Early postpartum administration of equine chorionic gonadotropin to dairy cows calved during the hot season: Effects on fertility after first artificial insemination.

Heat stress reduces fertility of high-producing dairy cows, and early administration of equine chorionic gonadotropin (eCG) may improve it. Here, 401 heat-stressed, high-producing dairy cows on a single commercial farm were given eCG (500 UI, n = 214) or saline (n = 187) on days 11-17 after calving, and the effects on fertility after the first artificial insemination (AI) were assessed. On post-partum day 96.34 ± 9.88, all cows were inseminated after a "double short Cosynch" synchronization protocol. Ovarian activity and uterine status were checked by ultrasound on the day of eCG administration and every 7 days thereafter for a total of 3 weeks; checks were also performed during synchronization, and 7 days after AI. On post-partum day 30, cytobrush uterine cytology was performed to check for subclinical endometritis. Pregnancy status was checked on days 30 and 60 after AI. The eCG and control groups did not differ significantly in terms of average lactations per cow (2.33 ± 1.34), days in milk at first AI (96.33 ± 9.88), average milk yield at AI (41.38 ± 7.74 L), or the particular inseminator or bull used for AI. The eCG and control groups showed increasing ovarian activity with time, with approximately 75% of cows in both groups showing a corpus luteum at the beginning of the synchronization protocol. On post-partum day 30, 17.4% of eCG cows and 22.9% of control cows showed subclinical endometritis. Cows treated with eCG showed a tendency toward lower hyperecogenic intraluminal content (16.8 vs. 21.4%, P = 0.15), but ovarian activity during the synchronization protocol was similar between eCG and control groups, with 91% of animals in both groups showing luteolysis after prostaglandin application and 88% showing ovulation after the last administration of gonadotropin-releasing hormone. Fertility was similar between the two groups at both time points after AI (30 days, 34.9 vs. 31.8%; 60 days, 30.6 vs. 28.5%; P > 0.2). These results suggest that early postpartum eCG administration does not improve fertility of heat-stressed dairy cows as long as 60 days after AI. Other strategies may be more effective at mitigating the ability of post-partum heat stress to reduce fertility of high-producing dairy cows.

Trastorno obsesivo compulsivo, su funcionamiento neuropsicológico y desarrollo escolar: a propósito de un caso / Obssesive-Compulsive Disorder, neuropsychology function and scholar development: case report

El TOC en la adolescencia constituye un punto de interés dentro de la psicología clínica y psiquiatría infantojuvenil. La adolescencia es uno de los periodos donde aparecen comportamientos repetitivos con mayor frecuencia siendo éstos evolutivos. Es importante diferenciar estos signos evolutivos de un cuadro clínico. En la infancia los síntomas del TOC son similares a la adultez. Los rituales más frecuentes son la limpieza excesiva, de repetición y de comprobación. En cuanto a la epidemiología hay pocos estudios y distintos datos, pero existe un predominio de niños en la infancia (3:2) siendo más equilibrado en la adolescencia. La etiología es multicausal. Presentamos el caso de una adolescente de 13 años derivada a la Unidad de Salud Mental Infanto Juvenil por ideas sobrevaloradas relativas a posibles sucesos desagradables o catastrofistas. Se realiza evaluación psicométrica y neuropsicológica a través de Inventario Clínico de Millon para Adolescentes MACI, Escala de Inteligencia para Adultos de Wechsler, Figura Compleja de Rey, Test de clasificación de tarjetas de Wisconsin, subtest Localización Espacial de la Escala de Memoria de Wechsler, Test de Colores Stroop, Escala infantil de obsesiones y compulsiones y autorregistros. El diagnóstico fue TOC. Se describe el tratamiento psicológico y psiquiátrico que se llevó a cabo. La sintomatología objeto de atención clínica incluye obsesiones sexuales, catastrofistas y religiosas, compulsiones en forma de rituales de repetición, de comprobación y motores, así como el manejo familiar de rasgos histeriformes. Desde el punto de vista de la eficacia terapéutica se recomienda la terapia cognitivo-conductual y farmacológica combinadas. Es importante tener esto en cuenta para la disminución de la interferencia sobre el funcionamiento vital. Se destaca el valor del análisis funcional para una evolución favorable, teniendo en cuenta diferentes factores intervinientes

Obsessive-Compulsive disorder (OCD) in adolescence is a point of interest within children and adolescent clinical psychology and psychiatry. Adolescence is one of the periods where repetitive behaviors are more often being these evolutionary. It is important to differentiate these symptoms of a clinical development. In childhood OCD symptoms are similar to adulthood. Most common rituals are excessive cleaning, repetition and verification. There are few epidemiological studies and different result, but there is a predominance of boys in infancy (3:2), in adolescence the prevalence is more well-balanced. Etiology is multicausal. We report the case of a 13 year old girl referred to our Mental Health Unit for Children and Adolescents in relation to overestimated ideas about possible unpleasant or catastrophic events. Clinical interview, Psychometric and neuropsychological assessment is realized with The Millon Adolescent Clinical Inventory MACI , Wechsler Adult Intelligence Scale WAIS-III, Rey-Osterrieth Complex Figure, Wisconsin Card Sorting Test, Spatial Span from Wechsler Memory Scale, Stoop Test, obsessions and compulsions scale. She was diagnoses as having OCD. We describe psychological and psychiatric treatment. The focus of clinical attention symptomatology includes sexual, catastrophic and religious obsessions, rituals as compulsions of repetition and checking; and family management of hysteriform personality. From the point of view of therapeutic efficacy cognitive behavioral therapy and pharmacological treatment combined are recommended. It is important to take this into account for the reduction of life interference. It highlights the value of functional analysis for a favorable progress, taking into account different factors involved

A phase II dose finding study of darbepoetin alpha and filgrastim for the management of anaemia and neutropenia in chronic hepatitis C treatment.

Dose reductions of pegylated interferon alpha and ribavirin may be avoided by using growth factors. This phase II clinical trial assesses the dose, efficacy and safety of darbepoetin alpha and filgrastim for treatment of anaemia and neutropenia associated with combination therapy for hepatitis C virus (HCV). Chronic hepatitis C patients (n = 101) received pegylated interferon alpha-2b (1.5 mug/kg once weekly) and ribavirin (800-1400 mg once daily). Patients with anaemia [haemoglobin (Hb) /= 0.75 x 10(9)/L and <10 x 10(9)/L. During antiviral therapy, 52% of patients required darbepoetin alpha, filgrastim or both. Hb at the time of darbepoetin alpha initiation was 10.2 +/- 0.4 g/dL. After 81 days of darbepoetin alpha, Hb increased by 1.9 +/- 1.0 g/dL to 12.1 +/- 1.1 g/dL (P < 0.0001). Filgrastim resulted in a significant increase in ANC [0.75 +/- 0.16 x 109/L to 8.28 +/- 5.67 x 10(9)/L (P < 0.0001)]. In treatment-naïve patients, 48% achieved sustained virological response (SVR), whereas 27% of patients previously treated with a course of pegylated interferon alpha achieved SVR. Low viral load, nongenotype 1 and treatment with growth factors were independently associated with SVR. Mild and severe anaemia were associated with quality of life impairments. Darbepoetin alpha resulted in an improvement in the Vitality domain of Short Form-36. No significant adverse events were related to growth factors. During anti-HCV therapy, filgrastim improved neutropenia and darbepoetin alpha improved both anaemia and quality of life. Future randomized clinical trials are needed to establish the impact of growth factors in improving sustained virological response.

Adipokines and cytokines in non-alcoholic fatty liver disease.

BACKGROUND: Several adipocytokines have been implicated in the pathogenesis non-alcoholic fatty liver disease (NAFLD). AIM: To assess adipocytokines in NAFLD patients and controls. METHODS: A total of 95 patients (26 non-alcoholic steatohepatitis (NASH), 19 simple steatosis (SS), 38 obese controls and 12 non-obese controls) were included. Fasting serum insulin, glucose, visfatin, resistin, adiponectin, tumour necrosis factor-alpha (TNF-alpha), interleukin-8 (IL-8) and IL-6 were determined. Univariate and multivariate analyses were used to compare groups and determine associations. RESULTS: Serum TNF-alpha and IL-8 were higher in NAFLD patients when compared with both obese and non-obese controls. Analysis involving all patients revealed a significant correlation between serum TNF-alpha and IL-8 (P < 6.319e-08), and between IL-6 and IL-8 (P < 5.271e-15). Homeostatic model assessment scores negatively correlated with adiponectin in NAFLD (P < 0.0032). Serum visfatin was higher in all three obese groups than in non-obese controls (P < 0.02, P < 0.002 and P < 0.008). Visfatin in NASH patients was lower than SS and obese controls. Although TNF-alpha was associated with NAFLD (P < 0.02), it was interdependent on visfatin. In comparison to SS, four factors were independently associated with NASH: age, alanine aminotransferase, IL-8 and adiponectin (P < 0.05). Multivariate analysis indicated that TNF-alpha was the only independent predictor of fibrosis in NASH (P < 0.0004). CONCLUSION: These findings support a complex interaction between adipocytokines and the pathogenesis of NAFLD.

Health-related quality of life in patients with non-alcoholic fatty liver disease.

BACKGROUND: The relative impact of non-alcoholic fatty liver disease (NAFLD) on health-related quality of life (HRQL) compared to other chronic liver diseases has not been fully explored. AIM: To compare the domain scores of the 29-item Chronic Liver Disease Questionnaire (CLDQ) for patients with NAFLD to those with chronic hepatitis B and chronic hepatitis C. METHODS: A HRQL questionnaire, CLDQ, was routinely administered to patients attending a liver clinic. Additional clinical and laboratory data were obtained on patients with NAFLD, chronic hepatitis B, and chronic hepatitis C from our quality of life database. Scores for each of the six CLDQ domains were compared using one-way anova and multiple regression. RESULTS: Complete data were available for 237 patients. NAFLD patients scored lowest on multiple CLDQ domains. Based on the bivariate data, NAFLD patients have the poorest HRQL, followed by chronic hepatitis C and chronic hepatitis B patients. Multivariate analysis showed that some specific domain score correlations remained significant for NAFLD diagnosis, cirrhosis, gender, and body mass index. CONCLUSION: NAFLD patients had significantly lower quality of life scores compared with patients with hepatitis B or hepatitis C on multiple CLDQ domains, suggesting that HRQL was severely impaired in patients with NAFLD.

The metabolic syndrome and nonalcoholic fatty liver disease.

Accumulating evidence supports an association between nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome, diabetes, and obesity. The epidemiology, pathogenesis, and approach to treatment of NAFLD follow the same trends as these other metabolic disorders, and insulin resistance is the key event linking NAFLD to these diseases. The impairment in fat and glucose metabolism that ensues once insulin resistance occurs leads to similar biochemical and clinical abnormalities in patients with NAFLD. Many recent studies investigating the cellular and genetic basis of these diseases have led to a better understanding of their pathogenesis and insight into treatment and management. The most effective treatment thus far is weight loss and the use of insulin-modulating pharmacologic agents. A few additional treatment strategies include the use of lipid-lowering, antioxidants or cytoprotective agents, but there is no single therapeutic approach that is effective for managing NAFLD. Future therapies may combine drugs that target specific pathways involved in NAFLD pathogenesis.