Genetic relationships of the Yucatan black hairless pig with Iberian breeds using single nucleotide polymorfisms / Relações genéticas de porcos pretos calvos de Yucatán com raças ibéricas usando Polimorfismo de nucleotídeos isolados

To conduct ex-situ creole pig conservation programs, it is essential to determine which breeding animals will be used, preferentially those with a more significant Iberian genetic component to preserve their origin. This study used a Yucatan black hairless pigs (YBHP) subpopulation to estimate its genetic diversity and population structure. One hundred four adult pigs were selected for the absence of hair, black skin (without spots), black hoof, and straight snout. The porcine-GGP-50K chip was used for SNP genotyping in YBHP, and information on Iberian and Yucatán hairless pigs from the United States (USYU) was taken from databases. All analysis was performed using PLINK v1.9 and v2.1 software. Inbreeding and fixation index values were lower in YBHP, with high observed heterozygosity and allogamy index values, which agree with those obtained in the populations of Canarias and Chato Murciano. According to the clusters generated by the "Genome-Wide Identity by State" analysis, four groups were identified, one of which included pigs from Guadyerbas, USYU, and YBHP. Between populations, YBHP was closely related to the hairless pigs from Guadyerbas, USYU, and Canarias. Principal component analysis showed the same result. According to the results obtained from the runs of homozygosity investigation, aimed to get pools consensus of regions of overlapping, 119 SNPs associated with genes and biological processes were identified. The BMP7 and NSUN2 genes were associated with epithelial cell differentiation, morphogenesis, and epithelial development. For nutrient metabolism: energy, the HADHA, PPARA, ADD1/SREBF1, and FAT 1genes were identified.(AU)

Para realizar programas de conservação ex-situ de suínos crioulos, é importante determinar quais animais serão criados, preferencialmente aqueles com maior componente de genética ibérica, para preservar sua origem. Uma subpopulação de porco preto calvo de Yucatán (YBHP) foi usada para estimar sua diversidade genética e estrutura populacional. Um total de 104 suínos adultos foram selecionados levando-se em consideração características como ausência de pelos, pele preta (sem manchas), casco preto e focinho reto. O painel GGP-50K foi utilizado para a genotipagem dos SNPs em animais YBHP, e informações de porcos sem pelos ibéricos e de Yucatán dos Estados Unidos (USYU) foram retiradas de bancos de dados. Todas as análises foram realizadas com o software PLINK v1.9 e v2.1. Os valores dos índices de endogamia e fixação foram menores em YBHP, com altos valores de índice de heterozigosidade e alogamia observados, que concordam com os obtidos nas populações de Canárias e Chato Murciano. De acordo com os clusters gerados pela análise "Genoma-Wide Identity By State", quatro grupos foram identificados, um dos quais incluiu porcos de Guadyerbas, USYU e YBHP. Entre as populações, YBHP estava intimamente relacionado com os porcos sem pelo de Guadyerbas, USYU e Canárias. A análise de componentes principais mostrou o mesmo resultado. De acordo com os resultados obtidos nas corridas de investigação de homozigose, visando obter consenso de pools de regiões de sobreposição, foram identificados 119 SNPs associados a genes e processos biológicos. Os genes BMP7 e NSUN2 foram associados à diferenciação de células epiteliais, morfogênese e desenvolvimento epitelial. Para metabolismo de nutrientes: energia, os genes HADHA, PPARA, ADD1/SREBF1 e FAT1 foram identificados.(AU)

Cross-sectional assessment of mild cognitive impairment in pre-dialysis chronic kidney disease and its association with inflammation and changes seen on MRI: what the eyes cannot see / Avaliação transversal do comprometimento cognitivo leve em doença renal crônica pré-dialítica e associação com inflamação e alterações na ressonância magnética: o que os olhos não veem

Abstract Introduction: Mild cognitive impairment (MCI) is a prevalent and underdiagnosed condition in chronic kidney disease (CKD), that shares common pathophysiological factors such as chronic inflammation. Objective: To evaluate the association of MCI in CKD stages 1-5 using inflammatory markers and changes by magnetic resonance imaging (MRI). Patients and Methods: Cross-sectional study in adult patients with pre-dialysis CKD. MCI was assessed by the Montreal Cognitive Assessment (MoCA) and the estimated glomerular filtration rate (eGFR) by the Chronic Kidney Disease Epidemiology Collaboration equation. Sociodemographic and clinical data were collected from medical records. The cytokines IL-4, IL-6, IL-17, TNF-α and hs-CRP were determined. Brain MRI was performed in a 1.5 Tesla device, without paramagnetic contrast. A descriptive analysis followed by a comparison of abnormal versus normal MoCA scores among all studied variables. A linear regression analysis was performed using MoCA as a dependent variable, adjusted for confounding factors. Results: Of 111 invited patients, eighty completed the neuropsychological assessment and 56 underwent MRI, and were included in the study. Mean age was 56.3 ± 8.3 years and 51.8% (n = 29) had altered MoCA. When compared to the group with normal MoCA, the group with altered MoCA had higher levels of IL-6 and IL-17. There was no correlation between altered MoCA with eGFR or with MRI abnormalities. Conclusão: MCI assessed by MoCA was prevalent in patients with pre-dialysis CKD, it was associated with inflammation and showed no correlation with MRI changes.

Resumo Introdução: O comprometimento cognitivo leve (CCL) é prevalente e subdiagnosticado na doença renal crônica (DRC), condição com a qual compartilha fatores fisiopatológicos como a inflamação crônica. Objetivo: Avaliar a associação do CCL na DRC estágios 1 a 5, com marcadores inflamatórios e alterações de exames de imagem por ressonância magnética (RM). Pacientes e métodos: Estudo transversal em pacientes adultos, com DRC pré-dialítica. CCL foi avaliado pelo Montreal Cognitive Assessment (MoCA) e a taxa de filtração glomerular estimada (TFGe), pela equação do CKD-EPI. Dados sociodemográficos e clínicos foram coletados nos prontuários médicos. Dosadas citocinas IL-4, IL-6, IL-17, o TNF-α e PCR-us. A RM do encéfalo foi realizada em aparelho de 1,5 Tesla, sem contraste. Realizada análise descritiva seguida por comparação de pontuações do MoCA anormais versus normais entre todas as variáveis estudadas. A regressão linear foi realizada usando MoCA como uma variável dependente, ajustada para fatores de confusão. Resultados: De 111 pacientes convidados, oitenta completaram a avaliação neuropsicológica, 56 realizaram RM, tendo sido incluídos no estudo. A média de idade foi de 56,3 ± 8,3 anos e 51,8% (n = 29) apresentavam MoCA alterado. Quando comparado ao grupo MoCA normal, o grupo MoCA alterado apresentou níveis mais elevados de IL-6 e IL-17. Não houve correlação entre MoCA alterado com TFGe nem com anormalidades na RM. Nos modelos ajustados, a IL-6 foi preditor independente do MoCA alterado Conclusão: O CCL avaliado pelo MoCA foi prevalente em pacientes com DRC pré-dialítica, associou-se com inflamação e não apresentou correlação com alterações da RM.

Radical Nephrectomy in Renal Cell Carcinoma with Venous Tumoral Thrombus: Long-term Outcomes and Overall Survival / Nefrectomía radical en carcinoma de células renales con trombo tumoral venoso: Desenlaces a largo plazo y supervivencia global

Objective To describe the five-year overall survival (OS) and perioperative morbidity of patients with renal cell carcinoma (RCC) with venous tumor thrombus (VTT) treated through radical nephrectomy and thrombectomy. Materials and Methods We evaluated a cohort of 530 patients with a diagnosis of RCC from January 2009 to December 2019, and found VTT in 42 of them; these 42 patients composed the study sample. The patients were stratified according to the Neves Thrombus Classification (NTC). The baseline and perioperative characteristics, as well as the follow-up, were described. The Kaplan-Meier curve and its respective Cox regression were applied to present the 5-year OS and the OS stratified by the NTC. Results The average age of the sample was of 63.19 ± 10.7 years, and there were no differences regarding gender. In total, VTT was present in 7.9% of the patients. According to the NTC, 30.9% of the cases corresponded to level I, 21.4%, to level II, 26.1%, to level III, and 21.4%, to level IV. The 5-year OS was of 88%. For level-I and level-II patients, the 5-year OS was of 100%, and of only 38% among level-IV patients. Complications, mostly minor, occurred in 57% of the cases. Conclusions Radical nephrectomy with thrombectomy is a morbid procedure; however, most complications are minor, and the five-year mortality is null for patients in NTC levels I and II, and low for levels III and IV, and it may be even lower in level-III patients when standardizing transesophageal echocardiogram intraoperatively and routinary extracorporeal bypass. Thus, we recommend considering this surgery as the first-line management in patients with RCC and VTT.

Objetivo Describir la supervivencia global (SG) a los cinco años y la morbilidad perioperatoria de pacientes con carcinoma de células renales (CCR) con trombo tumoral venoso (TTV) tratados por nefrectomía radical y trombectomía. Materiales y Métodos Se evaluó una cohorte de 530 pacientes con diagnóstico de CCR entre enero de 2009 y diciembre de 2019, y se encontró TTV en 42 de ellos; esos 42 pacientes compusieron la muestra de este estudio. Los pacientes fueron estratificados según la clasificación de trombos de Neves (CTN). Se describieron las características basales y perioperatorias de los pacientes, así como el seguimiento. Se aplicaron la curva de Kaplan-Meier y su respectiva regresión de COX para presentar la SG a los 5 años y la SG estratificada por CTN. Resultados La edad promedio de la muestra fue de 63,19 ± 10,7 años, sin diferencia respecto a género. El TTV estuvo presente en el 7,9% de los pacientes. Según la CTN, el 30,9% de los casos correspondía al nivel I, el 21,4%, al nivel II, el 26,1%, al nivel III, y el 21,4%, al nivel IV. La SG a los 5 años fue del 88%. Para los niveles I y II, la SG a los 5 años fue del 100%, y, para el nivel IV del 38%. Las complicaciones, menores en su mayoría, ocurrieron en el 57% de los casos. Conclusiones La nefrectomía radical con trombectomía es un procedimiento mórbido; sin embargo, la mayoría de las complicaciones son menores, y la mortalidad a los 5 años es nula cuando en los pacientes de niveles I y II en la CYN, y baja en los niveles III y IV, y puede ser incluso menor en los pacientes de nivel III al estandarizar el ecocardiograma transesofágico intraoperatorio y el baipás extracorpóreo rutinario. Por ello, recomendamos considerar esta cirugía como manejo de primera línea en pacientes con CCR y TTV.

Radiographic evaluation of osseointegration of uncemented targos® stems. a 5-year follow-up / Avaliação radiográfica da osseointegração de hastes não cimentadas targos®. um seguimento de 5 anos

ABSTRACT Introduction Total hip arthroplasty is a widespread treatment and is considered the gold standard in cases of hip osteoarthritis, with high rates of success in improving pain and function when well performed. After five years of follow-up, this study evaluates the osseointegration of uncemented Targos® collared stems in arthroplasties. Methods Observational study of 182 total hip arthroplasties performed in 2014 with Targos® cementless collared femoral stems (Lepine). Bone quality was assessed according to the Dorr scale and osseointegration according to the Engh score. Results The overall mean age was 56.5 years, consisting of 104 men (57.1%) and 103 women (56.6%). The osseointegration rate of the stems (total Engh>0) was 100%. There was no statistical difference between groups concerning age (p=0.262), gender (p=0.463), primary diagnosis (p=0.585), affected side (p=0.459), and degree of Dorr (p=0.857). Conclusion Targos® cementless collared femoral stems showed excellent osseointegration in all patients evaluated, regardless of age, gender, and preoperative bone quality. Moreover, spot welds observed on preoperative radiographs have the best association with implant osseointegration. Level of evidence IV, case series.

RESUMO Introdução A artroplastia total do quadril é um tratamento amplamente difundido, sendo considerado padrão ouro nos casos de osteoartrose do quadril, com altos índices de sucesso na melhora da dor e função, quando bem realizada. Este estudo avalia a presença de osseointegração de hastes com colar não cimentadas Targos® em artroplastias após cinco anos de seguimento. Métodos Estudo observacional com 182 artroplastias totais de quadril realizadas em 2014 com com hastes femorais com colar não cimentadas Targos® (Lepine). A qualidade óssea foi avaliada de acordo com a escala de Dorr e a osseointegração de acordo com o escore de Engh. Resultados A média geral de idade foi de 56,5 anos, sendo 104 homens (57,1%) e 103 mulheres (56,6%). A taxa de osseointegração das hastes (Engh total>0) foi de 100%. Não houve diferença estatística nos grupos quanto à idade (p=0,262), sexo (p=0,463), diagnóstico primário (p=0,585), lado acometido (p=0,459) e grau de Dorr (p=0,857). Conclusão As hastes femorais com colar não cimentadas Targos® apresentaram excelente osseointegração em todos os pacientes avaliados, independentemente da idade, sexo e qualidade óssea pré-operatória. Além disso, a presença de "spot welds" observados nas radiografias pré-operatórias tem a melhor associação com a osseointegração do implante. Nível de evidência IV, case series.

Molecular characterization of bacterial microbiota associated with infectious bovine keratoconjunctivitis in Michoacán, Mexico / Caracterización molecular de la microbiota bacteriana asociada con queratoconjuntivitis infecciosa bovina en Michoacán, México / Caracterização molecular da microbiota bacteriana associada à ceratoconjuntivite bovina infecciosa em Michoacán, México

Abstract Background: The most common ocular disease affecting cattle worldwide is infectious bovine keratoconjunctivitis (IBK), which has been associated with Moraxella bovis bacterium. Objective: To report the molecular characterization of the ocular bacterial microbiota and its relation to IBK in cattle in two dairy regions in Michoacán, Mexico. Methods: A total population of 761 bovines were evaluated, of which 17 (2.23%) showed symptoms of IBK. Thirty-eight bacterial isolates from ocular samples of bovines with IBK were characterized by Gram-staining and antimicrobial sensitivity. In addition, isolates were identified by sequence comparisons of the 16S ribosomal gene. Results: The genus Moraxella was one of the most abundant bacteria and M. bovoculi was the most predominant species. Conclusion: The bacterial isolates identified in eye lesions of cattle and associated to IBK are diverse. To the author´s knowledge, this is the first study on the subject in Mexico; therefore, more research is needed to estimate the incidence of IBK and determine its associated microbiota.

Resumen Antecedentes: la enfermedad ocular más común que afecta al ganado en todo el mundo es la queratoconjuntivitis infecciosa bovina (IBK), que se ha asociado con la bacteria Moraxella bovis. Objetivo: reportar la caracterización molecular de la microbiota bacteriana ocular y su relación con IBK en ganado de dos regiones lecheras en Michoacán, México. Métodos: se evaluó una población total de 761 bovinos de los cuales 17 (2,23%) mostraron síntomas de IBK. Se obtuvieron treinta y ocho aislamientos bacterianos de muestras oculares de bovinos con IBK, los cuales se caracterizaron por tinción de Gram y sensibilidad antimicrobiana. Además, los aislamientos se identificaron mediante comparaciones de secuencias del gen ribosomal 16S. Resultados: el género Moraxella fue una de las bacterias más abundantes y M. bovoculi fue la especie más predominante. Conclusión: los aislamientos bacterianos identificados en lesiones oculares de bovinos y asociados a IBK son diversos. Hasta donde sabemos, este es el primer estudio sobre el tema realizado en México; por lo tanto, es necesario ampliar esta investigación para estimar la incidencia de IBK y determinar la microbiota asociada con la misma.

Resumo Antecedentes: a doença ocular mais comum que afeta o gado no mundo é a ceratoconjuntivite bovina (IBK), que tem sido associada à bactéria Moraxella bovis. Objetivo: relatar a caracterização molecular da microbiota bacteriana ocular e sua relação com a IBK em bovinos de duas regiões leiteiras de Michoacán, México. Métodos: foi avaliada uma população total de 761 bovinos, más apenas 17 (2,23%) apresentaram sintomas de IBK. Trinta e oito isolados bacterianos de amostras de olho bovino com IBK foram caracterizados por coloração de Gram e sensibilidade antimicrobiana. Além disso, os isolados foram identificados por comparação de sequências do gene ribossômico 16S. Resultados: a microbiota bacteriana associada à IBK foi diversa, sendo o gênero Moraxella uma das mais abundantes e M. bovoculi a espécie predominante. Conclusão: de acordo com o conhecimento dos autores, este é o primeiro estudo sobre o tema no México até o momento, portanto é necessário expandir essa pesquisa para estimar a incidência de IBK e determinar a microbiota associada à mesma.

Complicaciones de la biopsia percutánea de pulmón guiada por tomografía / Complications of CT-guided percutaneous lung biopsy

Introducción: La biopsia percutánea guiada por tomografía computarizada (BPGTC) es un procedimiento ampliamente utilizado para el diagnóstico de masas pulmonares. El conocimiento de sus complicaciones y la relación de las mismas con variables individuales es vital a la hora de realizar el abordaje. Objetivo: Describir las complicaciones de la BPGTC y cómo estas se relacionan con características propias de los pacientes, los tipos de lesiones y la vía de abordaje utilizada en nuestra institución. Materiales y métodos: Estudio observacional retrospectivo descriptivo que incluyó 84 pacientes a los que se les realizó BPGTC entre enero de 2016 y abril de 2019 en el Departamento de Radiología de la Clínica CES, en Medellín. Resultados: 17 pacientes presentaron complicaciones, de las cuales el neumotórax fue la más común, 13,1 % (11/17), seguida de la hemorragia alveolar, 7,1 % (6/17) y la hemoptisis, 4,8 % (4/17). Uno de los pacientes falleció durante el procedimiento. Los pacientes con comorbilidades pulmonares, especialmente enfisema, lesiones de pequeño tamaño, sin adherencia a la pleura, en el lóbulo inferior derecho y con mayor recorrido de la aguja tuvieron un mayor número de complicaciones. Conclusiones: En nuestra institución hay pocas complicaciones derivadas de la BPGTC, y las más comunes son el neumotórax, la hemorragia alveolar y la hemoptisis con porcentajes del 13 %, 7 % y 4,8 % respectivamente, las cuales se encuentran por debajo de los estudios internacionales conocidos

Introduction: Percutaneous computed tomography-guided biopsy (PCTGB) is a widely used procedure for the diagnosis of lung masses. Knowledge of its complications and their relationship with individual variables is vital to perform the procedure. Objective: To describe the complications of percutaneous lung biopsy (PLB) and their relation with the characteristics of the patients, the types of lesions and the approach used in our institution. Materials and methods: Retrospective descriptive study of 84 patients who underwent PCTGB between January 2016 and April 2019 in the Radiology department of the CES clinic in Medellin. Results: 17 patients presented complications, of which pneumothorax was the most common 13.1% (11/17), followed by alveolar hemorrhage 7.1% (6/17) and hemoptysis 4.8% (4/17). One of the patients died during the procedure. Patients with pulmonary comorbidities, especially emphysema, with small lesions, without adherence to the pleura, in the right lower lobe and with greater needle travel, had a higher rate of complications. Conclusions: In our clinic there are few complications related to PCTGB, the most common being pneumothorax, alveolar hemorrhage and hemoptysis, with percentages of 13%, 7% and 4.8% respectively, which are below known international reports

Geographical origin of chronic Chagas disease patients in Brazil impacts the performance of commercial tests for anti-T. cruzi IgG

BACKGROUND Chagas disease, caused by Trypanosoma cruzi, affects nearly six million people worldwide. Various serological tests have been developed for its diagnosis. OBJECTIVE Examine the performance of a set of commercial immunological assays in relation to the geographical origin of the patient sample comparing four states of Brazil: Amazonas (AM), Mato Grosso do Sul (MS), Minas Gerais (MG) and Piauí (PI). METHODS Seven immunoassays were employed to detect anti-T. cruzi IgG antibodies in 379 patient samples that had been previously diagnosed using the two-step protocol required by the Brazilian Ministry of Health. FINDINGS A significant variation in the percent reactive was calculated for the samples from AM and MS, while the PI and MG showed a significant variation in the percent non-reactive. The average reactivity index was significantly higher for samples from the states of PI and MG states than AM and MS. MAIN CONCLUSIONS All tests presented a satisfactory performance overall. Yet, variations were observed that were associated to the region of origin of the samples. Our analyses suggest that future evaluations of immunoassays should include a sampling of sera from regions where the test will be applied in addition to the available International Biological Reference Standards.

Effect of Leptin, Pituitary Transcription Factor and Luteinizing Hormone Receptor Genes Polymorphisms on Reproductive Traits and Milk Yield in Holstein Cattle

Abstract The aim of this study was to estimate allelic and genotypic frequencies of markers in the leptin (LEP), pituitary transcription factor (PIT-1) and luteinizing hormone receptor (LHR) genes and evaluate their effects on reproductive traits and milk yield of Holstein cattle. Data from 147 cows from department of Francisco Morazán, Honduras, were collected and PCR-Restriction Fragment Length Polymorphism (RFLP) assays were performed to characterize the PIT-1-HinfI, LEP- A59V and LHR-rs41256848 polymorphisms. To estimate the effect of genotypes on reproductive traits and milk yield fixed and mixed linear models were fitted. The frequencies of the genotypes CC, CT and TT of A59V, AA, AB and BB of HinfI, and CC, CG and GG of rs41256848 were 0.46, 0.33 and, 0.21; 0.09, 0.32 and 0.58; and 0.37, 0.61 and 0.02, respectively. The genotypes of LEP and LHR showed deviations from Hardy-Weinberg equilibrium. The A59V polymorphism was significantly associated with the calving to conception interval (CCI) (p=0.01), being the C allele favorable. The HinfI and rs41256848 polymorphism were significantly associated (p=0.08 and p=0.04) with age to first calving (AFC), being the A and G the alleles favorable associated, respectively. The results suggest that LEP, PIT and LHR polymorphisms can probably act as candidate to be used in marker-assisted selection for AFC and CCI traits.

Infliximab-induced remission improves physical activity in patients with active Crohn's disease

SUMMARY AIM: To compare the level of physical activity (PA), exercise capacity, and body composition before and after infliximab-induced clinical remission in patients with Crohn's disease (CD). METHODS: This prospective longitudinal study evaluated 44 adult outpatients with active CD before infliximab administration and 24 weeks after infliximab therapy. The patients were evaluated for PA in daily life, exercise capacity, muscle strength, and body composition. RESULTS: 38 (86.4%) patients achieved infliximab-induced remission at 24 weeks and presented an increment in the number of steps taken of 1092 (7440±2980 vs. 6348±3177, respectively; p=0.006). The inactive time was reduced when compared to the baseline value (454.2±106.3 vs. 427.9±97.8, respectively; p=0.033). There was no difference in the distance walked before and after infliximab therapy, while there was an increase in the fat mass index in responders to infliximab compared to the baseline (19.1±7.6 vs. 14.9±5.8; p=0.001). CONCLUSIONS: Infliximab-induced remission was shown to be effective for increasing physical activity by improving the number of steps and reducing inactive time. The maintenance of clinical remission associated with incentives to regular PA may contribute to making these patients reach an ideal level of PA.

RESUMO OBJETIVO: Comparar o nível de atividade física (AF), capacidade de exercício e composição corporal antes e após remissão clínica induzida por infliximabe em pacientes com doença de Crohn (DC). MÉTODOS: Neste estudo longitudinal prospectivo, foram envolvidos 44 pacientes ambulatoriais adultos com DC ativa avaliados antes e depois de 24 semanas de terapia com infliximabe. Os pacientes foram avaliados quanto à AF, capacidade de exercício, força muscular e composição corporal. RESULTADOS: 38(86,4%) pacientes alcançaram remissão induzida por infliximabe em 24 semanas e apresentaram aumento no número de passos de 1092 (7440±2980 vs. 6348±3177, respectivamente; p=0,006). O tempo de inatividade foi reduzido quando comparado ao basal (454,2±106,3 vs. 427,9±97,8, respectivamente; p=0,033). Não houve diferença na distância percorrida antes e após a terapia com infliximabe, enquanto houve aumento no índice de massa gorda nos respondedores ao infliximabe em comparação ao basal (19,1±7,6 vs. 14,9±5,8; p=0,001). CONCLUSÕES: A remissão induzida pelo infliximabe mostrou-se eficaz no aumento da atividade física, melhorando o número de passos e reduzindo o tempo inativo. A manutenção da remissão clínica associada a incentivos à AF regular pode contribuir para que esses pacientes atinjam um nível ideal de AF.

Factores ambientales asociados con los días no-productivos de cerdas en el trópico mexicano / Environmental factors associated with lifetime non-productive days of sows in the Mexican tropics

RESUMEN Objetivo. Estimar el número de días no productivos (DNP) de por vida, la proporción de DNP (%DNP) y días no productivos por cerda por año (DNP/Y), y determinar el efecto de factores de hato y cerda sobre las características aquí estudiadas en tres granjas comerciales en el trópico mexicano. Materiales y métodos. Los datos de 6703 cerdas de tres granjas comerciales fueron usados. El modelo que describió las características de interés incluyeron los efectos fijos de granja, año de primer parto, época de primer parto, edad al primer parto, causa de desecho, interacción de año por época y error residual. Resultados. Las medias de DNP de por vida, %DNP y DNP/Y fueron 64 días, 12% y 39.3 días, respectivamente. Todos los factores tuvieron efectos significativos (p<0.01) en todas las características. Las cerdas con primer parto a mayor edad y las eliminadas por razones reproductivas tuvieron más DNP en el hato. Además, las cerdas eliminadas en el primer parto tuvieron menor DNP y mayor %DNP que las cerdas desechadas en partos subsecuentes. Conclusiones. La eliminación temprana de cerdas incrementó la proporción de días no productivos, que a su vez podrían reducir la rentabilidad de las granjas.

ABSTRACT Objectives. To estimate the lifetime non-productive days (NPD), lifetime proportion of NPD (%NPD) and non-productive days per sow per year (NPD/Y), and to determine the effect of herd and sow level factors on the traits here studied in three pig farms in the Mexican tropics. Materials and methods. Data from 6703 sows from three commercial farms were used. The model that described the traits studied comprise the fixed effects of farm, year and season of first farrowing, age at first parity, reasons of removal of sows, year x season interaction and the residual error. Results. The means for lifetime NPD, %NPD and NPD/Y were 64 days, 12.0% and 39.3 days, respectively. All fixed factors had significant effects (p<0.01) on the characteristics evaluated. Sows having their first parity at an old age and sows culled because of reproductive reasons had the highest lifetime NPD. In addition, sows culled at first parity had lower lifetime NPD and higher %NPD than sows culled in subsequent farrowing. Conclusions. The early culling of sows increased the percentage of non-productive days, which in turn is expected to reduce the profit of farms.

Application of WHO International Biological Reference Standards to evaluate commercial serological tests for chronic Chagas disease

BACKGROUND Chagas disease, resulting from Trypanosoma cruzi infections, continues to be a health concern mainly in Latin American countries where the parasite is endemic. The laboratory diagnosis of a chronic infection is determined through serological assays for antibodies against T. cruzi and several tests are available that differ in key components, formats and methodologies. To date, no single test meets the criteria of a gold standard. The situation is further complicated by the difficulties associated with performance comparisons between different immunoassays or methodologies executed at different times and geographical areas. OBJECTIVE To improve the diagnosis of Chagas disease, the WHO coordinated the development of two International Biological Reference Standards for antibodies against anti-T. cruzi: NIBSC 09/186 and NIBSC 09/188 that respectively represent geographical regions with the highest prevalence of TcII and TcI lineages of the parasite. METHODS The principle goal of this study was to verify the behavior of these standards when assayed by several commercially available serological tests that employ different methods to capture and detect human anti-T. cruzi antibodies. FINDINGS AND MAIN CONCLUSIONS The results reinforce the recommendation that these standards be considered for performance evaluations of commercialised immunoassays and should be an integral step in the development of new test components or assay paradigms.

Infiltración ecoguiada articular de plasma rico en factores de crecimiento como terapia regenerativa en lesiones del manguito rotador / Ultrasound guided platelet-rich plasma injection for the treatment of rotator cuff tendinopathy: changing the concept of palliative pain management to regenerative shoulder therapy

Introducción El plasma rico en factores de crecimiento (PRFC) es un concentrado natural, autólogo, de polipéptidos, que se ha utilizado en diferentes campos de la medicina por su potencial para mejorar la regeneración tisular. El objetivo del estudio es explorar esta novedosa técnica para el tratamiento de las lesiones del manguito rotador del hombro. Materiales y métodos se realizó una serie de casos de pacientes con dolor y limitación funcional del hombro en un periodo de más de 3 meses de evolución y con diagnóstico ecográfico o de resonancia magnética de tendinosis y/o desgarro parcial de cualquiera de los componentes del manguito rotador (tendones del supraespinoso, infraespinoso, subescapular o bíceps braquial), que tenían, en la mayoría de los casos, bursitis subacromial asociada, con pobre respuesta al tratamiento conservador de AINES y terapia física. Para este estudio preliminar, no se incluyeron los pacientes con diagnóstico de ruptura completa del tendón, habitualmente el supraespinoso distal. Se programaron 2 infiltraciones articulares ecoguiadas consistente en la inyección de PRFC en el/los segmentos comprometidos que señalaba la ecografía o la RMN del hombro. La primera valoración post- tratamiento al mes de la segunda infiltración y luego seguimiento a los 2, 4 y 6 meses de la infiltración de refuerzo. Resultados Se analizaron los resultados de 36 pacientes, en los que observamos una mejoría estadísticamente significativa y progresiva en los puntajes clínicos evaluados (VAS y MACNAB) desde la valoración del 2 mes post-infiltración hasta el final de seguimiento a los 6 meses. Discusión Los resultados de la infiltración ecoguiada de PRFC en hombro del presente estudio nos permiten concluir que se trata de un procedimiento seguro y útil para el tratamiento de la patología articular del manguito rotador del hombro superior a los manejos farmacológicos u otras terapias paliativas del dolor. Nivel de Evidencia IV

Background Plasma rich in growth factors (PRGF) is a natural concentrate of autologous blood polypeptides already used in several fields of medicine because of its potential to enhance tissue regeneration. The aim of this study is to explore this novel approach to treat rotator cuff injuries of the shoulder. Materials and methods A case series of patients with chronic pain of the shoulder and failed conservative pharmacological management were treated with ultrasound-guided intra-articular injections of the shoulder with PRGF. The procedure consisted of two ultrasound-guided injections of PRGF in a 6 week interval, in each component of the rotator cuff depending on the findings of the previous ultrasound or the MRI study of the shoulder. Patients were clinically prospectively evaluated, before and one month after, the second injection of PRGF, and then at a 6 months follow-up. Results A significant improvement in the clinical evaluation scores (VAS score for pain intensity and Macnab criteria for functional recovery) was obtained from the initial evaluation to the end of the 6 months follow-up. Discussion The results indicate that the treatment with PRGF injections is safe and has the potential to reduce pain and improve shoulder function, and the quality of life in patients with rotator cuff injury. Evidence Level IV

Overall survival prediction in metastatic castration-resistant prostate cancer treated with radium-223

ABSTRACT Objective Radium-223(223Ra) is indicated for patients (p) with metastatic castration resistant prostate cancer (mCRCP). Objectives The aim of this study was to evaluate the role of baseline clinical variables associated with overall survival (OS) and toxicity of 223Ra. Its purpose was to identify the factors that can predict a better response to treatment and provide information regarding the most appropriate time for the application of 223Ra. Materials and Methods Prospective study in 40p with mCRPC treated with 223Ra. End points were OS, progression-free survival and time to progression. The follow-up parameters were: doses received, hemoglobin (Hb), absolute neutrophil count (ANC), platelet count (PC), prostate specific antigen (PSA), alkaline phosphatase (ALP), Visual Analogue Scale for pain, Eastern Cooperative Oncology Group (ECOG) and WHO's Cancer Pain Ladder. The use of other treatments was also evaluated. Results Median OS was 17.1 months(mo) (CI95%6.5-27.7); 26/40p received complete treatment of 223Ra, without reaching a median OS and 14p received incomplete treatment with a median OS 13.6mo(CI95%1.6-25.6). Median follow-up was 11.2mo (range:1.3-45.2). The univariate analysis showed that factors as VAS, ECOG, Hb and ALP values were independently associated with OS. First line treatment with 223Ra was started in 11/40p, while 19p had been heavily pre-treated and 13p received concomitant treatment. Conclusions 223Ra therapy require an adequate selection of patients to obtain the greatest clinical benefit. Low basal Hb, hight basal ALP, bone marrow involvement and an altered ECOG were the main factors that decreased OS in our patients. 223Ra should be considered relatively early in the course of treatment.

Intususcepción ileotransversa por lipoma intraluminal / Ileotransverse intussusception due to intraluminal lipoma

Resumen La intususcepción intestinal consiste en la introducción o invaginación de un segmento del intestino dentro de la luz del segmento adyacente. Una parte del intestino se pliega como un telescopio y penetra dentro de otra. La ma yoría de los casos se producen durante los primeros cinco años de vida y la mitad de estos durante el primer año. En los niños mayores y en los adultos frecuentemente es el resultado de lesiones tumorales intraluminales como lipomas, carcinoma, pólipos fibroides inflamatorios o linfoma maligno. Se presenta el caso clínico de una paciente de 45 años con cuadro de dolor ab dominal originado por intususcepción ileotransversa causada por un lipoma intraluminal, el cual fue resuelto exitosamente mediante cirugía.

Abstract Intussusception involves the introduction or invagination of a segment of the intestine within the lumen of the adjacent segment. A part of the intes tine folds like a telescope and penetrates into another. Most cases occur during the first five years of life and half of these during the first year. In older children and adults are the result of intraluminal tumor lesions such as lipomas, carcinoma, inflammatory fibroid polyps or malignant lymphoma. We present the clinical case of a 45-year-old patient with abdominal pain caused by ileotransverse intussusception caused by an intraluminal lipoma, which was successfully resolved by surgery.

Abundancia altitudinal de Dendroctonus frontalis (Coleoptera: Curculionidae) en relación a variables climáticas en Hidalgo, México

Los descortezadores Dendroctonus frontalis (Coleoptera: Scolytidae) son un grupo de coleópteros estrechamente ligado a las masas forestales y son una de las plagas más dañinas en México, ocasionando que la cobertura forestal se reduzca considerablemente. Adicionalmente factores como el cambio climático, favorecen el aumento en las poblaciones de escarabajos descortezadores del género Dendroctonus. Por lo anterior es conveniente conocer la variación poblacional de descortezadores, particularmente de Dendroctonus frontalis, cuyas poblaciones dependen de la variabilidad climática que influye en su abundancia. Teniendo como hipótesis que la altitud y las variables ambientales afectan el comportamiento en la abundancia de D. frontalis, se planteó como objetivo estimar la variación espacio-temporal de poblaciones de D. frontalis en bosques de pino a diferentes altitudes. El estudio se realizó en la comunidad de Durango, Zimapán, Hidalgo, México. Se utilizó un diseño experimental de parcelas apareadas con dos tratamientos, de feromona y testigo. Se colocaron siete trampas con ambos tratamientos en un rango de 1 568 a 2 117 m.s.n.m. para determinar la abundancia altitudinal de D. frontalis. El muestreo se llevó a cabo de enero a diciembre 2015. Se obtuvo una relación positiva entre la abundancia de D. frontalis y el gradiente altitudinal y respecto a la abundancia de D. frontalis y la temperatura se observó una relación moderada, pero no significativa; de la misma forma para la precipitación media anual. La relación con la temperatura media máxima y el balance de precipitación de primavera/verano fueron estadísticamente significativos. Se presentó una tendencia positiva en la abundancia de D. frontalis de acuerdo al índice anual de aridez, por lo cual se espera que con el aumento de las temperaturas el estrés en la vegetación de los bosques sea mayor, favoreciendo el incremento de las poblaciones de escarabajos descortezadores.

The bark beetles Dendroctonus frontalis (Coleoptera: Scolytidae) are a group of coleoptera closely linked to forest masses, and one of the most harmful pests in Mexico, causing the forest cover to be considerably reduced. Additionally factors such as climate change, favor the increase in populations of bark beetles of the genus Dendroctonus. Taking as a hypothesis that altitude and environmental variables affect the behavior in the abundance of D. frontalis, the objective was to estimate the temporary-spatial variation of D. frontalis populations in pine forests at different altitudes. The study was conducted in the community of Durango, Zimapán, Hidalgo, Mexico. An experimental design of paired plots with two treatments was used, pheromone and control. Seven traps were placed with both treatments in a range of 1 568 to 2 117 m.a.s.l. to determine the altitudinal abundance of D. frontalis. The sampling was realized from January to December 2015. A positive relationship was observed between the abundance of D. frontalis and the altitudinal gradient. About the abundance of D. frontalis and the temperature, a moderate but not significant relationship was observed in the same way for the average annual precipitation. The relation with the maximum average temperature and the spring summer precipitation balance were statistically significant. There was a positive trend on the abundance of D. frontalis according to the annual aridity index, which is why it is expected that the increase of temperatures the stress in the vegetation of the forests will be greater, favoring the increase of bark beetles populations.

Abdominal Cutaneous Nerve Entrapment Syndrome, Case Report and Diagnostic Evaluation

Abdominal cutaneous nerve entrapment is a rarely diagnosed condition that leads to intense neuropathic pain in the anterolateral wall of the abdomen. Generally, it is triggered by some factor implied in the increase of the pressure on the nerve in its passage by the abdominal wall. Its most important differential diagnosis is pain of visceral origin. We present a case in which the clinical findings confirmed on ultrasound and other imaging tests established the diagnosis and in which the noninvasive treatment was effective.

Describing the growth curve of local turkey using non-linear models / Descripción de la curva de crecimiento de pavos locales usando modelos no lineales

ABSTRACT Objective. Determine the best non-linear model to fit the growth curve of local turkeys managed under confinement in Michoacan, Mexico. Material and methods. Twenty-four and 43 female and male turkeys, reared under commercial conditions were given commercial feed. Birds were weighed weekly from hatch to 29 weeks of age. The Gompertz, Brody, Richards, von Bertalanffy and Logistic models were chosen to describe the age-weight relationship. Results. The best fitting model was selected based on the multiple determination coefficient (R2), the Akaike information criterion (AIC) and visual analysis of the observed and predicted curves. In both female and male, von Bertalanffy was the best model. The highest estimates of parameter A (mature weight) for both females and males were obtained with the von Bertalanffy model followed by the Gompertz and Logistic. The estimates of A were higher for males than for females. The highest estimates of parameter k (rate of maturity) for both females and males were, in decreasing order, for the Logistic, Gompertz, and von Bertalanffy models. k values for female turkeys was higher than for males. The age at the point of inflection (ti) and body weight at the age of point of inflection (WI) varied with the model used. The largest values of TI and WI corresponded to the Logistic model. Between sexes, the largest TI and WI values corresponded to males. Conclusions. The best models to describe turkey growth was the von Bertalanffy because it present the highest R2 and lowest AIC values.

RESUMEN Objetivo. Determinar el modelo no lineal que mejor ajuste la curva de crecimiento de pavos locales criados en confinamiento. Material y métodos. Veinticuatro y 43 pavos hembras y machos, respectivamente, criados en confinamiento fueron alimentados con dietas comerciales. Cada animal se pesó desde el nacimiento hasta la semana 29 de edad. Los modelos de Gompertz, Brody, Richards, von Bertalanffy y Logístico fueron elegidos para describir la relación edad-peso. El mejor modelo se seleccionó con base en el coeficiente de determinación (R2), el criterio de información de Akaike (AIC) y el análisis visual de las curvas observadas y predichas. Resultados. El mejor ajuste (machos y hembras) correspondió al modelo von Bertalanffy. El más alto valor del parámetro A (edad a la madurez), para hembras y machos correspondió al modelo von Bertalanffy, seguido de Gompertz y Logístico. El estimador A fue mayor para machos que hembras. El mayor valor del parámetro k (tasa de madurez), para hembras y machos, variaron según el modelo utilizado. Los valores de k fueron más altos para hembras que para machos. La edad al punto de inflexión (T:) y peso vivo al punto de inflexión (W:) también variaron de un modelo a otro. Los valores más altos de T, y Wj correspondieron al modelo Logístico. Entre sexos, los valores mayores de T: y WI correspondieron a los machos. Conclusiones. El mejor modelo que describió la curva de crecimiento de los pavos locales fue el de von Bertalanffy.

Extradural lumbar nerve root cavernous hemangioma: case report and successful surgical resection / Hemangioma cavernoso extradural de raiz nervosa lombar: relato de caso e ressecção cirúrgica bem-sucedida

Extradural lumbar spinal canal cavernous hemangiomas (or cavernomas) are rare lesions that can induce intense back pain and neurological deficit. We present a case report of a patient with a pure radicular lombar extradural cavernoma resembling a benign neurological tumor in imaging exams and a successful surgical resection.

Os hemangiomas cavernosos do canal vertebral lombar extradural (ou cavernomas) são lesões raras que podem induzir dor intensa no dorso e déficit neurológico. Apresentamos um relato de caso de um paciente com um cavernoma extradural lombar radicular puro assemelhando-se a um tumor neurológico benigno em exames de imagem e uma ressecção cirúrgica bem-sucedida.

Immunohistochemical Markers for Schwannomas, Neurofibromas and Malignant Peripheral Nerve Sheath Tumors­What Can the Recent Literature Tell Us?

Introduction Schwannomas and neurofibromas are the two most common benign neoplasms of the peripheral nerve sheath, and although they are generally easy to distinguish, in some cases, they can closely resemble one another. Furthermore, malignant peripheral nerve sheath tumors (MPNSTs), another example of peripheral nerve sheath neoplasm, may likewise constitute, due to their morphology and lack of specific immunohistochemical markers, a challenging diagnostic. Objective To bring attention to new and promising biomarkers for schwannomas, neurofibromas and MPNSTs and to outline, based on the recent literature, a immunohistochemical profile for each neoplasm at hand, as well as to emphasize the need for further studies that could help us understand their diagnostic potential and disrupt our dependence of limited and nonspecific biomarkers. Methods An overview of the recent literature published in English on both the classical promising immunohistochemical markers of schwannomas, neurofibromasand MPNSTs was performed. We discarded case reports. Conclusions There is still a lack of specific biomarkers for peripheral nerve tumors. However, plenty of new immunohistochemical markers have been coming to light with presumed higher specificity and more diverse helpful uses than the classical ones. For example, Sox10 is a good biomarker for differentiating schwannomas and neurofibromas from sarcomas, calretinin schwannomas from neurofibromas, TLE1 and HMGA2 MPNSTs from sarcomas, and nestin, EGFR, p16 and Ki-67 MPNSTs from different types of schwannomas and neurofibromas. There is still need for further studies; however, the potential of some of these promising markers, among others, should not be disregarded.

Introdução Schwannomas e neurofibromas são as duas neoplasias benignas mais comuns a acometer o tecido nervoso periférico, e apesar de geralmente serem facilmente distinguíveis, em alguns casos, elas podem ser muito semelhantes. Além disso, os tumores malignos da bainha dos nervos periféricos (TMBNPs), outro exemplo de neoplasia da bainha do nervo periférico, podem da mesma forma constituir, pela sua morfologia e falta de marcadores imuno-histoquímicos específicos, um diagnóstico desafiador. Objetivo Chamar a atenção para novos e promissores biomarcadores para schwannomas, neurofibromas e TMBNPs e delinear, a partir da literatura atual, um perfil imuno-histoquímico para cada neoplasia em questão, além de enfatizar a necessidade de futuros estudos que possam elucidar-nos acerca de seu potencial diagnóstico e, por ventura, romper nossa dependência de biomarcadores inespecíficos e limitados. Método Foi feita uma revisão da literatura recente incluindo artigos em língua inglesa sobre os marcadores imunohistoquímicos clássicos e os promissores para schwannomas, neurofibromas e TMBNPs. Descartamos relatos de caso. Conclusão Ainda há uma falta de biomarcadores específicos para as neoplasias acima. Contudo, vários novos marcadores imuno-histoquímicos têm surgido, e com futuros estudos poderemos talvez definir biomarcadores específicos e indispensáveis para os casos desafiadores de neurofibromas, schwannomas e TMBNPs. Por exemplo, o Sox10 é um bom biomarcador para diferenciar schwannomas e neurofibromas de sarcomas; a calretinina é um bom marcador para diferenciar schwannomas de neurofibromas; os biomarcadores TLE1 e HMGA2 podem ajudar a diferenciar TMBNPs de sarcomas, e a nestina, o receptor do fator de crescimento epidérmico (EGFR), o gene p16 e a proteína Ki-67 podem diferenciar TMBNPs de diferentes tipos de schwannomas e neurofibromas. Ainda há necessidade de novos estudos; contudo, o potencial de alguns desses marcadores, dentre outros, não deveria ser negligenciado.

Unidades del dolor del siglo xxi. ¿protocolos de consenso o medicina basada en la evidencia? / 21st century pain units. consensus protocols or evidence-based medicine? / Unidades da dor do século xxi. protocolos de consenso ou medicina baseada na evidência?

Resumen La investigación en medicina tiene por objetivo generar nuevos conocimientos que ayuden al diagnóstico, el tratamiento y la prevención de enfermedades. Pero la medicina no es una ciencia exacta, sino una actividad humana heterogénea que se basa solo parcialmente en la ciencia, con varios factores no científicos que influyen en la forma de desarrollar esta actividad. El dolor, como síntoma o como enfermedad, es probablemente el trastorno que más afecta y preocupa a las personas y el que con mayor frecuencia motiva una consulta médica. A pesar de la magnitud del problema, y del interés médico y social por el dolor, la atención y el tratamiento de las personas con dolor crónico es un tema infravalorado o tratado inadecuadamente. Con base en múltiples preguntas que se plantean a lo largo del desarrollo del presente documento, nuestro objetivo es, por un lado, el de señalar que los cambios que se han producido en el manejo del dolor crónico hacen de los llamados protocolos de consenso un ejercicio obsoleto en la medicina del siglo XXI. Por otro lado, en términos de bioética, responder a la pregunta ¿se ajustan los protocolos de consenso al principio de beneficencia del paciente individual?

Abstract Research in medicine is intended to generate new knowledge to help in the diagnosis, treatment and prevention of disease. However, medicine is not an exact science; rather, it is a heterogeneous human activity based only partially on science and involves several non-scientific factors that influence the way it is developed. Pain, as a symptom or as a disease, is probably the disorder that most affects and worries people, and is what most often prompts medical consultation. Despite the magnitude of the problem, and the medical and social interest in pain, the care and treatment of persons with chronic pain is an issue that is undervalued or inadequately addressed. Based on variety of questions posed throughout this document, the objective is, on the one hand, to point out that the changes that have occurred in the way chronic pain is managed make the so-called consensus protocols an obsolete exercise in 21st century medicine. On the other hand, in terms of bioethics, the authors answer the question: Do consensus protocols conform to the principle of beneficence for the individual patient?

Resumo A pesquisa em medicina tem por objetivo gerar novos conhecimentos que ajudem no diagnóstico, tratamento e prevenção de doenças. Porém, a medicina não é uma ciência exata, mas sim uma atividade humana heterogênea que está apenas parcialmente baseada na ciência, com vários fatores não científicos que influenciam na maneira em que essa atividade é desenvolvida. A dor, como sintoma ou como doença, é provavelmente o transtorno que mais afeta e preocupa as pessoas e o que com maior frequência motiva uma consulta médica. Apesar da magnitude do problema e do interesse médico e social pela dor, o atendimento e o tratamento das pessoas com dor crônica é um tema subestimado ou tratado inadequadamente. Com base em múltiplas perguntas que são levantadas ao longo do desenvolvimento do presente trabalho, nosso objetivo é, por um lado, indicar que as mudanças que ocorreram na abordagem da dor crônica fazem dos chamados "protocolos de consenso" um exercício obsoleto na medicina do século XXI. Por outro lado, em termos de bioética, buscamos responder à pergunta: os protocolos de consenso se ajustam aos princípios de beneficência do paciente individual?