Effect of Dietary Guanidinoacetic Acid Levels on the Mitigation of Greenhouse Gas Production and the Rumen Fermentation Profile of Alfalfa-Based Diets.

The objective of this study was to evaluate the effect of different percentages of alfalfa (Medicago sativa L.) hay (AH) and doses of guanidinoacetic acid (GAA) in the diet on the mitigation of greenhouse gas production, the in vitro rumen fermentation profile and methane (CH4) conversion efficiency. AH percentages were defined for the diets of beef and dairy cattle, as well as under grazing conditions (10 (AH10), 25 (AH25) and 100% (AH100)), while the GAA doses were 0 (control), 0.0005, 0.0010, 0.0015, 0.0020, 0.0025 and 0.0030 g g-1 DM diet. With an increased dose of GAA, the total gas production (GP) and methane (CH4) increased (p = 0.0439) in the AH10 diet, while in AH25 diet, no effect was observed (p = 0.1311), and in AH100, GP and CH4 levels decreased (p = 0.0113). In addition, the increase in GAA decreased (p = 0.0042) the proportion of CH4 in the AH25 diet, with no influence (p = 0.1050) on CH4 in the AH10 and AH100 diet groups. Carbon monoxide production decreased (p = 0.0227) in the AH100 diet with most GAA doses, and the other diets did not show an effect (p = 0.0617) on carbon monoxide, while the production of hydrogen sulfide decreased (p = 0.0441) in the AH10 and AH100 diets with the addition of GAA, with no effect observed in association with the AH25 diet (p = 0.3162). The pH level increased (p < 0.0001) and dry matter degradation (DMD) decreased (p < 0.0001) when AH was increased from 10 to 25%, while 25 to 100% AH contents had the opposite effect. In addition, with an increased GAA dose, only the pH in the AH100 diet increased (p = 0.0142 and p = 0.0023) the DMD in the AH10 diet group. Similarly, GAA influenced (p = 0.0002) SCFA, ME and CH4 conversion efficiency but only in the AH10 diet group. In this diet group, it was observed that with an increased dose of GAA, SCFA and ME increased (p = 0.0002), while CH4 per unit of OM decreased (p = 0.0002) only with doses of 0.0010, 0.0015 and 0.0020 g, with no effect on CH4 per unit of SCFA and ME (p = 0.1790 and p = 0.1343). In conclusion, the positive effects of GAA depend on the percentage of AH, and diets with 25 and 100% AH showed very little improvement with the addition of GAA, while the diet with 10% AH presented the best results.

Effect of sublethal concentrations of glyphosate-based herbicides (Roundup Active®) on skin of the tropical frog (Dendropsophus molitor).

In Colombia, glyphosate (GP) is used to control weeds, with Roundup Active® being the most widely used. This use has affected aquatic ecosystems, causing malformations in amphibians. The Savannah frog (D. molitor) is a tropical frog inhabiting the mountain of Colombia. In the present study, we determined the effect of sublethal concentrations of GP (Roundup Active®) on the skin of D. molitor. Twenty-four tadpoles were exposed to concentrations of GP (T1: 0, T2: 1.4, T3: 3.6, and T4: 5.6 a.e mg/L) during 31 days. In 10 individuals per treatment, two skin regions were evaluated: dorsal cranial and caudal ventral to determine histopathological alterations. Morphometric analysis of the layers of the skin was performed: epidermis, dermis, and hypodermis-muscular. T1 did not present histopathological alterations. Since T2 was identified, glandular cell hyperplasia and hypertrophy increased melanophores and melanin accumulations in the highest concentrations of GP. The ultrastructure revealed an increase in excretory glands in the dermis. In the other layers, an increase of melanophores and melanocyte clusters was observed accompanied by vacuolization of basal cells. The morphometry showed an increase in the thickness of the dermis in the dorso-cranial region in T2 compared to the other treatments, while the ventral caudal region exhibited a variation in the thickness of the dermis from T2 and a decrease in T4. Despite evaluating sublethal concentrations, the skin of D. molitor tadpoles presents histopathological, ultrastructural, and morphometric alterations that could affect the survival of the species in the natural environment.

Marine Microalgae as a Nutritive Tool to Mitigate Ruminal Greenhouse Gas Production: In Vitro Fermentation Characteristics of Fresh and Ensiled Maize (Zea mays L.) Forage.

The aim of the present study was to evaluate the effects of marine microalgae (Dunaliella salina) as a food additive on biogas (BG), methane (CH4), carbon monoxide (CO), and hydrogen sulfide (H2S) production kinetics, as well as in in vitro rumen fermentation and the CH4 conversion efficiency of different genotypes of maize (Zea mays L.) and states of forage. The treatments were characterized by the forage of five maize genotypes (Amarillo, Montesa, Olotillo, Tampiqueño, and Tuxpeño), two states of forage (fresh and ensiled), and the addition of 3% (on DM basis) of microalgae (with and without). The parameters (b = asymptotic production, c = production rate, and Lag = delay phase before gas production) of the production of BG, CH4, CO, and H2S showed an effect (p < 0.05) of the genotype, the state of the forage, the addition of the microalgae, or some of its interactions, except for the time in the CO delay phase (p > 0.05). Moreover, the addition of microalgae decreased (p < 0.05) the production of BG, CH4, and H2S in most of the genotypes and stages of the forage, but the production of CO increased (p < 0.05). In the case of fermentation characteristics, the microalgae increased (p < 0.05) the pH, DMD, SCFA, and ME in most genotypes and forage states. With the addition of the microalgae, the fresh forage from Olotillo obtained the highest pH (p < 0.05), and the ensiled from Amarillo, the highest (p < 0.05) DMD, SCFA, and ME. However, the ensiled forage produced more (p < 0.05) CH4 per unit of SFCA, ME, and OM, and the microalgae increased it (p < 0.05) even more, and the fresh forage from Amarillo presented the highest (p < 0.05) quantity of CH4 per unit of product. In conclusion, the D. salina microalga showed a potential to reduce the production of BG, CH4, and H2S in maize forage, but its effect depended on the chemical composition of the genotype and the state of the forage. Despite the above, the energy value of the forage (fresh and ensiled) improved, the DMD increased, and in some cases, SCFA and ME also increased, all without compromising CH4 conversion efficiency.

Moringa oleifera as a Natural Alternative for the Control of Gastrointestinal Parasites in Equines: A Review.

Studies have shown a wide variety of parasites that infect horses, causing major gastrointestinal damage that can lead to death, and although the main method of control has been synthetic anthelmintics, there are parasites that have developed resistance to these drugs. For generations, plants have been used throughout the world as a cure or treatment for countless diseases and their symptoms, as is the case of Moringa oleifera, a plant native to the western region. In all its organs, mainly in leaves, M. oleifera presents a diversity of bioactive compounds, including flavonoids, tannins, phenolic acids, saponins, and vitamins, which provide antioxidant power to the plant. The compounds with the greatest antiparasitic activity are tannins and saponins, and they affect both the larvae and the oocytes of various equine gastrointestinal parasites. Therefore, M. oleifera is a promising source for the natural control of gastrointestinal parasites in horses.

Impact of Co-Ensiling of Maize with Moringa oleifera on the Production of Greenhouse Gases and the Characteristics of Fermentation in Ruminants.

The objective of this experiment was to evaluate the impact of maize co-ensiling with increasing percentages of MOL forage on the kinetics of biogas, methane (CH4), carbon monoxide (CO) and hydrogen sulfide (H2S) production, as well as the characteristics of ruminal fermentation and CH4 conversion efficiency, using steers (STI) and sheep (SHI) as inoculum sources. With the STI, the inclusion of MOL reduced (linear: p ≤ 0.0199; quadratic: p ≤ 0.0267) biogas production (mL g-1 DM incubated and degraded), CH4 (mL g-1 DM degraded), CO (mL g-1 DM degraded), and H2S (mL g-1 DM incubated and degraded), without affecting (p > 0.05) the parameters (b = asymptotic gas, c = rate of gas production and Lag = initial delay time before gas production) of CH4 and H2S, and the proportion and production of CH4 per kg of dry matter (DM). In addition, with this inoculum, pH, and dry matter degradation (DMD) increased (linear: p ≤ 0.0060), and although short-chain fatty acids (SCFA) and metabolizable energy (ME) decreased (linear: p < 0.0001; quadratic: p ≤ 0.0015), this did not affect (p > 0.05) the CH4 conversion efficiency. Meanwhile, with the SHI, the inclusion of MOL only decreased (linear: p ≤ 0.0206; quadratic: p ≤ 0.0003) biogas per dry matter (DM) degraded and increased (linear: p ≤ 0.0293; quadratic: p ≤ 0.0325) biogas per DM incubated, as well as the production (mL g-1 DM incubated and degraded and g-1 kg DM) and proportion of CH4, and CO per DM incubated and degraded. In addition, it did not impact (p > 0.05) on the CH4 and H2S parameters, and in the H2S by DM incubated and degraded, and although it increased (linear: p ≤ 0.0292; quadratic: p ≤ 0.0325) the DMD, SCFA, and ME, it was inefficient (quadratic: p ≤ 0.0041) in CH4 conversion. It is concluded that regardless of the percentage of MOL, the STI presented the highest values in the production of biogas, CH4, H2S, DMD, SCFA, and ME, and the lowest pH, so it turned out to be the most efficient in CH4 conversion, while with the SHI only the highest production of CO and pH was obtained, and the lowest DMD, SCFA, and ME, so it was less efficient compared to STI.

A Two-stage Approach for Rapid Assessment of the Proportion Achieving Viral Suppression Using Routine Clinical Data.

BACKGROUND: Improving viral suppression among people with HIV reduces morbidity, mortality, and transmission. Accordingly, monitoring the proportion of patients with a suppressed viral load is important to optimizing HIV care and treatment programs. But viral load data are often incomplete in clinical records. We illustrate a two-stage approach to estimate the proportion of treated people with HIV who have a suppressed viral load in the Dominican Republic. METHODS: Routinely collected data on viral load and patient characteristics were recorded in a national database, but 74% of patients on treatment at the time of the study did not have a recent viral load measurement. We recruited a subset of these patients for a rapid assessment that obtained additional viral load measurements. We combined results from the rapid assessment and main database using a two-stage weighting approach and compared results to estimates obtained using standard approaches to account for missing data. RESULTS: Of patients with recent routinely collected viral load data, 60% had a suppressed viral load. Results were similar after applying standard approaches to account for missing data. Using the two-stage approach, we estimated that 77% (95% confidence interval [CI] = 74, 80) of those on treatment had a suppressed viral load. CONCLUSIONS: When assessing the proportion of people on treatment with a suppressed viral load using routinely collected data, applying standard approaches to handle missing data may be inadequate. In these settings, augmenting routinely collected data with data collected through sampling-based approaches could allow more accurate and efficient monitoring of HIV treatment program effectiveness.

Cervical cancer screening programme attendance and compliance predictors regarding Colombia's Amazon region.

BACKGROUND: Cervical cancer (CC) promotion and prevention (P&P) programmes' challenge lies in guaranteeing that follow-up strategies have a real impact on reducing CC-related mortality rates. CC P&P programme compliance and coverage rates are relevant indicators for evaluating their success and good performance; however, such indicators' frequency rates are considerably lower among women living in rural and border areas. This study was aimed at identifying factors associated with CC screening programme attendance for women living in Colombia's Amazon region. METHODS: This study (qualitative and quantitative phases) was carried out between September 2015 and November 2016; women residing in the border towns of Leticia and Puerto Nariño participated in it. The first phase (qualitative) involved interviews and focus group discussions; this led to establishing factors related to CC P&P programme attendance which were used in the quantitative phase for designing a survey for determining the strength of association in a logistic regression model. The terms attendance and compliance were considered to apply to women who had followed the 1-1-3 scheme throughout their lives, i.e. a cytology examination every 3 years after receiving two consecutive negative annual cytology results. RESULTS: Inclusion criteria were met by 309 women (≥18-year-olds having an active sexual life, having resided in the target community for at least one year); 15.2% had suitable P&P programme follow-up. Screening programme attendance was positively associated with first intercourse after becoming 20 years-old (aOR: 3.87; 1.03-9.50 95%CI; p = 0.045), frequent contraceptive use (aOR: 3.11; 1.16-8.33 95%CI; p = 0.023), awareness of the age to participate in P&P programmes (aOR: 2.69; 1.08-6.68 95%CI; p = 0.032), awareness of cytology's usefulness in identifying cervical abnormalities (aOR: 2.43; 1.02-5.77 95%CI; p = 0.043) and considering cytology important (aOR: 2.64; 1.12-6.19 95%CI; p = 0.025). Women living in rural areas had a lower probability (aOR 0.43: 0.24-0.79 95%CI; p = 0.006) of adhering to CC P&P programmes. CONCLUSIONS: This study's findings suggested the need for including novel strategies in screening programmes which will promote CC P&P activities going beyond hospital outpatient attendance to reach the most remote or widely scattered communities, having the same guarantees regarding access, opportunity and quality. Including education-related activities and stimulating the population's awareness regarding knowledge about CC prevention could be one of the main tools for furthering the impact of attendance at and compliance with P&P programmes.

Effect of glyphosate (Roundup Active®) on liver of tadpoles of the colombian endemic frog Dendropsophus molitor (amphibia: Anura).

Glyphosate-based herbicide (GBH) using is increasing on a global scale. Few studies have investigated the sub-lethal effects of GBH in endemic amphibian species. The present work tested the GBH Roundup Active® on the tadpoles of Dendropsophus molitor. The exposure was in a range of plausible environmental concentrations (0-0.75 µg a.e./L) during a month. D. molitor is an endemic tropical frog of South America. The exposure from 325 µg a.e./L caused histological alterations in the liver. The high-resolution optical microscopy (HROM) detected sinusoidal dilatation and cytoplasmic vacuolization. The transmission electron microscopy (TEM) showed disorganization of the endoplasmic reticulum. Since the liver is essential for detoxification, these results suggest choric effects. Exposure to another GBH has caused histological alterations in liver tadpoles liver in a previous study, but, this study tested another endemic South-American frog for only 96h. The present work applied HROM to observe lipid alterations since it does not use organic solvents; and TEM for the ultrastructural observation of hepatocytes. Environmental risk of GBH can improve by including sub-lethal effects in endemic species.

Anatomía general, histología y morfometría del sistema digestivo del pez Pterophyllum scalare (Perciformes: Cichlidae)

Introducción: El pez escalar (Pterophyllum scalare) es una de las principales especies de peces ornamentales comercializados de Sur América. Objetivo: Describir histológica y morfométricamente el tracto digestivo del pez tropical P. scalare. Métodos: Se utilizaron 19 individuos adultos, y se calculó el coeficiente intestinal. Se realizó una descripción macroscópica e histológica del esófago, estómago e intestino (región anterior parte a, anterior parte b, media y posterior). Las muestras fueron procesadas en parafina, se obtuvieron cortes de 5 µm, que fueron teñidos con H&E y P.A.S. Se realizó conteo de células P.A.S +. Para la morfometría se digitalizaron los cortes y se midió el área y perímetro del lumen, y el área tisular para cada región. Resultados: P. scalare presenta un esófago corto, un estómago en forma de saco ciego poco muscular junto a un intestino con una longitud similar a su tamaño, coeficiente intestinal (1.66 +/- 0.52). Se identificaron cuatro capas constitutivas: mucosa, submucosa, muscular y en algunas regiones serosa. El esófago se destacó por ser la región con mayor número de células caliciformes P.A.S. + y mayor área tisular. En cuanto al área y perímetro luminar, la región anterior parte a del intestino fue la de mayor valor. Conclusiones: A partir del coeficiente intestinal (1.66 +/- 0.52), y las características histológicas y morfométricas de los órganos evaluados, se puede decir que P. scalare presenta un hábito alimenticio omnívoro con preferencia de presas blandas.

Introduction: Ornamental Angel fish (Pterophyllum scalare) is one of the main commercialized species from South America, with an important number of national and international dealers. Objective: To make a histological and morphometric description of P. scalare digestive tract. Methods: Nineteen adult individuals were used. Intestinal coefficient values were obtained, and a macroscopic and microscopic description of esophagus, stomach, and intestine (anterior, middle and posterior) was carried out. Samples were processed for paraffin embedding, and 5 µm sections were stained with H&E and P.A.S. Positive P.A.S. cells were counted. Lumen area and tissue area were measured in representative digitalized sections from each region. Results: P. scalare exhibited a short esophagus, followed by a blind bag shaped, scarcely muscular stomach, and a short intestine (intestinal coefficient 1.66 +/- 0.52). Four constitutive tissue layers were identified: mucosa, submucosa, muscular and in some areas also a serosa layer. Esophagus exhibit abundant globet P.A.S. + cells and shows the larger tisular area was observed. Luminal area and perimeter are larger in anterior intestinal region. Conclusions: The intestinal coefficient value (1.66 +/- 0.52), and the histological and morphometric characteristics of the evaluated organs, suggest that P. scalare is omnivorous with soft prey preferences.

Cambios en los niveles de nutrientes en solución hidropónica de espinaca baby (Spinacia oleracea L.), para su futura aplicación en acuapónia / Changes in nutrient levels in hydroponic solution of baby spinach (Spinacia oleracea L.), for future application in aquaponics / Mudanças nos níveis de nutrientes em solução hidropônica de spinaca baby (Spinacia oleracea L.), para sua futura aplicação na acuapónia

Resumen La espinaca es una planta de alto valor nutricional, mostrando gran acogida en su presentación "baby". La producción en hidroponía está limitada por la solución nutritiva, siendo la acuaponía un potencial complemento a este factor limitante. El objetivo de esta investigación fue definir los cambios de niveles de nutrientes en la solución hidropónica en espinaca baby. Se trabajó con 24 plántulas de espinaca en hidroponía de cama flotante usando solución "La Molina" en tanques de 50 L; se realizaron 5 repeticiones y 3 réplicas. Para cada réplica se cosechó cada tres semanas, registrando semanalmente variables fisicoquímicas de la solución. Además, se llevó a cabo un muestreo al inicio y final de cada réplica, evaluando las siguientes variables: número y longitud de hojas, área foliar, peso fresco y seco de la parte aérea. Se obtuvo en orden descendiente la siguiente extracción de macronutriente: N>K+>Ca2+>P y micronutrientes: Mn2+>Fe2+. Durante el ciclo de cultivo el pH de la solución osciló entre 6.00-6.97, el oxígeno disuelto entre 4.93-7.54 mg/L y la conductividad disminuyó constantemente a lo largo del ciclo, inició en 1558-1592 µS/cm y finalizó entre 1140-1275 µS/cm. Se obtuvo un TCC= 0.00002-0.00003 g/cm2/día; TRC=0.16, 0.15 y 0.14 g/g/día y TAN=0.006, 0.005 y 0.006 g/cm2/día para las réplicas 1, 2 y 3, respectivamente. Este estudio revela que esta planta podría tener buenos rendimientos en un sistema acuapónico, especialmente por los requerimientos de N, Ca2+>P, no obstante, se deberían adicionar bajas cantidades de algunos micronutrientes, que suelen ser escasos en los sistemas acuapónicos.

Abstract Baby spinach has a high nutritional value, and good entry in specialized markets. Its hydroponic production is limited by nutrient solution, and the aquaponic systems can avoid this limitation. The goal in this work was to evaluate nutrient level changes in hydroponic solution during baby spinach crop. 24 spinach plants were planted in 50 L tanks in floating hydroponic beds, using a modified "La Molina" nutrient solution. They were carried out 5 replications and 3 harvest. Water physicochemical values were registered every week, and plants were harvested after three weeks. Plant samples were also taken before planting (initial time) and after three weeks. Number of leaves, leaf length, leaf area, fresh and dry weight of the aerial part of each plant were recorded. The macronutrient extraction was obtained in descending order: N> P>K+> Ca2+ and micronutrients: Mn2+>Fe2+. pH values were maintained between 6.00-6.97, and DO levels were 4.93-7.54 mg/L. Initial conductivity was about 1558-1592 µS/cm and finally diminished to 1140-1275 µS/cm. CGR= 0.00002-0.00003 g/cm2/day; RGR=0.16, 0.15 y 0.14 g/g/day and NAR=0.006, 0.005 y 0.006 g/cm2/day for replica 1, 2 and 3 respectively. This study reveals that this plant could have good field performance in aquaponic system, especially due to the requirements of N, Ca2+>P, however low amounts of some micronutrients should be added, which are usually scarce in aquaponic systems

Resumo O espinafre é uma planta de alto valor nutricional, apresentando grande aceitação em sua apresentação "baby". A produção de hidroponia é limitada pela solução nutritiva, com a aquaponia sendo um complemento potencial para esse fator limitante. O objetivo desta pesquisa foi definir as alterações dos níveis de nutrientes na solução hidropônica em espinafre bebê. Trabalhamos com 24 mudas de espinafre em hidroponia de leito flutuante usando solução "La Molina" em tanques de 50 L; 5 repetições e 3 repetições foram realizadas. Para cada replicação, foi colhida a cada três semanas, registrando-se variáveis ​​físico-químicas semanais da solução. Além disso, foi realizada uma amostragem no início e no final de cada réplica, avaliando-se as seguintes variáveis: número e comprimento de folhas, área foliar, massa fresca e seca da parte aérea. A seguinte extração de macronutrientes foi obtida em ordem decrescente: N> K +> Ca2 +> P e micronutrientes: Mn2 +> Fe2 +. Durante o ciclo de cultivo, o pH da solução variou entre 6,00-6,97, o oxigênio dissolvido entre 4,93-7,54 mg/L e a condutividade diminuiu constantemente ao longo do ciclo, começando em 1558-1592 µS/cm e terminando entre 1140-1275 µS/cm. Obteve-se um TCC = 0,00002-0,00003 g / cm2 / dia; CRT = 0,16, 0,15 e 0,14 g / g / dia e TAN = 0,006, 0,005 e 0,006 g / cm2 / dia para os replicados 1, 2 e 3, respectivamente. Este estudo revela que esta planta pode ter bons rendimentos em um sistema aquapônico, especialmente por causa das exigências de N, Ca2+>P, porém pequenas quantidades de alguns micronutrientes devem ser adicionadas, que geralmente são escassas em sistemas aquapônicos.

National health information systems for achieving the Sustainable Development Goals.

OBJECTIVES: Achieving the Sustainable Development Goals will require data-driven public health action. There are limited publications on national health information systems that continuously generate health data. Given the need to develop these systems, we summarised their current status in low-income and middle-income countries. SETTING: The survey team jointly developed a questionnaire covering policy, planning, legislation and organisation of case reporting, patient monitoring and civil registration and vital statistics (CRVS) systems. From January until May 2017, we administered the questionnaire to key informants in 51 Centers for Disease Control country offices. Countries were aggregated for descriptive analyses in Microsoft Excel. RESULTS: Key informants in 15 countries responded to the questionnaire. Several key informants did not answer all questions, leading to different denominators across questions. The Ministry of Health coordinated case reporting, patient monitoring and CRVS systems in 93% (14/15), 93% (13/14) and 53% (8/15) of responding countries, respectively. Domestic financing supported case reporting, patient monitoring and CRVS systems in 86% (12/14), 75% (9/12) and 92% (11/12) of responding countries, respectively. The most common uses for system-generated data were to guide programme response in 100% (15/15) of countries for case reporting, to calculate service coverage in 92% (12/13) of countries for patient monitoring and to estimate the national burden of disease in 83% (10/12) of countries for CRVS. Systems with an electronic component were being used for case reporting, patient monitoring, birth registration and death registration in 87% (13/15), 92% (11/12), 77% (10/13) and 64% (7/11) of responding countries, respectively. CONCLUSIONS: Most responding countries have a solid foundation for policy, planning, legislation and organisation of health information systems. Further evaluation is needed to assess the quality of data generated from systems. Periodic evaluations may be useful in monitoring progress in strengthening and harmonising these systems over time.

Uterine Autotransplantation in the Nonhuman Primate With Preservation of the Uterine and Ovarian Vascular Pedicles.

PURPOSE: To evaluate the technical feasibility of performing a uterine autotransplantation in the nonhuman primate while preserving the uterine and ovarian vascular pedicles. METHODS: Eight (n = 8) female baboons at a primate research facility underwent a uterine autotransplant procedure with preservation of the vascular pedicles. The uterine arteries were separated from their amorphous tissue and skeletonized toward the internal iliac arteries bilaterally. A segment of the internal iliac artery was removed bilaterally along with both uterine arteries. Both ovarian veins were preserved to assist with the reperfusion of the uterine organ. Due to larger vascular pedicles in one of the primates, the uterine arteries were separated and reattached directly via end-to-end anastomosis. In another baboon, the deep uterine vein was used as a vascular pedicle rather than the ovarian vein on the left side due to adequate size and visualization. RESULTS: Immediate tissue reperfusion occurred intraoperatively in 5 of the animals, with slower perfusion in 3 of the animals. Average warm ischemia time was 43.8 minutes while the average cold ischemia time was 174 minutes (2 hours, 54 minutes). Average total surgical time was 5.9 hours. All animals were sheltered into separate cages and monitored for behavior changes and food and drink consumption. Three of the primates expired immediately postoperatively, 2 from severe dehydration and 1 from gastric aspiration. CONCLUSIONS: This pilot study describes a modified surgical approach for uterine transplants in the nonhuman primate. This surgical technique may be applicable to living and deceased donor uterine transplantation.

Glyphosate commercial formulation effects on preoptic area and hypothalamus of Cardinal Neon Paracheirodon axelrodi (Characiformes: Characidae)

In Colombia the use of glyphosate commercial formulations (Roundup™) for spraying have left deleterious effects on animals and humans. Much of this spraying takes place at the Orinoco basin, habitat of one of the most exported ornamental fish in Colombia, Cardinal neon. To evaluate the effect of Roundup Activo™ four experimental treatments were carried out with 0 mg/L (T1), 0.1 mg/L (T2), 1 mg/L (T3) and 5 mg/L (T4) during 30 days of exposure. The fishes were processed for high-resolution optical microscopy. The main finding of Roundup Activo™ exposure was an increase in mast cells number in brain blood vessels and some neuronal nuclei of the preoptic and posterior diencephalic areas, including hypothalamus. A correlation between concentrations and mast cells number was observed, with the largest mast cells number in T4 treatment. Mast cells presence is a stress benchmark, suggesting the beginning of allergic, inflammatory and apoptotic events. Presence of mast cells in these brain areas may lead to alterations on reproduction, visual and olfactory information integration among other processes. These alterations may result in diminished survival, affecting the conservation of this species in its natural habitat.(AU)

En Colombia, el uso de formulaciones comerciales de glifosato (Roundup™) para la fumigación ha producido efectos nocivos en animales y humanos. Gran parte de esta fumigación se realiza en la cuenca del Orinoco, hábitat de uno de los peces ornamentales más exportados de Colombia, el Neón Cardenal. Para evaluar el efecto de Roundup Activo™ se realizó un experimento con cuatro tratamientos 0 mg/L (T1), 0,1 mg/L (T2), 1 mg/L (T3) y 5 mg/L (T4) durante 30 días. Los peces fueron procesados para microscopía óptica de alta resolución. El principal hallazgo fue el aumento del número de mastocitos en los vasos sanguíneos cerebrales y algunos núcleos neuronales del área preóptica y diencefálica posterior, incluido el hipotálamo. Identificamos una correlación entre las concentraciones y el número de mastocitos, que alcanzó su máximo en T4. La presencia de mastocitos evidencia estrés, promoviendo eventos alérgicos, inflamatorios y apoptóticos. La presencia de mastocitos en estas áreas del cerebro puede llevar a alteraciones en la reproducción e integración de la información visual y olfativa entre otros procesos. Estas alteraciones pueden resultar en una disminución de la supervivencia, afectando la conservación de esta especie en su hábitat natural.(AU)

Evaluación de la calidad en la atención al usuario del servicio de urgencias del hospital público de Yopal en Casanare, Colombia / Assessment of the user service quality of the emergency department in the public hospital of Yopal, Casanare, Colombia

Resumen Objetivo. En esta investigación se evalúa la calidad en el proceso de atención al usuario del servicio de urgencias del hospital público de Yopal en Casanare, Colombia. Metodología. Esta investigación es de tipo descriptivo, exploratorio, apoyada en varias técnicas de investigación, iniciando con un cuestionario-encuesta, donde se realiza un análisis cuantitativo y cualitativo de la calidad de atención al usuario, la capacidad de la planta física, la comodidad, seguridad y confiabilidad del servicio; además se aplica la técnica de observación directa, análisis e interpretación de fenómenos, acontecimientos y hechos que prevalecen en el área. Resultados. Con este proyecto se pudo determinar la satisfacción o conformidad de los usuarios del servicio de urgencias y la aplicación de los protocolos de atención bajo estándares de calidad, cuál es el trato dado por los trabajadores y profesionales de la salud hacia los usuarios, las necesidades de capacitación al personal de atención, y posibles mejoras o modificaciones a los protocolos, cambios o recomendaciones para mejorar la calidad de atención. Conclusiones. El Hospital de Yopal no tiene capacidad suficiente en el área de urgencias para atender la alta demanda proveniente de los habitantes de Yopal y los municipios aledaños, la constante queja de los usuarios que dicen ser mal atendidos, el supuesto incumplimiento en su labor hacia los enfermos y familiares en la mayoría de las áreas del hospital, falta de personal profesional para la atención en el servicio de urgencias, largas jornadas de espera de los usuarios enfermos.

Abstract Objective. In this research is evaluated the quality in the customer service of the emergency department of the public Hospital of Yopal, Casanare, Colombia. Method. This investigation is of descriptive, exploratory type, supported on several investigation techniques, starting with a questionnaire - survey where there is carried out a quantitative and qualitative analysis of the quality of attention to the user, the capacity of the physical plant, comfort, safety and reliability of the service; besides, It is applied the technique of direct observation, analysis and interpretation of phenomena, events and facts that prevail in the area. Results. With this project it was possible to determine the satisfaction or conformity of the users of the first aid service and the application of the protocols of attention under quality standards, which is the treatment given by workers and health professionals toward users, if it is necessary to qualify the attention staff, if it is necessary to improve or modify the protocols, if changes or recommendations should be made to improve the quality of the attention. Conclusions. Yopal Hospital does not have enough capacity in the Emergency Department to meet the high demand coming from Yopal inhabitants and the surrounding municipalities, the incessant complaint of users claiming to be supposedly poorly served, the supposed nonperformance in its work towards the patients and relatives in most of the areas of the Hospital, lack of professional staff for the attention in the emergency department, long days of waiting for sick users.

Pregnancy and outcome of uterine allotransplantation and assisted reproduction in sheep.

This pilot study was performed from March 2008 through February 2010 to demonstrate that pregnancy can be achieved in a uterine allograft in the sheep model with the guidance of assisted reproductive technology. Uterine allotransplantation was performed in 12 sexually mature African sheep (Sudanese and Ethiopian). All animals underwent uterine transplantation via a minilaparotomy incision using a Mobius retractor device. A control group of pregnant Romney Marsh sheep with nontransplanted uteri were used to compare fetal development, uterine and placental histologic findings, and blood samples of progeny of the uterine transplant recipient sheep. Fetal size was obtained from ultrasound measurements during the early (crown-rump length) and late (biparietal diameter and abdominal circumference) gestational periods. The primary end point variables included preoperative and postoperative management, embryo transfer protocol, intraoperative assessments, and physiologic cardiopulmonary changes in the lamb during the first 5 hours of life. Four months after the initial uterine transplantation, 5 of 12 uterine allografts were considered candidates for the embryo transfer procedure. Fresh and frozen blastocyst donors were transferred accordingly to the remaining 5 uterine allografts via a minilaparotomy incision. Three of these resulted in pregnancies. One was an ectopic gestation, 1 sheep carried the pregnancy to 105 days, and 1 delivered a fully developed lamb from the transplanted uterus that was delivered via cesarean section. Neonatal lamb blood gas values and chemistry, gross organ examination, and ventilation and respiratory compliance studies yielded results normal for gestational age. This first reported case demonstrates that pregnancy can be carried in an allotransplanted uterus, with the end result a successful delivery.

International multicenter trial on clinical natural orifice surgery--NOTES IMTN study: preliminary results of 362 patients.

OBJECTIVES: Natural orifice translumenal endoscopic surgery (NOTES) is evolving as a promising alternative for abdominal surgery. IMTN Registry was designed to prospectively document early results of natural orifice surgery among a large group of clinical cases. METHODS: Sixteen centers from 9 countries were approved to participate in the study, based on study protocol requirements and local institutional review board approval. Transgastric and transvaginal endoscopic natural orifice surgery was clinically applied in 362 patients. Intraoperative and postoperative parameters were prospectively documented. RESULTS: Mean operative time for transvaginal cholecystectomy was 96 minutes, compared with 111 minute for transgastric cholecystectomy. A general complication rate of 8.84% was recorded (grade I-II representing 5.8%, grade III-IV representing 3.04%). No requirement for any analgesia was found in one fourth of cholecystectomy and appendectomy patients. CONCLUSIONS: Results of clinical applications of NOTES in the IMTN Study showed the feasibility of different methods of this new minimally invasive alternative for laparoscopic and open surgery.

Early experience in human hybrid transgastric and transvaginal endoscopic cholecystectomy.

BACKGROUND: Abdominal procedures have been performed for a long time through the anterior abdominal wall. Since the first reports in the 1980s, laparoscopy has become the standard for cholecystectomy, with many advantages over open procedures. Now a natural-orifice approach to the peritoneal cavity may further reduce the invasiveness of surgery by either diminishing or avoiding abdominal incisions. Several orifice routes to the abdominal cavity have been described: transgastric, transvaginal, transvesical, and transcolonic. Although most experiences with the porcine model showed the possibility of these approaches, few surgeons reported experiences with humans. The authors present their complete early experience with transgastric (TG) and transvaginal (TV) cholecystectomies in human beings. METHODS: Thirty-nine patients (4 males and 35 females) underwent hybrid NOTES procedures from January 2007 to January 2009. The mean age was 46 years (range = 19-83). The body mass index ranged from 20 to 41 and ASA was I-II. Transgastric (TG) cholecystectomy was performed in 27 patients and 12 patients had a transvaginal (TV) cholecystectomy. RESULTS: The mean operative time was 140 min. Although operative times were slightly shorter in the TG group 005B137 +/- 34.6 min (range = 75-195)] compared to the TV route [147 +/- 31.5 min (range = 95-220)], there were no significant differences between the two groups (p = 0.5, Mann-Whitney U test). Patients were started on liquids within 1 h and discharged 2 h later, except the last 11 TG patients, who went home 24 h later because of enrollment in a separate protocol. An overall 20% morbidity rate and no mortality were found. The complication rates for the TG and TV groups were 18% (5/27) and 25% (3/12), respectively, which was not statistically significant (p = 0.6, chi(2) test). Seventy-five percent of complications (6/8) occurred the first year and 25% (2/8) during the second year of our experience. CONCLUSION: Transgastric and transvaginal cholecystectomies are feasible. Although these NOTES procedures were laparoscopically assisted and current flexible endoscopes were used, it seems possible that major intra-abdominal surgeries may one day be performed without skin incisions. However, a learning curve is mandatory and, although there were no major bile duct injuries, there were NOTES-related complications. These trends toward incisionless surgery demand coordinated research in an interdisciplinary setting involving both surgeons and device manufacturers to further define appropriate indications, contraindications, and applications for natural-orifice surgery.

Research ethics training in Peru: a case study.

With the rapidly increasing number of health care professionals seeking international research experience, comes an urgent need for enhanced capacity of host country institutional review boards (IRB) to review research proposals and ensure research activities are both ethical and relevant to the host country customs and needs. A successful combination of distance learning, interactive courses and expert course instructors has been applied in Peru since 2004 through collaborations between the U.S. Naval Medical Research Center Detachment, the University of Washington and the Department of Clinical Bioethics of the National Institutes of Health to provide training in ethical conduct of research to IRB members and researchers from Peru and other Latin American countries. All training activities were conducted under the auspices of the Peruvian National Institute of Health (INS), Ministry of Health. To date, 927 people from 12 different Latin American countries have participated in several of these training activities. In this article we describe our training model.

Histología y morfometría de piel del pez Eremophilus mutisii (Trychomecteridae, Siluriformes)

Skin histology and morphometry of the fish Eremophilus mutisii (Trychomecteridae, Siluriformes). The tropical freshwater fish Eremophylus mutisii is endemic to the Cundinamarca highland in Colombia. Skin samples (0.5x0.5 cm²) were taken from 11 specimens at six body parts (mandible, dorsal head, dorsal trunk, caudal trunk, medial trunk and abdominal area), fixed in 4% formaldehyde, dehydrated in 95% ethanol and 99% isopropanol, embedded in paraffin and sectioned at 5 µm. The skin is made of two mayor cutaneous layers (epidermis and dermis) and a subcutaneous layer (hypodermis). The epidermis presents three layers with secretory cells, epithelial cells and a few taste buds; the dermis is separated from the epidermis by a basal membrane. We observed fibroblasts, two layers of melanophors and some blood vessels; the hypodermis has vascularized adipose tissue. Skin thickness changes with body area; the dermis is thicker than the epidermis; skin has more club cells than mucous cells. The medial trunk area has the largest number of club and mucous cells. The skin of E. mutissi seems to mainly have a protective function. Rev. Biol. Trop. 56 (2): 885-893. Epub 2008 June 30.

Se estudió la piel del pez dulceacuícola endémico de Colombia Eremophylus mutissi. Se tomaron muestras de piel (0.5x0.5 cm²) de 11 especimenes en seis partes del cuerpo (mandíbulas, cabeza dorsal, tronco dorsal, tronco caudal, tronco medial y abdominal). Se fijaron en formaldehído al 4%, con deshidratación en etanol al 95 % e isopropanol al 99%, inclusión en parafina y cortes a 5 µm. La piel está constituida por dos capas cutáneas (epidermis y dermis) y una capa subcutánea (hipodermis): la epidermis tiene tres capas con células secretoras, células epiteliales y pocas células gustativas; la dermis está separada de la epidermis por una membrana basal. Observamos fibroblastos, dos capas de melanóforos y algunos vasos sanguíneos; la hipodermis tiene un tejido adiposo vascularizado. La dermis es más delgada que la epidermis; la piel tiene más células tipo clava que células mucosas. El tronco medio tiene muchas células clava y células mucosas. La piel de E. mutissi parece tener una función principalmente protectora.

Modified uterine transplant procedure in the sheep model.

STUDY OBJECTIVE: The purpose of this project is to develop a uterine transplant procedure in the sheep model that may be suitable for human uterine transplants. DESIGN: Pilot study (Canadian Task Force classification II-2). SETTING: University De La Salle Bogotá, Colombia. PATIENTS: A total of 10 sexually matured sheep undergoing uterine allotransplantation. INTERVENTIONS: Uterine transplantation through a minilaparotomy incision with the application of a 900-500 modified Mobius retractor device. MEASUREMENTS AND MAIN RESULTS: The short-term effects of warm and cold tissue ischemia were quantified and uterine tissue reperfusion was analyzed after vascular reanastomosis. The ovine model was preferred since the anatomical landmarks and vascular anatomy are comparable to the human with the exception of a bicornuate uterus in the subprimate model. A modified surgical procedure was applied to our uterine allotransplanted sheep (n = 10) and tissue rejection was managed with cyclosporine therapy. A total abdominal hysterectomy without oophorectomy was performed and a cold ischemic time of 45 minutes was recorded. The uterine arteries and veins were reapproximated using a continuous end-to-end noninterlocking approach. Vascular patency and uterine tissue viability were assessed by histological studies. Complete tissue reperfusion of blood was achieved in our 10 animals within 30 seconds after vascular reanastomosis without evidence of arterial or venous thrombosis. At 6 months postuterine transplantation, hysterectomies were performed documenting viable uterine tissue and vascular patency in 6 out of the 10 uterine allotransplants. The site of uterine vessel reanastomosis was patent and histological studies indicated neovascularization with presence of smooth muscle and glandular endometrial tissue. CONCLUSION: We have developed a modified procedure that has allowed us to perform successful uterine transplants in the sheep model. This is the first reported case in the literature documenting a successful procedure of uterine allotransplantation in the ewe. Our pilot study demonstrates that the ewe is an excellent model for uterine transplant research and with further studies; we plan to demonstrate that a pregnancy can be achieved after a successful uterine transplant.