Histo-morphological effects on equine synovium after arthroscopic synovectomy using two different motorized synovial resectors and two different intensities.

The purpose of the study was to determine the histo-morphological effects on villous synovium after synovectomy using two different motorized synovial resectors and two different intensities ex-vivo. Thirty-three (n = 33) equine metacarpophalangeal/metatarsophalangeal joints were used. Synovectomy was performed along the dorsomedial/dorsolateral synovium (n = 66) using two motorized synovial resectors (aggressive full radius resector, AFRR, used at two intensities: single treatment, n = 24 vs. triple treatment, n = 21 vs. aggressive meniscus side cutter, AMSC, n = 21). Arthroscopic images were evaluated blindly for resector type and intensity. Histological images were evaluated descriptive for synovial morphology and the extent of tissue loss using a microscopic scale. Scanning electron microscopy described the synovial morphology. The synovectomized areas were specific for each resector used and distinguishable from arthroscopic images. The AFRR demonstrated a clear demarcation between treated and non-treated areas and removed the stratum synoviale completely including parts of the underlying stratum fibrosum. In contrast, the AMSC showed less clear demarcation, villous scaffolds and no involvement of the stratum fibrosum. Triple intense treated AFFR samples resulted in significantly deeper lesions compared to single treatments (p = 0.037) but could not be distinguished on arthroscopic images. The morphological effects on villous synovium differ according to the resector type used. The extent of synovial tissue loss cannot be estimated from arthroscopic images but histologically. The type and use of motorized synovial resector determines the morphological alterations of the treated synovium. Arthroscopic control is considered unsuitable to control synovectomy depth.

Effects of body weight gain on insulin and lipid metabolism in equines.

The objective of this study was to illuminate the changes in serum NEFA concentrations during a combined glucose-insulin test (CGIT) and basal serum triacylglycerides (TGs) with increasing BW in Shetland ponies and warmblood horses. Therefore, basal blood samples were taken during fasting and a CGIT was performed in 19 healthy equines (10 Shetland ponies, 9 warmblood horses) (t0). After one (t1) and two (t2) year(s) of receiving 200% of their maintenance metabolizable energy requirement, procedures were repeated in the same equines. Sixteen of 19 equines had no signs of insulin dysregulation confirmed by CGIT. Basal plasma glucose concentrations increased in ponies (P = 0.001) when comparing t0 and t2, and basal serum insulin concentrations increased in ponies (P = 0.009) and horses (P = 0.024) from t0 to t2. Basal serum NEFA concentrations increased in ponies comparing t0 and t2 (P = 0.01). During CGIT, NEFA levels dropped until reaching a nadir and subsequently recovered until reaching basal concentrations. The minimum serum NEFA value did not change over time in ponies or horses. However, a strong correlation between basal serum NEFA concentrations and the percentage drop to minimum NEFA levels was found in ponies. Two of three equines (one horse and one pony) graded as insulin-dysregulated suffered from laminitis at t2. The serum NEFA concentrations of these animals had a delay in recovery of the minimum NEFA levels. Basal serum TG levels did not change with BW gain, and no breed differences were observed. In conclusion, serum NEFA concentrations are useful parameters during CGIT to detect insulin dysregulation in equines. Thus, further investigation should be focused on lipid metabolism during insulin dysregulation.

Effects of mesenchymal stromal cells versus serum on tendon healing in a controlled experimental trial in an equine model.

BACKGROUND: Mesenchymal stromal cells (MSC) have shown promising results in the treatment of tendinopathy in equine medicine, making this therapeutic approach seem favorable for translation to human medicine. Having demonstrated that MSC engraft within the tendon lesions after local injection in an equine model, we hypothesized that they would improve tendon healing superior to serum injection alone. METHODS: Quadrilateral tendon lesions were induced in six horses by mechanical tissue disruption combined with collagenase application 3 weeks before treatment. Adipose-derived MSC suspended in serum or serum alone were then injected intralesionally. Clinical examinations, ultrasound and magnetic resonance imaging were performed over 24 weeks. Tendon biopsies for histological assessment were taken from the hindlimbs 3 weeks after treatment. Horses were sacrificed after 24 weeks and forelimb tendons were subjected to macroscopic and histological examination as well as analysis of musculoskeletal marker expression. RESULTS: Tendons injected with MSC showed a transient increase in inflammation and lesion size, as indicated by clinical and imaging parameters between week 3 and 6 (p < 0.05). Thereafter, symptoms decreased in both groups and, except that in MSC-treated tendons, mean lesion signal intensity as seen in T2w magnetic resonance imaging and cellularity as seen in the histology (p < 0.05) were lower, no major differences could be found at week 24. CONCLUSIONS: These data suggest that MSC have influenced the inflammatory reaction in a way not described in tendinopathy studies before. However, at the endpoint of the current study, 24 weeks after treatment, no distinct improvement was observed in MSC-treated tendons compared to the serum-injected controls. Future studies are necessary to elucidate whether and under which conditions MSC are beneficial for tendon healing before translation into human medicine.

Characterisation and intracellular labelling of mesenchymal stromal cells derived from synovial fluid of horses and sheep.

Multipotent mesenchymal stromal cells (MSCs) derived from synovial fluid (SF) are considered to be a promising cell type for therapeutic applications in joint disease. However, despite their potential relevance for clinical and experimental studies, there is insufficient knowledge about SF-derived MSCs isolated from horses and sheep. In this study, cells were recovered from healthy SF and bone marrow (BM) of sheep, and from healthy and osteoarthritic SF of horses. Ovine SF-MSCs were used to assess the efficiency of intracellular labelling with quantum dots (QDs). Colony forming units, generation times, trilineage differentiation potential and expression of CD73, CD90 and CD105 at mRNA level were assessed. QD labelling was efficient, with >98% positive cells directly after labelling at 10 nmol/L and >95% positive cells directly after labelling at 2 nmol/L. The label decreased over 7 days of culture, with more persistence at the higher labelling concentration. No significant differences in proliferation were observed. All MSCs had trilineage differentiation potential, but adipogenesis was more distinct in equine samples and chondrogenesis was most pronounced in ovine SF-MSCs. CD73, CD90 and CD105 were expressed in equine and ovine MSCs.

Computed Tomography of the Normal Bovine Tarsus.

The objective of this study was to provide a detailed multiplanar computed tomographic (CT) anatomic reference for the bovine tarsus. The tarsal regions from twelve healthy adult cow cadavers were scanned in both soft and bone windows via a 16-slice multidetector CT scanner. Tarsi were frozen at -20o C and sectioned to 10-mm-thick slices in transverse, dorsal and sagittal planes respecting the imaging protocol. The frozen sections were cleaned and then photographed. Anatomic structures were identified, labelled and compared with the corresponding CT images. The sagittal plane was indispensable for evaluation of bone contours, the dorsal plane was valuable in examination of the collateral ligaments, and both were beneficial for assessment of the tarsal joint articulations. CT images allowed excellent delineation between the cortex and medulla of bones, and the trabecular structure was clearly depicted. The tarsal soft tissues showed variable shades of grey, and the synovial fluid was the lowest attenuated structure. This study provided full assessment of the clinically relevant anatomic structures of the bovine tarsal joint. This technique may be of value when results from other diagnostic imaging techniques are indecisive. Images presented in this study should serve as a basic CT reference and assist in the interpretation of various bovine tarsal pathology.

Systematic arthroscopic investigation of the bovine stifle joint.

The objective of the present study was to establish a protocol for arthroscopic exploration of the bovine stifle joint using craniomedial, caudolateral and caudomedial approaches. An anatomic and arthroscopic study using 26 cadaveric limbs from 13 non-lame adult dairy cows was performed. The craniomedial approach was created between the middle and medial patellar ligaments to investigate the cranial pouches of the stifle joint. The inter-condylar eminence, the proximal aspect of the medial femoral trochlear ridge and the lateral aspect of the lateral femoral condyle were used as starting points for systematic examination of the medial femorotibial, the femoropatellar and the lateral femorotibial joints, respectively. The observed structures were: the suprapatellar pouch, articular surfaces of the patella, femoral trochlear ridges, cruciate ligaments, menisci, and the meniscotibial ligaments. The arthroscopic portal for the caudomedial femorotibial pouch was about 6-8 cm caudal to the medial collateral ligament. The proximal and distal caudolateral femorotibial pouches were explored 3 cm and 1.5 cm caudal to the ipsilateral collateral ligament, respectively. The observed structures were the caudal aspect of femoral condyles, menisci, caudal cruciate ligament, popliteal tendon and the meniscofemoral ligament. Restricted joint size and risk of common peroneal nerve damage were the major limitations for exploration of the caudal femorotibial compartments. The study described the arthroscopic portals and normal intra-articular anatomy of the bovine stifle joint but further investigations are warranted to validate these techniques in clinical cases.

[Comparison of the findings of rectal examination and ultrasonographic findings in horses with colic]. / Vergleich rektaler und sonographischer Untersuchungsbefunde bei der Kolik des Pferdes.

OBJECTIVE: The examination of patients suffering from an acute abdomen routinely comprises both clinical and rectal examinations, and is ever more frequently accompanied by an ultrasonographic abdominal examination. The aim of the study was to compare the findings as defined through rectal examination with the results of the ultrasonographic examination for different forms of colic. MATERIAL AND METHODS: In a retrospective study, the patient records of the Large Animal Clinic of the University of Leipzig from 2012 and 2013 were analysed, and those of horses suffering from colic were included. Diagnoses made through rectal and ultrasonographic examination were grouped and compared with the diagnoses made during colic surgery or pathologic examination, which served as the gold standard. Horses that underwent conservative treatment had a definitive diagnosis assigned only in cases where a pathognostic rectal finding defined the diagnosis. Based on these data, sensitivity, specificity and positive and negative predictive values were calculated for both techniques. RESULTS: Ultrasonography was more sensitive than rectal examination in cases of small intestinal occlusion (97.1% vs. 50.7%), torsion of the large colon in the long axis (63.2% vs. 26.3%) and dislocation of the large colon into the nephrosplenic space (90.9% vs. 72.7%). Rectal examination was more sensitive than ultrasonographic examination in cases of other types of dislocation of the large colon (96.5% vs. 8.8%) and of constipations of the large colon (93.6% vs. 29.8%). CONCLUSION AND CLINICAL RELEVANCE: In cases of severe diseases, including small intestinal occlusions and torsions of the large colon, ultrasonography helps to better identify and more precisely diagnose conditions that in most cases require abdominal surgery than rectal examination. Therefore, under hospital conditions, it is highly advisable to include ultrasonography in the routine examination of the equine acute abdomen. However, this technique does not replace the traditional rectal examination, which is superior in the diagnosis of dislocations and constipations of the large colon as well as diseases of the caecum.

Influence of cryopreservation and mechanical stimulation on equine Autologous Conditioned Plasma (ACP®).

OBJECTIVE: To determine the influence of cryopreservation at two different temperatures on platelet concentration, growth factor (GF) levels and platelet activation parameters in equine ACP®; moreover, to determine if adding mechanical ACP® stimulation to freeze-thaw activation amplifies GF release from platelets. MATERIAL AND METHODS: Firstly, blood from five horses was used to prepare ACP®. Platelet, platelet derived growth factor BB (PDGF-BB) and transforming growth factor ß1 (TGF-ß1) concentrations as well as mean platelet volume (MPV) and mean platelet component (MPC) were determined in fresh and corresponding ACP® samples after 2 months cryopreservation at -20 °C and -80 °C, respectively. Secondly, ACP® was prepared from blood of nine horses. Half of ACP® was activated using one freeze-thaw-cycle at -20 °C, whereas the rest was first vortexed. Their PDGF-BB and TGF-ß1 concentrations were subsequently determined. RESULTS: Platelet concentration significantly decreased after -80 °C cryopreservation. PDGF-BB level augmented significantly after both storage methods, whereas TGF-ß1 concentration was not significantly altered. MPV significantly increased after -20 °C cryopreservation. Both storage regimens induced a significant MPC decrease. No significant differences in GF concentrations between the vortexed and non-vortexed samples were detected. DISCUSSION: Both cryopreservation methods induced platelet activation, but storage at -80 °C apparently harmed the platelets without generating higher GF release than -20 °C. The mechanical stimulation process could not enhance GF release in subsequently frozen-thawed ACP®. CONCLUSION AND CLINICAL RELEVANCE: Storage of ACP® at -20 °C could be useful in equine practice, but, before this procedure can be recommended, further qualitative tests are needed. The mechanical stimulation technique should be adjusted in order to increase platelet activation.

Quantitative evaluation of bone scintigraphy of the spinous processes of the equine thoracic spine at different times after administering 99mTc-hydroxymethylene-diphosphonate.

Scintigraphic examination of the thoracic spine is well documented. However, there is limited information about the effects of time on image quality in the period following injection of radionuclide. This study aimed to determine the optimal time point after injection of (99m)Tc-HDP (hydroxymethylene-diphosphonate) to achieve scintigraphic images with the best possible contrast and adequate count rates. Scintigraphic images of the thoracic spine of 21 horses were acquired two, four and six hours after administering (99m)Tc-HDP. Eight regions of interest were drawn in the images, four in the spinous processes and four in the adjacent soft tissue. The bone uptake, soft tissue uptake and the bone-to-soft tissue ratio were determined and compared between the different time points. Total count rates decreased with time after injection, but were at least as high as 150,000 counts per image at every time point after injection. The bone-to-soft tissue ratio was significantly higher for the images acquired after six hours compared to those acquired after two and four hours (P<0.01). Delayed scintigraphic examinations of the spinous processes of the equine thoracic spine achieved images with high contrast and sufficient count rates. Therefore, the scintigraphic examination of the equine thoracic spine is recommended to be done four to six hours after injecting (99m)Tc-HDP. However, additional studies should be performed to determine the effect of delayed image acquisition compared to images taken after three hours on the detectability of lesions in other parts of the thoracic spine and the soft tissue.

Morphometrical analysis of the thoracolumbar dural sac in sheep using computed assisted myelography.

OBJECTIVES: Sheep are frequently used as animal models in experimental spinal injury studies. Therefore, extensive knowledge of ovine spinal dimensions is essential for experimental design and interpretation of results obtained in these trials. This study aimed to obtain quantitative morphometrical data of the thoracolumbar dural sac in sheep and determine the anatomical relationship between the dural sac and the vertebral canal. METHODS: Computed assisted myelography imaging was carried out in five adult German Black-Headed Mutton sheep under general anaesthesia. Transverse images were acquired with 2 mm slice thickness from the first thoracic to the sixth lumbar vertebrae. Sagittal and transverse diameters and the cross-sectional area of the dural sac and vertebral canal were measured. To determine the anatomical relationship between the dural sac and vertebral canal, the pedicle-dural sac distance (PPSD) and the epidural space as well as the SAC (available space for the dural sac) were calculated. RESULTS: Sagittal diameters of the dural sac ranged from 5.1 to 12.0 mm. Transverse diameters ranged from 5.6 to 12.2 mm. The dural sac area covered 45.9% and 49.0% of the thoracic and lumbar vertebral canal area. The PDSD in the lumbar vertebrae was up to 15.8% larger than in the thoracic ones. The dural sac area was significantly positively correlated with the transverse diameter and area of the vertebral canal. CLINICAL SIGNIFICANCE: The lumbar vertebral canal contained more space for the dural sac, which seems to be safer for testing spinal implants.

Parapagus conjoined twin calf: a case study - focused on CT and cardiac abnormalities.

Congenital duplication anomalies occasionally occur in both humans and animals. Although various forms of classification of these conjoined twins exist, each case should be considered as an individual. In the case study presented a Holstein Frisian calf, born alive after 281 days of normal gravidity was investigated by computed tomography (CT) and subsequent dissection. The calf could be classified as a parapagus dicephalus tetrabrachius. It exhibited two heads each of them with a complete cervical spine leading to a complete thoracic and lumbar spine and separate tails. Looking at the point of fusion, the twin was conjoined in the ventrolateral thoracic part of the body. The calf had two thoraces with four forelimbs and two pelvic limbs on a single pelvis. As two heads and thoraces were present, beginning at the oral cavity, two intestinal systems were observable leading to a fusion point at the ascending part of the duodenum been continued caudally as a single system. Within each thorax, two lungs and a heart were present. However, only the heart in the left thorax was normal shape, exhibiting a strong myocardium and increased size. In contrast, the heart within the right thorax was considerably smaller, round shaped, and it appeared to be spongy and not fully developed during the foetal period. Commonly, classification of conjoined twins is only based on the appearance of the skeletal system. However, in the case presented, the point of fusion of the skeletal system did not allow conclusions regarding the intestinal or cardiovascular system.

[Sport as a means to prevention, rehabilitation, and health promotion. An expert opinion]. / Sport als Mittel in Prävention, Rehabilitation und Gesundheitsförderung. Eine Expertise.

Physical activities are particularly health effective when they are structured and systematically organized, for example, with respect to a dose-response relationship or to psychosocial aspects. Which insights can be gained from scientific knowledge on the structure of physical activities? Which health-related goals can be sought with different physical activities in the field of sport? Which target groups can be reached with these kinds of sport? These questions are addressed in this article on the basis of current scientific knowledge-to promote the development of health-enhancing physical activities especially in sport federations, but also to create a communication platform between the sport and the health sector. The work of researchers in this field is focused mainly on health-enhancing physical activity, but they are also engaged in health-related scientific organizations and in sport federations.

Magnetic resonance imaging of plantar soft tissue structures of the tarsus and proximal metatarsus in foals and adult horses.

OBJECTIVES: The object of this study was to describe previously defined soft tissue structures by using spin and gradient sequences in a 0.5 Tesla magnetic resonance system in order to improve the characterisation of tendon and ligaments at the plantar region of the equine tarsus and metatarsus while considering possible age-related variations. METHODS: Cadaveric hindlimbs from twenty-two Warmblood horses with an age range from one month to twenty-five years were examined in spin and gradient echoes. The proximal suspensory ligament from six limbs was dissected to assign the signal intensities histologically. For statistical analysis, horses were divided into two groups (≤3 years and >3 years) for evaluating signal intensity and homogeneity of the plantar tendons and ligaments. RESULTS: Focal increase of the signal intensity within the deep digital flexor tendon was significantly more present in horses older than three years. Signal alterations of the long plantar ligament were seen without a significant dependency to age. The accessory ligament of the deep digital flexor tendon could not be visualized on all images within the region of interest. The morphology of the proximal suspensory ligament was not affected by age-related changes. CLINICAL RELEVANCE: Spin and gradient echoes in MRI were suitable to identify and assess soft tissue structures at the plantar aspect of the equine tarsus and proximal metatarsus. Age-related appearance must be considered when interpreting magnetic resonance images.

Normal radiographic and ultrasonographic appearance of the adult dromedary camel tarsus (one humped camel).

Six cadaver pelvic limbs were obtained from clinically sound dromedary camels and examined radiographically and ultrasonographically using a 7.5 MHz convex transducer. Radiographic examination was performed in dorsoplantar, lateromedial, dorsolateral-plantaromedial oblique and plantarolateral-dorsomedial oblique projections, and the bony structures and articulations of the tarsal joint were outlined. The tarsus was ultrasonographically investigated in four planes (dorsal, medial, lateral and plantar), and each plane was scrutinized in four levels (calcaneal tuber, tibial malleoli, base of calcaneus and proximal end of metatarsus) in both transverse and longitudinal views. Limbs were examined grossly, frozen at -20°C and sectioned. Radiographic and ultrasonographic findings correlated well with the gross anatomy and frozen sections. The normal appearance of bony and soft structures of the tarsus described in this study provided basic reference data for ultrasonographic and radiographic investigations of tarsal disorders in the dromedary camel.

Computed tomography and cross-sectional anatomy of the normal dromedary camel tarsus (one humped camel).

The purpose of this study was to provide a detailed computed tomographic (CT) anatomic reference for the dromedary camel tarsus. Six cadaver pelvic limbs, obtained from three clinically and radiographically sound dromedary camels, were scanned in both soft tissue and bone windows starting from the calcaneal tuber towards the proximal metatarsus. Limbs were frozen at -20°C and sectioned transversely via an electric bone saw. The CT images were evaluated and correlated with their corresponding cryosections. The resulting images provided detailed anatomic features for bones, joints and soft tissue components of the tarsus and are intended to serve as a basic reference for the CT scanning of the dromedary camel tarsal pathology.

Influence of in vitro maturation of engineered cartilage on the outcome of osteochondral repair in a goat model.

This study was designed to determine if the maturation stage of engineered cartilage implanted in a goat model of cartilage injury influences the repair outcome. Goat engineered cartilage was generated from autologous chondrocytes cultured in hyaluronic acid scaffolds using 2 d, 2 weeks or 6 weeks of pre-culture and implanted above hydroxyapatite/hyaluronic acid sponges into osteochondral defects. Control defects were left untreated or treated with cell-free scaffolds. The quality of repair tissues was assessed 8 weeks or 8 months post implantation by histological staining, modified O'Driscoll scoring and biochemical analyses. Increasing pre-culture time resulted in progressive maturation of the grafts in vitro. After 8 weeks in vivo, the quality of the repair was not improved by any treatment. After 8 months, O'Driscoll histology scores indicated poor cartilage architecture for untreated (29.7 ± 1.6) and cell-free treated groups (24.3 ± 5.8). The histology score was improved when cellular grafts were implanted, with best scores observed for grafts pre-cultured for 2 weeks (16.3 ± 5.8). As compared to shorter pre-culture times, grafts cultured for 6 weeks (histology score: 22.3 ± 6.4) displayed highest type II/I collagen ratios but also inferior architecture of the surface and within the defect, as well as lower integration with native cartilage. Thus, pre-culture of engineered cartilage for 2 weeks achieved a suitable compromise between tissue maturity and structural/integrative properties of the repair tissue. The data demonstrate that the stage of development of engineered cartilage is an important parameter to be considered in designing cartilage repair strategies.

Influence of head and neck position on radiographic measurement of intervertebral distances between thoracic dorsal spinous processes in clinically sound horses.

REASONS FOR PERFORMING STUDY: Reductions in distances between dorsal spinous processes on radiographs are used as criteria for the diagnosis of impingement of the thoracic dorsal spinous processes in horses but are potentially altered by spine motion and different head and neck positions. OBJECTIVES: To determine the influence of head and neck positions on intervertebral distances between dorsal spinous processes on radiographs of thoracic spines of clinically sound horses. METHODS: Lateral-lateral radiographs were obtained from 23 horses in 3 head and neck positions. The width of the thoracic dorsal spinous processes and intervertebral distances between adjacent thoracic dorsal spinous processes were measured at points perpendicular to a tangent between the dorsal spinous processes and the caudal extremity of the thoracic vertebrae. RESULTS: A low head and neck position increased intervertebral distances between adjacent thoracic dorsal spinous processes from the 8th to 15th dorsal spinous processes whereas a high head and neck position had the opposite effect (P < 0.05). Overall, intervertebral distances between adjacent thoracic dorsal spinous processes decreased from cranial to caudal in intermediate head and neck positions (P < 0.01). The 12th thoracic dorsal spinous process was readily identifiable due to its significant difference to the narrower cranial and broader caudal dorsal spinous process (P < 0.05). CONCLUSIONS: The head and neck position influences the distances between the dorsal spinous processes of the vertebrae of equine thoracic spine on radiography. POTENTIAL RELEVANCE: The measuring system reported here offers potential to improve and standardise radiographic evaluation of thoracic dorsal spinous processes.

Dynamic Stress Factor (DySF): A Significant Predictor of Severe Hypoglycemic Events in Children with Type 1 Diabetes.

Hemoglobin A1c (HbA1c) is the current standard used in the clinical treatment of patients with diabetes. However, it has been shown that patients with similar HbA1c values may have widely different fluctuations in blood glucose values over the same period of time, including time spent in hyper- and/or hypo-glycemia. Hence, there exists a need for quantitative measures that can supplement HbA1c in managing patients with diabetes. We introduce and compare the Dynamic Stress Factor, DySF, a newly developed metric that quantifies glycemic volatility based on patient-specific glucose transition density profiles with HbA1c and with currently used glucose variability metrics in predicting severe hypoglycemia in children with type 1 diabetes. DySF, the daily weighted number of large monotonic glycemic transitions that occur within one hour, was calculated for 441 total subjects with type 1 diabetes (146 children, aged 8-14 yrs) to assess the magnitude and frequency of glucose transitions per day. Severe hypoglycemic episodes (HE) were quantified for all subjects and evaluated against HbA1c and existing measures of glucose variability, including SD, MAGE, MODD, and CONGA using logistic regression models. DySF was found to be a predictor of severe HE in children (p = 0.018) with the likelihood of a child, aged 8-14 yrs, experiencing severe hypoglycemia increasing by up to 20% with decreasing values of up to 60% of DySF. Patients of any age who had one or multiple severe hypoglycemic episodes had on average a lower DySF when compared to those with no HE. Additionally, when considering mean glucose levels, DySF/mean was a preliminary predictor of severe HE in patients with HbA1c ≤ 6.5% (p = 0.062). DySF is a dynamic, quantitative, measure of daily glucose "volatility" that separates patients, within the same strata of HbA1c, into visually distinct patient profiles. DySF can be used as a preliminary predictor of clinically severe hypoglycemia in children and "well-controlled" patients with HbA1c ≤ 6.5%.

Successful treatment of equine sarcoids by topical aciclovir application.

Based on the anecdotally reported eradication of a sarcoid using aciclovir cream, the curative potential of this ointment was investigated in 22 sarcoid-affected horses referred to the Equine Clinic Tillysburg, Austria, between 2006 and 2009. Sarcoid disease was diagnosed by clinical examination and bovine papillomavirus types 1 and 2 from intact skin and tumour tissue. As nine horses had more than one lesion, a total of 47 sarcoids were treated by daily topical application of aciclovir 5 per cent cream for a period of two to six months; in four horses, surgical tumour ablation was performed before treatment. Disease parameters, including the tumour type, number, location and size, were recorded before and after aciclovir therapy. All 47 (100 per cent) of the sarcoids responded to treatment, with complete tumour regression observed for 32 (68 per cent) lesions and no recurrences reported thus far. Incomplete resolution was observed for 15 (32 per cent) lesions, probably due to their thickness. Aciclovir is proposed to be routinely used for the treatment of mild-type sarcoids and as an adjuvant therapeutic agent in combination with surgery.

[Physical activity during the transition period between occupation and retirement]. / Körperlich-sportliche Aktivität in der Übergangsphase vom Beruf in den Ruhestand.

BACKGROUND: During the transition period between occupation and retirement, different mental challenges may arise as a consequence of the numerous changes and necessary reorientation to the following phase of life. Personal well-being is a precondition to cope with these challenges. METHODS: Interviews with physically active people in the transition period between occupation and retirement, concerning the importance of physical activity in coping with mental challenges, were conducted. RESULTS: Physical activity is meant to affect well-being and the physical condition in a positive way. In addition, it should foster social contacts and make it easier to manage everyday life. Moreover, it is a measure of personal success during advanced age. CONCLUSION: Because of its influence on various physical, mental, and social aspects, physical activity can help a person to cope with mental challenges in the transition period between occupation and retirement.