Assessment of gastrointestinal health in racing Alaskan sled dogs using capsule endoscopy and inflammatory cytokines.

OBJECTIVES: Exercise-induced gastrointestinal syndrome occurs in dogs and people and might compromise athlete performance by increasing intestinal permeability and causing gastrointestinal erosions. Racing sled dogs often receive acid suppressant prophylaxis which decreases the incidence of gastric erosions induced by exercise. The objectives were to quantify intestinal injury by measuring serum pro-inflammatory cytokine concentrations before and after exercise and to evaluate gastrointestinal mucosa using video capsule endoscopy after exercise. MATERIALS AND METHODS: Prospective study of 12 racing Alaskan sled dogs receiving approximately 1 mg/kg omeprazole once daily from the day before the race until race completion. Blood was drawn before and 8 to 10 hours after an endurance race for the quantification of cytokines. Gastrointestinal tract mucosa was assessed with video capsule endoscopy immediately post-race. RESULTS: Eight of nine dogs (89%; 95% confidence interval 52 to 100%) had gastric erosions; all dogs (100%, 95% confidence interval 63 to 100%) had small intestinal erosions. Most of the dogs (seven of nine) had straw or foreign material present. Cytokine levels were not different from before to after the race. CLINICAL SIGNIFICANCE: Video capsule endoscopy identified gastrointestinal tract mucosal erosions after exercise in all dogs receiving once-daily omeprazole treatment, though other causes for the lesions besides exercise are possible.

A magnetic reconnection X-line extending more than 390 Earth radii in the solar wind.

Magnetic reconnection in a current sheet converts magnetic energy into particle energy, a process that is important in many laboratory, space and astrophysical contexts. It is not known at present whether reconnection is fundamentally a process that can occur over an extended region in space or whether it is patchy and unpredictable in nature. Frequent reports of small-scale flux ropes and flow channels associated with reconnection in the Earth's magnetosphere raise the possibility that reconnection is intrinsically patchy, with each reconnection X-line (the line along which oppositely directed magnetic field lines reconnect) extending at most a few Earth radii (R(E)), even though the associated current sheets span many tens or hundreds of R(E). Here we report three-spacecraft observations of accelerated flow associated with reconnection in a current sheet embedded in the solar wind flow, where the reconnection X-line extended at least 390R(E) (or 2.5 x 10(6) km). Observations of this and 27 similar events imply that reconnection is fundamentally a large-scale process. Patchy reconnection observed in the Earth's magnetosphere is therefore likely to be a geophysical effect associated with fluctuating boundary conditions, rather than a fundamental property of reconnection. Our observations also reveal, surprisingly, that reconnection can operate in a quasi-steady-state manner even when undriven by the external flow.

Efficacy of omeprazole versus high-dose famotidine for prevention of exercise-induced gastritis in racing Alaskan sled dogs.

BACKGROUND: Omeprazole and famotidine both reduce severity of exercise-induced gastritis, but administering famotidine is easier than administering omeprazole during racing competition. HYPOTHESIS: Famotidine is more efficacious than no treatment in reducing severity of exercise-induced gastritis; and high-dose famotidine is more efficacious than omeprazole in reducing severity of exercise-induced gastritis. ANIMALS: Experiment 1: Randomized placebo-controlled study, 36 sled dogs (3-8 years); Experiment 2: Randomized positive-control study, 52 sled dogs (2-8 years). METHODS: Experiment 1: Equal numbers of dogs randomly assigned to famotidine (20 mg q24h) or no treatment groups. Gastroscopy was performed 24 hours after the dogs ran 330 miles. Mucosal appearance was blindly scored by previously described scoring system. Experiment 2: Equal numbers of dogs randomly assigned to omeprazole (20 mg q24h) or high-dose famotidine (40 mg q12h) groups. Gastroscopy was performed 48 hours before and 24 hours after the dogs ran 300 miles. Mucosal appearance was blindly scored by previously described scoring system. RESULTS: Famotidine reduced the prevalence of clinically relevant, exercise-induced gastric lesions compared with no treatment (7/16 versus 11/16, P = .031). Compared with high-dose famotidine, omeprazole significantly decreased the severity (0.4 versus 1.2, P = .0002) and prevalence (2/23 versus 7/21, P = .049) of gastric lesions. CONCLUSIONS AND CLINICAL RELEVANCE: Although famotidine provides some benefit in the prevention of exercise-induced gastric lesions, omeprazole is superior to famotidine in preventing gastritis in dogs running 300 miles. Routine administration of omeprazole is recommended to prevent stress-associated gastric disease in exercising and racing Alaskan sled dogs.

Hepatic vein obstruction due to Swan-Ganz catheter placement.

Complications from Swan-Ganz catheters during insertion, long-term placement, or removal have been known since its development. I describe the unusual presentation of a pacing Swan-Ganz catheter mispositioned into the hepatic vein producing vascular obstruction, yet with adequate cardiac pacing.

Occupational hazards of operating: opportunities for improvement.

The emergence of hepatitis C virus compels us to refocus on protecting ourselves, our coworkers, and our families from potential illness, disability, or death. As blood-borne pathogens continue to evolve and mutate, the best option available is to prevent exposure. Surgeons have the opportunity to prevent the majority of exposures by utilizing currently available technology and knowledge. Surgeons should see, use, and evaluate a variety of safety-engineered devices, because their feedback can lead to improvements in technology. Education, communication, and access to safer technology will motivate surgeons to adopt safer behavior patterns. Provided with information and tools, we can change through self-motivation.

Pancreatic peptides regulate Cl- secretion in the marine teleost gill.

Hormonal regulation of the ionoregulatory function of the branchial epithelium in marine teleosts has been investigated using an isolated gill preparation of the seawater-adapted flounder Platichthys flesus. Agents which are assumed to elevate the effective intracellular concentration of cyclic AMP caused a stimulation of Cl- secretion as determined by measurement of the transepithelial electrical potential difference in the isolated gill. The pancreatic endocrine glucagon may act as an endogenous regulator of ion excretion in the gill as this peptide stimulated the transepithelial potential. Another islet peptide, somatostatin, inhibited branchial electrogenic ion transport. Attempts to investigate the mode of action of these peptides by measuring cyclic AMP levels in isolated gills were unsuccessful, since it appears that the pool of cyclic nucleotide which specifies the epithelial Cl- transport rate is small compared to total cyclic AMP content. A second approach investigating the ability of somatostatin to inhibit the transepithelial potential in gills stimulated by different secretagogues suggested dual modes of action for this peptide.

Videothoracoscopic treatment of hepatic hydrothorax.

Hepatic hydrothorax occurs frequently in ascites arising from communications in the diaphragm between peritoneal and pleural cavities. Numerous treatments have been described but are of limited utility due to invasiveness and poor success rate. We describe a case of hepatic hydrothorax in which the pore in the diaphragm was documented photographically and in which successful resolution was achieved with videothoracoscopic suture ligation and talc pleurodesis.

Heterotopic pancreas of the esophagus masquerading as Boerhaave's syndrome.

Heterotopic pancreas (HP) of the esophagus is rare. We report a patient with HP of the esophagus and review the presentation, treatment, and results of the nine previously reported cases. Two patients had cancer. This high incidence raises concerns that HP of the esophagus may be premalignant. Because surveillance endoscopy is not possible, all known or suspected esophageal HP should be treated surgically.

Clinical assessment of gas exchange in mature horses.

There are limited methods of assessing pulmonary function in horses at rest. We developed clinical techniques to measure gas exchange efficiency in horses and evaluated 3 groups of horses that were 1) asymptomatic based on auscultation with rebreathing, transtracheal aspirate cytology, and thoracic radiographs (n = 6), 2) asymptomatic at rest but symptomatic with rebreathing (n = 11) and 3) symptomatic at rest (n = 9). Blood samples were obtained from the transverse facial artery and jugular vein. Maximal end-tidal CO2 tension (PETCO2) was measured by an infrared capnograph through a facemask. Alveolar O2 tension, dead space fraction (V(D)/V(T)), and physiological shunt fraction (Q(S)/Q(T)) were calculated using standard formulae. Arterial O2 tension in Group 1 horses (mean +/-s.d.103+/-3 mmHg) was significantly higher than in Group 2 or Group 3 horses. Q(S)/Q(T) in Group 1 horses (0.37+/-0.98%) was significantly lower than in Group 2 and Group 3 horses. Mean +/-s.d.V(D)/V(T) in Group 1 horses (-18.2+/-3.1) was significantly lower than Group 3 horses but not Group 2 horses.

Efficacy of omeprazole for the prevention of exercise-induced gastritis in racing Alaskan sled dogs.

Exercise-induced gastritis and gastric ulcers are common in humans and horses, and recently have been described in racing sled dogs. The cause of exercise-induced gastric disease is not completely understood in any species, but pharmacologic suppression of acid secretion is an effective treatment in humans and horses. Thus, we tested the hypothesis that omeprazole, a proton-pump inhibitor shown to reduce gastric acid secretion in dogs, would reduce the severity of exercise-induced gastric disease. Three teams of 16 dogs each competing in the 2002 Iditarod Sled Dog Race were recruited for participation. Within each team, dogs were randomly assigned to either treatment (20 mg omeprazole PO q24h) or placebo. Treatments were administered until either completion of the race or withdrawal of an individual dog from competition. Gastric endoscopy was performed in all dogs 24 hours after completion or withdrawal, and the gastric mucosa was scored by using a subjective severity score (0 = normal, 3 = numerous bleeding ulcers). Treatment with omeprazole significantly reduced mean gastric severity score compared to placebo (omeprazole: 0.65 +/- 0.17, placebo: 1.09 +/- 0.18; P = .028), but also was associated with increased frequency of diarrhea during the race (omeprazole 54%, placebo 21%; P = .017). Examination of our data suggests that omeprazole may be an effective treatment for exercise-induced gastric disease in racing sled dogs. However, further investigation regarding the cause and clinical relevance of diarrhea associated with omeprazole treatment must be conducted before omeprazole can be recommended for routine prophylactic treatment in these athletes.

Prevalence of gastric lesions in racing Alaskan sled dogs.

Human and equine athletes are reported to have a high prevalence of gastric disease, and anecdotal evidence suggests a similar phenomenon applies to racing sled dogs. To investigate the prevalence of gastric disease in racing sled dogs, we conducted 2 gastroscopy studies on dogs competing in the annual Iditarod Sled Dog Race. A pilot study of dogs that were either dropped from the 2000 Iditarod Sled Dog Race because of illness or that finished the race indicated that, approximately 5 days after competing, 10 of 28 dogs (35%) had endoscopic evidence of gastric ulceration, erosion, or hemorrhage. The next year, an endoscopic study of 73 dogs participating in the 2001 Iditarod race was performed in order to evaluate a larger population of dogs. Data from 70 of these dogs could be used; 34 (48.5%) had ulceration, erosion, gastric hemorrhage, or some combination of these findings. When this group of 70 dogs was compared retrospectively to a control group of 87 dogs presented to the Texas A&M University (TAMU) Veterinary Medical Teaching Hospital, the Iditarod sled dogs had a significantly higher prevalence (P = .049) of gastric lesions. These findings suggest that, similar to athletes of other species, elite canine athletes have an increased prevalence of gastric disease compared to the canine population at large.

Neonatal equine herpesvirus type 1 infection on a thoroughbred breeding farm.

Of 17 foals born on a Thoroughbred breeding farm between March and April 1995, infection with equine herpesvirus type 1 (EHV-1) was associated with neonatal morbidity in 5 foals, 3 of which died or were euthanized. Morbidity and mortality were associated with pulmonary inflammation, and EHV-1 was identified in the lungs of the 3 foals that died. All neonatal EHV-1 infections occurred in foals of mares housed in the same pasture and barn. No other clinical manifestations of EHV-1 infection (e.g., abortion, neurologic disease, or respiratory disease) occurred during this outbreak. Three foals were treated with acyclovir (1 died, 2 survived), which may have influenced the clinical outcome in the surviving foals.

Effect of management strategies on reducing heat stress of feedlot cattle: feed and water intake.

Three experiments were conducted to evaluate management strategies designed to decrease heat stress of cattle finished during the summer. In Exp. 1, 144 Angus crossbred yearling steers were assigned to three treatments: 1) ad libitum access to feed at 0800 (ADLIB); 2) fed at 1600 with feed amount adjusted so that no feed was available at 0800 (BKMGT); and 3) fed at 1600 at 85% of predicted ad libitum levels (LIMFD). Treatments were imposed for 23 d of an 82-d study, after which all steers were fed ad libitum at 0800. Treatment did not affect (P > 0.10) overall DMI, although ADLIB cattle tended to consume less feed. Overall water intake was decreased (P < 0.05) by 6.8 L x animal(-1) x d(-1) for LIMFD vs. ADLIB steers. In Exp. 2, 96 Angus crossbred yearling steers were assigned to three treatments: 1) control, no water application; 2) water applied to the pen surfaces between 1000 and 1200 (AM); and 3) water applied to pen surfaces between 1400 and 1600 (PM). Water intake and DMI did not differ among treatments; however, feed efficiency of AM steers was superior (P = 0.06) to that of PM steers. Conversely, marbling scores of PM steers were higher (P = 0.06) than those of AM steers. In Exp. 3, 192 crossbred steers were used to determine the effects of feeding time (0800 [AMF] vs. 1400 [PMF]), with (WET) and without (DRY) sprinkling (20 min every 1.5 h between 1000 and 1750). Feed DMI did not differ among treatments; however, water intake and marbling scores were highest (P < 0.05) for AMF/DRY steers. During these experiments, bunk scores (0 = <10% of feed delivered remaining; 1 = 10 to 50% of feed remaining; 2 = >50% of feed remaining) were assigned to each pen at various times during the day. In Exp. 1, bunk scores of BKMGT pens remained similar (P > 0.20) under varying environmental conditions, whereas LIMFD steers had lower scores (P < 0.05) as days on feed increased, even under hot environmental conditions. In Exp. 3, bunk scores of PMF/WET steers tended to be lower (P < 0.10) at 1700 and 2000 compared with PMF/ DRY pens under mild heat stress but not under severe heat stress. Alternative feeding regimens and sprinkling can alter the feed intake pattern of steers. Heat stress management strategies imposed in these experiments had minimal effects on cattle performance. Such strategies would be most useful for decreasing the susceptibility of cattle to hyperthermia and reducing related feedlot cattle deaths without adversely affecting performance.

Feeding strategies for managing heat load in feedlot cattle.

Eighty-four Bos taurus crossbred steers were used to investigate effects of level and duration of limit-feeding feedlot cattle in a hot environment. Pens (four/treatment) of steers (seven/pen) were fed feedlot finishing diets and randomly assigned to the following treatments: 1) restricted to approximately 75% of feed consumed when offered ad libitum for 21-d duration (RES21); 2) restricted to approximately 75% of ad libitum for 42-d duration (RES42); and 3) feed offered ad libitum (ADLIB). Tympanic temperatures (TT) were measured via thermistors placed in the ear canal and attached to data loggers. Restricting feed intake for both 21- and 42-d reduced tympanic temperature when compared with ADLIB treatment groups under hot environmental conditions. Temperature reductions exceeded 0.5 degrees C (P < 0.05) depending on time of day. The reduced tympanic temperature is likely due to a reduction in metabolic heat load and/or a concurrent reduction in metabolic rate. Within respective periods, no differences (P > 0.05) were found among treatments for panting or bunching score. However, different proportions of cattle were found to be bunching and panting with ADLIB cattle displaying a greater number of bunched steers that were panting when compared with the other groups. When averaged across diet treatments, dark-colored cattle had the greatest percentage of cattle showing moderate to excessive panting, while light-colored cattle displayed the least panting under thermoneutral climatic conditions. Under hot (mean daily temperature-humidity index >74) conditions, dark-colored cattle tended to bunch more (P = 0.073) and pant more (P < 0.01) than light-colored cattle. Mean TT were 0.2 to 0.6 degrees C (P < 0.05) greater for dark- vs light-colored cattle under hot conditions. Limit-feeding feedlot cattle during early summer is a successful tool for enhancing animal comfort by alleviating the combined effects of high climatic and metabolic heat load.

Strategies to reduce feedlot cattle heat stress: effects on tympanic temperature.

Three experiments were conducted to evaluate the effect of different management strategies on body temperature of feedlot steers finished in the summer months. In Exp. 1, 24 crossbred steers were chosen to assess the effect of altered feed intake and feeding time on tympanic temperature (TT) response. Managed feeding (MF) treatments were applied for 22 d only and provided 1) ad libitum access to feed at 0800 (ADLIB), 2) feed at 1600 with amount adjusted so that no feed was available at 0800 (BKMGT), 3) feed at 1600 at 85% of predicted ad libitum levels (LIMFD). During heat stress conditions on d 20 to 22 of MF, LIMFD and BKMGT had lower (P < 0.05) TT than ADLIB from 2100 through 2400. A carryover effect of limit-feeding was evident during a severe heat episode (d 36 to 38) with LIMFD steers having lower (P < 0.05) TT than ADLIB. In Exp. 2, TT were obtained from 24 crossbred steers assigned to three treatments, consisting of no water application (CON), water applied to feedlot mound surfaces from 1000 to 1200 (AM) or 1400 to 1600 (PM). From 2200 to 0900 and 1200 to 1400, steers assigned to morning sprinkling treatment had lower (P < 0.05) TT than steers assigned to afternoon sprinkling treatment. In Exp. 3, 24 steers were utilized in a 2 x 2 factorial arrangement of treatments with factors of feeding time [0800 (AMF) and 1400 (PMF)] and sprinkling (WET and DRY). Tympanic temperatures were monitored under hot environmental conditions on d 30 to 32 and 61 to 62. A feeding time x sprinkling interaction (P < 0.001) was evident on d 30 to 32, although AMF/DRY steers had the highest (P < 0.05) TT. On d 61 to 62, TT of PMF steers was higher (P < 0.05) than AMF between 1500 to 1800. Use of sprinklers can effectively reduce TT of feedlot cattle, whereas shifting to an afternoon vs morning feeding time was most beneficial when bunks were empty several hours prior to feeding.

Cohesion, alliance and outcome in group psychotherapy.

Cohesiveness has been viewed as the group psychotherapy equivalent of the therapeutic alliance in individual treatment. Although researchers have attempted to study the concept of cohesion in group treatment, understanding of this so-called "curative" group factor remains quite primitive. In this study of 12 time-limited psychotherapy groups, with a total of 90 nonpsychotic outpatients, we explore the relationships between cohesion, alliance and treatment outcome. Our cohesion measure is a new instrument, the Harvard Community Health Plan Group Cohesiveness Scale, developed for use with group therapy videotapes. To measure alliance we have modified the Penn Helping Alliance Scale (Group Alliance Scale) to be scored from videotapes of group sessions. Both of these instruments use trained observers to make ratings for the group-as-a-whole. The outcome battery for patients in these groups included a widely varied set of measures, enabling us to view change from a number of perspectives. Our findings indicate that cohesion and alliance as measured here are related concepts. We also find that both cohesion and alliance appear to have strong relationships with improved self-esteem and reduced symptomatology for patients in these groups. In addition, it appears that outcome is most related to cohesion in the first 30 minutes of a group session. Implications of these and other findings are discussed.

The effect of promoting intrauterine attachment in primiparas on postdelivery attachment.

Twenty-two women participated in a modified replicate study which examined the effects of prenatal maternal attachment behaviors during first pregnancies. A pretest reflected the degree of maternal-fetal attachment behaviors and attitudes already formed. The women in the experimental group received three interventions aimed at directing the mothers' attentions toward their fetuses. The remaining women received routine prenatal care only. All mothers were observed once in the first few days postpartum to assess maternal attachment behaviors. Data analysis did not substantiate the findings of the earlier study. Factors identified in the added pretest may have accounted for this difference.

Evaluation of carbon dioxide laser and conventional incisional techniques for resection of soft palates in brachycephalic dogs.

OBJECTIVE: To compare clinical outcome, healing, and effect of tracheostomy in conventional incisional and carbon dioxide (CO2) laser techniques for resection of soft palates in brachycephalic dogs. DESIGN: Prospective randomized trial. ANIMALS: 20 adult brachycephalic dogs. METHODS: Dogs were randomly allocated into 4 groups, and 1 of the following was performed: palate resection by use of a CO2 laser; incisional palate resection and closure with suture; and palate resection by use of a C02 laser or incision with tracheostomy. A clinical score for respiratory function was assigned to each dog at 0, 2, 8, 16, and 24 hours. Biopsy specimens of incision sites obtained at days 0, 3, 7, and 14 were examined. Data were analyzed to determine the effects of technique on clinical and histologic outcome. RESULTS: Mean surgical time for laser (309 seconds) was significantly shorter than for sharp dissection (744 seconds). Surgical technique significantly affected clinical scores at 3 of the 5 postoperative time points, but differences were not clinically apparent. Tracheostomy significantly affected clinical scores at 3 of 5 postoperative time points. After tracheostomy tube removal, clinical scores were similar to those of dogs without tracheostomies. Inflammation, necrosis, and ulceration were evident in all groups at day 3; these lesions had almost resolved by day 14. Most complications were associated with tracheostomy. CONCLUSIONS AND CLINICAL RELEVANCE: Clinical outcomes appear to be similar with the laser and incisional techniques. Regarding surgical time and ease, laser resection of the soft palate appears advantageous. Tracheostomy is not warranted in dogs that have uncomplicated surgeries and recoveries.

Effects of spatial frequency of a vertically striped rotating drum on vection-induced motion sickness.

PURPOSE: The present study investigated the effects of differential spatial frequencies of a vertically striped, horizontally rotating drum on the observer's frequency of eye nystagmus, perceived velocity of self-motion, and symptoms of motion sickness. METHODS AND RESULTS: Two experiments were conducted. In Experiment 1, each of 10 subjects viewed 1 min of an optokinetic rotating drum at the speed of 10 rpm covered with 6, 12, 24, 48, and 96 pairs of black and white stripes, presented in counterbalanced order. The results indicated that subjects perceived significantly stronger circular vection (p < 0.05) and generated significantly higher frequencies of eye nystagmus (p < 0.05) when they were viewing 24 pairs of black and white stripes than when they were viewing any of the other combinations of 6, 12, 48, or 96 black and white stripes. In Experiment 2, 100 highly susceptible subjects viewed 16 min of an optokinetic rotating drum covered with one of the five different numbers of black and white stripe pairs: 6, 12, 24, 48, and 96. The results indicated that subjects in the group viewing 24 moving contrasts perceived significantly stronger circular vection (p < 0.001), reported significantly more severe symptoms of motion sickness (p < 0.001), and showed significantly greater ratios of EGG 4-9 cycles per minute spectral intensity between drum rotation and baseline periods (p < 0.004) than those in the groups of viewing 6, or 96 moving contrasts. CONCLUSION: These results demonstrated that the severity of vection-induced motion sickness is affected by differential spatial frequencies of the stripes of the rotating drum and may be affected by number of horizontal eye movements.

Suicidal adolescents: factors in evaluation.

Suicide attempts among adolescents are occurring more frequently and their evaluation is a difficult task. The factors related to suicide attempts in eighty-two adolescents, ages 12 to 18 were examined. They had been admitted to the adolescent unit of a large, urban general hospital for evaluation of self-destructive behavior. A systematic review of the patients' charts was performed to gather information about family structure, functioning in school, suicidal risk, degree of depression, and stressful life events. Although most were moderately depressed, a significant proportion denied having tried to harm themselves. While some repressed their anger, the majority expressed anger openly, tended to feel sad and to carry out premeditated as well as more serious suicide attempts. Most had experienced family disruption, and nearly half were functioning poorly in school. Suicide risk correlated only with current stress, while depression correlated with life-long as well as current stress. Results suggest that identification of the suicide attempt and the contributory factors, especially the degree of overt anger and depression, are crucial in deciding appropriate interventions, providing adequate treatment, and avoiding recurrence.