Experience in colorectal surgery at a quaternary care hospital in Bogotá, Colombia

INTRODUCTION AND AIMS

Colorectal cancer is among the three most common cancers worldwide. Knowledge and identification of suboptimal outcome-associated factors enable comprehensive patient management. The aim of the present study was to present the results of the surgical management of colorectal cancer at a quaternary care university hospital.

MATERIALS AND METHODS

An observational, analytic, cross-sectional study was conducted. Information was collected on a retrospective cohort of patients diagnosed with colorectal cancer from 2013 to 2017 at the Hospital Universitario Mayor Méderi, Bogotá, Colombia.

RESULTS

Data on 452 patients, within the study period, were collected. A total of 48.5% of the patients were men, the overall complication rate was 24%, the surgical site infection (SSI) rate was 15.38%, anastomotic dehiscence occurred in 4.18% of the patients, bleeding required reoperation in 1.32%, and the intrahospital mortality rate was 7.47%.

CONCLUSION

Colorectal cancer management at a university hospital was as beneficial as that provided by other types of hospitals, showing a direct association with complete R0 dissections; low complication rates, according to international reports; and reduced overall morbidity.

Struvite precipitation in wastewater treatment plants anaerobic digestion supernatants using a magnesium oxide by-product

Struvite precipitation is a well-known technology to recover and upcycle phosphorus from municipal wastewater as a slow-release fertiliser. However, the economic and environmental costs of struvite precipitation are constrained by using technical-grade reagents as a magnesium source. This research evaluates the feasibility of using a low-grade magnesium oxide (LG-MgO) by-product from the calcination of magnesite as a magnesium source to precipitate struvite from anaerobic digestion supernatants in wastewater treatment plants. Three distinct LG-MgOs were used in this research to capture the inherent variability of this by-product. The MgO content of the LG-MgOs varied from 42 % to 56 %, which governed the reactivity of the by-product. Experimental results showed that dosing LG-MgO at P:Mg molar ratio close to stoichiometry (i.e. 1:1 and 1:2) favoured struvite precipitation, whereas higher molar ratios (i.e. 1:4, 1:6 and 1:8) favoured calcium phosphate precipitation due to the higher calcium concentration and pH. At a P:Mg molar ratio of 1:1 and 1:2, the percentage of phosphate precipitated was 53-72 % and 89-97 %, respectively, depending on the LG-MgO reactivity. A final experiment was performed to examine the composition and morphology of the precipitate obtained under the most favourable conditions, which showed that (i) struvite was the mineral phase with the highest peaks intensity and (ii) struvite was present in two different shapes: hopper and polyhedral. Overall, this research has demonstrated that LG-MgO is an efficient source of magnesium for struvite precipitation, which fits the circular economy principles by valorising an industrial by-product, reducing the pressure on natural resources, and developing a more sustainable technology for phosphorus recovery.

Improvement of the Pour Plate Method by Separate Sterilization of Agar and Other Medium Components and Reduction of the Agar Concentration

Although the pour plate method is widely employed in microbiological quality control, it has certain drawbacks, including having to melt the culture medium before seeding. In this study, the preparation of the culture medium was modified by using a lower concentration of agar (10 g/L), which was separated from the nutrients during sterilization. The new protocol was assessed in media frequently used in microbiological quality control of food, cosmetics, and pharmaceutical products, with tryptic soy agar (TSA), Sabouraud 4% dextrose agar (SDA), and violet red bile glucose agar (VRBG). In comparison with the conventionally produced media, the modifications significantly improved the growth of Saccharomyces cerevisiae in SDA, Staphylococcus aureus, Salmonella enterica subsp. enterica serovar Typhimurium, and Candida albicans in TSA and Escherichia coli ATCC 8739 and ATCC 25922 and S. Typhimurium in VRBG. The modified VRBG was also more selective for Pseudomonas aeruginosa. Regarding physicochemical properties, a significantly lower pH was observed in TSA and VRBG and lower strength values in TSA. Sterilizing agar separately from the other components of the medium and reducing the agar concentration to 10 g/L can improve microorganism growth and enhance the selectivity of differential media in the pour plate method. These modifications could facilitate the automation of this culture technique. IMPORTANCE In the era of rapid microbiological methods, there is a need to improve long-established culture techniques. Drawbacks of the pour plate method include having to melt each medium separately before seeding. For this technique, we demonstrate that separating the agar from the other components of commonly used media during sterilization and reducing the agar concentration to 10 g/L can enhance microbial growth. The new protocol could have advantages in routine laboratory practice because less agar is required and the same molten agar suspension can be used to prepare different media. Moreover, these modifications could facilitate the automation of the pour plate method.

Specificity of Stenurus (Metastrongyloidea: Pseudaliidae) infections in odontocetes stranded along the north-west Spanish coast

Parasites extracted from the lungs and the pterygoid sinus complex of 6 species of odontocetes stranded along the north-west Spanish coast (Northeast Atlantic) between 2009 and 2019 were morphologically identified. The samples belonged to 14 specimens, including 3 harbour porpoises, Phocoena phocoena, 6 short-finned pilot whales, Globicephala macrorhynchus, 1 long-finned pilot whale, Globicephala melas, 1 Risso's dolphin, Grampus griseus, 1 striped dolphin, Stenella coeruleoalba and 2 bottlenose dolphins, Tursiops truncatus. All animals (14/14) were infected by nematodes of the genus Stenurus spp.; moreover, two of them presented a mixed lung nematode infection by Stenurus spp. and Halocercus spp., and another two a mixed infection by Stenurus spp. and the trematode Nasitrema spp. in the pterygoid sinuses. The morphological characterization of the Stenurus specimens revealed the existence of three different species: Stenurus minor, present in the pterygoid sinuses of harbour porpoises with a mean intensity of 43.0 ± 9.0; Stenurus globicephalae, in the pterygoid sinuses of pilot whales and the Risso's dolphin (370.3 ± 579.4); and Stenurus ovatus infecting bottlenose and striped dolphins’ lungs (47.7 ± 76.5). This is the first citation of S. minor and S. ovatus in odontoceti from the Galician coast. Nematodes of the genus Stenurus are frequent in odontocetes stranded along the north-west Spanish coast. A clear host-parasite association was observed between S. minor and the Phocoenidae family, between S. globicephalae and the subfamily Globicephalinae and between S. ovatus and subfamily Delphininae. Different trophic position and niche segregation may lead to different patterns of specificity.

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Stenurus is the most prevalent lungworm in odontoceti.

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First description of S. minor and S. ovatus in Galician waters.

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Short-finned whales are the most intensely infected odontocetes.

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Stenurus infection is favored by the greater length of the host.

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Stenurus spp show a clear pattern of specificity with their hosts.

Improvement of Mueller-Kauffman Tetrathionate-Novobiocin (MKTTn) enrichment medium for the detection of Salmonella enterica by the addition of ex situ-generated tetrathionate

The detection of Salmonella in food is based on the use of a selective enrichment broth such as Muller-Kauffman Tetrathionate-Novobiocin (MKTTn), in which tetrathionate plays a key role by providing Salmonella with a growth advantage. As sodium tetrathionate is unstable, it is generated in situ by the addition of iodine (Lugol's solution) before seeding. This step is cumbersome as the solution is easily spilled, compromising the performance of the medium and hindering the work of technicians. The aim of this study was to optimize MKTTn broth by generating tetrathionate ex situ through an external reaction between iodine and thiosulphate followed by lyophilization. Quality control procedures were performed to compare the modified and original media, testing pure productivity (enrichment with 50-120 CFU of Salmonella Thyphimurim ATCC 14028 and Salmonella Enteritidis ATCC 13076 and plating on Xylose Lysine Deoxycholate agar, XLD), mixed productivity (50-120 CFU of Salmonella strains and Pseudomonas aeruginosa and Escherichia coli at ≥10⁴ CFU and XLD plating) and selectivity (≥10⁴ CFU of P. aeruginosa and Enterococcus faecalis and plating on Tryptone Casein Soy agar, TSA). The modified MKTTn medium (S/L) performed comparably with the original medium in terms of growth of both Salmonella strains (>300 colonies in XLD), alone or with P. aeruginosa and E. coli. Quantitative assays showed no statistically significant differences in the number of colonies grown on XLD after 10^-5 dilution (p = 0.7015 with S. Thyphimurim ATCC 14028 and p = 0.2387 with S. enteritidis ATCC 13076; ANOVA test). MKTTn medium (S/L) was also selective against E. coli (≤100 colonies) and E. faecalis (<10 colonies). These results suggest that adding tetrathionate as a lyophilisate (S/L) is a feasible alternative to the use of Lugol's solution for the preparation of MKTTn enrichment broth and does not affect the properties of the medium.

Protposer: the web server that readily proposes protein stabilizing mutations with high PPV

Protein stability is a requisite for most biotechnological and medical applications of proteins. As natural proteins tend to suffer from a low conformational stability ex vivo, great efforts have been devoted toward increasing their stability through rational design and engineering of appropriate mutations. Unfortunately, even the best currently used predictors fail to compute the stability of protein variants with sufficient accuracy and their usefulness as tools to guide the rational stabilisation of proteins is limited. We present here Protposer, a protein stabilising tool based on a different approach. Instead of quantifying changes in stability, Protposer uses structure- and sequence-based screening modules to nominate candidate mutations for subsequent evaluation by a logistic regression model, carefully trained to avoid overfitting. Thus, Protposer analyses PDB files in search for stabilization opportunities and provides a ranked list of promising mutations with their estimated success rates (eSR), their probabilities of being stabilising by at least 0.5 kcal/mol. The agreement between eSRs and actual positive predictive values (PPV) on external datasets of mutations is excellent. When Protposer is used with its Optimal kappa selection threshold, its PPV is above 0.7. Even with less stringent thresholds, Protposer largely outperforms FoldX, Rosetta and PoPMusiC. Indicating the PDB file of the protein suffices to obtain a ranked list of mutations, their eSRs and hints on the likely source of the stabilization expected. Protposer is a distinct, straightforward and highly successful tool to design protein stabilising mutations, and it is freely available for academic use at http://webapps.bifi.es/the-protposer.

Feasibility and safety of transvaginal specimen extraction in deep endometriosis colorectal resectional surgery and analysis of risk factors for postoperative complications

BACKGROUND

The aim of the present study was to demonstrate that transvaginal specimen extraction is a feasible and safe approach in colorectal resection for deep endometriosis (DE) and to assess the risk factors for postoperative complications.

METHODS

This retrospective cohort study included all the consecutive patients undergoing segmental bowel resection for symptomatic endometriosis at "La Paz" University Hospital (Madrid, Spain) and at "Hospital General Universitario de Valencia" (Valencia, Spain) from January 2014 to December to 2017. Patients were grouped according to specimen extraction approach into those who had transvaginal extraction (Group I) and those who had suprapubic extraction (Group II). Clinic-demographical, surgical and post-surgical data were recorded. Intra- and postoperative complications were classified according to Clavien-Dindo criteria. Postoperative data were compared between groups. Risk factors associated with surgery were investigated.

RESULTS

Out of 99 female patients included (average age 36.91 ± 5.36 years), 23 patients (23.2%) had transvaginal and 76 (76.8%) had suprapubic specimen extraction. The groups were comparable regarding operative time, nodule size, level of anastomosis, hospital stay and intraoperative complications. We observed no statistically significant differences in postoperative complications and rectovaginal fistula rate between the groups. Binary logistic regression analyses determined that vaginal endometriosis is an independent risk factor for postoperative complications (OR: 2.63, 95% CI [1.10-6.48], p = 0.03).

CONCLUSIONS

Transvaginal specimen extraction is a safe and feasible technique in DE colorectal surgery and should be taken into consideration whenever vaginal endometriosis exists. Nevertheless, vaginal endometriosis can be an independent risk factor for postoperative complications in DE surgery.

Radiochromic film dosimetry for protons up to 10 MeV with EBT2, EBT3 and unlaminated EBT3 films

Passive dosimetry with radiochromic films is widely used in proton radiotherapy, both in clinical and scientific environments, thanks to its simplicity, high spatial resolution and dose-rate independence. However, film under-response for low-energy protons, the so-called linear-energy transfer (LET) quenching, must be accounted and corrected for. We perform a meta-analysis on existing film under-response data with EBT, EBT2 and EBT3 GAFchromic™ films and provide a common framework to integrate it, based on the calculation of dose-averaged LET in the active layer of the films. We also report on direct measurements with the 10 MeV proton beam at the Center for Microanalysis of Materials (CMAM) for EBT2, EBT3 and unlaminated EBT3 films, focusing on the 20-80 keVμm^-1LET range, where previous data was scarce. Measured film relative efficiency (RE) values are in agreement with previously reported data from the literature. A model on film RE constructed with combined literature and own experimental values in the 5-80 keVμm^-1LET range is presented, supporting the hypothesis of a linear decrease of RE with LET, with no remarkable differences between the three types of films analyzed.

Broadband photoluminescence in a ceramic (Mg2SnO4–SnO2):Cr3+ system

This study reports the synthesis and photoluminescence spectroscopic studies of Cr3+-doped Mg2SnO4–SnO2 ceramics. The crystal structure was analyzed by X-ray powder diffraction, and photoluminescence was investigated at room temperature. The diffractogram confirmed the presence of Mg2SnO4 and SnO2 phases. Photoluminescence spectroscopy identified broad and intense emission bands assigned to the Cr3+ cation occupation in octahedral Mg2SnO4 sites and an orange band assigned to SnO2 emission. All spectra were analyzed and interpreted according to crystal field theory and Tanabe–Sugano theory for the d3 electronic configuration. The broad and intense emission band covering the visible/near-infrared region suggests that this system may be a promising material for use as an active medium in a broadband light source at room temperature.

CO0003 TREATMENT WITH BIOLOGICAL THERAPIES AND RISK OF BEING ADMITTED TO THE HOSPITAL FOR COVID19 INFECTION

Objectives:

To analyze the risk of admission for COVID19 infection and outcome of patients treated with bDMARD or tsDMARD from our biologic therapy center, to compare with all patients admitted for COVID-19 infection in our hospital.

Methods:

Records of the patients from our center admitted for COVID-19 infection between March 8 and May 8, 2020 were analyzed retrospectively. Age, gender, and outcome of all patients admitted for COVID19 infection to our hospital on the same dates were collected. Chi-square, Student’s t and Man-Whitney U tests were used for comparisons when appropriate.

Results:

1,668 patients with inflammatory diseases treated with bDMARD or tsDMARD were included. Median age 53.0 years (range 17-91), 52.4% women. Diagnoses and DMARD distribution are shown in tables 1 and 2. 19/1668 (1.1%; 6.8 patient-years) were admitted for severe COVID19 infection. Mortality ratio: 4/19 (21.1%). Median age of the admitted patients was higher: 61.0y (SD 14.2) vs 53.0y (SD 15.0); p <0.009. Median age of deceased patients was also higher 69.5y (SD 20.3) vs 53.0y (SD 15.0); p: NS. Female gender had a worse prognosis trend: 52.4% of all group, 68.4% of those hospitalized, 75.0% of those who died. Females had a higher median age than men: 55.0y (SD 14.9) vs. 50.0y (SD 14.9); p <0.001.

When comparing patients treated with DMARD admitted for COVID19 infection with all patients hospitalized for the same reason (4,601patients), no differences were found neither in age (61.0y [SD 14.2] vs 58.3y [SD 18.1]; NS) nor gender (female: 68.4% vs 54.7%; NS). However, DMARD group seemed to have higher mortality: 4/19 (21.1%) vs 551/4601 (12.0%); p: NS, at a younger age: 69.5y (SD 20.3) vs 82.4 (SD 11.4); p: NS.

Rheumatoid arthritis patients were admitted more frequently: (9/392 (2.3%) vs 10/1276 (0.8%); p <0.025. And were older: median 62y (SD 13.5) vs 50.0y (SD 14.4); p <0.001.

Patients treated with anti-TNF suffered less admissions: 6/1055 (0.6%) vs 13/613 (2.1%); p<0.001 and were younger: median 51.0y (SD 15.0) vs 55.0y (SD 14.7); p <0.001. Anti-TNF were less used in patients with rheumatoid arthritis 188/392 (48.0%) vs 867/1276 (67.9%); p<0.001.

DiseaseN (%)AdmitteddeathsRheumatoid arthritisSpondylarthritisPsoriatic arthritisJIACTDVasculitisIBDPsoriasisOthers392 (23.5%)277 (16.6%)124 (7.4%)30 (1.8%)31 (1.9%)20 (1.2%)582 (34.9%)202 (12.1%)10 (0.6%)9/392 (2.3%)2/277 (0.7%)1/124 (0.8%)0/30 (0.0%)1/31 (3.2%)0/20 (0.0%)4/578 (0.7%)2/202 (1.0%)0/10 (0.0%)110010100TOTAL1,668 (100%)19/1668 (1.1%)4/19 (21.1%)

JIA: Juvenile Idiopathic Arthritis; CTD: Connective Tissue Disease; IBD: Inflammatory Bowel Disease

TreatmentN (%)AdmitteddeathsAnti-TNFAnti-CD20Anti-IL6CTLA4-IgAnti-IL17Anti-IL12/23Anti-integrinJAK inhibitorPDE4 inhibitorAnti-IL231055 (63.2%)79 (4.7%)96 (5.8%)44 (2.6%)92 (5.5%)143 (8.6%)79 (4.7%)34 (2.0%)32 (1.9%)14 (0.8%)6/1055 (0.6%)3/79 (3.8%)3/96 (3.1%)3/44 (6.8%)2/92 (2,2%)1/143 (0.7%)0/79 (0.0%)1/34 (2.9%)0/32 (0.0%)0/14 (0.0%)2101000000TOTAL1,668 (100%)19/1668 (1.1%)4/19 (21.1%)

Conclusion:

It seems reasonable that patients with inflammatory diseases treated with bDMARD or tsDMARD continue their treatment during the COVID19 epidemic. The different rates of hospitalization based on the diagnosis or DMARD may be due to comorbidity, confounding by indication and other bias. The study is not powerful enough to study these confounders.

Disclosure of Interests:

Carlos Gonzalez Consultant of: Gilead, Janssen, Novartis, Speakers bureau: Abbvie, Celgene, Gilead, Janssen, Novartis, Pfizer, Roche, Luis Alberto Menchén Viso Grant/research support from: Abbvie, Janssen, MSD, Takeda, Consultant of: Abbvie, Janssen, Takeda, MSD, Medtronic, Tillotts, Pfizer, Dr. Falk Pharma, Speakers bureau: Abbvie, Janssen, Takeda, MSD, General Electric, Tillotts, Pfizer, Ferring, General Electric, Fresenius, Ofelia Baniandrés Rodríguez: None declared, Ana Herranz Alonso: None declared, Carmen Lobo Rodríguez: None declared, Juan Carlos Nieto Speakers bureau: Pfizer, Abbvie, MSD, Novartis, Janssen, Lilly, Nordic Pharma, BMS, Gebro, FAES Farma, Roche, Sanofi, Indalecio Monteagudo Sáez: None declared, Ignacio Marín Jiménez: None declared, Amparo López: None declared, Ana López: None declared, Arantza Ais Larisgoitia: None declared, Esther Chamorro de Vega: None declared, Paloma Morales de los Ríos: None declared, Maria Jesus Lizcano: None declared, Jose Maria Alvaro Gracia: None declared, Sonia García de San José: None declared

Human Papillomavirus in the region of La Ribera-Valencia: Present and future

OBJECTIVE

Human Papillomavirus (HPV) is the main cause of cervical cancer. The etiology and effects derived from this infection are set by molecular techniques and cytological diagnosis, respectively. In the present study, data obtained by an opportunist screening of cervical cancer in La Ribera region are revised and related statistically.

METHODS

Data considering different variables such as age, degree of lesion, HPV type detected and number of virus in coinfection were collected from 1,372 HPV positive cytology samples. HPV detection was carried out by means of three molecular techniques and the degree of lesion was analyzed by cytological diagnosis (Bethesda). In order to determine the relationship between different selected variables, several statistical analyses were performed.

RESULTS

Only degree of lesion variable showed a direct relationship with the rest of variables, increasing with aging process, viral oncogenicity, presence of at least one high-risk virus and with the fact of being mono-infected. The probability of presenting a higher-level degree of lesion multiplied by 28.4 when high-risk HPV was detected in mono-infection.

CONCLUSIONS

HPV molecular detection is the most suitable technique to perform a cervix cancer primary screening for the management of women with negative cytological diagnose. The number of detected types is statistically related to the degree of lesion. The establishment of a properly regulated screening to identify HPV infection, and therefore, of cervical cancer risk, is essential.

Improving quality of care and clinical outcomes for rectal cancer through clinical audits in a multicentre cancer care organisation

Introduction

Colorectal cancer treatment requires a complex, multidisciplinary approach. Because of the potential variability, monitoring through clinical audits is advisable. This study assesses the effects of a quality improvement action plan in patients with locally advanced rectal cancer and treated with radiotherapy.

Methods

Comparative, multicentre study in two cohorts of 120 patients each, selected randomly from patients diagnosed with rectal cancer who had initiated radiotherapy with a curative intent. Based on the results from a baseline clinical audit in 2013, a quality improvement action plan was designed and implemented; a second audit in 2017 evaluated its impact.

Results

Standardised information was present on 77.5% of the magnetic resonance imaging (MRI) staging reports. Treatment strategies were similar in all three study centres. Of the patients whose treatment was interrupted, just 9.7% received a compensation dose. There was an increase in MRI re-staging from 32.5 to 61.5%, and a significant decrease in unreported circumferential resection margins following neoadjuvant therapy (ypCRM), from 34.5 to 5.6% (p <  0.001).

Conclusions

The comparison between two clinical audits showed improvements in neoadjuvant radiotherapy in rectal cancer patients. Some indicators reveal areas in need of additional efforts, for example to reduce the overall treatment time.

Assessment of the methodologies used in microbiological control of sewage sludge

Sewage sludge usually contains potentially polluting substances such as heavy metals, organic pollutants and various organisms including bacteria, protozoa, helminths, viruses and algae, some of which may be pathogenic. Certain of these pathogens could be transferred to the soil if the sludge is used on agricultural or land recovery applications. For its application on agricultural land, sewage sludge must comply with the limits established in the legislation, which in Europe does not include quality standards regarding microbiological parameters. Nevertheless, the presence of pathogens could limit its agricultural use, as it could pose a risk to human, animal and environmental health. This study compares 4 different methodologies used in microbiological analysis in order to identify the most efficient and reliable method on determining bacteria in sewage sludge. Escherichia coli and Enterococcus faecium are used as bacterial indicators. The results obtained in this work indicate that results obtained with three different plate count methods cannot be comparable with those obtained with the MPN method. The membrane filtration method is recommended for its high precision and sensitivity, both in low and high bacterial loads. It is also concluded that it would be necessary to establish the quality standard in concordance with the method used.

Survivorship of wild caught Mepraia spinolai nymphs: The effect of seasonality and Trypanosoma cruzi infection after feeding and fasting in the laboratory

Chagas disease is caused by Trypanosoma cruzi. Vector survival is an important variable affecting vectorial capacity to determine parasite transmission risk. The aims of this study are to evaluate vector survival under fasting/starvation conditions of wild-caught Mepraia spinolai after feeding and fasting, the pathogenicity of T. cruzi infection, the parasite burden and seasonal variation in parasite discrete typing units (DTU). The survivorship of M. spinolai nymphs after two continuous artificial feedings was evaluated, assessing their infection with microscopic observation of fecal samples and PCR. Later, insects were fasted/starved until death. We performed qPCR analyses of parasite load in the fecal samples and dead specimens. T. cruzi genotyping was performed using conventional PCR amplicons and hybridization tests. Infection rate was higher in M. spinolai nymphs in summer and spring than in fall. Parasite burden varied from 3 to 250,000 parasites/drop. Survival rate for starved nymph stage II was lower in insects collected in the spring compared to summer and fall. TcII was the most frequent DTU. Mainly metacyclic trypomastigotes were excreted. We conclude that M. spinolai infection rate in nymphs varies among seasons, suggesting higher transmission risk in warmer seasons. However, nymphs stage II collected in spring are more sensitive to starvation compared to other seasons. TcII in single or mixed infection does not seem relevant to determine vector pathogenicity. These results of vector survivorship after fasting/starvation are important to determine the competence of M. spinolai as a vector of T. cruzi, since they excrete metacyclic trypomastigotes and the parasitism with T. cruzi seems to be poorly pathogenic to the vector under a severe fasting/starvation condition.

Best Timing to Determine Field Parasitism by Released Diachasmimorpha longicaudata (Hymenoptera: Braconidae) Against Anastrepha (Diptera: Tephritidae) Pest Populations

Our objective was to determine the timing of the highest parasitic activity by released Diachasmimorpha longicaudata (Ashmead) (Hymenoptera: Braconidae) in areas with fruits of sour orange and hog plums infested by Anastrepha ludens (Loew) and Anastrepha obliqua (McQuart) (Diptera: Tephritidae), under shaded and sunny conditions. Percent parasitism along fruit sampling period was related to host availability, which was influenced by the fruit size rather than environmental conditions. The highest parasitism in sour orange was obtained just the first day after release, but in hog plums this was observed during the first 3 days without significant differences between them. The levels of fruit infestation and parasitism were higher in shaded trees in sour orange as in hog plums. The high availability of larvae and the small size of hog plums were decisive for obtaining high levels of parasitism and keeping parasitoids near the release points. By contrast, the size and thick rind of sour orange provided to the larvae a physical refuge that was associated with lower parasitism, causing that parasitoids spread out in search of hosts more accessible. In sour orange, parasitism was exclusively by D. longicaudata, while in hog plums, we additionally found the coexistence of four native parasitoid species. This information suggests that in sour orange, the sampling should be performed 1 day after release, while in hog plums, the samplings can be extended to within the first 3 days. Such sampling can serve to better estimate the effect of D. longicaudata releases against Anastrepha pest populations in different fruit types.

Modificación de la técnica microhistológica

La microhistología se basa en la identificación bajo microscopio de fragmentos epidérmicos vegetales, esta técnica ha sido ampliamente utilizada para estudiar la composición de la dieta de herbívoros silvestres y domésticos. El objetivo del trabajo fue modificar la técnica microhistológica actualmente utilizada con la finalidad de optimizar su uso. Se trabajó con la especie Guazuma ulmifolia debido a los tricomas estrellados que caracteriza esta especie arbórea forrajera. Las modificaciones de la técnica permitieron reducir el tiempo de preparación del material vegetal de seis días a 30 minutos, así como evitar el uso de sustancias de difícil acceso como hidrato de cloral (C2H3Cl3O2)y mejorar la calidad en las observaciones microscópicas.

Effect of type and feeding frequency of high-fibre feeds on intake, total tract digestibility and ruminal fermentation in beef steers fed a high-concentrate diet

The inclusion of fibre in a total mixed ration (TMR) often has operational and economic constraints. The objective of the present study was to compare intake and ruminal fermentation of steers fed either a TMR or a diet with the fibre fraction fed separately from the concentrate fraction. Six ruminally fistulated steers were used in a six-treatments, four-period cross-over experiment. Treatment structure was a 3 × 2 factorial. The first factor was fibre delivery either as a part of a TMR or offered separately from the concentrate fraction once every 3 or 6 days. The second factor was represented by two fibre sources, namely, alfalfa hay or cotton by-products. Fibre delivery and source did not significantly affect total, concentrate, fibre and digestible dry-matter intake, compared with TMR. A similar response was observed for ruminal pH, ammonia concentration and total volatile fatty acid concentration. Intake of crude protein and fibre, as well as the concentration of total volatile fatty acids, were higher for alfalfa hay than for cotton by-products. In conclusion, feeding the fibre portion separately from the concentrate fraction once every 3 or 6 days did not negatively affect intake and rumen function compared with when a TMR was fed, regardless of fibre source.

Chemical segregation of complex organic O-bearing species in Orion KL

We investigate the chemical segregation of complex O-bearing species (including the largest and most complex ones detected to date in space) towards Orion KL, the closest high-mass star-forming region. The molecular line images obtained using the ALMA science verification data reveal a clear segregation of chemically related species depending on their different functional groups. We map the emission of ¹³CH₃OH, HCOOCH₃, CH₃OCH₃, CH₂OCH₂, CH₃COOCH₃, HCOOCH₂CH₃, CH₃CH₂OCH₃, HCOOH, OHCH₂CH₂OH, CH₃COOH, CH₃CH₂OH, CH₃OCH₂OH, OHCH₂CHO, and CH₃COCH₃ with ~1.5″ angular resolution and provide molecular abundances of these species toward different gas components of this region. We disentangle the emission of these species in the different Orion components by carefully selecting lines free of blending and opacity effects. Possible effects in the molecular spatial distribution due to residual blendings and different excitation conditions are also addressed. We find that while species containing the C-O-C group, i.e. an ether group, exhibit their peak emission and higher abundance towards the compact ridge, the hot core south is the component where species containing a hydroxyl group (-OH) bound to a carbon atom (C-O-H) present their emission peak and higher abundance. This finding allows us to propose methoxy (CH₃O-) and hydroxymethyl (-CH₂OH) radicals as the major drivers of the chemistry in the compact ridge and the hot core south, respectively, as well as different evolutionary stages and prevailing physical processes in the different Orion components.

Concordance of the ions and GAP anion obtained by gasometry vs standard laboratory in critical care

OBJECTIVE

To evaluate the differences observed in ion and GAP anion determinations obtained by point-of-care (POC) blood gas versus laboratory biochemical testing, and to analyze the possible errors according to the limits of normality.

MATERIAL AND METHODS

A descriptive, cross-sectional retrospective study was made to assess concordance between two diagnostic tests in patients admitted to the Critical Care Unit of Ourense University Hospital Complex (Spain), between July and November 2015, involving at least one coinciding biochemical test and POC determination. Patients under 18years of age were excluded.

RESULTS

A total of 1,073 samples were analyzed. Lin's concordance correlation coefficients for sodium, potassium and chlorine were 0.87, 0.84 and 0.72, respectively. Kappa concordance of the normality limits for sodium, potassium and chlorine was 0.63, 0.74 and 0.32. The results indicated poor correlation of the anion GAP and null concordance between POC and biochemical testing, including the value corrected for albumin.

CONCLUSIONS

Poor concordance was observed between the ion values as determined by biochemistry and blood gases; the two methods are therefore not interchangeable. Kappa agreement with normality limits was good for sodium and potassium, and weak for chlorine. Possible validity was noted in orienting the classification within the ion limits, with the exception of chlorine. No agreement was recorded in relation to the anion GAP, even that corrected for albumin.

Bovine pancreatolithiasis: case report and review of the literature

An 8-y-old lactating Holstein cow was presented to the herd veterinarian with a history of acute ataxia, and because of poor prognosis, the animal was euthanized and submitted for postmortem examination. A lumbar vertebra was incompletely fractured and had an adjacent subdural hematoma. The pancreas had a hard texture with exaggerated nodular appearance, and on cut surface, the pancreatic ducts appeared fibrotic and contained scores of round-to-faceted pancreatoliths of 0.5-2.0 mm diameter. These calculi extended from the major ducts to the pancreatic duct, sphincter, and into the duodenal lumen. Microscopically, the pancreas had severe acinar atrophy and dissecting glandular fibrosis. The major pancreatic ducts were ulcerated with fibrosis and inflammation. In humans, chronic pancreatitis has been linked to osteoporosis and increased risk of bone fractures. Manual evaluation of ribs at the time of autopsy did not reveal abnormalities in bone pliability or fragility in our cow.

Is a blood sample for hemoglobins in the transfusional range reliable?

OBJECTIVE

To evaluate the correlation and agreement in our unit and population of hemoglobin in gasometry versus hematology analyzer, to evaluate errors in transfusion or lack thereof.

RESULTS

strong association between Point-of-care (POC) and hematimetry, with P<.001, with a coefficient of determination r² of 0.56, an intraclass correlation coefficient of 0.63 and a Lin's concordance correlation coefficient of 0.65. For hemoglobins less than 7g/dL, a success rate of 29.41% was obtained.

CONCLUSIONS

Low-moderate agreement of POC hemoglobin with standard haemothymetry. High probability of errors in the indication of transfusion based on gasometer hemoglobins, especially in low hemoglobins.

Hydroelectrolytic and infectious complications in one year of parenteral nutrition in critical care

OBJECTIVE

Parenteral nutrition consists of the intravenous administration of macronutrients, micronutrients and electrolytes. Our objectives were to evaluate the biochemical alterations during the first ten days of initiation and to quantify the bacteremia related to the central venous catheter during the administration of parenteral nutrition.

MATERIAL AND METHODS

Retrospective study of incidence and prevalence. We included 51 patients who started intravenous nutritional support therapy at Critical Care. We intend to know the infectious complications of the central line associated with parenteral nutrition, to evaluate the most frequent hydroelectrolytic complications of parenteral nutrition, and to identify minimum control points in the detection of hydroelectrolytic alterations.

RESULTS

Statistically significant daily variations were found for glucose, magnesium, potassium and creatinine, and bordering on the statistical significance for albumin and phosphate, the alterations occurring between the second and third days fundamentally. Hypoalbuminemia and hypocalcemia were very frequent. GGT was the liver enzyme that increased more frequently. The infection rate was 14.86 per 1,000 days of central venous catheter.

CONCLUSIONS

We found daily variations in glucose, potassium and magnesium, as well as a decrease in creatinine. We emphasize the frequency of hypoalbuminemia, hypocalcemia and elevation of GGT. The most important variations occurred between the second and third day, highlighting the precocity of potassium alteration and the peak of glycemia. The rate of infection related to the central venous catheter in patients with parenteral nutrition was high.