[Vaginal hysterectomy by the Porges technique].
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Female↗
Biomedical subjects
R Neiger
Publications and source records attributed to R Neiger.
Preeclampsia effect on platelet count.
Thrombocytopenia is well recognized when preeclampsia is complicated by the hemolysis, elevated liver tests, low platelet count (HELLP) syndrome. We studied the effect of preeclampsia on the platelets of women whose platelet count and liver function were within normal range. We prospectively evaluated 67 preeclamptic women, gestational age 30 to 42 weeks, with disease of variable severity. The platelet counts of these patients, obtained within 24 hours preceding delivery, were significantly lower than the platelet counts of 71 control subjects. The platelet counts did not differ significantly between patients with mild and severe preeclampsia. Our findings suggest the existence of subclinical thrombocytopenia in preeclamptic women whose platelet values are within normal range.
Adult↗
Radiology corner: differential diagnosis of pulmonary cavitary lesions.
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Animals↗
Gastric mucosal lesions in dogs with acute intervertebral disc disease: characterization and effects of omeprazole or misoprostol.
We characterized gastric mucosal lesions in dogs with acute degenerative disc disease treated by surgery and corticosteroid administration. The effect of omeprazole and misoprostol on gastric lesions in these dogs was also evaluated. Dogs were randomly assigned to 1 of 2 treatment groups or to the control group. Treatment consisted of omeprazole at 0.7 mg/kg orally once daily, or misoprostol at 2 microg/kg orally 3 times daily. All 3 groups received dexamethasone at 2 mg/kg on day 0, prednisolone at 2 mg/kg on day 1. prednisolone at 1 mg/kg on day 2, and prednisolone at 0.5 mg/kg on all further days (range, 5-6 days). Endoscopic examination was performed on day 0 and 5-6 days later. Four regions of the stomach were qualitatively scored from 1 to 12 based on the presence of submucosal hemorrhage, erosion, or ulceration, with ulceration receiving the highest numerical score. Nineteen of 25 dogs had gastric mucosal lesions at the beginning of the study. No significant difference was found in the gastric lesion score among the 3 groups at the end of the study. Gastric mucosal lesions were concluded to be common in dogs with acute degenerative disc disease treated with corticosteroids. Neither omeprazole nor misoprostol at the doses used was effective in healing or preventing the further development of gastric mucosal lesions.
Adrenal Cortex Hormones↗
Helicobacter infection in dogs and cats: facts and fiction.
The discovery of the spiral bacterium Helicobacter pylori and its causative role in gastric disease in humans has brought a dramatic change to gastroenterology. Although spiral bacteria have been known for more than a century to infect the stomachs of dogs and cats, recent research has been conducted mainly in the wake of interest in H. pylori. H. pylori has not been found in dogs and only very rarely in cats and zoonotic risk is minimal. A variety of other Helicobacter spp. can infect the stomach of pets; however, their pathogenic role is far from clear, and they have a small but real zoonotic potential. The prevalence of gastric Helicobacter spp. in dogs and cats is high, irrespective of clinical signs, and as in human medicine, mode of transmission is unclear. The relationship of Helicobacter spp. to gastric inflammation in cats and dogs is unresolved, with inflammation, glandular degeneration, and lymphoid follicle hyperplasia accompanying infection in some but not all subjects. Circulating anti-Helicobacter immunoglobulin G antibodies have been detected in 80% of dogs with naturally acquired infection and most dogs and cats with experimental infection. The gastric secretory axis is similar in infected and uninfected cats and dogs and no relationship of infection to gastrointestinal ulcers has been found. Differences in the pathogenicity of Helicobacter spp. are apparent, because infection with H pylori is associated with a more severe gastritis than infection with other Helicobacter spp. in both cats and dogs. Rapid urease test, histopathology, and touch cytology are all highly accurate invasive diagnostic tests for gastric Helicobacter-like organisms in dogs and cats, whereas culture and polymerase chain reaction are the only means to identify them to the species level. Urea breath and blood tests or serology can be used to diagnose Helicobacter spp. noninvasively in dogs and cats. Most therapeutic studies in pets have not shown long-term eradication of Helicobacter spp. Whether this is due to reinfection or recrudescence has not been established.
Animals↗
A comparison of the survival times of dogs treated with mitotane or trilostane for pituitary-dependent hyperadrenocorticism.
The survival times of 148 dogs treated for pituitary-dependent hyperadrenocorticism were studied using clinical records from 3 UK veterinary centers between 1998 and 2003. Of these animals, 123 (83.1%) were treated with trilostane, while 25 (16.9%) were treated with mitotane. Treatment groups were compared using t-tests and analysis of variance (or their nonparametric equivalents) and chi-square tests. Survival data were analyzed using Kaplan-Meier survival plots and Cox proportional hazard methods. There was no significant difference between the population attributes from each center or between treatment groups. The median survival time for animals treated with trilostane was 662 days (range 8-1,971) and for mitotane it was 708 days (range 33-1,399). There were no significant differences between the survival times for animals treated with trilostane and those treated with mitotane. In the multivariable model (including drug, center, breed group, weight, diagnostic group, and age at diagnosis), only age at diagnosis and weight were significantly negatively associated with survival. Importantly, there was no significant effect of drug choice on survival.
Adrenocortical Hyperfunction↗
The relationship of Helicobacter spp. infection to gastric disease in dogs and cats.
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Animals↗
Evaluation of the basal and post-adrenocorticotrophic hormone serum concentrations of 17-hydroxyprogesterone for the diagnosis of hyperadrenocorticism in dogs.
Serum concentrations of 17-hydroxyprogesterone and cortisol were measured before and after the administration of exogenous adrenocorticotrophic hormone (ACTH) to three groups of dogs: 27 healthy dogs (group 1), 19 dogs with non-adrenal illness (group 2) and 46 dogs with hyperadrenocorticism (group 3). The median (range) post-ACTH concentrations of 17-hydroxyprogesterone were 5.0 (22.2 to 16.8), 6.9 (2.0 to 36.2) and 14.4 (1.7 to 71) nmol/litre in groups 1, 2 and 3, respectively. There were no significant differences in the basal or post-ACTH concentrations of cortisol or 17-hydroxyprogesterone between groups 1 and 2. The post-ACTH concentrations of 17-hydroxyprogesterone in group 3 were significantly (P<0.001) greater than those in groups 1 and 2 combined. The area under the receiver operating curve (ROC) for the post-ACTH concentration of cortisol (0.94) was significantly greater than that for the post-ACTH concentration of 17-hydroxyprogesterone (0.76). Using a two-graph ROC analysis, a cut-off of 8.5 nmol/litre was found to maximise both the sensitivity and specificity of the post-ACTH concentration of 17-hydroxyprogesterone for the diagnosis of hyperadrenocorticism at 71 per cent. With a cut-off of 4.5 nmol/litre the sensitivity increased to 90 per cent but the specificity decreased to 40 per cent; with a cut-off of 16.7 nmol/litre the specificity increased to 90 per cent but the sensitivity decreased to 47 per cent.
17-alpha-Hydroxyprogesterone↗
Culturing tubal pregnancies for Chlamydia trachomatis: is it beneficial?
Chronic Chlamydia trachomatis infection has been demonstrated in the fallopian tubes of asymptomatic infertile women. These women have a significantly increased risk of ectopic pregnancies. The purpose of our study was to determine the efficacy of culturing the ectopic site for C. trachomatis, the likely cause of asymptomatic salpingitis in association with a tubal pregnancy. We cultured the fallopian tubes of 21 patients undergoing surgery for tubal pregnancy, all 21 cultures were negative for C. trachomatis. Although infection with this organism is one of the causes of ectopic pregnancy, we were unable to demonstrate the presence of a concomitant chlamydial infection at the time of surgery. Combining chlamydial cultures with nonculture techniques may be more beneficial in further attempts to demonstrate such an association.
Adolescent↗