RESUMEN
Many of the metrics used to evaluate farm performance are only partial indicators of farm operations, which are assumed to be best predictors of the whole farm efficiency. The main objective of this work was to identify aggregated multiple indexes of profitability using common partial indicators that are routinely available from individual farms to better support the short-term decision-making processes of the cattle-feeding process. Data were collected from face-to-face interviews with farmers from 90 dairy farms in Italy and used to calculate 16 partial indicators that covered almost all indicators currently used to target feeding and economic efficiency in dairy farms. These partial indicators described feed efficiency, energy utilization, feed costs, milk-to-feed price ratio, income over feed costs, income equal feed cost, money-corrected milk, and bargaining power for feed costs. Calculations of feeding costs were based on lactating cows or the whole herd, and income from milk deliveries was determined with or without considering the milk quality payment. Multivariate factor analysis was then applied to the 16 partial indicators to determine simplified and latent structures. The results indicated that 5 factors explained 70% of the variability. Each of the original partial indicator was associated with all factors in different proportions, as indicated by loading scores from the multivariate factor analysis. Based on the loading scores, we labeled these 5 factors as "economic efficiency," "energy utilization," "break-even point," "milk-to-feed price," and "bargaining power of the farm," in decreasing order of explained communality. The first 3 factors shared 83% of the total communality. Feed efficiency was similarly associated with factor 1 (53% loading) and factor 2 (66% loading). Only factor 4 was significantly affected by farm location. Milk production and herd size had significant effects on factor 1 and factor 2. Our multivariate approach eliminated the problem of multicollinearity of partial indicators, providing simple and effective descriptions of farm feeding economics. The proposed method allowed the evaluation, benchmarking, and ranking of dairy herd performance at the level of single farms and at territorial level with high opportunity to be used or replicated in other areas.
Asunto(s)
Industria Lechera , Lactancia , Alimentación Animal , Animales , Bovinos , Agricultores , Granjas , Femenino , Humanos , LecheRESUMEN
The objective of this study was to develop a quality index method for Engraulis anchoita stored in ice and to determine its shelf-life based on this quality index method and chemical indices such as total volatile bases and thiobarbituric acid-reactive substances. Besides, the chemical composition with emphasis on the polyunsaturated fatty acids content was determined. The results indicate that E. anchoita is a valuable protein source and lipid with important content of n-3 polyunsaturated fatty acids. The developed quality index method scheme was composed of 28 demerit points, divided into 4 parameters and 10 attributes. All attributes showed correlation with time of storage (R > 0.90). The quality index (QI) presented a linear relationship with storage (QI = 2.55x days in ice + 1.76; R²= 0.98). In the shelf-life assessment-based quality index method, the rejection sensory point was observed after 7 days of storage due to the presence of unpleasant odours and deteriorated appearance. The total volatile basic nitrogen value remained below the upper limit of acceptability during the 10 days of ice storage. The evolution of thiobarbituric acid-reactive substances indicates lipids oxidation during the storage of anchovies. According to the results, the quality index method scheme developed for the E. anchoita stored in ice could be considered adequate to evaluate their freshness and to estimate its shelf-life.
Asunto(s)
Peces , Inspección de Alimentos/métodos , Almacenamiento de Alimentos , Alimentos Marinos/análisis , Animales , Argentina , Océano Atlántico , Fenómenos Químicos , Frío , Ácidos Grasos Omega-3/análisis , Peces/crecimiento & desarrollo , Humanos , Odorantes , Oxidación-Reducción , Pigmentación , Análisis de Componente Principal , Control de Calidad , Alimentos Marinos/normas , Estaciones del Año , Sensación , Sustancias Reactivas al Ácido Tiobarbitúrico/análisis , Compuestos Orgánicos Volátiles/análisisRESUMEN
The impact with a diagnosis of terminal chronic kidney failure produces a strong reaction in the patient, who feels confused, scared, angry and often expresses his scepticism about the physician's competence. It as been observed that the physician's attitude during his first contact with the patient determines the features of the patient's approach to the disease and its treatment. Respect, tact, empathy, support and information precision are essential to the establishment of a productive communication relationship resulting in a satisfying level of patients' awareness and compliance. A group of 80 patients was surveyed with a semi-structured interview aimed at evaluating physicians' communication strategies and patients' emotional experience. In order to improve the patients' life quality by making him an active part of every step of his treatment, is strongly recommended the adoption of a patient-centred communication pattern based on contact and positive unconditioned acceptance.
Asunto(s)
Fallo Renal Crónico/diagnóstico , Relaciones Médico-Paciente , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Revelación de la VerdadRESUMEN
A young girl was admitted to the Renal Unit of our Hospital because of loin pain and mild renal failure with bilateral hydronephrosis. The abdomen ultrasound was very helpful to get the right diagnosis.
Asunto(s)
Himen/anomalías , Niño , Anomalías Congénitas/diagnóstico , Femenino , Humanos , Hidronefrosis/etiología , Dolor/etiología , Insuficiencia Renal/etiologíaRESUMEN
BACKGROUND: Ultrasonography artifacts are false representations of the image caused by the interaction between the ultrasound and the tissues. The ability to identify artifacts is an important source of information that can help the clinician in performing a correct diagnosis. The twinkling artifact (called 'Effetto Arlecchino' by the Italians) consists of a series of colored pixels that appear inside, around and often along the shadow cone of the calculi. METHODS: We evaluated the clinical effectiveness of this artifact in the diagnosis of kidney stone disease. In 107 ultrasonography cases of hyperechogenic formations with clinical features of kidney stones, we used the color box to evoke the twinkling artifact. Of the 107 cases, 102 cases (95%) presented this artifact, while five cases did not. Moreover, this artifact was present in all urethral and bladder stones and in 62/67 kidney stone cases. CONCLUSIONS: In our experience, we found that the twinkling artifact is often positive in urinary stone disease, and the ability to identify it adds useful information to the diagnosis of urinary kidney stone disease.
Asunto(s)
Artefactos , Cálculos Renales/diagnóstico por imagen , Humanos , UltrasonografíaRESUMEN
UNLABELLED: Vascular access (VA) for hemodialysis (HD) is one of the most important clinical problems in end-stage renal disease (ESRD) patients because it can limit a life support system and can influence long-term dialysis patient survival. Nevertheless, VA becomes useless after a successful renal transplant. Therefore, we wanted to evaluate the natural history of arteriovenous fistulas (AVF) in renal transplanted patients and the possibility of maintaining the fistula as patent or not. METHODS: A retrospective study was conducted to evaluate kidney transplant patients in our unit from April 1994 to April 2004. We studied 542 patients. RESULTS: There were 365 patients with a well functioning kidney. Eighty-six patients died. Ninety-one patients were put back on dialysis: 89 patients on HD and two patients on CAPD. Of the 365 patients with functioning kidney transplants, 198 patients demonstrated a patent fistula, while 167 patients had a closed fistula. One hundred and twenty-five patients had a spontaneous closure and 42 patients had a surgical closure. Of the 89 patients put back on dialysis, 49 patients used the previous AVF, while it was necessary to create a new VA in 40 patients. CONCLUSIONS: As demonstrated by the results of our study, after renal transplantation the possibility of spontaneous AVF closure caused by a thrombosis is not a rare event. The dilemma is whether to preserve a fistula that could be useful in case of restarting HD or to perform a systematic fistula closure because of cardiac output and cardiac failure risks. Concerning this question there is no consensus between different authors in the literature. In reviewing the literature and analyzing our data, we conclude that the definite indications for AVF closure in well functioning renal transplanted patients are heart failure, high flow fistula, VA complications and important aesthetic reasons. Routine AVF closure is not indicated until prospective and randomized studies can demonstrate the ability of this procedure to reduce the high incidence of cardiac morbidity and mortality that is present, even after renal transplantation.
RESUMEN
Platelet aggregation (PA) and erythrocyte deformability (ED) were studied in twenty patients undergoing TPN for major abdominal surgery. PA was studied by the method of Born. ED was evaluated using standard filters (Uni Pore) and recording the filterability time (FT). All the patients had normal basal values of both parameters. In those receiving TPN slight increases of PA and FT were noticed after the first post-operative day (ADP 1 muM = 31.29 + 6.4%, EPI 5 muM = 24.08 + 8.2%, COLL 0.5 mug/ml = 27.94 + 6.5%, FT = 35.5 + 3.5''). This trend was more pronounced on post-operative day 4, and was statistically significant on days 7, 14, and 19 (ADP = 49.76 + 8.8, EPI = 57.2 + 11%) (p 0.05), (COLL = 73.2 + 8.6%) (P 0.01), (FT = 65.5 + 10.5'') (p 0.05). Some days after stopping TPN, these values slowly returned towards normal. These changes were not observed in a control group of ten patients, not undergoing TPN. From our data the following conclusions can be drawn: 1) PA is progressively enhanced in surgical patients undergoing TPN and slowly returns to normal several days after oral feeding resumption. 2) There is a significant linear relationship between PA and FT in the post-operative phase.
RESUMEN
A survey has been carried out on 336 strains of staphylococci isolated in a hospital environment in order to assess the validity of the lyogroup classifying method, to know their epidemiological behavior in our territory and to test their sensitivity to various antibiotics. The findings of the survey can be summed up as follows: the practical test for bacteriolysis activity appears to be a valid method of identifying staphylococci in so far as it allows to classify them, but also to differentiate them from micrococci; lyogroup VI appears to be prevalent both as a whole and in nearly all materials of origin; the incidence of resistance is highest for piperacillin (47%), gentamicin (20%), tobramycin (19%); it is lowest for netilmicin (1.2%) and amikacin (2.6%); among meticilline resistant strains (18%) there is a marked resistance towards nearly all antibiotics tested.
Asunto(s)
Staphylococcus/clasificación , Antibacterianos/farmacología , Bacteriólisis , Farmacorresistencia Microbiana , Métodos Epidemiológicos , Hospitales , Humanos , Pruebas de Sensibilidad Microbiana , SerotipificaciónRESUMEN
We report the results of a study carried out upon samples of urine from 19,021 patients in various departments of medical school in Sassari and in the hospitals of Alghero and Ozieri. The 34.7% of samples examined proved to be positive. Among these we isolated Escherichia coli (32%), Proteus spp. (24%), Staphylococcus (12%), Klebsiella-Enterobacter-Serratia (KES) spp. (9%), Pseudomonas spp. (5%). We found microbic associations in 11% of cases. We also studied the sensitivity of microorganisms to various chemoantibiotics, and the efficacy of therapy on 964 patients. In the various checks made, the results point out a persisting positivity (53%). E. coli strains show a major sensitivity to the various antibiotics (aminoglycosides, quinolones, cephalosporins, etc.); Proteus spp. and KES are less sensitive; Pseudomonas spp. strains are very resistant and respond mainly to norfloxacin and ceftazidime.