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Regenerative biological therapies using mesenchymal stem cells (MSCs) are being studied and used extensively in equine veterinary medicine. One of the important properties of MSCs is the cells' reparative effect, which is brought about by paracrine signaling, which results in the release of biologically active molecules, which in turn, can affect cellular migration and proliferation, thus a huge potential in wound healing. The objective of the current study was to demonstrate the in vitro and in vivo potentials of equine allogenic bone marrow-derived MSCs for wound healing. Equine bone marrow-derived MSCs from one allogenic donor horse were used. Equine MSCs were previously characterized for their in vitro proliferation, expression of cluster-of-differentiation markers, and trilineage differentiation. MSCs were first evaluated for their migration using an in vitro wound healing scratch assay, and subsequently, the conditioned medium was evaluated for their effect on human fibroblast proliferation. Subsequently, allogenic cells were intradermally injected into full-thickness, cutaneous thoracic wounds of 4 horses. Wound healing was assessed by using 3-D digital imaging and by measuring mRNA expression of pro-and anti-inflammatory markers for 30 days. Using human fibroblasts in an in vitro wound healing assay, we demonstrate a significantly higher healing in the presence of conditioned medium collected from proliferating MSCs than in the presence of medium containing fetal bovine serum. The in vitro effect of MSCs did not translate into a detectable effect in vivo. Nonetheless, we proved that molecularly characterized equine allogenic MSCs do not illicit an immunologic response. Investigations using MSCs derived from other sources (adipose tissue, umbilical cord), or a higher number of MSCs or a compromised animal model may be required to prove the efficacy of equine MSCs in wound healing in vivo.
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Background: There are no reports describing the long-term outcome of sport horses undergoing unilateral mandibular condylectomy with meniscectomy (UMC) for treatment for severe temporomandibular joint (TMJ) disease (TMD). Whether horses undergoing UMC require a specialized diet, can return to riding with a bit, or return to intended function after surgery is unknown. Objective: To determine the long-term outcome of horses undergoing UMC for treatment of severe TMD. Study Design: A multi-institutional, retrospective study. Methods: Medical records obtained from seven equine referral hospitals of horses with severe TMD that underwent UMC were reviewed. Details regarding the presenting complaints, results of clinical examination, findings of diagnostic imaging, surgical technique, and outcome (including long-term follow-up with an owner questionnaire) were recorded. Results: Eleven horses fit the inclusion criteria. Three had severe idiopathic osteoarthritis, and eight had confirmed septic osteoarthritis of the TMJ. The most common post-operative complications were drainage and peri-incisional swelling (n = 5). One horse developed a hematoma at the surgical site because the facial artery was inadvertently transected during the approach, causing the condylectomy to be postponed. All horses were discharged alive from the hospital, and 10 returned to their previous or intended use. All had complete resolution of clinical signs of TMD. One mare was retired from athletic use due to her genetic value as a broodmare. One horse was euthanized 2 years after UMC due to progressively worsening of clinical signs of temporohyoid osteoarthropathy (THO), which were not present before surgery. When available, owner satisfaction of the results of the procedure was excellent. Main Limitations: Sample size; multiple institutions; owner bias. Conclusions: Unilateral mandibular condylectomy should not be considered a salvage procedure. Horses treated for severe TMD by UMC can return to their previous or intended level of athletic performance and do not require a specialized diet.
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BACKGROUND: To the authors' knowledge, the effect of a combination of butorphanol tartrate and detomidine hydrochloride on the laryngeal function and symmetry of the arytenoid cartilages in young Thoroughbred horses has not been examined. Therefore, this study aimed to examine the effects of administration of butorphanol and detomidine on left-to-right rima glottidis ratio (L:R RGR), cross-sectional area of the rima glottidis (CSARG) and grade of laryngeal function of Thoroughbred yearlings examined endoscopically at rest. METHODS: Forty-six Thoroughbred yearlings underwent laryngeal video endoscopy, at rest, before and after sedation with butorphanol and detomidine. Three clinicians assigned grades of laryngeal function after reviewing the video recordings. The L:R RGR and CSARG were measured at the point of arytenoid cartilages' maximal abduction. Student's t-test was used to compare the L:R RGR and CSARG. Cohen's kappa (κ) was used to compare the intra- and interobserver agreements. Spearman's rank order was used to assess agreement between CSARG and grade of laryngeal function. RESULTS: Sedation had no effect on L:R RGR and CSARG. Mean intraobserver agreement of grade of laryngeal function of unsedated yearlings was 93.1%, and that of sedated yearlings was 92.9%. Mean interobserver agreement of grade of laryngeal function of unsedated yearlings was 92.8%, and that of sedated yearlings was 92.7%. Correlation between CSARG and laryngeal function grade was significant for both groups (p < 0.001). CONCLUSION: Sedating Thoroughbred yearlings with detomidine and butorphanol, before endoscopically examining the larynx, did not significantly affect the grade of laryngeal function.
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Butorfanol , Laringe , Animales , Cartílago Aritenoides , Butorfanol/farmacología , Endoscopía/veterinaria , Caballos , Humanos , ImidazolesRESUMEN
OBJECTIVE: To determine whether palmar digital nerve (PDN) blockade in horses with a combination of dexmedetomidine and mepivacaine would block the response to mechanical force applied to the digit longer than would anesthetizing these nerves with mepivacaine alone or dexmedetomidine alone. ANIMALS: 8 mares with no signs of lameness. PROCEDURES: In a randomized, crossover, blinded, experimental study, both PDNs of the same forelimb of each horse were anesthetized by perineural injection with either 30 mg mepivacaine alone, 250 µg of dexmedetomidine alone, or 30 mg mepivacaine combined with 250 µg of dexmedetomidine. Each horse received each treatment, and treatments were administered ≥ 2 weeks apart. The mechanical nociceptive threshold was measured at a region between the heel bulbs with the use of a digital force gauge before (baseline) and at 15-minute intervals after treatment. RESULTS: The mean duration of sensory blockade of the digit was 2-fold longer when a combination of mepivacaine and dexmedetomidine was administered (371 minutes), compared with when mepivacaine alone was administered (186 minutes). Treatment with dexmedetomidine alone did not change the mechanical nociceptive threshold substantially from baseline and resulted in no clinical signs of sedation. CLINICAL RELEVANCE: Results indicated that relief from digital pain provided by perineural treatment with mepivacaine for PDN blockade can be extended by adding dexmedetomidine to the injectate.
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Dexmedetomidina , Bloqueo Nervioso , Anestésicos Locales/farmacología , Animales , Dexmedetomidina/farmacología , Femenino , Miembro Anterior , Caballos , Mepivacaína/farmacología , Bloqueo Nervioso/veterinariaRESUMEN
Parkinson's Disease (PD) is a progressive degenerative disease characterized by tremor, bradykinesia, rigidity and postural instability. There are approximately 7-10 million PD patients worldwide. Currently, there are no biomarkers available or pharmaceuticals that can halt the dopaminergic neuron degeneration. At the time of diagnosis about 60% of the midbrain dopamine (mDA) neurons have already degenerated, resulting in a depletion of roughly 70% of striatal dopamine (DA) levels and synapses. Symptomatic treatment (e.g., with L-dopa) can initially restore DA levels and motor function, but with time often lead to side-effects like dyskinesia. Deep-brain-stimulation can alleviate these side-effects and some of the motor symptoms but requires repeat procedures and adds limitations for the patients. Restoration of dopaminergic synapses using neuronal cell replacement therapy has shown benefit in clinical studies using cells from fetal ventral midbrain. This approach, if done correctly, increases DA levels and restores synapses, allowing biofeedback regulation between the grafted cells and the host brain. Drawbacks are that it is not scalable for a large patient population and the patients require immunosuppression. Stem cells differentiated in vitro to mDA neurons or progenitors have shown promise in animal studies and is a scalable approach that allows for cryopreservation of transplantable cells and rigorous quality control prior to transplantation. However, all allogeneic grafts require immunosuppression. HLA-donor-matching, reduces, but does not completely eliminate, the need for immunosuppression, and is currently investigated in a clinical trial for PD in Japan. Since immune compatibility is very important in all areas of transplantation, these approaches may ultimately be of less benefit to the patients than an autologous approach. By using the patient's own somatic cells, reprogrammed to induced pluripotent stem cells (iPSCs) and differentiated to mDA neurons immunosuppression is not required, and may also present with several biological and functional advantages in the patients, as described in this article. The proof-of-principle of autologous iPSC mDA restoration of function has been shown in parkinsonian non-human primates (NHPs), and this can now be investigated in clinical trials in addition to the allogeneic and HLA-matched approaches. In this review, we focus on the autologous approach of cell therapy for PD.
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OBJECTIVE: To determine the efficacy and duration of effect for liposomal bupivacaine following perineural administration to the medial and lateral palmar digital nerves of horses. ANIMALS: 9 nonlame mares. PROCEDURES: For each horse, 2 mL of liposomal bupivacaine (13.3 mg/mL; total dose, 53.2 mg or approx 0.11 mg/kg) or sterile saline (0.9% NaCl) solution was injected adjacent to the medial and lateral palmar digital nerves at the level of the distal aspect of the proximal sesamoid bones of a randomly selected forelimb. Twenty-one days later, the opposite treatment was administered in the contralateral forelimb. A digital algometer was used to measure the mechanical nociceptive threshold (MNT) immediately before and at predetermined times for 48 hours after injection of each treatment. The mean MNT was compared between the 2 treatments at each measurement time. RESULTS: The mean MNT for the liposomal bupivacaine-treated limbs was significantly greater (ie, the limb was less sensitive) than that for the saline-treated limbs between 30 minutes and 4 hours after treatment injection. Following liposomal bupivacaine administration, 1 horse developed mild swelling at the injection sites that resolved without treatment within 24 hours. No other adverse effects were observed. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that liposomal bupivacaine is another option for perineural anesthesia in horses. Further research is necessary to determine the optimal dose and better elucidate the duration of effect for the drug when used for palmar digital nerve blocks in horses.
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Bloqueo Nervioso/veterinaria , Anestésicos Locales , Animales , Bupivacaína , Femenino , Miembro Anterior , Caballos , Inyecciones/veterinariaRESUMEN
Rostral laryngeal advancement, also known as laryngeal tie-forward, is used to treat horses for intermittent dorsal displacement of the soft palate and has a morbidity rate of about 6%. We hypothesized that a novel laryngeal clamp would prevent morbidity associated with the sutures tearing through the thyroid cartilage. Larynges (n = 35 horses) were used for ex vivo testing. For uniaxial testing, 15 equine larynges were tested in one of three laryngeal tie-forward constructs [standard laryngeal tie-forward; modified laryngeal tie-forward using a suture-button; and modified laryngeal tie-forward using a laryngeal clamp]. For biaxial testing, 20 larynges were tested in one of two treatment groups: laryngeal tie-forward and laryngeal tie-forward using a laryngeal clamp. Constructs were tested in single cycle-to-failure. Statistical analyses were performed using ANOVA for uniaxial testing and t-tests for biaxial testing. The laryngeal tie-forward using a laryngeal clamp construct was superior to laryngeal tie-forward and laryngeal tie-forward using a suture-button constructs in resistance to pullout in uniaxial testing. The laryngeal tie-forward using a laryngeal clamp presented a significantly different method of failure than the standard laryngeal tie-forward in the biaxial testing. Failure modes for each construct were primarily by suture failure at the clamp (laryngeal tie-forward using a laryngeal clamp), suture pullout through the thyroid cartilage, or, less commonly, tearing of the cricothyroid ligament (laryngeal tie-forward). In uniaxial testing, the laryngeal tie-forward using a laryngeal clamp failed most commonly due to tearing of the cricothyroid ligament, whereas the standard laryngeal tie-forward and the laryngeal tie-forward using a suture-button failed due to the tearing of the cartilage. The laryngeal clamps provided greater stiffness, load at yield, and tensile stress at yield than did the standard construct. Laryngeal clamps may offer an alternative to standard methods of anchoring the thyroid cartilage when performing the laryngeal tie-forward procedure. Further testing and clinical trials are needed to elucidate the utility of the laryngeal tie-forward using a laryngeal clamp.
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OBJECTIVE: To determine whether therapeutic concentrations (> 0.5 to 1.0 µg/mL) of polymyxin B (PB) were achieved in the tarsocrural joint of horses when the drug was administered by IV regional limb perfusion (IV-RLP) via a saphenous vein at doses of 25, 50, and 300 mg and to describe any adverse systemic or local effects associated with such administration. ANIMALS: 9 healthy adult horses. PROCEDURES: In the first of 2 experiments, 6 horses each received 25 and 50 mg of PB by IV-RLP via a saphenous vein with at least 2 weeks between treatments. For each treatment, a tourniquet was placed at the midmetatarsus and another was placed midway between the stifle joint and tarsus. Both tourniquets were removed 30 minutes after the assigned dose was administered. Blood and tarsocrural joint fluid samples were collected for determination of PB concentration before and at predetermined times after drug administration. In experiment 2, 4 horses were administered 300 mg of PB by IV-RLP in 1 randomly selected pelvic limb in a manner identical to that used in experiment 1. RESULTS: For all 3 doses, the mean synovial fluid PB concentration was > 10 times the therapeutic concentration and below the level of quantification at 30 and 1,440 minutes after drug administration, respectively. No adverse systemic or local effects were observed following PB administration. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that IV-RLP of PB might be a viable alternative for treatment of horses with synovial infections caused by gram-negative bacteria.
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Administración Intravenosa/veterinaria , Caballos , Polimixina B/administración & dosificación , Polimixina B/análisis , Vena Safena , Líquido Sinovial/química , Animales , Antibacterianos/administración & dosificación , Antibacterianos/análisis , Antibacterianos/metabolismo , Miembro Posterior , Polimixina B/metabolismo , Distribución AleatoriaRESUMEN
Osteoarthritis (OA), the most common form of joint disease affecting humans and horses, is characterized by the advance and decline of cartilage and loss of function of the affected joint. The progression of OA is steadily accompanied with biochemical events, which interfere with the cytokines and proteolytic enzymes responsible for progress of the disease. Recently, regenerative therapies have been used with an assumption that mesenchymal stem cells (MSCs) possess the potential to prevent the advancement of cartilage damage and potentially regenerate the injured tissue with an ultimate goal of preventing OA. We believe that despite various challenges, the use of allogenic versus autologous MSCs in cartilage regeneration, is a major issue which can directly or indirectly affect the other factors including, the timing of implantation, dose or cell numbers for implantation, and the source of MSCs. Current knowledge reporting some of these challenges that the clinicians might face in the treatment of cartilage damage in horses are presented. In this regard we conducted two independent studies. In the first study we compared donor matched bone marrow and synovial fluid - derived equine MSCs in vitro, and showed that the SFMSCs were similar to the BMMSCs in their proliferation, expression of CD29, CD44 and CD90, but, exhibited a significantly different chondrogenesis. Additionally, 3.2-21% of all SFMSCs were positive for MHC II, whereas, BMMSCs were negative. In the second study we observed that injection of both the autologous and allogenic SFMSCs into the tarsocrural joint resulted in elevated levels of total protein and total nucleated cell counts. Further experiments to evaluate the in vivo acute or chronic response to allogenic or autologous MSCs are imperative.
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Enfermedades de los Caballos/terapia , Trasplante de Células Madre Mesenquimatosas , Osteoartritis/veterinaria , Animales , Cartílago , Condrogénesis , Caballos , Humanos , Células Madre Mesenquimatosas , Osteoartritis/terapia , Líquido SinovialRESUMEN
Proximal suspensory desmitis (PSD) is a common cause of lameness in the pelvic limb, but could also affect the thoracic limb of competing and non-competing horses. Most horses diagnosed with PSD in a thoracic limb respond to rest followed by controlled exercise, but in a small percentage of affected horses, lameness persists. In one study, four horses chronically lame because of PSD in a thoracic limb became sound after neurectomy of the deep branch of the lateral palmar nerve (DBLPaN), which innervates the proximal aspect of the suspensory ligament (SL; Guasco et al., 2013). Whether neurectomy of the DBLPaN results in changes in the SL that might predispose the horse to re-injury is not known. The aim of this study was to describe the findings observed during quantitative lameness evaluation, gross and histological examination of the proximal portion of the suspensory ligament (SL) of the thoracic limbs of eight horses after neurectomy of the DBLPaN performed after inducing unilateral PSD by injecting collagenase into the proximal portion of the SL. The clinical response to neurectomy was resolution of lameness in all horses. Muscle fibers of the denervated ligaments presented atrophy and were infiltrated with fat and connective tissue, thereby reducing the strength and elasticity of the ligament.
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Desnervación/veterinaria , Enfermedades de los Caballos/cirugía , Cojera Animal/patología , Ligamentos/cirugía , Enfermedades Musculoesqueléticas/veterinaria , Animales , Enfermedades de los Caballos/patología , Caballos , Cojera Animal/etiología , Cojera Animal/cirugía , Ligamentos/inervación , Ligamentos/patología , Enfermedades Musculoesqueléticas/patología , Enfermedades Musculoesqueléticas/cirugíaRESUMEN
OBJECTIVE To describe the signalment, clinical features, and outcome for male horses with urethral rents following perineal urethrotomy (PU) or corpus spongiotomy (CS). DESIGN Retrospective case series. ANIMALS 33 horses. PROCEDURES Medical records of male horses examined because of hematuria or hemospermia caused by urethral rents that underwent PU or CS at a referral hospital between 1989 and 2013 were reviewed. Data regarding signalment, clinical features, urethroscopic findings, surgical treatment, and outcome were recorded. Long-term follow-up information was obtained by telephone interviews. RESULTS Age of the study population ranged from 3 to 18 years. Nineteen geldings and 1 stallion were examined because of hematuria, of which 13 and 7 underwent PU and CS, respectively, at a mean of 56 days after onset of clinical signs. Thirteen stallions were examined because of hemospermia, of which 7 and 6 underwent PU and CS, respectively, at a mean of 193 days after onset of clinical signs. Hematuria resolved following 1 surgical procedure in all 17 horses for which long-term information was available. Of the 12 stallions for which long-term information was available, 7 had resolution of hemospermia after 1 PU or CS and 5 developed recurrent hemospermia that required additional PUs or CSs (n = 3) or primary closure of the urethral rent (2). CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that PU and CS were reliable treatments for resolution of hematuria in male horses with urethral rents; stallions with urethral rents may require multiple PUs or CSs or primary closure of the rent for resolution of hemospermia.
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Enfermedades de los Caballos/patología , Pene/cirugía , Uretra/cirugía , Enfermedades Uretrales/veterinaria , Animales , Hematuria/etiología , Hematuria/cirugía , Hematuria/veterinaria , Enfermedades de los Caballos/cirugía , Caballos , Masculino , Ureterostomía/veterinaria , Uretra/patologíaRESUMEN
OBJECTIVE: To describe canaliculosinostomy performed to resolve epiphora caused by nasolacrimal duct obstruction and to report the outcome of horses undergoing this procedure. STUDY DESIGN: Case series. ANIMALS: Seven horses with uni- or bilateral nasolacrimal duct obstruction. METHODS: The ventral lacrimal punctum and canaliculus were expanded with catheters of increasing diameter until a 14 gauge, Jamshedi needle could be passed into and through the lacrimal sac into the caudal maxillary sinus. One end of a plastic tube was inserted through the needle into the sinus, and the needle was withdrawn over the tubing. Using a hubless needle, the other end of the tube was passed through the lower eyelid leaving a segment of tubing exposed ventral to the eyelid. The end of the tubing within the sinus was exteriorized through a trephine hole in the frontal sinus and then tunneled beneath the skin adjacent to the osteotomy using a hubless needle, leaving a segment of tubing exposed on the forehead. Exposed tubing was sutured to the skin. The tubing was removed at 5-6 weeks. RESULTS: Canaliculosinostomy was easily performed with the horses sedated. Five horses had resolution of epiphora, and 2 had improvement. CONCLUSION: Canaliculosinostomy to divert lacrimal secretions into the sinuses resolves or improves epiphora caused by nasolacrimal duct obstruction and provides a good functional and cosmetic outcome. Canaliculosinostomy can be performed in the sedated horse.
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Seno Frontal/cirugía , Enfermedades de los Caballos/cirugía , Conducto Nasolagrimal/cirugía , Osteotomía/veterinaria , Animales , CaballosRESUMEN
Autologous transplantation of patient-specific induced pluripotent stem cell (iPSC)-derived neurons is a potential clinical approach for treatment of neurological disease. Preclinical demonstration of long-term efficacy, feasibility, and safety of iPSC-derived dopamine neurons in non-human primate models will be an important step in clinical development of cell therapy. Here, we analyzed cynomolgus monkey (CM) iPSC-derived midbrain dopamine neurons for up to 2 years following autologous transplantation in a Parkinson's disease (PD) model. In one animal, with the most successful protocol, we found that unilateral engraftment of CM-iPSCs could provide a gradual onset of functional motor improvement contralateral to the side of dopamine neuron transplantation, and increased motor activity, without a need for immunosuppression. Postmortem analyses demonstrated robust survival of midbrain-like dopaminergic neurons and extensive outgrowth into the transplanted putamen. Our proof of concept findings support further development of autologous iPSC-derived cell transplantation for treatment of PD.
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Neuronas Dopaminérgicas/metabolismo , Células Madre Pluripotentes Inducidas/metabolismo , Mesencéfalo/metabolismo , Enfermedad de Parkinson/metabolismo , Enfermedad de Parkinson/terapia , Trasplante de Células Madre , Animales , Autoinjertos , Modelos Animales de Enfermedad , Neuronas Dopaminérgicas/patología , Humanos , Células Madre Pluripotentes Inducidas/patología , Macaca fascicularis , Mesencéfalo/patología , Enfermedad de Parkinson/patologíaRESUMEN
PURPOSE: The purpose of this study is to investigate the structure and measurement properties of the Aphasia Communication Outcome Measure (ACOM), a patient-reported outcome measure of communicative functioning for persons with aphasia. METHOD: Three hundred twenty-nine participants with aphasia responded to 177 items asking about communicative functioning. The data were analyzed using a categorical item factor analysis approach. Validity of ACOM scores on the basis of their convergence with performance-based, clinician-reported, and surrogate-reported assessments of communication was also assessed. RESULTS: Fifty-nine items that obtained adequate fit to a modified bifactor measurement model and functioned similarly across several demographic and clinical subgroupings were identified. The factor model estimates were transformed to item response theory graded response model parameters, and the resulting score estimates showed good precision and moderately strong convergence with other measures of communicative ability and functioning. A free software application for administration and scoring of the ACOM item bank is available from the first author. CONCLUSIONS: The ACOM provides reliable measurement of patient-reported communicative functioning in aphasia. The results supported the validity of ACOM scores insofar as (a) factor analyses provided support for a coherent measurement model, (b) items functioned similarly across demographic and clinical subgroups, and (c) scores showed good convergence with measures of related constructs.
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Afasia/diagnóstico , Comunicación , Evaluación de Resultado en la Atención de Salud/métodos , Afasia/etiología , Calibración , Análisis Factorial , Femenino , Humanos , Difusión de la Información , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Autoinforme , Programas Informáticos , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/diagnósticoRESUMEN
PURPOSE: The purpose of this article is to describe the rationale, clinical processes, and outcomes of an intensive comprehensive aphasia program (ICAP). METHOD: Seventy-three community-dwelling adults with aphasia completed a residentially based ICAP. Participants received 5 hr of daily 1:1 evidence-based cognitive-linguistically oriented aphasia therapy, supplemented with weekly socially oriented and therapeutic group activities over a 23-day treatment course. Standardized measures of aphasia severity and communicative functioning were obtained at baseline, program entry, program exit, and follow-up. Results were analyzed using a Bayesian latent growth curve model with 2 factors representing (a) the initial level and (b) change over time, respectively, for each outcome measure. RESULTS: Model parameter estimates showed reliable improvement on all outcome measures between the initial and final assessments. Improvement during the treatment interval was greater than change observed across the baseline interval, and gains were maintained at follow-up on all measures. CONCLUSIONS: The rationale, clinical processes, and outcomes of a residentially based ICAP have been described. ICAPs differ with respect to treatments delivered, dosing parameters, and outcomes measured. Specifying the defining components of complex interventions, establishing their feasibility, and describing their outcomes are necessary to guide the development of controlled clinical trials.
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Afasia/terapia , Terapia del Lenguaje/métodos , Terapia del Lenguaje/organización & administración , Tratamiento Domiciliario/métodos , Adulto , Anciano , Afasia/etiología , Citas y Horarios , Teorema de Bayes , Terapia Cognitivo-Conductual/métodos , Terapia Cognitivo-Conductual/organización & administración , Femenino , Humanos , Pruebas del Lenguaje , Masculino , Persona de Mediana Edad , Evaluación de Programas y Proyectos de Salud , Psicolingüística/métodos , Psicolingüística/organización & administración , Tratamiento Domiciliario/organización & administración , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/terapia , Resultado del Tratamiento , VeteranosRESUMEN
PURPOSE: To evaluate the dimensionality and measurement invariance of the aphasia communication outcome measure (ACOM), a self- and surrogate-reported measure of communicative functioning in aphasia. METHODS: Responses to a large pool of items describing communication activities were collected from 133 community-dwelling persons with aphasia of ≥ 1 month post-onset and their associated surrogate respondents. These responses were evaluated using confirmatory and exploratory factor analysis. Chi-square difference tests of nested factor models were used to evaluate patient-surrogate measurement invariance and the equality of factor score means and variances. Association and agreement between self- and surrogate reports were examined using correlation and scatterplots of pairwise patient-surrogate differences. RESULTS: Three single-factor scales (Talking, Comprehension, and Writing) approximating patient-surrogate measurement invariance were identified. The variance of patient-reported scores on the Talking and Writing scales was higher than surrogate-reported variances on these scales. Correlations between self- and surrogate reports were moderate-to-strong, but there were significant disagreements in a substantial number of individual cases. CONCLUSIONS: Despite minimal bias and relatively strong association, surrogate reports of communicative functioning in aphasia are not reliable substitutes for self-reports by persons with aphasia. Furthermore, although measurement invariance is necessary for direct comparison of self- and surrogate reports, the costs of obtaining invariance in terms of scale reliability and content validity may be substantial. Development of non-invariant self- and surrogate report scales may be preferable for some applications.
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Comunicación , Calidad de Vida , Encuestas y Cuestionarios , Anciano , Anciano de 80 o más Años , Afasia/psicología , Afasia/rehabilitación , Sesgo , Cuidadores/psicología , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Psicometría , Reproducibilidad de los Resultados , Autoinforme , Factores SocioeconómicosRESUMEN
OBJECTIVE: To assess outcome after neurectomy of the deep branch of the lateral palmar nerve (DBLPaN) as a treatment for horses with persistent lameness associated with chronic proximal suspensory desmitis (PSD) of the thoracic limb. STUDY DESIGN: Case series. ANIMALS: Adult, mixed-breed horses (n = 4), weighing 510-585 kg, used for amateur show-jumping. METHODS: Records of 4 horses chronically lame because of PSD of one or both thoracic limbs that were treated by neurectomy of the DBLPaN were reviewed. The site of pain causing lameness was localized using regional anesthesia. The proximal aspect of the suspensory ligament of the affected limb(s) of all horses were enlarged on ultrasonographic examination, but fiber disruption was not observed. All horses remained lame after conservative therapy. Neurectomy was performed with the horses anesthetized and positioned in dorsal recumbency. RESULTS: All 4 horses were sound at 6 weeks and remained sound for at least 12 months after neurectomy. CONCLUSION: Lameness in horses caused by chronic PSD can be resolved by neurectomy of the DBLPaN in horses that are refractory to conservative management.
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Enfermedades de los Caballos/cirugía , Cojera Animal/cirugía , Ligamentos Articulares/cirugía , Anestesia de Conducción/veterinaria , Animales , Articulaciones del Carpo/lesiones , Articulaciones del Carpo/cirugía , Miembro Anterior/inervación , Miembro Anterior/cirugía , Enfermedades de los Caballos/etiología , Caballos/cirugía , Cojera Animal/etiología , Ligamentos Articulares/inervación , MasculinoRESUMEN
OBJECTIVE: To determine the effectiveness of preinduction hyperbaric oxygen treatment (HBOT) in ameliorating signs of experimentally induced endotoxemia in horses. ANIMALS: 18 healthy adult horses. PROCEDURES: Horses were randomly assigned to 1 of 3 equal-sized treatment groups to receive normobaric ambient air and lipopolysaccharide (LPS), HBOT and LPS, or HBOT and physiologic saline (0.9% NaCl) solution. Horses were physically examined, and blood was obtained for a CBC and to determine concentration or activity of plasma tissue necrosis factor-α, blood lactate, and blood glucose before the horses were treated with HBOT and then intermittently for 6 hours after administration of LPS or physiologic saline solution. RESULTS: All LPS-treated horses developed signs and biochemical and hematologic changes consistent with endotoxemia. Treatment with HBOT significantly ameliorated the effect of LPS on clinical endotoxemia score but did not significantly improve other abnormalities associated with endotoxemia. CONCLUSIONS AND CLINICAL RELEVANCE: The protective effect of HBOT was minimal, and results did not support its use as a treatment for horses prior to development of endotoxemia.
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Endotoxemia/veterinaria , Enfermedades de los Caballos/terapia , Oxigenoterapia Hiperbárica/veterinaria , Lipopolisacáridos/efectos adversos , Oxígeno/uso terapéutico , Animales , Análisis Químico de la Sangre/veterinaria , Temperatura Corporal , Endotoxemia/terapia , Femenino , Frecuencia Cardíaca , Caballos , Análisis de los Mínimos Cuadrados , Lipopolisacáridos/administración & dosificación , Lipopolisacáridos/farmacología , Oxígeno/sangre , Frecuencia Respiratoria , Factor de Necrosis Tumoral alfa/sangreRESUMEN
A predictive model for the attachment of spores of the green alga Ulva on patterned topographical surfaces was developed using a constant refinement approach. This 'attachment model' incorporated two historical data sets and a modified version of the previously-described Engineered Roughness Index. Two sets of newly-designed surfaces were used to evaluate the effect of two components of the model on spore settlement. Spores attached in fewer numbers when the area fraction of feature tops increased or when the number of distinct features in the design increased, as predicted by the model. The model correctly predicted the spore attachment density on three previously-untested surfaces relative to a smooth surface. The two historical data sets and two new data sets showed high correlation (R(2) = 0.88) with the model. This model may be useful for designing new antifouling topographies.
Asunto(s)
Incrustaciones Biológicas , Esporas/metabolismo , Ulva/metabolismo , Biopelículas/crecimiento & desarrollo , Adhesión Celular , Chlorophyta/fisiología , Biología Marina , Microscopía Electrónica de Rastreo/métodos , Modelos Biológicos , Análisis de Regresión , Propiedades de Superficie , Microbiología del AguaRESUMEN
Translationally symmetric topographies can be designed to induce anisotropy of static and dynamic contact angles. The validity of ignoring directionality of topography in contact angle characterization was evaluated using microscale patterned topographies. Seven patterned topographies comprising elongated discontinuous microfeatures oriented along parallel paths and one topography comprising ridges were fabricated in a poly(dimethyl siloxane) elastomer (PDMSe). The static contact angle, advancing contact angle, receding contact angle, contact angle hysteresis, and slip angle were measured using water on each surface at three in-plane perspectives, with respect to the feature orientation. Static and dynamic contact angle anisotropies were investigated on the topographies to evaluate the effect of discontinuities along the feature lengths on the anisotropy that has been shown on channels or ridges in previous reports. Discontinuous feature topographies exhibited a statistically significant anisotropy of 2 degrees-6 degrees between the perpendicular and parallel directions, with respect to the static and dynamic contact angles. The ridges topography exhibited much larger 5 degrees-42 degrees anisotropy in the contact angles. The discontinuities along the feature lengths greatly reduced, but did not eliminate, the anisotropies compared to the ridges. This evidence of contact angle anisotropy indicates a need to identify the orientation of topography, in relation to contact angle measurements. It also implies a need to consider directionality in the design of microfluidic devices and self-cleaning surfaces.