Uptake routes of microplastics in fishes: practical and theoretical approaches to test existing theories.

Microplastics are frequently detected in the gastrointestinal tracts of aquatic organisms worldwide. A number of active and passive pathways have been suggested for fish, including the confusion of microplastic particles with prey, accidental uptake while foraging and transfer through the food chain, but a holistic understanding of influencing factors is still lacking. The aim of the study was to investigate frequently suggested theories and identify relevant biotic factors, as well as certain plastic properties, affecting microplastic intake in fish. Four species of freshwater fish, each representing a different combination of foraging style (visual/chemosensory) and domestic status (wild/farmed) were exposed to different realistic plastic concentrations and polymer types with and without the provision of genuine food. As most previous investigations of microplastic uptake routes consider only particles large enough to be perceptible to fish, the potential for accidental intake via drinking water has been somewhat neglected. This route is evaluated in the current study using a model approach. The results show that visually oriented fish forage actively on microplastic particles that optically resemble their usual food, while fish with a predominantly chemosensory foraging style are more able to discriminate inedible food items. Even so, the accidental uptake of microplastics while foraging is shown to be relevant pathway, occurring frequently in both visual and chemosensory foragers alike. Several factors were shown to increase plastic uptake, including microplastic concentration in the water, foraging behaviour promoted by availability of genuine food, and fish size. Although both wild and farmed fish ingested microplastic particles, cultured fish showed less discernment in terms of colour and were more likely to forage actively on microplastics when no food was available. Drinking has been identified as a possible source of microplastic intake specifically for large marine fish species. Particles smaller than <5 µm can pass the gastrointestinal tract wall and bioaccumulation could arise when uptake exceeds release or when particles are assimilated in tissues or organs. The effects of accumulation may be significant, especially in long-living species, with implications for food web transfer and fish as food items.

Psychological and work-related outcomes after inpatient multidisciplinary rehabilitation of chronic low back pain: a prospective randomized controlled trial.

BACKGROUND: This study investigated the long-term effects (12 months post-rehabilitation) of a standard inpatient multidisciplinary rehabilitation program for patients with chronic low back pain (CLBP), in which a control group (CG) received pain competence training and an intervention group (IG) received combined pain competence and depression prevention training. METHODS: In this prospective control group study with cluster-block randomization, a total of n = 583 patients were included into per protocol analyses. To examine the effects of rehabilitation on depressive symptoms, pain self-efficacy, and work ability, patients were stratified in repeated-measures analyses of variance by treatment condition (IG vs. CG), level of depressive symptoms (low vs. high), and time of assessment (pre, post, 6, and 12 months after rehabilitation). The impact of each treatment on pain-related days of sick leave (DSL; dichotomized into ≤ vs. > 2 weeks) was determined separately by conducting non-parametric analyses. Multiple imputations (n = 1225) confirmed the results. Effects were interpreted if clinical significance was given. RESULTS: Only patients with high levels of depressive symptoms showed long-term improvements in depressive symptoms and self-efficacy. Long-term improvements in work ability index and mental work ability item were restricted to the IG. Furthermore, long-term effects on pain-related DSL were ascertained by per protocol and multiple imputation analyses only for the IG. CONCLUSIONS: Patients with high levels of depressive symptoms showed improvements in depressive symptoms and self-efficacy, supporting the psychological effectiveness of both interventions. However, the beneficial long-term effects of rehabilitation on work ability and pain-related DSL among the IG support implementation of combined pain competence and depression prevention training. TRIAL REGISTRATION: DRKS00015465 (German Clinical Trial Register DRKS); date of registration: 03.09.2018.

Treatment of tibial diaphyseal fractures following plateless tibial tuberosity advancement to manage cranial cruciate disease.

OBJECTIVE: To report diaphyseal fractures of the proximal tibia following tibial tuberosity advancement without plate stabilisation for the management of cranial cruciate ligament rupture in dogs. METHODS: Members of the British Veterinary Orthopaedic Association's online discussion forum were invited to submit revision cases of tibial diaphyseal fracture following tibial tuberosity advancement without plate fixation. Data collected included signalment, surgical revision technique, pre- and postoperative revision radiographic findings, complications and veterinary assessment. Owners were invited to complete the Liverpool Osteoarthritis in Dogs questionnaire. RESULTS: A total of 17 dogs were included in the study. Eleven dogs had OrthoFoam-wedge modified Maquet procedures and six had the tibial tuberosity advancement rapid procedure. Tibial tuberosity advancement was maintained in 14/17 cases. Postrevision surgery complications occurred in eight cases: minor complications in 3/17 dogs; major in 5/17 and no catastrophic complications. Surgical site infection was the most common complication (4/8). Final clinical outcome found 8/17 of dogs to have excellent, 8/17 satisfactory and 1/17 poor clinical outcome. The median Liverpool Osteoarthritis in Dogs score was 12/52 (range 2 to 28). Final outcome was 6/13 owners that were very satisfied, 2/13 owners indifferent and 5/13 owners very disappointed. CLINICAL SIGNIFICANCE: This is the first case series reporting tibial diaphyseal fractures following tibial tuberosity advancement without plate stabilisation. The authors report here a wide spectrum of potential fixation strategies should one of these fractures occur.

[Is the relationship between fear-avoidance cognitions and quality of life mediated by depressive symptoms?] / Mediiert die Depressivität die Beziehung zwischen Angst-Vermeidungs-Kognitionen und Lebensqualität?

BACKGROUND: Chronic low back pain is often accompanied by fear-avoidance cognitions, increased depressive symptoms and decreased quality of life. OBJECTIVE: Is the relationship between fear-avoidance cognitions and quality of life mediated by depressive symptoms? METHODS: Mediation analyses were conducted to predict the long-term quality of life with depressive symptoms as mediator using longitudinal data from 131 patients. RESULTS: Fear-avoidance cognitions prior to rehabilitation predicted the physical quality of life 24 months after rehabilitation, which was mediated by the degree of depressive symptoms 6 months after rehabilitation. The other assumed models could not be tested due to non-significant correlations between the model variables. CONCLUSION: To improve the physical quality of life, depressive symptoms should be included into the treatment of chronic low back pain.

Psychological Aspects in the Treatment of Chronic Low Back Pain in Germany: A Review.

Bei chronischen, nicht spezifischen Rückenschmerzen haben psychische Komorbiditäten deutlich zugenommen, sodass im Rahmen einer multimodalen Behandlung zunehmend auch psychotherapeutische Behandlungsansätze implementiert werden. Ziel dieses Reviews war es, die aktuelle Forschung zu psychologischen Aspekten bei der Behandlung von chronischen Rückenschmerzen zu thematisieren. Dazu wurde eine selektive Literaturrecherche durchgeführt, um Studien aus Deutschland zu identifizieren, die in den letzten 5 Jahren veröffentlicht wurden. Dabei wurden 12 Artikel von 5 Forschergruppen gefunden, die unterschiedliche Aspekte der stationären, teilstationären und ambulanten Rehabilitation sowie der Nachsorge thematisierten. Die Evidenz für die Effektivität von psychologischer Behandlung bei chronischen Rückenschmerzen ist in den letzten Jahren gestiegen, gerade im Bereich der Nachsorge ist jedoch weitere Forschung für eine erfolgreiche Implementierung notwendig.

Genetically distinct colour morphs of European perch Perca fluviatilis in Lake Constance differ in susceptibility to macroparasites.

The unusual yellow-finned morph of European perch Perca fluviatilis found in Lake Constance suffers more severely from macroparasite infections, including the tapeworm Triaenophorus nodulosus and the gill worm Ancyrocephalus percae, than conspecifics elsewhere. Microsatellite analysis of yellow-finned P. fluviatilis and red-finned variant recently discovered in Lake Constance revealed significant genetic differentiation. Red-finned P. fluviatilis and fish with mixed fin colour, suggested backcrosses between red and yellow-finned colour morphs, exhibit better resilience to parasite infection, suggesting that the inability of the yellow-finned morph to reject macroparasites may have a genetic basis.

Treatment of fractures of the tibial and/or fibular malleoli in 30 cats.

Five cats were treated for a fracture of the medial malleolus, 10 for a fracture of the lateral malleolus and 15 for fractures of both malleoli. Open reduction and internal fixation with Kirschner wires (K-wires) with or without a tension band wire was applied to 26 of the fractures. Unilateral-uniplanar or bilateral-uniplanar transarticular external skeletal fixators were applied to provide coaptation in 19 cases and appeared to be well tolerated. In 24 cases fracture healing was assessed radiographically between four and eight weeks after treatment. In seven cases fracture healing was good, in 12 cases it was reasonable, in four cases it was poor and in one case with two fractures healing was poor in one and reasonable in the other. The 12 fractures treated by open reduction and internal fixation with K-wires and a tension band wire all showed evidence of good or reasonable healing. The nine fractures treated by open reduction and internal fixation with K-wires without a tension band wire showed evidence of good or reasonable healing in six cases and poor healing in three cases. Complications occurred in nine of the cats and included persistent talocrural instability, soft tissue necrosis, implant migration and external fixator pin breakage. Twenty-one of the cats were followed up by telephone questionnaire for between 5.5 and 84 months; the owner satisfaction was excellent in 17 cases, good in two cases, moderate in one case and poor in one case.

Complications following tarsal arthrodesis using bone plate fixation in dogs.

OBJECTIVES: To report the complications encountered following tarsal arthrodesis surgery with bone plate fixation and describe the previously unreported complication of plantar necrosis. METHODS: Medical records of 40 dogs that had been treated by tarsal arthrodesis with bone plate fixation were reviewed to determine the major and minor complications and the associated risk factors. RESULTS: The major complication rate was 32.5 per cent and the minor complication rate was 42.5 per cent. Pantarsal arthrodeses had a higher major complication rate than partial tarsal arthrodeses. Plantar necrosis was the most common major complication and occurred in 15 per cent of cases. Plantar necrosis occurred more frequently when a bone plate was applied to the medial aspect of the hock, and only occurred in cases where tarsometatarsal joint arthrodesis was performed. CLINICAL SIGNIFICANCE: Plantar necrosis is a catastrophic complication that may be associated with injury to the dorsal pedal artery or perforating metatarsal artery. Application of a bone plate to the medial aspect of the hock should be performed with care during tarsal arthrodesis, particularly where the tarsometatarsal joint is debrided of cartilage. Strict attention to surgical technique and proper postoperative coaptation is critical to reduce the potential for complications with tarsal arthrodesis.

Treatment of medial patellar luxation by femoral closing wedge ostectomy using a distal femoral plate in four dogs.

This case report describes the treatment of recurrent medial patellar luxation associated with varus deformity of the distal femur by distal femoral ostectomy stabilised using a distal femoral plate. Four dogs (five affected limbs) were included in the study. All cases had received previous surgery for medial patellar luxation but remained significantly lame. All were treated by femoral ostectomy to correct distal femoral varus deformity with application of a distal femoral bone plate. All cases improved following surgery. An excellent outcome was recorded in four of five cases. Lameness persisted in one case despite satisfactory patellar stability as a result of concurrent cranial cruciate ligament deficiency. One case suffered implant failure. Femoral ostectomy is an effective treatment for medial patellar luxation associated with femoral varus deformity. The distal femoral plate provides a convenient method by which to stabilise the ostectomy. Care should be exercised when the 2 mm distal femoral plate is applied.

Cytokine mediated regulation of interferon-gamma-induced IDO activation.

Stimulation of human monocyte-derived-macrophages (MDM) with interferon gamma induces the L-tryptophan degrading enzyme indoleamine 2,3-dioxygenase (IDO). It has been well documented that the growth of some intra-cellular parasites such as Chlamydia and Toxoplasma in human fibroblasts and glioblastoma cells is inhibited by IDO mediated L-tryptophan depletion. We have recently shown that IDO induction in cord blood MDM is also responsible for the growth inhibition of extra-cellular group B streptococci and thus for the first time shown an anti-bacterial effect of IDO activation. In view of this immunological function we sought to investigate the regulation, and in particular the downregulation of IDO by the immune system. We describe here the effect of cytokines on IDO activation and in particular the inhibitory function of IL-10, TGF beta and IL-4.

[Assessment of vertebrobasilar insufficiency using magnetic resonance angiography]. / Valoración de la insuficiencia vertebrobasilar por medio de angiografía por resonancia magnética.

We present the protocol for diagnosis of VBI followed by ENT and Radiology Departments of the Valencia University General Hospital, using the 2D-PC magnetic resonance angiography technique (MRA) with variable VENC (30 and 40 cm/s) with a SIGMA 1.5 T Advantage system version 5 x with the corresponding software review 5.2 (General Electric Medical Systems, Milwaukee, WI, USA). After a coronal angiographic projection is obtained in a neutral position on an axial plane of localization, the patient head is set at the maximum left and right rotation and hyperextension allowed by patient and system. In this way, a coronal angiographic sequence is obtained in order to visualize potential compressions, decreases of the flow, arterial loops, etc. MRA is a non-invasive technique that requires no contrast, does not expose the patient to ionizing radiation, and allows to change the position of the patient's head easily. Since no hospitalization is required and contraindications are minimal (e.g., implanted pacemakers...), we believe that MRA constitutes and ideal screening technique to assess the vertebro basilar system. The results obtained and the advantages provided by MRA over Doppler-ultrasound and X-ray angiography are showed.