The effect of subclinical endometritis on reproductive performance in postpartum Bos indicus multiparous beef cows.

The objective was to investigate the prevalence of subclinical endometritis (SE) in postpartum Bos indicus multiparous beef cows using different polymorphonuclear cells (PMN) threshold ratios, and to evaluate the impacts of SE on their reproductive performance. A total of 689 postpartum Nellore cows (45.2 ± 7.8 days postpartum) were submitted to an estrus synchronization protocol + timed-artificial insemination (TAI). Endometrial cytology samples were collected by cytobrush before the beginning of the protocol. Cows were considered positive for SE if: (PMN) ≥ 3% (PMN3), PMN ≥ 5% (PMN5) and PMN ≥ 7% (PMN7). Pregnancy diagnosis was performed at 30 and 100 d after TAI. The prevalence of cows categorized as positive for SE increased (P < 0.05) as the threshold was lowered (PMN7 = 3.9%; PMN5 = 5.5%; PMN3 = 9.1%). Positive SE cows had similar (P > 0.41) BCS, days postpartum, and expression of estrus at TAI compared with negative SE cows. Positive SE cows had decreased (P = 0.04) pregnancy rates compared to negative SE cows in the PMN5 threshold (26.3 ± 8.7% vs 44.5 ± 4.1%); however, no difference (P > 0.45) was observed between positive and negative SE cows in the PMN3 and PMN7 thresholds. Embryonic mortality between days 30 and 100 was not affected by SE (P > 0.16). In conclusion, the prevalence of SE varies based on the PMN threshold used, whereas SE at the beginning of the TAI protocol decreased the pregnancy rates in postpartum Bos indicus beef cows when the PMN5 was used.

Amoxicillin prophylaxis in oral surgery.

INTRODUCTION: Postoperative infection is the most common postsurgical oral complication but no double-blind, randomized, placebo-controlled trial has been made yet to assess amoxicillin prophylaxis for oral surgery. The aim of this pilot study was to assess the effectiveness of prophylactic amoxicillin 3g per os versus placebo in the prevention of postoperative oral infections. METHODS AND MATERIALS: A 5-year, multicentric, randomized, double-blind clinical trial was made on healthy patients undergoing complex oral surgery. Final analysis was by intention to treat. RESULTS: The 286 patients were randomly assigned to the amoxicillin or placebo group. After a mean follow-up of two weeks, 11 patients in the control group and three patients in the amoxicillin prophylaxis group developed a postoperative infection (P=0.001 in unilateral test). The hazard ratio was 0.27 [95% CI: 0.07-0.94]. CONCLUSION: Amoxicillin prophylaxis seems to be effective in preventing postoperative infection in complex oral surgery, especially when mandibular third molars and multiple avulsions are involved.

[Bacteremia of oral origin]. / Bactériémies d'origine buccale.

Transient bacteremia from oral cavity related to oral anaerobic bacteria may occur as a result of dental healthcare procedures but also as a result of daily gestures involving the gums (chewing and oral hygiene). The risk of presenting a transient bacteremia is related to oral cavity bacterial load and to the severity of inflammation in the oral cavity. Although bacteremia is transient, in patients with immunodeficiency or comorbidity, this bacteremia may cause extra-oral infections. The bacteremia rate and the identified bacteria vary from one study to the next, depending on the method used to isolate and identify bacteria. Nevertheless, the risk for bacteremia is determined by the infectious and inflammatory conditions of each patient.

[218 tooth extraction in patients taking platelet aggregation inhibitors]. / Antiagrégant plaquettaire et chirurgie buccale: à propos de 218 extractions dentaires.

INTRODUCTION: The aim of this survey was to show that tooth extraction could be performed in patients taking antiplatelet agents. The main indication of antiplatelet agents is to reduce the thrombotic disease. MATERIAL AND METHOD: The authors made a descriptive and retrospective analysis of 52 patients taking antiplatelet agents in their department between February 2003 and January 2005. Two hundred and eighteen tooth extractions were performed. For each extraction, a protocol of local hemostasis (filling, suture, compression) was applied. RESULTS: Three hemorrhagic sockets were reported out of 218 extractions performed without stopping the antiplatelet agent treatment (1.3%). One patient presented with persistent bleeding out of 52 cases (1.9%). No hemostasis had been performed on this patient; a local hemostasis was performed during surgical revision, which stopped the persistent bleeding. DISCUSSION: These results show that the hemorrhagic risk can be controlled by a local hemostasis protocol.

Use of recombinant factor VIIa to treat persistent bleeding following dental extractions in two cirrhotic patients.

BACKGROUND AND OBJECTIVES: A single dose of recombinant factor VIIa (rFVIIa) has been shown to be effective and safe in correcting the prothrombin time (PT) in cirrhotic patients, but no clinical data exists demonstrating its efficacy in arresting active bleeding. MATERIALS AND METHODS: rFVIIa was used in two cirrhotic patients for persistent bleeding following dental extractions despite repeated treatment at the wound site and, in one case, repeated administrations of fresh-frozen plasma (FFP). RESULTS: Bleeding stopped promptly in both patients after administration of rFVIIa. However, bleeding recurred in the patient who had not received concomitant treatment at the extraction sites. No recurrence of bleeding was observed in the second patient, who underwent local treatment 15 min after rFVIIa. CONCLUSIONS: Recombinant factor VIIa arrested bleeding after dental extractions in two cirrhotic patients who had been unsuccessfully treated with FFP. However, additional local treatment is needed to limit the risk of recurrence as a result of the short half-life of rFVIIa.

Evaluation of the areas of neuronal cell bodies and nuclei in the myenteric plexus of the duodenum of adult rats

This study compared the areas of cell body and nucleus profiles of the myenteric neurons in the antimesenteric and intermediate regions of the duodenum of adult rats. Five male rats were used. The duodenum was removed and dissected to whole-mount preparations, which were stained by the Giemsa technique. The areas of cell body and nucleus profiles of 100 neurons, 50 from each region, of each animal, were assessed with image analyser. Based on the global mean +/- SD of the areas of cell body profiles, neurons were labelled as small, medium or large. It was observed that the neurons did not differ significantly in size or incidence between the antimesenteric and intermediate regions. However, the nuclei of the small and medium neurons were significantly smaller in the latter region. It is discussed that the smaller nuclear size could be related to the cell bodies being slightly smaller on this region and to a possible smaller biosynthetic activity which would influence nuclear size.

Number and size of myenteric neurons of the duodenum of adult rats with acute diabetes

This study had as its purpose to assess the effects of acute diabetes induced by streptozotocin (35 mg/kg body weight) on the number and size of the myenteric neurons of the duodenum of adult rats considering equally the antimesenteric and intermediate regions of the intestinal circunference. Experimental period extended for a week. Neuronal counts were carried out on the same number of fields of both regions of the duodenal circunference and measurements of neuronal and nuclear areas on equal numbers of cells. Number and size of the myenteric neurons stained with Giensa were not significantly different between groups. On the other hand, the proportion of NADH-positive neurons increased from 18.54 per cent on the controls to 39.33 per cent on the diabetics. The authors discuss that this increased reactivity probably results from a greater NADH/NAD* ratio, described in many tissues of diabetic animals, which has consequences on the modulation of the enzymes that use these cofactors and whose activity is detected by the NADH-diaphorase technique.

The value of unenhanced CT in the diagnosis of acute appendicitis.

OBJECTIVE: To establish the accuracy of unenhanced CT in the preoperative diagnosis of acute appendicitis. DESIGN: Accuracy study, prospective and blinded. SETTING: The University Hospital. PARTICIPANTS: 52 patients with clinical and laboratorial manifestations of acute appendicitis. CT diagnosis was made by: presence of an abnormal appendix, appendiceal calculi with pericecal phlegmon or alterations in the pericecal appendicular site and absence of signs that may lead to other diagnosis. MAIN OUTCOME MEASURES: Overall accuracy, comparing the tomographic aspects with the intra-operative findings and pathological reports ("gold standard"). RESULTS: Acute appendicitis was confirmed in 44 cases. Efficacy was 92%, sensitivity was 91%, specificity was 100%, positive predictive value was 100% and negative predictive value was 67%. CONCLUSIONS: Unenhanced CT presents a similar overall accuracy to that reported by other authors who studied enhanced CT diagnosis of acute appendicitis.

[Survey of focal infection in a hospital environment]. / Enquête sur l'infection focale en milieu hospitalier.

To make their study the authors inquired in the different departments of the University Hospital in Rennes, concerned by the problem of focal infection. This study aims at helping practitioners to take the right therapeutic decision in case of high, low or non existent infection risks. The results of the study show new pathologies involving focal infection risks. The evaluation of the patient's examination will be made by the service the patient comes from, and the Odonto-Stomatologist; the decision will be taken in common and according to the severity, the evolution, and the possible recurring of the disease.

[Idiopathic leg length inequality in childhood and its prognosis]. / Idiopathische Beinlängendifferenzen im Kindesalter und ihre Prognose.

In 128 children with leg length differences following observations had been done: Equalization by growth cannot be expected if there is no tendency for improvement within a year. Differences of leg length having transgressed 2 cm cannot be suggested to normalize spontaneously by growth. No relationships could be established between the tendency for equalization and age dependent growth spurts.

Voltage transients during ionic substitution in renal cortical tubules.

A voltage transient is described which is found during proximal tubular perfusion with impermeant cation or anion salt solutions in the rat. It was shown that the magnitude of transepithelial diffusion potentials depended on luminal hydrostatic pressure, suggesting that the observed transients might be the consequence of the enlargement of ionic pathways by tubular dilatation. Thus, when reporting PD values, care should be taken to define the pressure levels at which measurements were performed.

Effect of temperature on proximal tubular acidification.

The effect of temperature on proximal tubular acidification was studied in isolated rat kidney, perfused with 20 mM phosphate Ringer's containing 7.5 g/100 ml bovine albumin, equilibrated with air. Tubular pH was measured with Sb microelectrodes during stopped-flow microperfusion. The temperature of the kidney was varied between 10 and 46 degrees C. At 10 degrees C the proximal tubule was still able to maintain pH gradients of about 0.7 pH units. However, half-times (t/2) of both acidification and alkalinization were markedly increased, from 6-7 s at 37 degrees C to 27-30 s at 10 degrees C. In consequence, net H+-ion flux into the tubule was reduced to 26% of that at 37 degrees C. In this system, in the absence of exogenous HCO-3 and CO2, t/2 of acidification and alkalinization were very similar at 37 degrees C and below. Above 37 degrees C alkalinization t/2 fell markedly to 1.43 +/- 0.09 (11) s at 46 degrees C, while acidification t/2 stayed at about 7 s. H+-ion back-fluxes increased progressively from 10-46 degrees C, while secretory JH reached a maximal value at 37 degrees C and fell at higher temperatures. Apparent activation energies calculated from rate coefficients were 8.48 kcal . mol-1 for acidification, and 9.30 for alkalinization, and those calculated from JH were 6.30 and 9.55 respectively. These data indicate that both H-ion secretion and back-flux are carrier-mediated, probably flowing through the Na/H exchanger in the luminal membrane, since their activation energies are of the same order of magnitude and markedly higher than those for protons in solution.

H+ ion secretion in proximal tubule of low-Co2/HCO-3 perfused isolated rat kidney.

Acidification in proximal tubule of the isolated rat kidney, perfused in vitro, was studied by stopped-flow microperfusion techniques, using Sb microelectrodes to measure luminal pH. The kidney was perfused with mammalian Ringer's solution at pH 7.4 buffered by 20 mmol/l phosphate and containing 7.5 g/100 ml bovine albumin, equilibrated with air. Final urine pH was 6.88 +/- 0.5. Steady-state pH in proximal segments was 6.81 +/- 0.03 (n = 80), and acidification half-time (t/2) 7.25 +/- 0.33 (80) s, giving a net secretory H+ ion flux of 0.51 +/- 0.05 nmol . cm-2 . s-1. This flux was about 70% of "in vivo" (blood perfused kidneys). During luminal perfusion with solutions at pH 6.2, back-flux of H+ was 0.82 +/- 0.08 nmol . cm-2 . s-1, with an alkalinization t/2 of 6.33 +/- 0.34 (34) s. The difference between acidification and alkalization t/2 was not significant. This is compatible with a pump-leak system of H+ transport. This is compatible with a pump-leak system of H+ transport. The back flux of H from the lumen was markedly reduced in low Na+ perfused kidneys in the presence of 10(-4) mol/l amiloride in the lumen, indicating that this process is mediated by the luminal Na/H exchanger. Observations in the presence of high K levels suggest that it may have also a charged component. 10(-4) mol/l acetazolamide added to the kidney perfusate reduced acidification to 0.5% of control, and 10(-6) mol/l SITS to 25% of control. Thus, despite the low pCO2 (0.1-0.4 kPa, or 1-3 mm Hg), the CO2/HCO-3 buffer system still plays an important role in tubular acidification in this preparation.

Kinetics of luminal acidification in cortical tubules of the rat kidney.

1. Some kinetic aspects of renal tubular acidification were studied in proximal and distal tubules of the rat kidney by combining stationary microperfusion methods and continuous measurements of luminal pH changes of phosphate or bicarbonate buffers by means of antimony electrodes. The analysis included the measurement of steady-state pH, steady-state buffer concentrations and acidification half-times. From these data, net rates of tubular bicarbonate reabsorption and of H ion secretion were obtained since it was shown that the rate of phosphate acidification provides a realistic estimate of H ion secretion. 2. Experiments were performed in control rats, in animals undergoing metabolic acidosis or alkalosis and in control and acidotic rats receiving the carbonic anydrase inhibitor Diamox. 3. In all experiments, the rates of tubular bicarbonate reabsorption and of phosphate acidification (H ion secretion) were proportional to luminal buffer levels. The changes of luminal acid concentrations followed first-order kinetics. 4. Steady-state transepithelial pH differences were reduced in metabolic alkalosis and after diamox but augmented during metabolic acidosis. 5. Acidification half-times were prolonged in metabolic acidosis and after Diamox but remained similar to control levels in metabolic alkalosis. 6. From the observation that both bicarbonate reabsorption and phosphate acidification are similarly affected by these experimental manoeuvres, it is concluded that H ion secretion plays a key role in both transport processes.

Nephron function of the isolated perfused rat kidney.

Nephron functions of an improved isolated perfused rat kidney preparation were studied by micropuncture techniques. Single-nephron glomerular filtration rate (SNGFR), intratubular pydrostatic pressures (IP), transit time (TT), and the reabsorption (R) of H2O, Na, Cl, and K were measured in superficial proximal (PT) and distal tubules (DT) of the preparation. Mean SNGFR was 27.2 nl/min and 25.2 nl/min when measured in PT and DT, respectively. The PT transport functions were well maintained throughout the perfusion (mean values were: IP, 14.3 mmHg; TT, 17.7 s; fractional (F) RH2O, 64%; absolute RH2O, 15.4 nl/min; FRNA, 66.5%; FRK, 71%, and tubular fluid-to-perfusate tf/p) ratio of Cl, 1.37). The short loops of Henle reabsorbed less than 10% of the load of H2O and Na delivered to them and the TF/P ratio of electrolytes in the earliest DT segments were high (TF/P)Na = 0.88, (TF/P)Cl = 1.27, and (TF/P)K = 1.11). This deficiency in function of Henle's loop explains, at least in part, the degree of natriuresis of the preparation (overall FRNa = 97.5%). Transit time to end DT was prolonged (82.3 S) and IP in DT elevated (14.9 mmHg). The DT was able to compensate, in part, for the overload from Henle's loop by reabsorbing 36% of the fluid load and 54% of the Na load delivery to it. We concluded that the improved isolated perfused rat kidney is a suitable preparation with which to study several aspects of renal function, particularly proximal tubules transport functions.

Conductances, diffusion and streaming potentials in the rat proximal tubule.

1. Transtubular potential differences and specific resistances were measured in rat proximal tubules by means of single and double barrelled glass micro-electrodes. 2. Tip localization was made by observation of effective resistance changes measured with double barrelled micro-electrodes upon passage of oil droplets, and by perfusion with choline C1. 3. Mean early proximal p.d.s. of the order of -1 to -2 mV, and late values of +0-5 to +1mV were found. Mean specific resistances ranged from 12 to 15 omega cm2. 4. Diffusion potentials and single ion relative conductances were evaluated, perfusing the lumen with solutions differing only with respect to one salt concentration. Na and K conductances were similar and greater than those of C1. 5. Luminal and peritubular perfusions with hypotonic solutions showed the occurrence of streaming potentials in this structure suggesting the existence of pores lined with negative charges. The effective diameter of these pores appeared to be reduced by hypotonic perfusion, as evidenced by a significant increase in resistance, indicating that the main ion path across this structure is represented by intercellular spaces.