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Canine congenital extrahepatic portosystemic shunt (EHPSS) morphologies have not been fully elucidated. The goal of this retrospective, multi-institutional study was to use CT angiography to create an anatomical-based nomenclature system for canine congenital EHPSS. These shunt morphologies were then evaluated to identify any significant association with patient age, sex, breed, weight, or subjective portal perfusion score. Data collected respectively from the SVSTS and VIRIES list-serves included patient DOB, sex, breed, weight, CT date, and reported diagnosis. A single author (C.W.) viewed all CT scans and classified shunts based on the shunt portal vessel(s) of origin, the shunt systemic vessel(s) of insertion, and any substantial portal vessels contributing to the shunt. Additionally, hepatic portal perfusion was subjectively scored between one (poor/none) and five (good/normal) based on the caliber of the intrahepatic portal veins. A total of 1182 CT scans were submitted from 13 different institutions. Due to exclusion criteria, 100 (8.5%) were removed, leaving 1082 CT scans to be included. Forty-five different EHPSS anatomies were identified with five classifications accounting for 85% of all shunts (left gastric-phrenic [27%], left gastric-azygos [19%], left gastric-caval [15%], aberrant left gastric-caval with right gastric vein [12%], and aberrant left gastric-caval with right gastric vein and short gastric vein [11%]). Shunt origin involved the left gastric vein in 95% of the described classifications. Significant differences were identified among the five most common shunt types with respect to age at the time of the CT scan (P < .001), sex (P = .009), breed (P < .001), weight (P < .001), and subjective portal perfusion score (P < .001). An anatomical classification system for canine EHPSS may enable improved understanding, treatment comparisons, and outcome prediction for these patients.
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Introduction: Bone tumors, characterized by diverse locations and shapes, often necessitate surgical excision followed by custom implant placement to facilitate targeted bone reconstruction. Leveraging additive manufacturing, patient-specific implants can be precisely tailored with complex geometries and desired stiffness, enhancing their suitability for bone ingrowth. Methods: In this work, a finite element model is employed to assess patient-specific lattice implants in femur bones. Our model is validated using experimental data obtained from an animal study (n = 9). Results: The results demonstrate the accuracy of the proposed finite element model in predicting the implant mechanical behavior. The model was used to investigate the influence of reducing the elastic modulus of a solid Ti6Al4V implant by tenfold, revealing that such a reduction had no significant impact on bone behavior under maximum compression and torsion loading. This finding suggests a potential avenue for reducing the endoprosthesis modulus without compromising bone integrity. Discussion: Our research suggests that employing fully lattice implants not only facilitates bone ingrowth but also has the potential to reduce overall implant stiffness. This reduction is crucial in preventing significant bone remodeling associated with stress shielding, a challenge often associated with the high stiffness of fully solid implants. The study highlights the mechanical benefits of utilizing lattice structures in implant design for enhanced patient outcomes.
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Introduction: Stress shielding is a common complication following endoprosthetic reconstruction surgery. The resulting periprosthetic osteopenia often manifests as catastrophic fractures and can significantly limit future treatment options. It has been long known that bone plates with lower elastic moduli are key to reducing the risk of stress shielding in orthopedics. Inclusion of open space lattices in metal endoprostheses is believed to reduce the prosthesis modulus potentially improving stress shielding. However, no in vivo data is currently available to support this assumption in long bone reconstruction. This manuscript aims to address this hypothesis using a sheep model of extraarticular bone defect. Methods: Initially, CT was used to create a virtual resection plan of the distal femoral metaphyses and to custom design endoprostheses specific to each femur. The endoprostheses comprised additively manufactured Ti6Al4V-ELI modules that either had a solid core with a modulus of â¼120 GPa (solid implant group) or an open space lattice core with unit cells that had a modulus of 3-6 GPa (lattice implant group). Osteotomies were performed using computer-assisted navigation followed by implantations. The periprosthetic, interfacial and interstitial regions of interest were evaluated by a combination of micro-CT, back-scattered scanning electron microscopy (BSEM), as well as epifluorescence and brightfield microscopy. Results: In the periprosthetic region, mean pixel intensity (a proxy for tissue mineral density in BSEM) in the caudal cortex was found to be higher in the lattice implant group. This was complemented by BSEM derived porosity being lower in the lattice implant group in both caudal and cranial cortices. In the interfacial and interstitial regions, most pronounced differences were observed in the axial interfacial perimeter where the solid implant group had greater bone coverage. In contrast, the lattice group had a greater coverage in the cranial interfacial region. Conclusion: Our findings suggest that reducing the prosthesis modulus by inclusion of an open-space lattice in its design has a positive effect on bone material and morphological parameters particularly within the periprosthetic regions. Improved mechanics appears to also have a measurable effect on the interfacial osteogenic response and osteointegration.
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Developmental malformations can cause stunted or abnormal growth and clinical disease in dogs. In humans, measurements of the inferior vena cava are used as methods for detecting abnormal growth trajectories. The objectives of this retrospective, multicenter, analytical, cross-sectional study were to develop a repeatable protocol to measure the caudal vena cava (CVC) and generate growth curves in medium and large-breed dogs during development. Contrast-enhanced CT DICOM images from 438 normal dogs, aged from 1 to 18 months, from five specific breeds were included. A "best guess" measurement protocol was created. Dogs were stratified into medium or large breed groups based on growth rate trajectories. Linear regression models and logarithmic trend lines were used to evaluate the CVC growth over time. The CVC measurements were analyzed from four anatomical regions: thorax, diaphragm, intra-hepatic, and renal. The thoracic segment produced the most repeatable measurements with the highest explanatory power. The CVC thoracic circumference ranged from 2.5 to 4.9 cm from 1 to 18 months of age. Medium and large breeds had similar CVC growth trajectories, with comparable estimated marginal means, however medium dogs reached 80% of predicted final CVC size approximately 4 weeks earlier than large breed dogs. This new protocol provides a standardized technique for evaluation of the CVC circumference over time using contrast-enhanced CT and is most repeatable when taken at the thoracic level. This approach could be adapted for other vessels to predict their growth trajectories, generating healthy reference population data for comparison against patients with vascular anomalies.
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Doenças Vasculares , Veia Cava Inferior , Humanos , Cães , Animais , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/anormalidades , Estudos Retrospectivos , Estudos Transversais , Doenças Vasculares/veterinária , Tomografia Computadorizada por Raios X/veterinária , Estudos Multicêntricos como Assunto/veterináriaRESUMO
PURPOSE: Bone tumours must be surgically excised in one piece with a margin of healthy tissue. The unique nature of each bone tumour case is well suited to the use of patient-specific implants, with additive manufacturing allowing production of highly complex geometries. This work represents the first assessment of the combination of surgical robotics and patient-specific additively manufactured implants. METHODS: The development and evaluation of a robotic system for bone tumour excision, capable of milling complex osteotomy paths, is described. The developed system was evaluated as part of an animal trial on 24 adult male sheep, in which robotic bone excision of the distal femur was followed by placement of patient-specific implants with operative time evaluated. Assessment of implant placement accuracy was completed based on post-operative CT scans. RESULTS: A mean overall implant position error of 1.05 ± 0.53 mm was achieved, in combination with a mean orientation error of 2.38 ± 0.98°. A mean procedure time (from access to implantation, excluding opening and closing) of 89.3 ± 25.25 min was observed, with recorded surgical time between 58 and 133 min, with this approximately evenly divided between robotic (43.9 ± 15.32) and implant-based (45.4 ± 18.97) tasks. CONCLUSIONS: This work demonstrates the ability for robotics to achieve repeatable and precise removal of complex bone volumes of the type that would allow en bloc removal of a bone tumour. These robotically created volumes can be precisely filled with additively manufactured patient-specific implants, with minimal gap between cut surface and implant interface.
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Implantes Dentários , Ortopedia , Robótica , Cirurgia Assistida por Computador , Masculino , Animais , Ovinos , Cirurgia Assistida por Computador/métodos , Tomografia Computadorizada por Raios X , Fêmur/diagnóstico por imagem , Fêmur/cirurgiaRESUMO
OBJECTIVE: The aim of this study was to compare a 3-loop pulley (3LP) suture pattern with a 4-loop pulley (4LP) suture pattern for the tenorrhaphy of the canine gastrocnemius tendon STUDY DESIGN: Randomized, cadaveric, biomechanical study of 30 canine gastrocnemius tendons. Tendons were transected and repaired with either 3LP or 4LP suture pattern with 2-0 polypropylene. A tensile load was applied at 25 mm/min until construct failure. The load required to form a 1 mm gap, 3 mm gap and maximum load at failure was recorded and compared between groups. RESULTS: The estimated mean load to form a 1 mm gap for the 3LP and 4LP was 28.4 N (95% confidence interval [CI]: 24.0-32.6N) and 45.5 N (95% CI: 40.7-50.1N) respectively. The 4LP mean load to form a 1 mm gap was 17.1 N (95% CI: 11.7-22.5N) greater than the 3LP. The estimated mean load to form a 3mm gap for the 3LP and 4LP was 39.7 N (95% CI: 34.1-45.4N) and 55.0 N (95% CI: 49.3-60.9N) respectively. The mean load to form a 3mm gap was 15.3 N (95% CI: 8.5-21.9N) greater in the 4LP than the 3LP. The estimated mean load for failure in the 3LP and 4LP was 41.2 N (95% CI: 35.6-46.9 N) and 54.3 N (95% CI: 48.7-60.3 N) respectively. CONCLUSION: A 4LP pattern was biomechanically superior to a 3LP pattern, as demonstrated by a greater load required to form both a 1 and 3 mm gap and a greater load for failure CLINICAL SIGNIFICANCE: A 4LP suture pattern better resists gap formation and requires greater load prior to construct failure compared with a 3LP, in this canine gastrocnemius model.
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Doenças do Cão , Técnicas de Sutura , Cães , Animais , Técnicas de Sutura/veterinária , Polipropilenos , Fenômenos Biomecânicos , Suturas/veterinária , Tendões/cirurgia , Resistência à Tração , Cadáver , Doenças do Cão/cirurgiaRESUMO
Physical activity (PA) participation was substantially reduced at the start of the COVID-19 pandemic. The purpose of this study was to assess the association between PA, mental health, and wellbeing during and following the easing of COVID-19 restrictions in the United Kingdom (UK) and New Zealand (NZ). In this study, 3363 adults completed online surveys within 2-6 weeks of initial COVID-19 restrictions (April/May 2020) and once restrictions to human movement had been eased. Outcome measures included the International Physical Activity Questionnaire Short-Form, Depression Anxiety and Stress Scale-9 (mental health) and World Health Organisation-5 Wellbeing Index. There were no differences in PA, mental health or wellbeing between timepoints (p > 0.05). Individuals engaging in moderate or high volume of PA had significantly better mental health (-1.1 and -1.7 units, respectively) and wellbeing (11.4 and 18.6 units, respectively) than individuals who engaged in low PA (p < 0.001). Mental health was better once COVID-19 restrictions were eased (p < 0.001). NZ had better mental health and wellbeing than the UK (p < 0.001). Participation in moderate-to-high volumes of PA was associated with better mental health and wellbeing, both during and following periods of COVID-19 containment, compared to participation in low volumes of PA. Where applicable, during the current or future pandemic(s), moderate-to-high volumes of PA should be encouraged.
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COVID-19 , Adulto , Controle de Doenças Transmissíveis , Exercício Físico , Humanos , Saúde Mental , Nova Zelândia/epidemiologia , Pandemias , SARS-CoV-2 , Reino UnidoRESUMO
OBJECTIVE: This study aimed to describe changes in the length of the gastrocnemius muscle-tendon unit between the medial fabella and the calcaneus (MF-C) at different femorotibial joint (FTJ) and tibiotarsal joint (TTJ) angle combinations in the canine limb. STUDY DESIGN: This is an ex vivo kinematic study. ANIMALS: Canine cadaveric pelvic limbs (n = 11). PROCEDURES: One cadaveric pelvic limb was dissected to identify the anatomical origin and insertion of the gastrocnemius muscle-tendon unit for the radiographic landmark determination. The radiographic landmarks of the FTJ and TTJ were identified by lateral view radiographs. A series of lateral radiographs were evaluated to measure the linear MF-C at all combinations of the FTJ and TTJ angles. A mathematical model was defined for MF-C. RESULTS: The MF-C is associated with the FTJ and TTJ by a linear trigonometric relationship. Higher rate of increase in the MF-C was observed when the FTJ was > 135 degrees and the TTJ was < 125 degrees, compared with when the FTJ was <135 degrees and the TTJ was >125 degrees in all groups. CONCLUSIONS: Thirty degrees of free range of motion of the TTJ between 140 and 170 degrees did not elongate MF-C in this cadaveric limb study. CLINICAL RELEVANCE: Some degrees of free range of motion may be possible in the TTJ during tendon healing based on our cadaveric study without causing excessive change in the MF-C, although this concept should not be applied until isometric contractions of muscles are clearly understood. The relationship between the MF-C and tension at tenorrhaphy should be evaluated.
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Doenças do Cão , Músculo Esquelético , Animais , Fenômenos Biomecânicos , Cadáver , Cães , Membro Posterior/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Tendões/diagnóstico por imagemRESUMO
Canine appendicular osteosarcoma is commonly treated with limb amputation; however, limb-sparing options are frequently desired or necessary for a subset of patients. We evaluated 123 patients and 130 sites treated with stereotactic body radiation therapy (SBRT). Eighty-two out of 98 dogs (84%) had maximum lameness improvement at a median of 3 weeks for a median of 6 months duration. Histopathologic evaluation of available samples from amputation or necropsy revealed >80% tumor necrosis in 50% of limbs consistent with local disease control. Of evaluable patients, 41% fractured and 21% pursued an amputation after treatment. Fine needle aspirate (n = 52) and needle core biopsy (n = 28) did not result in increased fracture risk compared to those without tumor sampling (n = 50). Median survival time (MST) was 233 days and time to first event was 143 days. Gross tumor volume and planned target volume were significantly inversely associated with survival and tumor location was significantly associated with survival. Dogs with salvage amputation had a significantly longer MST compared to those without (346 vs 202 days; P = .04). The presence of metastatic disease at the time of treatment in 15 dogs did not significantly impact survival time (200 vs 237 days without metastasis; P = .58). Skin side effects correlated significantly with dose with 33% of patients with acute grade 3 effects developing consequential late grade 3 effects. While SBRT improves lameness in most patients, further investigation is needed to identify candidates with minimal early fracture risk prior to initiating therapy.
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Neoplasias Ósseas , Doenças do Cão , Osteossarcoma , Radiocirurgia , Animais , Neoplasias Ósseas/radioterapia , Neoplasias Ósseas/cirurgia , Neoplasias Ósseas/veterinária , Doenças do Cão/radioterapia , Doenças do Cão/cirurgia , Cães , Coxeadura Animal , Osteossarcoma/radioterapia , Osteossarcoma/cirurgia , Osteossarcoma/veterinária , Prognóstico , Radiocirurgia/veterinária , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Objective: To investigate the effect of a short-term, robotic-assisted (exoskeleton) gait training (RGT) program on central and peripheral hemodynamic measures in patients with spinal cord injury (SCI).Design: Parallel group, non-randomized trial with before (baseline) and after (follow-up) assessments.Setting: Single-center, community-based neuro-physiotherapy practice.Participants: Twelve individuals with SCI (ASI A to C).Interventions: Participants completed either a 5-day RGT program plus physiotherapy (n = 6), or a usual care physiotherapy only program (control group; n = 6). The RGT program consisted of daily 60-min physiotherapy and 90-min of RGT. Outcome measures were measured before and after the rehabilitation program.Main outcome measure(s): The primary outcome measure was arterial wave reflection (Augmentation index [AIx]), with central and peripheral blood pressures also reported. Data are presented as mean (SD) and effect sizes (partial eta squared; η2p).Results: There was a significant reduction in AIx (30 ± 18-21 ± 15%; η2p=0.75) and mean arterial pressure (89 ± 11-82 ± 10â mmHg; η2p=0.47) following completion of the RGT program (both P < 0.05). There were no changes in these measures for the control group. Although not significantly different, medium to large effects were observed in favor of RGT for all other central and peripheral measures (η2p=0.06-0.21), except for heart rate and pulse pressure (η2p<0.04).Conclusions: RGT using an exoskeleton is a promising therapy for improving cardiovascular health in patients with SCI. Specifically, this study indicates decreased arterial wave reflection and supports the need for larger randomized controlled trials.Trial Registration: Clinical trials Registry (https://clinicaltrials.gov/; NCT03611803).
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Exoesqueleto Energizado , Procedimentos Cirúrgicos Robóticos , Traumatismos da Medula Espinal , Marcha , Humanos , Projetos Piloto , Traumatismos da Medula Espinal/complicaçõesRESUMO
OBJECTIVES: To assess physical activity (PA), mental health and well-being of adults in the United Kingdom (UK), Ireland, New Zealand and Australia during the initial stages of National governments' Coronavirus disease (COVID-19) containment responses. DESIGN: Observational, cross-sectional. METHODS: An online survey was disseminated to adults (n=8,425; 44.5±14.8y) residing in the UK, Ireland, New Zealand and Australia within the first 2-6 weeks of government-mandated COVID-19 restrictions. Main outcome measures included: Stages of Change scale for exercise behaviour change; International Physical Activity Questionnaire (short-form); World Health Organisation-5 Well-being Index; and the Depression Anxiety and Stress Scale-9. RESULTS: Participants who reported a negative change in exercise behaviour from before initial COVID-19 restrictions to during the initial COVID-19 restrictions demonstrated poorer mental health and well-being compared to those demonstrating either a positive-or no change in their exercise behaviour (p<0.001). Whilst women reported more positive changes in exercise behaviour, young people (18-29y) reported more negative changes (both p<0.001). Individuals who had more positive exercise behaviours reported better mental health and well-being (p<0.001). Although there were no differences in PA between countries, individuals in New Zealand reported better mental health and well-being (p<0.001). CONCLUSION: The initial COVID-19 restrictions have differentially impacted upon PA habits of individuals based upon their age and sex, and therefore have important implications for international policy and guideline recommendations. Public health interventions that encourage PA should target specific groups (e.g., men, young adults) who are most vulnerable to the negative effects of physical distancing and/or self-isolation.
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COVID-19/prevenção & controle , Exercício Físico/psicologia , Comportamentos Relacionados com a Saúde , Saúde Mental , Distanciamento Físico , Adolescente , Adulto , Idoso , Ansiedade/diagnóstico , Ansiedade/etiologia , Austrália , COVID-19/psicologia , Estudos Transversais , Depressão/diagnóstico , Depressão/etiologia , Depressão/prevenção & controle , Feminino , Política de Saúde , Humanos , Irlanda , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Estresse Psicológico/diagnóstico , Estresse Psicológico/etiologia , Estresse Psicológico/prevenção & controle , Reino Unido , Adulto JovemRESUMO
OBJECTIVE: To compare the bursting strength of the uterine horns (UHs) and cervical-vestibule junction (CVJs) of rabbits following sealing with a vessel-sealing device (VSD) or encircling ligatures. SAMPLE: UHs and CVJs collected from 30 rabbit (Oryctolagus cuniculus) cadavers. PROCEDURES: UHs and CVJs were randomly assigned to sealing with encircling Miller knot ligatures (LIG; n = 10 CVJs and 20 UHs) or a VSD (12 CVJs and 24 UHs). Lumens were infused with saline (0.9% NaCl) solution under pressure until seals burst or to a maximum pressure of 300 mm Hg. RESULTS: For CVJs, median (range) bursting pressure of the LIG and VSD groups was > 300 mm Hg (224 to > 300 mm Hg) and 35 mm Hg (0 to 60 mm Hg), respectively. Five of 12 CVJs in the VSD group failed at pressures < 33 mm Hg. For UHs, median (range) bursting pressure of the LIG and VSD groups was 255 mm Hg (120 to > 300 mm Hg) and 154 mm Hg (range, 44 to 202 mm Hg), respectively. CONCLUSIONS AND CLINICAL RELEVANCE: The evaluated VSD was effective in sealing UHs at bursting pressures well in excess of expected physiologic pressures, indicating that the VSD may be useful for ovariectomy procedures in rabbits. However, CVJ seals created with the VSD were ineffective and could potentially burst at low pressures, which could predispose to urine entering the abdomen. Given these results, we do not recommend sealing of the CVJ with a VSD for ovariohysterectomy in rabbits.
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Histerectomia , Instrumentos Cirúrgicos , Animais , Feminino , Histerectomia/veterinária , Ligadura/veterinária , Ovariectomia/veterinária , CoelhosRESUMO
Osteosarcoma is the most common form of primary bone cancer. Over 20% of osteosarcoma patients present with pulmonary metastases at diagnosis, and nearly 70% of these patients fail to respond to treatment. Previous work revealed that human and canine osteosarcoma cell lines are extremely sensitive to the therapeutic proteasome inhibitor bortezomib in vitro. However, bortezomib has proven disappointingly ineffective against solid tumors including sarcomas in animal experiments and clinical trials. Poor tumor penetration has been speculated to account for the inconsistency between in vitro and in vivo responses of solid tumors to bortezomib. Here we show that the second-generation proteasome inhibitor ixazomib, which reportedly has enhanced solid tumor penetration compared to bortezomib, is toxic to human and canine osteosarcoma cells in vitro. We used experimental osteosarcoma metastasis models to compare the efficacies of ixazomib and bortezomib against primary tumors and metastases derived from luciferase-expressing KRIB or 143B human osteosarcoma cell lines in athymic mice. Neither proteasome inhibitor reduced the growth of primary intramuscular KRIB tumors, however both drugs inhibited the growth of established pulmonary metastases created via intravenous inoculation with KRIB cells, which were significantly better vascularized than the primary tumors. Only ixazomib slowed metastases from KRIB primary tumors and inhibited the growth of 143B pulmonary and abdominal metastases, significantly enhancing the survival of mice intravenously injected with 143B cells. Taken together, these results suggest ixazomib exerts better single agent activity against osteosarcoma metastases than bortezomib. These data provide hope that incorporation of ixazomib, or other proteasome inhibitors that penetrate efficiently into solid tumors, into current regimens may improve outcomes for patients diagnosed with metastatic osteosarcoma.
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Osteosarcoma (OS) is the most common malignant primary bone tumour in humans and dogs. Several studies have established the vital role of parathyroid hormone-related protein (PTHrP) and its receptor (PTHR1) in bone formation and remodeling. In addition, these molecules play a role in the progression and metastasis of many human tumour types. This study investigated the expression of PTHR1 and PTHrP in canine OS tissues and assessed their prognostic value. Formalin-fixed, paraffin-embedded tissue samples from 50 dogs diagnosed with primary OS were immunolabeled with antibodies specific for PTHR1 and PTHrP. The immunostaining intensity of tumours from patients with OS was correlated with survival time. Both PTHR1 and PTHrP were detected in all OS samples (n = 50). Dogs with OS tumours showing high immunostaining intensity for PTHR1 (n = 36) had significantly shorter survival times (p = 0.028, Log Rank; p = 0.04, Cox regression) when compared with OS that had low immunostaining intensity for PTHR1 (n = 14).PTHrP immunostaining intensity did not correlate with survival time (p > 0.05). The results of this study indicate that increased expression of PTHR1 antigen in canine OS is associated with poor prognosis. This suggests that PTHR1 may be useful as a prognostic indicator in canine OS.
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Neoplasias Ósseas/veterinária , Doenças do Cão/diagnóstico , Osteossarcoma/veterinária , Receptor Tipo 1 de Hormônio Paratireóideo/metabolismo , Animais , Neoplasias Ósseas/induzido quimicamente , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/mortalidade , Doenças do Cão/mortalidade , Cães , Feminino , Masculino , Osteossarcoma/química , Osteossarcoma/diagnóstico , Osteossarcoma/mortalidade , Inclusão em Parafina/veterinária , Prognóstico , Receptor Tipo 1 de Hormônio Paratireóideo/análiseRESUMO
BACKGROUND: Hepatic arteriovenous malformations (HAVMs) are rare congenital lesions consisting of multiple high-pressure arteries feeding into low-pressure veins via a central nidus. Massive haemorrhage, portal hypertension and hepatic insufficiency can ensue. Endovascular embolization is increasingly a first line treatment method although there is no general consensus or guidelines on the most effective embolic agent or approach. We describe the novel treatment of two dogs with congenital hepatic AVMs using a modified version of the 'pressure cooker' technique often utilised in neurointervention with the DMSO-based PHIL embolic agent delivered via the DMSO compatible Scepter-XC dual lumen balloon catheter. CASE PRESENTATION: Two paediatric dogs were diagnosed with hepatic AVMs. Both dogs presented with ascites and abnormal liver function tests. CT angiograms revealed hepatic arterio-portal malformations arising from an enlarged celiac artery. Selective catheterisation of the artery supplying the AVM was achieved via a femoral artery approach. A Scepter XC dual-lumen compliant balloon microcatheter and Traxcess 0.014 guidewire combination was advanced to the nidus via through the 5Fr guide catheter towards the nidus. Inflation of the balloon occluded arterial inflow and PHIL was injected under continuous fluoroscopic screening until the PHIL embolic agent penetrated into the draining portal vein beyond the nidus. In patient 1, normal portal venous waveform was restored with reversal of severe hepatic insufficiency. Whilst there was initial improvement post-operatively in patient 2 with normalisation of portal vein pressures and flow, opening of collateral nidus vessels re-established the high-pressure communication, and euthanasia was elected by the owner. CONCLUSIONS: The 'pressure cooker' technique is a safe and efficacious approach to the treatment of canine HAVMs. The novel use of PHIL and the Scepter XC balloon catheter has several advantages over conventional endovascular approaches. Translational application to human paediatric interventions for similar conditions where embolic and contrast agent volume constraints are similar can be considered.
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OBJECTIVE: To report the outcome of dogs treated with triple pelvic osteotomy (TPO) for dorsal luxation after total hip replacement (THR). STUDY DESIGN: Retrospective clinical case series. ANIMALS: Seventeen client-owned animals. METHODS: Medical records were searched at a single institution for dogs that had been treated with TPO for dorsal THR luxation. The angle of lateral opening (ALO), version angle (VA), and inclination angle (IA) were measured from radiographs after THR and TPO and corrected for pelvic rotation. A paired t test was performed to compare cup orientation after THR and TPO. Functional outcome was assessed at follow-up examination and during telephone interviews. RESULTS: Eighteen TPOs were performed in 17 dogs, and radiographs were available for 15 cases. Open and/or closed hip reduction with additional stabilization was attempted unsuccessfully in 6 dogs prior to TPO. Triple pelvic osteotomy reduced the ALO by a mean of 23.0 ° ± 10.9 ° (P ≤ .001), increased VA by 9.0 ° ± 4.9 ° (P < .001), and increased IA by 2.9 ° ± 5.8 ° (P = .126). An excellent or good outcome was achieved in 12 dogs. Ventral luxation occurred in 3 dogs, and dorsal luxation occurred in 1 dog after TPO. Triple pelvic osteotomy excessively reduced ALO in 2 dogs with ventral luxation. CONCLUSION: Triple pelvic osteotomy with cup retention is a viable alternative to cup revision for treatment of dorsal luxation of cemented and cementless THR. Triple pelvic osteotomy significantly reduces ALO and increases VA. Careful patient selection is recommended because excessive ventroversion can lead to ventral luxation. CLINICAL SIGNIFICANCE: Triple pelvic osteotomy offers a revision option that preserves the implant-bone interface and significantly reduces ALO. This technique may be appropriate in dogs with high ALO, luxoid hips, and prior failed revision attempts.
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Artroplastia de Quadril/veterinária , Displasia Pélvica Canina/cirurgia , Luxações Articulares/veterinária , Osteotomia/veterinária , Pelve/cirurgia , Animais , Cães , Feminino , Displasia Pélvica Canina/diagnóstico por imagem , Luxações Articulares/diagnóstico por imagem , Luxações Articulares/cirurgia , Masculino , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/cirurgia , Complicações Pós-Operatórias/veterinária , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVE To assess for any association between a history of tibial plateau leveling osteotomy (TPLO) and subsequent development of proximal tibial osteosarcoma in dogs. DESIGN Matched case-control study. ANIMALS 34 client-owned dogs in which proximal tibial osteosarcoma was diagnosed between January 2005 and December 2012 (cases) and 79 dogs without osteosarcoma, matched 3:1 to cases (when possible) by age, breed, and initial examination date (controls). PROCEDURES Information on each case and control was collected from the medical records and other sources regarding date of birth, sex and neuter status, body weight, breed, and whether TPLO had been performed ≥ 1 year ago. A multivariable conditional logistic regression model was constructed to evaluate associations of body weight and history of TPLO with the outcome of proximal tibial osteosarcoma in dogs. RESULTS After adjusting for body weight in the multivariable model, dogs with a history of TPLO were 40 times as likely to develop proximal tibial osteosarcoma as were dogs with no history of TPLO. In addition, each 1-kg (2.2-lb) increase in body weight was associated with an 11% increase in the odds of proximal tibial osteosarcoma. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that dogs with a history of TPLO were at increased risk of developing osteosarcoma of the proximal region of the tibia relative to dogs with no such history. Therefore, it is important for proximal tibial osteosarcoma to be included among the differential diagnoses for new or worsening hind limb lameness in dogs that underwent TPLO ≥ 1 year previously.
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Neoplasias Ósseas/veterinária , Doenças do Cão/epidemiologia , Osteossarcoma/veterinária , Osteotomia/efeitos adversos , Tíbia/cirurgia , Animais , Neoplasias Ósseas/epidemiologia , Estudos de Casos e Controles , Colorado/epidemiologia , Doenças do Cão/etiologia , Cães , Feminino , Masculino , Osteossarcoma/epidemiologia , LinhagemRESUMO
OBJECTIVE: To determine the effects of 6 types of transarticular immobilization techniques on tibiotarsal joint angles during stimulated weight bearing. STUDY DESIGN: Canine ex vivo biomechanical study. SAMPLE POPULATION: Canine cadaveric pelvic limbs (n = 15). METHODS: A validation study was conducted to determine tibiotarsal flexion before and after transection of the superficial digital flexor tendon in 5 canine cadaveric limbs without tibiotarsal joint immobilization. Six transarticular tibiotarsal immobilization techniques were tested sequentially in 10 canine cadaveric pelvic limbs. The tibiotarsal joint angles were measured from lateral projection radiographs before and during axial loading of 200 N. Mixed linear models were applied to determine the effects of the immobilization techniques on change in tibiotarsal joint angle under loading. RESULTS: There was no change of tibiotarsal joint angle between extended digits and flexed digits under both unloaded and loaded conditions. Change in tibiotarsal joint angles did not differ among any of the immobilization techniques tested here (mean change 1.36°, range 0-5). The main contributor to variance in angle explained by the final model was associated with the random effect for limb. CONCLUSION: Changes in tibiotarsal joint angles during single static loading in canine cadaveric limbs for the 6 immobilization techniques were minimal. CLINICAL SIGNIFICANCE: The 6 techniques appear equally effective at limiting tibiotarsal joint flexion during single axial loading of 200 N. Cyclic mechanical testing of these techniques is recommended to support our findings and validate their clinical application.
Assuntos
Placas Ósseas/veterinária , Cães/lesões , Instabilidade Articular/veterinária , Tarso Animal/lesões , Tíbia/lesões , Animais , Fenômenos Biomecânicos , Cadáver , Cães/cirurgia , Instabilidade Articular/cirurgia , Amplitude de Movimento Articular , Tarso Animal/diagnóstico por imagem , Tarso Animal/cirurgia , Tíbia/diagnóstico por imagem , Tíbia/cirurgia , Suporte de CargaRESUMO
The link between athlete physique and performance in sports is well established. However, a direct link between somatotype three-numeral rating and anaerobic performance has not yet been reported. The purpose of this study was to assess the relations between somatotype and anaerobic performance using both singular and multivariate analyses. Thirty-six physically active males (mean ± standard deviation age 26.0 ± 9.8 years; body mass 79.5 ± 12.9 kg; height 1.82 ± 0.07 m) were somatotype-rated using the Heath-Carter method. Subjects were assessed for 3 repetition maximum (3 RM) bench press and back squat, and completed a 30-second maximal sprint cycle test. Positive correlations were observed between mesomorphy and 3 RM bench press (r = 0.560, p < 0.001), mesomorphy and 3 RM back squat (r = 0.550, p = 0.001) and between mesomorphy and minimum power output (r = 0.357, p = 0.033). Negative correlations were observed between ectomorphy and 3 RM bench press (r = -0.381, p = 0.022), and ectomorphy and 3 RM back squat (r = -0.336, p = 0.045). Individual regression analysis indicated that mesomorphy was the best predictor of 3 RM bench press performance, with 31.4% of variance in 3 RM bench press performance accounted for by the mesomorphy rating (p < 0.001). A combination of mesomorphy and ectomorphy best predicted 3 RM back squat performance (R2 = 0.388, p < 0.04). Around one third of strength performance is predicted by somatotype-assessed physique in physically active males. This could have important implications for the identification of those predisposed to perform well in sports containing strength-based movements and prescription of training programmes.