Effect of perfusate volume on amikacin concentrations after saphenous intravenous regional limb perfusion in standing, sedated horses.

OBJECTIVE: To determine the influence of perfusate volume on synovial fluid amikacin concentrations in the joints of the hind limb after standing saphenous intravenous regional limb perfusion (IVRLP). STUDY DESIGN: Randomized crossover design. ANIMALS: Six adult horses. METHODS: Saphenous IVRLP was performed in 6 standing horses with 1 g of amikacin diluted with 0.9% NaCl to volumes of 10 ml, 60 ml, and 120 ml. Samples of synovial fluid from the tarsocrural, metatarsophalangeal, and hind limb distal interphalangeal joints were collected at 15 and 30 min after perfusate administration. Concentrations of 40 µg/ml and 160 µg/ml were considered therapeutic for susceptible and resistant pathogens, respectively. RESULTS: No difference in synovial fluid amikacin concentrations was detected between volumes in any joint (P = .4). All synovial fluid amikacin concentrations were higher at 30 min compared to 15 min (P = .003). All median synovial fluid amikacin concentrations at 30 min were > 40 µg/ml using the 60 ml and 120 ml volumes. Synovial fluid amikacin concentrations >40 µg/ml were only reached in the hind limb distal interphalangeal joint when the 10 ml volume was used. All median synovial fluid amikacin concentrations observed were < 160 µg/ml. CONCLUSIONS: Target concentrations for pathogens that were considered susceptible were consistently reached with perfusate volumes of 60 ml and 120 ml. However, median synovial fluid amikacin concentrations did not reach target levels for resistant pathogens. CLINICAL SIGNIFICANCE: Perfusate volumes of 60 ml or 120 ml are recommended to treat infections due to susceptible pathogens in the joints of the distal hind limb. These results justify investigation of saphenous IVRLP with different perfusate volumes using higher doses of amikacin.

Are Men With a History of Head Injury Less Responsive to Cognitive Behavioral Therapy for Intimate Partner Violence?

Head injury is highly prevalent among intimate partner violence (IPV) offenders. This study investigates responsiveness to cognitive behavioral therapy (CBT) for partnerviolent men with and without a history of head injury using archival data on 310 males seeking IPV counseling at a community domestic violence agency. Participants reported on their history of head injury, age at injury, and length of time unconscious in a structured interview at program intake. Criminal justice outcomes were assessed for the 2-year period after scheduled completion of treatment using a publicly available state database. A significantly greater percentage of men with a history of head injury (N = 84) than those without (N = 226) had criminal involvement for incidents of partner abuse during the follow-up period. In addition, men with a history of moderate-to-severe head injury (n = 25) had more criminal involvement for general violence than those with no history of head injury. The findings highlight the need to screen partner-violent men for head injury and to develop and investigate intervention enhancements for those individuals.

Intimate Partner Violence Victimization and Cognitive Function in a Mixed-Sex Epidemiological Sample of Urban Adults.

Intimate partner violence (IPV) victimization is associated with a wide range of mental and physical health problems, but little is known about the effect of IPV on cognitive decline. Previous research suggests an association between IPV victimization and cognitive dysfunction, but the few studies that have examined this phenomenon were cross-sectional in design and focused only on female victims of IPV. This study examined cognitive function over time among a diverse population of both male and female victims of IPV. Regression analyses indicated increased completion time on Trail Making Test (TMT) A for both male and female victims of IPV living below poverty as well as for female victims of IPV without previously depressive symptomatology. Results also indicated increased completion time on TMT B for male victims of IPV. Our findings support an association between IPV victimization and increased cognitive decline that is moderated by poverty status and previous depressive symptomatology.

Administration of exogenous melatonin increases spreading activation in lexical memory networks.

OBJECTIVE: Several studies have examined the effect of exogenous melatonin on memory and cognitive functioning. Many of these investigations have reported improvement in recall and recognition as well as performance on various other indices of neuropsychological functioning. However, there have been no investigations reported that have examined the effects of exogenous melatonin administration on spreading activation in lexical and semantic memory networks. Hence, the purpose of this investigation was to determine the effects of melatonin on spreading activation. METHODS: Participants were randomly assigned to either a 3-mg or 5-mg dose group, and spreading activation was measured both before and after administration. Spreading activation was measured by calculating the average word frequencies for words generated on the controlled oral word association test and the semantic fluency test. RESULTS: A significant main effect for time was found, with the controlled oral word association test average word frequency being significantly higher at baseline than after taking melatonin. Also, a significant group × time interaction was found when using log transformed data. Multiple comparisons indicated that the 3-mg group exhibited significantly greater spreading activation following melatonin than the 5-mg group. The results indicate that melatonin may produce an increase in spreading activation in lexical memory networks. These results potentially provide an explanation for the benefits of melatonin on memory functioning.

Microvasculature of the suspensory ligament of the equine hind limb.

OBJECTIVE: To describe the microvascular anatomy of the equine hind limb suspensory ligament. ANIMALS: 18 hind limbs harvested from 9 adult horses euthanized for reasons unrelated to lameness. METHODS: A catheter was placed in the transected cranial tibial artery at the level of the mid-distal tibia for each hind limb and used to inject 120 to 150 mL of contrast medium (2 limbs) to identify principal vasculature using contrast-enhanced CT or India ink (11 limbs) to identify microvasculature using the Spalteholz tissue-clearing technique. Routine histologic evaluation was performed on transverse sections from 4 hind limbs. RESULTS: The hind limb suspensory ligament is principally supplied by branches of the medial and lateral plantar metatarsal arteries and, to a lesser extent, the medial and lateral plantar arteries as well as the associated proximal and distal deep plantar arches. A uniformly distributed intraligamentous microvascular supply was observed without relative deficiencies in vascularity between the proximal, midbody, and distal regions. Histologic examination supported these findings, demonstrating a network of connective tissue surrounding and entering the suspensory ligament containing cross-sections of branches of the principal vasculature. CLINICAL RELEVANCE: The equine hind limb suspensory ligament has a uniformly distributed and abundant microvascular supply throughout its length, with no evidence of relative deficiency of vascular supply in any region. A region of hypovascularity does not appear to be a viable explanation for the high rate of injury to and commonality of lameness associated with the proximal hind suspensory ligament in horses.

Navicular bone fracture and severe deep digital flexor tendinopathy after palmar digital neurectomy in two horses.

Background: Navicular syndrome is a common cause of forelimb lameness in horses. Beyond changes to the navicular bone itself, horses with a clinical diagnosis of navicular syndrome often have pathology associated with other components of the navicular apparatus, including the navicular bursa, deep digital flexor (DDF) tendon, collateral sesamoidean ligaments, and impar ligament. Palmar digital neurectomy (PDN) is often used as a salvage procedure for horses diagnosed with navicular syndrome that become unresponsive to medical management. There are many potential complications associated with PDN, some of which are debilitating. Case Description: This report describes two cases of navicular bone fracture with severe DDF tendinopathy and distal interphalangeal joint subluxation/hyperextension that occurred 12 and 19 weeks after bilateral forelimb PDN. Conclusion: These two cases highlight the importance of proper patient selection before PDN due to the high incidence of undiagnosed soft tissue pathology in conjunction with radiographic evidence of navicular syndrome. Advanced imaging of the digit is recommended to identify and characterize any soft tissue pathology associated with the navicular apparatus before pursuing PDN to avoid disease progression and catastrophic injury.

Healing time of experimentally induced distal limb wounds in horses is not reduced by local injection of equine-origin liquid amnion allograft.

OBJECTIVE: To assess the efficacy of an equine-origin liquid amnion allograft (ELAA) derived from both amniotic fluid and amniotic membrane on the healing time of experimentally induced distal limb wounds in horses. ANIMALS: 8 adult horses. PROCEDURES: On day 0, horses were anesthetized and a 2.5 X 2.5-cm, full-thickness skin wound was created on the dorsal aspect of each metacarpus and bandaged. On day 9, wound margins were injected with ELAA (treatment) or 0.9% NaCl (control). Bandages were changed at specific intervals through day 91 and, on each occasion, wounds were photographed to allow calculation of wound area. Exuberant granulation tissue was resected, if present. Wounds were deemed healed when completely epithelialized. Mean wound area was compared between groups throughout the study period. RESULTS: Only 1 wound (control) remained unhealed at day 91. No difference was found between the treatment and control groups in either wound area over time (P = 1.0) or time for wounds to reduce in size by 95% (P = .2) Exuberant granulation tissue required resection twice (1 control wound and 1 treatment wound). CLINICAL RELEVANCE: In this model, a single treatment with ELAA administered locally by SC injection did not accelerate distal limb wound healing in horses. However, it is possible that naturally occurring, chronic, or nonhealing wounds would respond differently.

Pharmacokinetic Evaluation of a Cannabidiol Supplement in Horses.

Cannabidiol (CBD) products have gained popularity among horse owners despite limited evidence regarding pharmacokinetics. The purpose of this study was to describe the pharmacokinetic profile of multiple doses of an orally administered cannabidiol product formulated specifically for horses. A randomized 2-way crossover design was used. Seven horses received 0.35 or 2.0 mg/kg CBD per os every 24 hours for 7 total doses, separated by a 2-week washout. Plasma CBD and delta-9-tetrahydrocannabinol (THC) were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS) daily through day 10, then on day 14 after beginning CBD administration. On the final day of CBD administration, plasma CBD and THC were quantified at multiple times. After administration of 0.35 mg/kg of CBD, the Cmax of CBD was 6.6 ± 2.1 ng/mL while Tmax was 1.8 ± 1.2 hour, whereas the Cmax for THC was 0.7 ± 0.6 ng/mL with a Tmax of 2.5 ± 1 hour. After administration of 2.0 mg/kg of CBD, the Cmax of CBD was 51 ± 14 ng/mL with a mean Tmax of 2.4 ± 1.1 hour and terminal phase half-life of 10.4 ± 6 hour, whereas the Cmax of THC was 7.5 ± 2.2 ng/mL with a Tmax of 2.9 ± 1.1 hour. Oral administration of a cannabidiol product at 0.35 mg/kg or 2.0 mg/kg once daily for 7 days was well-tolerated. Based on plasma CBD levels obtained, dose escalation trials in the horse evaluating clinical efficacy at higher mg/kg dose rates are indicated.

Trauma Exposure and PTSD Among Women Receiving Treatment for Intimate Partner Violence Perpetration.

Trauma exposure and posttraumatic stress disorder (PTSD) symptoms have been associated with men's perpetration of intimate partner violence (IPV), but relatively little research has examined these associations among women who perpetrate IPV. This exploratory investigation evaluated the associations among trauma, PTSD symptoms, and IPV perpetration for women and a comparison sample of men. During intake at a community-based Abuse Intervention Program (AIP), women (n = 32) and a demographically similar comparison sample of men (n = 64) completed measures of trauma exposure, PTSD symptoms, physical aggression and emotional abuse perpetration, and use of alcohol and other drugs. The vast majority of women (93.5%) reported traumatic event exposure, and close to half (43.8%) screened positive for a probable PTSD diagnosis. Women's level of PTSD symptoms correlated positively with emotional abuse perpetration, with medium-to-large effect sizes. After controlling for substance use, women's PTSD symptoms were significantly and positively correlated with physical assault and emotional abuse perpetration. Women reported significantly higher rates of exposure to IPV victimization and had significantly higher rates of probable PTSD and PTSD symptoms than did men from the same AIP. Gender did not significantly moderate the associations between PTSD symptoms and IPV perpetration. Overall, findings indicate that trauma exposure and PTSD symptoms are important correlates of women's IPV perpetration. Women in treatment for IPV perpetration may benefit from additional assessment and treatment of trauma and trauma-related symptoms.

Safety and efficacy of cold atmospheric plasma for the sterilization of a Pasteurella multocida-contaminated subcutaneously implanted foreign body in rabbits.

OBJECTIVE: To determine whether a stainless steel implant sterilized with a novel cold atmospheric plasma sterilization (CAPS) device adversely affects local tissues in rabbits and whether CAPS was as effective as steam sterilization with an autoclave to inactivate Pasteurella multocida. ANIMALS: 31 healthy New Zealand White rabbits. PROCEDURES: Steam-autoclaved stainless steel implants inoculated with P multocida underwent a second steam autoclave sterilization (AIA) or CAPS (AICAPS). One AIA implant and 3 AICAPS implants were randomly placed subcutaneously at 4 sites in 21 rabbits (84 implants). These rabbits were monitored daily for 5 days for evidence of systemic illness and local tissue reactions at the implantation sites and then euthanized. Samples were taken from each implant site for bacterial culture and histologic examination. RESULTS: Cultures of samples obtained from all sites were negative for bacterial growth. No significant difference was observed in mean skin thickness or erythema between AIA and AICAPS implant sites on any observed day. Also, individual histologic grades for the epidermis, dermis, subcutis, and muscle and total histologic grade were not significantly different between AIA and AICAPS implant sites. CONCLUSIONS AND CLINICAL RELEVANCE: Cold atmospheric plasma sterilization was noninferior to steam sterilization of P multocida-contaminated stainless steel implants in the rabbits in the present study. However, studies of the efficacy of CAPS for inactivation of other important bacteria are needed.

Relations of Executive Function and Physical Performance in Middle Adulthood: A Prospective Investigation in African American and White Adults.

OBJECTIVES: Previous studies in older adults found robust associations between executive functions (EF) and physical performance, as well as sociodemographic variation in physical performance decline. To examine these associations earlier in the adult lifespan, we investigated relations of EF, race, and sex with age-related physical performance decline during middle adulthood. METHOD: Participants were 2,084 urban-dwelling adults (57.2% female; 57.8% African American; 37.3% living in poverty; mean baseline age = 48.1) from the Healthy Aging in Neighborhoods of Diversity across the Life Span study. Mixed-effects regression was used to examine interactive relations among EF, race, sex, and age (indexing time) with change in dominant and nondominant handgrip strength and lower extremity strength over approximately 5 years. All analyses adjusted for poverty status, and subsequently adjusted for education, body mass index, hypertension, and diabetes. RESULTS: There were no significant prospective associations between EF and decline in physical performance measures. Significant cross-sectional associations revealed that lower EF was associated with worse performance on all physical performance measures averaged across both time points (p < .05). A significant two-way interaction of Sex × Age (p = .019) revealed that men experienced greater age-related decline in lower extremity strength than women. DISCUSSION: Findings did not reveal prospective associations between EF and physical performance decline in middle adulthood. However, they identified robust cross-sectional associations between EF and physical performance, and unexpectedly greater decline in lower extremity strength in men than women. Ultimately, these findings may inform prevention and intervention strategies targeting groups at risk for poorer physical function status and decline.

Microvasculature of the suspensory ligament of the forelimb of horses.

OBJECTIVE: To determine the microvascular anatomy of the suspensory ligament of the forelimb of horses. SAMPLE: 17 cadaveric forelimbs from 9 adult horses with no known history of forelimb lameness. PROCEDURES: The median artery of the forelimb was cannulated proximal to the antebrachiocarpal joint and injected with contrast medium for CT evaluation of the gross vasculature (n = 2) or India ink to evaluate the microvasculature (12). Routine histologic evaluation was performed on an additional 3 forelimbs to confirm the microvascular anatomy. RESULTS: The vascular supply of the suspensory ligament of the forelimb originated from branches of the medial and lateral palmar and palmar metacarpal vessels as well as the proximal and distal deep palmar arches. An abundant, longitudinally oriented microvascular supply was evident throughout the length of the suspensory ligament without distinct variation among the proximal, midbody, and distal regions. The intraligamentous blood supply originated from a periligamentous vascular plexus that surrounded the suspensory ligament throughout its length. Histologic findings indicated the presence of a periligamentous connective tissue plexus, which contained vessels that penetrated and anastomosed with an extensive network of intraligamentous vessels throughout the length of the suspensory ligament. CONCLUSIONS AND CLINICAL RELEVANCE: The suspensory ligament of the equine forelimb had an abundant intraligamentous microvascular supply throughout its entire length. The absence of an obvious hypovascular area suggested that regional variations in healing rates of the suspensory ligament are not associated with the microvascular anatomy.

Immunological functioning in Alzheimer's disease: differential effects of relative left versus right temporoparietal dysfunction.

The cerebral hemispheres are differentially involved in regulating immunological functioning and the neuropathology associated with Alzheimer's disease (AD) is asymmetrical. Thus, subgroups of AD patients may exhibit different patterns of immunological dysfunction. We explored this possibility in a group of AD patients and found that patients with low white blood cell counts and low lymphocyte numbers exhibited better performance on tests of right temporoparietal functioning. Also, a significant positive relationship exists between lymph numbers and performance on a test of left temporoparietal functioning. Thus, some AD patients have greater immunological dysfunction based on relative left versus right temporoparietal functioning.

Assessing trophic interactions in a guild of primary parasitoids and facultative hyperparasitoids: stable isotope analysis.

Facultative hyperparasitism is likely to be the most common form of intraguild predation among parasitoids. However, difficulties associated with studying facultative hyperparasitoids in the field have hampered a thorough understanding of their trophic ecology. In this study, we used a combination of stable isotope analysis and published natural history information to infer trophic interactions in a guild of field-collected primary parasitoids and facultative hyperparasitoids that attack a gall-making midge on Baccharis pilularis. Our three a priori hypotheses were: (1) stable isotope values should increase incrementally from the host plant to higher trophic levels; (2) the two species of ectoparasitoids should exhibit higher stable isotope signatures than the two endoparasitoids, and; (3) the two facultative hyperparasitoids should exhibit stable isotope signatures that fall between zero and one trophic level steps above that observed for the primary parasitoids. Food webs inferred from stable isotope data generally agreed with previously published accounts of community structure. As expected, both delta(13)C and delta(15)N were progressively enriched in the heavy isotope from the host plant to the herbivorous midge to the parasitic wasps. Multivariate analysis of stable isotope data revealed that the two primary ectoparasitoids occupied a similar trophic niche, but were significantly different from the primary endoparasitoids. We attribute this result to "coincidental intraguild predation" by ectoparasitoids that develop on already-parasitized midge larvae. One of the facultative hyperparasitoids, Zatropis capitis, exhibited a stable isotope signature approximately one trophic step above the primary parasitoids. Unexpectedly, the second facultative hyperparasitoid, Mesopolobus sp., appeared to be developing as a primary parasitoid at all sites. Coupled with independent assessments of community structure, stable isotope analysis validated trophic links constructed by previous researchers and identified potential taxon-specific differences in trophic interactions for two facultative hyperparasitoids in the B. pilularis gall community.