Weight at conception and gestational gains in the efficiency of beef cows and progeny performance.

The aim of this study was to evaluate the effects of conception weight and gestational weight gain on performance and productive efficiency in beef cows and their calves. Eighty-eight primiparous, three-year old Braford females were used, divided according to weight at conception and gestational performance (High and Low): cows with a low conception weight and low gestational weight gain (LL), cows with low conception weight and high gestational weight gain (LH), cows with high conception weight and low gestational weight gain (HL), and cows with high conception weight and high gestational weight gain (HH). At calving, HH cows were heavier than LH and HL and these were heavier than LL cows. Male calves born to HH cows were superior in body weight to those born to LL cows at 150, 210 and 365 days. Female calves born to HH, HL or LH cows were superior to those born to LL cows in pregnancy at 14 months of age. The LL and HL cows were more efficient in calf production. Actual fertility was influenced by the nutritional level of the herd, where HH cows were superior than LL cows. Better cow herd nutrition increases the development and performance of the progeny.

Body mass index at calving on performance and efficiency of Charolais cow herds.

This study evaluated the productive and reproductive performance of Charolais cows with different body mass index (BMI) at calving and the development of their calves. Seventy-two Charolais cows and their calves were grouped into BMI classes at calving, namely, low, moderate, and high. Body mass index was determined by dividing the cows' body weight by their body length and hip height and finally dividing the result by 10. Cows and their calves were weighed immediately after calving, at early weaning (63-day postpartum), and at pregnancy diagnosis (210-day postpartum). To evaluate milk production and quality, collections were performed at 21, 42, and 63 days after calving. Cows with high and moderate BMI were heavier (P < 0.05) than low-BMI cows from calving to the date of pregnancy diagnosis. Calves from low-BMI cows were heavier (P < 0.05) at 210-day postpartum than those born to cows with moderate and high BMI. The low- and moderate-BMI cows had higher pregnancy rates than those with a high BMI and were more efficient (P < 0.05) at calving and at weaning in kilograms of calf produced per kilogram of cow kept in the herd. High- and moderate-BMI cows had the highest milk production, whereas low-BMI cows produced milk with the highest concentrations of lactose and solids-not-fat (P < 0.05). Charolais cows with low and moderate BMI at calving are more efficient in production systems. The BMI may be considered a selection variable to improve the productive results of breeding herds.

Carcass traits and meat quality of lambs slaughtered during different seasonal conditions.

This study was conducted to evaluate the effects of slaughtering feedlot Texel lambs during different climatic conditions on carcass and meat quality traits. Twenty castrated male Texel lambs (21.8 ± 0.62 kg) were distributed to two treatments according to the climatic conditions during the finishing period and at pre-slaughter: warm season (WS; mean temperature of 23.4 °C and 77.5% relative humidity) and cool season (CS; mean temperature of 14.9 °C and 79.5% relative humidity). During the pre-slaughter, thermal comfort was evaluated through the variables: respiratory frequency, rectal temperature, temperature of the ocular region, and temperature-humidity index (THI). After the finishing period, lambs were slaughtered, and carcass and meat quality traits were assessed. The THI values indicate that animals harvested in the WS spent 13 h of the day under potential thermal discomfort conditions in the week before slaughter and in the pre-slaughter period, whereas lambs harvested in the CS did not experience any thermal discomfort. Slaughter weight, carcass weight, carcass dressing, and backfat thickness were greater (P ≤ 0.03), whereas cooling losses were lower (P < 0.01) for lambs slaughtered in the CS. Moreover, thawing losses were lower (P < 0.01), whereas cooking losses were greater (P < 0.01) for lambs harvested in the CS. Lambs slaughtered in the CS also showed greater meat redness, yellowness, and chroma values (P < 0.05). Although carcass traits were affected by the greater thermal discomfort exposure, meat quality of lambs was less impacted by the climatic conditions at slaughter.

Age and calving time affects production efficiency of beef cows and their calves.

The aim of this study was to evaluate the influence of two sub-periods of the calving season and two cow maturity stages on the efficiency of beef cows and their calves. A total of 159 cow-calf pairs were divided by calving time (early or late) within the calving season and maturity stage (young or adult). Calves were weaned at 42 or 63 days after birth and evaluated until 210 days of age. Cows and calves had their development examined based on their weight and body condition score at calving, at weaning, and at 210 days. Reproductive performance was evaluated on the basis of time to become pregnant again. Milk yield was assessed by the direct method on three occasions spaced 21 days apart. Adult cows were heavier than young cows, at calving (398.5 vs 327.5 kg, respectively), weaning (397.3 vs 324.1 kg, respectively) at the end breeding season (424.1 vs 342.1 kg, respectively). Reproductive performance was influenced by calving time. Adult cows had higher pregnancy rates (83.75 and 69.17%, for early and for late calving, respectively) than young cows (57.03 and 35.01% for early and for late-calving, respectively). Calves from early-calving young cows weighed 158.8 kg at 210 days of age vs. 123.7 kg for those born from late-calving adult cows. However, late-calving cows produced 10.7% more milk than those that calved early in the season (227.0 vs 205.0 liters, respectively). Early calving associated with non-requirement of growth determine higher productivity efficiency in beef cows.

Efficacy of near-infrared spectroscopy cerebral oximetry on detection of critical cerebral perfusion during carotid endarterectomy under regional anesthesia.

Background: Patients undergoing carotid endarterectomy (CEA) may suffer from cerebral hypoperfusion during the carotid cross-clamping. Near-infrared spectroscopy cerebral oximetry (NIRS) is a non-invasive method of regional cerebral oxygen saturation measurement reflecting changes in cerebral blood flow during CEA. The main goal of the study was to evaluate the accuracy of the NIRS in detecting cerebral hypoperfusion during CEA under regional anesthesia (RA) and compare it with awake neurological testing. Patients and methods: A prospective observational study of 28 patients that underwent CEA in RA and manifested neurologic deficits, and 28 consecutive controls from a tertiary and referral center, was performed. All patients were monitored with NIRS cerebral oximetry and awake testing as the control technique. Subsequently, operating characteristic curve and Cohen's kappa coefficient were determined to evaluate the reliability of the monitoring test. Results: NIRS presented a sensitivity of 27.3% and a specificity of 89.3% in comparison to awake testing. Receiver operating characteristic (ROC) curve analysis demonstrated that a decrease of at least 20% in cerebral oxygen saturation is the best threshold to infer cerebral hypoperfusion. However, the respective area under the curve (AUROC) was 0.606 (95% CI: 0.456-0.756, P = 0.178) with a calculated Cohen's kappa of 0.179, P = 0.093. Regarding 30-days outcomes, only awake testing has shown significant associations with stroke and postoperative complications (P = 0.043 and P = 0.05), which were higher in patients with post-clamping neurologic deficits. Conclusions: NIRS demonstrated a reduced discriminative capacity for critical cerebral hypoperfusion, and does not seem to add substantial clinical benefits to the awake test.

Morphophysiology of forage peanut submitted to different intensities of defoliation on grazing with sheep.

The aim was to monitor the growth, the dry mass accumulation curve, and the structural photosynthetic components of forage peanut pasture, in different intensities of defoliation in sheep rotational stocking. Experimental area of Arachis pintoi (cv. Amarillo) had 0.29 ha divided equally into 16 paddocks of 180 m2 where they were assigned in a randomized block design with four repetitions; intensities of grazing were very lenient, lenient, moderate, and severe, represented by the residue heights of 11.2, 8.4, 5.9, and 3.2 cm respectively, from 14 cm (pre-grazing height). Weekly evaluations were carried out in the remaining period and in the pre and post-grazing period, with the forage cut to soil level for the determination of the dry mass available, separation of the structural components of pasture, and determination of the area of the leaflets. From this information, the values of leaf area index, leaf to stem ratio, and growth ratios were calculated. With these results, for the growth variables, regression curves were estimated as a function of the rest days offered by each treatment. Despite the lower mass of forage obtained when the leaf area is severely defoliated, the species presents even accumulation of biomass and foliar area. Severe grazing intensity resulted in greater accumulation of leaves, reflected in the leaf area ratio and leaf weight ratio. The lenient intensities provide less rest time between grazing, requiring a greater number of paddocks. Under the research conditions, severe defoliation provides less forage to the animals.

Chronic stress leads to long-lasting deficits in olfactory-guided behaviors, and to neuroplastic changes in the nucleus of the lateral olfactory tract.

A recent study reported that the integrity of the nucleus of the lateral olfactory tract (nLOT) is required for normal olfaction and for the display of odor-driven behaviors that are critical for species survival and reproduction. In addition to being bi-directionally connected with a key element of the neural circuitry that mediates stress response, the basolateral nucleus of the amygdala, the nLOT is a potential target for glucocorticoids as its cells express glucocorticoid receptors. Herein, we have addressed this hypothesis by exploring, first, if chronic variable stress (CVS) disrupts odor detection and discrimination, and innate olfactory-driven behaviors, namely predator avoidance, sexual behavior and aggression in male rats. Next, we examined if CVS alters the nLOT structure and if such changes can be ascribed to stress-induced effects on the activity of the main output neurons, which are glutamatergic, and/or of local GABAergic interneurons. Finally, we analyzed if the stress-induced changes are transient or, conversely, persist after cessation of CVS exposure. Our data demonstrate that CVS leads to severe olfactory deficits with inability to detect and discriminate between odors and to innately avoid predator odors. No effects of CVS on sexual and aggressive behaviors were observed. Results also showed that CVS leads to somatic hypertrophy of pyramidal glutamatergic neurons, which likely results from neuronal disinhibition consequent to the loss of inhibitory inputs mediated by GABAergic interneurons. Most of the CVS-induced effects persist beyond a 4-week stress-free period, suggesting long-lasting effects of chronic stress on the structure and function of the olfactory system.

Use of the correlation between input variables in estimating the risk of feedlot finishing of steers and young steers.

The objective of this study was to evaluate the risk of feedlot finishing of steers (22.8 months) and young steers (15.2 months), using or not a correlation between the random input variables (data collected from 2004 to 2010) in the simulation of the Net Present Value (NPV) financial indicator. The animals were fed a diet containing roughage:concentrate ratio of 60:40 for 34 and 143 days, respectively, until they had reached a predetermined slaughter weight of 430 kg. For the NPV simulation, Latin Hypercube sampling was used, with 2000 interactions. The stochastic dominance analysis, test of differences between pairs of curves of cumulative distributions and sensitivity analysis were carried out. The NPV simulation using the correlation resulted in the best option for risk estimate. The confinement of young steers was the alternative of investment most viable than confinement of steers (NPV ≥ 0 of 80.4 vs. 62.3% in the simulation with correlation, respectively). Sensitivity analysis determined the following items had the greatest impact on the estimate of NPV: prices of fat and thin cattle, initial and final weights, diet costs, minimum rate of attractiveness and diet intake.

Lactation performance, feed efficiency, and blood metabolites of dairy cows treated with recombinant bovine somatotropin: A systematic review and meta-analysis.

A systematic review and meta-analysis were conducted to assess the impact of recombinant bovine somatotropin (rbST) on lactation performance, feed efficiency, and blood metabolites in dairy cows. In the systematic review, articles were selected based on the following criteria: (1) Data focusing on the influence of bovine somatotropin doses on milk production; (2) Submission of original data; (3) Articles published in journals; and (4) Articles in English or Portuguese. The analysis of variance was used with a completely randomized design and mixed models methodology. Polynomial regression was applied to significant fixed effects (rbST dose). The use of rbST resulted in increased milk yield and 4% fat-corrected milk yield, while fat, protein, and lactose contents remained unaffected. Dry matter and metabolizable energy intakes, as well as milk/feed efficiency, exhibited a linear increase, but body condition score (BCS) was negatively impacted. The administration of rbST led to higher blood concentrations of triglycerides and insulin. Cows treated with rbST showed a 23% increase in non-esterified fatty acid (NEFA) concentrations compared to non-treated cows. Additionally, growth factors IGF-1 and IGF-2 displayed a linear increase with rbST treatment. In summary, rbST administration increased milk yield and fat-corrected milk yield without affecting milk components. However, despite increasing intake, it resulted in BCS losses and alterations in blood parameters such as NEFA, IGF-1, and IGF-2.

Factors intrinsic to handling and transport in pre-slaughter behavioural changes in beef cattle.

The aim of this study was to evaluate handling and transport variables as potential causes of disturbed behaviour in response to seeing a person on an overhead observation platform during pre-slaughter in batches of females and castrated males composed of pure or crossed Bos Taurus animals (Aberdeen Angus, Red Angus, Hereford and Charolais) with a maximum of 37.5% Bos indicus, and maturity at slaughter varying from zero to eight teeth, coming from pasture and confined systems. For the batches of castrated males, the independent variables included the distance covered on the trip, and the handling and facilities on the farms. For the female batches, the variables were travel time and waiting time prior to unloading. For both sexes, the presence of horns in the batches and the load density were included in the regression equations. Disturbed behaviour, the result of factors related to animal handling and transportation, is detrimental to satisfactory results in production systems. It is up to the managers in the production chain to seek alternatives in order to minimise inappropriate behaviour, which is one determinant of loss. Handling and transport are determining factors in the behaviour of beef cattle during the pre-slaughter period.

Trade and consumption of buffalo meat in Brazil.

Due to the lack of information concerning the buffalo production chain, the aim of this survey was to identify consumer behaviour, acceptance and trends in relation to buffalo meat. The survey research method was used, for which an online questionnaire was prepared using Google Forms, and distributed via digital platforms to Brazilian consumers. Using the exploratory technique of multivariate statistics, ordination was carried out by principal component analysis (PCA), where the words were grouped into dimensions. Of the respondents, 44.82% had already consumed buffalo meat; however, many did not know whether they had already tried it, since 50.24% of the respondents said they could not identify any difference between buffalo meat and beef. An identification and indication of the origin were considered important by 44.82% of respondents. The respondents cited 1130 different terms, the word 'quality' appearing in most responses. Principal component analysis explained 93.32% of the variations in the consumer perception of buffalo meat. A part of Brazilian consumers is unaware of the buffalo production chain, and have never had the opportunity to consume the meat. The creation and divulgation of a certificate of identification, together with the benefits to health from consuming buffalo meat is fundamental for consumer confidence, which, together with the ready availability of the product, would allow expansion, consolidation and improvement of the production chain. The results of the study show the potential for increasing the consumption of buffalo meat among Brazilian consumers, providing the product included a guarantee of origin, quality and healthiness.

Structural, functional and behavioral impact of allergic rhinitis on olfactory pathway and prefrontal cortex.

BACKGROUND: Allergic rhinitis (AR) has been identified as a cause of olfactory dysfunction. Beyond the classic symptoms, AR has been associated with altered sleep patterns, a decline in cognitive performance and higher likelihood of depression and anxiety. The olfactory pathway has been postulated to be a possible link between nasal inflammation and central nervous system (CNS) modifications. Thus, we aimed to investigate the structural, functional and behavioral changes in the olfactory pathway and related areas in an animal model of AR. METHODS: AR was induced in adult Wistar rats by ovalbumin sensitization and challenge. Following olfactory and behavioral tests we investigated the synaptic structure of the olfactory bulb (OB), anterior olfactory nuclei (AON), piriform cortex and prefrontal cortex (PFC), by immunofluorescence detection of synaptophysin (Syn) and glutamatergic, GABAergic and dopaminergic neuronal markers. RESULTS: We detected a significant decrease in Syn in the glomerular layer (GL) of OB and in the PFC of the AR group. Additionally, the optical density of GAD67 and VGLUT2 was reduced in the OB, AON and PFC, compared to controls. The behavioral tests demonstrated olfactory dysfunction and reduced male aggressiveness in AR rats, but we did not find any difference in the cognition and anxiety-like behavior. CONCLUSIONS: We confirmed olfactory dysfunction in a rat model of AR and we identified modifications in synaptic activity by reduction of Syn optical density in the GL of the OB and in the PFC. This was accompanied by structural changes in glutamatergic and GABAergic activity in essential components of the olfactory pathway and PFC.

Allergic Rhinitis Seasonality, Severity, and Disease Control Influence Anxiety and Depression.

OBJECTIVES: Allergic rhinitis (AR) has been associated with anxiety and depression. A possible influence of frequency and intensity of the AR symptoms has remained unclear. Therefore, we evaluated the association between AR, as well as its control, seasonality and severity, and the presence of anxiety and depression. METHODS: Participants were selected from a preexistent national database and consecutively contacted by phone. AR was classified according to Allergic Rhinitis and its Impact on Asthma. Presence of anxiety and depression was identified by Hospital Anxiety and Depression Scale (HADS), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II (BDI-II). We built linear regression models assessing the association between any of the assessed anxiety or depression scores and the occurrence, degree of control, seasonality or severity of AR. RESULTS: We analyzed 115 participants with AR and 38 participants with no respiratory symptoms. Patients with AR presented higher scores of anxiety (HADS: 3.1; 95% confidence interval [CI] = 1.9; 4.3; p < 0.001) and depression (HADS: 3.8; 95% CI = 2.5; 5.0; p < 0.001). Poorer AR control was positively associated with higher prevalence and scores of anxiety (HADS: 3.0; 95% CI = 1.5; 4.5; p < 0.001) and depression (HADS: 1.8; 95% CI = 0.2; 3.4; p = 0.031). Similar results were obtained with BAI and BDI-II scales. A moderate/severe presentation of AR were also related with higher scores of anxiety (HADS: 1.7; 95% CI = 0.1; 3.2; p = 0.040) and depression (HADS: 1.7; 95% CI = 0.1; 3.3; p = 0.037). CONCLUSION: The presence of AR, a poorer control, and a moderate/severe presentation of the disease were significantly associated with higher scores of anxiety and depression. Thus, it is important to alert to this association to allow a quick diagnosis of AR-associated pathologies. Laryngoscope, 133:1321-1327, 2023.

Environmental factors on the probability of pregnancy in early or conventionally weaned beef cows.

Potential variables for the reproductive success of beef cows were evaluated. Included in the model were the age of the cow at calving; the interval between the Julian calving date and the end of the breeding season; the body weight and conditions at calving, at 75 days post-partum and at the end of the breeding season; and the mean daily variation in weight between these dates. Logistic regression was used in the analysis, with the parameters evaluated using the odds ratio statistic, estimating the chance of pregnancy. The mean rate of pregnancy was 84% and 55% for early and late-weaned cows, respectively. For early weaned cows, the regression variables were the Julian calving date, age of the cow, weight gain from calving to 75 days post-partum, and from 75 days post-partum to the end of the reproductive period. For late-weaned cows, there were only two regression variables, weight at calving and weight gain from calving to the end of the reproductive period. For every year above the average age of the herd, early weaned cows have an 80.9% greater chance of pregnancy, while a reduction of one year reduces the chance of pregnancy by 44.7%. In early weaned cows, every seven days after the mean Julian calving date reduces the chances of pregnancy by 22.6%, whereas every seven days before the mean calving date increases pregnancy by 29.2%. Greater gains in cow body weight, from calving to the end of the reproductive period, determine a greater probability of pregnancy.

Probability and number of bruises in bovine carcasses according to animal type, handling and transport.

The aim of this study was to evaluate pre-slaughter risk factors on the probability of bruising and the number of bruises in different regions of the bovine carcass. The study evaluated the data from 4061 batches of slaughtered cattle, totalling 199,026 carcasses, from Hereford and Aberdeen Angus animals in crosses with continental European breeds and Zebu cattle. The factors that caused injury were sex, handling conditions (score), vehicle type, vehicle load density (kg/m2), travel time (minutes), travel distance (kilometres), physiological maturity (dentition), animal reactivity (score), and carcass fat (score). The type of vehicle had the greatest influence on the probability of carcass bruising and affected all carcass cuts. More bruising occurred in vehicles with a greater load capacity. A higher chance of bruising was seen in groups of older animals, those with an excitable temperament and, especially, in groups of females. Higher load densities during transport resulted in a greater chance of bruising occurring in all cuts except the hindquarters. Distance and travel time are unstable in the models, but also detrimental, increasing the probability of bruising and the number of bruises in the various cuts. The results of this study suggest that good practices in the welfare, handling and transport of the animals, as well as training the personnel responsible for their handling, should be adopted to minimise the risk of injury at different locations on the carcass.

Bond strength and interfacial micromorphology of etch-and-rinse and self-adhesive resin cements to dentin.

PURPOSE: To evaluate the microtensile bond strength and interfacial micromorphology of indirect composite restorations to dentin using three commercial resin cements after 24 hours and 30 days of water storage. MATERIALS AND METHODS: The medium dentin of third human molars was exposed (N = 30, n = 10 per group). Three commercial resin cements were used to cement indirect resin composite restorations to dentin: the auto-cured C&B Cement/All Bond 2, the dual-cured RelyX ARC/Adper Single Bond 2, and the self-adhesive dual-cured RelyX Unicem. Teeth were sectioned after water storage at 37°C (24 hours and 30 days) to obtain beams with a bonded area of 0.8 mm(2) . The specimens were tested in a universal testing machine at a 0.5 mm/min crosshead speed. Scanning electron microscopic fractographic and interfacial micromorphology analyses were performed. Data were analyzed using two-way ANOVA and Tukey's test (α= 0.05). RESULTS: Mean bond strength (MPa) after 24 hours: C&B Cement 19.5 ± 3.8, RelyX ARC 40.8 ± 9.4, RelyX Unicem 31.3 ± 7.4; after 30 days: C&B Cement 24.5 ± 5.1, RelyX ARC 44.2 ± 8.5, RelyX Unicem 28.3 ± 7.1. The mean bond strengths of both dual-cure cements were significantly higher than that obtained with C&B Cement after 24 hours. A significant increase in the bond strength of C&B Cement was verified after 30 days, reaching values statistically equivalent to those produced by RelyX Unicem and RelyX ARC. The self-adhesive cement preserved the same level of bond strength after 30 days. Fractographic analysis revealed a prevalence of cohesive fractures in the hybrid layer for C&B Cement, mixed (cohesive in the cement, hybrid layer, and adhesive) for RelyX ARC, and cohesive in the cement for RelyX Unicem. No distinguishable hybrid layer or resin tags were observed in the interaction of RelyX Unicem with dentin. CONCLUSIONS: The particular interaction of each cement with dentin results in specific bond strength and failure patterns that varied among groups in both evaluation times. Even though the self-adhesive cement tested exhibited no authentic hybrid layer, it was able to promote reliable adhesion with the underlying dentin.

The Surgical Vascular Anatomy of the Lower Lumbar Arteries and Its Implications in Minimally Invasive Spine Surgery: A Cadaveric Study.

BACKGROUND: Minimally invasive lateral lumbar interbody fusion is a technique that has become increasingly popular for the treatment of degenerative lumbar spine disease; however, the pertinent surgical vascular anatomy has not been examined in detail. The goal of this study is to examine the anatomy of the lower lumbar and median sacral arteries, which are important determinants of these surgical outcomes. METHODS: This is an observational, experimental study based on cadaveric models, including 20 embalmed adult human cadavers. The following measurements were made: length of the lumbar and median sacral arteries, vertical distance between the third and fourth lumbar arteries and the superior end plate of the corresponding vertebrae, anterior vertebral body height, and intervertebral disc height. RESULTS: Our sample showcased considerable variability regarding vascular anatomy around the lower lumbar spine. In 10% of specimens, the abdominal aorta bifurcated at the level of the L3-L4 intervertebral disc, and 20% showed variations in vena cava origin. Regarding the lumbar arteries, in 10% of the sample, the fourth lumbar artery was absent on the right side, and 10% presented a fifth lumbar artery. The median sacral artery was present in all cadavers; however, in 15% of specimens, it originated from a common trunk that also gave rise to the fourth pair of lumbar arteries. Anterior vertebral body height was smaller in L3 comparing with L5 (P = 0.003), and there was a significant cephalocaudal increase in the anterior intervertebral disc height in the analyzed levels (P < 0.001). Bilaterally, the distance between the fourth lumbar arteries and the superior end plate of the L4 vertebral body was shorter than this distance at the L3 vertebral body (P < 0.001 and P = 0.002 on the right and left, respectively). CONCLUSIONS AND CLINICAL RELEVANCE: These data may be useful in spine surgery planning and operative management. These anatomic variations should be identified beforehand to prevent difficulties during surgery and possible complications.

Palatine Tonsils Primary Presentation of Blastoid Variant of Mantle Cell Lymphoma: Case Report.

Head and neck lymphomas can present with a wide range of symptoms. Timely and accurate diagnosis is often challenging. The blastoid variant of mantle cell lymphoma (MCL) accounts for less than one-third of all MCL cases. Isolated primary presentation on the palatine tonsils is rare, and prognosis and outcome are seemingly unfavorable. An 81-year-old man presented with persistent odynophagia, dysphagia, and obstructive hypertrophic palatine tonsils with purulent exudate. The signs and symptoms were non-responsive to antibiotic therapy, and the tonsils were biopsied. The cellular morphology, immunophenotype, and genotype supported a diagnosis of the blastoid variant of MCL. After staging, the patient underwent chemotherapy with Rituximab-Bendamustine (R-Benda). The patient is in clinical remission more than two years after therapy. We report an exceedingly rare case of blastoid MCL that is prone to be misdiagnosed as tonsillitis. We review the literature and discuss treatment options of this uncommon malignancy.

Orbital Apex Syndrome due to Orbital Mucormycosis after Teeth Infection: A Successful Case Report.

Rhino-orbital-cerebral mucormycosis is a severe and rapidly progressive fungal infection associated with low survival rates. Early diagnosis and proper management are mandatory. We report the case of a 20-year-old female with diabetic ketoacidosis and teeth infection, who presented with sudden orbital apex syndrome. Several surgical procedures were necessary to provide a definite histopathological diagnosis of the fungal infection. Ultimately, given the progressive aggravation of the infection and the ineffectiveness of antifungal and antibiotic agents, an orbital exenteration was performed. A mycobacteriological examination revealed a polymicrobial culture with Mucorales. One year after the initial presentation, the patient is alive and with a good general health condition.

Red Blood Cell Distribution Width as a 5-Year Prognostic Marker in Patients Submitted to Carotid Endarterectomy.

OBJECTIVE: Patients submitted to carotid artery endarterectomy (CEA) have a long-term risk of major adverse cardiovascular events (MACE) of 6-9% at 2 years. Hematological parameters have been shown to have a predictive function in atherosclerotic diseases, namely the red blood cell distribution width-coefficient of variation (RDW-CV). This parameter has been associated with worse outcomes such as myocardial infarction (MI), stroke, and all-cause mortality. This study aims to evaluate the potential role of preoperative hematologic parameters such as RDW-CV in predicting perioperative and long-term cardiovascular adverse events and mortality in patients submitted to CEA. METHODS: From January 2012 to January 2019, 180 patients who underwent CEA with regional anesthesia in a tertiary care and referral center were selected from a prospective cohort database. Blood samples were collected preoperatively 2 weeks before admission, including a full blood count. The primary outcome included long-term MACE. Secondary outcomes included all-cause mortality, stroke, MI, acute heart failure, and major adverse limb events (MALE). RESULTS: At baseline, 27.2% of patients had increased RDW-CV. Increased RDW-CV was independently associated with baseline hemoglobin (adjusted odds ratio [aOR] 0.715, 95% CI 0.588-0.869, p = 0.001) and atrial fibrillation (aOR 4.028, 95% CI 1.037-15.639, p = 0.001). After a median follow-up of 50 months, log-rank univariate analysis of RDW-CV demonstrated a significant association between increased RDW-CV and long-term all-cause mortality (log-rank <0.001), MACE (log-rank <0.001), and MI (log-rank = 0.017). After multivariate Cox regression analysis, increased RDW-CV was associated with increased long-term mortality (adjusted hazard ratio [aHR] 2.455, 95% CI 1.231-4.894, p = 0.011) and MACE (aHR 2.047, 95% CI 1.202-3.487, p = 0.008). A decreased hemoglobin to platelet ratio (aHR 2.650e-8, 95% CI 9.049e-15 to 0.078, p = 0.019) was also associated with all-cause mortality. CONCLUSION: RDW is a widely available and low-cost marker that independently predicts long-term mortality, MACE, and MI after CEA. This biomarker could prove useful in assessing which patients would likely benefit from CEA in the long term.