Analysis of Doberman Pinscher and Toy Poodle samples with targeted next-generation sequencing.

Next-generation sequencing (NGS) technologies have enabled the identification of many causal variants of genetic disorders, the development of parentage tests and the analysis of multiple traits in domestic animals. In this study, we evaluated the performance of a Canine Targeted Genotyping-by-Sequencing (GBS) custom panel (Thermo Fisher Scientific, Waltham, Ma, USA) in a cohort of 95 dog DNA samples, comprising 76 Doberman Pinschers and 19 Toy Poodles from Argentina. The used panel included 383 targets (228 parentage SNVs, 137 genetic disorder markers and 18 trait markers). While paternity analysis showed correct duo (97.4%; LOD > 2.98E+13) and trio (100%; LOD > 2.20E+15) parentage assignment, the panel resulted still insufficient for excluding close relatives in inbred populations. In this sense, close relatives were wrongly assigned as parents in 12.6% of duos and 0.3% of trios. We detected 17 polymorphic markers (genetic disorders, n = 4; hair type, n = 3; coat color, n = 10) and estimated their allele frequencies in the studied breeds. The accuracy of targeted GBS results were evaluated for three markers that were associated with Progressive rod-cone degeneration, von Willebrand disease type 1 and dilated cardiomyopathy by pyrosequencing and Sanger sequencing genotyping, showing 94-100% concordance among assays. The targeted GBS custom panel resulted cost-effective strategy to study the prevalence of genetic disorders and traits in a large number of samples and to analyze genetic interactions between previously reported variants. Once assays based on AgriSeq technology were standardized, their uses are a good strategy for large-scale routine genetic evaluation of animal populations.

Recomendaciones para el tratamiento nutrometabólico especializado del paciente crítico: monitorización y seguridad. Grupo de Trabajo de Metabolismo y Nutrición de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) / Recommendations for specialized nutritional-metabolic management of the critical patient: Monitoring and safety. Metabolism and Nutrition Working Group of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC)

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Echocardiographic and electrocardiographic parameters during the normal postpartum period in toy breeds of dogs.

The aim of this study was to evaluate echocardiographic and electrocardiographic parameters during the normal canine postpartum period. Twenty clinically healthy pregnant bitches of toy breeds (11 Miniature poodles, five Yorkshire terriers, two Maltese terriers and two Bichons Frises) were evaluated on days -3, 3, 10, 17, 24, 38, 52 and 80 relative to parturition (day 0). During the first postpartum week, the width of the interventricular septum in systole, the shortening fraction and the left atrium size decreased, while the left ventricle internal diameter in systole and end systolic stress increased. There were progressive decreases in the velocity of circumferential fibre shortening, stroke volume, cardiac output, and mitral E and A wave values. Systolic blood pressure increased markedly during the first postpartum week to gradually increase thereafter. Heart rate and corrected QT interval progressively decreased, while P wave amplitude increased. QRS complex amplitude decreased in the second week after parturition and then increased during the following weeks. In conclusion, there were changes in systolic function and some structural adaptive changes in the bitch during the first 80days postpartum. In addition, maternal heart rate and corrected QT interval decreased, while P wave and QRS amplitudes increased.

Soporte nutricional en el paciente obeso crítico / Nutritional support in the obese critically ill patient

La prevalencia de la obesidad ha aumentado en todo el mundo desarrollado, hasta alcanzar una dimensión casi epidémica. Muchos pacientes obesos precisan ingreso en Medicina Intensiva, tanto por su patología de base como por descompensaciones agudas de alguna de sus comorbilidades, requiriendo un soporte nutricional especializado que contribuya a su recuperación global. El paciente obeso crítico, como respuesta al estrés metabólico, tiene igual riesgo de depleción nutricional que el paciente no obeso, pudiendo desarrollar una malnutrición energético-proteica con una acelerada degradación de masa muscular. Se ha constatado que la obesidad está estrechamente ligada con la resistencia a la acción de la insulina, que se une a la habitualmente existente en el paciente crítico y que, junto con el aumento de la producción endógena de glucosa y la menor capacidad para su oxidación, conducen a la hiperglucemia y a un aumento de las complicaciones globales y peor pronóstico. El primer objetivo del soporte nutricional en el paciente obeso crítico debe ser minimizar la pérdida de masa magra y realizar una evaluación adecuada del gasto energético, pero la aplicación de las fórmulas habituales para el cálculo de las necesidades calóricas puede sobreestimarlas si se utiliza el peso real, por lo que sería más correcto su aplicación con el peso ajustado. La controversia se centra en si hay que aplicar un criterio estricto de soporte nutricional ajustado a los requerimientos o se aplica un cierto grado de hiponutrición permisiva. La evidencia actual sugiere que la nutrición hipocalórica puede mejorar los resultados, en parte debido a una menor tasa de complicaciones infecciosas y a la disminución de la hiperglucemia, por lo que la nutrición hipocalórica e hiperprotéica, tanto enteral como parenteral, debe ser la práctica estándar en el soporte nutricional del paciente obeso crítico, si no hay contraindicaciones para ello. Las recomendaciones de la American Society for Parenteral and Enteral Nutrition (ASPEN) para el paciente obeso crítico se centran en no exceder del 60%- 70% de los requerimientos o 11-14 kcal/kg peso actual/d o 22-25 kcal/kg peso ideal/d, con 2-2,5 g/kg peso ideal/d de proteínas. La European Society for Clinical Nutrition and Metabolism (ESPEN) no da una recomendación específica. Puede considerarse a la nutrición hipocalórica-hiperproteica como específica del paciente obeso crítico, aunque las complicaciones ligadas a su comorbilidad hacen que se planteen otras posibilidades terapéuticas, con nutrientes específicos para hiperglucemia, síndrome del distress respiratorio agudo (SDRA) y sepsis, aunque no existe ningún estudio prospectivo y aleatorio en este concreto subgrupo de población y los datos de que disponemos se extraen de una población general de pacientes críticos, por lo que deben tomarse con mucha precaución. Para la hiperglucemia, como coadyuvante de la insulina, se ha constatado un control más efectivo en el efecto tratamiento, concentraciones pico y área bajo la curva con las fórmulas específicas para el paciente diabético frente a las estándar. ASPEN (grado A) y ESPEN (grado B) recomiendan la utilización de dietas con omega-3 y antioxidantes en el SDRA. La utilización de glutamina para el control de las complicaciones infecciosas y la propia hiperglucemia, es recomendada por ASPEN (grado C) como suplementación en nutrición parenteral (0,3-0,6 g/kg/d) y por ASPEN (grado B) y ESPEN (grado A) en nutrición enteral (0,3-0,5 g/kg/d) en quemados y trauma. Se desaconseja la utilización de arginina en sepsis grave (APACHE II > 15) (AU)

Obesity prevalence has increased in all developed countries until reaching almost an epidemic status. Many obese patients require admission to an Intensive Care Unit, because of both their baseline condition and acute decompensation of any of their comorbidities, requiring specialized nutritional support that contributes to their global recovery. The critically ill obese patient, in response to the metabolic stress, presents the same risk for nutritional depletion as non-obese patients, being able of developing accelerated energy-protein malnourishment and muscle mass degradation. It has been observed that obesity is closely linked to resistance to the action of the insulin, which usually combines with the resistance already present in the critically ill patient, and which, together with the increase in endogenous glucose production and the lessen oxidation capacity, will lead to hyperglycaemia and an increase in global complications and poorer outcomes. The main objective of nutritional support in the obese critically ill patient should be minimizing the loss of lean mass and performing an appropriate assessment of the energy waste, although the application of the usual calculations for the caloric requirements may overestimate them if the real weight is used, so it would be more appropriate to apply them with the adjusted weight. The controversy lays in whether applying a stringent criterion of nutritional support adjusted to the demands or a certain degree of permissive hyponutrition. The current evidence suggests that hypocaloric nutrition may improve the results, in part due to the lower rate of infectious complications and decreased hyperglycaemia, so that both enteral and parenteral hypocaloric and hyperproteic nutrition should be the standard practice for nutritional support in the critically ill obese patient, provided that there are no contraindications to it. The recommendations of the American Society for Parenteral and Enteral Nutrition (ASPEN) for the obese critically ill patient are focused on not exceeding 60%- 70% of the requirements or 11-14 kcal/kg real weight/d or 22-25 kcal/kg ideal weight/d, with 2-2.5 g/kg ideal weight/d of proteins. The European Society for Clinical Nutrition and Metabolism (ESPEN) does not provide a specific recommendation. Hypocaloric-hyperproteic nutrition may be considered especific for (.....) (AU)

Manual básico de nutrición clínica y dietética

Documento que pretende establecer unas pautas comunes de comportamiento en el manejo de la terapéutica nutricional hospitalaria. Contiene: principios generales, dietética y dietoterapia, nutrición enteral, nutrición parenteral, nutrición artificial en situaciones especiales : nutrición específica, nutrición en pediatría, etc.

[Recommendations for nutritional assessment and specialized nutritional support of critically ill patients]. / Recomendaciones para la valoración nutricional y el soporte nutricional especializado de los pacientes críticos.

Due to the characteristics of critically ill patients, elaborating recommendations on nutritional support for these patients is difficult. Usually the time of onset of nutritional support or its features are not well established, so that its application is based on experts' opinion. In the present document, recommendations formulated by the Metabolism and Nutrition Working Group of the Spanish Society of Intensive and Critical Medicine and Coronary Units (SEMICYUC) are presented. Recommendations are based on the literature analysis and further discussion by the working group members in order to define, consensually, the more relevant issues of metabolic and nutritional support of patients in a critical condition. Several clinical situations have been considered which are developed in the following articles of this publication. The present recommendations aim at providing a guideline for the less experienced clinicians when considering the metabolic and nutritional issues of critically ill patients.

[Artificial nutrition in hyperglycemia and diabetes mellitus in critically ill patients]. / Nutrición artificial en la hiperglucemia y diabetes mellitus en pacientes críticos.

The need to strictly control glucose levels, even in nondiabetic patients, has recently emerged following the publication of the results that indicate the possibility of reducing the morbidity and mortality in critically ill patients. Since hyperglycemia is one of the most frequent metabolic impairments in these patients, insulin therapy is a necessity in most of the cases. In order to prevent hyperglycemia and its associated complications, nutritional support must be adjusted to the patient's requirements, avoiding hyponutrition. Whenever possible, nutrients supply should be done through the digestive route. Parenteral nutrition is more often accompanied by hyperglycemia and requires an increase in insulin dosage to control it. There are two types of enteral diets designed to help controlling hyperglycemic conditions: carbohydrates rich diets, and fat rich diets. In general terms, carbohydrates rich diets may be recommended in type 1 diabetic patients who are in a stable condition, and fat rich diets in type 2 diabetes and in stress hyperglycemia. In both cases, the use of low glycemic index carbohydrates is recommended. Protein intake should be adjusted to the patients' metabolic stress level. In diabetic patients with acute disease, an increase in antioxidants intake is recommended.

[Artificial nutrition in hematopoietic stem cells transplantation]. / Nutrición artificial en el trasplante de células precursoras hematopoyéticas.

Patients submitted to hematopoietic stem cells transplantation (HSCT) have an increased risk for having hyponutrition, both in the phase prior to transplantation and after this one. The indication of specialized nutritional support is common in allogenic HSCT, whereas patients submitted to auto-HSCT need it in the presence of complications that compromise an adequate nutrients intake. Enteral nutrition through a nasogastric tube has difficulties in these patients; the presence of mucositis delays the indication for enteral nutrition, which usually is poorly tolerated. Thus, frequently parenteral nutrition needs to be used as the route for nutritional support. The use of specific substrates, such as glutamine, is a controversial issue.

Recomendaciones para la valoración nutricional y el soporte nutricional especializado de los pacientes críticos / Recommendations for nutritional assessment and specialized nutritional support of critically ill patients

Debido a las características de los pacientes críticos, la elaboración de recomendaciones sobre el soporte nutricional en estos pacientes es difícil. En muchas ocasiones no está claramente establecido el momento de inicio del soporte nutricional ni las características del mismo, por lo que su aplicación está basada en opiniones de expertos. En el presente documento se presentan las recomendaciones elaboradas por el Grupo de Trabajo de Metabolismo y Nutrición de la sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC). Las recomendaciones están basadas en el análisis de la literatura y en la posterior discusión entre los miembros del grupo de trabajo para definir, mediante consenso, los aspectos más relevantes del soporte metabólico y nutricional de los pacientes en situación crítica. Se han considerado diferentes situaciones clínicas, que se desarrollan en los artículos siguientes de esta publicación. Las presentes recomendaciones pretenden servir de guía para los clínicos con menor experiencia en la consideración de los aspectos metabólicos y nutricionales de los pacientes críticos (AU)

Due to the characteristics of critically ill patients, elaborating recommendations on nutritional support for these patients is difficult. Usually the time of onset of nutritional support or its features are not well established, so that its application is based on experts' opinion. In the present document, recommendations formulated by the Metabolism and Nutrition Working Group of the Spanish Society of Intensive and Critical Medicine and Coronary Units (SEMICYUC) are presented. Recommendations are based on the literature analysis and further discussion by the working group members in order to define, consensually, the more relevant issues of metabolic and nutritional support of patients in a critical condition. Several clinical situations have been considered which are developed in the following articles of this publication. The present recommendations aim at providing a guideline for the less experienced clinicians when considering the metabolic and nutritional issues of critically ill patients (AU)

Nutrición artificial en la hiperglucemia y diabetes mellitus en pacientes críticos / Artificial nutrition in hyperglycemia and diabetes mellitus in critically ill patients

La necesidad de controlar de manera estricta los niveles de glucemia, incluso en pacientes no diabéticos, ha surgido recientemente tras la publicación de los resultados que indican que con ello puede conseguirse un descenso en la morbi-mortalidad de los pacientes críticos. Dado que la hiperglucemia es una de las alteraciones metabólicas predominantes en estos pacientes, el tratamiento con insulina es una necesidad en la mayoría de los casos. Con el fin de prevenir la hiperglucemia y sus complicaciones asociadas, el aporte energético debe ajustarse a los requerimientos de los pacientes, evitando la hipernutrición. Siempre que sea posible, deberá intentarse al aporte de nutrientes por vía digestiva. La nutrición parenteral se acompaña con mayor frecuencia de hiperglucemia y requiere un aumento en las dosis de insulina necesarias para su control. Existen dos tipos de dietas enterales diseñadas para ayudar a corregir las situaciones hiperglucémicas: dietas ricas en carbohidratos y dietas ricas en grasa. En líneas generales, pueden recomendarse las dietas ricas en hidratos de carbono en los pacientes diabéticos tipo 1 que se encuentren en situación estable y las dietas ricas en grasas en la diabetes tipo 2 y en la hiperglucemia de estrés. Se recomienda, en ambos casos, el empleo de hidratos de carbono con bajo índice glucémico. El aporte proteico debe ajustarse al nivel de estrés metabólico de los pacientes. Se recomienda un aumento en el aporte de antioxidantes en los pacientes diabéticos con enfermedad aguda (AU)

The need to strictly control glucose levels, even in non-diabetic patients, has recently emerged following the publication of the results that indicate the possibility of reducing the morbidity and mortality in critically ill patients. Since hyperglycemia is one of the most frequent metabolic impairments in these patients, insulin therapy is a necessity in most of the cases. In order to prevent hyperglycemia and its associated complications, nutritional support must be adjusted to the patient's requirements, avoiding hyponutrition. Whenever possible, nutrients supply should be done through the digestive route. Parenteral nutrition is more often accompanied by hyperglycemia and requires an increase in insulin dosage to control it. There are two types of enteral diets designed to help controlling hyperglycemic conditions: carbohydrates rich diets, and fat rich diets. In general terms, carbohydrates rich diets may be recommended in type 1 diabetic patients who are in a stable condition, and fat rich diets in type 2 diabetes and in stress hyperglycemia. In both cases, the use of low glycemic index carbohydrates is recommended. Protein in-take should be adjusted to the patients' metabolic stress level. In diabetic patients with acute disease, an increase in antioxidants intake is recommended (AU)

Prognostic factors in patients with IVDA and bacteremia.

The medical records of all the patients with bacteremia and recent use of illicit intravenous drugs admitted to Hospital Universitario Ramón Ruíz Arnau from January 1, 1988 to June 30, 1989 were reviewed. It consisted of 28 records, 21 of which were male patients and 7 females. The mortality rate among these patients was 46%. Staphylococcus aureus was the most common pathogen recovered from blood cultures. All the S. aureus were methicillin sensitive. The presence of clinical sepsis, a low Karnofsky performance status at the time of admission and multiorgan abnormalities were the most important prognostic factors that determined outcome in these patients.