Effect of the racial group and body condition score at calving on production performance and metabolic profile of buffaloes during the transition period.

This study evaluated the body condition score (BCS) at calving and breed (B) effects on milk composition, yield, performance, physiological parameters, hemogram, blood metabolites, and urinary metabolites in the transition and early lactation periods of Mediterranean (MED) and Murrah (MUR) buffaloes. Twenty MED and fifteen MUR buffaloes were distributed into four experimental treatments, in a completely randomized design, considering their racial groups and BCS (LBCS = low; HBCS = high): LBCS MED (N = 9); HBCS MED (N = 11); LBCS MUR (N = 8); HBCS MUR (N = 7). Animals were monitored during the last 21 days of gestation and first 56 days postpartum and kept under the same management and feeding conditions. During data collection, milk composition, yield, performance, physiological parameters, hemogram, blood metabolites, and urinary metabolites were evaluated. Higher milk production and fat-corrected milk were observed in MED than MUR buffaloes. Breed effects were observed on body weight, rectal temperature, glucose, urea, calcium (Ca) concentrations, and BCS effects on total protein, albumin, urea, and Ca. There were BCS effects on hematocrit, neutrophils, eosinophils, and interactions between B × BCS for lymphocytes and platelets. There were breed effects on urinary concentrations of chlorine, uric acid, and interactions between weight (W) × B on chlorine and urea. The MED buffaloes can be considered the most prepared to undergo physiological changes, including the BCS value at calving, indicating higher physiological health. Besides, this study demonstrates more considerable preparation for the calving, regardless of the body condition score at calving.

Impact of diesel and biodiesel contamination on soil microbial community activity and structure.

Soil contamination as a result of oil spills is a serious issue due to the global demand for diesel fuel. As an alternative to diesel, biodiesel has been introduced based on its high degradability rates and potential for reducing of greenhouse gases emissions. This study assessed the impacts diesel and biodiesel contamination on soil microbial community activity and structure. Our results suggest higher microbial activity in biodiesel contaminated soils and analysis of PLFA profiles confirmed shifts in microbial community structure in response to contamination. High-throughput 16S rRNA amplicon sequencing also revealed a lower bacterial richness and diversity in contaminated soils when compared to control samples, supporting evidence of the detrimental effects of hydrocarbons on soil microbiota. Control samples comprised mostly of Actinobacteria, whereas Proteobacteria were predominantly observed in diesel and biodiesel contaminated soils. At genus level, diesel and biodiesel amendments highly selected for Rhodococcus and Pseudomonas spp., respectively. Moreover, predicted functional profiles based on hydrocarbon-degrading enzymes revealed significant differences between contaminated soils mostly due to the chemical composition of diesel and biodiesel fuel. Here, we also identified that Burkholderiaceae, Novosphingobium, Anaeromyxobacter, Pseudomonas and Rhodococcus were the main bacterial taxa contributing to these enzymes. Together, this study supports the evidence of diesel/biodiesel adverse effects in soil microbial community structure and highlights microbial taxa that could be further investigated for their biodegradation potential.

Hydrocarbon-degrading genes in root endophytic communities on oil sands reclamation covers.

In response to environmental regulations, the Canadian oil sands industry aims to reclaim all disturbed areas to equivalent land capability prior to mining operations. However, tailing sands used in reclamation contain residual hydrocarbons and plants growing in these areas may rely on hydrocarbon-degrading endophytic bacteria to survive. This study assessed the hydrocarbon-degrading potential (genes: CYP153, alkB and nah) of culturable and unculturable endophytic bacteria associated with annual barley (Hordeum vulgare) and sweet clover (Melilotus albus) plants in an oil sands reclamation area. Our results suggest higher CYP153 gene copy numbers in sweet clover when compared to barley. Yet, no significant differences were detected in 16S rRNA, alkB and nah genes. In addition, total hydrocarbons, pH, total soil carbon, organic carbon and total nitrogen play an important role in determining hydrocarbon-degrading potential in these communities. The assessment of culturable hydrocarbon-degrading bacteria revealed 42 isolates (total of 316) that were positive for at least one hydrocarbon-degrading gene. Most of these isolates were positive for alkB, and closely match the database for Pantoea, Pseudomonas and Enterobacter spp. Thus, to improve oil sands reclamation strategies, plant inoculation with select hydrocarbon-degrading endophytes could be used to increase plant tolerance and hydrocarbon degradation in these areas.

Bacterial microbiome associated with the rhizosphere and root interior of crops in Saskatchewan, Canada.

Rhizosphere and root associated bacteria are key components of plant microbiomes and influence crop production. In sustainable agriculture, it is important to investigate bacteria diversity in various plant species and how edaphic factors influence the bacterial microbiome. In this study, we used high-throughput sequencing to assess bacterial communities associated with the rhizosphere and root interior of canola, wheat, field pea, and lentil grown at four locations in Saskatchewan, Canada. Rhizosphere bacteria communities exhibited distinct profiles among crops and sampling locations. However, each crop was associated with distinct root endophytic bacterial communities, suggesting that crop species may influence the selection of root bacterial microbiome. Proteobacteria, Actinobacteria, and Bacteroidetes were the dominant phyla in the root interior, whereas Gemmatimonadetes, Firmicutes, and Acidobacteria were prevalent in the rhizosphere soil. Pseudomonas and Stenotrophomonas were predominant in the rhizosphere and root interior, whereas Acinetobacter, Arthrobacter, Rhizobium, Streptomyces, Variovorax, and Xanthomonas were dominant in the root interior of all crops. The relative abundance of specific bacterial groups in the rhizosphere correlated with soil pH and silt and organic matter contents; however, there was no correlation between root endophytes and analyzed soil properties. These results suggest that the root microbiome may be modulated by plant factors rather than soil characteristics.

Alimentação e Comunicação: Vídeo para Orientação de Cuidadores de Idosos / Food and Communication: Video for Guiding Elderly Caregivers

Objetivo: Analisar o conhecimento dos cuidadores formais com relação aos aspectos da alimentação e da comunicação com a pessoa idosa e elaborar um vídeo com orientações para o cuida-dor formal. Metodologia: Pesquisa realizada em instituições de longa permanência para idosos no Município de João Pessoa, Paraíba. Tornaram-se participantes 34 cuidadores de idosos. O instrumento utilizado para coleta de dados foi um questionário construído a partir das explanações da literatura sobre disfagia, linguagem e cognição. Na análise dos dados foi utilizada a es-tatística descritiva por meio da frequência absoluta, percentual e do teste de proporções. Foi elaborado o script do vídeo e as cenas avaliadas por 6 juízes. Todos concordaram com as cenas de forma unânime, sendo então o vídeo considerado confiável. Os juízes realizaram sugestões nas cenas e as mesmas foram analisadas por meio da estatística descritiva. Em seguida, foi realizada a edição do vídeo. Resultados:Os cuidadores não têm conhecimento das dificuldades de fala, audição, cognição do idoso e das estratégias que facilitam essas funções. Tam-bém, não mostram conhecer as dificuldades de alimentação dos idosos, embora realizem estratégias facilitadoras. Como produto final foi elaborado um vídeo de orientação ao profissio-nal cuidador. Conclusão: Ressalta-se a importância do vídeo para orientações com relação a alimentação e a comunicação, propiciando melhora na qualidade de vida da pessoa idosa institucionalizada. (AU)

Objective: To analyze the knowledge of formal caregivers regarding aspects of eating and communication of the elderly and to elaborate a video with guidelines for the formal caregiver. Methodology: Methodological research conducted in long-term care facilities for the elderly in the city of João Pessoa, Paraiba. 34 elderly caregivers became participants. The instrument used for data collection was a questionnaire built from the literature explanations on dysphagia, language and cognition. Data analysis was performed using descriptive statistics through the absolute frequency, percentage and the proportions test. The script of the video was elaborated and the scenes evaluated by 6 judges. Everyone agreed with the scenes unanimously, so the video was considered reliable. The judges made sugges-tions in the scenes and they were analyzed using descriptive statistics. Then, the video was edited. Results: Caregivers are unaware of the difficulties in speech, hearing, and cognition of the elderly and the strategies that facilitate these functions. They also do not show knowledge of the feeding difficulties of the elderly although they perform facilitating strategies. As a final product, a guidance video was prepared for the professional caregiver. Conclusion: We emphasize the importance of the video for guidance regarding food and communication, providing improvement in the quality of life of the institutionalized elderly, (AU)

Potential use of endophytic root bacteria and host plants to degrade hydrocarbons.

Microbe-assisted phytoremediation depends on competent root-associated microorganisms that enhance remediation efficiency of organic compounds. Endophytic bacteria are a key element of the root microbiome and may assist plant degradation of contaminants. The aim of this study was to investigate the application of four hydrocarbon-degrading endophytic strains previously isolated from an oil sands reclamation area. Strains EA1-17 (Stenotrophomonas sp.), EA2-30 (Flavobacterium sp.), EA4-40 (Pantoea sp.), and EA6-5 (Pseudomonas sp.) were inoculated in white sweet clover growing on soils amended with diesel at 5,000, 10,000, and 20,000 mg·kg-1. Our results indicate that plant growth inhibition caused by diesel fuel toxicity was overcome in inoculated plants, which showed significantly higher plant biomass. Analysis of soil F2 and F3 hydrocarbon fractions also revealed that these soils were remediated by inoculated plants when diesel was applied at 10,000 mg·kg-1 and 20,000 mg·kg-1. In addition, quantification of hydrocarbon-degrading genes suggests that all bacterial strains successfully colonized sweet clover plants. Overall, the endophytic strain EA6-5 (Pseudomonas sp.), which harbored hydrocarbon-degrading genes, was the most effective candidate in phytoremediation experiments and could be a strategy to increase plant tolerance and hydrocarbon degradation in contaminated (e.g., diesel fuel) soils.

Construção e validação de instrumento para uso de ventilação mecânica não invasiva em idosos após acidente vascular encefálico / Construction and validation of an instrument for the use of non-invasive mechanical ventilation in the elderly after stroke

O suporte ventilatório mecânico é um tipo de tecnologia empregada por fisioterapeutas para substituir temporariamente a função pulmonar, de maneira total ou parcial, com a finalidade de promover a ventilação alveolar adequada, corrigindo, dessa forma, as trocas gasosas e fornecendo repouso aos músculos respiratórios. O sucesso da ventilação mecânica não invasiva está diretamente relacionado com a adaptação ao modo ventilatório e com a interface escolhida. Portanto, torna-se fundamental para o fisioterapeuta o conhecimento dos equipamentos e das interfaces, indicação e contraindicação, escolha do modo ventilatório para cada paciente. Logo, percebe-se a importância em construir e validar um instrumento para uso de ventilação mecânica não invasiva em idosos pós acidente vascular encefálico, para que esta terapêutica seja aplicada o mais precoce possível, com o objetivo de melhorar a função respiratória e proporcionar melhor qualidade de vida em idosos pós AVE

Bacterial Root Microbiome of Plants Growing in Oil Sands Reclamation Covers.

Oil sands mining in northern Alberta impacts a large footprint, but the industry is committed to reclaim all disturbed land to an ecologically healthy state in response to environmental regulations. However, these newly reconstructed landscapes may be limited by several factors that include low soil nutrient levels and reduced microbial activity. Rhizosphere microorganisms colonize plant roots providing hosts with nutrients, stimulating growth, suppressing disease and increasing tolerance to abiotic stress. High-throughput sequencing techniques can be used to provide a detailed characterization of microbial community structure. This study used 16S rRNA amplicon sequencing to characterize the bacterial root microbiome associated with annual barley (Hordeum vulgare) and sweet clover (Melilotus albus) growing in an oil sands reclamation area. Our results indicate that Proteobacteria dominated the endosphere, whereas other phyla such as Acidobacteria and Gemmatimonadetes were restricted to the rhizosphere, suggesting that plants have the ability to select for certain soil bacterial consortia. The bacterial community in the endosphere compartments were less rich and diverse compared to the rhizosphere. Furthermore, it was apparent that sweet clover plants were more selective, as the community exhibited a lower richness and diversity compared to barley. Members of the family Rhizobiaceae, such as Sinorhizobium and Rhizobium were mainly associated with clover, whereas Acholeplasma (wall-less bacteria transmitted by insects) was unique to barley. Genera from the Enterobacteriaceae family, such as Yersinia and Lentzea were also mostly detected in barley, while other genera such Pseudomonas and Pantoea were able to successfully colonize both plants. Endophytic bacterial profiles varied within the same plant species at different sampling locations; however, these differences were driven by factors other than slope positions or cover management. Our results suggest that bacterial endophytic communities of plants growing in land reclamation systems are a subset of the rhizosphere community and selection is driven by plant factors.

Effect of replacing ground corn and soybean meal with licuri cake on the performance, digestibility, nitrogen metabolism and ingestive behavior in lactating dairy cows.

Licuri (Syagrus coronate) cake is a biodiesel by-product used in ruminant feed as a beneficial energy source for supplementation in managed pastures. The objective was to evaluate the performance, digestibility, nitrogen balance, blood metabolites, ingestive behavior and diet profitability of eight crossbred Holstein (3/4)×Gyr (5/8) multiparous cows (480±25 kg BW and 100 days milking) grazing and supplemented with licuri cake partially replacing ground corn and soybean meal in concentrate (0, 200, 400 and 600 g/kg in dry matter (DM)), distributed in an experimental duplicated 4×4 Latin square design. Licuri cake partially replacing ground corn and soybean meal increased (P<0.01) the intake and digestibility of ether extract and decreased the non-fiber carbohydrates; however, there were no influences on the intakes of DM, CP, NDF and total digestible nutrients (TDN). The digestibilities of DM, CP and NDF were not influenced by licuri cake addition. There was a decrease trend on TDN digestibility (P=0.08). Licuri cake replacing ground corn and soybean meal in concentrate did not affect the intake; fecal, urinary and mammary excretions; N balance; and triglycerides concentrations. However, the blood urea nitrogen (P=0.04) concentration decreased with the licuri cakes inclusion in cow supplementation. There was an increasing trend for serum creatinine (P=0.07). Licuri cake inclusion did not affect body condition score, production, yield, protein, lactose, total solids and solid non-fat contents of milk and Minas frescal cheese. There was a linear decrease in average daily weight gain (g/day). The milk fat concentration and cheese fat production (P<0.1) presented a linear increase with partial replacement of ground corn and soybean meal with licuri cakes. The addition of licuri cake did not alter the time spent feeding, ruminating or idling. There was an increasing trend in NDF feeding efficiency (P=0.09). The replacing of ground corn and soybean meal with licuri cake up to 600 g/kg decreased the concentrate cost by US$0.45/cow per day. Licuri cake replacing corn and soybeans (400 g/kg) in concentrate promoted a profit of US$0.07/animal per day. Licuri cake is indicated to concentrate the supplementation of dairy cows with average productions of 10 kg/day at levels up to 400 g/kg in the concentrate supplement because it provides an additional profit of US$0.07/animal per day and increased milk and Minas frescal cheese fat without negative effects on productive parameters.

Residual feed intake and reproductive traits of growing Purunã bulls.

Residual feed intake (RFI) and its relationship with reproductive traits was evaluated in growing bulls. Fifty-two growing Purunã bulls (11 mo initial age) were fed ad libitum in individual feedlot pens for 112 d. The animals were ranked for RFI and assigned to 3 feed efficiency groups: efficient (low RFI), intermediate (medium RFI), and inefficient (high RFI). Initial and final BW and ADG did not differ ( > 0.10) among the efficiency groups and were mean values of 254.6 (SD 44), 373.0 (SD 62), and 1.06 kg (SD 0.25), respectively. Mean values of 7.12 ± 0.28, 7.78 ± 0.28, and 8.04 ± 0.28 kg/d for DMI and -0.38 ± 0.04, -0.02 ± 0.04, and 0.51 ± 0.04 kg of DM/d for RFI were observed in the efficient, intermediate, and inefficient groups, respectively. Crude protein and ME intake were strongly correlated ( = 0.74, < 0.001 for both variables) with RFI and were lower ( < 0.10) in the efficient group (13.6 ± 0.2 g DM/kg BW∙d and 0.252 ± 0.003 Mcal/kg BW∙d, respectively) and greater ( < 0.10) in the inefficient group (15.3 ± 0.2 g DM/kg BW∙d and 0.282 ± 0.003 Mcal/kg BW∙d, respectively). Testicular measures (width, length, volume, ultrasonogram pixel intensity, and scrotum perimeter) and serum testosterone were not correlated with RFI ( > 0.10) but showed moderate to strong correlations with initial BW ( ranged from 0.36 to 0.51, ≤ 0.01), final BW ( ranged from 0.36 to 0.64, ≤ 0.01), and ADG ( ranged from 0.29 to 0.53, < 0.05). All the reproductive traits (testicular measurements and concentrations of serum testosterone) showed similar values among the efficiency groups. During the growth phase, feed intake and protein and energy requirements were decreased in more efficient bulls in terms of RFI. However, both groups maintained similar BW and ADG. Regardless of their RFI classification, Purunã bulls had the same reproductive traits during the growth phase.

Optical micro-knot resonator hydrophone.

We present results of what are believed to be the first underwater acoustic sensor using an optical micro-knot resonator. The mechanism involves straining the micro-fibre loop of the knot via an appropriate encapsulation material. The micro-knot sensor exhibited a spectral full-width half-depth of 37.7pm with a Q-factor of 41100 after deconvolution with the source. The shift in wavelength at 1550nm was observed to be around 67pm RMS when exposed to underwater acoustic excitation at 40Hz demonstrating a normalized sensitivity of -288 dB re µPa(-1), or 5.83 fm/Pa.

Antibiotic resistance versus antimicrobial substances production by gram-negative foodborne pathogens isolated from minas frescal cheese: heads or tails?

In this study, 15 Gram-negative isolates from Minas Frescal cheese sold in commercial establishments in Rio de Janeiro, Brazil, were able to produce antimicrobial substances (AMSs). Seven, four, two, one, and one isolates identified as Yersinia, Acinetobacter, Enterobacter, Escherichia, and Hafnia genera, respectively, were considered potentially pathogenic. All 15 AMS(+) isolates were resistant to at least 1 antibiotic; however, 7 strains presented resistance to at least 3 antibiotics from different classes, exhibiting multiresistance profiles. The strains were also subjected to plasmid profile analysis. All isolates presented different plasmid forms with most ranging in size from 1 to 10 kb. Activity against various pathogens associated with food was tested and all 15 AMS(+) showed the same activity spectrum, inhibiting all Escherichia coli and Salmonella strains that were tested. Although restricted, the action spectrum of AMS-producing strains is extremely relevant to the food industry because Gram-negative bacteria such as E. coli and Salmonella spp. are most often associated with foodborne illnesses. The findings of this study reveal that even AMS produced by pathogens can have potential applications against other foodborne pathogens.

[Utility of SPECT/CT scan for anatomical localization of pararectal and presacral sentinel nodes in prostate cancer]. / Utilidad de la SPECT-TC para la localización anatómica de los ganglios centinelas presacrales y pararrectales en el cáncer de próstata.

AIM: This study has aimed to evaluate the added value of SPECT-CT scan in the preoperative assessment of sentinel nodes of the presacral and pararectal regions localized outside the standard area of extended pelvic lymphadenectomy for the staging of the pelvis in prostate cancer. SPECT-CT scan can serve as a guide for the excision of these nodes by lymphadenectomy by open surgery or laparoscopy. MATERIAL AND METHODS: We evaluated 4 patients with prostate cancer presenting sentinel nodes in the pararectal and presacral regions on SPECT-CT scan performed in addition to lymphoscintigraphy. These patients underwent lymphadenectomy with robot-assisted laparoscopy together with prostatectomy. All of the excised lymph nodes were sent for histopathology study. RESULTS: An average of 6 sentinel nodes per patient were found on SPECT-CT scan with a mean of 2 sentinel nodes in presacral/pararectal región. Lymphadenectomy including these areas was performed. Pararectal/presacral sentinel nodes of all patients depicted by SPECT-CT scan were tumor free on histopathology study. Sentinel nodes (no pararectal/presacral) were positive for malignancy in only one patient. CONCLUSION: Preoperative SPECT-CT scan is a useful tool to localize the sentinel nodes in pararectal/presacral regions. It can be an anatomic guide for new modalities of laparoscopic surgery such as robot-assisted procedures that can access the pelvic areas visualized with SPECT-CT scan, making excision of these nodes possible.

Use of morpho-agronomic traits and DNA profiling for classification of genetic diversity in papaya.

We examined the genetic diversity of papaya (Carica papaya) based on morpho-agronomic and molecular data. Twenty-seven genotypes grown in Brazil were analyzed with 11 AFLP primer combinations, 23 ISSR markers, 22 qualitative, and 30 quantitative descriptors. For the joint analyses, we used the Gower algorithm (Joint Gower) and the average value of the individual dissimilarity matrix for each type of data (Average-Joint Gower); 359 AFLP and 52 ISSR polymorphic bands were found. Approximately 29.2 and 7.7% of the AFLP and ISSR bands, respectively, were genotype-specific and may therefore be used for papaya variety protection. Although there was a significant correlation between the qualitative and quantitative descriptor dissimilarity matrices (r = 0.43), the morpho-agronomic data were not highly correlated with the molecular data. Moreover, correlation between AFLP and ISSR dissimilarity matrices was nearly null (r = -0.01). Joint Gower analysis of all data showed high correlations, especially for AFLP markers, most likely due to the larger number of bands, generating a strong bias in the diversity estimates. The Average-Joint Gower analysis allowed a better balance between the correlations for the continuous and the discrete variables. The results generated by clustering analysis distinguished 5 genetically distinct groups. While we found that papaya genotypes are significantly variable for many traits, we observed that Average-Joint Gower analysis allowed for genotype clustering based on the most widely used criterion for classifying papaya genotypes, which is fruit type ('Formosa' or 'Solo'). This information helps provide an accurate estimate of the genetic diversity and structure of papaya germplasm, which will be used for further breeding strategies.

Aportación de una gammacámara portátil en la localización intraoperatoria del ganglio centinela en el cáncer de mama / Contribution of the portable gamma camera to detect the sentinel node in breast cancer during surgery

Objetivo. Mostrar nuestra experiencia en el uso de una gammacámara portátil en la localización intraoperatoria del ganglio centinela en el cáncer de mama. Material y métodos. 46 mujeres diagnosticadas de cáncer de mama fueron incluidas. Se realizo inyección periareolar intradérmica del radiotrazador. Se realizaron imágenes planares y SPECT-TAC. El día siguiente se emplearon una sonda y una gammacámara portátil para la detección del ganglio centinela intraoperatorio. Se tomaron imágenes en las proyecciones anterior y lateral de la axila antes y después de la extracción del ganglio centinela. Resultados. Las imágenes obtenidas intraoperatoriamente no mostraron actividad en todos los pacientes después de la extracción de todos los ganglios centinela. En cuatro de los 46 casos la gammacámara dio información importante (en dos casos localizó ganglios no detectados en las imágenes prequirúrgicas y en otros dos orientó al cirujano en localizar ganglios de baja actividad cuando el rastreo con sonda fue negativo). Conclusiones. El uso de la gammacámara portátil intraoperatoria en la localización del ganglio centinela en cáncer de mama es útil para asegurar, con independencia del cirujano, que todos los ganglios han sido extirpados. Puede guiar además al cirujano en la localización de ganglios de baja actividad(AU)

Aim. To show our experience using the portable gamma camera during surgery in the detection of the sentinel node in breast cancer. Material and methods. A total of 46 women diagnosed with breast cancer were included. This study was carried out by means of the periareolar intradermal injection. Planar images and SPECT/CT were acquired. On the following day, the sentinel nodes were localized intraoperatively with a portable gamma camera and a gamma probe. Images of the anterior axillary line projection and lateral axillary line projection were acquired before and after extraction of all the sentinel nodes. Results. The images acquired with the portable gamma-camera during the operation showed no activity in all of the patients after the removal of the sentinel nodes. In four out of the 46 cases, the portable gamma camera provided relevant information during the procedure (it detected a sentinel node in two cases in which it had not been detected prior to the surgery and it oriented the surgeon in the localization of low activity nodes when the probe screening had been negative). Conclusions. The use of the intraoperative portable gamma camera to detect the sentinel node in breast cancer patients is useful in order to ensure, independently of the surgeon, that all the sentinel nodes have been removed. It can also help guide the surgeon in the event of a single low activity sentinel node(AU)

Upgrading of the micro-marsupialisation technique for the management of mucus extravasation or retention phenomena.

This study evaluated the performance of an upgrading of the micro-marsupialisation technique for the management of mucus extravasation or retention phenomena. This study presents a prospective case series of management of ranulas and mucoceles, with a follow-up ranging from 6 to 18 months. Data included the age and gender of patients, as well as the type, size, and site of lesions, and number of punctures. The treatment performance was evaluated according to: postoperative pain, oedema, secondary infection, clinical healing, retreatment, and recurrence of the lesions. All patients showed clinical healing of the lesions within 30 days after the micro-marsupialisation technique. None of patients presented a recurrence or required retreatment, there was no oedema or infection. No pain, or mild pain was reported by the majority of patients (58.81%). Micro-marsupialisation proved to be a simple, low cost, relatively non-invasive, painless, effective, and low recurrence technique to treat mucus extravasation or retention phenomena. Micro-marsupialisation can be recommended primarily to treat oral ranulas and selected mucoceles.

Contribution of the portable gamma camera to detect the sentinel node in breast cancer during surgery.

AIM: To show our experience using the portable gamma camera during surgery in the detection of the sentinel node in breast cancer. MATERIAL AND METHODS: A total of 46 women diagnosed with breast cancer were included. This study was carried out by means of the periareolar intradermal injection. Planar images and SPECT/CT were acquired. On the following day, the sentinel nodes were localized intraoperatively with a portable gamma camera and a gamma probe. Images of the anterior axillary line projection and lateral axillary line projection were acquired before and after extraction of all the sentinel nodes. RESULTS: The images acquired with the portable gamma-camera during the operation showed no activity in all of the patients after the removal of the sentinel nodes. In four out of the 46 cases, the portable gamma camera provided relevant information during the procedure (it detected a sentinel node in two cases in which it had not been detected prior to the surgery and it oriented the surgeon in the localization of low activity nodes when the probe screening had been negative). CONCLUSIONS: The use of the intraoperative portable gamma camera to detect the sentinel node in breast cancer patients is useful in order to ensure, independently of the surgeon, that all the sentinel nodes have been removed. It can also help guide the surgeon in the event of a single low activity sentinel node.

Human brucellosis in the Mid-West 2002-3.

Human brucellosis remains a serious public health issue in Ireland. Clinical notifications in the Mid-Western Area (HSE-MWA) underestimate the burden of illness and attendant morbidity in the region. The diagnosis of acute and chronic human brucellosis depends on the clinical evidence and the results from laboratory serological testing or culture on rare occasion. This study examined the clinical evidence behind locally defined serological "positives" in the HSE-MWA from 2002 to 2003. Ninety cases were detected in 2002 and 31 in 2003. While sampling bias is likely to be present, aspects of brucellosis in Ireland were confirmed. Middle-aged males were most commonly affected. The majority of cases were linked to farming or veterinary practice. Symptoms such as sweats, fever and weight loss were commonly associated with acute brucellosis infection while malaise was common in acute and chronic brucellosis. A clear definition of what is notifiable is needed. Surveillance systems must appreciate the importance of both clinical and laboratory evidence to classify confirmed or probable brucellosis as paired sera were not common. Public health authorities must follow-up the clinical aspects for accurate national statistics. General practitioners in the Mid-West appear to be vigilant regarding brucellosis in their patients. Regional zoonoses committees are useful in monitoring disease prevalence in human and animal populations without compromising confidentiality.

The relationship between income and performance indicators in general practice: a cross-sectional study.

OBJECTIVE: To explore the relationship between the income of general practitioners (GPs) and the performance characteristics of their practices. DESIGN: Cross-sectional survey. SETTING: All practices (n = 166) in an inner city health authority, two years before the introduction of the new GP contract in April 2004 were studied. MAIN OUTCOME MEASURES: True income per GP was unavailable to us. Instead, the proxy measure - superannuable pay - was calculated (gross eligible income per GP minus the national average sum for GP expenses). Practice staff funding figures were also obtained. These two financial indicators were compared with practice characteristics and performance indicators. RESULTS: Data were available from 151 out of 166 practices. Based on regression analysis, larger list sizes and higher practice staff budgets predicted 31% of the variation in GP income (standardized beta = 0.66, P < 0.001; beta = 0.19, P = 0.02; respectively). Higher staff budgets were independently associated with better cervical smear and two-year-old vaccination rates (standardized beta = 0.24, P < 0.01; beta = 0.18, P = 0.03; respectively). No association was demonstrated between performance indicators and income. CONCLUSION: Under the previous contract, GPs were able to maximize their income by taking on more patients, whereas achievement of performance targets had very little impact on overall income. The opportunity costs of pursuing higher-quality care might have outweighed the modest financial rewards attached to performance targets. Provided rewards for good-quality care are sufficiently high, the new GP contract is likely to tip the balance in favour of generating earnings by improving the quality of clinical care. To deliver this care, as measured by available performance indicators, our findings imply that a greater investment in practice staff will be needed.

The incidence of S. aureus bacteraemia in acute hospitals of the Mid-Western Area, Ireland, 2002-2004.

Concerns about healthcare-associated infections and the global crisis in antimicrobial resistance has combined to accentuate the fears around so-called "superbugs". In Ireland there is no single agreed indicator regarded as a true measure of the level of methicillin resistant Staphylococcus aureus (MRSA) in hospitals. The objective of this study was to compare two crude measures of MRSA--the percentage of bacteraemia caused by MRSA and the incidence rate (per 1000 bed days used) of MRSA bacteraemia in six acute hospitals. We examined all blood cultures positive for S. aureus (methicillin sensitive and resistant) from 2002 to 2004 in the Health Service Executive (HSE) Mid-Western Area of Ireland. Hospital In-Patient Enquiry (HIPE) data was used to determine monthly in-patient bed days used. Of 245 patient episodes of bacteraemia, 119 were MRSA. The trends in the percentage of isolates that were MRSA and the incidence rate calculated were compared. The incidence rate appears to be a more reliable and robust indicator of MRSA in hospitals than the percentage. Despite many difficulties in interpreting indicators of MRSA they should not preclude the regular publication of data at least at regional level in Ireland.