Tratamiento de abscesos. Cartilla 6

El documento explica que son los abscesos en el ganado, sus causas, problemas que acarrean, métodos de tratamiento, manipulación del animal y medidas de seguridad durante el procedimientoThe document explains what are abscesses in livestock, their causes, the problems they cause, the methods of treatment, the handling of the animal and the security measures during the procedureIntroducción -- Objetivos -- Que son los absesos -- Causas de los absesos -- Que es la materia o pus -- Tratamiento de los absesos -- Normas de seguridad20 página

Aplicación de medicamentos vaginales y uterinos. Cartilla 10

El documento describe el aparato reproductor de la vaca, como aplicar medicamentos vía intravaginal y uterina en el momento oportuno, manejo animal y equipo y herramientas usados para aplicación de medicamentos y lavadosThe document describes the reproductive system of the cow, how to apply intravaginal and uterine medications at the right time, animal handling and equipment and tools used to apply medications and washesPor qué se requiere la aplicación de medicamentos por vía vaginal y uterina? -- Partes principales del aparato reproductor de la vaca -- Como deben ser los medicamentos que se aplican por vía vaginal y uterina -- Equipo y herramientas que se utilizan para la aplicación de medicamentos vía vaginal y uterina -- Aplicación de bolos vía intravaginal y uterina -- Aplicación de lavados o irrigaciones31 página

Aplicación de medicamentos intramamarios

Este documento describe aspectos físicos de la ubre de la vaca, y problemas mamarios como la mastitis, explica las técnicas y materiales para introducir medicamentos por el conducto del pezón de las vacas, ya sean en ungüentos o en líquidos, así como aspectos higiénicos y manejo animalThis document describes physical aspects of the udder of the cow, and breast problems such as mastitis, explains the techniques and materials for introducing drugs through the cow's nipple, whether in ointments or in liquids, as well as hygienic aspects and management animalAnatomía del sistema mamario -- Mastitis -- Ungüentos intramamarios -- Irrigaciones intramamarias -- Sondas mamarias -- Medidas de volumen -- Medidas de aseo -- Normas de seguridad – tratamiento de la mastitis36 página

Detección del celo. Cartilla 1

En el documento describe el concepto de celo, aspectos fisiológicos asociados a la reproducción de bovinos, se dan pautas para identificar vacas en celo oportunamente, llevar un registro de monta o inseminación artificial, programar el secado de la vaca y programación del partoThe document describes the concept of estrus, physiological aspects associated with the reproduction of bovines, guidelines are given to identify cows in heat timely, keep a record of mountaineering or artificial insemination, schedule the drying of the cow and programming of parturitionQue es el celo -- Como se produce el celo en la vaca -- Cuando se presenta el celo en la vaca -- Factores que alteran el ciclo estral -- Como detectar el celo en la vaca26 página

Epidemiology of Neonatal Acute Respiratory Distress Syndrome:Prospective, Multicenter, International Cohort Study

OBJECTIVES: Age-specific definitions for acute respiratory distress syndrome (ARDS) are available, including a specific definition for neonates (the "Montreux definition"). The epidemiology of neonatal ARDS is unknown. The objective of this study was to describe the epidemiology, clinical course, treatment, and outcomes of neonatal ARDS. DESIGN: Prospective, international, observational, cohort study. SETTING: Fifteen academic neonatal ICUs. PATIENTS: Consecutive sample of neonates of any gestational age admitted to participating sites who met the neonatal ARDS Montreux definition criteria. MEASUREMENTS AND MAIN RESULTS: Neonatal ARDS was classified as direct or indirect, infectious or noninfectious, and perinatal (≤ 72 hr after birth) or late in onset. Primary outcomes were: 1) survival at 30 days from diagnosis, 2) inhospital survival, and 3) extracorporeal membrane oxygenation (ECMO)-free survival at 30 days from diagnosis. Secondary outcomes included respiratory complications and common neonatal extrapulmonary morbidities. A total of 239 neonates met criteria for the diagnosis of neonatal ARDS. The median prevalence was 1.5% of neonatal ICU admissions with male/female ratio of 1.5. Respiratory treatments were similar across gestational ages. Direct neonatal ARDS (51.5% of neonates) was more common in term neonates and the perinatal period. Indirect neonatal ARDS was often triggered by an infection and was more common in preterm neonates. Thirty-day, inhospital, and 30-day ECMO-free survival were 83.3%, 76.2%, and 79.5%, respectively. Direct neonatal ARDS was associated with better survival outcomes than indirect neonatal ARDS. Direct and noninfectious neonatal ARDS were associated with the poorest respiratory outcomes at 36 and 40 weeks' postmenstrual age. Gestational age was not associated with any primary outcome on multivariate analyses. CONCLUSIONS: Prevalence and survival of neonatal ARDS are similar to those of pediatric ARDS. The neonatal ARDS subtypes used in the current definition may be associated with distinct clinical outcomes and a different distribution for term and preterm neonates

Wireless transmission system of ECG and temperature for hospital areas

Este artículo presenta el diseño, desarrollo y pruebas de un dispositivo multicanal de adquisición y transmisión de señales electrocardiográficas y de temperatura, utilizando tecnologías de transmisión inalámbrica (Bluetooth, ZigBee, Radio- Frecuencia RF), con una interfaz de usuario en una central de monitoreo. Se analizó el desempeño del sistema de acuerdo a su disponibilidad (97%), tiempo de conexión (6 segundos) y precisión en las mediciones (98%).This paper presents the design, development and testing of a multi-channel device for acquisition and transmission of ECG and temperature signals, using wireless transmission technologies (Bluetooth, ZigBee, RF), with a central monitoring user interface. We analyzed the system’s performance based on its availability (97%), connection time (6 seconds) and measurement’s accuracy (98%

Implementation of corticosteroids in treating COVID-19 in the ISARIC WHO Clinical Characterisation Protocol UK:prospective observational cohort study

BACKGROUND: Dexamethasone was the first intervention proven to reduce mortality in patients with COVID-19 being treated in hospital. We aimed to evaluate the adoption of corticosteroids in the treatment of COVID-19 in the UK after the RECOVERY trial publication on June 16, 2020, and to identify discrepancies in care. METHODS: We did an audit of clinical implementation of corticosteroids in a prospective, observational, cohort study in 237 UK acute care hospitals between March 16, 2020, and April 14, 2021, restricted to patients aged 18 years or older with proven or high likelihood of COVID-19, who received supplementary oxygen. The primary outcome was administration of dexamethasone, prednisolone, hydrocortisone, or methylprednisolone. This study is registered with ISRCTN, ISRCTN66726260. FINDINGS: Between June 17, 2020, and April 14, 2021, 47 795 (75·2%) of 63 525 of patients on supplementary oxygen received corticosteroids, higher among patients requiring critical care than in those who received ward care (11 185 [86·6%] of 12 909 vs 36 415 [72·4%] of 50 278). Patients 50 years or older were significantly less likely to receive corticosteroids than those younger than 50 years (adjusted odds ratio 0·79 [95% CI 0·70–0·89], p=0·0001, for 70–79 years; 0·52 [0·46–0·58], p80 years), independent of patient demographics and illness severity. 84 (54·2%) of 155 pregnant women received corticosteroids. Rates of corticosteroid administration increased from 27·5% in the week before June 16, 2020, to 75–80% in January, 2021. INTERPRETATION: Implementation of corticosteroids into clinical practice in the UK for patients with COVID-19 has been successful, but not universal. Patients older than 70 years, independent of illness severity, chronic neurological disease, and dementia, were less likely to receive corticosteroids than those who were younger, as were pregnant women. This could reflect appropriate clinical decision making, but the possibility of inequitable access to life-saving care should be considered. FUNDING: UK National Institute for Health Research and UK Medical Research Council

Association between trends in clinical variables and outcome in intensive care patients with faecal peritonitis: analysis of the GenOSept cohort

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated

Para-infectious brain injury in COVID-19 persists at follow-up despite attenuated cytokine and autoantibody responses

To understand neurological complications of COVID-19 better both acutely and for recovery, we measured markers of brain injury, inflammatory mediators, and autoantibodies in 203 hospitalised participants; 111 with acute sera (1–11 days post-admission) and 92 convalescent sera (56 with COVID-19-associated neurological diagnoses). Here we show that compared to 60 uninfected controls, tTau, GFAP, NfL, and UCH-L1 are increased with COVID-19 infection at acute timepoints and NfL and GFAP are significantly higher in participants with neurological complications. Inflammatory mediators (IL-6, IL-12p40, HGF, M-CSF, CCL2, and IL-1RA) are associated with both altered consciousness and markers of brain injury. Autoantibodies are more common in COVID-19 than controls and some (including against MYL7, UCH-L1, and GRIN3B) are more frequent with altered consciousness. Additionally, convalescent participants with neurological complications show elevated GFAP and NfL, unrelated to attenuated systemic inflammatory mediators and to autoantibody responses. Overall, neurological complications of COVID-19 are associated with evidence of neuroglial injury in both acute and late disease and these correlate with dysregulated innate and adaptive immune responses acutely