Population-level analysis of antibiotic use and death rates in beef feedlots over ten years in three cattle-feeding regions of the United States.

OBJECTIVE: To assess antibiotic use and other factors associated with death rates in beef feedlots in 3 regions of the US over a 10-year period. SAMPLE: Data for 186,297 lots (groups) of finished cattle marketed between 2010 and 2019 were obtained from a database representing feedlots in the central, high, and north plains of the US. PROCEDURES: Descriptive statistics were generated. Generalized linear mixed models were used to estimate lot death rates for each region, sex (steer or heifer), and cattle origin (Mexico or the US) combination. Death rate was calculated as the (number of deaths/number of cattle placed in the lot) × 100. Lot antibiotic use (TotalActiveMG/KGOut) was calculated as the total milligrams of active antibiotics assigned to the lot per live weight (in kilograms) of cattle marketed from the lot. Rate ratios were calculated to evaluate the respective associations between lot death rate and characteristics of cattle and antibiotic use. RESULTS: Mean death rate increased during the 10-year period, peaking in 2018. Mean number of days on feed also increased over time. Mean TotalActiveMG/KGOut was greatest in 2014 and 2015, lowest in 2017, and moderated in 2018 and 2019. Death rate was positively associated with the number of days on feed and had a nonlinear association with TotalActiveMG/KGOut. Feeding medicated feed articles mitigated death rate. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested a balance between disease prevention and control in feedlots for cattle with various risk profiles. Additional data sources are needed to assess TotalActiveMG/KGOut across the cattle lifetime.

Comparison of functional recovery following percutaneous coronary intervention for ST elevation myocardial infarction in three age groups (<70, 70 to 79, and ≥80 years).

Functional outcomes of elderly patients ≥80 years who undergo percutaneous coronary intervention (PCI) for ST elevation myocardial infarction (STEMI) are unknown. Registry data indicate that up to 55% of elderly patients with STEMI do not receive reperfusion therapy despite a suggested mortality benefit, and only limited data are available regarding outcomes in elderly patients treated with primary PCI. Therefore, prospective data from a regional STEMI transfer program were analyzed to determine major adverse cardiac events, length of stay, and discharge status of consecutive patients with STEMI ≥80 years from March 2003 to November 2006. Of the 1,323 consecutive patients with STEMI treated in this regional STEMI system from March 2003 to November 2006, 199 (15.0%) were ≥80 years old. In-hospital mortality in elderly patients was 11.6%, with a 1-year mortality rate of 25.6%. Of the 166 patients with age ≥80 who lived independently or in assisted living before hospital admission and survived, 150 (90.4%) were discharged to a similar living situation or projected to such a living situation after temporary nursing home care. The median length of hospital stay was 4 days for these patients. In conclusion, elderly patients with age ≥80 receiving PCI for STEMI in a regional STEMI program have short hospital stays and excellent functional recovery on the basis of a very high rate of return to a similar previous living situation.

Incidence of cardiovascular sudden deaths in Minnesota high school athletes.

BACKGROUND: Sudden death (SD) in young competitive athletes due to cardiovascular disease is an important community issue with relevance to designing effective screening initiatives. However, the frequency with which these tragic events occur importantly affects considerations for selecting the most appropriate screening strategy. OBJECTIVE: To determine the incidence and causes of cardiovascular SDs in Minnesota high school athletes. METHODS: The forensic case records of the US National Registry of Sudden Death in Athletes were interrogated to identify those events judged to be cardiovascular in origin, occurring in organized competitive interscholastic sports participants. RESULTS: Over the 26-year period, 1986-2011, 13 SDs occurred in high school student-athletes related to physical exertion, during competition (n = 7) or at practice (n = 6). Ages were 12-18 years (median 16 years); each was a white man. Most common sports involved were basketball, wrestling, or cross-country running. Forensic examination found cardiac causes in 7: hypertrophic cardiomyopathy (in 2), anomalous coronary artery (2), myocarditis (1), aortic stenosis (1), and arrhythmogenic right ventricular cardiomyopathy (1); 4 had structurally normal hearts (with negative toxicity). There were 4,440,161 sports participations, including 1,930,504 individual participants among 24 sports. SD risk was 1:341,551 participations and 148,500 participants/academic year (0.7/100,000 person-years). In only 4 (31%) athletes could the responsible cardiovascular diseases have been reliably detected by screening with history/physical examination or 12-lead electrocardiogram, equivalent to 1:1,000,000 participations (2:1,000,000 participants/year). CONCLUSIONS: In this high school athlete population, risk of cardiovascular SD was small, in the range of 1:150,000 participants/year. Based on autopsy data, only about 30% of the SDs were due to diseases that could be reliably detected by preparticipation screening, even with 12-lead electrocardiograms.

Outcome of performance-based removal and replacement decisions in commercial swine herds.

OBJECTIVE: To evaluate the success of removal and replacement decisions in commercial swine herds when sow removal was attributed to problems with fertility, fecundity, or old age. DESIGN: Retrospective case-control study. ANIMALS: 3,000 sows removed from 3 commercial swine herds (case sows), 3,000 matched control sows retained in the herds, and 3,000 replacement gilts. PROCEDURES: Control sows were included to generate an estimate of reproductive performance that could have been expected had case sows been retained in the herds. Control sows and replacement gilts were followed up until the next farrowing or until removed from the herd, and reproductive performance, calculated as number of pigs born alive per mated female per year, was compared between groups. RESULTS: In 2 of the 3 herds, reproductive performance was significantly higher for replacement gilts than for control sows matched with case sows removed for reasons of fertility, and in all 3 herds, reproductive performance was significantly higher for replacement gilts than for control sows matched with case sows removed for reasons of fecundity. In the 2 herds with case sows removed because of age, reproductive performance did not differ significantly between replacement gilts and control sows. The odds of greater performance among replacement gilts relative to control sows ranged from 1.305 to 1.955 for removals attributed to fertility, 1.305 to 1.955 for removals attributed to fecundity, and 1.000 to 3.999 for removals attributed to age. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that performance-based removal and replacement programs in commercial swine herds may not yield the anticipated results.