Reproductive response of crossbred Bos taurus × Bos indicus cows to biostimulation by pre-pubertal and pubertal teasers.

Although the beneficial effect of biostimulation on reproduction has been reported, the influence of selectivity and social factors on the response to biostimulation has not received sufficient research attention in both Bos indicus and Bos indicus influenced cattle. Furthermore, 'green and cheap' strategies to improve cattle reproduction are currently in demand while Bos indicus influenced cattle with inferior reproductive performance, and farmers with economic limitations are common in tropical zones. Hence, to assess the reproductive response of crossbred taurus × indicus cows to biostimulation by pre-pubertal (PPM) or pubertal (PM) teasers males, two trials of 2 years each were conducted. Trial 1 n = 187 cows (Year 1:85 cows exposed to PPM and Year 2:102 cows exposed to PM). Trial 2 n = 196 cows (Year 1:101 cows exposed to PPM and Year 2:95 cows exposed to PM). The effect of exposing cows to PPM and PM on the intervals calving to first service (ICFS), calving to conception (ICC) and economic cost of days open (ECDO) was analysed using Kruskal-Wallis ANOVA and the effect of exposing cows to PPM and to PM on reproductive status at 90 days (RS90) and proportion of cows requiring hormonal protocols (PRH) was compared using χ2 analysis. Both ICFS and ICC were shorter (p < .0001) for PM-exposed females (96.12 ± 4.1 and 110.93 ± 2.9 days; respectively) compared with those PPM-exposed (134.41 ± 3.3 and 135.64 ± 2.4 days; respectively). With RS90, more (p < .0001) PM-exposed cows (50.7%) were pregnant compared with PPM-exposed cows (16.1%). The PRH was greater (p < .0001) in PPM-exposed cows (79.0%) compared with PM-exposed (27.9%). The ECDO was less (p < .0001) in PM-exposed cows (US$ 142.9 ± 3.8) compared with PPM-exposed (US$ 176.3 ± 2.9). In conclusion, cows exposed to PM had shorter ICFS and ICC compared with cows exposed to PPM. More cows exposed to PM were pregnant after 90 days, and PRH was less than cows exposed to PPM. Cows exposed to PM had a reduced ECDO than those exposed to PPM.

Time to move beyond surgical classification systems for endometriosis.

Endometriosis is a common condition associated with chronic pelvic pain and infertility. Its pathogenesis is poorly understood, diagnosis relies on laparoscopy, and staging is based on extent of disease. Unfortunately, the current staging systems do not correlate well with pain severity and impact, nor do they predict prognosis, i.e., treatment success and recurrence of disease. In this article, we discuss the strengths and limitations of current staging systems and propose modifications that will enable better classification systems to be developed in the future.

Efectividad de las vacunas contra SARS-CoV-2 en hospitalizados con fallas vacunales en 10 hospitales de la CCINSHAE / Effectiveness of SARS-CoV-2 vaccines in hospitalized patients with vaccine failures in 10 CCINSHAE hospitals

Resumen: Objetivo: Evaluar la efectividad de las vacunas contra SARS-CoV-2 para evitar muerte e intubación en pacientes hospitalizados con Covid-19. Material y métodos: Se presentó un análisis de 3 565 hospitalizaciones por SARS-CoV-2 de personas mayores de 20 años de edad, reportadas con fines de salud pública por 10 hospitales de especialidad. Se comparó a los egresados por mejoría (2 094) con los fallecidos (1 471) en modelos mixtos de regresión logística ajustados por edad, sexo, número de comorbilidades y el hospital como variable aleatoria. Resultados: Un esquema completo de vacunación, con cinco tipos de vacunas disponibles, tuvo un efecto protector para muerte o intubación (RM: 0.67, IC95%: 0.54,0.83, 33% de protección); y para muerte (RM: 0.80, IC95%: 0.64,0.99, 20% de protección) estos datos se compararon con los que no habían sido vacunados. Todas las vacunas aplicadas mostraron un efecto protector con un RM<0.8, con intervalos de confianza variables. Conclusiones: El antecedente de vacunación reduce los riesgos de ser intubado y morir, aun en pacientes previamente vacunados y hospitalizados con Covid-19 grave.

Abstract: Objective: To evaluate the effectiveness of SARS-CoV-2 vaccines to avoid death and intubation in hospitalized patients with Covid-19. Materials and methods: We present an analysis of 3 565 hospitalizations for SARS-CoV-2 in people over 20 years of age, reported for public health purposes by 10 specialty hospitals, comparing those discharged for improvement (2 094) with those who died (1 471) in mixed models of logistic regression adjusted for age, sex, number of comorbidities and the reporting hospital as a random variable. Results: A complete vaccination schedule, with five types of vaccine available, had a protective effect for death or intubation (OR: 0.67, CI95%: 0.54,0.83, 33% protection) and for death (OR: 0.80, CI95%: 0.64,0.99, 20% protection) compared to those who had not been vaccinated. All the applied vaccines in the Mexican program showed a protective effect with an OR<0.8, with variable confidence intervals. Conclusions: Even in patients previously vaccinated and hospitalized with severe Covid-19, a history of vaccination reduces the risks of being intubated and dying.

Transportación ósea en defectos masivos de la tibia con fijador externo RALCA / Bone transportation in massive defects of the tibia with RALCA external fixator

Se presenta un paciente masculino, de 20 años de edad, que sufrió una fractura expuesta de la tibia derecha, grado II, el cual fue tratado, según el protocolo de urgencia, con la aplicación de antibióticos, desbridamiento, colocación de osteosíntesis interna mediante una placa de compresión y cobertura cutánea de la fractura. Se comenzó a observar una evolución desfavorable, con enrojecimiento de la piel y sepsis local mantenida, a pesar de desbridamientos repetidos y antibioticoterapia, lo cual provocó una osteomielitis postraumática y, finalmente, una seudoartrosis séptica. Fue necesaria la realización de una resección segmentaria amplia de la tibia, con la aplicación de un fijador externo RALCA, para la realización de una transportación ósea, como proceder de salvataje, para cubrir el defecto óseo y lograr la curación definitiva del paciente (AU)

This is a case of a 20-year-old male patient who suffered a grade II, open fracture of the right tibia and was treated according to the urgency protocol with the administration of antibiotics, debridement and placing of internal osteosynthesis by means of a compression plate and fracture tissue coverage. An unfavorable progress was observed with skin reddening and sustained local sepsis, despite the repeated debridement and the treatment with antibiotics, what caused a posttraumatic osteomyelitis and finally a septic pseudo-arthrosis. It was necessary to perform a wide segmental resection of the tibia and a RALCA external fixator was set to carry out a bone transportation in order to correct the bone defect and fulfill the patients final recovery (AU)

A phase II/III, multicenter, safety, efficacy, and pharmacokinetic study of dexmedetomidine in preterm and term neonates.

OBJECTIVE: To investigate the safety, efficacy, and pharmacokinetic profile of dexmedetomidine in preterm and full-term neonates ≥ 28 to ≤ 44 weeks gestational age. STUDY DESIGN: Forty-two intubated, mechanically ventilated patients (n = 42) were grouped by gestational age into group I (n = 18), ≥ 28 to <36 weeks, and group II (n = 24), ≥ 36 to ≤ 44 weeks. Within each age group, there were 3 escalating dose levels, including a loading dose (LD, µg/kg) followed by a maintenance dose (MD, µg · kg(-1) · h(-1)) for 6-24 hours: level 1, 0.05 LD/MD; level 2, 0.1 LD/MD; and level 3, 0.2 LD/MD. The primary endpoint was the number of patients requiring sedation as determined by the Neonatal Pain, Agitation, Sedation Scale. RESULTS: During dexmedetomidine infusion, 5% of Neonatal Pain, Agitation, Sedation Scale scores were >3, indicating agitation/pain, with 4 patients (10%) requiring more sedation and 17 (40%) requiring more analgesia. Though there was significant variability in pharmacokinetic variables, group I appeared to have lower weight-adjusted plasma clearance (0.3 vs 0.9 L · h(-1) · kg(-1)) and increased elimination half-life (7.6 vs 3.2 hours) compared with group II. Fifty-six adverse events (AEs) were reported in 26 patients (62%); only 3 AEs (5%) were related to dexmedetomidine. There were no serious AEs and no AEs or hemodynamic changes requiring dexmedetomidine discontinuation. CONCLUSION: Dexmedetomidine is effective for sedating preterm and full-term neonates and is well-tolerated without significant AEs. Preterm neonates had decreased plasma clearance and longer elimination half-life.

Prospective randomized controlled study comparing low-cost LED and conventional phototherapy for treatment of neonatal hyperbilirubinemia.

Our objective was to carry out a prospective, randomized, single-blind study to evaluate whether light emitting diode (LED) phototherapy using a low-cost set of lights is as effective as conventional phototherapy in treating hyperbilirubinemia in neonates. The study included 45 pre-term neonates requiring phototherapy as per American Academy of Pediatrics guidelines; participants were randomized to receive phototherapy using LED-based lights, conventional fluorescent blue lights or conventional halogen lights. There were no statistically significant differences in the average bilirubin levels at the onset, at the maximum and at the end of treatment, nor in the duration of phototherapy treatment and the rate of decrease in bilirubin levels in the neonates receiving conventional fluorescent blue light, conventional halogen light and LED phototherapy. (Differences were considered significant at p < 0.05). The average rate of decrease of bilirubin levels was 0.047 ± 0.037 mg dl(-1) h(-1), 0.055 ± 0.056 mg dl(-1) h(-1) and 0.057 ± 0.045 mg dl(-1) h(-1) in the groups receiving conventional fluorescent blue light, conventional halogen light and LED phototherapy, respectively. The average duration of phototherapy treatment in the three groups was 108.8 ± 85.9 h, 92.8 ± 38.1 h, 110.4 ± 42.6 h, respectively. In this pilot study, LED phototherapy using a simple, low-cost set of lights was as effective as conventional phototherapy in the treatment of neonatal hyperbilirubinemia. LED phototherapy lights that deliver 30-40 µW cm(-2 )nm(-1) can be assembled in small quantities for

Niveles séricos de antígeno prostático específico libre y total y kalikrenia 2 en hombres de 40 a 70 años consulta urológica Hospital Universitario Dr. Angel Larralde / Free/total PSA serum levels and kallikrein 2 in 40-70 year old men attending a urology practice at

El cáncer de próstata se considera un problema de salud a nivel mundial. Por eso, nuevas técnicas colocan en las manos del especialista instrumentos que podrán contribuir a su temprana detección. El objetivo de esta investigación fue comparar los niveles séricos del Antígeno Prostático Específico (APE) total y libre, la relación APE libre/APE total, Kalikreina-2 (HK2) y el riesgo en la enfermedad prostática en un grupo de hombres con edades comprendidas entre 40 y 70 años que asistieron a la consulta urológica en el Hospital Universitario Ángel Larralde. En el estudio clínico se les realizó tacto rectal y para el estudio Bioquímico, se tomaron muestras sanguíneas, que se clasificaron en dos grupos: grupo A, que estuvo constituido por individuos aparentemente sanos y grupo B, constituido por pacientes con presunta sintomatología prostática. Para la determinación del APE se utilizó un inmunoensayo comercial (Delfia); para la detección KH2 se usó ensayo inmunofluorométrico segunda generación (Becker). De los 90 pacientes estudiados, 78 (86,7 por ciento) fué del grupo A y 12 (13,3 por ciento) del Grupo B. El grupo A tuvo una media ± DE para APE total, relación PE libre/ total y HK2 de 1,45 ng/mL ± 1,62: 0,28 ± 0,21 y 0,52 µg/mL ± 0,11 respectivamente; y el grupo B de 29,0 ng/mL ± 48,9; 0,12 ± 0,098 y 1,56 µg/mL ± 0,75. Se calculó el coeficiente de correlación de Pearson para el grupo A y B en relación a HK2 y la relación APE libre/total con un valor de -0,32 y -0,07. Al comparar las medias por t de student de los Grupos A y B, resultaron para APE total t = -2,12 (p= 0,048); relación APE libre/total t = 4,3 (P= 0,0002) y HK2 t = -4,79 (p= 0,0006). Se puede concluir que la HK2 se correlaciona más que la relación APE libre/total en relación a la sintomatología prostátca. Se recomienda evaluar una población con sintomatología prostática comprobada a fin de conocer la especificidad de ambas pruebas