The Influence of Maternal Dietary Intake During Mid-Gestation on Growth, Feedlot Performance, miRNA and mRNA Expression, and Carcass and Meat Quality of Resultant Offspring

This research analyzed how maternal plane of nutrition during mid-gestation impacts growth, blood metabolites, expression of microRNA and messenger RNA in skeletal muscle, feedlot performance, and carcass characteristics of progeny. Thirty-two cows were bred to the same Angus sire and fed to either maintain a body condition score (BCS) of 5.0 to 5.5 (maintenance [MAIN]; n = 15) or to lose 1 BCS (restriction [REST]; n = 17) over an 84-d period of mid-gestation. Following the second trimester, all cows were co-mingled and fed at maintenance for the remainder of gestation. Following the 84-d treatment period, REST cows had a lower (P < 0.01) BCS than MAIN cows. At the end of the third trimester, there was no difference (P = 0.78) in BCS between the treatment groups. There was no difference (P > 0.10) between offspring in birthweight, weaning weight, average daily gain, feed efficiency, dry matter intake, carcass yield, steak quality, or in circulating levels of glucose, cortisol, insulin, or insulin-like growth factor-1. REST offspring expressed more (P < 0.05) miR-133a, miR-133b, miR-181d, miR-214, miR-424 and miR-486 at weaning than MAIN offspring. At harvest, REST offspring expressed more (P < 0.05) miR-133a and less (P < 0.01) miR-486 than MAIN offspring. REST steaks were perceived as more tender (P = 0.05) by a trained sensory panel. These results indicate that maternal nutrient restriction during mid-gestation resulting in a loss of 1 BCS has an effect on microRNA expression in the skeletal muscle but does not alter postnatal growth potential, carcass quality, or end product quality of the offspring. This suggests that moderate restriction in maternal nutrition during the second trimester, which results in a drop in BCS that can be recovered during the third trimester, should not cause alarm for producers when considering future offspring performance

Obstacles to Optimal Antenatal Corticosteroid Administration to Eligible Patients

Background Administration of antenatal corticosteroids (ANCS) is recommended for individuals expected to deliver between 24 and 34 weeks of gestation. Properly timed administration of ANCS achieves maximal benefit. However, more than 50% of individuals receive ANCS outside the recommended window. Objective To examine maternal and hospital factors associated with suboptimal receipt of ANCS among individuals who deliver between 24–34 weeks gestation. Study Design Secondary analysis of the Assessment of Perinatal Excellence (APEX), an observational study of births to 115,502 individuals at 25 hospitals in the US from March 2008–February 2011. Data from 3123 individuals who gave birth to a non-anomalous live-born infant between 240/7 to 340/7 weeks gestation, had prenatal records available at delivery, and data available on the timing of ANCS use were included in this analysis. Eligible individuals’ ANCS status was categorized as optimal (full course completed \u3e24 hours after ANCS but not \u3e7 days before birth) or suboptimal (none, too late, or too early). Maternal and hospital-level variables were compared using optimal as the referent group. Hierarchical multinomial logistic regression models, with site as a random effect, were used to identify maternal and hospital-level characteristics associated with optimal ANCS use. Results Overall, 83.6% (2612/3123) of eligible individuals received any treatment: 1216 (38.9%) optimal and 1907 (61.1%) suboptimal. Within suboptimal group495 (15.9%) received ANCS too late, 901 (28.9%) too early and 511 (16.4%) did not receive any ANCS. Optimal ANCS varied depending on indication for hospital admission (p\u3c0.001). Individuals who were admitted with intent to deliver were less likely to receive optimal ANCS while individuals admitted for hypertensive diseases of pregnancy were most likely to receive optimal ANCS (10% vs 35%). The median gestational age of individuals who received optimal ANCS was 31.0 weeks. Adjusting for hospital factors, hospitals with electronic medical records and who receive transfers had fewer eligible individuals who did not receive ANCS. ANCS administration and timing varied substantially by hospital; optimal frequencies ranged from 9.1 to 51.3%, and none frequencies from 6.1% to 61.8%. When evaluating variation by hospital site, models with maternal and hospital factors, did not explain any of the variation in ANCS use. Conclusions Optimal ANCS use varied by maternal and hospital factors and by hospital site, indicating opportunities for improvement

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Complications Associated with Insertion of Intrauterine Pressure Catheters: An Unusual Case of Uterine Hypertonicity and Uterine Perforation Resulting in Fetal Distress after Insertion of an Intrauterine Pressure Catheter

Insertion of intrauterine pressure catheters is a routine procedure performed in labor and delivery departments, with few associated complications. There are several reports of maternal and neonatal morbidity associated with the use of intrauterine pressure catheters and their rare adverse outcomes. We report an unusual case of uterine hypertonicity resulting in fetal distress, immediately after the placement of an intrauterine pressure catheter. An emergent Cesarean section was performed for fetal distress and revealed a 5 cm vertical rent in the posterior lower uterine segment. The uterine perforation was repaired intraoperatively. Mother and infant did well and were discharged home on postoperative day four

Central sensitization in opioid use disorder: a novel application of the American College of Rheumatology Fibromyalgia Survey Criteria

Abstract. Introduction:. Central sensitization (CS) involves dysfunctional central nervous system pain modulation resulting in heightened pain perception. Central sensitization is not commonly assessed among patients with opioid use disorder (OUD), despite the fact that pain has been implicated in the development, maintenance, and relapse of OUD and chronic opioid use may produce opioid-induced hyperalgesia. Central sensitization is a plausibly important mechanism underlying the complex relationship between OUD and chronic pain. However, this premise is largely untested. Methods:. Participants with OUD (n = 141) were recruited from an academic addiction treatment center in Columbus, Ohio. An established surrogate measure of CS, the American College of Rheumatology 2011 Fibromyalgia Survey Criteria, was administered using electronic survey. Participants also responded to questions about pain interference (Brief Pain Inventory), quality of life (RAND-36), and items regarding pain beliefs and expectations of pain and addiction treatment. Descriptive analyses, Spearman rho correlations, and Mann–Whitney U tests were performed. Results:. Hypothesized relationships were confirmed between degree of CS, pain interference, and health-related quality of life. Degree of CS was also positively correlated with greater endorsement of pain as a reason for the onset, maintenance, and escalation of OUD; treatment delay; and OUD relapse. Participants with the American College of Rheumatology 2011 Fibromyalgia Survey Criteria ≥13 had significantly greater endorsement of pain as a reason for delaying OUD treatment, continuing and increasing opioid use, and precipitating OUD relapse. Conclusions:. This study provides early evidence CS may underlie previously observed connections between clinically salient features of chronic pain and OUD, potentially informing future mechanistic research and precision treatment