Cardiac output affects the response to pulsed inhaled nitric oxide in mechanically ventilated anesthetized ponies determined by CT angiography of the lung

OBJECTIVE To measure changes in regional lung perfusion using CT angiography in mechanically ventilated, anesthetized ponies administered pulsed inhaled nitric oxide (PiNO) during hypotension and normotension.ANIMALS 6 ponies for anesthetic 1 and 5 ponies for anesthetic 2.PROCEDURES Ponies were anesthetized on 2 separate occasions, mechanically ventilated, and placed in dorsal recumbency within the CT gantry. Pulmonary arterial, right atrial, and facial arterial catheters were placed. During both anesthet-ics, PiNO was delivered for 60 minutes and then discontinued. Anesthetic 1: hypotension (mean arterial pressure < 70 mmHg) was treated using dobutamine after 30 minutes of PiNO delivery. Following the discontinuation of PiNO, dobutamine administration was discontinued in 3 ponies and was continued in 3 ponies. The lung was imaged at 30, 60, and 105 minutes. Anesthetic 2: hypotension persisted throughout anesthesia. The lung was imaged at 30, 60, and 90 minutes. At all time points, arterial and mixed venous blood samples were analyzed and cardiac output (Qt) was measured. Pulmonary perfusion was calculated from CT image analysis.RESULTS During PiNO delivery, perfusion to well-ventilated lungs increased if ponies were normotensive, leading to increased arterial oxygenation, reduced alveolar dead space, and reduced alveolar to arterial oxygen tension gradient. When PiNO was stopped and dobutamine administration continued, alveolar dead space and venous admixture increased, in contrast to when dobutamine and PiNO were both discontinued.CLINICAL RELEVANCE If PiNO is administered to mechanically ventilated, anesthetized ponies with concurrent hypotension and low Qt, this must be supported to achieve favorable redistribution of pulmonary perfusion to improve pulmonary gas exchange

Effects of early castration on carcass composition, yield and quality characteristics of meat from young reindeer (Rangifer tarandus tarandus) bulls and steers

Thirty male reindeer; n=16 bulls (control treatment) and n=14 steers (castrated males) were used to evaluate the effects of early castration on carcass yield and meat quality attributes. The reindeer were castrated at 2 and 13 months of age, and then slaughtered at 2 and 3 years of age. Live weights and carcass weights were significantly highest in the 3 year old bulls and steers. Dressing percentage did not differ between the 2 and 3 year old reindeer steers castrated at 2 months; however these values were higher than for 2 year old steers castrated at 13 months. Meat ultimate pH values (measured in the striploin; LD) were significantly highest in 2 year old steers castrated at 13 months and their corresponding control group of 2 year old bulls, indicating low muscle glycogen stores at slaughter. Castration had an effect on fat content with 3 year old steers having a higher fat content than bulls. No significant differences were found in any sensory attribute when the trained panel compared the meat from 2 year old reindeer bulls and steers. Abstract in Swedish / Sammanfattning:Effekter av tidig kastrering p&aring; slaktkroppssammans&auml;ttning, styckningsutbyte och k&ouml;ttkvalitet hos unga renarTrettio hanrenar; n=16 tjurar (kontrolldjur) och n=14 kastrater (h&auml;rkar) ingick i denna studie f&ouml;r att utv&auml;rdera effekterna av tidig kastrering p&aring; slaktkroppssammans&auml;ttning och k&ouml;ttkvalitetsparametrar. Renarna kastrerades vid 2 respektive 13 m&aring;naders &aring;lder och slaktades sedan n&auml;r de var antingen 2 eller 3 &aring;r gamla. Levandevikt och slaktkroppsvikt var h&ouml;gst f&ouml;r 3 &aring;r gamla tjurar och h&auml;rkar. Slaktutbytet skiljde sig inte mellan 2 och 3 &aring;r gamla h&auml;rkar som kastrerats vid 2 m&aring;naders &aring;lder, men deras slaktutbyte var h&ouml;gre &auml;n f&ouml;r de 2-&aring;riga h&auml;rkarna som kastrerats vid 13 m&aring;naders &aring;lder. K&ouml;ttets pH-v&auml;rde (m&auml;tt i ytterfil&eacute;n) var signifikant h&ouml;gst hos de 2-&aring;riga h&auml;rkarna som kastrerats vid 13 m&aring;naders &aring;lder och deras tillh&ouml;rande kontrollgrupp av 2-&aring;riga tjurar, vilket tydde p&aring; l&aring;ga niv&aring;er av muskelglykogen vid slakt. Kastrering hade en signifikant effekt p&aring; fettinneh&aring;llet i slaktkropparna hos de 3-&aring;riga renarna, med de h&ouml;gsta fetthalterna hos h&auml;rkarna. Inga skillnader i &auml;tkvalitet rapporterades n&auml;r k&ouml;tt fr&aring;n 2-&aring;riga rentjurar och h&auml;rkar j&auml;mf&ouml;rdes

Robotic intracorporeal urinary diversion: practical review of current surgical techniques

In this practical review, we discuss current surgical techniques reported in the literature to perform Intracorporeal Urinary Diversion (ICUD) after Robotic Radical Cystectomy (RARC), emphasizing criticisms of single approaches and making comparisons with Extracorporeal Urinary Diversion (ECUD). Although almost 97% of all RARCs use an ECUD, ICUD is gaining in popularity, in view of its potential benefits (i.e., decreased bowel exposure, etc.), although there are a few studies comparing ICUD and ECUD. Analysing single experiences and the data from recent metanalyses, we emphasize the current critiques to ICUD, stressing particular technical details which could reduce operative time, lowering the postoperative complications rate, and improving functional outcomes. Only analysis of long-term follow-up data from large-scale homogeneous series can ascertain whether robotic intracorporeal urinary diversion is superior to other approaches

Feeding soy or fish meal to Alaskan reindeer (Rangifer tarandus tarandus) – effects on animal performance and meat quality

Fourteen reindeer (8 steers and 6 females) were used to compare the effects of two different reindeer diets (a feed mix based on barley, brome hay and soybean meal (SBM) or fishmeal (WFM) as protein source) on animal growth performance, feed conversion efficiency and ultimate meat quality. Samples from free-ranging reindeer (n=4; 2 steers and 2 females) on the Seward Peninsula were included to provide comparisons with the traditional reindeer meat produced in Alaska. No significant difference was observed in overall weight gain between the WFM and SBM animals or between females and steers; however, the feed conversion efficiency was significantly higher for the reindeer fed the WFM mix. Carcass dressing percentage from the SBM group was higher compared with the WFM animals. No differences were found in live weight, carcass characteristics, meat pH, temperature decline, shear force, meat color or cooking loss when comparing the treatment groups. The meat samples (M. longissimus) from the free-range group had the highest amount of omega-3 fatty acids and also the highest amount of polyunsaturated fatty acids (PUFA). Meat from the animals fed SBM was significantly higher in triglyceride content and lower in phospholipid content compared with the two other groups. No significant differences were found when the trained panel compared the sensory attributes of the meat. Off-flavor attributes related to &ldquo;wild&rsquo; or &ldquo;gamey&rdquo; flavor was reported by consumers for samples from the WFM and free-range reindeer (15 and 24 per cent of the consumers, respectively). No &ldquo;fish-related&rdquo; flavor was reported. In conclusion, no negative effects in either animal performance or meat quality characteristics by using fish meal as opposed to soybean meal as a protein supplement in a milled reindeer diet were found.Abstract in Swedish / Sammandrag:Utfordring av ren med soja- eller fiskmj&oslash;l &ndash; effekter p&aring; tillv&auml;xt, foderutnyttjande och k&ouml;ttkvalitet I v&aring;r unders&ouml;kning ingick 14 renar (8 kastrerade sarvar (h&auml;rkar)och 6 vajor) f&ouml;r att j&auml;mf&ouml;ra effekter av tv&aring; olika renfoder (baserade p&aring; korn, h&ouml; och soja- (SBM) eller fiskmj&ouml;l (WFM) som proteintillskott) med avseende p&aring; tillv&auml;xt, foderutnyttjande och k&ouml;ttkvalitet. K&ouml;ttprover fr&aring;n naturbetande renar (n=4; 2 h&auml;rkar och 2 vajor) fr&aring;n Seward Peninsula inkluderades i studien f&ouml;r att representera kvaliteten p&aring; traditionellt producerat renk&ouml;tt fr&aring;n Alaska. Inga signifikanta skillnader i tillv&auml;xt observerades, varken mellan SBM- och WFM-grupperna eller mellan h&auml;rkar och vajor. Foderutnyttjandet var dock signifikant b&auml;ttre hos WFM-renarna. Slaktutbytet var h&ouml;gst f&ouml;r renarna i SBM-gruppen, d&auml;remot rapporterades inga skillnader i levandevikt, slaktkroppsegenskaper, pH-v&auml;rde och temperatur i ytterfil&eacute;n, sk&auml;rmotst&aring;nd, f&auml;rg eller vattenh&aring;llande f&ouml;rm&aring;ga i k&ouml;ttet n&auml;r de tre grupperna av renar j&auml;mf&ouml;rdes (SBM, WFM och naturbetande djur). K&ouml;ttet fr&aring;n de naturbetande renarna hade det signifikant h&ouml;gsta inneh&aring;llet av b&aring;de omega-3-fettsyror och av flerom&auml;ttade fettsyror. K&ouml;tt fr&aring;n SBM-renarna hade det h&ouml;gsta inneh&aring;llet av triglycerider och det l&auml;gsta inneh&aring;llet av fosfolipider j&auml;mf&ouml;rt med de andra tv&aring; grupperna. Den tr&auml;nade smakpanelen kunde inte hitta n&aring;gra skillnader i sensoriska egenskaper hos k&ouml;ttet fr&aring;n renarna i de tre olika grupperna. I en konsumentunders&ouml;kning rapporterades kommentarer om olika &rdquo;vilt-relaterade&rdquo; bismaker i k&ouml;tt fr&aring;n naturbetande renar (24% av konsumenterna) och fr&aring;n WFM-gruppen (15% av konsumenterna), men inga &rdquo;fisk-liknande&rdquo; bismaker i k&ouml;ttet kunde p&aring;visas. Att byta ut sojamj&ouml;l mot fiskmj&ouml;l som proteintillskott i renfoder hade inga negativa effekter p&aring; renarnas tillv&auml;xt, foderutnyttjande eller p&aring; renk&ouml;ttets kvalitet

Effect of Comorbidity on Prostate Cancer-Specific Mortality: A Prospective Observational Study.

Purpose To determine the effect of comorbidity on prostate cancer (PCa)-specific mortality across treatment types. Patients and Methods These are the results of a population-based observational study in Sweden from 1998 to 2012 of 118,543 men who were diagnosed with PCa with a median follow-up of 8.3 years (interquartile range, 5.2 to 11.5 years) until death from PCa or other causes. Patients were categorized by patient characteristics (marital status, educational level) and tumor characteristics (serum prostate-specific antigen, tumor grade and clinical stage) and by treatment type (radical prostatectomy, radical radiotherapy, androgen deprivation therapy, and watchful waiting). Data were stratified by Charlson comorbidity index (0, 1, 2, or ≥ 3). Mortality from PCa and other causes and after stabilized inverse probability weighting adjustments for clinical patient and tumor characteristics and treatment type was determined. Kaplan-Meier estimates and Cox proportional hazards regression models were used to calculate hazard ratios. Results In the complete unadjusted data set, we observed an effect of increased comorbidity on PCa-specific and other-cause mortality. After adjustments for patient and tumor characteristics, the effect of comorbidity on PCa-specific mortality was lost but maintained for other-cause mortality. After additional adjustment for treatment type, we again failed to observe an effect for comorbidity on PCa-specific mortality, although it was maintained for other-cause mortality. Conclusion This large observational study suggests that comorbidity affects other cause-mortality but not PCa-specific- mortality after accounting for patient and tumor characteristics and treatment type. Regardless of radical treatment type (radical prostatectomy or radical radiotherapy), increasing comorbidity does not seem to significantly affect the risk of dying from PCa. Consequently, differences in oncologic outcomes that were observed in population-based comparative effectiveness studies of PCa treatments may not be a result of the varying distribution of comorbidity among treatment groups

Psychometric validation of the German translation of the Gastrointestinal Symptom Rating Scale (GSRS) and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire in patients with reflux disease

BACKGROUND: Symptoms of heartburn has an impact on health-related quality of life (HRQL). When a questionnaire is translated into a new language, a linguistic validation is necessary but not sufficient unless the psychometric characteristics have been verified. The aim is to document the psychometric characteristics of the German translation of the Gastrointestinal Symptom Rating Scale (GSRS) and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire. METHODS: 142 patients with symptoms of heartburn (Age: M = 47.5, ± 14.6; Males = 44.4%) completed the German translation of GSRS, the QOLRAD, the Short-Form-36 (SF-36) and the Hospital Anxiety and Depression (HAD) scale. RESULTS: The internal consistency reliability of GSRS ranged from 0.53–0.91 and of QOLRAD from 0.90–0.94, respectively. The test-retest reliability of GSRS ranged from 0.49–0.73 and of QOLRAD from 0.70–0.84. The relevant domains of the GSRS and QOLRAD domain scores significantly correlated. GSRS domains of Abdominal Pain and Constipation correlated (negatively) with most of the domains of the SF-36. The relevant QOLRAD domains significantly correlated with all SF-36 domains. CONCLUSIONS: The psychometric characteristics of the German translation of GSRS and QOLRAD were found to be good, with satisfactory reliability and validity. The reliability of the GSRS Abdominal Pain domain was moderate

Biochemical Recurrence and Risk of Mortality Following Radiotherapy or Radical Prostatectomy

Importance: Stratifying patients with biochemical recurrence (BCR) after primary treatment for prostate cancer based on the risk of prostate cancer-specific mortality (PCSM) is essential for determining the need for further testing and treatments. Objective: To evaluate the association of BCR after radical prostatectomy or radiotherapy and its current risk stratification with PCSM. Design, Setting, and Participants: This population-based cohort study included a total of 16 311 male patients with 10 364 (64%) undergoing radical prostatectomy and 5947 (36%) undergoing radiotherapy with curative intent (cT1-3, cM0) and PSA follow-up in Stockholm, Sweden, between 2003 and 2019. Follow-up for all patients was until death, emigration, or end of the study (ie, December 31, 2018). Data were analyzed between September 2022 and March 2023. Main Outcomes and Measures: Primary outcomes of the study were the cumulative incidence of BCR and PCSM. Patients with BCR were stratified in low- and high-risk according to European Association of Urology (EAU) criteria. Exposures: Radical prostatectomy or radiotherapy. Results: A total of 16 311 patients were included. Median (IQR) age was 64 (59-68) years in the radical prostatectomy cohort (10 364 patients) and 69 (64-73) years in the radiotherapy cohort (5947 patients). Median (IQR) follow-up for survivors was 88 (55-138) months and 89 (53-134) months, respectively. Following radical prostatectomy, the 15-year cumulative incidences of BCR were 16% (95% CI, 15%-18%) for the 4024 patients in the low D'Amico risk group, 30% (95% CI, 27%-32%) for the 5239 patients in the intermediate D'Amico risk group, and 46% (95% CI, 42%-51%) for 1101 patients in the high D'Amico risk group. Following radiotherapy, the 15-year cumulative incidences of BCR were 18% (95% CI, 15%-21%) for the 1230 patients in the low-risk group, 24% (95% CI, 21%-26%) for the 2355 patients in the intermediate-risk group, and 36% (95% CI, 33%-39%) for the 2362 patients in the high-risk group. The 10-year cumulative incidences of PCSM after radical prostatectomy were 4% (95% CI, 2%-6%) for the 1101 patients who developed low-risk EAU-BCR and 9% (95% CI, 5%-13%) for 649 patients who developed high-risk EAU-BCR. After radiotherapy, the 10-year PCSM cumulative incidences were 24% (95% CI, 19%-29%) for the 591 patients in the low-risk EAU-BCR category and 46% (95% CI, 40%-51%) for the 600 patients in the high-risk EAU-BCR category. Conclusions and Relevance: These findings suggest the validity of EAU-BCR stratification system. However, while the risk of dying from prostate cancer in low-risk EAU-BCR after radical prostatectomy was very low, patients who developed low-risk EAU-BCR after radiotherapy had a nonnegligible risk of prostate cancer mortality. Improving risk stratification of patients with BCR is pivotal to guide salvage treatment decisions, reduce overtreatment, and limit the number of staging tests in the event of PSA elevations after primary treatment.</p

Application of an acoustofluidic perfusion bioreactor for cartilage tissue engineering

Cartilage grafts generated using conventional static tissue engineering strategies are characterised by low cell viability, suboptimal hyaline cartilage formation and, critically, inferior mechanical competency, which limit their application for resurfacing articular cartilage defects. To address the limitations of conventional static cartilage bioengineering strategies and generate robust, scaffold-free neocartilage grafts of human articular chondrocytes, the present study utilised custom-built microfluidic perfusion bioreactors with integrated ultrasound standing wave traps. The system employed sweeping acoustic drive frequencies over the range of 890 to 910 kHz and continuous perfusion of the chondrogenic culture medium at a low-shear flow rate to promote the generation of three-dimensional agglomerates of human articular chondrocytes, and enhance cartilage formation by cells of the agglomerates via improved mechanical stimulation and mass transfer rates. Histological examination and assessment of micromechanical properties using indentation-type atomic force microscopy confirmed that the neocartilage grafts were analogous to native hyaline cartilage. Furthermore, in the ex vivo organ culture partial thickness cartilage defect model, implantation of the neocartilage grafts into defects for 16 weeks resulted in the formation of hyaline cartilage-like repair tissue that adhered to the host cartilage and contributed to significant improvements to the tissue architecture within the defects, compared to the empty defects. The study has demonstrated the first successful application of the acoustofluidic perfusion bioreactors to bioengineer scaffold-free neocartilage grafts of human articular chondrocytes that have the potential for subsequent use in second generation autologous chondrocyte implantation procedures for the repair of partial thickness cartilage defects

Mapping of the three-dimensional lymphatic microvasculature in bladder tumours using light-sheet microscopy

Background: Cancers are heterogeneous and contain various types of irregular structures that can go undetected when examining them with standard two-dimensional microscopes. Studies of intricate networks of vasculature systems, e.g., the tumour lymphatic microvessels, benefit largely from three-dimensional imaging data analysis.Methods: The new DIPCO (Diagnosing Immunolabeled Paraffin-Embedded Cleared Organs) imaging platform uses three-dimensional light-sheet microscopy and whole-mount immunolabelling of cleared samples to study proteins and micro-anatomies deep inside of tumours.Results: Here, we uncovered the whole three-dimensional lymphatic microvasculature of formalin-fixed paraffin-embedded (FFPE) tumours from a cohort of 30 patients with bladder cancer. Our results revealed more heterogeneous spatial deviations in more advanced bladder tumours. We also showed that three-dimensional imaging could determine tumour stage and identify vascular or lymphatic system invasion with higher accuracy than standard two-dimensional histological diagnostic methods. There was no association between sample storage times and outcomes, demonstrating that the DIPCO pipeline could be successfully applied on old FFPE samples.Conclusions: Studying tumour samples with three-dimensional imaging could help us understand the pathological nature of cancers and provide essential information that might improve the accuracy of cancer staging.</div