#Rehabilitation Journal

[crimson-marine]

What are the Perceived Therapy Needs of Adults Living with Osteogenesis Imperfecta? A Focus Group Study

 Abstract

Background: Osteogenesis Imperfecta (OI) is a rare genetic disorder characterised by fragile bones. Clinical presentation includes multiple health issues which impact on quality of life. There is no published data on what adults with OI perceive their therapy needs to be. 

Objective: This study aims to explore the therapy needs of adults with OI. 

Methods: A convenience sample of adults were recruited from a multidisciplinary OI clinic. Participants were split into two groups based on their clinical classification. Semi-structured questions were asked focusing on perceived needs for therapy. Thematic analysis identified common themes from the data. 

Result: Eleven participants were allocated to two focus groups, ages ranged from 27-68 years. The discussions from both groups elicited similar interconnecting themes of 1) knowledge and expertise, 2) confidence in healthcare services, 3) access to healthcare and community services. There was consensus that therapy was required for adults with OI and treatment was not only for fractures. However, participants valued continuity of care with healthcare professionals who understood OI and where this wasn’t available dissatisfaction with healthcare was identified. Therapy included multiple disciplines reflecting the participants’ wide-ranging needs which reflected a bio-psycho-social framework.

 Conclusion: The results reflect the life-long nature of OI and its impact on quality of life. Participants felt a holistic approach to treatment was the most beneficial due to the complexity and variability of OI. Impact statement: This study demonstrates a need for specialist multidisciplinary services to be commissioned for adults with OI.

Read more about this article: https://crimsonpublishers.com/epmr/pdf/EPMR.000598.pdf

Read more Crimson Publishers Google Scholar

Articles: https://scholar.google.com/citations?view_op=view_citation&hl=en&user=MAr8S6kAAAAJ&citation_for_view=MAr8S6kAAAAJ:TQgYirikUcIC

[bamsara]

Death of the Heart

A peak into Narinder's journal.

Speedpaint here, and also a bonus:

[acrobattack]

i don’t know if this is a hot take or not but the rr/b skew more neutral than evil to me

[complicatedconstellation-blog]

[jcsmicasereports]

Prevention and rehabilitation in Middle Ages by Prof. Francesco Carelli in Journal of Clinical Case Reports Medical Images and Health Sciences

Italian hospitals in the late Middle Ages already offered much more than a simple reception and care.  In a work that can be consulted in the Laurentian Library in Florence, datable about 1300,  painter Gaddi shows a series of hospitalized people. Already the representation is not very sad perhaps due to the lack of modern white walls and patients appear regularly placed in beds with acts of assistance and care.  The two couples in the foreground completely decline an idea of health that we moderns tend to, even though we have not yet reached it.  In fact, therapy is combined with education and prevention.   The disease in question is a chronic vascular sore, a subject not resolved at by us moderns and a source of great health care costs.    One of the reasons for these costs is to be fund in the lack of attention of moderns to preventive and educational activities.   In the foreground on the right the therapeutic act is portrayed, in which it is evident a doctor performing a cleaning, disinfection and dressing of a vascular sore.   But the great news that is incredible in the so – called dark ages, is portrayed on the left. The doctor, recognizable by the red headdress, gives a stick, that is a device to improve, encourage and facilitate the ambulatory exercise by his patient.   We also note that he spends time on an explanation to the patient who is portrayed as he listens to medical advice with interest.  The rehabilitation intentions are proven by the fact the patient wears a rudimentary orthopaedic brace which surrounds widely the neck.  The device allows the patient to walk keeping the arm hanging from the neck, unable to move perhaps following a trauma. In the hospitals of the Middle Ages, therefore, education and adapted motor activity were carried out which, today, together with food, is considered the basis of disease prevention.

[parasite-core]

Last night I had a really in depth dream about spider-man (specifically Miles Morales) going through this sort of apocalyptic horror scenario. I don’t remember the details except that at some point Doc Ock was there, and Miles was trying really hard to impress Peter.

Then at some point when it started going horror again, I had a lucid moment and decided to nope out of that and turned into a dragon themed super hero who was working with another hero who was very much a lesbian and they were very much in a relationship. At some point she had to go, though, but she acknowledged that this was a dream and said she’d be back in a few months.

[insufferable-mental-plague]

03/19/2024—“The Truth” vs “Ignorance is Bliss”

The path of the unknown & the fear it holds, but yet, is coincided with a certainty shaped by the will of the beholder, whom is battling with the demons of grief & trauma-induced addiction.

[Note from Writer—this is a passage of me journaling my current state of deprivation. I’m writing as I’m 25 years old, almost 26, & dealing with indescribable grief, struggling with addiction, C-PTSD, homelessness, & with being completely lost. Today is the four year anniversary of losing a friend to fentanyl, & after breaking my sobriety despite how successful rehab was for me with the fulfillment, resources, safety, & guidance I’ve been needing for recovery… I am undoubtedly, very lost.]

“Ignorance is bliss”—a notion I will never stand by; although, the ulterior within that, “the truth”, doesn’t necessarily hold bliss within its conditions & circumstances either.

More often than not, it’s darker & unnerving, yet paradoxically formidable as well.

Undoubtedly, I can say with unshakeable confidence, that despite how much “the truth” can (& will) bring forth an unforgiving misery…. It will always be the chosen route, as I will always rather see & know the harsher realities within the truth than be willfully nor complacently ignorant.

I refuse to feed into a perception that is inadequate, falsified, or fabricated… as it perpetuates a foreboding essence & circumstances that stains the soul—inevitably fueling ‘the fear of the unknown’—a daunting absence of understanding that lingers when one traps themselves within ignorance (whether it’s willful, or otherwise).

Yet, despite all the certainty I hold with denying willful ignorance, I still shake the hand of doubt on what to do with the knowledge I discover & seek. This uncontainable curiosity I hold within myself that disallows me to seek anything but “the truth”, induces such dismaying consequences within my psyche & my physiological-being—holding such understandings of the realities has me disillusioned more often than not, whether it’s with myself, or with the world I interact with around me.

I hold a light that is unyielding, limitless potential that can (& will) instill tangible change, it’ll cultivate the growth & healing that my very own being embodies within this universe with the visions I hold with hope & an unbreakable drive…

Yet, despite this, there’s an undeniable & almost indescribable side I also hold that is nihilistic in-on-itself. Often, I use this to create this imperishable goal that is self-driven & is now deterministic by my own free-will, but some days, all I see is doubt.

Doubt in anything & everything, & everything is seemingly meaningless at its conceptual core. Purpose is a materialized system that derive from human emotion, beliefs, experience, fear, etc.; our capability to have higher-level thinking that allows for conceptualization to occur from a core that means nothing.

I know this duality gives me power & allows myself to deepen my understanding within “the truth”… but how do I not fall into becoming a subject of complete incapability that has me in a state of unbearable despair that diminishes everything in & around me? The question still remains—how does one deal with the unknown when the fear festers naturally?

It seems to thrive during your darkest moments, moments that have an unallocated amount of time in place with an indeterminate duration of when it’s haunting us deep within our souls… how do I come out alive, & shift from always being in this constant state of survival, so I can live life to the perception I which go achieve?

[strawbynrobyn]

Had a dream that I was doing high school like normal but then when it was time to go- I went to some kind of at risk/recovery house with the other students. Like I didn't go home. I was institutionalized but they still let you got off campus for school.

Also it was implied as an alternative to juvie on top of the rehab (which tracks) but I was the only one there for something ✨ violent ✨ that everyone knew about but they weren't afraid of me either, just picked on me.

Some girls were like "that's so scorpio of you" -actually I'm a Pisces "oh no that's so much worse"

[povrehab]

She is not OK, but she doesn’t know it

With a packed schedule, work, kids, life maintenance

There is no time created for silence to listen to her own needs, wants, desires

To hear her own cries for peace written off as normal anxieties, insomnia and a general lack of appetite

She is not ok

She thinks everyone grinds through life just like her with the only prize being no prize, simply to make it to the end

She is not ok, but she doesn’t know it

So be kind and gentle, take nothing personally, and give space and love with nothing expected in return

Because you know. She is not ok.

[unusual-uraniidae]

FAIR WARNING THAT THESE ARE GRAPHIC SURGICAL IMAGES AND YOU MAY NOT WANT TO WATCH. IT INVOLVES A CHICKEN THAT IS LIGHTLY SEDATED SO SHE DOES MOVE A LITTLE. SHE DID HAVE A LOCAL ANESTHETIC AND SHOULD NOT HAVE BEEN IN MUCH PAIN IF ANY.

My Mom contacted the closest farm vet to us. She said she didn’t have any experience with chickens, but if it was truly an impacted crop then she might be able to perform the surgery necessary to fix it. We said that would be fine; if there’s a chance of saving her we might as well try.

Below is a video of the surgery (done on the dining room table and you can see my parrot, Bean, making a cameo) and a photo of everything taken out of her. She was eating her bedding as I recently switched over from sawdust to straw, thinking they might like it better. 🙄 Looks like I’m back to sawdust. This was a nightmare and I’m so so sorry to Patti for not catching it sooner.

My mom took this video because I was busy holding the surgical light lol!

I can’t believe this all fit inside one chicken. Insanity.

Patti is currently doing very well! She’s standing on her own and has been eating and drinking. She receives small doses of amoxicillin 3 times a day, we have a Honey Silver spray to put on the wound to prevent her from chewing at the stitches while also helping prevent infection, and we are feeding her a mash of their usual crumble pellets mixed with sugar and some soldier worms for energy. She also has access to one water that has an aspirin solution (325mg per gallon) and another that has Poultry Cel, which is a high vitamin content solution that should bring her back to her usual self in no time!

[biomedres]

Perception of Palestinian Undergraduate Nursing and Midwifery Students About Professional Values: A Cross-Sectional Study

Perception of Palestinian Undergraduate Nursing and Midwifery Students About Professional Values: A Cross-Sectional Study in Biomedical Journal of Scientific & Technical Research

Background: Professional values provide a context for appraising beliefs and attitudes that guide behaviors and considered as standards for acceptable actions by professionals toward providing safe patient care. Aim: This study aimed to assess professional values among Palestinian undergraduate nursing and midwifery students and examine the relationship between students’ demographics and professional values. Materials and Methods: A cross-sectional design was used in this study. A convenient sample of 370 undergraduate nursing and midwifery students from the Islamic University of Gaza, Palestine completed an electronic version of the revised nursing professional values scale, which consists of 26 items covering five domains (caring, trust, justice, activism and professionalism). Results: Age of participants ranged between 18 and 36 years with a mean of 21.1 years. The majority of them were females (60.7%), regular students (87.3%), were enrolled in the nursing program (95.4%). The top caring statement rated by the participants was “Maintain confidentiality of patient” (4.41) while the statement “Protect rights of participants in research” received the lowest score (3.62). The mean total scores of the domains of revised nursing professional values scale ranged between 3.610 for the “professionalism” domain and 4.133 for the “justice” domain. The variables related to age, gender, grades cumulative average, study year did not impact the scores of the revised nursing professional values scale or its domains. Conclusion: This study found that professional values were relatively high among Palestinian nursing and midwifery students. Justice and caring domains were rated highest by participants, while activism and professionalism domains were rated low. These results should alert nursing educators to their roles in improving these values among nursing and midwifery students. This could be approached by empowering, role modeling and engagement of students in more activities to enhance these values.

For more articles in Journals on Biomedical Sciences click here bjstr Follow on Twitter : https://twitter.com/Biomedres01 Follow on Blogger : https://biomedres01.blogspot.com/ Like Our Pins On : https://www.pinterest.com/biomedres/

[crimson-rehabilitation]

A Good Therapeutic Approach for Patients with Paraparesis due to Spinal Arteriovenous Fistula

 Abstract

Although Spinal Dural Arteriovenous Fistula (SDAVF) is the most common arterio-venous malformation of the spinal cord, it is an extremely rare pathology. It is usually an acquired condition that may cause congestive myelopathy through chronic venous hypertension. The clinical picture is non-specific but the diagnosis can be inferred from Magnetic Resonance Imaging (MRI) and confirmed through Digital Subtraction Angiography (DSA). We report four cases that presented in our clinic in the past twelve months and in which SDAVF was suspected based on spinal MRI. The mean age was 54. Three of them presented with severe motor deficits and two of them had sphincteric disturbances. Sensory deficits varied. Three of the patients had a subacute progression, while one of them evolved rather acutely. The diagnosis was confirmed through DSA with selective catheterization and endovascular occlusion of the feeding artery by injection of liquid embolic material was performed with no periprocedural incidents. There was no further progression of deficits and three of the patients presented partial improvement by the time of discharge. One of the main challenges posed by these patients is correctly identifying the feeding artery of the SDAVF, which may be achieved by spinal Magnetic Resonance Angiography (MRA) and elaborate DSA. Another aspect relates to the recovery of neurologic deficits which includes motor rehabilitation programmes, as well as management of associated symptoms and pathologies. It is our experience that shunt obliteration should be always attempted as SDAVF is a rare but recuperable cause of severe neurologic deficits.

Read more about this article: https://crimsonpublishers.com/epmr/pdf/EPMR.000588.pdf

Read more Crimson Publishers Google Scholar

Articles: https://scholar.google.com/citations?view_op=view_citation&hl=en&user=MAr8S6kAAAAJ&citation_for_view=MAr8S6kAAAAJ:maZDTaKrznsC

[cleaningmydollsfeet]

excerpt from my father’s rehab journal 22 years ago.

[dontforgetukraine]

Ukraine Donation Guide Master Post

(Ver. 2 updated Aug 13th, 2024) I will be reformatting this and adding more in the future when I have time.

Also a quick note, all of the groups I have found through twitter have been around long enough for them to be vetted by each other and the brigades they work with. In fact, a lot of these groups collaborate with each other too. Those that are in the fight for Ukraine have been diligent in calling out those that are grifters. Word spreads around quickly if an organization doesn't show up with what they promised. They also use their social media (often Twitter) as a means of transparency for their work.

Remember: When considering on whether to donate, always use your best judgement and donate to those you trust if you do not see what is listed is up to your standards.

Multi-Purpose

United 24 has various fundraisers dedicated to defense and drones, medical aid, rebuilding Ukraine, humanitarian demining, and science and education. You can pick which one you want to contribute to under their various projects.

Liberty Ukraine uses funds for humanitarian aid, medical supplies, protective gear and equipment, and rehabilitation therapy. You can choose which campaign of theirs to donate to.

Come Back Alive is a charitable foundation that supports Ukraine's military with competent assistance while also focusing on security and defense. They also have projects that use sports to help veterans rehabilitate. You can choose which campaign to donate to.

Serhiy Prytula Charity Foundation works to help both civilians and Ukraine's army. You can choose to donate to an active project or any of their general campaigns. Civilian aid campaigns cover temporary housing, supporting crisis and emergency responses, schools, demining, and healthcare. Military aid campaigns cover drones, optics units, communications equipment, and support of air defense teams.

Food Aid

World Central Kitchen works with local partners wherever they are providing food aid. They make sure meals and meal kits are what the local population eats. Even though there is no separate fundraising campaign for Ukraine (that I can see), they still do great work.

Animal Rescue

Hachiko Foundation works to help displaced pets and strays in frontline areas. They help with veterinary care, outdoor shelters, setting up feeding stations, and rehoming animals.

Medical Aid

Hospitallers (Website) is a volunteer organization of paramedics that was founded in 2014. They evacuate the wounded, provide medical aid on the frontlines, assist in rehabilitation, and transfer of the deceased to burial sites. They are also supported by Ukraine Charity. Visit Hospitallers' website to see how many they have evacuated, different methods you can donate, and more information about them.

Other

Saint Javelin (Twitter; Website) is a great place to get apparel, gear, and other cool loot to show your support for Ukraine. They don't take donations, but instead raise funds through their shop with a portion of their sales going towards humanitarian aid and critical items needed by the defenders (generators, pick-up trucks, medical supplies etc). Part of their shop has items made in Ukraine to support Ukrainian businesses. Overall, their products are high-quality. I include them due to their impactful presence in the Twitter community I follow and how they make Ukraine visible in an alternative way. Consider buying someone a gift from their shop.

The Kyiv Independent (Twitter; Website) is a great English language resource for news about Ukraine. I include them because I think supporting good journalism is incredibly important, especially now when the information space is fraught with Russian propaganda, misinformation, and disinformation. My followers have probably noticed I've pulled a lot of quotes from their stories in an effort to amplify Ukrainian voices and experiences. Look on their website for more information on different way to support them, such as their Patreon.

---

If you're on twitter, there are a number of groups and people that fundraise for Ukraine and for specific units fighting on the frontlines. If there is no official website, a PayPal for donations is listed in their profiles. When considering on whether to donate, always use your best judgement and donate to those you trust if you do not see what is listed is up to your standards.

@/Teoyaomiquu almost always has a fundraiser for Liberty Ukraine with a specified purpose. At the time of writing this, he is currently raising funds for engineering equipment such as excavators. One such excavator is already in Kursk. Follow him to stay up to date with what he's fundraising for.

Dyga's Paw (Twitter: @/dzygaspaw) is a smaller group that has recently raised funds for starlinks, drones, batteries, and Ecoflow generators. You can look at the fundraising campaigns they currently have on their website.

@/DefactoHumanity represents and founded Planet of the People with their website U(a)nited for Freedom. She frequently posts updates about their fundraisers and what their partners need. They are known for providing Frontline medical aid supplies, protective equipment and other military aid, technical equipment (starlinks, drones, scopes, etc), and infrastructure equipment (generators, vehicles, power stations, etc). They even have a merch store of the battalions they partner with if that's your jam. Here is their link tree if you wish to explore more. And in case you're curious, there is an article bout the founder here.

@/wilendhornets (Website) specialize in making high quality drones that have gotten a lot of praise from Ukraine's army. They have attracted a lot of media attention too. Check out their website for the list of articles that have been written about them. Their Twitter is very active with strike footage.

Ants Kitchen Hub (@/ants_kyiv) is a volunteer kitchen that makes dry rations for the Ukrainian army. They are more active on their other social media. To learn more about them, check out their link tree.

@/frontlinekit (Front Line Kitchen) is represented by Richard Woodruff. Originally they made shelf stable food for the Ukrainian army, but now their fundraising has branched out to other campaigns such as raising funds for medical supplies and drones. They are a well known group that many battalions have come to for help.

@/bekamaciorowski (Rebekah Maciorowski) is as combat medic and nurse who helps provide medical care to soldiers and civillians at the frontlines. She raises funds for medical supplies and other equipment, but also helps train soldiers in first aid. More of her social media that features her work can be found in her link tree.

@/UkraineAidOps (Website) is another organization battalions frequently go to for help. They fundraise for all sorts of equipment from medical supplies to drones. If you're interested, they also have a shop with patches from different brigades and flags signed by soldiers. Their shop also includes a separate section called the Victory Gallery where artifacts from the war are turned into art. This includes shells that are painted on, scrap metal from downed enemy planes are turned into keychains, and pieces of a rocket are turned into lamps.

Chris Garrett is the co-founder of Prevail. His organization deals with humanitarian demining as well as training for trauma care, training of bomb disposal, and education to the public. Prevail works with local agencies in Ukraine as well as the army.

Project Konstantin (Twitter; Website; Linktree) is still going strong after the death of their founder, British paramedic Peter Fouché. His digital ghost can be found here. They collaborate with the military, thus giving them an insight into what is dearly needed. They often raise funds for starlinks, personalized first aid kits (IFAKs), generators, portable power stations, and other nonlethal military equipment. I regret forgetting them the first time this post went around. Visit their website to see everything they have done and more. It has more information on what and how they do it than this post can cover.

One Team One Fight (Twitter; Website; Linktree) has some of the original members that worked for Ukraine Aid Ops. They formed their own group after differences with the previous one, and are still helping Ukraine. They are very visible on various social media showing what they have accomplished in their deliveries to various brigades. They're another group that seeks to bring starlinks, drones, medical supplies and protective gear to the battalions that come to them for help. Check out their website for more information on their current fundraisers, their achievements, and received recognition.

NAFO 69th Sniffing Brigade (Twitter; Website) Another small group that focuses their funds on delivering drones, generators, vehicles, and saving the occasional furry companion. They are very diligent in their updates for their fundraising campaigns. Check out their website for more information and the articles written about them.

Postmaster General Boomer (Twitter; Website) focuses on humanitarian aid, animal aid, and logistics. Boomer is the beloved pet of one of the founders and the secret boss/mascot. They have many transparency reports and are diligent in reporting the various "tours" they do in getting supplies where they are needed to go. They are based in Germany but have built up many connections during their existence. They have also worked closely with Ukraine Aid Ops.

--

I am sure I have forgotten some, so please reply or comment with any more I should add to this master post. I will edit and update as I see and evaluate more.

Last updated: Aug. 13th, 2024

Version updates listed below

August 13th, 2024 Added:

Hospitallers

Saint Javelin

The Kyiv Independent

Project Konstantin

1 Team 1 Fight

NAFO 69th Sniffing Brigade

Post Master General Boomer

[juniperpublishers-jdvs]

Enteritis: Still a Problem in Dairy Calves

Abstract

The neonatal phase of calves is a phase that needs extra care due to newborns’ vulnerability. Enteritis - an inflammation of the intestinal mucosa, resulting mainly in diarrhea - stands out among the conditions that affect animals in this period. Enteritis are responsible for huge losses in cattle breeding, especially in the early stages of rearing. Besides the losses caused by mortality, there are also expenses with veterinarians, treatments and decreased performance of the animal throughout its productive life. The present study aimed to perform a review of diarrhea in newborn calves.

Keywords: Neonatal diarrhea; Infectious agents; Dairy cattle

Abbrevations: ETEC: E. coli enterotoxigenic; EHEC: E. coli enterohemorragic; BVDV: Bovine Viral Diarrhea Virus

Introduction

The neonatal period in cattle - that goes from birth to 28 days of age - is especially important from a health point of view, since approximately 75% of losses in young calves occur in this phase [1], and the first week of life is considered the most critical phase, with 50% of losses. Therefore, maintaining the health of calves is highly related to the hygiene of the place where they live, as they are extremely sensitive to environmental pathogens [2]. Lorenz [3] report that there are several measures to maintain calf health from birth to weaning, including the provision of good quality colostrum in adequate quantity in the first hours after birth and the need to emphasize the prevention of diseases of the gastrointestinal tract and respiratory system. Among the main conditions that cause loss in the early stages of calves development are pneumonia, malformations, central nervous system diseases, and enteritis [4]. Enteritis is clinically mainly manifested by diarrhea and stands out due to its high mortality rate [2,3,5,6], since it is commonly difficult to recover because it is almost always accompanied by malnutrition [7].

Diarrhea is a complex multifactorial disease involving animal, environmental, nutritional, and infectious agents and it is a major cause of mortality, morbidity, and economic loss in cattle worldwide [8], because the treatment of affected calves is slow and impacts on growth, weight gain to weaning and loss of genetic potential of recovered animals [9]. Due its clinical and economic importance and due the preventive measures are often neglected, it is necessary an approach on this subject, to broaden the knowledge and to promote a better conduct regarding the prevention, diagnosis and treatment of the affected animals. Therefore, the present study aimed to review diarrhea in newborn calves.

Diarrhea in Newborn Ruminants

Newborn calf diarrhea is a disease of great impact on the economic viability of cattle herds worldwide [10] (Table 1). The economic impact caused by this condition is significant, although many new intervention strategies, such as vaccine development drug development and herd management, have been developed and implemented to minimize it [2]. In this sense, the veterinarian needs to assess the status of immunoglobulins in calves, feeding, shelter, environmental disinfection, hygiene and sanitary management, to prevent neonatal deaths caused by the disease [11]. The processes involved in the pathophysiology of diarrhea are related to intestinal secretion/ hypersecretion, nutrient bad absorption and digestion, osmolarity, abnormal intestinal motility, increased hydrostatic pressure, and gastrointestinal inflammation [12-21], which may occur singly or, more commonly, by the combination of two or more factors of these mechanisms [22,23].

Secretory diarrheas occur due to abnormal stimuli to the intestinal mucosa crypts that may be caused by the action of enterotoxins and/ or the action of inflammation mediators such as prostaglandins, causing an imbalance in physiological processes, like secretion and intestinal resorption, with consequent diarrhea [24]. Diarrhea is typically profuse without blood or effort, and signs in affected calves include depression, weakness, and sometimes shock and death secondary to hypovolemia and mild acidemia [25]. The difference in osmolarity with increased concentration of solutes within the intestinal lumen, promotes greater absorption of water by the lumen, thus resulting in dehydration of the animal. Osmotic particles include poorly digested disaccharides and increased levels of D-lactate from bacterial fermentation of unabsorbed nutrients entering the colon. Reduced intestinal transit time can lead to poor digestion and malabsorption due to inadequate time for digestion and absorption of ingested food, impaired fluid resorption has a major impact on fluid balance [23].

When a calf has diarrhea, there is a huge loss of fluids and electrolytes from its body. Thus, the consequent dehydration and the appearance of metabolic acidosis are the main causes of death of these animals [26]. This happens partly because the evaluation of the animal is generally based only on clinical examination, and a more detailed approach to assessing the degree of electrolyte disturbance and acidosis through blood gas analysis is lacking or not [27]. Although this condition being common in rural properties, treatment is usually inadequate and / or insufficient, because the administration of antibiotics and anti-inflammatory drugs do not correct the hydroelectrolytic disorders and acid-base [28]. Therefore, in order for the recovering of the animal, these parameters must be measured and corrected quickly, enabling the return to homeostasis. The high frequency and persistence of calf neonatal diarrhea has attracted the interest of many researchers. The multifactorial etiology (bacteria, viruses and protozoa) influenced by nutritional and environmental factors, as well as difficulties in the precise diagnosis of the agent and the failure of treatment has required the adoption of prophylactic measures, such as cow hygiene, management and vaccination [8].

Diarrhea Infectious Agents

Diarrhea is a condition of complex multifactorial etiology, influenced by infectious, nutritional and environmental factors, as well as improper management practices. Causes include toxins, bacteria, protozoa, viruses, and management / environmental factors such as overfeeding, low temperature, poor hygiene, colostrum deprivation, and individual susceptibility of the animal [8]. Numerous infectious agents have been implicated in diarrhea of calves, such as Escherichia coli, Salmonella spp., Cryptosporidium spp., Rotavirus and coronavirus. Coinfection is commonly seen in diarrheal calves, although a single primary pathogen may be the cause in some cases. The non-infectious causes of origin are related to improper management and poor hygiene of the environment in which the animals are placed. The incidence of the disease may vary according to the geographical location of the farms, farm management practices and herd size [2]. Rotaviruses, coronaviruses and cryptosporides, the most commonly recognized enteric pathogens of calves, all produce intestinal villi atrophy, intestinal bacterial overgrowth, malabsorption, and osmotic diarrhea [25].

In general, infections caused by viruses and protozoans tend to damage the intestinal mucosa promoting alteration in intestinal absorption due to damage to intestinal cells, compromising the normal absorption of nutrients, fluids and electrolytes, without alteration in intestinal secretion [22]. Rotaviruses are the most common cause of diarrhea in newborn calves and are often involved in co-infections with other agents [11,23,25]. Clinical signs usually appear 1 to 3 days after infection lasting 5 to 9 days [23]. High environmental contamination, herds with high numbers of animals and management that favors the transmission of the agent, associated with an inexpressive immunization rate, provide favorable conditions for the spread of rotavirus in dairy herds in Brazil, justifying the prevalence and difficulty to control the infection and the spread of the virus [28]. The incidence of many etiological agents varies with the calf’s age (Table 2) and this is useful for establishing the probability of a particular agent being involved and it is generally impossible to establish a definitive field diagnosis [11].

Diarrhea may result from hypersecretion or decreased absorption. Enteropathogenic strains of E. coli are occasionally causing diarrhea in calves [29]. Enterotoxigenic E. coli, Salmonella spp, Campylobacter spp. and rotavirus cause diarrhea by secreting enterotoxins that stimulate increased intestinal secretions, while protozoa and enteric viruses cause epithelial destruction of the absorptive cell villi. Enterotoxigenic E. coli produces profuse watery diarrhea, mainly in calves older than 4 days of age and occasionally in older calves. The F5 antigen may produce a mild clinical syndrome characterized by diarrhea, dehydration and weakness in calves from 1 to 4 days of age with rapid course and may progress from healthy to decubitus and death from 6 to 12 hours [11]. Salmonella spp. is an important causative agent of diarrhea and septicemia in dairy calves and the depression caused in the animal is probably due in part to endotoxemia, not just dehydration and acidosis. Campylobacter jejuni and Campylobacter fecalis are believed to be of minor importance in calves and lambs [11].

Cryptosporidium is cited as the main agent of diarrhea in calves, not only as an opportunistic agent, but also as a primary agent. Preventive measures should be taken related to the management of cows at the time of giving birth, avoiding the agglomeration of animals and environmental contamination to reduce economic losses, and to avoid the risks to public health arising from infection [24]. The recognition of enteropathogens guides the adoption of effective prevention and control measures, besides alerting to public health reflexes, due to the zoonotic potential of several of these enteric pathogens [29,30].

Treatment

Physical examination of the diarrheal calf comprises the first step in establishing the therapeutic approach, requiring the determination of the presence of any intercurrent disease. Treatment of simple cases depends on the estimative of dehydration (Table 3), severity of acidosis, likelihood of concomitant infection, presence or absence of hypothermia and hypoglycemia [11]. The most common causes of death are dehydration and acidosis. Blood gas analysis will accurately determine the degree of metabolic acidosis [29] (Table 4). Therefore, the immediate goal in treating depressed calves is to restore them to physiological systemic status. The estimated severity of dehydration can be combined with estimates of diarrhea loss and maintenance of essential functions to manage total daily fluid requirement [11,29].

Abbreviations: pCO2, carbon dioxide pressure; pO2, oxygen pressure; HCO3-, plasma bicarbonate concentration; TCO2, total carbon dioxide in plasma; BE, base excess in the blood; StB, standard bicarbonate blood concentration; SatO2, blood oxygen saturation. Fonte: Lisbôa et al. [31]. Replacement may be administered intravenously or orally, reminding that for the latter one should be increased by 60 to 80% for partial fluid absorption [11,29]. If performed early in the disease, oral replacement can be highly effective and inexpensive. In animals with severely impaired intestinal motility, the intravenous way may be more effective in correcting hydroelectrolytic imbalances than oral administration [23]. Success of therapy is monitored based on clinical signs of calf and restoration of urination [11]. Another point to consider in chronically diarrheal calf is the need for nutritional support. When a samll quantity of milk or solid food is ingested, energyrich oral electrolytes may be used to maintain the body condition of the animal. Stop giving milk can reduce the severity of diarrhea and depression in severe diarrhea, because malabsorption exacerbates diarrhea by the osmotic effect of unabsorbed milk nutrients and also promotes bacterial proliferation and possibly poor fermentation generating organic acids. However, stop giving milk reduces weight gain [11].

Antibiotic use is frequent in the treatment of diarrhea, although few agents respond to antimicrobials, viral and parasitic agents are not directly sensitive to antibiotics. Their indiscriminate use promotes the selection of resistant strains and complicates future therapeutic efforts. However, they can attenuate clinical disease, decrease the release of pathogens to the environment and animal mortality [11,29]. Some treatment protocols include the use of anti-inflammatory drugs to help reduce the secretory effects of some agents [11]. The use of non-steroidal anti-inflammatory drugs (NSAIDs) should be restricted in dehydrated animals and administered only when the patient is sufficiently hydrated [23]. The use of probiotics, oligosaccharides and intestinal protectors is also cited, and the use of gastrointestinal motility modifiers is contraindicated, as the reduction in motility will lead to the accumulation of bacteria and pathogenic toxins [29].

Prevention

The principles of prevention are based on ensuring adequate colostral intake, specific help and nonspecific immunity, reduction of the possibility of introduction / dissemination of infectious agents [11]. Colostrum is important in preventing morbidity and mortality of diarrheal calves. Colostral antibody is responsible for the low incidence of rotavirus infections in calves under 4 days of age. Vaccination of pregnant cows is important to increase colostral immunity. Colostrum privation, lack of maternal instinct, and early separation of cow and calf are major causes of failure to transfer immunity in dairy calves [11]. Prophylactic measures include separating calves from each other with enough space to prevent contact and infection through contaminated feces and urine. All feeding facilities and equipment (buckets and bottles) must be maintained with strict hygiene conditions. There is not much difference between the patterns of disease development and the prevention of calf diarrhea according to each etiological agent. Knowledge of the causal pathogen (s) is important to accurately avaliate the current status of the affected property and to develop new interventions [2].

To Know More About  Journal of Dairy & Veterinary sciences

Please click on: https://juniperpublishers.com/jdvs/index.php

For more Open Access Journals in Juniper Publishers

please click on: https://juniperpublishers.com/index.php

[bamsara]

The Rehabilitation of Death

Chapter 19: Feed Your Friendly Monsters

Lambert brings Narinder breakfast as promised, appearing to catch Narinder on the waking end of a particularly nasty nightmare. A peak into his journal is unsuccessful, but the cat enjoys the mortal joys of comfort food for the first time in millennia and the two enjoy talking normally with each other, every day and current stressors aside, it's pleasant. Heket is moved into what will now be considered the Bishop's formal home, it's only occupant until Leshy is found and/or Kallamar is rescued, in whichever order, and Lamb makes it very clear what rules are to be expected with their arrival. After Heket unintentionally gives the Lamb an idea of how she cares for her brothers, they find perhaps the frog is more somber than they thought. Lambert finds a brief repose in the snow one night and finds a cat ending his disappearing act to confront their own. They offer him an opening to be simple and soft, if only for a single moment, and he follows it.

Chapter Wordcount: 10,237 | Read Tags, Happy Reading!

(Originally part of a larger chapter but sliced for reading/editing ease. Another chapter either tomorrow or within a few days hopefully.)