Background and aims
In Europe, the antimicrobial use (AMU) for food‐producing animals has decreased rapidly. However, studies indicate that a too strict policy, with too restrictive AMU, is ...potentially problematic for veterinarians because it threatens animal welfare and creates tensions between farmers and veterinarians. The AMU in Sweden is among the lowest in Europe, and regulation of AMU in farm animals is strict. The aim of our study was to explore how Swedish veterinarians describe the relations between (1) being restrictive with antibiotics due to the risk of AMR and (2) concerns for animal welfare and/or the veterinarian‐client relationship.
Methods
Semi‐structured interviews with 21 veterinarians, working with dairy cattle, were performed. The transcripts were analysed, and a number of dominant patterns which recurred in all, or most of, the interviews were identified.
Result
The interviewed veterinarians described AMR prevention and tackling the threat AMR poses towards public health, as central for their profession and as influencing their everyday practice and decisions on AMU. Importantly, veterinarians described accounting for AMR in everyday practice as fairly unproblematic, both in relation to animal welfare as well as in relation to farmers. The veterinarians generally perceived that they could treat animals with antibiotics when justified, and being restrictive with antibiotics was described as an expression of professional skill and not as challenging as animal welfare. Moreover, they stated that restrictive AMU seldom or never caused conflicts with farmers.
Conclusion
Strict AMU policy and restrictive AMU do not necessarily put veterinarians in a problematic position where they are caught between conflicting demands and risks.
Diagnosis of pulmonary arterial hypertension (PAH) is difficult due to the lack of specific clinical symptoms and biomarkers, especially at early stages. We compared plasma metabolic fingerprints of ...PAH patients (n = 20) with matched healthy volunteers (n = 20) using, for the first time, untargeted multiplatform metabolomics approach consisting of high-performance liquid and gas chromatography coupled with mass spectrometry. Multivariate statistical analyses were performed to select metabolites that contribute most to groups' classification (21 from liquid in both ionization modes and 9 from gas chromatography-mass spectrometry). We found metabolites related to energy imbalance, such as glycolysis-derived metabolites, as well as metabolites involved in fatty acid, lipid and amino acid metabolism. We observed statistically significant changes in threitol and aminomalonic acid in PAH patients, which could provide new biochemical insights into the pathogenesis of the disease. The results were externally validated on independent case and control cohorts, confirming up to 16 metabolites as statistically significant in the validation study. Multiplatform metabolomics, followed by multivariate chemometric data analysis has a huge potential for explaining pathogenesis of PAH and for searching potential and new more specific and less invasive markers of the disease.
Actinic cheilitis is thought to be a premalignant lesion or a superficial squamous cell carcinoma. The prevalence of actinic cheilitis in Europe is unknown. The aim of this study was to determine the ...prevalence of actinic cheilitis in the Galicia region (north-west Spain). Secondary objectives were the description of risk factors of actinic cheilitis. A cross-sectional multicentre study in patients ≥ 45 years of age was performed in 8 dermatology departments in Galicia region during a 1-year period. The prevalence of actinic cheilitis was 31.3%. Significant and independent risk factors of actinic cheilitis after multivariate analysis were age ≥ 60 years, Fitzpatrick skin phototype II, outdoor working for more than 25 years, and previous history of non-melanoma skin cancer. This is the first cross-sectional multicentre study of the prevalence of actinic cheilitis in Europe. Actinic cheilitis was present in almost one-third of the screened patients. Lip examination should be performed in all patients with chronic actinic damage.
Aim
The rapid spread of a novel human coronavirus SARS‐CoV‐2 led to drastic measures world‐wide. Most countries were forced to declare a national lockdown. We studied the effect of lockdown measures ...on the level of asthma control and maintenance treatment in children with recurrent wheezing and asthma during the first wave of COVID‐19 in Spain.
Methods
We analysed children with recurrent wheezing or asthma before and after the implementation of the lockdown, by using a questionnaire aimed to examine pre‐existing respiratory disorders, step treatment and level of asthma control before/after lockdown, COVID history and laboratory testing including IgG SARS‐CoV‐2.
Results
We enrolled 475 asthmatic and pre‐school wheezers (60.6% males), mean age 5.6 years. There were no differences in asthma treatment comparing both periods: 81.7% maintained the same treatment (P = 0.103). According to child asthma‐control questionnaire, 87.7% remained well controlled during confinement. Nearly, a third of children (34.9%) needed reliever treatment, mainly in older children. Determination of IgG SARS‐CoV‐2 was performed in 233 children (49.1%) of whom 17 (7.3%) tested positive. Seven patients positive to IgG SARS‐CoV‐2 were assisted in the emergency department and two required hospital admission.
Conclusions
During COVID‐19 lockdown in Spain, most children with recurrent wheezing and asthma remained well controlled from their underlying disease and did not modify greatly their maintenance treatments. Unexpectedly, we also observed that those children who tested positive to SARS‐CoV‐2 IgG showed a significant increase in paediatric hospital admissions and attendances to urgent care settings.
Giant sigmoid diverticulum de Armas-Conde, María; Hernández-Alonso, Ricardo; Concepción-Martín, Vanessa ...
Revista española de enfermedades digestivas,
09/2023, Letnik:
116, Številka:
9
Journal Article
Recenzirano
Odprti dostop
Unlike acute diverticulitis, giant diverticulum larger than 4 cm is a rare entity with few cases described in the literature. We present a case of a 66-year-old male patient diagnosed with colonic ...diverticulosis. He presented to the emergency department with symptoms of acute abdomen and was diagnosed by CT scan with a 13x14 cm giant diverticulum showing signs of complication. Given the findings, an urgent surgical intervention was decided, and diverticulectomy at the diverticular neck was performed using an endostapler. The etiology of giant diverticula is related to a mechanism of one-way valve at the diverticular neck. Diagnosis poses a challenge as the clinical presentation is nonspecific. The imaging modality of choice is CT scan, which reveals a large cystic image dependent on the sigmoid colon. Definitive treatment is surgical, either by resecting the affected segment including the lesion or by performing a simple diverticulectomy in uncomplicated cases.
The use of topical and intralesional immunotherapy in the treatment of cutaneous malignant neoplasia in sensitive areas such as the lips and eyelids is discussed. Surgery may not be feasible or may ...result in deformities in these areas, making alternative treatment options necessary. A narrative literature review was conducted using MEDLINE (PubMed) as the main literature database, collecting available evidence of experiences with various topical and intralesional therapies in the aforementioned anatomical locations, ranging from case reports to clinical trials. The clearance rates and potential adverse reactions of therapeutic options such as imiquimod 5%, 5-fluorouracil (5-FU), photodynamic therapy (PDT), ingenol mebutate (IM), diclofenac, intralesional methotrexate, and interferon are reviewed. Although limited by their heterogeneity and the scarcity of clinical trials, these studies point towards promising response rates and minimal adverse effects, making these treatments viable options in selected cases.
This article discusses how the future Emissions Trading Scheme legislation should be designed to allow the European Union to comply with the 20% CO
2 emissions reduction target, while at the same ...time promoting wind energy investments. We examine whether CO
2 prices could eventually replace the existing support schemes for wind and if they adequately capture its benefits. The analysis also looks at the effectiveness of the clean development and joint implementation mechanisms to trigger wind projects and technology transfer in developing countries. We find out that climate policy is unlikely to provide sufficient incentives to promote wind power, and that other policies should be used to internalise the societal benefits that accrue from deploying this technology: CO
2 prices can only reflect the beneficial impact of wind on climate change but not its contribution to the security of supply or employment creation. A minimum price of around €40/tCO
2 should be attained to maintain present support levels for wind and this excludes income risks and intermediation costs. Finally, CDM improves the return rate of wind energy projects in third countries, but it is the local institutional framework and the long-term stability of the CO
2 markets that matters the most.
The purpose of this study was to compare animal health in compost-bedded pack (CBP) and cubicle housing (CH) systems using data from dairy herd improvement associations. Thirty-two commercial dairy ...farms located in Austria, Germany, Italy, The Netherlands, Slovenia, and Sweden were included in the study. A matching design (pairing CBP and CH within country) according to herd selection criteria was used. We explored the following health indicators: somatic cell counts (SCC), high SCC, new high SCC, ketosis risk, prolonged calving intervals, dystocia, and stillbirth. Traits for culling and culling-related issues, such as length of life and length of productive life, were also included. We used multivariable (mixed) linear and logistic regression models to evaluate differences between the systems. Udder health, as measured by SCC, was inferior in CBP, although the geometric means were low in both systems. The incidence of stillbirths was higher in CBP, while prolonged calving intervals were fewer, indicating that there were fewer reproductive disorders. There were no differences in longevity between the systems, although CBP had lower proportions of first calvers. Overall, we conclude that there were few and minor differences in health and longevity between the CBP and CH systems in the European context.
Calves are very susceptible to stress in the early stages of life, and it is necessary to ensure maximum welfare. Feeding management has been identified as a major risk factor for calf health and ...welfare at this stage. However, the management protocol for calf rearing and its impact on animal welfare is unclear. A systematic review of different management strategies for rearing dairy calves according to the three spheres of animal welfare was conducted using an electronic search strategy. In this review, management strategies were studied to identify scientific gaps, to know the welfare problems of these animals in order to prioritize actions and future research and to study the interpretive approach of this management from the three welfare spheres.
A protocol was used to analyze and extract information from the studies. Of the 1,783 publications screened, only 351 met the inclusion criteria for the management or welfare of calves' items.
The publications identified in the search can be divided into two main groups feeding and socialization, based on the main topic of the publication. The main topics that emerged from the search in the feeding management group were milk replacer, colostrum, and weaning, divided into the three main areas of biological functioning and health, natural life and affective states or cognitive judgement.
The main issues to be addressed were the different types of feed consumed by animals from birth to weaning and the weaning management. It has been found that the most researched issues are colostrum and solid starter feed management. Unresolved issues were highlighted, such as the lack of a clear protocol for the administration of milk replacers to reduce hunger and the best management of weaning to reduce stress.
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