A novel study, textbook outcome in adrenalectomy: retrospective observational study in an endocrine surgical unit.

Textbook outcome is a multidimensional quality management tool that uses a set of traditional surgical measures to reflect an "ideal" surgical result for a particular pathology. Retrospective study of all patients undergoing scheduled for adrenal tumors surgery at an endocrine surgery unit from January 2010-December 2022. The definition of Textbook Outcome were: R0 resection, no Clavien-Dindo ≥ IIIa complications, no prolonged stay (< P75), no readmissions, and no mortality in the first 30 days. The main objective was to analyze the rate of Textbook Outcome obtained. One hundred and five patients were included in the study. Textbook Outcome was achieved in 71.4%. Surgical approach (p < 0.001), Charlson scale (p = 0.031), American Society of Anesthesiologists Classification (p = 0.047) and surgical time (p < 0.001) were all significantly associated with the achievement of Textbook Outcome. The laparoscopic approach was associated as an independent factor with obtaining Textbook Outcome (OR:5.394; p = 0.016), as was surgical time (OR:0.986; p = 0.004). Textbook Outcome is a novel, useful, easy-to-interpret tool for measuring results in adrenal surgery. The laparoscopic approach is associated with a higher rate of "ideal" surgical results. The study was registered in the public accessible database clinicaltrials.gov with the ClinicalTrials.gov ID: NCT05888753.

Growth modeling approach with the Verhulst coexistence dynamic properties for regulation purposes.

For this research, the properties of the logistic growth model for independent and coexisting species were used to set definitions for the possible regulation of one or two growth variables through their coupling parameters. The present analysis is done for the single-species Verhulst model without coupling, the single-species Verhulst model coupled with an exogenous signal, and the two-species Verhulst coexistence growth model which represents six different ecological regimes of interaction. The models' parameters, such as the intrinsic growth rate and the coupling, are defined. Finally, the control results are expressed as lemmas for regulation, and they are shown using a simulation example of a fish population growing independent of human interaction (no harvesting, no fishing) and the simulation of the regulation of said population when the coupling of fish and humans is involved (harvesting, fishing).

Endothelial ILK induces cardioprotection by preventing coronary microvascular dysfunction and endothelial-to-mesenchymal transition.

Endothelial dysfunction is an early event in coronary microvascular disease. Integrin-linked kinase (ILK) prevents endothelial nitric oxide synthase (eNOS) uncoupling and, thus, endothelial dysfunction. However, the specific role of endothelial ILK in cardiac function remains to be fully elucidated. We hypothesised that endothelial ILK plays a crucial role in maintaining coronary microvascular function and contractile performance in the heart. We generated an endothelial cell-specific ILK conditional knock-out mouse (ecILK cKO) and investigated cardiovascular function. Coronary endothelial ILK deletion significantly impaired cardiac function: ejection fraction, fractional shortening and cardiac output decreased, whilst left ventricle diastolic internal diameter decreased and E/A and E/E' ratios increased, indicating not only systolic but also diastolic dysfunction. The functional data correlated with extensive extracellular matrix remodelling and perivascular fibrosis, indicative of adverse cardiac remodelling. Mice with endothelial ILK deletion suffered early ischaemic-like events with ST elevation and transient increases in cardiac troponins, which correlated with fibrotic remodelling. In addition, ecILK cKO mice exhibited many features of coronary microvascular disease: reduced cardiac perfusion, impaired coronary flow reserve and arterial remodelling with patent epicardial coronary arteries. Moreover, endothelial ILK deletion induced a moderate increase in blood pressure, but the antihypertensive drug Losartan did not affect microvascular remodelling whilst only partially ameliorated fibrotic remodelling. The plasma miRNA profile reveals endothelial-to-mesenchymal transition (endMT) as an upregulated pathway in endothelial ILK conditional KO mice. Our results show that endothelial cells in the microvasculature in endothelial ILK conditional KO mice underwent endMT. Moreover, endothelial cells isolated from these mice and ILK-silenced human microvascular endothelial cells underwent endMT, indicating that decreased endothelial ILK contributes directly to this endothelial phenotype shift. Our results identify ILK as a crucial regulator of microvascular endothelial homeostasis. Endothelial ILK prevents microvascular dysfunction and cardiac remodelling, contributing to the maintenance of the endothelial cell phenotype.

Bisphenol A induces coronary endothelial cell necroptosis by activating RIP3/CamKII dependent pathway.

Epidemiological studies link long term exposure to xenoestrogen Bisphenol-A to adverse cardiovascular effects. Our previous results show that BPA induces hypertension by a mechanism involving CamKII activation and increased redox stress caused by eNOS uncoupling. Recently, CamKII sustained activation has been recognized as a central mediator of programmed cell death in cardiovascular diseases, including necroptosis. However, the role of necroptosis in cardiac response to BPA had not yet been explored. Mice exposed to BPA for 16 weeks showed altered heart function, electrical conduction, and increased blood pressure. Besides, a stress test showed ST-segment depression, indicative of cardiac ischemia. The hearts exhibited cardiac hypertrophy and reduced vascularization, interstitial edema, and large hemorrhagic foci accompanied by fibrinogen deposits. BPA initiated a cardiac inflammatory response, up-regulation of M1 macrophage polarization, and increased oxidative stress, coinciding with the increased expression of CamKII and the necroptotic effector RIP3. In addition, cell death was especially evident in coronary endothelial cells within hemorrhagic areas, and Evans blue extravasation indicated a vascular leak in response to Bisphenol-A. Consistent with the in vivo findings, BPA increased the necroptosis/apoptosis ratio, the expression of RIP3, and CamKII activation in endothelial cells. Necrostatin-1, an inhibitor of necroptosis, alleviated BPA induced cardiac dysfunction and prevented the inflammatory and hemorrhagic response in mice. Mechanistically, silencing of RIP3 reversed BPA-induced necroptosis and CamKII activation in endothelial cells, while inhibition of CamKII activation by KN-93 had no effect on RIP3 expression but decreased necroptotic cell death suggesting that BPA induced necroptosis is mediated by a RIP 3/CamKII dependent pathway. Our results reveal a novel pathogenic role of BPA on the coronary circulation. BPA induces endothelial cell necroptosis, promotes the weakening of coronary vascular wall, which caused internal ventricular hemorrhages, delaying the reparative process and ultimately leading to cardiac dysfunction.

Effects of Oral Prednisone Administration on Serum Cystatin C in Dogs.

BACKGROUND: Oral administration of glucocorticoid alters serum cystatin C (sCysC) concentration in humans. OBJECTIVE: To determine if oral administration of prednisone alters sCysC in dogs without pre-existing renal disease. ANIMALS: Forty six dogs were included: 10 dogs diagnosed with steroid responsive meningitis arteritis (SRMA; group A), 20 dogs diagnosed of pituitary-dependent hyperadrenocorticism (PDH; group B), and 16 healthy control dogs (group C). METHODS: Retrospective observational study. SRMA diagnosed dogs were administered prednisone 4 mg/kg/24 h PO 7 days, reducing the dose to 2 mg/kg/24 h 7 days before medication withdrawal. In group A, sampling was performed at days 0, 7, 14 and a final control at day 21. Blood and urine samples were collected in the 3 groups, and in group A, sampling was performed at all time points (days 1, 7, 14, and 21). RESULTS: In group A, sCysC was significantly higher at day 7 compared to the control group (0.4 ± 0.04 mg/L vs. 0.18 ± 0.03 mg/L mean ± SEM respectively P < 0.01); sCysC values decreased to basal at day 14 when the dose was decreased and after 1 week of withdrawal of prednisone (0.27 ± 0.03 mg/L for group A at day 14 and 0.15 ± 0.02 mg/L at day 21; P > 0.05). Dogs with PDH included in group B did not have significant differences in sCysC (0.22 ± 0.03 mg/L) compared to control (P > 0.05). CONCLUSIONS AND CLINICAL IMPORTANCE: Oral administration of prednisone unlike altered endogenous glucocorticoid production, increases sCysC in dogs in a dose-dependent fashion.

Sensor fault detection and isolation via high-gain observers: application to a double-pipe heat exchanger.

This paper deals with fault detection and isolation (FDI) in sensors applied to a concentric-pipe counter-flow heat exchanger. The proposed FDI is based on the analytical redundancy implementing nonlinear high-gain observers which are used to generate residuals when a sensor fault is presented (as software sensors). By evaluating the generated residual, it is possible to switch between the sensor and the observer when a failure is detected. Experiments in a heat exchanger pilot validate the effectiveness of the approach. The FDI technique is easy to implement allowing the industries to have an excellent alternative tool to keep their heat transfer process under supervision. The main contribution of this work is based on a dynamic model with heat transfer coefficients which depend on temperature and flow used to estimate the output temperatures of a heat exchanger. This model provides a satisfactory approximation of the states of the heat exchanger in order to allow its implementation in a FDI system used to perform supervision tasks.

Multicentric observational study of pain after the use of a self-gripping lightweight mesh.

INTRODUCTION: Investigation in the field of inguinal hernia surgery is now focused on postoperative pain. The extended use of lightweight meshes and alternative methods of fixation may play a relevant role in the reduction of pain. In this study, a new self-gripping lightweight polypropylene mesh is tested. METHODS: A multicentric, observational study was scheduled to prospectively evaluate this new mesh. Ten centers agreed to participate. Only primary, type 1 or 2 uncomplicated hernias in adults were included. The mesh was placed as a Lichtenstein procedure without any fixation. A complete pain questionnaire was followed at 1 week, and at 1, 3 and 6 months postoperatively. The principal goal of the study was to evaluate maximum pain score at 6 months. Pain was assessed by a visual analog scale. A total of 256 patients were operated. Mean operative time was 35.6 min; 76.2% of patients were operated in an ambulatory setting. RESULTS: There were a few postoperative complications: 2 wound infections, 17 seromas, 21 hematomas, 6 orchitis. The incidence of acute pain was 27.3% at week 1 and 7.5% at month 1. The incidence of chronic pain was 3.6% at month 3 and 2.8% at month 6. No recurrences or long-term complications were observed. CONCLUSION: This self-gripping mesh can be used safely in type 1 and 2 primary, uncomplicated inguinal hernia with minimal morbidity and most patients under ambulatory setting. The registered incidence of chronic pain is lower than 3%.

Effect of transient carotid artery compression during transcranial Doppler ultrasonography in dogs.

Changes in blood flow in the arteries of the canine skull base following compression of the ipsilateral carotid artery were evaluated. Forty healthy conscious dogs were evaluated during examination in lateral recumbency. Using the temporal window, the rostral, middle and caudal cerebral arteries were evaluated. The basilar artery was studied through the suboccipital window. Following compression, the pulse Doppler signal was reduced or inverted when interrogating the rostral or middle cerebral artery, and no change was observed when the caudal cerebral artery or basilar artery was evaluated.

Two unusual cases of canine prostatitis: prostatitis in a castrated dog and preputial oedema in an intact male.

In this study, two unusual presentations of canine prostatitis are described; in the first case a 10-years-old neutered Boxer dog was presented to the Veterinary Teaching Hospital of the University of Extremadura with a complaint of anorexia, apathy and preputial discharge. In the second case, a local veterinarian referred an 8-years-old male Labrador to the Veterinary Teaching Hospital of the University of Extremadura. The dog had a history of pain in the caudal abdomen and preputial oedema. The final diagnosis in both cases was acute prostatitis. It is concluded that although canine prostatitis is a common disease, sometimes can have presentations that may differ from those classically described in the literature.

[Factors of risk of bacterial vaginosis]. / Factores de riesgo asociados a vaginosis bacteriana.

OBJECTIVES: To recognise factors in the host that might condition the appearance of the bacterial vaginosis (BV) syndrome, whether gynae-obstetrical factors, habits of sexual conduct, hygiene, or other factors. DESIGN: Cross-sectional, observational study. SETTING: The study was conducted from January 2002 to June 2003 in the Primary Care Dr. Jose Castro Villagrana Community Health Centre at Tlalpan, Mexico City. PARTICIPANTS: 968 patients with an active sexual life who had not taken antibiotics for at least 15 days before the study and who were not menstruating at the moment of taking a swab, 859 of whom had a diagnosis of cervico-vaginitis and 109 had no symptoms. MAIN MEASUREMENTS: Confidential questionnaire and a cervical-vaginal culture. The Amsel criteria were used to make the diagnosis of bacterial vaginosis. RESULTS: There was 32.9% prevalence of BV. There was a statistically significant association with factors such as age, start of active sexual life, the number of sexual relations per week, the number of sexual partners, and pregnancy. CONCLUSIONS: Bacterial vaginosis is the main cause of infectious processes in the vagina. Its appearance appears to be linked to factors involving sexual transmission. Interventions to reduce its prevalence and complications are recommended.

Canine pyometra: a study of the urinary proteins by SDS-PAGE and Western blot.

Canine pyometra often causes glomerulonephritis by immune complex deposition in the glomeruli. Proteinuria, ranging from moderate to severe, may be present secondary to renal damage. To determine urinary protein excretion due to pyometra, sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) was conducted on urine from 15 bitches with pyometra and 10 healthy bitches. To characterize urinary immunoglobin excretion, Western blot analysis of the urine samples using antibodies to canine IgG and IgA was also performed. Nine bands were detected by electrophoresis in bitches with pyometra, while only four were detected in the healthy animals. The urinary proteins from bitches with pyometra were primarily of glomerular origin; 58% were of medium-high molecular weight (MW), and the remainder were low MW. None of the healthy dogs had IgG or IgA in their urine, whereas three bitches with pyometra had IgG in their urine and another bitch with pyometra had both IgG and IgA. The low proportion of bitches with urinary immunoglobins was probably be due to early diagnosis of the disease. Although only a limited number of dogs was used, this study is apparently the first to characterize the electrophoretic pattern of urinary proteins and to quantify urinary excretion of IgG and IgA in bitches with pyometra.

Regeneration of herbicide-tolerant black locust transgenic plants by SAAT.

A protocol based on SAAT (sonication-assisted Agrobacterium-mediated transformation) has been developed to obtain herbicide-resistant transgenic black locust (Robinia pseudoacacia L.) plants. Cotyledon explants were co-cultivated with Agrobacterium AGL1 strain carrying the pTAB16 plasmid (bar and gusA genes). The effects of bacterial concentration (OD550 of 0.3, 0.6, 0.8) and method of infection (sonication vs immersion) on bacterial delivery were determined by assaying cotyledons for transient beta-glucuronidase expression 3 days after infection. SAAT increases transient expression efficiency especially at an OD550 of 0.6. After determining bacterial concentration and infection method, other factors affecting transformation efficiency, such as explant preconditioning and period of time before applying selection, were tested. From these experiments, the preferred protocol for black locust cotyledon transformation should include sonication of preconditioned cotyledons in AGL1 suspension, coculture for 3 days with 100 microM acetosyringone and transfer to selection medium with 4 mg/l phosphinothricin and 150 mg/l timentin. Of the initial explants, 2% produced at least one transgenic shoot. Genetic transformation was confirmed by Southern hybridization, chlorophenol red assay and herbicide tolerance of the regenerated plants.

Native and oxidized low density lipoproteins oppositely modulate the effects of insulin-like growth factor I on VSMC.

OBJECTIVE: Changes in the local expression and signaling activity of the insulin-like growth factor-I (IGF-I) axis regulate growth and survival of plaque-derived vascular smooth muscle cells (VSMC) and influence plaque fate. Recent evidence suggests that accumulation of low density lipoproteins (LDL) in VSMC during the progression of atherogenesis is linked to local changes in IGF-I signaling. We investigated the effects of LDL on the biological actions and downstream signaling pathways mediated by this growth factor in A10 VSMC. METHODS AND RESULTS: We first characterized the effects of LDL on the proliferative and anti-apoptotic actions of IGF-I in A10 VSMC. Native LDL were mitogenic and synergistically enhanced DNA synthesis induced by IGF-I from 4-, 9- up to 7.8-fold, while having no effect on its anti-apoptotic actions. In contrast, oxidized LDL, at oxidation levels that did not modify these actions by themselves, significantly reduced the mitogenic and survival effects of IGF-I by 40% and 60%, respectively. These observations correlated with opposite changes exerted by native and oxidized LDL on the insulin receptor substrate-1 (IRS)-associated PI3 kinase/Akt response to IGF-I. The extracellular signal-regulated kinase (ERK) signaling response was not affected. CONCLUSIONS: Our study demonstrates a previously unidentified modulation of the actions of IGF-I on A10 VSMC by LDL, dependent on their extent of oxidative modification. Our findings suggest that the differential modulation of the PI3 kinase/Akt response to IGF-I play a pivotal role.

Cardiovascular morbidity and obesity in adult liver transplant recipients.

There is a direct relationship between the grade of obesity and mortality based on the increased cardiovascular diseases, cancer, etc. However, the results of studies in renal and liver allograft recipients relating obesity to morbidity and mortality are contradictory. A retrospective cohort study of 170 patients transplanted between March 1987 and July 1997 showed obesity to be identified in 77 (45.3%) patients. During the mean follow-up of 5 years posttransplantation, 16 (9.4%) patients experienced cardiovascular complications, including 10 patients with ischemic cardiac syndromes (five acute infarctions and five angina), five patients with acute cerebrovascular accidents, and one patient with intermittent lower limbs claudication. The prevalence of obesity at 1, 3, 5, 7, and 9 years after transplantation was 58.2%, 56.9%, 60.3%, 59.5%, and 66.4%, respectively. Compared with the baseline value, the BMI was increased at 1 year posttransplantation (25.78), a significant difference. No significant differences were found between the mean BMI values of patients with and without cardiovascular diseases, or overweight and morbidly obese patients compared to the normal weight population. Among liver transplant recipients, obesity was a frequent complication after transplantation, but it was not clearly associated with increased morbidity and mortality secondary to cardiovascular disease.

Characterization of renal damage in canine leptospirosis by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting of the urinary proteins.

Canine leptospirosis is a zoonotic disease that can cause interstitial nephritis. As a consequence of the renal damage, proteinuria may occur. To determine the urine protein pattern in the disease we performed sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) on the urine from 10 dogs with leptospirosis and 20 healthy dogs. Western blotting analysis of the urine samples with antibodies against canine IgG and IgA was also performed to identify these immunoglobulins in the urine. Urine electrophoresis showed three new bands in the dogs suffering from leptospirosis. Only two of the dogs with leptospirosis showed detectable concentrations of IgG and IgA in urine, while a third animal showed IgG alone. The study showed a 36.7% increase in the excretion of low molecular weight proteins in dogs with leptospirosis but almost no change in the high molecular weight protein pattern. These results, together with the low number of animal with detectable concentrations of IgG and IgA in the urine, support the view that canine leptospirosis is characterized by interstitial nephritis.

Biotypes resistant to herbicides in paddy fields in the Iberian Peninsula.

A consequence of modern agriculture and its dependence on herbicides, is the appearance of resistant weed populations. The first case of resistance on the Iberian Peninsula was found in Portugal and it was in a population of Alisma plantago-aquatica, resistant to bensulfuronmethyl, an ALS-inhibitor. For the same herbicide, control problems with Cyperus difformis were found in some Spanish rice fields. In the same rice field area, tolerance was observed in some Echinochloa spp. when auxinic herbicides (quinclorac) were used and some resistant Echinochloa spp. populations were found due to the long use of PS II inhibitors herbicides (propanil). The association of active ingredients, rotation of crops and adoption of mechanical control methods are the main strategies to combat resistance to herbicides.