Neuromiotonía ocular: un infrecuente caso tras carcinoma nasofaríngeo tratado con radioterapia local / Ocular neuromyotonia: An unusual case after radiotheraphy for nasopharyngeal carcinoma

La neuromiotonía ocular es una patología poco frecuente caracterizada por episodios recurrentes de diplopía binocular ocasionada por una contracción paroxística mantenida de uno o más músculos extraoculares inervados por un mismo nervio craneal, espontáneamente o inducidos por una versión concreta mantenida en el tiempo, normalmente relacionado con un antecedente de radioterapia local intracraneal. Presentamos el caso de una mujer de 46 años que presenta episodios de diplopía binocular recurrentes, diagnosticada de neuromiotonía ocular del VI nervio craneal izquierdo a los 8 años de padecer un cáncer de cavum tratado mediante radioterapia local y en completa remisión. Aunque es poco frecuente, la radiación a nivel de cavum debe tenerse en cuenta como potencial causa de neuromiotonía ocular, por su proximidad a la base del cráneo y su estrecha relación con el trayecto de los nervios oculomotores, especialmente el VI par craneal, como el caso que se presenta en este artículo.(AU)

Ocular neuromyotonia is an infrequent disorder characterised by recurrent episodes of binocular diplopia caused by paroxysmal contraction of one or several extraocular muscles innervated by the same cranial nerve. It can be triggered spontaneously or caused by prolonged contraction of specific eye muscle(s) and is usually related to a local intracranial radiotherapy antecedent. We report the case of a 46-year-old woman who developed intermittent episodes of binocular diplopia 8 years after radiotherapy for a nasopharyngeal carcinoma. After a complete neuro-ophthalmic assessment we diagnosed the case as an abducens nerve neuromyotonia. Although it is infrequent, radiotherapy to the nasopharynx is a possible cause of ocular neuromyotonia, due to the proximity to the base of the skull and extraocular motor nerve pathways, especially that of the VI cranial nerve, as is the case presented in this article, about a patient whose history is a nasopharyngeal carcinoma treated with local radiotherapy.(AU)

Establishment of a desirable dose using neutral argon plasma to eradicate miliary peritoneal implants: A phase I/II controlled trial.

INTRODUCTION: Neutral argon plasma (NAP) system could meet the requirements to achieve oncological cytoreduction of peritoneal carcinomatosis with miliary lesions, minimizing the associated morbidity. This phase I/II trial aims to establish the desirable dose that is safe and effective in eliminating tumor cells with lower penetration. METHODS: Patients diagnosed with different origins for peritoneal carcinomatosis and miliary implants were selected for the study. The safe and potentially effective dose (desirability) of NAP was evaluated according to three factors: distance (mm), application time (s) and power (%), to evaluate the response variables such as the presence of tumor cells (Y/N) and the depth of penetration. RESULTS: Ten patients and 120 samples were evaluated and treated with NAP. There was no vascular or organ injury intraoperative using a pre-established dose of 100% (coagulation mode) at a distance of 2-3 cm. The distance was found to be correlated with the presence of the tumor cells in ex-vivo analysis, with an OR of 15.4 (4.0-111.4). The time and energy used were protective factors to eliminate tumor cells with an OR of 0.4 (0.1-0.9) and 0.8 (0.8-0.9), respectively. The safest and most effective desirability results were as follows i) energy 80% during 2-4 s with a distance of 2 cm (0.89), and ii) energy 100% during 2-4 s with a distance of 3 cm (0.90). CONCLUSIONS: The use of NAP during a CRS and HIPEC is safe and effective for eradicating tumor cells on the peritoneal surface at suggested doses of energy, distance and duration. TRIAL IDENTIFICATION: ClinicalTrials.gov Identifier: NCT04904042.

Struvite precipitation in wastewater treatment plants anaerobic digestion supernatants using a magnesium oxide by-product.

Struvite precipitation is a well-known technology to recover and upcycle phosphorus from municipal wastewater as a slow-release fertiliser. However, the economic and environmental costs of struvite precipitation are constrained by using technical-grade reagents as a magnesium source. This research evaluates the feasibility of using a low-grade magnesium oxide (LG-MgO) by-product from the calcination of magnesite as a magnesium source to precipitate struvite from anaerobic digestion supernatants in wastewater treatment plants. Three distinct LG-MgOs were used in this research to capture the inherent variability of this by-product. The MgO content of the LG-MgOs varied from 42 % to 56 %, which governed the reactivity of the by-product. Experimental results showed that dosing LG-MgO at P:Mg molar ratio close to stoichiometry (i.e. 1:1 and 1:2) favoured struvite precipitation, whereas higher molar ratios (i.e. 1:4, 1:6 and 1:8) favoured calcium phosphate precipitation due to the higher calcium concentration and pH. At a P:Mg molar ratio of 1:1 and 1:2, the percentage of phosphate precipitated was 53-72 % and 89-97 %, respectively, depending on the LG-MgO reactivity. A final experiment was performed to examine the composition and morphology of the precipitate obtained under the most favourable conditions, which showed that (i) struvite was the mineral phase with the highest peaks intensity and (ii) struvite was present in two different shapes: hopper and polyhedral. Overall, this research has demonstrated that LG-MgO is an efficient source of magnesium for struvite precipitation, which fits the circular economy principles by valorising an industrial by-product, reducing the pressure on natural resources, and developing a more sustainable technology for phosphorus recovery.

Effects of enriching IgG concentration in low- and medium-quality colostrum with colostrum replacer on IgG absorption in newborn Holstein calves.

Ingestion and absorption of greater quantities of IgG are required to increase serum IgG levels in newborn calves. This could be achieved by adding colostrum replacer (CR) to maternal colostrum (MC). The objective of this study was to investigate whether low and high-quality MC can be enriched with bovine dried CR to achieve adequate serum IgG levels. Male Holstein calves (n = 80; 16/treatment) with birth body weights (BW) of 40 to 52 kg were randomly enrolled to be fed 3.8 L of the following combinations: 30 g/L IgG MC (C1), 60 g/L IgG MC (C2), 90 g/L IgG MC (C3), C1 enriched with 551 g of CR (60 g/L; 30-60CR), or C2 enriched with 620 g of CR (90 g/L: 60-90CR). A subset of 40 calves (8/treatment) had a jugular catheter placed and were fed colostrum containing acetaminophen at a dose of 150 mg/kg of metabolic body weight, to estimate abomasal emptying rate per hour (kABh). Baseline blood samples were taken (0 h), followed by sequential samples at 1, 2, 3, 4, 5, 6, 8, 10, 12, 24, 36, and 48 h relative to initial colostrum feeding. Results for all measurements are presented in the following order, unless otherwise stated: C1, C2, C3, 30-60CR, and 60-90CR. Serum IgG levels at 24 h were different among calves fed C1, C2, C3, 30-60CR, and 60-90CR: 11.8, 24.3, 35.7, 19.9, and 26.9 mg/mL ± 1.02 (mean ± SEM), respectively. Serum IgG at 24 h increased when enriching C1 to 30-60CR, but not from C2 to 60-90CR. Similarly, apparent efficiency of absorption (AEA) values for calves fed C1, C2, C3, 30-60CR, and 60-90CR were different: 42.4, 45.1, 43.2, 36.3, and 33.4% ± 1.93, respectively. Enriching C2 to 60-90CR reduced AEA, and enriching C1 to 30-60CR tended to decrease AEA. The kABh values for C1, C2, C3, 30-60CR, and 60-90CR were also different: 0.16, 0.13, 0.11, 0.09, and 0.09 ± 0.005, respectively. Enriching C1 to 30-60CR or C2 to 60-90CR reduced kABh. However, 30-60CR and 60-90CR have similar kABh compared with a reference colostrum meal (90 g/L IgG, C3). Even though kABh was reduced for 30-60CR, results indicate that C1 has the potential to be enriched and achieve acceptable serum IgG levels at 24 h without affecting AEA.

Effects of maternal choline supplementation on performance and immunity of progeny from birth to weaning.

The objectives were to investigate whether supplementation with rumen-protected choline (RPC) during late pregnancy in Holstein cows affects offspring immunity and growth, and whether effects are utero-placental, colostrum dependent, or both. A total of 105 multiparous Holstein cows were assigned randomly to a prepartum diet (1.54 Mcal of NEL/kg of DM, and 15.8% CP) without (control) or with added RPC (12.9 g/d of choline ion). Calves (n = 111) were blocked by sex and assigned randomly to colostrum from control cows or colostrum from RPC cows, resulting in 4 treatments in a 2 × 2 factorial arrangement: (1) calves born and fed colostrum from non-supplemented dams (NN; n = 33); (2) calves from non-supplemented dams and fed colostrum from RPC-fed cows (NC; n = 25); (3) calves from RPC-supplemented dams and colostrum from non-supplemented cows (CN; n = 28); and (4) calves from RPC-supplemented dams and colostrum from RPC-fed cows (CC; n = 25). Growth, intakes, and immunity of females were evaluated up to 56 d of age. Growth and intake of male calves was evaluated up to 35 d of age, and physiological and immune responses to intravenous LPS challenge were evaluated from 21 to 35 d of age. Effects of prenatal and colostrum treatments and interactions between treatments were analyzed using mixed models. Calves fed colostrum from RPC-supplemented dams had a 17.4% increase in apparent efficiency of absorption of IgG compared with calves fed colostrum from control dams (27.4 vs. 23.3%). Incidence of fever in the first 21 d of age tended to be less in females born from RPC-supplemented dams compared with females born from control dams (31 vs. 58%). Prenatal RPC females had increased hematocrit and concentrations of red blood cells, leukocytes, neutrophils, and lymphocytes in blood compared with prenatal females born from control dams. Compared with prenatal control females, prenatal RPC females had greater intake of milk replacer (704 vs. 748 ± 9.9 g/d) and starter (45.4 vs. 60.2 ± 5.9 g/d) during the first 21 d of age. In male calves, mean intake of DM was greater (1,074 vs. 976 ± 45 g/d) after the LPS challenge (0 to 8 d) by calves born from dams fed RPC compared with males born from control dams. Calves born from RPC-fed dams also had lower mean rectal temperature (39.0 vs. 39.2°C) and mean respiration rate (35.6 vs. 39.3 breaths/min) compared with males born from control dams. Moreover, serum concentrations of metabolites (i.e., ß-hydroxybutyric acid, fatty acids, and glucose), cytokines (i.e., tumor necrosis factor-α) and acute phase proteins (i.e., serum amyloid A) were consistent with less-severe inflammatory response to LPS in males born from dams fed RPC compared with control. Source of colostrum and interaction between prenatal and colostrum treatments had minimal effects on calf responses to LPS. Overall, maternal RPC supplementation during late gestation suggests a positive effect on immunity, in that colostrum from RPC-fed dams increased efficiency of IgG absorption and maternal supplementation with RPC during late gestation, regardless of colostrum source, attenuated responses to LPS.

Effects of a low- or high-frequency colostrum feeding protocol on immunoglobulin G absorption in newborn calves.

Calves might experience an upper limit of IgG absorption from colostrum ingestion at birth, but it is not clear whether the total IgG mass fed in the first meal or feeding frequencies can saturate the IgG transport mechanism and therefore limit IgG absorption. The objective of this study was to determine whether different colostrum replacer (CR) feeding frequencies affect serum IgG levels or apparent efficiency of absorption (AEA) in neonatal calves. Male Holstein calves (n = 40) were separated from their dams immediately after parturition and randomly assigned to receive CR [12% of birth body weight (BW)], following either (1) a low-frequency (LF; n = 20) or (2) a high-frequency (HF; n = 20) feeding protocol. Low-frequency calves received 2 CR meals (8% and 4% birth BW within 1 h after birth and 12 h after first CR feeding, respectively), whereas HF calves received 3 CR meals (4% of BW for each meal; within 1 h after birth, 6, and 12 h after first CR feeding). The CR powder fed had a dry matter IgG concentration of 30% and an IgG concentration of 70.5 g/L when reconstituted. All CR was fed via esophageal tube within 1 h after birth. Calves were bottle-fed pasteurized milk (5% birth BW) at 24, 36, and 48 h after the first CR feeding. Blood was collected before first CR feeding and at the following intervals post-CR feeding: every 2 h until 18 h; every 3 h from 18 to 30 h; and every 6 h from 30 to 48 h after the first CR feeding. Serum IgG values at 24 h did not differ between LF and HF (25.79 ± 0.93 and 25.66 ± 0.88 g/L, respectively). In the first meal, calves fed LF ingested a higher total IgG mass than HF (257.98 ± 4.16 g and 126.72 ± 4.05 g, respectively); however, AEA at 24 h did not differ for calves fed HF or LF (27.68 ± 1.16% and 27.63 ± 1.26%, respectively). The IgG area under the curve (AUC) at 24 h was greater for calves fed LF than HF (443.13 ± 15.17 and 379.59 ± 13.99 g of IgG/L × h, respectively). Additionally, AUC at 6 h, 12 h, and 48 h were greater for calves fed LF than HF. These results indicate that, although LF calves had a greater AUC, HF calves were still able to absorb IgG in the second and third meal, allowing HF calves to achieve serum IgG levels similar to those of LF calves at 24 h. In addition, the provision of 3 meals at 70.5 g/L of IgG within the first 12 h of life did not result in added benefits to serum IgG or AEA levels.

Invited review: The importance of colostrum in the newborn dairy calf.

It is critical that bovine maternal colostrum is fed to newborn calves during their first hours of life. Colostrum is the secretion a cow produces after mammary involution that is rich in various nutrients. In addition to the nutritive value for newborn calves, immunoglobulins are of interest due to their role in developing the naïve immune system of calves at birth. The process by which a calf acquires immunity via absorption of immunoglobulins is defined as passive immunity. When calves consume an adequate amount of immunoglobulins, they are classified as having successful passive immunity (SPI). In contrast, if they are deprived of adequate colostrum, they are considered to have had a failure of transfer of passive immunity (FPI). Transfer of passive immunity is assessed by measuring serum IgG concentrations at 24 to 48 h of age. The major factors that influence whether a calf has SPI or FPI are colostrum IgG concentration, quantity fed, and age of calf at colostrum feeding. Monitoring apparent efficiency of immunoglobulin absorption in calves is often recommended to evaluate overall colostrum management practices. Serum IgG analyses can be determined with direct (radial immunodiffusion) or indirect (refractometry) methods and used to assess SPI or FPI prevalence.

Hot topic: Accuracy of refractometry as an indirect method to measure failed transfer of passive immunity in dairy calves fed colostrum replacer and maternal colostrum.

Serum total protein (STP) refractometry is a widely used indicator of failed transfer of passive immunity (FTPI), defined as serum IgG concentrations of <10 mg/mL or STP levels <5.2 g/dL measured at 24 h of life. However, recent reports have demonstrated that refractometry could be inaccurate at estimating serum IgG concentrations and FTPI when calves are fed colostrum replacer (CR). The objective of this study was to evaluate the accuracy of STP measurements to estimate FTPI in calves fed CR compared with calves fed maternal colostrum. Blood was collected from dairy calves fed maternal colostrum (n = 927) or colostrum-derived CR (n = 1,258) and analyzed for STP and serum IgG. Serum total protein was measured with a digital refractometer, whereas radial immunodiffusion was used to determine IgG concentrations. Calves fed maternal colostrum had a mean STP of 5.80 ± 0.72 (standard deviation) g/dL and a mean IgG concentration of 22.81 ± 10.14 mg/mL, respectively, whereas calves fed CR had a mean STP and IgG concentration of 5.14 ± 0.50 g/dL and 12.78 ± 4.60 mg/mL, respectively. Rates of FTPI for calves fed maternal colostrum or CR were 4.2% and 27.26%, respectively. Calves were considered to have FTPI if their IgG postcolostrum feeding was <10 mg/mL. Logistic and linear regression analyses were performed to determine cutoff points and existent relationships between STP and IgG. Serum total protein and IgG for calves fed maternal colostrum were highly correlated. In contrast, STP and IgG for calves fed CR were lowly correlated. A receiver operator characteristic curve analysis demonstrated that an STP cutoff point that could predict FTPI when calves are fed CR would be 4.9 g/dL (sensitivity = 0.68; specificity = 0.75). This study suggests that current cutoff points used for STP inflates the number of calves estimated to have FTPI when they are fed CR.

Short communication: Variation in serum immunoglobulin G concentrations from birth to 112 days of age in Holstein calves fed a commercial colostrum replacer or maternal colostrum.

Serum IgG concentrations in dairy calves change throughout their first weeks of life, peaking at 24 h and then steadily decreasing until calves begin to produce endogenous IgG. The objective of this study was to observe serum IgG dynamics from birth until 16 wk of life in calves fed either maternal colostrum (MC) or colostrum replacer (CR). A total of 44 Holstein calves were randomly assigned to 1 of the 4 colostrum treatments and followed throughout the study. Treatments consisted of feeding high-quality MC, low-quality MC supplemented with CR, or 1 of 2 distinct levels of IgG concentration from CR. Overall, the interaction between type of colostrum fed and sampling time was significant. Individual differences for this effect were found at d 1, 7, 14, 21, 28, and 98, while the other time points were not different.

Timing of initiation and duration of feeding rumen-protected choline affects performance of lactating Holstein cows.

Objectives were to evaluate the effects of altering timing of initiating and duration of supplementing rumen-protected choline (RPC) on lactation performance in dairy cows. The hypothesis was that RPC increases yields of milk and milk components, regardless of when supplementation is initiated, and that the effects of supplementing RPC starting prepartum and continuing post-transition would be additive. Cows at 241 ± 2.2 d of gestation were blocked by parity group (49 entering lactation 2, 50 entering lactation >2) and 305-d milk yield and, within block, assigned randomly to 1 of 4 treatments arranged as a 2 × 2 factorial with 2 levels of choline in transition, from 21 d pre- to 21 d postpartum, and 2 levels of choline in post-transition, from 22 to 105 d postpartum. The 2 levels of RPC supplemented were either 0 g/d or 12.9 g/d of choline ion fed as 60 g/d of an RPC product that was top-dressed onto the total mixed ration. Thus, treatments were as follows: NN (n = 25): no choline in transition or post-transition; NC (n = 25): no choline in transition and choline in post-transition; CN (n = 25): choline in transition and no choline in post-transition; CC (n = 24): choline in transition and in post-transition. Prepartum, treatments were supplemented (mean ± SD) for the last 18.8 ± 5.7 and 19.2 ± 5.0 d of gestation in treatments with 0 or 12.9 g/d of choline ion, respectively. Supplementing RPC prepartum did not affect dry matter intake (DMI), body weight (BW), or body condition score (BCS) in the last 3 weeks of gestation. Likewise, RPC did not affect the yield or the composition of colostrum. Supplementation with RPC during transition increased fat percent by 0.02 percentage units, fat yield by 0.16 kg/d, and energy-corrected milk (ECM) by 3.1 kg/d in the first 21 d postpartum, and increased fat yield by 0.10 kg/d and ECM by 2.4 kg/d from 22 to 105 d postpartum. Supplementing RPC during transition did not affect DMI postpartum, but it improved feed efficiency, and cows produced 0.11 kg/d more ECM per kg of DMI. Changes in BW and BCS during the first 21 d postpartum did not differ between treatments. Cows fed RPC during transition had more negative net energy balance and 0.1 unit smaller BCS in the first 105 d postpartum than non-supplemented cows. Supplementing RPC in post-transition did not influence productive performance in dairy cows, and choline supplementation during transition or post-transition did not affect measures of reproduction. Collectively, supplementing RPC to supply 12.9 g/d of choline ion benefited productive performance in dairy cows when supplementation occurred during the transition period, but no additional benefit was observed from supplementing RPC past 22 d postpartum.

Comparison of immunoglobulin G absorption in calves fed maternal colostrum, a commercial whey-based colostrum replacer, or supplemented maternal colostrum.

Successful passive transfer of antibodies in neonatal calves can be achieved by feeding an adequate quantity and quality of maternal colostrum (MC) or colostrum replacer (CR). An alternative could be feeding low-quality maternal colostrum (LMC) with added IgG from a CR. The objective of this study was to determine if a commercial whey-based CR product containing low levels of casein (Premolac PLUS Bovine IgG; Zinpro Corporation, Eden Prairie, MN) fed to replace MC or supplement LMC could lead to adequate serum IgG levels and apparent efficiency of absorption (AEA) in neonatal dairy calves. Holstein calves (n = 20 per treatment) were separated from their dam after birth and randomly assigned to be fed 3.79 L of MC (106 g/L of IgG; 401 g of IgG fed), LMC (30 g/L IgG) supplemented with CR (41 g/L IgG; 154 g of IgG total fed; LMC-CR), or 1.3 L of 1 of 2 levels of CR (110 or 150 g of IgG fed; CR-110 or CR-150) within 1.5 h of birth. Colostrum was obtained from the first (MC) or second and third milkings (LMC) of cows from Pennsylvania State University dairy and pooled by source into large batches. Blood samples were taken from calves before colostrum feeding and 24 h after birth and were analyzed for serum total protein, total IgG, hematocrit, and Brix percentage. Calves fed MC had higher 24-h IgG values (means ± SEM) than calves fed LMC-CR (27.04 ± 1.07 vs. 22.33 ± 1.08 mg/mL, respectively). Feeding 150 g of IgG from CR led to higher 24-h serum IgG values than feeding 110 g of IgG (16.90 ± 1.09 vs. 12.79 ± 1.08 mg/mL). Serum IgG levels were different between the CR-fed calves and the calves fed LMC-CR and MC, but all had average values >10 mg/mL IgG. Calves fed LMC-CR had greater AEA than calves fed MC (54.58 ± 2.39 vs. 24.38 ± 2.36%, respectively). Among calves fed CR-110 or CR-150, AEA did not differ. Serum total protein and Brix percentage had strong correlations with actual IgG values across the entire study. We found no differences in average daily gain or health variables measured, and no differences in final hip width, withers height, or body weight for calves fed MC, LMC-CR, CR-150, or CR-110. These results indicate that CR can be fed successfully as an alternative to MC or as a supplement to colostrum with low IgG.

Effects of rumen-protected choline on the inflammatory and metabolic status and health of dairy cows during the transition period.

The objectives of this study were to evaluate the effects of rumen-protected choline (RPC) supplementation from 21 d pre- to 21 d postpartum on markers of metabolic status and inflammatory response, concentrations of liposoluble vitamins, and plasma total Ca in parous Holstein cows. The hypotheses were that supplementing RPC during the transition period would reduce hepatic triacylglycerol accumulation postpartum and attenuate markers of inflammatory response following parturition, and collectively, such responses were expected to benefit health of dairy cows. Parous cows at 241 d of gestation were blocked by parity group and 305-d milk yield, and within block, they were assigned randomly to receive either 0 g/d [no choline in transition (NT), n = 55] or 12.9 g/d choline ion [choline in transition (CT), n = 58] from 21 d pre- to 21 postpartum. The RPC product was individually top-dressed onto the total mixed ration once daily. Prepartum, treatments were supplemented (mean ± standard deviation) for the last 18.8 ± 5.7 and 19.2 ± 5.0 d of gestation in NT and CT, respectively. Supplementing RPC prepartum did not affect concentrations of plasma metabolites and inflammatory markers during the last 3 wk of gestation. Postpartum, cows fed RPC had greater hepatic concentration of hepatic triacylglycerol (NT = 3.4 vs. CT = 4.4%) and tended to have increased concentration of ß-hydroxybutyrate (NT = 0.48 vs. CT = 0.53 mM) in plasma. In spite of the increased hepatic triacylglycerol in cows fed RPC, treatment did not affect the concentrations of the inflammatory marker tumor necrosis factor-α or of the positive acute phase proteins, haptoglobin and fibrinogen. Supplementing choline tended to increase the concentration of plasma triacylglycerol by 0.69 mg/dL in the first 21 d postpartum and reduced the incidence of subclinical hypocalcemia by 20.9 percentage units compared with NT. Supplementing transition cows with RPC did not affect the concentrations of liposoluble vitamins in the first 7 d postpartum or the incidence of individual diseases or morbidity in early lactation. The inability of supplemental choline to reduce hepatic triacylglycerol might have been a consequence of the increased productive performance without additional dry matter intake.

The effect of aromatherapy with lavender (Lavandula angustifolia) on serum melatonin levels.

OBJECTIVE: Physiologically, blood melatonin levels decrease as a person ages and the older adult commonly presents with insomnia and other types of sleep disorders. Alternative therapies can be used to attenuate sleep disturbances. The aim of the present study was to analyze the effect of aromatherapy with lavender on serum melatonin levels in the noninstitutionalized older adult (OA). DESIGN AND SETTING: A pre-experimental, quantitative study with a pre-test - post-test design was conducted on 67 OAs that included both sexes. MAIN OUTCOME MEASURES: Serum melatonin levels were measured before and after eight sessions of aromatherapy with lavender that lasted 4 weeks. The results were expressed as mean ±â€¯standard deviation of melatonin levels (pg/ml). The differences were compared using the Student's t-test and statistical significance was set at a p ≤ 0.05. RESULTS: Blood melatonin levels significantly increased in the total population after the intervention with aromatherapy (pg/ml): 102.3 ±â€¯33.4 VS 132.5 ±â€¯42.3, p = 0.000004. There were significant differences in the pre-test and post-test phases in the women and men measured as separate groups (p = 0.00005 and p = 0.026), respectively. However, those differences were not observed when the measurements were compared between the two sexes, before (p = 0.64) or after (p = 0.31) the intervention. CONCLUSION: Aromatherapy with lavender essential oil similarly favors an increase in blood melatonin levels in both older adult men and women.

Effect of Moringa oleifera consumption on diabetic rats.

BACKGROUND: Therapeutic use of leaves of M. oleifera has been evaluated in diabetes because of its possible capacity to decrease blood glucose and lipids concentration after ingestion, as result of the polyphenols content and others compounds. Nevertheless most results have been obtain from leaf extract, therefore this study would use leaf powder as the regular way of consumption of population to know effects over toxicity glucose, triglycerides, cholesterol, corporal weight, and predominant groups of microbiota. METHODS: Powdered leaf was administrated in different doses to know toxicity and genotoxicity using LD50 and micronuclei assay. Hyperglycemia was induced by alloxan on Sprague Dawley rats. Glucose and body weight were measured once a week meanwhile cholesterol and triglycerides were analyzed at the end of the study by commercial kits. Different organs were examined by hematoxylin-eosin technique. Lactic acid bacteria and Enterobacteriaceae were enumerated from stool samples. RESULTS: The tested doses revealed no lethal dose and no significant differences in genotoxicity parameter. The consumption of the leaves showed a hypoglycemic effect (< 250 mg/dL in diabetic M. oleifera treated group), however in corporal weight showed an increased (> 30 g over no M. oleifera treated groups). There was no change in enumeration of lactic acid bacteria (8.4 CFU/g) but there were differences in the predominance of type of lactobacillus and enterobacteria enumeration. CONCLUSIONS: These results help to increase information over the most popular use of M. oleifera and its safety. However there are needed more studies over the hypoglycemic mechanisms and effects over intestinal microbiota.

Population pharmacokinetics of oxaliplatin after intraperitoneal administration with hyperthermia in Wistar rats.

BACKGROUND: The evaluation of the efficacy and toxicity of hyperthermic intraoperative peritoneal chemotherapy presents some difficulties, due in part to the lack of information about the pharmacokinetic behavior of the drugs administered in this procedure. The aim of this study was to characterize the population pharmacokinetics of hyperthermic intraoperative peritoneal oxaliplatin in Wistar rats and to evaluate the effect of treatment-related covariates dose, instillation time and temperature on the pharmacokinetic parameters. METHODS: Oxaliplatin peritoneal and plasma concentrations from 37 rats treated by either intravenous or intraperitoneal oxaliplatin administrations under different instillation times, temperatures and doses were analyzed according to a population pharmacokinetic approach using the software NONMEM V7.3®. RESULTS: Intraperitoneal (n = 115) and plasma (n = 263) concentrations were successfully described according to a two-compartment model with first order absorption. No significant effect of dose, temperature and instillation time on pharmacokinetic parameters was found. However, an abrupt decrease in the elimination process was observed, reflected in the structural pharmacokinetic model through a modification in clearance. The typical parameters values and the interindividual variability (CV %) in clearance, central and peripheral volume of distribution were 3.25 mL/min (39.1%), 53.6 mL (37.8%) and 54.1 mL (77.3%), respectively. Clearance decreased to 0.151 mL/min (39.1%) when the instillation was still ongoing, at 31.4 min. One of the possible reasons behind the clearance decrease would be an alteration of renal function due to surgery and/or hyperthermia. CONCLUSIONS: This study described the deterioration of the drug elimination process due to the procedure, and estimated the time at which this deterioration is most likely to occur. In addition, dose, instillation time and temperature had no influence in the PK parameters.

Guía de estilos de vida y glaucoma (i). Deporte y actividades / Lifestyles guide and glaucoma (i). Sports and activities

Objetivos: El aumento de la calidad y de la esperanza de vida y el hecho de que el glaucoma se diagnostique cada vez más precozmente hace preguntarse a muchos pacientes si afectan a su enfermedad determinados deportes, actividades o aficiones. El objetivo de este trabajo es establecer unas guías para aconsejar a los pacientes con base en la evidencia científica de los trabajos publicados. Métodos: Revisión de todos los trabajos publicados sobre glaucoma y deportes u otras actividades. Los trabajos fueron clasificados según el nivel de evidencia científica basada en la clasificación del Oxford Centre for Evidence-Based Medicine. Resultados: Las actividades aeróbicas son beneficiosas para el paciente. Se han de evitar deportes o técnicas de relajación tipo yoga con maniobras de Valsalva o colocación de la cabeza en posición inferior. También se deben evitar los cambios bruscos en altura. El calor intenso no parece influir en el glaucoma, pero el frío intenso puede afectar a pacientes con disregulación vascular. Las actividades de visión próxima disminuyen levemente la presión intraocular. El uso de instrumentos de viento puede elevar la presión intraocular dependiendo de la técnica utilizada. Conclusiones: Ciertos deportes y actividades pueden tener una influencia en la aparición o la progresión del glaucoma. Los especialistas en glaucoma deben tener información adecuada sobre la evidencia científica de las publicaciones para poder aconsejar apropiadamente a los pacientes (AU)

Purposes: The increase in quality and life expectancy, often leads to many patients asking the glaucoma specialist whether some sports, activities or hobbies would affect their illness. The aim of this article is to establish guidelines for patients, based on the scientific evidence of published papers. Methods: Review of all published articles on glaucoma and sports or other activities. The papers were classified according to the level of scientific evidence based on the Oxford Centre for Evidence-Based Medicine classification. Results: Aerobic sports are beneficial for the patient. Yoga indoor sports or relaxation techniques should be avoided if Valsalva manoeuvres are performed or the head is placed very low. Also, the patients must avoid sudden changes in height. Intense heat does not seem to lead to progression of glaucoma, but intense cold can affect patients with vascular dysregulation. Activities using the near vision slightly reduce the intraocular pressure. The use of wind instruments may raise intraocular pressure, depending on the technique used. Conclusions: Certain sports and activities may have an influence on the onset or progression of glaucoma. Glaucoma specialists should have adequate information about the scientific evidence in the publications, in order to properly advise the patients (AU)

Guía de estilos de vida y glaucoma (II). Dieta, suplementos, drogas, sueño, embarazo e hipertensión arterial / Lifestyles guide and glaucoma (II). Diet, supplements, drugs, sleep, pregnancy, and systemic hypertension

Objetivos: Establecer guías para aconsejar a los pacientes respecto a la relación entre dieta y hábitos de vida y glaucoma. Métodos: Revisión de los trabajos publicados sobre glaucoma y la dieta, la ingesta de suplementos, el consumo de drogas o el tabaco, el sueño, el embarazo y la hipertensión. Los trabajos fueron clasificados según el Oxford Center for Evidence-Based Medicine. Resultados: La evidencia sobre la relación entre la dieta o el uso de suplementos y la incidencia o la progresión del glaucoma es insuficiente para justificar una recomendación. Si bien algunos estudios en glaucoma de tensión normal sugieren que el Ginkgo biloba podría reducir la progresión, no permiten recomendar su uso generalizado. Los estudios sobre tabaco no demuestran claramente una relación entre consumo de tabaco e incidencia del glaucoma. La marihuana no es un tratamiento útil para el glaucoma. Los resultados sobre la relación entre la apnea del sueño y glaucoma son heterogéneos, pero sí parece conveniente que los pacientes con grado moderado o severo de apnea sean evaluados para descartar glaucoma. El embarazo no suele afectar al curso de la enfermedad, pero varios medicamentos hipotensores pueden ser nocivos para el feto. La hipotensión nocturna es un factor de riesgo de empeoramiento del glaucoma. Conclusiones: Ciertas costumbres, circunstancias o enfermedades pueden tener una influencia en la aparición o progresión del glaucoma. Es importante conocer la evidencia científica existente para poder aconsejar adecuadamente a los pacientes (AU)

To establish evidence based guidelines to advise patients on the relationship between habits, diet, certain circumstances, diseases and glaucoma. Methods: Review of all published articles on glaucoma and sports or other activities. The papers were classified according to the level of scientific evidence based on the Oxford Centre for Evidence-based Medicine classification. Results: The evidence on the relationship between diet or supplements and the incidence or progression of glaucoma is insufficient to make a general recommendation for glaucoma patients. Although some studies on normal tension glaucoma suggest that Gingko biloba could reduce glaucoma progression, the results do not allow a general recommendation for all these patients. Similarly, the evidence on the usefulness of vitamin supplements is not conclusive. The studies on smoking do not clearly demonstrate the relationship between this habit and incidence of glaucoma. Marihuana is not a useful treatment for glaucoma. Although the results on the relationship between sleep apnoea and glaucoma are heterogeneous, it is recommended that patients with moderate to intense apnoea are tested for glaucoma. Pregnancy does not influence the course of the disease, but several hypotensive drugs may be harmful for the foetus. Nocturnal systemic hypotension is a risk factor for glaucoma progression. Conclusions: Certain habits, circumstances, or diseases may have an influence on the onset or progression of glaucoma. It is important to have adequate information about the scientific evidence in the publications in order to properly advise patients (AU)

Lifestyles guide and glaucoma (II). Diet, supplements, drugs, sleep, pregnancy, and systemic hypertension. / Guía de estilos de vida y glaucoma (II). Dieta, suplementos, drogas, sueño, embarazo e hipertensión arterial.

PURPOSE: To establish evidence based guidelines to advise patients on the relationship between habits, diet, certain circumstances, diseases and glaucoma. METHODS: Review of all published articles on glaucoma and sports or other activities. The papers were classified according to the level of scientific evidence based on the Oxford Centre for Evidence-based Medicine classification. RESULTS: The evidence on the relationship between diet or supplements and the incidence or progression of glaucoma is insufficient to make a general recommendation for glaucoma patients. Although some studies on normal tension glaucoma suggest that Gingko biloba could reduce glaucoma progression, the results do not allow a general recommendation for all these patients. Similarly, the evidence on the usefulness of vitamin supplements is not conclusive. The studies on smoking do not clearly demonstrate the relationship between this habit and incidence of glaucoma. Marihuana is not a useful treatment for glaucoma. Although the results on the relationship between sleep apnoea and glaucoma are heterogeneous, it is recommended that patients with moderate to intense apnoea are tested for glaucoma. Pregnancy does not influence the course of the disease, but several hypotensive drugs may be harmful for the foetus. Nocturnal systemic hypotension is a risk factor for glaucoma progression. CONCLUSIONS: Certain habits, circumstances, or diseases may have an influence on the onset or progression of glaucoma. It is important to have adequate information about the scientific evidence in the publications in order to properly advise patients.