Ex vivo evaluation of the soft tissue components of the equine stifle using 3 Tesla magnetic resonance imaging under flexion, extension, and loading.

High-field MRI of the equine stifle provides high-resolution information about soft tissues that is useful in the diagnosis of stifle lameness. The aim of this prospective anatomic study was to describe the appearance, position, size, and shape of the equine femorotibial ligaments, meniscal ligaments, and menisci using 3 Tesla MRI under extended, extended-loaded, and flexed conditions. Additionally, histologic examination of the collateral and cruciate ligaments (CLs) of a single stifle was performed to compare with MRI images. In extension, mild variations in MRI signal intensity were apparent in the CLs, and the cranial had two distinct longitudinal regions indicating two ligament bundles. Flexion had minor effects on CL signal intensity and altered the tibial angles of attachment. Histology indicated that both CLs were comprised of two fiber bundles. The collateral ligaments were the same low-signal intensity. The medial collateral ligament had a smaller cross-sectional area than the lateral, and flexion increased the length of the medial collateral ligament and the cross-sectional area of the lateral. Low loads in extension did not affect the MRI appearance of stifle soft tissues. Flexion of the stifle impacted cruciate ligament insertion angles and the size and shape of collateral ligaments. This study provides support for the use of MRI to understand the anatomy and function of stifle ligaments.

Comparison of Two Bandage Splint Constructs in an Ex Vivo Equine Metacarpal Fracture Model.

OBJECTIVES: The aim of this study was to compare the deflection distance, deflection angle and pre-loading sub-bandage pressure of a transverse, mid-metacarpal fracture in an equine cadaver limb when loaded in bending while stabilized with either a Robert Jones Bandage (RJB) or a single-stack bandage (SS), each containing two orthogonal splints. STUDY DESIGN: In an ex vivo experimental study, forelimb pairs from eight horses were collected, and one forelimb from each pair was assigned to either the SS or RJB groups. A transverse osteotomy was performed at the midpoint of the metacarpus. After bandaging, the limbs were loaded in bending. Pre-loading sub-bandage pressure, pre- and post-loading radiographs and post-loading deflection distance measurements were taken. Dorsopalmar radiographs were used to measure the loaded deflection angle. RESULTS: There was no significant difference between RJB and SS constructs in change in deflection angle (10.7 ± 3.0 degrees vs. 9.8 ± 2.6 degrees; p = 0.5) or deflection distance (13.1 ± 2.6 cm vs. 11.4 ± 3.1 cm; p = 0.2). Sub-bandage pressures were significantly greater for the SS than the RJB both dorsally and laterally. CONCLUSION: The SS splint construct resists bending forces similarly to the RJB splint construct in an ex vivo transverse, metacarpal fracture model. The SS splint construct may be a useful alternative to the RJB splint construct in field situations for metacarpal fracture stabilization.

Equine heel bulb lacerations: 62 cases (2004-2018).

OBJECTIVE: To characterize clinical findings and outcomes for horses with heel bulb lacerations. ANIMALS: Medical records of a teaching hospital were reviewed to identify horses treated for heel bulb lacerations between February 2004 and October 2018. Long-term outcome was assessed by telephone communication with owners. Results were analyzed to determine association with clinical outcome. RESULTS: 31 mares and 31 geldings of various ages, breeds, and uses were evaluated. Thirty-six horses had a wound of 0 to 2 days' duration, and 17 horses had a wound of > 2 days' duration. Horses with a wound duration of < 2 days had a significantly greater likelihood of a higher outcome score (P = .025; OR = 7.08; 95% CI = 1.28% to 39.08%). Synovial communication with the wound was confirmed in 21 of 62 (33.9%) horses. One synovial structure was involved in 17 horses, and > 1 synovial structure was involved in 4 horses. Fifty-nine horses survived to discharge, and follow-up information was available for 18 (30.5%) horses. Of the horses available for follow-up, 78% returned to the previous level of work (14/18). Degree of lameness at presentation, degree of wound contamination, treatment prior to presentation, treatment with foot casting, and involvement of synovial structures were not found to be significantly associated with clinical outcome. CLINICAL RELEVANCE: Results suggest that horses with heel bulb lacerations have a good prognosis for survival and a favorable prognosis for return to work. Clinical application of additional findings needs further investigation before clinical relevance can be ascertained.

The impact of COPD on polyneuropathy: results from the German COPD cohort COSYCONET.

BACKGROUND: Peripheral neuropathy is a common comorbidity in COPD. We aimed to investigate associations between alterations commonly found in COPD and peripheral neuropathy, with particular emphasize on the distinction between direct and indirect effects. METHODS: We used visit 4 data of the COPD cohort COSYCONET, which included indicators of polyneuropathy (repeated tuning fork and monofilament testing), excluding patients with diabetes a/o increased HbA1c. These indicators were analysed for the association with COPD characteristics, including lung function, blood gases, 6-min walk distance (6-MWD), timed-up-and-go-test (TUG), exacerbation risk according to GOLD, C-reactive protein (CRP), and ankle-brachial index (ABI). Based on the results of conventional regression analyses adjusted for age, BMI, packyears and gender, we utilized structural equation modelling (SEM) to quantify the network of direct and indirect relationships between parameters. RESULTS: 606 patients were eligible for analysis. The indices of polyneuropathy were highly correlated with each other and related to base excess (BE), ABI and TUG. ABI was linked to neuropathy and 6-MWD, exacerbations depended on FEV1, 6-MWD and CRP. The associations could be summarized into a SEM comprising polyneuropathy as a latent variable (PNP) with three measured indicator variables. Importantly, PNP was directly dependent on ABI and particularly on BE. When also including patients with diabetes and/or elevated values of HbA1c (n = 742) the SEM remained virtually the same. CONCLUSION: We identified BE and ABI as major determinants of peripheral neuropathy in patients with COPD. All other associations, particularly those with lung function and physical capacity, were indirect. These findings underline the importance of alterations of the micromilieu in COPD, in particular the degree of metabolic compensation and vascular status.

Use of a motorized morcellator for elective bilateral laparoscopic ovariectomy in standing equids: 30 cases (2007-2013).

OBJECTIVE: To describe the use of a motorized morcellator for elective bilateral laparoscopic ovariectomy in standing equids and to evaluate long-term outcome. DESIGN: Retrospective case series. ANIMALS: 30 equids (20 horses, 9 mules, and 1 pony). PROCEDURES: Medical records of equids undergoing elective bilateral laparoscopic ovariectomy from 2007 to 2013 were evaluated. Cases were selected on the basis of use of a motorized morcellator for ovary extraction. Data collected included age, breed, reason for surgery, surgery date, surgical approach, intraoperative complications, surgery and morcellation times, postoperative complications, and duration of hospitalization. Long-term follow-up was obtained by telephone interview with owners, and included effectiveness at resolving original reason for surgery, time to return to usual activity, incision site appearance, signs of estrus after surgery, and overall owner satisfaction. RESULTS: 30 equids underwent laparoscopic bilateral ovariectomy with the morcellator technique. Median surgery time was 102 minutes (range, 47 to 150 minutes). Median single ovary morcellation time was 3.5 minutes (range, 2 to 8 minutes). Intraoperative complications occurred in 2 of 30 cases and included iatrogenic organ damage (uterus; 1) and persistent hemorrhage (1). Nineteen of 20 mares for which long-term follow-up was available returned to their previous use at a median of 60 days after surgery (range, 21 to 180 days). CONCLUSIONS AND CLINICAL RELEVANCE: Results of the present study indicated that use of a mechanical morcellator with a 2-portal technique for bilateral laparoscopic ovariectomy in clinically normal equids eliminated the need for a larger laparotomy incision as well as a third portal. Few complications occurred, and clients were satisfied with the procedure. The morcellator technique may offer advantages over other techniques but should only be used by experienced laparoscopic surgeons following adequate training.

Laparoscopic removal of a bladder urolith in a standing horse.

CASE DESCRIPTION: An 11-year-old Arabian gelding was evaluated for hematuria, stranguria, and pollakiuria that had been observed for 1 week. CLINICAL FINDINGS: Transrectal palpation revealed a 5-cm firm round mass in the urinary bladder. Cystoscopy and transrectal ultrasonography confirmed the diagnosis of urinary bladder urolithiasis. TREATMENT AND OUTCOME: A multiportal transparalumbar fossa laparoscopic approach was selected for cystotomy and urolith removal. Cystotomy and urolith removal was performed with sedation and local anesthesia with the horse standing. No perioperative complications were observed. Urination returned to normal 5 days after surgery. The horse returned to its previous level of activity at 3 weeks after surgery. CLINICAL RELEVANCE: Findings suggested that minimally invasive transparalumbar fossa laparoscopic approach can be successfully used for cystotomy and urolith extraction in standing horses; this avoids the disadvantages of conventional laparocystotomy for removal of large uroliths in male equids and the potential complications of general anesthesia and recovery. The technique provided excellent viewing and access to the bladder, permitting extraction of the urolith and secure closure of the cystotomy with minimal tension and tissue trauma to the bladder.

Incentives and barriers to physical activity for working women.

A questionnaire was completed by 393 working women to examine incentives and barriers to physical activity based on the stages of change from the transtheoretical model. Using Chi Square tests, differences were found across the five stages suggesting that work site programs be designed and tailored for women at different stages of readiness.

History of women in sports. Societal issues.

Despite the general trend toward increased participation of women in sports and physical activity across the lifespan, the future of women in sports is not clear. Whereas many women have benefited from the passage of Title IX and increased opportunities for competition, a large percentage have had no instruction in sports either in school or at home. Working women report they can find little time for themselves and that physical activity or exercise is hard to fit into an already overextended schedule. Single working mothers and women at the lower end of the economic scale are doubly disadvantaged. There is a widespread belief, promulgated by the press, that physical activity enriches one's life, but a great percentage of women plan to start "tomorrow." At the same time, women's concerns about their health encourages them to ask more questions that can aid in decisions to make good lifestyle choices. Combining the desire women express for healthy lifestyles with the knowledge of the positive features of physical activity should help health professionals and educators encourage more widespread participation in lifelong sports.

[Duplex ultrasonography of the portal circulation before and after sclerotherapy of esophageal varices]. / A portalis keringés duplex ultrahangvizsgálata oesophagus varix sclerotherapia elött és után.

Authors examined 40 patients suffered from portal hypertension before and after sclerotherapy of esophageal varices with duplex ultrasonography. The patients were divided into four groups: the first and recurrently bleeding patients and those who were treated with propranolol. The average velocity of the main portal vein before the treatment was significantly lower in the patient group, than in the normal control group. There were no significant changes observed after treatment. The portal blood flow increased in the first bleeding patients who did not take propranolol. The diameter of the main portal vein increased in the recurrently bleeding patients. The conclusion is, that the duplex ultrasonography of the portal circulation is a valuable noninvasive method. One has to take into consideration the limits of this technique and further data are needed for the diagnostic and prognostic accuracy.

[Comparative observations of internal and external quality controls in the districts of Neubrandenburg and Rostock]. / Vergleichende Betrachtungen interner und externer Qualitätskontrollen in den Bezirken Neubrandenburg und Rostock.

A useful combination of results from internal quality control and external quality assessment is possible only if the statistical procedures of both systems involve the same limits to accept control data. These limits are shown. For 45 laboratories expected quality groups QG-T are calculated from results of internal quality control. Quality groups QG-RVL are calculated from results of external quality control assessment. In 30 cases the great difference of QG-T and QG-RVL is supposed to be caused by inaccurate performance of internal quality control.

Health concerns of women runners.

The medical concerns of women runners focus not only on injury but also on how their activity affects their overall health. This article discusses lifestyle and nutritional patterns, menstrual change in active women, amenorrhea and decreased bone density, and issues related to pregnancy. Research data as well as recommendations for the clinician are included.

The potency testing of diphtheria and tetanus toxoids as determined by the induction of antibody in mice.

An antibody induction (AI) assay in mice has been developed for the potency testing of diphtheria and tetanus toxoids. A diphtheria-pertussis-tetanus served as a reference preparation so that both toxoids could be tested within the same experiment. Results have been compared with those obtained by the conventional lethal challenge tests in guinea pigs (diphtheria) and mice (tetanus). The potency values obtained in the AI tests reflected the differences in the toxoid content of the preparations. Being an economical method, the AI test can be recommended for the potency control of DPT vaccines subject to confirmation of the authors' observations by others.

Mixed Messages About Osteoporosis in Female Athletes.

Does exercise-induced amenorrhea lead to osteoporosis? Existing studies are difficult to compare because of differing methods and subjects.