Tratamiento de mixoma odontogénico en maxilar superior. Reporte de un caso / Treatment of odontogenic myxoma in upper maxillary. A case report

El mixoma odontogénico es una neoplasia benigna, localmente agresiva, con una baja prevalencia (frecuencia del 2% al 5% de los tumores odontogénicos) en los maxilares. Este tumor a menudo se presenta como una lesión expansiva asintomática sin cambios nerviosos sensoriales. El objetivo del presente trabajo es detallar el caso de un paciente masculino de 42 años quien acude al servicio de Cirugía Bucal y Maxilofacial del Hospital Nacional Hipólito Unanue por presentar una tumoración de crecimiento lento en maxilar superior, que fue aumentando de tamaño con el tiempo y desplazando órganos dentarios, y que se extiende al paladar duro y parte de paladar blando, el diagnóstico anatomopatológico fue de mixoma odontogénico y recibió un tratamiento radical (hemimaxilectomia) por la naturaleza agresiva del tumor. En este trabajo discutimos la presentación del mixoma odontogénico en el maxilar superior, los enfoques de trata- miento; detallando la importancia de plantear alternativas de tratamiento que permitan la reconstrucción inmediata generando la menor morbilidad posible.

Odontogenic myxoma is a locally aggressive benign neoplasm with a low prevalence (frequency 2% to 5% of odontogenic tumors) in the jaws. This tumor often presents as an asymptomatic expansive lesion without sensory nerve changes. The aim of this study is to detail the case of a 42-year-old male patient who attends the Oral and Maxillofacial Surgery service of the Hipólito Unanue National Hospital due to a slow-growing tumor in the upper jaw, which increased in size over time and displacing dental organs, and extending to the hard palate and part of the soft palate, the pathological diagnosis was odontogenic myxoma and received radical treatment (hemimaxilectomy) due to the aggressive nature of the tumor. In this work we discuss the presentation of odontogenic myxoma in the maxilla, treatment approaches; detailing the importance of proposing treatment alternatives that allow immediate reconstruction generating the least possible morbidity.

Psychological status and role of caregivers in the neuro-rehabilitation of patients with severe Acquired Brain Injury (ABI).

OBJECTIVE: To investigate the relationships between (a) the psychological status of the caregiver, (b) the specific features of caregiving as perceived by the cognitive therapist in neuro-rehabilitation, (c) the caregivers' subjective approach to neuro-rehabilitation, and (d) the functional outcome of the patient. METHODS: Twenty-four patients with severe acquired brain injury and their 24 caregivers participated in this observational study. Caregivers underwent a psychological assessment examining emotional distress, burden and family strain; their subjective approach to neuro-rehabilitation has been evaluated by two specific answers. The patients' cognitive therapists responded to an ad-hoc questionnaire, namely the "Caregiving Impact on Neuro-Rehabilitation Scale" (CINRS), evaluating the features (i.e., amount and quality) of caregiving. Finally, the functional outcome of the patient was assessed through standardized scales of disability and cognitive functioning. RESULTS: The caregivers' psychological well-being was associated to the features of caregiving, to the subjective approach to neuro-rehabilitation, and to the functional recovery of their loved ones. A better caregivers' approach to neuro-rehabilitation was also associated to an overall positive impact of caregiving in neuro-rehabilitation and to a better functional outcome of the patients. CONCLUSIONS: We posited a virtuous circle involving caregivers within the neuro-rehabilitation process, according to which the caregivers' psychological well-being could be strictly associated to a better level of caregiving and to a better functional outcome of the patients that, in turn, could positively influence the caregivers' psychological well-being. Although preliminary, these results suggest a specific psycho-educational intervention, aimed at improving the caregivers' psychological well-being and at facilitating their caring of the loved one.

[Self-awareness as a key process for rehabilitation of patients with acquired brain injury: a systematic review]. / Conciencia de déficit como proceso clave en la rehabilitación de pacientes con daño cerebral adquirido: revisión sistemática.

INTRODUCTION: Self-awareness impairment is a common symptom of patients after suffering acquired brain injury, affecting the rehabilitation process and achievements in terms of patients's daily living functionality. PATIENTS AND METHODS: A systematic review was performed using Scopus and PubMed databases of scientific articles that address self-awareness in patients with brain injury between 2000 and 2019. Finally, 65 articles were reviewed. RESULTS: As a metacognitive process, self-awareness is linked to other higher order cognitive domains such an executive functions and memory. In recent years, specific intervention programs for self-awareness have been developed and implemented, and have proved their effectiveness, by using different techniques (i.e. psychoeducation and feedback). Considering the importance of assessing the success of the self-awareness interventions in terms of functional improvement, some studies have explored the generalization and transfer of results from those interventions to activities of daily living. CONCLUSIONS: Research in self-awareness in patients with acquired brain injury has developed significantly in recent years, considering the neuropsychological, psychological and social factors of this phenomenon. The promising future of research in this field points at its inclusion as screening tool in the assessment protocols and, if applicable, its individualized intervention, contributing to an effective global rehabilitation that affects patient's quality of life.

TITLE: Conciencia de déficit como proceso clave en la rehabilitación de pacientes con daño cerebral adquirido: revisión sistemática.Introducción. La afectación de la conciencia de déficit es un síntoma habitual de los pacientes que sufren una lesión cerebral, que afecta al proceso rehabilitador y a los logros en términos de independencia funcional del paciente. Pacientes y métodos. Se realizó una revisión sistemática en las bases bibliográficas Scopus y PubMed de los trabajos científicos que han abordado la conciencia de déficit en pacientes con daño cerebral entre 2000 y 2019. Finalmente se revisaron 65 artículos. Resultados. La conciencia de déficit como proceso metacognitivo está ligada a otros procesos cognitivos de orden superior, como las funciones ejecutivas y la memoria. En los últimos años, se han diseñado e implementado programas de intervención específicos sobre conciencia de déficit que han demostrado su eficacia mediante la incorporación de diferentes técnicas (por ejemplo, psicoeducación y feedback). Ante la necesidad de evaluar el éxito de la intervención sobre la conciencia de déficit en términos de mejora funcional, algunos trabajos han estudiado la generalización y la trasferencia de los resultados de la intervención sobre la conciencia de déficit a las actividades de la vida diaria. Conclusiones. La investigación en conciencia de déficit en pacientes con daño cerebral se ha desarrollado de forma significativa en los últimos años, considerando los factores neuropsicológicos, psicológicos y sociales de este fenómeno. Su futuro prometedor apunta hacia su incorporación como cribado en los protocolos de evaluación y, en su caso, su intervención de forma específica, lo que contribuirá a una rehabilitación eficaz que repercuta en la calidad de vida de los pacientes.

In situ provision of drinking water to grazing dairy cows improves milk production.

AIMS: To determine the effect of providing water within the area grazed by dairy cows on milk yield and quality, compared to requiring cows to walk to a distant water trough, on a dairy farm in the Pampa region of Argentina during summer. METHODS: Holstein dairy cows were allocated to two herds with similar parity, days in milk and milk production. They were grazed in one paddock that was divided in two, with a fixed water trough at one end. Cows were moved twice daily to grazing plots within the paddock. Control cows (n=66) could only access water from the fixed trough, whereas supplemented cows (n=67) also received water from a mobile trough within the grazing plot. Milk production of each cow, and water consumption of the two herds were measured daily over 62 days. Milk composition for each herd was determined weekly from Days 18 to 60 of the study, and grazing behaviour was observed between 08:00 and 16:00 hours on Days 11-15, 19-22 and 39-43. RESULTS: Over the 62 days of the study, supplemented cows produced 1.39 (SE 0.11) L/cow/day more milk than Control cows (p=0.027). Estimated mean daily water intake was 50.4 (SE 2.1) L/cow/day for supplemented cows and 58.2 (SE 2.7) L/cow/day for Control cows (p=0.004). Percentage total solids in milk was higher for supplemented (12.5 (SE 0.06)%) than Control (12.4 (SE 0.04)%) cows (p=0.047). During the periods of behavioural observation, a higher percentage of cows in the water supplemented than the Control herd were observed in the grazing area (p=0.012). CONCLUSIONS AND CLINICAL RELEVANCE: This preliminary study demonstrated that provision of water to dairy cows within the grazing plot was beneficial for milk production and composition, and may be associated with longer periods spent within the grazing area, during hot weather in the Pampa region of Argentina.

Linfoma anaplásico de células grandes (lacg) asociado a implante mamario. Reporte de un caso y revisión de la literatura / Breast implant-associated anaplastic large cell lymphoma (bia-alcl). Description of one case diagnosed at the Buenos Aires British Hospital and literature review

Introducción El linfoma anaplásico de células grandes (lacg) asociado a implante mamario es una rara entidad descripta por primera vez en 1977. Hasta la actualidad, la Food and Drug Administration (fda) ha recibido 359 reportes de casos. Se manifiesta habitualmente como un seroma peri-protésico tardío o, menos frecuentemente, como una masa peri-capsular. En la mayoría de los casos, se asocia con implantes texturizados. Es fundamental el estudio citológico del seroma y la realización de cd30 en casos de sospecha diagnóstica. El tiempo medio desde la colocación del implante al desarrollo de la enfermedad es de 7 años a 10 años. Más del 80% de las pacientes se presentan en estadios tempranos, pudiendo ser tratadas solo con cirugía y sin requerir tratamientos adyuvantes. Objetivo El objetivo del presente trabajo es realizar el reporte de un caso de lacg diagnosticado y tratado en el Hospital Británico de Buenos Aires y realizar una revisión de la literatura

Introduction Breast implant-associated anaplastic large cell lymphoma (bia-alcl) is a rare T-cell lymphoma first described in 1977. As of February 1, 2017, the fda has received a total of 359 medical device reports. It typically occurrs in a delayed fluid collection around a textured implant. Specimens should be sent for cytology; essential to the diagnosis of bia-alcl is immunohistochemistry for cd30 cell surface protein. The median time from implant placement to diagnosis of alcl was 7 to 10 years. Disease localized to the capsule may be treated with surgery alone. Objective In this report we describe our experience with one case of bia-alcl diagnosed at the Buenos Aires British Hospital and we perform a review of the literature.

Neuroendocrine Regulation of Metabolism.

Given the current environment in most developed countries, it is a challenge to maintain a good balance between calories consumed and calories burned, although maintenance of metabolic balance is key to good health. Therefore, understanding how metabolic regulation is achieved and how the dysregulation of metabolism affects health is an area of intense research. Most studies focus on the hypothalamus, which is a brain area that acts as a key regulator of metabolism. Among the nuclei that comprise the hypothalamus, the arcuate nucleus is one of the major mediators in the regulation of food intake. The regulation of energy balance is also a key factor ensuring the maintenance of any species as a result of the dependence of reproduction on energy stores. Adequate levels of energy reserves are necessary for the proper functioning of the hypothalamic-pituitary-gonadal axis. This review discusses valuable data presented in the 2015 edition of the International Workshop of Neuroendocrinology concerning the fundamental nature of the hormonal regulation of the hypothalamus and the impact on energy balance and reproduction.

Cellular proliferation rate and insulin-like growth factor binding protein (IGFBP)-2 and IGFBP-3 and estradiol receptor alpha expression in the mammary gland of dairy heifers naturally infected with gastrointestinal nematodes during development.

Mammary ductal morphogenesis during prepuberty occurs mainly in response to insulin-like growth factor-1 (IGF-1) and estradiol stimulation. Dairy heifers infected with gastrointestinal nematodes have reduced IGF-1 levels, accompanied by reduced growth rate, delayed puberty onset, and lower parenchyma-stroma relationship in their mammary glands. Immunohistochemical studies were undertaken to determine variations in cell division rate, IGF-1 system components, and estradiol receptors (ESR) during peripubertal development in the mammary glands of antiparasitic-treated and untreated Holstein heifers naturally infected with gastrointestinal nematodes. Mammary biopsies were taken at 20, 30, 40, and 70 wk of age. Proliferating cell nuclear antigen immunolabeling, evident in nuclei, tended to be higher in the parenchyma of the glands from treated heifers than in those from untreated. Insulin-like growth factor binding proteins (IGFBP) type 2 and type 3 immunolabeling was cytoplasmic and was evident in stroma and parenchyma. The IGFBP2-labeled area was lower in treated than in untreated heifers. In the treated group, a maximal expression of this protein was seen at 40 wk of age, whereas in the untreated group the labeling remained constant. No differences were observed for IGFBP3 between treatment groups or during development. Immunolabeling for α ESR (ESR1) was evident in parenchymal nuclei and was higher in treated than in untreated heifers. In the treated group, ESR1 peaked at 30 wk of age and then decreased. These results demonstrate that the parasite burden in young heifers negatively influence mammary gland development, affecting cell division rate and parameters related to estradiol and IGF-1 signaling in the gland.

Metritis in dairy cows: risk factors and reproductive performance.

The objectives of this study were to assess the risk factors for metritis, its effects on milk yield and on reproductive performance, and the efficacy of ceftiofur therapy in Holstein dairy cows. Cows (n=303) from a commercial dairy herd in Argentina were studied. Cows were scored for body condition, and blood samples were collected on d -14, 7, 21, 31, 41, and 50 relative to parturition. Cows having a watery, purulent, or brown, and fetid vaginal discharge (VD) and rectal temperature ≤ 39.2°C were diagnosed as having clinical metritis, and those having a similar VD and rectal temperature >39.2°C were diagnosed as having puerperal metritis. Both clinical and puerperal metritis cows were randomly assigned to control (no treatment) or ceftiofur group (2.2mg/kg×3 consecutive days). Cure was declared if clear VD was observed at 21 d in milk (DIM). Blood samples were analyzed for nonesterified fatty acids, ß-hydroxybutyrate, and blood urea nitrogen using commercial kits, and for insulin-like growth factor-1, insulin, and leptin by RIA. Data were analyzed with PROC MIXED, GENMOD, PHREG, and LIFETEST from SAS (SAS Institute Inc., Cary, NC). The risk for metritis increased with dystocia, retained fetal membranes, and dead calf [AOR (adjusted odds ratio)=2.58, 95% CI: 1.189-5.559], and as prepartum nonesterified fatty acids levels increased (AOR=1.001, 95% CI: 0.999-1.002). Conversely, risk decreased as prepartum insulin-like growth factor-1 increased (AOR=0.65, 95% CI: 0.349-1.219). Cows having either clinical or puerperal metritis produced less milk by 90 DIM than did healthy cows (2,236 ± 172 vs. 2,367 ± 77 vs. 2,647 ± 82 kg, respectively). Cows with puerperal metritis had lower risk for pregnancy by 100 DIM (AOR=0.189, 95% CI: 0.070-0.479) and a lower hazard rate for pregnancy by 150 DIM (hazard rate: 0.753, 95% CI: 0.621-0.911), and took longer to get pregnant (129 vs. 111 vs. 109 d, for puerperal metritis, clinical metritis, and healthy cows, respectively). Ceftiofur treatment was not associated with cure rate or milk yield but was related to increased risk for pregnancy at timed artificial insemination (AOR=2.688, 95% CI: 0.687-10.832), and for lower risk of reproductive cull (AOR=0.121, 95% CI: 0.014-1.066). In conclusion, abnormal calving and negative energy balance are associated with increased risk for metritis. Metritis, especially puerperal metritis, correlates with reduced milk production and poor reproductive performance. Finally, the likelihood for having a normal VD (indicative of cure) increased 2.6% for every day of increase in postpartum time and was 2 times higher for cows with clinical metritis than for those with puerperal metritis.

Mecanismos de tumorogénesis hipofisaria: Estudio de factores angiogénicos y de proliferación / Mechanisms of Pituitary Tumorigenesis: Study of Angiogenic and Proliferation factors

Introducción y Objetivos: La angiogénesis es un proceso fundamental en el desarrollo tumoral. Sin embargo, se han encontrado discrepancias en el patrón angiogénico de los tumores hipofisarios. Nos propusimos estudiar la expresión de VEGF y FGF2 y su importancia en la vascularización de los adenomas hipofisarios, cuantificar los vasos con los marcadores CD31 y CD34 y determinar el índice de proliferación con PCNA y Ki67. Materiales y Métodos: Se estudiaron 76 macroadenomas hipofisarios que fueron intervenidos quirúrgicamente. Los adenomas se clasificaron según su secreción hormonal. A partir de cortes histológicos se realizó inmunohistoquímica para los marcadores de endotelio CD31 y CD34; y Ki-67 para estudio de proliferación celular. Por western blot se midieron VEGF, CD31 y PCNA. Se efectuaron comparaciones con glándulas normales. Resultados: El nivel de expresión de VEGF, hallado en todas las muestras analizadas, resultó mayor en los prolactinomas resistentes respecto a los demás tipos de adenomas hipofisarios. Esta proteína localizó en las células endoteliales de los vasos como así también en citoplasmas y núcleos de células tumorales. El 56 % de las muestras resultaron positivas para FGF2, mostrando localización citoplasmática y en matriz extracelular. Obtuvimos una fuerte correlación positiva entre VEGF y CD31 en las muestras tumorales, sin encontrar correlación lineal entre PCNA y VEGF, ni Ki-67 y VEGF en las muestras estudiadas. El área vascular resultó mayor en los tejidos normales que en los tumores utilizando CD34 como marcador de vasos. Conclusión: La importancia del estudio de la angiogénesis en los adenomas hipofisarios radica en la necesidad de hallar marcadores moleculares que predigan el comportamiento tumoral. Pudimos demostrar la expresión de los factores angiogénicos VEGF y FGF2 en estos adenomas, y la existencia de correlación lineal entre VEGF y CD31. Nuestros resultados son indicativos de existencia de angiogénesis en los adenomas hipofisarios por lo que su bloqueo podría plantearse como una estrategia alternativa para los casos resistentes a las terapias convencionales.

Introduction and objectives: Angiogenesis is an essential process in tumor development. Nevertheless, discrepancies in the angiogenic pattern of pituitary tumors, in terms of hormonal phenotype, size or invasiveness have been found. Our aim was to study the expression of VEGF and FGF2 growth factors, and their importance in the vascularization of pituitary adenomas. We also quantified blood vessels with the endothelial cell markers CD31 and CD34 determining the vascular area, and the proliferation rate through PCNA and Ki67 index. Materials and Methods: We studied 76 pituitary macroadenomas that were surgically resected in the period between 2006 and 2010 from a total of 276 patients with this pathology. Adenomas were classified into prolactinomas (PRL), somatotropinomas (GH), corticotropinomas (ACTH), non-functioning (NF) and plurihormonal (Ph) according to their hormonal secretion. Samples were collected in formalin, embedded in paraffin, and immunohistochemistry was performed from histological sections for endothelial markers CD31 and CD34; and for Ki-67 to study cell proliferation. VEGF, CD31 and PCNA were measured by Western blot. We compared results with normal glands (N=6). Results: VEGF expression levels, found in all of the samples analyzed, were higher in resistant prolactinomas than in other pituitary adenomas. This protein was detected in endothelial cells of blood vessels and in tumor cells cytoplasms and nuclei. Fifty-six percent of samples were positive for FGF2, the other potent angiogenic factor studied, showing cytoplasmatic and extracellular matrix localization. We obtained a strong positive correlation between VEGF and CD31 in tumor samples, but we did not find lineal correlation between PCNA and VEGF, or between Ki-67 and VEGF in the samples studied. The vascular area was higher in normal tissues than in tumors when CD34 was used as endothelial cell marker. Conclussion: The importance of studying angiogenesis in pituitary adenomas lies in the need to find molecular markers that can predict tumor behavior. We could demonstrate the expression of VEGF and FGF2, two potent angiogenic factors, and the existence of linear correlation between VEGF and CD31. Our results are indicative of the existence of angiogenesis in pituitary adenomas; therefore the blockage of angiogenesis might be proposed as an alternative strategy for cases of resistance to standard therapy.

Clinical endometritis in an Argentinean herd of dairy cows: risk factors and reproductive efficiency.

The objectives of this study were to assess the clinical and metabolic risk factors for clinical endometritis, the likelihood for having a normal vaginal discharge during postpartum, and the effects of endometritis on milk yield, reproductive efficiency, and metabolic status in Holstein cows. The study was conducted in a commercial dairy herd (Cordoba, Argentina) where 303 Holstein cows were enrolled. Cows were body condition scored (1 to 5) and tail bled on -14, 7, 21, 31, 41, and 50 d relative to parturition. Cows having a vaginal discharge with presence of pus between 21 and 41 d postpartum (dpp) were diagnosed as having clinical endometritis. Plasma blood samples were analyzed for nonesterified fatty acids (NEFA), ß-hydroxybutyrate (BHBA), and blood urea nitrogen using commercial kits and insulin-like growth factor 1, insulin, and leptin by RIA. Data were analyzed with PROC MIXED, PROC GENMOD, and PROC PHREG of SAS (SAS Institute Inc., Cary, NC). Abnormal calving and puerperal metritis increased the risk for endometritis [adjusted odds ratio (AOR)=2.21 for both]. High prepartum NEFA and high postpartum BHBA increased the risk for endometritis (AOR=1.003 and 1.001, respectively), whereas high prepartum blood urea nitrogen reduced it (AOR=0.853). Cut-offs of 456.6 µM NEFA and 402.5 µM BHBA had sensitivities of 0.69 and 0.58, and specificities of 0.88 and 0.86, respectively. The likelihood for having normal vaginal discharge increased with time (∼1% × dpp) and with normal calving. Cows with endometritis had higher milk yield than normal herdmates (27.8±0.9 vs. 25.7±0.4 kg/d), lower risk for pregnancy by 100 dpp (AOR=0.10), higher nonpregnancy risk by 200 dpp (AOR=2.87), and higher risk for culling than normal cows (AOR=2.28). Cows with endometritis had a lower hazard rate (0.44) for pregnancy and had approximately 70 d longer calving-to-conception intervals. Finally, endometritis had no effect on metabolic hormones. In conclusion, the risk for clinical endometritis increases with abnormal calving and puerperal metritis, as prepartum NEFA and postpartum BHBA concentrations increase. Prepartum NEFA and postpartum BHBA could be useful for the prediction of endometritis. Last, clinical endometritis has detrimental effects on reproductive efficiency, as affected cows take longer to get pregnant and are at higher risk for culling.

Comparison of three methods for gastrointestinal nematode diagnosis determination in grazing dairy cattle in relation to milk production.

Development of resistance to anthelmintic drugs has motivated the search for diagnostic methods to identify animals for targeted selective treatments. We compared three methods for the diagnosis of nematode infection in relation to milk production in a fully grazing dairy herd of 150 cows in the humid Pampa (Argentina). Animals had feces, blood and milk sampled during the first postpartum month for EPG, pepsinogen and anti-Ostertagia antibody determination, respectively. With the results obtained two groups of cows, divided in high and low parasite burden, were conformed for each method, and milk production was then compared between groups. When cows were separated by the EPG method (EPG=0 (N=106) vs. EPG>0 (N=44)) a difference of nearly 800 l of milk per cow per lactation was found (P<0.05). On the other hand, milk production between groups separated by Pepsinogen (mUtyr ≤ 1000 vs. mUtyr > 1000) or by anti-Ostertagia (ODR ≤ 0.5 vs. ODR > 0.5) results did not differ. Interestingly, proportion of cows in each group differed between methods (P<0.0001), and the anti-Ostertagia method yielded significantly more cows in the high index group compared to results using the EPG or Pepsinogen method. No correlations were found between parasite indexes determined by the different methods. High parasite burden estimation found may be ascribed to the production system, fully grazing all year round, and to the sampling time, at the beginning of lactation with cows in negative energy balance and depressed immunity. The fact that the cows were born and reared outside, on pasture with continuous nematode larvae exposure, may also account for the results obtained. In conclusion, EPG counting during the first postpartum month may be a useful tool for the diagnosis of production impairment induced by high nematode burden in adult grazing dairy cows. The anthelmintic treatment of only the EPG-positive recently calved cows would improve milk production, while reducing selective pressure on nematode population for the development of resistance.

Gastrointestinal parasites presence during the peripartum decreases total milk production in grazing dairy Holstein cows.

Parasitism in cattle is known to impair growth and development. Recent findings suggest that productivity of adult animals is also affected, but little is known about the physiological mechanisms involved. Furthermore, development of nematode resistance to drugs makes imperative the search of management practices that avoid whole herd treatment. We undertook an epidemiological and endocrine study in a grass based dairy farm in Argentina to study the effect of parasites on milk production and the underlying mechanisms involved, and identify individual animals that would benefit from antiparasitic treatment. All the cows in the dairy were followed monthly for egg parasite output in feces. Samples were cultured for genera determination. Milk production and reproductive results were recorded and periodical bleedings for hormone determination were performed. Nematode egg output (EPG) was maximal in late Summer and Autumn and minimal in Spring in coincidence with the Ostertagia inhibition-disinhibition cycle as this genus had the highest prevalence in all the study. The highest proportion of positive samples was found in the high producing herd and maximal counts were found in the peripartal period. Milk production did not correlate with EPG mean values but, when cows were grouped by EPG positivity around parturition, a significant difference in total milk production between EPG null and positive cows was observed. Positive cows produced 7%, 12% or 15% less milk than null EPG cows, depending on the sampling month/s chosen for classification. The highest difference was seen when both prepartum and postpartum samples were taken into account. No difference in lactation length and a marginal effect on partum to first service interval were encountered. Endocrine studies revealed a decrease in serum growth hormone (GH), type I insulin-like growth factor (IGF-I) and prolactin during lactation in cows with positive EPG in the first postpartum sample with respect to null EPG cows at that time. GH levels decreased and prolactin and IGF-I levels increased in both groups of cows from month 0 to 6 in milk. Serum insulin levels remained stable throughout lactation and were similar in both groups of cows. In conclusion, EPG around parturition may be a useful tool for identifying cows that will have a decrease in productivity due to parasite effects and would possibly benefit from an antiparasitic treatment. Besides, our results suggest that detrimental effect of parasites on milk production may be mediated by GH, IGF-I and prolactin serum levels.

Effect of anthelmintics on reproductive performance and first-lactation culling rate in Holstein heifers.

Female Holstein calves were treated with ivermectin from birth to first oestrus to study the effect of parasitic burden and anthelmintic treatment on reproductive and productive performance. First oestrus, age at first service and age at calving were advanced by 30, 70 and 110 days, respectively (P<0.05), in ivermectin-treated animals compared with controls. No significant differences were observed in the conception rate, the number of services and the characteristics of the newborn calves and any problems at calving between the two groups. Daily milk yield, fat content in milk during first lactation, and the concentrations of growth hormone, insulin-like growth factor type 1, insulin and prolactin in serum were similar in both groups of cows. Culling during the first lactation was more common in untreated (47 per cent) than in treated (11 per cent) cows (P<0.05).

Hypothalamic orexin, OX1, alphaMSH, NPY and MCRs expression in dopaminergic D2R knockout mice.

In 5-month-old male and female dopamine receptor 2 (D2R) knockout mice food intake per animal was unaltered while food per g BW was increased. We wished to evaluate the effect of D2R disruption on different components of energy balance and food intake regulation. We determined hypothalamic orexin precursor (PPO) expression, its receptor OX1, serum leptin levels, hypothalamic leptin receptor (OBR), circulating and pituitary alpha MSH levels, as well as central MC3 and MC4 receptors and NPY mRNA in wildtype and D2R knockout mice (KO). Loss of D2R caused a marked increase in serum prolactin levels, to higher levels in females compared to male KO mice. On the other hand, it produced a female-specific increase in circulating alphaMSH, and hypothalamic alphaMSH content, while neurointermediate alphaMSH content was decreased in both sexes. No differences were found in hypothalamic NPY, MC3R or MC4R concentration. Hypothalamic PPO mRNA expression was significantly decreased only in female KOs, while OX1 mRNA was not different between genotypes. Serum leptin levels were also similar in both genotypes. Our results show that in female and not in male mice disruption of the D2R produces two potentially anorexigenic events: an increase in serum and hypothalamic alphaMSH, and a decrease in hypothalamic orexin expression. Very high prolactin levels, which are orexigenic, probably counterbalance these effects, so that food intake is slightly altered. In males, on the other hand, hypothalamic PPO, and serum or hypothalamic alphaMSH are not modified, and increased prolactin levels may account for increased food intake per g BW. These results suggest a sexually dimorphic participation of the D2R in food intake regulation.

Restorative effect of insulin-like growth factor-I gene therapy in the hypothalamus of senile rats with dopaminergic dysfunction.

Insulin-like growth factor-I (IGF-I) is emerging as a powerful neuroprotective molecule that is strongly induced in the central nervous system after different insults. We constructed a recombinant adenoviral vector (RAd-IGFI) harboring the gene for rat IGF-I and used it to implement IGF-I gene therapy in the hypothalamus of senile female rats, which display hypothalamic dopaminergic (DA) neurodegeneration and as a consequence, chronic hyperprolactinemia. Restorative IGF-I gene therapy was implemented in young (5 months) and senile (28 months) female rats, which received a single intrahypothalamic injection of 3 x 10(9) plaque-forming units of RAd-betagal (a control adenoviral vector expressing beta-galactosidase) or RAd-IGFI and were killed 17 days post-injection. In the young animals, neither vector modified serum prolactin levels, but in the RAd-IGFI-injected senile rats a nearly full reversion of their hyperprolactinemic status was recorded. Morphometric analysis revealed a significant increase in the total number of tyrosine hydroxylase-positive cells in the hypothalamus of experimental as compared with control senile animals (5874+/-486 and 3390+/-498, respectively). Our results indicate that IGF-I gene therapy in senile female rats is highly effective for restoring their hypothalamic DA dysfunction and thus reversing their chronic hyperprolactinemia.

Increased pituitary vascular endothelial growth factor-a in dopaminergic D2 receptor knockout female mice.

Vascular endothelial growth factor (VEGF)-A is an important angiogenic cytokine in cancer and pathological angiogenesis and has been related to the antiangiogenic activity of dopamine in endothelial cells. We investigated VEGF expression, localization, and function in pituitary hyperplasia of dopamine D2 receptor (D2R)-knockout female mice. Pituitaries from knockout mice showed increased protein and mRNA VEGF-A expression when compared with wild-type mice. In wild-type mice, prolonged treatment with the D2R antagonist, haloperidol, enhanced pituitary VEGF expression and prolactin release, suggesting that dopamine inhibits pituitary VEGF expression. VEGF expression was also increased in pituitary cells from knockout mice, even though these cells proliferated less in vitro when compared with wild-type cells, as determined by 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium proliferation assay, proliferating cell nuclear antigen expression, and [(3)H]thymidine incorporation. In contrast to other animal models, estrogen did not increase pituitary VEGF protein and mRNA expression and lowered serum prolactin secretion in vivo and in vitro in both genotypes. VEGF (10 and 30 ng/ml) did not modify pituitary cell proliferation in either genotype and increased prolactin secretion in vitro in estrogen-pretreated cells of both genotypes. But conditioned media from D2R(-/-) cells enhanced human umbilical vein cell proliferation, and this effect could be partially inhibited by an anti-VEGF antiserum. Finally, using dual-labeling immunofluorescence and confocal laser microscopy, we found that in the hyperplastic pituitaries, VEGF-A was mostly present in follicle-stellate cells. In conclusion, pituitary VEGF expression is under dopaminergic control, and even though VEGF does not promote pituitary cellular proliferation in vitro, it may be critical for pituitary angiogenesis through paracrine actions in the D2R knockout female mice.

Dehydroepiandrosterone (DHEA) modulates GHRH, somatostatin and angiotensin II action at the pituitary level.

In view of the present controversy related to the potential beneficial effects of clinical dehydroepiandrosterone (DHEA) treatments, and considering our own previous results that reveal an influence of this steroid in pituitary hyperplasia development in vivo in rats, we decided to evaluate the role of DHEA in prolactin and GH secretion, as well as in second messengers involved, in cultured rat anterior pituitary cells. DHEA (1 x 10(-5) to 1 x 10(-7) M) did not modify basal GH or prolactin release, and a prolactin inhibitory effect was observed only for androstenediol, a metabolite of DHEA. DHEA partially prevented dopamine (1 x 10(-6) M)-induced prolactin inhibition and facilitated the prolactin-releasing effect of 10(-8) M Ang II, without modifying the resulting Ca2+(i) mobilization. Furthermore, DHEA potentiated the GH release and cAMP production induced by 1 x 10(-8) M GHRH. Finally, DHEA partially reversed the inhibitory effect of 1 x 10(-8) M somatostatin on GH, but not prolactin, release. We conclude that DHEA in vitro, directly or indirectly through conversion into metabolites, is able to modulate the hormonal response of the pituitary to hypothalamic regulators. It can enhance pituitary prolactin release and induce GH secretion. These effects could help explain some of the side effects observed in prolonged DHEA treatments in vivo and should be taken into account when considering its use in human clinical trials.

Partial replacement of corn grain by hydrogenated oil in grazing dairy cows in early lactation.

Thirty-six grazing dairy cows were used to determine milk production and composition, and dry matter and energy intake when corn grain was partially replaced by hydrogenated oil in the concentrate. Four additional cows, each fitted with a ruminal cannula, were used in a crossover design to evaluate effects of supplemental fat on rumen environment and pasture digestion. All cows grazed mixed pastures with an herbage allowance of 30 kg dry matter/cow per day. The control group was fed a concentrate containing corn grain (4.49 kg dry matter/cow per day) and fishmeal (0.37 kg dry matter/cow per day), whereas the other group (fat) received a concentrate containing corn grain (2.87 kg dry matter/cow per day), fishmeal (0.37 kg dry matter/cow per day) and fat (0.7 kg dry matter/cow per day). The fat was obtained by hydrogenation of vegetable oils (melting point 58 to 60 degrees C, 30.3% C16:0, 34.9% C18:0, 21.8% C18:1, 3.3% C18:2). Supplemental fat increased milk production (control = 23.7 vs. fat = 25.0 kg/cow per day), fat-corrected milk (control = 22.5 vs. fat = 24.5 kg/cow per day), milk fat content (control = 3.64% vs. fat = 3.86%) and yields of milk fat (control = 0.86 vs. fat = 0.97 kg/cow per day) and protein (control = 0.74 vs. fat = 0.78 kg/cow per day). Milk percentages of protein, lactose, casein, cholesterol, and urea nitrogen were not affected. Pasture DMI and total DMI of pasture and concentrate and estimated energy intake were unchanged. No differences in loss of body weight or body condition score were detected. Plasma concentrations of nonesterified fatty acids, somatotropin, insulin, and insulin-like growth factor were not affected by supplemental fat. Concentrations of plasma triglyceride and total cholesterol were increased by supplemented fat, and no changes in plasma glucose and urea nitrogen were observed. The acetate-to-propionate ratio was higher in rumen fluid of cows that consumed fat (fat = 3.39 vs. control = 3.27). In situ pasture NDF degradation was not affected. The partial replacement of corn grain with fat improved the productive performance of early-lactation cows grazing spring pastures. No negative effects of supplemental fat on ruminal fiber digestion were detected.

Duodenitis en niños: correlación endoscópica e histológica / Duodenitis in children: correlation endoscopic and histological

Realizar un estudio comparativo entre los hallazgos endoscópicos e histológicos, debido a que la duodenitis es una patología frecuente nuestro medio y no hay una clasificación o score en niños. Estudio prospectivo descriptivo, entre enero de 2000 y abril de 2003 dónde se incluyó a niños con o sin diagnóstico etiológico, que presentaran uno o más de los siguientes síntomas: dolor abdominal, vómitos, diarrea, hematemesis y distensión abdominal, y con indicación de endoscopia digestiva superior. De 253 pacientes, 246 presentaron inflamación de la mucosa duodenal (97.23 por ciento). 137 masculinos (54.15 por ciento) y 116 femeninos (45.85 por ciento), con edades comprendidas entre 5 meses y 17 años, con una media de 5.8 ± 4.34 DE. El grupo de edad con más casos por año fueron los lactantes con 25.5. Los hallazgos descriptivos macroscópicos reportados en la endoscopia digestiva superior fueron: mucosa afelpada o aterciopelada 65.22 por ciento, lesiones puntuales en "grano de sal" 47.43 por ciento, mucosa friable 34.78 por ciento y eritema severo 34,39 por ciento. El 0.79 por ciento presentó úlcera duodenal. El análisis histológico de las biopsias reveló la presencia de duodenitis crónica inespecífica en 57 casos (22.53 por ciento) y duodenitis crónica activa severa en 110 (43.78 por ciento). 130 casos con duodenitis crónica activa (DCA) (68.79 por ciento) presentaron Giardia lamblia. Las lesiones puntuales se correlacionaron con la DCA moderada y severa asociada a Giardia lamblia. La hiperplasia nodular linfoide se relacionó con alergia a la proteína de la leche de vaca en 23 por ciento de los pacientes. Nuestros resultados apoyan una estrecha relación clínico patológica entre los hallazgos endoscópicos y las alteraciones histológicas observadas en la mucosa duodenal, por lo que recomendamos la introducción de la endoscopia digestiva superior como método diagnóstico en niños