Validation of pitchAITM markerless motion capture using marker-based 3D motion capture.

This study sought to compare and validate baseball pitching mechanics, including joint angles and spatiotemporal parameters, from a single camera markerless motion capture solution with a 3D optical marker-based system. Ten healthy pitchers threw 2-3 maximum effort fastballs while concurrently using marker-based optical capture and pitchAITM (markerless) motion capture. Time-series measures were compared using R-squared (r2), and root mean square error (RMSE). Discrete kinematic measures at foot plant, maximal shoulder external rotation, and ball release, plus four spatiotemporal parameters were evaluated using descriptive statistics, Bland-Altman analyses, Pearson's correlation coefficients, p-values, r2, and RMSE. For time-series angles, r2 ranged from 0.69 (glove arm shoulder external rotation) to 0.98 (trunk and pelvis rotation), and RMSE ranged from 4.37° (trunk lateral tilt) to 20.78° (glove arm shoulder external rotation). Bias for individual joint angle and spatiotemporal parameters ranged from -11.31 (glove arm shoulder horizontal abduction; MER) to 12.01 (ball visible). RMSE was 3.62 m/s for arm speed, 5.75% height for stride length and 21.75 ms for the ball visible metric. pitchAITM can be recommended as a markerless alternative to marker-based motion capture for quantifying pitching kinematics. A database of pitchAITM ranges should be established for comparison between systems.

A biomechanical comparison of the Mitek RapidLoc, Mitek Meniscal repair system, clearfix screws and vertical PDS and Ti-Cron sutures.

The aim of this in vitro study was to measure and compare the biomechanical properties and mode of failure of the five different methods of meniscal repair. Reproducible tears were created in 50 bovine medial menisci and repaired in a standardized fashion with one of the following devices: the RapidLoc meniscal repair device (Mitek Products, Westwood, MA), an 8 mm Mitek meniscal repair system (Mitek Products, Westwood, MA), Clearfix screw (Innovasive Devices, Marlborough, MA), a single vertical mattress suture of 2-0 Ti-Cron (Ethicon, Massachusetts) and a vertical mattress suture of No. 1 PDS II (Johnson and Johnson Int.). The repairs were tested by single cycle load to failure in a materials testing machine. The mean loads to failure for each of the repair groups were as follows: Mitek RapidLoc 44.9 N, Mitek meniscal repair system 20.3 N, Clearfix screw 37.4 N, vertical Ti-Cron 66.1 N and vertical PDS suture 103.0 N. The mean load to failure was significantly greater with PDS vertical sutures than with other techniques (P<0.05). The Mitek RapidLoc had the least extension at failure (14.8 mm) (P<0.05). This study confirms meniscal repair with vertical PDS sutures confers the highest biomechanical stability and that the new Mitek RapidLoc device offers improved load to failure than the previous generations.

The Lubinus patellofemoral arthroplasty: a series of 17 cases.

INTRODUCTION: The Lubinus patellofemoral arthroplasty was introduced in our institution in 1994. The first 17 patients were followed-up in order to identify the short-term outcome for this prosthesis. MATERIALS AND METHODS: The average age at surgery was 66 years (range 37-82 years). The mean follow-up was 19 months. The indications for surgery were strictly limited to radiographically proven primary osteoarthritis affecting only the patellofemoral joint (13) and secondary arthritis due to maltracking, subluxation (3) or trauma to the patella (1). At review, the range of movement and Lysholm and Tegner scores were recorded and radiographs obtained. Patients were also asked if their outcome was satisfactory or unsatisfactory. RESULTS: At review, only 9 (53%) knees were classified as satisfactory by the patients. Further surgery had been carried out in 6 cases (35%) including revision to total knee arthroplasty in 4 (24%). Other complications included clicking and subluxation in 3 cases (18%), extension block in 3 (18%) and infection in 1 (6%). Progression of osteoarthritis to involve other compartments occurred in 2 cases (12%). CONCLUSIONS: Many of these early problems are related to the unforgiving nature of the prosthesis on insertion. These poor early results have led us to stop using the prosthesis.

Do we practice evidence based medicine with regard to drain usage in knee arthroplasty? Results of a questionnaire of BASK members.

Clinical governance requires our clinical practice to be evidence based. We wished to see if British Orthopaedic surgeons are using the current evidence with regards to the use of drains in knee arthroplasty. A questionnaire was faxed to all UK members of BASK to ascertain their current practice regarding the use of drains in knee arthroplasty and the rationale for their drain policy. The study suggests that the majority of practising members of BASK do not practice evidence based medicine with regard to the use of drains in knee arthroplasty.

Ex-professional association footballers have an increased prevalence of osteoarthritis of the hip compared with age matched controls despite not having sustained notable hip injuries.

OBJECTIVE: To compare the prevalence of self reported, physician diagnosed osteoarthritis (OA) of the hip in ex-professional footballers with that in age matched controls in the general public. METHOD: A questionnaire was sent to the 92 football league and premiership managers to assess the prevalence of OA of various joints. The prevalence of OA of the hip in those managers that were ex-professional footballers was assessed. Radiographic controls were obtained and used to assess the prevalence of OA of the hip in the general population. The results of the two groups were compared statistically using chi(2) tabulation. RESULTS: Seventy four (80%) of the managers responded to the questionnaire. Nine of the 68 ex-professional footballers who replied had OA of the hip, and six of these had undergone a total of eight total hip replacements. Of the 18 managers who did not respond, 12 were known to be ex-professionals. In the control group of 136, two had OA of the hip. The two groups differed significantly (p<0.001). The odds ratio for OA of the hip was 10.2 (95% confidence interval 2.1 to 48.8). CONCLUSION: The ex-professional footballers had a significantly higher prevalence of OA of the hip than an age matched group of radiographic controls.

Effects of antimanic mood-stabilizing drugs on fetuses, neonates, and nursing infants.

Pregnancy presents a special problem to the clinician treating bipolar disorders in women. Since the first episode of mania typically occurs before the age of 30, many women in their prime childbearing years may be exposed to potentially teratogenic mood-stabilizing agents. This exposure may also continue for the nursing infant during lactation. Pregnancy itself can exacerbate bipolar symptoms and also alter the pharmacokinetics of mood-stabilizing drugs. Risks to mother and fetus can be reduced with a number of simple strategies, including monotherapy with the lowest effective dose of a drug for the shortest period necessary, periconceptional use of multivitamins with folate, prescription of drugs with established safety records, and avoidance of exposure to antimanic agents during the first trimester of pregnancy. In this article, we review existing evidence on the risks to fetuses and nursing infants of mothers taking specific mood-stabilizing agents, and we present appropriate management guidelines designed to minimize these risks.

Control of flea populations in a simulated home environment model using lufenuron, imidacloprid or fipronil.

Control strategies were evaluated over a 6-month period in a home simulation model comprising a series of similar carpeted pens, housing matched groups of six cats, in which the life-cycle of the flea Ctenocephalides felis felis Bouche (Siphonaptera: Pulicidae) had been established. Additional adult fleas were placed on the cats at intervals to mimic acquisition of extraneous fleas from outside the home. Treatment strategies included a single subcutaneous deposition of injectable lufenuron supported by initial treatments with a short-acting insecticidal spray, or monthly topical applications of imidacloprid or fipronil. An untreated control group indicated that conditions were suitable for flea replication and development. Controls had to be combed on 18 occasions to remove excessive flea burdens and two developed allergic reactions. Lufenuron cats were combed once and required two insecticidal treatments in the first month to achieve control. Even so, small flea burdens were constantly present thereafter. Imidacloprid and fipronil treatments appeared to give virtually complete control throughout. Single fleas were found on imidacloprid cats on two occasions, whereas none were recovered from fipronil cats at any time after the first treatment. Tracer cats were used to monitor re-infestation rates at the end of the trial period. Small numbers of host-seeking fleas were demonstrated in all treatment pens, indicating that total eradication had not been accomplished. It is concluded that the home environment simulation model incorporating tracer animals could provide a powerful tool for studying flea population dynamics under controlled conditions but improved techniques are needed for quantifying other off-host life-cycle stages.

Effect of a peri-parturient eprinomectin treatment of dairy cows on milk production.

AIM: To quantify and economically evaluate the effect on milk production of peri-parturient treatment of dairy cows with eprinomectin. METHODS: On 3 farms in separate geographic areas of New Zealand, 849 first-calf heifers and multiparous cows were ranked and paired within parity, date of calving and expected milk production. Within pairs, cows were randomly allocated to treatment with either a commercial formulation of eprinomectin, applied at a dose rate of 500 mug/kg liveweight, or an equivalent volume of vehicle containing no antiparasitic agent and administered at the same dose volume, generally within the first week post-calving. On each farm, trial cows shared the same pasture. Over a single lactation, records were maintained of milk quantity and content. RESULTS: Trichostrongylid eggs were identified in pre-treatment faecal samples from all farms, verifying the presence of gastrointestinal parasites. Overall 25.5% of the cows sampled were positive for nematode eggs, but only 8% had counts 50 eggs per gram of faeces (epg). Daily milk volume, milk protein and milksolids (yield of milk fat + milk protein) were higher for eprinomectin-treated multiparous cows than for controls (milk volume: 20.36 l/day vs 19.76 l/day, p=0.005; milk protein: 0.700 kg/day vs 0.685 kg/day, p=0.012; milksolids: 1.613 kg/day vs 1.583 kg/day, p=0.031, respectively). The daily value of the increased production from eprinomectin-treated multiparous cows was estimated to be NZ0.034 dollar for milk fat (p=0.095) and NZ0.078 dollar for milk protein (p=0.012), equating to NZ0.104 dollars for milksolids (p=0.031), averaged over the whole lactation. No significant difference in milk production was detected between treated and control first-calf heifers. Averaged over the whole herd, the peri-parturient treatment of multiparous cows and first-calf heifers with eprinomectin increased daily milk volume and milk protein production of treated vs control cows (19.28 l/day vs 18.86 l/day, p=0.020, and 0.661 kg/day vs 0.650 kg/day, p=0.047, respectively). CONCLUSION: These data provide evidence that the use of a peri-parturient treatment of eprinomectin on multiparous cows can increase their production of fluid milk and milksolids.

At issue: a default analysis for schizophrenia research.

The concept that there are at least three clinical syndromes within schizophrenia has been influential, and the significance of these syndromes is supported by a growing number of studies. However, the meaning of these syndromes is not clear. The yield of research studies could be increased by the application of a "default" data analysis, in which the differential association--if any--of the three syndromes with the dependent variable(s) of a study is determined.

Anthelmintic treatment of dairy cows and its effect on milk production.

The results of more than 80 experiments on gastrointestinal parasitism and the impact of anthelmintic treatment on milk production in dairy cattle were reviewed. Abattoir surveys of culled dairy cows, faecal egg counts in milking cows, and serological tests and worm counts in cull cows in milk production studies were collated to assess the level of parasitism in dairy herds. The studies were divided into four general categories: induced infections in previously uninfected cattle; naturally infected cattle treated in mid-lactation; naturally infected cattle treated one to three times during the dry period and/or just before or just after parturition; and naturally infected cattle treated repeatedly from early lactation or given strategic treatments throughout the year. In most studies, the milk production of anthelmintic-treated cattle was compared with that of untreated controls. The anthelmintics investigated included members of the organophosphate, benzimidazole, imidazothiazole and macrocyclic lactone groups. The number of experiments in which the medicated (or uninfected) group had a higher milk yield was compared with the number of experiments in which the control (or infected) group had a higher yield. Overall, the studies demonstrated that grazing dairy cattle are likely to be infected with gastrointestinal nematode parasites, usually Ostertagia ostertagi and Cooperia species. These infections may be present as inhibited larvae, and a periparturient or spring rise is associated with their emergence. There is, at present, no reliable means of determining whether a cow or a herd may be parasitised subclinically at a level sufficient to interfere with milk production. In 70 of 87 experiments (80 per cent) there was an increase in milk production (P < 0.001) after anthelmintic treatment, with a median increase of 0.63 kg/day. In each of the four trial categories, a majority of the studies showed that anthelmintic treatment increased milk production. The yield of milk fat by the medicated cows was greater than by the controls in 26 of the 35 experiments in which that variable was studied (P < 0.01).

Risedronate, a highly effective, short-term oral treatment for Paget's disease: a dose-response study.

Risedronate is a potent pyridinyl bisphosphonate being developed for bone diseases such as Paget's disease and osteoporosis. In this study, we compared the efficacy, safety, and tolerability of three different doses of oral risedronate in 62 patients with severe Paget's disease of bone [serum alkaline phosphatase (AP) >3 times the upper limit of normal]. Patients were treated at six study centers with either 10, 20, or 30 mg oral risedronate daily for 28 days and followed up to day 85. The primary efficacy parameter was percentage change from baseline in AP excess. The data show that there is a dose-response with risedronate: patients who received 30 mg oral risedronate for 28 days benefited most, with a mean percentage decrease in AP excess of 72.2% (20 mg: 57.9%; 10 mg: 48. 0%). Time to response-the first time point when there was a >/=30% reduction from baseline in AP excess and >/=50% reduction from baseline in urinary hydroxyproline (HP)/creatinine-was also significantly shorter (median 29 days) in the 30 mg group compared with the other two groups (20 mg: 43 days and 10 mg: 71 days). Long-term follow-up data up to 33 months from the start of the study indicated that AP remained below baseline levels for all patients. Histologic evaluation of bone formed during risedronate therapy demonstrated that normal lamellar bone was formed as opposed to woven pagetic bone, with no evidence of osteomalacia. Risedronate was well tolerated. Transient decreases in serum calcium and increases in serum intact parathyroid hormone were observed, consistent with the pharmacology of risedronate. In conclusion, risedronate administered at daily doses of 10, 20, and 30 mg for 28 days was effective in reducing the biochemical indices of disease activity in patients with severe Paget's disease of bone. A daily dose of 30 mg was most effective without compromising safety or tolerability.

Persistence of the activity of topical ivermectin against biting lice (Bovicola bovis).

To assess the persistence of the activity of topical ivermectin against a natural challenge with biting lice (Bovicola bovis), 90 mixed-breed cattle that had been treated to remove lice, were blocked by bodyweight within sex and randomly allocated to three treatments: untreated control, doramectin at 200 micrograms/kg by subcutaneous injection, and ivermectin at 500 micrograms/kg by topical application. Forty-five pens were blocked into three groups of 15, and the blocks of pens were randomly allocated to three 14-day challenge periods starting 21, 28 and 35 days after treatment. There were five pens per treatment for each challenge period, and one B bovis-infested donor calf was introduced into each pen containing two principal calves at the start of the challenge period for that block of pens. The calves were examined thoroughly for B bovis seven, 14 and 21 days after the introduction of the donors. There were no significant differences between the control and doramectin groups for the numbers of animals infested, or the geometric mean louse counts at the final examination for any of the challenge periods. At the final examination for each challenge period, the louse counts of the cattle treated with topical ivermectin were all zero, and significantly (P < 0.05) fewer cattle treated with topical ivermectin were infested than either the controls or cattle treated with doramectin.

Risedronate in the treatment of Paget's disease of bone: an open label, multicenter study.

An open-label, multicenter study was conducted to determine the efficacy and safety of oral risedronate (a pyridinyl bisphosphonate) in 162 patients (102 men, 60 postmenopausal women; mean age, 68 years) with moderate to severe Paget's disease of bone (mean serum alkaline phosphatase [ALP] approximately seven times the upper limit of normal). Patients were treated with oral risedronate, 30 mg/day for 84 days, followed by 112 days without treatment. This 196-day cycle was repeated once if serum ALP did not normalize or increased from the nadir value by > or = 25%. At the end of the first and second cycles, the mean percentage decreases for serum ALP were 65.7% and 69.1%, and for urinary hydroxyproline/creatinine 50.4% and 66.9%, respectively. The decreases from baseline in ALP and urinary hydroxyproline/creatinine were significant (p < 0.001). Normalization of serum ALP was observed in 86 patients (53.8%): 53 during the first treatment cycle and 33 during the second. There was a significant proportion of patients reporting a decrease in the pagetic bone pain at days 84 and 196 (p < 0.001). Overall, risedronate was well tolerated. Five patients withdrew due to adverse events, none of which were considered to be drug related. In conclusion, 30 mg of oral risedronate administered daily for 84 days significantly reduced the biochemical indices of disease activity and was associated with pain reduction in patients with moderate to severe Paget's disease of bone. Normalization of ALP was observed in the majority of patients. Repeated administration of risedronate was shown to be beneficial. In general, risedronate was well tolerated and demonstrated a good safety profile.

Assessment of parasite control and weight gain after use of an ivermectin sustained-release bolus in calves.

OBJECTIVE: To assess parasite control and weight gain after administration of an ivermectin sustained-release bolus over 135 days to calves grazing in the midwestern United States. DESIGN: Replicated pasture study. ANIMALS: 56 Bos taurus calves. PROCEDURE: Calves were matched for body weight and randomly allocated to remain untreated or to receive an ivermectin sustained-release bolus before turnout on day 0. Calves were grazed by treatment group on B pastures (4 replicates). Body weights and fecal egg counts were recorded on days- 1 and 28, and then at 28-day intervals until day 168. RESULTS: Parasitism was not clinically evident prior to or during the study. In treated calves, mean fecal egg counts were at or near 0 at all posttreatment evaluations. Although the mean egg count exceeded 20 ova/g only once in control calves, the cumulative egg output was > 42 million/calf. For the treated group, it was < 0.1% of this number. Mean total weight gain was 33.9 kg (74.6 lb) greater for ivermectin-treated calves than for untreated control calves (P < 0.02): a 34% increase. CLINICAL IMPLICATIONS: Fecal trichostrongyle eggs from calves can accumulate over a grazing season to provide enormous potential for augmenting pasture infectivity. An ivermectin sustained-release bolus (administered to calves being placed on pasture) controls parasitism, limits pasture infectivity, and can substantially influence growth by limiting the impact of subclinical parasitism.

Surgical removal of heartworms from the right atrium of a cat.

As few as 2 adult heartworms can cause cardiac enlargement and severe respiratory compromise in cats. Use of echocardiography to view heartworms may indicate whether surgical removal is possible. Aided by fluoroscopy, manual insertion of a catheter that contains basket-type retrieval forceps into the right atrium, via jugular venotomy, may permit removal of adult heartworms from cats. Surgical removal of heartworms and supportive treatment with heparin, prednisone, and antibiotics may result in complete recovery from heartworm infection in cats.

Late-onset anorexia nervosa in schizophrenia: a case report.

The authors report a case of a woman with chronic schizophrenia who developed anorexia nervosa in middle age. The reported rarity of this diagnostic combination and the need to be aware of treatment issues in all patients with coexisting psychoses and eating disorder symptoms are discussed.

Evaluation of the persistence of the effect of ivermectin and abamectin against gastrointestinal and pulmonary nematodes in cattle.

The persistence of the effect of ivermectin and abamectin against gastrointestinal nematodes and lungworm in cattle was evaluated in two trials, each involving 28 animals. Groups of seven cattle either remained untreated, or were treated topically with ivermectin at 500 micrograms/kg bodyweight or subcutaneously with either ivermectin or abamectin at 200 micrograms/kg bodyweight. Starting on the day of treatment the cattle were given daily trickle infections with various infective nematode larvae for two weeks (Haemonchus species, Trichostrongylus axei and Cooperia species), three weeks (Ostertagia ostertagi and Oesophagostomum radiatum) and four weeks (Dictyocaulus viviparus). The cattle were killed 49 to 51 days after treatment and their worm burdens measured. An efficacy of > 99 per cent was recorded in all the groups demonstrating that the products controlled Haemonchus species, T axei, C oncophora, C punctata and C surnabada for at least two weeks, O ostertagi and O radiatum for at least three weeks and D viviparus for at least four weeks.

Persistent efficacy of abamectin and doramectin against gastrointestinal nematodes of cattle.

OBJECTIVE: To assess the persistent activity of injectable formulations of abamectin and doramectin against gastrointestinal nematodes of cattle. DESIGN: Controlled slaughter study assessing residual efficacy. PROCEDURE: Nematode-free calves were treated with abamectin or doramectin (each at a dose of 200 micrograms/kg) and infections then induced with repeated doses of infective larvae of Trichostrongylus axei, Haemonchus placei, Ostertagia ostertagi and Cooperia species. The duration of challenge ranged from 14 to 28 days. The calves were slaughtered at either 38/39 or 45/46 days after the treatments and nematodes recovered from the gastro-intestinal tract. RESULTS: Significant reductions in numbers of O ostertagi occurred for both abamectin and doramectin treatments (> 93%) relative to counts in untreated calves, when challenge was administered up to 21 days after treatment. For T axei and Cooperia spp significant reductions occurred when the challenge occurred for 14 days after treatment (99%). Although differences from untreated animals were not significant, the results for H placei suggested high efficacy (> 85%) for up to 21 days for doramectin and up to 28 days for abamectin. CONCLUSIONS: There was no significant difference between abamectin and doramectin for any parasite at any challenge point, indicating that there is equivalent persistent activity of doramectin and abamectin against important gastrointestinal nematodes of cattle.