Correction: Validation of the Unesp-Botucatu composite scale to assess acute postoperative abdominal pain in sheep (USAPS).

[This corrects the article DOI: 10.1371/journal.pone.0239622.].

A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses.

Proper pain therapy requires adequate pain assessment. This study evaluated the reliability and validity of the Unesp-Botucatu horse acute pain scale (UHAPS), the Orthopedic Composite Pain Scale (CPS) and unidimensional scales in horses admitted for orthopedic and soft tissue surgery. Forty-two horses were assessed and videotaped before surgery, up to 4 hours postoperatively, up to 3 hours after analgesic treatment, and 24 hours postoperatively (168 video clips). After six evaluators viewing each edited video clip twice in random order at a 20-day interval, they chose whether analgesia would be indicated and applied the Simple Descriptive, Numeric and Visual Analog scales, CPS, and UHAPS. For all evaluators, intra-observer reliability of UHAPS and CPS ranged from 0.70 to 0.97. Reproducibility was variable among the evaluators and ranged from poor to very good for all scales. Principal component analysis showed a weak association among 50% and 62% of the UHAPS and CPS items, respectively. Criterion validity based on Spearman correlation among all scales was above 0.67. Internal consistency was minimally acceptable (0.51-0.64). Item-total correlation was acceptable (0.3-0.7) for 50% and 38% of UHAPS and CPS items, respectively. UHAPS and CPS were specific (90% and 79% respectively), but both were not sensitive (43 and 38%, respectively). Construct validity (responsiveness) was confirmed for all scales because pain scores increased after surgery. The cut-off point for rescue analgesia was ≥ 5 and ≥ 7 for the UHAPS and CPS, respectively. All scales presented adequate repeatability, criterion validity, and partial responsiveness. Both composite scales showed poor association among items, minimally acceptable internal consistency, and weak sensitivity, indicating that they are suboptimal instruments for assessing postoperative pain. Both composite scales require further refinement with the exclusion of redundant or needless items and reduction of their maximum score applied to each item or should be replaced by other tools.

Spontaneous Behaviors of Post-Orchiectomy Pain in Horses Regardless of the Effects of Time of Day, Anesthesia, and Analgesia.

This prospective and longitudinal study aimed to identify spontaneous post-orchiectomy pain behaviors in horses regardless of the effects of anesthesia, analgesia, and recording time of day. Twenty-four horses divided into four groups were submitted to: inhalation anesthesia only (GA), or combined with previous analgesia (GAA), or orchiectomy under pre (GCA), or postoperative (GC) analgesia. The data obtained from the subtraction of frequency and/or duration of 34 behaviors recorded during seven 60-min time-points in the 24 h after the anesthesia from those recorded in the mirrored time-points in the 24 h before the anesthesia (delta) were compared over time and among groups by Friedman and Kruskal-Wallis tests, respectively (p < 0.05). Time of day influenced the behaviors of walk, look out the window, rest the pelvic limb, and rest standing still. The only pain-related behaviors were decreased mirrored proportional differences in time spent drinking, and eating, and increased mirrored proportional differences in the frequency or duration of look at the wound, retract the pelvic limb, expose the penis, and look at the back of the stall. In conclusion, confounding factors rather than pain may influence several suggestive pain-related behaviors documented in the literature.

Validation of the Unesp-Botucatu composite scale to assess acute postoperative abdominal pain in sheep (USAPS).

A scale with robust statistical validation is essential to diagnose pain and improve decision making for analgesia. This blind, randomised, prospective and opportunist study aimed to develop an ethogram to evaluate behaviour and validate a scale to assess acute ovine postoperative pain. Elective laparoscopy was performed in 48 healthy sheep, filmed at one preoperative and three postoperative moments, before and after rescue analgesia and 24 hours after. The videos were randomised and assessed twice by four evaluators, with a one-month interval between evaluations. Statistical analysis was performed using R software and differences were considered significant when p <0.05. Based on the multiple association, a unidimensional scale was adopted. The intra- and inter-observer reliability ranged from moderate to very good (intraclass correlation coefficient ≥ 0.53). The scale presented Spearman correlations > 0.80 with the numerical, simple descriptive, and visual analogue scales, and a correlation of 0.48 with the facial expression scale. According to the mixed linear model, the scale was responsive, due to the increase and decrease in pain scores of all items after surgery and analgesic intervention, respectively. All items on the scale demonstrated an acceptable Spearman item-total correlation (0.56-0.76), except for appetite (0.25). The internal consistency was excellent (Cronbach's α = 0.81) and all items presented specificity > 0.72 and sensitivity between 0.61-0.90, except for appetite. According to the Youden index, the cut-off point was ≥ 4 out of 12, with a diagnostic uncertainty zone of 4 to 5. The area under the curve > 0.95 demonstrated the excellent discriminatory capacity of the instrument. In conclusion, the Unesp-Botucatu pain scale in sheep submitted to laparoscopy is valid, reliable, specific, sensitive, with excellent internal consistency, accuracy, discriminatory capacity, and a defined cut-off point.

Feasibility and safety of intrathecal transplantation of autologous bone marrow mesenchymal stem cells in horses.

BACKGROUND: Recent studies have demonstrated numerous biological properties of mesenchymal stem cells and their potential application in treating complex diseases or injuries to tissues that have difficulty regenerating, such as those affecting the central and peripheral nervous system. Thus, therapies that use mesenchymal stem cells are promising because of their high capacity for self-regeneration, their low immunogenicity, and their paracrine, anti-inflammatory, immunomodulatory, anti-apoptotic and neuroprotective effects. In this context, the purpose of this study was to evaluate the feasibility and safety of intrathecal transplantation of bone marrow-derived mesenchymal stem cells in horses, for future application in the treatment of neurological diseases. RESULTS: During the neurological evaluations, no clinical signs were observed that were related to brain and/or spinal cord injury of the animals from the control group or the treated group. The hematological and cerebrospinal fluid results from day 1 and day 6 showed no significant differences (P > 0.05) between the treated group and the control group. Additionally, analysis of the expression of matrix metalloproteinase (MMP) -2 and -9 in the cerebrospinal fluid revealed only the presence of pro-MMP-2 (latent), with no significant difference (P > 0.05) between the studied groups. CONCLUSIONS: The results of the present study support the hypothesis of the feasibility and safety of intrathecal transplantation of autologous bone marrow-derived mesenchymal stem cells, indicating that it is a promising pathway for cell delivery for the treatment of neurological disorders in horses.

Refinement and partial validation of the UNESP-Botucatu multidimensional composite pain scale for assessing postoperative pain in horses.

BACKGROUND: Quantification of pain plays a vital role in the diagnosis and management of pain in animals. In order to refine and validate an acute pain scale for horses a prospective, randomized, blinded study was conducted. Twenty-four client owned adult horses were recruited and allocated to one of four following groups: anaesthesia only (GA); pre-emptive analgesia and anaesthesia (GAA,); anaesthesia, castration and postoperative analgesia (GC); or pre-emptive analgesia, anaesthesia and castration (GCA). One investigator, unaware of the treatment group, assessed all horses at time-points before and after intervention and completed the pain scale. Videos were also obtained at these time-points and were evaluated by a further four blinded evaluators who also completed the scale. The data were used to investigate the relevance, specificity, criterion validity and inter- and intra-observer reliability of each item on the pain scale, and to evaluate construct validity and responsiveness of the scale. RESULTS: Construct validity was demonstrated by the observed differences in scores between the groups, four hours after anaesthetic recovery and before administration of systemic analgesia in the GC group. Inter- and intra-observer reliability for the items was only satisfactory. Subsequently the pain scale was refined, based on results for relevance, specificity and total item correlation. CONCLUSIONS: Scale refinement and exclusion of items that did not meet predefined requirements generated a selection of relevant pain behaviours in horses. After further validation for reliability, these may be used to evaluate pain under clinical and experimental conditions.

Mecânica e microbiologia de placas produzidas a partir de osso cortical bovino, conservadas em diferentes meios / Mechanic and microbiology of plates produced from bovine cortical bone, conserved in several means

Objetivou-se com este trabalho avaliar a resistência mecânica de placas ósseas produzidas a partir de osso cortical bovino, conservadas em diferentes meios, e a eficiência desses meios em inibir o crescimento de microrganismos. Foram utilizadas 168 placas confeccionadas a partir de tíbia bovina e conservadas em glicerina a 98 por cento, solução salina a 150 por cento, solução de açúcar a 300 por cento, líquido de Dakin, congeladas em N2L a -196°C, ou esterilizadas em óxido de etileno. Após reidratação em solução de cloreto de sódio a 0,9 por cento por seis horas, elas foram submetidas a ensaios mecânicos de tração, compressão, flexão e torção. Foi realizada avaliação microbiológica das placas anterior e imediatamente após a reidratação, com ou sem adição de enrofloxacina a 0,5 por cento. Não se observou diferença significativa (P<0,01 por cento) da resistência ao ponto de ruptura entre as placas conservadas nos diferentes meios, congeladas-descongeladas ou esterilizadas. Micro-organismos foram isolados das placas conservadas em solução saturada de sal, açúcar, Dakin ou congeladas em N2L, anterior e após a reidratação. Entretanto, após o uso da solução de cloreto de sódio 0,9 por cento, acrescida de enrofloxacina a 0,5 por cento, não foram isolados microrganismos. Portanto, placas de osso bovino, conservadas em solução saturada de açúcar ou sal, glicerina a 98 por cento, solução de Dakin, congeladas em N2L ou esterilizadas em óxido de etileno assemelham-se em relação à biomecânica e a reidratação com solução de cloreto de sódio a 0,9 por cento, acrescida de enrofloxacina a 0,5 por cento, é eficaz no controle do crescimento microbiano.

The objective of this study was to evaluate the mechanical strength of bone plates yielded from bovine cortical bone, conserved in different solutions, and the efficiency of these solutions in the inhibition of microorganism's growth. A hundred and sixty eight plates yielded from bovine tibiae were conserved in 98 percent glycerin, 150 percent saline solution, 300 percent sugar solution, Dakin solution, frozen in N2L at - 196°C, or sterilized in ethylene oxide gas. After rehydration in NaCl 0.9 percent solution for six hours, plates were subjected to tensile, compression, bending and twisting testing. The microbiological evaluation of bone plates was s carried out before and immediately after rehydration, with or without enrofloxacin 0.5 percent addition. There was no significant difference (P<0.01 percent) on resistance to the rupture point in plates conserved in different solutions, frozen-thawed or sterilized. Microorganisms were isolated from plates conserved in satured salt solution, sugar satured solution, Dakin solution or frozen in N2L, before and after rehydraion However, after the use of NaCl 0.9 percent solution added of enrofloxacin 0.5 percent, microorganisms were not isolated. Therefore, bovine bone plates conserved in sugar or salt satured solution, 98 percent glycerin, Dakin solution, frozen in N2L or sterilized in ethylene oxide gas present similar biomechanical tests results, and rehydrated with a solution of NaCl 0.9 percent plus enrofloxacin 0.5 percent is effective on microorganism growth control.

Radiografia quantitativa hepática de cães tranquilizados com acepromazina / Hepatic quantitative radiography in dogs with acepromazine

O maleato de acepromazina é um dos tranquilizantes mais utilizados em medicina veterinária, podendo causar esplenomegalia, mas não é conhecida a possibilidade de ocorrência de hepatomegalia. Objetivou-se, com o presente estudo, utilizar a radiografia quantitativa com auxilio digital para determinar o tamanho e volume do fígado de cães tranquilizados com acepromazina. Foram radiografados, na projeção lateral direita e ventrodorsal do fígado, nove cães hígidos, antes e após a administração intramuscular de maleato de acepromazina, na dose de 0,1mg kg-1 de peso. Foi possível caracterizar aumento das dimensões hepáticas (P<0,05) entre os diferentes momentos experimentais com forte correlação positiva entre as medidas corpóreas. A técnica radiográfica quantitativa empregada neste estudo caracterizou com precisão o aumento de tamanho e volume hepático nos cães tratados com acepromazina.

The acepromazine is one of the most commonly tranquilizer used in veterinary medicine and its use may cause splenomegaly. However it is not known if it can cause hepatomegaly. The aim of this study is to evaluate the quantitative radiography with digital assistance to determine the liver size and volume of dogs tranquilized with acepromazine. Nine healthy dogs were radiographed in the lateral right and ventral-dorsal liver , before and after intramuscular administration of acepromazine at a dose of 0.1kg-1. It was possible to characterize the size and increase in liver size (P<0.05) between the different experimental moments with a strong positive correlation between the measures liver assets. The quantitative radiographic technique used in this study accurately characterized the increase in size and volume of the liver in dogs treated with acepromazine.

Acupuntura e analgesia: aplicações clínicas e principais acupontos / Acupuncture and analgesia: clinical applications and main acupoints

A dor é uma resposta protetora do organismo a estímulos nocivos, que resulta em efeitos indesejáveis quando não controlada. A analgesia pode ser promovida mediante a utilização de vários tipos de fármacos. No entanto, estes podem causar efeitos adversos de acordo com a espécie e condição física do paciente. A acupuntura tem se mostrado eficaz como coanalgésico pela capacidade de diminuir a quantidade de fármacos utilizados para o controle da dor e raramente ser contraindicada. Objetivou-se com este trabalho fazer uma breve revisão sobre as aplicações clínicas e os efeitos fisiológicos da acupuntura nos mecanismos da dor, bem como demonstrar os principais pontos de acupuntura utilizados para analgesia em animais. A pesquisa foi realizada em bases de dados eletrônicas por palavra-chave, durante o período de março a dezembro de 2008.

Pain is a protective response of the body to harmful stimulus, which results in undesirable effects if not controlled. Analgesia can be achieved with the use of different types of drugs. However, these drugs can cause adverse effects according to species and patient physical condition. Acupuncture has been proved to be an effective analgesic adjuvant, by the capacity to decrease the amount of drug used for pain control, rarely contra-indicated. The aim of this paper was to review the physiological effects of acupuncture on pain mechanisms, and demonstrate the main acupoints used for animal analgesia. The search was done in electronic search database using key words, in 2008.

Esofagoplastia torácica com retalho de pericárdio em gatos / Thoracic esophagoplasty with pericardial flap in cats

Com o objetivo de testar a eficiência do retalho de pericárdio autógeno pediculado como alternativa para reparar defeitos esofágicos torácicos em felinos, foram estudados doze animais adultos, sendo seis avaliados até 30 dias de pós-operatório. Todos os animais foram submetidos à ressecçäo esofágica e posterior reparo com pericárdio pediculado. As análises constaram de exames clínicos diários e, ao final do período estabelecido, os animais foram submetidos à eutanasia e necropsiados para avaliaçäo macroscópica e microscópica dos esôfagos. Observou-se proliferaçäo da mucosa esofágica sobre o pericárdio pediculado.