Distribution of mortality patterns in cats with naturally occurring trauma: A Veterinary Committee on Trauma registry study.

A greater understanding of the prognostic variables that affect the timing of death for cats with trauma may help clinicians select treatments and monitoring plans. This study investigated the mortality rate and its distribution pattern in a large population of cats to identify variables associated with the timing of trauma-related deaths. Clinical data was retrieved from the Veterinary Committee on Trauma database to determine mortality rates and timing of deaths, defined as early death (ED; <1 day post-presentation) or delayed death (DD; ≥1 day post-presentation). Multivariable logistic regression analyses were performed to identify characteristics and interventions that best predicted timing of death. Overall mortality rate for 6703 feline trauma patients with complete records was 17.2%, with 7.6% due to natural death and 92.3% due to euthanasia. Among the subset of 543 cats with trauma that died after presentation or required euthanasia due to a grave prognosis (representing an 8.1% mortality rate), EDs were more common (71.7%) than DD and the cause of death was not significantly associated with the timing of death. Clinical pathology parameters were unable to identify animals more likely to die or to require euthanasia due to a poor prognosis during hospitalisation. Factors that were significantly different for cats with ED vs. DD included the median cumulative results for the Modified Glasgow Coma Scale (MGCS) score and the Animal Trauma Triage (ATT) score, the presence of spinal trauma, administration of blood products and undertaking surgical procedures. An increased likelihood of DD rather than ED was associated with the administration of blood products (odds ratio [OR], 3.959; P = 0.019) vs. not, performing a surgical procedure (OR, 6.055; P < 0.001) vs. not, and a cumulative MGCS of 15-17 or 18 (OR, 1.947 and 3.115; P = 0.031 and P = 0.01, respectively) vs. a cumulative MGCS ≤ 11.

Identifying drivers for user preference and acceptability of different hydro-alcoholic hand rub formulations.

BACKGROUND: In the current era, the importance of proper hand hygiene to reduce the transmission of infectious diseases has become difficult to debate. Yet, compliance rates remain low and are affected by many factors, amongst which is user acceptability of hand hygiene products. AIM: The present study aimed at investigating drivers of preference towards different hand hygiene formulations. METHODS: Three different formulations (liquid, foam and gel) of the same brand were randomly and blindly evaluated by 54 participants based on the WHO Protocol for Evaluation of Tolerability and Acceptability of Alcohol-based Handrubs. RESULTS: The majority (76%) of respondents indicated that the product formulation impacted their level of compliance with hand hygiene protocols. The preferred formulation was liquid, with 50% of participants ranking it as first choice. General product satisfaction, the product texture, the drying speed and the ease of application, were the statistically significant drivers for participants to rank a formulation as their first choice vs not ranking it as their first choice. CONCLUSIONS: When designing alcohol formulations and implementing hand hygiene protocols, understanding drivers of preference for formulations may enhance product user acceptability and therefore compliance with hand hygiene.

Colonic Health in Hospitalized Horses Treated with Non-Steroidal Anti-Inflammatory Drugs - A Preliminary Study.

Non-steroidal anti-inflammatory drugs (NSAIDs) can cause right dorsal colitis, but longitudinal clinical studies are lacking. This study investigates whether NSAID treated horses develop right dorsal colonic pathology in a clinical setting. Non-gastrointestinal hospitalized horses treated with NSAIDs >4 days, and untreated hospital-owned teaching horses and non-gastrointestinal client-owned hospitalized horses were included. All horses were monitored over time with clinical examinations (focusing on presence of colic, depression, reduced appetite, unstructured feces), ultrasonographic intestinal wall measurements, fecal occult blood tests (semi-quantitative results), and blood analysis (total protein and albumin concentrations, white blood cell and neutrophil counts). Outcomes were recorded as "ultrasonographically thickened right dorsal colon (RDC) walls", "colitis" and "right dorsal colitis". Findings over time were compared to baseline values and to control horses. Seventeen NSAID treated horses and 5 controls were included. NSAID treated horses developed thickened RDC walls (4/9), and subclinical and mild colitis (9/11) and right dorsal colitis (4/10), whereas all control horses remained healthy. The first changes were identified on treatment day 2. RDC walls of treated horses were significantly thicker compared to their own baseline values and compared to control horses. In conclusion, presumptive colon pathology was identified with a high incidence, starting early in the course of treatment, but with low severity. Appropriate monitoring should be advised throughout NSAID treatment. Additional research for noninvasive diagnostic tests for colon pathology is required.

Expression of immune regulatory genes correlate with the abundance of specific Clostridiales and Verrucomicrobia species in the equine ileum and cecum.

Billions of bacteria inhabit the gastrointestinal tract. Immune-microbial cross talk is responsible for immunological homeostasis, and symbiotic microbial species induce regulatory immunity, which helps to control the inflammation levels. In this study we aimed to identify species within the equine intestinal microbiota with the potential to induce regulatory immunity. These could be future targets for preventing or treating low-grade chronic inflammation occurring as a result of intestinal microbial changes and disruption of the homeostasis. 16S rRNA gene amplicon sequencing was performed on samples of intestinal microbial content from ileum, cecum, and colon of 24 healthy horses obtained from an abattoir. Expression of genes coding for IL-6, IL-10, IL-12, IL-17, 18 s, TNFα, TGFß, and Foxp3 in the ileum and mesenteric lymph nodes was measured by qPCR. Intestinal microbiota composition was significantly different in the cecum and colon compared to the ileum, which contains large abundances of Proteobacteria. Especially members of the Clostridiales order correlated positively with the regulatory T-cell transcription factor Foxp3 and so did the phylum Verrucomicrobia. We conclude that Clostridiales and Verrucomicrobia have the potential to induce regulatory immunity and are possible targets for intestinal microbial interventions aiming at regulatory immunity improvement.

Development of the equine gut microbiota.

Shortly after birth the mammalian gut is colonized, by a transient microbiota, highly susceptible to environment and diet, that eventually stabilizes and becomes the resident gut microbiota. In a window of opportunity during the colonization, oral tolerance is established towards resident bacteria. In this study, the development of the equine gut microbiota was investigated in ten foals from parturition until post weaning. We found great differences in the core species of the gut microbiota composition between time-matched samples on Day 7 and 20 post-partum. Between day 20 and Day 50 post-partum, we saw the gut microbiota became increasingly dominated by fiber fermenting species. After Day 50, no significant changes in species abundance were observed. Gene expression analysis of pro- and anti-inflammatory cytokines in the blood revealed no significant changes before and after weaning. In summary, relative stability of the gut microbiota was reached within 50 days post-partum and, weaning did not have a major impact on the microbial composition.

The composition of the inflammatory infiltrate in three cases of polyneuritis equi.

Polyneuritis equi (PNE) is a rare neurological disease in the horse. Because of the suspicion in PNE of a T-lymphocyte mediated immune response against the myelin, the objective of this study was to determine the composition of the inflammatory infiltrate in the involved nerves of 3 horses with PNE, studied retrospectively. T-lymphocytes were demonstrated in the lesions, which suggests a T-lymphocyte mediated immune response against myelin. In addition, the presence of B-lymphocytes indicated a local production of antibodies. More research, involving a prospective study, is needed to determine whether the T-lymphocytes are cytotoxic or T-helper lymphocytes.

Vegetative endocarditis in equids (1994--2006).

BACKGROUND: Endocarditis is a rare heart condition with variable clinical expressions in equids. Risk factors for this disease are incompletely understood. OBJECTIVE: Describe risk factors for endocarditis in equids. ANIMALS: One hundred and fifty-three equids admitted to Liège University, 9 diagnosed with endocarditis and 144 free from endocarditis but admitted to the hospital with a differential diagnosis including this disease. METHODS: Retrospective case-control study. RESULTS: Equids with endocarditis were significantly younger (mean age = 4.84 +/- 5.74 years) than control equids (mean age = 10.8 +/- 7.73 years) (P = .01). No sex or breed predisposition was observed. Animals with hyperthermia (odds ratio [OR] = 24.4; confidence interval [CI] = 1.40-428), synovial distension (OR = 13.4; CI = 3.00-59.8), lameness (OR = 6.52; CI = 1.63-26.1), hyperglobulinemia (OR = 26.4; CI = 3.03-229), hypoalbuminemia (OR = 11.4; CI = 1.34-96.8), hyperfibrinogenemia (OR = 9.81; CI = 1.16-82.7), or leukocytosis (OR = 7.12; CI = 1.40-36.4) presented a significantly higher risk of having endocarditis than control horses. The presence of two of the clinical signs mentioned above significantly increased the probability of a diagnosis of endocarditis (P< or = .05). CONCLUSIONS AND CLINICAL IMPORTANCE: Age is associated with equine endocarditis. The diagnostic value of certain clinical signs and abnormalities in blood parameters in this disease are described.

The use of radial extracorporeal shockwave therapy in the treatment of urethral urolithiasis in the horse: a preliminary study.

BACKGROUND: Radial extracorporeal shockwave therapy (ESWT) is widely used in equine practice for the treatment of orthopedic problems. However, its original use as a lithotripsy device in human and canine urology led us to postulate that it could be used as an alternative to the surgical treatment of urethral calculi in horses. HYPOTHESIS: Radial ESWT can easily and safely fragment calculi in the distal urethra of the horse. ANIMALS: Two postmortem cases and 1 live case of obstructive urinary disease admitted at the Veterinary Teaching Hospital of Liege. METHODS: A radial shockwave device was directly applied to the urethra in an attempt to fragment calculi. An ex vivo trial was performed on the same retrieved calculi to investigate pressure settings in order to obtain complete fragmentation of the calculus. RESULTS: In all cases, radial ESWT was able to fragment the calculus partially, enabling retrieval of the remaining fragments via the urethra. Much higher pressure settings than those used for in vivo partial fragmentation were necessary to obtain complete destruction of the calculi ex vivo. CONCLUSIONS AND CLINICAL IMPORTANCE: This brief report suggests the use of radial ESWT as a safe and useful alternative to more invasive surgical management of urethral calculi in horses.

Tetanus in the equine species: a retrospective study of 31 cases.

BACKGROUND: Few studies exist about factors affecting the outcome of horses with tetanus. ANIMALS: 31 equids (30 horses and 1 donkey) with a clinical diagnosis of tetanus admitted to the Equine Clinic of the University of Liege between 1991 and 2006. The cases were divided into two groups according to the outcome (survivors and non-survivors). METHODS: The clinical data of survivors and non-survivors were compared using an ANOVA (continuous data) or a Fisher's test (discrete data). RESULTS: The survival rate was 32%. Most animals were 5 years or younger, and none had been appropriately vaccinated. The non-survivors were significantly younger than the survivors. The development of dyspnoea, recumbency, and the combination of dysphagia, dyspnoea, and recumbency was observed significantly more in the non-survivors than in the survivors. The timing of tetanus antitoxin administration (either immediately after the onset of suggestive signs or after a delay) was not different between the two groups. The time between the occurrence of a wound and the first signs ranged from 2 days to 2 months and was not significantly different between groups. All non-survivors died within 8 days of the first signs. CONCLUSIONS & CLINICAL IMPORTANCE: This study suggests that young animals are affected more often and more severely by tetanus than older animals. Dyspnoea, recumbency, and the combination of dysphagia, dyspnoea, and recumbency can be considered as indicators of a poor prognosis in equids suffering from tetanus.

Clinical Sentinel Surveillance of Equine West Nile Fever, Spain.

West Nile fever (WNF) is a viral zoonotic infection caused by a mosquito-borne flavivirus of the Flaviviridae family. According to a comparative study, the passive surveillance of horses by equine veterinarians appeared to be the most cost-effective system in the European context of WNF. Clinical data issued from a passive epidemiosurveillance network from September 2010 to December 2011 on horses in Spain were statistically compared and used to develop a predictive diagnostic decision tree, both with the aim to improve the early clinical detection of WNF in horses. Although clinical signs were variable in horses affected by WNF, four clinical signs and the month of occurrence were identified as useful indicators to distinguish between WNF-related and WNF-unrelated cases. The signs that pointed out a presumptive diagnosis of WNF in horses were cranial nerves deficits, limb paralysis, photophobia and nasal discharge. Clinical examination of horses with neurological signs that are not vaccinated against WNV could provide important clues for the early clinical detection of WNF and therefore serve as an alert for possible human viral infections. The study of the clinical pattern of WNF in horses is of importance to enhance awareness and better understanding and to optimize surveillance designs for clinical detection of WNF in horses in advance of epidemic activity affecting humans.

Prolactin stimulation test with perphenazine: an evaluation of plasma prolactin levels and pituitary secretory activity in the rat.

Many investigations of the regulation of prolactin synthesis and release are based on single plasma prolactin determinations. The purpose of the present experiment was to ascertain whether groups of rats (i.e. young or adult, male or female animals, being either intact, gonadectomized or gonadectomized and treated with oestrone), differing in age and/or endocrine status, will react to a single dose of perphenazine by an acute release of pituitary prolactin in proportion to their initial plasma prolactin levels. No consistent relation existed between the classification of the twelve groups of rats into three categories of basal plasma prolactin levels (i.e. less than 20, 25-50, greater than 125 ng/ml) and their response to perphenazine. Even though all groups showed a highly significant increase of plasma prolactin levels the magnitude of the maximum prolactin response at 30 min varied greatly within the groups of one category and thus was not related to the initial prolactin levels. The effect of 14 days of oestrone treatment in increasing plasma prolactin levels in gonadectomized animals was greatest in young and adult male rats, less in young females and not significant in adult females. The results obtained after perphenazine treatment in the latter group made it clear that the effect of oestrogen treatment on prolactin release can be completely blocked by increasing synthesis and/or release of the prolactin-release inhibiting factor (PIF). Since perphenazine induces decrease of pituitary prolactin and a concomitant increase of plasma prolactin levels through lowered PIF-action, the positive effect of oestrogens on prolactin release (as observed in gonadectomized male and young female rats) apparently is caused by a different mode of action. The implications of these findings for the regulation of prolactin release, as affected by the endocrine status of the rat, is discussed. Moreover, comparison of prolactin lost from the pituitary and gained in the circulation of the experimental animals, with amounts of prolactin that were observed to disappear from plasma during the experiment, provided suggestive evidence that the capacity to synthesize and/or eliminate prolactin, after a sudden provoked release of the hormone, differed among the groups. The rates of synthesis by the pituitary, of release from the pituitary into the circulation as well as of elimination of the hormone from the circulation (equally involved in determing actual plasma levels) are thought, therefore, to be far more important for the elucidation of prolactin regulation than single plasma prolactin determinations.

Prolactin inhibition test with L-dopa: decrease and restoration of plasma prolactin levels in the rat by a peripheral process.

L-DOPA, within 30 min after administration, induced a highly significant decrease of plasma prolactin levels (phase 1) in a number of groups of rats, differing in age and/or endocrine status, apparently by direct inhibition of prolactin release from the pituitary. Three hours after administration of L-DOPA these low plasma prolactin concentrations in treated animals had increased (phase 2) and did not differ significantly from levels in control animals, indicating that the effect of L-DOPA on plasma prolactin levels is only of short duration. During this process some interesting phenomena were observed, especially in the animals treated with oestrone. The elimination rate of prolactin from plasma was very high (t 1/2 = 2.8 min), as indicated by decreasing concentrations of the hormone during phase 1. Pituitary prolactin content did not change during phase 1, suggesting that prolactin synthesis was also stopped. Notwithstanding the high elimination rate, plasma prolactin regained initial concentrations in phase 2, suggesting release of a substantial part of the pituitary prolactin content. The latter,however, remained constant during the whole experiment (i.e. before L-DOPA administration and during phase 1 as well as phase 2). The results suggested another working mechanism of L-DOPA in decreasing plasma prolactin levels, namely by stimulating the uptake of this hormone in the periphery. After the effect of L-DOPA had ceased, most of the prolactin from the periphery returned into the bloodstream, causing a rapid restoration of plasma prolactin levels without substantial release from the pituitary. The nature of the processes responsible for the peripheral uptake of prolactin is discussed.

Stress, neuromotor noise, and human performance: a theoretical perspective.

A new theory on stress and human performance is proposed in which physical and cognitive stressors enhance the level of neuromotor noise in the information-processing system. The neuromotor noise propagates in time and space. A 2nd assumption states that such noise facilitates easy tasks but disrupts complex tasks. In 4 experiments, 2 graphic tasks (number writing and graphic aiming) were crossed with 2 stressors (cognitive stress from a dual-task situation and physical stress in the form of loud auditory noise). Reaction time (RT), movement time (MT), and axial pen pressure were measured. In the RT phase, stress was predicted to lead to decreased RT with easy tasks and to increased RT with difficult tasks. In the execution phase, biomechanical adaptation to enhanced levels of noise was expected to manifest in higher levels of limb stiffness. In all 4 experiments, an increase of axial pen pressure with higher levels of stress evidenced the generality of biomechanical adaptation as a response to stress. RT and MT showed differential effects among the 4 experiments.

Effects of motor programming on the power spectral density function of finger and wrist movements.

Power spectral density analysis was applied to the frequency content of the acceleration signal of pen movements in line drawing. The relative power in frequency bands between 1 and 32 Hz was measured as a function of motoric and anatomic task demands. Results showed a decrease of power at the lower frequencies (1-4 Hz) of the spectrum and an increase in the middle (9-12 Hz), with increasing motor demands. These findings evidence the inhibition of visual control and the disinhibition of physiological tremor under conditions of increased programming demands. Adductive movements displayed less power than abductive movements in the lower end of the spectrum, with a simultaneous increase at the higher frequencies. The relevance of the method for the measurement of neuromotor noise as a possible origin of delays in motor behavior is discussed.

Error, stress and the role of neuromotor noise in space oriented behaviour.

In this article both movement errors and successful movements are considered to be the product of varying ratios of muscle force signals and the composite of neuromotor noise in which the force signal is embedded. Based on earlier work we derived four propositions, which together form a theoretical framework for understanding the incidence of error in conditions of time pressure and mental load. These propositions are: (1) motor behaviour is an inherently stochastic and therefore noisy process; (2) biophysical, biomechanical and psychological factors all contribute to the level of neuromotor noise in a movement signal; (3) endpoint variability of movement is related to the signal-to-noise ratio of the forces which drive the moving limb to the target; and (4) optimal signal-to-noise ratios in motor output can be arrived at by adjusting limb stiffness. In an experiment with a graphical aiming task in which subjects made pen movements to targets varying in width and distance, we tested the prediction that time pressure and dual task load would influence error rates and movement noisiness, together resulting in biomechanical adaptations of pen pressure. The latter is seen as a manifestation of a biomechanical filtering strategy to cope with increased neuromotor noise levels. The results confirmed that especially under time pressure error rates and movement noise were enhanced, while pen pressure was higher in both conditions of stress.

Phonological and motoric demands in handwriting: evidence for discrete transmission of information.

In an experiment with handwriting tasks effects of phonological and motoric task factors upon reaction time and movement time were measured to test implications of a discrete information processing account of the task. The model is built up of serially organized stages, each of which monitors one specific type of operation, necessary to generate a message. The serial structure of the model is defined as the limitation that higher levels of the model provide their output to the next lower processor in the hierarchy, and receive their input from the next higher stage. The parallel character of the model is exemplified through the assumption that all processors are active at the same time and concurrently with the real time production of writing movements. The study adds evidence that a serial architecture of processors can be compatible with the parallel processing of a message as long as more abstract operations are prepared more in advance to real-time movements than operations lower in the hierarchy. In the experiment the prediction was tested that the time course of the manifestation of phonological and motoric task demands reflects the discrete and serial structure of the model.

Neuromotor control in handwriting and drawing: introduction and overview.

In this introduction to the Special Issue on Neuromotor Control in Handwriting and Drawing, an overview is given of the themes and sub-themes covered by these proceedings of the eighth Biennial Conference of the International Graphonomics Society (IGS) on handwriting and other graphic tasks, held in Genoa, Italy, 24-28 August, 1997. Section overviews are given for Neuromuscular and Biophysical Models; Learning and Cognitive Models; and Neuropsychological Issues. Moreover, to guide researchers in the field, this introduction also provides a summary list of major publications following the preceding IGS conferences.

Auditory stress effects on preparation and execution of graphical aiming: a test of the neuromotor noise concept.

Effects of physical and mental stress, on the preparation and execution of a psychomotor task were studied to test the applicability of the neuromotor noise concept (Van Gemmert and Van Galen, 1997) as an explanation of stress effects. Central to this notion is that both physical stress and mental load raise neuromotor noise levels in the human information processing system. It is proposed that increased levels of neuromotor noise lead to decreased processing times during task preparation (activation effect), decreased or increased reaction times during task initiation, depending on task difficulty (impoverished signal-to-noise effect) and increased limb stiffness during task execution (biomechanical filtering effect). To test these predictions, an experiment was conducted in which two types of auditory stressors, physical stress and mental load, were manipulated across the stages of preparation, initiation, and execution of a graphical aiming task. The results confirmed the notion that the neuromotor noise concept is a tenable approach to explain the effects of stress on human performance.

Phonological and orthographic demands in the production of handwriting.

In an experimental handwriting task, with two parts, we varied the phonological and orthographic complexity of visually presented nonwords. Twelve adult subjects had to write these nonwords in shorthand as well as in Latin script. Phonological complexity was varied by presenting a nonword which included two identical vowel characters. These were either phonologically similar (simple condition) or phonologically different (complex condition). Orthographic complexity was varied by using nonwords which either have a graphemic format for shorthand that corresponds with the graphemic format that is applied for Latin script (simple condition) or a graphemic format for shorthand which is discrepant from the Latin script format (complex condition). It appeared that a higher degree of phonological and orthographic complexity led to a slower and less fluent performance in graphemes that preceded the actual locus of complexity of the nonword. Furthermore, complexity effects were by far the strongest under the production of shorthand. The results are interpreted from the point of view of a psychomotor theory of handwriting, which assumes that the spelling process of visually presented nonwords may follow a phonological or an orthographic (sublexical) route. The finding that orthographic complexity interferes with the production of a phonologically oriented task such as shorthand is interpreted as evidence in favour of an interactive transmission of information between these two processing routes.

Texture information in tactual space perception.

The significance of texture as a source of information in tactual space perception was studied using a linear positioning task. A spatial texture gradient, whose elements changed with position and distance, a homogeneous raised-element pattern and a smooth surface were used. Participants had to reproduce locations and distances on these surfaces under various conditions. In active conditions, participants moved their indexfinger across the surface. In passive conditions, the texture was moved beneath the indexfinger of the participant. In conditions with equal movement speed, movement speeds' of criterion and reproduction phase were matched, in conditions with unequal movement speed, they did not match. The largest errors were obtained for the combined passive movement-unequal movement speed conditions. In these conditions, differences between textures were visible for signed and unsigned errors, indicating that textures may differ in the cutaneous specification of distance and location.