Introduction Efficacious therapies are urgently required to tackle the coronavirus disease 2019 (COVID-19). This trial aims to evaluate the effects of atorvastatin in comparison with standard care for adults hospitalized with COVID-19. Methods We conducted a randomized controlled clinical trial on adults hospitalized with COVID-19. Patients were randomized into a treatment group receiving atorvastatin + lopinavir/ritonavir or a control group receiving lopinavir/ritonavir alone. The primary outcome of the trial was the duration of hospitalization. The secondary outcomes were the need for interferon or immunoglobulin, receipt of invasive mechanical ventilation, and O2 saturation (O2sat), and level of C-reactive protein (CRP) which were assessed at the onset of admission and on the 6th day of treatment. Results Forty patients were allocated and enrolled in the study with a 1 to 1 ratio in atorvastatin + lopinavir/ritonavir and lopinavir/ritonavir groups. Clinical and demographic characteristics were similar between the two groups. CRP level was significantly decreased in the lopinavir/ritonavir + atorvastatin group (P < 0.0001, Cohen’s d = 0.865) so that there was a significant difference in CRP level on the 6th day between the two groups (P = 0.01). Nevertheless, there was no significant difference in O2sat on day 6. Although the duration of hospitalization in the lopinavir/ritonavir + atorvastatin group was significantly reduced compared to the control group (P = 0.012), there was no significant difference in the invasive mechanical ventilation reception and the need for interferon and immunoglobulin. Conclusion Atorvastatin + lopinavir/ritonavir may be more effective than lopinavir/ritonavir in treating COVID-19 adult hospitalized patients.
Breeding soundness evaluation (BSE) is the primary assessment for determining the reproductive potential of male animals. This method, however, cannot be used to evaluate semen frequently or to predict future semen quality. Computerized analysis of ultrasonographic images provides information on histophysiological changes in male reproductive organs. We hypothesized that: (i) semen parameters would correlate with ultrasonographic characteristics of the distal region (cauda) of the epididymis and (ii) testicular ultrasound images and/or circulating testosterone concentration would predict future semen quality in the ram. Six adult rams underwent BSE and scrotal ultrasonography approximately 60 d apart (average duration of the spermatogenic cycle) both during the breeding (December and February) and non-breeding (June and August) seasons. An inverse correlation was found between pixel intensity (numerical pixel values) of the epididymes and percentage of sperm in semen with normal morphology (r = -0.46, P < 0.05). Pixel heterogeneity (standard deviation of pixel values) correlated negatively with percentage of sperm with normal morphology (r = -0.42, P < 0.05) and directly with percentage of spermatozoa with abnormal tails (r = 0.43, P < 0.05). Pixel heterogeneity of testicular parenchyma obtained approximately 60 d prior to semen evaluation inversely correlated with percentage of sperm with normal morphology (r = -0.73, P < 0.01) and sperm progressive motility (r = -0.76, P < 0.01), and directly with percentage of sperm with abnormal tails (r = 0.72, P < 0.01) and loose heads (r = 0.79, P < 0.01). We concluded that scrotal ultrasonography combined with computer-assisted analyses of epididymal and testicular echotexture in the ram was a valuable method for determining certain current and future semen parameters, respectively.
Introduction Mechanical bowel prep (MBP) prior to surgical treatment of Hirschsprung's disease (HSCR) has been a great problem of pediatric surgeons for a long time. We conducted a single-institution randomized controlled trial to evaluate the efficacy of no MBP in children with HSCR undergoing the Duhamel procedure. Materials and Methods In this study, children with HSCR who were candidate for the Duhamel procedure were included (40 cases vs. 40 controls). In the case group, intraoperatively after transection of the bowel at the level of transitional zone, feces bulk was pulled up from the upper part of the rectum to the sigmoid colon above the peritoneal reflection and aganglionic bowel was resected. Inspissated stool in the distal of the rectum was removed by rectal washout intraoperatively. In the control group, routine MBP was performed. Cleanness of the rectum was evaluated intraoperatively. Results In this study, a total of 80 children were enrolled. In 32 patients (80%), the goal of MPB was achieved in 4 hours. Mean polyethylene glycol volume was 1372.3 ± 231.9 mL. Preoperative rectal washout fluid was 635 ± 233.3 mL. There was no statistically significant difference in individual complication rates between groups. Four patients (5%) had intra-abdominal infection and 16 (20%) had wound infection. We had no anastomotic leak in our groups. All children or parents in the control group described the preoperative MBP as the most unpleasant part of the hospital administration. Conclusion For young children with HSCR who were scheduled for Duhamel operation, we had found no clear benefit of MBP. However, a multicenter randomized controlled trial is needed to more definitely determine the best preoperative approach for children with HSCR.
Thirty clinically healthy Holstein-Friesian cows underwent twice daily machine milking and ultrasonographic examinations of the udder just prior to and after milking. Digital ultrasonographic images of each udder quarter were subjected to computer-assisted echotextural analyses to obtain mean numerical pixel values (NPVs) and pixel heterogeneity (PSD) of the mammary gland parenchyma. The average milk yield and pH were higher (p < 0.05) in the morning, whereas crude fat, total solids, solids non-fat and citric acid content were higher (p < 0.05) during the evening milking period. Mean NPVs and PSDs of the mammary gland parenchyma were greater (p < 0.05) after than before milking. There were significant correlations among echotextural characteristics of the udder and protein percentage, lactose content and freezing point depression determined in the milk samples collected in the morning and crude protein, casein, lactose and solids non-fat in the evening. Our results can be interpreted to suggest that computerized analysis of the mammary gland ultrasonograms has the makings of a technique for estimating non-fat milk constituents in cows. However, future validating studies are necessary before this method can be employed in commercial settings and research. Moreover, significant inter-quarter differences in udder echogenicity may necessitate further echotextural studies of separate quarters.
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