Risk factors related to the appearance of umbilical disorders in dairy calves / [Fatores de risco relacionados ao surgimento de afecções umbilicais em bezerros leiteiros]

The objective of this study was to determine the types of calve housing used in dairy farms, the prevalence of umbilical disorders and related risk factors. The 16 farms studied were visited to characterize the types of installation and possible risk factors, as well as information obtained from a questionnaire applied to the farmers. 806 Holstein calves were physically examined, in addition to collecting blood samples for the evaluation of Failures in Passive Immunity Transfer (FPIT), in animals that manifested inflammatory omphalopathies, and were also submitted to ultrasound examination. The prevalence of omphalopathies was assessed by Fisher's test, and multivariate logistic regression to assess risk factors. Eight types of installation were found: tropical house, suspended cage, collective stall, collective picket, Argentinean type, single-story cage, individual stall, and collective picket with chain. Omphalopathies accounted for 6.45% of the calves. Small size farms (up to 99 lactation cows) had high risk for umbilical disorders, ground floor collective calves, without side protection, with sand floor, in closed sheds and without heatstroke were considered risk factors for omphalopathies. Adequate colostrum and umbilical antisepsis are not associated with disease, its appearance being related to the housing conditions of the animals.(AU)

O objetivo deste estudo foi determinar os tipos de alojamento para bezerros leiteiros, a prevalência de onfalopatias e os fatores de risco relacionados. As 16 fazendas estudadas foram visitadas buscando-se caracterizar os tipos de instalação e os possíveis fatores de risco, além de informações obtidas de um questionário aplicado aos fazendeiros. Foram examinados fisicamente 806 bezerros da raça Holandesa, além da coleta de amostras de sangue, para avaliação da falha de transferência de imunidade passiva (FTIP), nos animais que manifestaram onfalopatias inflamatórias, sendo submetidos também ao exame ultrassonográfico. A prevalência das onfalopatias foi avaliada por teste de Fisher, e foi feita regressão logística multivariada a fim de se avaliarem os fatores de risco. Verificou-se oito tipos de instalação: casinha tropical, gaiola suspensa, baia coletiva, piquete coletivo, bezerreiro tipo argentino, gaiola térrea, baia individual e piquete coletivo com corrente. As onfalopatias corresponderam a 6,45% dos bezerros. Os bezerreiros coletivos térreos, sem proteções laterais, com piso de areia, borracha, concreto ou madeira, em galpões fechados, sem insolação, com alta densidade animal, antissepsia umbilical realizada por três dias e FTIP acima de 50% foram considerados fatores de risco para onfalopatias e possuem relação com o bezerreiro, sendo decisivas para evitar essas condições a colostragem e a antissepsia umbilical adequadas.(AU)

Low Dose Aspirin in high-risk pregnancies: The volatile effect of acetylsalicylic acid on the inhibition of platelets uncovered by G. Born's light transmission aggregometry.

Preeclampsia still represents a life-threatening pregnancy complication, associated with severe maternal and neonatal morbidity and mortality. Low-dose Aspirin is advised to avoid preeclampsia in high-risk pregnancies worldwide. As Aspirin does not cover all women at risk, the prescription raises questions concerning optimal target population, dosage, and onset of therapy. The aim of this study was to test platelet responsiveness on Aspirin by optical aggegrometry, to gain robust biochemically assessment data of Aspirin in an obstetric cohort. 248 women at high risk for development of preeclampsia were included in the study. Aspirin-prophylaxis was administered either in 100 mg (n = 229) or 150 mg (n = 90) daily. Dosing of 100 mg Aspirin was maintained if testing revealed a sufficient platelet inhibition. If platelet inhibition was insufficient, dosage was increased to 150 mg Aspirin and re-testing was advised. 91 patients (91/229 = 39.7%) presented a sufficient inhibitory Aspirin effect at a dosage of 100 mg, but in 138 patients LTA showed an inadequate Aspirin response (138/229 = 60.3%). In 19 women 150 mg Aspirin was administered as starting dose due to new recommendations. Of all women at 150 mg Aspirin 64 did not properly respond (35.4%). The overall rate of sufficient responding women regardless the Aspirin dose was 64.6%. This study demonstrates still an insufficient inhibition of platelet aggregation in about 1/3 of women even with a dosage of 150 mg Aspirin daily, who might potentially benefit from further increase. These data show, that there is a need for further research to allow a personalized approach for individualized Aspirin therapy, maximizing the preventive benefit for mother and child.

Implementation of buffy-coat-derived pooled platelet concentrates for internal quality control of light transmission aggregometry: a proof of concept study.

Essentials In platelet function testing, standardized internal controls (IQC) are not commercially provided. Platelet function testing was performed daily on aliquoted pooled platelet concentrates. Pooled platelet concentrates showed stability for control purposes from Monday to Friday. Pooled platelet concentrates provide the necessary steadiness to serve as IQC material. SUMMARY: Background Standardized commercially available control material for internal quality control (IQC) of light transmission aggregometry (LTA) is still lacking. Moreover, the availability of normal blood donors to provide fresh platelets is difficult in small laboratories, where 'volunteers' may be in short supply. Objectives To evaluate the implementation of buffy-coat-derived pooled platelet concentrates (PCs) for IQC material for LTA. Methods We used buffy-coat-derived pooled PCs from the blood bank as IQC material for LTA. On each weekend one PC was prepared (> 200 mL) and aliquoted from the original storage bag on a daily basis in four baby bags (40-50 mL), which were delivered from Monday to Friday to our laboratory. The IQC measurements of at least 85 work-weeks (from Monday to Friday) were evaluated with this new IQC material. LTA was performed on a four-channel Chronolog 700 Aggregometer (Chronolog Corporation, Havertown, PA, USA) (agonists: collagen, adenosine diphosphate [ADP], arachidonic acid [AA] and thrombin receptor activator peptide-6 [TRAP-6]). Results The medians of platelet aggregation from IQC measurements with collagen, ADP and AA from Monday to Friday were 68.0-59.5, 3.0-2.0 and 51.0-50.0%, respectively, and the mean of platelet aggregation with TRAP-6 was 71.2-66.4%. Conclusions Buffy-coat-derived pooled PCs serve as a reliable and robust IQC material for LTA measurements and would be beneficial for the whole laboratory procedure and employees' safety.

Delivery of a live newborn in a triplet pregnancy complicated by preeclampsia after intrauterine demise of two and expulsion of one triplet: a case report.

Delayed interval delivery in twin pregnancies is an unusual occurrence, even more so in triplet pregnancies. We report on a delayed interval delivery in a dichorionic triamniotic triplet pregnancy after in vitro fertilization (IVF). Because of severe twin to twin transfusion syndrome (TTTS), two fetuses demised at 22 weeks of gestation. One of the two fetuses spontaneously aborted at 25 weeks of gestation. The remaining live fetus and the second demised fetus were delivered by cesarean section 9 weeks later because of the occurrence of preeclampsia. This case indicates that delayed interval delivery in triplets is possible and that preeclampsia can occur after intrauterine demise of two fetuses.

[Ultrasound hard tissue detection for registration in orthopedics and traumatology]. / Ultraschall-Hartgewebedetektion zur Registrierung in der Orthopädie und Traumatologie.

The application of x-ray diagnostics for intraoperative navigation and for registration of hard tissue structures is restrained due to high radiation loads and the not given real time ability. Previous approaches with conventional ultrasonic imaging are only interactively applicable due to the high information content of soft tissue optimised B-mode-images. A pure image processing does not allow an automatic identification of individual structures, so that this must be done by the physician. To decrease the high expense of time, this report presents a concept for an adapted chain of rf-signal processing as well as an ultrasonic system for the contrast-enhanced representation of tissue borders. The system permits an exact measurement of the body geometry, which is demonstrated by determining the position of the pelvis entry plane.

[Ultrasound control of thermal tissue therapy]. / Ultraschall-Kontrolle Thermischer Tumor Therapien.

As alternatives to surgical resection and/or supportive to radio- or chemo-therapy of tumors and metastases minimal invasive interstitial thermal treatment procedures by which the tissue is heated up locally to temperatures up to 100 degrees C are used. However beside nuclear magnetic resonance tomography there is no economical, by routine applicable procedure for non invasive therapy control at present disposal. In this work the possibility of non invasive control of thermal therapies by means of temporal and spectral analysis of radio frequency ultrasound signals are evaluated. Two different ultrasonic procedures, the first beeing based on the analysis of local modifications in the time of flight of the ultrasound signal for determination of the temperature distribution in the tissue, the second beeing based on the physical attenuation characteristics of biological tissue and their dependence on the tissue structure are proposed and evaluated for therapy control. With in vitro experiments the possibilities and limitations of both procedures and preliminary results of a prototype control system are demonstrated.

Disappearance of hepatitis B surface antigen during an unusual case of fulminant hepatitis B.

A 30-year-old surgical resident was admitted to the hospital with symptoms of acute hepatitis; two days later he became comatose. Hepatitis B surface antigen had been detected in his serum two days prior to admission, but it was not detected at any time thereafter. Hepatitis B e antigen, antibody to hepatitis B core antigen, and antibody to hepatitis B surface antigen were detected using sensitive radioimmunoassays at admission. Titers of antibody to hepatitis B core antigen increased over the next five weeks. Clearance of hepatitis B e antigen and subsequent appearance of antibody to hepatitis B e antigen accompanied clinical improvement and recovery. This unusual case documents that hepatitis B surface antigen can become undetectable during the course of fulminant hepatitis B and indicates the importance of tests for other serologic markers of hepatitis B virus in the evaluation of hepatitis B surface antigen-negative fulminant hepatitis.

Echocardiographic observations of paradoxic pulse without pericardial disease.

Echocardiograms were obtained in 10 normal patients and in 11 patients with respiratory insufficiency due to chronic obstructive lung disease (8) and to thoracic poliomyelitis (3). Only the eight patients with obstructive lung disease had paradoxic pulse. No patient had pericardial disease. The left ventricular internal dimension, stroke volume, and the mitral valve E-F slope and D-E excursion were measured. The inspiratory to expiratory ratio of each measurement was significantly lower in patients with obstructive lung disease than in normal subjects. The patients with thoracic poliomyelitis demonstrated almost no respiratory change in these measurements. The magnitude of the change in the measured factors probably relates to the degree of negativity of intrathoracic pressure during respiration. The inspiratory reduction of mitral valve motion and left ventricular internal dimension is not specific to tamponade but may be seen in patients who exhibit paradoxic pulse due to other conditions.

Chest wall stimulation for temporary suppression of competitive rhythms due to permanent pacemaker malfunction.

Chest wall stimulation by electrical stimuli was employed to suppress permanent demand (ventricular-inhibited) pacemakers in two patients with competitive ventricular rhythms. The stimuli were nor perceived by either patient, and were continued until surgical intervention was effected. In selected patients with permanent pacemaker malfunction, chest wall stimulation may be appropriate and necessary initial therapy until definitive correction is performed.