Arthroscopic Versus Mini-open Rotator Cuff Repair: A Randomized Trial and Meta-analysis.

BACKGROUND: Patients with complete rotator cuff tears who fail a course of nonoperative therapy can benefit from surgical repair. PURPOSE: This randomized trial compared mini-open (MO) versus all-arthroscopic (AA) rotator cuff repair. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: Patients with rotator cuff tears were randomized to undergo MO or AA repair at 9 centers by 23 surgeons. The primary outcome (Western Ontario Rotator Cuff Index [WORC]) and secondary outcomes (American Shoulder and Elbow Surgeons [ASES] score, Shoulder Pain and Disability Index [SPADI] pain subscale, 12-Item Short Form Health Survey [SF-12], reported medication use, adverse events), as well as measurements of range of motion and strength, were collected at 1 month before surgery; at 2 and 6 weeks postoperatively; and at 3, 6, 12, 18, and 24 months postoperatively. A blinded radiologist evaluated rotator cuff integrity on magnetic resonance imaging (MRI) at baseline and 1 year. Intention-to-treat analysis of covariance with the preoperative WORC score, age, and tear size as covariates assessed continuous outcomes. Sex differences were assessed. A meta-analysis synthesized the primary outcome between MO and AA repair with previous trials. RESULTS: From 954 patients screened, 411 were ineligible (276 because of recovery with physical therapy), 449 were screened at surgery (175 ineligible), and 274 completed follow-up (138 MO and 136 AA). The AA and MO groups were similar before surgery. WORC scores improved from 40 preoperatively to 89 (AA) and 93 (MO) at 2 years, for an adjusted mean difference of 3.4 (95% CI, -0.4 to 7.2). There were no statistically significant differences between the AA and MO groups at any time point. All secondary patient-reported outcomes were not significantly different between the MO and AA groups, except the 2-year SPADI pain score (8 vs 12, respectively; P = .02). A similar recovery in range of motion and strength occurred in both groups over time. MRI indicated minimal improvement in muscle relative to fat (AA: n = 3; MO: n = 2), with most worsening (AA: n = 25; MO: n = 24) or remaining unchanged (AA: n = 70; MO: n = 70). Opioid use was significantly reduced after surgery (from 21% to 5%). The meta-analysis indicated no significant standardized mean difference between groups in the primary outcome across all pooled studies (standardized mean difference, -0.06 [95% CI, -0.34 to 0.22]). CONCLUSION: Both AA and MO rotator cuff repair provide large clinical benefits, with few adverse events. There is strong evidence of equivalent clinical improvements. TRIAL REGISTRATION: NCT00128076.

Supplemental safflower oil affects the fatty acid profile, including conjugated linoleic acid, of lamb.

The objective of this study was to determine whether increasing levels of dietary safflower oil would alter unsaturated fat (especially CLA) and tocopherol content of lamb, animal performance, carcass characteristics, or color stability of lamb muscle tissue. Targhee x Rambouillet wethers (n = 60) were assigned to one of three diets (four pens per treatment with five lambs per pen) in a completely random design. Diets were formulated with supplemental safflower oil at 0 (control), 3, or 6% (as-fed basis) of the diet. Diets containing approximately 80% concentrate and 20% roughage were formulated, on a DM basis, to be isocaloric and isonitrogenous and to meet or exceed NRC requirements for Ca, P, and other nutrients. A subsample of 12 wethers per treatment was selected based on average BW (54 kg) and slaughtered. Carcass data (LM area, fat thickness, and internal fat content) and wholesale cut weight (leg, loin, rack, shoulder, breast, and foreshank), along with fatty acid, tocopherol, and color analysis, were determined on each carcass. The LM and infraspinatus were sampled for fatty acid profile. Increasing safflower oil supplementation from 0 to 3 or 6% increased the proportion of linoleic acid in the diet from 49.93 to 55.32 to 62.38%, respectively, whereas the percentage of oleic acid decreased from 27.94 to 23.80 to 20.73%, respectively. The percentage of oil in the diet did not (P > or = 0.11) alter the growth and carcass characteristics of lambs, nor did it alter the tocopherol content or color stability of meat. Increasing levels of safflower oil in lamb diets decreased (P < 0.01) the weight percentage of oleic acid in the infraspinatus and LM, and increased linoleic acid (P < 0.01). Oil supplementation increased (P < 0.01) the weight percentage of various isomers of CLA in muscle, with the greatest change in the cis-9,trans-11 isomer. Supplementation of sheep diets with safflower oil, up to 6% of the diet, resulted in increasing levels of unsaturated fatty acids and CLA in the lean tissue, without adversely affecting growth performance, carcass characteristics, or color stability of lamb.

Safflower: A New Host of Cercospora beticola.

Safflower is an oilseed crop adapted to the small-grain production areas of the western Great Plains, including the Northern Plains Area (NPA). In the NPA, safflower production is being evaluated for potential rotation with sugar beet. Safflower is susceptible to Cercospora carthami, whereas sugar beet is susceptible to C. beticola C. carthami has not been observed on safflower in the NPA but C. beticola is ubiquitous on sugar beet. Observation of unusual leaf spots on irrigated safflower cv. Centennial at Sidney, MT prompted this investigation of safflower as a potential alternate host of C. beticola. Safflower plants were inoculated with four isolates of C. beticola (C1, C2, Sid1, and Sid2) and incubated in growth chambers; leaf spot symptoms appeared between 3 and 4 weeks later. Polymerase chain reaction (PCR) amplification of extracts from lesion leaf tissue with C. beticola-specific primers produced fragments comparable with amplified fragments from purified cultures of control C. beticola. PCR assay of cultures of single spores from diseased safflower leaf lesions also produced fragments comparable with fragments from C. beticola cultures. Antibody that was raised from isolate C2 also bound to antigens from the single-spore cultures of the four C. beticola isolates. Inoculum from single-spore cultures from infected safflower also infected sugar beet and produced typical Cercospora leaf spot symptoms. Assay of these leaf lesions by PCR resulted in amplification of target fragments with the C. beticola-specific primers. Our results demonstrate that safflower is a new host of C. beticola.

Effects of dietary fat and sire breed on puberty, weight, and reproductive traits of F1 beef heifers.

Prepubertal F1 heifers (n = 246; from crossbred dams bred to either Hereford [H], Limousin [L], or Piedmontese [P] sires) were fed 1.9% (LF) or 4.4% (HF) dietary fat from 254+/-4 d of age until they reached puberty or the breeding season started. Safflower seeds (37% oil with 79% linoleic acid) were the added fat source. Blood samples and backfat thickness measurements were obtained from 60 randomly selected heifers representing the sire breeds and diets studied. In addition, five H-sired heifers from both diets were serially bled at 28-d intervals. Total gain, ADG, body condition score, and backfat thickness were affected by sire breed (P < 0.001) but not diet. Backfat thickness was affected (P < 0.01) by the diet x time on feed interaction. Diet did not affect pubertal age (P > 0.10) but tended (P = 0.08) to affect the percentage of heifers pubertal by the beginning of breeding (June 4). Sire breed effects on puberty age at beginning of breeding, percentage pubertal at the beginning of breeding, and puberty age during the entire study were all highly significant. The effect of the diet x sire breed interaction on percentage of heifers pubertal at beginning of breeding (P < 0.05) was 74.4 vs 76.3% in H-sired, 69.8 vs 60.5% in L-sired, and 76.2 vs 97.6% in P-sired heifers (LF vs HF, respectively). Number of AI services per pregnancy and final pregnancy percentage were not affected by diet or the diet x sire breed interaction. Diet affected progesterone (P < 0.05) and cholesterol (P < 0.001) concentrations, and sire breed tended to affect (P = 0.06) cholesterol concentrations. The effect of the diet x time on feed interaction on cholesterol concentrations was highly significant. There were no effects of diet or sample period on insulin or growth hormone concentrations in serially collected blood samples. We conclude that effects of supplemental dietary fat may be breed-dependent and hypothesize that a feeding period of approximately 60 d duration may be more appropriate than the 162 d used in this study.

Effects of prepartum supplementary fat and muscle hypertrophy genotype on cold tolerance in newborn calves.

Effects of feeding pregnant dams supplemental dietary fat during the last 55 d of gestation on cold tolerance of newborn crossbred calves with (Piedmontese cross, P, n = 15) or without (Hereford cross, H, n = 16) the muscle hypertrophy allele was determined. Primiparous F1 dams gestating F2 calves of the respective breeds were assigned randomly within breed to receive gestation diets containing either 2.2 (Low Fat; LF) or 5.1% fat (High Fat; HF). Safflower (Carthamus tinctorius L.) seeds containing 37% oil with 79% linoleic acid were the supplemental fat source in diets formulated to be isocaloric-isonitrogenous. At parturition, calves were separated from their dams, fed 38 degrees C pooled dairy cow colostrum (30 mL/kg BW), muzzled to prevent suckling, and returned to their dams in a heated (22 degrees C) room for 3.5 h. At 4 h of age (birth = 0 h), a catheter was inserted into the jugular vein. At 5 h of age, calves were placed in a 0 degrees C room for 140 min, and rectal temperatures and blood samples were obtained at 10- and 20-min intervals. Blood was assayed for cortisol and glucose. Rectal temperature was affected by diet (P<.05), time, diet x time, and breed x time (P<.01 for time and the interactions). Cortisol and glucose concentrations were not affected by diet, breed, or the diet x breed interaction, but they were affected by time, breed x time (both P<.01), and diet x time (P = .06). Calves from HF dams had higher rectal temperatures than calves from LF dams, and the HF calves maintained higher rectal temperatures throughout cold exposure. Cortisol concentrations were lower (P = .06) in calves from HF dams, and these calves had more (P = .06) glucose available for metabolic heat production than calves from LF dams. Piedmontese-cross calves maintained higher (P<.01) rectal temperatures and had higher cortisol and glucose (both P<.01) concentrations than did H-cross calves. We conclude that feeding dams supplemental fat during late gestation increased heat production in newborn calves and potentially could increase calf survival; calves with muscle hypertrophy may have a different ratio of shivering vs nonshivering thermogenesis due to differences in body composition or relationships among uncoupling proteins.

Effects of feeding beef females supplemental fat during gestation on cold tolerance in newborn calves.

Effects of prepartum fat supplementation of the dam on cold tolerance of calves were determined in two studies. In Exp. 1, 22 F1, crossbred heifers gestating F2 calves received diets containing either 1.7 or 4.7% dietary fat starting at d 230+/-2d of gestation. Safflower seeds (Carthamus tinctorius) containing 37% oil with 79% linoleic acid were the supplemental fat source in isocaloric-isonitrogenous diets. Calves were separated from their dams at birth, fed pooled dairy-cow colostrum, muzzled to prevent sucking, and returned to their dams in a heated (22 degrees C) barn for 3.5 h. At 4 h of age, a jugular catheter was inserted. At 5 h of age, calves were placed in a 0 degrees C room for 140 min and rectal temperatures and blood samples were obtained at 10- and 20-min intervals. Blood was assayed for glucose, cortisol, and cholesterol. In Exp. 2, 18 multiparous, crossbred beef cows bred to Murray Grey sires were randomly assigned to receive diets containing either 1.7 or 3.1% dietary fat starting at 235+/-2 d gestation. Safflower seeds were used as the supplemental fat source in isocaloric-isonitrogenous diets. At d 260 of gestation, premature parturition was induced in one-half of the cows from each diet group by feeding Ponderosa pine (Pinus ponderosa) needles. Experimental protocols were the same as in Exp. 1, except that cold exposure was at 9 degrees C for 200 min. Rectal temperatures were affected in Exp. 1 by time and diet x time (both P < .01) and diet x calf sex (P < .05) and in Exp. 2 by calf age (P < .05), time, and calf age x time (both P < .01). Plasma cortisol concentrations were affected by time (P < .01) and calf sex x time (P < .05) in Exp. 1 and by time ( P < .01) in Exp. 2. Cholesterol concentrations in Exp. 1 were affected by diet x time (P < .05) and in Exp. 2 by time (P < .05). Plasma glucose concentrations were affected in Exp. 1 by diet (P < .05) and in Exp. 2 by calf age, time, and calf age x time (all P < .01). We conclude from Exp. 1 that feeding heifers supplemental fat during late gestation increased glucose concentrations in the newborn calf, resulting in favorable responses in body temperature in the cold-stressed newborns. This increase in substrate availability suggests a potential positive effect on heat generation in newborns during sustained periods of cold stress. In Exp. 2, premature calves had compromised cold tolerance possibly due to impaired shivering or brown adipose tissue thermogenesis.

A rare site and appearance for lymphomatous recurrence.

A patient with a recurrence of large cell lymphoma is reported. There was psoas muscle involvement, which showed ring enhancement post-intravenous contrast on CT scan. Ring enhancement in skeletal muscle infiltration by lymphoma has not been described previously.

Agrobacterium tumefaciens-mediated transformation of safflower (Carthamus tinctorius L.) cv. 'Centennial'.

Efficient callus formation was achieved from cotyledon, stem, and leaf expiants of the domestic safflower cultivar 'Centennial' on MS salts medium containing 1 mg/L BAP and 1 mg/L NAA. Shoot buds were regenerated from 26% of leaf-derived calli on callus induction medium, although attempts to root regenerated shoots were not successful. 'Centennial' expiants inoculated with Agrobacterium tumefaciens containing NPT II and GUS genes produced kanamycin-resistant calli from which buds were regenerated. Transformation and stable integration of transgenes was confirmed by GUS assay and DNA hybridization in kanamycin-resistant calli, and GUS assay in regenerated shoots.

Effect of kwashiorkor on the cardiovascular system.

In kwashiorkor the heart is clinically and radiologically small. This study utilises echocardiography, a tool not previously used in this disease, to show that this is due to decreased muscle mass.