Prevalence of childhood overweight/obesity in basic school in Accra

BACKGROUND

This study intends to determine the prevalence of obesity among children in the University Primary School, Legon. It also intends to determine relationship between the prevalence of obesity in children and socio-economic status of their parents and the most endemic age group.

METHOD

The study was conducted using 270 students sampled at random in the basic school. Children's height, weight and skin fold measurement were taken. Children's parent's socio-economic status was assessed using close and open-ended questionnaires administered to parents. Data obtained was then analyzed using SPSS software.

RESULTS

Prevalence of obesity in the university primary school was found to be 10.9% with higher prevalence in girls (15.0%) than in boys (7.2%) (P-value=0.001). There was higher prevalence among children from high socioeconomic background (21 - 23%) with least prevalence in those from low socio-economic homes (10 - 20%) though this was not significant (p-value=0.23). Girls showed a higher body fat composition between 10 - 12years, whiles boys showed higher body fat stores between 8 - 10 years old. Increasing mother educational level reduced prevalence of child obesity (p-value=0.043) but this was not seen in increasing fathers' educational level (p-value=0.261).

CONCLUSIONS

The prevalence of obesity in children in University primary school was very high and worrying. The prevalence increased with socio-economic status and it is more common in females than males. It was recommended that similar study should be expanded nationwide.

Sexual deprivation increases ethanol intake in Drosophila

The brain's reward systems reinforce behaviors required for species survival, including sex, food consumption, and social interaction. Drugs of abuse co-opt these neural pathways, which can lead to addiction. Here, we used Drosophila melanogaster to investigate the relationship between natural and drug rewards. In males, mating increased, whereas sexual deprivation reduced, neuropeptide F (NPF) levels. Activation or inhibition of the NPF system in turn reduced or enhanced ethanol preference. These results thus link sexual experience, NPF system activity, and ethanol consumption. Artificial activation of NPF neurons was in itself rewarding and precluded the ability of ethanol to act as a reward. We propose that activity of the NPF-NPF receptor axis represents the state of the fly reward system and modifies behavior accordingly.

Persistent hypokalaemia in a Jamaican hypertensive patient

We report the case of a 48-year old man with uncontrolled hypertension and persistent hypokalaemia from an aldosterone producing adrenal adenoma treated by laparoscopic adrenalectomy. Clinicians' identification of primary hyperaldosteronism is critical as the correct treatment results in improved blood pressure control and reduced risk of complications.

Inhibition of MT1-MMP activity using functional antibody fragments selected against its hemopexin domain

The membrane associated MMP, MT1-MMP, is a critical pericellular protease involved in tumour cell invasion and angiogenesis and is highly up-regulated in numerous human cancers. It therefore represents an exciting new therapeutic cancer-specific target. We have generated recombinant human scFv antibodies against the non-catalytic, hemopexin domain of MT1-MMP that modulate its interactions with collagen. One of these is an effective inhibitor of the invasive capacity of cancer cells and of angiogenesis in model systems. This demonstrates that targeting sites outside the catalytic domain presents a potential novel approach to proteinase inhibition that could have applications in cancer therapeutics.

First record of Anopheles albimanus from St Kitts

OBJECTIVE

Previous mosquito surveys performed in the Federation of St Kitts and Nevis identified Anopheles albimanus in Nevis but there is no recorded occurrence of this mosquito in St Kitts. To determine the presence of this and other species in St Kitts and Nevis, a mosquito survey was conducted.

METHODS

Surveys were performed in two phases--the dry season (March 16-23, 2010, in St Kitts), and the rainy season (October 18-25, 2010) in St Kitts and Nevis. BG Sentine mosquito traps baited with BG Lure and CO2 were set in a variety of habitats (urban, rural, semi-urban, dry forest and mangrove). Identification was performed using morphological keys.

RESULTS

The most abundant species during both phases were Culex quinquefasciatus, Aedes taeniorhynchus and Aedes aegypti. A new record for St Kitts was Anopheles albimanus which was trapped during the rainy season near a mangrove site.

CONCLUSION

This is the first time a potential malaria vector has been identified in St Kitts.

Trinidadian women's knowledge, perceptions, and preferences regarding cesarean section: How do they make choices?

Objectives

The objective of this study is to determine the awareness of perception and attitude toward cesarean section (CS) in a high-user setting.

Design and methods

A cross-sectional design using multistage sampling methods was used to select participants from antenatal and postnatal clinics in a primary health care setting in north Trinidad. A multi-item structured questionnaire was designed and administered by in-depth interviews. Sociodemographic data and data about history of previous pregnancies and outcomes and about knowledge and perceptions of CSs were collected from women aged 16 years and older.

Results

Of the women who were eligible for entry into the study, 368 participated. However, participants chose not to respond to some questions. The majority of women (46.2%) were found to have very little information from which to make informed decisions about selecting CS as the preferred choice of delivery. Their preference was significantly associated with the perception of safety (maternal or fetal death, P = 0.001), difficulty (complications to mother and baby, P = 0.001), and pain (P = 0.001). Notwithstanding, persons who received information from health care professionals (odds ratio [OR], 1.9; confidence interval, 1.50–2.33) were more likely to have high or adequate levels of information about CSs. Data were analyzed using SPSS software, and ORs were calculated using logistic regression.

Conclusion

The majority of women attending antenatal and postnatal clinics in north Trinidad were not sufficiently knowledgeable about CS to enable them to make informed choices. In addition, the information obtained was from an unreliable source, emphasizing the need for information on CS to form a component of a structured antenatal education program.

Forgotten intrauterine contraceptive device: a rare cause of infertility

Worldwide, Intra Uterine Devices (IUDs) are among the most commonly used reversible methods of contraception. This is particularly true in developing countries. Insertion of IUD may be interval or postpartum. The concept of early postpartum IUD insertion has been investigated since the 1960s and has become accepted worldwide, even though IUDs inserted in the immediate postpartum appear to have a higher expulsion rate. Several complications associated with IUD use have been documented, for instance, the association between IUD use and pelvic inflammatory disease or salpingitis has been demonstrated in several studies. Contamination at the time of insertion has been suggested to be responsible for this risk of infection. We report here an unusual case of early postpartum IUD insertion without the patient's knowledge or adequate counselling sixteen years prior to presentation with secondary infertility.

Evaluation of breed as a risk factor for sarcoid and uveitis in horses

The relationship between breed and the risk of developing sarcoid tumours or uveitis of unknown etiology was evaluated in a retrospective study of 16242 equine cases admitted between 1975 and 1987 to the New York State College of Veterinary Medicine Large Animal Hospital, and 3198 equine tissue samples sent to the New York State Veterinary Diagnostic Laboratory between 1977 and 1987. Of 120 sarcoid cases from the Large Animal Hospital, sarcoids were twice as likely to develop in Quarter Horses (odds ratio, OR = 1.8, P less than 0.05) relative to Thoroughbreds and less than half as likely to develop in Standardbreds (OR = 0.2, P less than 0.001) relative to Thoroughbreds. Similarly, of 376 sarcoid cases from the Diagnostic Laboratory, Quarter Horses had a significantly higher risk of developing sarcoid (OR = 2.0, P less than 0.001) relative to Thoroughbreds, while Standardbreds had a significantly lower risk of developing sarcoid (OR = 0.5, P less than 0.05) relative to Thoroughbreds. In the uveitis diagnosis category, Appaloosas had a significantly higher risk of developing uveitis (OR = 6.4, P less than 0.001) relative to Thoroughbreds, while Standardbreds had a significantly lower risk of developing uveitis (OR = 0.4, P less than 0.05) relative to Thoroughbreds.

A study on the coherence of compacted binary composites of microcrystalline cellulose and paracetamol

This paper describes and interprets the coherence and the tensile strength of bi-component compacted tablets, composing a mixture of a poorly compactable drug, paracetamol and a very cohesive and ductile carrier, microcrystalline cellulose (MCC), Avicel PH 102, using the concepts of the stored elastic strain in conjunction with the particle size and the relative volume fraction of the powders. Cylindrical compacts of the bi-component tablets, at various compositions formed at a common ultimate stress of 99 MPa, were subsequently fractured using the indirect tensile test method (Brazilian test method) to obtain a measure of their tensile strength. Various inter-relations between the compaction and tensile rupture characteristics are described. A simple model, which may predict the required volume fraction of MCC to produce a cohesively viable tablet is suggested, and applied to the current system. The results show to some extent the consistency of the suggested model with the experimental results.

Patterns of spread and persistence of foot-and-mouth disease types A, O and Asia-1 in Turkey: a meta-population approach

Despite significant control efforts, foot-and-mouth disease (FMD) persists in Turkey, and new strains of serotypes A, O and Asia-1 are periodically reported to enter the country from the east. The status of FMD in Turkey is important regionally because the country forms a natural bridge between Asia where the disease is endemic, and Europe which has disease-free status. This study analysed spatial and temporal patterns of FMD occurrence in Turkey to explore factors associated with the disease's persistence and spread. Annual records of FMD distribution in Turkish provinces throughout 1990-2002, grouped by serotype (O, A and Asia 1), were analysed using geostatistical techniques to explore their spatial and temporal patterns. A meta-population model was used to test how disease status, expressed in terms of presence/absence, extinction, and colonization, and measured at the province level throughout the periods 1990-1996 and 1997 2002, could be predicted using province-level data on: ruminant livestock numbers; meat production-demand discrepancy (as a surrogate measure of animal and animal products marketing, i.e. long-distance contagion through the traffic of mainly live animals to urban centres); and the disease prevalence distribution as recorded for the previous year. A drastic overall reduction in FMD occurrence was observed from the period 1990-1996 to 1997-2002 when the disease was shown to retract into persistence islands. FMD occurrence was associated with host abundance, short distance contagion from adjacent provinces, and meat production-demand discrepancies. With FMD retracting into identified provinces, a shift in predictors of FMD occurrence was observed with a lower contribution of short-distance contagion, and a relatively higher association with meat production-demand discrepancies leading to live animal transport over long distances, and hence presenting opportunities for identifying critical-control points. The pattern of persistence differed according to serotype groups and is discussed in relation to their differential affinity to cattle and small ruminant hosts.

How well do GP's and Hospital Consultants in Qatar Interacts? A Survey of the Professional Relationship

The study involved 196 participants, 83 (42.3%) of which were consultants and 113 (57.7%) were General Practitioners (GP's).

Background: The way that GP's and hospital consultants or specialists interact has important implications for any health care system in which a GP is the first contact health professional person for patients and the point of access to relatively scarce and expensive hospital services, for this reason, the relationship between the two main branches of the medical profession has received a considerable amount of interest.

Objectives: To test out some professional issues on a random sample of both parties to determine their ability to work together productively.

Methods: We conducted a lickert-style survey based upon statements made in qualitative questionnaire sent to GP's and specialists working at Hamad Medical Corporation and health centers in state of Qatar. The questionnaire was modified and validated during a multistage pilot and was distributed to a stratified random sample of 196 clinicians.

Results: GP's and consultants demonstrated a good level of agreement, mutual understanding and respect (Significant difference in opinion only in four statements out of 13).

Conclusion: The ability of GP's and specialists to work together has been tested out and confirmed with acceptable significance and it may be repeated to assess the relationship which is central to an efficient and effective operation of health care delivery.

Are the anticipated benefits of myomectomy achieved in women of reproductive age? A 5-year review of the results at a UK tertiary hospital

Fibroids are the most common benign tumours of the pelvis in women, with a prevalence estimated at 20-50%. They are more common towards the end of the reproductive years. There is a racial preponderance, being more common in black than white women. This may relate to the aetiology, which is still poorly understood. Generally, fibroids do not cause symptoms but some sufferers do complain about pressure symptoms, abnormal vaginal bleeding and infertility. For these reasons, myomectomy is often resorted to after failure of medical interventions on the premise that it brings about improvement/cure of symptoms and enhancement of fertility. However, the evidence for these indications for surgery is hazy. An analysis of the 109 medical records of symptomatic patients who had myomectomy over a 5-year period at a tertiary centre revealed the following. Single-symptom presentation in 41 (38%), menorrhagia in 20 (18%) being the most common. Only 52 (48%) patients had medical treatment of one form or another before myomectomy. Additional operative findings included pelvic adhesions, evidence of PID and endometriosis. Thirty-four (31%) had an estimated blood loss 500 ml and 23 of these patients needed blood transfusion. There were four cases of unscheduled hysterectomies due to uncontrollable bleeding. Pyrexia was the most common (38%) postoperative complication followed by superficial wound infection in 5%. We observed improvement of symptoms, assessed over a range of 2-24 months, in 34 cases (68%) in patients without fertility symptoms who accounted for 50 of these women. The symptomatic benefit was less (36%) in the 'infertility group'. Following an observation period of over 12-36 months, 17 patients in the 'infertility group' were lost to follow-up. Two (14%) of the 14 patients who attempted in vitro fertilisation (IVF) were successful. In the non-IVF group, 13 (46%) of the 28 achieved natural conception. These results suggest that symptomatic improvement and fertility enhancement may be possible in some patients with fibroids. In view of the risks and potential failure of treatment associated with myomectomy these results, yet again, support the fact that patients should be properly counselled before embarking on myomectomy and we strongly advocate local data to form the basis of the advice given during the consultation rather than what obtains in the literature.

Distribution and changes with age of nitric oxide synthase-immunoreactive nerves of the rat urinary bladder, ureter and in lumbosacral sensory neurons

In the distal parts of the urinary tract, nerves containing nitric oxide (NO) are either postganglionic parasympathetic nerves, with cell bodies in the major pelvic ganglia, or sensory nerves with cell bodies in the lumbosacral dorsal root ganglia. We have used indirect immunohistochemical techniques to examine the distribution and regional variation of nerves immunoreactive for neuronal nitric oxide synthase (NOS) in the urinary bladder, distal ureter and in neurons in lumbosacral dorsal root ganglia (L1-L2 & L6-S1) of young adult (3 months) and aged (24 months) male rats. Semi-quantitative estimations of nerve densities were made of NOS fibres innervating the dome, body and base of the urinary bladder and distal ureter. Quantitative studies were also used to examine the effects of age on the percentage of dorsal root ganglion neurons immunoreactive for NOS. The dome and the body regions, in both age groups, contained no NOS-immunoreactive axons. The bladder base and distal ureter in young adults showed sparse to moderate numbers of fibres immunoreactive to NOS within the urothelium and in the subepithelium and muscle coat. In the aged rat there were slight reductions in the densities of NOS-immunoreactive nerves in all three regions. In the lumbosacral dorsal root ganglia, the percentage of NOS-immunoreactive neuronal profiles showed a significant reduction from 4.6 +/- 0.2% in young adult to 2.7 +/- 0.2% (means +/- S.E.M) in aged rats. These findings suggest that the effects of NO on the bladder and distal ureteric musculature and also its expression in dorsal root ganglion neurons are affected in aged rats and that the micturition reflex may be perturbed as a result.

The exacerbating effect of infectious bronchitis virus infection on the infectious bursal disease virus-induced suppression of opsonization by Escherichia coil antibody in chickens

Chickens infected with infectious bronchitis virus (IBV) and infectious bursal disease virus (IBDV) commonly develop secondary infection of the respiratory tract with Escherichia coli, resulting in significant economic losses. To understand the host factors that may contribute to the E. coli infection, we investigated macrophage-mediated E. coli phagocytosis, intracellular bacterial killing, and development of opsonizing antibody in previously uninfected chickens and in those infected with IBV, IBDV, and IBDV plus IBV. Macrophages from the peripheral blood and the respiratory tracts of chickens infected with IBV or IBDV plus IBV efficiently performed in vitro phagocytosis of E. coli in the presence of positive-control serum (i.e., E. coli antiserum produced in normal chickens). Those macrophages also had adequate bactericidal activity, indicating that IBV and IBDV infections had not affected their phagocytic activity or bactericidal function. The phagocytic activity of macrophages remained unaffected (P < 0.05) when the positive-control serum was replaced with E. coli antiserum produced in chickens infected with IBV alone. However, when E. coli antisera raised in IBDV-infected and, especially, that produced in IBDV plus IBV-infected chickens were supplemented, the percentage of phagocytosis and number of bacteria ingested per phagocyte were significantly (P < 0.05) less. These results indicate that although IBDV alone has the potential to markedly reduce opsonizing ability of antibody, this effect is significantly (P < 0.05) exacerbated by IBV infection.

Shear bond strength of "one bottle" dentin adhesives

STATEMENT OF PROBLEM

Several 1-bottle dentin adhesive resins have been introduced to the market; however, their shear bond strength still requires further investigation.

PURPOSE

This study was designed to evaluate the shear bond strength of five 1-bottle fifth generation dentin adhesive resin materials.

MATERIAL AND METHODS

Bond 1, Single Bond, One-Step, Prime & Bond 2.1, and Tenure Quick with fluoride were evaluated. Tenure All-Surface Bonding System, a fourth generation dentin adhesive resin, was used as the control group. Twelve specimens were prepared from each material, and the shear bond strength was measured by using a universal testing machine at a crosshead speed of 0.5 mm/min. Fracture patterns were studied with the use of light and SEM. The results were analyzed with the use of ANOVA.

RESULTS

The mean shear bond strength for each resin was as follows: Bond 1: 18.36 +/- 3.19 MPa; Single Bond: 16.22 +/- 2.11 MPa; One-Step: 22.51 +/- 3.69 MPa; Prime & Bond: 16. 64 +/- 3.66 MPa; Tenure Quick: 16.43 +/- 3.2 MPa; and Tenure All-Surface Bonding System: 15.06 +/- 3.5 MPa. The shear bond strength values of One-Step dentin adhesive resin showed significant differences compared with the other 5 groups (P<.001). No significant differences were seen between the control group and the other four 1-bottle dentin adhesive resins (0.25 > P>.1). Eighty percent or more of the specimens for each adhesive failed at the dentin/adhesive interface. An exception was Tenure All-Surface Bonding System in which all specimens failed at the dentin/adhesive interface.

CONCLUSION

The 1-bottle systems tested bond to dentin with a strength similar to that of the control group. In addition, the shear bond strengths of 4 of the 1-bottle systems tested were not significantly different.

[Quantitative risk assessment related to microbial food contamination]

The four keystones of quantitative risk assessment are hazard identification, exposure assessment, dose-response assessment and risk characterization. This paper considers the different steps of risk assessment and their application to food microbiology. Traditionally, quantitative risk assessment has been viewed simply as a method to estimate risk. However, when we conduct a complete risk assessment including different factors from "farm to fork" it can serve to understand the risk process. Quantitative risk assessment can also provide valuable insights as how to best manage the risk.

Parasight-F dipstick antigen test in the diagnosis of falciparum malaria in Ethiopia

OBJECTIVE

To determine the shelf life, rapidity and diagnostic performance of ParaSight-F.

DESIGN

Prospective randomised study.

SETTINGS

Malaria diagnostic and treatment posts and health centres in central-southern part of the Ethiopian Rift Valley.

SUBJECTS

Three hundred and eighty two subjects randomly selected.

MAIN OUTCOME MEASURES

Double blind evaluation of the sensitivity, specificity and predictive values of PFT versus CBF.

RESULTS

The point prevalence was found to be 29.7% with species dominance of P. falciparum to P. vivax in the ratio of 4:1. The ParaSight-F test showed, considering P. falciparum only, a sensitivity of 92.5% and specificity of 93%. A remarkably high positive predictive value (PPV) of 82% as well as a negative predictive value (NPV) of 99% was obtained. Considering all species of Plasmodium, sensitivity was 78.6% and specificity 93%, with PPV and NPV of 82% and 91% respectively. Moreover, PFT was found to be rapid with a batch of ten-strips--a rack completed in 30 to 50 minutes, which was five to six times faster than CBF reading. In shelf-life studies, after one year of storage at room temperature, results were found similar to the original readings, indicating the stability and long durability of the test strips.

CONCLUSION

In their durability and high diagnostic performances, both the microscopic slide readings and PFT were found comparable and interchangeable, and advantage in endemic areas where laboratory facilities are not available. The rapidity of PFT may be of greater value during malaria epidemics. But during non-epidemic seasons, the inability of PFT not to detect all forms of malaria remains a draw back.

Enhanced repair of extensive articular defects by insulin-like growth factor-I-laden fibrin composites

Stem cells indigenous to the cancellous spaces of the bone bed in an acute injury provide an important source of pluripotent cells for cartilage repair. Insulin-like growth factor-I facilitates chondrogenesis of bone marrow-derived stem cells in long-term culture and may enhance chondrogenesis in healing cartilage lesions in vivo. This study examined the impact of insulin-like growth factor-I, gradually released from fibrin clots polymerized in situ, on the recruitable stem-cell pool in a full-thickness critical cartilage defect model. Twelve full-thickness 15-mm cartilage lesions in the femoropatellar articulations of six young mature horses were repaired by an injection of autogenous fibrin containing 25 microg of human recombinant insulin-like growth factor-I or, in control joints, fibrin without the growth factor. All horses were killed at 6 months, and cartilage repair tissue and surrounding cartilage were assessed by histology, histochemistry, types I and II collagen immunohistochemistry, types I and II collagen in situ hybridization, and matrix biochemical determinations. White tissue filled grafted and control lesions, with the growth factor-treated defects being more completely filled and securely attached to the subchondral bone. A moderately improved chondrocyte population, more columnar cellular organization, and better attachment to the underlying bone were evident on histological evaluation of growth factor-treated defects. Type-II procollagen mRNA was abundantly present in the deeper half of the treated sections compared with moderate message expression in control tissues. Immunolocalization of type-II collagen showed a preponderance of the collagen in growth factor-treated lesions, confirming translation of type-II message to protein. Composite histologic healing scores for treated defects were significantly improved over those for control defects. DNA content in the cartilage defects was similar in treated and control joints. Matrix proteoglycan content was similar in treated and control defects and lower in the defects than in the intact surrounding and remote cartilage of the treated and control joints. The proportion of type-II collagen significantly increased in growth factor-treated tissues. Fibrin polymers laden with insulin-like growth factor-I improved the histologic appearance and the proportion of type-II collagen in healing, full-thickness cartilage lesions. However, none of the biochemical or morphologic features were consistent with those of normal articular cartilage.

Ocular manifestations of equine motor neuron disease

The characteristics of the ocular manifestations of equine motor neuron disease (EMND) are described. Forty-two horses with histories, clinical signs and necropsies compatible with EMND were the subjects of this study. Ophthalmoscopic lesions that varied in severity were found in 40 of 42 horses and appeared as a distinct pigmented reticulated pattern at the tapetal-nontapetal junction or throughout the fundus, depending upon severity. The pattern colours ranged from yellow brown to black. Areas of hyperreflectivity formed mosaic patterns in the tapetal fundus. ERG B-wave amplitudes were usually at least 50% reduced and many animals showed extinguished amplitudes. None of the horses had apparent visual impairment. Histopathologically, all 42 horses had retinal pigment epithelial (RPE) congestion with ceroid-lipofuscin. Retinal degeneration was variable even within the eyes. Thin layer chromatography (TLC) analysis of the RPE and neural retina identified both green and orange emitting fluorescent compounds not found in normal horses. All unsupplemented horses had plasma vitamin E levels <1.0 microg/ml. The potential significance of this report is the pathognomonic role the ocular manifestations exhibit in helping to diagnose equine motor neuron disease.

Systemic and local antibody responses to infectious bronchitis virus in chickens inoculated with infectious bursal disease virus and control chickens

Serum and local (respiratory) antibody responses to infectious bronchitis virus (IBV) were studied in 5-wk-old white leghorn-type control chickens and chickens inoculated with infectious bursal disease virus (IBDV) at 1 day of age. Of the chickens inoculated with IBV alone, 93% had detectable levels of IBV antibodies in the sera and 87% had detectable antibodies in the respiratory lavage fluids. Compared to this group, only 73% and 65% of IBDV-IBV inoculated chickens had serum and respiratory antibodies, respectively. In chickens inoculated with IBV alone, the IBV antibodies were evenly associated with immunoglobulin classes IgM, IgG, and IgA, whereas the IBDV-IBV inoculated chickens mainly produced IgM-associated antibodies with low to negligible levels of IgA- and IgG-associated antibodies. These results suggest that the lack of adequate IgA- and IgG-associated antibody production in IBDV-infected chickens may account for their increased susceptibility to IBV infection.

Effect of progesterone on prostaglandin F2 alpha secretion and outcome of pregnancy during cloprostenol-induced abortion in mares

OBJECTIVES

To determine the role of progesterone in the regulation of endogenous prostaglandin F2 alpha (PGF2 alpha) secretion during cloprostenol-induced abortion and to investigate use of progestins to prevent prostaglandin-associated abortion.

ANIMALS

16 pregnant mares.

PROCEDURE

To induce abortion, cloprostenol (250 micrograms/d) was administered daily until fetal expulsion or for up to 5 days. In experiment 1, 8 mares, 98 to 153 days' pregnant, received progesterone (300 mg/d) at 24-hour intervals for 5 days, starting 18 hours after the first cloprostenol administration. In experiment 2, 8 mares, 93 to 115 days' pregnant, received altrenogest (44 mg/d) at 24-hour intervals, starting 12 hours after the first cloprostenol administration. Historic control mares, 82 to 102 days' pregnant, received cloprostenol (250 micrograms/d) daily until fetal expulsion.

RESULTS

In control mares, fetal expulsion occurred after 2 to 3 cloprostenol administrations and was associated with significant increases in PGF2 alpha secretion. Abortion did not occur in 5 of 8 progesterone-treated mares and 8 of 8 altrenogest-treated mares, and endogenous PGF2 alpha secretion was inhibited, compared with values in aborting mares.

CONCLUSION

Circulating progestogen concentrations may have a role in the outcome of pregnancy during prostaglandin-induced abortion. Altered prostaglandin secretion may be a reflection of a direct effect of progesterone or may be caused by the abortion process.

CLINICAL RELEVANCE

Progestogens might be useful for prevention of abortion in mares in which pregnancy is at risk owing to diseases that are associated with excess prostaglandin secretion.

Influence of lamination on the flexural strength of a dental castable glass ceramic

This study evaluated the effect of veneering Dicor castable ceramic with Vitadur N and Dicor Plus feldspathic porcelains. A biaxial flexure test was conducted on five groups of specimens (Dicor castable ceramic, Vitadur N dentinal porcelain, Dicor Plus dentinal porcelain, Dicor core veneered with Vitadur N and Dicor core veneered with Dicor Plus castable ceramic). Each group consisted of 10 disks of nearly identical dimensions with a 1.98 +/- 0.04 mm thickness and 15.7 +/- 0.35 mm in diameter. Statistical analysis indicated that there was neither significant difference (p > 0.05) between mean flexural strength of Dicor Plus and Vitadur N ceramic or Vitadur N and Dicor/Vitadur N ceramic specimens. The mean flexural strength of Dicor/Vitadur N specimens was significantly lower than the mean flexural strength of Dicor ceramic specimens. Conversely, there was no significant difference between mean flexural strength of Dicor ceramic and Dicor/Dicor Plus ceramic specimens. Scanning electron microscope (SEM) examinations of Dicor/Dicor Plus ceramic specimens suggested better wetting of Dicor core by Dicor Plus ceramic with lower incidence of porosity at the interface. However, Dicor/Vitadur N ceramic specimens exhibited a higher incidence of porosity at the interface. This indicated that lamination of Dicor castable ceramic material with feldspathic porcelain for esthetics could be attained without sacrificing strength of the original material, provided that appropriate veneering material was selected.

Hysteroscopy in women with abnormal uterine bleeding on hormone replacement therapy: a comparison with postmenopausal bleeding

OBJECTIVE

To determine the role of outpatient diagnostic hysteroscopy in patients with abnormal uterine bleeding (AUB) on hormone replacement therapy (HRT) and to contrast this with a control group of women presenting with postmenopausal bleeding.

DESIGN

Comparative observational study.

SETTING

Outpatient hysteroscopy clinic in a university hospital.

PATIENTS

Three hundred ten patients undergoing outpatient hysteroscopy.

INTERVENTIONS

Outpatient diagnostic hysteroscopy with endometrial biopsy when indicated.

MAIN OUTCOME MEASURES

Hysteroscopic findings, need for cervical dilatation and local anaesthesia, correlation between hysteroscopy and histologic diagnosis.

RESULTS

There were 157 (7.1%) patients with AUB on HRT and another 153 (6.9%) with postmenopausal bleeding out of 2,203 outpatient hysteroscopies. Hysteroscopy was successful in 97% and 92% of patients, respectively, and intrauterine pathology was diagnosed in 46.7% and 39.7% of these cases. Functional endometrium was noted significantly more often with HRT and endometrial atrophy with postmenopausal bleeding. Overall, local anesthesia was used in 126 (40.6%) and shown to be associated significantly with the need for cervical dilatation. Endometrial biopsy was attempted in 125 (80%) and 119 (78%) patients in the study and control groups, but was unsuccessful significantly more often with postmenopausal bleeding (38.7%) versus 16%). There were six cases of endometrial carcinoma, all in the control group.

CONCLUSION

There is a high incidence of intrauterine abnormalities in women with menstrual symptoms while taking HRT, but the pathology differed from those with postmenopausal bleeding. As focal lesions are found commonly in such patients, their detection by diagnostic hysteroscopy should improve compliance with HRT as it would allow individualization of treatment.

Cryptosporidiosis in children seen at the children's clinic of Yekatit 12 Hospital, Addis Ababa

The stools of 214 children under five years of age with diarrhoea were examined for Cryptosporidium oocysts using the Modified Ziehl Nelson Technique. Twelve (5.6%) of the children had Cryptosporidium oocysts in their faeces. All of these were above 6 months of age and were either partially or fully weaned. There were 15 exclusively breast fed children of whom 11 were less than 6 months of age. None of these cases had the evidence of Cryptosporidial infection. The present study indicates the importance of Cryptosporidium as a possible etiologic agent in patients with diarrhoeal diseases. However, a comprehensive investigation is needed in order to rule out other enteropathogens.

Recombinant OspA protects dogs against infection and disease caused by Borrelia burgdorferi

Twenty-two specific-pathogen-free beagles were vaccinated with recombinant OspA (ospA gene derived from Borrelia burgdorferi B31) alone or with adjuvant (QuilA, Montanide ISA25, or aluminum hydroxide) at 6 weeks of age. Thirteen dogs were used as nonvaccinated controls with or without adjuvant. Three dogs were kept as contact controls and received neither vaccine nor challenge. Six weeks or 6 months after the first vaccination, the vaccinated (20 of 22) and nonvaccinated dogs (13) were challenged by exposure to adult ticks (Ixodes scapularis) naturally that were infected with B. burgdorferi (tick infection rate, > or = 60%) and that were collected from Westchester County, N.Y. Protection from infection was evaluated by culture for B. burgdorferi from skin biopsies taken near the sites of tick bites. Skin biopsies were taken at monthly intervals for 3 months. B. burgdorferi was not isolated from any of the vaccinated dogs. In contrast, 12 of 13 control dogs challenged by exposure to the ticks were culture positive. The histopathology of the joint capsules 3 months after the challenge was used to evaluate protection from arthritis. Eight of 13 control dogs showed synovitis in single or multiple joints, while only 1 of the 22 vaccinated dogs had a single focus of mild inflammation in a single joint. At the time of the challenge, the vaccinated dogs had antibody to B. burgdorferi, which was demonstrable by kinetic enzyme-linked immunosorbent assay, Western blotting (immunoblotting), and a serum growth inhibition assay. The vaccinal antibody declined gradually after the challenge, especially in dogs vaccinated with OspA without adjuvants. Antibodies in the challenge control dogs were only detectable by 4 to 6 weeks after the challenge and remained at high levels until the termination of the study. Contact control dogs showed no antibody responses or histopathologic lesions and were culture negative. By Western blot analysis, antibodies to OspA first appeared in the sera of vaccinated dogs 3 weeks after the first vaccination. The absence of additional bands after the challenge suggests that infection in vaccinated dogs was blocked. Results from this study show that vaccination with recombinant OspA protected dogs against infection and disease after an experimental challenge with B. burgdorferi by exposure to ticks.

Local and remote matrix responses to chondrocyte-laden collagen scaffold implantation in extensive articular cartilage defects

Chondrocyte-laden collagen scaffolds were evaluated in extensive cartilage defects in an equine model. Arthroscopic techniques were used to implant a chondrocyte-collagen culture product in 15-mm defects in the lateral trochlear ridge of the femoropatellar joint of 12 horses. Ungrafted control defects were formed in the opposite joint. Groups of six horses were terminated at 4 and 8 months after implantation and the repair sites, adjacent cartilage, and remote cartilage within each femoropatellar joint examined biochemically. Eight months following surgery the relative proportions of type II collagen in grafted and ungrafted defects, determined using the ratio of cyanogen bromide cleavage products alpha 1(II)CB10/alpha 2(I)CB3,5, were not significantly different (31.57 +/- 2.76% and 26.88 +/- 2.76%, respectively). Aggrecan content was significantly improved in grafted defects (85.61 +/- 6.51 and 74.91 +/- 10.31 micrograms/mg dry weight). Cartilage surrounding grafted defects also showed improved maintenance of cartilage glycosaminoglycan content. Thus, chondrocyte grafting in collagen scaffold vehicles improved the aggrecan content in extensive cartilage defects and surrounding normal cartilage. However, given the continued disparity between repair tissue and normal cartilage aggrecan content, and the low proportion of type II collagen in grafted defects, the utility of collagen scaffolds for chondrocyte grafting of large cartilage defects seems limited.

Button versus buttonless castings for removable partial denture frameworks

Casting removable partial dentures (RPDs) without completely filling the sprue channels and generating casting buttons would result in saving metal and making more defect-free castings. This investigation tested whether a complete and sound RPD casting can be obtained when a minimal amount of metal is used. A factorial experimental design, three spruing methods, two metal feeding directions, and two different weights of metal were used to cast 60 Kennedy class II, modification 1 RPDs. The metal used to cast each framework was either enough to result in a full button or in no button. Visual and radiographic examinations and counting of defects were made by two independent operators who were unaware of the spruing method, feeding direction, or amount of metal used to make the framework. The completeness of the casting and the presence of porosities were evaluated for clasps, major connectors, and meshworks. The use of minimal metal to cast RPDs was equally as successful as using enough for a full button, provided that the appropriate spruing arrangement and metal feeding direction were chosen. Indirect metal feeding for maxillary RPDs was successful with the proper spruing arrangement.

Effect of breed and body weight on echocardiographic values in four breeds of dogs of differing somatotype

Eighty normal dogs of four morphologically disparate breeds (Pembroke Welsh Corgi, Miniature Poodle, Afghan Hound, Golden Retriever) (twenty of each breed), were studied by echocardiography to determine the importance of breed and weight in establishing normal echocardiographic reference ranges. Echocardiographic measurements included left-ventricular chamber dimension at systole and end-diastole, right-ventricular chamber dimension at end-diastole, interventricular septal thickness at systole and end-diastole, left-ventricular free wall thickness at systole and end-diastole, E-point septal separation, aortic root dimension at end-diastole, left atrial dimension, and fractional shortening. Analyses of covariance indicated that for all measurements except right-ventricular chamber dimension, the means were significantly different among breeds, after the differences in weight were taken into account. Echocardiographic measurements are variable even within the same breed. Breed must be considered in establishing echocardiographic measurement reference ranges. Echocardiographic values for each breed are presented.

Accuracy of ultrasonography in the detection of severe hepatic lipidosis in cats

The accuracy of ultrasonography in detection of feline hepatic lipidosis was studied retrospectively. The following ultrasonographic criteria were associated positively with severe hepatic lipidosis: the liver hyperechoic, compared with falciform fat; the liver isoechoic or hyperechoic, compared with omental fat; poor visualization of intrahepatic vessel borders; and increased attenuation of sound by the liver. In a group of 36 cats with clinically apparent hepatobiliary disease and in which liver biopsy was done, liver hyperechoic, compared with falciform fat, was the best criterion for diagnosis of severe hepatic lipidosis with 91% sensitivity, 100% specificity, and 100% positive predictive value.

The POEMS syndrome

The POEMS syndrome is an unusual disorder manifesting primarily as a peripheral sensorimotor neuropathy in association with a monoclonal gammopathy. The importance of its recognition is that significant clinical improvement may result from localization and treatment of the underlying plasma cell tumour.

Characteristics of digital flexor tendon sheath fluid from clinically normal horses

Physical, biochemical, and cytologic properties of synovial fluid from digital flexor tendon sheaths of clinically normal horses were investigated. Tendon sheath fluid was pale yellow, clear, and did not clot. Volume of fluid within a tendon sheath varied minimally, with a mean of 2.11 ml. Total erythrocyte counts were higher than values observed in normal equine joint fluid, whereas values for total leukocyte count (770 +/- 73 cells/mm3), viscosity (6.05 +/- 0.58 cs), and protein concentration (7.87 +/- 0.03 mg/ml) were similar to those in joint fluid. Large mononuclear cells were the predominant synovial fluid cell type. Mean hyaluronic acid concentration (0.74 +/- 0.02 mg/ml) and mucinous precipitate quality were lower than values in joint fluid.

Effects of sodium hyaluronate on tendon healing and adhesion formation in horses

Sodium hyaluronate reduces adhesions after tendon repair in rodents and dogs, and has been used in limited clinical trials in people. To evaluate its effect on tendon healing and adhesion formation in horses and to compare these effects with those of a compound of similar visco-elastic properties, a study was performed in horses, using a model of collagenase injection in the flexor tendons within the digital sheath. Eight clinically normal horses were randomly allotted to 2 groups. Adhesion formation between the deep digital flexor tendon and the tendon sheath at the pastern region was induced in the forelimbs of all horses. Using tenoscopic control, a 20-gauge needle was inserted into the deep digital flexor tendon of horses under general anesthesia and 0.2 ml of collagenase (2.5 mg/ml) was injected. The procedure was repeated proximally at 2 other sites, spaced 1.5 cm apart. A biopsy forceps was introduced, and a 5-mm tendon defect was created at each injection site. Group-A horses had 120 mg of sodium hyaluronate (NaHA) gel injected into the tendon sheath of one limb. Group-B horses had methylcellulose gel injected at the same sites. The contralateral limbs of horses in both groups served as surgical, but noninjected, controls. Horses were euthanatized after 8 weeks of stall rest. Ultrasonographic evaluation revealed improved tendon healing after NaHa injection, but no difference in peritendinous adhesion formation. Tendon sheath fluid volume and hyaluronic acid (HA) content were greater in NaHA-treated limbs. Gross pathologic examination revealed considerably fewer and smaller adhesions when limbs were treated with NaHA. However, significant difference in pull-out strengths was not evident between NaHA-treated and control limbs. Histologically, the deep digital flexor tendon from the NaHA-treated limbs had reduced inflammatory cell infiltration, improved tendon structure, and less intratendinous hemorrhage. Treatment with methylcullulose had no significant effect on tendon healing, adhesion size, quantity, or strength or on the volume and composition of the tendon sheath fluid. Sodium hyaluronate, administered intrathecally, appears to have a pharmaceutically beneficial action in this collagenase-induced tendinitis and adhesion model in horses.

Pulsed carbon dioxide laser for cartilage vaporization and subchondral bone perforation in horses. Part I: Technique and clinical results

A carbon dioxide laser, used in a rapidly pulsed mode, was evaluated for intra-articular use in horses. Under arthroscopic guidance, a lensed 5 mm laser probe attached directly to a hand-held carbon dioxide laser was inserted into one intercarpal joint of eight horses. In four horses, a cartilage crater 1 cm in diameter was created to the level of the subchondral bone of the articular surface of the third carpal bone. In four horses, the laser was directed perpendicular to the articular surface of the third carpal bone and activated to penetrate the cartilage and subchondral bone. The intercarpal joint of the opposite carpus in each horse was subjected to arthroscopic examination and insertion of the laser probe for an equivalent time. The laser was not activated and these joints served as sham operated controls. The horses were evaluated clinically for 8 weeks, then euthanatized, and the joints were examined radiographically, grossly, and histologically. Pulsed carbon dioxide laser vaporized cartilage readily but penetrated bone poorly. Cartilage vaporization resulted in no greater swelling, heat, pain on flexion, lameness, or synovial fluid reaction than the sham procedure. Laser drilling resulted in a shallow, charred hole with a tenacious carbon residue, and in combination with the thermal damage to deeper bone, resulted in increased swelling, mild lameness and a low-grade, but persistent synovitis. The carbon dioxide laser is a useful intra-articular instrument for removal of cartilage and has potential application in inaccessible regions of diarthrodial joints. It does not penetrate bone sufficiently to have application in subchondral drilling.