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Abstract

Objective—To identify reasons for engagement in continuing veterinary medical education (CVME) activities, obstacles to participation, ways to provide more effective programs, and ideas to improve participation in CVME.

Design—Focus group interviews.

Sample Population—Selected practicing veterinarians from a state that did mandate continuing education for relicensure.

Procedure—12 focus group interviews were held throughout the state of California between May and September 1998. Practitioners were asked to respond to questions about where they obtain information to improve their practice, what value they see in CVME, what motivates them to participate, what obstacles to CVME participation exist, and ways CVME providers and practitioners could overcome those obstacles.

Results—84 practitioners participated in the focus group interviews. In addition to the educational value of CVME, participation was used to rejuvenate practice life and prevent feelings of isolation. Continuing education activities ranged from problem-oriented chats with colleagues to formal educational programs. Timing of events, distance, money, solo practice, stage of career, and family demands were identified as barriers to participation. Designing and marketing CVME with specific learning objectives and for specific career stages and using new educational delivery technologies were suggested to overcome some of these barriers.

Conclusion and Clinical Relevance—If CVME is to improve practice and patient care, it should be integrated into a practice's strategic planning and considered a legitimate business expense. Decisions about CVME participation are made easier if program objectives are clearly outlined. (J Am Vet Med Assoc 2000;217:1001–1006)

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine which antimicrobials that are used to treat neonatal foals with septicemia attributable to Escherichia coli will minimize endotoxin release from bacteria and subsequent activity of inflammatory mediators while maintaining bactericidal efficacy.

Sample Population—Blood samples from 10 healthy foals.

ProcedureEscherichia coli isolates A and B were isolated from 2 septicemic foals, and minimal inhibitory concentrations (MIC) were determined for 9 antimicrobials. Five of these antimicrobials were tested in vitro at 2 and 20 times their respective MIC. Whole blood or mononuclear cells grown in tissue- culture media were incubated with 105 colonyforming units of E coli and each antimicrobial or saline (0.9% NaCl) solution. After 6 hours, number of viable bacteria remaining was determined, and supernatant was tested for endotoxin and tumor necrosis activity.

Results—Testing in whole blood was compromised by bactericidal effects of the blood itself. In mononuclear cell suspensions, each antimicrobial significantly reduced the number of viable bacteria to low or undetectable amounts. Antimicrobials did not differ significantly in efficacy of bacterial killing. Amikacin used alone or in combination with ampicillin resulted in significantly less endotoxin activity than did ampicillin, imipenem, or ceftiofur alone. There was a correlation between TNF-α and endotoxin activity.

Conclusions and Clinical Relevance—Aminoglycosides appear less likely to induce endotoxemia and TNF-α synthesis during bactericidal treatment of E coli septicemia, compared with β-lactam antimicrobials. Use of ampicillin, imipenem, or ceftiofur in the treatment of septicemic neonatal foals should be accompanied by appropriate treatment for endotoxemia. (Am J Vet Res 2002;63:660–668)

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in American Journal of Veterinary Research