Microbiological and functional evaluation of an alternative device (OB®) for estrous synchronization in ewes Avaliação microbiológica e funcional de um dispositivo vaginal alternativo (OB®) para sincronização de cio em ovelhas

The use of synthetic progestagens released by vaginal devices is an important tool to overcome the reproductive seasonality in sheep, but cost and/or subsequent vaginitis are limiting factors for their use. To identify economic, simple and innocuous alternative vaginal devices for estrous synchronization/induction protocols in sheep, this study aimed to evaluate the microbiological and functional viability of the human vaginal tampons (OB®) impregnated with medroxyprogesterone acetate (MAP) on reproductive performance of ewes. The study compared them with commercial vaginal inserts (CIDR®) and polyurethane sponges impregnated with MAP. In Experiment 1, the device loss rate, the degree of vaginitis during the device removal, the count and identification of bacterial colonies at the device insertion and removal, and efficiency in estrous synchronization and estrus temporal distribution were evaluated. Pubertal ewes at the beginning of the breeding season were randomly allocated to three experimental groups: CIDR®, PSP (polyurethane sponge) and OB®. No device losses occurred in any group, but the use of OB® caused milder signs of vaginitis than polyurethane sponges, with a similar vaginal bacterial growth and microbiota than the CIDR group. The estrus distribution was more disperse in the CIDR than PSP or OB groups. In Experiment 2, pregnancy rates using CIDR® or OB® devices were compared, with estrus manifestation (85.4% and 89.8%) and pregnancy rates (58.3% and 49.0%) being similar between groups (P>0.05), respectively. In conclusion, the use of human intra-vaginal tampons (OB®) impregnated with MAP was proven highly hygienic, practical and effective as a low-cost alternative for estrous synchronization and AI in sheep.<br>O uso de progestágeno sintético liberado por pessários vaginais é uma importante ferramenta para suplantar a sazonalidade reprodutiva em ovelhas. Todavia, seu uso é limitado pelo custo ou pelas subsequentes vaginites. Na busca de uma alternativa simples e de baixo custo para sincronizar estro em ovelhas, este estudo avaliou o tampão vaginal humano (OB®) impregnado com MAP, na performance reprodutiva de ovelhas, comparando com o CIDR® e as esponjas de poliuretano, estas também impregnadas com MAP. No experimento 1 foram avaliados a taxa de perdas; o grau das vaginites no momento da remoção do pessário; a contagem e identificação das colônias bacterianas; bem como a eficiência da sincronização e a distribuição temporal dos cios. As ovelhas foram aleatoriamente distribuídas em um de três grupos experimentais: CIDR, Esponjas e OB, no inicio da estação reprodutiva. Não ocorreram perdas de pessários em qualquer grupo, porém o OB causou menor grau de vaginite em relação às esponjas, com um crescimento bacteriano e microbiota similares ao grupo CIDR. A distribuição dos cios foi mais dispersa no grupo CIDR do que nos grupos Esponja ou OB. No experimento 2, foram comparados o CIDR e OB em relação à manifestação de cio (85,4% e 89,8%) e taxa de prenhez (58,3% e 49,0%), que foram similares (P<0,05). Conclui-se que o pessário OB impregnado com MAP é higiênico, de baixo custo, prático e efetivo como para a sincronização de cios e IA em ovelhas

Advanced imaging for detection and differentiation of colorectal neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2019

1:  ESGE suggests that high definition endoscopy, and dye or virtual chromoendoscopy, as well as add-on devices, can be used in average risk patients to increase the endoscopist's adenoma detection rate. However, their routine use must be balanced against costs and practical considerations.Weak recommendation, high quality evidence. 2:  ESGE recommends the routine use of high definition systems in individuals with Lynch syndrome.Strong recommendation, high quality evidence. 3:  ESGE recommends the routine use, with targeted biopsies, of dye-based pancolonic chromoendoscopy or virtual chromoendoscopy for neoplasia surveillance in patients with long-standing colitis.Strong recommendation, moderate quality evidence. 4:  ESGE suggests that virtual chromoendoscopy and dye-based chromoendoscopy can be used, under strictly controlled conditions, for real-time optical diagnosis of diminutive (≤ 5 mm) colorectal polyps and can replace histopathological diagnosis. The optical diagnosis has to be reported using validated scales, must be adequately photodocumented, and can be performed only by experienced endoscopists who are adequately trained, as defined in the ESGE curriculum, and audited.Weak recommendation, high quality evidence. 5:  ESGE recommends the use of high definition white-light endoscopy in combination with (virtual) chromoendoscopy to predict the presence and depth of any submucosal invasion in nonpedunculated colorectal polyps prior to any treatment. Strong recommendation, moderate quality evidence. 6:  ESGE recommends the use of virtual or dye-based chromoendoscopy in addition to white-light endoscopy for the detection of residual neoplasia at a piecemeal polypectomy scar site. Strong recommendation, moderate quality evidence. 7:  ESGE suggests the possible incorporation of computer-aided diagnosis (detection and characterization of lesions) to colonoscopy, if acceptable and reproducible accuracy for colorectal neoplasia is demonstrated in high quality multicenter in vivo clinical studies. Possible significant risks with implementation, specifically endoscopist deskilling and over-reliance on artificial intelligence, unrepresentative training datasets, and hacking, need to be considered. Weak recommendation, low quality evidence