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Introduction: A feedlot is an intensive farming system for finishing livestock. Bovine respiratory disease (BRD) is a cause of morbidity and mortality in beef cattle, especially in feedlots. Methodology: This study investigated the morbidity and mortality of BRD in a beef cattle feedlot in southeastern Brazil using: clinical diagnoses, therapy, morbidity, and mortality. Pulmonary fragments were collected from five steers, on feed from 3-32 days, with lesions of pneumonia for identification of BRD infectious agents PCR. Results: 188,862 steers were on feed and morbidity was 7.05% (13,315/188,862), mortality 0.64% (1,214/188,862). The causes of morbidity were: BRD (6.13%), lameness (0.29%), trauma (0.21%), clostridiosis (0.13%) and polioencephalomalacia, PEM (0.12%). The causes of mortality were: BRD (0.21%), trauma (0.17%), and clostridiosis (0.13%). When all sick cattle were considered (n=13,315), BRD (86.9%) was the principal cause of morbidity, followed by lameness (4.13%), trauma (3.05%), and clostridiosis (1.82%). The cost of BRD-associated cattle mortality and morbidity was estimated at$14,334.00/10,000 and $ 16,315.40/10,000 respectively. It was projected that the economic effects due to BRD-associated morbidity in Brazil were$6.31 million/annum, while losses due to mortality were $ 5.54 million, resulting in an annual loss of $11.85 million. Coinfections in cattle with pneumonia due to Mannheimia haemolytica and Pasteurella multocida were identified in 4/5 steers tested. Conclusions: This is the first longitudinal study that investigated the incidence of BRD in feedlot cattle from Brazil, and the results herein described indicate that BRD contributed significantly to the development of mortality and morbidity of cattle on feed.

Bovine respiratory diseases (BRD) affect production rates negatively because it compromise health and well-being of the affected animal. The hypothesis of this study was that the use of metaphylactic protocols based on the risk to develop BRD would reduce morbidity and pulmonary lesions. For this purpose, the aims of this study were to evaluate the effect of two metaphylactic protocols on the morbidity of feedlot cattle with a known sanitary history, occurrence of pulmonary lesions at slaughter, and the possible participation of Mannheimia haemolytica, Histophilus somni, Bovine alphaherpesvirus 1 (BoHV-1) and bovine respiratory syncytial virus (BRSV) in the development of BRD. An experimental study was designed in which 3,094 adult, male, cattle, were grouped according to the risk to develop BRD: a) group without metaphylaxis (n=2,104), low-risk animals; b) metaphylaxis group with oxytetracycline (n=789), moderate-risk animals; c) metaphylaxis group with tildipirosin (n=201), high-risk animals. All cattle were immunized against pathogens associated with BRD (BoHV-1, BVDV, BRSV, PI3). The morbidity for BRD was 8.2% (253/3,094); cattle within the moderate-risk group for BRD had the lowest frequency (6.1%), followed by high-risk animals with tildipirosin metaphylaxis (6.5%) and low-risk without metaphylaxis (9.1%) (P=0.019). At the abattoir, 1.2% of lungs with lesions were found. There was a difference (P=0.036) in the frequency of pulmonary lesions between healthy animals (1.1%) and those diagnosed with BRD (2.8%). Two agents associated with BRD were identified by PCR assays in the lungs (n=37) of cattle: M. haemolytica (16.2%) and H. somni (5.4%). In addition, concomitant infections involving these pathogens were identified in the lungs of two steers. These results demonstrate that the use of metaphylactic protocols, based on the risk to develop BRD, reduces morbidity and pulmonary lesions in affected cattle. Furthermore, pulmonary lesions were more frequent in animals with a history of BRD. RESUMO: As doenças respiratórias dos bovinos (DRB) afetam negativamente as taxas de produção por comprometer a saúde e o bem-estar animal. A hipótese deste estudo foi que o uso de protocolos metafiláticos com base no risco de desenvolvimento de DRB reduziria a morbidade e as lesões pulmonares ao abate. Para tanto, objetivou-se avaliar o efeito de dois protocolos metafiláticos sobre a morbidade de bovinos confinados com histórico sanitário conhecido, ocorrência de lesões pulmonares no abate e possível participação de Mannheimia haemolytica, Histophilus somni, Alphaherpesvírus bovino 1 (BoHV-1) e Vírus respiratório sincicial bovino (BRSV) na DRB. Foram avaliados 3.094 bovinos adultos, machos, agrupados de acordo com o risco de desenvolvimento de DRB: a) grupo sem metafilaxia (n=2.104), animais de baixo risco; b) grupo metafilaxia com oxitetraciclina (n=789), animais de risco moderado; c) grupo metafilaxia com tildipirosina (n=201), animais de alto risco. Todos os animais foram previamente vacinados contra os principais agentes virais causadores das DRB (BoHV-1, BVDV, BRSV e PI3). A morbidade para DRB foi de 8,2% com menor frequência em animais com risco moderado e metafilaxia com oxitetraciclina (6,1%), seguido por animais com alto risco com metafilaxia com tildipirosina (6,5%) e animais com baixo risco sem metafilaxia (9,1%) (P=0,019). No frigorífico, foram encontrados 1,2% 1,2% de animais com lesões pulmonares. Houve diferença (P=0,036) na frequência de lesões pulmonares entre animais saudáveis (1,1%) e aqueles diagnosticados com DRB (2,8%). Foram identificados dois agentes associados à DRB pela técnica de PCR nos pulmões (n=37) dos bovinos: M. haemolytica (16,2%) e H. somni (5,4%). Adicionalmente, infecções concomitantes envolvendo estes potenciais patógenos foram identificadas nos pulmões de dois animais. Concluiu-se que o uso de protocolos metafiláticos, com base no risco de desenvolvimento de DRB, reduziu a morbidade e a ocorrência de lesões pulmonares nos bovinos acometidos que foram identificadas com maior frequência em animais com histórico de DRB.

Bovine respiratory diseases (BHD) affect production rates negatively because it compromise health and well-being of the affected animal. The hypothesis of this study was that the use of metaphylactic protocols based on the risk to develop BRD would reduce morbidity and pulmonary lesions. For this purpose, the aims of this study were to evaluate the effect of two metaphylactic protocols on the morbidity of feedlot cattle with a known sanitary history, occurrence of pulmonary lesions at slaughter, and the possible participation of Mannheimia haemolytica. Histophilus somni. Bovine alphaherpesvirus 1 (BoHV-1) and bovine respiratory syncytial virus (BRSV) in the development of BRD. An experimental study was designed in which 3.094 adult, male, cattle, were grouped according to the risk to develop BRD: a) group without metaphylaxis (n=2.104), low-risk animals: b) metaphylaxis group with oxytetracycline (n=789), moderate-risk animals: c) metaphylaxis group with tildipirosin (n=201), high-risk animals. All cattle were immunized against pathogens associated with BRD (BoHV-1. BVDV BRSV PI3). The morbidity for BRD was 8.2% (253/3.094): cattle within the moderate-risk group for BRD had the lowest frequency (6.1%), followed by high-risk animals with tildipirosin metaphylaxis (6.5%) and low-risk without metaphylaxis (9.1%) (P=0.019). At the abattoir. 1.2% of lungs with lesions were found. There was a difference (P=0.036) in the frequency of pulmonary lesions between healthy animals (1.1%) and those diagnosed with BRD (2.8%). Two agents associated with BRD were identified by PCR assays in the lungs (n=37) of cattle: M. haemolytica (16.2%) and H. somni (5.4%). In addition, concomitant infections involving these pathogens were identified in the lungs of two steers. These results demonstrate that the use of metaphylactic protocols, based on the risk to develop BRD. reduces morbidity and pulmonary lesions in affected cattle. Furthermore, pulmonary lesions were more frequent in animals with a history of BRD. Key words: Histophilus somni, Mannheimia haemolytica, pulmonary lesions. As doencas respiratorias dos bovinos (DRB) afetam negativamente as taxas de producao por comprometer a saude e o bem -estar animal. A hipotese deste estudo foi que o uso de protocolos metafilaticos com base no risco de desenvolvimento de DRB reduziria a morbidade e as lesoes pulmonares ao abate. Para tanto, objetivou-se avaliar o efeito de dois protocolos metafilaticos sobre a morbidade de bovinos confinados com historico sanitario conhecido, ocorrencia de lesoes pulmonares no abate e possivel participacao de Mannheimia haemolytica. Histophilus somni. Alphaherpesvirus bovino 1 (BoHV-1) e Virus respiratorio si nei ciai bovino (BRSV) na DRB. Foram avaliados 3.094 bovinos adultos, machos, agrupados de acordo com o risco de desenvolvimento de DRB: a) grupo sem metafilaxia (n=2.104). animais de baixo risco: b) grupo metafilaxia com oxitetraciclina (n=789), animais de risco moderado: c) grupo metafilaxia com tildipirosina (n=201), animais de alto risco. Todos os animais foram previamente vacinados contra os principais agentes virais causadores das DRB (BoHV -1. BVDV BRSV e PI3). A morbidade para DRB foi de 8.2%> com menor frequencia em animais com risco moderado e metafilaxia com oxitetraciclina (6,1%), seguido por animais com alto risco com metafilaxia com tildipirosina (6,5%) e animais com baixo risco sem metafilaxia (9,1%) (P=0.019). No frigorifico, foram encontrados 1,2% 1,2% de animais com lesoes pulmonares. Houve diferenca (P=0.036) na frequencia de lesoes pulmonares entre animais saudaveis (1,1%) e aqueles diagnosticados com DRB (2,8%). Foram identificados dois agentes associados aDRB pela tecnica de PCR nos pulmoes (n=37) dos bovinos: M. haemolytica (16,2%) e H. somni (5,4%). Adicionalmente, infeccoes concomitantes envolvendo estes potenciais patogenos foram identificadas nos pulmoes de dois animais. Concluiu-se que o uso de protocolos metafilaticos. com base no risco de desenvolvimento de DRB. reduziu a morbidade e a ocorrencia de lesoes pulmonares nos bovinos acometidos que foram identificadas com maior frequencia em animais com historico de DRB. Palavras-chave: Histophilus somni, Mannheimia haemolytica, lesoes pulmonares.

To validate the WHO maternal near-miss criteria and develop a benchmark tool for severe maternal morbidity assessments. In a multicenter cross-sectional study implemented in 27 referral maternity hospitals in Brazil, a one-year prospective surveillance on severe maternal morbidity and data collection was carried out. Diagnostic accuracy tests were used to assess the validity of the WHO maternal near-miss criteria. Binary logistic regression was used to model the death probability among women with severe maternal complications and benchmark the management of severe maternal morbidity. Of the 82,388 women having deliveries in the participating health facilities, 9,555 women presented pregnancy-related complications, including 140 maternal deaths and 770 maternal near misses. The WHO maternal near-miss criteria were found to be accurate and highly associated with maternal deaths (Positive likelihood ratio 106.8 (95% CI 99.56-114.6)). The maternal severity index (MSI) model was developed and found to able to describe the relationship between life-threatening conditions and mortality (Area under the ROC curve: 0.951 (95% CI 0.909-0.993)). The identification of maternal near-miss cases using the WHO list of pregnancy-related life-threatening conditions was validated. The MSI model can be used as a tool for benchmarking the performance of health services managing women with severe maternal complications and provide case-mix adjustment.

Background The aim of this study was to assess severe maternal morbidity (SMM) and near miss (NM) cases among adolescent girls and women over 35 years of age in the Brazilian Network for Surveillance of Severe Maternal Morbidity, using a set of standard criteria, compared to pregnant women aged 20 to 34 years. Methods A cross-sectional multicenter study conducted in 27 referral obstetric units in Brazil. All pregnant women admitted to these centers during a one-year period of prospective surveillance were screened to identify cases of maternal death (MD), NM and other SMM . Indicators of maternal morbidity and mortality were evaluated for the three age groups. Sociodemographic, clinical and obstetric characteristics, gestational and perinatal outcomes, main causes of morbidity and delays in care were also compared. Two multiple analysis models were performed, to estimate the adjusted prevalence ratio for identified factors that were independently associated with the occurrence of severe maternal outcome (SMO = MNM + MD). Results Among SMM and MD cases identified, the proportion of adolescent girls and older women were 17% each. The risk of MNM or death was 25% higher among older women. Maternal near miss ratio and maternal mortality ratios increased with age, but these ratios were also higher among adolescents aged 10 to 14, although the absolute numbers were low. On multivariate analysis, younger age was not identified as an independent risk factor for SMO, while this was true for older age (PR 1.25; 1.07-1.45). Conclusions SMO was high among women below 14 years of age and increased with age in Brazilian pregnant women.

Objective. To assess quality of care of women with severe maternal morbidity and to identify associated factors. Method. This is a national multicenter cross-sectional study performing surveillance for severe maternal morbidity, using the World Health Organization criteria. The expected number of maternal deaths was calculated with the maternal severity index (MSI) based on the severity of complication, and the standardized mortality ratio (SMR) for each center was estimated. Analyses on the adequacy of care were performed. Results. 17 hospitals were classified as providing adequate and 10 as nonadequate care. Besides almost twofold increase in maternal mortality ratio, the main factors associated with nonadequate performance were geographic difficulty in accessing health services (P<0.001), delays related to quality of medical care (P=0.012), absence of blood derivatives (P=0.013), difficulties of communication between health services (P=0.004), and any delay during the whole process (P=0.039). Conclusions. This is an example of how evaluation of the performance of health services is possible, using a benchmarking tool specific to Obstetrics. In this study the MSI was a useful tool for identifying differences in maternal mortality ratios and factors associated with nonadequate performance of care.