreed more with the idea of interprofessional collaboration (OR: 0.103) and receiving educational information not learned elsewhere in the curriculum (OR: 0.134) compared to semester one students. Higher odds for the session being well organized and conducted in a suitable time were found for semester four compared to semester two (OR: 0.217). These comparisons reflect improvement in teaching methodologies over the four semesters and an overall increased confidence for NP students in performing an oral health assessment.

Introduction: In 2014, the state of Colorado initiated new dental coverage benefits for adults in the Colorado Medicaid program. The goal of this study was to investigate the utilization and impact of this new dental coverage at the University of Colorado School of Dental Medicine. The utilization of dental services delivered and the numbers of patients in this program were compared before and after the implementation of the benefit., Materials and Methods: This retrospective study compared the utilization of services provided 2 years prior and 2 years after the Medicaid adult benefit was made available. Through the University of Colorado School of Dental Medicine (CU-SODM) electronic dental record, all adult Medicaid dental patients' (ages 21+) charts were extracted for zip code, CDT dental procedure codes, with a focus on tooth extraction compared to tooth saving procedures. Graphical analysis and Pearson's chi-squared tests were applied to assess the statistical significance of procedure utilization changes over time., Results: After implementation of the Medicaid adult benefit, the number of patients seen at the school under this program increased by a factor of 4.5. The geographic range (zip code) increased with some patients coming from further distances to receive dental care. The number of patients from local zip codes increased by as much as 235%. There was a 51% increase in tooth saving procedures, which was statistically significant ( P  = 0.0013). Additionally, there was a 22% decrease in extractions, while not statistically significant ( P  = 0.0992), a downward trend was clear., Discussion: The focus was on the utilization of Medicaid adult benefits at the dental school, which was only a small proportion of the state-wide Medicaid population. Therefore, these data are not generalizable for statewide assessments of the program. However, based on the findings at the school clinics, more adult patients utilized the benefits; and chose to receive more tooth saving procedures and less extractions after implementation of the Medicaid adult benefit. This Medicaid study conducted at the CU-SODM 2 years after the adult dental coverage can be used as a baseline for future studies.

Dental disease is largely preventable. Many older adults, however, experience poor oral health. National data for older adults show racial/ethnic and income disparities in untreated dental disease and oral health-related quality of life. Persons reporting poor versus good health also report lower oral health-related quality of life. On the basis of these findings, suggested public health priorities include better integrating oral health into medical care, implementing community programs to promote healthy behaviors and improve access to preventive services, developing a comprehensive strategy to address the oral health needs of the homebound and long-term-care residents, and assessing the feasibility of ensuring a safety net that covers preventive and basic restorative services to eliminate pain and infection.

Background: The objective of this study was to enhance removal of fishing gear from right whales (Eubalaena glacialis) at sea that evade disentanglement boat approaches. Titrated intra muscular injections to achieve sedation were undertaken on two free swimming right whales., Methodology/principal Findings: Following initial trials with beached whales, a sedation protocol was developed for right whales. Mass was estimated from sighting and necropsy data from comparable right whales. Midazolam (0.01 to 0.025 mg/kg) was first given alone or with meperidine (0.17 to 0.25 mg/kg) either once or four times over two hours to whale #1102 by cantilevered pole syringe. In the last attempt on whale #1102 there appeared to be a mild effect in 20-30 minutes, with duration of less than 2 hours that included exhalation before the blowhole fully cleared the water. Boat avoidance, used as a measure of sedation depth, was not reduced. A second severely entangled animal in 2009, whale #3311, received midazolam (0.03 mg/kg) followed by butorphanol (0.03 mg/kg) an hour later, delivered ballistically. Two months later it was then given midazolam (0.07 mg/kg) and butorphanol (0.07 mg/kg) simultaneously. The next day both drugs at 0.1 mg/kg were given as a mixture in two darts 10 minutes apart. The first attempt on whale #3311 showed increased swimming speed and boat avoidance was observed after a further 20 minutes. The second attempt on whale #3311 showed respiration increasing mildly in frequency and decreasing in strength. The third attempt on whale #3311 gave a statistically significant increase in respiratory frequency an hour after injection, with increased swimming speed and marked reduction of boat evasion that enabled decisive cuts to entangling gear., Conclusions/significance: We conclude that butorphanol and midazolam delivered ballistically in appropriate dosages and combinations may have merit in future refractory free swimming entangled right whale cases until other entanglement solutions are developed.

Capillary channel fibers (CCF) were selected for use in tissue engineering systems, due to their fluid wicking and cell guiding abilities. A study was conducted, comparing cell adhesion to CCF and mesh to traditional systems with fibers of round cross sectional area. A series of biochemical assays was conducted; the results indicated enhanced cellular attachment to the CCF based systems. Ongoing studies are being conducted to determine the rate of liquid diffusion within CCF reinforced tissue engineered composite systems.

Introduction: Local, state, and national health policy makers require information on the economic burden of oral disease and the cost-effectiveness of oral health programs to set policies and allocate resources. In this study, we estimate the cost savings associated with community water fluoridation programs (CWFPs) in Colorado and potential cost savings if Colorado communities without fluoridation programs or naturally high fluoride levels were to implement CWFPs., Methods: We developed an economic model to compare the costs associated with CWFPs with treatment savings achieved through averted tooth decay. Treatment savings included those associated with direct medical costs and indirect nonmedical costs (i.e., patient time spent on dental visit). We estimated program costs and treatment savings for each water system in Colorado in 2003 dollars. We obtained parameter estimates from published studies, national surveys, and other sources. We calculated net costs for Colorado water systems with existing CWFPs and potential net costs for systems without CWFPs. The analysis includes data for 172 public water systems in Colorado that serve populations of 1000 individuals or more. We used second-order Monte Carlo simulations to evaluate the inherent uncertainty of the model assumptions on the results and report the 95% credible range from the simulation model., Results: We estimated that Colorado CWFPs were associated with annual savings of 148.9 million dollars (credible range, 115.1 million dollars to 187.2 million dollars) in 2003, or an average of 60.78 dollars per person (credible range, 46.97 dollars dollars to 76.41 dollars). We estimated that Colorado would save an additional 46.6 million dollars (credible range, 36.0 dollars to 58.6 dollars million) annually if CWFPs were implemented in the 52 water systems without such programs and for which fluoridation is recommended., Conclusion: Colorado realizes significant annual savings from CWFPs; additional savings and reductions in morbidity could be achieved if fluoridation programs were implemented in other areas.

Objective: To evaluate effects of butorphanol tartrate and buprenorphine hydrochloride on withdrawal threshold to a noxious stimulus in conscious African grey parrots., Animals: 29 African grey parrots (Psittacus erithacus erithacus and Psittacus erithacus timneh)., Procedure: Birds were fitted with an electrode on the medial metatarsal region of the right leg, placed into a test box, and allowed to acclimate. An electrical stimulus (range, 0.0 to 1.46 mA) was delivered to each bird's foot through an aluminum perch. A withdrawal response was recorded when the bird lifted its foot from the perch or vigorously flinched its wings. Baseline threshold to a noxious electrical stimulus was determined. Birds then were randomly assigned to receive an i.m. injection of saline (0.9% NaCl) solution, butorphanol (1.0 mg/kg of body weight), or buprenorphine (0.1 mg/kg), and threshold values were determined again., Results: Butorphanol significantly increased threshold value, but saline solution or buprenorphine did not significantly change threshold values., Conclusions and Clinical Relevance: Butorphanol had an analgesic effect, significantly increasing the threshold to electrical stimuli in African grey parrots. Buprenorphine at the dosage used did not change the threshold to electrical stimulus. Butorphanol provided an analgesic response in half of the birds tested. Butorphanol would be expected to provide analgesia to African grey parrots in a clinical setting.

Objective: To develop a technique for objective assessment of modulation of nociperception in conscious perching birds., Animals: 31 adult African grey parrots., Procedure: Birds were randomly assigned to receive saline (0.9% NaCl) solution (n = 10), butorphanol tartrate (11), or buprenorphine hydrochloride (10), i.m. Birds were fitted with a surface electrode on the medial metatarsus of 1 leg. An electrical stimulus was delivered to the bird's foot through an aluminum surface on half of the perch. The alternate side of the perch delivered a noxious thermal stimulus. A withdrawal response to either stimulus was recorded when the bird lifted its foot or vigorously flinched its wings., Results: Responses to thermal stimuli were extremely variable during baseline testing and after administration of drugs. Thus, significant differences were not detected after drug injection. In contrast, responses to an electrical stimulus were predictable with much less variation., Conclusions and Clinical Relevance: This method and device allowed for the reliable determination of withdrawal threshold in perching birds. Use of this technique for objective assessment of modulation of nociperception in conscious perching birds will enable assessment of analgesic drugs.

Objective: To compare mask anesthesia induction and recovery characteristics between 2 inhalant anesthetic agents: isoflurane and sevoflurane., Animals: 16 clinically normal, young adult Beagles., Procedure: Using a cross-over design, dogs were randomly selected to receive sevoflurane or isoflurane via a face mask and a circle anesthetic system. Vaporizer setting concentrations were increased in stepwise, equal minimum alveolar concentrations (MAC) for each anesthetic until the vaporizer setting of 2.6% for isoflurane or 4.8% for sevoflurane (2 MAC) was reached. Concentration was kept constant until the dog had a negative tail clamp response and was intubated. End-tidal concentration was maintained at 1.8 to 2.0% or 3.3 to 3.8% for isoflurane or sevoflurane, respectively (1.4 to 1.6 MAC) for 30 minutes. Dogs were allowed to recover with only tail clamp stimulation until a positive response was obtained. Extubation was performed when a spontaneous swallow reflex was observed. Dogs were allowed to achieve sternal recumbency and stand unassisted without further stimulation., Results: Sevoflurane induction resulted in shorter time to loss of palpebral reflex, negative tail clamp response, and time to tracheal intubation, and was of better quality than isoflurane induction. Both anesthetics were associated with rapid and smooth recovery., Conclusions: Sevoflurane mask induction is faster and of better quality, compared with isoflurane, in adult dogs. Recovery time and quality are comparable., Clinical Relevance: On the basis of these results, sevoflurane is a suitable inhalant anesthetic for mask induction and recovery in adult dogs and appears to have some advantages over isoflurane, including faster and smoother mask induction.

Objective: To compare, in psittacines, the mydriatic effects of several topically applied curariform, sympathomimetic, and parasympatholytic drugs with and without the addition of surface-acting penetrating agents., Design: Prospective, randomized controlled trial., Animals: 10 adult cockatoos (Cacatua sulphurea subspecies), 2 adult African gray parrots (Psittacus erithacus), and 3 adult Blue-fronted Amazon parrots (Amazona aestiva)., Procedure: Three curariform drugs (d-tubocurarine, pancuronium, and vecuronium bromide) and 2 autonomic drugs (atropine and phenylephrine hydrochloride) were evaluated. Drugs were tested with and without the addition of a surface-acting penetrating agent, either saponin or benzalkonium chloride. The agent that resulted in the most significant change in pupillary diameter with the fewest systemic side effects in the cockatoos then was evaluated for its effects in the African gray parrots and the Blue-fronted Amazon parrots. During each drug trial, 1 eye was randomly selected to receive the control drug (0.9% NaCl), and the opposite eye was selected to receive the test drug. Each pupil was videotaped 5 (cockatoos only), 15, 30, 45, 60, and 75 minutes after treatment. Pupil diameters were measured by use of a computerized image analysis system. Data for pupil size were analyzed by means of repeated measures ANOVA., Results: Vecuronium without the addition of a surface-acting penetrating agent produced the most consistent and greatest pupillary dilatation in all 3 species with the fewest systemic side effects., Clinical Implications: Vecuronium is potentially a clinically useful, topical mydriatic agent for use in avian species. Documented differences in the prevalence of systemic side effects between species suggests that caution should be applied when applying this drug bilaterally.

The use of butorphanol as an analgesic in a psittacine species was evaluated by determining its isoflurane-sparing effects. The Effective Dose 50 (ED50) of isoflurane was determined using a bracketing technique based on the purposeful movement elicited by pressure applied to a digit with a hemostat. The ED50 of isoflurane for 11 cockatoos (four greater sulfur crested, three lesser sulfur crested, and four citron crested) was determined to be 1.44 +/- 0.07%. After the administration of 1 mg/kg of butorphanol tartrate intramuscularly (IM), the ED50 was significantly (P < .05) decreased to 1.08 +/- 0.05%. Physiological variables that changed significantly included decreases in heart rate, tidal volume (Vt), inspiratory (Ti) and expiratory times (Te), and an increase in respiratory rate. No complications resulted because of these changes. Based on the results, butorphanol produces an isoflurane-sparing effect in cockatoos and has the potential to be a useful analgesic in psittacines.

A 3.5-year-old domestic long-hair cat was admitted to the veterinary hospital for routine procedures, including dental prophylaxis. The cat appeared clinically normal. General anesthesia was induced, and 30 minutes later, the pop-off valve was inadvertently left in a closed position. The cat developed pneumothorax, which was treated via thoracentesis and administration of oxygen. The condition resolved and the cat was released from the hospital to its owner. Barotrauma resulted because of high pressure in the anesthetic circuit. Barotrauma is a life-threatening complication of general anesthesia.

Dogs given parenteral anticholinergic drugs have been thought to be at risk for development or exacerbation of elevated intraocular pressure (IOP). In a randomized, blinded, placebo-controlled study, we evaluated the effect of intramuscular glycopyrrolate (0.01 mg/kg) on pupil diameter and IOP in unanesthetized normal dogs. Treatment with glycopyrrolate did not change pupil diameter or IOP from baseline, nor were there differences between glycopyrrolate and saline-treated (control) dogs. In addition, the authors retrospectively reviewed the medical records of 2,828 dogs undergoing general anesthesia between April 1987 and September 1990 to determine if there was an association between parenteral anticholinergic medication and postanesthetic elevation in IOP. The authors also determined the frequency of bradycardia requiring anticholinergic therapy during anesthesia in dogs with glaucoma. Of the 2,828 cases reviewed, the records of 46 dogs coded for glaucoma were examined in detail. The 46 dogs underwent 62 episodes of anesthesia, with 23 episodes including exposure to an anticholinergic drug. An increase in IOP from preanesthetic to postanesthetic measurement occurred in three dogs. One of these dogs received anticholinergic medication for bradycardia during anesthesia. The postanesthetic elevation in IOP in this dog was probably not drug related. Preanesthetic anticholinergic administration did not affect the incidence of anticholinergic administration for bradycardia during the anesthetic episode. Anticholinergic therapy during anesthesia was more frequent when the preanesthetic medication included an opiate drug. These studies do not indicate an association between parenteral anticholinergic administration and elevations in IOP.

When compared with halothane, isoflurane has several distinct characteristics. Vaporizer settings are higher because of its lower potency. Respiratory rates will be slower, and intraoperative changes in depth and recovery from surgical depth of anesthesia will be more rapid, although total recovery times frequently will not be different. Halothane and isoflurane appear similar in their effects on ocular reflexes and mean arterial blood pressure. Recovery from isoflurane should be managed to provide added sedation or physical support if the horse attempts to stand prematurely.

The role of succinylcholine in the precipitation of malignant hyperthermia (MH) necessitates the testing of new neuromuscular relaxants for their ability to trigger MH in MH-susceptible swine before general human use. We tested doxacurium and mivacurium, two new nondepolarizing bis-benzylisoquinolinium neuromuscular relaxants, at ED95 and at four times ED95 doses in swine previously documented to be MH-susceptible. In none of the 16 animals was MH triggered after administration of these relaxants, whereas all animals developed fatal MH after administration of halothane or halothane plus succinylcholine. Muscle biopsy specimens taken before administration of the relaxant confirmed that all animals had increased sensitivity to halothane, caffeine, or both. Thus, we conclude that doxacurium and mivacurium are not triggering agents of malignant hyperthermia in MH-susceptible swine.

Anesthesia of equids is associated with pulmonary dysfunction. Cardiovascular and respiratory effects of inhalation anesthetic agents and duration of anesthesia have been studied, using oxygen as the carrier gas. To our knowledge, the effects of inspired oxygen have not been determined. We studied the cardiovascular and respiratory effects of 2 inspired oxygen fractions (0.30 and greater than 0.85) in 5 laterally recumbent, halothane-anesthetized horses. Mean systemic arterial blood pressure, cardiac output, central venous pressure, pulmonary arterial pressure, arterial pH, and arterial base excess were similar in horses of the 2 groups during 4 hours of anesthesia at constant end-tidal halothane concentration. End-tidal partial pressure of CO2, arterial partial pressure of CO2 and O2, and alveolar-to-arterial O2 tension difference were greater in horses exposed to the higher oxygen concentration. On the basis of the data obtained, we suggest that greater hypoventilation and ventilation/perfusion mismatch occur when horses are breathing high-oxygen fraction. Arterial partial pressure of O2 was not different between the 2 groups of horses after they were disconnected from the anesthesia circuit and allowed to breathe room air. Horses recovered from anesthesia without complications.

Anesthetic management of the pediatric patient is a challenge which can give rise to a most rewarding anesthetic management if one takes into consideration the normal physiological function of the pediatric patient. One should choose the appropriate medications which may safely be administered to an animal of this age. Control of anesthesia through the use of appropriate anesthetic equipment and the use of appropriate monitoring will aid safe management. The selection of adjunct medications can achieve control of complications and aid ultimate uncomplicated recovery.

Anesthetic management of the pleasure horse consists of the appropriate selection and administration of pre-anesthetic medications including anticholinergics, tranquilizers and narcotics followed by appropriate techniques of anesthetic induction. The anesthetic induction must vary somewhat for the pleasure horse practice since many of the procedures are completed on farms and ranches. As a result the inducing of anesthesia will frequently be with the same agent which will be used to maintain anesthesia. Noticeably will be the reduction and duration of anesthesia and surgical time. The induction of anesthesia will predominately be with ultra-short barbiturates alone or in combination with muscle relaxants or combinations of tranquilizers and dissociative anesthetics. Supplemental injections of intravenous agents or halothane, methoxyflurane or enflurane may be used to maintain anesthesia. Recoveries can be expected to vary according to the duration of anesthesia and the selection of agents that have been used. Anesthetic complications predominately consist of cardiopulmonary responses and those associated with recovery.

Ketamine, 3 X 10(-4) M, was found to inhibit transmural electrical stimulation-induced contractile responses of the mainstem and hilar bronchi isolated from reserpine-pretreated guinea-pigs. This concentration of ketamine did not cause direct smooth muscle relaxation in these preparations and a smaller concentration (3 X 10(-5) M) was ineffective in blocking contractions. The pattern of inhibition produced by ketamine was similar to that produced by atropine, 1 X 10(-6) M, in both preparations and was observed at the larger stimulation frequencies employed. When studied in the presence of atropine to optimize noncholinergic-induced contractions, ketamine did not antagonize contractile responses to transmural electrical stimulation. After pretreatment of the isolated tissues with capsaicin, 1 X 10(-6) M, to optimize cholinergic-induced contractions, ketamine produced inhibition of responses to electrical stimulation. Ketamine, 3 X 10(-4) M, produced a shift to the right of the dose-response curve without altering the maximum contractile responses to carbachol, but had no effect on dose-response curves to substance P, the putative noncholinergic transmitter in these bronchial segments. The data suggest that ketamine exerts a selective inhibitory effect on cholinergically mediated contractions in guinea-pig bronchi and that this antagonism is largely exerted post-junctionally, at the level of the smooth muscle muscarinic receptors.

Wick catheters were used to measure intracompartmental pressures of the extensor carpi radialis muscles and long heads of the triceps brachii muscles of 7 horses maintained under halothane anesthesia during controlled ventilation. Horses were positioned in left lateral recumbency on a water bed for 4 hours. Using a crossover design, 6 of the 7 horses were subjected to normotensive and hypotensive anesthesia on separate occasions. Hypotension was achieved by increasing the inspired halothane concentration. Hematologic and biochemical measurements were determined at designated intervals before, during, and for 7 days after each anesthetic episode. Under hypotensive conditions, 2 horses developed severe generalized myositis and were euthanatized. Three of the 5 other horses developed swelling of the downside masseter muscle, 4 demonstrated mild extensor deficits of the downside forelimb, and 1 had a severe extensor deficit of the uppermost hind limb. As a group, the hypotensive horses had markedly increased activities of serum enzymes (creatine kinase, aspartate transaminase, and blood lactate) and abnormalities in calcium-phosphorus homeostasis. Lameness or enzyme alterations were not observed in normotensive horses. Although the intracompartmental pressure values were markedly increased in the muscle bellies of the compressed limbs of all horses, there was a statistically significant difference in intracompartmental pressures between the downside or compressed muscle compartments of the extensor carpi radialis of hypotensive and normotensive horses. High concentrations of halothane may predispose anesthetized horses to postanesthetic myositis, even when protective padding is used. Intracompartmental muscle pressure, as measured by the wick catheter, may not be a reliable predictor of equine postanesthetic lameness.

The decreased adaptability normally associated with aging animals is described. Anesthetic evaluation and management of these alterations can be successfully completed if wide variations in organ functions are not required of the patient by the surgeon or anesthetist.

Plasma fluoride, urine fluoride and urine oxalate concentrations were measured before administering an anesthetic to 8 dogs, and at 0, 3, 9, 24, 48, and 72 hours following 1.5 hours of anesthesia with 1% methoxyflurane. Plasma and urine osmolalities were measured and compared with fluoride and oxalate values. Fluoride concentration increased in both plasma and urine following anesthesia when compared with the preanesthetic concentrations. Maximum mean plasma inorganic fluoride was 106.71 mumoles per liter (+/- 25.44 SE) at 9 hours after exposure to methoxyflurane was completed. By 72 hours after exposure to methoxyflurane the plasma fluoride concentration was 23.47 microM/L (+/- 5.74 SE). Mean urine inorganic fluoride concentration was highest at 9 hours after exposure to methoxyflurane and reached 6047.03 microM/L (+/- 1378.46 SE) as compared to the mean preanesthetic base-line concentration of 542.68 microM/L (+/- 132.93 SE), and the 72 hour mean urine fluoride concentration which was 1593.78 microM/L (+/- 579.46 SE). Urine oxalate concentrations, when compared with urine osmolality (mg/mOsm), increased throughout the study. The 72-hour concentration after exposure to methoxyflurane was 2.5 times the preanesthetic (mg/mOsm) oxalate concentration. Plasma osmolality did not change markedly during the study. Urine osmolalities varied between animals and collection times, but a consistent pattern did not occur. Clinical and laboratory signs of renal dysfunction were not observed in any animal during the study.

Arterial blood gas tensions, pulmonary mechanics, and lung volumes were measured in 4 sedated ponies every hour for 6 hours and in 5 ponies 4 times at 2-month intervals to assess the short- and long-term reproducibility of pulmonary function measurements. Variability in blood gas tensions was small over the short- and long-term measurement periods, whereas the variability in total respiratory resistance and functional residual capacity was small over the short term but larger over the long term. The variability in tidal volume, minute ventilation, respiratory rate, and dynamic and quasistatic compliance was relatively large over the short and long term. When data from 5 ponies were pooled, significant change did not occur in any of the variables over a 6-month period. Vagal blockade increased tidal volume and decreased respiratory rate and total respiratory resistance, but arterial blood gas tensions, minute ventilation, dynamic compliance, quasistatic compliance, functional residual capacity, and lung and thoracic cage pressure-volume curves were unaffected. Total respiratory resistance decreased with increasing lung volume, with the vagus intact. After vagal blockade, the decrease in total respiratory resistance with lung volume was minimal. Dynamic compliance was frequency independent over a range of 15 to 60 breaths/min-1, suggesting that measurable inhomogeneity of peripheral time constants did not exist in our clinically normal ponies.

A 2-year-old Old English Sheepdog had right-side congestive heart failure characterized by pericardial effusion, pleural effusion, ascites, and increased pulmonary wedge pressure. A diagnosis of atrial septal defect was made by means of cardiac catheterization and angiography. Surgical correction initially was deferred because of pulmonary hypertension. However, when congestive heart failure could not be managed adequately, surgical correction was attempted. Postsurgically, thrombocytopenia developed and that led to bleeding, oliguira, and pulmonary edema. The bleeding was controlled by whole blood transfusion, but the oliguria and pulmonary edema were not resolved, even with intensive diuretic therapy. The dog died 24 hours after surgery.