The effect of manually facilitated flexion of the thoracic spine on the interspinous space among horses with impinging dorsal spinous processes of the thoracic vertebrae.

Impinging dorsal spinous processes (IDSP) are typically diagnosed and graded using radiography, during which the effect of the horses' thoracolumbar posture on the interspinous spaces is not commonly considered. Posture can be altered from a spontaneous, relatively extended, or lordotic, position by manual facilitation of thoracic flexion ('thoracic lift'). This study aimed to ascertain if the thoracic vertebral interspinous space distances were increased by using facilitated thoracic flexion to alter the posture in horses diagnosed with IDSP. Seven horses of mixed breed and sex, median age 9.1 years (interquartile range, 7.2-12.4 years), with a diagnosis of thoracic IDSP with no history of spinal surgery, were included in the study. Two sets of radiographs were obtained. The initial set was taken in the horses' spontaneous posture and the second in the manually facilitated flexed posture. Each image was anonymised allowing blinded measurement of the interspinous spaces. Analysis was performed using Hodges-Lehmann median differences estimates. An increase in the median interspinous space distance was achieved after manual facilitation of thoracic flexion at every thoracic intervertebral space (5th-18th thoracic [T] vertebra). The greatest median increase was seen between T7-T8 and T12-T13 (3.1 mm and 3.0 mm, respectively) whereas the lowest median increase was seen between T17-T18 (0.7 mm). In this study, thoracic interspinous space distances could be increased by using manual facilitation to alter the thoracic posture in horses with IDSP, which could affect grading and decision making.

Serum HE4 concentration differentiates malignant ovarian tumours from ovarian endometriotic cysts.

Human epididymal secretory protein E4 (HE4, also known as WAP four-disulphide core domain protein 2) is a new promising biomarker for ovarian cancer but its specificity against ovarian endometriotic cysts is only superficially known. We, thus, analysed serum HE4 concentrations together with a tumour marker CA125 in serum samples of women diagnosed with various types of endometriosis, endometrial cancer or ovarian cancer, and in samples from healthy controls. The mean serum concentration of HE4 was significantly higher in serum samples of patients with both endometrial (99.2 pM, P<0.001) and ovarian (1125.4 pM, P<0.001) cancer but not with ovarian endometriomas (46.0 pM) or other types of endometriosis (45.5 pM) as compared with healthy controls (40.5 pM). The serum CA125 concentrations were elevated in patients with ovarian cancer, advanced endometriosis with peritoneal or deep lesions, or ovarian endometriomas, but not in the patients with endometrial cancer. The microarray results revealed that the mRNA expression of the genes encoding HE4 and CA125 reflected the serum protein concentrations. Taken together, measuring both HE4 and CA125 serum concentrations increases the accuracy of ovarian cancer diagnosis and provides valuable information to discriminate ovarian tumours from ovarian endometriotic cysts.

Acceptability of flavoured pharmaceutically non-active mini-tablets in pet cats tested with a rapid 3-portal acceptance test with and without food.

Palatable oral pharmaceuticals are crucial for feline medication. The pharmaceutical industry prefers synthetic flavours over organic ones because of hygiene and regulatory issues. The aim of this study was to find a palatable synthetic flavour for future taste-masking of feline pharmaceuticals. The hypothesis was that synthetic meat aromas and free amino acids would be palatable to cats. The palatability of 18 synthetically flavoured mini-tablets was screened with 10-19 pet cats using a rapid 3-portal acceptance test with and without food. The tested flavours were synthetic amino acids (L-carnitine, l-glutamic acid monosodium salt hydrate, l-leucine, l-methionine, l-phenylalanine, l-proline, and taurine), d-(+)-Maltose monohydrate and thiamine hydrochloride. Furthermore, thiamine hydrochloride was combined with amino acids (l-cysteine, l-leucine, l-methionine and l-proline) and synthetic meat flavours (2-acetylpyridine, 2-acetylthiazole, 2-pentylpyridine and 4-hydroxy-5-methyl-3(2H)-furanone). The negative control was a non-flavoured placebo mini-tablet, while positive controls were an organic yeast-flavoured mini-tablet and a yeast- and fish-based commercial vitamin tablet in mini-tablet form. No significant differences were detected between palatable synthetic flavours and the placebo, nor between the synthetic flavours and the yeast flavour. In general, the mini-tablet seemed to be small enough to be accepted inside a food item. These results differ from the earlier literature about the taste preferences of cats for amino acids, and hence free amino acids should not be considered palatable to cats based purely on previous findings.

Effects of general anaesthesia in dorsal recumbency with and without vatinoxan on bronchoalveolar lavage cytology of healthy horses.

Pneumonia is one of the potential complications of general anaesthesia in horses. Anaesthesia is known to increase neutrophils in bronchoalveolar lavage fluid (BALF) of horses after lateral recumbency, but studies after dorsal recumbency are lacking. Our primary aim was to determine when lung inflammation reaches its maximum and how rapidly BALF cytology returns to baseline after anaesthesia in dorsal recumbency. A secondary aim was to investigate the possible effect of vatinoxan, a novel drug, on the BALF cytology results. Six healthy experimental horses were enrolled in this observational crossover study. The horses were subject to repeated BALF and blood sampling for 7 days after general anaesthesia with two treatment protocols, and without anaesthesia (control). During the two treatments, the horses received either medetomidine-vatinoxan or medetomidine-placebo as premedication, and anaesthesia was induced with ketamine-midazolam and maintained with isoflurane for 1h in dorsal recumbency. The differences in BALF and blood variables between the two anaesthesia protocols and control were analysed with repeated measures analysis of variance models. In this study, anaesthesia in dorsal recumbency resulted in no clinically relevant changes in airway cytology that could be differentiated from the effect of repeated BALF sampling. No differences in BALF matrix metalloproteinase gelatinolytic activity could be detected between the two treatments or the control series. Marked increase in serum amyloid A was detected in some animals. Vatinoxan as premedication did not consistently affect lung cytology or blood inflammatory markers after anaesthesia.

Radiographic evaluation of elbow incongruity in Skye terriers.

OBJECTIVES: Aims of this study were to radiographically evaluate elbow congruity and to explore associations between elbow incongruity and lameness in Skye terriers. METHODS: Mediolateral, 90°-flexed, elbow joint radiographs were obtained for 45 Skye terriers. Elbow joint incongruity was graded mild, moderate or severe by measuring the width of the humeroulnar joint space. A questionnaire provided information on lameness history for each dog. RESULTS: In total, 49% (22/45) of the dogs had moderate or severe elbow joint incongruity which associated with lameness. Owner-reported lameness was common: 15/45 (33%) dogs had been lame when less than one year old, and 6 (14%) had been lame at an older age. All dogs presenting with lameness when older than one year had also been lame in adolescence. CLINICAL SIGNIFICANCE: Lameness and moderate-to-severe elbow joint incongruity were common in Skye terriers and the two were associated. A novel protocol for radiographic screening of elbow joint incongruity of chondrodystrophic breeds is suggested.

Use of bathroom scales in measuring asymmetry of hindlimb static weight bearing in dogs with osteoarthritis.

OBJECTIVE: The study assessed the use and reliability of bathroom scales as an objective measurement tool, and setting a normal variance of static weight bearing between hindlimbs. METHODS: Two groups of dogs were tested: a healthy control group (n = 21) and a group (n = 43) of dogs with confirmed osteoarthritis in at least one stifle joint, with or without hip joint osteoarthritis. Static weight bearing was evaluated manually and measured with two bathroom scales. An orthopaedic examination was done and dynamic weight bearing was measured using a force platform. Radiographs were taken to confirm the presence of osteoarthritis, and dogs were divided into groups of severe and non-severe osteo- arthritic changes. Reliability by repeatability was tested using analysis of variance, and the congruity between static weight bearing and other evaluation methods with Kappa statistics and proportion of agreement. RESULTS: The difference between the hindlimbs proportional to the body weight in control dogs was 3.3% (± 2.7%). The repeatability of measuring static weight bearing in the hindlimbs of osteoarthritic dogs with bathroom scales was 81% with osteoarthritic limbs, and 70% for unaffected limbs. The sensitivity of static weight bearing measurements using bathroom scales was 39% and specificity 85%. CLINICAL SIGNIFICANCE: Bathroom scales are a reliable, simple, and cost-effective objective method for measuring static weight bearing and can be used as an outcome measure when rehabilitating dogs with osteoarthritic changes in the hindlimbs.

Functional outcome of distal bypasses for lower limb ischemia.

OBJECTIVES: The purpose of this study was to assess limb salvage and functional outcome in patients who underwent distal reconstructions. DESIGN: Retrospective study. MATERIALS AND METHODS: Fifty-nine consecutive patients underwent 63 femorodistal bypass operations during 1998-2002 at a university hospital. Late functional outcome was assessed using a questionnaire (mean 27 months after the primary operation). RESULTS: At the end of the study, 81% (30/37) of the surviving patients were alive with a viable limb. In all, 90% (27/30) of patients were living in their own homes and 3% (1/30) in a nursing home. Sixty percent (18/30) were able to walk independently. The walking distance was unlimited in 42% (13/31) and limited in 42% (13/31) of the operated limbs. In 16% (5/31) of cases, the treated limbs served only as a support. CONCLUSIONS: According to our results, the functional outcome of distal bypasses seems to be favourable. It is recommended that these operations should be performed even in elderly patients to avoid major amputations and to maintain the independence of the patient.

Testicular masses.

Family physicians often must evaluate patients with testicular pain or masses. The incidental finding of a scrotal mass may also require evaluation. Patients may seek evaluation of a scrotal mass as an incidental finding. An accurate history combined with a complete examination of the male external genitalia will help indicate a preliminary diagnosis and proper treatment. Family physicians must keep in mind the emergency or "must not miss" diagnoses associated with testicular masses, including testicular torsion, epididymitis, acute orchitis, strangulated hernia and testicular cancer. Referral to a urologist should be made immediately if one of these diagnoses is suspected. Benign causes of scrotal masses, including hydrocele, varicocele and spermatocele, may be diagnosed and managed easily in the primary care office.