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OBJECTIVES: To evaluate the efficacy of subcutaneous administration of dexmedetomidine/atipamezole at the Governing Vessel 20 (GV20) acupuncture point compared with other administration routes (intramuscular and intravenous) in dogs presented for orthopaedic radiographs. MATERIALS AND METHODS: Prospective, randomised, blinded, controlled clinical study. Sixty-four client-owned dogs were randomly injected with 200 µg/m2 of dexmedetomidine intramuscular (lumbar muscles) (n=20), intravenous (n=23) or subcutaneous at the GV20 point (n=21). Following radiographs, dogs received 2000 µg/m2 of atipamezole intramuscular (n=31), or subcutaneous at the GV20 point (n=27). Degree and time to sedation and recovery were assessed using a sedation scale and a Dynamic and Interactive Visual Analog Scale (DIVAS). Clinical physiological variables and adverse events were used. Statistical linear mixed-effect models (analysis of variance) and Cox models were performed. Significance was set at P-value <0.05. RESULTS: Sedation was insufficient to perform orthopaedic radiographs in six dogs in the intramuscular group. The time to sedation was significantly longer, and sedation scale and DIVAS scores were significantly lower in the intramuscular group. The intravenous group had significantly higher sedation scale and DIVAS scores than the GV20 group. No significant differences were observed between the intramuscular and GV20 recovery groups, although the time effect was significantly more pronounced in the GV20 recovery group. CLINICAL SIGNIFICANCE: Subcutaneous administration of dexmedetomidine and atipamezole at GV20 provided effective sedation and recovery in dogs undergoing orthopaedic radiographic studies. GV20 administration provided a clinically similar level of sedation to the intravenous route, and greater and faster sedation and similar recovery to intramuscular.
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Puntos de Acupuntura , Enfermedades de los Perros , Hipnóticos y Sedantes , Ortopedia , Animales , Perros , Dexmedetomidina/administración & dosificación , Dexmedetomidina/efectos adversos , Método Doble Ciego , Hipnóticos y Sedantes/administración & dosificación , Hipnóticos y Sedantes/efectos adversos , Estudios Prospectivos , Enfermedades de los Perros/diagnóstico por imagen , Inyecciones Subcutáneas/métodosRESUMEN
Objective: The juvenile equine medial femoral condyle (MFC) is frequently affected with radiographic changes (sclerosis and subchondral lucencies) that arise at a similar site to juvenile osteochondritis dissecans (JOCD) in children. There is little information on maturation of the MFC. To describe the normal development of the equine MFC osteochondral unit from birth to 2 years. Methods: Micro CT, histology and immunohistochemistry were performed on healthy equine MFCs (n = 29) at sites where lesions occur. Parameters assessed included: cartilage thickness; the epiphyseal growth plate cartilage organization; the osteochondral junction and progression of endochondral ossification. Results: From 0 to 6 months, chondrocytes near the articular surface are small and flat and have a characteristic hypertrophic appearance near the osteochondral junction but are not arranged in columns like physeal growth plates. The osteochondral junction is also crossed by cartilage canals containing vessels giving a porous appearance on 3D µCT images. At 7 months of age, a subchondral bone plate compact structure emerged histologically coincident with the end of endochondral ossification (absence of type X collagen immunostain and chondrocyte hypertrophy). Conclusion: New information is provided on MFC osteochondral unit maturation that will improve our understanding of the development of juvenile equine orthopaedic disease. Equine MFC endochondral ossification is complete at 6 months of age. The immature osteochondral junction may be structurally fragile because of its microarchitecture and susceptible to focal traumatic events that induce developmental lesions.
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BACKGROUND: The aetiology of equine metacarpal condylar fractures is not completely understood and a developmental cause has been postulated. OBJECTIVES: To investigate the subchondral bone trabecular microarchitecture of the lateral parasagittal groove and condyle in equine neonates and its adaptation with maturation and athletic activity. STUDY DESIGN: Ex vivo observational study. METHODS: Distal metacarpi of neonates, yearlings and adult racehorses (n = 24) were harvested. Dorsal and palmar frontal histological sections, containing the lateral parasagittal groove and condyle, were studied. The sections were digitalised and subchondral trabecular bone quantity and quality parameters and trabecular orientation in the frontal plane were measured. RESULTS: Trabecular spacing and length were greater (P = 0.004 and P = 0.0005 respectively) whereas bone fraction, trabecular number and connectivity were all lower (P = 0.0004, P = 0.0001 and P = 0.001 respectively) in the lateral parasagittal groove compared with the condyle in neonatal foals. Trabecular thickness and bone fraction increased with age in racehorses and trabecular spacing decreased. The predominant trabecular orientation had a consistent pattern in neonates and it changed with maturity and the cumulative effect of racing at all the ROIs except for the palmar lateral parasagittal groove that retained a more 'immature' pattern. MAIN LIMITATIONS: Samples were investigated in 2D. 3D processing could have provided more information. CONCLUSIONS: Already at birth there are striking differences in the subchondral bone trabecular microarchitecture between the lateral parasagittal groove and condyle in foals. Adaptation of trabeculae is confirmed with maturity in racehorses, with the greatest adaptation measured in bone quantity parameters. The trabecular orientation had a unique and more immature orientation pattern in the lateral palmar parasagittal grooves in adult racehorses and may reflect a weaker structure at this site.
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Animales Recién Nacidos/anatomía & histología , Hueso Esponjoso/anatomía & histología , Caballos/anatomía & histología , Huesos del Metacarpo/anatomía & histología , Adaptación Fisiológica , Envejecimiento/fisiología , Animales , Animales Recién Nacidos/crecimiento & desarrollo , Animales Recién Nacidos/fisiología , Hueso Esponjoso/crecimiento & desarrollo , Hueso Esponjoso/fisiología , Caballos/crecimiento & desarrollo , Caballos/fisiología , Procesamiento de Imagen Asistido por Computador , Modelos Lineales , Huesos del Metacarpo/crecimiento & desarrollo , Huesos del Metacarpo/fisiología , Condicionamiento Físico AnimalRESUMEN
BACKGROUND: Corticosteroids are the most potent drugs for the control of severe equine asthma, but adverse effects limit their chronic systemic administration. Inhaled medications allow for drug delivery directly into the airways, reducing the harmful effects of these drugs. OBJECTIVES: To evaluate the efficacy of inhaled budesonide specifically formulated for the equine use and administered by a novel inhalation device in horses with severe asthma. STUDY DESIGN: Experimental studies in horses with naturally occurring asthma with cross-over, randomised, blinded experimental designs. METHODS: In Study 1, budesonide (1800 µg twice daily) administered using a novel Respimat® based inhaler was compared to i.v. dexamethasone (0.04 mg/kg). In Study 2, 3 doses of budesonide (450, 900, and 1800 µg) were compared to oral dexamethasone (0.066 mg/kg). Lung function, bronchoalveolar fluid cytology (Study 1), CBC, serum chemistry, and serum cortisol and adrenocorticotropic hormone (ACTH) values were evaluated. RESULTS: In Study 1, there was a marked and significant improvement in the lung function of all horses treated with budesonide and dexamethasone. Neutrophil percentages in bronchoalveolar fluid decreased in all horses treated with dexamethasone and in four of six horses treated with budesonide. Serum cortisol and blood ACTH concentrations decreased with both treatments. In Study 2, there was a significant improvement in the lung function with all dosages of budesonide, and the effects of higher dosages were comparable to those of dexamethasone. Dexamethasone and budesonide at the two higher dosages induced a significant decrease of cortisol concentrations. MAIN LIMITATIONS: The Respimat® based inhaler is not currently commercially available. CONCLUSIONS: Administration of budesonide with the Respimat® based inhaler provided dose-dependent relief of airway obstruction in horses with severe asthma, but also a suppression of serum cortisol.
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Antiinflamatorios/uso terapéutico , Asma/veterinaria , Budesonida/uso terapéutico , Enfermedades de los Caballos/tratamiento farmacológico , Animales , Antiinflamatorios/administración & dosificación , Asma/tratamiento farmacológico , Budesonida/administración & dosificación , Estudios Cruzados , Relación Dosis-Respuesta a Droga , Caballos , Distribución AleatoriaRESUMEN
OBJECTIVE: To measure the nerve fiber density in synovial membranes from healthy and OA equine joints and to investigate the relationship between synovial innervation and OA severity, synovial vascularity and synovitis. DESIGN: Twenty-five equine metacarpophalangeal joints were collected post-mortem. The joints were dissected and the macroscopic lesions of the articular cartilage were scored. Synovial membrane specimens (n = 50) were harvested, fixed, sectioned and scored histologically. Immunohistochemical staining and immunofluorescence with S-100 protein, that identifies nerve fibers, and âº-actin, that stains vascular smooth muscle, were also performed on site-matched specimens and the relationships between these tissues was interrogated. RESULTS: The nerve fiber density was higher in the superficial layer (≤200 µm) of the synovium when compared to the deeper layer in control equine joints (mean difference (95% C.I.): 0.054% (0.018%, 0.11%)). In osteoarthritic joints, synovial innervation decreased in the superficial layer with increasing macroscopic OA score (ß (SEM), 95% C.I.: -0.0061 (0.00021), -0.0011, -0.00017). The blood vessel density was also higher in the superficial layer of the synovium compared to the deep layer in the control (mean difference (95% C.I.): 1.1% (0.36%, 2.3%)) and OA (mean difference (95% C.I.): 0.60% (0.22%, 1.2%)) equine joints. Moreover, considering all synovial specimens, higher nerve fiber density in the deep layer positively correlated with blood vessel density (ß (SEM), 95% C.I.: 0.11 (0.036), 0.035, 0.18). CONCLUSION: The reduction in nerve fiber density with advanced cartilage degeneration suggests that peripheral neuropathy is associated with equine OA. Whether this link is associated with neuropathic pain, requires further investigation.
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Enfermedades de los Caballos/patología , Articulación Metacarpofalángica , Fibras Nerviosas/patología , Osteoartritis/patología , Membrana Sinovial/inervación , Animales , Progresión de la Enfermedad , Femenino , Caballos , Masculino , Osteoartritis/veterinariaRESUMEN
According to the World Health Organization, depression has become the leading cause of disability in the world, contributing significantly to the burden of health issues especially in the industrialized countries. This is a major public health problem, with potential impact on work climates, productivity at work and the continued existence of the organizations. Some recent studies have examined potential links between professional factors and common mental health disorders, but none have demonstrated a direct causal link. OBJECTIVE: In the present study, we explored possible links between work-related stressors and common mental health disorders, with the objective of determining priority mental health prevention axes. METHOD: The study used a life trajectory method. We compared professional stressors and difficulties present in other spheres of life in the last five years between two groups: a group of 29 participants with common mental health disorders during the last five years (depression, anxiety disorders, eating disorders, substance use disorders, pathological gambling), and a group of 29 participants who have not experienced a mental health disorder in the last five years. Data were collected from semi-structured interviews with the participants using a life course analysis method. Each participant was interviewed during two or three meetings of two to three hour duration. Questions regarding difficulties in different spheres of life and mental health were asked. More precisely, data were collected with regards to the presence or absence of mental health disorders in the last five years and the nature of mental health disorders and difficulties. Moreover, we collected data pertaining to the most important positive and negative events in different spheres of life that were present in the last five years, including family life, romantic relationships, social life, academic difficulties, losses and separations, episodes of personal difficulties, financial difficulties as well as protective factors. Regarding professional difficulties present in the last five years, data were collected on different kinds of adversities such as difficulties in finding a job, periods of unemployment, frequent job changes, difficult working conditions, discrimination, difficult working relationships with colleagues and with employers, moral harassment and family-work conflicts. RESULTS: Participants with common mental health disorders are more concerned about having general professional difficulties at work and about having difficult working relationships with employers. However, difficulties related to other spheres of life do not differentiate the two groups. CONCLUSION: It is possible that the work environment is linked to common mental health disorders. In particular, having general professional stressors at the work place and having difficult relationships with employers can impact the occurrence of common mental health disorders. Inversely, these stressors at work can be the consequence of a common mental health disorder. Complementary studies are of interest. Professional stressors can constitute an essential part in the occurrence of common mental health disorders. Thus, the workplace seems a priority environment for deploying effective mental health prevention strategies. Moreover, this can be a strategy for organizations to improve the work climate and to increase productivity.
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Trastornos Mentales/psicología , Enfermedades Profesionales/psicología , Estrés Laboral/psicología , Adolescente , Adulto , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Entrevista Psicológica , Masculino , Trastornos Mentales/etiología , Persona de Mediana Edad , Enfermedades Profesionales/etiología , Estrés Laboral/complicaciones , Satisfacción Personal , Factores Socioeconómicos , Intento de Suicidio/estadística & datos numéricos , Lugar de Trabajo , Adulto JovenRESUMEN
OBJECTIVES: Training health professionals about suicidal crisis is one major line of suicide prevention worldwide. France has one of the highest suicide rates in Europe, and although crisis intervention training has been set up since 2001, there presently is no training assessment tool in the French language for health professionals trained in suicide prevention. In the four levels of Kirpatrick's education pyramid, training that takes place in France today solely assesses level one status, that is to say relative to the level of satisfaction of participants (self-report). This study proposes a validated short French version of the Suicide Intervention Response Inventory-2 (SIRI-2) of Neimeyer & Mc Innes. The SIRI-2 questionnaire assesses the ability of first line intervention in dealing with suicidal individuals. METHODS: The translation methodology was inspired from Vallerand's model of cross-cultural back translation. This method is regularly used for translating from the English language to a French version. In order to translate the English version, we used an extensive 7-step methodology implicating several bilingual translators, expert reviewers (psychologists and psychiatrists) and a scientific committee. Participants were 107 students from different French universities and study programs: psychology, medicine and nursing (17 were men; average age was 26.6). Fifteen of these participants answered the SIRI-2-VF on two occasions (separated by a 15-day interval) in order to estimate the temporal stability of the instrument. The scores of the students were compared to six French experts in suicide prevention and with the original expert group who worked on the development of SIRI-2 (n=7). We used Student t Test for construct validity, Cronbach's Alpha for internal consistency and Pearson's correlation coefficient for temporal stability. RESULTS: Following a fidelity comparison of the results of the French experts with those of the American experts, ten items presenting the least good fidelity were suppressed in order to obtain a short version of the SIRI-2 containing 15 questions (SIRI-2-VF). Statistical analyses of the short version (15 questions, SIRI-2-VF) showed good validity (difference between experts and subjects is significant: t=31.5, P<0.001) and reliability (good internal consistency: α=0.850 for positive statements and α=0.830 for negative statements, and a temporal stability: r=0.827, bilateral test, P<0.001). CONCLUSIONS: This tool should improve the range of specific instruments in French suicidology adapted for French culture of suicide intervention. It is the first tool in France that reaches level 2a of Kirkpatrick's pyramid to assess clinical skills after training in suicidology.
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Intervención en la Crisis (Psiquiatría)/métodos , Inventario de Personalidad , Psicometría/métodos , Prevención del Suicidio , Encuestas y Cuestionarios , Traducciones , Adolescente , Adulto , Femenino , Francia , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Medición de Riesgo/métodos , Suicidio/psicología , Adulto JovenRESUMEN
OBJECTIVES: Develop a species-specific ELISA for a neo-epitope generated by cathepsin K cleavage of equine type II collagen to: (1) measure cartilage type II collagen degradation by cathepsin K in vitro, (2) identify cytokines that upregulate cathepsin K expression and (3) compare cathepsin K with matrix metalloproteinase (MMP) collagenase activity in stimulated cartilage explants and freshly isolated normal and osteoarthritic (OA) articular cartilages. DESIGN: A new ELISA (C2K77) was developed and tested by measuring the activity of exogenous cathepsin K on equine articular cartilage explants. The ELISA was then employed to measure endogenous cathepsin K activity in cultured cartilage explants with or without stimulation by interleukin-1 beta (IL-1ß), tumour necrosis-alpha (TNF-α), oncostatin M (OSM) and lipopolysaccharide (LPS). Cathepsin K activity in cartilage explants (control and osteoarthritic-OA) and freshly harvested cartilage (control and OA) was compared to that of MMPs employing C2K77 and C1,2C immunoassays. RESULTS: The addition of Cathepsin K to normal cartilage caused a significant increase (P < 0.01) in the C2K77 epitope release. Whereas the content of C1,2C, that reflects MMP collagenase activity, was increased in media by the addition to cartilage explants of TNF-α and OSM (P < 0.0001) or IL-1ß and OSM (P = 0.002), no change was observed in C2K77 which also unchanged in OA cartilages compared to normal. CONCLUSIONS: The ELISA C2K77 measured the activity of cathepsin K in equine cartilage which was unchanged in OA cartilage. Cytokines that upregulate MMP collagenase activity had no effect on endogenous cathepsin K activity, suggesting a different activation mechanism that requires further study.
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Cartílago Articular/metabolismo , Catepsina K/metabolismo , Colágeno Tipo II/metabolismo , Articulación Metacarpofalángica/metabolismo , Osteoartritis/metabolismo , Animales , Cartílago Articular/efectos de los fármacos , Cartílago Articular/patología , Estudios de Casos y Controles , Catepsina K/efectos de los fármacos , Colágeno Tipo II/efectos de los fármacos , Citocinas/farmacología , Ensayo de Inmunoadsorción Enzimática , Caballos , Técnicas In Vitro , Interleucina-1beta/farmacología , Lipopolisacáridos/farmacología , Articulación Metacarpofalángica/efectos de los fármacos , Articulación Metacarpofalángica/patología , Oncostatina M/farmacología , Factor de Necrosis Tumoral alfa/farmacologíaRESUMEN
OBJECTIVES: The aim of this study was to evaluate the perceptions and opinions of Canadian pet owners about anaesthesia, pain and surgery in dogs and cats. METHODS: Six Canadian veterinary hospitals participated. Each practice received 200 copies of a questionnaire that were distributed to pet owners. Questions regarding the use of analgesics, anaesthesia, surgery and onychectomy (cats) were included. Responses were transformed into ordinal scores and analysed with a Cochran-Mantel-Haenszel test. RESULTS: A total of 849 out of 1200 questionnaires were returned. Owners believed more frequently that analgesics are needed for surgical procedures than for the medical conditions. Owners rated as very important/important: "knowing what to expect during illness/injury/surgery" (99·3%), "being assured that all necessary analgesic drugs/techniques will be used" (98·6%), "being informed about procedures/risk" (98·5%), and having a board-certified anaesthesiologist (90·5%). Most owners agreed/partly agreed that pain impacts quality of life (94·2%), and affects their pet's behaviour (89·5%). Most respondents (69%) were women; they were significantly more concerned than men about anaesthesia, pain, cost and client-communication. Cat owners believed that analgesics were necessary for some procedures/conditions significantly more often than canine-only owners. Pet owners with previous surgery disagreed more frequently that "pain after surgery can be helpful" and that "pain in animals is easy to recognize" than those without previous surgery. Most owners think onychectomy should be banned in cats (56·4%). CLINICAL SIGNIFICANCE: This study identified important areas of client communication regarding pain and its control in pets.
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Anestesia/veterinaria , Bienestar del Animal , Propiedad , Dolor Postoperatorio/veterinaria , Animales , Canadá , Gatos/psicología , Perros/psicología , Femenino , Humanos , Masculino , Dolor Postoperatorio/epidemiología , Dolor Postoperatorio/prevención & control , Calidad de Vida , Cirugía Veterinaria , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
OBJECTIVES: To evaluate and compare nasal mucosal contact, septal deviation and caudal aberrant nasal turbinates in brachycephalic and normocephalic dogs using computed tomography. METHODS: Dogs without nasal disease and having undergone computed tomography scan of the head (plica alaris to the cribiform plate) were retrospectively selected and divided into brachycephalic and normocephalic groups. Eighteen brachycephalic and 32 normocephalic dogs were included. Anatomic criteria were used to locate predetermined pairs of intranasal structures and nasal mucosal contact was described as present or absent for each site. Septal deviations were identified and measured using angle of septal deviation. Caudal aberrant nasal turbinates were identified and categorised when present. RESULTS: Prevalence of nasal mucosal contact was significantly higher in brachycephalic dogs. No significant difference was seen in prevalence or in angle of septal deviation between groups. Prevalence of caudal aberrant nasal turbinates was significantly higher in brachycephalic dogs. CLINICAL SIGNIFICANCE: Nasal mucosal contact and caudal aberrant nasal turbinates were significantly more prevalent in brachycephalic dogs than in normocephalic dogs in our study. Computed tomography can be a valuable aid in obtaining data on nasal mucosal contact, caudal aberrant nasal turbinates and septal deviations. Combination of computed tomography with endoscopy and functional airway testing would be useful to further evaluate the correlation between intranasal features and symptoms of brachycephalic airway syndrome.
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Craneosinostosis/veterinaria , Enfermedades de los Perros/diagnóstico por imagen , Tomografía Computarizada por Rayos X/veterinaria , Animales , Craneosinostosis/diagnóstico por imagen , Perros , Femenino , Masculino , Mucosa Nasal/anatomía & histología , Mucosa Nasal/diagnóstico por imagen , Mucosa Nasal/patología , Tabique Nasal/diagnóstico por imagen , Estudios Retrospectivos , Cornetes Nasales/anatomía & histología , Cornetes Nasales/diagnóstico por imagen , Cornetes Nasales/patologíaRESUMEN
UNLABELLED: The role of osteoclasts in osteochondral degeneration in osteoarthritis (OA) has rarely been investigated in spontaneous disease or animal models of OA. OBJECTIVE: The objectives of the current study were to investigate osteoclast density and location in post-traumatic OA (PTOA) and control specimens from racehorses. METHOD: Cores were harvested from a site in the equine third carpal bone, that undergoes repetitive, high intensity loading. Histological and immunohistochemical (Cathepsin K and Receptor-activator of Nuclear Factor kappa-ß ligand (RANKL)) stained sections were scored (global and subregional) and the osteoclast density calculated. The cartilage histological scores were compared with osteoclast density and RANKL scores. RESULTS: There was a greater density of osteoclasts in PTOA samples and they were preferentially located in the subchondral bone plate. RANKL scores positively correlated to the scores of cartilage degeneration and the osteoclast density. The relationship between hyaline articular cartilage RANKL score and osteoclast density was stronger than that of the subchondral bone RANKL score suggesting that cartilage RANKL may have a role in recruiting osteoclasts. The RANKL score in the articular calcified cartilage correlated with the number of microcracks also suggesting that osteoclasts recruited by RANKL may contribute to calcified cartilage degeneration in PTOA. CONCLUSION: Our results support the hypothesis that osteoclasts are recruited during the progression of spontaneous equine carpal PTOA by cartilage RANKL, contributing to calcified cartilage microcracks and focal subchondral bone loss.
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Huesos del Carpo/patología , Articulaciones del Carpo/patología , Enfermedades de los Caballos/patología , Osteoartritis/patología , Osteoartritis/veterinaria , Osteoclastos/patología , Animales , Calcinosis/metabolismo , Calcinosis/patología , Huesos del Carpo/metabolismo , Articulaciones del Carpo/lesiones , Enfermedades de los Cartílagos/etiología , Enfermedades de los Cartílagos/metabolismo , Enfermedades de los Cartílagos/patología , Enfermedades de los Cartílagos/veterinaria , Cartílago Articular/metabolismo , Cartílago Articular/patología , Recuento de Células , Movimiento Celular/fisiología , Caballos , Masculino , Osteoartritis/etiología , Osteoartritis/metabolismo , Osteoclastos/fisiología , Ligando RANK/metabolismo , Ligando RANK/fisiologíaRESUMEN
Patients may be intubated after exposure to a variety of substances because of respiratory failure, CNS sedation, pulmonary pathology, or cardiovascular instability. However, there is little data describing the types of substances that are associated with endotracheal intubation or the rates of intubation after these exposures. Evaluation of this association may inform future research on intubation after exposures to specific substances and guide poison prevention education. Our objective was to determine which exposures were commonly associated with intubation using the data from National Poison Data System (NPDS). The NPDS tracks data from potential exposures to substances reported to all American Association of Poison Control Centers. We performed a retrospective analysis of NPDS data from January 1st, 2000 to December 31st, 2013 to identify human exposures to substances that were associated with endotracheal intubation. Descriptive statistics were used to analyze the data. There were 93,474 single substance exposures and 228,507 multiple substance exposures that were associated with intubation. The most common exposures to substances that were associated with intubation were atypical antipsychotics (7.4 %) for single exposures and benzodiazepines (27.4 %) for multiple exposures. Within each age group, the most common known exposures to substances were for patients under 6 years, clonidine for single and multiple exposures; for patients aged 6-12 years, clonidine for single exposures and atypical antipsychotics for multiple exposures; for patients aged 13-19 years, atypical antipsychotics for single and multiple exposures; and for patients over 19 years, atypical antipsychotics for single exposures and benzodiazepines for multiple exposures. From 2000-2013, the exposures to substances most commonly associated with intubation varied by single versus multiple exposures and by age. This study helps clarify the exposures to substances that are associated with intubation reported to poison centers in the USA.
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Sobredosis de Droga/terapia , Intubación Intratraqueal , Intoxicación/terapia , Pautas de la Práctica en Medicina , Insuficiencia Respiratoria/prevención & control , Adolescente , Agonistas de Receptores Adrenérgicos alfa 2/envenenamiento , Adulto , Factores de Edad , Anticonvulsivantes/envenenamiento , Antidepresivos Tricíclicos/envenenamiento , Niño , Terapia Combinada , Sobredosis de Droga/fisiopatología , Femenino , Aceites Combustibles/envenenamiento , Intercambio de Información en Salud , Humanos , Lactante , Masculino , Centros de Control de Intoxicaciones , Intoxicación/fisiopatología , Pautas de la Práctica en Medicina/tendencias , Insuficiencia Respiratoria/etiología , Estudios Retrospectivos , Estados UnidosRESUMEN
Many prey species alternate between bouts of foraging and bouts of antipredator vigilance. Models of vigilance typically predict how much total time prey animals should allocate to vigilance but do not specify how that time should be scheduled throughout foraging. Here, we examine how the scheduling of vigilance pays off in terms of food intake and predator detection. Specifically, we study how changes in ecological factors affect the expected duration of scans to look out for predators and the duration of interscan intervals dedicated to foraging. Our framework includes factors like the risk of attack, how difficult it is to locate food and predators, and the distance to protective cover. Our individual-based model makes several predictions about scan and interscan durations, which are discussed in relation to the available empirical evidence in birds and mammals. This model of antipredator vigilance is a first step in incorporating constraints related to food gathering and the detection of predators. Adding such constraints adds a novel dimension to vigilance models and produces a variety of predictions that await empirical scrutiny.
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Reacción de Prevención/fisiología , Conducta Alimentaria/fisiología , Modelos Biológicos , Conducta Predatoria/fisiología , Animales , Reacción de Fuga/fisiologíaAsunto(s)
Relaciones Comunidad-Institución , Defensa del Consumidor , Información de Salud al Consumidor , Personal de Salud , Centros de Control de Intoxicaciones , Intoxicación/prevención & control , Rol Profesional , Toxicología , Conducta Cooperativa , Educación Médica , Becas , Personal de Salud/educación , Humanos , Comunicación Interdisciplinaria , Colaboración Intersectorial , Toxicología/educación , Recursos HumanosRESUMEN
BACKGROUND: Predicting subaortic stenosis (SAS) in adult Golden Retriever dogs (GRs) by evaluating them as puppies is hampered by the progressive expression of the SAS phenotype in youth. In some children who develop SAS as adults, an abnormal aortoseptal angle (AoSA) precedes development of stenosis. OBJECTIVES: To determine the normal AoSA in young adult GRs using echocardiography; to assess the value of AoSA in GR puppies for predicting development of the SAS phenotype. ANIMALS: Forty-eight 2- to 6-month-old GR puppies. METHODS: Prospective study. Puppies were recruited from clients and breeders. Puppies were evaluated with a physical examination and an echocardiogram, and this evaluation was repeated when they were 12-18-month-old adults. Puppies were classified as unaffected (WNL) or affected (SAS) retroactively, based on their results as adults. RESULTS: In WNL young adult GRs, mean ± SD AoSA was 152.3 ± 6.5°. Mean ± SD AoSA in SAS puppies (144.9 ± 8.6°) was significantly different from mean AoSA in WNL puppies (155.7 ± 8.8°, P < .01). No puppy with AoSA >160° had the SAS phenotype as a young adult; 93% (75.7-99.1%) of puppies with AoSA <145° had the SAS phenotype as young adults. Peak LVOT velocity increased significantly between evaluations (P < .0001) whereas AoSA did not (P = .45). CONCLUSION AND CLINICAL SIGNIFICANCE: A steep AoSA in GR puppies is associated with the SAS phenotype in young adulthood. Some GR puppies have an abnormal AoSA that persists in young adulthood and is detectable before peak LVOT velocity reaches levels consistent with SAS.
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Aorta/anomalías , Enfermedades de los Perros/etiología , Defectos de los Tabiques Cardíacos/veterinaria , Factores de Edad , Animales , Aorta/diagnóstico por imagen , Estenosis Aórtica Subvalvular/diagnóstico por imagen , Estenosis Aórtica Subvalvular/veterinaria , Enfermedades de los Perros/diagnóstico por imagen , Perros , Ecocardiografía/veterinaria , Femenino , Defectos de los Tabiques Cardíacos/complicaciones , Defectos de los Tabiques Cardíacos/diagnóstico por imagen , Masculino , Estudios Prospectivos , Factores de RiesgoRESUMEN
In HPTN 061, a study of Black men who have sex with men (MSM), we evaluated the association of healthcare-specific racial discrimination with healthcare utilization and HIV testing among 1167 HIV-negative participants. Median age was 38 years, 41 % were uninsured, and 38 % had an annual household income <$10,000. Overall, 19 % reported healthcare-specific racial discrimination directed toward family, friend, or self; 61 % saw a healthcare provider in the previous 6 months and 81 % HIV tested within the past year. Healthcare-specific racial discrimination was positively associated with seeing a provider [adjusted odds ratio (AOR) = 1.4 (1.0, 2.0)] and HIV testing [AOR = 1.6 (1.1, 2.4)] suggesting that barriers other than racial discrimination may be driving health disparities related to access to medical care and HIV testing among Black MSM. These results contrast with previous studies, possibly due to measurement or cohort differences, strategies to overcome discrimination, or because of greater exposure to healthcare.
Asunto(s)
Negro o Afroamericano , Infecciones por VIH/prevención & control , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Disparidades en Atención de Salud , Homosexualidad Masculina , Aceptación de la Atención de Salud/estadística & datos numéricos , Racismo/estadística & datos numéricos , Adolescente , Adulto , Negro o Afroamericano/psicología , Negro o Afroamericano/estadística & datos numéricos , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Humanos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Oportunidad Relativa , Aceptación de la Atención de Salud/etnología , Racismo/psicología , Conducta Sexual , Percepción Social , Factores Socioeconómicos , Encuestas y CuestionariosRESUMEN
REASONS FOR PERFORMING STUDY: Bronchospasm results in airway obstruction in horses with heaves. Atropine is the most potent bronchodilator drug currently available for horses, but is associated with side effects that limit its use. Like atropine, N-butylscopolammonium bromide (NBB) is an anticholinergic agent with bronchodilatory properties. OBJECTIVES: To compare the bronchodilating effects and side effects of atropine and NBB in horses with heaves. STUDY DESIGN: Cross-over experiment using horses with heaves. METHODS: Eight horses with heaves were administered atropine and NBB, using a cross-over design. Heart rate, pupillary dilatation, transrectal palpation, lung mechanics (maximal changes in transpulmonary pressure, pulmonary resistance and elastance) and arterial blood gases were assessed before and 10 and 30 min after drug administration. RESULTS: One horse treated with atropine developed colic. Significant pupillary dilatation was observed only with atropine. Tachycardia developed in all horses, but was more marked with atropine. Lung function improved with both drugs, but elastance values had returned to baseline at 30 min with NBB. There was no improvement in arterial hypoxaemia with either drug. CONCLUSIONS: The study indicated that the bronchodilatory properties of NBB were not statistically different from those of atropine, but were of shorter duration. N-butylscopolammonium bromide was associated with fewer systemic side effects, and therefore NBB should be preferred over atropine when assessing the reversibility of airway obstruction in horses.
Asunto(s)
Atropina/efectos adversos , Broncoconstricción/efectos de los fármacos , Bromuro de Butilescopolamonio/efectos adversos , Enfermedades de los Caballos/tratamiento farmacológico , Enfermedades Pulmonares Obstructivas/veterinaria , Parasimpatolíticos/efectos adversos , Animales , Atropina/uso terapéutico , Bromuro de Butilescopolamonio/uso terapéutico , Estudios Cruzados , Femenino , Caballos , Enfermedades Pulmonares Obstructivas/tratamiento farmacológico , Masculino , Parasimpatolíticos/uso terapéuticoRESUMEN
Due to recent establishment of the blacklegged tick, Ixodes scapularis Say, in southeastern Canada, tick-borne zoonoses (Lyme disease, human granulocytotropic anaplasmosis, and babesiosis) are of growing concern for public health. Using white-tailed deer (Odocoileus virginianus) culled in southwestern Quebec during 2007-2008, we investigated whether hunter-killed deer could act as sentinels for early establishing tick populations and for tick-borne pathogens. Accounting for environmental characteristics of culling sites, and age and sex of deer, we investigated whether their tick infestation levels could identify locations of known tick populations detected in active surveillance, presumed tick populations detected by passive surveillance, or both. We also used spatial cluster analyses to identify spatial patterns of tick infestation and occurrence of tick-borne zoonoses infection in ticks collected from the deer. Adult ticks were found on 15% of the 583 deer examined. Adult male deer had the greatest number (approximately 90%) of adult ticks. Overall, 3, 15, and 0% of the ticks collected were polymerase chain reaction (PCR)-positive for Borrelia burgdorferi, Anaplasma phagocytophilum, and Babesia microti, respectively. Our statistical analyses suggest that sex and age of deer, temperature, precipitation, and an index of tick dispersion by migratory birds were significantly associated with tick infestation levels. Cluster analysis identified significant clusters of deer carrying ticks PCR-positive for A. phagocytophilum, and for deer carrying two or more I. scapularis. Our study suggests that hunter-killed deer may be effective as sentinels for emerging areas of tick-borne anaplasmosis. They may have limited use as sentinels for early emerging I. scapularis tick populations and emerging Lyme disease risk.
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Ciervos , Ixodes/fisiología , Vigilancia de la Población/métodos , Infestaciones por Garrapatas/veterinaria , Zoonosis/epidemiología , Factores de Edad , Anaplasma phagocytophilum/aislamiento & purificación , Animales , Babesia microti/aislamiento & purificación , Proteínas de la Membrana Bacteriana Externa/análisis , Borrelia burgdorferi/aislamiento & purificación , Clima , Ecosistema , Femenino , Humanos , Ixodes/microbiología , Ixodes/parasitología , Masculino , Reacción en Cadena de la Polimerasa/veterinaria , Quebec/epidemiología , ARN Bacteriano/análisis , ARN Ribosómico 23S/análisis , Reacción en Cadena en Tiempo Real de la Polimerasa , Vigilancia de Guardia/veterinaria , Análisis de Secuencia de ADN , Factores Sexuales , Infestaciones por Garrapatas/epidemiología , Infestaciones por Garrapatas/parasitología , Infestaciones por Garrapatas/transmisión , Zoonosis/parasitología , Zoonosis/transmisiónRESUMEN
Catching crew members can heavily contaminate their hands with organic material. They can act as mechanical vector and spread diseases between farms. Hand hygiene is an important issue for the industry as a whole and for human health by reducing contamination risks. Many studies, in human medicine, tend to make hand rub a standard for hand hygiene. However, few studies have tested the effectiveness of hand hygiene products on visibly contaminated hands. The objective of this study was to evaluate the effectiveness of practical hand sanitization protocols: water and soap, degreasing cream and hand wipes, all combined with alcohol-based hand gel. The use of alcohol-based gel alone was also evaluated. For the reduction of coliforms after washing, there was no statistically significant difference between protocols when the initial level of bacterial contamination was low to moderate. When hands were highly contaminated, the alcohol-based gel alone was less effective than the degreasing cream combined with the alcohol-based gel (p=0.002). As for the reduction in total aerobic bacteria counts, there was no difference between protocols when the initial level of bacterial contamination was low. The water, soap and alcohol-based gel protocol was more effective than the scrubbing wipes and alcohol-based gel protocol when hands were moderately (p=0.002) and highly contaminated (p=0.001). All protocols were effective in neutralizing Salmonella on hands. Reducing the level of bacterial contamination on hands before using an alcohol-based gel seems important to ensure effective hand sanitation for highly and moderately contaminated hands. This can be done by using a degreasing cream or water and soap. Based on the survey, catching crew members preferred using warm water and soap compared to a degreasing cream.
Asunto(s)
Crianza de Animales Domésticos , Geles/uso terapéutico , Desinfección de las Manos/métodos , Conocimientos, Actitudes y Práctica en Salud , Crema para la Piel/uso terapéutico , Jabones/uso terapéutico , Adolescente , Adulto , Alcoholes/uso terapéutico , Animales , Humanos , Masculino , Persona de Mediana Edad , Aves de Corral , Quebec , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVES: To determine the short- and long-term outcome for sport horses after arthroscopic treatment of osteochondrosis of the lateral trochlear ridge of the femur. METHODS: A retrospective study was performed using the medical records of horses intended for use as English sport horses. Outcome was obtained through telephone questionnaire. RESULTS: Thirty-seven horses, mainly Warmbloods, underwent arthroscopic surgery for treatment of lateral femoral trochlear ridge osteochondrosis. Short-term outcome revealed that 27 of 37 horses had no complications. Seven horses had postoperative lameness and effusion which eventually resolved in four horses. Long-term outcome was available for 29 horses, of which 19 were performing to full expectations. Five horses were athletic but at a lower level than expected, and five horses were unable to be used. The depth of the lesion was significantly associated with short-term complications of effusion and lameness. The depth and length of the lesion were not associated with the long-term outcome, but involvement of structures other than the lateral trochlear ridge (patella, medial trochlear ridge) was associated with a worse prognosis. CLINICAL SIGNIFICANCE: The prognosis for sport horses following stifle arthroscopy for lateral trochlear ridge is similar to that reported in other studies and lesions at other sites within the stifle joint.