International consensus for a dissection room quality system (DRQS): A Delphi panel study.

Dissection Rooms (DRs) are key facilities that allow teaching and research on human anatomy, where students and researchers work with human bodies to acquire, increase, or create new knowledge. Usually, DRs work with a Body Donation Program (BDP), where living donors bequeath their bodies for use in teaching and research after they expire. Despite DRs being part of universities worldwide, no common guidelines, regulations, or quality management systems (QMS) exist that could be applied to different countries. With that purpose in mind, we aimed to develop a QMS that could be applied to DRs globally, using a Delphi panel to achieve consensus about the items that should constitute the QMS. The panel was constituted by 20 anatomy professors from 20 different countries, and the 167 standards to create the rules or guidelines that constitute the QMS were divided in five categories: direction, body donation, students, instructors, and research. After two rounds of revisions, 150 standards were considered "essential" or "important" by more than 70% of the participants, thus being incorporated to the Dissection Room Quality System (DRQS). The results of this panel represent a minimum list of items of the DRQS for improving the functioning of DRs globally.

Treatment of calcific tendinopathy of the rotator cuff with ultrasound-guided puncture and aspiration.

OBJECTIVE: Calcific tendinopathy of the rotator cuff is a common condition caused by the deposition of calcium crystals in the tendons of the rotator cuff. This study aimed to analyze the effectiveness of ultrasound-guided puncture and aspiration in calcific tendinopathy of the should in 86 patients treated at our center and to determine the factors associated with poor prognosis after this treatment. MATERIAL AND METHODS: This retrospective descriptive study included 86 patients with calcific tendinopathy of the rotator cuff treated with ultrasound-guided puncture and aspiration between 2015 and 2019 for whom clinical and radiological variables were collected 1, 3, 6, and 12 months after the procedure. RESULTS: One year after treatment, 81.4% patients showed clinical improvement and 96.5% showed radiological improvement. Complications were observed in 34.9%; all complications were mild. CONCLUSIONS: Ultrasound-guided puncture and aspiration is an effective treatment for calcific tendinopathy of the shoulder, resulting in a high rate of clinical and radiological improvement and a low rate of minor complications. This technique has additional advantages, such as interaction with the patient and the lack of ionizing radiation.

Time series forecasting methods in emergency contexts.

The key issues in any fire emergency are recognising fire hotspots, locating the emergency intervention team (EI), following the evolution of the fire, and selecting the evacuation path. This leads to the study and development of HelpResponder, a solution capable of detecting the focus of interest in hostile spaces derived from fire due to high temperatures without visibility. A study is conducted to determine which model best predicts measured [Formula: see text] levels. The variables used are temperature, humidity, and air quality, obtained from sensors installed in a fire tower. The statistical methods applied, namely ARIMAX, KNN, SVM, and TBATS, allow the adjustment and modelling of the variables. Explanatory variables with temporal structure are incorporated into SVM, a new improvement proposal. Moreover, combining different models showed the best efficiency in forecasting. In fact, another contribution of our work lies in offering a small-scale prediction system that is specifically designed to save batteries. The system has been tested and validated in a hostile environment (building), simulating real emergency situations. The system has been tested and validated in several hostile environments, simulating real emergency situations. It can help firefighters respond faster in an emergency. This reduces the risks associated with the lack of information and improves the time for tactical operations, which could save lives.

Motor imagery EEG signal classification with a multivariate time series approach.

BACKGROUND: Electroencephalogram (EEG) signals record electrical activity on the scalp. Measured signals, especially EEG motor imagery signals, are often inconsistent or distorted, which compromises their classification accuracy. Achieving a reliable classification of motor imagery EEG signals opens the door to possibilities such as the assessment of consciousness, brain computer interfaces or diagnostic tools. We seek a method that works with a reduced number of variables, in order to avoid overfitting and to improve interpretability. This work aims to enhance EEG signal classification accuracy by using methods based on time series analysis. Previous work on this line, usually took a univariate approach, thus losing the possibility to take advantage of the correlation information existing within the time series provided by the different electrodes. To overcome this problem, we propose a multivariate approach that can fully capture the relationships among the different time series included in the EEG data. To perform the multivariate time series analysis, we use a multi-resolution analysis approach based on the discrete wavelet transform, together with a stepwise discriminant that selects the most discriminant variables provided by the discrete wavelet transform analysis RESULTS: Applying this methodology to EEG data to differentiate between the motor imagery tasks of moving either hands or feet has yielded very good classification results, achieving in some cases up to 100% of accuracy for this 2-class pre-processed dataset. Besides, the fact that these results were achieved using a reduced number of variables (55 out of 22,176) can shed light on the relevance and impact of those variables. CONCLUSIONS: This work has a potentially large impact, as it enables classification of EEG data based on multivariate time series analysis in an interpretable way with high accuracy. The method allows a model with a reduced number of features, facilitating its interpretability and improving overfitting. Future work will extend the application of this classification method to help in diagnosis procedures for detecting brain pathologies and for its use in brain computer interfaces. In addition, the results presented here suggest that this method could be applied to other fields for the successful analysis of multivariate temporal data.

Atheromatosis of the brain-supplying arteries: Circle of Willis, basilar, vertebral and their branches.

PURPOSE: Atherosclerotic plaques in the brain-supplying arteries are slowly-developing alterations of vascular structures that can lead to neurological impairment due to stenosis and insufficient oxygenation of eloquent brain areas. The aim of this study is to provide detailed demographic information related to the incidence of atherosclerotic plaques in the cerebral arteries. MATERIAL AND METHODS: Forty-eight circles of Willis (21 men, 21 women, mean age: 70.26, six samples unknown) were macroscopically analyzed for length, diameter, and presence of atherosclerotic plaques. Statistical analysis was used to identify potential differences in the locations and frequencies of atherosclerotic plaques in relation to age and sex. RESULTS: The study sample revealed 261 atherosclerotic plaques. The key findings were significant correlations between plaque development and age and between plaque location and age; however, there was no significant sex difference. CONCLUSION: The upper and lower branches of the middle cerebral artery (MCA) were novel locations predisposing to plaque development. A cut-off value at 60 years revealed a significant difference in plaque development and distribution. There were no significant sex differences in the occurrence of atherosclerotic plaques.

Treatment of calcific tendinopathy of the rotator cuff with ultrasound-guided puncture and aspiration. / Tratamiento de la tendinopatía calcificante del manguito de los rotadores mediante punción-aspiración ecoguiada.

OBJECTIVE: Calcific tendinopathy of the rotator cuff is a common condition caused by the deposition of calcium crystals in the tendons of the rotator cuff. This study aimed to analyze the effectiveness of ultrasound-guided puncture and aspiration in calcific tendinopathy of the should in 86 patients treated at our center and to determine the factors associated with poor prognosis after this treatment. MATERIAL AND METHODS: This retrospective descriptive study included 86 patients with calcific tendinopathy of the rotator cuff treated with ultrasound-guided puncture and aspiration between 2015 and 2019 for whom clinical and radiological variables were collected 1, 3, 6, and 12 months after the procedure. RESULTS: One year after treatment, 81.4% patients showed clinical improvement and 96.5% showed radiological improvement. Complications were observed in 34.9%; all complications were mild. CONCLUSIONS: Ultrasound-guided puncture and aspiration is an effective treatment for calcific tendinopathy of the shoulder, resulting in a high rate of clinical and radiological improvement and a low rate of minor complications. This technique has additional advantages, such as interaction with the patient and the lack of ionizing radiation.

Partially defatted olive cake in finishing pig diets: implications on performance, faecal microbiota, carcass quality, slurry composition and gas emission.

One of the key factors to improve swine production sustainability is the use of agro-industrial by-products in feeds, such as olive by-products. However, it is necessary to assess its effects on the overall production process, including the animal and the environment. With this aim, an experiment was conducted to determine the effects of including a partially defatted olive cake (PDOC) in pig diets on growth performance, faecal microbiota, carcass quality and gas emission from the slurry. Two finishing diets were formulated, a control (C) diet and a diet with PDOC included at 120 g/kg. Eighty finishing male pigs Duroc-Danbred × (Landrace × Large White) of 60.4 ± 7.00 kg BW were divided between these two treatments. During the finishing period (60 to 110 kg BW, 55 days) average daily gain, average daily feed intake and feed conversion ratio were recorded. Faecal samples from the rectum of 16 animals per treatment were incubated for bacteria enumeration. At the end of finishing period, backfat thickness and loin depth (LD) were measured. Animals were slaughtered to obtain carcass weight and carcass composition parameters, and subcutaneous fat was sampled to analyse the fatty acid (FA) profile. In addition greenhouse gas and ammonia emissions were measured during pig slurry storage using the methodology of dynamic flux chambers. An initial slurry characterisation and biochemical methane potential (B0) were also determined. No significant differences between treatments were found in performance, carcass quality and microbial counts with the exception of LD, which was lower in PDOC compared with C animals (45.5 v. 47.5 mm, SEM: 0.62; P = 0.020). The FA profile of the subcutaneous fat did not differ between treatments, but the monounsaturated FA (MUFA) concentration was higher and the polyunsaturated FA was lower in the animals fed PDOC (50.9 v. 48.3, SEM: 0.48, P < 0.001; 17.6 v. 19.3, SEM: 0.30, P < 0.001 in mg/100 g of Total FA, for PDOC and C animals, respectively). The initial pig slurry characterisation only showed differences in ADF concentration that was higher (P < 0.05) in the slurry from PDOC treatment. Regarding gas emission, slurries from both treatments emitted similar amounts of ammonia (NH3), carbon dioxide (CO2), methane (CH4) and nitrous oxide (N2O), as well as B0 values. The results obtained suggest that PDOC may be included in balanced pig diets at rates of up to 120 g/kg without negative effects on performance, carcass quality, gut microflora and slurry gas emission, while improving the MUFA concentration of subcutaneous fat.

Management factors affecting mortality, feed intake and feed conversion ratio of grow-finishing pigs.

The aim of this study was to determine the effect of animal management and farm facilities on total feed intake (TFI), feed conversion ratio (FCR) and mortality rate (MORT) of grower-finishing pigs. In total, 310 batches from 244 grower-finishing farms, consisting of 454 855 Pietrain sired pigs in six Spanish pig companies were used. Data collection consisted of a survey on management practices (season of placement, split-sex by pens, number of pig origins, water source in the farm, initial or final BW) and facilities (floor, feeder, ventilation or number of animals placed) during 2008 and 2009. Results indicated that batches of pigs placed between January and March had higher TFI (P=0.006), FCR (P=0.005) and MORT (P=0.03) than those placed between July and September. Moreover, batches of pigs placed between April and June had lower MORT (P=0.003) than those placed between January and March. Batches which had split-sex pens had lower TFI (P=0.001) and better FCR (P<0.001) than those with mixed-sex in pens; pigs fed with a single-space feeder with incorporated drinker also had the lowest TFI (P<0.001) and best FCR (P<0.001) in comparison to single and multi-space feeders without a drinker. Pigs placed in pens with <50% slatted floors presented an improvement in FCR (P<0.05) than pens with 50% or more slatted floors. Batches filled with pigs from multiple origins had higher MORT (P<0.001) than those from a single origin. Pigs housed in barns that performed manual ventilation control presented higher MORT (P<0.001) in comparison to automatic ventilation. The regression analysis also indicated that pigs which entered to grower-finisher facilities with higher initial BW had lower MORT (P<0.05) and finally pigs which were sent to slaughterhouse with a higher final BW presented higher TFI (P<0.001). The variables selected for each dependent variable explained 61.9%, 24.8% and 20.4% of the total variability for TFI, FCR and MORT, respectively. This study indicates that farms can increase growth performance and reduce mortality by improving farm facilities and/or modifying management practices.

Aportaciones e inconvenientes de la incorporación de metodología cualitativa en la evaluación de servicios sanitarios. Un caso práctico: la evaluación de una consulta de alta resolución / Advantages and disadvantages of incorporating qualitative methodology in the evaluation of health services. A practical case: evaluation of a high-resolution clinic

Objetivo. En el marco de una evaluación sobre la calidad asistencial en una Unidad de Cardiología de Alta Resolución (UCAR) realizada con técnicas cuantitativas, se analizó la utilidad de incorporar una fase cualitativa a la investigación. Material y métodos. Se realizó una investigación cuantitativa con cuestionario estructurado y selección de sujetos por muestreo aleatorio sistemático (n=320) y una investigación cualitativa mediante entrevistas semiestructuradas a pacientes seleccionados por criterios de conveniencia (n=11), observaciones en el circuito asistencial y una entrevista en grupo con los profesionales de la UCAR. Posteriormente, el equipo de investigación, multidisciplinar, analizó individualmente la información recabada en las fases cuantitativa y cualitativa, evaluando los diferentes resultados obtenidos en ambas fases y los posibles sesgos derivados del uso de métodos cualitativos. Se realizaron tres reuniones siguiendo la técnica «brainstorming», para identificar las diversas aportaciones de cada una de las metodologías empleadas, utilizando diagramas de afinidades. Resultados. La investigación cualitativa permitió profundizar en algunos aspectos concretos del servicio que habían sido recogidos en la fase cuantitativa, matizando los resultados obtenidos en la fase previa, ahondando en las razones de insatisfacción con aspectos específicos, como los tiempos de espera y las infraestructuras disponibles, e identificando cuestiones emergentes del servicio, no evaluadas anteriormente. Conclusiones. Globalmente, la fase cualitativa enriqueció de forma sustantiva los resultados de la investigación. Es adecuado y recomendable incorporar este enfoque metodológico en investigaciones encaminadas a evaluar la calidad del servicio en un determinado contexto sanitario puesto que aporta, de primera mano, la voz del cliente(AU)

Objective. We examined the usefulness of incorporating a qualitative phase in the evaluation of the quality of care in a high-resolution medical service carried out with quantitative methods. Design and methods. A quantitative research was performed using a structured questionnaire and selecting interviewees by systematic randomized sampling methods (n=320). In addition, a qualitative research was carried on through semi-structured interviews with patients selected by convenience criteria (n=11), observations in the care assistance circuit, and a group interview with health professionals working in the service. A multidisciplinary research team conducted an individual analysis of the information collected in both quantitative and qualitative phases. Subsequently, three meetings based on group brainstorming techniques were held to identify the diverse contributions of each of the methodologies employed to the research, using affinity graphs to analyse the different results obtained in both phases and evaluate possible bias arising from the use of qualitative methods. Results. Qualitative research allowed examining specific aspects of the health care service that had been collected in the quantitative phase, harmonizing the results obtained in the previous phase, giving in-depth data on the reasons for patient dissatisfaction with specific aspects, such as waiting times and available infrastructures, and identifying emerging issues of the service which had not been previously assessed. Conclusions. Overall, the qualitative phase enriched the results of the research. It is appropriate and recommendable to incorporate this methodological approach in research aimed at evaluating the quality of the service in specific health care settings, since it is provided first hand, by the voice of the customer(AU)

[Advantages and disadvantages of incorporating qualitative methodology in the evaluation of health services. A practical case: evaluation of a high-resolution clinic]. / Aportaciones e inconvenientes de la incorporación de metodología cualitativa en la evaluación de servicios sanitarios. Un caso práctico: la evaluación de una consulta de alta resolución.

OBJECTIVE: We examined the usefulness of incorporating a qualitative phase in the evaluation of the quality of care in a high-resolution medical service carried out with quantitative methods. DESIGN AND METHODS: A quantitative research was performed using a structured questionnaire and selecting interviewees by systematic randomized sampling methods (n=320). In addition, a qualitative research was carried on through semi-structured interviews with patients selected by convenience criteria (n=11), observations in the care assistance circuit, and a group interview with health professionals working in the service. A multidisciplinary research team conducted an individual analysis of the information collected in both quantitative and qualitative phases. Subsequently, three meetings based on group brainstorming techniques were held to identify the diverse contributions of each of the methodologies employed to the research, using affinity graphs to analyse the different results obtained in both phases and evaluate possible bias arising from the use of qualitative methods. RESULTS: Qualitative research allowed examining specific aspects of the health care service that had been collected in the quantitative phase, harmonizing the results obtained in the previous phase, giving in-depth data on the reasons for patient dissatisfaction with specific aspects, such as waiting times and available infrastructures, and identifying emerging issues of the service which had not been previously assessed. CONCLUSIONS: Overall, the qualitative phase enriched the results of the research. It is appropriate and recommendable to incorporate this methodological approach in research aimed at evaluating the quality of the service in specific health care settings, since it is provided first hand, by the voice of the customer.

Effect of type of grinding of barley and dehydrated alfalfa on performance, digestion, and crude mucin ileal concentration in growing rabbits.

The effects of type of grinding of barley and dehydrated alfalfa (DA) were tested in rabbits weaned at 35 d of age with an average BW of 846 ± 93 g. Four nonmedicated diets were arranged in a 2 × 2 factorial structure, with type of grinding (coarse grinding with a 4.5-mm screen or fine grinding with a 1.5-mm screen) of barley (TGB) and DA (TGDA) as the main factors. A total of 1,056 mixed-sex rabbits (264 per diet) were fattened until d 63. Most of these rabbits (216 per diet) were housed in pairs and were used only to record mortality rate. Mortality was also recorded for the remaining 192 rabbits, which were housed individually and used to determine growth performance. From this group, 100 rabbits were used to determine digestive traits. Apart from those rabbits, a different group of 88 rabbits (44 housed individually and the remaining 44 housed in pairs) was used in the digestibility trial. All rabbits in this group were used to determine ileal digestibility (13 pools of ileal digesta per diet) and ileal mucin concentration (6 pools of ileal digesta per diet), whereas only the 44 individually housed rabbits were used to assess the fecal digestibility coefficients (11 rabbits per diet). Last, a jejunal sample was excised from 32 of the 44 individually housed rabbits to determine mucosal histology. Treatments did not affect ADG, ADFI, or G:F in the entire fattening period, but in the 49- to 63-d period, the diet containing both finely ground barley and DA reduced ADFI (P=0.08) compared with the other treatments (130 vs. 137 g). Moreover, this diet increased total digestive tract (4.76%, P=0.08) and cecal content (11.3%, P=0.08) weights compared with the other 3 treatments. Pylorus (P=0.09) and mixed digesta (P=0.06) pH, respectively, were reduced from 1.53 and 1.59 to 1.37 and 1.44 when both barley and DA were finely instead of coarsely ground. Grinding both barley and DA coarsely reduced the ileal digestibility of starch (0.899 vs. 0.936, P=0.06), increased (P < 0.01) its ileal flow and content in the feces to 1.66 g/d and 7.42 g/kg of DM, respectively, and led to decreased fecal digestibility (0.932 vs. 0.951, P < 0.01) compared with fine grinding. Coarse DA shortened villi (612 vs. 704 µm, P=0.02), increased crypt depth (121 vs. 92.1 µm, P=0.01), and reduced the villus:crypt ratio (5.08 vs. 7.66, P < 0.01) compared with finely ground DA. Furthermore, the greatest ileal crude mucin (148 vs. 107 g/kg of DMI, P=0.02) and sialic acid (71.7 vs. 61.7 mg/kg of DMI, P=0.04) concentrations were reported in rabbits receiving the diet with both coarsely ground barley and DA. Finally, mortality rate was not influenced by treatments, with an average of 9.64%. In conclusion, the diet containing finely ground barley and coarsely ground DA did not increase the weight of cecal contents, resulting in increased feed intake and leading to increased ileal digestibility and reduced ileal flow of starch.

Sistemática para la protocolización de los cuidados de enfermería / A program to protocolize nursing care

Objetivo. Disminuir la variabilidad de la práctica clínica y homogeneizar y sistematizar los cuidados que prestan los profesionales mediante la protocolización de los cuidados de enfermería. Material y métodos. La dirección de enfermería del Hospital Gregorio Marañón en 2004 decidió desarrollar una sistemática para la protocolización de los cuidados de enfermería en 5 fases temporales: preparación, elaboración, difusión, evaluación y actualización, y que adquiriera el carácter de actividad continuada basada en la metodología del ciclo de mejora continua (PDCA). Se presta especial atención a la fase de la evaluación y a los tres tipos de herramientas utilizadas: evaluación de los indicadores de proceso, evaluación de los indicadores de resultados y encuesta sobre la percepción de los profesionales. Resultados. Elaboración de 30 protocolos y 80 procedimientos basados en la evidencia, accesibles, actualizables y con indicadores de evaluación. Discusión. La protocolización de los cuidados de enfermería disminuye la variabilidad de la práctica clínica, homogeneiza los cuidados y aumenta la implicación de los profesionales. La evaluación de proceso, de resultados y de adhesión de los profesionales es una parte imprescindible para la mejora continua(AU)

Objective. To decrease variability in clinical practice and to standardise and develop a systematic care programusing nursing care protocols. Materials and methods. The Directorate of Nursing of the Gregorio Marañón Hospital decided to develop a systematic program to produce nursing care protocols in 2004. It followed 5 phases: preparation, processing, dissemination, evaluation and updating. The program was based on the methodology for continuous improvement cycle (PDCA). Particular attention was paid to the evaluation phase, and to the three types of tools used: evaluation of the process and performance indicators and a survey on the perception of professionals. Results. A total of 30 protocols and 80 procedures were developed. They were evidence based, accessible, available for updating and with evaluation indicators. Discussion. Nursing care protocols decrease the variability of clinical practice. They homogenize care and increase the involvement of professionals. The evaluation of the process, outcomes and adherence of professionals is imperative for continuous improvement(AU)

[A program to protocolize nursing care]. / Sistemática para la protocolización de los cuidados de enfermería.

OBJECTIVE: To decrease variability in clinical practice and to standardise and develop a systematic care programusing nursing care protocols. MATERIALS AND METHODS: The Directorate of Nursing of the Gregorio Marañón Hospital decided to develop a systematic program to produce nursing care protocols in 2004. It followed 5 phases: preparation, processing, dissemination, evaluation and updating. The program was based on the methodology for continuous improvement cycle (PDCA). Particular attention was paid to the evaluation phase, and to the three types of tools used: evaluation of the process and performance indicators and a survey on the perception of professionals. RESULTS: A total of 30 protocols and 80 procedures were developed. They were evidence based, accessible, available for updating and with evaluation indicators. DISCUSSION: Nursing care protocols decrease the variability of clinical practice. They homogenize care and increase the involvement of professionals. The evaluation of the process, outcomes and adherence of professionals is imperative for continuous improvement.

Effect of dietary supplementation with glutamine and a combination of glutamine-arginine on intestinal health in twenty-five-day-old weaned rabbits.

The effect of dietary supplementation with 1% l-glutamine and a combination of 1% l-glutamine and 0.5% l-arginine on intestinal health was examined in weaned rabbits. A basal diet was formulated to meet nutrient recommendations. Another 2 diets were formulated by adding 1% (as-fed basis) Gln or a mixture of 1% (as-fed basis) Gln + 0.5% (as-fed basis) Arg (Gln-Arg) to the basal diet. In Exp. 1, a total of 357 rabbits were blocked by litter and assigned at random to the experimental diet to determine mortality (119 per diet) and growth performance (35 per diet; from weaning at 25 to 56 d of age). Rabbits were fed the experimental diets for a 2-wk period and thereafter received a commercial diet. Rabbits weaned at 25 d (blocked by litter and assigned at random to diets) were slaughtered at 35 d and used to determine apparent ileal digestibility of DM, CP, and AA (Exp. 2, a total of 60 rabbits), intestinal morphology, N-aminopeptidase and myeloperoxidase intestinal activity, the expression of PPARgamma at the ileum and kidney, serum immunoglobulin in healthy and sick rabbits (Exp. 3, a total of 24 rabbits), and ileal and cecal microbial composition by PCR-RFLP (Exp. 4, a total of 45 rabbits). Dietary treatment did not affect ADG, ADFI, or G:F, during the entire fattening period. Supplementation with Gln reduced mortality during the first 2 wk and the whole fattening period from 18.5 to 8.4% (P = 0.023) and from 31.9 to 20.2% (P = 0.039), respectively, whereas no effect was detected for Arg supplementation. Among all the variables studied, the reduction on mortality due to Gln was related to a reduced intestinal colonization (Eimeria lesions) and changes on microbial ecosystem in the ileum and cecum, reducing the frequency of detection of Clostridium spp. (from 86.7 to 33.3%, P = 0.003) at the ileum, and Helicobacter spp. at the ileum (from 86.7 to 46.7%, P = 0.003) and at the cecum (from 86.7 to 46.7, P = 0.028), whereas no effect was detected for Arg supplementation. In conclusion, 1% l-Gln supplementation to postweaned rabbit diets decreased fattening mortality and modified the intestinal microbiota (although no consistent effects were observed on mucosal histology or inflammatory and systemic immune response). Diets containing a combination of 1% Gln and 0.5% Arg were of little additional benefit.

Neutral detergent-soluble fiber improves gut barrier function in twenty-five-day-old weaned rabbits.

The effect of neutral detergent-soluble fiber level on gut barrier function and intestinal microbiota was examined in weaned rabbits. A control diet (AH) containing 103 g of neutral detergent-soluble fiber/ kg of DM included alfalfa hay as main source of fiber. Another diet (B-AP) was formulated by replacing half of the alfalfa hay with a mixture of beet and apple pulp resulting in 131 g of soluble fiber/kg of DM. A third diet (OH) was obtained by substituting half of the alfalfa hay with a mix of oat hulls and a soybean protein concentrate and contained 79 g of soluble fiber/kg of DM. Rabbits weaned at 25 d and slaughtered at 35 d were used to determine ileal digestibility, jejunal morphology, sucrase activity, lamina propria lymphocytes, and intestinal microbiota. Suckling 35-d-old rabbits were used to assess mucosa morphology. Mortality (from weaning to 63 d of age) was also determined. Villous height of the jejunal mucosa increased with soluble fiber (P = 0.001). Rabbits fed with the greatest level of soluble fiber (BA-P diet) showed the highest villous height/ crypt depth ratio (8.14; P = 0.001), sucrase specific activity (8,671 mumol of glucose/g of protein; P = 0.019), and the greatest ileal starch digestibility (96.8%; P = 0.002). The opposite effects were observed in rabbits fed decreased levels of soluble fiber (AH and OH diets; 4.70, 5,848 mumol of glucose/g of protein, as average, respectively). The lowest ileal starch digestibility was detected for animals fed OH diet (93.2%). Suckling rabbits of the same age showed a lower villous height/crypt depth ratio (6.70) compared with the B-AP diet group, but this ratio was higher than the AH or OH diet groups. Lower levels of soluble fiber tended (P = 0.074) to increase the cellular immune response (CD8+ lymphocytes). Diet affected IL-2 production (CD25+, P = 0.029; CD5+CD25+, P = 0.057), with no clear relationship between soluble fiber and IL-2. The intestinal microbiota biodiversity was not affected by diets (P >/= 0.38). Rabbits fed the B-AP and AH diets had a reduced cecal frequency of detection compatible with Campylobacter spp. (20.3 vs. 37.8, P = 0.074), and Clostridium perfringens (4.3 vs. 17.6%, P = 0.047), compared with the OH diet group. Moreover, the mortality rates decreased from 14.4 (OH diet) to 5.1% (B-AP diet) with the increased presence of soluble fiber in the diet. In conclusion, increased levels of dietary soluble fiber improve mucosal integrity and functionality.

Effect of vitamin E and A supplementation on egg yolk alpha-tocopherol concentration.

The objective of this study was to asses the effect of dietary dl-alpha-tocopheryl acetate (alpha-TAC) and vitamin A supplementation on egg yolk alpha-tocopherol (alpha-T) concentration. A total of 96 ISA brown hens (a brown-egg laying hen), 32 wk of age, was used. Eight concentrations of alpha-TAC (0, 20, 40, 80, 160, 320, 640, and 1,280 IU/kg diet) were included in a corn-soybean meal-based diet containing 4,000 IU of vitamin A/kg diet. Production parameters were not affected by dietary treatment. Interhen variation in yolk alpha-T concentration increased at higher dietary intakes. Logarithmic transformation stabilized variance and showed the existence of a linear relationship between dietary alpha-TAC supplementation level and alpha-T egg yolk concentration (P < 0.001). As the dietary concentration of alpha-TAC rose, efficiency of uptake of alpha-T from feed to yolk decreased linearly (P < 0.001). A parallel experiment was carried out in which four additional groups of hens were fed diets containing four levels of dietary alpha-TAC (0, 40, 160, and 640 IU/kg) and 40,000 IU vitamin A/kg diet. A significantly lower egg yolk alpha-T concentration was found in hens fed diets including the highest level of vitamin A supplementation (P < 0.001). No interaction of dietary alpha-TAC and vitamin A concentrations was observed on egg yolk alpha-T concentration. No effect of dietary treatment was observed on yolk oxidation and other egg quality characteristics.

Influence of source and percentage of fat added to diet on performance and fatty acid composition of egg yolks of two strains of laying hens.

We conducted a trial to study the influence of strain of hen (white vs. brown) and source and percentage of added fat to diet on productive performance and fatty acid (FA) profile of the egg yolk. There were nine dietary treatments: a control diet without added fat and eight diets arranged as a 2 x 4 factorial (5 vs. 10% added tallow, olive, soy, or linseed oil). Each treatment was replicated five times, and the trial lasted 12 wk. White hens produced yolks with more saturated FA (P < 0.001) and less monounsaturated FA (P < 0.001) and polyunsaturated FA (P < 0.05) than brown hens. Fat supplementation improved egg mass output (P < 0.05) and feed efficiency of hens (P < 0.001). Linseed and soy oil diets produced greater egg mass than diets based on tallow or olive oil (59.6, 59.4, 57.9, and 57.1%, respectively; P < 0.001). The proportion of saturated FA in the yolk decreased as the percentage of added fat increased (36.5, 32.3, and 31.0% for diets containing 0, 5, and 10% added fat, respectively; P < 0.001). When the alpha-linolenic acid content of the diets increased from 0 to 0.8%, the arachidonic, docosapentanoic, and docosahexanoic acids in the egg yolk increased. Increases in the alpha-linolenic acid content of the diet over 2.3% did not further augment the concentration of docosapentanoic or docosahexanoic acid of the yolk and, in fact, decreased that of arachidonic acid. Only diets supplemented with linseed oil produced eggs with measurable amounts of eicosapentanoic acid. Diets supplemented with soy oil, with moderate levels of alpha-linolenic acid and high levels of linoleic acid, increased arachidonic and docosahexanoic acids in the egg yolk but not eicosapentanoic acid.

Immunotherapy units: a follow-up study.

Immunotherapy units are becoming an increasingly important component of allergy and clinical immunology departments in Spain. The objective of this study was to establish the rate of adverse reactions registered in an immunotherapy unit in Tenerife, Canary Islands, Spain, from May 1998 to May 2000. A total of 5,108 immunotherapy doses were administered to 339 patients (123 males and 216 females): 254 patients (75%) received mite, 48 patients (14.1%) pollen, 7 patients (2%) cat, 2 patients (0.6%) Alternaria alternata, and 38 patients (11.2%) hymenoptera venom immunotherapy; 238 patients (70.2%) had rhinoconjunctivitis and asthma, 59 (17.4%) rhinoconjunctivitis, 5 (1.4%) asthma, and 38 (11.2) hymenoptera sensitivity. A total of 42 episodes of adverse reactions were recorded (0.8% of all the administered doses). Of these reactions, 36 (85.7%) occurred within 30 minutes after the injection was administered, consisting of 15 large local reactions (0.3% of the total amount of injection given) and 21 systemic reactions (0.4%) that occurred only in asthmatic patients. All the systemic reactions were mild and rapidly reversible with appropriate treatment. Only in two cases was an immediate systemic reaction associated with a large local reaction. Six reactions (14.3%) occurred after 30 minutes and consisted only of large local reactions. A total of 15 systemic episodes (71.4% of all the systemic reactions) were registered at initial build-up doses. As to the types of allergens, 14.2% of the individuals receiving cat immunotherapy, 7.8% of the individuals receiving hymenoptera venom, 6.3% of the individuals receiving pollen immunotherapy, and 2.7% of the individuals receiving mite immunotherapy experienced an adverse reaction. Only 0.8% of the administered doses presented any kind of adverse reaction, of which only 0.4% were systemic. The latter were always mild and rapidly reversible with adequate treatment, and there was no vital danger for any patient. Immunotherapy is a safe modality of treatment for allergic respiratory diseases and immunotherapy units provide a controlled and safe environment for its administration.

Laying hen productivity as affected by energy, supplemental fat, and linoleic acid concentration of the diet.

A trial using 720 Isabrown hens was conducted to determine the influence of energy (AMEn), supplemental fat (SFAT), and linolenic acid (LIN) concentration of the diet on performance and weight of eggs and egg components throughout the laying cycle (22 to 65 wk of age). There were six treatments whose calculated AMEn, SFAT, and LIN content were, respectively: 1) 2,810 kcal/kg, 0%, 1.15%; 2) 2,810 kcal/kg, 4%, 1.15%; 3) 2,810 kcal/kg, 4%, 1.65%; 4) 2,680 kcal/kg, 0%, 1.15%; 5) 2,680 kcal/kg, 4%, 1.15%; and 6) 2,680 kcal/kg, 4%, and 1.65%. All diets were formulated to have the same crude protein, lysine, TSAA, calcium, and nonphytin phosphorus levels per kilocalorie of AMEn. The data were analyzed with SFAT constant (4%) and AMEn, and LIN variables (Diets 2, 3, 5, and 6) and with LIN constant (1.15%) and AMEn and SFAT variables (Diets 1, 2, 4, and 5). When LIN was maintained at a constant of 1.15%, an increase in the AMEn of the diets from 2,680 to 2,810 kcal/kg decreased feed intake by 4% (P < 0.001). Increasing AMEn also improved feed conversion per dozen eggs and per kilogram of eggs by 4.9 and 4.7% (P < 0.05), respectively, and increased BW gain by 55.7% (P < 0.05). Egg production rate, egg weight, egg mass output, and energy intake were not modified by treatments. An increase in SFAT within both energy levels from 0 to 4% improved all of the traits studied except feed conversion. Supplemental fat increased both yolk and albumen weight, but the effect was more pronounced on the latter. When SFAT was maintained constant at 4%, an increase in AMEn of the diets decreased feed intake and improved feed conversion per dozen and per kilogram of eggs by 5.7, 5.5, and 5.2%, respectively (P < 0.001). An increase in LIN content from 1.15 to 1.65% did not modify any of the parameters studied. The results indicate that SFAT consistently improves productivity of hens and egg weight and that the LIN requirement for maximal productivity is 1.15% or less. The beneficial effects of adding SFAT to diets containing more than 1.15% LIN are due to the fat itself rather than to an increase in LIN or AMEn of the diet.

Influence of dietary energy, supplemental fat and linoleic acid concentration on performance of laying hens at two ages.

1. The aim of this study was to investigate the influence of metabolisable energy (ME), supplemental fat (SFAT) and linoleic acid (LIN) content of the diet on the productive performance and weight of eggs and egg components of Isabrown hens of 22 or 74 weeks of age. 2. Six diets were formulated to contain the following concentrations of ME (MJ/kg), SFAT (g/kg) and LIN (g/kg), respectively: A) 11.8, 0 and 11.5; B) 11.8, 40 and 11.5; C) 11.8, 40 and 16.5; D) 11.2, 40 and 16.5; E) 11.2, 40 and 11.5; and F) 11.2, 0 and 11.5. Data were collected for 28 d and analysed using linear contrasts to test the effect of SFAT, LIN, ME and their interactions. 3. When the LIN content of the diets was maintained constant at 11.5 g/kg, an increase in the SFAT from 0 to 40 g/kg increased egg weight (63.8 vs 64.5 g; P<0.05), food intake (119 vs 124 g; P<0.01) and energy intake (1.36 vs. 1.42 MJ/d; P<0.01) and body weight change of the hens (-85 vs. 27 g; P<0.001). Supplemental fat also increased yolk (15.8 vs. 16.3 g; P<0.001) and albumen weight (40.8 vs. 42.3 g; P<0.01) but yolk to albumen ratio was not modified. 4. Egg and albumen weights were improved by SFAT in early but not in late producing hens. As a result, yolk to albumen ratio decreased in the younger hens, from 0.371 to 0.357, but increased in the older hens, from 0.408 to 0.415; P<0.01) with fat addition. 5. An increase in the LIN content of the diets from 11.5 to 16.5 g/kg did not modify any of the traits studied. 6. It was concluded that the LIN requirement of the hens for maximal productivity and weight of eggs is 11.5 g/kg or less. Supplemental fat increased the weight of eggs and albumen in the younger but not in older hens and the beneficial effect was independent of its LIN content.