Effects of Dietary Supplementation of Stimbiotics to Sows on Lactation Performance, Immune Function, and Anti-Inflammatory and Antioxidant Capacities during Late Gestation and Lactation.

Stimbiotic supplementation may provide an innovative feed additive solution to accelerate the proliferation of beneficial fiber-degrading bacteria in the distal intestine and the utilization of dietary fiber. Optimal utilization of dietary fiber has multiple benefits for gut health and nutrient utilization. This study was conducted to evaluate the late gestation and lactation performance, the plasma, colostrum, and milk immunoglobulin (IgA, IgG, and IgM) concentrations, and the anti-inflammatory and antioxidant biomarkers in plasma of sows fed with or without a stimbiotic during the late gestation and lactation phase. A total of 40 sows were allocated to two treatment groups: control (CT) with no supplementation or 100 mg/kg stimbiotic (VP), with 20 sows per treatment. Sows were fed the treatment diets from d 85 of gestation to d 28 of lactation. In the results, the average daily weight gain of piglets during lactation was greater from sows fed in the VP group compared to that in the CT group (p < 0.05). The plasma concentrations of IgM at farrowing and IgG at weaning of the sows fed the diet with the stimbiotic supplementation were much higher than those in the CT sows (p < 0.05), respectively. In addition, the dietary stimbiotic increased the concentrations of IgM in the colostrum and of IgA and IgM in the milk at d 14 of lactation (p < 0.05). Plasma concentrations of malondialdehyde (MDA) on d 0 and d 28 of lactation tended to be lower in sows fed the VP diets compared with those of the sows fed the CT diets. Thus, our study indicated that stimbiotic supplementation could improve the daily weight gain of piglets and the immune function of sows in lactation.

Stimbiotics Supplementation Promotes Growth Performance by Improving Plasma Immunoglobulin and IGF-1 Levels and Regulating Gut Microbiota Composition in Weaned Piglets.

This study was conducted to investigate the effects of dietary supplementation with stimbiotics (STB) on growth performance, diarrhoea incidence, plasma antioxidant capacity, immunoglobulin concentration and hormone levels, and faecal microorganisms in weaned piglets. Compared with the control (CT) group, the addition of STB improved the body weight (BW) of piglets on days 28 and 42 (p < 0.05) and increased daily weight gain and daily feed intake from days 14-28 and throughout the trial period (p < 0.05). Correspondingly, the plasma insulin-like growth factor 1 (IGF-1) level on day 42 was significantly improved by STB (p < 0.05). VistaPros (VP) group levels of immunoglobulin (Ig) A and G were significantly higher on days 14 and 42 (p < 0.05) than the CT group levels. In addition, the activity of plasma catalase tended to be increased on day 14 (p = 0.053) in the VP group, as for superoxide dismutase, glutathione peroxidase, and malondialdehyde, STB did not significantly affect their levels (p > 0.05). Moreover, dietary STB increased the relative abundance of beneficial bacteria, including norank_f_Muribaculaceae, Rikenellaceae_RC9_gut_group, Parabacteroides, and unclassified_f__Oscillospiraceae. In summary, STB improved the immunity and IGF-1 levels in the plasma of weaned piglets and consequently promoted the growth performance of weaned piglets.

Sublingual Bacterial Vaccination Reduces Recurrent Infections in Patients With Autoimmune Diseases Under Immunosuppressant Treatment.

Introduction: Conventional or biologic disease-modifying anti-rheumatic drugs (DMARDs) are the mainstay of treatment for systemic autoimmune disease (SAD). Infectious complications are a major concern in their use. Objective: To evaluate the clinical benefit of sublingual mucosal polybacterial vaccines (MV130 and MV140), used to prevent recurrent respiratory and urinary tract infections, in patients with SAD and secondary recurrent infections following conventional or biologic DMARDs. Methods: An observational study in SAD patients with recurrent respiratory tract infections (RRTI) and/or recurrent urinary tract infections (RUTI) was carried out. All patients underwent mucosal (sublingual) vaccination with MV130 for RRTI or with MV140 for RUTI daily for 3 months. Clinical evaluation was assessed during 12 months of follow-up after the first dose, i.e., 3 months under treatment and 9 months once discontinued, and compared with the previous year. Results: Forty-one out of 55 patients completed 1-year follow-up. All patients were on either conventional or biologic DMARDs. A significant decrease in the frequency of RUTI (p<0.001), lower respiratory tract infections (LRTI) (p=0.009) and upper respiratory tract infections (URTI) (p=0.006) at 12-mo with respect to the previous year was observed. Antibiotic prescriptions and unscheduled medical visits decreased significantly (p<0.020) in all groups. Hospitalization rate also declined in patients with RRTI (p=0.019). The clinical benefit demonstrated was concomitant to a significant increase in both anti-S. pneumoniae IgA and IgG antibodies following MV130 vaccination. Conclusions: Sublingual polybacterial vaccines prevent recurrent infections in patients with SAD under treatment with immunosuppressant therapies, supporting a broad non-specific anti-infectious effect in these patients.

The Smc5/6 Core Complex Is a Structure-Specific DNA Binding and Compacting Machine.

The structural organization of chromosomes is a crucial feature that defines the functional state of genes and genomes. The extent of structural changes experienced by genomes of eukaryotic cells can be dramatic and spans several orders of magnitude. At the core of these changes lies a unique group of ATPases-the SMC proteins-that act as major effectors of chromosome behavior in cells. The Smc5/6 proteins play essential roles in the maintenance of genome stability, yet their mode of action is not fully understood. Here we show that the human Smc5/6 complex recognizes unusual DNA configurations and uses the energy of ATP hydrolysis to promote their compaction. Structural analyses reveal subunit interfaces responsible for the functionality of the Smc5/6 complex and how mutations in these regions may lead to chromosome breakage syndromes in humans. Collectively, our results suggest that the Smc5/6 complex promotes genome stability as a DNA micro-compaction machine.

Stimbiotic supplementation improved performance and reduced inflammatory response via stimulating fiber fermenting microbiome in weaner pigs housed in a poor sanitary environment and fed an antibiotic-free low zinc oxide diet.

This study investigated whether the inclusion of a stimbiotic (STB) can improve performance, influence intestinal microbiota and fermentation activity, and reduce pro-inflammatory cytokines in piglets fed a low zinc oxide diet without antimicrobial growth promotors compared to fructo-oligosaccharide (FOS) and mannan-oligosaccharide (MOS) when housed either in good sanitary (GS) or poor sanitary (PS) environments. One hundred forty-four male pigs (28-day-old) were sorted by initial body weight (BW) and allocated to one of six experimental treatments: 1) GS environment without any additive (GS-CTR); 2) GS environment with 0.01% stimbiotic (GS-STB); 3) PS environment (without cleaning and disinfection of a previously populated room) without any additive (PS-CTR); 4) PS environment with 0.01% STB (PS-STB); 5) PS environment with 0.1% MOS (PS-MOS); and 6) PS environment with 0.2% FOS (PS-FOS). Each treatment had six replicates, with four animals each. Three feeding phases, based on corn, wheat, and soybean meal were available ad libitum for the 42-days of the study. Housing piglets under PS conditions negatively influenced performance, increased plasma tumor necrosis factor alpha (TNF-α), affected the fecal microbial populations and increased concentrations of branched-chain fatty acids (BCFA) compared to GS. Stimbiotic improved 42-d-BW under PS conditions (P < 0.05) whereas MOS or FOS had no effect. On d35, plasma TNF-α was reduced with STB in PS (P < 0.05). The ratio between VFA:BCFA increased (P < 0.05) with STB, MOS or FOS in PS, and under GS condition, STB also increased the ratio. Stimbiotic increased the proportion of Clostridiales Family XIII Incertae Sedis and Clostridiaceae, while MOS and FOS increased Selenomonadaceae, Catabacteriaceae and Fibrobacteraceae. These results indicate that STB shifted the intestinal microbiome to favor fiber fermentation which likely contributed to reduced inflammatory response and improved performance, particularly in piglets reared in PS conditions.

Fast-track extubation in patients after intracranial hematoma surgery.

Early extubation, also known as fast track, is desirable after intracranial hematoma surgery to avoid ventilator-associated complications associated with admission to an intensive care unit (ICU). The objective of the present study was to determine whether ICU stay and ventilator-associated complications are reduced in patients who received surgery for intracranial hematoma if they are extubated early. A total of 17 patients were randomly assigned to two groups: In Group 1, patients were extubated early or using the fast track method, while those in Group 2 were conventionally extubated at a later stage and were managed at the ICU. Patients from both groups were assessed on admission to the operating room per the established standards and after the selection criteria had been confirmed, general anesthesia was applied. Extubation time and hemodynamic stability (number of anesthetic adjustments required to maintain hemodynamic parameters within 20% of the predicted values) were assessed post-operatively. Patients in the conventional group (n=10) were transferred to the ICU and extubated at 8 h post-operatively; hemodynamic stability and the presence of complications were evaluated. The fast track group had no complications associated with ventilation or any other parameter. All patients extubated in a conventional manner and who were transferred to the ICU presented with complications, including seizures, aspiration, atelectasis or failed extubation. In the future, fast track should be regarded as a routine technique in patients who meet the required criteria, so that they may be discharged quickly and with fewer complications. The present study was authorized by the ethics committee of the hospital and the research sub-directorate with the number AN14-003; it was submitted to and approved by the ISRCTN registry for clinical trials (ID, ISRCTN16924441).

Sinusitis odontogénica, fístula oroantral y su reparación quirúrgica mediante colgajo de bolsa de Bichat: revisión de la literatura / Odontogenic sinusitis, oro-antral fistula and surgical repair by Bichat's fat pad: Literature review

La sinusitis odontógena da cuenta del 10 a 12% de los casos de sinusitis maxilar y ocurre por una interrupción del mucoperiostio en respuesta a varias condiciones, siendo la más frecuente la extracción de una pieza dentaria superior. Su manejo consta de dos pilares; tratar la inflamación e infección sinusal y el manejo de la fístula oroantral que perpetúa la infección. Las comunicaciones menores de 5 mm se pueden resolver espontáneamente, pero las mayores se deben cerrar por distintas técnicas de colgajos. El uso de la bolsa de Bichat para cerrar la fístula oroantral se documentó por primera vez en 1977. Es un colgajo pediculado que ha demostrado ser exitoso y tiene varias ventajas que lo hacen el método de elección de tratamiento de la fístula oroantral: su ubicación permite su fácil uso, mínima disección, tiene gran versatilidad, buena movilidad, gran aporte sanguíneo, baja tasa de complicaciones, escasa morbilidad del sitio donante, bajo riesgo de infección, rápida técnica quirúrgica, rápida epitelización, sin cicatriz visible, entre otras. Es por esto que promovemos el uso de esta técnica y la presentamos como la mejor opción en la actualidad para nuestros pacientes (AU)

Odontogenic sinusitis accounts for 10-12% of maxillary sinusitis. It occurs due to an interruption of the mucoperiosteum in response to a series of conditions, most frequently the extraction of a superior tooth. Its treatment has two bases: treating the infection and managing the oroantral fistula that perpetuates the infection. Communications smaller than 5 mm can resolve spontaneously; bigger ones must be closed by a flap. Bichat's fat pad flap was first used in 1977 to close an oroantral fistula. It is a pedicled flap that has been shown to be successful, with advantages that make it the best option in oroantral fistula treatment. Its location allows easy access, minimum dissection, great versatility, good mobility, good blood supply, low rate of complications, no morbidity in the donor site, low risk of infection, shortened surgical time and fast cover by epithelium, and it leaves no visible scar, amongst other benefits. That is why we encourage the use of this technique and choose it as the best option for management of our patients (AU)

Odontogenic sinusitis, oro-antral fistula and surgical repair by Bichat's fat pad: Literature review.

Odontogenic sinusitis accounts for 10-12% of maxillary sinusitis. It occurs due to an interruption of the mucoperiosteum in response to a series of conditions, most frequently the extraction of a superior tooth. Its treatment has two bases: treating the infection and managing the oroantral fistula that perpetuates the infection. Communications smaller than 5mm can resolve spontaneously; bigger ones must be closed by a flap. Bichat's fat pad flap was first used in 1977 to close an oroantral fistula. It is a pedicled flap that has been shown to be successful, with advantages that make it the best option in oroantral fistula treatment. Its location allows easy access, minimum dissection, great versatility, good mobility, good blood supply, low rate of complications, no morbidity in the donor site, low risk of infection, shortened surgical time and fast cover by epithelium, and it leaves no visible scar, amongst other benefits. That is why we encourage the use of this technique and choose it as the best option for management of our patients.

Lower Oral Doses of Micellized α-Tocopherol Compared to α-Tocopheryl Acetate in Feed Modify Fatty Acid Profiles and Improve Oxidative Status in Pigs.

This study evaluated the effect of vitamin E supplementation source, and the dose given to sows or piglets, on the fatty acid profile of colostrum, milk, subcutaneous and intramuscular fat, and the oxidative status of piglets at 39 days of age. Sows (n = 10) were given 150 mg dl-α-tocopheryl acetate/d in feed, or 75 or 50 mg micellized-d-α-tocopherol/d in water from Day 103 of pregnancy. Weaning piglets from each group of sows (n = 7) received 3.33 mg dl-α-tocopheryl acetate/d in feed, or 1.7 mg micellized-d-α-tocopherol/d or 1.1 mg micellized-d-α-tocopherol/d in water for 14 days. Colostrum from sows supplemented with micellized-d-α-tocopherol had a lower proportion of C20:0 (P = 0.02), C18:4 n-3 (P = 0.03) and a higher C18:1 n-9 to C18:0 ratio than those given dl-α-tocopheryl acetate. Supplementation with micellized-d-α-tocopherol decreased the C18:0 proportion (P = 0.04) and the C18:1 n-9 to C18:0 ratio (P = 0.03) in milk, whereas the C18:1 n-7 proportion increased (P = 0.03) compared to dl-α-tocopheryl acetate. Composition was affected by the d-α-tocopherol dose. A similar trend to that observed in milk was observed in fatty acid composition in piglet fat. Piglets supplemented with micellized-d-α-tocopherol at low doses did not have different ferric reducing antioxidant power in muscle tissues (P = 0.31) than when they were supplemented with dl-α-tocopheryl acetate. Piglets given 1.7 mg micellized-d-α-tocopherol/d had lower oxidized glutathione than those given 1.1 mg/d (P = 0.0055). In conclusion, oral supplementation of sows (75 mg/d) and piglets (1.7 mg/d) with micellized natural vitamin E modified the fatty acid profile of piglet tissues and improved their oxidative status.

Assessment of infection with polyomaviruses BKV, JCV and SV40 in different groups of Cuban individuals.

We investigated the frequency of BKV, JCV and SV40 reactivation in three groups of Cuban patients by multiplex nested PCR assay of 40 paraffin-embedded colorectal neoplasm tissues, 113 urine samples, and 125 plasma samples from 27 transplant recipients, and cerebrospinal fluid (CSF) from 67 HIV-1-infected individuals with central nervous system (CNS) disorders. None of these polyomaviruses were detected in colorectal neoplasms. JCV DNA was detected in 2 of 67 patients (2.9%) with CNS disorders, but neither BKV nor SV40 was identified. BKV was found in urine from 38.5% and 28.6% of adult and pediatric transplant recipients, respectively. In adult renal transplant recipients, excretion of BKV in urine was significantly associated with episodes of acute rejection (p=0.012) and with excretion of HCMV in urine (p= 0.008). In Cuba, the polyomaviruses studied here could not be related to colorectal neoplasms, and JCV was rarely detected in CSFs of HIV-1-infected individuals, whilst BKV reactivation was found to occur frequently in organ transplant recipients.

[Efficacy of sedation in outpatient procedures performed by pediatric residents]. / Eficacia de la sedación en procedimientos ambulatorios realizados por residentes de pediatría.

OBJECTIVE: To determine the efficacy of sedation in outpatient procedures performed by Pediatric Residents. MATERIAL AND METHODS: Observational, analytic, cross-sectional study in patients that require diagnostic and therapeutic procedures. Data were collected during the period between June 01 and September 2007 in the Pediatrics Department. Patients from 1 month to 15 years of age that required sedation were included. RESULTS: 97 sedations were carried out, with an average age of 3.5 years. 59.3% were males and 40.7% were females. 100% of the procedures were carried out with 12.3% adverse effects. CONCLUSIONS: The procedures were done successfully; the pediatric residents demonstrated the required preparation for sedating and reverting adverse effects.

Fracture of a reverse total shoulder arthroplasty retentive liner.

Reverse shoulder arthroplasty may be indicated in shoulders that cannot be effectively managed by conventional reconstruction procedures. Reported complications include instability, infection, hematoma, scapular notching, and premature component loosening. To our knowledge, however, fracture of a humeral component polyethylene inlay has not been described. A 72-year-old man presented with unstable, painful shoulders after undergoing unsuccessful open repairs and acromioplasties at an outside institution for bilateral massive rotator cuff tears. We performed a left reversed shoulder arthroplasty with a 36-mm glenosphere and a +9-mm polyethylene liner. In the operating room under general anesthesia with chemical paralysis and an interscalene block, his shoulder was stable. The patient required revision with a metal 9-mm lateralizer following an atraumatic dislocation 4 weeks postoperatively. Four weeks following the revision, the patient again presented with a dislocated left shoulder without antecedent trauma. During this second revision, the +6-mm standard polyethylene liner was replaced with a +6-mm lateral retentive polyethylene liner. A third revision surgery was performed after the patient experienced 2 more dislocations with minor activity. Intraoperatively, a fracture of the previously placed +6-mm retentive polyethylene liner was noted. This article may represent a case of dramatic scapular impingement by the humeral components. More subtle forms of scapular notching are common and may suggest significant long-term problems. Many reverse shoulder prostheses are being refined or modified in an attempt to eliminate or reduce the scapular notching phenomenon.

Infected total knee arthroplasty: diagnosis and treatment.

Infection following total knee arthroplasty is a challenging complication for both the patient and the surgeon. Precautions to prevent infection include the use of prophylactic antibiotics, minimized surgical time, and meticulous surgical technique. A patient's risk factors should be thoroughly assessed and medical comorbidities should be treated before surgery. When infection is suspected, prompt evaluation of the patient is necessary. The management of a TKA infection is dictated by the duration of symptoms, suspicion for infection, time since index surgery, the patient's willingness and medical capability for undergoing multiple surgeries, the bacteria's sensitivity to antibiotics, and the surgeon's ability to perform complex surgery. Acute infections are treated with aggressive débridement and parenteral antibiotics. In appropriate circumstances, chronic infections are best treated with two-stage reimplantation, which can reliably eradicate infection, relieve pain, and restore good function.

Manejo anestésico de pacientes embarazada con síndrome de Osler-Weber-Rendú e insuficiencia cardiaca congestiva / Anesthetic management of pregnant patient with osler weber-rendu syndrome and congestive heart failure

Paciente femenina de 20 años de edad con síndrome de Osler-Weber-Rendú (telangiectasia hemorrágica hereditaria) en trabajo de parto. Se presenta el manejo anestésico y preparación preoperatoria y se discuten los problemas específicos de este síndrome asociado al embarazo

Anestesia para cesárea en unapaciente con siringomielia. Reporte de un caso / Anesthesia for cesarean section in a patient with syringomiella. a case report

Paciente femenina de 39 años de edad con diagnóstico de Siringomielia a la que se le realiza cesárea. Se presenta el manejo anestésico y se discute el caso

Diagnóstico de situación de salud del distrito sanitario Nro. 3 instrumentación del Hospital I "Dr. Egidio Montesinos A" el Tocuyo, Estado Lara / Diagnostico of health situation sanitary district Nro. 3 Hospital instrumentation I \"Dr. Egidio Montesinos A\" el Tocuyo, Lara State

Trabajo realizado de manera exploratoria y descriptiva resaltando las características generales de la región estudiada, y se identifican en terminos de salud los factores condicionantes, socio-económicos, saneamiento ambiental y se establece un diagnóstico de la atención en salud. Se escogieron para la investigación un conjunto de centros de información y archivos para la obtención de los datos y se realizaron entrevistas entre el personal. Los datos fueron procesados de manera sistemática (guión-programa) y se incluye una fase analítica e interpretativa en función de parámetros normalizados. Se concluye indicando cifras de los factores condicionantes, sistemas de salud, recursos para la atención de salud y se hacen algunas recomendaciones al sector salud