Impact of 48-h water and feed deprivation and hydroxychloride sources of copper and zinc on the metabolism and performance of grazing Nellore cattle during the dry period.

Procedures such as transport and marketing can subject animals to water and feed deprivation and impair animal health and performance. Maintaining the mineral status of animals under these conditions can bring benefits to health and performance. The use of hydroxychloride mineral sources can improve mineral status, nutrient digestibility and performance. Two studies were conducted to investigate how the supplementation of 02 trace mineral sources of Cu and Zn and 48-hour water/feed deprivation would affect the performance and metabolism of grass-fed beef cattle. In the first study, 20 castrated and rumen-canulated Nellore steers (BW = 350 ±â€¯132 kg; 20 m) were distributed in individual pens, in a 2 × 2 factorial arrangement: supplemental Cu and Zn sources from inorganic vs hydroxychloride (HTM) and 48-hours deprivation (WFD) vs unrestricted (WFU) access to water and feed. The 57d of study was divided into two periods: (1) Adaptation from -21d to -1d and (2) evaluation from 0d to 36d. Interaction between deprivation × period was detected (P < 0.05) for digestibility of DM (DMD), organic matter (OMD), neutral detergent fiber (NDFD), and acid detergent fiber (ADFD). Deprivation increased DMD, OMD, NDFD, and ADFD immediately after the deprivation period (3-5d), but impaired digestibility at longer periods such as 11-13d and 32-34d. DM (DMI) and nutrient intake (P = 0.075), as well as NDFD were higher in HTM. Several ruminal parameters were affected by deprivation: short-chain fatty acids concentration decreased, while rumen pH increased (deprivation × time; P < 0.05); decreased propionate, butyrate and increased isobutyrate, isovalerate, and valerate in WFD (deprivation × time; P < 0.05), respectively. In the second study, eighty-four intact Nellore males (BW = 260 ±â€¯35 kg) were blocked by BW and randomly assigned to Urochloa brizantha cv. Marandu paddocks for 131d in a 2 × 2 factorial arrangement. Liver Cu was higher in WFU/HTM animals (mineral × deprivation; P < 0.05). Interaction between deprivation × period (P < 0.05) was detected for BW and average daily gain (ADG). On 2d and 12d after deprivation, WFD increased ADG and recovered the BW lost. In conclusion, water and feed deprivation imposed in these trials were able to impact several nutrient digestibility and ruminal fermentation parameters in short- and long-term. Performance was not affected by the studied factors. Furthermore, supplementation with sources of Cu and Zn hydroxychloride increased Cu in the liver and tended to increase DMI and NDFD.

Comparison of rumen and abomasal infusions of an exogenous emulsifier on fatty acid digestibility of lactating dairy cows.

We evaluated the effects of infusing an exogenous emulsifier (polysorbates-C18:1) either into the rumen or abomasum on fatty acid (FA) digestibility and production responses of lactating dairy cows. Nine ruminally cannulated multiparous Holstein cows (170 ± 13.6 d in milk) were assigned to a treatment sequence in replicated 3 × 3 Latin squares with 18-d periods consisting of 7 d of washout and 11 d of infusion. Treatments were abomasal infusions of water carrier only into the rumen and abomasum (control, CON), 30 g/d polysorbate-C18:1 (T80) infused into the rumen (RUM), or 30 g/d T80 infused into the abomasum (ABO). Emulsifiers were dissolved in water and delivered at 6-h intervals (total daily infusion was divided into 4 equal infusions per day). Cows were fed the same diet that contained [% diet dry matter (DM)] 32.2% neutral detergent fiber (NDF), 16.1% crude protein, 26.5% starch, and 3.41% FA (including 1.96% FA from a saturated FA supplement containing 28.0% C16:0 and 54.6% C18:0). Two orthogonal contrasts were evaluated: (1) the overall effect of T80 {CON vs. average of the T80 infusions [1/2 (ABO + RUM)]}, and (2) the effect of ABO versus RUM infusion. Compared with CON, infusing T80 increased the digestibilities of NDF (2.85 percentage units), total (4.35 percentage units), 16-carbon (3.25 percentage units), and 18-carbon FA (4.60 percentage units), and tended to increase DM digestibility and total and 18-carbon FA absorption. Compared with RUM, ABO decreased the intakes of total (28 g/d), 16-carbon (7 g/d), and 18-carbon FA (19 g/d); tended to increase the digestibility of total and 18-carbon FA; and had no effect on the absorption of total, 16-carbon, or 18-carbon FA. Production responses did not change among our treatments. In conclusion, infusing 30 g/d polysorbates-C18:1 increased NDF and total, 16-carbon, and 18-carbon FA digestibility. Compared with RUM, ABO tended to increase the digestibilities of total and 18-carbon FA; however, this may be related to the fact that ABO reduced the intakes of total, 16-carbon, and 18-carbon FA, not necessarily due to better emulsifying action per se. In summary, ABO and RUM both improved FA absorption.

Abomasal infusion of oleic acid and exogenous emulsifier alter fatty acid digestibility and production responses of lactating dairy cows.

We evaluated the effects of abomasal infusion of cis-9 C18:1 (oleic acid) and an exogenous emulsifier (polysorbate-C18:1) on fatty acid (FA) digestibility and production responses of dairy cows. Eight rumen-cannulated multiparous cows (96 ± 23 d in milk) were assigned to a 2 × 2 factorial arrangement of treatments in 4 × 4 Latin squares with 18-d periods consisting of 7 d of washout and 11 d of infusion. Treatments were abomasal infusions of water carrier only (CON), 45 g/d oleic acid (OA), 20 g/d polysorbate-C18:1 (T80), or both 45 g/d OA and 20 g/d T80 (OA+T80). The OA treatments were dissolved in ethanol and the T80 treatments in water. To deliver the daily dose for each treatment, the infusate solution was divided into 4 equal infusions per day, occurring every 6 h. Cows were fed the same diet, which contained (% of dry matter [DM]) 30.3% neutral detergent fiber (NDF), 16.3% crude protein, 30% starch, and 3.2% FA (including 1.8% DM from a FA supplement containing 34.4% C16:0 and 47.7% C18:0). Infusion of T80 increased NDF digestibility compared with all other treatments (3.57 percentage units), whereas OA+T80 decreased NDF digestibility compared with CON (3.30 percentage units). Compared with CON, OA (4.90 percentage units) and T80 (3.40 percentage units) increased total FA digestibility, whereas OA+T80 had no effect on total FA digestibility. We did not observe differences between OA and T80 for total FA digestibility. Infusion of OA (3.90 percentage units) and T80 (2.80 percentage units) increased 16-carbon FA digestibility compared with CON. Digestibility of 16-carbon FA did not differ between OA and T80 or between CON and OA+T80. Compared with CON, OA increased (5.60 percentage units) and T80 tended to increase 18-carbon FA digestibility. Digestibility of 18-carbon FA did not differ between OA and T80 or between CON and OA+T80. Compared with CON, all treatments increased or tended to increase the absorption of total and 18-carbon FA. Infusion of OA and T80 increased the yields of milk fat (both increased 0.10 kg/d), 3.5% fat-corrected milk (1.90 and 2.50 kg/d), and energy-corrected milk (1.80 and 2.60 kg/d) compared with CON. We did not observe differences between OA and T80 or between CON and OA+T80 for yields of milk fat, 3.5% fat-corrected milk, or energy-corrected milk. Infusing OA tended to increase plasma insulin concentration compared with CON. Compared with the other treatments, OA+T80 decreased the yield of de novo milk FA (31.3 g/d). Compared with CON, OA tended to increase the yield of de novo milk FA. Compared with OA+T80, CON and OA tended to increase the yield of mixed milk FA, whereas T80 increased it (83 g/d). Compared with CON, all emulsifier treatments increased the yield of preformed milk FA (52.7 g/d). In conclusion, abomasally infusing either 45 g of OA or 20 g of T80 improved digestibility and similarly favored the production parameters of dairy cows. In contrast, providing both (45 g of OA + 20 g of T80) had no additional benefits and moderated the positive responses observed in the individual treatments with OA and T80.

Increasing levels of calcium salts of palm fatty acids affect production responses during the immediate postpartum and carryover periods in dairy cows.

Our objective was to determine the dose-response effects of calcium salts of palm fatty acids (CSPF) on nutrient digestibility and production responses of early-lactation dairy cows grazing on tropical pastures and to evaluate carryover effects throughout mid and late lactation. Forty multiparous dairy cows (Jersey × Holstein) with (mean ± standard error of the mean) 20 ± 1.69 kg of milk/d and 20 ± 5.0 d in milk were used in a randomized complete block design. During the treatment period, all cows were kept in a grazing system. The treatments were offered for 90 d (treatment period) and consisted of 4 increasing levels of CSPF: 0 (0 kg/d), 0.2 (0.2 kg/d), 0.4 (0.4 kg/d), and 0.6 (0.6 kg/d). Each treatment had 10 animals. Increasing CSPF from 0 to 0.6 kg/d replaced an equivalent amount of a corn-based concentrate supplement offered at 10 kg/d on an as-fed basis (8.96 kg/d as a dry matter basis). All cows were housed and received a diet without fat inclusion fed as total mixed ration once a day from 91 to 258 d of the experiment (carryover period). During the treatment period, increasing CSPF linearly decreased dry matter intake (1.20 kg/d), linearly increased neutral detergent fiber digestibility (3.90 percentage units), and quadratically increased total fat digestibility (6.30 percentage units at 0.4 kg/d CSPF). Increasing CSPF linearly increased the yields of milk (4.10 kg/d), milk fat (0.11 kg/d), milk lactose (0.19 kg/d), energy-corrected milk (ECM; 3.30 kg/d), and feed efficiency (ECM/dry matter intake, 0.34 kg/kg), and linearly decreased milk protein content (0.38 g/100 g), body weight change (0.05 kg/d), and body condition score (0.37). We observed interactions between CSPF and time during the carryover period. Overall, CSPF supplementation linearly increased or tended to increase milk yield until 202 d of the experiment with a similar pattern observed for all the other yield variables. In conclusion, supplementing CSPF from 0 to 0.6 kg/d during 90 d increased neutral detergent fiber and total fat digestibility and the yields of milk, milk fat, and ECM in early-lactation dairy cows grazing on tropical pastures. Most production measurements linearly increased during the treatment period, indicating that 0.6 kg/d CSPF was the best dose. Also, supplementing CSPF from 0 to 0.6 kg/d for 90 d during early lactation had positive carryover effects across mid and late lactation.

Videolaryngoscopy vs. direct Macintosh laryngoscopy in tracheal intubation in adults: a ranking systematic review and network meta-analysis.

Videolaryngoscopes are thought to improve glottic view and facilitate tracheal intubation compared with the Macintosh direct laryngoscope. However, we currently do not know which one would be the best choice in most patients undergoing anaesthesia. We designed this systematic review with network meta-analyses to rank the different videolaryngoscopes and the Macintosh direct laryngoscope. We conducted searches in PubMed and a further five databases on 11 January 2021. We included randomised clinical trials with patients aged ≥16 years, comparing different videolaryngoscopes, or videolaryngoscopes with the Macintosh direct laryngoscope for the outcomes: failed intubation; failed first intubation attempt; failed intubation within two attempts; difficult intubation; percentage of glottic opening seen; difficult laryngoscopy; and time needed for intubation. We assessed the quality of evidence according to GRADE recommendations and included 179 studies in the meta-analyses. The C-MAC and C-MAC D-Blade were top ranked for avoiding failed intubation, but we did not find statistically significant differences between any two distinct videolaryngoscopes for this outcome. Further, the C-MAC D-Blade performed significantly better than the C-MAC Macintosh blade for difficult laryngoscopy. We found statistically significant differences between the laryngoscopes for time to intubation, but these differences were not considered clinically relevant. The evidence was judged as of low or very low quality overall. In conclusion, different videolaryngoscopes have differential intubation performance and some may be currently preferred among the available devices. Furthermore, videolaryngoscopes and the Macintosh direct laryngoscope may be considered clinically equivalent for the time taken for tracheal intubation. However, despite the rankings from our analyses, the current available evidence is not sufficient to ensure significant superiority of one device or a small set of them over the others for our intubation-related outcomes.

Nutrient digetibility and production responses of lactating dairy cows when saturated free fatty acid supplements are included in diets: A meta-analysis.

Our objective was to perform a series of meta-analyses to evaluate the effects of diets supplemented with saturated free fatty acid (FA) supplements (SFAA) compared with nonfat supplemented control diets (CON) on nutrient digestibility and production responses of lactating dairy cows and to determine whether experimental design affects responses to SFFA. We divided SFFA into C16:0-enriched supplements (PALM, FA supplements with ≥80% C16:0) and C16:0+C18:0-enriched supplements (MIX, FA supplements with ≥80% C16:0+C18:0). The database was formed from 32 peer-reviewed publications with SFFA supplemented at ≤3% diet dry matter (DM). We completed 3 different meta-analyses to meet our objectives. We analyzed the interaction between experimental design (continuous vs. change-over) and treatments (CON vs. SFFA; Meta.1). Regardless of experimental design, we evaluated the effect of treatment (CON vs. PALM vs. MIX; Meta.2) and the effect of 1-percentage-unit increase of MIX and PALM in diet DM (Meta.3). In Meta.1, there was no interaction between treatments and experimental design for any variable. In Meta.2, compared with CON, MIX had no effect on NDF digestibility, milk protein yield and energy corrected milk (ECM), increased the yields of milk (1.20 kg/d) and milk fat (0.04 kg/d), and decreased FA digestibility (5.20 percentage units). Compared with CON, PALM increased NDF digestibility (4.50 percentage units), the yields of milk (1.60 kg/d), milk fat (0.10 kg/d), milk protein (0.04 kg/d), and ECM (2.00 kg/d), and had no effect on FA digestibility. Compared with MIX, PALM tended to increase FA digestibility (3.20 percentage units), increased NDF digestibility (3.50 percentage units), milk fat yield (0.06 kg/d), and ECM (1.20 kg/d). In Meta.3, for each 1-percentage-unit increase of supplemental FA in diet DM, MIX had no effect on NDF digestibility, decreased FA digestibility, increased the yields of milk and milk fat, had no effect on milk protein yield, ECM and milk fat content, and decreased milk protein content. For each 1-percentage-unit increase of supplemental FA in diet DM, PALM increased NDF digestibility, had no effect on FA digestibility, increased the yields of milk, milk fat, ECM and milk fat content, tended to increase milk protein yield, and had no effect on milk protein content. Our results indicate no reason for the restrictive use of change-over designs in saturated FA supplementation studies and meta-analyses. Lactating dairy cows responded better to a FA supplement enriched in C16:0 compared with one containing C16:0 and C18:0.

Abomasal infusion of oleic acid increases fatty acid digestibility and plasma insulin of lactating dairy cows.

Our objective was to determine whether abomasal infusions of increasing doses of oleic acid (cis-9 C18:1; OA) improved fatty acid (FA) digestibility and milk production of lactating dairy cows. Eight rumen-cannulated multiparous Holstein cows (138 d in milk ± 52) were randomly assigned to treatment sequence in a replicated 4 × 4 Latin square design with 18-d periods consisting of 7 d of washout and 11 d of infusion. Production and digestibility data were collected during the last 4 d of each infusion period. Treatments were 0, 20, 40, or 60 g/d of OA. We dissolved OA in ethanol before infusions. The infusate solution was divided into 4 equal infusions per day, occurring every 6 h, delivering the daily cis-9 C18:1 for each treatment. Animals received the same diet throughout the study, which contained (percent diet dry matter) 28% neutral detergent fiber, 17% crude protein, 27% starch, and 3.3% FA (including 1.8% FA from a saturated FA supplement containing 32% C16:0 and 52% C18:0). Infusion of OA did not affect intake or digestibility of dry matter and neutral detergent fiber. Increasing OA from 0 to 60 g/d linearly increased the digestibility of total FA (8.40 percentage units), 16-carbon FA (8.30 percentage units), and 18-carbon FA (8.60 percentage units). Therefore, increasing OA linearly increased absorbed total FA (162 g/d), 16-carbon FA (26.0 g/d), and 18-carbon FA (127 g/d). Increasing OA linearly increased milk yield (4.30 kg/d), milk fat yield (0.10 kg/d), milk lactose yield (0.22 kg/d), 3.5% fat-corrected milk (3.90 kg/d), and energy-corrected milk (3.70 kg/d) and tended to increase milk protein yield. Increasing OA did not affect the yield of mixed milk FA but increased yield of preformed milk FA (65.0 g/d) and tended to increase the yield of de novo milk FA. Increasing OA quadratically increased plasma insulin concentration with an increase of 0.18 µg/L at 40 g/d OA, and linearly increased the content of cis-9 C18:1 in plasma triglycerides by 2.82 g/100 g. In conclusion, OA infusion increased FA digestibility and absorption, milk fat yield, and circulating insulin without negatively affecting dry matter intake. In our short-term infusion study, most of the digestion and production measurements responded linearly, indicating that 60 g/d OA was the best dose. Because a quadratic response was not observed, improvements in FA digestibility and production might continue with higher doses of OA, which deserves further attention.

Effects of calcium salts of palm fatty acids on nutrient digestibility and production responses of lactating dairy cows: A meta-analysis and meta-regression.

Our primary objective was to perform a meta-analysis and meta-regression to evaluate the effects of diets supplemented with calcium salts of palm fatty acids (CSPF) compared with nonfat supplemented control diets (CON) on nutrient digestibility and production responses of lactating dairy cows. Our secondary objective was to perform a meta-analysis to evaluate whether experimental design affects production responses to supplemental CSPF. The data set was formed from 33 peer-reviewed publications with CSPF supplemented at ≤3% diet dry matter. We analyzed the interaction between experimental design (continuous vs. change-over) and treatments (CON vs. CSPF) to evaluate whether experimental design affects responses to CSPF (Meta.1). Regardless of experimental design, we evaluated the effects of CSPF compared with CON on nutrient digestibility and production responses of lactating dairy cows by meta-analysis (Meta.2) and meta-regression (Meta.3) approaches. In Meta.1, there was no interaction between treatments and experimental design for any variable. In Meta.2, compared with CON, CSPF reduced dry matter intake [DMI, 0.56 ± 0.21 kg/d (±SE)] and milk protein content (0.05 ± 0.02 g/100 g), increased neutral detergent fiber (NDF) digestibility (1.60 ± 0.57 percentage units), the yields of milk (1.53 ± 0.56 kg/d), milk fat (0.04 ± 0.02 kg/d), and 3.5% fat corrected milk (FCM, 1.28 ± 0.60 kg/d), and improved feed efficiency [energy corrected milk (ECM)/DMI, 0.08 kg/kg ± 0.03]. There was no effect of treatment for milk protein yield, milk fat content, body weight, body weight change, or body condition score. Compared with CON, CSPF reduced the yield of de novo milk fatty acids (FA) and increased the yields of mixed and preformed milk FA. In Meta.3, we observed that each 1-percentage-unit increase of CSPF in diet dry matter reduced DMI, increased NDF digestibility, tended to increase FA digestibility, increased the yields of milk, milk fat, and 3.5% FCM, reduced the content of milk protein, reduced the yield of de novo milk FA, and increased the yields of mixed and preformed milk FA. In conclusion, our results indicate no reason for the restrictive use of change-over designs in CSPF supplementation studies or meta-analysis. Feeding CSPF increased NDF digestibility, tended to increase FA digestibility, and increased the yields of milk, milk fat, and 3.5% FCM. Additionally, CSPF increased milk fat yield by increasing the yields of mixed and preformed milk FA.

Spotting intruders: Species distribution models for managing invasive intertidal macroalgae.

Invasive macroalgae represent one of the major threats to marine biodiversity, ecosystem functioning and structure, as well as being important drivers of ecosystem services depletion. Many such species have become well established along the west coast of the Iberian Peninsula. However, the lack of information about the distribution of the invaders and the factors determining their occurrence make bioinvasions a difficult issue to manage. Such information is key to enabling the design and implementation of effective management plans. The present study aimed to map the current probability of presence of six invasive macroalgae: Grateloupia turuturu, Asparagopsis armata, Colpomenia peregrina, Sargassum muticum, Undaria pinnatifida, and Codium fragile ssp. fragile. For this purpose, an extensive field survey was carried out along the coast of the north-western Iberian Peninsula. Species distribution models (SDMs) were then used to map the presence probability of these invasive species throughout the study region on the basis of environmental and anthropogenic predictor variables. The southern Galician rias were identified as the main hotspots of macroalgal invasion, with a high probability of occurrence for most of the species considered. Conversely, the probability of presence on the Portuguese coast was generally low. Physico-chemical variables were the most important factors for predicting the distribution of invasive macroalgae contributing between 57.27 and 85.24% to the ensemble models. However, anthropogenic factors (including size of vessels, number of shipping lines, distance from ports, population density, etc.) considerably improved the estimates of the probability of occurrence for most of the target species. This study is one of the few to include anthropogenic factors in SDMs for invasive macroalgae. The findings suggest that management actions aimed at controlling these species should strengthen control and surveillance at ports, particularly in southern Galician rias. Early detection should be of main concern for risk assessment plans on the Portuguese coast.

Túnica vaginal autógena para herniorrafia perineal em cães / Autogenous tunica vaginalis for perineal herniorrhaphy in dogs

A túnica vaginal possui características ideais para enxertia e já foi empregada na reparação de diversos tecidos, inclusive do diafragma pélvico. Objetivou-se avaliar a aplicabilidade da túnica vaginal como enxerto autógeno livre, em dupla camada, para a reparação do diafragma pélvico em 14 cães portadores de hérnia perineal, das quais, nove eram unilaterais e cinco, bilaterais. Após a orquiectomia, as túnicas de ambos os testículos foram coletadas, sobrepostas e fixadas entre si por meio de quatro pontos de reparo. Foi realizada abordagem ao saco herniário, inspeção, redução do conteúdo herniário, desbridamento muscular e síntese primária mediante sutura. O enxerto foi fixado à musculatura remanescente por meio de pontos simples separados e, posteriormente, encoberto pela sutura intradérmica e por síntese cutânea. Observações transoperatórias e, posteriormente, avaliações clínicas e ultrassonográficas, por período de um ano, permitiram sugerir que a túnica vaginal possui atributos ideais para a reparação do diafragma pélvico. Conclui-se que o enxerto autógeno livre de túnica vaginal, em dupla camada, é exequível e aplicável para o reparo do diafragma pélvico no tratamento da hérnia perineal em cães.(AU)

The tunica vaginalis has ideal characteristics for grafting and has already been used to repair several tissues, including the pelvic diaphragm. The aim of this study was to evaluate the applicability of the tunica vaginalis as a free double-layer autogenous graft to repair the pelvic diaphragm in 14 dogs with perineal hernia, of which, nine were unilateral and five, bilateral. After orchiectomy, the tunics of both testicles were collected, overlapped and fixed to each other by four repair points. The hernial sac was approached, followed by inspection, reduction of the hernia content, muscle debridement and primary synthesis through suture. The graft was attached to the remaining musculature by simple interrupted stitches and later hidden by intradermal suture and cutaneous synthesis. Intraoperative observations and, later, clinical and sonographic evaluations over a one-year period, allow to suggest that the tunica vaginalis has ideal attributes for the pelvic diaphragm repair. It is concluded that the autogenous graft-free of tunica vaginalis in double layer is feasible and applicable in order to repair the pelvic diaphragm in the perineal hernia treatment in dogs.(AU)

Pre-operative voice evaluation as a hypothetical predictor of difficult laryngoscopy

We examined the potential for voice sounds to predict a difficult airway as compared with prediction by the modified Mallampati test. A total of 453 patients scheduled for elective surgery under general anaesthesia with tracheal intubation were studied. Five phonemes were recorded and their formants analysed. Difficult laryngoscopy was defined as the Cormack-Lehane grade 3 or 4. Univariate and multivariate logistic regression were used to examine the association between some variables (mouth opening, sternomental distance, modified Mallampati and formants) and difficult laryngoscopy. Difficult laryngoscopy was reported in 29/453 (6.4%) patients. Among five regression models evaluated, the model achieving better performance to predict difficult laryngoscopy, after a variable selection criteria (stepwise, multivariate) and included a modified Mallampati classification (OR 2.920; 95%CI 1.992-4.279; p < 0.001), first formant of /i/(iF1) (OR 1.003; 95%CI 1.002-1.04; p < 0.001), and second formant of /i/(iF2) (OR 0.998; 95%CI 0.997-0.998; p < 0.001). The receiver operating curve for a regression model that included both formants and Mallampati showed an area under curve of 0.918, higher than formants alone (area under curve 0.761) and modified Mallampati alone (area under curve 0.874). Voice presented a significant association with difficult laryngoscopy during general anaesthesia showing a 76.1% probability of correctly classifying a randomly selected patient. (AU)

Pre-operative voice evaluation as a hypothetical predictor of difficult laryngoscopy.

We examined the potential for voice sounds to predict a difficult airway as compared with prediction by the modified Mallampati test. A total of 453 patients scheduled for elective surgery under general anaesthesia with tracheal intubation were studied. Five phonemes were recorded and their formants analysed. Difficult laryngoscopy was defined as the Cormack-Lehane grade 3 or 4. Univariate and multivariate logistic regression were used to examine the association between some variables (mouth opening, sternomental distance, modified Mallampati and formants) and difficult laryngoscopy. Difficult laryngoscopy was reported in 29/453 (6.4%) patients. Among five regression models evaluated, the model achieving better performance to predict difficult laryngoscopy, after a variable selection criteria (stepwise, multivariate) and included a modified Mallampati classification (OR 2.920; 95%CI 1.992-4.279; p < 0.001), first formant of /i/(iF1) (OR 1.003; 95%CI 1.002-1.04; p < 0.001), and second formant of /i/(iF2) (OR 0.998; 95%CI 0.997-0.998; p < 0.001). The receiver operating curve for a regression model that included both formants and Mallampati showed an area under curve of 0.918, higher than formants alone (area under curve 0.761) and modified Mallampati alone (area under curve 0.874). Voice presented a significant association with difficult laryngoscopy during general anaesthesia showing a 76.1% probability of correctly classifying a randomly selected patient.

Ropivacaína isolada ou associada à metadona ou à morfina, pela via epidural, em cadelas submetidas à ovário-histerectomia / Ropivacaine sole or associated to methadone or morphine, by epidural route, in bitches undergoing ovariohysterectomy

Objetivou-se avaliar os efeitos fisiológicos, sedativos e analgésicos da administração peridural de ropivacaína isolada ou associada à morfina ou à metadona. Para tal, 24 cadelas submetidas à ovário-histerectomia receberam acepromazina, e a anestesia foi induzida e mantida com propofol e isoflurano (FiO2 = 1,0), respectivamente. De acordo com o protocolo peridural, formaram-se três grupos de igual número: GR (ropivacaína - 2,0mg/kg); GRMETA (ropivacaína - 2,0mg/kg e metadona - 0,3mg/kg) e GRMORF (ropivacaína - 2,0mg/kg e morfina - 0,1mg/kg). Registraram-se os parâmetros fisiológicos intraoperatórios e os graus de sedação e analgesia pós-operatórios. No GR constataram-se maiores médias de pressões arteriais 30 minutos após a anestesia epidural em relação ao GRMETA (sistólica e média) e ao final do procedimento cirúrgico comparativamente ao GRMORF (sistólica, diastólica e média). Não foram observadas diferenças significativas entre os grupos relativamente à analgesia e ao grau de sedação pós-operatórios. A administração epidural de ropivacaína é segura e eficaz e proporciona boa analgesia, independentemente da sua associação com morfina ou metadona.(AU)

The aim of this study was to evaluate the physiological, sedative and analgesic effects of epidural administration of ropivacaine sole or associated to morphine or methadone. Twenty-four bitches were submitted to ovariohysterectomy and received acepromazine and after, propofol and isoflurane (FiO 2 = 1.0) for anesthesia induction and maintenance, respectively. Based on established epidural protocol (L7-S1), three groups were formed: GR (ropivacaine - 2.0mg/kg); GRMETA (ropivacaine - 2.0mg/kg and methadone - 0.3mg/kg) and GRMORF (ropivacaine - 2.0mg/kg and morphine - 0.1mg/kg). Intraoperative physiological parameters and degrees of postoperative sedation and analgesia were recorded. In the GR, the means of arterial pressures, 30 minutes after epidural anesthesia, were higher compared with GRMETA (systolic and mean) and, at the end of the clinical procedure, compared to GRMORF (systolic, diastolic and mean). Differences between groups were not observed for postoperative analgesia and degree of sedation. Epidural administration of ropivacaine is safe and effective and provides good analgesia regardless of its association with morphine or methadone.(AU)

C-phycocyanin to overcome the multidrug resistance phenotype in human erythroleukemias with or without interaction with ABC transporters.

The phenotype of multidrug resistance (MDR) is one of the main causes of chemotherapy failure. Our study investigated the effect of C-phycocyanin (C-PC) in three human erythroleukemia cell lines with or without the MDR phenotype: K562 (non-MDR; no overexpression of drug efflux proteins), K562-Lucena (MDR; overexpression of ATP-binding cassette, sub-family B/ABCB1), and FEPS (MDR; overexpression of ABCB1 and ATP-binding cassette, sub-family C/ABCC1). Using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, we showed that 20 and 200 µg/mL C-PC decreased K562 viable cells after 24 h and 200 µg/mL C-PC decreased K562-Lucena cell proliferation after 48 h. C-PC did not decrease viable cells of FEPS cells. On the other hand, the MTT assay showed that exposure of 2, 20, and 200 µg/mL C-PC for 24 or 48 h was not cytotoxic to peritoneal macrophages. At 72 h, the trypan blue exclusion assay showed that 20 µg/mL C-PC decreased K562 and K562-Lucena cell proliferation and in FEPS cells, only 200 µg/mL C-PC decreased proliferation. In addition, protein-protein docking showed differences in energy and binding sites of ABCB1 and ABCC1 for C-PC, and these results were confirmed by the efflux protein activity assay. Only ABCC1 activity was altered in the presence of C-PC and FEPS cells showed lower C-PC accumulation, suggesting C-PC extrusion by ABCC1, conferring C-PC resistance. In combination with chemotherapy (vincristine [VCR] and daunorubicin [DNR]), the sensitivity of K562-Lucena cells for C-PC + VCR did not increase, whereas FEPS cell sensitivity for C-PC + DNR was increased. In molecular docking experiments, the estimated free energies of binding for C-PC associated with chemotherapy were similar (VCR: -6.9 kcal/mol and DNR: -7.2 kcal/mol) and these drugs were located within the C-PC cavity. However, C-PC exhibited specificity for tumor cells and K562 cells were more sensitive than K562-Lucena cells, followed by FEPS cells. Thus, C-PC is a possible chemotherapeutic agent for cells with the MDR phenotype, both alone in K562-Lucena cells (resistance due to ABCB1), or in combination with other drugs for cells similar to FEPS (resistance due to ABCC1). Moreover, C-PC did not damage healthy cells (peritoneal macrophages of Mus musculus).

Cyclosporine Versus Tacrolimus: Which Calcineurin Inhibitor Has Influence on Cytomegalovirus Infection in Cardiac Transplantation?

INTRODUCTION: Cytomegalovirus (CMV) infection is a relevant cause of morbidity and mortality in transplantation patients. Its major incidence is in the first year and viral replication is related to acute rejection, survival reduction, and graft vascular disease. OBJECTIVE: This study aims to evaluate retrospectively whether a high dose of calcineurin inhibitors correlates with CMV-positive polymerase chain reaction (PCR), need for treatment, and death in cardiac transplantation patients. METHODS: This is a case-control study including patients who underwent transplantation between 2014 and 2016. They were separated into two groups (positive or negative PCR) and evaluated for dosage serum levels of cyclosporine and tacrolimus. Patients were classified with adequate dose of immunosuppressant or high dose, and was analyzed that there was any association with those and positive CMV-PCR, need for treatment for CMV, and deaths. For statistical analysis, the Student t test was used for the quantitative variables and the Fisher's Exact Test for qualitative variables. To show CMV-free survival, the Kaplan-Meier curve was used. The level of significance was set at 5%. RESULTS: CMV-positive PCR in the sample was 72% for a total of 50 individuals. Positive PCR correlated with a high dose of calcineurin inhibitors in a statistically significant way (P = .002), as did a high dose of cyclosporine (P = .004); however, a high dose of tacrolimus had no such association (P = .17). When a high dose was assessed with a need for treatment, the chance of needing treatment increased more than eight times (P = .024; odds ratio = 8.25; 95% CI = 1.33 to 51.26), which was different from results found with high-dose tacrolimus (P = 1.0). However, no significant association was found in relation to deaths. CONCLUSIONS: Tacrolimus serum levels showed no association with CMV-PCR, which was different from serum cyclosporine, which showed association with CMV-PCR positivity, increasing the need for treatment approximately 8-fold, without association with death.

Cyclosporine Versus Tacrolimus: Which Calcineurin Inhibitor Has Influence on Cytomegalovirus Infection in Cardiac Transplantation?

INTRODUCTION: Cytomegalovirus (CMV) infection is a relevant cause of morbidity and mortality in transplantation patients. Its major incidence is in the first year and viral replication is related to acute rejection, survival reduction, and graft vascular disease. Objective. This study aims to evaluate retrospectively whether a high dose of calcineurin inhibitors correlates with CMV-positive polymerase chain reaction (PCR), need for treatment, and death in cardiac transplantation patients. Methods. This is a case-control study including patients who underwent transplantation between 2014 and 2016. They were separated into two groups (positive or negative PCR) and evaluated for dosage serum levels of cyclosporine and tacrolimus. Patients were classified with adequate dose of immunosuppressant or high dose, and was analyzed that there was any association with those and positive CMV-PCR, need for treatment for CMV, and deaths. For statistical analysis, the Student t test was used for the quantitative variables and the Fisher's Exact Test for qualitative variables. To show CMV-free survival, the Kaplan-Meier curve was used. The level of significance was set at 5%. Results. CMV-positive PCR in the sample was 72% for a total of 50 individuals. Positive PCR correlated with a high dose of calcineurin inhibitors in a statistically significant way (P » .002), as did a high dose of cyclosporine (P » .004); however, a high dose of tacrolimus had no such association (P » .17). When a high dose was assessed with a need for treatment, the chance of needing treatment increased more than eight times (P » .024; odds ratio » 8.25; 95% CI » 1.33 to 51.26), which was different from results found with high-dose tacrolimus (P » 1.0). However, no significant association was found in relation to deaths. Conclusions. Tacrolimus serum levels showed no association with CMV-PCR, which was different from serum cyclosporine, which showed association with CMV-PCR positivity, increasing the need for treatment approximately 8-fold, without association with death.

Lower levels of dehydroepiandrosterone sulfate are associated with more advanced liver fibrosis in chronic hepatitis C.

Chronic infection with the hepatitis C virus induces liver fibrosis, but it is unknown why some patients progress to advanced fibrosis while others remain with mild disease. Recently, an inverse association between serum levels of dehydroepiandrosterone sulphate (DHEA-S) and liver fibrosis in patients with nonalcoholic fatty liver disease was described, and it was postulated that dehydroepiandrosterone (DHEA) has antifibrotic effects. Our aim was to compare serum DHEA-S levels with liver fibrosis in hepatitis C patients. We collected serum samples from hepatitis C patients at the same day they underwent a liver biopsy. S-DHEA was compared to different stages of fibrosis. Binary logistic regression models were applied to evaluate independent variables associated to fibrosis. We included 287 patients (43.9% male). According to fibrosis stages 0, 1, 2, 3 and 4, median serum DHEA-S levels were 103 (26-462), 73 (5-391), 46 (4-425), 35 (6-292) and 28 (2-115) µg/dL, respectively (P < .001). Median serum DHEA-S levels were 74 (5-462) vs 36 (2-425) µg/dL for mild (F0-1) vs significant (F2-4) fibrosis, respectively (P < .001). Median serum DHEA-S levels were 64 (4-462) vs 31 (2-292) µg/dL for non advanced (F0-2) vs advanced fibrosis (F3-4), respectively (P < .001). The same association was found when the subgroup of HCV patients with and without steatosis or steatohepatitis was analysed. The association between lower DHEA-S levels and advanced fibrosis was independent of age, gender, diabetes mellitus, obesity and steatosis. Lower circulating DHEA-S levels are associated with more advanced stages of liver fibrosis in hepatitis C patients.

Avaliação da dexmedetomidina e do tramadol, associados ao midazolam, em gatas anestesiadas com isoflurano e submetidas à ovário-histerectomia / Evaluation of dexmedetomidine and tramadol, associated with midazolam, in cats anesthetized with isoflurane, undergoing ovariohysterectomy

Objetivou-se comparar as alterações cardiorrespiratórias e a analgesia pós-operatória promovidas pela dexmedetomidina e pelo tramadol, quando associados ao midazolam, em felinas. Para tal, foram selecionadas 18 gatas hígidas, divididas em dois grupos randomizados: GDM, tratadas com dexmedetomidina (10µg/kg) e GTM, tratadas com tramadol (2mg/kg), ambos associados a midazolam (0,2mg/kg,) IM. Após 15 minutos, procedeu-se à indução anestésica com propofol (1,46±0,79mL), mantendo-se a anestesia com isoflurano. As felinas foram submetidas à ovário-histerectomia, registrando-se as variáveis cardiorrespiratórias 15 minutos após a MPA (M0), 15 minutos após a indução (M15) e sequencialmente a cada cinco minutos, até o término do procedimento cirúrgico (M20, M25, M30, M35 e M40). A avaliação da dor iniciou-se 30 minutos após o término do procedimento cirúrgico (MP30) e sequencialmente em intervalos de 30 minutos (MP60, MP90, MP120). A partir do MP120, as avaliações foram registradas a cada hora (MP180, MP240 e MP360). A associação dexmedetomidina-midazolam infere diminuição inicial de frequência cardíaca (FC) sem significado clínico e está relacionada à sedação mais pronunciada, à analgesia menor e menos duradoura e a episódios de êmese, quando comparada à associação tramadol-midazolam. Ambos os protocolos denotaram estabilidade cardiorrespiratória e podem ser considerados seguros em felinas submetidas à ovário-histectomia.(AU)

The aim of this study was to compare cardiorespiratory changes and post-operative analgesia provided by dexmedetomidine or tramadol, associated with midazolam, in female cats. For that purpose, 18 healthy cats were assigned to two randomized groups: GDM, which received dexmedetomidine (10 µg/kg) and GTM, which received tramadol (2 mg/kg), both associated with midazolam (0.2 mg/kg) IM. After 15 minutes, anesthesia was induced with propofol (1.46±0.79 mL) and maintained with isofluorane. Ovariohysterectomy was performed and cardiorespiratory variables were registered 15 minutes after pre-anesthetic medication (M0), 15 minutes after anesthetic induction (M15), and every five minutes until the end of the surgical procedure (M20, M25, M30, M35 e M40). Pain evaluation started 30 minutes after the surgery (MP30) and sequentially at thirty-minute intervals (MP60, MP90, MP120). After MP120, each evaluation was registered at every hour (MP180, MP240 e MP360). Dexmedetomidine-midazolam association results in decreases on initial heart rate (HR) without clinical relevance and it is related to pronounced sedation, poor and less durable antinociception and vomiting events, when compared to tramadol-midazolam association. Both protocols indicate cardiorespiratoy stability and safety in cats undergoing ovariohysterectomy.(AU)

Potential of autogenous or fresh-frozen allogeneic bone block grafts for bone remodelling: a histological, histometrical, and immunohistochemical analysis in rabbits.

Our aim was to compare the wound healing of autogenous bone grafts with that of fresh-frozen allogeneic block bone in rabbits. We used 25 animals. One was killed before the experiment to provide the allogeneic bone, and the remainder were killed at four time points (n=6 in each group). On histometrical analysis there was a significant difference between the two groups only at 45days and between 15 and 45days in the intergroup analysis. However, there was significantly more revascularisation (p<0.05), resorption (p<0.05), and bony replacement (p<0.05) in the autogenous group in the immunohistochemical analysis. In later periods, the autogenous bone was replaced by newly-formed bone in all samples, whereas it was always possible to find regions of devitalised bone in the fresh-frozen allogeneic bone grafts. Autogenous grafts were completely replaced whereas, in the fresh- frozen allogeneic grafts, we found acellular tissue that had been incorporated into the receptor bed interface during the later evaluation times.