Effects of supplemental calcium salts of palm oil and chromium-propionate on insulin sensitivity and productive and reproductive traits of mid- to late-lactating Holstein × Gir dairy cows consuming excessive energy.

This experiment compared insulin sensitivity, milk production, and reproductive outcomes in dairy cows consuming excessive energy during mid to late lactation and receiving in a 2 × 2 factorial design (1) concentrate based on ground corn (CRN; n = 20) or including 8% (DM basis) of Ca salts of palm oil (CSPO; n = 20), and (2) supplemented (n = 20) or not (n = 20) with 2.5 g/d of Cr-propionate. During the experiment (d 0-203), 40 multiparous, nonpregnant, lactating 3/4 Holstein × 1/4 Gir cows (initial days in milk = 81 ± 2; mean ± SE) were offered corn silage for ad libitum consumption, and individually received concentrate formulated to allow diets to provide 160% of their daily net energy for lactation requirements. From d -15 to 203, milk production was recorded daily, blood samples collected weekly, and cow body weight (BW) and body condition score (BCS) recorded on d 0 and 203. For dry matter intake evaluation, cows from both treatments were randomly divided in 5 groups of 8 cows each, and allocated to 8 individual feeding stations for 3 d. Intake was evaluated 6 times/group. Glucose tolerance tests (GTT; 0.5 g of glucose/kg of BW) were performed on d -3, 100, and 200. Follicle aspiration for in vitro embryo production was performed via transvaginal ovum pick-up on d -1, 98, and 198. Mean DMI, net energy for lactation intake, as well as BW and BCS change were similar across treatments. On average, cows gained 40 kg of BW and 0.49 BCS during the experiment. Within weekly blood samples, CRN cows had lower serum concentrations of glucose, insulin, fatty acids, and insulin-to-glucose ratio compared with CSPO cows, suggesting increased insulin sensitivity in CRN cows. During the GTT, insulin-sensitivity traits were also greater in CRN versus CSPO cows. Supplemental Cr-propionate resulted in lower serum insulin concentrations and insulin-to-glucose ratio within CRN cows only, indicating that Cr-propionate improved basal insulin sensitivity in CRN but not in CSPO cows. During the GTT, however, Cr-propionate supplementation reduced hyperinsulinemia and insulin-to-glucose ratio across CSPO and CRN cows. Milk production, as well as number of viable oocytes collected and embryos produced within each aspiration, were not affected by treatments. Hence, replacing corn by Ca salts of palm oil in the concentrate did not improve insulin sensitivity in Holstein × Gir dairy cows consuming excessive energy during mid to late lactation, whereas Cr-supplementation was effective in improving basal insulin sensitivity in cows not receiving Ca salts of palm oil.

External fixation of distal femoral fractures in adults' multicentre retrospective study of 43 patients.

BACKGROUND: A multicenter cohort of 43 adults with distal femoral fractures (DFFs) managed with external fixation was evaluated to determine the potential of this treatment. PATIENTS AND METHODS: The patients were young adults (mean age: 39.6 years) with high-energy trauma; 12 had polytrauma and 41 multiple fractures. Most patients (38/43) had compound DFFs. Fracture types were A in 3 patients, B in 3 patients, and C in 37 patients. A tibio-femoral construct was required in 11 patients and a femoro-femoral construct in 32 patients. RESULTS: The normal femoral axis was restored within 5° in the coronal plane in 34 (79%) patients and in the sagittal plane in 22 (51%) patients. Axis restoration within 5° in both planes was achieved in 19 (44.7%) patients. After femoro-femoral external fixation, mean malalignment was 4.2° in the coronal plane and 8.6° in the sagittal plane; corresponding values after tibio-femoral external fixation were 1.3° and 8.6°. In 23 patients (of whom 1 was lost to follow-up), external fixation was intended as the only and definitive treatment; among them, 1 required amputation after a failed revascularization procedure, 10 achieved fracture healing within a mean of 21.2 weeks, 6 required conversion to another technique, and 5 underwent non-conservative procedures (total knee arthroplasty in 3 and arthrodesis in 2). In the remaining 20 patients, conversion to internal fixation was intended initially and performed within a mean of 4.7 weeks; 1 of these patients required amputation for ischemia, 3 did not achieve fracture healing, 12 achieved primary fracture healing, and 4 achieved fracture healing after repeated grafting (n=3) or osteotomy (n=1). At last follow-up (at least 1 year), the mean International Knee Society (IKS) Function Score was 67.3 and an IKS Knee Score of 68.5. Range of active flexion was 85.75° overall, 62.3° in the group with intended definitive external fixation and 101° in the group with intended conversion to internal fixation. Healing without complications was achieved in 10 (43%) in the former group and 12 (60%) in the latter group. CONCLUSION: Our data support provisional external fixation followed by early conversion to internal fixation in patients with extensively compounded DFFs; patients with multiple fractures requiring several surgical procedures; and polytrauma patients awaiting hemodynamic, respiratory, or neurological stabilization. LEVEL OF EVIDENCE: IV, retrospective study.

Vasodilation and radical-scavenging activity of imperatorin and selected coumarinic and flavonoid compounds from genus Casimiroa.

Hypertension is a very widespread condition which is not strictly considered as an illness but if not countered, progressively causes damage to all tissues and loss in their functionality. For this reason the find of new antihypertensive agents is prominent and medicinal plants and their derivatives are valuable for the purpose. The genus Casimiroa (Rutaceae) includes plants from Central America and Mexico; among these, Casimiroa edulis Llave et Lex. and Casimiroa pubescens Ramirez are the most relevant species, even for their medicinal uses. The decoction of leaves and seeds is traditionally taken as a tea mainly to lower blood pressure. The object of this research was the study of vascular activity of coumarinic and flavonoid compounds isolated from seeds of Casimiroa spp. in comparison with Casimiroa edulis and Casimiroa pubescens extracts. The phenolic compounds isolated from Casimiroa were herniarin (Her), imperatorin (Imp), 8-geranyloxypsoralen (GOP) and 5,6,2',3',4'-pentamethoxyflavone (PMF). All these compounds induced vasorelaxation on rat arterial tissues although with different effectiveness. To study the cellular mechanisms of the vasorelaxation exhibited by imperatorin, we used selective inhibitors of different receptors and enzymes, such as atropine, pyrilamine, nifedipine, L-NAME and DETC. In a further step of this research, we evaluated the radical-scavenging activity of Casimiroa extracts and isolated compounds by means of DPPH assay. In general, we observed that the scavenging activities increased in a concentration-dependent manner for all substances. The phenolic compounds highlight a synergism of vasodilation and antioxidant activity which may be very useful in the management of cardiovascular diseases. Among the evaluated compounds, imperatorin shows a significant vasorelaxant activity even higher than acetylcholine and similar to nitrite, and also useful antiradical capabilities. All these properties suggest its possible role against hypertension and vasculopathies, even if in vivo studies are needed to determine the actual applications.

Visuo-vestibular interaction in the reconstruction of travelled trajectories.

We recently published a study of the reconstruction of passively travelled trajectories from optic flow. Perception was prone to illusions in a number of conditions, and was not always veridical in the others. Part of the illusionary reconstructed trajectories could be explained by assuming that subjects base their reconstruction on the ego-motion percept built during the stimulus' initial moments. In the current paper, we test this hypothesis using a novel paradigm: if the final reconstruction is governed by the initial percept, providing additional, extra-retinal information that modifies the initial percept should predictably alter the final reconstruction. The extra-retinal stimulus was tuned to supplement the information that was under-represented or ambiguous in the optic flow; the subjects were physically displaced or rotated at the onset of the visual stimulus. A highly asymmetric velocity profile (high acceleration, very low deceleration) was used. Subjects were required to guide an input device (in the form of a model vehicle; we measured position and orientation) along the perceived trajectory. We show for the first time that a vestibular stimulus of short duration can influence the perception of a much longer-lasting visual stimulus. Perception of the ego-motion translation component in the visual stimulus was improved by a linear physical displacement, perception of the ego-motion rotation component by a physical rotation. This led to a more veridical reconstruction in some conditions, but to a less veridical reconstruction in other conditions.

Mucormicosis rinosinusal / Rhinosinusal mucormycosis

Se presenta el caso clínico de una paciente de 61 años, con diabetes mellitus moderadamente descompensada, sin cetoacidosis, inmunocompetente, con mucormicosis invasiva de evolución crónica, con buena respuesta al tratamiento quirúrgico y con antimicóticos, que incluyó en una primera etapa fluconazol y, posteriormente, anfotericina B. Se destaca la evolución indolente de la enfemedad y se discute la probable utilidad de los agentes azólicos. Se realiza una revisión bibliográfica de la sinusitis fúngica invasiva por Mucorales.

[Orthopedic treatment of fifth metacarpal neck fractures: prospective study]. / Traitement orthopédique des fractures du col du cinquième métacarpien: étude prospective.

Many methods of treatment have been proposed for the metacarpal neck fractures of the little finger, from early mobilisation to open or closed surgical techniques. A prospective studies of 20 cases treated by a non surgical technique is presented. The reduction was performed by manipulation under local anesthesia according to the Jahss technique and a modified Thomine brace was applied for four weeks. All patients were reviewed for follow-up at 30, 60, and 180 days. The fracture displacement was initially 34 degrees. It was reduced by manipulation to 12 degrees. All fractures healed with an average final displacement of 20 degrees. At 6 months for final examination, average T.A.M. was 245 degrees, T.P.M. was 276 degrees, grip strength reached 96% of the other hand. There were 19 excellent and one bad results. In conclusion, ambulatory non surgical treatment by reduction and local immobilisation of the fractures of the fifth metacarpal provide a good final result with a low cost.

[Intramedullary interlocking nailing for humeral fractures: report of 38 cases treated by Russel and Taylor nail]. / Enclouage verrouillé des fractures diaphysaires récentes de l'humérus.

PURPOSE OF THE STUDY: We assessed outcome after intramedullary interlocking nailing for humeral fractures to identify problems and indications in comparison with reports in the literature. MATERIAL AND METHODS: We implanted the Russel and Taylor nail to treat 38 fresh humeral shaft non-pathological fractures using 33 anterograde insertions and 5 retrograde insertions. RESULTS: All patients were examined at a mean follow-up of 16.3 months. Problems and complications involved 3 open procedure conversion, 3 peroperative re-fractures, 2 locking errors, 2 secondary dismantelings, 2 regressive iatrogenic palsies, and 4 cases of pain due to protruding material. First intention bone healing was achieved in 34 cases and following a revision procedure in 2. Two cases of nonunion were not reoperated. The Neer and Constant scores, used to assess functional outcome, identified 5 non-satisfactory results. DISCUSSION: The risk of infection with locking nails is low, as is the risk of nervous complications which are generally related to traction manoeuvres during reduction. Bone healing is easily achieved if the assembly is perfectly stable. The risk of disassembly or nonunion is related to technical errors: defective locking, insufficient hold in the bone fragments. The risk of stiffness or rotator cuff tears is low, generally related to protrusion of the material and not to insertion through the cuff muscles. Retrograde insertion can be recommended for fractures of the distal third of the humeral shaft. CONCLUSION: Insertion of the Russel and Taylor intramedullary locking nail requires a learning curve to minimize the risk of iatrogenic complications. It can be proposed for fractures of the mid-third of the humeral shaft and can be discussed for the proximal and distal thirds if perfect stability can be obtained on the short bony fragment.

Perception of two-dimensional, simulated ego-motion trajectories from optic flow.

A veridical percept of ego-motion is normally derived from a combination of visual, vestibular, and proprioceptive signals. A previous study showed that blindfolded subjects can accurately perceive passively travelled straight or curved trajectories provided that the orientation of the head remained constant along the trajectory. When they were turned (whole-body, head-fixed) relative to the trajectory, errors occurred. We ask whether vision allows for better path perception in that situation, to correct or complement vestibular perception. Seated, stationary subjects wore a head mounted display showing optic flow stimuli which simulated linear or curvilinear 2D trajectories over a horizontal ground plane. The observer's orientation was either fixed in space, fixed relative to the path, or changed relative to both. After presentation, subjects reproduced the perceived movement with a model vehicle, of which position and orientation were recorded. They tended to correctly perceive ego-rotation (yaw), but they perceive orientation as fixed relative to trajectory or (unlike in the vestibular study) to space. This caused trajectory misperception when body rotation was wrongly attributed to a rotation of the path. Visual perception was very similar to vestibular perception.

[Pseudarthrosis and non-union of disjunctive talar fractures]. / Pseudarthroses et cals vicieux des fractures séparation du talus.

PURPOSE OF THE STUDY: Neck fractures of the talus are rare. Necrosis is the complication most often observed. Mal union or non union are rarely reported: 11 cases of such complications have been treated and are presented with results of surgical treatment. MATERIAL: Seven non unions and 4 mal unions after separation fracture of the talus, presenting with pain and deformity of the hindfoot were treated. The treatment included removal of the fibrous tissue, heel reaxation, bone grafting, peritalar joints arthrodesis. RESULTS: Bone healing was observed in 5 of 7 non unions, and the correction of the hindfoot deformity in 9 of the 11 cases. DISCUSSION: Non union or mal union after separation fracture of the neck of the talus are poorly tolerated, the patients walking with the foot in internal rotation, bearing most of the weight on the lateral border of the foot. Such poor course results from: the less mechanical stiffness of the medial part of the talus, the severity and the comminution of the fracture, insufficienct reduction and fixation, too early weight bearing, and is associated with degenerative changes of peritalar joints. Functional and antomical good results can be obtained with bone healing, hindfoot reaxation and peritalar arthrodesis. We emphasize the interest of X Rays in the examination and the adequacy of a good initial treatment.

Tumores parafaríngeos en niños: descripción de dos casos clínicos / Parapharyngeal tumors in pediatrics: 2 clinical cases

Se presentan dos casos clínicos de tumores parafaríngeos de niños tratados en el Servicio de ORL del Hospital Regional Valdivia. El primero corresponde a un coristoma que histológicamente constituye tejido neuroglial maduro el cual fue tratado con cirugía exclusiva. El segundo caso es un Rabdomiosarcoma embrionario que fue sometido a una resección con quimioterapia y radioterapia según protocolo y a una cirugía de rescate por una recidiva local. Se revisa la literatura con especial énfasis a la anatomía, técnica quirúgica e histología de los tumores que afectan el espacio parafaríngeo

Effects of acute asphyxia at birth on subsequent heat production capacity in newborn pigs.

The effect of acute asphyxia at birth on subsequent ability to produce heat was investigated in 30 newborn pigs. A model of experimentally induced asphyxia consisting of the prevention of breathing within the first four minutes of life was used. Blood was sampled from an umbilical artery catheter within the first 75 minutes of life for blood gas, pH, glucose, lactate and catecholamine analysis. After the treatment and 24 hours later, heat production capacity, shivering intensity and rectal temperature were measured 10 degrees C below thermoneutrality. Effects on blood gas parameters were severe but transient whereas alterations in carbohydrate metabolism were maintained during the first 75 minutes (P < 0.05). Acute asphyxia at birth induced only minor alterations of thermoregulatory abilities during the first day of life: rectal temperature was lower one hour after birth (P < 0.05) and the postnatal increase in heat production capacity was less pronounced than in controls. It is suggested that the lower viability usually reported for piglets suffering from asphyxia during delivery is most likely to result from reduced vigour and colostrum intake, as well as altered carbohydrate metabolism early after birth.

Phototaxic foraging of the archaepaddler, a hypothetical deep-sea species.

An autonomous agent (animat, hypothetical animal), called the (archae) paddler, is simulated in sufficient detail to regard its simulated aquatic locomotion (paddling) as physically possible. The paddler is supposed to be a model of an animal that might exist, although it is perfectly possible to view it as a model of a robot that might be built. The agent is assumed to navigate in a simulated deep-sea environment, where it forages for autoluminescent prey. It uses a biologically inspired phototaxic foraging strategy, while paddling in a layer just above the bottom. The advantage of this living space is that the navigation problem--and hence our model--is essentially two-dimensional. Moreover, the deep-sea environment is physically simple (and hence easy to simulate): no significant currents, constant temperature, completely dark. A foraging performance metric is developed that circumvents the necessity to solve the traveling salesman problem. A parametric simulation study then quantifies the influence of habitat factors, such as the density of prey, and body geometry (e.g., placement, direction and directional selectivity of the eyes) on foraging success. Adequate performance proves to require a specific body geometry adapted to the habitat characteristics. In general, performance degrades gracefully for modest changes of the geometric and habitat parameters, indicating that we work in a stable region of "design space." The parameters have to strike a compromise between, on the one hand, to "see" as many targets at the same time as possible. One important conclusion is that simple reflex-based navigation can be surprisingly efficient. Additionally, performance in a global task (foraging) depends strongly on local parameters such as visual direction tuning, position of the eyes and paddles, and so forth. Behavior and habitat "mold" the body, and the body geometry strongly influences performance. The resulting platform enables further testing of foraging strategies or vision and locomotion theories stemming either from biology or from robotics.

Floral sex ratios and gynomonoecy in Aster (Asteraceae).

Gynomonoecy is the sexual system in which female and bisexual flowers occur on the same plant. This system has received little attention despite the considerable work on other plant sexual systems in the past few decades. Our study examines one hypothesized advantage of having two flower types on a plant, namely that this arrangement permits flexibility in allocation of resources to male and female reproductive functions. We examined 16 species of Aster (Asteraceae), a genus of gynomonoecious, perennial herbs. Plants in this genus produce heads consisting of a whorl of female flowers around a cluster of bisexual flowers. Among field-grown plants we found no evidence that plant size, date, position of heads, rainfall, or shade influenced the proportion of female flowers. A series of greenhouse experiments likewise revealed no large or consistent effects of light, nutrients, or position of heads on the proportion of ray flowers. While floral ratios proved very stable in the face of environmental and physiological variables, they exhibited significant variation among plants and among sibships in most species. We conclude that the presence of two flower types in gynomonoecious asters is not advantageous in permitting flexibility in allocation of resources to male and female functions. We believe that the advantage of the female flowers in aster heads lies either in reducing pollen-pistil interference or in attracting pollinators.

[Value of external fixation in proximal tibial fractures]. / Intérêt de la fixation externe dans les fractures du quart proximal du tibia.

PURPOSE OF THE STUDY: This study was a retrospective analysis of 39 proximal metaphyseal tibial fractures treated by Orthofix fixator in two trauma departments. MATERIAL AND METHOD: There were 28 men and 10 women with a mean age of 49.5 years. 13 pedestrians were stroked by a car and 18 had a traffic accident on a motorcycle. In 27 cases, the fracture was open with following Cauchoix grading: 15 types 2, 6 types 1 and 6 types 3. All fractures were partially or totally included in the proximal epiphyseal square of the AO system. 14 fractures were metaphyseal, 13 diaphyso-metaphyseal and 12 had an articular irradiation. All external fixations were performed using the Orthofix device, with image intensification. A partial weight bearing was allowed for 2.4 months as an average and full weight bearing at mean 3.7 months. 7 skin grafts, 2 micro surgical (latissimus dorsi) and 2 local flaps were necessary. RESULTS: In 3 patients this technique failed. 3 patients had an autologous bone graft at the metaphyseal and 2 at the diaphyseal fracture site. 30 patients healed without other procedure after an average delay of 5.5 months. During the healing and weight bearing time, 6 frontal deformities appeared and 5 flexion contractures were not reoperated. With a minimum follow up of one year (mean 3 years) 22 fractures had no deformity, 8 had a valgus deformity (5 degrees to 10 degrees) and 3 a varus deformity (6 to 17 degrees). For the 25 patients with an isolated proximal tibial fracture, 11 (44%) had an excellent functional result (no pain, full range knee motion, normal daily activity); 12 (48%) had a good result (episodic pain, minimally knee discomfort, flexion limitation). DISCUSSION: Orthofix fixator appear to be a good solution for comminuted fractures. These fractures have anatomical and epidemiological particularities. AO classification system is not useful; a new one is proposed. External fixator must be placed meticulously after closed fracture reduction.