Purpose: -lb present a case of brainstem anaesthesia as a complication of peribulbar anaesthesia.Clinical features: A 75-yr-old woman received peribulbar anaesthesia for cataract surgery. A few seconds after the block was performed, she had a respiratory arrest, became unconscious, and developed hypertension and tachycardia followed by hypotension and bradycardia, Ventilatory and haemodynamic support were performed before the patient regained adequate spontaneous breathing, and normal heart rate and blood pressure. Conclusion:Peribulbar anaesthesia generally carries a low risk of serious complications, However, respiratory arrest and brainstem anaesthesia may occur as complications of peribulbar blocks. Conclusion : En general, I'anesthesie peribulbaire comporte un faible risque de complications seneuses, Un arr@t resp.-atolre par anesth6sie du tronc c@rebral est toujours possible.

The objective was to evaluate the development and reproductive performance of beef cows of different body weights at calving were evaluated. Milk yield and calf production efficiency were assessed in secundiparous Braford cows classified at calving according to weight as Light (325.2±3.7 kg), Moderate (347.7±4.0 kg), and Heavy (384.2±4.1 kg). Heavy cows had higher total milk yield than Light cows, but did not differ from Moderate, reflecting in calves weighing at weaning 82.1, 76.6, and 76.9 kg, respectively. Differences on pregnancy rates for Light (90.0%, 18 pregnant cows/2 of eligible cows), Moderate (70.2%, 12 pregnant cows/5 of eligible cows), and Heavy (62.5%, 10 pregnant cows/6 of eligible cows) were not detected. Light cows were more productive and efficient when production performance was adjusted for the pregnancy rates than Moderate and Heavy cows. Production of kilograms of calves adjusted for pregnancy was 20.5, 16.2±0.5, and 14.0±0.5 kg for the Light, Moderate, and Heavy cows, respectively. Heavy and Moderate cows were less efficient as compared with the Light ones for production of calves adjusted for their calving interval. Light cows produce more kilograms of calf/cow, requiring the same amount of milk to produce one kilogram of calf. Light cows also have higher efficiency converting milk into calf weight than Moderate and Heavy cows. The productivity and efficiency of breeding herds should be evaluated by the combination of pregnancy rate and kilograms of weaned calves per cow exposed to breeding.

Resumo. O desempenho dos animais de uma criação está intimamente relacionado com o programa nutricional desenvolvido na propriedade. As definições das características dos animais e dos alimentos que estarão envolvidos no programa nutricional são de fundamental importância, tornando possível formular uma ração que atenda as necessidades nutricionais dos animais e que otimize a utilização dos alimentos. Desta forma, o objetivo desta revisão é abordar os princípios básicos que devem ser considerados para a formulação de uma ração e apresentar, de forma didática, exemplos de formulação de ração que podem ser realizados manualmente ou com o auxílio de uma calculadora.

The aim of this study was to evaluate the effects of conception weight and gestational weight gain on performance and productive effi ciency in beef cows and their calves. Eighty-eight primiparous, three-year old Braford females were used, divided according to weight at conception and gestational performance (High and Low): cows with a low conception weight and low gestational weight gain (LL), cows with low conception weight and high gestational weight gain (LH), cows with high conception weight and low gestational weight gain (HL), and cows with high conception weight and high gestational weight gain (HH). At calving, HH cows were heavier than LH and HL and these were heavier than LL cows. Male calves born to HH cows were superior in body weight to those born to LL cows at 150, 210 and 365 days. Female calves born to HH, HL or LH cows were superior to those born to LL cows in pregnancy at 14 months of age. The LL and HL cows were more effi cient in calf production. Actual fertility was infl uenced by the nutritional level of the herd, where HH cows were superior than LL cows. Better cow herd nutrition increases the development and performance of the progeny.

The calving period influences productivity and reproductive efficiency the herds. The objective of this study was to evaluate two calving months (October and November) and their effect on the efficiency of a breeding herd for three consecutive years. A total of 298 Braford cows were evaluated at three, four, and five years of age, with their calves early-weaned at 148 days of age. The performance characteristics of the cow/calf pairs were evaluated with the calving month and calf sex as the independent variables. The animals were kept as a single group for the three years of observation. Cows calving in November were heavier and had a higher body condition score at calving. Cows calving in October were heavier and produced heavier calves at weaning. Male calves were heavier at birth and weaning than females (30.8 vs 28.6 kg and 118.9 vs 114.7 kg, respectively). The pregnancy rate was 82.35 and 69.23% for cows calving in October and November, respectively. Calving intervals were shorter in cows calving in November. Cows calving in October were more efficient compared with those calving in November, with a higher actual fertility rate. The production of kilograms of the calf/cow pair was higher for cows calving in October.

The objective of this study was to evaluate, for two years, the performance of 124 female and 105 male Braford calves born during the first and second halves of the same calving season and the effects of birth period on the development of males until slaughter, as yearlings, and of females until calving, after having mated at 13-15 months of age. Early-born females were heavier than those born late at weaning (119.3 vs 109.9kg; P<0.05), at the start of the breeding season (275.0 vs 263.0kg; P<0.05), and at the end of the breeding season (300.0 vs 289.5kg; P<0.05), in addition to being more fertile (70 vs 50% pregnancy rate). There was no difference (P>0.05) in the development of males born early in relation to those born late, except for weaning weight, which was higher in the former. Steers born early were ready for slaughter at a younger age (459.6 vs 490.1 days; P<0.05), and both groups (early- and late-born) had a body condition classified as fat (4.21 points). In intensive production systems, both male and female calves perform better if they are born during the first half of the calving season.

BackgroundThe health-related quality of life (HRQL) is an important indicator of the burden of inflammatory rheumatic diseases (IRD). Their outcomes may also be affected by coexisting chronic conditions that can cause functional impairment and activity limitation with significant reductions in HRQL.ObjectivesTo determine the health status and quality of life in patients with IRD followed in a rheumatology day-care unit and to identify associated demographic and disease-related parameters influencing it.MethodsThe Health Assessment Questionnaire (HAQ) to assess impairment in daily activities due to illness and Short Form-36 (SF-36) to assess HRQL were applied to patients on day-care routine visits. Disease activity clinical measures (DAS28-ESR, ASDAS-PCR, mean pain on VAS) were collected according to the disease and the predominant involvement. A p value of <0.05 was considered as significant.ResultsA total of 84 patients were consecutively included, predominantly female (59.5%), with a mean age of 46.25±13.25 years (range 19-85) and a mean disease duration of 14.62±8.07 years (1-38). Thirty six (42.9%) patients had rheumatoid arthritis and 48 (57.1%) had spondylarthritis. Seventy seven (91.7%) patients with current bDMARDS, 51 (60.7%) also with cDMARDS and 19 (22.6%) with low doses corticosteroid treatment. Twenty four (28.6%) had associated hypertension, 4 (4.8%) diabetes and 10 (11.9%) dyslipidemia.The mean DAS28-ERS was 2.59±1.06 (0.53 to 6.94), median ASDAS-PCR 1.40±1.15 (0.20 to 5.50), mean pain on a VAS 3.77±2.58 (0 to 10), mean HAQ 0.76±0.71 (0 to 2.88) and mean SF-36 418.71±162.31 (103.50 to 707).Strong correlation (p<0.01) was found between high scores of HAQ and low SF-36. These scores correlated also with older age, high pain on a VAS and high disease activity measured by ASDAS-PCR and DAS28-ESR. Longer disease duration correlated as well with lower level of SF-36 (p<0.05), but not with HAQ. Rheumatoid arthritis showed significant higher levels of HAQ than spondylarthritis. The female gender, current corticosteroid treatment and history of hypertension were associated both with higher HAQ and lower SF-36 (p<0.05). The scores were not statistically different between bDMARDS or cDMARDS, smoking and alcohol consumption, civil or employment status, level of education or other associated diseases.ConclusionsOur findings suggest that not only the activity or duration of the disease, but also the gender, concomitant comorbidities and therapies can influence the HRQL and daily activities. The disease activity could be a determinant of disability but is important to incorporate coexisting conditions and demographic data in the evaluation of HRQL.Disclosure of InterestNone declared

Background:Patients with psoriatic arthritis (PsA) experience substantial functional impairment, which impacts on health-related quality of life.1Evidence from randomized clinical trials (RCTs) suggests better patient-reported functional outcomes when lower disease activity is achieved.2,3,4Objectives:To evaluate the impact of achieving DAPSA remission (REM) or low disease activity (LDA) on long term function measured by HAQ-DI. To verify predictors of achieving a minimum clinically important difference (MCID) in HAQ-DI (≤ -0.35).Methods:This is a longitudinal analysis of a real-life retrospective cohort. Inclusion criteria were adult patients fulfilling CASPAR criteria for PsA with at least 4 years of follow-up in the PsA Clinic. Demographic and clinical data were extracted from electronic medical records. Comparison of HAQ-DI variation between patients with DAPSA REM/LDA and those with moderate/high disease activity was performed using generalized estimating equation (GEE), adjusted by Bonferroni test. Correlation between HAQ-DI and DAPSA was analyzed by Spearman correlation method. A multivariate hierarchical regression model was applied in order to evaluate predictors of achieving a MCID in HAQ-DI scores.Results:Seventy-three patients were included in the analysis, of which 58.9% were female, with a median (25/75th) of 8 (3-15) years since PsA diagnosis and a mean follow up time of 6.2±1.2 years. In total, 37% of patients (N=27) presented a MCID in HAQ-DI during the follow-up. Function measured by HAQ-DI was determined by PsA disease activity measured by DAPSA (interaction test: p <0.0001) (Figure 1). A moderate and statistically significant correlation between ΔDAPSA and ΔHAQ-DI was observed (rs= 0.60; p<0.001) (Figure 2), demonstrating that a decrease in PsA disease activity was associated to improvement in function. Only patients in DAPSA REM demonstrated a constant declining in HAQ-DI scores during the 6 years of follow-up (Figure 1). White ethnicity and older age at baseline were predictors for not achieving MCID in HAQ-DI (RR 0.33 95% CI 0.16-0.67, p=0.002 and RR 0.96 95% CI 0.93-0.98, p<0.0001, respectively), while higher scores of HAQ-DI at baseline were predictors of achieving a MCID (RR 1.71 95%CI 1.12-2.60, p=0.013).Figure 1.Variation in HAQ-DI according to PsA disease activity measured by DAPSAFigure 2.Correlation between changes in PsA disease activity (ΔDAPSA) and changes in functional indices (ΔHAQ-DI) over three years of follow-upConclusion:In PsA, patients who maintained DAPSA REM/LDA over time had better long term functional outcomes. Higher HAQ-DI scores at baseline, non-white ethnicity and younger age were predictors for achieving a clinical significant improvement in HAQ-DI.References:[1]Mease P et al. Semin Arthritis Rheum. 2018 Dec;48(3):436-448.[2]Coates, LC et al. The Lancet. 2015 Dec; 386, 19-26.[3]Aletaha D et al. Ann Rheum Dis. 2017;76(2):418-421.[4]Kavanaugh A et al. Annals rheum Dis 2014; 73: 1689-94.Median HAQ-DIFollow-up in yearsDisclosure of Interests:Larissa Vargas Cruz: None declared, Júlia Boechat Farani: None declared, Júlia Rabello Costa: None declared, Franciele Menegat: None declared, João Victor Andrade Águas: None declared, Bruna Ruschel: None declared, Andrese Aline Gasparin: None declared, Claiton Brenol: None declared, Charles Kohem Grant/research support from: This work was sponsored by the regional society of rheumatology (Sociedade de Reumatologia do Rio Grande do Sul)., Penelope Palominos Grant/research support from: This work was sponsored by the regional society of rheumatology (Sociedade de Reumatologia do Rio Grande do Sul).