Efecto de la suplementación con semilla de algodón y maíz molido sobre el consumo y el desempeño productivo de ovinos de pelo colombiano

Objetivo. Efecto de la suplementación con semilla de algodón y maíz molido sobre el consumo y el desempeño productivos de ovinos de pelo Colombiano. Materiales y métodos. Se utilizaron 24 ovinos con peso de 16 ± 2 kg durante 127 días. Los tratamientos fueron T0: pastoreo, T1: pastoreo + 25% semilla de algodón (SA) + 75% maíz molido (MM), T2: pastoreo + 50% (SA) + 50% (MM) y T3: pastoreo + 75% (SA) + 25% (MM). Para estimar la digestibilidad se utilizó la fibra en detergente ácido indigerible (FDAi) recuperada en las muestras de heces, forrajes y suplementos, las cuales fueron incubadas in situ durante 144 horas y oxido de cromo (Cr2O3) como marcador externo para cuantificar la producción de heces. Se utilizó un diseño completo aleatorizado con cuatro tratamientos y seis repeticiones, se realizó análisis de varianza para determinar diferencias significativas al nivel de (p<0.05) Resultados. Se encontró diferencias (p≤0.05) para la digestibilidad y el consumo de materia seca. Los valores medios de digestibilidad fueron 47.6, 56.2, 58.6 y 59.0% y de consumo de 0.514, 0.788, 1.02 y 1.40 kg d-1 para T0, T1, T2 y T3, respectivamente. Para la ganancia de peso y la condición corporal se encontraron diferencias significativas (p≤0,05) presentando promedios de 0.053, 0.126, 0.128 y 0.130 kg d-1 y una condición corporal de 2, 3, 3, 3 para T0, T1, T2 y T3, respectivamente. Conclusiones. La suplementación con semilla de algodón y maíz estimuló el consumo y mejoró el desempeño productivo de los animales.

Efecto de la suplementación con semilla de algodón y maíz molido sobre el consumo y el desempeño productivo de ovinos de pelo colombiano

Objective. Effect of supplementation with cotton seed and ground corn on the intake and productive performance of Colombian hair sheep. Materials and methods. 24 sheep with an average weight of 16 ± 2 kg were distributed in four treatments T0: grazing, T1: grazing + 25% cotton seed (CS) + 75% ground corn (GC), T2: grazing + 50% CS + 50% GC and T3: grazing + 75% CS + 25% GC. The indigestible acid detergent fiber (FDAi) was used as internal marker and chromium oxide (Cr2O3) as an external marker. Samples of feces, forages and supplements were incubated in situ (rumen) for 144 hours. To calculate fecal production, 1 g of (Cr2O3) was given to each ovine in a gelatin capsule for 15 days. A complete randomized design with four treatments and six replicates was used. The animals were weighed every 14 days to determine the daily weight gains. Food conversion and feed efficiency were determined. An ANOVA was performed in a completely randomized design. Results. There were differences (p≤0.05) for digestibility and dry matter intake (DMi) and, presenting values of 47.6, 56.2, 58.6, and 59.0% and DMi were 0.514, 0.788, 1.02, and 1.40 kg/animal/d for T0, T1, T2 and T3, respectively. For DWG differences (p≤0.05) were found, being 0.053, 0.126, 0.128 and 0.130 kg d-1 for T0, T1, T2, and T3, respectively. Conclusions. Supplementation with cotton seed and ground corn stimulated DMS and improved the productive performance of the animals.Objetivo. Efecto de la suplementación con semilla de algodón y maíz molido sobre el consumo y el desempeño productivos de ovinos de pelo Colombiano. Materiales y métodos. Se utilizaron 24 ovinos con peso de 16 ± 2 kg durante 127 días. Los tratamientos fueron T0: pastoreo, T1: pastoreo + 25% semilla de algodón (SA) + 75% maíz molido (MM), T2: pastoreo + 50% (SA) + 50% (MM) y T3: pastoreo + 75% (SA) + 25% (MM). Para estimar la digestibilidad se utilizó la fibra en detergente ácido indigerible (FDAi) recuperada en las muestras de heces, forrajes y suplementos, las cuales fueron incubadas in situ durante 144 horas y oxido de cromo (Cr2O3) como marcador externo para cuantificar la producción de heces. Se utilizó un diseño completo aleatorizado con cuatro tratamientos y seis repeticiones, se realizó análisis de varianza para determinar diferencias significativas al nivel de (p&lt;0.05) Resultados. Se encontró diferencias (p≤0.05) para la digestibilidad y el consumo de materia seca. Los valores medios de digestibilidad fueron 47.6, 56.2, 58.6 y 59.0% y de consumo de 0.514, 0.788, 1.02 y 1.40 kg d-1 para T0, T1, T2 y T3, respectivamente. Para la ganancia de peso y la condición corporal se encontraron diferencias significativas (p≤0,05) presentando promedios de 0.053, 0.126, 0.128 y 0.130 kg d-1 y una condición corporal de 2, 3, 3, 3 para T0, T1, T2 y T3, respectivamente. Conclusiones. La suplementación con semilla de algodón y maíz estimuló el consumo y mejoró el desempeño productivo de los animales.

Diazoxide choline extended‐release tablet in people with Prader‐Willi syndrome: results from long‐term open‐label study

Objective: This study assessed the effect of 1-year administration of diazoxide choline extended-release tablet (DCCR) on hyperphagia and other complications of Prader-Willi syndrome (PWS). Methods: The authors studied 125 participants with PWS, age ≥ 4 years, who were enrolled in the DESTINY PWS Phase 3 study and who received DCCR for up to 52 weeks in DESTINY PWS and/or its open-label extension. The primary efficacy endpoint was Hyperphagia Questionnaire for Clinical Trials (HQ-CT) score. Other endpoints included behavioral assessments, body composition, hormonal measures, and safety. Results: DCCR administration resulted in significant improvements in HQ-CT (mean [SE] −9.9 [0.77], p &lt; 0.0001) and greater improvements in those with more severe baseline hyperphagia (HQ-CT &gt; 22). Improvements were seen in aggression, anxiety, and compulsivity (all p &lt; 0.0001). There were reductions in leptin, insulin, and insulin resistance, as well as a significant increase in adiponectin (all p &lt; 0.004). Lean body mass was increased (p &lt; 0.0001). Disease severity was reduced as assessed by clinician and caregiver (both p &lt; 0.0001). Common treatment-emergent adverse events included hypertrichosis, peripheral edema, and hyperglycemia. Adverse events infrequently resulted in discontinuation (7.2%). Conclusions: DCCR administration to people with PWS was well tolerated and associated with broad-ranging improvements in the syndrome. Sustained administration of DCCR has the potential to reduce disease severity and the burden of care for families

Prader-Willi syndrome: A primer for clinicians

The advent of sensitive genetic testing modalities for the diagnosis of Prader-Willi syndrome has helped to define not only the phenotypic features of the syndrome associated with the various genotypes but also to anticipate clinical and psychological problems that occur at each stage during the life span. With advances in hormone replacement therapy, particularly growth hormone children born in circumstances where therapy is available are expected to have an improved quality of life as compared to those born prior to growth hormone

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Letter regarding "Prevalence of growth hormone deficiency in previously GH‐treated young adults with Prader‐Willi syndrome" by Donze et al

International audienceDear Editor,In the publication ‘Prevalence of growth hormone (GH) deficiency in previously GH treated young adults with Prader‐Willi syndrome’ (PWS), Donze et al1 report that none of the 60 patients in their co‐hort fulfilled the consensus criteria for adult GH deficiency.Although we do not question the results, we are concerned about the conclusion at the end of the manuscript that states, ‘as most adults with PWS do not fulfil the consensus criteria for adult GHD, they currently cannot be treated with GH after attainment of adult height’.Firstly, a dysfunction of the hypothalamus is generally accepted in (PWS). In addition to the often present obesity, this complicates evaluation for GH deficiency as most GH stimulation tests including the GHRH‐arginine test stimulate secretion of GH from the pituitary. This can lead to falsely normal GH responses in patients with GH de‐ficiency of hypothalamic origin such as patients with PWS.2 As also mentioned by the authors, the insulin tolerance test is not feasible in patients with PWS because of the cumbersome procedure and side effects. However, a comprehensive discussion on the difficulties of confirming GH deficiency in patients with hypothalamic diseases is lacking and in line with this is the problem of applying cut‐offs based on examinations of patients with pituitary diseases and not hypo‐thalamic diseases.Secondly, among the GH‐dependent peptides (IGF‐I, free/bioac‐tive IGF‐I, IGFBP‐3 and acid labile subunit (ALS)), analysis of IGF‐I is most common and the levels of IGF‐I correlate with the levels of the others.2 However, a major drawback of IGF‐I is a considerable over‐lap in IGF‐I levels between adults with verified GH deficiency and healthy controls. Furthermore, circulating IGF‐I mainly reflects the hepatic secretion of IGF‐I and not the production in tissues, which is another limitation regarding IGF‐I levels. IGF‐I is also affected by nutritional status and presence of sex steroid deficiencies. Again, in PWS there are many potential explanations for a patient's IGF‐I level and they are only partially addressed in the present manuscript.Thirdly, although previous studies using standard approaches to testing for GH deficiency suggest it is not present in every child and adult with PWS, other studies, including placebo‐controlled trials, have consistently shown significant benefits of GH therapy on growth, body composition, physical and psycho‐social function in both children and adults with PWS as recently summarized in a consensus meeting.3 This is good evidence that GH deficiency ex‐ists in PWS, and the approval by the United States Food and Drug Administration for treatment of children with PWS was based on these studies including 24 hour spontaneous GH release.4 Just because GH deficiency cannot be demonstrated by conventional testing does not mean that it does not exist and that should be dis‐cussed. Differences in GH molecular size, defects in the GH receptor or insufficient unstimulated GH secretion could be some of the pos‐sibilities not completely examined.In summary, PWS is a neurodevelopmental, endocrine and multi‐system disease. GH treatment offers an opportunity to reduce some of the adverse consequences of the syndrome. Although the aetiol‐ogy of the GH deficiency is still not fully known, we do think that these patients deserve a proper scientific discussion rather than just a sim‐ple statement that they do not fulfil cut‐offs for GH deficiency defined for other patient categories. In our efforts to help patients with rare disorders such as PWS, physicians must keep in mind that multisys‐tem conditions may necessitate different interpretation of test results from that in the typical population to avoid suboptimal care. Leaving adults with PWS falsely diagnosed as GH sufficient and thus without GH treatment could be detrimental, particularly in those adolescents/young adults treated during childhood in whom the positive effect of resuming GH treatment after completion of growth has been previ‐ously convincingly demonstrated by the same team.5As members of the Clinical and Scientific Advisory Board of the International PWS Organisation (IPWSO), we are particularly con‐cerned about statements that undermine the implementation of GH treatment programmes in many countries across the world for adults and/or children with PWS, depriving them of GH's well‐documented benefits