Comparison of a reverse-transverse cross pin technique with a same side cross pin type II external skeletal fixator in 89 dogs

The objective of this study was to determine whether a novel reverse-transverse cross pin insertion technique could increase the stability of type II external skeletal fixators (ESF) in dogs compared with an alternate, same side cross pin ESF. Reverse-transverse cross pin technique and type II ESFs same side cross pin technique were applied and compared among subjects. Two of 42 ESFs (4.8%) applied with the reverse-transverse cross pin technique and 39 of 47 ESFs (83%) applied with the same side cross pin technique were subjectively unstable at the time of fixator removal (P < 0.001). The same side cross pin ESFs had significantly more pin tract new bone formation than the reverse-transverse ESFs (P = 0.038). In summary, this approach may provide a method of treating a variety of musculoskeletal conditions and soft tissue cases, which reverse-transverse cross pin ESFs are tolerated in dogs for a variety of conditions

Incidence rates and management of urinary tract infections among children in Dutch general practice: results from a nation-wide registration study

BACKGROUND: We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections. METHOD: During one calendar year, 195 general practitioners in 104 practices in the Netherlands registered all their patient contacts. This study was performed by the Netherlands Institute for Health Services Research (NIVEL) in 2001. Of 82,053 children aged 0 to 18 years, the following variables were collected: number of episodes per patient, number of contacts per episode, month of the year in which the diagnosis of urinary tract infection was made, age, gender, urbanisation level, drug prescription and referral. RESULTS: The overall incidence rate was 19 episodes per 1000 person years. The incidence rate in girls was 8 times as high as in boys. The incidence rate in smaller cities and rural areas was 2 times as high as in the three largest cities. Throughout the year, incidence rates varied with a decrease in summertime for children at the age of 0 to 12 years. Of the prescriptions, 66% were in accordance with current guidelines, but only 18% of the children who had an indication were actually referred. CONCLUSION: This study shows that incidence rates of urinary tract infections are not only related to gender and season, but also to urbanisation. General practitioners in the Netherlands frequently do not follow the clinical guidelines for urinary tract infections, especially with respect to referral

Prostaglandin E2 Signals Through PTGER2 to Regulate Sclerostin Expression

The Wnt signaling pathway is a robust regulator of skeletal homeostasis. Gain-of-function mutations promote high bone mass, whereas loss of Lrp5 or Lrp6 co-receptors decrease bone mass. Similarly, mutations in antagonists of Wnt signaling influence skeletal integrity, in an inverse relation to Lrp receptor mutations. Loss of the Wnt antagonist Sclerostin (Sost) produces the generalized skeletal hyperostotic condition of sclerosteosis, which is characterized by increased bone mass and density due to hyperactive osteoblast function. Here we demonstrate that prostaglandin E2 (PGE2), a paracrine factor with pleiotropic effects on osteoblasts and osteoclasts, decreases Sclerostin expression in osteoblastic UMR106.01 cells. Decreased Sost expression correlates with increased expression of Wnt/TCF target genes Axin2 and Tcf3. We also show that the suppressive effect of PGE2 is mediated through a cyclic AMP/PKA pathway. Furthermore, selective agonists for the PGE2 receptor EP2 mimic the effect of PGE2 upon Sost, and siRNA reduction in Ptger2 prevents PGE2-induced Sost repression. These results indicate a functional relationship between prostaglandins and the Wnt/β-catenin signaling pathway in bone

Rescuing Loading Induced Bone Formation at Senescence

The increasing incidence of osteoporosis worldwide requires anabolic treatments that are safe, effective, and, critically, inexpensive given the prevailing overburdened health care systems. While vigorous skeletal loading is anabolic and holds promise, deficits in mechanotransduction accrued with age markedly diminish the efficacy of readily complied, exercise-based strategies to combat osteoporosis in the elderly. Our approach to explore and counteract these age-related deficits was guided by cellular signaling patterns across hierarchical scales and by the insight that cell responses initiated during transient, rare events hold potential to exert high-fidelity control over temporally and spatially distant tissue adaptation. Here, we present an agent-based model of real-time Ca2+/NFAT signaling amongst bone cells that fully described periosteal bone formation induced by a wide variety of loading stimuli in young and aged animals. The model predicted age-related pathway alterations underlying the diminished bone formation at senescence, and hence identified critical deficits that were promising targets for therapy. Based upon model predictions, we implemented an in vivo intervention and show for the first time that supplementing mechanical stimuli with low-dose Cyclosporin A can completely rescue loading induced bone formation in the senescent skeleton. These pre-clinical data provide the rationale to consider this approved pharmaceutical alongside mild physical exercise as an inexpensive, yet potent therapy to augment bone mass in the elderly. Our analyses suggested that real-time cellular signaling strongly influences downstream bone adaptation to mechanical stimuli, and quantification of these otherwise inaccessible, transient events in silico yielded a novel intervention with clinical potential

Prevention of vertical transmission of human immunodeficiency type 1 virus in a managed care setting

The original publication is available at http://www.samj.org.zaPlease cite as follows: Regensberg, L., Pead, C., Mahumapelo, J. & Cotton, M. 2000. Prevention of vertical transmission of human immunodeficiency type 1 virus in a managed care setting. South African Medical Journal, 90(11):1093-1094.[No abstract available]Publisher’s versio

Assessment: Cinderella or Sleeping Beauty? Evolution of Final Examinations at the Royal Veterinary College

Teachers of veterinary medicine frequently regard assessment as a Cinderella subject. Consciously or unconsciously, they allow assessment systems to become faithful slaves, brought out and dusted off when required, out of sight and out of mind at other times. This often means that assessment Is last on the priority list when educational development Is considered. Pedagogical literature is full of references to the power of appropriate assessment systems and the role that they can play In shaping and driving the learning environment. "Assessment drives learning" and "Students respect what Is Inspected" are the headlines associated with such references, and this viewpoint places assessment much more In the role of a Sleeping Beauty, requiring only a simple touch to become a vehicle for modernizing an educational system. This article uses an example of change to a UK veterinary final examination to present the tensions between these contrasting views, and some solutions for them, In an effort to fuel the debate on improving the use of assessment