Relationships between the concentration of insulin-like growth factor-1 in serum in dairy cows in early lactation and reproductive performance and milk yield.

The objective of this study was to evaluate the relationships of different insulin-like growth factor-1 (IGF1) measures [5 distinct IGF1 concentrations on particular days, area under the curve (AUC), and linear regression coefficient] in the postpartum period in lactating dairy cows and reproductive performance. A total of 417 healthy multiparous Holstein-Friesian cows were enrolled in the study. Serum samples for the determination of the concentration of IGF1 were collected on d 0, 4, 10, 20, and 40 postpartum (pp). The concentration of total IGF1 in serum was determined by immunometric chemiluminescence immunoassay. All cows were examined for vaginal discharge as a sign of clinical endometritis at 20 d pp by external inspection and rectal palpation. The mean concentration of IGF1 ranged from 57 +/- 18.9 ng/mL within the first 12 h pp to 74 +/- 19.9 ng/mL at 40 d pp. On d 10 pp, first and all artificial insemination conception rates were greater in cows with IGF1 concentrations above the median compared with cows with IGF1 concentrations below the median. Cows with greater AUC (second to fourth quartile) conceived earlier (11.4, 16.0, and 18.8 d) than cows in the first IGF1 quartile (117.0 +/- 43.6). Proportion of cows pregnant within 200 d pp increased significantly from the first to the third IGF1 quartile of AUC (58.7, 66.7, and 74.0%). The proportion of cows culled decreased from the first to the fourth IGF1 quartile. Correlations between IGF1 measures and days to pregnancy were significant (except for the linear regression coefficients) but low (R(2) = 0.0009 to 0.025). Differences between single or composite measurements of IGF1 were not significant. We could also demonstrate a statistically significant correlation between the concentration of IGF1 in serum and the average 10-d milk production (31.6 to 44.0 kg). In conclusion, our study indicates that single or multiple measurements of IGF1 concentration in the postpartum period have very limited value to predict individual fertility in dairy cows.

Gallstones in spinal cord injury (SCI): a late medical complication?

STUDY DESIGN: Prospective controlled study. OBJECTIVES: To assess the prevalence of cholelithiasis among chronic spinal spinal cord injured (SCI) male patients of the ACHS (Asociación Chilena de Seguridad). To evaluate statistically the prevalence of cholelithiasis among SCI patients compared to a control group and to the general male Chilean population. To assess the correlation between cholelithiasis in chronic SCI patients and usual risk factors such as age, obesity and diabetes mellitus. To assess the association of cholelithiasis in chronic SCI patients and the duration of the spinal cord injury. SETTING: Rehabilitation Service at the Hospital del Trabajador, in Santiago, Chile. METHODS: One hundred SCI patients followed up at the Hospital del Trabajador on a regular basis were included in the study; one group consisted of 76 subjects rated ASIA A or B and the other group consisted of 24 subjects rated ASIA C and D. They were all male, older than 20 years old (average age: 41,9 and 42,6 respectively), and suffered from a spinal cord injury greater than one year of evolution. The control group (CG) consisted of 100 male volunteers, without both SCI and history of biliary disease, aged 40.3 years old in average. All three groups underwent ultrasonographic imaging evaluation of the gallbladder and the biliary tract between 1998 and 2000. RESULTS: The prevalence of cholelithiasis among the groups was the following: 25% in the SCI patients ASIA A and B (19/76), 25% in the SCI patients ASIA C and D (6/24) and 9% (1/100) in the CG. The statistical analysis showed a value of P=0.0037, thus establishing a significant association between cholelithiasis and SCI, both complete and incomplete. The difference was not statistically significant when correlating the presence of cholelithiasis with the neurological level of the injury--above and below T10 (24,1 and 25%, respectively)--with the duration of the SCI, with age, obesity and diabetes mellitus. CONCLUSIONS: SCI represents a major risk factor for the development of cholelithiasis, and it should be considered a late, secondary complication of a spinal cord injury. SPONSORSHIP: The present work is sponsored by the Fundación Científica y Tecnológica of the ACHS, grant No 2899.

Stereotactic breast biopsies: analysis of needle deviation based on stereotactic views.

Stereotaxy is widely used for breast biopsy and needle localization of mammographically detected lesions. If a lesion shift occurs during stereotaxy, corrections (even though possible with vacuum biopsy) is difficult due to the difficult assessment of the exact 3D shift. In this study we investigated the correlation between lesion shift (in up to three dimensions) and its visualisation on the stereotactic images (0 degree, -15 degrees, +15 degrees). The study was performed on a Fischer prone table (Fischer Imaging Europe, Vejle, Denmark) using a 3.8-mm steel ball (as lesion) and a 20-G needle. The 17 major malpositions of the ball with respect to the needle were imitated and imaged. A simple rule is suggested as to how the deviation in all three dimensions can be detected from the scout and the two stereotactic views. The rule proved to be a valuable tool to correctly assess lesion shifts.

Clinical evaluation and management of neurogenic bowel after spinal cord injury.

OBJECTIVES: To assess the state of the neurological bowel in spinal cord injured (SCI) patients, design and apply a program for the comprehensive management of neurogenic bowel and evaluate outcome. SETTING: Out-patient in a Rehabilitation Service. SUBJECTS: Thirty-eight SCI patients, 12 (32%) with complete lesions of more than 5 years duration. DESIGN: Observational, longitudinal and prospective. Pre and post intervention. METHOD: Pre and post SCI intestinal function was evaluated clinically prior to beginning program. The presence of GI symptoms were studied. Laboratory work-up included colonic transit time (CTT), anorectal manometry and recto-colonoscopy. An intestinal program was designed, in order to achieve an effective and efficient evacuation in a predictable and socially acceptable time, to avoid short and long term complications and eliminate inadequate intestinal evacuation habits. OUTCOME MEASURES: Pre and post SCI difficulty in intestinal evacuation (DIE) was increased (from 2.6% to 26.3%). The most frequent GI symptom was abdominal distention (53%). Colonic inertia was present in 49% of CTT, internal anal sphincter pressure was normal or increased in 77% and rectoanal inhibitory reflex was present in 88%. With the intestinal program, the incidence of DIE was reduced to 8.8%, manual extraction (ME) was reduced from 53% to 37%. Excellent and good results were obtained in 56% of the patients. CONCLUSION: The proposed intestinal program is effective in the rehabilitation of SCI patients with neurogenic bowel. It is essential to initiate these physiological and safe procedures as soon as possible after sustaining the injury; this will lead to better results and to the elimination of inadequate intestinal maneuvering in the future Spinal Cord (2000) 38, 301 - 308.

HBV-DNA level in blood serum as a predictor of good response to therapy with interferon-alpha-2b of patients with chronic hepatitis B.

The prevalence of hepatitis B infection in population in Poland is low and averages 1-1.5%. However, it means that about 380,000 Poles constantly or temporarily replicate HBV. Chronic HBV infection is associated with increased risk of serious liver diseases and it is estimated that 25-40% of patients with chronic hepatitis B will die prematurely of cirrhosis or primary liver cancer. Up to the present, interferon-alpha (IFN-alpha), with low response rate between 25-55% and some limitations of therapy, has been the only available treatment for chronic hepatitis B. A favorable outcome of IFN-alpha therapy is associated with some prognostic factors, not accepted by all investigators, such as low level of HBV-DNA in serum. The aim of this study was to assess the efficacy of therapy with IFN-alpha 2b (Intron A), administered s.c. 5 MU x 3/week for 16 weeks, in 65 patients with chronic hepatitis B, divided into groups according to the baseline HBV-DNA level. Except for serum HBV-DNA level, there were no demographical and biochemical differences between all the treated groups. The patients were followed-up for 12 months. Sustained response (SR) to the therapy (defined as ALAT normalization, loss of detectable HBV-DNA, seroconversion HBeAg to anti-HBeAg and improvement in liver histology) was observed in 16 (57.14%) of patients in the group with HBVDNA level < 1000 pg/ml, in 6 (37.5%) with HBV-DNA level of 1001-3000 pg/ml, in 4 (28.57%) with HBV-DNA level of 3001-5000 pg/ml and only in 2 (28.57%) of patients in group with HBVDNA level > 5000 pg/ml. We conclude that IFN-alpha is particularly useful in therapy of patients with chronic hepatitis B with low levels of HBV-DNA. The baseline HBVDNA level < 1000 pg/ml in serum is the predictor of good response to IFN-alpha therapy.

[Therapeutic efficacy of low-dose alpha interferon therapy in liver cirrhosis associated with HBV]. / Skutecznosc terapeutyczna niskich dawek interferonu alfa w wyrównanej marskosci watroby zwiazanej z zakazeniem HBV.

The aim of this study was the assessment the efficacy and safety of therapy with interferon alpha (Intron A) administered s.c. 3 MU x 3/week for 12 weeks for patients with HBV related liver cirrhosis (Child's class A). Fifteen patients completed therapy and 12 months follow-up. At the end of follow-up sustained response to the therapy, defined by clearance of HBV-DNA, normalization of ALAT activity in serum and improvement in the liver histology was achieved in 46.6% of treated patients. Moreover, among few patients from group of nonresponders (patients without sustained clearance of HBV-DNA) decrease of HBV-DNA level, ALAT activity in serum and improvement in the liver histology were observed. Adverse effects of IFN alpha therapy were typical, but in any case were no necessity terminate the therapy.

[Plasma fibronectin in chronic liver disease--marker of fibrosis?]. / Fibronektyna osoczowa w przewleklych chorobach watroby--znacznik wlóknienia?

The determination of fibronectin (FN) concentration in plasma has been performed in the group of 77 patients (60-with various chronic liver diseases, 6-with AIDS IVc, 11-healthy patients). The purpose of this study was: evaluation of the value of plasma FN determination in assessment the degree of liver fibrosis and the degree of liver damage. The obtained results were compared with routine biochemical tests and histopathological picture of liver sections. Among patients with liver diseases, we observed that plasma FN concentration was significantly lower only in the group with decompensated liver cirrhosis, in relation to control group. Non significant lower values of FN was observed in the group of patients with chronic hepatitis, as well as non significant higher ones in the group with cholestasis and fibrosis. It has been concluded that determination of plasma FN concentration has not any importance in evaluation of degree of liver fibrosis and its only one from many functional liver tests.

[Evaluation of treatment outcome for bacterial meningitis and encephalitis at the provincial hospital of infectious diseases in Wroclaw during 1985-1989]. / Ocena wyników leczenia ropnych zapalen opon mózgowo-rdzeniowych i mózgu w Wojewódzkim Szpitalu Chorób Zakaznych we Wroclawiu w latach 1985-1989.

Data about 848 patients treated in the years 1985-1989 in the Province Hospital of Infectious Diseases were analyzed. Among them were 98 patients with bacterial meningitis and encephalitis. The most frequent etiological agents were Neisseria meningitidis and Diplococcus pneumoniae. In none case Haemophilus influenzae was isolated. The average time of hospitalization was limited to 45 days. Treatment introduced at once was based on the results of bacteriological tests. Crystalline penicillin, cephalosporins of the II and the III generation and in some cases metronidazole were antibiotics of choice. Serious complications were observed in 25% of patients. 5% of patients died.

Selective procedure to isolate haemophilus influenzae from sputa with large quantities of Pseudomonas aeruginosa.

The identification of respiratory pathogens (e. g. Haemophilus influenzae, Streptococcus pneumoniae) is impaired by the presence of large quantities of Pseudomonas aeruginosa, as is the case in the sputum specimens of cystic fibrosis patients. A procedure has been evaluated whereby the selective inhibition of the proliferation of P. aeruginosa is achieved by a broad spectrum pyocin, whereas the growth of H. influenzae is not influenced. This technique has been tested over a two year period resulting in a significantly augmented rate of identification of H. influenzae.