Cieľ: Overiť efektívnosť a spoľahlivosť skríningu postduktálnej saturácie pulznou oxymetriou pre včasnú diagnostiku kritickej vrodenej vývojovej chyby srdca (VCC) v regióne severného Slovenska. Metodika: Postduktálna saturácia bola sledovaná prospektívne u zdravých donosených novorodencov narodených od 15. 11. 2009 do 31. 10. 2010 v regióne perinatologického centra Martin. Prvé meranie bolo vykonané vo veku 6-12 hodín, pri saturácii viac ako 95 % bol skríning považovaný za negatívny. Pri nižších hodnotách saturácie bolo meranie opakované v 6-hodinových intervaloch do veku 30 hodín. Výsledky: Zo súboru 7280 detí bola skríningom zistená kritická VCC u 7, senzitivita vyšetrenia bola 87,5 %, špecificita 98,9 %, negatívna prediktívna hodnota 99 %. Skríning bol falošne negatívny u 1 dieťaťa s neskôr diagnostikovaným hypoplastickým ľavokomorovým syndrómom. Z náhodne vybratej podskupiny 3210 detí bez VCC bol pozitívny skríning u 77 (2,39 %). Do 24 hodín sa u 63 z nich saturácia upravila a deti boli zdravé, príčinou bola prechodná cirkulácia (saturácia 93,03 ± 1,16 %, medián 93 %). U zvyšných 14 detí bolo diagnostikované iné ochorenie a saturácia bola vo veku 24 hodín menej ako 95 % u 50 % z nich (saturácia 90,64 ± 4,38 %, medián 92 %). Pri kritickej VCC boli hodnoty saturácie 86,0 ± 5,6 %, medián 87 %. Záver: Pulzná oxymetria je účinnou skríningovou metódou pre včasnú diagnostiku kritických VCC v asymptomatickom štádiu. Ak je postduktálna saturácia vo veku 24 hodín menej ako 90 %, indikované je echokardiografické vyšetrenie. Pri hodnotách 90–94 % je potrebné meranie opakovať o 6–12 hodín, v prípade pozitívneho nálezu vykonať kardiologické a iné potrebné vyšetrenia. Porovnanie hodnôt saturácie z pravej hornej a ktorejkoľvek dolnej končatiny zvyšuje efektivitu skríningu.
Aim: To evaluate the efficacy of the routine use of pulse oximetry to detect critical congenital heart disease (CCHD) in the region of Northern Slovakia. Methods: Postductal saturation was recorded prospectively in healthy term infants born from 15.11.2009 to 31.10.2010. The first screen was performed at the age of 6–12 hours. If pulse-oximetry measured arterial oxygen saturation was lower than 95%, the screening was positive and it was repeated in 6 hours intervals until the age of 30 hours. Results: 7280 infants were included in the study. The CCHD was detected due to the screening in 7 out of the infants. The sensitivity was 87.5%, specificity 98.9% and negative predictive value 99%. The false negative result was recorded in 1 baby with the hypoplastic left heart syndrome that was diagnosed clinically at the age of 2 days. In a randomly chosen subgroup of infants without CCHD the screening was positive in 77 out of the 3210 newborns (2.39%). Up to 24 hours the saturation was normal in 63 out of them, they were healthy and the positive screening was due to the transitional circulation (mean saturation 93.03±1.16%, median 93%). In remaining 14 out of the 77 infants other disease was diagnosed and the saturation was less than 95% in 50% out of them at the age of 24 hours (saturation 90.64±4.38%, median 92%). The saturation in infants with CCHD was 86.0±5.6%, median 87%. Conclusion: Pulse oximetry is an effective screening method for early detection of CCHD at asymptomatic stage. If the postductal saturation is less than 90% at the age of 24 hours, echocardiographic examination is indicated. Babies with saturation between 90 and 94% should have a second screen 6–12 hours later. If it is positive, the cardiologic and other necessary examinations are performed. Comparison of saturation values from the right hand and either foot increases the effectiveness of the screening.
- MeSH
- časná diagnóza MeSH
- financování organizované MeSH
- lidé MeSH
- nemoci novorozenců MeSH
- novorozenec MeSH
- novorozenecký screening mortalita MeSH
- oxymetrie využití MeSH
- transkutánní měření krevních plynů metody využití MeSH
- vrozené srdeční vady diagnóza MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- Geografické názvy
- Slovenská republika MeSH
Relationships between conformation traits and functional longevity in Holstein cows were evaluated using survival analysis. Functional longevity was defined as the number of days between the first calving and culling; that is, length of productive life. The data set consisted of 116,369 Holstein cows that first calved from 2003 to 2008. All cows used in the analysis were scored for conformation between d 30 and d 210 of their first lactation. The data included 48% censored records. Analyses were done separately for 20 linear descriptive type traits, 6 composite traits, and height at sacrum measured in centimeters. Cox proportional hazard models were fitted to analyze data. The hazard function was described as the product of a baseline hazard function and the time-independent effects of age at first calving and sire (random), and the time-dependent effects of stage of lactation and lactation number, herd, year and season, herd size, and 305-d milk production. The strongest relationship between a composite trait and functional longevity was for dairy form, followed by udder and final score. Among the descriptive type traits, the strongest relationships with longevity were found for body condition score, angularity, traits related to udder attachment, and udder depth. Foot and leg traits showed substantially lower effect on functional longevity, and the effect of foot angle was minimal. Functional longevity declined with decreased body condition score of cows. Cows with deep udders had significantly lower functional survival compared with cows with shallow udders. In addition, weak central ligament was associated with significant reduction of cow longevity. For dairy form and angularity, cows classified as very good were the worst with respect to longevity, whereas cows classified as poor were the best. An intermediate optimum was evident for rear legs rear view and rear legs set (side view), whereas cows with sickled legs had lower longevity than cows with straighter legs.
- MeSH
- biometrie MeSH
- dlouhověkost genetika MeSH
- kvantitativní znak dědičný MeSH
- laktace genetika MeSH
- mléčné žlázy zvířat anatomie a histologie MeSH
- proporcionální rizikové modely MeSH
- skot anatomie a histologie genetika fyziologie MeSH
- zvířata MeSH
- Check Tag
- skot anatomie a histologie genetika fyziologie MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
