Praktična primjena brzog progesteronskog P4 testa za rano otkrivanje gravidnosti iz kravljeg mlijeka

Pregnancy diagnosis is an essential part of fertility management in cattle. Early detection of pregnancy 21 days after artificial insemination (AI) allows for early recognition and rebreeding of non-pregnant animals with a minimum delay, which benefits the economic interest for farmers. Rapid progesterone P4 tests are widely used in fertility management strategies, yet there is limited data about the efficiency of tests for P4 measurements in cow’s milk. By measuring P4 concentrations in the milk of different breeds: Red Holstein, Black-Holstein, Simmental, and local crossbreeds, this study aimed to assess the practical application and efficiency of an early and rapid pregnancy detection test from cow’s milk. The study was conducted in 2017–2018 and milk samples were taken from animals at day 21 after artificial insemination (AI) to diagnose pregnancy. The test indicated that of the total cows (n=400) included in this study, 69% were pregnant and 31% were not pregnant, as interpreted based on the P4 Rapid (Ridgeway Science UK) test results. Accuracy of the early diagnosis was verified 60 days after AI (without further AI of cows) by rectal palpation. Based on this examination, 263 (66%) cows were diagnosed as pregnant, while 14 (34%) were diagnosed as non-pregnant. The highest accuracy in pregnancy detection was found in the local crossbreeds and the Simmental breed, with 97% correct diagnosis of cows, followed by Red Holstein with 94% and Black Holstein with an accuracy of 90%. This study showed that the use of progesterone P4 rapid tests in milk samples is an effective, fast and accurate method for the early detection of pregnancy in cows, with an accuracy rate of 90 to 97% based on cattle breed.Dijagnoza gravidnosti bitan je dio menadžmenta plodnosti u goveda. Rana dijagnostika gravidnosti 21 dana nakon osjemenjavanja omogućava rano prepoznavanje i ponovno umjetno osjemenjivanje (UO) negravidnih krava s minimalnim produžetkom servisnog razdoblja te je od ekonomskog interesa za poljoprivrednike. Brzi progesteronski P4 testovi puno se koriste u strategijama upravljanja plodnosti, ali postoji ograničen broj podataka o učinkovitosti tih testova za mjerenje P4 iz kravljeg mlijeka. Mjereći koncentraciju progesterona P4 iz mlijeka različitih pasmina krava kao što su: crveni holstein, crni holstein, simentalska pasmina i lokalne križane pasmine, ova studija ima za cilj procjenu praktične primjene i učinkovitosti ranog i brzog testa dijagnostike gravidnosti iz kravljeg mlijeka. Studija je provedena u razdoblju od 2017. i 2018., a uzorci mlijeka uzorkovani su životinjama 21. dana nakon UO u svrhu dijagnostike gravidnosti. Od 400 krava uključenih u ovo istraživanje, interpretacijom rezultata na temelju uporabe progesteronskog P4 brzog testa (Ridgeway Science, VB) 69 % testiranih krava je bilo gravidno, dok 31 % krava nisu bile gravidne. Točnost rane dijagnoze potvrđena je 60 dana nakon UO krava (bez daljnjih UO krava) rektalnom palpacijom. Na temelju ovog ispitivanja 263 krave, odnosno njih 66 % je dijagnosticirano gravidnima, dok 14 krava ili 34 % nisu bile gravidne. Najveća preciznost u otkrivanju gravidnosti ovom metodom ustvrđena je u lokalnih križanih pasmina i krava simentalske pasmine s 97 % točno dijagnosticiranih krava, a slijede ih pasmina crveni holstein s 94 % i crni holstein s 90 % točnosti. Naše istraživanje pokazalo je da se s preciznošću od 90 % do 97 % za različite testirane pasmine krava uporaba brzih progesteronskih P4 testova u uzorcima mlijeka pokazala učinkovitom, brzom i točnom metodom za rano otkrivanje gravidnosti krava

Compliance of a cobalt chromium coronary stent alloy – the COVIS trial

BACKGROUND: Cobalt chromium coronary stents are increasingly being used in percutaneous coronary interventions. There are, however, no reliable data about the characteristics of unfolding and visibility of this stent alloy in vivo. The aim of this study is to compare cobalt chromium coronary stents with conventional stainless steel stents using intracoronary ultrasound. METHODS: Twenty de novo native coronary stenoses ≤ 20 mm in length (target vessel reference diameter ≥ 2.5 and ≤ 4.0 mm) received under sequential intracoronary ultrasound either a cobalt chromium stent (Multi-Link Vision(®); n = 10) or a stainless steel stent (Multi-Link Zeta(®); n = 10). RESULTS: For optimal unfolding, the cobalt chromium stent requires a higher balloon deployment pressure (13.90 ± 2.03 atm) than the stainless steel stent (11.50 ± 2.12 atm). Furthermore, the achieved target vessel diameter of the cobalt chromium stent (Visibility-Index QCA/IVUS Multi-Link Vision(®)1.13 / Multi-Link Zeta(® )1.04) is more easily overrated by Quantitative Coronary Analysis. CONCLUSION: These data indicate that stent material-specific recommendations for optimal implantation pressure and different stent material with an equal design should both be considered in interpreting QCA-analysis

Phytoestrogen supplementation and body composition in postmenopausal women: A systematic review and meta-analysis of randomized controlled trials.

Phytoestrogen-based medications are commonly used by menopausal women, and especially by obese postmenopausal women, to relieve menopausal symptoms. Substitution of animal with soy protein is often used in weight loss regimens, yet the effect of phytoestrogens, the main constituent of soy foods, on body composition is not completely understood. We conducted a systematic review and meta-analysis to investigate the associations between phytoestrogen supplementation and body weight and the main parameters of body composition in postmenopausal women. A literature search was done using 5 electronic databases from inception to April 2018. Randomized controlled trials (RCTs) with postmenopausal women comparing phytoestrogen supplementation followed by usual diet and placebo were included in the present meta-analysis. From 5932 references, we identified 23 RCTs that met our inclusion criteria, with a total of 1880 postmenopausal women. No association was observed between phytoestrogen supplementation and body weight, body mass index, waist and hip circumference, total fat mass or percentage of body fat. However, the use of phytoestrogens supplementation was associated with a slight decrease in waist-hip ratio; the pooled mean difference was -0.01 cm (95%CI: -0.01 to -0.006). In subgroup analysis, we found a modest decrease in body weight with phytoestrogens supplementation compared with placebo in healthy postmenopausal women [pooled mean difference of changes -0.28 kg (95%CI: -0.52 to -0.04)] and in RCTs with a median number of participants of 66 or less [pooled mean difference of changes -0.49 kg (95%CI: -0.87 to -0.11)]. In contrast, phytoestrogen supplementation was associated with increased body weight in postmenopausal women with preexisting metabolic disorders (prediabetes, type 2 diabetes, prehypertension and hyperlipidemia) [pooled mean difference of changes: 0.78 kg (95%CI: 0.53-1.03)]. In addition, there were some indications that some types of phytoestrogens, such as daidzein, but not soy products or isoflavone mix, could lead to modest adverse changes in body composition in menopausal women. Therefore, future studies should investigate the potential adverse effects of phytoestrogen supplementation on body composition among postmenopausal women

Classification of coronary artery bifurcation lesions and treatments: Time for a consensus!

Background: Percutaneous coronary intervention (PCI) of coronary bifurcation lesions remains a subject of debate. Many studies have been published in this setting. They are often small scale and display methodological flaws and other shortcomings such as inaccurate designation of lesions, heterogeneity, and inadequate description of techniques implemented. Methods: The aim is to propose a consensus established by the European Bifurcation Club (EBC), on the definition and classification of bifurcation lesions and treatments implemented with the purpose of allowing comparisons between techniques in various anatomical and clinical settings. Results: A bifurcation lesion is a coronary artery narrowing occurring adjacent to, and/or involving, the origin of a significant side branch. The simple lesion classification proposed by Medina has been adopted. To analyze the outcomes of different techniques by intention to treat, it is necessary to clearly define which vessel is the distal main branch and which is (are) the side branche(s) and give each branch a distinct name. Each segment of the bifurcation has been named following the same pattern as the Medina classification. The classification of the techniques (MADS: Main, Across, Distal, Side) is based on the manner in which the first stent has been implanted. A visual presentation of PCI techniques and devices used should allow the development of a software describing quickly and accurately the procedure performed. Conclusion: The EBC proposes a new classification of bifurcation lesions and their treatments to permit accurate comparisons of well described techniques in homogeneous lesion groups. © 2008 Wiley-Liss, Inc

Use of platelet glycoprotein IIb/IIIa inhibitors in diabetics undergoing PCI for non-ST-segment elevation acute coronary syndromes: impact of clinical status and procedural characteristics

Background: The most recent ESC guidelines for percutaneous coronary intervention (PCI) recommend the use of glycoprotein IIb/IIIa inhibitors (GPI) in high risk patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS), particularly in diabetics. Little is known about the adherence to these guidelines within Europe. Methods and results: Between May 2005 and April 2008 a total of 47,407 consecutive patients undergoing PCI were prospectively enrolled into the PCI-Registry of the Euro Heart Survey Programme. In the present analysis we examined the use of GPI in 2,922 diabetics who underwent PCI for NSTE-ACS. In this high risk population only 22.2% received a GPI; 8.9% upstream and 13.4% during PCI. The strategy of the individual institution had a major impact on the usage of GPI. In the multiple regression analysis clinical instability and complex lesion characteristics were strong independent determinants for the use of GPI, whereas renal insufficiency was negatively associated with its use. After adjustment for confounding variables no significant differences in hospital mortality could be observed between the cohorts, but a significantly higher rate of non-fatal postprocedural myocardial infarction was observed among patients receiving GPI upstream. Conclusions: Despite the recommendation for its use in the current ESC guidelines, only a minority of the diabetics in Europe undergoing PCI for NSTE-ACS received a GPI. The use of GPI was mainly triggered by high-risk interventional scenarios

Five-Year Clinical Outcomes of a Polymer-Free Sirolimus-Eluting Stent Versus a Permanent Polymer Paclitaxel-Eluting Stent: Final Results of the Intracoronary Stenting and Angiographic Restenosis -Test Equivalence Between Two Drug-Eluting Stents (ISAR-TEST

Background: Limited evidence exists regarding the long-term performance of polymerfree (PF) drug-eluting stents (DES) in comparison to permanent polymer DES. This study investigated the 5-year efficacy and safety of a PF sirolimus-eluting stent (PF-SES) versus a permanent polymer paclitaxel-eluting stent (PES) in the setting of the Intracoronary Stenting and Angiographic Restenosis-Test Equivalence Between Two Drug-Eluting Stents (ISAR-TEST) randomized trial. Methods and Results: A total of 450 patients undergoing percutaneous coronary intervention were randomized to receive either PF-SES (Yukon, Translumina; n 5 225) or PES (Taxus, Boston Scientific; n 5 225). Clinical follow-up was performed to 5 years after enrollment. The endpoints were major adverse cardiac events (MACE), target lesion revascularization (TLR), the composite of death or any myocardial infarction (MI) and stent thrombosis (ST). The incidence of MACE at 5 years was 27.3% (57 patients) in the PF-SES group and 31.7