PLASTIC CANNULA FOR RUMEN FISTULA

PLASTIC CANNULA FOR RUMEN FISTUL

EFFECT OF ESTROGEN IN THE ELIMINATION OF SEXUAL ODOR IN BOARS

EFFECT OF ESTROGEN IN THE ELIMINATION OF SEXUAL ODOR IN BOAR

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Título en español.

Resumen en inglés.Resumen en español

Título en español.

Further studies on the evaluation of "Valsyn-Gel" were carried out, using both sterile and nonsterile preparations of this drug and comparing it with a drug of choice currently used in mastitis control. The object of the study was to obtain a clearer idea of the time-lapse between the treatment of a quarter until organisms showed again, by taking a series of samples of each treated quarter obtained consecutively at 3-day intervals up to 21 days posttreatment. Results showed that the therapeutic efficiency of the nonsterile product ranged from 86.4 percent 3 days after treatment to 63.6 percent 21 days after treatment. With the sterile product the efficiency ranged from 72.7 to 50.0 percent. The drug of choice, a chlortetracycline ointment, showed a higher efficiency than either of the two other products as evaluated. Nevertheless, it seems apparent that the preparations had a high therapeutic value for the first 9 to 12 days following treatment.Se continuó el estudio de la evaluación del Valsyn-Gel, usando preparaciones esterilizadas y sin esterilizar del producto, comparándolas con otra droga corrientemente usada para el tratamiento de la mastitis. El objetivo primordial era tener una idea más precisa del tiempo que transcurre desde que se empieza el tratamiento de la infección hasta la aparición del organismo nuevamente en la leche, para lo cual se tomó una serie de muestras consecutivas de cada cuarto tratado a intervalos de 3 días hasta un límite de 21 días. Los resultados demostraron que la eficiencia terapéutica del producto sin esterilizar varió desde el 83.4 por ciento a los 3 días de comenzar el tratamiento, hasta un 63.6 por ciento a los 21 días después. La eficiencia terapéutica para el producto esterilizado varió desde un 72.7 hasta 50.0 por ciento. La droga escogida para comparación demostró tener una eficiencia terapéutica mayor que cualesquiera de los dos productos evaluados. Sin embargo, es aparente que los tres productos poseen un valor terapéutico bastante alto durante los primeros 9 a 12 días subsiguientes al tratamiento

"Valsyn Mix" In Comparative Studies of the Prevention of Coliform Diarrhea in Calves

A group of 12 newborn calves was fed antibiotic-free reconstituted skim milk, at a 10-percent body weight daily level, for 35 days. Each of two other calf-groups was fed the basal ration with an oxy tot rocy clin e-HCl additive, and the basal ration, with "Vaisyn Mix", a furaltadone preparation. All calves wore orally inoculated for 10 consecutive days with doses of E. coli. Daily temperature and physical observations, and weekly clinico-hematological data were recorded for each calf. Statistical, analyses showed that there were no significant differences between treatment groups in relation to the hematocrit, level and death of calves, or the leukocyte level and death of calves, and also that gain in body-weight of survivor calves is independent of treatment-schedule influence. However, there is statistical significance at the 5-percent level between the ability of Valsyn Mix to protect calves from E. coli diarrhea when compared with oxytetracycline hydrochloride, and no medication

Título en español.

A study was conducted to evaluate the therapeutic efficiency of "Valsyn- Gel," a furaltadone-containing preparation, in the control of mastitic infections. Two hundred and thirteen quarters were randomly treated with the preparations used in the evaluation study. Treatment-efficiency percentages for Valsyn-Gel were 89.5, 78.9, 78.9, and 78.9 for 10, 19, 20, and 21 days posttreatment. Percentages for two other preparations, oxytetracycline and chlortetracyclinc neomycin, varied from 100 for the 10-day posttreatment check to 81.3 for the 21-day posttreatment observation.Se llevó a cabo un estudio para evaluar la eficiencia terapéutica del Valsyn-Gel, preparación que contiene furaltadone y que se usa para combatir la mastitis. Se trataron doscientos trece (213) cuartos, agrupados al azar, con las tres preparaciones bajo estudio. La eficiencia terapéutica del Valsyn-Gel después de los 10, 19, 20, 21 días del tratamiento fue de 89.5, 78.9, 78.9, y 78.9 por ciento, respectivamente. El porcentaje de eficiencia de los otros dos compuestos varió desde 100 por ciento, diez días después del tratamiento, hasta 81.3 por ciento 21 días después