Dolor lumbar y aneurisma de aorta abdominal: red flags / Low back pain and abdominal aortic aneurysm: Red flags España

Aproximadamente el 70% de los adultos experimentarán dolor lumbar en algún momento de su vida. En la mayoría de los casos no se puede identificar una causa, tratándose de algias inespecíficas. Las guías clínicas sobre el manejo del dolor lumbar indican sospechar la presencia de procesos graves mediante las denominadas banderas rojas (red flags). El aneurisma de aorta abdominal en el 91% de los casos se acompaña de dolor lumbar, de allí su importancia de incluirlo como diagnóstico diferencial. Exponemos el caso de un varón de 75años con dolor lumbar, sin mejoría con tratamiento conservador, derivado a consulta de rehabilitación 3meses después del inicio de los síntomas, y ante signos de alarma se solicitan estudios de imagen que evidencian aneurisma de aorta abdominal y masa renal derecha. Debemos tener presente las banderas rojas en pacientes con lumbalgia y así evitar desenlaces que pueden poner en riesgo su vida.(AU)

Approximately 70% of adults will experience low back pain at some point in their life. Most of the cases cannot be identified a cause, being nonspecific pains. The clinical guidelines on the management of low back pain indicate suspecting the presence of serious processes by means of the so-called red flags. Abdominal aortic aneurysm in 91% of cases is accompanied by low back pain, hence its importance of including it as a differential diagnosis. We present the case of a 75-year-old man with low back pain, without improvement with conservative treatment, referred to a rehabilitation consultation 3months after the onset of symptoms, and in the event of warning signs, imaging studies are requested that show abdominal aortic aneurysm and mass right kidney. We must bear in mind the red flags in patients with low back pain, and thus avoid outcomes that can put their lives at risk.(AU)

[Low back pain and abdominal aortic aneurysm: Red flags]. / Dolor lumbar y aneurisma de aorta abdominal: red flags.

Approximately 70% of adults will experience low back pain at some point in their life. Most of the cases cannot be identified a cause, being nonspecific pains. The clinical guidelines on the management of low back pain indicate suspecting the presence of serious processes by means of the so-called red flags. Abdominal aortic aneurysm in 91% of cases is accompanied by low back pain, hence its importance of including it as a differential diagnosis. We present the case of a 75-year-old man with low back pain, without improvement with conservative treatment, referred to a rehabilitation consultation 3months after the onset of symptoms, and in the event of warning signs, imaging studies are requested that show abdominal aortic aneurysm and mass right kidney. We must bear in mind the red flags in patients with low back pain, and thus avoid outcomes that can put their lives at risk.

Removal of bacteria from boar semen using a low-density colloid.

Antibiotics are added to semen extenders when preparing commercial semen doses for artificial insemination according to national and international guidelines. However, this addition of antibiotics represents non-therapeutic usage and could be contributing to the development of antibiotic resistance. Colloid centrifugation was shown to reduce the load of bacteria present in boar semen and was capable of removing all bacteria if performed directly after semen collection, albeit with some loss of spermatozoa. The present experiment was conducted with a low density colloid to investigate whether it was possible to separate all of the spermatozoa from seminal plasma i.e. without selection for robust spermatozoa, or whether this would have a detrimental effect on sperm quality. Ejaculates from nine boars were extended in Beltsville Thawing Solution without antibiotics and were transported to the laboratory for Single Layer Centrifugation (SLC) on modified Porcicoll i.e. at a low density (S). A further modification was that a sterile inner tube was included inside some of the 50 mL centrifuge tubes to facilitate harvesting of the sperm pellet (M). Aliquots of all samples (control, S and M) were cultured for bacterial quantification and identification using standard microbiological methods. Sperm quality was evaluated daily. Three of the C and M samples and five of the S samples did not contain any bacteria. Mean bacterial counts for the remaining samples (colony forming units/mL) were as follows: C 259 ±â€¯216; S 30 ±â€¯22; M 33 ±â€¯15 (P < 0.01). Citrobacter spp., Staphylococcus simulans, Klebsiella variicola, Escherichia coli, Myroides odoratimimus, Proteus spp. and Enterococcus faecalis were identified in the control samples. There were marginal differences in sperm quality among treatments, with sperm velocity and linearity being higher in S and M samples than in C at all time points. However, sperm viability, capacitation and acrosome status were marginally better in controls than in S or M on day 0, but these differences disappeared during storage. Conclusions: centrifugation through a low density colloid can remove or reduce bacterial contamination in boar ejaculates without using antibiotics. Furthermore, it is possible to collect boar ejaculates without bacterial contamination by paying strict attention to hygiene.

Does nutritional intervention maintain its prognostic benefit in the long term for malnourished patients hospitalised for heart failure? / ¿Mantiene la intervención nutricional en pacientes hospitalizados por insuficiencia cardiaca desnutridos su beneficio pronóstico a largo plazo?

OBJECTIVE: To assess the long-term effect of nutritional intervention on malnourished, hospitalised patients with heart failure (HF). METHODS: A total of 120 malnourished patients hospitalized for HF were randomised to undergo (or not) an individual nutritional intervention for 6 months. The primary event was the combination of all-cause death and readmission for HF. We performed an intent-to-treat analysis and assessed the effect of the intervention at 24 months. RESULTS: The combined event occurred in 47.5% of the intervention group and in 73.8% of the control group (hazard ratio: 0.45; 95% confidence interval: 0.28-0.72; P=.001). Thirty-nine percent of the intervention group and 59% of the control group died (hazard ratio: 0.53; 95% confidence interval: 0.31-0.89; P=.017). CONCLUSION: A nutritional intervention for malnourished patients hospitalised for HF maintains its prognostic benefit in the long-term follow-up.

Effect of Single Layer Centrifugation Porcicoll (70%, 80% and 90%) or supplementation with reduced glutathione, seminal plasma and bovine serum albumin on frozen-thawed boar sperm.

Selecting the optimal sperm population is essential for success with reproductive techniques. Porcicoll (formerly Androcoll-P) is a colloid formulation for selection of high-quality boar spermatozoa by single layer centrifugation (SLC). To date, most studies have been carried out with fresh semen and large volumes. We carried out 2 experiments to test the use of Porcicoll for thawed boar semen in small volumes. In Experiment 1, cryopreserved semen doses were thawed, split in 200-µL aliquots and layered on 1mL of Porcicoll 70%, 80% or 90%, or buffer without colloid. We assessed sperm recovery (the proportion of the loading dose that appeared in the pellet, %), and the physiology of the selected spermatozoa (flow cytometry: Viability, apoptotic changes, capacitation, mitochondrial activity, intracellular reactive oxygen species). The most suitable proportion was Porcicoll 80%, allowing acceptable sperm recovery (16.9±4.2%, compared to 70% (35.4%±3.0, p<0.001) and 90% (8.2%±3.0, P=0.001), and improved quality (mitochondrial activity: Porcicoll 80%: 77.7±1% vs Control: 60.3±0.7%, P<0.05). In Experiment 2, we compared 3 supplements to Porcicoll 80%: 500mM reduced glutathione (GSH), 20% seminal plasma (SP) and 0.5% bovine serum albumin (BSA). Supplementation with GSH or BSA did not cause relevant changes relative to Control. In contrast, SP induced membrane and acrosomal changes resembling capacitation, which might preclude its use in some applications, and decreased recovery (5.5%±1.9 vs. 24.3%±1.2 Control; P<0.001). However, it could be useful prior to other applications such as in vitro fertilisation. Overall, Porcicoll is an effective colloid for isolating a high-quality population from thawed boar sperm, 80% being a balanced option for good recovery and high quality. Supplements could be useful depending on the proposed use of the spermatozoa.

Evolution of the corpus luteum volume determined ultrasonographically and its relation to the plasma progesterone concentration after artificial insemination in pregnant and non-pregnant dairy cows.

The aim of this study was to assess the relationship of the evolution of the corpus luteum (CL) volume that was determined ultrasonographically with the pregnancy status in lactating dairy cows during early pregnancy. Ultrasound examinations were carried out on 76 cows following artificial insemination (AI). Plasma concentrations of progesterone were determined from blood samples collected at each ultrasound examination. Conception was confirmed by ultrasonography on day 30 after AI. Around day 14 post-insemination (p.i.), the CL volume tended to decrease in pregnant and non-pregnant cows, and, after day 19 p.i., both groups differed significantly, indicating the luteal regression in non-pregnant cows. Reaching signification on day 20. The diminution in CL volume was also reflected in the plasma progesterone concentration. However, the patterns of CL volume, estimated by ultrasonography, differed more evidently and earlier between both groups (around 1 week p.i., at day 9 p.i. P < 0.05, whereas progesterone started to differ around 2 weeks p.i., at day 14 p.i, P < 0.05). These results indicate that the estimation of the CL volume by ultrasonography could be useful for assessing the presence of a functional CL.

Influence of gonadotrophin-induced first oestrus on gilt fertility.

The aim of this study was to determine the association between the oestrous response of pre-pubertal gilts to gonadotrophin injection or boar exposure and their subsequent farrowing rate and litter size. At 154 days of age, randomly selected pre-pubertal gilts received an intramuscular injection of 400 IU equine chorionic gonadotrophin plus 200 IU human chorionic gonadotrophin (PG600(®) ; Merck Animal Health; n = 181). From the remaining pool of animals not treated with hormones, the first gilts showing signs of oestrus were selected to act as controls (n = 201). Boar exposure began at 155 days of age for both groups, and gilts were bred at a weight of approximately 130 kg. Comparisons were made between PG600(®) -treated gilts exhibiting oestrus or not within 7 days post-injection (early and late responders, respectively) and control gilts exhibiting oestrus or not within 30 days after beginning of boar exposure (select and non-select control gilts, respectively). By 162 days, oestrus was detected in 67.5% of PG600(®) -treated gilts compared with 5.7% of control gilts (p < 0.0001). The proportion of animals observed in oestrus at least three times before breeding was greater for select control gilts compared with early and late responder PG600(®) -treated gilts (p ≤ 0.001). There were no significant differences in farrowing rate and litter size between the four treatment groups. These data indicate that PG600(®) is an effective tool to induce an earlier oestrus in gilts, that subsequent farrowing rate and born alive litter size compare favourably to that of select gilts and that gilts failing to respond promptly to hormonal stimulation do not exhibit compromised fertility.

Influence of lactation length and gonadotrophins administered at weaning on fertility of primiparous sows.

The aim of this study was to determine the effect of lactation length and treatment with gonadotrophins at weaning on reproductive performance of primiparous sows. After 3 wk of lactation, primiparous sows were either weaned (W3; n=273) or received a 7-d-old foster litter for a further 14 d of suckling (W5; n=199). At final weaning (3 wk or 5 wk lactation) sows were randomly assigned to receive an injection of 400 IU equine chorionic gonadotrophin plus 200 IU human chorionic gonadotrophin (PG600(®); W3 + P; n=108 and W5 + P; n=96) or no injection (W3; n=165 and W5; n=103). Sows were inseminated at first observed estrus after final weaning and 24h later. The proportion of sows showing estrus by 6 d post-weaning was greater (P<0.01) for W3+P (86%) compared to W3 (64%), however, there was not a difference (P=0.13) for W5 + P (79.4%) compared to W5 (69.1%). There was no effect of either lactation length or gonadotrophin treatment on farrowing rates or on the proportion of sows culled before breeding. Total born litter size was smaller (P=0.05) for W3 + P (11.7 ± 0.4) compared to W3 (12.6 ± 0.3). However, sows that lactated for 35 d had larger litters than sows that lactated for 21 d regardless of gonadotrophin treatment (14 ± 0.5 and 14.5 ± 0.4 for W5+P and W5, respectively; P<0.001). These data indicate that for primiparous sows, a longer lactation improves total born litter size at their next farrowing. Gonadotrophin treatment is useful in shortening the weaning to estrus interval but subsequent total born litter size may be negatively affected.

Adaptation of the Montreal Cognitive Assessment for elderly Filipino patients.

OBJECTIVE: The Montreal Cognitive Assessment (MoCA) is an instrument that aids clinicians in detecting mild cognitive impairment and early Alzheimer's disease. The study aimed to adapt the MoCA for use in the Philippines, and determine its psychometric validity when used in the Filipino setting. METHODS: The MoCA was adapted by a multidisciplinary team working at the Memory Center of St. Luke's Medical Center, Manila, the Philippines. Contextual adaptation, rather than direct translation, was done. Pilot testing of the Filipino version of the MoCA (MoCA-P) was done on 12 grade 6 pupils and subsequently on 14 cognitively intact elderly people. Reliability testing of the MoCA-P was done on 25 elderly people by trained psychologists. Internal consistency, inter-rater and intra-rater reliability, as well as convergent and divergent validity of the MoCA-P were determined. RESULTS: The MoCA-P yielded a high level of internal consistency (Cronbach's alpha; = 0.938). Inter-rater and intra-rater reliability were 0.887 (p ≤ 0.05) and 0.969 (p ≤ 0.05), respectively. The MoCA-P correlated negatively with the Epworth Sleepiness Scale (r = -0.233) and had a positive but low correlation with the Mini-Mental State Examination (r = 0.555). CONCLUSION: Contextual translation and pilot testing yielded several modifications of the MoCA. The MoCA-P is a reliable instrument for use in elderly Filipino patients. Further diagnostic validation of the MoCA-P to establish cutoff scores that would discriminate elderly individuals with normal cognition from those with dementia is needed to establish the clinical utility of the test.

Rectal hyposensitivity for non-noxious stimuli, postprandial hypersensitivity and its correlation with symptoms in complete spinal cord injury with neurogenic bowel dysfunction.

STUDY DESIGN: Prospective clinical study. OBJECTIVES: To assess fasting and postprandial (PP) perception of rectal distension and its correlation with symptoms in patients with spinal cord injury (SCI) and neurogenic bowel dysfunction compared to ten healthy subjects (HS). SETTING: Experimental Medicine and Motility Unit, Mexico General Hospital and National Institute of Rehabilitation. METHODS: Twenty patients with complete SCI at cervical, thoracic and lumbar levels [American Spinal Injury Association (ASIA) A] were studied. Rectal sensitivity was evaluated with a barostat. RESULTS: In SCI patients, while lower the rectal tone more time was used for defecate (R=0.50, P=0.048) and more PP episodes of fecal incontinence occur (R=0.54, P=0.030). The thresholds for non-noxious stimuli of first (23.6 mmHg, CI 19.5-27.7) vs 14.0 (CI 10.9-17.1), P=0.004; gas (27.9 mmHg, CI 19.9-35.8) vs 17.9 mmHg (CI 14.25-21.69), P=0.02 and urge-to-defecate sensation (33.2 mmHg, CI 27.5-38.8) vs 22.4 mmHg (CI 17.9-26.9), P=0.01 were reported by SCI patients at higher pressure than HS, respectively. SCI patients reported PP pain sensation at a lower pressure than controls (27.8 mmHg, CI 21.5-34.2 vs 36.5 mmHg, CI 31.8-41.2), P=0.04. CONCLUSION: SCI patients preserve rectal sensation, present rectal hyposensitivity for non-noxious stimuli and PP hypersensitivity. Lower rectal tone was related to the time used for defecate and with fecal incontinence. The results suggest that an intact neural transmission between the spinal cord and higher centres is indispensable for noxious stimulus, but not for non-noxious stimuli. Also, barostat sensitivity studies can complement ASIA criteria to verify a complete injury.

Effect of gonadotropin treatment on estrus, ovulation, and litter size in weaned and anestrous sows.

In the first of 2 experiments, we evaluated the effects on anestrous sows of pretreatment with FSH to stimulate the growth of small follicles, followed by eCG to stimulate the growth of medium follicles, estrus, and ovulation. In Exp. 2, we examined the effect of sows receiving 400 IU of eCG plus 200 IU of hCG (PG 600, Intervet/Schering Plough Animal Health, Boxmeer, the Netherlands) at weaning and then different doses and timing of supplemental hCG. In Exp. 1, a total of 87 multiparous Hypor sows deemed anestrus 7 d after weaning were assigned to intramuscular (i.m.) injection of 1) PG 600, 2) eCG (600 IU), 3) pretreatment with 87.5 IU of FSH on d 7 and 8 plus eCG on d 9, or were 4) noninjected controls. Sows had daily boar contact for 15 d after weaning for estrus detection. Blood samples were obtained on d 9 and 19 and assayed for progesterone to determine ovulation status. The weaning-to-estrus interval, number of sows in estrus and ovulating, farrowing rate, and litter size were not different (P > 0.1) in treated groups compared with controls. In Exp. 2, a total of 247 Hypor sows were assigned at weaning by parity (1 and 2 or > or = 3) to receive 1) an i.m. injection of PG 600, 2) PG 600 supplemented with 100 IU of hCG injected either concurrently or after 24 h, 3) 200 IU of hCG after 24 h, or 4) no injection (controls). Sows were exposed to boars daily for 7 d. After treatment of parity 1 and 2 sows, all gonadotropin-treated groups had an increased (P < 0.05) number of sows in estrus compared with the control group; weaning-to-estrus interval, farrowing rates, and litter size were unaffected (P > 0.1). After treatment of parity > or = 3 sows, there was no treatment effect on the estrous response and weaning-to-estrus interval; compared with control and PG 600-treated sows, farrowing rate was decreased (P < 0.05) for sows receiving 200 IU of hCG after 24 h. There was no effect (P > 0.1) of treatment on litter size. We conclude that gonadotropins can be used to increase estrus response in weaned sows, but that hCG treatment subsequent to PG 600 may be detrimental to sow fertility in parity > or = 3 sows.

Thawing boar semen in the presence of seminal plasma: Effects on sperm quality and fertility.

Causes of poor fertility after insemination of frozen-thawed (FT) sperm include reduced sperm viability at thawing and a shorter longevity of surviving sperm in the female genital tract due to sub-lethal damage. The present studies examined the effect of incubating thawed boar sperm in seminal plasma (SP) on sperm membrane integrity (viability), and motility in vitro (experiment 1), and fertility in vivo (experiment 2). For experiment 1, FT sperm from five individual boars and a sperm pool from these boars were thawed and incubated for 4 h in media containing 0%, 10%, or 50% autologous seminal plasma (individual boars) or pooled seminal plasma (sperm pool). At approximately 10 min (0 h) and again at 1 h, 2 h, 3 h, and 4 h, sperm populations were examined for percentage sperm viability and percent sperm motility. Each variable progressively decreased during the incubation period. Incubation in 50% SP increased percentages of live sperm (P < 0.0001) and percent sperm motility (P < 0.01) at all time points compared to incubation in either 0% or 10% SP. For experiment 2, multiparous Large white x Landrace sows (n = 82) each received 900 IU eCG at weaning and 750 IU hCG 80 h later to control time of ovulation. Sows were assigned on the basis of parity to be inseminated with pooled semen with or without SP from the boars used in experiment 1. Sows received 3 x 10(9) live fresh-extended sperm (n = 30) or FT sperm thawed in 80 mL BTS extender (n = 26) or 3 x 10(9) live FT sperm thawed in 80 mL BTS containing 50% SP (FT-SP; n = 26). Sows were inseminated at 36 h, and 42 h after hCG injection. Compared to sows receiving fresh semen, the pregnancy rate of FT inseminated sows tended (P = 0.06) to be lower with the FT-SP group being intermediate. Farrowing rates were not different (83.3%, 69.2%, and 65.4% for fresh, FT, and FT-SP, respectively). Inseminations with FT sperm were associated with a reduction in litter size (P < 0.05), which was not evident in the FT-SP group. Taken together, these data confirm an adverse effect of inseminating FT sperm on sperm quality and sow fertility but suggest that thawing FT sperm in 50% SP may partially alleviate these adverse effects.

Effect of hCG on early luteal serum progesterone concentrations in PG600-treated gilts.

Gilt oestrus and ovulation responses to injection of a combination of equine chorionic gonadotrophin (eCG) and human chorionic gonadotrophin (hCG) (PG600) can be unpredictable, possibly reflecting inadequate circulating LH activity. The objective of this study was to determine the effect of PG600 followed by supplemental hCG on gilt ovarian responses. In experiment 1, 212 Hypor gilts (160 day of age) housed on two farms in Spain received intramuscular (i.m.) injections of PG600 (n = 47), or PG600 with an additional 200 IU hCG injected either concurrently (hCG-0; n = 39), or at 24 h (hCG-24; n = 41) or 48 h (hCG-48; n = 45) after PG600. A further 40 gilts served as non-injected controls. Ovulation responses were determined on the basis of initial blood progesterone concentrations being <1 ng/ml and achieving >5 ng / ml 10 d after the PG600 injection. The incidence of ovulating gilts having progesterone concentrations >30 ng/ml were recorded. During the study period, 10% of control gilts ovulated whereas 85-100% of hormone-treated gilts ovulated. There were no significant differences among hormone groups for proportions of gilts ovulating. The proportions of gilts having circulating progesterone concentrations >30 ng/ml were increased (p < or = 0.02) in all hCG treated groups compared with the PG600 group. In experiment 2, a total of 76 Hypor gilts at either 150 or 200 days of age were injected with PG600 (n = 18), 400 IU eCG followed by 200 IU hCG 24 h later (n = 20), PG600 followed by 100 IU hCG 24 h later (n = 17), or 400 IU eCG followed by 300 IU hCG 24 h later (n = 21). Blood samples were obtained 10 days later for progesterone assay. There were no effects of treatment or age on incidence of ovulation, but fewer 150-day-old gilts treated with PG600 or 400 IU eCG followed by 200 IU hCG had progesterone concentrations >30 ng / ml. We conclude that hCG treatment subsequent to PG600 treatment will generate a higher circulating progesterone concentration, although the effect is not evident in older, presumably peripubertal, gilts. The mechanism involved and implications for fertility remain to be determined.

Effect of eCG or eCG Plus hCG on oestrus expression and ovulation in prepubertal gilts.

To meet weekly breeding targets, it is occasionally necessary to inject exogenous gonadotrophins to induce oestrus in prepubertal gilts. However, the gilt oestrus response to equine chorionic gonadotrophin (eCG) either alone or in combination with human chorionic gonadotrophin (hCG) can be unpredictable. The objective of the present study was to examine possible reasons for this unpredictability. Prepubertal gilts (90 kg and 153 days of age, n = 109) received an injection of either 600 IU eCG or a combination of 400 IU eCG and 200 IU hCG (PG600), or were non-injected controls, and were then exposed to a mature boar for 15 min daily for 7 days for oestrus detection. At the time of injection, real-time ultrasound revealed that the gilt ovaries had primarily 1-2 mm follicles. Blood samples were obtained at time of hormone injection (day 0) and at days 3, 7 and 10 for assay of serum progesterone concentrations. The oestrus responses by 7 days were 15.5%, 73.3% and 0%, for eCG, PG600, and control gilts, respectively (p < 0.001). The oestrus response improved (p < 0.05) with increasing body weight. Based on circulating progesterone levels, all oestrous gilts ovulated except for four of the PG600 gilts. Failure to express oestrus in PG600 gilts was not associated with a premature rise in progesterone.

Effect of hCG treatment on the oestrous and ovulation responses to FSH in prepubertal gilts.

To ensure sufficient numbers of pregnant females, particularly at hotter times of the year, hormonal induction of gilt oestrus may be necessary. However, the gilt oestrus and ovulation responses to gonadotrophin treatment have often proven unpredictable. The objective of this study was to examine possible reasons for this unpredictability. Prepubertal gilts (approximately 150 days of age, n = 63) were assigned to one of three treatments: injection of 300 IU hCG (n = 15); pre-treatment with 100 mg FSH in polyvinylpyrrolidinone administered as 2 x 50 mg injections 24 h apart, followed by 600 IU eCG at 24 h after the second FSH injection (n = 23); or FSH pre-treatment as above followed by 300 IU hCG at 24 h after the second FSH injection (n = 25). To facilitate oestrus detection, gilts were exposed to a mature boar for 15 min daily for 7 days. Blood samples were obtained on the day of eCG or hCG injection and again 10 days later and gilt ovulation responses determined based on elevated progesterone concentrations. The oestrus responses by 7 days were 6.7%, 17.5% and 64.0% for gilts treated with hCG, FSH + eCG and FSH + hCG, respectively (p < 0.001). The oestrous gilt receiving hCG alone and one oestrous FSH + hCG gilt did not ovulate, all other oestrous gilts ovulated. A further two anoestrous FSH + eCG-treated gilts ovulated. These data suggest that FSH pre-treatment facilitated the development of ovarian follicles to the point where they became responsive to hCG, but had little effect on the response to eCG.

Effect of prior FSH treatment on the estrus and ovulation responses to eCG in prepubertal gilts.

The objective of this study was to determine the effect of pre-treatment of prepubertal gilts with FSH on the estrus and ovulatory responses to eCG injection at two ages. A total of 149 prepubertal Hypor gilts were selected at 150 days (n=76) or 180 days (n=73) of age and assigned to injection of 400 IU eCG plus 200 IU hCG (PG600), 600IU eCG alone (Folligon), pre-treatment with 72 mg FSH (Folltropin) administered as 6 x 12 mg injections at 12 h intervals with 600 IU Folligon 12h after last FSH injection, or non-injected controls. To facilitate detection of estrus, gilts were exposed to a mature boar for 15 min daily for 7 days. To determine ovulatory responses, blood samples were obtained on the day of injection and 10 days later and assayed for progesterone content. Following treatment at 150 days, one control gilt (5.3%) was deemed estrus but ovulation did not occur. Compared to treatment with Folligon alone, PG600 injection tended (P=0.1) to increase the estrus response (52.6% compared with. 26.3%) and increased (P<0.01) the ovulatory response (89.5% compared with. 47.4%). The estrous response in gilts pretreated with Folltropin was intermediate (42.1%) but the ovulatory response (47.4%) was the same as for Folligon alone. Following treatment at 180 days, two control gilts (10.5%) were deemed estrus and ovulation did occur in these gilts. There was no difference between hormone-treated groups for estrus or ovulatory responses, although the ovulatory response of PG600-treated gilts tended (P=0.1) to be greater than for the Folligon-treated group (89.5% compared with 66.7%), with Folltropin-pretreated gilts being intermediate (76.5%). These data demonstrate that the estrus and ovulatory responses of gilts were greater for PG600 than for Folligon and that while responses to PG600 were not affected by gilt age, for the combined Folligon groups, estrous response (P<0.02) and ovulatory response (P<0.05) improved with increased gilt age.

Contribución al estudio de la contractilidad del suelo pélvico / Contribution to the pelvic floor contractility analysis

Objetivo. Realizar un estudio instrumental tonimétrico de la contractilidad del suelo pélvico (elemento que creemos podría ser necesario en el mantenimiento de sus funciones fisiológicas normales) y su correlación con distintos parámetros. Material y método. Cumplimentación de un cuestionario y realización de un examen ginecológico que incluye una tonimetría perineal para la recogida de las variables del estudio. Comparación estadística de la fuerza muscular entre dos poblaciones similares, con la única diferencia de que una de ellas se encontraba en posparto inmediato. Además, se trató de correlacionar este parámetro con distintas variables: edad, índice de masa corporal (IMC), práctica deportiva y distintos factores ginecoobstétricos. Resultados. La media de la fuerza muscular en ambos grupos es similar y se sitúa por encima de la media de referencia. Por el contrario, no es suficiente para realizar un correcto bloqueo perineal al esfuerzo (sobre todo en la población en posparto inmediato). No existe correlación entre las variables estudiadas y la fuerza muscular del suelo pélvico en ninguna de las dos poblaciones. Conclusiones. El parto no está relacionado, en modo alguno, con la fuerza de contracción del suelo pélvico, y se muestra como un parámetro totalmente independiente. Este hecho, unido a la imposibilidad de buena parte de la población (incluso joven y asintomática) de realizar un correcto bloqueo perineal, nos lleva a afirmar que no tiene ningún sentido realizar en el posparto la tan extendida reeducación del suelo pélvico basada, prioritariamente o de forma exclusiva, en la mejora de la fuerza muscular del mismo

Aim. To perform an instrumental study (tonimetric test) of the pelvic floor contractility (element that we consider may be necessary for the maintenance of its normal physiological functions) and its correlation with different parameters. Material and method. To fill out a questionnaire together with a gynecological examination that includes a perineal tonimetric test in order to collect the study variables. Statistical comparison of muscular strength in two similar patient groups, with the only difference that one of them is composed of women in immediate postpartum period. In addition, a correlation was performed between this parameter and some different variables such as body mass index (BMI), sports activity and several gynecological factors. Results. Mean muscular strength in both patient groups is similar and above the mean reference. Nevertheless, it is not high enough to achieve correct perineal blockage with stress (especially among patients in immediate postpartum period). There is no correlation between any of the variables studied and pelvic floor muscular strength in either of the patient groups. Conclusions. Partum and strength of contraction of pelvic floor are not related in any case and must be considered as totally independent variables. This fact, together with the impossibility for the majority of the population (even for young and asymptomatic individuals) to perform correct perineal blockage, has led us to conclude that there is no reason to use the so extended practice of pelvic floor re-education as a priority treatment or exclusive one for muscular strength enhancement during the postpartum period

Effect of cloprostenol treatment at artificial insemination on sow fertility.

In two experiments, we examined the effect of administration of cloprostenol at artificial insemination on fertility of multiparous sows. Lactation length was 21 days and only sows exhibiting estrus by 7 days after weaning were included. Cloprostenol was administered by IM injection (175 microg; n=126) or supplemented in the semen dose (525 microg; n=129). Control sows (n=130) received no hormone. In either experiment, there was no effect of any treatment on subsequent litter sizes. In experiment 1, there was no effect of treatment on farrowing rate, but in experiment 2, farrowing rate was higher (p < 0.05) in sows receiving cloprostenol by injection. Taken together, these results indicate no consistent effect of cloprostenol administration by intramuscular injection or by inclusion in the semen dose on sow fertility and so its routine use is not warranted.

[Differential characteristics of primary acute pericarditis and severe pericardial effusion without tamponade]. / Características diferenciales de las pericarditis agudas primarias con derrame pericárdico severo sin taponamiento.

The aim or our study was to evaluate the main clinical and etiological features or primary acute pericarditis with severe pericardial effusion without cardiac tamponade. Our experience included 35 patients with this problem diagnosed in the last 5 years. Patients with a previous potential etiology for acute pericarditis were excluded. The diagnostic protocol identified a specific etiology in 20% of patients, the most frequent being idiopathic forms. Patients with severe pericardial effusion without cardiac tamponade who had a favourable clinical outcome on nonsteroidal antiinflammatory drugs therapy presented a lower proportion of specific etiology than those with a poor response to this therapy (8% versus 45%; p = 0.03). An exhaustive etiological investigation, including diagnostic pericardiocentesis should be reserved for these patients with unfavourable response to antiinflammatory drug therapy.