Performance, blood and antioxidant status in dual-purpose laying hens supplemented with aqueous extract of Christ's thorn jujube (Ziziphus spina-christi L.) leaves as phytogenic agent in subtropical conditions.

OBJECTIVE: The potential of aqueous extract of Christ's thorn jujube (Ziziphus spina-christi) leaves (SLAE) to reduce the negative impacts of heat stress on production performance and physiological traits was investigated in dual-purpose layers under subtropical farming. METHODS: A total of 200, 25-week-old laying hens (Inshas strain) were randomly assigned to four dietary treatments including SLAE at 0, 2.5, 5.0, and 7.5 mL/kg, respectively. The average temperature-humidity index value was 26.69 during the experimental period. The SLAE contained saponin (0.045%), total flavonoid content of 17.9 mg of quercetin equivalent/ 100 g and overall antioxidant capacity concentration of 17.9 mg of ascorbic acid equivalent/100 g. RESULTS: The maximum final body weight (BW), BW gain, egg weight, number, and mass occurred at the level of SLAE7.5 inclusion. The egg quality was significantly higher in SLAE groups than in control, and overall, SLAE7.5 had the most favorable influence at 28 and 32 weeks. Liver and kidney function, as well as lipids profile, improved significantly by SLAE inclusion; the lowest concentrations of these parameters were in SLAE7.5 hens. Treatment with SLAE7.5 increased total antioxidant capacity and endogenous antioxidant enzymes compared to control, whereas no effect on superoxide dismutase was noticed. CONCLUSION: The addition of SLAE at 7.5 mL/kg diet improved egg laying performance and quality, metabolic profiles, and antioxidant status during hyperthermia conditions.

Outcomes Evaluation of Zero-Profile Devices Compared to Stand-Alone PEEK Cages for the Treatment of Three- and Four-Level Cervical Disc Disease.

BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is a well-accepted treatment option for patients with cervical spine disease. Three- and four-level discectomies are known to be associated with a higher complication rate and lower fusion rate than single-level surgery. This study was performed to evaluate and compare zero-profile fixation and stand-alone PEEK cages for three- and four-level ACDF. METHODS: Two cohorts of patients who underwent ACDF for the treatment of three- and four-level disease were compared. Thirty-three patients underwent implantation of zero-profile devices that included titanium screw fixation (Group A). Thirty-five patients underwent implantation of stand-alone PEEK cages without any form of screw fixation (Group B). RESULTS: In Group A, twenty-seven patients underwent a three-level and six patients a four-level ACDF, with a total of 105 levels. In Group B, thirty patients underwent a three-level and five patients underwent a four-level ACDF, with a total number of 110 levels. In Group A, the mean preoperative visual analog scale score (VAS) for arm pain was 6.4 (range 3-8), and the mean postoperative VAS for arm pain decreased to 2.5 (range 1-7). In group B, the mean preoperative VAS of arm pain was 7.1 (range 3-10), and the mean postoperative VAS of arm pain decreased to 2 (range 0-4). In Group A, four patients (12%) developed dysphagia, and in Group B, three patients (9%) developed dysphagia.  Conclusions: This study found zero-profile instrumentation and PEEK cages to be both safe and effective for patients who underwent three- and four-level ACDF, comparable to reported series using plate devices. Rates of dysphagia for the cohort were much lower than reports using plate devices. Zero-profile segmental fixation devices and PEEK cages may be considered as viable alternatives over plate fixation for patients requiring multi-level anterior cervical fusion surgery.

Underage mothers in Turkey.

BACKGROUND: All individuals under the age of 18 are considered as children by the Convention on the Rights of Children. Underage mothers are a pediatric-age group of children that become pregnant and give birth. It may be unfamiliar in Western countries, but in Middle-Eastern countries ruled by religious laws and old-fashioned traditions, it is common for an older man to marry a girl. The aim of this study was to describe the status of underage mothers within the framework of children's rights and to draw attention to this issue. We presented this study to increase awareness and sensitivity, and to scrutinize and discuss these topics. MATERIAL AND METHODS: We retrospectively investigated cases of underaged pregnant girls who applied to Forensic Science Department outpatient clinics and Obstetrics and Gynecology Department outpatient clinics of Gaziosmanpasa University Faculty of Medicine between 2003 and 2013. Results We accessed records of 163 underage mothers (≤ 18 age). Mean age was 16.9 ± 0.83 (14-18 years). Gravida and parity rates increased proportionately with increasing age. Most of our cases were 16 and 17 years of age (n: 117, 71.8%). CONCLUSIONS: Underage motherhood is not only a medical issue; it is a multi-dimensional problem with social, economic, traditional, religious, and legal aspects.

Endoscopic endonasal transsphenoidal surgery. Before scrubbing in: tips and tricks.

BACKGROUND: The interest in endoscopic endonasal transsphenoidal surgery for the treatment of sellar and perisellar lesions is growing as a consequence of the results achieved in the past 10 years and of the interest by patients, endocrinologists, and neurosurgeons. Furthermore, the special ability of the endoscope to offer a wider and detailed view of anatomic structures is a major advantage that increases the attention of neurosurgeons who seek less invasive procedures and better results. Most neurosurgeons performing transsphenoidal surgery, however, are not used to endoscopy, and changing from microsurgical to endoscopic technique can be difficult and even discouraging, often because of difficulties in the initial phase of the procedure. TECHNIQUE: With the purpose of helping minimize some of the difficulties, we describe herein useful tips and tricks that mainly concern familiarization with the endoscopic equipment, details of the transsphenoidal anatomy, and endoscopic skills. We stress the steps and details that we judge most important. CONCLUSION: We believe that by following these recommendations neurosurgeons can overcome, or even avoid, the difficulties frequently encountered transsphenoidal surgery, allowing them to safely and efficiently perform endonasal transsphenoidal endoscopic procedures.