Therapeutic potential of cristobalite in the treatment of calf diarrhea.

Calf diarrhea continues to be the major problem of calves in the neonatal period. The effect of zeolites has been increasingly studied in ruminant health in recent years. In the present study, the efficacy of cristobalite, a zeolite, in neonatal calf diarrhea was studied first time. For this purpose, twenty-five neonatal calves with diarrheas were divided into two groups, and Group 1 (n=12) received conventional treatment and Group 2 (n=13) received cristobalite (Zoosorb 10 mg/kg) orally 3 times a day in addition to conventional treatment. Escherichia coli k99 and CS31a, bovine rotavirus and bovine coronavirus were isolated from fecal samples at the beginning of the treatment, on the third day and before discharge. It was determined that the recovery period in Group 2 was 0.95 (20.6%) days shorter than in Group 1 (p⟨0.05) while no viral agents were found on the fifth day in Group 2, viral shedding continued in 4 of 5 calves in Group 1. In conclusion, the study revealed that cristobalite speeds the recovery time and possibly decreases viral shedding in neonatal calf diarrhea, demonstrating a remarkable efficiency in the treatment.

Evaluation of mean gray values of a cat with chronic renal failure: case report / [Avaliação dos valores médios de cinza em um gato com insuficiência renal crônica: relato de caso]

In this case, a 12-year-old female domestic cat with chronic renal failure (CRF), which had lived longer than the mean survival time for cats with that condition, was monitored to evaluate the effects of treatment and mean gray value (MGV) changes. The cat has lived for nearly four years since the diagnosis. Probiotics have been used as an additional, classical supportive therapy since the beginning of treatment. The temporal changes in renal MGV were statistically evaluated in the last year of the four-year period. The cat had a comfortable existence and good body condition all her life and probiotic therapy may have had a positive influence post-CRF diagnosis. Ultrasonography (US) examination is a commonly used tool for monitoring the CRF situation, but it is not particularly sensitive. Therefore, MGV may be more useful for the quantitative evaluation of the extent of renal failure. Also, to the best of our knowledge, this is the first report for a long-term clinical evaluation of MGV in a cat with CRF. The aim of this case report was the evaluation of the relationship between MGV and clinical and biochemical changes in a cat with chronic renal failure.(AU)

No presente caso, uma gata doméstica de 12 anos com insuficiência renal crônica (IRC), que viveu mais do que o tempo médio de sobrevivência para gatos nessa condição, foi monitorada para avaliar os efeitos do tratamento e as alterações do valor cinza médio (MGV). A gata viveu quase quatro anos desde o diagnóstico. Os probióticos têm sido usados como uma terapia de suporte clássica adicional desde o início do tratamento. As alterações temporais do MGV renal foram avaliadas estatisticamente no último ano do período de quatro anos. A gata teve uma existência confortável e boas condições corporais durante toda a vida e a terapia com probióticos pode ter tido uma influência positiva após o diagnóstico de IRC. O exame de ultrassonografia (US) é uma ferramenta comumente usada para monitorar a situação da IRC, mas não é particularmente sensível. Portanto, o MGV pode ser mais útil para a avaliação quantitativa da extensão da insuficiência renal. Além disso, até onde se sabe, este é o primeiro relatório de uma avaliação clínica de longo prazo de MGV em um gato com IRC. O objetivo deste relato de caso foi avaliar a relação entre o MGV e as alterações clínicas e bioquímicas em um gato com insuficiência renal crônica.(AU)

Diffusion-Weighted MR Imaging Findings of Cortical Vein Thrombosis at 3 T.

PURPOSE: Diagnosis of cortical vein thrombosis (CVT) on the basis of clot hyperintensity on diffusion-weighted imaging (DWI) has been reported as limited. Our aim was to evaluate different DWI findings of CVT either in isolated form or in combination with sinus thrombosis. METHODS: In this review-board-approved study, patients with the diagnosis of CVT on magnetic resonance venography (MRV) between 2004 and 2011 were evaluated, and 13 patients with 26 CVT (3 isolated and 23 combined CVT) sites were recruited. The evaluated DWI findings were as follows: (1) the hyperintense clot signal (CS) itself, and (2) clot susceptibility signal (CSS) that appears next to the CVT. Two blinded radiologists evaluated the data. Kappa (κ) statistics was applied for interobserver agreement. RESULTS: Both readers reported CS within the vascular clot itself in 6 of 26 (23%) CVT sites on DWI. CSS was reported in 16 of 26 (61.5%) CVT sites by reader 1, and in 14 of 26 (54%) of the CVT sites by reader 2. At four CVT sites with thrombosed veins on MRV, both readers reported no DWI findings. When both CS and CSS were evaluated together, reader 1 reported a positive DWI finding in 22 of 26 (84%) of the CVT sites, and reader 2 reported in 20 of 26 (79%) of the sites. κ Statistics showed a very good agreement (κ: 0.87). CONCLUSIONS: Besides the hyperintense CS, with additional evaluation of the presence of CSS, DWI can provide an additional clue in CVT patients and may suggest its diagnosis, which is important in clinically unsuspected patients.

Expected treatment benefits of percutaneous transluminal coronary angioplasty: the patient's perspective.

This study aimed to determine the expected treatment benefits from the patient's perspective before and after percutaneous transluminal coronary angioplasty (PTCA). Descriptive study. The sample consisted of 60 patients that underwent PTCA in the cardiology department of a university hospital in Bolu province in Turkey. The patients were interviewed one hour before the procedure and a week after discharge from hospital. The proportion of patients that perceived their health as good after the PTCA was two-fold in comparison to before (48.3%, 88.3%) (P < 0.05). The rate of patients taking heart disease seriously decreased by half after PTCA compared to before (40.0%, 83.3%) (P < 0.05). Almost all of the patients had the wrong interpretation of complete recovery from the diseases before and after PTCA (100.0%, 96.7%) (P > 0.05). Expectations of not having chest pain (P > 0.05), not having MI (P > 0.05), not having fear of death (P < 0.05), and not having stress (P > 0.05) were lower after PTCA in comparison to before. The expectation of not having chest pain was higher in women (60.9%, 47.8%) (P > 0.05), in those not having MI (56.1%, 48.8%) (P > 0.05), and in those having chronic diseases (59.0%, 43.6%) (P > 0.05) before PTCA compared with after. The majority of the patients had the wrong interpretation regarding their PTCA expectations, which decreased dramatically after the procedure. Continuing individualized health education programs on angioplasty for patients and their families will be an important way of dealing with patients' inaccurate interpretations.

Prediction of difficult tracheal intubation in Turkish patients: a multi-center methodological study.

BACKGROUND AND OBJECTIVE: Preoperative evaluation is important in the detection of patients at risk for difficult airway management. It is still unclear whether true prediction is possible and which variables should be chosen for evaluation. The aim of this prospective, multi-centre study was to investigate the incidence of difficult intubation, the sensitivity and positive predictive values of clinical screening tests and whether combining two or more of these tests will improve the prediction of difficult intubation in Turkish patients. METHODS: Seven study sites from six regions in Turkey participated in this study. One thousand six hundred and seventy-four ASA physical status I-III patients, scheduled to undergo elective surgery under general anaesthesia, were included. RESULTS: The incidence of difficult intubation was 4.8% and increased with age (P < 0.05). The incidence of difficult intubation was significantly higher in patients who had a Mallampati III or IV score, a decreased average thyromental and sternomental distance, decreased mouth opening, or decreased protrusion of the mandible (P < 0.05). Mouth opening and Mallampati III-IV were found to be the most sensitive criteria when used alone (43% and 35%, respectively). Combination of tests did not improve these results. CONCLUSIONS: There is still no individual test or a combination of tests that predict difficult intubations accurately. Tests with higher specificity despite low positive predictive value are needed.

beta-cell-specific deletion of the Igf1 receptor leads to hyperinsulinemia and glucose intolerance but does not alter beta-cell mass.

Regulation of glucose homeostasis by insulin depends on the maintenance of normal beta-cell mass and function. Insulin-like growth factor 1 (Igf1) has been implicated in islet development and differentiated function, but the factors controlling this process are poorly understood. Pancreatic islets produce Igf1 and Igf2, which bind to specific receptors on beta-cells. Igf1 has been shown to influence beta-cell apoptosis, and both Igf1 and Igf2 increase islet growth; Igf2 does so in a manner additive with fibroblast growth factor 2 (ref. 10). When mice deficient for the Igf1 receptor (Igf1r(+/-)) are bred with mice lacking insulin receptor substrate 2 (Irs2(-/-)), the resulting compound knockout mice show a reduction in mass of beta-cells similar to that observed in pancreas of Igf1r(-/-) mice (ref. 11), suggesting a role for Igf1r in growth of beta-cells. It is possible, however, that the effects in these mice occur secondary to changes in vascular endothelium or in the pancreatic ductal cells, or because of a decrease in the effects of other hormones implicated in islet growth. To directly define the role of Igf1, we have created a mouse with a beta-cell-specific knockout of Igf1r (betaIgf1r(-/-)). These mice show normal growth and development of beta-cells, but have reduced expression of Slc2a2 (also known as Glut2) and Gck (encoding glucokinase) in beta-cells, which results in defective glucose-stimulated insulin secretion and impaired glucose tolerance. Thus, Igf1r is not crucial for islet beta-cell development, but participates in control of differentiated function.

Sacrospinous fixation for the prolapsed vaginal vault.

In 54 patients, transvaginal sacrospinous ligament fixation procedures were reviewed retrospectively. The mean operation time was 15 (12-45) min. The mean blood loss was 126 (110-175) cm3. The only intraoperative complication was a rectal laceration that was repaired primarily. The mean duration of follow-up was 28 (4-54) months. There were only 2 recurrent vaginal vault prolapses. There were 3 cases of cystocele (5.5%), 1 case of rectocele (1.8%), 5 cases of enterocele (9.2%), 3 cases of stress incontinence (5.5%), and 5 cases of dysparonia (9.2%). Sacrospinous ligament fixation can be used as an alternative treatment to vaginal hysterectomy in aged women with medical problems and young women suffering from genital descent with infertility. The procedure has the advantage of avoiding laparatomy, facilitating other vaginal repairs needed during the same operation, preserving vaginal function and shortening the time necessary for anesthesia and surgery.

Impact of baseline cysts at the time of administration of gonadotropin-releasing hormone analog for in vitro fertilization.

OBJECTIVE: To assess the effects of cysts developed prior to the commencement of luteal phase gonadotropin-releasing-hormone-agonist (GnRH-a) in IVF cycles. DESIGN: Retrospective analysis. SETTING: In vitro fertilization program in a tertiary hospital infertility clinic. PATIENTS: Women stimulated for IVF-ET. All stimulations were down-regulated with GnRH-a commenced on day 21 in a long protocol before gonadotropin stimulation. MAIN OUTCOME MEASURE: Pregnancy rate. RESULTS: Twenty-five of 121 cycles had cysts >15 mm (20.6%); these were classified as baseline (nonfunctional) (n = 12) or corpus luteum (n = 13) cysts. They had significantly longer suppression periods and lower peak estradiol levels, and used more gonadotropins during stimulation. Cysts had no impact on the number of oocytes collected or fertilization and pregnancy rates. Patients with baseline cysts had a greater duration of suppression and required more gonadotropin than those with corpus luteum cysts or those without cysts. The cycle outcomes were similar between the groups, but baseline cyst formation is likely to increase the cost of IVF. CONCLUSION: These findings suggest that baseline cyst formation causes longer suppression duration and greater gonadotropin utilization, although an impact on pregnancy rates is unlikely.

Bee and wasp venom allergy in Turkey.

BACKGROUND: Beekeeping has progressed recently to where bee sting exposure is an important public health problem in Turkey. OBJECTIVE: To investigate the status of bee and wasp sting allergy in a region of Turkey. METHODS: We conducted a questionnaire-based study of 786 subjects (cellulose paper factory personnel and family members older than 16 years of age) in Cay town of Afyon. Skin prick test with common aeroallergens and measurements of total IgE and specific IgE for bee and wasp venom were performed in 212 randomly selected subjects. RESULTS: Cumulative lifetime sting rate was 94.5% (geometric mean: 6.1 times), and last year bee sting rate was 20.4% (geometric mean: 1.6 times). Subjects who had beehives had higher risk of bee sting (P < .05) in the last year, whereas there was no significant difference among the groups for the cumulative lifetime sting exposure. Severe and mild systemic reactions were noted in 2.2% and 5.3%, respectively. Emergency room visits were reported in 9.3%, and familial Hymenoptera allergy in 10.2%. Fatal potential of bee sting was known by 81%. There was no mortality related with Hymenoptera allergy in records of the last 5 years. In 24 subjects with multiple sting exposures, allergic reactions changed severity in the latter exposures, which became less severe in five and more severe in 19 subjects. Atopy rate detected by prick testing was 20.3%. Specific IgE levels were class 1 in 22, class 2 in 11, and class 3 in 2 subjects for bee; and class 1 in 24 and class 2 in 2 subjects for wasp. Nobody had received immunotherapy for venom allergy. None of the factors including atopy, sex, occupation, smoking and family history of bee sting was significantly related with severity of the systemic reaction (P > .05). CONCLUSIONS: Bee and wasp stings are prevalent in Turkey. Severe systemic reactions complicating the sting are frequent (2.2%). Public awareness of potential fatality and treatment of the allergic reaction is not adequate.

Influence of anterior colporrhaphy with colpoperineoplasty operations for stress incontinence and/or genital descent on sexual life.

The effect of anterior colporrhaphy and colpoperineoplasty operation for stress incontinence and/or genital descent on sexual life was studied in 44 women. All sexually active cases prior to the operation for stress incontinence and/or genital descent were evaluated by interview and gynaecological examination immediately before and six months after the operation. Prior to the operation, 30 out of 44 patients (68.2%), found their sexual life unsatisfactory because of various reasons like urinary incontinence, genital descent, vaginal relaxation and urinary incontinence during intercourse. Postoperatively, 20 (66%) of these 30 patients improved, 4 (14%) showed no change and 6 (20%) deteriorated. Twelve of 14 (86%) patients who found their sexual life satisfactory before the operation described no change and 2 (14%) experienced deterioration postoperatively. Overall, 8 patients described deterioration postoperatively and all complained of dyspareunia. Colpoperineoplasty in combination with anterior colporrhaphy might cause dyspareunia in some patients. Colpoperineoplasty may increase the disturbances due to the atrophic changes related to menopause and should therefore be done selectively.

Do the suppression criteria in GnRH-a cycles predict in vitro fertilization outcome?

The addition of gonadotropin releasing hormone analog (GnRH-a) to controlled ovarian hyperstimulation regimes has been reported to have several advantages, such as reduced cancellation rate, fewer premature luteinizations and increased clinical pregnancy rate. The aim of this study was to determine the effect of pituitary/ovarian suppression, in terms of the levels of luteinizing hormone (LH), estradiol and follicle stimulating hormone (FSH), and the duration of GnRH-a administration, on in vitro fertilization (IVF) outcome. Retrospectively, 153 IVF cycles with GnRH-a and human menopausal gonadotropin (hMG) were examined. After a minimum of 10 days of GnRH-a administration, the patients were started on hMG. The correlations were investigated between the fertilization rates, the numbers of retrieved oocytes and transferred embryos, the cancellation rates, the suppressed LH, FSH and estradiol levels, the total ampules of hMG used and the duration of GnRH-a usage. The duration of GnRH-a usage and the total ampules of hMG used were not correlated. The number of oocytes retrieved and total number of hMG ampules used showed weak correlations with suppressed levels of FSH (-0.297 and 0.285, respectively). However, the fertilization, cleavage and pregnancy rates did not correlate with the LH, FSH and estradiol levels on hMG start days. In conclusion, for selected cases, 10 days of GnRH-a administration is sufficient to suppress endogenous gonadotropin levels. Since FSH and LH are protein hormones and their bioactivity may change in a manner that is unrelated to their immunological levels, it is not necessary to measure FSH, LH and estradiol levels to detect whether suppression is adequate.