Pregnancy rates in hair sheep after Ovsynch synchronization and a combined intracervical fixed-time artificial insemination and 10-day mating period.

AIM: This study aimed to evaluate the pregnancy rates in hair ewes using an Ovsynch synchronization protocol under a breeding system that combines fixed-time insemination plus a 10-day mating period as an alternative. MATERIALS AND METHODS: Through an experimental study (n=27), ewes were randomly located into one of three treatments: (1) Pre-synch (n=9): Prostaglandin F2α (PGF2α)+Gonadotropin-releasing hormone (GnRH)+PGF2α+GnRH; (2) Ovsynch (n=9): GnRH+PGF2α+GnRH; and (3) control: Ewes bred by natural mating (NM) (n=9). Ewes were fixed-time inseminated (fixed-time artificial insemination [FTAI]) with fresh semen, collected just before the insemination time through vaginoscopy at 16 h after the second GnRH (gonadorelin) injection. Each experimental group was placed separately during 15 days and, after this time, fertile rams were allowed back with ewes for a 10-day mating period. Control group ewes remained with the rest of the herd suitable for breeding and were bred under NM. Pregnancy diagnosis was performed by ultrasound at 28-, 56-, and 84-day post-breeding to differentiate between FTAI and NM pregnancies. Total (FTAI±NM) pregnancy rates at 56-day post-breeding were used to compared Pre-synch, Ovsynch, and control. For this purpose, two-tailed proportions comparison z-test was used with a 95% confidence level, for testing as the null hypothesis whether two proportions were equal. RESULTS: Pregnancy rates were higher in control ewes (66.4%) than FTAI (46.6%). When pregnancy rates after a 10-day mating period (40%) were added, the final rate (86.6%) was significantly (p<0.05) higher in Ovsynch-based protocols. The pregnancy rate was significantly lower in FTAI ewes compared to FTAI +10-day mating group (p<0.05). The overall pregnancy rate was 88.0, 85.7, and 67.0 (p>0.05) for Pre-synch, Ovsynch, and control ewes, respectively. CONCLUSION: These results provide evidence on the benefits of combined FTAI protocols for improving the reproductive efficiency of sheep.

Prevalence and correlates of cervical HPV infection in a clinic-based sample of HIV-positive Hispanic women.

OBJECTIVES: Puerto Rico (PR), is the fifth highest jurisdiction of the United States of America (US) with respect to HIV prevalence and the leading in cervical cancer incidence. This cross-sectional study describes the prevalence and correlates of cervical HPV infection among a clinic-based sample of 302 women living with HIV/AIDS in PR. METHODS: Data collection included questionnaires, blood and cervical samples. Multivariable logistic regression models were used to estimate the magnitude of association (adjusted Prevalence odds ratio [aPOR]) between HPV cervical infection and other covariates. RESULTS: Mean age of participants was 40.3 years (± 10.3SD). The prevalence of HPV infection was 50.3%; 41.1% for low-risk types and 29.5% for high-risk types. Having ≥ 10 lifetime sexual partners (aPOR = 2.10, 95% CI:1.02-4.29), an abnormal Pap (aPOR = 3.58, 95% CI:1.93-6.62), active genital warts (aPOR = 3.45, 95% CI:1.60-7.42), and CD4 counts ≤ 200 (aPOR = 4.24, 95% CI: 1.67-10.78) were positively associated with any cervical HPV infection. Similar results were observed for HR HPV infection. CONCLUSIONS: A high burden of HPV co-infection exists among women living with HIV/AIDS in this population. Given the high incidence of HIV in PR and the higher risk of cervical cancer among women living with HIV/AIDS, HPV vaccination should be promoted in this population.

HIV-1-negative female sex workers sustain high cervical IFNɛ, low immune activation, and low expression of HIV-1-required host genes.

Sex workers practicing in high HIV endemic areas have been extensively targeted to test anti-HIV prophylactic strategies. We hypothesize that in women with high levels of genital exposure to semen changes in cervico-vaginal mucosal and/or systemic immune activation will contribute to a decreased susceptibility to HIV-1 infection. To address this question, we assessed sexual activity and immune activation status (in peripheral blood), as well as cellular infiltrates and gene expression in ectocervical mucosa biopsies in female sex workers (FSWs; n=50), as compared with control women (CG; n=32). FSWs had low-to-absent HIV-1-specific immune responses with significantly lower CD38 expression on circulating CD4(+) or CD8(+) T-cells (both: P<0.001) together with lower cervical gene expression of genes associated with leukocyte homing and chemotaxis. FSWs also had increased levels of interferon-ɛ (IFNɛ) gene and protein expression in the cervical epithelium together with reduced expression of genes associated with HIV-1 integration and replication. A correlative relationship between semen exposure and elevated type-1 IFN expression in FSWs was also established. Overall, our data suggest that long-term condomless sex work can result in multiple changes within the cervico-vaginal compartment that would contribute to sustaining a lower susceptibility for HIV-1 infection in the absence of HIV-specific responses.

Haematopoiesis radioprotection in Balb/c mice by an aqueous mycelium extract from the Basidiomycete Pleurotus ostreatus mushroom.

The study examined the radioprotective activity of an aqueous extract from Pleurotus ostreatus mycelium administered to Balb/c mice. Male mice were whole-body irradiated on day 0 ((60)Co, at 0.43 Gy/min) and divided into two groups. The extract was administered intraperitoneally to one group (100 mg/kg) on days - 10 to - 6 and - 2 to +1 with respect to the irradiation. The irradiated-control group was injected with saline solution; non-irradiated mice were used as negative controls. The radioprotective effect was evident by increases in bone marrow cellularity (5.1 × 10(6)/femur vs. 1.1 × 10(6)/femur in saline-control mice, p < 0.05), leucocyte counts (10.5 × 10(9)/L vs. 4.5 × 10(9)/L, p < 0.05), and spleen cellularity (11.2 × 10(7)/spleen vs. 6.2 × 10(7)/spleen, p < 0.05). The extract stimulated macrophage phagocytic activity as judged by a faster rate of carbon clearance in terms of absorbance ratios (1.62 vs. 2.01, p < 0.05). Therefore, this extract may be a candidate therapeutic agent with radioprotective activity for haematopoiesis damage, particularly to cells involved in immune function.

Effect of awareness through movement on the head posture of bruxist children.

The aim of this study was to evaluate the effectiveness of physiotherapy to improve the head posture and reduce the signs of bruxism in a group of bruxist children. A single-blind randomized clinical trial was performed. All the subjects were 3- to 6-year old, had complete primary dentition, dental and skeletal class I occlusion and were classified as bruxist according to the minimal criteria of the ICSD for bruxism. For each child, a clinical, photographic and radiographic evaluation of the head and cervical posture were realized with standardized techniques. The children were randomized in an experimental (n = 13) and a control (n = 13) group. A physiotherapeutic intervention was applied to the children of the experimental group once a week, until 10 sessions were completed. Afterwards, the cephalogram and the clinical and photographic evaluation of the head posture were measured again. The data were analysed with the t-test and Mann-Whitney test. The subjects of the experimental group showed statistically significant improvement in the natural head posture. The physiotherapeutic intervention showed to be efficient to improve the head posture at the moment of measurement in the studied children. The relationship between bruxism and head posture, if exists, seems to be worthwhile to examine.

Head posture and dental wear evaluation of bruxist children with primary teeth.

UNLABELLED: The aim of the present study was to compare the head position and dental wear of bruxist and non-bruxist children with primary dentition. METHODS: All the subjects had complete primary dentition, dental and skeletal class I occlusion and were classified as bruxist or non-bruxist according to their anxiety level, bruxism described by their parents and signs of temporomandibular disorders. The dental wear was drawn in dental casts and processed in digital format. Physiotherapeutic evaluation and a cephalometric radiograph with natural head position were also performed for each child to evaluate the cranio-cervical position for the bruxist group (n = 33) and the control group (n = 20). The variables of the two groups were compared, using the Student t-test and Mann-Whitney U-test. RESULTS: A more anterior and downward head tilt was found in the bruxist group, with statistically significant differences compared with the controls. More significant dental wear was observed in the bruxist children. CONCLUSIONS: Bruxism seems to be related to altered natural head posture and more intense dental wear. Further studies are necessary to explore bruxism mechanisms.

Cuidadores familiares de ancianos: quienes son y como asumen este rol / Relatives as caregivers of the elderly: who they are and how they assume their role

Objetivo: caracterizar el perfil sociodemográfico de cuidadores familiares de ancianos con dependencia funcional y describir cómo asumen su rol. Materiales y métodos: estudio descriptivo de corte transversal; 39 cuidadores familiares de ancianos con dependencia funcional, con seis o más meses como cuidadores, sin retribución económica, que viven en Envigado. Muestreo por conveniencia. Resultados: 100 por ciento mujeres, edad promedio 53,9 años, 64,1 por ciento hijas de quien cuidan; 89,7 por ciento comparten vivienda con el anciano; 38,5 por ciento solteras y 38,5 por ciento casadas, 51,3 por ciento tienen hijos. Baja escolaridad: 28,1 por ciento primaria incompleta. Situación socioeconómica así: ingreso familiar promedio del 89,7 por ciento es menor de dos salarios mínimos legales mensuales. El 79,5 por ciento comparten el papel de cuidadora con otro; 64,1 por ciento sin actividad remunerada previamente. Con referencia al cuidado: 30,8 por ciento lleva entre 3 y 6 años, 12,9 por ciento más de 12 años; 76,9 por ciento dedica más de ocho horas día; 56,3 por ciento reciben apoyo fundamentalmente de familiares y, del sistema formal, el 7,7 por ciento . Conclusiones: en Colombia es incipiente el reconocimiento del cuidado familiar; hay similitud del perfil de cuidadores con otros países; la situación del perfil de las cuidadoras se acentúa por el escaso tiempo para enriquecimiento personal y poco apoyo sistemático; se percibe ausencia de políticas de salud para fortalecer el cuidado familiar y los cuidadores.

[Congenital urethral diverticulum in adults]. / Divertículo uretral congénito en el adulto.

OBJECTIVE: To report an additional case of congenital urethral diverticulum that was incidentally discovered in an adult patient that presented with prostatic syndrome. METHODS: The clinical features diagnosis and treatment of this urethral anomaly are discussed. RESULTS/CONCLUSIONS: Congenital urethral diverticulum is an uncommon finding that usually requires treatment only if it is large or causes important symptoms. The patient described herein had a small urethral diverticulum that did not require treatment. However, the dome of the diverticulum was ruptured during urethrocystoscopy, thus facilitating drainage.

[Orthotopic bilateral ureterocele]. / Ureterocele bilateral ortotópico.

OBJECTIVE: To describe two additional cases of bilateral orthotopic ureterocele and review the literature. METHODS/RESULTS: Both patients, a 70-year-old male and a 56 year-old female, were diagnosed by IVP. Treatment was by a bilateral transverse "smile" incision, which achieved good functional results. However, one of the patients with a calculus inside both ureteroceles developed unilateral grade II-III vesico-ureteral reflux. CONCLUSIONS: Despite the risk of developing vesicoureteral reflux, the transurethral transverse incision is a good method of treatment in symptomatic bilateral orthotopic ureterocele.

[Synchronous manifestation of bladder inverted papilloma and transitional carcinoma of the renal pelvis]. / Presentación sincrónica de papiloma invertido vesical y carcinoma transicional de pelvis renal.

OBJECTIVE: To review briefly the histological and biological aspects of inverted papilloma and to determine whether it is a benign tumor or low-grade malignant lesion. METHOD/RESULTS: We report a patient with synchronous presentation of bladder inverted papilloma and renal pelvis transitional cell carcinoma. After endoscopic resection of the bladder tumor and left ureteral meatus, a radical nephroureterectomy was carried out with success. The clinical features, diagnostic and therapeutic aspects are briefly reviewed. CONCLUSIONS: Inverted papilloma accounts for 2.2% of all urothelial tumors; the bladder is most commonly involved. It is frequently a single lesion with endophytic growth pattern. The clinical significance remains a controversy. Most investigators consider them as benign neoplastic tumors, although in one third of the patients it may be associated with synchronous urothelial carcinomas, implying a malignant condition. Therapeutic management and follow-up are emphasized.

[Renal hydatidosis: importance of preoperative diagnosis]. / Hidatidosis renal: importancia del diagnóstico preoperatorio.

OBJECTIVE: We report on a patient who underwent a right nephrectomy for a mass suggesting hypernephroma, which was shown to be renal hydatid disease on pathological examination. METHODS/RESULTS: The epidemiological, diagnostic and therapeutic aspects described in the literature are briefly reviewed. CONCLUSIONS: Although uncommon, renal cystic lesions should be suspected in the presence of a renal mass and a differential diagnosis should be made. CT is the most useful diagnostic imaging technique. The importance of preoperative diagnosis for the surgical strategy is underscored.

[Ectopic ureter in prostatic urethra. Unusual discovery in an adult]. / Uréter ectópico en uretra prostática. Descubrimiento inusual en adulto.

OBJECTIVE: Ectopic ureter is a congenital anomaly more frequent in the female, in the pediatric age and is commonly left-sided. The present article reports an uncommon case without the common features of this anomaly. METHODS/RESULTS: We report on a 67-year-old man with complete duplex system and ectopic obstructive megaureter in the prostatic urethra with a silent onset. The diagnostic and therapeutic aspects in the literature are briefly discussed. CONCLUSION: Because this anomaly is asymptomatic and incidentally discovered because of contralateral disease, the approach is conservative.

["Sand-clock" lithiasis on prostatic transurethral resection bed]. / Litiasis en "reloj de arena" sobre celda de resección transuretral prostática.

OBJECTIVES: Although uncommon, prostatic surgical bed lithiasis may present among post-TURP complications. The present study underscores the importance of diagnosis and treatment. METHODS/RESULTS: We report on a patient with magnesium ammonium phosphate hourglass lithiasis in the prostatic surgical bed one year and a half following transurethral resection due to adenomyomatous prostatic hyperplasia that was successfully treated by intracorporeal lithotripsy with the Lithoclast. The physiopathological, clinical, diagnostic and therapeutic aspects are discussed. CONCLUSIONS: This condition should be suspected in patients with dysuric syndrome post-TURP. The importance of simple complementary diagnostic procedures as DRE and plain abdominal films in discarding lithiasis in underscored. We consider retrograde endoscopic manipulation and ultrasonic lithotripsy or penumatic lithotripsy with the Lithoclast to be the safest procedures for this type of lithiasis.

[Late metastasis in thyroid gland after nephrectomy for renal clear cell carcinoma]. / Metástasis tardía en glándula tiroidea tras nefrectomia por carcinoma renal de células claras.

Renal carcinoma natural history is unpredictable. Spontaneous metastases regression after nephrectomy, as well as late recurrence are suggestive of this peculiar human neoplasm. tumor metastases localized to thyroid gland are uncommon in clinical practice; and carcinoma of the kidney, breast, lung, melanoma and gastrointestinal tract tumors are responsible for the majority of them. This paper reports on a patient with metachronous thyroid gland metastases after fourteen years of renal carcinoma nephrectomy, with one year after hemithyroidectomy recurrence on cervical striated muscle followed by surgical excision. Therapeutical aspects are briefly reviewed in literature, emphasizing surgical treatment and the need of all-life follow-up, with more alert attitude toward thyroid gland after renal cell carcinoma nephrectomy.

[Obstruction of the urethral conduct following implantation of the endoprosthesis Urolume: therapeutic management]. / Obliteración de la luz uretral tras implante de endoprotesis urolume: manejo terapéutico.

The introduction of self-expandable urethral endoprostheses for the management of relapsing urethral stenosis has required the development of a minimally invasive therapeutical approach of widespread acceptance by the urological community. The reason for its success is the simplicity of implantation and the low rate of complications up to date. This paper reports on a patient carrying a ¿Urolume¿ urethral endoprosthesis for a relapsing bulbar urethral stenosis, which two years after implantation presents re-stenosis secondary to endoluminal inflammatory tissue growth. After two failure endoscopic resections, endoscopic removal of the prosthesis was required. Currently the patient carries a ¿Urocoil¿ spiral endoprosthesis to avoid tissular reaction. The therapeutical aspects found in the literature are reviewed, emphasizing the need of follow-up to detect complications, to improve indications and to select those patients that may be candidates for this treatment.

[Megacalycosis and lithiasis]. / Megacalicosis y enfermedad litiásica.

OBJECTIVES: Megacalycosis or Puigvert's disease is a clinical entity characterized by dilatation of all renal calyces without dilatation of the renal pelvis or ureter in the absence of any obstructive factor. To date, its pathogenesis remains unclear. The rarity of this disease and the importance of making a correct differential diagnosis prompted us to report on the present case. METHODS/RESULTS: Two patients with urolithiasis associated with ipsilateral megacalyces who were successfully treated by ESWL are described. The clinical, diagnostic and therapeutic aspects reported in the literature are briefly reviewed. CONCLUSIONS: There is a greater lithogenic predisposition in these patients. Intravenous urography has proved to be very accurate in making the differential diagnosis from other disorders such as obstructive uropathy and intermittent hydronephrosis. The efficacy of ESWL in the treatment of lithiasis associated with megacalycosis is underscored. A yearly control follow up by analyses and intravenous urography is advocated.

[Ureteral endometriosis]. / Endometriosis del uréter.

OBJECTIVES: Ureteral involvement due to endometriosis is uncommon. Its silent onset and the progression of ureteral obstruction, if undiagnosed, can lead to the loss of the renal unit. The present case is described to underscore the importance of early diagnosis. METHODS/RESULTS: We report on a patient with obstructive uropathy secondary to intrinsic ureteric endometriosis that had undergone nephrectomy due to parenchymal destruction. One year following resection of the endovesical portion, recurrence in the ureteral stump was observed. The clinical features, the diagnostic and clinical aspects are briefly discussed. CONCLUSIONS: Although ureteric involvement is uncommon, renal function of patients with pelvic endometriosis must be followed closely by analyses, ultrasound and/or intravenous urography for early detection of this condition.

[Cystic pyeloureteritis. A diagnosis to keep in mind]. / Pieloureteritis quística. Un diagnóstico a tener en cuenta.

OBJECTIVES: Cystic pyeloureteritis is a disease entity of unknown etiology and unspecific symptoms. It is incidentally detected and is difficult to distinguish from other disorders showing filling defects on urographic evaluation. All the foregoing prompted us to report the present case. METHODS/RESULTS: We report a case of cystic pyeloureteritis that had been diagnosed during ureterorenoscopy in a patient with lithiasis and recurrent urinary tract infection. The etiopathogenesis, diagnostic and therapeutic aspects described in the literature are briefly reviewed. CONCLUSIONS: We underscore the importance of confirming the diagnosis by endoscopic and cytological studies. Conservative management is advocated. Patient follow up should include urinalysis, urine culture and cytology twice yearly and intravenous urography once a year.

[Obstructive uropathy secondary to genitourinary prolapse]. / Uropatía obstructiva secundaria a prolapso genitourinario.

Genital prolapse is associated to a greater concurrence of repeat urinary infections, stress urinary incontinence, arterial hypertension and obstructive uropathy with a higher or lower degree of renal impairment. Incidence of uropathy in the genital prolapse setting ranges between 4 and 13%. This paper presents a female patient with renal insufficiency secondary to bilateral obstructive uropathy caused by a concomitant genital prolapse. A brief revision is made of the pathophysiological, diagnostic and therapeutic aspects in the literature. The need to perform both prone and standing urographic studies is emphasized; also a study of the renal function should be performed in these patients in order to establish the appropriate treatment and avoid major complications and renal function impairment.

[Penile prosthetic implant in the treatment of impotence: our experience]. / Implante de prótesis de pene en el tratamiento de la impotencia: nuestra experiencia.

The aim of this study was to review the current situation of penile prostheses in the treatment of erectile dysfunction and to analyze the indications, degree of acceptability and complications in our experience. From 1987 to 1993, 35 implants were inserted in men suffering from impotence due to different etiologies. The mean age was 54 years and the mean duration of erectile dysfunction was 37 months. Diabetes, vascular disease and pelvic surgery were the most common pathologies recorded. We utilized the penoscrotal approach in 97.14% of the cases and implanted the following prostheses: 12 Hydroflex, 7 Uniflate 1000, 6 Acuform, 4 Mark II, 3 Dynaflex and 3 Alpha 1. The mean follow-up was 38 months. Infection of the prosthesis by Staph. epidermidis was observed in 5.71% of the cases. This infectious complication required removal of the prosthesis. Two patients with a Uniflate prosthesis complained of mechanical failure. Eighty percent of the patients and 74.28% of their partners were satisfied with the results. When asked if they would undergo another operation again if it were necessary, 71.42% answered "yes". Penile prostheses have withstood the test of time and continue to be an effective and valid therapeutic alternative in impotent men. Although the complication rate is low, adequate information must be provided to the patient and partner in order to enhance the results.