Short- and Long-Term Effects of Split-Suckling in Pigs According to Birth Weight.

Forty-eight litters were used, with a total number of 645 piglets involved in the study. The split-suckling technique was applied to half of the litters at the end of farrowing by removing the heaviest piglets over three periods of 1 h. The piglets were individually weighed at 0, 1 d, and at weaning. Piglet losses were recorded daily. Traceability was maintained until the carcass splitting and meat analysis took place. Carcasses were eviscerated and weighed individually. Total mortality at weaning was affected by body weight, where the low-body-weight piglets showed a mortality rate almost four times higher than that of the normal-weight piglets. Mortality was highest in the first days of life, especially in the low-body-weight piglets. At weaning, split-suckling treatment caused a slight increase in mortality compared to the control group piglets (25% vs. 17.1%). Split-suckling had a positive effect on weight gain during the first 24 h of life (p = 0.014), and there was an interaction between treatment and parity (p = 0.007), with split-suckling being more effective in the primiparous sows compared to the multiparous sows. The piglets from litters receiving the split-suckling treatment had a lower average daily gain during the lactation period (p < 0.001) than the piglets from the control group. Weight gain during the first 24 h of life of the piglets subjected to split-suckling was higher than those of the control group. A lower IgG and α-tocopherol in plasma in the heavier piglets subjected to split-suckling treatment was observed in comparison to their respective control. The piglets from litters receiving the treatment showed a lower average daily gain during the lactation period (p < 0.001) than the piglets from the control group. No difference in slaughter weight was observed according to treatment. The pigs which received split-suckling treatment showed lower subcutaneous fat thickness (p < 0.0013) and higher lean meat yield (p < 0.0027), this effect being more marked in pigs from primiparous sows. Intramuscular fat concentration was higher in the Longissimus Dorsi muscle of the low-body-weight piglets. In the pigs that received split-suckling treatment, a higher concentration of C18:3n-3 (p = 0.036) and a tendency towards a higher concentration of C18:2n-6 (p = 0.107) and unsaturation index (p = 0.113) was observed in intramuscular fatty acids at slaughter, together with a lower concentration of C16:0 (p = 0.053) and SFA (p = 0.064). In conclusion, long-term response to split-suckling, particularly in low-birth-weight piglets, suggests an alteration in adiposity and metabolic regulation in these piglets that receive high levels of colostrum.

Short- and Long-Term Effects of Birth Weight and Neonatal Care in Pigs.

Swine industries worldwide face a loss in profit due to high piglet mortality, particularly as a consequence of the marked increase in prolificity and low birth weight (BW) of piglets. This research studied the effect of BW and individual neonatal care provided to piglets on preweaning mortality, and the long-term effects on growth and carcass and meat characteristics. Litters from seventy-one crossbred sows (PIC 34) were included in the trial. Half of each litter did not receive any further management, and the remaining half received the pre-established management protocol of early assistance of neonatal care (NC). Along lactation, the low-BW piglets (weight equal to or less than 1.1 kg) showed a threefold higher mortality rate than piglets of higher weights (32 vs. 10%; p = 0.001), with mortality particularly concentrated within the first week after birth. No effect of NC treatment was observed on mortality ratio caused by crushing, but a significant effect was observed in low-BW piglets who died of starvation (p < 0.01). The effect of NC on growth is dependent on BW, and heavier piglets at birth benefit from NC treatment to a higher extent than low-BW piglets. Low-BW piglets showed a higher fatness (p = 0.003), lower lean cut yield (p = 0.002) in carcasses, and higher intramuscular fat (IMF) content (2.29% vs. 1.91%; p = 0.01) in meat. NC treatment increased the lean content in carcasses from low-BW piglets (p < 0.01). The monounsaturated fatty acids concentration was higher in lower-than-normal-BW piglets (48.1% vs. 47.1%; p = 0.002) and the opposite effect was observed for polyunsaturated fatty acids (13.6% vs. 15.7%; p = 0.002). NC treatment induced a higher concentration of n-7 fatty acids. In conclusion, NC treatment may be a useful practice to reduce mortality in low-BW piglets. Moreover, NC could affect carcass fatness and meat quality, thus suggesting a long-term effect on metabolism.

Fractura de cadera en el paciente mayor de 90 años: nuestro nuevo desafío / Hip fracture in the extremely elderly: our new dilemma

INTRODUCCIÓN: El envejecimiento mundial de la población ha resultado en un aumento de las fracturas de cadera y sobre todo en pacientes cada vez más añosos. El objetivo es buscar la mortalidad al año y factores asociados en nuestra realidad nacional. MATERIALES Y MÉTODOS: Estudio retrospectivo observacional de fichas clínicas e imagenología de pacientes mayores de 90 años operados por fractura de cadera en la capital de nuestro país. Se presentan dos grupos según su sistema previsional, pacientes pertenecientes al sistema de salud público (SSPu) y pertenecientes a un sistema de salud privado (SSPr). Se realiza análisis estadístico univariado y multivariado con test de Chi2, Mann-Whitney y regresión logística. RESULTADOS: 129 pacientes mayores de 90 años operados por fractura de cadera (85 pertenecientes al SSPu y 44 en el SSPr), cumplieron con criterios de inclusión y exclusión en un período de 2 años. El promedio de edad general fue de 93,2 años (SD 2,9) sin diferencia entre grupos. El tiempo preoperatorio fue significativamente menor en el SSPr con mediana de 1 día (0­7) y de 6 días (1­40) para el SSPu (p < 0,001). La mortalidad general al año fue de 30,2% siendo de 38,8% para el SSPu y de 13,6% para el SSPr con diferencia significativa (p = 0,003). No se encontró asociación estadística en la mortalidad al año con las variables edad, género ni tipo de fractura. Se encontró asociación entre la mortalidad al año y menor tiempo preoperatorio (p < 0,001). En el análisis multivariado de mortalidad el único factor protector fue pertenecer al SSPr (p = 0,010). DISCUSIÓN: La mortalidad general de nuestros pacientes es similar a lo encontrado en la literatura internacional, siendo el menor tiempo preoperatorio y pertenecer al sistema de salud privado factores asociados a menor mortalidad al año, donde ese último es el único factor asociado en el estudio multivariable. Este estudio aporta a la contingencia nacional en describir cómo se comporta nuestra población tanto en el sistema de salud privado como en el público. Es necesario estudiar el efecto en la mortalidad de otros factores asociados que no fueron evaluados en el presente trabajo.

INTRODUCTION: The aging of world population has resulted in an increase of hip fractures and especially in extremely elderly patients. The objective is to describe 1-year mortality in these patients in our national reality. MATERIALS AND METHODS: Observational retrospective study of clinical records and imaging of patients over 90 years old who were operated for hip fracture in the capital of our country, belonging one group to private care health system (SSPr) and the other group to the public health system (SSPu). Statistical analysis was performed to type of implant and mortality. RESULTS: 129 patients over 90 years old were operated for hip fracture (85 in the SSPu and 44 in the SSPr) in a period of 2 years. The average age was of 93.2 years (SD 2.9) without statistical difference between groups. Preoperative time was significantly lower in SSPr group with mean of 1 day (0­7) for the SSPr and 6 days (1­40) for the SSPu (p < 0,001). The overall 1-year mortality was 30.2%; 38.8% in the SSPu and 13.6%%, which was statistically relevant (p = 0,003). No association was found between 1-year mortality and age, sex or fracture type. Statistical association was found between preoperative time and 1-year mortality where patients who have lower preoperative time have lower 1-year mortality (p < 0,001). Association was found between lower 1-year mortality and belonging to SSPr. This last association was the only one with statistical relevance in the multivariable analysis (p = 0,010) DISCUSSION: Surgery for hip fractures in extremely elderly patients is an increasing reality in our country. The overall mortality of our patients is similar to that published in the international literature, where belonging to private care health system and having a low preoperative time is associated with a lower 1-year mortality in our study. This study contributes to the national contingency in the sense of how our population develops in the private sphere as well as in the public care. It is necessary to study the effect on mortality of other associated factors that were not evaluated in the present study.

[Alopecia areata secondary to the use of leflunomide in patients with rheumatoid arthritis: a case report and literature review]. / Alopecia areata por uso de leflunomida en una paciente con artritis reumatoide: reporte de caso y revisión de literatura.

Rheumatoid arthritis is a chronic, highly disabling autoimmune disease that requires aggressive pharmacological treatment using immunomodulatory drugs grouped under the name of Disease-Modifying Anti-rheumatic Drugs (DMARDs). Leflunomide is one of the most frequently prescribed. This drug, through its mechanism of action is able to suppress key factors in the disease process. However, its use is not without side effects. While there are series that report that the most prevalent adverse effects are diarrhea, nausea, rash and alopecia, there are few reported cases of alopecia universalis secondary to the use of leflunomide. We present a case in the Regional Hospital of Talca and a review of the use of leflunomide.

La artritis reumatoide es una enfermedad de tipo autoinmune. Por su carácter altamente invalidante, requiere de manejo farmacológico agresivo. Para ello, habitualmente se hace necesario el uso de drogas inmunomoduladoras agrupadas bajo el nombre de fármacos antirreumáticos modificadores de la enfermedad. Uno de los utilizados con mayor frecuencia es la leflunomida, la cual por su mecanismo de acción es capaz de suprimir ejes fundamentales en el proceso de la enfermedad. Sin embargo, su uso no se encuentra exento de efectos secundarios. Si bien existen series que reportan que los efectos adversos más prevalentes son diarrea, náuseas, exantema y alopecia, existen escasos reportes de casos de alopecia areata universal secundaria al uso de leflunomida. A propósito de un caso en el Hospital Regional de Talca, se realizó una revisión de la literatura acerca del tema.