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The Veterinary Clinics of North... Jan 2000Passerines (songbirds) and softbills (toucans and mynahs) are increasingly presented for veterinary care as pet owners and aviculturists recognize that successful... (Review)
Review
Passerines (songbirds) and softbills (toucans and mynahs) are increasingly presented for veterinary care as pet owners and aviculturists recognize that successful medical and surgical treatment can be performed in these often tiny patients. Even with an increasing amount of pharmacokinetic data in birds, the use of extrapolated drug regimens continues to be a common practice for these species. The extrapolation, using allometric scaling from human, mammalian, and avian drugs to passeriformes and softbills, is complicated and limited. In this article, the choice of the therapeutic approach is discussed. Once the choice for a specific drug is made, tables help calculate the dose in milligrams per kilocalorie without using complicated formulas.
Topics: Animals; Bird Diseases; Birds; Formularies as Topic; Songbirds; Veterinary Drugs
PubMed: 11228833
DOI: 10.1016/s1094-9194(17)30094-4 -
The Cochrane Database of Systematic... Apr 1996The administration of clomiphene citrate is followed by an enhanced release of pituitary gonadotropins resulting in follicular recruitment. After the drug is stopped,... (Review)
Review
BACKGROUND
The administration of clomiphene citrate is followed by an enhanced release of pituitary gonadotropins resulting in follicular recruitment. After the drug is stopped, there is continuing secretion of estradiol, selection of the dominant follicle and, in successful cases, ovulation. Clomiphene is indicated as the initial treatment in the majority of women with amenorrhoea and oligomennorhoea. In women with irregular ovulation it seems to re-establish typical frequency of ovulation. Its effectiveness in oligo-amenorrhoeic women was tested in a number of randomised controlled trials at that time. These trials form the basis for the following review.
OBJECTIVES
Clomiphene citrate enhances the release of pituitary hormones, often resulting in ovulation. The objective of this review was to assess the effects of clomiphene citrate on ovulation and pregnancy in women with oligo-ovulatory subfertility.
SEARCH STRATEGY
The Cochrane Subfertility Review Group specialised register of controlled trials was searched.
SELECTION CRITERIA
Randomised trials of clomiphene compared with placebo or no treatment in women with oligo-ovulatory subfertility of at least 12 months duration.
DATA COLLECTION AND ANALYSIS
Trial quality was assessed and data were extracted independently by two reviewers.
MAIN RESULTS
Four studies were included. They were all of crossover design. Since it was not possible to separate data from the first and second phases of these trials, the effect of clomiphene may be overestimated. Compared with placebo, clomiphene citrate was associated with increased ovulation. The odds ratio for high doses (50-250 milligrams per day) was 6.82 (95% confidence interval 3.92 to 11.85). This dropped to a non-significant odds ratio of 1.29 (95% confidence interval 0.48 to 3.49) with low doses (10 milligrams per day). Clomiphene citrate (all doses) was associated with an increased pregnancy rate per treatment cycle (odds ratio 3.41, 95% confidence interval 4.23 to 9.48).
AUTHORS' CONCLUSIONS
Clomiphene citrate (at doses between 50 to 250 milligrams per day) appears to be an effective method of inducing ovulation and improving fertility in oligo-ovulatory women. However adverse effects include possible ovarian cancer risk and risk of multiple pregnancy.
Topics: Amenorrhea; Clomiphene; Female; Fertility Agents, Female; Humans; Infertility, Female; Oligomenorrhea; Ovulation Induction; Pregnancy
PubMed: 17636579
DOI: 10.1002/14651858.CD000056.pub2 -
California Medicine Jul 1952Recent experimental evidence suggests that hydrocortisone (Kendall's Compound F) is probably the principal glycogenic steroid secreted by the adrenal cortex and that...
Recent experimental evidence suggests that hydrocortisone (Kendall's Compound F) is probably the principal glycogenic steroid secreted by the adrenal cortex and that under conditions of stress it may participate more than cortisone in physiologic reactions. Laboratory studies indicate that hydrocortisone has greater physiologic activity, milligram for milligram, than cortisone and with certain assays its potency is twice as great.Two forms of hydrocortisone, the free alcohol preparation and the acetate, were given systemically to patients with rheumatoid arthritis and were observed to possess significant differences in ability to suppress the disease manifestations. When administered orally in large initial doses, hydrocortisone (free alcohol) appeared to produce greater suppressive effects, milligram for milligram, than either hydrocortisone acetate or cortisone acetate. Comparisons of potency made by determining maintenance dosage requirements for equivalent degrees of clinical control in the same patients indicated that the effectiveness of hydrocortisone (free alcohol) is more than 50 per cent greater than that of either the free or acetated forms of cortisone and approximately twice as great as that of hydrocortisone acetate. Certain observations suggested that the greater antirheumatic activity of hydrocortisone (free alcohol) is not accompanied by a correspondingly greater tendency toward endocrine complications. If more extensive future investigations support this observation, hydrocortisone (free alcohol), by producing equally efficient results with smaller doses, may prove superior to cortisone as a therapeutic agent.Intra-articular injections of hydrocortisone acetate appear to have only a limited place in the management of rheumatoid arthritis but may be used for temporary relief under certain conditions. In preliminary studies by the author it was noted that whereas improvement resulted in 80 per cent of the treated joints, the improvement was graded as pronounced or very pronounced in only one-half of the joints so injected. In almost all instances the benefits derived were quite temporary. Results observed in treatment of osteoarthritic joints by this method were decidedly poorer than in rheumatoid arthritis.
Topics: Adrenal Cortex; Antirheumatic Agents; Arthritis, Rheumatoid; Biological Assay; Biological Transport; Cortisone; Ethanol; Glycogen; Humans; Hydrocortisone; Mental Disorders
PubMed: 12978878
DOI: No ID Found -
The American Journal of Clinical... Oct 2018Expert guidelines advise that intake of added sugars (ASs), free sugars, and saturated fats be limited to <10% total energy (TE), and that children's sodium not exceed...
BACKGROUND
Expert guidelines advise that intake of added sugars (ASs), free sugars, and saturated fats be limited to <10% total energy (TE), and that children's sodium not exceed 1500-1900 mg, yet intake among many older children and adolecents exceeds these limits. Although research suggests young children's diets influence future eating patterns, little is known about the intake of these nutrients throughout early childhood.
OBJECTIVE
The objective of this study was to describe intake and leading sources of sugars, saturated fats, and sodium among US children from infancy through preschool age.
DESIGN
Cross-sectional data from the NHANES 2009-2014 were used to estimate 1) mean intake of sugars [%TE from ASs, naturally occurring sugars (NOSs), and free sugars], saturated fats (%TE), and sodium (milligrams), 2) the proportion exceeding recommended limits, and 3) the leading sources of these nutrients in the diets of US (nonbreastfeeding) children <5 y old (n = 3345). Sampling weights and procedures to account for the complex sampling design were used to estimate intake by age and to compare across race/ethnicity, sex, and income subgroups.
RESULTS
Nonbreastfeeding children <5 y old consumed a mean ± SE %TE of 10.1% ± 0.2% from ASs, 13.9% ± 0.2% from free sugars, 12.8% ± 0.1% from saturated fats, and 1804 ± 26 mg Na . Sugary beverages (sugar-sweetened beverages + 100% juices) contributed 6.7% ± 0.2% TE, with consumption lowest among higher-income children. AS and sodium consumption rose rapidly from infancy to age 1-<2 y and gradually thereafter. Saturated fat intake was highest in infancy and decreased to a mean ± SE of 11.3% ± 0.3% TE among 4-<5-y-olds. Intake exceeded recommended limits for ASs, free sugars, saturated fats, and sodium for 45%, 63%, 72%, and 67% of all children, respectively.
CONCLUSION
The consumption of sugars, fats, and sodium exceeds recommended guidelines before many US children reach school age.
Topics: Child Behavior; Child, Preschool; Cross-Sectional Studies; Diet; Dietary Fats; Dietary Sugars; Energy Intake; Feeding Behavior; Female; Humans; Infant; Male; Nutrition Surveys; Recommended Dietary Allowances; Sodium, Dietary
PubMed: 30247504
DOI: 10.1093/ajcn/nqy168 -
International Journal of Environmental... Dec 2022Among individuals with normal glucose tolerance (NGT), subjects with high levels of plasma glucose (≥155 mg/dL) at sixty minutes during an oral glucose tolerance test...
BACKGROUND AND OBJECTIVES
Among individuals with normal glucose tolerance (NGT), subjects with high levels of plasma glucose (≥155 mg/dL) at sixty minutes during an oral glucose tolerance test (1h-OGTT) are at an increased risk of developing type 2 diabetes. We investigated the association between the triglycerides and glucose (TyG) index, a novel marker of insulin resistance, with 1h-OGTT glucose plasma concentrations.
MATERIAL AND METHODS
1474 non-diabetic Caucasian subjects underwent a 75 g OGTT and were divided into two groups according to the cutoff 1h-OGTT plasma glucose < 155 mg/dL (NGT-1h-low) and ≥ 155 mg/dL (NGT-1h-high). The TyG index was calculated as ln [fasting triglycerides (milligrams per deciliter) × fasting blood glucose (milligrams per deciliter)/2]. Multivariable linear and logistic regression analyses were used to establish the contribution of the TyG index to the variability of 1h-OGTT glucose, and how the former affected the risk of being NGT-1h-high.
RESULTS
1004 individuals were NGT-1h-low and 470 were NGT-1h-high. The TyG index was higher for NGT-1h-high ( = 0.001) individuals, and it was an independent factor influencing 1h-OGTT glycemia (β = 0.191, < 0.001) after correcting for age, sex, and BMI. The TyG index was the strongest marker associated with the risk of being NGT-1h-high (OR = 1.703, CI 95% 1.34-2.17, < 0.001) when compared with FPG (OR = 1.054, CI 95% 1.04-1.07, < 0.001) and the HOMA-IR (OR = 1.156, CI 95% 1.08-1.23, < 0.001).
CONCLUSIONS
Our study demonstrated that the TyG index, an efficient and cost-effective marker of insulin resistance, is associated with the variability of early post-challenge glucose levels and is an independent marker of being NGT-1h-high.
Topics: Humans; Glucose Tolerance Test; Glucose; Insulin Resistance; Blood Glucose; Diabetes Mellitus, Type 2; Triglycerides
PubMed: 36613109
DOI: 10.3390/ijerph20010787 -
Cureus Mar 2024Objectives An observational, retrospective, longitudinal, and analytical study aimed to evaluate the effectiveness of the erector spinae plane (ESP) block in managing...
Objectives An observational, retrospective, longitudinal, and analytical study aimed to evaluate the effectiveness of the erector spinae plane (ESP) block in managing pain in patients with vertebral fractures secondary to tumoral activity. This study included patients treated at the Pain Clinic who underwent ESP block. The objectives were to describe demographic characteristics, oncological diagnosis, vertebral fracture features, imaging techniques, medications used, and the level of ESP block. Additionally, pain levels were assessed using a numerical analog scale, and the consumption of opioid analgesic medications before and after the ESP block, during follow-up consultations, along with patient satisfaction. Methodology This retrospective, observational, and analytical study was conducted at the Pain Clinic of the National Cancer Institute of Mexico. Patients with vertebral fractures secondary to tumor activity were included, with data collected from March 2020 to September 2023. A consecutive non-probabilistic sampling method was employed, and specific inclusion and exclusion criteria were applied. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test for quantitative variables, with a significance level of p ≤ 0.05. IBM SPSS Statistics v. 26.0 (IBM Corp., Armonk, NY) software was utilized. Results A sample comprising 16 individuals was obtained, with an equal distribution between males and females. Fracture levels displayed variation, with L3 (12.5%) and T6 (12.5%) being the most prevalent. The ESP approach was primarily conducted using ultrasound (68.8%), while fluoroscopy and computed tomography were utilized in 25.0% and 6.3% of cases, respectively. Predominantly, methylprednisolone and ropivacaine (75.0%) were administered, with phenol used in 18.8% and a combination of methylprednisolone and bupivacaine in 6.3%. Patient satisfaction levels were reported at 81.3% (satisfied or very satisfied). Statistically significant disparities were noted between baseline and incidental pain reduction and oral opioid equivalent dosage in milligrams of morphine per day (MME/day) before and after ESP block (p ≤ 0.05). Conclusions This research provides promising preliminary evidence supporting the effectiveness of ESP block for pain management in vertebral fractures secondary to tumoral activity, enhancing the quality and safety of care for oncology patients. The absence of complications, significant improvement in pain, and reduction in opioid dependence underscore the clinical relevance of this therapeutic approach. An observational, retrospective, longitudinal, and analytical study aimed to evaluate the effectiveness of the ESP block in managing pain in patients with vertebral fractures secondary to tumoral activity. This study included patients treated at the Pain Clinic who underwent ESP block. The objectives were to describe demographic characteristics, oncological diagnosis, vertebral fracture features, imaging techniques, medications used, and the level of ESP block. Additionally, pain levels were assessed using a numerical analogue scale, and the consumption of opioid analgesic medications before and after the ESP block, during follow-up consultations, along with patient satisfaction.
PubMed: 38586726
DOI: 10.7759/cureus.55599 -
Diseases of the Colon and Rectum Dec 2018Thoracic epidural analgesia has been shown to be an effective method of pain control. The utility of epidural analgesia as part of an enhanced recovery after surgery... (Observational Study)
Observational Study
BACKGROUND
Thoracic epidural analgesia has been shown to be an effective method of pain control. The utility of epidural analgesia as part of an enhanced recovery after surgery protocol is debatable.
OBJECTIVE
This study aimed to determine if the use of thoracic epidural analgesia in an enhanced recovery after surgery protocol decreases hospital length of stay or inpatient opioid consumption after elective colorectal resection.
DESIGN
This is a single-institution retrospective cohort study.
SETTINGS
The study was performed at a high-volume, tertiary care center in the Midwest. An institutional database was used to identify patients.
PATIENTS
All patients undergoing elective transabdominal colon or rectal resection by board-certified colon and rectal surgeons from 2013 to 2017 were included.
MAIN OUTCOME MEASURES
The main outcome was length of stay. The secondary outcome was oral morphine milligram equivalents consumed during the first 48 hours.
RESULTS
There were 1006 patients (n = 815 epidural, 191 no epidural) included. All patients received multimodal analgesia with opioid-sparing agents. Univariate analysis demonstrated no difference in length of stay between those who received thoracic epidural analgesia and those who did not (median, 4 vs 5 days; p = 0.16), which was substantiated by multivariable linear regression. Subgroup analysis showed that the addition of epidural analgesia resulted in no difference in length of stay regardless of an open (n = 362; p = 0.66) or minimally invasive (n = 644; p = 0.46) approach. Opioid consumption data were available after 2015 (n = 497 patients). Univariate analysis demonstrated no difference in morphine milligram equivalents consumed in the first 48 hours between patients who received epidural analgesia and those who did not (median, 135 vs 110 oral morphine milligram equivalents; p = 0.35). This was also confirmed by multivariable linear regression.
LIMITATIONS
The retrospective observational design was a limitation of this study.
CONCLUSION
The use of thoracic epidural analgesia within an enhanced recovery after surgery protocol was not found to be associated with a reduction in length of stay or morphine milligram equivalents consumed within the first 48 hours. We cannot recommend routine use of thoracic epidural analgesia within enhanced recovery after surgery protocols. See Video Abstract at http://links.lww.com/DCR/A765.
Topics: Aged; Analgesics, Opioid; Anesthesia, Epidural; Anesthetics, Local; Bupivacaine; Clinical Protocols; Colon; Female; Humans; Length of Stay; Male; Middle Aged; Pain, Postoperative; Recovery of Function; Rectum; Retrospective Studies; Thoracic Vertebrae
PubMed: 30308525
DOI: 10.1097/DCR.0000000000001226 -
Journal of Visualized Experiments : JoVE Jul 2012Recombinant protein expression in bacteria, typically E. coli, has been the most successful strategy for milligram quantity expression of proteins. However, prokaryotic...
Recombinant protein expression in bacteria, typically E. coli, has been the most successful strategy for milligram quantity expression of proteins. However, prokaryotic hosts are often not as appropriate for expression of human, viral or eukaryotic proteins due to toxicity of the foreign macromolecule, differences in the protein folding machinery, or due to the lack of particular co- or post-translational modifications in bacteria. Expression systems based on yeast (P. pastoris or S. cerevisiae) (1,2), baculovirus-infected insect (S. frugiperda or T. ni) cells (3), and cell-free in vitro translation systems (2,4) have been successfully used to produce mammalian proteins. Intuitively, the best match is to use a mammalian host to ensure the production of recombinant proteins that contain the proper post-translational modifications. A number of mammalian cell lines (Human Embryonic Kidney (HEK) 293, CV-1 cells in Origin carrying the SV40 larget T-antigen (COS), Chinese Hamster Ovary (CHO), and others) have been successfully utilized to overexpress milligram quantities of a number of human proteins (5-9). However, the advantages of using mammalian cells are often countered by higher costs, requirement of specialized laboratory equipment, lower protein yields, and lengthy times to develop stable expression cell lines. Increasing yield and producing proteins faster, while keeping costs low, are major factors for many academic and commercial laboratories. Here, we describe a time- and cost-efficient, two-part procedure for the expression of secreted human proteins from adherent HEK 293T cells. This system is capable of producing microgram to milligram quantities of functional protein for structural, biophysical and biochemical studies. The first part, multiple constructs of the gene of interest are produced in parallel and transiently transfected into adherent HEK 293T cells in small scale. The detection and analysis of recombinant protein secreted into the cell culture medium is performed by western blot analysis using commercially available antibodies directed against a vector-encoded protein purification tag. Subsequently, suitable constructs for large-scale protein production are transiently transfected using polyethyleneimine (PEI) in 10-layer cell factories. Proteins secreted into litre-volumes of conditioned medium are concentrated into manageable amounts using tangential flow filtration, followed by purification by anti-HA affinity chromatography. The utility of this platform is proven by its ability to express milligram quantities of cytokines, cytokine receptors, cell surface receptors, intrinsic restriction factors, and viral glycoproteins. This method was also successfully used in the structural determination of the trimeric ebolavirus glycoprotein (5,10). In conclusion, this platform offers ease of use, speed and scalability while maximizing protein quality and functionality. Moreover, no additional equipment, other than a standard humidified CO2 incubator, is required. This procedure may be rapidly expanded to systems of greater complexity, such as co-expression of protein complexes, antigens and antibodies, production of virus-like particles for vaccines, or production of adenoviruses or lentiviruses for transduction of difficult cell lines.
Topics: Biotechnology; Cell Adhesion; Chromatography, Affinity; Culture Media, Conditioned; DNA; HEK293 Cells; Humans; Recombinant Proteins; Transfection
PubMed: 22872008
DOI: 10.3791/4041 -
The Western Journal of Emergency... May 2021Intravenous haloperidol has been shown to decrease milligram morphine equivalents (MME) of analgesia and reduce hospital admissions for diabetic gastroparesis. The...
INTRODUCTION
Intravenous haloperidol has been shown to decrease milligram morphine equivalents (MME) of analgesia and reduce hospital admissions for diabetic gastroparesis. The objective of this study was to evaluate whether haloperidol decreases MME for the treatment of non-specific abdominal pain diagnoses in the emergency department (ED), including gastroparesis, cyclic vomiting, cannabinoid hyperemesis syndrome, and unspecified abdominal pain. The primary outcome compared the difference in MME between encounters. Secondary outcomes included admission rate, pain scores, length of stay, rescue therapy administration, and adverse effects.
METHODS
This retrospective chart review included patients ≥ 18 years old who presented to the ED. Patients must have had ≥ 2 ED encounters for abdominal pain, one in which they received conventional therapy with opioids (C-encounter), and the other in which they received haloperidol (H-encounter). Agitated patients were excluded. Seventy-five patients were needed to detect a 3 MME difference with 80% power and two-sided alpha of 0.05.
RESULTS
We analyzed 107 patients with self-matched encounters. The median dose of haloperidol administered was 5.0 milligrams (mg) (interquartile range [IQR] 2.0 - 5.0). C-encounters had significantly more MME administered than H-encounters (median 5.7 mg [IQR 4.0 - 8.0] vs 0.0 mg [IQR 0.0 - 2.5], P < 0.001). These results remained significant despite route of haloperidol administration. C-encounters had higher rates of rescue therapy administration than H-encounters, (56% vs 33.6%, P < 0.001). There were higher rates of ketorolac administration in the H-encounter (P = 0.02).
CONCLUSION
Encounters in which patients received haloperidol and ketorolac for abdominal pain had a statistically significant reduction in MME administered and lower rates of rescue therapy administration than encounters in which patients were treated with opioids.
Topics: Abdominal Pain; Adolescent; Adult; Analgesics, Opioid; Antiemetics; Cross-Over Studies; Emergency Service, Hospital; Haloperidol; Humans; Male; Middle Aged; Pain Management; Retrospective Studies
PubMed: 34125037
DOI: 10.5811/westjem.2021.2.50390 -
Cells Mar 2022Apart from the known associations between arachidonic acid (AA), weight gain, and neurological and immune function, AA exposure leads to alterations in global and...
Apart from the known associations between arachidonic acid (AA), weight gain, and neurological and immune function, AA exposure leads to alterations in global and gene-specific DNA methylation (DNAm) and fatty acid (FA) content in human cultured cells. However, it is unknown as to whether the latter effects occur in vivo and are maintained over extended periods of time and across generations. To address this issue, we asked whether AA supplementation for three consecutive generations (prior to coitus in sires or in utero in dams) affected offspring growth phenotypes, in addition to liver DNAm and FA profiles in mice. Twelve-week-old BALB/c mice were exposed daily to AA dissolved in soybean oil (vehicle, VH), or VH only, for 10 days prior to mating or during the entire pregnancy (20 days). On average, 15 mice were supplemented per generation, followed by analysis of offspring body weight and liver traits (x average = 36 and 10 per generation, respectively). Body weight cumulatively increased in F2 and F3 offspring generations and positively correlated with milligrams of paternal or maternal offspring AA exposure. A concomitant increase in liver weight was observed. Notably, akin to AA-challenged cultured cells, global DNAm and cis-7-hexadecenoic acid (16:1n-9), an anti-inflammatory FA that is dependent on stearoyl-CoA desaturase 1 (SCD1) activity, increased with milligrams of AA exposure. In accordance, liver promoter methylation decreased with milligrams of germline AA exposure and was negatively correlated with liver weight. Our results show that mice retain cellular memories of AA exposure across generations that could potentially be beneficial to the innate immune system.
Topics: Animals; Arachidonic Acid; Dietary Supplements; Epigenesis, Genetic; Female; Humans; Mice; Mice, Inbred BALB C; Pregnancy; Weight Gain
PubMed: 35326508
DOI: 10.3390/cells11061057