Intratesticular transplantation of allogenic mesenchymal stem cells mitigates testicular destruction after induced heat stress in Miniature-horse stallions.

Testicular degeneration (TD) is the most frequent cause of sub or infertility in stallions. Currently, mesenchymal stem cells (MSC) have been studied as a therapeutic option for several diseases including induced-TD in laboratory animals. Therefore, this study aimed to evaluate the effect of intratesticular MSC therapy on the testicular histology of stallions submitted to scrotal heat stress. Ten healthy Miniature-horse stallions were submitted to testicular heat stress induced by a heating wrap device (42-45°C). Afterward, the stallions were divided into two groups and treated seven days later. MSCs-treated stallions were treated with an intratesticular injection of 10 × 106 of MSCs diluted in 5 mL of PBS, whereas placebo-treated stallions had 5 mL of PBS intratesticular injected. All stallions had testicular biopsies collected seven days before and one- and 14-days post-heat stress and were castrated 30 days after testicular insult. Tissue sections were stained with H&E and evaluated for the tubular and luminal diameter, epithelial thickness, seminiferous tubules (STs) integrity, the number of spermatozoa in the STs, and the percent of abnormal STs. Significance was set at P≤0.05. In both groups, testicular heat stress damaged the STs (P<0.05). However, STs' parameters were improved in MSCs-treated stallions compared to placebo-treated stallions 30 days after the testicular insult (P<0.05). In conclusion, the results of the present study suggest that intratesticular MSC therapy provided a therapeutic advantage in rescuing acute TD in stallions. However, further studies are essential to evaluate the benefits of this therapy on semen parameters and stallions with idiopathic TD.

Pharmacokinetics of Subcutaneous Levetiracetam in Palliative Care Patients.

Background: Seizure control is challenging in the palliative care setting. Subcutaneous (SC) levetiracetam (LEV) is currently an off-label route of administration and effectiveness, tolerability, and pharmacokinetics studies for this route are scarce. Objectives: This prospective study aimed at evaluating effectiveness and tolerability of SC LEV as well as characterizing its pharmacokinetics. Subjects: Patients (n = 7) who attended the palliative care clinic between September 2018 and January 2019 with diagnosis of seizures, ≥18 years, and in need of SC route of administration were included in the study. Measurements: LEV plasma levels were determined using high-performance liquid chromatography and pharmacokinetic analysis were performed using Monolix 2018R2 (France). pH and osmolality of the three SC infusion solutions were also determined. Results: Seven patients took part in the study. Seizures were controlled in six out of seven patients with doses of 1000 and 3000 mg/day. Adverse effects were mild. pH and osmolality of the SC infusion solutions were within the accepted values reported in the literature. Mean plasma LEV concentrations were 14.4 mg/L (1000 mg/day) and 27.7 mg/L (2000 mg/day). The population clearance (2.5 L/h) and the elimination half-life (10.4 hours) were successfully estimated. Conclusions: Based on this data, SC LEV was effective and well tolerated. Pharmacokinetic parameters for the SC route were successfully determined.

Clinical safety of intratesticular transplantation of allogeneic bone marrow multipotent stromal cells in stallions.

Although stem cell therapy is a promising alternative for treatment of degenerative diseases, there are just few reports on the use of stem cells therapy in horse's reproductive system. This study aims to evaluate the effect of intratesticular injection of bone marrow mesenchymal stromal/stem cells (MSCs) in healthy stallions, and its outcome on seminal parameters and fertility. In Experiment 1, 24 stallions were divided into treatment group (TG) and control group (CG). In the TG, an intratesticular application of MSC was performed, and in the CG, only PBS was used. Measurements of testicular volume, surface temperature and Doppler ultrasonography were performed 24 and 48 hr after treatments. Fifteen days after application, the testicles were removed and submitted to histological analysis. In Experiment 2, 3 fertile stallions received similarly treatment with MSCs. Physical examination and sperm analysis were performed weekly during 60 days after treatment, and at the end, semen from one of them was used for artificial inseminations of 6 healthy mares. In Experiment 1, clinical examinations showed no signals of acute inflammation on both groups according to the analysed variables (p > .05). Also, no signal of chronic inflammation was observed on histological evaluation. In Experiment 2, stallions presented no physical alterations or changes in sperm parameters, and a satisfactory fertility rate (83%; 5/6) was observed after AI. The results support the hypothesis that intratesticular application of bone marrow MSCs is a safe procedure, and this could be a promising alternative to treat testicular degenerative conditions.

Histrelin acetate-induced ovulation in Brazilian Northeastern jennies (Equus asinus) with different follicle diameters.

The aim of the present study was to evaluate the efficacy of a GnRH analog for induction of ovulation in Brazilian Northeastern jennies (Equus asinus) with different follicle diameters. Four consecutive estrus of 10 jennies were used in a crossover study; C (Control, n = 10) jennies were evaluated by transrectal palpation and ultrasonography until a spontaneous ovulation and the intervals between the predetermined follicular size (25-28 mm [C1], 29-32 mm [C2] and 33-36 mm [C3] follicle) and ovulation were registered. In treated cycle, jennies had the ovulation induced by 250 µg of Histrelin acetate (Strelin®, Botupharma, Botucatu, Brazil) when respective follicle diameters 25-28 mm (T1), 29-32 mm (T2) and 33-36 mm (T3) were diagnosed. Ovulation was monitored by transrectal palpation and ultrasonography. Different follicle diameters significantly affected (P < 0.05) the interval until ovulation between control and matched treated cycles. Interval between prostaglandin administration and ovulation diagnosis was lower in jennies from T2 group (145.2 ±â€¯34.6 h) compared with the control cycle (220.0 ±â€¯41.8 h) and also with other treated cycles (T1 - 209.8 ±â€¯48.0 h; T3 - 183.3 ±â€¯33.9 h). Histrelin acetate treatment also reduces the interval between detection of predetermined follicular size and ovulation (P < 0.05) in all treated cycles groups compared with matched control group. Higher percentage (P < 0.05) of jennies had success of ovulation induction (36-48 h after Histrelin acetate injection) in all treated cycles in contrast with the matched control group. In addition, in comparison among treated cycle groups, more (P < 0.05) jennies (100%) in T2 ovulated between 36 and 48 h after ovulation induction, compared with T1 and T3, which did not differ (P > 0.05) from each other. Edema scoring and ovulation were not associated events (r = 0.0219). In conclusion, jennies with 29-32 mm follicles satisfactory responded to ovulation induction with Histrelin acetate, which allowed the shortening of interovulatory interval in all groups evaluated.

New Treatment for Urethral Rent in Stallions.

The aim of this report is to describe a new methodology to successfully treat stallions diagnosed with urethral rent. Four stallions of ages ranging from 7 to 12 years (median 9) with hemospermia were admitted for clinical evaluation, breeding soundness examination, and urethroscopy for inspection of the urethra and vesicular glands. Once the presence of urethral rent was identified and/or other sources of hemorrhage were excluded, a topical treatment was performed with 4% Policresulen solution (Albocresil). The treatment was carried out by infusing 100 mL of the solution into the lumen of the urethra through a catheter placed up to the region of the ischial arch. This procedure was repeated once daily, or at 48 hours intervals, resulting in a total of 4-7 infusions. In all cases, chemical cauterization was efficient in the healing of the urethral rent. However, due to masturbation during treatment, one animal did not completely heal, and the treatment with the Policresulen was prolonged. It is believed that the low pH of the solution resulted in urethritis, which was treated with systemic therapy of antibiotic and anti-inflammatory nonsteroidal. Topical treatment with 4% Policresulen was found to be efficient in the chemical cauterization of urethral rent in stallions. This treatment was efficient, practical, less invasive, and less costly than the alternative of surgical methods, which are more invasive and require longer recovery time of the animal. However, sexual rest and the elimination of sexual stimuli from the environment are essential management in association with this therapeutic method.

Strategies to improve the fertility of fresh and frozen donkey semen.

Fertility rates of donkey semen in jennies are lower compared to mares. The aims of this study were to evaluate different sperm cryopreservation methods and insemination strategies to improve the fertility of donkey semen in jennies. Three experiments were performed: (1) the comparison of two freezing methods of donkey semen (conventional method and automated method); (2) the determination of a suitable insemination dose of fresh donkey semen for jennies and mares; and (3) the influence of the semen deposition site on fertility of jennies inseminated with frozen donkey semen. For experiment 1, no differences were observed in total motility, angular velocity, curvilinear velocity, straight-line velocity, and plasma membrane integrity between samples frozen with the conventional (Styrofoam box) and the automated method (TK 4000C). However, the automated method provided higher values of progressive motility and rapid cells in frozen-thawed samples in comparison with the conventional method (P < 0.05). For experiment 2, mares were bred using 500 × 10(6) fresh sperm (M); and jennies using 1 × 10(9) (J1) or 500 × 10(6) fresh sperm (J5). Pregnancy rates in M, J1, and J5 were 93% (14/15), 73% (11/15), and 40% (6/15), respectively. When using different insemination doses, 500 × 10(6) or 1 × 10(9) sperm, no significant difference was observed in pregnancy rates of mares (M, 14/15) and jennies (J1, 11/15). Furthermore, there was no significant difference between the two insemination doses in jennies. However, with an insemination dose of 500 × 10(6) fresh sperm, the pregnancy rates were significantly higher in mares (M, 14/15) than in jennies (J5, 6/15; P < 0.05). For experiment 3, the inseminations were carried out in the uterine body (UB) or in the uterine horn of jennies with frozen-thawed donkey semen. No pregnancies were achieved with inseminations performed in the UB (0/12). The pregnancy rate for uterine horn group was 28.26% (13/46) and thus significantly higher than the UB group (0%; 0/12; P < 0.05). In conclusion, the automated method showed higher values on progressive motility and rapid cells parameters compared to the conventional method and can be used as an alternative for freezing donkey semen. The increase in the number of sperm cells per insemination dose using fresh donkey semen improved the fertility rates in jennies. The deep horn inseminations using frozen-thawed donkey semen increased the pregnancy rate in jennies, and the multiple inseminations may be an option to improve the fertility rates of donkey semen in jennies.

Different extenders in the cryopreservation of bovine epididymal spermatozoa.

The objective of this study was to evaluate the effects of two different egg yolk extenders incubated with or without Sperm Talp on the motility and plasma membrane integrity of cryopreserved bovine epididymal spermatozoa after freezing. Twenty-five testicles with epididymides from mature bulls were collected at the abattoir. Epididymal sperm recovery was performed by retrograde flushing using a skim milk-extender (Botu-Semen™). After recovery, sperm were incubated either without or with Sperm Talp and then submitted to centrifugation. For the freezing process, half of the testes were processed with Tris egg yolk extender, and half were processed with Botu-Bov™ egg yolk extender. Samples incubated in Sperm Talp exhibited better results than epididymal spermatozoa that were incubated without Sperm Talp (p<0.05). Both Botu-Bov™ and Tris could be utilised to freeze sperm from the bovine epididymides if the sperm were previously incubated with Sperm Talp. The extenders examined in this work did not differ in their effect on plasma membrane integrity after freezing.

Effect of glycerol on the viability and fertility of cooled bovine semen.

The aim of the present study was to compare the viability and fertility of bovine semen diluted in Botu-Bov (BB) commercial extender with and without the cryoprotectant glycerol then cooled at 5 degree C for 24 hours in the Botu-Flex passive cooling system and of semen diluted in BB with glycerol then frozen. One ejaculate of 30 Nelore Bos Taurus indicus bulls between 24 and 30 months of age was used for in vitro analysis. Sperm kinetics and cell viability were analyzed using computer-assisted sperm analysis and flow cytometry, respectively. Three Nelore bulls approximately 30 month old were used for in vivo test using fixed-time artificial insemination for the fertility analysis. The ejaculates were divided into three experimental groups: semen in BB extender with 7% glycerol cooled at 5 °C for 24 hours (cooled semen with cryoprotectant), semen in BB without glycerol cooled at 5 °C for 24 hours (cooled semen without cryoprotectant), and semen diluted in BB with 7% glycerol then subsequently frozen rather than cooled (frozen semen). For the fertility analysis, 762 Nelore cows (B taurus indicus) were randomly inseminated using fixed-time artificial insemination. For the groups corresponding to cooled semen with cryoprotectant, cooled semen without cryoprotectant, and frozen semen, 278, 268, and 216 cows were inseminated, respectively, and the resulting conception rates were 51% a, 44%ab and 41%b (P < 0.05), respectively. In conclusion, the fertility rates improved, when samples were cooled with glycerol at 5 °C for 24 hours compared with the frozen samples.

Neostigmine for the treatment of gastrointestinal atony: a report of one case.

BACKGROUND: A case of severe constipation is described in a 75-year- old cancer patient receiving methadone for pain. Her constipation was refractory to the current treatment and she suffered severe discomfort and cognitive impairment. Due to the severity of the clinical situation and after excluding mechanical obstruction, low doses of subcutaneous neostigmine were administered, having bowel movements with evacuation of stools in a few hours after its administration. DISCUSSION: The results suggest that subcutaneous neostigmine could be an alternative choice in a group of selected patients with advanced cancer and opioid-induced constipation.

Tratamiento del dolor oncológico con morfina por vía oral y subcutánea / Treatment of oncologic pain with oral and subcutaneous morphine

El objetivo de este trabajo fue evaluar la eficacia del tratamiento del dolor oncológico con opiáceos vía oral y subcutánea y la aparición de efectos colaterales. Se realizó un estudio retrospectivo donde se analizaron 261 pacientes neoplásicos con una edad promedio de 59,70 ± 12,55 años que consultaron en la Unidad de Terapia del Dolor del Servicio de Anestesiología del Hospital Universitario (Hospital de Clínicas).Se realizó una clasificación de las neoplasias según su origen y se documentaron las zonas más frecuentes de aparición del dolor. La terapia se basó en las guías de la Organización Mundial de la Salud (OMS) para el tratamiento del dolor por cáncer (1982). La morfina (licor de Brompton) fue administrada por vía oral o enteral, utilizándose la vía subcutánea en caso de intolerancia digestiva o depresión de conciencia. Se documentaron los siguientes puntos: intensidad del dolor (mediante la Escala Visual Análoga: EVA), cambios en los planes de tratamiento y requerimientos de morfina y presencia de efectos colaterales adversos. Se logró una reducción estadísticamente significativa de los pacientes con dolor severo (EVA: 7-10) al final del tratamiento, así como un aumento estadísticamente significativo (p<0,01) de pacientes analgesiados (EVA: 0) y pacientes con dolor leve (EVA: 1-3). Los pacientes con dolor moderado (EVA: 4-6) registraron también un aumento significativo en su número. Los efectos colaterales más frecuentes fueron aquellos relacionados con el tracto gastrointestinal: náuseas y vómitos (34,4 por ciento) y constipación (31,20 por ciento); se registró depresión de conciencia (1,20 por ciento) y depresión respiratoria (0,6 por ciento) en pacientes con falla renal o hepática o ambas