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Idiopathic myointimal hyperplasia of the mesenteric veins is an extremely rare non-thrombotic mesenteric veno-occlusive disease. The management of idiopathic myointimal hyperplasia of the mesenteric veins is not well-established, and although surgery is the mainstay of treatment, the optimal operation remains unclear. Therefore, we aimed to perform a systematic review to assess the various surgical procedures and associated outcomes for patients with idiopathic myointimal hyperplasia of the mesenteric veins. A systematic search for articles published from 1946 to April 2022 in MEDLINE, EMBASE, Cinahl, Scopus, Web of Science, and Cochrane Library databases is reported. In addition, we report 4 cases of idiopathic myointimal hyperplasia of the mesenteric veins managed at our institution until March 2023. A total of 53 studies and 88 patients with idiopathic myointimal hyperplasia of the mesenteric veins were included. Most (82%) were male patients, with a mean age of 56.6 years old. The majority (99%) of patients required surgery. Most reports described the involvement of the rectum and sigmoid colon (81%). The most common surgical procedures were Hartmann's procedure (24%) and segmental colectomy (19%); completion proctectomy with ileal pouch-anal anastomosis was performed in 3 (3.4%) cases. In 6 (6.8%) cases, idiopathic myointimal hyperplasia of the mesenteric veins was suspected preoperatively and managed with elective surgery. Four (4.5%) complications were reported. Nearly all (99%) patients achieved remission with surgical intervention. Idiopathic myointimal hyperplasia of the mesenteric veins is a rare pathologic entity infrequently suspected preoperatively and typically diagnosed after surgical resection. Surgical resection with Hartmann's procedure or segmental colectomy was most commonly performed, with completion proctectomy and ileal pouch-anal anastomosis reserved for cases of extensive rectal involvement. Surgical resection was safe and effective, with a low risk of complications and recurrence. Surgical decision-making should be based on the extent of the disease at the time of presentation. [ABSTRACT FROM AUTHOR]

Spontaneous gastric perforation of the neonate is a rare phenomenon with a high risk of mortality. Despite an uncertain etiology, an association with prematurity and low-birth weight has been demonstrated. Prompt surgical repair and intensive care remain imperative to survival. A premature, low-birth weight male was born at 32 weeks and admitted to the NICU for respiratory distress syndrome. Forty-eight hours after birth he developed abdominal distention and an abdominal radiograph demonstrated pneumoperitoneum. Antibiotics were initiated and he was taken for emergent operative exploration. A 3 cm longitudinal perforation was identified in the greater curvature of the stomach. A two-layered repair was performed and a protective Stamm gastrostomy created. On postoperative day 10, an upper gastrointestinal contrast study demonstrated no evidence of leakage. After sustained clinical improvement, the initiation of oral feeding, and continued weight gain, the neonate was successfully discharged home. The etiology of spontaneous gastric perforation remains a debate with several proposed mechanisms. In most cases, the neonate will present with abdominal distention and emesis. Although presentation and evidence of pneumoperitoneum on abdominal radiograph are suspicious for this pathology, definitive diagnosis is confirmed during operative exploration. Dedicated intensive care and prompt surgical repair are paramount to survival. Despite decreasing mortality rates, premature and low-birth weight neonates continue to have the lowest rates of survival. We present a rare case of a premature, low-birth weight neonate who developed spontaneous gastric perforation and was successfully rescued using a coordinated multidisciplinary approach enabling prompt diagnosis and surgical repair. • Spontaneous gastric perforation is likely multifactorial in etiology due to numerous mechanisms. • Gastrorrhaphy provides adequate repair of the perforation; protective gastrostomy should be strongly considered. • Survival is reliant on dynamic intensive care and prompt surgical repair. [ABSTRACT FROM AUTHOR]

Objective: This study was undertaken to search for differences between fetal weights estimated both ultrasonographically and clinically before and after amniotomy in laboring gravid women.Study Design: Estimates of fetal weight (ultrasonographic and clinical) were obtained for laboring gravid women before and after amniotomy. These estimates were compared with actual birth weights determined post partum.Results: One hundred sixty-two patients completed the study protocol. Comparisons made with unpaired Student t test analyses demonstrated a difference (P <.001) between ultrasonographically estimated fetal weights before and after amniotomy. Simple regression analysis showed a correlation between both ultrasonographic and clinical estimates of fetal weight and actual birth weights before and after amniotomy, with postamniotomy clinical estimates having the strongest correlation (ultrasonographic preamniotomy estimate, R = 0.717; ultrasonographic postamniotomy estimate, R = 0.630; clinical preamniotomy estimate, R = 0.742; and clinical postamniotomy estimate, R = 0.788). Of all ultrasonographic parameters measured, preamniotomy abdominal circumference correlated best with actual birth weight (R = 0.730).Conclusion: Clinical estimates of fetal weight after amniotomy correlated well with actual birth weights. Preamniotomy abdominal circumference was the ultrasonographic parameter best for prediction of actual birth weight. Maternal weight affected clinical but not ultrasonographic estimates of fetal weight in this study. However, clinical estimates of fetal weight were actually superior to ultrasonographic estimates of fetal weight in this study. [ABSTRACT FROM AUTHOR]

Several studies have evaluated the effects of excessive heat stress on chromatin damage; however, DNA damage due to ambient seasonal heat stress has yet to be evaluated. The objective of the present study was to evaluate the effects of natural heat stress on equine sperm chromatin structure by means of two tests: the sperm chromatin structure assay (SCSA) and Sperm-Halomax kit (Halo). Stallion semen samples were collected after a period of excessive heat load (31.05°C) and were compared with samples collected at lower ambient temperatures (14.26°C) to evaluate chromatin damage caused by ambient heat stress produced in the testes. The data indicate that there is no correlation between the SCSA and Halo assays ( r = 0.18 and F = 0.48). Additionally, no correlation for ambient heat stress was observed for any of the applied techniques—SCSA, Halo, and live:dead staining ( P = .2682, .4628, and .0377, respectively). These results suggest that ambient heat load has little effect on stallion chromatin damage. Other elements, such as relative humidity and heat index, were outside the realm of this study and should be assessed in future studies with a larger sample size. [ABSTRACT FROM AUTHOR]

Abstract: Cyathostome resistance to the benzimidazole fenbendazole (FBZ) and other anthelmintic medication has been documented worldwide. Parasite resistance to anthelmintic medication is of great concern to the anthelmintic industry and to horse owners. The present study examines the efficacy of FBZ anthelmintic treatments in horse herds from ranches in four different geographical locations within Texas. In addition, the load reduction method was compared with the traditional fecal egg count reduction test to determine the incidence of parasite resistance to FBZ. Four ranches in different areas of Texas were surveyed to determine cyathostome resistance to FBZ. Two of the four ranches had young (aged ≤2 years) and older animals (aged >2 years). The number of animals with parasites varied widely between the study''s locations. Differences were observed in both the fecal egg count reduction test and load reduction method across the four study sites (P < .001). Cyathostome resistance to FBZ seemed to be prevalent in three of the four ranches, whereas FBZ was highly efficacious against cyathostomes on one ranche. There was a trend toward increased parasite resistance in the younger animals (P = .081). These results show the importance of testing anthelmintic medication effectiveness. [Copyright &y& Elsevier]

For years now, the German Society of Anaesthesiology and Intensive Care Medicine and the Professional Association of German Anaesthesiologists have been actively involved in efforts to improve patient safety. To this end, a whole range of activities have been initiated in recent years and, since February 2011, collected together on our home page ‘PATSI’ (www.patientensicherheit-ains.de). Further, the implementation of syringe labelling (ISO 26825) with additional information on drugs frequently used in intensive care was carried out. Under the item Helsinki Declaration, all decisions and recommendations so far worked out by our speciality have, in structured form, been assigned to individual points and saved as PDF files. This has made it possible for every anaesthesiological department in Germany to integrate all the relevant instructions and conditions of the Helsinki Declaration into their own individual work structures. These systematic solutions represent a major contribution towards reducing the possibility of errors at the workplace. We are certainly still in the early stages of our efforts to achieve a nationwide integration of a cultural change in the way we deal with mistakes in medicine. We have incorporated the item ‘learning from mistakes’ in our project ‘critical incident reporting system for anaesthesia, intensive care medicine, emergency care, and pain therapy, CIRS-AINS’, and have brought out a range of relevant illustrative publications. Accepting these ‘mistakes’ as an opportunity to critically examine ourselves and our work with a view to learning from them and further improving our speciality service is, we believe, a great challenge for future developments in anaesthesia. [ABSTRACT FROM AUTHOR]

Objective: Previous research has suggested a correlation between the subtle rise in progesterone induced by the administration of human chorionic gonadotropin (hCG) and cycle outcome in patients undergoing in vitro fertilization with embryo transfer (IVF-ET). The data suggest that patients who have <2-fold increase in progesterone levels will not conceive as a result of that IVF-ET attempt (poor responders). Further, if the luteinizing-granulosa cells of poor responders are placed in culture, their steroid hormone production will be significantly less than that of the luteinizing-granulosa cells of patients with a normal response to hCG (>3-fold; normal responders). Recent studies have demonstrated that steroidogenic acute regulatory protein (StAR) regulates the rate-limiting step in steroid hormone biosynthesis. The objective of the present study was to determine whether StAR expression differed in normal responders and poor responders undergoing IVF-ET.Study Design: The luteinizing-granulosa cells of 6 patients were isolated after follicular aspiration and assayed for StAR expression. Three sets of cells were from patients exhibiting a normal response to hCG administration and 3 sets were from patients exhibiting a poor response.Results: Data suggest a 17% drop in StAR protein in patients with a poor response to hCG administration when compared with those with a normal response.Conclusions: Although StAR protein was expressed in all 6 cellular extracts, expression appeared greatest in cells recovered from normal responders. Further, although two thirds of the patients with a normal response reported term pregnancies, no pregnancies were reported in the poor responders. Low levels of progesterone and absence of pregnancy may be due to a defect in the mechanism that converts granulosa and theca-lutein cells to luteal cells after the luteinizing hormone surge (or hCG administration). Data from the current study would suggest that the StAR protein may be involved. [ABSTRACT FROM AUTHOR]