Biomedical subjects
Publications and source records attributed to B B Martin.
The successful conservative treatment of an open, displaced fracture of the radius of a horse suggests that conservative treatment should not be ignored when surgery is not an option. The importance of proper soft-tissue management and the use of broad-spectrum antimicrobial treatment in the management of orthopedic injuries is emphasized.
Fifteen horses that could not train or perform their sport at an acceptable level because of chronic back pain of 2 to 24 months' duration, and that did not obtain lasting improvement from other previous treatments, were treated with acupuncture. The treatments consisted of injection of 1 ml of sterile saline (0.9% NaCl) solution, with no preservatives, at 9 acupuncture points. The horses were treated once a week for a mean of 9 treatments. The mean number of treatments before obvious improvement was 4. After treatment, 13 of the 15 horses had apparent alleviation of their signs of pain and could train and compete. Six to 12 months after their last treatment, 2 horses had been removed from competition; one had sustained a fracture and the other had died. The remaining 11 of the original 13 that competed after treatment were still competing.
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The case records of 23 horses with cecal perforation (CP) were reviewed. The horses averaged 4.5 years of age (6 weeks to 13 years) and included 9 intact males, 12 mares, and 2 geldings. Twelve of the horses were Standardbreds, 9 were Thoroughbreds, and 1 each, a Belgian and Morgan. The horses were allotted to 2 groups: group I-13 hospitalized horses in which CP occurred unexpectedly, and group II-10 horses with CP at the time of admission. The horses characteristically had been sick or affected with disease unrelated to the cecum. Sixteen horses had been given nonsteroidal anti-inflammatory drugs before the onset of CP. Twelve of the 13 hospitalized patients (group I) had vague, scarcely recognizable clinical signs of gastrointestinal disease before CP. The clinical signs and clinical laboratory changes that appeared in affected horses were identifiable with severe endotoxin shock, secondary to peritoneal contamination with ingesta and bacteria. All horses died. At necropsy of the horses, the cecum was large and firm and was filled with ingesta, and the colon was empty; however, in 1 postpartum mare, the cecum and colon contained the usual amount of ingesta and were normal in size. In all horses, a single perforation was present, which appeared at various sites. The most common was a transverse perforation along the ventral aspect of the cecal body. Gross and microscopic examinations uncovered no existing disease near the perforation site or in other areas of the cecal wall or cecocolic orifice.(ABSTRACT TRUNCATED AT 250 WORDS)
The role of the pediatric discharge planner is complex. Because of the constant changes in medical technology and reimbursement policies, it is important to remain knowledgeable about existing resources. In addition, the medical status and treatment plans of pediatric patients frequently change. The discharge planner must have the ability to be flexible in the organization and implementation of discharge plans to facilitate meeting the needs of the patients and their families. Discharge planning for the pediatric patient is not a simple process. Instead it is a collaborative effort between health care professionals and families whose primary goal is the optimum health of the child.
The two referenced organisms have been subjected to microwave irradiation (2,450 MHz CW). Initial experiments indicated no statistically significant loss of cell numbers as a result of simple temperature rise (6 degrees C) or experimental manipulation. Cell survival for P. brevis one week after irradiation was related to total energy absorbed, not power level used. Over a 48 h period, a first-order decrease in cell numbers was observed. All cells were destroyed at a threshold level of 0.1 kJ/cm3. In contrast, the blue-green alga G. aponina in log phase of growth showed no loss of cells. In the presence of G. aponina, P. brevis suffered cell lysis, though G. aponina thrived. Irradiation of the mixed cultures appeared to enhance the lysis effect.
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OBJECTIVE: To describe the clinical findings in 52 racehorses with axial deviation of the aryepiglottic folds (ADAF) and to report outcome in 33 of these horses after either rest or transendoscopic laser excision of aryepiglottic fold tissue. STUDY DESIGN: Retrospective study. ANIMAL OR SAMPLE POPULATION: Racehorses admitted for high-speed treadmill (HST) evaluation of poor performance. METHODS: Medical records and videotapes of resting and exercising videoendoscopic examinations were reviewed. Racing performance records and owner or trainer interviews, at least 1 year after HST examination, were used to compare results after either surgical management or rest in 33 horses with ADAF and no other upper-airway abnormalities. RESULTS: ADAF occurred in 6% of horses evaluated for poor performance. No breed or gender predisposition existed, but horses with ADAF were younger than the overall population evaluated on the HST. Of 52 horses with ADAF, 19 horses had at least one other upper-airway abnormality. There was no apparent association between ADAF and other causes of dynamic upper-respiratory obstruction. Surgical correction was successfully performed in standing or anesthetized horses without complications. When ADAF was the only upper-airway obstruction, 75% of horses that had surgery and 50% of rested horses had objective improvement in performance. Owners and trainers also perceived greater improvement in performance in horses that had surgery. CONCLUSIONS: Whereas surgical management of ADAF is recommended, clinical experience indicated that it is not required to resolve ADAF in all horses. However, owners and trainers of horses that had surgery were more satisfied with outcome than those with horses managed conservatively. CLINICAL RELEVANCE: Diagnosis of ADAF can only be made by videoendoscopic evaluation during high-speed exercise. Transendoscopic laser excision of the collapsing portion of the aryepiglottic folds can be performed safely in standing horses and results in resolution of airway obstruction and rapid return to training.
Fourteen horses that could not perform at their expected standards due to chronic back pain of 4 to 48 months duration, and had not obtained lasting improvement from other forms of therapy, were treated by stimulating nine acupuncture points using a low powered infrared laser (300 microW, 904 nm). The treatments were performed weekly, and consisted of stimulating each point for 2 minutes with a pulse frequency of 360 pulses per second. After completion of a mean of 11 treatments, clinical signs of back pain were alleviated in 10 of the 14 horses, there was no change in three, and one was lost to follow-up. Of the 10 horses who were training and competing, four won. One year after treatment was discontinued, 9 of these 10 horses continued to perform at a standard acceptable to the owner.
Circumferential wiring was used to repair 12 mid-body fractures and four large basilar fractures of proximal sesamoid bones in 15 horses. Eighteen-gauge stainless steel wire was placed around both fragments in five horses, and through the proximal fragment and around the distal fragment in 10 horses. The horses were returned to work when they were clinically sound and fracture healing was evident radiographically. Eleven horses resumed athletic performance, three horses were used as breeding animals, and one horse was retired. Five horses performed at an athletic level equal to or better than their previous levels, and six horses performed at a lower level.
Infectious arthritis of the tarsocrural joint was treated in 13 horses with closed suction drainage through a flat, fenestrated, latex (Jackson-Pratt) drain, broad-spectrum antimicrobial agents, nonsteroidal anti-inflammatory drugs, and bandage immobilization. In 11 horses, arthroscopic lavage and debridement were also performed. Ingress drains were placed for lavage in six horses. Ten horses returned to their previous level of competition or were sound. One horse raced but had lameness of the affected tarsocrural joint and dropped in racing class; one horse was euthanatized because of laminitis in the supporting limb; and one horse was lame, but useful as a breeding animal. Closed suction drainage appeared to be a useful treatment in horses with infectious arthritis. Although arthroscopy was not necessary, it facilitated fibrin removal, lavage, and partial synovectomy. Because of the development of Pseudomonas superinfection in one horse, the use of simultaneous ingress catheters was not recommended.
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