Supplementation of protease to low amino acid diets containing superdose level of phytase for wean-to-finish pigs: effects on performance, postweaning intestinal health and carcass characteristics.

This experiment investigated the effects of protease supplementation to low amino acid (AA) diets containing phytase on pig growth performance, postweaning intestinal health and carcass characteristics. A total of 936 weaned pigs (21 d of age, initial BW 5.87 ± 0.31 kg) were used in a 2 × 2 factorial design comparing the main effects of AA supply [standard feeding program: balanced for all nutrients with adjustment of Ca and P due to inclusion of phytase (2,500 FTU/kg in Phase 1 to 4; 500 FTU/kg in Phase 5 to 9) vs. low AA feeding program: 15% lower standardized ileal digestible lysine with relative reduction of all other essential AA] and protease level (0 vs. 0.0125%). Pens were assigned to dietary treatment according to a randomized complete block design with 26 pigs per pen and nine replicates per dietary treatment. Feed and water were provided on an ad libitum basis for all phases throughout the wean-to-finish period. Feed intake and body weight were determined every 2 wk during nursery period and monthly in the grow-finish period. Intestinal health in the first 17 d was assessed based on lactulose:mannitol ratio (L:M), serum IgA, and pen diarrhea assessment. Overall, pigs fed standard wean-to-finish diets had greater (P < 0.05) ADG and G:F than pigs fed low AA diets. Pig growth performance was not different throughout the wean-to-finish period with or without protease supplementation and with no interaction between AA supply and protease supplementation. There were no differences among dietary treatments for carcass characteristics. No difference was observed for urinary L:M and serum IgA; however, the L:M ratio was approximately 32% lower in pigs fed low AA diets + protease compared with pigs fed standard and low AA diets at d 5 and d 17 postweaning. Pigs fed protease supplemented diets had lower incidence of diarrhea (χ 2 < 0.05) compared with pigs fed diets without protease. Results of the experiment indicate that dietary protease supplementation benefits intestinal health of nursery pigs.

Swine foetal myogenesis in different gestation periods.

This experiment was conducted to evaluate the effects of sex and uterus position on swine foetal myogenesis at different gestational ages. Fifteen primiparous sows were divided into three groups according to gestational age: 50, 80, and 106 days. The experiment was a block randomized factorial design with two sexes (male and female) and three uterine regions (apex, middle, and base). After slaughter, each uterus horn was divided into three segments of equal length: apex region near the ovary; base region near the uterine body; and the middle region, lying between the apex and base regions. The foetuses were weighed, identified, and longitudinally opened to harvest the semitendinosus muscle for later morphological analysis. After 50 days of pregnancy, male foetuses had greater (p < .05) weight than females. The number of primary fibres at 50 days of gestation was negatively correlated (r = -.29, p = .04) with the number of foetuses in utero. After 80 days, foetuses in the base region had less (p < .05) secondary area of muscle fibres compared to the apex region, which was accompanied by differences in the weight of the foetuses, the lowest weight were for foetuses located in the base region (p < .05). In the same period, the ratio of secondary to primary fibres had a positive correlation with weight. In conclusion, sex did not influence myogenesis in the gestational ages studied and the development of secondary muscle fibres of the foetuses at 80 days of gestation was affected by their uterine position with foetuses at the base of the uterine horn being less developed.

Arginine for gestating sows and foetal development: A systematic review.

The use of functional amino acids during pregnancy has been linked to improved reproduction in mammals. In this context, arginine is a precursor in the synthesis of numerous molecules, such as nitric oxide and polyamines, which play an important role during reproduction. However, contradictory studies are found in the literature, particularly regarding the amount of supplementation and the period of pregnancy in which it is used. The objective of this study was to evaluate the effects of dietary arginine supplementation for pregnant sows on foetal development via a systematic review. The search for papers was performed during the month of December 2015, in the databases ISI Web of Science, Science Direct, Scopus, and SciELO. From a total of 5675 returned studies, only 13 papers were selected after applying selection criteria. Most (47%) of the studies that evaluated the effects of dietary arginine supplementation on foetal development in pigs used 1% arginine. Supplementation was initiated in the first third of pregnancy in 47% of tests, including in both primiparous and multiparous sows. These studies showed positive results for embryo survival and foetal development, evidenced by the increase in placental weight and the number and weight of piglets born alive. Of all evaluated studies, 53% showed benefits on foetal development. It is concluded that supplementing dietary arginine in gestating sows can benefit embryo survival and foetal development. However, to establish a supplementation plan with this amino acid, aspects related to the period of pregnancy, supplementation levels, and source of arginine must be well defined.

Comparison of the epidemiological behavior of mastitis pathogens by applying time-series analysis in results of milk samples submitted for microbiological examination.

The objective of this study is to examine and compare the trends of mastitis pathogens in quarter milk samples (n = 240,232) submitted for microbiological examination at the Milk Analysis Laboratory (L.I.G.A.L.) at Galicia, Spain from June 2005 to September 2011. Autoregressive Integrated Moving Average (ARIMA) models and multivariate statistical techniques such as Cluster Analysis were used in order to detect seasonal trends and similarities between the series trends and to classify mastitis pathogens into relatively homogeneous groups. The decrease of bulk milk somatic cell counts achieved by the mastitis control program, developed in recent years in this region, is the result of the decrease in IMI caused by a limited number of mastitis pathogens. The obtained results reflect a greater complexity in the behavior of mastitis pathogens, unlike the traditional classification into contagious or environmental. Staphylococcus aureus showed a trend similar to Streptococcus dysgalactiae, a mastitis pathogen can behave in both a contagious and an environmental manner. Among the traditionally considered environmental mastitis pathogens, Strep. uberis showed a different behavior to Escherichia coli and Klebsiella pneumoniae. Coagulase-negative staphylococci (CNS) species and Streptococcus other than Strep. agalactiae showed differences in the trend model. Time-series analysis and multivariate statistical techniques, such as Cluster Analysis, could be powerful tools to assess the isolation trend of mastitis pathogens because of their ability to cope with stochastic dependence of consecutive data. Furthermore, they could be used to identify the epidemiological behavior of mastitis pathogens using the results of milk samples submitted for routine microbiological examination, by classifying them into relatively homogeneous groups.

Lisis espinal por aneurisma de aorta abdominal con rotura crónica / Spinal lysis due to abdominal aortic aneurysm with chronic rupture

Introducción. La evolución clínica en forma de rotura crónica contenida es poco frecuente en los aneurismas de aorta abdominal. Caso clínico. Se exponen la sintomatología clínica y los datos diagnósticos y operatorios en un varón de 56 años con aneurisma de arteria aorta abdominal con rotura crónica cuya característica clínica principal ha sido la lesión espinal extensa

Introduction. The clinical course of abdominal aortic aneurysms rarely takes the form of a chronic contained rupture. Case report. We report the clinical signs and symptoms and the diagnostic and operative data of a 56-year-old male patient with an abdominal aortic aneurysm with chronic rupture, the main clinical feature of which was extensive spinal involvement

[Life-style in eating behavior disorders]. / Estilo de vida en trastornos de conducta alimentaria.

GOAL: To identify the eating habits and lifestyles of patients with eating behaviour disorders (TCA in its Spanish acronym) who attended our out-patients' clinic at the "La Paz" Teaching Hospital for the first time. METHOD: A questionnaire was drafted to which patients responded freely and anthropometric data were assessed. RESULTS: The sample comprised 94 patients who were subsequently distributed into two groups: the first group contained 43 offspring of working mothers (HMTF) and the second 46 offspring of mothers who did not work outside the home (HMNTF in its Spanish acronym). In the case of the 5 remaining patients, their mothers had deceased. The results from the group as a whole showed the following lifestyles for Monday-Friday: 34.4% eat alone, 72% watch television while they eat and 68.1% use restrictive behaviour in their eating habits. When assessing the existence of a friend with TCA, the results were significantly higher among those under the age of 20 years (53.7%) versus those older than 20 (26.9%) (p < 0.05). No differences were found in the habits and nutritional status of HMTF and HMNTF since 8.2% of the first had severe caloric malnutrition versus 2.3% in the second group. While 12.2% of the HMTF group eat outside the home on weekdays and 44.9% of them eat alone, 20.5% of the HMNTF group eat outside the home on weekdays and 22.7% of them eat alone. The age of onset of TCA was significantly earlier among the HMTF group (16.6 years) than in the HMNTF group (19.0 years) (p < 0.05). CONCLUSION: A large number of subjects had a friend with TCA in their close environment and this situation was more frequent among the youngest ones in the group. Some mistaken ideas regarding food have favoured unhealthy eating: in our group a large majority of people eat while watching TV. The development of TCA occurs earlier in connection with a particular family structure: where the mother works outside the home.

Estilo de vida en trastornos de conducta alimentaria / Lifestyle in eating behaviour disorders

Objetivo: Conocer las prácticas alimentarias y hábitos de vida en los pacientes con trastornos del comportamiento alimentario (TCA) que acudieron como primera vez a nuestra consulta externa del Hospital Universitario de La Paz. Método: Se elaboró un cuestionario que los pacientes respondían libremente y una valoración de datos antropométricos. Resultados: La muestra la constituían 94 pacientes que posteriormente fueron divididos en dos grupos: un primer grupo compuesto por 43 hijos de madres que trabajaban fuera del hogar (HMTF) y 46 hijos de madres que no trabajan fuera (HMNTF). En los 5 pacientes restantes sus madres habían fallecido. Como resultado del grupo total obtenemos en los hábitos de vida en días laborables: un 34,4 por ciento comen solas, un 72 por ciento ven la televisión (TV) mientras comen y un 68,1 por ciento utilizan conductas restrictivas en su alimentación. Al valorar la existencia de algún amigo/a con TCA, resultó significativamente mayor entre los más jóvenes 20 años (26,9 por ciento) (p<0,005). No encontramos diferencias en los hábitos y estado nutricional de las HMTF e HMNTF: dado que en el primer grupo un 8,2 por ciento tienen malnutrición calórica severa frente al 2,3 por ciento del segundo grupo. Mientras que un 12,2 por ciento de HMTF comen fuera de casa en los días laborables y un 44,9 por ciento lo hacen en soledad, un 20,5 por ciento del grupo HMNTF comen fuera de sus casas y 22,7 por ciento comen solas. La edad de inicio del TCA fue significativamente más precoz entre HMTF (16,6 años) frente a HMNTF (19,0 años) (p<0,05). Conclusión: Un elevado número de pacientes tiene en su entorno algún amigo con TCA y son los más jóvenes de edad, en las que esta situación es más frecuente. Algunas actitudes erróneas frente a la comida favorecen un comportamiento alimentario insano: en nuestro grupo una gran mayoría come viendo la televisión. El desarrollo del TCA es más precoz en relación con una estructura familiar determinada; que la madre trabaje fuera de casa (AU)

Goal: To identify the eating habits and lifestyles of patients with eating behaviour disorders (TCA in its Spanish acronym) who attended our out-patients’ clinic at the “La Paz” Teaching Hospital for the first time. Method: A questionnaire was drafted to which patients responded freely and anthropometric data were assessed. Results: The sample comprised 94 patients who were subsequently distributed into two groups: the first group contained 43 offspring of working mothers (HMTF) and the second 46 offspring of mothers who did not work outside the home (HMNTF in its Spanish acronym). In the case of the 5 remaining patients, their mothers had deceased. The results from the group as a whole showed the following lifestyles for Monday-Friday: 34.4% eat alone, 72% watch television while they eat and 68.1% use restrictive behaviour in their eating habits. When assessing the existence of a friend with TCA, the results were significantly higher among those under the age of 20 years (53.7%) versus those older than 20 (26.9%) (p < 0.05). No differences were found in the habits and nutritional status of HMTF and HMNTF since 8.2% of the first had severe caloric malnutrition versus 2.3% in the second group. While 12.2% of the HMTF group eat outside the home on weekdays and 44.9% of them eat alone, 20.5% of the HMNTF group eat outside the home on weekdays and 22.7% of them eat alone. The age of onset of TCA was significantly earlier among the HMTF group (16.6 years) than in the HMNTF group (19.0 years) (p < 0.05). Conclusion: A large number of subjects had a friend with TCA in their close environment and this situation was more frequent among the youngest ones in the group. Some mistaken ideas regarding food have favoured unhealthy eating: in our group a large majority of people eat while watching TV. The development of TCA occurs earlier in connection with a particular family structure: where the mother works outside the home (AU)

[Caudal regression syndrome]. / Síndrome de regresión caudal.

INTRODUCTION: The regression caudal syndrome includes a spectrum of malformations which vary from the symptomless coccygeal agenesis until thoracic vertebrae and sacrococcygeal agenesis with severe neurological deficit; it is associated sometimes with malformations in other organs and systems. We present a case of partial agenesis of sacro and coccix with neuromuscular, sphincter and orthopedist alterations. CLINICAL CASE: A 4-year-old patient consults because of walk alterations, with daytime and nocturnal enuresis and urinary incontinence, constipation/encopresis and rectal prolapse. Familiar and personnel precedents are uninteresting. She began to walk at normal age, referring only rectal prolapse with constipation from nursing and urinary tract infections and encopresis when she was 3 years old, with normal complementary explorations (digestive and nephrourologyc). She presents in lumbosacral X-rays four lumbar vertebrae, a dysplasic sacro and absence of coccix. Hypoplasy of sacro with bilateral stenosis of the pelvis and coxa vara in both femurs are seen in the lumbar CT. In RMI is observed agenesis of sacro and coccix vertebrae. CONCLUSIONS: There are a wide variety of sacrococcygeal agenesis, which are classified by Renshaw and modified by Pang. As etiologics factors we find the gestational diabetes, in addition to genetic factors. The clinic exploration guides us toward a flaccid paraparesia/areflexia, with orthopaedist alterations, sometimes of artrogripotyc type. With image techniques (X-rays, CT, MRI) we can accomplish the diagnosis and we can discard or demonstrate associated medullary anomalies. We concluded that in all patient with alterations of walk and/or lack of sphincters control we should explore the lumbosacral region searching for medulodiysplasic or vertebral alterations.

Anaesthetic implications of Cornelia de Lange syndrome.

Cornelia de Lange syndrome is a congenital disease characterized basically by psychomotor retardation associated with a series of malformations (mainly skeletal craniofacial deformities together with gastrointestinal and cardiac malformations). We present the case of a patient who underwent trauma surgery, discuss the anaesthetic problems involved and their relationship to the malformations that constitute this syndrome.

[Efficacy of the EMLA cream in the reduction of pain caused by venipuncture in children premedicated with oral midazolam]. / Eficacia de la crema EMLA en la disminución del dolor a la venopunción en niños premedicados con midazolam oral.

OBJECTIVE: EMLA cream, a lidocaine-prilocaine mixture, penetrates skin easily. Our aim was to compare EMLA and placebo to assess the efficacy of EMLA in decreasing the pain of venipuncture in children premedicated with oral midazolam 0.5 mg/kg. PATIENTS AND METHODS: This was a prospective study enrolling 100 children 3 to 9 years of age (5.6 +/- 2) randomly distributed in 2 groups of 50. EMLA cream was applied in group 1 while placebo was applied in group 2 (control group). All were premedicated with oral midazolam. Either EMLA or placebo was applied at least 30 minutes before transfer to the operating theater and the area was covered with a transparent dressing. Parameters recorded upon arrival in the operating room and upon hand puncture with a 22-G needle were systolic and diastolic arterial pressures (SAP and DAP) and heart rate (HR). Pain was assessed on a behavior scale, a visual analog scale evaluated by the anesthesiologist (VAS-anesthesiologist) and a VAS evaluated by a nurse (VAS-nurse). Adverse events were also recorded. A Student t-test and a Mann-Whitney U-test were used for statistical analysis; the level of significance was p < 0.05. RESULTS: There were no significant differences in mean age or weight between the 2 groups. In the area EMLA was applied, 2 children presented erythema and 2 pruritus. Mean scores on the pain scales were lower in the EMLA group (p < 0.05) than in the control group: behavior scale 1.8 +/- 1.3 versus 3.2 +/- 1.7; VAS-anesthesiologist 2.8 +/- 2.3 versus 5.1 +/- 2.7; VAS-nurse 2.7 +/- 2.1 versus 5.9 +/- 1.9. HR increased in both groups (with placebo from 105 +/- 16 to 118 +/- 19, and with EMLA from 99 +/- 19 to 109 +/- 21), but the increase in SAP was statistically significant only in the placebo group, in which it rose from 113 +/- 11 to 125 +/- 16. CONCLUSION: EMLA cream decreases the pain of hand venipuncture in children premedicated with oral midazolam.

[Pseudomembranous colitis complicated with toxic megacolon. Report of a case]. / Colitis seudomembranosa complicada con un megacolon tóxico. A propósito de un caso.

We present a patient who developed pseudomembranous colitis a few days after suffering serious multiple traumas and after receiving a variety of antibiotic treatments. The patient, whose condition was further complicated by toxic megacolon, underwent subtotal colectomy and ileostomy. Toxic megacolon is a rare complication of enterocolitis due to C. difficile and is associated with a high rate of mortality. We review the cases published to date, describe the pathogenesis of the condition, and discuss the diagnostic criteria for pseudomembranous colitis, emphasizing treatment and possible complications.

[ 2 cases of tension pneumopericardium after unilateral lung transplantation]. / Dos casos de neumopericardio a tensión tras trasplante pulmonar unilateral.

We present 2 patients who developed tension pneumopericardium after undergoing unilateral lung transplantation, describing their clinical evolution after surgery until the diagnosis of tension pneumopericardium. In both cases aspiration of air from the pericardium resulted in improved hemodynamic status. Tension pneumopericardium is rare in adults. Our patients were at high risk due to the difficulty of ventilating native and implanted lungs with different compliances. Moreover, the passage of air from the mediastinum to the pericardium is facilitated by the large opening made in order to dissect the pulmonary veins.