1
|
Kahnau P, Mieske P, Wilzopolski J, Kalliokoski O, Mandillo S, Hölter SM, Voikar V, Amfim A, Badurek S, Bartelik A, Caruso A, Čater M, Ey E, Golini E, Jaap A, Hrncic D, Kiryk A, Lang B, Loncarevic-Vasiljkovic N, Meziane H, Radzevičienė A, Rivalan M, Scattoni ML, Torquet N, Trifkovic J, Ulfhake B, Thöne-Reineke C, Diederich K, Lewejohann L, Hohlbaum K. A systematic review of the development and application of home cage monitoring in laboratory mice and rats. BMC Biol 2023; 21:256. [PMID: 37953247 PMCID: PMC10642068 DOI: 10.1186/s12915-023-01751-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Traditionally, in biomedical animal research, laboratory rodents are individually examined in test apparatuses outside of their home cages at selected time points. However, the outcome of such tests can be influenced by various factors and valuable information may be missed when the animals are only monitored for short periods. These issues can be overcome by longitudinally monitoring mice and rats in their home cages. To shed light on the development of home cage monitoring (HCM) and the current state-of-the-art, a systematic review was carried out on 521 publications retrieved through PubMed and Web of Science. RESULTS Both the absolute (~ × 26) and relative (~ × 7) number of HCM-related publications increased from 1974 to 2020. There was a clear bias towards males and individually housed animals, but during the past decade (2011-2020), an increasing number of studies used both sexes and group housing. In most studies, animals were kept for short (up to 4 weeks) time periods in the HCM systems; intermediate time periods (4-12 weeks) increased in frequency in the years between 2011 and 2020. Before the 2000s, HCM techniques were predominantly applied for less than 12 h, while 24-h measurements have been more frequent since the 2000s. The systematic review demonstrated that manual monitoring is decreasing in relation to automatic techniques but still relevant. Until (and including) the 1990s, most techniques were applied manually but have been progressively replaced by automation since the 2000s. Independent of the year of publication, the main behavioral parameters measured were locomotor activity, feeding, and social behaviors; the main physiological parameters were heart rate and electrocardiography. External appearance-related parameters were rarely examined in the home cages. Due to technological progress and application of artificial intelligence, more refined and detailed behavioral parameters have been investigated in the home cage more recently. CONCLUSIONS Over the period covered in this study, techniques for HCM of mice and rats have improved considerably. This development is ongoing and further progress as well as validation of HCM systems will extend the applications to allow for continuous, longitudinal, non-invasive monitoring of an increasing range of parameters in group-housed small rodents in their home cages.
Collapse
Affiliation(s)
- Pia Kahnau
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Berlin, Germany
| | - Paul Mieske
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Berlin, Germany
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Science of Intelligence, Research Cluster of Excellence, Marchstr. 23, 10587, Berlin, Germany
| | - Jenny Wilzopolski
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Berlin, Germany
| | - Otto Kalliokoski
- Department of Experimental Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Silvia Mandillo
- Institute of Biochemistry and Cell Biology, National Research Council CNR, Rome, Italy
| | - Sabine M Hölter
- Helmholtz Zentrum München, German Research Centre for Environmental Health, Munich, Germany
| | - Vootele Voikar
- Neuroscience Center, Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
| | - Adriana Amfim
- Faculty of Veterinary Medicine, Spiru Haret University, Bucharest, Romania
| | - Sylvia Badurek
- Preclinical Phenotyping Facility, Vienna Biocenter Core Facilities (VBCF), member of the Vienna Biocenter (VBC), Vienna, Austria
| | - Aleksandra Bartelik
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Angela Caruso
- Istituto Superiore Di Sanità, Research Coordination and Support Service, Rome, Italy
| | - Maša Čater
- Department of Animal Science, Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Elodie Ey
- Université de Strasbourg, CNRS, Inserm, Institut de Génétique et de Biologie Moléculaire et Cellulaire UMR 7104- UMR-S 1258, Illkirch, 67400, France
| | - Elisabetta Golini
- Institute of Biochemistry and Cell Biology, National Research Council CNR, Rome, Italy
| | - Anne Jaap
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Science of Intelligence, Research Cluster of Excellence, Marchstr. 23, 10587, Berlin, Germany
| | - Dragan Hrncic
- Institute of Medical Physiology "Richard Burian", Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Anna Kiryk
- Laboratory of Preclinical Testing of Higher Standard, Neurobiology Center, Nencki Institute of Experimental Biology, Polish Academy of Science, Warsaw, Poland
| | - Benjamin Lang
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Science of Intelligence, Research Cluster of Excellence, Marchstr. 23, 10587, Berlin, Germany
| | - Natasa Loncarevic-Vasiljkovic
- iNOVA4Health, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Hamid Meziane
- Université de Strasbourg, CNRS, INSERM, Institut Clinique de La Souris (ICS), CELPHEDIA, PHENOMIN, 1 Rue Laurent Fries, Illkirch, 67404, France
| | - Aurelija Radzevičienė
- Lithuanian University of Health Sciences, Medical Academy, Institute of Physiology and Pharmacology, Kaunas, Lithuania
| | - Marion Rivalan
- Research Institute for Experimental Medicine (FEM) and NeuroCure Cluster of Excellence, Animal Behaviour Phenotyping Facility, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Maria Luisa Scattoni
- Istituto Superiore Di Sanità, Research Coordination and Support Service, Rome, Italy
| | - Nicolas Torquet
- Université de Strasbourg, CNRS, Inserm, IGBMC, Institut Clinique de la Souris (ICS), CELPHEDIA, PHENOMIN, UMR 7104- UMR-S 1258, Illkirch, 67400, France
| | - Julijana Trifkovic
- Department of Veterinary Medicine, Faculty of Agriculture, University of East Sarajevo, East Sarajevo, Bosnia and Herzegovina
| | - Brun Ulfhake
- Div. Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Christa Thöne-Reineke
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Science of Intelligence, Research Cluster of Excellence, Marchstr. 23, 10587, Berlin, Germany
| | - Kai Diederich
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Berlin, Germany
| | - Lars Lewejohann
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Berlin, Germany
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Science of Intelligence, Research Cluster of Excellence, Marchstr. 23, 10587, Berlin, Germany
| | - Katharina Hohlbaum
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Berlin, Germany.
- Science of Intelligence, Research Cluster of Excellence, Marchstr. 23, 10587, Berlin, Germany.
| |
Collapse
|
2
|
Kahnau P, Jaap A, Urmersbach B, Diederich K, Lewejohann L. Development of an IntelliCage-based cognitive bias test for mice. Open Res Eur 2023; 2:128. [PMID: 37799631 PMCID: PMC10548109 DOI: 10.12688/openreseurope.15294.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 03/28/2024]
Abstract
The cognitive bias test is used to measure the emotional state of animals with regard to future expectations. Thus, the test offers a unique possibility to assess animal welfare with regard to housing and testing conditions of laboratory animals. So far, however, performing such a test is time-consuming and requires the presence of an experimenter. Therefore, we developed an automated and home-cage based cognitive bias test based on the IntelliCage system. We present several developmental steps to improve the experimental design leading to a successful measurement of cognitive bias in group-housed female C57BL/6J mice. The automated and home-cage based test design allows to obtain individual data from group-housed mice, to test the mice in their familiar environment, and during their active phase. By connecting the test-cage to the home-cage via a gating system, the mice participated in the test on a self-chosen schedule, indicating high motivation to actively participate in the experiment. We propose that this should have a positive effect on the animals themselves as well as on the data. Unexpectedly, the mice showed an optimistic cognitive bias after enrichment was removed and additional restraining. An optimistic expectation of the future as a consequence of worsening environmental conditions, however, can also be interpreted as an active coping strategy in which a potential profit is sought to be maximized through a higher willingness to take risks.
Collapse
Affiliation(s)
- Pia Kahnau
- Laboratory Animal Science, German Federal Institute for Risk Assessment, Berlin, 10589, Germany
| | - Anne Jaap
- Laboratory Animal Science, German Federal Institute for Risk Assessment, Berlin, 10589, Germany
| | - Birk Urmersbach
- Laboratory Animal Science, German Federal Institute for Risk Assessment, Berlin, 10589, Germany
| | - Kai Diederich
- Laboratory Animal Science, German Federal Institute for Risk Assessment, Berlin, 10589, Germany
| | - Lars Lewejohann
- Laboratory Animal Science, German Federal Institute for Risk Assessment, Berlin, 10589, Germany
- Insitute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Freie Universität Berlin, Berlin, 14163, Germany
| |
Collapse
|
3
|
Kahnau P, Jaap A, Urmersbach B, Diederich K, Lewejohann L. Development of an IntelliCage-based cognitive bias test for mice. Open Res Eur 2023; 2:128. [PMID: 37799631 PMCID: PMC10548109 DOI: 10.12688/openreseurope.15294.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 10/07/2023]
Abstract
The cognitive bias test is used to measure the emotional state of animals with regard to future expectations. Thus, the test offers a unique possibility to assess animal welfare with regard to housing and testing conditions of laboratory animals. So far, however, performing such a test is time-consuming and requires the presence of an experimenter. Therefore, we developed an automated and home-cage based cognitive bias test based on the IntelliCage system. We present several developmental steps to improve the experimental design leading to a successful measurement of cognitive bias in group-housed female C57BL/6J mice. The automated and home-cage based test design allows to obtain individual data from group-housed mice, to test the mice in their familiar environment, and during their active phase. By connecting the test-cage to the home-cage via a gating system, the mice participated in the test on a self-chosen schedule, indicating high motivation to actively participate in the experiment. We propose that this should have a positive effect on the animals themselves as well as on the data. Unexpectedly, the mice showed an optimistic cognitive bias after enrichment was removed and additional restraining. An optimistic expectation of the future as a consequence of worsening environmental conditions, however, can also be interpreted as an active coping strategy in which a potential profit is sought to be maximized through a higher willingness to take risks.
Collapse
Affiliation(s)
- Pia Kahnau
- Laboratory Animal Science, German Federal Institute for Risk Assessment, Berlin, 10589, Germany
| | - Anne Jaap
- Laboratory Animal Science, German Federal Institute for Risk Assessment, Berlin, 10589, Germany
| | - Birk Urmersbach
- Laboratory Animal Science, German Federal Institute for Risk Assessment, Berlin, 10589, Germany
| | - Kai Diederich
- Laboratory Animal Science, German Federal Institute for Risk Assessment, Berlin, 10589, Germany
| | - Lars Lewejohann
- Laboratory Animal Science, German Federal Institute for Risk Assessment, Berlin, 10589, Germany
- Insitute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Freie Universität Berlin, Berlin, 14163, Germany
| |
Collapse
|
4
|
Kahnau P, Jaap A, Diederich K, Gygax L, Rudeck J, Lewejohann L. Determining the value of preferred goods based on consumer demand in a home-cage based test for mice. Behav Res Methods 2023; 55:751-766. [PMID: 35469084 PMCID: PMC10027648 DOI: 10.3758/s13428-022-01813-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 11/08/2022]
Abstract
From the preference of one good over another, the strength of the preference cannot automatically be inferred. While money is the common denominator to assess the value of goods in humans, it appears difficult at first glance to put a price tag on the decisions of laboratory animals. Here we used consumer demand tests to measure how much work female mice expend to obtain access to different liquids. The mice could each choose between two liquids, one of which was free. The amount of work required to access the other liquid, by contrast, increased daily. In this way, the value of the liquid can be determined from a mouse's microeconomic perspective. The unique feature is that our test was carried out in a home-cage based setup. The mice lived in a group but could individually access the test-cage, which was connected to the home-cage via a gate. Thereby the mice were able to perform their task undisturbed by group members and on a self-chosen schedule with minimal influence by the experimenter. Our results show that the maximum number of nosepokes depends on the liquids presented. Mice worked incredibly hard for access to water while a bitter-tasting solution was offered for free whereas they made less nosepokes for sweetened liquids while water was offered for free. The results demonstrate that it is possible to perform automated and home-cage based consumer demand tests in order to ask the mice not only what they like best but also how strong their preference is.
Collapse
Affiliation(s)
- Pia Kahnau
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Max-Dohrn Str. 8-10, 10589, Berlin, Germany.
| | - Anne Jaap
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Max-Dohrn Str. 8-10, 10589, Berlin, Germany
| | - Kai Diederich
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Max-Dohrn Str. 8-10, 10589, Berlin, Germany
| | - Lorenz Gygax
- Animal Husbandry and Ethology, Albrecht Daniel Thaer-Institute of Agricultural and Horticultural Sciences, Faculty of Life Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Juliane Rudeck
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Max-Dohrn Str. 8-10, 10589, Berlin, Germany
| | - Lars Lewejohann
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Max-Dohrn Str. 8-10, 10589, Berlin, Germany
- Animal Behavior and Laboratory Animal Science, Institute of Animal Welfare, Freie Universität Berlin, Berlin, Germany
| |
Collapse
|
5
|
Hobbiesiefken U, Urmersbach B, Jaap A, Diederich K, Lewejohann L. Rating enrichment items by female group-housed laboratory mice in multiple binary choice tests using an RFID-based tracking system. PLoS One 2023; 18:e0278709. [PMID: 36656912 PMCID: PMC9851564 DOI: 10.1371/journal.pone.0278709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/21/2022] [Indexed: 01/20/2023] Open
Abstract
Laboratory mice spend most of their lives in cages, not experiments, so improving housing conditions is a first-choice approach to improving their welfare. Despite the increasing popularity of enrichment, little is known about the benefits from an animal perspective. For a detailed analysis, we categorized enrichment items according to their prospective use into the categories 'structural', 'housing', and 'foraging'. In homecage-based multiple binary choice tests 12 female C57BL/6J mice chose between enrichment items within the respective categories over a 46-hour period. A new analyzing method combined the binary decisions and ranked the enrichment items within each category by calculating worth values and consensus errors. Although there was no unequivocal ranking that was true in its entire rank order for all individual mice, certain elements (e.g. lattice ball, second plane) were always among the top positions. Overall, a high consensus error in ranking positions reflects strong individual differences in preferences which could not be resolved due to the relatively small sample size. However, individual differences in the preference for enrichment items highlights the importance of a varied enrichment approach, as there does not seem to be one item that satisfies the wants and needs of all individuals to the same degree. An enrichment concept, in which the needs of the animals are central, contributes to a more specific refinement of housing conditions.
Collapse
Affiliation(s)
- Ute Hobbiesiefken
- German Center for the Protection of Laboratory Animals (Bf3R), German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Birk Urmersbach
- German Center for the Protection of Laboratory Animals (Bf3R), German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Anne Jaap
- German Center for the Protection of Laboratory Animals (Bf3R), German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Kai Diederich
- German Center for the Protection of Laboratory Animals (Bf3R), German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Lars Lewejohann
- German Center for the Protection of Laboratory Animals (Bf3R), German Federal Institute for Risk Assessment (BfR), Berlin, Germany
- Animal Behavior and Laboratory Animal Science, Institute of Animal Welfare, Freie Universität Berlin, Berlin, Germany
| |
Collapse
|
6
|
Kahnau P, Jaap A, Hobbiesiefken U, Mieske P, Diederich K, Thöne-Reineke C, Lewejohann L, Hohlbaum K. A preliminary survey on the occurrence of barbering in laboratory mice in Germany. Anim Welf 2022. [DOI: 10.7120/09627286.31.4.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Although barbering is common in laboratory mice ( Mus musculus), little is known about its effects, both on animal welfare and the research data collected from barbered mice. To gain information on the occurrence of barbering and related risk factors in animal facilities in Germany,
we performed an online survey. All the respondents (n = 32 animal facilities) had experienced barbering in their facility. In most cases, less than 10% of the mice were affected, and the age of onset was mostly observed to be 2 to < 6 months. A greater susceptibility was reported
in females and in C57BL/6 mice, but this could not be verified as the prevalence of females and the C57BL/6 strain was unknown. One facility reported differences in barbering between commercial animal suppliers. Barbering was also recorded in mice provided with enrichments, such as houses,
wood-gnawing blocks, tunnels, running wheels/discs or cage dividers. None of the responding facilities provided swings, structural elements such as an elevated platform or foraging and cognitive enrichment. The questions of whether barbering may have an impact on study results and whether
victims of barbering can be used for experiments revealed mixed opinions, most likely due to a lack of data on potential effects. This survey clearly demonstrated barbering to be a widely underestimated problem that is not given enough attention. We suggest that the occurrence of barbering
should be systematically documented in every animal facility and reported in research articles, to provide a greater understanding of barbering and its potential effects.
Collapse
Affiliation(s)
- P Kahnau
- German Centre for the Protection of Laboratory Animals (Bf3R), German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - A Jaap
- German Centre for the Protection of Laboratory Animals (Bf3R), German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - U Hobbiesiefken
- German Centre for the Protection of Laboratory Animals (Bf3R), German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - P Mieske
- German Centre for the Protection of Laboratory Animals (Bf3R), German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - K Diederich
- German Centre for the Protection of Laboratory Animals (Bf3R), German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - C Thöne-Reineke
- Institute of Animal Welfare, Animal Behavior, and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - L Lewejohann
- Institute of Animal Welfare, Animal Behavior, and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - K Hohlbaum
- Institute of Animal Welfare, Animal Behavior, and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| |
Collapse
|
7
|
Lawton J, Kirkham J, Rankin D, White DA, Elliott J, Jaap A, Smithson WH, Heller S. Who gains clinical benefit from using insulin pump therapy? A qualitative study of the perceptions and views of health professionals involved in the Relative Effectiveness of Pumps over MDI and Structured Education (REPOSE) trial. Diabet Med 2016; 33:243-51. [PMID: 26248590 DOI: 10.1111/dme.12879] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2015] [Indexed: 12/20/2022]
Abstract
AIMS To explore health professionals' views about insulin pump therapy [continuous subcutaneous insulin infusion (CSII)] and the types of individuals they thought would gain greatest clinical benefit from using this treatment. METHODS In-depth interviews with staff (n = 18) who delivered the Relative Effectiveness of Pumps Over MDI and Structured Education (REPOSE) trial. Data were analysed thematically. RESULTS Staff perceived insulin pumps as offering a better self-management tool to some individuals due to the drip feed of insulin, the ability to alter basal rates and other advanced features. However, staff also noted that, because of the diversity of features on offer, CSII is a more technically complex therapy to execute than multiple daily injections. For this reason, staff described how, alongside clinical criteria, they had tended to select individuals for CSII in routine clinical practice based on their perceptions about whether they possessed the personal and psychological attributes needed to make optimal use of pump technology. Staff also described how their assumptions about personal and psychological suitability had been challenged by working on the REPOSE trial and observing individuals make effective use of CSII who they would not have recommended for this type of therapy in routine clinical practice. CONCLUSIONS Our findings add to those studies that highlight the difficulties of using patient characteristics and variables to predict clinical success using CSII. To promote equitable access to CSII, attitudinal barriers and prejudicial assumptions amongst staff about who is able to make effective use of CSII may need to be addressed.
Collapse
Affiliation(s)
- J Lawton
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - J Kirkham
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - D Rankin
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - D A White
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - J Elliott
- The Sheffield Diabetes and Endocrine Centre, Northern General Hospital, Sheffield, UK
| | - A Jaap
- Department of Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - W H Smithson
- Department of General Practice, University College Cork, Ireland
| | - S Heller
- Unit of Diabetes, Endocrinology and Metabolism, University of Sheffield, Sheffield, UK
| |
Collapse
|
8
|
Abstract
AIM To examine pregnancy outcome in women with Type 1 diabetes treated with glargine. METHODS Glargine use in pregnancy was surveyed over 2 years in 20 UK obstetric-diabetes centres. Outcomes, including maternal complications, miscarriage, congenital abnormalities, perinatal morbidity and mortality, were recorded in a standardized format. RESULTS Outcomes on 109 babies from 115 women with Type 1 diabetes were collected. Insulin glargine was used prior to pregnancy in 69% of women, started during pregnancy in 30%, and stopped at booking in one patient. Insulin aspart was the bolus insulin in 45%, lispro in 42% and human soluble in 8% of women. HbA(1c) fell from 8.1 +/- 0.2% at booking to 6.8 +/- 0.1% during the third trimester. Background retinopathy developed in one patient, worsened in seven and laser photocoagulation was required in three women. Preeclampsia occurred in 12%, and 14% of women had more than one episode of severe hypoglycaemia. One hundred and nine babies were live born, with six miscarriages and no neonatal deaths. The mean gestational age was 37.5 weeks, and mean birth weight was 3500 g. Three babies had congenital abnormalities (malformation rate = 28/1000). Neonatal hypoglycaemia was seen in 46% and hyperbilirubinaemia in 22% of babies. No major adverse outcome was noted in a smaller subset of five Type 2 and seven gestational diabetes patients on glargine. CONCLUSIONS The use of glargine in Type 1 diabetes during pregnancy was not associated with any unexpected adverse maternal or fetal outcome in this study.
Collapse
|
9
|
Abstract
Riedels thyroiditis is a rare chronic inflammatory disorder characterised by extensive fibrosis of the thyroid gland and sometimes the surrounding tissues. We report a case of Riedels Thyroiditis in a middle aged female presenting with goitre, stridor and dyspnoea. She initially responded to corticosteroid treatment and subsequently to tamoxifen. The rationale for these treatments are discussed.
Collapse
Affiliation(s)
- M De
- Department of Ear, Nose and Throat, Crosshouse Hospital, Kilmarnock
| | | | | |
Collapse
|
10
|
Abstract
Riedel's thyroiditis is a rare chronic inflammatory disorder characterised by extensive fibrosis of the thyroid gland and sometimes the surrounding tissues. We report a case of Riedel's Thyroiditis in a middle aged female presenting with goitre, stridor and dyspnoea. She initially responded to corticosteroid treatment and subsequently to Tamoxifen. The rationale for these treatments are discussed.
Collapse
Affiliation(s)
- M De
- Crosshouse Hospital, Kilmarnock, Ayrshire.
| | | | | |
Collapse
|