Effect of castration timing and weaning strategy on the taxonomic and functional profile of ruminal bacteria and archaea of beef calves.

BACKGROUND: Beef cattle experience several management challenges across their lifecycle. Castration and weaning, two major interventions in the early life of beef cattle, can have a substantial impact on animal performance. Despite the key role of the rumen microbiome on productive traits of beef cattle, the effect of castration timing and weaning strategy on this microbial community has not been formally described. We assessed the effect of four castration time windows (at birth, turnout, pre-weaning and weaning) and two weaning strategies (fence-line and truck transportation) on the rumen microbiome in a randomized controlled study with 32 male calves across 3 collection days (i.e., time points). Ruminal fluid samples were submitted to shotgun metagenomic sequencing and changes in the taxonomic (microbiota) and functional profile (metagenome) of the rumen microbiome were described. RESULTS: Using a comprehensive yet stringent taxonomic classification approach, we identified 10,238 unique taxa classified under 40 bacterial and 7 archaeal phyla across all samples. Castration timing had a limited long-term impact on the rumen microbiota and was not associated with changes in alpha and beta diversity. The interaction of collection day and weaning strategy was associated with changes in the rumen microbiota, which experienced a significant decrease in alpha diversity and shifts in beta diversity within 48 h post-weaning, especially in calves abruptly weaned by truck transportation. Calves weaned using a fence-line weaning strategy had lower relative abundance of Bacteroides, Lachnospira, Fibrobacter and Ruminococcus genera compared to calves weaned by truck transportation. Some genes involved in the hydrogenotrophic methanogenesis pathway (fwdB and fwdF) had higher relative abundance in fence-line-weaned calves post-weaning. The antimicrobial resistance gene tetW consistently represented more than 50% of the resistome across time, weaning and castration groups, without significant changes in relative abundance. CONCLUSIONS: Within the context of this study, castration timing had limited long-term effects on the rumen microbiota, while weaning strategy had short-term effects on the rumen microbiota and methane-associated metagenome, but not on the rumen resistome.

A Rare Case of Recurrent Parathyroid Adenomas After Initial Parathyroidectomy.

Hyperparathyroidism usually presents asymptomatically with elevated levels of calcium and parathyroid hormone; this biochemical imbalance establishes the diagnosis. In 80-85% of cases of primary hyperparathyroidism, singular parathyroid adenomas occur. In rare cases, this problem occurs due to multiple adenomas, multiglandular hyperplasia, or parathyroid carcinoma. Recurrent primary hyperparathyroidism (R-PHPT), as demonstrated in this case, is defined as hypercalcemia that arises after six months of normocalcemia following initial surgery for PHPT. The aim of this report is to describe the diagnosis and management of three parathyroid adenomas in a patient, two of which occurred after an initial partial parathyroidectomy.

Dairy Manure Co-composting with Wood Biochar Plays a Critical Role in Meeting Global Methane Goals.

Livestock are the largest source of anthropogenic methane (CH4) emissions, and in intensive dairy systems, manure management can contribute half of livestock CH4. Recent policies such as California's short-lived climate pollutant reduction law (SB 1383) and the Global Methane Pledge call for cuts to livestock CH4 by 2030. However, investments in CH4 reduction strategies are primarily aimed at liquid dairy manure, whereas stockpiled solids remain a large source of CH4. Here, we measure the CH4 and net greenhouse gas reduction potential of dairy manure biochar-composting, a novel manure management strategy, through a composting experiment and life-cycle analysis. We found that biochar-composting reduces CH4 by 79%, compared to composting without biochar. In addition to reducing CH4 during composting, we show that the added climate benefit from biochar production and application contributes to a substantially reduced life-cycle global warming potential for biochar-composting: -535 kg CO2e Mg-1 manure compared to -194 kg CO2e Mg-1 for composting and 102 kg CO2e Mg-1 for stockpiling. If biochar-composting replaces manure stockpiling and complements anaerobic digestion, California could meet SB 1383 with 132 less digesters. When scaled up globally, biochar-composting could mitigate 1.59 Tg CH4 yr-1 while doubling the climate change mitigation potential from dairy manure management.

Pinto Bean Amino Acid Digestibility and Score in a Mexican Dish with Corn Tortilla and Guacamole, Evaluated in Adults Using a Dual-Tracer Isotopic Method.

BACKGROUND: Ultra-processed foodstuffs have been replacing traditional beans with tortillas in the Mexican diet in the last decades. Therefore, scientific support is needed to promote a return to good-quality traditional dishes. OBJECTIVES: This study aims to evaluate the amino acid digestibility and score of pinto beans (Phaseolus vulgaris) consumed with corn tortillas and guacamole in adults using the dual-tracer method. METHODS: The pinto beans were intrinsically labeled using 250 mL of 2H2O (99.8%) per 19 L pot with 3 plants. A paste of cooked beans on toasted corn tortillas and guacamole topping were administered to 3 male and 3 female adults (21-25 years old; BMI, 19-23.5 kg/m2). The protocol was plateau feeding given along with U-[13C]-spirulina protein to evaluate indispensable amino acid (IAA) digestibility using the dual-tracer method. Blood samples were taken in the plateau state. The digestibility of each IAA of the bean protein was calculated by the ratio of its enrichment in the beans to the spirulina in the meal and its appearance in plasma collected in the plateau state, as a percentage corrected by spirulina digestibility. Additionally, the digestible IAA score (DIAAS) was calculated. RESULTS: The 2H enrichment of IAA in the pinto beans was 471 parts per million excess. The isotopic enrichment of 2H and 13C in IAA at 5-8 hours presented plateau states with mean CVs of 12.2% and 13.3%, respectively. The mean digestibility of IAA from pinto beans was 77% ± 1.6%, with the lowest value for threonine. The DIAAS calculated with respect to the pattern requirement for children older than 3 years, adolescents, and adults was 83%, with methionine and cysteine being the limiting amino acids. CONCLUSIONS: A Mexican dish of pinto beans, tortillas, and guacamole is a good source of protein as evaluated in adults and could be promoted as a nutritious snack. The assay is registered with the Ethical Committee of the Centro de Investigación en Alimentación y Desarrollo, A.C. as CE/015/2019.

Universal approach for full endoscopic decompression and percutaneous transpedicular fixation of the lumbar spine: A medial central approach (ACM).

ABSTRACT: Cohort study.This study aimed to determine the effectiveness of the universal approach of full endoscopy and percutaneous transpedicular fixation via a medial central approach (ACM) performed to surgically treat patients with lumbar degenerative surgical pathologies.Alternatives to interventionist treatments available to patients with lumbar degenerative surgical pathologies are related to recovery from minimally invasive surgery. Considering this, full endoscopic spinal decompression (full endoscopy) and percutaneous transpedicular fixation via an ACM represent advances in neurosurgical procedures, in particular, spinal surgery. Thus, the introduction of endoscopic and minimally invasive surgeries for the lumbar region has become 1 of the most important advances in modern surgery.A cohort of 79 patients undergoing full endoscopy and percutaneous transpedicular fixation was evaluated 6 times in 1 year. Pain intensity was measured using the visual analog scale (VAS), and lumbar functionality was measured using the Oswestry Disability Index (ODI). Six evaluations were performed: before surgery and on discharge after surgery as well as at 1, 3, 6, and 12 months after surgery.Before the ACM was applied, the VAS pain score was 8.52. At 11 hours post-surgery, the pain score reduced to 2.59 points (a difference of 5.73 points; P = 0.001). Of the 10 ODI domains evaluated, a difference was found between the period prior to surgery and 1 month later (P < 0.01).The universal approach to full endoscopy and lumbar percutaneous transpedicular fixation via an ACM is highly effective for patients with lumbar surgical degenerative pathologies.

MOF-derived Co/Cu-embedded N-doped carbon for trifunctional ORR/OER/HER catalysis in alkaline media.

In this report, we demonstrate a bimetallic Co/Cu-embedded N-doped carbon structure for trifunctional catalysis of oxygen reduction, oxygen evolution and hydrogen evolution reactions in alkaline media. A hybrid catalyst synthesized through a metal-organic framework-based process (M-NC-CoCu) enables an active trifunctional catalysis due to its multi-faceted favorable characteristics. It is believed that a range of catalytically active sites are formed through the approach including well-dispersed tiny CuCo2O4 phases, a high concentration of pyridinic and graphitic N, and Cu-Ox, Cu-Nx and Co-Nx moieties. In addition, a high-surface-area morphology with a high concentration of sp2 bonding, which is beneficial for facilitated electron conduction, further contributes to the performance as an electrocatalyst.

Caracterización de la evolución clínica del trasplante renal en pacientes con virus de la hepatitis C positivo / Characterization of the clinical course of kidney transplantation in patients with positive hepatitis C virus

Introducción: La infección por el virus de la hepatitis C es un evento común en los receptores de trasplante renal que la arrastran desde su estancia en los tratamientos de hemodiálisis previos al implante. La positividad al virus C se ha asociado a una evolución desfavorable después del trasplante, dado por una mayor frecuencia de complicaciones clínicas, metabólicas e inmunológicas que repercuten de forma negativa tanto en la supervivencia del injerto como del paciente. Objetivos: Caracterizar la evolución clínica de los pacientes trasplantados de riñón con virus de la hepatitis C positivo y determinar la evolución de este grupo de enfermo de acuerdo a variables demográficas, clínicas y de supervivencia. Método: Estudio analítico, transversal, retrospectivo en pacientes trasplantados renales del Hospital Clínico Quirúrgico Hermanos Ameijeiras, desde el año 2005 al 2017. Se excluyeron los menores de 15 años, los retrasplantes, los trasplantes dobles y los combinados o cuando no se pudo obtener la información. Se comparan las variables escogidas entre enfermos que llegan al trasplante con serología positiva al virus C, (HVC positivos), con los HVC negativos. Resultados: Del total de 156 enfermos, 65 por ciento (102) fueron HVC positivos, no se encontraron diferencias entre grupo en cuanto a edad y sexo de receptores y donantes, así como tampoco en el tratamiento inmunosupresor utilizado. El donante vivo se empleó menos en los HVC positivos donde se encontraron más enfermos con poliquistosis renal. La necrosis tubular aguda (NTA) y el rechazo fueron más frecuentes en los HVC positivos, siendo la primera estadísticamente significativa, p=0,0421, también resultaron significativamente más frecuente en el grupo HVC positivo, la proteinuria, p=0,041, la elevación de enzimas hepáticas, p=0,047 y la diabetes postrasplante, p=0,047. La supervivencia del injerto y los pacientes fue menor en los HVC positivos. Conclusiones: En este estudio la hepatitis por virus C impacta negativamente en la evolución del injerto y propicia la aparición de algunas complicaciones clínicas, lo que sin dudas pudiera influir en una menor expectativa de vida tanto para el injerto como para el enfermo(AU)

Introduction: Hepatitis C virus infection is a common event in kidney transplant recipients that has dragged it along since their stay in hemodialysis treatments prior to implantation. Positivity to virus C has been associated with an unfavorable evolution after transplantation, due to higher frequency of clinical, metabolic and immunological complications that negatively affect both graft and patient survival. Objectives: To describe the clinical evolution of kidney transplant patients with positive hepatitis C virus and to determine the evolution of this group of patients according to demographic, clinical and survival variables. Method: An analytical, cross-sectional, retrospective study in kidney transplant patients at Hermanos Ameijeiras Hospital was carried out from 2005 to 2017. This study excluded children under 15 years of age, re-transplants, double and combined transplants or when it was not possible to gather the information. The variables chosen among patients who arrive at transplantation with positive serology for virus C (positive HCV) were compared with negative HCV. Results: One hundred and fifty six patients were the total, 65 percent (102) were HVC positive, no differences were found between groups in terms of age and sex of recipients and donors, nor in the immunosuppressive treatment used. The living donor was less used in positive HVC where more patients with polycystic kidney disease were found. Acute tubular necrosis (ATN) and rejection were more frequent in positive HVC, the former being statistically significant, p = 0.0421, proteinuria, p = 0.041, elevation was also significantly more frequent in the positive HVC group of liver enzymes, p = 0.047 and post-transplant diabetes, p = 0.047. Graft and patient survival was lower in positive HCV. Conclusions: In this study, hepatitis C virus has negative impact on the evolution of the graft and favors the appearance of some clinical complications, which undoubtedly could influence a shorter life expectancy for both the graft and the patient(AU)

The magnitude and impact of the 431 CE Tierra Blanca Joven eruption of Ilopango, El Salvador.

The Tierra Blanca Joven (TBJ) eruption from Ilopango volcano deposited thick ash over much of El Salvador when it was inhabited by the Maya, and rendered all areas within at least 80 km of the volcano uninhabitable for years to decades after the eruption. Nonetheless, the more widespread environmental and climatic impacts of this large eruption are not well known because the eruption magnitude and date are not well constrained. In this multifaceted study we have resolved the date of the eruption to 431 ± 2 CE by identifying the ash layer in a well-dated, high-resolution Greenland ice-core record that is >7,000 km from Ilopango; and calculated that between 37 and 82 km3 of magma was dispersed from an eruption coignimbrite column that rose to ∼45 km by modeling the deposit thickness using state-of-the-art tephra dispersal methods. Sulfate records from an array of ice cores suggest stratospheric injection of 14 ± 2 Tg S associated with the TBJ eruption, exceeding those of the historic eruption of Pinatubo in 1991. Based on these estimates it is likely that the TBJ eruption produced a cooling of around 0.5 °C for a few years after the eruption. The modeled dispersal and higher sulfate concentrations recorded in Antarctic ice cores imply that the cooling would have been more pronounced in the Southern Hemisphere. The new date confirms the eruption occurred within the Early Classic phase when Maya expanded across Central America.

Seasonality of the dinoflagellate Amphidinium cf. carterae (Dinophyceae: Amphidiniales) in Bahía de la Paz, Gulf of California.

Monthly phytoplankton samples were collected from January 2013 to December 2015 at a fixed sampling site in Bahía de La Paz, Gulf of California. During this study 26 samplings were Amphidinium cf. carterae positive. The highest densities of A. cf. carterae (754.2 × 103 to 1022.4 × 103 cells L-1) were recorded during a bloom detected in January 2015 when water temperatures were 20-22 °C. This dinoflagellate showed a well-marked seasonal variation, being found mainly from November to April. Blooms of the species were linked to the upwelled water due to the northwesterly wind. Cysts surrounded by a mucilaginous membrane of A. cf. carterae were found. We also observed these hyaline cysts inside zooplankton fecal pellets. Other benthic/tychoplanktonic dinoflagellates and diatoms, including some potentially toxic species were also found. The occurrence of blooms of A. cf. carterae in Bahía de La Paz could represent a risk for aquaculture activities and human health.

Factores influyentes en la supervivencia de los segundos trasplantes renales / Influential factors in the survival of the second kidney transplants

Introducción: La realización de un segundo trasplante renal es la mejor opción de tratamiento de reemplazo de la función de este órgano para aquellos enfermos que han perdido un primer injerto, no obstante, parece una terapéutica poco empleada y existe la opinión de que sus resultados son inferiores a un primer trasplante. Objetivos: Determinar el porcentaje de utilización de los segundos trasplantes renales, su supervivencia e identificar los factores que influyen en estos. Métodos: Estudio analítico, retrospectivo de corte longitudinal, que abarcó todos los trasplantes renales realizados desde 1984 al 2015, excluyendo los trasplantes en receptores menores de 15 años, dobles, combinados o cuando no se pudo obtener toda la información. Se compararon los resultados de la supervivencia en general, y los de cada variable de los segundos trasplantes con los de los primarios a través de las curvas de Kaplan y Meier y de forma multivariada con una regresión de Cox. Resultados: La utilización de los segundos trasplantes renales fue de 5,6 por ciento, con una supervivencia global similar a los primarios. En el análisis comparativo de las curvas de acuerdo a las variables utilizadas no se encontraron diferencias estadísticamente significativas entre los dos grupos de estudio, de forma multivariada sí emergieron como factores de riesgo independientes para la pérdida del injerto, la edad del receptor ≥ 55 años, la edad del donante ≥ 50 años, la presencia de necrosis tubular aguda y el rechazo en los trasplantes primarios, mientras que en los secundarios esto solo ocurrió cuando la edad del donante fue ≥ a 50 años y presentaron necrosis tubular aguda. Conclusiones: El porcentaje de utilización de un segundo trasplante fue bajo, con una supervivencia similar al primero, influenciada por variables propias del receptor y del acto del trasplante(AU)

Introduction: Performing a second kidney transplant is the best treatment option to replace the function of this organ for those patients who have lost a first graft. However, it seems a little used therapeutics and there is the opinion that its results are inferior to a first transplant. However, it seems a little used therapy and there is the opinion that its results are inferior to a first transplant. Objective: To determine the percentage of use of the second kidney transplants, their survival and identify the influential factors. Methods: An analytical, retrospective longitudinal study was done in all renal transplants performed from 1984 to 2015, excluding transplants in recipients under 15 years old, doubles, combined or when all the information could not be obtained. The results of survival in general were compared, and those of each variable of the second transplants were compared with those of the primary ones through Kaplan and Meier curves and multivariate with a Cox regression. Results: The use of a second renal transplants was 5.6 percent, with global survival similar to the primary ones. The comparative analysis of the curves according to the variables used were found no statistically significant different between the two study groups, although multivariate did emerge as independent risk factors for graft loss, the age of the recipient 55 years, the age of the donor 50 years, the presence of acute tubular necrosis and rejection in primary transplants, while in secondary cases this only occurred when the age of the donor was 50 years and they presented acute tubular necrosis. Conclusions: The percentage of a second transplant was low, with similar survival to the primary one, influenced by specific variables of the recipient and the act of transplantation(AU)

Development of AlN and TiB2 Composites with Nb2O5, Y2O3 and ZrO2 as Sintering Aids.

The synthesis of AlN and TiB2 by spark plasma sintering (SPS) and the effect of Nb2O5, Y2O3 and ZrO2 additions on the mechanical properties and densification of the produced composites is reported and discussed. After the SPS process, dense AlN and TiB2 composites with Nb2O5, Y2O3 and ZrO2 were successfully prepared. X-ray diffraction analysis showed that in the AlN composites, the addition of Nb2O5 gives rise to Nb4N3 during sintering. The compound Y3Al5O12 (YAG) was observed as precipitate in the sample with Y2O3. X-ray diffraction analysis of the TiB2 composites showed TiB2 as a single phase in these materials. The maximum Vickers and toughness values were 14.19 ± 1.43 GPa and 27.52 ± 1.75 GPa for the AlN and TiB2 composites, respectively.

Relación entre los resultados de la biopsia del trasplante renal, según la clasificación de Banff del 2011, y el tiempo de vida del injerto / Relationship between biopsy results of renal transplantation, according to 2011 Banff classification, and the graft lifetime

Introducción: la biopsia del trasplante renal es el método más eficaz para diagnosticar las complicaciones que producen disfunción del injerto. Las clasificaciones establecidas en las reuniones de consenso de Banff constituyen un instrumento de inestimable valor para esclarecer, unificar y comparar resultados. Objetivo: evaluar los resultados de las biopsias de trasplante renal, según los criterios de la clasificación de Banff del 2011, y relacionarlos con el tiempo de vida del injerto. Métodos: estudio retrospectivo, descriptivo, que abarcó las biopsias de los trasplantes renales realizados en el hospital Hermanos Ameijeiras que cumplieran con los criterios de utilidad desde el año 2007 hasta el 2013. Se evaluaron 89 especímenes de biopsias. Los resultados fueron reevaluados por un especialista en nefropatología, de acuerdo a los criterios de Banff del 2011, y relacionados con el tiempo de vida del injerto, según los intervalos: menos de 3 meses, de 3 meses a un año y más de un año. Resultados: predominaron la categoría 6: otros cambios no debido a rechazo, 35 (39,2 por ciento); la categoría 4: rechazo mediado por células T, 30 (33,7 por ciento) y la categoría 2: rechazo medido por anticuerpos, 10 (11,23 por ciento). Se detallaron estas tres categorías en sus subclasificaciones correspondientes. En los primeros tres meses se realizó el mayor número de biopsias (69) en las que predominaron la nefrotoxicidad aguda por ciclosporina A y las reacciones de rechazo por células T y anticuerpos, de tres meses a un año, solo se efectuaron 9 biopsias con predominio de iguales causas. Después del año, en los 17 estudios histológicos revisados, la mayor frecuencia correspondió a daño crónico...

Introduction: biopsy of renal transplantation is the most effective method for diagnosing complications of graft dysfunction. Ratings established in Banff consensus meetings are invaluable tool to clarify, unify, and compare results. Objective: evaluate the results of renal transplant biopsies, according to 2011 Banff classification, and compare them to the graft lifetime. Methods: a retrospective, descriptive study was conducted on biopsies of kidney transplants performed at Hermanos Ameijeiras hospital which met usefulness criteria from 2007 to 2013. 89 biopsy specimens were assessed. The results were re-assessed by a renal pathology specialist, according to 2011 Banff classification, and correlated to the graft lifetime, according to the intervals: less than 3 months, 3 month to one year, and over one year. Results: category 6 predominated: 35 (39.2 percent) other changes not due to rejections; Category 4: 30 (33.7 percent) rejection mediated by T cells and category 2: 10 (11.23 percent) rejection measured by antibodies. These three categories are detailed in their respective sub-classifications. In the first three months, the largest number of biopsies (69) were performed in which acute nephrotoxicity by cyclosporine A and rejection reactions by T cells and antibodies predominated; from three months to one year only 9 biopsies were performed mostly with same causes. After the year, the most frequently accounted for chronic damage in the 17 revised histological studies...

The Text in the Machine: American Copyright Law and the Many Natures of Software, 1974-1978.

This article is a case study in the history of software copyright in the United States from 1974 to 1978. It focuses on the work of a group called the National Commission on New Technological Uses of Copyrighted Works. CONTU, as this group was known, faced the problem of choosing which ontology of software-by which I mean a conception of the nature of software as an invention-should serve as the conceptual underpinning for the law of software copyright. In particular, the commissioners needed to decide whether computer programs are texts, machines, means to communicate with machines, or many of these things at once. CONTU's history shows how the discursive emergence of software as a new technology has been shaped by the convergence of commercial interests, the transmission of technical knowledge to lay audiences, and idiosyncratic views on the nature of information technology and human creativity.

Estadía hospitalaria prolongada y creatinemia al alta en el postrasplante renal inmediato. Causas y consecuencias en la evolución del injerto / Creatinemia and long stay at hospital discharge in post renal transplant period. Causes and consequences on graft outcome

Introducción: en el período del postrasplante renal inmediato interactúan condiciones y complicaciones que propician una estadía hospitalaria prolongada, así como una función subóptima del injerto al alta, dada por valores elevados de creatinina sérica.Objetivo: relacionar la presencia de algunas complicaciones clínicas y variables de índole general con la función del trasplante y la estadía en el posoperatorio inmediato.Métodos: estudio observacional, retrospectivo y longitudinal, que abarcó los trasplantes renales efectuados desde 1984 al 1 de enero de 2013, en el Hospital Hermanos Ameijeiras, a sujetos mayores de 15 años y que sobrevivieron al año. Se excluyeron los trasplantes combinados, los terceros trasplantes y aquellos de los que no se pudo obtener la información requerida. Se asociaron las variables: edad del receptor y del donante, sexo del receptor, tipo de donante, enfermedad de base que provocó la insuficiencia renal, tiempos de isquemia fría y caliente secundaria, presencia de necrosis tubular aguda, rechazo y toxicidad por ciclosporina A, con estadía hospitalaria y valores de creatinina al alta en el posoperatorio, a través de un análisis multivariado. Se determinó la posible influencia de estos 2 últimos parámetros en la supervivencia del injerto mediante el método de Kaplan y Meir.Resultados: la mayor edad del donante y el receptor, el donante cadáver, la diabetes mellitus y la poliquistosis renal, la aparición de necrosis tubular aguda, rechazo y nefrotoxicidad por ciclosporina A condicionaron mayor tiempo de ingreso y menor función del injerto al alta, lo que además influyó negativamente en la posterior supervivencia del trasplante renal.Conclusiones: los valores más altos de creatinina al alta y un tiempo de internamiento prolongado en el posoperatorio inmediato del TR constituyeron la base de las complicaciones y los parámetros que incidieron negativamente en la supervivencia del injerto a largo plazo(AU)

Estadía hospitalaria prolongada y creatinemia al alta en el postrasplante renal inmediato. causas y consecuencias en la evolución del injerto / Creatinemia and long stay at hospital discharge in post renal transplant period. causes and consequences on graft outcome

INTRODUCCIÓN: en el período del postrasplante renal inmediato interactúan condiciones y complicaciones que propician una estadía hospitalaria prolongada, así como una función subóptima del injerto al alta, dada por valores elevados de creatinina sérica. OBJETIVO: relacionar la presencia de algunas complicaciones clínicas y variables de índole general con la función del trasplante y la estadía en el posoperatorio inmediato. MÉTODOS: estudio observacional, retrospectivo y longitudinal, que abarcó los trasplantes renales efectuados desde 1984 al 1 de enero de 2013, en el Hospital "Hermanos Ameijeiras", a sujetos mayores de 15 años y que sobrevivieron al año. Se excluyeron los trasplantes combinados, los terceros trasplantes y aquellos de los que no se pudo obtener la información requerida. Se asociaron las variables: edad del receptor y del donante, sexo del receptor, tipo de donante, enfermedad de base que provocó la insuficiencia renal, tiempos de isquemia fría y caliente secundaria, presencia de necrosis tubular aguda, rechazo y toxicidad por ciclosporina A, con estadía hospitalaria y valores de creatinina al alta en el posoperatorio, a través de un análisis multivariado. Se determinó la posible influencia de estos 2 últimos parámetros en la supervivencia del injerto mediante el método de Kaplan y Meir. RESULTADOS: la mayor edad del donante y el receptor, el donante cadáver, la diabetes mellitus y la poliquistosis renal, la aparición de necrosis tubular aguda, rechazo y nefrotoxicidad por ciclosporina A condicionaron mayor tiempo de ingreso y menor función del injerto al alta, lo que además influyó negativamente en la posterior supervivencia del trasplante renal. CONCLUSIONES: los valores más altos de creatinina al alta y un tiempo de internamiento prolongado en el posoperatorio inmediato del TR constituyeron la base de las complicaciones y los parámetros que incidieron negativamente en la supervivencia del injerto a largo plazo.

INTRODUCTION: a number of conditions and complications interact during period immediately after kidney transplantation, which affect a lengthy hospital stay and a suboptimal graft function at discharge, given this high serum creatinine. OBJECTIVE: relate the presence of some clinical complications and general nature variables with transplant function and during immediate postoperative stay. METHODS: observational, retrospective, longitudinal study was conducted at Hermanos Ameijeiras hospital, covering renal transplants performed from 1984 to January 1st, 2013, in subjects older than 15 years of age and who survived a year after. Combined transplants, third transplants or those whose all required information could not be obtained were excluded. Through a multivariate analysis, variables were considered such as age of the recipient and the donor, recipient sex, donor type, the underlying disease that caused the kidney failure, cold ischemic time and secondary warm ischemia time, the presence of acute tubular necrosis, rejection and cyclosporine A nephrotoxicity, hospital stay and creatinine values at discharge in the post- operative period. The possible influence of the latter two parameters was determined in graft survival by Kaplan and Meir. RESULTS: the oldest age of the donor and recipient, deceased donor, diabetes mellitus and polycystic kidney disease, the occurrence of acute tubular necrosis, rejection and cyclosporine nephrotoxicity conditioned longer admission and less graft function at discharge, which also influenced negatively the subsequent survival of renal transplant. CONCLUSIONS: the highest values of creatinine at discharge and prolonged hospital stay in the immediate postoperative period of renal transplant formed the basis of complications, and long term negative impact parameters on graft survival.

Mediterranean-style diet reduces metabolic syndrome components in obese children and adolescents with obesity.

BACKGROUND: The beneficial effects of the Mediterranean diet have been amply proven in adults with cardiovascular risk factors. The effects of this diet have not been extensively assessed in pediatric populations with obesity, insulin resistance (IR) and metabolic syndrome (MetS). The aim of this study was to assess the efficacy of the Mediterranean style diet (MSD) to decrease cardiovascular risk factors in children and adolescents with obesity. METHODS: Participants were randomly assigned to a MSD rich in polyunsaturated fatty acids, fiber, flavonoids and antioxidants (60% of energy from carbohydrate, 25% from fat, and 15% from protein, (n = 24); or a standard diet (55% of carbohydrate, 30% from fat and 15% from protein, (n = 25), the caloric ingest was individualized. At baseline and 16-week of intervention, the glucose, triglycerides (TG), total cholesterol (TC), HDL-C, LDL-C were measured as well as the body composition and anthropometric data. The diet compliance was determined by the 24-hour recalls.Paired Student's t and Macnemar's test were used to compare effects in biochemical, body composition, anthropometric, and dietary variables. RESULTS: The MSD group had a significantly decrease in BMI, lean mass, fat mass, glucose, TC, TG, HDL-C and LDL-C. (p < 0.05); the diet compliance increased consumption of omega 9 fatty acids, zinc, vitamin E, selenium, and decreased consumption of saturated fatty acids (p < 0.05). The standard diet group decrease in glucose levels and frequency of glucose >100 mg/dL (p < 0.05). CONCLUSION: The MSD improves the BMI, glucose and lipid profile in children and adolescents with obesity and any MetS component.

Comparación de resultados entre el retrasplante y el trasplante renal primario en el Hospital Hermanos Ameijeiras de 1984 a 2012 / Comparison of results between retransplantation and primary kidney transplantation on Hermanos Ameijeiras Hospital from 1984 to 2012

Introducción: el retrasplante constituye la mejor opción terapéutica para los enfermos que pierden un primer trasplante renal y vuelven a diálisis, existen disímiles criterios en cuanto a sus resultados al compararlos con los trasplantes renales primarios. Objetivo: analizar el porcentaje de retrasplantes, revisar la supervivencia del injerto y del enfermo, el comportamiento de variables que pueden incidir en los resultados y compararlos con los de los enfermos que reciben un primer trasplante renal. Métodos: se realizó un estudio analítico, descriptivo, retrospectivo, de los trasplante renales realizados en el Hospital Hermanos Ameijeiras desde 1984 hasta diciembre de 2012; quedaron excluidos, los terceros trasplante, dobles (2 riñones a un mismo receptor), combinados (páncreas-riñón e hígado-riñón) y aquellos en los que no fue posible obtener la información requerida para la investigación. Se compararon (entre los grupos retrasplantes y primeros trasplantes) variables de índole general: edad de los receptores y donantes, sexo del receptor, enfermedad que ocasionó la insuficiencia renal, porcentaje de reactividad ante un panel de linfocito (PRA), compatibilidades HLA, tipo de donante (vivo o cadáver), tiempos de isquemia, presencia y duración de necrosis tubular aguda (donante cadáver), rechazo y supervivencia del injerto y el paciente. Resultados: los retrasplantes constituyeron el 5,4 por ciento de la muestra. No existieron diferencias entre edades, sexo, PRA, compatibilidades ni tipo de donante entre los segundos y primeros injertos...

Introduction: retransplant constitutes the best therapeutic choice for patients who lose a first renal transplant and return to dialysis, existing dissimilar criteria as to its results when ranking them with renal primary transplant. Objective: to analyze the percentage of retransplantation, to revise graft and patient survival, to review the behavior of variables that can affect the results and to compare them with patients receiving a first renal transplant. Methods: an analytic, descriptive, retrospective study was accomplished, including all renal transplant performed at the Hermanos Ameijeiras Hospital from 1984 to December of 2012. Third transplants, double transplants (two kidneys to the same receptor), combined transplants (pancreas-kidney and liver-kidney) and those where it was not possible to obtain the information required for this research were excluded. Variables of general nature were compared between retransplantation groups and first transplants, such as: age of recipient and donor, sex of the recipient, a disease that caused kidney failure, percentage of reactivity to a lymphocyte panel (PRA), HLA compatibility, donor type (living or dead), ischemia time, presence and duration of acute tubular necrosis (dead donor), rejection and graft and patient survival. Results:rRetransplant constituted only 5.4 percent of the sample (34 patients). There were no differences in age, sex, PRA, donor type or compatibilities between the second and first grafts...