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Down syndrome (DS) is the most common chromosomal anomaly in humans. Numerous congenital malformations associated with DS have been described. However, there are insufficient data available about airway anomalies. Our objective was to characterize the clinical presentation, frequency, and type of airway anomalies in a population of patients with DS. A retrospective evaluation of flexible bronchoscopies performed in 24 DS patients due to significant respiratory morbidity was compared to the findings in 324 non-DS patients during the same time period. The procedure was carried out under sedation, using an Olympus BF3C20 bronchoscope. The main indications for the procedure were atelectasis of the right upper lobe (12/24) and stridor (7/24). The most common associated conditions were congenital heart disease (12/24) and reactive airways disease (12/24). The most important endoscopic findings were: laryngomalacia (12/24), tracheomalacia (8/24), tracheal bronchus (5/24), and bronchomalacia (5/24). Only six patients had a normal examination. Multiple airway anomalies (>/=2) were a common finding in this series. We conclude that patients with DS and respiratory symptoms have a high incidence of airway anomalies compared to non-DS patients. The clinician should have a high index of suspicion for airway anomalies in DS patients with respiratory symptoms.

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BackgroundThere is increasing interest in recording tail damage in pigs at slaughter to identify problem farms for advisory purposes, but also for benchmarking within and between countries as part of systematic monitoring of animal welfare. However, it is difficult to draw conclusions when comparing prevalence’s between studies and countries partly due to differences in management (e.g. differences in tail docking and enrichment routines) and partly due to differences in the definition of tail damage.MethodsTail damage and tail length was recorded for 15,068 pigs slaughtered during three and four consecutive days at two slaughterhouses in Sweden. Tail damage was visually scored according to a 6-point scale and tail length was both visually scored according to a 5-point scale and recorded as tail length in centimetres for pigs with injured or shortened tails.ResultsThe total prevalence of injury or shortening of the tail was 7.0% and 7.2% in slaughterhouse A and B, respectively. When only considering pigs with half or less of the tail left, these percentages were 1.5% and 1.9%, which is in line with the prevalence estimated from the routine recordings at slaughter in Sweden. A higher percentage of males had injured and/or shortened tails, and males had more severely bitten tails than females.ConclusionsWhile the current method to record tail damage in Sweden was found to be reliable as a method to identify problem farms, it clearly underestimates the actual prevalence of tail damage. For monitoring and benchmarking purposes, both in Sweden and internationally, we propose that a three graded scale including both old and new tail damage would be more appropriate. The scale consists of one class for no tail damage, one for mild tail damage (injured or shortened tail with more than half of the tail remaining) and one for severe tail damage (half or less of the tail remaining).

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