Physiological and blood biochemical variables in horses exercising on a treadmill submerged in water.

The blood lactate concentration (LA) and heart rate (HR) of 10 horses exercising in water on a treadmill were examined. With the water at 10 and 50% of the withers height (WH), the blood LA increased up to mean values around 1.9 mm during the standardized exercise test (SET) until after step 3 of 5 (each step lasted 5 min, speed increasing step by step). Thereafter, blood LA of horses remained constant, while with the water at 80% of WH, the blood LA decreased from the mean peak of 2.16 ± 0.62 mm after the 4th step. The HR of the horses increased to 132 ± 14 beats/min until the 3rd step of SET with the water at 10% of WH, up to the 2nd step with the water at 50% (134 ± 10 beats/min) and up to the 1st step only with the water at 80% of WH (134 ± 10 beats/min). In another SET, horses were exercised five times for 5 min at the maximal attainable speed of 5.5 m/s in water at 20% of the withers height in step 1, 35% in step 2, 49% in step 3, 63% in step 4 and 77% in step 5. On using this SET, blood LA increased to 1.91 ± 0.25 mm until after the 2nd step and decreased after the 3rd step. The HR increased between before commencing SET and the 1st step (143 ± 13 beats/min) and remained constant thereafter. In conclusion, increasing water height and speed of exercise does not augment continuously blood LA and HR of horses exercising in water treadmills.

Effects of haemofiltration and mannitol treatment on cardiopulmonary-bypass induced immunosuppression.

Cardiac surgery using cardiopulmonary bypass (CPB) causes a systemic inflammatory response. Additionally, an impairment of the responsiveness of peripheral blood mononuclear cells (PBMC) to further immunological stimuli has been observed. The aim of our present study was to evaluate the ability of antioxidant therapy with mannitol or haemofiltration during CPB to modulate this immunosuppression after CPB. Forty-five patients undergoing elective heart-surgery were prospectively enrolled and randomized into three groups (control, mannitol, haemofiltration). Blood samples were taken after induction of anaesthesia (T1), 20 min after CPB (T2) and 24 h post-operatively (T3). Expression density of the monocytic surface receptor CD14, HLA-DR expression and cytokine release (TNF-alpha and IL10) after lipopolysaccharide-stimulation were evaluated. At T2, the CD14(dim) cell population was maintained in both intervention groups while in the control group there was a decrease of this proinflammatory monocytic phenotype. No significant differences regarding HLA-DR expression or cytokine release could be demonstrated. This study shows that the suppression of the stimulated immune response after CPB can potentially be alleviated by mannitol or haemofiltration in an experimental in-vitro setting. In the light of data showing that this depression of the immune response might affect the post-operative course of patients, these results could have a potential clinical relevance.

Antibiotics modulate the stimulated cytokine response to endotoxin in a human ex vivo, in vitro model.

BACKGROUND: Sepsis may lead to the suppression of stimulated cytokine release after Gram-negative stimuli, correlating with a fatal outcome. Treatment of sepsis includes adequate therapy with antibiotics. The aim of this study was to investigate the role of antibiotics in the modulation of the lipopolysaccharide (LPS)-stimulated cytokine response of human monocytes. METHODS: In this ex vivo, in vitro study, whole blood samples were taken from 10 healthy volunteers, stimulated with LPS in the presence or absence of various antibiotics (penicillin, amoxicillin, cefuroxime, ceftazidime, cefotaxime, piperacillin/tazobactam, imipenem/cilastatin, gentamicin, netilmicin, ciprofloxacin, vancomycin) and cultured for 24 h. Thereafter, tumor necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) were measured in the supernatants by enzyme-linked immunosorbent assay (ELISA). Furthermore, CD14 and HLA-DR expression on monocytes was assessed using flow cytometry. RESULTS: All cephalosporins decreased LPS-stimulated IL-10 release. Cefuroxime and cefotaxime also decreased the expression density of the LPS recognition molecule CD14 on monocytes. An increase in LPS-stimulated IL-10 release was observed with vancomycin. A suppression of LPS-stimulated TNF-alpha and IL-10 release was observed in the presence of ciprofloxacin. CONCLUSION: These results indicate a modulation of the expression density of CD14 on monocytes, together with a shift from a balanced to an inflammatory cytokine release pattern, by cefuroxime and cefotaxime. Vancomycin changes the response to an anti-inflammatory release pattern. After ciprofloxacin, a profound unresponsiveness of immune-competent cells to LPS stimulation is observed. Because of the critical role of a balanced innate immune response, these data may be of importance for the selection of antibiotics in septic patients.

[Percutaneous occlusion of arterial vessels using permanent embolization for the treatment of an air sac hemorrhage in horses. A case report]. / Perkutaner Verschluss arterieller Gefässe durch permanente Embolisate zur Therapie einer Luftsackblutung beim Pferd. Ein Fallbericht.

This article reports a case of guttural pouch bleeding which was managed successfully by using intravascular embolisation systems to occlude the damaged vessels. Percutaneous catheterisation of the common carotid artery allowed angiographic visualisation of the main head arteries: A. carotis externa, A. carotis interna and A. occipitalis, which showed no abnormalities angiographically. Originating from the A. occipitalis, one artery sent smaller, extensively branching and tortuous vessels to the guttural pouch area. This branching was interpreted as a sign of inflammatory hypervascularization. The artery was occluded by positioning of a detachable balloon distally of the origin of the two small vessels. Insertion of two coils in the A. occipitalis proximally of the origin of this artery completed the embolisation. Occlusion of the distal part was necessary to avoid blood supply to the lesion from the contralateral arterial system via the circle of Willis. The technique used allowed occlusion of a selected head artery without direct surgical intervention in this area. There is no need to remove the implants. After catheterisation, no more episodes of epistaxis occurred. The causing diphtheroid inflammation in the guttural pouch was treated by local infusions of iodine-solutions and resolved completely within 24 days.

Studies on pulmonary and systemic Aspergillus fumigatus-specific IgE and IgG antibodies in horses affected with chronic obstructive pulmonary disease (COPD).

Inhalant exposure to Aspergillus fumigatus (Asp. f.) antigens induces marked inflammatory and immunological alterations in the lungs of horses affected with chronic obstructive pulmonary disease (COPD). In this study we investigated the role of specific allergen(s) present in Asp. f. on systemic and pulmonary IgE and IgG responses in control and COPD-affected horses, using an enzyme-linked immunosorbent assay (ELISA) and immunoblotting techniques. Compared with controls, horses affected with COPD had significantly higher levels of BALF IgE and IgG to somatic Asp. f. antigens as well as to the allergen 1/a (Asp. f. 1/a). Serum levels of IgE and IgG against these antigens did not differ between control and COPD-affected horses. Antigen specific IgE and IgG levels did not correlate between BALF and serum. Scanning of Asp. f. and IgE and IgG blots revealed bands that are recognised by both IgE- and IgG-specific antibodies. Additionally, all horses responded with BALF IgE- and IgG-specific for 93, 35, 31 and 23 kDa allergens, suggesting that these antigens are involved in the induction of airway IgE and IgG responses. These allergens may have the potential to be used as biomarkers for the diagnosis of Asp. f. related exacerbations of equine COPD.

[Demonstration of activity of two potentiated sulfonamides in feces of horses after oral or intravenous administration]. / Aktivitätsnachweis zweier potenzierter Sulfonamide in Kotproben von Pferden nach oraler oder intravenöser Verabreichung.

Both, the oral and intravenous application of two trimethoprim-potentiated sulfonamides induced measurable antibacterial activities in the feces of horses. With regard to the risk of antibiotic-induced alterations of the gastrointestinal flora, the route of application of potentiated sulfonamides seems to be of minor importance. The antibiotics used were Sulfadimethoxine/Trimethoprim (Trafigal 30% ad us. vet.) for oral and Sulfadoxine/Trimethoprim (Borgal 24% ad us. vet., both Hoechst AG, Frankfurt) for intravenous application. As recommended, both drugs were given in a dose of 20 mg per kg bodyweight. The detection method is based on a procedure layed down in German laws for sulfonamide residues in meat-samples and has undergone some modifications for the examination of feces.

[Demonstration of two trimethoprim/sulfonamide combinations in bronchoalveolar lavage fluid of horses and determination of blood levels]. / Nachweis zweier Trimethoprim/Sulfonamid-Kombinationen im Bronchialsekret von Pferden und Bestimmung der Blutspiegel.

Five healthy horses were given a sulfadoxine/trimethoprim combination (Borgal, Hoechst AG) i.v. on day 1. The next ten days the horses got once a day a sulfadimethoxine/trimethoprim combination orally (Trafigal, Hoechst AG). The doses were given as recommended. One horse received no medicaments for control. On each horse six bronchoalveolar lavages were performed. Blood samples were taken to calculate blood levels and elimination half lives. To determine the amount of substances in lavage fluid and plasma the high performance liquid chromatography (HPLC) was used. Regularly low quantities of sulfonamides and trimethoprim were detected in lavage-samples. The mean plasma concentration (n = 4) of sulfadoxine and trimethoprim 30 min after i.v. administration was 71.6 and 1.13 micrograms/g respectively. 24 h after injection the sulfadoxine blood level was 3.0 micrograms/g, while trimethoprim was no longer detectable. The average elimination half lives of sulfadoxine and trimethoprim were 7.94 h and 1.35 h respectively. 8 h after oral application (n = 5) the highest mean sulfadimethoxine blood levels of 53.8 micrograms/g were measured. The elimination half life of sulfadimethoxine was 9.77 h. Two hours after feeding the drug the first blood samples were taken. They already contained the highest mean trimethoprim concentration of 0.32 microgram/g plasma.

[Horse controls--animal welfare in equine sports]. / Pferdekontrollen--Tierschutz im Pferdesport.

In the course of ten horse-shows 248 horses were submitted to a short veterinary examination in the course of the horse controls that were introduced in 1991. In 143 horses (57.6%) animal cruelty preventive deficiencies were found. The results of the horse controls are compared to previous results and discussed from the point of view of animal protection.

Sexual lifestyles in injecting drug users in Italy: potential for HIV infection transmission. First Multicentre Study Group.

To better target efforts aimed at modifying sexual behaviour among injecting drug users (IDUs), we conducted a detailed analysis of sexual partners and practices reported by 1214 Italian heterosexual drug users during the period June 1985-June 1987. Females were more likely to have only drug-using partners (42.8% vs 17.1%), while males were more likely to have only non drug-using partners (50.5% vs 21.4%). Female drug users were more likely to report either one partner or greater than 10 partners, while males were more likely to report 2-10 partners. Nearly 90% of women with only drug-using partners had only one partner. Overall, 29% of women with only non drug-using partners reported that they always used condoms. This proportion increased to 65% among women with greater than 10 non drug-using partners. In Italy, male IDUs may play a greater role than female IDUs in sexual transmission of HIV infection to the heterosexual non drug-using partners.

The spread of HIV-1 infection in Italy: seropositivity and AIDS related syndromes.

A retrospective study on 52,900 individuals tested in 177 Italian Medical Centres for AIDS and related syndromes is reported. The data confirm that I.V. drug users are the group at highest risk in Italy (46% were seropositive and more than one half of these presented PGL or ARC) and that the epidemic probably started in northern Italy and spread south. One third of the examined subjects resulted seropositive for HIV-1 antibodies. ARC was diagnosed in 19% of the symptomatic seropositives. This study is the first national effort to establish a picture of the diffusion of HIV-1 infection in Italy. To reach this aim a periodical survey for the recognition of seropositives should be added to the already existing AIDS notification system.

Drug use and HIV-1 infection: report from the Second Italian Multicenter Study.

A cross-sectional study was carried out in October 1988 among clients of public health centers in Italy that provide assistance for drug dependency. In addition to estimating the frequency of HIV-1 infection and of risk factors related to drug use, the study estimated the temporal gap between relevant events in the drug history of each subject. Forty-eight centers participated, representing 16 of the 20 Italian regions. Among 1,038/1,348 subjects, 395 (38%) were carriers of HIV-1 antibodies. Seropositivity was related to the length of heroin use (with the risk of being seropositive increasing by 1% for each month of use), to frequency of sharing injection equipment, and to sexual intercourse with a seropositive partner. Women were more likely to have shared injection equipment and to have engaged in sexual intercourse with seropositive partners. Most subjects began sharing injection equipment within a year of initiating drug use, and the median temporal gap between first drug use and first visit to a drug dependency center was 5 years. A high proportion of both seropositive (87%) and seronegative (74%) subjects reported the adoption of safer drug-use practices. In both groups many behavioral changes (38%) were reported to have been introduced before the initial HIV test. These findings confirm that efforts to reduce HIV infection among drug users in Italy will need to concentrate both on prevention of drug use and on early intervention to reduce high-risk behaviors.

Influence of clenbuterol on mucociliary transport in healthy horses and horses with chronic obstructive pulmonary disease.

The mucociliary tracheal transport rate and clearance index were measured in 16 healthy horses and 16 horses suffering from chronic obstructive pulmonary disease. A marker, Indian ink in syrup, was placed in the mucus layer of the interior wall of the trachea, just in front of the carina, and its displacement was measured after 30 and 60 minutes. The same procedure was repeated 30 minutes after the intravenous administration of 0.8 microgram clenbuterol/kg bodyweight. In the diseased horses the mucociliary transport rate was significantly lower than in the healthy horses. After clenbuterol administration there was a significant increase in the transport rate and a similar increase in the clearance index. Sixty and 90 minutes after clenbuterol there was a significant increase of mucus secretion in both the healthy and diseased horses. Measurements in five healthy horses and five diseased horses on two different days gave similar results, showing that the technique provided reproducible data.

Risk behaviors for HIV-1 infection in Italian drug users: report from a multicenter study. First Drug User Multicenter Study Group.

In June 1987, a cross-sectional study was carried out on drug users attending public centers for drug dependency in Italy. Observed proportions of HIV seropositives among the 1,363 subjects from 34 public centers in 11 regions included in the study varied widely, with an overall seropositivity rate of 37%. Sharing syringes/needles, already used by other intravenous drug users, for preparing and injecting drugs represented independent risk factors for HIV-1 infection, while sexual lifestyle did not. Risk of infection increased with frequency of sharing equipment for preparing and for injecting drugs. Modification of risk behaviors in drug use was reported more frequently than in sexual lifestyle; both were significantly associated with knowledge of being seropositive for HIV-1 infection.

[Recent aspects of antirheumatic therapy in the elderly]. / Neuere Aspekte antirheumatischer Therapie bei älteren Patienten.

Consequences have to be derived in respect to the antirheumatic treatment from recent withdrawals of several non-steroidal anti-inflammatory drugs (NSAID). This especially applies for elderly patients with reduced renal function. The dosage has to be carefully adjusted to the individual problems of the patient. No attempts should be made to achieve a completely pain-free state by use of highest dosages: the lower the dose maintaining the patient's mobility, the safer the therapy. NSAID with long elimination half-life time carry a special risk of adverse effects for the elderly due to accumulation. Reduced renal function of the elderly may also result in hypertension and heart failure. Combination of NSAID with glucocorticoids may enhance the antiinflammatory effect, but also causes an increase of adverse effects. Therefore, the combined use appears to be justified only in special situations of severe inflammatory activity no sufficiently controlled by NSAID in which the glucocorticoids are used in the lowest effective dose applied according to the circadian rhythm. The duration of treatment is to be limited, since the adverse effects of glucocorticoids increase with time.

[An unusual case of equine lymphoid leukosis (author's transl)]. / Een bijzonder geval van lymfoïde leucose bij het paard.

The case of a three-year-old mare is reported, in which clinical examination revealed the presence of haemorrhagic diathesis as a result of disseminated intravascular coagulation. The animal also showed severe lameness which was due to involvement of the long bones. The diagnosis was only established after death.

[Veterinary and clinical experience of the use of a beta2-receptor-stimulating sympathicomimetic agent (NAB 365) in horses with respiratory discase (author's transl)]. / Enkele veterinair-klinische ervaringen met het gebruik van een beta2-receptoren stimulerend sympaticomymeticum (NAB 365) bij paarden met longaandoeningen.

The manufacturers state that NAB 365 is a beta2-receptor-stimulating sympathicomimetic agent. According to the medical literature it combines a bronchial antispasmodic effect with certain bronchia secretolytic properties and has few untoward side-effects on, for instance, the heart and intestine. The effectiveness of administration of NAB 365 in horses with chronic or acute respiratory disease was tested in the Department of Veterinary Internal medicine in Utrecht. NAB 365 administered at a dosage of 0.8 gamma/kg, of body weight was found to have a marked bronchodilative effect in horses. There was also evidence of a bronchialsecretolytic effect. NAB 365 has a beneficial effect on respiration. At a dosage of 0.8 gamma/kg of body weight, twice daily, there are few side-effects, even when administration is continued for a fortnight. The clinical effect on respiration continued practically throughout the day.