Effects of flavour variety on the intake and palatability of commercial feed in nursery pigs

Sensory-specific satiety (SSS) could negatively affect pigs' feed intake, even when diets satisfy their nutritional requirements. We evaluated the short-term effects of SSS on feed intake and palatability. Thirty-two nursery pigs (tested in pairs) were exposed to short-term feeding trials for 6 days. In Trial 1, animals received for 90 min over three consecutive days three feeders: with different flavours (VAR); the same flavour (MON); or a mixture of the three flavours (MIX) in a 3 × 3 Latin square design. In Trial 2, with the same animals and different flavours, the three feeders were delivered successively (1 feeder every 30 min). In Trial 1, there was a day-by-diet interaction (F 4,36 = 2.98; p = 0.032), where the VAR diet was least consumed on the first day but most consumed subsequently. In Trial 2 a triple interaction between diet, day and delivery order modified pig's intake (F 12,15 = 3.33; p = 0.015), and consumption patterns (F 12,15 = 3.52; p = 0.012); where VAR diet presented the highest values in the last delivery order on the third experimental day. Flavour variety may decrease the effect of SSS, increasing feed intake and hedonic value in nursery pigs when there was a previous experience with those flavours.

The Effect of Demonstrator Social Rank on the Attentiveness and Motivation of Pigs to Positively Interact with Their Human Caretakers

Simple Summary

Motivation to express a socially learned behavior can be inhibited or facilitated by the presence of socially dominant individuals, who often attract greater attention from their conspecifics. This study investigated whether experienced pigs (termed “demonstrators”) of higher rank attract greater attention from their pen mates when they are observed from behind an acrylic panel while being gently handled by the stockperson. We also investigated whether the presence of a demonstrator pig of different social rank, who previously established a positive relationship with the stockperson in presence of conspecifics, affects the motivation and behaviors of their pen mates to positively interact with humans. Our results show that during the gentle handling of the demonstrator, there was an overall preference for observer pigs to visually attend to the dominant demonstrators more than the low-ranking demonstrators. Furthermore, our study shows that the proximity of a dominant demonstrator pig interfered with the motivation of their pen mates to positively interact with the stockperson, whereas the presence of a subordinate demonstrator facilitated the expression of a greater affinity toward the human, resulting in longer physical contact, and a higher percentage of accepted strokes. These findings reveal that social dynamics and dominance rank have a strong effect on the attentional state and the facilitation and inhibition of social behaviors in domestic pigs.

Abstract

In this study, we addressed the social attentiveness, as well as the phenomenon of social facilitation and inhibition in the context of a positive human–pig relationship. Specifically, we investigated whether the social rank of an experienced pig (termed “demonstrator”) has an effect on the attentiveness of the remaining pen mates (N = 40) when they observe the demonstrator being gently handled by a stockperson from behind an acrylic panel. We found that pigs preferentially attended to dominant demonstrators rather than subordinate demonstrators during their gentle handling sessions with the stockperson. Additionally, we also examined whether the presence of a demonstrator pig of different social rank, who previously established a positive relationship with the stockperson in presence of conspecifics, affects the behavior and motivation of their pen mates to positively interact with the stockperson. To test for the effect of the presence and demonstrator’s social rank on pen mate interactions with the stockperson, we evaluated the behavior of domestic pigs (N = 65) toward the stockperson using a human-approach test in their home-pen. Pigs showed a decrease in their motivation to positively interact with the stockperson when a socially dominant demonstrator was present, behaving similarly to animals receiving minimal human contact (control group). Overall, they exhibited a greater latency to physical contact, a lower acceptance of stroking, and spent more time looking at the stockperson compared to pigs exposed to subordinate demonstrators. Taken together, these findings expand our current understanding of pigs’ cognition and social behavior, and the nature of social attention bias in farm animals. Our findings indicate that positive handling of previously selected subordinate demonstrators seems to be the best strategy to reduce the level of fear in large groups of pigs.

Síntesis de nanoestructuras de carbono mediante la Técnica de Deposición Química de Vapores: Una revisión general

Es innegable el auge que ha tenido la nanotecnología en las últimas tres décadas. Responsables de este interés en los nanomateriales son principalmente las formas nanoestructuradas del carbono, ya que históricamente fueron las que inauguraron el estudio de los nanomateriales con el descubrimiento de los fullerenos en 1985 y los nanotubos de carbono en 1991. Aunque existen diversas técnicas para producir estos materiales, la deposición química de vapores (CVD, por sus siglas en inglés) es particularmente valiosa, ya que permite la producción de una gran variedad de nanoestructuras de carbono, es versátil, escalable, de fácil implementación y de relativamente bajo costo. En este artículo de revisión se destaca la importancia de CVD y se detallan sus principios, condiciones y parámetros de operación, así como sus principales variantes. Se realiza una descripción de la técnica utilizada para producir fullerenos, nano-cebollas, nanotubos de carbono, nanoesferas, grafeno y otras, recalcando los parámetros específicos para cada síntesis.

Do Domestic Pigs Acquire a Positive Perception of Humans through Observational Social Learning?

Farm animals can perceive humans positively by observing another animal being positively handled. This study evaluated whether pigs acquire a positive perception of humans after observing either a high or low socially ranked conspecific receiving gentle handling. Seventy-five 21-week-old pigs were housed in 15 nursery pens (five pigs/pen) and randomly assigned to one of three pen treatments: Dominant Demonstrator Group (DDG), Subordinate Demonstrator Group (SDG) and Control Group (CG). Pigs from DDG and SDG observed a high and low socially ranked conspecific ("demonstrator"), respectively, while the demonstrator received gentle stroking and a sucrose solution for 10 min, twice a day for 5 weeks. Control group pigs received minimal human contact. Following treatment, the behavior and heart rate variability of non-demonstrator pigs were evaluated in response to a stockperson in an open-field test. Pigs from the DDG and SDG contacted the stockperson sooner (p < 0.001), spent more time investigating the stockperson (p < 0.05), accepted more stroking (p < 0.001) and exhibited a lower low/high frequency ratio (p = 0.015) compared to the CG. No differences in learning between the pigs from the DDG and SDG were found. These results suggest that pigs can learn to perceive humans positively through observational social learning, regardless of the demonstrator conspecific's social rank.

Exploring Anhedonia in Kennelled Dogs: Could Coping Styles Affect Hedonic Preferences for Sweet and Umami Flavours?

Simple Summary

Kennelled dogs are susceptible to suffer chronic stress when social interactions with conspecifics and spatial needs are long-term restricted. Chronic stress may affect pleasure perception of food and solutions in dogs as observed in several animals, a phenomenon known as anhedonia. However, little information exists on how different coping styles could prevent the onset of anhedonia. Fourteen kennelled Beagle dogs were used to study the acceptability and preference for different dilute palatable sucrose and monosodium glutamate (MSG) solutions. Coping style of animals was previously evaluated through a modified human-approach test. This test consisted in assessing whether or not dogs approached an unfamiliar human when a feeding opportunity was presented, classifying them as close dogs (CD; proactive) or distant dogs (DD; reactive) respectively. It was observed that DD presented a lower intake of both sucrose and MSG dilute solutions compared with CD. Moreover, DD exhibited a higher consumption of MSG than CD at the highest concentrations, supporting that their intake depends on solution palatability. Finally, DD did not prefer sucrose or MSG solutions over water at any dilute solution offered. Together, these results suggest that dogs that are categorized as reactive animals could diminish their ability to perceive dilute palatable solutions reflecting depressive-like behaviours such as anhedonia.

Abstract

Kennelled dogs are at risk of suffering chronic stress due to long-term spatial, social and feeding restrictions. Chronic stress may decrease the dogs’ capacity to feel pleasure when facing hedonic experiences, modifying their perception for palatable ingredients. However, different abilities to cope with environmental stressors could prevent the onset of anhedonia. Fourteen kennelled Beagle dogs were used to study the acceptability and preference for different dilute sucrose and monosodium glutamate (MSG) solutions. Coping style of animals was previously evaluated through a human approach test (HAT) and classified as close dogs (CD; proactive) or distant dogs (DD; reactive) according to whether or not they approached an unfamiliar human when a feeding opportunity was presented. Consumption results were analysed taking into account the sucrose/MSG concentrations, HAT (CD or DD), age, and weight of the animals. DD presented a lower intake of sucrose (p = 0.041) and MSG (p = 0.069) solutions compared with CD. However, DD exhibited a higher consumption of MSG than CD at its highest concentrations, supporting that their intake depends on solution palatability. Finally, DD did not prefer sucrose or MSG solutions over water at any dilute solution offered. Together, these results suggest that dogs that are categorized as reactive animals could diminish their ability to perceive dilute palatable solutions, reflecting depressive-like behaviours as anhedonia.

Challenges of In-House Development and Implementation of a CPOE for Oncology

Hospital Italiano de Buenos Aires (HIBA) is an academic tertiary care hospital highly specialized that has started the process of informatization of chemotherapy protocols. The objective is to describe the development of a computerized physician order entry (CPOE) oriented to the oncology adult patient and the members of the healthcare team that works with him (physicians, pharmacists, nurses and administrative staf) to improve the process and prevent errors at a critical point in the patient's health care: during prescription, preparation and / or administration. The development of this system consisted of several stages: inquiries about the usual work and perception of needs of the potential users; user-centered design; interoperability with the electronic health record (EHR) and development of a final prototype.

Evaluating the Use of a CPOE for Chemotherapy Protocols

Chemotherapy drugs are one of the most common causes of serious and fatal medication errors, especially during prescribing, where computerized physician order entry (CPOE) take on importance. This study proposes the description of the post-implementation status of a CPOE in a highly specialized hospital between January and June 2018, among patients older than 18 years. Results: a total of 8835 protocols were indicated using the specific CPOE (93% use rate over all protocols) 91% completed the administration, 1.2% were rejected by pharmacy, and 6.8% was canceled. The most frequent cause of rejection by pharmacy and cancellation by oncologist was an inadequate dose. Most of the protocols indicated using the CPOE implemented, with a reject by pharmacy rate of 1.2%, indicates the utility of CPOE as an error prevention strategy.

Change Management in Healthcare Organizations: Soft Skills Training Strategies Through Blended Learning Environments

Teaching soft skills for change management in healthcare organizations is becoming increasingly necessary, even more, when implementing health information systems (HIS). There is little evidence that these skills can be learned through online teaching environments. This paper describes the experience of having taught soft skills to health informatics master's degree students, through blended learning environments.

Comparison of two identification and susceptibility test kits for Ureaplasma spp and Mycoplasma hominis in amniotic fluid of patients at high risk for intra-amniotic infection

Objective: Ureaplasma urealyticum and Mycoplasma hominis are the most common microorganisms found in the amniotic fluid of patients at risk for preterm delivery. However, culture techniques for genital mycoplasms require special conditions, are barely considered as part of the evaluation of suspected intra-amniotic infection (IAI) and the results are available within 2 and 7 days. The objectives of this study are to validate the use of two commercially available kits (Mycoplasma IES y MYCOFAST^® RevolutioN) for the identification of Ureaplasma spp. and Mycoplasma hominis in amniotic fluid, to compare the results of these kits with those obtained by culture and real-time polymerase chain reaction (qPCR) and to report the antibiotic sensitivity profile of the genital mycoplasms identified.Methods: This is a prospective cohort study including women with singleton and twin gestations between 16 and 36 weeks. Patients were admitted to perform an amniocentesis due to pregnancy complications considered at high risk for IAI (e.g. preterm labor with intact membranes, preterm prelabour rupture of membranes, short cervix, etc.), treatment of polyhydramnios, and for the assessment of fetal death and fever without a focus.Results: Overall, 93 patients underwent amniocentesis and 63 had results available for all tests. The prevalence of a positive culture was 6% (4/63). There were four cases of Ureaplasma spp. and none of Mycoplasma hominis. The qPCR identified one case as Ureaplasma spp., one case as Ureaplasma parvum and two cases as Ureaplasma urealyticum. For all tests, the diagnostic performance was as follows: sensitivity 100% [95% CI (39.8-100%)], specificity 100% [95% CI (93.9-100%)], positive predictive value 100% [95% CI (39.8-100%)] and negative predictive value 100% [95% CI (93.9-100%)]. In this cohort, Ureaplasma spp. showed low resistance to erythromycin, but a high resistance to clindamycin and clarithromycin that may change according to the antibiotic concentration.Conclusions: To our knowledge, this is the first study that validates the use of the Mycoplasma IES and MYCOFAST^® RevolutioN kits for the identification of genital mycoplasmas in amniotic fluid. The results of these kits are mostly available within 24 hours, have an excellent correlation with those from broth cultures and qPCR and characterize the antibiotic sensitivity profile of the genital mycoplasms identified, providing an opportunity for specific treatment in cases of IAI. Further validation studies in other populations are needed.

Health Informatics in Developing Countries: A Review of Unintended Consequences of IT Implementations, as They Affect Patient Safety and Recommendations on How to Address Them

Background: Patient safety concerns every healthcare organization. Adoption of Health information technology (HIT) appears to have the potential to address this issue, however unanticipated and undesirable consequences from implementing HIT could lead to new and more complex hazards. This could be particularly problematic in developing countries, where regulations, policies and implementations are few, less standandarized and in some cases almost non-existing.

Methods: Based on the available information and our own experience, we conducted a review of unintended consequences of HIT implementations, as they affect patient safety in developing countries.

Results: We found that user dependency on the system, alert fatigue, less communications among healthcare actors and workarounds topics should be prioritize. Institution should consider existing knowledge, learn from other experiences and model their implementations to avoid known consequences. We also recommend that they monitor and communicate their own efforts to expand knowledge in the region.

Cultural Problems Associated with the Implementation of eHealth

A major hurdle in eHealth implementation is that it is difficult to put into practice. In this study, the primary aim was to identify the main barrier associated with implementing eHealth. This study surveyed IMIA members from May to November 2015. From the results, it is clear that medical professionals were recording most of their data by hand. This paper culture is a paradigm that is difficult to break. Cultural factors are the primary barrier in eHealth implementation.

Design of a Mobile Application for Transfusion Medicine

One of the most frequent error in transfusion medicine is the failure in verifying the patient's identity prior to transfusion. This paper describes the design and development of a Mobile Application (MA) for transfusion medicine. The app uses barcode and QR reading technology for the verification of the patient's identity and the administration of blood components when making a blood transfusion. Physicians, developers, technicians of transfusion medicine and a User Centered Design team participated in the design. The inclusion of end users was fundamental to get full representativeness of their workflow. The project was based on agile methodologies of project management and software development.

Why Patient Centered Care Coordination Is Important in Developing Countries? Contribution of the IMIA Health Informatics for Development Working Group

Patient Centered Care Coordination (PCCC) focuses on the patient health care needs. PCCC involves the organization, the patients and their families, that must coordinate resources in order to accomplish the goals of PCCC. In developing countries, where disparities are frequent, PCCC could improve clinical outcomes, costs and patients satisfaction.

OBJECTIVE

the IMIA working group Health Informatics for Development analyzes the benefits, identifies the barriers and proposes strategies to reach PCCC.

METHODS

Discussions about PCCC emerged from a brief guide that posed questions about what is PCCC, why consider PCCC important, barriers to grow in this direction and ask about resources considered relevant in the topic.

RESULTS

PCCC encompasses a broad definition, includes physical, mental, socio-environmental and self care. Even benefits are proved, in developing countries the lack of a comprehensive and integrated healthcare network is one of the main barriers to reach this objective. Working hard to reach strong health policies, focus on patients, and optimizing the use of resources could improve the performance in the devolvement of PCCC programs. International collaboration could bring benefits. We believe information IT, and education in this field will play an important role in PCCC.

CONCLUSION

PCCC in developing countries has the potential to improve quality of care. Education, IT, policies and cultural issues must be addressed in an international collaborative context in order to reach this goal.

Challenges and Hurdles of eHealth Implementation in Developing Countries

Health informatics has the potential to improve the security and quality of patient care, but its impact has varied between developed and developing countries. Related to this, the objective of this study is to identify the challenges and hurdles to improve eHealth in developing countries. We surveyed experts to discover their opinions about five general questions: economic support by Government for eHealth, Government education or training projects in the field, issues related to cultural or educational problems for the implementation of eHealth, policies in terminology or messaging standards and eHealth status policies for long periods. The respondents answered affirmatively in these proportions: 1. Economic support policies 58%, 2. Training policies 25%, 3. Cultural and educational problems 95%, 4. Standards policies, 38%, 5. Policies for long periods, 50%

CONCLUSION

Our survey has shown that the important problems that need to be addressed in order to implement e-Health in developing countries are firstly, cultural and educational, secondly, economic resources and thirdly policies for long periods.

Providers Expectations on Telemedicine: A Qualitative Research in a Large Healthcare Network of Latin America

The benefits of Telemedicine make it a viable, reliable and useful discipline for dispensing health care. This qualitative study is aimed to understand the expectations, opinions and previous knowledge of the professionals about telemedicine at the Hospital Italiano de Buenos Aires.

RESULTS

Professionals realize that Telemedicine is inserted into their usual practice in an informal way. They consider telemedicine as an alternative to the traditional delivery of health care, but are afraid of their role in health care is undermined. Professionals point out very specific applications of Telemedicine such as monitoring the health of patients remotely, drug doses adjustments and sharing clinical information.

CONCLUSION

Results suggest that professionals are not familiar with telemedicine and will be necessary to develop a training plan before implementation.

[Ellis van Creveld. Case report]

INTRODUCTION

Ellis-van Creveld (EVC) (OMIM # 225500) syndrome is a rare skeletal dysplasia disorder transmitted by autosomal recessive inheritance. The diagnosis is made based on phenotypic characteristics such as chondrodysplasia, heart defects and polydactyly. The prognosis depends mainly on the severity of the disease, diagnosis and comprehensive management of the condition.

OBJECTIVE

To describe a patient diagnosed with EVC syndrome.

CASE REPORT

Newborn diagnosed with EVC syndrome who presented dysmorphic facies, shortened long bones, rhizomelic shortening, small hands, brachydactyly, single transverse palmar crease, postaxial polydactyly in the upper limbs, bilateral preaxial polysyndactyly in lower limbs and hypoplastic nails, complex heart defects and narrow thorax. The evolution was unfavorable; the patient died 8 weeks after birth from complications due to heart defects.

CONCLUSIONS

EVC syndrome is rare and unknown; therefore, it is important to spread its characteristics within the pediatric community, emphasizing that it affects multiple organ systems and requires a multidisciplinary approach to treat individually each patient, to provide genetic and reproductive counseling to couples and to give information regarding child development expectations.

Challenges and potential solutions for big data implementations in developing countries

BACKGROUND

The volume of data, the velocity with which they are generated, and their variety and lack of structure hinder their use. This creates the need to change the way information is captured, stored, processed, and analyzed, leading to the paradigm shift called Big Data.

OBJECTIVES

To describe the challenges and possible solutions for developing countries when implementing Big Data projects in the health sector.

METHODS

A non-systematic review of the literature was performed in PubMed and Google Scholar. The following keywords were used: "big data", "developing countries", "data mining", "health information systems", and "computing methodologies". A thematic review of selected articles was performed.

RESULTS

There are challenges when implementing any Big Data program including exponential growth of data, special infrastructure needs, need for a trained workforce, need to agree on interoperability standards, privacy and security issues, and the need to include people, processes, and policies to ensure their adoption. Developing countries have particular characteristics that hinder further development of these projects.

CONCLUSIONS

The advent of Big Data promises great opportunities for the healthcare field. In this article, we attempt to describe the challenges developing countries would face and enumerate the options to be used to achieve successful implementations of Big Data programs.

Health Informatics in Developing Countries: Systematic Review of Reviews Contribution of the IMIA Working Group Health Informatics for Development

Objectives: An evidence-base is important for medicine and health informatics. Despite numerous publications showing the benefits of health informatics, the emergence of health information systems in developing countries has been slower than expected. The aim of this paper is to identify systematic reviews on the domain of health informatics in developing countries, and classify the different types of applications covered.

Methods: A systematic review of reviews was conducted. The literature search spanned the time period between 2000 and 2012 and included PubMed, EMBASE, CINAHL, Scopus, Cochrane Systematic Reviews, LILACS, and Google Scholar. The search term was ‘systematic reviews of health informatics in developing countries’, and transparent and systematic procedures were applied to limit bias at all stages.

Results: Of the 982 identified articles, only 10 met the inclusion criteria and one more article was added in a second manual search, resulting in a total of 11 systematic reviews for the analysis.

Conclusions: Although it was difficult to find high quality resources on the selected domain, the best evidence available allowed us to generate this report and create an incipient review of the state of the art in health informatics in the developing countries. More studies will be needed to optimize the results.

Health Informatics in Developing Countries: Systematic Review of Reviews. Contribution of the IMIA Working Group Health Informatics for Development

OBJECTIVES

An evidence-base is important for medicine and health informatics. Despite numerous publications showing the benefits of health informatics, the emergence of health information systems in developing countries has been slower than expected. The aim of this paper is to identify systematic reviews on the domain of health informatics in developing countries, and classify the different types of applications covered.

METHODS

A systematic review of reviews was conducted. The literature search spanned the time period between 2000 and 2012 and included PubMed, EMBASE, CINAHL, Scopus, Cochrane Systematic Reviews, LILACS, and Google Scholar. The search term was 'systematic reviews of health informatics in developing countries', and transparent and systematic procedures were applied to limit bias at all stages.

RESULTS

Of the 982 identified articles, only 10 met the inclusion criteria and one more article was added in a second manual search, resulting in a total of 11 systematic reviews for the analysis.

CONCLUSIONS

Although it was difficult to find high quality resources on the selected domain, the best evidence available allowed us to generate this report and create an incipient review of the state of the art in health informatics in the developing countries. More studies will be needed to optimize the results.

Health Informatics for Development: a Threepronged Strategy of Partnerships, Standards, and Mobile Health

Describe the issues surrounding health informatics in developing countries and the challenges faced by practitioners in building internal capacity. From these issues, the authors propose cost-effective strategies that can fast track health informatics development in these low to medium income countries (LMICs).

The authors conducted a review of literature and consulted key opinion leaders who have experience with health informatics implementations around the world.

Despite geographic and cultural differences, many LMICs share similar challenges and opportunities in developing health informatics.

Partnerships, standards, and inter-operability are well known components of successful informatics programs. Establishing partnerships can be comprised of formal inter-institutional collaborations on training and research, collaborative open source software development, and effective use of social networking. Lacking legacy systems, LMICs can discuss standards and inter-operability more openly and have greater potential for success. Lastly, since cellphones are pervasive in developing countries, they can be leveraged as access points for delivering and documenting health services in remote under-served areas. Mobile health or mHealth gives LMICs a unique opportunity to leapfrog through most issues that have plagued health informaticsin developed countries. By employing this proposed roadmap, LMICs can now develop capacity for health informaticsusing appropriate and cost-effective technologies.

Health Informatics for Development: a Three-pronged Strategy of Partnerships, Standards, and Mobile Health. Contribution of the IMIA Working Group on Health Informatics for Development

OBJECTIVE

Describe the issues surrounding health informatics in developing countries and the challenges faced by practitioners in building internal capacity. From these issues, the authors propose cost-effective strategies that can fast track health informatics development in these low to medium income countries (LMICs).

METHODS

The authors conducted a review of literature and consulted key opinion leaders who have experience with health informatics implementations around the world.

RESULTS

Despite geographic and cultural differences, many LMICs share similar challenges and opportunities in developing health informatics.

CONCLUSIONS

Partnerships, standards, and inter-operability are well known components of successful informatics programs. Establishing partnerships can be comprised of formal inter-institutional collaborations on training and research, collaborative open source software development, and effective use of social networking. Lacking legacy systems, LMICs can discuss standards and inter-operability more openly and have greater potential for success. Lastly, since cellphones are pervasive in developing countries, they can be leveraged as access points for delivering and documenting health services in remote under-served areas. Mobile health or mHealth gives LMICs a unique opportunity to leapfrog through most issues that have plagued health informatics in developed countries. By employing this proposed roadmap, LMICs can now develop capacity for health informatics using appropriate and cost-effective technologies.

A medical informatics distance-learning course for Latin America. Translation, implementation and evaluation

BACKGROUND

There is a growing need and interest worldwide for healthcare and information technology professionals trained in medical informatics. Distance learning technologies are increasingly used to deliver such education, but have mainly been limited to the English language.

OBJECTIVE

Describe the implementation and student satisfaction of a medical informatics course delivered in Spanish for a Latin American audience.

METHODS

The course was based on the 10 x 10 program of the American Medical Informatics Association and Oregon Health & Science University that was translated and adapted to the Latin American setting. The initial course consisted of ten one-week units, currently the course has 15 modules that are delivered in 16 weeks with topics that address the needs of medical informatics in the region. We also administered an anonymous questionnaire of student satisfaction.

RESULTS

A total of 499 individuals have enrolled in the course, and 70% have completed it. Most of the students have been healthcare professionals (86%), with the largest proportion from Argentina. Student satisfaction with all aspects of the course was high. After the initial experience and feedback from the students, the course has been adapted to better meet regional needs.

CONCLUSION

The initial experience obtained in training healthcare professionals in medical informatics in Latin America in their own language demonstrated that it could be used across the region, and this could represent a model for disseminating knowledge of medical informatics across other languages and cultures.

336 MEIOTIC DEVELOPMENT AND CORTICAL GRANULES DISTRIBUTION IN CANINE OOCYTES DURING IN VITRO MATURATION

Low development of IVM canine oocytes could be in part attributed to an impaired cytoplasmic maturation. In mammalian oocytes, migration and the redistribution of cortical granules (CGs) around the periphery of the oocyte contribute to the inhibition of polyspermy and it is an important criterion to evaluate cytoplasmic maturation. The state of nuclear maturation and the distribution of CGs were evaluated in canine oocytes cultured for different periods in order to compare the synchrony of nuclear and cytoplasmic maturation during in vitro maturation. Bitch ovaries at different stages of the estrous cycle were obtained following ovariectomy. COCs with compact cumulus cells showing a homogeneous cytoplasm were selected for experiments. Thirty-six COCs were processed at immature stage, placed in PBS medium until evaluation. A total of 275 COCs were matured in vitro for 48, 72, and 96 h in TCM-199 with Earle’s salt supplemented with 25 mM Hepes, 10% FCS, 0.25 mM pyruvate, 10 IU mL-1 of hCG, 300 IU mL-1 penicillin, and 20 mg mL-1 streptomycin, at 38.5°C and 5% CO2. At each culture period, the oocytes were stained with Lens culinaris agglutinin (LCA), labeled with fluorescein isothiocyanate, and the CGs distributions were examined under a fluorescent microscope. The nuclear status of the denuded oocytes was determined by DAPI staining under a fluorescence microscope. For each treatment, at least four replicates were performed and the data was analyzed by ANOVA using Tukey’s test to determine the differences P < 0.05. Three types of CGs distribution were distinguished during canine oocyte maturation: (1) homogeneous distribution throughout the cytoplasm including the cortex; (2) heterogeneous (clusters) within the cytoplasm and (3) densely distributed beneath the oolemma. Nuclear stages were classified as immature or germinal vesicle (GV) stage; resumption of meiosis or germinal vesicle break down (GVBD); metaphase I to telophase I (MI toTel I); and mature or second metaphase (MII). The distribution patterns of GCs were different (P < 0.05) among oocytes cultured for different periods and the nuclear maturation status also differed between oocytes cultured for different intervals (P < 0.05). Most (>84%) of the immature oocytes at GV showed a uniform distribution of CGs throughout the cytoplasm. At 48 h of culture, CGs distribution was mainly Type 2 (25%) and 3 (61%) and the oocytes were at GVBD (33%) and MI-Tel I (33%) stages. Most nuclei of the type 3 oocytes were in the MI (40%) and MII (11%) stages, corresponding to those oocytes matured for 72 (88%) or 96 h (71%). These results indicate that canine oocytes migrate to the cortex during IVM and this process is not finished before 72 h of culture. In addition, although the re-distribution of the CGs occurred in parallel with nuclear maturation, the oocytes cannot always proceed to the MII stage; however, in such oocytes the CGs are distributed beneath the oolemma. Supported by Grant FONDECYT 1080618.

Implementing rules to improve the quality of concept post-coordination with SNOMED CT

The use of SNOMED CT as a standard reference terminology enables interoperability between clinical systems. This reference tool provides a method for creating post-coordinated terms by users according to local needs. While the creation of these terms is free, there are a number of rules, as defined in the user manual of SNOMED CT that must be followed.The Hospital Italiano of Buenos Aires has a Terminology Server that encodes medical terms, using SNOMED CT as the reference vocabulary. An interoperability analysis performed with the Nebraska Medical Center in 2006 found a high error rate (26%) in post-coordinated terms. Therefore, we implemented an automatic system of rules within the Terminology Server as defined in the user manual. Following rules implementation, the error rate decreased from 26% to 2%.

Spreading Knowledge in Medical Informatics: the Contribution of the Hospital Italiano de Buenos Aires

Medical Informatics (MI) is an emerging discipline with a high need of trained and skillful professionals.

Objective To describe the educational experience of the Department of Health Informatics of the Hospital Italiano de Buenos Aires.

Methods A descriptive study of the development of the Medical Informatics Residency Program (MIRP) and the e-learning courses related to medical informatics.

Results A four-year MIRP with 15 rotations was started in 2000, and was awarded national educational accreditation. Eight residents have been fully trained and their main academic contributions are shown in this study.

The e-learning courses related to medical informatics (Healthcare Management, Epidemiology & Biostatistics, Information Retrieval, Computer Literacy started, 10x10 Spanish version and HL7 introductory course) started in 2006 and were followed by more than 2266 students from all over the world, with an increase trend in foreign students.

Conclusions These educational activities have produced skilled human resources for the development and maintenance of the health informatics projects at our Hospital. In parallel, the number of students trained by e-learning continues to increase, demonstrating the worldwide need of knowledge in this field.

Spreading knowledge in medical informatics: the contribution of the hospital Italiano de Buenos Aires

Medical Informatics (MI) is an emerging discipline with a high need of trained and skillful professionals.

OBJECTIVE

To describe the educational experience of the Department of Health Informatics of the Hospital Italiano de Buenos Aires.

METHODS

A descriptive study of the development of the Medical Informatics Residency Program (MIRP) and the e-learning courses related to medical informatics.

RESULTS

A four-year MIRP with 15 rotations was started in 2000, and was awarded national educational accreditation. Eight residents have been fully trained and their main academic contributions are shown in this study. The e-learning courses related to medical informatics (Healthcare Management, Epidemiology & Biostatistics, Information Retrieval, Computer Literacy started, 10x10 Spanish version and HL7 introductory course) started in 2006 and were followed by more than 2266 students from all over the world, with an increase trend in foreign students.

CONCLUSIONS

These educational activities have produced skilled human resources for the development and maintenance of the health informatics projects at our Hospital. In parallel, the number of students trained by e-learning continues to increase, demonstrating the worldwide need of knowledge in this field.

Bilateral lacrimal sac mucocele with punctal and canalicular atresia

Congenital absence of lacrimal puncta may be an isolated finding or associated with other developmental abnormality. Nasolacrirnal ducts can be absent thus predisposing to the formation of a congenital lacrimal mucocele. Punctal and canalicular agenesis is very rare. Four percent of new patients attending the lacrimal clinic at Moorfields Eye Hospital, London, UK. from 1981 to 1990 inclusive were diagnosed to have this condition. We describe a case of bilateral congenital absence of lacrimal puncta with lacrimal mucocele. Combined surgery was carried out by Ophthalmologist and Otolaryngologist with successful results.

[Neurological aspects of ceroid-lipofuscinoses]

OBJECTIVE

We discuss the historical, epidemiological, clinical, complementary tests and neuropathological details of ceroid-lipofuscinoses in children.

DEVELOPMENT

Initially, we review the basic concepts and historical details of the disorders, and the frequency and distribution of the different clinical forms. Subsequently, we review the subtypes and variants most commonly found in children, together with the elements necessary for diagnosis. Finally we analyze the neuropathological studies and their clinical correlation.

CONCLUSIONS

The clinical diagnosis of ceroid-lipofuscinoses should be based on a clinical history showing disorders of vision, convulsions and regression of psychomotor functions. Neuroimaging findings, neurophysiological changes and ultrastructural studies confirm the diagnosis.

Genome search for susceptibility loci of common idiopathic generalised epilepsies

Genetic factors play a major role in the aetiology of idiopathic generalised epilepsies (IGEs). The present genome scan was designed to identify susceptibility loci that predispose to a spectrum of common IGE syndromes. Our collaborative study included 130 IGE-multiplex families ascertained through a proband with either an idiopathic absence epilepsy or juvenile myoclonic epilepsy, and one or more siblings affected by an IGE trait. In total, 413 microsatellite polymorphisms were genotyped in 617 family members. Non-parametric multipoint linkage analysis, using the GeneHunter program, provided significant evidence for a novel IGE susceptibility locus on chromosome 3q26 (Z(NPL) = 4.19 at D3S3725; P = 0.000017) and suggestive evidence for two IGE loci on chromosome 14q23 (Z(NPL) = 3.28 at D14S63; P = 0.000566), and chromosome 2q36 (Z(NPL) = 2.98 at D2S1371; P = 0.000535). The present linkage findings provide suggestive evidence that at least three genetic factors confer susceptibility to generalised seizures in a broad spectrum of IGE syndromes. The chromosomal segments identified harbour several genes involved in the regulation of neuronal ion influx which are plausible candidates for mutation screening.

[Prolonged bradyarrhythmias after coronary revascularization surgery]

The authors report four cases of prolonged bradyarrhythmias after isolated coronary artery bypass graft surgery. All the four patients required permanent pacemaker implantation. Etiologic factors of conduction disturbances after coronary artery bypass and long term follow-up are discussed.

Stiparin: a glycoprotein from sea cucumber dermis that aggregates collagen fibrils

The interactions between collagen fibrils in many echinoderm connective tissues are rapidly altered by the secretions of resident neurosecretory cells. Recent evidence has suggested that a secreted protein is responsible for the interactions that lead to an increase in tissue stiffness (Trotter and Koob, 1995). Structurally intact collagen fibrils have been isolated from such a connective tissue- the dermis of the sea cucumber Cucumaria frondosa- and used in an assay in vitro to identify a protein that binds to them and causes them to aggregate. This protein has been purified by anion-exchange and molecular sieve chromatography. It is eluted from a MonoQ column at approximately 0.55 M NaCl. Its isoelectric point is 5.2. It elutes from a Superose-6 column in a position corresponding to a molecule with a Stokes radius of 11.5 nm. Its native molecular weight estimated from sedimentation equilibrium analysis under non-denaturing conditions is 375,000, and its monomer molecular weight, estimated by polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate, is approximately 350,000. Sedimentation velocity measurements indicated for the native molecule a sedimentation coefficient of 11 x 10(-13)s, a diffusion coefficient of 3.274 x 10(-7) cm2s-1, and a frictional ratio of 1.95, which corresponds to a prolate ellipsoid of revolution with an axial ratio of 19. The highly asymmetric structure suggested by the above correlated well with the images obtained by transmission electron microscopy following rotary shadowing, which revealed a flexible structure approximately 125 nm long. Based on its ability to aggregate collagen fibrils, this protein has been named "stiparin," from the Latin stipare, "to pack together."