Allogeneic Stem Cells Alter Gene Expression and Improve Healing of Distal Limb Wounds in Horses.

Distal extremity wounds are a significant clinical problem in horses and humans and may benefit from mesenchymal stem cell (MSC) therapy. This study evaluated the effects of direct wound treatment with allogeneic stem cells, in terms of gross, histologic, and transcriptional features of healing. Three full-thickness cutaneous wounds were created on each distal forelimb in six healthy horses, for a total of six wounds per horse. Umbilical cord-blood derived equine MSCs were applied to each wound 1 day after wound creation, in one of four forms: (a) normoxic- or (b) hypoxic-preconditioned cells injected into wound margins, or (c) normoxic- or (d) hypoxic-preconditioned cells embedded in an autologous fibrin gel and applied topically to the wound bed. Controls were one blank (saline) injected wound and one blank fibrin gel-treated wound per horse. Data were collected weekly for 6 weeks and included wound surface area, thermography, gene expression, and histologic scoring. Results indicated that MSC treatment by either delivery method was safe and improved histologic outcomes and wound area. Hypoxic-preconditioning did not offer an advantage. MSC treatment by injection resulted in statistically significant increases in transforming growth factor beta and cyclooxygenase-2 expression at week 1. Histologically, significantly more MSC-treated wounds were categorized as pro-healing than pro-inflammatory. Wound area was significantly affected by treatment: MSC-injected wounds were consistently smaller than gel-treated or control wounds. In conclusion, MSC therapy shows promise for distal extremity wounds in horses, particularly when applied by direct injection into the wound margin. Stem Cells Translational Medicine 2018;7:98-108.

An Overview of the Use of Neurofeedback Biofeedback for the Treatment of Symptoms of Traumatic Brain Injury in Military and Civilian Populations.

Background: Neurofeedback, a type of biofeedback, is an operant conditioning treatment that has been studied for use in the treatment of traumatic brain injury (TBI) in both civilian and military populations. In this approach, users are able to see or hear representations of data related to their own physiologic responses to triggers, such as stress or distraction, in real time and, with practice, learn to alter these responses in order to reduce symptoms and/or improve performance. Objective: This article provides a brief overview of the use of biofeedback, focusing on neurofeedback, for symptoms related to TBI, with applications for both civilian and military populations, and describes a pilot study that is currently underway looking at the effects of a commercial neurofeedback device on patients with mild-to-moderate TBIs. Conclusions: Although more research, including blinded randomized controlled studies, is needed on the use of neurofeedback for TBI, the literature suggests that this approach shows promise for treating some symptoms of TBI with this modality. With further advances in technology, including at-home use of neurofeedback devices, preliminary data suggests that TBI survivors may benefit from improved motivation for treatment and some reduction of symptoms related to attention, mood, and mindfulness, with the addition of neurofeedback to treatment.

Preexisting lesions associated with complete diaphyseal fractures of the third metacarpal bone in 12 Thoroughbred racehorses.

We characterized features of complete diaphyseal fractures of third metacarpal bones in Thoroughbred racehorses. Given that stress fractures are known to occur in the third metacarpal bone, an additional aim was to determine if complete fractures are associated with signs of a preexisting incomplete stress fracture. Bilateral metacarpi from 12 Thoroughbred racehorses euthanized because of complete unilateral metacarpal diaphyseal fracture were examined visually and radiographically. Open, comminuted, transverse or short oblique fractures occurred in the middle of the diaphysis or supracondylar region. Periosteal surface discoloration and bone callus formation contiguous with the fracture line were present in fractured bones. All contralateral intact metacarpi had gross anatomic lesions, and 10 had radiographic abnormalities similar to those observed on fractured metacarpi. Catastrophic metacarpal fractures occurred in racehorses with bilateral evidence of preexisting bone injury.

Identification, management and outcome of postoperative hemoperitoneum in 23 horses after emergency exploratory celiotomy for gastrointestinal disease.

OBJECTIVE: To investigate postoperative hemoperitoneum in a population of horses that had surgery for colic. STUDY DESIGN: Retrospective case series. ANIMALS: Horses (n = 23). METHODS: Preoperative, intraoperative, and postoperative information was obtained from medical records (1985-2012) of horses with postoperative hemoperitoneum after emergency exploratory celiotomy. Pre-existing hemoperitoneum during surgery and nonsurgical hemoperitoneum were excluded. RESULTS: Of 4520 horses that had emergency exploratory celiotomy for gastrointestinal disease, 23 horses met inclusion criteria; an incidence of 0.5%. Horse signalment approximated the colic population, although Thoroughbreds were significantly overrepresented. Hemoperitoneum was significantly associated with intestinal resection. Postoperative hemoperitoneum was recognized a mean (± SD) of 1.0 ± 0.7 days after surgery and associated with tachycardia, decreasing hematocrit, incisional drainage, or ultrasonographic identification of swirling, echogenic abdominal fluid. Primary treatments included intravenous fluid therapy (n = 23), colloid support (20), blood transfusion (13), and antifibrinolytic agents (11). Fifteen horses (65%) survived to discharge, which was associated with admission lactate and days of hospitalization. CONCLUSIONS: Postoperative hemoperitoneum is a rare complication of exploratory celiotomy in horses that should be considered when there are signs of abdominal discomfort and declining hematocrit in the early postoperative period. Prognosis is guarded because of potential sequelae of septic peritonitis and adhesion formation.

Computed tomographic arthrography of the intercarpal ligaments of the equine carpus.

Injuries of the intercarpal ligaments are an important cause of lameness in performance horses. The purpose of this prospective cadaver study was to determine whether computed tomography (CT) arthrography would be a feasible method for visualizing and characterizing intercarpal ligaments in the horse. One cadaver limb from each of eight nonlame horses was collected immediately after euthanasia. For each limb, overlapping 2.0 mm CT images were acquired before and after injection of iodinated contrast medium into the antebrachiocarpal joint, middle carpal joint, and carpal sheath. Spin echo magnetic resonance imaging (MRI) sequences were acquired in three planes using a 1.5 Tesla MRI scanner in three limbs. Following MRI, colored resin was injected into the synovial structures of these three limbs, limbs were frozen, and anatomic sections were obtained in three planes. Findings from CT arthrograms were compared to findings from precontrast CT, MRI, anatomic slices, and arthroscopy. Medial and lateral palmar intercarpal ligaments, radiocarpal and transverse intercarpal ligaments, and palmar carpal ligament were visible in CT arthrograms of all limbs. The proximal and distal entheses of all ligaments were readily identifiable. Findings indicated that CT arthrography is feasible for visualizing intercarpal ligaments and may be a useful adjunct imaging technique for diagnosing lameness due to suspected carpal ligament injury in horses.