Comparative anatomy of the proximal tibia in healthy Labrador Retrievers and Yorkshire Terriers.

OBJECTIVES: 1) To provide specific quantitative data of tibial conformation in Labrador Retrievers and Yorkshire Terriers; 2) To compare the tibial conformation of these two breeds; and 3) To compare these data with previously reported data. METHODS: Mediolateral radiographs of the stifle were obtained from 30 consecutive Labrador Retrievers and 30 consecutive Yorkshire Terriers with an angle of extension of 135°. The tibial plateau angle (TPA), the angle between the tibial plateau and the patellar tendon (PTA), the Z angle, the distal tibial axis/proximal tibial axis angle (DPA), and the relative tibial tuberosity width (rTTW) were measured and compared among the two breeds. RESULTS: The breed had a significant effect on all of the measured variables (p <0.01): Labrador Retrievers had a lower TPA (25 ± 3° compared to 30 ± 4°), a lower Z angle (58.8 ± 3.2° compared to 69.2 ± 4.5°), a lower DPA (4.5 ± 2.3° compared to 10.8 ± 4.3°), and a lower rTTW (0.74 ± 0.1 compared to 0.86 ± 0.1) than Yorkshire Terriers. The PTA was greater in Labrador Retrievers compared to Yorkshire Terriers (106.9 ± 3.9° compared to 103.7 ± 6.5°). Four correlations were found to be significant: the DPA angle was correlated with the TPA, the Z angle, and the rTTW. The TPA was also correlated with the Z angle. CLINICAL SIGNIFICANCE: The variation in tibial conformation between breeds should be taken into account when studying the role of each measured parameter in the pathology of cruciate disease. When the relevance of each of the aforementioned measured parameters is better understood, it may help determine the most appropriate surgical treatment.

[Are SPA therapy and pulsed electromagnetic field therapy effective for chronic neck pain? Randomised clinical trial. Second part: medicoeconomic approach]. / Y a-t-il un effet des soins thermaux et des champs électromagnétiques pulsés sur la cervicalgie chronique? Essai clinique randomisé. Deuxième partie: approche médicoéconomique.

UNLABELLED: We report the results of a cost-effectiveness evaluation of pulsed electromagnetic field (PEMF) therapy and spa therapy (ST) versus usual care (control) for chronic neck pain. MATERIALS AND METHODS: Inclusion criteria were age 18 to 80 years with pain in the neck area of more than 3 months' duration and no contraindications for PEMF therapy and ST. Randomization to the ST (n=25) and PEMF groups (n=26) was blinded, as was collection of data. Non-included subjects (n=29) underwent usual care. The trial respected the Helsinki declaration, and informed consent was obtained from subjects. The analysis was intent to treat; the main outcome measure was increase in health dimension scores on the MOS SF-36 in terms of increase in French health care costs from 6 months preceding to 6 months after the start of the study. RESULTS: The increase in health care costs was less for the PEMF group (+68 euro+/-539 [95% confidence interval (CI)]: -145.0+281) than the ST and control groups. The increase tended to be less, but not significantly, for the ST group (+373+/-938 euro [95% CI, -14.0+76.0]) than for controls (+618+/-2715 euro [95% CI, -434.0+167.0]). The gain of one physical MOS SF-36 unit during one year cost 3400 euro [95% CI, -6759+13 100] for the PEMF group, 29,000 euro [95% CI, -1093+59 375] for the ST group and 95076 euro [95% CI, -66 769+256 923] for the control group, but the differences were not significant. COMMENTARY: These results suggest a potential cost-effectiveness for ST and particularly PEMF as compared to usual care in chronic cervical pain. Our results perhaps lack significance probably because of lack of statistical power and do not distinguish costs related or not to chronic cervical pain.

[Are SPA therapy and pulsed electromagnetic field therapy effective for chronic neck pain? Randomised clinical trial First part: clinical evaluation]. / Y a-t-il un effet des soins thermaux et des champs électromagnétiques pulsés sur la cervicalgie chronique? Essai clinique randomisé. Première partie: étude clinique.

OBJECTIVES: The purpose of this study was to compare SPA therapy (ST) with pulsed electromagnetic field (PEMF) therapy in chronic neck pain. MATERIALS AND METHODS: Inclusion criteria were age between 18 and 80 years, neck pain of more than 3 months' duration and pain score>30 mm on a visual analog scale (VAS). Exclusion criteria were contraindication to ST or PEMF. The protocol was approved by the ethics committee of Grenoble Hospital. Randomisation to the ST (n=44) and PEMF groups (n=42) was blinded. The main outcome measure was number of improved patients at 6 months in each group. A patient was considered improved if pain score decreased by more than 20%. Secondary measures were score on the Copenhagen and MOS SF-36 scales. Evaluation and intent-to-treat analysis were also blinded. RESULTS: Patients' preferences were for PEMF. At 6 months, in the PEMF group, 33 patients were improved, 5 not improved and 4 lost to follow-up. In the ST group, 24 patients were improved, 14 not improved and 6 lost to follow-up, for significantly greater improvement in the PEMF than ST group (p=0.02). Significant improvement was seen in both groups in terms of pain score, Copenhagen scale score and score on some dimensions of the MOS SF-36 survey. CONCLUSION: PEMF seems to be superior to standard ST without massage in control of neck pain. The difference between groups, although perhaps biased, seem to suggest the importance of our conclusions.

[Prolonged benefit of dobutamine treatment in decompensated myocardiopathies]. / Bénéfice prolongé du traitement par la dobutamine dans les myocardiopathies décompensées.

Prolonged infusions of dobutamine improve, often rapidly, nonobstructive decompensated cardiomyopathies. This improvement may sometimes persist over several months even without changing maintenance therapy.