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Objective: The aim of the presented study was to gather quantitative data regarding the impact of high ambient temperatures on dairy cows under practical conditions in southern Lower Saxony., Material and Methods: In summer 2018 (from mid of July to end of September), the climatic conditions in the dairy barn as well as the temperatures of feeds (silages and partial mixed ration, PMR) and feed leftovers were recorded on the Farm for Education and Research of the University of Veterinary Medicine Hannover in Ruthe. Furthermore, daily dry matter intake (of PMR) and milk yield on herd basis as well as respiration rate and rectal temperature of 10 selected cows were measured as indicators for heat stress., Results: During a heat period (daily average temperature up to 27.9° C) dry matter intake (PMR) and milk yield were reduced by about 15 % and 8 %, respectively although ambient temperatures had already been relatively high at the beginning of the observation period (daily average temperature between 19.6 and 23.0° C). Daily dry matter intake of PMR was NEGATIVELY: correlated with daily average temperature-humidity index in the barn (Spearman's correlation coefficient: -0.774, p < 0.0001) and POSITIVELY: correlated with daily milk yield (Spearman's correlation coefficient: 0.766, p < 0.0001). Correlation coefficients were slightly higher when a 1-day time lag was considered (Spearman's correlation coefficient: -0.796 and 0.800, respectively; p < 0.0001). During the heat period hyperthermia (> 39° C) was frequently recorded in lactating cows (up to 100 %)., Conclusion and Clinical Relevance: The presented results indicate that heat stress in dairy cows may occur to a considerable extent under extreme climatic conditions also in the region of Northern Germany. In consequence, this is associated with a significant decrease in performance. As severe and long-lasting effects of heat stress on health and performance of dairy cows are well described in the literature, especially the temporarily high prevalence of hyperthermia should be taken seriously. Under these circumstances, differentiating between hyperthermia and fever is of special importance for veterinary practitioners., Competing Interests: Die Autoren bestätigen, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

A sudden decrease in feed intake (within 24 hours) without an impaired general condition occurred on a bull-rearing and -fattening farm in western Germany in December 2017. One day later, some of the bulls displayed signs of ruminal tympany (free gas bloat) and the reduction in feed intake became more severe. The maize silage was recognized as the cause of the observed symptoms, because clinical signs first appeared after taking the silage from a different localization within the bunker silo. Maize in this particular section was harvested from a separate area previously affected by wind damage (numerous bent maize plants), where no crop protection (herbicide application) was performed. Fruits and seeds of Jimson weed were identified in the incriminated maize silage samples. Following replacement of the contaminated parts of the maize silage with non-contaminated material and treatment of the clinically affected animals (anti-tympanic medication plus live yeast preparation), the feed intake returned to the normal level and the affected animals recovered within 6 days. The cause of the symptoms was probably the anti-nutritive properties of Datura stramonium that affect the motor function of the gastrointestinal tract., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (© Georg Thieme Verlag KG Stuttgart · New York.)

Introduction: Hyperbaric oxygen therapy (HBOT) is discussed as an adjuvant option to treat necrotizing soft tissue infections (NSTI). While the Federal Joint Committee decided in 2007 not to support HBOT for the indication necrotizing fasciitis and Fournier's gangrene, it was decided to accept HBOT for treatment of clostridial myonecrosis for the German health insurance. Thus, in Germany necrotizing fasciitis (NF) is not a confirmed indication for HBOT. Against this background the cons of the clinical benefits of HBOT should be formulated., Methods: A literature search (MEDLINE/EMBASE/COCHRANE/manual search) using the keywords "necrotizing fasciitis", "Fournier's gangrene", "necrotizing cellulitis", "necrotizing soft tissue infections" as well as "hyperbaric medicine", "hyperbaric therapy" and "hyperbaric treatment" was carried out. An analysis of the spatial distribution of German hyperbaric oxygen chambers enabling intensive care (HOC-IC) was made., Results: A total of 250 articles with n=2,556 NSTI patients (n=993 treated by HBOT) was found and 50% of the articles were case reports or series. There were only ten retrospective studies comparing the effects of HBOT with non-HBO treatment and none of them verified the benefit of HBOT in NF patients. In Germany only nine hyperbaric oxygen chambers (HOC-IC) enable intensive care. Currently, patient data are not included in scientific studies or multicenter studies, while studies assessing the benefit with higher evidence levels have been required for more than 15 years., Conclusions: The previously published human clinical studies do not confirm any therapeutic benefit of HBOT in NF patients. Any time delay in the start of surgical therapy by HBOT would not be acceptable. In Germany a comprehensive clinical care with HOC is not possible. On average the additional costs of HBO treatment for NF patients is approximately 8,000-25,000 /patient which is not generally reimbursed by health insurance companies. Initializing a register study to assess the benefit of HBOT in NF patients appears feasible and is urgently needed.