Evaluation of Oxidative Stress Parameters in Healthy Saddle Horses in Relation to Housing Conditions, Presence of Stereotypies, Age, Sex and Breed

Oxidative stress plays an important role in the development of many horse diseases and it has been shown that housing has important implications for the psychophysical well-being of horses. The aim of this study is to determine if there are any dierences between the redox status in horses in relation to housing conditions. The four housing conditions analyzed were: single box, without external access and without contact (Cat A), single box with external access and possibility of partial contact (Cat B), group housing with box and large paddock (Cat C), pasture with more than 7 horses and the possibility of green forage for the whole year (Cat D). A group of 117 healthy horses were selected in several private stables in Northern Italy. All subjects treated with any type of drug were excluded. At the end of the enrollment, the 117 selected horses were divided into the four housing categories. Stereotypies were highest in the group of horses in single box, without external access and without contact (Cat A). Oxidative stress was evaluated by testing plasma or serum samples for the following parameters: superoxide anion (WST), nitric oxide (NO), reactive oxygen species (d-ROMs), ferric reducing ability of plasma (FRAP), and the activity of superoxide dismutase (SOD). Simultaneously with the blood sampling, the owners completed a questionnaire with all the management aspects of the horse (signaling, feeding, equestrian activity, vaccinations, foot management etc.). The statistical evaluation was carried out based on the categories previously described, on the presence and absence of stereotypies and on some signaling data obtained from the questionnaire. There were no significant dierences in the parameters analyzed between the categories. No significant redox status dierences were detected based on the presence or absence of stereotypies. Interestingly, when the age was introduced as selection (<14 and >14 years old) parameter inside the categories, statistical significance was observed for some of the stress markers considered. Finally, independently of the housing conditions, the horses of the most two represented breeds exhibited dierent values of FRAP. All these aspects are commented in the discussion

Patent ductus arteriosus treatment in the premature newborn: clinical and surgical analisys

BACKGROUND: The surgical treatment of patency ductus arteriosus is indicated when the clinical intervention fails. However, this treatment may have some complications. OBJECTIVE: To analyze clinical and surgical aspects involved on the treatment of patency ductus arteriosus in premature newborn. METHODS: Twenty two premature newborns, submitted to surgical treatment for patency ductus arteriosus from January, 2000 to June, 2006, were evaluated. There were 77,3% female patients, the mean birth weight was 952,5g and the mean gestational age was 27 weeks. The use of vasoactive drugs, indometacin, echocardiograph parameters and complications, in the pre and postoperative periods were evaluated. RESULTS: In this casuistic 59,1% patients needed intratracheal intubation at birth, 77,3% needed surfactants, 59,1% used vasoactive drugs preoperative. The mean doses of indometacin were 3,43, with dose range 0,1 to 0,25 mg/Kg/day. The mean caliber of arterial duct patent was 1,96 mm. The surgical procedure was carried out through extrapleural approach in 59.1% of the patients, the mean time of postoperative intubation was 30,9 days, and 50% of the patients used vasoactive drugs postoperative. There were 18,1% postoperative complications (postoperative non-fatal complications). CONCLUSION: More than the half of the patients needed intratracheal intubation at birth, surfactant use and vasoactive drugs in the preoperative period. There was greater prevalence of the extrapleural approach during the surgery. In the postoperative period, there was less demand of vasoactive use and there was not deaths related to the surgical procedure.FUNDAMENTO: O tratamento cirúrgico da persistência de canal arterial é indicado quando a intervenção clínica fracassa. No entanto, esse tratamento não é livre de complicações. OBJETIVO: Analisar aspectos clínicos e cirúrgicos envolvidos no tratamento da persistência do canal arterial, em recém-nascidos prematuros. MÉTODOS: No período de janeiro de 2000 a junho de 2006, foram analisados 22 recém-nascidos prematuros submetidos a tratamento cirúrgico para persistência de canal arterial. Do total de pacientes, 77,3% eram do sexo feminino, com peso médio ao nascimento de 952,5 g e idade gestacional média de 27 semanas. O uso de agentes vasoativos, indometacina, parâmetros ecocardiográficos e complicações, nos períodos pré e pós-operatórios, foi avaliado. RESULTADOS: Na casuística avaliada, 59,1% dos pacientes necessitaram de intubação orotraqueal ao nascimento; 77,3%, de surfactante; e 59,1% usaram agentes vasoativos no pré-operatório. O número médio de aplicações de indometacina foi de 3,4, com dosagem variando de 0,1 a 0,25 mg/kg/dia. O calibre médio do canal arterial foi de 1,96 mm. O procedimento cirúrgico foi realizado por abordagem extrapleural em 59,1% dos casos, e no pós-operatório o tempo médio de intubação foi de 30,9 dias, com emprego de agentes vasoativos em 50% dos pacientes. Observaram-se 18,1% de complicações pós-operatórias não-fatais. CONCLUSÃO: Mais da metade dos pacientes necessitou de intubação orotraqueal ao nascimento, emprego de surfactante e agentes vasoativos no período pré-operatório. Houve maior prevalência de abordagem extrapleural durante o ato operatório. No período pós-operatório, houve menor demanda de agentes vasoativos e não houve óbitos diretamente relacionados ao procedimento cirúrgico.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

The Effect of Anatomical Location of Lymph Node Metastases on Cancer Specific Survival in Patients with Clear Cell Renal Cell Carcinoma

Background: Positive nodal status (pN1) is an independent predictor of survival in renal cell carcinoma (RCC) patients. However, no study to date has tested whether the location of lymph node (LN) metastases does affect oncologic outcomes in a population submitted to radical nephrectomy (RN) and extended lymph node dissection (eLND). Objective: To describe nodal disease dissemination in clear cell RCC (ccRCC) patients and to assess the effect of the anatomical sites and the number of nodal areas affected on cancer specific mortality (CSM). Design, setting and partecipants: The study included 415 patients who underwent RN and eLND, defined as the removal of hilar, side-specific (pre/paraaortic or pre/paracaval) and interaortocaval LNs for ccRCC, at two institutions. Outcome measurement and statistical analysis: Descriptive statistics were used to depict nodal dissemination in pN1 patients, stratified according to nodal site and number of involved areas. Multivariable Cox regression analyses and Kaplan-Meier curves were used to explore the relationship between pN1 disease features and survival outcomes. Results and limitations: Median number of removed LN was 14 (IQR 9\u201319); 23% of patients were pN1. Among patients with one involved nodal site, 54 and 26% of patients were positive only in side-specific and interaortocaval station, respectively. The most frequent nodal site was the interaortocaval and side-specific one, for right and left ccRCC, respectively. Interaortocaval nodal positivity (HR 2.3, CI 95%: 1.3\u20133.9, p < 0.01) represented an independent predictor of CSM. Conclusions: When ccRCC patient harbour nodal disease, its spreading can occur at any nodal station without involving the others. The presence of interoartocaval positive nodes does affect oncologic outcomes. Patient summary: Lymph node invasion in patients with clear cell renal cell carcinoma is not following a fixed anatomical pattern. An extended lymph node dissection, during treatment for primary kidney tumour, would aid patient risk stratification and multimodality upfront treatment

Inflammation-Independent Antinociceptive Effects of DF2755A, a CXCR1/2 Selective Inhibitor: A New Potential Therapeutic Treatment for Peripheral Neuropathy Associated to Non-Ulcerative Interstitial Cystitis/Bladder Pain Syndrome

Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a chronic bladder disease of unknown etiology characterized by urinary frequency and episodic and chronic pain. Analgesic treatments for IC/BPS are limited, especially for patients with non-Hunner (non-ulcerative) type IC who usually have poor overall outcomes. Here, we demonstrate that oral treatment with DF2755A, a potent and selective inhibitor of chemokine receptors CXCR1/2, can prevent and reverse peripheral neuropathy associated to non-Hunner IC/BPS by directly inhibiting chemokine-induced excitation of sensory neurons. We tested DF2755A antinociceptive effects in a cyclophosphamide (CYP)-induced non-ulcerative IC rat model characterized by severe peripheral neuropathy in the absence of bladder inflammatory infiltrate, urothelial hyperplasia, and hemorrhage. Treatment with DF2755A prevented the onset of peripheral neuropathy and reversed its development in CYP-induced IC rats, showing a strong and long-lasting anti-hyperalgesic effect. Ex vivo and in vitro studies showed that DF2755A treatment strongly inhibited the expression of CXCR2 agonists, CXCL1/KC, and CXCL5 and of transient receptor potential vanilloid 1 (TRPV1) compared to vehicle, suggesting that its effects can be due to the inhibition of the nociceptive signaling passing through the CXCL1/CXCR1-2 axis and TRPV1. In conclusion, our results highlight the key pathophysiological role played by the CXCL1/CXCR1-2 axis and TRPV1 in the onset and development of peripheral neuropathy in non-Hunner IC and propose DF2755A as a potential therapeutic approach for the treatment of not only inflammatory painful conditions but also neuropathic ones and in particular non-Hunner IC/BPS

Posición Ghlischro-cárica: conocerla puede ampliar sus recursos médicos y psicoanalíticos.

Melanie Klein enunció las posiciones Depresiva (1935) y Esquizoparanoide (1946). Esther Bick y Donald Meltzer desarrollaron, a partir de los estudios de Klein, el concepto de identificación adesiva. José Bleger, presenta (post mortem), en 1977, utilizando este conocimiento y conjeturando sobre la simbiosis, la posición Ghlischro-cárica, que él consideraba, con maestría, una posición anterior a la posición Esquizoparanoide. La posición Ghlischro-cárica incluye un conglomerado yoico con el objeto de que no está diferenciado, que fue nombrado por Bleger como un núcleo aglutinado. Tiene en su constitución, ansiedad por defusión que puede manifestarse como ansiedad de tipo pánico, somatizaciones y enfermedades psicosomáticas, como esclerosis múltiple, artritis reumatoide, vitiligo, entre otras. Es interesante decir que 72% de los pacientes que buscan atención médica neuropsiquiátrica y psicológica utilizan la posición Ghlischro-cárica dentro de su universo relacional, con sus idiosincrasias que afectan sus vidas y el entorno terapéutico. El conocimiento de sus particularidades puede ampliar el volumen de recursos del profesional de la salud mental, en el uso de técnicas psicoterapéuticas e incluso en la elección de los medicamentos psicotrópicos más adecuados para los clientes en este puesto, lo que hace que el desarrollo de este tema sea esencial. Utilizamos un modelo de estudio clínico-cualitativo y transdisciplinario basado en una revisión conceptual sobre el tema

FERALGINE™ a New Oral iron Compound

Management of iron deficiency (ID) and iron deficiency anemia (IDA) is primarily focused to remove, when possible, the underlying cause of ID; subsequently its treatment is primary focused on iron stores repletion. Ferrous sulphate (FS) remains the mainstay of treatment and it is recommended as the first-line treatment of ID and IDA in children as in adults by all guidelines of scientific societies. However the effectiveness of FS is largely compromised by increased adverse effects, poor compliance and discontinuation of treatment. A new oral iron source named FERALGINE™ (FBC-A) has been recently developed. This new molecule is a patented co-processed one-to-one ratio compound between Ferrous Bysglicinate Chelate (FBC) and Sodium Alginate (AA), obtained by using a spray drying technology. The data presented in this short review highlight the efficacy and safety of the treatment with FBC-A and support its use in adult patients with IDA. Furthermore the present review also provides preliminary evidence to suggest FBC-A as first-line treatment for ID/IDA in patients with celiac disease (CD) or inflammatory bowel diseases (IBD)