The objective was to assess the effect of a structured intervention on caregiver stress and the institutionalization rate of patients with dementia and problem behaviors. Caregivers contacting the Federazione Alzheimer Italia (AI) to receive help, advice, or information in relation to problem behaviors of outpatients were enrolled. Eligible caregiver-patient dyads were randomized to receive either a structured intervention or the counseling AI usually provides (control group). After basal assessment, families were reassessed at 6 and 12 months. Problem behavior (particularly agitation) was the only variable significantly correlated (P = 0.006) with the baseline caregivers' stress score. Thirty-nine families completed the 12-month follow-up; the mean problem behavior score was significantly lower in the intervention than the control group (p < 0.03); the time needed for care of the patient increased by 0.5 +/- 9.7 hours/day in the control group and decreased by 0.3 +/- 4.1 in the intervention group (p = 0.4, Wilcoxon test). The main determinant of institutionalization seemed to be the level of caregiver stress (p = 0.03). In patients of the intervention group, there was a significant reduction in the frequency of delusions. This pilot study suggests that caregiver stress is relieved by a structured intervention. The number of families lost to follow-up, the relatively short duration of the study, and the ceiling effect due to the severity of the clinical characteristics of patients probably all partly dilute the observed findings.
Plasma concentrations of FSH, LH, oestradiol and progesterone were studied daily during 12 interovulatory intervals and 21 periovulatory periods in nine Miniature ponies. The peak of the FSH surge that was temporally associated with emergence of the future ovulatory follicle occurred when the follicle was approximately 9 mm, compared with a reported diameter of 13 mm in larger breeds. The ovulatory LH surge involved a slow increase between Days 13 and 18 (ovulation=Day 0; 0.6+/-0.1 ng day(-1)), a minimal increase or a plateau on Days 18 to 21 (0.04+/-0.1 ng day(-1)), and a rapid increase after Day 21 (2.2+/-0.4 ng day(-1); P<0.0001). The end of the plateau and the beginning of the rapid increase occurred on the day of maximum concentration in the oestradiol preovulatory surge. An unexpected mean increase and decrease in LH occurred (P<0.04) on Days 5 to 9. Concentrations of oestradiol and progesterone seemed similar to reported results in larger breeds. Results indicated that in Miniature ponies the peak of the FSH surge associated with emergence of the future ovulatory follicle occurred at a smaller diameter of the future ovulatory follicle than in larger breeds, the ovulatory LH surge increased in three phases, and the ovulatory LH surge was followed by an LH increase and decrease during the early luteal phase.
Follicular dynamics were studied during 12 interovulatory intervals (IOIs) and 36 preovulatory periods in Miniature mares. The percentage of IOIs with the following follicle events was: ovulatory wave with only one follicle>or=10 mm (55%), diameter deviation similar to previous reports in larger mares (25%) and minor waves emerging before or after the ovulatory wave (55%). Follicle data were compared among Miniature ponies, large ponies and Breton horses (n=12 IOIs per breed). The IOI was longer (P<0.001) in Miniature ponies (23.3+/-0.9 days) and in large ponies (23.9+/-0.5 days) than in Breton horses (20.3+/-0.7 days). The Miniature ponies had fewer (P<0.0001) growing follicles>or=10 mm per ovulatory wave (1.5+/-0.3) and more (P<0.0004) ovulatory waves (6/11) with only one follicle>or=10 mm than large ponies (9.8+/-0.8 and 0/12) and horses (5.8+/-0.9 and 0/12). Maximum diameter of the preovulatory follicle was smaller (P<0.003) in the Miniature ponies (38.3+/-0.7 mm) than in the horses (44.5+/-1.4 mm), but the difference between breeds was slight (6%) compared with the difference in bodyweight (65%). Considering the small number of follicles per ovulatory wave, Miniature mares are a potential model for comparative studies in folliculogenesis within and among species.
Corticotherapy is a common treatment in mares susceptible to endometritis. Isoflupredone improves pregnancy rates and affects the protein profile of endometrial fluid in comparison to untreated mares. Dexamethasone decreases postbreeding fluid accumulation and uterine edema; however, its effects on the protein profile of the endometrial fluid have not yet been studied. The aim of the present study was to verify the effect of dexamethasone on the protein profile of endometrial fluid, in the presence or absence of infection, from mares susceptible to persistent postbreeding endometritis. Nine susceptible mares aged between 7 and 18 years were used. After checking for signs of estrus, mares were subjected to four treatments: C: mares received no treatment and served as control; D: mares received 40-mg dexamethasone at breeding, with collection of samples after 6 hours; I-6 and I-24: intrauterine infusion of 1 × 10(9)Streptococcus zooepidemicus/mL and samples collected after 6 and 24 hours; I/D-6 and I/D-24: intrauterine infusion of 1 × 10(9)S zooepidemicus/mL and 40-mg dexamethasone, collecting the sample after 6 and 24 hours. All mares were subjected to all treatments. Samples were collected and subjected to two-dimensional electrophoresis and mass spectrometry for the identification of relevant protein spots. Corticotherapy altered the protein profile of the endometrial fluid of susceptible mares, characterized by an increase and/or decrease in the optical density of inflammatory acute-phase proteins. We conclude that the use of dexamethasone in mares with and without infection alters the protein profile of endometrial fluid of susceptible mares.
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