Synovial fluid D-dimer concentration in horses with osteochondritis dissecans and osteoarthritis.

OBJECTIVE: To assess the synovial fibrinolytic pathway activation in adult horses with developmental and degenerative arthropathies such as osteochondritis dissecans (OCD) and osteoarthritis (OA) by measuring synovial D-dimer concentrations. METHODS: Prospective observational clinical study of horses admitted for OCD or OA. Synovial fluid was collected during lameness examination or prior to the surgical procedure, and D-dimer concentration and routine synovial fluid analysis were performed. RESULTS: Fifty-eight horses (14 with OCD, 10 with OA and 34 controls) were included in this study. Synovial D-dimer concentrations of horses with OCD and OA were both higher when compared with controls, but were only significantly different in horses with OCD (p = 0.005). However, no statistical differences were observed when comparing synovial D-dimer concentrations from the OCD horses with the OA-affected horses (p = 0.444). CLINICAL SIGNIFICANCE: Activation of coagulation and fibrinolysis play a role in the pathophysiology of equine OCD and OA.

Synovial fluid D-dimer concentration in foals with septic joint disease.

BACKGROUND: Increased synovial fibrinolytic activity (detected by increases in synovial D-Dimer concentrations) has been observed in different joint diseases in humans and adult horses, presumably in order to minimize fibrin deposition within the joint and thus avoid its detrimental effects. OBJECTIVE: To investigate fibrinolytic pathway activation in joint sepsis in foals by measuring synovial D-Dimer concentrations. ANIMALS: Eighteen septic foals with septic joints, 9 septic foals without septic joints, 9 systemically healthy foals with septic joint, and 3 controls are included. METHODS: Prospective observational clinical study of foals admitted for septic arthritis. Synovial D-Dimer concentration and routine synovial fluid analysis were performed. Diagnosis of joint sepsis was made whenever synovial total nucleated cell count was >30,000 cells/µL, synovial total protein >4 g/dL, and neutrophil percentage of >80%, or synovial fluid culture resulted positive. Results were compared among groups by general lineal models. RESULTS: Synovial D-Dimer concentration was significantly (P < .001) higher in the foals with septic joints compared with foals without joint disease (P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE: Septic joint disease is associated with a marked increase of synovial D-Dimer concentration (marked activation of the fibrinolytic activity) within the affected joint. Although further studies are needed, the measurement of synovial D-Dimer concentration may be considered a complementary diagnostic marker of septic joint disease.

Modified technique for the repair of third-degree rectovaginal lacerations in mares.

Eight mares with third-degree rectovestibular lacerations were treated by a two-stage surgical technique. The rectovestibular shelf was corrected with three parallel 'circular' continuous suture rows distributed along the longitudinal axis of the vagina, and the perineal body was reconstructed with three divergent simple continuous rows. Primary healing of the first-stage surgery occurred in all the mares. Seven of the mares completed the two-stage surgery and primary healing occurred in all of them. One of them returned to endurance racing competition and one was lost to follow-up. The other five were bred and became pregnant; one foaled four times, two foaled three times, one foaled once and the other was pregnant at the time of writing. The condition did not recur in any of the mares after foaling.

Amiloidosis sistémica primaria y miocardiopatía dilatada / Primary systemic amyloidosis and dilated cardiomyopathy

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La atención a la persona con patología crónica: un nuevo enfoque para la enfermería de atención primaria / Health care of patients with chronic disease. A new focus for primary health care nursing

Para operativizar el documento "L'atenció d'Infermería a l'Atenció Primària" (Institut Català de la Salut), se creó un grupo de trabajo cuyo objetivo fue analizar la actividad en la consulta de enfermería y consensuar cuál debería ser el contenido de la visita al paciente crónico, así como en qué circunstancias podríamos hablar de alta. Se diseña un algoritmo de seguimiento planteado en dos fases: inicial y de seguimiento. En ambas se aplica el proceso de enfermería, planteando la actuación de enfermería desde el rol autónomo y el de cooperación. Se concluye que el alta será de procesos concretos y no de cuidados de enfermería (AU)