Salivary analysis to unveil the paradigma of stress of domestic horses reared in the wild.

Horse welfare is the product of multiple factors, including behavioral and physiological adjustments to cope with stressful situation regarding environment and housing condition. Collectively, it is supposed that a horse kept in the wild has a lower level of stress than other housing system, and the aim of the present study was to investigate the level of stress in domestic horses reared in the wild and then moved to human controlled housing, through saliva analysis. Twelve clinically healthy Catria (Italian local breed) mares, usually reared in the wild, were moved into collective paddocks for a folkloric event. Saliva samples were obtained before and after the change of housing condition to evaluate stress biomarkers including salivary cortisol, salivary alpha-amylase, and butyrylcholinesterase (BChol). The mares were also scored using the Welfare Aggregation and Guidance (WAG) Tool to highlight the presence of abnormal behaviors. Despite the absence of differences in behavioral scores between wild and paddocks, salivary cortisol and BChol were found to be higher in the wild and lower when mares were moved to paddocks. The highest concentrations in stress biomarkers like salivary cortisol and BChol in the wild was unexpected, but the need for managing hierarchical relationships, and the exposure to feral animals, predators, and weather changes, might explain these findings. The overall results of the present study may provide further knowledge toward stress response in domesticated horses living in the wild moved to human controlled housing system.

Reducing the anxiety of patients undergoing an oral biopsy by means of graphic novels: an open-label randomized clinical trial.

BACKGROUND: The use of graphic novels is a trending topic in health communication as a new form of visual storytelling which explores narratives of health care, cancer, healing, and disability. The objective of the present study was to evaluate - for the first time in the literature - the effect of graphic novels in reducing the anxiety of patients waiting for an incisional biopsy in an oral oncology setting. MATERIAL AND METHODS: This open-label randomized clinical trial comprised 50 patients with a clinical suspicion of oral potentially malignant disorders. Twenty-five patients were randomly allocated to the test group, and a colourful graphic novel was provided. Subsequently, the Beck Depression Inventory and the Depression Anxiety Stress Scales-21 were administered to all 50 recruited patients, after which a biopsy was performed on each patient. RESULTS: No statistically significant difference was observed between the test and control groups for the variables regarding the demographic data (p>0.2). There was a significant difference after the introduction of the graphic novel, regardless of which questionnaire was used. The graphic novel demonstrated an improvement in the ability of the test group to tolerate anxiety while waiting for an oral biopsy in both psychological tests (p<0.05). CONCLUSIONS: In light of these initial positive results, the authors of this study would like to suggest the use of graphic novels in oral oncology, dentistry, and medicine with the aim of reducing patient anxiety.

Isolation of extracellular vesicles from bitch's amnion-derived cells culture and their CD59 expression: Preliminary results.

Extracellular vesicles (EVs) are small spherical particles surrounded by a membrane with an unusual lipid composition and a striking cholesterol/phospholipidic ratio. About 2000 lipid and 3500 protein species were identified in EVs secreted by different cell sources. EVs mediate cell to cell communication in proximity to or distant from the cell of origin. In particular, it was suggested that they represent modulators of multiple processes during pregnancy. The aim of this study was to identify the presence of EVs in canine amnion-derived cells (ASCs) culture and the expression of CD 59 on their surface. Amniotic membrane was collected in PBS with antibiotics added from 2 bitches during elective caesarean section. Cells culture was prepared and EVs were isolated. EVs were used to evaluate CD59 expression by flow cytofluorimetry. We found that the majority of EVs expressed CD59. Our results could increase the knowledge about the complex mechanisms that regulate the pregnancy in the bitch.

Incidencia de eventos adversos a quimioterapia mediante dos métodos de detección: caracterización y costos sanitarios asociados / Incidence of adverse events to chemotherapy using two detection methods: characterization and associated health costs

A pesar del avance que ha supuesto en la supervivencia de los pacientes oncológicos, la aparición de nuevos agentes quimioterápicos y nuevas combinaciones, estos han traído consigo numerosos efectos adversos que pueden llegar a comprometer el tratamiento y, por consiguiente, el pronóstico de la enfermedad.Objetivos: Conocer la incidencia de los eventos adversos asociados a quimioterapia (EA), caracterizarlos y analizar sus implicancias económicas utilizando dos herramientas de detección.Materiales y métodos: Estudio de incidencia de corte longitudinal.Resultados: Se estudiaron 350 pacientes. La media de edad: 56,9, mediana: 43,4, rango: 19-85. El número de pacientes con EA fue: 323 en los cinco años. La incidencia acumulada (IA) fue: 0,923 es decir 92,3% pacientes en 5 años y la densidad de incidencia (DI) fue 0,186 en cinco años es decir 18,6%. El número de ADES en la muestra fue 1.601 con la revisión manual, una media de 4,57 EA/paciente en el total de la muestra. Los indicadores de EA fueron: 457,42 EA/100 altas, y 118,57 EA/1.000 días paciente hospitalizados. Se detectaron 152,47 EA/1.000 dosis de oncológicos administrados. Con la revisión de GTT se hallaron 1.578 EA, una media de 4,50 EA/paciente. Los indicadores de EA fueron: 450,8 EA/100 altas, y 126,64 EA/1.000 días paciente y 141,45 EA/1.000 dosis de medicamentos oncológicos administrados. Los costos facturados con y sin eventos son USD 5.343,75 vs. 15.287,5. Las dos herramientas de detección tienen similar capacidad de detección en cuanto número de EA pero la revisión completa de historia clínica sin gatillos lleva seis veces el tiempo que lleva la herramienta de gatillos. (AU)

Despite the progress it has made in the survival of cancer patients, the appearance of new chemotherapeutic agents and new combinations, these have brought with them numerous adverse effects that can compromise treatment and, consequently, the prognosis of the disease.Objectives: To know the incidence of adverse events associated with chemotherapy (AE), characterize them and analyze their economic implications using two detection tools.Materials and methods: Longitudinal cut incidence study.Results: 350 patients were studied. Mean age: 56.9, median: 43.4, range: 19-85. The number of patients with AD was: 323 in the five years. The cumulative incidence (AI) was: 0.923 that is 92.3% patients in 5 years and the incidence density (DI) was 0.186 in five years that is 18.6%. The number of ADES in the sample was 1,601 with manual review, a mean of 4.57 EA/patient in the total sample. The AE indicators were: 457.42 AE/100 discharges, and 118.57 AE/1,000 hospitalized patient days. 152.47 EA/1,000 doses of oncology administered were detected. With the GTT review, 1,578 AE were found, a mean of 4.50 AE/patient. The AE indicators were: 450.8 AE/100 discharges, and 126.64 AE/1,000 patient days and 141.45 AE/1,000 doses of oncological drugs administered. The costs invoiced with and without events are USD 5,343.75 vs. 15,287.5. The two detection tools have a similar detection capacity in terms of number of AE, but the complete medical history review without triggers takes six times the time that the trigger tool takes.Conclusions: The incidence of adverse cancer events is high, the GTT tool is useful compared to the complete review of medical records to find AE, the costs of hospitalization with events in relation to without events are significantly higher. The most frequent reactions are dermatological, and those that affect the blood system, among others. (AU)

Leukocyte modifications during the first month after foaling in mares and their newborn foals.

During early post-partum period both neonatal foals and peripartum mares are most susceptible to diseases. The aim of this study was to establish physiologic modifications of leukogram during the first month after foaling in mares and their newborn foals. To this end blood samples were collected from nine mares and nine foals (T0-T10), every three days from the 1st day until the 30th day after foaling. Samples were analysed for white blood cell (WBC) count and differential leucocyte counts. Two-way repeated measure analysis of variance (ANOVA) showed, in postpartum mares WBC showed significant higher values at T0 (9.02±0.76) in respect to other time points, and at T2 (8.08±0.53) and T3 (7.92±0.59) compared to T1 (6.98±0.43), whereas in foals lower WBC values at T0 (6.11±0.49) compared to other experimental periods except T1 (6.90±0.94), and at T1 compared to T8 (7.95±0.61) and T10 (7.90±0.36) were observed. The differential leucocyte counts showed significant modifications in the percentage of neutrophils (π<0.001) and lymphocytes (p<0.001) both in postpartum mares and in foals during the experimental period. Furthermore ANOVA showed significant differences between postpartum mares and foals (P<0.01) in all studied parameters, and between postpartum mares and control mares in WBC and neutrophils values. The obtained results provide suitable information about the influence of foaling on leukogram of periparturient mares and reveal WBC dynamics in newborn foals during the first month post-partum.

Obesity induced by cafeteria diet disrupts fertility in the rat by affecting multiple ovarian targets.

Obesity constitutes a health problem of increasing worldwide prevalence. Among the health detriments caused by obesity, reproduction is disrupted. However, the mechanisms involved in this disruption are not fully understood. Animals fed a cafeteria diet constitute the model for the study of obesity that most closely reflects Western diet habits. The aims of this study were to evaluate whether a cafeteria diet affects ovarian function and to contribute to the understanding of the mechanisms involved. For that purpose, 22-day-old female Wistar rats were fed ad libitum with a standard diet (control group; n = 20) or cafeteria diet (CAF group; n = 20). The cafeteria diet induced obesity and hyperglycaemia, without altering serum triglycerides, cholesterol or C-reactive protein concentrations. This diet also altered ovarian function: the rats showed prolonged dioestrous phases, decreased serum oestradiol concentrations and increased number of antral atretic follicles. Moreover, follicular cysts were detected in the CAF group, concomitantly with a decrease in the number of anti-Müllerian hormone immunoreactive pre-antral follicles and COX-2-positive antral and pre-ovulatory follicles. The authors conclude that a cafeteria diet reduces ovarian reserve, induces the presence of follicular cysts and disturbs the ovulatory process, leading to the delayed pregnancy observed in these animals.

Metabolic profile of broodmares during late pregnancy and early post-partum.

Pregnancy represents a specific physiological status characterized by continuous adjustments that affect maternal metabolism of all nutrients. In the last trimester of pregnancy, mare's nutrient requirements greatly increase and most pregnancy-associated diseases are likely to occur. Therefore, we aimed to assess the metabolic profile of broodmares focusing on the last 3 months of pregnancy and the early post-partum. Fifteen pregnant mares (Group A) were monitored from 263 ± 3 days of pregnancy until 21 days after foaling. Seven non-pregnant mares (Group B) were used as the control group. Blood samples were collected weekly by jugular venipuncture throughout the experimental period, and additional blood samples were collected within 24 ± 12 h of foaling. Obtained sera were analyzed for urea (Ur), creatinine (Cre), total protein (TP), total, direct and indirect bilirubin (tB, dB, iB), triglycerides (TG), total cholesterol (tChol) and ß-hydroxybutyrate (BHB). During pregnancy, Ur (p = 0.015) and dB (p = 0.028) were higher in Group A than Group B. Serum Cre, tB, iB and TG (p < 0.001) decreased after foaling; furthermore, Group A exhibited lower tChol (p < 0.001) and higher BHB (p < 0.001) than Group B during the study. There were significant interactions of time × peripartum on Ur (p = 0.007), Cre (p < 0.001), tB (p = 0.018), TG (p < 0.001) and tChol (p < 0.001). These results can be used in the interpretation of biochemical studies in late gestation mares which develop systemic disease. The improved understanding of the metabolic profile during the peripartum might assist in monitoring the health status of the broodmares to promote foetal growth and well-being.

Hemostatic profile during late pregnancy and early postpartum period in mares.

Hemostasis is a physiological process that prevents excessive blood loss and represents a protective mechanism at the time of delivery. Peripartum hemorrhage is a recurring hazardous condition to mare's health; therefore, we aimed to study mares' hemostatic profile to investigate whether physiological adjustments occur during late pregnancy and early postpartum. Fifteen pregnant mares have been monitored from the 34th week of pregnancy until the third week after foaling. Fifteen nonpregnant mares were used as control group. Jugular blood samples were analyzed for platelet count (Plt), prothrombin time (PT), activated partial thromboplastin time (aPTT), and fibrinogen (Fb). Platelet count showed significant changes at foaling (P < 0.05) and a negative correlation (r = -0.968; P = 0.032) with postpartum. Prothrombin time changed (P < 0.05) showing a significant correlation (r = 0.675; P = 0.016) with late pregnancy. Fibrinogen concentrations changed throughout the experimental period (P < 0.0001). The linear regression model revealed a positive correlation (r = 0.9210; P < 0.0001) between Fb and late pregnancy and a negative correlation (r = -0.9583; P = 0.042) between Fb and early postpartum. The shortening in PT recorded in the imminence of parturition along with the increase in Plt and Fb at foaling might reflect a physiological hypercoagulable state that constrains excessive bleeding, enhancing mares' odds of surviving. Our research improves the knowledge about blood coagulation in periparturient mares providing specific information on routine coagulation tests that may support in monitoring mare's hemostatic profile during late pregnancy and early postpartum.

Eficacia del empleo del balón intragástrico en el control temporal de la obesidad en Paraguay / Efficacy of the use of the intragastric balloon in the temporary control of obesity in Paraguay

El balón intragástrico es un procedimiento no quirúrgico indicado para el control de la obesidad. En el presente estudio se describe la experiencia de los primeros 100 casos en Paraguay, donde se estima un 32% de obesidad en la población urbana. El objeto de estudio fue determinar la eficacia del balón intragástrico en el descenso ponderal y de circunferencia de cintura de los pacientes obesos sometidos a este tratamiento. Desde octubre del 2004 hasta diciembre de 2008 se han sometido 100 pacientes obesos a la colocación del balón intragástrico luego de una evaluación clínica, sicológica y nutricional. Recibieron dieta hipocalórica e indicación de actividad física diaria. En el análisis de los resultados los valores de peso disminuyeron significativamente después de la intervención siendo los valores de la mediana de 112 (IC 95%: 96,4 a 113,9 Kg; p< 0,0001) a nivel inicial y de 88 (IC 95%: 80,0 a 89,3) a nivel final, dándonos una diferencia neta de 24 Kg en un periodo de seis a ocho meses. En cuanto al índice de masa corporal (IMC), el cambio observado fue un grado de obesidad de diferencia, pasando de obesidad mórbida y grado III a obesidad grado II y I. Los valores fueron los siguientes: mediana de 38 Kg/m2 (IC 95%: 36,4 a 39,9) en el nivel inicial y en el final, mediana de 31,0 Kg/ m2 (IC 95% 29,4 a 33,9). Los resultados muestran una pérdida significativa de peso, IMC y diámetro de cintura. Esto se logra combinando el balón intragástrico, dieta restringida y terapia de apoyo conductual

Nine years' experience of telecardiology in primary care.

The ITMS telecardiology network started in April 1995. Over nine years, about 7000 peripheral medical users (mainly general practitioners), who were experienced in using transtelephonic electrocardiography and who were spread throughout Italy, conducted teleconsultations with the Telecardiology Centre. A total of 106,942 patients were evaluated. Teleconsultation was carried out for non-cardiac symptoms or routine control for 30,444 patients (28%) and for symptoms suggestive of heart disease for 76,498 (72%). After teleconsultation, 61,908 patients (58%) were reported to have no heart disease, 27,947 patients (26%) had their drug dose adjusted and remained at home, 11,503 patients (11%) were sent to their cardiologist for further investigations and 5584 patients (5%) were urgently hospitalized. Among the hospitalized patients, the echocardiogram demonstrated an ST-elevation coronary syndrome in 1785 patients (32%), a non-ST-elevation coronary syndrome in 2236 (40%) and a life-threatening arrhythmia in 1354 (24%). Telecardiology improves the decision making of general practitioners, avoids unnecessary hospitalizations, reduces the time before treatment in cardiac emergencies, rationalizes health-care costs and promotes home care.

[Congenital malformations in twins]. / Malformaciones congénitas en gemelos.

BACKGROUND: A higher prevalence of congenital malformations among twins than among single has been reported in the literature. AIM: To study the incidence of congenital malformations in twins in the maternity hospital of the University of Chile in the period 1983-1997. MATERIAL AND METHODS: As part of the Latin American Collaborative Study of Congenital Malformations, every newborn in the maternity hospital was examined by a neonatologist and congenital malformations were recorded in a special file. RESULTS: In the study period there were 48.663 deliveries of single pregnancies and 448 deliveries of twin pregnancies, giving birth to 886 twins borns alive and 17 stillbirths (1.9% mortality). Of these, there were 423 twins, 17 triplets, a sextuple delivery and two siamese. Seven point one percent of twins born alive and 6.5% of single newborns had a congenital malformation. The prevalence of malformations in twins and single stillbirths was 35.2 and 17.2% respectively (p < 0.04). In four pairs and siamese newborns, malformations typical of monozygotic twins were present, such as an acardiac fetus with Trap sequence, a papyraceous fetus and two with hydroanencephaly. Twelve twins had malformations attributable to uterine compression. CONCLUSIONS: This study did not find a higher frequency of malformations comparing twins with single babies born alive, but in stillbirths there was a significant difference between single and twin stillbirths (7.1% versus 35.2%, respectively, p < 0.05).

In vitro activity of rufloxacin against Listeria monocytogenes, Legionella pneumophila, and Chlamydia trachomatis.

The in vitro activity of a new fluoroquinolone, rufloxacin, was determined against both clinical isolates and standard strains of Legionella pneumophila, Chlamydia trachomatis, and Listeria monocytogenes and compared to that of ciprofloxacin, ofloxacin, and erythromycin. Among the antibacterials tested erythromycin was the most active. Rufloxacin inhibited the growth of L. pneumophila at concentrations in the range of 0.06-0.25 mg/l, that of C. trachomatis at concentrations in the range of 2-4, and that of L. monocytogenes at concentrations in the range of 1-2 mg/l. Rufloxacin demonstrated approximately the same activity as ciprofloxacin against C. trachomatis, but twice as less potency as ofloxacin and erythromycin against L. pneumophila, L. monocytogenes, and C. trachomatis, and twice as less potency as ciprofloxacin against L. pneumophila.