Intermittent food restriction (IFR) is used mainly for weight loss; however, its effects on adipose tissue are not known when alternating with an obesogenic diet. To demonstrate its effects on morphological dynamics of fat deposits, female Wistar rats were distributed into groups: standard control (ST-C), with commercial diet; DIO control (DIO-C), with a diet that induces obesity (DIO) during the first and last 15 d, replaced by a standard diet for thirty intermediate days; standard restricted (ST-R), with standard diet during the first and last 15 d, with six cycles of IFR at 50 % of ST-C; and DIO restricted (DIO-R), in DIO during the first and last 15 d, with six cycles of IFR at 50 % of DIO-C. At 105 d of life, white adipose tissue (WAT) and brown adipose tissue (BAT) deposits were collected, weighed and histology performed. The DIO-R group showed higher total food intake (DIO-R 10 768·0 (SEM 357·52) kJ/g v. DIO-C 8868·6 (SEM 249·25) kJ/g, P < 0·0001), energy efficiency during RAI (DIO-R 2·26 (SEM 0·05) g/kJ v. DIO-C 0·70 (SEM 0·03) g/kJ, P < 0·0001) and WAT (DIO-R 5·65 (SEM 0·30) g/100 g v. DIO-C 4·56 (SEM 0·30) g/100 g) than their respective control. Furthermore, IFR groups presented hypertrophy of WAT and BAT, as well as fibrosis in BAT. Thus, IFR can establish prospective resistance to weight loss by favouring changes in adipose tissue morphology, increased energy intake and efficiency. Finally, the DIO diet before and after IFR aggravates the damages caused by the restriction.

The effect of growth on the subcutaneous cardioverter defibrillators when implanted in small children is unknown. These two chest X-rays demonstrate that these devices can cope well with growth.

Perinatal maternal high-fat (HF) diet programmes offspring obesity. Obesity is associated with overactivation of the endocannabinoid system (ECS) in adult subjects, but the role of the ECS in the developmental origins of obesity is mostly unknown. The ECS consists of endocannabinoids, cannabinoid receptors (cannabinoid type-1 receptor (CB1) and cannabinoid type-2 receptor (CB2)) and metabolising enzymes. We hypothesised that perinatal maternal HF diet would alter the ECS in a sex-dependent manner in white and brown adipose tissue of rat offspring at weaning in parallel to obesity development. Female rats received standard diet (9 % energy content from fat) or HF diet (29 % energy content from fat) before mating, during pregnancy and lactation. At weaning, male and female offspring were killed for tissue harvest. Maternal HF diet induced early obesity, white adipocyte hypertrophy and increased lipid accumulation in brown adipose tissue associated with sex-specific changes of the ECS’s components in weanling rats. In male pups, maternal HF diet decreased CB1 and CB2 protein in subcutaneous adipose tissue. In female pups, maternal HF diet increased visceral and decreased subcutaneous CB1. In brown adipose tissue, maternal HF diet increased CB1 regardless of pup sex. In addition, maternal HF diet differentially changed oestrogen receptor across the adipose depots in male and female pups. The ECS and oestrogen signalling play an important role in lipogenesis, adipogenesis and thermogenesis, and we observed early changes in their targets in adipose depots of the offspring. The present findings provide insights into the involvement of the ECS in the developmental origins of metabolic disease induced by inadequate maternal nutrition in early life.

Perinephric abscesses often present with flank pain and signs of sepsis, and are known to discharge to the skin. We report a case of a young patient presenting with a 48-hour history of painful swelling in her right renal angle following a urinary tract infection and no overt signs or symptoms of sepsis. Plain abdominal films showed a perinephric abscess secondary to a staghorn calculus in the upper pole of the right kidney. On incision and drainage, 700 mL of pus was drained freely. The patient recovered well but required partial nephrectomy.

Subcutaneous abscess as a result of intra-abdominal pathology is a recognized but rare complication. This case illustrates that subcutaneous abscesses may have underlying intra-abdominal pathology without overt signs of sepsis.

In the present study body condition scores (BCS), ultrasound fat thickness and ultrasound m. longissimus dorsi thickness as well as body measurements and management factors were recorded repeatedly during lactation in 71 Holstein-Friesians, 71 Jerseys and 71 Holstein-Jersey F1-crosses (first to ninth lactation) on four feeding regimens. BCS were analysed with ultrasound measurements as explanatory variables by mixed models. A compound symmetry structure for the variance components was applied. The models were also tested for an autoregressive error structure [AR(1)]. Ultrasound fat thickness and ultrasound m. longissimus dorsi thickness explained most of the variability in BCS. Coefficients of determination were between 0•84 and 0•85. Management factors such as feeding group and stage of lactation (week of taking measurements) and the breed type ✕ lactation interaction were, although significant, not relevant for the fit. Holsteins tended to have lower scores than F1-crosses and Jerseys and younger cows tended to have higher scores than older cows. Despite small differences between breeds, Edmonson’s BCS proved to be consistent within each breed type; thus BCS can be applied to various dairy breeds.

This randomized double blind study investigates the relative efficacies of controlled analgesia (PCA) regimens in three different patient groups: epidural diamorphine 2.5mg followed by PCA bolus 1mg with a 20-min lockout (Gp1), subcutaneous diamorphine 2.5mg followed by PCA bolus with a 10-min lockout period (Gp2) and epidural diamorphine 2.5mg in 4mL of 0.125% (w/v) bupivacaine followed by a PCA bolus of 1mg diamorphine in 4mL 0.125% (w/v) bupivacaine with a 20-min lockout (Gp3). Patients were evaluated at 0, 1, 2, 3, 4, 8, 12, 16, 20, 24 and 48 h. Patients in Gp2 consumed significantly more diamorphine than those in Gp1 or Gp3 (P>0.05), but their pain scores were higher only at 1, 2 and 3 h (P>0.05) with respect to Gp3 and at 1 h with respect to Gp1. Fewer side effects (sedation, pruritis and nausea as assessed by antiemetic requirements) occurred in Gp2 compared to Gp1 (P>0.05). Fewer patients in Gp2 required catheterization than in Gp3 (P>0.05). This study indicates that the use of PCA epidural diamorphine, either alone or in combination with bupivacaine, reduces the dose requirement for analgesia but offers little clinical advantage over subcutaneous PCA diamorphine.