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The Veterinary Clinics of North... Mar 2022Rumen development from weaning, 200 pounds (91 kg) to 400 pounds (181.2 kg), is critical and depend on proper papillae development. Papillae development is tied to... (Review)
Review
Rumen development from weaning, 200 pounds (91 kg) to 400 pounds (181.2 kg), is critical and depend on proper papillae development. Papillae development is tied to propionic and butyric acid production in the rumen, and this favors a diet based on concentrate. Forage intake produces acetic acid, which does not promote papillae development. Previous research illustrates that although increasing forage intake as a percentage of the dry matter diet increases rumen size, it shows a reduction in papillae length compared with diets containing a lower percentage of forage and a higher percentage of concentrate intake.
Topics: Animal Feed; Animals; Diet; Rumen; Weaning
PubMed: 35219482
DOI: 10.1016/j.cvfa.2021.11.010 -
The American Surgeon Jul 2023Lymphangiomas of pancreatic origin are rare and can often be found with abdominal symptoms or incidentally on imaging. A 46-years-old female presented with epigastric...
Lymphangiomas of pancreatic origin are rare and can often be found with abdominal symptoms or incidentally on imaging. A 46-years-old female presented with epigastric abdominal pain and vomiting, and twenty-pound weight loss over 3 months. Computed tomography of the abdomen showed a septated mass of the distal pancreas measuring 25.4 cm in largest diameter and extending superiorly into the mediastinum via a hiatal hernia. Endoscopic ultrasound demonstrated abutment but no invasion of the esophagus and stomach. She underwent an exploratory laparotomy with retroperitoneal mass excision, distal pancreatectomy, splenectomy, and hiatal hernia repair with Dor fundoplication. Pathology was consistent with a cystic lymphangioma. Patient was discharged on postoperative day 3 and remained recurrence free for over a year.
Topics: Female; Humans; Middle Aged; Diaphragm; Pancreatic Neoplasms; Pancreas; Lymphangioma; Pancreatectomy
PubMed: 37501311
DOI: 10.1177/00031348231157912 -
Journal of Magnetic Resonance (San... May 2021
PubMed: 33711750
DOI: 10.1016/j.jmr.2021.106947 -
Cureus Mar 2023Malignant pleural mesothelioma (MPM) involves the uncontrolled growth of mesothelial cells that form the lining of pleural serous layers. MPM has been linked with...
Malignant pleural mesothelioma (MPM) involves the uncontrolled growth of mesothelial cells that form the lining of pleural serous layers. MPM has been linked with asbestos exposure in mining and manufacturing occupations with an unforgiving prognosis of 4-18 months. In this case report, we present a 56-year-old male with a significant past medical history of hypertension, hyperlipidemia, hepatic steatosis, and ulcerative colitis who presented to the emergency department for worsening cough, eight-pound weight loss over the previous year, night sweats, and fatigue. The patient was admitted due to right pleural effusion with lower lobe collapse seen on imaging; upon diagnostic workup including pleural biopsy, results were consistent with malignant mesothelioma of the epithelioid type. Over the course of six months post-diagnosis, the patient underwent multiple hospital admissions due to acute hypoxic respiratory failure from the segmental left upper lobe and subsegmental right upper lobe pulmonary emboli, recurrent pleural effusion, and anemia. Given the aggressive nature of MPM, the patient was determined not to be a surgical candidate and underwent palliative chemotherapy sessions until his passing. As the patient worked in heating/ventilation/air conditioning with asbestos exposure, taking a full occupational history was crucial. MPM is relatively rare; however, the incidence has increased over the last decade due to tumor development lag time post-asbestos exposure and an increase in do-it-yourself projects. There is no cure for MPM. Multimodal treatment approaches with surgery, chemotherapy, radiotherapy, and immunotherapy have been noted in the literature.
PubMed: 37090283
DOI: 10.7759/cureus.36479 -
The American Journal of Geriatric... Nov 2023
Topics: Humans; Palliative Care; Pneumonia; Dementia
PubMed: 37407383
DOI: 10.1016/j.jagp.2023.06.011 -
Interactive Cardiovascular and Thoracic... Aug 2022
Topics: Humans; Mitral Valve
PubMed: 35976129
DOI: 10.1093/icvts/ivac216 -
Expert Review of Pharmacoeconomics &... Jan 2022The National Institute for Health and Care Excellence (NICE) makes recommendations on the reimbursement of new drugs utilizing an Incremental Cost-Effectiveness Ratio...
BACKGROUND
The National Institute for Health and Care Excellence (NICE) makes recommendations on the reimbursement of new drugs utilizing an Incremental Cost-Effectiveness Ratio (ICER) threshold range that has been in use since 2004 and has remained unchanged.
RESEARCH DESIGN AND METHODS
To model how the NICE cost-effectiveness thresholds would vary if inflation was accounted for and their potential effects on appraisal outcomes, all single technology appraisal (STA) recommendations published in 2019 were identified. The outcome and most plausible ICERs were then evaluated against thresholds, after taking inflation into account.
RESULTS
41 STAs with base-case ICERs were identified. For general STAs, 46% of ICERs were ≤£20,000/QALY, 27% were £20,000-£30,000/QALY and 27% >£30,000/QALY. Cumulatively, there was a 43% decrease in the purchasing power of the pound from 2004 to 2019 due to inflation. To compensate, the NICE ICER threshold would have to increase to £28,584-£42,876/QALY. Using inflation-adjusted thresholds led to an absolute increase of 18% and 12% of STAs whose ICERs fell below the lower and upper bounds of this threshold range, respectively.
CONCLUSION
By not adjusting for inflation, the NICE ICER thresholds have declined in real terms. Whether ICER thresholds should be dynamic to reflect factors like inflation requires further research.
Topics: Academies and Institutes; Cost-Benefit Analysis; Humans; Inflation, Economic; State Medicine; United Kingdom
PubMed: 33980118
DOI: 10.1080/14737167.2021.1929926 -
Chest Oct 2020A 21-year-old male African American college student from Southern California, with no significant medical history, was visiting family in southwestern Texas when he...
A 21-year-old male African American college student from Southern California, with no significant medical history, was visiting family in southwestern Texas when he presented to the hospital with 1 week history of cough, shortness of breath, lower back pain, and a 10-pound weight loss.
Topics: Coccidioidomycosis; Cough; Humans; Male; Respiratory Distress Syndrome; Young Adult
PubMed: 33036116
DOI: 10.1016/j.chest.2020.05.556 -
JAMA Dermatology Mar 2022
Topics: Cardiovascular Diseases; Humans; Psoriasis
PubMed: 35044422
DOI: 10.1001/jamadermatol.2021.4723