Physiological profiles of Zebu steers during transport and pre-slaughter / Perfiles fisiológicos de novillos Cebú durante el transporte y pre-sacrificio / Perfis fisiológicos de novilhos Zebu durante o transporte e pré-sacrifício

Background: pre-slaughter handling causes stress in cattle that may alter numerous physiological variables. Objective: to determine whether in-farm handling of steers, road transport by truck, or slaughterhouse lairage affect blood stress indicators. Methods: a total of 65 castrated Zebu steers were randomly selected and transported during 4 h in the same truck, under similar handling conditions. Blood samples were taken by jugular or coccygeal venipuncture at the farm, at the slaughterhouse, and during exsanguination to measure plasma cortisol, glucose, lactate, creatine kinase (CK), ß-hydroxybutyrate (ßHB), creatinine, total protein, urea, packed cell volume (PCV) values, white blood cells (WBC) and neutrophil:lymphocytes ratio (N/L). Results: pre-slaughter handling did not have a negative influence on protein metabolism nor did it cause dehydration. ß-hydroxybutyrate and lactate values did not change (p>0.05). Transportation increased cortisol, glucose, creatine kinase concentrations and N/L ratio (p<0.05). Conclusion: pre-slaughter was a stress-generating event that moderately affected animal welfare and increased physiological variables within a range considered normal for steers.

Antecedentes: el manejo presacrificio causa estrés en el ganado que puede alterar variables fisiológicas. Objetivo: determinar si el manejo en la granja, el transporte terrestre o la estadía en la planta de bovinos cebú sacrificados en una planta localizada en una zona productiva tienen efecto sobre los indicadores sanguíneos de estrés. Métodos: se seleccionaron aleatoriamente 65 novillos Cebú, los cuales fueron transportados durante 4 h, bajo las mismas condiciones de manejo. El ganado fue muestreado por venopunción de la vena yugular o coccígea en la granja, en la planta de sacrificio y durante el desangrado para medir los niveles de cortisol, glucosa, lactato, creatinquinasa (CK), betahidroxibutirato (ßHB), creatinina, proteína total, urea, volumen celular acumulado (PCV), conteo de células blancas (WBC) y la relación neutrófilos/linfocitos (N/L). Resultados: el manejo presacrificio no influyó negativamente sobre el metabolismo proteico, ni causó deshidratación. El ß-hidroxibutirato y el lactato no presentaron cambios (p>0,05). El transporte incrementó las concentraciones de cortisol, glucosa, creatinquinasa y la relación N/L (p<0,05). Conclusiones: el presacrificio afectó moderadamente el bienestar animal e incrementó algunas variables fisiológicas, las cuales se encontraron dentro de los rangos considerados como normales para la especie bovina.

Antecedentes: o manejo pré-abate causa estresse no gado, o que pode alterar numerosas variáveis fisiológicas. Objetivo: determinar se o manejo na fazenda, o transporte terrestre ou a permanência no frigorífico de bovinos zebuínos abatidos em um abatedouro instalado numa região produtiva, tem efeito nos indicadores sanguíneos do estresse. Métodos: foram selecionados aleatoriamente 65 novilhos zebu, os quais foram transportados durante 4 h, sob as mesmas condições de manejo. O gado foi monitorado por venopunção na fazenda, no frigorífico e durante a sangria para medir os níveis de cortisol, glucosa, lactato, creatinoquinase (CK), beta hidroxibutirato (ßHB), creatinina, proteína total, uréia, volume celular acumulado (PCV), contagem de células brancas (WBC) e a relação neutrófilos/linfócitos (N/L). Resultados: o manejo pré-abate não influenciou negativamente o metabolismo proteico, nem provocou desidratação. O ß-hidroxibutirato e o lactato não apresentaram mudanças (p>0,05). O transporte elevou as concentrações de cortisol, glicose, creatina-quinase e a relação N/L (p<0,05). Conclusões: o pré-abate afetou moderadamente o bem-estar animal e incrementou algumas variáveis fisiológicas avaliadas, as quais encontraram-se dentro de intervalos considerados como normais para a espécie bovina.

Capsular block syndrome: a case report and literature review.

PURPOSE: To report the case of a patient who developed late capsular block syndrome and to review the current literature regarding this complication of phacoemulsification procedures. METHODS: The literature was reviewed to summarize the diagnosis, classification, use of diagnostic aids, and the current treatments for this complication. RESULTS: A 69-year-old patient complained of decreased visual acuity 11 months after undergoing phacoemulsification. She was found to have a secondary myopization. Anterior segment ultrabiomicroscopy confirmed the diagnosis of capsular block syndrome. The patient underwent neodymium-doped yttrium aluminum garnet (Nd:YAG) laser posterior capsulotomy, which resulted in complete resolution of her symptoms. CONCLUSION: CAPSULAR BLOCK SYNDROME IS A FAIRLY RARE COMPLICATION OF PHACOEMULSIFICATION PROCEDURES THAT, DEPENDING PRIMARILY ON THE TIMING OF ITS OCCURRENCE FOLLOWING SURGERY, CAN DEVELOP INTO ONE OF THE THREE FOLLOWING POSSIBLE CLINICAL SCENARIOS: intraoperatory, early postoperatory, and late postoperatory. In this patient, Nd:YAG laser capsulotomy was shown to be a safe and effective treatment option for this type of complication.

Simultaneous surgery for corneal edema and aphakia: DSEK and placement of a retropupillary iris claw lens.

PURPOSE: The aim was to report the surgical outcomes of simultaneous Descemet stripping endothelial keratoplasty (DSEK) with a retropupillary fixated iris claw lens in patients with aphakic corneal edema without capsular support. METHODS: The clinical records of aphakic patients with corneal edema and no capsular support who underwent a combined DSEK and implantation of a retropupillary fixated iris claw lens (Artisan) were evaluated. Presurgical and postsurgical best-corrected visual acuity, postsurgical refraction, and endothelial cell count were analyzed at the first and sixth months after the surgery and were imaged with anterior segment ultrasound biomicroscopy. RESULTS: A total of 9 eyes from 7 females and 2 males were analyzed. The average age was 72.1 years. The mean duration of the postoperative follow-up was 7.7 months. All the patients achieved corrected visual acuities over 0.60 logarithm of the minimum angle of resolution. There was no significant variation in the endothelial count between the first and sixth months. Astigmatism >1 D was induced in all the patients, with 7 patients having against the rule, and 2 patients having oblique astigmatism. CONCLUSIONS: DSEK combined with a retropupillary fixated iris claw lens was shown to be a safe surgical technique in patients with aphakia without capsular support and corneal swelling. This surgery resulted in stable endothelial cell counts during the first 6 months after the surgery and an improvement in visual acuity.

Ocular trauma from land mines among soldiers treated at a University Hospital in Medellin, Colombia / Caracterización del trauma ocular por minas antipersonales en soldados atendidos en un hospital Universitario en Medellín, Colombia

Introduction: Currently ocular combat injuries are complex and associated with poor visual outcomes. Our objective is to characterize the military population that suffer land mine combat ocular trauma in Colombia and identify the type of wound, treatment and visual outcomes. Methods: Retrospectively review of medical history of soldiers evaluated in Pablo Tobon Uribe Hospital, whom had land mine trauma during January of 2004 and December 2012. Results: 635 soldiers had land mine trauma, 153 of them had ocular trauma (226 eyes). Open ocular trauma was observed in 29.6%. The Ocular Trauma Score was calculated in 183 eyes, the initial visual acuity was not possible to be reported in the rest of them; the 45% of the eyes were classified in category 3. Three patients had no light perception in both eyes. 97.3% of the eyes received medical treatment and 49.1% had surgery also. Primary evisceration was made in 5.8% and enucleation in 1.8%. Intraocular foreign body was observed by ultrasonography in 11.1% and in 5.8% by orbital tomography. Eleven patients were legally blind at discharge. Conclusions: The ocular trauma related to a land mine is highly destructive at an ocular level. The treatments associated with better visual outcomes are primary closure of globe and systemic antibiotics; although the characteristics of the wound itself are the main prognostic factor. The Ocular trauma score is a useful tool for determining visual outcome in combat ocular trauma.

Introducción: Los combates armados generan heridas oculares complejas con mal pronóstico visual. Nuestro objetivo es caracterizar la población militar que sufre trauma ocular de combate en Colombia asociado a minas antipersona, así como las características de las lesiones, el tratamiento recibido y desenlace visual final. Métodos: Se evaluó retrospectivamente las historias clínicas de soldados atendidos en el Hospital Pablo Tobon Uribe, que sufrieron accidente por mina antipersona durante el período entre enero de 2004 y diciembre de 2012. Resultados: 635 soldados, sufrieron trauma por mina antipersona; de estos, 153 (226 ojos) tuvieron trauma ocular. El 29.6% tuvieron trauma abierto. Se calculó el Ocular Trauma Score en 183 ojos. El 45% de los ojos se clasificaron como categoría 3. Tres pacientes tuvieron una visión final de no percepción de luz por ambos ojos. El 97.3% de los ojos tuvieron tratamiento farmacológico y 49.1% recibieron cirugía además. Se realizó evisceración primaria en el 5.8% y enucleación en 1.8%. Se logró comprobar cuerpo extraño intraocular por ecografía en el 11.1% y por tomografía de órbitas en el 5.8%. Once pacientes fueron legalmente ciegos, al momento de abandonar el hospital. Conclusiones: Las principales medidas terapéuticas asociadas con mejoría del pronóstico visual son el cierre primario de herida y la administración de antibióticos; aunque las características de las heridas oculares son el principal factor pronóstico. El Ocular Trauma Score es una herramienta útil para determinar el pronóstico visual en trauma ocular de combate.

Ocular trauma from land mines among soldiers treated at a University Hospital in Medellín, Colombia.

INTRODUCTION: Currently ocular combat injuries are complex and associated with poor visual outcomes. Our objective is to characterize the military population that suffer land mine combat ocular trauma in Colombia and identify the type of wound, treatment and visual outcomes. METHODS: Retrospectively review of medical history of soldiers evaluated in Pablo Tobon Uribe Hospital, whom had land mine trauma during January of 2004 and December 2012. RESULTS: 635 soldiers had land mine trauma, 153 of them had ocular trauma (226 eyes). Open ocular trauma was observed in 29.6%. The Ocular Trauma Score was calculated in 183 eyes, the initial visual acuity was not possible to be reported in the rest of them; the 45% of the eyes were classified in category 3. Three patients had no light perception in both eyes. 97.3% of the eyes received medical treatment and 49.1% had surgery also. Primary evisceration was made in 5.8% and enucleation in 1.8%. Intraocular foreign body was observed by ultrasonography in 11.1% and in 5.8% by orbital tomography. Eleven patients were legally blind at discharge. CONCLUSIONS: The ocular trauma related to a land mine is highly destructive at an ocular level. The treatments associated with better visual outcomes are primary closure of globe and systemic antibiotics; although the characteristics of the wound itself are the main prognostic factor. The Ocular trauma score is a useful tool for determining visual outcome in combat ocular trauma.

INTRODUCCIÓN: Los combates armados generan heridas oculares complejas con mal pronóstico visual. Nuestro objetivo es caracterizar la población militar que sufre trauma ocular de combate en Colombia asociado a minas antipersona, así como las características de las lesiones, el tratamiento recibido y desenlace visual final. MÉTODOS: Se evaluó retrospectivamente las historias clínicas de soldados atendidos en el Hospital Pablo Tobon Uribe, que sufrieron accidente por mina antipersona durante el período entre enero de 2004 y diciembre de 2012. RESULTADOS: 635 soldados, sufrieron trauma por mina antipersona; de estos, 153 (226 ojos) tuvieron trauma ocular. El 29.6% tuvieron trauma abierto. Se calculó el Ocular Trauma Score en 183 ojos. El 45% de los ojos se clasificaron como categoría 3. Tres pacientes tuvieron una visión final de no percepción de luz por ambos ojos. El 97.3% de los ojos tuvieron tratamiento farmacológico y 49.1% recibieron cirugía además. Se realizó evisceración primaria en el 5.8% y enucleación en 1.8%. Se logró comprobar cuerpo extraño intraocular por ecografía en el 11.1% y por tomografía de órbitas en el 5.8%. Once pacientes fueron legalmente ciegos, al momento de abandonar el hospital. CONCLUSIONES: Las principales medidas terapéuticas asociadas con mejoría del pronóstico visual son el cierre primario de herida y la administración de antibióticos; aunque las características de las heridas oculares son el principal factor pronóstico. El Ocular Trauma Score es una herramienta útil para determinar el pronóstico visual en trauma ocular de combate.

Actividad del cortisol plasmático en ratas en condiciones de estrés crónico suplementadas con resveratrol / Plasma cortisol activity in rats under conditions of chronic stress supplemented with resveratrol

Objective: Determine the activity of cortisol in rats treated with exogenous adrenocorticotropic hormone (ACTH) and a resveratrol supplement. Methodology:Forty-eight adult male rats and 16 adult female rats (Rattus norvegicus) three months old with a body weight of 200 to 250g and 300 to 350g for both male and female were used and kept in controlled environmental conditions, temperature of 20±2°C and light-dark cycles of 14 and 10 hours. They were fed with balanced food and had free access to water. The rats were randomly divided into four groups: group 1, was treated with 5 µg/kg of ACTH i.p. every twelve hours; group 2, received the same treatment with ACTH plus a grape extract supplementation of 40 mg/kg; group 3, only received grape extract and group 4,served as control and only received saline solution (0.9%) i.p. The experimental was designed as a 2×2 factorial with two ACTH levels and two extract grape levels. Results:Significant differences were not found in cortisol concentrations for day, gender or treatment effects (0.75ug/dL ± 0.11; p<0.001).

Objetivo: Determinar la actividad de cortisol en ratas tratadas con hormona adrecorticotropa (ACTH) exógena y un suplemento de resveratrol.Metodología:Se utilizaron 48 ratas hembras adultas y 16machos de la cepa wistar (Rattus norvegicus) de tres meses de edad y con un peso corporal de 200-250g y 300-350 g, para hembras y machos, respectivamente, que permanecieron en condiciones ambientales controladas, temperatura 20±2°C de ciclos de luz-oscuridad de 14 y 10 horas, respectivamente.Se les proporcionó alimento balanceado con libre acceso a agua. Las ratas fueron divididas en cuatro grupos al azarasí: grupo 1, fue tratado con 5 µg/kg de ACTH i.p. cada 12 horas; grupo 2, recibió el mismo tratamiento con ACTH además de una suplementación oral de 40 mg/kg de extracto deshidratado de uva (resveratrol); grupo 3, solo recibió extracto de uva y el grupo 4,recibió solución salina y sirvió como control y (0,9%) i.p. y oral. El diseño experimental fue en factorial 2×2, con dos niveles de ACTH y dos niveles de polifenol. Resultados: No se encontraron diferencias significativas del cortisol sanguíneo, con respecto al día y sexo, entre los tratamientos (0,75ug/dL ± 0,11; p<0,001). Conclusión: Los resultados sugieren que el estrés crónico y el consumo de resveratrol no alteran directamente los niveles plasmáticos de cortisol, en ratas estresadas y no estresadas. De la misma manera que, posiblemente la dosis utilizada de ACTH no produjo estimulación de la glándula suprarrenal en las ratas.

Plasma cortisol activity in rats under conditions of chronic stress supplemented with resveratrol.

OBJECTIVE: To determine the activity of cortisol in rats treated with exogenous adrenocorticotropic hormone (ACTH) and a resveratrol supplement. METHODS: Forty-eight adult female rats and 16 male rats of the strain (Rattus norvegicus) that were three months old and with body weights ranging from 200 to 250 g for females and 300 to 350 g for males were used and kept in controlled environmental conditions: temperature of 20±2° C and light-dark cycles of 14 and 10 hours. They were fed a balanced diet and had free access to water. The rats were randomly divided into four groups: group 1 - was treated with 5 µg/kg of ACTH i.p. every twelve hours; group 2 - received the same treatment with ACTH plus a grape extract supplement (resveratrol) of 40 mg/kg; group 3 - only received grape extract (resveratrol); and group 4 - received a saline solution (0.9%) i.p. and oral, and served as controls. The experimental design was a 2×2 factorial with two levels ACTH and two polyphenol levels (grape extract). RESULTS: No significant differences were found in blood cortisol concentrations, by day and gender, or by treatment effects (0.75 µg/dL ± 0.11; p <0.001). CONCLUSION: Results suggest that chronic stress and consumption of resveratrol did not directly alter levels of plasmatic cortisol in either stressed or unstressed rats. It was concluded that the given dosage levels of ACTH possibly did not produce sufficient stimulation of the adrenal gland for these animals.

OBJETIVO: Determinar la actividad de cortisol en ratas tratadas con hormona adrecorticotropa (ACTH) exógena y un suplemento de resveratrol. METODOS: Se utilizaron 48 ratas hembras adultas y 16 machos de la cepa wistar (Rattus norvegicus) de tres meses de edad y con un peso corporal de 200-250 g y 300-350 g para hembras y machos, respectivamente, que permanecieron en condiciones ambientales controladas, temperatura 20±2° C de ciclos de luz-oscuridad de 14 y 10 horas, respectivamente. Se les proporcionó alimento balanceado con libre acceso a agua. Las ratas fueron divididas en cuatro grupos al azar así: grupo 1, fue tratado con 5 µg/kg de ACTH i.p. cada 12 horas; grupo 2, recibió el mismo tratamiento con ACTH además de una suplementación oral de 40 mg/kg de extracto deshidratado de uva (resveratrol); grupo 3, solo recibió extracto de uva y el grupo 4, recibió solución salina y sirvió como control y (0.9%) i.p. y oral. El diseño experimental fue en factorial 2×2, con dos niveles de ACTH y dos niveles de polifenol. RESULTADOS: No se encontraron diferencias significativas del cortisol sanguíneo, con respecto al día y sexo, entre los tratamientos (0.75 µg/dL ± 0.11; p <0.001). CONCLUSIÓN: Los resultados sugieren que el estrés crónico y el consumo de resveratrol no alteran directamente los niveles plasmáticos de cortisol, en ratas estresadas y no estresadas. De la misma manera que, posiblemente la dosis utilizada de ACTH no produjo estimulación de la glándula suprarrenal en las ratas.

Viktor Emil Frankl: el médico y el pensador de una vida con sentido / Viktor Emil Frankl: the physician and the thinker of a life with sense

Viktor Emil Frankl, nacido en Viena a comienzos del siglo XX en el seno de una familia judía, llegó a ser uno de los hombres más carismáticos de ese siglo, no solo como médico psiquiatra, neurólogo y filósofo, sino también como persona, por su calidad humana, sus aportes científicos y su testimonio de vida. Creador de la Logoterapia, considerada como uno de los modelos más importantes de Psicoterapia Existencial, se interesó profundamente por el problema del Sentido de la Vida y cómo éste se puede ver afectado por experiencias tan traumáticas y dolorosas como las que él mismo debió enfrentar durante la Segunda Guerra Mundial, tras su cautiverio en los campos de concentración nazis. Luego de sobrevivir a esta devastadora experiencia, dedicó gran parte de su vida a difundir la Logoterapia; utilizando este modelo psicoterapéutico tanto en su ejercicio clínico como en su labor docente, ayudó a muchas personas a descubrir y a reorientar el sentido de sus vidas. Autor de numerosos libros, dejó un valioso legado para la humanidad, una luz de esperanza, y así mismo, una invitación para aquellos que como médicos o como psicólogos hemos decidido acoger su teoría: Valorar lo que de humano hay en el enfermo, y no sólo la enfermedad que hay en el hombre.

Viktor Emil Frankl was born in Vienne at the beginning of the XX century, the son of a Jewish family. He ended up being one of the most charismatic men of that century, not only as physician, psychiatrist, neurologist and philosopher, but also as a human being because of his qualities, his scientific production, and the testimony of his life. He was the creator of Logotherapy, which is considered one of the most important models of Existential Psychotherapy. He was deeply interested in the problem of the Sense of Life and of how it can be affected by traumatic and painful experiences, such as the ones he faced during World War II being a prisoner at several Nazi concentration camps. Having survived such devastating experiences, he devoted many years to diffuse Logotherapy using this psychotherapeutic model both in his clinical practice and in his activities as a professor. This way he helped many people to discover and to reorient the sense of their lives. He wrote many books and left for humankind a valuable legacy, a light of hope, and an invitation for those that, as physicians or psychologists, have accepted his theory: to value the human aspects of diseased people, and not only their sickness.