Endophthalmitis is one of the leading sources of dispute in ophthalmology. The patient has a number of means to make an appeal. Fortunately, appeal to the criminal justice system is rare in medicine, ...but always possible (e.g., indictment for endangering the life of others or for involuntary injury). Civil action is more frequent, allowing the patient to recover damages in case of negligence on the part of the surgeon. Finally, the law of March 4th 2002 allows the CRCI to award an indemnity to patients if the surgeon is not at fault, but in certain conditions only. The knowledge of the surgeon's obligations and the means of appeal available to the patient is very useful for the ophthalmologist.
The feasibility of using electrokinetic phenomena for contaminant removal from low-permeability porous media is investigated by laboratory experiments and theoretical modeling. The main processes by ...which contaminant transport takes place under a dc electric field in soil are electromigration, electro-osmosis and electrophoresis. They are particularly effective in fine-grained soils, which is not the case for pressure-driven flushing. Meanwhile, although the results of various studies on a laboratory scale suggest that electrokinetics is a promising technology for water soluble contaminant removal, further research is needed at both laboratory and field scales in order to determine the effectiveness of this technology in situ and in the case of non-soluble organic matter such as heavy hydrocarbons. First, this paper describes the electrochemical processes occurring in soil under an electric field. Then the electro-osmosis phenomenon is more particularly investigated in a theoretical and experimental way. Furthermore, the main previous work on the subject is summarized, and experiments conducted in the laboratory on decontamination by electric field of clay samples polluted by motor oil, are presented.
To assess with truly long follow-up the long-term results of valve replacement with the St. Jude Medical prosthesis (St. Jude Medical, Inc., St. Paul, Minn.), we reviewed the case histories of the ...first 1112 patients undergoing 1244 valve replacements with this valve between June 12, 1978, and June 12, 1987: 690 male (62%) and 422 female patients, mean age 56 years. A total of 773 patients (69%) had the aortic valve replaced, 207 (19%) the mitral valve, and 132 (12%) the aortic and mitral valves. There were 42 hospital deaths (3.8%). Follow-up was 97.5% complete (8988 patient-years). There were 213 late deaths. Ninety-one (43%) were considered valve-related: sudden death,
n = 27; anticoagulant-related hemorrhage,
n = 22; thromboembolism,
n = 19; prosthetic valve endocarditis,
n = 13; valve thrombosis,
n = 9; and noninfectious perivalvular leak,
n = 1. Overall actuarial survival, including hospital mortality, was 68% ± 6% (95% confidence limits) 14 years after the operation. Linearized rates of late valve-related events were as follows: thromboembolism, 1.09% per patient-year; anticoagulant-related hemorrhage, 0.94% per patient-year; prosthetic valve endocarditis, 0.32% per patient-year; valve thrombosis, 0.33% per patient-year; and perivalvular leak, 0.19% per patient-year. Actuarial freedom, at 14 years, from thromboembolism was 89% ± 3%, anticoagulant-related hemorrhage 83% ± 8%, valve thrombosis 97% ± 1%, and reoperation 95% ± 3%. Actuarial freedom from all valve-related deaths and valve-related morbidity and mortality, at 14 years, was 84% ± 6% and 61% ± 8%, respectively. We conclude that, because of its low thrombogenicity, low incidence of valve-related events, and low valve-related mortality, the St. Jude Medical valve is one of the best performing mechanical prosthesis currently available. Nevertheless, the late valve-related complications and deaths illustrate that the quest for a "perfect" prosthesis remains unfulfilled. (J T
HORAC C
ARDIOVASC S
URG 1995;109:858-70)
The negative relationship between intake and digestibility of an unchanging diet has been widely described. The review of the different processes of ruminal digestion shows that the main cause of the ...variation in digestibility is the retention time of particles in the rumen. However, most experiments have been carried out at levels of intake higher than maintenance. For this reason, a special attention is paid to experiments carried out at low levels of intake. In these conditions, the response of digestibility to a decrease in intake is variable: it can increase, be stable or decrease. Up till now, it has not been possible to determine the animal or nutritional factors which influence the way of variation, and especially the unexpected decrease in digestibility. However, it has been clearly shown that these decreases are not due to an insufficient retention time of particles in the rumen, or to an insufficient reduction of particle size. Differences in microbial activity have not been exhibited by in situ measurements. It is hypothesised that a reduction of bacterial growth, or of the expression of microbial degradation potential occurs at very low intakes, but mechanisms are still not elucidated. The decrease in weight and oxygen uptake by the digestive tract contributes to the adaptation of animals maintenance requirements. At short term, the proportion of metabolisable energy intake which is recovered in the portal vein remains unchanged when animals are underfed but the supply of absorbable amino acids (AAs) cannot keep up with the gut requirements. The consequences of underfeeding on nutrition and absorption do not differ between small ruminants and cattle.
A survey was carried out on milk production and reproductive performance of dairy cattle: 24 farms, with a total of 900 animals and distributed in four agro-ecological zones, were visited every 15 ...days over 18 months. Cows were fed on natural pastures as the only source of feed, and animal performance was dependent on the season and exhibited a dramatic drop in dry spells. Numeric productivity indices integrating productive performance for settler's, multipurpose, crop-livestock integrated and modern farms were 0.56, 0.74, 0.69 and 0.63, respectively. Milk productivity was higher on modem farms (6.7 L/cow per day) than in the other systems, and higher with Holstein-Friesian cows (7.7 L/cow per day) than with indigenous cattle (1.8 L/cow per day) or crossbred animals (3.7 L/cow per day). This paper speculates on the opportunity to improve the genetic potential of indigenous cattle, concomitantly with the efforts to adapt exotic cattle to a mountainous equatorial environment.
The basic diet of ruminants in Mauritius comprises mainly tropical forages, whose productivity is highly dependent on the season. Dry matter concentrations and nutritive value of the three most ...important grasses (Bothriochloa pertusa, Cynodon plectostachyus and Ischaemum aristatum) on Mauritius were measured on three occasions during the year. They showed an increase in dry matter concentration and a decrease in nutritional value at the end of the dry season, more marked for farms located in the coastal region. To allow animals to meet their nutrient requirements, farmers have to adapt their practices (supplementary feeding, rotational grazing, and fertilization) to the seasonal changes on the island.
Dans les Hauts de la Réunion, l’élevage bovin constitue la principale activité agricole. L’élevage naisseur « professionnel » représente 8828 vaches mères pour 497 exploitations. Ce sont des ...exploitations de taille modeste (18 vaches mères en moyenne) dont les performances animales sont en-deçà de leurs homologues métropolitaines. L’objectif de l’étude est d’analyser les pratiques des éleveurs naisseurs et d’en faire le lien avec les performances obtenues afin d’identifier des voies d’amélioration potentielles. Pour cela, 10 éleveurs ont fait l’objet d’un suivi de 1999 à 2002, qui était fondé sur l’évaluation des performances des animaux et sur l’enregistrement des pratiques des éleveurs en particularisant l’allotement, la gestion du pâturage et la complémentation alimentaire. Cet article montre que les pratiques sont variées et conditionnées par des objectifs de production différents : stratégies de maximisation des performances ou du chargement, simplification de la conduite.
The effect of extended underfeeding on digestion was studied in dairy cows. Four nonlactating cows (BW = 747 kg) were first fed a forage-based diet at a level above energy maintenance requirements ...for 7 wk (9.4 kg DM/d) then were restricted at a low level of intake of the same diet for 5 mo (5.2 kg DM/d), then refed at the first level. Digestion measurements were made before and after the underfeeding period, and at 1, 5, 9, and 19 wk of underfeeding. Organic matter digestibility decreased with underfeeding then increased (62.7, 56.2, and 61.5% before, 1 wk after, and 19 wk after underfeeding, respectively). Differences in ruminal apparent OM digestion were nonsignificant (P > 0.05). This lack of difference was related to the absence of variation of ruminal particle passage rate and DM degradability measured in situ. However, the decrease in feed intake decreased ruminal (P < 0.01) and intestinal (P < 0.05) liquid dilution rates, ruminal DM pool size and DM content (P < 0.01), and protozoa concentration (P < 0.01). The decrease (P < 0.01) in N retention with underfeeding was followed by an increase (P < 0.05) during the underfeeding period, due to a decrease in fecal and urine N losses. This experiment has shown an unusual and temporary response of digestion to underfeeding. Knowledge of adaptation of digestion to low intakes needs to be improved.
Brucellosis is an important zoonotic disease in developing countries yet it is often not recognized, goes unreported and does not attract public health action by these governments including Uganda.
...To estimate the sero-prevalence and assess modifiable risk factors associated with Brucella seropositivity in cattle keepers and consumers of unpasteurized milk in Uganda.
One group comprised of 161 individuals randomly selected from households living on farms that had Brucella sero-positive cattle and/or goats in Mbarara District from an earlier survey; the second group comprised of 168 randomly selected individuals attending an HIV voluntary counseling and testing clinic in Kampala District. Sera samples were tested using Rapid Plate Agglutination Test, Standard Tube Agglutination Test and cELISA.
The sero-prevalence of brucellosis among exposed cattle keepers in Mbarara and consumers of unpasteurised milk in Kampala Districts was 5.8% (95%CI: 3.3%, 8.3%) and 9% (95%CI: 13.3%, 4.7%), respectively. Consumption of unboiled milk was significantly (p=0.004) associated with seropositivity in Mbarara District. There was no association between sero-positivity with age, sex and awareness of human brucellosis.
Human brucellosis is prevalent among livestock rearing communities and consumers of unpasteurised milk. The continued consumption of unboiled milk is a major health risk.
The effect of drastic undernutrition was studied in Bos indicus cows. Four nonlactating cows (body weight = 208kg) fitted with ruminal cannulas were used in a crossover design. They received, in two ...1-mo periods, a diet of 80% rice straw and 20% cotton-seed meal fed either at energy maintenance 3.91kg of dry matter (DM)/d or at one-third of this intake (1.30kg of DM/d). The variation in digestibility was studied in relation to particle retention time and microbial events. Organic matter digestibility decreased with underfeeding (64.5 and 53.7%, respectively, at high and low intakes) without modification of mean ruminal or total tract retention times. This lower digestibility can be related to a decrease in protozoal population in the rumen; however, other characteristics of microbial activity did not vary, such as in situ DM degradability (41.9 and 43.3%, respectively, at high and low intakes) and ruminal soluble Ca concentration, a factor involved in the attachment of microorganisms to feed particles. Mean size of ruminal particles was not modified, although more time spent chewing was observed at the low intake (165 and 221 min/kg of DM intake, respectively, at high and low intakes). This experiment confirms that, at intakes below maintenance, digestibility can decrease when feed intake is restricted, contrary to the general view described in the literature.
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