Adição de plasma seminal ao sêmen descongelado e taxa de prenhez de ovelhas inseminadas em tempo fixo / Addition of seminal plasma to frozen-thawed semen and pregnancy rate of fixed time inseminated ewes

Avaliou-se o efeito da adição de plasma seminal ovino ao sêmen descongelado sobre a taxa de prenhez de ovelhas em rebanho comercial. Cento e setenta e quatro ovelhas cruza Texel foram distribuídas em quatro tratamentos: T1) inseminação artificial cervical (IAC) com sêmen descongelado (SD) diluído em solução tampão fosfato salino (PBS); T2) IAC com SD e adição de plasma seminal ovino; T3) grupo-controle I: IAC com sêmen fresco diluído em PBS; T4) grupo-controle II: inseminação artificial por laparoscopia com SD diluído em PBS. Para indução de cio, utilizaram-se esponjas impregnadas com acetato de medroxiprogesterona (MAP) por 12 dias, com aplicação intramuscular de 400 UI de eCG (Novormon®) e de 37,5µg de cloprostenol sódico (Sincrocio®), no dia da retirada das esponjas. O aparecimento de cio foi monitorado com rufiões vasectomizados a partir da retirada das esponjas até a inseminação artificial em tempo fixo - 54 a 60 horas. A taxa de prenhez do tratamento com adição de plasma seminal ao sêmen descongelado (7,0%) não diferiu (P>0,05) do tratamento sem adição de plasma (4,3%), entretanto foi menor (P<0,05) se comparada à taxa de prenhez dos grupos-controle I inseminação via cervical superficial com sêmen fresco diluído (50,0%) e II inseminação via laparoscopia com sêmen descongelado (39,4%). A inseminação artificial por via cervical superficial com adição de plasma seminal ao sêmen descongelado não elevou o percentual de prenhez em valores que justifiquem a indicação desta biotecnologia em rebanhos comerciais de ovinos.

The effect of seminal plasma addition to thawed-frozen ram semen on the pregnancy rate of commercial herd ewes was evaluated. One hundred and seventy-four crossbred Texel sheep were allocated to four treatments: T1) cervical artificial insemination (CAI) using frozen-thawed semen (FTS) diluted in phosphate buffered saline solution (PBS); T2) CAI using FTS diluted in ovine seminal plasma; T3) control group I: CAI using fresh semen diluted in PBS; T4) control group II: laparoscopic insemination using FTS diluted in PBS. Estrus induction was performed with medroxiprogesterone acetate (MAP) impregnated sponges for 12 days, followed by intramuscular injection of 400 IU of eCG (Novormon®) and 37.5µg of sodium cloprostenol (Sincrocio®) on the day of sponge removal. Estrus was monitorated with vasectomized rams, beginning at the time of the sponge removal until the fixed time artificial insemination - 54 to 60 hours. The pregnancy rate of FTS diluted in seminal plasma treatment (7.0%) did not differ (P>0.05) for the treatment without addition of seminal plasma (4.3%), however it was lower (P<0.05) when compared to the pregnancy rate of the cervical inseminated control I group with PBS diluted fresh semen (50.0%) and laparoscopic inseminated control group II with PBS diluted FTS (39.4%). The cervical artificial insemination with the addition of seminal plasma to frozen-thawed semen did not increase the pregnancy rate at acceptable values to make this biotechnology useful on commercial herds.

Glucose intolerance and associated factors in the multi-ethnic population of the United Arab Emirates: results of a national survey.

AIMS: To determine the prevalence of diabetes and impaired fasting glycaemia (IFG) and associated conditions such as obesity and hypertension, in the multi-ethnic, adult population of the United Arab Emirates in 1999-2000. METHODS: A stratified, multistage, random sample was selected. Diagnosis was based on the latest recommendations of a WHO Expert Group. RESULTS: The overall response rate was 89%. Crude prevalence of diabetes was 20%. It was higher in UAE citizens (25%) than in expatriates (13-19% depending on country of origin). Prevalence of diabetes rose with age to a maximum of 40% after the age of 55 years. Prevalence of impaired fasting glycaemia was 5% in men and 7% in women. Forty-one percent of subjects with diabetes were undiagnosed prior to the survey. Of the previously diagnosed subjects with diabetes, 59% were taking oral hypoglycaemic agents, 8% used insulin and 17% relied on diet alone. Obesity was common in all ethnic groups. Approximately three-quarters of all subjects were either obese (BMI> or =30) or overweight (BMI 25-29). Presence of diabetes was associated with increasing waist-hip ratio (WHR), age and with systolic blood pressure and ethnicity. Co-morbidity with glucose intolerance occurred with obesity in 8% and with hypertension in 5%. Three-quarters of all subjects had one or more of these conditions. CONCLUSIONS: Diabetes, obesity and hypertension are extremely prevalent in the adult population of the UAE. Prompt action is required to avert a major public health crisis due to the long-term complications of diabetes in the near future.

Common prescriptions in ambulatory care in Lebanon.

OBJECTIVE: To describe prescribing practices of family physicians in a staff model health maintenance organization at a university health center in Lebanon and estimate costs of such practices for common diseases. METHODS: All prescriptions issued between July 1, 1997, and June 30, 1998, were prospectively collected. The diagnoses made by physicians at each encounter were recorded, and the total price of medications prescribed was calculated. The core prescribing indicators as defined by the World Health Organization and the mean annual prescription price per person for the 25 most common diagnoses were calculated. RESULTS: Prescribing occurred in 27.1% of encounters, with a mean of 1.6 medications per encounter; 17.5% of all prescriptions included an antibiotic. Generic drugs and essential drugs each accounted for 2.9% of all medications. Approximately 50% of the consultations for either respiratory or ear infections resulted in a prescription. Cervical spine syndromes and lipid metabolism disorders cost most among recorded diagnoses, with mean annual prescription prices per person of US $2016 and $1128, respectively. CONCLUSIONS: The low rate of generic and essential drug prescribing, as well as the frequency of prescribing in respiratory infections, highlight the need for initiatives to help rationalize prescribing in primary care in Lebanon. Together with the diagnostic categories incurring high cost per person, these issues can be part of physician education or treatment guideline development. These measures may aid the government in its subsidy of primary health care centers.

List of essential drugs for primary care in Lebanon.

In 1966, Lebanon had around 19,000 drug formulations registered in the Ministry of Public Health. The government decreased that number to 5400 in 1992 through numerous interventions. In 1995 and in an effort to rationalize drug prescribing, the Lebanese government organized an ad hoc committee of medical and pharmaceutical experts to review the 1992 list and create a list of essential drugs for primary care (LEDPC). This report describes the process and the studies used to update the 1992 list by the ad hoc committee.

Chest pain evaluation.

Chest pain is one of the frequent complaints in patients presenting to emergency rooms and ambulatory care clinics. For the primary care physician evaluating these patients, there are three essential steps in the evaluation of chest pain. The first step is to determine whether the chest pain is cardiac in origin or not. If the pain is suspected to be cardiac, then the next step would be to determine if the chest pain is secondary to an acute coronary syndrome (acute myocardial infarction or unstable angina) that requires immediate referral to an emergency room to initiate therapy and admit to the hospital. If the pain is not considered to be due to an acute coronary syndrome, then we proceed with a systematic approach to try to determine the likelihood that a particular patient has significant coronary artery disease (CAD). This is determined based on the patient's history, risk factors and electrocardiogram. Once the likelihood is assessed, this will determine what further invasive or non-invasive tests would be required to complete the patient's evaluation.

Recommendations for the school health physical examination in Lebanon.

School health developed gradually over the years; starting with efforts to keep contagion out of schools to global programs of comprehensive services. One of its components, school medicine, covers screening examinations, record maintenance, emergency care, immunization monitoring and health counseling. This paper proposes the essential health activities to be performed during a screening school examination in Lebanon. The recommendations are based on a combination of international literature review of evidence and the existence of Lebanese epidemiological reports identifying specific problems. Vaccination record review, tuberculin testing, vision, hearing, dental and skin disorders screening procedures are proposed as essential activities of the school physical examination.

Purified protein derivative (PPD) conversion rate among Lebanese children in Beirut.

To determine the purified protein derivative conversion rate among Lebanese children we followed a cohort of 1236 students, ages 5-14 years, enrolled in 25 public schools in Beirut. All cases received an intradermal injection of purified protein derivative in 1992 and one year later. Test administration was done using standard techniques and results were read by the same physician 48-72 hours later. Demographic information was also obtained on the enrolled students. The majority of children identified belonged to a low socioeconomic class. The one year conversion rate was 1.4%. This underscores the urgent need for preventive programs.

Lessons from a courageous dying patient.

The atypical reaction of a patient to the news of her terminal illness raises a number of questions about care for the dying.

Data from a public school health project in Beirut.

The health status of 2778 elementary students enrolled in twenty-five government schools in Beirut was evaluated. Parents completed special forms relating to demographic information, socioeconomic status, the students' medical and vaccination history, and the presence of certain medical conditions in the family. A complete physical examination of each student was carried out. Seventy-six percent of the children belonged to families with a monthly income between US $118-237. The most common medical problems encountered were poor dentition (53%), incomplete immunization (22-63%) for the various vaccines, enuresis (9%), pediculosis (8%), and defective vision (6%). It was also noticed that 72% of the students have at least one member in the family who smokes. The data presented in this study show the need for fluoridation of public water; provision of accessible and affordable medical and dental care; carrying vaccination campaigns and introducing health education in elementary schools in Lebanon.

Reliability and validity of self and proxy reporting of morbidity data: a case study from Beirut, Lebanon.

We compared the self-reported illnesses (heart disease, back pain, rheumatoid arthritis, hypertension, and pulmonary disease) and smoking histories of 100 cases and 100 controls matched for age and sex with reports of this information from proxy informants from the same household in two areas in the city of Beirut. In addition, both cases and controls were given physical examinations to evaluate the accuracy of the responses. The level of agreement between the responses of subjects and of their informants varied from one condition to the other. Heart disease had the highest level of agreement, with the proportion of agreement greater than 93% for the cases and the controls and having chi values of 0.79 and 1.0, respectively. The report of back pain exhibited the lowest level of agreement, with responses showing a proportion of agreement of 74% for the cases and 90% for the controls, with chi values of 0.49 and 0.50, respectively. In comparing the responses of subjects and proxy informants with the results of physical examinations, heart disease had the highest level of agreement (J index ranged from 0.69 to 0.84), and back pain had the lowest level of agreement (J index ranged 0.42 to 0.48). These results show that proxy informants are good respondents for members of the same household and that health interview surveys are accurate for data collection of well defined chronic conditions.