RESUMEN
Lameness in dairy cattle is a highly prevalent condition that impacts on the health and welfare of dairy cows. Prompt detection and implementation of effective treatment is important for managing lameness. However, major limitations are associated with visual assessment of lameness, which is the most commonly used method to detect lameness. The aims of this study were to investigate the use of metabolomics and machine learning to develop novel methods to detect lameness. Untargeted metabolomics using liquid chromatography-mass spectrometry (LC-MS) alongside machine learning models and a stability selection method were utilized to evaluate the predictive accuracy of differences in the metabolomics profile of first-lactation dairy cows before (during the transition period) and at the time of lameness (based on visual assessment using the 0-3 scale of the Agriculture and Horticulture Development Board). Urine samples were collected from 2 cohorts of dairy heifers and stored at -86°C before analysis using LC-MS. Cohort 1 (n = 90) cows were recruited as current first-lactation cows with weekly mobility scores recorded over a 4-mo timeframe, from which newly lame and nonlame cows were identified. Cohort 2 (n = 30) cows were recruited within 3 wk before calving, and lameness events (based on mobility score) were recorded through lactation until a minimum of 70 d in milk (DIM). All cows were matched paired by DIM ± 14 d. The median DIM at lameness identification was 187.5 and 28.5 for cohort 1 and 2, respectively. The best performing machine learning models predicted lameness at the time of lameness with an accuracy of between 81 and 82%. Using stability selection, the prediction accuracy at the time of lameness was 80 to 81%. For samples collected before and after calving, the best performing machine learning model predicted lameness with an accuracy of 71 and 75%, respectively. The findings from this study demonstrate that untargeted LC-MS profiling combined with machine learning methods can be used to predict lameness as early as before calving and before observable changes in gait in first-lactation dairy cows. The methods also provide accuracies for detecting lameness at the time of observable changes in gait of up to 82%. The findings demonstrate that these methods could provide substantial advancements in the early prediction and prevention of lameness risk. Further external validation work is required to confirm these findings are generalizable; however, this study provides the basis from which future work can be conducted.
Asunto(s)
Enfermedades de los Bovinos , Cojera Animal , Bovinos , Animales , Femenino , Humanos , Cojera Animal/diagnóstico , Lactancia , Marcha , Leche , Enfermedades de los Bovinos/diagnóstico , MetabolómicaRESUMEN
Symptomatic aortic aneurysms can manifest in different clinical settings, such as acute coronary syndrome (ACS), acute heart failure, a shock that is mostly due to the complications related to dissection or rupture of the aneurysm. In these clinical settings, the diagnosis can be established with the help of medical history, physical examination, and promptly performed imaging tests. However, the diagnosis of an asymptomatic aortic aneurysm is usually incidental. Thus, it is very rare to find a case of ACS with intact aortic aneurysm and without obstructive coronary artery disease. In this paper, we report a successfully treated male patient aged 41 years with intact ascending aortic aneurysm who presented with ACS and was diagnosed with the help of bedside echocardiographic assessment.
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Síndrome Coronario Agudo/complicaciones , Aneurisma de la Aorta/diagnóstico por imagen , Enfermedades Asintomáticas , Ecocardiografía , Pruebas en el Punto de Atención , Adulto , Electrocardiografía , Urgencias Médicas , Humanos , Masculino , Admisión del Paciente , Radiografía Torácica , Tomografía Computarizada por Rayos XRESUMEN
Deltamethrin [(S)-cyano-3-phenoxybenzyl-cis-(1R,3R)-2,2-dimethyl) cyclo-propane carboxylate),1] labelled at gem-dimethyl groups of the cyclopropane ring was applied on two Egyptian soils at a level of 10 mg/kg soil for a laboratory incubation experiment under aerobic and anaerobic conditions. A steady decrease of soil extractable ¹4C-residues, accompanied by a corresponding increase of non- extractable bound ¹4C-residues was observed over a 90-day incubation period. The percentage of evolved ¹4CO2 increased with time under aerobic and anaerobic conditions in both soils. The effect of deltamethrin on soil microorganisms as well as the counter effect of microorganisms on the insecticide was also investigated. As the incubation period increased, the inhibitory effect of the insecticide on the microorganisms decreased and the evolution of carbon dioxide depended on the applied dose. The nature of soil methanol soluble residues was determined by chromatographic analysis which revealed the presence of the parent insecticide as the main product in addition to four metabolites: 3-(2',2'-dibromovinyl)-2,2-dimethylcyclopropane carboxylic acid (II); 3-phenoxybenzaldehyde (III); 3-phenoxybenzoic acid (IV); 3-phenoxybenzyl alcohol (V).
Asunto(s)
Bacterias/metabolismo , Insecticidas/metabolismo , Nitrilos/metabolismo , Piretrinas/metabolismo , Microbiología del Suelo , Contaminantes del Suelo/metabolismo , Bacterias/efectos de los fármacos , Biodegradación Ambiental , Insecticidas/química , Insecticidas/farmacología , Cinética , Nitrilos/química , Nitrilos/farmacología , Piretrinas/química , Piretrinas/farmacología , Suelo/química , Contaminantes del Suelo/químicaRESUMEN
The purpose of this study was to provide an account of the 5-year experience we have gained using holmium:yttrium-aluminium-garnet (Ho:YAG) lasertripsy in the treatment of ureteral stones. One-hundred thirty-seven transurethral ureterolithotripsies were performed in 131 patients. A Ho:YAG laser device, fibres with diameters of 360 and 550 mum, a video camera as well as semi-rigid and flexible ureterorenoscopes were used. Results showed that the direct success rates-which meant stone-free ureters on the first post-operative day-in the upper, middle and lower ureters were 84.6, 88.7 and 94.8%, respectively. The final success rates--which meant stone-free ureters 4 weeks after the operation without a second intervention--were 84.6, 96.7 and 96.7%, respectively. The pulsatile Ho:YAG laser beam fragmented all kinds of stones easily. No ureteral stricture or reflux was identified during the follow-up period. The advantages of Ho lasertripsy outweighed its disadvantages. Based on our experience, the Ho:YAG laser is one of the most effective and safest energy sources in the treatment of ureteral calculi.
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Terapia por Láser , Litotripsia por Láser/métodos , Terapia por Luz de Baja Intensidad , Cálculos Ureterales/terapia , Ureteroscopía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Litotripsia por Láser/instrumentación , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de TiempoRESUMEN
PURPOSE: We report 52 percutaneous urterolithotomies in 51 patients having large, impacted middle ureteral stones. Direct percutaneous stone removal can be performed as successfully as in cases of renal stones treated with percutaneous nephrolithotomy. METHODS: The operation is performed under local anesthesia; therefore, the procedure is quicker and simpler than the laparoscopic or retroperitoneoscopic intervention. All patients became stone free. In two patients (4%), ultrasound disintegration was necessary; in the remaining cases, there was no need for any fragmentation: the stone was removed intact. A retroperitoneal drain was always left at the end of the procedure. With the exception of two cases, the ureter was always stented without closure of the ureteral incision. RESULTS: Fever (> or = 38 degrees C) was observed in 15 patients (29%) for 2 days. Retroperitoneal hematoma 5 cm in diameter was seen in one patient. One patient had urine leakage through the retroperitoneal drain in the postoperative period for 18 days. Also, one patient came back 3 days after discharge with urine leakage through the percutaneous retroperitoneal tract. CONCLUSION: Direct percutaneous ureterolithotomy is an effective way to remove impacted middle ureteral stones but is advisable only for endourologists with considerable experience.
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Nefrostomía Percutánea , Cálculos Ureterales/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Drenaje/efectos adversos , Femenino , Hematoma/etiología , Humanos , Masculino , Persona de Mediana Edad , Nefrostomía Percutánea/efectos adversos , Hemorragia Posoperatoria/etiología , Espacio Retroperitoneal , Ultrasonografía , Cálculos Ureterales/diagnóstico , UrografíaRESUMEN
OBJECTIVE: To evaluate our experience with percutaneous suprapubic cystolithotripsy (PCCL) in Yemeni children with endemic urinary bladder stones. PATIENTS AND METHODS: Between January 1993 and December 1998, 117 children underwent percutaneous suprapubic lithotripsy in Arabia Felix Modern Hospital, Sana'a Republic of Yemen. The patients' ages ranged from 8 months to 14 years (average 3.7 years). Ninety patients (77%) were under 5 years old; 20 patients (16%) were between 6 and 10 years old, and 7 patients (6%) were between 11 and 14 years old. There were 116 boys and 1 girl. The stone size ranged from 0.7 to 4 (average 2.3) cm. Five patients had coexisting urinary bilharziasis and another 5 patients had coexisting renal stone. In 10 patients, the stone was in the urethra. The procedure was done under general anesthesia. Dilation of the tract was made under fluoroscopy. The instrument was an adult 26-french nephroscope, the same as that used for percutaneous nephrolithotripsy. Ultrasound disintegration was needed for stones of > 1 cm. A suprapubic catheter was left for 24 h, and a urethral catheter was kept for 48 h. RESULTS: All patients became stone free. The average operating time was 15 (5-50) min. The average hospital stay was 2.7 (2-5) days. No severe intra- or postoperative complication was observed. The nucleus and/or the main component of the stones were ammonium acid urate in 109 patients (93%). CONCLUSION: Based on our experience we can conclude that percutaneous suprapubic lithotripsy is a safe and effective method for the treatment of bladder stones in children. It reduces morbidity and hospital stay and thus the cost of treatment. Our series proves the nutritional etiology of endemic pediatric bladder stones. To our knowledge, this is the largest series reported on percutaneous suprapubic management of endemic bladder stones in children.
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Litotricia/métodos , Cálculos de la Vejiga Urinaria/terapia , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , YemenRESUMEN
OBJECTIVE: To evaluate abnormalities detected by ultrasonography in Yemeni patients with active Schistosoma haematobium infection. PATIENTS AND METHODS: As part of a co-operation between a private hospital and the Schistosomiasis Control Project in Yemen, laboratory and ultrasonographic examinations were undertaken in 158 patients (eight female, 150 male, mean age 17 years) with active S. haematobium infection. Upper urinary tract dilatation, lower ureteric changes and bladder wall abnormalities (thickness, hyper-echogenicity and polypoid lesions) were recorded. Laboratory findings and ultrasonographic changes were evaluated and categorized according to the age of the patients. RESULTS: Twenty-eight patients (18%) showed no morphological lesion on ultrasonography. Bladder abnormalities (thickness, hyper-echogenicity and polypoid lesions) were found in 130 patients (82%) and upper tract lesions in 86 (54%). There were no upper tract lesions seen without an associated bladder abnormality. There were polyps within the lower ureteric lumen in four patients; in these patients there was a higher incidence of severe infection. One patient had a urinary bladder tumour. CONCLUSION: Urinary bilharziasis has typical ultrasonographic features, but may occur with no morphological lesion detectable on ultrasonography. Upper tract lesions seem to develop only with lower tract abnormalities.
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Esquistosomiasis Urinaria/diagnóstico por imagen , Enfermedades de la Vejiga Urinaria/diagnóstico por imagen , Adolescente , Adulto , Niño , Dilatación Patológica/diagnóstico por imagen , Dilatación Patológica/parasitología , Femenino , Humanos , Masculino , Ultrasonografía , Enfermedades de la Vejiga Urinaria/parasitología , YemenRESUMEN
OBJECTIVE: Evaluation of ultrasonographic abnormalities with active Schistosoma haematobium infection in Yemeni patients. METHODS: As part of a cooperation between a private hospital and Schistosomiasis Control Project in Yemen, laboratory and ultrasonographic examinations were performed in 158 patients (8 females, 150 males, mean age: 17 years) with active Schistosoma haematobium infection. Upper urinary tract dilation, lower ureter changes and bladder wall abnormalities (thickness, hyperechogenicity and polypoid lesions) were registered. Laboratory findings and ultrasonographic changes were evaluated and assorted according to age groups of the patients. RESULTS: Twenty-eight patients (18%) showed no ultrasonographic morphological lesion. Bladder abnormalities (thickness, hyperechogenicity and polypoid lesions) were found in 130 patients (82%) and upper tract lesions in 86 patients (54%). No upper tract lesions were seen without bladder abnormality. Polyps within the lower ureteric lumen occurred in four patients. In patients with polypoid lesions, higher incidence of severe infection was found. One patient had urinary bladder mass. CONCLUSION: Urinary schistosomiasis has typical sonographic features, however, it may occur also without ultrasonographic morphological lesion. Upper tract lesions seem to develop only with lower tract abnormalities.
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Esquistosomiasis Urinaria/diagnóstico por imagen , Sistema Urinario/diagnóstico por imagen , Adolescente , Adulto , Niño , Femenino , Humanos , Riñón/diagnóstico por imagen , Masculino , Ultrasonografía , Uréter/diagnóstico por imagen , Vejiga Urinaria/diagnóstico por imagen , Vejiga Urinaria/fisiopatología , Retención UrinariaRESUMEN
Eight cases of cervical necrotizing fasciitis are presented. Three were odontogenic, two were pharyngeal in origin and three were primary or idiopathic. Soft tissue gas was recognized in four patients. The bacteriology showed streptococci on the top of the list (50%), while for the idiopathic cases, it was monomicrobial and caused by staphylococci. Third generation cephalosporin and metronidazole represent good initial empirical antibacterial coverage. Histopathologically, all cases showed extensive necrosis of the debrided fascia and vascular thrombosis of the dermal vessels. The mortality rate was 3/8 (37.5%). Early diagnosis of cervical necrotizing fasciitis and initiation of definitive therapy in an intensive care environment is essential to minimize mortality. It is also important to recognize that this devastating infection may occur spontaneously, and it should be suspected in patients with unexplained soft tissue pain and tenderness.
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Causas de Muerte , Fascitis Necrotizante/mortalidad , Adulto , Anciano , Bacteroides/efectos de los fármacos , Bacteroides/aislamiento & purificación , Cefalosporinas/farmacología , Fascitis Necrotizante/diagnóstico , Fascitis Necrotizante/microbiología , Fascitis Necrotizante/terapia , Femenino , Humanos , Klebsiella/efectos de los fármacos , Klebsiella/aislamiento & purificación , Tiempo de Internación , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Insuficiencia Multiorgánica/mortalidad , Cuello , Estudios Retrospectivos , Choque Séptico/mortalidad , Staphylococcus/efectos de los fármacos , Staphylococcus/aislamiento & purificación , Streptococcus/efectos de los fármacos , Streptococcus/aislamiento & purificación , Tasa de Supervivencia , Tomografía Computarizada por Rayos X , Traqueostomía , Reino Unido/epidemiologíaRESUMEN
A newly developed laparoscopic knot-substituting technique is presented and applied in cases of retroperitoneal laparoscopic ureterolithotomies. The authors substituted the difficult laparoscopic knotting techniques with the technique of using one or two clips to hold the sutures tight, which shortens and simplifies the endoscopic suturing. This technique is a great advantage, mainly in cases of major reconstructive laparoscopic operations. The technique and advantages of retroperitoneoscopy are discussed as well.
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Laparoscopía/métodos , Técnicas de Sutura , Cálculos Ureterales/cirugía , Humanos , Espacio RetroperitonealRESUMEN
Visco-anaesthetic medication has been used for controlling the gagging sensation in 35 dental patients during intra-oral radiography and impression making. The drug was satisfactory in 29 patients and failed to control the gagging reflex in 6 patients. A direct relation between loss of oral sensation and control of gag reflex has been established.