The prevalence of hematological and milk quality in cows and the prevalence of mineral metabolism diseases and mastitis in Company X

By: Vilius Urbonas. Subject: The prevalence of hematological and milk quality in cows and the prevalence of mineral metabolism diseases and mastitis in Company X. Head of the work: prof., Dr. Judita Žymantienė. Place of performance: Lithuanian University of Health Sciences. Department of Anatomy and Physiology, Veterinary Academy. Thesis consist of: 38 pages: (9 pictures, 4 tables, 70 literature sources). The aim of the study was to investigate and analyze the qualitative indices of cows' blood and milk and the prevalence of mineral metabolism diseases and mastitis in company X. A company with more than 1000 dairy cattle was chosen for the research. Blood and milk samples were taken. Mastitis tests and Mastitis strain detection tests were performed. The milk was studied in SLS - the number of somatic cells - Somascope (CA-3A4, 2004) and the CMT-California mastitis test was used. Blood analysis of mineral substances and enzymes: AST-aspartate aminotransferase, ALT-alanine aminotransferase, ALP-alkaline phosphatase-analyzer. SPSS 20.0 for Windows was used for statistical processing, and the results were considered reliable when p <0.05. Changes in the level of mineral substances in the milk of dairy cows: calcium, potassium, magnesium, phosphorus and blood enzyme activity disrupt metabolic processes, reduce milk yield and alter the quality of milk, disrupt the general functional state, increase the activity of mastitis causing agents. Regardless of the seasonal nature of mastitis, in the herd of cows most commonly mastitis was caused by mixed pathogens, followed by Streptococcus agalactiae and Staphylococcus spp. And very few E. coli cases. The maximum milk yield of healthy cows in the herd was 4th lactations. Comparing the milk yield of this lactation, it was 1.71%. more than 3rd lactations and 5.53% more than 2nd lactations cows. More milk fat was in milk of older cows, but the protein content and lactose varied insignificantly in the herd of cows and were almost independent of lactation. More somatic cells were found in the autumn season. Milk urea all season varied irrespective of seasonality. In winter, calcium in cows blood was 12.84% and in spring 11.28% more than autumn; In winter potassium was 17.65% less then average rate, but in spring the potassium content was not much different than in the autumn; The magnesium content in the winter period was 26.67%. lower in comparison with the average rate, the phosphorus content of cows did not change during the separate seasons. Enzyme activity in the blood has varied throughout the season, but was within the normal range

Architectural Heritage as a Socioeconomic Opportunity for Revitalization of Historic Urban Centres: a Global Perspective

The focus of the research was to analyze how theuse, re-use and the preservation of the architectural heritage couldcontribute to the socioeconomic revitalization of historic urbancentres. The research was based on the analysis of literature andexamples and was carried out from the global perspective: theexperience of different countries on how the architectural heritagecould become a socioeconomic catalyst was reviewed and compared.The results of the research include the conceptual framework forthe architectural heritage as a socioeconomic opportunity forrehabilitation of historic built environment based on the idea thatsustainably managed use, re-use, preservation, and maintenanceof architectural heritage can have multipartite positive impacton revitalization and successful development of historic urbanenvironment

Life cycle process model of a market-oriented and student centered higher education

There is not a single definition/explanation about market-orientation education. Two opposite definitions/explanations of pure market-oriented education (Cato, 2010) and social-market-oriented education (Amaratunga, 2009) are provided in the paper. Integrated multiple criteria analysis at the micro-, meso- and macro-levels are needed to increase efficiency of the market-oriented higher education reforms. Market-oriented higher education reforms management involves numerous aspects that should be considered in addition to making educational, pedagogical, didactical, economic, political and legal/regulatory decisions. These must include social, culture, ethical, psychological, environmental, technological, technical, organizational and managerial aspects. This article presents a Life Cycle Process Model of a Market-Oriented and Student Centered Higher Education (developed during BELL-CURVE (Built Environment Lifelong Learning Challenging University Responses to Vocational Education) project's activities) for such considerations and discusses certain composite parts of it. To demonstrate the application of this research, two Case Studies from Lithuania are submitted for consideration

Extracorporeal Life Support for Cardiogenic Shock in Octogenarians: Single Center Experience

Background: The age limit for the use of extracorporeal membrane oxygenation (ECMO) support for post-cardiotomy cardiac failure is not defined. The aim of the study was to evaluate the outcomes of octogenarians supported with ECMO due to cardiogenic shock. Methods: A retrospective review of consecutive elderly patients supported with ECMO during a 13-year period in a tertiary care center. Patient’s demographic variables, comorbidities, perioperative data and outcomes were collected from patient medical records. Data of octogenarian patients were compared with the septuagenarian group. The main outcomes of the study was in hospital mortality, 6-month survival and 1-year survival after hospital discharge and discharge options. Multivariate logistic regression analysis was performed to identify the factors associated with hospital survival. Results: Eleven patients (18.3%) in the elderly group were octogenarians (aged 80 years or above), and forty-nine (81.7%) were septuagenarians (aged 70–79 years). There were no differences except age in demographic and preoperative variables between groups. Pre ECMO SAVE, SOFA, SAPS—II and inotropic scores were significantly higher in septuagenarians than octogenarians. There was no statistically significant difference in hospital mortality, 6-month survival, 1 year survival or discharge options between groups. Conclusions: ECMO could be successfully used in selected octogenarian patients undergoing cardiac surgery to support a failing heart. An early decision to initiate ECMO therapy in elderly post-cardiotomy shock patients is associated with favorable outcomes

A comparison of the catheter-based transapical and surgical treatment modalities for mitral paravalvular leak

Background: There is a lack of studies where the outcomes of mitral paravalvular leak treatment were compared between surgery and catheter-based closure. The aim of this study was to compare the outcomes of re-do surgery with transapical catheter-based paravalvular leak closure. Methods: This is a retrospective observational study at a single institution; 76 patients were included. According to the treatment, two groups were formed: the “Surgical” group (49 patients after re-do surgery) and the “Catheter” group (27 patients after transapical catheter–based treatment). Results: In-hospital myocardial infarction occurred in 9 (18%) cases in the “Surgical” group and none in the “Catheter” group, p = 0.018. Procedure-related life-threatening bleeding occurred in 9 (18%) patients in the “Surgical” group and none in the “Catheter” group, p = 0.018. Nine (18%) patients died in 30 days in the “Surgical” group, and none died in the “Catheter” group, p = 0.039. A mean follow-up was 3.3 years. No difference was found between the groups by the degree of residual paravalvular regurgitation either at discharge or at follow-up. During the follow-up, 19 (39%) patients died in the “Surgical” group and 2 (7%) among the “Catheter” patients. Conclusions: Transapical catheter-based closure of mitral paravalvular leak seems to be a safer treatment procedure than conventional re-do surgery, and the effectiveness of these procedures does not differ

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research