Genetically Engineered Cow Makes Anti-Allergy Milk

LONDON (Reuters) Oct 01 - Researchers in New Zealand have genetically engineered a cow to produce milk with very little of a protein that causes an allergic reaction in some children.

They hope the technique, which uses RNA interference that reduces the activity of certain genes without eliminating it completely, can be used to control other traits in livestock.

With new mothers breastfeeding less, cows' milk is an increasing source of protein for babies, but the different composition of cows' milk can cause an allergic reaction.

In developed countries, 2% to 3% of infants are allergic to cows' milk proteins in the first year of life, the researchers said in a paper published in the Proceedings of the National Academy of Sciences.

Anower Jabed and colleagues at the New Zealand government-run AgResearch company said their genetically modified cow produced milk with a 96% reduction in beta-lactoglobulin (BLG), a protein known to cause allergic reactions that is not present in human milk.

While there are dairy industry processes that can reduce the allergenic potential of normal milk, they are expensive and can result in a bitter taste.

Another gene manipulation technique using a process called homologous recombination could theoretically knock out, rather than suppress, the gene that produces BLG but the researchers said that, so far, this has not worked.

Bruce Whitelaw, professor of animal biotechnology at the University of Edinburgh, said the New Zealand research "offers a good example of how these technologies can be used to provide alternative strategies to current manufacturing process".

He said that although RNA interference has been shown to work in manipulating plants and worms, "it has not worked in livestock before."

Whitelaw told Reuters that aside from accentuating or reducing genetically determined characteristics in farm animals, such as growth rate, the technique could be used to improve defence against infection.

"Time will tell how widely applicable RNA interference will be in GM livestock. But this is certainly a milestone study in this field," he said.

ReadmoreGenetically Engineered Cow Makes Anti-Allergy Milk

Why is it sometimes that you testicles shrink?

Sometimes my balls shrink and it sorts of "go backwards" into the body. Does it have anything got to do with the weather? And how big should my testicles be? (I'm 16). And how do you measure them?

Best Answer - Chosen by Asker

Sam your ball sack is tempreture controlled so that your balls can be a optimum tempreture to produce sperm. If your balls get too hot your ballsack relaxes and allows your balls to hang away from the heat of your body and stay cool for example after a hot jaccuzi or out in the desert riding bikes now when your cold like swimming in the river or cold pool your ball sack shrinks and holds your balls close to your body so they can stay warm. Dude your balls can be in one or both conditions depending on the tempreture. your balls are genitic you get your penis and balls size from your parents genes that put you together someone in your family has balls like yours on your dads side or moms side. dude your balls are probably fine i would not worry about them you complete the puberty process at 20 so you have more years to possabliy grow. 

low hanging balled dude
ReadmoreWhy is it sometimes that you testicles shrink?

NCP Urolithiasis (Renal Calculi)

Kidney stones (calculi) are formed of mineral deposits, most commonly calcium oxalate and calcium phosphate; however, uric acid, struvite, and cystine are also calculus formers. Although renal calculi can form anywhere in the urinary tract, they are most commonly found in the renal pelvis and calyces. Renal calculi can remain asymptomatic until passed into a ureter and/or urine flow is obstructed, when the potential for renal damage is acute.

Acute episodes may require inpatient treatment on a medical or surgical unit.


Fluid and electrolyte imbalances
Metabolic acidosis (primary base bicarbonate deficiency)
Metabolic alkalosis (primary base bicarbonate excess)
Psychosocial aspects of care
Renal failure: acute

Patient Assessment Database

Dependent on size, location, and etiology of calculi.

May report: Sedentary occupation or occupation in which patient is exposed to high environmental temperatures
Activity restrictions/immobility due to a preexisting condition (e.g., debilitating disease,
spinal cord injury)

May exhibit: Elevated BP/pulse (pain, anxiety, kidney failure)
Warm, flushed skin; pallor

May report: History of recent/chronic UTI; previous obstruction (calculi)
Decreased urinary output, bladder fullness
Burning, urgency with urination
May exhibit: Oliguria, hematuria, pyuria
Alterations in voiding pattern

May report: Nausea/vomiting, abdominal tenderness
Diet high in purines, calcium oxalate, and/or phosphates
Insufficient fluid intake; does not drink fluids well
May exhibit: Abdominal distension; decreased/absent bowel sounds

May report: Acute episode of excruciating, colicky pain with location depending on stone location, e.g., in the flank in the region of the costovertebral angle; may radiate to back,
abdomen, and down to the groin/genitalia. Constant dull pain suggests calculi
located in the renal pelvis or calyces.
Pain may be described as acute, severe, not relieved by positioning or any other measures
May exhibit: Guarding; distraction behaviors; self-focusing
Tenderness in renal areas on palpation

May report: Use of alcohol
Fever; chills

May report: Family history of calculi, kidney disease, hypertension, gout, chronic UTI
History of small-bowel disease, previous abdominal surgery, hyperparathyroidism
Use of antibiotics, antihypertensives, sodium bicarbonate, allopurinol, phosphates,
thiazides, excessive intake of calcium or vitamin D

Discharge plan

DRG projected mean length of inpatient stay: 2.9 days

Refer to section at end of plan for postdischarge considerations.


Urinalysis: Color may be yellow, dark brown, bloody. Commonly shows RBCs, WBCs, crystals (cystine, uric acid, calcium oxalate), casts, minerals, bacteria, pus; pH may be less than 5 (promotes cystine and uric acid stones) or higher than 7.5 (promotes magnesium, struvite, phosphate, or calcium phosphate stones).
Urine (24-hr): Cr, uric acid, calcium, phosphorus, oxalate, or cystine may be elevated.
Urine culture: May reveal UTI (Staphylococcus aureus, Proteus, Klebsiella, Pseudomonas).
Biochemical survey: Elevated levels of magnesium, calcium, uric acid, phosphates, protein, electrolytes.
Serum and urine BUN/Cr: Abnormal (high in serum/low in urine) secondary to high obstructive stone in kidney causing ischemia/necrosis.
Serum chloride and bicarbonate levels: Elevation of chloride and decreased levels of bicarbonate suggest developing renal tubular acidosis.
Hb/Hct: Abnormal if patient is severely dehydrated or polycythemia is present (encourages precipitation of solids), or patient is anemic (hemorrhage, kidney dysfunction/failure).
RBCs: Usually normal. WBCs: May be increased, indicating infection/septicemia.
Parathyroid hormone (PTH): May be increased if kidney failure present. (PTH stimulates reabsorption of calcium from bones, increasing circulating serum and urine calcium levels.)
KUB x-ray: Shows presence of calculi and/or anatomical changes in the area of the kidneys or along the course of the ureter.
IVP: Provides rapid confirmation of urolithiasis as a cause of abdominal or flank pain. Shows abnormalities in anatomical structures (distended ureter) and outline of calculi.
Cystoureteroscopy: Direct visualization of bladder and ureter may reveal stone and/or obstructive effects.
CT scan: Identifies/delineates calculi and other masses; kidney, ureteral, and bladder distension.
Ultrasound of kidney: To determine obstructive changes, location of stone; without the risk of failure induced by contrast medium.


1. Alleviate pain.
2. Maintain adequate renal functioning.
3. Prevent complications.
4. Provide information about disease process/prognosis and treatment needs.


1. Pain relieved/controlled.
2. Fluid/electrolyte balance maintained.
3. Complications prevented/minimized.
4. Disease process/prognosis and therapeutic regimen understood.
5. Plan in place to meet needs after discharge.
ReadmoreNCP Urolithiasis (Renal Calculi)

NCP Prostatectomy

Many men older than age 75 have small, slow-growing prostate tumors that cause little harm. However, surgical resection of the portion of the prostate gland encroaching on the urethra may be required to improve urinary flow and relieve acute urinary retention regardless of the patient’s age. Note: Laser prostatectomy is being done in routine practice; however, published data relative to the efficacy of the procedure are currently insufficient for long-term outcomes.

Transurethral resection of the prostate (TURP): Obstructive prostatic tissue of the medial lobe surrounding the urethra is removed by means of a cystoscope/resectoscope introduced through the urethra.

Suprapubic/open prostatectomy: Indicated for masses exceeding 60 g (2 oz). Obstructing prostatic tissue is removed through a low midline incision made through the bladder. This approach is preferred if bladder stones are present.

Retropubic prostatectomy: Hypertrophied prostatic tissue mass (located high in the pelvic region) is removed through a low abdominal incision without opening the bladder. This approach may be used if the tumor is limited.

Perineal prostatectomy: Large prostatic masses low in the pelvic area are removed through an incision between the scrotum and the rectum. This more radical procedure is done for larger tumors/presence of nerve invasion and may result in impotence.


Inpatient acute surgical unit.



Psychosocial aspects of care

Surgical intervention

Patient Assessment Datebase

Refer to CP: Benign Prostatic Hyperplasia (BPH), p. 000, for assessment information.

Discharge plan

DRG projected mean length of inpatient stay: 3.3–7.1 days

Refer to section at end of plan for postdischarge considerations.


1. Maintain homeostasis/hemodynamic stability.
2. Promote comfort.
3. Prevent complications.
4. Provide information about surgical procedure/prognosis, treatment, and rehabilitation needs.


1. Urinary flow restored/enhanced.
2. Pain relieved/controlled.
3. Complications prevented/minimized.
4. Procedure/prognosis, therapeutic regimen, and rehabilitation needs understood.
5. Plan in place to meet needs after discharge.
ReadmoreNCP Prostatectomy

NCP Benign Postatic Hyperplasia (BPH)

Benign prostatic hyperplasia is characterized by progressive enlargement of the prostate gland (commonly seen in men older than age 50), causing varying degrees of urethral obstruction and restriction of urinary flow.


Community level, with more acute care provided during outpatient procedures.



Psychosocial aspects of care

Renal failure: acute

Patient Assessment Database


May exhibit: Elevated BP (renal effects of advanced enlargement)


May report: Decreased force/caliber of urinary stream; dribbling

Hesitancy in initiating voiding

Inability to empty bladder completely; urgency and frequency of urination

Nocturia, dysuria, hematuria

Sitting to void

Recurrent UTIs, history of calculi (urinary stasis)

Chronic constipation (protrusion of prostate into rectum)

May exhibit: Firm mass in lower abdomen (distended bladder), bladder tenderness

Inguinal hernia; hemorrhoids (result of increased abdominal pressure required to empty bladder against resistance)


May report: Anorexia; nausea, vomiting

Recent weight loss


May report: Suprapubic, flank, or back pain; sharp, intense (in acute prostatitis)

Low back pain


May report: Fever


May report: Concerns about effects of condition/therapy on sexual abilities

Fear of incontinence/dribbling during intimacy

Decrease in force of ejaculatory contractions

May exhibit: Enlarged, tender prostate


May report: Family history of cancer, hypertension, kidney disease

Use of antihypertensive or antidepressant medications, OTC cold/allergy medications containing sympathomimetics, urinary antibiotics or antibacterial agents

Self-treatment with saw palmetto or soy products

Discharge plan

DRG projected mean length of stay: 3.7 days

May need assistance with management of therapy, e.g., catheter

Refer to section at end of plan for postdischarge considerations.


Urinalysis: Color: Yellow, dark brown, dark or bright red (bloody); appearance may be cloudy. pH 7 or greater (suggests infection); bacteria, WBCs, RBCs may be present microscopically.

Urine culture: May reveal Staphylococcus aureus, Proteus, Klebsiella, Pseudomonas, or Escherichia coli.

Urine cytology: To rule out bladder cancer.

BUN/Cr: Elevated if renal function is compromised.

Prostate-specific antigen (PSA): Glycoprotein contained in the cytoplasm of prostatic epithelial cells, detected in the blood of adult men. Level is greatly increased in prostatic cancer but can also be elevated in BPH. Note: Research suggests elevated PSA levels with a low percentage of free PSA are more likely associated with prostate cancer than with a benign prostate condition.

WBC: May be more than 11,000/mm3, indicating infection if patient is not immunosuppressed.

Uroflowmetry: Assesses degree of bladder obstruction.

IVP with postvoiding film: Shows delayed emptying of bladder, varying degrees of urinary tract obstruction, and presence of prostatic enlargement, bladder diverticuli, and abnormal thickening of bladder muscle.

Voiding cystourethrography: May be used instead of IVP to visualize bladder and urethra because it uses local dyes.

Cystometrogram: Measures pressure and volume in the bladder to identify bladder dysfunction unrelated to BPH.

Cystourethroscopy: To view degree of prostatic enlargement and bladder-wall changes (bladder diverticulum).

Cystometry: Evaluates detrusor muscle function and tone.

Transrectal prostatic ultrasound: Measures size of prostate and amount of residual urine; locates lesions unrelated to BPH.


1. Relieve acute urinary retention.

2. Promote comfort.

3. Prevent complications.

4. Help patient deal with psychosocial concerns.

5. Provide information about disease process/prognosis and treatment needs.


1. Voiding pattern normalized.

2. Pain/discomfort relieved.

3. Complications prevented/minimized.

4. Dealing with situation realistically.

5. Disease process/prognosis and therapeutic regimen understood.

6. Plan in place to meet needs after discharge.
ReadmoreNCP Benign Postatic Hyperplasia (BPH)

NCP Urinary Diversions / Urostomy (Postoperative Care)

Incontinent urinary diversions: These ostomies require permanent stoma care and external collecting devices.
Ileal conduit: Ureters are anastomosed to a segment of ileum, resected with the blood supply intact (usually 15–20 cm long). The proximal section is closed, and the distal end brought to skin opening to form a stoma (a passageway, not a storage reservoir).
Colonic conduit: This is a similar procedure using a segment of colon.
Ureterostomy: The ureter(s) is brought directly through the abdominal wall to form its own stoma.
Continent urinary diversions: Continent urinary reservoirs (CURs) have become one of the major options for patients to improve their quality of life regarding stoma care and the ability to sleep and travel.
Kock reservoir or Indiana (ileocecal) pouch: A section of intestine is used to form a pouch inside the patient’s abdomen, creating a reservoir that the patient periodically drains by inserting a catheter through the stoma, thus negating the need for an external collecting device.


Inpatient acute surgical unit.


Psychosocial aspects of care
Surgical intervention
Patient Assessment Database
Data depend on underlying problem, duration, and severity, e.g., malignant bladder tumor, congenital malformations, trauma, chronic infections, or intractable incontinence due to injury/disease of other body systems (e.g., multiple sclerosis). (Refer to appropriate CP.)


Discharge plan

DRG projected mean length of inpatient stay: 5.5 days

May require assistance with management of ostomy and acquisition of supplies.

Refer to section at end of plan for postdischarge considerations.


Intravenous pyelogram (IVP): Visualizes size/location of kidneys and ureters and rules out presence of tumors elsewhere in urinary tract.
Cystoscopy with biopsy: Determines tumor location/stage of malignancy. Ultraviolet cystoscopy outlines bladder lesion.
Bone scan: Determines presence of metastatic disease.
Bilateral pedal lymphangiogram: Determines involvement of pelvic nodes, where bladder tumor easily seeds because of close proximity.
CT scan: Defines size of tumor mass, degree of pelvic spread.
Urine cystoscopy: Detects tumor cells in urine (for determining presence and type of tumor).
Endoscopy: Evaluates intestines for use as conduit.
Conduitogram: Assesses length and emptying ability of the conduit and presence of stricture, obstruction, reflux, angulation, calculi, or tumor (may complicate or contraindicate use as a urinary diversion).


1. Prevent complications.
2. Assist patient/SO in physical and psychosocial adjustment.
3. Support independence in self-care.
4. Provide information about procedure/prognosis, treatment needs, potential complications, and resources.


1. Complications prevented/minimized.
2. Adjusting to perceived/actual changes.
3. Self-care needs met by self/with assistance as necessary.
4. Procedure/prognosis, therapeutic regimen, potential complications understood and sources of support identified.
5. Plan in place to meet needs after discharge.
ReadmoreNCP Urinary Diversions / Urostomy (Postoperative Care)

NCP Hemodialysis

In hemodialysis (HD), blood is shunted through an artificial kidney (dialyzer) for removal of toxins/excess fluid and then returned to the venous circulation. Hemodialysis is a fast and efficient method for removing urea and other toxic products and correcting fluid and electrolyte imbalances but requires permanent arteriovenous access. Procedure is usually performed three times per week for 4 hr. HD may be done in the hospital, outpatient dialysis center, or at home.
ReadmoreNCP Hemodialysis