Feasibility Study of an Automated Assembly Process for Ultrathin Chips.

This paper presents a feasibility study of an automated pick-and-place process for ultrathin chips on a standard automatic assembly machine. So far, scientific research about automated assembly of ultrathin chips, with thicknesses less than 50 µm, is missing, but is necessary for cost-effective, high-quantity production of system-in-foil for applications in narrow spaces or flexible smart health systems applied in biomedical applications. Novel pick-and-place tools for ultrathin chip handling were fabricated and a process for chip detachment from thermal release foil was developed. On this basis, an adhesive bonding process for ultrathin chips with 30 µm thickness was developed and transferred to an automatic assembly machine. Multiple ultrathin chips aligned to each other were automatically placed and transferred onto glass and polyimide foil with a relative placement accuracy of ±25 µm.

Mammary gland health of Santa Inês ewes at the drying and puerperium and evaluation of a dry-off terapy with gentamicin / Sanidade da glândula mamária de ovelhas Santa Inês na secagem e no puerpério e avaliação da terapia intramamária com gentamicina na secagem

Mastitis represents an important health problem for Santa Inês breed, causing losses to the producer, due to loss of ewes or the decrease in weight gain of lambs. The aim of this work was to assess the health of the mammary gland of Santa Inês ewes at the drying and puerperium and to investigate the efficacy of a dry-off therapy with gentamicin. In this study, 64 ewes were divided in a control group (GC) and treatment group (GT), and the health of the mammary gland was assessed at the drying and puerperium. The GT ewes received 250mg of gentamicin (Gentocin® DryCow/Schering-Plough, product indicated for use in dairy cows) in each mammary half. For diagnosis, clinical examination, California Mastitis Test, somatic cell count and milk culture was performed. In the GC, of the 45 (70.3%) healthy mammary halves at the drying, 12 developed subclinical mastitis and nine clinical mastitis at the puerperium. In the GT, among 51 (79.7%) healthy mammary halves at the drying, six developed subclinical mastitis and 11 clinical mastitis at the puerperium. No association was observed between treatment and the occurrence of mastitis at puerperium. Of the 19 (29.7%) mammary halves of the GC that presented subclinical mastitis at the drying, three remained with subclinical mastitis and five developed clinical mastitis at the puerperium. In the GT, of the 13 (20.3%) mammary halves that had subclinical mastitis at the drying, four remained with subclinical mastitis and four developed clinical mastitis. No association was observed between treatment and cure or persistence of mastitis at the puerperium. The main microorganisms isolated, at the drying and puerperium, from animals with subclinical or clinical mastitis were Staphylococcus spp., predominantly coagulase negative Staphylococcus (CSN). At the puerperium, 29 cases of clinical mastitis occurred, 19 with isolation, where 10 were CNS and six S. aureus. Mannheimia haemolytica was isolated in one case of subclinical mastitis and other of clinical mastitis. News protocols and different ways of handling at drying and at puerperium must be investigated.(AU)

A mastite é um problema sanitário importante em ovelhas da raça Santa Inês, ocasionando prejuízo ao produtor em virtude do descarte de matrizes e da queda no ganho de peso dos cordeiros. O objetivo deste trabalho foi avaliar a saúde da glândula mamária de ovelhas da raça Santa Inês na secagem e no puerpério e pesquisar a eficácia da terapia intramamária com gentamicina na secagem. Sessenta e quatro ovelhas foram divididas em grupos controle (GC) e tratamento (GT), cada um contendo 32 animais, e a saúde da glândula mamária avaliada na secagem e no puerpério. As ovelhas do GT receberam 250mg de gentamicina (Gentocin® Mastite Vaca Seca/ Schering-Plough Veterinária, produto indicado pela empresa para utilização em vacas de leite) em cada metade mamária. Para o diagnóstico, foram realizados exame físico da glândula mamária, California Mastitis Test, contagem de células somáticas e cultura do leite. No GC, das 45 (70,3%) metades mamárias sadias na secagem, 12 desenvolveram mastite subclínica e nove mastite clínica no puerpério. No GT, das 51 (79,7%) metades mamárias sadias na secagem, seis desenvolveram mastite subclínica e 11 mastite clínica no puerpério. Não houve associação entre o tratamento e a ocorrência de mastite no puerpério. Das 19 (29,7%) metades mamárias do GC que apresentaram mastite subclínica na secagem, três permaneceram com mastite subclínica e cinco desenvolveram mastite clínica no puerpério. No GT, das 13 (20,3%) metades mamárias com mastite subclínica na secagem, quatro permaneceram com mastite subclínica e quatro desenvolveram mastite clínica. Não houve associação entre o tratamento e a cura ou persistência da mastite no puerpério. Os principais micro-organismos isolados, na secagem e puerpério, de animais com mastite subclínica ou clínica foram Staphylococcus spp., com predominância de Staphylococcus Coagulase Negativa (SCN). No puerpério, ocorreram 29 casos de mastite clínica, sendo 19 com isolamento, 10 com SCN e seis com S. aureus. Mannheimia haemolytica foi isolado em um caso de mastite subclínica e um caso de mastite clínica. Novos protocolos e diferentes formas de manejo na secagem e no puerpério devem ser pesquisados.(AU)

Erlotinib and bevacizumab versus cisplatin, gemcitabine and bevacizumab in unselected nonsquamous nonsmall cell lung cancer.

Erlotinib with bevacizumab showed promising activity in recurrent nonsquamous (NS) nonsmall cell lung cancer (NSCLC). The INNOVATIONS study was designed to assess in first-line treatment of unselected cisplatin-eligible patients this combination compared to cisplatin, gemcitabine and bevacizumab. Stage IIIB/IV patients with NS-NSCLC were randomised on erlotinib (150 mg daily) and bevacizumab (15 mg·kg(-1) on day 1, every 3 weeks) (EB) until progression, or cisplatin (80 mg·m(-2) on day 1, every 3 weeks) and gemcitabine (1250 mg·m(-2) on days 1 and 8, every 3 weeks) up to six cycles and bevacizumab (15 mg·kg(-1) on day 1, every 3 weeks) (PGB) until progression. 224 patients were randomised (EB n=111, PGB n=113). The response rate (12% versus 36%; p<0.0001), progression-free survival (median 3.5 versus 6.9 months; hazard ratio (HR) 1.85, 95% CI 1.39-2.45; p<0.0001) and overall survival (median 12.6 versus 17.8 months; HR 1.41, 95% CI 1.01-1.97; p=0.04) clearly favoured PGB. In patients with epidermal growth factor receptor mutations (n=32), response rate, progression-free survival and overall survival were not superior with EB. Platinum-based combination chemotherapy remains the standard of care in first-line treatment of unselected NS-NSCLC. Molecular targeted approaches strongly mandate appropriate testing and patient selection.

Fatores de risco, etiologia e aspectos clínicos da mastite em ovelhas de corte no Paraná / Risk factors, etiology and clinical aspects of mastitis in meat ewes of Parana, Brazil

A mastite em ovelhas da raça Santa Inês apresenta-se como um problema de grande proporção e gravidade e é dificilmente tratada com sucesso. O objetivo deste estudo foi caracterizar aspectos clínicos, epidemiológicos e etiológicos da mastite clínica em ovelhas de corte criadas no norte do Paraná. O presente estudo foi realizado entre os meses de outubro de 2009 a setembro de 2010 envolvendo 54 rebanhos de ovinos de corte de diferentes raças. Durante as visitas às propriedades, um questionário foi preenchido com a finalidade de caracterizar o problema. Setenta ovelhas com mastite clínica foram examinadas e amostras de secreção láctea foram colhidas para exame microbiológico. A mastite foi considerada um problema relevante em 39 propriedades (72,3%), com frequência média de 6,74%. Casos crônicos e agudos de mastite foram observados em 69% e 31% das ovelhas examinadas, respectivamente. Em ambos os casos, a mastite flegmonosa foi a forma mais encontrada (65,5% dos casos). O agente etiológico mais prevalente foi Staphylococcus coagulase negativo (54,5%), seguido por S. aureus e A. pyogenes (11,5% cada). Mannheimia haemolytica foi isolada em dois casos. Sistema de criação não extensivo e raça Santa Inês foram identificados como fatores de risco para o desenvolvimento de mastite clínica. Secagem das fêmeas após 120 dias de lactação e separação de fêmeas doentes do rebanho foram associadas com menor ocorrência da doença. Recomenda-se a limpeza adequada das instalações e a secagem mais tardia, principalmente em rebanhos Santa Inês.

Mastits is infrequent in meat ewes. However Santa Ines ewes have a high incidence of this disease and it is severe and difficult to treat. The goal of this study was to characterize clinical, epidemiological and etiological aspects of clinical mastitis in meat ewes reared in the north of Parana, Brazil. Fifith four farms were visited from October 2009 to September 2010. The surveyed data included frequency, breeds of sheep affected, lamb mortality rates, main clinical signs, attempts and outcome of treatment, method and period of weaning and management features. Seventy ewes with clinical mastitis were fully examinated and samples of mammary secretion were asseptically taken for bacteriological culture. Mastitis was identified in 39 farms (72.3%) as a relevant problem (mean frequency was 6,74%). Chronic and acute mastitis were observed in 69% and 31% of the examinated ewes, respectively. In both cases, phlegmonous mastitis was the most prevalent form (65.5%). Coagulase negative Staphylococccus (CNS) was the main isolated microorganism (54.5%), followed by Staphylococcus aureus and Arcanobacterium pyogenes (11.5%, each one). Mannheimia haemolytica was found in two cases. The risk factors for clinical mastitis were intensive management system and Santa Ines breed. Weaning after 120 days of lactation and isolation of affected ewes were associated with lower frequency of mastitis. Preventive measures recommended are daily cleaning of facilities and delayed weaning, mainly in Santa Ines flocks.

Treatment of Dens Fractures with Anterior Screw Fixation.

INTRODUCTION: Direct anterior screw fixation of the dens preserves C1-C2 rotation, and the reported fusion rates range from 88% to 100%. STEP 1 POSITIONING OF THE PATIENT: Exact positioning of the patient and use of image intensifiers are mandatory to obtain perfect anteroposterior and lateral views of the axis. STEP 2 SURGICAL APPROACH: The surgical approach is standardized, and the pretracheal layer can be exposed without violating any essential anatomic structures. STEP 3 ENTRY POINT OF THE SCREW: The perfect entry point is directly anterior-inferior at the base of C2; therefore, the anterior rim of the C2-C3 intervertebral disc must be penetrated. STEP 4 SCREW INSERTION: We use a single cannulated screw in most cases: insert the screw in the center of the dens with its tip perforating the cranial, cortical bone of the dens just posterior to the apex. STEP 5 WOUND CLOSURE: Precise and anatomic closure of the platysma determines the quality of the scar that will be visible after the operation. STEP 6 FOLLOW-UP: The patient wears a rigid collar for six weeks, removing it for body care; radiographic evaluations should be performed regularly. RESULTS: In a study of sixty-nine patients with a fracture of the dens, three of the thirteen patients who underwent direct anterior screw fixation had persistent instability and nonunion of the dens four months after surgery. Indications Contraindications Pitfalls & Challenges.

Treatment of Dens Fractures with Posterior Transarticular Fixation.

INTRODUCTION: Treatment of unstable dens fractures with posterior transarticular C1-C2 arthrodesis provides a biomechanically stable construct, even when poor bone quality is present, and a low rate of complications even in elderly patients; however, when this method of fixation is performed, cervical spine rotation is substantially reduced as compared with that associated with alternative fixation techniques. STEP 1 POSITIONING: Exact positioning of the patient and use of image intensifiers are mandatory to obtain appropriate anteroposterior and lateral views of C1 and C2. STEP 2 SURGICAL APPROACH: Use the modified technique of Magerl and Seemann, as it allows a less extensive approach to C1 and C2, and the drill can enter through two incisions at the level of T1. STEP 3 INSERTION OF SCREWS: Use smooth 2.0-mm Kirschner wires to prepare the canal for the screws, and subsequently replace them with 3.0-mm self-tapping screws. STEP 4 GALLIE FUSION: Perform a modified Gallie fusion, in addition to the transarticular screw fixation, to increase stability and osseous fusion between C1 and C2. STEP 5 WOUND CLOSURE: Perform meticulous closure of the wound to avoid wound-healing complications. RESULTS: In our original study, we treated twenty-five patients with posterior transarticular fixation.IndicationsContraindicationsPitfalls & Challenges.

[Procedural organisation: surgical and anaesthesiological management in hip fractures]. / Ablauforganisation - unfallchirurgisches und anästhesiologisches Management bei Hüftfrakturen.

In patients with hip fractures, in order to reduce the high number of general complications and those associated with the specific treatment, the functional loss and cognitive impairment, implementation of co-ordinated, multidisciplinary treatment pathways, and rehabilitation, is mandatory. The imminent treatment of proximal femoral fracture consists of major orthopaedic surgery in most cases (total or partial hip arthroplasty, osteosynthesis). After the diagnosis of a hip fracture, an adequate pain medication should be initiated. The decision making for the fracture treatment includes fracture type, patient's age, cognitive function, mobility before the fall and functional demands of the patient in the context of patients life expectancy and goals of care. The anaesthesiological evaluation focuses on risk assessment. Medical abnormalities should be optimized within 24 to 48 h, or an increased perioperative risk due to comorbidities has to be accepted. The timing and the course of further preoperative diagnostic examinations and therapeutic interventions should be co-ordinated between the involved medical disciplines. After the operation a structured screening for delirium should be initiated and further evaluation of patient's nutrition, fall-associated medication, living conditions and osteoporosis treatment has to be performed.

Rehabilitation after hip fracture.

Low-trauma hip fracture in old age leads to impairment, increased need of care and mortality. Rehabilitation should start in the department for traumatology and accompany the patient through different settings until the pretraumatic status is reached. Besides the surgical procedure and the medical management of an aged person with complex disease and polypharmacy, the multidisciplinary rehabilitation process is an important factor for regaining ability for self-care and autonomous decisions. Pain management supports the process. The ideal setting is not clear yet. Besides established rehabilitation facilities for elderly people, including the departments for 'Akutgeriatrie/Remobilisation', the 'Outreach Geriatric Remobilisation' project offers new perspectives. It was designed to remobilise patients with multimorbidity in their own homes.

Stress ulcer prophylaxis, thromboprophylaxis and coagulation management in patients with hip fractures.

Hip fracture in older patients is a major health concern. 20-25 % of hip fracture patients will die in the first year after the trauma (Lane, Clin Orthop Relat Res 471(8):2711, 2013). Postoperative venous thrombosis and gastrointestinal stress-ulcer bleeding are frequent complications with a high case-fatality rate particularly in older patients. Thromboprophylaxis and stress ulcer prophylaxis are important and well established measures to decrease postoperative complications and the mortality rate in this high-risk population.The working group on orthogeriatrics of the Austrian Society on Geriatrics and Gerontology (ÖGGG) is composed of geriatricians who work as trauma surgeons, internists, anaestesists and nurses. A thorough literature search was done, using the terms "orthogeriatrics" and "hip fracture" in combination with "stress ulcer", "gastrointestinal bleeding" and "thrombosis", "thromboprophylaxis". The data was collected, discussed and evaluated in several adjustment meetings of the group and summarized in this article.

Treatment and prevention of postoperative complications in hip fracture patients: infections and delirium.

The course of older patients with hip fractures is often complicated by infections and delirium. Accurate care and high suspicion for these complications are essential, since these conditions are associated with an increase in mortality, length of hospital stay and nursing home placement, poorer mobility, and functional decline. Because of immunosenescence and higher infection rates, older patients need specific care, immediate diagnosis, and treatment of infections. Numerous guidelines of various medical societies outline the management of nosocomial infections, but there is a need of an individualized treatment plan because of comorbidities and polypharmacy. Hygiene measures have first priority to reduce the rate of infections. Treatment of geriatric syndromes like malnutrition, exsiccosis, gait disorders, falls, delirium, urine incontinence, and organ insufficiency are as important as immunization against pneumococci and influenza. Advanced age, cognitive impairment, hearing loss, peripheral vascular disease, prior delirium episodes, sight disorders, and polypharmacy are established risk factors for delirium; thus, older people with several chronic diseases are prone to delirium. A multifactorial approach, comprising standardized screening, oxygen support, intravenous fluid administration and augmented nutrition, monitoring of vital signs, pain treatment, optimized medication, and modification in perioperative management, significantly reduces delirium incidence during hospitalization for hip fracture. An interdisciplinary approach between surgeons and geriatricians may warrant optimized satisfaction of patients' needs.

Treatment algorithm for dens fractures: non-halo immobilization, anterior screw fixation, or posterior transarticular C1-C2 fixation.

BACKGROUND: The appropriate treatment of dens fractures is unclear. We established a staged treatment protocol for dens fractures and conducted a prospective study to evaluate the outcome of treatment based on this protocol. METHODS: We prospectively evaluated sixty-nine consecutive patients who presented to our institution with a dens fracture. The mean duration of follow-up was 9.7 months (range, six to fifty-eight months). Fractures were categorized as stable or unstable. Stable fractures were treated by immobilization in a rigid collar. Patients seventy-five years or older with unstable fractures, patients with a neurological deficit, and patients with Anderson and D'Alonzo type-III fractures underwent posterior transarticular C1-C2 stabilization. Unstable fractures in patients younger than seventy-five years were stabilized with direct anterior screw fixation. Thirty-one patients were treated with a Philadelphia collar, twenty-five with posterior transarticular fixation, and thirteen with direct anterior screw fixation. RESULTS: Fracture-healing or solid fusion of C1-C2 was documented in sixty-eight of sixty-nine treated patients at final follow-up. The remaining patient had a stable nonunion of the dens. Secondary procedures were performed in five patients. CONCLUSIONS: Our treatment algorithm based on dens fracture type, fracture stability, and patient age was associated with a high success rate. Evaluating fracture stability is crucial when considering nonoperative treatment. External stabilization with a rigid cervical collar was adequate for stable fractures of the dens and was associated with a high healing rate. Posterior transarticular screw fixation of C1-C2 was associated with a high success rate, including in elderly patients. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Prevalência e fatores de risco associados à Leptospira spp. em rebanhos bovinos da região centro-sul do estado do Paraná / Prevalence and risk factors for Leptospira spp. in cattle herds in the south central region of Paraná state

O objetivo deste trabalho foi determinar a prevalência de anticorpos anti-Leptospira spp e os fatores de risco associados à infecção em rebanhos bovinos com atividade reprodutiva da região centro-sul do estado do Paraná. Foram utilizados o delineamento estatístico, as amostras sorológicas e as informações referentes às propriedades empregadas no estudo da brucelose bovina no estado do Paraná dentro do Contexto do Programa Nacional de Controle e Erradicação da Brucelose e Tuberculose. Foram estudadas 1.880 fêmeas com idade igual ou superior a 24 meses, provenientes de 274 rebanhos não vacinados contra a Leptospira spp. Para o diagnóstico sorológico da infecção foi utilizada a prova de soroaglutinação microscópica (SAM) com 22 sorovares de Leptospira spp. Em cada propriedade foi aplicado um questionário epidemiológico, a fim de obter informações epidemiológicas e práticas de manejo empregadas. Dos 274 rebanhos analisados, 181 foram considerados positivos para a Leptospira spp., com a prevalência de rebanhos de 66,06% (I.C.95%=60,12- 71,65%). Presença de > 43 bovinos (OR=3,120; I.C=1,418- 6,867), compra de reprodutores (O.R=2,010; I.C=1,154- 3,500), aluguel de pasto (O.R=2,925; I.C=1,060-8,068), presença de piquete de parição (O.R=1,981; I.C=1,068- 3,676) foram identificados como fatores de risco para a infecção para qualquer sorovar de Leptospira spp. na análise de regressão logística multivariada. Os fatores de risco para a infecção pelo sorovar Hardjo foram presença de >43 bovinos (O.R=3,622; I.C=1,512-8,677), compra de reprodutores (O.R=3,143; I.C=1,557-6,342), aluguel de pasto (O.R=4,070; I.C=1,370-12,087) e presença de eqüinos (O.R=2,981; I.C=1,321-6,726). Estes resultados indicam que a infecção pela Leptospira spp está amplamente distribuída na região centro-sul do estado do Paraná e que fatores elacionados às características das propriedades e ao manejo estão associados à infecção.

The aim of this study was to determine the prevalence of anti-Leptospira spp. antibodies and the risk factors for Leptospira spp. infection in breeding cattle herds in the south central region of Paraná state. It was based on the statistic delineation/serological samples and information regarding the selected farms employed in the study of bovine brucellosis for Paraná state in the context of National Program for Control and Eradication of Brucellosis and Tuberculosis. A total of 1.880 females aged >24 months from 274 non vaccinated herds were studied. Serum samples were tested for antibodies against Leptospira spp. using microscopic agglutination test (MAT) with 22 Leptospira serovars. The epidemiological questionnaire was applied on all the selected farms and aimed to obtain epidemiological data. Hundred eighty one of 274 herds were positive for Leptospira spp./presenting prevalence of positive herds of 66.06% (IC95%=60.12-71,65%). Presence of >43 cattle (OR=3.120; IC=1.418-6.867)/animal purchase (OR=2.010; IC=1.154-3.500)/rent of pastures (OR=2.925; IC=1.060-8.068) and presence of maternity paddock (OR=1.981; IC=1,068-3,676) were identified as risk factors for leptospirosis due to any serovar in the multivariate logistic regression. Risk factors for leptospirosis due to serovar Hardjo were presence of >43 cattle (OR=3.622; IC=1.512-8,677)/animal purchase (OR=3.143; IC=1.557-6.342)/rent of pastures (OR=4.070; IC=1.370-12.087) and presence of horses (OR=2.981; IC=1.321-6.726). These results indicate that Leptospira spp. infection is widespread in the south central region of Paraná state and that factors related to the herd characteristic and management are associated with the infection.

Pharyngeal lavage lymphocytosis in patients with obstructive sleep apnea: a preliminary observation.

BACKGROUND: Upper airway inflammation has been previously demonstrated in obstructive sleep apnea (OSA). However, investigation has been hampered by the necessity of invasive tissue biopsies. OBJECTIVE: To evaluate the pharyngeal lavage (PHAL) as a new tool to analyze mucosal inflammation in the pharynx of patients with sleep-related disordered breathing. PATIENTS AND METHODS: 36 patients with a diagnosis of OSA, 14 patients with heavy snorer syndrome (HS) or body position dependent OSA (bd-OSA), and 14 healthy volunteers underwent PHAL. Inflammatory cell counts were compared. RESULTS: Neutrophils were the predominant cells in PHAL in all groups (94.3% ± 0.7%, 98.5% ± 0.6%, 94.3% ± 0.7%, and 96.2% ± 1.4%). OSA patients had significantly increased numbers of lymphocytes (3.2% ± 0.4%) compared to bd-OSA/HS and controls group (0.5% ± 0.1% and 0.6% ± 0.2%, respectively; P<0.05). Patients with moderate to severe OSA had significantly higher numbers of lymphocytes compared to patients with mild OSA (P<0.05). CONCLUSIONS: Data from this study suggest that PHAL is a feasible tool to investigate upper airway inflammation in OSA. In addition, PHAL demonstrates lymphocytic inflammation of the pharynx in OSA patients. Future studies are warranted to evaluate whether PHAL can be used to monitor disease and whether lymphocytic inflammation is affected by OSA treatment.

Cotinus coggygria wood: novel flavanone dimer and development of an HPLC/UV/MS method for the simultaneous determination of fourteen phenolic constituents.

Phytochemical investigations of Cotinus coggygria Scop. wood, a medicinal and tinctorial plant used since antiquity, resulted in the isolation and structure elucidation of the novel C-3/C-3'' dimer of butin (3',4',7-trihydroxyflavanone) and other known compounds: gallic acid and its methyl ester; catechin; profisetinidins: fisetinidol-(4α→8)-(+)-catechin and epifisetinidol-(4ß→8)-(+)-catechin; flavanonols: fustin and dihydroquercetagetin; flavanones: butin and eriodictyol; flavonols: fisetin and quercetin; the chalcone butein and the aurone sulfuretin. The isolated compounds were used for the development and validation of a HPLC-method which enables the determination of these bioactive substances in C. coggygria extracts. Separation was possible on an ether-linked phenyl column material, using as mobile phase mixtures of water, methanol, and acetonitrile with 0.02% trifluoroacetic acid. Sensitivity, selectivity, linearity, precision, accuracy, and repeatability of the method were verified and assured suitability for its intended use. LC-MS experiments performed in positive and negative electrospray ionization mode confirmed the identity of analytes and allowed unambiguous assignment of all peaks of interest. The analysis of different C. coggygria samples revealed that sulfuretin (0.38-0.69%) and fustin (0.33-0.59%) dominated, followed by dihydroquercetagetin (0.12-0.35%), a rare flavanonol derivative with a 5,6,7-trihydroxysubstituted A-ring. The new natural compound C-3/C-3'' flavanone dimer occurred in concentrations of 0.03-0.06%; the two latter compounds could represent valuable markers for the identification and quality control of C. coggygria wood.

Evaluation on the Pathogenesis of Streptococcus agalactiae in Nile Tilapia (Oreochromis niloticus)

The pathogenesis of a Streptococcus agalactiae was evaluated in a three-period experiment. Two groups of 40 fishes were intraperitoneally (i.p.) challenged in each experimental period with different infective doses of the pathogen. Doses varied from 1.0 x 10(6) to 1.5 x 10(8) CFU/fish. One group of 40 tilapia i.p. injected with tryptic soy broth (TSB) was used as a control group in each period. Mortalities varied from 67.5 percent in group 8 (infective dose 1.0 x 10(6) CFU/fish) to 90.0 percent in group 1 (infective dose 1.5 x 10(8) CFU/fish). Significant differences in mortalities were found only between group 8 and each of the other groups, except group 5 (infective dose 6.0 x 10(6) CFU/fish; mortality 75.0 percent). The highest mortality coefficients were observed in days 1-2 after inoculation (accumulated mortality 44.4 percent), and a second peak of mortality occurred at days 6-7. Challenged fishes from all the groups showed alterations in behaviour and similar clinical signs. These were anorexia, lethargy, erratic swimming, exophthalmia and ascites. Macroscopically, skin hemorrhage, splenomegaly, hepatomegaly with organ paleness and visceral adherences were observed. S. agalactiae was re-isolated from all the fishes from the experimental groups submitted to bacteriological examination. The illness observed in tilapia naturally infected with S. agalactiae was experimentally reproduced in this study, and the clinical signs produced were similar to those reported from the natural infections.

A patogenicidade do S. agalactiae foi avaliada experimentalmente em três períodos. Dois grupos de 40 peixes foram inoculados intraperitonealmente (i.p.) em cada período com diferentes doses infectantes do patógeno. As doses variaram de 1,0 x 10(6) a 1,5 x 10(8)UFC/peixe. Como controle, um grupo de 40 peixes foi inoculado tryptic soy broth (TSB) via i.p. em cada período. Mortalidades variaram de 67,5 por cento no grupo 8 (dose infectante 1,0 x 10(6) UFC/peixe) a 90,0 por cento no grupo 1 ( dose infectante 1,5 x 10(8) UFC/ peixe). Diferença significativa de mortalidade foi observada somente entre o grupo 8 e os demais grupos, exceto com grupo 5 (dose infectante 6,0 x 10(6) UFC/peixe - 75,0 por cento de mortalidade). Os maiores coeficientes de mortalidade foram observados no 1 e 2° dia após a inoculação (mortalidade acumulada de 44,4 por cento), e o segundo pico de mortalidade ocorreu no 6 e 7° dia. Em todos os peixes inoculados foi observada alteração de comportamento e sinais clínicos semelhantes. Anorexia, letargia, natação errática, exoftalmia e ascite. Macroscopicamente, foi observada hemorragia na pele, esplenomegalia, hepatomegalia, palidez dos órgãos e aderências viscerais. S. agalactiae foi re-isolado dos peixes submetidos ao exame bacteriológico. A doença observada nas tilápias infectadas naturalmente com essa cepa de S. agalactiae foi experimentalmente reproduzida nesse trabalho, e os sinais clínicos foram similares à infecção natural.

Free corticoperiosteal flap in the treatment of an infected bone defect of the tibia. A case report.

The treatment of septic bone defects represents a significant challenge in orthopaedic surgery. Non-vascularised cancellous bone grafts are very commonly used. In contrast, thin and malleable periosteal grafts have generally only been investigated in animal models. The free corticoperiosteal flap is used only in exceptional cases in traumatology. This case report describes the treatment of an infected and non-reactive bone defect in the shaft of the tibia. This case involves a septic non-union over two years old with evidence of methicillin-resistant Staph. aureus. A vascularised corticoperiosteal flap was used to bridge this defect. The procedure was supplemented by rigid internal fixation. There were no postoperative complications. Bone healing was documented eleven months after the described treatment. No further invasive procedures were required. The patient was able to return to his original occupation as a store manager. Stable internal fixation is an important precondition for successful treatment. The method described in this article can be considered for short defects when a conventional cancellous bone graft appears to be contraindicated.

Prevalência de anticorpos anti-Chlamydophila spp. em propriedades rurais com histórico de aborto bovino no estado do Paraná / Prevalence of antibodies against Chlamydophila spp. in herds with bovine abortion of Paraná state, Brazil

Chlamydophila abortus é o agente etiológico do aborto epizoótico bovino, cujas manifestações clínicas mais freqüentes são aborto, nascimento de bezerros prematuros e de animais fracos, natimorto e repetição de cio em intervalos irregulares. O objetivo deste trabalho foi estimar a prevalência de anticorpos anti-Chlamydophila spp. em fêmeas bovinas de propriedades rurais com histórico de aborto, selecionadas dentro do delineamento amostral do Plano Nacional de Controle e Erradicação da Brucelose e Tuberculose no estado do Paraná. Foram testadas pela prova de fixação de complemento 3.102 amostras de soro de fêmeas bovinas (idade > 24 meses), provenientes de 373 propriedades. Ao total, 44 (1,42 por cento) animais foram positivos com títulos > 32. A prevalência de focos foi de 8,82 por cento (6,15 por cento-12,17 por cento). Animais confinados ou semi-confinados (OR=3.339, P=0.004), propriedade com menos de 35 matrizes (OR=3.339, P=0.017), presença de produtos do aborto na pastagem (OR=2.372, P=0.037) e aluguel de pasto (OR=3.398, P=0.006) foram considerados fatores de risco para Chlamydophila spp. A infecção por Chlamydophila spp. acometeu um número pequeno de animais, oriundos de propriedades com histórico de aborto. A importância deste agente como causa de aborto em bovinos no estado do Paraná, se existir, é muito pequena.

Chlamydophila abortus is a recognized cause of bovine epizootic abortion. Abortion, premature birth and weak lamb/calf, stillbirth and repeat breeding in irregular intervals are the most frequent disease manifestations. The complement fixation test is the recommended by the World Organization of Animal Health (OIE) for Chlamydophila spp. serologic diagnosis. The aim of this study was estimate the prevalence of antibodies against Chlamydophila spp. in cattle herds with abortion, selected inside the sampling design of National Program of Control and Erradication of Brucellosis in Paraná state. Serum samples of 3,102 cows (age > 24 months) from 373 herds were analyzed by complement fixation test. Totally, 44 (1.42 percent) animal were positive with titers > 32. The seroprevalence of Chlamydophila spp. in the herds was 8.82 percent (6.15 percent-12.17 percent). Four variables were associated with seroprevalence for Chlamydophila spp. in the final model of logistic regression: confined or semi-confined breeding (OR=3.339, P=0.004), farms with less than 35 cows (OR=3.339, P=0.017), abortion in the pasture (OR=2.372, P=0.037) and pasture rent (OR=3.398, P=0.006) were risk factors for Chlamydophila spp. This bacterium infected a small number of cattle from herds with abortion in Paraná state. Chlamydophila spp impact as abortion cause is reduced in this state.

[Free microvascular transfer of segmental corticocancellous femur for the treatment of scaphoid nonunion]. / Das freie mikrovaskuläre Knochentransplantat vom medialen Femurkondylus zur Behandlung der Kahnbeinpseudarthrose.

OBJECTIVE: Reconstruction of the scaphoid in length and form. Revitalization of the proximal fragment in case of avascular necrosis. INDICATIONS: Nonunion of the scaphoid, especially with avascular necrosis of the proximal pole. Persisting nonunion of the scaphoid after operative treatment. CONTRAINDICATIONS: Pattern of advanced carpal collapse (SNAC > 1). Malformation, disease or previous injury of the vascular system. Low compliance. Reduced general health. SURGICAL TECHNIQUE: Reconstruction of the scaphoid in correct dimension and angulation with use of a vascularized microvascular corticocancellous bone graft from the medial distal femur. Anastomoses to the radial artery or its palmar branch. Fixation by a cannulated scaphoid screw or Kirschner wires. POSTOPERATIVE MANAGEMENT: Postoperative immobilization in a short cast with thumb support for 6 weeks followed by a removable splint for another 6 weeks. Physiotherapy after cast removal. RESULTS: 15 patients with avascular necrosis of the scaphoid were treated with this technique after a mean of 128 weeks following trauma. In five patients, one to three previous operations had already been performed. 6 months after surgery, osseous healing of the nonunion was registered in all patients. The carpal height ratio according to Nattrass was increased by 0.07. The scapholunate angle had decreased by 10.7 degrees on average. 14 patients had a mean improvement of the Mayo Wrist Score of 13.3 points.

Free vascularised corticoperiosteal bone flaps in the treatment of non-union of long bones: an ignored opportunity?

Five patients with atrophic or septic non-union of long bones were treated with free vascularised corticoperiosteal bone flaps. The patients had undergone an average of nine prior operations (range, 2-29). The treatment was combined with repeat internal fixation in four patients,. Treatment took place an average of 25.5 months (range 5-83 months) after the initial injury. The thin corticoperiosteal grafts were harvested from the supracondylar region of the femur. One patient died from unrelated causes 2.5 months postoperatively. In the other four patients, bone healing was documented after an average of 7.7 months (range 6-11 months). No further operations were necessary during the follow-up period of 13.7 months on average (range 10-17 months). There were no complications associated with the procedure. The treatment presented here is complex but was successful in this small population. The procedure has the potential to become established as a treatment option for problematic bone defects.

Fatores de risco associados à mastite bovina causada por Prototheca zopfii / Risk factors associated with bovine mastitis caused by Prototheca zopfii

Este trabalho teve como objetivo o estudo de fatores de risco associados à mastite bovina causada por Prototheca zopfii. Foram analisadas 13 propriedades leiteiras dos Estados do Paraná e de São Paulo, segundo os seguintes critérios de seleção: confirmação prévia de casos de mastite por Prototheca spp., triagem pela pesquisa de Prototheca spp. em tanques de expansão e latões e rebanhos com contagem de células somáticas acima de 5x105cel mL-1. As amostras coletadas consistiram de: leite, água, solo, fezes e swab de teteiras. Prototheca spp. foi isolada de amostras de leite dos quartos mamários com mastite clínica ou subclínica em uma propriedade e de amostras de leite e do ambiente em quatro propriedades, nas quais foi isolada em amostras de: água de bebedouro, abastecimento, esgoto, empoçada no piso de estábulo e sala de ordenha, solo de piquete e pasto, teteiras, fezes de bezerros e suínos. Do total de 383 vacas examinadas, Prototheca spp. foi isolada em 20 (5,2 por cento) vacas, sendo caracterizada como P. zopfii em 18. Os fatores de risco associados à mastite causada por P. zopfii foram: criação das vacas a pasto, alimentação dos animais com pasto e silagem, realização de ordenha mecânica em estábulo, permanência das vacas após ordenha em piquete sem alimento, criação de suínos próxima às instalações dos bovinos, existência de cães, gatos e roedores, falta de higienização dos tetos com água, pré-imersão dos tetos em aplicador com retorno e sem a troca do anti-séptico, alimentação dos bezerros com leite de vacas com mastite clínica e serem as vacas da raça holandesa.

This research had as objective the study of risk factors associated with bovine mastitis caused by Prototheca zopfii. Thirteen dairy herds in Paraná and São Paulo states were analyzed and selected according to the following criteria: previous confirmation of Prototheca spp. mastitis cases, screening of Prototheca spp. in bulk tanks and milk cans, and herds with somatic cells count over 5x105cel mL-1. The samples collected consisted of: milk, water, soil, manure and swabs of teat cup rubbers. Prototheca spp. was isolated from mammary quarters with clinical and subclinical mastitis of milk samples in one herd and from the environment and cows in four herds. Out of 383 cows examined, Prototheca spp. was isolated in 20 (5.2 percent) cows with mastitis, and 18 of them were characterized as P. zopfii. In four herds when Prototheca spp. was identified from mammary quarters and environment the agent was isolated from the following samples: water in the waterers, puddled water in the stalls and the milking parlour, supply, sewage, cow pen and pasture soil, teat cup rubbers and manure from calves and swines. The risk factors associated with P. zopfii mastitis consisted of: pasture system, pasture and silage feeding, use of milking machine in stalls, cow pen without fresh feed after milking, raising of swines near bovine housing, existence of dogs, cats and rodents, absence of teats hygienization with water, use of pre-immersion devices with return and without change of antiseptic, calves fed with milk of clinical mastitis cases and the Holstein breed.