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OBJECTIVE: To describe the sonomorphological changes and appearance of deep endometriosis (DE) affecting the nervous tissue of the sacral plexus (SP). METHODS: This was a retrospective study of symptomatic patients who underwent radical resection of histologically confirmed DE affecting the SP and who had undergone preoperative transvaginal sonography (TVS) between 2019 and 2023. Lesions were described based on the terms and definitions of the International Deep Endometriosis Analysis (IDEA), International Ovarian Tumor Analysis (IOTA) and Morphological Uterus Sonographic Assessment (MUSA) groups. A diagnosis of DE affecting the SP on TVS was made when the sonographic criteria of DE were visualized in conjunction with fibers of the SP and the presence of related symptoms corresponding to sacral radiculopathy. Clinical symptoms, ultrasound features and histological confirmation were analyzed for each patient included. RESULTS: Twenty-seven patients with DE infiltrating the SP were identified in two contributing tertiary referral centers. Median age was 37 (range, 29-45) years and all patients were symptomatic and presented one or more of the following neurological symptoms: dysesthesia in the ipsilateral lower extremity (n = 17); paresthesia in the ipsilateral lower extremity (n = 10); chronic pelvic pain radiating in the ipsilateral lower extremity (n = 9); chronic pain radiating in the pudendal region (n = 8); and motor weakness in the ipsilateral lower extremities (n = 3). All DE lesions affecting the SP were purely solid tumors in the posterior parametrium in direct contact with, or infiltrating, the S1, S2, S3 and/or S4 roots of the SP. The median of the largest diameter recorded for each of the DE nodules was 35 (range, 18-50) mm. Echogenicity was non-uniform in 23 (85%) of the DE nodules, with all but one of these nodules containing hyperechogenic areas. The shape of the lesions was irregular in 24 (89%) cases. Only one lesion exhibited a lobulated form, with all other irregular lesions showing a spiculated appearance. An acoustic shadow was produced in 20 (74%) of the nodules, all of which were internal. On color or power Doppler examination, 21 (78%) of the nodules showed no signal (color score of 1). The remaining six (22%) lesions showed a minimal color content (color score of 2). According to pattern recognition, most DE nodules were purely solid, non-uniform, hypoechogenic nodules containing hyperechogenic areas, with internal shadows and irregular spiculated contours, and were poorly vascularized on color/power Doppler examination. CONCLUSION: The ultrasound finding of a parametrial, unilateral, solid, non-uniform, hypoechogenic nodule with hyperechogenic areas and possible internal shadowing, as well as irregular spiculated contours, demonstrating poor vascularization on Doppler examination in proximity to or involving the structures of the SP, indicates DE affecting the SP. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Endometriosis , Plexo Lumbosacro , Humanos , Femenino , Endometriosis/diagnóstico por imagen , Endometriosis/patología , Endometriosis/complicaciones , Adulto , Estudios Retrospectivos , Persona de Mediana Edad , Plexo Lumbosacro/diagnóstico por imagen , Ultrasonografía/métodos , Dolor Pélvico/etiología , Dolor Pélvico/diagnóstico por imagen , Parestesia/etiologíaRESUMEN
OBJECTIVE: To investigate the feasibility of identifying and measuring the normal sacral plexus (SP) on gynecological transvaginal ultrasound (TVS) examination. METHODS: This was a prospective observational study conducted at a single tertiary gynecological referral center, including consecutive women undergoing TVS for various indications between November 2021 and January 2022. A standardized assessment of the pelvic organs was performed and the presence of any congenital or acquired uterine pathology or ovarian abnormality was recorded. Visualization of the right and left SP was attempted in all cases. The success rate and the time needed to identify the SP were recorded and measurements of the SP were made. RESULTS: A total of 326 patients were included in the study. In all women, the SP was identified successfully on at least one side. SP were visualized bilaterally in 317 (97.2% (95% CI, 94.4-98.5%)) women. Only the right SP was seen in 3/326 (0.9% (95% CI, 0.2-2.7%)) and only the left in 6/326 (1.8% (95% CI, 0.6-4.0%)) (P = 0.5048). There was no significant difference in the median time required to visualize the right vs left SP (9.0 (interquartile range (IQR), 8.0-10.0) s vs 9.0 (IQR, 8.0-10.0) s; P = 0.0770). The median transverse diameter of the right SP was 15.0 (IQR, 14.2-15.6) mm and that of the left SP was 14.9 (IQR, 14.4-15.6) mm. CONCLUSIONS: We describe a novel method which allows for the consistent and rapid identification of the SP on TVS. Integrating assessment of the SP into routine pelvic TVS may be helpful particularly for women suffering from deep endometriosis. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Endometriosis , Ginecología , Plexo Lumbosacro , Enfermedades del Ovario , Femenino , Humanos , Embarazo , Endometriosis/patología , Estudios de Factibilidad , Ultrasonografía/métodos , Útero/diagnóstico por imagen , Útero/patologíaRESUMEN
OBJECTIVE: To compare the preoperative detection of endometriosis using transvaginal sonography (TVS) supplemented by transabdominal sonography (TAS) with surgical assessment of disease, using the #Enzian classification for endometriosis. METHODS: This was a prospective multicenter diagnostic accuracy study of women undergoing TVS/TAS and radical surgery for deep endometriosis (DE) at different tertiary referral centers. The localization and grade of severity of the endometriotic lesions and adhesions were described according to the criteria of the #Enzian classification, both at preoperative ultrasound examination and during surgery. According to the #Enzian classification, the small pelvis is divided into three compartments for DE: A (rectovaginal septum and vagina); B (uterosacral and cardinal ligaments, parametrium and pelvic sidewalls); and C (rectum). In addition, further locations (F) are classified as adenomyosis (FA), urinary bladder involvement (FB) and ureteric involvement with signs of obstruction (FU). Other intestinal locations (FI) and other extragenital locations (FO) are also included. Ovarian endometriosis and adhesions at the level of the tubo-ovarian unit are listed as O and T, respectively. The #Enzian grade of severity (Grade 1-3) was determined for #Enzian compartments O, T, A, B and C based on the size of the lesion or the severity of the adhesions. Concordance between preoperative assessment using TVS/TAS and evaluation at surgery was assessed. The sensitivity, specificity, positive and negative predictive values and accuracy of TVS/TAS in the detection of endometriotic lesions/adhesions in the different #Enzian compartments were calculated. RESULTS: In total, 745 women were included in the analysis. Preoperative TVS/TAS and surgical findings showed a concordance rate ranging between 86% and 99% for the presence or absence of endometriotic lesions/adhesions, depending on the evaluated #Enzian compartment. The concordance rate between TVS and surgery ranged between 71% and 92% for different severity grades, in #Enzian compartments O, T, A, B and C. Determining the presence or absence of adhesions at the level of the tubo-ovarian unit and classifying them accurately as Grade 1, 2 or 3 on TVS was more difficult than determining the presence and severity of endometriotic lesions in #Enzian compartments O, A, B and C. The sensitivity of TVS/TAS for the detection of endometriotic lesions ranged from 50% (#Enzian compartment FI) to 95% (#Enzian compartment A), specificity from 86% (#Enzian compartment Tleft ) to 99% (#Enzian compartment FI) and 100% (#Enzian compartments FB, FU and FO), positive predictive value from 90% (#Enzian compartment Tright ) to 100% (#Enzian compartment FO), negative predictive value from 74% (#Enzian compartment Bleft ) to 99% (#Enzian compartments FB and FU) and accuracy from 88% (#Enzian compartment Bright ) to 99% (#Enzian compartment FB). CONCLUSIONS: The localization and severity of endometriotic lesions/adhesions, as described and classified according to the #Enzian classification, can be diagnosed accurately and non-invasively using TVS/TAS. The #Enzian classification provides a uniform classification system for describing endometriotic lesions, which can be used both at TVS/TAS and during surgical evaluation. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Endometriosis , Endometriosis/patología , Femenino , Humanos , Estudios Prospectivos , Recto/diagnóstico por imagen , Sensibilidad y Especificidad , Adherencias Tisulares/patología , Ultrasonografía , Vagina/diagnóstico por imagenRESUMEN
Lentiviral vectors have proved an effective method to deliver transgenes into the brain; however, they are often hampered by a lack of spread from the site of injection. Modifying the viral envelope with a portion of a rabies envelope glycoprotein can enhance spread in the brain by using long-range axon projections to facilitate retrograde transport. In this study, we generated two chimeric envelopes containing the extra-virion and transmembrane domain of rabies SADB19 or CVS-N2c with the intra-virion domain of vesicular stomatitis virus. Viral particles were packaged containing a green fluorescent protein reporter construct under the control of the phosphoglycerokinase promoter. Both vectors produced high-titer particles with successful integration of the glycoproteins into the particle envelope and significant transduction of neurons in vitro. Injection of the SADB19 chimeric viral vector into the lumbar spinal cord of adult mice mediated a strong preference for gene transfer to local neurons and axonal terminals, with retrograde transport to neurons in the brainstem, hypothalamus and cerebral cortex. Development of this vector provides a useful means to reliably target select populations of neurons by retrograde targeting.
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Transporte Axonal , Técnicas de Transferencia de Gen , Lentivirus/genética , Virus de la Rabia/genética , Médula Espinal/citología , Vesiculovirus/genética , Proteínas del Envoltorio Viral/genética , Animales , Células Cultivadas , Vectores Genéticos/genética , Glicerol Quinasa/genética , Proteínas Fluorescentes Verdes/genética , Proteínas Fluorescentes Verdes/metabolismo , Ratones , Ratones Endogámicos C57BL , Neuronas/metabolismo , Regiones Promotoras Genéticas , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Médula Espinal/metabolismo , Proteínas del Envoltorio Viral/metabolismoRESUMEN
STUDY QUESTION: Is it possible to replicate the previously identified genetic association of four single-nucleotide polymorphisms (SNPs), rs12700667, rs7798431, rs1250248 and rs7521902, with endometriosis in a Caucasian population? SUMMARY ANSWER: A borderline association was observed for rs1250248 and endometriosis (P = 0.049). However, we could not replicate the other previously identified endometriosis-associated SNPs (rs12700667, rs7798431 and rs7521902) in the same population. WHAT IS KNOWN ALREADY: Endometriosis is considered a complex disease, influenced by several genetic and environmental factors, as well as interactions between them. Previous studies have found genetic associations with endometriosis for SNPs at the 7p15 and 2q35 loci in a Caucasian population. STUDY DESIGN, SIZE, DURATION: Allele frequencies of SNPs were investigated in patients with endometriosis and controls. PARTICIPANTS/MATERIALS, SETTING, METHODS: Blood samples and peritoneal biopsies were taken from a Caucasian female population consisting of 1129 patients with endometriosis and 831 controls. DNA was extracted for genotyping. The study was performed at a University hospital and research laboratories. MAIN RESULTS AND THE ROLE OF CHANCE: A weak association with endometriosis (all stages) was observed for rs1250248 (P = 0.049). No significant associations were observed for the SNPs rs12700667, rs7798431 and rs7521902. A non-significant trend towards the association of rs1250248 with moderate/severe endometriosis was observed (odds ratio 1.18, 95% confidence interval 0.97-1.44). LIMITATIONS, REASONS FOR CAUTION: The inability to confirm all previous findings may result from differences between populations and type II errors. WIDER IMPLICATIONS OF THE FINDINGS: Our result demonstrates the difficulty of identifying common genetic variants in complex diseases. STUDY FUNDING/COMPETING INTEREST(S): This study was supported by grants from the Karolinska Institutet and Stockholm City County/Karolinska Institutet (ALF), Stockholm, Sweden, Swedish Medical Research Council (K2007-54X-14212-06-3, K2010-54X-14212-09-3), Stockholm, Sweden, Leuven University Research Council (Onderzoeksraad KU Leuven), the Leuven University Hospitals Clinical Research Foundation (Klinisch onderzoeksfonds) and by the National Scientific Foundation (Fonds voor Wetenschappelijk Onderzoek, FWO). The authors have no conflict of interest.
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Cromosomas Humanos Par 2 , Endometriosis/genética , Fibronectinas/genética , Polimorfismo de Nucleótido Simple , Región de Flanqueo 5' , Adulto , Alelos , Factores de Transcripción con Cremalleras de Leucina de Carácter Básico/genética , Factores de Transcripción con Cremalleras de Leucina de Carácter Básico/metabolismo , Bélgica , Biopsia , Cromosomas Humanos Par 7 , Registros Electrónicos de Salud , Endometriosis/metabolismo , Endometriosis/patología , Endometriosis/fisiopatología , Femenino , Fibronectinas/metabolismo , Estudio de Asociación del Genoma Completo , Proteínas Homeobox A10 , Proteínas de Homeodominio/genética , Proteínas de Homeodominio/metabolismo , Humanos , Modelos Genéticos , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Proteína Wnt4/genética , Proteína Wnt4/metabolismoRESUMEN
BACKGROUND: At present, the only way to conclusively diagnose endometriosis is laparoscopic inspection, preferably with histological confirmation. This contributes to the delay in the diagnosis of endometriosis which is 6-11 years. So far non-invasive diagnostic approaches such as ultrasound (US), MRI or blood tests do not have sufficient diagnostic power. Our aim was to develop and validate a non-invasive diagnostic test with a high sensitivity (80% or more) for symptomatic endometriosis patients, without US evidence of endometriosis, since this is the group most in need of a non-invasive test. METHODS: A total of 28 inflammatory and non-inflammatory plasma biomarkers were measured in 353 EDTA plasma samples collected at surgery from 121 controls without endometriosis at laparoscopy and from 232 women with endometriosis (minimal-mild n = 148; moderate-severe n = 84), including 175 women without preoperative US evidence of endometriosis. Surgery was done during menstrual (n = 83), follicular (n = 135) and luteal (n = 135) phases of the menstrual cycle. For analysis, the data were randomly divided into an independent training (n = 235) and a test (n = 118) data set. Statistical analysis was done using univariate and multivariate (logistic regression and least squares support vector machines (LS-SVM) approaches in training- and test data set separately to validate our findings. RESULTS: In the training set, two models of four biomarkers (Model 1: annexin V, VEGF, CA-125 and glycodelin; Model 2: annexin V, VEGF, CA-125 and sICAM-1) analysed in plasma, obtained during the menstrual phase, could predict US-negative endometriosis with a high sensitivity (81-90%) and an acceptable specificity (68-81%). The same two models predicted US-negative endometriosis in the independent validation test set with a high sensitivity (82%) and an acceptable specificity (63-75%). CONCLUSIONS: In plasma samples obtained during menstruation, multivariate analysis of four biomarkers (annexin V, VEGF, CA-125 and sICAM-1/or glycodelin) enabled the diagnosis of endometriosis undetectable by US with a sensitivity of 81-90% and a specificity of 63-81% in independent training- and test data set. The next step is to apply these models for preoperative prediction of endometriosis in an independent set of patients with infertility and/or pain without US evidence of endometriosis, scheduled for laparoscopy.
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Biomarcadores/metabolismo , Endometriosis/sangre , Endometriosis/diagnóstico , Adulto , Estudios de Casos y Controles , Ácido Edético/metabolismo , Femenino , Humanos , Inflamación , Laparoscopía , Análisis de los Mínimos Cuadrados , Ciclo Menstrual , Persona de Mediana Edad , Modelos Estadísticos , Curva ROC , Análisis de Regresión , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: An early semi-invasive diagnosis of endometriosis has the potential to allow early treatment and minimize disease progression but no such test is available at present. Our aim was to perform a combined mRNA microarray and proteomic analysis on the same eutopic endometrium sample obtained from patients with and without endometriosis. METHODS: mRNA and protein fractions were extracted from 49 endometrial biopsies obtained from women with laparoscopically proven presence (n= 31) or absence (n= 18) of endometriosis during the early luteal (n= 27) or menstrual phase (n= 22) and analyzed using microarray and proteomic surface enhanced laser desorption ionization-time of flight mass spectrometry, respectively. Proteomic data were analyzed using a least squares-support vector machines (LS-SVM) model built on 70% (training set) and 30% of the samples (test set). RESULTS: mRNA analysis of eutopic endometrium did not show any differentially expressed genes in women with endometriosis when compared with controls, regardless of endometriosis stage or cycle phase. mRNA was differentially expressed (P< 0.05) in women with (925 genes) and without endometriosis (1087 genes) during the menstrual phase when compared with the early luteal phase. Proteomic analysis based on five peptide peaks [2072 mass/charge (m/z); 2973 m/z; 3623 m/z; 3680 m/z and 21133 m/z] using an LS-SVM model applied on the luteal phase endometrium training set allowed the diagnosis of endometriosis (sensitivity, 91; 95% confidence interval (CI): 74-98; specificity, 80; 95% CI: 66-97 and positive predictive value, 87.9%; negative predictive value, 84.8%) in the test set. CONCLUSION: mRNA expression of eutopic endometrium was comparable in women with and without endometriosis but different in menstrual endometrium when compared with luteal endometrium in women with endometriosis. Proteomic analysis of luteal phase endometrium allowed the diagnosis of endometriosis with high sensitivity and specificity in training and test sets. A potential limitation of our study is the fact that our control group included women with a normal pelvis as well as women with concurrent pelvic disease (e.g. fibroids, benign ovarian cysts, hydrosalpinges), which may have contributed to the comparable mRNA expression profile in the eutopic endometrium of women with endometriosis and controls.
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Endometriosis/metabolismo , Endometriosis/fisiopatología , Análisis de Secuencia por Matrices de Oligonucleótidos/métodos , Proteómica/métodos , ARN Mensajero/metabolismo , Adulto , Biomarcadores/química , Biomarcadores de Tumor/metabolismo , Biopsia , Estudios de Casos y Controles , Endometriosis/diagnóstico , Endometrio/patología , Femenino , Humanos , Péptidos/química , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción/métodos , Máquina de Vectores de SoporteRESUMEN
BACKGROUND: Endometriosis is a common benign gynaecological disease. Epidemiological studies have demonstrated associations between endometriosis and ovarian cancer. Recent genome-wide association studies of ovarian cancer have identified several single nucleotide polymorphisms (SNPs) in the Basonuclin 2 (BNC2) gene. In this study, we investigated these polymorphism in women with endometriosis. METHODS: Six SNPs in and upstream of the BNC2 gene (rs3814113, rs4445329, rs10962656, rs12379183, rs10756819 and rs1339552) were investigated using TaqMan allelic discrimination analysis in a Caucasian population (cases: 798, controls: 351). Allelic frequencies were used as main outcome measure. RESULTS: No associations were observed between the analysed SNPs and endometriosis. CONCLUSIONS: Our results suggest that the analysed polymorphisms in the BNC2 gene are unlikely to contribute to the previously reported risk of ovarian cancer in women with endometriosis.
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Proteínas de Unión al ADN/genética , Endometriosis/genética , Neoplasias Ováricas/genética , Adulto , Endometriosis/complicaciones , Endometriosis/patología , Femenino , Humanos , Polimorfismo de Nucleótido SimpleRESUMEN
BACKGROUND: The aim of our study was to test the hypothesis that multiple-sensory small-diameter nerve fibres are present in a higher density in endometrium from patients with endometriosis when compared with women with a normal pelvis, enabling the development of a semi-invasive diagnostic test for minimal-mild endometriosis. METHODS: Secretory phase endometrium samples (n = 40), obtained from women with laparoscopically/histologically confirmed minimal-mild endometriosis (n = 20) and from women with a normal pelvis (n = 20) were selected from the biobank at the Leuven University Fertility Centre. Immunohistochemistry was performed to localize neural markers for sensory C, Adelta, adrenergic and cholinergic nerve fibres in the functional layer of the endometrium. Sections were immunostained with anti-human protein gene product 9.5 (PGP9.5), anti-neurofilament protein, anti-substance P (SP), anti-vasoactive intestinal peptide (VIP), anti-neuropeptide Y and anti-calcitonine gene-related polypeptide. Statistical analysis was done using the Mann-Whitney U-test, receiver operator characteristic analysis, stepwise logistic regression and least-squares support vector machines. RESULTS: The density of small nerve fibres was approximately 14 times higher in endometrium from patients with minimal-mild endometriosis (1.96 +/- 2.73) when compared with women with a normal pelvis (0.14 +/- 0.46, P < 0.0001). CONCLUSIONS: The combined analysis of neural markers PGP9.5, VIP and SP could predict the presence of minimal-mild endometriosis with 95% sensitivity, 100% specificity and 97.5% accuracy. To confirm our findings, prospective studies are required.
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Técnicas de Diagnóstico Obstétrico y Ginecológico , Endometriosis/diagnóstico , Endometrio/inervación , Fibras Nerviosas/patología , Adulto , Biomarcadores/metabolismo , Biopsia , Endometriosis/patología , Endometrio/patología , Femenino , Humanos , Inmunohistoquímica , Fase Luteínica , Índice de Severidad de la Enfermedad , Estadística como Asunto , Sustancia P/metabolismo , Bancos de Tejidos , Ubiquitina Tiolesterasa/metabolismo , Péptido Intestinal Vasoactivo/metabolismoRESUMEN
Endometriosis, defined as the ectopic presence of endometrial-like cells, is associated with infertility and pelvic pain in women. Whereas pathogenesis and spontaneous evolution of endometriosis are still poorly understood, recurrences after surgical therapy or after medical treatment are common. Spontaneous endometriosis occurs only in women and in nonhuman primates (NHPs). Inbred rhesus monkeys kept in colonies offer an attractive preclinical model to study the inheritance of spontaneous endometriosis. Baboons with spontaneous or induced endometriosis appear to be the best NHP model to study pathogenesis, pathophysiology, spontaneous evolution and new medical treatment options. In baboons, induction of endometriosis after intrapelvic injection of menstrual endometrium leads to biological changes in peritoneal cavity and in endometrium. This induction process may allows the study of cause-effect relationships which may lead to the discovery of new biomarkers for the development of new non-invasive diagnostic tests and drugs that may prevent or treat endometriosis.
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Investigación Biomédica , Modelos Animales de Enfermedad , Endometriosis , Macaca mulatta , Papio , Animales , Investigación Biomédica/economía , Investigación Biomédica/ética , Endometriosis/diagnóstico , Endometriosis/etiología , Endometriosis/fisiopatología , Endometriosis/terapia , Femenino , Fármacos para la Fertilidad Femenina/farmacología , Humanos , Factores Inmunológicos/farmacología , Inmunosupresores/farmacología , Infertilidad Femenina/etiología , Infertilidad Femenina/fisiopatología , Inflamación/etiología , Inflamación/fisiopatología , Menstruación , Dolor Pélvico/etiología , Dolor Pélvico/fisiopatología , Reproducibilidad de los Resultados , Reproducción , Factores de Riesgo , Índice de Severidad de la Enfermedad , Especificidad de la EspecieRESUMEN
AIM: To mathematically describe the growth of a population of Thoroughbred foals reared on pasture in New Zealand from birth to weaning. METHODS: Twice-monthly liveweight data (including birthweight; BW) from 218 foals (98 colts and 120 fillies) born over a 6-year period, and reared on four different pasture types, were available for analysis. Data truncated to the time of weaning (107-217 days old) provided 3,200 data points. After testing for non-linearity of the relationship of age and liveweight (LW), five non-linear regression equations were tested for goodness of fit. RESULTS: Colts and fillies had similar BW, weaning ages, weaning weights (WW) and average daily gain (ADG) between birth and weaning (ADG b-w). Weaning age explained 48% (p<0.001) of the variation in WW and 11% (p<0.001) of the variation in ADGb-w. After correction for weaning age, BW explained 16% (p<0.001) of the variation in WW and 6% (p<0.001) of the variation in ADG b-w. The best fit of age and LW was the polynomial equations based on Akaike's information criteria (AIC), residual variance (RV), residual standard deviation (RSD), and coefficient of determination (R2). The most accurate, biologically sound representation of growth was provided by Brody's type equation: LW = [b0- (b0-BW) x e(-b1 x age)], and an equation including BW: LW = [((b0 x BW x age) + BWb1)b2], that was developed in this study (b0 is an intercept, b1 and b2 are regression coefficients, and e is the base of natural logarithms). The advantage of the Brody's equation is that ADG at a given LW can simply be calculated as: ADG (kg/day) = (b0 x b1)-b1 x LW. CONCLUSIONS AND CLINICAL RELEVANCE: The similarity of the present data with growth data from the Northern Hemisphere provides further recognition that foals reared on pasture can grow as well as foals reared in grain-based systems in the Northern Hemisphere. BW provides a logical set point for the explanation of growth of the foal up to weaning, rather than the use of polynomial equations, which do not fully describe the biology of growth, even though they provide an accurate mathematical description.
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Fenómenos Fisiológicos Nutricionales de los Animales/fisiología , Caballos/crecimiento & desarrollo , Poaceae , Destete , Aumento de Peso , Alimentación Animal , Animales , Animales Recién Nacidos/crecimiento & desarrollo , Peso al Nacer , Peso Corporal/fisiología , Femenino , Caballos/fisiología , Masculino , MatemáticaRESUMEN
The aim of this study was to detect Thoroughbred mare families and sire lines, in France, in the United Kingdom and Ireland, whose offspring may be successful in steeplechase races and can be recommended therefore for sport horse breeding. Race results were collected from all steeplechase races in these countries between 1998 and 2003, which contained the results of 17,355 horses from 12,861 dams and 2452 sires. In France, non-Thoroughbred horses were also included in the analysis because they race and mate together with Thoroughbreds. Performance was measured with two criteria: earnings and ranks after mathematical transformation. The effects of year, sex, age and race were considered as fixed, animal, permanent environment and maternal environment as random. Precorrection for the effect of race was done to avoid computational difficulties. Maternal environmental components for ranks were 0.02 in France and zero in the United Kingdom and Ireland. Estimated heritabilities for the ranking criteria were 0.18 (repeatability 0.33) in France and 0.06 (repeatability 0.19) in the United Kingdom and Ireland. The high genetic correlation between the two criteria of measurement (0.94 and 0.97 respectively) gives the opportunity to choose the most suitable criteria for breeding value estimation. The ranking value, after statistical normalization has a great advantage for comparison between the countries.
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Caballos/genética , Caballos/fisiología , Selección Genética , Deportes , Animales , Cruzamiento , Femenino , Francia , Irlanda , Masculino , Reino UnidoRESUMEN
BACKGROUND: The evolution of American health care into integrated systems of delivery and finance requires a specialized set of population-based skills for physicians. The field of preventive medicine represents one source of this expertise. Specific competencies for the emerging area of managerial medicine have not been well delineated. METHODS: Using concept documents from the Residency Review Committee for Preventive Medicine and the American Board of Preventive Medicine, a list of proposed competencies for managerial medicine was identified. Surveys were mailed to medical directors of all members of the American Association of Health Plans and to a random sample of diplomates of the American Board of Preventive Medicine. Respondents were asked to rate the importance of these competencies for a population-oriented clinician manager. RESULTS: Areas rated highly by medical directors included health services research (including outcome research), quality assurance and improvement, health risk assessment and reduction, programmatic skills, and clinical preventive skills. Responses from preventive medicine specialists were similar, but placed lower emphasis on these skills. CONCLUSION: Despite its limited response rate, this survey may be useful in the implementation of specialty training in managerial medicine. Residency training programs may choose to emphasize specific content area that reflect the priorities expressed by physicians actively involved in management.