bluuebunny/crossref_metadata_2025 huggingface dataset:
Time Course of Right Ventricular Remodeling after Percutaneous Atrial Septal Defect Closure: Assessment of Regional Deformation Properties with Two‐Dimensional Strain and Strain Rate Imaging
Authors: Eroglu Elif , Cakal Sinem Deniz , Cakal Beytullah , Dundar Cihan , Alici Gokhan , Ozkan Birol , Yazicioglu Mehmet Vefik , Tigen Kursat , Esen Ali Metin
Published: November 2012

Background: Quantitative assessment of the right ventricular (RV) function in atrial septal defect (ASD) patients before and after closure remains difficult. The aim of this study was to assess the regional RV function in ASD patients, to evaluate the extent and time course of RV remodeling following ASD closure, and to investigate whether any regional difference exists in RV remodeling. Methods: Twenty patients with ASD and 20 age‐matched controls were included. All underwent standard echocardiography and two‐dimensional strain (S) and strain rate (SR) imaging by speckle tracking before, and 24 hours and 1 month after the defect closure. Results: Right ventricular S was higher in ASD patients except apical lateral segment S, which was lower when compared with controls. There was no difference in RV SR between ASD patients and controls. RV septal S and SR, and lateral SR decreased in 24 hours after the procedure and remained the same at 1 month. RV lateral basal and mid S decreased and apical S increased in 24 hours after the closure. All 3 segments showed some more increase at 1 month. RV apical S showed strong correlations with systolic pulmonary artery pressure and global RV systolic function indices. Conclusions: Chronic volume overload in ASD patients causes alterations in RV deformation. Percutaneous closure results in rapid remodeling and normalization of RV deformation. The major geometrical and deformational changes are completed in 24 hours. Lateral wall S seems to reflect the RV deformational changes due to volume loading and unloading better than SR in ASD patients.
A current approach to superficial vein thrombosis
Authors: Ellis Martin H. , Fajer Simone
Published: November 2012

Superficial vein thrombosis (SVT) is an entity commonly encountered in practice. While the clinical diagnosis is reasonably straightforward, care must be taken to exclude concurrent thrombosis of the deep veins, and the possibility of the presence of occult systemic illness such as malignancy should be considered. Recent studies of the epidemiology of SVT demonstrate a high incidence of concurrent deep vein thrombosis emphasizing the need for surveying the deep veins using compression ultrasonography.

Treatment decisions are may now be based upon the results of randomized clinical trials and should include a period of anticoagulation using fondaparinux or a low molecular weight heparin. The appropriate doses and duration of therapy are not fully established, and the cost‐effectiveness of these drugs for the treatment of SVT needs further evaluation.
Galectin‐7 and actin are components of amyloid deposit of localized cutaneous amyloidosis
Authors: Miura Yoshinori , Harumiya Satoru , Ono Koji , Fujimoto Eita , Akiyama Minoru , Fujii Noriko , Kawano Hiroo , Wachi Hiroshi , Tajima Shingo
Published: November 2012

The precursor protein of localized cutaneous amyloidosis (LCA) is believed to be cytokeratins on the basis of previous immunohistochemical studies. To identify the candidate amyloid protein biochemically, amyloid proteins were extracted with distilled water from lesional skin of LCA associated with Bowen's disease. The proteins were resolved on one‐ or two‐dimensional polyacrylamide gel electrophoresis followed by characterization with immunoblot analysis. The proteins with multiple molecular weights of 50–67 kDa and two proteins with 25 and 35 kDa were identified as keratins, serum amyloid P component and apolipoprotein E, respectively. The unknown 14‐kDa (pI = 7.0) and 42‐kDa (pI = 5.4) proteins reacted with the antibody against galectin‐7 and actin, respectively. The protein with the molecular weight of 14 kDa was identified as galectin‐7 by MALDI‐TOF mass spectrometer. Their electrophoretic mobilities were identical with normal counterparts extracted from cultured normal human keratinocytes. Galectin‐7 and actin were detected by immunoblot assay in the water‐soluble fractions prepared from the lesional skins of two patients with primary LCA. Immunohistochemical studies of tumor‐associated (n = 9) and primary (n = 10) LCA revealed various degrees of positive immunoreactivities with the antibodies for galectin‐7 and F‐actin. Galectin‐7 and actin, which contain considerable amount of β‐sheet structure, may be candidate amyloidogenic proteins of primary and secondary LCA.
Serum coenzyme Q10 levels are associated with coronary flow reserve in hemodialysis patients
Authors: Macunluoglu Beyza , Kaya Yuksel , Atakan Aydin , Ari Elif , Kaspar Cigdem , Demir Halit , Alp Hamit Hakan , Asicioglu Ebru , Kedrah Alla Eldeen
Published: November 2012

Accelerated atherosclerosis is the major cause of mortality in patients on chronic hemodialysis (HD). The aim of this study was to evaluate the relation between coenzyme Q10 (CoQ10) levels and coronary flow reserve (CFR) in HD patients as an indicator of atherosclerosis. Seventy‐one chronic HD patients and 65 age‐ and sex‐matched healthy individuals were included in the study. Plasma CoQ10 levels were performed by high‐performance liquid chromatography measurements. CFR was assessed by transthoracic Doppler echocardiography. Serum CoQ10 levels (1.36 ± 0.43 vs. 2.53 ± 0.55, P < 0.001) and CFR values (1.73 ± 0.11 vs. 2.32 ± 0.28, P < 0.001) were significantly lower in HD patients compared with controls. There was a significant positive correlation between CFR and serum levels of CoQ10 (r = 0.669, P < 0.001). A linear regression analysis showed that serum levels of CoQ10 were still significantly and positively correlated with CFR (regression coefficient = 0.235, P < 0.001). Our data have demonstrated that HD patients exhibit decreased plasma CoQ10 levels and CFR values. The study also showed for the first time that serum CoQ10 levels independently predict CFR in HD patients.
Perihepatic lymph node enlargement observed at a general health examination: A cross‐sectional study
Authors: Gotoh Hiroaki , Enooku Kenichiro , Soroida Yoko , Sato Mamiko , Hikita Hiromi , Suzuki Atsushi , Iwai Tomomi , Yokota Hiromitsu , Yamazaki Tsutomu , Koike Kazuhiko , Yatomi Yutaka , Ikeda Hitoshi
Published: November 2012

Aim

Although perihepatic lymph node enlargement (PLNE) is known as a common finding in chronic liver disease, it can be found occasionally at a general health examination. We aimed to clarify the clinical significance of PLNE in general.

Methods

Between January 2008 and December 2011, 4234 subjects were enrolled, who underwent a general health examination at the University of Tokyo Hospital.

Results

PLNE was observed in 69 (1.6%) subjects, among whom 17 (0.4%) had liver disorders and 13 (0.3%) had malignancy, one of whom had both. No disorders were determined in the remaining 40 subjects (0.9%). Among 17 subjects with liver disorder‐associated PLNE, anti‐hepatitis C virus (HCV) antibody was determined in 11 and serum alanine aminotransferase levels were less than 40 U/L in eight. Among 13 subjects with malignancy‐associated PLNE, para‐aortic lymph nodes were also enlarged in eight. Among 40 subjects with PLNE of unknown etiology, 27 could be followed up for the mean period of 2.08 years, where no underlying disorders were newly determined with largely unaltered size of PLNE.

Conclusion

The incidence of PLNE in the general population may vary with the prevalence of chronic liver disease, especially HCV infection. When PLNE is observed, liver disorders should be first surveyed including HCV infection even with normal serum alanine aminotransferase levels. PLNE with para‐aortic lymph node enlargement may be suggestive of a malignant lesion. The incidence of PLNE of unknown etiology may be approximately 1% in the general population, which may be just followed up without further change.
Presurgical downstaging of vena caval tumor thrombus in advanced clear cell renal cell carcinoma using temsirolimus
Authors: Sano Futoshi , Makiyama Kazuhide , Tatenuma Tomoyuki , Sakata Ryoko , Yamanaka Hiroyuki , Fusayasu Syusei , Nakayama Takashi , Nakaigawa Noboru , Yao Masahiro , Kubota Yoshinobu
Published: November 2012

A 63‐year‐old man presenting with a 7.2‐cm right renal mass, an inferior vena cava tumor thrombus, and pulmonary metastases underwent renal mass biopsy that revealed clear cell renal cell carcinoma. Temsirolimus (25 mg weekly) was given because of the extent of the disease and poor performance status, which resulted in a marked reduction in the tumor thrombus (from level III to level I) after 20 weeks of treatment. Subsequently, radical nephrectomy and tumor thrombectomy were carried out. Final pathological analysis confirmed the diagnosis of high‐grade clear cell carcinoma (pT4N0M1). One year after initiation of temsirolimus therapy, the patient remained alive despite the presence of disease.
Fathers’ perceptions of the barriers and facilitators to their involvement with their newborn hospitalised in the neonatal intensive care unit
Authors: Feeley Nancy , Waitzer Elana , Sherrard Kathryn , Boisvert Linda , Zelkowitz Phyllis
Published: November 2012

Aims and objectives.  To explore what fathers perceive to be facilitators or barriers to their involvement with their infants.

Background.  Fathers make unique and important contributions to the development of their infants. Fathers of infants in the neonatal intensive care unit often feel that they have a limited role to play in their infant’s care, and surveys suggest that they are not typically involved in infant caregiving. Paradoxically, qualitative studies have found that fathers do want to be involved, and their lack of involvement is an important source of stress.

Design.  Qualitative descriptive.

Methods.  Eighteen fathers of infants, in the neonatal intensive care unit for at least one week, were interviewed and asked to describe what they perceived to be the barriers and facilitators to their involvement. Interviews were audio taped and transcribed, and the data was content analysed.

Results.  Three major categories of barriers/facilitators were identified: (1) infant factors (size and health status, twin birth and infant feedback), (2) interpersonal factors (the rewards of and attitudes and beliefs regarding fatherhood; family management; previous experiences) and (3) neonatal intensive care unit environmental factors (physical and social). These factors could often be a barrier or facilitator to involvement depending on the context.

Conclusions.  This study provides insights into what factors influence involvement, and how nursing staff can support involvement and best meet fathers’ needs.

Relevance to clinical practice.  Nurses should explore the forms of involvement that a father desires, as well as the demands on their time, and determine what might be done to promote involvement. Fathers should be assisted to maximise the time that they do have with the infant. Nurses must provide clear and consistent information about whether and when caregiving is advisable, and they can explain and demonstrate how fathers can care for their infant.
Improving the systematic approach to pain and sedation management in the ICU by using assessment tools
Authors: Wøien Hilde , Værøy Henning , Aamodt Geir , Bjørk Ida T
Published: November 2012

Aims and objectives

To assess the effects of introducing a systematic approach to pain and sedation management in the ICU.

Background

Identification of ICU patients' analgesic and sedative needs decreases the risk of complications and the hospital length of stay. Several studies have reported a lack of systematic assessment.

Design and methods

Three assessment tools were implemented in two Norwegian ICUs in a prospective two‐site study (April–July 2009). Frequency of pain and sedation documentation, the number of days when a sedation level was prescribed, and the amount of analgesics and sedatives used were documented for 958 ICU days in 139 mechanically ventilated patients. Fifty‐five ICU nurses completed a questionnaire on the effects of the assessment tools before and after implementation.

Results

Patients assessed by the tools had a documented pain score 2·5 times daily and a sedation score three times daily. A sedation level was prescribed for 70% of the total patient days. A documented match between prescribed and reported sedation level was achieved for 27% of the days. Combinations of continuous analgesia and sedation were prescribed with wide therapeutic ranges. Significant improvements were seen in the units' assessment and documentation routines scored by the nurses after the implementation of the tools.

Conclusion

Although the tools were well accepted, they were not used as frequently as recommended. The proportion of missing written prescriptions and documentation of sedation levels most likely reflects the nurses' and physicians' poorly defined intentions for the prescribed treatment. The tools applied helped nurses to focus on significant signs and symptoms.

Relevance to clinical practice

Without well‐organised pain treatment and sedation, the risk of oversedation is always present. Our results show that the implementation of tools contributes to a systematic approach of the assessment and treatment of pain and sedation in intensive care.
Perspectives on healthy aging among Thai elderly: A qualitative study
Authors: Thanakwang Kattika , Soonthorndhada Kusol , Mongkolprasoet Jiraporn
Published: November 2012

In this qualitative study, we provide an in‐depth understanding of the views of healthy aging among Thai elderly and explore the ways that contribute to healthy aging. Data were collected using focus groups and in‐depth interviews in four selected provinces of Thailand, and were analyzed using content analysis. The results revealed that Thai elderly described being healthy as the result of multiple components involving physical, mental, and social well‐being. Healthy aging was viewed as an absence of serious diseases, having functional independence, a positive psycho‐emotional outlook, and making a social contribution. The factors considered to contribute to healthy aging included activities promoting physical and psychological health, as well as active engagement in social activities. Understanding how the elderly define healthy aging and identifying the most important components and factors that contribute to being healthy provides insight into possible policy implications and interventions to promote health and well‐being among Thai elderly.
Cost‐benefit analysis of soil remediation in Israeli industrial zones
Authors: Lavee Doron , Ash Tomer , Baniad Gilat
Published: November 2012

Industrial zones are the main source of soil pollution in Israel. Due to the upcoming approval of the bill on soil contamination and remediation in Israel, it is important to assess the economic feasibility of soil remediation. This study examines the economic feasibility of an extensive remediation project of all contaminated industrial zones in Israel. The estimated economic benefits include both direct benefits, resulting from the increase in the land value of the contaminated site, and indirect benefits, arising from the increase in nearby property values. A cost‐benefit analysis showed a cost benefit ratio of 1:14. Nonetheless, the direct benefits were found to be lower than the costs. Thus, the question of funding requires collaboration between government and the private sector.
Climate, land, energy and water (CLEW) interlinkages in Burkina Faso: An analysis of agricultural intensification and bioenergy production
Authors: Hermann Sebastian , Welsch Manuel , Segerstrom Rebecka Ericsdotter , Howells Mark I. , Young Charles , Alfstad Thomas , Rogner Hans‐Holger , Steduto Pasquale
Published: November 2012

This paper discusses climate, land, energy and water (CLEW) interactions in Burkina Faso. It shows that integrated assessments of resource use at the national level can provide important insights and benefits, especially for a resource constrained least developed country. Agricultural policy is shown to have strong implications for energy use, whereas energy policies are found to be strongly interrelated with water constraints. Without an integrated and coordinated approach, strategy and policy formulation efforts to increase energy, food and water security could become both incoherent and counter‐productive.
Work Rage: The Invention of a Human Resource Management Anti‐Conflictual Fable
Authors: DiFruscia Kim Turcot
Published: November 2012

This paper discusses the use of the concept of “work rage” in human resource management. “Work rage” is a construct that serves a dual purpose in contemporary personnel management: first, as a means of control and individualization of workers through psychotherapeutic governance, and second, as a way to position human resource managers as providers of expertise on how to limit problems caused by troublesome laborers. The paper is based on ethnographic fieldwork conducted in Quebec and the eastern United States.
The simultaneity of experience: cultural identity, magical realism and the artefactual in digital storytelling
Authors: Honeyford Michelle A.
Published: November 2012

This paper explores how students, as multimodal storytellers, can weave powerful narratives blending modes, genres, artefacts and literary conventions to represent the real and imagined in their lives. Part of a larger ethnographic case study of student writing in a middle years class for immigrant students learning English as an additional language, the research featured in this paper is framed by a theory of artefactual literacies, narrative theory – particularly the genre of magical realism – and cultural studies, specifically notions of representation and cultural identity. The theoretical emphases on the artefactual, structural and representational aspects of multimodal narratives informs a multilayered, fine‐grained approach to analysing students’ digital narrative poems using the tools of critical discourse analysis, literary analysis and a visual analytic framework developed for analysing student‐produced digital photographs. This process is applied to a selected example, Gabriel's ‘My Name Is’ narrative, a story that plays with elements of magical real‐ism to explore the simultaneity of his experience as an immigrant youth. The illustrative example speaks to the power of the ‘fantastical’ in literacy pedagogies that seek to take seriously students’ cultural identities and their visions for new realities.
Advances in menopausal therapy: The tissue‐selective estrogen complex
Authors: Moore Anne
Published: November 2012

Purpose

Most menopausal women experience vasomotor symptoms, vulvar‐vaginal atrophy, and/or bone loss. Although available estrogen and progestin therapies are effective in treating menopausal symptoms and preventing bone loss, some women may seek a therapy that provides symptom relief and has an improved tolerability profile. One option is a tissue‐selective estrogen complex (TSEC), or the pairing of estrogen(s) with a selective estrogen receptor modulator (SERM) to achieve the benefits of each component with fewer side effects. The first TSEC in clinical development combines the SERM bazedoxifene (BZA) with conjugated estrogens (CEs). The purpose of this article is to review published data for BZA/CE.

Data sources

Data were obtained from phase 3 BZA/CE clinical trial study articles.

Conclusions

Daily BZA 20 mg/CE 0.625 mg or 0.45 mg effectively relieved hot flushes, maintained or increased bone mineral density, treated vulvar‐vaginal atrophy, and improved quality of life. Further, BZA prevented stimulation of the endometrium by CE, and resulted in rates of amenorrhea and breast pain similar to placebo.

Implications for practice

These results support the use of a TSEC consisting of BZA/CE as a promising therapy for managing the signs and symptoms from reduced estrogen levels associated with menopause.
Effects of repeated transvaginal aspiration of immature follicles on mare health and ovarian status
Authors: Velez I. C. , Arnold C. , Jacobson C. C. , Norris J. D. , Choi Y. H. , Edwards J. F. , Hayden S. S. , Hinrichs K.
Published: November 2012

Reasons for performing study:Transvaginal ultrasound‐guided follicle aspiration (TVA) is performed clinically but there is little information available on complications associated with this procedure.

Objectives:It is possible that TVA is associated with damage to the ovary and may induce peritonitis or peritoneal adhesions. This study was conducted to determine the effect of repeated TVA on mare health and ovarian status.

Methods:Thirty‐two mares were used for oocyte recovery via repeated TVA over a 3 year period; different mares were used each year. In Year 1, ovarian status was monitored in 11 mares by transrectal palpation and ultrasonography. In Year 2, 6 of 11 mares underwent abdominocentesis and were examined by laparoscopy after one TVA and again after multiple TVAs. In Year 3, 10 mares underwent multiple TVAs with either a 15 or a 12 gauge needle and the ovaries were removed for examination.

Results:Four hundred and twenty‐seven aspiration sessions (390 via TVA and 37 via needle placement through the flank) and 3202 follicle punctures (3161 TVA and 41 flank) were performed. One mare developed an ovarian abscess. Transient rectal bleeding was evident after 16% of TVA sessions. No adhesions were found on laparoscopic or gross examination of ovaries and there were minimal changes on histological evaluation.

Conclusions:Follicle aspiration carries a small possibility (<0.5%) of ovarian abscess formation. There is a possibility of rectal abrasion or puncture but little gross or histological damage to the ovary.

Potential relevance:These results provide a basis for using prophylactic administration of antibiotics after TVA and for advising mare owners of the rare but potential complications associated with the procedure.
Retrospective study on equine uterine fungal isolates and antifungal susceptibility patterns (1999–2011)
Authors: Beltaire K. A. , Cheong S. H. , Coutinho da Silva M. A.
Published: November 2012

Reasons for performing study: Knowledge of commonly encountered fungi infecting the mare's reproductive tract and their respective drug susceptibilities should improve treatment efficacy in mares with fungal endometritis. This is particularly important when practitioners need to start empiric treatment before culture results are complete.

Objective: To report the spectrum of fungal isolates from uterine samples from mares with reproductive problems and their respective antifungal susceptibilities.

Methods: Equine uterine samples submitted to the Cornell University Animal Health Diagnostic Centre for fungal culture between July 1999 and June 2011 were reviewed. Each mare's reproductive history, fungal culture results, antifungal susceptibilities and concurrent aerobic culture results were evaluated. Patterns of antifungal susceptibility and resistance were assessed over time.

Results: One hundred and two fungal isolates were cultured from 92 uterine samples from mares with reproductive problems. Yeast (69%) and mould with septated hyphae (26%) were the most common isolates. Ninety‐five to 100% of all fungal isolates were susceptible to the polyenes, while response to the azoles varied with 47–81% of fungal isolates displaying susceptibility. Yeast isolates were 100% susceptible to the polyenes and least susceptible to miconazole (48%) while isolates of mould with septated hyphae were most susceptible to natamycin (100%) and least susceptible to fluconazole (0%). From July 1999 to June 2005 and July 2005 to June 2011, yeast demonstrated increasing resistance to miconazole, while mould with septated hyphae demonstrated increasing resistance to ketoconazole.

Conclusions and clinical relevance: Results from this study suggest that polyenes are effective against uterine fungal isolates in vitro and may be the empiric treatment of choice for fungal endometritis. Isolate resistance to specific azoles increased over time.
Use of a wireless, inertial sensor‐based system to objectively evaluate flexion tests in the horse
Authors: Marshall J. F. , Lund D. G. , Voute L. C.
Published: November 2012

Objectives: A wireless, inertial sensor‐based system has previously been validated for evaluation of equine lameness. However, threshold values have not been determined for the assessment of responses to flexion tests. The aim of this investigation was to evaluate a sensor‐based system for objective assessment of the response to flexion.

Methods: Healthy adult horses (n = 17) in work were recruited prospectively. Horses were instrumented with sensors on the head (accelerometer), pelvis (accelerometer) and right forelimb (gyroscope), before trotting in a straight line (minimum 25 strides) for 2 consecutive trials. Sensors measured 1) vertical pelvic movement asymmetry (PMA) for both right and left hindlimb strides and 2) average difference in maximum and minimum pelvic height (PDMax and PDMin) between right and left hindlimb strides in millimetres. A hindlimb was randomly selected for proximal flexion (60 s), after which the horse trotted a minimum of 10 strides. Response to flexion was blindly assessed as negative or positive by an experienced observer. Changes in PMA, PDMax and PDMin between baseline and flexion examinations were calculated for each test. Statistical analysis consisted of a Pearson's product moment test and linear regression on baseline trials, Mann–Whitney rank sum test for effect of flexion and receiver operator curve (ROC) analysis of test parameters.

Results: There was a strong correlation between trials for PMA, PDMin and PDMax measurements (P<0.001). A positive flexion test resulted in a significant increase in PMA (P = 0.021) and PDMax (P = 0.05) only. Receiver–operator curve analysis established cut‐off values for change in PMA and PDMax of 0.068 and 4.47 mm, respectively (sensitivity = 0.71, specificity = 0.65) to indicate a positive response to flexion.

Conclusions: A positive response to flexion resulted in significant changes to objective measurements of pelvic symmetry.

Potential relevance: Findings support the use of inertial sensor systems to objectively assess response to flexion tests. Further investigation is warranted to establish cut‐off values for objective assessment of other diagnostic procedures.
The addition of ticarcillin‐clavulanic acid to INRA 96 extender for stallion semen cooling
Authors: Dean C. J. , Hobgood A. M. , Blodgett G. P. , Love C. C. , Blanchard T. L. , Varner D. D.
Published: November 2012

Reasons for performing study

A commonly used commercial extender (i.e. INRA 96) contains antimicrobials that may have limited effectiveness. Therefore, addition of ticarcillin‐clavulanic acid to this extender is a widespread procedure in the equine breeding industry in the United States. However, such practice has not been critically evaluated.

Objectives

To evaluate the addition of ticarcillin‐clavulanic acid to INRA 96 and different extender and antimicrobial storage conditions on sperm function and antimicrobial effectiveness.

Methods

Gel‐free semen (42 ejaculates from 14 mature Quarter Horse stallions) was extended with INRA 96 and stored for 24 h in an Equitainer II. The effects of added ticarcillin‐clavulanic acid and different extender storage procedures on sperm motion characteristics (by computer‐assisted analysis), sperm membrane integrity (by fluorescence‐based measurement) and suppression of bacterial growth (by aerobic and anaerobic culture methods) were evaluated using analysis‐of‐variance and Chi‐square statistical methods. The P value for significance was set at <0.05.

Results

Freezing and thawing of modified or unmodified extender prior to use for stallion semen resulted in reduced sperm quality post cooling for 24 h, as evidenced by a significant reduction in sperm motility (i.e. total and progressive) and sperm membrane integrity. Addition of ticarcillin‐clavulanic acid to extender resulted in higher sperm velocity when the reconstituted antimicrobial was subjected to cooled storage, as compared with frozen storage, prior to use. Only 28 of 42 ejaculates (67%) yielded presence of bacteria in neat semen but addition of ticarcillin‐clavulanic acid to INRA 96 was not different than INRA 96 alone for inhibiting growth of bacteria (98 vs. 94%, respectively).

Conclusions

Addition of ticarcillin‐clavulanic acid (1 mg/ml) to INRA 96 did not adversely affect sperm quality in extended semen after cooled storage. Extender freezing and thawing prior to use had detrimental effects on sperm quality.

Potential relevance

These data suggest that INRA 96 should not be frozen and thawed prior to use. Addition of ticarcillin‐clavulanic acid to INRA 96 did not impair sperm quality. All extender treatments effectively controlled the bacterial growth compared with neat semen.
Identification of periparturient mare and foal associated predictors of post parturient immunoglobulin A concentrations in Thoroughbred foals
Authors: Jenvey C. , Caraguel C. , Howarth G. B. , Riley C. B.
Published: November 2012

Reasons for performing the study

Prior to the start of endogenous production of immunoglobulins (Igs), absorption of maternal Igs is important to protect against pathogens in the early neonatal period. It is possible that mare‐ or foal‐associated factors may influence neonatal IgA concentrations.

Objectives

The temporal relationships among serum and milk IgA concentrations in Thoroughbred mare–foal pairs were explored to determine if periparturient mare‐ and foal‐associated factors contribute to the prediction of foal serum IgA concentrations.

Methods

Blood and milk samples as well as complete veterinary records, were collected for 84 Thoroughbred mare–foal pairs from one month before to 2 months after parturition. Samples were tested using enzyme‐linked immunosorbent assay (ELISA) for concentrations of IgA. Pairwise correlation coefficients were estimated (P<0.01) and simple linear regression used to investigate unconditional associations between mare IgA levels, mare and foal risk factors and foal serum IgA concentration at 12 h. Backwards, stepwise elimination of nonsignificant factors was used to create a final model.

Results

There were significant temporal relationships among mare serum IgA and among colostrum and milk IgA concentrations within mares (P<0.01). Mare serum IgA concentrations up to one month before parturition were associated with foal serum IgA concentrations at all time points and with colostrum and milk IgA concentrations. Mare serum IgA at ‐28 days and parity were associated with foal serum IgA concentration at 12 h (P<0.001).

Conclusions

Mare serum IgA concentrations up to 28 days before parturition, together with mare parity, are indicative of neonatal foal serum IgA concentrations.

Potential relevance

Mare serum and colostrum IgA concentrations may be useful peripartum predictors of neonatal mucosal immune status, enabling earlier intervention to prevent the consequences of mucosal infections.
Dose titration of the clinical efficacy of intravenously administered flunixin meglumine in a reversible model of equine foot lameness
Authors: Foreman J. H. , Bergstrom B. E. , Golden K. S. , Roark J. J. , Coren D. S. , Foreman C. R. , Schumacher S. A.
Published: November 2012

Reasons for performing study

There are no refereed controlled documentations of the skeletal analgesic efficacy of different dosages of flunixin meglumine (FM).

Objectives

The objective of this experiment was to compare the efficacy of various dosages ofFMwith a negative control. The hypothesis was that higher doses would result in improved efficacy in a dose‐dependent manner when tested in a reversible model of foot lameness.

Methods

Ten horses shod with adjustable heart bar shoes had weekly modifiedAAEP grade 4.0/5.0lameness induced by tightening a set screw against the heart bar. Heart rate (HR)and lameness score (LS) were monitored by one double‐blinded investigator at rest; every 20 min after lameness induction for 5 h and hourly for another 8 h. One hour after lameness induction, treatments were administered i.v. in a randomised order: negative control (isotonic saline:SAL) orFMat 0.55 (half‐dose), 1.1 (single‐dose) or 2.2 (double‐dose) mg/kg bwt. Results were compared usingRM ANOVAand Student–Newman–Keul's test with the level of significance set atP<0.05.

Results

Compared toSAL, half‐doseFMreducedHRat 2.33, 2.67, 4.0–8.0, and 10.0 h andLSat 1.33–12.0 h (P<0.05). Single‐ and double‐doseFMreducedHRfrom 0.67 to 12.0 h andLSfrom 1.0 to 12.0 h post administration (P<0.05). Compared with half‐doseFM, single‐ and double‐doseLSwere further decreased from 1.67 to 12.0 h post administration (P<0.05). Mean peak and decaying plasmaFMconcentrations were different between dosages in a dose‐dependent manner through 6 h post administration (P<0.05).

Conclusions

Flunixin meglumine administration affected dependent variables in a dose‐dependent manner with half‐doseFMclinically effective for a shorter period. Higher dosages did not perform differently from one another.

Potential relevance

Practitioners must be aware that half‐doses ofFMare less efficacious than single doses but double doses are not more efficacious and yet are potentially more toxic.
Equine piroplasmosis treatment protocols: Specific effect on orocaecal transit time as measured by the lactose13C‐ureide breath test
Authors: Kutscha J. , Sutton D. G. M. , Preston T. , Guthrie A. J.
Published: November 2012

Reasons for performing study

Imidocarb dipropionate is the drug of choice for equine piroplasmosis but its administration causes severe colic and diarrhoea. An imidocarb protocol that reduces these effects is needed.

Objectives

1) Quantification of the effects of imidocarb dipropionate on equine orocaecal transit time (OCTT), with and without atropine or glycopyrrolate premedication and 2) investigation of an improved pretreatment regimen for imidocarb administration.

Hypothesis

Treatment with imidocarb dipropionate will result in colic and reducedOCTTas demonstrated by the lactose13C‐ureide breath test which will be ameliorated by premedication with either atropine or glycopyrrolate.

Methods

The effects of 3 drug therapies onOCTTwere compared in 6 healthy horses in a randomised double‐blind study vs. a saline control: 1) imidocarb dipropionate 2.4 mg/kg bwt administered intramuscularly (i.m.) with saline administered intravenously (i.v.; imidocarb/saline); 2) imidocarb dipropionate 2.4 mg/kg bwt administered i.m. with atropine 0.035 mg/kg bwt administered i.v. (imidocarb/atropine) and 3) imidocarb dipropionate 2.4 mg/kg bwt administered i.m. with glycopyrrolate 0.0025 mg/kg bwt administered i.v. (imidocarb/glycopyrrolate). The lactose13C‐ureide breath test was used to measureOCTTin each case and significance of treatment effect determined by a linear model analysis of variance.

Results

Imidocarb/atropine treatment caused an increase inOCTT(P<0.05) whereas imidocarb/saline produced a nonsignificant decrease inOCTT. Imidocarb/saline caused colic and diarrhoea in 4 of 6 horses, which were not seen in any of the horses treated with imidocarb/atropine or imidocarb/glycopyrrolate or administered the saline control. Intestinal borborygmi were increased in imidocarb/saline and decreased in imidocarb/atropine treated horses, respectively.

Conclusions

Imidocarb/saline treatment induced colic signs and a potential reduction inOCTTwhile imidocarb/atropine treatment increasedOCTTsignificantly when compared with imidocarb/saline. Both atropine and glycopyrrolate premedication ameliorated the clinical gastrointestinal effects of imidocarb but atropine produced significant inhibition of gastric and/or small intestinal motility not detected with glycopyrrolate. Premedication with glycopyrrolate is recommended when using imidocarb for treatment of equine piroplasmosis.
Visual outcome after corneal transplantation for corneal perforation and iris prolapse in 37 horses: 1998–2010
Authors: de Linde Henriksen M. , Plummer C. E. , Mangan B. , Ben‐Shlomo G. , Tsujita H. , Greenberg S. , Toft N. , Brooks D. E.
Published: November 2012

Reasons for performing study

We wanted to investigate the visual outcome of horses presented with iris prolapse and treated with corneal transplantation.

Objective

To evaluate the visual outcome of horses with iris prolapse treated with penetrating keratoplasty alone and penetrating keratoplasty in combination with overlying conjunctival or amniotic membrane grafting.

Methods

A retrospective medical records study of horses presented to the University of Florida Veterinary Medical Center for iris prolapse and treated with penetrating keratoplasty in the period of 1998‐2010. Data collected from the medical records included signalment, clinical descriptions of ocular lesions, treatments, and therapeutic outcome.

Results

Iris prolapses in this study were caused by corneal ulcers with keratomalacia (n = 37). All horses were treated medically for infection, hyperproteinase activity and iridocyclitis, and then surgically treated with either penetrating keratoplasty alone (n = 9) or penetrating keratoplasty with either a conjunctival pedicle flap (n = 22), amniotic membrane transplant (n = 5) or amnion membrane and conjunctival pedicle flap (n = 1). The eyes were visual postoperatively in a majority of the cases (n = 24; 64.9%). Limited vision was noted in 6 eyes (16.2%), 3 eyes became phthisical (8.1%) and 4 globes were enucleated (10.8%). Graft rejection manifested as some degree of donor corneal graft opacification in all cases. Anterior synechiae were present in 48.6% of the eyes. Wound dehiscence and aqueous humour leakage were also common as post operative problems.

Conclusion

Penetrating keratoplasty alone or in combination with an overlying graft of conjunctiva or amniotic membrane can achieve a successful visual outcome in a high percentage of horses with iris prolapse.
The clinical and pathological features of gastric impaction in twelve horses
Authors: Bird A. R. , Knowles E. J. , Sherlock C. E. , Pearson G. R. , Mair T. S.
Published: November 2012

Reasons for performing study

Gastric impaction in the horse is poorly described in the veterinary literature.

Objectives

To review the clinical and pathological features of gastric impaction.

Methods

The clinical details of horses presenting with colic over a 7‐year period and cases in which gastric impaction was considered to determine the outcome were reviewed. Clinical and clinicopathological data were recorded.

Results

Twelve cases of gastric impaction were recorded (1.4% of 857 horses hospitalised for colic). Diagnosis was achieved by ultrasonographic examination, gastroscopy, exploratory celiotomy and/or post mortem examination. Five out of 12 horses were successfully treated, 5/12 were subjected to euthanasia (3 at celiotomy and 2 due to recurrence of impaction) and 2/12 died. Three out of 12 horses had spontaneous gastric rupture despite attempted treatment (one was subjected to euthanasia at celiotomy and 2 died). Post mortem examination (7 horses) revealed gross muscular thickening of the stomach wall in 6/7 horses. Histological examination revealed focal fibrosis of the stomach wall in 4/6 and focal myositis in 1/6 horses.

Conclusions and practical significance

Gastric impaction is a rare cause of colic and affected horses can present with acute, chronic or recurrent colic in the presence or absence of other gastrointestinal disease. Spontaneous gastric rupture may occur. A proportion of affected horses have gross thickening of the muscular layers of the stomach wall.
Magnetic resonance and radiographic diagnosis of osseous resorption of the flexor surface of the distal phalanx in the horse
Authors: Young A. C. , Dimock A. N. , Puchalski S. M. , Murphy B. , Spriet M.
Published: November 2012

Reasons for performing study

Osseous resorption of the flexor surface of the distal phalanx of the horse has been identified previously using magnetic resonance (MR) imaging; however, little is known about the prevalence and characteristics of this lesion.

Objectives

To establish the MR prevalence of resorptive lesions in the flexor surface of the distal phalanx and identify concurrent lesions associated with this finding and associations between the MR and radiographic findings.

Methods

Horses with distal extremity MR and radiographs performed within 2 weeks of each other were included in the study. The flexor surface of the distal phalanx was graded independently on both modalities for the presence of osseous resorption. The sensitivity and specificity of radiography for identifying osseous resorption was calculated using MR as the gold standard.

Results

Eighty‐two MR studies met the inclusion criteria, 8 of which included osseous resorption of the flexor surface of the distal phalanx. Concurrent injury to the deep digital flexor tendon and the navicular bone was a common finding. An association between MR and radiographic grades was identified. Radiography had a high specificity (0.96) but lower sensitivity (0.45–0.55) for detecting osseous resorption.

Conclusions

Osseous resorption of the flexor surface of the distal phalanx can be observed both on MR and radiographic examinations of horses with lameness localised to the foot. This lesion is most often associated with other pathological changes in the podotrochlear apparatus.

Potential relevance

Focal radiolucency of the flexor surface of the distal phalanx is a newly recognised radiographic sign associated with pathological changes of the podotrochlear apparatus.
Hindlimb kinematics before and after laser fibrotomy in horses with fibrotic myopathy
Authors: Janicek J. , Lopes M. A. F. , Wilson D. A. , Reed S. , Keegan K. G.
Published: November 2012

Reasons for performing study

Fibrotic myopathy can cause incapacitating gait abnormalities. Transection of the fibrotic mass followed by early post operative exercise is the best treatment for fibrotic myopathy. A laser may be used to transect the fibrotic mass. Assessment of the effectiveness of therapies for fibrotic myopathy has been limited to subjective evaluation.

Objectives

To objectively assess gait abnormalities associated with fibrotic myopathy before and after laser fibrotomy followed by early post operative exercise.

Methods

Kinematic evaluation of horses with fibrotic myopathy walking and trotting on a treadmill was used to investigate hindfeet trajectories (n = 8) and lameness (n = 5) before and after laser fibrotomy. Hoof flight trajectory length (HFTL), relative protraction length (%PL), maximum hoof height during swing (MXHH), hoof height at end of protraction (HHpro) and retraction (HHret) were measured and differences between fibrotic myopathy affected and nonaffected limbs were calculated. Lameness was quantified by measuring maximum and minimum pelvic height differences between right and left halves of the stride.

Results

Before surgery the foot of the fibrotic myopathy affected limb had abnormal trajectories characterised as increasedHFTL,MXHHandHHproand decreased %PLandHHretand the 5 horses objectively evaluated for lameness were lame in the fibrotic myopathy affected limb. Immediately after surgery the difference between affected and nonaffected limbs decreased forHFTL, %PLandHHpro. Six to 11 weeks after surgery, theHFTLdifference increased but was still smaller than before surgery, which was interpreted as partial recurrence of the gait abnormality; all horses objectively evaluated for lameness were either improved (n = 1) or not lame (n = 4) in the previously affected, operated limb.

Conclusions

Fibrotic myopathy affects the foot flight and leads to asymmetric vertical excursion of the pelvis. Laser fibrotomy followed by early post operative exercise can minimise these abnormalities.

Potential relevance

Laser fibrotomy combined with early post operative exercise is a viable therapy for fibrotic myopathy.
Malnutrition in Austrian hospital patients. Prevalence, risk factors, nursing interventions, and quality indicators: a descriptive multicentre study
Authors: Tannen Antje , Lohrmann Christa
Published: November 2012

Aims

This study reports the prevalence of malnutrition (according to body mass index and malnutrition universal screening tool) and the prevalence of health problems that may influence the development of malnutrition in Austrian hospitals. Screening routines and nutrition‐related interventions on patient level and quality indicators on ward and facility levels were also investigated.

Background

Malnutrition is an undesirable condition of care‐dependent patients and can increase morbidity and mortality of those affected; it is therefore required to screen every patient to detect people at risk and treat them early. Only little data are available on the prevalence of the underlying causes and on the extent of nutrition‐related interventions.

Design

A cross‐sectional multicentre study in 11 Austrian hospitals (n = 2,283) in 2009.

Methods

Every patient was assessed by two trained nurses. Data were collected using a standardized validated questionnaire.

Results/findings

The prevalence of malnutrition according to the malnutrition universal screening tool was 15·7% (high risk) and 8·3% (middle risk). A body mass index <20·0 kg/m² was found in 12·0% (6% <18·5 kg/m²). Main problems were loss of appetite (56·6%), acute disease (38·6%), and nausea (22·3%). About 70% of the patients were screened on admission. Patients at risk were referred to a nutritional expert (7–28·7%), received protein‐energy‐enriched diets (2·5–15·1%) or snacks (5·1–17·4%). A dietician was available in all hospitals; 8/11 hospitals had fixed criteria for assessing malnutrition; guideline policy varied among the facilities.

Conclusion

The majority of wards acted in compliance with clinical guidelines; nevertheless, there are still some facilities that do not screen and weigh their patients in a standardized manner and do not treat high‐risk patients adequately.