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Johnson F, Madan I, Pattani S, De Bono A, Boorman S, Goss C, Parsons V. Assessing the profile and utility of diplomates in occupational medicine. Occup Med (Lond) 2024:kqae018. [PMID: 38606796 DOI: 10.1093/occmed/kqae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND The utility of the occupational medicine diploma in the UK is yet to be explored. The NHS 'Growing Occupational Health (OH) and Wellbeing' programme provides opportunities for diplomates to increase their OH work. AIMS To assess what proportion of diplomates carry out OH work, the type of work being undertaken, to identify obstacles impeding OH work, to capture their interest in future work opportunities and what additional support they require. METHODS A link to an online questionnaire was sent to diplomates via several professional bodies; we estimate that 2428 diplomates received this. The survey was open from 24 March to 31 May 2022. RESULTS Replies were received from 310/2428 (13%) diplomates. Fifty-two per cent of respondents were males and 35% were female. Respondents were diverse in terms of age and geographical region. Main employment settings: 13% primary care, 43% secondary care, 31% private sector, 24% public sector and 20% self-employed. Seventy-two per cent of diplomates had undertaken OH clinical work since completion of their diploma, and 90% of those were undertaking OH clinical work at the time of the survey. Specific obstacles to accessing OH work highlighted included existing workload constraints, lack of employment opportunities with OH providers and lack of time. CONCLUSIONS Many (126/310; 41%) respondents had considered increasing their OH work in the previous 12 months. Increasing mentorship from senior OH clinicians to diplomates was suggested by 4% of respondents to enhance the utility of diplomates.
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Affiliation(s)
- F Johnson
- Leicester Medical School, University of Leicester, Leicester, UK
| | - I Madan
- Occupational Health, Safety and Wellbeing Service, Guy's and St Thomas NHS Foundation Trust, London, UK
- School of Life Sciences and Medicine, King's College London, London, UK
| | - S Pattani
- Occupational Health Service, London North West University Hospitals NHS Trust, London, UK
| | - A De Bono
- Occupational Health Service, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - S Boorman
- Employee Health Empactis, Reading, UK
| | - C Goss
- Occupational Health Service, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - V Parsons
- Occupational Health, Safety and Wellbeing Service, Guy's and St Thomas NHS Foundation Trust, London, UK
- School of Life Sciences and Medicine, King's College London, London, UK
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2
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Zhao N, Curry D, Evans RE, Isguven S, Freeman T, Eisenbrey JR, Forsberg F, Gilbertie JM, Boorman S, Hilliard R, Dastgheyb SS, Machado P, Stanczak M, Harwood M, Chen AF, Parvizi J, Shapiro IM, Hickok NJ, Schaer TP. Microbubble cavitation restores Staphylococcus aureus antibiotic susceptibility in vitro and in a septic arthritis model. Commun Biol 2023; 6:425. [PMID: 37069337 PMCID: PMC10110534 DOI: 10.1038/s42003-023-04752-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/24/2023] [Indexed: 04/19/2023] Open
Abstract
Treatment failure in joint infections is associated with fibrinous, antibiotic-resistant, floating and tissue-associated Staphylococcus aureus aggregates formed in synovial fluid (SynF). We explore whether antibiotic activity could be increased against Staphylococcus aureus aggregates using ultrasound-triggered microbubble destruction (UTMD), in vitro and in a porcine model of septic arthritis. In vitro, when bacterially laden SynF is diluted, akin to the dilution achieved clinically with lavage and local injection of antibiotics, amikacin and ultrasound application result in increased bacterial metabolism, aggregate permeabilization, and a 4-5 log decrease in colony forming units, independent of microbubble destruction. Without SynF dilution, amikacin + UTMD does not increase antibiotic activity. Importantly, in the porcine model of septic arthritis, no bacteria are recovered from the SynF after treatment with amikacin and UTMD-ultrasound without UTMD is insufficient. Our data suggest that UTMD + antibiotics may serve as an important adjunct for the treatment of septic arthritis.
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Affiliation(s)
- Neil Zhao
- Department of Orthopaedic Surgery, Sidney Kimmel College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Dylan Curry
- Department of Orthopaedic Surgery, Sidney Kimmel College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Rachel E Evans
- Department of Orthopaedic Surgery, Sidney Kimmel College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Selin Isguven
- Department of Orthopaedic Surgery, Sidney Kimmel College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Theresa Freeman
- Department of Orthopaedic Surgery, Sidney Kimmel College, Thomas Jefferson University, Philadelphia, PA, USA
| | - John R Eisenbrey
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Flemming Forsberg
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jessica M Gilbertie
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA
| | - Sophie Boorman
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA
| | - Rachel Hilliard
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA
| | - Sana S Dastgheyb
- Department of Orthopaedic Surgery, Sidney Kimmel College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Priscilla Machado
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Maria Stanczak
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Marc Harwood
- Rothman Orthopaedic Institute, Philadelphia, PA, USA
| | - Antonia F Chen
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Javad Parvizi
- Department of Orthopaedic Surgery, Sidney Kimmel College, Thomas Jefferson University, Philadelphia, PA, USA
- Rothman Orthopaedic Institute, Philadelphia, PA, USA
| | - Irving M Shapiro
- Department of Orthopaedic Surgery, Sidney Kimmel College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Noreen J Hickok
- Department of Orthopaedic Surgery, Sidney Kimmel College, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Thomas P Schaer
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA.
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Boorman S, Hanson RR, Velloso Alvarez A, Zhong K, Hofmeister E, Boone LH. Concurrent versus delayed exposure to corticosteroids in equine articular tissues cultured with local anesthetic. Vet Surg 2023; 52:361-369. [PMID: 36571324 DOI: 10.1111/vsu.13924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 11/07/2022] [Accepted: 11/19/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To determine the effect of concurrent versus delayed treatment with corticosteroid on equine articular tissues also treated with local anesthetic in vitro in the presence of inflammatory mediators. STUDY DESIGN Controlled laboratory study. ANIMALS Five geldings, one mare (aged 3-18 years). METHODS From each horse, 24 synovial and 12 osteochondral explants were cultured in a 12-well plate (2 wells/group, 2 synovial and 1 osteochondral explant/well, total 216 explants in the study). Explants were stimulated in culture medium with 10 μg/ml recombinant equine interleukin-1β and 10 μg/ml tumor necrosis factor-α for 48 hours, then randomly assigned to six treatments: unstimulated control, stimulated control, triamcinolone acetonide (TA, 10-6 M), mepivacaine hydrochloride (MH, 4.4 mg/ml), MH + TA (concurrent) and MH + TA (delayed). The delayed group was treated with MH and, 6 days later, treated with TA. Every 3 days for 9 days total, medium levels of lactate dehydrogenase (LDH), prostaglandin E2 (PGE2 ), matrix metalloproteinase 13 (MMP-13) and glycosaminoglycan (GAG) were quantified via ELISA. Data were analyzed with mixed-effects models with Tukey's multiple comparisons. RESULTS Stimulation increased medium PGE2 and MMP-13 and had no effect on LDH or GAG. Treatment with MH increased LDH and decreased PGE2 and MMP-13. Treatment with TA decreased PGE2 and MMP-13. CONCLUSION There were no differences in cytotoxicity, inflammation or matrix degradation for delayed or concurrent MH and TA treatment groups up to 9 days in culture. CLINICAL SIGNIFICANCE The lack of an effect of concurrent versus delayed treatment might indicate that concurrent therapy is acceptable.
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Affiliation(s)
- Sophie Boorman
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | - R Reid Hanson
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | | | - Kevin Zhong
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | - Erik Hofmeister
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | - Lindsey H Boone
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
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4
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Boorman S, Rodgerson DH. Single-incision drilling technique to achieve hemiepiphysiodesis of the distal metacarpus - complications and outcome in 207 foals with metacarpophalangeal varus deformities. Vet Surg 2023; 52:26-32. [PMID: 36161662 DOI: 10.1111/vsu.13888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/02/2022] [Accepted: 08/24/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To report the outcome of foals treated for metacarpophalangeal varus deformity with a single-incision drilling technique for hemiepiphysiodesis of the distal lateral metacarpal physis. STUDY DESIGN Retrospective case-control cohort study. ANIMALS Thoroughbred foals (n = 207), 171 age- and sex-matched maternal siblings. METHODS Medical records (2017-2020) were reviewed for signalment, limb(s) treated, location of the surgery, and any reported complications. Follow-up radiographs obtained for the yearling sale were assessed for abnormalities. Horses were matched to maternal siblings using an online database. Sales and racing performance data were compared between cohorts. RESULTS The average age at the time of surgery was 97 days. The treated limb was the left front in 52, right front in 31, both fronts in 119, unknown in 5. Three horses developed calcinosis circumscripta lesions adjacent to the physis, which were removed successfully. No radiographic abnormalities associated with the surgery site were detected on yearling prepurchase radiographs. There were no differences in sales and racing performance data between treated horses and maternal controls. CONCLUSION Hemiepiphysiodesis is a safe and effective treatment for metacarpophalangeal varus deformities in foals. No negative effect on sales or racing performance was identified. CLINICAL SIGNIFICANCE This technique avoids risks, costs, and the need for second surgery associated with an orthopedic implant. The surgeon should be aware of the potential for development of a calcinosis circumscripta lesion with this technique.
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Affiliation(s)
- Sophie Boorman
- Marion duPont Scott Equine Medical Center, Virginia Maryland College of Veterinary Medicine, Leesburg, Virginia, USA
| | - Dwayne H Rodgerson
- Davidson Surgery Center, Hagyard Equine Medical Institute, Lexington, Kentucky, USA
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5
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Boorman S, Caldwell F, Cole R. What Is Your Diagnosis? J Am Vet Med Assoc 2022; 261:56-57. [PMID: 36264715 DOI: 10.2460/javma.22.07.0281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Sophie Boorman
- 1Marion duPont Scott Equine Medical Center, Virginia Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Leesburg, VA
| | - Fred Caldwell
- 2Department of Clinical Sciences, JT Vaughan Large Animal Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, AL
| | - Robert Cole
- 2Department of Clinical Sciences, JT Vaughan Large Animal Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, AL
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Boorman S, McMaster MA, Groover E, Caldwell F. Review of glucocorticoid therapy in horses: Intra‐articular corticosteroids. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Sophie Boorman
- College of Veterinary Medicine Auburn University Auburn Alabama USA
| | - Mattie A. McMaster
- College of Medical, Veterinary and Life Sciences University of Glasgow Glasgow UK
| | - Erin Groover
- College of Veterinary Medicine Auburn University Auburn Alabama USA
| | - Fred Caldwell
- College of Veterinary Medicine Auburn University Auburn Alabama USA
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7
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Boorman S, Caldwell F, Neto RT. Pathology in Practice. J Am Vet Med Assoc 2022; 260:1800-1802. [DOI: 10.2460/javma.22.05.0194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Sophie Boorman
- Department of Clinical Sciences, College of Veterinary Medicine, JT Vaughan Large Animal Teaching Hospital, Auburn University, Auburn, AL
| | - Fred Caldwell
- Department of Clinical Sciences, College of Veterinary Medicine, JT Vaughan Large Animal Teaching Hospital, Auburn University, Auburn, AL
| | - Rachel T. Neto
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL
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8
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Zetterström S, Horzmann K, Yin J, Moon R, Boorman S, Ceriotti S, Wooldridge A, Boone L. Paratracheal air cyst in a foal. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S. Zetterström
- Department of Clinical Sciences J. T. Vaughan Teaching Hospital College of Veterinary Medicine Auburn University Auburn AlabamaUSA
| | - K. Horzmann
- Department of Pathobiology College of Veterinary Medicine Auburn University Auburn Alabama USA
| | - J. Yin
- Department of Pathobiology College of Veterinary Medicine Auburn University Auburn Alabama USA
| | - R. Moon
- Department of Clinical Sciences J. T. Vaughan Teaching Hospital College of Veterinary Medicine Auburn University Auburn AlabamaUSA
| | - S. Boorman
- Department of Clinical Sciences J. T. Vaughan Teaching Hospital College of Veterinary Medicine Auburn University Auburn AlabamaUSA
| | - S. Ceriotti
- Department of Clinical Sciences J. T. Vaughan Teaching Hospital College of Veterinary Medicine Auburn University Auburn AlabamaUSA
| | - A. Wooldridge
- Department of Clinical Sciences J. T. Vaughan Teaching Hospital College of Veterinary Medicine Auburn University Auburn AlabamaUSA
| | - L. Boone
- Department of Clinical Sciences J. T. Vaughan Teaching Hospital College of Veterinary Medicine Auburn University Auburn AlabamaUSA
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9
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Affiliation(s)
- S. Boorman
- Department of Clinical Sciences JT Vaughan Large Animal Teaching Hospital Auburn University ‐ College of Veterinary Medicine Auburn Alabama USA
| | - F. Caldwell
- Department of Clinical Sciences JT Vaughan Large Animal Teaching Hospital Auburn University ‐ College of Veterinary Medicine Auburn Alabama USA
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10
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Boorman S, DeGraves F, Schumacher J, Hanson RR, Boone LH. Comparison of 2% mepivacaine and a solution of 2% lidocaine/epinephrine administered for median and ulnar nerve blocks in horses with naturally occurring forelimb lameness. Vet Surg 2021; 51:279-285. [PMID: 34964510 DOI: 10.1111/vsu.13754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/06/2021] [Accepted: 12/05/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare a 2% lidocaine solution containing 5 μg/ml (1:200 000) epinephrine with 2% mepivacaine for reducing lameness in horses after use in proximal nerve blocks. STUDY DESIGN Experimental randomized crossover. ANIMALS Six adult horses with naturally occurring forelimb lameness. METHODS Horses were evaluated using an inertial gait sensor system. Lameness was measured as a vector sum (VS). Following baseline lameness examination, median and ulnar nerve blocks were performed with lidocaine/epinephrine (0.5 mg epinephrine added to 50 ml of 2% lidocaine immediately prior to administration) or an equal volume of 2% mepivacaine. Horses were trotted at 5 min and then at 30 min intervals for 150 min. After 24 h, nerve blocks were repeated using the other local anesthetic. Data were evaluated using linear models. RESULTS The reduction in the VS did not differ after nerve blocks with lidocaine/epinephrine or mepivacaine (P = .791). Mean time to VS <8.5 mm (n = 5) was 5 and 9.6 min for lidocaine/epinephrine and mepivacaine, respectively. For one horse, VS was not reduced to <8.5 mm with either treatment (this horse had the highest VS before treatments were administered). The decrease in VS to <8.5 mm lasted for 150 min in both treatment groups. CONCLUSION The outcomes of the median and ulnar nerve blocks performed with 2% lidocaine with epinephrine did not differ from blocks performed with 2% mepivacaine. CLINICAL RELEVANCE Two percent lidocaine with epinephrine may serve as an adequate replacement for proximal nerve blocks when mepivacaine is unavailable.
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Affiliation(s)
- Sophie Boorman
- Department of Clinical Sciences, JT Vaughan Large Animal Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
| | - Fred DeGraves
- Department of Agriculture and Food Science, Western Kentucky University, Bowling Green, Kentucky, USA
| | - John Schumacher
- Department of Clinical Sciences, JT Vaughan Large Animal Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
| | - Russel Reid Hanson
- Department of Clinical Sciences, JT Vaughan Large Animal Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
| | - Lindsey H Boone
- Department of Clinical Sciences, JT Vaughan Large Animal Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
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11
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Boorman S, Zetterström S, Hamersky J, Velloso Álvarez A, Boone L, Hanson RR, Caldwell F. Use of serial standing computed tomography for diagnosis, treatment and monitoring of a horse with acute myonecrosis of the head. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S. Boorman
- Department of Clinical Sciences College of Veterinary Medicine Auburn University Auburn Alabama USA
| | - S. Zetterström
- Department of Clinical Sciences College of Veterinary Medicine Auburn University Auburn Alabama USA
| | - J. Hamersky
- Department of Clinical Sciences College of Veterinary Medicine Auburn University Auburn Alabama USA
| | - A. Velloso Álvarez
- Department of Clinical Sciences College of Veterinary Medicine Auburn University Auburn Alabama USA
| | - L. Boone
- Department of Clinical Sciences College of Veterinary Medicine Auburn University Auburn Alabama USA
| | - R. R. Hanson
- Department of Clinical Sciences College of Veterinary Medicine Auburn University Auburn Alabama USA
| | - F. Caldwell
- Department of Clinical Sciences College of Veterinary Medicine Auburn University Auburn Alabama USA
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12
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Abstract
OBJECTIVE To characterize the clinical features, treatment, and outcome of aural hematomas in horses. ANIMALS 7 horses with 1 or 2 aural hematomas (8 ears in total) treated at a veterinary teaching hospital in 2008 through 2019. PROCEDURES Data retrieved from medical records included signalment, pertinent historical information, clinical signs, diagnostic procedures (including dermatologic assessment), and treatments. Case outcome was determined from documentation in the medical record or via telephone communication with owners or referring veterinarians. RESULTS 3 horses were presented after recurrence of aural hematoma following treatment by the referring veterinarian. Four horses had a history of allergic skin disease prior to aural hematoma development. Most (6/7) horses were unilaterally affected. Diagnostic assessments included otoscopic evaluation (3 horses), ultrasonography (3 horses), cytologic examination of ear canal swab samples (3 horses), and histologic examination of a pinnal biopsy specimen (1 horse). Of the 8 pinnae, 2 were treated by nonsurgical needle drainage (1 with concurrent corticosteroid injection) and the remaining 6 underwent surgical incision and placement of compressive sutures. Follow-up information was available for 6 horses, and all affected pinnae were fibrotic with 4 horses having permanent drooping of the pinna. One horse developed a hematoma in the contralateral pinna 1 year after hospital discharge. CONCLUSIONS AND CLINICAL RELEVANCE Equine aural hematoma is a rare condition. The main principle of treatment is drainage, and treatment options commonly used in small animal practice can be successfully applied in horses. Permanent changes in the cosmetic appearance of the pinna are likely to develop owing to secondary fibrosis.
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13
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Boorman S, Hofmeister EH, Ross MW, Ralston S, Bell G, Mackie S, Ortved K. Influence of osteochondrosis on the longevity and racing performance of standardbred trotters and pacers. Vet Surg 2021; 50:507-516. [PMID: 33460472 DOI: 10.1111/vsu.13568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/12/2020] [Accepted: 12/06/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the influence of clinical osteochondrosis (OC) on the short-term (2, 3, and 4-year-old) and long-term racing performance and longevity of standardbred racehorses. STUDY DESIGN Retrospective case-control study. SAMPLE POPULATION Standardbred racehorses from a single breeding farm born between 2009 and 2017 that survived to racing age (n = 2711). Three hundred eighty-two (14%) horses were OC-affected (829 lesions confirmed arthroscopically during surgical treatment), and 2329 (86%) horses were nonaffected. METHODS Racing performance data were obtained from an online database and evaluated with multiple linear regression models. RESULTS Trotters were more likely than pacers to be affected by OC (odds ratio [OR] = 1.4, 95% CI = 1.1-1.9, P = .006). Compared with nonaffected horses, long-term OC-affected horses had 8.8 fewer starts (95% CI = -14.4 to -3.2, P = .002), 1.0 fewer wins (95% CI = -1.9 to -0.1, P = .030), and 3.8 fewer total number of first through third place finishes (95% CI = -6.2 to -1.4, P < .0001). Nonaffected horses had longer careers compared with OC-affected horses, racing 0.32 years longer (95% CI = -0.52 to -0.12, P = .002). Osteochondrosis had no impact on short-term racing performance. Horses with lesions at the distal intermediate ridge of the tibia or lateral trochlear ridge of the talus had decreased performance compared with horses without these lesions. CONCLUSION Pacers were less likely than trotters to be affected by OC. Affected horses had fewer starts and shorter careers, despite early surgical intervention. CLINICAL SIGNIFICANCE Osteochondrosis decreases long-term racing performance in racing standardbreds.
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Affiliation(s)
- Sophie Boorman
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama
| | - Erik H Hofmeister
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama
| | - Michael W Ross
- New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania
| | - Sarah Ralston
- New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania
| | - Garrett Bell
- New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania
| | - Sarah Mackie
- New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania
| | - Kyla Ortved
- New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania
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14
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Zhang C, Gullbrand SE, Schaer TP, Boorman S, Elliott DM, Chen W, Dodge GR, Mauck RL, Malhotra NR, Smith LJ. Combined Hydrogel and Mesenchymal Stem Cell Therapy for Moderate-Severity Disc Degeneration in Goats. Tissue Eng Part A 2020; 27:117-128. [PMID: 32546053 DOI: 10.1089/ten.tea.2020.0103] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Intervertebral disc degeneration is a cascade of cellular, structural, and biomechanical changes that is strongly implicated as a cause of low-back pain. Current treatment strategies have poor long-term efficacy as they seek only to alleviate symptoms without preserving or restoring native tissue structure and function. The objective of this study was to evaluate the efficacy of a combined triple interpenetrating network hydrogel (comprising dextran, chitosan, and teleostean) and mesenchymal stem cell (MSC) therapy targeting moderate-severity disc degeneration in a clinically relevant goat model. Degeneration was induced in lumbar discs of 10 large frame goats by injection of chondroitinase ABC. After 12 weeks, degenerate discs were treated by injection of either hydrogel alone or hydrogel seeded with allogeneic, bone marrow-derived MSCs. Untreated healthy and degenerate discs served as controls, and animals were euthanized 2 weeks after treatment. Discs exhibited a significant loss of disc height 12 weeks after degeneration was induced. Two weeks after treatment, discs that received the combined hydrogel and MSC injection exhibited a significant, 10% improvement in disc height index, as well as improvements in histological condition. Discs that were treated with hydrogel alone exhibited reduced tumor necrosis factor-α expression in the nucleus pulposus (NP). Microcomputed tomography imaging revealed that the hydrogel remained localized to the central NP region of all treated discs after 2 weeks of unrestricted activity. These encouraging findings motivate further, longer term studies of therapeutic efficacy of hydrogel and MSC injections in this large animal model. Impact statement Low-back pain is the leading cause of disability worldwide, and degeneration of the intervertebral discs is considered to be one of the most common reasons for low-back pain. Current treatment strategies focus solely on alleviation of symptoms, and there is a critical need for new treatments that also restore disc structure and function. In this study, using a clinically relevant goat model of moderate-severity disc degeneration, we demonstrate that a combined interpenetrating network hydrogel and mesenchymal stem cell therapy provides acute improvements in disc height, histological condition, and local inflammation.
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Affiliation(s)
- Chenghao Zhang
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sarah E Gullbrand
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA.,Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Thomas P Schaer
- Comparative Orthopaedic Research Laboratory, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Sophie Boorman
- Comparative Orthopaedic Research Laboratory, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Dawn M Elliott
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware, USA
| | - Weiliam Chen
- Department of Surgery, New York University School of Medicine, New York, New York, USA
| | - George R Dodge
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA.,Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Robert L Mauck
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA.,Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Neil R Malhotra
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lachlan J Smith
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Boorman S, Boone L, Weatherall K, Caldwell F. Actinomyces as a Cause of Osteomyelitis of the Nasofrontal Suture in a Gelding. J Equine Vet Sci 2020; 91:103148. [PMID: 32684273 DOI: 10.1016/j.jevs.2020.103148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
A 7-year-old American Quarter Horse gelding was referred to the JT Vaughan Large Animal Teaching Hospital at Auburn University, College of Veterinary Medicine, for an investigation of a recurrent swelling of the nasofrontal region. Computed tomography examination of the skull was most consistent with a sequestrum of the left nasofrontal suture with associated focal osteomyelitis and left conchofrontal sinusitis. Surgery to remove the sequestrum, debride the devitalized bone, and flush the left conchofrontal sinus was performed. A microbial culture was obtained at the time of surgery, which yielded a mixed heavy growth of an Actinomyces species. Quantitative PCR indicated a species with 93% resemblance to Actinomyces funkei. A treatment course of two weeks of oral chloramphenicol was prescribed. At three-month follow-up, the owner reported resolution of the swelling.
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Affiliation(s)
- Sophie Boorman
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
| | - Lindsey Boone
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL.
| | - Kathleen Weatherall
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
| | - Fred Caldwell
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
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16
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Boorman S, Scherrer NM, Stefanovski D, Johnson AL. Facial nerve paralysis in 64 equids: Clinical variables, diagnosis, and outcome. J Vet Intern Med 2020; 34:1308-1320. [PMID: 32249997 PMCID: PMC7255662 DOI: 10.1111/jvim.15767] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 03/12/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Facial nerve paralysis (FNP) in equids is not well described in the veterinary literature. OBJECTIVE To investigate the causes of FNP and associations among clinical variables, diagnosis, and outcome. ANIMALS Sixty-four equids presenting with FNP between July 2000 and April 2019. Cases of postanesthetic FNP were excluded. METHODS Medical records were retrospectively reviewed. Variables were evaluated for associations with outcomes (diagnosis and case outcome) using logistic regression. RESULTS The most common cause of FNP was trauma (n = 20). Additional diagnoses included central nervous system (CNS) disease (n = 16), idiopathic (n = 12, 4 of which had adequate diagnostic investigation and were considered "true" idiopathic, and 8 of which were considered "not investigated" idiopathic), temporohyoid osteoarthropathy (n = 10), otitis media-interna (n = 3), lymphoma (n = 1), iatrogenic as a consequence of infiltration of local anesthetic (n = 1), and clostridial myositis (n = 1). Follow-up was available for 55 (86%) cases. Twenty-nine (53%) equids had full resolution of FNP, 14 (25%) were euthanized, 6 (11%) partially improved, and 6 (11%) were unchanged or worse. CONCLUSIONS AND CLINICAL IMPORTANCE If FNP is the consequence of CNS disease, successful treatment of the primary disease likely leads to resolution of FNP. Most cases of FNP in equids are traumatic in origin. True idiopathic cases are uncommon.
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Affiliation(s)
- Sophie Boorman
- Department of Clinical SciencesJ. T. Vaughan Teaching Hospital, Auburn University College of Veterinary MedicineAuburnAlabamaUSA
| | - Nicole M. Scherrer
- Department of Clinical Studies, New Bolton CenterUniversity of PennsylvaniaKennett SquarePennsylvaniaUSA
| | - Darko Stefanovski
- Department of Clinical Studies, New Bolton CenterUniversity of PennsylvaniaKennett SquarePennsylvaniaUSA
| | - Amy L. Johnson
- Department of Clinical Studies, New Bolton CenterUniversity of PennsylvaniaKennett SquarePennsylvaniaUSA
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Boorman S, Richardson DW, Hogan PM, Stefanovski D, Levine DG. Racing performance after surgical repair of medial condylar fracture of the third metacarpal/metatarsal bone in thoroughbred racehorses. Vet Surg 2020; 49:648-658. [PMID: 32133662 DOI: 10.1111/vsu.13403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/18/2020] [Accepted: 02/15/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To report the performance of thoroughbred racehorses after surgical repair of a medial condylar fracture of the third metacarpal/metatarsal bone. STUDY DESIGN Retrospective cohort study. SAMPLE POPULATION Forty-three horses surgically treated for medial condylar fractures, 30 with previous racing experience, 13 without previous racing experience (nonexperienced). METHODS Medical records (2009-2017) were reviewed for signalment, radiographic fracture characteristics, repair technique, and postoperative morbidity and mortality. Each experienced horse was matched with two horses randomly selected from its most recent race to serve as healthy controls. Racing performance parameters (race rating, competitive level, speed rating, performance index) and career racing statistics were compared with multiple regression models between injured experienced horses and controls. The career racing statistics for nonexperienced horses were evaluated. Reasons for nonreturn to racing were obtained. RESULTS The median duration of follow-up was 6 years (minimum 2, maximum 10). Twenty-one of 43 (49%) horses raced again as well as 18 of 30 (60%) experienced horses and three of 13 (23%) nonexperienced horses. Experienced horses were five times more likely than nonexperienced horses to return to racing (95% confidence interval = 0.07-0.58, P = .003). Higher preoperative racing performance parameters were associated with return to racing. Racing performance parameters were lower after the date of fracture in injured horses compared with controls. CONCLUSION Experienced horses were more likely to return to racing after medial condylar fracture repair, although their performance was generally lower than that of comparably uninjured horses. CLINICAL SIGNIFICANCE Owners should be aware that horses with medial condylar fractures likely will race at a lower level than their uninjured peers.
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Affiliation(s)
- Sophie Boorman
- Department of Clinical Science, JT Vaughan Large Animal Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, Alabama
| | - Dean W Richardson
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania
| | | | - Darko Stefanovski
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania
| | - David G Levine
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania
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Boorman S, Douglas H, Driessen B, Gillespie MJ, Schaer TP. Fatal Ovarian Hemorrhage Associated With Anticoagulation Therapy in a Yucatan Mini-Pig Following Venous Stent Implantation. Front Vet Sci 2020; 7:18. [PMID: 32083102 PMCID: PMC7002391 DOI: 10.3389/fvets.2020.00018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 01/10/2020] [Indexed: 01/10/2023] Open
Abstract
Swine models are commonly utilized in endovascular research for development of intravascular interventions and medical device development. As part of a pilot study for a venous vascular stent device, a 5-year-old female Yucatan mini-pig underwent bilateral external iliac vein stent placement under general anesthesia. To reduce thrombotic complications by reduction of thrombus formation on wires, sheaths, and catheters, the pig was heparinized with a total of 300 IU/kg of heparin, establishing an activated clotting time (ACT) of 436 s. The ACT had returned to below 200 s by the end of the procedure. To prevent postoperative thrombosis, the pig received an anticoagulation therapy protocol consisting of enoxaparin, clopidogrel, and aspirin. There were no complications during the immediate postoperative period. However, the pig died 4 days after surgery. Necropsy established the cause of death as abdominal exsanguination due to severe, acute, intra-ovarian hemorrhage, most likely related to ovulation. Life-threatening ovarian hemorrhage is occasionally seen in women with congenital or acquired bleeding disorders; to our knowledge this is the first report of fatal ovarian hemorrhage in an animal enrolled in a pre-clinical research trial.
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Affiliation(s)
- Sophie Boorman
- Department of Clinical Sciences, College of Veterinary Medicine, JT Vaughan Large Animal Teaching Hospital, Auburn University, Auburn, AL, United States
| | - Hope Douglas
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Bernd Driessen
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Matthew J Gillespie
- Department of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Thomas P Schaer
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Boorman S, Johnson AL, Schaer TP, Fecteau ME. Clinical Findings, Treatments and Outcomes in Farm Animals with Vertebral Fractures or Luxations: 22 Cases (2006-2017). Vet Comp Orthop Traumatol 2019; 32:492-498. [PMID: 31242518 DOI: 10.1055/s-0039-1692637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The aim of this study was to describe the signalment, clinical presentation, diagnostic findings, medical and surgical treatment and outcome of 22 farm animals diagnosed with a vertebral fracture or luxation. STUDY DESIGN Medical records of 22 farm animals (7 goats, 6 alpacas, 5 cattle, 3 sheep and 1 deer) were reviewed for signalment, history, presenting clinical signs and neurological examination findings, clinicopathological results, diagnostic imaging, final diagnosis, medical and surgical management, clinical progression and outcome. RESULTS Animals' age ranged from 1 day to 15 years. Neurological examination findings included decreased motor function (20/22), recumbency (14/22), altered mentation (13/22), cranial nerve deficits (4/22) and lack of nociception (3/22). Lesions were localized to the atlanto-occipital region (2/22), C1 to C5 (7/22), C6 to T2 (4/22), T3 to L3 (3/22), and L4 to S1 (6/22). Diagnoses included vertebral fracture only (4/22), luxation only (5/22) or both vertebral fracture and luxation (13/22). In five cases, no therapy was attempted, while 12 cases were treated medically and five cases were treated surgically. Surgical interventions included manual reduction (n = 1); arthrodesis (n = 2); laminectomy (n = 1); and laminectomy with pin fixation, cerclage wire and polymethylmethacrylate bridging (n = 1). Five of the 22 cases survived to hospital discharge; two of these were treated surgically. CONCLUSION The cervical region was most commonly affected. Prognosis for these injuries in farm animals is guarded.
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Affiliation(s)
- Sophie Boorman
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, Unites States
| | - Amy L Johnson
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, Unites States
| | - Thomas P Schaer
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, Unites States
| | - Marie-Eve Fecteau
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, Unites States
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Boorman S, Stefanovski D, Southwood LL. Clinical findings associated with development of postoperative reflux and short-term survival after small intestinal surgery in geriatric and mature nongeriatric horses. Vet Surg 2019; 48:795-802. [PMID: 31002397 DOI: 10.1111/vsu.13217] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 02/26/2019] [Accepted: 04/03/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine risk factors, especially age, associated with postoperative reflux (POR; >2 L of reflux present upon intubation), high-volume POR (≥20 L in 24 hours), and short-term outcome after small intestinal (SI) surgery. STUDY DESIGN Retrospective case-control study. SAMPLE POPULATION Horses aged ≥16 years (geriatric; range, 16-30; n = 44) and <16 years (mature; range, 2-15; n = 39) with an SI surgical lesion that survived general anesthesia and did not have a second exploratory celiotomy during the same visit. METHODS Medical records (2009-2015) were reviewed; perioperative variables were evaluated for associations with outcomes by using multivariable logistic regression. RESULTS Postoperative reflux was associated with an increasing packed cell volume at admission (odds ratio [OR], 1.08; 95% CI, 1.00-1.16; P = .042) and presence of nasogastric reflux at admission (OR, 4.61; 95% CI, 1.3-15.69; P = .014). High-volume POR was associated with an increasing glycemia at admission (OR, 1.19; 95% CI, 1.01-1.40; P = .041), presence of nasogastric reflux at admission (OR, 10.05; 95% CI, 2.21-45.74; P = .003), and SI resection (OR, 10.52; 95% CI, 1.81-61.25; P = .009). Increasing surgical time (OR, 2.50; 95% CI, 1.16-5.29; P = .019) and high-volume POR (OR, 6.37; 95% CI, 2.12-19.12; P = .001) were associated with nonsurvival. CONCLUSION Age, considered as both a continuous variable and a categorical variable, was not associated with the development of POR, high-volume POR, or nonsurvival. CLINICAL SIGNIFICANCE Age does not influence the occurrence of POR and should not negatively impact an owner's decision to pursue surgery in aged horses.
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Affiliation(s)
- Sophie Boorman
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania
| | - Darko Stefanovski
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania
| | - Louise L Southwood
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania
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Boorman S. Quick Reference Dictionary for Occupational Therapy. Occup Med (Lond) 2007. [DOI: 10.1093/occmed/kqm017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Welch R, Boorman S, Golding JF, Towell T, Roberts R. Variations in self-reported health by occupational grade in the British Post Office: the Q-health project. Occup Med (Lond) 1999; 49:491-7. [PMID: 10658301 DOI: 10.1093/occmed/49.8.491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Between 1995 and 1998 a national sample of 58,501 (42,885 males, 15,616 females) Post Office employees (29%) completed and returned a postal questionnaire survey providing information on demographic characteristics, physical and psychological health, health and lifestyles and health screening behaviour. Response rates by occupational grade were as follows: manual (male 69.3%, females 43.6%); clerical (male = 11.8%, female, 42.3%); middle management (males 15.5%, females 10.7%) and senior management (males 3.4%, females 3.3%). A number of differences in health status occurred with occupational grade. Angina, high blood pressure, obesity, smoking, arthritis, disability, GP consultations and abnormal smears were all more prevalent in lower occupational grades. Height, job satisfaction, seat belt use and breast self-examination were also lower in lower status jobs. Some findings were unexpected: GHQ scores indicated better mental health in lower grades, whilst knowledge and frequency of testicular self-examination and attendance for mammograms were higher in lower grades. Self-reports for asthma, diabetes and family history of bowel cancer were also greater in higher grades. These findings are considered in terms of response bias, health selection, the psychosocial work environment, occupational health interventions and the nature, meaning and organization of social position within the Post Office.
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Affiliation(s)
- R Welch
- Concept 2000, Farnborough, Hampshire, UK
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Abstract
Following a review of car fleet performance information, the high cost of accidents in a small fleet was highlighted. Measures were introduced, including advanced driver training and fleet performance followed-up. Significant improvements in accident rates, with reduced costs were recorded. The savings achieved outweighed the expenditure on the measures introduced.
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Boorman S. Are your employees fit to drive? Occup Health (Lond) 1995; 47:86-90. [PMID: 7724159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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