Rib osteomyelitis in three foals.

Three foals aged between 21 and 44 days were presented for evaluation of pyrexia and lameness. Each had subcutaneous abscessation associated with osteomyelitis of a rib at the costochondral junction and pathological fracture of the affected rib; one foal had more than one rib affected. Other localised sites of infection included other sites of osteomyelitis, omphalophlebitis, uveitis, enterocolitis, and calcaneal bursitis. The subcutaneous abscessation and rib osteomyelitis was treated surgically in two foals. Salmonella typhimurium was isolated from the subcutaneous abscess in one foal and from the faeces of another. Two of the three foals were euthanased. Ultrasonography was a more useful modality than radiography for establishing the diagnosis of costal osteomyelitis.

Surgical treatment of carpal flexural deformity in 72 horses.

UNLABELLED: Carpal flexural deformities (CFD) are frequently encountered in the horse, with both congenital and acquired forms described. The success of surgical correction of CFD, both in terms of the ability to achieve a straight palmar carpal angle and the impact on future athletic performance, requires further investigation. OBJECTIVE: To report the surgical management and outcome of treatment of flexural deformity of the carpus in 72 horses up to 12 months of age. METHOD: Information was obtained from the medical records of horses surgically treated for CFD and through follow-up contact with owners. At the time of examination each case was graded on the severity of the flexural deformity as grade 1, 2, or 3, in order of ascending severity. Surgical treatment consisted of tenotomy of the ulnaris lateralis and flexor carpi ulnaris muscles. Re-assessment of the palmar carpal angle was made in the immediate postoperative period and again from at least 8 months after surgery via telephone contact with owners and/or breeders. A successful outcome was defined as achievement of a straight palmar carpal angle. Long term outcome was assessed in terms of fullfilment of intended use for horses reaching 3 years of age at the time of the study. RESULTS: A total of 135 surgical procedures were performed on 72 horses. A successful outcome was recorded in 111 limbs (82%). Excluding cases lost to follow-up, surgical correction was more successful in restoring a straight palmar carpal angle in grade 1 limbs (25/25, 100%) compared to grade 2 limbs (78/87, 89%) and grade 3 limbs (8/14, 57%). For those horses that had reached 3 years of age, 26 of 36 Thoroughbreds started in a race (72%) and 12 of 14 non-Thoroughbreds fulfilled their intended use (86%). CONCLUSION: Tenotomy of the ulnaris lateralis and flexor carpi ulnaris tendons for treatment of grade 1 and 2 CFD's has an excellent prognosis for restoration of a straight palmar carpal angle and for intended athletic pursuit of the horse. In cases of grade 3 CFD, the prognosis following surgery is guarded, especially in neonates. Horses treated in this study were up to 12 months of age, indicating that this deformity may not always be self-limiting as previously thought, and treatment may be required for successful resolution of flexural deformity of the carpus in older animals. The results of this study will help veterinarians to make recommendations regarding the surgical treatment of CFDs.

Repair of sinocutaneous fistulae in two horses.

Chronic facial defects extending into the sinuses of two mares were repaired using periosteal flaps. Partial osseous bridging was established over the defects following repair. Previous attempts to close the defects with skin alone had failed. A periosteal flap is a simple surgical technique that provides the foundations for successful repair, despite the chronicity of some fistulae.

Placing healers, healees, and healing into a wider research context.

Healers claim that they can relieve, and often heal, injury and illness against the odds of medical prognosis. Skeptics say that such claims can be accounted for by possible misdiagnosis, uncritical reportage, placebo response, and coincident natural improvement. Their a priori objection is that subjective intention in one person cannot, of itself, affect the physiology and/or mental processes of another person. This a priori objection becomes invalid if experimental evidence, using simultaneous electroencephalographic recordings from two or more brains, has demonstrated that direct brain-to-brain communication can occur. Evidence that something very unusual is occurring during the healing transaction comes from recordings of anomalous electrical and magnetic fields generated by healers when they are in the intention-to-heal mindset.

Report of the New England Task Force on Reducing Heart Disease and Stroke Risk.

Five years ago, a task force on reducing risk for heart disease and stroke was established by the six New England States. The task force included representatives from State public health departments, academia, the corporate sector, and voluntary organizations. This article is the final report of the task force. Heart disease and cerebrovascular disease are major causes of mortality in the New England region. Heart disease causes nearly 40 percent of all deaths in each of the six States and cerebrovascular disease, 7 percent of the deaths. Major risk factors for ischemic heart disease that have been identified--elevated serum cholesterol, high blood pressure, and cigarette smoking--are caused largely by lifestyle behaviors. Similarly, cerebrovascular disease results largely from uncontrolled high blood pressure, much of which is attributable to unhealthy lifestyle behaviors. In a series of studies evidence has accumulated that the reduction or elimination of these risk factors results in a decline in mortality rates. Many intervention programs have been mounted in the region, but there has been no population-wide effort to attack these risk factors. The task force proposed a broad range of activities for New Englanders at sites in the community and in health facilities. These activities would promote not smoking, exercising regularly, and maintaining desirable levels of serum cholesterol and blood pressure.

Industrial hypertension program in a rural state. Efficacy and cost effectiveness.

A program was designed to evaluate the efficacy and cost of detecting and treating hypertension in an industrial population of a rural state. Original screening and evaluation was initiated by a trained blood-pressure technician team, but initiation of therapy was the responsibility of the private physician. Follow-up data were obtained at one year by rescreening in 83% and by telephone contact in 91% of the original hypertensive patients. Eighty-three percent of those patients with moderate or severe hypertension complied with physician visits. The condition of 60% of the treated patients was controlled, and the condition of 74% was improved. The total cost per patient treated for one year was 250 dollars; per patient with controlled hypertension, 446 dollars; and per patient with controlled or improved hypertension, $362.

Industrial hypertension control program in a rural state.

Many problems remain in attempting to improve the detection and management of hypertension in the United States. This study applied a previously established model community hypertension program to a wide geographic area in a rural state. In 47 industries in 18 communities, 15,689 subjects were screened for the presence of hypertension. Eight hundred five subjects were found to have an elevated blood pressure on three separate occasions and were classified for further management. Follow-up showed that 76% visited their physicians within six months, and of these 81% were being observed. Sixty-seven percent of the subjects who saw their physicians were receiving antihypertensive drug therapy. The cost of finding each subject with an elevated blood pressure was $80 and of identifying a subject who received drug therapy, $160.