Using milk leukocyte differentials for diagnosis of subclinical bovine mastitis.

This research study aimed to evaluate the use of the milk leukocyte differential (MLD) to: (a) identify quarter milks that are culture-positive; and (b) characterize the milk leukocyte responses to specific groups of pathogens causing subclinical mastitis. The MLD measures the absolute number and relative percentage of inflammatory cells in milk samples. Using the MLD in two dairy herds (170 and 172 lactating cows, respectively), we studied all lactating cows with a most recent monthly Dairy Herd Improvement Association somatic cell count (SCC) >200 × 103 cells/ml. Quarter milk samples from 78 cows meeting study criteria were analysed by MLD and aseptically collected milk samples were subjected to microbiological culture (MC). Based upon automated instrument evaluation of the number and percentage of inflammatory cells in milk, samples were designated as either MLD-positive or - negative for subclinicial mastitis. Positive MC were obtained from 102/156 (65·4%) of MLD-positive milk samples, and 28/135 (20·7%) of MLD-negative milk samples were MC-positive. When MC was considered the gold standard for mastitis diagnosis, the calculated diagnostic Se of the MLD was 78·5% (IC(95%) = 70·4 to 85·2%) and the Sp was 66·5% (IC(95%) = 58·6 to 73·7%). [corrected]. Quarter milks positive on MC had higher absolute numbers of neutrophils, lymphocytes and macrophages, with higher neutrophils% and lymphocytes% but lower macrophages%. The Log10 (N/L) ratios were the most useful ratio to differentiate specific subclinical mastitis quarters from healthy quarters. Use of the MLD on cows with monthly composite SCC > 200 × 103 cells/ml for screening at quarter level identified quarters more likely to be culture-positive. In conclusion, the MLD can provide an analysis of mammary quarter status more detailed than provided by SCC alone; however, the MLD response to subclinical mastitis was not found useful to specifically identify the causative pathogen.

Human placenta hydrogel reduces scarring in a rat model of cardiac ischemia and enhances cardiomyocyte and stem cell cultures.

INTRODUCTION: Xenogeneic extracellular matrix (ECM) hydrogels have shown promise in remediating cardiac ischemia damage in animal models, yet analogous human ECM hydrogels have not been well development. An original human placenta-derived hydrogel (hpECM) preparation was thus generated for assessment in cardiomyocyte cell culture and therapeutic cardiac injection applications. METHODS AND RESULTS: Hybrid orbitrap-quadrupole mass spectrometry and ELISAs showed hpECM to be rich in collagens, basement membrane proteins, and regenerative growth factors (e.g. VEGF-B, HGF). Human induced pluripotent stem cell (iPSC)-derived cardiomyocytes synchronized and electrically coupled on hpECM faster than on conventional cell culture environments, as validated by intracellular calcium measurements. In vivo, injections using biotin-labeled hpECM confirmed its spatially discrete localization to the myocardium proximal to the injection site. hpECM was injected into rat myocardium following an acute myocardium infarction induced by left anterior descending artery ligation. Compared to sham treated animals, which exhibited aberrant electrical activity and larger myocardial scars, hpECM injected rat hearts showed a significant reduction in scar volume along with normal electrical activity of the surviving tissue, as determined by optical mapping. CONCLUSION: Placental matrix and growth factors can be extracted as a hydrogel that effectively supports cardiomyocytes in vitro, and in vivo reduces scar formation while maintaining electrophysiological activity when injected into ischemic myocardium. STATEMENT OF SIGNIFICANCE: This is the first report of an original extracellular matrix hydrogel preparation isolated from human placentas (hpECM). hpECM is rich in collagens, laminin, fibronectin, glycoproteins, and growth factors, including known pro-regenerative, pro-angiogenic, anti-scarring, anti-inflammatory, and stem cell-recruiting factors. hpECM supports the culture of cardiomyocytes, stem cells and blood vessels assembly from endothelial cells. In a rat model of myocardial infarction, hpECM injections were safely deliverable to the ischemic myocardium. hpECM injections repaired the myocardium, resulting in a significant reduction in infarct size, more viable myocardium, and a normal electrophysiological contraction profile. hpECM thus has potential in therapeutic cardiovascular applications, in cellular therapies (as a delivery vehicle), and is a promising biomaterial for advancing basic cell-based research and regenerative medicine applications.

Demineralized bone matrix fibers formable as general and custom 3D printed mold-based implants for promoting bone regeneration.

INTRODUCTION: Bone repair frequently requires time-consuming implant construction, particularly when using un-formed implants with poor handling properties. We therefore developed osteoinductive, micro-fibrous surface patterned demineralized bone matrix (DBM) fibers for engineering both defect-matched and general three-dimensional implants. METHODS AND RESULTS: Implant molds were filled with demineralized human cortical bone fibers there were compressed and lyophilized, forming mechanically strong shaped DBM scaffolds. Enzyme linked immunosorbent assays and mass spectrometry confirmed that DBM fibers contained abundant osteogenic growth factors (bone morphogenetic proteins, insulin-like growth factor-I) and extracellular matrix proteins. Mercury porosimetry and mechanical testing showed interconnected pores within the mechanically stable, custom DBM fiber scaffolds. Mesenchymal stem cells readily attached to the DBM and showed increasing metabolic activity over time. DBM fibers further increased alkaline phosphatase activity in C2C12 cells. In vivo, DBM implants elicited osteoinductive potential in a mouse muscle pouch, and also promoted spine fusion in a rat arthrodesis model. SIGNIFICANCE: DBM fibers can be engineered into custom-shaped, osteoinductive and osteoconductive implants with potential for repairing osseous defects with precise fitment, potentially reducing operating time. By providing pre-formed and custom implants, this regenerative allograft may improve patient outcomes following surgical bone repair, while further advancing personalized orthopedic and craniomaxillofacial medicine using three-dimensional-printed tissue molds.

The relationship between glenohumeral joint total rotational range of motion and the functional movement screen™ shoulder mobility test.

PURPOSE/BACKGROUND: Side to side asymmetry in glenohumeral joint rotation correlates with injury risk in overhead athletes. The purpose of the current study was to identify the relationship between side-to-side asymmetries in glenohumeral joint total rotational range of motion and shoulder mobility test scores from the Functional Movement Screen™ in collegiate overhead athletes. The authors hypothesized that asymmetries of > 10° in glenohumeral total rotation would not be associated with asymmetrical findings in the Functional Movement Screen™ (FMS) shoulder mobility test. METHODS: Passive glenohumeral total rotational range of motion and the shoulder mobility test of the FMS were measured during pre-participation examinations in 121 NCAA male and female Division II collegiate overhead athletes from varied sports. Passive shoulder range of motion was measured in supine at 90° of abduction, with the humerus in the scapular plane using two measurers and a bubble goniometer. A Pearson Chi-square analysis, p<.05 was used to associate the presence of asymmetries in glenohumeral joint rotation and in the FMS shoulder mobility test in each subject. RESULTS: 40/114 (35.1%) athletes demonstrated asymmetries in total glenohumeral rotation. 45/114 (39.5%) athletes demonstrated asymmetries in the shoulder mobility test. Only 17 of the 45 subjects who demonstrated asymmetry on the shoulder mobility test also demonstrated glenohumeral joint rotation differences of > 10°. Athletes with asymmetries in rotation of > 10° were not any more likely to have asymmetries identified in the shoulder mobility test (95% CI=.555-2.658, P=.627). CONCLUSIONS: Glenohumeral joint range of motion is one of multiple contributors to performance on the FMS shoulder mobility test, and alone, did not appear to influence results. The FMS shoulder mobility test should not be used alone as a means of identifying clinically meaningful differences of shoulder mobility in the overhead athlete. Clinicians working with overhead athletes may consider using both assessments as a complete screening tool for injury prevention measures. LEVEL OF EVIDENCE: Level 3.

The middle finger flexion test to locate the thenar motor branch of the median nerve.

PURPOSE: To assess the accuracy of a physical examination maneuver, the middle finger flexion test, in locating the thenar branch of the median nerve (TBMN). METHODS: Forty-one cadaveric hands were studied. The TBMN was dissected and identified as it emerged from the median nerve. The middle finger was then passively flexed to 90° at both the metacarpophalangeal and the proximal interphalangeal joints with the distal interphalangeal joint at neutral, which allowed the fingertip to contact the thenar eminence. The distance of the TBMN in millimeters with respect to the position of the center of the tip of the middle finger was measured. Two measurements were obtained from each specimen: the distance from the origin of the TBMN to the tip of the finger (+ distal to fingertip, - proximal to fingertip), and the radioulnar distance from the center of the middle fingertip (+ radial, - ulnar). RESULTS: The average location of the TBMN was 1.9 mm ulnar and 0.9 mm proximal to the tip of the flexed middle finger. There were 2 transligamentous median nerve thenar branches. CONCLUSIONS: This physical examination method accurately located the TBMN. This method is simple to perform, does not require secondary landmarks to derive vectors, and may more closely approximate the position of the TBMN than the previously described methods. CLINICAL RELEVANCE: Understanding the location of the TBMN in the palm will aid in accurate identification of this structure and prevent damage to it during surgery.

Dorsal carpal wedge osteotomy in the arthrogrypotic wrist.

PURPOSE: To assess the outcome of patients who underwent dorsal carpal wedge osteotomy (DCWO) for the treatment of wrist flexion deformities causing functional limitations resulting from arthrogryposis. METHODS: We performed a retrospective chart review of consecutive patients treated with DCWO between 1996 and 2009 by a single surgeon. Follow-up of greater than 1 year (mean, 45 mo; range, 12-108 mo) was available in 12 patients (20 wrists). RESULTS: All 12 patients' parents reported subjective improvement in position and appearance, and in performing activities of daily living. Wrist extension was significantly increased (mean, 43°), wrist flexion was significantly decreased (mean, 34° from neutral), and there was no significant change in wrist motion arc. We saw significantly greater improvement in wrist extension in children operated on at 7 years of age or greater and in patients treated concomitantly with an extensor carpi ulnaris tendon transfer. Complications included 1 infection. CONCLUSIONS: The excessively flexed wrist in children with arthrogryposis can safely and effectively be improved with DCWO, which in turn facilitates independence in activities of daily living and school-related tasks as reported by parents. For patients older than 7 years of age at the time of surgery, and for patients treated with concomitant extensor carpi ulnaris transfer at the time of DCWO, we found greater recovery of wrist extension. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

Biomechanical and radiographic analysis of partial coracoclavicular ligament injuries.

BACKGROUND: A spectrum of acromioclavicular joint injuries may exist between type II acromioclavicular joint disruption (coracoclavicular strain) and type III acromioclavicular joint injuries (coracoclavicular disruption). This may help explain the variability in outcomes seen in patients with type II acromioclavicular injuries. HYPOTHESIS: Injury to either the conoid or trapezoid ligaments would lead to instability of the acromioclavicular joint after complete acromioclavicular joint injury. A secondary hypothesis was that the resulting instability could be recognized with Zanca radiographs. STUDY DESIGN: Controlled laboratory study. METHODS: The acromioclavicular ligaments were sectioned in 40 cadaveric shoulder specimens. Ten intact specimens were loaded to failure to evaluate the normal failure patterns of the coracoclavicular ligaments. Thirty specimens then had either the conoid or trapezoid ligament sectioned after creation of complete acromioclavicular joint injury. Preinjury and postinjury radiographs and stability testing quantified the effect of coracoclavicular joint injury on acromioclavicular joint stability. RESULTS: During failure testing, the conoid always failed first. Sectioning of the conoid led to significant increases in posterior and superior displacement on radiographs and with materials testing. Sectioning of the trapezoid led to significant increases in posterior displacement for materials testing and superior displacement on radiographs. CONCLUSION: Sectioning of the acromioclavicular ligaments in conjunction with partial disruption of the coracoclavicular ligament complex led to significant changes in both radiographic and mechanical measures of acromioclavicular stability. The conoid fails first when a load is applied to the coracoclavicular complex in a superior direction. CLINICAL RELEVANCE: Zanca radiograph may detect incomplete injury to the coracoclavicular ligaments associated with acromioclavicular disruption.

Propuesta de un sistema de ejercicios físicos a pacientes con enfermedades venosas crónicas / A proposed set of physical exercises to patients with chronic venous diseases

Se presenta un Sistema de Ejercicios Físicos como propuesta para pacientes con enfermedades venosas crónicas, los mismos se aplican a los portadores de la enfermedad, así como aquellas personas que no la padecen a manera de profilaxis con el fin de mejorar el drenaje venoso de las extremidades inferiores, logrando un incremento de la fuerza de las piernas y mejorar el tono muscular, este Sistema también es aplicable a todas las personas interesadas por las características de su modo de vida y de su vida laboral y social, debe aplicarse de forma sistemática en correspondencia al lugar donde sea más factible, ya sean en clases de gimnasia básica, en los programas de estudio de las Universidades, gimnasia aeróbica, preparación física, gimnasia laboral y también en el hogar(AU)

A given set of physical exercises as a proposal to patients with chronic venous diseases is presented. These exercises are applied to people that are suffering from this disease, and to other healthy people as a prophylactic measure in order to improve the venous drainage of lower extremities, having an increasing of legs strength and muscular tone. This system could be applied to other interested persons because of their life style, work; etc.It should be applied in a systematic way in correspondence to the best place, for example: in basic gymnastics lessons, university syllabus, aerobic gymnastics, and physical preparation, work gymnastics, and at home(AU)

Resolución de vigas curvas espaciales biempotradas de inercia variable

El proyecto consta de lineas generales de una primera parte que no es mas que un repaso sencillo de los conocimientos de algebra vectorial, con un pequeño ejemplo de aplicación específico dentro del campo de las estructuras. En la segunda parte se profundiza el tema, constando de un análisis teórico y finalizando con el desarrollo de un ejemplo práctico. Para un mejor entendimiento se basa en el siguiente esquema: Elementos de geometría. Elementos de mecánica vectorial. Ejemplos elementales de apliocación a retticulados tridimensionales. Resolución de vigas curvas biempotradas en el espacio. Ejemplo práctico. Manejo de programa para resolución de vigas curvas helicoidales acarteladas y las Conclusiones.