Subpoblaciones espermáticas en el semen de conejo refrigerado con diferentes diluyentes

The reproductive activity of various species of mammals is influenced by the sperm subpopulations of their ejaculates. These subpopulations differ in the motility and kinetic characteristics of the sperm and have been related and classified according to their capacity for the fertilization process. The objective of this research was to evaluate the effect of the composition of the semen diluent on the sperm subpopulations of the chilled rabbit semen. The semen of 10 rabbits of the Californian breed (three ejaculated per animal) was obtained. Each ejaculate was divided into four aliquots, which were diluted in one of four diluents, whose basic composition consisted of T1: skim milk and sugars; T2: dextrose, sodium citrate and potassium acetate; T3: sodium caseinates, phosphates and sugars; and T4: tris-citric acid and egg yolk. Each aliquot was kept refrigerated at 16 °C for 72 h. Immediately after dilution and every 24 h, the distribution of four sperm subpopulations was evaluated using a computerized system: Type A (rapid progressive spermatozoa), Type B (rapid spermatozoa and medium progressive spermatozoa), Type C (medium spermatozoa and slow spermatozoa) and Type D (static spermatozoa). The data were analyzed using the PROC GLM and Tukey's HSD test of the SAS v. 9.2. It was found that T1 and T3 produced superior results for curvilinear velocity (VCL), straight line velocity (VSL), average path velocity (VAP) and amplitude of lateral head displacement (ALH) of sperm refrigerated for 24 and 48 hours (p<0.05), while T2 and T4 produced an increase in the beat cross frequency (BCF) (p<0.05). It is concluded that the composition of the diluent influences the distribution of the sperm subpopulations of the refrigerated rabbit semen, by generating changes in the progressivity and kinetics of the sperm.La actividad reproductiva de diversas especies de mamíferos se encuentra influenciada por las subpoblaciones espermáticas de sus eyaculados. Dichas subpoblaciones se diferencian en las características de movilidad y cinética de los espermatozoides y han sido relacionadas y catalogadas según su capacidad para el proceso de fertilización. El objetivo de este estudio fue evaluar el efecto de la composición del diluyente de semen sobre las subpoblaciones espermáticas del semen refrigerado de conejo. Se obtuvo el semen de 10 conejos de la raza Californiano (tres eyaculados por animal). Cada eyaculado se dividió en cuatro alícuotas, las cuales se diluyeron en uno de cuatro diluyentes, cuya composición básica consistió en T1: leche descremada y azucares; T2: dextrosa, citrato sódico y acetato potásico; T3: caseinatos de sodio, fosfatos y azúcares; y T4: tris-ácido cítrico y yema de huevo. Cada alícuota se mantuvo en refrigeración a 16 °C durante 72 horas. Inmediatamente después de la dilución y cada 24 horas se evaluó la distribución de cuatro subpoblaciones de espermatozoides mediante un sistema computarizado: Tipo A (espermatozoides rápidos progresivos), Tipo B (espermatozoides rápidos y espermatozoides medios progresivos), Tipo C (espermatozoides medios y espermatozoides lentos), y Tipo D (espermatozoides estáticos). Los datos se analizaron mediante el PROC GLM y la prueba HSD de Tukey del software SAS v. 9.2. Se encontró que T1 y T3 produjeron resultados superiores para la velocidad curvilínea (VCL), la velocidad rectilínea (VSL), la velocidad promedio (VAP) y la amplitud de desplazamiento lateral de la cabeza (ALH) de los espermatozoides refrigerados durante 24 y 48 horas (p<0.05), mientras que T2 y T4 produjeron un incremento en la frecuencia de batido (BCF) (p<0.05). Se concluye que la composición del diluyente influye sobre la distribución de las subpoblaciones espermáticas del semen refrigerado de conejo, al generar cambios en la progresividad y la cinética de los espermatozoides

Evaluación de diluyentes para la refrigeración de semen de conejo (Oryctolagus cuniculus)

The aim of this research was to evaluate the use of different extenders for cooling of rabbit semen and its effect on sperm quality. Thirty semen samples from 10 sexually mature rabbits (Oryctolagus cuniculus) were used. Each sample was diluted separately in a 1:10 ratio in four extenders, composed of skim milk and sugars (T1); dextrose, sodium citrate, and potassium acetate (T2); sodium caseinates, phosphates and sugars (T3); and tris-citric acid and egg yolk (T4). The semen was kept at 16 °C for 72 hours. At the time of dilution and every 24 hours, total motility (MT), progressive motility (MP) and sperm kinetics were evaluated with the Sperm Class Analyzer® system, and vitality and morphology were evaluated by the eosin-nigrosin staining. Statistical analysis was performed using mixed models and the comparison of means by the Duncan test. At the time of dilution (0 h), a lower MT for T2 and T4 was observed (p<0.05). This same effect at 24 h of cooling was observed, while at 48 h the MT was lower for T2, compared to T1, T3 and T4 (p <0.05). The MP was equally higher for T1 and T3 at 0, 24 and 48 h (p<0.05). A decrease in normal morphology at 72 h for T4 was found (p<0.05). Greater preservation of the viability over time for T1 and T3 was observed (p<0.05). It is concluded that the extenders composed by skim milk or caseinates, and sugars, protect more efficiently the rabbit semen preserved by refrigeration.El objetivo de esta investigación fue evaluar el uso de diferentes diluyentes para la refrigeración de semen de conejo y su efecto sobre la calidad espermática. Se utilizaron 30 muestras de semen de 10 conejos (Oryctolagus cuniculus) sexualmente maduros. Cada muestra se diluyó separadamente en proporción 1:10 en cuatro diluyentes, compuestos por leche descremada y azucares (T1); dextrosa, citrato sódico y acetato potásico (T2); caseinatos de sodio, fosfatos y azúcares (T3); y tris-ácido cítrico y yema de huevo (T4). El semen se mantuvo a 16 °C durante 72 horas. Al momento de la dilución y cada 24 horas se evaluó la movilidad total (MT), la movilidad progresiva (MP) y la cinética espermática con el sistema Sperm Class Analizer®, y la viabilidad y la morfología mediante la tinción con eosina-nigrosina. El análisis estadístico se realizó mediante modelos mixtos y la comparación de medias por la prueba de Duncan. Al momento de la dilución (0 h), se observó una MT inferior para T2 y T4 en comparación con T1 y T3 (p<0.05). Este mismo efecto se observó a las 24 h de refrigeración, mientras a las 48 h la MT fue inferior para T2, respecto a T1, T3 y T4 (p<0.05). La MP fue igualmente superior para T1 y T3 a las 0, 24 y 48 h (p<0.05). Se halló un descenso en la morfología normal a las 72 h para T4 (p<0.05). Se observó una mayor conservación de la viabilidad en el tiempo para T1 y T3 (p<0.05). Se concluye que los diluyentes compuestos por leche descremada o caseinatos con azucares protegen de forma más eficiente los espermatozoides de conejo conservados mediante refrigeración

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

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care