Drug utilisation study in patients receiving antiepileptic drugs in Colombia.

INTRODUCTION: This study examines the indications according to which antiepileptic drugs are prescribed and used in a population of patients enrolled in the Colombian national health system (SGSSS). METHODS: Retrospective cross-sectional study. From the pool of individuals in 34 Colombian cities who used antiepileptic drugs between 18 July, 2013 and 31 August, 2014 during a period of no less than 12 months, we obtained a random sample stratified by city. Socio-demographic, pharmacological and comorbidity variables were analysed. Continuous and categorical variables were compared, and logistic regression models were used. RESULTS: Our patient total was 373 patients, with 197 women (52.1%) and a mean age of 41.9 ± 21.7 years; 65.4% of the patients were treated with monotherapy. The most frequently used drugs were valproic acid (53.1%) and carbamazepine (33.2%). Epilepsy was the most frequent indication (n=178; 47.7%); however, 52.3% of the patients were prescribed antiepileptics for different indications, especially neuropathic pain (26.8%), affective disorders (14.2%) and migraine prophylaxis (12.3%). A total of 81 patients with epilepsy (46.6%) displayed good seizure control while another 25 (14.4%) had drug-resistant epilepsy. In the multivariate analysis, medication adherence was associated with a lower risk of treatment failure in patients with epilepsy (OR: 0.27; 95%CI, 0.11-0.67). CONCLUSIONS: In Colombia, antiepileptic drugs are being used for indications other than those originally intended. Monotherapy is the most commonly used treatment approach, together with the use of classic antiepileptic drugs.

Distribution of sexes within the left and right uterine horns of cattle.

In cattle, limited data are available regarding the sex ratio of the offspring in relation to the horn of gestation. Therefore, the objective of this study was to evaluate the sex ratio of fetuses gestated in the left and right uterine horns of cattle (Bos taurus, Bos indicus and crosses). The distribution of male and female fetuses in the left and right uterine horn was analyzed on gravid, abattoir-derived reproductive tracts and artificially inseminated crossbred cows. The total number of fetuses/calves and the sex of the fetuses/calves gestated in each uterine horn were used as the end point for side comparisons using the Glimmix Procedure. Of 64 gravid reproductive tracts evaluated, 29 (45.3%) pregnancies occurred in the left uterine horn, whereas 35 (54.7%) occurred in the right. The sex ratio (% males) of fetuses in the left uterine horn (37.9%) was significantly lower than the sex ratio detected in the right uterine horn (65.7%). Of 113 pregnancies evaluated in artificially inseminated heifers, 53 (46.9%) occurred in the left uterine horn, whereas 60 (53.1%) occurred in the right uterine horn. The sex ratio of calves gestated in the left uterine horn (35.8%) was significantly lower than the sex ratio of calves gestated in the right uterine horn (63.3%). In conclusion, in these experiments, a significantly greater proportion of males were gestated in the right uterine horn of cattle and a greater proportion of females in the left uterine horn. Further investigation is needed to determine the mechanisms underlying the observed disparity of the expected sex ratio within the uterine horns of cattle.

Effects of culture medium and protein supplementation on mRNA expression of in vitro produced bovine embryos.

Numerous studies have reported aberrant gene expression levels attributed to suboptimal in vitro culture conditions. This study investigated the effects of different culture systems and protein sources on the developmental competence of in vitro production (IVP) embryos measured by cleavage and blastocyst rates, cell number, and relative abundance of POU5F1 (OCT4), nanog, GJA1 (connexin 43), and SLC2A1 (GLUT1) transcripts when compared to in vivo embryos. Experiment 1 compared IVP embryos cultured in either synthetic oviductal fluid (SOFaa) or potassium simplex optimized medium supplemented with amino acids (KSOMaa). Experiment 2 compared the same two culture systems with and without the addition of calf serum (CS). Results from both experiments indicated that despite similar developmental rates, significant differences were observed at the mRNA level. In Experiment 1, OCT4 was the only transcript to have a mean abundance level significantly higher in KSOMaa blastocysts when compared with both SOFaa and in vivo embryos. The same pattern of upregulation of OCT4 mRNA was noted in Experiment 2. There were no significant alterations of the ICM specific transcript nanog in either experiment. In contrast to reports by others, connexin 43 mRNA was not expressed at detectable levels in in vivo embryos analyzed in our studies. Blastocysts cultured in SOFaa with CS or KSOMaa had a significant upregulation of GLUT1 mRNA when compared with other treatments and in vivo embryos. Until differences between IVP and in vivo embryos are minimized, aberrations in IVP will continue to arise.