Outcomes of gestation length in relation to farrowing performance in sows and daily weight gain and metabolic profiles in piglets

The objective of this study was to evaluate uterine activity at farrowing in sows with different gestation lengths (GL), and its effect on the metabolic profile, blood gases and daily weight gain of neonate piglets. The experiment covered a period of 25 weeks and involved 200 Yorkshire-Landrace sows. The animals were assigned to four groups of 50 sows each and distributed according to GL, as follows: GL1: 107–109 days; GL2: 110–113 days; GL3: 114–116 days; GL4: 117–119 days. The productive indicators of the sows were recorded, as were the survival outcomes of the neonatal pigs. Fetal cardiac frequency and both intensity and frequency of myometrial contractions were monitored using a Corometrics Fetal monitor. The blood gases, electrolytes and glucose levels of the neonates were obtained by means of an automatic blood gas and electrolyte analyser. The GL groups GL1 and GL2 had more prolonged births (>226.26 ± 4.95 min) regardless of litter size (P < 0.05). Of the four groups, GL1 presented the longest duration (P < 0.05) of the expulsion phase (P < 0.05), the highest number of uterine contractions (P < 0.05), and the highest and lowest number of intra-partum deaths (P < 0.05) and live births, respectively. The live birth piglets in this group had both the lowest birthweights (P < 0.05) and the highest incidences of hypercapnia, hyperlactatemia and hypercalcaemia (P < 0.05), which later resulted in lower rates of daily weight gain (P < 0.05). In conclusion, premature births increase the number of intra-partum deaths and result in lower birthweights, the presence of apnoea, and severe metabolic alterations in piglets.

Recommendations for radiological diagnosis and assessment of treatment response in lung cancer: a national consensus statement by the Spanish Society of Medical Radiology and the Spanish Society of Medical Oncology

The last decade has seen substantial progress in the diagnostic and therapeutic approach to lung cancer, thus meaning that its prognosis has improved. The Spanish Society of Medical Radiology and the Spanish Society of Medical Oncology have therefore produced a national consensus statement to make recommendations for radiological diagnosis and assessment of treatment response in patients with lung cancer. This expert group recommends multi-detector computed tomography as the technique of choice for investigating this disease. The radiology report should include a full assessment by the TNM staging system. Lastly, when the patient is on immunotherapy, response evaluation should employ not only response evaluation criteria in solid tumours, but also immune-related response criteria.

Plasma methionine, choline, betaine, and dimethylglycine in relation to colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

BACKGROUND

Disturbances in one carbon metabolism may contribute to carcinogenesis by affecting methylation and synthesis of DNA. Choline and its oxidation product betaine are involved in this metabolism and can serve as alternative methyl group donors when folate status is low.

PATIENTS AND METHODS

We conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), to investigate plasma concentrations of the methyl donors methionine, choline, betaine (trimethylglycine), and dimethylglycine (DMG) in relation to colorectal cancer (CRC) risk. Our study included 1367 incident CRC cases (965 colon and 402 rectum) and 2323 controls matched by gender, age group, and study center. Multivariate-adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for CRC risk were estimated by conditional logistic regression, comparing the fifth to the first quintile of plasma concentrations.

RESULTS

Overall, methionine (OR: 0.79, 95% CI: 0.63-0.99, P-trend = 0.05), choline (OR: 0.77, 95% CI: 0.60-0.99, P-trend = 0.07), and betaine (OR: 0.85, 95% CI: 0.66-1.09, P-trend = 0.06) concentrations were inversely associated with CRC risk of borderline significance. In participants with folate concentration below the median of 11.3 nmol/l, high betaine concentration was associated with reduced CRC risk (OR: 0.71, 95% CI: 0.50-1.00, P-trend = 0.02), which was not observed for those having a higher folate status. Among women, but not men, high choline concentration was associated with decreased CRC risk (OR: 0.62, 95% CI: 0.43-0.88, P-trend = 0.01). Plasma DMG was not associated with CRC risk.

CONCLUSIONS

Individuals with high plasma concentrations of methionine, choline, and betaine may be at reduced risk of CRC.

Pulmonary complications in hematopoietic SCT: a prospective study

Pulmonary complications are common and often lethal in hematopoietic SCT recipients. The objective of this prospective interventional study was to evaluate the etiology, diagnostic procedures, risk factors and outcome of pulmonary complications in a cohort of hematopoietic SCT recipients followed up for 1 year. For patients suffering from a pulmonary complication, a diagnostic algorithm that included non-invasive and bronchoscopic procedures was performed. We identified 73 pulmonary complications in 169 patients: 50 (68%) were pneumonias; 21 (29%) were non-infectious complications and 2 (3%) were undiagnosed. Viruses (particularly Rhinovirus) and bacteria (particularly P. aeruginosa) (28 and 26%, respectively) were the most common causes of pneumonia. A specific diagnosis was obtained in 83% of the cases. A non-invasive test gave a specific diagnosis in 59% of the episodes. The diagnostic yield of bronchoscopy was 67 and 78% in pulmonary infections. Early bronchoscopy (⩽5 days) had higher diagnostic yield than late bronchoscopy (78 vs 23%; P=0.02) for pulmonary infections. Overall mortality was 22 and 32% of all fatalities were due to pulmonary complications. Pulmonary complications are common and constitute an independent risk factor for mortality, stressing the importance of an appropriate clinical management.

Ultrasound-guided platelet-rich plasma injections for the treatment of common peroneal nerve palsy associated with multiple ligament injuries of the knee

PURPOSE

Peroneal nerve palsy in traumatic knee dislocations associated with multiple ligament injuries is common. Several surgical approaches are described for this lesion with less-than-optimal outcomes. The present case represents the application of plasma rich in growth factors (PRGF) technology for the treatment of peroneal nerve palsy with drop foot. This technology has already been proven its therapeutic potential for various musculoskeletal disorders. Based on these results, we hypothesized that PRGF could stimulate the healing process of traumatic peroneal nerve palsy with drop foot.

METHODS

The patient was a healthy 28-year-old man. He suffered peroneal nerve palsy with drop foot after multiple ligament injuries of the knee. PRGF was prepared according to the manufactured instruction. Eleven months after the trauma with severe axonotmesis, serial intraneural infiltrations of PRGF were started using ultrasound guidance. The therapeutic effect was assessed by electromyography (EMG), echogenicity of the peroneal nerve under ultrasound (US) and manual muscle testing.

RESULTS

Twenty-one months after the first injection, not complete but partial useful recovery is obtained. He is satisfied with walking and running without orthosis. Sensitivity demonstrates almost full recovery in the peroneal nerve distribution area. EMG controls show complete reinnervation for the peroneus longus and a better reinnervation for the tibialis anterior muscle, compared with previous examinations.

CONCLUSION

Plasma rich in growth factors (PRGF) infiltrations could enhance healing process of peroneal nerve palsy with drop foot. This case report demonstrates the therapeutic potential of this technology for traumatic peripheral nerve palsy and the usefulness of US-guided PRGF.

LEVEL OF EVIDENCE

V.

Effect of lairage time ( 0h, 3 h, 6 h or 12 h) on glycogen content and meat quality parameters in suckling lambs

The effect of slaughter at arrival (L0) or after 3 (L3), 6 (L6), 12 (L12) h of lairage on carcass and meat quality of suckling lambs has been studied. Lairage time had a slight effect on carcass quality traits, but most of the meat quality parameters at 24h post mortem were affected. Weight losses increased and glycogen content of liver and longissimus muscle decreased as lairage time increased. Longissimus muscle from L3 lambs had the highest pH, shear force and toughness and the lowest b* and C* values, at 24h post mortem. L3 and L6 had the higher proportion of expelled juice, or low water holding capacity (WHC), at 24h post mortem. Texture parameters and WHC were similar among groups after 5 days of storage. Despite the fact that the effects of lairage time on meat quality disappears after storage, from the point of view of weight losses the slaughter of suckling lambs at arrival is recommended.

Comparative antitumor effect among GM-CSF, IL-12 and GM-CSF+IL-12 genetically modified tumor cell vaccines

Genetically modified cells have been shown to be one of the most effective cancer vaccine strategies. An evaluation is made of the efficacy of both preventive and therapeutic antitumor vaccines against murine melanoma, using C57BL/6 mice and irradiated B16 tumor cells expressing granulocyte and macrophage colony-stimulating factor (GM-CSF), interleukin-12 (IL-12) or both. Tumor was transplanted by the injection of wild-type B16 cells. Tumor growth and survival were measured to evaluate the efficacy of vaccination. Specific humoral response and immunoglobulin G (IgG) switch were evaluated measuring total IgG and IgG1 and IgG2a subtypes against tumor membrane proteins of B16 cells. In preventive vaccination, all treated groups showed delayed tumor growth. In addition, the group vaccinated to express only GM-CSF achieved 100% animal survival (P<0.005). Vaccination with GM-CSF+IL-12-producing B16 cells yielded lesser results (60% survival, P<0.005). Furthermore, all surviving animals remained disease-free after second tumor implantation 1 year later. The therapeutic vaccination strategies resulted in significantly delayed tumor growth, mainly using B16 cells producing GM-CSF+IL-12 cytokines, with 70% tumor growth inhibition (P<0.001)-although none of the animals reached overall survival. The results obtained suggest that the GM-CSF+IL-12 combination only increases the efficacy of therapeutic vaccines. No differences in classical regulatory T cells were found among the different groups.

[Learning of percutaneous nephrolithotomy in supine position. An observational multicenter study]

OBJECTIVE

To prospectively study the post-operative results and complications of percutaneous nephrolithotomy (PNL) in supine position to assess difficulty of learning it and how experience affects the results. To establish a relative comparison with the data published in the literature on the prone position.

MATERIAL AND METHODS

A prospective observational multicenter study on PNL in Valdivia position or in its Galdakao variant was performed. Demographic variables and specific variables related to the lithiasis were collected. Technical aspects, surgery time, success rate and complications according to the Clavien-Dindo classifications were assessed.

RESULTS

A total of 335 PNL in supine position conducted in 13 Spanish centers were registered from September 2008 to June 2011. The man:woman ratio was 1:1.28 and mean age 51.3+14.5 years. 211 (63%) cases were performed by urologists with experience in >50 cases and 124 (37%) by urologists with less experience. Mean operation time was 113.3 ± 46.4 min, 106.6 ± 38.2 for the experienced ones vs. 124.9 ± 56.2 in the novice ones (P<.002). No difference was detected in the mean size of the lithiasis. However, in the experienced group, there was a greater proportion of coraliform cases and multiple lithiasis than in the novice group (P<.001). Success rate evaluated as total absence of lithiasic residuals was 69.6%, without differences between groups (68.2 vs. 71.8%). In 102 (30.6%) patient had residual lithiasis and 60 (17,9%) required complementary treatment. Relative global success rate was 82.1% and complications rate 25.4%, without detecting differences between groups. However, the novel group had more major complications (P>.001).

CONCLUSION

The PNL in supine position is obtaining rapid and consolidated diffusion in our setting and its effectiveness and safety seems to be equivalent to that described in the literature for PNL in prone position. It is possible to obtain good results with a modest learning curve. The rate of greater complications associated to the procedure decreases with experience.

[Review of initiatives carried out in Spain to implement teaching of basic cardiopulmonary reanimation in schools]

Cardiorespiratory arrest (CRA) is a situation of maximum medical emergency which can be potentially reversed if basic cardiopulmonary resuscitation manoeuvres (CPR) are provided by the first bystander. Nonetheless, this is done in less than 25 % of the cardiorespiratory arrests (CRA) witnessed by bystanders. Thus, it is urgent to increase the knowledge of such basic CPR manoeuvres among the public in general. One strategy consists in the teaching of basic CPR techniques in schools following the recommendations made by specialized institutions. This study analyzes the initiatives carried out in Spain, including the authors' own experience acquired during the development of PROCES, a program aimed a students from 15 to 16 years of age and carried out during the last 10 years in Barcelona.