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Background Peritoneal metastasis from biliary carcinoma (PMC) is associated with poor prognosis when treated with chemotherapy. Objective To evaluate the impact on survival of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), and compare with conventional palliative chemotherapy for patients with PMC. Material and methods A prospective multicenter international database was retrospectively searched to identify all patients with PMC treated with a potentially curative CRS/HIPEC (CRS/HIPEC group). The overall survival (OS) was compared to patients with PMC treated with palliative chemotherapy (systemic chemotherapy group). Survival was analyzed using Kaplan-Meier method and compared with Log-Rank test. Results Between 1995 and 2015, 34 patients were included in the surgical group, and compared to 21 in the systemic chemotherapy group. In the surgical group, median peritoneal cancer index was 9 (range 3–26), macroscopically complete resection was obtained for 25 patients (73%). There was more gallbladder localization in the surgical group compared to the chemotherapy group (35% vs. 18%, p = 0.001). Median OS was 21.4 and 9.3 months for surgical and chemotherapy group, respectively (p=0.007). Three-year overall survival was 30% and 10% for surgical and chemotherapy group, respectively. Conclusion Treatment with CRS and HIPEC for biliary carcinoma with peritoneal metastasis is feasible and may provide survival benefit when compared to palliative chemotherapy.

Opinions of those in the cattle, swine, and sheep slaughtering and rendering sectors were characterized regarding aspects of the National Animal Identification System. Across plants of all size categories, operators of 51, 46, 65, and 22% of cattle, swine, and sheep slaughtering and rendering plants, respectively, said they would now, voluntarily, submit animal termination records (ATR). By size category, however, too few operators of large cattle and swine slaughtering and rendering plants are willing to do so. There are preconditions that might make slaughtering and rendering plant operators more willing to voluntarily submit ATR; 79 to 88% would do so if radio frequency identification devices (cattle and sheep) and slap-tattoo or premises identification numbers (swine) were made mandatory. Only 22, 29, 29, and 14% of cattle, swine, and sheep slaughtering and rendering plant operators, respectively, would voluntarily pay a private database provider a fee to protect ATR data from the Freedom of Information Act, and 53, 25, 31, and 57%, respectively, of plant operators would—if ATR submission were made mandatory—send their ATR data through a private database provider if the fees were paid by the government. Support for mandatory animal identification (which would include submission of ATR) across small-, medium-, and large-sized plant categories was 47 to 80, 25 to 43, 25 to 100, and 100% for cattle, swine, and sheep slaughtering and rendering plant operators, respectively, if industry had to pay for it, but increased to 65 to 90, 64 to 75, 50 to 100, and 100% if the government would pay for it.

The threat of a livestock disease outbreak or other animal health events in North America is real. However, predicting both the timing and severity of an outbreak can be extremely difficult. Animal identification and traceability programs can help limit the spread of disease. The overall objective of this review is to evaluate and compare animal identification and traceability systems in North America. Mandated animal identification programs, which exist for Canadian cattle and sheep and Mexican cattle, are designed to control and eradicate trade-limiting diseases and to maintain or gain access to international markets. In contrast, the United States has chosen to implement the National Animal Identification System as a voluntary program for cattle, sheep, and swine. However, the US sheep industry has operated with a mandatory National Scrapie Eradication Program since 2001, and the US pork industry has independently implemented a mandatory swine premises registry, which targeted 100% compliance by December 31, 2007, and a mandatory swine identification program targeting full compliance by December 31, 2008. Likewise, the Canadian National Hog Traceability and Identification System will become a mandatory program in 2008. It is recognized that a country’s ability to respond to an animal disease outbreak is greatly enhanced with the implementation of a national animal identification program.

Animal diseases and related food safety issues, such as bovine spongiform encephalopathy, have become concerns to many people in the last decade. With approximately one billion domesticated swine in the world, traceability is becoming increasingly important throughout the world as a way to control disease outbreaks before they have devastating effects on a country’s livestock and related livestock industries. The objective of this review is to discuss swine identification and traceability systems outside North America. Some countries, such as those in the European Union, have mandatory traceability programs that require that pigs be traced from birth to slaughter and that imported products to adhere to the same standard. Countries with mandatory swine traceability programs have systems in place that can document animal movement records (premises changes), as well as animal birth and termination records. Many countries that have voluntary programs, such as Australia and Brazil, are currently trying to develop comprehensive traceability programs for swine and pork.

Animal identification by means of marking animals’ bodies was first recorded 3,800 yr ago in the Code of Hammurabi, and throughout history, valuable animals such as horses have been identified to prevent thievery all over the world. Today, the reasons for identification of livestock include production management, control of disease outbreaks, establishment of ownership, requirements for export, and consumer demands. Additionally, there are many methods of animal identification and traceability available today including ear tags, tattooing, branding, electronic methods that implement radio frequency identification technologies (such as rumen boluses, ear tags, and injectable transponders), and biometric methods (such as retinal scanning, nose prints, and DNA). The objective of this review is to demonstrate the implementation of bovine animal identification and traceability systems in selected countries outside of North America (i.e., United States, Canada, and Mexico) for the purpose of creating a knowledge base whereby an effective North American bovine animal identification and traceability system may be created and implemented. This review will discuss regulatory requirements of animal identification and traceability in selected countries.

Purpose: Determining serum total prostate specific antigen (PSA) has proved to be a valuable diagnostic aid for detecting prostatic carcinoma, although the lack of specificity has limited its usefulness. Studies indicate that the use of percent free PSA would improve specificity while maintaining sensitivity. Since complexed PSA represents the major proportion of measurable PSA in serum, we determined whether it represents a single test alternative to the use of percent free PSA for the early detection of prostate cancer. Materials and Methods: Archival serum was obtained from 385 men with no evidence of malignancy on biopsy and 272 with biopsy confirmed prostate cancer. We determined the concentration and proportion of total, complexed and free PSA. Results: Receiver operating characteristics analysis using total PSA results from all samples (range 0.32 to 117 ng./ml.) indicated that the areas under the curve for complexed PSA alone as well as the free-to-total and complexed-to-total PSA ratios were similar and significantly greater than those for total PSA alone. Within the range of 85% to 95% sensitivity receiver operating characteristics analysis revealed that the specificity of complexed PSA was higher than that of total PSA and equivalent to that of the free-to-total PSA ratio. We noted a similar improvement in specificity in the 4 to 10 ng./ml. total PSA range. Using published cutoff values for complexed, total and percent free PSA when total PSA was in the 4 to 10 ng./ml. range the sensitivity and specificity of complexed and percent free PSA were similar. Within the 4 to 10 ng./ml. total PSA range the population of patients with no evidence of malignancy and complexed PSA below the upper limit was different with respect to total PSA from that with no evidence of malignancy and free PSA greater than 25%. Conclusions: The measurement of complexed PSA represents an alternative to the use of percent free PSA, although the patient populations identified by the 2 tests are different.

A prospective study was conducted to quantify the individual animal and maternal factors that affected morbidity and mortality of calves in Colorado beef herds. The study subjects were all calves born in ten participating herds during the 1990 and 1991 calving seasons. All 3666 calves born during the study period were individually identified at birth, and subsequent disease events were recorded by the producers. The disease outcomes of interest and their observed incidence rates were: perinatal (birth to 12 h) mortality, 2.5%; general neonatal (12 h to 45 days) mortality, 2.2%; general neonatal morbidity, 4.4%; neonatal diarrhea, 1.1%; neonatal respiratory disease, 1.0%; mothering problems/weak calves, 1.2%; and neonatal enterotoxemia/sudden death, 1.4%. Data analysis utilized multiple logistic regression. All analyses were adjusted for herd. Perinatal mortalily was greater ( P P P =0.06). General neonatal mortality was higher ( P

The effect of morbidity during early life on the weaning weight of calves in Colorado beef herds was investigated as part of a prospective longitudinal observational study. A total of 2609 calves born in nine participating herds during the 1990 and 1991 calving seasons were monitored for disease events and subsequently weighed at weaning as a measure of performance. Morbidity outcomes of interest and their observed incidence rates were: general neonatal (to 45 days) morbidity, 2.6%; neonatal diarrhea, 1.0%; neonatal respiratory disease, 1.0%; and mothering problems/weak calves, 0.4%. Mean calf weaning weight was 244±46 kg. Weaning weight data were adjusted by multiple regression for the effects of the herd, year, age of the calf, age of the dam, calf sex, frame size of the dam, and twin birth. General morbidity during the neonatal period resulted in a 15.9 kg reduction (P

Study objectives: Many patients with suspected acute coronary syndrome (ACS) are admitted from the emergency department (ED) because of the insensitivity of presentation ECGs and troponin levels. Ischemia-modified albumin (IMA) is a novel cardiac biomarker of acute cardiac ischemia. The US Food and Drug Administration has approved the use of a normal IMA concentration in low-risk (per history/physical examination, ECG, and troponin) patients with chest pain syndrome as an indication for safe ED discharge. Methods: We reviewed all studies identified by computerized literature and obtained proprietary data from the assay manufacturer that evaluated IMA as an ACS “rule-out” in the ED setting. For trials to be included, patients were required to present to the ED within 3 hours of symptom onset. For each study, the appropriate IMA diagnostic cutoff was defined by receiver operating characteristic curve analysis or a normal range study. Studies eligible for inclusion were required to document discharge diagnosis with respect to cardiac ischemia or pertinent clinical outcomes for a minimum of 30 days after the index presentation. Results: There were 8 studies meeting eligibility criteria. Three trials evaluated all nontraumatic chest pain presentations; 4 studies evaluated low- to moderate-risk patients with nondiagnostic ECG and a negative troponin at presentation; and 1 study evaluated patients initially triaged as high risk and requiring a cardiology consult. IMA in conjunction with troponin and ECG at presentation had a high negative predictive value for ACS at the index visit and during the follow-up period: 84% in a high-risk population and 91% to 100% in the low-risk population. Conclusion: IMA has a high negative predictive value for short-term adverse outcomes in a preselected low- to moderate-risk population of patients with suspected ACS and may be used to facilitate contraction of the risk stratification process for chest pain syndrome in the ED.

We describe a case of simultaneous tuberculous and pyogenic infection of the pancreas in a 58-year-old Asian man who presented with a pyrexia of unknown origin. There was no evidence of disseminated tuberculosis or immuno-deficiency. The diagnosis was confirmed by ultrasound-guided percutaneous pancreatic aspiration and subsequent progress assessed by sequential computed tomography (CT) and ultrasonography. Complete recovery was achieved on anti-tuberculous chemotherapy without surgical intervention.

ABSTRACT Self-bored pressuremeter (SBP) tests are an important part of site investigations for gravity base structure (GBS) foundations. This applies in particular when such structures are expected to experience significant lateral loads, as most arctic structures are. The SBP data is used for both serviceability state analysis and for providing fundamental information on undisturbed soil behavior. SBP testing has been carried out offshore for Gulf Canada Resources Inc. (GCRI) during the past two years (1982-1983 arctic open water seasons). Testing has been carried out in a variety of soil conditions across the GCRI land interest on the Canadian continental shelf in the Beaufort Sea. The paper outlines the equipment used, operational successes and difficulties, and presents productivity data. Techniques and equipment for improving productivity are outlined. Experience with SBP operations has shown that the SBP is no more difficult to use offshore than the electric static cone penetrometer (CPT). One result in particular of the SBP testing stands out; the in-situ geostatic stress ratio (Ko) has been found to be not a unique function of past overburden hi story. This result is discussed in the geological context. It appears prudent to regard as an independent variable for engineering purposes. INTRODUCTION An estimated 12 percent of the worlds untapped hydrocarbon reserves occur with in the Canadian Offshore regions (Beaufort Sea, Labrador Coast, Scotian Shelf and Arctic Islands). Gulf Canada Resources Inc. (GCRI) has significant interest in all these areas and is a major operator in the Beaufort Sea. The Beaufort Sea is characterized by being frozen and ice covered for about 9 months each year. This ice cover presents the principal environmental constraint in offshore operations because of the large forces it may exert on stationary structures [1]. Artifical islands have proved successful in resisting large, horizontal ice forces in shallow waters. However, the average water depth of the GCRI land interest is about 35 m (115 ft). Artifical islands would be very expensive in such water depths so caisson technology has been developed as a technique for gaining the performance of islands without their cost. The GCRI system is called the Mobile Arctic Caisson (MAC). The MAC is a hybrid soil-steel structure and the principles of its design and operation have been presented elsewhere [2], [3]. A prerequisite to deployment of the MAC is a site investigation paying particularly attention to the foundation response under inclined and dynamic load vectors. GCRI has carried out site investigations at various sites within its land interest during 1981, 1982 and 1983. However, it was found during 1981 that conventional laboratory tests gave scattered and ambiguous results at some sites.