Significant variability was found for total phenolics 5 mg caduet with visa, total monomeric anthocyanins and antioxidant capacity of wild raspberries discount caduet 5 mg. Nevertheless buy caduet 5 mg on line, the results indicated that some of the wild accessions of red raspberries have higher antioxi dant power and phytonutrients content than existing domesticated cultivars. Finally, two strawberry cultivars were studied as to their content of total phenolic compounds and anti oxidant capacity in different ripeness stages . It was concluded that despite the berries in general have better taste and be more appreciated at ripe stage, higher contents of total phe nolic compounds and antioxidant power were observed at pink stage for both strawberry cultivars studied. By this study, it was able to con clude that the two fruits can be applied as antioxidant supplements to the normal diet. Con sumption of a combination of both fruits could be recommended in order to obtain the best results. There was a strong correlation between total phenolics and antioxidant power of nectarines, peaches, and plums. By continuing to study the plum fruits, 20 genotypes of plums were investigated for their antioxidant capacity and total phenolics content . It was concluded that phenolic com pounds seem to play a significant role in antioxidant value and health benefits of plums. The antioxidant power of the plum peels, flesh and pits reflected the total phenolics content of the samples with efficacy increasing of the order: peels < flesh < pits across the assays. The results obtained showed that the total phenolics content in the peel can be up to 25 times higher than in the flesh. This study demonstrated that selection of raw materials (co-extraction of arils and peel) and pressure, respectively, markedly affected the profile and content of phenolics in the pomegranate juices, underlining the necessity to optimise these parameters for obtaining products with well-defined functional qualities. Studies have also been carried out to quan tify the total phenolics content and antioxidant capacity of citrus fruits. Phenol ic compounds were among the two main antioxidant substances found in all extracts. Peels polar fractions showed the highest contents in phenolics, which probably contribute to the highest antioxidant power found in these fractions. In another experiment, grapefruit and sour orange were extracted with five different polar solvents. It was concluded that the data obtained clearly established the antioxidant power of the studied citrus fruit extracts. Significant differences were also found in antioxidant capacity val 104 Oxidative Stress and Chronic Degenerative Diseases - A Role for Antioxidants ues via the same method in different solvents, as well as on the antioxidant capacity of each extract via different methods. Nonetheless, the broad range of activity of the extracts led to the conclusion that multiple mechanisms are responsable for the antioxidant power of the samples and clearly indicated the potential application value of the citrus fruits studied. Fi nally, the study of the content of phenolic compounds and antioxidant power of tropical fruits such as guava has also been conducted. One white-fleshed and three pink-fleshed of guava were analyzed as to their content of total phenolics, in addition to ascorbic acid and total carotenoids, as well as to their antioxidant capacity . The results obtained showed that white pulp guava had more total phe nolics and ascorbic acid than pink pulp guava. In all antioxidant assays the methanol extracts showed good corre lation with the content of total phenolics and ascorbic acid, as well as between them, but showed negative correlation with total carotenoids. In addition to the aforementioned fruits, in the search for new foods rich in phenolic com pounds and high antioxidant capacity, unconventional tropical fruits have been widely researched. The antioxidant power of these fruits showed a strong correlation with their total phenolics content . Other plant-originated foods studied for their content of phenolic compounds and antioxi dant capacities are as follows. The cocoa and chocolate liquor antioxidant capacities as well as monomeric and oligomeric procyanidins were studied . However, following the changes in total and individual phenolics content as well as antioxidant capacity during the processing of cocoa beans , it can be noted that the loss of phenolic compounds and antioxidant capacity of cocoa vary according to the degree of technological processing. The roasting process and cocoa nib alkalization had the greatest influence on the content of phenolic compounds and antioxidant power. The antioxidant capacity of 107 different Spanish red wines, from different varieties of grapes, aging proc esses and vintages  was also investigated by different methods and the results showed that all samples had an important capacity of removing hydroxyl radical and were able to block the superoxide radical, but with 10 times lower intensity. The wines also showed important protective action on biomarkers of oxidative stress. However, few statistically significant correlations were found between the levels of total phenolics and antioxidant power of the wines and the values of these correlations were very low. The correlation between antioxidant capacity and content of phenolic compounds as well as between antioxidant capacity and phenolic profile of samples  was determined. However, no significant correlation was found between their antioxidant capacity and to tal phenolics content. Nevertheless, the canonical correlation and multiple regression anal ysis showed that the antioxidant capacity of the samples was highly correlated with their profile of phenolic compounds. The results obtained in this study showed the importance of analyzing the phenolic profile of the sample rather than total phenolics to help under stand the differences in the antioxidant power of wines, which should be extended to oth er food products. Among the alcoholic beverages, antioxidant power has also been reported for whiskey, sake and sherries. In addition to alcoholic beverages, the free radical- scavenging activity and total phenolic content of commercial tea  were determined, finding that green tea contained higher content of phenolic compounds than black tea. The antioxidant capacity per serving of green tea was also much higher than that of black tea. In the two methods applied, the antioxidant power of the samples per serving was found in the following descending order: cocoa, red wine, green tea and black tea. The coffee extracts with the highest antioxidant capaci ty were obtained after extraction with water neutral (pH 7. In addition, the drink degreasing and lyophilization of the extract permitted to obtain coffee extract powder with high antioxidant power, which can be used as an ingredient or additive in the food industry with potential for preservation and functional properties. It is also know that tamarind, canola, sesame, linseed and sunflower seeds are other possible sources of phenolic compounds  and have high antioxidant capacity. In the three methods applied, the aqueous extract showed higher an tioxidant capacity than the ethanolic. It was concluded in this study that the high anti oxidant power found for the aqueous extract of the studied sunflower seed suggests that the intake of this seed may prevent in vivo oxidative reactions responsible for the development of several diseases. Although some studies have shown few statistically significant correlations between the levels of total phenolics and antioxidant capacity in foods, in others the content of total phenolic compounds was highly correlated with the antioxidant power of samples. Author details Maria de Lourdes Reis Giada* Address all correspondence to: mlgiada@nutricao. Compuestos polifenlicos: estructura y classificacin: presencia en alimentos y consumo: biodisponibilidad y metabolismo.
If owners elect treatment purchase caduet 5 mg on line, referral to surgeons experienced in this repair is recommended discount caduet 5 mg fast delivery. Growth rates may be compro- mised generic caduet 5 mg without a prescription, at least initially, in some animals that do survive the surgery. This syndrome results in gas and uid accumulation in the proximal colon with a subsequent ping detected in rather than pathologically distended. Location of this ping leads to tal examination conrms this nding, the animal must confusion in differential diagnosis, and many cattle be reassessed and a diagnosis sought. Because the region of this ping overlaps ping, which never extends more than three rib spaces that of a cecal dilatation, a rectal examination should be cranial to the right paralumbar fossa. In cattle with Occasionally pings associated with the proximal and benign proximal colonic distention, rectal palpation descending duodenum occur when small intestinal ob- reveals mild to undetectable colonic distention. Signs are disparate because of variable etiologies, but straining to defecate and narrow liquid streams of feces are observed in most cases, regardless of specic signs. Il- eus or passage of some gas and uid from the displaced Diagnosis abomasum into the lower gastrointestinal tract during Rectal examination conrms the diagnosis in most transportation may have resulted in the benign colonic cases. History of in perimetritis patients, in severe cases the acute over- recent calving, presence of fever, and rectal and vaginal whelming infection usually results in a degenerative left examinations conrm perimetritis. Treatment Vaginal examination should be performed to ascertain Pelvic abscesses causing extraluminal rectal compression whether adhesions exist between the pelvic masses and have a fair to good prognosis depending on location. Appropriate systemic antibiotics should be between the mass lesions and vagina are absent, abdom- administered after drainage. Penicillin at 22,000 U/kg inal exploratory surgery would be necessary to conrm once or twice daily is suitable when A. Organic iodide powder may be fed at Postparturient pelvic hematomas are extremely com- 1 oz/day for 2 to 3 weeks for its nonspecic activity mon in primiparous cattle and possible in multiparous against thick-walled abscesses. Hematomas can be without contamination of the peritoneal cavity, prognosis singular or multiple and may be found at any location is poor, but long-term penicillin therapy (3 to 6 weeks) of the pelvic region, although most occur in the ventral and oral iodide powder for a similar length of time may or lateral pelvic areas. The addition of rifampin to the antibiotic regi- a massive hematoma may develop secondary to dysto- men may also be considered to improve abscess pene- cia and cause severe anemia and rectal compression. Laboratory Aids Treatment of perimetritis is not highly successful but In confusing cases, ancillary aids such as cytology from includes broad-spectrum intensive antibiotic therapy to aspirates or biopsies may be indicated. Serum globulin control the mixed bacterial ora likely found in such levels usually are elevated in cattle affected with pelvic cases. These animals will survive than rest and once-monthly rectal palpation to assess longer (2 to 7 days) than cattle with full-thickness lac- resolution. Most resolve within 30 to 60 days after erations directly entering the peritoneal cavity but still freshening. Diagnosis Unless present for the causative injury, the veterinarian may not be condent of a diagnosis until a rectal exami- Rectal Lacerations nation is done. As soon as the rectal injury is palpated Etiology or suspected by the rapid appearance of blood on the Rectal lacerations result from ignorant roughness by examiner s sleeve and severe tenesmus, the rectal exami- neophyte examiners, frustrated or angry attempts at nation should be terminated. Inexperienced examiners cause most rec- tent of the injury then can be palpated gently and a di- tal lacerations. If no history of previous less common in cattle than horses, they occur fre- rectal examination exists, the veterinarian must keep in quently enough to emphasize the need for gentle, well- mind the possibly of sadism and decide judiciously if lubricated rectal palpation. Plastic sleeves are to blame and when to discuss the possibility with the owner and for some of the rectal lacerations that occur in dairy authorities. Neophyte examiners should be trained with rubber gloves and sleeves; it is not possible to palpate Treatment as carefully or gently with a plastic sleeve as it is with If only mucosal injury has occurred, rest from rectal a rubber glove. Even experienced examiners using plas- examinations for a minimum of 1 week along with tic sleeves often inadvertently cause rectal mucosal lac- laxative feeds (silage or green chop) are indicated. The prognosis is graded, as are equine rectal tears, but a simple classi- favorable. Once again, epidural anesthesia may be required for 1 to 4 days Signs to minimize tenesmus in individual cattle that strain ex- If rectal laceration occurs during rectal examination, cessively such that they refuse feed and water because signs are immediate in the form of fresh blood on the of the vicious cycle of straining more pain straining. If the veterinarian has not been present should perform a rectal examination and assess the rectal for the causative rectal examination, signs will depend integrity. The prognosis is favorable, but only an ex- on the depth of the rectal injury and the time elapsed perienced veterinarian should palpate such cows in the since injury. Attempts at rectal examination will be greatly the peritoneal cavity, the cow should be slaughtered resisted with tenesmus and often bellowing. If full-thickness with gastrointestinal ileus, elevated heart rate, and an rectal lacerations communicate with the retroperito- arched stance. Septic peritonitis has occurred, and if the neal space in the pelvic region, the prognosis is usually rectal tear communicates fully with the peritoneal cavity, poor. However, some cattle with small full-thickness the cow will usually be dead in less than 24 hours. The laxative be suspected, and the exact cause will escape detection diet and species difference in fecal consistency preclude unless an autopsy is performed. This simple, autosomal, recessive defect results in con- Permanent tail paralysis may persist and result in a striction at the anorectal region and vulva-vestibule soiled perineum and tail, as well as possible vulvovagi- region. Fibrous tissue at these areas prevents rectal ex- nal fecal contamination, which interfere with fertility. Jersey cattle with this Surgical repair may be possible for show animals or very defect also appear especially prone to severe parturient valuable breeding animals in which a fractured tail udder edema. Af- fected calves show signs shortly after birth because they Pneumorectum may be caused by conformational de- are unable to pass manure. The rectal lumen usually bulges subcutane- rectum usually does not require treatment because it ously in the normal region of the anus when the abdo- does not cause illness unless it persists and becomes men is compressed. Although simple cutaneous puncture severe, in which case one or more epidurals may be often allows fecal passage, these incisions often brose needed as treatment. Cows can get into a vicious cycle and lead to anal stricture, tenesmus, and abdominal of sucking air and straining such that they will be- distention. When a rectal examination is essential for diag- has not been documented, the ethics of performing this nostic purposes (e. This may be accomplished by a gentle sweeping of the rectum until a contraction band can be grasped and pulled caudally Constipation to express the air from the rectum. The procedure may This condition is uncommon in cattle and, when ob- need to be repeated several times to complete evacua- served, generally points to neurologic decits or painful tion and is quite successful except in instances of severe conditions that interfere with defecation. Because matic caudal spinal cord injury include lymphosarcoma, the rectum traverses the right upper abdominal quad- neurobroma, and ascending cauda equine myelitis as- rant, the ping occurs from the tuber coxae through the sociated with tail head cellulitis caused by perivascular right paralumbar fossa and a variable distance cranially. Poor aseptic technique during repeated epidural this nding creates a broad differential diagnosis (cecal administration is another possible cause of ascending myelitis. Fractures of the base of the tail involving the sacro- coccygeal junctional area may cause so much pain and can also cause neurologic defects that the cow shows signs of constipation. The most common cause of tail fractures in cattle is being ridden by other cows or bulls during standing estrus. Sadistic tail restraint that frac- tures the tail may also cause severe pain, constipation, tail head swelling, and accidity of the tail.
Diagnosis: The pain can be reproduced by placing the fingers under the inferior rib margin and pulling the rib edge outward and upward discount 5mg caduet fast delivery. Treatment: Many patients with slipping rib syndrome will have spontaneous reso- lution of their symptoms in about a week caduet 5 mg with visa. Improvement may also be seen after short course of treatment and several options may be considered buy caduet 5 mg lowest price. Chiropractic manipulation often provides complete resolution after a few sessions. Trauma and Muscle Strain Definition: This is seen more frequently in the adolescent population who are involved in sports, particularly weightlifting. Presentation: The pain is localized to the site of injury and usually is associated with swelling or erythema. In severe trauma to the chest, patients will present with shortness of breath, severe chest pain and arrhythmia and you should rule out myo- cardial injury and hemopericardium. Diagnosis: Findings in the physical exam (erythema, bruises, hematomas), make the diagnosis straightforward. Chest X-ray is necessary if trauma is severe to rule out rib fractures, lung injury (hemothorax, pneumothorax) or cardiac injury (hemopericardium). If mild trauma and no other lesions associated, nonsteroidal anti-inflammatory drugs help to reduce the pain. It is often associated with exercise, and is described as sharp, short duration, and located in the left substernal region. Characteristics that distinguish it from angina are its sudden onset, localized nature, and short duration. Presentation: This is characterized by sudden pain in the anterior left side of the chest and occurs at rest or during mild activity and can last for few seconds to sev- eral minutes. The pain occurs exclusively with inspiration, and resolves quickly and completely. Respiratory Conditions Reactive Airway Disease (Asthma) Definition: Chest pain due to overuse of chest wall muscles secondary to reactive airway disease is a common cause of chest pain in the pediatric cage group. Presentation: Vague muscular pain, typically bilateral occurring just after worsening of respiratory distress due to reactive airway disease exacerbation. Diagnosis: History of reactive airway disease and occurrence of chest pain after exacerbation of reactive airway disease should alert the physician to this diagnosis. Treatment: management of this condition should focus on management of reactive airway disease with inhalation bronchodilators to eliminate pain caused by overuse of accessory respiratory muscles. Diagnosis: This is made through history, findings of rales, tachypnea, or decreased breath sounds. Treatment: Antibiotics and drainage of the abscess or pleural fluid is the main treatment, some patients will benefit of additional O2 and hospitalization. Pleural Disease Definition: Pleural space has the potential to collect large amount of fluid, air and consequent irritation of the phrenic nerve with posterior pleural irritation and chest pain. Presentation: Spontaneous pneumothorax or pneumomediastinum can present with sudden respiratory distress and severe none localize chest pain. Children at high risk for these conditions are those who have asthma, cystic fibrosis, and Marfan syndrome, but previously healthy children may rupture an unrecognized subpleural bleb as well. Treatment: Drainage of the fluid or air out of the pleural cavity will resolve this condition. Children may not be able to make the distinction of pain caused by a cutaneous lesion versus true chest pain. Herpes zoster is caused by the varicella zoster virus reactivation and posterior inflammation in the dorsal root ganglion accompanied by hemorrhagic necrosis of nerve cells. Patients complain of severe pain usually unilateral and restricted to a dermatomal distribution. It is important to note that initial chest pain is usually not associated with a vesicular rash; this will appear in the next 24 48 h of initial presentation. Diagnosis: Careful inspection of skin over the thorax is essential when evaluating chest pain as it may reveal skin lesions causing the pain. Presentation: Pericarditis presents with a sharp, stabbing pain that improves when the patient sits up and leans forward. The child is usually febrile, in respiratory distress, and has a friction rub heard through auscultation. Distant heart sounds, neck vein distention and pulsus paradoxus can occur when fluid accumulates rap- idly. However, it should be noted that chest pain typically resolves when pericardial fluid accumu- lates as it serves to separate the two pericardial surfaces and prevent their friction which is the cause of pericardial pain. Diagnosis: History and physical examination is helpful in making the presumptive diagnosis. Echocardiography is important to assess extent of fluid accumulation and need for intervention to pre- vent cardiac tamponade. Nonsteroidal anti-inflammatory agents are typically used to reduce inflammation and to assist with pain. Steroids may be indicated if fluid accumulation is significant and there is urgent need to reverse inflammatory process. Pericardiocentesis is indicated if pericardial fluid accumulation is excessive and interfering with cardiac output. Cardiac Conditions An essential goal for evaluating any child with chest pain is to rule out cardiac anomalies. Cardiac cause of chest pain is rare; however, it is primary concern of families of children with chest pain and if left undiagnosed may lead to significant complications. The role of any primary care physician confronted with a child with chest pain is to develop a list of differential diagnosis based upon history of illness, family history and physical findings on examination. In making the determination whether the cardiovascular system is the cause of chest pain it is helpful to identify on one hand red flags pointing towards cardiac disease and on the other hand signs which indicate etiologies of chest pain other than the cardiovascular system. Features suggesting cardiac disease (red flags) Abnormal findings in history Syncope Palpitations 418 I. Severe pulmonary or aortic valve stenosis: This can lead to ischemia and results from increase myocardial oxygen demand from tachycardia and increase pressure work by the ventricle. These disorders almost always are diagnosed before the child presents with pain, and the associated murmurs are found on physical examination. Chest X-ray may show a prominent ascending aorta or pulmonary artery trunk, echocardiogram is the key in the diagnosis. Anomalous coronary arteries: Such as anomalous origin of the left or right coronary arteries, coronary artery fistula, coronary aneurysm/ stenosis secondary to Kawasaki disease. These can result in myocardial infarction without evidence of underlying pathology.