Dilated small and large intestines combined with a severely abnormal demeanor are characteristic of mesenteric torsion in cattle

Objective: To describe the clinical, laboratory, and ultrasonographic findings; treatment; and outcome of cattle with mesenteric torsion (MT). Animals: 61 cattle with MT between November 1, 1986, and December 31, 2019. Methods: Medical records were retrospectively reviewed. Results were compared for cattle that survived versus did not survive to hospital discharge. Results: All cattle had abnormal demeanor. The most common clinical signs were tachycardia (80.3% [49/61]), tachypnea (65.0% [39/60]), and lower rectal temperature (59.3% [35/59]). Signs of colic occurred in 65.6% (40/61). The most common gastrointestinal findings were an empty or almost empty rectum (100% [59/59]), reduced or absent motility of the small intestines (96.6% [57/59]) or rumen (93.2% [55/59]), positive ballottement and/or percussion and simultaneous auscultation on the right side (91.7% [55/60]), and dilated small (49.2% [29/59]) and large intestines (spiral colon and/or cecum, 44.1% [26/59]) detected during transrectal examination. The most common laboratory findings were acidosis (82.6%, [38/46]) hypermagnesemia (74.5% [35/47]). Ultrasonographic findings included reduced or absent small intestinal motility (86.7% [26/30]) and dilated small intestines (83.8% [31/37]). The spiral colon was dilated in 32.4% (12/37) of the cattle. Eighty-two percent (50/61) of the cattle underwent right flank laparotomy and the MT could be reduced in 34.4% (21/61). Twenty-three percent (14/61) of the cattle survived to hospital discharge, and 77.0% (47/61) were euthanized before hospital discharge. Clinical relevance: Dilated small and large intestines (spiral colon, cecum) combined with a severely abnormal demeanor and tachycardia are characteristic findings in cows with MT. Immediate surgical treatment is paramount

Small intestinal volvulus in 47 cows

OBJECTIVE: To describe the findings, treatment, and outcome of small intestinal volvulus (SIV) in 47 cows. ANIMALS AND PROCEDURE: Retrospective analysis of medical records. Comparison of the findings for 18 surviving and 29 non-surviving cows. RESULTS: The most common abnormal vital signs were tachycardia (68.0%), tachypnea (59.6%), and decreased rectal temperature (51.1%). Signs of colic occurred in 66.0% of cows in the study. Rumen motility was reduced or absent in 93.6% of cows, and intestinal motility in 76.6%. Clinical signs on ballottement and/or percussion and simultaneous auscultation were positive on the right side in 78.7% of cows. Transrectal examination showed dilated small intestines in 48.9% of cows. The rectum contained little or no feces in 93.6% of cows. The principal laboratory abnormalities were hypocalcemia (74.1%), hypokalemia (73.8%), azotemia (62.8%), hypermagnesemia (61.6%), and hemoconcentration (60.0%). The principal ultrasonographic findings were dilated small intestines (87.1%) and reduced or absent small intestinal motility (85.2%). Forty-one of the 47 cows underwent right flank laparotomy and the SIV was reduced in 21 cows. When comparing the clinical and laboratory findings of 18 surviving and 29 non-surviving cows, the groups differed significantly with respect to severely abnormal general condition (16.7 versus 37.9%), rumen stasis (22.2 versus 79.3%), intestinal atony (16.7 versus 48.3%), serum urea concentration (6.5 versus 9.8 mmol/L), and serum magnesium concentration (0.98 versus 1.30 mmol/L). In summary, 38.3% of the cows were discharged and 61.7% were euthanized before, during, or after surgery. CONCLUSION AND CLINICAL RELEVANCE: An acute course of disease, little or no feces in the rectum, and dilated small intestines were characteristic of SIV in this study population

A retrospective review of small intestinal intussusception in 126 cattle in Switzerland

BackgroundIntussusception is a form of ileus of the intestines in which an oral intestinal segment slides into the adjacent aboral intestinal segment, causing obstruction of the bowel.MethodsWe analysed the medical records of 126 cattle with intussusception of the small intestine.ResultsDemeanour and appetite were abnormal in 123 cattle. Non‐specific signs of pain occurred in 26.2%, signs of visceral pain in 46.8% and signs of parietal pain in 56.4%. Intestinal motility was decreased or absent in 93.7% of the cattle. The most common findings of transrectal palpation were rumen dilation (37.3%) and dilated small intestines (24.6%). In 96% of the cattle, the rectum was empty or contained little faeces. The principal laboratory findings were hypokalaemia (89.6%), hypocalcaemia (76.5%), base excess (72.9%), hypochloraemia (71.8%), azotaemia (62.1%) and haemoconcentration (61.1%). The main ultrasonographic findings were reduced or absent intestinal motility (98.2%) and dilated small intestines (96.0%). A diagnosis of ileus was made in 87.8% and a diagnosis of ileus attributable to intussusception was made in another 9.8%. Right‐flank laparotomy was carried out in 114 cattle. Fifty‐six (44.4%) cows were discharged.ConclusionsClinical findings of intussusception in cattle are often non‐specific. Ultrasonography may be required to diagnose ileus

HCC biomarkers – state of the old and outlook to future promising biomarkers and their potential in everyday clinical practice

Hepatocellular carcinoma (HCC) is one of the most common and deadly tumors worldwide. Management of HCC depends on reliable biomarkers for screening, diagnosis, and monitoring of the disease, as well as predicting response towards therapy and safety. To date, imaging has been the established standard technique in the diagnosis and follow-up of HCC. However, imaging techniques have their limitations, especially in the early detection of HCC. Therefore, there is an urgent need for reliable, non/minimal invasive biomarkers. To date, alpha-fetoprotein (AFP) is the only serum biomarker used in clinical practice for the management of HCC. However, AFP is of relatively rather low quality in terms of specificity and sensitivity. Liquid biopsies as a source for biomarkers have become the focus of clinical research. Our review highlights alternative biomarkers derived from liquid biopsies, including circulating tumor cells, proteins, circulating nucleic acids, and exosomes, and their potential for clinical application. Using defined combinations of different biomarkers will open new perspectives for diagnosing, treating, and monitoring HCC

Messmethodensammlung Feinstaub: Methodenvorschlag zur Feinstauberfassung an Feuerungsanlagen für feste biogene Brennstoffe

Bereits lange vor der Debatte über den Umbau der Energieversorgung, hin zu mehr erneuerbaren Energien, wurde Holz für die Erzeugung von Wärme verwendet. Gegenwärtig werden knapp drei Viertel aller aus Erneuerbaren Energien bereitgestellten Wärme durch feste biogene Brennstoffe gedeckt (Musiol et al., 2012). Der überwiegende Teil (knapp die Hälfte) kommt dabei aus kleinen Holzfeuerungsanlagen. Die Verbrennung von Holz und anderen festen Brennstoffen biogener Herkunft trägt damit zu einem sehr großen Teil dazu bei, dass die von den Menschen benötigte Energie aus nachwachsenden Rohstoffen erzeugt wird. Die von der Bundesregierung verfolgten Klimaschutzziele sind auch deshalb, ohne die Verbrennung von Holz in Kleinfeuerungsanlagen nicht erreichbar. Die aktuelle Forschung zeigt allerdings auch, dass die Verbrennung von Holz in Kleinfeuerungsanlagen nennenswerte Emissionen, vor allem auch Feinstaubemissionen, verursacht und so maßgeblich zur Luftbelastung beiträgt (Birmili et al., 2008; Hausmann, 2010; Struschka et al., 2008). Die in der Luft verteilten Feinstäube können sich dabei auf sehr unterschiedliche Weise negativ auswirken. Es können sich bestimmte Komponenten, auf Grund ihrer chemisch-physikalischen Eigenschaften in der Luft anreichern. Die Gefahr diesen Komponenten ausgesetzt zu sein, erhöht unter anderem das Risiko für Atemwegserkrankungen (Dockery et al., 1993). Daher ist eines der Ziele des Förderprogramms zur Optimierung der energetischen Biomassenutzung des BMU, den vermeintlichen Zielkonflikt zwischen Klimaschutz bzw. Treibhausgasminderung und der Luftreinhaltung durch Projekte zur Minderung von schädlichen Emissionen zu lösen. Dieses Spannungsfeld aus Luftreinhaltung und Ausbau der thermochemischen Biomassekonversion wurde bereits in der Vergangenheit erkannt und es wurden erste Ansätze zur Emissionsminderung aufgezeigt (Lenz et al., 2010). Im Förderprogramm werden nun gezielt innovative Ansätze zur Emissionsminderung entwickelt. Allen diesbezüglich bearbeiteten Projekten ist gemein, dass Emissionen gemessen werden müssen. Dies betrifft neben den gasförmigen Emissionen insbesondere eben auch die Feinstaubemissionen. Hierbei gibt es in der Praxis eine Reihe unterschiedlicher Randbedingungen, die einen Einfluss auf das Messergebnis haben und die Vergleichbarkeit der Ergebnisse einschränken können (Typenprüfungen, Labormessungen, Feldmessungen, Schornsteinfegermessungen usw.). Auch die verwendeten Messgeräte und die eingesetzten Messprozeduren unterscheiden sich teilweise deutlich voneinander. Dass das Messen von Staubpartikeln und insbesondere die Beurteilung der Wirkung, die diese Stäube auf den Menschen und die Umwelt ausüben keine leichte Aufgabe ist zeigen regelmäßig vorgestellte Studien (Mudgal & Turbé, 2009; Orthen et al., 2007; Rödelsperger et al., 2009; UBA, 2008; Wiedensohler et al., 2012). Mit der Novellierung der 1. BImSchV im Jahr 2010 wurden die Emissionsanforderungen, die an kleine Holzfeuerungsanlagen gestellt werden, verschärft. Die Untersuchung und Einführung neuer und vor allem präziser Messverfahren gewinnt seit dem kontinuierlich an Bedeutung. Vor allem für die Weiterentwicklung von Feuerungstechniken mit außerordentlich niedrigen Staubemissionen ist der Einsatz von hochauflösender Messtechnik erforderlich. Die etablierte zeitlich aufwendige gravimetrische Bestimmung von Staubkonzentrationen ist hierbei nicht immer ausreichend. Die zeitaufgelöste Bestimmung der Staubkonzentrationen z. B. durch Zählung von einzelnen Partikeln rückt in den Fokus des Interesses. Verschiedene Anbieter vertreiben Geräte, die auf den ersten Blick verlässliche Messwerte generieren, die aber im Vergleich der Geräte untereinander erhebliche Abweichungen offenbaren. Zudem zeigen die Erkenntnisse der letzten Jahre, dass sich gerade Aerosole aus einer unvollständigen Verbrennung fester Biomasse, abhängig von den Umgebungsbedingungen, erheblich verändern können. Neben diesen eher akademisch-wissenschaftlichen Herausforderungen weist der Alltag der Staubmessung im Labor, aber insbesondere auch im Feld zusätzliche – häufig nicht unerhebliche – Herausforderungen auf, die eine Vergleichbarkeit der Messwerte zwischen verschiedenen Projekten weiter erschweren. Insofern erscheint es als eine der wesentlichen Herausforderungen eines Begleitprogramms für Projekte zur Minderung von Staubemissionen diese Zielgröße so gut es möglich ist unter vergleichbaren, reproduzierbaren und allgemein anerkannten Methoden zu ermitteln – dies insbesondere auch in dem Kontext zunehmender europäischer Bemühungen, vereinheitlichte Messverfahren festzulegen

TILGen: A Program to Investigate Immune Targets in Breast Cancer Patients - First Results on the Influence of Tumor-Infiltrating Lymphocytes

Background: Despite advancements in the treatment of primary and metastatic breast cancer, many patients lack a durable response to these treatments. Patients with triple-negative breast cancer (TNBC) and human epidermal growth factor receptor 2(HER2)-positive breast cancer who do not have a pathological complete response (pCR) after neoadjuvant chemotherapy (NACT) have a very poor prognosis. Tumor-infiltrating lymphocytes (TILs) have been identified as a predictive marker for pCR after NACT in TNBC and HER2-positive breast cancer. These patient populations could also be suitable for novel treatment strategies including neoepitope-based therapies. This work analyses the effect of TILs on the pCR in neoadjuvantly treated patients in the TILGen study and presents the procedures aimed at establishing neoepitope-based therapies in this study. Methods: Neoadjuvantly treated HER2-positive and TNBC patients were eligible for the presented analysis concerning the association between TILs and pCR. A total of 146 patients could be identified within the TILGen study. TILs were evaluated as percentage of stromal tumor tissue in core biopsies at primary diagnosis. The phenotype ‘lymphocyte-predominant breast cancer' (LPBC) was associated with pCR by logistic regression adjusted for estrogen receptor status, progesterone receptor status, HER2 status, age at diagnosis, and grading. Results: LPBC was seen in 24 (16.4%) patients. In this patient group, 66.7% achieved a pCR, while the pCR rate was 32.8% in patients with a low TIL count. The adjusted odds ratio was 6.60 (95% confidence interval 2.02-21.56; p < 0.01). Conclusion: TILs are a strong predictor of pCR in TNBC and HER2-positive breast cancer patients. Implications for the use of this information including the effect on prognosis might help to identify patients most likely to benefit from a neoepitope-based therapy approach

Stratospheric aerosol - Observations, processes, and impact on climate

Interest in stratospheric aerosol and its role in climate have increased over the last decade due to the observed increase in stratospheric aerosol since 2000 and the potential for changes in the sulfur cycle induced by climate change. This review provides an overview about the advances in stratospheric aerosol research since the last comprehensive assessment of stratospheric aerosol was published in 2006. A crucial development since 2006 is the substantial improvement in the agreement between in situ and space-based inferences of stratospheric aerosol properties during volcanically quiescent periods. Furthermore, new measurement systems and techniques, both in situ and space based, have been developed for measuring physical aerosol properties with greater accuracy and for characterizing aerosol composition. However, these changes induce challenges to constructing a long-term stratospheric aerosol climatology. Currently, changes in stratospheric aerosol levels less than 20% cannot be confidently quantified. The volcanic signals tend to mask any nonvolcanically driven change, making them difficult to understand. While the role of carbonyl sulfide as a substantial and relatively constant source of stratospheric sulfur has been confirmed by new observations and model simulations, large uncertainties remain with respect to the contribution from anthropogenic sulfur dioxide emissions. New evidence has been provided that stratospheric aerosol can also contain small amounts of nonsulfate matter such as black carbon and organics. Chemistry-climate models have substantially increased in quantity and sophistication. In many models the implementation of stratospheric aerosol processes is coupled to radiation and/or stratospheric chemistry modules to account for relevant feedback processes