Investigation the impact of ZTA addition on the properties of nano biogenic hydroxyapatite.

The target of the recent study is to achieve a significant inexpensive and eco-friendly way for getting ZTA/HA composites, based on the nano-HA derived from the eggshell biogenic source. Combining simultaneously the porous structure; which is considered as a bone formation key, with developed mechanical properties and adequate biocompatibility, is another purpose of this study. Furthermore, the impact of ZTA addition from 10-30 mass-%, fabricated by uniaxial pressing and sintering at 1200-1300 °C for 2 h, on the physical and mechanical properties, microstructure and phase composition of ZTA/HA composite bodies was investigated. The results demonstrated that the increasing of ZTA content increases the bodies' apparent porosity and decreases the bulk density due to the decomposition of HA into ß-TCP. Where the formation of ß-TCP possessed the predominant impact on the mechanical properties of the sintered ZTA/HA composites. ICP, SEM, EDX and thin film XRD results of composites containing 20 mass-% ZTA affirmed the excellent bioactivity of the bodies.

Towards an optimal luteal support modality in agonist triggered cycles: a randomized clinical trial.

STUDY QUESTION: In ICSI patients with high risk of ovarian hyperstimulation syndrome (OHSS), are antagonist cycles triggered by gonadotropin releasing hormone (GNRH) agonist with a specialized luteal support regimen associated with comparable ongoing pregnancy rate (OPR) and less OHSS than those triggered by hCG? SUMMARY ANSWER: In antagonist ICSI cycles, GnRH agonist triggering with a specialized luteal support regimen is associated with comparable OPR to those triggered by hCG but may be less likely to be associated with OHSS. WHAT IS KNOWN ALREADY: In IVF/ICSI protocols, exogenous hCG was used for years as a substitute of the endogenous LH surge. However, because of its longer half life, hCG is associated with more risk of OHSS, especially in high risk women. For this reason, GnRH agonist triggering was introduced. There is, however, no consensus on the best protocol for luteal support on agonist triggered cycles. STUDY DESIGN, SIZE, DURATION: Randomized controlled open label trial including 190 participants recruited from June 2015 to March 2016 in a private fertility center. Participants were divided into 2 equal groups; GnRH agonist trigger and hCG trigger. Randomization was done using identical sealed envelope technique. PARTICIPANTS/MATERIALS, SETTING, METHODS: One hundred ninety women, predicted to have high response, were randomized on the day of final oocyte maturation into two equal groups: group (A), GnRH agonist trigger followed by specialized regimen (1500 IU hCG) at time of oocyte retrieval plus oral estradiol and intramuscular progesterone during luteal phase; and group (B), 5000 IU of hCG with luteal support (oral estradiol and vaginal progesterone). MAIN RESULTS AND THE ROLE OF CHANCE: The 2 groups were comparable in baseline characteristics. OPR per randomized patient was comparable in the 2 groups {49/95 (51.6%) in group A, and 50/95 (52.6%) in group B ((P = 0.88); RR = 0.980, 95% CI: 0.75-1.29)}. Considerable (moderate + severe) OHSS was higher in group B (13/95 [14%] versus 5/95 [5%] P = 0.047; uncorrected Chi-square test). Upon performing multivariate regression analysis for predicting OHSS, number of follicles ≥11 mm on trigger day was the only independent predictor (P = 0.0004). LIMITATIONS, REASONS FOR CAUTION: Strict selection criteria limit generalization of results. The study was powered for pregnancy rate not OHSS, so that the strength of evidence on OHSS prediction is weak. WIDER IMPLICATIONS OF THE FINDINGS: We recommend the use of GnRH agonist plus the specialized luteal phase support in high responders with high risk of OHSS undergoing IVF/ICSI cycles. This protocol achieved a similar ongoing pregnancy to hCG triggering and may be less likely to result in moderate to severe OHSS. STUDY FUNDING/COMPETING INTEREST(S): None. TRIAL REGISTRATION NUMBER: PACTR 201506001132105. TRIAL REGISTRATION DATE: 24/6/2015. DATE OF FIRST PATIENT'S ENROLLMENT: 26/6/2015.

Hyperpneumatisation of the craniocervical bones: an emerging aetiological pattern.

Background: Hyperpneumatisation of the skull base and upper cervical vertebrae is a very rare condition of uncertain aetiology and pathophysiology. Case report: A case of extensive hyperpneumatisation of the craniocervical junction and upper three cervical vertebrae is described, in a patient who habitually performed the Valsalva manoeuvre to relieve the symptoms of a patulous eustachian tube. Reported symptoms of ear, neck and shoulder pain deteriorated after minor head trauma. There was a drastic radiological and clinical improvement after ceasing to perform the Valsalva manoeuvre. Discussion: All reported cases of craniocervical bone hyperpneumatisation have in common a history of raised middle-ear pressure, minor trauma or both. We therefore suggest that chronically raised middle-ear pressure leads to destruction of bony tissue and pneumatisation, and that this process is able to cross joints into the cervical spine, either via micro-fractures following trauma, or as a result of congenital assimilation of the craniocervical junction.

Comparison of two surgical techniques for mastectomy of goats.

Two different techniques for mastectomy were carried out on 14 goats with gangrenous mastitis. The animals were randomly assigned to one of two groups containing seven goats each. The first group was operated via a classical surgical mastectomy technique (either bilateral (n=5) or unilateral (n=2)). The second group was operated via vascular ligation of the external pudendal blood vessels and milk vein and amputation of the affected teat (either bilateral (n=3) or unilateral (n=4)). Comparison between the two groups was carried out. Vascular ligation and teat amputation proved to be an effective, quick, safe, and less expensive technique for mastectomy in goats. Ligation of udder vasculature was less traumatic than surgical amputation and the stress on the patient was minimal.

Retrograde ureteropyeloscopic holmium laser lithotripsy for large renal calculi.

OBJECTIVE: To assess the efficacy and safety of the retrograde ureteropyeloscopic holmium laser for treating renal stones that are too large to treat with extracorporeal shock wave lithotripsy (ESWL). PATIENTS AND METHODS: Thirty patients (22 men and eight women, mean age 43 years, range 18-62) with a renal stone burden of > 2 cm were selected for laser treatment. The stones were in the renal pelvis in 16 patients, lower calyx in five, middle calyx in two, upper calyx in one and multiple pelvic and calyceal in six. Lithotripsy was undertaken using a holmium laser through 550 microm and 200 microm laser fibres passed through a semi-rigid fibre-optic long ureteroscope or the actively deflectable flexible ureteropyeloscope, respectively. Success was defined as total fragmentation of the stone to < 2 mm in diameter and/or clear imaging on renal ultrasonography and plain films within the 3-month follow-up. Patients in whom the treatment failed received either alternative therapy or complementary ESWL. RESULTS: Endoscopic access and complete stone fragmentation was achieved in 23 of the 30 patients (77%). The treatment failed in seven patients because of poor visualization, the initial presence of stones in, or migration of their large fragments to, an inaccessible calyx. There were no major intraoperative complications. Minor complications after treatment included haematuria that persisted for 2 days in one patient and high-grade fever in two patients; all were treated conservatively. CONCLUSION: Large renal calculi that are not amenable to ESWL monotherapy can be safely and effectively treated with a retrograde endoscopic technique that seems to compete well with the more invasive percutaneous or open surgical manoeuvres.

Primary nocturnal enuresis: a new approach to conditioning treatment.

OBJECTIVES: Conditioning treatment is the most effective therapy for nocturnal enuresis, precluding the use of drugs. An ordinary alarm clock can be used as an enuresis alarm. We sought to assess its clinical utility as a new means of conditioning treatment. METHODS: Using the ordinary home alarm clock, 125 enuretic children were enrolled into two treatment groups. Group I included 70 children who set the alarm so as to get up and void in the toilet at a critical time when the bladder was full and they were still dry. Group II included 55 children who used the alarm to be awakened for voiding after 2 to 3 hours of sleep regardless of whether they were dry or wet. All children were motivated to use the alarm clock continuously for 4 months. RESULTS: Initial success was achieved in 54 (77.1%) of 70 group I and 34 (61.8%) of 55 group II children. Three months after treatment was stopped, success was still maintained in 46 (65.7%) and 31 (56.4%) children in groups I and II, respectively, but dropped to 41 (58.6%) and 29 (52.7%), respectively, after 6 months. The relapse rate after 3 and 6 months was 14.8% and 24.1% for group I and 8.8% and 14.7% for group II, respectively. CONCLUSIONS: The ordinary alarm clock performs as well as currently used enuresis alarms. It is an effective, elective, noncontact alarm that does not wait for bedwetting to initiate a conditioning reflex. It is both reliable and safe.

Foetal anasarca in Awassi sheep.

Two anasarcous foetuses of Awassi sheep are described. The foetuses were removed from the dams by caesarean section because of dystocia due to failure of cervical dilation. Uterine incision was made in situ because uteri were so distended they could not be brought out from the site of incision. Large quantities of uterine fluids and abnormal thick placentas were found. One foetus weighed about 7 kg and the other 13 kg. The foetal heads were deformed: the upper jaw was prognathic and the left ear of the small foetus was cystic. Necropsy revealed subcutaneous musculature was soft and flabby and abdominal and thoracic cavities contained serosanguinous fluid. Histopathological examination revealed that only the larger foetus had focal aggregates of basophilic nucleated red blood cells and scattered megakaryocytes in the liver. We conclude that anasarca can occur in Awassi sheep, with and without associated extramedullary haematopoiesis.