Cigarette smoking and risk of adult-onset Still disease: a propensity score matching analysis.

BACKGROUND: Environmental factors play an important role in the pathogenesis of rheumatic diseases. Smoking is thought to be a risk factor for autoimmune rheumatic diseases. AIMS: The purpose of the present study was to assess the association between smoking and adult-onset Still disease (AOSD) and the effect of smoking on outcomes of this disease. METHODS: In this case-control study, patients with AOSD who met the Yamaguchi criteria, were older than 16 years at the disease onset and were in follow-up for at least 12 months were consecutively enrolled in the study. The outcome of AOSD was assessed by acquiring remission on treatment, remission off treatment, time to remission and rate of flare. The smoking status of participants was defined by direct or phone interviews. Individuals who had smoked daily for at least 6 months were defined as a smoker. We performed propensity score matching analyses by using four parameters, including age, sex, educational status and marital status. RESULTS: Propensity score matching resulted in 72 patients with AOSD and 216 matched controls. The number of ever smokers in the AOSD and control groups were 11 (15.3%) and 25 (11.6%) respectively. There was no significant increase in the risk of AOSD in multivariate analysis after adjustment for age, sex, marital status and educational level. There were no significant differences in the outcomes of AOSD between ever and never smokers. CONCLUSIONS: Smoking probably is not a risk factor for AOSD and did not affect the response to treatment.

Surgical management of a Salter-Harris type I proximal physeal fracture of the tibia in a foal: a case report.

BACKGROUND: One of the traumatic fractures occurring in the hindlimb of the foals is physeal fractures of the tibia. The most common type of proximal tibial fracture in foals is reported to be Salter-Harris type II. CASE PRESENTATION: This case report describes the history, clinical signs, radiographic findings, and surgical management of a proximal physeal fracture of the tibia due to the kick trauma in a 2-weeks-old Kurdish female foal, with signs of left pelvic limb lameness, valgus deviation with non-weight-bearing, non-mobility in stifle region and crepitation in the affected area. In this case, radiography was utilized to confirm the fracture and detect the exact location of the fracture fragments. The Salter-Harris type I accompanied by tibial tuberosity fracture was diagnosed. In this case, a size 4.5 mm seven-hole, T-plate, and cortical bone screws were employed to fix the physeal fracture, and a cortical bone screw was utilized to fix the tibial tuberosity in the normal position. Case follow-up during two months showed no significant complications, and the patient was fully recovered (no lameness anymore). CONCLUSIONS: To our knowledge, this is the first report of Salter-Harris type I fracture in proximal tibia accompanied by tibial tuberosity fracture in a foal treated by a T-plate implant. A cortical screw in lag fashion for tibial tuberosity was utilized in this case for the first time, and the results were satisfying. T-Plate fixation can be recommended as an effective surgical treatment for proximal tibial fractures in foals.

Surgical management of penile sarcoid in a stallion.

This report describes surgical management and breeding implications of a case of penile sarcoid associated with penis laceration in a 4-year-old Kurdish stallion. A large fleshy mass on the distal end of the penis that resulted in urethral meatus deviation and dysuria was detected in a physical examination. No evidence of local extent or metastasis was detected. Under general anaesthesia, the involved distal portion of the penis was removed through partial phallectomy. Histopathological examination of the mass confirmed a fibroblastic sarcoid. Partial phallectomy was successful for management of penile sarcoid and resulted in no postoperative complications or tumour recurrence in long-term follow up; however, successful ejaculation and semen collection have not been achieved.

Transverse mode instability threshold enhancement in Yb-doped fiber lasers by cavity modification.

To enhance the transverse mode instability (TMI) threshold of a fiber oscillator, a novel configuration is presented. In this configuration the oscillator cavity length is considerably reduced and the remaining active fiber is released out of the cavity to absorb the rest of the pump power and amplify the output signal of the cavity. In fiber oscillators, the index gratings generated by both forward and backward propagating signals can interact with light propagating in the backward and forward directions and degrade the output beam quality. In the proposed modified configuration, due to lower intra-cavity forward and backward signal power the index grating is smoothed and the TMI threshold is increased. Experimental results indicate that this modified configuration has a higher TMI threshold than a conventional fiber oscillator. Finally a higher TMI threshold is achieved in the bidirectional pumping scheme of the modified configuration.

Evaluation of the Sedative Effects of Diazepam, Midazolam, and Xylazine After Intranasal Administration in Juvenile Ostriches ( Struthio camelus ).

The sedative effects of diazepam, midazolam, and xylazine after intranasal administration were evaluated in 72 (36 male and 36 female) juvenile healthy ostriches ( Struthio camelus ), weighing 50-61 kg and aged 4-5 months. The birds were randomly divided into 3 groups (n = 24), then each group was further subdivided to 4 subgroups (n = 6). For each drug, 4 different doses were chosen and the total calculated dose was equally administered into either naris of the individual bird. The appropriate dose of each drug to produce standing chemical restraint or sternal recumbency was evaluated based on the onset time, the duration of maximum effect, and the duration of sedation. Midazolam showed significantly shorter onset time (2.9 ± 1.2 minutes) compared with xylazine (4.4 ± 1 minute) and diazepam (4.3 ± 0.4 minutes). Longer duration of sedation was also achieved with midazolam compared with xylazine and diazepam. Moderate sedation was achieved with diazepam (0.8 mg/kg), midazolam (0.4 mg/kg), and xylazine (2 mg/kg) for standing chemical restraint, with the maximum duration effects of 7.0 ± 1.4, 17.7 ± 4.1, and 9.2 ± 2.5 minutes, respectively. Deep sedation was also achieved with midazolam (0.8 mg/kg) and xylazine (4 mg/kg), with sternal recumbency duration of 21.7 ± 4.9 and 13.5 ± 2.6 minutes, respectively. The results of the present study show that intranasal administration can be an effective route for delivery of sedatives in juvenile ostriches. Intranasal midazolam and xylazine could be suggested for standing chemical restraint or inducing sternal recumbency in juvenile ostriches.

Effects of linalool on postoperative peritoneal adhesions in rats.

The current study examines the effects of linalool in preventing postoperative abdominal adhesions. Twenty male Wistar rats were randomly divided into four groups. (1) Sham: in this group, the abdomen was approached, and without any manipulations, it was sutured. (2) Control: rats in this group underwent a surgical procedure to induce adhesions. This involved making three incisions on the right abdominal side and removing a 1×1-cm piece of the peritoneum on the left abdominal side. (3) Treatment groups: these groups underwent the same surgical procedure as the control group to induce adhesions. Animals in these groups received linalool orally with doses of 50 and 100 mg/kg, respectively, for a period of 14 days. Moreover, rats in the sham and control groups received normal saline via gavage for 14 days. The evaluation of TNF-α, TGF-ß, VEGF, and caspase 3 was performed using western blot and IHC methods. Furthermore, oxidative stress biomarkers such as MDA, TAC, GSH, and NO were assessed in the peritoneal adhesion tissue. The findings revealed that linalool significantly reduced peritoneal adhesions by reducing TNF-α, TGF-ß, VEGF, and caspase 3 levels. Moreover, MDA concentration was significantly decreased, while NO, TAC, and GSH levels were notably increased. Overall, linalool was effective in preventing adhesion formation and reduced inflammation, angiogenesis, apoptosis, and oxidative stress. Therefore, linalool as a potent antioxidant is suggested for reducing postoperative adhesions in rats.

Unusual left colon displacement and clockwise torsion in a 10-month-old Arab filly: A case report.

In this case report, we present an unusual clockwise torsion of left colon around mesenteric root in a 10-month-old Arab filly, highlighting the clinical presentation, diagnostic approach and successful surgical intervention. A 10-month-old Arab filly weighing approximately 250 kg was referred with signs of acute abdominal pain. The history revealed anorexia, restlessness and severe abdominal pain that had begun the previous day. The local practitioner had previously administered flunixin meglumine, an analgesic, but it proved ineffective in relieving the pain. Upon physical examination, the filly exhibited sweating, a body temperature of 38.5°C, tachycardia (65 beats per minute) and tachypnea (25 breaths per minute). Due to the severity of the colic and the lack of response to the conservative treatments, surgical intervention was deemed necessary. An exploratory midline celiotomy was performed to evaluate the abdominal organs. During the examination, no obvious primary lesions were identified in the evaluated organs. However, a restriction in exteriorizing the left colon's length was observed. Further examination revealed an unusual clockwise torsion of the left colon that displaced in left to the right side around the mesenteric root; thereby, pelvic flexure was located in the normal anatomical position with a short length. To the best of our knowledge, this is the first reported case of clockwise torsion and an atypical displacement of the left colon in horses. The surgical correction of the displacement was successfully performed. The filly showed improvement post-surgery and did not exhibit any complications during the recovery period.

Effects of undifferentiated cultured omental adipose-derived stem cells on peripheral nerve regeneration.

BACKGROUND/AIMS: Employment of regenerative properties of stem cells at the service of nerve repair has been initiated during recent decades. Effects of transplantation of undifferentiated cultured omental adipose-derived stem cells (uADSCs) on peripheral nerve regeneration were studied using a rat sciatic nerve transection model. METHODS: A 10-mm sciatic nerve defect was bridged using a silicone rubber chamber filled with uADSCs. In control group, the silicone conduit was filled with phosphate-buffered saline alone. The regenerated nerve fibers were studied 4, 8, and 12wk after surgery. In sham-operated group, the sciatic nerve was only exposed and manipulated. RESULTS: Functional study confirmed faster recovery of regenerated axons in uADSC-transplanted animals than in control group (P<0.05). Gastrocnemius muscle mass in uADSC-transplanted animals is found to be significantly more than that in control group. Morphometric indices of the regenerated fibers showed that the number and diameter of the myelinated fibers were significantly higher in uADSC-transplanted animals than in control group. In immunohistochemistry, location of reactions to S-100 in uADSC-transplanted animals was clearly more positive than that in control group. CONCLUSION: uADSC transplantation could be considered as a readily accessible source of stromal cells that improve functional recovery of sciatic nerve.

A novel neural-evolutionary framework for predicting weight on the bit in drilling operations.

This study compares the performance of artificial neural networks (ANN) trained by grey wolf optimization (GWO), biogeography-based optimization (BBO), and Levenberg-Marquardt (LM) to estimate the weight on bit (WOB). To this end, a dataset consisting of drilling depth, drill string rotational speed, rate of penetration, and volumetric flow rate as input variables and the WOB as a response is used to develop and validate the intelligent tools. The relevance test is applied to sort the strength of WOB dependency on the considered features. It was observed that the WOB has the highest linear correlation with the drilling depth and drill string rotational speed. After dividing the databank into the training and testing (4:1) parts, the proposed LM-ANN, GWO-ANN, and BBO-ANN ensembles are constructed. A sensitivity analysis is then carried out to find the most powerful structure of the models. Each model performs to reveal the relationship between the WOB and the mentioned independent factors. The performance of the models is finally evaluated by mean square error (MSE) and mean absolute error criteria. The results showed that both GWO and BBO algorithms effectively help the ANN to achieve a more accurate prediction of the WOB. Accordingly, the training MSEs decreased by 14.62% and 24.90%, respectively, by applying the GWO and BBO evolutionary algorithms. Meanwhile, these values were obtained as around 9.86% and 9.41% for the prediction error of the ANN in the testing phase. It was also deduced that the BBO performs more efficiently than the other technique. The effect of input variables dimension on the accuracy and training time of the BBO-ANN clarified that the most accurate WOB predictions are achieved when the model constructs with all four input variables instead of utilizing either three or two of them with the highest linear correlation. It was also observed that the training stage of the BBO-ANN model with four input variables needs a little more computational time than its training with either two or three variables. Finally, the accuracy of the BBO-ANN model for the WOB prediction has been compared with the multiple linear regression, support vector regression, adaptive neuro-fuzzy inference systems, and group method of data handling. The statistical accuracy analysis confirmed that the BBO-ANN is more accurate than the other checked techniques.

Hyperpressure intraperitoneal fluid administration for control of bleeding after liver injury.

BACKGROUND: Acute hemorrhage is the principal cause of death in trauma patients, with most fatalities occurring during the pre-hospital phase. Recently, intra-abdominal insufflation by carbon dioxide has been shown to drastically reduce bleeding in vascular and splanchnic hemorrhagic animal models simulating the pre-hospital phase. Here, we propose that using dialysate fluid for increasing intra-abdominal pressure is at least as effective as gas with some potential advantages. MATERIALS AND METHODS: A novel method of inducing liver trauma was used in 24 White New Zealand rabbits randomized into three groups: intra-abdominal carbon dioxide insufflation (GAS) with 15 cm H(2)O pressure; intra-abdominal infusion of type III dialysate solution (DIAL) with the same pressure; no change in intra-abdominal pressure (CTRL). All groups received intravenous resuscitation when their mean arterial pressure was below 30 mmHg. Physiologic parameters were recorded during 20 min of bleeding. RESULTS: Red blood cell (RBC) volume loss in the DIAL and GAS was 45% and 48% lower than that in the CTRL, respectively (P < 0.0005). Similar trends were observed for losses in RBC count and hemoglobin (Hb). Final mean arterial pressure, arterial RBC, Hb, and hematocrit were higher in the DIAL and GAS than in the CTRL; glucose concentration in the DIAL group was significantly higher than that in the GAS and CTRL groups. No intravenous fluid therapy was needed in the DIAL group. CONCLUSIONS: Hyperpressure intraperitoneal dialysate administration successfully reduced bleeding after severe liver injury in rabbits. This method can potentially be used as an adjunct to increase patient survival during pre-hospital cares.

Effects of topically administered FK506 on sciatic nerve regeneration and reinnervation after vein graft repair of short nerve gaps.

OBJECT: Despite the development of various nerve coaptation materials and techniques, achievement of desired functional peripheral nerve regeneration is still inadequate, and repair of peripheral nerve injuries is still one of the most challenging tasks and concerns in neurosurgery. The effect of an FK506-loaded vein graft as an in situ delivery system for FK506 in bridging the defects was studied using a rat sciatic nerve regeneration model. METHODS: A 10-mm sciatic nerve defect was bridged using an inside-out vein graft (IOVG) filled with 10 µl of a carrier-drug dilution (10 ng/ml FK506) in the IOVG/FK506 group. In the IOVG control group, the vein was filled with the same volume of carrier dilution alone. The regenerated fibers were studied 4, 8, and 12 weeks after surgery. RESULTS: Functional study confirmed faster recovery of the regenerated axons in the IOVG/FK506 group than in the IOVG group (p < 0.05). There was a statistically significant difference between the mean gastrocnemius muscle weight ratios of the IOVG/FK506 and IOVG control groups (p < 0.05). Morphometric indices of regenerated fibers showed that the number and diameter of the myelinated fibers were significantly higher in the IOVG/FK506 group than in the IOVG control group. Immunohistochemical analysis showed more positive immunoreactivity to S100 protein in the IOVG/FK506 group than in the IOVG control group. CONCLUSIONS: When loaded in a vein graft, FK506 resulted in improvement of functional recovery and quantitative morphometric indices of sciatic nerve. Topical application of this readily available agent offers the benefit of cost savings as well as avoiding the complications associated with systemic administration.

Strangulating left colon volvulus following nonsurgical castration in a 6-year-old donkey.

Colic is a clinical syndrome and has been defined as a visceral abdominal pain and/or acute abdominal disease. It is a common cause of morbidity and mortality in horses. The most common forms of colics are related to gastrointestinal tract in nature and most often linked to colonic disturbances. However, colics are not well understood in donkeys compared to those of in horses and the literature is poor regarding bowel strangulating obstruction in donkeys. This report described the clinical signs and post-mortem necropsy findings of an abdominal colic due to the left colon volvulus following a non-surgical castration using Burdizzo emasculatome in a 6-year-old donkey. The castration was done under local analgesia following a sedation with a combination of xylazine-acepromazine and physical restraint on a tilt table. Severe abdominal colic and death occurred after discharging from the hospital. Left colon volvulus at the sternal and diaphragmatic flexures in a ventromedial-dorsolateral direction of 720° was the main cause of colic found at the necropsy examination. Although left colon volvulus is not considered as a complication of castration, it maybe rational to prescribe an analgesic agent in postoperative care in donkeys undergoing non-surgical castration.

Rosemary as an adjunctive treatment in patients with major depressive disorder: A randomized, double-blind, placebo-controlled trial.

BACKGROUND: Rosemary has shown antidepressant and anxiolytic properties. Thus, the present study aimed at assessing the therapeutic effects of orally administered rosemary capsules in patients with major depressive disorder. MATERIALS AND METHODS: Rosmarinic acid content of rosemary was determined using high performance liquid chromatography method. Hard gelatin capsules of rosemary were prepared, and their physicochemical properties were assessed. In this clinical trial, patients with major depressive disorder were randomly divided into rosemary and control groups. They received one capsule of rosemary or placebo twice a day for 8 weeks. The anxiety subscale of Hospital Anxiety and Depression Scale and Beck Depression Inventory - Second Edition were respectively used to measure the symptoms of anxiety and depression in the patients before initiating the treatment and four and eight weeks after the treatment. RESULTS: The amount of rosmarinic acid in rosemary was found to be 21.13 ± 0.56 mg/g dried plant. The scores of anxiety subscale of Hospital Anxiety and Depression Scale and Beck Depression Inventory significantly decreased in the rosemary group compared to those in the control group 8 weeks after the treatment. Memory improvement was a beneficial side effect observed in the study. CONCLUSION: The use of rosemary as an adjunctive therapy could improve the symptoms of anxiety and depression in people with major depression.

Comparison of beneficial effects of undifferentiated cultured bone marrow stromal cells and omental adipose-derived nucleated cell fractions on sciatic nerve regeneration.

Adipose tissue is a good source for isolation of cells with stem-cell-like properties. The effects of undifferentiated cultured bone marrow stromal cells (BMSCs) and omental adipose-derived nucleated cells (OADNCs) on peripheral nerve regeneration were compared in a rat nerve regeneration model. A 10-mm sciatic nerve defect was bridged using a vein graft. In one group, the vein was filled with BMSCs and in the other group with OADNCs. Functional study, morphometric indices, and immunohistochemistry indicated there was no significant difference (P > 0.05) between groups in recovery of regenerated axons at 4, 8, and 12 weeks after surgery. OADNCs enhanced regeneration similar to undifferentiated BMSCs. These observations suggest OADNCs represent an effective and cost-saving cell population due to the shortened time interval from tissue collection to cell injection as well as procedural simplicity. This approach is clinically translatable toward new methods for enhanced peripheral nerve repair without the limitations of BMSC.

Functional recovery of sciatic nerve through inside-out vein graft in rats.

OBJECTIVE: Present study aimed at further comprehensive functional, histomorphometrical and immunohistochemical assessment of peripheral nerve regeneration using rat sciatic nerve transection model. METHODS: The 10-mm rat sciatic nerve gap was created in rats. In control group nerve stumps were sutured to adjacent muscle and in treatment group the gap was bridged using an inside-out vein graft. In sham-operated group the nerve was manipulated and left intact. All animals underwent walking track analysis test 4, 8, and 12 weeks after surgery. Subsequently, muscle mass measurement was performed to assess reenervation, histological examination to observe the sciatic nerve regeneration morphologically and immunohistochemistry to detect Schwann cells using anti S-100. Results were analyzed using a factorial ANOVA with two between-subjects factors. Bonferroni test for pairwise comparisons was used to examine the effect of treatments. RESULTS: Functional analysis of myelinated nerve fibers showed that nerve function improved significantly in the time course in treatment group. However, quantitative morphometrical analysis of myelinated nerve fibers showed that there was no significant difference between 8 and 12 weeks in treatment group. Muscle weight ratio was bigger and weight loss of the gastrocnemius muscle was ameliorated by inside-out vein grafting. The position of positive immunohistochemical reactions further implied that regenerated axons and Schwann cell-like cells existed after vein grafting was performed, and was accompanied by the process of myelination and structural recovery of regenerated nerves. CONCLUSION: Functional analysis of peripheral nerve repair is far more reliable than quantitative morphometrical analysis.

Histomorphometrical evaluation of extensor digitorum longus muscle in sciatic nerve regeneration using tissue engineering in rats.

Skeletal muscle atrophy induced by denervation is one of the common disorders in traumatic nerve injuries. The aim of this study was the evaluation of histomorphometrical changes of extensor digitorum longus muscle after denervation and its regeneration by tissue engineering. Ninety adult male Wistar rats were randomly divided into six main groups (n = 15) in three time periods (2, 4 and 8 weeks; n = 5). Control group was treated without surgery, in transection (Tr) group left sciatic nerve was transected, in scaffold (S) group only collagen gel scaffold was used, in mast cell (MC) group mast cells were used, mesenchymal stem cell (MSC) group was treated with mesenchymal stem cells and in MC+MSC group, mast cells along with mesenchymal stem cells were used. In the cellular groups, the scaffold and cells were mixed and placed in the transected nerve gap. The average diameter of muscle fibers, ratio of the muscle fibers nuclei to the fibrocytes nuclei (mn/fn), ratio of the muscle fibers nuclei number to the muscle fibers number (mn/mf), the average ratio of blood vessels to muscle fibers number (v/mf) and muscles weight in Tr group were the lowest compared to the other groups; but, in cellular and S groups, amelioration was observed according to the time period. However, in MC+MSC group, there were the highest ameliorative results. This study revealed that simultaneous use of MCs and MSCs mixed with collagen gel scaffold can be considered as a suitable approach to improve denervated skeletal muscle atrophy associated with sciatic nerve injury.

The effect of population inversion saturation on the transverse mode instability threshold in high power fiber laser oscillators.

To achieve a 3.02 kW Yb-doped fiber laser oscillator, the behavior of transverse mode instability (TMI) is experimentally studied in different pumping configurations; co, hybrid, counter, and bidirectional. A comparative analysis showed that population inversion saturation has a substantial impact on TMI threshold enhancement in high power fiber oscillators. Monitoring the dynamic power exchange of fundamental mode and higher-order mode of laser output beam indicates that in a hybrid pumping scheme, simultaneous pumping with two different wavelengths enhances the TMI threshold to a great stand. Moreover, injecting a few watts of pumping light in the counter direction mitigates the TMI caused by pumping in the co-direction. Calculation of population inversion in different pumping configurations using simulation shows that higher population inversion saturation leads to increasing the TMI threshold.

Surgical repair and management of congenital intestinal atresia in 68 calves.

OBJECTIVE: To determine outcome and survival rate after surgical treatment of intestinal atresia, gender predilection, and effect of rectal palpation on the cause of atresia coli in calves. STUDY DESIGN; Prospective clinical study. ANIMALS: Newborn calves (n=68). METHODS: Data collected were husbandry system, anamneses, physical examination findings, surgical treatments, and postoperative results. Calves with atresia ani, and with atresia coli et recti had anal reconstruction and right flank colostomy, respectively. In midflank colostomized calves, the inner muscular layers were dissected to form a valve-like stoma. RESULTS: Of 68 calves with intestinal atresia, 37 were treated surgically. Anal reconstruction was performed in 21 calves with atresia ani with a long-term survival rate of at least 6 months with good condition. Colostomy was performed in 14 calves with atresia coli and 1 with atresia coli et recti; survival rate was 73%. The case morbidity rate for intestinal atresia was 13.8% and for atresia coli, 5.7% in the hospital population. No gender predilection for occurrence of atresia ani and atresia coli was identified. Palpation per rectum for early pregnancy diagnosis did not predispose to atresia coli. CONCLUSION: Surgical treatment of atresia ani through circular anal skin removal has a good prognosis for survival. Colostomy is not an acceptable treatment from the calf's perspective because of the resulting poor condition but the high survival rate is important to allow continued milk production of the dam. CLINICAL RELEVANCE: Early diagnosis, supportive treatment, and surgical correction are important in management of atresia coli.

Detecting dysplasia using white light endoscopy or chromoendoscopy in ulcerative colitis patients without primary sclerosing cholangitis: A systematic review and meta-analysis.

BACKGROUND: Endoscopic examinations are a vital diagnostic tool for dysplasia. Establishing the precision of different modes of examination is essential due to the disparate pick-up rates of dysplasia. OBJECTIVE: The aim of this article was to establish the pick-up rates of dysplastic or cancerous lesions using white light endoscopy (WLE) and random/targeted biopsies, or chromoendoscopy (CE), in patients with ulcerative colitis (UC) without primary sclerosing (PSC) or Crohn's disease (CD). DATA SOURCES: A systematic review to identify all studies up to November 2017, without language restriction, was conducted from PubMed, the Cochrane Controlled Trials Register (1960-2017), MEDLINE, CINAHL and EMBASE (1981-2017). MeSH and text word terms used included "ulcerative colitis", "dysplasia", "random biopsy", "targeted biopsy", "colonoscopy", "white light", and "chromoendoscopy". Further searches were performed using the bibliographies of these articles. STUDY SELECTION: All studies reporting on colonoscopy detection rates of dysplasia and cancers in UC without involvement of PSC or CD were included. There was no age restriction to include patients. DATA EXTRACTION: Outcome data were extracted by 2 authors independently using outcome measures defined a priori. Quality assessment was performed using the Newcastle-Ottawa scales. DATA SYNTHESIS: Data were extracted and analysed according to meta-analytical techniques using comprehensive meta-analysis. The pooled overall pick-up rate of dysplastic/cancerous lesions on WLE random biopsies was 5.6% [Event rate 0.06 (0.01, 0.23), df = 4, I2 = 94%]. Using a combined random and targeted approach with WLE the incidence was 5.1% [Event rate 0.05 (0.03, 0.09), df = 4, I2 = 96%]. One study reported on CE and found a 7% pick-up rate for dysplastic lesions. CONCLUSIONS: Endoscopic examination of UC patients without PSC identifies dysplastic or cancerous lesions in 5-7% of cases. WLE and random biopsies may pick-up a similar number of lesions to targeted biopsies, however the number of biopsies may need to be greater to achieve this equivalence. CE has a slightly higher pick-up rate. Further comparative studies are required to strengthen the body of evidence.

Associations between teat injuries and fistula formation in lactating dairy cows treated with surgery.

OBJECTIVE: To determine associations between rate of fistula formation and parity, lactation period, wound age, wound location, and shape of teat injuries in surgically treated teats in dairy cows. STUDY DESIGN: Prospective clinical study. ANIMALS: 106 lactating dairy cows with teat lacerations. PROCEDURES: Lacerations were classified via shape, location, and age. Associations between potential risk factors and fistula formation were analyzed. Seasonal distribution, type of injured teat, parity, and days in lactation were determined. RESULTS: Cows with teat injury in their first and second parity had 4.1 times the odds of fistula formation, compared with cows with parity >or= 3. Teats sutured within 48 to 72 hours of injury had 8.3 times the odds of fistula formation, compared with teats sutured within the first 24 hours. Cows in early lactation stage (first 60 days of lactation) were more susceptible to teat injuries. Occurrence of teat injury was greater at the third, fourth, and fifth parity. CONCLUSIONS AND CLINICAL RELEVANCE: Season, parity, and lactation period were associated with prevalence of teat injury in lactating dairy cows in a range system. Neither the type of suture material used nor the suturing technique was associated with effects on healing of the operated full-thickness teat wounds. Factors such as parity and age of the wound can be associated with delay in the healing process, which may result in fistula formation.