Comparative efficacy of stannous fluoride and copper sulfate footbath solutions for the treatment and prevention of digital dermatitis in lactating dairy cows.

The objective of this study was to determine whether a novel footbath solution containing stannous fluoride (SnF2) was superior to 5% copper sulfate solution for the treatment and prevention of digital dermatitis (DD) in dairy cattle. Study 1 was conducted over 4 weeks in Missouri and involved 34 lactating Holstein-Friesian cows with hind feet DD lesions. Cows in group SF walked through a footbath containing a proprietary formulation of SnF2 once weekly, whereas cows in group CS walked through a 5% CuSO4 footbath once daily for 5 d each week. Study 2 was conducted over 8 weeks in California and involved 40 lactating Holstein-Friesian cows with hind feet DD lesions. Cows in group SF walked through a SnF2 footbath for 3 consecutive days then once a week for the following 7 weeks. Cows in group CS walked through a 5% CuSO4 footbath 3 times each week for 8 weeks. Data collection included lesion type, lesion area, locomotion score, and pain score. Digital dermatitis was actively transmitted in study 1, and lesion area and locomotion scores were lower in group SF than group CS. In contrast, DD was not actively transmitted in study 2, and lesion area and locomotion scores were similar in groups SF and CS. Stannous fluoride delayed the development of active DD lesions in study 1 compared with copper sulfate, with a lower relative risk (0.57, P < 0.001) of a hind foot developing an active DD lesion over 28 d. However, SnF2 decreased the rate that active DD lesions transitioned to M3, M4, or M0 lesions compared with 5% copper sulfate in both studies, with the relative risk of a hind foot with an active DD lesion transitioning to M3, M4, or M0 in group SF being slightly lower in study 1 (0.83, P = 0.042) and study 2 (0.90, P = 0.020) than group CS. Our findings demonstrated that walking cows through a stannous fluoride footbath once per week in a herd undergoing active transmission of infection was more effective in preventing active DD lesions, but less effective in treating active DD lesions, than walking cows through a copper sulfate footbath 4 times per week. The novel SnF2 footbath solution shows promise for controlling DD in dairy herds that want an alternative footbath solution to CuSO4 and are interested in limiting the environmental accumulation of copper.

Evaluation of potassium monopersulfate footbath solution for controlling digital dermatitis in lactating dairy cattle. A randomized clinical trial.

Our objective was to assess potassium monopersulfate as a disinfectant used in footbath to control digital dermatitis (DD) in dairy cows. We hypothesized that a potassium monopersulfate solution would control DD. A 180-day randomized negative controlled trial was conducted in a 265-Holstein free-stall facility. Throughout the trial, foot bathing was performed bi-weekly using a split (left vs. right feet) footbath: one tub filled with 1% potassium monopersulfate (treatment), the other with tap water (control). Digital dermatitis lesions were scored during trimming chute examinations of the unwashed hind heels every 90 days using the modified M-scoring system. Digital dermatitis lesions were re-categorized into four variables: 1) inactive; 2) active; 3) any; 4) inactive or absence of DD lesions. Three longitudinal outcomes were characterized: risks of 1) developing a DD lesion; 2) reactivating an inactive DD lesion; 3) development of an inactive or the absence of the DD lesion. A generalized linear model was used to compare the variables and longitudinal outcomes between treated and control groups. Prevalence of active DD lesions increased from 12.5% to 39.9% between days 0 and 90. This significant increase in prevalence justified the discontinuation of the study on day 90 for ethical reasons. There was no statistical difference between treated and control groups for the first outcome (RR: 1.0; 95% CI: 0.62, 1.7), the second outcome (RR: 1.0; 95% CI: 0.62,-1.7); or the third outcome (RR: 0.88; 95% CI: 0.37, 2.1). A 1% potassium monopersulfate footbath solution appears ineffective to control DD in this study.

The effect of footbath applied to patients receiving hemodialysis treatment on comfort, fatigue, and dialysis symptoms: A randomized controlled study.

INTRODUCTION: This study aimed to evaluate the effect of warm water footbaths on comfort, fatigue, and dialysis symptoms in patients undergoing hemodialysis. METHODS: Data were collected from a total of 58 patients, 31 in the intervention group and 27 in the placebo group. The data in the study are collected using the intervention and control group informed volunteer Form, Patient Demonstration Form, foot Bath Application Monitoring Chart, fatigue VAS Scale Form, Dialysis Symptom Index, and Hemodialysis Comfort Scale (HCS). RESULTS: In the second follow-up in the intervention group, HCS was determined to significantly increase all sub-size and total score averages by the first trace (p < 0.05). VAS fatigue point averages were significantly lower (p < 0.05) in the intervention group. CONCLUSION: It was determined that the footbath applied to patients who received hemodialysis treatment increased comfort and reduced fatigue and dialysis symptoms.

Efficacy of quaternary ammonium salt-based disinfectant or chelated copper-zinc footbath solution in the treatment of digital dermatitis on one research dairy farm in Taiwan.

BACKGROUND: Footbaths can be used to manage digital dermatitis (DD), a common cause of lameness in dairy cattle. Copper sulfate and chelated copper-zinc (CZS) solutions in footbaths are potentially harmful to the environment. HYPOTHESIS/OBJECTIVES: To determine if a quaternary ammonium salt-based disinfectant (QASD) footbath is as effective as a chelated CZS solution in controlling DD in dairy cows. ANIMALS: Fifty-one lactating Holstein cows were randomly assigned to one of two treatment groups, with DD status based on the M-stage scoring system and locomotion score balanced between treatment groups. MATERIALS AND METHODS: The groups were treated with a 1% QASD or a 2.5% chelated CZS. Footbaths were performed once per week for 15 weeks. Logistic regression was used to analyse clinical improvement. All cows received appropriate medical treatment for DD and other hoof diseases. RESULTS: Clinical improvement rates were 67% in the QASD group and 38% in the CZS group (p = 0.03). Logistic regression analysis showed that the odds (95% confidence interval) for clinical improvement rate in the CZS group were 0.30 (0.095-0.948) times that of the QASD group (p = 0.04). The M0 score in the QASD and CZS groups increased significantly (p < 0.05) at the end of the 15 week study period. In the QASD group, the proportion of M2, M3 and M4 scores were significantly decreased (p < 0.05). CONCLUSION AND CLINICAL RELEVANCE: Over a 15 week period, QASD for footbathing was associated with a lower prevalence of active DD lesions than when using CZS.

Changes in Salivary Oxytocin Level of Term Pregnant Women after Aromatherapy Footbath for Spontaneous Labor Onset: A Non-Randomized Experimental Study.

BACKGROUND: Aromatherapy is usually used to stimulate labor. However, its specific physiological effects have been scarcely examined. We evaluated whether an aromatherapy footbath increases oxytocin levels in term pregnant women. METHODS: In this quasi-experimental study, low-risk term pregnant women in Japan underwent aromatherapy using a footbath (1) infused with clary sage and lavender essential oils, (2) infused with jasmine oil, or (3) with no infused oils (control group). The primary outcome was the salivary oxytocin level. The secondary outcomes were uterine contractions and cortisol levels. RESULTS: In the clary sage and lavender group (n = 28), the oxytocin level increased significantly after the footbath (p = 0.035). The jasmine group (n = 27) and control group (n = 27) exhibited trends toward a respective increase and decrease in the oxytocin level; however, the changes in the oxytocin levels between the clary sage and lavender group and the control group showed no significance difference. There were no significant differences in the changes in the uterine contractions and cortisol levels between the experiment and control groups. CONCLUSIONS: The changes in the oxytocin levels in the clary sage and lavender group did not differ significantly with those in the control group, possibly because of the small sample size. Further studies are required to examine the effects of repeated aromatherapy footbaths to stimulate labor.

Comparison of clinical cure rates from footrot and contagious ovine digital dermatitis using zinc sulphate foot bathing and topical oxytetracycline: A randomised trial.

BACKGROUND: This study reports the clinical cure rates of topical oxytetracycline and 10% zinc sulphate foot bathing for treatment of interdigital dermatitis (ID), footrot (FR) and contagious ovine digital dermatitis (CODD) in lambs. METHODS: The study was a randomised controlled trial of 75 lambs. Group A (n = 38) was foot bathed daily for 5 days in 10% zinc sulphate for 15 minutes and group B was treated with daily topical oxytetracycline for 5 days. On days 0, 7, 14, 28 and 42, lambs were scored for locomotion and foot lesions were recorded. RESULTS: The initial cure rates for ID were 96.20% and 97.00%; for FR, 100% and 95%; and for CODD, 90.09% and 83.33% for zinc sulphate and oxytetracycline, respectively. By day 42, these had changed to 53.16% and 61% for ID; 47.82% and 70% for FR; and 100% and 83.33% for CODD. There were no significant differences in cure rates between the treatments for most time points. LIMITATIONS: The sample size was small, and further studies in larger cohorts and different classes of sheep are required before the findings can be translated into recommendations for clinical practice. CONCLUSION: Both treatments achieved cure rates that are comparable to reported cure rates using systemic antibiotics and could be an effective alternative.

Management of Digital Dermatitis in Dairy Herds: Optimization and Time Allocation.

The objective of this study is to determine the most effective time allocation for digital dermatitis management and to quantify the marginal economic gain from extra time devoted to digital dermatitis management. The model simulating foot disease occurrence and the associated management was Dairy Health Simulator©. Then, an econometric model was applied to identify the relationship between the dairy workshop's gross margin and time for lameness management as well as the hourly marginal gain curve associated with lameness management. The gross margin was optimized under two constraints, i.e., the overall time spent for lameness management and the mean lameness duration (mimicking cow welfare). The results show that allocating less time to lameness detection and more to footbath application can contribute as follows: (i) reduces time spent for lameness management, (ii) maintains the best welfare level, and (iii) obtains the highest gross margin. The optimal time to devote to footbath application ranged from 17.8 to 22.3 h/month. A hiring strategy was investigated, and the break-even point ranged from 16.1 to 19.8 h/month. The recommended time to spend on footbath application is relatively important; therefore, stakeholders should consider the importance of lameness to the dairy industry and should devote enough time for footbath applications.

Comparing the Effects of Warm Footbath and Foot Reflexology on the Fatigue of Patients Undergoing Radiotherapy: A Randomized Clinical Trial.

BACKGROUND AND AIM: Fatigue is a common side effect of radiotherapy. While warm footbath and foot reflexology can both reduce fatigue, it is still unclear which method is more effective in reducing fatigue. This study aimed to compare the effects of warm footbath and foot reflexology on the fatigue of patients undergoing radiotherapy. METHOD: A randomized clinical trial study was conducted on 62 patients undergoing radiotherapy. Eligible patients were randomly assigned to the 2 groups. Patients in the footbath group immersed their feet in 41°C water for 20 minutes every night for 2 weeks starting from the seventh day of radiotherapy. Patients in the reflexology group received 20 minutes of foot reflexology every night for 2 weeks starting from the seventh day of radiotherapy. Fatigue was measured by the Multidimensional Fatigue Inventory (MFI) once on the seventh day of radiotherapy and 3 more times on days 7, 14, and 28 after the start of the intervention. Data were analyzed by SPSS20 and descriptive/inferential statistics. RESULTS: The total MFI score of both groups declined significantly over time (P < .001). The reflexology group indicated a significant reduction from 90.9 ± 3.2 in the pre-test to 56.0 ± 3.7 on the 28th day in, while the footbath group indicated it from 90 ± 2.6 in the pre-test to 71.4 ± 2.8 on the 28th day. CONCLUSION: Our results showed that foot reflexology and warm footbath reduced the fatigue of patients undergoing radiotherapy. However, foot reflexology was more effective in reducing the fatigue of patients undergoing radiotherapy than warm footbath. It is recommended that simple and low cost non-pharmacological interventions such as foot reflexology to decrease of side effect of radiotherapy among cancer patients should be widely performed.Trial registration: Iranian Registry of Clinical Trials (IRCT20190625044009N1).

Clinical efficacy of Chinese herbal footbath plus traditional Chinese medicine decoction in diabetic peripheral neuropathy.

OBJECTIVE: To evaluate the clinical efficacy of Chinese herbal footbath plus traditional Chinese medicine (TCM) decoction in diabetic peripheral neuropathy. METHODS: This retrospective study enrolled 120 patients with diabetic peripheral neuropathy treated in Shanghai Jinshan TCM-Integrated Hospital from January 2019 to January 2021. The eligible patients received either routine treatment (control group) or Chinese herbal GuBu Decoction footbath plus oral Yiqi Huoxue Decoction (experimental group), with 60 patients in each group. The duration of treatment was one month. Outcome measures included motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) of the common peroneal nerve, blood glucose, TCM symptom scores and clinical efficacy. RESULTS: TCM interventions resulted in significantly faster MNCV and SNCV versus routine treatment (P<0.05). Patients with TCM treatment exhibited lower fasting blood glucose, 2 h postprandial glucose and glycosylated hemoglobin than those with routine treatment (P<0.05). Remarkably lower TCM symptom scores were observed in the experimental group than in the control group (P<0.05). Chinese herbal GuBu Decoction footbath plus oral Yiqi Huoxue Decoction regimen was associated with a significantly higher clinical efficacy when comparing with routine treatment (P<0.05). The incidence of adverse events was not significantly different between the two groups (P>0.05). CONCLUSION: Chinese herbal GuBu Decoction footbath plus oral Yiqi Huoxue Decoction can provide promising blood glucose control, alleviate clinical symptoms, accelerate nerve conduction speed and enhance clinical efficacy.

Erratum: Field validation of a non-carcinogenic and eco-friendly disinfectant in a stand-in footbath for treatment of footrot associated with aprV2-positive strains of Dichelobacter nodosus in Swiss sheep flocks.

[This corrects the article DOI: 10.3389/fvets.2022.812638.].

Field Validation of a Non-carcinogenic and Eco-Friendly Disinfectant in a Stand-In Footbath for Treatment of Footrot Associated With aprV2-Positive Strains of Dichelobacter nodosus in Swiss Sheep Flocks.

A national control program for virulent footrot is currently planned in Switzerland. Since commonly used disinfectants either contain heavy metals or are carcinogenic, the aim of this study was to verify the effectiveness of an eco-friendly and non-carcinogenic candidate disinfectant against aprV2-positive strains of Dichelobacter nodosus. Additionally, the effect of the selective use of long-acting oxytetracyclines was evaluated. A total of 18 farms with confirmed footrot infection, randomly allocated to two treatment groups: (1) with antibiotics (AB; n = 9) and, (2) no antibiotics (NAB; n = 9), were included. Claws were carefully trimmed and scored using a scale from 0 (clinically healthy) to 5 (complete loss of the horn capsule) and a prewash waterbath was implemented on 11 farms. Twice-weekly, repeated whole-flock stand-in footbaths with the candidate disinfectant (6%) were performed. Additionally, animals of group AB with a score ≥ 3 were administered oxytetracyclines by injection. On all farms, 10 days after last treatment, aprV2-positive strains could not be detected by risk-based sampling for real-time PCR analysis after 7-21 (median = 12) footbaths with a minimal culling rate of non-responders on nine farms. Farms without contact to other sheep remained without clinical signs of footrot for a minimum of 245 days (mean ± standard deviation: 293.6 ± 23.6). Antibiotic treatment did not reduce the number of footbaths needed. In contrast, a mean of 3.3 disinfecting footbaths could be saved by implementing a prewash waterbath. At animal level, individual and selective use of oxytetracyclines lead to a higher chance (odds ratio = 9.95; 95% CI: 3.54-27.95; p < 0.001) for a lesion score ≥ 3 to improve to a lesion score < 3 within 2 weeks compared to treatment without antibiotics. The test disinfectant is an effective and eco-friendly alternative for the planned Swiss footrot control program and selective use of oxytetracycline has a beneficial impact on the recovery of animals with lesion scores ≥ 3.

Do ginger footbaths improve symptoms of insomnia more than footbaths with warm water only? - A randomized controlled study.

OBJECTIVES: To compare the effects between warm water (WW) and ginger footbaths (WW+ginger) on sleep quality and warmth regulation in adults with self-reported insomnia symptoms. METHODS: A prospective randomized-controlled study in which 28 participants (mean age 50.9 years, 64.3% women, insomnia symptom duration 11.4 years) were randomized to receive WW (n = 13) or WW+ginger (n = 15) daily for 2 weeks. Treatment involved nightly footbaths (12 liters of 38-42 °C warm tap water, maximum duration 20 min) with and without topical ginger (80 g of powdered ginger rhizomes). MAIN OUTCOME MEASURES: The primary outcome measure was self-reported sleep quality (global score from Pittsburgh Sleep Quality Index, PSQI) at 2 weeks. Secondary outcomes included measures of insomnia severity (Insomnia Severity Index, ISI) and warmth regulation (Herdecke Warmth Perception Questionnaire, HWPQ and 24-hour distal-proximal skin temperature gradient, DPG). RESULTS: WW+ginger had no greater effect on PSQI (mean between-difference 0.0 [95% CI -3.0 to 2.9], Cohen's d=0.0) or ISI (-0.2 [-3.9 to 3.4], 0.0) than WW. Nor were there any significant differences in HWPQ perceived warmth (0.1 ≥d≥0.5) or DPG (0.1 ≥d≥0.4) between WW and WW+ginger. Both groups improved over time in PSQI (WW+ginger: d=0.7, WW: d=1.3) and ISI (WW+ginger: d=0.8, WW: d=1.0). Perceived warmth of the feet increased only in WW+ginger over time (d=0.6, WW: d=0.0). CONCLUSIONS: This dose of ginger (6.67 g/liter) did not have greater effects on sleep quality, insomnia severity or warmth regulation than WW. Considering effect sizes, costs and risks, the use of WW would be recommended over WW+ginger in this patient population.

The Immediate Effect of Sinapis nigra and Zingiber officinale as Thermogenic Substances during Footbaths: A Randomized Controlled Crossover Trial.

OBJECTIVE: Warm footbaths infused with Sinapis nigra (mustard, or MU) or Zingiber officinale (ginger, or GI) are used for various thermoregulatory conditions, but little is known about how they are perceived by individuals, both short- and long-term. We analyzed the immediate and long-term effects of MU and GI on warmth and stimulus perception in healthy adults. METHODS: Seventeen individuals (mean age 22.1±2.4 years; 11 female) received three footbaths (mean temperature was 40 ± 0.2°C, administered between 1:30 and 6:30 p.m.) in a randomized order with a crossover design: 1. with warm water only (WA), 2. with warm water and MU, and 3. with warm water and GI. Warmth and stimulus perception at the feet were assessed at the 1st, 5th, 10th, 15th, and 20th minute of the footbaths, in the late evening (EVE), and the following morning (MG). We further assessed well-being (at EVE and MG) and sleep quality (at MG). The primary outcome measure was the warmth perception at the feet at the 10th minute of the footbath. RESULTS: At the 10th minute of the footbath, warmth perception at the feet was significantly higher with MU and GI compared to WA. The immediate thermogenic effects pointed to a quick increase in warmth and stimulus perception with MU, a slower increase with GI, and a gradual decrease with WA. Regarding the long-term effects, warmth and stimulus perception were still higher after GI compared to WA at EVE and MG. No differences were seen for general well-being and sleep quality. CONCLUSION: Thermogenic substances can significantly alter the dynamics of warmth and stimulus perception when added to footbaths. The different profiles in the application of GI and MU could be relevant for a more differentiated and specific use of both substances in different therapeutic indications.

Warm-water footbath improves dysmenorrhoea and heart rate variability in college students: a randomised controlled trial.

The effect of warm-water footbath in improving dysmenorrhoea has been rarely investigated. The study aimed to examine whether a warm-water footbath effectively reduces dysmenorrhoea pain and improves the autonomic nervous system (ANS) activity. The randomised controlled trial was registered at ClinicalTrials.gov. (NCT04071028) We enrolled college students with dysmenorrhoea in Northern Taiwan from December 1 2013 to June 30 2014, and randomised them into footbath (n = 35, median age 19 years) and control groups (n = 33, 18 years). Pain visual analogue scale and Short-Form McGill Pain Questionnaire were used for pain assessment, while heart rate variability (HRV) was measured to assess ANS function. After the interventions, the footbath group significantly improved ANS activity and reduced pain severity comparing to the control group. Furthermore, the changes in HRV positively correlated with the improvement of pain severity. In conclusion, a warm-water footbath is beneficial in improving the pain severity among college students with dysmenorrhoea.Impact StatementWhat is already known on this subject? Dysmenorrhoea is the most common gynaecological condition affecting 34-94% of young women. The existing conventional therapeutic strategies for dysmenorrhoea have potential adverse events. Among the complementary therapies for pain, the warm-water footbath is a widely used thermal therapy in improving peripheral neuropathy symptoms and improving patients' quality of life. The subjects with dysmenorrhoea associate with significantly altered autonomic nervous system (ANS) activity. However, the association among warm-water footbath, menstrual pain and ANS was rarely investigated previously.What the results of this study add? The randomised controlled trial enrolling 68 college students with dysmenorrhoea found warm-water footbath improved ANS activity and reduced pain severity. Furthermore, the changes in heart rate variability positively correlated with pain severity improvement.What the implications are of these findings for clinical practice and/or further research? A warm-water footbath for 20 minutes on menstruation days 1 and 2 is beneficial in improving pain among college students with dysmenorrhoea.

Increasing Warmth in Oncological Patients: A Randomized Controlled Cross-Over Pilot Trial Examining the Efficacy of Mustard and Ginger Footbaths.

OBJECTIVE: To analyze the thermogenic effects of footbaths with medicinal powders in oncological patients (ON) and healthy controls (HC). INTERVENTION AND OUTCOMES: Thirty-six participants (23 ON, 13 HC; 24 females; 49.9 ± 13.3 years) received 3 footbaths in a random order with cross-over design: warm water only (WA), warm water plus mustard (MU, Sinapis nigra), and warm water plus ginger (GI, Zingiber officinale). Warmth perception of the feet (Herdecke Warmth Perception Questionnaire, HeWEF) at the follow-up (10 minutes after completion of footbaths, t2) was assessed as the primary outcome measure. Secondary outcome measures included overall warmth as well as self-reported warmth (HeWEF) and measured skin temperature (high resolution thermography) of the face, hands and feet at baseline (t0), post immersion (t1), and follow-up (t2). RESULTS: With respect to the warmth perception of the feet, GI and MU differed significantly from WA (P's < .05) with the highest effect sizes at t1 (WA vs GI, d = 0.92, WA vs MU, d = 0.73). At t2, perceived warmth tended to be higher with GI compared to WA (d = 0.46). No differences were detected between ON and HC for self-reported warmth. With respect to skin temperatures, face and feet skin temperatures of ON were colder (at t0 and t1, 0.42 ≥ d ≥ 0.68) and tended to have diametrical response patterns than HC (ON vs HC: colder vs warmer after MU). CONCLUSION: Among adult oncological patients and healthy controls, footbaths with mustard and ginger increased warmth perception of the feet longer than with warm water only. The potential impact of regularly administered thermogenic footbaths over extended periods merits further investigation for the recovery of cancer-related sense of cold.

Psychological and Antibacterial Effects of Footbath Using the Lindera umbellata Essential Oil.

Lindera umbellata (Lu) essential oil primarily contains linalool and has relaxation properties. We investigated the psychological and antibacterial effects of footbath with Lu essential oil. The participants included 20 women without medical history and received two intervention plans: footbath without any essential oil and footbath using Lu essential oil. Next, questionnaires regarding impressions and mood states were provided for them to answer. In addition, their autonomic nervous system activity was measured, and the aerobic viable of count on the feet was determined. The high-frequency value reflecting the parasympathetic nervous system activity significantly increased after footbath using Lu essential oil. In the questionnaire about the mood states, the subscale scores of tension-anxiety, depression, fatigue, and confusion after intervention were lower than those before intervention regardless of the use of the essential oil. Conversely, the anger-hostility score decreased only in the group using Lu essential oil. Furthermore, the decrease in aerobic viable count after intervention was not significantly different between the two groups. Footbath using Lu essential oil increased the parasympathetic nervous system activity and relieved anger. Taken together, we suggest that footbath using Lu essential oil has a relaxation effect.

The effect of footbath on the quality of sleep in older adults: A pilot study.

This pilot study was a randomized controlled trial that aimed to investigate the effect of the warm footbath on the sleep quality of Iranian older adults. Males and females aged over 60 were randomly divided into three groups (footbath group with water at 40°C, footbath group with water at 37°C, and one control group) using the permutation block method. Repeated measures design was used to compare the groups after week two and week four to study the effects of footbath on sleep quality. Footbath with water at 40°C and 37°C caused significant improvement in the participants' sleep quality. No significant difference was found between the participants' sleep quality treated with water at 40°C and 37°C. Future studies with larger samples are recommended for assessing the effectiveness of warm footbath in enhancing sleep quality in older adults.

Regression of viral pathogen indicators due to improvement of hygiene protocols on boots in a bovine farm.

Rotavirus A (RVA), bovine torovirus (BToV), bovine enterovirus (BEV) and bovine coronavirus (BCV) at a bovine farm in Ibaraki prefecture were monitored by one-step multiplex reverse transcription polymerase chain reaction (RT-PCR), with the aim of confirming the reduction of "viral pathogen indicators". A total of 960 bovine fecal samples were collected from calves less than 2 month-old within the period from October 2016 to October 2018 every 2 months at the bovine farm. In each sampling, 40 samples were taken from calves 3 week-old or less, and 40 samples from calves over 3 week-old, in principle. At the end of September 2017, the farm introduced improvement of hygiene protocols on boots by exchanging boots and appropriate usage of a footbath at the entrance of calf sheds. In the comparison of the virus detection by RT-PCR, prevalence of all 4 viruses was significantly reduced (P<0.01) in calves 3 week-old or less after the improvement. The mortality of calves less than 2 month-old was also significantly reduced after the improvement of hygiene protocols. These data suggest that the proper control of boots at calf sheds is important, perhaps even vital, for rearing hygiene measures at bovine farms so as to attain substantial decrease in the prevalence of pathogens.

Kaposi Sarcoma Inflammatory Cytokine Syndrome Presenting as Infection: A Case Report.

Kaposi sarcoma inflammatory cytokine syndrome is a rare and fatal malignancy that is challenging to treat. The syndrome appears in individuals who are both human immunodeficiency virus and human herpesvirus 8 positive. The diagnosis of disease is challenging because its presentation mimics sepsis and it has a high mortality rate. A bone marrow biopsy is necessary for definitive diagnosis. This case report discusses a 40-year-old human immunodeficiency virus infection-positive African American male who presented to the emergency department with a chief complaint of left hallux pain in January 2018 after a trip to a nail salon in December 2017. Radiographic and magnetic resonance images suggested osteomyelitis of the distal phalanx, and Gram stain of bone showed gram-negative rods. The patient was started on antibiotic therapy for presumed osteomyelitis. As the patient's status deteriorated, a partial hallux amputation was then performed. Intraoperative specimens were negative for bacterial involvement, but pathology was positive for Kaposi sarcoma. During a 7-month progression, the patient's hematologic and overall status continued to decline. Despite diagnostic and treatment guidelines being followed, the patient died from this illness in July 2018. This case is interesting because of the atypical presentation of Kaposi sarcoma and highlights the rapid progression of the disease.

The Effect of Warm Footbath on the Quality of Sleep on Patients with Acute Coronary Syndrome in Cardiac Care Unit.

Introduction: This study aimed to determine the effect of warm footbath before bedtime on the quality of sleep on patients with acute Coronary Syndrome in Cardiac Care Unit. Methods: This study was conducted on 120 patients admitted to CCU at Mazandaran Heart Center and randomly divided into two groups of intervention and control. In the intervention group, warm footbath was performed after the second night in hospital before bed time by 41 C water for 20 minutes for three consecutive nights; in contrast, the control group did not receive anything of this sort. The next day, St Mary's Hospital Sleep Questionnaire was completed to evaluate sleep quality. Then, the obtained data were analyzed using SPSS software and Friedman, Wilcoxon exact statistical tests. Results: The quality of sleep in the first night of hospitalization was different from the third night after the intervention in both groups and the improvement process of sleep quality was observed in both groups. Most patients had moderate impairments (23-36), which had not changed during the intervention. In intervention groups, 8 patients had severe sleep disorders (greater than 37), which declined to 1 after three nights of intervention. While, in the control group this number fell from 10 patients with severe sleep disorders to 5. Warm footbath had a great positive impact on patients suffering from severe sleep disorders (P<0.05). Conclusion: Although warm footbath did not improve the quality of sleep in all patients, it reduced the number of patients who had severe sleep disturbances.