On-farm supplementation of rumen-protected niacin: A randomized clinical trial.

B vitamins, including niacin (vitamin B), are synthesized by rumen microbes, but supplementation may provide additional benefits for ruminant health and productivity. Supplementing rumen-protected niacin (RPN) during the transition period can reduce lipolysis after calving and, consequently, may improve health and fertility of dairy cattle later in lactation. Our objective was to determine if supplementing RPN during the first 21 DIM would improve the health of dairy cows on a commercial dairy farm.

X-ray burns--painful, protracted, and preventable.

Very high doses of x-ray may produce deep burns in the backs of patients having fluoroscopically guided cardiac interventional procedures. While these incidents are uncommon they can be prevented by judicious limitation of fluoroscopy and timely repositioning of the x-ray tube. Better education and improved methods for dose mapping should make these distressing complications a thing of the past.

Choice of pacemakers in patients aged 75 years and older: ventricular pacing mode vs. dual-chamber pacing mode.

Half of all pacemakers implanted in the United States are for patients aged 75 years and older. The expectations and needs of an older group are different from patients who are younger, yet it is only recently that different pacing mode benefits for elderly persons have been tested in clinical trials. Some of the results have been surprising and suggest new algorithms for management.

Keeping the autopsy alive.

The recent decline in autopsy rates has many causes and has been the subject of vigorous debate amongst clinicians, pathologists, and investigators. For cardiologists, the lack of direct information on the vessel wall may impede the ability to develop and interpret new imaging methods and to understand the effects of the newest interventions.

Radiation burns as a severe complication of fluoroscopically guided cardiological interventions.

Radiation-induced skin burns can be produced by high doses of fluoroscopic X rays. Though uncommon, such injuries can cause considerable distress to the patient and they can lead to deep ulcers requiring skin grafts. Factors that increase the chance of a burn can be readily identified and in nearly all instances they can be avoided or minimized.