By O. Ford. City University of New York. 2019.

Thyroid surgery: comparison between the electrothermal bipolar vessel sealing system cheap 250 mcg fluticasone asthma definition sign, harmonic scalpel order fluticasone 250mcg free shipping asthma symptoms chart, and classic suture ligation discount 500 mcg fluticasone fast delivery asthma diagnosis. Comparison between minimally invasive video- assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study generic fluticasone 250 mcg without a prescription asthmatic bronchitis in adults. Randomized Controlled Trial of Harmonic Scalpel Use During Thyroidectomy Arch Otolaryngol Head Neck Surg. Efficacy and cost-effectiveness of the UltraCision harmonic scalpel in thyroid surgery: an analysis of 200 cases in a randomized trial. Prospective Randomized Trial of Ligasure Versus Harmonic Hemostasis Technique in Thyroidectomy. Harmonic scalpel in multinodular goiter surgery: impact on surgery and cost analysis. Use of the electrothermal vessel sealing systemversus standard vessel ligation in thyroidectomy. The Use of the Harmonic Scalpel vs Conventional Knot Tying for Vessel Ligation in Thyroid Surgery Arch Surg. Such overproduction results in increased blood calcium levels because of increased renal absorption, increased vitamin D synthesis (and calcium absorption in the gastrointestinal tract), and increased bone resorption. Embryology Most normal parathyroid glands (parathyroids for short) weigh between 35 and 50 mg, are under 5 mm in diameter, and are yellowish-brown. They descend with the thyroid into the neck and tend to have a fairly consistent location in the posterior portion of the middle third of the thyroid, just above the intersection of the inferior thyroid artery and recurrent laryngeal nerve. It is typically identified as hypercalcemia on routine laboratory evaluation in a seemingly asymptomatic individual. Patients typically present in one of three groups: those with osteitis fibrosa, those with nephrolithiasis, and those who are asymptomatic and whose disease is incidentally found. Moreover, 25-hydroxy vitamin D levels should be checked, in order to identify coexisting vitamin D deficiency. They should be adequately hydrated, especially if they have significant hypercalcemia. Those with pancreatitis should be offered a parathyroidectomy; without one, the risk of disease recurrence and of significant complications is significant. Those with osteitis fibrosa and osteoporosis also benefit from a parathyroidectomy, which improves cortical and trabecular bone symptoms, though not always bone mineral density. A parathyroidectomy also decreases the risk of a pathologic fracture and lessens muscle weakness and fatigue. And about 90% of patients with nephrolithiasis saw improvement, although renal function improved only variably (in 0% to 43% of patients). Such patients are also potentially at risk for cardiovascular and neurocognitive problems, and they have lower quality of life scores and more psychological symptoms. Other populations who particularly benefit from preoperative localization via imaging include asymptomatic patients who previously underwent related neck surgery (such as a thyroidectomy or neck dissection); patients with difficult anatomic issues (such as those who are obese with a short neck); and patients at high operative risk. Since then, it has been thought to be a valuable tool for preoperative evaluation of the parathyroids. The technetium is taken up by both the thyroid and parathyroids, so iodine (I123) is used for thyroid subtraction. Initially, the study was performed with thallium technetium; however, sestamibi has a higher affinity for abnormal parathyroids. A sestamibi scan result is deemed positive if it pinpoints a hot focus on the initial and/or the delayed image of the parathyroids (but not on the thyroid scan). As a single modality, it has a higher sensitivity than other imaging modalities for identifying solitary adenomas. However, false-positives may be due to thyroid nodules, lymph nodes, and brown adipose. Patients with negative sestamibi scan results are more likely to have lower operative cure rates (92%) than those whose scans showed a distinct adenoma (99%). Patients who are taking a calcium channel blocker are more likely to have a negative sestamibi scan result. Radiotracer retention is necessary in order for the sestamibi scan result to be positive; therefore, patients with high levels of P-glycoprotein (a multidrug resistance protein) are likely to have a negative result. The thyroid is imaged as well, looking for nodules or intrathyroidal parathyroids. Doppler is added to image the vascular structures and to visualize vessels supplying adenomas. Thyroid nodules, especially those posteriorly located, can also be difficult to differentiate from parathyroids. However, it can help predict four-gland hyperplasia (necessitating bilateral neck exploration) more frequently than other imaging modalities. It has also been shown to pick up some parathyroid adenomas previously missed on ultrasound scans. It is helpful in patients who have had a negative result on localization imaging studies or who need a reoperation. Adjuncts in parathyroid surgery As minimally invasive procedures become more popular, the need becomes greater to provide minimally invasive parathyroidectomies. With a minimally invasive parathyroidectomy, as previously mentioned, preoperative imaging is necessary in order to determine which gland needs to be removed. Additionally, intraoperative adjuncts (described below) are frequently used in order to decrease operative time and increase operative success. The most common reason for a failed initial operation is missed multigland disease. Additional intervals are also measured if deemed necessary by the operating surgeon. It is also beneficial in reoperative parathyroidectomies, when it is necessary to find the source of disease. After the surgical field is exposed, the radioactivity of the parathyroid adenoma, thyroid, and surrounding area are all re- measured. An adenoma is defined as an ex-vivo parathyroid with at least 20% of the background radioactivity. The empty parathyroid bed is also checked for radioactivity, and any remaining tissue should only have up to 3% of the radioactivity of the adenoma. It allows re-checking not only of the operative field for radioactivity after removal of the presumed source but also of the removed tissue, in order to be certain that the hyperactive adenoma has been removed. It is also helpful for reoperations, because scar tissue makes finding the adenoma of interest much more difficult. Despite advances in preoperative imaging studies, their accuracy remains limited; sampling parathyroids intraoperatively, before excision, may be necessary to look for hypercellularity. During the freezing process, the tissue can be damaged and distorted, leading to a delay in diagnosis (while awaiting final pathology results) or to an error in diagnosis. In small glands, the sample may not be large enough for an adequate diagnosis (although this is not an issue with enlarged, abnormal glands). It can be very difficult to differentiate thyroid nodules from intrathyroidal parathyroids. Scrape cytology requires few instruments and little equipment, which makes it a more economical test. Its main drawback is that, in very small glands, obtaining an adequate sample may be more difficult. This method is more cost-effective than frozen section analysis because it allows for intraoperative identification without the need for pathologic evaluation. Some have raised the concern that this method can damage normal parathyroids, yet no evidence of this effect exists. Its sensitivity for identifying parathyroid tissue is 99%, using 1,000 pg/mL as the cutoff. Percutaneous aspiration can be performed safely with minimal associated complications. Although this method allows for accurate identification of parathyroid tissue, the false-negative rate is 13% (likely depending on the needle aspiration technique). Most clinicians agree that candidates for a minimally invasive parathyroidectomy need to have two concordant preoperative imaging studies (typically, sestamibi and ultrasound scans). Most patients have single-gland disease, so a minimally invasive approach seems preferable. All patients undergoing a focused parathyroidectomy were thought to possibly have single-gland disease, per preoperative imaging. A 2-cm transverse incision is made over the site of the suspected adenoma, at the medial border of the ipsilateral sternocleidomastoid muscle. The sternocleidomastoid muscle and carotid artery are retracted laterally, and the thyroid is retracted anteromedially. If the adenoma is not identified, the ipsilateral neck should be explored; conversion to a traditional bilateral exploration may be necessary. Although focused parathyroidectomy allows for a smaller cosmetic incision, the downside is that conversion to a bilateral neck exploration may require a second incision. The skin and subcutaneous layers are divided down through the platysma, and the subplatysmal flaps are raised. The median raphe of the strap muscles is divided; the ipsilateral strap muscles are retracted laterally; and the thyroid lobe is rotated anteromedially. Both parathyroids on the ipsilateral side should be visualized: one normal and one abnormal gland should be visualized. However, if both those glands appear normal, or if an abnormal adenoma is not localized, the contralateral side must be explored.

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Seventy-four Ross broiler chicks were picked One chick found dead in Room A was discarded up from a local hatchery on day of hatch (Day 0) for before it could be examined order fluticasone 250 mcg asthma treatment wiki. Routine treatment at the Four more chicks were found dead acutely in hatchery included in ovo vaccination for Mareks and Room B the next day discount 100 mcg fluticasone otc asthma definition 420. One was diagnosed with infectious bursal disease buy fluticasone canada asthmatic bronchitis and flying, and spray vaccination for sudden death syndrome buy fluticasone on line asthma 01, and the other three had infectious bronchitis virus at hatch. One chick had white plaques with examined, neck tagged, and divided between two depressed centers visible through the serosa biocontainment rooms (Rooms A and B) in a throughout the small intestine, and fibrino-necrotic th 273 65 Western Poultry Disease Conference 2016 debris was found associated with these areas. The lesions were seen in any of the gizzards and intestines second chick had a walled-off area of peritonitis examined at the end of the trial (14 birds at 18 days surrounding an obvious intestinal rupture, and of age and 21 birds at 28 days). Necrotic enteritis primarily affects two to On day 11, one more chick was found dead in six week-old broiler chickens raised on litter although Room B. Food was present in the gizzard, however outbreaks in older birds have also been reported (1, there were urate crystals in the ureters indicating 2). The intestinal mucosa from the which is a normal inhabitant of the intestines of jejunum to the cecae was coated with a fibrino- healthy chickens (1). Microscopic Predisposing factors are thought to include a drastic examination of tissues from all three chicks showed change in intestinal microflora, high dietary levels of lesions of extensive coagulation necrosis of the villi fishmeal or grains, or any condition that results in which were lined by rod shaped bacterial. Larger damage to the intestinal mucosa, such as coccidiosis numbers of short rod bacteria were also present in the or mycotoxicosis (1, 2, 3). Colonization of the intestinal epithelium by Eimeria On day 12, two more birds were found dead in spp. No further testing was feed particle size, nutritional deficiencies, adenoviral done on these two birds. One additional runted bird infections, and toxic substances such as mycotoxins was euthanized. Gizzard On day 14 a decision was made to euthanize the erosions have also been associated with high numbers remaining 24 birds in Room B since we could not be of C. In a case dating back to confident they would be useful for the intended 1981, an increased frequency of gizzard erosions research. The remaining 10 birds were sent to a perfringens isolated from the koilin layer of the diagnostic laboratory for complete post mortem gizzard. In No other significant gross abnormalities were retrospect, the cecal intussusception that occurred in observed. A summary of post mortem findings is the five-day-old chick may have been related to the presented in Table 1. Overview of necrotic enteritis rinsing of feed or water containers, or exposure to in poultry. Rethinking our understanding of feed and more extensive contamination may have the pathogenesis of necrotic enteritis in chickens. Gizzard erosions as a cause of mortality in white Despite this, it is important to remember to perform a leghorn chickens. Dupont Material Safety Data Sheet Virkon systems even in young chicks, so lesions are not S. Days of Age Lesions Seen in Room A Lesions Seen in Room B 4 sudden death syndrome 5 cecae intussuscepted into rectum 6 unknown - not fully examined 7 unknown - not fully examined 8 did not examine necrotic enteritis 9 necrotic enteritis 10 necrotic enteritis (2); intestinal perforation (1); sudden death syndrome (1) 11 necrotic enteritis 12 colibaccillosis (2); runt (1) 14 gizzard erosions/ulcers (7) Summary Sudden Death Syndrome 1/37 Gizzard Erosion 7/37 Unknown 1/37 Necrotic Enteritis 5/37 No Apparent Lesions 35/37 Intestinal Accident 2/37 Unknown 2/37 Colibacillosis 2/37 Sudden Death Syndrome 1/37 Runt 1/37 No Apparent Lesions 17/37 (gizzard not examined in 14 of these birds) Table 2. Mycotoxin Amount Detected in Room A Feed Amount Detected in Room B Feed 3-acetyl-deoxynivalenol 29. Just after hatching (Sept 15, 2015 for both eggs), the adult female was presented with acute left A three- year-old adult female roller pigeon limb lameness. She was able to ambulate in the cage used as part of a breeding pair for an ongoing but would not brood her recent hatchlings, which research study was presented with acute left limb subsequently died. Palpation of the leg revealed a large lump large lump that felt near the hip joint. Sections of affected organs were Microscopic examination of the various organs fixed in 10% buffered formalin, routinely processed, revealed neoplastic proliferation of round cells sectioned and stained with hematoxylin and eosin. Osteopenia or osteoporosis is more A three-year-old adult female roller pigeon used likely to occur in adult birds and results in a as a part of a breeding pair for an ongoing research reduction in bone mass. Typical causes include study was housed with her mate at the Poultry starvation, calcium, copper, phosphorus or vitamin D Diagnostic and Research Center animal facilities. Females in production that lack housing consisted of a large wire cage with perches, sufficient dietary calcium can experience bone water and feed. A cardboard nesting box was present resorption due to a high calcium requirement during for laying eggs and brooding hatchlings. Common examples of trauma include foot o study animals comfortable at around 25 C. The entrapment in caging material, flying into objects, breeding pair had produced two eggs laid a couple of improper handling etc. In the present clinical case, days apart (Aug 26 and 28, 2015) and were brooding we perceived that the bird had caught her foot in the th 277 65 Western Poultry Disease Conference 2016 wire caging and dislocated the femur from the hip choice of chemotherapeutic regimes. Nutritional diseases none of the previously cited reports characterized the were ruled out as the diet supplied was balanced for cell origin of the lymphosarcoma. One types of tumors in a pigeon research colony at Perdue possibility is that some of neoplastic cells were University (5). Eighty-three birds were submitted for immature or anaplastic and thus, not able to exhibit necropsy and 28 (33. Seminoma and thyroid veterinary patients is largely dependent on the staging adenoma were the most common tumors diagnosed and pathological grade of the tumor, none of the over an 11 year period. Lymphosarcoma was these diagnostic parameters exist nor have any documented in four birds and grossly had multiple chemotherapeutic agents or protocols been approved nodules in multiple organs. In our (A case report manuscript will be submitted to clinical case, with the exception of the spleen similar Avian Diseases or Journal of Veterinary Diagnostic organs were affected in a 3 year-old bird. Journal of Avian Medicine and suspected respiratory infections, euthanasia was Surgery 9:3-7. Journal of left kidney was most likely applying pressure to the American Veterinary Medical Association 179:1266- sciatic nerve, resulting in lameness. Naturally occurring neoplasms in Immunohistochemistry is typically performed pigeons in a research colony: a retrospective study. Many of these of interest to the industry including additional salmonellas do not pose any risk to human health and Salmonella serovars (Gallisepticum and Enteritidis), are not of significant health concern for the host pathogenic mycoplasmas, and avian influenza. Some usually as a consequence of subclinical infection in laboratories may need to send isolates to a reference food animals leading to contamination of meat, eggs, laboratory to confirm the full serological identity and and milk or secondary contamination of fruits and to determine the phage type and genotype of the vegetables that have been fertilized or irrigated by strain, where applicable. An important initial factor animal feedstuffs, causing subclinical gastro- to consider in the determination of the diagnostic intestinal carriage or infectious disease in animals, method of choice is whether the goal is to detect particularly poultry and swine. The poultry industry antigen presence (the bacteria is present) or antibody works vigilantly to minimize and prevent the detection (evidence of previous exposure or infection introduction of these pathogenic strains from entering to the bacteria). One should then further consider the identification for the presence of the bacterium, as feasibility of the organism, to understand expected done by various methods of diagnostic testing. The differentiate between the presence of live and dead species of interest to poultry and human health is bacteria. This factor can play an exposure to the bacteria in question, resulting in an important role in relation to the spread of infection immune response, and the generation of pathogen between flocks and herds and as causes of human specific antibodies. In the latter case, this can occur when history of vaccination to understand what results are these animals enter the food chain thus producing expected with these modalities. In the study consistent with standard procedures at our lab, but reported herein, randomly selected birds were not consistent with label indications. Both piperazine obtained from three organic, pasture operations and and levamisole are indicated for use in the drinking then randomly subdivided at the research facility into water over a days period of time (approximately). Animal acclimation and post-treatment above, anthelmintic efficacies based on helminth periods were three and seven days, respectively. At numbers seen in this study might be lower than those seven days post-treatment, all birds were humanely seen after a more real life treatment regime, but can euthanized and their intestines processed for helminth be used as approximations. Helminth incidences as seen populations are not within the spectrum of activity in the control birds from the three sites (Table 1) for piperazine or levamisole, and treatable with were 55-100% (Ascaridia galli [roundworm]), 78- fenbendazole only at higher dose rates and as 100% (Heterakis gallinarum [cecal worm]) and 33- multiple-day administrations. Helminth, arithmetic means (and ranges) by Choanataenia infundibulum (tapeworm) was found in farm and treatment group are presented in Table 2. Capillaria obsignata (wireworm), an Helminth populations per bird ranged from 0 to 170, extremely common nematode seen in older 0 to 1220, and 0 to 280 for A. Compared to parasite levels were the highest in the control birds from each infections seen in typical commercial birds, the farm, and with efficacy ranges of 68 to 100 % for A. Ascaridia Heterakis Raillietina galli gallinarum cesticillus Farm N 1 9 55 78 33 2 9 78 100 78 3 9 100 100 66 Table 2. Helminth Trt Ascaridia Heterakis Raillietina Farm Grp galli gallinarum cesticillus 1 Control 6. Materials appearing in this book prepared by individuals as part of their official duties as U. Their work represents their personal and professional views and not necessarily those of the U. Application of this information in a particular situation remains the professional responsibility of the practitioner. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication. This is particularly important when the recommended agent is a new or infrequently employed drug. Department of Neurology Genesis Medical Center of Davenport School of Medicine Davenport, Iowa Washington University in St. We have attempted to offer relevant and information to several groups: current references. The information is readily adapt-able to Busy clinical practitioners in neurology, general practice, emer- handheld devices and will be available from the publisher in that gency rooms, and nonneurologic specialties who need rapid format shortly following publication of the book. Some are young stars while others are quickly refresh their knowledge about the basics of a neurologic accomplished masters in neurology, but all have attempted to condition provide the best distillation of relevant information for each Patients and their families whowant quick information about their condition. Neurolo gy is an areaofmedicine that incites anxiety and dis- comfort for many students, nurses, and physicians whohave not Practice is science touched with emotion.

Debido al nmero limitado de linces ibricos order fluticasone 100mcg on-line asthma treatment diet, en el presente estudio se trabaj paralelamente con especies menos sensibles fluticasone 500mcg discount asthmatic bronchitis with exacerbation, como el lince boreal y el lince rojo buy fluticasone 100mcg with amex asthma flare up. Se evaluaron distintos parmetros morfolgicos y funcionales de los rganos reproductores masculinos antes discount fluticasone generic asthma 7 news, durante y despus de la poca de reproduccin de linces boreales adultos en cautividad (n=3). El tamao y la morfologa del tracto reproductivo fueron estudiados mediante ecografa transcutnea (testculos) y transrectal (glndulas sexuales auxiliares). En el caso del lince ibrico, se trabaj con varios machos del Programa de cra en cautividad (n=7; 4 adultos y 3 juveniles), as como con ejemplares de las poblaciones de vida libre (n=4 adultos); todas las ecografas se realizaron en poca no reproductiva (fnales de noviembre/principios de diciembre). Los testculos y la prstata del lince boreal mostraron cambios de tamao y de textura relacionados con la poca del ao. Se observaron las concentraciones ms 3 elevadas de testosterona en febrero (1240 393 ng/g heces) con un segundo incremento en mayo (971 202 ng/g heces). En las hembras de lince boreal e ibrico, as como en las de lince rojo, se utiliz la ecografa transrectal para visualizar las estructuras ovricas (folculos, cuerpos lteos) y para evaluar la actividad ovrica. Los resultados ecogrfcos de la estructura ovrica indican que los cuerpos lteos formados a partir de la ovulacin permanecen activos hasta noviembre y regresionan antes del inicio del siguiente estro. Pa l a b R a s c l a v e Ecografa, estacionalidad, evaluacin reproductiva, calidad espermtica ab s t R a c t Knowledge on lynx reproduction biology and reliable methods for reproductive monitoring are imperative to assist and propagate the Iberian lynx in captivity. Because of limited access to Iberian lynxes the less endangered Eurasian lynx and the bobcat were included as a surrogate species in this comparative study. We examined morphological and functional parameters of the male reproductive organs prior to, during and after the breeding season in adult captive Eurasian lynxes (n=3). Size and morphology of the reproductive tract was monitored by transcutaneous (testes) and transrectal (accessory sex glands) ultrasonography. Captive (n=7; 4 adult and 3 juvenile animals) and free ranging (n=4 adult animals) male Iberian lynxes were available for ultrasound examination out of breeding season (late November/early December). Testes and prostate of Eurasian lynx showed seasonal-related changes in size and texture. The highest testosterone concentrations were found in February (1240 393 ng/g feces). Mean testosterone3 3 concentration measured in blood serum was higher in the Iberian lynx (0. In female Eurasian and Iberian lynxes and in bobcats, transrectal ultrasonography was implemented to visualize ovarian structures (follicles, corpora lutea) and to assess ovarian activity in addition to analysis of serum progesterone and estradiol. The presence of active corpora lutea during the non breeding season was confrmed by ultrasonography and by elevated serum levels of progesterone averaging 3. The ultasonographical fndings on the ovarian structure suggests strongly that corpora lutea developed after ovulation stay active at least until November and regress before the onset of the next estrus. Qu e v e d o a n d kata r I n a Je w g e n o w Ultrasonographical assessment of structure and function of the male and female reproductive organs in the Eurasian and the Iberian lynx Fr a n k g r I t z, as t r Id va r g a s, Fe r n a n d o ma r t n e z, th o m a s b. In recent studies on Eurasian lynx we have shown that male reproduction is seasonal corresponding to the female estrus (Jewgenow et al. Fecal testosterone concentration, volume of ejaculates, percentages of motile spermatozoa and intact sperm were maximized during the breeding season in February/March (Gritz et al. In several felid species, pregnancy diagnosis based on faecal hormone metabolites A became almost a routine procedure. However, it has been shown that progesterone 369 metabolites in lynxes did not follow the typical pregnancy pattern and made pregnancy diagnosis unattainable by faecal sampling (Jewgenow et al. Surprisingly, progesterone measurement suggestive of luteal activity was also detected after the weaning of cubs (Gritz et al. Because information on reproductive physiology in lynxes is limited, our recent studies focused on implementation of transrectal ultrasonography to assess their reproductive health and to monitor ovarian and testicular activity of the two sister taxa: the Iberian and Eurasian lynx. Due to limited access to the endangered Iberian lynx, where frequent examinations were not possible, Eurasian lynx and bobcats were also examined for comparative purposes. Almost all females from the breeding centers were examined in late October 2006 (n=10) and late november 2007 (n=18). Additionally, seven males and six females captured from the free ranging populations in Doana national Park were also examined to assess their health and reproductive status in late november/early December 2006. Eurasian females were examined in June 2002/2005 (n=11), July (n=7) and november 2003 (n=3). In addition, males were examined prior to (november), during (March) and after (April and June) breeding season between 2002 and 2004. Examined bobcats (Bc) were kept in Russia at the same station (n=1 female, June 2007) and at the Jerez Zoo in Spain (n=3 females, november 2007). Mating was observed, either by direct observation (in Russia) or by 24 hours surveillance using remote controlled camera systems (in Spain). In the Iberian lynxes and bobcats we used 50 g/kg medetomidine (Domitor, Pfzer, Karlsruhe, Germany) and 5 mg/kg ketamine hydrochloride (Imalgene 1000). The entire genital tract of each female was examined from caudad to craniad by transrectal ultrasonography in lateral recumbency (Gritz et al. The transducer was ftted with of two specifc adaptors (15 and 25 cm in lengths, A. Schnorrenberg chirurgiemechanik, Schnwalde, Germany) and introduced into the rectum using ultrasound gel. The dimensions of the ovaries were measured using a calliper system integrated into the ultrasound machine and their volume calculated as that of a simple spheroid (Gritz et al. The diameter of the smallest and largest corpus luteum (cl) was measured and the mean volume of total luteal tissue (mm ) calculated per animal (V=4/3 * mean cl radius * number of cll). In males, ultrasonography of testes and accessory glands was performed as described before (Gritz et al. Accessory glands (prostate) were visualized transrectally and the testes and epididymis by transcutaneous ultrasound using a handheld 7. The volume of the prostate and testes were calculated according to the volume of a simple rotation ellipsoid (V=1/6 * length * height * width) accommodating the spherical and symmetrical shape of these organs. The bugs were placed into cork plates, which were installed at the lynxes preferable resting sites. The obtained serum (syringe collection during anesthesia) and plasma (bug ingested blood) samples were kept frozen until hormone assessment. Progesterone, estradiol (females) and testosterone (males) were measured in the blood serum or plasma by enzyme immunoassays with double antibody technique (Meyer et al. Relationship between volume of luteal tissue and progesterone concentration in blood serum was determined by Spearman correlation. Qu e v e d o a n d kata r I n a Je w g e n o w (a) (b) (c) (d) 371 Fi g u r e 1. So n o g r a m S o F teStiS (a a n d c) a n d p r o S t a t e (b a n d d) o F a S i n g l e m a l e eu r a S i a n ly n x d u r i n g t h e breeding S e a S o n (ma r c h ; a a n d b) a n d o u t o F breeding S e a S o n (november; c a n d d). In all lynx species, sonomorphology of urogenital tracts was similar to other carnivores (Gritz et al. In male Eurasian lynx, seasonal fuctuation of male reproductive organs was evident. They were most active in March and June, while in April and in november they appeared inactive. Seasonal changes were most pronounced in the testes, with a maximum and minimum volume of 2. These fndings are in agreement with our recent results on steroid hormone metabolite concentrations measured in faeces and urine (Jewgenow et al. To our knowledge, the existence of elevated progesterone during lactation and presumably active corpora lutea throughout much of the year is unique for felid species. The existence of large corpora lutea and increased volume of luteal tissue several months after parturition detected by ultrasound examination (Table 1) allows us to assume that progesterone is of luteal origin, although additional studies are required to confrm that the source is ovarian and not adrenal. The low but steady progesterone concentration may function to induce a negative feed back to inactivate folliculogenesis. That would represent a mechanism to turn the normally polyoestric cycle seen in most felids into in a monoestric cycle in the lynx and thus contribute to the seasonality of its breeding pattern so as to match the seasonal sperm production in the males (Gritz et al. The apparent correlation between estrogen and progesterone secretion suggested by current results may refect the important role of estrogens, which might help maintain progesterone receptors and sensitivity for progesterone. Qu e v e d o a n d kata r I n a Je w g e n o w sPecIes age class Recent bReedIng mean (sd) mean (sd) no. Whether this is caused by absence of fertilization of oocytes after ovulation or by early embryonic resorption or possibly by lutenization of antral follicles and subsequent development of accessory corpora lutea is yet uncertain. Our comparative approach is very useful to gain new insights into the reproductive pecularities of both Eurasian and Iberian lynx. Since frequent examination procedures are not possible in the endangered Iberian lynx, the Eurasian lynx can serve as a model species. Assessment of reproductive health by transrectal ultrasound was applied to study seasonal changes in male and female Eurasian lynx. This knowledge was essential to assess the reproductive soundness and physiology of the Iberian lynx. The ultrasonographical fndings strongly suggest that corpora lutea developed from ovulations in mid-winter and stayed active until at least late november. Their functional role on lynx reproduction is still unknown, but we hypothesize that the associated elevated progesterone may support lactation, prevent a new estrus cycle and thus restrict the breeding season to midwinter (as opposed to the strategy used by the polyoestric bobcat). Further comparative longitudinal ultrasound and hormone evaluations on all species within the lynx family are needed to further elucidate their unique reproductive patterns. Pregnancy diagnosis in urine Diagnostic and treatment of reproductive disorders in wild of Iberian lynx (Lynx pardinus). Reproduction in Domestic Animals 43 (2) 74- Asdells Patterns of Mammalian Reproduction. General and ultrasonographic examination of the female urogenital comparative Endocrinology 149, 151-158. Seasonal profles of ovarian activity in Iberian lynx (Lynx pardinus) based on urinary hormone metabolite analyses. Reproductive health assessment of captive pure-bred Amur leopards (Panthera pardus Jewgenow, K.

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They had already moved twice to different rooms in their motel buy fluticasone 100 mcg fast delivery asthma definition airways, each time bringing the tap water in to test for copper generic fluticasone 500 mcg asthma treatment by zubaida tariq. It would mean sitting in a long line of border traffic each day discount fluticasone 100 mcg otc asthma treatment 1, but at least the copper problem would disappear purchase genuine fluticasone on line asthma definition zen. Her blood test, done May 16, showed the typical drop in uric acid as it becomes unmasked by folic acid and other supplements. This results in almost no purines (nucleic acids) being formed or used (catabolized) and hence a low uric acid. The contrast medium brings in all the lanthanide elements, causing serious immune lowering. Until we know which part of her treatment program was responsible, we do not understand it and can- not abbreviate it in any way. Certainly her iron level had become normal (about 100), indicating the absence of com- peting heavy metal, specifically copper [and germanium]. She would now be able to make more red blood cells and improve her immunity so deadly bac- teria could no longer live in her brain lesion. They were getting ready to leave as a happy couple again feeling, as we all did, that their mission had been accomplished. But a marble-like lymph node had popped out at the left side of her neck near the collar bone. Her toxin test showed she was getting toluene on a daily basis; this would certainly go to her brain. She was not drinking commercial beverages, so toluene was suspected in the pre- scription pills and capsules she was taking. We gave Karl the malonate-free food list; his determination was greater than ever. She was Positive for Staphylococcus aureus at the lymph nodes; we knew the problem would be dental since the lymph nodes at the neck drain the mouth fluids. She and Karl had done an exemplary job of keeping a clean envi- ronment at home. Could there be a tumor growtheven just onethat did not contain copper: free, metallic copper? But, with her huge improvement quite visible, they had decided to wait and see for a month. The first thing to do was test the up- per denture she had received at her first visit. She had been getting copper from her polluted dentures, It was replaced immediately (in a few days) with an identical denture, free of the toxins. Plus maleic anhydride which would give her the symptoms of edema again, also due to polluted plastic in her mouth. She was started on potassium gluconate powder to raise her potassium level, and on creatine powder. She would put castor oil hot packs on her neck over the lymph nodes to help them shrink. A new X-ray of her teeth showed a root tip had been left in from previ- ous dental work. All the remaining plastic in each of her lower molars and premolars was scheduled for removal. By September 30, her iron had come up significantly, but copper and malonic acid were still testing Positive at the lymph nodes. But this would not explain the malonatesall four malonic derivatives were present in her lymph nodes. There was only one conclusion: there must be left over toxic plastic in her mouth. There were only eight teeth present, across the front on the lower side and these were pristine, untouched, never-filled teeth! But she had accidentally fallen down the previous night, and we were all concerned that it could have been due to a seizure. She had taken herself off dilantin, although she had been on two a day when she arrived. Could it have been due to rotenone used liberally in all motels except the safe one? It now required 3 tablets of dilantin a day to get her blood level up high enough. Although the ranges are not strictly compara- ble and serum iron was missing, the results are informative. If it was indeed seizure activity, then she was still getting maleic anhydride to her seizure center causing edema there. On October 9, she tested Positive for cobalt at the liver, vanadium at the bone marrow, and copper at the liver. Each of her remaining eight lower pristine untouched front teeth was rubbed with an emery board. The end of the emery board with the rubbing was cut off and dropped in a baggie for testing (water added first). The last tooth on the lower right side was Positive for cobalt, copper, and vanadium. We sampled the tooth again, compared it with the saliva test; there was no mistaking the Positive results for the familiar trio. We discussed the risk and possible benefit for Danielle, namely death versus a gap in her teeth. He explained that plastic can easily escape detection by X-ray, as well as by the dentists eye even with the help of dental dye. Although three individual X- rays had been done to search for it, plus numerous dental visual inspections, it had escaped detection. Possibly, not enough time (two days) had passed to reflect the dental improvement (latest extraction). The toxicity of dental plastic is unknown, its relevance to tumor growth is unknown. The general pollution of human food products with a dozen tumor-growers is unknown. It lay on his lap in the form of scans and summaries; lung cancer, liver cancer, possibly now the brain, as well as skin. His January 2 chest X-ray showed a large tumor, the size of a pear lying vertically in the right lung. He also had considerable infiltrate meaning fluid accumulation in the lung tissue. When he arrived on June 14, he had the appearance of a tired old man, rather corpulent and quick with the lip. He was losing his balance, needed someone to help him get about, and had some pain around the lung area, but he still made quips about all this. He was given Jan 2 X-ray shows pear-sized tumor the parasite killing herbs on the spot and zapped. He was given the malonate-free food list and told to change his copper plumbing, which was also giving him lead. He had paid his bill and simply walked away without even making a follow-up appointment. He wasnt feeling bad; in fact, he was feeling better and didnt want any medicine. Current clinical the- ory holds that high alk phos is a result of cancer; I see the opposite. Uric acid was much too low, showing there was not enough glu- tamine to manufacture purines which metabolize into uric acid. He had done another blood test, picked up fresh supplies of supplements, had been tested for copper and malonic acid and left! If this should happen, he should come in at once; we would give him a Chinese herb to prevent hemorrhageas much as possible! We explained that as lung tumors shrink they may pull away from tissue, causing pain and bleeding, not to be alarmed. We had told him about his blood test improvements, in the hope this would improve his concern for himself. Uric acid was up (he was eating no malonate foods and taking glu- tamine supplement). His thyroid was better; calcium was down and less phosphate was coming from his bones. The letter with summary stated there was no tumor or pleural effusion or pulmonary edema or hyperinflation. June 21 a negative lung His August 2 blood test showed further improvement in the alk phos. We must somehow trap him long enough to sample each of his new dental fillings and test them for copper, cobalt, vanadium, and the malonate compounds. He had changed his glasses frames quite early, did get his copper plumbing changed, and said he was doing everything. But trapping Herve was no small challenge especially now that life was being handed back to him. Summary: We saw him again a few months later; he was still his devil- may-care self. Friends had prevailed upon her to come to us rather than lose one and soon both breasts to a mastectomy at her young age. Throughout her stay she vacillated between optimism and pessimism, not sure whether to go with the opinion of friends or family. Her family had insisted on four courses of chemotherapy, which brought the breast tumor down from 5 cm to half that size. No professional person would want to see a young life snuffed out, so whatever dismemberment could guarantee safety for her was gladly recommended.

9 of 10 - Review by O. Ford
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