Inhalational anaesthetic agent consumption within a multidisciplinary veterinary teaching hospital: an environmental audit
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SUBMITTER: Elzahaby D
PROVIDER: S-EPMC11297182 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:Of the total carbon footprint of Australia, 7% is attributed to healthcare. In the UK, inhalational agents make up 5% of the healthcare carbon footprint. This systematic review aims to determine which methods of education about the environmental impact of inhalational anaesthetic agents can be utilised to promote behaviour change, reducing the anaesthetic-related carbon footprint. This systematic review sourced records from CINAHL, EMBASE, ERIC, JBI and MEDLINE from 1970 to March 2022. The search identified 589 records, 13 of which met eligibility criteria after the screening process, in which 10 of these records were conference abstracts. Education curricula focused on inhalational agent choice (69%), lowering the fresh gas flow during maintenance anaesthesia (69%), encouraging alternatives such as total intravenous anaesthesia (23%) and/or switching off the gas on transfer (8%). The most common teaching techniques utilised in education curricula were didactic lectures (85%), visual prompts (54%), emails (46%), and conversation forums (31%). All but one study reported a positive relationship between teaching sessions and behavioural change resulting in lower inhalational anaesthetic use by participants and their organisations, reducing healthcare-associated emissions. This systematic review has demonstrated that single education sessions as well as multi-focused, multimodal education curricula on the topic of greener anaesthesia can be beneficial in promoting behavioural change.
| S-EPMC11531086 | biostudies-literature
Project description:The transition into the clinical environment is challenging and associated with significant stress and anxiety. This study aimed to examine the perspectives of students on the characteristics important for preparedness for clinical learning and the influence of gender, age, and graduate status on those perspectives. This descriptive, questionnaire-based study of 62 characteristics categorised into six themes was conducted within the Surrey School of Veterinary Medicine completed by 139 students commencing their final clinical year. The Friedman test and post-hoc Wilcoxon signed rank sum test explored for differences in ranking across the themes. Ordinal logistic regression and Mann-Whitney U pairwise comparisons were utilised to investigate for effects of gender, age, and graduate status on theme ranking. There was a significant difference (P <0.05) between medians for themes of preparedness characteristics with comparisons revealing willingness and communication and interaction as the most highly rated characteristics. Knowledge and understanding were viewed as the least important characteristic. Regression and pairwise Mann-Whitney U comparisons confirmed no significant effects (P >0.05) of gender, age or graduate status on student rating of preparedness characteristics. Integrating learning opportunities of those preparedness characteristics in the pre-clinical curriculum may improve students' preparedness for the clinical environment.
| S-EPMC8118455 | biostudies-literature
Project description:ObjectiveTo describe a large population of dogs with a diagnosis of hyperadrenocorticism at the time of death in North American veterinary teaching hospitals, and to identify comorbid conditions associated with hyperadrenocorticism.Materials and methodsRetrospective cohort study of 1519 dogs with hyperadrenocorticism from a population of 70,574 dogs reported to the Veterinary Medical Database. Signalment, presence or absence of hyperadrenocorticism, aetiology of hyperadrenocorticism (if described), frequency of select comorbidities and causes of death were evaluated in dogs with and without hyperadrenocorticism.ResultsHyperadrenocorticism was more frequent in females. Neutering was associated with a minor, but significant, increase in the odds of hyperadrenocorticism. Hyperadrenocorticism was the presumed cause of death of 393 (25∙9%) of affected dogs. When aetiology was specified (527 dogs, corresponding to 34∙7% of the cases), pituitary-dependent hyperadrenocorticism [387 (73∙4%) out of 527 dogs] was more common than functional adrenocortical tumour [136 (25∙8%) out of 527 dogs). Hyperadrenocorticism was over-represented in certain expected (miniature poodle, dachshund) and unexpected (Irish setter, bassett hound) breeds compared with the population at large. Of the select comorbidities investigated, dogs with hyperadrenocorticism were at increased risk for concurrent diabetes mellitus, urinary tract infection, urolithiasis, hypertension, gall bladder mucocoele and thromboembolic disease compared with dogs without hyperadrenocorticism.Clinical significanceHyperadrenocorticism is significantly associated with certain comorbid conditions but is not a major cause of mortality in affected dogs. Documented patterns now provide targets for prospective clinical research.
| S-EPMC6559942 | biostudies-literature
Project description:Introduction Ammonia is a highly toxic irritant gas, and its toxicity usually occurs from occupational exposure. Most are unintentional toxicity. It causes tissue damage via exothermic reaction with body tissues causing liquefactive necrosis. Presentation depends on the level and duration of exposure. Management is supportive and its antidote is not available yet. Presentation of case We report a case of a 22-year-old male with accidental workplace exposure from coolant damage and leakage. He had altered mental status with visible injury to the nasal cavity, and ulcerated laryngeal mucosa with asymmetric vocal cords on bronchoscopy. Computed tomography showed right lower lobe consolidations. A muti-disciplinary approach and prompt management with respiratory support along with inhaled steroids and bronchodilators, antibiotics, electrolyte replacement, analgesics, and supportive eye and oral treatments were initiated. He had to be managed with a high-flow nasal cannula with subsequent tapering of the oxygen supplementation with titration. Discussion Inhalation injury due to ammonia toxicity can have varied presentations from mild to severe life-threatening respiratory distress and neurological deterioration. Complications can range from upper airway edema to pulmonary edema. Most of these are usual findings except for the presence of pneumothorax. It could be due to the pre-existing lung status or oxygen therapy but the literature is inadequate. Conclusion Ammonia inhalational injury may be associated with pneumothorax. It is important to have a multi-disciplinary approach and in-hospital management of ammonia toxicity as well as to raise awareness regarding the work environment and timely recognition of the possible occupational health hazards. Highlights • Pneumothorax in a case of inhalation ammonia injury.• Early recognition and a multispecialty approach are vital for the outcome of the toxicity.• Awareness of occupational safety measures in the workplace can help minimize the associated health hazards.
| S-EPMC9577859 | biostudies-literature
Project description:The digitalization of university teaching has been taking place for many years and, in addition to traditional teaching formats such as practicals and face-to-face lectures, more and more e-learning courses have been used in veterinary education for several years. In the context of the COVID-19 pandemic, universities across Germany had to switch to an ad-hoc, purely digital summer semester. This study evaluated the experiences and implementation of the digital summer semester 2020 at the University of Veterinary Medicine Hannover (TiHo) Foundation from the perspective of the teaching staff. In addition to the technical equipment used by lecturers, this survey also focused on the effects of the digital semester on teaching and the future practicality of digital teaching formats and strategies in veterinary education. Therefore, a questionnaire was designed and distributed among lecturers involved in the digital summer semester 2020. One hundred and three completed questionnaires were evaluated. The results of the evaluation show that teachers see huge potential in blended learning as a teaching method in veterinary education. In addition, teachers were able to digitize teaching well with the available hardware and software. The teaching staff saw difficulties above all in the loss of practical training and in the digitalization of practical exercises. Teachers also needed significantly more time to plan and implement digital teaching compared to pure face-to-face teaching. In summary blended learning offers many advantages, such as increased flexibility for students and teaching staff. In order to be able to use digital teaching methods and strategies profitably in veterinary education in the future, well thought-out didactic concepts and further technical expansion of the universities are required. In addition, the digital skills of teaching staff should be further trained and promoted.
| S-EPMC11238364 | biostudies-literature
Project description:Multilocus DNA sequence data were used to assess the genetic diversity and evolutionary relationships of 67 Fusarium strains from veterinary sources, most of which were from the United States. Molecular phylogenetic analyses revealed that the strains comprised 23 phylogenetically distinct species, all but two of which were previously known to infect humans, distributed among eight species complexes. The majority of the veterinary isolates (47/67 = 70.1%) were nested within the Fusarium solani species complex (FSSC), and these included 8 phylospecies and 33 unique 3-locus sequence types (STs). Three of the FSSC species (Fusarium falciforme, Fusarium keratoplasticum, and Fusarium sp. FSSC 12) accounted for four-fifths of the veterinary strains (38/47) and STs (27/33) within this clade. Most of the F. falciforme strains (12/15) were recovered from equine keratitis infections; however, strains of F. keratoplasticum and Fusarium sp. FSSC 12 were mostly (25/27) isolated from marine vertebrates and invertebrates. Our sampling suggests that the Fusarium incarnatum-equiseti species complex (FIESC), with eight mycoses-associated species, may represent the second most important clade of veterinary relevance within Fusarium Six of the multilocus STs within the FSSC (3+4-eee, 1-b, 12-a, 12-b, 12-f, and 12-h) and one each within the FIESC (1-a) and the Fusarium oxysporum species complex (ST-33) were widespread geographically, including three STs with transoceanic disjunctions. In conclusion, fusaria associated with veterinary mycoses are phylogenetically diverse and typically can only be identified to the species level using DNA sequence data from portions of one or more informative genes.
| S-EPMC5078561 | biostudies-literature
Project description:A teaching workshop was delivered for faculty members of East African colleges of veterinary medicine to foster teaching development and reflection. The goal was for participants to use knowledge gained to improve teaching skills. The approach was to "train the trainer" so attendees could transfer new knowledge to colleagues at their institutions. Techniques were used to increase the likelihood that participants would apply the training. A culturally responsive survey was developed to assess training transfer 1 year later. Pilot survey results suggest that participants applied what they learned and shared with colleagues largely due to peer and supervisor support.Supplementary informationThe online version contains supplementary material available at 10.1007/s40670-021-01428-2.
| S-EPMC8651839 | biostudies-literature
Project description:Chromosomal DNA must be in single-strand form for important transactions such as replication, transcription, and recombination to occur. The single-strand DNA (ssDNA) is more prone to damage than double-strand DNA (dsDNA), due to greater exposure of chemically reactive moieties in the nitrogenous bases. Thus, there can be agents that damage regions of ssDNA in vivo while being inert toward dsDNA. To assess the potential hazard posed by such agents, we devised an ssDNA-specific mutagenesis reporter system in budding yeast. The reporter strains bear the cdc13-1 temperature-sensitive mutation, such that shifting to 37°C results in telomere uncapping and ensuing 5' to 3' enzymatic resection. This exposes the reporter region, containing three closely-spaced reporter genes, as a long 3' ssDNA overhang. We validated the ability of the system to detect mutagenic damage within ssDNA by expressing a modified human single-strand specific cytosine deaminase, APOBEC3G. APOBEC3G induced a high density of substitutions at cytosines in the ssDNA overhang strand, resulting in frequent, simultaneous inactivation of two reporter genes. We then examined the mutagenicity of sulfites, a class of reactive sulfur oxides to which humans are exposed frequently via respiration and food intake. Sulfites, at a concentration similar to that found in some foods, induced a high density of mutations, almost always as substitutions at cytosines in the ssDNA overhang strand, resulting in simultaneous inactivation of at least two reporter genes. Furthermore, sulfites formed a long-lived adducted 2'-deoxyuracil intermediate in DNA that was resistant to excision by uracil-DNA N-glycosylase. This intermediate was bypassed by error-prone translesion DNA synthesis, frequently involving Pol ζ, during repair synthesis. Our results suggest that sulfite-induced lesions in DNA can be particularly deleterious, since cells might not possess the means to repair or bypass such lesions accurately.
| S-EPMC3521656 | biostudies-literature
Project description:Background and aimsDespite its superior blood-gas partition coefficient compared to sevoflurane, use of desflurane in neurosurgery is limited due to concerns about cerebral vasodilation and potential adverse haemodynamic effects. This study aims to systematically evaluate the comparative efficacy and safety of desflurane and sevoflurane in neurosurgical procedures.MethodsA search was performed in the Cochrane Library, Scopus, Europe PMC and Medline databases for articles published until 5 November 2024 using a combination of pertinent keywords. This review includes randomised controlled trials (RCTs) that analyse the comparison between desflurane and sevoflurane in neurosurgery. The risk of bias from each RCT was assessed using the Risk of Bias version 2 tool from Cochrane Collaboration. We utilised random-effects models to evaluate the mean difference (MD) and odds ratio (OR) for the outcomes presented.ResultsFourteen trials, encompassing 904 patients, were included in the analysis. Our analysis revealed significantly faster recovery profiles with desflurane, including reduced emergence time [MD -2.26; 95% confidence interval (CI): -2.99, -1.52, P < 0.00001, I 2 = 71%], extubation time (MD -3.02; 95% CI: -3.89, -2.15, P < 0.00001, I 2 = 79%) and overall recovery time (MD -3.26; 95% CI: -5.01, -1.51, P = 0.0003, I 2 = 83%), compared to sevoflurane. Desflurane was associated with better postoperative cognitive function, as evidenced by higher short orientation memory concentration test scores - a measure of attention and memory - at 15 min (MD: 2.26; 95% CI: 0.13, 4.39, P = 0.04, I 2 = 91%) and 60 min (MD: 0.29; 95% CI: 0.09, 0.50, P = 0.005, I 2 = 0%) after extubation. We did not find any significant difference in the intra- and/or postoperative events, such as emergence agitation, nausea and vomiting, shivering, hypertension, hypotension, tachycardia, bradycardia, pain and convulsions, between the two groups of intervention.ConclusionThis study suggests that desflurane anaesthesia offers faster recovery with a similar safety profile to sevoflurane for neurosurgery.
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Project description:Education for the general public about antibiotic resistance is advocated as a key component of our response to this crisis. Since this is a multidisciplinary problem encompassing natural, medical and social sciences, it is an educational challenge as both students and lecturers will have vastly different backgrounds in the topics. Here we describe an online multidisciplinary course on antibiotic resistance spanning topics as diverse as chemistry and practical philosophy. The target group was any post-secondary school student and the participating students had different occupations and educational experience. Although as many as 38% of the students were currently studying natural sciences at university, the course included a diverse group with medical professionals (16%) and teachers (6%) making up a significant fraction of the class. The outcomes based on examination and the course evaluations were very positive and we have indications that the information students gained from this course has been spread to others. Unlike other online courses addressing antibiotic resistance, this course is both accessible to a wide range of students and covers a broad range of topics. We advocate courses like ours as an effective tool in educating the public about this crisis.
| S-EPMC8962684 | biostudies-literature