Carcass traits and meat quality assessment of two slow-growing chicks strains fed Acheta domesticus larval meal.

Presently, there has been a noticeable rise in the consumption of poultry meat within the general population, particularly focusing on poultry sourced from alternative rearing systems as opposed to intensive ones. This study evaluated the impact of incorporating house cricket (Acheta domesticus,AD) larvae meal into the diet of 2 slow-growing chicken strains on their carcass traits and meat quality. A total of 256 one-day-old male chicks were utilized, with 128 belonging to the Red (R) strain and 128 to the Naked Neck (NN) strain. Chicks from each strain were randomly assigned to 16 replicates of 8 chicks each. Eight replicates were allocated to 2 distinct treatments (n=64 chicks/treatment) based on the diet employed: the control treatments for the Red (R-C) and Naked Neck (NN-C) strains were fed soybean meal, while the other 2 treatments were fed AD meal (R-AD and NN-AD). Three different rations were used throughout the growth cycle of the animals, tailored to meet the nutritional needs of the birds. All chickens were slaughtered at 95 d of age, and eight chickens per treatment were randomly chosen to assess carcass traits and meat quality. Near-infrared reflectance spectroscopy (NIRS) was employed to classify meat based on the feed and the chick strain, achieving a correct discrimination of 100% of the samples. The carcass traits exhibited significant alterations due to the inclusion of insect larval meal in the diet, resulting in reduced values across all parameters for chickens consuming AD meal, irrespective of genotype. The pH and cooking losses were generally higher for chicks fed cricket meal, as occurred with moisture. However, protein content was lower in the meat of chicks consuming cricket meal. Fat content showed lower values for NN chickens. There were minimal differences in the fatty acid profile, with lower C18:3n-3 values for chickens fed cricket meal. Therefore, including Acheta domesticus meal in the diets of slow-growing chick strains is a viable alternative to replace soybean meal. It provides meat quality characteristics comparable to those obtained in conventional systems.

Use of Acheta domesticus meal as a full soybean substitute in the feeding of slow-growing chicks.

Sustainable poultry meat production involves the use of slow-growing chick strains and the utilization of new protein sources as an alternative to the current monopoly of soybean meal. In this scenario, a study was conducted to assess the effect of replacing soybean meal with domestic cricket (Acheta domesticus) meal on the developing cycle of slow-growing chicks. To this end, a total of 128 one-day-old male chicks (Colorield) were randomly assigned into 16 experimental units, each consisting of 8 chicks, which in turn were grouped into 2 groups fed isoproteic and isoenergetic diets in which the protein source differed: the control group (C) fed soybean meal and the Acheta group (AD) fed Acheta domesticus insect meal as the main protein source. Chicks were slaughtered at 95 d of age. Three different diets (F1, F2 and F3) were used for each experimental group according to the nutritional needs of the birds during their growth. The F1 diet (1-29 d) resulted in higher feed and water intake and higher body weight gain for group C, but a lower feed conversion rate. On the contrary, during F2 (29-60 d) no differences in productive performances were observed between the 2 groups, except for a higher water intake for group C. Finally, during the period corresponding to diet F3 (60-95 d) there were only differences in feed intake, which was higher for the AD group. In conclusion, the substitution of soybean meal for Acheta domesticus meal caused a decrease in feed intake during the first month and consequently a lower body weight. During the first 4 weeks of life of the chicks, a partial replacement of soybean meal may be recommended, since high inclusions of A. domesticus meal in this period seem to be detrimental in young chicks. Given the absence of relevant differences in productive performances between both groups, it could be concluded that the use of A. domesticus cricket meal can be a potential protein alternative to soybean meal.

Performance of Slow-Growing Chickens Fed with Tenebrio molitor Larval Meal as a Full Replacement for Soybean Meal.

Insect larval meal is an increasingly common protein source in poultry systems. In this study, the effect of replacing soybean meal with Tenebrio molitor larval meal on the performance of slow-growing chickens was assessed. A total of 128 one-day-old chickens (Colorield) were randomly divided into a control group (C) (n = 64), fed with soybean meal, and an experimental group (TM) (n = 64), fed with T. molitor larvae meal. The chicks were slaughtered after 95 days. Three different isoenergetic and isoproteic diets (F1, F2 and F3) were used for each group. The F1 diet resulted in higher body weight gain and higher feed and water intakes in group C, but a lower feed conversion ratio. Contrarily, diets F2 and F3 did not produce differences in the studied parameters between the two groups, except for body weight gain in the case of diet F2, which was highest in group C. Therefore, weight gain and feed and water intakes were significantly higher in group C, but there were no differences in feed conversion ratio or live weight. In conclusion, the total replacement of soybean meal with T. molitor larvae meal resulted in a reduction in feed intake and a consequent reduction in weight. During this period, partial rather than total substitution may be recommended.

Milk Quality and Carbon Footprint Indicators of Dairy Sheep Farms Depend on Grazing Level and Identify the Different Management Systems.

Currently, there are very few studies in the dairy sheep sector associating milk quality and indicators regarding carbon footprint and their link to grazing levels. For 1 year, monthly milk samples and records related to environmental emissions and management systems were collected through surveys from 17 dairy sheep farms in the region of Castilla y León (Spain), in order to relate this information to the use of natural pastures under free grazing. Indicators were constructed on the collected data and subjected to a multivariate statistical procedure that involved a factor analysis, a cluster analysis and a population canonical analysis. By applying multivariate statistical techniques on milk quality and carbon footprint indicators, it was possible to identify the management system of the farms. From an environmental point of view, farms with a higher grazing level (cluster 4) were more sustainable, as they had the lowest carbon footprint (lower CO2, N2O and CO2 equivalent emissions per sheep and year) and the lowest energy consumption levels, which were gradually lower than those of farms in cluster 3; both indicators were much lower than those of farms in clusters 1 and 2. The milk quality of cluster 1 and 2 farms was significantly lower in terms of total protein and fat content, dry extract, omega-3 fatty acid levels and α-tocopherol content than farms in clusters 3 and 4, which had higher accessibility to grazing resources. In sum, the higher the use of natural resources, the lower the external inputs the farms required and the lower environmental impact and energy costs they have.

EMG characteristics of the external anal sphincter guarding reflex and effects of a unilateral ventral root avulsion injury in rhesus macaques ( Macaca mulatta).

The external anal sphincter (EAS) is important for the maintenance of bowel continence and may be compromised by a variety of neuropathic conditions. However, large animal models for the study of EAS functions have been sparse. The EAS guarding reflex was examined by electromyography (EMG) in neurologically intact rhesus macaques ( n = 6) and at 4-6 wk after a unilateral EAS denervation from an L6-S3 ventral root avulsion (VRA) injury ( n = 6). Baseline EAS EMG recordings were quiescent in all subjects, and evoked responses showed an initial large-amplitude EMG activity, which gradually returned to baseline within 1-2 min. At 4-6 wk postoperatively, the EAS guarding reflex showed a significantly reduced EMG response duration of 47 ± 15 s and area under the curve (AUC) of 0.198 ± 0.097 mV·s compared with the corresponding evoked EAS EMG duration of 102 ± 19 s and AUC of 0.803 ± 0.225 mV·s ( P < 0.05) in the control group. Detailed time- and frequency-domain analysis of the evoked EAS EMG responses for the first 40 s showed no difference between groups for the maximum amplitude but a significant decrease for the mean amplitude across the study period and an early AUC reduction for the first 10 s in the VRA injury group. Time-frequency analysis and power spectrum plots indicated decreased intensity and a narrower midrange of frequencies in the VRA injury group. We conclude that the EAS guarding reflex in rhesus macaques shows characteristic EMG features in control subjects and signs of partial target denervation after a unilateral L6-S3 VRA injury. NEW & NOTEWORTHY The external anal sphincter guarding reflex showed initial large-amplitude peaks and a gradual return to a quiescent baseline after a rectal probe stimulus in rhesus macaques. At 4-6 wk after a unilateral ventral root avulsion (VRA) injury, the electromyography duration, mean amplitude, and area under the curve measurements were decreased. Time-frequency analysis and power spectrum plots indicated decreased intensity and a narrowed midrange of frequencies in the VRA injury cohort.

Extrasístoles ventriculares: relación deflexión intrinsecoide / QRS para discriminar el origen / Ventricular extrasystoles: QRS intrinsiccoid deflection relationship to discriminate the origin

Introducción: las taquicardias ventriculares (TV) y complejos ventriculares prematuros (CVP) de los tractos de salida (TS) son arritmias ventriculares más frecuentes que se producen en el corazón estructuralmente sano. El manejo intervencionista con ablación es el tratamiento que en casos seleccionados ha demostrado tener mayor efectividad terapéutica; para optimizar el lugar de ablación sobre el foco de origen se han conformado ayudas complementarias a los estudios de extensión. Objetivo: proponer una herramienta para discriminar tempranamente el origen de las extrasístoles ventriculares provenientes de los tractos de salida a partir del cálculo del valor de la relación deflexión intrinsecoide/QRS medida en extrasístoles ventriculares en V6. Materiales y métodos: se realizó un estudio de corte transversal, en pacientes con diagnóstico de CVP llevados a estudio electrofisiológico más ablación exitosa. Se midió la deflexión intrinsecoide y se relacionó con el tiempo total del QRS en V6. Resultados: a partir de los análisis de los puntos del corte se estableció un valor de la relación deflexión intrisecoide/qrs menor o igual a 0.67 para el ventrículo derecho y mayor o igual a 0.68 para el ventrículo izquierdo. El análisis de los datos registró una correcta clasificación de los pacientes en el 80% de los casos. Conclusiones: este estudio propone una herramienta corta y sencilla de aplicar, que intenta predecir el origen de estas arritmias a partir de unas mediciones realizadas en un electrocardiograma en que se muestre dicha extrasístole ventricular en V6, en donde es obtener posible origen del foco arritmogénico antes del procedimiento intervencionista.

ntroduction: outflow tract ventricular tachycardia (VT) and premature ventricular complexes (PVC) are common ventricular arrhythmias that occur in the structurally normal heart. Interventional management using ablation procedures in selected cases has demonstrated good therapeutic efficacy; diagnostic aids supplementary to extensión studies have been designed to optimize the target ablation site based on the site of origin. Objective: to propose a tool for early diagnosis of ventricular extrasystoles originating at the outflow tracts by calculating the time to intrinsicoid deflection / QRS measured in lead V6. Materials and Methods: a cross sectional study conducted in patients diagnosed with PVC who underwent an electrophysiological evaluation and a successful ablation procedure. We measured the time to intrinsicoid deflection or onset of the QRS complex to the peak of the R wave in V6. Results: the value of the intrinsicoid deflection /QRS time resulting from the cut off points analysis was less than or equal to 0.67 for the right ventricle and greater than or equal to 0.68 for the left ventricle. Data analysis provided a correct classification of patients in 80% of cases. Conclusions: this study proposes a short and simple predictive tool of the site of origin of these arrhythmias by measuring some electrocardiographic features showing said ventricular extrasystoles in V6, where it is possible to identify the site of origin of arrhythmias prior to an interventional procedure.

Mapeo y ablación por radiofrecuencia a cielo abierto: un caso de taquicardia ventricular refractaria en anomalía de Ebstein / Open-heart mapping and radiofrequency ablation: a case of refractory ventricular tachycardia in Ebstein's anomaly

Resumen La anomalía de Ebstein es una enfermedad congénita, caracterizada por el desplazamiento y la adherencia de la válvula tricúspide. Las valvas septal y posterior se implantan en posiciones más inferiores, causando insuficiencia tricuspídea, esta condición de forma progresiva genera dilatación y deterioro de la función sistólica ventricular derecha. Comúnmente se asocia a otras entidades, principalmente, a la comunicación interauricular y las arritmias mediadas por vías accesorias. La muerte súbita ocurre en estadios avanzados, usualmente relacionados con episodios de taquicardia ventricular. Este reporte describe un caso de anomalía de Ebstein y tormenta arrítmica, que se sometió a ablación del sustrato arrítmico endo y epicárdico en la porción atrializada del ventrículo derecho, que presentó como complicación intraprocedimiento la perforación del ventrículo, el taponamiento cardiaco y la necesidad urgente de la reparación quirúrgica, realizándose en el intraoperatorio una segunda ablación por radiofrecuencia a cielo abierto con el objetivo de eliminar los potenciales tardíos y los fragmentados remanentes en el área de bajo voltaje de la escara. Veintidós semanas después de la ablación se implantó un cardiodesfibrilador subcutáneo para prevención secundaria de la muerte súbita; en el seguimiento a 14 meses no hubo terapias apropiadas del dispositivo.

Abstract Ebstein's anomaly is a congenital disease characterised by the displacement and adherence of the tricuspid valve. Septal and posterior valves are implanted in lower positions, thus causing tricuspid insufficiency. This condition gradually generates dilation and deterioration of the right ventricular systolic function. It is commonly associated to other conditions, mainly atrial septal defect and accessory pathway arrhythmias. Sudden death occurs in the advanced stages, usually related to episodes of ventricular tachycardia. This report describes a case of Ebstein's anomaly and arrhythmic storm who underwent ablation of the arrhythmic endo- and epicardial substract in the atrialized portion of the right ventricle, that developed as an intrasurgical complication the perforation of the ventricle, cardiac tamponade and urgent need of surgical repair. During the surgery a second open-heart radiofrequency ablation was conducted with the goal of eliminating potentially late and fragmented remnants in the low voltage area of the scars. Twenty two weeks after the ablation a subcutaneous cardioverterdefibrillator was implanted for secondary prevention of sudden death; in the follow-up after 14 months there were no appropriate therapies of the device.

Radiographic and Magnetic Resonance Imaging Identification of Thoracolumbar Spine Variants with Implications for the Positioning of the Conus Medullaris in Rhesus Macaques.

The anatomy of the vertebral column in mammals may differ between species and between subjects of the same species, especially with regards to the composition of the thoracolumbar spine. We investigated, using several noninvasive imaging techniques, the thoracolumbar spine of a total of 44 adult rhesus macaques of both genders. Radiographic examination of the vertebral column showed a predominant spine phenotype with 12 rib-bearing thoracic vertebrae and 7 lumbar vertebrae without ribs in 82% of subjects, whereas a subset of subjects demonstrated 13 rib-bearing thoracic vertebrae and 6 lumbar vertebrae without ribs. Computer tomography studies of the thoraco-lumbar spine in two cases with a pair of supernumerary ribs showed facet joints between the most caudal pair of ribs and the associated vertebra, supporting a thoracic phenotype. Magnetic resonance imaging (MRI) studies were used to determine the relationship between the lumbosacral spinal cord and the vertebral column. The length of the conus medullaris portion of the spinal cord was 1.5 ± 0.3 vertebral units, and its rostral and caudal positions in the spinal canal were at 2.0 ± 0.3 and 3.6 ± 0.4 vertebral units below the thoracolumbar junction, respectively (n = 44). The presence of a set of supernumerary ribs did not affect the length or craniocaudal position of the conus medullaris, and subjects with13 rib-bearing vertebrae may from a functional or spine surgical perspective be considered as exhibiting12 thoracic vertebrae and an L1 vertebra with ribs. Anat Rec, 300:300-308, 2017. © 2016 Wiley Periodicals, Inc.

Uñas amarillas Más allá de lo visible / Yellow nails Beyond visible

Resumen El síndrome de uñas amarillas (SUA) es una entidad caracterizada por pigmentación anormalmente amarillenta, verdosa o café de las uñas acompañado de linfedema de miembros inferiores y derrame pleural y/u otra sintomatología en relación con el tracto respiratorio. La etiología y mecanismos fisiopatológicos hasta el momento no están bien dilucidados, sin embargo es aceptada una alteración anatómica o funcional en los vasos linfáticos adquirida congénitamente. La presentación clínica es más frecuente en individuos con edades entre 40 y 80 años. La falta de evidencia científica en torno a esta patología, dificulta sus direccionamientos diagnósticos y terapéuticos; los signos y síntomas que abarcan esta enfermedad son concretos, sin embargo tienen un espectro de presentación muy variado, por lo cual el diagnóstico es esencialmente clínico y el tratamiento sintomático. Hasta el momento algunas intervenciones han demostrado ser útiles en la resolución de algunos signos y síntomas, pero ninguna con el soporte científico ni epidemiológico que justifique su reproducción. Existen gran número de casos reportados a nivel mundial, no obstante son contados los documentados en América Latina. Se presenta el caso de una paciente de 90 años de edad quien consulta en múltiples ocasiones al servicio de urgencias por dificultad para respirar, en quien como hallazgo incidental se documenta pigmentación amarilla e hiperqueratosis ungueal. (Acta Med Colomb 2016; 40: 269-272).

Abstract Yellow nail syndrome (YNS) is an entity characterized by abnormally yellowish, greenish or brown pigmentation of the nails accompanied by lymphedema of lower limbs and pleural effusion and / or other symptomatology related to the respiratory tract. The etiology and pathophysiological mechanisms to date are not well known, but nevertheless an anatomical or functional alteration in the lymphatic vessels acquired congenitally is accepted. The clinical presentation is more frequent in individuals between the ages of 40 and 80 years. The lack of scientific evidence about this pathology makes difficult its diagnostic and therapeutic directions. The signs and symptoms that comprise this disease are concrete, although they have a very varied spectrum of presentation, whereby the diagnosis is essentially clinical and the treatment symptomatic. So far some interventions have proved useful in solving some signs and symptoms, but none with scientific or epidemiological support to justify their reproduction. There are a large number of cases reported worldwide, but very few cases are documented in Latin America. The case of a 90-year-old female patient who consults the emergency department on many occasions due to shortness of breath, in whom yellow pigmentation and nail hyperkeratosis are documented as an incidental finding, is reported. (Acta Med Colomb 2016; 40: 269-272).

Cumplimiento de metas de lípidos en pacientes de prevención secundaria hospitalizados por medicina interna / Achievement of lipid goals in patients with secondary prevention hospitalized in the internal medicine service

En los pacientes de prevención secundaria, el ATP III recomienda metas de lípidos estrictas (colesterol LDL <100 mg/dL y <70 mg/dL en pacientes de muy alto riesgo). A pesar de las recomendaciones y los múltiples beneficios demostrados de la terapia con estatinas, ésta continúa siendo subutilizada en este grupo de pacientes. Objetivo: describir la frecuencia de cumplimiento de metas de niveles de lípidos en pacientes de prevención secundaria hospitalizados por medicina interna del Hospital San José, según criterios del ATP III. Métodos: estudio descriptivo prospectivo, de corte transversal, realizado entre el 11 de abril y el 30 de agosto de 2011. Ingresaron pacientes mayores de 18 años con criterios de prevención secundaria. Se realizó un análisis descriptivo donde se evaluaron porcentajes, promedios y desviaciones estándares de datos demográficos, clínicos y paraclínicos. Se estableció la proporción de pacientes que cumplían metas adecuadas en el perfil lipídico según lo establecido por las guías ATP III. Resultados: se reclutaron 121 pacientes, edad promedio 66.7±14.1 años, predominio del sexo femenino (54.5%). Se encontró cumplimiento de metas LDL en el 55.3%, HDL 31.4%, no HDL 51.2% y triglicéridos 52%. El 57.7% recibían estatinas (todos ellos lovastatina) y 49 (40.5%) no recibían ningún hipolipemiante. Conclusiones: hay bajo cumplimiento según metas ATP III en los pacientes de prevención secundaria del colesterol LDL, no HDL, triglicéridos y en mayor proporción del colesterol HDL. Una gran parte de la población de estudio no recibía ningún hipolipemiante, el bajo cumplimiento puede tener diversas causas por lo que es necesario evaluarlas y buscar mecanismos para superarlas.

In secondary prevention patients, ATP III recommends strict lipid goals (LDL cholesterol <100 mg/dL and <70 mg/dL in very high-risk patients). Despite the recommendations and the multiple proven benefts of statin therapy, this continues to be underutilized in this group of patients. Objective: to describe the frequency of compliance with lipid level goals for secondary prevention in patients hospitalized in the Internal Medical Service in San Jose Hospital, according to the ATP III criteria. Methods: a descriptive, prospective, cross-sectional study, conducted between April 11 and August 30, 2011. Patients over 18 years with secondary prevention criteria were admitted. A descriptive analysis which evaluated percentages, means and standard deviations of demographic, clinical and para-clinical data was performed. The proportion of patients meeting appropriate goals in the lipid profle as defined by ATP III guidelines was established. Results: we recruited 121 patients, mean age 66.7 ± 14.1 years, with female predominance (54.5%). Achievement of LDL goals was found in 55.3%, HDL 31.4%, non-HDL 51.2%and triglycerides 52%. 57.7% received statins (lovastatin all of them) and 49 (40.5%) did not receive any lipid-lowering drug. Conclusions: there is poor compliance according to ATP III goals in secondary prevention patients of LDL cholesterol, non-HDL, triglycerides and increased HDL cholesterol ratio. A large proportion of the study population did not receive any lipid-lowering drug. Low compliance may have different causes; therefore it is necessary to make an evaluation and to seek ways to overcome them.

The role of postoperative radiation therapy in the treatment of meningeal hemangiopericytoma-experience from the SEER database.

PURPOSE: The aim of this study was to examine the effect of postoperative radiation therapy (RT) on cause-specific survival in patients with meningeal hemangiopericytomas. METHODS AND MATERIALS: The Surveillance, Epidemiology, and End Results database from 1990-2008 was queried for cases of surgically resected central nervous system hemangiopericytoma. Patient demographics, tumor location, and extent of resection were included in the analysis as covariates. The Kaplan-Meier product-limit method was used to analyze cause-specific survival. A Cox proportional hazards regression analysis was conducted to determine which factors were associated with cause-specific survival. RESULTS: The mean follow-up time is 7.9 years (95 months). There were 76 patients included in the analysis, of these, 38 (50%) underwent gross total resection (GTR), whereas the other half underwent subtotal resection (STR). Postoperative RT was administered to 42% (16/38) of the patients in the GTR group and 50% (19/38) in the STR group. The 1-year, 10-year, and 20-year cause-specific survival rates were 99%, 75%, and 43%, respectively. On multivariate analysis, postoperative RT was associated with significantly better survival (HR = 0.269, 95% CI 0.084-0.862; P=.027), in particular for patients who underwent STR (HR = 0.088, 95% CI: 0.015-0.528; P<.008). CONCLUSIONS: In the absence of large prospective trials, the current clinical decision-making of hemangiopericytoma is mostly based on retrospective data. We recommend that postoperative RT be considered after subtotal resection for patients who could tolerate it. Based on the current literature, the practical approach is to deliver limited field RT to doses of 50-60 Gy while respecting the normal tissue tolerance. Further investigations are clearly needed to determine the optimal therapeutic strategy.

Use of daptomycin for the treatment of methicillin-resistant coagulase-negative staphylococcal ventriculitis.

Coagulase-negative staphylococci (CoNS) are the main pathogens causing hospital-acquired external-ventricular-drain- (EVD-) and lumbar-drain- (LD-) associated meningitis and ventriculitis. The treatment of these infections can be challenging and may require combination of intraventricular and intravenous administration of antibiotics. Limited animal data demonstrate rapid daptomycin bactericidal activity, adequate penetration in the setting of inflamed meninges, and extended half-life in the ventricles Steenbergen et al. (2009). There are limited clinical data using daptomycin intravenously and/or intraventricularly for the treatment of central nervous system infections (CNS) Elvy et al. (2008), Stucki et al. (2007), Lee et al. (2008) and Wallace et al. (2009). We report here our experience in the treatment of an EVD-related infection.

Titanium mesh implantation--a method to stabilize the spine and protect the spinal cord following a multilevel laminectomy in the adult rat.

The development of clinically relevant larger spinal cord injury models is in part limited by the possibility of a widened or multilevel laminectomy causing a spinal cord injury from an unstable spine or from compression of the spinal cord by adjacent soft tissues. In the adult rat, we have developed a method to protect the spinal cord and stabilize the spinal column using a titanium mesh implant following a bilateral, multilevel lumbar laminectomy. For this purpose, bilateral and expanded L1-4 laminectomies were performed with or without the use of a titanium mesh to protect the spinal cord and stabilize the spine. Without titanium mesh protection, the rats developed a severe paraparesis or paraplegia, urinary retention, gross anatomical signs of cord compression, and motoneuron loss. In the titanium mesh treatment group, the rats typically maintained a normal gait and lower urinary tract function, normal gross anatomical features of the spinal cord, and normal motoneuron counts. We propose that the use of a titanium mesh implant may assist in the development of clinically relevant larger spinal cord injury and repair models.

The separation of Guatemalan craniopagus twins.

CASE REPORT: The particularities of the surgical procedure for the separation of craniopagi twins performed at UCLA in 2002 are presented. The main difficulty for the neurosurgeons was that the twins shared a common sagittal sinus and that one of the sisters had a poorly developed collateral venous system, thus anticipating a set of postoperative clinical problems. During surgery, the response of the brain to the progressive occlusion of the venous bridges was monitored with EEG and Doppler ultrasound. One of the sisters had a large intracerebral hematoma that was evacuated and later developed hydrocephalus, which was treated with a ventriculoperitoneal shunt. OUTCOME: One of the sisters had a basically uneventful recovery while the other contracted E. coli meningitis 8 months after surgery, thus impairing her motor and cognitive development. DISCUSSION: The details and intricacies of the anesthesia and plastic surgery are also outlined.

Autonomic and motor neuron death is progressive and parallel in a lumbosacral ventral root avulsion model of cauda equina injury.

Injuries to the cauda equina of the spinal cord result in autonomic and motor neuron dysfunction. We developed a rodent lumbosacral ventral root avulsion injury model of cauda equina injury to investigate the lesion effect in the spinal cord. We studied the retrograde effects of a unilateral L5-S2 ventral root avulsion on efferent preganglionic parasympathetic neurons (PPNs) and pelvic motoneurons in the L6 and S1 segments at 1, 2, 4, and 6 weeks postoperatively in the adult male rat. We used Fluoro-Gold-prelabeling techniques, immunohistochemistry, and quantitative stereologic analysis to show an injury-induced progressive and parallel death of PPNs and motoneurons. At 6 weeks after injury, only 22% of PPNs and 16% of motoneurons remained. Furthermore, of the neurons that survived at 6 weeks, the soma volume was reduced by 25% in PPNs and 50% in motoneurons. Choline acetyltransferase (ChAT) protein was expressed in only 30% of PPNs, but 80% of motoneurons remaining at 1 week postoperatively, suggesting early differential effects between these two neuronal types. However, all remaining PPNs and motoneurons were ChAT positive at 4 weeks postoperatively. Nuclear condensation and cleaved caspase-3 were detected in axotomized PPNs and motoneurons, suggesting apoptosis as a contributing mechanism of the neural death. We conclude that lumbosacral ventral root avulsions progressively deplete autonomic and motor neurons. The findings suggest that early neuroprotection will be an important consideration in future attempts of treating acute cauda equina injuries.

Informatización de la biberonería de un hospital materno-infantil con una producción diaria de 700 biberones / No disponible

Introducción: Con motivo de la remodelación de la biberonería del Hospital Materno-Infantil, se diseñó una aplicación destinada a optimizar la petición, preparación, distribución y control de consumos, de todas las fórmulas elaboradas en dicha biberonería. Material y métodos: El programa desarrollado en Microsoft Access 971 contiene información sobre pacientes hospitalizados y las dietas que se le asignen junto con clasificaciones de fórmulas, marcas comerciales, concentraciones de elaboración, proveedores, material fungible que intervienen en la preparación de dichas dietas. Para la cumplimentación de los datos, se han prepararon diversos formularios que son utilizados tanto por el personal de enfermería de las plantas de hospitalización como por el implicado en la elaboración de los biberones. El acceso a cada una de las funciones es restringido en función del grupo funcional (planta, elaboración y administración) al que pertenece cada usuario. Resultados: El programa está implantado con utilización progresiva de las diversas plantas desde mayo de 1999. Hasta el día de hoy ha controlado la petición y elaboración de 44.281 biberones para 419 neonatos y lactantes. Conclusión: Se ha observado una disminución del número de peticiones fuera de los horarios establecidos y tiempo de elaboración, así como un ahorro en las cantidades de fórmula empleadas (AU)

Introduction: Due to the changes at the nursery of the Paediatric Hospital an application was designed for the purpose of optimizing the request, preparation, distribution and control of use, for all the formulae elaborated in that nursery. Materials and methods: The programme in Microsoft Access 97 built, contains information about inpatients and the diets given to them, along with the classification of the formulae, trade names, their concentration, suppliers and the perishable ingredients that were involved in the preparation of these diets. In order to complete the data, several formularies were prepared which were used by the nursing staff and by those responsible for their preparation. The access to each of these functions was restricted according to the role of each group (Ward staff, preparation and administration areas) that different members belonged to. Results: The programme was initiated in a progressive fashion throughout the different wards starting in May 1999. Until to date there had been a control over the request and elaboration of 44.281 feeding bottles for 419 neonates. Conclusion: A reduction in the number of requests out of hours was observed as was the time of preparation. Also, there was a reduction in the quantity of the formulae used (AU)