Use of positive contrast radiography to identify synovial involvement in horses with traumatic limb wounds.

BACKGROUND: The diagnostic value of positive contrast radiography in the work-up of suspected synovial infection in horses with limb wounds near synovial structures has yet to be systematically evaluated. OBJECTIVES: To determine the specificity, sensitivity and positive and negative predictive values of positive contrast radiography for identification of synovial infection in a population of horses with limb wounds. STUDY DESIGN: Retrospective case study comparing the performance of positive contrast radiography to the gold standard of synovial fluid cytology in horses presenting with limb wounds in the vicinity of synovial structures. METHODS: Case records of horses presenting to the Royal Veterinary College Equine Hospital between 2010 and 2015 with limb wounds that may have compromised adjacent synovial structures were analysed. Synovial fluid cytology results were used to categorise synovial structures in infected and noninfected groups. Positive contrast radiography results were compared between infected and noninfected groups and sensitivity, specificity, positive and negative predictive values were calculated. RESULTS: Fifty horses with 66 synovial structures were included in the study. Positive contrast radiography had a high specificity (86.4%), but only a moderate sensitivity (59.1%) for the identification of synovial infection. In addition, a low positive predictive value (68.4%) and high negative predictive value (80.9%) were observed in this population of horses. MAIN LIMITATIONS: Sensitivity, specificity and predictive values may differ between different synovial structures and cases. Different conclusions may be drawn from the results in a single population. Sensitivity and specificity of positive contrast radiography may also be influenced by different techniques used by examiners and by inherent characteristics of individual cases. CONCLUSIONS: Positive contrast radiography should be used for the investigation of potential synovial infection in horses with limb wounds, particularly if no synovial fluid sample for laboratory analysis can be obtained. However, it appears that positive contrast radiography is best used in combination with other tests to ensure that a correct and timely diagnosis is made.

Parental attributions for positive behaviours in children with autism spectrum disorder.

BACKGROUND: The present study examined parental attributions for positive child behaviour in children with Autism Spectrum Disorder (ASD) and their association with parent outcomes. METHOD: In total, 175 couples who had a child with ASD (5-12 years) completed measures about the child's positive behaviour, ASD symptoms, functional skills and negative behaviour problems, and their own positive and negative affect and closeness in the parent-child relationship. A comparison group of 170 couples who had a child without a neurodevelopmental disability also completed measures. RESULTS: Dyadic multilevel models were conducted. Parents of children with ASD believed that their child's positive behaviour was due to factors less internal to the child, less stable and less controllable by the child than the comparison group. Beliefs about stability were associated with closeness in the parent-child relationship. Child age and level of impairment and parent education were associated with parental attributions. CONCLUSIONS: Interventions that alter parental attributions may offer pathways to increase closeness in the parent-child relationship.

Technical innovation changes standard radiographic protocols in veterinary medicine: is it necessary to obtain two dorsoproximal-palmarodistal oblique views of the equine foot when using computerised radiography systems?

Since the 1950s, veterinary practitioners have included two separate dorsoproximal-palmarodistal oblique (DPr-PaDiO) radiographs as part of a standard series of the equine foot. One image is obtained to visualise the distal phalanx and the other to visualise the navicular bone. However, rapid development of computed radiography and digital radiography and their post-processing capabilities could mean that this practice is no longer required. The aim of this study was to determine differences in perceived image quality between DPr-PaDiO radiographs that were acquired with a computerised radiography system with exposures, centring and collimation recommended for the navicular bone versus images acquired for the distal phalanx but were subsequently manipulated post-acquisition to highlight the navicular bone. Thirty images were presented to four clinicians for quality assessment and graded using a 1-3 scale (1=textbook quality, 2=diagnostic quality, 3=non-diagnostic image). No significant difference in diagnostic quality was found between the original navicular bone images and the manipulated distal phalanx images. This finding suggests that a single DPr-PaDiO image of the distal phalanx is sufficient for an equine foot radiographic series, with appropriate post-processing and manipulation. This change in protocol will result in reduced radiographic study time and decreased patient/personnel radiation exposure.

Identifying optimal parameters for quantification of changes in pelvic movement symmetry as a response to diagnostic analgesia in the hindlimbs of horses.

REASONS FOR PERFORMING STUDY: Subjective evaluation of the response to diagnostic analgesia of hindlimb lameness is influenced by expectation bias. Quantification of pelvic movement with inertial measurement units is possible, but it is unclear which measure of movement symmetry best reflects the changes seen after diagnostic analgesia. OBJECTIVES: To test our hypothesis that objective measures closely relating to those used for subjective visual lameness scoring (quantifying the difference between sacral upward or downward movement or between movement amplitudes of the left and right tubera coxae) would show the largest and most consistent response. STUDY DESIGN: Retrospective analysis of subjective and objective clinical lameness data. METHODS: Thirteen horses with hindlimb lameness underwent visual lameness scoring and independent gait assessment with inertial measurement units. Established objective measures were calculated and changes before/after diagnostic analgesia regressed against the change in lameness grade. Slopes of regression lines were calculated and confidence intervals assessed. RESULTS: All objective parameters showed variation between horses and across lameness grades. The following 3 measures documented a consistent increase in symmetry for each grade of change in lameness score: difference between sacral displacement minima; upward movement difference; and range of motion difference between the tubera coxae. CONCLUSIONS: Several pelvic parameters are suitable for objective quantification of changes after diagnostic analgesia in hindlimb-lame horses. A change of 9-13% per lameness grade can be expected. Upward movement of the tubera coxae is the most sensitive objective measure for quantifying a response to diagnostic analgesia. However, when assessed visually, this measure requires simultaneous focusing on pelvic and limb movements. Other parameters that show a similar response might be more easily perceived, requiring only assessment of tubera coxae range of motion or downward displacement of the sacrum without simultaneous focus on limb movement.

Development and validation of an equine nerve block simulator to supplement practical skills training in undergraduate veterinary students.

Lameness is the most common presenting complaint in equine practice. Performing diagnostic nerve blocks is an integral part of any lameness work-up, and is therefore an essential skill for equine practitioners. However, the opportunities for veterinary students to practice this skill are limited. The aim of this study was to design and validate an equine nerve block simulator. It was hypothesised that the simulator would improve students' ability and enhance their confidence in performing nerve blocks. A simulator was built using an equine forelimb skeleton and building foam. Wire wool targets were placed under the foam in the positions corresponding to the anatomical location of the most palmar digital, abaxial and low four-point nerve blocks and attached to an electrical circuit. The circuit became complete when the operator placed a needle in the correct position and immediate audible feedback with a buzzer was provided. To validate the simulator, it was compared with two established teaching methods: cadaver training and theoretical training with a hand-out. Cadaver-trained students achieved the best results (73 per cent correct blocks), compared with simulator-trained students (71 per cent correct blocks), and a hand-out trained group (58 per cent correct blocks). Feedback obtained with a questionnaire showed that students enjoyed simulator training more, and that they felt more confident in performing diagnostic nerve blocks than the other two groups. The equine nerve block simulator provides a safe, cost-effective method to supplement the teaching of diagnostic analgesia to undergraduate veterinary students.

Forces applied with a hoof tester to cadaver feet vary widely between users.

Hoof testers are commonly used in equine practice. In this study, we determined the intraoperator and interoperator reliability of force application with hoof testers for different groups: experienced veterinarians, novices and farriers. For this purpose, we have developed and validated an instrumented hoof tester. Forces varied significantly between the different regions of the foot for experienced operators applying the highest forces to the heels, then the frog, then the toe, and the lowest forces to the quarters. Novices applied significantly more force to the toe versus the frog. Intraoperator reliability varied significantly between regions and operators. Novices had the narrowest width of limits of agreement for the frog and heel, but the widest for the toe and the quarters, whereas farriers had the narrowest width of agreement for the toe and quarter. Force application differed significantly between groups for the frog and heel regions, but not the toe and quarters. Veterinarians applied higher forces to the frog compared with farriers and novices, and higher forces to the heel compared with novices. This study showed that hoof tester forces vary widely within and between operators, and standardisation of hoof tester use is needed to make this diagnostic test more reliable.

Detection of joint effusion on radiographs of horses.

Joint effusion is one of the classic radiographic signs of osteoarthritis, but no information is available regarding clinicians' ability to detect joint effusion radiographically. This study determined the accuracy and precision of experienced and inexperienced observers in detecting joint effusion of the distal interphalangeal (DIP), metacarpophalangeal (MCP) and midcarpal joints on radiographs. Fresh cadaverous forelimbs were loaded in a material testing machine to mimic a standing horse. The joints were gradually distended and lateromedial and dorsopalmar radiographs were acquired. The images were assessed by three experienced and three inexperienced observers. This study showed that the sensitivity was high for both groups for all joints and projections. Specificity was high for the experienced group but low for the inexperienced group. There was a significant positive correlation between joint distension and severity of joint effusion when reported by experienced observersfor most views (except DIP joint), but only for the MCP joint for inexperienced observers. Interoperator agreement was poor to fair for the experienced group and poor for the inexperienced group. In conclusion, the accuracy and precision of grading joint effusion on radiographs was highly subjective and related to experience.

Stimulus-dependent release of tissue-regenerating factors by equine platelets.

REASONS FOR PERFORMING THE STUDY: Platelet-rich plasma (PRP) is increasingly used for treatment of orthopaedic injuries. However, the effects of different stimuli on the release pattern of regenerative and proinflammatory factors from equine platelets are largely unknown and an optimal treatment protocol remains to be established. OBJECTIVES: The aim of this study was to identify a stimulus that enhanced release of histopromotive factors (platelet-derived growth factor BB [PDGF] and transforming growth factor 1ß[TGF]) without causing concurrent release of a proinflammatory mediator (CCL5). METHODS: Washed platelets were prepared from 6 healthy ponies and release of growth factors and CCL5 measured using commercially available ELISAs for human proteins following incubation with or without thrombin, chitosan or equine recombinant tumour necrosis factor (erTNF) over 24 h and subsequently over 96 h. Additionally, noncoagulated samples were analysed. RESULTS: Regardless of whether a stimulus was present or what stimulus was used, PDGF and TGF release was maximal by 0.5-1 h when clot formation took place and very little release was observed after 24 h. Growth factor release was minimal in noncoagulated samples. In contrast, CCL5 release was not associated with coagulation and appeared to persist for much longer. High concentrations of erTNF caused significantly greater release of CCL5 at 6 h than any other stimulus tested. CONCLUSIONS: Growth factor release from equine platelets is dependent on coagulation but independent of the initiating stimulus, and is accompanied by more sustained release of proinflammatory mediators. POTENTIAL RELEVANCE: Supernatants collected from coagulated platelets could be an alternative treatment to PRP.

The Determinacy of Variables in Structural Equation Models.

The indeterminacy of variables in a structural equation model - a path model with latent variables - is considered. It is shown that when the variables in the structural ]model are all manifest, the error-terms - disturbances - are uniquely determined given the parameters and the data; when the variables in the structural model are all latent, the error-terms have indeterminate components that are simple linear transformations of the indeterminate I components of the common factor model; and when they are mixed, a sufficient condition for the error-term associated with a manifest variable to be uniquely determined is that there is no directed path to it from a latent variable. Moreover, for error-terms that are indeterminate due to the effects of latent variables it is demonstrated that error-term analysis along the lines of residual analysis can be employed by the use of suitable estimates of the latent variables.

Non-suppurative myocarditis in piglets associated with porcine parvovirus infection.

The involvement of porcine parvovirus (PPV) in the aetiology of non-suppurative myocarditis in sucking piglets was investigated by a polymerase chain reaction (PCR), designed to assess the presence of viral genome in formalin-fixed paraffin wax-embedded tissue of diseased animals. Myocardium and lung of stillborn piglets with a confirmed PPV infection were used to set up the PCR amplification method. Subsequently, 20 myocardia with inflammatory lesions were examined in parallel with 20 myocardia without lesions, from age-matched control piglets. Tissues were first tested for the presence and the integrity of porcine DNA by amplifying a sequence encoding the highly conserved nuclear protein histone H4. Tissue from 15 out of 20 animals with myocarditis contained amplifiable histone H4 DNA and in 12 of the 15 histone H4-positive samples, PPV DNA was detected. It proved possible to amplify histone H4 DNA in all 20 negative controls (without myocarditis), and PPV DNA was detected in three cases. In-situ hybridization with a digoxigenin-labelled probe homologous to PPV was performed in four PCR-positive cases of non-suppurative myocarditis. In two animals several positively stained nuclei were observed in the myocardium, within or close to the mild inflammatory cellular infiltrates. These results strongly suggest that PPV can cause non-suppurative myocarditis in sucking piglets.

Transfer of an ovine metallothionein-ovine growth hormone fusion gene into swine.

An ovine metallothionein-1a (oMT1a)-ovine growth hormone (oGH) fusion gene was microinjected into 400 pig zygotes, the zygotes were transferred into recipient females, and 15 founder transgenic pigs were born. Of 12 transgenic pigs assayed, five expressed high levels of oGH (> 900 ng/mL plasma), one expressed low levels of oGH (10 to 30 ng/mL), and six did not express oGH. Dietary supplementation with 2,000 ppm of zinc for 6 d induced a 20-fold increase in plasma oGH in the transgenic pig with low expression but did not induce expression in the six transgenic pigs with no constitutive oGH expression. The average daily gain of five transgenic pigs with elevated oGH was similar to that of non-transgenic littermates during a 9-wk feeding trial (P = .52). The liver, kidney, adrenal, and thyroid weights were all significantly heavier for the oGH-expressing transgenic pigs than for non-transgenic littermates. Total carcass fat, longissimus muscle fat, subcutaneous backfat thickness, and loin eye area were lower and carcass protein and water content and beta R fiber area of longissimus muscle were higher in the transgenic pigs with elevated oGH than in their littermate controls (P < .05 for each). The data indicate that even though the oMT1a promoter was more inducible by zinc than was previously reported for the mouse MT promoter in swine, the former provided a higher level of oGH expression than the mouse MT promoter.

Erythroid-specific expression of human growth hormone affects bone morphology in transgenic mice.

The regulation of bone deposition and remodeling is highly complex. To further understand the influence of growth hormone on bone deposition, several lines of transgenic mice were generated that expressed the human growth hormone gene (hGH) driven by beta-globin regulatory elements. In situ hybridization confirmed that the hGH gene in these mice was expressed in an erythroid tissue-specific manner; in the fetus hGH was expressed in the liver and in the adult mice hGH was expressed in the bone marrow. The bones of mice in two lines were visualized radiographically by mammography, and relative bone densities were measured. The transgenic mice had detectably more bone density than nontransgenic littermate controls by approximately 3 weeks of age and the relative difference in density increased with age. Histological cross-sections of the tibia showed that adult transgenic mice had increased average cortical bone thickness when compared to their controls. The hypothesis is that the local effect of hGH release from differentiating erythroid cells in the bone marrow is a major contributor to the increased bone deposition in these transgenic mice.

Appearance of insulin-like growth factor mRNA in the liver and pyloric ceca of a teleost in response to exogenous growth hormone.

Augmentation of vertebrate growth by growth hormone (GH) is primarily due to its regulation of insulin-like growth factor I (IGF I) and IGF II levels. To characterize the effect of GH on the levels of IGF I and IGF II mRNA in a teleost, 10 micrograms of bovine GH (bGH) per g of body weight was administered to juvenile rainbow trout (Oncorhynchus mykiss) through i.p. injection. The levels of IGF I and IGF II mRNA were determined simultaneously, by using RNase protection assays, in the liver, pyloric ceca, kidney, and gill at 0, 1, 3, 6, 12, 24, 48, and 72 hr after injection. In the liver, IGF I mRNA levels were significantly elevated at 6 and 12 hr (approximately 2- to 3-fold, P < or = 0.01), while IGF II mRNA levels were significantly elevated at 3 and 6 hr (approximately 3-fold, P < or = 0.01). In the pyloric ceca, IGF II mRNA levels were significantly elevated at 12, 24, and 48 hr (approximately 3-fold, P < or = 0.01), while IGF I mRNA was below the limits of assay accuracy. GH-dependent IGF mRNA appearance was not detected in the gill and kidney. Serum bGH levels, determined by using a radioimmunoassay, were significantly elevated at 3 and 6 hr (P < 0.005). In primary hepatocyte culture, IGF I and IGF II mRNA levels increased in a bGH dose-dependent fashion, with ED50 values of approximately 45 and approximately 6 ng of bGH per ml, respectively. The GH-dependent appearance of IGF II mRNA in the liver and pyloric ceca suggests important roles for this peptide hormone exclusive of IGF I.

To stay or not to stay: issues in rural primary care physician retention in eastern Kentucky.

An important aspect of primary care physician availability is the retention of physicians once they have located. While retention has been under-researched compared to recruitment, it is especially important in rural areas where physician shortages already exist. This study reports the results of a retention survey completed by 132 primary care physicians in rural eastern Kentucky. The survey sets up an objective, hypothetical retention scenario and asks physicians to respond to structured questions and to an open-ended question about factors not appearing in the survey. In response to the structured portion of the survey, physicians indicate that relief coverage is the most important factor in rural physician retention. A content analysis of 75 open-ended responses reveals that besides the other factors in the survey, "sociocultural integration" is the pre-eminent retention issue for rural practitioners. This article concludes that the role of the local rural community may be more important in retention than in recruitment. Finally, it is suggested that additional in-depth qualitative research be conducted within the local contexts to enhance the understanding of rural physician retention processes.

Lipid composition of carcass tissue from transgenic pigs expressing a bovine growth hormone gene.

Fatty acid profiles and cholesterol content of whole-carcass ground tissue were compared from 26 transgenic (T) pigs expressing a bovine growth hormone gene (bGH) to 26 sibling control (C) pigs. All pigs were fed a common diet and were slaughtered at five different live weights: 14, 28, 48, 68, and 92 kg. The left side of each intact carcass was ground and tissue samples were analyzed for lipid composition and cholesterol content. At 14-kg body weight, carcasses from bGH-T pigs contained 38% less fat, 44% less saturated fatty acids (SFA), 48% less monounsaturated fatty acids (MUFA), and 38% less polyunsaturated fatty acids (PUFA) than C pigs. At 28 kg, bGH-T pigs had 38% less total carcass fat, 42% less SFA, 46% less MUFA, and 24% less PUFA than C pigs. At 48-kg body weight, bGH-T pigs contained 48% less carcass fat, 55% less SFA, 59% less MUFA, and 22% less PUFA than C pigs. At 68 kg, bGH-T pigs had 78% less carcass fat, 78% less SFA, 79% less MUFA, and 53% less PUFA than C pigs. At 92 kg, carcasses from bGH-T pigs contained 85% less carcass fat, 85% less SFA, 91% less MUFA, and 66% less PUFA than those from C pigs. Cholesterol content was not different between bGH-T pigs and C pigs at any of the carcass weights. The trend was for cholesterol content to decrease from the 14- to 92-kg weight group. These results suggest a dilution effect of carcass fat and fatty acids in carcass tissue from bGH-T pigs with increasing live weight.

Expression of a bovine growth hormone transgene inhibits pregnant mare's serum gonadotropin-induced follicle maturation in prepuberal gilts.

Prepuberal gilts were injected with PMSG to determine whether expression of a bovine growth hormone (bGH) transgene inhibited preovulatory maturation of ovarian follicles. Seven transgenic (TG) gilts of line 3706, which expresses a mouse metallothionein-bGH transgene, and eight nontransgenic, control (C) gilts (128 to 147 d old) were injected with PMSG, 12.5 IU/kg BW, 72 h before necropsy. Surface ovarian follicles > or = 1 mm in diameter were counted, measured for diameter, and aspirated for fluid. Follicles were classified morphologically as healthy or atretic and those with follicular fluid estradiol-17 beta > or = 100 ng/mL were classified as estrogenactive (EA). The number of follicles per gilt was 64.3 +/- 6.1 (mean +/- SEM) and did not differ significantly between bGH-TG and C gilts. The PMSG treatment induced growth of large (> 5 mm) follicles in both bGH-TG and C gilts. However, compared with C gilts, bGH-TG gilts had fewer (P < .05) large follicles (5.9 +/- 1.5 vs 18.3 +/- 5.4), a lower proportion of EA large follicles (35 +/- 12.5 vs 69 +/- 13.2%), and in large follicles less (P < .05) estradiol-17 beta (86 +/- 17 vs 350 +/- 69 ng/mL) and androstenedione (300 +/- 33 vs 1,283 +/- 221 ng/mL). Follicular fluid progesterone and inhibin did not differ significantly between bGH-TG and C gilts. The incidence of atresia among small and medium follicles did not differ significantly between bGH-TG and C gilts.(ABSTRACT TRUNCATED AT 250 WORDS)

Development of an homologous radioimmunoassay for chicken follicle-stimulating hormone and measurement of plasma FSH during the ovulatory cycle.

1. A highly specific and sensitive homologous radioimmunoassay was developed for measurement of chicken follicle stimulating hormone (cFSH). 2. Mammalian gonadotropin releasing hormone (GnRH) significantly stimulated secretion of chicken luteinising hormone (cLH) but not cFSH when administered to 22 week non-laying hens. 3. Chicken GnRH-I did not affect circulating cFSH concentrations but significantly stimulated cLH secretion when administered to 3 week cockerels. 4. The plasma concentration of cFSH was low throughout the ovulatory cycle, but a significant decline in cFSH occurred prior to the pre-ovulatory LH surge and a significant increase occurred during the 3 hr prior to oviposition as LH levels decline.

Changes in follicular estradiol-17 beta, progesterone and inhibin immunoactivity in healthy and atretic follicles during preovulatory maturation in the pig.

Follicular hormones, growth and granulosa cell gonadotropin sensitive adenylate cyclase activity were determined in healthy and atretic follicles during preovulatory maturation in pigs. Ovaries were recovered at slaughter which was 1, 3, 5 or 7 d after the last administration of a progesterone agonist (altrenogest). Plasma FSH decreased (P < .05) by 64% between days 1 and 3 and remained low through day 5. The number of large (> 5 mm) follicles increased from 2.7 on day 1 to 14.8 on day 3 and did not differ significantly among days 3, 5 and 7. The number of small (1-2 mm) and medium (3-5 mm) follicles decreased (P < or = .05) by 82% between days 3 and 5. Follicles first became estrogen-active (EA) (> or = 100 ng of estradiol-17 beta/ml of follicular fluid) on day 3, with 14.3% of medium and 73.8% of large follicles being EA. About 30% of small and 13% of medium follicles were morphologically atretic on days 1 and 3. However, by day 5, the proportion of atretic small and medium follicles had increased (P < or = .05) to 100 and 59%, respectively. Follicular fluid inhibin immunoactivity and estradiol-17 beta were lower (P < or = .05) and progesterone was greater (P < or = .05) in atretic than healthy follicles. Granulosa cells from large follicles produced (P < or = .05) more cAMP than cells from healthy or atretic small/medium follicles. Compared to control or pFSH treatment, pLH increased cAMP production by granulosa cells from large follicles on all days and from small/medium follicles on days 1 and 5; pLH had no effect on granulosa cells from atretic follicles. Compared to control, pFSH increased cAMP production in granulosa cells from healthy small/medium follicles only on day 1; no effect was detected in granulosa cells from large or atretic follicles on any day. We conclude that decreased secretion of FSH increased loss and atresia among non-ovulatory follicles. Atretic follicles were marked by loss of granulosa cell gonadotropin-sensitive adenylate cyclase activity and by low concentrations of estradiol-17 beta.