Chronic disruption of the lateral collateral ligament complex of the carpus in two dogs.
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Animals↗
Biomedical subjects
D Bennett
Publications and source records attributed to D Bennett.
Myasthenia gravis--a rare presentation with tongue atrophy and fasciculation.
We report the case of an unusual presentation of myasthenia gravis with tongue atrophy and fasciculation. Myasthenia gravis is an autoimmune condition associated with weakness and fatigability of voluntary muscles. In >50%, the initial symptoms and signs are related to extraocular muscle weakness, such as diplopia or ptosis [Tsung K, Seggev JS. An unusual cause of dysphagia. West J Med 1995; 163: 159-60]. Rarely, it is known to affect bulbar muscles and can lead to dysphagia and respiratory compromise.
Aged↗
Use of reconstructed computed tomography for the assessment of joint spaces in the canine elbow.
OBJECTIVES: To assess the accuracy of reconstructed computed tomography for imaging canine elbow joint spaces. METHODS: Computed tomography scans of eight cadaveric elbows were obtained and reconstructed computed tomography images were formatted in the dorsal and sagittal planes. Humeroradial and humeroulnar joint space measurements were obtained from these images. Intra-observer and inter-observer variations in joint space measurements were assessed, as was the effect of specimen positioning (inter-image variation). After freezing, four elbows were sectioned in the dorsal plane and four in the sagittal plane. In addition to visual comparison of the frozen sections with reconstructed computed tomography images, joint space measurements were obtained from frozen sections and compared with those from reconstructed computed tomography images. Variation was assessed using statistical calculations and graphical techniques. RESULTS: Both inter-image and intra-observer analyses revealed good agreement and low variation between data sets. Inter-observer correlation was only moderate, though variation was low. Visually, the reconstructed computed tomography images accurately reflected the frozen section anatomy. Agreement between frozen section and reconstructed computed tomography joint space measurements was good, with minimal variation. CLINICAL SIGNIFICANCE: These results indicate that reconstructed computed tomography is capable of accurately imaging elbow joint spaces and precise joint space measurements can be obtained. Reconstructed computed tomography may be useful for determining joint space measurements and detecting elbow incongruencies in dogs with elbow dysplasia.
Animals↗
Feline osteoarthritis: a prospective study of 28 cases.
OBJECTIVES: To identify a cohort of cats with clinical osteoarthritis and to report on the clinical signs, the frequency of joints affected and the possible aetiopathogenesis within this population. METHODS: Inclusion criteria for this prospective study were presence of historical evidence and/or clinical signs of osteoarthritis, together with radiographic evidence of osteoarthritis. Patients showed clinical improvement within four weeks of analgesic administration and were free from other disease processes, which might explain the clinical signs and/or their response to analgesia. RESULTS: Twenty-eight cases were included in the cohort. The elbow (45 per cent) and the hip (38 per cent) were the most frequently affected joints. Seventy-one per cent of cases had primary/idiopathic aetiology. Alterations in both the ability to jump (71 per cent) and the height (67 per cent) of jump (lifestyle changes) were the most frequent signs of disease. Sixty-one per cent of owners felt that their pet had made a marked improvement following administration of an analgesic/anti-inflammatory drug. There were statistically significant improvements in the ability to jump (P < 0.001), the height of jump (P < 0.001), lameness (P = 0.03), stiff gait (P = 0.04) and the activity level (P = 0.02) when compared with the start and the end of the study period. CLINICAL SIGNIFICANCE: Osteoarthritis is a clinical problem in cats, but overt lameness is not the most common clinical feature.
Analgesics↗
Prevalence of radiographic signs of degenerative joint disease in a hospital population of cats.
The prevalence of radiographic signs of degenerative joint disease (including appendicular osteoarthritis) among a hospital population of 218 cats was 33.9 per cent (74 cats), and the prevalence of signs of appendicular joint osteoarthritis was 16.5 per cent (36 cats). Half of the cases of appendicular joint osteoarthritis had no apparent radiographic or historical cause, and clinical signs of lameness were recorded in only six of them, all of which had an apparent radiographic cause. The 74 cats with radiographic signs of degenerative joint disease were on average significantly older than the 144 cats in which there were no radiographic signs of the disease.
Age Factors↗
Chitosan for overweight or obesity.
BACKGROUND: Chitosan, a deacetylated chitin, is a dietary supplement reported to decrease body weight. It is widely available over the counter worldwide and although evaluated in a number of trials its efficacy remains in dispute. OBJECTIVES: To assess the effects of chitosan as a treatment for overweight and obesity. SEARCH STRATEGY: We searched electronic databases (MEDLINE, EMBASE, BIOSIS, CINAHL, The Cochrane Library), specialised web sites (Controlled Trials, IBIDS, SIGLE, Reuter's Health Service, Natural Alternatives International, Pharmanutrients), bibliographies of relevant journal articles, and contacted relevant authors and manufacturers. Last searches were completed in March 2004. SELECTION CRITERIA: Trials were included in the review if they were randomised controlled trials of chitosan a minimum of four weeks duration in adults who were overweight or obese. Authors of included studies were contacted for additional information where appropriate. DATA COLLECTION AND ANALYSIS: Details from eligible trials were extracted independently by two reviewers using a standardised data extraction form. Differences in data extraction were resolved by consensus. Continuous data were expressed as weighted mean differences and standard deviations. The pooled effect size was computed by using the inverse variance weighted method. MAIN RESULTS: Fourteen trials including a total of 1131 participants met the inclusion criteria. No trial to date has measured the effect of chitosan on mortality or morbidity. Analyses including all trials indicated that chitosan preparations result in a significantly greater weight loss (weighted mean difference -1.7 kg; 95% confidence interval (CI) -2.1 to -1.3 kg; P < 0.00001), decrease in total cholesterol (-0.2 mmol/L; 95% CI -0.3 to -0.1; P < 0.00001), decrease in systolic (-5.9 mmHg; 95% CI -7.3 to -4.6; P < 0.0001) and diastolic (-3.4 mmHg; 95% CI -4.4 to -2.4; P < 0.00001) blood pressure compared with placebo. There were no clear differences between intervention and control groups in terms of frequency of adverse events or in faecal fat excretion. However, the quality of many studies was sub-optimal and analyses restricted to studies that met allocation concealment criteria, were larger, or of longer duration showed that such trials produced substantially smaller decreases in weight and total cholesterol. AUTHORS' CONCLUSIONS: There is some evidence that chitosan is more effective than placebo in the short-term treatment of overweight and obesity. However, many trials to date have been of poor quality and results have been variable. Results obtained from high quality trials indicate that the effect of chitosan on body weight is minimal and unlikely to be of clinical significance.
Adult↗
Neutralizing antibodies and efficacy of interferon beta-1a: a 4-year controlled study.
OBJECTIVE: To determine the incidence and clinical significance of neutralizing antibody (NAb) formation in patients with relapsing multiple sclerosis (MS) who participated in the European Interferon Beta-1a IM Dose-Comparison Study. METHODS: Patients were randomized to treatment with interferon beta-1a (IFNbeta-1a) 30 microg or 60 microg IM once weekly for up to 4 years. Serum samples obtained at baseline and every 3 months thereafter were screened for the presence of IFN binding antibodies by ELISA. Patients whose results were seropositive on ELISA were screened for the presence of NAbs using an antiviral cytopathic effect assay. Patients were considered to be positive for NAbs (NAb+) if the baseline NAb titer was 0 and two or more consecutive postbaseline titers were > or = 20. Patients were considered to be negative for NAbs (NAb-) if the baseline NAb titer was 0 and all postbaseline NAb titers were < 5. RESULTS: The proportion of patients who became NAb+ was lower in patients who received 30 microg of IFNbeta-1a than in those who received 60 microg (7/400 [1.8%] vs 19/395 [4.8%]; p = 0.02). The mean time to NAb+ status was 14.5 +/- 6.2 months. Compared with patients who remained NAb-, NAb+ patients showed the following: higher relapse rates from months 12 to 48 (p = 0.04), higher rate of mean change (worsening) in Expanded Disability Status Scale score from baseline to month 48 (p = 0.01), greater number of T1 gadolinium-enhanced lesions at months 24 and 36 (p = 0.02 and 0.03), and greater accrual of new or enlarging T2 lesions from month 12 to months 24 and 36 (p = 0.05 and 0.09). CONCLUSIONS: Neutralizing antibodies (NAbs) to interferon beta-1a (IFNbeta-1a), as observed with other IFNbetas used in the treatment of multiple sclerosis, reduce the therapeutic benefits measured by relapses and MRI activity. Data from this study also suggest NAbs to IFNbeta-1a reduce treatment benefits as measured by change in Expanded Disability Status Scale score.
Adult↗
Fludarabine, melphalan, and alemtuzumab conditioning in adults with standard-risk advanced acute myeloid leukemia and myelodysplastic syndrome.
PURPOSE: This prospective phase II study evaluated toxicity, relapse rate, progression-free survival, and overall survival after allogeneic transplantation and conditioning with fludarabine, melphalan, and alemtuzumab in patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). PATIENTS AND METHODS: Fifty-two consecutive adults with AML and MDS were enrolled onto the study. Median age was 52 years (range, 17 to 71 years) and the majority of patients had high-risk disease, comorbidities, and/or modest reduction in performance status. Fifty-six percent of patients had unrelated or mismatched related donors. RESULTS: After a median follow-up of 18 months (range, 2 to 34 months), 1-year survival was 48% (95% CI, 34% to 61%), progression-free survival was 38% (95% CI, 25% to 52%), relapse rate was 27% (95% CI, 15% to 40%), and treatment-related mortality was 33% (95% CI, 20% to 46%). The cumulative probability of extensive chronic graft-versus-host disease (GVHD) was only 18% (95% CI, 8% to 40%); extensive chronic GVHD was only observed in recipients of unrelated donor transplants. Performance score and disease status were the major predictors of outcome. High-risk disease (ie, active AML or MDS with > 5% blasts) or even modest decreases in performance status were associated with poor outcomes. Patients with standard-risk leukemia (first or second complete remission) or MDS (< 5% blasts) had excellent outcomes despite unfavorable disease characteristics. CONCLUSION: Fludarabine and melphalan combined with in vivo alemtuzumab is a promising transplantation regimen for patients with AML or MDS and low tumor burden. For patients with active disease, this regimen provides at best modest palliation. Despite a low incidence of GVHD, transplantation is still associated with considerable nonrelapse mortality in patients with decreased performance status.
Acute Disease↗
Comparison of gait kinematics in patients receiving minimally invasive and traditional hip replacement surgery: a prospective blinded study.
Minimally invasive (MI) total hip replacement (THR) supposedly provides improved ambulation in the immediate post-operative period. This study used a prospective blinded design to analyse early post-operative walking ability using gait analysis. Seventeen patients were available for full analysis with nine having had the MI technique and eight having the standard incision (SI) technique. Patients were blinded as to the incision used, as were all physiotherapists and assessors. Differences in temporal-spatial variables and joint kinematics measured 1 day pre-operatively, 2 days post-operatively and 42 days (6 weeks) post-operatively were compared between groups. There was no significant difference in velocity, step length of the affected or unaffected leg, stride length or stance phase duration between the MI and SI groups between any of the timepoints tested. There was no significant improvement in the gait kinematics of the MI group compared to the SI group either 2 days post-operatively or 6 weeks post-operatively. Contrary to previous studies, there was no improvement in early post-operative gait for those patients who received THR using the minimally invasive technique.
Arthroplasty, Replacement, Hip↗
Disease- and cell-type-specific transcriptional targeting of vectors for osteoarthritis gene therapy: further development of a clinical canine model.
OBJECTIVES: The potential for undesirable systemic effects related to constitutive expression of certain therapeutic transgenes may be limited through the development of transcriptionally targeted disease- and cell-type-specific vectors. The objective of this study was to analyse the canine matrix metalloproteinase-9 (MMP-9) promoter and deletion constructs for its ability to drive expression in response to pro-inflammatory cytokines (interleukin-1beta and tumour necrosis factor-alpha). METHODS: Initial analysis of MMP-9 deletion constructs was made using a luciferase reporter system. The promoter was subsequently engineered to incorporate multiple NF-kappaB sites. In parallel experiments we used the mouse collagen type XI promoter to study cell-type-specific promoter activity in chondrocyte-specific cells (SW1353) and undifferentiated chondroprogenitor cells (ATDC5). RESULTS: Incorporation of multiple NF-kappaB sites into the MMP-9 promoter enhanced activity while maintaining disease specificity. Further, manipulation of the mouse collagen type XI (mColXI) promoter by the incorporation of SOX9 enhancer sites downstream of a reporter gene, increased gene activity while maintaining cell type specificity. CONCLUSIONS: Manipulation of promoter and enhancer regions can improve transcriptionally targeted genes. A combination of these systems, in the context of the canine model, has the potential to improve the safety of osteoarthritis gene therapy vectors.
Animals↗
Arthrographic diagnosis of shoulder joint masses in two dogs.
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Animals↗
Detailed assessment of activities of daily living in moderate to severe Alzheimer's disease.
Patients with Alzheimer's Disease (AD) who have reached a stage of moderate to severe dementia are capable of completing a restricted range of cognitive tests and performing a limited range of activities of daily living (ADL). As part of an initiative to develop instruments to evaluate AD, we analyzed data describing the performance of a large number of ADL and scores on cognitive and global assessment measures in a cohort of patients with AD with moderate to severe cognitive impairment, defined as a Mini-Mental State Examination score ranging from 0-15 (out of 30). From the large pool of ADL, 19 met criteria of applicability, reliability, good scaling, concordant validity, and sensitivity to detect change in performance over 6-12 months. A total score derived from these 19 ADL ratings, comprising a scale termed the Alzheimer Disease Cooperative Study ADL-sev, correlated strongly with measures of cognition and of global dementia severity. Patients with moderate to severe AD showed a decline on the ADL-sev and cognitive measures over 6 and 12 months, consistent with the progression of AD. Detailed evaluation of ADL may provide a useful index to evaluate patients with moderate to severe AD and may complement cognitive assessment, especially for characterizing change in interventional or therapeutic studies.
Activities of Daily Living↗
Transcriptional control by chromosome-associated protein phosphatase-1.
Tight regulation of gene expression is critical for cells to respond normally to physiological and environmental cues and to allow cell specialization. Reversible phosphorylation of key structural and regulatory proteins, from histones to the transcriptional machinery, is acknowledged to be an important mechanism of regulating spatial and temporal patterns of gene expression. PP1 (protein phosphatase-1), a major class of serine/threonine protein phosphatase, is found at many sites on Drosophila polytene chromosomes where it is involved in controlling gene expression and chromatin structure. PP1 is targeted to different chromosomal loci through interaction with a variety of different regulatory subunits, which modify PP1's activity towards specific substrates. This mini-review gives an overview of known chromosome-associated PP1 complexes, their role in transcriptional control and the prospects for future analysis.
Animals↗
Effect of chitosan on weight loss in overweight and obese individuals: a systematic review of randomized controlled trials.
This article aims to determine whether chitosan, a popular, over-the-counter, weight loss supplement, is an effective treatment for overweight and obesity. It is designed as a systematic review of randomized controlled trials. The data sources include the electronic databases Medline, EMBASE, Biosis, CINAHL and Cochrane Central Register of Controlled Trials (CCTR); the specialized websites Controlled Trials, International Bibliographic Information on Dietary Supplements (IBIDS), System for Information on Grey Literature in Europe (SIGLE), Reuter's Health Service, Natural Alternatives International and Pharmanutrients; and bibliographies of relevant journal articles. Included were randomized controlled trials of chitosan with a minimum duration of 4 weeks in adults who were overweight or obese and/or had hypercholesterolaemia at baseline. Fourteen trials involving a total of 1071 participants were included in the review. Analyses involving all trials indicated that chitosan preparations result in a small but statistically significant greater reduction in body weight (weighted mean difference -1.7 kg; 95% confidence interval -2.1, -1.3 kg, P < 0.00001) compared with placebo. Analyses restricted to high-quality studies showed that reductions in weight [-0.6 (-1.2, 0.1) kg, P = 0.11] were less than in lower quality studies [-2.3 (-2.7, -1.8) kg, P < 0.00001]. Results obtained from high-quality trials indicate that the effect of chitosan on body weight is minimal and unlikely to be of clinical significance.
Anti-Obesity Agents↗
Retrospective study of bacterial infective arthritis in 31 dogs.
OBJECTIVES: To characterise the presenting signs and pathological changes of canine bacterial infective arthritis in 31 dogs, and to document the response to different treatment regimens. Risk factors that may predispose joints to bacterial infective arthritis and influence the success of treatment were also investigated. METHODS: A retrospective review of cases of bacterial infective arthritis that were presented to three university veterinary referral hospitals over a five-year period (January 1997 to January 2002) was performed. RESULTS: The elbow joint (38 per cent) and stifle joint (44 per cent) were most commonly affected. Radiographic changes consistent with pre-existing osteoarthritis were identified in 14 joints, which had no history of previous surgery (articular or periarticular) or penetrating wound. No significant difference (P = 0.78) was identified between the outcome of combined surgical and medical management, and medical management alone. There were trends for poorer outcomes with increased bodyweight of the dog, longer duration of lameness and a higher nucleated cell count of the affected joint fluid at presentation. The overall infection rate for articular surgical procedures at one institution was 1-3 per cent. CLINICAL SIGNIFICANCE: Medical and/or surgical management were usually successful in resolving infection (94 per cent). However, they were frequently unsuccessful in restoring full joint function; this may in part have been due to the nature of the underlying joint
Animals↗
Evaluation of elbow incongruency using reconstructed CT in dogs suffering fragmented coronoid process.
OBJECTIVES: A retrospective study was undertaken to evaluate elbow joint congruency in dogs suffering fragmented coronoid process (FCP). METHODS: Based on clinical, radiographic and computed tomographic (CT) examinations, elbows were divided into control and FCP groups. Standardised CT reconstructions were formatted in the frontal and sagittal planes. Humeroradial and humeroulnar joint space measurements were obtained from the Images and incongruencies were calculated by comparing the two measurements. RESULTS: Forty-two FCP and 29 control elbows were identified. No incongruencies were noted at the coronoid base. At the level of the coronoid apex, FCP elbows exhibited a significant radioulnar incongruency compared with controls (P < 0.0001), though incongruency was not identified in all cases. Comparing FCP and control elbows at the level of the apex, the humeroradial joint space was increased in FCP elbows (P = 0.0006) whereas no difference was noted in the humeroulnar space. CLINICAL SIGNIFICANCE: This study supports the hypothesis that joint incongruency is associated with FCP in dogs, though is not present in every case at the time of diagnosis. The precise mechanism of development of this incongruency cannot be determined from these data.
Animals↗
Compensatory humeral overgrowth associated with antebrachial shortening in six dogs.
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Animals↗
Acute injury and chronic disability resulting from surfboard riding.
We undertook a cross-sectional survey of surfers at eight Victorian beaches between February and May 2003 and analysed acute injury and chronic disability sustained while surfing during the preceding 12 months. Significant injuries were defined as requiring medical attention or time off surfing/work. 646 surfers were enrolled (90.2% male, median age 27 years, median years of surfing 10). 145 surfers sustained 168 significant acute injuries in the preceding 12 months (0.26 injuries/surfer/year, 95% CI 0.22-0.30). Most were caused by striking a surfboard or another surfer (45.2%, 95% CI 37.6-53.1), "wiping out" (36.3%, 95% CI 29.1-44.1) or striking the seabed (17.9%, 95% CI 12.6-24.7). Injuries included lacerations (46.4%, 95% CI 38.8-54.3), sprains (28.6%, 95% CI 22.0-36.1), dislocations (10.7%, 95% CI 6.7-16.6) and fractures (8.9%, 95% CI 5.3-14.6). Body parts most frequently injured were the lower limb (45.8%, 95% CI 38.2-53.7) and the head/face (26.2%, 95% CI 19.9-33.6). Surfing injuries that were treated in Victorian emergency departments over a six year period revealed a similar pattern, although there was a greater proportion of head/face injuries (42.0%, 95% CI 36.0-48.1, p = 0.001). 20 surfers reported long-term effects from acute injuries, mainly unstable/stiff/painful joints. 136 surfers reported chronic health problems not related to acute injury including chronic/recurrent otitis externa and exostoses, muscle and joint pain/stiffness and pterygium. Significant injury while surfing is not uncommon. Although head injury accounts for a considerable proportion, very few surfers wear protective headgear. Greater use of protective headgear should be considered.
Adolescent↗