Hallazgos quirúrgicos en pacientes con apendicitis agudadurante la pandemia COVID-1 / Surgical findings in patients with acute appendicitis duringthe COVID-19 pandemic

Objetivo: Caracterizar los hallazgos quirúrgicos en pacientes con apendicitis aguda durante la pandemia COVID-19. Métodos: se realizó un estudio retrospectivo, descriptivo, observacional de corte transversal en pacientes con apendicitis aguda operados por el Servicio de Cirugía I del Hospital Universitario de Caracas, durante el período marzo2020-marzo 2022. Resultados: Se incluyeron 83 pacientes, cuya edad promedio fue 28,2±15,3 años, la mayoría del sexo femenino. Los síntomas clínicos más frecuentes fueron: dolor abdominal, náuseas, vómitos y fiebre; la paraclínica indicó importante leucocitosis, y el ultrasonido fue positivo en algunos pacientes. El tiempo de espera para la cirugía fue de 10,4±7,99horas, la vía de abordaje más común fue la abierta, seguida de la laparoscópica; el tiempo quirúrgico promedio fue de116,5±42,3 minutos. Los principales hallazgos quirúrgicos fueron, en orden decreciente: apendicitis flegmonosa (casi la mitad de los casos), seguida de catarral, gangrenosa y perforación, con dos pacientes con apéndice normal; otros hallazgos fueron: líquido inflamatorio, mesoapéndice engrosado, y adherencias. Sólo hubo complicaciones en 5 pacientes (6,0 %). La condición al alta de los pacientes fue buena en el 97,0 %. Conclusión: Los hallazgos de esta serie, no difieren de los obtenidos en periodos de tiempo previos a la pandemia, es decir, más frecuentes apendicitis en fase flegmonosa y catarral, sobre el resto de las otras formas de presentación(AU)

Objective: To characterize the surgical findings in patients with acute appendicitis during the COVID-19 pandemic. Methods: a retrospective, descriptive, observational cross-sectional study was carried out in patients with acute appendicitis operated on by the Surgery Service I of the Hospital Universitario de Caracas, during the period March 2020-March2022. Results: 83 patients were included, whose age average was 28.2 ± 15.3 years, most of them female. The most frequent clinical symptoms were: abdominal pain, nausea, vomiting and fever; paraclinical tests indicated significant leukocytosis, and ultrasound was positive in some patients. The waiting time for surgery was 10.4±7.99 hours, the most common approach was open, followed by laparoscopic.; the mean surgical time was 116.5±42.3 minutes. The main surgical findings were, in decreasing order: phlegmonous appendicitis (almost half of the cases), followed by catarrhal, gangrenous, and perforation, with two patients with a normal appendix; other findings were: inflammatory fluid, thickened mesoappendix, and adhesions. There were only complications in 5 patients (6.0%). The condition at discharge of the patients was good in 97.0 %. Conclusion: the findings of this series do not differ from those obtained in periods of time prior to the pandemic, that is,appendicitis in the phlegmonous and catarrhal phase is more frequent than the rest of the other forms of presentatio(AU)

Quantifying long-term phenological patterns of aerial insectivores roosting in the Great Lakes region using weather surveillance radar.

Organisms have been shifting their timing of life history events (phenology) in response to changes in the emergence of resources induced by climate change. Yet understanding these patterns at large scales and across long time series is often challenging. Here we used the US weather surveillance radar network to collect data on the timing of communal swallow and martin roosts and evaluate the scale of phenological shifts and its potential association with temperature. The discrete morning departures of these aggregated aerial insectivores from ground-based roosting locations are detected by radars around sunrise. For the first time, we applied a machine learning algorithm to automatically detect and track these large-scale behaviors. We used 21 years of data from 12 weather surveillance radar stations in the Great Lakes region to quantify the phenology in roosting behavior of aerial insectivores at three spatial levels: local roost cluster, radar station, and across the Great Lakes region. We show that their peak roosting activity timing has advanced by 2.26 days per decade at the regional scale. Similar signals of advancement were found at the station scale, but not at the local roost cluster scale. Air temperature trends in the Great Lakes region during the active roosting period were predictive of later stages of roosting phenology trends (75% and 90% passage dates). Our study represents one of the longest-term broad-scale phenology examinations of avian aerial insectivore species responding to environmental change and provides a stepping stone for examining potential phenological mismatches across trophic levels at broad spatial scales.

Demographic modelling helps track the rapid and recent divergence of a conifer species pair from Central Mexico.

Secondary contact of recently diverged species may have several outcomes, ranging from rampant hybridization to reinforced reproductive isolation. In plants, selfing tolerance and disjunct reproductive phenology may lead to reproductive isolation at contact zones. However, they may also evolve under both allopatric or parapatric frameworks and originate from adaptive and/or neutral forces. Inferring the historical demography of diverging taxa is thus a crucial step to identify factors that may have led to putative reproductive isolation. We explored various competing demographypotheses to account for the rapid divergence of a fir species complex (Abies flinckii-A. religiosa) distributed in "sky-islands" across central Mexico (i.e., along the Trans-Mexican Volcanic Belt; TMVB). Despite co-occurring in two independent sympatric regions (west and centre), these taxa rarely interbreed because of disjunct reproductive phenologies. We genotyped 1147 single nucleotide polymorphisms, generated by GBS (genotyping by sequencing), across 23 populations, and compared multiple scenarios based on the geological history of the TMVB. The best-fitting model revealed one of the most rapid and complete speciation cases for a conifer species-pair, dating back to ~1.2 million years ago. Coupled with the lack of support for stepwise colonization, our coalescent inferences point to an early cessation of interspecific gene flow under parapatric speciation; ancestral gene flow during divergence was asymmetrical (mostly from western firs into A. religiosa) and exclusive to the most ancient (i.e., central) contact zone. Factors promoting rapid reproductive isolation should be explored in other slowly evolving species complexes as they may account for the large tropical and subtropical diversity.

Intradermal Immunization of SARS-CoV-2 Original Strain Trimeric Spike Protein Associated to CpG and AddaS03 Adjuvants, but Not MPL, Provide Strong Humoral and Cellular Response in Mice.

Despite the intramuscular route being the most used vaccination strategy against SARS-CoV-2, the intradermal route has been studied around the globe as a strong candidate for immunization against SARS-CoV-2. Adjuvants have shown to be essential vaccine components that are capable of driving robust immune responses and increasing the vaccination efficacy. In this work, our group aimed to develop a vaccination strategy for SARS-CoV-2 using a trimeric spike protein, by testing the best route with formulations containing the adjuvants AddaS03, CpG, MPL, Alum, or a combination of two of them. Our results showed that formulations that were made with AddaS03 or CpG alone or AddaS03 combined with CpG were able to induce high levels of IgG, IgG1, and IgG2a; high titers of neutralizing antibodies against SARS-CoV-2 original strain; and also induced high hypersensitivity during the challenge with Spike protein and a high level of IFN-γ producing CD4+ T-cells in mice. Altogether, those data indicate that AddaS03, CpG, or both combined may be used as adjuvants in vaccines for COVID-19.

Immunogenicity of SARS-CoV-2 Trimeric Spike Protein Associated to Poly(I:C) Plus Alum.

The SARS-CoV-2 pandemic has had a social and economic impact worldwide, and vaccination is an efficient strategy for diminishing those damages. New adjuvant formulations are required for the high vaccine demands, especially adjuvant formulations that induce a Th1 phenotype. Herein we assess a vaccination strategy using a combination of Alum and polyinosinic:polycytidylic acid [Poly(I:C)] adjuvants plus the SARS-CoV-2 spike protein in a prefusion trimeric conformation by an intradermal (ID) route. We found high levels of IgG anti-spike antibodies in the serum by enzyme linked immunosorbent assay (ELISA) and high neutralizing titers against SARS-CoV-2 in vitro by neutralization assay, after two or three immunizations. By evaluating the production of IgG subtypes, as expected, we found that formulations containing Poly(I:C) induced IgG2a whereas Alum did not. The combination of these two adjuvants induced high levels of both IgG1 and IgG2a. In addition, cellular immune responses of CD4+ and CD8+ T cells producing interferon-gamma were equivalent, demonstrating that the Alum + Poly(I:C) combination supported a Th1 profile. Based on the high neutralizing titers, we evaluated B cells in the germinal centers, which are specific for receptor-binding domain (RBD) and spike, and observed that more positive B cells were induced upon the Alum + Poly(I:C) combination. Moreover, these B cells produced antibodies against both RBD and non-RBD sites. We also studied the impact of this vaccination preparation [spike protein with Alum + Poly(I:C)] in the lungs of mice challenged with inactivated SARS-CoV-2 virus. We found a production of IgG, but not IgA, and a reduction in neutrophil recruitment in the bronchoalveolar lavage fluid (BALF) of mice, suggesting that our immunization scheme reduced lung inflammation. Altogether, our data suggest that Alum and Poly(I:C) together is a possible adjuvant combination for vaccines against SARS-CoV-2 by the intradermal route.

Decoupling the adsorption mechanisms of arsenate at molecular level on modified cube-shaped sponge loaded superparamagnetic iron oxide nanoparticles.

In this study, a commercial cube-shaped open-celled cellulose sponge adsorbent was modified by in-situ co-precipitation of superparamagnetic iron oxide nanoparticles (SPION) and used to remove As(V) from aqueous solutions. Fe K-edge X-ray absorption spectroscopy (XAS) and TEM identified maghemite as the main iron phase of the SPION nanoparticles with an average size 13 nm. Batch adsorption experiments at 800 mg/L showed a 63% increase of adsorption capacity when loading 2.6 wt.% mass fraction of SPION in the cube-sponge. Experimental determination of the adsorption thermodynamic parameters indicated that the As(V) adsorption on the composite material is a spontaneous and exothermic process. As K-edge XAS results confirmed that the adsorption enhancement on the composite can be attributed to the nanoparticles loaded. In addition, adsorbed As(V) did not get reduced to more toxic As(III) and formed a binuclear corner-sharing complex with SPION. The advantageous cube-shape of the sponge-loaded SPION composite together with its high affinity and good adsorption capacity for As(V), good regeneration capability and the enhanced-diffusion attributed to its open-celled structure make this adsorbent a good candidate for industrial applications.

Consulta en servicio de urgencia y reingreso hospitalario después de una cirugía bariátrica primaria / Emergency department visit and Hospital Readmission after Primary Bariatric Surgery

Resumen Introducción: Las consultas en el servicio de urgencia (CU) y el reingreso (RI) hospitalario después de una cirugía bariátrica (CB) son importantes indicadores de calidad y seguridad. Sin embargo, existe escasa información de estos indicadores en nuestro medio nacional. En este trabajo analizamos las CU y RI de pacientes sometidos a una CB primaria en un centro universitario de alto volumen, y buscamos variables asociadas a estos indicadores. Materiales y Método: Estudio observacional retrospectivo que incluyó a todos los pacientes sometidos a bypass gástrico (BPG) o gastrectomía en manga (GM) laparoscópica primaria realizados de forma consecutiva en nuestra institución durante el período 2006-2007 y 2012-2013. Utilizando nuestros registros clínicos y base de seguimiento prospectivo, identificamos aquellos pacientes con CU o RI en nuestro hospital durante los primeros 30 días después del alta. Resultados: Se incluyeron 1.146 CB primarias, 53% (n = 613) fueron BPG y 47% (n = 533) GM. Un 8,03% (n = 92) de los pacientes tuvo al menos una CU y un 3,7% (n = 42) un RI. Las variables independientes asociadas tanto a CU como RI fueron el tiempo operatorio e índice de masa corporal (IMC) preoperatorio. No se encontró asociación estadística, en el periodo estudiado, para el tipo de CB realizada con la CU ni con el RI. Conclusión: Existe una baja proporción de pacientes que requieren CU y RI posterior a la CB, lo que demuestra la seguridad de estas intervenciones.

Introduction: Emergency department visits (EDV) and hospital readmission (HR) after bariatric surgery (BS) are important indicators of quality and safety in surgery, however there is little information on their characteristics in our national environment. Aim: In this work we analyze EDV and HR in patients undergoing a primary BS in a high-volume university center, and identify variables that could be associated with these indicators. Materials and Method: A retrospective observational study where we identified all patients undergoing Roux-in-Y gastric bypass (RYGBP) or primary laparoscopic sleeve gastrectomy (SG) performed consecutively at our institution during the period 2006-2007 and 2012-2013. Using our clinical records and prospective follow-up database, we identify those patients with EDV and/or HR in our hospital during the first 30 days after discharge. Results: 1146 primary BS were included, of these 53% (n = 613) were RYGBP and 47% (n = 533) SG. 8,03% (n = 92) of the patients had at least one EDV, of these 3,7% (n = 42) had an HR. The independent variables associated with EDV and HR were the operative time and preoperative body mass index (BMI). No statistical association was found, in the period studied, for the type of BS performed with EDV or HR. Conclusion: There is a low proportion of patients who require EDV and HR after BS, which demonstrates the safety of these interventions.

Lung Nodule Malignancy Prediction in Sequential CT Scans: Summary of ISBI 2018 Challenge.

Lung cancer is by far the leading cause of cancer death in the US. Recent studies have demonstrated the effectiveness of screening using low dose CT (LDCT) in reducing lung cancer related mortality. While lung nodules are detected with a high rate of sensitivity, this exam has a low specificity rate and it is still difficult to separate benign and malignant lesions. The ISBI 2018 Lung Nodule Malignancy Prediction Challenge, developed by a team from the Quantitative Imaging Network of the National Cancer Institute, was focused on the prediction of lung nodule malignancy from two sequential LDCT screening exams using automated (non-manual) algorithms. We curated a cohort of 100 subjects who participated in the National Lung Screening Trial and had established pathological diagnoses. Data from 30 subjects were randomly selected for training and the remaining was used for testing. Participants were evaluated based on the area under the receiver operating characteristic curve (AUC) of nodule-wise malignancy scores generated by their algorithms on the test set. The challenge had 17 participants, with 11 teams submitting reports with method description, mandated by the challenge rules. Participants used quantitative methods, resulting in a reporting test AUC ranging from 0.698 to 0.913. The top five contestants used deep learning approaches, reporting an AUC between 0.87 - 0.91. The team's predictor did not achieve significant differences from each other nor from a volume change estimate (p =.05 with Bonferroni-Holm's correction).

Assessment of anthelmintic effectiveness to control Fasciola hepatica and paramphistome mixed infection in cattle in the humid tropics of Mexico.

The objective of this study was to evaluate the effectiveness of the main anthelmintics used for the control of trematodes in cattle in an endemic area in the humid Mexican tropics. A diagnostic study was carried out in nine cattle farms to determine the prevalence of flukes through faecal examination. Only three farms with more than 20 cows positive to trematodes were chosen to determine the effectiveness of commercial anthelmintics (triclabendazole, TCBZ; ivermectin + closantel, (IVM + CLOS); IVM + clorsulon, (CLORS); nitroxynil, NITROX). The prevalence of Fasciola hepatica was 27.1% and 29.6% of paramphistomes. The faecal egg count of trematodes ranged from 0.0 to 12.2 eggs per gram of faeces. The highest effectiveness against F. hepatica was 96.7%, and 92.7% against paramphistomes. NITROX was the most effective in the control of trematodes, while other products, such as IVM + CLORS and TCBZ obtained values lower than 90%, which puts sustainable trematode control at risk. The presence of trematodes was observed on most farms, although the prevalence per herd was highly variable, which indicates that the trematodes F. hepatica and paramphistomes are endemic to the region and a suitable management programme is suggested to control infections caused by these parasites.

Laparoendoscopic rendezvous procedure in a patient with situs inversus totalis: A case report and review of the literature.

Situs inversus totalis patients may be associated with difficulties in the diagnosis and treatment of surgical diseases. This case suggests that laparoendoscopic rendezvous procedure could be associated with a lower morbidity and length of hospital stay.

Automated lung cancer diagnosis using three-dimensional convolutional neural networks.

Lung cancer is the deadliest cancer worldwide. It has been shown that early detection using low-dose computer tomography (LDCT) scans can reduce deaths caused by this disease. We present a general framework for the detection of lung cancer in chest LDCT images. Our method consists of a nodule detector trained on the LIDC-IDRI dataset followed by a cancer predictor trained on the Kaggle DSB 2017 dataset and evaluated on the IEEE International Symposium on Biomedical Imaging (ISBI) 2018 Lung Nodule Malignancy Prediction test set. Our candidate extraction approach is effective to produce accurate candidates with a recall of 99.6%. In addition, our false positive reduction stage classifies successfully the candidates and increases precision by a factor of 2000. Our cancer predictor obtained a ROC AUC of 0.913 and was ranked 1st place at the ISBI 2018 Lung Nodule Malignancy Prediction challenge. Graphical abstract.

Heavy metal availability assessment using portable X-ray fluorescence and single extraction procedures on former vineyard polluted soils.

The periodic application of copper-based fungicides (Bourdeaux mixture) to vineyards of the Mediterranean region has generated an important pollution source that in some cases requires a quick intervention due to the high bioavailable copper content measured. Despite some vineyards were abandoned 40 years ago, noticeable amounts of Cu and other man-related metals are still nowadays detected in soils. In the present work, the development of a mobility test for the available heavy metal (Cu, Pb, Zn and As) content in soil has been performed using portable X-ray fluorescence (FP-XRF) combined with single leaching test, and was applied to a calcareous soil of a former vineyard area in Catalonia (NE Spain). The combined methodology has provided useful information for fast and detailed risk assessment, in terms of mobility and bioavailability of metals. The anthropogenic contribution was evaluated by means of the Concentration Enrichment Ratios (CER) in soil. The results reflect a clear anthropogenic contribution for Cu, a partial anthropogenic contribution for Pb proceeding from an external pollution source, and a non-significant external contribution for As and Zn. The topsoil concentration ranges for Cu (70-128 mg kg-1) were found to be above the background level and several samples above the regional governmental limits (Generic Reference Levels or GRL values) for soil ecosystem protection and for human health (90 mg kg-1). The present study reveals that the use of FP-XRF equipment constitute a highly valid option for quick decision making during the field location, characterization and quantitative elemental analysis of soil samples for screening of potential pollutants such as heavy metals.

Rol de la cirugía bariátrica/metabólica en el manejo de la diabetes mellitus 2. Consenso SOCHED/SCCBM / Consensus statement of the Chilean endocrinological society on the role of bariatric surgery in type 2 diabetes

Diabetes Mellitus (DM) and obesity are a public health problem in Chile. Bariatric surgery is the most effective treatment alternative to achieve a significant and sustained weight reduction in patients with morbid obesity. The results of controlled clinical trials indicate that, compared to medical treatment, surgery for obese patients with DM2 allows a better control of blood glucose and cardiovascular risk factors, reduces the need for medications and increases the likelihood for remission. Consensus conferences and clinical practice guidelines support bariatric surgery as an option to treat DM2 in Class III Obesity (Body Mass Index (BMI) > 40) regardless of the glycemic control and the complexity of pharmacological treatment and in Class II Obesity (BMI 35-39,9) with inadequate glycemic control despite optimal pharmacological treatment and lifestyle. However, surgical indication for patients with DM2 and BMI between 30-34.9, the most prevalent sub-group, is only suggested. The Chilean Societies of Endocrinology and Diabetes and of Bariatric and Metabolic Surgery decided to generate a consensus regarding the importance of other factors related to DM2 that would allow a better selection of candidates for surgery, particularly when weight does not constitute an indication. Considering the national reality, we also need a statement regarding the selection and characteristics of the surgical procedure as well as the role of the diabetologist in the multidisciplinary team.

Stimulation of murine cell-mediated immunity by dietary administration of a cell preparation of Enterococcus faecalis strain KH-2 and its possible activity against tumour development in mice.

It is well known that dietary lactic acid bacteria (LAB) stimulate cell-mediated immunity such as natural killer (NK) activity in mice. Here, we aimed to assay the immunomodulatory effects of a cell preparation of Enterococcus faecalis strain KH-2 (CPEF). We further evaluated the possibility of antitumour activity caused by CPEF administration, because NK cells actively participate in the prevention of tumour formation. NK cell activity and gene expression of IFN-γ and Perforin 1, which were induced most likely by a synergetic action of their cytotoxic activity, were higher in splenocytes of CPEF-administered mice than they were in control mice. Moreover, unlike those of control mice, the splenocytes of CPEF-administered mice had significantly higher CD28+CD69+/CD4+ and CD28+CD69+/CD8+ ratios that resulted in a survival rate with a tendency toward improvement after 47 days of CPEF administration (p=0.1) in Meth-A fibrosarcoma-bearing mice. In conclusion, we showed that CPEF might be effective in treating Meth-A fibrosarcoma in mice, as it helped increase their survival rate via stimulation of an immune response in splenocytes, which involved systemic cellular immunity processes such as cytotoxic activity, and active T cells.

Probiotic supplementation improves reproductive performance of unvaccinated farmed sows infected with porcine epidemic diarrhea virus.

We investigated if probiotic supplementation could improve the health and reproductive performance of unvaccinated lactating sows infected with porcine epidemic diarrhea (PED) virus. Twenty unvaccinated pregnant sows were equally allocated to probiotic-supplemented (P) and control (C) groups. For the experiment, 15 g/day of probiotic compound BIO-THREE PZ was given to P sows. Reproductive performance was checked daily. The number of neonates fostered by each sow was maintained at eight throughout the experiment. Individual milk production post-parturition was measured twice. Milk protein and fat ratios were determined by a milk analyzer. Total immunoglobulin (Ig) A and G concentrations were measured by ELISA. At day 7 post-parturition, the body weight of P sows was 10 kg higher than that of C sows, and at day 3 post-parturition, P sows produced more milk (+2 kg) and had a higher IgA concentration in whey than did C sows (p < .05). Finally, unlike C sows, P sows tended to return to estrus faster, and had larger piglets at birth with a lower mortality percentage during early days of suckling. In conclusion, probiotic compound BIO-THREE PZ helped strengthen the immune system of unvaccinated, PED-infected sows and improved their reproductive performance.

[Consensus statement of the Chilean endocrinological society on the role of bariatric surgery in type 2 diabetes]. / Rol de la cirugía bariátrica/metabólica en el manejo de la diabetes mellitus 2. Consenso SOCHED/SCCBM.

Diabetes Mellitus (DM) and obesity are a public health problem in Chile. Bariatric surgery is the most effective treatment alternative to achieve a significant and sustained weight reduction in patients with morbid obesity. The results of controlled clinical trials indicate that, compared to medical treatment, surgery for obese patients with DM2 allows a better control of blood glucose and cardiovascular risk factors, reduces the need for medications and increases the likelihood for remission. Consensus conferences and clinical practice guidelines support bariatric surgery as an option to treat DM2 in Class III Obesity (Body Mass Index (BMI) > 40) regardless of the glycemic control and the complexity of pharmacological treatment and in Class II Obesity (BMI 35-39,9) with inadequate glycemic control despite optimal pharmacological treatment and lifestyle. However, surgical indication for patients with DM2 and BMI between 30-34.9, the most prevalent sub-group, is only suggested. The Chilean Societies of Endocrinology and Diabetes and of Bariatric and Metabolic Surgery decided to generate a consensus regarding the importance of other factors related to DM2 that would allow a better selection of candidates for surgery, particularly when weight does not constitute an indication. Considering the national reality, we also need a statement regarding the selection and characteristics of the surgical procedure as well as the role of the diabetologist in the multidisciplinary team.

A preliminary study of gut dysbiosis in children with food allergy.

Gut microbiota of food allergic children was analyzed by high throughput 16S rRNA gene sequencing. Signs of gut dysbiosis, which is likely associated with gut inflammation, was observed in children with food allergies. For example, decreased abundance of genus Akkermansia but increased abundance of Veillonella was found in children with food allergy in comparison with healthy control children.

Dietary Probiotic Compound Improves Reproductive Performance of Porcine Epidemic Diarrhea Virus-Infected Sows Reared in a Japanese Commercial Swine Farm under Vaccine Control Condition.

Lactogenic immunity transferred to piglets after inoculation of a live vaccine to pregnant sows was proved limited to control porcine epidemic diarrhea (PED). Hence, here we evaluated the efficacy of administration of a probiotic compound containing Bacillus mesentericus, Clostridium butyricum, and Enterococcus faecalis together with a commercial live-attenuated PED vaccine (Nisseiken PED Live Vaccine, Nisseiken, Tokyo, Japan) to improve the health and reproductive performance of PED-infected sows. Twenty pregnant sows in a PED-positive farm were equally divided into probiotics-administered (VP) and control (VC) sow groups. A commercial live-attenuated vaccine was injected as per the manufacturer's instruction. The probiotic compound (15 g/day) was orally administered to VP from 6 weeks pre-parturition to 7 days post-parturition (ppd7). VP had a significantly higher body weight at ppd7 than VC (191 vs 186 kg; P < 0.05). At day 3 post-parturition (ppd3) (4.18 vs 3.63 kg/day) and ppd7 (5.14 vs 4.34 kg/day), milk produced by VP was significantly (P < 0.05) greater than that by VC. Total immunoglobulin (Ig)A and IgG concentrations at day 0 were significantly (P < 0.05) higher in whey of VP (1.9 and 6.6 g/dL, respectively) than in that of VC (1.7 and 6.1 g/dL, respectively). However, total IgG concentration in whey of VP and VC at ppd3 and ppd7 did not differ. Antibody titer was significantly higher at day 0 in serum of VP than it was that of VC (60 vs 37 in geometric mean; P < 0.05). Likewise, the antibody titer in whey of VP and VC was found to be similar at day 0 (416 vs 208 in geometric mean; P = 0.13). Consequently, VP had fewer days between weaning and return to estrus than did VC (7 vs 10 days; P < 0.05). Moreover, piglets of VP had a significantly (P < 0.05) higher litter weight at birth (9,252 g/litter) and a lower mortality (12%) during suckling than those of VC (8,686 g/litter and 28%, respectively). In summary, probiotic-supplemented, PED-vaccinated sows were healthier, transferred PED-specific antibodies via colostrum to piglets, had greater litter weight at birth, and reduced mortality during suckling.

El ejercicio físico disminuye la pérdida de masa magra en pacientes obesos sometidos a cirugía bariátrica / Exercise reduces lean mass loss in obese patients undergoing bariatric surgery

Objetivo: Caracterizar el efecto de un programa de ejercicio físico en la pérdida de masa magra en pacientes obesos mórbidos durante el primer año después de la cirugía bariátrica. Pacientes y métodos: Estudio de cohorte no concurrente de pacientes obesos mórbidos sometidos a bypass gástrico en Y de Roux (BPGYR) o gastrectomía en manga (GM) que contaran con medición de su composición corporal antes y a los 3, 6 y 12 meses después de la cirugía. Los pacientes se clasificaron como ejercicio físico (+) o ejercicio físico (−) según realizaran o no un programa de ejercicio físico supervisado durante el primer año después de la cirugía. Resultados: Se identificaron 35 pacientes obesos mórbidos sometidos a BPGYR o GM. Veinte (57%) pacientes fueron ejercicio físico (+) y 15 (43%) ejercicio físico (−). Los promedios de edad e IMC preoperatorio en ejercicio físico (+) y ejercicio físico (−) fueron de 33,5 ± 8,9 y 43,3 ± 12,4 años (p < 0,05), y 40,4 ± 7,1 y 35,8 ± 5 kg/m² (p < 0,05), respectivamente. No hubo diferencias en composición corporal entre ambos grupos. Un año después de la cirugía, la pérdida de masa magra en pacientes ejercicio físico (+) y ejercicio físico (−) representó un 17,9 ± 4,1% y 30,1 ± 4,5% del total de la pérdida de peso, respectivamente (p < 0,05). Conclusiones: Estos resultados sugieren que la estimulación muscular mediante ejercicio físico regular logra disminuir la pérdida de masa magra observada después de la cirugía bariátrica, mejorando así la composición corporal de los pacientes.

Objective: We sought to characterize the effect of a physical exercise program on fat free mass loss in morbidly-obese patients one year after bariatric surgery. Patients and methods: Retrospective cohort study of a group of patients who underwent Roux-en-Y gastric bypass (RYGB) or Sleeve Gastrectomy (SG) and had body composition analysis before and at 3, 6 and 12 months after surgery. Identified patients were further classified as physical exercise (+) or physical exercise (−) based on whether they followed or not a physical exercise program during the first year after surgery. Results: We identified 35 morbidly obese patients who underwent RYGB or SG. 20 (57%) patients were physical exercise (+) and 15 (43%) patients were physical exercise (−). Mean age and preoperative BMI in physical exercise (+) and physical exercise (−) patients was 33.5 ± 8.9 and 43.3 ± 12.4 years (P < .05), and 40.4 ± 7.1 and 35.8 ± 5 kg/m² (P < .05), respectively. There were no differences in body composition between both groups. One year after surgery, fat free mass loss in physical exercise (+) and physical exercise (−) patients represented 17.9 ± 4.1% and 30.1 ± 4.5% of total weight loss, respectively (P < .05). Conclusions: The results of this study suggest that muscle stimulation through physical exercise can decrease the lean body mass loss induced by surgery, thus improving body composition outcomes after surgery.