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

Small intestinal strangulation in 60 cattle – clinical, laboratory and ultrasonographic findings, treatment and outcome

Background: Intestinal strangulation is constriction of the intestine by a band of tissue, ligament or blood vessel causing partial or complete intestinal obstruction. This retrospective study describes the clinical, laboratory and ultrasonographic findings, treatment and outcome of 60 cows with intestinal strangulation. Results: The general condition was abnormal in all cows (60/60), 23.3% (14/60) had nonspecific signs of pain, 40.0% (24/60) had signs of colic and 48.3% (29/60) had signs of somatic (parietal) pain. The most common digestive tract abnormalities were, in decreasing frequency, reduced or absent intestinal motility (100%, 60/60), reduced or absent faecal output (98.3%, 59/60), reduced or absent rumen motility (93.4%, 56/60), dilated small intestines on transrectal palpation (63.3%, 38/60), positive ballottement and swinging auscultation (BSA) and/or percussion and simultaneous auscultation (PSA) on the right side of the abdomen (58.3%, 35/60) and at least one positive foreign body test, most commonly the back grip, in 33.9% (20/59) of the cows. Other common findings were reduced skin surface temperature (67.8%, 40/59), reduced skin turgor (51.7%, 31/60), prolonged capillary refill time (49.2%, 29/59), enophthalmus (48.3%, 29/60) and moderate to severe scleral injection (46.6%, 27/58). The most common laboratory findings were hypokalaemia (58.3%, 35/60), haemoconcentration (57.6%, 34/59), base excess (51.1%, 24/47), hyperproteinaemia (45.8%, 27/59), hyperbilirubinaemia (43.3%, 26/60), acidosis (42.6%, 20/47) and azotaemia (38.3%, 23/60). The principal ultrasonographic findings were subjectively reduced or absent small intestinal motility and dilated small intestines, but the strangulation could not be visualised by ultrasonography. With one exception, all cows underwent a right flank laparotomy to resolve the strangulation by transection or resection of the impinging tissue. Forty-nine (81.7%) cows were discharged and 11 (18.3%) were euthanized before, during or after surgery. Conclusions: Without laparotomy, intestinal strangulation could be clinically (transrectally) diagnosed in only 10% of the cows. A laparotomy is therefore essential for the correct diagnosis. The prognosis is good with prompt surgical treatment

Left and right displaced abomasum and abomasal volvulus: comparison of clinical, laboratory and ultrasonographic findings in 1982 dairy cows.

BACKGROUND: Although left and right displacement of the abomasum and abomasal volvulus are well-known disorders of cattle, a comparative evaluation of the clinical, laboratory and ultrasonographic findings of these types of abomasal displacements has not been undertaken. Therefore, the objective of this study was to compare these conditions in a large population of cows. The medical records of 1982 dairy cows with left displaced abomasum (LDA, n = 1341), right displaced absomasum (RDA, n = 338) and abomasal volvulus (AV, n = 303) were searched for the results of clinical, laboratory and ultrasonographic evaluations. RESULTS: The main clinical findings were an abnormal demeanour in 48.2% of the cows, reduced rumen motility in 89.7% and decreased intestinal motility in 61.1%. Ballottement and simultaneous auscultation and percussion and simultaneous auscultation were positive on the left side in 96.9% of the cows with LDA and on the right in 98.5% of the cows with RDA and in 99.3% of the cows with AV. Ultrasonography was useful for diagnosing LDA in 97.9% of the cows and RDA/AV in 90.2% of the cows. The laboratory findings characteristic of abomasal reflux syndrome varied in severity; 83% of the cows had hypokalaemia, 67% had increased rumen chloride concentration, 67% had an increased base excess and 50% had haemoconcentration. Based on the clinical signs, a definitive diagnosis was made in 75.0% of the cows with LDA and in 22.5% of the cows with RDA/AV. Ultrasonography was required for a definitive diagnosis in another 22.0% of the cows with LDA and in 53.0% of the cows with RDA/AV. Laparotomy or postmortem examination was required for reliable differentiation of RDA and AV. CONCLUSIONS: LDA, RDA and AV differ with respect to the severity and the frequency of several abnormal clinical, laboratory and ultrasonographic findings as well as the methods required for a diagnosis

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

Therapeutic anticoagulation complications in the elderly: a case report

Background: The demographic transition leads to a continuously growing number of elderly patients who receive therapeutic anticoagulation by reason of several comorbidities. Though therapeutic anticoagulation may reduce the number of embolic complications in these patients, major complications such as bleeding complications need to be kept in mind when considering such therapy. However, evidence regarding the choice of anticoagulation agents in chronic kidney disease patients of higher age is limited. In this report, a guideline-based anticoagulation treatment which led to a fulminant atraumatic bleeding complication is discussed. Case presentation: We present the case of an 85-year-old female stage V chronic kidney disease patient who suffered from a diffuse arterial, subcutaneous bleeding in her lower left leg due a therapeutic anticoagulation using low molecular weight heparin (LMWH). Anticoagulation was started in accordance with general recommendations for patients with atrial fibrillation, and the dosage was adapted for the patient's renal function. Nevertheless, the above-mentioned complication occurred, and the bleeding led to a hemorrhagic shock and an acute kidney injury on top of a chronic kidney disease. The hematoma required surgical evacuation and local coagulation in the operating room. In the further course, the patient underwent additional four surgical interventions due to a superinfected skin necrosis, including skin grafting. Furthermore, the patient needed continuous renal replacement therapy, as well as intensive care unit treatment, for a total of 47 days followed by 36 days of geriatric rehabilitation. Afterwards, she was discharged from the hospital to her previous nursing home. Discussion and conclusions: Although therapeutic anticoagulation may sufficiently protect patients at cardiovascular risk, major complications such as bleeding complications may occur at any time. Therefore, physicians need to regularly re-evaluate any prior indication for therapeutic anticoagulation. With this case report, we hope to draw attention to the cohort of geriatric patients and the need for more and well differentiated study settings to preferably prevent any potentially avoidable complications

Wirtschaften. Kulturwissenschaftliche Perspektiven.

Unter dem Titel „Wirtschaften. Kulturwissenschaftliche Perspektiven“ fand 2017 in Marburg der 41. Kongress der Deutschen Gesellschaft für Volkskunde (dgv) auf Einladung des Instituts für Europäische Ethnologie / Kulturwissenschaft der Philipps-Universität Marburg statt. Die vorliegende Publikation liefert eine umfassende Dokumentation der auf dem Kongress diskutierten Beiträge

The Realization of Redistribution Layers for FOWLP by Inkjet Printing

The implementation of additive manufacturing technology (e.g., digital printing) to the electronic packaging segment has recently received increasing attention. In almost all types of Fan-out wafer level packaging (FOWLP), redistribution layers (RDLs) are formed by a combination of photolithography, sputtering and plating process. Alternatively, in this study, inkjet-printed RDLs were introduced for FOWLP. In contrast to a subtractive method (e.g., photolithography), additive manufacturing techniques allow depositing the material only where it is desired. In the current study, RDL structures for different embedded modules were realized by inkjet printing and further characterized by electrical examinations. It was proposed that a digital printing process can be a more efficient and lower-cost solution especially for rapid prototyping of RDLs, since several production steps will be skipped, less material will be wasted and the supply chain will be shortened.EC/H2020/737487/EU/(Ultra)Sound Interfaces and Low Energy iNtegrated SEnsors/SILENS

A Raf-competitive K-Ras binder can fail to functionally antagonize signaling

Mutated in approximately 30% of human cancers, Ras GTPases are the most common drivers of oncogenesis and render tumors unresponsive to many standard therapies. Despite decades of research, no drugs directly targeting Ras are currently available. We have previously characterized a small protein antagonist of K-Ras, R11.1.6, and demonstrated its direct competition with Raf for Ras binding. Here we evaluate the effects of R11.1.6 on Ras signaling and cellular proliferation in a panel of human cancer cell lines. Through lentiviral transduction, we generated cell lines that constitutively or through induction with doxycycline express R11.1.6 or a control protein YW1 and show specific binding by R11.1.6 to endogenous Ras through microscopy and co-immunoprecipitation experiments. Genetically-encoded intracellular expression of this high-affinity Ras antagonist, however, fails to measurably disrupt signaling through either the MAPK or PI3K pathway. Consistently, cellular proliferation was unaffected as well. To understand this lack of signaling inhibition, we quantified the number of molecules of R11.1.6 expressed by the inducible cell lines and developed a simple mathematical model describing the competitive binding of Ras by R11.1.6 and Raf. This model supports a potential mechanism for the lack of biological effects that we observed, suggesting stoichiometric and thermodynamic barriers that should be overcome in pharmacological efforts to directly compete with downstream effector proteins localized to membranes at very high effective concentrations.National Institutes of Health (U.S.) (grant 5 -R01-CA096504 -15)Massachusetts Institute of Technology. Associate Director FundMassachusetts Institute of Technology. Frontier FundDavid H. Koch Institute for Integrative Cancer Research at MIT. (Support core Grant P30- CA14051)National Institute of General Medical Sciences (U.S.). Interdepartmental Biotechnology Training Program ([T32 GM008334-25)German Cancer Foundation (Mildred-Scheel fellowship)Massachusetts Institute of Technology. Ludwig Center for Cancer Researc

The effects of response probability on commission errors in high go low no-go dual response versions of the sustained attention to response task (SART)

In the current investigation, we modified the high Go low No-Go Sustained Attention to Response Task (SART) by replacing the single response on Go trials with a dual response (dual response SART or DR SART). In three experiments a total of 80 participants completed the SART and versions of the DR SART in which response probabilities varied from 50-50, through 70-30 to 90-10. The probability of No-Go withhold stimuli was .11 in all experiments. Using a dynamic utility based model proposed by Peebles and Bothell (2004) we predicted that the 50-50 DR-SART would dramatically reduce commission errors. Additionally, the model predicted that the probability of commission errors to be an increasing function of response frequency. Both predictions were confirmed. Although the increasing rate of commission errors with response probability can also be accommodated by the rationale originally proposed for the SART by its creators (Robertson, Manly, Andrade, Baddeley, & Yiend, 1997) the fact that the current DR SART results and SART findings in general can be accommodated by a utility model without need for any attention processes is a challenge to views that ascribe commission errors to lapses of sustained attention