WHEN TOPHACEOUS GOUT INVOLVES MULTIPLE ORGANS: CHALLENGES AND SOLUTIONS.

Uncontrolled chronic gout can lead to deposition of monosodium urate crystals, better known as tophi. Such depositions can involve several organ systems, including unusual locations such as the vertebrae. Nevertheless, certain complications, such as hypercalcemia, can arise because of tophi. Despite an aggressive intervention, hypercalcemia might not resolve spontaneously, as long as an ongoing inflammatory process secondary to gouty tophi is taking place. Herein, we present the case of a 62-year-old man with a long history of gouty tophi who presented for back pain and was found to have spinal cord involvement with PTH-independent hypercalcemia which only resolved with pegloticase therapy.

Effect of drilling process parameters on bearing strength of glass fiber/aluminum mesh reinforced epoxy composites.

The current study attempted to evaluate the impact of drilling parameters and delamination on the bearing strength of both neat GFRP (NG) and hybrid GFRP/aluminum (Al)-wire mesh with two various configurations, first with Al-mesh in the outer surface of specimen (AG) and the other with Al-mesh in the core of specimen (GA). Drilling procedure is carried out using [Formula: see text] 6 mm carbide twist drill with three different tip angles (90°, 120° and 135°), as well as Three different speeds and feeds (1000, 2000, and 3000 rpm) and (20, 40, and 60 mm/min), respectively. Taguchi and ANOVA analyses are used to analyze the influence of processing parameters. The findings showed that AG specimen experienced the least delamination damage. The maximum bearing strength refers to NG specimen, which is 9.6% and 8.7% more than AG and GA specimens, respectively. Drill point angle has the major effect on bearing strength for both AG and GA specimens, while for NG feed rate is of the major effect. The developed regression model displayed a high level of fitness with an average prediction error of less than 3%.

Study of bearing strength for injection molded GFRPP composites under dry and wet conditions.

Thermoplastics and fiber-reinforced thermoplastics represent great deals in nowadays industries and applications where some of these applications are projected to wet environment. The present study investigates the effect of water moisture on the bearing strength (BS) of Polypropylene (PP) and glass fiber (GF) reinforced Polypropylene (GFRPP) composites. PP and GFRPP are produced by injection molding using different GF weight fractions (wt%), 10, 20, and 30 wt%, and two different initial fiber lengths 12 and 24 mm. A burnout test indicated that produced specimens with 12 mm long fibers have higher final fiber lengths than those made of 24 mm long fibers. More water was absorbed for higher GF weight fractions. The results of the dry bearing test showed higher bearing strengths for specimens with higher GF wt% and longer fibers. The same observation was obtained from wet tests, while, wet-tested specimens of all compositions have higher strengths than their dry counterparts. Strain-at-break seemed to be significantly reduced by water absorption for all specimens. Specimens tested in wet conditions have different fracture morphology than dry ones due to the change in the mechanical behavior of the materials after water immersion.

Comparison between bearing strengths of molded-in and machined holes of GFR/PP composites.

This study is an investigation of weight fraction (wt%) and fiber feedstock length (FFSL) effects on the bearing strength (BS) of bolted joints in glass-fiber-reinforced (GFR) polypropylene (PP) composites manufactured by an injection molding technique. The investigation was made for holes produced either by molding or machining. For machined holes, the effect of drilling parameters (feed and speed) on BS was discussed. It is observed that BS decreased as FFSL increased. BS of both molded-in and drilled specimens was enhanced by increasing wt% of glass fiber. While slightly better BS was observed for molded-in specimens than drilled ones for all specimens. The drilling conditions' effect on BS was found to be insignificant for drilled holes in long fibers reinforced PP, where the most significant factor was wt%. However, for short fibers reinforced PP, the spindle speed was the most significant factor followed by feed, while wt% has the lowest effect. Failure morphology mode for specimens indicates that for molded-in specimens, neat PP specimens failed under pure bearing mode while GFR/PP specimens failed under the mixed-mode failure (bearing and net tension). For machined specimens, all specimens failed under mixed-mode failure except for the highest wt% specimens which failed under net tension.

Technical note: Evaluation of a colorimetric point-of-care test for measuring urine ammonium concentration in periparturient dairy cattle.

Urine ammonium concentration ([NH4+]) provides a clinically useful indicator of the magnitude of nutritionally induced systemic acidification in dairy cattle when urine pH < 6.1. The objective of this study was to evaluate the analytical performance of a low-cost point-of-care colorimetric test in measuring urine [NH4+] in dairy cattle consuming an acidogenic ration. A method comparison study was performed using 154 urine samples from 43 periparturient Holstein-Friesian cows. We compared urine [NH4+] measured by an indophenol blue colorimetric test (MColortest, Merck KGaA, Billerica, MA; test method) with levels measured by formaldehyde titration (reference method). Diagnostic performance was evaluated using Pearson correlation coefficient (r), Passing-Bablok regression, Bland-Altman plot, and binary logistic regression. Urine [NH4+] measured by the colorimetric test was strongly correlated (r = 0.98) with urine [NH4+] measured by formaldehyde titration. Method comparison studies indicated that the colorimetric test provided acceptable test performance when urine [NH4+] < 80 mmol/L. Logistic regression analysis indicated that the area under the receiver operating characteristic curve for the colorimetric ammonium test was high at 0.985 when used to identify formaldehyde titration [NH4+] > 10 mmol/L, equivalent to urine pH <6.1. At the optimal cut point ([NH4+] > 11 mmol/L) for the colorimetric test, sensitivity = 0.94, specificity = 0.97, positive likelihood ratio = 27.6, and κ = 0.89, indicating excellent test performance. We conclude that the indophenol blue colorimetric test provided an accurate, low-cost, and practical on-farm test for measuring urine [NH4+] in diluted urine samples from dairy cattle consuming an acidogenic ration.

Clinical utility of plasma progesterone and blood and plasma glucose concentrations in predicting parturition in Holstein cows.

An accurate, practical, and low-cost method for predicting parturition is urgently needed in the dairy industry. The objective of this study was to evaluate changes in plasma progesterone concentration ([prog]) and glucose concentration in whole blood ([gluc]b) and plasma ([gluc]p) as predictors of parturition within 6, 12, and 24 h in primiparous and multiparous Holstein cows. Blood samples were obtained daily at approximately 0900 h from 34 primiparous and 72 multiparous Holstein cows in late gestation and the time of calving recorded to the nearest hour. Plasma [prog] was measured using an ELISA, and [gluc]b and [gluc]p using a low-cost point-of-care glucose meter. The optimal cut-point for predicting parturition was determined using binomial logistic regression with general estimating equations, because the data set consisted of repeated measures for each cow. Diagnostic test performance was evaluated by comparing the area under the receiver operating characteristic curve (AUC) and calculating the sensitivity, specificity, and κ at the optimal cut-point for predicting parturition. Plasma [prog] was the most accurate predictor of parturition within 24 h (AUC = 0.96) and 12 h (AUC = 0.93), whereas [gluc]b was the most accurate predictor of parturition within 6 h (primiparous, AUC = 0.96; multiparous, AUC = 0.86). We conclude that a decrease in plasma [prog] is currently the most accurate test for predicting calving within 24 h. Measurement of [gluc]b is a promising new test for the cow-side prediction of parturition in dairy cows due to its accuracy, practicality, and low cost.

Measurement of urine pH and net acid excretion and their association with urine calcium excretion in periparturient dairy cows.

Urine pH (UpH) and net acid excretion (NAE) are used to monitor the degree of systemic acidification and predict the magnitude of resultant hypercalciuria when feeding an acidogenic ration to control periparturient hypocalcemia in dairy cattle. The objectives of this study were to evaluate the diagnostic performance of urine dipstick and pH paper for measuring UpH, and to characterize the UpH-NAE relationship and the association of urine Ca concentration ([Ca]) with UpH and NAE. Urine samples (n = 1,116) were collected daily from 106 periparturient Holstein-Friesian cows fed an acidogenic ration during late gestation. Net acid excretion was measured by titration, and UpH was measured by a glass-electrode pH meter (reference method), Multistix-SG urine dipsticks (Siemens Medical Solutions Inc., Ann Arbor, MI), and Hydrion pH paper (Micro Essential Laboratory Inc., Brooklyn, NY). Diagnostic performance was evaluated using Spearman correlation coefficient (rs), Bland-Altman plots, and logistic regression. Urine pH measured by urine dipstick (rs = 0.94) and pH paper (rs = 0.96) were strongly associated with UpH. Method-comparison studies indicated that the urine dipstick measured an average of 0.28 pH units higher, and pH paper 0.10 pH units lower, than UpH. Urine [Ca] was more strongly associated with UpH (rs = -0.65) than NAE (rs = 0.52). Goals for controlling periparturient hypocalcemia under the study conditions were UpH <6.22 and <6.11, based on achieving urine [Ca] ≥5 mmol/L and estimated urinary Ca excretion ≥4 g/d, respectively. Urine pH was as accurate at predicting urine [Ca] as NAE when UpH >6.11. We conclude that pH paper is an accurate, practical, and low-cost cow-side test for measuring UpH and provides a clinically useful estimate of urine [Ca].

Evaluation of the analytical performance of a portable ion-selective electrode meter for measuring whole-blood, plasma, milk, abomasal-fluid, and urine sodium concentrations in cattle.

A portable ion-selective electrode (ISE) meter (LAQUAtwin B-722; Horiba Instruments Inc., Irvine, CA) is available for measuring the sodium ion concentration ([Na]) in biological fluids. The objective of this study was to characterize the analytical performance of the ISE meter in measuring [Na] in whole-blood, plasma, milk, abomasal fluid, and urine samples from cattle. Method comparison studies were performed using whole-blood and plasma samples from 106 sick calves and 11 sick cows admitted to a veterinary teaching hospital, 80 milk and 206 urine samples from 16 lactating Holstein-Friesian cows with experimentally induced free water, electrolyte, and acid-base imbalances, and 67 abomasal fluid samples from 7 healthy male Holstein-Friesian calves fed fresh milk with or without an oral electrolyte solution. Deming regression and Bland-Altman plots were used to determine the accuracy of the meter against reference methods. The meter used in direct mode on undiluted samples measured whole-blood [Na] 9.7 mmol/L (7.3%) lower than a direct ISE reference method and plasma [Na] 16.7 mmol/L (12.7%) lower than an indirect ISE reference method. The meter run in direct mode measured milk [Na] 3.1 mmol/L lower and abomasal fluid [Na] 9.0% lower than indirect ISE reference methods. The meter run in indirect mode on diluted samples accurately measured urine [Na] compared with an indirect ISE reference method. We conclude that, after adjustment for the bias determined from Bland-Altman plots, the LAQUAtwin ISE meter provides a clinically useful and low-cost cow-side instrument for measuring [Na] in whole blood, plasma, milk, and abomasal fluid.

Changes in skeletal muscle thickness and echogenicity and plasma creatinine concentration as indicators of protein and intramuscular fat mobilization in periparturient dairy cows.

High-producing dairy cows experience a state of negative energy balance in the periparturient period that is partially addressed by increasing the rate of fat and protein mobilization. Previous studies have focused on the rate of fat mobilization, and consequently the rate of protein mobilization has not been well characterized. The objective of this study was therefore to determine the change in indicators of muscle mass during early lactation using ultrasonographic measurement of muscle thickness and changes in plasma creatinine concentration. The maximum thickness of the gluteus medius and longissimus dorsi muscles of 106 Holstein cows (34 primiparous, 72 multiparous) was determined ultrasonographically on d -3, 0, 3, 7, 14, 21, and 28 relative to the day of parturition. Plasma creatinine concentration was measured periodically during the same period. Mixed models analysis and Passing-Bablok regression were used to analyze the data. Gluteus medius thickness, longissimus dorsi loin thickness (LDLT), and longissimus dorsi thoracic thickness (LDTT) were decreased at 28 d postpartum compared with d 3 antepartum. Plasma creatinine concentration was weakly associated with gluteus medius thickness, LDLT, and LDTT (Spearman's rho = 0.31, 0.39, and 0.32, respectively). Plasma creatinine concentration in primiparous and multiparous cows at 28 d postpartum decreased by 0.24 and 0.30 mg/dL, respectively, compared with values 3 d antepartum. We concluded that ultrasonographic measurement of LDLT and LDTT and change in plasma creatinine concentration may provide practical methods for monitoring the rate of protein mobilization in periparturient dairy cows. Ultrasonographic examination of LDLT and LDTT therefore complements ultrasonographic measurement of backfat thickness and may be useful in the evaluation of energy reserve mobilization in periparturient dairy cows.

Ability of milk pH to predict subclinical mastitis and intramammary infection in quarters from lactating dairy cattle.

Milk pH is increased in lactating dairy cattle with subclinical mastitis (SCM) and intramammary infection (IMI). We hypothesized that milk pH testing provides an accurate, low-cost, and practical on-farm method for diagnosing SCM and IMI. The main objective was to evaluate the clinical utility of measuring milk pH using 3 tests of increasing pH resolution: Multistix 10 SG Reagent Strips for Urinalysis (Multistix strips, Bayer HealthCare Inc., Elkhart, IN), pH Hydrion paper (Microessential Laboratory, Brooklyn, NY), and Piccolo plus pH meter (Hanna Instruments, Woonsocket, RI), for diagnosing SCM and IMI in dairy cattle. Quarter foremilk samples were collected from 115 dairy cows at dry off and 92 fresh cows within 4 to 7 d postcalving. Quarter somatic cell count (SCC) was measured using a DeLaval cell counter (DeLaval, Tumba, Sweden), with SCM defined as SCC >200,000 cells/mL and IMI defined as SCC >100,000 cells/mL and the presence of microorganisms at ≥10 cfu/mL of milk. Milk pH was measured at 37°C using the 3 test methods. The Hydrion pH paper performed poorly in diagnosing SCM and IMI. Receiver operating curve analysis provided optimal pH cutpoints for diagnosing SCM for the pH meter (dry off, ≥6.67; freshening, ≥6.52) and Multistix strips (dry off and freshening, ≥7.0). Test performance of the pH meter and Multistix strips was poor to fair based on area under the receiver operating curve, sensitivity, specificity, positive likelihood ratio, and kappa coefficient. The pH meter and Multistix strips performed poorly in diagnosing IMI at dry off and freshening. We concluded that milk pH does not provide a clinically useful method for diagnosing SCM or IMI in dairy cattle.

Evaluation of 3 esterase tests for the diagnosis of subclinical mastitis at dry-off and freshening in dairy cattle.

Subclinical mastitis (SCM) and intramammary infection (IMI) increase esterase activity in the glandular secretions of dairy cattle. Our objective was to evaluate the clinical performance of 3 commercially available esterase tests for diagnosing SCM and IMI. Foremilk samples were collected from 380 quarters (96 cows) at dry-off and from 329 quarters (83 cows) within 4 to 7 d after calving. Quarter somatic cell count (SCC) was measured using the reference method (DeLaval cell counter; De Laval International AB, Tumba, Sweden) with SCM defined as SCC >200,000 cells/mL. Bacterial culture of foremilk samples was used to diagnose IMI based on the growth of ≥100 cfu/mL. The SCC was estimated using 3 PortaSCC tests (PortaCheck, Moorestown, NJ) from the measured esterase activity and the California Mastitis Test (CMT). Clinical performance was evaluated using logistic regression to determine the area under the receiver operating characteristic curve (AUC) and identify test sensitivity (Se) and specificity (Sp) at the optimal cut-point for diagnosing SCM and IMI. Test agreement was also evaluated using the kappa coefficient (κ) and weighted κ. The PortaSCC color test was the best-performing PortaSCC test for diagnosing SCM at dry-off (AUC = 0.90, Se = 0.91, Sp = 0.81, κ = 0.71) and at freshening (AUC = 0.86, Se = 0.74, Sp = 0.95, κ = 0.72), at an optimal cut-point of ≥250,000 cells/mL but required 45 min to produce a result. For comparison, the CMT required 2 min to produce a result and a CMT score of trace or higher was superior to the PortaSCC color test for diagnosing SCM at dry-off (AUC = 0.95, Se = 0.95, Sp = 0.86, κ = 0.81) and freshening (AUC = 0.88, Se = 0.79, Sp = 0.95, κ = 0.76). The PortaSCC quick test was the best-performing PortaSCC test for diagnosing IMI at dry-off (AUC = 0.81, Se = 0.81, Sp = 0.78 κ = 0.40) and required 5 min to produce a result, whereas the PortaSCC color test was the best performing PortaSCC test for diagnosing IMI at freshening (AUC = 0.80, Se = 0.75, Sp = 0.79 κ = 0.38). For comparison, the CMT was inferior to the PortaSCC quick test for diagnosing IMI at dry-off (AUC = 0.73, Se = 0.76, Sp = 0.60, κ = 0.20) but was equivalent to the PortaSCC color test at freshening (AUC = 0.79, Se = 0.58, Sp = 0.93, κ = 0.50). The PortaSCC color and quick tests and CMT were considered good tests for diagnosing SCM and IMI because clinically useful tests typically have an AUC >0.80 and κ >0.6. Based on the test sensitivity, cost, and analysis time, there does not appear to be a persuasive reason to select the PortaSCC tests over the traditional CMT for diagnosing SCM and IMI.

Synthesis and multifunctionality of (CeO2-NiO) nanocomposites synthesized via sonochemical technique.

CeO2, NiO and their nanocomposite were synthesized using facile sonochemical technique. XRD assure single phase CeO2 and NiO while the nanocomposite consists of the two phases only. CeO2 nanoparticles possess cubic shape, NiO was formed in nanorods, and CeO2 decorated the NiO nanorods in the nanocomposite. The magnetic behavior of the nanocomposite lies between those of the two parents with a ferromagnetic tendency. Metal oxide nanoparticles acted as catalyst in the formation of carbon nanofibers (CNFs), while the nanocomposite leads to the production of carbon nanotubes. The photocatalyst (CeO2-NiO) achieved complete dye degradation (100%) in light for the tested dye at 50 min. The decay products were analyzed using GC mass confirming mineralization of Bb red dye.

Clinical Utility of Plasma Fructosamine Concentration as a Hypoglycemic Biomarker during Early Lactation in Dairy Cattle.

BACKGROUND: Plasma fructosamine concentration ([FRA]) is a widely used long term hyperglycemic biomarker in humans and dogs, but its clinical usefulness as a hypoglycemic biomarker in dairy cattle is uncertain. OBJECTIVES: To evaluate the relationship between plasma [FRA] and glucose concentration ([gluc]) as well as indices of energy balance during early lactation in dairy cattle, and to characterize the influence of plasma total protein concentration ([TP]) and albumin concentration ([albumin]) on [FRA]. ANIMALS: Convenience sample comprising 103 periparturient Holstein-Friesian cattle. METHODS: Plasma [gluc], [TP], [albumin], and other clinicopathologic indices of energy status were determined periodically from Day 4 postpartum. Body condition score (BCS) was assessed, and backfat thickness (BFT) and longissimus dorsi muscle thickness (LDT) were measured ultrasonographically. Plasma [FRA] was measured at approximately 28 days postpartum. Associations between plasma [FRA] and study variables were evaluated using Spearman's rho and stepwise forward linear regression. Statistical significance was declared at P < 0.05. RESULTS: A positive association was detected between plasma [FRA] and mean plasma [gluc] from Days 4-28 postpartum (rs = +0.36, P < 0.001), and between plasma [FRA] and LDT (rs = +0.28, P = 0.007), BCS (rs = +0.23, P = 0.029), and BFT (rs = +0.21, P = 0.043). Multivariable regression identified a positive association between plasma [FRA] and mean plasma [gluc] and [albumin] from Days 4-28 postpartum. Correcting plasma [FRA] for [albumin] improved the association (rs = +0.46, P < 0.001) between plasma [FRA] and mean plasma [gluc]. CONCLUSIONS AND CLINICAL IMPORTANCE: Plasma [FRA] does not provide a clinically useful method for quantifying the magnitude of hypoglycemia or negative energy balance in dairy cows during early lactation.

Evaluation and Comparison of 2 On-Farm Tests for Estimating Somatic Cell Count in Quarter Milk Samples from Lactating Dairy Cattle.

BACKGROUND: The somatic cell count (SCC) is commonly used to monitor udder health and diagnose subclinical intramammary infection (IMI) in dairy cattle. HYPOTHESIS: The Somaticell test (ST) and California mastitis test (CMT) are clinically useful cow-side tests for diagnosing subclinical IMI. ANIMALS: One hundred and eleven dairy cows at dry-off and 92 cows within 4-7 days postcalving. METHODS: Quarter foremilk samples were obtained and analyzed with a DeLaval cell counter (DCC, reference method), ST, and CMT. The ST was run in a simulated cow-side manner using milk at 37°C instead of 0-8°C as recommended by the manufacturer. Test performance for diagnosing IMI (DCC SCC >200,000 cells/mL) was evaluated by calculating the area under the receiver operating characteristic curve (AUC) and the kappa coefficient (κ) at the optimal cut-point for each test. The effect of milk/reagent temperature also was evaluated. RESULTS: Compared to the reference method, the ST run in a simulated cow-side manner had an AUC = 0.68 and κ = 0.24 at dry-off, and AUC = 0.74 and κ = 0.40 in fresh cows. The CMT performed much better than the ST in diagnosing subclinical IMI with AUC = 0.88 and κ = 0.77 at dry-off, and AUC = 0.87 and κ = 0.76 in fresh cows. The measured ST value decreased with increasing temperature of the milk/reagent mixture. CONCLUSIONS/CLINICAL IMPORTANCE: The ST is optimized for use on milk at 0-8°C and is therefore designed for on-farm use on refrigerated milk samples. The ST is not suited for use as a cow-side screening test for IMI because the milk temperature exceeds the recommended range for the test.

Evaluation of 2 portable ion-selective electrode meters for determining whole blood, plasma, urine, milk, and abomasal fluid potassium concentrations in dairy cattle.

Two low-cost ion-selective electrode (ISE) handheld meters (CARDY C-131, LAQUAtwin B-731; Horiba Ltd., Albany, NY) have recently become available for measuring the potassium concentration ([K(+)]) in biological fluids. The primary objective of this study was to characterize the analytical performance of the ISE meters in measuring [K(+)] in bovine whole blood, plasma, urine, milk, and abomasal fluid. We completed 6 method comparison studies using 369 whole blood and plasma samples from 106 healthy periparturient Holstein-Friesian cows, 138 plasma samples from 27 periparturient Holstein-Friesian cows, 92 milk samples and 204 urine samples from 16 lactating Holstein-Friesian cows, and 94 abomasal fluid samples from 6 male Holstein-Friesian calves. Deming regression and Bland-Altman plots were used to characterize meter performance against reference methods (indirect ISE, Hitachi 911 and 917; inductively coupled plasma-optical emission spectroscopy). The CARDY ISE meter applied directly in plasma measured [K(+)] as being 7.3% lower than the indirect ISE reference method, consistent with the recommended adjustment of +7.5% when indirect ISE methods are used to analyze plasma. The LAQUAtwin ISE meter run in direct mode measured fat-free milk [K(+)] as being 3.6% lower than the indirect ISE reference method, consistent with a herd milk protein percentage of 3.4%. The LAQUAtwin ISE meter accurately measured abomasal fluid [K(+)] compared to the indirect ISE reference method. The LAQUAtwin ISE meter accurately measured urine [K(+)] compared to the indirect ISE reference method, but the median measured value for urine [K(+)] was 83% of the true value measured by inductively coupled plasma-optical emission spectroscopy. We conclude that the CARDY and LAQUAtwin ISE meters are practical, low-cost, rapid, accurate point-of-care instruments suitable for measuring [K(+)] in whole blood, plasma, milk, and abomasal fluid samples from cattle. Ion-selective electrode methodology is not suitable for measuring [K(+)] in bovine urine.

Evaluation of an Electrochemical Point-of-Care Meter for Measuring Glucose Concentration in Blood from Periparturient Dairy Cattle.

BACKGROUND: The Precision Xtra(®) meter is a promising low cost electrochemical point-of-care unit for measuring blood glucose concentration ([gluc]) in cattle blood. The meter uses an algorithm that assumes the intra-erythrocyte [gluc] equals the plasma [gluc] on a molal basis, and that the hematocrit is similar in humans and cattle. OBJECTIVES: The primary objective was to determine the accuracy of the meter for measuring plasma [gluc] in dairy cattle. Secondary objectives were to characterize the influence of hematocrit and sample temperature on the measured value for [gluc]. ANIMALS: A total of 106 periparturient Holstein-Friesian cattle. METHODS: Blood and plasma samples (1,109) were obtained and Deming regression and Bland-Altman plots were used to determine the accuracy of the meter against the reference method (plasma hexokinase assay). Multivariable regression and linear regression were used to determine the effect of hematocrit and sample temperature on the plasma [gluc] measured by the meter. RESULTS: Intra-erythrocyte [gluc] was 18% of plasma [gluc] on a molar basis. Sample temperature had a significant linear effect on plasma [gluc] as measured by the meter for 3/5 plasma samples when measured [gluc] > 160 mg/dL. CONCLUSIONS AND CLINICAL IMPORTANCE: The meter utilizes an algorithm that is optimized for human blood and is inaccurate when applied to bovine blood. Until a cattle-specific algorithm is developed, we recommend using plasma as the analyte instead of blood and calculating plasma [gluc] using the equation: [gluc] = 0.66 × [gluc]p-meter + 15, where [gluc]p-meter is the value reported by the meter. If blood is measured, then we recommend using the equation: [gluc] = 0.90 × [gluc]b-meter + 15.

Insulin resistance in patients on valproic acid: relation to adiponectin.

OBJECTIVES: To investigate the presence of insulin resistance in obese children with idiopathic epilepsy on valproic acid (VPA) monotherapy in comparison to obese otherwise healthy subjects. Secondary outcome was to explore the relation between adiponectin and insulin resistance among those patients. MATERIALS AND METHODS: Fifty obese children with generalized idiopathic epilepsy on VPA monotherapy and a control group of 49 obese clinically healthy age and sex-matched children with simple obesity were recruited in the study. Anthropometric assessment, fasting plasma insulin (FI), fasting glucose (FG) and fasting adiponectin levels were measured. Fasting glucose insulin ratio (FGIR) and homoeostasis model assessment for insulin resistance (HOMA-IR) were calculated for both patients and control subjects. Measurement of serum VPA trough level was also performed in patients. RESULTS: Patients had significantly higher fasting blood glucose, fasting insulin, lower FGIR and higher HOMA-IR values, compared to controls. Mean adiponectin level was significantly lower in patients compared to controls. The duration of treatment with valproic acid negatively correlated with adiponectin (r = -0.285, P = 0.045), but did not correlate with fasting glucose, insulin, FGIR or HOMA-IR. Total daily VPA dose significantly correlated with fasting insulin (r = 0.495, P < 0.001), FGIR (r = -0.525, P < 0.001) and HOMA-IR (r = 0.404, P = 0.004). CONCLUSION: This study ascertains the relationship between dose and duration of VPA therapy, insulin resistance and the adipocytokine axis. We are reporting the novel proposal that obese VPA-treated children are more insulin resistant and have lower adiponectin levels than obese and otherwise healthy children.

Induction of resistance in tomato plants against tomato mosaic tobamovirus using beneficial microbial isolates.

The possibility of making use of the phenome non of Systemic Acquired Resistance (SAR) to control viruses achieved by the soaking treatment of tomato seeds cv. Castl Rock with three growth forms to Bacillus circulans, Pseudomonas fluorescens 2 and Trichoderma harzianum against Tomato mosaic tobamovirus (ToMV) infection. All the application forms of beneficial biotic inducers were reduced the mean number of ToMV local lesions on Datura metel. P. fluorescens 2 was found to be the best treatment in three forms on reduction of local lesion number 42.2, 32.7 and 38.1 of microbial liquid culture, microbial cells or spores and microbial culture filtrate forms, respectively, while the highest mean numbers of local lesions were 51.5, 61.7 and 73.5 of microbial liquid culture, microbial cells or spores and microbial culture filtrate, respectively for T. harzianum. The microbial culture filtrate form was more effective than other microbial forms to reduce mean number of ToMV local lesions to B. circulans, P. fluorescens 2 and T. harzianum isolates, 40.7, 32.1 and 51.5, respectively. The individual microbial isolates on all three microbial forms able to vary ToMV local lesions similarity (homologous or heterologous) and morphology (size center and surrounded with halo or without halo) compared with TMV mother strain.

Role of diffusion-weighted magnetic resonance imaging in differentiation between the viable and necrotic parts of head and neck tumors.

BACKGROUND: Differentiation between the viable and necrotic parts of a tumor is essential for accurate biopsy results and for treatment planning. PURPOSE: To determine the role of diffusion-weighted magnetic resonance (MR) imaging in differentiation between the viable and necrotic parts of head and neck tumors. MATERIAL AND METHODS: Thirty patients with malignant head and neck tumors underwent postcontrast MR imaging. Diffusion MR imaging was done on a 1.5T unit using multislice single-shot echo-planar imaging. Diffusion-weighted MR images were acquired with a diffusion-weighted factor b of 0, 500, and 1000 s/mm(2), and an apparent diffusion coefficient (ADC) map was reconstructed. The ADC value was measured within the enhanced and nonenhanced part of the tumor, and the mean ADC values were calculated. The ADC value was correlated with biopsy results. RESULTS: The mean ADC value of a viable part of the tumor was 1.17+/-0.33 x 10(-3) mm(2)/s, and of the necrotic parts of the tumor 2.11+/-0.05 x 10(-3) mm(2)/s. The difference in the ADC value between the viable and necrotic parts of the head and neck tumors was statistically significant (P<0.001). Sensitivity, specificity, and accuracy of the ADC value were 92.9%, 93%, and 94.6%, respectively. CONCLUSION: Creation of an ADC map is an excellent method for differentiation between the viable and necrotic parts of head and neck tumors. Thus, the ADC map can be used to select the best biopsy site and to detect tumor viability in post-treatment follow-up of patients after radiation therapy.

Diagnosis of giardiasis using an enzyme-linked immunosorbent assay (ELISA) on formalin preserved stools.

From a total of 162 children, three stool samples were collected from each child over a period of one week and preserved in formalin. Giardia lamblia was diagnosed by direct microscopy of formol-ether concentrates for each of the three samples. The first sample was also subjected to an ELISA test for detection of Giardia Iambia stool antigen in formalin preserved stool specimens. Microscopic examination revealed that 45 children were infected whereas ELISA detected 41 cases giving a sensitivity of 91.1% and a specificity of 99.1%. Predictive value of a positive test was 97.6% and that of a negative test was 96.7%. A significant correlation was present between mean optical density readings of ELISA and number of cysts present. No crossreactivity was observed ELISA is a simple, sensitive and specific test that can be applied in epidemiological studies for detection of Giardia lamblia coproantigen in formalin preserved stool specimens.