Postoperative pain in dogs undergoing either laparoscopic or open ovariectomy.

A prospective, quasi-experimental, clinical trial was performed to assess acute postoperative pain in healthy female dogs following elective ovariectomy by either laparoscopy (n=13) or laparotomy (n=14). Pain was assessed by both a veterinarian at the hospital, and by the owner once the patient was discharged. The Spanish version of the short form of the Glasgow Composite Measuring Pain Scale (CMPS-SF) was used. Pain scores were assessed by the veterinarian preoperatively and at 1, 2, 4, and 6 h after extubation, whilst owner-assessed scores were performed preoperatively and at postoperative days 0, 1, 2, 3, 5 and 7. Data were compared with Mann-Whitney-U test. Veterinarian-assessed CMPS-SF scores were different between both groups at all postoperative times but not at baseline, being below 6/24 in all dogs in the laparoscopy group, but equal to or greater than 6/24 in the laparotomy group at 1 h (n=12), and 4 h (n=4) (P<0.001 and P=0.029, respectively). There were also differences in pain scores between both groups at 2 h (P=0.012) and 6 h (P=0.007), being below 6/24 in all of them. However, there were no differences in owner assessments between groups. In conclusion, ovariectomy performed by laparoscopy induced lower pain scores that were below the pain threshold set by the CMPS-SF during the first 6 h postoperatively. After discharge, and up to one week later, ongoing owner-assessed scores suggest no pain was induced with neither of the techniques. Owners were proactive allowing real-time pain assessment to be reported. The development and validation of instruments for acute pain assessment by owners is warranted, as these tools are currently lacking.

Investigación de mindfulness en neurociencia cognitiva / Mindfulness Research in Cognitive Neuroscience

Mindfulness es un término que ha pasado a formar parte del vocabulario en nuestra sociedad, y su práctica se ha instalado en el contexto educativo, terapéutico, clínico y como herramienta de bienestar o crecimiento personal. En este artículo hacemos un repaso de los trabajos de investigación más relevantes en neurociencia cognitiva del mindfulness clasificándolos en tres grandes áreas: a) cambios diferenciales en la actividad de la red por defecto debidas a la práctica del mindfulness; b) cambios funcionales o estructurales de la red atencional, y c) cambios funcionales o estructurales de la red frontolímbica y la amígdala, relacionados con la regulación emocional. Hay suficiente bibliografía para afirmar el efecto cerebral que conlleva la práctica de mindfulness, pero todavía necesitamos generar mejores diseños experimentales que nos permitan encontrar los mecanismos de acción de prácticas específicas.(AU)

Mindfulness is a term that has become part of our society’s vocabulary and its practice has become firmly established in educational, therapeutic and clinical contexts and as a tool for fostering well-being and personal growth. In this article we review the most relevant research conducted on mindfulness in cognitive neuroscience, classifying it in three broad areas: a) differential changes in default network activity due to the practice of mindfulness; b) functional or structural changes in the attentional network, and c) functional or structural changes in the frontal limbic network and the amygdala, related to emotion regulation. There is enough evidence in the literature to affirm the effect of mindfulness practice on the brain, but we still need to produce better experimental designs that allow us to find the mechanisms of action underlying specific practices.(AU)

[Investigacion de mindfulness en neurociencia cognitiva]. / Investigación de mindfulness en neurociencia cognitiva.

Mindfulness is a term that has become part of our society's vocabulary and its practice has become firmly established in educational, therapeutic and clinical contexts and as a tool for fostering well-being and personal growth. In this article we review the most relevant research conducted on mindfulness in cognitive neuroscience, classifying it in three broad areas: a) differential changes in default network activity due to the practice of mindfulness; b) functional or structural changes in the attentional network, and c) functional or structural changes in the frontal limbic network and the amygdala, related to emotion regulation. There is enough evidence in the literature to affirm the effect of mindfulness practice on the brain, but we still need to produce better experimental designs that allow us to find the mechanisms of action underlying specific practices.

TITLE: Investigación de mindfulness en neurociencia cognitiva.Mindfulness es un término que ha pasado a formar parte del vocabulario en nuestra sociedad, y su práctica se ha instalado en el contexto educativo, terapéutico, clínico y como herramienta de bienestar o crecimiento personal. En este artículo hacemos un repaso de los trabajos de investigación más relevantes en neurociencia cognitiva del mindfulness clasificándolos en tres grandes áreas: a) cambios diferenciales en la actividad de la red por defecto debidas a la práctica del mindfulness; b) cambios funcionales o estructurales de la red atencional, y c) cambios funcionales o estructurales de la red frontolímbica y la amígdala, relacionados con la regulación emocional. Hay suficiente bibliografía para afirmar el efecto cerebral que conlleva la práctica de mindfulness, pero todavía necesitamos generar mejores diseños experimentales que nos permitan encontrar los mecanismos de acción de prácticas específicas.

Dengue: Valoración por imagen / Dengue: Imaging evaluation

El dengue es una enfermedad aguda viral causada por un flavivirus. Clínicamente se clasifica en dengue sin signos de alarma, con signos de alarma y severo. Los pacientes con sospecha clínica de dengue sin o con signos de alarma pueden presentar síntomas como náuseas, vómitos, rash, mialgias, artralgias, fiebre, cefalea, dolor retro ocular y petequias. Las alteraciones de laboratorio en esta incluyen leucopenia, trombocitopenia. El conteo plaquetario ha sido utilizado como un predictor potencial. Los métodos de estudio por imagen en el dengue más frecuentemente utilizados son la radiografía de tórax y el ultrasonido abdominal. El ultrasonido abdominal es usado ampliamente para estudiar el dolor abdominal y los procesos febriles agudos. Los hallazgos abdominales relacionados con el dengue son el engrosamiento de la pared de la vesícula biliar, ascitis, derrame pleural, hepatomegalia y esplenomegalia y derrame pericárdico. A nivel del tórax el hallazgo más frecuente es el derrame pleural. (provisto por Infomedic International)

Dengue is an acute viral disease caused by a flavivirus. Clinically it is classified into dengue without alarm signs, with alarm signs and severe. Patients with clinically suspected dengue without or with alarm signs may present with symptoms such as nausea, vomiting, rash, myalgia, arthralgia, fever, headache, retro ocular pain and petechiae. Laboratory alterations in this case include leukopenia, thrombocytopenia. Platelet count has been used as a potential predictor. The most frequently used imaging methods in dengue are chest radiography and abdominal ultrasound. Abdominal ultrasound is widely used to study abdominal pain and acute febrile processes. Abdominal findings related to dengue fever are gallbladder wall thickening, ascites, pleural effusion, hepatomegaly and splenomegaly, and pericardial effusion. At the thoracic level the most frequent finding is pleural effusion. (provided by Infomedic International)

Radiofrecuencia percutánea en el tratamiento de masas renales pequeñas: análisis de resultados y complicaciones tras diez años de experiencia / Percutaneous radiofrequency for the treatment of small renal masses: Analysis of outcomes and complications after 10 years of experience

Introducción y objetivo: El manejo de tumoraciones renales ≤ 4 cm en población anciana o con comorbilidades supone un reto, constituyendo las terapias ablativas una alternativa interesante. El objetivo es evaluar la radiofrecuencia percutánea en el tratamiento de masas renales pequeñas en nuestro centro, las complicaciones asociadas y los resultados obtenidos.Material y métodosEvaluación retrospectiva de las radiofrecuencias realizadas entre abril de 2010 y abril de 2020 en nuestro centro. Se revisaron datos demográficos, comorbilidades asociadas, características tumorales, complicaciones y resultados oncológicos y funcionales.ResultadosSe trataron 57 tumores en 53 pacientes. Seguimiento medio de 48,2 meses. Se obtuvo un 89,5% de ablaciones completas. Hubo un 19,3% de complicaciones. Fueron catalogadas como mayores un 3,5% y un 5,3% según Clavien-Dindo y SIR. Se encontró asociación estadísticamente significativa entre el resultado inicial de la ablación y la edad (p = 0,047), el score RENAL modificado (RENAL-m) (p = 0,044), la presencia de componente quístico (p = 0,049) y el tamaño tumoral (p = 0,01). El punto de corte de tamaño quedó establecido en 25 mm (p = 0,012). En el análisis multivariante, únicamente el tamaño permaneció como predictor de resultado inicial de ablación (p = 0,01; OR 1,183; IC 95% 1,041-1,345). La supervivencia cáncer específica y supervivencia libre de recurrencia a cinco años fueron del 98,1% y del 89,5% respectivamente.Se observó una disminución media del MDRD-4 de 6,59 mL/min (p = 0,005) en los seis primeros meses tras radiofrecuencia (RFA).ConclusionesDados los excelentes resultados oncológicos y funcionales demostrados, la radiofrecuencia percutánea guiada por ecografía es una terapia eficaz y segura en el tratamiento de masas renales pequeñas en pacientes seleccionados. (AU)

Introduction and objective: The management of renal tumors ≤ 4 cm in elderly population or patients with comorbidities is a challenge, for which ablative therapies are an interesting alternative. The objective is to evaluate in our center the role of percutaneous radiofrequency in the treatment of small renal masses, the associated complications and the results obtained.Material and methodsRetrospective evaluation of the radiofrequency treatments carried out between April 2010 and April 2020 in our center. Demographic data, associated comorbidities, tumor characteristics, complications and oncological and functional outcomes were reviewed.ResultsFifty-seven tumors were treated in 53 patients. Mean follow-up of 48.2 months. The percentage of complete ablations obtained was of 89.5%. There were 19.3% of complications. According to Clavien-Dindo and SIR classification systems, 3.5% and 5.3% were major complications. A statistically significant association was found between the initial result of ablation and age (p = 0.047), RENAL-m (p = 0.044), the presence of cystic component (p = 0.049) and tumor size (p = 0.01). The cut-off point for size was established at 25 mm (p = 0.012). In multivariate analysis, only size remained as a predictor of initial ablation result (p = 0.01; OR 1.183; CI 95% 1.041-1.345). Cancer-specific survival and 5-year recurrence-free survival were 98.1% and 89.5%, respectively.A mean decrease of MDRD-4 of 6.59 mL/min (p = 0.005) was observed in the first six months after RFA.ConclusionsGiven the excellent oncological and functional results demonstrated, ultrasound-guided percutaneous radiofrequency ablation is an effective and safe treatment for small renal masses in selected patients. (AU)

Percutaneous radiofrequency for the treatment of small renal masses: Analysis of outcomes and complications after 10 years of experience. / Radiofrecuencia percutánea en el tratamiento de masas renales pequeñas: análisis de resultados y complicaciones tras diez años de experiencia.

INTRODUCTION AND OBJECTIVE: The management of renal tumors ≤ 4 cm in elderly population or patients with comorbidities is a challenge, for which ablative therapies are an interesting alternative. The objective is to evaluate in our center the role of percutaneous radiofrequency in the treatment of small renal masses, the associated complications and the results obtained. MATERIAL AND METHODS: Retrospective evaluation of the radiofrequency treatments carried out between April 2010 and April 2020 in our center. Demographic data, associated comorbidities, tumor characteristics, complications and oncological and functional outcomes were reviewed. RESULTS: Fifty-seven tumors were treated in 53 patients. Mean follow-up of 48.2 months. The percentage of complete ablations obtained was of 89.5%. There were 19.3% of complications. According to Clavien-Dindo and SIR classification systems, 3.5% and 5.3% were major complications. A statistically significant association was found between the initial result of ablation and age (p = 0.047), RENAL-m (p = 0.044), the presence of cystic component (p = 0.049) and tumor size (p = 0.01). The cut-off point for size was established at 25 mm (p = 0.012). In multivariate analysis, only size remained as a predictor of initial ablation result (p = 0.01; OR 1.183; CI 95% 1.041-1.345). Cancer-specific survival and 5-year recurrence-free survival were 98.1% and 89.5%, respectively. A mean decrease of MDRD-4 of 6.59 mL/min (p = 0.005) was observed in the first six months after RFA. CONCLUSIONS: Given the excellent oncological and functional results demonstrated, ultrasound-guided percutaneous radiofrequency ablation is an effective and safe treatment for small renal masses in selected patients.

Antimicrobial resistance increased over an 8-year period in Enterobacteriaceae cultured from canine urine samples.

OBJECTIVES: The aims of the present study were to describe the prevalence of positive urinary bacterial culture in dogs, to identify the most commonly isolated microorganisms and to analyse changes in antimicrobial susceptibility patterns over time. MATERIAL AND METHODS: A retrospective case series was performed using culture and susceptibility results from canine urine samples collected between January 2010 and December 2017. The presence or absence of infection, identity of the bacterium with heaviest growth, and susceptibility profile were recorded for each sample. Trends in the frequency of positive culture and antimicrobial resistance were assessed by Poisson regression modelling. Prevalence rate ratio and 95% confidence interval were reported for resistance to each antimicrobial. RESULTS: A positive urine culture was documented in 771 (22.5%) of 3420 samples. Escherichia coli was the most commonly isolated microorganism. There was no significant increase in the frequency of positive bacterial culture over the study period (prevalence rate ratio 0.98; 95% confidence interval: 0.92 to 1.0). Overall, there was an increase in antimicrobial resistance within Enterobacteriaceae from 5.2 to 35.6%. The prevalence of multidrug-resistant bacteria varied from year to year throughout the study period. However, the Poisson regression model identified a significant increase in the frequency of multidrug-resistant Enterobacteriaceae over this period, averaging approximately 22% per year (prevalence rate ratio 1.22, 95% confidence interval: 1.06 to 1.42). CLINICAL SIGNIFICANCE: The significant increase in antimicrobial resistance observed in this study is concerning and may have implications for veterinary and public health. Appropriate measures, such as antibiotic stewardship programmes, should be implemented to address increasing antimicrobial resistance.

COVID-19 in Parkinson's disease: what holds the key?

INTRODUCTION: Parkinson's disease (PD) is more frequent in the elderly and increases the risk of respiratory infections. Previous data on PD and SARS-CoV-2 are scarce, suggesting a poor prognosis in advanced disease and second-line therapies. METHODS: A retrospective case-control study comparing patients with PD and COVID-19 and patients with PD without COVID-19 was conducted during the pandemic period in Spain (March 1st-July 31st 2020) in a tertiary university hospital. RESULTS: Thirty-nine (COVID-19 +) and 172 (COVID-19-) PD patients were included. Fifty-nine percent were males in both groups, with similar age (75.9 ± 9.0 COVID-19 + , 73.9 ± 10.0 COVID-19-), disease duration (8.9 ± 6.2 COVID-19 + , 8.5 ± 5.6 COVID-19-) and PD treatments. COVID-19 was mild in 10 (26%), required admission in 21 (54%) and caused death in 8 (21%) patients. Dementia was the only comorbidity more frequent in COVID-19 + patients (36% vs. 14%, p = 0.0013). However, in a multivariate analysis, institutionalization was the only variable associated with COVID-19 + (OR 17.0, 95% CI 5.0-60.0, p < 0.001). When considering severe COVID-19 (admission or death) vs. mild or absent COVID-19, institutionalization, neoplasm, dementia and a lower frequency of dopamine agonists were associated with severe COVID-19. In multivariate analysis, only institutionalization [OR 5.17, 95% CI 1.57-17, p = 0.004] and neoplasm [OR 8.0, 95%CI 1.27-49.8, p = 0.027] remained significantly associated. CONCLUSION: In our experience, institutionalization and oncologic comorbidity, rather than PD-related variables, increased the risk of developing COVID-19, and impacted on its severity. These findings suggest that epidemiologic factors and frailty are key factors for COVID-19 morbidity/mortality in PD. Appropriate preventive strategies should be implemented in institutionalized patients to prevent infection and improve prognosis.

Factors affecting respiratory system compliance in anaesthetised mechanically ventilated healthy dogs: a retrospective study.

OBJECTIVES: To determine the influence of several factors on respiratory system compliance in volume-controlled mechanically ventilated healthy anaesthetised dogs. MATERIALS AND METHODS: Review of 100 dogs anaesthetised for elective surgeries between 2015 and 2016. Dogs were mechanically ventilated with a respiratory rate adjusted to maintain normocapnia and a fraction of inspired oxygen of 50%. Body weight, body condition score, age, thoracic shape, time in spontaneous ventilation before volume-controlled ventilation, time with a fraction of inspired oxygen of 100% until starting mechanical ventilation, type of surgery and patient position were recorded. Respiratory system compliance, expressed per kg of bodyweight, was recorded every 15 minutes following initiation of volume-controlled ventilation. RESULTS: Baseline respiratory system compliance was 1.3 ± 0.3 mL/cmH2 O/kg and was reduced by high body condition score and barrel-shaped thorax but not by age, type of surgery or patient position, time in spontaneous ventilation nor time with a fraction of inspired oxygen of 100%. CLINICAL SIGNIFICANCE: Respiratory system compliance is lower in overweight and barrel-chested dogs and should be taken into account during monitoring of lung function and ventilation management under general anaesthesia.

Efecto de la interacción luz-agua sobre la fotosíntesis de la Vanilla planifolia (Orchidaceae) / Light-water interaction effect on photosynthesis of the Vanilla planifolia (Orchidaceae)

Introducción: La vainilla (Vanilla planifolia Andrews) es una planta CAM de gran importancia económica en el mercado mundial de saborizantes y aromatizantes. Por ser una planta hemiepífita que inicialmente crece en el sotobosque sombreado y posteriormente asciende hasta el dosel, se aclimata a diferentes condiciones de radiación y humedad. La posibilidad de extender su cultivo a zonas secas donde sea menor la incidencia de enfermedades, dependerá de su respuesta a períodos prolongados de sequía. Objetivo: Evaluar los efectos de la interacción entre la radiación y la humedad sobre los parámetros de la fotosíntesis y funcionamiento del CAM de plantas de vainilla en sus fases iniciales de desarrollo vegetativo, y determinar si las condiciones de radiación en las que crece la planta pueden ayudar a moderar los efectos negativos de la sequía. Métodos: Se evaluaron plantas de vainilla que crecieron con riego durante 18 meses en casetas con iluminación relativa (IR) de 8, 17, 31 y 67 %; posteriormente se suspendió el riego y se fueron deshidratando durante 94 días hasta alcanzar un contenido de humedad crítico (contenido hídrico relativo, CHR ≤ 50 %), y finalmente se reinició el riego durante 22 días; se evaluó el efecto de estos procesos sobre la asimilación de CO2, la acidez titulable y la eficiencia cuántica del Fotosistema II (Fv/Fm). Resultados: Bajo condiciones intermedias de IR (17 % y 31 %), la asimilación de CO2 y laacumulación nocturna de ácidos orgánicos presentaron la menor afectación por el déficit hídrico, así como la mejor recuperación luego de la rehidratación. El CHR se vio más afectado por la disponibilidad de agua en el tejido vegetal, mientras que Fv/Fm lo fue por el ambiente de radiación. Los efectos combinados de estrés hídrico y alta radiación ocasionaron daños irreversibles en la fotosíntesis para el tratamiento de IR de 67 %. Conclusiones: En las plantas de vainilla, el impacto negativo de la sequía sobre los parámetros de la fotosíntesis fue mayor en alta radiación; sin embargo, en condiciones de baja radiación también aumentó la susceptibilidad de las plantas a la sequía, en comparación con los ambientes de radiación intermedia, en los cuales la densidad de flujo de fotones media fue de 340 μmol m-2 seg-1 (17 % de IR) y 620 μmol m-2 seg-1 (31 % de IR). Estos resultados sugieren el potencial de cultivar vainilla en zonas con sequía estacional bajo sistemas productivos de baja tecnificación, manteniendo estas condiciones de radiación.

Introduction: Vanilla planifolia Andrews is a CAM plant of economic importance in the global market of flavorings and essences. Being a hemiepiphyte which initially grows in the shady understory and later climbs to the canopy, it acclimates to different conditions of radiation and humidity. The possibility of extending this crop to dry areas where the incidence of diseases is lower will depend on the response to prolonged periods of drought. Objective: To evaluate the effects of the interaction of radiation and humidity on the parameters of photosynthesis and operation of CAM of vanilla plants, and to determine if the radiation environment could help to moderate the negative effects of drought. Methods: We evaluated well-watered vanilla plants grown for 18 months in relative illumination (RI) of 8, 17, 31 and 67 %, which underwent dehydration for 94 days until reaching critical water content (relative water content, RWC < 50 %) and then rehydration for 22 days; variables evaluated were: CO2 assimilation, titratable acidity, and quantum efficiency of Photosystem II (Fv / Fm). Results: Under intermediate conditions of radiation (17 % and 31 % RI), CO2 assimilation and nocturnal accumulation of organic acids were less affected by water deficit and also showed the best recovery after rehydration. The RWC was most affected by the water available in plant tissue, while Fv / Fm was affected by radiation. The combined effects of water stress and high radiation caused irreversible damage to photosynthesis for the 67 % RI treatment. Conclusions: In vanilla plants, the negative impact of drought on photosynthetic parameters was greater in high radiation; however, in low radiation conditions the susceptibility of plants to drought also increased, as compared to intermediate radiation environments, which were under a mean photon flux density of 340 µmol m-2 s-1 (17 % IR) and 620 µmol m-2 s-1 (31 % IR). These results suggest the potential for growing vanilla in areas with seasonal drought under low-tech production systems, maintaining these radiation conditions.

Toxicology tailored low density oligonucleotide microarray for the thicklip grey mullets (Chelon labrosus): Biomarker gene transcription profile after caging in a polluted harbour.

In aquatic organisms inhabiting polluted waters genes are activated to build an adaptive/compensatory defence against the possible effects of pollutants. Such responses can be used as biomarkers of exposure to chemical compounds, outlining the molecular mechanisms activated under specific pollution scenarios. With the aim of exploiting such approach in environmental health assessment, toxicologically relevant gene fragments were sequenced in the thicklip grey mullet (Chelon labrosus) and a toxicologically tailored low-density (160 genes) oligonucleotide microarray was customised. The tool was validated comparing organ/sex specific gene expression profiles and characterising responses under laboratory exposure to model chemicals. Finally, juvenile mullets were caged in a polluted harbour and hepatic gene expression profiles analysed after 5 and 21 days of deployment. Cages were deployed in the inner (IH) and outer (OH) Pasaia harbour, Bay of Biscay. Mussels (Mytilus galloprovincialis) were also caged as biological matrix for chemical bioaccumulation analysis and stress biomarkers measurements. Slightly higher concentrations of chemicals (metals, tributyltin, PAHs, phthalates) were quantified in IH than in OH, fish bile metabolites also revealing higher availability of PAHs in IH. Lysosome membrane stability in mussels was reduced, indicating stress condition in both sites. The developed microarray discriminated mullets showing distinctive expression profiles depending on site and deployment time. Genes related to immune and hypoxia responses were regulated comparing IH and OH at day 5. Phase I and II biotransformation genes, such as cyp2, cyp3 and ugt, were up-regulated in IH, together with the aryl hydrocarbon receptor 2 (ahr2) and the ahr repressor. Similarly, TBT-binding proteins and genes involved in lipid metabolism (pparγ, cyp7) were up-regulated with deployment time. Even if nowadays higher throughput approaches for gene expression analyses are available, the developed mullet tool constitutes a comprehensive tool to assess molecular responses of mullets exposed to pollutants, although it remains to be explored whether it can be applied to assess pollutant exposure in active pollution monitorings and in environmental health assessment.

Acute Kidney Injury After Cardiac Transplantation: Foe or Common Innocent Bystander?

BACKGROUND: Heart transplantation (HT) is regarded as the treatment of choice for end-stage heart failure (ESHF) patients. Severe acute kidney injury (AKI) after HT is a frequent clinical problem with devastating consequences for HT recipients. METHODS: Data from 112 ESHF patients undergoing HT in 2010-2015 were retrospectively reviewed. The primary end point was the development of AKI stage III, and secondary outcomes were in-hospital and 1-year mortality according to Kidney Disease Improving Global Outcomes criteria. RESULTS: In total, 81 patients (72.3%) developed AKI, of which 33 (29.4%) developed AKI stage I, 18 (16%) stage II, and 30 (26.7%) stage III; within this group, 27 recipients (24%) required renal replacement therapy (RRT). Overall hospital mortality was 14%. However, when stratifying by AKI stage, hospital mortality increased from 0% to 46% comparing recipients without AKI and those with AKI stage III, respectively (P = .001). In the same way, 1-year mortality increased from 6% to 53% for recipients without AKI compared with those who developed AKI stage III (log-rank test for trend: P = .001). Recipients that required RRT had a 1-year mortality of 59.2% compared with 5.8% in those without RRT requirement. CONCLUSIONS: The findings indicate that AKI stage III is common after HT and adversely affects early and late mortality. Clinical variables together with perioperative hemodynamic assessment could add more powerful prognostic information to predict severe AKI before HT and therefore evaluate potential heart-kidney recipients.

Single-Center Long-Term Follow-Up of Kidney Donors in Argentina (Hospital Italiano de Buenos Aires).

INTRODUCTION: Living kidney donor (LKD) transplantation is increasing due to organ shortage. Clinical studies have shown that the risk of developing end-stage renal disease (ESRD) in donors is similar to that in the general population. Our goal was to evaluate postdonation renal outcomes assessed by glomerular filtration rate (GFR), proteinuria, and blood pressure. METHODS: A total of 210 LKD transplants were performed at Hospital Italiano de Buenos Aires between 2000 and 2014. Postdonation outcomes were analyzed in 109 donors. GFR was assessed by 24-hour creatinine clearance (as 24-hour ClCr) and estimated using the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. Additionally, we correlated the predonation renal functional reserve (RFR) with postdonation GFR. Donor results were compared to the expected GFR (adjusted to age and single kidney). Other renal outcome indicators measured were albuminuria and blood pressure, and they were compared (predonation and postdonation) using univariate analysis. RESULTS: A total of 109 patients were followed up for 47 ± 34 months (range, 12-168): 70% were female, age at donation was 48.58 years (range, 25-70), and predonation serum creatinine was 0.85 ± 0.17 mg/dL. Postnephrectomy GFR (24-hour ClCr) was significantly lower compared to predonation GFR (105.38 ± 21.78 mL/min/1.73 m2 vs 90.14 ± 17.78 mL/min/1.73 m2). However, postdonation GFR was not significantly different compared to the expected GFR. No differences were found for blood pressure or albuminuria. Age >50 and an RFR (<20%) was associated with a lower GFR. CONCLUSIONS: In this population of LKD, renal outcome (24-hour CrCl, albuminuria, and blood pressure) was within the expected outcome for healthy individuals after uninephrectomy.

El correo electrónico en la consulta de Parkinson: ¿soluciones a un clic? / Use of e-mail for Parkinson's disease consultations: Are answers just a clic away?

Introducción: La problemática de los trastornos del movimiento (TM) es compleja y la duración y frecuencia de las consultas presenciales puede estar limitada por problemas de espacio y tiempo. Analizamos el funcionamiento de un servicio de atención por correo electrónico institucional para médicos de Atención Primaria (MAP) y pacientes en la Unidad de Trastornos del Movimiento (UTM). Métodos: Se revisaron retrospectivamente los correos electrónicos enviados y recibidos en un periodo de 4 meses, un año tras su implantación. La dirección se proporcionaba en consulta y mediante sesiones informativas a los MAP del área. Se analizaron datos clínicos y demográficos de los pacientes, tipo de interlocutor, número de consultas, motivo y actuaciones derivadas de ellas. Resultados: Del 1 de enero al 30 de abril de 2015 se recibieron 137 correos de 63 pacientes (43% varones; edad 71 ± 10,5 años) diagnosticados de enfermedad de Parkinson (76%), parkinsonismos atípicos (10%) y otros (14%), y se enviaron 116 respuestas. En 20 casos (32%) fueron redactados por el paciente, en 38 (60%) por sus familiares y en 5 (8%) por MAP. Los motivos de consulta fueron clínicos en 50 casos (80%): deterioro clínico (16; 32%), nuevos síntomas (14; 28%), efectos secundarios o dudas sobre medicación (20; 40%). Como consecuencia, se adelantó una cita programada en 9 casos (14%), mientras que el resto se solucionaron por correo electrónico. En 13 (20%), el motivo de consulta fue burocrático: relacionado con citas (11, 85%) y solicitud de informe (2, 15%). La satisfacción fue generalizada, sin constituir una sobrecarga asistencial excesiva para los facultativos responsables. Conclusiones: La implantación de una consulta por correo electrónico es factible en UTM, facilita la comunicación médico-paciente y la continuidad asistencial con Atención Primaria (AU)

Introduction: The clinical problems of patients with movement disorders (MD) are complex, and the duration and frequency of face-to-face consultations may be insufficient to meet their needs. We analysed the implementation of an e-mail-based query service for our MD unit's patients and their primary care physicians (PCPs). Methods: We retrospectively reviewed all consecutive emails sent and received over a period of 4 months, one year after implementation of the e-mail inquiry system. All patients received the during consultations, and PCPs, during scheduled informative meetings. We recorded and later analysed the profile of the questioner, patients' demographic and clinical data, number of queries, reason for consultation, and actions taken. Results: From 1 January 2015 to 30 April 2015, the service received 137 emails from 63 patients (43% male, mean age 71 ± 10.5) diagnosed with Parkinson's disease (76%), atypical parkinsonism (10%), and others (14%); 116 responses were sent. Twenty (32%) emails were written by patients, 38 (60%) by their caregivers, and 5 (8%) by their PCPs. The reasons for consultation were clinical in 50 cases (80%): 16 (32%) described clinical deterioration, 14 (28%) onset of new symptoms, and 20 (40%) side effects or concerns about medications. In 13 cases (20%), the query was bureaucratic: 11 were related to appointments (85%) and 2 were requests for clinical reports (15%). In response, new appointments were scheduled in 9 cases (14%), while the rest of the questions were answered by email. Patients were satisfied overall and the additional care burden on specialists was not excessive. Conclusions: Implementing an e-mail-based consultation system is feasible in MD units. It facilitates both communication between neurologists and patients and continued care in the primary care setting (AU)

Use of e-mail for Parkinson's disease consultations: Are answers just a clic away? / El correo electrónico en la consulta de Parkinson: ¿soluciones a un clic?

INTRODUCTION: The clinical problems of patients with movement disorders (MD) are complex, and the duration and frequency of face-to-face consultations may be insufficient to meet their needs. We analysed the implementation of an e-mail-based query service for our MD unit's patients and their primary care physicians (PCPs). METHODS: We retrospectively reviewed all consecutive emails sent and received over a period of 4 months, one year after implementation of the e-mail inquiry system. All patients received the during consultations, and PCPs, during scheduled informative meetings. We recorded and later analysed the profile of the questioner, patients' demographic and clinical data, number of queries, reason for consultation, and actions taken. RESULTS: From 1 January 2015 to 30 April 2015, the service received 137 emails from 63 patients (43% male, mean age 71±10.5) diagnosed with Parkinson's disease (76%), atypical parkinsonism (10%), and others (14%); 116 responses were sent. Twenty (32%) emails were written by patients, 38 (60%) by their caregivers, and 5 (8%) by their PCPs. The reasons for consultation were clinical in 50 cases (80%): 16 (32%) described clinical deterioration, 14 (28%) onset of new symptoms, and 20 (40%) side effects or concerns about medications. In 13 cases (20%), the query was bureaucratic: 11 were related to appointments (85%) and 2 were requests for clinical reports (15%). In response, new appointments were scheduled in 9 cases (14%), while the rest of the questions were answered by email. Patients were satisfied overall and the additional care burden on specialists was not excessive. CONCLUSIONS: Implementing an e-mail-based consultation system is feasible in MD units. It facilitates both communication between neurologists and patients and continued care in the primary care setting.

Experiencia inicial con la nueva plataforma de puerto único da Vinci robótico / Initial experience with the new da Vinci single-port robot-assisted platform

Objetivo: Describir nuestra experiencia en los primeros casos de cirugías urológicas realizadas mediante el puerto único robótico da Vinci. Material y métodos: Se realizaron 5 cirugías robóticas por puerto único (R-LESS) entre mayo y octubre de 2014. Se realizaron 3 reimplantes ureterales, una ureteropieloplastia en un riñón invertido y una nefrectomía parcial. Se recogieron los resultados peri- y postoperatorios así como un informe de las complicaciones según la clasificación de Clavien. Resultados: De los 5 procedimientos, 4 se realizaron completamente por LESS, mientras que uno se reconvirtió a cirugía robótica multipuerto. No hubo complicaciones intraoperatorias. Se observaron complicaciones perioperatorias en 4 pacientes, siendo todas de grado 1 o 2. El tiempo operatorio medio fue de 262 min (rango 230-300). Discusión: En nuestra experiencia inicial con el dispositivo da Vinci, la cirugía R-LESS es factible y segura. Persisten algunas limitaciones en su uso, que requieren de nuevas plataformas R-LESS mejoradas

Objective: To describe our experience in the first cases of urological surgeries performed with the da Vinci single-port robot-assisted platform. Material and methods: We performed 5 single-port robot-assisted surgeries (R-LESS) between May and October 2014. We performed 3 ureteral reimplant surgeries, one ureteropyeloplasty in an inverted kidney and 1 partial nephrectomy. The perioperative and postoperative results were collected, as well as a report of the complications according to the Clavien classification system. Results: Of the 5 procedures, 4 were performed completely by LESS, while 1 procedure was reconverted to multiport robot-assisted surgery. There were no intraoperative complications. We observed perioperative complications in 4 patients, all of which were grade 1 or 2. The mean surgical time was 262 minutes (range, 230-300). Discussion: In our initial experience with the da Vinci device, R-LESS surgery was feasible and safe. There are still a number of limitations in its use, which require new and improved R-LESS platforms

Digestive activity and stomach temperature in farmed bluefin tuna Thunnus thynnus measured by acoustic tag.

Eight farmed Atlantic bluefin tuna Thunnus thynnus were tagged with temperature and depth transmitters inserted in chub mackerels Scomber colias to characterize their digestive activity, feeding physiology and behaviour in captivity. Results obtained in the experiment can be used to optimize daily T. thynnus feeding strategy in farms, reducing the early regurgitation of food and thus the environmental effects of inappropriate feeding practices.

Initial experience with the new da Vinci single-port robot-assisted platform. / Experiencia inicial con la nueva plataforma de puerto único da Vinci robótico.

OBJECTIVE: To describe our experience in the first cases of urological surgeries performed with the da Vinci single-port robot-assisted platform. MATERIAL AND METHODS: We performed 5 single-port robot-assisted surgeries (R-LESS) between May and October 2014. We performed 3 ureteral reimplant surgeries, one ureteropyeloplasty in an inverted kidney and 1 partial nephrectomy. The perioperative and postoperative results were collected, as well as a report of the complications according to the Clavien classification system. RESULTS: Of the 5 procedures, 4 were performed completely by LESS, while 1 procedure was reconverted to multiport robot-assisted surgery. There were no intraoperative complications. We observed perioperative complications in 4 patients, all of which were grade 1 or 2. The mean surgical time was 262minutes (range, 230-300). DISCUSSION: In our initial experience with the da Vinci device, R-LESS surgery was feasible and safe. There are still a number of limitations in its use, which require new and improved R-LESS platforms.

Comparison Between CKD-EPI Creatinine and MDRD Equations to Estimate Glomerular Filtration Rate in Kidney Transplant Patients.

BACKGROUND: The Modification of Diet in Renal Disease (MDRD) equation is widely used to estimate glomerular filtration rate (eGFR) in kidney transplant (KT) patients. The novel Chronic Kidney Disease-Epidemiology Collaboration equation (CKD-EPI) could improve accuracy of GFR estimation. Our aim was to compare both equations for staging of CKD in KT patients. METHODS: In a cohort of KT patients, correlation of eGFR according to MDRD and CKD-EPI with 24-hour creatinine clearance (24h-CrCl) was evaluated. Concordance between both equations for CKD staging was performed. MDRD was used for initial CKD staging. The mean difference of GFR between 24h-CrCl and each equation was calculated and Bland-Altman analysis applied. RESULTS: A cohort of 463 KT patients were studied: 67% female, overall average age 46 ± 14 years, 41% living donor, mean time of transplantation 71 months (3-95), and mean serum creatinine 1.68 ± 1.03 mg/dL. For the whole cohort (all CKD stages), eGFR by CKD-EPI was 5.33 mL/min/1.73 m(2) higher than by MDRD (P < .01). For CKD stages 1, 2, and 3A, the mean eGFR differences (CKD-EPI - MDRD) were 13.98 ± 3.27, 8.2 ± 1.98, and 5.34 ± 1.32 mL/min/1,73 m(2), respectively. The percentage of patients with eGFR <60 mL/min/1.73 m(2) decreased from 63.8% according to MDRD to 53.9% with the use of CKD-EPI. In women and patients ≤65 years old, eGFR by CKD-EPI was 5.98 and 5.81 mL/min/1.73 m(2) higher, respectively, than by MDRD (P < .01). CONCLUSIONS: The novel CKD-EPI reduces the number of patients with eGFR <60 mL/min/1.73 m(2) and consequently assigns lower CKD stages to our KT population.

Biological characterization of the skin of shortfin mako shark Isurus oxyrinchus and preliminary study of the hydrodynamic behaviour through computational fluid dynamics.

This study characterized the morphology, density and orientation of the dermal denticles along the body of a shortfin mako shark Isurus oxyrinchus and identified the hydrodynamic parameters of its body through a computational fluid-dynamics model. The study showed a great variability in the morphology, size, shape, orientation and density of dermal denticles along the body of I. oxyrinchus. There was a significant higher density in dorsal and ventral areas of the body and their highest angular deviations were found in the lower part of the mouth and in the areas between the pre-caudal pit and the second dorsal and pelvic fins. A detailed three-dimensional geometry from a scanned body of a shark was carried out to evaluate the hydrodynamic properties such as drag coefficient, lift coefficient and superficial (skin) friction coefficient of the skin together with flow velocity field, according to different roughness coefficients simulating the effect of the dermal denticles. This preliminary approach contributed to detailed information of the denticle interactions. As the height of the denticles was increased, flow velocity and the effect of lift decreased whereas drag increased. The highest peaks of skin friction coefficient were observed around the pectoral fins.