RESUMEN
First two decades of the twenty-first century are characterised by epidemics of non-communicable diseases such as many hundreds of millions of patients diagnosed with cardiovascular diseases and the type 2 diabetes mellitus, breast, lung, liver and prostate malignancies, neurological, sleep, mood and eye disorders, amongst others. Consequent socio-economic burden is tremendous. Unprecedented decrease in age of maladaptive individuals has been reported. The absolute majority of expanding non-communicable disorders carry a chronic character, over a couple of years progressing from reversible suboptimal health conditions to irreversible severe pathologies and cascading collateral complications. The time-frame between onset of SHS and clinical manifestation of associated disorders is the operational area for an application of reliable risk assessment tools and predictive diagnostics followed by the cost-effective targeted prevention and treatments tailored to the person. This article demonstrates advanced strategies in bio/medical sciences and healthcare focused on suboptimal health conditions in the frame-work of Predictive, Preventive and Personalised Medicine (3PM/PPPM). Potential benefits in healthcare systems and for society at large include but are not restricted to an improved life-quality of major populations and socio-economical groups, advanced professionalism of healthcare-givers and sustainable healthcare economy. Amongst others, following medical areas are proposed to strongly benefit from PPPM strategies applied to the identification and treatment of suboptimal health conditions:Stress overload associated pathologiesMale and female healthPlanned pregnanciesPeriodontal healthEye disordersInflammatory disorders, wound healing and pain management with associated complicationsMetabolic disorders and suboptimal body weightCardiovascular pathologiesCancersStroke, particularly of unknown aetiology and in young individualsSleep medicineSports medicineImproved individual outcomes under pandemic conditions such as COVID-19.
RESUMEN
CASE DESCRIPTION: In February 2020, a swine farm operating in multiple states throughout the Midwest began to evaluate emergency plans to respond to potential impacts of the COVID-19 pandemic. CLINICAL FINDINGS: From February through April, extensive mitigation strategies were implemented in anticipation of market disruption. The farm consulted the AVMA Guidelines for the Depopulation of Animals to identify preferred methods for depopulation of swine; however, none of these methods were feasible. When the first US packing plant closed in April 2020 because of human COVID-19 infection, the farm began to evaluate whether ventilation shutdown plus (VSD+) could be used for depopulation. TREATMENT AND OUTCOME: Through proof-of-concept trials, a method for ventilation shutdown with the addition of supplemental temperature and humidity was developed. A single location with 4 barns that could be retrofitted for the process was selected, and between April and June 2020, 243,016 pigs were depopulated (59,478 nursery and 183,538 finishing pigs). Mean ± SD time to silent (the time when no sounds could be heard and no motion seen) was 55.4 ± 14.5 minutes for the nursery pigs and 65.0 ± 18.1 minutes for the finishing pigs. Only 728 (0.300%) pigs required manual euthanasia at the end of the depopulation process. CLINICAL RELEVANCE: Efficacy exceeded AVMA recommendations for the use of VSD+ (> 95% mortality rate in < 1 hour). Findings could potentially guide the use of this method for mass depopulation in the event of a foreign animal disease outbreak or severe market disruption in the future.