Measuring lamb activity during lactation by actigraphy.

Twenty-two lambs were used to determine their locomotor activity during lactation, and its circadian rhythm, based on data collected by actigraphy; the relationships among lambs were also measured calculating their proximity and distance. Lambs were fitted with Bluetooth-enabled (BT) accelerometers during weeks 1 and 4 of age, and data were downloaded as activity counts at 1-min intervals (Vector Magnitude, VM). Sensors were programmed as receivers and as beacons of the BT signal to calculate proximity (min/h) and distance (m) to another lamb. For each week, mean daily VM was calculated at hourly intervals. Circadian rhythms in VM were graphed by fitting the time-series measurements of each lamb to the cosine curve of a 24-h activity rhythm. Week of lactation and lamb sex had a significant (P < .05) effect on VM. Lambs had a higher (P < .05) VM (counts/min ±S.E.) in week 1 (154 ± 13) than in week 4 (117 ± 4), and female (113 ± 10) were more active (P < .01) than male lambs (113 ± 10). Twin lambs spent more time (P < .001) close to its sibling than to another lambs. Lamb activity followed a 24-h rhythm in week 4, only. In conclusion, actigraphy demonstrated that circadian rhythms in activity were not present in the first week of life, and twin-born lambs had stronger associations with their littermates than did singletons with other lambs, which reflected the strong bond that is established between twin lambs.

Implanting melatonin at lambing enhances lamb growth and maintains high fat content in milk.

Three experiments were designed to study the effects of melatonin implantation of ewes and lambs after lambing on the growth of lambs and milk quality throughout lactation. In experiment 1, 53 lambs either did (n = 28) or did not (n = 25) receive a subcutaneous 18-mg melatonin implant at the base of the left ear. In experiment 2, 55 lambs and their mothers either did (lambs: n = 28; ewes: n = 15) or did not (lambs: n = 27; ewes: n = 16) receive a melatonin implant. Milk samples were collected at 15, 30, and 45 d after lambing. In experiment 3, 16 lambs were separated from their mothers 24 h after birth, moved to an artificial rearing unit, and either did (n = 9) or did not (n = 7) receive a melatonin implant. In the three experiments, implants were inserted 24 h after lambing, and lambs were weighed (LW) weekly until weaning (for each experiment, 7, 6, and 5 wk., respectively). Average daily gains (ADG) from birth to weaning were calculated. Melatonin treatment of lambs did not have a significant effect on LW at weaning or ADG, but lambs reared by implanted ewes in experiment 2 presented higher (P < 0.05) LW (±S.E.M.) at weaning (implanted: 13.61 ± 0.51; non-implanted: 12.09 ± 0.57 kg) and ADG (implanted: 221.00 ± 10.45; non-implanted: 189.92 ± 12.44 g/d) than did lambs reared by control ewes. At day 45 of lactation, milk fat and total solid content were higher (P < 0.05) in implanted ewes than they were in control ewes. Groups did not differ significantly in the protein and lactose content of their milk. In conclusion, melatonin treatment of ewes at lambing induced a high growth rate of their lambs and increased the fat content of the milk; however, the direct treatment with melatonin of the lambs at birth did not have an effect in their growth rate.

Cross-cultural adaptation and assessment of the reliability and validity of the Core Outcome Measures Index (COMI) for the Brazilian-Portuguese language.

PURPOSE: The use of patient-orientated questionnaires is of utmost importance in assessing the outcome of spine surgery. Standardisation, using a common set of outcome measures, is essential to aid comparisons across studies/in registries. The Core Outcome Measures Index (COMI) is a short, multidimensional outcome instrument validated for patients with spinal disorders. This study aimed to produce a Brazilian-Portuguese version of the COMI. METHODS: A cross-cultural adaptation of the COMI into Brazilian-Portuguese was carried out using established guidelines. 104 outpatients with chronic LBP (>3 months) were recruited from a Public Health Spine Medical Care Centre. They completed a questionnaire booklet containing the newly translated COMI, and other validated symptom-specific questionnaires: Oswestry Disability Index (ODI) and Roland Morris disability scale (RM), and a pain visual analogue scale. All patients completed a second questionnaire within 7-10 days to assess reproducibility. RESULTS: The COMI summary score displayed minimal floor and ceiling effects. On re-test, the responses for each individual domain of the COMI were within 1 category in 98% patients for the domain 'function', 96% for 'symptom-specific well-being', 97% for 'general quality of life', 99% for 'social disability' and 100% for 'work disability'. The intraclass correlation coefficients (ICC(2,1)) for COMI pain and COMI summary scores were 0.91-0.96, which compared favourably with the corresponding values for the RM (ICC, 0.99) and ODI (ICC, 0.98). The standard error of measurement for the COMI was 0.6, giving a "minimum detectable change" (MDC95%) of approximately 1.7 points i.e., the minimum change to be considered "real change" beyond measurement error. The COMI scores correlated as hypothesised (Rho, 0.4-0.8) with the other symptom-specific questionnaires. CONCLUSIONS: The reproducibility of the Brazilian-Portuguese version of the COMI was comparable to that of other language versions. The COMI scores correlated in the expected manner with existing but longer symptom-specific questionnaires suggesting good convergent validity for the COMI. The Brazilian-Portuguese COMI represents a valuable tool for Brazilian study-centres in future multicentre clinical studies and surgical registries.

A new distractable implant for vertebral body replacement: biomechanical testing of four implants for the thoracolumbar spine.

INTRODUCTION: Expandable titanium implants for vertebral body replacement in the thoracolumbar spine have been well established in the reconstruction of the anterior spinal column. Load transfer at the bone-implant interface remains a point of concern. The purpose of the study was to compare the performance in axial load transfer from the implant to the vertebral body in four different implants, all of them in clinical use to date. MATERIALS AND METHODS: We tested a second generation implant (Synex II) in comparison to three different expandable titanium cages: Synex I, Obelisc and X-Tenz. Twenty-four intact fresh frozen human lumbar vertebrae (L1-L4) were distributed into four identical groups according to bone mineral density (BMD). The BMD was determined by quantitative computed tomography (qCT). Specimens were loaded in craniocaudal direction with a material testing machine (Mini Bionix II) at a constant speed of 5 mm/min. Load displacement curves were continuously recorded for each specimen until failure (diminishment of compressive force (F) and/or obvious implant migration through the vertebral body end plate). One-way analysis of variance (ANOVA) and post-hoc tests (Bonferroni) were applied to detect differences at 1, 2, 3, and 4 mm displacement (F (1-4 mm)) between implant groups. RESULT: No significant differences were observed with regard to maximum compression force (F (max)) and displacement (d (max)) until failure: Synex II (1,782.3 N/4.67 mm); Synex I (1,645.3 N/4.72 mm); Obelisc (1,314.0 N/4.24 mm); X-Tenz (1470.3 N/6.92 mm). However, the mean compression force at 1-4 mm displacement (F (1-4 mm): 300-1,600 N) was highest for Synex II. The difference at 2 mm displacement was significant (p = 0.028) between Synex II (F (2 mm) = 879 N) and X-Tenz (F (2 mm) = 339 N). CONCLUSION: The modified end plate design of Synex II was found to perform comparably at least with regard to the compressive performance at the implant-bone interface. The risk of the new implant for collapse into the vertebral body might be reduced when compared to the competitors.

[An improved vertebral body replacement for the thoracolumbar spine. A biomechanical in vitro test on human lumbar vertebral bodies]. / Ein verbessertes Wirbelkörperersatzimplantat für die thorakolumbale Wirbelsäule. Biomechanischer In-vitro-Test an humanen Lendenwirbelkörpern.

BACKGROUND: In recent years, the use of expandable titanium cages for vertebral body replacement in the thoracolumbar spine has been well established for the treatment of tumors, unstable traumatic lesions, or posttraumatic deformity. Collapse of the implant into the vertebral body remains a point of concern. A biomechanical compression test was designed to assess implant subsidence for a newly developed prototype for vertebral body replacement in the thoracolumbar spine using human cadaveric lumbar vertebrae. The objective of this study was to compare the compressive performance of a new expandable cage with modified end-plate design with three commonly available expandable cages for vertebral body replacement. MATERIALS AND METHODS: The compressive strengths at the implant-vertebral body interface were measured via axial loading of the new prototype (Synex II) in comparison with three different expandable titanium cages: Synex I (Synthes), Obelisc (Ulrich Medical) and X-Tenz (DePuy Spine). Twenty-four intact, fresh frozen human lumbar vertebrae (L1-L4) were distributed into four identical groups according to BMD (determined by quantitative computed tomography) and the vertebral level. Specimens were loaded in the craniocaudal direction with a material testing machine at a constant speed of 5 mm/min. Load displacement curves were continuously recorded for each specimen until failure (diminishment of compressive force (F)/obvious implant migration through the vertebral body endplate). One-way analysis of variance and post-hoc tests (Bonferroni) were applied to detect differences at 1, 2, 3, 4 mm displacement (F1-4 mm), and Fmax between implant groups. RESULTS: The four expandable cages did not show statistically significant biomechanical differences in terms of maximum compression force (Fmax) until failure: Synex II (1,782 N/4.7 mm); Synex I (1,645 N/4.7 mm); Obelisc (1,314 N/4.2 mm); X-Tenz (1,470 N/6.9 mm). However, the mean compression force until 4 mm displacement (F1-4 mm: 300-1,600 N) was highest for Synex II. The difference at 2 mm displacement was significant (p=0.028) between Synex II (F2 mm=879 N) and X-Tenz (F2 mm=339 N). CONCLUSION: The modified endplate design of the new prototype was found to improve its compressive performance under constrained uniaxial loading conditions at the implant-bone interface. The improved compressive behaviour of the new implant might help to reduce the risk of implant subsidence and collapse into the vertebral body in vivo.

Successful posterior interlaminar fusion at the thoracic spine by sole use of beta-tricalcium phosphate.

We report on a 43-year-old male who sustained an isolated distraction injury of the thoracic spine Th7/Th8 (AO/ASIF B 2.3) with wedge compression Th8 and sagittal split Th10 without neurological injury. A bisegmental posterior stabilisation and a monosegmental interlaminar fusion was the treatment of choice. A synthetic bone substitute, beta-tricalcium phosphate (beta-TCP, Chronos) without additional autogenous bone was used to achieve the monosegmental posterior fusion. The clinical course was favourable and 10 months postoperatively the implant was removed. On implant removal the CT scan showed a fused segment and intraoperatively it was found that the fusion was solidly healed. A biopsy was taken from the fusion mass and histology showed vital bone that was rich with osteocytes. Noncalcified osteoid surrounding the bone marrow cavity could be identified. Several studies and the reported case might indicate that osteoconductive material alone can be sufficient for achieving a solid fusion.