[Five case reports on granulosa cell tumors in cattle with practical information on diagnosis and possible progression]. / Fünf Fallberichte zum Granulosazelltumor beim Rind mit praktischen Hinweisen zur Diagnostik und zum möglichen Verlauf.

INTRODUCTION: Five cases of ovarian tumors (granulosa cell tumors) in cattle are presented from the patient load of the Vetsuisse University of Zurich and Bern. The aim of this work was to demonstrate the variable development of the illness and to indicate diagnostic and therapeutic possibilities to the practicing veterinarians. Case 1 shows bilateral appearance and the development of malignancy and metastases. The main symptoms in case 2 were the development of the mammary gland in a juvenile animal and the behavior modification due to a hormonal imbalance. The cases 3, 4 and 5 underwent surgery, case 4 restarted reproductive activity resulting in five subsequent pregnancies. The initial presumption is a result of a gynecological including ultrasonographic examination and can be verified by the analysis of Müllerian Inhibiting Hormone in serum. The decision to perform surgery should be done rapidly, as normal fertility can be achieved if the tumor is located unilaterally. Tumor growth and potential malignancy can provoke fatal health issues and also make it impossible to use meat of these animals for consumption.

INTRODUCTION: Cinq cas de tumeurs ovariennes (tumeurs des cellules de la granulosa) chez les bovins sont présentés à partir de la patientèle de l'Université Vetsuisse de Zurich et de Berne. Le but de ce travail était de montrer l'évolution variable de la maladie et d'indiquer les possibilités diagnostiques et thérapeutiques aux vétérinaires praticiens. Le cas 1 montre la possibilité d'une apparition bilatérale avec développement d'une tumeur maligne et de métastases. Les principaux symptômes du cas 2 étaient le développement de la glande mammaire chez un animal juvénile et la modification du comportement due à un déséquilibre hormonal. Les cas 3, 4 et 5 ont subi une intervention chirurgicale, le cas 4 a repris une activité de reproduction avec cinq gestations ultérieures. La présomption initiale résulte d'un examen gynécologique et peut être vérifiée par l'analyse de l'hormone anti-müllérienne dans le sérum. La décision d'opérer doit être prise rapidement, car une intervention chirurgicale pour enlever l'ovaire atteint peut, dans l'idéal, permettre une reprise de l'activité de reproduction. La croissance de la tumeur et la malignité potentielle peuvent provoquer des problèmes de santé fatals et rendre la viande de ces animaux impropre à la consommation.

The effect of isosorbide dinitrate on uterine and ovarian blood flow in cycling and early pregnant mares: A pilot study.

Poor uterine perfusion has been proposed as a cause of infertility in mares. The objective of this study was to investigate the effect of isosorbide dinitrate (ISDN), a nitric oxide donor, on uterine and ovarian blood flow resistance during diestrus and early pregnancy in mares. Six Trotter mares, aged 7 to 14 years, were examined daily during the first 11 days of three diestrous periods, and five of those mares were also examined during the first 11 days of two pregnancies. Six mares randomly received a placebo, a low dose (30 mg, ISDN30), or a high dose of ISDN (60 mg, ISDN60) through three nonconsecutive cycles. The treatments were administered orally, every 12 hours from Day 1 to 11 of the cycle (Day 0 = ovulation). Five of the 6 mares received a placebo or 60 mg of ISDN orally every 12 hours from Day 1 to 11 of pregnancy. The mares were short cycled on Day 12 of each trial. Transrectal color Doppler was used to determine blood flow resistance semiquantitatively and expressed as pulsatility index. Mean pulsatility index of both uterine arteries combined and of the dominant (ipsilateral to the CL) ovarian artery was lower (treatment effects: P ≤ 0.01; time effects: P ≤ 0.002) in mares receiving 30 mg or 60 mg of ISDN compared with placebo-treated mares. Blood flow resistance in the dominant ovarian artery was lower in ISDN-treated pregnant mares than in placebo-treated pregnant and cycling mares (treatment effect: P = 0.04; time effect: P = 0.003). Isosorbide dinitrate increases uterine and ovarian perfusion in cycling mares and ovarian perfusion in early pregnant mares. Further studies are needed to investigate these effects in relation to fertility of the mare.

Quantitative analysis of fecal flora in goat kids with and without floppy kid syndrome.

BACKGROUND: Floppy kid syndrome (FKS) affects goat kids in the first month of life and is associated with high morbidity and mortality rates. The condition is characterized by neurological signs that can be ascribed to increased plasma D-lactate concentrations. The source of D-lactate has not been identified conclusively, but D-lactate-producing bacteria in the large intestine are thought to be involved. OBJECTIVES: To determine the number of colony-forming unit (CFUs) of certain groups of bacteria in the feces of kids with and without FKS. ANIMALS: Nineteen goat kids with clinical signs of FKS, acidemia (pH ≤ 7.2), and plasma D-lactate concentration >7 mM and 15 healthy goat kids without acidemia (pH >7.2) and D-lactate concentration <1 mM. METHODS: In this case-control study, the goat kids were examined clinically and blood was collected to measure D-lactate concentration, blood gases, and acid-base parameters. Fecal samples were collected and the total aerobic bacterial count and CFU counts of coliforms, enterococci, staphylococci, streptococci, lactobacilli, and clostridia were determined using the surface plating method. RESULTS: Goat kids with FKS had a mean plasma D-lactate concentration of 10.9 ± 3.7 mM compared with 0.3 ± 0.9 mM in healthy kids, and significantly greater CFU counts for enterococci, streptococci, staphylococci, and lactobacilli than healthy kids. CONCLUSIONS AND CLINICAL IMPORTANCE: The groups of bacteria present in greater numbers in the feces of goat kids with FKS include several D-lactate-producing species, which makes dysbacteriosis a likely cause of the increased plasma D-lactate concentration in FKS.

Balling gun-induced trauma in cattle: clinical presentation, diagnosis and prevention.

Pharyngeal trauma in cattle can occur during the administration of oral medication using a balling gun. The number of cases of severe complications due to bolus application that have been referred to our hospital has increased from nil between 1996 and 2008 to three or four per year. In our experience, reports by bovine veterinarians of patients with severe and often fatal pharyngeal trauma, which were not referred to the clinic, have become more common in recent years as well. The incidence of this complication is likely to be higher than this number of referrals suggests. Diagnosis without the help of imaging techniques, such as radiography and endoscopy, may be difficult, especially in cases where exploration of the pharynx cannot be carried out, or is unable to confirm the absence or presence of a lesion. Prognosis is often poor in cases where perforation has been confirmed. Boluses are increasingly administered by the owners or farm personnel without the supervision of a veterinarian. In order to prevent losses due to balling gun-induced injuries, the veterinarian plays a crucial role in giving advice to his clients. Five cases of cattle suffering from varying degrees of balling gun-induced trauma are presented, and consideration is given to incorrect application techniques.

[The use of the Epidemiology Cancer registry Baden-Württemberg in the follow-up of the EPIC cohort]. / Nutzung des Epidemiologischen Krebsregisters Baden-Württemberg bei der Nachbeobachtung der EPIC-Kohorte.

The European Prospective Investigation into Cancer and Nutrition (EPIC) is a prospective multicentre study that has been implemented to further the understanding of the association between diet and chronic diseases with emphasis on cancer. In Heidelberg from June 1994 until October 1998 about 25,500 subjects aged 35 to 65 years in women and 40 to 65 years in men were recruited. Apart from extensive questions about food intake, the participants were also asked to provide detailed information about their smoking habits, physical activity, subjective well-being, medical history and use of medications. As well as completing the questionnaire and a personal interview, the participants also gave blood samples and anthropometiric measures and the blood pressure were taken in standardized manner. The analyses of the EPIC study will depend on achieving a comprehensive record of all new cancer cases, and all deaths, together with the corresponding cause of death, within the study population. To date all self-reported incident cancer cases are verified by comparing them with pathology reports and hospital records. They are then coded according to the coding list for the International Classification of Diseases (ICD-O2) issued by the World Health Organisation (WHO). Since at begin of the investigation in the study region no cancer registration existed, the participants are followed -up by interval questioning ('active follow-up'). In order to integrate increasingly the data of the Cancer registry Baden-Württemberg (EKR-BW) attempts were made to explore record linkage systems. For this purpose, in the years 2000, 2002, 2003 record linkages between EPIC-Heidelberg and EKR-BW were performed. Procedures were evaluated for performing an anonymous linkage of the EPIC data with the data of the EKR-BW. After a pilot project on the feasibility of the linkage the program was evaluated on the EPIC data, record linkages are performed regularly. Different coding systems were applied. Simultaneously, the EPIC data about on cancer cases among the Heidelberg study participants are passed on to the Cancer Registry, thus contributing to improve completeness of the registry. So far the active follow-up can not be replaced by passive follow-up through record linkage with the cancer registry, but in the long-term it may be possible. Since the technical requirements are complied with, attempts should be made to improve the completeness of the epidemiological cancer registry Baden- Württemberg.

Bond-selective photodissociation of aliphatic disulfides.

The photochemistry of aliphatic disulfides is presented. The photolysis products are photoionized with coherent vacuum ultraviolet radiation and analyzed by time-of-flight mass spectrometry. With 248-nm excitation, the predominant dissociation pathway is S-S bond cleavage. With 193-nm excitation, S-S bond cleavage, C-S bond cleavage, and molecular rearrangements are all observed as primary processes. The branching ratio for S-S bond cleavage relative to C-S bond cleavage is typically 1-2 orders of magnitude greater at 248 run than 193 run. This wavelength dependence cannot be explained readily by photodissociation from the ground electronic state. The ground state S-S bond energy, ∼ 280 kJ/mol, is much larger than the C-S bond energy, ∼ 235 kJ/mol. If dissociation occurred from the ground state, higher wavelength radiation would be expected to favor the lower energy process, but the opposite effect is observed. Thus, excited state photochemistry is indicated. These results are discussed with respect to the differences between low and high energy collision-induced dissociation of peptides that contain disulfide linkages and to the possibility of achieving bond-selective photodissociation of such ions.

Communication and level of AIDS knowledge among homeless African-American mothers and their children.

One hundred and thirty residents and their children from eight transitional living shelters in the midwest participated in a study designed to assess their level of knowledge about HIV/AIDS, concerns about susceptibility to the virus, patterns of general communication, and level of comfort in discussing sexual and HIV/AIDS related matters within the family unit. Overall, parents and children demonstrated significant misinformation about HIV/AIDS and did not perceive themselves as being at risk for contracting the virus. Parents who possessed more formal education were more knowledgeable about HIV/AIDS, sexuality, and reported greater levels of parent-child communication. Parents who possessed higher levels of self-esteem indicated that they discussed sexual topics with their children more than parents with lower levels of self-esteem and that when sexual matters were discussed the mother was the agent of communication.

Screening for gestational diabetes.

Traditionally, screening for gestational diabetes mellitus (GDM) has been done only for those women with identifiable risk factors. To determine the value of screening all pregnant women, 363 consecutive patients were tested for GDM using a glucose challenge test (GCT). The test measured plasma glucose 1 hour after administration of a 50-gram oral glucose load. Those patients with a plasma glucose greater than 140 mg/dL were given a standard 3-hour glucose tolerance test (GTT) using 100 g of oral glucose. Patients with risk factors were compared with those without risk factors. There was no significant difference between the two groups for number of abnormal 3-hour GTTs. We conclude that in order to identify GDM, all pregnant patients must be screened. Universal screening was found to be simple and cost effective.

The physiology of aging.

A knowledge of the physiology of aging is necessary in understanding the medical problems of the elderly. Far-reaching effects results from such diverse changes as increased density and decreased water content of connective tissue, reduced estrogen production, reduced respiratory ciliary function, diminished efficiency of the pulmonary macrophages and decreases in brain and renal mass.

Six-year experience with graded exercise testing in a model family practice office.

The Office for Family Practice began in-office graded exercise testing utilizing the Bruce or Balke protocol in March of 1978. Over the past six years approximately 275 graded exercise tests have been done. The purpose of this paper is to outline the indications, results, complications, and follow-up of those patients who have had graded exercise testing done in the office over this six-year period. These results demonstrate (1) the various indications and utilization of a treadmill machine in the family practice office setting, (2) the results of graded exercise testing and complications in those graded exercise tests done in the office in comparison with those reported in the literature done by other health care providers, and (3) the usefulness and applicability of graded exercise testing in the residency training and private practice setting. In addition to the above-collected data, the results of a questionnaire sent to former residents show the benefits of having training in graded exercise testing and also the applicability of this training in their practice settings. The results support the concept that graded exercise testing should be taught in the residency program and that this can be done both safely and effectively in the model office setting.

A wellness program model for family practice residency programs.

For some time health promotion and disease prevention have been expected tenets of medical practices with the public. However, the medical profession has only recently emphasized prevention and wellness promotion as required curricula for study at the undergraduate and graduate levels. Family physicians have been at the forefront in accepting this additional responsibility, but actual implementation of such practices has been difficult for the individual physician. To address this needed transitional step from public demand to practice, a wellness program for residents, faculty, staff, and patients was designed for the Family Practice Residency Program at Cheyenne.

Principles of managing the high-risk pregnant patient.

The family physician has opportunities for reducing perinatal morbidity and mortality. The potential for a high-risk pregnancy must be recognized. Important elements in the management of a high-risk pregnancy include determination of fetal age, ultrasound, estriol determination, contraction stress test, nonstress test, lecithin/sphingomyelin ratio and scalp blood pH measurement. Electronic fetal monitoring, including direct techniques, should be used in the course of labor.