RESUMO
Dystocia is one of the main causes of calf death around calving. In addition, peripartum deaths may occur due to other factors, such as weather or predators, especially in the case of grazing animals. Precision Livestock Farming (PLF) tools aimed at the automatic detection of calving may be useful for farmers, allowing cow assistance in case of dystocia or checking the condition of the cow-calf pair after calving. Such PLF systems are commercially available for dairy cows, but these tools are not suitable for rangelands, mainly due to power and connectivity constraints. Thus, since most commercial PLF tools for rangelands are based on Global Navigate Satellite System (GNSS) technology, the objective of this study was to design and evaluate several indicators built from data gathered with GNSS collars to characterise their potential for the detection of calving on rangelands. Location data from 57 cows, 42 of which calved during the study, were curated and analysed following a standardised procedure. Several indicators were calculated using two different strategies. The first approach consisted of having indicators that could be computed using the data of a single GNSS collar (cow indicators). The second strategy involved the use of data from several animals (herd indicators), which requires more animals to be monitored, but may allow the characterisation of social behaviour. Several indicators, such as the length of the daily trajectory or the sinuosity of cow path, showed significant differences between the pre- and postpartum periods, but no clear differences between calving day and previous days. Herd indicators, such as the distance to herd centroid or to the nearest peer were superior in terms of the detection of calving day, as cows showed isolation behaviour from 24 hours before calving. Relative indicators, i.e., the value of cow or herd indicators for the calving cow in relation to the average value of the same indicators for its herdmates, provided additional information on cow behaviour. For instance, according to the relative indicator for the change in daily trajectory, pregnant cows had a differential exploratory behaviour up to 14 days before calving. In conclusion, data from commercial GNSS collars proved to be useful for the computation of several indicators related to the occurrence of calving on rangelands. Some of those indicators showed changes from baseline values on the day before calving, which could serve to predict the onset of parturition.
Assuntos
Doenças dos Bovinos , Distocia , Feminino , Gravidez , Animais , Bovinos , Humanos , Distocia/veterinária , Comportamento Exploratório , Fazendeiros , Gado , PartoRESUMO
Recurrent pyogenic cholangitis, or oriental cholangiohepatitis, is highly prevalent in Southeast Asia where it is a common cause of attendance at emergency centers. Sporadic cases have been described outside these areas, especially in asian immigrants but its appearance in westerners is exceptional. We present a case of this disease in a western patient and discuss aspects of its diagnosis and therapy.
Assuntos
Colangite/diagnóstico , Colangite/complicações , Colangite/terapia , Doença Crônica , Febre/complicações , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Autoantibodies are prominent findings in the diagnosis of autoimmune liver diseases. However, their usefulness is limited due to the high reported prevalence in others nonautoimmune disorders. The purpose of this report was to assess the significance of these markers in patients with autoimmune liver diseases and to determine the prevalence of extrahepatic autoimmune phenomena. METHODS: We evaluated the samples from all the patients with altered biochemical liver parameters (ALT, AST, alkaline phosphatase or bilirubin) and a complete profile of autoimmunity [Anti-nuclear (ANA), anti-mitocondrial (AMA), anti-smooth muscle (SMA) and anti-liver/kidney microsomes (LKM1) antibodies] received in the Immunology Laboratory from 1993 to 1996. The records of the patients with at least one positive serologic marker were retrospectively reviewed. Autoimmune liver diseases (Autoimmune hepatitis (AIH), Primary biliary cirrhosis (PBC) and Overlap syndromes) were diagnosed according to composite clinical, analytical, histological or response-to-treatment parameters. RESULTS: Samples from 548 patients were analyzed. Of these 85 (15.5%) were positive for at least one antibody. Disorders and autoantibodies were: Autoimmune liver diseases: 18 (4 AIH, 11 PBC, 3 Overlap syndromes); alcohol-induced liver disease: 14 (5 ANA, 9 SMA), Chronic HCV infection: 28 (9 ANA, 17 SMA, 2 ANA + SMA), Chronic HCV + AIH: 2 (1 ANA, 1 ANA + SMA); other liver diseases: 7 (4 ANA, 1 AMA, 2 SMA); other diseases with liver involvement: 10 (8 ANA, 2 SMA); no liver disease (normal): 6 (3 ANA, 1 AMA, 2 SMA). In 75% (64/85) of the positivities processes regarded as immunological liver disease were not found. We identified in 12 out of 20 patients with autoimmune liver diseases others autoimmune extrahepatic processes; in 4 before a diagnosis of liver disease was made. CONCLUSIONS: Autoimmune serologic markers are useful in the study of liver diseases. However, due to inespecifity each individual patient deserves a careful evaluation. Autoimmune extrahepatic manifestations are often found and in some cases allow to recognize the hepatic involvement.
Assuntos
Autoanticorpos/sangue , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/epidemiologia , Hepatopatias/diagnóstico , Hepatopatias/imunologia , Doenças Autoimunes/sangue , Biomarcadores/sangue , Humanos , Hepatopatias/sangue , Prevalência , Estudos RetrospectivosRESUMO
OBJECTIVE: To establish the time elapsed from the patient arrival to the emergency room to the beginning of antibiotic therapy. To identify etiologic factors for treatment delay. METHODS: 73 patients diagnosed of bacterial meningitis in the emergency room and admitted to the hospital were studied. Patient characteristics as well as meningitis predisposing factors, symptoms, physical examination, laboratory data, radiological studies and previous ambulatory treatment, were recorded retrospectively. Arrival time, time expended at diagnostic procedures and time of administration of the first antibiotic dose, as well as the administration place were registered. Patients clinical evolution, and factors influencing the delay of antibiotic administration were analyzed. RESULTS: Median age was 17 years. Patient care was evenly distributed along the day, 80% had a light base risk, 29% had at least a risk factor for meningitis, 22% received antibiotic previously. Clinical presentation was classic in more than 71% of patients. Blood cultures were positive in 41%, and CSF cultures were positive in 63%, 43% of cases were related to Neisseria meningitidis, 20% Streptococcus pneumoniae and unknown bacteria in 31.5%. Computerized Tomography (CT) was performed in 9 cases. Median time from the arrival to the Emergency Room until antibiotic administration was 5 hours and 25 minutes: When antibiotics were given before Lumbar Puncture (LP), it was 2 hours and 50 minutes, 5 hours 20 minutes when therapy was started after LP, and 7 hours and 22 minutes when CT was performed before LP. The only factor showing a statistically significant relation with the time to antibiotic administration was the patient being sent by the primary care physician to the hospital with a presumptive diagnosis of bacterial meningitis (1 hour 20 minutes vs. 5 hours 51 minutes). CONCLUSION: Only a small part of bacterial meningitis cases start antibiotic treatment in the first 30 minutes. Delay is high and it increases when certain diagnostic tests are performed. Information received from the primary care physician, has the highest influence on the beginning of treatment.
Assuntos
Serviço Hospitalar de Emergência , Meningites Bacterianas/diagnóstico , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Hospitais com 300 a 499 Leitos , Humanos , Masculino , Meningites Bacterianas/tratamento farmacológico , Meningites Bacterianas/microbiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Espanha , Fatores de TempoRESUMO
At the present time, it has been clearly demonstrated that at home oxygen therapy either on a long term basis or on a continuous basis brings important benefits for a patient: his/her physical and neuro-psychological conditions improve and his/her quality of life increases. However, given that this is some controversy about its indications, therapeutic effects and manner to administrate it, the authors review all these aspects, drawing from very up-to-date bibliographical references. At a later date, in another article, these same authors will evaluate nursing treatment corresponding directly to at home oxygen therapy.
Assuntos
Serviços de Assistência Domiciliar/organização & administração , Oxigenoterapia/métodos , Oxigenoterapia/enfermagem , Humanos , Pneumopatias Obstrutivas/psicologia , Pneumopatias Obstrutivas/terapia , Oxigenoterapia/efeitos adversos , Oxigenoterapia/psicologia , Cooperação do Paciente/psicologiaRESUMO
The authors present a brief historical summary of the use of oxygen therapy in a patient's home from its start in 1970 to the present time, analyzing the controversies which have developed and the interest in oxygen therapy in a patient's home. For a review of the indications, initial evaluation, requirements and dose of this treatment, one should consult the article written by these authors published in Revista Rol de Enfermeria 2000; 23(4):257-261. In continuation, the authors explain the main nursing care which a patient receiving oxygen therapy at home requires, the circumstances which can compromise its efficiency, its secondary effects and complications, and the follow-up that is necessary to carry out on patients using this therapy.
Assuntos
Enfermagem em Saúde Comunitária/organização & administração , Serviços de Assistência Domiciliar/organização & administração , Oxigenoterapia/métodos , Oxigenoterapia/enfermagem , Assistência ao Convalescente , Humanos , Oxigenoterapia/efeitos adversos , Fatores de RiscoRESUMO
BACKGROUND: Linguistic inquiry and word count (LIWC), a computerized method for text analysis, is often used to examine suicide writings in order to characterize the quantitative linguistic features of suicidal texts. AIMS: To analyze texts compiled in Marilyn Monroe's Fragments using LIWC, in order to explore the use of different linguistic categories in her narrative over the years. METHOD: Selected texts were grouped into four periods of similar word count and processed with LIWC. Spearman's rank correlation was used to assess changes in language use across the documents over time. The Kruskal-Wallis test was applied to compare means between periods and for each of the 80 LIWC output scores. RESULTS: Significant differences (p < .05) were found in 11 categories, the most relevant being a progressive decrease in the use of negative emotion words, a reduction in the use of long words in the third period, and an increase in the proportion of personal pronouns used as Monroe approached the time of her death. CONCLUSIONS: The consistently elevated usage of first-person personal singular pronouns and the consistently diminished usage of first-person personal plural pronouns are in line with previous studies linking this pattern with a low level of social integration, which has been related to suicide according to different theories.
Assuntos
Pessoas Famosas , Linguística , Filmes Cinematográficos/história , Semântica , Ideação Suicida , Suicídio/história , Redação , Adulto , Feminino , História do Século XX , Humanos , Estados UnidosRESUMO
In Drosophila, the GATA family transcription factor Pannier and the Wnt secreted protein Wingless are known to be important for the patterning of the notum, a part of the dorsal mesothorax of the fly. Thus, both proteins are necessary for the development of the dorsocentral mechanosensory bristles, although their roles in this process have not been clarified. Here, we show that Pannier directly activates the proneural genes achaete and scute by binding to the enhancer responsible for the expression of these genes in the dorsocentral proneural cluster. Moreover, the boundary of the expression domain of Pannier appears to delimit the proneural cluster laterally, while antagonism of Pannier function by the Zn-finger protein U-shaped sets its limit dorsally. So, Pannier and U-shaped provide positional information for the patterning of the dorsocentral cluster. In contrast and contrary to previous suggestions, Wingless does not play a similar role, since the levels and vectorial orientation of its concentration gradient in the dorsocentral area can be greatly modified without affecting the position of the dorsocentral cluster. Thus, Wingless has only a permissive role on dorsocentral achaete-scute expression. We also provide evidence indicating that Pannier and U-shaped are main effectors of the regulation of wingless expression in the presumptive notum.
Assuntos
Padronização Corporal/fisiologia , Proteínas de Ligação a DNA/genética , Proteínas de Drosophila , Drosophila/embriologia , Regulação da Expressão Gênica no Desenvolvimento , Proteínas Proto-Oncogênicas/metabolismo , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Animais , Animais Geneticamente Modificados , Sequência de Bases , Fatores de Transcrição Hélice-Alça-Hélice Básicos , Drosophila/genética , Elementos Facilitadores Genéticos , Proteínas de Insetos/genética , Dados de Sequência Molecular , Mosaicismo , Mutagênese Sítio-Dirigida , Sistema Nervoso/embriologia , Proteínas Recombinantes/biossíntese , Proteínas Repressoras/genética , Proteínas Repressoras/metabolismo , Tórax , Proteína Wnt1 , Dedos de ZincoRESUMO
A retrospective study of cases of paronychia associated with anti-retroviral therapy diagnosed in two general hospitals is here reported. Lesions appeared from 3 and 48 months after institution of therapy. At diagnosis, 84.6% of patients were on indinavir therapy. CD4 values ranged from 120 and 1,332 cells/mm3 and viral load was lower than 200 copies/ml in 92.3 of cases. Conservative therapy was applied in 7 patients and surgery in 6. In all patients indinavir therapy was discontinued, and cure was achieved 16 weeks later. The "retinoid" effect of indinavir is discussed as likely pathogenic explanation for this complications. We advocate for topic therapy and change of anti-retroviral therapy, reserving surgery for patients not responding to therapy. Pain and functional limitation caused by this non uncommon complication (1.6% of our patients treated with anti-retroviral agents) makes its knowledge necessary and an active search by clinicians in patients receiving indinavir therapy.
Assuntos
Infecções por HIV/tratamento farmacológico , Inibidores da Protease de HIV/efeitos adversos , Indinavir/efeitos adversos , Paroniquia/induzido quimicamente , Adulto , Feminino , Humanos , Masculino , Estudos RetrospectivosRESUMO
We present a prospective study about 100 intravascular catheters inserted into 88 newborns. 35 positive blood cultures were obtained; 19 with clinical signs of sepsis and 16 in asymptomatic newborns. Coagulase-negative Staphylococci were the most common isolated organisms -84.2% in the symptomatic cases, 100% in the asymptomatic ones. A comparative study was realized between cases of catheter-related sepsis with positive blood culture of coagulase-negative Staphylococcus (n = 14) versus asymptomatic cases with positive blood culture (n = 16). Risk factors in the appearance of symptoms are: prematurity, newborns old age when catheters are inserted and days of catheter placement.
Assuntos
Infecções Bacterianas/microbiologia , Cateterismo/efeitos adversos , Coagulase , Doenças do Prematuro/microbiologia , Infecções Estafilocócicas/etiologia , Staphylococcus/enzimologia , Infecções Bacterianas/mortalidade , Cateteres de Demora , Infecção Hospitalar/microbiologia , Humanos , Recém-Nascido , Doenças do Prematuro/diagnóstico , Doenças do Prematuro/mortalidade , Estudos Prospectivos , Espanha , Infecções Estafilocócicas/enzimologia , Infecções Estafilocócicas/mortalidade , Artérias Umbilicais/microbiologia , Veias Umbilicais/microbiologiaRESUMO
A 5 years old girl with status epilepticus refractory to treatment with Diphenylhydantoin at a dose of 30 mg/kg/day and Thiopental in continuous IV perfusion at a dose of 4 mg/kg/h is presented. Control of status was achieved by continuous IV perfusion of Chlormethiazole at a dose of 10 mg/kg/h which also caused respiratory depression. Seizure activity reappeared after IV perfusion of Chlormethiazole was retired, and could be controlled only with Sodium Valproate. Mechanisms of action of Chlormethiazole and its effectiveness in treatment of refractory status epilepticus are revised.