Association between hoof trimming frequency in primiparous cows and hoof health and survival in second lactation.

Lameness, mostly resulting from claw lesions, causes major welfare problems in the dairy industry. One way to prevent claw lesions is hoof trimming, but the overall effect and the optimal hoof trimming frequency are unknown. In a retrospective cohort study, we investigated the association between hoof trimming frequency in primiparous cows and hoof health and culling in second lactation. We based our analysis on breed, calving and culling data in the period 2015-2018 for 30,613 primiparous cows in 202 Swedish dairy herds. Of the cows enrolled, 20% were not hoof-trimmed, 30% were trimmed once, 34% were trimmed twice, 13% were trimmed 3 times, and 2% were trimmed ≥ 4 times. We used multivariable mixed-effect logistic and multivariable multinomial logistic regression models to investigate the association between trimming frequency and 2 outcomes: hoof lesions at first trimming occasion within 90 d from second calving and culling in second lactation within 300 d after second calving. In general, cows trimmed 2 or 3 times during first lactation were at lower odds of having claw lesions compared with cows that were not trimmed (Odds Ratio (OR) = 0.66, 95% CI = 0.62-0.71 and 0.60, 95% CI = 0.55-0.66, respectively) or cows trimmed once (OR = 0.80, 95% CI = 0.75-0.85 and OR = 0.72, 95% CI = 0.66-0.79, respectively), and this beneficial effect was observed for most types of claw lesions. Moreover, cows trimmed 2, 3, or ≥ 4 times were at lower odds of being culled compared with cows that were not trimmed (OR = 0.71, 95% CI = 0.65-0.77, 0.68, 95% CI = 0.61-0.76 and 0.70, 95% CI = 0.54-0.90, respectively) or trimmed once (OR = 0.77, 95% CI = 0.71-0.83, OR = 0.74, 95% CI = 0.66-0.82 and OR = 0.75, 95% CI = 0.59-0.97, respectively). In particular, 2 trimmings, compared with 1 or no trimming, lowered the relative risk-ratio of dying or being euthanized on-farm, or being culled due to claw and leg disorders. More than 1 hoof trimming in first lactation also reduced the relative-risk ratio of being culled for other reasons. In conclusion, 2 or 3 hoof trimmings during first lactation were generally beneficial for hoof health in early second lactation and survival in second lactation. These findings can help improve animal welfare and production by reducing claw lesions, and thereby lameness among dairy cows, which would increase the longevity of dairy cows and the sustainability of the dairy industry.

[Lipid profile in patients admitted with acute coronary syndrome in Spain: data from Toledo health care area between 2005 and 2008]. / Perfil lipídico en pacientes ingresados por síndrome coronario agudo en España: datos del área sanitaria de Toledo entre los años 2005 y 2008.

INTRODUCTION AND OBJECTIVES: To evaluate the lipid profile of patients admitted with acute coronary syndrome in Toledo (Spain) between 2005 and 2008. METHODS: Total cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride levels were evaluated. Descriptive analyses and means comparison were performed. RESULTS: 1,381 patients of 3,986 admitted with acute coronary syndrome had a complete lipid profile. The mean age was 67.8±12.9 years (72.4% men). A first event was present in 76.3%. The mean total cholesterol (±SD) was 180.0±43.4, LDL-cholesterol 115±38.0, HDL-cholesterol 44.1±12.3, and triglyceride 145.3±92.4mg/dL, with statistically significant differences between men and women in LDL-cholesterol (116.3±37.8 vs 111.6±38.5mg/dL; p=0.04) and HDL-cholesterol (42.3±11.6 vs 48.4±13.2mg/dL; p=0.0001). In first or recurrent events were found, respectively, total cholesterol 179.1±43.1 and 174.5±44.1 (p<0.05), LDL-cholesterol 116.5±38.4 and 110±36.5 (p=0.007), HDL-cholesterol 44.1±12.2 and 44.2±12.9 (p<0.05), and triglyceride 141.2±81.7 and 158.5±119.7 (p=0.03). Optimal levels of LDL-cholesterol and HDL-cholesterol were found in 14.1 and 11.6% of patients with recurrent episodes, respectively. CONCLUSIONS: While most patients admitted with first episode of acute coronary syndrome to the Toledo Health Area have a lipid profile according to current guidelines, only 10% of those with recurrent acute coronary syndrome presented optimal LDL-cholesterol and HDL-cholesterol levels, which suggest the need to be more aggressive in the lipids control.

Perfil lipídico en pacientes ingresados por síndrome coronario agudo en España: datos del área sanitaria de Toledo entre los años 2005 y 2008 / Lipid profile in patients admitted with acute coronary syndrome in Spain: data from Toledo health care area between 2005 and 2008

Introducción y objetivos. Evaluar el perfil lipídico de los pacientes ingresados por síndrome coronario agudo en Toledo entre 2005 y 2008. Métodos. Se estudiaron los niveles de colesterol total, colesterol unido a las lipoproteínas de baja densidad (cLDL), colesterol unido a las lipoproteínas de alta densidad (cHDL) y triglicéridos. Se realizó estadística descriptiva y comparación de medias. Resultados. De los 3.986 ingresados por síndrome coronario agudo, 1.381 pacientes tenían perfil lipídico completo. El 76,3% eran primeros episodios. La edad media fue 67,8 ± 12,9 años (72,4% hombres). El colesterol total medio (± DE) fue 180,0 ± 43,4, cLDL 115 ± 38,0, cHDL 44,1 ± 12,3, y triglicéridos 145,3 ± 92,4 mg/dl, con diferencias significativas entre hombres y mujeres en el cLDL (116,3 ± 37,8 vs 111,6 ± 38,5 mg/dl; p = 0,04) y cHDL (42,3 ± 11,6 vs 48,4 ± 13,2 mg/dl; p = 0,0001). En primeros episodios y episodios recurrentes se halló, respectivamente, colesterol total 179,1 ± 43,1 y 174,5 ± 44,1 (p < 0,05), cLDL 116,5 ± 38,4 y 110,0 ± 36,5 (p = 0,007), cHDL 44,1 ± 12,2 y 44,2 ± 12,9 (p < 0,05), y triglicéridos 141,2 ± 81,7 y 158,5 ± 119,7 mg/dl (p = 0,03). Se observaron niveles óptimos de cLDL y cHDL en el 14,1 y en el 11,6%, respectivamente, de los episodios recurrentes. Conclusiones. Aunque la mayoría de pacientes ingresados por primeros episodios de síndrome coronario agudo presenta un perfil lipídico adecuado, solo el 10% de pacientes con episodios recurrentes muestran niveles óptimos de c-LDL y c-HDL, lo que sugiere la necesidad de ser más rigurosos en el control lipídico (AU)

Introduction and objectives. To evaluate the lipid profile of patients admitted with acute coronary syndrome in Toledo (Spain) between 2005 and 2008. Methods. Total cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride levels were evaluated. Descriptive analyses and means comparison were performed. Results. 1,381 patients of 3,986 admitted with acute coronary syndrome had a complete lipid profile. The mean age was 67.8 ± 12.9 years (72.4% men). A first event was present in 76.3%. The mean total cholesterol (±SD) was 180.0 ± 43.4, LDL-cholesterol 115 ± 38.0, HDL-cholesterol 44.1 ± 12.3, and triglyceride 145.3 ± 92.4 mg/dL, with statistically significant differences between men and women in LDL-cholesterol (116.3 ± 37.8 vs 111.6 ± 38.5 mg/dL; p = 0.04) and HDL-cholesterol (42.3 ± 11.6 vs 48.4 ± 13.2 mg/dL; p = 0.0001). In first or recurrent events were found, respectively, total cholesterol 179.1 ± 43.1 and 174.5 ± 44.1 (p < 0.05), LDL-cholesterol 116.5 ± 38.4 and 110 ± 36.5 (p = 0.007), HDL-cholesterol 44.1 ± 12.2 and 44.2 ± 12.9 (p < 0.05), and triglyceride 141.2 ± 81.7 and 158.5 ± 119.7 (p = 0.03). Optimal levels of LDL-cholesterol and HDL-cholesterol were found in 14.1 and 11.6% of patients with recurrent episodes, respectively. Conclusions. While most patients admitted with first episode of acute coronary syndrome to the Toledo Health Area have a lipid profile according to current guidelines, only 10% of those with recurrent acute coronary syndrome presented optimal LDL-cholesterol and HDL-cholesterol levels, which suggest the need to be more aggressive in the lipids control (AU)

Pericardial synovial sarcoma.

We report a rare case of a primary synovial sarcoma of the pericardium. Surgical resection was incomplete and chemotherapy and radiotherapy (tomotherapy) were therefore administered. Regular cardiac magnetic resonance imaging scans were used throughout the follow-up, allowing effective planning and application of adjuvant therapies. The survival of our patient was 26 months, substantially longer than most previously reported cases.