Health and welfare assessment of beef cattle during the adaptation period in a specialized commercial fattening unit.

Beef cattle welfare and health status are influenced by housing and management systems. The present study aimed to assess the welfare and health status in the first 15 days after arrival of Limousine bulls imported from France and fattened in a commercial fattening unit in Italy. A total of 264 bulls were included in the study. Welfare, biosecurity, and major hazard and warning system were assessed on days 2 (T1) and 15 (T2) after arrival to the unit. At T1 and T2 an inspective clinical examination was performed on all bulls. At T1 and T2 blood samples were collected from 88 bulls for haematological analysis. Both at T1 and T2, the welfare, biosecurity, and major hazards and warning systems were classified with a general score of medium but with a decrease on animal-based measurements in T2. At T1 and T2 the clinical examination revealed a significant increase (p-value≤0.05) of skin lesions and lameness in T2. A high incidence of respiratory disease was noticed in both assessed times. Leucocytes and all differentials count, and platelets were significantly increased (p-value≤0.05) at T2, while the fibrinogen was significantly decreased. The haematological changes suggest that the bulls were under higher stress in T2 when compared with T1 linked with a difficult adaptation response to the fattening unit. A multi-factorial approach that integrates the indicators of the checklist and the clinical and haematological findings of animals can be a useful method to deepen the assessment of welfare in beef cattle.

Are grape juices more erosive than orange juices?

AIMS: To evaluate the chemical characteristics of grape and orange juices, and their erosive potential in the decrease of microhardness and the loss of enamel structure. METHODS: Five grape and orange juices were evaluated for pH, titratable acidity, calcium, phosphate, and fluoride concentration. De-ionised water and Cola soft drink were used as a negative and positive control, respectively. Twelve specimens of bovine enamel were immersed in beverages for 10 min at 37 °C, 3 times/day for 7 days. Erosive potential was quantified using microhardness and loss of enamel structure. Anova One Way, Student's t test, Multiple Regression and Spearman Correlation (p < 0.05) were used to analyse the results. RESULTS: Powdered grape juice showed the lowest pH (3.18 ± 0.03) and pure grape juice presented the highest titratable acidity (5.48 ± 0.06 mL NaOH/100 mL). Fresh orange juice and soya-based grape juice revealed the lowest calcium (0.77 ± 0.12 mmol/L) and phosphate concentrations (0.35 ± 0.06 mmol/L), respectively. Among juices, powdered orange juice caused the greatest decrease in surface microhardness (SMH) (127.99 ± 40.47 ΔSMH) and grape juice from concentrate caused the greatest loss of enamel structure (13.30 ± 3.56 µm). CONCLUSIONS: All of the evaluated juices contributed to dental erosion. Grape juices presented greater erosive potential than orange juices. Pure, powdered and concentrated grape juices showed similar loss of enamel structure to the Cola soft drink. The erosive potential of beverages was statistically correlated to pH, titratable acidity, calcium, phosphate and fluoride concentrations.

Growth Plate Lesions of Fattening Bulls.

Lameness related to growth plate lesions is an important problem in the beef industry. This article describes the macroscopic and microscopic lesions in the distal metatarsal physis of bulls from an association of farmers in northeastern Italy. The metatarsal bones of 62 bulls (12 with severe lameness and 50 without lameness), average age 16.44 ± 1.72 months, were examined at the abattoir. The animals came from the same geographic area and shared intensive husbandry practices and a diet based on maize starch. A total of 124 metatarsal bones were sectioned, and the distal metaphyseal growth plate was grossly examined. Twenty-three cases, including 12 lame and 9 nonlame animals with visible lesions on macroscopic examination, and 2 controls (a total of 46 physes) were examined microscopically. Eight of 12 bulls with severe lameness had a chronic purulent physitis in at least 1 limb. Segmental thickening of the hypertrophic zone, consistent with osteochondrosis (OC), was present contralaterally ( n = 3 cases) and bilaterally ( n = 3 cases) in 6 of these animals. In the group of nonlame bulls, 19 of 50 (38%) had similar segmental thickening of the physis consistent with OC. In the remaining bulls, minor findings included partial closure of the physis and a variable degree of metaphyseal hyperemia. A high incidence of OC was found in both lame and nonlame fattening bulls. It is likely that lame animals were clinically more severe due to secondary hematogenous implantation of bacteria, resulting in a purulent physitis and severe lameness that required emergency slaughter in some cases.

Design evolution in total knee replacement: which is the future?

Total knee replacement (TKR) procedures have evolved in the last 40 years to guarantee improvements implants life and an excellent joint function. The goals for the future evolutions are make easier prosthesis implantation and promote precision. The demand for TKR will rise for the life length increase and for the risk factors impact increase. Design evolution in total knee replacement has to satisfy these new necessities: anatomic congruence, range of motion, less material wear and better resistance to the weight bearing and to the stresses. This paper analyzes design evolution, materials development and future purposes in total knee arthroplasty. At the beginning, TKR history is treated; then we compare several prosthetic designs developed during years. At last the paper speak about recent innovations, like CAD (computer aided design) for example, born to reach the most important goal in the future: better TKR design, is the one that better imitate natural knee characteristics, and that is able to integrate it-self with capsule-ligaments and muscle-tendons patient structures.

Arthroscopic treatment of isolated subscapolaris lesions: our experience.

BACKGROUND AND AIM OF THE WORK: Subscapularis tendon lesions, in particular the isolated ones, are often not recognized and undervalued, so in the literature they are described with a variable incidence. Aim of the work is presenting our experience with the short to medium term follow up results of the arthroscopic repair of isolated subscapularis lesions. METHODS: We retrospectively analyzed 311 shoulder arthroscopies performed by a single senior surgeon, from which we have found 10 isolated subscapularis lesions. After the arthroscopic repair of subscapularis tendon the patients have been evaluated with a median follow up of 17.7 months with specific tests for the subscapularis (Napoleon's and lift off tests) and clinical scores (Constant and UCLA scores). RESULTS: We have obtained the tests negativization with an internal rotation level up to D8. The Constant score reached 86.7 with a median improvement of 49.4 points. The UCLA score at the last follow up was 30.8 with a median improvement of 20.1 points. CONCLUSIONS: Isolated subscapularis lesions are uncommon and often they are not correctly diagnosed. Arthroscopy has a decisive role in both the diagnostic and therapeutic side, with good short to medium term results.

Bacterial intensity and localization in primary molars with caries disease.

AIM: The aim was to assess the characteristics and outcomes of infections affecting the structures of carious primary molars. MATERIALS AND METHODS: Forty primary molars were used and classified according to the following clinical situation: With profound caries lesion, with bone loss at the furcation region, with perforation of the pulp chamber floor, and residual roots. The teeth were demineralized, cut, and stained with both haematoxylin-eosin and Brown and Brenn staining techniques. Assessment was performed using optical microscopy. RESULTS: Statistical analysis of the data by means of the Chi-square test suggests that there was a significant relationship (P<0.001) between the intensity and localization of infection and the level of destruction of dental structures. A significant difference was also observed in the intensity and localization of infection between the groups regarding crown, furca, and root (P<0.001). CONCLUSION: More intense and profound the infection, more severe is the dental destruction. The groups of residual roots showed the most severe bacterial infection compared to other groups.

A prospective survey of febrile events in hematological malignancies.

The Hema e-Chart prospectively collected data on febrile events (FEs) in hematological malignancy patients (HMs). The aim of the study was to assess the number, causes and outcome of HM-related FEs. Data were collected in a computerized registry that systematically approached the study and the evolution of FEs developing in a cohort of adult HMs who were admitted to 19 hematology departments in Italy from March 2007 to December 2008. A total of 869 FEs in 3,197 patients with newly diagnosed HMs were recorded. Fever of unidentified origin (FUO) was observed in 386 cases (44.4%). The other causes of FE were identified as noninfectious in 48 cases (5.5%) and infectious in 435 cases (50.1%). Bacteria were the most common cause of infectious FEs (301 cases), followed by fungi (95 cases), and viruses (7 cases). Mixed agents were isolated in 32 episodes. The attributable mortality rate was 6.7% (58 FEs). No deaths were observed in viral infection or in the noninfectious groups, while 25 deaths were due to FUO, 16 to bacterial infections, 14 to fungal infections, and three to mixed infections. The Hema e-Chart provided a complete system for the epidemiological study of infectious complications in HMs.

Human cases of West Nile Virus infection in north-eastern Italy, 15 June to 15 November 2010.

In 2010, for the third consecutive year, human cases of West Nile virus (WNV) infection, including three confirmed cases of neuroinvasive disease and three confirmed cases of West Nile fever, were identified in north-eastern Italy. While in 2008 and 2009 all human cases of WNV disease were recorded in the south of the Veneto region, cases of WNV disease in 2010 additionally occurred in two relatively small northern areas of Veneto, located outside those with WNV circulation in the previous years. WNV IgG antibody prevalence in blood donors resident in Veneto was estimated as ranging from 3.2 per 1,000 in areas not affected by cases of WNV disease to 33.3 per 1,000 in a highly affected area of the Rovigo province. No further autochthonous human cases of WNV disease were notified in Italy in 2010. The recurrence of human cases of WNV infection for the third consecutive year strongly suggests WNV has become endemic in north-eastern Italy.

Electronic determination of root canal working length in primary molar teeth: an in vivo and ex vivo study.

AIM: To evaluate in vivo and ex vivo the accuracy of an electronic apex locator in primary molar teeth with or without root resorption. METHODOLOGY: Fifteen primary molar teeth with 30 root canals were divided into two groups: roots without resorption (n = 13) and roots with resorption (n = 17). Root canals were measured with the Root ZX apex locator in vivo, and then after tooth extraction, each canal was measured electronically ex vivo. The actual root canal length was measured visually, with the placement of a K-file into the most cervical edge of either apical foramen or resorption. The Student's t-test was applied for statistical analysis at a 5% significance level. RESULTS: The electronic apex locator was precise in 69% and 65% of the cases with and without root resorption, respectively (tolerance = ± 0.5 mm), in vivo and 69% and 77%ex vivo. When the tolerance was ± 1 mm, however, these figures increased to 92% and 94% for root canals with and without resorption, respectively, in vivo and ex vivo. No significant difference was observed between the resorbed and non-resorbed root canals measured using the Root ZX. CONCLUSION: The Root ZX apex locator was accurate in determining in vivo and ex vivo the working length ± 1 mm in primary molar teeth in over 90% of roots regardless of the presence of root resorption.

Conserved T cell and natural killer cell function in treatment-experienced adults receiving tenofovir plus didanosine as nucleoside reverse transcription inhibitor backbone.

Anti-retroviral treatment (ART) usually results in efficient control of virus replication and in immune reconstitution. Among potential adverse effects, impairment of immune responses in terms of CD4(+) T cell counts has been attributed to some ART regimens, as with didanosine-tenofovir. We studied the functional integrity of adaptive and innate immunity during didanosine-tenofovir-containing ART. Two groups of extensively pretreated patients completing at least 48 weeks of ART containing either lamivudine-didanosine (n = 21) or tenofovir-didanosine (n = 25) were identified. In addition to standard clinical immune and virological parameters, we performed a flow cytometric analysis of natural killer (NK) cells, of memory and naive CD4(+) T cells and of T cell receptor alphabeta(+) T cells co-expressing inhibitory NK receptors. Functional analysis consisted in specific and total interferon-gamma production by NK cells and of recall antigen proliferation of peripheral blood mononuclear cells. Comparable clinical immunological reconstitution and virological control were confirmed in the two groups of patients in the absence of clinically relevant adverse effects. The proportion of CD4(+)CD45RA(+) T cells and of functionally inhibited killer immunoglobulin-like receptor T cell receptor alphabeta(+) cells, the proliferation to recall antigens as well as NK cell phenotype and function as determined by interferon-gamma production in patients treated with tenofovir-didanosine were comparable to those treated with a different regimen. Thus, no differences in functional innate or adaptive immune reconstitution are detected in drug-experienced human immunodeficiency virus-infected patients on tenofovir-didanosine nucleoside reverse transcription inhibitor regimens.

A fatal case of invasive fungal sinusitis by Scopulariopsis acremonium in a bone marrow transplant recipient.

A fatal case of Scopulariopsis acremonium sinus infection in an allogeneic hematopoietic stem cell transplant patient is reported. Rapid vascular diffusion of the fungus to the major head vessels was observed, which led to subsequent repeated cerebral ischemia and death. The presence of hyphae in the right carotid wall might be considered an indirect sign of fungal blood diffusion in the absence of positive blood cultures. The infection developed during the course of prolonged voriconazole prophylaxis, which was found to be effective in the in vitro antifungal drug assay. This finding induced us to consider the capacity of this drug to reach infected paranasal sinuses, and the need in cases such as this of a combined systemic and local pharmacological therapy or a combined medical and surgical approach.

Clinical experience with eperisone in the treatment of acute low back pain.

AIM: A muscle contracture is the main responsible for low back pain and it consists of a persistent and involuntary muscle shortening, but it may be also the consequence of back pain thus fostering the painful condition. The goals of a pharmacological treatment for acute low back are, therefore, not only the relief of pain, but also the reduction of muscle spasm and inflammation, since nociception often results from local secondary inflammation and muscle spasm. Although systematic reviews have shown that muscle relaxants are effective in the management of non-specific low back pain, the use of these compounds is often limited by adverse effects on central nervous systems (CNS), such as drowsiness. Thus, the effects of eperisone, a new muscle relaxant agent with no CNS adverse effects, have been investigated. METHODS: A total of 100 patients (38 males and 62 females) with acute low back pain and moderate contracture of the spinal muscles arisen since less than 48 h were enrolled in the study. After physical examination, these patients were treated with eperisone 50 mg every 8 h for 10 consecutive days and were visited again after 3 days and at the end of treatment. RESULTS: Only 4 patients (4%) were obliged to stop treatment because of minor gastrointestinal adverse reactions. The administration of eperisone resulted in a prompt reduction of both spontaneous and provoked pain, as well as in a progressive decontracture of spinal muscles, as suggested by a reduction in resistance to passive movement, antalgic rigidity and ''hand-to-floor'' distance. CONCLUSION: Eperisone is thus a muscle relaxant agent, with a mechanism of action slightly different from that of other muscle relaxants. In addition to an inhibition of mono- and multisynaptic reflexes in the spinal cord and supra-spinal structures, eperisone regulates the blood supply to skeletal muscles; this action is noteworthy since a muscle contracture may compress the small blood vessels and induce an ischemia leading to release of nociceptive compounds. Most importantly, eperisone is devoid of detrimental effects on CNS.

Therapeutical aspects and outcome of HIV/HCV coinfected patients treated with pegylated interferon plus ribavirin in an Italian cohort.

BACKGROUND: One-third of HIV-infected individuals suffer from chronic hepatitis C virus infection (HCV) in Europe. Recommendations from HCV-HIV International Panel advise current treatment with pegylated interferon plus ribavirin. We assessed the impact of interferon and ribavirin combination in 43 patients between 2002 and 2006. PATIENTS AND METHODS: All coinfected patients treated for HCV during the 5-year period were included in retrospective data collection. CD4+ T-lymphocyte count, HAART discontinuation, reasons for treatment interruption and factors correlated to sustained virological response (SVR) were monitored. RESULTS: The mean age was 41 +/- 6.7 years; the risk factor for coinfection was intravenous drug abuse in 32/43 (74%). The baseline CD4+ T-lymphocytes cell count was > 500 in 51% (22/43). Genotype 3a represented 51% (22/43); 37% were on HAART at baseline (16/43) and half of patients showed high HCV RNA levels (> 800,000 IU/ml). High rates of treatment discontinuation were observed (27/43, 63%), caused by voluntary interruptions in 52% (14/27) and virological failure in 26% (7/27). The overall population had an SVR of 30%; genotypes 3a and 1 had SVR of 38% and 24%, respectively. The SVR was significantly lower in three groups: high HCV RNA viral load (chi2 = 6, p < 0.0025), CD4+ T-lymphocyte historical nadir <350 cells/mm3 (chi2 = 3.26, p < 0.01) and genotype 1 with high viral load (chi2 = 4.8, p < 0.005). CONCLUSIONS: Although factors such as HCV viral load rates and genotype 1 have been confirmed to threaten the response to therapy, we observed a significant response rate when patients had a history of CD4+ T-lymphocyte nadir >350 per mm3. The high dropout rates due to voluntary discontinuations complicated the patients' case management.

[An unusual case of severe arterial hypertension and acute renal failure in an obese young adult]. / Un inusuale caso di ipertensione arteriosa severa e insufficienza renale acuta in un soggetto obeso di età giovane-adulta.

We report a case of type-B aortic dissection occurring in a 38-year-old obese man, whose past medical history was positive for arterial hypertension and apparently negative for chronic kidney disease. The patient had severe refractory hypertension and acute renal insufficiency due to renal vascular impairment. The correct diagnosis was delayed because the clinical presentation was atypical, initially mimicking an acute abdominal inflammatory process (such as acute pyelonephritis) with secondary sepsis, and there was no major hemodynamic impairment. Percutaneous management (endografting of the thoracic aorta to seal the thoracic intima tear and renal revascularization by PTA+stenting) led to remission, albeit partial, of the acute renal insufficiency and to target blood pressure achievement with use of multiple antihypertensive agents. Follow-up at 12 months showed stable renal function, normal endograft placement and normal aortic diameter at CT examination. The percutaneous endovascular management of aortic dissection is a valid alternative to traditional surgery, with less morbidity and mortality; when the renal circulation is impaired by the aortic dissection, aortic endografting and renal revascularization by PTA+stenting, where appropriate, may allow at least partial reversal of renal insufficiency and target blood pressure achievement.

Persistence of Candida albicans candidemia in non-neutropenic surgical patients: management of a representative patient in the absence of second-line treatment guidelines.

Primary treatment failure and mortality in non-neutropenic patients with candidemia is high according to clinical trial experience. Current guidelines are mainly useful only for first line treatment strategies.We describe treatment failure and persistent protracted Candida albicans candidemia without clinically evident ocular involvement nor catheter recolonization in a malnourished non-neutropenic surgical patient with peritonitis. Primary antifungal treatment failure with fluconazole and secondary treatment failure with caspofungin occurred in the absence of evident Candida seeding the eye, valvular endocardium, or the intravascular catheter. Switch to liposomal amphotericin B was followed by clinical and microbiological cure. In patients with multiple risk factors for the acquisition of candidemia and life-threatening clinical conditions, the possibility of primary/secondary failure of new potent antifungal regimens may be initially neglected. Additional multicenter controlled clinical data are needed to guide the timing and choice of secondary antifungal treatment regimens in non-neutropenic candidemia patients.

Neurological manifestation of tick-borne encephalitis in North-Eastern Italy.

Tick-borne encephalitis (TBE) is an infectious zoonotic disease, moving from Central Europe to other countries and still rare in Italy. The disease, produced by the European subtype virus, typically takes a biphasic course with neurological disorders of different severity during its second phase. We report the first three TBE cases in Friuli Venezia Giulia (FVG), characterised by extremely variable clinical features. Knowledge of these different presentations will assist physicians in increasing their level of attention to TBE also in this region, where no cases of TBE had been reported in the past, despite the fact that it borders countries with high prevalence of the infection.

Physiological changes of Fagus sylvatica seedlings infected with Phytophthora citricola and the contribution of its elicitin "citricolin" to pathogenesis.

Beech seedlings were infected with the root rot pathogen Phytophthora citricola to study its impact on leaf physiology and water status. Net photosynthesis rate decreased two days after inoculation in infected seedlings. In contrast, electron quantum yield of photosystem II, leaf water potential, and total water consumption were only slightly impaired until 6 dpi. At the same time, wilt symptoms occurred on leaves. These results indicate the involvement of a mobile signal triggering the early changes in leaf physiology by root infection. As the elicitin gene of P. citricola was induced during root infection, we purified and characterised the elicitin protein and tested its ability to change leaf physiological parameters of beech and tobacco plants. P. citricola produced a single acidic elicitin (citricolin), which caused necrosis and decreased gas exchange of tobacco leaves. Furthermore, it induced an oxidative burst in tobacco cell suspension culture. However, none of these effects were observed in beech.

Mycobacterium marinum: a case of skin granuloma complicated by tenosynovitis of the extensors.

The authors report the case of a male patient who owned a tropical aquarium and who developed a M. marinum skin infection of the wrist. The clinical findings and microbiological features of the case are described, as are the difficulty in providing a prompt diagnosis, and the need for surgical treatment and the use of antibiotics to treat the infection.

HIV/HTLV co-infection: frequency and epidemiological characteristics among patients admitted to an Italian hospital.

BACKGROUND: Human T-cell leukemia/lymphoma viruses (HTLV) and HIV share identical modes of transmission and co-infections may be detected in populations that are highly exposed to common risk factors. MATERIALS AND METHODS: A total of 599 serum samples from HIV-positive patients attending our outpatient clinic during the last semester of 2000 were tested to assess the prevalence of HTLV co-infection in both Italian (n = 472) and non-European HIV-infected patients (n = 127). RESULTS: 72 samples were positive for HTLV-II. Most of the HTLV-II-positive patients were Italian (71/72, 98.6%) and 98.5% of them had acquired the HIV infection through use of intravenous recreational drugs. CONCLUSION: These data demonstrate a high HTLV-II exposure among HIV-positive intravenous drug users in our area which was not previously considered to be an area of endemicity for HTLV-II.