Short communication: Impact of corn grain particle size on production performance of lactating dairy cows.

Corn grain particle size has the potential to influence the performance of lactating dairy cows and the overall profitability of a dairy farm. The objective of this study was to evaluate the productive performance of lactating cows fed diets containing finely or coarsely ground corn grain. Fifty lactating Holstein cows (n = 50; 10 primiparous and 40 multiparous), averaging (mean ± standard deviation, SD) 658 ± 64 kg of BW, 38.8 ± 7.3 kg of milk/d, and 155 ± 80 DIM, were fed diets with finely ground corn grain (FGC) or coarsely ground corn grain (CGC) in a randomized block design with a 28-d treatment period. Finely and coarsely ground corn grain had an average particle size of 660 and 915 µm, respectively. Dry matter intake (DMI) was reduced (p < 0.01) for cows fed FGC (22.1 vs. 21.2 kg d-1). Milk yield and efficiency were not affected by treatments (37.9 vs. 36.8 kg d-1; p = 0.12 and 1.78 vs. 1.79; p = 0.15). Concentrations of milk protein and fat, as well as other milk solids, were unaffected (p > 0.05) by treatments. Fecal starch (FS) concentrations were greater (p < 0.01) for cows fed CGC (7.0 vs. 4.9%), whereas plasma concentrations of D-lactate were greater (p < 0.05) for cows fed FGC (98.5 vs. 79.7 µM). Overall, feeding finely ground corn grain increased total-tract starch digestibility and reduced DMI while maintaining milk yield.

Presentation of the Prehospital Emergency Research Network and an analysis of bibliometric indicators for scientific productivity in out-of-hospital care. / Presentación de la Red de Investigación en Emergencias Prehospitalarias (RINVEMER) y análisis bibliométrico de la producción científica en emergencias prehospitalarias.

TEXT: Through research we advance scientific understanding and its application in medical practice. Many of the advances in out-of-hospital emergency care are extracted from hospital settings, perhaps because of the difficulties inherent to our prehospital environments: heterogeneity, obstacles to data collection, biases not controlled for, among other limitations. Research networks offer opportunities to create connections among researchers and facilitate homogeneous data collection. We introduce the Prehospital Emergency Research Network (whose Spanish acronym is RINVEMER) and analyze bibliometric indicators of Spanish productivity in this specialty. Since 1975, a total of 512 articles have been published in journals with impact factors by 381 authors working in Spanish prehospital settings. The first such article published after the creation of the Web of Science appeared in 1999. The 61 authors affiliated with the emergency health services of Andalusia, a public company, made up the largest single author group. Publication productivity increased substantially in the last 2 years. A total of 63 PhD theses have been registered in this specialty - 8 of them at the University of Oviedo. With the growth of Spanish out-of-hospital research in recent years, we expect the creation of the RINVEMER network to improve collaboration among our researchers.

TEXTO: La investigación permite mejorar el conocimiento científico y su aplicación a la práctica profesional. En la asistencia extrahospitalaria, muchos de los avances provienen de entornos hospitalarios, quizás debido a dificultades inherentes al entorno extrahospitalario (heterogeneidad, dificultad en la recogida de datos, sesgos no controlados). Las redes de investigación permiten, entre otras cosas, la interconexión de distintos investigadores y la homogenización en la recogida de datos. En este artículo presentamos la Red de Investigación en Emergencias Prehospitalarias (RINVEMER) y los resultados de un análisis bibliométrico de la producción científica en emergencias prehospitalarias en España. Desde 1975 se han publicado 512 trabajos en revistas indexadas en la Web of Science (el primero en 1999), realizados por 381 investigadores españoles del ámbito de las emergencias prehospitalarias [máximo en Empresa Pública de Emergencias Sanitarias (EPES) de Andalucía, con 61 autores], con un claro incremento en los últimos 2 años. Además, se han realizado 63 tesis doctorales (máximo en Universidad de Oviedo, con 8). La producción científica en emergencias extrahospitalarias en España ha crecido sustancialmente en los últimos años, y la creación de RINVEMER permitirá mejorar las interconexiones entre los investigadores.

Presentación de la Red de Investigación en Emergencias Prehospitalarias (RINVEMER) y análisis bibliométrico de la producción científica en emergencias prehospitalarias / Presentation of the Prehospital Emergency Research Network and an analysis of bibliometric indicators for scientific productivity in out-of-hospital care

La investigación permite mejorar el conocimiento científico y su aplicación a la práctica profesional. En la asistencia extrahospitalaria, muchos de los avances provienen de entornos hospitalarios, quizás debido a dificultades inherentes al entorno extrahospitalario (heterogeneidad, dificultad en la recogida de datos, sesgos no controlados). Las redes de investigación permiten, entre otras cosas, la interconexión de distintos investigadores y la homogenización en la recogida de datos. En este artículo presentamos la Red de Investigación en Emergencias Prehospitalarias (RINVEMER) y los resultados de un análisis bibliométrico de la producción científica en emergencias prehospitalarias en España. Desde 1975 se han publicado 512 trabajos en revistas indexadas en la Web of Science (el primero en 1999), realizados por 381 investigadores españoles del ámbito de las emergencias prehospitalarias [máximo en Empresa Pública de Emergencias Sanitarias (EPES) de Andalucía, con 61 autores], con un claro incremento en los últimos 2 años. Además, se han realizado 63 tesis doctorales (máximo en Universidad de Oviedo, con 8). La producción científica en emergen- cias extrahospitalarias en España ha crecido sustancialmente en los últimos años, y la creación de RINVEMER permitirá mejorar las interconexiones entre los investigadores.

Through research we advance scientific understanding and its application in medical practice. Many of the advances in out-of-hospital emergency care are extracted from hospital settings, perhaps because of the difficulties inherent to our prehospital environments: heterogeneity, obstacles to data collection, biases not controlled for, among other limitations. Research networks offer opportunities to create connections among researchers and facilitate homogeneous data collection. We introduce the Prehospital Emergency Research Network (whose Spanish acronym is RINVEMER) and analyze bibliometric indicators of Spanish productivity in this specialty. Since 1975, a total of 512 articles have been published in journals with impact factors by 381 authors working in Spanish prehospital settings. The first such article published after the creation of the Web of Science appeared in 1999. The 61 authors affiliated with the emergency health services of Andalusia, a public company, made up the largest single author group. Publication productivity increased substantially in the last 2 years. A total of 63 PhD theses have been registered in this specialty — 8 of them at the University of Oviedo. With the growth of Spanish out-of-hospital research in recent years, we expect the creation of the RINVEMER network to improve collaboration among our researchers.

La ventilación mecánica no invasiva durante la atención urgente prehospitalaria / Noninvasive ventilation in prehospital emergencies

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[Endogenous hyperinsulinism: two diagnostic challenges]. / Hiperinsulinismo endógeno: dois desafios diagnósticos.

Hypoglycemia in apparently healthy adults is a rare finding in clinical practice requiring a thorough investigation of the cause. During the investigation, identification of hypoglycemia associated with inappropriately high levels of insulin and C-peptide should prompt the exclusion of rare causes of hypoglycemia, including pancreatic islet-cells disease and autoimmune hypoglycemia. In this paper, we describe two cases of hypoglycemia associated with endogenous hyperinsulinism, whose causes are uncommon in clinical practice, and review important aspects of the diagnosis and treatment of hyperinsulinemic hypoglycemia.

Hiperinsulinismo endógeno: dois desafios diagnósticos / Endogenous hyperinsulinism: two diagnostic challenges

A hipoglicemia em um adulto aparentemente saudável é um achado raro na prática clínica que exige uma investigação exaustiva da causa. A identificação de glicemia plasmática diminuída associada a concentrações plasmáticas de insulina e peptídeo-C não suprimidos deverá levar à exclusão de causas raras de hipoglicemia, entre elas, doença das células betapancreáticas e hipoglicemia autoimune. Neste artigo, descrevemos dois casos de hipoglicemia associada a hiperinsulinismo endógeno, cujas causas são pouco habituais na prática clínica. A propósito desses casos clínicos revemos aspectos importantes de diagnósticos e tratamento da hipoglicemia no contexto de hiperinsulinismo endógeno.

Hypoglycemia in apparently healthy adults is a rare finding in clinical practice requiring a thorough investigation of the cause. During the investigation, identification of hypoglycemia associated with inappropriately high levels of insulin and C-peptide should prompt the exclusion of rare causes of hypoglycemia, including pancreatic islet-cells disease and autoimmune hypoglycemia. In this paper, we describe two cases of hypoglycemia associated with endogenous hyperinsulinism, whose causes are uncommon in clinical practice, and review important aspects of the diagnosis and treatment of hyperinsulinemic hypoglycemia.

Phenotypic heterogeneity in body fat distribution in patients with atypical Werner's syndrome due to heterozygous Arg133Leu lamin A/C mutation.

CONTEXT: A heterozygous missense mutation substituting arginine at position 133 to leucine in the lamin A/C protein has been reported in two young women with clinical features of short stature, bird-like faces, and early onset of aging processes. OBJECTIVE: The objective of the study was to carry out detailed phenotyping of these two women by evaluating the pattern of fat loss using anthropometry, dual-energy x-ray absorptiometry (DEXA), and magnetic resonance imaging (MRI) and study metabolic abnormalities in glucose and lipid metabolism. DESIGN: The study consisted of descriptive case reports. SETTING: The study was conducted at a referral center. PATIENTS: Patient 1 was a 23-yr-old African-American female with progeroid features. Patient 2 was a 24-yr-old Caucasian female with generalized lipodystrophy, hypertriglyceridemia, and severe insulin resistance diabetes who required more than 200 U of insulin daily. INTERVENTIONS: There were no interventions. MAIN OUTCOME MEASURES: Body fat distribution to characterize pattern of lipodystrophy and nuclear morphology abnormalities in skin fibroblasts were studied. RESULTS: Patient 1 had normal body fat (27%) by DEXA. However, MRI revealed relative paucity of sc fat in the distal extremities, with preservation of sc truncal fat. She had impaired glucose tolerance and elevated postprandial serum insulin levels. Patient 2, in contrast, had only 11.6% body fat as determined by DEXA and had generalized loss of sc and intraabdominal fat on MRI. Skin fibroblasts from patient 2 showed marked abnormal nuclear morphology, compared with those from patient 1. Despite the deranged nuclear morphology, the lamin A/C remained localized to the nuclear envelope, and the nuclear DNA remained within the nucleus. CONCLUSIONS: Atypical Werner's syndrome associated with Arg133Leu mutation in the LMNA gene presents with a phenotypically heterogeneous disorder. Furthermore, the severity of metabolic complications seems to correlate with the extent of lipodystrophy.