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Introduction The cause of colic in the postpartum mare can be a challenge to classify. A rapid, prompt diagnosis is crucial to initiate appropriate treatment. This study investigates the diagnostic utility of abdominocentesis in the postpartum mare. Materials and Methods Records were reviewed for mares presented to Scone Equine Hospital (2005-2019) within 7 days postpartum. Mares were included if abdominocentesis was performed with fluid cytology and diagnosis either a) at surgery, laparoscopy or post-mortem or b) uncomplicated postpartum haemorrhage at abdominal ultrasonography confirmed by abdominocentesis (RBCC > 1x1012 cells/L and TP >20g/L). Results The 111 included mares were classified via colic origin into groups: GIT (n=33), uterine compromise (n=47), haemoabdomen (n=19) and other (n=13). Haemoabdomen cases were more likely to have a systemic PCV ≤ 41% (P < 0.0001), plasma protein ≤ 60g/L (P < 0.0001), peritoneal PCV ≥16% (P < 0.0001), peritoneal WBCC ≤ 38.6 x 109/L (P = 0.0014), no plant material (P < 0.0013), no degenerate neutrophils (P = 0.0063) and no bacteria (P < 0.0001). Uterine cases had a higher peritoneal WBCC (median: 109 x 109/L, P = 0.0074) than GIT cases (median: 31.9 x 109/L). Relevance to Australian Clinical Equine Practice Abdominocentesis is a useful aid to distinguish uncomplicated haemoabdomen from colic of GIT and uterine causes in the post-partum mare. Abdominocentesis could not reliably differentiate GIT from uterine causes in this study and exploratory laparotomy remains a useful tool to establish a definitive diagnosis in postpartum colic. [ABSTRACT FROM AUTHOR]

Background: The equine conjunctival microbiota has often been reported to be dominated by Gram-positive species such as Staphylococcus sp., Bacillus sp., and Corynebacterium sp. However, traditional culture-based methods can only recover a fraction of the bacterial species present in the sample., Objectives: This pilot study aimed at exploring the diversity of the equine conjunctival microbiota using culture-independent methods., Study Design: Eight horses were included in this study, and only eyes with normal ophthalmic examination (n = 15 eyes) were sampled., Methods: Conjunctival biopsies (culture-independent) were collected, and DNA was extracted from the tissues. Bacterial communities in conjunctival biopsies were characterized by next-generation sequencing of the 16S rRNA genes. Individual reads were ascribed to operational taxonomic units (OTUs) using BLASTn and Greengenes databases. Species richness, evenness, and Good's coverage were determined for each conjunctiva-associated microbial community., Results: Culture-independent samples produced a total of 329 bacterial OTUs. The main OTUs identified in the study belonged to the Gram-negative species Ralstonia mannitolilytica (88.0%), Nicoletella semolina (3.3%), and Pseudomonas tolaasii (1.5%)., Conclusions: Contrary to previously published data based on culture-dependent methods, the horse eye microbial community was dominated by Gram-negative bacteria of the phylum Proteobacteria., (© 2020 American College of Veterinary Ophthalmologists.)

Health care facilities can be dangerous places. The mission of the Occupational Safety and Health Administration (OSHA) is to improve the safety of the American workplace by developing and implementing standards that prevent occupational injury, illness, and death. Perioperative services are performed in environments where exposure to bloodborne pathogens is a daily occurrence, making implementation and compliance with OSHA standards very important. Employees and employers must remain current with workplace safety requirements, including use of personal protective equipment. This article presents implications of the OSHA standards for employers, educators, and employees.

Purpose: This study was performed to determine whether early duplex findings predicted restenosis after carotid endarterectomy., Methods: One hundred ninety-two symptomatic patients who underwent carotid endarterectomy were studied with color duplex imaging at 1 day and 1 week after surgery to identify minor residual disease (causing < 50% stenosis), arterial kinking, and suture stricture, and to measure the external and luminal diameters of the carotid bulb and distal internal carotid artery. Patients were then observed prospectively with duplex surveillance for a median of 24 months to identify > 50% restenosis., Results: Twenty-five stenoses > 50% of the operated carotid artery (13%) were identified, four at 1 day (residual) and 21 at a median follow-up of 6 months (restenosis). On multiple logistic regression analysis, > 50% restenosis was found to be associated with minor day-1 residual stenosis (p = 0.01) and with small luminal diameter of the distal internal carotid artery (p = 0.03) as measured 1 week after carotid endarterectomy. Life table analysis showed restenosis at 24 months to be more common for patients with below-median than patients with above-median carotid bulb external diameter (18% vs 5%, respectively; p = 0.01)., Conclusions: Duplex scanning within a week of carotid endarterectomy identifies > 50% residual stenosis, in addition to minor residual 25% to 50% stenosis and small carotid dimensions, which are good predictors of > 50% restenosis at 6 months.

Purpose: The value of duplex surveillance and the significance of contralateral carotid disease after endarterectomy have been assessed., Methods: Three hundred five patients were observed prospectively after carotid endarterectomy for a median time of 36 months (range, 6 to 96 months), with duplex surveillance performed at 1 day; 1 week; 3, 6, 9, and 12 months; and then each year after endarterectomy., Results: Thirty patients (10%) had ipsilateral symptoms (13 strokes, 17 transient ischemic attacks [TIAs]) at a median time of 6 months (range, 0 to 60 months). Life table analysis demonstrated that ipsilateral stroke was equally common for patients who had > or = 50% restenosis (3% at 36 months) and those who did not (6% at 36 months, p > 0.5). Twenty-three patients (8%) developed symptoms (stroke 5, TIA 14) attributable to the contralateral carotid artery at a median time of 9 months (range, 0 to 36 months) after endarterectomy. By life table analysis, 40% of patients with 70% to 99%, 6% with 50% to 69%, 1% with < 50% contralateral internal carotid stenosis, and 5% with contralateral carotid occlusion at the time of endarterectomy had a contralateral TIA in the 36 months after endarterectomy (p < 0.01). However, contralateral stroke was not significantly more common for patients with severe contralateral internal carotid stenosis demonstrated at the time of endarterectomy (< 50% stenosis, 0%; 50% to 69%, 3%; 70% to 99%, 7%; occlusion, 6% stroke rate at 36 months). Seven of the 32 patients who developed progression of contralateral disease had a TIA, compared with 11 of 227 patients who did not develop progression of contralateral disease (p < 0.01). None of the 12 patients who progressed from a < 70% to a 70% to 99% contralateral stenosis had a stroke., Conclusions: After carotid endarterectomy restenosis is rarely associated with symptoms; contralateral stroke is rare and is not associated with progressive internal carotid artery disease suitable for endarterectomy. This study has shown no benefit from long-term duplex surveillance after carotid endarterectomy. Selective clinical follow-up of patients who have high-grade contralateral stenoses would appear more appropriate.

Carotid surgery was performed urgently on 22 occasions out of 300 (7%). Of 15 patients with progressing stroke, in all, progression of stroke was arrested. Six patients recovered virtually completely and eight had improving neurological deficit after surgery, i.e. 14 of 15 (93%) benefitted. The other patient had arrest of stroke for a week and then suffered ipsilateral stroke. Of the seven patients operated upon for crescendo transient ischaemic attacks, five had no deficit after surgery or further attacks. The sixth patient had no further attacks but was found to have a tiny, neurological deficit. In these six patients (87%), surgery was greatly beneficial. The remaining patient had a fatal stroke following operation.

The purpose of this study was to determine the prevalence, progression and prognosis of asymptomatic carotid artery stenosis in a population of 1198 patients with peripheral arterial disease (n = 986) or aortic aneurysm (n = 212), mean age 67.7 (S.D. = 10.0) years. Patients were recruited from 1985 to 1989 with annual assessment of carotid artery stenosis of over 50% using Doppler peak frequency analysis. Patients were followed up annually until 1990 or their first event, transient ischaemic attack (TIA), amaurosis fugax (AFx), stroke without antecedent TIA, or death (mean follow up 20 months). Life tables were used to determine risk of events in different patient groups. Only 164 (13.7%) patients had a stenosis of over 50% in either of the common or internal carotid arteries, disease was bilateral in 33 (2.8%) patients. A total of 33 patients (2.8%) had over 80% stenosis in common or internal carotid arteries. During follow up 37 (3.1%) patients developed a stenosis greater than 50%. Only 27 (2.3%) patients developed a stroke, 11 of which were fatal. A further 33 (2.8%) suffered a TIA or AFx and a total of 155 patients died during follow up. The total neurological event rate (TIA, AFx and stroke) was significantly associated with the presence of over 50% stenosis, [relative risk (RR) = 2.98, 95% confidence interval (95% C.I.) 1.68-5.29, p less than 0.001] and carotid bruit (RR = 1.16, 95% C.I. 1.23-3.81, p = 0.010). Although risk of stroke was higher in patients with a 50% stenosis, this failed to achieve statistical significance (RR = 1.78, 95% C.I. 0.66-4.80, p = 0.275).(ABSTRACT TRUNCATED AT 250 WORDS)