Failure of lactation following radiotherapy for breast cancer.
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Adenocarcinoma↗
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Loss in milk yield and related composition changes resulting from clinical mastitis in dairy cows.
Relationships between clinical mastitis and milk yield and composition in dairy cows were reviewed. Requirements for inclusion were: data had to be collected after 1975; dependent variables for milk yield and milk composition had to be defined at the cow level; mastitis cases had to be defined by clinical signs, and at least 250 lactations had to be considered. Twenty studies dealing with milk-yield loss and, for four of them, also with related composition changes were selected. Study populations, design of data collection, and analysis methods differed widely between studies. As expected from these differences--but also due to structural-variation factors such as type of pathogen, animal and production level--estimates for milk-yield losses differed in average magnitude and pattern. Literature data regarding changes in milk-fat % and total-protein % changes were contradictory. Critiques of materials and methods allowed us to propose some final recommendations for values to be used as basic inputs in economic calculations of losses caused by mastitis.
Animals↗
Incidence risk and aetiology of mammary abnormalities in dry ewes in 10 flocks in southern Greece.
In a field investigation of 10 flocks in Southern Greece, 3367 dairy ewes were examined twice, in order to estimate the incidence risk and the aetiology of mammary abnormalities during the dry-period. Abnormal secretion, lumps, nodules, diffuse hardness, abscesses and cysts were the abnormalities detected. The cumulative incidence of mammary abnormalities during the dry-period was 5.1% (95% confidence interval: 4.4-5.8%); 47% of the cases detected developed during the first three weeks after cessation of lactation. Despite variation in the flock size, there was no between-flock variation in the risk of a ewe developing mammary abnormalities. Staphylococci (Staphylococcus aureus and coagulase-negative isolates) were the most frequently isolated bacteria from mammary samples; Actinomyces pyogenes, Clostridium perfringens, streptococci and Escherichia coli were also isolated. Resistance was encountered among the staphylococcal isolates.
Animals↗
Frustrating case presentations in canine theriogenology.
The practice of small animal theriogenology is rewarding, but frustrations exist concerning technologic advances as compared with other species. Reproductive clinicians striving to practice good quality medicine readily identify topics of common concern: causes that are not identified or therapeutics that are not available or applicable. Improved collaboration among theriogenologists specializing in small animal practice is evidenced by growing attendance at national and international scientific meetings, increased scientific publications, and internet communications.
Animals↗
Galactorrhea secondary to chest wall surgery in an adolescent.
Although nonpuerperal galactorrhea in youth may be a sign of pituitary prolactinoma, the etiology may be benign and extensive neurologic or endocrinologic evaluation and treatment may be unnecessary. An 18-year-old female with an unusual but benign form of transient galactorrhea due to chest wall surgery is reported. It is hypothesized that the sectioning of the intercostal nerves may result in reflex stimulation of hypothalamic centers controlling lactation through the same neural pathways involved in puerperal lactation. The patient experienced galactorrhea for two months and transient amenorrhea. She is asymptomatic without galactorrhea at nine months follow up.
Adolescent↗
Galactorrhea in the adolescent.
Inappropriate lactation--that which occurs beyond the usual postpartum or breast-feeding period or in the male--has been of medical interest for centuries. There is a suggestion that the first recorded case occurred in the Bible in the Book of Esther wherein Mordecai may have breast-fed his niece Esther [1,2]. The Talmud describes a man who nursed his infant after his wife's death during childbirth [3]. Lactation in virgin women was noted by the early Greeks [4], and Aristotle observed lactation in men [5]. The phenomenon of "witch's milk," seen in the newborn, was described as early as 1684 by Bonetus [6]. The first alleged pediatric case of nonpuerperal lactation was of an 8-year-old girl who was able to suckle her baby brother as reported in the 18th Century by Baudelocque [7]. Subsequently, many other cases of abnormal lactation were described in the 19th and early 20th centuries [7-10]. In the past 15 years, there has been a vast proliferation of cases and studies concerning galactorrhea of both sexes [11]. The advent of the prolactin radioimmunoassay was the single most important factor behind the profusion of these investigations [11-14]. Most recently, attention has focused on the high incidence of pituitary tumors--specifically the prolactinoma--in women and to some degree in men [13,15]. The occurrence of such tumors in children and adolescents is also receiving more attention [16,17]. The purpose of this review is to update the reader on galactorrhea with a specific emphasis on: 1) outlining the various causes of galactorrhea that may be seen in adolescent patients; 2) describing the work-up and management of both the male and female adolescent patient with galactorrhea; and 3) describing what is known about the natural history of galactorrhea. A brief description of the physiology of the hypothalamic-pituitary-breast axis and lactation is also presented.
Adolescent↗
The present status of prolactin assays in clinical practice.
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Amenorrhea↗
A study of the medical ethnobotany of the Zuni Indians of New Mexico.
This paper examines the medical ethnobotany of the Zuni Indians of west-central New Mexico. Historically, these people were hunters and gatherers, and later, farmers and sheepherders. They developed an extensive knowledge of the local flora and a complex religious rite and system of medical practice. Now, as customs and values of Western societies encroach upon their lifestyle, the Zuni's knowledge of the medicinal use of plants is in danger of being forgotten. Field work conducted during the summers of 1977 and 1978 with the Zuni involved interviews with 27 Zuni medicine men and elders and the collection of 138 plant species. For 49 species a medicinal use was described. These remedies were examined in detail to determine their pharmacological and physiological action and their cultural significance. A total of 31 medicinal plants collected in this study were not mentioned in the Zuni ethnobotanical study by Stevenson over 60 years earlier. This may reflect a difficulty in recording all the plant remedies of a culture rather than an acquisition of new remedies since that time. The use of herbal remedies today and the knowledge of their use in the past has diminished.
Cough↗
Pathogenesis, prevention, and treatment of lactational insufficiency in sows.
Lactational insufficiency is one of the major problems in swine production, and the consequences on the growth of the litter must be emphasized. Pathophysiology involves neuroendocrinologic interactions and the role of target organs such as the mammary glands, uterus, bladder, and gut. The complexity of these interactions and the fact that all interactions are not well understood leads to a broad approach. Some risk factors and their associations with lactational insufficiency are described to help the practitioner in the clinical approach to such a problem.
Animals↗
Perceived insufficient milk as a barrier to optimal infant feeding: examples from Bolivia.
In its recently adopted Global Strategy on Infant and Young Child Feeding, the World Health Assembly called for urgent action in addressing the barriers to optimal feeding practices. This paper examines mothers' concerns about milk insufficiency as a major contributor to suboptimal infant feeding decisions, using survey data from peri-urban areas of two Bolivian cities. Mothers in the lowland modernizing city of Santa Cruz were more likely than mothers in the highland traditional city of Cochabamba to express concern about insufficient milk, and also less likely to feed their infants according to international recommendations. Furthermore, perceived milk insufficiency was particularly common among mothers of infants younger than 6 months of age -- an age at which infants are particularly vulnerable to the adverse effects of breast-feeding cessation and complementary feeding initiation. The paper concludes with policy, programme and research recommendations to address the critical problem of perceived insufficient breast milk.
Adult↗
Lactation failure in crossbred Sahiwal Friesian cattle.
Milk producers in Malaysia make extensive use of crossbred Sahiwal Friesian dairy cattle. These animals have, however, been found susceptible to lactation failure. A survey of cows in an experimental herd of F1 Sahiwal Friesian animals indicated that, in 30% of animals, milk yield decreased to negligible levels within the first 8 weeks post partum. Lactation failure was associated with a progressive increase in the amount of residual milk left in the udder after normal milking. By week 3 of lactation, residual milk volume was significantly greater than that in animals that, based on previous lactation history were not susceptible to lactation failure, and accounted for up to 30% of milk available at the morning milking. The cellular consequences of residual milk accumulation were evident in the activities of acetyl-CoA carboxylase, fatty acid synthetase and galactosyltransferase, key enzyme markers of cellular differentiation, which decreased in glands undergoing lactation failure and were lower than values measured in tissue of control cows. Mammary cell number, estimated by tissue DNA content, was also reduced in animals undergoing lactation failure. These indices of mammary development indicate that lactation failure is the result of premature involution in susceptible animals. Premature involution is a predictable consequence of progressive milk stasis in failing lactation, and attributable to an increase in autocrine feedback by inhibitory milk constituents. The progressive increase in residual milk is, on the other hand, unlikely to be attributable to impaired mammary development. Measurements of milk storage during milk accumulation showed no differences between control and lactation failure cows in the distribution of milk between alveolar and cisternal storage compartments. We conclude that lactation failure in Sahiwal Friesian cows is due to a failure of milk removal, and probably the result of an impaired milk ejection reflex rather than to the glands' milk storage characteristics.
Animals↗
Lactation and breast cancer risk.
Breast cancer is a common disease with few practical preventive measures. The recent evidence that lactation, like other reproductive experiences, is associated with a modest reduction in breast cancer risk is therefore of great interest. Overall, the reduction in risk appears to be about 20% for ever breast feeding and is even greater for women with histories of prolonged lactation, or who initiate breast feeding at young ages. In many studies this risk reduction seems to be limited to premenopausal women. It appears unlikely that this inverse association is attributable either to higher risk among women who use lactation suppressants or who have difficulty either starting or continuing breast feeding. While a strong or consistent protective effect of lactation on breast cancer risk has not been observed in some large and well conducted studies, this likely reflects the limited breast feeding practices among modern women. If early, exclusive and extended breast feeding is necessary to achieve a breast cancer risk reduction, future studies among U.S. women may be unable to clarify this association.
Adult↗
Prolactin, its control and clinical significance.
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Adult↗
Genital lesions in an outbreak of caprine contagious agalactia caused by Mycoplasma agalactiae and Mycoplasma putrefaciens.
This paper reports on the genital lesions observed in adult male and female goats from a commercial flock in the Extremadura region of southwestern Spain, following an outbreak of contagious agalactia syndrome caused by Mycoplasma agalactiae and M. putrefaciens. Although both species were isolated from several organs, M. putrefaciens was the only agent isolated from the genital lesions reported here, characterized by desquamative salpingitis and cystic catarrhal metritis in females and by testicular degeneration in males. Mycoplasma putrefaciens was isolated from the testes of only one of the males examined.
Animals↗
Investigation on the efficacy of meloxicam in sows with mastitis-metritis-agalactia syndrome.
The efficacy of meloxicam in the treatment of sows with mastitis-metritis-agalactia syndrome was investigated in comparison with flunixin. Basic therapy comprised administration of an antibiotic and oxytocin. A total of 200 sows and litters were examined in a double-blind clinical study with observations up to 8 days after the first treatment. The primary parameter, the clinical index score on day 2, consisting of rectal temperature, feed intake, general demeanour, respiratory rate, vaginal discharge, degree of inflammation of mammary glands, milk flow and nursing behaviour, revealed a significant (P < or = 0.05) non-inferiority of meloxicam in comparison with flunixin implying equal efficacy of both drugs. No significant differences were noted in the distribution of clinical efficacy scores within both groups at each day of examination. The differences in litter weight and daily weight gain per piglet were not significant between the two test groups. The mortality rates until day 8 of the study were without significant difference between groups. In piglets of diseased litters, however, the mortality rate was 50% lower in the meloxicam group in comparison with the reference group, this difference reaching statistical significance (P < or = 0.05).
Animals↗
Lactation headache--a new form of headache?
The case of a 26-year-old woman suffering from brief attacks of headache occurring on every occasion of nursing is described. Pulse rate and blood pressure are normal during the attacks and serum prolactin responds normally to nursing. Plasma vasopressin increases before each headache attack. Propranolol does not prevent the headache, which disappears only after lactation has ceased. Possible pathophysiological mechanisms related to suckling are discussed.
Adult↗