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Biomedical subjects

C Macias

Publications and source records attributed to C Macias.

At least 19 recordsLinked to original sources
PubMed2006

Patellar luxation in 70 large breed dogs.

OBJECTIVES: To report the signalment, history, clinical features, and outcome in dogs weighing greater than 15 kg, treated surgically and non-surgically for patellar luxation. Risk factors for the development of patellar luxation, postoperative complications, and outcome were evaluated. METHODS: Details regarding signalment, bodyweight, breed, aetiology, unilateral or bilateral luxation, duration of lameness, grade of luxation, direction of luxation, grade of lameness at presentation, concomitant cranial cruciate ligament rupture, method of treatment, surgical technique, surgeon, and complications were obtained from the medical records. Outcome was graded as excellent, good, fair, or poor, according to the degree of lameness. RESULTS: Seventy dogs (45 males and 25 females) were included. Thirty-five had bilateral luxations (105 limbs). Mean age was two years, and mean weight was 30 kg. The relative risk for Labrador retrievers was 3.3 (P<0.001). All luxations were developmental. Luxations were medial in 102 stifles and lateral in three. Fourteen stifles had concomitant cranial cruciate ligament rupture. As the grade of patellar luxation increased, so did the grade of lameness (P<0.001). Surgery was performed in 70 stifles, and outcome was excellent/good in 94 per cent and fair/poor in 6 per cent of stifles. Complications occurred in 29 per cent of stifles, and increasing bodyweight was found to be a risk factor (P=0.03). Thirty-five stifles were managed non-surgically, and outcome was excellent/good in 86 per cent and fair/poor in 14 per cent of stifles. CLINICAL SIGNIFICANCE: In view of the potential risk of postoperative complications, all surgically treated cases of patellar luxation in large breed dogs should be managed with a femoral trochleoplasty, a tibial tuberosity transposition (stabilised with K-wires and a tension band wire), and soft tissue releasing and tightening procedures.

Animals↗
PubMed2006

Y-T humeral fractures with supracondylar comminution in five cats.

Five cats with Y-T fractures of the humeral condyle were reviewed. Breeds presented included domestic shorthair (four cats) and Maine Coon (one cat). Age ranged from two to 16 years. All the cats were neutered males. A road traffic accident was suspected in all cases. Four of the fractures were severely comminuted and one fracture had four fragments. The fractures were repaired via combined medial and lateral approaches. Fixation of the epicondylar ridges was performed using buttress plates in four cases and neutralisation plates in one case. The intracondylar fracture was stabilised using a 2.7 mm lag screw in four cases and a 3.5 mm lag screw in the other. A corticocancellous bone graft was applied in two cases. The intracondylar fracture was accurately reduced in all cases. Complete radiographic healing was documented in two cases 6 and 11 weeks following surgery. Failure of the fixation occurred in the most severely comminuted fracture five days postoperatively. Surgical revision was not performed, and the limb was amputated. Three cats were free of lameness and had resumed outdoor activities at follow-up (five to eight months after surgery). Marked lameness due to loss of elbow movement was observed in the other case.

Animals↗
PubMed2006

The value of oblique versus ventrodorsal myelographic views for lesion lateralisation in canine thoracolumbar disc disease.

OBJECTIVE: To determine the value of oblique versus ventrodorsal myelographic views for lesion lateralisation in canine thoracolumbar disc disease. METHODS: The ventrodorsal and oblique views from 196 lumbar myelograms of dogs with single thoracolumbar disc extrusions or protrusions were blindly and independently reviewed by two of the authors for evidence of lesion lateralisation. Medical records were reviewed for details regarding hemilaminectomy surgery. The side (left versus right) of the surgery and whether or not the disc material was retrieved were noted. RESULTS: Both reviewers lateralised significantly more disc lesions from the oblique views (93 and 95 per cent) than from the ventrodorsal views (59 and 70 per cent) (P<0.001). Using a combination of oblique and ventrodorsal views, 194 (99 per cent) and 195 (99.5 per cent) lesions were lateralised. Unilateral hemilaminectomy was performed in 193 dogs with myelographic lateralisation and in one dog without myelographic lateralisation. The side of spinal cord decompression corresponded with the myelographic findings in all dogs showing lateralisation on myelography. In the dog without myelographic lateralisation, a left (randomly chosen) hemilaminectomy revealed dorsal protrusion of the annulus fibrosus. CLINICAL SIGNIFICANCE: Myelography, including oblique, ventrodorsal and lateral views, is an accurate method for determining lateralisation of extruded or protruded disc material in the vertebral canal before decompressive surgery. Combined oblique and ventrodorsal views are more useful than either view alone and should be routinely obtained in all lumbar myelographic studies when investigating thoracolumbar disc disease.

Animals↗
PubMed2005

Bilateral fixation of Y-T humeral condyle fractures via medial and lateral approaches in 29 dogs.

OBJECTIVES: To describe bilateral fixation of Y-T fractures of the humeral condyle via combined medial and lateral approaches, and to determine the technique's clinical and radiographic short-term outcomes. METHODS: Details of 30 consecutive fractures in 29 dogs were reviewed. These included signalment, method of fixation, complications, and follow-up limb function and range of elbow joint motion. RESULTS: The age of the dogs ranged from three months to nine years, and bodyweight ranged from 1.9 to 48 kg. The humeral condyle was reattached to the shaft using medial and lateral bone plates in 18 fractures, a medial plate and lateral Kirschner wire(s) in six fractures, and medial and lateral Kirschner wire(s) in six fractures. Major complications were recorded in four fractures and minor complications in two fractures. Limb function at follow-up was graded as excellent in 12, good in 15 and fair in three fractures. The range of elbow flexion was normal in seven, mildly reduced in 18, moderately reduced in four and severely reduced in one fracture. CLINICAL SIGNIFICANCE: In contrast to the caudal approach, combined medial and lateral approaches decrease the extent of periarticular soft tissue dissection, avoid complications associated with olecranon osteotomy and enable exposure of the entire humeral diaphysis for fixation. Bilateral fixation is likely to be better at counteracting bending and torsional forces compared with unilateral fixation.

Animals↗
PubMed2004

Pantarsal arthrodesis with a customised medial or lateral bone plate in 13 dogs.

Pantarsal arthrodesis was performed in 12 dogs using a customised medial bone plate, and in one using a lateral bone plate. The dogs' ages ranged from 14 months to 144 months (median 30 months) and their bodyweights ranged from 7 to 66 kg (median 32 kg). Before the surgery they had been lame on a pelvic limb for between one and 16 months (median eight months). In eight of the dogs the fixation of the plate was augmented with a calcaneotibial positional screw, and in one of them with a talocrural lag screw. A cranial half cast was applied to 12 of the dogs and an external skeletal fixator to the other for six to eight weeks. Five complications were recorded in four of the dogs. Between 29 and 156 weeks postoperatively the clinical outcome was graded as excellent in six dogs, good in six dogs and fair in the other.

Animals↗
PubMed2002

The emergency department versus the computer: which is the better electrocardiographer?

Electrocardiograms (ECGs) are frequently ordered in the pediatric emergency department (ED). Pediatric cardiologists are generally not asked to interpret every ECG; thus, ED patient management is often guided by the ED physicians' ECG interpretation. The objective of this study was to analyze the accuracy of ECG interpretation by ED physicians and a computer-generated interpretation and compare the two. A 12-month prospective study was performed in a pediatric ED. All patients (<22 years) who had an ECG in the ED were included. The ED physicians and the computer interpretation were compared to a reference standard. Each electrocardiographic diagnosis, as well as the ECG as a whole, was assigned to one of the following predetermined classes: I, normal sinus rhythm; II, minimal clinical significance; III, indeterminate clinical significance; IV, those of definite clinical significance. Both groups correctly interpreted all normal (class I) ECGs. The computer correctly interpreted approximately 75% of the class II and class III ECGs, whereas the ED physicians correctly interpreted 36% of both groups. For the class IV ECGs, both the computer and the ED physicians performed poorly, correctly interpreting just 14% and 28%, respectively. The computer proved to be more accurate than the ED physicians in interpreting ECGs of less than critical significance (classes II and III), but neither group was able to correctly interpret even a simple majority of the most significant abnormalities (class IV). We speculate that distributing the computer-generated interpretation to the ED physicians and formal review of all ED ECGs by a skilled interpreter may decrease the number of missed diagnoses.

Adolescent↗
PubMed2002

Caudal proximal tibial deformity and cranial cruciate ligament rupture in small-breed dogs.

Eight dogs presented with chronic hindlimb lameness associated with cranial cruciate ligament rupture. Seven were small terriers. A caudal deformity of the proximal tibial shaft, originating at the proximal tibial physis, and an excessive caudal slope of the tibial plateau were present bilaterally in all dogs. The deformity was thought to be responsible for the cranial cruciate ligament failure and poor response to conservative management. Tibial plateau angles were in excess of 26 degrees in all dogs. The lameness was bilateral in three dogs. There was complete cranial cruciate ligament rupture in seven stifles and partial rupture in four. There were no meniscal injuries. Surgical correction resulted in a significant improvement (P<0.0001) in all dogs, with a mean follow-up of 12 months (range three to 24 months). There were no complications.

Animals↗
PubMed2002

Thoracolumbar disc disease in large dogs: a study of 99 cases.

The records of 99 dogs weighing over 20 kg with thoracolumbar disc disease were reviewed. Two types of disc disease were recognised: degenerative nuclear extrusion (n=63) and degenerative annular protrusion (n=36). Sixty-nine per cent of the affected discs were located between T12-T13 and L2-L3. Of the 63 dogs with degenerative nuclear extrusions, 35 were non-ambulatory and seven had no conscious pain perception at the time of presentation. Decompressive surgery was performed in 55 dogs, four dogs were managed non-surgically and three dogs were euthanased. A successful outcome was achieved in 49 (78 per cent) cases as assessed by the authors and in 53 (84 per cent) cases as assessed by the owners. Mean follow-up time was 11.7 months (range 1.5 to 48 months). Five dogs subsequently lost the ability to ambulate on their hindlimbs. Myelographic investigations in three of these dogs revealed a second thoracolumbar degenerative nuclear extrusion. Of the 36 dogs with degenerative annular protrusions, seven were non-ambulatory at the time of presentation. Fifteen cases had multiple protrusions. Twenty dogs were managed non-surgically, 12 surgically and four were euthanased. A successful outcome was achieved in eight (22 per cent) cases as assessed by the authors and in 19 (52 per cent) cases as assessed by the owners. Mean follow-up time was 9.2 months (range 1.5 to 30 months). The outcome of dogs with annular protrusions was significantly worse compared to the outcome of dogs with nuclear extrusions (P<0.001).

Animals↗
PubMed2001

Work interest as a predictor of competitive employment: policy implications for psychiatric rehabilitation.

Consumers with serious mental illness (N = 166) enrolling in two community-based mental health programs, a vocational Program of Assertive Community Treatment and a clubhouse certified by the International Center for Clubhouse Development (ICCD), were asked about their interest in work. About one third of the new enrollees expressed no interest in working. Equivalent supported employment services were then offered to all participants in each program. Stated interest in work and receipt of vocational services were statistically significant predictors of whether a person would work and how long it would take to get a job. Two thirds of those interested in work and half of those with no initial interest obtained a competitive job if they received at least one hour of vocational service. Once employed, these two groups held comparable jobs for the same length of time. These findings demonstrate the importance of making vocational services continuously available to all people with serious mental illness, and the viability of integrating these services into routine mental health care.

Adult↗
PubMed2001

Strategic planning for ICCD clubhouse implementation: development of the Clubhouse Research and Evaluation Screening Survey (CRESS). International Center for Clubhouse Development.

The Clubhouse Research and Evaluation Screening Survey (CRESS) is a brief instrument designed to predict clubhouse readiness for certification assessment and, hence, performance in regard to expected model outcomes. The development of CRESS provides a practical example of the methodological challenges involved in creating a brief and valid screening instrument. Developed over a period of 5 years, CRESS is grounded in a series of workgroups, surveys, and pilot studies conducted by Fountain House and the International Center for Clubhouse Development (ICCD) in New York City. CRESS is shown to have criterion-oriented validity for the measurement of ICCD clubhouse model-related performance, as well as demonstrated ease in administration to a national sample of mental health programs.

Certification↗
PubMed2001

Changes in the concentration of carotenoids, vitamin A, alpha-tocopherol and total lipids in human milk throughout early lactation.

BACKGROUND: In mammals the composition of milk changes during early lactation showing a rapid decline in fat-soluble vitamins and a continuous increase in total lipids. Changes in the concentrations of carotenoids, vitamin A, alpha-tocopherol and total lipids in human milk (colostrum, transitory and mature milk) were studied to understand this not well characterised phenomenon. METHODS: Colostrum, transitory and mature milk was collected from 21 women and analysed for carotenoids, vitamin A and alpha-tocopherol by HPLC. RESULTS: Total lipids increased from the lowest levels in colostrum (1.5 +/- 1.6 mg/ml) to the highest in transitory milk (3.6 +/- 2.5 mg/ml, p < 0.01). Contrary to this, levels of total carotenoids (236.7 +/- 121.9 ng/ml), vitamin A (1.02 +/- 0.56 microg/ml) and alpha-tocopherol (11.8 +/- 6.3 microg/ml) were highest in colostrum and declined significantly during the first weeks of lactation (63.2 +/- 23.3 ng/ml, 0.33 +/- 0.14 microg/ml, 2.7 +/- 1.1 microg/ml, respectively; p < 0.001). CONCLUSIONS: The magnitude of decrease was not the same for all carotenoids and was dependent on the polarity of the carotenoid with the smallest decrease in the polar carotenoids. This might be due to differences in the distribution of carotenoids among plasma lipoproteins and might point to possible selective mechanisms being involved in the transfer of these components in early human milk.

Adult↗
PubMed2001

The ICCD benchmarks for clubhouses: a practical approach to quality improvement in psychiatric rehabilitation.

OBJECTIVE: The study evaluated whether the average performance of clubhouses certified by the International Center for Clubhouse Development (ICCD) should be considered valid benchmarks for clubhouse programs. METHODS: A representative sample of clubhouses more than three years old that were based on the Fountain House model participated in a 1998 mail survey. To verify that ICCD certification is a valid indicator of program quality for use in setting benchmark performance rates, 71 certified and 48 noncertified programs were compared on a variety of organizational variables. RESULTS: Even though certified and noncertified clubhouses were similar in organizational structure and resources, findings from a logistic regression analysis confirmed that certified clubhouses provided a wider array of rehabilitation services and achieved higher rates of employment. CONCLUSIONS: The findings suggest that ICCD certification is a valid indicator of program quality. The ICCD has therefore proposed that the average performance of certified U.S. clubhouses in specific domains be adopted as benchmarks for organizational performance. When tailored for programs in particular regions and with specific levels of funding, the ICCD benchmarks for clubhouse performance set fair and reasonable expectations for clubhouse programs and for the design of performance contracts between departments of mental health and ICCD clubhouses.

Benchmarking↗
PubMed2000

Fibronectin/fibroblast growth factor/cell matrix signaling pathways and reciprocal membrane interaction may be the regulators of cell growth and apoptosis in Trypanosoma musculi in co-cultures with fibroblasts.

Trypanosoma musculi cultivated in medium containing serum alone or in the absence of fibroblasts in vitro were transformed into rounded, immotile cells, incapable of division and infectivity. Only in close contact with fibroblasts could the parasites survive and grow indefinitely. This report established the identity of the splenic 'sustentacular' cells as fibroblasts and utilized immunocytochemistry to demonstrate the putative cytoskeletal and membrane-associated molecules that may be involved in the control of growth and division, and apoptosis of T. musculi in vitro. The results indicated that cells that reacted intensely for fibroblast growth factor (FGF) also displayed a complex cytoskeletal system of F-actin bands underlying the plasma membrane of the fibroblast cell body and its numerous processes. Among the cytoskeletal and membrane glycoproteins, fibronectin, I-CAM, laminin, occludin, vinculin and desmin were most prominent. Fibronectin was most highly enhanced on the cell membrane and deposited as 'finger prints or tracks' on the extracellular culture surfaces. Transmission and scanning electron microscopy confirmed the intimate contact between trypanosomes and fibroblasts, however, neither membrane fusion or junctions were apparent. Our results suggested that a fibroblast-derived, membrane-associated factor appeared to be the putative growth regulator and apoptosis inhibitor in co-cultures of spleen-derived fibroblasts and T. musculi.

Animals↗
PubMed1999

What is a clubhouse? Report on the ICCD 1996 survey of USA clubhouses.

This article summarizes the findings from the ICCD 1996 Clubhouse Survey for the 173 respondent clubhouses located in the United States. It is our intent in the present article to identify commonalties in clubhouse organizational structure and practice across diverse geographic areas of the USA and within diverse health care systems, and, thereby, to identify typical or 'average' clubhouse performance in a variety of organizational and practice domains.

Activities of Daily Living↗
PubMed1999

The value of program certification for performance contracting.

A survey of clubhouses listed in the 1996 ICCD Clubhouse Directory provided a research sample of 80 ICCD-certified clubhouses and 88 non-certified clubhouses with which to test the discriminant validity of ICCD certification. A statistically significant logistic regression model revealed that ICCD certification status could be clearly predicted for 78% of the clubhouses in the survey sample on the basis of director-reported compliance with representative measures of the Standards for Clubhouse Programs. The predictive power of compliance with the Standards was obtained even while controlling for other organizational variables, including clubhouse age, total staff salaries, and receipt of Medicaid funding. These findings provide support for the practical utility of adopting program certification as a performance indicator in an era of managed care, as well as the specific value of relying on ICCD certification as a quality assurance indicator.

Certification↗
PubMed1994

The role of case management within a community support system: partnership with psychosocial rehabilitation.

The Strengths model of team case management was assessed relative to an existing high quality psychosocial rehabilitation program that informally provided many services typical of case management (e.g., service linkage, monitoring, and consumer advocacy). The experimental evaluation triangulated consumer and family member responses with mental health professional reports and consumer records of hospitalization and crisis center contacts. An analysis of data from these four sources revealed that one year after full program implementation, consumers who received case management in conjunction with psychosocial rehabilitation functioned at a higher level of competency and experienced significantly lower psychiatric symptomatology than consumers who received only psychosocial rehabilitation. Implications for the successful integration of case management into an existing community support program are discussed.

Activities of Daily Living↗
PubMed1993

Phototoxic coumarins in limes.

Coumarins in the rind and pulp of Persian and Key limes were quantified. In the rind of Persian limes, coumarin concentrations were in the order: limettin > bergapten > isopimpinellin > xanthotoxin > psoralen. In the rind of Key limes, psoralen and xanthotoxin were analytically absent; limettin was 10 times more concentrated than either bergapten or isopimpinellin, which were equal in concentration. Coumarin content in Persian lime pulp was in the order: isopimpinellin > limettin > bergapten > xanthotoxin > psoralen. For Key lime pulp, the concentrations of limettin, isopimpinellin and bergapten were equal; psoralen and xanthotoxin were not detected. Coumarins in lime pulp were 13 to 182 times less concentrated than those in the peel. Based on the amounts and types of coumarins, Persian limes appear to be potentially more phototoxic than Key limes. Although bergapten may be the main component of limes responsible for phytophotodermatitis, dermatological interaction assays with psoralen, bergapten, xanthotoxin and limettin should be conducted.

Chromatography, High Pressure Liquid↗