Effect of Two Nutritional Strategies to Balance Energy and Protein Supply in Fattening Heifers on Performance, Ruminal Metabolism, and Carcass Characteristics.

Latin America is an important contributor to the worldwide beef business, but in general, there are limited studies considering strategies to reduce nitrogen contamination in their production systems. The study's goal was to assess the effect of two nutritional strategies to balance energy and protein supply in fattening heifers on performance, ruminal metabolism, and carcass characteristics. A total of 24 crossbred heifers (initial body weight 'BW 'of 372 ± 36 kg) were used to create two blocks (based on live weight) of two pens each, that were equipped with individual feeders. Within each block, half of the animals were assigned to a diet based on tabular Crude Protein (CP) requirements denominated Crude Protein Diet 'CPD' but without a ruminal degradable protein balance. The other half received a diet denominated Metabolizable Protein Diet 'MPD', formulated with the metabolizable protein system, balanced for the ruminal degradable protein. Both diets had the same ingredients and as well as similar synchrony indexes (0.80 and 0.83, respectively). For nitrogen concentration in feces and urine as well as microbial crude protein synthesis, a total of 12 heifers (three per pen) were randomly selected to collect samples. The dataset was analyzed as a randomized complete block design with a 5% significance. No diet × time interaction was observed for Average Daily Gain 'ADG' (p = 0.89), but there was an effect of the time on ADG (p ≤ 0.001). No differences were observed neither for final weight, dry matter intake 'DMI', and feed conversion rate (p > 0.05). Heifers fed with CPD showed greater cold carcass weight (p = 0.041), but without differences in ribeye area, backfat thickness, pH, dressing %, and marbling (p > 0.05). Differences between diets were observed for the in vitro parameters as well as for the Total Volatile Fatty Acids 'VFA' and NH3 (p < 0.05). Total N concentrations (urine + feces) of heifers fed with MDP was lower than in those fed with the CPD (p < 0.01), but no differences were observed in microbial protein, purine derivatives, and creatinine (p > 0.05). We conclude that the combination of synchrony and the metabolizable protein system achieve greater efficiency in the use of nitrogen, without negatively affecting animals' performance or the quality of the carcass.

[Cerebrotendinous xanthomatosis. Report of one case]. / Xantomatosis cerebrotendinosa sin xantomas tendíneos. Caso clínico.

Cerebrotendinous xanthomatosis (CTX) is an uncommon autosomal recessive disease caused by deficiency of 27-sterol-hydroxylase that results in an accumulation of cholestanol in the central nervous system, eyes, tendons, and blood vessels. We report a 22-year-old woman with a history of cataract surgery at the age of 14, cholecystectomy due to cholelithiasis at the age of 17 and chronic diarrhea, who presented with a six months period of gait instability and frequent falls. Physical examination revealed a bilateral pyramidal and cerebellar syndrome, with no visible tendon xanthomas. Cerebral magnetic resonance imaging showed an increase of the signal intensity on the T2-weighted images in periventricular cerebral white matter, dentate nuclei and spinal cord. With a high suspicion of CXT, a genetic study was conducted identifying a pathogenic variant in the CYP27A1 gene. There is considerable variation in clinical characteristics and age of onset of this disease, including absence of tendon xanthomas, delaying the diagnosis. Early recognition and chronic chenodeoxycholic acid therapy can improve outcome and quality of life.

[Stiff-person syndrome mistaken for conversive disorder: a common error]. / Síndrome de persona rígida confundido por trastorno conversivo: un error común. Caso clínico.

Stiff-person syndrome is characterized by persistent muscle spasms, involving agonist and antagonist muscles simultaneously, starting in the lower limbs and trunk. It tends to occur in the fourth to sixth decade of life, presenting with intermittent spasms that later become continuous and usually painful. Minor sensory stimuli, such as noise or light touch, precipitate severe spasms. Spasms do not occur during sleep and only rarely involve cranial muscles. We present a case that for two years was diagnosed and treated as a conversion disorder associated with depression. After two years she was admitted to another hospital with an unmistakable picture of stiff-person syndrome with hypertrophy and rigidity of lower limb muscles, compatible electrophysiology and positive anti-GAD antibodies. She had autoimmune hypothyroidism, that should have raised the suspicion of stiff-person syndrome earlier. She responded to intravenous immunoglobulin and mycophenolate mofetil and and to tranquilizers that have muscle relaxant properties.

Síndrome de persona rígida confundido por trastorno conversivo: un error común. caso clínico / Stiff-person syndrome mistaken for conversive disorder: a common error

Stiff-person syndrome is characterized by persistent muscle spasms, involving agonist and antagonist muscles simultaneously, starting in the lower limbs and trunk. It tends to occur in the fourth to sixth decade of life, presenting with intermittent spasms that later become continuous and usually painful. Minor sensory stimuli, such as noise or light touch, precipitate severe spasms. Spasms do not occur during sleep and only rarely involve cranial muscles. We present a case that for two years was diagnosed and treated as a conversion disorder associated with depression. After two years she was admitted to another hospital with an unmistakable picture of stiff-person syndrome with hypertrophy and rigidity of lower limb muscles, compatible electrophysiology and positive anti-GAD antibodies. She had autoimmune hypothyroidism, that should have raised the suspicion of stiff-person syndrome earlier. She responded to intravenous immunoglobulin and mycophenolate mofetil and and to tranquilizers that have muscle relaxant properties.

Xantomatosis cerebrotendinosa sin xantomas tendíneos: caso clínico / Cerebrotendinous xanthomatosis: report of one case

Cerebrotendinous xanthomatosis (CTX) is an uncommon autosomal recessive disease caused by deficiency of 27-sterol-hydroxylase that results in an accumulation of cholestanol in the central nervous system, eyes, tendons, and blood vessels. We report a 22-year-old woman with a history of cataract surgery at the age of 14, cholecystectomy due to cholelithiasis at the age of 17 and chronic diarrhea, who presented with a six months period of gait instability and frequent falls. Physical examination revealed a bilateral pyramidal and cerebellar syndrome, with no visible tendon xanthomas. Cerebral magnetic resonance imaging showed an increase of the signal intensity on the T2-weighted images in periventricular cerebral white matter, dentate nuclei and spinal cord. With a high suspicion of CXT, a genetic study was conducted identifying a pathogenic variant in the CYP27A1 gene. There is considerable variation in clinical characteristics and age of onset of this disease, including absence of tendon xanthomas, delaying the diagnosis. Early recognition and chronic chenodeoxycholic acid therapy can improve outcome and quality of life.

BNP predicts mortality of cardiovascular disease in patients with end-stage renal disease treated / BNP predictor de mortalidad cardiovascular en pacientes con enfermedad renal crónica terminal

BACKGROUND: Mortality for cardiovascular disease (CVD) in patients with chronic kidney disease (CKD) is higher. In the end-stage renal disease (ESRD) the mortality is 20 times greater in comparison with general population. Natriuretic peptides, particularly type-B natriuretic peptide (BNP) have been studied as potential markers of risk of cardiovascular (CV) mortality. The aim of this paper is to determine whether BNP acts as a prognostic marker for CV mortality in patients with ESRD. METHODS: We studied 53 patients with ESRD prevalent in peritoneal dialysis without clinical evidence of heart failure at baseline was studied. The impact of variables was performed with linear regression model. The probability of survival was estimated by Kaplan-Meir analysis and the difference between survivals between groups with log-rank test according the levels of BNP. Adjusted hazard ratios were calculated with Cox proportional hazards analysis. RESULTS: BNP strongly predicts CVD mortality. The Cox regression model showed that BNP is a predictor of death from CVD. Patients with high levels of BNP were at increased risk of death. Several pathophysiological mechanisms not well defined are involved. CONCLUSIONS: BNP predicts CVD mortality in patients with ESRD. Serum measurement of this peptide can be useful for risk stratification in these patients and adjust treatment.

INTRODUCCIÓN: la mortalidad por enfermedad cardiovascular (ECV) en pacientes con enfermedad renal crónica (ERC) es alta. En la población con ERC terminal (ERCT) la mortalidad es hasta 20 veces mayor en comparación a la población general. Los péptidos natriuréticos, especialmente el péptido natriurético tipo-B (BNP), han sido estudiados como posibles marcadores de riesgo de mortalidad por ECV. El objetivo de este trabajo es determinar si el BNP actúa como un marcador pronóstico para mortalidad por ECV en pacientes con ERCT. MÉTODOS: se estudiaron 53 pacientes con ERCT prevalentes en diálisis peritoneal sin evidencia clínica de insuficiencia cardiaca al inicio del estudio. El impacto de las variables se realizó con el modelo de regresión lineal. La probabilidad de sobrevida fue estimada con el análisis de Kaplan-Meier y la diferencia entre grupos con el test de Log-Rank, acorde a los niveles de BNP dividido en tertiles. La asociación de riesgo fue calculada con el análisis proporcional de Cox ajustado. RESULTADOS: el BNP fuertemente predice la mortalidad por ECV. El modelo de regresión de Cox mostró que el BNP es un predictor de muerte por ECV. Pacientes con niveles altos de BNP tuvieron mayor riesgo de muerte. Varios mecanismos fisiopatológicos no bien definidos están involucrados. CONCLUSIONES: el BNP predice la mortalidad por ECV en pacientes con ERCT. La medición sérica de este péptido puede ser útil para la estratificación de riesgo en estos pacientes y ajustar el plan terapéutico

Therapeutic effect of orally administered microencapsulated oxaliplatin for colorectal cancer.

Colorectal cancer is a significant source of morbidity and mortality in the United States and other Western countries. Oral delivery of therapeutics remains the most patient accepted form of medication. The development of an oral delivery formulation for local delivery of chemotherapeutics in the gastrointestinal tract can potentially alleviate the adverse side effects including systemic cytotoxicity, as well as focus therapy to the lesions. Here we develop an oral formulation of the chemotherapeutic drug oxaliplatin for the treatment of colorectal cancer. Oxaliplatin was encapsulated in pH sensitive, mucoadhesive chitosan-coated alginate microspheres. The microparticles were formulated to release the chemotherapeutics after passing through the acidic gastric environment thus targeting the intestinal tract. In vivo, these particles substantially reduced the tumor burden in an orthotopic mouse model of colorectal cancer, and reduced mortality.