Response of cows with osteomalacia grazing sub-tropical native pastures to phosphorus supplementation with loose mineral mix or feed blocks.

Osteomalacia outbreaks often occur in cattle grazing native pastures in regions with endemic phosphorous (P) deficiency. This study evaluated the responses of two groups of cows, initially with clinical signs of chronic P deficiency, to P supplements (100 g P/kg) offered ad libitum for 13 weeks as a loose mineral mix (LMM group) or the same mineral mix offered as blocks (BMM group). Half of the cows in each group were categorized as 'with' or 'without' severe osteopenia according to a test that depended on the resistance to penetration of a needle through the left lateral process of the L4-L5 lumbar vertebra. The groups grazed two paddocks that were switched each 3 weeks. The liveweight, supplement intakes, and the P-concentrations in soil, forage, blood, and external cortical bone (ECB) of the ribs were measured. The bicarbonate-extractable P in soil was 3.5 mg/kg. The mean of total P in forage (0.95 g/kg/DM), inorganic P in serum (iP, 0.96 mmol/L), and total P in the ECB of the ribs (85 mg/mL) at the beginning of the experiment were all low and consistent with severe chronic P deficiency. The P supplementation allowed clinical recovery in 18/20 cows with their serum and ECB P and calcium approaching normal values and in the two remaining cows the only sign was abnormal gait. Cows consumed more of the LMM than BMM supplement (means 8.3 and 6.6 g P/day, respectively). After 13 weeks cows initially classified as 'with severe osteopenia' and supplemented with LMM had higher (P < 0.05) final liveweight (difference = 21.6 kg), iP (difference = 0.74 mmol/L), bone Ca (difference = 65.7 mg/mL) and bone P (difference = 26.5 mg/mL) concentrations and lower (P < 0.01) final serum Ca/iP ratio (difference = -0.65) than cows with severe osteopenia but supplemented with BMM. The treatment of severe P deficiency cows grazing P deficient sub-tropical grasslands by P supplementation for 13 weeks was more effective with LMM than BMM.

Eimeria spp. in dairy calves in Uruguay. Identification, dynamics of oocyst excretion and association with the age of calves.

Eimeria bovis, Eimeria zuernii, Eimeria ellipsoidalis, Eimeria auburnensis, Eimeria canadensis and Eimeria alabamensis were identified on different dairy farms in Uruguay. The most prevalent species were E. bovis and E. zuernii, which were mainly found in the feces of calves with diarrhea. The dynamics of oocyst excretion were evaluated via the weekly determination of oocysts per gram (OPG) values in fecal samples from 97 calves over seven months. Three groups of calves were formed according to their age in days: Group 1 (1-20 days old), Group 2 (21-40 days old) and Group 3 (41-65 days old). In Group 1, the median OPG was zero, and the maximum OPG was 1,680. In Group 2, the median OPG was between zero and 8,240, and the maximum OPG was 428,800. In Group 3, the median OPG was between zero and 220, and the maximum OPG was 16,000. For the evaluation of the relationship between OPG and age group, a proportional odds model was built. Two samples from 60 bovines evaluated in Group 2 and in Group 3 were selected. OPG was categorized as negative, moderate (lower than or equal to 4,000) or high (greater than 4,000). Calves of Group 2 (21-40 days old) were significantly (p < 0.001) more affected by eimeriosis than calves of Group 3 (41-65 days old). Considering that diarrhea in calves is a multifactorial disease, eimeriosis should be considered when evaluating the control measures for diarrhea syndrome, particularly in calves of 21-40 days of age.

Varón de 70 años con parada respiratoria secundaria a angioedema / A 70-year-old male with respiratory arrest secondary to angioedema

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Overview of alternative dispute resolution in healthcare disputes.

Various methods of alternative dispute resolution have gained wide acceptance in general commercial disputes. With the ever-increasing commercialization of the healthcare industry, many participants are examining ADR as a means of resolving disputes in this area as well. This Commentary provides an overview of the two most prevalent forms of ADR (arbitration and mediation), and discusses ongoing legislative, judicial, and industry activities that will guide the application of ADR in the healthcare arena.

Cooperative activity among health care providers in New Jersey.

The New Jersey Legislature is considering legislation providing antitrust exemption for health care entities or professionals in order to encourage them to enter into joint ventures without the fear of antitrust prosecution. This legislation will promote better health care.

[A kinetic model for heparin dosing in patients on chronic hemodialysis]. / Modelo cinetico de heparina para individualizar su dosificacion en pacientes hemodializados cronicos.

The quality of anticoagulation was evaluated in 5 patients receiving heparin during chronic hemodialysis. 50 kinetic studies were performed using 2 monitoring tests, TTPK and TCK. Basal and intradialysis measurements were used to estimate sensitivity and the elimination constant according to formulae described by Milthorpe. Mean basal TTPK time was 27.3 sec and TCK time was 211 sec. Mean initial intradialysis TTPK time was 107.5 sec and after correction applying the kinetic model it was 62 sec. Intradialysis TCK time varied from 806 to 683 sec after correction. At the end of the study, mean intradialysis TTPK time was 61 sec not significantly different from the target time of 55 sec. TCK time, however, was significantly greater than target (684 vs 434 sec).

Pharmacologic properties of Moringa oleifera. 2: Screening for antispasmodic, antiinflammatory and diuretic activity.

Hot water infusions of flowers, leaves, roots, seeds and stalks or bark of Moringa oleifera were screened to detect three pharmacologic activities in experimental models in rats. The antispasmodic activity was demonstrated using isolated duodenum, oral anti-inflammatory activity by carrageenan-induced hindpaw edema and oral diuretic activity by urine output in metabolic cages. The seed infusion showed a significant inhibition of acetylcholine-induced contraction with an ED50 of 65.6 mg/ml bath concentration, inhibition of carrageenan-induced edema at 1000 mg/kg and diuretic activity at 1000 mg/kg. Some activity was also demonstrated in the roots. All doses expressed here are as equivalents of dried starting plant material.

Bases diagnosticas para una programacion infantil en consultorio. / Diagnostic bases of a programming for an out patient care of children

Se trata de un estudio historico prospectivo en 315 lactantes atendidos en un consultorio periferico hasta cumplir por lo menos 2 anos de vida. Se describen por una parte, caracteristicas biologicas y socio-economicas del nino y su grupo familiar y por otra parte se describe las actividades de salud entregadas a estos lactantes a nivel del consultorio periferico. Los resultados del trabajo contribuyen a orientar la programacion y sugieren nuevas lineas de investigacion en atencion medica

Estructura de la morbilidad del lactante en la atencion primaria. / Structure of morbidity of infant in primary health care

Se estudia la ficha clinica del total de lactantes ingresados a un consultorio periferico en el curso de un ano y seguidos por espacio de 2 anos. Se analiza la estructura de morbilidad de estos ninos en terminos de la importancia relativa de los distintos grupos de causas y de su incidencia. Se establecen 3 grupos de lactantes con distinto grado de utilizacion de la consulta de morbilidad y se estudia su patron de consultas por causa. Se concluye que la revision de la ficha clinica tiene ventajas metodologicas sobre el uso de la hoja de estadistica diaria. Se insiste en la utilidad de mantener informacion actualizada sobre incidencia de enfermedades en el nino a nivel de atencion primaria