Improvement in Glycemic and Lipid Profiles in Type 2 Diabetics with a 90-Day Ketogenic Diet.

Because low-carbohydrate diets are effective strategies to improve insulin resistance, the hallmark of type 2 diabetes, the purpose of reporting these clinical cases was to reveal the meaningful changes observed in 90 days of low-carbohydrate (LC) ketogenic dietary intervention in female type 2 diabetics aged 18-45. Eleven women (BMI 36.3 kg/m2) who were recently diagnosed with type 2 diabetes based on HbA1c over 6.5% (8.9%) volunteered to participate in an intensive dietary intervention to limit dietary carbohydrates to under 30 grams daily for 90 days. The main outcome was to determine the degree of change in HbA1c, while secondary outcomes included body weight, blood pressure, and blood lipids. The volunteers lost significant weight (85.7 ± 3.2 kg to 76.7 ± 2.8 kg) and lowered systolic (134.0 ± 1.6 to 123.3 ± 1.1 mmHg) and diastolic (89.9 ± 1.3 to 82.6 ± 1.0 mmHg) blood pressure. HbA1c dropped to 5.6%. Most blood lipids were significantly altered, including HDL cholesterol (43.1 ± 4.4 to 52.3 ± 3.3 mg/dl), triglycerides (177.0 ± 19.8 to 92.1 ± 8.7 mg/dl), and the TG : HDL ratio (4.7 ± 0.8 to 1.9 ± 0.2). LDL cholesterol was not significantly different. AST and ALT, plasma markers of liver health, were reported for eight patients and revealed no significant changes. These findings indicate that a short-term intervention emphasizing protein and fat at the expense of dietary carbohydrate functionally reversed the diabetes diagnosis, as defined by HbA1c. Furthermore, the intervention lowered body weight and blood pressure, while eliciting favorable changes in blood lipids.

Long-term observations on the dynamics of bovine digital dermatitis lesions on a California dairy after topical treatment with lincomycin HCl.

The objective of this study was to observe the dynamics of clinical cure and recurrence of the lesions of bovine digital dermatitis for 11 months after treatment with topical lincomycin HCl. The study was a clinical follow-up of 39 active bovine digital dermatitis lesions (from 29 cows). Cows with active, painful bovine digital dermatitis (BDD) lesions on the interdigital commissure of the rear feet were identified on day 0. On day 1, lesions in all cows were photographed and full-skin thickness 6mm punch biopsies were obtained for histological evaluation. All lesions on all cows were treated with topical lincomycin paste under a light bandage. On days 12 and 23, a subsample of 10 lesions was randomly selected, photographed, and biopsied. On day 37, all lesions on all cows were photographed and biopsied. After day 37, lesions were evaluated on a monthly basis. All lesions were photographed at each observation until day 341 (end of study) but only cows that had macroscopically active lesions were biopsied. Of the 39 lesions treated on day 1, 21 (54%) required re-treatment on at least one occasion before day 341. Macroscopic classification agreed well with histological classification when lesions were small, focal and active (M1 lesions) or large, ulcerative and active (M2), but agreement was variable for lesions that had healed macroscopically (M5) or that were chronic (M4). A transition model showed that M1 and M2 lesions were 27 times more likely to be an M2 lesion on the next observation than to be a healed (M5) lesion.

Cumulative trauma disorders among California veterinarians.

BACKGROUND: The prevalence of cumulative trauma disorders (CTDs) in veterinarians has not been adequately studied. METHODS: A questionnaire was sent to 2,000 California veterinarians in 1997; the return rate was 73% (n = 1,415). RESULTS: Ninety-six percent (1,353) of the respondents were professionally active and were included in the analyses. Sixty-four percent were male and 90% were working full-time. One-fourth of the respondents reported a CTD during their career that required treatment or restricted usual activities. Two-thirds of those reporting CTDs reported chronic or residual problems. In a multivariate regression analysis female sex, working full-time, rectal palpations, and large animal practice were significant risk factors for CTDs. CONCLUSIONS: Being in large animal practice increased the CTD risk for both women and men whether they worked full or part-time. CTD risk was highest in women working full-time and doing 80% rectal palpations. Preventive methods to attenuate the risk of CTDs especially in large animal practice should be investigated.

Clinical, histologic, and bacteriologic findings in dairy cows with digital dermatitis (footwarts) one month after topical treatment with lincomycin hydrochloride or oxytetracycline hydrochloride.

OBJECTIVE: To compare the effectiveness of lincomycin and oxytetracycline for treatment of digital dermatitis (DD) in dairy cows through gross visual examination, histologic evaluation, and bacteriologic evaluation. DESIGN: Randomized controlled clinical trial. ANIMALS: 25 cows with DD lesions from a commercial Holstein dairy herd. PROCEDURES: Cows with DD lesions were randomly assigned to 1 of 3 groups: topical treatment with 10 g of lincomycin hydrochloride (n = 11), topical treatment with 10 g of oxytetracycline hydrochloride (11), and no treatment (3) on days 1 and 2 (d1). Biopsy specimens were obtained for histologic examination from DD lesions prior to treatment and 28 or 31 days (d30) after treatment for histologic examination. Cows were clinically examined on d1, days 12 or 14 (d14), and d30. RESULTS: No difference was evident in clinical responses to lincomycin and oxytetracycline, so data were pooled; at d30, 8 of 11 of lincomycin-treated lesions and 7 of 11 oxytetracycline-treated lesions appeared visually healed, respectively. Gross visual examination suggested 73% (16/22) of treated cows were healed at d14 and 68% (15/22) of treated cows were healed on d30. Of the 15 lesions that appeared healed on d30, 7 of 15 were classified histologically as active (ulceration and bacterial invasion; 2/15) or incipient (5/15). CONCLUSIONS AND CLINICAL RELEVANCE: Clinical responses to lincomycin and oxytetracycline did not differ. Agreement was good between gross visual and histologic assessments of DD lesions before treatment; agreement 1 month after treatment was variable. Histologic evaluation could not distinguish incomplete healing from lesion recurrence.