Perfusion of Muscle Flaps Independent of the Anatomical Vascular Pedicle: Pedicle Autonomy

Free muscle flaps are being used more commonly for complex lower limb reconstruction. Up to 33% of flaps used to reconstruct lower limb trauma will require an orthopaedic procedure after reconstruction. To date there have been only case reports detailing the variable survival of muscle flaps after actual or simulated pedicle injury and the process and timeframe of neovascularisation remains undefined. We aim to show that perfusion of a muscle flap is possible after injury to its anatomical vascular pedicle.

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Ultraviolet A photosensitivity profile of dexchlorpheniramine maleate and promethazine-based creams: Anti-inflammatory, antihistaminic, and skin barrier protection properties

Summary

Background

Unwanted side effects such as dryness, hypersensitivity, and cutaneous photosensitivity are challenge for adherence and therapeutical success for patients using treatments for inflammatory and allergic skin response.

Aims

In this study, we compared the effects of two dermatological formulations, which are used in inflammatory and/or allergic skin conditions: dexchlorpheniramine maleate (DCP; 10 mg/g) and promethazine (PTZ; 20 mg/g).

Methods

We evaluated both formulations for phototoxicity potential, skin irritation, anti-inflammatory and antihistaminic abilities, and skin barrier repair in vitro and ex vivo using the standard OECD test guideline n° 432, the ECVAM protocol n° 78, and cultured skin explants from a healthy patient. Ultraviolet A was chosen as exogenous agent to induce allergic and inflammatory response.

Results

Both PTZ and DCP promoted increases in interleukin-1 (IL-1) synthesis in response to ultraviolet A (UVA) radiation compared to control. However, the increase observed with PTZ was significantly greater than the DCP, indicating that the latter has a lower irritant potential. DCP also demonstrated a protective effect on UVA-induced leukotriene B4 and nuclear factor kappa B (NF-κB) synthesis. Conversely, PTZ demonstrates more robust UVA antihistaminic activity. Likewise, PTZ promoted a significantly greater increase in the production of involucrin and keratin 14, both associated with protective skin barrier property.

Conclusion

In conclusion, these data suggest possible diverging UVA response mechanisms of DCP and PTZ, which gives greater insight into the contrasting photosensitizing potential between DCP and PTZ observed in the patients.

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Ad libitum milk replacer feeding, but not butyrate supplementation, affects growth performance as well as metabolic and endocrine traits in Holstein calves

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): D. Frieten, C. Gerbert, C. Koch, G. Dusel, K. Eder, E. Kanitz, J.M. Weitzel, H.M. Hammon
The enhanced growth performance of calves fed a higher plane of nutrition pre-weaning is well documented, and the effect of butyrate on the development of the gastrointestinal tract in calves has been evaluated. The aim of this study was to examine the synergistic effects of ad libitum milk replacer (MR) feeding and butyrate supplementation on growth performance and energy metabolism in calves. Sixty-four (32 male, 32 female) Holstein calves were examined from birth until wk 11 of life. Calves received MR either ad libitum (Adl) or restrictively (Res) with (AdlB+, ResB+) or without (AdlB−, ResB−) 0.24% butyrate supplementation. Colostrum and transition milk were fed in predefined amounts (Res or Adl) for the first 3 d postpartum. Ad libitum and restrictive MR feeding with or without butyrate was performed from d 4 until wk 8 of age. From wk 9 to 10, all calves were gradually weaned and were fed 2 L/d until the end of the trial. Concentrate (CON), hay, and water were freely available. Intakes of MR and CON were measured daily. Calves were weighed at birth and weekly thereafter. Blood was drawn on d 1 before the first colostrum intake; on d 2, 4, and 7; and weekly thereafter until the end of the study to measure plasma concentrations of metabolites and hormones. Liver samples were taken at d 50 and at the end of the study to determine gene expression related to glucose metabolism. Milk, MR, and total nutrient intake were greater, but CON intake was lower in Adl than in Res calves, resulting in a greater body weight, but partially lower gain to feed ratio in Adl than in Res. Plasma concentrations of glucose and insulin were higher during the ad libitum milk-feeding period, whereas plasma β-hydroxybutyrate was lower in Adl than in Res. Plasma concentrations of nonesterified fatty acids, lactate, total bilirubin, and cortisol were lower, but triglyceride and cholesterol concentrations were higher in Adl than in Res at specific time points. Feed intake, growth performance, and metabolic and endocrine changes were insignificantly affected by butyrate, and hepatic gene expression of enzymes related to endogenous glucose production was barely influenced by ad libitum MR feeding and butyrate supplementation. Intensive MR feeding indicated greater stimulation of growth and anabolic metabolism, but butyrate supplementation did not further improve postnatal growth or anabolic processes either in intensive or restrictive MR-fed calves.



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Methane emissions from dairy lagoons in the western United States

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): A.B. Leytem, D.L. Bjorneberg, A.C. Koehn, L.E. Moraes, E. Kebreab, R.S. Dungan
Methane generation from dairy liquid storage systems is a major source of agricultural greenhouse gas emissions. However, little on-farm research has been conducted to estimate and determine the factors that may affect these emissions. Six lagoons in south-central Idaho were monitored for 1 yr, with CH4 emissions estimated by inverse dispersion modeling. Lagoon characteristics thought to contribute to CH4 emissions were also monitored over this time period. Average emissions from the lagoons ranged from 30 to 126 kg/ha per day or 22 to 517 kg/d. Whereas we found a general trend for greater emissions during the summer, when temperatures were greater, events such as pumping, rainfall, freeze or thaw of lagoon surfaces, and wind significantly increased CH4 emissions irrespective of temperature. Lagoon physicochemical characteristics, such as total solids, chemical oxygen demand, and volatile solids, were highly correlated with emission. Methane prediction models were developed using volatile solids, wind speed, air temperature, and pH as independent variables. The US Environmental Protection Agency methodology for estimating CH4 emissions from manure storage was used for comparison of on-farm CH4 emissions from 1 of the lagoon systems. The US Environmental Protection Agency method underestimated CH4 emissions by 48%. An alternative methodology, using volatile solids degradation factor, provided a more accurate estimate of annual emissions from the lagoon system and may hold promise for applicability across a range of dairy lagoon systems in the United States.



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A cohort study of the effect of winter dysentery on herd-level milk production

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): Ingrid Toftaker, Ingrid Holmøy, Ane Nødtvedt, Olav Østerås, Maria Stokstad
Winter dysentery (WD) is a contagious disease caused by bovine coronavirus. It is characterized by acute onset of diarrhea, fever, depression, and reduced milk yield in adult cattle. Although production loss is a well-known consequence of WD, large-scale studies estimating the effect on milk production are lacking. The objective of this study was to estimate the effect of farmer-reported WD on herd-level milk production and milk composition. A cohort study was performed based on reports of herd outbreaks of winter dysentery during a regional epidemic in Norway during the winter of 2011–2012. Reports were made by farmers, and diagnosis was based on a herd outbreak of acute diarrhea in adults. Milk shipment data were retrieved from the dairy company, and information on herd size and milking system were retrieved from the Norwegian Dairy Herd Recording System. We compared milk production in herds with reported outbreaks of WD (n = 224) with all herds in the same area without a reported outbreak (n = 2,093) during the same period. The outcome variable in the analysis was milk volume per cow per day, and the main predictor was whether the herd had a reported outbreak of WD or not. We assessed the effect of WD on milk production by fitting a linear mixed model, adjusting for milk production in the herd before the outbreak. Similarly, we assessed the effect of WD on milk composition using linear regression, adjusting for the levels of milk components before the outbreak. This study estimated a total loss of 51 L/cow during the study period, from 7 d before to 19 d after a reported outbreak. The lowest estimated production was 2 d after the outbreak was reported, when the average milk yield was 19.4 L/cow per day, compared with 23.0 L/cow per day 7 days before notification (i.e., a difference of 3.6 L/cow, or 15%). The effect gradually declined with time. The estimated effect on milk composition was modest, but an increase of 11% in free fatty acids and a small increase in fat/protein ratio indicated that WD might put cows into negative energy balance. Descriptive analysis indicated that herd milk yield was still reduced 4 mo after an outbreak. This cohort study showed that WD causes considerable decreases in milk production, and it alters milk composition. These findings highlight the important negative consequences of WD, and should motivate actions to prevent between-herd spread of bovine coronavirus.



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Short communication: Weak associations between mastitis control measures and bulk milk somatic cell counts in Swedish dairy herds

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): U. Emanuelson, C. Nielsen
Despite the fact that control programs have been available for several decades, mastitis remains an important problem in dairy herds around the world. Possible reasons for this include poor uptake and application of recommended mastitis control measures; poor or variable compliance; or variability in the effects of these measures. The objective of this study was to evaluate the associations between implemented mastitis control measures and bulk milk somatic cell count (BMSCC) in Swedish dairy herds. Data for this study were collected primarily from an extensive self-administered postal questionnaire about the herds, the people responsible for udder health, and details of udder health and mastitis management. A total of 898 questionnaires were distributed, and 428 questionnaires were returned (overall response rate of 48%), but we used the information from only 395 herds in this study. For all herds, we collected data on herd size and geometric average calculated BMSCC from the Swedish Official Milk Recording Scheme. We used logistic regression to assess the association between mastitis control measures and BMSCC, dichotomized as low (<200,000 cells/mL) or high (>200,000 cells/mL). We investigated 21 measures that have been suggested for mastitis control, but found only 2 to be associated with udder health as measured by BMSCC. Not providing dry cows with a specialized mineral feed was significantly associated with increased risk of high BMSCC, and not using post-milking teat disinfectant tended to be associated with increased risk. The lack of association for all other measures was not likely due to low power (because most of these measures had variable implementation rates) but could be due to the relatively narrow range of BMSCC in our study (range 61,000–524,000 cells/mL). However, our results agreed well with those of other recent studies, supporting the call for a thorough review of the current knowledge of mastitis control and for wider application of intervention studies to verify the actual effects of suggested control measures.



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Evaluation of the capillary electrophoresis method for measurement of immunoglobulin concentration in ewe colostrum

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): V. Lopreiato, C. Ceniti, F. Trimboli, E. Fratto, M. Marotta, D. Britti, V.M. Morittu
Capillary electrophoresis (CE) is a technique routinely used in clinical laboratories that allows the separation and quantification of blood serum proteins in a rapid, precise, accurate, and inexpensive manner. Recently, CE has been proposed to separate and measure colostral proteins, but an evaluation of the agreement between CE and radial immunodiffusion (RID) method, currently used to quantify IgG in colostrum, is still lacking. The purpose of this study was to test the ability of a CE instrument, normally used in blood serum protein analysis, to realize the correct quantification of total Ig concentration in ewe colostrum, using RID assay as reference. Colostrum samples (n = 68) were collected from 35 multiparous Sarda ewes at first milking (n = 33) and at 24 h postpartum (n = 35). The mean ± standard deviation of IgG concentration measured by RID and whey colostrum total Ig concentration measured by CE were 54.76 ± 41.82 g/L and 54.70 ± 41.43 g/L, respectively. Lin's concordance correlation coefficient (r = 0.993; 95% confidence interval = 0.989 to 0.996) and linear regression analysis results (RID = 1.0022CE − 0.063; R² = 0.986) showed an excellent agreement between these 2 methods. Bland-Altman analysis confirmed that CE method can be a suitable alternative to RID: the mean of the differences between CE and RID was −0.055 ± 4.95 g/L (95% confidence interval = −1.25 to 1.14 g/L) and the agreement limits were −9.75 to 9.60 g/L (low limit 95% confidence interval = −11.82 to −7.68 g/L; high limit 95% confidence interval = 7.57 to 11.72 g/L). In conclusion, the current study indicates that CE method may be a reliable tool for the quantification of the total Ig concentration in ewe colostrum.



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Phenotypic and genotypic antimicrobial susceptibility pattern of Streptococcus spp. isolated from cases of clinical mastitis in dairy cattle in Poland

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): E. Kaczorek, J. Małaczewska, R. Wójcik, W. Rękawek, A.K. Siwicki
Mastitis of dairy cattle is one of the most frequently diagnosed diseases worldwide. The main etiological agents of mastitis are bacteria of the genus Streptococcus spp., in which several antibiotic resistance mechanisms have been identified. However, detailed studies addressing this problem have not been conducted in north-eastern Poland. Therefore, the aim of our study was to analyze, on phenotypic and genotypic levels, the antibiotic resistance pattern of Streptococcus spp. isolated from clinical cases of mastitis from dairy cattle in this region of Poland. The research was conducted using 135 strains of Streptococcus (Streptococcus uberis, n = 53; Streptococcus dysgalactiae, n = 41; Streptococcus agalactiae, n = 27; other streptococci, n = 14). The investigation of the antimicrobial susceptibility to 8 active substances applied in therapy in the analyzed region, as well as a selected bacteriocin (nisin), was performed using the minimum inhibitory concentration method. The presence of selected resistance genes (n = 14) was determined via PCR. We also investigated the correlation between the presence of resistance genes and the antimicrobial susceptibility of the examined strains in vitro. The highest observed resistance of Streptococcus spp. was toward gentamicin, kanamycin, and tetracycline, whereas the highest susceptibility occurred toward penicillin, enrofloxacin, and marbofloxacin. Additionally, the tested bacteriocin showed high efficacy. The presence of 13 analyzed resistance genes was observed in the examined strains [gene mef(A) was not detected]. In most strains, at least one resistance gene, mainly responsible for resistance to tetracyclines [tet(M), tet(K), tet(L)], was observed. However, a relationship between the presence of a given resistance gene and antimicrobial susceptibility on the phenotypic level was not always observed.



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Effects of changing freestall area on lameness, lying time, and leg injuries on dairy farms in Alberta, Canada

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): Emily Morabito, Herman W. Barkema, Edmond A. Pajor, Laura Solano, Doris Pellerin, Karin Orsel
Cow comfort is of increasing importance in the dairy industry, due to an increased focus on animal welfare. However, whether producer changes to the cows' environment affect cow comfort has not been well characterized. Our objectives were to: (1) quantify the effect of freestall area changes on the prevalence of lameness, leg injuries, and average lying time; and (2) compare cow comfort outcomes on farms that had never had an assessment of cow comfort to farms that had had a previous assessment of cow comfort. A sample of 60 Holstein-Friesian cows were selected on each of 15 farms that made changes to the freestall area after an assessment of cow comfort (change, CHG); 15 farms that did not make changes to the freestall area after an assessment of cow comfort (no change, NC); and 14 farms that had yet to be evaluated (new farms, NF). Cows in NC and NF were lame 1.50 and 1.71 times more often, respectively, than cows on CHG farms. Additionally, daily lying time was 0.33 and 0.62 h/d lower in NC and NF, respectively, than on CHG farms. The prevalence of hock and knee injuries was not different among the 3 groups of farms. No differences were detected in the parameters of interest when comparing NF with NC farms; therefore, we concluded that the NC group was not biased by a previous assessment of cow comfort. Farms in the CHG group had a lower prevalence of lame cows and greater lying time than the NC and NF groups.



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Inclusion of wheat and triticale silage in the diet of lactating dairy cows

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): M.T. Harper, J. Oh, F. Giallongo, G.W. Roth, A.N. Hristov
The objective of this experiment was to partially replace corn silage with 2 alternative forages, wheat (Triticum aestivum) or triticale (X Triticosecale) silages at 10% of the diet dry matter (DM), and investigate the effects on dairy cow productivity, nutrient utilization, enteric CH4 emissions, and farm income over feed costs. Wheat and triticale were planted in the fall as cover crops and harvested in the spring at the boot stage. Neutral- and acid-detergent fiber and lignin concentrations were higher in the wheat and triticale silages compared with corn silage. The forages had similar ruminal in situ effective degradability of DM. Both alternative forages had 1% starch or less compared with the approximately 35% starch in corn silage. Diets with the alternative forages were fed in a replicated 3 × 3 Latin square design experiment with three 28-d periods and 12 Holstein cows. The control diet contained 44% (DM basis) corn silage. In the other 2 diets, wheat or triticale silages were included at 10% of dietary DM, replacing corn silage. Dry matter intake was not affected by diet, but both wheat and triticale silage decreased yield of milk (41.4 and 41.2 vs. 42.7 ± 5.18 kg/d) and milk components, compared with corn silage. Milk fat from cows fed the alternative forage diets contained higher concentrations of 4:0, 6:0, and 18:0 and tended to have lower concentrations of total trans fatty acids. Apparent total-tract digestibility of DM and organic matter was decreased in the wheat silage diet, and digestibility of neutral-and acid-detergent fiber was increased in the triticale silage diet. The wheat and triticale silage diets resulted in higher excretion of urinary urea, higher milk urea N, and lower milk N efficiency compared with the corn silage diet. Enteric CH4 emission per kilogram of energy-corrected milk was highest in the triticale silage diet, whereas CO2 emission was decreased by both wheat and triticale silage. This study showed that, at milk production of around 42 kg/d, wheat silage and triticale silage can partially replace corn silage DM and not affect DM intake, but milk yield may decrease slightly. For dairy farms in need of more forage, triticale or wheat double cropped with corn silage may be an appropriate cropping strategy.



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Production and nitrogen utilization in lactating dairy cows fed ground field peas with or without ruminally protected lysine and methionine

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): A.B.D. Pereira, N.L. Whitehouse, K.M. Aragona, C.S. Schwab, S.F. Reis, A.F. Brito
Previous research has shown that cows fed ≥24% of the diet dry matter (DM) as field peas decreased milk yield as well as concentration and yield of milk protein, possibly due to reduced DM intake and limited supply of Lys and Met. Twelve multiparous and 4 primiparous lactating Holstein cows were randomly assigned to 1 of 4 diets in a replicated 4 × 4 Latin square design. The diets contained (DM basis) 34.8% corn silage, 15.2% grass-legume silage, 5.9% roasted soybean, 2.4% mineral-vitamin premix, 2.0% alfalfa pellets, and either (1) 36% ground corn, 2.4% soybean meal, and 1.3% urea (UR), (2) 29.7% ground corn, 9.8% soybean meal, 0.13% ruminally protected (RP) Lys, and 0.07% RP-Met (CSBAA), (3) 25% ground field peas, 12.3% ground corn, and 2.4% soybean meal (FP), or (4) FP supplemented with 0.15% RP-Lys and 0.05% RP-Met (FPAA). Our objective was to test the effects of FP versus UR, FPAA versus CSBAA, and FPAA versus FP on milk yield and composition, N utilization, nutrient digestibility, ruminal fermentation profile, and plasma concentration of AA. Milk yield did not differ across diets. Compared with cows fed UR, those fed FP had greater DM intake, concentration and yield of milk true protein, apparent total-tract digestibility of fiber, urinary excretion of purine derivatives, and concentrations of total volatile fatty acids in the rumen and Lys in plasma, and less milk urea N and ruminal NH3-N. The concentration of milk urea N, as well as the concentration and yield of milk fat increased in cows fed FPAA versus CSBAA. Moreover, cows fed FPAA had greater ruminal concentration of total volatile fatty acids, increased proportions of acetate and isobutyrate, and decreased proportions of propionate and valerate than those fed CSBAA. The plasma concentrations of His, Leu, and Phe decreased, whereas plasma Met increased and plasma Lys tended to increase in cows fed FPAA versus CSBAA. Concentration of milk true protein, but not yield, was increased in cows fed FPAA versus FP. However, cows fed FPAA showed decreased concentrations of His and Leu in plasma compared with those fed FP. Overall, compared with the CSBAA diet, feeding FPAA did not negatively affect milk yield and milk protein synthesis. Furthermore, RP-Lys and RP-Met supplementation of the FP diet did not improve milk yield or milk protein synthesis, but decreased urinary urea N excretion.



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Efficacy and clinical safety of pegbovigrastim for preventing naturally occurring clinical mastitis in periparturient primiparous and multiparous cows on US commercial dairies

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): Peter Canning, Renee Hassfurther, Terry TerHune, Karen Rogers, Scott Abbott, David Kolb
Periparturient dairy cows experience impaired immune function, exhibited as a transient decrease in neutrophil function and neutropenia. This decrease in immune competence is associated with an increase in susceptibility to bacterial infections, including mastitis and metritis. Bovine granulocyte colony stimulating factor (bG-CSF) is an endogenous protein that enhances neutrophil bactericidal functions and increases the production of neutrophils from bone marrow precursors. Administration of pegbovigrastim (recombinant bG-CSF covalently bound to polyethylene glycol) around the time of calving has been shown to reduce the incidence of new clinical mastitis cases in a natural disease model system. To further explore the application of pegbovigrastim under herd management systems typical of those found in the US dairy industry, we conducted a multicenter field study to evaluate the efficacy and clinical safety of pegbovigrastim administered to multiparous cows and heifers approximately 7 d before calving and within 24 h of calving. Responses of treated cows were compared with those of animals treated with sterile saline. Animals treated with pegbovigrastim exhibited 4- to 5-fold increases in circulating neutrophil numbers within 24 h of treatment initiation, and this increase persisted at least a week beyond the second dose. Pegbovigrastim-treated animals exhibited a 35% decrease in the incidence of clinical mastitis relative to the controls during the first 30 d of lactation. Animals treated with pegbovigrastim also exhibited a 52% reduction in failure to return to visual estrus within 80 d of calving. We observed no differences in somatic cell count or milk composition between treated and control animals. We also found no differences in the duration of pregnancy or proportion of viable calves in treated cows relative to control animals. These results indicate that administration of pegbovigrastim provides a well-tolerated, novel approach to overcoming periparturient immune suppression, resulting in reduced susceptibility to clinical mastitis during early lactation.



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In vitro response to EPA, DPA, and DHA: Comparison of effects on ruminal fermentation and biohydrogenation of 18-carbon fatty acids in cows and ewes

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): P.G. Toral, G. Hervás, D. Carreño, H. Leskinen, A. Belenguer, K.J. Shingfield, P. Frutos
The modulation of milk fat nutritional quality through fish oil supplementation seems to be largely explained by the action of n-3 very long chain polyunsaturated fatty acids (PUFA) on ruminal biohydrogenation (BH) of C18 fatty acids (FA). However, relationships among this action, disappearance of those PUFA in the rumen, and potential detrimental consequences on ruminal fermentation remain uncertain. This study compared the effect of 20:5n-3 (eicosapentaenoic acid; EPA), 22:5n-3 (docosapentaenoic acid; DPA), and 22:6n-3 (docosahexaenoic acid; DHA) on rumen fermentation and BH of C18 FA and was conducted simultaneously in cows and sheep to provide novel insights into interspecies differences. The trial was performed in vitro using batch cultures of rumen microorganisms with inocula collected from cannulated cows and ewes. The PUFA were added at a dose of 2% incubated dry matter, and treatment effects on ruminal C18 FA concentrations, PUFA disappearances, and fermentation parameters (gas production, ammonia and volatile FA concentrations, and dry matter and neutral detergent fiber disappearances) were examined after 24 h of incubation. A principal component analysis suggested that responses to PUFA treatments explained most of the variability; those of ruminant species were of lower relevance. Overall, EPA and DHA were equally effective for inhibiting the saturation of trans-11 18:1 to 18:0 and had a similar influence on ruminal fermentation in cows and sheep (e.g., reductions in gas production and acetate:propionate ratio). Nevertheless, DHA further promoted alternative BH pathways that lead to trans-10 18:1 accumulation, and EPA seemed to have specific effects on 18:3n-3 metabolism. Only minor variations attributable to DPA were observed in the studied parameters, suggesting a low contribution of this FA to the action of marine lipids. Although most changes due to the added PUFA were comparable in bovine and ovine, there were also relevant specificities, such as a stronger inhibition of 18:0 formation in cows and a greater increase in 18:3n-3 metabolites in sheep. No direct relationship between in vitro disappearance of the incubated PUFA and effect on BH (in particular, inhibition of the last step) was found in either cows or ewes, calling into question a putative link between extent of disappearance and toxicity for microbiota. Conversely, an association between the influence of these PUFA on ruminal lipid metabolism and fermentation may exist in both species. In vivo verification of these findings would be advisable.



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Addition of glycerol to lactating cow diets stimulates dry matter intake and milk protein yield to a greater extent than addition of corn grain

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): D.L. Bajramaj, R.V. Curtis, J.J.M. Kim, M. Corredig, J. Doelman, T.C. Wright, V.R. Osborne, J.P. Cant
The objective of this study was to determine if the addition of glycerol to the diet of dairy cows would stimulate milk protein yield in the same manner as the addition of corn grain. Twelve multiparous lactating dairy cows at 81 ± 5 d in milk were subjected to 3 dietary treatments in a replicated 3 × 3 Latin square design for 28-d periods. The diets were a 70% forage diet considered the basal diet, the basal diet with 19% ground and high-moisture corn replacing forages, and the basal diet with 15% refined glycerol and 4% added protein supplements to be isocaloric and isonitrogenous with the corn diet. Cows were milked twice a day and samples were collected on the last 7 d of each period for compositional analysis. Within each period, blood samples were collected on d 26 and 27, and mammary tissue was collected by biopsy on d 28 for Western blot analysis. Dry matter intake increased from 23.7 kg/d on the basal diet to 25.8 kg/d on the corn diet and 27.2 kg/d on the glycerol diet. Dry matter intake tended to be higher with glycerol than corn. Milk production increased from 39.2 kg/d on the basal diet to 43.8 kg/d on the corn diet and 44.2 kg/d on the glycerol diet. However, milk yield did not differ between corn and glycerol diets. Milk lactose yields were higher on the corn and glycerol diets than the basal diet. Milk fat yield significantly decreased on the glycerol diet compared with the basal diet and tended to decrease in comparison with the corn diet. Mean milk fat globule size was reduced by glycerol feeding. Milk protein yield increased 197 g/d with addition of corn to the basal diet and 263 g/d with addition of glycerol, and the glycerol effect was larger than the corn effect. The dietary treatments had no effects on plasma glucose concentration, but plasma acetate levels decreased 27% on the glycerol diet. Amino acid concentrations were not affected by dietary treatments, except for branched-chain amino acids, which decreased 22% on the glycerol diet compared with the corn diet. The decreases in plasma acetate and branched-chain amino acid concentrations with glycerol and the larger effects of glycerol than corn on milk protein and fat yields suggest that glycerol is more glucogenic for cows than corn grain.



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Production and economic responses to intensification of pasture-based dairy production systems

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): K.A. Macdonald, J.W. Penno, J.A.S. Lancaster, A.M. Bryant, J.M. Kidd, J.R. Roche
Production from pasture-based dairy farms can be increased through using N fertilizer to increase pasture grown, increasing stocking rate, importing feeds from off farm (i.e., supplementary feeds, such as cereal silages, grains, or co-product feeds), or through a combination of these strategies. Increased production can improve profitability, provided the marginal cost of the additional milk produced is less than the milk price received. A multiyear production system experiment was established to investigate the biological and economic responses to intensification on pasture-based dairy farms; 7 experimental farmlets were established and managed independently for 3 yr. Paddocks and cows were randomly allocated to farmlet, such that 3 farmlets had stocking rates of 3.35 cows/ha (LSR) and 4 farmlets had stocking rates of 4.41 cows/ha (HSR). Of the LSR farmlets, 1 treatment received no N fertilizer, whereas the other 2 received either 200 or 400 kg of N/ha per year (200N and 400N, respectively). No feed was imported from off-farm for the LSR farmlets. Of the 4 HSR farmlets, 3 treatments received 200N and the fourth treatment received 400N; cows on 2 of the HSR-200N farmlet treatments also received 1.3 or 1.1 t of DM/cow per year of either cracked corn grain or corn silage, respectively. Data were analyzed for consistency of farmlet response over years using mixed models, with year and farmlet as fixed effects and the interaction of farmlet with year as a random effect. The biological data and financial data extracted from a national economic database were used to model the statement of financial performance for the farmlets and determine the economic implications of increasing milk production/cow and per ha (i.e., farm intensification). Applying 200N or 400N increased pasture grown per hectare and milk production per cow and per hectare, whereas increasing stocking rate did not affect pasture grown or milk production per hectare, but reduced milk production per cow. Importing feed in the HSR farmlets increased milk production per cow and per hectare. Marginal milk production responses to additional feed (i.e., either pasture or imported supplementary feed) were between 0.8 and 1.2 kg of milk/kg of DM offered (73 to 97 g of fat and protein/kg of feed DM) and marginal response differences between feeds were explained by metabolizable energy content differences (0.08 kg of milk/MJ of metabolizable energy offered). The marginal milk production response to additional feed was quadratic, with the greatest milk production generated from the initial investment in feed; 119, 99, and 55 g of fat and protein were produced per kilogram of feed DM by reducing the annual feed deficit from 1.6 to 1.0, 1.0 to 0.5, and 0.5 to 0 t of DM, respectively. Economic modeling indicated that the marginal cost of milk produced from pasture resulting from applied N fertilizer was less than the milk price; therefore, strategic use of N fertilizer to increase pasture grown increased farm operating profit per hectare. In comparison, operating profit declined with purchased feed, despite high marginal milk production responses. The results have implications for the strategic direction of grazing dairy farms, particularly in export-oriented industries, where the prices of milk and feed inputs are subject to the considerable volatility of commodity markets.



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Evaluation of an automated milk leukocyte differential test and the California mastitis test for detecting intramammary infection in early- and late-lactation quarters and cows

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): S.M. Godden, E. Royster, J. Timmerman, P. Rapnicki, H. Green
Study objectives were to (1) describe the diagnostic test characteristics of an automated milk leukocyte differential (MLD) test and the California mastitis test (CMT) to identify intramammary infection (IMI) in early- (EL) and late-lactation (LL) quarters and cows when using 3 different approaches to define IMI from milk culture, and (2) describe the repeatability of MLD test results at both the quarter and cow level. Eighty-six EL and 90 LL Holstein cows were sampled from 3 Midwest herds. Quarter milk samples were collected for a cow-side CMT test, milk culture, and MLD testing. Quarter IMI status was defined by 3 methods: culture of a single milk sample, culture of duplicate samples with parallel interpretation, and culture of duplicate samples with serial interpretation. The MLD testing was completed in duplicate within 8 h of sample collection; MLD results (positive/negative) were reported at each possible threshold setting (1–18 for EL; 1–12 for LL) and CMT results (positive/negative) were reported at each possible cut-points (trace, ≥1, ≥2, or 3). We created 2 × 2 tables to compare MLD and CMT results to milk culture, at both the quarter and cow level, when using each of 3 different definitions of IMI as the referent test. Paired MLD test results were compared with evaluate repeatability. The MLD test showed excellent repeatability. The choice of definition of IMI from milk culture had minor effects on estimates of MLD and CMT test characteristics. For EL samples, when interpreting MLD and CMT results at the quarter level, and regardless of the referent test used, both tests had low sensitivity (MLD = 11.7–39.1%; CMT = 0–52.2%) but good to very good specificity (MLD = 82.1–95.2%; CMT = 68.1–100%), depending on the cut-point used. Sensitivity improved slightly if diagnosis was interpreted at the cow level (MLD = 25.6–56.4%; CMT = 0–72.2%), though specificity generally declined (MLD = 61.8–100%; CMT = 25.0–100%) depending on the cut-point used. For LL samples, when interpreted at the quarter level, both tests had variable sensitivity (MLD = 46.6–84.8%; CMT = 9.6–72.7%) and variable specificity (MLD = 59.2–79.8%; CMT = 52.5–97.3%), depending on the cut-point used. Test sensitivity improved if interpreted at the cow level (MLD = 59.6–86.4%; CMT = 19.1–86.4%), though specificity declined (MLD = 32.4–56.8%; CMT = 14.3–92.3%). Producers considering adopting either test for LL or EL screening programs will need to carefully consider the goals and priorities of the program (e.g., whether to prioritize test sensitivity or specificity) when deciding on the level of interpretation (quarter or cow) and when selecting the optimal cut-point for interpreting test results. Additional validation studies and large randomized field studies will be needed to evaluate the effect of adopting either test in selective dry cow therapy or fresh cow screening programs on udder health, antibiotic use, and economics.



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Nitrogen efficiency of eastern Canadian dairy herds: Effect on production performance and farm profitability

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): L. Fadul-Pacheco, D. Pellerin, P.Y. Chouinard, M.A. Wattiaux, M. Duplessis, É. Charbonneau
Nitrogen efficiency (milk N/dietary N; NE) can be used as a tool for the nutritional, economic, and environmental management of dairy farms. The aim of this study was to identify the characteristics of herds with varying NE and assess the effect on farm profitability. One hundred dairy herds located in Québec, Canada, comprising on average 42 ± 18 cows in lactation were visited from October 2014 to June 2015. Feed intake was measured over 24 h. Samples of each feedstuff were taken and sent to a commercial laboratory for analysis of chemical composition. Feeding management and feed prices were recorded. Milk yield was recorded and milk samples were collected over 2 consecutive milkings. Fat, protein, and milk urea N were analyzed. Balances of metabolizable protein (MP; MP supply − MP requirements) and rumen degradable protein (RDP; RDP supply − RDP requirement) were calculated. A hierarchical cluster analysis was conducted and allowed grouping the farms by their NE. Four clusters were identified with an average NE of 22.1 (NE22), 26.9 (NE27), 30.0 (NE30), and 35.8% (NE36). Herds in clusters NE30 and NE36 were fed diets with greater concentrations of starch, net energy for lactation, and nonfiber carbohydrates than those in the other 2 clusters. Moreover, the average proportion of corn silage was lower for herds in cluster NE22 compared with NE30 and NE36 (8.23 vs. 31.8 and 31.3% of total forages, respectively). In addition, crude protein of the diets declined from an average of 16.0 to 14.9% with increasing NE among clusters. Average dry matter intake declined from 26.1 to 22.5 kg/d as NE of clusters increased. Herds in cluster NE22 had lower yields of milk (28.7 vs. 31.8 kg/d), fat (1.15 vs. 1.29 kg/d), and protein (0.94 vs. 1.05 kg/d) than the other clusters. Also, milk urea N was greater for farms in cluster NE22 (13.2 mg/dL) than for farms in the other clusters (11.4 mg/dL). Furthermore, MP and RDP balances decreased from 263.2 to −153.7 g/d and from 594.7 to 486.9 g/d, respectively, with increasing NE among clusters. Income over feed cost increased from $14.3 to $17.3/cow per day (Can$) as NE among clusters augmented. Results from this study showed that some farms were able to achieve high NE by using lower levels of dietary N and having cows with lower DMI while maintaining milk performance. These farms had a potentially lower environmental impact, and they were more profitable.



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Effect of uncertainty in composition and weight measures in control of cheese yield and fat loss in large cheese factories

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): Brenda Margolies, Michael C. Adams, Joice Pranata, Kathleen Gondoutomo, David M. Barbano
Our objective was to develop a computer-based cheese yield, fat recovery, and composition control performance measurement system to provide quantitative performance records for a Cheddar and mozzarella cheese factory. The system can be used to track trends in performance of starter cultures and vats, as well as systematically calculate theoretical yield. Yield equations were built into the spreadsheet to evaluate cheese yield performance and fat losses in a cheese factory. Based on observations in commercial cheese factories, sensitivity analysis was done to demonstrate the sensitivity of cheese factory performance to analytical uncertainty of data used in the evaluation. Analytical uncertainty in the accuracy of milk weight and milk and cheese composition were identified as important factors that influence the ability to manage consistency of cheese quality and profitability. It was demonstrated that an uncertainty of ±0.1% milk fat or milk protein in the vat causes a range of theoretical Cheddar cheese yield from 10.05 to 10.37% and an uncertainty of yield efficiency of ±1.5%. This equates to ±1,451 kg (3,199 lb) of cheese per day in a factory processing 907,185 kg (2 million pounds) of milk per day. The same is true for uncertainty in cheese composition, where the effect of being 0.5% low on moisture or fat is about 484 kg (1,067 lb) of missed revenue opportunity from cheese for the day. Missing the moisture target causes other targets such as fat on a dry basis and salt in moisture to be missed. Similar impacts were demonstrated for mozzarella cheese. In analytical performance evaluations of commercial cheese quality assurance laboratories, we found that analytical uncertainty was typically a bias that was as large as 0.5% on fat and moisture. The effect of having a high bias of 0.5% moisture or fat will produce a missed opportunity of 484 kg of cheese per day for each component. More accurate rapid methods for determination of moisture, fat, and salt contents of cheese in large cheese factories will improve the accuracy of yield performance evaluation and control of consistency of cheese composition and quality.



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Strategies for implementing genomic selection for feed efficiency in dairy cattle breeding schemes

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): S.E. Wallén, M. Lillehammer, T.H.E. Meuwissen
Alternative genomic selection and traditional BLUP breeding schemes were compared for the genetic improvement of feed efficiency in simulated Norwegian Red dairy cattle populations. The change in genetic gain over time and achievable selection accuracy were studied for milk yield and residual feed intake, as a measure of feed efficiency. When including feed efficiency in genomic BLUP schemes, it was possible to achieve high selection accuracies for genomic selection, and all genomic BLUP schemes gave better genetic gain for feed efficiency than BLUP using a pedigree relationship matrix. However, introducing a second trait in the breeding goal caused a reduction in the genetic gain for milk yield. When using contracted test herds with genotyped and feed efficiency recorded cows as a reference population, adding an additional 4,000 new heifers per year to the reference population gave accuracies that were comparable to a male reference population that used progeny testing with 250 daughters per sire. When the test herd consisted of 500 or 1,000 cows, lower genetic gain was found than using progeny test records to update the reference population. It was concluded that to improve difficult to record traits, the use of contracted test herds that had additional recording (e.g., measurements required to calculate feed efficiency) is a viable option, possibly through international collaborations.



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Season of creation is associated with future survival, fertility, and milk yield of Holstein cows

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): P.J. Pinedo, A. De Vries
Environmental influences during different stages of pregnancy can induce lifelong changes in the structure, physiology, and metabolism of the offspring. Our hypothesis was that season of creation (when the female conceived), associated with heat stress conditions at conception and during the initial stages of embryonic development, affects the lifetime performance and survival of the female after birth. The objective was to analyze the association between month of creation and subsequent survival, fertility, and milk yield in cows maintained on dairy farms in Florida, where the climate during the summer is hot and humid but winters are mild. Initial data consisted of 667,104 Dairy Herd Improvement lactation records from cows calving between 2000 and 2012 in 152 herds. Dates of creation were estimated as birth date minus 280 d. The magnitude of heat stress in each herd was quantified by comparing milk yield during summer and winter. Wood's lactation curves were fitted to adjust milk yields for effects of days in milk, and residuals were obtained for each calendar month. A sine function was fitted on the 12 residuals per farm. The difference between the highest and lowest points on the sine function was termed the seasonality index, a measure of the direct effect of heat stress on milk production. Herds were categorized in 3 levels of seasonality [low (seasonality index values less than the 25th percentile value; <2.84), medium (values within the interquartile range), and high (values greater than the 75th percentile value; >5.22)]. Cows were grouped by their month of creation: summer (July–September) and winter (December–February), and comparisons were performed by parity using logistic regression, ANOVA, and survival analysis. Two models were developed. Model A included the complete population of cows (n = 337,529 lactation records) created in winter or summer. Model B included cows (n = 228,257 lactation records) that had parent-average genetic information available to be able to correct for farmer's use of lower genetic merit of sires in summer. Other variables included in the models were month and year of calving, age at first calving, and herd. Models were run per parity group (1, 2, and ≥3). In both models, age at first calving was lower for cows created during winter versus summer. The odds (95% confidence interval) of survival to a second calving for cows created in winter were 1.21 and 1.15 times the odds of survival for cows created in summer for models A and B, respectively. Numbers of days from calving to first breeding and from calving to conception were consistently smaller for winter versus summer months of creation across all parity categories. Milk yields (305 d and by 70 d in milk) were greater for winter versus summer. In conclusion, cows that were created in the winter had better subsequent survival and performance than cows that were created in the summer. There is evidence that season of creation may have lifelong negative consequences for the cow.



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Survey of work processes on German dairy farms

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): A. Hesse, S. Bertulat, W. Heuwieser
The objective of this study was to conduct a survey to gain insight into the organization of work processes on commercial German dairy farms analyzing the use of standard operating procedures (SOP). Practices and routines were surveyed regarding the existence, creation, and use of SOP. A total of 250 survey forms were returned, and 248 could be used for final analysis. The existence of SOP was indicated by 82% of all respondents, but only 54% stated that these SOP were written down. Existence of SOP correlated with farm size such that larger farms were more likely to implement SOP than smaller farms. However, many farmers lacked the time (41%) or ability (42%) to create SOP to provide the employees with detailed instructions on how to perform a specific task. The majority of respondents (59%) were interested in using ready-made SOP that could be adjusted to their farm. An obvious discrepancy exists between the motivation of the farmers to improve the performance on their farm and their expertise in attaining these goals and intentions.



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Fatty acid profile of goat milk in diets supplemented with chia seed (Salvia hispanica L.)

Publication date: Available online 7 June 2017
Source:Journal of Dairy Science
Author(s): B. Schettino, S. Vega, R. Gutiérrez, A. Escobar, J. Romero, E. Domínguez, M. González-Ronquillo
Chia seed (Salvia hispanica L.) is the greatest known plant source of n-3 α-linolenic acid. The present study evaluated the effects of 3 inclusion levels of chia seed [zero (control); low, 2.7% (CLow); and high, 5.5% (CHigh)] in diets of dairy goats on milk yield and fatty acid profile. Nine Saanen dairy goats in the last third of lactation period, live weight 38 ± 8.7 kg, housed in metabolic cages, were fed iso-proteic and iso-energetic (160 g of crude protein/d and 11 MJ of metabolizable energy/d) diets. Gas chromatography was used to analyze fatty acid profile and total conjugated linoleic acid (CLA). Silver ion HPLC was used to analyze the isomeric profile of CLA. The results were subjected to variance analysis using a Latin square design repeated 3 × 3. The CHigh treatment was higher for dry matter, neutral detergent fiber, and acid detergent fiber intake compared with CLow and control diets. Digestibility was not affected by the inclusion of chia seeds. The CHigh diet improved N intake with respect to the control and CLow diet. Milk yield and chemical composition were not affected by the treatment. The milk fatty acid profile of C18:0, C18:1, C18:2, and C:20 was higher for CHigh than the other treatments. The in vitro gas production (mL of gas/g of dry matter) was lower in CHigh than the control diet. In conclusion, the addition of chia seeds at the CHigh level in dairy goat diets negatively affected in vitro rumen fermentation, but increased the milk fatty acid profile of C18:0, C18:1n-9 cis, and C:20, monounsaturated fatty acids, and polyunsaturated fatty acids. The total CLA content increased from 0.33 to 0.73% with the supplementation of chia to the diet, as well as the isomers cis-9, trans-11, trans-7, cis-9, trans-11, cis-13, and trans-12, trans-14.



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How Radiologists Think

Publication date: June 2017
Source:Academic Radiology, Volume 24, Issue 6
Author(s): Anouk van der Gijp, Emily M. Webb, David M. Naeger
Scholars have identified two distinct ways of thinking. This "Dual Process Theory" distinguishes a fast, nonanalytical way of thinking, called "System 1," and a slow, analytical way of thinking, referred to as "System 2." In radiology, we use both methods when interpreting and reporting images, and both should ideally be emphasized when educating our trainees. This review provides practical tips for improving radiology education, by enhancing System 1 and System 2 thinking among our trainees.



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Scholar : Ειδοποίηση Μελετητή - [ Myringotom

Ειδοποίηση Μελετητή:[ Myringotomy and tubes ]

A study of occurrence of postoperative sensorineural hearing loss after middle ear surgeries

MS Mazhar, BH Shrikrishna - International Journal of Otorhinolaryngology and Head …, 2017

... Holmquist J, Oleander R, Hallen O. Perioperative Drill Generated Noise Levels in Ear Surgery.
ActaOtolaryngol 1979;87:458-60. Spencer MG. Suction tube noise and myringotomy. J Laryngol
Otol. 1980;94:383-6. Paparella MM. Acoustic Trauma from the Bone Cutting Burr. ...

[PDF] An Evaluation of the use of Antibiotics in Children with Otitis Media using Evidence Based Guidelines

J Silva

Page 1. University of Massachusetts Amherst ScholarWorks@UMass Amherst Doctor of
Nursing Practice (DNP) Projects College of Nursing 2017 An Evaluation of the use of
Antibiotics in Children with Otitis Media using Evidence Based Guidelines ...

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Scholar : Ειδοποίηση Μελετητή - [ ΓΛΩΣΣ

Ειδοποίηση Μελετητή:[ ΓΛΩΣΣΙΤΙΣ ]

INHIBITORS OF CXCR2

XI Chen, DR Dragoli, J Fan, J Kalisiak, MR Leleti… - US Patent 20,170,144,996, 2017

... pancreatitis, hepatic ischemia/reperfusion injury, acute alcoholic hepatitis, necrotizing enterocolitis,
chronic sinusitis, uveitis, polymyositis, vasculitis, acne, gastric and duodenal ulcers, intestinal
ischemia/reperfusion injury, celiac disease, esophagitis, glossitis, rhinitis, airflow ...

[PDF] FREQUENCY OF THE MUCOSAL LESIONS IN CHILDREN. RETROSPECTIVE STUDY

FG Boeru, I Părlătescu, C Gheorghe, Ş Ţovaru

... Also, the large number of variants of the normal and especially of the migratory glossitis shows
that this lesion is not fully known, and its clinic appearance, sometimes spectacular, unnecessarily
bothers the parents and raises problems of differential diagnosis with other ...

[HTML] BJMP December 2015 Volume 8 Number 4

C Cristiano, M Catanuso, C Di Gregorio, A Di Gregorio…

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Scholar : Ειδοποίηση Μελετητή - [ ΜΑΣΤΟ

Ειδοποίηση Μελετητή:[ ΜΑΣΤΟΕΙΔΙΤΙΣ ]

[PDF] An Evaluation of the use of Antibiotics in Children with Otitis Media using Evidence Based Guidelines

J Silva

... Some complications may prevent the patient complaint with prescribe medication (El-Shabrawi,
Tolba, & El-Adly, 2016). Some short-term complications include: mastoiditis, labrynthitis, facial
nerve paralysis, petrositis, hearing loss, subperiosteal abscess. ...

Improving access to otolaryngology–head and neck surgery expert advice through eConsultations

S Kohlert, P Murphy, D Tse, C Liddy, A Afkham, E Keely - The Laryngoscope

... H&N–headaches/TMJ, 5. Otology–vertigo/dizziness, 5. H&N–neck mass/Lump, 4. Otology–aural
Fullness, 4. Otology–mastoiditis, 4. Otology–otalgia/earache/ear pain, 4. Rhinology–smell
disturbance, 4. Otology - Tinnitus, 3. Otology–tympanic membrane perforation, 3. ...

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Scholar : Ειδοποίηση Μελετητή - [ CPAP ]

Ειδοποίηση Μελετητή:[ CPAP ]

P. 078 Diaphragm ultrasound in amyotrophic lateral sclerosis: a case report demonstrating a critical role for this technique

MA Ross, BE Smith, I Muzyka, J Dalrymple - Canadian Journal of Neurological …, 2017

... respiratory functions worsened. He was wheelchair bound and had severe dysarthria
and dysphagia. He had exertional dyspnea and used CPAP at night for obstructive
apnea. Results: FVC was 47% predicted. Initial phrenic ...

P. 076 Quantitative EEG in Canada: a national technologist survey

MC Ng, K Gillis, J Nikkel - Canadian Journal of Neurological Sciences, 2017

... respiratory functions worsened. He was wheelchair bound and had severe dysarthria
and dysphagia. He had exertional dyspnea and used CPAP at night for obstructive
apnea. Results: FVC was 47% predicted. Initial phrenic NCS ...

A heritable microduplication encompassing TBL1XR1 causes a genomic sister‐disorder for the 3q26. 32 microdeletion syndrome

V Riehmer, F Erger, P Herkenrath, S Seland, M Jackels… - American Journal of Medical …, 2017

... 6 months. At the age of 3 months she crossed below the third percentile for height.
Her further course was complicated by the development of sleep apnea which
required CPAP treatment over a period of 1 year. Between the ...

[HTML] Don't forget the bubbles

D Roland - Sat, 2017

... After going through the basic equipment required by the retrieval team and some of the specific
challenges of air control, ventilator support (be that mechanical or via high flow nasal cannula
O2 or CPAP) and vascular access, the book then covers some of the more common ...

METHODS AND DEVICES FOR POSITIONING OF A MANDIBLE OF A SUBJECT FOR DETERMINING AN OPTIMAL AIRWAY OPENING

WH Hanewinkel, M Gleeson - US Patent 20,170,135,603, 2017

... The diagnosis may be made overnight or otherwise during a time when the subject
is asleep. Additionally, preferred treatment measures for OSA were to provide the subject
with a continuous positive airway pressure (CPAP) system. ...

CPAP 治疗 OSAS 合并冠心病的研究进展

谢国庆， 楚天舒， 朱国富

摘要: 阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome, OSAS)
公认具有较高的患病率并导致显着的心血管风险, 在许多报道中, 冠状动脉疾病与阻塞性睡眠
呼吸暂停有关. 有趣的是, 冠状动脉疾病患者的预后与阻塞性睡眠呼吸暂停和睡眠呼吸障碍的

Atrial Fibrillation and Sleep Apnoea: Guilt by Association?

Z Al-Falahi, J Williamson, H Dimitri - Heart, Lung and Circulation

Skip to Main Content.

[PDF] Obstructive Sleep Apneu (OSA), Obesitas Hypoventilation Syndrome (OHS) dan Gagal Napas

M Mukhlis, A Bakhtiar

... dijelaskan. Respons yang berbeda terhadap CPAP, BPAP dan NIV mungkin
merefleksikan sesuatu yang menarik, berat badan dengan mekanisme patofisiologi
yang berbeda mungkin bervariasi pada setiap individu dengan OHS. ...

[HTML] BJMP December 2015 Volume 8 Number 4

C Cristiano, M Catanuso, C Di Gregorio, A Di Gregorio…

... The nasogastric tube was removed, and his breathing was then supported with CPAP
via a Mapleson C circuit and 100% oxygen. Direct examination of his airway, and indirect
nasendoscopy with a Storz fibre-optic scope were performed. ...

[PDF] Modelo de atención integral para el manejo relacionado con las complicaciones del recíen nacido en el servicio de neonatología del Hospital Provincial Docente …

AG López Buenaño - 2017

Page 1. UNIVERSIDAD REGIONAL AUTONOMA DE LOS ANDES UNIANDES FACULTAD DE
CIENCIAS MÉDICAS CARRERA DE ENFERMERÍA PROYECTO DE INVESTIGACIÓN PREVIO
A LA OBTENCIÓN DEL TÍTULO DE LICENCIADA EN ENFERMERÍA TEMA: ...

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