Is it safe to combine abdominoplasty and posterior vaginal repair in one surgical session?

UNLABELLED: Many multiparous women complain of protruded and pendulous abdomens and vaginal outlet relaxation which affect their sexual relationships with their male partners. This study included 47 patients who had these complaints. Some of these patients were working outside the homes and all were mothers of 2-5 children. Due of their home and job responsibilities, they did not have enough time or money for multiple surgeries in more than one session. MATERIAL AND METHODS: The age of these patients was 26-54 years and all patients had poor skin elasticity, pendulous excess subcutaneous fat and skin below the level of the anterior vulvar commissure, and a lax musculoaponeurotic anterior abdominal wall. Also, all patients had a relaxed vaginal outlet and 32 patients had rectocele. Careful perioperative assessment and management was done for each patient to ensure fitness for the long operation and to avoid complications. The combined surgical session consisted of two steps: abdominoplasty and posterior vaginal repair. All the patients were kept in the hospital for two days and they returned to their usual routines in the third week after surgery, and they resumed their sexual relationships with their male partners in the sixth week after surgery. RESULTS: There were no serious complications and this approach was convenient for the patients and their families. The recovery time of the combined surgical session was the same as that of just abdominoplasty, and significantly less than the sum of the recovery periods if the two surgeries had been performed in two sessions. The cost of the combined surgical session was significantly less than doing the surgeries in two sessions. All the patients had significant improvement in their sexual relationships.

Demonstration of therapeutic equivalence of generic and innovator beclomethasone in seasonal allergic rhinitis. SAR Study Group.

BACKGROUND: Although generic formulations of drugs are chemically equivalent, they may not be bioequivalent to the innovator. Since bioequivalence of intranasal corticosteroids has been difficult to demonstrate by pharmacokinetic methods, clinical trials have been necessary to compare generic and innovator agents. OBJECTIVE: We therefore designed a multicenter, randomized double-blind, parallel-group placebo-controlled study to examine the therapeutic equivalence of generic beclomethasone diproprionate to the innovator. METHODS: A total of 518 patients, ages 12 to 60, with ragweed-induced seasonal allergic rhinitis from eight centers were randomized to receive intranasal generic or innovator beclomethasone 42 microg, 84 microg or placebo twice daily for 6 weeks. Efficacy was assessed by means of rhinitis symptom scores as recorded in patient diaries. Adverse events were recorded throughout the study to assess safety. RESULTS: Mean rhinitis composite symptom scores (congestion, postnasal drip, runny nose, and sneezing) were significantly lower in patients receiving 42 microg (P = .0003) or 84 microg (P = .0001) beclomethasone twice daily compared with placebo. Generic beclomethasone was equivalent therapeutically to the innovator in alleviating nasal congestion (42 microg and 84 microg doses), postnasal drip (84 microg dose), runny nose (84 microg dose), sneezing (42 microg and 84 microg doses) and mean composite (42 microg and 84 microg doses) symptom scores during the 6-week study period. Similar and equivalent efficacy was also demonstrated during the 5-day period of peak pollen counts at each site. The type and incidence of drug-related adverse events were similar for both beclomethasone treatment groups and did not differ significantly from placebo in severity and frequency. CONCLUSIONS: Generic beclomethasone was therapeutically equivalent to the innovator in regards to both efficacy and side effect profile in the treatment of ragweed-induced allergic rhinitis.

Calving intervals in beef cows at 2, 3, and 4 years of age when breeding is not restricted after calving.

The objective of this study was to evaluate calving intervals and repeatability of calving intervals of young beef cows when breeding seasons were initiated immediately after calving. Average calving date at 2, 3, and 4 yr of age was recorded, and duration of calving interval between the first and second and second and third parities was compared in 178 crossbred beef cows calving between 1981 and 1988. Cows were placed in paddocks with intact bulls immediately after calving so they had the opportunity to conceive at the estrus associated with the initial estrous cycles after calving. Average Gregorian date of calving for cows was progressively earlier with older age (March 9, March 5, and February 14 at 2, 3, and 4) yr of age, respectively). Repeatability of calving intervals within individual cows was also evaluated. There was an interaction between year and parity on calving interval between 2 and 3 (P < .001) and 3 and 4 (P < .004) yr of age. Repeatability of calving interval was low and negative during 5 of the 6 yr. In young beef cows, year and parity interact to influence calving interval, and this average interval is less than 365 d when initiation of the breeding season is not restricted after calving.

Relationship between circulating progesterone and conception at the first postpartum estrus in young primiparous beef cows.

The objective of this study was to determine whether patterns of change in concentration of progesterone in circulation of primiparous beef cows were related to conception rates at the first postpartum estrus. Data were collected over 2 yr from crossbred primiparous 2-yr-old cows (n = 77). Cows were artificially inseminated when estrus was detected between 3 and 20 (yr 1) or 3 and 23 (yr 2) wk after parturition. Cows were exposed to intact bulls for 32 (yr 1) or 21 d (yr 2) after the periods of AI, and estrus detection also occurred during the period when natural mating occurred. After parturition, blood samples were collected twice weekly to determine time of transient (less than 1 wk) and sustained increases (more than 1 wk) in progesterone of more than 1 ng/mL of serum. Mean times from parturition to transient increase in progesterone, first estrus, conception, and sustained increase in progesterone were 91, 100, 108, and 105 d, respectively. Sixty-four percent of the cows conceived as a result of AI at the first estrus that was detected after parturition, 32% conceived at a subsequent estrus, and 4% failed to conceive. In 31.1% of the cows, a transient increase in progesterone was not detected before the first estrus after calving. Conception as a result of AI at the first estrus after calving was less if a transient increase in progesterone did not precede estrus (76 vs 41%; P < .01). These data indicate that the majority of cows have increases in progesterone before the first postpartum estrus. If the transient pre-estrus increase in progesterone occurs in postpartum cows, there seems to be an enhanced conception rate as compared with cows without the increase in progesterone before their first estrus following parturition.

Environmental effects on neonatal mortality of beef calves.

Calving records from 1969 to 1989 from the Roman L. Hruska U.S. Meat Animal Research Center were used to investigate how climatic conditions, in addition to dystocia, age of dam, size of calf, and sex affect calf survival from birth to 1 wk of age. Data were analyzed separately for cows calving with (n = 11,094) or without (n = 72,187) dystocia. Neonatal mortality was described by a logit model and parameters were estimated by maximum-likelihood procedures. Calves born to cows with dystocia were five times as likely to die neonatally than calves born without assistance. Of all calves that died, 43.6% were born with difficulty. Of these calves, survival was lowest for those that were small relative to their genetic group, sex, and age of dam. Large calves had markedly increased mortality only when born to 2-yr-old dams. Average ambient temperature and precipitation on day of calving affected survival nonlinearly and the magnitude of the effect depended on age of dam, sex and size of calf, and dystocia incidence. Calves born to 2-yr-old cows were more susceptible to severe weather conditions than calves born to older cows. The negative effect of precipitation on survival increased with decreasing temperature.

Use of a simulation model to evaluate the influence of reproductive performance and management decisions on net income in beef production.

A stochastic dynamic model of reproduction and a deterministic cow-herd economic simulation model were used to evaluate how management decisions and reproductive performance interact to influence net income in a cow-calf operation (1,000 cows) for 1 yr of production. The stochastic model was used to determine herd performance when length of breeding season (45, 70, or 120 d) interacted with three postpartum intervals of anestrus (48, 65, or 90 d) and three conception rates at first service (60, 70, or 80%). Short, moderate, and long postpartum intervals were used to reflect differences in reproductive performance. In addition, replacement heifers were bred beginning either 3 wk ahead of the cow herd or at the same time as the cow herd. Fifty-four simulations were generated. Inputs into the economic model were herd performance, livestock and feed prices, nonfeed costs, and feed requirements for 1 yr of production. Feed requirements were calculated separately for each postpartum interval to reflect three different body condition scores, thin, moderate, and good, to correspond with long, moderate, and short postpartum intervals. Net income was greatest with 70-d breeding seasons when the postpartum interval was short or moderate. When the postpartum interval was long, net income was greatest with 120-d breeding seasons because pregnancy rates, as a result of the long breeding season, were highest and feed costs were lowest for thin cows. Overall, net income was greatest when cows were managed to have postpartum intervals of moderate length. Breeding heifers 3 wk before the cows provided the most economic benefit with long postpartum intervals.

A Markovian decision model for beef cattle replacement that considers spring and fall calving.

In certain production environments, beef cows are mated during a breeding season that starts in early summer. Cows found not to be pregnant at the end of the breeding season could either be culled or retained and remated the following summer. Alternatively, nonpregnant cows could be mated in the winter. This option would result in having both a spring and a fall calving herd. The purpose of our study was to determine the optimal replacement policy (maximizing long-run average net returns) for a specific production environment by determining for each age of cow, reproductive status (nonpregnant or pregnant), and season of pregnancy checking (spring or fall) whether the cow should be retained to the next breeding season (summer or winter) or be replaced by a pregnant heifer. The problem was formulated as a Markovian decision process and the optimal policy was found by linear programming. The optimal policy was one in which nonpregnant cows were always culled and replaced by heifers in the summer breeding herd, resulting in spring calving only.

Distribution of time to first postpartum estrus in beef cattle.

The function of a distribution that describes postpartum interval (PPI) under any experimental treatment is useful for simulation modeling, understanding the effects of stimuli on the endocrine system, and estimating the average PPI in experiments terminated before all animals have expressed estrus. This study was undertaken to compare the fit of three statistical distributions, the Weibull, the log-normal, and the linear hazard rate (LHR), to the empirical distribution of PPI for five treatment regimens: no bull exposure postpartum, bull exposure from 53 d postpartum, bull exposure from 3 d postpartum, and bull exposure from an average of 63 d postpartum for 2-yr-old cows and for mature cows. The Weibull and the log-normal distributions deviated considerably from the empirical distribution. The LHR distribution with parameters changing over three different regions gave an excellent fit. The resulting hazard rate (instantaneous probability of a cow expressing her first estrus at time t postpartum) revealed a low probability of expressing estrus within 27 d postpartum (43 d for 2-yr-olds). For cows not exposed to bulls, the hazard rate increased slowly with time. For cows exposed to bulls after 3 d postpartum, the hazard rate increased rapidly between d 27 and d 50. For cows exposed to bulls after 53 d postpartum, the hazard rate increased instantaneously approximately 12 d after initial exposure to bulls. This increase was also seen when cows were exposed to bulls beginning at a constant date (at an average of 63 d postpartum). Because of lack of fit, the Weibull and the log-normal distributions should not be used in survival analysis of PPI.(ABSTRACT TRUNCATED AT 250 WORDS)

Markov chains as a shortcut method to estimate age distributions in herds of beef cattle under different culling strategies.

Markov chains were used to estimate the age distribution at equilibrium and average age in herds of beef cattle and the age distribution and average age of culled cows. These estimates are essential in systems simulation and economic analyses of beef production alternatives because the biological input and output from a beef production system depend on the age structure of the cows in the system. Ten sets of data on age-specific probabilities of culling for different reasons were found in the literature and used in simulation of different culling strategies. Three different culling strategies were simulated using these data. In addition to culling on maximum age, culling was either based on health alone, health and reproductive failure in one year (not pregnant) or health and reproductive failure in two consecutive years (not pregnant twice). The average herd age in the data sets reviewed under the actual culling strategies ranged from 4.58 to 6.73 yr and the average age of culled cows ranged from 5.41 to 9.94 yr. Description of the culling process as a Markov chain enables calculations of the age distribution at equilibrium by simple matrix operations, an advantage over the methods presently used. The scarcity of estimated age-specific probabilities of health and reproductive failure points to the need for more population analyses of beef cattle.

Conception rate at first insemination in beef cattle: effects of season, age and previous reproductive performance.

The effects of season, age at previous parturition, and whether the female was retained because she failed to conceive or be detected in estrus during the previous breeding season were analyzed for first-service conception rate in beef cattle. Twelve years of reproductive data on females that were at least 50% Simmental were obtained from a single farm. All females detected in estrus were artificially inseminated during 42-d breeding seasons (52 d for heifers), starting either in June or November. The data, consisting of 9,071 first-service records, were described by a logit model and parameters were estimated using weighted least squares procedures. Age and previous reproductive performance (whether the female had failed to conceive or be detected in estrus during the previous breeding season) significantly affected first-service conception rate, as did the interaction between the two factors. Season of insemination, when considered across all other effects, did not influence first-service conception rate, but the interaction of season and previous reproductive performance was significant, as was the three-way interaction between season, age and previous reproductive performance. Except for those calving at 2.5 yr of age, females that were inseminated in the winter subsequent to parturition in the fall had the highest first-service conception rates. Those that did not conceive during the breeding season subsequent to parturition and were carried over to the following season had lower first-service conception rates, with the lowest being for females carried over to the winter breeding season.

Postnatal litter size effects on growth and reproduction in rats.

The effects of postnatal litter size on pre- and postweaning growth, daughter's litter size and rebreeding performance of the dam were examined in rats that had undergone 14 generations of selection for rate (LG) or efficiency (LE) of postweaning protein gain followed by relaxed selection, and in a randomly selected control line (C). Data came from generations 23 to 24 (standardized litters) and 25 to 26 (unstandardized litters). Generation 25 dams were remated at weaning for two additional parities. Regressions of average pup weight on average postnatal litter size were negative and increased in magnitude from birth to weaning, but decreased with parity number. Average litter size from birth to weaning (3 wk) affected postweaning weights at 5 and 7 wk, but compensatory growth occurred, especially during wk 3 to 5. The effect of dam's litter size (the litter in which the daughter was born) on daughter's weight was still negative and significant at mating and affected litter size of daughters. This negative maternal effect on daughter's litter size was larger when the dam's litter was not standardized. Litter size weaned also affected rebreeding interval of females.

Maternal performance over three parities in rats selected for rate or efficiency of protein gain.

Direct, maternal and heterosis effects were estimated for preweaning traits over three parities, with unstandardized litters, in rats selected for 14 generations for rate (LG) or efficiency (LE) of postweaning protein gain. In generation 25, after 11 generations of relaxed selection, 60 males and females from each of the selected lines and the control (C) line were mated in a 3 X 3 diallel. Two more parities were produced by remating the females at each weaning. Loss of female breeders due to infertility and death was higher in the selected lines (LG 43%, LE 40%, C 27%). Rebreeding intervals in parities 2 and 3 were 3.1 (P less than .01) and 3.0 (P less than .10) d longer in LG compared with C, while LE was similar to C. Heterosis was significant only for litter size born and it was negative. Because the estimate included all line interactions, negative heterosis could arise from incompatibilities between sperm and ova or embryo and uterus. Both selected lines, but especially LE, had positive direct effects and negative maternal effects on litter size born and weaned. Maternal effects of LG on average pup weight were similar or slightly better than C, while lactational performance was lower in LE.