Metabolic and Productive Response and Grazing Behavior of Lactating Dairy Cows Supplemented with High Moisture Maize or Cracked Wheat Grazing at Two Herbage Allowances in Spring.

The aim was to determine the effect of the herbage allowance (HA) and supplement type (ST) on dry matter intake (DMI), milk production and composition, grazing behavior, rumen function, and blood metabolites of grazing dairy cows in the spring season. Experiment I: 64 Holstein Friesian dairy cows were distributed in a factorial design that tested two levels of daily HA (20 and 30 kg of dry matter (DM) per cow) and two ST (high moisture maize (HMM) and cracked wheat (CW)) distributed in two daily rations (3.5 kg DM/cow/day). Experiment II: four mid-lactation rumen cannulated cows, supplemented with either HMM or CW and managed with the two HAs, were distributed in a Latin square design of 4 × 4, for four 14-d periods to assess ruminal fermentation parameters. HA had no effect on milk production (averaging 23.6 kg/day) or milk fat and protein production (823 g/day and 800 g/day, respectively). Cows supplemented with CW had greater protein concentration (+1.2 g/kg). Herbage DMI averaged 14.17 kg DM/cow.day and total DMI averaged 17.67 kg DM/cow.day and did not differ between treatments. Grazing behavior activities (grazing, rumination, and idling times) and body condition score (BCS) were not affected by HA or ST. Milk and plasma urea concentration increased under the high HA (+0.68 mmol/L and +0.90 mmol/L, respectively). Cows supplemented with HMM had lower milk and plasma urea concentrations (0.72 mmol/L and 0.76 mmol/L less, respectively) and tended (p = 0.054) to have higher plasma ß-hydroxybutyrate. Ruminal parameters did not differ between treatments.

Prevalencia y características histológicas de los pólipos diminutos del recto y del sigmoides en una población colombiana / Prevalence and histological characteristics of tiny rectal and sigmoid polyps in a Colombian population

Resumen Introducción: el cáncer de colon y recto (CCR) se origina a partir de pólipos adenomatosos y serrados. Por tanto, se recomienda que todos los pólipos colónicos sean resecados y enviados a patología. Sin embargo, en los pólipos diminutos (<5 mm) del recto y del sigmoides existe controversia sobre esta conducta, razón por la cual se ha planteado la estrategia de resecar y descartar o dejar in situ, a partir de la utilización de endoscopios avanzados (con una imagen de banda angosta [Narrow Band Imaging, NBI] u otras), y se logre concordancia con la histopatología, superior al 90 %. En nuestro medio, no hay estudios prospectivos con luz blanca sobre la prevalencia y las características histológicas de estos pólipos en el recto y el sigmoides. Por esta razón, se desarrolló este trabajo. Materiales y métodos: estudio de prevalencia analítica, prospectivo. Se incluyeron las colonoscopias de tamización realizadas en la Unidad de Gastroenterología de la Clínica Fundadores de Bogotá, entre enero y julio de 2018. Resultados: se incluyeron 719 pacientes. La prevalencia de pólipos diminutos en el recto y el sigmoides fue del 27 % (intervalo de confianza [IC], 95 %: 23,7-30,2 %). El 50 % eran pólipos adenomatosos, mientras que en 8 casos se presentó una displasia de alto grado (DAG). Entre los pólipos diminutos, 3 fueron tumores neuroendocrinos. No hubo cáncer en ninguna de las lesiones. Conclusiones: la mitad de los pólipos diminutos encontrados fueron adenomatosos y 8 (0,83 %) tuvieron DAG. Recomendamos resecar todos los pólipos diminutos hasta que los estudios locales realizados con NBI u otra tecnología demostrasen la capacidad para discriminar en más del 90 % los pólipos hiperplásicos (dejarlos in situ) o adenomatosos (resecarlos).

Abstract Introduction: Because colorectal cancer (CRC) originates from adenomatous and serrated polyps, it is recommended that all colonic polyps be resected and sent to pathology. However, there is controversy over this recommendation in the case of rectal and sigmoid polyps measuring less than 5 mm. Strategies using advanced NBI endoscopes to either "resect and discard" or leave "in situ" have been proposed. Concordance with histopathology of over 90% has been achieved. No prospective studies of the prevalence and histological characteristics of these rectal and sigmoid polyps had been done with white light in this country, so we undertook this study. Materials and methods: This is an analytical and prospective prevalence study. Screening colonoscopies performed in the gastroenterology unit of Clínica Fundadores in Bogotá between January and July 2018 were included. Results: Seven hundred nineteen patients were included. The prevalence of tiny polyps in the rectum and sigmoid colon was 27% (95% CI: 23.7 to 30.2%). Fifty percent were adenomatous, but eight cases had high grade dysplasia. Among the tiny polyps, three were neuroendocrine tumors. There was no cancer in any of the lesions. Conclusions: Half of the tiny polyps found were adenomatous, and eight (0.83%) had high grade dysplasia. We recommend resecting all tiny polyps until local studies conducted with NBI or other technology demonstrate the ability to discriminate between the more than 90% hyperplastic polyps (leaving them in situ) and adenomatous polyps (resect them).

Serología del virus de la hepatitis B: para múltiples escenarios, múltiples exámenes / Serology of hepatitis B virus: multiple scenarios and multiple exams

Resumen El virus de la hepatitis B (VHB) tiene un gran impacto mundial. No obstante la disponibilidad de la vacuna, 2000 millones de personas se han infectado agudamente y, de ellos, 240 millones persisten crónicamente infectados. La infección tiene diferentes formas de presentación tales como infección aguda, infección crónica, infección oculta y reactivación cuando hay inmunosupresión. Así mismo, hay marcadores muy sensibles como el anticore, cuya positividad puede tener diversos significados. El recientemente descrito antígeno relacionado con el antígeno core es un marcador emergente que podría reemplazar al ácido desoxirribonucleico (ADN) viral. En la presente revisión se discuten los exámenes de laboratorio necesarios para el diagnóstico de los diferentes escenarios de la infección.

Abstract Hepatitis B virus (HBV) has an enormous global impact. Despite the availability of a vaccine, two billion people have been acutely infected. Of these, 240 million remain chronically infected. The infection has different forms of presentation including acute infections, chronic infections, hidden infections, and reactivation when there is immunosuppression. Similarly, there are very sensitive markers such as anti-core, but a positive test can have different meanings. This recently described antigen which is related to the core antigen is an emerging marker that could replace viral DNA. In this review we discuss the laboratory tests necessary for diagnosing the various scenarios of the infection.