3rd Mo Research Articles

Rehabilitation care for pain in elderly knee replacement patients.

Total knee arthroplasty (TKA) is recognized as the most effective surgical intervention for relieving pain and improving joint mobility and deformity in patients with knee osteoarthritis and other synovial diseases. The application of accelerated postoperative rehabilitation (enhanced recovery after surgery) has demonstrated its efficacy in improving patient outcomes, and early postoperative joint function exercise has become a key prognostic factor in knee replacement. The unexpected appearance of limb pain and swelling hindered the patient's tendency for early mobilization, leading in prolonged hospitalization, delayed functional recovery and negative psychological responses. To investigate the impact of incorporating programmed pain nursing with collaborative nursing on elderly patients undergoing knee replacement surgery. A retrospective analysis was conducted on a cohort of 116 patients who underwent TKA at our hospital between July 2019 and July 2021. The patients were divided into two groups: A control group (n = 58) receiving programmatic nursing, and an observed group (n = 58) receiving programmed nursing combined with a collaborative nursing model. A pain management team consisting of attending physicians, head nurses, and responsible nurses was established. Outcome measures included visual analogue scale (VAS) scores, activities of daily living (ADL) scale scores, and functional scores. The ADL scores of patients in both groups exhibited a continuous increase. However, there was no statistically significant difference in the ADL scores between the two groups at 48 h and the 7th d post-surgery (P > 0.05). Upon reexamination at the 3rd mo, the observation group demonstrated higher ADL scores compared to the control group (67.48 ± 14.69 vs 59.40 ± 16.06, P < 0.05). The VAS scores of both groups significantly decreased, with no significant difference observed between the groups at each time point (P > 0.05). The functional status of patients in both groups exhibited a gradual increase prior to intervention and at the 1st, 2nd, and 3rd month following discharge (P < 0.05). There was no statistically significant difference in knee joint function scores between the two groups at the 1st month after discharge (47.52 vs 45.81, P > 0.05). However, the knee joint function scores of patients in the observation group were significantly higher than those in the control group at the 2nd (59.38 vs 53.19, P < 0.05) and 3rd month (71.92 vs 64.34, P < 0.05) following discharge. The utilization of programmed pain nursing in conjunction with collaborative nursing for out-of-hospital care of TKA patients has demonstrated favorable outcomes, encompassing pain reduction, enhanced prognosis, and improved nursing quality for patients.

Percutaneous Pain Procedures in Patients Who Underwent Lumbar Disc Herniation Surgery: Is It an Important Tool in the Management of Post-Surgical Ongoing Pain?

Treatment of ongoing pain in patients undergoing disc surgery is extremely difficult, and there is no consensus. Our study aimed to evaluate the efficacy of percutaneous pain interventions in these patients. We retrospectively analyzed 48 patients with persistent / recurring complaints who underwent lumbar disc surgery (LDS) and were treated with percutaneous interventions. They were grouped into recurrent disc herniations (RDHs) and other discovertebral pathologies (ODVP). Moreover, patients were evaluated as those who received transforaminal injection (TFI) with facet blockage (FB) and who received both caudal injection (CI) and TFI in addition to FB. Patients were evaluated using Oswestry Disability Index (ODI) and visual analog scale (VAS). Between the recurrent and ODVP groups, preoperative, 1 h postoperative, and 6 mo postoperative ODI (p = 0.867, p = 0.055, p = 0.892) and VAS (p = 0.902, p = 0.136, p = 0.462) scores did not show a statistically significant difference, respectively. Additionally, in the comparison of patients who underwent FB+TFI+CI and only FB+TFI, there was no statistically significant correlation between preoperative and 6 mo postoperative ODI (p = 0.284) and VAS (p = 0.248) scores in both recurrent and ODVP groups, respectively. The success rates at the 3rd and 6th mo of patients with RDH and ODVP were 47.61% (10/21) and 42.85% (9/21) and 70.37% (19/27) and 63.96% (17/27), respectively. There was no statistically significant difference in ODI and VAS scores between recurrent and ODVP groups. The clinical success rate was numerically better in the ODVP group. Thus, we suggest that co-administration of TFI and CI did not significantly contribute to our clinical outcome.

Antiandrogenic treatment of obsessive compulsive neurosis: A case review

IntroductionObsessive-compulsive disorder (OCD) is a mental disorder in which patients who suffer from it have repetitive and undesirable thoughts, feelings, ideas, sensations (obsessions) and behaviors that drive them to do something over and over again (compulsions).Often the person tries to get rid of the obsessive thoughts through compulsions, but this only provides short-term relief. Not carrying out the obsessive rituals can cause enormous anxiety and suffering.ObjectivesTo describe a 23-year-old male patient, who suffers from anxiety and mood symptoms, reacts to ego-dystonic obsessive ideas and sexual content, of months of evolution, and who manages to calm down through compulsive masturbation or watching sexual videos on the internet. All this clinic negatively interferes with their quality of life, asking the patient for medical help to calm these ideas.MethodsWe carried out a review in Pubmed with the terms Antiandrogens and TOC, in order to make a better description of the clinical case.ResultsAfter several treatment attempts (Sertraline, Paroxetine, Clomipramine, Clomipramine + SSRI), reaching maximum doses according to clinical guidelines, and with poor therapeutic response, it was decided to discuss the case with the endocrinology department of our hospital, deciding to start treatment with antiandrogens, in order to alleviate the persistent intrusive ideas of a sexual nature. The administration of antiandrogens in men can cause a decrease or increase in the development or involution of secondary sexual characteristics in men, reducing the activity or function of accessory sexual organs, and hyposexuality, with decreased sexual desire or libido.After several weeks, there was improvement in the obsessive symptoms with a decrease in compulsive rituals. However, after the 3rd mo, some symptoms reappeared, but not with the same severity and intensity as before treatment. In addition, we cannot ignore the adverse effects that have occurred, such as involution of secondary sexual characteristics. However, and taking into account the negative repercussion that this clinic had on the patient’s quality of life, the benefit obtained exceeded the risk, having noted clear improvement with this therapy, and maintaining evolutionary controls by both psychiatry and endocrinology.ConclusionsPatients suffering from obsessive-compulsive disorder can be effectively treated with anti-androgenic pharmacological agents with various modes of action. The most effective group of such agents is the long-acting analogues of the gonadotropin-releasing hormone. The objective of this review is to elucidate the possibility of using such powerful anti-androgenic agents in the treatment of obsessive-compulsive disorder.Disclosure of InterestNone Declared

Clinical Observation of the Effect of Erbium-Doped Yttrium Aluminium Garnet Laser on the Treatment of Pit and Fissure in Children

To apply erbium-doped yttrium aluminium garnet laser to the closure of young permanent teeth and pits, compare the total retention rate of sealants, and discuss whether erbium-doped yttrium aluminium garnet laser is suitable for clinical treatment in children. Sixty children with 6-9 y old and bilateral mandibular first molars with complicated sulcus were randomly divided into two groups: A and B. The self-half control method was used: group A children’s control side test teeth application of corundum The enamel was performed by enamel, acid etching, coating pit and fissure sealant, erbium-doped yttrium aluminium garnet laser enameloplasty was applied to the contralateral test teeth and pit and fissure sealant was applied; group B children’s control side test teeth were treated with group A. The contralateral test teeth were treated with erbium-doped yttrium aluminium garnet laser enameloplasty, acid etching, and coating pit and fissure sealant. The children were scored for treatment after surgery, and regular follow-up was performed to observe the retention of the sealant. 63.3 % of the children tested were willing to take the initiative to choose laser treatment. At the 3rd and 6th mo of follow-up, there was no significant difference in the total retention rate of the two groups of sealants (p>0.05); at the 12th and 18th mos of followup, the total retention rate of the sealant materials: laser+etchant group>traditional bur. The difference between the needle group and the laser group was statistically significant (p<0.05). Laser is a more acceptable treatment for children. Erbium-doped yttrium aluminium garnet laser is used in the formation of permanent enamel. It needs to be combined with acid etchant to enhance the retention of the sealant.

Late complications of pancreas transplant.

To summarize the long-term complications after pancreas transplantation that affect graft function, a literature search was carried out on the long-term complications of pancreatic transplantation, namely, complications from postoperative 3rd mo onwards, in terms of loss of graft function, late infection and vascular complications as pseudoaneurysms. The most relevant reviews and studies were selected to obtain the current evidence on these topics. The definition of graft failure varies among different studies, so it is difficult to evaluate, a standardized definition is of utmost importance to know the magnitude of the problem in all worldwide series. Chronic rejection is the main cause of long-term graft failure, occurring in 10% of patients. From the 3rd mo of transplantation onwards, the main risk factor for late infections is immunosuppression, and patients have opportunistic infections like: Cytomegalovirus, hepatitis B and C viruses, Epstein-Barr virus and varicella-zoster virus; opportunistic bacteria, reactivation of latent infections as tuberculosis or fungal infections. Complete preoperative studies and serological tests should be made in all recipients to avoid these infections, adding perioperative prophylactic treatments when indicated. Pseudoaneurysm are uncommon, but one of the main causes of late bleeding, which can be fatal. The treatment should be performed with radiological endovascular approaches or open surgery in case of failure. Despite all therapeutic options for the complications mentioned above, transplantectomy is a necessary option in approximately 50% of relaparotomies, especially in life-threatening complications. Late complications in pancreatic transplantation threatens long-term graft function. An exhaustive follow-up as well as a correct immunosuppression protocol are necessary for prevention.

COMPARATIVE STUDY BETWEEN THE EFFECT OF HISTAMINE RECEPTOR ANTAGONISTS OF TYPE II (FAMOTIDINE) AND PROTON PUMP INHIBITORS (OMEPRAZOLE) ON THE EFFICACY OF CALCIUM CARBONATE AS PHOSPHATE BINDER IN HAEMODIALYSIS PATIENT

Objective: The purpose of this study was to compare the effect of famotidine versus omeprazole on the efficacy of calcium carbonate as a phosphate binder in the hemodialysis patient.Methods: From February 2014 to June 2014 a total number of 64 patients of both sexes were recruited from the department of renal dialysis, Tanta University Hospital, Egypt. Patients categorized into 3 groups. Group I (control group) consisted of 20 Patients (10) females and (10) males take calcium carbonate (caco3) (2.5–4 g/d) only, Group II consisted of 21 Patients (13) females and (8) males take the same dose of caco3 with famotidine 10 mg/d and Group III consisted of 23 Patients (8) females and (15) male take the same dose caco3 with omeprazole 20 mg/d.Results: All data are expressed as the mean±SD. Group II showed a significant increase (p&lt;0.05) in serum phosphorus at 3rd mo with significant decreased (p&lt;0.05) in serum calcium comparing with pre-treatment. Group III showed no significant change (p&gt;0.05) in serum calcium, phosphorus and parathyroid hormone (PTH) comparing with pre-treatment. Both groups (II and III) showed a significant decrease in alkaline phosphatase (ALP) (p&lt;0.05).Conclusion: Co-administration of famotidine with calcium carbonate aggravates hyperphosphatemia and this may increase the incidence of complications. The efficacy of calcium carbonate as a phosphate binder was not affected by co-administration of omeprazole.

Impact of a pre- and postoperative chemotherapy (Ctx) on overall survival (OS) and progression free survival (PFS) in locally advanced gastric cancer (LAGC).

156 Background: Perioperative Ctx has become standard of care for LAGC. Duration of pre- and post-op Ctx is a matter of debate. Our study evaluated effects of varying durations of pre- and post-op Ctx on PFS and OS. Secondary endpoints were toxicity, reasons for cessation of Ctx and response. We compared the outcome to a group of pts receiving no perioperative Ctx as an internal control. Methods: Pts with LAGC were included in a prospective cohort trial from a single institution from 2007 to 2015. Inclusion criteria were T1-T4, N0-3, M0, AEG (n=27) or gastric cancers (n=65). Initial therapy decisions were made by an interdisciplinary tumor board for all pts. Pts received DDP/5-FU (qw d28 mod FFCD-Protocol, Ychou et al. JCO 2011) for 2 mo, and a 3rd mo of pre-op Ctx in case of non-progression after 2 mo and proceeded to Ctx after surgery for a planned total of six mo of Ctx. Results: 92 pts (53 m; 39 f pts) with a median age of 69 ys (range 33-96) were included. A total of 74 pts were recommended periop Ctx and 18 primary surgery (S). A total of 67 (91%) of the periop Ctx received pre-op Ctx (NA) of which 47 (64%) received 3 mo of pre-op Ctx, 19 (26%) two mo, 1 pt (1%) one mo, and 7 pts refused preop Ctx (9%) of which only 3 proceeded to surgery. Only 53 pts (72 %) received post-op Ctx; 25 pts (34%) received three mo, 9 pts (12 %) two mo, and another 10 pts (14 %) one mo of postop Ctx. Nine pts (13%) in the NA group and 20 pts (39%) in the post-op Ctx group had to stop Ctx due to toxicity after 1 (n=11) and &lt;2 (n=9) mo of Ctx. Only 23 pts (31%) received the planned pre- and postop Ctx of 6 mo in total. Up to 07/2016 a total of 36 deaths were observed (39%). 5 yr PFS was 49% in the group of periop Ctx vs 14% in the S group. PFS in pts receiving a total of &lt; 4 mo of Ctx was 36% vs. 61% in pts receiving 6 mo of Ctx. 3 yr OS was 19% in the S group vs 48% in the Ctx group. The OS in pts receiving &lt; 4 mo was 34% vs.43% in pts with 6 mo Ctx. A pCR after preop Ctx was observed in 2 pts, a PR in 47 pts, a SD in 12 pts, while a PD occurred in 3 pts only. Conclusions: Pre-op Ctx was considerably better tolerated than post-op Ctx and led to fewer Tx cessations. We found a better PFS for pts with &gt;4 mo of periop Ctx, as well as OS was affected by a shorter duration of periop Ctx.

MRNA-transfected dendritic cell vaccine in combination with metronomic cyclophosphamide as treatment for patients with advanced malignant melanoma

ABSTRACTIntroduction: Vaccination with dendritic cells (DCs) has generally not fulfilled its promise in cancer immunotherapy due to ineffective translation of immune responses into clinical responses. A proposed reason for this is intrinsic immune regulatory mechanisms, such as regulatory T cells (Tregs). A metronomic regimen of cyclophosphamide (mCy) has been shown to selectively deplete Tregs. To test this in a clinical setting, we conducted a phase I trial to evaluate the feasibility and safety of vaccination with DCs transfected with mRNA in combination with mCy in patients with metastatic malignant melanoma (MM). In addition, clinical and immunological effect of the treatment was evaluated.Experimental design: Twenty-two patients were enrolled and treated with six cycles of cyclophosphamide 50 mg orally bi-daily for a week every second week (day 1–7). During the six cycles patients received at least 5 × 106 autologous DCs administered by intradermal (i.d.) injection in the week without chemotherapy. Patients were evaluated 12 and 27 weeks and every 3rd mo thereafter with CT scans according to RECIST 1.0. Blood samples for immune monitoring were collected at baseline, at the time of 4th and 6th vaccines. Immune monitoring consisted of IFNγ ELISpot assay, proliferation assay, and flow cytometry for enumeration of immune cell subsets.Results: Toxicity was manageable. Eighteen patients were evaluable after six cycles. Of these, nine patients had progressive disease as best response and nine patients achieved stable disease. In three patients minor tumor regression was observed. By IFNγ ELISpot and proliferation assay immune responses were seen in 6/17 and 4/17 patients, respectively; however, no correlation with clinical response was found. The percentage of Tregs was unchanged during treatment.Conclusion: Treatment with autologous DCs transfected with mRNA in combination with mCy was feasible and safe. Importantly, mCy did not alter the percentage of Tregs in our patient cohort. There was an indication of clinical benefit; however, more knowledge is needed in order for DCs to be exploited as a therapeutic option.

Comparement of anterior cervical discectomy fusion techniques: bladed and non bladed peek cages

The aim of this study is to compare the different types of fusion materials known as PEEK cages used during anterior cervical discectomy (ACD) surgery. A total of 67 patients were operated and evaluated retrospectively under two groups (group A: 35 PEEK cage patients, group B: 32 bladed PEEK cage patients) between 2009 and 2013. Preoperative and postoperative (postoperative first day, postoperative 1st, 3rd and 12-24th mo) images were obtained. The cervical disc heights, cervical and segmental lordotic angles of the operated levels were calculated. Pain assessment was performed and fusion rates were also compared. Mann-Whitney U test was applied to compare the outcomes. The pain scores (especially for arm pain) were decreased significantly in both groups after surgery regardless of the type of operation technique (P < 0.05). There were no significant differences between both groups at the disc height measurements of operated levels in postoperative periods (P > 0.05). In addition to these; there was no significant difference between both groups of segmental and cervical lordodic angles in postoperative periods (P > 0.05). There was no statistically significant difference between the fusion rates and pain scores of both groups (P > 0.05). The PEEK cage and bladed PEEK cages can be used safely to obtain fusion after ACD.

AB1172 Safety and efficacy of a 12-MO canakinumab administration in patients with systemic juvenile idiopathic arthritis: Data from the greek national registry

BackgroundTargeted treatments are becoming the mainstay for many autoinflammatory diseases, including the systemic juvenile idiopathic arthritis (sJIA). Canakinumab (CAB), a fully human anti-interleukin-1β (IL-1β) antibody, has recently been shown to...

Selective estrogen receptor modulator promotes weight loss in ovariectomized female rhesus monkeys (Macaca mulatta) by decreasing food intake and increasing activity

The effect of hormone replacement therapy (HRT) on body weight in postmenopausal women is controversial, with studies reporting an increase, a decrease, and no change in body weight. To examine estrogen receptor actions on body weight, we investigated the effects of treatment with a selective estrogen receptor modulator (SERM) on body weight, food intake, and activity and metabolic rate in a nonhuman primate model. Eighteen ovariectomized female rhesus monkeys were treated with a nonsteroidal SERM (GSK232802A, 5 mg/kg po) for 3 mo. GSK232802A decreased lutenizing hormone (P < 0.0001) and follicle-stimulating hormone levels (P < 0.0001), consistent with the estrogenic action of the compound. GSK232802A treatment produced a small but sustained weight loss (4.6 ± 1.0%, P < 0.0001) and reduced adiposity (P < 0.0001), which was due at least in part to a suppression of food intake (3.6 ± 3.7%, P < 0.0001). Physical activity increased during the 3rd mo of treatment (P = 0.04). Baseline activity level and the change in activity due to treatment were correlated, with the most sedentary individuals exhibiting increased physical activity during the 1st mo of treatment (P = 0.02). Metabolic rate did not change (P = 0.58). These results indicate that GSK232802A treatment reduces body weight and adiposity in ovariectomized nonhuman primates by suppressing food intake and increasing activity, particularly in the most sedentary individuals. These findings suggest that SERM treatment may counteract weight gain in postmenopausal women.

Effects of Calisthenics and Pilates Exercises on Coordination and Proprioception in Adult Women: A Randomized Controlled Trial

To assess and compare the effects of 6 mo of Pilates and calisthenics on multijoint coordination and proprioception of the lower limbs at the 3rd and 6th mo of training. Randomized, controlled, assessor-blinded, repeated-measures. University research laboratory. Healthy, sedentary, female participants age 25-50 y were recruited and randomly divided into 3 groups: a calisthenic exercise group (n = 34, mean age ± SD 40 ± 8 y, body-mass index [BMI] 31.04 ± 4.83 kg/m2), a Pilates exercise group (n = 32, mean age ± SD 37 ± 8 y, BMI 31.04 ± 4.83 kg/m2), and a control group (n = 41, mean age ± SD 41 ± 7 y, BMI 27.09 ± 4.77 kg/m2). The calisthenics and Pilates groups underwent related training programs for 6 mo, while the controls had no specific training. Coordination and proprioception of the lower extremities with concentric and eccentric performances in the closed kinetic chain assessed with the monitored rehab functional squat system at baseline and at the 3rd and 6th mo of training. For the within-group comparison, coordinative concentric and eccentric deviation values were significantly decreased for both dominant and nondominant lower limbs at pretraining and at the 3rd and 6th mo posttraining in the calisthenics group (P < .05). In contrast, there was no improvement in the Pilates group throughout the training. However, for comparisons between groups, the baseline values of coordinative concentric and eccentric deviations were different in the calisthenics group than in Pilates and the controls (P < .05). There were no differences in the proprioception values of either visible or nonvisible movement in any group throughout the training (P > .05). It seems that calisthenic exercises are more likely to improve coordination of the lower extremity after 3 and 6 mo of training than Pilates exercises. Calisthenic exercises may be useful for individuals who require improved coordination.

Experimental estrogen-induced hyperprolactinemia results in bone-related hearing loss in the guinea pig

Our group (Horner KC, Guieu R, Magnan J, Chays A, Cazals Y. Neuropsychopharmacology 26: 135-138, 2002) has earlier described hyperprolactinemia in some patients presenting inner ear dysfunction. However, in that study, it was not possible to determine whether hyperprolactinemia was a cause or an effect of the symptoms. To investigate the effect of hyperprolactinemia on inner ear function, we first developed a model of hyperprolactinemia in estrogen-primed Fischer 344 rats and then performed functional studies on pigmented guinea pigs. Hyperprolactinemia induced, after 2 mo, a hearing loss of approximately 30-40 dB across all frequencies, as indicated by the compound action potential audiogram. During the 3rd mo, the hearing loss continued to deteriorate. The threshold shifts were more substantial in males than in females. Observations under a dissection microscope revealed bone dysmorphology of the bulla and the cochlea. Light microscopy observations of cryostat sections confirmed bone-related pathology of the bony cochlear bulla and the cochlear wall and revealed morphopathology of the stria vascularis and spiral ligament. Scanning electron microscopy revealed loss of hair cells and stereocilia damage, in particular in the upper three cochlear turns and the two outermost hair cell rows. The data provide the first evidence of otic capsule and hair cell pathology associated with estrogen-induced prolonged hyperprolactinemia and suggest that conditions such as pregnancy, anti-psychotic drug treatment, aging, and/or stress might lead to similar ear dysfunctions.

Effect of a Fermented Formula on Thymus Size and Stool pH in Healthy Term Infants

To investigate the effects of fermented formula (FF) with Bifidobacterium breve C50 and Streptococcus thermophilus 065 on thymus size and stool pH of healthy term infants, ultrasound examinations and evaluations of thymus sizes and thymus indices (TI) and measurements of stool pH were performed in the same 90 term neonates on the 3rd d of life and on the 1st, 2nd, 3rd, and 4th mo of life. Thirty newborns were exclusively breast-fed while the remaining 60 were randomly assigned to receive either a FF or a standard formula (SF). The fecal pH of the breast-fed group was lower than the SF group (p < 0.05), although it was similar to that of the FF group on the third postnatal day, persisting for the entire 4 mo of the study. The difference in TI was statistically significant over repeated measurements among the groups. The FF infants showed a TI similar to the breast-fed newborns. Probiotic fermentation products have effects comparable to those of the bacteria composing the intestinal microflora supporting the idea that intestinal bacterial balance plays an important role in improving host immune responses.

Effect of Breathwalk on body composition, metabolic and mood state in chronic hepatitis C patients with insulin resistance syndrome

To identify the anthropometric, metabolic and mood state in hepatitis C virus (HCV)-infected patients from the west of Mexico and to evaluate the effect of Breathwalk (BW), a combination of walking, synchronized breathing and focussed attention, on those patients. In an experimental study, 17 patients with serological and molecular diagnosis of HCV, not receiving pharmacological treatment, were studied. One hour sessions of BW were practiced 3 times at week for six months. Body composition was assessed by electric impedance. Biochemical profiles and insulin resistance (IR) risk was assessed by conventional methods. Mood state was evaluated with specific and open questions at the beginning and at the end of the program. Seventy percent of patients were overweight or obese, and 77% of the patients presented with IR at the beginning of the study. Improvements were observed at the 3rd mo, and statistically significant differences were recorded at the 6th mo using the fitness score (76 vs 83, P < 0.01), in alanine aminotransferase (ALT) (106 +/- 93 U/L vs 59 +/- 32 U/L, P < 0.01), total bilirubin (0.09 +/- 1 mg/dL vs 0.62 +/- 0.2 mg/dL, P < 0.01), ALT/AST ratio (1.04 vs 0.70, P < 0.01), triglycerides (165 +/- 86 mg/dL vs 124 +/- 49 mg/dL, P < 0.01) and the IR risk (4.0 vs 2.7). Most patients (88%) indicated to feel better at the end of BW (P < 0.01). Breathwalk has an important effect on body composition, lipid profile and liver enzymes. It is also easy, inexpensive and has a beneficial effect on metabolic and mood state in HCV patients.

Spontaneous rupture of a hepatic hydatıd cyst into the peritoneum causing only mild abdominal pain: A case report

Hydatid disease is an endemic disease in certain areas of the world. It is located mostly in the liver. Spontaneous rupture of the hydatid cyst into the peritoneum is a rare condition, which is accompanied by serious morbidity and mortality generally. We present herein a case with a spontaneous rupture of a hepatic hidatid disease into the peritoneum without any serious symptoms. A 15-year-old boy was admitted to the emergency room with a mild abdominal pain lasting for a day. Physical examination revealed only mild abdominal tenderness. There was no history of trauma or complaints related to hydatid diseases. Ultrasonography showed a large amount of free fluid and a cystic lesion with irregular borders in the liver. He was operated on. Postoperative albendazol therapy was given for 2 mo. No recurrence or secondary hydatidosis was seen on CT investigation in the 3rd, 6th and 12th mo following surgery.

Characterization of the growth hormone receptor in human dermal fibroblasts and liver during development.

Human tissues express growth hormone receptors (hGHR) by the 3rd mo of gestation. We assessed developmental changes in hGHR function in fibroblasts and liver, testing binding and hormonal response. Fetal cells showed low but reproducible hGH binding. No age-related changes occurred in fibroblasts (9 wk-34 yr). In contrast, there was a fourfold increase in hGH binding in postnatal liver, with a sixfold increase in hGHR mRNA. Both full-length and truncated hGHR mRNAs were detected in all livers. Cross-linking revealed a larger hGH/receptor complex in fetal liver. Fetal hepatocytes produced 10 times more insulin-like growth factor (IGF)-II than IGF-I, and responded to hGH (150 ng/ml) with a significant increase in IGF-II. Fetal hepatocytes secreted three IGF-binding proteins (IGFBPs), including IGFBP1, but not IGFBP3. hGH did not alter fetal hepatocyte IGFBPs but stimulated glucose uptake. Exposure of fibroblasts to hGH decreased hGH binding only in >1-yr postnatal fibroblasts, whereas treatment with dexamethasone (100-400 nM) increased binding only in postnatal cells. Thus, although fetal hepatocytes and fibroblasts possess functional hGHR, these receptors (and/or their signaling pathways) are immature or have adapted to the in utero environment.

Increase in Milk Yield of Commercial Dairy Herds Fed a Microbial and Enzyme Supplement

A microbial and enzyme supplement fed at 21.2 g/d per cow to 46 Virginia dairy herds increased the milk yield of 31 herds (17 significantly) and decreased the milk yield of 15 herds (7 significantly). Effects of season were important but consistent with overall results. Herds began receiving the supplement, which contained dried fermentation products of Aspergillus oryzae, Bacillus subtilis, Lactobacillus acidophilus, and yeast culture, midway between the first and second monthly Dairy Herd Improvement tests and continued on the supplement through the 3rd mo. Entry of herds was staggered over 8 mo to reduce the influence of season. The trial involved 3417 cows with 5 test mo between 60 and 365 d in milk. Milk yield during mo 3 averaged 0.64 kg/d per cow more (+0.73 kg/d for first lactation cows and +0.56 kg/d for later lactation cows) than the mean milk yield during mo 1 and 5. Herds completing the study before summer responded similarly to all other herds, which included herds that were fed the product during summer and those that finished the study during summer. Fat and protein yields and protein percentage differed little with or without the supplement. Fat percentage decreased (0.10%). Twenty-one herds that were fed a yeast product prior to and during the study responded similarly to the 17 herds that were not fed a yeast product.

Helicobacter pylori acquisition in infancy after decline of maternal passive immunity.

We evaluated the natural history of Helicobacter pylori infection and the host immune response in 80 infants, and determined seroprevalence of H. pylori infection in their Taiwanese mothers. Decline in passively transferred maternal anti-H. pylori IgG antibodies and subsequent H. pylori infection was assessed in infants over 14 mo. A sensitive and specific, 96-well microtiter ELISA for the detection of H. pylori IgG antibodies was used to evaluate maternal serum (single specimen) and their infants (birth, 1, 2, 3, 6, 12, and 14 mo). Sera were also evaluated by ELISA for the presence of anti-H. pylori IgM antibodies in the infants. Maternal H. pylori IgG seroprevalence was 62.5% [50/80; 95% confidence intervals (CI), 51-73%]. All infants born to the 50 seropositive mothers passively acquired maternal H. pylori IgG. Transplacentally transferred maternal anti-H. pylori IgG lasted until about the 3rd mo of life, and disappeared in nearly all the infants by 6 mo of age. Seven and one-half percent of infants (6/80; 95% CI, 3-16%) acquired H. pylori infection; two were born to H. pylori-negative mothers. Among the six IgG seropositive infants, an IgM response specific for H. pylori antigens was detected and appeared to precede the rise in IgG in five. We conclude that maternal passive transfer of IgG antibodies occurs in the infant and disappears by 6 mo of age. H. pylori infection is acquired in infancy in this population; IgM antibodies against H. pylori are detectable, seem short-lived, and appear to precede IgG antibody development.

The Effect of Calfhood Diseases on Growth of Female Dairy Calves During the First 3 Months of Life in New York State

Our objective was to study the effects of pneumonia (cumulative incidence, 25%), diarrhea (29%), umbilical infection (14%), and umbilical hernia (15%) on BW and height gains during the first 3 mo of life. Female dairy calves (n = 410) born from January to December 1990 in 18 commercial herds in New York state were used. Average daily gains during the 1st, 2nd, and 3rd mo were 374, 596, and 719g, respectively; average gain was 565g during the 3-mo period. Average monthly height gains during the 1st, 2nd, and 3rd mo were 4.4, 5.6, and 5.7cm, respectively.Use of multiple linear regression, with farms treated as random effects, indicated that treated, verified pneumonia was associated with a reduction in average daily gain of 66g and that failure of passive transfer reduced average daily gain by 48g during the 1st mo. During the 2nd mo, neither disease nor failure of passive transfer affected average daily gain. During the 3rd mo, each additional week of pneumonia reduced average daily gain by 14g, and umbilical infection reduced average daily gain by 96g. Each additional week of diagnosed pneumonia reduced total BW gain during the first 3 mo by 0.8kg. Similarly, each week of pneumonia reduced total height gain by 0.2cm and failure of passive transfer by 0.9cm. Prevention of chronic pneumonia and umbilical infection may improve average daily gain of calves.