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The objective of this study was to identify potential effects of increased grazing intensity, characterized by differing pasture availability and stocking rate, on indicators of welfare during both early and late grazing periods. Seventy spring-calving, pasture-based Holstein-Friesian and cross-bred dairy cows, averaging 35 ± 16 d in milk on the first day of data collection, were assigned to 3 treatments (20–26 cows/treatment) representing a range in grazing intensity: LO (high pasture availability, 980 kg DM/ha opening cover, 2.75 cows/ha, 90:10% pasture:concentrate diet), MOD (medium pasture availability, 720 kg DM/ha opening cover, 2.75 cows/ha, 90:10% pasture:concentrate diet), and HI (low pasture availability, 570 kg DM/ha opening cover, 3.25 cows/ha, 80:20% pasture:concentrate diet); representative of current, best practice and proposed production levels respectively for this system. Welfare indicators were locomotion score, digital dermatitis and white line disease, rumen fill, ocular and nasal discharge, integument damage to the neck-back and hock regions, and lying time. Data were collected during a 5-wk early grazing period in spring (EG) and a 7-wk late grazing period in autumn (LG). Average daily lying time was recorded for 8 to 10 focal cows per treatment. Results demonstrated only minor treatment effects. Cows on MOD [odds ratio (OR) = 3.11] and HI (OR = 1.95) were more likely to display nasal discharge compared with LO. Cows on MOD tended to have more damage to the skin on the neck-back region than LO (OR = 4.26). Total locomotion score (maximum = 25) was greater on LOW (7.1 ± 0.20) compared with HI (6.5 ± 0.19). Average lame cow prevalence for EG and LG respectively was 15.3 ± 3.12% and 39.2 ± 3.00% (LO), 20.0 ± 2.58% and 24.2 ± 5.69% (MOD), and 14.9 ± 4.79% and 17.0 ± 3.44% (HI). Cows on HI were less likely to have impaired walking speed than either LO (OR = 0.24) or MOD (OR = 0.29). Cows on both HI (OR = 0.36) and MOD (OR = 0.40) were less likely to display impaired abduction or adduction compared with those on LO. An interaction between treatment and period revealed longer lying times for cows on LO (10.6 h/d ± 0.39) compared with both MOD and HI (8.7 ± 0.43 and 8.4 ± 0.41 h/d) during EG only. The greatest effects were across grazing periods, with all indicators except rumen fill and locomotion score demonstrating improvements from EG to LG. This suggests cows were able to cope well with increasing levels of grazing intensity, and that regardless of treatment, a greater number of days on pasture led to improvements in welfare indicators. [ABSTRACT FROM AUTHOR]

Twice-daily milking is the most common milking regimen used globally. A reduction in milking frequency to once daily, combined with a reduced feed allowance (FA), could reduce the physiological stress associated with the transition to peak milk production, and hence improve immune function. This study investigated how milking frequency and FA affect dairy cow immune status. Cows (n = 48) were milked once a day (OAD) or twice a day (TAD) on 1 of 2 FA: high (HFA) or low (LFA), in a 2 x 2 factorial arrangement of treatments. After the mean calving date of March 11, HFA cows were offered ad libitum grass silage and 7 kg of concentrates/cow per day until March 22, then 4 kg of concentrates/cow per day until April 17, and thereafter allocated 31.3 kg of dry matter (DM) grass/cow per day. The LFA cows were offered 4 kg of concentrates/cow per day, 1 kg of concentrates/cow per day, and allocated 19 kg of DM grass/cow per day for the same respective periods. Milk yield was recorded daily and body condition score weekly, and somatic cell count was performed at approximately 2-wk intervals. Blood samples were collected prepartum (d -7 to -1) and at d 1 to 7, d 14 to 21, and d 42 to 49 postpartum. Total and differential leukocyte percentage, IFN-ᵞ. production in response to concanavalin A and phytohemagglutinin, and cortisol, haptoglobin (Hp), and serum amyloid A (SAA) concentrations were evaluated. Cows milked OAD had reduced milk yield and body reserve mobilization, but higher somatic cell counts. Milking frequency and diet had no effect on total leukocyte counts. Cows milked OAD had a higher lymphocyte percentage and lower monocyte percentage, and tended to have a lower neutrophil percentage than cows milked TAD. In addition, the LFA cows had a higher eosinophil percentage than cows fed the HFA. Milking frequency and diet had no effect on IFN-ᵞ, Hp, SAA, or cortisol production. Utilization of strategies to reduce milk yield at the beginning of the lactation could not only reduce body reserve mobilization, but also help to maintain a functioning immune system, and thus improve cow welfare. [ABSTRACT FROM AUTHOR]

Access to open water is considered good for the welfare of Pekin ducks. These studies investigated the effect that the type of water resource, provided over either straw bedding or a rubber mesh, had on measures of duck health. Pekin strain ducklings (n = 2,600) were managed in pens of 100 on straw over a solid concrete floor. In study 1, one of two water resources (nipple, n = 5 pens; wide-lip bell drinker, n = 5 pens), was located directly over the straw. In study 2, one of three water resources (narrow lip bell drinker, n = 6 pens; trough, n = 5 pens; and bath, n = 5 pens) was located over a rubber mesh. On d 16, 24, 29, 35, and 43, (study 1) or d 21, 29, 35, and 43 posthatch (study 2), 10 birds were selected from each pen and weighed, and then feather hygiene, footpad dermatitis, eye health, gait score, and nostril condition scores were taken. Treatment had no effect on BW in either study, but in study 2, ducks in the open water treatments had higher scores (P < 0.001) than those in the narrow-lip bell drinker treatment by d 43. In study 1, treatment had no effect on hygiene scores, but scores increased over time (P < 0.001). In study 2, ducks in the narrow-lip bell drinker treatment were dirtier than those in the bath treatment (P = 0.01), with those in the trough treatment being intermediate. In both studies, ducks with bell drinkers had worse gait scores than those in the other treatments (study 1, P < 0.01; study 2, P < 0.05). Treatment had no effect on eye health scores. However, ducks were less likely to have dirty nostrils when provided with more open water resources in both studies (P < 0.01), or were less likely to have blocked nostrils in the trough and bath treatments than in the narrow-lip bell drinker treatment in study 2 (P = 0.01). Provision of open water, particularly over a properly constructed drainage area, improved some aspects of duck health (improved feather hygiene and BW, and fewer dirty and blocked nostrils). However, further work is needed to investigate these treatments on a commercial scale. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of 2 dairy cow housing systems on cow locomotion, immune status, and expression of genes associated with lameness during the dry and periparturient periods. Cows were assigned to freestall housing with either rubber (RUB; n = 13) or concrete (CON; n = 14) at the feed-bunk and alley immediately after their first calving, and managed on this system during all subsequent lactations. At dry off, cows were moved to a straw bedded-pack dry cow pen, and remained there until about 2 d before subsequent calving. To investigate whether greater exposure to RUB or CON increased the differences between cows on each treatment, cows at the end of either their first (n = 16) or second (n = 11) lactations were included in the experiment. Locomotion scores and blood samples were obtained at -60 (beginning of the dry period), -30, 0 (after calving), +10 and +18 d relative to calving. Leukocyte counts were obtained by using an automated cell counter. Phagocytic activity, and cells positive for CD14 and CD18 expression were measured by flow cytometry using labeled microbeads and antibodies. Expression of tachikinin 1(TAC1), histamine receptor 1 (H1), and metalloproteinase (MMP)13 in blood leukocytes was estimated using quantitative real-time PCR. Treatment effects were determined using a repeated measures model. Provision of rubber flooring did not improve dairy cow locomotion during the subsequent study period. However, time relative to calving had an effect on locomotion score and speed, which were worst on d 0, probably because of the discomfort associated with calving. An interaction occurred between treatment and time for neutrophil and lymphocyte counts. The RUB cows had greater neutrophil and lesser lymphocyte numbers postpartum than CON. These cows also had more cells positive for CD14 postpartum compared with prepartum. Moreover, RUB cows showed upregulation of MMP13 and TAC1 compared with CON. These genes are associated with lameness and pain detection respectively. Greater neutrophil to lymphocyte ratios and CD14 expression are associated with physiological stress or with activated immunity. Rubber flooring is associated with an increase in activity and standing. This may have resulted in indications of physiological stress and upregulation of genes associated with lameness and pain for RUB cows. However, this study did not take into account the long-term effects of concrete or rubber flooring; for instance, occurrence of lameness or survivability within the herd. [ABSTRACT FROM AUTHOR]

Objective – De-novo psychiatric symptoms may develop within 3 months after a temporal lobectomy for epilepsy. The objective of this study was to identify presurgical risk factors for psychiatric symptoms. Methods – Twenty-seven patients who had a temporal lobectomy for epilepsy were included. Twenty-four had hippocampal sclerosis or gliosis, and three had cavernous haemagiomata. Twelve had operations on the left, and 15 on the right side. Twenty-four patients were rendered free of seizures (SZ) with loss of awareness, three had early post-operative convulsions, one continued to have habitual SZ. Results – Nine patients (33%) developed low mood, anxiety and emotional lability within 3 months after surgery. Patients with early post-operative psychiatric symptoms were younger (27.9/34.8 years, P = 0.01), and more anxious on the presurgical Hospital Anxiety and Depression Scale (12/8.44, P = 0.02) than patients without post-operative psychiatric symptoms. There was also an association between right temporal lobectomies and early post-surgical symptoms ( P = 0.02 Fisher’s exact test). Conclusion – Potential risk factors were age, anxiety and operation on the right side. Larger studies are required to determine if these risk factors are independent. [ABSTRACT FROM AUTHOR]

The study investigated differences in behavior synchrony of dairy cows during the winter confinement period when managed in 1 of 3 out-wintering pad (OWP) systems, or indoors in free-stall housing. There were 2 replicates of each treatment, and observations were carried out on 3 recording occasions in January and February 2006. On each recording occasion, behavior was recorded every 30 min between 0600 and 0130 h the following day (n = 40). The outcomes for measurement were eligible cows lying (ECL), cow comfort index (CCI), and proportion of animals feeding (AF). Autocorrelation as an indicator of synchrony was calculated using the Durban-Watson statistic and compared across treatments. A centered moving average was calculated, used to obtain the residual, and compared between treatments. Low autocorrelations were recorded in free stalls (39.6 ± 0.1%), indicating lower temporal behavioral synchrony than in the 3 OWP designs. Overall, the greatest proportion of ECL, CCI, and AF occurred in free stalls (60%). However, high proportions (>90%) of ECL were recorded on OWP in the early morning, whereas the range of ECL in free stalls (22 to 87%) was lower. The low overall proportions for ECL (44, 52, and 54%) and CCI (48, 55, and 58%) in the OWP were caused by the cows standing without feeding during daylight hours. Nevertheless, these cows performed more synchronized lying at night, and their behavior was more highly autocorrelated (65.9 ± 0.1, 73.3 ± 0.1, and 52.3 ± 0.1%) than cows in free stalls. Synchrony of behavior is part of the normal behavior repertoire of herd-living animals such as dairy cattle, and OWP may promote a more natural circadian behavior pattern than do free-stall systems. It is important that indices such as CCI and ECL are utilized at appropriate times of the day, when cows are expected to lie; that is, during the evening time. Estimated acceptable levels of these indices may be dependent on the confinement system employed. [ABSTRACT FROM AUTHOR]

This study compared locomotion, hoof health, and lameness of dairy cows confined in either indoor free stalls (FS) or 1 of 3 out-wintering pad (OWP) designs. Out-wintering pad treatments were 1) uncovered OWP with a concrete feed apron (UP); 2) covered OWP with a concrete feed apron (CO); and 3) uncovered OWP on top of which grass was ensiled so that the cows could self-feed (SP). Cows were assigned to treatment at drying offusing a randomized complete block design. They remained on treatment until calving, when they were turned out to pasture. Sole lesions, heel erosion, dermatitis, and claw hardness on both hind feet were scored according to severity at assignment to treatment, at calving, and 9 and 14 wk postpartum. Locomotion score was recorded weekly after calving for 14 wk. Incidence of clinical lameness was recorded during the treatment period and in the subsequent lactation. Treatment had no effect on sole lesion score, but scores increased over time (calving = 5.5 + 1.3, wk 9 = 10.8 + 1.3, wk 14 = 14.2 + 1.3, mean ± SE). Self-fed cows had higher heel erosion scores (6.4 ± 0.4) than FS and CO cows (4.7 ± 0.4 and 4.7 ± 0.4, respectively) at calving. Cows on SP had the highest dermatitis scores [1.14 (0-2) mean (interquartile range)] and FS cows the lowest [0.51 (0-0)]. Hooves were hardest at assignment to treatment (43.9 ± 0.6) with a significant reduction in hardness at calving (40.0 ± 0.6). The hooves of CO cows were harder than those of SP and UP cows (CO = 43.3 ± 0.7, SP = 41.7 + 0.7, UP = 41.7 ± 0.7, Shore D scale). There was no treatment effect on locomotion scores or lameness incidence. Higher dermatitis scores and heel erosion in SP may be due to exposure to excreta and moisture, because the SP treatment had no manure removal system at the feed face. In FS, the alleys and the feed face were cleaned regularly by automatic scraper, explaining the lower dermatitis scores recorded indoors. Providing shelter for OWP likely reduced exposure to environmental moisture. This ensured that the hooves of CO cows remained as hard as those of FS cows. Low correlations between hardness and pathologies indicate that other factors are involved in the development of hoof pathologies. Confining dry dairy cows on OWP does not increase locomotion scores or lameness incidence. [ABSTRACT FROM AUTHOR]

Group housing provides increased access to space and social interactions for calves while reducing labor costs for producers. However, group housing necessarily requires that calves be mixed and no research to date has addressed the effects of mixing on behavior of milk-fed dairy calves. The objective of this study was to monitor the feeding and competitive behavior of individual dairy calves (n = 8) after introduction into an established group of older calves fed ad libitum by a computer-controlled milk feeder. Milk feeding was monitored for 2 d before introduction into the new group and both milk feeding and competitive behaviors were monitored for 4 d after mixing. Mean (± SE) milk consumption before mixing was 9.7 ± 0.7 kg/d, dropped slightly on the day of mixing to 8.6 ± 0.6 kg/d, but increased on d 1 to 3 after mixing to 11.1 ± 0.3 kg/d. Calves visited the feeder less frequently on the day of mixing (6.0 ± 1.8 visits/d) than on either the days before mixing (20.3 ± 2.5 visits/d) or the days after mixing (25.3 ± 6.9 visits/ d). The mean duration of feeder visits and mean milk consumption per visit increased from 4 min 15 s ± 21 s and 0.53 ± 0.06 kg per visit before mixing to 8 min 17 s ± 1 min 28 s and 1.87 ± 0.51 kg per visit on the day of mixing. Competitive displacements from the milk-feeding stall were rare. In summary, feeding behavior of young calves is altered on the day of mixing, but calves are able to maintain milk intake when using a milk feeder fitted with a stall that prevents calves from displacing one another. [ABSTRACT FROM AUTHOR]

The present study investigated the spatial organization of electrical activity in the canine rectoanal region and its relationship to motility patterns. Contraction and resting membrane potential (E[sub m]) were measured from strips of circular muscle isolated 0.5-8 cm from the anal verge. Rapid frequency [25 cycles/min (cpm)] E[sub m] oscillations (MPOs, 12 mV amplitude) were present across the thickness of the internal anal sphincter (IAS; 0.5 cm) and E[sub m] was constant (-52 mV). Between the IAS and the proximal rectum an 18 mV gradient in E[sub m] developed across the muscle thickness with the submucosal edge at -70 mV and MPOs were replaced with slow waves (20 mV amplitude, 6 cpm). Slow waves were of greatest amplitude at the submucosal edge. Nifedipine (1 µM) abolished MPOs but not slow waves. Contractile frequency changes were commensurate with the changes in pacemaker frequency. Our results suggest that changing motility patterns in the rectoanal region are associated with differences in the characteristics of pacemaker potentials as well as differences in the sites from which these potentials emanate. [ABSTRACT FROM AUTHOR]

Examines the medical need for induction of labor. Determination of the duration of pregnancy; Correlation between hypertension and proteinuria; Analysis of perinatal mortality in pre-eclampsia without proteinuria.

The aim of this study was to evaluate three overwinter housing options for spring calving dairy cows; indoor cubicles [IC], uncovered woodchip pad [UP] (12m2/cow) and sheltered woodchip pad [SP] (6m2/cow), with regard to cow dirt score, incidence of mastitis, and somatic cell score (SCS). Animals (n=147) were randomly assigned to the housing treatments from 6 Dec until calving (median = 14 Feb), and scored for dirtiness (1 to 5 in half score increments) prior to housing, then every 14 days until calving. Cows were quarter milk sampled (QMS) for microbiology and somatic cell count (SCC) prior to housing, at drying off and approx. 3 weeks post partum. QMS were also collected 2.2 ± 1.98 days post calving and assayed for California Mastitis Test (CMT) and microbiology. Clinical mastitis (CM) was diagnosed when macroscopic changes in the milk or udder were observed. Subclinical mastitis (SCM) was diagnosed in the event of SCC > 500,000 or CMT > 2, without macroscopic changes. SCC was recorded at 2 week intervals throughout the following lactation. A log transformation of SCC to SCS was used to normalize the data distribution. Average SCS was calculated for three stages of lactation: 6 to 60 days in milk (DIM) (early), 61 to 220 DIM (mid), and 221 to 305 DIM (late). Dirt scores and SCS were analyzed using the Mixed Procedure of SAS. Differences in the incidence of CM, SCM, and the incidence of pathogens detected in QMS were analyzed using Fishers exact probability test. Housing had an effect on animal dirtiness, with SP cows dirtiest, then UP, and IC cleanest (P < 0.001). There were no cases of CM prior to housing, at dry off or during the housing period, and no difference in incidence of SCM. Three weeks post calving combined incidence of CM and SCM was higher in SP than UP or IC (P < 0.05), and a higher number of cows from SP had an infectious agent isolated (P < 0.05). However there was no effect of treatment on SCS over the following lactation. [ABSTRACT FROM AUTHOR]

Abstract: The International Nusantara Stratification and Transport (INSTANT) program measured currents through multiple Indonesian Seas passages simultaneously over a three-year period (from January 2004 to December 2006). The Indonesian Seas region has presented numerous challenges for numerical modelers — the Indonesian Throughflow (ITF) must pass over shallow sills, into deep basins, and through narrow constrictions on its way from the Pacific to the Indian Ocean. As an important region in the global climate puzzle, a number of models have been used to try and best simulate this throughflow. In an attempt to validate our model, we present a comparison between the transports calculated from our model and those calculated from the INSTANT in situ measurements at five passages within the Indonesian Seas (Labani Channel, Lifamatola Passage, Lombok Strait, Ombai Strait, and Timor Passage). Our Princeton Ocean Model (POM) based regional Indonesian Seas model was originally developed to analyze the influence of bottom topography on the temperature and salinity distributions in the Indonesian seas region, to disclose the path of the South Pacific Water from the continuation of the New Guinea Coastal Current entering the region of interest up to the Lifamatola Passage, and to assess the role of the pressure head in driving the ITF and in determining its total transport. Previous studies found that this model reasonably represents the general long-term flow (seasons) through this region. The INSTANT transports were compared to the results of this regional model over multiple timescales. Overall trends are somewhat represented but changes on timescales shorter than seasonal (three months) and longer than annual were not considered in our model. Normal velocities through each passage during every season are plotted. Daily volume transports and transport-weighted temperature and salinity are plotted and seasonal averages are tabulated. [Copyright &y& Elsevier]

Examines the nature of slow electrical oscillations (SEO) and determines whether the mechanisms giving rise to SEO are similar to those that generate slow waves in the submucosal region. Effect of nitric oxide on electrical activity in myenteric muscle; Effects of dihydropyridines and low calcium solution on SEO; Effects of mitochondrial inhibitors on SEO; Properties of SEO that share with slow waves.

Liquid paraffin or mineral oil is a transparent, colourless, odourless, or almost odourless, oily liquid composed of saturated hydrocarbons obtained from petroleum. Petroleum was used as a medicine at least 400 years before Christ. The article analyzes the role of the liquid paraffin in treatment of constipation among children. The popularity of liquid paraffin as a treatment for constipation and encopresis stems primarily from its tolerability and ease of titration. Authors of the article describe properly designed randomized and controlled study for role of the paraffins.

Pig production in Ireland has gone through enormous changes during the past 60 yr, from pigs being primarily produced as a sideline on dairy farms, to an industry with one of the highest average herd sizes in Europe. This happened in part due to external pressure on the industry, whereby economies of scale were needed to compete with pigs produced in other countries, but largely due to the instigation of national programmes to support the pig industry through research, education and knowledge transfer. These efforts helped producers to take advantage of genetic improvements and monitor their own performance over time, as well as allowing for benchmarking of the national herd against other countries. The research programme initiated in the 1960s continues to grow and expand, providing the pig industry with internationally renowned data and knowledge in the areas of nutrition, animal welfare, the environment and energy use. Recent initiatives such as the establishment of the Teagasc and Irish Farmers Association Pig Joint Programme, and a Pig Health Check section in Animal Health Ireland, will help to promote further cross-collaboration between stakeholders in the pig industry, and enable it to rise to the challenges of the years ahead. [ABSTRACT FROM AUTHOR]

The welfare status of an animal is dependent on its ability to cope and exist in harmony with its environment, such that good physical and psychological health is maintained. Improving animal welfare is an increasingly important aspect of livestock production systems due, in a large extent, to increased consumer concerns about animal production practices. Animal welfare is an integrated part of quality assurance programmes for sustainable animal production, considering that welfare, health, management, economy, consumer acceptance and environmental impact are interdependent. The major welfare concerns in the livestock industry in recent years relate to the rearing and management of dairy calves, the welfare of the dairy cow, effect of husbandry management procedures on the welfare of beef cattle, rearing of sows in gestation and farrowing crates, and the broiler (meat) chicken sector. The paper will focus on scientific research underpinning these welfare concerns, with a particular focus on research conducted on the island of Ireland. [ABSTRACT FROM AUTHOR]

Abstract: A patient with a mood disorder and a Parkinsonian syndrome with frontal cognitive impairment thought to resemble progressive supranuclear palsy defied precise diagnosis until the development of respiratory compromise, prompting consideration of the diagnosis of Perry syndrome. A mutation in the dynactin 1 gene confirmed the diagnosis. Few examples of this disorder, characterised by depression, Parkinsonism, and respiratory insufficiency, have been reported but it may be more commonly recognised with the availability of genetic testing. Perry syndrome needs to be considered in the differential diagnosis of Parkinsonism, particularly in autosomal dominant pedigrees. Diagnosis early in the disease course may facilitate monitoring and prompt intervention to avoid potentially fatal respiratory failure. [Copyright &y& Elsevier]

AIMS: To describe the change in incidence of paediatric inflammatory bowel disease (IBD) observed at the National Centre for Paediatric Gastroenterology, Hepatology and Nutrition, and to determine whether the presenting disease phenotype and disease outcomes have changed during the past decade. METHODS: The annual incidence of IBD in Irish children aged <16 years was calculated for the years 2000-2010. Two subsets of patients, group A (diagnosed between 1 January 2000 and 31 December 2001), and group B (diagnosed between 1 January and 31 December 2008) were phenotyped according to the Paris Classification. Phenotype at diagnosis and 2-year follow-up were then compared. RESULTS: 406 new cases of IBD were identified. The incidence was 2.5/100 000/year in 2001, 7.3 in 2008 and 5.6 in 2010, representing a significant increase in the number of new cases of Crohn's disease (CD) and ulcerative colitis (UC). There were 238 cases of CD; 129 of UC; and 39 of IBD unclassified. Comparing groups A and B, no differences were found in disease location at diagnosis or, for CD, in its behaviour. CONCLUSIONS: There has been a substantial and sustained increase in the incidence of childhood UC and CD in Ireland over a relatively short period of time. However, disease phenotype at diagnosis has not changed. At 2 years follow-up, CD appears to progress less frequently than in some neighbouring countries. These variations remain unexplained. Prospective longitudinal studies will help to elucidate further the epidemiology of childhood IBD. [ABSTRACT FROM AUTHOR]

Aims To describe the change in incidence of paediatric inflammatory bowel disease (IBD) observed at the National Centre for Paediatric Gastroenterology, Hepatology and Nutrition, and to determine whether the presenting disease phenotype and disease outcomes have changed during the past decade. Methods The annual incidence of IBD in Irish children aged <16 years was calculated for the years 2000- 2010. Two subsets of patients, group A (diagnosed between 1 January 2000 and 31 December 2001), and group B (diagnosed between 1 January and 31 December 2008) were phenotyped according to the Paris Classification. Phenotype at diagnosis and 2-year follow-up were then compared. Results 406 new cases of IBD were identified. The incidence was 2.5/100 000/year in 2001, 7.3 in 2008 and 5.6 in 2010, representing a significant increase in the number of new cases of Crohn's disease (CD) and ulcerative colitis (UC). There were 238 cases of CD; 129 of UC; and 39 of IBD unclassified. Comparing groups A and B, no differences were found in disease location at diagnosis or, for CD, in its behaviour. Conclusions There has been a substantial and sustained increase in the incidence of childhood UC and CD in Ireland over a relatively short period of time. However, disease phenotype at diagnosis has not changed. At 2 years follow-up, CD appears to progress less frequently than in some neighbouring countries. These variations remain unexplained. Prospective longitudinal studies will help to elucidate further the epidemiology of childhood IBD. [ABSTRACT FROM AUTHOR]

Aims: The sentinel node concept states that the first lymph node on a direct pathway from a tumour will be the first site of lymphatic spread. The aim of this study was to determine the feasibility and accuracy of sentinel node biopsy for oesophageal adenocarcinoma. Methods: Fifty-seven patients (median age: 62 years; M : F = 4 : 1) with adenocarcinoma of the lower oesophagus (n = 40) or cardia (n = 17) underwent endoscopic peritumoural injection of 99m Tc-nanocolloid prior to en-bloc resection with extended lymphadenectomy. Sentinel lymph nodes (SLNs) were identified intraoperatively using a Navigator™ gamma probe and the pattern of radioactive uptake was quantified postoperatively. All 1667 resected lymph nodes were examined for micrometastases using immunohistochemistry. Results: SLNs were identified for all 57 patients (median 2, range 1–4) and were most frequently lower paraoesophageal (n = 31) or left gastric nodes (n = 28). They contained metastases (n = 32) or micrometastases (n = 3) in 35 of 37 node-positive cases and were more likely to contain tumour than other lymph nodes (P < 0.0001). SLN biopsy had an overall accuracy of 96 per cent (55/57) and a false-negative rate of 5 per cent (2/37). Tumour-infiltrated nodal stations received a higher proportion of radioactive uptake (P < 0.0001). Lower oesophageal tumours had a greater proportion of SLNs (P = 0.018), radioactive uptake (P < 0.0001) and malignant nodes (P = 0.004) in the mediastinum compared to cardia tumours. Conclusions: The sentinel node concept is applicable for oesophageal adenocarcinoma and could be used to tailor the extent of lymphadenectomy. There is a close relationship between patterns of radioactive uptake and lymphatic tumour dissemination, which differ for lower oesophageal and cardia tumours. [ABSTRACT FROM AUTHOR]