Spontaneous Regression of Intracranial Arteriovenous Malformations

Spontaneous and complete regression of cerebral arteriovenous malformations has rarely been reported in the literature. We describe two new cases with a literature review.

Neuromyelitis optica: Contribution of therapeutic responses markers monitoring in patients given rituximab

Neuromyelitis optica (NMO) is a central nervous system inflammatory autoimmune disease characterized by medullary and/or optical nerve damage. It is rare but life-threatening. Concerning the treatment of NMO, many drugs have been used in background therapy. Some studies have shown efficacy of rituximab (an antiCD20 monoclonal anti-body) either on the reduction of the annual number of exacerbation or the mean score EDSS. In 2013, a Korean team reported a new protocol during which they administered rituximab only when memory B lymphocytes CD27+ were detectable in the bloodstream. In our patient, institution of this protocol led to clinical benefit with a major decrease in the EDSS score over time (7 in August 2012 vs. 1 in October 2015), a reduction of the total administered dose (4g in 2013 vs. 1.375g in 2014 vs. 0g in 2015) and side effects. Compared with the rate of theoretical administration, health expenditure savings reached 1700 Euros per month over the 11-month treatment. Monitoring therapeutic response markers with memory B lymphocyte counts appear to be an efficient cost-effective way to measure clinical efficiency, reduce total doses, and limit side effects.

[Adrenal insufficiency in cirrhotic patients]

Relative adrenal insufficiency (RAI) is a common finding in cirrhotic patients with severe sepsis, and increased mortality. Its significance is unknown in stable conditions. The aim of this study was to evaluate the prevalence of RAI in stable cirrhotic patients at different stages of the disease. Also, the impact of RAI on the survival was evaluated and basal cortisol levels between plasma and saliva was correlated in control subjects and cirrhotic patients. Forty seven ambulatory patients and 16 control subjects were studied. RAI was defined as a serum cortisol increase of less than 9 υg/dl from baseline after the stimulation with 250 mg of synthetic ACTH. Twenty two had Child-Pugh = 8 and 25 = 9. The prevalence of RAI in patients with stable cirrhosis was 22%. A higher incidence of RAI was observed in patients with a Child-Pugh = 9 (8/32) than in those with = 8 (3/13, p < 0.05). A correlation between salivary cortisol and basal plasma cortisol (r = 0.6, p < 0.0004) was observed. Finally, survival at 1 year (97%) and 3 years (91%) was significantly higher without RAI than those who developed this complication (79% and 51%, p < 0.05, respectively). In summary, the prevalence of RAI is frequent in patients with stable cirrhosis and that it is related to the severity of liver diseaseand increased mortality.

Effect of puerperal metritis on reproductive and productive performance in dairy cows in Argentina

The objectives of this study were to evaluate the reproductive and productive performance of dairy cows with and without puerperal metritis and to evaluate the effectiveness of using a long-acting ceftiofur preparation. Dairy cows in one dairy farm, calving from July 2009 to January 2010, were examined between 3 and 14 days postpartum and classified on the basis of vaginal discharge into three groups: cows with normal discharge (control; C); cows with a bloody mucus purulent or pathologic nonfetid discharge (PnFD), and cows with bloody mucopurulent or purulent fetid discharge (PFD). Cows in C and PnFD groups were not treated, whereas those in the PFD group were randomly allocated to receive 2.2 mg/kg of ceftiofur subcutaneously behind the ear (PFD-T) or remain untreated (PFD-No T). From the 640 cows examined, 58.2% formed the C group, 13.4% formed the PnFD group, and 28.4% formed the PFD group. Survival curves differed between cows in the C group and PFD-No T group (P = 0.0013) and between PFD-No T versus PFD-T group (P = 0.0006). Survival curves of PnFD were intermediate and did not differ from those in the C group (P = 0.2) and PFD-T group (P = 0.1) but tended to be different from the PFD-No T group (P = 0.056). The postpartum interval to achieve a 25% pregnancy rate was 72 days for cows in the C group, 73 days for the PFD-T group, 83 days for PnFD group, and 95 days for the PFD-No T group. The chance of pregnancy in a cow in the C group was 1.98 times higher (95% confidence interval = 1.33, 3.08) and in cows in the PFD-T group was 2.16 times higher (95% confidence interval = 1.37, 3.50) than that in the PFD-No T group. Finally, the chance of pregnancy in cows in the PnFD group tended to be higher (P = 0.08) than that in the PFD-No T group but did not differ from the other two groups. Cumulative 305-day milk production was higher (P < 0.0001) in C group than those with vaginal discharge, regardless of fetidness and regardless of treatment. It is concluded that puerperal metritis affects the reproductive and productive performance of dairy cows and the treatment with ceftiofur was effective in reducing the adverse effects on reproductive performance but not on milk production.

Quantum Rabi Model with Trapped Ions

We propose the quantum simulation of the quantum Rabi model in all parameter regimes by means of detuned bichromatic sideband excitations of a single trapped ion. We show that current setups can reproduce, in particular, the ultrastrong and deep strong coupling regimes of such a paradigmatic light-matter interaction. Furthermore, associated with these extreme dipolar regimes, we study the controlled generation and detection of their entangled ground states by means of adiabatic methods. Ion traps have arguably performed the first quantum simulation of the Jaynes-Cummings model, a restricted regime of the quantum Rabi model where the rotating-wave approximation holds. We show that one can go beyond and experimentally investigate the quantum simulation of coupling regimes of the quantum Rabi model that are difficult to achieve with natural dipolar interactions.

Scalable quantum memory in the ultrastrong coupling regime

Circuit quantum electrodynamics, consisting of superconducting artificial atoms coupled to on-chip resonators, represents a prime candidate to implement the scalable quantum computing architecture because of the presence of good tunability and controllability. Furthermore, recent advances have pushed the technology towards the ultrastrong coupling regime of light-matter interaction, where the qubit-resonator coupling strength reaches a considerable fraction of the resonator frequency. Here, we propose a qubit-resonator system operating in that regime, as a quantum memory device and study the storage and retrieval of quantum information in and from the Z2 parity-protected quantum memory, within experimentally feasible schemes. We are also convinced that our proposal might pave a way to realize a scalable quantum random-access memory due to its fast storage and readout performances.

Fermion-fermion scattering in quantum field theory with superconducting circuits

We propose an analog-digital quantum simulation of fermion-fermion scattering mediated by a continuum of bosonic modes within a circuit quantum electrodynamics scenario. This quantum technology naturally provides strong coupling of superconducting qubits with a continuum of electromagnetic modes in an open transmission line. In this way, we propose qubits to efficiently simulate fermionic modes via digital techniques, while we consider the continuum complexity of an open transmission line to simulate the continuum complexity of bosonic modes in quantum field theories. Therefore, we believe that the complexity-simulating-complexity concept should become a leading paradigm in any effort towards scalable quantum simulations.

Within-day variation and effect of acute stress on plasma and milk cortisol in lactating goats

An experiment was carried out to study the effect of acute stress on cortisol concentration in goat milk (milk cortisol; MC) and its suitability for stress assessment. Additional variables studied were plasma cortisol (PC), blood glucose (BG), and somatic cell count (SCC). Ten goats free of mastitis at 2 mo of lactation were divided into 2 groups. One group of animals was exposed to acute stress (visual and auditory, but not physical, contact with a barking dog for 3 min) immediately before the 1000 h sampling (STR), and the other group was considered as the control group, not exposed to acute stress (CON). The animals were gradually accustomed to the sampling schedule for 1 wk before the stress treatment (pre-experimental period). The variables PC, MC, BG, SCC, and milk composition (fat, lactose, whey protein, true protein, and casein) were recorded at 0600, 1000, 1130, 1400, 1800, 2200, and 0200 h. Milk variables were recorded in both glands separately. The right gland (n=10) was completely milked and the left gland (n=10) was milked to 30 mL at every sampling except at 1000 h, when complete milking was carried out on both glands. Variables were analyzed by using a linear mixed model. Both PC and MC concentrations varied throughout the day, with values being highest in the morning. Higher PC levels were recorded in the STR group immediately after treatment compared with CON (36.9 vs 16.3 ng/mL). For MC, differences between treatments were noted 1.5h after STR treatment (1.27 vs 0.25 ng/mL). Blood glucose increased immediately after treatment in STR animals, being different from CON until 1.5h after treatment sampling (101 vs. 58 mg/dL). The SCC was not increased by STR treatment, showing higher values in the morning and afternoon compared with evening and night (5.6±0.13 to 5.87±0.13 log10 SCC). The STR treatment had no significant effect on milk composition, and overall milk yield of a complete day after stress stimulus of both groups was similar (STR: 2,067±280 g/d; CON: 2,134±427 g/d). We conclude that plasma and milk cortisol concentrations in control dairy goats varied throughout the day; MC showed significant differences in the STR group if samples were taken 1.5h after the stressing stimulus, whereas PC showed significant differences in samples taken immediately after the stressing stimulus. Additionally, MC sampling has the advantage of being noninvasive compared with blood sampling.

Dynamical Casimir effect entangles artificial atoms

We show that the physics underlying the dynamical Casimir effect may generate multipartite quantum correlations. To achieve it, we propose a circuit quantum electrodynamics scenario involving superconducting quantum interference devices, cavities, and superconducting qubits, also called artificial atoms. Our results predict the generation of highly entangled states for two and three superconducting qubits in different geometric configurations with realistic parameters. This proposal paves the way for a scalable method of multipartite entanglement generation in cavity networks through dynamical Casimir physics.

Short communication: effects of milk removal on teat tissue and recovery in Murciano-Granadina goats

The aim of this work was to study how machine milking (MM) carried out in appropriate conditions affects teat wall thickness and canal length and their return after milking to premilking conditions compared with other milk removal methods considered biological referents: kid suckling (KS), catheter removal (CATH), and hand milking (HM). Three Latin square experiments were designed, each divided into 2 periods. In the first period, the left glands of each animal were machine milked and the KS, CATH, and HM treatments were applied to the right glands in experiments 1, 2, and 3, respectively. Subsequently, in the second period, the removal methods were interchanged. Teat wall thickness, teat wall area, teat end wall area, and teat canal length were measured from the ultrasound images. Milk removal using the reference methods (KS, CATH, and HM) and by MM caused increases in teat wall thickness and teat canal length, which were greater with MM. The time needed for the teat walls and canal to return to their physiological conditions before milk removal was greater than 10h in the reference methods and following machine milking.

[Endoscopic versus endoscopic plus octreotide treatment for acute variceal bleeding. Benefit according to severity at admission]

Vasoactive agents plus endoscopic treatment was recommended in esophageal variceal bleeding (EVB). However, the use according to severity on admission has been poorly evaluated

OBJECTIVES

To evaluate the efficacy of endoscopic versus endoscopic plus octreotide treatment in patients with EVB according to severity on admission.

METHODS

Between June 2001 and December 2011, 247 patients with EVB were treated using endoscopic or combined endoscopic plus octreotide treatment. Patients were analyzed according to the following cohorts: all patients, those with and without active bleeding, and by Child classes. Initial hemostatic failure, in-hospital rebleeding and in-hospital mortality were compared with both treatments.

RESULTS

All patients with combined treatment had less initial hemostatic failure (P = 0.0157) and rebleeding (P = 0.0011) when compared to endoscopic treatment. Active bleeding patients and Child C patients had a significant reduction of initial hemostatic failure when receiving combined treatment vs endoscopic treatment (P = 0.0479 and P = 0.0222, respectively). Child C patients and patients without active bleeding significantly decreased rebleeding with combined treatment (P = 0.0139 and P = 0.0056, respectively). Global mortality was 17%, and did not differ between treatments. None patient in Child A died.

CONCLUSIONS

Combined endoscopic plus octreotide treatment in patients with EVB resulted in a reduction of initial hemostatic failure and rebleeding. Moreover, the most relevant effect of combined treatment in decreasing initial hemostatic failure was seen in Child C and active bleeding patients, and for in-hospital rebleeding the same effect was seen in Child C and in patients without active bleeding. Mortality did not differ with both mentioned treatments.

[Gastric cancer risk estimate in patients with chronic gastritis associated with Helicobacter pylori infection in a clinical setting]

BACKGROUND/AIM

Severity of chronic gastritis associated with Helicobacter pylori infection (CGAHpI) could play a role in evaluating the potential risk to develop gastric cancer. Our aim was to estimate the risk for gastric cancer in a clinical setting, according to histopathologic criteria, by applying the gastric cancer risk index (GCRI) METHODS: Histopathologic study of the gastric biopsies (corpus-antrum) from consecutive adult patients that underwent gastroesophageal duodenoscopy was carried out, and the GCRI was applied in patients presenting with CGAHpI.

RESULTS

One hundred eleven patients (77% female) with a mean age of 38.6±13.1 years were included. Active Helicobacter pylori infection (aHpi) was diagnosed in 77 cases (69.40%). In 45% of the cases with aHpi, pangastritis (23%) or corpus-predominant gastritis (22%) was diagnosed. Nine cases were diagnosed with intestinal metaplasia (8%), 7 of which (77.70%) were in the aHpi group. Twenty one percent of the patients with aHpi had a GCRI of 2 (18.10%) or 3 (2.50%) points (high risk index), while 79.10% accumulated a GCRI of 0 or 1 points (low risk index). Of the patients with no aHpi, none of them had 3 points (p=0.001). Of the 18 patients that accumulated 2 or 3 points, 6 (33.30%) presented with intestinal metaplasia (all with pangastritis and corpus-predominant gastritis), of which 4 cases (66.60%) had aHpi.

CONCLUSIONS

The estimated gastric cancer risk in patients with CGAHpI in the clinical setting studied was relatively low and 5% of the patients had a histopathologic phenotype associated with an elevated risk for developing gastric cancer.

18 PREGNANCY RATES IN LACTATING DAIRY COWS TREATED WITH GONADOTROPIN-RELEASING HORMONE-BASED SYNCHRONIZATION PROGRAMS AND INSEMINATED AT A FIXED TIME

An experiment was designed to compare pregnancy rates in lactating dairy cows synchronized with a 7-day CIDR-Synch or a 5-day CIDR-Synch program and to determine if the addition of a second prostaglandin F2α (PGF) injection to the 7-day CIDR-Synch program would improve pregnancy rates following fixed-time AI (FTAI). The experiments were performed on 2 dairy farms in Argentina, with year-round calving and a mixed feeding system (35% grazing plus 65% corn silage and grain). Cows (n = 621) were 39.3 ± 6.5 days in milk (DIM, mean ± SD) when they were enrolled in the program, had 2.4 ± 1.5 lactations and a body condition score (BCS) of 3.1 ± 0.2 (range: 2.7 to 4.0). All cows received a pre-synchronization treatment with 2 doses of prostaglandin (PGF, 25 mg of dinoprost, Lutalyse, Pfizer Animal Health, Argentina) 14 days apart, and 11 days after the second PGF (Day 0) received 10 µg of Buserelin (GnRH, Receptal, MSD-Intervet, Argentina) and a CIDR device (1.9 g of progesterone, Pfizer Animal Health). Cows were randomly allocated to 1 of 3 groups. The CIDR devices were removed and PGF was administered to cows in Groups 1 and 2 on Day 7. A second GnRH was given 56 h later and cows experienced FTAI 16 h after gonadotropin-releasing hormone (GnRH) injection (i.e. 72 h after CIDR removal). Cows in Group 2 also received a second PGF injection on the afternoon of Day 7. Cows in Group 3 had the CIDR removed and received 2 PGF injections 12 h apart on Day 5. A second dose of GnRH was given and FTAI was performed at the same time, on Day 8 (i.e. 72 h after CIDR removal). All cows were examined by ultrasonography (Aloka 500V, Aloka, Tokyo, Japan) on the day of the first PGF injection and at CIDR removal to determine the presence and number of corpora lutea (CL), and 30 days after FTAI to determine pregnancy status. Data were analyzed by logistic regression to determine the effects of treatment, parity, days postpartum, milk production, BCS, presence of a CL at enrollment, and number of CL at the time of CIDR removal on pregnancy rates. Overall pregnancy rates did not differ among groups: 32.9% (68/207), 38.2% (78/204), and 38.3% (80/209) for Groups 1, 2, and 3, respectively (P = 0.2). Although the number of CL present at CIDR removal did not significantly affect pregnancy rates (P = 0.4), pregnancy rates in cows with 1 CL in Groups 1 and 2 tended to differ [29.0% (11/38) v. 48.9% (21/43); P < 0.07], but neither differed from that in Group 3 [37.2% (16/43)]. No differences were detected among groups in cows without a CL at CIDR removal [overall pregnancy rate: 29.4% (5/17)] and those with ≥2 CL [overall pregnancy rate: 36.1% (173/479)]. Among the other variables evaluated, first-parity cows had 1.96 (1.38–2.78) times more chance of getting pregnant than second-or-more-parity cows (P = 0.002) and cows with BCS >3 had 1.63 (1.16–2.28) times more chance of getting pregnant than those with BCS <3 (P = 0.003). Finally, herd, days postpartum, milk production, and presence of a CL at enrollment did not significantly affect pregnancy rates. We concluded that the 3 treatments resulted in similar pregnancy rates for lactating dairy cows and that the benefit of adding a second PGF injection to the 7-day protocol was only marginal in cows with 1 CL at CIDR removal.

163 EFFECT OF PUERPERAL METRITIS ON REPRODUCTIVE AND PRODUCTIVE PERFORMANCE IN DAIRY COWS IN ARGENTINA

The objectives of this study were to evaluate the reproductive and productive performance of dairy cows with and without puerperal metritis and to evaluate the effectiveness of using a long-acting antibiotic (200 mg mL–1 ceftiofur, Excede, Pfizer Animal Health, New York, NY, USA). Dairy cows in one dairy farm calving from July 2009 to January 2010 were examined between 3 and 14 days postpartum and classified based on vaginal discharge into 3 groups: cows with normal discharge (control); cows with purulent or red-brown vaginal discharge without foul smell, and cows with purulent or red-brown vaginal discharge with foul smell (Sheldon et al. 2006 Theriogenology 65, 1516–1530). Cows in the first 2 groups were not treated, whereas those in the third group were randomly allocated to receive 1 mL/30 kg of body weight of Excede subcutaneously behind the ear or remain untreated. From the 640 cows examined, 372 (58.2%) had normal discharge, 86 (13.4%) had a discharge without foul smell and 182 (28.4%) had a discharge with foul smell. Kaplan-Meier survival curves were obtained to compare pregnancy rates across days postpartum, and differences between curves were tested with the log rank statistic. Proportional hazards regression with PROC PHREG Cox of SAS were done to estimate the risk of pregnancy in terms of treatment, parity (first parity or ≥2 parities), type of delivery (normal or assisted), and milk production. Finally, lactation curves were modeled using SAS PROC NLMIXED to estimate the cumulative milk production at 305 days. Survival curves differed between cows in the control group and those with foul-smell discharge that were not treated (P < 0.01) and between untreated versus treated cows (P < 0.01) in the latter group. Survival curves of cows with discharge but without foul smell were intermediate and did not differ from those in the control group (P = 0.2) and those with foul smell discharge and treated (P = 0.1), but tended to be different from those with foul smell discharge and not treated (P = 0.056). The postpartum interval to achieve a 25% pregnancy rate was 72 days for cows in the control group, 73 days for cows with foul smell and treated, 83 days for cows with discharge without foul smell, and 95 days for those with foul smell and not treated. The chance of pregnancy in cows in the control group was 1.98 times higher (95% CI = 1.33, 3.08) and in cows with foul smell and treated was 2.16 times higher (95% CI = 1.37, 3.50) than those with foul smell and not treated. Finally, the chance of pregnancy in cows with discharge but without a foul smell tended to be higher (P = 0.08) than those with foul smell that were not treated, but did not differ with the other 2 groups. Parity, type of delivery, and production level did not affect pregnancy rates. Cumulative 305-day milk production was higher (P < 0.01) in control cows than those with vaginal discharge, regardless of smell and regardless of treatment. It is concluded that puerperal metritis affects the reproductive and productive performance of dairy cows, and the treatment with Excede was effective in reducing the adverse effects on reproductive performance.