Popliteal artery entrapment associated with cannabis arteritis.

OBJECTIVE: To report popliteal artery entrapment in a patient with distal necrosis and cannabis-related arteritis, two rare or exceptional disorders never described in association. To conduct a targeted review and especially to seek information on the clinical presentation with characteristics specific to each disorder so as to hasten the diagnosis and choose appropriate management. MATERIAL AND METHODS: A 19-year-old man who presented with plantar claudication associated with necrosis in a toe underwent diagnostic arteriography and surgery for popliteal artery entrapment type III. RESULTS: Surgical clearance resolved the popliteal artery entrapment but left the clinical symptoms unchanged. Closer questioning disclosed a history of cannabis consumption and intravenous vasodilatory therapy was started. After the 21-day course of vasodilator agents the pain disappeared and the toe necrosis regressed. The patient stopped taking cannabis and had no signs of recurrence. CONCLUSION: Whereas a popliteal artery entrapment, albeit a rare event, is well described and responds to standardized treatment, popliteal artery entrapment associated with cannabis-induced arteritis is an exceptional event that could confuse management. Because young people-the age group mainly at risk for popliteal artery entrapment-increasingly use cannabis, cannabis arteritis could become a more frequent event associated with other arterial disorders that may confuse the diagnosis and complicate management. Our experience in a young patient suggests that coexisting popliteal artery entrapment and distal necrosis in a young patient should raise a strong suspicion of an associated vascular disorder possibly related to cannabis consumption. Intravenous vasodilatation treatment is successful provided that cannabis use is discontinued

Apparent digestibility of nitrogen in rumen and whole tract of Friesian cattle fed direct-cut and wilted grass silages.

Spring grass consisting of Lolium perene L. (81%), Poa pratensis L. (9%), and annual weeds (5%) was stored as direct-cut or as wilted silage and used in feeding trials to determine the effects of wilting on N utilization. Six mature Friesian cattle, fitted with rumen and simple duodenal cannulae, were fed the silages for ad libitum intake in a crossover design consisting of two 49-d periods. Wilting increased intake of organic matter and decreased ruminal apparent digestibility or organic matter and whole tract apparent digestibilities of organic matter, NDF, and total N. Rumen degradability of silage N was increased by wilting (.7 vs. .67). Direct-cut silage, in comparison with wilted silage, provide (g/d) less N intake (232 vs. 286) and lower duodenal flows of total N (215 vs. 293), non-NH3 N (202 vs. 280), microbial N (111 vs. 177), and total amino acids (1056.8 vs. 1342.7). Duodenal flows of NH3 N and undegraded N were not different between silages. Efficiency of bacterial N synthesis in rumen was higher for wilted than for direct-cut silage (32.3 vs. 21.4 g N/kg organic matter apparently digested in rumen). It was concluded that wilting increase silage intake, rumen bacterial synthetic efficiency, and duodenal flow of non-NH3 N in cattle

Apparent digestibility of nitrogen in rumen and whole tract of Friesian cattle fed direct-cut and wilted grass silages.

Spring grass consisting of Lolium perene L. (81%), Poa pratensis L. (9%), and annual weeds (5%) was stored as direct-cut or as wilted silage and used in feeding trials to determine the effects of wilting on N utilization. Six mature Friesian cattle, fitted with rumen and simple duodenal cannulae, were fed the silages for ad libitum intake in a crossover design consisting of two 49-d periods. Wilting increased intake of organic matter and decreased ruminal apparent digestibility or organic matter and whole tract apparent digestibilities of organic matter, NDF, and total N. Rumen degradability of silage N was increased by wilting (.7 vs. .67). Direct-cut silage, in comparison with wilted silage, provide (g/d) less N intake (232 vs. 286) and lower duodenal flows of total N (215 vs. 293), non-NH3 N (202 vs. 280), microbial N (111 vs. 177), and total amino acids (1056.8 vs. 1342.7). Duodenal flows of NH3 N and undegraded N were not different between silages. Efficiency of bacterial N synthesis in rumen was higher for wilted than for direct-cut silage (32.3 vs. 21.4 g N/kg organic matter apparently digested in rumen). It was concluded that wilting increase silage intake, rumen bacterial synthetic efficiency, and duodenal flow of non-NH3 N in cattle

Influence du préfanage de l'herbe avant ensilage sur l'ingestion, les temps de mastication et la digestion dans le rumen des bovins

International audienc

[Crohns-disease of the Esophagus - a Case-report]

A case of oesophageal Crohn's disease associated with large bowel lesions and with ocular, articular and cutaneous manifestations is reported. The patient, a 45 year old woman, was successfully treated with corticosteroids. The authors review the literature about oesophageal involvement in Crohn's disease and extra-intestinal manifestations

Dysregulated apoptosis in primary varicose veins

OBJECTIVE: Programmed cell death plays a critical role in various physiological processes. To investigate its possible pathogenic role in primary varicose veins we studied histological changes in surgical specimens from human varicose veins. In varicose and healthy veins, we also determined the number of cells in apoptosis, and investigated mediators regulating the intrinsic apoptotic mitochondrial pathway (Bax and caspase 9). METHODS: A total 23 varicose veins were obtained from 18 patients undergoing lower-extremity varicose vein surgery for primary varicose disorders. We used nine healthy veins obtained from nine patients undergoing distal arterial bypass grafting surgery as controls. The venous segment analysed was the distal part of the greater saphenous vein. Specimens for histological examination were stained with hematoxylin and eosin, trichromic and Victoria blue. Cell apoptoses and mediators of the mitochondrial pathway were detected in the media by immunohistochemistry using antibodies to peroxidase in situ apoptosis, Bax and caspase 9. Results were expressed as indexes for the three antibodies tested. The Mann-Whitney test was used to compare the results obtained in the two groups. RESULTS: Varicose vein specimens exhibited a more disorganised architecture than healthy veins and showed an increased number of collagen fibres and a decrease in the density and size of elastic fibres. All anti-apoptotic antibodies tested detected significantly fewer immunoreactive cells in tissue sections from the media of varicose veins than of healthy veins (peroxidase in situ, varicose veins (VV) median 2.4% (inter-quartile range 1.6-3.9) versus control (C) 14% (IQR 8.8-19); Bax, VV 1.4% (IQR 0.36-2.4) versus C 11% (IQR 7.6-15); and caspase 9, VV 1.7% (IQR 0.06-3.4) versus C 10% (IQR 9.1-12), P=0.0001 (Mann-Whitney test). CONCLUSION: Apoptosis is down regulated in the medial layer of varicose veins. This dysregulation of the cellular mechanism that maintains normal tissue integrity is mediated through the intrinsic apoptotic pathway and may be among the causes of primary varicose veins