Claw health and prevalence of lameness in cows from compost bedded and cubicle freestall dairy barns in Austria.

Claw health and lameness data from five dairies with compost bedded barns (n = 201 data sets) were evaluated and compared with data from five dairy herds housed in freestall cubicle barns (n = 297 data sets). They were matched for having the same cow numbers, flooring type and similar milk yield. The prevalence of lameness, claw lesions and their severity grades were analysed. Two claw health indicators, the cow claw score (CCS) and the farm claw score (FCS), were calculated using a computerised claw trimming database programme; there was no significant difference in overall lameness prevalence in cows from five compost bedded barns (18.7%) compared to cows from five freestall cubicle herds (14.9%). A cumulative link mixed model (CLMM) did not show significant differences in locomotion between different types of bedding material, flooring system, breed, visit number, observer and time since last trimming, but locomotion was significantly influenced by CCS. Another CLMM tested the impact of parameters mentioned on CCS and showed significant influence of flooring type, visit number and cattle breed. Statistically significant differences in the prevalence of claw disorders between compost bedded and freestall cubicle barns were found for white line disease (WLD; 20.4% and 46.6%, respectively), heel horn erosion (HHE; 26.9% and 59.9%, respectively), concave dorsal wall as a result of chronic laminitis (6.5% and 15.9%, respectively) and for interdigital hyperplasia (0.2% and 3.1%, respectively). The results of this study indicate that compost dairy barns are a good alternative to common cubicle housing systems in terms of lameness, claw health and animal welfare.

Influence of porcine circovirus type 2 vaccination on the level of antimicrobial consumption on 65 Austrian pig farms.

The administration of antibiotics to farm animals is an important contemporary topic. Veterinarians, pig producers, politicians, retailers and consumers all have a vested interest in reducing antimicrobial use on farm, while ensuring adequate health and welfare of food-producing animals. Vaccination programmes may be used to reduce the overall level of clinical disease in a population, subsequently leading to a decline in antimicrobial use. In 2008, a vaccination programme against porcine circovirus type 2 (PCV-2) was initiated in Austria. In the retrospective observational study presented here, farm medication records (2008-2011) from 65 conventional pig farms were evaluated. As PCV-2 has been shown to lead to generalised immunosuppression, enabling secondary bacterial infections to occur, the authors hypothesised that PCV-2 vaccination would decrease antimicrobial consumption at farm level. Firstly, we focused on the annual antimicrobial consumption expressed as the number of administered animal daily doses per kg liveweight (nADDkg/kg/year). Secondly, a linear mixed effects model was applied to evaluate the influence of PCV-2 vaccination on the antimicrobial consumption at farm level. The interaction between farm type and PCV-2 vaccination was found to be a highly significant factor (P=0.0002) influencing antimicrobial use at farm level. The estimated impact of PCV-2 vaccination revealed a highly significant (P<0.001) decline in total antimicrobial drug use from 1.72 ADDkg/kg/year to 0.56 ADDkg/kg/year on finishing farms, whereas only a negligible decline was detectable on farrow-to-finish farms.

Influence of porcine circovirus type 2 vaccination on the probability and severity of pneumonia detected postmortem.

To evaluate the influence of porcine circovirus type 2 vaccination (PCV-2) on the probability and severity of pneumonia, postmortem findings of 247,505 pigs slaughtered between 2008 and 2011 were analysed by applying a cumulative link mixed model. Three major effects could be observed: (1) PCV-2 vaccination significantly (P<0.01) reduced the odds (coefficient: -0.05) of postmortem findings of mild, moderate and severe pneumonia for vaccinated pigs. (2) Pigs from fattening farms were less likely (coefficient: -0.44; P<0.05) to exhibit signs of pneumonia at slaughter than pigs from farrow-to-finish farms. (3) When vaccinated, the odds of detecting postmortem signs showed an even more pronounced reduction (coefficient: -0.19; P<0.001) for pigs from fattening farms. Combining PCV-2 vaccination, farm type and interaction effects between these two factors, a pig vaccinated against PCV-2 from a fattening farm had only half the chance (OR 0.51) of pneumonia being detected at postmortem than a non-vaccinated pig from a farrow-to-finish farm. The study demonstrates the benefit of a vaccination programme against PCV-2 as an important tool to reduce the risk of postmortem pneumonia findings and the severity of pneumonia in pigs at slaughter.

[Bone pain after long distance flight as first manifestation of HbSC disease]. / Rezidivierende Knochenschmerzen nach Langstreckenflug als Erstmanifestation einer HbSC Krankheit.

A 7-year old Ghanese boy was admitted with repeated bone pain. Multiple bone marrow alterations were seen as the causal factor. HbSC disease was diagnosed by hemoglobin electrophorics. The onset of pain attacks appears to be linked to the long distance flight from Ghana to Austria. Due to severe bone marrow affection, beside symptomatic therapy a long-term treatment with hydroxyurea was started, leading to an HbF increase from 5.1 % to 19.3 %. After a follow-up of 8 months the patient has remained free of complaints.

[Rotational abnormalities of the hip joint]. / Rotationsfehler des Hüftgelenks.

Changes or limitations of the rotational range of motion of the hip are a non-specific clinical sign. There is a big variety of underlying morphological pathologies resulting in a symptomatic alteration of hip rotation. They need to be assessed by imaging techniques: based on plain radiographs (including specialized projections), often CT or MRI are necessary to visualize the underlying changes of shape, rotation and offset of the articulating surfaces, which might result in a painful "femoroacetabular impingement" as a trigger of secondary osteoarthritis. Highly sophisticated MR-arthrography-protocols are able to visualize conventionally "obscure" but biomechanically relevant morphological changes, that might be individually normalized by joint-preserving corrective surgery.

[Cervical spine injuries in stable lower cervical spine with spinal stenosis]. / Zervikale Rückenmarkverletzungen bei stabiler unterer Halswirbelsäule mit Spinalkanalstenose.

The aim of the study was to investigate the neurological outcome of spinal cord injuries in the traumatized cervical spine with a stenosis of the spinal medullary canal. From 1992 to 1999 we treated 145 spinal cord injuries and/or injuries with an unstable cervical spine, 138 were treated operatively, in 7 patients we found an injury of the spinal cord with a stable cervical spine and a stenosis of the spinal medullary canal. The radiological diagnostics consisted of anterioposterior X-rays of the cervical spine, an X-ray view of the dens axis and a stress roentgenogramm in extension and flection. An MRI was performed within the first 12 hours after the accident. The stenosis of the spinal medullary canal was evaluated by the quotient of the mid-sagittal diameter of the spinal medullary canal as well as the vertebral body (Torg-quotient) and ranged from 0.5 to 0.8. Pathological changed values were found in 4 patients within 2 segments and in 3 patients within 3 segments. In the T2-turbospin echo sequence hyperintense lesions of the spinal cord, accordingly to an edema were found in 6 patients. The neurological evaluation was performed according to the "Standard Neurological Classification of Spinal Cord Injuries". Treatment of these 7 patients was performed conservatively, consisting of NSAR as well as Methyl-Prednisolon according to the pattern of NASCIS-II and III. The follow-up was performed after 12 to 18 months. We evaluated the X-rays in anterioposterior and lateral view, stress roentgenogramms and neurological status. Radiological findings showed stable conditions of the cervical spine with block vertebras and increased osteophytes. The neurological outcome was evaluated according to the "Motor-Score" and showed an improvement from 8 to 63 points within 13 months in one case. In 6 cases, the average "Motor-Score" of 78 increased to 100 points within 2 to 5 months after injury. Most defunctionalization symptoms were found in the upper extremities. Disturbances in fine motor movement were unable to be examined with the "Motor-Score". We can conclude that spinal cord injuries in stable cervical spines with stenosis of the spinal medullary canal can be treated conservatively with a good outcome. A regression of the neurological deficiency can be expected within 2 to 5 months, but even after one year, deficiency regression is possible.

[Current status of diagnostic imaging of focal nodular hyperplasia of the liver]. / Aktueller Stand der bildgebenden Diagnostik der fokalen nodulären Hyperplasie der Leber.

Ranging behind hemangiomas, focal nodular hyperplasias (FNH) are the second most common benign solid liver lesions. Women between the age of 20 and 50 years are predominantly affected. In rare cases FNH may occur in children. Etiologically, an arteriovenous vascular malformation of the liver is discussed, which causes pseudotumorous growth of the surrounding liver parenchyma. Morphological features such as the presence of a radial vascular architecture and feeding arteries within a central scar are characteristic for the presence of FNH. Imaging techniques which enable the depiction of the arterial blood supply with a characteristic centrifugal filling pattern, the contrast enhancement in the early arterial phase, the absence of calcifications and of a tumour capsule and the typical enhancement of the central scar, are of particular importance. Knowledge of these features is important in order to differentiate FNH from other hypervascular focal liver lesions with tendency of scar formation, such as hepatic adenomas, giant hemangiomas, hepatocellular and fibrolamellar carcinomas, and metastases. Diagnosis and differential diagnosis of FNH will be enabled by a combined modality approach consisting of (Doppler) sonography and triphasic CT. To confirm the diagnosis of FNH, dynamic MRI is advisable. Because of the invasiveness of angiography as well as the limited sensitivity and spatial resolution of the various scintigraphic methods, these modalities no longer play a role in the diagnostic work-up of FNH. Lesions lacking typical features diagnostic for FNH remain subjects for biopsy and histological examination.

CT findings in post-operative subphrenic abscess with teratomatous inclusions.

A 39-year-old woman presented with abdominal pain after tubal sterilization. CT showed a subphrenic abscess with fatty inclusions owing to laceration or rupture of a mature ovarian teratoma. Although subphrenic abscess is a well recognized post-operative complication, and ovarian teratomas are frequent, a teratomatous inclusion within a subphrenic abscess is a unique finding.

Acute myelofibrosis: multifocal bone marrow infiltration detected by scintigraphy and magnetic resonance imaging.

Acute myelofibrosis is a rare, malignant hematological disorder of unknown etiology with an inevitably fatal outcome. Here we present the study of a 63-year-old Caucasian man with acute onset of pancytopenia. Repeated bone marrow biopsies showed dense fibrosis and hypoplastic hematopoiesis raising various differential diagnoses of malignant and nonmalignant conditions. Bone marrow scintigraphy and magnetic resonance imaging (MRI) showed areas suggesting neoplastic infiltration, mainly in both femurs and tibias. Histological examination of a surgical biopsy of the left tibia revealed acute megakaryoblastic leukemia. As the patient refused polychemotherapy, therapy with interferon gamma was initiated but discontinued prematurely because of intolerable side effects. The presented case therefore suggests that the combination of bone marrow scintigraphy and MRI is a valuable diagnostic tool in patients presenting with myelofibrosis of unknown origin.

Diagnosis of lateral hypopharyngeal pouches: a comparative study of videofluorography and pseudovalsalva maneuver in double contrast pharyngography.

BACKGROUND: To evaluate the difference between the pseudovalsalva maneuver in double-contrast pharyngography and the videofluorographic swallowing examination in the detection and grading of lateral hypopharyngeal pouches. METHODS: Two hundred twenty-seven videofluorographic swallowing examinations and double-contrast pharyngography using the pseudovalsalva maneuver were retrospectively analyzed by two radiologists. The mean age of the patients was 54 years (range = 21-81 years). The examination was performed on a fluoroscopy unit with a U-matic videorecording system in standard projections. Iodinated contrast agent was used, followed by barium if there was no massive aspiration. RESULTS: In contrast to the videofluorographic swallowing examination, which showed 170 lateral hypopharyngeal pouches (113 grade I, 39 grade II, 18 grade III) in 101 patients, the pseudovalsalva maneuver showed 304 pouches (304 grade III) in 179 patients. No videofluorographically diagnosed lateral hypopharyngeal pouches were missed by the pseudovalsalva maneuver; 134 pouches in 78 patients diagnosed with pseudovalsalva maneuver had no correlation videofluorographically. CONCLUSION: Double-contrast pharyngography using the pseudovalsalva maneuver is not a reliable method for the diagnosis of lateral hypopharyngeal pouches.

Giant liposarcoma of the esophagus: radiological findings.

This case of an esophageal liposarcoma illustrates a polypoid lesion within the esophagus that extended from the left pyriform sinus to the distal esophagus above the gastric cardia. Contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) showed an inhomogenously-enhancing intraluminal mass, while video-fluoroscopy revealed that the mass was adherent to the esophageal wall and was associated with esophageal dilatation and diminished peristalsis. This ninth reported case of esophageal liposarcoma is the first described where preoperative radiologic studies and endoscopy showed broad fixation of the tumor to the esophageal wall.

Ex juvantibus approach for chronic posterior laryngitis: results of short-term pantoprazole therapy.

The aim of this study was to investigate whether patients with chronic posterior laryngitis and symptoms of gastro-pharyngeal reflux benefit from a six-week therapy with pantoprozole. Twenty-nine out-patients with voice disorders (case history of at least two months) and simultaneous symptoms of gastro-pharyngeal reflux were recruited for this study. At the entry to the study a symptom questionnaire and a video-laryngo/stroboscopy were completed. The symptom questionnaire and the video-laryngo/stroboscopy were repeated after the six weeks of therapy with pantoprazole 40 mg once a day and again six weeks and three months after this follow-up, during which time the patient was without therapy. Hoarseness, globus pharyngeus, sore throat, heartburn, and coughing were the symptoms which showed a significant (p < 0.05) recovery at the follow-ups (mean of hoarseness index: 7.28 to 0.92; mean of globus pharyngeus index: 3.14 to 0.58; mean of heartburn index: 2.86 to 0.5; mean of cough index: 1.72 to 0.25; mean of throat soreness index: 1.72 to 0.15). Laryngoscopy scores of the posterior laryngeal region, the glottic and the supraglottic region showed statistically significant improvement (p < 0.05) after the treatment with pantoprazole. The therapeutic effect exceeded the drug administration until the last follow-up (after three months). The medication was tolerated without side-effects in all patients. A primary (ex juvantibus) therapy with proton pump inhibitors seems to be a therapeutic option for patients with long-lasting chronic inflammation of the larynx not responding to common therapy. In this case a six-week course of treatment has been shown to be sufficient.

Aneurysms of hemodialysis access grafts: treatment with covered stents: a report of three cases.

Three patients with dialysis access graft shunts, having a symptomatic pseudoaneurysm and a hemodynamically significant stenosis at the anastomosis between the graft shunt and the subclavian vein, were treated with percutaneous transluminal angioplasty and insertion of a Wallstent. Pseudoaneurysms were excluded by percutaneous insertion of a Cragg Endo-Pro stent-graft with a diameter of 6 mm and a length of 6-10 cm. All three aneurysms were excluded successfully. In two patients, the stent-graft was punctured repeatedly during follow-up and the aneurysms recurred after 7 and 8 months, respectively. The patency of the dialysis shunt after stent-graft insertion was 8 (n = 1) and 9 months (n = 2). Due to the recurrence of the aneurysm (n = 2) or recurrent thrombosis (n = 1) the use of these shunts was discontinued.

Functional imaging of the pharynx using electron beam tomography.

Due to long scan times it was impossible to make dynamic swallowing imaging using computer tomography (CT) of the third or fourth generation. This study evaluates whether electron beam tomography with scan times of 100 ms enables a more detailed dynamic imaging of swallowing disorders. Examination using electron beam tomography was done in three planes: (1) Passavant's cushion (n = 6), (2) thyrohyoid membrane (n = 9), and (3) upper esophageal sphincter (n = 5). The technique is discussed here in detail and documented with figures of the plane before swallowing as well as the intradeglutitive reachend plane. This study shows that electron beam tomography enables dynamic imaging of pharyngeal deglutition in transverse planes and can give useful additional information to the videofluorographic or kinematographic swallowing examination, which remain the gold standard in the functional evaluation of swallowing disorders.

Topographic evaluation of lateral hypopharyngeal pouches using electron beam tomography.

BACKGROUND: To evaluate the exact topography of lateral hypopharyngeal pouches using electron beam tomography. METHODS: Seventeen patients, nine female, eight male, aged 28-72 years, who showed lateral hypopharyngeal pouches in the videofluorographic swallowing examination were studied using electron beam tomography. Upon swallowing a 20-ml bolus of water, the region of the thyrohyoid membrane was scanned 20 times per level. Scan parameters: single slice cine mode (exposure time 100 ms, slice thickness 3 mm, 620 mA, 130 KV). RESULTS: The lateral hypopharyngeal pouches appeared air-filled in the posterior aspect of the thyrohyoid membrane closely attached to the upper horn of the thyroid cartilage, just below the hyoid bone. CONCLUSIONS: With electron beam tomography it was possible to define the topographic location of the pouches more accurately, compared with the prior assumption of position.

Aspiration resulting from lateral hypopharyngeal pouches.

OBJECTIVE: This study was performed to evaluate the frequency of postdeglutitive aspiration in lateral hypopharyngeal pouches and to correlate postdeglutitive aspiration to pouch size and dynamics. MATERIALS AND METHODS: Two radiologists retrospectively analyzed 325 videofluorography examinations of patients swallowing. The 325 patients were 22-81 years old, 173 men and 152 women. Patients who had undergone surgery of the hypopharynx were excluded from the study. All pouches found on videofluorography were classified into grade I, II, or III. Because iodinated contrast agent had been used initially, patients who had no or minimal aspiration underwent a second imaging examination using high-density barium. RESULTS: Of the 325 patients, 118 had lateral hypopharyngeal pouches: 77 bilateral and 41 unilateral. Postdeglutitive aspiration was diagnosed in 14 (56%) of the 25 grade III pouches and in two (3%) ot the 58 grade II pouches. Aspiration was not seen in any of the 112 grade I pouches. CONCLUSION: The prevalence of postdeglutitive aspiration is high in patients who have grade III pouches. To date, no appropriate conservative treatment has been described; however, in severe cases surgery is warranted.