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PubMed2004

Neurophysiological tests and neuroimaging procedures in non-acute headache: guidelines and recommendations.

The use of instrumental examinations in headache patients varies widely. In order to evaluate their usefulness, the most common instrumental procedures were evaluated, on the basis of evidence from the literature, by an EFNS Task Force (TF) on neurophysiological tests and imaging procedures in non-acute headache patients. The conclusions of the TF regarding each technique are expressed in the following guidelines for clinical use. 1 Interictal electroencephalography (EEG) is not routinely indicated in the diagnostic evaluation of headache patients. Interictal EEG is, however, indicated if the clinical history suggests a possible diagnosis of epilepsy (differential diagnosis). Ictal EEG could be useful in certain patients suffering from hemiplegic and basilar migraine. 2 Recording of evoked potentials is not recommended for the diagnosis of headache disorders. 3 There is no evidence to justify the recommendation of autonomic tests for the routine clinical examination of headache patients. 4 Manual palpation of pericranial muscles, with standardized palpation pressure, can be recommended for subdividing patient groups but not for diagnosis. Pressure algometry and electromyography (EMG) cannot be recommended as clinical diagnostic tests. 5 In adult and paediatric patients with migraine, with no recent change in attack pattern, no history of seizures, and no other focal neurological signs or symptoms, the routine use of neuroimaging is not warranted. In patients with atypical headache patterns, a history of seizures and/or focal neurological signs or symptoms, magnetic resonance imaging (MRI) may be indicated. 6 If attacks can be fully accounted for by the standard headache classification [International Headache Society (IHS)], a positron emission tomography (PET) or single-photon emission computerized tomography (SPECT) and scan will generally be of no further diagnostic value. 7 Nuclear medicine examinations of the cerebral circulation and metabolism can be carried out in subgroups of headache patients for diagnosis and evaluation of complications, when patients experience unusually severe attacks, or when the quality or severity of attacks has changed. 8 Transcranial Doppler examination is not helpful in headache diagnosis. Although many of the examinations described are of little or no value in the clinical setting, most of the tools have a vast potential for further exploring the pathophysiology of headaches and the effects of pharmacological treatment.

Diagnosis, Differential↗
PubMed2005

Headache children with temporomandibular disorders have several types of pain and other symptoms.

The aim was to investigate the association between temporomandibular disorders (TMD) and overall muscle tenderness, depressive symptoms, sleep difficulties, headache frequency and related symptoms in children with primary headache in comparison with controls. Based on an unselected population sample of 1135 Finnish schoolchildren classified according to the type of headache at age 12, altogether 297 children aged 13-14 from different headache groups and healthy controls were randomly selected for an interview and clinical examinations. Children with migraine had more TMD signs than children with nonmigrainous headaches or healthy controls. High TMD total scores were associated with palpation tenderness in other parts of the body and with frequent headache attacks. We conclude that children with overall headache, migraine in particular, and high total TMD scores showed an increased overall tenderness to muscle palpation and multiply manifested hypersensitivity pain.

Adolescent↗
PubMed1997

Predictors of successful external cephalic version at term: a prospective study.

OBJECTIVE: To investigate clinical and ultrasonographic predictors of outcome of external cephalic version at term. DESIGN: Prospective observational study. SETTING: University obstetric unit. POPULATION: All external cephalic versions performed over two years (n = 243). METHODS: Nineteen different clinical and ultrasonographic variables were recorded before each procedure. The ability of each of the 19 variables to predict the success or failure of external cephalic version was assessed by univariate analysis. The study population was then divided into two subgroups of 129 and 114 patients by random allocation using computer generated numbers. Logistic regression was performed in each subgroup to assess the relative importance and independence of the important variables. The derived regression models were then applied to the other subgroup of patients to assess accuracy and reproducibility. RESULTS: The overall success rate of the procedure was 69.5%. Both regression models identified the same three variables as independent predictors of failed versions: 1. presenting part engaged; 2. difficult to palpate the fetal head, and 3. a tense uterus on palpation. The two models correctly predicted 75.2% and 84.2% of outcomes in the other subgroup. If uterine tone, which was assessed after administration of tocolytic, was excluded from the analysis, the other two factors remained in the models, with the addition of nulliparity as a significant predictor of failed external cephalic version. The chance of success of external cephalic version in the original 243 women was found to be < 20% if two of these variables were present, 0% if all three were present, and 94% if none were present. CONCLUSIONS: The outcome of external cephalic version can be predicted by easily available clinical parameters.

Adolescent↗
PubMed1995

Diagnostic criteria for screening headache patients for temporomandibular disorders.

Patients with temporomandibular disorders frequently suffer from headache. The purpose of this study was to develop a simple screening exam which would allow the physician to identify headache patients with coexisting temporomandibular disorders. Twenty-eight migraine and 27 tension headache patients were identified by a board certified neurologist and then were examined by a dentist for signs of temporomandibular disorders. These patients were then compared to 63 patients with temporomandibular internal derangements and 62 patients with myofascial pain dysfunction. Comparisons of the clinical signs showed that the temporomandibular internal derangement and myofascial pain dysfunction patients differed significantly from the headache patients in regards to specific signs of jaw dysfunction. The presence of reciprocal clicking of the temporomandibular joint or pain with maximum jaw opening and pain upon palpation of the temporomandibular joint distinguished temporomandibular internal derangement patients from headache patients. These criteria have a sensitivity of 92% and specificity of 91%. Pain on palpation over the temporomandibular joint, or pain with maximum jaw opening using passive stretch, and pain with lateral movement of the jaw, distinguished myofascial pain dysfunction patients from headache patients. These criteria have a sensitivity of 77% and specificity of 85%. By using these screening tests, the physician can identify the concurrent existence of temporomandibular disorders in headache patients and triage the patient to a clinician knowledgeable in the diagnosis and treatment of temporomandibular disorders for further evaluation.

Cross-Sectional Studies↗
PubMed2006

Myofascial trigger points and their relationship to headache clinical parameters in chronic tension-type headache.

OBJECTIVE: To assess the presence of trigger points (TrPs) in several head and neck muscles in subjects with chronic tension-type headache (CTTH) and in healthy subjects; and to evaluate the relationship of these TrPs with forward head posture (FHP), headache intensity, duration, and frequency. BACKGROUND: Tension-type headache (TTH) is a headache in which myofascial TrPs in head and neck muscles might play an important etiologic role. DESIGN: A blinded, controlled, pilot study. METHODS: Twenty-five CTTH subjects and 25 matched controls without headache were studied. TrPs in bilateral upper trapezius, sternocleidomastoids, and temporalis muscles were identified according to Simons et al's diagnostic criteria: tenderness in a hyperirritable spot within a palpable taut band, local twitch response elicited by snapping palpation, and elicited referred pain with palpation. A TrP was considered active if the subject recognized the evoked referred pain as familiar headache. If the evoked referred pain was not recognized as familiar headache, the TrP was considered as latent. Side-view pictures of each subject were taken in both sitting and standing positions in order to assess FHP by measuring the cranio-vertebral angle. Both measurements were made by a blinded assessor. A headache diary was kept for 4 weeks in order to assess headache intensity, frequency, and duration. RESULTS: The mean number of TrPs on each CTTH subject was 3.9 (SD: 1.2), of which 1.9 (SD: 1.2) were active TrPs and 1.9 (SD: 0.8) were latent TrPs. Control subjects only exhibited latent TrPs (mean: 1.4; SD: 0.8). There was a significant difference between the CTTH group and the controls for active TrPs (P < .001), but not for latent TrPs (P > .05). Differences in the distribution of active and latent TrPs within each muscle were also significant for all the analyzed muscles (P < .01). CTTH subjects with active TrPs in the right upper trapezius muscle or left sternocleidomastoid muscle showed a greater headache intensity and duration, but not headache frequency, compared to those with latent TrPs (P < .05). Active TrPs in the right temporalis muscle were associated with longer headache duration (P < .01), whereas active TrPs in the left temporalis muscle were associated with greater headache intensity (P < .05). CTTH subjects with active TrPs in the analyzed muscles had a greater FHP than those with latent TrPs in both sitting and standing positions. Differences were only significant for TrPs in the left sternocleidomastoid and FHP in the sitting position (P < .01). CONCLUSIONS: Active TrPs in upper trapezius, sternocleidomastoid, and temporalis muscles were associated with CTTH. CTTH subjects with active TrPs usually reported a greater headache intensity and longer headache duration than those with latent TrPs. CTTH subjects with active TrPs tended to have a greater FHP than CTTH subjects with latent TrPs.

Adolescent↗
PubMed2002

A randomized clinical trial of analgesia in children with acute abdominal pain.

OBJECTIVE: To evaluate the effects of intravenous morphine on pain reduction, physical examination, and diagnostic accuracy in children with acute abdominal pain. METHODS: A randomized, double-blind, placebo-controlled clinical trial was conducted at an emergency department of a tertiary care children's hospital. Children aged 5-18 years with abdominal pain of < or =5 days' duration, pain score > or =5 on a 0-10 visual analog scale, and need for surgical evaluation were eligible. Following the initial assessment, patients were randomized to receive either 0.1 mg/kg morphine or an equal volume of saline. The pediatric emergency medicine physician and surgical consultant independently recorded the areas of tenderness to palpation and percussion, and their diagnoses before the study medication and 15 to 30 minutes later. RESULTS: Sixty patients were enrolled, and 29 received morphine and 31 received saline. The demographic characteristics between the two groups were similar. The median reduction of pain score between the two study groups was 2 (95% CI = 1 to 4; p = 0.002). There was no significant change in the areas of tenderness in both study groups. Children with surgical conditions had persistent tenderness to palpation and/or percussion. There was no significant change in the diagnostic accuracy between the study groups and between the physician groups. All patients requiring laparotomy were identified and no significant complication was noted in the morphine group. CONCLUSIONS: Intravenous morphine provides significant pain reduction to children with acute abdominal pain without adversely affecting the examination, and morphine does not affect the ability to identify children with surgical conditions.

Abdomen, Acute↗
PubMed1987

Longitudinal study of functional conditions in the masticatory system in Flemish children.

A 5-yr longitudinal study on occlusal and functional parameters has been made in 75 children aged 8-11. They were selected at random from an original group of 510 studied 5 yr earlier. The following parameters were measured: frequency of frontal open bite lateral and frontal crossbite, the attrition on molars and on front teeth, the contacts on lateral excursion, pain on condyle palpation, TMJ clicking, deviations in the opening and lateral movement, and the maximal interincisal distance. There was an increase in the percentage of deep bite and crossbite. Attrition on molars was seen in 41% and on front teeth in 13% of the children. No real pattern could be observed as a function of age. The mean maximal opening range was 43.7 mm, varying between 23 and 52 mm. Restricted opening was found in one girl. In 60% a deviation in the opening has been found. In 26% TMJ sounds were observed and 28% had pain on condyle palpation. In most of the children the symptoms were very mild to moderate. No significant correlation could be found between dysfunctional signs and occlusal parameters. The present results did not provide any conclusive answer to the tremendous increase in dysfunctional signs over this 5-yr period. The treatment need is, however, low and should not be overestimated.

Belgium↗
PubMed1994

Heart rate increases in patients with growth hormone receptor deficiency treated with insulin-like growth factor I.

Cardiac function was measured in 16 prepubertal Ecuadorean patients with growth hormone receptor deficiency given insulin-like growth factor I (IGF-I) during part of a clinical trial. The IGF-I was given subcutaneously twice daily at a dose of 40 micrograms/kg on days 1 and 2, 80 micrograms/kg on days 3 and 4, and 120 micrograms/kg thereafter. Heart rate was determined at baseline (pretreatment) and on days 1-7 by repeated palpation of the radial artery and at baseline and on days 2, 4 and 7 by continuous portable Holter monitoring. Heart rate measured by both methods rose progressively with increasing doses of IGF-I. The mean palpated pulse exceeded baseline on each treatment day and was significantly higher on day 5 than day 4 and significantly higher on day 3 than day 2. The mean Holter heart rate was significantly higher on day 4 than on day 2 and significantly higher on day 2 than at baseline. Non-significant glucose and electrolyte changes did not appear to be associated with the cardiac events.

Adolescent↗
PubMed2001

Evaluation of the clinical efficacy of meloxicam in cats with painful locomotor disorders.

The ability of two non-steroidal anti-inflammatory drugs to modify the clinical manifestations of pain associated with locomotor disease was assessed. Sixty-nine cats with acute or chronic locomotor disorders were recruited from 14 first opinion UK veterinary practices and randomly allocated to one of two treatment groups. Group A received meloxicam drops (0.3 mg/kg orally on day 1 followed by 0.1 mg/kg daily for four more consecutive days) and group B received ketoprofen tablets (1.0 mg/kg orally once daily for five days). Each cat underwent a full clinical examination before treatment, 24 hours after initiation of treatment and 24 hours after completion of treatment. General clinical parameters (demeanour and feed intake) and specific locomotor parameters (weightbearing, lameness, local inflammation and pain on palpation) were scored using a discontinuous scale scoring system. The two groups did not differ in terms of age, weight, gender distribution or duration of clinical signs; nor did they differ in terms of general clinical or specific locomotor scores pretreatment. Both treatment regimens resulted in a significant improvement in demeanour, feed intake and weightbearing, and a significant reduction in lameness, pain on palpation and inflammation. No significant difference was observed between the two treatment groups with respect to any of the parameters measured and both treatments were associated with minimal observed side effects. Meloxicam and ketoprofen were found to be effective analgesics and well tolerated in cats with acute or chronic locomotor disorders when administered for short-term treatment (five days) in such cases. However, meloxicam was assessed to be significantly more palatable than ketoprofen.

Administration, Oral↗
PubMed1996

The impacted maxillary canine. Further observations on aetiology, radiographic localization, prevention/interception of impaction, and when to suspect impaction.

Adjacent anomalous or missing maxillary lateral incisors have been implicated in the aetiology of palatally displaced canines by not providing proper guidance to the canine during its eruption. However, a recent review of the literature suggests that the aetiology of palatally displaced canines is genetic in origin. The aetiology of labially impacted canines differs, being due to inadequate arch space. Vertex occlusal radiographs have been recommended for localization but have limitations, and a case is illustrated where this radiograph is deceptive. The prevention/interception of a palatally displaced canine by the extraction of the deciduous canine is best carried out as early as the displacement is detected, mostly soon after 10 years of age. Usually, prevention/interception will avoid the surgical and orthodontic treatment needed to align a palatally impacted canine and may help prevent resorption of the adjacent incisor root. Suspicions that an impaction could occur or has occurred arise a) before the age of 10 years if there is a familial history and/or the maxillary lateral incisors are anomalous or missing; b) after the age of 10 years if there is asymmetry in palpation or a pronounced difference in eruption of canines between the left and right side; or the canines cannot be palpated and occlusal development is advanced; or, the lateral incisor is proclined and tipped distally; and, on a panoramic radiograph of the late mixed dentition if the incisal up of the canine overlaps the root of the lateral incisor.

Anodontia↗
PubMed1986

Efficacy of human chorionic gonadotrophin and gonadotrophin releasing hormone for hastening ovulation in thoroughbred mares.

Plasma progesterone levels were measured daily to determine the accuracy of diagnosing ovulation by rectal palpation carried out every other day; 81.5 per cent mares injected with human chorionic gonadotrophin showed increases of progesterone more than 1 ng/ml by 72 h after injection compared with 65 per cent of mares injected with gonadotrophin releasing hormone (GnRH) or saline. Mating at ovulation achieved a 74 per cent pregnancy rate in mares given hCG compared with 50 per cent given GnRH and 45 per cent controls. Diagnosis of ovulation per rectum on the basis of a pit in the ovarian surface or the presence of a soft friable structure was found to be accurate in 91 per cent of cases. Diagnosis based on the presence of a firm plum-like structure or the disappearance of a previously identified follicle at a given site was 60 per cent accurate. In cases of rectal diagnosis of non-ovulation 38 per cent had actually ovulated based on a rise in progesterone more than 1 ng/ml and a further 19 per cent showed a rise in progesterone by 24 h after the diagnosis. The use of hCG may improve conception rates by synchronisation of ovulation and mating and where rectal palpation of the ovaries remains the only basis for timed mating.

Animals↗
PubMed1989

The in vivo biodynamic properties of the intact equine linea alba.

Liquid metal strain gauges (LMSG) were implanted surgically at three locations on the intact linea alba (LA) in eight horses. LA strain, strain rate, change in strain and stress were recorded during general anaesthesia, recovery from anaesthesia, standing, vocalisation, rectal palpation and at the walk, trot and canter. LA stress was quantitated using an in vitro tensiometric technique. Stress-strain responses differed significantly (P < 0.05) with location, but each described a characteristic relationship for viscoelastic tissues. Maximum peak stress, peak strain and change in strain occurred during anaesthetic recovery. Maximum strain rate occurred at the canter. An abdominal bandage provided no consistent change in strain magnitude. The caudal LA experienced greater stress and strain than the cranial LA. LA strain varied cyclically with cadence. It was concluded that: LMSGs provide a suitable technique for recording LA biodynamics; the dynamic properties of the LA are not homogenous throughout its length; the LA is suited to accommodate the rapid acceleration/deceleration forces associated with strenuous activity which might otherwise cause injury to abdominal viscera; and LA resultant strain alters significantly with phase of stride. It was implied that the likelihood of incisional dehiscence is reduced by minimising exercise and rectal palpation post operatively. The data will permit a more accurate representation of physiological conditions for future laboratory studies.

Abdominal Muscles↗
PubMed1992

Idiopathic muscular hypertrophy of the equine small intestine: 11 cases (1980-1991).

The medical records of 11 horses with idiopathic muscular hypertrophy (MH) of the small intestine were reviewed to determine the clinical and pathological features of the disease. The median age of affected horses was 10.0 years (range 5-18 years). No breed or sex predisposition was apparent. Ten horses (91%) had chronic (23 days to 2.4 years) signs of mild, intermittent colic, and 1 horse had signs of severe colic of only 3 days' duration. Partial anorexia and chronic weight loss of variable duration (1-6 months) were prominent historical findings in 5 (45%) horses. Diagnostic tests, with the exception of exploratory caeliotomy, were ineffective for definitive diagnosis of intestinal MH as a cause of colic. In 2 horses, however, a thickened, rigid ileum was detected by palpation per rectum, and in 5 horses, multiple loops of distended small intestine were detected by palpation per rectum. Hypertrophy of both the circular and longitudinal layers of muscularis was determined as the cause of intestinal thickening in all horses. Muscular hypertrophy of the ileum was present in 9 (82%) horses. Two horses (18%) had MH of a section of jejunum only, and 4 (36%) horses had MH of the ileum in combination with MH of other sections of small intestine. Two (18%) horses had MH of the entire small intestine. In 9 (82%) horses, intestinal MH resulted in narrowing of the luminal diameter at the site of MH. Small diverticula were present on the mesenteric border of the hypertrophied ileum of 5 (45%) horses. Five linear (up to 150-cm) diverticula were present in the hypertrophied jejunum of 1 (9%) horse. Haemomelasma ilei was present on the antimesenteric serosal surface of affected intestine of 8 (73%) horses. Full-thickness rupture of the ileum with subsequent diffuse, septic peritonitis occurred in 3 (27%) horses.

Animals↗
PubMed1997

Chronic colic in the mature horse: a retrospective review of 106 cases.

The clinical features of 106 horses presenting with chronic colic examined over a 5 year period were reviewed. Chronic colic was defined as colic signs observed daily for 3 days or longer, except when masked by analgesics. The diagnosed causes of chronic colic included colonic impaction (31%), peritonitis (16%), enteritis/colitis (7%), colonic displacement/torsion (6%) and lymphosarcoma (4%). A variety of other diseases were diagnosed in a small number of cases, including intestinal adhesions, ileal obstructions, grass sickness, liver disease, caecal impactions, thromboembolic disease, intussusceptions etc. No diagnosis was reached in 8% of cases. Diagnosis was relatively easily achieved in most cases of colonic impaction and peritonitis by results of transrectal palpation and evaluation of peritoneal fluid. Specific clinical features, transrectal palpation, abdominal paracentesis and laboratory evaluations of blood were helpful in the diagnosis of some of the other diseases, but exploratory laparotomy remained necessary in a few cases to achieve a diagnosis.

Animals↗
PubMed2004

Longitudinal development of skin involvement and reliability of high frequency ultrasound in systemic sclerosis.

BACKGROUND: Measurement of skin involvement is essential for diagnosis and prognosis in systemic sclerosis. Assessment by palpation skin score is the current method. OBJECTIVE: To explore high frequency ultrasound as an objective method to improve skin characterisation by combining measurements of skin thickness and echogenicity. METHODS: Skin thickness and echogenicity were measured at the proximal phalanx of the second digit, the back of the hand, the forearm, and the lower leg and, in order to separate limited (lSSc) from diffuse SSc (dSSc), at the chest in 16 patients with early disease and in 16 controls. Measurements were repeated in each patient three or four times with an interval of 1-2 years. Ultrasound measurements of skin thickness were compared with the palpation skin score. RESULTS: Compared with controls, the skin was thickened on the phalanx, hand, forearm, and chest of patients with dSSc, but not patients with lSSc, at the 1 year examination. In dSSc the degree of thickening tended to diminish with time, and at 4 years, thickness was significantly decreased on the forearm and chest compared with the 1 year measurements. Low reflectancy was most pronounced at the 1 year evaluation on the forearm, hand, and phalanx in dSSc, and on the phalanx in lSSc. CONCLUSION: Separate measurements of skin thickness and echogenicity by high frequency ultrasound add a new dimension to the assessment of skin involvement in SSc, and this seems to be an objective non-invasive tool for use in the study of disease development and in clinical trials.

Adult↗
PubMed1977

Cloprostenol as a treatment for no visible oestrus and cystic ovarian disease in dairy cows.

A total of 253 cows was treated using 500mug cloprostenol intramuscularly. Of those, 129 cows were treated for failure to exhibit an observed oestrus, 124 for being negative at pregnancy diagnosis examination; all possessed a corpus luteum as detected by rectal palpation. One hundred and sixty nine (66.8 per cent) were detected in oestrus within eight days, and of these 159 were served. Eight-seven (54.7 per cent) of them conceived. Sixteen cases of luteinised ovarian cysts were also treated with a resultant 14 conceptions occurring at a mean interval of 19-4 days. It is condisered that the time of the induced oestrus is not predictable enough to warrant "fixed time" insemination. The success of treatment will be related to: (1) The efficiency of oestrus detection on the farm (2) The normal conception rate on the farm (3) The accuracy of the rectal palpations.

Animals↗
PubMed1980

Non-surgical transfer of bovine eggs: investigation of some factors affecting embryo survival.

In an investigation on the effect of position of deposition of the egg within the uterus, surgical transfer of single eggs to the tip of the horn resulted in a significantly higher pregnancy rate than transfer to the base. To determine embryo survival at differing times after transfer single eggs were transferred non-surgically to the base of the uterine horn. The highest pregnancy rate occurred in a group of heifers slaughtered 16 to 17 days after oestrus followed by heifers slaughtered on days 24 to 26. The lowest pregnancy rate occurred in a group where pregnancy diagnosis was on day 42 by rectal palpation. The pregnancy rates of the highest and the lowest groups were significantly different. The pregnancy rate was increased in a group of heifers which were treated with human chorionic gonadotrophin from day 13 to 24 and palpated per rectum on day 42 to determine pregnancy. The presence or absence of penicillin and streptomycin in the medium and of passing differing volumes into the uterus after non-surgical transfer of single eggs using a glass pipette had no effect on pregnancy rate and there was no significant difference in pregnancy rate and there was no significant difference in pregnancy rate between the groups using different volumes of transfer media. The position of the egg within the uterine lumen after transfer contributes to the reduced pregnancy rate achieved after nonsurgical transfer when compared with the surgical method. The greatest proportion of embryonic death after non-surgical transfer occurs after day 17 and there is some evidence that human chorionic gonadotrophin treatment can improve embryo survival. The use of comparatively small volumes of medium to eject the egg into the uterus may be preferable to achieve maximum pregnancy rates.

Animals↗
PubMed1985

Estimation of superovulation response in donor cows.

Estimates were made of the superovulation response in donor cows using ovarian size, the number of corpora lutea (palpated per rectum) and blood progesterone levels. Neither the estimated number of corpora lutea nor ovarian size gave a satisfactory prediction of superovulation response. There was a large discrepancy between the number of corpora lutea present on the ovaries of nine superovulated cows (166) and the estimated number (106). All the corpora lutea on superovulated ovaries were smaller than normal (1.95 g). Blood progesterone levels at the time of embryo recovery were correlated with both the number of corpora lutea on the superovulated ovaries (r = 0.9, P less than 0.001) and the weight of the corpora lutea (r = 0.95, P less than 0.001). There were 67 embryos and ova recovered from the nine donors, representing 40 per cent of the actual and 63 per cent of the palpated corpora lutea. However, neither ovarian size, the number of corpora lutea nor blood progesterone levels were correlated with embryo production.

Animals↗