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INTRODUCTION: Aortic arch complex atheromatosis is a source of cerebral embolism. A percentage of lacunar infarct could be of embolic etiology, especially due to microemboli of the aortic arch. CASE REPORT: We present the case of a 63-year-old hypertensive man suffering from dysarthria-clumsy hand syndrome for a right hemispheric minor ischemic stroke. The patient developed sequential acute thromboembolism of the left lower and right upper limbs. Computed tomography angiography revealed an aortic arch thrombus. Vascular surgery was successfully performed. CONCLUSION: This case highlights the importance of considering embolic sources in lacunar syndromes, especially at the level of the aortic arch.

TITLE: Síndrome de disartria-mano torpe y embolias agudas secuenciales múltiples de las extremidades como forma de presentación de un trombo del cayado aórtico.Introducción. La ateromatosis del complejo del arco aórtico es una fuente de embolia cerebral. Un porcentaje de infartos lacunares podría ser de etiología embólica, especialmente debidos a microembolias del arco aórtico. Caso clínico. Presentamos el caso de un varón hipertenso de 63 años con síndrome de disartria-mano torpe por un ictus isquémico minor hemisférico derecho. El paciente desarrolló un tromboembolismo agudo secuencial de los miembros inferior izquierdo y superior derecho. La angiografía por tomografía computarizada reveló un trombo en el arco aórtico. La cirugía vascular se llevó a cabo con éxito. Conclusión. Este caso destaca la importancia de considerar las fuentes embólicas en los síndromes lacunares, especialmente en el arco aórtico.

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It is hypothesized that the combined effects of suckling and milking in the dual purpose cows is one of the main suppressors of reproductive efficiency in this production system. The experiment described here examined whether managing the interval between milking and suckling could reduce the postpartum anoestrous period and whether the presence of a teaser bull could enhance the effects of these managements. The experiment involved 39 Bos taurus x Bos indicus cows which had an average weight of 523.0 +/- 12.8 kg (mean +/- S.E.M.) and body condition score of 5-7 (scale 1-9) at calving. The cows and calves grazed separate pastures and the cows were supplemented with 2 kg 17% CP concentrates and 1 kg molasses per cow per day. The experiment was conducted over the first 100 days postpartum. Cows were hand-milked once per day in the presence of the calf to stimulate milk release. The factors in the 2 x 2 design were the milking to suckling interval (0 h, control suckling; CS versus 8 h prolonged-delay suckling; PDS) and no exposure versus exposure to a teaser bull (B). Cows were assigned at random within calving date to the four treatments: CS (n = 10), PDS (n = 10), CS-B (n = 9) and PDS-B (n = 10). Cows on treatments CS and CS-B had three-quarters of the udder milked and one-quarter was not milked. The entire udder was milked on those treatments where there was an interval between milking and suckling. The bull was introduced 7 days after calving in treatments where the cows were exposed to a teaser bull. Body weights of cows and calves and cow milk yield were recorded. Weekly blood samples were collected for plasma progesterone assay. Data were analyzed by ANOVA in a 2 x 2 factorial design and by chi(2)-test. There were no statistically significant differences between treatments in cow body weight at calving and at 100 days postpartum, nor in milk yield (overall mean 6.0 +/- 1.1 kg per day). Calf daily gain was 598 +/- 25 g for treatments CS and CS-B in which suckling immediately followed milking and 833 +/- 24 g for treatments PDS and PDS-B (P < 0.001). The proportion of cows ovulating was CS 80.0%, PDS 100.0%, CS-B 88.8% and PDS-B 100.0%. The difference between CS and PDS or PDS-B was significant (P < 0.05). CS-B did not differ significantly from the other three treatments. The calving to first ovulation interval was not improved when the interval between milking and suckling was increased from 0 h (56.5 +/- 5.0 days) to 8 h (64.8 +/- 4.5 days). Exposure to a teaser bull, however, significantly (P < 0.001) reduced this interval from 77.0 +/- 2.7 days (no bull exposure) to 44.4 +/- 2.7 days (exposure to teaser bull). Exposure to a teaser bull significantly reduced the calving to first anoestrus interval. Delaying the start of suckling after milking did not improve the reproductive performance of the cows or alter the effect of bull exposure, however, delaying suckling after milking improved the performance of the calves without affecting milk yield.

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In the dual purpose milk/beef production system practised in Mexico, the cows are milked once a day in the presence of the calf and then the calf suckles for the next 1-8 h. It was hypothesised that the imposition of milking and suckling in close succession contributes to the long postpartum anoestrous periods experienced by cows in this system. Therefore, separating these two inhibiting factors, by delaying the start of suckling after milking would lower the impact on the hypothalamus-hypophysial axis and allow it to recover more readily. This hypothesis was tested in two experiments using Bostaurus x Bosindicus cows which weighed 541.3 +/- 12.7 kg (mean +/- S.E.M.; experiment 1) and 537.8 +/- 10.6 kg (experiment 2) and had a body condition score of 5-6 (scale 1-9) at calving. The cows and calves were maintained on separate pastures and the cows were offered concentrate supplements. Experiment 1 was conducted in the dry season and cows were offered a daily supplement of 3 kg of 17% crude protein (CP) concentrates plus 1 kg molasses per cow. Experiment 2 was conducted during the wet season and the nutritional supplement consisted of only 1 kg of 17% CP plus 1 kg molasses per cow per day. Each experiment lasted for the first 100 days postpartum and the cows were not mated during this time. Cows were hand-milked once a day in the presence of the calf to stimulate milk let-down. In experiment 1, 30 multiparous cows were assigned at random by date of calving, to one of three treatments: controlled suckling (CS; n = 10), delayed suckling (DS; n = 10) and prolonged delayed suckling (PDS; n = 10). The suckling period on all treatments lasted for 2 h and started at 0 h (CS), 4 h (DS) or 8 h (PDS) after milking. In experiment, 34 multiparous cows were assigned at random to three treatments: CS (n = 11), PDS (n = 11) or prolonged delayed short suckling (PDSS; n = 12), in this last treatment the suckling period was reduced to only 30 min. In both experiments, one quarter of the udder of cows on treatment CS was not milked but all the udder was milked on the other treatments. Body weights of cows and calves and cow milk yields were recorded. Weekly blood samples were collected for plasma progesterone assay to detect the first postpartum corpus luteum. Data were analysed by ANOVA and chi-square test. Cows in experiment 1 had similar weight changes during the first 100 days postpartum. Milk production was higher for DS (8.0 +/- 0.7 kg per day) and PDS (7.0 +/- 0.5 kg per day) cows than for CS (5.2 +/- 0.7 kg per day) cows (P < 0.01). Calf daily gain was greater (P < 0.05) for PDS (827 +/- 35 g per day), than CS (702 +/- 26 g per day) or DS (715 +/- 29 g per day). The proportion of cows ovulating during the first 100 days postpartum were 50.0, 70.0 and 100.0%, for CS, DS and PDS, respectively (P < 0.05). The intervals from calving to first significant rise in progesterone were 70.4 +/- 1.6, 72.1 +/- 1.3 and 64.6 +/- 1.5 days for CS, DS and PDS (P > 0.05), respectively. In experiment 2, cow body weight during the first 100 days postpartum did not differ between treatments. Milk production was not significantly different between CS (7.3 +/- 1.0 kg per day) and PDSS (6.8 +/- 1.0 kg per day), but was higher (P < 0.05) for CS than PDS (5.2 +/- 1.0 kg per day). Calf daily gain was lower for CS (576 +/- 31 g per day; P < 0.05) than PDS (779 +/- 38 g per day) and PDSS (780 +/- 20 g per day). The proportion of cows ovulating was higher (P < 0.05) for treatments PDS (100%) and CS (81.8%) than PDSS (50%). Calving to first ovulation interval was shorter (P < 0.05) for PDS (57.3 +/- 4.5 days) and PDSS (49.7 +/- 3.0 days) cows than CS (72.1 +/- 3.5 days) cows. It is concluded that delaying suckling for 8 h after milking, increases the proportion of cows ovulating within 100 days of calving, shortened the calving to first ovulation interval and improved calf performance without adversely affecting cow milk yield or body weight change.

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