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1.
J Dairy Sci ; 2023 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-38135042

RESUMO

The objective of the study was to quantify the association between the birth weight of a calf and subsequent performance of its dairy dam in the absence of any recorded calving assistance. A total of 11,592 lactation records from 4,549 spring-calving dairy cows were used. The association between a series of quantitative cow performance metrics (dependent variable) and calf birth weight (independent variable) was determined using linear mixed models; logistic regression was used where the dependent variable was binary. Nuisance factors in the models were calf sex, heterosis coefficient of both the cow and calf, dry period length immediately before the birth of the calf, cow age at calving relative to the median cow age per parity, breed proportion of the cow, cow live-weight between 100 and 200 d of lactation relative to the mean cow weight per parity, and contemporary group. Calf birth weight was included in the model as either a continuous or a categorical variable. Primiparous and multiparous cows were analyzed separately. Mean (SD) calf birth weight was 36.2 (6.8) kg. In primiparous cows, calf birth weight was associated with milk yield in the first 60 d of lactation, calving to first service interval, calving body weight (BW), and both nadir BW and body condition score (BCS). In multiparous cows, calf birth weight was associated with total milk, fat and protein yield in the first 60 and 305 d of lactation, peak milk yield, total milk solids, both calving and nadir BW, and BCS loss from calving to nadir. Relative to primiparous cows that gave birth to calves that were 34 - 37 kg (i.e., population mean), their contemporaries who gave birth to calves that were 15 - 29 kg produced 9.82 kg more milk in the first 60 d of lactation, had a 2-d shorter interval to first service, and were 8.08 kg and 5.51 kg lighter at calving and nadir BW, respectively; the former was also 0.05 units lower BCS (scale 1 [thin] to 5[fat]) at nadir. Relative to multiparous cows that gave birth to calves that were 34 - 37 kg birth weight, multiparous cows that gave birth to calves that were 15 - 29 kg yielded 59.63 kg, 2.44 kg and 1.76 kg less milk, fat and protein, respectively, in the first 60 d of lactation, produced 17.69 kg less milk solids throughout the 305-d lactation, and were also 10.49 kg lighter at nadir and lost 0.01 units more BCS to nadir. In a separate series of analyses, sire breed was added to the model as a fixed effect with and without calf birth weight. When calf birth weight was not adjusted for, 60-d milk yield for multiparous cows who gave birth to calves sired by a traditional beef breed (i.e., Angus, Hereford) produced 59.63 kg more than multiparous cows who gave birth to calves sired by a Holstein-Friesian. Hence, calf birth weight is associated with some subsequent dam performance measures albeit, where associations do exit, the effect is biologically small.

2.
J Dairy Sci ; 105(9): 7550-7563, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35879159

RESUMO

The cumulative improvement achieved in the genetic merit for reproductive performance in dairy populations will likely improve dairy cow longevity; therefore, it is time to reassess whether linear type traits are still suitable predictors of survival in an aging dairy cow population. The objective of the present study was therefore to estimate the genetic correlations between linear type traits and survival from one parity to the next and, in doing so, evaluate if those genetic correlations change with advancing parity. After edits, 152,894 lactation survival records (first to ninth parity) were available from 52,447 Holstein-Friesian cows, along with linear type trait records from 52,121 Holstein-Friesian cows. A series of bivariate random regression models were used to estimate the genetic covariances between survival in different parities and each linear type trait. Heritability estimates for survival per parity ranged from 0.02 (SE = 0.004; first parity) to 0.05 (SE = 0.01; ninth parity). Pairwise genetic correlations between survival among different parities varied from 0.42 (first and ninth parity) to 1.00 (eighth to ninth parity), with the strength of these genetic correlations being inversely related to the interval between the compared parities. The genetic correlations between survival and the individual linear type traits varied across parities for 9 of the 20 linear type traits examined, but the correlations with only 3 of these linear type traits strengthened as the cows aged; these 3 traits were rear udder height, teat length, and udder depth. Given that linear type traits are frequently scored in first parity and are genetically correlated with survival in older parities, they may be suitable early predictors of survival, especially for later parity cows. Additionally, the direction of the genetic correlations between survival and rear udder height, teat length, and udder depth did not change between parities; hence, selection for survival in older parities using these linear type traits should not hinder genetic improvement for survival in younger parities.


Assuntos
Lactação , Glândulas Mamárias Animais , Animais , Bovinos , Feminino , Lactação/genética , Longevidade/genética , Leite , Paridade , Fenótipo , Gravidez
3.
J Dairy Sci ; 105(4): 3341-3354, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35123785

RESUMO

The inclusion of reproductive performance in dairy cow breeding schemes has resulted in a cumulative improvement in genetic merit for reproductive performance; this improvement should manifest in longer productive lives through a reduced requirement for involuntary culling. Nonetheless, the average length of dairy cow productive life has not changed in most populations, suggesting that risk factors for culling, especially in older cows, are possibly more associated with lower yield or high somatic cell score (SCS) than compromised reproductive performance. The objective of the present study was to understand the dynamics of lactation yields and SCS in dairy cows across parities and, in doing so, quantify the potential to alter this trajectory through breeding. After edits, 3,470,520 305-d milk, fat, and protein yields, as well as milk fat and protein percentage and somatic cell count records from 1,162,473 dairy cows were available for analysis. Random regression animal models were used to identify the parity in which individual cows reached their maximum lactation yields, and highest average milk composition and SCS; also estimated from these models were the (co)variance components for yield, composition, and SCS per parity across parities. Estimated breeding values for all traits per parity were calculated for cows reaching ≥fifth parity. Of the cows included in the analyses, 91.0%, 92.2%, and 83.4% reached maximum milk, fat, and protein yield in fifth parity, respectively. Conversely, 95.9% of cows reached their highest average fat percentage in first parity and 62.9% of cows reached their highest average protein percentage in third parity. In contrast to both milk yield and composition traits, 98.4% of cows reached their highest average SCS in eighth parity. Individual parity estimates of heritability for milk yield traits, milk composition, and SCS ranged from 0.28 to 0.44, 0.47 to 0.69, and 0.13 to 0.23, respectively. The strength of the genetic correlations per trait among parities was inversely related to the interval between the parities compared; the weakest genetic correlation was 0.67 (standard error = 0.02) between milk yield in parities 1 and 8. Eigenvalues and eigenfunctions of the additive genetic covariance matrices for all investigated traits revealed potential to alter the trajectory of parity profiles for milk yield, milk composition, and SCS. This was further demonstrated when evaluating the trajectories of animal estimated breeding values per parity.


Assuntos
Lactação , Leite , Animais , Bovinos/genética , Contagem de Células/veterinária , Feminino , Lactação/genética , Leite/metabolismo , Paridade , Fenótipo , Gravidez
4.
J Dairy Sci ; 105(2): 1346-1356, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34955265

RESUMO

Measuring dry matter intake (DMI) in grazing dairy cows using currently available techniques is invasive, time consuming, and expensive. An alternative to directly measuring DMI for use in genetic evaluations is to identify a set of readily available animal features that can be used in a multitrait genetic evaluation for DMI. The objectives of the present study were thus to estimate the genetic correlations between readily available body-related linear type traits and DMI in grazing lactating Holstein-Friesian cows, but importantly also estimate the partial genetic correlations between these linear traits and DMI, after adjusting for differences in genetic merit for body weight. Also of interest was whether the predictive ability derived from the estimated genetic correlations materialized upon validation. After edits, a total of 8,055 test-day records of DMI, body weight, and milk yield from 1,331 Holstein-Friesian cows were available, as were chest width, body depth, and stature from 47,141 first lactation Holstein-Friesian cows. In addition to considering the routinely recorded linear type traits individually, novel composite traits were defined as the product of the linear type traits as an approximation of rumen volume. All linear type traits were moderately heritable, with heritability estimates ranging from 0.27 (standard error = 0.14) to 0.49 (standard error = 0.15); furthermore, all linear type traits were genetically correlated (0.29 to 0.63, standard error 0.14 to 0.12) with DMI. The genetic correlations between the individual linear type traits and DMI, when adjusted for genetic differences in body weight, varied from -0.51 (stature) to 0.48 (chest width). These genetic correlations between DMI and linear type traits suggest linear type traits may be useful predictors of DMI, even when body weight information is available. Nonetheless, estimated genetic merit of DMI derived from a multitrait genetic evaluation of linear type traits did not correlate strongly with actual DMI in a set of validation animals; the benefit was even less if body weight data were also available.


Assuntos
Lactação , Leite , Ração Animal/análise , Animais , Peso Corporal/genética , Bovinos/genética , Ingestão de Alimentos , Feminino , Lactação/genética , Fenótipo
5.
Transl Anim Sci ; 5(3): txab101, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34278237

RESUMO

Validation of beef total merit breeding indexes for improving performance and profitability has previously been undertaken at the individual animal level; however, no herd-level validation of beef genetic merit and profit has been previously investigated. The objective of the present study was to quantify the relationship between herd profitability and both herd-average terminal and maternal genetic merit across 1,311 commercial Irish beef herds. Herd-level physical and financial performance data were available from a financial benchmarking tool used by Irish farmers and their extension advisors. Animal genetic merit data originated from the Irish Cattle Breeding Federation who undertake the national beef and dairy genetic evaluations. Herd-average genetic merit variables included the terminal index of young animals, the maternal index of dams, and the terminal index of service sires. The herds represented three production systems: 1) cow-calf to beef, 2) cow-calf to weanling/yearling, and 3) weanling/yearling to beef. Associations between herd financial performance metrics and herd average genetic merit variables were quantified using a series of linear mixed models with year, production system, herd size, stocking rate, concentrate input, and the two-way interactions between production system and herd size, stocking rate, and concentrate input included as nuisance factors. Herd nested within the county of Ireland (n = 26) was included as a repeated effect. Herds with young cattle excelling in terminal index enjoyed greater gross and net profit per hectare (ha), per livestock unit (LU), and per kg net live-weight output. The change in gross profit per LU per unit change in the terminal index of young animals was €1.41 (SE = 0.23), while the respective regression coefficient for net profit per LU was €1.37 (SE = 0.30); the standard deviation of the terminal index is €37. Herd-average dam maternal index and sire terminal index were both independently positively associated with gross profit per ha and gross profit per LU. Each one unit increase in dam maternal index (standard deviation of €38) was associated with a €1.40 (SE = 0.48) and €0.76 (SE = 0.29) greater gross profit per ha and per LU, respectively. Results from the present study at the herd-level concur with previous validation studies at the individual animal level thus instilling further confidence among stakeholders as to the expected improvement in herd profitability with improving genetic merit.

6.
J Dairy Sci ; 104(1): 561-574, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33189261

RESUMO

Lactation yield estimates standardized to common lactation lengths of 270-d or 305-d equivalents are commonly used in management decision support tools and dairy cow genetic evaluations. The use of such measurements to quantify the (genetic) merit of individual cows fails to penalize cows that do not reach the standardized lactation length, or indeed reward cows that lactate for more than the standardized lactation length. The objective of the present study was to quantify the genetic and nongenetic factors associated with lactation length in seasonal-calving, pasture-based dairy cows. A total of 616,350 lactation length records from 285,598 Irish cows were used. Linear mixed models were used to quantify the associations between lactation length and calving month, parity, age at calving, previous dry period length, calving difficulty score, heterosis, recombination loss, breed, and herd size, as well as to estimate the genetic and residual variance components of lactation length. The median lactation length in the edited data set was 288 d, with 27% of cows achieving lactations of at least 305 d. Relative to cows calving in January, the lactations of cow calving in February, March, or April was, on average, 4.2, 12.7, and 21.9 d shorter, respectively. The lactation length of a first parity cow was, on average, 7.8, 8.6, and 8.4 d shorter than that of second, third, and fourth parity cows, respectively. Norwegian Red and Montbéliarde cows had, on average, a 4.7- and 1.6-d shorter lactation than Holstein-Friesian cows, respectively. The heritability estimate, coefficient of genetic variation, and repeatability estimate of lactation length were 0.02, 1.2%, and 0.04, respectively. Based on the genetic standard deviation for lactation length estimated in the present study (3.3 d), cows ranked in the top 20% for genetic merit for lactation length would be expected to have lactations 9.2 d longer than cows in the bottom 20%, demonstrating exploitable genetic variability. Given the vast array of genetic and nongenetic factors associated with lactation length, an approach which combines improved management practices and selective breeding may be an efficient and effective strategy to lengthen lactations.


Assuntos
Bovinos/genética , Lactação/genética , Animais , Feminino , Herbivoria , Leite , Paridade , Gravidez , Estações do Ano , Tempo
7.
Genes Brain Behav ; 17(3): e12427, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29028150

RESUMO

The current treatment of post-traumatic stress disorder (PTSD), phobias and other anxiety disorders, remains insufficient particularly in producing long-lasting full symptom control. Dysfunctional fear processing is common in these disorders, including a deficiency in fear-inhibitory mechanisms and impairment in the ability to discriminate between safety and danger cues. Research has aimed to elucidate brain circuitries, neurotransmitters and downstream signaling pathways important in the alleviation of aberrant fear, with a specific focus on mechanisms modulating fear memory and its behavioral expression. MicroRNAs (miRNA) as "fine tuners" of gene expression at the post-transcriptional level have emerged as critical regulators of such mechanisms important in both, the generation and the inhibition of fear memories. Along these lines, abnormal expression of miRNAs has been associated with different fear-related disorders. After providing an updated overview on the involvement of miRNAs in fear learning mechanisms, we summarize and discuss in particular those studies in which the implication of miRNAs in successful inhibition of fear has been explored. For a better overview, we dissociate the different modes of fear alleviation investigated in this regard and present studies in rodents demonstrating that specific miRNAs are involved in the destabilization of fear by interfering with consolidation/reconsolidation mechanisms or that they are associated with the generation of fear extinction or safety learning. Finally, we discuss the potential of miRNAs as biomarkers and novel therapeutic targets, as well as the challenges involved in applying the discovered mechanisms in the development of improved treatments of fear- and trauma-related disorders.


Assuntos
Medo/fisiologia , Medo/psicologia , MicroRNAs/genética , Animais , Transtornos de Ansiedade/fisiopatologia , Encéfalo/fisiopatologia , Condicionamento Clássico/fisiologia , Humanos , Aprendizagem/fisiologia , Memória/fisiologia , MicroRNAs/uso terapêutico , Plasticidade Neuronal/genética , Transdução de Sinais/fisiologia , Transtornos de Estresse Pós-Traumáticos/fisiopatologia
8.
Epidemiol Infect ; 144(1): 1-18, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25904121

RESUMO

A scoping review was conducted to identify modifiable non-antimicrobial factors to reduce the occurrence of antimicrobial resistance in cattle populations. Searches were developed to retrieve peer-reviewed published studies in animal, human and in vitro microbial populations. Citations were retained when modifiable non-antimicrobial factors or interventions potentially associated with antimicrobial resistance were described. Studies described resistance in five bacterial genera, species or types, and 40 antimicrobials. Modifiable non-antimicrobial factors or interventions ranged widely in type, and the depth of evidence in animal populations was shallow. Specific associations between a factor or intervention with antimicrobial resistance in a population (e.g. associations between organic systems and tetracycline susceptibility in E. coli from cattle) were reported in a maximum of three studies. The identified non-antimicrobial factors or interventions were classified into 16 themes. Most reported associations between the non-antimicrobial modifiable factors or interventions and antimicrobial resistance were not statistically significant (P > 0·05 and a confidence interval including 1), but when significant, the results were not consistent in direction (increase or decrease in antimicrobial resistance) or magnitude. Research is needed to better understand the impacts of promising modifiable factors or interventions on the occurrence of antimicrobial resistance before any recommendations can be offered or adopted.


Assuntos
Criação de Animais Domésticos/métodos , Antibacterianos/farmacologia , Doenças dos Bovinos/prevenção & controle , Farmacorresistência Bacteriana , Enterobacteriaceae/efeitos dos fármacos , Animais , Canadá , Bovinos , Doenças dos Bovinos/microbiologia , Estados Unidos
9.
Zoonoses Public Health ; 57(6): 429-38, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19638166

RESUMO

This study evaluated specific infection control practices in community veterinary practices in southern Ontario. Environmental disinfection, management of infectious patients and antimicrobial use in clean surgical procedures were investigated. Community companion animal veterinary practices (n=101) in Southern Ontario were recruited, and a questionnaire was administered to one veterinarian and one veterinary technician from each practice. The veterinarian questionnaire gathered data on clinic demographics, management of infectious patients, infectious diseases of concern, environmental disinfection and antimicrobial use in surgical procedures. The veterinary technician questionnaire gathered data on environmental disinfection. None of the veterinary practices had a formal infection control programme. Sixty-five per cent (n=66) of the veterinary practices did not have an isolation area and 61% (n=40) of these practices did not employ any specific infection control measures for infectious cases. The products most frequently used for environmental disinfection were hydrogen peroxide based or quaternary ammonium compounds. Bleach was the agent most commonly used for environmental disinfection of infectious body fluids; however 60% of the veterinarians and 40% of the veterinary technicians did not identify a product for environmental disinfection of infectious body fluids. Twenty-four per cent of the veterinarians reported using antimicrobials in animals undergoing elective sterilization surgeries and 60% reported using antimicrobials in other clean surgical procedures. There is a need for community veterinary practices to develop infection control programmes specific to their individual practice. In addition, veterinarians should discontinue the common use of antimicrobials for clean elective sterilization surgical procedures.


Assuntos
Infecção Hospitalar/veterinária , Desinfetantes , Hospitais Veterinários/normas , Controle de Infecções/métodos , Animais de Estimação , Cirurgia Veterinária/normas , Técnicos em Manejo de Animais , Animais , Antibacterianos/uso terapêutico , Infecção Hospitalar/prevenção & controle , Humanos , Ontário , Controle de Qualidade , Características de Residência , Inquéritos e Questionários , Médicos Veterinários
10.
J Prof Nurs ; 16(1): 21-30, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-10659516

RESUMO

In spite of the passage of the Patient Self-Determination Act in 1991, research indicates that providing information alone has not brought about a significant increase in the completion rates of advance directive (AD) documents. The purpose of this pilot study was to design, implement, and evaluate an interactive multimedia CD-ROM educational program on AD. Study subjects consisted of 31 volunteer elderly men and women in a senior citizens center. An interactive multimedia CD-ROM program was developed in phase I of the study. Subjects were administered on-line pretests and posttests. The effectiveness of the CD-ROM intervention was measured by AD attitude and knowledge changes. A program satisfaction scale was used, and an observer rated the subjects' use of the computer program. Subjects had a statistically significant change in posttest knowledge scores and a high degree of satisfaction and ease in using the computer program. The use of an interactive multimedia CD-ROM program with a touch-sensitive monitor to operate a computer-based AD program for senior citizens shows future promise.


Assuntos
Diretivas Antecipadas , Tomada de Decisões , Enfermagem , Educação de Pacientes como Assunto , Software , Idoso , Idoso de 80 Anos ou mais , Feminino , Serviços de Saúde para Idosos , Humanos , Masculino , Pessoa de Meia-Idade , Enfermagem/métodos , Projetos Piloto , Materiais de Ensino
12.
ANS Adv Nurs Sci ; 16(4): 55-70, 1994 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-8092813

RESUMO

Literature on clinical judgment is discussed as a background for proposing an integrated model of diagnostic-therapeutic and ethical reasoning. Information processing and nursing process components related to problem identification and problem solving serve as a framework for the integration of the two domains of clinical reasoning. Discussion focuses on the integration of process components, identification of areas of research, and the use of the model in education and practice.


Assuntos
Competência Clínica , Julgamento , Modelos de Enfermagem , Árvores de Decisões , Educação em Enfermagem , Análise Ética , Ética em Enfermagem , Humanos , Processos Mentais , Desenvolvimento Moral , Diagnóstico de Enfermagem , Processo de Enfermagem , Pesquisa em Enfermagem , Resolução de Problemas
13.
Cancer ; 71(10): 3153-5, 1993 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-8490845

RESUMO

BACKGROUND: Cutaneous toxicities are seen frequently in association with administration of high doses, but not standard doses, of agents. With the increasing use of etoposide in dose-intensive regimens, cutaneous toxicities are appearing with increasing frequency. METHODS: A retrospective analysis of 145 patients treated with various doses of etoposide was conducted. RESULTS: This analysis revealed a statistically significant increase in the frequency of these toxicities at doses of 2400 mg/m2 and 4200 mg/m2, compared with doses of 1800 mg/m2. Intense, painful palmar erythema accompanied by bullae formation and desquamation occurred at the 4200 mg/m2 dose. Symptoms were controlled by a short course of corticosteroids. CONCLUSION: Although they are not dose limiting, substantial dose-related skin toxicities can be an important side effect of high-dose etoposide therapy.


Assuntos
Etoposídeo/toxicidade , Dermatopatias/induzido quimicamente , Relação Dose-Resposta a Droga , Mãos , Humanos , Estudos Retrospectivos
14.
Bone Marrow Transplant ; 10(4): 383-5, 1992 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-1422497

RESUMO

Hemorrhagic cystitis is a significant toxic effect of cyclophosphamide therapy. Continuous bladder irrigation of a 1% alum solution is a simple and generally safe method of chemical cautery to treat the bleeding urothelium. We report four cases of encephalopathy coincident with elevated aluminum levels as well as one patient who developed seizures while receiving continuous bladder irrigations with alum. All patients had significant renal insufficiency. We recommend the cautious use of alum irrigation in patients with renal impairment and monitoring of serum aluminum levels to prevent excessive accumulation and toxicity.


Assuntos
Compostos de Alúmen/efeitos adversos , Encefalite/induzido quimicamente , Convulsões/induzido quimicamente , Administração Intravesical , Adolescente , Adulto , Compostos de Alúmen/administração & dosagem , Alumínio/sangue , Ciclofosfamida/efeitos adversos , Cistite/induzido quimicamente , Cistite/tratamento farmacológico , Encefalite/sangue , Hemorragia/induzido quimicamente , Hemorragia/tratamento farmacológico , Humanos , Leucemia/tratamento farmacológico , Masculino , Convulsões/sangue
15.
J Orthop Trauma ; 6(1): 10-3, 1992.
Artigo em Inglês | MEDLINE | ID: mdl-1556609

RESUMO

We report herein the results of operatively treating 44 consecutive acute fractures of the humeral shaft using plates for internal fixation. Ninety-seven percent (43 of 44) of the fractures healed after plate fixation at an average of 12 weeks. One short plate pulled out and required revision with a longer plate and bone grafting; this fracture also healed. Cancellous bone grafting successfully filled in cortical bone gaps. Range of motion of the shoulder and elbow were essentially normal. Plate size varied depending on the location of the fracture and bone size. Eight of nine fractures treated with 3.5-mm compression plates healed uneventfully. All 11 open fractures, eight from bullet wounds, healed uneventfully after early plating. Fifteen radial nerve injuries were associated with the fractures. Twelve anatomically intact radial nerve palsies recovered in 17 weeks on average after plate fixation. One lacerated nerve was sutured and recovered. One nerve with segmental loss associated with an open fracture was left unrepaired, as was an avulsed nerve associated with a closed fracture. The dissection required for plate fixation provides information that may be helpful in determining appropriate treatment of radial nerve injuries and the prognosis for spontaneous return of function.


Assuntos
Placas Ósseas/normas , Fixação Interna de Fraturas/normas , Fraturas do Úmero/cirurgia , Nervo Radial/lesões , Adolescente , Adulto , Idoso , Transplante Ósseo/normas , Feminino , Seguimentos , Fixação Interna de Fraturas/métodos , Hospitais Universitários , Humanos , Fraturas do Úmero/complicações , Fraturas do Úmero/etiologia , Louisiana , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Cicatrização
16.
Ann Pharmacother ; 26(1): 30-1, 1992 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-1606341

RESUMO

Two patients without prior histories of neurologic disorders experienced generalized seizures while receiving high-dose busulfan (total dose 16 mg/kg) as part of a preparative regimen for allogeneic bone marrow transplantation. A review of the literature revealed 14 similar occurrences. Maintenance of therapeutic blood concentrations of phenytoin in subsequent patients at our institution has resulted in no further patients experiencing generalized seizures. Prophylactic anticonvulsant therapy should be considered in patients receiving high doses of busulfan.


Assuntos
Bussulfano/efeitos adversos , Epilepsia Tônico-Clônica/induzido quimicamente , Adolescente , Adulto , Bussulfano/administração & dosagem , Feminino , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/complicações , Leucemia Promielocítica Aguda/complicações , Masculino
17.
Orthopedics ; 14(3): 273-80, 1991 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-2020626

RESUMO

We used a Monticelli-Spinelli small pin circular external fixator in five cases, in combination with closed reduction or limited open reduction internal fixation, to salvage a satisfactory result in juxtaarticular, intraarticular fractures of the proximal tibia, when associated soft tissue compromise prevented standard fixation with plates and screws. The small pin circular fixator allows juxtaarticular placement of the small pins, enhancing stabilization of the comminuted fractures, allowing early range of motion of the joint and early patient mobilization. The small diameter pins support the soft cancellous bone fragments. This technique attempts to combine the benefits of traction, external fixation, and limited internal fixation. We recommend this method as a salvage procedure when plates and screws are contraindicated because of poor bone and soft tissue conditions.


Assuntos
Pinos Ortopédicos , Fixadores Externos , Fraturas da Tíbia/terapia , Adulto , Fios Ortopédicos , Desenho de Equipamento , Seguimentos , Fraturas Fechadas/terapia , Fraturas Expostas/terapia , Humanos , Articulação do Joelho/fisiologia , Pessoa de Meia-Idade , Radiografia , Amplitude de Movimento Articular , Fraturas da Tíbia/diagnóstico por imagem
18.
Orthopedics ; 14(3): 283-90, 1991 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-2020627

RESUMO

A Monticelli-Spinelli small pin circular external fixator was used in combination with closed reduction or a limited open reduction internal fixation in five cases in an attempt to salvage a satisfactory result in distal tibia pilon fractures when associated soft tissue compromise prevented standard fixation with plates and screws. The small pin fixator enhances the ability to perform a closed reduction through a technique that uses distraction with pins in the tibia and calcaneus, combined with correction of angulation by tensioning wires with a stop nut. Small pin stabilization of these comminuted fractures allows early patient mobilization. The small diameter pins support the soft cancellous bone fragments. This technique attempts to combine the benefits of traction, external fixation, and limited internal fixation. We recommend this technique as a salvage procedure when plates and screws are contraindicated because of poor bone and soft tissue conditions.


Assuntos
Pinos Ortopédicos , Fixadores Externos , Fraturas da Tíbia/terapia , Adulto , Placas Ósseas , Desenho de Equipamento , Seguimentos , Humanos , Masculino , Radiografia , Reoperação , Fraturas da Tíbia/diagnóstico por imagem , Cicatrização
20.
Clin Orthop Relat Res ; (246): 165-71, 1989 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-2766606

RESUMO

Eleven cases of sacroiliac dislocation and/or fracture (Malgaigne pattern) were successfully reduced and stabilized using two threaded compression rods. The mean follow-up period was 26.1 months (range, seven to 45 months). None of the implants failed and there was no subsequent displacement. Two patients had mild residual lower back pain, and one was treated with implant removal without subsequent relief of pain. One patient, in whom the operation was done 110 days after dislocation, had extension of an incomplete preoperative peroneal nerve palsy. After anterior pelvic ring stabilization has been performed, two threaded 3/16-inch diameter rods are driven from the normal posterior iliac wing superficial to the sacrum and through the reduced opposite iliac wing. Compression is obtained with washers and nuts. This procedure can be performed safely and effectively, providing stable fixation and allowing early mobilization to help lessen or prevent the complications associated with prolonged bed rest.


Assuntos
Fixação Interna de Fraturas/instrumentação , Fraturas Ósseas/cirurgia , Luxações Articulares/cirurgia , Dispositivos de Fixação Ortopédica , Ossos Pélvicos/lesões , Articulação Sacroilíaca/lesões , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Masculino , Fatores de Tempo
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