193 research outputs found

    Clinical insights: Diagnosis of laminitis

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    Laminitis in horses

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    Laminitis is a common and painful condition of adult equids that often results in permanent lameness or euthanasia. In recent years, our knowledge of the condition has developed and this article discusses the current understanding of laminitis and approaches to its treatment and prevention

    Prevalence of and risk factors for acute laminitis in horses treated with corticosteroids

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    A retrospective treated versus untreated study (study 1) and multicentre prospective cohort study (study 2) were undertaken to determine the prevalence of, and risk factors associated with, acute laminitis in horses treated with corticosteroids. All old treated with corticosteroids January–December 2014 (study 1) and January 2015–February 2017 (study 2) by two first opinion and referral hospitals in UK were included. Additionally, an untreated animal was identified for each treated animal (study one). Signalment, body condition (study 2 only), relevant medical history, primary condition, corticosteroid therapy prescribed and occurrence of acute laminitis during or within 14 days of cessation of corticosteroid treatment were recorded. For study 1, 205 cases and 205 controls were identified; two animals within each group (1 per cent) developed laminitis. In total, 1565 animals were included in study 2; laminitis period prevalence was 0.6 per cent (95 per cent CI 0.4 per cent to 1.2 per cent), with 10 cases in 1565 treated animals. There were significant associations between laminitis and breed (pony vs horse; p=0.01; univariable analysis only), the presence of a laminitis risk factor (history of laminitis or an underlying endocrinopathy; p<0.001; OR (95 per cent CI) 18.23 (5.05 to 65.87)) and body condition (overweight/obese vs not; p=0.04; OR (95 per cent CI) 4.0 (1.09 to 14.75))

    Hypercalcemia associated with a parathyroid cyst.

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    Parathyroid cysts are rare. When they do occur they usually have no demonstrable endocrine function, but may cause respiratory distress by tracheal compression or may be mistakenly diagnosed as thyroid carcinomas or adenomas. We report a case of a parathyroid cyst which presented with hypercalcemia. CASE REPORT: A fifty eight year old man undergoing routine investigations was found to have hypercalcaemia. His calcium level was elevated to 3.63 mmol/l and the serum parathyroid hormone level was 18.4 pmol/l (normal range 1.0- 5.3). Serum alkaline phosphatase was at the upper limit of normal at 1 1 3U/1. X-ray of the renal tract revealed no evidence of calcification. He was asymptomatic and had no palpable neck mass. Ultrasound examination revealed a 3 cm cyst-like structure inferior and posterior to the left lobe of the thyroid, with a well defined wall approximately 2 mm thick. Exploration of the neck revealed a large cyst (6.5 x 5 x 3 cm), which was removed and found to weigh 57 g. Three other parathyroid glands with a normal appearance were found. Macroscopic examination of the removed specimen showed a smooth lined cyst containing greasy, pearly material. Histology revealed a fibrous lined cyst, containing several islands of parathyroid tissue with clear cell cytology and moderate nuclear pleomorphism. Post-operatively serum calcium returned to normal. The patient was discharged on the fourth post-operative day. DISCUSSION Many theories have been advanced regarding the aetiology of parathyroid cysts. Goris1 was the first to report a case. Nylander2 has suggested that they arise from remnants of the third or fourth pharangeal pouch or are vestigia

    Systematic Literature Review of Systemic Corticosteroid Use for Asthma Management

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    Writing and editing assistance, including preparation of a draft manuscript under the direction and guidance of the authors, incorporating author feedback, and manuscript submission, was provided by Debra Scates, Ph.D., of JK Associates, Inc., and Michael A. Nissen, E.L.S., of AstraZeneca. This support was funded by AstraZeneca.Peer reviewedPublisher PD
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