Detection of nonpregnant cows and potential embryo losses by color Doppler ultrasound and interferon-stimulated gene expression in grazing dairy cows.

Many studies have been conducted to estimate pregnancy losses between 19 and 34 d after artificial insemination (AI) in dairy cows managed under confinement-based systems, but few studies have examined embryo mortality during this interval in dairy cows managed under gazing systems. The objectives of this prospective cohort study were (1) to assess the diagnostic value of the corpus luteum (CL) blood perfusion (BP) evaluation by Doppler ultrasound (US) to detect nonpregnant cows at 19 to 20 d post-AI, and (2) to assess the rate of potential embryo mortality between 19 to 34 d post-AI. The CL-BP of all cows included in the study (n = 131) was examined on farm by power and color mode of Doppler US and later using an image processing software by a second evaluator. The endometrium thickness and echotexture were evaluated by B-mode US at the same visit to assess if the nonpregnancy diagnosis could be improved at 19 to 20 d post-AI by this additional diagnostic tool. Blood samples were obtained at 19 to 20 d post-AI for progesterone (P4) measurement by chemiluminescence and to determine the mRNA expression of ISG by real-time PCR. Pregnancy diagnosis based on embryo visualization was performed at 33 to 34 d post-AI by US B-mode. In parallel interpretation, ISG15 and MX2 mRNA expression in leukocytes [sensitivity (Se), 100%] were regarded as suitable biomarkers for early pregnancy and were selected for molecular characterization of pregnancy at 19 to 20 d post-AI. At 19 to 20 d post-AI, 61.1% of the cows had positive CL-BP by Doppler US (Se, 98.0%), 62.7% had ISG mRNA expression in leukocytes over the cutoff point (Se, 95.7%), and 50.8% were positive, based on the combination of ISG mRNA expression, CL-BP by Doppler US, and P4 concentration (Se, 100%), and were considered as possible pregnant. At 33 to 34 d, the pregnancy rate was 37.4% diagnosed by the B-mode US. Based on the expression of the selected biomarkers in cows with active CL, we found that 28.1% of the cows could have potentially lost their pregnancy between 19 and 34 d post-AI. The Doppler US color mode showed similar accuracy and a higher negative predictive value than the genes selected as biomarkers. The additional B-mode ultrasound evaluation of the uterine stratum vasculare and the endometrium thickness improved the diagnostic accuracy. Therefore, assessing the CL-BP by Doppler US allowed early detection of nonpregnant cows at 19 to 20 d post-AI. The combination of early CL-BP by Doppler US (d 19 to 20) with early embryo detection by B-mode US (d 33-34) could be used to facilitate earlier rebreeding of dairy cows.

[Electrocardiogram of the healthy premature infant]. / El electrocardiograma del recién nacido prematuro sano.

At the Hospital de Ginecobstetricia del Centro Médico "La Raza", were taken EKG to 30 healthy premature newborn during a six month period. The first EKG was recorded 3 hours after birth, the second in 8 hours, the third in 24 h, the fourth in 48 h, the fifth in 72 hours, the sixth at the end of the first week, the seventh at the fifteen days and the eighth at 30 days after birth. The mean heart rate was 135 +/- 10 beats/min in the first week. There were heart rate elevation for the first three days after birth. The QRS mean axis were + 130 +/- 25 degrees, without changes during the study time. The QTc interval in all cases was higher than 0.42 sec. The voltage of waves R and S at right and left precordial leads were similar. At this gestational age the ventricular masses are equals. The T waves changes reflected hemodynamic changes. It is concluded what the healthy premature newborn had a typical EKG as a reflex to the cardiocirculatory adaptations.

[Coronary arteriovenous fistula. Considerations on differential diagnosis]. / Fístula arteriovenosa coronaria. Consideraciones sobre el diagnóstico diferencial.

Review is made of the literature of coronary arteriovenous fistula, since its first description up to 1975; we mention the most important points treated by each author. Two cases are studied clinically, by entheterization and coronariography. We take into consideration the differential diagnosis with patent ductus arteriosus, ventricular septal defect with aortic insufficiency, and rupture of congenital aneurysm sinus of valsalva to right cavities. The result of these studies is that, if an atypical continous murmur for an arterial duct is present, we may suspect a coronary fistula as a first possibility, since an aneurysm of valsalva's sinus is a rare entity.

[Percutaneous transluminal angioplasty using balloon catheter in a Blalock-Taussig pulmonary-systemic fistula]. / Angioplastia transluminal percutánea con catéter de globo en una fístula sistémico-pulmonar de Blalock-Taussig.

Percutaneous transluminal balloon angioplasty has been used successfully in the treatment of valvular and vascular stenosis. This article describes our experience with this technique to improve pulmonary blood flow in a patient with a severely stenotic Blalock-Taussig (B-T) systemic-to-right pulmonary artery anastomosis, with improvement in oxygen peripheric saturation from 33 to 78% immediately postdilatation and 69% three months later. Hemoglobin decreased from 20.4 to 18.9 gm/dl and hematocrit from 64% to 58.5%. In conclusion we think that this technique is an alternative instead of cardiac surgery, in these cases the procedure is only palliative.

[Rhabdomyoma in a newborn infant. Echocardiographic diagnosis]. / Rabdomioma en un recién nacido. Diagnóstico ecocardiográfico.

With the 2D echocardiography, is easier the diagnosis of intracardiac tumors nowadays. We present a case of a newborn girl with a rhabdomyoma intra-myocardiac and intracavitary. We discuss the clinical manifestations, surgical indications and the association with tuberous sclerosis.

Síndrome de Parkinson / Syndrome of Parkinson

El Síndrome de Parkinson (SP) es una enfermedad degenerativa, lentamente progresiva caracterizada por temblor de reposo, cara inexpresiva, rigidez, lentitud al iniciar y practicar movimientos voluntarios. Neuropatológicamente se caracteriza por pérdida de células dopaminérgicas en la sustancia nigra lo cual conlleva déficit en el suministro de dopamina a nivel de ganglios básales. Inclusiones intracelulares llamadas cuerpos de Lewy, que consisten esencialmente de Alfa-Sinucleína y ubiquitina también se observan, especialmente en SP esporádico. Mutaciones en el gen de Alfa-sinucleína pueden causar SP autosómico dominante con cuerpos de Lewy. Mutaciones en el gene Parkin son más frecuentes en SP de inicio temprano y en parkinsonismo juvenil (autosómico recesivo). Algunas mutaciones en el gene Tau están relacionadas con parkinsonismo -demencia en algunas familias. La causa de la forma más común de SP, la esporádica, no se ha establecido, aunque existe evidencia que la relaciona con estrés oxidativo y alteraciones en actividad del complejo I, mitocondrial. La influencia de algunos factores de trascripción que actúan desde muy temprano en la vida y que regulan la neurogénesis dopaminérgica hasta la edad adulta (LMX1B, Pentaxina 3, NURR 1 entre otros) permite mejorar la comprensión de la patogénesis de ésta entidad y ofrece alternativas para la identificación temprana de individuos susceptibles

Nuevo criterio en la indicacion del marcapaso cardiaco definitivo. / New criterion in the indication of definitive cardiac pacemaker

Se revisa la literatura a partir de 1901, desde la primera publicacion del bloqueo A-V congenito hasta las recientes publicaciones de diferentes autores en nuestro medio. Se agregan seis casos de la experiencia del Servicio de Cardiologia Pediatrica del CMR y tomando la referencia del estudio cooperativo de Michaelsson de los cinco factores de riesgo en el bloqueo A-V congenito, se trata de clasificar cada caso en particular, para indicar en forma definitiva el implante de marca-paso, se le dio valor de dos puntos a cada uno de los factores de riesgo y dependiendo de la calificacion de cada caso se indica el tratamiento de eleccion