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1.
Equine Vet J ; 42(1): 5-9, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20121906

RESUMO

UNLABELLED: Summary Reasons for performing study: Medial meniscal injuries and subchondral cystic lesions (SCL) are known to occur independently within the medial femorotibial (MFT) joint in horses. However, there are no reports of a potential clinical relationship between these 2 types of lesions. OBJECTIVES: To: 1) document the concurrent presence or sequential development of medial meniscal and SCL of the medial femoral condyle within the MFT joint; and 2) determine the prognosis with both types of lesions. METHODS: Retrospective case series of horses with both a medial meniscal and SCL of the medial femoral condyle identified concurrently or sequentially by radiography, arthroscopy or post mortem examination. Case records and radiographs were reviewed, and a telephone survey of referring veterinarians, owners and trainers was conducted. RESULTS: Twenty-one horses (9.1% of all horses undergoing MFT joint arthroscopy) were identified to have both a medial meniscal injury and SCL of the medial femoral condyle. Thirteen horses had both abnormalities identified concurrently, 6 developed a meniscal lesion subsequent to SCL debridement, and 2 developed a SCL subsequent to a medial meniscal injury. Only 4/19 horses were classified as successful and returned to their intended use. The severity of the meniscal injury was significantly associated with the severity of lameness but not with outcome. CONCLUSIONS: A low percentage of horses may develop both a meniscal injury and SCL of the medial femoral condyle within the MFT joint and have a poor prognosis. POTENTIAL RELEVANCE: Trauma to the MFT joint may lead to both meniscal and subchondral bone damage of the medial femoral condyle that may be recognised concurrently or sequentially.


Assuntos
Cartilagem Articular/patologia , Cistos/veterinária , Doenças dos Cavalos/patologia , Joelho de Quadrúpedes/patologia , Animais , Artroscopia/veterinária , Cistos/patologia , Feminino , Cavalos , Masculino , Estudos Retrospectivos
2.
Equine Vet J ; 40(5): 461-7, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18089474

RESUMO

REASONS FOR PERFORMING STUDY: There are no published results of subchondral cystic lesions (SCLs) in the medial femoral condyle (MFC) treated with arthroscopic injection of corticosteroids into the lining of the cyst. OBJECTIVES: 1) To determine the success rate for treatment of SCLs in the MFC with arthroscopic injection of the fibrous tissue of the cyst with corticosteroids. 2) To identify any factors that may predict outcome. HYPOTHESES: Injection of the fibrous tissue of SCLs of the MFC with corticosteroids utilising arthroscopic guidance yields a similar or higher chance for intended performance than does arthroscopic debridement as previously reported; this technique will be effective for treating SCLs in older horses. METHODS: Horses with clinical and radiographic evidence of a SCL in the MFC were injected with corticosteroids under arthroscopic guidance, and case records and radiographs were reviewed retrospectively. A telephone survey of referring veterinarians, owners and trainers was conducted. RESULTS: Thirty-five of 52 (67%) cases were classified as successful involving 73 SCLs of which 56 (77%) were classified as successful. There was no significant association between age group (age3 years) and outcome, or cyst configuration and outcome. Significantly more unilateral SCLs (28/31 [90%] SCLs) were classified as successful than bilateral (28/42: 67%). There were significant differences in outcome based on the surgeon operating the case and an association between pre-existing radiographic findings of osteophytes and negative outcome. CONCLUSIONS: Injection of SCLs utilising arthroscopic guidance is an effective alternative method of surgical treatment of SCL. POTENTIAL RELEVANCE: This technique offers a similar chance of success as has been reported with debridement and may allow for a shorter period of convalescence. If unsuccessful, the option remains to debride the cyst in a second surgery.


Assuntos
Corticosteroides/uso terapêutico , Cistos Ósseos/veterinária , Doenças dos Cavalos/tratamento farmacológico , Injeções Intra-Articulares/veterinária , Corticosteroides/administração & dosagem , Animais , Artroscopia/veterinária , Cistos Ósseos/tratamento farmacológico , Feminino , Fêmur/efeitos dos fármacos , Fêmur/patologia , Membro Anterior , Membro Posterior , Cavalos , Coxeadura Animal/tratamento farmacológico , Masculino , Recuperação de Função Fisiológica , Estudos Retrospectivos , Joelho de Quadrúpedes/efeitos dos fármacos , Joelho de Quadrúpedes/patologia , Fatores de Tempo , Resultado do Tratamento
3.
J Clin Oncol ; 18(3): 519-26, 2000 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-10653867

RESUMO

PURPOSE: To assess, in a multi-institutional setting, the impact on relapse, survival, and toxicity of adding two cycles of intravenous methotrexate to cranial irradiation for immunocompetent patients with primary CNS lymphoma. PATIENTS AND METHODS: Forty-six patients with a median age of 58 years and Eastern Cooperative Oncology Group performance status 0 to 3 were entered onto this phase II study. The protocol consisted of methotrexate 1 g/m(2) on days 1 and 8 followed by cranial irradiation on day 15. A whole-brain dose of 45 Gy was followed by a boost of 5.4 Gy. Intrathecal chemotherapy and spinal irradiation were given only to patients for whom cytologic examination of CSF was positive for CNS lymphoma. The median follow-up time was 36 months, with a minimum potential follow-up of 12 months. RESULTS: Median survival was 33 months, with 2-year probability of survival 62% +/- 15% (95% confidence interval). Twenty patients have relapsed. The predominant site of relapse was the brain. Neither performance status nor age was found to influence survival. Six patients developed a dementing illness at a median of 16 months after treatment, and three of these died as a consequence. CONCLUSION: A brief course of intravenous methotrexate before cranial irradiation is associated with 2-year and median survival rates superior to those reported for radiotherapy alone and similar to more intensive combined-modality regimens. Neurotoxicity remains an important competing risk for these patients.


Assuntos
Antimetabólitos Antineoplásicos/uso terapêutico , Neoplasias do Sistema Nervoso Central/tratamento farmacológico , Neoplasias do Sistema Nervoso Central/radioterapia , Linfoma/tratamento farmacológico , Linfoma/radioterapia , Metotrexato/uso terapêutico , Adulto , Idoso , Antimetabólitos Antineoplásicos/efeitos adversos , Neoplasias do Sistema Nervoso Central/líquido cefalorraquidiano , Neoplasias do Sistema Nervoso Central/patologia , Terapia Combinada , Irradiação Craniana , Feminino , Humanos , Infusões Intravenosas , Linfoma/líquido cefalorraquidiano , Linfoma/patologia , Masculino , Metotrexato/efeitos adversos , Pessoa de Meia-Idade , Cooperação do Paciente , Análise de Sobrevida
5.
Equine Vet J ; 37(3): 227-31, 2005 May.
Artigo em Inglês | MEDLINE | ID: mdl-15892231

RESUMO

REASONS FOR PERFORMING STUDY: Clinical trials in human and veterinary literature have documented the benefits of oral nutraceutical joint supplements containing glucosamine (GU) and chondroitin sulphate (CS) to treat mild to moderate osteoarthritis, but the effects of these components have not yet been conclusively determined. OBJECTIVES: To assess varying dosages of GU and CS on normal and interleukin-1alpha (IL-1) conditioned equine cartilage explants and rationalise the use of these products. HYPOTHESIS: Treatment would not be detrimental to cartilage metabolism and higher dosages and the combination of GU and CS would be more beneficial than lower dosages and. GU or CS alone. METHODS: Articular cartilage explants collected from the femoral trochlea and condyles were cultured in normal and IL-1 conditioned media. Treatment groups included 0, 12.5, 25,125 and 250 microg/ml concentrations of GU alone, CS alone, or GU+CS in combination. Glycosaminoglycan (GAG) synthesis and total GAG content in the explants and media were analysed. RESULTS: There were no detrimental effects of GU, CS or GU+CS on cartilage metabolism. High dosages of GU+CS reduced total GAG release into the media (degradation). CONCLUSIONS: Our results suggests that GU+CS may prevent cartilage GAG degradation. POTENTIAL RELEVANCE: The combination of GU and CS may be more effective in preventing or treating osteoarthritis in horses than either product alone.


Assuntos
Cartilagem Articular/efeitos dos fármacos , Sulfatos de Condroitina/farmacologia , Glucosamina/farmacologia , Interleucina-1/farmacologia , Animais , Cartilagem Articular/metabolismo , Sulfatos de Condroitina/uso terapêutico , Meios de Cultura , Relação Dose-Resposta a Droga , Sinergismo Farmacológico , Glucosamina/uso terapêutico , Glicosaminoglicanos/metabolismo , Doenças dos Cavalos/tratamento farmacológico , Doenças dos Cavalos/imunologia , Cavalos , Interleucina-1/fisiologia , Osteoartrite/tratamento farmacológico , Osteoartrite/imunologia , Osteoartrite/veterinária , Distribuição Aleatória , Proteínas Recombinantes/farmacologia , Técnicas de Cultura de Tecidos/veterinária , Resultado do Tratamento
6.
Radiother Oncol ; 39(1): 1-7, 1996 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-8735487

RESUMO

PURPOSE: To review the Australasian results of Stage I and IIA Infradiaphragmatic Hodgkin's Disease (IHD) treated solely by irradiation. METHODS AND MATERIALS: Eligible patients had IHD only and were treated by irradiation with curative intent over the period of 1969 to 1988. Ten radiation oncology centres from within Australia and New Zealand were surveyed for patient, tumour and treatment variables. Disease free rates, survival and complications were analysed. RESULTS: 106 patients with IHD were studied. The average potential follow up was 9.4 years. The male to female ratio was 3.3:1. The median age was 37.5 years. Histological subgroups were as follows; lymphocyte predominant 43%, mixed cellularity 21%, lymphocyte depleted 5%, nodular sclerosing 27% and unclassifiable 4%. Fifty nine patients had laparotomy of which 22 (37%) were positive for tumour. Nine laparotomies were performed for diagnosis and the remainder for staging. One patient was up-staged by laparotomy and three were down-staged. Sixty-eight patients presented with inguinal disease alone, five with abdominal disease alone, 19 with two sites of involvement and 12 with inguinal, pelvic and abdominal disease. In two patients the site was unknown. There was no correlation between site of involvement, age, sex or histological subtype. Forty seven cases were clinically staged (CS) as follows: CS IA-23, CS IIA-24. The other 59 were pathologically staged (PS) as follows: PS IA-37, PS IB-1, PS IIA-21. Treatment consisted of involved field alone (16), inverted Y (68), inverted Y and spleen (13), para-aortic irradiation only (3), or total nodal irradiation (6). Mean dose was 37 Gy. There were 30 recurrences to give an acturial 10-year disease-free rate of 70%. In multivariate analysis lower number of tumour sites, lymphocyte predominant histology and higher dose were all significantly correlated with higher disease free rates. Eight patients died of Hodgkin's disease and 19 of other causes. The 10-year overall survival rate was 71%. Older age and higher number of disease sites were significantly correlated with shorter survival. Fourteen of 30 relapses may have been avoidable by the use of total nodal irradiation. In particular ten of 21 patients with abdominal disease relapsed in nodal sites which would have been covered by total nodal irradiation. CONCLUSIONS: The rate of control in IHD could perhaps be improved by avoiding involved field irradiation or by aggressive therapy with total nodal irradiation or combined modality chemo-irradiation in Stage II disease. Staging laparotomy does not appear to be indicated.


Assuntos
Neoplasias Abdominais/radioterapia , Doença de Hodgkin/radioterapia , Neoplasias Abdominais/patologia , Análise Atuarial , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Austrália , Criança , Terapia Combinada , Intervalo Livre de Doença , Feminino , Seguimentos , Doença de Hodgkin/patologia , Humanos , Laparotomia , Irradiação Linfática , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Nova Zelândia , Dosagem Radioterapêutica , Terapia de Salvação , Taxa de Sobrevida
7.
Altern Ther Health Med ; 6(4): 62-8, 2000 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10895515

RESUMO

In this article, sources of error that are likely involved when alternative medical traditions are assessed from the standpoint of orthodox biomedicine are discussed. These sources include (1) biomedicine's implicit reductive materialism (manifested in its negative orientation toward placebo effects), (2) a related bias against ritual, and (3) cultural barriers to the construction of externally valid protocols. To overcome these biases, investigators must attend to ritualistic elements in alternative treatments and should recruit patients from appropriate cultural groups. Collaborative research may be the key. Benefits of collaborative research include (1) increased mutual respect and integration between culturally distinct groups and practices, (2) increased understanding and use of sophisticated techniques of empirical analysis among practitioners from the alternative traditions, (3) increased appropriation of the therapeutic benefits of ritual, and (4) enhanced overall benefit for patients of all cultural backgrounds.


Assuntos
Terapias Complementares , Cultura , Ética , Humanos
8.
Equine Vet J ; 23(3): 215-8, 1991 May.
Artigo em Inglês | MEDLINE | ID: mdl-1884705

RESUMO

The anatomical and functional communications of the synovial sacs of the equine stifle joint were evaluated in 50 stifle joints of 25 horses. Femoropatellar joint (FPJ) sacs were injected with 50 ml of gelatin-based dye and horses were then walked for 50 m. Horses were subsequently killed, the stifle joints dissected and the location of the dye recorded. Twenty-three horses (46 joints) had clinically normal stifle joints and in this group, anatomical communications of the stifle joints were bilaterally symmetrical in each horse. In 15 of these 23 horses (65 per cent), direct anatomical communication between the FPJ sac and the medial sac of the femorotibial joint (FTJ) was demonstrated. The FPJ sac communicated with both the medial and lateral sacs of the FTJ in four of these 23 horses (17.5 per cent). There were no anatomical communications between the FPJ sac and either sac of the FTJ in the remaining four horses (17.5 per cent). Functional communication, which was established by finding dye in the FTJ sacs were anatomical communication with the FPJ sac existed, was demonstrated in 14 of 19 horses (74 per cent). Two horses were affected with degenerative joint disease of one stifle joint. In both of these joints the FPJ sac communicated with both the medial and lateral FTJ sacs. This distribution was different from that of the contralateral joint. When performing intra-articular anaesthesia of equine stifle joints, each synovial sac needs to be injected separately to ensure that anaesthesia of the appropriate synovial sac is obtained.


Assuntos
Cavalos/anatomia & histologia , Joelho de Quadrúpedes/anatomia & histologia , Membrana Sinovial/anatomia & histologia , Animais , Feminino , Doenças dos Cavalos/patologia , Doenças dos Cavalos/fisiopatologia , Cavalos/fisiologia , Artropatias/patologia , Artropatias/fisiopatologia , Artropatias/veterinária , Masculino , Joelho de Quadrúpedes/fisiologia , Membrana Sinovial/fisiologia
9.
Equine Vet J ; 24(6): 419-23, 1992 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-1459053

RESUMO

Arthroscopic surgery for the treatment of osteochondritis dissecans was undertaken on 252 femoropatellar joints in 161 horses (82 Thoroughbreds, 39 Quarter Horses, 16 Arabians, 9 Warmbloods and 15 others of various breeds). There were 53 females and 108 males. Twenty-two horses were 1 year of age at the time of surgery, 68 were yearlings, 36 were 2-year-olds, 21 were 3-year-olds, and 14 were > or = 4 years old. Ninety-one had bilateral involvement and 70 had unilateral disease. Follow-up information was obtained on 134 horses, including 79 racehorses and 55 non-racehorses: 86 (64%) of these 134 horses returned to their intended use, 9 (7%) were in training, 21 (16%) were unsuccessful and 18 (13%) were unsuccessful due to other defined reasons. Horses with Grade I lesions (< 2 cm in length) had a significantly higher success rate (78%) than did horses with Grade 2 (2-4 cm) or Grade 3 (> 4 cm) lesions (63% and 54% success rates respectively). A significantly higher success rate was also noted for horses operated on as 3-year-olds compared with the remainder of the study population. A significantly lower success rate was noted for yearlings than for the remainder of the population. There was no significant difference in outcome as related to sex of animal involved, racehorse versus non-racehorse, lesion location, unilateral versus bilateral involvement, presence or absence of patellar or trochlear groove lesions, or presence or absence of loose bodies.


Assuntos
Doenças dos Cavalos/cirurgia , Osteocondrite Dissecante/veterinária , Joelho de Quadrúpedes/cirurgia , Animais , Artroscopia/veterinária , Distribuição de Qui-Quadrado , Feminino , Seguimentos , Doenças dos Cavalos/diagnóstico por imagem , Cavalos , Masculino , Osteocondrite Dissecante/diagnóstico por imagem , Osteocondrite Dissecante/cirurgia , Radiografia , Joelho de Quadrúpedes/diagnóstico por imagem , Resultado do Tratamento
10.
Equine Vet J ; 35(5): 444-50, 2003 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12875321

RESUMO

REASONS FOR PERFORMING STUDY: Osteoarthritis is a frequent sequela of joint disease, especially with severe injuries or if attempts at therapy are unsuccessful. Negative and positive effects of corticosteroid treatment of articular cartilage have been demonstrated by in vitro and in vivo studies. OBJECTIVES: To assess the metabolic effects of varying dosages of methylprednisolone acetate (MPA) and triamcinolone acetonide (TA) on interleukin-1alpha (IL-1) conditioned equine cartilage explants. Our hypothesis was that lower dosages of corticosteroids would be less detrimental to cartilage metabolism than higher dosages. TA would be less detrimental to cartilage metabolism than MPA. METHODS: Treatment groups included articular cartilage explants with no IL-1 (control), IL-1 alone, and IL-1 plus 10, 5, 1 and 0.5 mg/ml MPA or 1.2, 0.6, 0.12 and 0.06 mg/ml TA. Explants were labelled with 35SO4 prior to the beginning and end of the experiment to assess glycosaminoglycan (GAG) degradation and synthesis, respectively. Total GAG content in media and explants and total cartilage DNA were also analysed. RESULTS: MPA and TA reduced GAG synthesis compared to control and IL-1 alone. The highest dosage of MPA (10 mg/ml) reduced GAG synthesis less than lower dosages of MPA and all dosages of TA. Compared to IL-1 alone, all dosages of TA and lower dosages of MPA increased GAG degradation. MPA at 10 mg/ml reduced GAG degradation. Both MPA and TA increased media GAG content compared to control and IL-1 explants. Total cartilage GAGs were unchanged with MPA, but reduced with TA, compared with IL-1 alone. Total cartilage DNA was decreased with MPA and increased with TA compared to IL-1 and control explants. CONCLUSIONS: MPA and TA did not counteract the negative effects of IL-1 and did not maintain cartilage metabolism at control levels. Lower dosages of MPA and TA were not less detrimental to cartilage metabolism than higher dosages. TA did not appear to be less harmful than MPA on cartilage metabolism. The results of this study differ from the findings of comparable in vivo studies. POTENTIAL RELEVANCE: The low numbers of horses used in this study limits extrapolation of these findings to the equine population; however, this study also questions the clinical relevance of this in vitro model.


Assuntos
Anti-Inflamatórios/farmacologia , Cartilagem Articular/efeitos dos fármacos , Glicosaminoglicanos/metabolismo , Interleucina-1/metabolismo , Metilprednisolona/análogos & derivados , Metilprednisolona/farmacologia , Triancinolona Acetonida/farmacologia , Animais , Cartilagem Articular/metabolismo , Técnicas de Cultura , DNA/metabolismo , Relação Dose-Resposta a Droga , Glicosaminoglicanos/análise , Doenças dos Cavalos/tratamento farmacológico , Cavalos , Masculino , Acetato de Metilprednisolona , Osteoartrite/tratamento farmacológico , Osteoartrite/veterinária
11.
Equine Vet J ; 30(1): 66-71, 1998 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9458401

RESUMO

To determine the effects of osteochondral fragmentation and intra-articular corticosteroid treatment on dynamics of bone remodelling and fragility, 12 horses each had a unilateral, 8 mm osteochondral fragment created in the distal aspect of one radiocarpal bone. Six of the horses were treated in the fragmented joint, and the other 6 were treated in the nonfragmented joint with 12 mg of triamcinolone acetonide (TA) 14 and 28 days after surgery. All horses were exercised on a high-speed treadmill starting 15 days, and ending 72 days after surgery. Horses treated with TA in the fragmented joints were significantly less lame than those treated in the nonfragmented joints. Third carpal bones from joints with fragments showed significantly more vascularity, single labelled surface, total labelled surface and mineralising surface in subchondral and subjacent trabecular bone. Trends were also seen towards higher vascular canal volume and osteochondral junction remodelling sites in third carpal bones from fragmented joints. No significant differences were seen in microdamage density or size between fragmented and nonfragmented joints. No significant influence of TA treatment was seen on any parameter measured. The results from this study show that osteochondral fragmentation induces significant changes in remodelling of opposing bones, and that the administration of corticosteroids into joints with fragmentation does not significantly alter bone remodelling or fragility.


Assuntos
Anti-Inflamatórios/farmacologia , Ossos do Carpo/lesões , Carpo Animal/efeitos dos fármacos , Fraturas Ósseas/veterinária , Cavalos/lesões , Cavalos/fisiologia , Triancinolona Acetonida/farmacologia , Animais , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Desenvolvimento Ósseo/efeitos dos fármacos , Desenvolvimento Ósseo/fisiologia , Remodelação Óssea/efeitos dos fármacos , Remodelação Óssea/fisiologia , Carpo Animal/irrigação sanguínea , Carpo Animal/patologia , Teste de Esforço/métodos , Teste de Esforço/veterinária , Fraturas Ósseas/tratamento farmacológico , Fraturas Ósseas/fisiopatologia , Injeções Intra-Articulares/veterinária , Coxeadura Animal/etiologia , Coxeadura Animal/fisiopatologia , Coxeadura Animal/prevenção & controle , Triancinolona Acetonida/administração & dosagem , Triancinolona Acetonida/uso terapêutico
12.
Equine Vet J ; 23(6): 422-5, 1991 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-1778158

RESUMO

Fifty-five horses were presented to Colorado State University Veterinary Teaching Hospital between 1st of January 1980 and 31st of December 1989 for treatment of distal limb lacerations involving flexor tendons (n = 35) or extensor tendons (n = 20). Of the 35 flexor tendon lacerations, 11 horses were killed without treatment and 24 horses were treated. Twenty-two horses were included in determining outcome. Four (18 per cent) returned to their original level of use, nine (41 per cent) returned to limited riding, seven (32 per cent) returned to breeding or pasture soundness and two (9 per cent) were killed. Eighteen of the 20 horses with extensor tendon lacerations underwent treatment and 15 had sufficient follow-up to determine outcome. Seven (47 per cent) returned to their original or intended use, five (33 per cent) returned to limited use, one (7 per cent) was used for breeding and two (13 per cent) were killed. Results for horses with extensor tendon lacerations support previous reports that these injuries can be treated successfully. Results for horses having flexor tendon lacerations were better than in previous reports.


Assuntos
Cavalos/lesões , Traumatismos dos Tendões/veterinária , Animais , Extremidades , Feminino , Seguimentos , Masculino , Prognóstico , Estudos Retrospectivos , Técnicas de Sutura/veterinária , Traumatismos dos Tendões/cirurgia , Traumatismos dos Tendões/terapia , Resultado do Tratamento
13.
Equine Vet J ; 29(5): 349-59, 1997 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9306060

RESUMO

The objective of this study was to determine the effects of intra-articularly administered triamcinolone acetonide (TA) in exercised equine athletes with carpal osteochondral fragmentation. Eighteen horses were randomly assigned to each of 3 groups. An osteochondral chip fragment was created in one randomly chosen intercarpal joint of each horse. Both intercarpal joints in the placebo control group (CNT) horses were injected with intra-articular administration (IA) of polyionic fluid. Both joints in the TA control group (TA CNT) horses were treated with 12 mg of TA in the intercarpal joint without an osteochondral fragment, and the opposite intercarpal joint was injected with a similar volume of polyionic fluid. The TA treated group (TA TX) horses were treated with 12 mg of TA in the joint that contained the osteochondral fragment and the opposite intercarpal joint was injected with a similar volume of polyionic fluid. All horses were treated IA on days 13 and 27 after surgery and exercised on a high speed treadmill for 6 weeks starting on Day 14. Horses in the TA TX group were significantly less lame than horses in the CNT and TA CNT groups. Horses in either TA CNT or TA TX groups had lower total protein, and higher hyaluronan, and glycosaminoglycan concentrations in synovial fluid than did those in the CNT group. Synovial membrane collected from subjects in TA CNT and TA TX groups had significantly less inflammatory cell infiltration, subintimal hyperplasia and subintimal fibrosis compared to the CNT group. Articular cartilage histomorphological parameters were significantly better from the TA CNT and TA TX groups compared to the CNT group. In conclusions, results from this study support favourable effects of TA on degree of clinically detectable lameness, and on synovial fluid, synovial membrane, and articular cartilage morphological parameters, both with direct intra-articular administration and remote site administration as compared to placebo treatment. The clinical use of IA administered TA in horses may be therapeutically beneficial in selected cases of osteochondral fragmentation and osteoarthritis.


Assuntos
Anti-Inflamatórios/farmacologia , Cartilagem Articular/efeitos dos fármacos , Cartilagem Articular/lesões , Cavalos/lesões , Condicionamento Físico Animal/efeitos adversos , Líquido Sinovial/efeitos dos fármacos , Triancinolona Acetonida/farmacologia , Animais , Anti-Inflamatórios/administração & dosagem , Doenças das Cartilagens/tratamento farmacológico , Doenças das Cartilagens/etiologia , Doenças das Cartilagens/veterinária , Cartilagem Articular/química , Glicosaminoglicanos/análise , Glicosaminoglicanos/metabolismo , Doenças dos Cavalos/tratamento farmacológico , Doenças dos Cavalos/etiologia , Doenças dos Cavalos/metabolismo , Cavalos/metabolismo , Cavalos/fisiologia , Ácido Hialurônico/análise , Ácido Hialurônico/metabolismo , Hiperplasia/tratamento farmacológico , Hiperplasia/etiologia , Hiperplasia/veterinária , Injeções Intra-Articulares/métodos , Injeções Intra-Articulares/veterinária , Condicionamento Físico Animal/fisiologia , Líquido Sinovial/química , Líquido Sinovial/metabolismo , Membrana Sinovial/química , Membrana Sinovial/efeitos dos fármacos , Membrana Sinovial/metabolismo , Triancinolona Acetonida/administração & dosagem
14.
Can J Vet Res ; 53(2): 224-30, 1989 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-2469533

RESUMO

The effect of intramuscular polysulfated glycosaminoglycan (PSG) on repair of cartilage injury was evaluated in eight horses. In each horse, one middle carpal joint had both a partial-thickness and a full-thickness articular cartilage defect created. In the contralateral middle carpal joint, chemical articular cartilage injury was created by intra-articular injection of 50 mg sodium monoiodoacetate (MIA). Horses were divided into two groups for treatment. Group 1 horses (control) received an intramuscular injection of normal saline every four days for a total of seven injections starting seven days after cartilage injury. Group 2 horses received 500 mg of PSG intramuscularly every four days for seven treatments starting seven days after cartilage injury. Horses were maintained for 12 weeks. Horses were evaluated clinically, and their middle carpal joints were evaluated radiographically and arthroscopically at the end of the study. Joint tissues were also collected and examined microscopically. The only significant difference between groups was slightly greater matrix staining intensity for glycosaminoglycans in the radiate articular cartilage layer in MIA injected and PSG treated joints. Partial-thickness defects had not healed and the predominant repair tissue in full-thickness defects was fibrous tissue. It was concluded that using this joint injury model, 500 mg PSG administered intramuscularly had no effect on the healing of articular cartilage lesions, and minimal chondroprotective effect from chemically induced articular cartilage degeneration.


Assuntos
Doenças das Cartilagens/veterinária , Cartilagem Articular/lesões , Doenças do Pé/veterinária , Glicosaminoglicanos/uso terapêutico , Doenças dos Cavalos/tratamento farmacológico , Animais , Ossos do Carpo/lesões , Ossos do Carpo/patologia , Doenças das Cartilagens/induzido quimicamente , Doenças das Cartilagens/tratamento farmacológico , Doenças do Pé/induzido quimicamente , Doenças do Pé/tratamento farmacológico , Doenças do Pé/patologia , Doenças dos Cavalos/induzido quimicamente , Doenças dos Cavalos/patologia , Cavalos/lesões , Iodoacetatos , Ácido Iodoacético , Coloração e Rotulagem
15.
J Emerg Med ; 16(2): 227-34, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9543408

RESUMO

This essay examines the nature of service in medicine and the relationship between service and profit. "Customer service medicine" is identified with the interrelated views that 1) profit is or ought to be healthcare's fundamental concern and 2) the quality of medical service corresponds to the degree to which it produces a feeling of approval in patients. This position is contrasted with the more traditional "beneficence model," which holds that 1) service ought to be healthcare's fundamental concern and 2) the proper criterion of quality medical service is the alleviation, mitigation, or prevention of the human suffering that occasions illness. Five shortcomings in the customer service model are identified: 1) customer service advocates often appeal to an unsound "efficiency argument"; 2) the prioritization of profit over service will vitiate patients' legitimate trust in healthcare; 3) the prioritization of profit converts medicine from a "practice" into an "instrumental activity"; 4) the prioritization of profit countervails the values of continuity and thoroughness; and 5) the notion of service as customer satisfaction derives more from the exigencies of turning a profit than from an analysis of sick persons' needs.


Assuntos
Economia Médica , Satisfação do Paciente/economia , Relações Médico-Paciente , Qualidade da Assistência à Saúde/economia , Continuidade da Assistência ao Paciente , Ética Médica , Prioridades em Saúde , Humanos , Modelos Teóricos , Objetivos Organizacionais , Estados Unidos
16.
Am J Vet Res ; 52(2): 317-27, 1991 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-2012344

RESUMO

The use of periosteal autografts to resurface osteochondral defects was investigated in 10 horses (2 to 3 years old), and the repair tissue was characterized morphologically. Middle carpal joint arthrotomies were made, and osteochondral defects were induced bilaterally on the distal articular surface of each radial carpal bone. Each defect measured approximately 1 cm2 and extended 3 mm into the subchondral bone plate. Residual subchondral bone plate of control and principal defects was perforated by drilling. A sterile fibrin adhesive was made by mixing a fibrinogen component and a thrombin component. A periosteal autograft was harvested from the proximal portion of the tibia and was glued onto the recipient osseous surface, with its cambium facing the joint cavity. Control defects were glued, but not grafted. Horses were walked 1 hour daily on a walker, starting at postoperative week 7 and continuing for 9 weeks. Sixteen weeks after the grafting procedure was done, carpal radiography was performed, after which horses were euthanatized. Quality of repair tissue of control and grafted defects was evaluated and compared grossly, histologically, and histochemically. Using a reticule, the proportions of various repair tissue types filling each defect were quantitated. Seven weeks after the grafting procedure was done, bilateral arthroscopy revealed synovial adhesions and marginal pannus formation in control and grafted defects. None of the autografts was found floating unattached within the respective middle carpal joints. At 16 weeks, the gross appearance of most grafted and nongrafted defects was similar, and repair was dominated by a fibrous pannus. In 4 grafted defects, bone had formed either concentrically within the defect or eccentrically in the fibrous adhesions between the defect and the joint margin. Histologically, all grafted and nongrafted defects were repaired similarly by infiltration of a mixture of fibrous tissue, fibrocartilage, and bone. Fibrous tissue was the predominant tissue in most defects and its mean proportion was 56 and 59% in the grafted and nongrafted defects, respectively. Fibrocartilaginous tissue in the deeper layers approximated 20%, and woven bone at the base of the defect was 20% in all defects. Histochemically, difference in staining for proteoglycans was not observed between grafted and nongrafted defects. Little remaining original periosteal graft tissue was evident at the defect sites. The only distinguishing feature of grafted defects was the presence of islands of bone formation either at the defect site (n = 2 horses), or in somewhat dorsally displaced tissue that was incorporated in fibrous adhesions (n = 2 horses).(ABSTRACT TRUNCATED AT 400 WORDS)


Assuntos
Ossos do Carpo/cirurgia , Cartilagem/lesões , Cavalos/cirurgia , Periósteo/transplante , Transplante Autólogo/veterinária , Animais , Cicatrização
17.
Am J Vet Res ; 61(4): 436-41, 2000 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10772110

RESUMO

OBJECTIVE: To determine response of interleukin-1alpha (IL-1alpha)-conditioned equine articular cartilage explants to insulin-like growth factor-1 (IGF-1). Sample Population-Cartilage from the trochlea and condyles of the femur of a clinically normal 4-year-old horse. PROCEDURE: Effects of IGF-1 (0 to 500 ng/ml) after addition of IL-1alpha were evaluated by assessing matrix responses, using a sulfated glycosaminoglycan (GAG) assay, matrix 35SO4 GAG incorporation, and release of GAG. Mitogenic response was assessed by 3H-thymidine incorporation into DNA and fluorometric assay of total DNA concentration. RESULTS: Human recombinant IL-1alpha (40 ng/ml) increased the amount of labeled GAG released and decreased labeled and total GAG remaining in explants, and IL-1alpha decreased mitogenic response. Addition of IGF-1 counteracted effects seen with IL-1alpha alone. In general, IGF-1 decreased total and labeled GAG released into the medium, compared with IL-1alpha-treated explants (positive-control sample). Values for these variables did not differ significantly from those for negative-control explants. A significant increase in total and newly synthesized GAG in the explants at termination of the experiment was observed with 500 ng of IGF-1/ml. Labeled GAG remaining in explants was greater with treatment at 50 ng of IGF-1/ml, compared with treatment with IL-1alpha alone. Concentrations of 200 ng of IGF-1/ml abolished actions of IL-1alpha and restored DNA synthesis to values similar to those of negative-control explants. CONCLUSIONS AND CLINICAL RELEVANCE: IGF-1 at 500 ng/ml was best at overcoming detrimental effects associated with IL-1alpha in in vitro explants. These beneficial effects may be useful in horses with osteoarthritis.


Assuntos
Cartilagem/efeitos dos fármacos , Fator de Crescimento Insulin-Like I/metabolismo , Interleucina-1/farmacologia , Mitose/efeitos dos fármacos , Animais , Cartilagem/metabolismo , Meios de Cultura , Técnicas de Cultura , Replicação do DNA/efeitos dos fármacos , Glicosaminoglicanos/metabolismo , Cavalos/metabolismo , Humanos , Proteínas Recombinantes/farmacologia
18.
Am J Vet Res ; 53(11): 2094-101, 1992 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-1466506

RESUMO

A sample of testicular parenchymal tissue, approximately 2 x 7 x 7 mm, was aseptically removed from 1 testis in each of 9 stallions on day 0. Slight to moderate hemorrhage from the tunica albuginea was observed in 8 stallions, but bleeding from the parenchyma was detected in only 2 stallions. Stallions were castrated 27 days later. Normal development of granulation tissue was evident at the biopsy site, but hematomas were not observed. In situ measurement of the widths of the right and left testes, total scrotal width, and evaluation of testicular echogenicity during ultrasonography were variables used to monitor changes in the testicular parenchyma from 14 days before biopsy through 27 days after biopsy. The control testis was consistently larger than the biopsied testis, except for day 3. Ultrasonography revealed signs of a localized change in the parenchyma of the biopsied testis in 4 stallions, but each lesion decreased in size by day 27. Tissues removed during biopsy enabled an excellent appraisal of spermatogenesis at that time. Detailed examinations of seminiferous tubules in the testes were performed to assess for damage to testicular function. At castration, samples were taken from 6 sites in each testis. Quantitative histologic evaluations of testicular tissues revealed low numbers of spherical spermatids and pachytene spermatocytes in biopsied testes, compared with control testes. It was concluded that there was a transitory increase in degeneration of preleptotene spermatocytes and B spermatogonia at the time of biopsy. A mild inflammatory response at the biopsy site in some testes was evidenced by an increased number of leukocytes at the biopsy site and at a dorsal site.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Cavalos/anatomia & histologia , Testículo/patologia , Animais , Biópsia/efeitos adversos , Biópsia/veterinária , Masculino , Testículo/diagnóstico por imagem , Testículo/lesões , Ultrassonografia
19.
Am J Vet Res ; 59(6): 704-11, 1998 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-9622738

RESUMO

OBJECTIVES: To clone equine interleukin 1 alpha (IL-1 alpha) and equine interleukin 1 beta (IL-1 beta) and determine their full-length cDNA sequences. PROCEDURES: The mRNA isolated from lipopolysaccharide-stimulated cultured equine monocytes was reverse transcribed, and a cDNA library was constructed in a lambda phage. The cDNA library was screened by means of plaque hybridization with radiolabeled human IL-1 alpha and IL-1 beta cDNA probes. The cDNA nucleotide sequences for equine IL-1 alpha and equine IL-1 beta were determined by use of the dideoxy chain termination technique. The cDNA sequences were analyzed, using computer software, for sequence characteristics and compared with sequences reported for other species. RESULTS: The cDNA for equine IL-1 alpha was 1,728 base pairs in length with an ORF encoding a peptide of 270 amino acids with a predicted molecular mass of 30.823 kd. The cDNA for equine IL-1 beta was 1,473 base pairs in length with an ORF encoding a peptide of 268 amino acids with a predicted molecular mass of 30.342 kd. Similarity between amino acid sequence of equine IL-1 alpha and sequences for IL-1 alpha of other species ranged from 62.5 to 82.2%; similarity between amino acid sequence of equine IL-1 beta and sequences for IL-1 beta of other species ranged from 62.5 to 82.2%; similarity between amino acid sequences of equine IL-1 alpha and equine IL-1 beta was 26%. CONCLUSIONS AND CLINICAL RELEVANCE: Results establish a basis for studying the roles of interleukin 1 in healthy and diseased joints in horses.


Assuntos
DNA Complementar/química , Interleucina-1/biossíntese , Leucócitos Mononucleares/imunologia , Sequência de Aminoácidos , Animais , Sequência de Bases , Bovinos , Células Cultivadas , Clonagem Molecular , Biblioteca Gênica , Cavalos , Humanos , Interleucina-1/química , Interleucina-1/genética , Leucócitos Mononucleares/efeitos dos fármacos , Lipopolissacarídeos/farmacologia , Camundongos , Dados de Sequência Molecular , Ratos , Proteínas Recombinantes/biossíntese , Proteínas Recombinantes/química , Alinhamento de Sequência , Homologia de Sequência de Aminoácidos , Ovinos , Suínos
20.
Am J Vet Res ; 59(6): 712-6, 1998 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-9622739

RESUMO

OBJECTIVES: To clone equine interleukin 1 receptor antagonist (IL-1ra) and determine its full-length cDNA sequence. PROCEDURE: A cDNA library derived from lipopolysaccharide-stimulated equine monocytes was screened by means of plaque hybridization to radiolabeled equine IL-1ra DNA probes generated by means of the polymerase chain reaction. The cDNA nucleotide sequence for equine IL-1ra was determined by use of the dideoxy chain termination technique, analyzed by use of computer software for sequence characteristics, and compared with sequences reported for IL-1ra of other species. RESULTS: The cDNA of equine IL-1ra was 1,614 base pairs in length with an ORF encoding a peptide of 177 amino acids with a predicted molecular mass of 20.427 kd. Similarity between the amino acid sequence of equine IL-1ra and sequences for human, murine, rat, and lapine IL-1ra was 76%. Similarity between sequence for equine IL-1ra and sequences for equine interleukin-1 alpha and equine interleukin-1 beta were 22.6 and 24.6%, respectively. CONCLUSION: Comparison of the sequence for equine IL-1ra with sequences for IL-1ra of other species indicated a high degree of conservation. CLINICAL RELEVANCE: Results establish a basis for studying the roles of interleukin-1 in healthy and diseased joints in horses.


Assuntos
Sialoglicoproteínas/biossíntese , Sequência de Aminoácidos , Animais , Sequência de Bases , Clonagem Molecular , Sondas de DNA , DNA Complementar , Biblioteca Gênica , Cavalos , Humanos , Proteína Antagonista do Receptor de Interleucina 1 , Camundongos , Dados de Sequência Molecular , Monócitos/imunologia , Reação em Cadeia da Polimerase , Coelhos , Ratos , Receptores de Interleucina-1/antagonistas & inibidores , Proteínas Recombinantes/biossíntese , Proteínas Recombinantes/química , Alinhamento de Sequência , Homologia de Sequência de Aminoácidos , Sialoglicoproteínas/química
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