Uterine Adenocarcinoma with Pulmonary, Liver and Mesentery Metastasis in a Holstein Cow

The clinical and pathology features of a cow with uterine adenocarcinoma and multiple metastasis are described. Weight loss, inappetence, mild respiratory signs, and reduced milk yield were evident on clinical examination. Grossly deformed uterus, enlarged iliac lymph nodes, and rosary arranged nodules in the mesentery were felt by rectal palpation. Right side laparotomy revealed numerous small masses covering the omentum, and mesentery. Euthanasia was performed. Necropsy and histopathology exam revealed a uterine adenocarcinoma with multiple pulmonary, liver and mesentery metastasis. Uterine adenocarcinoma with metastasis should be included in the differential diagnosis of cows showing weight loss and mild respiratory distress and palpation of numerous firm nodules in the mesentery should be suggestive of neoplasias' metastasis

Three experimental homes for the elderly mentally ill : final report

Against a background of increasing numbers of elderly mentally ill people, the Department of Health [Liverpool] established an initiative to develop and evaluate alternative ways of caring for this client group. Three experimental schemes were established, with the Department providing 50% funding for five years. All three units aim to provide a homely and domestic living environment and provide individualised care for clients.Chapter 1. INTRODUCTION; Chapter 2. METHODOLOGY; Chapter 3. OVERVIEW OF THE THREE EXPERIMENTAL HOMES; Chapter 4. THE NEED FOR SERVICES; Chapter 5. STAFF ACTIVITY STUDY; Chapter 6. THE CLIMATE OF CARE; Chapter 7. OUTCOMES OF CARE; Chapter 8. CONCLUSION

Therapy-based exercise from the perspective of adult patients: a qualitative systematic review conducted using an ethnographic approach

© The Author(s) 2019.Objectives: Many patients do not meet recommended levels of therapy-based exercise. This review aims to explore how adult patients view being prescribed therapy-based exercise, the information/education they are given and receive and if/how they independently practise and adhere. Design: A qualitative systematic review conducted using an ethnographic approach and in accordance with the PRISMA statement. Sources: PubMed, CINAHL, SCOPUS and EMBASE databases (01 January 2000–31 December 2018). Methods: Qualitative studies with a focus on engagement/adherence with therapy-based exercise were included. Data extraction and quality appraisal were undertaken by two reviewers. Results were discussed and data synthesized. Results: A total of 20,294 titles were screened, with data extracted from 39 full texts and data from 18 papers used to construct three themes. ‘The Guidance received’ suggests that the type of delivery desired to support and sustain engagement was context-dependent and individually situated. ‘The Therapist as teacher’ advocates that patients see independent therapy-based exercise as a shared activity and value caring, kind and professional qualities in their therapist. ‘The Person as learner’ proposes that when having to engage with and practise therapy-based exercise because of ill-health, patients often see themselves as new learners who experience fear and uncertainty about what to do. Patients may have unacknowledged ambivalences about learning that impact on engagement and persistence. Conclusion: The quality of the interaction between therapists and patients appears integral to patients engaging with, and sustaining practice of, rehabilitation programmes. Programmes need to be individualized, and health care professionals need to take patients’ previous experiences and ambivalences in motivation and empowerment into account.Peer reviewe

Contact transmission of influenza virus between ferrets imposes a looser bottleneck than respiratory droplet transmission allowing propagation of antiviral resistance

Influenza viruses cause annual seasonal epidemics and occasional pandemics. It is important to elucidate the stringency of bottlenecks during transmission to shed light on mechanisms that underlie the evolution and propagation of antigenic drift, host range switching or drug resistance. The virus spreads between people by different routes, including through the air in droplets and aerosols, and by direct contact. By housing ferrets under different conditions, it is possible to mimic various routes of transmission. Here, we inoculated donor animals with a mixture of two viruses whose genomes differed by one or two reverse engineered synonymous mutations, and measured the transmission of the mixture to exposed sentinel animals. Transmission through the air imposed a tight bottleneck since most recipient animals became infected by only one virus. In contrast, a direct contact transmission chain propagated a mixture of viruses suggesting the dose transferred by this route was higher. From animals with a mixed infection of viruses that were resistant and sensitive to the antiviral drug oseltamivir, resistance was propagated through contact transmission but not by air. These data imply that transmission events with a looser bottleneck can propagate minority variants and may be an important route for influenza evolution

Maus Tratos na Primeira Infância – A Experiência de Um Hospital Terciário

Introdução: Os maus tratos (MT) na infância, têm repercussões na vida da criança e das comunidades. A identificação, particularmente difícil em estádios precoces do desenvolvimento, é essencial para a interrupção precoce dos MT. Objectivo: Caracterizar os casos sinalizados como MT até aos 3 anos de idade, num hospital terciário. Material e métodos: Estudo retrospectivo descritivo das sinalizações de crianças dos 0 aos 2 anos, no período de 2015 a 2017, atendendo ao sexo, família, forma de MT, origem da sinalização, agressor e se este coabitava com a criança. Resultados: Dos 460 casos reportados como MT, 72 (16%) pertenciam à faixa etária avaliada. A distribuição foi semelhante entre os sexos (33M-39F). Na maioria, vinham de famílias nucleares (31) ou monoparentais (22); foram sinalizadas pela Urgência (58-80%); a principal forma de MT foi a negligência (43- 60%) – estas crianças residiam maioritariamente com os pais. As sinalizações associadas a violência (19 por agressão física, 8 de abuso sexual (AS) e 2 exposição a violência doméstica) distribuíram-se por famílias monoparentais (11) seguida das nucleares (10), reconstruídas (5) e alargadas (3). Em 21 casos o agressor pertencia à família, em 13 era coabitante. Das 8 notificação por AS, em 5 a família era monoparental, o agressor era familiar em 6, só em 2 eram coabitantes. Conclusões: A identificação e prevenção de MT neste grupo etário é delicada, pois os agressores tendem a ser próximos da criança, e são até, muitas vezes, quem a traz ao SU. Nos últimos anos, tem-se verificado um aumento das situações suspeitas de abuso sexual, algumas configurando casos de alienação parental. Todos estes aspectos exigem particular atenção dos profissionais de saúde, particularmente no SU, habitual porta de entrada destas situações.info:eu-repo/semantics/publishedVersio

Citalopram Enhances the Activity of Chloroquine in Resistant Plasmodium in Vitro and in Vivo 1

ABSTRACT Citalopram, is an extremely potent inhibitor of neuronal serotonin reuptake. It is structurally unrelated to other antidepressants, but it contains the chemical features associated with reversal of drug resistance and exhibits minimal cardiotoxic side effects and fewer of the anticholinergic and adrenolytic side effects associated with other psychotropic agents. Sensitivity tests to citalopram alone and in combination with chloroquine were performed against chloroquine-resistant and chloroquine-sensitive strains of Plasmodium falciparum and Plasmodium chabaudi. Citalopram alone showed intrinsic activity against the chloroquine-resistant strains of P. falciparum (IC 50 ϭ 1.51 Ϯ .6 M) but only limited activity against the chloroquine-sensitive strain (IC 50 ϭ 33.27 Ϯ 5.87 M) and no activity in vivo. The interaction of chloroquine and citalopram in vitro resulted in a synergistic response in the chloroquineresistant strain but there was no interaction between the drugs in the chloroquine-sensitive strain-a pattern found with other reversal agents. Citalopram enhanced chloroquine susceptibility in both strains of P. chabaudi, however, the potentiating effect was seen at lower doses in the chloroquine-resistant strain. The results of this study suggest that citalopram may have potential as a chemosensitizer in Plasmodium infections on the basis of the low toxicity of citalopram at concentrations potentiating chloroquine activity both in vitro and in vivo. Malaria is a significant source of global morbidity and mortality. Despite the development of new antimalarial agents such as mefloquine, halofantrine and the artemisins, chloroquine remains the drug of choice for the treatment of uncomplicated Plasmodium falciparum malaria infections, due to its low cost, rapid onset of action and its low toxicity. However, the efficacy of chloroquine has diminished due to the emergence and prevalence of chloroquine-resistant strains of P. falciparum (Wensdorfer and Payne, 1991). The rapid development and spread of resistance to chloroquine and other antimalarials, and the tremendous cost of drug development has emphasized the necessity to optimize the use of existing antimalarial agents A number of adjunct drugs have been identified from a wide variety of chemical classes including calcium-channel blockers Citalopram,1-[3-(dimethylamino)propyl]-1-(4-fluorophenyl)-1,3dihydroisobenzofuran-5-carbonite), is an extremely potent inhibitor of neuronal serotonin reuptake The low toxicity coupled with the chemical similarity to chemosensitizers (resistance reversal agents) prompted us to investigate the chemosensitizing effect of citalopram in Plasmodium. In this study, we screened citalopram for chloroquine potentiating activity in chloroquine-resistant and chloroquine sensitive-parasites; both in vitro against P. falciparum and in a rodent malaria model (Plasmodium chabaudi). Methods Effect of Citalopram in Vitro Parasites. Two well-characterized isolates of P. falciparum were used for the drug assays. The chloroquine-resistant FCR-3 strain (IC 50 ϳ 150 nM) (donated by J. Freese, Research in diseases of the Tropical Environment, Durban, South Africa) and the chloroquine

Changes in the Management of Patients having Radical Radiotherapy for Lung Cancer during the First Wave of the COVID-19 Pandemic in the UK.

AIMS: In response to the COVID-19 pandemic, guidelines on reduced fractionation for patients treated with curative-intent radiotherapy were published, aimed at reducing the number of hospital attendances and potential exposure of vulnerable patients to minimise the risk of COVID-19 infection. We describe the changes that took place in the management of patients with stage I-III lung cancer from April to October 2020. MATERIALS AND METHODS: Lung Radiotherapy during the COVID-19 Pandemic (COVID-RT Lung) is a prospective multicentre UK cohort study. The inclusion criteria were: patients with stage I-III lung cancer referred for and/or treated with radical radiotherapy between 2nd April and 2nd October 2020. Patients who had had a change in their management and those who continued with standard management were included. Data on demographics, COVID-19 diagnosis, diagnostic work-up, radiotherapy and systemic treatment were collected and reported as counts and percentages. Patient characteristics associated with a change in treatment were analysed using multivariable binary logistic regression. RESULTS: In total, 1553 patients were included (median age 72 years, 49% female); 93 (12%) had a change to their diagnostic investigation and 528 (34%) had a change to their treatment from their centre's standard of care as a result of the COVID-19 pandemic. Age ≥70 years, male gender and stage III disease were associated with a change in treatment on multivariable analysis. Patients who had their treatment changed had a median of 15 fractions of radiotherapy compared with a median of 20 fractions in those who did not have their treatment changed. Low rates of COVID-19 infection were seen during or after radiotherapy, with only 21 patients (1.4%) developing the disease. CONCLUSIONS: The COVID-19 pandemic resulted in changes to patient treatment in line with national recommendations. The main change was an increase in hypofractionation. Further work is ongoing to analyse the impact of these changes on patient outcomes

Extensive Sheep and Goat Production: The Role of Novel Technologies towards Sustainability and Animal Welfare

ReviewSheep and goat extensive production systems are very important in the context of global food security and the use of rangelands that have no alternative agricultural use. In such systems, there are enormous challenges to address. These include, for instance, classical production issues, such as nutrition or reproduction, as well as carbon-efficient systems within the climate-change context. An adequate response to these issues is determinant to economic and environmental sustainability. The answers to such problems need to combine efficiently not only the classical production aspects, but also the increasingly important health, welfare, and environmental aspects in an integrated fashion. The purpose of the study was to review the application of technological developments, in addition to remote-sensing in tandem with other state-of-the-art techniques that could be used within the framework of extensive production systems of sheep and goats and their impact on nutrition, production, and ultimately, the welfare of these species. In addition to precision livestock farming (PLF), these include other relevant technologies, namely omics and other areas of relevance in small-ruminant extensive production: heat stress, colostrum intake, passive immunity, newborn survival, biomarkers of metabolic disease diagnosis, and parasite resistance breeding. This work shows the substantial, dynamic nature of the scientific community to contribute to solutions that make extensive production systems of sheep and goats more sustainable, efficient, and aligned with current concerns with the environment and welfareinfo:eu-repo/semantics/publishedVersio