To describe outcomes of horses with temporohyoid osteoarthropathy (THO) treated with partial ceratohyoidectomy.
10 client-owned horses.
Medical records from 2 institutions were examined for records ...of horses with THO treated with partial ceratohyoidectomy between 2010 and 2021. History, signalment, clinical signs, diagnostics, medications, and surgery-related details were recorded. Horses with a minimum of 6 months follow-up were recruited for neurologic and imaging examinations in the hospital or field where radiography of the basihyoid-ceratohyoid articulation were performed along with CT, when available.
10 horses with THO were included (9 unilateral; 1 bilateral). Nine planned partial ceratohyoidectomies were performed in 8 horses, whereas 2 horses had preoperatively planned complete ceratohyoidectomies transitioned to partial ceratohyoidectomies during surgery due to intraoperative complications. Postoperative complications occurred mostly in transitioned surgeries (obstructed airway, tongue mobility issues, and incisional hemorrhage), whereas only 1 horse with a planned ceratohyoidectomy had postoperative complication of rhabdomyolysis. All complications resolved before hospital discharge. Neurologic signs improved in all 10 horses, with 2 showing complete resolution. Nine horses were available for radiographic follow-up, 6 of which also had head CT scans. A space between the ceratohyoid and basihyoid bones was measurable on radiography in all 9 horses, and was confirmed on CT. Three horses demonstrated proliferation of either ceratohyoid or basihyoid bones. The 9 horses with unilateral disease returned to previous work, and the horse with bilateral disease was retired.
Partial ceratohyoidectomy is a surgical option for treatment of THO that provides similar clinical outcomes to published reports on ceratohyoidectomy.
Objective: In the US, Hispanic persons have a higher rate of Type 2 diabetes (T2D) than the national average, as well as experience more diabetes-related complications than non-Hispanic whites (NHWs) .... This increased prevalence can be attributed to social and biological factors, like access to care and increased predisposition to pre-diabetic conditions. Currently, limited evidence exists for the effectiveness of randomized controlled trials (RCTs) at improving A1C levels in this population with T2D.
Methods: A systematic search focused on T2D interventions published from 1985 to 20was conducted using PubMed, Scopus, PsycInfo, and CINAHL. Search terms were structured around five broad concepts: diabetes, study design, language, race/ethnicity, and disparities. We focused on non-pharmacologic interventions, and included RCTs with ≥18.5% Hispanic persons, utilizing the 2020 US Census as standard. A random effects meta-analysis was performed to calculate the pooled effect size to provide summary estimates.
Results: Of the 111,289 articles reviewed, 28 trials met inclusion criteria. Participants were 90% Hispanic and 70% female with a mean age of 55.8 years. Most interventions used cultural tailoring, lifestyle and behavioral changes, or telehealth support and included bilingual nurses, Spanish educational materials, or community health workers. Compared to control, these interventions were associated with a 0.19% (95% confidence interval: -0.39% to 0.01%; p<0.01) reduction in A1c.
Conclusion: This meta-analysis examined non-pharmacologic interventions in Hispanic persons with T2D and found that they reduced A1c to a small degree. This finding is important for future T2D interventions tailoring to this population, as well as future health policy. Future analyses will examine which type of interventions (i.e. individual, community, societal, or multi-level) are most successful at reducing A1c among Hispanic persons.
Disclosure
S.Uranga: None. L.Bianco: None. A.Deckard: None. W.Wan: n/a. J.Alexander: None. E.M.Staab: None. A.W.Rodriguez: None. R.Shetty: None. N.Laiteerapong: None.
•Equine mortality composting is effective during spring and fall in Minnesota.•Mostly large bones remained in compost piles after 6 months of composting.•Composting reduced estimated sodium ...pentobarbital quantities.•Physicochemical characteristics of compost were suitable for land application.
Recent changes in rendering availability for chemically-euthanized animals have created a need to explore composting as an equine mortality management method. The objectives of this study were to evaluate equine mortality composting in the Upper Midwest during fall and spring, document sodium pentobarbital concentrations throughout the process, and determine nutrient content of finished compost. During each season, four horses were euthanized by intravenous administration of sodium pentobarbital. Carcasses were positioned at the center of a woodchip and shavings base and covered with a 2:1 mixture of horse stall waste and cattle feedlot waste. Data loggers were placed at 46- and 91cm depths to record pile temperatures every 8 hours. At turning (44–50 days) and trial conclusion (181–216 days), compost piles were sampled for sodium pentobarbital and nutrient composition. Piles contained large bones after 6 months of composting. Sodium pentobarbital remained detectable at trial conclusion (<0.002–1.49 mg kg1 dry matter); however, composting reduced the estimated quantities of sodium pentobarbital by ≥94% (P ≤ .001). Compost from each season met ideal land application values for organic matter (45%–48%), pH (7.3–7.6), and electrical conductivity (3.3–3.4 mm hos cm−1). Low NPK and high C:N ratio (20–30) indicate compost could partially replace synthetic fertilizers when land applied. These findings suggest equine mortality composting is an effective management practice during fall and spring in the Upper Midwest. While remaining sodium pentobarbital residues were minimal, further research is needed to determine environmental implications of composting chemically-euthanized equines.
•Surveys were used to assess end-of-life decisions made by owners and veterinarians.•Most respondents were middle aged women with long-term industry involvement.•Respondents preferred chemical ...euthanasia and burial over other methods.•Limited research and knowledge remain barriers to wide acceptance of composting.•Most respondents would be willing to try composting if more research was available.
Challenges associated with burial, rendering, and cremation have forced horse owners to seek alternative mortality disposal methods. While equine mortality composting has been successfully demonstrated, industry-wide adoption has been limited. Therefore, evaluation of horse owners’ and veterinarians’ perceptions and experience with mortality composting is needed. Two surveys were developed to evaluate industry practices and decisive factors regarding equine euthanasia and mortality disposal methods. Each survey was designed for a separate audience: horse owners or veterinarians serving equines. The surveys were advertised as weblinks on relevant Facebook pages, e-newsletters, and email listservs. Data were analyzed using bivariate and multivariate models for associations and factors influencing decisions surrounding composting. The surveys yielded 1,225 and 244 usable responses from horse owners and veterinarians, respectively. Respondent demographics were consistent with previous survey reports for horse owners and veterinarians in the United States with a majority being female between 41 and 60 years of age with long-term industry involvement. Horse owners (86%) and veterinarians (84%) that preferred chemical euthanasia tended to prefer burial (58% and 42%, respectively) over other mortality disposal methods. Only 12% of horse owner respondents had ever tried composting and only 25% of veterinarian respondents had ever recommended composting. Horse owner (47%) and veterinarian (67%) respondents indicated they would be more open to trying and recommending mortality composting if more scientific research were available. Equine mortality composting shows potential as a primary disposal method for the equine industry. Research and educational programs are key to industry-wide acceptance of equine mortality composting.
Two Quarter horses with weight loss had glucosuria, euglycemia, and a mild metabolic acidosis suggesting a proximal renal tubular defect. Further testing revealed transient generalized aminoaciduria, ...lactic aciduria, and glucosuria, indicating Fanconi syndrome. Both horses recovered with supportive therapy. This is the first report of acquired Fanconi syndrome in horses.
Abstract
OBJECTIVES
Patients undergoing surgical mitral valve repair (MVr) for degenerative mitral regurgitation are at risk of even late postoperative atrial fibrillation (AF). Left atrial (LA) ...function has been shown superior to LA volume in evaluating the risk of AF in diverse cardiac conditions. We therefore investigated the prognostic value of LA function and volume in predicting mid-to-late postoperative AF after MVr (>30 days postoperatively).
METHODS
We retrospectively identified all patients who underwent MVr for degenerative mitral regurgitation between 2012 and 2019 at our institution. Exclusion criteria were preoperative AF, concomitant procedures, re-operations, missing or insufficiently processable preoperative echocardiograms and missing follow-up. LA function and volume measurements were conducted using speckle-tracking strain echocardiographic analysis. Postoperative LA function was measured in a subgroup with sufficient postoperative echocardiograms.
RESULTS
We included 251 patients, of whom 39 (15.5%) experienced AF in the mid-to-late postoperative period. Reduced LA strain parameters and more than mild preoperative tricuspid regurgitation were independently associated with mid-to-late postoperative AF. LA volume index had no association with mid-to-late postoperative AF in univariable analysis and did not improve the performance of multivariable models. Patients with mid-to-late AF exhibited diminished improvement in LA function after surgery.
CONCLUSIONS
In MVr patients, LA function (but not volume) showed independent predictive value for mid-to-late postoperative AF. Including LA function into surgical decision-making and approach may identify patients who will benefit from earlier intervention with the aim to prevent irreversible LA damage with consequent risk of postoperative AF.
Degenerative mitral regurgitation (DMR) can lead to heart failure (HF), arrhythmia, stroke and cardiac death if not treated in a timely manner 1–3.
Secondary mitral regurgitation (MR) refers to MR resulting from left ventricular or left atrial remodeling. In ischemic or nonischemic cardiomyopathy, left ventricular dilation (regional or global) ...leads to papillary muscle displacement, tethering, and leaflet malcoaptation. In atrial functional MR, MR occurs in patients with left atrial dilation and altered mitral annular geometry due to atrial fibrillation. In addition to cardiac remodeling, leaflet remodeling is increasingly recognized. Mitral leaflet tissue actively adapts through leaflet growth to ensure adequate coaptation. Leaflets, however, can also undergo maladaptive thickening and fibrosis, leading to increased stiffness. The balance of cardiac and leaflet remodeling is a key determinant in the development of secondary MR. Clinical management starts with detection, severity grading, and identification of the underlying mechanism, which relies heavily on echocardiography. Treatment of secondary MR consists of guideline-directed medical therapy, surgical repair or replacement, and transcatheter edge-to-edge repair. Based on a better understanding of pathophysiology, novel percutaneous mitral repair and replacement devices have been developed and clinical trials are underway.
Endovascular treatment in large artery occlusion stroke reduces disability. However, the impact of anesthesia type on clinical outcomes remains uncertain.
We compared consecutive patients in the ...Swiss Stroke Registry with anterior circulation stroke receiving endovascular treatment with or without general anesthesia (GA). The primary outcome was disability on the modified Rankin Scale after 3 months, analyzed with ordered logistic regression. Secondary outcomes included dependency or death (modified Rankin Scale score
3), National Institutes of Health Stroke Scale after 24 hours, symptomatic intracranial hemorrhage with
4 points worsening on National Institutes of Health Stroke Scale within 7 days, and mortality. Coarsened exact matching and propensity score matching were performed to adjust for indication bias.
One thousand two hundred eighty-four patients (GA: n=851, non-GA: n=433) from 8 Stroke Centers were included. Patients treated with GA had higher modified Rankin Scale scores after 3 months than patients treated without GA, in the unmatched (odds ratio OR, 1.75 1.42-2.16;
<0.001), the coarsened exact matching (n=332-524, using multiple imputations of missing values; OR, 1.60 1.08-2.36;
=0.020), and the propensity score matching analysis (n=568; OR, 1.61 1.20-2.15;
=0.001). In the coarsened exact matching analysis, there were no significant differences in National Institutes of Health Stroke Scale after 1 day (estimated coefficient 2.61 0.59-4.64), symptomatic intracranial hemorrhage (OR, 1.06 0.30-3.75), dependency or death (OR, 1.42 0.91-2.23), or mortality (OR, 1.65 0.94-2.89). In the propensity score matching analysis, National Institutes of Health Stroke Scale after 24 hours (estimated coefficient, 3.40 1.76-5.04), dependency or death (OR, 1.49 1.07-2.07), and mortality (OR, 1.65 1.11-2.45) were higher in the GA group, whereas symptomatic intracranial hemorrhage did not differ significantly (OR, 1.77 0.73-4.29).
This large study showed worse functional outcome after endovascular treatment of anterior circulation stroke with GA than without GA in a real-world setting. This finding appears to be independent of known differences in patient characteristics between groups.
ABSTRACT
This paper presents a new optical imaging survey of four deep drilling fields (DDFs), two Galactic and two extragalactic, with the Dark Energy Camera (DECam) on the 4-m Blanco telescope at ...the Cerro Tololo Inter-American Observatory (CTIO). During the first year of observations in 2021, >4000 images covering 21 deg2 (seven DECam pointings), with ∼40 epochs (nights) per field and 5 to 6 images per night per filter in g, r, i, and/or z have become publicly available (the proprietary period for this program is waived). We describe the real-time difference-image pipeline and how alerts are distributed to brokers via the same distribution system as the Zwicky Transient Facility (ZTF). In this paper, we focus on the two extragalactic deep fields (COSMOS and ELAIS-S1) characterizing the detected sources, and demonstrating that the survey design is effective for probing the discovery space of faint and fast variable and transient sources. We describe and make publicly available 4413 calibrated light curves based on difference-image detection photometry of transients and variables in the extragalactic fields. We also present preliminary scientific analysis regarding the Solar system small bodies, stellar flares and variables, Galactic anomaly detection, fast-rising transients and variables, supernovae, and active Galactic nuclei.
ABSTRACT
This paper presents a new optical imaging survey of four deep drilling fields (DDFs), two Galactic and two extragalactic, with the Dark Energy Camera (DECam) on the 4-m Blanco telescope at ...the Cerro Tololo Inter-American Observatory (CTIO). During the first year of observations in 2021, >4000 images covering 21 deg2 (seven DECam pointings), with ∼40 epochs (nights) per field and 5 to 6 images per night per filter in g, r, i, and/or z have become publicly available (the proprietary period for this program is waived). We describe the real-time difference-image pipeline and how alerts are distributed to brokers via the same distribution system as the Zwicky Transient Facility (ZTF). In this paper, we focus on the two extragalactic deep fields (COSMOS and ELAIS-S1) characterizing the detected sources, and demonstrating that the survey design is effective for probing the discovery space of faint and fast variable and transient sources. We describe and make publicly available 4413 calibrated light curves based on difference-image detection photometry of transients and variables in the extragalactic fields. We also present preliminary scientific analysis regarding the Solar system small bodies, stellar flares and variables, Galactic anomaly detection, fast-rising transients and variables, supernovae, and active Galactic nuclei.
