Technical note: Validation of an ear-tag accelerometer to identify feeding and activity behaviors of tiestall-housed dairy cattle.

The objective of this study was to validate the CowManager SensOor ear-tag accelerometer (Agis Automatisering BV, Harmelen, the Netherlands) against visual observations of feeding, rumination, resting, and active behaviors of tiestall-housed dairy cows. Prior validation of the sensor has been published for freestall and grazing dairy herds. However, the behavioral differences that exist among these and a tiestall system necessitate additional validation. Lactating Holstein cows (n = 10) at different lactation stages and parities were included in the study. Cows were monitored both visually and with the sensor for 10 h/d for 4 consecutive days (10 cows × 10 h × 4 d = 400 h of observation total). A single trained observer classified each minute of visual observation into 1 of 13 behaviors and then summarized them into the 4 behavioral categories of eating, rumination, not active, or active. The sensor registered ear movements continuously and, based on a proprietary model, converted them into the behavioral categories. Multivariate mixed models were run to obtain covariance estimates, from which correlation coefficients were computed to assess agreement between visual observation and sensor data. The models included the percentage of time spent performing each behavior per day as the dependent variable and technology (visual observation versus sensor) and day as fixed effects. The models also included the random effects of technology and the repeated effects of technology and day. The correlation strength between visual observation and sensor data varied from poor to almost perfect by behavioral category (eating: r = 0.27; rumination: r = 0.69; eating-rumination: r = 0.83; not active: r = 0.95; and active: r = 0.89). The results suggest that the sensor can be used to accurately monitor active and not-active behaviors of tiestall-housed dairy cows. The results also suggest that although the sensor shows promise for identifying feeding behaviors in general, the independent classification of rumination and eating requires additional sensitivity.

The effects of providing portable shade at pasture on dairy cow behavior and physiology.

Access to pasture has advantages for cows such as reduced lameness and improved udder health, but also may expose cows to stressors such as extreme heat. The objective of this study was to understand how portable shade affected physiological and behavioral responses of pastured dairy cows in a Canadian summer. Over 8wk, a total of 24 lactating Holstein cows were separated into 2 treatments, one with access to shade and a control without access to shade. The cows were pastured in groups of 4, with 3 field sections per treatment. Instantaneous scan sampling of behaviors (drinking, lying, grazing, other) performed in the shade or not were recorded every 5min for 3h/d during the hottest part of the day (peak hours: 1130-1530h) 3d/wk. Ambient temperature, humidity, and vaginal temperature were recorded at 10-min intervals. Daily milk production was also recorded. Differences between treatments by week were analyzed using the generalized linear mixed model with group as random effect and treatment as fixed effect. Cows with shade access were observed at the water trough up to 6.42 times less and lying down up to 1.75 times more. Cows with shade access grazed up to 1.5 times more but only when the temperature-humidity index was above their comfort threshold (≥72) during the hottest part of the day (wk 2). Cows sought shade when it was made available, but spent less than half of their time observed (%) in the shade (40.8±4.67) with the exception of wk 2 when most of the time was spent under the shade (74.3±4.77). Daily lying time was highest during peak hours for cows with shade access. However, no overall difference in total lying time between the 2 treatments was observed. No differences were found in vaginal temperature or milk production between treatments with the exception of wk 1 for daily milk production, which was higher for cows in the control treatment. In conclusion, cows sought shade when it was provided at pasture, whereas cows without access to shade seemed to alter their behavior to cope with heat stress, as seen from the lack of physiological differences between treatments. The results indicate that providing cows with access to pasture under a temperate climate does not seem to have any detrimental physiological or production effects and providing them with shade can potentially decrease production costs and help with water conservation strategies as fewer cows were observed at the water when shade was provided.

[In-transit metastasis in melanoma: Efficacy of topical imiquimod combined with carbon dioxide laser or with electrocautery]. / Métastases en transit du mélanome : efficacité de l'imiquimod topique combiné au laser CO2 ou à l'électrocoagulation.

BACKGROUND: In-transit metastases in cutaneous melanoma are common and difficult to manage. Therapy is mainly palliative. Use of topical imiquimod has been assessed for surface metastases. PATIENTS AND METHODS: We report on four patients with cutaneous melanoma metastases treated with topical imiquimod associated with carbon dioxide laser in the first two patients and with electrocoagulation in the two others. For two patients, we noted complete regression of the lesions after 15 and 18 months. For the two others, treatment was stopped after 9 to 10 months because of progression of subcutaneous metastasis and distant metastasis. DISCUSSION: Topical imiquimod is an alternative treatment used in superficial in-transit metastasis of melanoma. Its use as a monotherapy is sometimes ineffective. We elected to use combined pre-treatment with carbon dioxide laser or electrocoagulation in order to potentiate the action of imiquimod. This simple and inexpensive therapeutic strategy constitutes a palliative treatment that can allow prolonged local control of cutaneous metastasis.

[Reversible lower limb lymphedema as the first manifestation of cutaneous periarteritis nodosa]. / Lymphoedème réversible des membres inférieurs précédant le diagnostic de périartérite noueuse cutanée pure.

INTRODUCTION: Cutaneous periarteritis nodosa is a localized form middle-sized arteriolitis. Its main clinical features are nodules, livedo reticularis and ulcers of the lower limbs. EXEGESIS: We reported a 45 year-old woman with distal lower limb lymphedema. Lymphedema initially spontaneously remitted but recurred nine months after, accompanied with nodules. Cutaneous periarteritis nodosa was diagnosed on histological findings and absence of extracutaneous manifestations. Lymphoscintigraphy showed functional lymphatic insufficiency. Treatment consisted of prednisone followed by colchicine and dapsone. After six months of follow-up, patient remained symptom-free. CONCLUSION: We report the first case of lower limb lymphedema associated with cutaneous periarteritis nodosa. Parallel course and unusual corticosensivity of lymphedema and nodules raised the problem of their non coincidental association.

[Subacute cutaneous lupus gyratus repens]. / Lupus subaigu gyratus repens.

BACKGROUND: Erythema gyratum repens is a rare paraneoplastic eruption. To date, only sixty have appeared in the literature. We report a patient with clinical and histological cutaneous subacute lupus and typical erythema gyratum repens. CASE REPORT: A 86-year-old woman presented with a 2-month history erythematous patches, confined mainly to the trunk, arms, thighs and the face. Cutaneous biopsy was compatible with cutaneous subacute lupus. After 4 weeks of hydroxychloroquine treatment, physical examination revealed erythematous, concentric, serpiginous and scaly bands on the trunk. Erythematous patches persisted on the limbs and the face. Physical examination and investigations in search of an internal malignancy were negative. All cutaneous lesions resolved after three months of chloroquine and dapsone treatment. DISCUSSION: Fourteen cases of erythema gyratum repens have been reported unassociated with underlying malignancy. This eruption usually precedes the occurrence of the neoplasm. Erythema gyratum repens is a migrating gyrate erythema with a serpiginous, concentric appearance creating a wood-grain look in the skin, which is pathognomonic. Histological findings are not specific, showing light parakeratosis and perivascular lymphocytic infiltrate of superficial dermis. Five cases of cutaneous lupus associated with erythema gyratum repens eruption have been reported. Considering the negative check-up in search of internal malignancy on a follow-up period of 20 months, our case is a probably a particular form of subacute lupus.

Long-term efficacy on Kaposi's sarcoma of highly active antiretroviral therapy in a cohort of HIV-positive patients. CISIH 92. Centre d'information et de soins de l'immunodéficience humaine.

OBJECTIVE: To assess the efficacy of highly active antiretroviral treatment (HAART) on AIDS-Kaposi's sarcoma (KS). DESIGN: Prospective cohort of patients followed for 24 months. SETTING: Four referral hospitals of the West Paris metropolitan area. PATIENTS/INTERVENTION: Thirty-nine AIDS-KS patients, 42 +/- 9 years old, who began HAART (HIV-protease inhibitor and two nucleoside analogues) between March and December 1996, were enrolled. One was lost to follow-up at month 12. MAIN OUTCOME MEASURES: KS response, using criteria of the AIDS clinical trials group (ACTG), CD4 cell counts, and plasma HIV-RNA, assessed every 6 months. ACTG TIS staging of KS. RESULTS: Eighteen patients had T1 KS and 21 T0 KS. One patient died from KS at month 6. KS improved progressively, with complete and partial response rates of 46% and 28% at month 24, respectively. Only six patients were still receiving systemic KS therapy at month 24. Complete response was observed in 10 of the 19 patients without systemic KS therapy at inclusion. Patients with complete response at month 24 had higher CD4 cell counts than others (465 +/- 343 versus 185 +/- 167 x 10(6)/l; P < 0.01), but the proportion of patients with HIV-1 RNA < 500 copies/ml was not significantly different. An increase in CD4 cell counts from inclusion to month 12 of > 150 x 10(6)/l [odds ratio (OR), 13.4; 95% confidence interval (CI), 2-82] and T0 KS at inclusion: [OR, 7; 95% CI, 1.1-42] were predictive of complete response at month 24. CONCLUSIONS: HAART appears to have prolonged efficacy on AIDS-KS, even without specific KS therapy, and this effect appears to be linked to the restoration of immune function.

Lipodystrophy associated with protease inhibitors.

Lipodystrophies, characterized by reduction of subcutaneous fat over part or all of the body surface, are uncommon. Their causes are unknown. Recently, lipodystrophy has been reported in human immunodeficiency virus (HIV)-infected patients taking protease inhibitors, which have been recommended since 1996 as standard therapy for HIV disease in combination with nucleoside analogues. In these cases, lipodystrophy consists of an association of peripheral lipoatrophy with central adiposity. We report four HIV-infected men on protease inhibitors who developed a disfiguring lipodystrophy. In three of them, the protease inhibitor was administered for a mean duration of 21.5 months (range 19-23) with good immunological and virological responses. Patient 4 had been treated for 2 years with successive combinations of protease inhibitors with nucleoside analogues without success. The four patients progressively developed an increase in abdominal girth associated with fat wasting of the face and legs. Two of them had recurrent paronychia of the great toes. Triglyceride levels were moderately increased in all patients, and one had a slightly increased cholesterol level. One patient had elevated glucose and insulin plasma levels during a glucose tolerance test. In two patients, a deep biopsy taken from the thigh showed thinning of the subcutaneous fat without other morphological changes. Computed tomographic scans of the face and abdomen confirmed the loss of almost all subcutaneous fat of the cheek and temporal regions, and abdominal perivisceral fat accumulation. For patients 1-3, the protease inhibitor was replaced by a non-nucleoside reverse transcriptase inhibitor. Nine months later, dysmorphic changes had not regressed, but lipid abnormalities had returned to normal and the paronychia had disappeared.

Ivermectin-responsive crusted scabies in HTLV1 carrier.

We report a case of HTLV1 infection revealed by crusted scabies and widespread dermatophytosis in an African woman. HTLV1 infection was not complicated by adult T cell leukemia or myelopathy. Crusted scabies is a marker of HTLV1 infection. The importance of oral ivermectin therapy in crusted scabies is emphasized.

Primary cutaneous medium and large cell lymphomas other than mycosis fungoides. An immunohistological and follow-up study on 54 cases. French Study Group for Cutaneous Lymphomas.

Primary cutaneous medium and large cell lymphomas (MLCL) other than mycosis fungoides (MF) are rare, and their prognosis and treatment are controversial. The clinical, immunohistological and follow-up data of 54 well-documented cases of primary cutaneous MLCL other than MF, seen in our institutions over a 14-year period, were retrospectively reviewed, in order to determine the prognostic factors related to these lymphomas, and to analyse the results obtained with different treatment regimens. Forty-six patients presented with a solitary tumour or with localized lesions, and eight had disseminated cutaneous lesions. According to the updated Kiel classification, 45 cases (83%) corresponded to B-cell lymphomas: centroblastic lymphomas, 32 cases; centroblastic-centrocytic lymphomas, 11 cases; immunoblastic lymphomas, two cases. Nine cases (17%) were classified as T-cell lymphomas: pleomorphic medium and large cell lymphomas, eight cases; anaplastic large cell lymphoma, one case. Four of eight patients with disseminated skin lesions had a T-cell lymphoma, whereas 41 of 46 patients with a solitary tumour had a B-cell lymphoma. Patients with disseminated skin lesions and elevated serum lactate dehydrogenase (LDH) levels had a poor prognosis. Comparison of patients' overall survival, depending on immunohistological subtype, showed that the median survival of patients with pleomorphic T-cell lymphoma was 2.5 years, whereas it was not reached at 12 years for patients with centroblastic-centrocytic and centroblastic lymphoma. The eight patients with disseminated skin lesions were treated with polychemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

[Mycosis fungoides in the child. Three cases]. / Mycosis fongoïde de l'enfant. Trois cas.

INTRODUCTION: Cutaneous lymphoma is unusual in children but according to data in the literature, approximated 5 p. 100 of the cases observed would begin in childhood. CASE REPORT: We retrospectively studied 3 cases of mycosis fungoides where the first manifestations occurred before 10 years of age. In one of the patients, the diagnosis was not definitively confirmed until adulthood. DISCUSSION: Diagnosis in these forms which begin in childhood is usually achieved after a long delay. Clinically, these lymphomas form a homogeneous group. In approximately 15 p. 100, guttate parapsoriasis occurs before mycosis fungoides. Biopsy is indicated if the lesions change in aspect or become atypical. The most frequent presentation in children or young adults is vitiligoid hypo-pigmented macules. Histologically, childhood forms do not differ from the adult forms and also respond to local treatment as in adults. Prospective studies conducted conjointly by paediatricians and dermatologists would be needed to describe the natural history of these cutaneous lymphomas in light of progression to aggressive lymphoma of Hodgkin's disease described in certain cases.

[Diagnostic value of thermography and Tc 99m bleomycin scintigraphy for nodules of the thyroid (author's transl)]. / Valeur diagnostique de le thermographie et de la scintigraphie à la bléomycine Tc 99m dans les nodules thyroïdiens. Apropos de 86 observations.

The combined interest of thermography and 99mTc Bleomycin scintigraphy in the differential diagnosis of a cold thyroid nodule was evaluated in 86 patients. In all cases a histological examination was performed. Of the 30 malignant nodules (clinically suspect and solitary nodules) 21 (70%) showed concentrations of 99mTc Bleomycin while only 7 of the 12 solitary malignant nodules did so. Among the 54 benign nodules the false positive rate was 54%. Thermography was positive in 26 (87%) of the 30 malignant nodules and in only 8 (67%) of the 12 solitary malignant nodules. For the 54 benign nodules the false positive rate was 72%. The combined results of the study do not provide any improvement in diagnostic accuracy. Thus it can be said that applications of 99mTc Bleomycin and thermography in the diagnosis of solitary hypofixiant nodules are of limited value.