bluuebunny/crossref_metadata_2025 huggingface dataset:
Substitutive “Hospital at Home” Versus Inpatient Care for Elderly Patients with Exacerbations of Chronic Obstructive Pulmonary Disease: A Prospective Randomized, Controlled Trial
Authors: Aimonino Ricauda Nicoletta , Tibaldi Vittoria , Leff Bruce , Scarafiotti Carla , Marinello Renata , Zanocchi Mauro , Molaschi Mario
Published: February 2008

OBJECTIVES: To evaluate hospital readmission rates and mortality at 6‐month follow‐up in selected elderly patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).

DESIGN: Prospective randomized, controlled, single‐blind trial with 6‐month follow‐up.

SETTING: San Giovanni Battista Hospital of Torino.

PARTICIPANTS: One hundred four elderly patients admitted to the hospital for acute exacerbation of COPD were randomly assigned to a general medical ward (GMW, n=52) or to a geriatric home hospitalization service (GHHS, n=52).

MEASUREMENTS: Measurements of baseline sociodemographic information; clinical data; functional, cognitive, and nutritional status; depression; and quality of life were obtained.

RESULTS: There was a lower incidence of hospital readmissions for GHHS patients than for GMW patients at 6‐month follow‐up (42% vs 87%, P<.001). Cumulative mortality at 6 months was 20.2% in the total sample, without significant differences between the two study groups. Patients managed in the GHHS had a longer mean length of stay than those cared for in the GMW (15.5±9.5 vs 11.0±7.9 days, P=.010). Only GHHS patients experienced improvements in depression and quality‐of‐life scores. On a cost per patient per day basis, GHHS costs were lower than costs in GMW ($101.4±61.3 vs $151.7±96.4, P=.002).

CONCLUSION: Physician‐led substitutive hospital‐at‐home care as an alternative to inpatient care for elderly patients with acute exacerbations of COPD is associated with a substantial reduction in the risk of hospital readmission at 6 months, lower healthcare costs, and better quality of life.
Holocaust Survivors in Old Age: The Jerusalem Longitudinal Study
Authors: Stesssman Jochanan , Cohen Aaron , Hammerman‐Rozenberg Robert , Bursztyn Michael , Azoulay Daniel , Maaravi Yoram , Jacobs Jeremy M.
Published: February 2008

OBJECTIVES: To examine the hypothesis that Holocaust exposure during young adulthood negatively affects physical aging, causing greater morbidity, faster deterioration in health parameters, and shorter survival.

DESIGN: A longitudinal cohort study of the natural history of an age‐homogenous representative sample born in 1920/21 and living in Jerusalem.

SETTING: Community‐based home assessments.

PARTICIPANTS: Four hundred fifty‐eight subjects of European origin aged 70 at baseline and 77 at follow‐up.

MEASUREMENTS: Comprehensive assessment of physical, functional, and psychosocial domains; biographical history of concentration camp internment (Camp), exposure to Nazi occupation during World War II (Exposure), or lack thereof (Controls); and 7‐year mortality data from the National Death Registry.

RESULTS: Holocaust survivors of the Camp (n=93) and Exposure (n=129) groups were more likely than Controls (n=236) to be male and less educated and have less social support (P=.01), less physical activity (P=.03), greater difficulty in basic activities of daily living (P=.009), poorer self‐rated health (P=.04), and greater usage of psychiatric medication (P=.008). No other differences in health parameters or physical illnesses were found. Holocaust survivors had similar rates of deterioration in health and illness parameters over the follow‐up period, and 7‐year mortality rates were identical. Proportional hazard models showed that being an elderly Holocaust survivor was not predictive of greter 7‐year mortality.

CONCLUSION: Fifty years after their Holocaust trauma, survivors still displayed significant psychosocial and functional impairment, although no evidence was found to support the hypothesis that the delayed effects of the trauma of the Holocaust negatively influence physical health, health trajectories, or mortality.
Age‐Related Differences in the Use of Guideline‐Recommended Medical and Interventional Therapies for Acute Coronary Syndromes: A Cohort Study
Authors: Schoenenberger Andreas W. , Radovanovic Dragana , Stauffer Jean‐Christophe , Windecker Stephan , Urban Philip , Eberli Franz R. , Stuck Andreas E. , Gutzwiller Felix , Erne Paul ,   for the Acute Myocardial Infarction in Switzerland Plus Investigators
Published: February 2008

OBJECTIVES: To compare the use of guideline‐recommended medical and interventional therapies in older and younger patients with acute coronary syndromes (ACSs).

DESIGN: Prospective cohort study.

SETTING: Fifty‐five hospitals in Switzerland.

PARTICIPANTS: Eleven thousand nine hundred thirty‐two patients with ACS enrolled between March 1, 2001, and June 30, 2006. ACS definition included ST‐segment elevation myocardial infarction (STEMI), non‐ST‐segment elevation myocardial infarction (NSTEMI), and unstable angina pectoris (UA).

MEASUREMENTS: Use of medical and interventional therapies was determined after exclusion of patients with contraindications and after adjustment for comorbidities. Multivariate logistic regression models were used to calculate odds ratios (ORs) per year increase in age.

RESULTS: Elderly patients were less likely to receive acetylsalicylic acid (OR=0.976, 95% confidence interval (CI)=0.969–0.980) or beta‐blockers (OR=0.985, 95% CI=0.981–0.989). No age‐dependent difference was found for heparin use. Elderly patients with STEMI were less likely to receive percutaneous coronary intervention (PCI) or thrombolysis (OR=0.955, 95% CI=0.949–0.961). Elderly patients with NSTEMI or UA less often underwent PCI (OR=0.943, 95% CI=0.937–0.949).

CONCLUSION: Elderly patients across the whole spectrum of ACS were less likely to receive guideline‐recommended therapies, even after adequate adjustment for comorbidities. Prognosis of elderly patients with ACS may be improved by increasing adherence to guideline‐recommended medical and interventional therapies.
High Blood Pressure, Hypertension, and High Pulse Pressure Are Associated with Poorer Cognitive Function in Persons Aged 60 and Older: The Third National Health and Nutrition Examination Survey
Authors: Obisesan Thomas Olabode , Obisesan Odunayo Abiodun , Martins Sayyida , Alamgir Laila , Bond Vernon , Maxwell Celia , Gillum Richard Frank
Published: February 2008

OBJECTIVES: To test the hypothesis that hypertension, high blood pressure, and high pulse pressure (PP) are independently associated with lower cognitive function.

DESIGN: Cross‐sectional study of persons examined in 1988 to 1994.

SETTING: U.S. noninstitutionalized population.

PARTICIPANTS: Six thousand one hundred sixty‐three men and women aged 60 and older who participated in the Third National Health and Nutrition Examination Survey (NHANES III).

MEASUREMENTS: Measurements included blood pressure, short‐portable Mini‐Mental State Examination (sp‐MMSE), self‐reported history of hypertension, diagnosis, and treatment.

RESULTS: In the initial bivariate analysis within age groups of 60 to 64, 65 to 69, and 70 to 74, optimal blood pressure (<120/80 mmHg) was associated with best cognitive performance; the severe hypertension group had the poorest performance in all age groups except the very old (≥80), where the pattern was reversed, showing poorest performance in the optimal blood pressure group and best in the group with moderate hypertension. This pattern changed slightly in multiple regression analyses modeling sp‐MMSE as the outcome variable. Higher stage of hypertension according to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and higher PP were associated with worse cognitive performance than normal blood pressure at ages 70 to 79 and 80 and older. No significant negative association was seen in subjects aged 60 to 69. Subjects with treated but uncontrolled hypertension had significantly lower sp‐MMSE scores than those without hypertension or with controlled hypertension after controlling for age, sex, ethnicity, income, and PP.

CONCLUSION: At age 70 and older, high blood pressure, hypertension, and uncontrolled blood pressure are associated with poorer cognitive function than normal blood pressure. Optimal control of blood pressure may be useful in preserving neurocognitive loss as the population ages.
Inflammatory Biomarkers and Physical Function in Older, Obese Adults with Knee Pain and Self‐Reported Osteoarthritis After Intensive Weight‐Loss Therapy
Authors: Miller Gary D. , Nicklas Barbara J. , Loeser Richard F.
Published: February 2008

OBJECTIVES: To describe the relationships between proinflammatory biomarkers and self‐reported and performance‐based physical function and to examine the effect of weight loss on these markers of inflammation.

DESIGN: Randomized, longitudinal, clinical study comparing subjects eating an energy‐restricted diet and participating in exercise training with a control group.

SETTING: Community‐base participants for the Physical Activity, Inflamation and Body Composition Trial.

PARTICIPANTS: Eighty‐seven obese (body mass index (BMI) >30.0 kg/m2) adults aged 60 and older with knee pain and self‐report of osteoarthritis.

MEASUREMENTS: Inflammatory biomarkers (interleukin 6 (IL‐6), tumor necrosis factor alpha (TNFα), C‐reactive protein, and soluble receptors for TNFα (sTNFR1 and sTNFR2)) and self‐reported (Western Ontario and McMaster University Osteoarthritis Index questionnaire) and performance‐based (6‐minute walk distance and stair climb time) measures of physical function at baseline and 6 months.

RESULTS: Mean (standard error of the mean) weight loss was 8.7% (0.8%) in the intervention group, compared with 0.0% (0.7%) in the control group. sTNFR1 was significantly less in the intervention group than in the control group at 6 months. sTNFR1 and sTNFR2 predicted stair climb time at baseline. Change across the 6‐month intervention for sTNFR2 was an independent predictor for change in 6‐minute walk distance.

CONCLUSION: These results indicate that an intensive weight‐loss intervention in older obese adults with knee pain can help improve inflammatory biomarkers and that changes in these concentrations showed associations with physical function.
MONITORING THE TRAUMA PATIENT
Authors: Jennings Paul B.
Published: February 2008

Patient monitoring devices may be considered as extensions of the veterinary clinician's senses. Many of the parameters outlined above have been used for years, without the term “monitor” being used. In this report, several patient monitoring methods have been discussed, and their advantages weighed. It is hoped that judicious use of some of these monitoring methods may aid the veterinary clinician in diagnosis and treatment of his trauma patients.
INHALATION ANESTHETICS AND ANESTHETIC UPTAKE
Authors: Lumb William V.
Published: February 2008

With the advent of new inhalant anesthetic agents and specialized equipment for their administration, inhalation anesthesia has become the method of choice of many small and large animal practitioners.
METABOLIC MANAGEMENT OF THE HORSE WITH ACUTE ABDOMINAL CRISIS*
Authors: Donawick William J.
Published: February 2008

The horse with an abdominal crisis caused by acute gastro‐intestinal tract obstruction develops hypovolemia, hemoconcentration, electrolyte depletion, metabolic acidosis and shock. During preparation for operation, treatment with fluids, antibiotics and bicarbonate will impede metabolic imbalance. Stomach decompression may slow the passage of sodium, water and potassium to the gut lumen, reduce pain and minimize the risk of stomach rupture. Selected laboratory determinations and the monitoring of arterial and venous pressures will provide a measure of severity and serve as a guide to replacement therapy. In the post surgical period, vigilance must be directed towards potassium and bicarbonate imbalanc and adequate hydration.
SELECTED SURGICAL DISEASE STATES WHERE MICROBIOLOGICAL EVALUATION IS ESSENTIAL
Authors: Dixon Robert
Published: February 2008

Infection caused by bacterial organisms constitutes an important problem in surgical practice. Bacteremia due to both Gram positive and Cram negative bacteria is often complicated by shock.

Frequent antibiotic susceptibility tests and bacterial culture of blood, urine, body fluids, draining wounds or other sources of infection is an essential adjunct to the proper management of surgical infections which may lead to septic shock.

In combination with current medical and surgical principles of septic shock therapy, two things may help to reverse the high mortality rate, making the diagnosis early enough and supporting the patient until the shock can be reversed.
EXPERIMENTAL ACUTE GASTRIC DILATATION AND VOLVULUS IN THE DOG: CHANGES IN BIOCHEMICAL PARAMETERS*
Authors: Wingfield Wayne E. , Cornelius Larry M. , DeYoung Donald W.
Published: February 2008

Acute gastric dilatation and volvulus with dilatation were produced in 11 dogs anesthetized with halothane. Blood samples were taken during these procedures for biochemical analyses.

Serum potassium did not change significantly during the experimental procedure, but there was a significant increase (p<0.05) after release of the dilatation with volvulus. Renal function was impaired with significant increases (p<0.05) in the serum concentration of urea nitrogen, phosphorus, and creatinine. Evidence of cellular damage was reflected by a significant elevation (P<0.05) in glutamic‐oxaloacetic transaminase activity. Serum glucose concentration increased significantly (P<0.05) during experimental gastric dilatation and dilatation with volvulus.
PATHOPHYSIOLOGICAL EFFECTS OF RENAL ALLOGRAFTS IN THE DOG
Authors: Gourley Ira M. , Parker Harold R. , Gribble David H. , Conzelman G. M. , Ishizaki G.
Published: February 2008

Seven dogs with renal allografts were studied to: (1) determine the practicality of the procedure for the treatment of end stage kidney disease in small animal medicine, and (2) measure allograft function to permit evaluation of immunosuppressive drug dosage to prevent rejection.

Infection (bacterial nephritis, pneumonia, pleuritis), drug toxicity (bone marrow depression, liver degeneration and/or necrosis), and rejection of the transplants were the consistent problems.

No objective measurement which would permit accurate determination of immunosuppressive drug dosage was found.

Polyuria in the transplanted animals was attributed to failure to develop the interstitial osmotic gradient essential for the allografts to respond to antidiuretic hormone. Polydipsia probably was compensation for the polyuria.

The results would indicate that until a major immunological breakthrough occurs in tissue transplantation, the clinical placement of a renal allograft in the dog for long term function is not practical.

Prolonged function of the renal allograft has been accomplished in the dog using immunosuppressive drugs, suggesting that the procedure can be utilized for the treatment of end stage renal disease in this animal.18

Immunosuppressive drugs have inherent toxicities, of which bone marrow depression, liver and gastrointestinal tract damage are most notable.5,18,23

Ideally, minimal immunosuppression is desired to avoid drug toxicity, maintain some degree of immune competence to reduce chances of serious, if not fatal infection, and yet allow the transplanted kidney to survive in a hostile immune environment.22

There are no good measurements to determine the immunological status of patients on immunosuppressive therapy,22 consequently, such treatment is emperic; based on experimental and clinical experience. 13,18

Although the dog is a common model for renal allograft investigations, 15,18 there is limited information in the veterinary literature 3.5.6,11,14 concerning the experience of veterinary clinicians and their attempts to maintain the renal homograft.

This report summarizes the author's experiment with renal transplants in the dog.
COMPLICATIONS RELATED TO THE INSERTION OF A SUTURE TO RETRACT THE ARYTENOID CARTILAGE TO CORRECT LARYNGEAL HEMIPLEGIA IN THE HORSE
Authors: Raker Charles W.
Published: February 2008

Laryngeal sacculectomy has proven to be a useful surgical procedure to correct respiratory distress caused by paralysis of the left recurrent laryngeal nerve. However, to improve the rate of recovery procedures for the insertion of a suture to retract the paralyzed arytenoid have been developed. This procedure was found to be accompanied by some serious complications such as a cough, delayed wound healing, regurgitation of food and aspiration pneumonia.

To avoid these complications it is suggested that mersilene be used instead of lycra to suture the arytenoid to the cricoid as it is tolerated better by the horse. Tension upon the suture should be sufficient to stabilize the paralyzed arytenoid in a median position between adduction and abduction or one of slight abduction. Extreme care should be used when placing the suture to avoid invasion of the laryngeal airway.
A Comparison of Size of Kuntscher Nails with the Length and the Width of Femurs and Humeri in Dogs
Authors: Charles Knecht , Robinson W.C. , Roesel O.F.
Published: February 2008

Femurs and humeri were measured from 79 mixed breed dogs and 15 radiographs. Width to length relationships were established and compared to available sizes of intramedullary Kuntscher nails. Analysis of the data presented and an awareness of the advantages and merits of Kuntscher nailing will, it is hoped, precipitate a renewal of efforts to make nails of appropriate lengths available for the dog.
CARDIOPULMONARY PHYSIOLOGY — AS IT RELATES TO THORACIC SURGERY
Authors: Hobson H. Phil
Published: February 2008

The supplying of oxygen to tissues, and the removal of gaseous wastes are quickly compromised once the chest has been surgically invaded. Of necessity the expansion of the lungs becomes one of a positive rather than a negative pressure process. Abnormal positioning of lobes of the lungs to facilitate exposure for surgery, reduced rate of respiration, atelectasis due to underinflation as well as diseased areas aggrevate the situation.

Return of vascular flow to the heart is impaired by loss of negative pressure in the chest cavity. Blood flow through the pulmonary vasculature is impaired by anything that adds resistence. Life itself is very dependent on the delicate balance between hydrostatic and osmotic pressures within the pulmonary capillaries in order for there to be adequate oxygenization.

Retention of CO2 or undersupply of oxygen to tissues contribute to an acidotic state. This acidosis can accelerate a viscious shock cycle if not controlled.

Body temperature must not be allowed to drop excessively without careful monitoring of all vital parameters. Motility of cillia along the respiratory tree is slowed by drop in temperature. Phagacytosis within the alveoli undoubtedly diminishes as the temperature drops or the tissues become dehydrated.

The heart and respiratory rates are controlled by many autonomic mechanisms which, if interrupted, may need to be compensated for and which must be returned to body control at the end of surgery.

The chest is not an area which should be entered with fear but with much respect for its contents and their functions. The surgeon should keep this well in mind and should thus enter the chest as though it were his own.
Femoral Head and Neck Fractures in the Dog and Cat: A Review of 115 Cases
Authors: DALY WILLIAM R.
Published: February 2008

Case histories of 115 dogs and cats with fractures of the femoral head or neck, were reviewed; these animals had been presented to the Ohio State University Veterinary Hospital between 1969 and 1976. Signalment, fracture type by anatomic location, fracture to fixation interval, surgical approaches used, methods of surgical repair, surgical complications, and final results of surgical repair were examined. Avascular necrosis of the femoral head was not a clinically significant problem following internal fixation in this study. Most animals had very good to excellent limb function following fracture repair.
Equine Cryptorchidism: Pre‐surgical Considerations and Surgical Management
Authors: MOORE J. N. , JOHNSON J. H. , TRITSCHLER L G. , GARNER H. E.
Published: February 2008

Horses with undescended testes are frequently presented to the veterinary surgeon for castration. The pertinent pre‐operative evaluations and diagnostic procedures that should be made prior to either surgical intervention or referral of such cases are outlined. Several accepted anesthetic and surgical techniques are similarly reviewed. Case histories of 58 horses referred during a two year period are reviewed and correlated with the findings of a recent study of equine testicular development and descent.
Indwelling Jugular Catheterization Technique in the Dog
Authors: TROY GREGORY C.
Published: February 2008

THE main use of indwelling jugular catheters is for the administration of intravenous fluids. Proper placement and fixation of these catheters is important so that a minimum of problems are encountered during the administration of fluid therapy. This photographic essay will show one method of fixation that has been used on many canine patients with few complications.
Intraoperative Biopsy and Microscopy During Exploratory Laparotomies
Authors: STONE E. A. , RAWLINGS C. A. , PRASSE K. W. , DUNCAN J. R.
Published: February 2008

Intraoperative biopsy and microscopy were evaluated, retrospectively, in 23 exploratory laparotomies. After comparing the surgical impression to the microscopic diagnosis obtained during surgery, the use of intraoperative cytologic and frozen section examination altered the surgical plan in 13 cases and reinforced the surgical plan in 10 cases. No cases had an intraoperative microscopic diagnosis that differed from the postoperative histologic examination of paraffin sections. Recommendations for selecting cases and for using intraoperative biopsy and microscopy are included.
Surgical Management of Multiple Ligamentous Injuries of the Feline Stifle Joint: Case Report
Authors: TOOMBS JAMES P. , WALLACE LARRY J.
Published: February 2008

We report a case of complete rupture of the tendon of origin of the long digital extensor at the myotendinous junction, with concurrent ruptures of the posterior cruciate and lateral collateral ligaments in the stifle joint of a cat. Stabilization was accomplished by direct suturing of the long digital extensor injury, imbrication of the joint capsule and lateral retinacular fascia, and creation of a synthetic lateral collateral ligament
Medical Mythology
Authors: SHIRES G. M. H.
Published: February 2008

THE heritage of medicine and veterinary medicine is rich in mythic figures and legends. Many of these figures and symbols are evident in today's profession and some are universally accepted as symbols of medicine. Perhaps a moment spared from busy daily schedules to reflect on a segment of this fascinating history will cause us to appreciate our profession and its family tree a little more.
Obstruction of the Ascending Colon in Cattle: I. Clinical Presentation and Surgical Management
Authors: SMITH DONALD F. , DONAWICK WILLIAM J.
Published: February 2008

Obstruction of the spiral loop of the ascending colon (spiral colon) due to adhesions causing extraluminal constriction was diagnosed in 8 cows during a 2‐year period. The adhesions resulted from intraperitoneal injections in 7 cows and from previous intra‐abdominal surgery in the 8th. Surgical correction was performed in 4 of the cows by uniting the bowel proximal and distal to the obstruction, thus creating an intestinal bypass. Approximately half of the large intestine was bypassed in this manner in 3 cows; all but a portion of the descending colon and rectum was bypassed in the 4th. Each of the cows survived surgery, although 1 died 30 days later, possibly as a result of a second obstruction caused by further adhesions. Appetite, general physical condition, and milk production returned after celiotomy and intestinal bypass. Feces were loose after operation but gradually firmed to near‐normal consistency in 3 of the cows.
Obstruction of the Ascending Colon in Cattle: II. An Experimental Model of Partial Bypass of the Large Intestine
Authors: SMITH DONALD F. , DONAWICK WILLIAM J.
Published: February 2008

Four dairy calves were subjected to partial bypass of the large intestine by uniting the ileum to the distal centrifugal coil of the spiral loop of the ascending colon (spiral colon). Digesta bypassed the distal ileum, cecum, proximal loop of the ascending colon, and the centripetal coils of the spiral colon. The calves survived the surgical procedure and were healthy throughout the 4‐week postoperative experimental period. Feces were loose immediately after bypass, but fecal dry matter (DM) gradually increased over the subsequent 2 weeks (P < 0.01), indicating adaptation of remaining bowel to absorb more water. There was no significant change in serum concentration of sodium or chloride. The calves continued to grow and gain weight at acceptable rates after bypass. Necropsy of 3 of the calves demonstrated a decrease in size of the bypassed bowel.
Partial Arytenoidectomy in the Horse
Authors: WHITE N. A. , BLACKWELL R. B.
Published: February 2008

Four horses were examined because of inspiratory dyspnea and noise resulting from an inability to abduct one or both arytenoid cartilages. Two unilateral arytenoidectomies were done following failure of laryngoplasty, and two bilateral arytenoidectomies were done to correct permanent arytenoid adduction caused by laryngeal ossification. The surgical procedure included submucosal dissection of the arytenoid cartilage and removal of the vocal fold, lateral ventricle (when present), and the arytenoid cartilage, excluding the muscular process. Excessive mucous membrane was pulled caudally from the opening of the larynx and carefully sutured to close the mucous membrane and smooth the rima glottis. Postoperative swelling was greatest between the 3rd and 7th days. Long‐term results included one horse returned to normal function with no noise, one horse returned to normal function but with respiratory noise, one horse returned to light riding with reduced noise, and one horse salvaged for pasture use.
Closed Reduction of a Tibial Nonunion by Transfixation Pinning
Authors: CLAMEN C.
Published: February 2008

Closed reduction and fixation by transfixation pinning is a successful operation for nonunion of the tibia following failure of intramedullary pin fixation. This technique has several advantages. It allows compression at the site of nonunion. It can be performed in a short time and causes minimal tissue trauma. The joints are not restricted and the patient has unrestricted ambulation.
Technique for Canine Total Hip Replacement
Authors: OLMSTEAD MARVIN L. , HOHN R. BRUCE , TURNER THOMAS M.
Published: February 2008

Between August 1976 and April 1980, a total of 132 canine total hip replacements using a commercially available prosthesis, were performed on clinical patients at The Ohio State University Veterinary Hospital and Berwyn Veterinary Hospital, Chicago. The technique for total hip replacement is described. Details of preoperative evaluation, the operative procedure, and postoperative care are presented.
Use of the Temporalis Muscle Flap in the Dog
Authors: TOMLINSON JAMES , PRESNELL K. R.
Published: February 2008

Tissue defects resulting from radiation necrosis or monoblock resection of tumors of the orbit and periorbital area are difficult surgical problems. A temporalis muscle graft provides a simple and effective means of closing orbitonasal defects. The principles and operative approach for the use of the temporalis muscle transposition are described. A case report of temporalis muscle transposition illustrates the various beneficial effects in repairing an orbitonasal defect caused by radiation necrosis and monoblock resection of an orbital tumor. This muscle flap can also be used to provide an improved cosmetic appearance to the face after exenteration of the orbit.
Prosthetic Coxofemoral Joint Repiacement in the Goose (AnserSp.): I. Preliminary Results
Authors: von RECUM ANDREAS F. , WROBLEWSKI THADDEUS J. , BRYANT CHARLEY C.
Published: February 2008

In order to study failure modes of fixation of artificial hip joints in man, an animal model was needed that had similar loading conditions concerning the hip joint and a life expectancy long enough to allow for fixation failures to occur. Femoral components of a hip joint were implanted into domestic geese (Ansersp.) to evaluate their suitability for long‐termin vivostudies of femoral implants. A prosthesis was developed. It was implanted into mature geese under general anesthesia using a lateral surgical approach. The animals were sacrificed 5 to 11 months after implantation. The results indicate that prosthetic hip joints could be implanted and that joint function was restored in all cases. There was no postoperative morbidity or mortality. Prosthetic loosening was observed in three out of the nine implants.
Muscle Contractures in the Limbs of Dogs and Cats
Authors: LEIGHTON ROBERT L
Published: February 2008

Muscle contractures causing varying degrees of lameness commonly occur from skeletal muscle fibrosis, the result of injury such as that caused by circulatory insufficiency, infection, autoimmune reaction, or trauma. Quadriceps contracture, whether congenital or acquired, is treated by sectioning the cordlike fibrotic muscle group by “Z” plasty, resulting in lengthening it enough to allow the knee to assume a normal standing angle. Adhesion of the muscle group to a large femoral callus (muscle tie down) may occur and require additional surgical correction. Infraspinatus contracture results in a typical foreleg deformity and change in gait. Surgical repair by tenotomy is usually followed by rapid return to normal. Gracilis contracture, though common in racing greyhounds, is not commonly reported in pet dogs. Surgical excision of the entire affected muscle mass is curative.
Superficial Osteitis and Sequestrum Formation as a Result of Skin Avulsion in the Horse
Authors: BOOTH LARRY C. , FEENEY DANIEL A.
Published: February 2008

Metatarsal injuries with exposed bone are described in seven horses. Superficial osteitis and sequestrum formation occurred in six of the seven horses. The basic pathophysiology includes local vascular stasis leading to ischemic necrosis of osteocytes and establishment of bacterial infection within dead bone. Radiographic features of superficial osteitis and sequestrum formation include reactive periosteal new bone formation, an area of radiodense necrotic bone (sequestrum) surrounded by a radiolucent zone of granulation tissue, which in turn, is surrounded by an area of increased radiodensity (involucrum). The presence of a sequestrum may usually be confirmed radiographically by 12–14 days after injury. Surgical management included wound debridement, wound irrigation, bandaging or casting, sequestrectomy and skin grafting. Five of the seven patients required sequestrectomy, in one the sequestrum disappeared without removal. Mixed bacterial populations were commonly found in the wounds. No specific etiologic agent was associated with sequestrum formation.
Circumcostal Gastropexy in the Dog A Preliminary Study
Authors: FALLAH A. M. , LUMB W. V. , NELSON A. W. , FRANDSON R. D. , WITHROW S. J.
Published: February 2008

Gastric dilatation‐volvulus (GDV) is a disease which causes many fatalities among large deep‐chested dogs. Despite several different surgical techniques used currently, recurrence is high among dogs that survive the first episode of GDV. Circumcostal gastropexy is a new surgical technique which utilizes a muscular flap of the ventral pyloric antrum to anchor the stomach to the costochondral junction of one of the last four ribs. The gastric lumen is not entered.

This operation was performed on nine clinically normal dogs. A strong adhesion was created without altering the stomach's physiologic function and with minimal anatomic displacement. The technique has the advantage of being easy, safe, and fast (15 min). These results suggest that this operation will have great potential in preventing recurrence.
In Vitro Cerclage Wiring Analysis
Authors: ROOKS R. L. , TARVIN G. B. , PIJANOWSKI G. J. , DALY W. B.
Published: February 2008

The ability of six different instruments to apply a cerclage wire under tension to a tension gage was compared. The loop knot produced greater final wire tension than the twist knot, both before and after bending. No significant difference in tension was found between the Swiss Osteo and A.S.I.F. instruments. The Rhinelander and Richards instruments gave approximately the same tension before the bend. The Rhinelander, Richards, and Vise Grip instruments showed no statistical difference in tension produced after the bend. The Bowen instrument developed the least amount of tension, both before and after bending the twist. All twist knots lost a significant amount of tension during the bending process. The twist‐type knots that were twisted until breakage in the middle of the knot produced greater tension than those that were cut once they were tight. Cutting the twisted knot caused a significant decrease in wire tension. No correlation was found between operator pull and final cerclage wire tension.
Tendon Transfer for Treatment of Peroneal Nerve Paralysis in a Dog Report of a Case
Authors: LEIGHTON R. L.
Published: February 2008

A six‐year‐old male Labrador cross was left with a sensory and proprioceptive deficit in the right hind paw after recovering from a severe case of warfarin poisoning. Palliative treatment in the form of protective devices, casts and bandages was not successful. A chronic ulcerative infection developed with enlargement of the popliteal lymph node requiring medical treatment. A conscious proprioceptive deficit in the right hind leg only was consistent with a peroneal or ischiatic nerve deficit. A surgical procedure to shorten the long digital extensor was not satisfactory. A second precedure, the transfer of the long digital flexor tendon to the long digital extensor tendon provided an excellent end result.
Surgical Treatment of Complicated Fractures of the Splint Bones in the Horse
Authors: BOWMAN K. F. , FACKELMAN G. E.
Published: February 2008

The clinical signs, diagnosis, surgical treatment, and postoperative results in 8 horses with comminuted or open fractures of the splint bone are described. Surgical therapy was chosen to hasten the convalescent period, prevent large callus formation, improve cosmetic appearance, and, in open fractures, for aggressive wound management. Four horses used for nonracing purposes had full recovery following surgery. Two of four racehorses had residual lameness after surgery. Three of four racehorses eventually raced with decreased performance.
Surgical Approach to the Equine Scapulohumeral Joint Through a Longitudinal Infraspinatus Tenotomy
Authors: BOWES R. M. De , WAGNER P. C. , GRANT B. D.
Published: February 2008

Surgical curettage of an osteochondrosis lesion in an equine scapulohumeral joint was performed. A modified approach to the scapulohumeral joint through a longitudinal infraspinatus tenotomy is described. This technique was performed on a second horse that was free of osteochondrosis lesions to further assess the clinical course of healing following this technique. Both operative sites healed well with no evidence of dehiscence. Previously, four similar clinical cases of osteochondrosis were operated on at the same institution through a transverse infraspinatus tenotomy. All four cases exhibited dehiscence with attendant septic arthritis during the postoperative period. The use of a longitudinal infraspinatus tenotomy to approach the equine scapulohumeral joint for surgical curettage does not appear to clinically compromise the lateral collateral support of the shoulder. When compared retrospectively to other cases of transverse infraspinatus tenotomy performed at this clinic, the described technique appears to have a less complicated postoperative period.
Measurement of Femoral Torsion in Dogs Using a Biplanar Method
Authors: BARDET J.F. , RUDY R.L. , HOHN R.B.
Published: February 2008

The authors defined the concept of femoral torsion using three axes and two planes. Two techniques were used to measure the femoral anteversion angle on 30 femurs of 15 adult mixed breed dogs. The conventional fluoroscopic technique was compared to the right angle triangle technique. The mean angle for each technique was 30.80 and 31.31 degrees, respectively. The right angle triangle technique, using conventional radiographs, appeared as reliable, accurate, and reproducible as the fluoroscopic method and is recommended for clinical use.
Clinical and Radiographic Evaluation of a Median Sternotomy Technique in the Dog
Authors: BRIGHT RONALD M. , BRIGHT JANICE McINTOSH , RICHARDSON DANIEL R. , SIMS JEFFREY
Published: February 2008

This study evaluated postoperative sequelae following a sternotomy closed with transsternal and parasternal sutures in nine dogs. Wound complications noted within 30 days suggested excessive intraoperative trauma to bone or surrounding soft tissues. Radiographic evaluation at the end of this period demonstrated a significant lack of osseous bridging between the sternal halves in eight of nine dogs. There was frequent wire breakage, suggesting instability of the sternal halves and considerable midline inaccuracy when splitting the sternum. Postoperative pain was minimal. This technique is suitable for use in dogs provided that swaged‐on needles and sufficient transsternal wires are used, the sternebrae are carefully split on the midline, and the wires are carefully twisted to assure a tight closure.
A Comparison of Two Surgical Approaches to the Equine Femoropatellar Joint for the Treatment of Osteochondritis Dissecans
Authors: TROTTER GAYLE W. , McILWRAITH C. WAYNE , NORRDIN ROBERT W.
Published: February 2008

The femoropatellar joints of four mature, clinically normal horses were surgically entered by a craniolateral or a lateral approach. Visualization of intra‐articular structures was documented for each approach. Horses were euthanized 21, 42, and 63 days after surgery. Joint healing was evaluated clinically, and the joints were subjected to gross pathological and histopathological examination. Healing was by first intention following arthrotomy in six limbs. Skin dehiscence occurred in two limbs with healing by second intention. Subcutaneous seromas developed which resulted in peri‐incisional swelling in seven limbs. The lateral approach to the femoropatellar joint provided greater exposure of the lateral femoral trochlear ridge and articular surface of the patella.

Surgery was performed on nine joints of seven clinical patients with osteochondritis dissecans. The craniolateral approach was used on four joints, and the lateral approach was used on five joints. Skin dehiscence occurred following four arthrotomies. Location of the lesion was concluded to be the main criterion for selection of the surgical approach.
Delayed Wound Closure A Review and Report of Use of the Technique on Three Equine Limb Wounds
Authors: HACKETT R. P.
Published: February 2008

Limb wounds of three horses were managed by delayed wound closure. In each, the wound was such that it was unlikely that healing would occur following primary closure and that second intention healing would have been unsatisfactory. Wounds were cleaned and debrided at the time of admission and maintained under sterile pressure bandages until free of infection and devitalized tissue. Suture closure of the wound at that time resulted in satisfactory healing in each case.
Fractures of the Humerus in Dogs and Cats A Retrospective Study of 130 Cases
Authors: BARDET J. F. , HOHN R. B. , RUDY R. L. , OLMSTEAD M. L.
Published: February 2008

Case histories of 130 dogs and cats with humeral fractures were reviewed. The different types of fractures were classified. Most animals with proximal, shaft, and supracondylar fractures had excellent results. The poor prognosis associated with distal articular fractures was due most often to failure of the fixation device in the supracondylar area; best results were achieved with a plate on the caudal and medial surface of the distal humerus.
Biomechanics of Cranial Cruciate Ligament Reconstruction in the Dog I. In Vitro Laxity Testing
Authors: HULSE DONALD A. , BUTLER DAVID L. , KAY MATTHEW D. , NOYES FRANK R. , SHIRES PETER K. , D'AMBROSIA ROBERT , SHOJI HIROMU
Published: February 2008

Following an “over‐the‐top” reconstruction of the cranial cruciate ligament using fascia lata and the lateral one‐third of the patellar ligament, joint instability was measured using an in vitro laxity testing device. Cranlocaudal drawer increased between zero and four weeks, then returned to initial values at 26 weeks.
Ventral Surgical Fixation and Fusion for Atlanto‐occipital Subluxation in a Goat
Authors: SORJONEN D. C. , POWE T. A. , WEST M. , EDMONDS S.
Published: February 2008

Atlanto‐occipital subluxation causing tetraplegia in a mature Pygmy goat was treated by ventral surgical fixation and fusion. Radiographic evidence of fusion and clinical improvement were noted two months after surgery.
Mandibular Condylectomy Effects in Normal Dogs
Authors: TOMLINSON JAMES , PRESNELL K. R.
Published: February 2008

Mandibular condylectomy and meniscectomy were performed unilaterally on six dogs and bilaterally on six dogs. All six dogs that underwent unilateral condylectomy functioned normally. Bilateral condylectomy caused temporary malocclusion in five of six dogs. At necropsy one to six months following surgery, a fibrous pseudoarthrosis had formed. One dog that underwent bilateral condylectomy had significant loss of maximal mouth opening three months after surgery. Good functional use of the mandible was obtained with unilateral and bilateral condylectomy.
Rectal Diseases and Their Role in Perineal Hernia
Authors: KRAHWINKEL D. J.
Published: February 2008

Rectal abnormalities frequently coexist with perineal hernia. The three commonly recognized are deviation, sacculation, and diverticulum. If not corrected, these problems may lead to incomplete rectal emptying at defecation, persistent straining, and breakdown of the herniorrhaphy. Diagnosis of these abnormalities is by physical examination, with confirmation by barium enema. Amputation of rectal sacculations was performed during perineal herniorrhaphy on four dogs, three of which had previously had multiple recurrences of perineal hernia. None of the four experienced further straining or reherniation during a 12 to 16 month period following surgery.
Mandibular Adamantinoma in a Horse Radical Surgical Treatment
Authors: FRENCH D. A. , FRETZ P. B. , DAVIS G. D. , HOLMBERG D. L. , DOIGE C.
Published: February 2008

An 11‐year‐old, throughbred stallion was examined for a small, firm swelling on the right mandible. During the following 4 weeks, the swelling markedly increased in size. An adamantinoma was diagnosed on histopathologic examination. Surgical treatment was “enblock” resection of the tumor and associated mandible, cryosurgery, and stabilization with both internal and external orthopedic fixation devices. The horse recovered from surgery, and for the past year has been a useful breeding stallion.
The Effect of 360° Gastric Volvulus on the Blood Supply of the Nondistended Normal Dog Stomach
Authors: LANTZ GARY C. , BOTTOMS GERALD D. , CARLTON WILLIAM W. , NEWMAN SCOTT , CANTWELL H. DAN
Published: February 2008

Eighteen dogs were divided into three groups, each containing three volvulus and three control dogs. The stomachs of the volvulus dogs were rotated 360°, sutured in position, and kept decompressed by a Foley catheter placed in the fundus. Control dogs underwent the same manipulation, except that the stomach was replaced to normal position. One dog in each group was evaluated at 4, 8, and 12 hours. Evaluation consisted of SC46 microsphere injection to determine percent cardiac output to various stomach regions, and gross and microscopic changes in the stomach and other tissues drained by the portal system. Cardiac output to the control stomachs exceeded the volvulus stomachs by fivefold. Time was not a significant factor. Edema was present throughout the volvulus stomach. The most severe histologic changes, such as hemorrhage, were seen in the greater curvature of volvulus stomachs. Other portal tissues were grossly and histologically normal. Three additional dogs were evaluated 1 week after creation and reduction of a 12 hour volvulus; the stomachs were normal indicating reversibility of pathologic changes. This study demonstrates abnormal blood flow in rotated nondistended stomachs. Anatomic repositioning should take place as soon as possible in the treatment of gastric dilation volvulus.
Arthrodesis of the Distal Intertarsal and Tarsometatarsal Joints in the Horse
Authors: BARBER SPENCER M.
Published: February 2008

Arthrodesis created by destruction of the articular surfaces of the distal intertarsal and tarsometatarsal joints by repeated insertion of a drill was studied in one limb of each of nine horses. Postoperatively, the horses were housed in box stalls for 8 weeks and then confined to a paddock for 19 weeks. Clinical and radiographic evaluations were performed prior to surgery, immediately following surgery, and at 2,4, 6, 8,10,12,16, 20, and 27 weeks following surgery. There was a statistically significant positive correlation between decreasing degree of lameness and increasing radiographic evidence of bony fusion; fusion of the distal intertarsal and tarsometatarsal joints was present in five horses 27 weeks after surgery. The horses lost weight during the first 8 weeks after surgery. Flexion of the treated tarsal joints was decreased significantly at the end of the experiment.

Complications encountered included fracture of the third tarsal bone (five horses), instability of the tarsus (four horses), septic arthritis (three horses), and diarrhea (four horses).

Arthrodesis, with this method of surgical drilling of the distal intertarsal and tarsometatarsal joints, is not recommended because of severe pain, prolonged convalescence, and high incidence of complications.
Use of Isobutyl‐Cyanoacrylate Adhesive in Osteosynthesis A Preliminary Study
Authors: WALKER A. M. , TOMLINSON J. L.
Published: February 2008

Isobutyl 2‐cyanoacrylate was used to reattach partial‐thickness cortical bone fragments from the femur in rabbits. Stability, apposition, callus formation, and inflammation around the fragments were evaluated at 2, 4, 8, and 12 weeks.

All glued bone fragments were stable, compared with 85% of controls. Good apposition was achieved in 95% of the glued bone fragments, compared with 19% of the controls. Analysis of the mean scores for callus formation revealed a significant difference only in the 8 week survival group.

Bony union was noted in 20 of 21 of the glued fragments. No evidence of inflammation was seen around the glue, and viable bone was seen adjacent to the adhesive in many sections. In control legs, 13 fragments had healed by osseous union, two by fibrous union, and in six the chip had resorbed.
Arthroscopic Anatomy of the Equine Femoropatellar Joint and Approaches for Treatment of Osteochondritis Dissecans
Authors: MARTIN G. S. , McILWRAITH C. W.
Published: February 2008

Arthroscopic approaches to the femoropatellar joint were developed to determine their usefulness for evaluation and surgical treatment of osteochondritis dissecans. It was found that the articular cartilage of the lateral trochlear ridge, medial trochlear ridge, intertrochlear groove, patella, and the lateral and medial reflections of the joint capsule could be examined from an infrapatellar arthroscopic portal. The suprapatellar pouch could be examined partially. Lateral and medial instrument portals were evaluated to determine the accessibility of the lateral and medial trochlear ridges of the femur in the areas where osteochondritis dissecans lesions frequently occur. Sliding the arthroscope sleeve beneath the patella when entering the joint was associated with iatrogenic cartilage lesions. A new technique that directed the arthroscope lateral to the lateral trochlear ridge eliminated iatrogenic cartilage damage.