Awake pronation with helmet continuous positive airway pressure for COVID-19 acute respiratory distress syndrome patients outside the ICU: A case series.

OBJECTIVE: Continuous positive airway pressure (CPAP) is an important therapeutic tool in COVID-19 acute respiratory distress syndrome (ARDS) since it improves oxygenation, reduces respiratory rate and can prevent intubation and intensive care unit (ICU) admission. CPAP during pronation has seldom been described and never during sedation. DESIGN: Case series. SETTING: High dependency unit of San Carlo University Hospital (Potenza, Italy). PATIENTS: Eleven consecutive patients with COVID-19 ARDS. INTERVENTION: Helmet CPAP in prone position after failing a CPAP trial in the supine position. MAIN VARIABLE OF INTEREST: Data collection at baseline and then after 24, 48 and 72h of pronation. We measured PaO2/FIO2, pH, lactate, PaCO2, SpO2, respiratory rate and the status of the patients at 28-day follow up. RESULTS: Patients were treated with helmet CPAP for a mean±SD of 7±2.7 days. Prone positioning was feasible in all patients, but in 7 of them dexmedetomidine improved comfort. PaO2/FIO2 improved from 107.5±20.8 before starting pronation to 244.4±106.2 after 72h (p<.001). We also observed a significantly increase in Sp02 from 90.6±2.3 to 96±3.1 (p<.001) and a decrease in respiratory rate from 27.6±4.3 to 20.1±4.7 (p=.004). No difference was observed in PaCO2 or pH. At 28 days two patients died after ICU admission, one was discharged in the main ward after ICU admission and eight were discharged home after being successfully managed outside the ICU. CONCLUSIONS: Helmet CPAP during pronation was feasible and safe in COVID-19 ARDS managed outside the ICU and sedation with dexmedetomidine safely improved comfort. We recorded an increase in PaO2/FIO2, SpO2 and a reduction in respiratory rate.

Awake pronation with helmet continuous positive airway pressure for COVID-19 acute respiratory distress syndrome patients outside the ICU: A case series.

OBJECTIVE: Continuous positive airway pressure (CPAP) is an important therapeutic tool in COVID-19 acute respiratory distress syndrome (ARDS) since it improves oxygenation, reduces respiratory rate and can prevent intubation and intensive care unit (ICU) admission. CPAP during pronation has seldom been described and never during sedation. DESIGN: Case series. SETTING: High dependency unit of San Carlo University Hospital (Potenza, Italy). PATIENTS: Eleven consecutive patients with COVID-19 ARDS. INTERVENTION: Helmet CPAP in prone position after failing a CPAP trial in the supine position. MAIN VARIABLE OF INTEREST: Data collection at baseline and then after 24, 48 and 72h of pronation. We measured PaO2/FIO2, pH, lactate, PaCO2, SpO2, respiratory rate and the status of the patients at 28-day follow up. RESULTS: Patients were treated with helmet CPAP for a mean±SD of 7±2.7 days. Prone positioning was feasible in all patients, but in 7 of them dexmedetomidine improved comfort. PaO2/FIO2 improved from 107.5±20.8 before starting pronation to 244.4±106.2 after 72h (p<.001). We also observed a significantly increase in Sp02 from 90.6±2.3 to 96±3.1 (p<.001) and a decrease in respiratory rate from 27.6±4.3 to 20.1±4.7 (p=.004). No difference was observed in PaCO2 or pH. At 28 days two patients died after ICU admission, one was discharged in the main ward after ICU admission and eight were discharged home after being successfully managed outside the ICU. CONCLUSIONS: Helmet CPAP during pronation was feasible and safe in COVID-19 ARDS managed outside the ICU and sedation with dexmedetomidine safely improved comfort. We recorded an increase in PaO2/FIO2, SpO2 and a reduction in respiratory rate.

Safety of aerosol therapy in children during noninvasive ventilation with helmet and total face mask.

PURPOSE: To evaluate the consequences of using nebulized drugs in patients subjected to noninvasive ventilation (NIV) with total face mask (TFM) and helmet. DESIGN: A descriptive analytical study of a prospective patient cohort was carried out. AMBIT: Pediatric intensive care unit (PICU) of a tertiary hospital. PATIENTS: Consecutive sampling was used to include all patients admitted to the PICU and requiring NIV with helmet or TFM over a period of 29 months. No patients were excluded. INTERVENTIONS: Nebulized treatment was added according to medical criteria. VARIABLES OF INTEREST: Independent variables were age, sex, diagnosis, disease severity, ventilation parameters and nebulized drugs (if administered). Secondary outcomes were duration and failure of NIV, and length of PICU stay. RESULTS: The most frequent diagnoses were bronchiolitis (60.5%) and asthma (23%). Patients received NIV for a median of 43h. Nebulized drugs were administered in 40% of the cases during NIV, and no adverse effects were registered. Using Bayesian statistics, the calculated probability of suffering an adverse effect was 1.3% with helmet and 0.5% with TFM (high density 95% probability intervals). Patients with helmet and nebulized therapy were in more serious condition than those who did not receive nebulization; nevertheless, no differences were observed regarding the need to change to bilevel modality. With TFM, PICU stay was shorter for the same degree of severity (p=0.033), and the NIV failure rate was higher in patients who did not receive inhaled drugs (p=0.024). CONCLUSIONS: The probability of suffering an adverse effect related to nebulization is extremely low when using a helmet or TFM. Inhaled therapy with TFM may shorten PICU stay in some patients.

Mannheimia varigena as the etiologic agent of lameness and coronary band lesion in cattle / Mannheimia varigena como agente etiológico de claudicação e lesão na banda coronária em bovinos

Mannheimia varigena was identified as the etiologic agent of lameness and coronary band lesion in 30% of cattle in a farm located in Rio Grande do Sul, Brazil. Swab samples from the lesions were cultured in McConkey Agar and Blood Agar for microbiological identification. Culture growth was submitted to Gram staining and Matrix Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS) identification. Antimicrobial susceptibility test based on disc diffusion was performed for three antibiotics: ceftiofur, gentamicin and florfenicol. Furthermore, molecular characterization of 16S rDNA gene sequencing was performed and the data was used in a phylogenetic analysis. For that purpose, total DNA was extracted by thermo extraction directly from the bacterial colonies and the polymerase chain reaction (PCR) was performed. Gram-negative Mannheimia varigena strain LBV010/22 was identified as the causative of the lesions. The strain was susceptible to all antibiotics tested. The phylogenetic analysis demonstrated that the analyzed strain is closely related to M. varigena strains from pyelonephritis and respiratory tract. Overall, this is the first report of M. varigena as the causative agent of coronary band injury in bovine. Therefore, our findings show the importance of an accurate microbiological identification of infectious agent in lameness cases in order to prevent the occurrence and perform an appropriate treatment in the future.

Mannheimia varigena foi identificada como agente etiológico de claudicação e lesão de banda coronária em 30% dos bovinos de uma fazenda localizada no Rio Grande do Sul, Brasil. Amostras de swab das lesões foram cultivadas em Ágar McConkey e Ágar Sangue para identificação microbiológica. O crescimento da cultura foi submetido à coloração de Gram e identificação por Espectrometria de Massa de Ionização por Dessorção a Laser Assistida por Matriz (MALDI-TOF MS). O teste de suscetibilidade antimicrobiana baseado na difusão em disco foi realizado para três antibióticos: ceftiofur, gentamicina e florfenicol. Além disso, foi realizada a caracterização molecular do sequenciamento do gene 16S rDNA e o resultado utilizado para análise filogenética. Para tanto, o DNA total foi extraído por termoextração diretamente das colônias bacterianas e uma reação em cadeia da polimerase (PCR) foi realizada. Foi identificada como causadora das lesões a cepa gram-negativa de Mannheimia varigenaLBV010/22. Ela foi suscetível a todos os antibióticos testados. A análise filogenética demonstrou que a cepa analisada está intimamente relacionada às M. varigena presentes em pielonefrite e no trato respiratório. No geral, este é o primeiro relato de M. varigenacomo agente causador de lesão de banda coronária em bovinos. Portanto, nossos achados mostram a importância de uma identificação microbiológica precisa do agente infeccioso nos casos de claudicação, a fim de prevenir a ocorrência e realizar um tratamento adequado no futuro.

Estudio retrospectivo. Influencia de la Terapia Kinesiológica Temprana en el uso de Casco Modelador Craneal / Retrospective study. Influence of early physical therapy on the need to wear a skull molding helmet

Introducción. La plagiocefalia no sinostósica es una condición de salud caracterizada por una asimetría de cráneo que tiene diversas consecuencias en el desarrollo. Los principales tratamientos son la kinesioterapia y el casco de moldeado craneal (CMC). Objetivo. Evidenciar la influencia de la kinesioterapia temprana en la necesidad de usar casco modelador craneal. Métodos. Se realizó un estudio cuantitativo, descriptivo y retrospectivo en lactantes mayores de tres meses ingresados al Centro de Rehabilitación Integral de Carabineros (CRICAR) con diagnóstico confirmado de plagiocefalia mediante la técnica de craneometría. Se recopilaron datos de 39 pacientes diagnosticados con plagiocefalia, evaluados y tratados entre 2017 y 2019. Se dividieron en dos grupos, ingreso temprano (bajo los 5,5 meses de edad cronológica) e ingreso tardío (sobre los 5,5 meses de edad cronológica). Resultados. Al realizar un análisis bivariado, se obtuvo que 9 de 20 pacientes tuvieron que usar CMC en el grupo de ingreso tardío, y solo 4 de 19 pacientes en el grupo de ingreso temprano. Al contrastar la razón de riesgo de usar CMC en el grupo expuesto versus el grupo no expuesto se obtiene que es 3 veces mayor, sin embargo, esta diferencia no es estadísticamente significativa (OR=3.06, IC95% 0.6-16.8) Conclusiones. El principal resultado de este estudio es la disminución en la diferencia de diagonales evaluadas con craneometría. Además, se ha observado que en nuestra muestra el uso de CMC es tres veces mayor cuando el ingreso a terapia kinesiológica es tardío.

Introduction. Non-synostotic plagiocephaly is health condition characterized by a skull asymmetry that has various developmental consequences. The main treatments are kinesiotherapy and cranial molding helmet (CMH). The purpose of this study is to evidence the influence of early kinesiotherapy on the need to use CMH. Methods. A quantitative, descriptive and retrospective study of infants older than three months, admitted to the Carabineros Comprehensive Rehabilitation Center (CRICAR) since January 2017 with a confirmed diagnosis of plagiocephaly by craniometry technique was performed. Data were collected from 39 patients diagnosed with plagiocephaly, evaluated and treated between 2017 and 2019. They were divided into two groups, early admission (under 5.5 months of chronological age) and late admission (over 5.5 months of chronological age). Results. When performing a bivariate analysis, we obtained that 9 out of 20 patients had to use CMC in the late admission group, and only 4 out of 19 patients had to use it in the opposite group. When contrasting the oods ratio of using CMC in the exposed group versus the non-exposed group we obtain that it is 3 times higher, however, this difference is not statistically significant (OR=3.06, IC95% 0.6-16.8). Conclusions. The main result of this study is the decrease in the difference in diagonals assessed with craniometry. In addition, it has been observed that in our sample the use of CMC is three times higher when admission to physical therapy is late.

Awake pronation with helmet continuous positive airway pressure for COVID-19 acute respiratory distress syndrome patients outside the ICU: A case series / Pronación en la planta en pacientes despiertos conectados a ventilación mecánica no invasiva y casco, con insuficiencia respiratoria aguda secundaria a COVID-19: una serie de casos

Objective: Continuous positive airway pressure (CPAP) is an important therapeutic tool in COVID-19 acute respiratory distress syndrome (ARDS) since it improves oxygenation, reduces respiratory rate and can prevent intubation and intensive care unit (ICU) admission. CPAP during pronation has seldom been described and never during sedation.DesignCase series.SettingHigh dependency unit of San Carlo University Hospital (Potenza, Italy).PatientsEleven consecutive patients with COVID-19 ARDS.InterventionHelmet CPAP in prone position after failing a CPAP trial in the supine position.Main variable of interestData collection at baseline and then after 24, 48 and 72h of pronation. We measured PaO2/FIO2, pH, lactate, PaCO2, SpO2, respiratory rate and the status of the patients at 28-day follow up.ResultsPatients were treated with helmet CPAP for a mean±SD of 7±2.7 days. Prone positioning was feasible in all patients, but in 7 of them dexmedetomidine improved comfort. PaO2/FIO2 improved from 107.5±20.8 before starting pronation to 244.4±106.2 after 72h (p<.001). We also observed a significantly increase in Sp02 from 90.6±2.3 to 96±3.1 (p<.001) and a decrease in respiratory rate from 27.6±4.3 to 20.1±4.7 (p=.004). No difference was observed in PaCO2 or pH. At 28 days two patients died after ICU admission, one was discharged in the main ward after ICU admission and eight were discharged home after being successfully managed outside the ICU.Conclusions: Helmet CPAP during pronation was feasible and safe in COVID-19 ARDS managed outside the ICU and sedation with dexmedetomidine safely improved comfort. We recorded an increase in PaO2/FIO2, SpO2 and a reduction in respiratory rate (AU)

Objetivo: La ventilación con presión positiva continua (CPAP) es una opción terapéutica útil en pacientes con síndrome de dificultad respiratoria aguda (SDRA) secundaria a infección por coronavirus 2019 (COVID-19) porque mejora la oxigenación, disminuye la frecuencia respiratoria y puede prevenir la intubación orotraqueal y así la admisión en la unidad de cuidados intensivos (UCI). El uso de la CPAP en pronación se ha descrito raramente, y nunca en pacientes con sedación superficial.DiseñoSerie de casos.ÁmbitoUnidad de cuidados intensivos del Hospital San Carlo (Potenza, Italia).PacientesOnce casos consecutivos de pacientes con SDRA secundario a infección por COVID-19.IntervencionesCasco y CPAP y en posición de prono, después de fracasar una sesión de una hora de CPAP en posición supina.Variables de interés principalesDatos clínicos registrados antes de iniciar la primera sesión de 12h de pronación y a las 24, 48 y 72h. Los datos registrados fueron PaO2/FiO2, pH, lactatos, PaCO2, SpO2, frecuencia respiratoria y visita de seguimiento a los 28días.ResultadosTodos los pacientes fueron tratados con CPAP y casco durante una media ±DE de 7±2,7. La posición de prono se realizó con éxito en los 11 pacientes, pero 7 pacientes recibieron dexmetodomidina para mejorar el confort.El valor de PaO2/FiO2 mejoró desde 107,5±20,8 antes de la pronación hasta 244,4±106,2 después de 72h (p<0,001). Se observó un aumento significativo de la SpO2 desde un basal de 90,6±2,3 hasta 96±3,1 a las 72h (p<0,001) y una reducción de la frecuencia respiratoria desde 27,6±4,3 hasta 20,1±4,7 (p=0,004). No se observaron diferencias en los valores de PaCO2 o de pH. A los 28días dos pacientes habían fallecido, uno permanecía todavía ingresado en la planta después de la dimisión de la UCI y ocho fueron remitidos al domicilio después de ser tratados en la planta sin necesidad de ingreso en la UCI.Conclusio: nesLa CPAP con casco durante la posición de prono fue segura y eficaz

[Biomechanical analysis of cervical spine movement on removal of motorcycle helmets]. / Análisis biomecánico del movimiento cervical en la extracción del casco en motoristas.

OBJECTIVES: To measure cervical spine movement during removal of a motorcycle helmet by health care professionals. MATERIAL AND METHODS: Observational study using biomechanical inertial sensors to detect movement in the spinal column during removal of helmets. RESULTS: Thirty-four emergency medicine specialists and nurses participated. The mean (SD) rotation was 1.14° (0.82°) to the left and 3.30° (1.69°) to the right (P<.001). Mean flexion was 9.82° (7.46°) and mean extension was 6.23° (6.86°) (P<.001). Mean lateral displacement was 5.73° (2.97°) to the left and 5.62° (8.22°) to the right (P=.678). The removal maneuvers took a mean of 70 seconds (4 seconds). CONCLUSION: Helmet removal was completed in an average of 70 seconds with flexion and rotation mainly toward the side where the professional supporting the head was positioned.

OBJETIVO: Determinar el movimiento cervical durante la extracción de un casco realizada por profesionales sanitarios. METODO: Estudio observacional mediante análisis biomecánico con sensores inerciales de los movimientos producidos en la columna durante la extracción de un casco. RESULTADOS: La muestra final la componen 34 profesionales de servicios de urgencias y emergencias. La rotación fue de 1,14 (DE 0,82)° hacia el lado izquierdo y de 3,30 (1,69)° hacia el lado derecho (p < 0,001). La flexoextensión fue de 9,82 (7,46)° para la flexión y de 6,23 (6,86)° para la extensión (p < 0,001). La lateralización fue de 5,73 (2,97)° para el lado izquierdo y de 5,62 (8,22)° para el lado derecho (p = 0,678). El tiempo medio de realización de la extracción fue 70 (4) seg. CONCLUSIONES: La extracción del casco se realizó en 70 segundos con flexión y rotación hacia el lado donde se encuentra colocado el profesional que sujeta la cabeza.

Concentração de minerais no tecido queratinizado podal de equinos jovens da raça Crioula em diferentes fases de crescimento / [Mineral concentrations in the keratinized tissue on the feet of young Crioulo horses at different stages of growth]

O presente estudo avaliou o perfil mineral de Cálcio (Ca), Cobre (Cu) e Zinco (Zn) no estojo córneo pré e pós-desmame e sua associação com pigmentação, gênero e idade de potros da raça Crioula criados em pastagens nativas no Rio Grande do Sul. Foram coletadas amostras do casco de potros da raça Crioula 41 dias pré e 28 dias pós-desmame. Os teores de Ca, Cu e Zn variaram no casco fetal (571,0±39,4; 14,5±7,6 e 130,0±30,5mg/kg, respectivamente; P<0,05) e no definitivo (653,0±169,2; 33,8±11,5 e 69,3±36,8mg/kg, respectivamente; P<0,05), no pré (620,0±184; 17,2±21,2 e 103,0±75,5mg/kg, respectivamente; P<0,05) e no pós-desmame (517,5±181; 0 e 79,0±41,7mg/kg, respectivamente; P<0,05). Houve associação positiva (P<0,05) com a faixa etária no pré-desmame para Ca (r=0,5) e Cu (r=0,57), e negativa para Zn (r=-0,69; P<0,05). No pós-desmame, houve associação positiva (P<0,05) para Ca (r=0,36) e Zn (r=0,64) e negativa para Cu (r=-0,39; P<0,05). Tanto a pigmentação quanto o gênero não afetaram o perfil mineral. Conclui-se que há diferenças nas concentrações de Ca, Cu e Zn na epiderme do casco de potros da raça Crioula no pré e pós-desmame, independentemente da pigmentação e do gênero, onde as concentrações de Ca e Cu aumentam com a idade, enquanto as de Zn diminuem.(AU)

The aim of this study was to evaluate the mineral profile of Ca, Cu and Zn in the hoof horny capsule at pre and post-weaning and its association with pigmentation, gender and age range of Crioulo foals raised in native pastures in RS. Samples were collected from the epidermis of the Crioulo foal's hoof at two times, 41 pre and 28 post-weaning. The contents of Ca, Cu, Zn Varied in the fetal hoof ( 571.0±139.4, 14.5±7.6 and 130.0±30.5mg/kg, respectively, P<0.05) and definitive (653.0±169.2, 33.8±11.5 and 69.3±36.8mg/kg, respectively, P<0.05), in the pre (620.0±184, 17.2±21.2 and103.0±75.5mg/kg, respectively, P<0.05) and post-weaning (517.5±181, 0.1 and 79.0±41.7mg/kg, respectively, P<0.05).There was a positive association (P<0.05) with a preweaning age for Ca (r=0.5) and Cu (r=0.57) and negative for Zn (r=-0.69, P<0.05). In the post weaning there was a positive association (P<0.05) for Ca (r=0.36) and Zn (r=0.64) and negative for Cu (r=-0.39; P<0.05). Neither pigmentation nor gender affected the mineral profile. It is concluded that there are differences in Ca, Cu, Zn concentrations in the epidermis of foals of the crioulo breed at the pre and post weaning, regardless of pigmentation and sex, where Ca and Cu concentrations increase with age, while Zn concentrations decrease.(AU)

[Bicycle accidents treated in emergency departments. A multicentre study]. / Accidentes de bicicleta atendidos en los Servicios de Urgencias. Estudio multicéntrico.

OBJECTIVES: To describe epidemiological characteristics, types of injury, prognosis and medical management of bicycle-related Paediatric Emergency Department (ED) visits and to identify potential preventive measures. PATIENTS AND METHODS: This multicentred, observational prospective study included all children between 3 and 16 years of age treated for bicycle-related injuries in the Emergency Departments of 15 Spanish Hospitals belonging to the «Unintentional Paediatric Injury Workshop¼ of the Spanish Paediatric Emergency Society between the 1(st) of June 2011 and the 31(st) of May 2012. Characteristics of all ED visits, as well as epidemiological data and accident-related information, were collected. RESULTS: A total of 846 patients were included in the study, with a male predominance (72.9%) and a median age of 9.6 ± 3.6 years. Head injury was the third most common injury (22.3%) and the main cause of admission to the Pediatric Intensive Care Unit (PICU) (68.4%). More than three-quarters (77.9%) of the patients did not wear a helmet, which was significantly associated to a higher incidence of head injury and admission to PICU. Older children (OR 1.063) and bicycle injuries involving motor vehicles (OR 2.431) were identified as independent risk factors for worse outcomes. CONCLUSIONS: Since helmet use reduces up to 88% of central nervous system lesions secondary to head injury, promotion of its use should be the main preventive measure, followed by restriction of bike-riding to cycling areas.

Isolation, cultivation and immunofluorescence characterization of lamellar keratinocytes from equine hoof by using explants / Isolamento, cultivo e caracterização por imunofluorescência de queratinócitos lamelares de casco equino utilizando explantes

The importance of the hoof to the horse health is clear, and the current knowledge regarding the cellular aspects of hoof keratinocytes is poor. Studies on equine keratinocyte culture are scarce. Developing keratinocyte cultures in vitro is a condition for studies on molecular biology, cell growth and differentiation. Some methods have already been established, such as those for skin keratinocyte culture. However, few methodologies are found for lamellar keratinocytes. The objective of this study was to standardize the equine hoof keratinocyte isolation and cultivation, and then characterize the cell immunophenotype. For this, the primary culture method used was through explants obtained from three regions of the equine hoof (medial dorsal, dorsal, and lateral dorsal). After the cell isolation and cultivation, the cell culture and its explants were stained with anti-pan cytokeratin (pan-CK) (AE1/AE3), vimentin (V9), p63 (4A4), and Ki-67 (MIB-1) antibodies. Cells were grown to third passage, were positive for pan-CK, p63 and Ki-67, and few cells had vimentin positive expression. As for the explants, the epidermal laminae were not stained for vimentin or Ki-67. However, some cells presented positive pan-CK and p63 expression. This study demonstrated the viability of lamellar explants of equine hooves as a form of isolating keratinocytes in primary cultures, as well as characterized the proliferation ability of such keratinocytes in monolayers.(AU)

É notória a importância do casco na saúde dos equinos, mas o conhecimento em nível celular é pouco entendido. Estudos envolvendo o cultivo de queratinócitos equinos são escassos. Sabe-se que o desenvolvimento de cultivos de queratinócitos in vitro é uma condição para estudos sobre a biologia molecular, crescimento e diferenciação celular. Alguns métodos já estão estabelecidos, como para cultivo de queratinócitos de pele, mas poucas metodologias são encontradas para queratinócitos lamelares. O objetivo desse estudo foi padronizar o cultivo de queratinócitos provenientes de casco equino visando futuramente associar ao estudo da medicina regenerativa para assim estabelecer um modelo experimental in vitro e indicar o uso criterioso de terapias regenerativas para a laminite equina. Desta forma, o cultivo em monocamada e a caracterização de queratinócitos lamelares foram realizados. Para isso, o método de cultura primária utilizado foi através de explantes obtidos de três regiões do casco (dorso-medial, dorsal e dorso-lateral). As células foram caracterizadas para os marcadores anti pan-cytokeratin (AE1/AE3), vimentin (V9), p63 (4A4) e Ki-67 (MIB-1) nos cultivos e nos explantes. As células foram cultivadas até terceira passagem, tendo marcação positiva para pan-CK, p63 e Ki-67 e fraca marcação para vimentina. Já as lâminas epidermais não tiveram marcação de vimentin e Ki-67, porém marcaram acentuadamente para pan-CK e p63. Este estudo demonstrou a exiquibilidade do uso de explantes lamelares do casco de equinos, como forma de isolamento de queratinócitos em cultivos primários, bem como caracterizou a habilidade de proliferação desses queratinócitos em monocamada.(AU)

Impact of high-energy diets on the rumen environment and digital cushion in confined cattle / O impacto de dietas de alto valor energético sobre o ambiente ruminal e o tecido digital em bovinos confinados

This study aimed to identify gross and microscopic changes, caused by high-energy diets, in the rumen environment and hoof of confined beef cattle. The study sample comprised 40 confined heifers (Bos taurus) with no disease history divided into four experimental groups using different diets: Group 1 (D1, control), 48:52 forage:concentrate ratio; Group 2 (D2), 30:70 forage:concentrate ratio; Group 3 (D3), 30:70 forage:concentrate ratio + sucrose; Group 4 (D4), 100% concentrate. All animals underwent clinical examination, assessment of ruminal fluid pH and lameness, and sample collection after slaughter for histopathology of the hoof laminae and digital cushion and ruminal tissue. All dependent variables of the study were compared using the SPSS 20.0 statistical software. The variables that did not show normality (HR, RM, ST, and CRT) were compared with application of the Kruskal-Wallis test followed by the Dunnet's multiple comparison test. All other variables were submitted to analysis of variance (ANOVA) followed by Tukey's test. The different diets had an impact on the rumen environment (p<0.05) of the heifers assessed, with momentary general depression in the first 12 h after sucrose induction (D3), as well as mild clinical signs in D4. The animals in D3 and D4 presented lower motility (p<0.05) and ruminal pH (p<0.01) than those in D1. Of the 40 heifers, 27.5% (n=11) showed gross lesions in the epithelium of ruminal pillars, whereas 22.5% (n=9) of those in D3 and D4 presented these lesions. Sole corium thickness varied between heifers in D3 compared with those in D1 and D2 (p<0.05). Therefore, high-energy diets, as used in this study, alter some clinical parameters and the rumen environment, causing lesions in the rumen mucosa, and of lesser intensity, in the hoof corium and laminae, suggestive of laminitis.(AU)

O objetivo deste trabalho foi identificar alterações macroscópicas e microscópicas provocadas por dietas de alto valor energético no ambiente ruminal e casco de bovinos de corte (Bos taurus) em confinamento. Foram utilizadas 40 novilhas mantidas em confinamento, sendo divididas em 4 grupos experimentais: Grupo D1(controle) - 48% de volumoso e 52% de concentrado; Grupo D2 - 30% de volumoso e 70% de concentrado; Grupo D3 - 30% de volumoso e 70% de concentrado + sacarose; Grupo D4 - 100% de concentrado. Foi realizado exame clínico dos animais, avaliação do pH ruminal, da claudicação, além de coletas de amostras post-mortem para análises histopatológicas da região laminar do casco, coxim digital e do rúmen. Todas as variáveis dependentes do estudo foram comparadas por meio do software estatístico SPSS 20.0. As variáveis sem normalidade (FC, MR, Tc e TPC) foram comparadas pelo teste de Kruskal Wallis, seguido pelo teste de comparação múltipla de Dunnet. Todas demais foram submetidas a análise de variância (ANOVA), seguida pelo teste de Tukey. Foi observado impacto das distintas dietas ao ambiente ruminal (p<0,05). Os grupos D3 e D4 exibiram menor motilidade (p<0,05) e pH ruminal (p<0,01). 27,5% (n=11) dos animais tiveram registros macroscópicos de lesões no epitélio dos pilares ruminais enquanto que os submetidos às dietas 3 e 4 foi observada ocorrência de 22,5% (n=9) de lesões macroscópicas no rúmen. As espessuras do córium solear variaram entre os grupos que receberam a indução de sacarose em relação ao grupo controle e novilhas alimentadas com a dieta 2 (p<0,05). Sendo assim dietas com elevada densidade energética, na condição em que foi empregada, alteraram alguns parâmetros clínicos e o ambiente ruminal, provocando lesões na mucosa do rúmen e de pouca intensidade no córium e tecido laminar, sugestiva de laminite.(AU)

Relação entre escore de condição corporal e escore de locomoção em vacas leiteiras submetidas a manejo semiextensivo de alimentação / Relationship between body condition score and locomotion score on dairy cows submitted to semiextensive feeding management

Métodos observacionais subjetivos, como escore de locomoção (EL) e escore de condição corporal (ECC), têm sido amplamente utilizados para avaliação populacional de diferentes graus de claudicação e estado nutricional em bovinos. Este estudo objetivou verificar a associação longitudinal entre o escore de condição corporal e o escore de locomoção em vacas da raça Holandesa submetidas a um regime alimentar semiextensivo. O período experimental compreendeu dois anos de observações, em uma propriedade localizada no sul do Rio Grande do Sul. O grupo experimental foi constituído por 900 vacas lactantes, que foram avaliadas trimestralmente por dinâmica ortopédica pelo EL e do estado metabólico pelo ECC. A coleta desses dados foi realizada por três veterinários treinados. A fim de se verificar a correlação entre variáveis, utilizou-se o programa SAS, por meio do método de correlação de Pearson, para determinar a associação entre as variáveis avaliadas (EL e ECC), com nível de significância de 5%. A distribuição dos diferentes escores de locomoção durante o período foi a seguinte: 57,2% dos animais tiveram o escore de locomoção 1, ou seja, estavam saudáveis em relação ao sistema locomotor. O restante dos animais que apresentou algum grau de dificuldade de locomoção distribuiu-se da seguinte forma, segundo a intensidade: 21,6% dos animais apresentaram EL2, 15,5% deles EL3, 3,5% deles EL4 e 2,2% deles EL5. Quanto ao resultado da correlação, observou-se associação negativa (r= -0,57) entre ECC e EL (P= 0,03), com ECC médio de 2,97±0,33 e EL de 1,35±0,24 durante o período experimental. Portanto, há uma correlação negativa entre o escore de condição corporal e o escore de locomoção em vacas da raça Holandesa submetidas ao regime alimentar semiextensivo.(AU)

Subjective observational methods such as locomotion score (LS) and body condition score (BSC) have been widely used for populations evaluation of different degrees of claudication and nutritional status in cattle. This study aimed to verify the longitudinal association between body condition score and locomotion score in Holstein cows submitted to a semi-extensive breeding regime. The experimental period comprised two years of observations at a property located in the South of Rio Grande do Sul. The experimental group consisted of 900 lactating cows, which were evaluated quarterly, being evaluated by orthopedic dynamics through LS and of the metabolic status through BCS. The collection of these data was performed by three trained veterinarians. To verify the correlation between variables, the SAS program was used using the Pearson Correlation method to determine the association between the variables evaluated (LS and BSC), at a significance level of 5%. The rest of the animals that showed some degree of locomotion difficulty, were distributed following intensity: 21.6% of LS2 animals, 15.5% of LS3 animals, 3.5% with LS4, and 2.2% with LS5, while 57,2% were without locomotion difficulty (LS1). Regarding the correlation result, a negative association (r= -0.57) was found between BSC and LS (P=0.03), with an overall of BSC of 2.97±0.33 and LS of 1, 35±0.24 during the experimental period. Therefore, there is a negative correlation between body condition score and locomotion score in Holstein cows submitted to the semi-extensive breeding regime.(AU)

Comparative study of biotin supplementation on weight gain and occurrence of digital diseases in cattle (Bos taurus x Bos indicus) / Estudo comparativo da suplementação com biotina sobre o ganho de peso e ocorrência de enfermidades digitais em bovinos (Bos taurus x Bos indicus)

This study aimed to assess the weight gain and the incidence of foot diseases in male, crossbred (Bos taurus x Bos indicus) bovines that were supplemented with biotin. An amount of 240 animals, supplemented or not with biotin, allocated in 12 groups of 20 animals, was assessed for a period of six months. The study was conducted during three years and the groups were divided according to the forage available, corn, corn residue and sorghum silage, and initial weights between 100 and 200 kg and between 200 and 300 kg. The statistical analyses used were the Tukey's Test, in triple factorial scheme (type of silage x use of biotin x initial body weight) and the Fisher´s Exact Test, both at 5% significance level. The biotin supplementation in bovines did not influence weight gain and the incidence of foot diseases, however, when comparing only the type of forage, corn and sorghum silage provided higher weight gain than silage made of corn residue.

Esse estudo teve como objetivo avaliar o ganho em peso e a ocorrência de enfermidades digitais em bovinos do sexo masculino, mestiços (Bos taurus x Bos indicus) que foram suplementados com biotina. Avaliaram-se, por um período de seis meses, 240 bovinos, suplementados ou não com biotina, alocados em 12 grupos de 20 animais. O estudo foi realizado durante três anos e os grupos foram divididos de acordo com o volumoso disponibilizado, silagem de milho, de resíduo de milho e de sorgo, e pesos iniciais entre 100 e 200 kg e entre 200 e 300 kg. As análises estatísticas empregadas foram o Teste de Tukey, em esquema de fatorial triplo (tipo de silagem x uso da biotina x peso corporal inicial) e o Teste Exato de Fisher, ambas em nível de significância de 5%. A suplementação com biotina nos bovinos não exerceu influência sobre o ganho em peso e a ocorrência de enfermidades digitais, mas, quando se comparou apenas o tipo de volumoso, a silagem de milho e sorgo, pode se observar um maior ganho em peso que a silagem confeccionada de resíduo de milho.

Testing a new surgical instrument to obtain bovine hoof biopsy samples / Teste de viabilidade de um instrumento cirúrgico para obtenção de biópsias do tecido laminar do casco de bovinos

The histological and molecular analysis of biopsy samples are fundamental steps for the understanding of physiopathology, diagnosis and prognosis of the diseases. However, harvest of tissue biopsies from hoof lamellar tissue is a procedure with limitations due to lack of effective surgical instruments and techniques. The aim of the current study is to develop and test in vivo a surgical instrument with the specific purpose of harvesting lamellar tissue in cattle. A prototype called Falcão-Faleiros' lamellotome (INPIBR102013018765-8) was designed, produced and tested. After sedation, five adult cattle were restrained in lateral recumbency and locally anesthetized in two digits. The stratum corneum was worn down using a rotary tool coupled to a 3/8" high-speed cutter until the soft tissue proximity was reached. Next, the inner edge of the worn area was bounded with a scalpel. The lamellotome was introduced to obtain and hold the sample. The histological specimens of 16mm length by 6mm depth were stained with HE, PAS, Masson's thricome and Shorr. The structures of interest were differentiated in the histological analysis without technical artifacts and a mean number of 85 epidermal laminae per sample were counted. No relevant lameness or wound complication were seen following the procedure. In conclusion the technique using the lamellotme was effective in obtaining lamellar tissue biopsy samples without causing clinical harm in cattle. The procedure showed potential to be used in clinical research or even as a supplementary diagnosis method for routine bovine podiatry.(AU)

A avaliação das propriedades histológicas e da expressão de genes e proteínas em biópsias tem sido determinante para o entendimento da fisiopatologia, o diagnóstico e o prognóstico das enfermidades. Entretanto, a obtenção de biópsias do casco é um procedimento com limitações devido à ausência de técnicas e instrumentos específicos. O objetivo foi desenvolver e testar, na espécie bovina, um instrumento cirúrgico especificamente desenvolvido para realização de biópsias de casco nominado lamelótomo de Falcão-Faleiros (INPI, BR102013018765-8). Utilizaram-se cinco bovinos adultos que foram sedados, contidos em decúbito lateral e tiveram dois dígitos anestesiados. Em seguida, uma serra circular acoplada a uma microretífica foi usada para o desgaste do estrato córneo na parede dorsal até próximo do estrato lamelar. Após incisões retilíneas delimitando a borda interna da área desgastada, utilizou-se o lamelótomo para obtenção da amostra. Os fragmentos de 16mm de comprimento e 6mm de profundidade foram fixados em formalina e processados para histologia com colorações HE, PAS, Shorr e tricrômico de Masson. Nenhum dos animais apresentou claudicação ou complicação relevantes no período pós-opertório. As amostras foram consideradas adequadas quanto à integridade das lâminas e à preservação de sua arquitetura. Obtiveram-se média de 85 lâminas epidérmicas viáveis por biópsia. Conclui-se que o lamelótomo de Falcão-Faleiros é apropriado e seguro para a obtenção de biópsias de casco em bovinos, se mostrando promissor para uso em estudos clínicos e na rotina de diagnóstico de problemas podais em bovinos.(AU)

Morphometric changes in the hoof capsule of Criollo foals from birth to weaning / Alterações morfológicas na capsula do casco em potros Crioulos do nascimento ao desmame

ABSTRACT: South America has numerous Criollo horse breeding farms; however, information on foal hoof growth is still limited and identifying the ideal periods to apply corrective trimming is a frequent concern for horse owners. In the present study, a morphometric analysis of hoof growth was performed on 46 Criollo foals from birth to weaning (0-8 months). Results showed that hoof growth rate was higher in the first four months followed by a decrease until the eighth month. Average growth rate of the hoof was 0.21cm per month, whereas that of the heel was 0.14cm per month. However, no significant differences were observed between medial and lateral heel length or between limbs. Coronary band perimeter and solar width showed an average increase of 0.97cm and 0.46cm per month, respectively, and were significantly correlated (r=0.99, P≤0.01). The characteristic most positively correlated to biometric variables was foal age, followed by solar width, toe length, and coronary band perimeter. In conclusion, hoof length increase in Criollo foals was more intensive during the first four months of life.

RESUMO: A América do Sul possui um grande número de criatórios da raça Crioula, no entanto, há uma carência de informações sobre o desenvolvimento natural dos cascos dos potros, tornando a identificação de períodos ideais para o casqueamento corretivo uma dúvida frequente entre os criadores. Portanto, o objetivo deste estudo foi realizar a biometria natural (do nascimento aos 8 meses) no casco de 46 potros da raça Crioula. Os resultados indicaram uma taxa de crescimento mais rápido nos primeiros 4 meses, com subsequente desaceleração até o desmame. O crescimento médio do casco foi em média 0,21cm mo-1, enquanto o comprimento do talão foi de 0,14cm mo-1. Não foram observadas diferenças significativas no equilíbrio médio/lateral do casco ou entre os membros durante o período experimental. O perímetro da banda coronária e a largura solar do casco apresentaram um crescimento médio de 0,97 e 0,46cm mo-1, respectivamente, e foram altamente correlacionados (r=0,99, P≤0,01). A idade dos potros foi a característica mais correlacionada positivamente, seguida da largura solar, do comprimento do casco e do perímetro da banda coronária. Nós concluímos que o crescimento do casco em potros da raça Crioula foi mais intenso durante os quatro primeiros meses de vida.

Relação espacial entre a falange distal e o estojo córneo em éguas Campolinas jovens com e sem sinais de obesidade / Spatial relationship between the distal phalanx and the hoof capsule in young Campolina mares with and without obesity

Estudos prévios têm demonstrado alterações radiográficas em cascos de equinos obesos. Os objetivos foram estudar, com avaliação radiográfica, a relação espacial entre estojo córneo e falange distal de éguas jovens da raça Campolina com e sem obesidade. Foram utilizadas 22 éguas entre três e cinco anos de idade, sendo analisadas varáveis de adiposidade e medidas radiográficas dos cascos dos membros torácicos de éguas com escore corporal de 5 a 7/9 (Grupo Controle) e de 8 a 9 (Grupo Obeso). Foram feitas comparações entre os grupos e correlacionaram-se as variáveis de adiposidade entre si, variáveis adiposidade com variáveis casco e variáveis de casco entre si. Utilizou-se o teste t de Student para variáveis paramétricas e o teste Mann-Whitney para as não-paramétricas, para as medidas de correlação, utilizou o teste de Pearson para duas amostras paramétricas e o teste de Spearman para comparações que envolvam pelo menos uma variável não paramétrica (P<0,05). Os resultados demonstraram que éguas Campolinas obesas, ainda jovens, já apresentam indícios de alteração na relação espacial entre estojo córneo e falange distal.(AU)

Previous studies have demonstrated radiographic changes in the hoof of obese horses. The objective was to study through radiographic evaluation the spatial relationship between the hoof capsule and the distal phalanx of Campolina mares with and without obesity. Twenty-two Campolina mares 3 to 5 years old were used. We analyzed adiposity variables and radiographic measurements of the hoof of both forelimbs of mares with body condition score from 5 to 7/9 (Control group) and from 8 to 9 (Obese group). Comparisons were made between groups using the Student t test for parametric variables and the Mann-Whitney test for the nonparametric ones. Pearson or Spearman tests were used to evaluate the correlation among parametric and nonparametric variables respectively (P<0.05). Evidences of changes in the spatial relationship between the hoof capsule and the distal phalanx were observed in obese Campolina young mares.(AU)

Biometrics of hoof balance in equids / Biometria do equilíbrio podal de equídeos

Differences in hoof balance between horses, mules and donkeys were identified in order to form more specific considerations for proper management of the animals. Measurements of the natural dimensions of hooves in sixty animals were used: 20 horses from the Crioulo breed, 20 mules and 20 donkeys from the Pêga breed. Liveweight was estimated using the correlation equations in each species by heart girth. Using a caliper rule, tape measure and hoof gauge, measurements of the length and width of the frog, hoof height, angle of heel, medial and lateral dorsal length, angle of the toe and crown circumference of the hooves of forelimbs and hindlimb were taken. Within each group the hooves of the hindlimbs exhibited narrower measurements than the hooves of the forelimbs and no difference was observed between the hoof angle of both members of groups. The conformation of the hooves of donkeys is shown to be substantially different from that observed in horses, the mules being in an intermediate condition, being smaller, angled and robust frog and proportionally more developed. Similarly, the hooves of donkeys provide greater support area compared to mules and horses, in descending order, even being dimensionally smaller. We conclude that the hooves of horses, mules and donkeys, have specific patterns of geometric balance that must be taken into consideration at the time of trimming and imbalance inferences.(AU)

O objetivo deste trabalho foi determinar o equilíbrio dos cascos de equídeos. Foram utilizados 60 animais, sendo estes: 20 equinos da raça Crioula, 20 muares e 20 asininos da raça Pêga. O peso vivo foi estimado por meio de equações de correlação com o perímetro torácico específico a cada espécie. Utilizando-se paquímetro, fita métrica e podogoniômetro, foram mensurados comprimento e largura da ranilha e do casco, altura e ângulo dos talões medial e lateral, comprimento dorsal e ângulo da pinça e perímetro da banda coronária dos cascos dos membros torácicos e pélvicos. Dentro de cada grupo, observou-se que os cascos dos membros pélvicos exibem-se mais estreitos que os cascos dos membros torácicos, e não houve diferença entre o ângulo das pinças de ambos os grupos de membros. A conformação dos cascos dos asininos mostra-se substancialmente divergente do observado nos equinos, estando os muares numa condição intermediária, sendo aqueles menores, mais angulados e com ranilha robusta e proporcionalmente mais desenvolvida. Da mesma forma, os cascos dos asininos proporcionam maior área de apoio em relação aos muares e equinos, em ordem decrescente, mesmo sendo dimensionalmente menores. Conclui-se que os cascos de equinos, muares e asininos apresentam padrões de equilíbrio geométrico específicos, que devem ser levados em consideração no momento do casqueamento e na inferência de desequilíbrios.(AU)

Morphology, development and heterochrony of the carapace of giant amazon river turtle podocnemis expansa (testudines, podocnemidae) / Morfologia, desenvolvimento e heterocronia da carapaça da tartagura da amazônia, podocnemis expansa (testudines, podocnemidae)

With aim to report the ontogeny of the osseous elements of the carapace in Peurodiras, 62 embryos and 43 nestlings of Podocnemis expansa were collected and submitted to the clearing and staining technique of bones and cartilages and study of serial histological slices. The carapace has mixed osseous structure of endo and exoskeleton, formed by 8 pairs of costal bones associated with ribs, 7 neural bones associated with neural arches, 11 pairs of peripheral bones, 1 nuchal, 1 pygal and 1 suprapygal. This structure begins its formation in the beginning of stage 16 with the ossification of the periosteal collar of the ribs. With exception of the peripheral bones, the other ones begin their ossification during the embrionary period. In histologic investigation it was found that the costal bones and neural bones have a close relation to the endoskeleton components, originating themselves as intramembranous expansions of the periosteal collar of the ribs and neural arches, respectively. The condensation of the mesenchyme adjacent to the periosteal collar induces the formation of spikes that grow in trabeculae permeated by fibroblasts below the dermis. The nuchal bone also ossifies in an intramembranous way, but does not show direct relation to the endoskeleton. Such information confirms those related to the other Pleurodira, mainly with Podocnemis unifilis, sometimes with conspicuous variations in the chronology of the ossification events. The formation of dermal plates in the carapace of Pleurodira and Criptodira follow the same pattern.

Com objetivo de relatar a ontogenia dos elementos ósseos da carapaça em Pleurodiras, coletaram-se 62 embriões e 43 filhotes de Podocnemis expansa que foram submetidos à técnica de clareamento e coloração dos ossos e cartilagens e pelo estudo cortes histológicos seriados. A carapaça possui estrutura óssea mista de endo e exoesqueleto, sendo formada por 8 pares de ossos costais associados às costelas, 7 ossos neurais associados aos arcos vertebrais, 11 pares de ossos periféricos, 1 nucal, 1 pigal e 1 supra-pigal. Esta estrutura começa sua formação no início do estágio 16 com a ossificação do colar periostal das costelas. Com exceção dos ossos periféricos, os demais iniciam sua ossificação durante o período embrionário. A investigação histológica explicitou que os ossos costais e neurais possuem uma estreita relação com componentes do endoesqueleto, originando-se como expansões intramembranosas do colar periostal das costelas e dos arcos neurais, respectivamente. A condensação do mesenquima adjacente ao colar periostal induz a formação de espiculas que crescem em trabéculas permeadas por fibroblastos abaixo da derme. O osso nucal, também se ossifica de maneira intramembranosa mas não apresenta relação direta com o endoesqueleto. Tais informações corroboram àquelas relatadas para os demais Pleurodiras, principalmente com Podocnemis unifilis, outrora com variações conspícuas na cronologia dos eventos de ossificação. A formação das placas dérmicas da carapaça em Pleurodira e Criptodira seguem um mesmo padrão.

Técnica venográfica contrastada in vivo dos dígitos de ovinos e caprinos / Contrast venography technique in vivo of the digits of sheep and goat

Foram utilizados 10 membros torácicos e pélvicos de ovinos e caprinos hígidos, de raça e sexo variados, com idade entre dois e quatro anos e peso corpóreo médio de 53kg. A porção distal dos membros torácicos e pélvicos foi submetida à técnica venográfica contrastada e à contagem vascular venosa da mesma região, em ambas as espécies. Não foram observadas diferenças numéricas em relação às veias entre machos e fêmeas, nem entre os membros direito e esquerdo da mesma espécie. Os ovinos possuem maior número de veias em relação aos caprinos. A técnica venográfica distal anterógrada de ambos os membros em ovinos e caprinos se mostrou aplicável revelando a vasculatura distal e podal, a comunicação entre os vasos venosos e a quantidade dos vasos presentes na região.

Ten forelimbs and hindlimbs of healthy sheep and goats, of varied breeds and gender with ages ranging between two and four years and an average body weight of 53kg were used in the study. The forelimbs and hindlimbs underwent a contrasted venography of the distal region. No numerical differences were observed in relation to veins between males and females and between the left and right members of the same species. Sheep had more veins than goats. The antiretrograde venography technique of both limbs in sheep and goats was proved to be applicable, showing the vasculazation of the distal region of the foot, the communication between the vessels and the quantity of vessels.