Methane Emission, Carbon Footprint and Productivity of Specialized Dairy Cows Supplemented with Bitter Cassava (Manihot esculenta Crantz).

The objective of this research was to determine the effect of cassava (Manihot esculenta Crantz) supplementation on enteric methane (CH4) emissions, carbon footprint, and production parameters in dairy cows. Daily concentrate supply for Jersey and Jersey * Holstein breeds was evaluated in four treatments (T): T1: 100% commercial concentrate; T2: 70% concentrate + 30% cassava leaves; T3: 70% concentrate + 30% cassava roots; and T4: 70% concentrate + 15% cassava leaves + 15% cassava root chips. Measurements of CH4 emissions were performed using the polytunnel technique. Average daily dry matter intake ranged from 7.8 to 8.5 kg dry matter (DM). Cassava leaves were characterized by a high crude protein (CP) content (171 g CP/kg DM), with 5 times more neutral detergent fiber (NDF) content than cassava root (587 vs. 108 g NDF/kg DM). Average enteric CH4 emissions per animal ranged from 194 to 234 g/d (p > 0.05). The carbon footprint was reduced by replacing 30% of the concentrate with cassava leaves and/or roots. Energy-corrected milk production was 1.15 times higher in Jersey * Holstein animals than Jersey cows (47 vs. 55 kg). Therefore, supplementation with cassava leaves and/or roots is a nutritionally and environmentally sustainable strategy.

Environmental impact of primary beef production chain in Colombia: Carbon footprint, non-renewable energy and land use using Life Cycle Assessment.

In Colombia, the beef production chain accounts for approximately 11.6 million cattle heads and annually produces 933 million kg of the beef carcass. There are no life cycle assessment (LCA) studies that have evaluated the environmental performance of Colombian beef systems. The present study aimed to estimate the carbon footprint (CF), non-renewable energy use, and land use of 251 cow-calf and 275 fattening farms in Colombia. The study also aimed to identify the main hotspots of adverse environmental impacts and propose possible mitigation options and their cost-effectiveness. The impact categories were estimated using the 2006 IPCC and the 2019 Refinement to 2006 IPCC guidelines, databases, and locally estimated emission factors. The functional units used were 1 kg fat and protein corrected milk (FPCM) and 1 kg live weight gain (LWG), leaving the farm gate. Three methods of allocating environmental burdens to meat and milk products were applied: economic, energy, and mass allocation. The adoption of improved pastures was considered a mitigation measure, and an economic assessment was performed to estimate the relative cost-effectiveness of its establishment. A principal component multivariate analysis and a Hierarchical Clustering on Principal Components were performed. The economic allocation method assigned a greater environmental burden to meat (83%), followed by energy content (80%) and mass production (73%). The largest sources of GHG emissions were enteric fermentation and manure deposited on pasture. Both cow-calf and fattening systems had a cluster of farms with better productivity, pasture and cattle management practices, and environmental performance. The CF for meat could be reduced by 33 to 56% for cow-calf and 21 to 25% for fattening farms, by adopting improved pastures. Therefore, our results suggest that GHG emissions can be reduced by adopting improved pastures, better agricultural management practices, efficient fertilizer usage, using the optimal stocking rate, and increasing productivity.

Measured ammonia emissions from tropical and subtropical pastures: A comparison with 2006 IPCC, 2019 Refinement to the 2006 IPCC, and EMEP/EEA (European Monitoring and Evaluation Programme and European Environmental Agency) inventory estimates.

Agriculture is the largest source of ammonia (NH3) emissions. As NH3 is an indirect greenhouse gas, NH3 measurements are crucial to improving greenhouse gas emission inventory estimates. Moreover, NH3 emissions have wider implications for environmental and human health. Only a few studies have measured NH3 emissions from pastures in the tropics and subtropics and none has compared emissions to inventory estimates. The objectives of this study were to (1) measure NH3 emissions from dairy pastures in tropical and subtropical regions; (2) calculate NH3 emissions factors (EF) for each campaign; and (3) compare measured EF with those based on the 2006 Intergovernmental Panel on Climate Change (IPCC) Tier 1, 2019 Refinement to the 2006 IPCC Tier 1, and the European Monitoring and Evaluation Programme/European Environmental Agency (EMPE/EEA) Tier 2 inventory estimates. Pasture NH3 emissions were measured on 3 dairy farms in Costa Rica. On each dairy, NH3 emissions were measured twice during the wet season and once during the dry season using a micrometeorological integrated horizontal-flux mass-balance method. Emissions were measured from excreta (dung and urine) deposited by grazing cattle and the subsequent application of organic (slurry) or synthetic fertilizer (ammonium nitrate or urea). Measured EF for all campaigns [from grazing cattle excreta and any subsequent slurry or fertilizer application; 4.9 ± 0.9% of applied nitrogen (mean ± SE)] were similar to those of the EMEP/EEA Tier 2 approach (6.1 ± 0.9%; mean ± SE) and 4 times lower than 2006 IPCC and 2019 Refinement to 2006 IPCC Tier 1 default estimates (17.7 ± 1.4 and 18.2 ± 0.9%, respectively; mean ± SE). Measured EF for excreta deposited on pasture and excreta both deposited on pasture and slurry application [3.9 ± 2.1 and 4.2 ± 2.1% (mean ± 95% CI), respectively] were 5 times lower than default EF assumed by 2006 IPCC and 2019 Refinement to 2006 IPCC methodology (both 20 and 21%, respectively), whereas EMEP/EAA estimates were similar [6.0 and 4.6 ± 0.3% (mean ± 95% CI), respectively]. This suggests an overestimation of EF from excreta deposited on pasture and slurry applications in tropical and subtropical regions by IPCC methodologies. Furthermore, rainfall, which is not included as a parameter in the current EMEP/EEA Tier 2 methodology, appeared to reduce NH3 emissions, suggesting that accounting for this in the inventory methodologies could improve inventory estimates.

Acute intermittent porphyria: A case report / [Porfiria intermitente aguda: reporte de caso].

The term 'porphyria' comes from the Greek 'porphyra'. It refers to a heterogeneous group of metabolic disorders caused by the enzymatic deficiency in the biosynthesis of the heme group. Acute intermittent porphyria is caused by a deficiency of the porphobilinogen deaminase enzyme. A 40-year-old woman presented with abdominal pain for ten days (which required laparotomy that evidenced no surgical pathology), severe hydroelectrolytic disorder due to hyponatremia and resistant hypokalemia, persistent tachycardia and hypertension. Seven days later, she developed acute flabby quadriparesis and presented a single generalized tonic-clonic convulsive crisis. Neurophysiological studies supported mixed axonal polyneuropathy and urine results of porphobilinogen and porphyrins were elevated. After acute intermittent porphyria was diagnosed, hemin was administered, which stabilized the patient's clinical signs and normalized the porphobilinogen. The prevalence of this entity is 1 in 2,000 people. It is an autosomal dominant disease, which affects mainly women between 20 and 40 years of age. This entity manifests with neurological and visceral symptoms. Management consists of hematin and dextrose administration avoiding hypotonic solutions because of the risk of exacerbating hyponatremia.

El término 'porfiria' proviene del griego 'porphyra' y alude a un grupo heterogéneo de trastornos metabólicos causados por una deficiencia enzimática en la biosíntesis del grupo hemo. La causa de la porfiria intermitente aguda es la deficiencia de la enzima deaminasa del porfobilinógeno. Se presenta el caso de una mujer de 40 años que presentó dolor abdominal de 10 días de evolución, trastorno hidroelectrolítico grave debido a hiponatremia e hipopotasemia, taquicardia e hipertensión arterial sistémica persistentes, por lo cual fue sometida a una laparotomía en la que no se encontró ninguna afección de origen quirúrgico, A los siete días del examen inicial, la paciente desarrolló cuadriparesia flácida aguda y presentó una crisis convulsiva tónico-clónica generalizada. Los estudios neurofisiológicos evidenciaron una polineuropatía axonal mixta, y los valores de porfobilinógeno y porfirinas en orina eran elevados. Tras diagnosticarse porfiria intermitente aguda, esta se trató con hemina, lo que estabilizó los signos clínicos y normalizó el porfobilinógeno. La prevalencia de esta enfermedad es de 1 en 2.000 personas. Tiene un patrón de herencia autosómico dominante y se manifiesta principalmente en mujeres con edades entre los 20 y los 40 años. La enfermedad cursa con síntomas neurológicos y viscerales, y se trata con la administración de hemina y dextrosa, evitando las soluciones hipotónicas por el riesgo de exacerbar la hiponatremia.

Porfiria intermitente aguda: reporte de caso / Acute intermittent porphyria: A case report

El término 'porfiria' proviene del griego 'porphyra' y alude a un grupo heterogéneo de trastornos metabólicos causados por una deficiencia enzimática en la biosíntesis del grupo hemo. La causa de la porfiria intermitente aguda es la deficiencia de la enzima deaminasa del porfobilinógeno. Se presenta el caso de una mujer de 40 años que presentó dolor abdominal de 10 días de evolución, trastorno hidroelectrolítico grave debido a hiponatremia e hipopotasemia, taquicardia e hipertensión arterial sistémica persistentes, por lo cual fue sometida a una laparotomía en la que no se encontró ninguna afección de origen quirúrgico, A los siete días del examen inicial, la paciente desarrolló cuadriparesia flácida aguda y presentó una crisis convulsiva tónico-clónica generalizada. Los estudios neurofisiológicos evidenciaron una polineuropatía axonal mixta, y los valores de porfobilinógeno y porfirinas en orina eran elevados. Tras diagnosticarse porfiria intermitente aguda, esta se trató con hemina, lo que estabilizó los signos clínicos y normalizó el porfobilinógeno. La prevalencia de esta enfermedad es de 1 en 2.000 personas. Tiene un patrón de herencia autosómico dominante y se manifiesta principalmente en mujeres con edades entre los 20 y los 40 años. La enfermedad cursa con síntomas neurológicos y viscerales, y se trata con la administración de hemina y dextrosa, evitando las soluciones hipotónicas por el riesgo de exacerbar la hiponatremia.

The term 'porphyria' comes from the Greek 'porphyra'. It refers to a heterogeneous group of metabolic disorders caused by the enzymatic deficiency in the biosynthesis of the heme group. Acute intermittent porphyria is caused by a deficiency of the porphobilinogen deaminase enzyme. A 40-year-old woman presented with abdominal pain for ten days (which required laparotomy that evidenced no surgical pathology), severe hydroelectrolytic disorder due to hyponatremia and resistant hypokalemia, persistent tachycardia and hypertension. Seven days later, she developed acute flabby quadriparesis and presented a single generalized tonic-clonic convulsive crisis. Neurophysiological studies supported mixed axonal polyneuropathy and urine results of porphobilinogen and porphyrins were elevated. After acute intermittent porphyria was diagnosed, hemin was administered, which stabilized the patient's clinical signs and normalized the porphobilinogen. The prevalence of this entity is 1 in 2,000 people. It is an autosomal dominant disease, which affects mainly women between 20 and 40 years of age. This entity manifests with neurological and visceral symptoms. Management consists of hematin and dextrose administration avoiding hypotonic solutions because of the risk of exacerbating hyponatremia.

Melorreostosis con compromiso de múltiplesestructuras óseas y distribución inusual / Melorheostosis with involvement of multiple bone structures and unusual distribution

La melorreostosis, también denominada enfermedad de Leri, es una displasia ósea esclerosante no familiar, de baja prevalencia, de etiología poco clara, descrita en 1922 por Leri y Jhonny; afecta igualmente a hombres y mujeres, suele manifestarse alrededor de los 20 años de edad, hasta en la mitad de los casos. Esta osteopatía es usualmente asimétrica y compromete, principalmente, las extremidades inferiores, siendo raro el compromiso del cráneo, huesos de la cara y de la columna. Se presenta un caso de una paciente, de 49 años de edad, con compromiso de múltiples estructuras óseas y distribución inusual.

Melorheostosis, also called Leri’s disease is a non-familial sclerosing bone displasia, with low prevalence and a etiology that remains unclear, it was described in 1922 by Leri and Jhonny; it affects men and women equally; it usually makes evident by age 20 years in almost half cases. This bone disease is usually asymmetric and involves primarily the lower extremities, with rare involvement of the skull, facial bones and spine. We report a case of a 49 years old, with involvement of multiple bone structures and unusual distribution.

Observancia de las guías internacionales de manejo temprano en sepsis grave y choque séptico / Adherence to international guidelines on early management in severe sepsis and septic shock

Introducción. La observancia completa del tratamiento temprano dirigido por objetivos, disminuye significativamente la mortalidad a 28 días, mientras que la observancia parcial no tiene ningún beneficio. Objetivos. Determinar la observancia de las guías internacionales en sepsis grave y choque séptico, mediante el conjunto de medidas (bundle) de reanimación de las primeras seis horas en pacientes mayores de 16 años de edad, en un centro de referencia de alta complejidad. Materiales y métodos. Se presenta un estudio de cohorte, prospectivo y descriptivo, llevado a cabo durante un período de seis meses, en pacientes con sepsis grave o choque séptico admitidos a los servicios de urgencias, unidades de cuidados intensivos y cuidados especiales. Se midió la observancia del conjunto de medidas mediante ocho intervenciones: 1) medición del lactato sérico, 2) inicio temprano de antibióticos, 3) toma de hemocultivos, 4) infusión de líquidos intravenosos, 5) uso de medicamentos vasopresores, 6) inserción de catéter venoso central, 7) presión venosa central mayor de 8 mm Hg, y 8) saturación venosa central de oxígeno mayor de 70 %. Resultados. Se tamizaron 723 pacientes; 16 % (n=116) cumplieron los criterios de inclusión, 92,2 % (n=107) cumplieron los criterios para sepsis grave y 37,9 % (n=44) para choque séptico. El 62,9 % (n=73) fue subdiagnosticado. La observancia completa de las 8 intervenciones del conjunto de medidas fue de 0 %; de 6 a 7, 19 % (n=22); de 3 a 5, 67,2 % (n=78), y de 0 a 2, 98,3 % (n=114). Conclusión. La completa observancia de las guías internacionales de manejo en sepsis grave y choque séptico en las primeras seis horas es nula y solo se cumple de manera parcial.

Introduction. Complete adherence to early goal-directed therapy has shown a significant reduction in 28-day mortality rate, whereas partial adherence has not shown beneficial effect. Objectives. The effect of adherence to 6 hour sepsis bundle treatment was evaluated on patients with severe sepsis and septic shock. Materials and methods. A prospective cohort study was conducted during a six-month period. The patients were limited to those 16 years or older and included admissions to intensive care units, special care units or emergency departments with severe sepsis or septic shock. The adherence to the 6-hour sepsis bundle was evaluated through 8 interventions as follows: (1) serum lactate measure,( 2) early antibiotic administration, (3) blood culture samples, (4) infusion of intravenous fluids, (5) vasopressor use, (6) central venous catheter, (7) central venous pressure >8 mm Hg, and (8) central venous oxygen saturation >70%. Results. Seven hundred and twenty three patients were screened; 16% (n=116) met the inclusion criteria; 92.2% (n=107) met the criteria for severe sepsis and 37.9% (44) for septic shock; 62.9% (n=73) were subdiagnosed. Complete adherence to the 8 interventions of 6-hour sepsis bundle was 0%; 6 to 7 (19%, n=22), 3 to 5 (67.2%, n=78), and 0 to 2 (98.3%, n=114). Conclusion. Adherence to 6-hour sepsis bundle treatment for severe sepsis and septic shock was not done for the full 8 interventions and only partial accomplishment of the first 4 interventions.

[Adherence to international guidelines on early management in severe sepsis and septic shock]. / Observancia de las guías internacionales de manejo temprano en sepsis grave y choque séptico.

INTRODUCTION: Complete adherence to early goal-directed therapy has shown a significant reduction in 28-day mortality rate, whereas partial adherence has not shown beneficial effect. OBJECTIVES: The effect of adherence to 6 hour sepsis bundle treatment was evaluated on patients with severe sepsis and septic shock. MATERIALS AND METHODS: A prospective cohort study was conducted during a six-month period. The patients were limited to those 16 years or older and included admissions to intensive care units, special care units or emergency departments with severe sepsis or septic shock. The adherence to the 6-hour sepsis bundle was evaluated through 8 interventions as follows: (1) serum lactate measure,( 2) early antibiotic administration, (3) blood culture samples, (4) infusion of intravenous fluids, (5) vasopressor use, (6) central venous catheter, (7) central venous pressure >8 mm Hg, and (8) central venous oxygen saturation >70%. RESULTS: Seven hundred and twenty three patients were screened; 16% (n=116) met the inclusion criteria; 92.2% (n=107) met the criteria for severe sepsis and 37.9% (44) for septic shock; 62.9% (n=73) were subdiagnosed. Complete adherence to the 8 interventions of 6-hour sepsis bundle was 0%; 6 to 7 (19%, n=22), 3 to 5 (67.2%, n=78), and 0 to 2 (98.3%, n=114). CONCLUSION: Adherence to 6-hour sepsis bundle treatment for severe sepsis and septic shock was not done for the full 8 interventions and only partial accomplishment of the first 4 interventions.