RESUMEN
ABSTRACT Introduction: Bladder neck dissection is one of the most delicate surgical steps of robotic-assisted radical prostatectomy (RARP) [1, 2], and it may affect surgical margins rate and functional outcomes [3, 4]. Given the relationship between outcomes and surgical experience [5-7], it is crucial to implement a step-by-step approach for each surgical step of the procedure, especially in the most challenging part of the intervention. In this video compilation, we described the techniques for bladder neck dissection utilized at OLV Hospital (Aalst, Belgium). Surgical Technique: We illustrated five different techniques for bladder neck dissection during RARP. The anterior technique tackles the bladder neck from above until the urethral catheter is visualized, and then the dissection is completed posteriorly. The lateral and postero-lateral approaches involve the identification of a weakness point at the prostate-vesical junction and aim to develop the posterior plane - virtually until the seminal vesicles - prior to the opening of the urethra anteriorly. Finally, we described our techniques for bladder neck dissection in more challenging cases such as in patients with bulky middle lobes and prior surgery for benign prostatic hyperplasia. All approaches follow anatomic landmarks to minimize positive surgical margins and aim to preserve the bladder neck in order to promote optimal functional recovery. All procedures were performed with DaVinci robotic platforms using a 3-instruments configuration (scissors, fenestrated bipolar, and needle driver). As standard protocol at our Institution, urinary catheter was removed on postoperative day two [8]. Conclusions: Five different approaches for bladder neck dissection during RARP were described in this video compilation. We believe that the technical details provided here might be of help for clinicians who are starting their practice with this surgical intervention.
RESUMEN
INTRODUCTION: Bladder neck dissection is one of the most delicate surgical steps of robotic-assisted radical prostatectomy (RARP) [1, 2], and it may affect surgical margins rate and functional outcomes [3, 4]. Given the relationship between outcomes and surgical experience [5-7], it is crucial to implement a step-by-step approach for each surgical step of the procedure, especially in the most challenging part of the intervention. In this video compilation, we described the techniques for bladder neck dissection utilized at OLV Hospital (Aalst, Belgium). SURGICAL TECHNIQUE: We illustrated five different techniques for bladder neck dissection during RARP. The anterior technique tackles the bladder neck from above until the urethral catheter is visualized, and then the dissection is completed posteriorly. The lateral and postero-lateral approaches involve the identification of a weakness point at the prostate-vesical junction and aim to develop the posterior plane - virtually until the seminal vesicles - prior to the opening of the urethra anteriorly. Finally, we described our techniques for bladder neck dissection in more challenging cases such as in patients with bulky middle lobes and prior surgery for benign prostatic hyperplasia. All approaches follow anatomic landmarks to minimize positive surgical margins and aim to preserve the bladder neck in order to promote optimal functional recovery. All procedures were performed with DaVinci robotic platforms using a 3-instruments configuration (scissors, fenestrated bipolar, and needle driver). As standard protocol at our Institution, urinary catheter was removed on postoperative day two [8]. CONCLUSIONS: Five different approaches for bladder neck dissection during RARP were described in this video compilation. We believe that the technical details provided here might be of help for clinicians who are starting their practice with this surgical intervention.
Asunto(s)
Neoplasias de la Próstata , Procedimientos Quirúrgicos Robotizados , Robótica , Masculino , Humanos , Vejiga Urinaria/cirugía , Procedimientos Quirúrgicos Robotizados/métodos , Robótica/métodos , Disección del Cuello , Próstata , Vesículas Seminales , Prostatectomía/métodos , Neoplasias de la Próstata/cirugíaRESUMEN
In this paper, a passivity-based control (PBC) scheme for output voltage regulation in a fuel-cell/boost converter system is designed and validated through real-time numerical results. The proposed control scheme is designed as a current-mode control (CMC) scheme with an outer loop (voltage) for voltage regulation and an inner loop (current) for current reference tracking. The inner loop's design considers the Euler-Lagrange (E-L) formulation to implement a standard PBC and the outer loop is implemented through a standard PI controller. Furthermore, an adaptive law based on immersion and invariance (I&I) theory is designed to enhance the closed-loop system behavior through asymptotic approximation of uncertain parameters such as load and inductor parasitic resistance. The closed-loop system is tested under two scenarios using real-time simulations, where precision and robustness are shown with respect to variations in the fuel cell voltage, load, and output voltage reference.
RESUMEN
STUDY DESIGN: Retrospective multicenter. OBJECTIVE: The aim was to investigate the factors involved in, and their relative contributions to, the overall accuracy of robot-assisted pedicle screw placement. SUMMARY OF BACKGROUND DATA: Robot-assisted surgery has reportedly resulted in greater accuracy for placement of pedicle screws than conventional methods. There are many potential factors affecting the accuracy of pedicle screws placed with a robot. No study has investigated these factors in a robust way. MATERIALS AND METHODS: Radiographic and clinical data of three centers were pooled. Preoperative and postoperative computerized tomographies were obtained by all three centers to assess the accuracy of the placed screws. The primary outcome measured was accuracy of pedicle screws placed with the robot. The authors performed a multivariate regression analysis to determine the significant patient-related and screw-related variables and their relative contribution to the overall accuracy. In addition, an ordinal regression analysis was conducted to investigate the effects of different variables on accuracy of robot-placed screws graded by Gertzbein-Robbins grading system (GRS). RESULTS: The total contribution of all studied variables to overall accuracy variation as measured by offsets between the placed and planned screws was only 18%. Obesity, long constructs, female gender, surgeon, and vertebral levels were among the factors that had small contributions to the different screw offsets. For GRS grades, significant variables were gender (Log odds: 0.62, 95% CI: 0.38-0.85), age (Log odds: 0.02, 95% CI: 0.01-0.03), length of constructs (Log odds: 0.07, 95% CI: 0.02-0.11), screw diameter (Log odds: 0.55, 95% CI: 0.39-0.71), and length of the screws (Log odds: 0.03, 95% CI: 0.01-0.05). However, these variables too, regardless of their significant association with the accuracy of placed screws, had little contribution to overall variability of accuracy itself (only about 7%). CONCLUSION: The accuracy of screws placed with robotic assistance, as graded by GRS or measured offsets between planned and placed screw trajectories, is minimally affected by different patient-related or screw-related variables due to the robustness of the robotic navigation system used in this study. LEVEL OF EVIDENCE: Level III.
Asunto(s)
Tornillos Pediculares , Procedimientos Quirúrgicos Robotizados , Robótica , Fusión Vertebral , Cirugía Asistida por Computador , Femenino , Humanos , Procedimientos Quirúrgicos Robotizados/métodos , Fusión Vertebral/métodos , Estudios Retrospectivos , Cirugía Asistida por Computador/métodosRESUMEN
Magnetic properties of ferromagnetic nanostructures were studied by atomistic simulations following Monte Carlo and Landau-Lifshitz-Gilbert approaches. First, we investigated the influence of particle size and shape on the temperature dependence of magnetization for single cobalt and gadolinium nanoparticles and also in bi-magnetic Co@Gd core-shell nanoparticles with different sizes. The Landau-Lifshitz-Gilbert approach was subsequently applied for inspecting the magnetic hysteresis behavior of 2 and 4 nm Co@Gd core-shell nanoparticles with negative, positive, and zero values of interfacial magnetic exchange. We were able to demonstrate the influence of finite-size effect on the dependence of the Curie temperature of Co and Gd nanoparticles. In the Co@Gd core-shell framework, it was possible to handle the critical temperature of the hybrid system by adjusting the Co core size. In addition, we found an improvement in the coercive field values for a negative interfacial exchange energy and for a different core size, suggesting an exchange spring behavior, while positive and zero values of interfacial exchange constant showed no strong influence on the hysteresis behavior.
RESUMEN
Infections with gastrointestinal nematodes can impair both the animal health and performance. Thereby, the aim of this study was to evaluate the use of targeted selective treatments as the FAMACHA© system and faecal egg count on controlling gastrointestinal nematodes in different sheep categories under grazing system. Thirty Santa Inês sheep, six in each category (six weaning, six weaned lambs, six non-pregnant ewes, six pregnant ewes and six lactating ewes were used. Sheep were weighed, and blood and faecal samples were collected on day 0, 15, 30, 45, 60 and 75 for determination of faecal egg count (FEC), packed cell volume (PCV), total plasma protein (PPT) and the mucosa colour by FAMACHA© system in the morning (1) and afternoon (2). The faecal egg count was higher (p=0.0039) in weaning and weaned lambs compared to the non-pregnant, pregnant and lactating ewes. Also, FEC differed between ewes with higher counts in lactating ewes. The observation of eye mucosae showed a frequency of 100% of FAMACHA© scores ranged of 2.45 to 2.91 in the morning, differing (p=0.0494) among the categories, where weaned lambs showed better score. The animal categories and period interaction had a significant (p=0.0148) effect on FAMACHA© score 1 with better score in weaned lambs compared to the pregnant ewes at day 0, 15 and 75. In addition, weaned lambs were presented better FAMACHA© score compared with weaning lambs and lactating ewes at day 45 than weaning lambs at day 60 and 75. Packed cell volume in the morning and in the afternoon was influenced by days of collection with lower percentage at 30 days of experiment. The FAMACHA© system seems to be a suitable method to detect parasite infections. However, use of all available methods increases the accuracy of the diagnosis and promotes better control of gastrointestinal nematodes in grazing sheep.(AU)
Infecções por nematóides gastrointestinais podem prejudicar tanto a saúde como o desempenho animal. Diante disso, objetivou avaliar o uso de tratamentos seletivos como o sistema FAMACHA© e a contagem de ovos por grama de fezes no controle de nematóides gastrointestinais em diferentes categorias de ovinos sob sistema de pastejo. Trinta ovelhas Santa Inês, seis em cada categoria (seis cordeiros lactentes, seis cordeiros desmamados, seis ovelhas não-prenhes, seis ovelhas prenhes e seis ovelhas lactantes) foram utilizadas. Os ovinos foram pesados, amostras de sangue e fezes foram coletadas nos dias 0, 15, 30, 45, 60, 75 para determinação de ovos por grama de fezes (OPG), volume globular (VG), proteínas plasmáticas totais (PPT) e avaliação da mucosa ocular pelo sistema FAMACHA© pela manhã (1) e pela tarde (2). A contagem de ovos por grama de fezes foi maior (p=0,0039) nos cordeiros lactentes e desmamados comparado às ovelhas não prenhes, prenhes e lactantes. Também o OPG diferiu entre ovelhas com maior contagem em ovelhas lactantes. A observação da mucosa ocular mostrou que a frequência do escore FAMACHA© variou de 2,45 a 2,91 pela manhã, diferindo (p=0,0494) entre categorias, aonde cordeiros desmamados mostraram melhor escore. A interação categoria animal e período teve um efeito significante no escore FAMACHA© 1 com melhor escore em cordeiros desmamados comparado às ovelhas prenhes nos dias 0, 15 e 75. Além disso, cordeiros desmamados apresentaram melhor escore FAMACHA© comparado com os cordeiros lactentes e ovelhas lactantes aos 45 dias e com cordeiros lactentes nos dias 60 e 75. O volume globular pela manhã e pela tarde foi influenciado pelos dias de coleta com menor porcentagem aos 30 dias de experimento. O Sistema FAMACHA© mostrou ser um método eficaz para detectar infecções parasitárias. Contudo, o uso de todos os métodos disponíveis aumenta a acurácia do diagnóstico e promove melhor controle de nematóides gastrointestinais em sistemas de pastejo.(AU)
Asunto(s)
Animales , Ovinos/parasitología , Resultado del Tratamiento , Enfermedades Gastrointestinales/parasitología , Pastizales/análisisRESUMEN
Infections with gastrointestinal nematodes can impair both the animal health and performance. Thereby, the aim of this study was to evaluate the use of targeted selective treatments as the FAMACHA© system and faecal egg count on controlling gastrointestinal nematodes in different sheep categories under grazing system. Thirty Santa Inês sheep, six in each category (six weaning, six weaned lambs, six non-pregnant ewes, six pregnant ewes and six lactating ewes were used. Sheep were weighed, and blood and faecal samples were collected on day 0, 15, 30, 45, 60 and 75 for determination of faecal egg count (FEC), packed cell volume (PCV), total plasma protein (PPT) and the mucosa colour by FAMACHA© system in the morning (1) and afternoon (2). The faecal egg count was higher (p=0.0039) in weaning and weaned lambs compared to the non-pregnant, pregnant and lactating ewes. Also, FEC differed between ewes with higher counts in lactating ewes. The observation of eye mucosae showed a frequency of 100% of FAMACHA© scores ranged of 2.45 to 2.91 in the morning, differing (p=0.0494) among the categories, where weaned lambs showed better score. The animal categories and period interaction had a significant (p=0.0148) effect on FAMACHA© score 1 with better score in weaned lambs compared to the pregnant ewes at day 0, 15 and 75. In addition, weaned lambs were presented better FAMACHA© score compared with weaning lambs and lactating ewes at day 45 than weaning lambs at day 60 and 75. Packed cell volume in the morning and in the afternoon was influenced by days of collection with lower percentage at 30 days of experiment. The FAMACHA© system seems to be a suitable method to detect parasite infections. However, use of all available methods increases the accuracy of the diagnosis and promotes better control of gastrointestinal nematodes in grazing sheep.(AU)
Infecções por nematóides gastrointestinais podem prejudicar tanto a saúde como o desempenho animal. Diante disso, objetivou avaliar o uso de tratamentos seletivos como o sistema FAMACHA© e a contagem de ovos por grama de fezes no controle de nematóides gastrointestinais em diferentes categorias de ovinos sob sistema de pastejo. Trinta ovelhas Santa Inês, seis em cada categoria (seis cordeiros lactentes, seis cordeiros desmamados, seis ovelhas não-prenhes, seis ovelhas prenhes e seis ovelhas lactantes) foram utilizadas. Os ovinos foram pesados, amostras de sangue e fezes foram coletadas nos dias 0, 15, 30, 45, 60, 75 para determinação de ovos por grama de fezes (OPG), volume globular (VG), proteínas plasmáticas totais (PPT) e avaliação da mucosa ocular pelo sistema FAMACHA© pela manhã (1) e pela tarde (2). A contagem de ovos por grama de fezes foi maior (p=0,0039) nos cordeiros lactentes e desmamados comparado às ovelhas não prenhes, prenhes e lactantes. Também o OPG diferiu entre ovelhas com maior contagem em ovelhas lactantes. A observação da mucosa ocular mostrou que a frequência do escore FAMACHA© variou de 2,45 a 2,91 pela manhã, diferindo (p=0,0494) entre categorias, aonde cordeiros desmamados mostraram melhor escore. A interação categoria animal e período teve um efeito significante no escore FAMACHA© 1 com melhor escore em cordeiros desmamados comparado às ovelhas prenhes nos dias 0, 15 e 75. Além disso, cordeiros desmamados apresentaram melhor escore FAMACHA© comparado com os cordeiros lactentes e ovelhas lactantes aos 45 dias e com cordeiros lactentes nos dias 60 e 75. O volume globular pela manhã e pela tarde foi influenciado pelos dias de coleta com menor porcentagem aos 30 dias de experimento. O Sistema FAMACHA© mostrou ser um método eficaz para detectar infecções parasitárias. Contudo, o uso de todos os métodos disponíveis aumenta a acurácia do diagnóstico e promove melhor controle de nematóides gastrointestinais em sistemas de pastejo.(AU)
Asunto(s)
Animales , Ovinos/parasitología , Resultado del Tratamiento , Enfermedades Gastrointestinales/parasitología , Infecciones por Nematodos/tratamiento farmacológico , Pastizales/análisisRESUMEN
Este trabajo examina el proceso de diseño e implementación del Fondo de Estabilización de Precios para el Palmiste, el Aceite de Palma y sus Fracciones (fep, Palmero), como instrumento de política en función del rol del Estado en la economía. En ese sentido, se busca contrastar la teoría positiva y normativa del análisis económico con las políticas públicas resultantes, utilizando como unidad de análisis el caso de estudio. Con el fin de mejorar la posición del productor, reduciendo el poder de mercado de la industria que se generaba por tener una estructura oligopsónica, el diseño del fep tenía la finalidad de estabilizar los precios entre mercados (interno y de exportación), distribuyendo los diferenciales de precio entre los productores. Aunque el proceso de implementación presentó varias dificultades, principalmente por la complejidad de entender el mecanismo en operación, la labor gremial previo al diseño y entrada en vigencia del fep facilitó la comunicación productores-gremio-industria, fomentando poco a poco una confianza en la gestión del sector
This paper examines the design and implementation process of the Price Stabilization Fund for Kernel, Palm Oil and their Fractions (fep, in Spanish), as a policy instrument according to the role of the State in the economy. In this sense, this document seeks to contrast the positive and normative theory of economic analysis with the resulting public policies, using the case study as unit of analysis. In order to improve the position of the producer by reducing the market power of the industry that was generated by having an oligopsonic structure, the fep design had the purpose of stabilizing prices between the domestic and export markets by distributing price differentials among producers. Although the implementation process encountered several difficulties, mainly due to the complexity of understanding the mechanism in the operation stage, the work done by the Colombian National Federation of Oil Palm Growers (Fedepalma) previous to the design and enactment of the fep, facilitated communication between producers, Fedepalma and the industry, fostering confidence in the management of the sector. According to that, the analysis carried out in this work supports the idea that the oil palm sector designed an innovative scheme, without a close referent for that time, which has allowed the development of its activity and favored the growth of the sector.
Asunto(s)
Historia del Siglo XXI , Salud Pública , Política Pública , Comercio , AgroindustriaRESUMEN
Hematologic analysis provides reliable information on the health status of animals. It is an important variable in the assessment of adaptive and productive capacity of breeds under unfavorable environmental conditions. It is an assessment that combined with other genetic and environmental factors and management can become useful for the future sustainability of mainstream agriculture in a hot environment. Adaptive capacity is affected by some factors such as breed, pregnancy and lactation. Therefore, hematological profile is an important indicator of animal health and production. The objective of this study was to perform the comparative hematological analysis of Santa Inês and Morada Nova breeds (native ewes from Brazil) in all different reproductive stages. Twenty Santa Ines and 20 Morada Nova sheep distributed in a completely randomized design in a split-plot arrangement over time were used. To obtain blood counts, blood samples were collected by jugular venipuncture every 14 days, always in the morning, before the animals were released into the pasture. The Morada Nova breed had higher hemoglobin and total leukocyte count than Santa Inês breed. Regarding the influence of pregnancy and puerperium on the eritrogram, there was an increment in red blood cell, hemoglobin and packed cell volume of both breeds in middle pregnancy. However, had a reduction in late pregnancy. There were a reestablishment of the blood cell counts during the puerperium period. It was verified an increase on neutrophil: lymphocyte ratio indicated that ewes in the late pregnancy, postpartum and puerperium were under stress conditions compared to others reproductive stages. The total plasma proteins also increased during this period to compensate for the high nutritional requirements of the fetus, and these levels remained high until the end of the puerperal phase, when the lambs were weaned. The pregnancy and puerperium influenced all erythrocyte indices and changed the total leukocyte count.(AU)
A análise hematológica fornece informação confiável sobre a saúde dos animais. É uma variável importante na avaliação da capacidade adaptativa e produtiva das raças sob condições ambientais desfavoráveis. É uma avaliação que aliada a outros fatores genéticos, ambientais e de manejo pode se tornar cada vez mais útil para a sustentabilidade futura da agricultura convencional em um ambiente quente. A capacidade adaptativa é afetada por alguns fatores como raça, gestação e lactação. Portanto, o perfil hematológico é um indicador importante da saúde e produção animal. O objetivo deste estudo foi realizar a análise hematológica comparativa de ovelhas Morada Nova e Santa Inês (ovelhas nativas do Brasil) em todos os estágios reprodutivos. Foram utilizadas 20 ovelhas Santa Inês e 20 Morada Nova distribuídas em um delineamento inteiramente casualizado, em parcelas subdivididas e medidas repetidas no tempo. Para a análise do sangue, foram coletadas amostras por venopunção jugular a cada 14 dias, sempre colhidas pela manhã, antes que os animais fossem soltos no pasto. A raça Morada Nova apresentou maior teor de hemoglobina e contagem total de leucócitos que a raça Santa Inês. Em relação à influência da gestação e do puerpério sobre o eritrograma, observou-se que houve um incremento dos valores da contagem dos eritrócitos, hematócrito e hemoglobina até o terço médio da gestação, reduzindo no final da gestação e restabelecendo novamente no período puerperal. Foi verificado um aumento na relação neutrófilo/linfócito indicando que ovelhas no final da gestação, no pós-parto e puerpério estavam sob condição de estresse comparado com os outros estágios reprodutivos. As proteínas plasmáticas totais também aumentaram durante o período gestacional para compensar os altos requisitos nutricionais do feto, e estes níveis permaneceram elevados até ao final da fase de puerpério quando os cordeiros foram desmamados. A gestação e o puerpério influenciaram todos os índices eritrocitários com alteração da contagem total de leucócitos.(AU)
Asunto(s)
Animales , Femenino , Embarazo , Hemoglobinas/análisis , Preñez/sangre , Ovinos/sangre , Fenómenos Fisiológicos Reproductivos , Recuento de Leucocitos/veterinaria , Pruebas Hematológicas/veterinariaRESUMEN
Hematologic analysis provides reliable information on the health status of animals. It is an important variable in the assessment of adaptive and productive capacity of breeds under unfavorable environmental conditions. It is an assessment that combined with other genetic and environmental factors and management can become useful for the future sustainability of mainstream agriculture in a hot environment. Adaptive capacity is affected by some factors such as breed, pregnancy and lactation. Therefore, hematological profile is an important indicator of animal health and production. The objective of this study was to perform the comparative hematological analysis of Santa Inês and Morada Nova breeds (native ewes from Brazil) in all different reproductive stages. Twenty Santa Ines and 20 Morada Nova sheep distributed in a completely randomized design in a split-plot arrangement over time were used. To obtain blood counts, blood samples were collected by jugular venipuncture every 14 days, always in the morning, before the animals were released into the pasture. The Morada Nova breed had higher hemoglobin and total leukocyte count than Santa Inês breed. Regarding the influence of pregnancy and puerperium on the eritrogram, there was an increment in red blood cell, hemoglobin and packed cell volume of both breeds in middle pregnancy. However, had a reduction in late pregnancy. There were a reestablishment of the blood cell counts during the puerperium period. It was verified an increase on neutrophil: lymphocyte ratio indicated that ewes in the late pregnancy, postpartum and puerperium were under stress conditions compared to others reproductive stages. The total plasma proteins also increased during this period to compensate for the high nutritional requirements of the fetus, and these levels remained high until the end of the puerperal phase, when the lambs were weaned. The pregnancy and puerperium influenced all erythrocyte indices and changed the total leukocyte count.(AU)
A análise hematológica fornece informação confiável sobre a saúde dos animais. É uma variável importante na avaliação da capacidade adaptativa e produtiva das raças sob condições ambientais desfavoráveis. É uma avaliação que aliada a outros fatores genéticos, ambientais e de manejo pode se tornar cada vez mais útil para a sustentabilidade futura da agricultura convencional em um ambiente quente. A capacidade adaptativa é afetada por alguns fatores como raça, gestação e lactação. Portanto, o perfil hematológico é um indicador importante da saúde e produção animal. O objetivo deste estudo foi realizar a análise hematológica comparativa de ovelhas Morada Nova e Santa Inês (ovelhas nativas do Brasil) em todos os estágios reprodutivos. Foram utilizadas 20 ovelhas Santa Inês e 20 Morada Nova distribuídas em um delineamento inteiramente casualizado, em parcelas subdivididas e medidas repetidas no tempo. Para a análise do sangue, foram coletadas amostras por venopunção jugular a cada 14 dias, sempre colhidas pela manhã, antes que os animais fossem soltos no pasto. A raça Morada Nova apresentou maior teor de hemoglobina e contagem total de leucócitos que a raça Santa Inês. Em relação à influência da gestação e do puerpério sobre o eritrograma, observou-se que houve um incremento dos valores da contagem dos eritrócitos, hematócrito e hemoglobina até o terço médio da gestação, reduzindo no final da gestação e restabelecendo novamente no período puerperal. Foi verificado um aumento na relação neutrófilo/linfócito indicando que ovelhas no final da gestação, no pós-parto e puerpério estavam sob condição de estresse comparado com os outros estágios reprodutivos. As proteínas plasmáticas totais também aumentaram durante o período gestacional para compensar os altos requisitos nutricionais do feto, e estes níveis permaneceram elevados até ao final da fase de puerpério quando os cordeiros foram desmamados. A gestação e o puerpério influenciaram todos os índices eritrocitários com alteração da contagem total de leucócitos.(AU)
Asunto(s)
Animales , Femenino , Embarazo , Hemoglobinas/análisis , Preñez/sangre , Ovinos/sangre , Fenómenos Fisiológicos Reproductivos , Recuento de Leucocitos/veterinaria , Pruebas Hematológicas/veterinariaRESUMEN
ABSTRACT: Hematologic analysis provides reliable information on the health status of animals. It is an important variable in the assessment of adaptive and productive capacity of breeds under unfavorable environmental conditions. It is an assessment that combined with other genetic and environmental factors and management can become useful for the future sustainability of mainstream agriculture in a hot environment. Adaptive capacity is affected by some factors such as breed, pregnancy and lactation. Therefore, hematological profile is an important indicator of animal health and production. The objective of this study was to perform the comparative hematological analysis of Santa Inês and Morada Nova breeds (native ewes from Brazil) in all different reproductive stages. Twenty Santa Ines and 20 Morada Nova sheep distributed in a completely randomized design in a split-plot arrangement over time were used. To obtain blood counts, blood samples were collected by jugular venipuncture every 14 days, always in the morning, before the animals were released into the pasture. The Morada Nova breed had higher hemoglobin and total leukocyte count than Santa Inês breed. Regarding the influence of pregnancy and puerperium on the eritrogram, there was an increment in red blood cell, hemoglobin and packed cell volume of both breeds in middle pregnancy. However, had a reduction in late pregnancy. There were a reestablishment of the blood cell counts during the puerperium period. It was verified an increase on neutrophil: lymphocyte ratio indicated that ewes in the late pregnancy, postpartum and puerperium were under stress conditions compared to others reproductive stages. The total plasma proteins also increased during this period to compensate for the high nutritional requirements of the fetus, and these levels remained high until the end of the puerperal phase, when the lambs were weaned. The pregnancy and puerperium influenced all erythrocyte indices and changed the total leukocyte count.
RESUMO: A análise hematológica fornece informação confiável sobre a saúde dos animais. É uma variável importante na avaliação da capacidade adaptativa e produtiva das raças sob condições ambientais desfavoráveis. É uma avaliação que aliada a outros fatores genéticos, ambientais e de manejo pode se tornar cada vez mais útil para a sustentabilidade futura da agricultura convencional em um ambiente quente. A capacidade adaptativa é afetada por alguns fatores como raça, gestação e lactação. Portanto, o perfil hematológico é um indicador importante da saúde e produção animal. O objetivo deste estudo foi realizar a análise hematológica comparativa de ovelhas Morada Nova e Santa Inês (ovelhas nativas do Brasil) em todos os estágios reprodutivos. Foram utilizadas 20 ovelhas Santa Inês e 20 Morada Nova distribuídas em um delineamento inteiramente casualizado, em parcelas subdivididas e medidas repetidas no tempo. Para a análise do sangue, foram coletadas amostras por venopunção jugular a cada 14 dias, sempre colhidas pela manhã, antes que os animais fossem soltos no pasto. A raça Morada Nova apresentou maior teor de hemoglobina e contagem total de leucócitos que a raça Santa Inês. Em relação à influência da gestação e do puerpério sobre o eritrograma, observou-se que houve um incremento dos valores da contagem dos eritrócitos, hematócrito e hemoglobina até o terço médio da gestação, reduzindo no final da gestação e restabelecendo novamente no período puerperal. Foi verificado um aumento na relação neutrófilo/linfócito indicando que ovelhas no final da gestação, no pós-parto e puerpério estavam sob condição de estresse comparado com os outros estágios reprodutivos. As proteínas plasmáticas totais também aumentaram durante o período gestacional para compensar os altos requisitos nutricionais do feto, e estes níveis permaneceram elevados até ao final da fase de puerpério quando os cordeiros foram desmamados. A gestação e o puerpério influenciaram todos os índices eritrocitários com alteração da contagem total de leucócitos.
RESUMEN
Very little is known about the distinct reproductive biology of armadillos. Very few studies have investigated armadillo spermatogenesis, with data available only for Euphractus sexcinctus and Dasypus novemcinctus. In the present study, we analysed male germ cell differentiation in the large hairy armadillo Chaetophractus villosus throughout the year, describing a cycle of the seminiferous epithelium made of eight different stages. Evaluation of the testis/body mass ratio, analysis of the architecture of the seminiferous epithelium and the frequency of defective seminiferous tubules allowed identification of a temporal interruption of spermatogenesis during the period between mid-May to July (mid-end autumn) in correlation with very low testosterone levels. Overall, these results suggest that spermatogenesis is seasonal in C. villosus.
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Armadillos/fisiología , Epitelio Seminífero/citología , Espermatogénesis , Animales , Argentina , Forma del Núcleo Celular , Ensamble y Desensamble de Cromatina , Masculino , Microscopía Electrónica de Transmisión , Microtúbulos/metabolismo , Tamaño de los Órganos , Estaciones del Año , Epitelio Seminífero/crecimiento & desarrollo , Epitelio Seminífero/metabolismo , Epitelio Seminífero/ultraestructura , Células de Sertoli/citología , Células de Sertoli/metabolismo , Células de Sertoli/ultraestructura , Espermátides/citología , Espermátides/crecimiento & desarrollo , Espermátides/metabolismo , Espermátides/ultraestructura , Espermatocitos/citología , Espermatocitos/crecimiento & desarrollo , Espermatocitos/metabolismo , Espermatocitos/ultraestructura , Espermatogonias/citología , Espermatogonias/crecimiento & desarrollo , Espermatogonias/metabolismo , Espermatogonias/ultraestructura , Testículo/citología , Testículo/crecimiento & desarrollo , Testículo/metabolismo , Testículo/ultraestructura , Testosterona/sangre , Testosterona/metabolismoRESUMEN
OBJECTIVE: To explore which attributes of insulin therapy drive patients' preferences for management in Canada and Brazil. METHODS: A qualitative design was implemented in which a total of 32 patients with type 2 diabetes from Canada and Brazil, were interviewed in one of the 4 focus groups, or 16 individual interviews. Eighteen participants (56%) were women and fourteen participants (44%) were men (15 insulin nonusers and 17 insulin users). Two focus groups of 4 participants each and 9 individual interviews were conducted in Brazil. In Canada, 2 focus groups of 4 participants each and 7 individual interviews were conducted. A framework analysis was used to analyse all data. RESULTS: Brazilian participants, when considering two insulin treatments, would prefer the one that had fewer side-effects (specially hypoglycemia events), was noninjectable, had the lowest cost and was most effective. Meanwhile, Canadian participants would prefer a treatment that had fewer side-effects (specially weight gain), was less invasive, was more convenient and was most effective. CONCLUSIONS: Finding the insulin-delivery system and the attributes of insulin therapy that best meet patients' preferences may lead to improved control, through improved compliance, which may ultimately reduce the financial burden of the disease and improve quality of life.
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OBJECTIVE: To evaluate patients' preferences for various attributes of insulin treatment, including route of insulin delivery. METHODS: We used a discrete choice experiment (DCE) to quantify patients' preferences. The attributes (and levels) included in the DCE questionnaire were: glucose control, frequency of hypoglycemic events, weight gain, route of administration for the long-acting and the short-acting insulin, and out-of-pocket cost. Data were analyzed using conditional logit regression and segmented models were also developed to evaluate differences in preferences between subgroups. RESULTS: Two hundred and seventy-four questionnaires were completed. The mean age (SD) of participants was 56.7 (12.9) years. Forty-nine percent of participants were insulin users, and 17% had type 1 diabetes. Overall, patients' ideal insulin treatment would provide better glucose control, result in fewer adverse reactions, have the lowest cost, and be administered orally. Overall, there was a strong positive preference for better glucose control relative to the other attributes. Segmented analyses by insulin use and type of diabetes suggest that there may be an important psychosocial barrier to initiating insulin therapy but that patients tend to adjust to subcutaneous administration once they initiate therapy. CONCLUSIONS: This study illustrates the importance that patients with diabetes place on glucose control and how preferences for insulin therapy differ between subgroups. Specifically, efforts need to be made to overcome the psychosocial barriers to initiating insulin therapy which may lead to improved control through improved treatment acceptance and ultimately improve patients' quality of life and reduce the economic burden of the disease.
RESUMEN
BACKGROUND: An evaluation of patients' preferences is necessary to understand the demand for different insulin delivery systems. The aim of this study was to investigate the association between socioeconomic status (SES) and patients' preferences and willingness to pay (WTP) for various attributes of insulin administration for diabetes management. METHODS: We conducted a discrete choice experiment (DCE) to determine patients; preferences and their WTP for hypothetical insulin treatments. Both self-reported annual household income and education completed were used to explore differences in treatment preferences and WTP for different attributes of treatment across different levels of SES. RESULTS: The DCE questionnaire was successfully completed by 274 patients. Overall, glucose control was the most valued attribute by all socioeconomic groups, while route of insulin delivery was not as important. Patients with higher incomes were willing to pay significantly more for better glucose control and to avoid adverse events compared to lower income groups. In addition, they were willing to pay more for an oral short-acting insulin ($Can 71.65 [95% confidence interval, $40.68, $102.62]) compared to the low income group ($Can 9.85 [95% confidence interval, 14.86, 34.56; P < 0.01]). Conversely, there were no differences in preferences when the sample was stratified by level of education. CONCLUSIONS: This study revealed that preferences and WTP for insulin therapy are influenced by income but not by level of education. Specifically, the higher the income, the greater desire for an oral insulin delivery system, whereas an inhaled route becomes less important for patients.
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Diabetes Mellitus/tratamiento farmacológico , Insulina/administración & dosificación , Prioridad del Paciente/psicología , Administración por Inhalación , Administración Oral , Adulto , Anciano , Glucemia , Colombia Británica , Conducta de Elección , Intervalos de Confianza , Diabetes Mellitus/economía , Escolaridad , Femenino , Homeostasis , Humanos , Insulina/efectos adversos , Insulina/economía , Modelos Logísticos , Masculino , Persona de Mediana Edad , Prioridad del Paciente/economía , Medición de Riesgo , Factores Socioeconómicos , Encuestas y CuestionariosRESUMEN
Este trabajo es el octavo de una serie dedicada a los procedimientos de referencia para la medición de las concentraciones de actividad catalítica de las enzimas a 37 ºC y a la certificación de las preparaciones de referencia. Otras partes se refieren a: Parte 1. El concepto de los procedimientos de referencia para la medición de las concentraciones de la actividad catalítica de las enzimas; Parte 2. Procedimiento de referencia para la medición de la concentración catalítica de creatina quinasa; Parte 3: Procedimiento de referencia para la medición de la concentración catalítica de lactato deshidrogenasa; Parte 4. Procedimiento de referencia para la medición de la concentración catalítica de alanin aminotransferasa; Parte 5. Procedimiento de referencia para la medición de la concentración catalítica de aspartato aminotransferasa; Parte 6. Procedimiento de referencia para la medición de la concentración catalítica de gamma-glutamiltransferasa; Parte 7. Certificación de cuatro materiales de referencia para la determinación de la actividad enzimática de gamma-glutamiltransferasa, lactato deshidrogenasa, alanin aminotransferasa y creatina quinasa a 37 ºC. El procedimiento que se describe aquí se deduce a partir del método de referencia de la IFCC a 30 ºC descrito previamente. Las diferencias se tabulan y comentan en Clin Chem Lab Med 2006; 44: 1146-55.
RESUMEN
OBJECTIVES: The aim of this study was to determine the insulin-delivery system and the attributes of insulin therapy that best meet patients' preferences, and to estimate patients' willingness-to-pay (WTP) for them. METHODS: This was a cross-sectional discrete choice experiment (DCE) study involving 378 Canadian patients with type 1 or type 2 diabetes. Patients were asked to choose between two hypothetical insulin treatment options made up of different combinations of the attribute levels. Regression coefficients derived using conditional logit models were used to calculate patients' WTP. Stratification of the sample was performed to evaluate WTP by predefined subgroups. RESULTS: A total of 274 patients successfully completed the survey. Overall, patients were willing to pay the most for better blood glucose control followed by weight gain. Surprisingly, route of insulin administration was the least important attribute overall. Segmented models indicated that insulin naïve diabetics were willing to pay significantly more for both oral and inhaled short-acting insulin compared with insulin users. Surprisingly, type 1 diabetics were willing to pay $C11.53 for subcutaneous short-acting insulin, while type 2 diabetics were willing to pay $C47.23 to avoid subcutaneous short-acting insulin (p < .05). These findings support the hypothesis of a psychological barrier to initiating insulin therapy, but once that this barrier has been overcome, they accommodate and accept injectable therapy as a treatment option. CONCLUSIONS: By understanding and addressing patients' preferences for insulin therapy, diabetes educators can use this information to find an optimal treatment approach for each individual patient, which may ultimately lead to improved control, through improved compliance, and better diabetes outcomes.
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Diabetes Mellitus Tipo 1/tratamiento farmacológico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Financiación Personal , Insulina/uso terapéutico , Aceptación de la Atención de Salud , Anciano , Colombia Británica , Estudios Transversales , Femenino , Humanos , Insulina/economía , Masculino , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
Objetivos: conocer el nivel cognitivo global y el impacto familiar en un grupo de niños con epilepsias de dificil control, posibles candidatos a tratamiento quirúrgico. Material y método: la muestra estuvo constituida por 100 niños (edad media 11.2 años). El nivel cognitivo global se evaluó con un test de inteligencia general (Stanford-Binet, Wechsler). El impacto sobre la familia se estimó a través de una encuesta donde se consideró la percepción subjetiva de los padres acerca del nivel de calidad de vida de sus hijos. Resultados. Nivel cognitivo: el 58 por ciento registra retraso mental de grado leve a grave (Organización Mundial de la Salud OMS) el 11 por ciento tiene un cociente intelectual promedio y el 31 por ciento restante se sitúa en la franja de normal bajo y limítrofe. Percepción subjetiva de calidad de vida: 12 por ciento mala o muy mala, 40 por ciento regular, 37 por ciento buena, y 11 por ciento muy buena. Conclusiones. coincidente con otras investigaciones los niños con epilepsias refractantes registran un nivel intelectual inferior al término medio, lo cual refleja un grado variable pero claramente significativo de afectación cognitiva. De acuerdo a la percepción de sus padres, la calidad de vida es mala o regular en el 52 por ciento de los casos. Estos datos confirman la importancia de buscar medidas terapéuticas más efectivas, incluyendo un eventual tratamiento quirúrgico con el objeto de evitar o detener el deterioro cognitivo y mejorar la calidad de vida (presente y futura)de estos niños(AU)
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Adolescente , Humanos , Preescolar , Niño , Cognición , Epilepsia , Calidad de Vida , Discapacidad Intelectual , Procesos Mentales , Relaciones FamiliaresRESUMEN
Objetivos: conocer el nivel cognitivo global y el impacto familiar en un grupo de niños con epilepsias de dificil control, posibles candidatos a tratamiento quirúrgico. Material y método: la muestra estuvo constituida por 100 niños (edad media 11.2 años). El nivel cognitivo global se evaluó con un test de inteligencia general (Stanford-Binet, Wechsler). El impacto sobre la familia se estimó a través de una encuesta donde se consideró la percepción subjetiva de los padres acerca del nivel de calidad de vida de sus hijos. Resultados. Nivel cognitivo: el 58 por ciento registra retraso mental de grado leve a grave (Organización Mundial de la Salud OMS) el 11 por ciento tiene un cociente intelectual promedio y el 31 por ciento restante se sitúa en la franja de normal bajo y limítrofe. Percepción subjetiva de calidad de vida: 12 por ciento mala o muy mala, 40 por ciento regular, 37 por ciento buena, y 11 por ciento muy buena. Conclusiones. coincidente con otras investigaciones los niños con epilepsias refractantes registran un nivel intelectual inferior al término medio, lo cual refleja un grado variable pero claramente significativo de afectación cognitiva. De acuerdo a la percepción de sus padres, la calidad de vida es mala o regular en el 52 por ciento de los casos. Estos datos confirman la importancia de buscar medidas terapéuticas más efectivas, incluyendo un eventual tratamiento quirúrgico con el objeto de evitar o detener el deterioro cognitivo y mejorar la calidad de vida (presente y futura)de estos niños