Biomedical subjects

Joanne Hardy

Publications and source records attributed to Joanne Hardy.

16 recordsLinked to original sources

PubMed2005

Retention of surgery specialists in academia: a critical agenda.

Recruitment and retention of specialists to academia appears to be a growing problem in university teaching hospitals. Members of the American College of Veterinary Surgeons (ACVS) believe that the movement of surgery specialists to practice may have an impact on the training of veterinary students and surgery residents. To address these concerns, 1,071 ACVS diplomates and 60 department heads and hospital directors from all veterinary schools in North America were surveyed to determine whether a problem exists, the extent of the problem, and potential reasons for migration of specialists to practice. Responses were obtained from 620 ACVS diplomates (58 per cent) and 38 department heads and hospital directors (63%) from 28 different universities. The responses confirmed a net movement of surgery specialists from academia to practice. Eighty seven percent of department heads and hospital directors believed there was a shortage of small animal surgery specialists in academia; this information was supported by the fact that 47% responded that they had open positions and 68% had difficulty filling positions in the last five years. The demand was slightly less for large animal surgery specialists, and 42 per cent of respondents indicated that they had open positions. Financial considerations were the most common reason for surgery specialists to move from academia to private practice. Seventy-six percent of responding ACVS diplomates in private practice had a total compensation package valued at greater than $125,000 per year, whereas 77.8% of diplomates in academia had total compensation valued at $125,000 or less. Most universities offer starting salaries (not including benefits) for recently certified surgery specialists ranging from $70,000 to $90,000. Reasons for moving from academia to practice besides financial considerations included undesirable location of university hospitals; lack of interest in research; and a belief that university administration was not supportive of surgery specialists. Many academic surgery specialists were frustrated by the requirement for productivity in research, teaching, and service for promotion in tenure-track positions.

Animals↗

PubMed2004

Design and organization of an equine intensive care unit.

Careful planning and design of a new ICU are warranted to maximize use of the facility, minimize the risk of hospital-acquired infection, and improve overall patient outcome. In addition, personnel satisfaction improves with an improved work environment. A functional equine ICU is also tailored to the geographic area, local needs of the practice, and anticipated investment.

Animals↗

PubMed2004

Validation of diagnostic tests for determination of magnesium status in horses with reduced magnesium intake.

OBJECTIVE: To evaluate the diagnostic value of serum concentrations of total magnesium (tMg) and ionized magnesium (iMg), concentrations of magnesium (Mg) in muscle, intracellular Mg (icMg) concentrations, urinary Mg excretion (EMg), Mg clearance (CMg), and fractional clearance of Mg (FCMg) in horses fed diets with Mg content above and below National Research Council recommendations. ANIMALS: 9 young female horses. PROCEDURES: 6 horses were fed a reduced-Mg diet for 29 days followed by an Mg-supplemented diet for 24 days. Control horses (n = 3) were fed grass hay exclusively. Blood, urine, and tissue samples were collected, and an Mg retention test was performed before and after restriction and supplementation of Mg intake. Serum tMg, serum iMg, muscle Mg, icMg, and urine Mg concentrations were measured, and 24-hour EMg, CMg, and FCMg were calculated. RESULTS: Reductions in urinary 24-hour EMg, CMg, and FCMg were evident after 13 days of feeding a reduced-Mg diet. Serum tMg and iMg concentrations, muscle Mg content, and results of the Mg retention test were not affected by feeding the Mg-deficient diet. Spot urine sample FCMg accurately reflected FCMg calculated from 6- and 24-hour pooled urine samples. Mean +/- SD FCtMg of horses eating grass hay was 29 +/- 8%, whereas mean FCtMg for horses fed a reduced-Mg diet for 29 days was 6 +/- 3%. CONCLUSIONS AND CLINICAL RELEVANCE: The 24-hour EMg was the most sensitive indicator of reduced Mg intake in horses. Spot sample FCMg can be conveniently used to identify horses consuming a diet deficient in Mg.

Analysis of Variance↗

PubMed2003

Diseases of the guttural pouches.

Guttural pouches are unique anatomic structures in Equidae. Conditions affecting the guttural pouches present with clinical signs that are not observed in other domestic species, and treatment of some of these conditions can be challenging. This article describes the anatomy and examination of the guttural pouches and reviews the presenting signs and treatment of the more common conditions affecting them, including empyema, tympany, mycosis, and stylohyoid arthropathy.

Animals↗

PubMed2002

Effect of administration of a phospholipid emulsion on the initial response of horses administered endotoxin.

OBJECTIVE: To evaluate the effect of a phospholipid emulsion (PLE) on the initial response of horses to administration of endotoxin. ANIMALS: 12 healthy adult horses. PROCEDURES: Horses were assigned to 2 treatment groups (6 horses/group). The control group was administered 1 L of saline (0.9% NaCl) solution, and the treated group was administered PLE (200 mg/kg, IV); treatments were administered during a period of 120 minutes. An infusion of endotoxin was initiated in both groups starting 1 hour after initiation of the saline or PLE solutions. Physical examination and hemodynamic variables were recorded, and blood samples were analyzed for concentrations of tumor necrosis factor (TNF)-alpha, interleukin-6, thromboxane B2 (TxB2), 6 keto-prostaglandin F (PGF)1alpha, total leukocyte count, and PLE concentrations. An ANOVA was used to detect significant differences. RESULTS: Administration of PLE resulted in significantly lower rectal temperature, heart rate, cardiac output, right atrial pressure, and pulmonary artery pressure and higher total leukocyte counts in treated horses, compared with values for control horses. The TNF-alpha concentration was significantly less in treated horses than in control horses. The TxB2 and 6 keto-PGFF1alpha concentrations were significantly different between treated and control horses at 30 minutes (TxB2) and at 30 and 60 minutes (6 keto-PGF1alpha). CONCLUSIONS AND CLINICAL RELEVANCE: Prior infusion of PLE in horses administered a low dose of endotoxin decreased rectal temperature, heart rate, pulmonary artery pressure, and TNF-alpha concentrations. Results of this study support further evaluation of PLE for use in the treatment of horses with endotoxemia.

Analysis of Variance↗

PubMedDate not supplied

Bone gentamicin concentration after intra-articular injection or regional intravenous perfusion in the horse.

OBJECTIVE: To compare intra-articular (IA) and bone gentamicin concentrations achieved after intra-articular administration or regional intravenous perfusion (RIP). STUDY DESIGN: Experimental study. ANIMALS: Twelve healthy adult horses. METHODS: Horses were assigned to 2 treatment groups (n = 6/group): Group 1, 1 g gentamicin administered simultaneously in both left and right metacarpophalangeal joints and group 2, 1 g gentamicin administered simultaneously in both left and right lateral palmar veins. Serum, synovial fluid, and bone biopsy specimens were collected. Gentamicin concentrations were determined by fluorescence polarization immunoassay. Bone, synovial fluid, and serum gentamicin concentrations were compared over time and between groups using 2-way ANOVA. Significance of all tests were evaluated at P <.05. RESULTS: IA metacarpophalangeal joint administration resulted in higher concentration of gentamicin in synovial fluid than RIP administration. Synovial fluid concentration remained above minimum inhibitory concentration (MIC) for common pathogens for over 24 hours with IA and RIP administration. Bone gentamicin concentration remained above MIC for 8 hours with both methods; there was no significant difference in gentamicin concentration in bone with either method. Neither IA nor RIP administration had a significant effect on serum concentration of gentamicin. CONCLUSIONS: In normal horses, there is no difference in bone gentamicin concentration obtained with IA or RIP administration. CLINICAL RELEVANCE: Based on MIC for common equine pathogens, administration of gentamicin intra-articularly or by regional intravenous perfusion should be useful for treatment of osteomyelitis.

Analysis of Variance↗

PubMedDate not supplied

Laparoscopic repair of a small intestinal mesenteric rent in a broodmare.

OBJECTIVES: To describe standing laparoscopic repair of mesoduodenal rent inaccessible by ventral median celiotomy. STUDY DESIGN: Clinical case report. SAMPLE POPULATION: A 6-year-old Thoroughbred broodmare with a right displacement of the dorsal colon and small intestinal incarceration in a mesoduodenal rent. METHODS: Two days after correction of a right dorsal displacement of the ascending colon, small intestinal incarceration, and partial closure of mesoduodenal rent, standing left and right flank laparoscopy was used to explore the abdomen to identify the mesoduodenal defect. The mesenteric rent was repaired from right flank portals by approximation with hemostatic clips. RESULTS: Approximation of the mesoduodenal rent was achieved with laparoscopic clips. No further complications or signs of abdominal pain occurred over the following year. CONCLUSIONS: Mesenteric rents in the mesoduodenum can be repaired by laparoscopic techniques in the standing horse. CLINICAL RELEVANCE: Use of laparoscopic techniques in the standing horse should be considered for mesoduodenal rents that are not accessible form a ventral median celiotomy.

Animals↗

PubMedDate not supplied

Evaluation of a sheep laparoscopic uterine trauma model and repeat laparoscopy for evaluation of adhesion formation and prevention with sodium carboxymethylcellulose.

OBJECTIVE: To evaluate topical application of 1% sodium carboxymethyl cellulose (SCMC) for prevention of postoperative adhesions in a laparoscopic model of uterine trauma in sheep. STUDY DESIGN: Experimental study. ANIMALS: Fourteen non-pregnant ewes. METHODS: Ewes were randomly assigned to 1 of 2 groups: control (saline solution) or 1% SCMC treatment. By left flank laparoscopy, traumatic forceps were used to create serosal trauma (1.5 x 5 cm) and hemorrhage on the left uterine horn. Either 30 mL saline solution or 30 mL 1% SCMC was applied topically to the traumatized uterine horn. Adhesion formation was evaluated by repeat laparoscopy at days 14 and 21. Sheep were euthanatized on day 28 for necropsy evaluation of adhesions. RESULTS: Five control sheep had adhesions of the uterine horn by day 14, but only 4 had adhesions at day 21, and 2 at day 28. Adhesions did not occur in SCMC-treated sheep. No adhesions occurred elsewhere in the abdomen. CONCLUSIONS: Laparoscopically created uterine trauma is an effective method for induction of uterine adhesions, and laparoscopy is an excellent method for serial evaluation of adhesion formation. SCMC (1%) was effective at preventing adhesion formation in sheep and no inflammatory response was noted. CLINICAL RELEVANCE: SCMC (1%) should be considered for prevention of adhesions in abdominal surgery in sheep.

Animals↗

PubMedDate not supplied

Actinobacillus sp. bacteremia in foals: clinical signs and prognosis.

Medical records of 101 blood culture-confirmed bacteremic foals were reviewed to determine whether foals with Actinobacillus sp. bacteremia are affected at an earlier age, have more severe signs of disease, and have a worse prognosis than do foals with bacteremia of other causes. Thirty percent (30/101) of bacteremic foals had Actinobacillus sp. cultured, and these were 2 times more likely to die (crude odds ratio [OR(CR)] 0.8, 4; P = .14), with a survival rate of 43% (13/30) compared to the overall survival rate of 55% (56/101). When compared to other bacteremic foals, foals with actinobacillosis were 7 times more likely to have been sick from birth (adjusted odds ratio [OR(ADJ)] 2, 26; P = .003) and 6 times more likely to have diarrhea (OR(ADJ) 1, 22; P = .009). By bivariate analysis. foals with Actinobacillus sp. bacteremia were 5 times more likely to have a sepsis score >11 (OR(CR) 1, 18; P = .007), 6 times more likely to be obtunded (OR(CR) 2, 20; P = .005), and 3 times more likely to have pneumonia (OR(CR) 1, 7; P = .03). Furthermore, Actinobacillus sp. bacteremic foals were 27 times more likely to have a segmented neutrophil count <3.3 X 10(9) cells/L (OR(ADJ) 4, 166: P < .0001) and were 4.5 times more likely to have a band neutrophil count >0.46 x 10(9) cells/L (OR(ADJ) 1, 17; P = .02) when compared to foals that had bacteremia caused by either gram-negative enteric or gram-positive organisms. Sepsis score was < or = 11 in 49% (29/59) of bacteremia foals aged <13 days for which a discernible sepsis score was calculable. Results of this study should improve the diagnostic sensitivity of clinical examinations of neonatal foals, thereby facilitating treatment decisions.

Actinobacillosis↗

PubMedDate not supplied

Alterations in serum parathyroid hormone and electrolyte concentrations and urinary excretion of electrolytes in horses with induced endotoxemia.

Hypocalcemia and hypomagnesemia are common in horses with sepsis and endotoxemia. We hypothesize that endotoxemia triggers a systemic inflammatory response that results in hypocalcemia and hypomagnesemia. The goal of this study was to determine the effect of endotoxin (lipopolysaccharide [LPS]) administration to healthy horses on serum parathyroid hormone (PTH), ionized calcium (Ca2+) and total calcium (tCa), ionized magnesium (Mg2+) and total magnesium (tMg), phosphate (Pi), potassium (K+), sodium (Na+), chloride (Cl-), and insulin concentrations, and on the urinary excretion of these electrolytes. Twelve mares were infused with Escherichia coli LPS (30 ng/kg/h i.v.) for 1 hour. Six mares were infused with saline (controls). In LPS-infused horses, heart rate increased significantly from (mean +/- SD) 40.0 +/- 1.3 to 70.0 +/- 9.0 beats/min, respiratory rate from 12.7 +/- 1.0 to 21.1 +/- 3.0 breaths/min, body temperature from 37.4 +/- 0.3 to 38.9 +/- 0.6 degrees C, and tumor necrosis factor-alpha concentrations from 6.6 +/- 3.5 to 507 +/- 260 pg/mL (P < .05). White blood cell count decreased significantly from 7570 +/- 600 to 1960 +/- 560 cells/ microL. Serum concentrations of Ca2+ decreased from 6.5 +/- 0.3 to 6.0 +/- 0.3 mg/dL, of Mg2+ from 0.53 +/- 0.06 to 0.43 +/- 0.04 mM, of tMg from 0.78 +/- 0.05 to 0.62 +/- 0.08 mM, of K+ from 4.3 +/- 0.4 to 3.0 +/- 0.5 mEq/L, and of Pi from 3.4 +/- 0.5 to 1.7 +/- 0.5 mg/dL (all P < .05). PTH increased significantly from 1.3 +/- 0.4 to 6.0 +/- 5.2 pM; however, in some horses (n=2), PTH did not increase despite hypocalcemia. Insulin increased significantly from 9.4 +/- 3.6 to 50.5 +/- 9.6 microIU/mL (n=3). Urinary fractional excretion of Ca2+ decreased significantly from 4.7 +/- 1.4 to 1.7 +/- 1.2%, of Mg2+ from 36.6 +/- 6.5 to 11.7 +/- 7.3%, and of K+ from 37.9 +/- 11.3 to 17.7 +/- 6.2%. Fractional excretion of Pi increased from 0.02 +/- 0.02 to 0.14 +/- 0.07% and of Na+ from 0.26 +/- 0.13% to 1.2 +/- 0.5%. No changes were found in serum tCa, Na+, and Cl- concentrations. In conclusion, endotoxemia in horses resulted in electrolyte abnormalities that included hypocalcemia, hypomagnesemia, hypokalemia, hypophosphatemia, and increased serum PTH and insulin concentrations.

Animals↗

PubMedDate not supplied

Usefulness of a commercial equine IgG test and serum protein concentration as indicators of failure of transfer of passive immunity in hospitalized foals.

Detection of failure of transfer of passive immunity (FTPI) is important in reducing morbidity and mortality in neonatal foals. We investigated the performance of a commercial equine IgG test (SNAP Foal IgG Test Kit) to diagnose FTPI in hospitalized foals. Furthermore, we evaluated the usefulness of serum total protein (STP) and serum globulin (SG) concentrations as indicators of FTPI. Serum IgG concentration was measured by means of the SNAP test and single radial immunodiffusion, and SG and STP concentrations were determined by means of a clinical chemistry analyzer. Subjects were 67 hospitalized foals <19 days old. The SNAP test was repeated on 37 samples from 29 foals, with identical results for 24 samples (kappa statistic, 0.64; 95% confidence interval [CI], 0.46-0.82). The sensitivity of the SNAP test to detect serum IgG concentration [IgG] < or =400 and < or =800 mg/dl was 90% (95% CI, 71-98%) and 95% (85-99%), respectively, and the specificity was 79% (71-82%) and 52% (39-57%), respectively. Sensitivity for detection of [IgG] < or =400 mg/dl was not affected (P > .05) by plasma fibrinogen concentration, sepsis score, or bacteremia. Specificity for detection of [IgG] < or = 800 mg/dl was lower (P < .05) in foals with sepsis score < or =11 (50% [31-60%] versus 100% [8-100%]) and bacteremia (25% [5-56%] versus 62% [45-62%]). Sensitivity and specificity of [STP] < or = 5.0 g/dl for [IgG] < or =800 mg/dl was 94% (83-99%) and 47% (30-56%), respectively. Performance of the SNAP test in hospitalized foals is impaired because of low specificity, but can have usefulness provided that the properties of the test and characteristics of the foal being examined are considered when interpreting the results. The STP and SG concentrations are poor sole indicators of FTPI in hospitalized foals, but may be useful adjunctive tests.

Animals↗

PubMedDate not supplied