Systematic Review: Efficacy and Safety of Accelerated Induction Regimes in Infliximab Rescue Therapy for Hospitalized Patients with Acute Severe Colitis.

BACKGROUND: Pharmacokinetic data suggest that standard induction dosing schedules may not be sufficient in patients with acute severe colitis (ASUC). Hence, intensified induction regimes are increasingly used in the rescue treatment of hospitalized patients with ASUC to avoid the need for colectomy although the evidence for this is uncertain. AIM: To conduct a systematic review of short- and long-term efficacy outcomes from accelerated infliximab induction studies. METHODS: Systematic search of relevant databases (MEDLINE, EMBASE, Cochrane Database of Systematic Reviews) and relevant conference proceedings (Digestive Diseases Week, European Colitis and Crohn's Organisation Congress, United European Gastroenterology Week) was done. RESULTS: We identified ten relevant studies with a total of 705 patients, of whom 308 received an intensified infliximab regime. Pooled analysis showed no difference in short-term or long-term colectomy rates in those receiving accelerated induction regimes when compared to standard induction. No significant differences in complication rates were identified. CONCLUSIONS: The available uncontrolled studies so far do not suggest short-term or long-term benefit in using accelerated induction in hospitalized ASUC. The overall poor quality of available studies with confounding variables indicates the need for a randomized controlled trial with personalized risk stratification.

15d-PGJ2 as an endoplasmic reticulum stress manipulator in multiple myeloma in vitro and in vivo.

Multiple myeloma (MM) is characterised by intense protein folding and, consequently endoplasmic reticulum (ER) stress. The prostaglandin 15d-PGJ2 is able to raise oxidative stress levels within the cell and potentially trigger cell death. The aim of this study was to evaluate the antineoplastic effect of 15d-PGJ2 on MM in vitro and in vivo via ER and oxidative stress pathways. MM.1R and MM.1S cell lines were treated with 15d-PGJ2 at 1-10µM and evaluated with regard to proliferation, mRNA expression of PRDX1, PRDX4, GRP78, GRP94, CHOP, BCL-2 and BAX. Stress data was validated via oxidized glutathione assays. MM.1R cells were inoculated into NOD/SCID mice, which were subsequently treated daily with 15d-PGJ2 at 4mg/kg or vehicle (control), with tumour volume being monitored for 14days. 15d-PGJ2 reduced cell proliferation, induced cell death and apoptosis at 5µM and 10µM and Stress-related genes were upregulated at the same doses. Oxidized glutathione levels were also increased. 15d-PGJ2 at 4mg/kg in vivo halted tumour growth. In conclusion, 15d-PGJ2 induced myeloma cell death via ER stress in vitro. 15d-PGJ2 in vivo also inhibited tumour growth.

EUV-induced oxidation of carbon on TiO2.

Previously we reported estimates of the maximum etch rates of C on TiO2 by oxidizers including NO, O3 and H2O2 when irradiated by a spatially-non-uniform beam of extreme ultraviolet (EUV) radiation at 13.5 nm (Faradzhev et al., 2013). Here we extend that work by presenting temporally and spatially resolved measurements of the C etching by these oxidizers as a function of EUV intensity in the range (0.3 to 3) mW/mm2 [(0.2 to 2) × 1016 photons s-1 cm-2]. We find that the rates for NO scale linearly with intensity and are smaller than those for O3, which exhibit a weak, sub-linear intensity dependence in this range. We demonstrate that these behaviors are consistent with adsorption of the oxidizing precursor on the C surface followed by a photon-stimulated reaction resulting in volatile C-containing products. The kinetics of photon-induced C etching by hydrogen peroxide, however, appear to be more complex. The spatially resolved measurements reveal that C removal by H2O2 begins at the edges of the C spot, where the light intensity is the lowest, and proceeds toward the center of the spot. This localization of the reaction may occur because hydroxyl radicals are produced efficiently on the catalytically active TiO2 surface.

SOFAT as a Putative Marker of Osteoclasts in Bone Lesions.

Secreted osteoclastogenic factor of activated T cells (SOFAT) is a novel activated human T-cell-secreted cytokine that induce osteoclastogenesis in a RANKL-independent manner. The aim of this study was to evaluate the immunohistochemical expression of SOFAT in intraosseous and extraosseous lesions. Thirty-two oral biopsies were divided into 2 groups: (1) intraosseous lesions-4 cases of cherubism, 5 central giant cell lesions, 3 osteoblastomas, 3 cementoblastomas, 2 periapical lesions and (2) extraosseous lesions-5 peripheral giant cell lesions, 5 cases of oral paracoccidioidomycosis, and 5 foreign body reactions. Immunohistochemistry was performed for SOFAT and tartrate-resistant acid phosphatase. Image analysis consisted of a descriptive evaluation of the immunohistochemical staining pattern observed. Tartrate-resistant acid phosphatase-positive lesions included those containing multinucleated giant cells (MGC) from both groups. SOFAT was positive in MGC of the intraosseous lesions group, except in periapical foreign body reactions as well as extraosseous lesions. SOFAT was shown to be a putative marker of osteoclasts, which proved useful to differentiate them from multinucleated macrophages. Osteoclast induction may be both dependent and independent from the RANK/RANKL/OPG pathway and independent from the bone microenvironment.

Local Structure and Polar Order in Liquid N-Methyl-2-pyrrolidone (NMP).

N-Methyl-2-pyrrolidone (NMP) is an exceptional solvent, widely used in industry and for nanomaterials processing. Yet despite its ubiquity, its liquid structure, which ultimately dictates its solvation properties, is not fully known. Here, neutron scattering is used to determine NMP's structure in unprecedented detail. Two dominant nearest-neighbor arrangements are found, where rings are parallel or perpendicular. However, compared with related solvents, NMP has a relatively large population of parallel approaches, similar only to benzene, despite its nonaromaticity and the presence of the normally structure-reducing methyl group. This arrangement is underpinned by NMP's dipole moment, which has a profound effect on its structure: nearest-neighbor molecules arrange in an antiparallel but offset fashion. This polar-induced order extends beyond the first solvation shell, resulting in ordered trimers that reach the nanometer range. The degree of order and balance of interactions rationalize NMP's high boiling point and versatile capabilities to solvate both charged and uncharged species.

Quantitative analysis of trace levels of surface contamination by X-ray photoelectron spectroscopy Part I: statistical uncertainty near the detection limit.

We discuss the problem of quantifying common sources of statistical uncertainties for analyses of trace levels of surface contamination using X-ray photoelectron spectroscopy. We examine the propagation of error for peak-area measurements using common forms of linear and polynomial background subtraction including the correlation of points used to determine both background and peak areas. This correlation has been neglected in previous analyses, but we show that it contributes significantly to the peak-area uncertainty near the detection limit. We introduce the concept of relative background subtraction variance (RBSV) which quantifies the uncertainty introduced by the method of background determination relative to the uncertainty of the background area itself. The uncertainties of the peak area and atomic concentration and of the detection limit are expressed using the RBSV, which separates the contributions from the acquisition parameters, the background-determination method, and the properties of the measured spectrum. These results are then combined to find acquisition strategies that minimize the total measurement time needed to achieve a desired detection limit or atomic-percentage uncertainty for a particular trace element. Minimization of data-acquisition time is important for samples that are sensitive to x-ray dose and also for laboratories that need to optimize throughput.

Relationship of seminal traits and insemination time to fertilization rate and embryo quality.

The nature of subfertility due to the male or inseminate is as complex as that of the female. Fertilization failure or failure in embryogenesis are both documented to be of seminal origin. Males also differ in the numbers of sperm required to reach their maximum fertilization rate. Males requiring more sperm would be considered to have compensable seminal deficiencies. These include a number of known (viability and morphology) and unknown factors (functional or molecular traits) precluding sperm access to the ovum or ability to engage the ovum sufficiently to initiate fertilization and the block to polyspermy. Differences in fertility among males or inseminates independent of sperm dosage are considered uncompensable. These deficiencies would be associated with fertilizing sperm that are incompetent to maintain the fertilization process or subsequent embryogenesis once initiated, with most failures occurring prior to maternal recognition of pregnancy. Such sperm would preempt fertilization by competent sperm. Chromatin aberrations in morphologically normal or near normal spermatozoa from abnormal semen samples appear to be the best candidates for the uncompensable deficiency. However, recognition of uncompensable or incompetent fertilizing sperm has not been achieved. Six-day-old non-surgically recovered bovine ova/embryos have been used to evaluate compensable and uncompensable seminal deficiencies as well as to test reproductive strategies. These ova/embryos provide information on fertilization status and embryo quality as well as quantitative and qualitative data regarding associated accessory sperm. Thus, they permit the separation of reproductive failure by fertilization from that by embryonic development. Accessory sperm number is positively associated with both fertilization rate and embryonic quality. Early insemination results in low fertilization rates (low accessory sperm number), but good embryo quality, whereas, late insemination results in high fertilization rates (high accessory sperm number), but poor embryo quality. Additional studies will be necessary to substantiate this model; however, if true, future research designed to improve results to artificial insemination should be tested by breeding early in estrus where sperm viability is most limiting and embryo quality is best.

Honey increased saliva, plasma, and urine content of total nitrite concentrations in normal individuals.

This study investigated effects of oral honey solution on total nitrite, a stable nitric oxide metabolite, in saliva, plasma, and urine samples collected from normal subjects. Fourteen adult healthy volunteers, 25-50 years old, nine males and three females, were enrolled in the study. Total nitrite was estimated in saliva, plasma, and urine after 14 hours of food fasting. Each subject was then asked to drink honey solution (80 g of raw honey dissolved in 250 mL of water). Saliva and blood samples were collected at 1, 2, and 3 hours after ingestion of honey solution for total nitrite assay, while urine samples were collected after 3 hours for total nitrite assay. The mean total fasting nitrite in saliva was 108 +/- 61.3 micromol/L, which was increased to 130 +/- 62.9, 131.2 +/- 59, and 135.1 +/- 64.3 micromol/L at 1, 2, and 3 hours, respectively. Plasma total nitrite was 22.41 +/- 16.22 micromol/L before drinking honey, which was increased to 34.71 +/- 18.13, 29.38 +/- 14.29, and 33 +/- 13.09 micromol/L at 1, 2, and 3 hours, respectively, after drinking honey. Urine total nitrite before drinking honey was 75.8 +/- 54.79 micromol/L, which was increased to 107.8 +/- 70.83 micromol/L 3 hours after ingestion of honey solution. Although not statistically significant, honey solution showed a tendency to increase total nitrite concentration in different biological fluids from humans, including saliva, plasma, and urine.

Effect of a deep uterine insemination on spermatozoal accessibility to the ovum in cattle: a competitive insemination study.

A competitive insemination study was conducted to determine the effect of a deep uterine insemination on accessory sperm number per embryo in cattle. Cryopreserved semen of a fertile bull characterized by spermatozoa with a semi-flattened region of the anterior sperm head (marked bull) was matched with cryopreserved semen from an unmarked bull having spermatozoa with a conventional head shape. Using 0.25-mL French straws and a side delivery embryo transfer device, deep uterine insemination (0.125 mL deposited in each horn) was performed 2 cm from the uterotubal junction. Immediately after, the uterine body was artificially inseminated using semen (0.25 mL) from an alternate bull and a conventional insemination device. The complete dose (both inseminations) was 50x10(6) total sperm cells consisting of an equal number of spermatozoa from each bull. Single ovulating cows (n = 95) were inseminated at random with either the unmarked semen in the uterine body and marked semen in the uterine horn, or the unmarked semen in the uterine horn and marked semen in the uterine body. Sixty-one embryos(ova) were recovered nonsurgically 6 d post insemination, of which 40 were fertilized and contained accessory spermatozoa. The ratio and total number of accessory spermatozoa recovered was different among treatments: 62:38 (326) for the unmarked semen in the uterine body and marked semen in the uterine horn, and 72:28 (454) for the unmarked semen in the uterine horn and marked semen in the uterine body (P<0.05). Deep uterine insemination using this semen in a split dose and a side delivery device favors accessibility of spermatozoa to the ovum compared with conventional uterine body insemination.

Effect of freezing semen and dosage of sperm on number of accessory sperm, fertility, and embryo quality in artificially inseminated cattle.

This experiment was conducted to determine whether use of fresh or frozen semen at either 20 x 10(6) (low) or 100 x 10(6) (high) sperm per dose affects the number of accessory sperm and fertilization status/embryo quality as determined from ova/embryos recovered nonsurgically 6 d after insemination. Ejaculates of four bulls were split and prepared for use as fresh or frozen semen at either the high or low dose. From 129 inseminations to normally cycling cows, 98 ova/embryos were recovered. To reduce male effects, ova/embryos used were randomly balanced across treatments, by ejaculate within bull for evaluation of frozen vs fresh semen (n = 80) and by bull for evaluation of high vs low dosage treatments (n = 76). Distribution of accessory sperm was highly skewed downward; thus, median values were more meaningful than means. Freezing semen had no significant effect on fertility status/embryo quality or number of accessory sperm at either dosage. Increasing dosage improved the number of accessory sperm per ovum or embryo (median value) and fertility status/embryo quality (P < .05). Mean +/- SD and median values for accessory sperm were 37.8 +/- 38.3 and 27.5; 28.9 +/- 62.8 and 3.0 for the high and low dose, respectively. Percentage of unfertilized ova, degenerate embryos, and embryos classified poor to fair and good to excellent were 3, 5, 24, 68, and 21, 16, 18, 45, for the high and low dose, respectively. We conclude that number of accessory sperm and fertility status/embryo quality respond favorably to increased dosage of semen and that freezing semen in this study was not detrimental to these parameters.

The effect of time of artificial insemination on fertilization status and embryo quality in superovulated cows.

Thirty nonlactating Holstein cows were superovulated to determine the effect of artificial insemination time on fertilization status and embryo quality. During the luteal phase of the estrous cycle, cows were administered 38 mg FSH-P in a 4-d descending dose regimen. Luteolysis was induced with two injections of prostaglandin on the last day of FSH-P treatment. All cows were continuously monitored for behavioral estrus using the HeatWatch estrus detection system. All cows were inseminated once with one .5-mL straw (50 x 10(6) sperm) at either 0 (n = 10), 12 (n = 10), or 24 h (n = 10) after the first standing event. The elapsed time (mean +/- SD) from the first prostaglandin dose to the first standing event was 39.4 h +/- 7.7 h. The (mean +/- SD) duration of behavioral estrus was 13.2 h +/- 4.1 h. The (mean +/- SD) number of standing events was 27 +/- 17. Five hundred twenty-nine embryos and ova were recovered nonsurgically 6 d after insemination. Fertilization rates were 29 (0 h), 60 (12 h), and 81% (24 h) (P < .01). Percentages of excellent and good, fair and poor, and degenerate embryos were not different (P > .05). Percentages of embryos with accessory sperm were 5 (0 h), 8 (12 h), and 41 (24 h) and differed between the 0 and 24 h and the 12 and 24 h inseminations (P < .01). Artificial insemination of superovulated, nonlactating Holstein cattle 24 h after onset of estrus increased fertilization rate and percentage of embryos with accessory sperm compared with insemination at 0 or 12 h after onset of estrus. Embryo quality was not affected by time of insemination.

The allele 4 of neck region liver-lymph node-specific ICAM-3-grabbing integrin variant is associated with spontaneous clearance of hepatitis C virus and decrease of viral loads.

L-SIGN is a C-type lectin expressed on liver sinusoidal endothelial cells involved in the capture of hepatitis C virus and trans-infection of adjacent hepatocyte cells. The neck region of L-SIGN is highly polymorphic, with three to nine tandem repeats of 23 residues. This polymorphism is associated with a number of infectious diseases, but has not been explored in HCV. We therefore investigated the impact of L-SIGN neck region length variation on the outcome of HCV infection. We studied 322 subjects, 150 patients with persistent HCV infection, 63 individuals with spontaneous clearance and 109 healthy controls. In healthy subjects, we found a total of nine genotypes, with the 7/7 genotype being the most frequent (33%) followed by the 7/6 (22.9%) and the 7/5 (18.3%). The frequencies of the alleles were as follows: 7-LSIGN (56.4%), 6-LSIGN (20.2%), 5-L-SIGN (18.3%) and 4-L-SIGN (5%). The frequency of the 7/4 genotype was higher in spontaneous resolvers (14.3%) as compared with the persistent group (4%) (OR = 0.25, 95% CI = 0.07-0.82, p 0.022). In addition, we found that 4-L-SIGN was associated with spontaneous resolution of HCV infection (OR = 0.30, 95%CI, 0.12-0.74, p 0.005). Interestingly, patients with 4-L-SIGN had lower viral loads when compared with carriers of the 5 (p 0.001), 6 (p 0.021) and 7-alleles (p 0.048). The results indicate that neck region polymorphism of L-SIGN can influence the outcome of HCV infection and the four-tandem repeat is associated with clearance of HCV infection.

Reinsertion of the stylet does not affect incidence of Post Dural Puncture Headaches (PDPH) after spinal anesthesia.

BACKGROUND AND OBJECTIVES: This study was conducted to investigate the effects of reinsertion of the stylet after a spinal anesthesia procedure on the Post Dural Puncture Headache (PDPH) METHODS: We have enrolled into this study 630 patients who were undergoing elective operations with spinal anesthesia and randomized them to Group A (stylet replacement before needle removal) and Group B (needle removal without stylet replacement). These patients were observed for the duration of 24 hours in the hospital and they were checked for PDPH on the 3(rd) and the 7(th) day of the study. RESULTS: Overall, the PDPH incidence was at 10.8% (68 patients). Thirty-three of these patients (10.5%) who were in Group A (stylet replacement before needle removal) and the other 35 patients (11.1%) who were in Group B (needle removal without stylet replacement) experienced PDPH. There was no significant difference between the two groups with respect to the PDPH. CONCLUSIONS: In contrary to the diagnostic lumbar puncture, reinsertion of the stylet after spinal anesthesia with 25-gauge Quincke needles does not reduce the incidence of PDPH.

Reinsertion of the stylet does not affect incidence of post dural puncture headaches (PDPH) after spinal anesthesia.

BACKGROUND AND OBJECTIVES: This study was conducted to investigate the effects of reinsertion of the stylet after a spinal anesthesia procedure on the Post Dural Puncture Headache (PDPH). METHODS: We have enrolled into this study 630 patients who were undergoing elective operations with spinal anesthesia and randomized them to Group A (stylet replacement before needle removal) and Group B (needle removal without stylet replacement). These patients were observed for the duration of 24 hours in the hospital and they were checked for PDPH on the 3rd and the 7th day of the study. RESULTS: Overall, the PDPH incidence was at 10.8% (68 patients). Thirty-three of these patients (10.5%) who were in Group A (stylet replacement before needle removal) and the other 35 patients (11.1%) who were in Group B (needle removal without stylet replacement) experienced PDPH. There was no significant difference between the two groups with respect to the PDPH. CONCLUSIONS: In contrary to the diagnostic lumbar puncture, reinsertion of the stylet after spinal anesthesia with 25-gauge Quincke needles does not reduce the incidence of PDPH.

A reinserção do estilete não afeta a incidência de cefaleia pós-punção dural (CPPD) após raquianestesia / Reinsertion of the stylet does not affect incidence of post dural puncture headaches (PDPH) after spinal anesthesia / La reinserción del estilete no afecta la incidencia de cefalea pos punción dural (CPPD) posteriormente a la raquianestesia

JUSTIFICATIVA E OBJETIVOS: Este estudo foi conduzido para investigar os efeitos da reinserção do estilete em cefaleia pós-punção dural (CPPD) após raquianestesia. MÉTODOS: Foram selecionados para este estudo 630 pacientes submetidos a cirurgia eletiva com raquianestesia. Os pacientes foram randomicamente designados para dois grupos: Grupo A (reinserção do estilete antes da retirada da agulha) e Grupo B (retirada da agulha sem reinserção do estilete). Os pacientes foram observados durante 24 horas no hospital e avaliados quanto à CPPD no terceiro e sétimo dias do estudo. RESULTADOS: No geral, a incidência da CPPD foi de 10,8% (68 pacientes). Trinta e três desses pacientes (10,5%) que estavam no Grupo A e 35 (11,1%) no grupo B tiveram CPPD. Não houve diferença significativa entre os dois grupos em relação à CPPD. CONCLUSÕES: Ao contrário da punção lombar diagnóstica, a reinserção do estilete após raquianestesia com agulhas tipo Quincke de calibre 25 não reduz a incidência de CPPD.

BACKGROUND AND OBJECTIVES: This study was conducted to investigate the effects of reinsertion of the stylet after a spinal anesthesia procedure on the Post Dural Puncture Headache (PDPH). METHODS: We have enrolled into this study 630 patients who were undergoing elective operations with spinal anesthesia and randomized them to Group A (stylet replacement before needle removal) and Group B (needle removal without stylet replacement). These patients were observed for the duration of 24 hours in the hospital and they were checked for PDPH on the 3rd and the 7th day of the study. RESULTS: Overall, the PDPH incidence was at 10.8% (68 patients). Thirty-three of these patients (10.5%) who were in Group A (stylet replacement before needle removal) and the other 35 patients (11.1%) who were in Group B (needle removal without stylet replacement) experienced PDPH. There was no significant difference between the two groups with respect to the PDPH. CONCLUSIONS: In contrary to the diagnostic lumbar puncture, reinsertion of the stylet after spinal anesthesia with 25-gauge Quincke needles does not reduce the incidence of PDPH.

JUSTIFICATIVA Y OBJETIVOS: Este estudio fue hecho para investigar los efectos de la reinserción del estilete en la cefalea pos punción dural (CPPD) después de la raquianestesia. MÉTODOS: Un total de 639 pacientes sometidos a la cirugía electiva con raquianestesia se seleccionaron para este estudio. Los pacientes fueron aleatoriamente designados para dos grupos: Grupo A (reinserción del estilete antes de la retirada de la aguja) y Grupo B (retirada de la aguja sin la reinserción del estilete). Los pacientes fueron observados durante 24 horas en el hospital y evaluados CPPD en el tercero y en el séptimo día del estudio. RESULTADOS: En general, la incidencia de CPPD fue de un 10,8% (68 pacientes). Treinta y tres de ellos (10,5%) que estaban en el Grupo A (reinserción del estilete antes de la retirada de la aguja) y 35 (11,1%) en el grupo B (retirada de la aguja sin la reinserción del estilete) tuvieron CPPD. No hubo diferencia significativa entre los dos grupos con relación a la CPPD. CONCLUSIONES: Al contrario de la punción lumbar diagnóstica, la reinserción del estilete posterior a la raquianestesia con agujas tipo Quincke de calibre 25 no reduce la incidencia de CPPD.

Patología vulvar en niñas y adolescentes / Vulvar disordes during childhood and adolescence

RESUMEN Introducción: El aparato genital de la niña sufre modificaciones en las diferentes etapas de la vida desde el nacimiento hasta la pubertad. Los motivos de consulta y la frecuencia de patologías vulvares varían según las distintas etapas de la vida. El diagnóstico correcto favorece el tratamiento y seguimiento adecuados.Objetivo: Identificar las patologías vulvares en niñas y adolescentes que asisten a un consultorio especializado.Materiales y Métodos: Diseño observacional, descriptivo, retrospectivo, de corte transversal. Población de estudio: niñas y adolescentes con diagnóstico de patologías vulvares que consultaron en el Departamento Infanto-Juvenil del Centro Materno Infantil de la Cátedra de Clínica Gineco-obstétrica del Hospital de Clínicas, Universidad Nacional de Asunción, en período enero 2005-diciembre 2009.Resultados: Se estudió a 132 pacientes. El 62% corresponde a la primera y segunda infancia, 12% a adolescencia temprana, 6% a adolescencia media, 22% a adolescencia tardía. Los motivos de consulta más frecuentes en la primera y segunda infancia fueron la falta de apertura vaginal (40%), sangrado vaginal premenárquico, dolor abdominal y vulvar (10%). En la adolescencia temprana fue el dolor vulvar (44%), en la adolescencia media dolor y tumor vulvar (75%), en la adolescencia tardía el tumor vulvar (21%). Los diagnósticos más frecuentes en la primera y segunda infancia fueron coalescencia de labios menores (44%) y vulvitis (24%), en la adolescencia temprana las malformaciones genitales (63%), en la adolescencia media y tardía los condilomas gnitales (38%) y bartolinitis (20%). El 79% de las pacientes recibió tratamiento médico.Conclusión: la edad es un factor importante que determina el tipo y frecuencia de las patologías vulvares. El motivo de consulta y los síntomas presentes son parámetros fundamentales para guiar el diagnóstico. Las patologías inherentes al hipoestrogenismo son más frecuentes en la infancia y adolescencia temprana. Las infecciones o tumores debidos a enfermedades de transmisión sexual son característicos en la adolescencia media y tardía. El tratamiento en la mayoría de los casos es médico.

ABSTRACT Introduction: Children’s genitalia undergo changes throughout the different stages of life, from birth to puberty. The chief complaint and the frequency of the vulvar disorders vary according to the different stages of life. The correct diagnosis guarantees a correct treatment and follow up.Objective: To identify the vulvar disorders in girls and teenagers that consult at speciality offices.Materials and Methods: Design: Retrospective, descriptive, analytic, cross-sectional. Population: girls and teenagers with vulvar disorder diagnosis that attended the Child and Adolescent department at the Centro Materno Infantil, Hospital de Clinicas, during the period of January 2005 to December 2009.Results: 132 patients were studied. 62% (80/132) correspond to early childhood, 12 %( 16/132) early teenage years, 6 %( 8/132) middle teenage years, 22 %( 28/132) late teenage years. The most frequent chief complaint in early childhood were: the lack of vaginal opening (40%), vaginal bleeding before the menarche, abdominal and vulvar pain (10%). In early teenage years was: vulvar pain (44%), in middle teenage years were: vulvar pain and tumor (75%), and in the late teenage years: vulvar tumor (21%). The most frequent diagnose in early childhood were: labia minor coalescence (44%) and vulvitis (24%), in early teenage years, genital malformations (63%), in middle and late teenage years, genital condilomas (38%) and bartholinitis (20%). 79% of the patients received medical treatment. Conclusion: The patient´s age is an important factor that determines the type and the frequency of the vulvar disorders. The chief complaint and the symptoms are fundamental guidelines to the diagnosis. The hypoestrogenism related disorders are more frequent during chilhood and the early teenage years. The sexually transmitted infections and tumors are found in middle and late teenage years. In most cases there is a medical treatment.

[Tuberculous abscess of the liver. Apropos of 2 cases]. / Abcès tuberculeux du foie. A propos de deux observations.

The authors report two cases of tuberculous liver abscess. They stress the rarity of this site, and differential diagnostic difficulties with other types of infection and liver tumors, notably amebiasis, hydatid cyst and carcinoma. Echo- or Scan-guided needle biopsy is useful for diagnosis and, in some cases, treatment by drainage of the purulent cavity.

[Cancer of the rectum in young adults. Apropos of 38 cases]. / Les cancers du rectum de l'adulte jeune. A propos de 38 observations.

This retrospective study is based upon 38 cases of rectal carcinomas occurring in young individuals aged under 25, collected during the 15 year period from January 1978 to December 1993. The mean age of the patients was 23 (range: 14 to 25), with a gender ratio of 2.1. Histology revealed a well differentiated adenocarcinoma in 12 cases, a moderately or slightly differentiated and undifferentiated carcinoma in 14 cases, a colloid carcinoma in 10 cases and a villous tumor with malignant change in 2 cases. Curative surgical excision was possible in only 11 patients. Sixteen patients underwent a palliative procedure, while 12 refused surgery. No treatment was proposed to 3 patients with visceral metastases. Only 11 patients could be followed up, with a mean 5-year survival rate of 10%. The prognosis of rectal carcinoma in young individuals is poor because of late diagnosis at an advanced stage and the aggressive histologic forms encountered.

Effect of time of insemination on number of accessory sperm, fertilization rate, and embryo quality in nonlactating dairy cattle.

Two experiments were conducted to determine the effect of insemination time on number of accessory sperm per embryo (ovum), fertilization rate, and embryo quality. Semen was collected from three fertile Holstein bulls and cryopreserved in egg yolk-citrate-glycerol. In experiment 1, cows were continuously monitored for behavioral estrus by the HeatWatch estrous detection system and were artificially inseminated (AI) with one 0.5-ml straw (25 x 10(6) sperm) at the onset of estrus (AI 0 h), 12 h after onset (AI 12 h), or received natural service at 0 h (Nat 0 h) from one of three bulls. From 150 inseminations, 115 embryos and ova (AI 0 h: n = 39; AI 12 h: n = 39; Nat 0 h: n = 37) were recovered 6 or 7 d after insemination. Fertilization rates differed between treatments (AI 0 h: 67%; AI 12 h: 79%; Nat 0 h: 98%). Median accessory sperm per embryo (ovum) also differed (AI 0 h: 1; AI 12 h: 10; and Nat 0 h: 27) and paralleled the fertilization rate. Embryo quality was not affected by insemination time or natural service. In experiment 2, cows received AI at 0, 12, or 24 h (AI 24 h) after the onset of estrus as determined by HeatWatch. From 154 inseminations, 117 embryos and ova (AI 0 h: n = 39; AI 12 h: n = 39; AI 24 h: n = 39) were recovered 6 or 7 d after insemination. Fertilization rates did not differ in experiment 2 (AI 0 h: 66%; AI 12 h: 74%; AI 24 h: 82%); however, a trend toward a higher fertilization rate accompanied AI 24 h. Median accessory sperm values increased from AI 0 h (1) to AI 24 h (4). Embryo quality declined with AI at increasing intervals after onset of estrus, as percentages of excellent and good, fair and poor, and degenerate embryos were as follows: 77, 15, 8; 52, 38, 10; and 47, 19, 34 for the 0-, 12-, and 24-h inseminations, respectively. Results indicate AI 12 h after the onset of estrus provides a compromise between potential fertilization failure (AI 0 h) and embryo failure (AI 24 h), despite increased accessory sperm per embryo (ovum) after AI 24 h. Artificial insemination 12 h after onset of estrus should optimize fertility of dairy cattle through an acceptable fertilization rate, number of accessory sperm per embryo, and desirable embryo quality.