Fowl adenovirus induced different manifestations of the disease in two consecutive chicken breeding flocks in a poultry hall

This study investigated an adenovirus infection in two consecutive breeding flocks in the same poultry hall. Thirty-six thousand one-day-old chickens of the ROSS 308 hybrid broiler type were kept together in one hall. The chickens in the first breeding flock during fattening did not show any clinical signs of the disease or increased mortality. Typical clinical signs of the adenovirus infection were seen in the second breeding flock. The signs included: depression, apathy, somnolence, a crouched position with a droopy head, fuzzy feathers, anaemic combs and wattles, sporadic nervous signs, and reduced weight gain. Increased mortality was recorded from 18 to 25 days of age, the higher mortality rate resulted from dehydration and exhaustion. The surviving chickens showed growth slightly below average by the end of the fattening period. The necropsies of the chickens in the first flock showed characteristic lesions for inclusion body hepatitis (IBH). Adenoviral gizzard erosions (AGE) were found mainly in the chickens of the second consecutive breeding flock. In both breeding flocks, FAdV-A was detected by polymerase chain reaction (PCR) in the liver and gizzard samples. The presence of fowl adenovirus B was not confirmed in the evaluated samples. The results showed lesions in the first flock typical for IBH, whereas the pathological changes in the second flock were characteristic of AGE

Implantation of venous access devices under local anesthesia: patients’ satisfaction with oral lorazepam

De-Hua Chang,1 Sonja Hiss,1 Lena Herich,2 Ingrid Becker,2 Kamal Mammadov,1 Mareike Franke,1 Anastasios Mpotsaris,1 Robert Kleinert,3 Thorsten Persigehl,1 David Maintz,1 Christopher Bangard1 1Department of Radiology, 2Institute of Medical Statistics, Informatics and Epidemiology, 3Department of Surgery, University Hospital of Cologne, Cologne, Germany Objective: The aim of the study reported here was to evaluate patients’ satisfaction with implantation of venous access devices under local anesthesia (LA) with and without additional oral sedation.Materials and methods: A total of 77 patients were enrolled in the prospective descriptive study over a period of 6 months. Subcutaneous implantable venous access devices through the subclavian vein were routinely implanted under LA. Patients were offered an additional oral sedative (lorazepam) before each procedure. The level of anxiety/tension, the intensity of pain, and patients’ satisfaction were evaluated before and immediately after the procedure using a visual analog scale (ranging from 0 to 10) with a standardized questionnaire.Results: Patients’ satisfaction with the procedure was high (mean: 1.3±2.0) with no significant difference between the group with premedication and the group with LA alone (P=0.54). However, seven out of 30 patients (23.3%) in the group that received premedication would not undergo the same procedure without general anesthesia. There was no significant influence of lorazepam on the intensity of pain (P=0.88). In 12 out of 30 patients (40%) in the premedication group, the level of tension was higher than 5 on the visual analog scale during the procedure. In 21 out of 77 patients (27.3%), the estimate of the level of tension differed between the interventionist and the patient by 3 or more points in 21 out of 77 patients (27.3%).Conclusion: Overall patient satisfaction is high for implantation of venous access devices under LA. A combination of LA with lorazepam administered orally might not be adequate for patients with a high level of anxiety and tension. The level of tension is often underestimated by the interventionist. Pre-procedural standardized questionnaires could be used to identify patients for whom a gradual approach of individualized sedation may be more effective. Keywords: patient satisfaction, pain, supportive care, chemotherapy, central venous port implantatio