Determining Objective Parameters to Assess Gait Quality in Franches-Montagnes Horses for Ground Coverage and Over-Tracking - Part 2: At Trot.

In gait quality assessments of horses, stride length (SL) is visually associated with spectacular movements of the front limbs, and described as ground coverage, while the movement of the hind limb under the body is supposedly essential to a longer over-tracking distance (OTD). To identify movement patterns with strong associations to SL and OTD, limb and body kinematics of 24 Franches-Montagnes (FM) stallions were measured with 3D optical motion capture (OMC) on a treadmill during an incremental speed test at trot (3.3-6.5 m/s). These measurements were correlated to the scores of ground coverage and over-tracking from six breeding experts. The amount of explained variance of parameters on SL and OTD were estimated using linear mixed-effect models in two models: a full model with all parameters measurable with OMC, and a reduced model with a subset of parameters measurable with inertial measurement units (IMUs). The front limb stance duration (16%) and OTD (7%) measured with OMC, or the OMC parameters front limb stance duration (24%) and suspension duration (14%) measurable with IMUs explained most variance in SL. However, four of six breeding experts were also significantly correlated (r>|0.41|) to front limb protraction angle. OTD variance was explained with OMC parameters suspension duration (10%) and hind limb contralateral pro-retraction angles (9%) or IMU-measurable parameters suspension duration (20%) and maximal pelvis pitch (5%). Four experts' scores for over-tracking were correlated to suspension duration. These results underscore the need for precise definitions of gait quality traits.

Visualization of anatomical structures in the fetlock region of the horse using cone beam computed tomography in comparison with conventional multidetector computed tomography.

Introduction: Cone-beam computed tomography (CBCT) is regarded as a convenient and suitable alternative to conventional computed tomography. However, in the horse, the quality of obtained data sets needs to be evaluated. Therefore, the aim of this study was to compare the visibility and accessibility of clinically relevant anatomical structures displayed in CBCT and conventional multidetector computed tomography (MDCT). Materials and methods: Twenty-nine limbs from horses euthanized for reasons unrelated to this study were used. Native and intraarticular contrast scans of the fetlock (CBCT vs. MDCT) were performed. The visibility and accessibility of selected anatomical structures were blindly scored by three independent experienced observers using a scoring system previously reported and adapted to the fetlock joint. Results: Only minor differences between CBCT and MDCT were identified concerning the diagnostic quality of images for osseous structures. Soft tissue structures were better evaluated on MDCT images. In CBCT as well as in MDCT articular cartilage could only be visualized after intraarticular injection of contrast medium. Discussion/conclusion: Cone beam computed tomography of the fetlock is a useful and reliable diagnostic tool when evaluating osseous structures and delineating articular cartilage with contrast medium. However, this modality is limited for assessing soft tissues structures.

Bilateral Change in Vertical Hoof Force Distribution in Horses with Unilateral Forelimb Lameness before and after Successful Diagnostic Anaesthesia.

Kinetic examinations of horses with induced lameness as well as the effect of perineural anaesthesia in sound horses have shown promise, but clinical studies regarding the effect of diagnostic anaesthesia during the different stance phases are rare. Fourteen horses with unilateral forelimb lameness were examined with the Hoof™ System during trot to assess vertical force distribution (in kg) affecting both front hooves before and after diagnostic anaesthesia during landing, midstance, and breakover. For statistical analysis, a covariance analysis with repeated measurements regarding the limb (lame/sound) as well as anaesthesia (before/after) and the covariable body weight was performed. The p-values for the pairwise comparisons were adjusted using the Bonferroni−Holm correction (p < 0.05). For all phases of the stance, a significant interaction between the factors limb and anaesthesia was shown. Before diagnostic anaesthesia, vertical force was significantly reduced on the lame limb compared to the sound limb during landing (−25%, p < 0.001), midstance (−20%, p < 0.001) and breakover (−27%, p < 0.001). After anaesthesia, the difference between both forelimbs was not significant anymore for all phases. The vertical force on the lame limb increased significantly after positive anaesthesia during the whole stance phase, with breakover being most affected (+27%, p = 0.001). Pressure measurements with the Hoof™ System can be used to evaluate the effect of diagnostic anaesthesia in a clinical setting with pain-related vertical force asymmetries being neutralised after diagnostic anaesthesia. Breakover is the main event influenced by lameness.

Determining Objective Parameters to Assess Gait Quality in Franches-Montagnes Horses for Ground Coverage and Over-Tracking - Part 1: At Walk.

Ground coverage and over-tracking are two gait quality traits describing the forward movement of the front respectively the hind limbs in relation to stride length and over-tracking distance. To investigate the complex interplay of different movement patterns in ground coverage and over-tracking, limb and body kinematics of 24 Franches-Montagnes (FM) stallions were measured with 3D optical motion capture (OMC) on a treadmill during an incremental speed test at the walk (1.4-2.0 m/s). The significance and amount of explained variance of kinematic parameters on stride length and over-tracking distance were estimated using linear mixed-effect models, with speed and horse as random effects. Two separate models were tested: a full model with all parameters measurable by OMC, and a reduced model with a subset of parameters also measurable with inertial measurement units (IMUs). The kinematic parameters were correlated to the subjective scores from six breeding experts to interpret their external validity. The parameter for ground coverage at the walk, explaining most of the variance in stride length, were the maximal forelimb retraction angle (11%) measured with OMC, and the range of pelvis pitch (10%) if measuring with IMUs. The latter was also the most relevant for quantifying over-tracking, explaining 24% to 33% of the variance in the over-tracking distance. The scores from most breeding experts were significantly correlated (r ≥ |0.41|) with the fore- and hind limb protraction angles, which reflect the textual definition of ground coverage and over-tracking. Both gait quality traits can be objectively quantified using either OMC or IMUs.

Inter-evaluator and Intra-evaluator Reliability of a Software Program Used to Extract Kinematic Variables Obtained by an Extremity-Mounted Inertial Measurement Unit System in Sound Horses at the Trot Under Soft and Hard Ground Conditions and Treadmill Exercise.

Objective: To assess the inter-evaluator and intra-evaluator reliability of a software program used to extract kinematic variables by a commercially available extremity-mounted inertial measurement unit system in sound horses at the trot under soft and hard ground conditions and treadmill exercise. Animals: Thirty adult, sound and healthy French Montagne stallions. Procedures: Data collection was performed with six IMUs strapped to the distal, metacarpal, metatarsal and tibial regions of every horse. Per surface (treadmill, soft and hard ground) 10 stallions were trotted three times. Prior to the analysis done by six evaluators (three experienced, three inexperienced) the data was blinded and copied three times. For every analysis a minimum of five strides had to be selected. To assess the intra- and inter-evaluator reliability a selection of gait variables was used to calculate intra and inter correlation coefficients (ICCs) as well as variance partitioning coefficients (VPCs). Results: All of the tested gait variables showed high levels of reliability. There was no mentionable difference considering the correlation coefficients between the intra and inter reliability as well as between the three different surfaces. VPCs showed that the factor horse is by far the most responsible for any appearing variance. The experience of the evaluator had no influence on the results. Conclusions and Clinical Relevance: The software program tested in this study has a high inter- and intra-evaluator reliability under the chosen conditions for the selected variables and acts independent of the ground situation and the experience of the evaluator. On the condition of a correct application it has the potential to become a clinically relevant and reliable gait analysis tool.

Delayed onset vagus nerve paralysis after occipital condyle fracture in a horse.

Occipital condylar fractures (OCFs) causing delayed onset lower cranial nerve paralysis (LCNPs) are rare. We present a 7-year-old Friesian horse with delayed onset dysphagia caused by vagus nerve (CNX) paralysis and suspicion of glossopharyngeal nerve (CNIX) paralysis developed several days after a minor head injury. Endoscopic examination revealed right laryngeal hemiplegia and intermittent dorsal displacement of the soft palate. An area of submucosal hemorrhage and bulging was appreciated over the dorsal aspect of the medial compartment of the right guttural pouch. Radiological examination of the proximal cervical region showed rotation of the atlas and the presence of a large bone fragment dorsal to the guttural pouches. Occipital condyle fracture with delayed onset cranial nerve paralysis was diagnosed. Delayed onset cranial nerve paralysis causing dysphagia might be a distinguishable sign of OCF in horses. Delayed onset dysphagia after head injury should prompt equine clinicians to evaluate the condition of the atlanto-occipital articulation and skull base.

Ceratohyoidectomy in standing sedated horses.

OBJECTIVE: To investigate the feasibility and complications associated with ceratohyoidectomy (CHE) in standing sedated horses unaffected (experimental horses) and standing sedated horses affected (clinical cases) with temporohyoid osteoarthropathy (THO). STUDY DESIGN: Case series. ANIMALS: Six experimental horses and four clinical cases. METHODS: Standing CHE was performed in six experimental horses euthanized 30 minutes (n = 3) and 7 days (n = 3) postoperatively. The four clinical cases were presented because of central facial nerve paralysis (n = 3), vestibular ataxia (n = 3), auricular hemorrhage (n = 2), quidding (n = 1), and oesophageal impaction (n = 1). Evolution was assessed by clinical examination during hospitalization and later by telephone interviews for the clinical cases. RESULTS: The procedure was successfully performed in all horses. Experimental horses did not show any short-term postoperative complications. Hemorrhage was experienced intraoperatively in one of the clinical cases and was successfully managed with placement of hemostatic forceps. Vestibular ataxia and other symptoms of THO improved within days, but facial nerve paralysis did not improve until 9 days to 6 months after surgery. Follow-up ranged from 9 to 24 months. All clinical cases returned to performance, and client satisfaction was excellent. CONCLUSION: Ceratohyoidectomy was consistently feasible in standing sedated horses. The method did not result in postoperative complications and led to resolution of clinical signs associated with THO. CLINICAL SIGNIFICANCE: Standing CHE should be considered in horses affected with THO, especially when horses present with marked vestibular deficits and ataxia, to reduce risks associated with recovery from general anesthesia.

Effect of three types of horseshoes and unshod feet on selected non-podal forelimb kinematic variables measured by an extremity mounted inertial measurement unit sensor system in sound horses at the trot under conditions of treadmill and soft geotextile surface exercise.

Therapeutic farriery is part of the management of certain orthopaedic conditions. Non-podal parameters are important as most horses shod with therapeutic shoes are expected to perform again and the choice of shoe type may be influenced by the effects they may have on gait. The aim of this prospective study was to evaluate the effects of three different shoe designs and unshod front feet on forelimb non-podal kinematic variables using an extremity mounted inertial measurement unit (IMU) system under conditions of treadmill and overground exercise on a soft geotextile surface at the trot. Ten sound horses with no underlying orthopaedic problem were instrumented with eight IMUs at distal radii, tibia and third metacarpal/tarsal regions. Measurements were performed during four consecutive days. During the first three days, the three shoe types were randomly selected per horse and day. On the fourth day, all horses were tested unshod. Data were collected at the trot on a treadmill, and on a soft geotextile surface. Specifically designed software and a proprietary algorithm processed the accelerometer and gyroscope signals to obtain orientation and temporal data to describe selected kinematic variables predetermined by the system. Repeated-measures analysis of variance (ANOVA) was used to assess differences between shoe type and surface. The presence of shoes produced significant changes in spatiotemporal variables which seemed to be related to shoe mass rather than shoe design as there were no significant differences found between different shoe types. Shod horses showed a gait characterised by an increased range of motion (ROM) of the fore limbs. Previously reported effects of the investigated shoes on podal kinematics do not seem to affect the investigated kinematic variables indicating perhaps a compensatory effect occurring at some level in the extremity.

Effect of trotting speed on kinematic variables measured by use of extremity-mounted inertial measurement units in nonlame horses performing controlled treadmill exercise.

OBJECTIVE To assess effects of speed on kinematic variables measured by use of extremity-mounted inertial measurement units (IMUs) in nonlame horses performing controlled exercise on a treadmill. ANIMALS 10 nonlame horses. PROCEDURES 6 IMUs were attached at predetermined locations on 10 nonlame Franches Montagnes horses. Data were collected in triplicate during trotting at 3.33 and 3.88 m/s on a high-speed treadmill. Thirty-three selected kinematic variables were analyzed. Repeated-measures ANOVA was used to assess the effect of speed. RESULTS Significant differences between the 2 speeds were detected for most temporal (11/14) and spatial (12/19) variables. The observed spatial and temporal changes would translate into a gait for the higher speed characterized by increased stride length, protraction and retraction, flexion and extension, mediolateral movement of the tibia, and symmetry, but with similar temporal variables and a reduction in stride duration. However, even though the tibia coronal range of motion was significantly different between speeds, the high degree of variability raised concerns about whether these changes were clinically relevant. For some variables, the lower trotting speed apparently was associated with more variability than was the higher trotting speed. CONCLUSIONS AND CLINICAL RELEVANCE At a higher trotting speed, horses moved in the same manner (eg, the temporal events investigated occurred at the same relative time within the stride). However, from a spatial perspective, horses moved with greater action of the segments evaluated. The detected changes in kinematic variables indicated that trotting speed should be controlled or kept constant during gait evaluation.

Repeatability of gait pattern variables measured by use of extremity-mounted inertial measurement units in nonlame horses during trotting.

OBJECTIVE To determine repeatability of gait variables measured by use of extremity-mounted inertial measurement units (IMUs) in nonlame horses during trotting under controlled conditions of treadmill exercise. ANIMALS 10 horses. PROCEDURES Six IMUs were strapped to the metacarpal, metatarsal, and distal tibial regions of each horse. Data were collected in a standardized manner (3 measurements/d on 3 d/wk over a 3-week period) while each horse was trotted on a treadmill. Every measurement consisted of a minimum of 20 strides from which a minimum of 10 strides was selected for analysis. Spatial and temporal variables were derived from the IMUs. Repeatability coefficients based on the within-subject SD were computed for each gait analysis variable at each week. RESULTS Most of the temporal and spatial variables had high repeatability (repeatability coefficients < 10), and the repeatability coefficients were consistent among the 3 weeks of data collection. Some spatial variables, specifically the symmetry variables (which were calculated from other variables), had somewhat higher repeatability coefficients (ie, lower repeatability) only in the last week. CONCLUSIONS AND CLINICAL RELEVANCE With the exceptions of some symmetry variables, which may reflect individual variations during movement, the extremity-mounted IMUs provided data with high repeatability for nonlame horses trotting under controlled conditions of treadmill exercise. Repeatability was achieved for each instrumented limb segment with regard to the spatial relationship between 2 adjacent segments (joint angles) and the temporal relationship among all segments (limb phasing). Extremity-mounted IMUs could have the potential to become a method for gait analysis in horses.

Evaluation of experimental impact injury for inducing post-traumatic osteoarthritis in the metacarpophalangeal joints of horses.

OBJECTIVE: To determine whether a single contusive impact injury to the palmar aspect of the metacarpus would progress to post-traumatic osteoarthritis or palmar osteochondral disease in horses. ANIMALS: 12 horses. PROCEDURES: In each horse, an impact injury was created on the palmar aspect of the medial metacarpal condyle of 1 randomly chosen limb with an impactor device under arthroscopic and fluoroscopic guidance. The opposite limb was sham operated as a control. A low to moderate amount of forced exercise was instituted, and horses were evaluated clinically via lameness examinations weekly for 5 months, then biweekly until endpoint, with synovial fluid analysis performed at 0, 1, 2, 3, 4, 6, 8, and 10 months and radiography at baseline and endpoint. Macroscopic examination, micro-CT, and sample collection for cartilage viability and sulfated glycosaminoglycan content, histologic evaluation, immunohistochemical analysis, and fluorochrome analysis were performed following euthanasia at 1 (3 horses), 4 (4), and 8 to 10 (5) months after surgery. RESULTS: There was variability in impact lesion location, depth, and area on macroscopic inspection, but on histologic evaluation, cartilage defects were less variable. Mean sulfated glycosaminoglycan concentration from cartilage at the impact site was significantly lower than that at a similar site in control limbs. Higher concentrations of cartilage oligomeric matrix protein were observed in synovial fluid from impact-injured joints. CONCLUSIONS AND CLINICAL RELEVANCE: The impact injury method caused mild focal osteoarthritic lesions in the metacarpophalangeal joint, but did not progress to palmar osteochondral disease at this site. Repeated injury is probably required for the development of palmar osteochondral disease.

Changes in hoof surface strain distribution in response to moderate exercise in Standardbreds.

OBJECTIVE: To quantify changes in hoof wall strain distribution associated with exercise and time in Standardbreds. ANIMALS: 18 young adult Standardbreds. PROCEDURES: 9 horses were exercised 4 d/wk for 30 to 45 minutes at a medium trot for 4 months; 9 nonexercised horses served as the control group. Rosette strain gauges were used to measure the principal surface strains at the toe, lateral quarter of the hoof wall (LQ), and medial quarter of the hoof wall (MQ) of the right forefoot at the beginning and end of the experiment. Midstance maximal (msϵ1) and minimal (msϵ2) principal and peak minimal principal (pkϵ2) surface strains were measured; SDs of each of those variables were also calculated. Results were compared through ANOVA of time and exercise effects between and within the groups. RESULTS: Both the exercised and nonexercised groups had changes in strain distribution in their hooves over time. The msϵ1 did not change significantly with exercise; however, it changed significantly in both groups at both hoof quarters over time. At the beginning of the study, mean msϵ2 and pkϵ2 values were significantly higher in the exercised group than in the control group at the MQ and LQ but not at the toe. At the end of the study, these values were significantly higher in the control group than in the exercised group at the toe but not at the MQ or LQ. CONCLUSIONS AND CLINICAL RELEVANCE: Detected changes in hoof wall surface strain may indicate the ability of hoof capsule material to respond to exercise. A better understanding of hoof adaptation to applied forces may allow implementation of proper trimming and shoeing techniques to promote adaptation to exercise loads in horses.

Determination of the prevalence and severity of metacarpophalangeal joint osteoarthritis in Thoroughbred racehorses via quantitative macroscopic evaluation.

OBJECTIVE: To determine the prevalence and severity of osteoarthritis in the metacarpophalangeal joints of Thoroughbred racehorses via development and validation of a quantitative macroscopic evaluation system. SAMPLE POPULATION: Metacarpophalangeal joints from 50 Thoroughbred racehorses. PROCEDURES: Joints were collected from horses that died or were euthanized within 60 days of racing. Metacarpophalangeal joints were assessed for osteoarthritic degeneration by use of macroscopic and histologic scoring systems, polarized light microscopy, and cartilage biochemical analysis. The global macroscopic score for the entire metacarpophalangeal joint was based on factors that reflected the size and severity of lesions as well as the involvement of weight-bearing surfaces. RESULTS: One-third of all 2- and 3-year-old horses had partial-or full-thickness cartilage lesions and osteoarthritis. Osteoarthritis severity increased until age 6 in this population. Significant correlations were found between macroscopic grade and age, cause of death, glycosaminoglycan depletion, and loss of superficial cartilage zone polarized light intensity. CONCLUSIONS AND CLINICAL RELEVANCE: The macroscopic system devised for this study had good correlations with quantitative methods. Two-and 3-year-old horses had full-thickness cartilage lesions that may have been career limiting. Year-to-year attrition and a small population of older horses may have led to underestimation of the prevalence of osteoarthritis in older horses. The macroscopic scoring system was reliable when used by nonexpert and expert users.

Analysis of the subchondral microarchitecture of the distopalmar aspect of the third metacarpal bone in racing Thoroughbreds.

OBJECTIVE: To determine the anisotropic characteristics of the microarchitecture of the subchondral bone (SCB) plate and trabecular bone (TBB) of the distopalmar aspect of the metacarpal condyles in horses with different stages of SCB disease. SAMPLE POPULATION: 12 third metacarpal bone pairs from racing Thoroughbreds euthanized for diverse reasons. PROCEDURES: Both metacarpi were collected from horses with SCB changes that were mild (sclerosis and focal radiolucencies; n=6) or severe (multifocal radiolucencies and articular surface defects; 6). Sample blocks of SCB plate and TBB were collected from the distopalmar aspect of both condyles and the sagittal ridge and examined via 3-D micro-computed tomography at 45-?m isotropic voxel resolution. For each sample, the angle between the principal orientation of trabeculae and the sagittal plane and the degree of anisotropy (DA) were calculated from mean intercept length measurements. RESULTS: Condylar samples had significantly lower angle (mean, 8.9°; range, 73° to 10.9°) than sagittal ridge samples (mean, 40.7°; range, 33.6° to 49.2°), TBB had significantly higher DA (mean±SE, 1.75±0.04) than SCB plate (1.29±0.04), and mildly diseased TBB had higher DA (1.85±0.06) than severely diseased TBB (1.65±0.06). CONCLUSIONS AND CLINICAL RELEVANCE: The highly ordered appearance of trabeculae within the condyles supports the concept that joint loading is primarily transmitted through the condyles and not the sagittal ridge. The sharp changes in the trajectories of the SCB trabeculae at the condylar grooves may be indicative of hypothetical tensile forces at this location contributing to the pathogenesis of condylar fractures.

Aplicación de técnicas de clustering para caracterizar proveedores de servicios de mantenimiento / Applying the clustering technique for characterising maintenance outsourcing

Objetivo Utilizar técnicas de clustering para caracterizar a los proveedores de servicios de mantenimiento de una institución de salud. Métodos El estudio analiza el inventario del equipamiento perteneciente a 7 áreas pilotos (264 equipos médicos). Se aplican técnicas de clustering usando 26 variables. Entre las más significativas: el tiempo de respuesta (RT), la duración de las intervenciones (DR), la disponibilidad y el tiempo de cambio de estado (TAT). Resultados La obsolescencia del equipo biomédico en promedio es de 0,78. Se identifican 4 grupos de proveedores de servicios. Grupos (1 y 3): Mejor desempeño, menores valores de TAT, RT y DR; cuyos proveedores son: O, L, C, B, I, S, H, F, G; representan el 56 por ciento del total; con valores de TAT entre: 1,4 días

Objective Using clustering techniques for characterising companies providing health institutions with maintenance services. Methods The study analysed seven pilot areas' equipment inventory (264 medical devices). Clustering techniques were applied using 26 variables. Response time (RT), operation duration (OD), availability and turnaround time (TAT) were amongst the most significant ones. Results Average biomedical equipment obsolescence value was 0.78. Four service provider clusters were identified: clusters 1 and 3 had better performance, lower TAT, RT and DR values (56 percent of the providers coded O, L, C, B, I, S, H, F and G, had 1 to 4 day TAT values:

[Applying the clustering technique for characterising maintenance outsourcing]. / Aplicación de técnicas de clustering para caracterizar proveedores de servicios de mantenimiento.

OBJECTIVE: Using clustering techniques for characterising companies providing health institutions with maintenance services. METHODS: The study analysed seven pilot areas' equipment inventory (264 medical devices). Clustering techniques were applied using 26 variables. Response time (RT), operation duration (OD), availability and turnaround time (TAT) were amongst the most significant ones. RESULTS: Average biomedical equipment obsolescence value was 0.78. Four service provider clusters were identified: clusters 1 and 3 had better performance, lower TAT, RT and DR values (56 % of the providers coded O, L, C, B, I, S, H, F and G, had 1 to 4 day TAT values:

Use of quantitative ultrasonography for noninvasive surveillance of the third metacarpal bone in racing and training Thoroughbreds.

OBJECTIVE-To use quantitative ultrasonography to evaluate the association between the speed of sound (SOS) at 9 sites in the third metacarpal bone (MCIII) of racing Thoroughbreds with workload accumulation and the effect that MCIII failure has on this association. ANIMALS-Sixty-two 2- and 3-year-old Thoroughbreds in racing condition. PROCEDURES-Cumulative work index (CWI) was used to calculate total workload (CWI(total)) and also 3 independent CWIs for the various gaits (ie, trot [CWI(trot)], gallop [CWI(gallop)], and race [CWI(race)]) used during training and racing. Speed of sound was monitored in horses during the 2007 racing season and compared with the CWIs via regression analysis. Sex, age, limb, and MCIII failure were included as covariates in the model. RESULTS-SOS was significantly associated with CWI(total) at 8 sites and with independent CWIs of the various gaits at all 9 sites. Progression of SOS in MCIIIs with workload differed significantly in horses with clinical signs of metacarpal bone failure, compared with results for horses with clinically normal MCIIIs, in 1 site by use of CWI(total) and in 5 sites by use of the independent CWIs for the various gaits. CONCLUSIONS AND CLINICAL RELEVANCE-These results indicated that SOS in the MCIII of racing Thoroughbreds followed a constant pattern of progression as workload accumulated. With the development of more precise quantitative ultrasonography devices, SOS corrected for amount of activity may be used to identify horses at risk of bone failure.

Evaluation of endotoxin activity in blood measured via neutrophil chemiluminescence in healthy horses and horses with colic.

OBJECTIVE: To evaluate the performance of a chemiluminescent endotoxin activity assay in horses with colic and healthy horses. ANIMALS: 20 horses with colic and systemic inflammatory response syndrome (SIRS group), 8 horses with colic with no SIRS (NSIRS group), and 20 healthy horses. PROCEDURES: Venous blood was collected into EDTA blood collection tubes after completion of a physical examination, and a chemiluminescent endotoxin activity assay was performed within 60 minutes of collection. Medical or surgical interventions and outcome were recorded for each horse. RESULTS: Mean + or - SE endotoxin activity was 0.16 + or - 0.05 for healthy horses, 0.18 + or - 0.07 for the NSIRS group, and 0.53 + or - 0.05 for the SIRS group and was significantly different among the groups. Mean endotoxin activity was significantly higher in the SIRS group than in the NSIRS group and the healthy group. No significant difference between the healthy and NSIRS groups was present. The higher the measured endotoxin activity, the more likely it was for horses to be euthanized. CONCLUSIONS AND CLINICAL RELEVANCE: The chemiluminescent endotoxin assay was easy to use, required a short time to perform, could be completed at the patient's side, and with some modifications, may be a useful component in the clinical assessment and prognostication of horses with colic.

Medición de la Eficiencia del Método Datum para seleccionar Tecnologías Biomédicas / Measuring the Datum or Pugh method's efficiency for selecting biomedical technology

Objetivo Determinar la efectividad del método multicriterio Pugh para la selección de tecnologías biomédicas en el proceso de nuevas adquisiciones. Materiales y Métodos Se realizó un estudio de los métodos multicriterios de toma de decisión. El método seleccionado fue el método "Datum" o Pugh. Se realizó el cálculo y caracterización del tamaño de la muestra de los expertos que participarían en el ensayo. Se obtuvo una muestra de 23 expertos. Se realizó el ejercicio de selección de la tecnología de electrocardiografía, empleando el método de toma de decisión seleccionado. Resultados De las 46 pruebas realizadas el modelo más utilizado como referencia fue el modelo codificado como "3". El modelo que más fue seleccionado como la "mejor opción" fue el equipo o modelo "5". Conclusiones. El método Pugh resultó ser efectivo para la toma de decisión a la hora de seleccionar tecnologías biomédicas, pues en un 87 por ciento de los casos siempre se obtuvo el mismo modelo de referencia como el óptimo.

Objective Determining the Pugh multicriteria method's effectiveness as a selection tool when acquiring new technology. Materials and Methods The state of the art regarding multicriteria method use was studied; the Datum or Pugh method was selected. The size of the sample of experts participating in the trial was calculated and characterised; a data sample of 23 experts was thus obtained. Electrocardiography technology was selected by using the selected decision-making method; 5 models from different providers were used. Results 46 tests were conducted. The model labelled "3" was selected as referent in most cases, whilst the model labelled "5" was selected as being the best option in most cases. Conclusions The Pugh method was effective as a method for decision-making when selecting biomedical technologies as the same model was always selected by the experts as being the best option in 87 percent of the tests applied.

Estudio Comparativo de los Servicios de Mantenimiento Utilizando Técnicas de Minería de Datos / A comparative study of maintenance services using the data-mining technique

Objetivos: Comparar la calidad del servicio de mantenimiento de dos entidades de salud. Una posee los servicios de mantenimientos tercerizados y la otra propios. El indicador de calidad bajo estudio es el tiempo de cambio de estado. Estudiar el comportamiento de la productividad del servicio de salud versus la disponibilidad. Materiales y Métodos. Se realizó un levantamiento del inventario de los equipos médicos y no médicos en dos servicios de diálisis ubicados en dos instituciones de salud. Ambas de tercer nivel. Estos poseen características similares en cuanto a las unidades de dializado y equipos médicos. Cada una de ellas posee 16 unidades para la atención a pacientes y 92 equipos médicos. La diferencia consiste en el servicio de mantenimiento; uno es tercerizado mientras que el otro es propio. Se recolectaron las órdenes de trabajo de mantenimiento por un período de 6 meses y se calcularon los indicadores: Tiempo de Respuesta, Duración Real, Tiempos Perdidos y Tiempo de cambio de estado (TAT) para cada orden de trabajo. Se construyó un predictor para la variable TAT (variable dependiente) en función de las otras variables. Resultados. La calidad del servicio de mantenimiento por la entidad que posee su propio personal es mejor que la entidad con servicios tercerizados. El indicador TAT es como promedio de 2,95 horas para la entidad con mantenimiento propio, mientras que para la otra entidad es de 3,4 horas. Conclusiones: El comportamiento de la productividad del servicio versus la disponibilidad resultó ser de tipo positiva lineal.

Objectives The main goal in this research was comparing two hospitals’ maintenance service quality. One of them had a contract service; the other one had an in-house maintenance service. Materials and methods The authors followed the next stages when conducting this research: domain understanding, data characterisation and sample reduction, insight characterisation and building the TAT predictor. Multiple linear regression and clustering techniques were used for improving the efficiency of corrective maintenance tasks in a clinical engineering department (CED). The indicator being studied was turnaround time (TAT). Results The institution having an in-house maintenance service had better quality indicators than the contract maintenance service. Conclusions There was lineal dependence between availability and service productivity.