Rehabilitation of dogs with surgically treated cranial cruciate ligament-deficient stifles by use of electrical stimulation of muscles

OBJECTIVE: To determine effect of electrical muscle stimulation (EMS) on rate and degree of return to function of the limb and development of degenerative joint disease (DJD) after surgical creation and subsequent stabilization of the cranial cruciate ligament (CrCL)-deficient stifle. ANIMALS: 12 clinically normal adult large (19.5 to 31.5 kg) dogs. PROCEDURE: Dogs were anesthetized, and the right CrCL was severed via arthrotomy, destabilizing the stifle. After 3 weeks, the stifle was surgically stabilized. Three weeks later, 6 dogs were subjected to an EMS treatment protocol for the thigh muscles. At 5, 9, 13, and 19 weeks after stifle destabilization, treated (n = 6) and control (n = 6) dogs were evaluated for return of stifle function. Gross and histologic evaluations of the stifles were performed at 19 weeks after stifle destabilization. RESULTS: Treated dogs had significantly (P = 0.001) better lameness score than did control dogs. There was less palpable crepitation of the stifle in treated dogs (P = 0.06); treated dogs also had significantly (P = 0.01) fewer radiographic signs of bone changes. Thigh circumference was significantly (P = 0.02) larger in treated dogs. There was less gross cartilage damage (P = 0.07) in the EMS-treated dogs, but more medial meniscal damage (P = 0.058, cranial pole; P = 0.051, caudal pole). CONCLUSIONS: Improved lameness scores, larger thigh circumference, and decreased radiographically apparent bony changes observed for the treated group of dogs support the hypothesis that dogs treated by EMS after surgical stabilization of the CrCL-deficient stifle had improved limb function, with less DJD, than did dogs treated with the currently accepted clinical protocol of cage rest and slow return to normal activity. However, results of force plate evaluation did not support the hypothesis. Increased meniscal damage in dogs treated by EMS may be cause for concern.     

The nitric oxide synthase inhibitor L-NAME (N omega-nitro-L-arginine methyl ester) does not produce discriminative stimulus effects similar to ethanol

Three key aspects of Florence Nightingale remarkable life are examine. First, the influence during her formative years: the education and guidance provided by her father, the resistance by her family when she decided to become a nurse; and the rejection by Nightingale of the societal expectations of a woman in the Victorian era. Secondly, her professional life is examined, in particular how she appears to have been viewed by certain members of society, and how it turn she viewed them. It is anticipated that her position as an early feminist will be postulated and illuminated. Thirdly, an analysis of her personal and professional life indicates a way forward for the nursing profession.     

Fast fluid-attenuated inversion-recovery imaging: first experience with a 3D version in epilepsy

Breast reconstruction has been the subject of many controversies. It now seems generally agreed however that the operation has no deleterious influence on the follow up of breast cancer patients and that it has favorable psychologic effects. Breast reconstruction can be performed either by using prostheses or analogous tissues. These two different modalities have each their own advantages and limitations. Deep knowledge of the techniques and their indications allows to select the most appropriate approach in the individual patient and, thus, to improve long term results.     

Fetal and maternal catecholamine levels at delivery

Endovascular treatment methods that are largely catheter/guidewire-based permit treatment of a variety of vascular lesions from remote access sites in a minimally invasive manner. Because these endovascular technologies have intrinsic appeal to patients and physicians, they may, if proved safe and effective, replace a substantial proportion of current vascular surgical procedures. This change will have a substantial impact on the specialties involved in their development and use, that is, vascular surgery and interventional radiology (which in this discussion includes other interventional specialists devoted to peripheral vascular disease management). The relationship between these previously distinct specialties must also be influenced greatly by the introduction of endovascular technologies, the use of which requires skills that overlap the specialties. This paper considers several possible approaches for dealing with the altered interspecialty relationships that will result if new endovascular treatment methods prove to be safe and effective. Because the development and use of these endovascular technologies require the skills and talents of vascular surgeons and interventional radiologists (or other interventionalists), a collaborative, multispecialty approach to the use of endovascular technologies is recommended as the most reasonable and optimal for patient care. Although this approach may not be applicable for every environment, it is the one most likely to minimize costs and turf battles, particularly if interspecialty conflict can be minimized by collaboration and compromises developed by a conjoint executive committee representing the leadership of the involved specialty societies.     

The Human Genome Project and the role of genetics in health care

The Human Genome Project, the mapping of our 100,000 genes and the sequencing of all of our DNA, will have major impact on biomedical research and the therapeutic and preventive health care. The tracing of genetic diseases to their molecular causes is rapidly expanding diagnostic and preventive options, while the increased insights into molecular pathways open tremendous perspectives for pharmacological and genetic therapies. The design of animal model systems for the functional study of disease and development of bioinformatics and biostatistics to improve our pattern recognition abilities are greatly accelerating progress. However, the optimal value from the current explosion of 'data mining' possibilities will only be gained when the basic data are made and kept publicly accessible, at the same time preventing the jeopardisation of the protection of intellectual property, arising from downstream inventions. This is one of the goals of HUGO, the international Human Genome Organisation, established 9 years ago to assist coordinating data acquisition and exchange and societal implementation of the genome project. Additional points of major importance in this historic endeavour are the safeguarding of a worldwide balance in the contribution and benefits to countries and population, the prevention of stigmatisation and discrimination of individuals and groups and the maintenance of respect for the priceless diversity of our world's cultures and traditions.