Publication date: Available online 14 June 2018
Source:Clinical Gastroenterology and Hepatology
Author(s): Christopher Ma, Bram D. van Rhijn, Vipul Jairath, Tran M. Nguyen, Claire E. Parker, Seema S. Aceves, Glenn T. Furuta, Sandeep K. Gupta, David A. Katzka, Ekaterina Safroneeva, Alain M. Schoepfer, Alex Straumann, Jonathan M. Spergel, Rish K. Pai, Brian G. Feagan, Ikuo Hirano, Evan S. Dellon, Albert J. Bredenoord
Background & AimsAgents are being developed for treatment of eosinophilic esophagitis (EoE). However, it is not clear what outcome measures would best determine the efficacy and safety of these agents in clinical trials. We performed a systematic review of outcomes used in randomized placebo-controlled trials of EoE and we estimate the placebo response and rates of remission.MethodsWe searched MEDLINE, Embase, CENTRAL, ClinicalTrials.gov, and the EU Clinical Trials Register from inception through February 20, 2018 for randomized controlled trials of pharmacologic therapies for EoE. Efficacy outcome definitions, measurement tools, and the proportion of patients responding to placebo were collected and stratified by based on histologic, endoscopic, and patient-reported outcomes.ResultsWe analyzed data from 22 placebo-controlled trials, comprising 1112 patients with EoE. Ten additional active registered trials were identified. Most published trials evaluated topical corticosteroid therapy (13/22, 59.1%). Histologic outcomes measuring eosinophil density and patient-reported outcomes were reported in 21/22 published trials (95.5%). No consistently applied definitions of histologic or patient-reported response or remission were identified. Endoscopic outcomes were described in 60% (12/20) of published trials. The EoE Endoscopic Reference Score is the most commonly applied tool for describing changes in endoscopic appearance. The median histologic response to placebo was 3.7% (range 0%-31.6%) and the median rate of remission in patients given placebo was 0.0% (range 0%-11.0%). The median patient-reported response to placebo was 14.4% (range 8.6%-77.8%) and rate of remission in patients given placebo was 26.2% (range 13.2%-35.7%).ConclusionsIn a systematic review of the literature, we found that no standardized definitions of histologic, endoscopic, or patient-reported outcomes are used to determine whether pharmacologic agents produce a response or remission in patients with EoE. A core outcome set is needed to reduce heterogeneity in outcome reporting and facilitate trial interpretation and comparison of results from trials.
https://ift.tt/2yc89fa
Τετάρτη 13 Ιουνίου 2018
Heterogeneity in Clinical, Endoscopic, and Histologic Outcome Measures and Placebo Response Rates in Clinical Trials of Eosinophilic Esophagitis: A Systematic Review
Brain Activity and Network Interactions in the Impact of Internal Emotional Distraction
https://ift.tt/2ya3ESp
Atypical Cutaneous Presentations of Sarcoidosis: Two Case Reports and Review of the Literature
Abstract
Purpose of Review
The goal of this review is to provide the reader with an updated summary of the cutaneous manifestations of systemic sarcoidosis, with a particular emphasis on the predilection of sarcoidosis for scars, tattoos, and other areas of traumatized skin.
Recent Findings
While the mechanism underlying the propensity for traumatized skin to develop sarcoidosis lesions remains unclear, several theories have been proposed including the idea that cutaneous sarcoidosis represents an exuberant, antigen-driven foreign-body response, as well as the theory that traumatized skin represents an immunocompromised district with altered local immune trafficking and neural signaling.
Summary
In this review, we present two cases in which the development of cutaneous lesions in scars and tattoos was integral to the diagnosis of systemic sarcoidosis. We then review the various cutaneous manifestations of systemic sarcoidosis, the clinical characteristics and differential diagnosis of scar and tattoo sarcoidosis, the proposed mechanism by which traumatized skin is prone to developing sarcoidosis lesions, and current treatments for cutaneous sarcoidosis.
https://ift.tt/2JQkjip
Food-Induced Anaphylaxis: an Update
Abstract
Purpose of Review
This review aims to provide an update of recent advances in the epidemiology, clinical features and diagnosis, and management of food-induced anaphylaxis (FIA).
Recent Findings
Food allergy prevalence and FIA rates continue to rise, but FIA fatalities are stable. Basophil and mast cell activation tests promise more accurate identification of food triggers. Oral, sublingual, and epicutaneous immunotherapy can desensitize a significant portion of subjects. Epinephrine use for FIA remains sub-optimal.
Summary
As the burden of food allergy continues to increase, it appears that the corresponding increase in research focused on this epidemic is beginning to bear fruit. The stable number of FIA fatalities in the face of an ongoing epidemic indicates lives have already been saved. The emergence of new diagnostic tests and interventional therapies may transform the management of FIA in the coming years.
https://ift.tt/2LOBoXn
Fever of unknown origin: a rare presentation of giant hepatic hemangioma
https://ift.tt/2sWpsM7
Borderline resectable pancreatic cancer. challenges and controversies
Source:Cancer Treatment Reviews
Author(s): Luis Sabater, Elena Muñoz, Susana Roselló, Dimitri Dorcaratto, Marina Garcés-Albir, Marisol Huerta, Desamparados Roda, María Carmen Gómez-Mateo, Antonio Ferrández-Izquierdo, Antonio Darder, Andrés Cervantes
Pancreatic cancer is a dismal disease with an increasing incidence. Despite the majority of patients are not candidates for curative surgery, a subgroup of patients classified as borderline resectable pancreatic cancer can be selected in whom a sequential strategy of neoadjuvant therapy followed by sugery can provide better outcomes. Multidisciplinary approach and surgical pancreatic expertise are essential for successfully treating these patients. However, the lack of consensual definitions and therapies make the results of studies very difficult to interpret and hard to be implemented in some settings. In this article, we review the challenges of borderline resectable pancreatic cancer, the complexity of its management and controversies and point out where further research and international cooperation for a consensus strategy is urgently needed.
https://ift.tt/2HJQFX3
Mg–Fe layered double hydroxide assembled on biochar derived from rice husk ash: facile synthesis and application in efficient removal of heavy metals
Abstract
The pollution of toxic and persistent heavy metals commonly exist in water environment; such multi-component pollutants pose a serious threat to human beings and other organisms. Herein, to make full use of the advantages of both layered double hydroxide (LDH) and rice husk ash (RHA), a novel Mg–Fe-LDH-RHA functional material was synthesized by assembling LDH on the biochar derived from RHA and used as an adsorbent for removal of heavy metal ions including Pb2+, Cu2+, Co2+, Ni2+, Zn2+, and Cd2+. The adsorption kinetics and isotherms of heavy metal ions in a mono-component system, the adsorption capacities in mixed multi-metal ion system, and the regeneration of the adsorbent were studied in detail. The results showed that the synthesized Mg–Fe-LDH-RHA might efficiently remove the above six heavy metals in water under optimized experimental conditions. Interestingly, the removal performance toward Pb(II) showed high static distribution coefficients (Kd) of ~ 107 mL/g and maximum capacity of ~ 682 mg/g. Besides, further characterizations of the adsorbent have been conducted, and the result suggested the formation of abundant functional groups including hydroxyl, carbonyl, and carboxyl groups. The removal mechanism of the metal ions might be related to ion-exchange, surface precipitation, complexation, and hydrogen binding during the interactions between the LDH-RHA material and pollutants. Such a facile and environmentally friendly approach, efficient removal performance suggests that the LDH-RHA material thus has potential for efficient removal of heavy metals in practical application.
https://ift.tt/2JBeLcr
A multi-criteria sustainability assessment framework: development and application in comparing two food waste management options using a UK region as a case study
Abstract
Preventing food wastage is a key element of sustainable resource management. But as food waste is still generated at high volumes, priority is placed on its proper management as a resource, maximising sustainability benefits. This study, by integrating a multi-criteria decision analysis with a sustainability assessment approach, develops a screening and decision support framework for comparing the sustainability performance of food waste management options. A structured process for selecting criteria based on the consideration of environmental, economic and social aspects related to region-specific food waste system planning, policy and management has been developed. Two food waste management options, namely the use of food waste disposal units, which grind food waste at the household's kitchen sink and discharge it to the sewer, and the anaerobic co-digestion of separately collected food waste with sewage sludge, were selected for comparison due to their potential to create synergies between local authorities, waste and water companies, with local circumstances determining which of the two options to adopt. A simplified process used for assessing and comparing the two food waste management options in the Anglian region in the UK, indicated that there are benefits in using the framework as a screening tool for identifying which option may be the most sustainable. To support decision-making, a detailed analysis that incorporates stakeholders' perspectives is required. An additional use of the framework can be in providing recommendations for optimising food waste management options in a specific region, maximising their sustainability performance.
https://ift.tt/2y6LLE4
Time-dependent expression pattern of cytochrome P450 epoxygenases and soluble epoxide hydrolase in normal human placenta
Source:Acta Histochemica
Author(s): K. Cizkova, Z. Tauber
CYP2C and CYP2 J enzymes, commonly named as cytochrome P450 (CYP) epoxygenases, convert arachidonic acid to four regioisomeric epoxyeicosatrienoic acids (EETs), biologically active eicosanoids with many functions in organism. EETs are rapidly hydrolysed to less active dihydroxyeicosatrienoic acids (DHETs) by soluble epoxide hydrolase (sEH). We investigated spatio-temporal expression pattern of CYP2C8, CYP2C9, CYP2 J2 and sEH in normal human placenta by immunohistochemical method. In the villous trophoblast, CYP2C8 was the most abundant protein. Its expression is higher than the CYP2C9 and CYP2 J2 in the cytotrophoblast in the embryonic stage of development and remains higher in syncytiotrophoblast of term placenta. Unlike to CYP2C8, CYP2C9 and CYP2 J2 expression decrease in term placenta. sEH expression increases with gestation age and is strictly limited to cytotrophoblast in embryonic and foetal stages of the development. Moreover, CYP2C8 shows more intensive staining than the other protein monitored in Hofbauer cells in villous stroma. Specific information regarding the exact role of EETs and DHETs functions in a normal placenta is still unknown. Based on CYP epoxygenases and sEH localization and well known information about the functions of placental structures during development, we suggest that these enzymes could play different roles in various cell populations in the placenta. As the placenta is absolutely crucial for prenatal development, arachidonic acid is essential part of human nutrient and CYP epoxygenases expression can be affected by xenobiotics, further investigation of the exact role of CYP epoxygenases, sEH, and their metabolites in normal pregnancy and under pathological conditions is needed.
https://ift.tt/2t5dVti
DEPOT EXTRACTS FOR RUSH VENOM IMMUNOTHERAPY: A NEW THERAPEUTIC OPPORTUNITY FOR HYMENOPTERA STING ALLERGY
Source:Annals of Allergy, Asthma & Immunology
Author(s): Stefano Pucci, Fedra Ciccarelli, Tiziana De Pasquale, Ilenia Illuminati, Simona D'Alò
https://ift.tt/2JNben5
Short communication: Lack of intramammary niche recolonization during a sanitation program for the contagious mastitis pathogen Staphylococcus aureus genotype B
Source:Journal of Dairy Science
Author(s): C. Sartori, V. Perreten, I. Ivanovic, M.C. Härdi-Landerer, H.U. Graber
In Switzerland, sanitation programs of dairy herds infected with the contagious mastitis pathogen Staphylococcus aureus genotype B (GTB) have been established for several years. In recent years, Streptococcus uberis and non-aureus staphylococci have emerged as the bacteria most frequently isolated from bovine milk samples. The latter cause subclinical mastitis, and some species are more persistent or pathogenic than others. The present study aimed to investigate the developments in the intramammary colonization spectrum of 5 dairy herds undergoing a sanitation program for Staph. aureus GTB. We collected single-quarter milk samples aseptically from all lactating cows at 3-mo intervals during the sanitation period; after classical bacteriological analysis, MALDI-TOF mass spectrometry was used to identify the isolates to the species level. Non-aureus staphylococci were found to be the bacterial group most frequently occurring on the selected farms, with Staphylococcus chromogenes and Staphylococcus xylosus being predominant. The present study demonstrated that GTB-infected cows treated with antibiotics lacked systematic recolonization with other bacteria during herd sanitation for the contagious Staph. aureus GTB.
https://ift.tt/2JS3Zh3
Methionine supply alters mammary gland antioxidant gene networks via phosphorylation of nuclear factor erythroid 2-like 2 (NFE2L2) protein in dairy cows during the periparturient period
Publication date: Available online 13 June 2018
Source:Journal of Dairy Science
Author(s): L. Han, F. Batistel, Y. Ma, A.S.M. Alharthi, C. Parys, J.J. Loor
The periparturient period is the most critical period during the lactation cycle of dairy cows and is characterized by increased oxidative stress status. The objective of this experiment was to evaluate the effect of supplementing rumen-protected methionine on nuclear factor erythroid 2-like 2 (NFE2L2, formerly NRF2) protein and target gene expression in the mammary gland during the early postpartal period. Multiparous Holstein cows were used in a block design experiment with 30 cows per treatment. Treatments consisting of a basal control diet (control) or the basal diet plus rumen-protected methionine (methionine) were fed from d −28 to 60 relative to parturition. Mammary tissue biopsies were harvested on d 21 postpartum from 5 cows per treatment. Compared with control, methionine increased dry matter intake, milk yield, and milk protein content. Among plasma parameters measured, methionine led to greater methionine and lower reactive oxygen metabolites. Compared with control, methionine supply resulted in greater mRNA abundance of the NFE2L2 target genes glutamate-cysteine ligase catalytic subunit (GCLC), glutamate-cysteine ligase modifier subunit (GCLM), glutathione reductase (GSR), glutathione peroxidase 1 (GPX1), malic enzyme 1 (ME1), ferrochelatase (FECH), ferritin heavy chain 1 (FTH1), and NAD(P) H quinone dehydrogenase 1 (NQO1) in the mammary tissue. In addition, methionine upregulated the mRNA abundance of NFE2L2, NFKB1, MAPK14 and downregulated KEAP1. The ratio of phosphorylated NFE2L2 to total NFE2L2 protein, and total heme oxygenase 1 (HMOX1) protein were markedly greater in response to methionine supply. In contrast, total protein abundance of Kelch-like ECH-associated protein 1 (KEAP1), which sequesters NFE2L2 in the cytosol and reduces its activity, was lower with methionine. Besides the consistent positive effect of methionine supply on systemic inflammation and oxidative stress status, the present data indicate a positive effect also on antioxidant mechanisms within the mammary gland, which are regulated, at least in part, via phosphorylation of NFE2L2 and its target genes. The exact mechanisms for these responses merit further study.
https://ift.tt/2LPoJmO
Short communication: Lymphocyte proliferative responses in cattle naturally infected with digital dermatitis consist of CD8+ and γδ-T cells but lack CD4+ T cells
Source:Journal of Dairy Science
Author(s): Jennifer H. Wilson-Welder, Jarlath E. Nally, David P. Alt, Samuel B. Humphrey, Steven C. Olsen
Digital dermatitis is an infectious disease of cattle and the leading cause of lameness. This disease is complicated by the reoccurrence of the lesions and the observation of lesions on more than one limb at different time points, indicating infection may not result in a protective immune response. The objective of this study was to characterize the peripheral blood cellular response in naturally infected and naïve cattle to bacterial antigens derived from pathogens associated with digital dermatitis lesions. Peripheral blood mononuclear cells were isolated from dairy cattle identified as having active or chronic lesions during routine hoof-trimming. Following bacterial antigen stimulation, cells were analyzed for proliferation and phenotype by flow cytometry, and culture supernatants were analyzed for IFN-γ secretion. Digital-dermatitis-infected animals had greater serum antibody titers to treponemal antigens, higher percentages of proliferating CD8+, γδ-T cells, and B cells, and increased IFN-γ secretion in vitro when compared with responses of naïve animals. No increase in proliferation of CD4+ T cells was detected in infected or naïve cattle. Although CD8+ and γδ-T cell responses may be antigen specific, the memory nature or long-lived response is yet unknown. The lack of responsiveness of CD4+ memory cells to treponemal antigens could explain the high rate of reoccurrence of digital dermatitis in infected animals.
https://ift.tt/2JVXdal
Field trial to evaluate the effect of an intranasal respiratory vaccine protocol on calf health, ultrasonographic lung consolidation, and growth in Holstein dairy calves
Source:Journal of Dairy Science
Author(s): T.L. Ollivett, K.E. Leslie, T.F. Duffield, D.V. Nydam, J. Hewson, J. Caswell, P. Dunn, D.F. Kelton
The objective of this field trial was to evaluate the effect of a vaccine protocol using a commercially available trivalent vaccine designed for intranasal use. Experimental challenge studies have demonstrated varying efficacies of vaccines administered via the intranasal route. A total of 468 calves from 3 herds were enrolled and randomized into 3 treatment groups (positive control, PC, n = 211; intranasal vaccine, IN, n = 215; negative control, NC, n = 42) and followed for 8 to 12 wk. The PC consisted of one dose of commercially available multivalent injectable vaccine against bovine respiratory syncytial virus, infectious bovine rhinotracheitis, parainfluenza 3, and bovine viral diarrhea administered subcutaneously at 6 wk of age. The IN was administered at enrollment and 6 wk of age, and contained antigen against bovine respiratory syncytial virus, infectious bovine rhinotracheitis, and parainfluenza 3. The NC was sterile saline administered intranasally and subcutaneously at enrollment and 6 wk of age. Clinical illness was assessed using systematic respiratory scoring, and thoracic ultrasonography was used to identify the lung consolidation associated with pneumonia. Rib fractures were identified in 6% of calves, and an association was observed between rib fractures and calving ease. Overall, 54% of the calves had at least one episode of an abnormal respiratory score (ILL). Vaccination protocol did not affect the occurrence of ILL. Similarly, 54% of the calves had at least one episode of lung consolidation ≥3 cm (CON). Vaccine protocol affected the odds of CON. The odds of CON in PC were 1.63 (95% confidence interval: 1.04–2.56) times the odds of CON in IN, and 0.38 (95% confidence interval: 0.16–0.93) times the odds of CON in NC. The odds of CON in IN were 0.23 (95% confidence interval: 0.09–0.59) times the odds of CON in NC. The outcomes ILL and CON were associated; however, the measure of agreement was only fair (kappa = 0.38). Multivariable linear regression revealed an interaction between vaccine protocol and herd on average daily gain (ADG); therefore, these data were stratified. In herd 1, IN (0.53 ± 0.03 kg/d) decreased ADG compared with PC (0.63 ± 0.03 kg/d). In herd 2, IN increased ADG (0.41 ± 0.03 kg/d) compared with PC (0.38 ± 0.03 kg/d). In contrast, none of the protocols affected ADG at herd 3. In conclusion, this commercially available trivalent IN vaccine protocol did not alter the incidence of ILL, reduced the risk of lung lesions associated with pneumonia, and improved the ADG of the calves in one of the commercial study herds.
https://ift.tt/2LMecco
Maternal supply of methionine during late pregnancy is associated with changes in immune function and abundance of microRNA and mRNA in Holstein calf polymorphonuclear leukocytes
Source:Journal of Dairy Science
Author(s): C.B. Jacometo, A.S. Alharthi, Z. Zhou, D. Luchini, J.J. Loor
Pregnancy and early life are critical periods during which environmental factors such as nutrition can affect development. Rumen-protected methionine (Met; RPM) supplementation during the prepartum period improves not only performance but immune responses in dairy cows. We investigated the effects of enhanced maternal supply of Met via feeding RPM on whole-blood in vitro lipopolysaccharide (LPS; 0, 0.01, or 5 μg/mL of blood) challenge and targeted microRNA and mRNA abundance in calf blood polymorphonuclear leukocytes (PMNL). Calves (n = 12/maternal diet) born to cows fed RPM at 0.08% of diet dry matter (DM)/d (MET) for the last 21 ± 2 d before calving or fed a control diet with no added Met (CON) were used. The PMNL were isolated at birth (before colostrum feeding) and d 1 (24 h after colostrum intake), 14, 28, and 50 of age. Maternal blood was collected at −10 ± 1.3 d relative to calving. Cows in the MET group had greater DM intake and lower prepartal haptoglobin concentration. In CON cows, haptoglobin was positively correlated with proinflammatory and host-defense mRNA abundance in CON calves. Except for NOS2 and NFE2L2, abundance of CASP8, MPO, ZBP1, and TNF was lower at birth in MET calves. Interleukin 1β concentration in response to LPS challenge in CON and MET calves was greatest at birth, underscoring the role of this cytokine for lymphocyte activation. Compared with 1 d of age, the interleukin-1β response to incremental doses of LPS was greater at 14 through 28 d, suggesting that the neonatal calf can mount a robust response to inflammatory stimuli. Greater abundance in CON calves of NOS2, CADM1, and TLR2 coupled with lower SELL from 1 through 50 d of age suggested a chronic activation of the PMNL. There was a marked upregulation over time of MIR125b, MIR146a, MIR155, and MIR9 in both CON and MET calves, suggesting that these microRNA could affect gene transcription associated with differentiation and inflammatory function in PMNL. Regardless of maternal diet, the gradual downregulation of MIR223 (the most abundant microRNA in PMNL) is in line with the progressive increase over time in the proinflammatory signature of the PMNL. Data revealed the potential for maternal supply of Met during late pregnancy through either greater DM intake or Met to elicit some changes in PMNL function during early postnatal life, partly through changes in mRNA expression encompassing cell adhesion and chemotaxis, oxidative stress, Toll-like receptor signaling, and Met metabolism.
https://ift.tt/2JR0JCt
Factors associated with productivity on automatic milking system dairy farms in the Upper Midwest United States
Source:Journal of Dairy Science
Author(s): Justin M. Siewert, James A. Salfer, Marcia I. Endres
The objective of this study was to identify housing and management factors associated with productivity on automatic milking system (AMS) dairy farms measured as daily milk yield/AMS and daily milk yield/cow. Management, housing, and lameness prevalence data were collected from 33 AMS farms in Minnesota and Wisconsin during a farm visit. All farms in the study used free-flow cow traffic. Mixed model analysis of cross-sectional data showed that farms with automatic feed push-up via a robot produced more milk per AMS/day and per cow/day than farms where feed was pushed up manually. New versus retrofitted facility, freestall surface, manure removal system, and the number of AMS units/pen were not associated with daily milk yield per AMS or per cow. Cow comfort index (calculated as number of cows lying down in stalls divided by total number of cows touching a stall) was positively associated with daily milk yield/cow. Prevalence of lameness and severe lameness, number of cows per full-time employee, depth of the area in front of the AMS milking station, and length of the exit lane from the AMS milking station were not associated with daily milk yield per AMS or per cow. Multivariable mixed model analysis of longitudinal AMS software data collected daily over approximately an 18-mo period from 32 of the farms found a positive association between daily milk yield/AMS and average age of the cows, cow milking frequency, cow milking speed, number of cows/AMS, and daily amount of concentrate feed offered/cow in the AMS. Factors negatively associated with daily milk yield/AMS were number of failed and refused cow visits to the AMS, treatment time (the time spent preparing the udder before milking and applying a teat disinfectant after milking), and amount of residual concentrate feed/cow. Similar results were also found for daily milk yield on a per cow basis; however, as it would be expected, average days in milk of the herd were also negatively associated with daily milk yield/cow. These findings indicate that several management and cow factors must be managed well to optimize AMS productivity.
https://ift.tt/2HNBMCY
Preweaned heifer management on US dairy operations: Part II. Factors associated with colostrum quality and passive transfer status of dairy heifer calves
Source:Journal of Dairy Science
Author(s): C.B. Shivley, J.E. Lombard, N.J. Urie, D.M. Haines, R. Sargent, C.A. Kopral, T.J. Earleywine, J.D. Olson, F.B. Garry
Passive transfer of immunity is essential for the short- and long-term health of dairy calves. The objective of this study was to evaluate factors associated with colostrum quality and passive transfer status of US heifer calves. This study included 104 operations in 13 states that participated in the calf component of the National Animal Health Monitoring System's Dairy 2014 study. This 18-mo longitudinal study included 1,972 Holstein heifer calves from birth to weaning. Multivariable mixed linear regression models were selected using backward elimination model selection after univariate screening to determine which factors were associated with colostrum IgG and serum IgG concentrations. The mean colostrum IgG concentration was 74.4 g/L with 77.4% of colostrum samples having IgG concentrations >50 g/L. The final model for colostrum IgG included colostrum source and a categorized temperature-humidity index value (cTHI) for the month before calving. Mean colostrum IgG concentrations were highest for dams in third and higher lactations (84.7 g/L) and lowest for commercial colostrum replacers (40.3 g/L). Colostrum IgG concentrations were highest for cTHI ≥70 (72.6 g/L) and lowest for cTHI <40 (64.2 g/L). The mean serum IgG concentration was 21.6 g/L, with 73.3% of calves having serum IgG concentrations >15 g/L. The final model for serum IgG concentration included region, heat treatment of colostrum, colostrum source, timing to first feeding, volume of colostrum fed in the first 24 h, age of the calf at blood sampling, and colostrum IgG concentration. Mean serum IgG concentrations were highest for calves that received colostrum from first-lactation dams (25.7 g/L) and lowest for calves fed commercial colostrum replacer (16.6 g/L). Serum IgG concentrations were higher for calves fed heat-treated colostrum (24.4 g/L) than for calves fed untreated colostrum (20.5 g/L). Serum IgG concentration was positively associated with the volume of colostrum fed in the first 24 h and colostrum IgG concentration, and negatively associated with the number of hours from birth to colostrum feeding and age (days) at blood collection. Dairy producers should be encouraged to measure the quality of colostrum before administering it to calves and to measure serum IgG or a proxy such as serum total protein or Brix to evaluate passive immunity and colostrum management programs.
https://ift.tt/2JRkVnW
Measurement of dairy calf behavior prior to onset of clinical disease and in response to disbudding using automated calf feeders and accelerometers
Source:Journal of Dairy Science
Author(s): M.A. Sutherland, G.L. Lowe, F.J. Huddart, J.R. Waas, M. Stewart
We determined if feeding and lying behavior, recorded by automatic calf feeding systems (ACFS) and accelerometers, could be used to detect changes in behavior before onset of neonatal calf diarrhea (NCD) or in response to disbudding pain in dairy calves. At 4 d of age, 112 calves had accelerometers attached to their hind leg and were housed in pens with ACFS. Calves were examined daily for signs of illness or injury. Of the 112 calves monitored, 18 were diagnosed with NCD; activities of calves with NCD were then compared with those of 18 healthy controls (calves that had no symptoms of NCD, other illnesses, or injury). Feeding (milk consumption and the number of rewarded and unrewarded visits to the feeder) and lying behavior during the 5 d leading up to calves displaying clinical signs of NCD were analyzed. Calves with NCD performed fewer unrewarded visits and consumed less milk than healthy calves during the 2- and 4-d periods before diagnosis with NCD, respectively. Calves with NCD tended to perform fewer lying bouts than healthy calves over the 5-d period before diagnosis with NCD. At 3 wk of age, a subset of 51 healthy calves were allocated to 1 of 5 treatment groups: (1) sham handling (SHAM, n = 10), (2) cautery disbudding (DB, n = 11), (3) administration of local anesthetic (LA) and DB (LA+DB, n = 11), 4) administration of a nonsteroidal anti-inflammatory drug (NSAID) and DB (NSAID+DB, n = 9), and (5) administration of LA, NSAID and DB (LA+NSAID+DB, n = 10). Feeding and lying behavior were recorded continuously for 24 h pre- and postdisbudding. We found no effect of treatment on the number of rewarded or unrewarded visits to the feeder and milk volume consumed 24 h before administration of treatments. During the 24-h postdisbudding period, SHAM calves performed more unrewarded visits than DB, LA+DB, and NSAID+DB calves, but the number of unrewarded visits did not differ between SHAM and LA+NSAID+DB calves. During the first hour of the posttreatment period we noted a difference in lying times among treatments, with DB and NSAID+DB calves spending less time lying than SHAM calves and lying times being similar between SHAM, LA+DB, and LA+NSAID+DB calves. The ACFS and accelerometers have the potential to automatically gather valuable information regarding health status and pain in calves. Therefore, it may be advantageous to combine both of these measures (ACFS and accelerometers) when evaluating NCD on farm or pain in calves in future research.
https://ift.tt/2LJHt7e
Short communication: Effect of adding a second prostaglandin F2α injection during the Ovsynch protocol on luteal regression and fertility in lactating dairy cows: A meta-analysis
Source:Journal of Dairy Science
Author(s): S. Borchardt, A. Pohl, P.D. Carvalho, P.M. Fricke, W. Heuwieser
Incomplete luteal regression after treatment with a single dose of prostaglandin F2α during an Ovsynch protocol decreases fertility to timed artificial insemination (TAI). To increase the proportion of cows with complete luteal regression and subsequently pregnancy per artificial insemination (P/AI), an additional treatment with PGF2α 24 h after the first has been recommended. A systematic review of the literature and meta-analytical assessment were performed with the objective of evaluating the effects of adding a second PGF2α treatment during the Ovsynch protocol on luteal regression and reproductive performance in lactating dairy cows. Based on the heterogeneity among the experimental treatments, a fixed or a random effects meta-analysis was conducted. Reproductive outcomes of interest were luteal regression at the end of the Ovsynch protocol, and P/AI measured 32 to 39 d after TAI. Seven randomized controlled experiments from 6 published manuscripts including 5,356 cows with the primary objective to evaluate the effect of an additional treatment with PGF2α during the Ovsynch protocol on P/AI were used. Information regarding luteal regression at the end of the Ovsynch protocol was available for 1,856 cows. Adding a second PGF2α treatment on d 8 during the Ovsynch protocol increased the relative risk (RR) of complete luteal regression at the end of the Ovsynch protocol (RR = 1.14; 95% confidence interval = 1.10 to 1.17) using a fixed effects model and the RR for pregnancy (RR = 1.14; 95% confidence interval = 1.06 to 1.22) 32 d after TAI using a fixed effects model. No heterogeneity was observed among the 6 manuscripts regarding complete luteal regression (P = 0.450) and P/AI (P = 0.942). In summary, there was a clear benefit of an additional PGF2α treatment during the Ovsynch protocol on luteal regression (+11.6 percentage units) and on P/AI (+4.6 percentage units).
https://ift.tt/2JRkREI
Effects of an automatic milking system on milk yield and quality of Mediterranean buffaloes
Source:Journal of Dairy Science
Author(s): M. Sannino, S. Faugno, M. Crimaldi, A. Di Francia, L. Ardito, F. Serrapica, F. Masucci
A study was carried out to evaluate the effects of an automatic milking system (AMS) on milk yield and composition of buffalo (Mediterranean-type Bubalus bubalis) cows. Performed from January 2015 to December 2015 in an organic buffalo dairy farm equipped with both a traditional tandem milking parlor and an AMS, the study involved 90 primiparous buffaloes randomly allotted to a tandem or AMS group from 5 to 10 d of lactation onward. Number of milkings per day and daily milk yield of each cow were recorded, and individual milk sampling was carried out twice a month. Compared with the tandem, the AMS group showed significantly higher daily milk yield and persistence of lactation. Use of the AMS resulted in higher protein and casein contents, and lower somatic cell and total bacterial counts, whereas fat, freezing point, and pH were unaffected by the system. We conclude that, in terms of milk yield and quality, automatic milking may be a suitable alternative to conventional milking for buffaloes.
https://ift.tt/2LQYP2r
Short-term responses in production and behavior during periods of change in concentrate allowance for dairy cows
Source:Journal of Dairy Science
Author(s): J.C.S. Henriksen, L. Munksgaard, M.R. Weisbjerg
The aim of this study was to investigate the short-term responses of dairy cows during periods of change in the concentrate allowance in an automatic milking system. The experiment had a design with a 2 × 2 factorial arrangement including 2 types of concentrates and 2 amounts of concentrates (type O: mix of pelleted concentrate and steamrolled, acidified barley; type S: pelleted) in amounts of 3 and 6 kg/d. The experiment length was 11 wk. The concentrate type changed between wk 6 and 7 and included both increase and decrease in concentrate allowance for each concentrate type. The concentrate allowance was changed by 0.5 kg/d over 6 d. The 96 cows (48 Danish Jersey, 48 Danish Holstein) included in the experiment were blocked according to breed, parity, and days in milk, and randomly divided into 8 groups of treatment order. The cows visited the automatic milking unit more often when concentrate type O was offered, but not when an increased concentrate allowance was provided. The changes in concentrate intake and partial mixed ration (PMR) eating time showed a symmetrical pattern between the periods of increasing allowance and decreasing allowance. However, PMR intake and milk yield varied in the magnitude of the responses, indicating that these responses may not be driven by the same underlying mechanisms during increase and decrease in concentrate allowance. The daily lying time increased and the PMR eating rate decreased during periods of both increase and decrease in concentrate allowance. We found no significant change in milk yield during increase in concentrate allowance, despite a higher milk yield during periods with constant concentrate allowance at the high concentrate amount; however, the milk yield decreased during periods of decrease in concentrate allowance. Visit frequency, lying time, and steps changed during periods of changes in concentrate allowance without showing any differences at the constant concentrate allowance. In conclusion, these results indicate that it may be difficult to adjust the individual concentrate allowance based on the short-term responses of the cow.
https://ift.tt/2JN6Fwz
The influence of fat and hemicellulose on methane production and energy utilization in lactating Jersey cattle
Source:Journal of Dairy Science
Author(s): O.R. Drehmel, T.M. Brown-Brandl, J.V. Judy, S.C. Fernando, P.S. Miller, K.E. Hales, P.J. Kononoff
Feeding fat to lactating dairy cows may reduce methane production. Relative to cellulose, fermentation of hemicellulose is believed to result in less methane; however, these factors have not been studied simultaneously. Eight multiparous, lactating Jersey cows averaging (±SD) 98 ± 30.8 d in milk and body weight of 439.3 ± 56.7 kg were used in a twice-replicated 4 × 4 Latin square to determine the effects of fat and hemicellulose on energy utilization and methane production using a headbox-type indirect calorimetry method. To manipulate the concentration of fat, porcine tallow was included at either 0 or 2% of the diet dry matter. The concentration of hemicellulose was adjusted by manipulating the inclusion rate of corn silage, alfalfa hay, and soybean hulls resulting in either 11.3 or 12.7% hemicellulose (dry matter basis). The resulting factorial arrangement of treatments were low fat low hemicellulose (LFLH), low fat high hemicellulose (LFHH), high fat low hemicellulose (HFLH), and high fat high hemicellulose (HFHH). Neither fat nor hemicellulose affected dry matter intake, averaging 16.2 ± 1.18 kg/d across treatments. Likewise, treatments did not affect milk production, averaging 23.0 ± 1.72 kg/d, or energy-corrected milk, averaging 30.1 ± 2.41 kg/d. The inclusion of fat tended to reduce methane produced per kilogram of dry matter intake from 24.9 to 23.1 ± 1.59 L/kg, whereas hemicellulose had no effect. Increasing hemicellulose increased neutral detergent fiber (NDF) digestibility from 43.0 to 51.1 ± 2.35%. Similarly, increasing hemicellulose concentration increased total intake of digestible NDF from 6.62 to 8.42 ± 0.89 kg/d, whereas fat had no effect. Methane per unit of digested NDF tended to decrease from 64.8 to 49.2 ± 9.60 L/kg with increasing hemicellulose, whereas fat had no effect. An interaction between hemicellulose and fat content on net energy balance (milk plus tissue energy) was observed. Specifically, increasing hemicellulose in low-fat diets tended to increase net energy balance, but this was not observed in high-fat diets. These results confirm that methane production may be reduced with the inclusion of fat, whereas energy utilization of lactating dairy cows is improved by increasing hemicellulose in low-fat diets.
https://ift.tt/2HNBDzq
Housing, management characteristics, and factors associated with lameness, hock lesion, and hygiene of lactating dairy cattle on Upper Midwest United States dairy farms using automatic milking systems
Source:Journal of Dairy Science
Author(s): James A. Salfer, Justin M. Siewert, Marcia I. Endres
The objectives of this cross-sectional study were to describe housing and management practices on farms using automatic milking systems (AMS) in 2 states of the upper Midwest and to evaluate the association of various housing and management factors with 3 measures of animal welfare: prevalence of lameness, severe hock lesions, and dirty cows. Fifty-four farms were visited once to collect facility measurements and observations, interview the dairy producer, and score cows for locomotion, hock lesions, and hygiene. Median number of AMS units/farm was 2 (interquartile range = 1; range = 1 to 8). Factors concerning labor were the most commonly cited reason by dairy producers for making the transition to the AMS; additional commonly cited factors were an improvement in lifestyle and human health. Number of cows fetched per AMS, or manually brought to the AMS if not milked voluntarily, was 4.7 ± 2.3 cows/AMS per day (8% of cows) for free traffic flow farms and 3.3 ± 1.8 cows/AMS per day (5% of cows) for guided traffic flow farms. Cow resting surface was significantly associated with prevalence of lameness and severe lameness. Farms with sand-bedded freestalls (17.2%) and bedded packs (17.4%) had significantly lower lameness prevalence (score ≥3 on a 1 to 5 scale, with 1 = normal locomotion) than farms with mattress freestalls (30.5%), waterbeds (25.0%), and mattresses with access to pasture (22.6%). Farms with mattresses and access to pasture had similar lameness prevalence to farms with waterbeds, but were lower than farms with mattresses only. A somewhat similar result was found for severe lameness prevalence (score ≥4 on a 1 to 5 scale, with 1 = normal locomotion); farms with sand-bedded freestalls (2.8%), bedded packs (0.0%), and mattress freestalls with access to pasture (1.5%) had significantly lower prevalence than farms with mattresses (7.1%) or waterbeds (10.8%). Severe hock lesion prevalence (score = 3 on a 1 to 3 scale, with 1 = normal, 3 = swelling) in herds with sand-bedded freestalls, waterbeds, and bedded packs were similar and significantly lower than the prevalence in mattress-based freestalls. Cows housed in sand-bedded freestalls had significantly lower prevalence of dirty cows (score = 3 or 3.5 on a 1 to 5 scale, with 1 = clean) than those housed on mattresses and waterbeds, and had significantly lower prevalence of severely dirty cows (score = 4, 4.5 or 5 on a 1 to 5 scale, with 1 = clean) than all other housing systems except waterbeds, which was similar. Manure removal system (manual, automatic, or slatted floor) was significantly associated with prevalence of severely dirty cows; farms with manual scraping had lower prevalence of severely dirty cows than farms where alley scraping was practiced automatically or slatted floors were used. Dairy producers using AMS appeared to be successful with a variety of facility designs and management practices. Cow resting surface in AMS herds was associated with some animal health and welfare measurements.
https://ift.tt/2JQ4Lex
Randomized clinical trial of the effect of a fixed or increasing milk allowance in the first 2 weeks of life on health and performance of dairy calves
Source:Journal of Dairy Science
Author(s): W.A. Knauer, S.M. Godden, S.M. McGuirk, J. Sorg
The objective of this study was to describe the effect of offering a fixed or increasing milk allowance in the first 1 to 2 wk of life. We hypothesized that calves offered a fixed amount of milk early in life would not experience more scours, but rather would experience improved health and growth compared with calves that had their daily milk allowance slowly increased over a period of 1 to 2 wk. This randomized controlled clinical trial was conducted on 5 dairy farms in Minnesota with both a summer (June–August 2016) and winter (December–February 2017) period of enrollment. Heifer calves were enrolled at birth, weighed, and systematically assigned by birth order to either the slowly increasing (INC) control group or fixed allowance (FIX) treatment group by farm personnel. Calves assigned to the INC group were slowly increased from 4 to 5 L/d to gradually reach the full peak milk allowance of 6 to 8 L/d over a 7- to 14-d period, whereas calves assigned to the FIX group were offered a full peak milk allowance of 6 to 8 L/d beginning on d 1 after birth. The average FIX calf consumed an extra 14 L of milk as compared with INC calves over the first 2 wk of life, corresponding to an average INC intake of 5 L/d during first 1 to 2 wk of life as compared with an average intake of 6.8 L/d in FIX calves. Study technicians visited all farms weekly to collect health and performance data. Multivariable mixed models were used to describe the effect of treatment (INC/FIX) on 3-wk average daily gain (kg/d), 3-wk weight (kg), and hip height at wk 1, 3, and 7, controlling for the effect of season, birth weight, and the random effect of calf within farm. Multivariable logistic regression models were used to describe the effect of treatment on odds of technician and producer reported health events. One thousand two hundred and sixty-four heifer calves were enrolled (FIX n = 641; INC n = 623) with no difference in enrollment weight or hip height between groups. By 3 wk of age, FIX calves weighed 1.4 (0.59) kg more than INC calves, though the magnitude of this difference varied depending on the period of time INC calves were slowly increased in milk allowance (7 vs. 10 vs. 14 d). Calves in the FIX group grew 0.1 kg/d faster and were taller at wk 3 (0.3 ± 0.15 cm) of life. Forty-two percent (536/1264) of all enrolled calves had a first treatment event, with no effect of treatment on technician-reported health scores and no overall effect on producer-reported treatment or mortality events. Under the conditions of this study, offering a fixed milk allowance from d 1 of life improved calf growth during the first 3 wk as compared with a gradual increase in milk allowance, with no detrimental effect on calf health.
https://ift.tt/2LNNP5T
Rapid detection and characterization of postpasteurization contaminants in pasteurized fluid milk
Source:Journal of Dairy Science
Author(s): Alexander A. Alles, Martin Wiedmann, Nicole H. Martin
Microbial spoilage of pasteurized fluid milk is typically due to either (1) postpasteurization contamination (PPC) with psychrotolerant gram-negative bacteria (predominantly Pseudomonas) or (2) growth of psychrotolerant sporeformers (e.g., Paenibacillus) that have the ability to survive pasteurization when present as spores in raw milk, and to subsequently grow at refrigeration temperatures. While fluid milk quality has improved over the last several decades, continued reduction of PPC is hampered by the lack of rapid, sensitive, and specific methods that allow for detection of PPC in fluid milk, with fluid milk processors still often using time-consuming methods (e.g., Moseley keeping quality test). The goal of this project was to utilize a set of commercial fluid milk samples that are characterized by a mixture of samples with PPC due to psychrotolerant gram-negative bacteria and samples with presence and growth of psychrotolerant sporeforming bacteria to evaluate different approaches for rapid detection of PPC. Comprehensive microbiological shelf-life characterization of 105 pasteurized fluid milk samples obtained from 20 dairy processing plants showed that 60/105 samples reached bacterial counts >20,000 cfu/mL over the shelf-life due to PPC with gram-negative bacteria. Among these 60 samples with evidence of gram-negative PPC spoilage over the shelf-life, 100% (60/60) showed evidence of contamination with noncoliform, non-Enterobacteriaceae (EB) gram-negative bacteria (e.g., Pseudomonas), 20% (12/60) showed evidence of contamination with coliforms, and 7% (4/60) showed evidence of contamination with noncoliform EB. Among the remaining 45 samples, 28 showed levels of gram-positive bacteria above 20,000 cfu/mL and the remaining 17 samples did not exceed 20,000 cfu/mL over the shelf-life. Evaluation of the same set of 105 samples using 6 different approaches {all possible combinations of 2 different enrichment protocols (13°C or 21°C for 18 h) and 3 different plating media [crystal violet tetrazolium agar, EB Petrifilm (3M, St. Paul, MN), and Coliform Petrifilm]} showed that enrichment at 21°C for 18 h, followed by plating on crystal violet tetrazolium agar provided for the most sensitive, accelerated detection of samples that reached >20,000 cfu/mL due to PPC with psychrotolerant gram-negatives (70% sensitivity). These results show that tests still required and traditionally used in the dairy industry (e.g., coliform testing) are not suitable for monitoring for PPC. Rather, approaches that allow for detection of all gram-negative bacteria are essential for improved detection of PPC in fluid milk.
https://ift.tt/2JRkH04
Effects of overstocking at the feedbunk on the growth performance and sorting characteristics of a forage-based diet offered for ad libitum intake to replacement Holstein dairy heifers
Source:Journal of Dairy Science
Author(s): W.K. Coblentz, M.S. Akins, N.M. Esser, R.K. Ogden, S.L. Gelsinger
Various forms of overcrowding are common in heifer-rearing operations. Our objectives for this study were to evaluate the effects of overstocking at the feedbunk (100, 133, 160, or 200% of capacity) on the growth performance, feedbunk sorting behaviors, and hygiene of 128 gravid Holstein heifers (475 ± 55.3 kg) consuming an alfalfa haylage and corn silage diet diluted with processed wheat straw at an inclusion rate of 25.2% (DM basis). In this study, heifers were overstocked only at the feedbunk, and not with respect to available freestalls or pen area. Heifers were blocked by weight, and subsequently assigned to 1 of 16 identical research pens. A total mixed ration was distributed at 1000 h daily for 91 d via a drive-through feed alley, with heifers allowed access to the feedbunk through head-locking feeding gates. Mean weights for the 4 blocks (32 heifers/block) were 406 ± 14.9, 453 ± 15.3, 493 ± 17.6, and 548 ± 21.9 kg. Generally, nutrient intakes were not affected by stocking rate at the feedbunk; mean intakes of dry matter, neutral detergent fiber, and total digestible nutrients across all feedbunk stocking rates were 10.63, 5.19, and 6.29 kg/d, respectively. Overall, the effects of competition at the feedbunk on heifer growth performance were minor, with a collective average daily gain of 1.02 kg/d across all treatments. Only trends for linear increases in total weight gain and BCS were observed with overstocking at the feedbunk. Collectively, overstocked rates also exhibited a trend for better feed-to-gain ratio than pens stocked at 100% of feedbunk capacity (10.3 vs. 11.0 kg:kg). We observed solid evidence that heifers collectively sorted against large (>19 mm) particles, and also exhibited preference for short (>1.18 and <8 mm) and fine (<1.18 mm) feed particles; however, these responses were not affected by feedbunk stocking rate. Additionally, heifers sorted against neutral detergent fiber as the concentration of neutral detergent fiber remaining in the feedbunk increased during the 24-h period following feeding; conversely, they preferred crude protein, as indicated by a decreasing concentration of this nutrient over time. Heifer hygiene was not affected by competition at the feedbunk. Under the experimental conditions established for this trial, overstocking at the feedbunk did not affect heifer growth performance, but it should not be practiced blindly without attention to other critical components of animal welfare.
https://ift.tt/2LKEOKL
Hepatic phosphorylation status of serine/threonine kinase 1, mammalian target of rapamycin signaling proteins, and growth rate in Holstein heifer calves in response to maternal supply of methionine
Publication date: Available online 13 June 2018
Source:Journal of Dairy Science
Author(s): T. Xu, A.S.M. Alharthi, F. Batistel, A. Helmbrecht, C. Parys, E. Trevisi, X. Shen, J.J. Loor
The study investigated whether methionine supply during late pregnancy is associated with liver mammalian target of rapamycin (MTOR) pathway phosphorylation, plasma biomarkers, and growth in heifer calves born to cows fed a control diet (CON) or the control diet plus ethylcellulose rumen-protected methionine (MET; 0.09% of dry matter intake) for the last 28 d prepartum. Calves were fed and managed similarly during the first 56 d of age. Plasma was harvested at birth and 2, 7, 21, 42, and 50 d of age and was used for biomarker profiling. Liver biopsies were harvested at 4, 14, 28, and 50 d of age and used for protein expression. Body weight, hip height, hip width, wither height, body length, rectal temperature, fecal score, and respiratory score were measured weekly. Starter intake was measured daily, and average daily gain was calculated during the first 8 wk of age. During the first 7 wk of age, compared with calves in the CON group, calves in the MET group had greater body weight, hip height, wither height, and average daily gain despite similar daily starter intake. Concentration of methionine in plasma was lower at birth but increased markedly at 2 and 7 d of age in MET calves. Plasma insulin, glucose, free fatty acids, and hydroxybutyrate did not differ. A greater ratio of phosphorylated α-serine/threonine kinase (AKT):total AKT protein expression was detected in MET calves, namely due to differences at 4 d of age. The phosphorylated MTOR:total MTOR ratio also was greater in MET calves due to differences at 28 and 50 d (8 d postweaning). The decrease in phosphorylated MTOR:total MTOR between 14 and 28 d in CON calves agreed with the increase in phosphorylated eukaryotic translation initiation factor 4E binding protein 1 (EIF4EBP1):total EIF4EBP1 ratio during the same time frame. The overall expression of phosphorylated ribosomal protein S6 kinase B1 (RPS6KB1):total RPS6KB1 and phosphorylated eukaryotic translation elongation factor 2 (EEF2):total EEF2 was lower in MET calves. Regardless of methionine supply prepartum, there was an 11-fold temporal decrease from 4 to 50 d in phosphorylated AKT:total AKT. Similarly, regardless of methionine supply, there were overall decreases in phosphorylation ratios of AKT, MTOR, RPS6KB1, and eukaryotic translation initiation factor 2A (EIF2A) over time. Data provide evidence of a positive effect of methionine supply during the last month of pregnancy on rates of growth during the first 7 wk of age. Phosphorylation status of some components of the MTOR pathway in neonatal calf liver also was associated with greater maternal supply of methionine. Thus, the data suggest that molecular mechanisms in the liver might be programmed by supply of methionine during late pregnancy. The exact mechanisms coordinating the observed responses remain to be determined.
https://ift.tt/2JRkCti
Erratum: Validierung der deutschen Version des Eating Assessment Tool bei Kopf-Hals-Tumor-Patienten
Laryngo-Rhino-Otol
DOI: 10.1055/a-0623-6772
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
https://ift.tt/2HMEado
Curvilinear locus coeruleus functional connectivity trajectories over the adult lifespan: a 7T MRI study
Source:Neurobiology of Aging, Volume 69
Author(s): Heidi I.L. Jacobs, Lisa Müller-Ehrenberg, Nikos Priovoulos, Alard Roebroeck
The locus coeruleus (LC) plays a crucial role in modulating several higher order cognitive functions via its widespread projections to the entire brain. We set out to investigate the hypothesis that LC functional connectivity (FC) may fluctuate nonlinearly with age and explored its relation to memory function. To that end, 49 cognitively healthy individuals (19–74 years) underwent ultra high-resolution 7T resting-state functional magnetic resonance imaging and cognitive testing. FC patterns from the LC to regions of the isodendritic core network and cortical regions were examined using region of interest–to–region of interest analyses. Curvilinear patterns with age were observed for FC between the left LC and cortical regions and the nucleus basalis of Meynert. A linear negative association was observed between age and LC-FC and ventral tegmental area. Higher levels of FC between the LC and nucleus basalis of Meynert or ventral tegmental area were associated with lower memory performance from age of 40 years onward. Thus, different LC-FC patterns early in life can signal subtle memory deficits. Furthermore, these results highlight the importance of intact interactions between neurotransmitter systems for optimal cognitive aging.
https://ift.tt/2JBCJnJ
Postmortem brain MRI is related to cognitive decline, independent of cerebral vessel disease in older adults
Publication date: September 2018
Source:Neurobiology of Aging, Volume 69
Author(s): Robert J. Dawe, Lei Yu, Julie A. Schneider, Konstantinos Arfanakis, David A. Bennett, Patricia A. Boyle
The purpose of this study was to determine whether metrics of brain tissue integrity derived from postmortem magnetic resonance imaging (MRI) are associated with late-life cognitive decline, independent of cerebral vessel disease. Using data from 554 older adults, we used voxelwise regression to identify regions where the postmortem MRI transverse relaxation rate constant R2 was associated with the rate of decline in global cognition. We then used linear mixed models to investigate the association between a composite R2 measure and cognitive decline, controlling for neuropathology including 3 indices of vessel disease: atherosclerosis, arteriolosclerosis, and cerebral amyloid angiopathy. This composite R2 measure was associated with the rate of decline (0.049 unit annually per R2 unit, p < 0.0001) and accounted for 6.1% of its variance, beyond contributions from vessel disease indices and other prominent age-related neuropathologies. Thus, postmortem brain R2 reflects disease processes underlying cognitive decline that are not captured by vessel disease indices or other standard neuropathologic indices and may provide a measure of brain tissue integrity that is complementary to histopathologic evaluation.
https://ift.tt/2y8TpO1
Data on empirical investigation of direct and indirect effect of personality traits on entrepreneurs’ commitment of SMEs
Source:Data in Brief, Volume 19
Author(s): Ayoade Omisade Ezekiel, Ogunnaike Olaleke, Adegbuyi Omotayo, Fatai Lawal, Onakoya Femi
This data article presented the effect of the Big Five Personality traits on entrepreneurs' commitment. 400 copies of questionnaire were administered to practicing entrepreneurs whom were members of a business guild in their annual end of year meeting and award day. 369 copies were duly filled and returned for use. Using statistic package for social science (SPSS 20) and Amos 22, correlation and regression analysis were used to find out the relationship between the two constructs and the strength of the relationship respectively. The Amos path diagram revealed the standardized estimates of the regression coefficient.
https://ift.tt/2JFxsrc
A retrospective analysis of the association between providing nicotine replacement therapy at admission and motivation to quit and nicotine withdrawal symptoms during an inpatient psychiatric hospitalization
Source:Addictive Behaviors, Volume 85
Author(s): Chizimuzo T.C. Okoli, Yazan D. Al-Mrayat, Charles I. Shelton, Milan Khara
BackgroundPsychiatric patients have high tobacco use prevalence, dependence, and withdrawal severity. A tobacco-free psychiatric hospitalization necessitates the management of nicotine withdrawal (NW) for tobacco using patients. NW management often requires the provision of approved nicotine replacement therapy (NRT) to patients, which may also motivate tobacco users towards cessation. However, few studies have examined the associations between providing NRT, motivation to quit, and NW among psychiatric patients.Objective(s)To examine the associations between providing NRT at admission and motivation to quit smoking and severity of NW symptoms.DesignA retrospective review of the medical records of 255 tobacco using patients on whom NW was assessed during their hospital stay. The time when NRT was provided (i.e., at admission vs. not provided vs. on the unit), motivation to quit smoking, and 8-item Minnesota Nicotine Withdrawal Scale were assessed.ResultsThe primary NW symptom was 'craving' (65.1%); reporting of 'anxiety' varied by psychiatric diagnosis. Providing NRT at admission was not associated with motivation to quit. Patients receiving NRT on the unit (i.e., delayed receipt) had significantly higher NW than those who received NRT at admission. In multivariate analyses, receiving NRT on the unit was significantly associated with greater NW severity (β = .19, p = .002).ConclusionsAmong psychiatric patients, providing NRT at admission is associated with greater severity of NW. The provision of NRT for NW management may be considered as standard practice during tobacco-free psychiatric stays. Future studies may consider the effect of other tobacco treatment medications (such as varenicline, bupropion) on managing NW.
https://ift.tt/2HNzkMR
Assessing the factor structure and measurement invariance of the eating attitude test (EAT-26) across language and BMI in young Arab women
Abstract
Background
The objective of the study was to determine the factorial structure and test the measurement invariance of the EAT-26 in a large probability sample of young female university students in Qatar (n = 2692), a Muslim country in the Middle East.
Methods
The maximum number of factors was derived based on results from initial exploratory factor analysis (EFA) in the first-half of the randomly split sample (Sample 1). A subsequent EFA and Exploratory Structural Equation Models (ESEM) were conducted to identify the number of valid factors. A five-factor model with 19 items was identified as the optimal factor structure. This structure was further replicated using ESEM in the second-half of the sample (Sample 2). Multi-group Confirmatory Factor Analyses (CFAs) were conducted at this stage and their fit was evaluated with and without further sub-grouping by language (Arabic and English) and BMI (underweight, normal weight, and overweight/obese). Finally, measurement invariance tests were conducted in the entire sample assessing equivalence across language and BMI within the final five-factor model.
Results
The five-factor structure of the new EAT-19 [fear of getting fat (FGF), eating-related control (ERC), food preoccupation (FP), vomiting-purging behavior (VPB), and social pressure to gain weight (SP)] provided the best fit: CFI = 0.976, TLI = 0.952, RMSEA = 0.045 (90%CI 0.039–0.051), SRMR = 0.018, CD =1.000. CFAs supported metric invariance for language and for BMI. Language and BMI-based population heterogeneity comparisons provided modest and small-to-moderate evidence for differential factor means, respectively.
Conclusion
Although the five-factor model of the EAT-19 demonstrated good item characteristics and reliability in this young female population, the lack of scalar invariance across language and BMI-categories pose measurement challenges for use of this scale for screening purposes. Future studies should develop culture- and BMI-specific cut-offs when using the EAT as a screening instrument for disordered eating in non-clinical populations.
https://ift.tt/2t7z8Th
Combustion performance and exhaust emissions fuelled with non-surfactant water-in-diesel emulsion fuel made from different water sources
Abstract
Non-surfactant water-in-diesel emulsion fuel (NWD) is an alternative fuel that has the potential to reduce major exhaust emissions while simultaneously improving the combustion performance of a diesel engine. NWD comprises of diesel fuel and water (about 5% in volume) without any additional surfactants. This emulsion fuel is produced through an in-line mixing system that is installed very close to the diesel engine. This study focuses mainly on the performance and emission of diesel engine fuelled with NWD made from different water sources. The engine used in this study is a direct injection diesel engine with loads varying from 1 to 4 kW. The result shows that NWD made from tap water helps the engine to reduce nitrogen oxide (NOx) by 32%. Rainwater reduced it by 29% and seawater by 19%. In addition, all NWDs show significant improvements in engine performance as compared to diesel fuel, especially in the specific fuel consumption that indicates an average reduction of 6%. It is observed that all NWDs show compelling positive effects on engine performance, which is caused by the optimum water droplet size inside NWD.
https://ift.tt/2JUoytu
Trace element contaminant uptake in phytocap vegetation and implications for koala habitat, Lismore, Australia
Abstract
Phytocapping is increasingly regarded as an economical and environmentally sustainable post-closure landfill management strategy. During 2013, a phytocap comprised of koala habitat trees was established on a historic landfill site in Lismore as part of an Australian trial program (A-ACAP). This case study was conducted to determine trace element contamination of the Lismore phytocap soil and foliage, and identify risks to grazing koalas. Foliage of Eucalyptus tereticornis, a key koala food tree, and Acacia melanoxylon, a reference native species, were assessed at the phytocap and an uncontaminated reference site. Concentrations of Ag, As, Hg and Pb were significantly higher in foliage from the phytocap compared to that from the reference site (p < 0.0001df 7, 52). Mean trace element concentrations in phytocap E. tereticornis foliage were compliant with state and international standards for contaminants in food and animal feed (NSW State Government, 2010; WHO and FAO, 2015) and soil was compliant with national health-based investigation levels for contaminated sites (NEPC, 2011). However, contaminant distribution was not homogenous, and As and Pb concentrations exceeded guidelines in some soil and foliage samples. Based on available guidelines and weekly dietary intake calculations, risks to koala health posed by trace element contamination of phytocap foliage are currently low, though should be managed by continued monitoring as the vegetation matures.
https://ift.tt/2LPSF2t
ASSOCIATION OF FREE VITAMIN D3 CONCENTRATIONS AND ASTHMA TREATMENT FAILURES in the VIDA Trial
Vitamin D (vitamin D2 and vitamin D3) derived from sunlight exposure, diet or supplementation are converted to vitamin D2 (calciferol) and vitamin D3 (cholecalciferol) (25 (OH) D3) by vitamin D-25 hydroxylase (CYP2R1) in the liver, and subsequently converted to the biologically active 1,25-dihydroxyvitamin D2 and 1,25-dihydroxyvitamin D3 (25 (OH)2 D3) by CYP27B1 in the kidney and other tissue.1,2 Circulating total concentrations of vitamin D3 but not concentrations of active 1,25-dihydroxyvitamin D3 are used to define vitamin D status in part because of differences in total concentrations and half-life between the two metabolites.
https://ift.tt/2HLgtlm
DEPOT EXTRACTS FOR RUSH VENOM IMMUNOTHERAPY: A NEW THERAPEUTIC OPPORTUNITY FOR HYMENOPTERA STING ALLERGY
Stings by Hymenoptera insects are relatively common in the general population and may cause different symptoms ranging from mild and local reactions to life-threatening and fatal anaphylaxis.1
https://ift.tt/2JOV0NI
Decreased interleukin-35 serum levels in patients with chronic spontaneous urticaria
Chronic spontaneous urticaria (CSU), a mast cell-driven disease, is defined as the spontaneous appearance of wheals, angioedema or both for > 6 weeks for unknown or known causes.1 Mast cells, as one of the major effector cells in the immune response system, play important roles in the pathogenesis of CSU. Interleukin (IL)-35 is a new anti-inflammatory cytokine which belongs to the IL-12 family and is composed of two subunits: Epstein-Barr virus-induced gene 3 (EBI3) and IL-12p35. IL-35 is widely recognized as a definite immune suppressor with a huge potent of suppression.
https://ift.tt/2LNiekN
Immunotherapy and Skin Side Effects
https://ift.tt/2Mo2HZu
Sulfur Ointment Treatment of Cutaneous Myiasis Caused by the Tumbu Fly
https://ift.tt/2KbiHwS
Quality of Life and the Dermatologist
https://ift.tt/2ptLTqd
Carvedilol for Treatment of Red Vulva Syndrome
https://ift.tt/2FfOKIB
Thomas Hindson and Discovery of Ascorbic Acid to Treat Prickly Heat
https://ift.tt/2Mo2GEU
Vascular Malformations and Health-Related Quality of Life
https://ift.tt/2ptFJGK
Mogamilizumab Prior to HSCT and GVHD in Patients With CTCL
https://ift.tt/2GIcSV3
Endocrine Therapy–Induced Alopecia in Patients With Breast Cancer
https://ift.tt/2HeRESM
Recurrent Unilateral Periorbital Edema Associated With Subcutaneous Cysticercosis
https://ift.tt/2rwXO6N
Efficacy of Guselkumab Compared With Adalimumab and Placebo for Psoriasis in Specific Body Regions
https://ift.tt/2Glki09
Knowledge Removes Discomfort—Reply
https://ift.tt/2KumcP6
Interest and Uptake of MC1R Testing for Melanoma Risk in a Diverse Primary Care Population
https://ift.tt/2rwXQLX
Endurance—Frostbite, Then and Now
https://ift.tt/2JzyF7r
Cost-effectiveness of Skin Cancer Referral and Consultation Using Teledermoscopy in Australia
https://ift.tt/2KNLS9C
Association of Nodal Metastasis With Vermilion Lip Location in Cutaneous SCC of the Lip
https://ift.tt/2rgAaeP
Teaching Intuitive Visual Diagnosis of Melanoma
https://ift.tt/2rKNtVS
Frontalis Myocutaneous Transposition Flap for Forehead Defect Reconstruction
https://ift.tt/2L7Towm
Disentangling the interaction of sex differences and hemispheric specialization for face processing – evidence from ERPs
Source:Biological Psychology
Author(s): Joanna Stasch, Bettina Mohr, Andres H. Neuhaus
Recent studies on face processing and its hemispheric lateralization suggest that inconsistencies in earlier findings might be partially explained by sex differences, as findings from event-related potential studies indicated a more asymmetric functioning of the visual cortex during face encoding in men, whereas women seemed to display a more bilateral activation pattern. The aim of this study was to further investigate the role of sex differences in hemispheric specialization during face recognition. Fifty-four healthy participants (27 females and 27 males) engaged in a familiarity decision task in which famous and unfamiliar faces were presented in a lateralized tachistoscopic fashion with unilateral und bilateral presentation modes and measurement of event-related potentials and behavioral responses. Results showed a clear N170 component for males and females in all experimental conditions. No hemispheric differences of the N170 were observed in the bilateral condition and both groups showed larger right-hemispheric than left-hemispheric N170 amplitudes in the left visual field condition. In the right visual field condition, however, only female participants showed significantly larger left-hemispheric compared to right-hemispheric N170 amplitudes, whereas male participants did not show such a modulation. The effect corresponds to a greater responsivity of left-hemispheric processes underlying the N170 component in female participants. Further analyses revealed N170 differences in the left and right hemisphere for females only, when stimuli were presented unilaterally. In contrast, this modulation of N170 amplitudes was only observed in the left hemisphere in males. The results suggest a stronger hemispheric lateralization in men than in women during face processing.
https://ift.tt/2JQCZOR
Moyamoya disease in a Moroccan baby: a case report
A stroke in a baby is uncommon, recent studies suggested that their incidence is rising. Moyamoya disease is one of the leading causes of stroke in babies. This condition is mostly described in Japan. In Moroc...
https://ift.tt/2HNxtaF
Association between Breslow Thickness and Dermoscopic Findings in Acral Melanoma
Dermoscopy is a useful tool for the diagnosis of acral melanomas (AM). However, little is known about the influence of tumor thickness on the dermoscopic findings of AM.
https://ift.tt/2LOTV5E
Successful treatment of eosinophilic otitis media associated with severe bronchial asthma with an anti-IL-5 monoclonal antibody, mepolizumab
Eosinophilic otitis media (EOM), which is characterized by the accumulation of eosinophils in middle ear effusion and the middle ear mucosa, is a refractory type of otitis media that is often associated with asthma. Although an early diagnosis and appropriate treatment are necessary to prevent the progression of hearing loss in patients with EOM, there are currently no well-established treatments for this condition. We treated a 60-year-old male patient with asthma and EOM. The patient's asthma was poorly controlled, despite the use of high-dose inhaled corticosteroids, long-acting beta-agonist treatment, and the regular use of systemic corticosteroids.
https://ift.tt/2JGTaeh
An overview on personalisation of radiotherapy prescriptions in locally advanced non-small cell lung cancer: Are we there yet?
Source:Radiotherapy and Oncology
Author(s): Sarah Barrett, Gerard G. Hanna, Laure Marignol
Standard of care radiotherapy in LA-NSCLC is 60–66 Gy in 30–33 fractions. However outcomes for these patients are poor with 5-year survival in the range of 10–20%. Randomised controlled trials have shown that dose escalation in a linear fashion does not improve outcomes for all patients, thus there is a need to tailor the prescription to the individual patient. This review assesses the strategies published to personalise the radiation therapy dose prescription in LA-NSCLC. A systematic and scoping search of the literature was performed to identify studies that met the inclusion criteria. 19 relevant studies were identified ranging from prospective clinical trials to mathematically modelled concept studies. Heterogeneity existed between all clinical studies. Nine heterogeneous publications proposed methodology to adapt the dose prescription to the individual patient. A number of encouraging strategies have been identified but fall short of the evidence level required to influence clinical practice.
https://ift.tt/2l65bzt
Re: “Concurrent Milk Ingestion Decreases Absorption of Levothyroxine” by Chon et al. (Thyroid 2018;28:454–457)
Thyroid, Ahead of Print.
https://ift.tt/2JSMJbB
Does Reverse Triiodothyronine Testing Have Clinical Utility? An Analysis of Practice Variation Based on Order Data from a National Reference Laboratory
Thyroid, Ahead of Print.
https://ift.tt/2HLjPoH
Implication of surgical procedure in the induction of headache and generalized painful sensation in a fluid percussion injury model in rats
Source:Journal of Neuroscience Methods
Author(s): Fernando da SilvaFiorin, Caroline Cunha do Espírito Santo, Adair Roberto Soares Santos, Michele Rechia Fighera, Luiz Fernando Freire Royes
BackgroundThis study demonstrated the effects of traumatic brain injury (TBI) and each step of the surgical procedure for a fluid percussion injury (FPI) model on periorbital allodynia.New methodAdult male Wistar rats were divided in naive, incision, scraping, sham-TBI and TBI groups. Periorbital allodynia was evaluated using von Frey filaments, and heat hyperalgesia of the hindpaws was evaluated by a Plantar Test Apparatus.ResultsThe statistical analyses revealed that the surgical procedure decreased von Frey filaments thresholds twenty-four hours after the surgery in all groups when compared to the naive group (p < 0.0001). Scraping, sham-TBI and TBI groups showed a decrease in the periorbital mechanical threshold for 35 days compared with the naive and incision groups (p < 0.0001). Only the TBI group demonstrated a significant difference in periorbital allodynia at 45 and 60 days after the injury (p < 0.01). A significant decrease in the thermal withdrawal latency of the hindpaw contralateral to the lesion was observed in the TBI group compared with the naïve group at 7 days and 28 days after the lesion (p < 0.05).Comparison with existing methodsThis study presented in detail the effects of each stage of the surgical procedure for a FPI model on periorbital allodynia over time and characterized the TBI model for this evaluation.ConclusionThe FPI model is relevant for the study of headache and generalized pain in both acute and chronic phases after an injury.
https://ift.tt/2LPPXdl
A new frontier: Central line–associated bloodstream infection surveillance in home infusion therapy
Publication date: Available online 13 June 2018
Source:American Journal of Infection Control
Author(s): Sara C. Keller, Deborah Williams, Clare Rock, Shiv Deol, Polly Trexler, Sara E. Cosgrove
https://ift.tt/2JGKncn
Polycyclic aromatic hydrocarbons, phthalates, parabens and other environmental contaminants in dust and suspended particulates of Algiers, Algeria
Abstract
Chemicals such as polycyclic aromatic hydrocarbons (PAHs), phthalateesters, parabens, siloxanes and squalene, all of them classified as endocrine-disrupting chemicals (EDCs), have been reported to occur in all environmental compartments. The effects of EDCs on development, reproduction, growth, metabolism and obesity constitute a real public health issue. A list of EDCs (> 40 compounds) were characterised in total suspended particulates (outdoor soot: 92 samples) collected in July–September 2016 in an Algiers urban area; besides, settled indoor dusts (36 samples) were collected between November and December 2016 in schools, homes, manufacture and hospital of the same province. The analytical procedure consisted of ultrasonic bath extraction, column chromatography separation into fractions of different polarity and gas chromatographic-mass spectrometric processing. The total loads of phthalates ranging from 6.0 to 347 ng/m2 (median, 26 ng/m2) were determined in indoor dust and 4.6 to 11.6 ng/m3 (median, 7.9 ng/m3) in outdoor soot; meanwhile, PAHs ranged from 12.1 to 108 ng/m2 (median, 36 ng/m2) in indoor dust and ranged from 5.6 to 7.7 ng/m3 (median 5.7 ng/m3) in outdoor soot. Finally, illicit substances such as cocaine, cannabinol and Δ9-tetrahydrocannabinol were found to range from 0.5 to 11 pg/m3, 4.6 to 9.2 pg/m3 and 11 to 81 pg/m3, respectively, in outdoor soot.
https://ift.tt/2l4q79Y
Diurnal variations and pulpal status: is there a need for FFT besides LDF?
Abstract
The aim of this article was to investigate the use of laser Doppler flowmetry (LDF) combined with a fast Fourier transformation (FFT). LDF data in relation to three different scenarios were evaluated: (a) LDF records of a right central upper incisor of one patient were used for FFT analysis. These records were obtained by means of 30 pre-manufactured splints, handled by dentists without any experience in LDF recording. (b) Diurnal variations in one patient were analysed with LDF and FFT using 11 splints by one and same experienced investigator at four specific moments of the day. (c) Pulpal status was analysed using 17 splints. Eleven for a patient, standing as case model and six splints for six other patients. In this specific group, each patient had one vital and one non-vital central maxillary incisor and was analysed separately by LDF and FFT. The data of assessment (b) showed diurnal variations on LDF values of almost 80%, indicating that LDF registration is best performed in the same time period of the day. Data verification with FFT confirmed the findings without FFT of assessment (a) and (b). In assessment, (c) FFT demonstrated a clear distinction between a vital and a non-vital pulp for those cases with one vital tooth and one root canal treated tooth. In those cases with one vital incisor and the other traumatised, FFT was undeterminated. Considered that FFT was obtained after LDF recording and remained undeterminated for a decision in cases with decreasing pulpal blood flow in time, the added value of FFT in pulpal traumatology was minimal.
https://ift.tt/2l8YA7u
Problematic End Points in a Keratinocyte Carcinoma Chemoprevention Trial—Reply
https://ift.tt/2Mq2ntB
An Elderly Woman With Painful Buttock and Vulvar Ulcers
https://ift.tt/2y50QWB
Association of RARβ Expression With Lichen Sclerosus–Associated Vulvar Squamous Cell Carcinoma
https://ift.tt/2MlY42a
Problematic End Points in a Keratinocyte Carcinoma Chemoprevention Trial
https://ift.tt/2y8mCIY
Efficacy and Safety of Ozenoxacin for Treatment of Patients With Impetigo
https://ift.tt/2MlurOt
Contributions by MC1R Variants to Melanoma Risk in Males and Females
https://ift.tt/2y47494
Stent-induced compression necrosis for the endoscopic removal of a partially eroded Lap-Band
Endoscopic removal of eroded Lap-Bands is a minimally invasive alternative to surgical removal that prerequires sufficient erosion through the gastric wall, that is, ≥180° of the gastro-oesophageal wall circumference. A 69-year-old woman presented with dysphagia due to a long-standing Lap-Band erosion, currently of a 60° circumference. Adhesions due to her extensive surgical history rendered surgical treatment undesirable, so a self-expanding stent was placed endoscopically to induce sufficient erosion for subsequent endoscopic removal. During therapy, the patient complained of ructus and dysphagia, probably related to an overly proximally (oesophageal) positioned stent. After a total of 12 weeks, far longer than the described stenting duration in the literature, the Lap-Band was found free in the gastric lumen and was successfully removed using an endoscopic loop. Stent-induced compression necrosis should be considered as a minimally invasive treatment option for Lap-Bands eroded for <180°, with caution in the context of extensive fibrosis.
https://ift.tt/2JGbRPl
Phlegmasia cerulea dolens presenting with acute compartment syndrome and pulmonary embolism
Description
A 50-year-old woman, a known diabetic and hypertensive with poor compliance to treatment, presented with fever, dyspnoea and left-sided pleuritic chest pain for 15 days and left lower limb swelling worsening over the past 1 week. On examination, her vitals were stable, and she had significant left lower limb oedema extending up to the upper thigh with livedo reticularis (figure 1). The left lower limb pulses were not palpable. There was excruciating pain on light touch and passive flexion of the toes and ankle. Urgent arterial and venous Doppler sonography of the lower limbs revealed a left-sided iliofemoral venous thrombus. With the clinical diagnosis of acute compartment syndrome, urgent single incision four compartment fasciotomy was performed.
Figure 1
(A) Clinical examination at the time of admission showing lower limb oedema with livedo reticularis, (B) left lower leg livedo reticularis with superficial blistering (white arrow) and (C)...
https://ift.tt/2Mmz4YR
Spontaneous tumour lysis syndrome in small cell lung cancer: a rare phenomenon
Tumour lysis syndrome (TLS) is an oncological emergency. It is caused by cellular death occurring secondary to cancer therapy or spontaneously in rapidly dividing tumours. More common in haematological malignancies, it has also been reported in solid tumours. Out of 14 cases of small cell lung cancer (SCLC) with TLS, only three cases of spontaneous TLS have been reported in literature to date. Here we report a case of SCLC presenting as a spontaneous TLS.
https://ift.tt/2y7nwpc
Fulminant pulmonary embolism with fatal outcome in a patient with low clinical prediction scores
We present a case of a 72-year-old man with submassive acute pulmonary thromboembolism. Pulmonary embolism severity index Score and common clinical risk stratification recommended systemic anticoagulation and a clinical course without complications was expected. A primary reperfusion strategy was not indicated by the current guidelines. Under established anticoagulation, the patient was found in cardiac arrest immediately after mobilisation from the bed the next morning. Right heart catheterisation under ongoing resuscitation revealed a complete obstruction of the right pulmonary artery by a big thrombus. Catheter-directed intervention trying to bypass the thrombus with interventional guidewires failed. Ultimately, the patient died from acute right heart failure. The current case raises concern that the prediction scores available for pulmonary embolism may insufficiently predict short-term outcome in isolated patients.
https://ift.tt/2MiGbBv
Giant choledochal cyst presenting during third trimester of pregnancy
Biliary cystic disease is a rare entity. Twenty-five per cent of cases are diagnosed during adulthood and only a few reports have described this condition during pregnancy, where it represents a therapeutic challenge for both obstetricians and surgeons with regard to the risks it entails for the patient and the fetus.
Definitive management is surgical resection, as cysts may progress to malignancy if untreated. During pregnancy, resection is generally deferred to after delivery, especially in the context of suspected cholangitis.
A 19-year-old young woman with no previous prenatal control, presented to the emergency department on her 32nd week of gestation with abdominal pain and jaundice. A giant Todani I biliary cyst was observed on imaging along with dilation of the proximal biliary tree suggesting acute cholangitis. Fetal compromise prompted immediate delivery after which percutaneous biliary drainage was performed. Following recovery, the cyst was surgically resected.
https://ift.tt/2JLufql
Circumcaval ureter/retrocaval ureter
Description
A 33-year-old non-diabetic married woman from rural background presented with complaints of dull intermittent right flank pain since 1 year. She had no history of fever, dysuria, haematuria or weight loss. Clinical examination of the abdomen was within normal limits. Complete laboratory evaluation including urinalysis, complete blood picture, urea, creatinine and electrolytes were within normal limits. Ultrasonography (USG) of kidney, ureters and bladder showed moderate hydroureteronephrosis (HDUN) until right midureter. Intravenous pyelography (IVP) revealed dilated right renal pelvicalyceal system and upper ureter with abrupt S-shaped turn of ureter at the level of L4 vertebrae.
The appearance on IVP was strongly suspicious of retrocaval ureter and hence a contrast-enhanced CT urography was performed to confirm the diagnosis, which showed dilated right proximal ureter (figure 1) coursing medially and lying posterior to inferior vena cava (IVC). Three-dimensional reconstruction from CT urography showed proximal HDUN and classical S-shaped loop of the ureter behind the IVC...
https://ift.tt/2MiG88N
Aortopulmonary window with pumonary atresia with ventricular septal defect with D-transposition of great arteries: extremely rare anomaly
Aortopulmonary window (APW) is rare a congenital heart disease accounting for 0.1%–0.2% of all congenital heart defects. The 35% of the APW has been associated with wide variety of other structural heart diseases such as ventricular septal defect, persistent ductus arteriosus, arch anomalies and coronary artery anomalies. To the best of our knowledge, only six cases of APW with pulmonary atresia with ventricular septal defect has been described in the literature. It resembles the type 1 truncus arteriosus, and differentiation from this condition is important prior to surgical correction. We present a case of 14-year-old girl child; she was diagnosed with APW with pulmonary atresia with ventricular septal defect and D transposition of great arteries with the help of echocardiography, cardiac catheterisation and cardiac CT.
https://ift.tt/2JGbHrd
Association between Breslow Thickness and Dermoscopic Findings in Acral Melanoma
Publication date: Available online 13 June 2018
Source:Journal of the American Academy of Dermatology
Author(s): Je-Ho Mun, Gwanghyun Jo, Claudia C. Darmawan, Jin Park, Jung Min Bae, HyunJu Jin, Woo-Il Kim, Hoon-Soo Kim, Hyun-Chang Ko, Byung-Soo Kim, Moon-Bum Kim
BackgroundDermoscopy is a useful tool for the diagnosis of acral melanomas (AM). However, little is known about the influence of tumor thickness on the dermoscopic findings of AM.ObjectiveTo investigate the impact of Breslow thickness (BT) on the dermoscopic patterns of AM.MethodsData on cases of AM on the glabrous skin were collected from four university hospitals. We investigated the frequency of each dermoscopic feature of AM according to the BT. Statistical analysis was performed to investigate the association between the specific dermoscopic patterns and BT.ResultsMultivariable analysis revealed that red (odds ratio [OR] 16.482, 95% confidence interval [CI] 3.605-99.016), blue (OR 7.092; 95% CI 1.707-37.435), and white colors (OR 5.048, 95% CI 1.152-22.897) were more common in AM with BT >2 mm. Regarding patterns, atypical vascular patterns (OR 34.589, 95% CI 6.458-305.852), blue-white veil (OR 9.605, 95% CI 1.971-72.062), and ulcers (OR 5.084, 95% CI 1.145-24.152) were more frequently detected in cases with BT >2 mm.LimitationsA retrospective study design and small sample sizeConclusionThis study showed an association between dermoscopic patterns and tumor thickness among patients with AM. Dermoscopy can be a useful adjuvant tool in predicting BT in AM.
https://ift.tt/2HJT3NB
Incontinentia Pigmenti Misdiagnosed as Neonatal Herpes Simplex Virus Infection
Incontinentia pigmenti (IP) is an X-linked dominant neurocutaneous syndrome with ophthalmologic, neurologic, cutaneous, and dental manifestations and in most cases antenatally lethal in boys. Occasionally, typical IP may occur in boys due to Klinefelter syndrome or a genomic mosaicism. Skin lesions are observed in 4 stages: blistering, verrucous linear plaques, swirling macular hyperpigmentation, followed by linear hypopigmentation that develop during adolescence and early adulthood. Neonatal herpes simplex virus (HSV) infection can be manifested in 3 forms: localized, disseminated, and central nervous system (CNS) involvement. Timely diagnosis and treatment of neonatal HSV infection is critical. In this case report, we present a 12-day female newborn with a history of maternal genital HSV in second trimester and vesicular lesions on the upper and lower limbs that was appeared at first hours of life. She was admitted in the maternity hospital that was born and was treated by antibiotic and acyclovir for 11 days. Then, she readmitted for her distributed vesicular lesions. The results of blood and CSF for HSV PCR were negative. Eventually the diagnosis for incontinentia pigmenti was made by consultation with a dermatologist, and skin biopsy confirmed the diagnosis.
https://ift.tt/2JHK29w
Developmental assessment of preterm infants: Chronological or corrected age?
Source:Research in Developmental Disabilities, Volume 80
Author(s): Ayelet Harel-Gadassi, Edwa Friedlander, Maya Yaari, Benjamin Bar-Oz, Smadar Eventov-Friedman, David Mankuta, Nurit Yirmiya
The aim of this study is to examine the effect of age correction on the developmental assessment scores of preterm infants, using for the first time, the Mullen scales of early learning (MSEL) test. Participants included 110 preterm infants (born at a gestational age of ≤ 34 weeks) at ages 1, 4, 8, 12, 18, 24 and 36 months. The corrected age-based MSEL composite score and each of the five MSEL scale scores were significantly higher than chronological age-based scores at all ages. These corrected scores were significantly higher than the chronological scores regardless of gestational age whether weight was, or adequate or small for gestational age. Larger differences between corrected and chronological age-based scores significantly correlated with earlier gestational age and with lower birth weight between 1 and 24 months but not at 36 months. Using chronological age-based scores yielded significantly more infants identified with developmental delays than using corrected age-based scores. The findings indicate that clinicians and researchers, as well as family members, should be aware of and acknowledge the distinction between corrected and chronological ages when evaluating preterm infants in research and clinical practices.
https://ift.tt/2t223bq