Tissue predictability of elastography is low in collagenase induced deep digital flexor tendinopathy.

Elastography is an emerging imaging modality for characterizing tendon injury in horses, but its ability to differentiate tissue deformability relative to treatment group and biochemical properties using a prospective, experimental study design remain unknown. Objectives of the current study were to (a) to investigate differences in glycosaminoglycan, DNA, and soluble collagen levels in mesenchymal stem cell (MSC) treated limbs compared to untreated control limbs utilizing a collagenase model of tendinopathy; (b) compare elastographic features between treatment groups; and (c) determine tissue-level predictive capabilities of elastography in relation to biochemical outcomes. Bone marrow was collected for MSC culture and expansion. Tendinopathy of both forelimb deep digital flexor tendons (DDFTs) was induced with collagenase under ultrasonographic guidance. One randomly assigned limb was treated with intra-lesional MSC injection with the opposite limb serving as an untreated control. Horses were placed into a controlled exercise program with elastographic evaluations performed baseline (0) and 14, 60, 90, and 214 days post-treatment. Postmortem biochemical analysis was performed. MSC-treated limbs demonstrated significantly less (42%) glycosaminoglycan (P = .006). Significant differences in elastographic region of interest (ROI) percent hardness, ROI color histogram, and subjective lesion stiffness were appreciated between treatment groups at various study time points. Elastographic outcome parameters were weak predictors of biochemical tissue analysis, with all R2 values ≤ 0.50. Within this range of differences in glycosaminoglycan content between treatment groups, elastography outcomes did not predict biochemical differences. Tissue-specific differences between DDFTs treated with MSCs compared to controls were apparent biochemically, but not predicted by elastography.

Evaluation of peer teaching and deliberate practice to teach veterinary surgery.

OBJECTIVE: To assess the impact of peer teaching and deliberate practice on surgical skills acquisition and retention in first- and second-year veterinary students. STUDY DESIGN: Randomized, prospective, comparative study. SAMPLE POPULATION: Eighteen first-year and 25 second-year students from 1 college of veterinary medicine who had previously demonstrated proficiency in basic surgical skills. METHODS: Forty-three participants were divided into 3 groups: the test group (group A, n = 15), who participated in a structured peer-assisted learning program using deliberate practice; the time-practice control group (group B, n = 15), who participated in an unstructured peer-supported environment; and the assessment-only control group (group C, n = 13), who participated in the assessments. Participants performed a subcutaneous mass removal on a cadaver model and were assessed via a global rating system. Three assessment points were evaluated: pretraining, immediate posttraining, and retention. RESULTS: The number of participants who achieved acceptable or excellent grand total scores in group A increased after training. Among all participants, 22% in group A, 35% in group B, and 38% in group C did not achieve an acceptable total score at the retention assessment. CONCLUSION: The study population improved in skill level and retention through the use of standardized video and peer instruction with attention to effective learning strategies, particularly deliberate practice. CLINICAL SIGNIFICANCE: Use and enhancement of the format introduced in this study could augment veterinary surgical education.

In vitro antimicrobial activity of equine platelet lysate and mesenchymal stromal cells against common clinical pathogens.

Septic arthritis is considered a medical emergency. Disease following bacterial colonization can lead to significant morbidity and mortality and requires costly treatment. Antimicrobial properties of regenerative therapies, including mesenchymal stromal cells and platelet products, have been researched extensively in human medicine. Although fewer studies have been conducted in veterinary species, they have shown promising results. The purpose of this study was to evaluate bacterial suppression by equine platelet lysate (EPL) and adipose-derived mesenchymal stromal cells (ASCs) in vitro. We hypothesized that both products would significantly inhibit the growth of Staphylococcus aureus and Escherichia coli. Pooled blood from 10 horses was used for production of EPL. Mesenchymal stromal cells were isolated from adipose tissue harvested from the gluteal region of 3 horses. The study evaluated 3 treatment groups: 10 × EPL, 1.6 million ASCs, and a control, using an incomplete unbalanced block design with repeated measurements. Optical density readings and colony-forming units/mL were calculated at 0, 3, 6, 9, 12, 18, and 24 hours. Decreased bacterial growth was seen at multiple time points for the S. aureus-ASC and S. aureus-EPL treatments, supporting our hypothesis. Increased bacterial growth was noticed in the E. coli-EPL group, with no difference in the E. coli-ASC treatment, which opposed our hypothesis. A clear conclusion of antimicrobial effects of EPL and ASCs cannot be made from this in vitro study. Although it appears that ASCs have a significant effect on decreasing the growth of S. aureus, further studies are needed to explore these effects, particularly in Gram-positive bacteria.

L'arthrite septique est considérée comme une urgence médicale. La maladie consécutive à une colonisation bactérienne peut entraîner une morbidité et une mortalité importantes et nécessite un traitement coûteux. Les propriétés antimicrobiennes des thérapies régénératives, y compris les cellules stromales mésenchymateuses et les produits plaquettaires, ont fait l'objet de recherches approfondies en médecine humaine. Bien que moins d'études aient été menées chez les espèces animales, elles ont montré des résultats prometteurs. Le but de cette étude était d'évaluer la suppression bactérienne par le lysat plaquettaire équin (EPL) et les cellules stromales mésenchymateuses adipeuses (ASC) i n vitro. Nous avons émis l'hypothèse que les deux produits inhiberaient de manière significative la croissance de Staphylococcus aureus et d'Escherichia coli. Un pool de sang de 10 chevaux a été utilisé pour la production d'EPL. Des cellules stromales mésenchymateuses ont été isolées à partir de tissu adipeux prélevé dans la région fessière de trois chevaux. L'étude a évalué trois groupes de traitement : 10 × EPL, 1,6 million d'ASC et un témoin, en utilisant un design en blocs non équilibrés incomplets avec des mesures répétées. Les lectures de densité optique et les unités formatrices de colonie/mL ont été calculées à 0, 3, 6, 9, 12, 18 et 24 heures. Une diminution de la croissance bactérienne a été observée à plusieurs moments pour les traitements S. aureus-ASC et S. aureus-EPL, soutenant notre hypothèse. Une croissance bactérienne accrue a été remarquée dans le groupe E. coli-EPL, sans différence dans le traitement E. coli-ASC, ce qui s'opposait à notre hypothèse. Une conclusion claire des effets antimicrobiens de l'EPL et des ASC ne peut pas être tirée de cette étude in vitro. Bien qu'il semble que les ASC aient un effet significatif sur la diminution de la croissance de S. aureus, d'autres études sont nécessaires pour explorer ces effets, en particulier chez les bactéries à Gram positif.(Traduit par Docteur Serge Messier).

Relative stiffness of 3 bandage/splint constructs for stabilization of equine midmetacarpal fractures.

OBJECTIVE: Determine the relative stiffness of 3 bandage/splint constructs intended for emergency fracture stabilization. DESIGN: Experimental model. A single plane free end deflection model was developed to simulate the forces placed on a bandage/splint construct during stabilization of a complete mid-metacarpal bone fracture. The total deflection of the model in one plane was measured following application of 3 different bandage/splint combinations including a classic, 3 layered Robert Jones Bandage (RJB) with a splint placed on the outside of the bandage (RJB-3), an RJB with splint placed after the first of 3 bandage layers (RJB-1), and a single layer full limb bandage with external splint (SS). Comparisons were made between the deflections of the model with each bandage/splint combinations in an effort to determine the most effective method for field fracture stabilization. SETTING: Laboratory. ANIMALS: No animals were utilized in data collection for this study. Two live horses were utilized during the pilot study. INTERVENTIONS: Application of bandage and splint to a model intended to simulate the bending force on a lower forelimb fracture in a horse MEASUREMENTS AND MAIN RESULTS: Deflection was determined by the difference between the height of the model's supported free end before application of a 4.5 kg weight and at the conclusion of the deflection test. There was no significant difference in the amount of deflection between bandage/splint combinations (78 ± 32 mm (RJB-1), 94 ± 44 mm (RJB-3), and 93 ± 33 mm (SS)) CONCLUSIONS: The one-layer bandage with splint was equivalent to either RJB configuration in the mean amount of deflection in the simple model of a fracture.

Medical treatment of horses with deep digital flexor tendon injuries diagnosed with high-field-strength magnetic resonance imaging: 118 cases (2000-2010).

OBJECTIVE: To describe the location and severity of deep digital flexor tendon (DDFT) lesions diagnosed by means of high-field-strength MRI in horses and to identify variables associated with return to activity following medical treatment. DESIGN: Retrospective case series. ANIMALS: 118 horses. PROCEDURES: Medical records of horses with DDFT injury diagnosed with MRI over a 10-year period (2000-2010) and treated medically (intrasynovial administration of corticosteroids and sodium hyaluronan, rest and rehabilitation, or both) were reviewed. History, signalment, use, results of lameness examination and diagnostic local anesthesia, MRI findings, and treatment details were recorded. Outcome was obtained by telephone interview or follow-up examination. Horses were grouped by predictor variables and analyzed with logistic regression to identify significant effects. RESULTS: Overall, of 97 horses available for follow-up (median time to follow-up, 5 years; range, 1 to 12 years), 59 (61%) returned to activity for a mean duration of 22.6 months (median, 18 months; range, 3 to 72 months), with 25 (26%) still sound at follow-up. Of horses with mild, moderate, and severe injury, 21 of 29 (72%), 20 of 36 (56%), and 18 of 32 (56%), respectively, returned to use. Horses treated with intrasynovial corticosteroid injection and 6 months of rest and rehabilitation returned to use for a significantly longer duration than did horses treated without rest. Western performance horses returned to use for a significantly longer duration than did English performance horses. CONCLUSIONS AND CLINICAL RELEVANCE: Results of the present study suggested that outcome for horses with DDFT injuries treated medically depended on injury severity, presence of concurrent injury to other structures in the foot, type of activity, and owner compliance with specific treatment recommendations. Although some horses successfully returned to prior activity, additional treatment options are needed to improve outcome in horses with severe injuries and to improve long-term prognosis.