Parathyroid hormone evaluation in normal horses and horses with renal failure

Immunoreactive parathyroid hormone (iPTH), calcium, and inorganic phosphorus levels were measured in the serum of 13 apparently normal horses and in six horses with renal insufficiency. Serum iPTH levels were measured by radioimmunoassay using an antisera produced by immunization of guinea pigs with bovine parathyroid hormone. The antisera reacts primarily with the carboxy-terminal hormone fragment. Serum iPTH level in the normal horses was 504.5 ± 191.4 pg/ml and varied from 246 to 750 pg/ml. Serum iPTH levels in three horses with chronic renal failure, hypercalcemia and hypophosphatemia were below the limits of detection for the assay (<165 pg/ml). The hypercalcemia and hypophosphatemia were thus considered not to be the result of increased parathyroid hormone. Three horses with renal insufficiency which were not hypercalcemic had serum iPTH levels which were normal or greater than normal

Effects of inhaled dry powderipratropium broide on reconvery from exercise of horses with COPD

The present study evaluated ventilatory, cardiovascular and metabolic parameters during recovery from strenuous exercise in horses suffering from a crisis of chronic obstructive pulmonary disease (COPD) and to determine whether ipratropium dry powder inhalation (DPI) before exercise has an effect on these parameters. When 6 saddle horses, affected with COPD, developed airway obstruction, they inhaled placebo and ipratropium (2400 pghorse), the order being randomly chosen. Pulmonary function tests were then recorded 15 min after inhalation. Following these tests, the horses underwent a strenuous treadmill exercise, followed by a ecovery period that consisted of a 10 min walk. Measurements were made at the first and tenth min of recovery. Respiratory flow, 0 2 and C02 fractions in the respired gas, pleural pressure changes and heart rate were recorded. Arterial and mixed venous blood samples were analysed or gas tensions, haemoglobin and plasma lactate concentrations. Oxygen consumption (Wz), C02 production, tidal volume, alveolar oxygen tension (PAOz), alveolar ventilation, the alveolar-pulmonary capillary oxygen difference ((A-a)dOz) and total pulmonary resistance (RL) were measured. The PA02 was the only parameter significantly improved during recovery following ipratropium DPI. This improvement was not accompanied by evidence of improvement of other ventilatory or cardiorespiratory parameters. The results showed that in horses suffering from a crisis of COPD, recovery is characterised by an exercise-induced bronchodilation. Secondly, ipratropium DPI at a dose of 2400 pghorse is an effective bronchoddator in these horses at rest but it has little effect on the airway calibre during the recovery period. It is suggested that the short term recovery period is still Muenced by exercise-induced adjustments that may exceed the bronchodilatory effect of inhaled ipratropium that are observed before exercis

Developing an integrated rehabilitation model for thoracic cancer services: views of patients, informal carers and clinicians

Abstract Background Access to rehabilitation to prevent disability and optimise function is recommended for patients with cancer, including following cancer diagnosis. Models to integrate rehabilitation within oncology services as cancer treatment commences are required, but must be informed by those they are intended to support. We aimed to identify views of patients, carers and clinicians to develop and refine a rehabilitation model to be tested in a feasibility trial for people newly diagnosed with lung cancer or mesothelioma. Methods We conducted a focus group study with people affected by lung cancer or mesothelioma, their carers and clinicians providing their care to identify priorities for rehabilitation in this period. We sought views on core intervention components, processes and outcomes and integration with oncology services. Data were analysed using thematic analysis. Results Fifteen clinicians (oncologists, nurse specialists, physiotherapists and occupational therapists), nine patients and five carers participated. A proposed outline rehabilitation model was perceived as highly relevant for this population. Participants recommended prompt and brief rehabilitation input, delivered whilst people attend for hospital appointments or at home to maximise accessibility and acceptability. Participants recognised variation in need and all prioritised tailored support for symptom self-management, daily activities and the involvement of carers. Clinicians also prioritised achieving fitness for oncology treatment. Patients and carers prioritised a sensitive manner of approach, positivity and giving hope for the future. Participant’s recommendations for outcome measurement related to confidence in usual daily activities, symptom control and oncology treatment completion rates over objective measures of cardiorespiratory fitness. Conclusion The importance of providing tailored rehabilitation around the time of diagnosis for people with lung cancer or mesothelioma was affirmed by all participants. The refined model of rehabilitation recommended for testing in a feasibility trial is flexible, tailored and short-term. It aims to support people to self-manage symptoms, tolerate cancer treatments and to remain active and independent in daily life. It is delivered alongside scheduled hospital appointments or at home by an expert practitioner sensitive to the psycho-social sequelae that follow a diagnosis of thoracic cancer