The intra-articular administration of triamcinolone hexacetonide in the treatment of osteoarthritis. Its effects in a naturally occurring canine osteoarthritis model

Objective To evaluate the effect of an intra-articular (IA) administration of triamcinolone hexacetonide, compared with saline. Patients and methods Forty (N = 40) hip joints were randomly assigned to a treatment group (THG, n = 20, receiving IA triamcinolone hexacetonide) and a control group (CG, n = 20, receiving IA saline). On treatment day (T0), and at 8, 15, 30, 90 and 180 days post-treatment, weight distribution, joint range of motion, thigh girth, digital thermography, radiographic signs, synovial fluid interleukin-1 and C-reactive protein levels were evaluated. Data from four Clinical Metrology Instruments was also gathered. Results were compared Repeated Measures ANOVA, with a Huynh-Feldt correction, Paired Samples T-Test or Wilcoxon Signed Ranks Test. A Kaplan-Meier test was performed to compare both groups, with p<0.05. Results Joints were graded as mild (65%), moderate (20%) and severe (15%). Patients of both sexes, with a mean age of 6.5±2.4 years and bodyweight of 26.7±5.2kg, were included. No differences were found between groups at T0. Comparing THG to CG, weight distribution showed significant improvements in THG from 8 (p = 0.05) up to 90 days (p = 0.01). THG showed lower values during thermographic evaluation in the Lt view (p<0.01). Pain and function scores also improved from 30 to 180 days. Increasing body weight, age, and presence of caudolateral curvilinear osteophyte corresponded to worse response to treatment. Results of the Kaplan Meier test showed significant differences between groups, with THG performing better considering several evaluations and scores. Conclusion THG recorded significant improvements in weight-bearing and in with the considered CMIs, particularly pain scores. Lower thermographic values were registered in THG up to the last evaluation day. Age, sex, and radiographic findings did significantly influenced response to treatment.

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Effect of a single intra-articular high molecular weight hyaluronan in a naturally occurring canine osteoarthritis model: a randomized controlled trial

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02423-4 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

J. C. Alves ◽

Ana Margarida Moniz Pereira dos Santos ◽

Patrícia Jorge ◽

Catarina Falcão Trigoso Vieira Bran Lavrador ◽

L. Miguel Carreira

Keyword(s):

Repeated Measures ◽

Financial Burden ◽

Controlled Trial ◽

Interleukin 1 ◽

Well Being ◽

Joint Disease ◽

Response To Treatment ◽

Control Group ◽

Paired Samples ◽

Treatment Experiment

Abstract Background Osteoarthritis (OA) is a complex joint disease and chronic pain source, affecting a patient’s quality of life and posing a financial burden. As the dog is considered a nearly ideal species for translation research of human OA and the most used model for research, exploring spontaneous dog OA under the One Health/One Medicine concept can improve both humans and dogs’ health and well-being. Methods In a clinical treatment experiment, forty (N=40) joints were selected and randomly assigned to a control group (CG), which received 0.9% NaCl or a treatment (HG), which received Hylan G-F 20. Evaluations were performed on treatment day (T0), 8, 15, 30, 90, and 180 days post-treatment. They consisted of four different Clinical Metrology Instruments (CMI), evaluation of weight distribution, joint range of motion, thigh girth, radiographic and digital thermography imaging, synovial fluid interleukin-1 (IL-1), and C-reactive protein concentrations. Results were compared with repeated measures ANOVA, with a Huynh-Feldt correction, Paired samples T-test, or Wilcoxon signed-ranks test, with p<0.05. Results Patients had a mean age of 6.5±2.4 years and a bodyweight of 26.6±5.2kg, and joints graded as mild (n=28, 70%), moderate (n=6, 15%), and severe OA (n=6, 15%). No differences were found between groups at T0. Symmetry index and deviation showed significant improvements in HG from 30 days (p<0.01) up to 180 days (p=0.01). Several CMI scores, particularly pain scores, improved from 90 to 180 days. Radiographic signs progressed in both groups. In both groups, increasing body weight and age corresponded to worse clinical presentation. IA hyaluronan administration produced increased lameness in six cases, which resolved spontaneously. Conclusions This study characterizes the response to treatment with Hylan G-F 20, which can produce significant functional and pain level improvements in patients with OA, even those with factors related to worse response to treatment.

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Management of Osteoarthritis Using 1 Intra-articular Platelet Concentrate Administration in a Canine Osteoarthritis Model

The American Journal of Sports Medicine ◽

10.1177/0363546520981558 ◽

2021 ◽

pp. 036354652098155

Author(s):

João Carlos Agostinho Alves ◽

Ana Margarida Moniz Pereira dos Santos ◽

Patrícia Isabel Figueiredo Jorge ◽

Catarina Falcão Trigoso Vieira Branco Lavrador ◽

Luis Miguel Alves Carreira

Keyword(s):

Body Weight ◽

Repeated Measures ◽

Interleukin 1 ◽

Canine Model ◽

Platelet Concentrate ◽

Rank Test ◽

Control Group ◽

Laboratory Findings ◽

Paired Samples ◽

Naturally Occurring

Background: Osteoarthritis (OA) represents a significant burden to societies, as it affects quality of life and performance and implies a large cost in terms of health care. Autologous platelets are a regenerative treatment modality for OA that are thought to be a potential stimulation of the natural healing cascade. Purpose: To describe the effect of the platelet concentrate V-PET in the management of OA in a naturally occurring canine model, using several outcome assessment modalities. Study Design: Controlled laboratory study. Methods: A total of 40 joints of active working police dogs with hip OA were randomly assigned to a control group (CG) and a platelet concentrate group (PCG; treatment) and evaluated. At treatment day (T0) and 8, 15, 30, 90, and 180 days after treatment, weight distribution, joint range of motion at flexion and extension, thigh girth, digital thermography, radiographic signs, 4 clinical metrology instruments, and synovial fluid interleukin 1 and C-reactive protein levels were recorded. Results were compared using repeated-measures analysis of variance with a Huynh-Feldt correction, paired-samples t test, or Wilcoxon signed rank test, with P < .05. Results: Dogs were 6.5 ± 2.4 years old (mean ± SD) and had a body weight of 26.7 ± 5.2 kg. At T0, 32 (80%) joints were graded as having mild OA, 6 (15%) as moderate, and 2 (5%) as severe. No differences were found between groups at T0. Between the PCG and CG, the symmetry index showed significant improvements in the PCG from 8 days ( P = .01) to 180 days ( P = .01). Joint flexion also improved in the PCG up to 90 days ( P < .05) and extension improved up to 180 days ( P < .01). Several clinical metrology instrument scores also improved up to 90 to 180 days after treatment. In the CG, radiographic signs progressed, while the PCG showed some improved signs. In both groups, increasing body weight and age corresponded with worse clinical and laboratory findings. Conclusion: A single injection of platelet concentrate had a positive effect, lasting up to 6 months, on several clinical, imaging, and laboratory signs in a naturally occurring canine OA model. Clinical Relevance: We characterized the effects of this platelet concentrate in dogs, considered the gold standard of the study of OA, with a group of working animals with similar high demands as athletes.

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Impact of Mindfulness Training on Spanish Police Officers’ Mental and Emotional Health: a Non-Randomized Pilot Study

Mindfulness ◽

10.1007/s12671-022-01827-5 ◽

2022 ◽

Author(s):

Jaime Navarrete ◽

Miguel Ángel García-Salvador ◽

Ausiàs Cebolla ◽

Rosa Baños

Keyword(s):

Police Officers ◽

Repeated Measures ◽

Emotional Health ◽

Analysis Of Covariance ◽

Controlled Study ◽

Group Differences ◽

Control Group ◽

Depression Symptoms ◽

Control Group Design ◽

Paired Samples

Abstract Objectives The purpose of this exploratory non-randomized controlled study was to determine the acceptance and effectiveness of an 8-week mindfulness-based intervention (MBI) co-designed by a police officer. Methods A pretest-posttest control group design was followed. Participants (MBI group = 20; control group = 18) answered baseline and post-training self-reported measures. In addition, the weekly emotional state of the MBI group was collected. Paired-samples t-test and analysis of covariance were performed for pre-post within-group and between-group differences, respectively, as well as linear mixed effects analysis of repeated measures for week-by-week data. Results High acceptance and attendance rates, as well as significant pre-post within-group differences in the MBI group in mindfulness (η2 = 0.43), self-compassion (η2 = 0.43), depression (η2 = 0.54), anxiety (η2 = 0.46), stress (η2 = 0.51), difficulties in emotion regulation, sleep quality (η2 = 0.57), and burnout (η2 = 0.31–0.47), were identified. Moreover, police officers who underwent the MBI experienced a week by week decrease of anger, disgust, anxiety, sadness, and desire. Finally, after adjusting for pre-test scores, significant between-group differences were found in the way of attending to internal and external experiences (observing mindfulness facet; ηp2 = 0.21), depression symptoms (ηp2 = 0.23), general distress (ηp2 = 0.24), and the degree of physical and psychological exhaustion (personal burnout; ηp2 = 0.20). Conclusions The preliminary effectiveness of this MBI on psychopathology and quality of life outcomes in Spanish police officers was discussed. Previous evidence regarding the promising use of MBIs in this population was supported.

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Balance and postural control in basketball players

Fisioterapia em Movimento ◽

10.1590/1980-5918.030.002.ao12 ◽

2017 ◽

Vol 30 (2) ◽

pp. 319-328 ◽

Cited By ~ 2

Author(s):

Murilo Curtolo ◽

Helga Tatiana Tucci ◽

Tayla P. Souza ◽

Geiseane A. Gonçalves ◽

Ana C. Lucato ◽

...

Keyword(s):

Postural Control ◽

Repeated Measures ◽

Balance Control ◽

Weight Bearing ◽

Cross Sectional Study ◽

Control Group ◽

Basketball Players ◽

Balance Test ◽

Cross Sectional ◽

Step Down

Abstract Introduction: Basketball is one of the most popular sports involving gestures and movements that require single-leg based support. Dorsiflexion range of motion (DROM), balance and postural control may influence the performance of this sport. Objective: To compare and correlate measures of balance, postural control and ankle DROM between amateur basketball athletes and non-athletes. Methods: Cross-sectional study, composed by 122 subjects allocated into one control group (CG = 61) and one basketball group (BG = 61). These groups were subdivided into two other groups by age: 12-14 years and 15-18 years. The participants were all tested for postural balance with the Star Excursion Balance Test (SEBT), postural control with the Step-down test and DROM with the Weight-bearing lunge test (WBLT). Between-groups differences were compared using repeated-measures multivariate analysis of variance. Normalized reaching distances were analyzed and correlated with the WBLT and Step-down test. Results: There was no difference in the scores of WBLT (P = .488) and Step-down test (P =. 916) between the groups. Scores for the anterior reach (P = .001) and total score of SEBT (P = .030) were higher in BG. The values for the posterolateral (P = .001) and posteromedial reach (P = .001) of SEBT were higher in BG at the age of 15-18. The correlation between the anterior reach of the SEBT and WBLT was significant in BG between 12-14 years (r = 0.578, P = .008), and in the CG between 15-18 years (r = 0.608, P=.001). Conclusion: The balance was better in the BG, although adolescents between 15-18 years have better balance control for the posteromedial and posterolateral reaches of the SEBT.

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101 Effects of Active Immunization Against GnRH in Oocyte Donors with Cystic Ovarian Disease

Reproduction Fertility and Development ◽

10.1071/rdv30n1ab101 ◽

2018 ◽

Vol 30 (1) ◽

pp. 190

Author(s):

O. A. C. Faria ◽

L. R. O. Dias ◽

L. Leme ◽

G. Fernandes ◽

A. A. G. Fidelis ◽

...

Keyword(s):

Repeated Measures ◽

Endometrial Thickness ◽

Active Immunization ◽

Response To Treatment ◽

Control Group ◽

Individual Response ◽

Embryo Production ◽

Ovarian Disease ◽

Oocyte Donors ◽

Cystic Ovarian Disease

Cows intensively used as oocyte donors for in vitro embryo production (IVEP) are usually kept nonpregnant for prolonged intervals, exposed to successive hormonal treatments, and frequently become overweight. These are all risk factors for the development of endocrine unbalance and, consequently, cystic ovarian disease (COD). The aim of this study was to evaluate the effect of active immunization against gonadotropin-releasing hormone (GnRH) on (1) ovarian follicular population, and (2) development potential of oocytes used for IVEP. Nelore (Bos indicus) cows (n = 14), previously diagnosed with chronic COD (Faria et al. 2017 Anim. Reprod., in press), weighing 620.0 ± 12.8 kg and with body condition score of 4.1 ± 0.2, were assigned to control (n = 6) or treatment (n = 8) group. Cows in the treatment group received 2 SC injections of 1.0 mL of anti-GnRH vaccine (Bopriva, Zoetis, Brazil), 28 days apart (weeks 0 and 4), whereas cows in the control group received placebo on the same schedule. Transrectal ultrasonography was performed weekly from week 0 to evaluate the number and distribution of follicles among size classes, endometrial thickness, and clinical presence of mucometra. Immunization was considered effective (E-IM) when no follicles ≥5.0 mm were observed on the ovaries during a given examination. Cows having E-IM were then used as oocyte donors for IVEP. Cumulus-oocyte complexes (COC) were collected in 5 consecutive ovum pick-up weekly sessions. As a control for IVEP, oocytes from a slaughterhouse were used, with similar procedures performed on the same days and using the same semen batch. The MIXED procedure of SAS (SAS Institute Inc., Cary, NC, USA) with repeated-measures statement was used to evaluate the effects of treatment, time, and interactions on ovarian endpoints; and the GLM procedure was used to analyse embryo production data. Results are shown as mean ± SEM. There were time and time × treatment effects on ovarian parameters. Treated cows had a decrease (P < 0.05) in the average diameter of the largest follicle and in the number of follicles ≥8 mm, and an increase (P < 0.05) in follicular population after week 6. Nonetheless, individual response to treatment was variable: only 50% of the cows (4 of 8) were E-IM at week 8, whereas 25% (2 of 8) still had COD (largest follicle ≥18.0 mm) at this timepoint. Overall, a negative correlation was detected between follicular population and the diameter of the largest follicle (r = –0.60, P < 0.0001) or the number of follicles ≥8 mm (r = –0.47, P < 0.0001). There was no effect (P > 0.05) of treatment on endometrial thickness or mucometra score. Cows with E-IM produced 22.2 ± 3.6 total and 12.9 ± 2.3 viable COC. Cleavage rate did not differ between E-IM and control (slaughterhouse) oocytes (70.8 ± 7.0 v. 75.1 ± 3.0%, respectively; P > 0.05); however, blastocyst rate was greater in the E-IM group compared with controls (39.7 ± 5.5 v. 20.5 ± 4.7%, respectively; P < 0.02). In summary, our results suggest that active immunization against GnRH leads to variable results in the distribution of the follicular population in cows with COD, but it does not negatively affect IVEP efficiency. This research was supported by Zoetis, CNPq, and CAPES.

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4 Induction of ovulation by kisspeptin in llamas

Reproduction Fertility and Development ◽

10.1071/rdv31n1ab4 ◽

2019 ◽

Vol 31 (1) ◽

pp. 127 ◽

Cited By ~ 2

Author(s):

R. A. Carrasco ◽

C. E. Leonardi ◽

K. D. Hutt ◽

J. Singh ◽

G. P. Adams

Keyword(s):

Body Weight ◽

Corpus Luteum ◽

Repeated Measures ◽

Ovarian Function ◽

Gnrh Receptor ◽

Response To Treatment ◽

Transrectal Ultrasonography ◽

Control Group ◽

Gnrh Analogue ◽

Dominant Follicle

After mating, female camelids ovulate in response to nerve growth factor (NGF) present in semen (formerly referred to as ovulation-inducing factor). The ovulatory effect appears to be induced by stimulation of hypothalamic gonadotropin-releasing hormone (GnRH) neuronal activity and LH secretion. Recent studies have identified kisspeptin as an important mediator of GnRH secretion in several species. In the present study, we tested the hypothesis that kisspeptin is involved in the ovulatory pathway in llamas and investigated the mechanism of this effect. In Experiment 1, ovarian function in non-pregnant, non-lactating adult female llamas was synchronized by intramuscular administration of a GnRH analogue (50µg of gonadorelin acetate; Fertiline, Vetoquinol, Quebec, QC, Canada). When a growing dominant follicle ≥8mm in diameter was detected, llamas were assigned randomly to 3 treatment groups and given an intravenous dose of purified seminal NGF (1mg, single dose; n=5), kisspeptin (0.1mg kg−1 of body weight, 2 doses 1h apart; n=5), or PBS (n=4). The bioactive 10 amino acid fragment of murine kisspeptin was used. Ovulation and corpus luteum development were assessed by transrectal ultrasonography every other day from the day of treatment (Day 0) to Day 8. In Experiment 2, ovarian function among female llamas was synchronized, as in Experiment 1. When a growing dominant follicle ≥8mm in diameter was detected, llamas were given kisspeptin (0.1mg kg−1 of body weight IV, 2 doses 1h apart) beginning 2h after pretreatment with either a GnRH receptor blocker (cetrorelix acetate, 1.5mg per llama IV; Sigma, Oakville, ON, Canada; n=6) or saline (n=6). Llamas were examined 48h later by transrectal ultrasonography to detect ovulation and 8 days later to determine the presence of a corpus luteum. Chi-square tests were used to compare ovulation rates, and ANOVA for repeated measures was used to compare diameter profiles of the corpus luteum. In Experiment 1, ovulation rate did not differ between the NGF and kisspeptin groups (5/5 in each; 100%) and was greater than in the control group (0/4; 0% P<0.05). Corpus luteum diameter did not differ between llamas that ovulated in response to treatment with NGF or kisspeptin (13.2±0.8 and 14.0±1.2mm on Day 8, respectively). In Experiment 2, none of the llamas pretreated with cetrorelix ovulated in response to kisspeptin treatment (0/6; 0%), whereas all of the llamas pretreated with saline ovulated in response to kisspeptin treatment and had a corpus luteum at Day 8 (6/6; 100%; P<0.05). Results supported the hypothesis that kisspeptin induces ovulation in llamas. Because a GnRH receptor antagonist blocked ovulation, our interpretation is that the site of action of kisspeptin is upstream of the pituitary gland and involves control of GnRH release from the hypothalamus. These findings raise the possibility that kisspeptin mediates the ovulation-inducing effect of NGF. Research was supported by the Natural Sciences and Engineering Research Council of Canada.

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Vertical force analysis in dogs with hip osteoarthritis undergoing treatment with chondroprotectors

Revista Acadêmica Ciência Animal ◽

10.7213/academica.14.2016.02 ◽

2016 ◽

Vol 14 ◽

pp. 19

Author(s):

Alexandre Navarro Alves Souza ◽

Julia Maria Matera

Keyword(s):

Repeated Measures ◽

Chondroitin Sulphate ◽

Weight Bearing ◽

Hip Osteoarthritis ◽

Treated Group ◽

Control Group ◽

Vertical Force ◽

Significance Level ◽

Healthy Group ◽

Post Hoc

This study was aimed at evaluating vertical forces generated during locomotion in dogs affected with hiposteoarthritis (OA) submitted to chondroprotective treatment with chondroitin sulphate and lucosamine(CS-GLU). Eighteen dysplastic dogs suffering from secondary bilateral hip OA and treated with CS-GLU(200mg and 300mg/10kg/SID respectively) for 60 days (treated group), and 18 lameness free dogs withnormal hip joints (healthy group) were evaluated. A pressure sensitive walkway was used to measure peakvertical force (PVF), vertical impulse (VI) and stance phase (SP) duration. Data collection was performed prior to and within 30 and 60 days of treatment (treated group), or on a single occasion (healthy group). Longitudinal and intergroup comparisons were made using repeated measures ANOVA followed by the Tukey post-hoc test and the unpaired t-test respectively, with a significance level of 5% (p<0.05). Mean peak vertical force did not differ significantly within the treated group. However, mean PVF and VI were lower in the treated compared to the control group. A slight increase in mean VI was documented in one treated limbat time points 30 and 60. Results of this study suggest hip OA leads to decreased weight bearing and treatmentwith CS-GLU does not improve PVF in the short term.

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Intraarticular triamcinolone hexacetonide, stanozolol, Hylan G-F 20 and platelet concentrate in a naturally occurring canine osteoarthritis model

Scientific Reports ◽

10.1038/s41598-021-82795-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

J. C. Alves ◽

A. Santos ◽

P. Jorge ◽

C. Lavrador ◽

L. Miguel Carreira

Keyword(s):

Clinical Signs ◽

Platelet Concentrate ◽

Controlled Study ◽

Control Group ◽

Functional Evaluation ◽

Distribution Analysis ◽

Significance Level ◽

Triamcinolone Hexacetonide ◽

Kaplan Meier ◽

Prospective Longitudinal

AbstractOsteoarthritis (OA) is a disease transversal to all mammals, a source of chronic pain and disability, a huge burden to societies, with a significant toll in healthcare cost, while reducing productivity and quality of life. The dog is considered a useful model for the translational study of the disease, closely matching human OA, with the advantage of a faster disease progression while maintaining the same life stages. In a prospective, longitudinal, double-blinded, negative controlled study, one hundred (N = 100) hip joints were selected and randomly assigned to five groups: control group (CG, n = 20, receiving a saline injection), triamcinolone hexacetonide group (THG, n = 20), platelet concentrate group (PCG, n = 20), stanozolol group (SG, n = 20) and hylan G-F 20 group (HG). Evaluations were conducted on days 0 (T0, treatment day), 8, 15, 30, 60, 90, 120, 150 and 180 days post-treatment, consisting of weight distribution analysis and data from four Clinical Metrology Instruments (CMI). Kaplan–Meier estimators were generated and compared with the Breslow test. Cox proportional hazard regression analysis was used to investigate the influence of variables of interest on treatment survival. All results were analyzed with IBM SPSS Statistics version 20 and a significance level of p < 0.05 was set. Sample included joints of 100 pelvic limbs (of patients with a mean age of 6.5 ± 2.4 years and body weight of 26.7 ± 5.2 kg. Joints were graded as mild (n = 70), moderate (n = 20) and severe (n = 10) OA. No differences were found between groups at T0. Kaplan–Meier analysis showed that all treatments produced longer periods with better results in the various evaluations compared to CG. Patients in HG and PCG took longer to return to baseline values and scores. A higher impact on pain interference was observed in THG, with a 95% improvement over CG. PCG and HG experienced 57–81% improvements in functional evaluation and impairments due to OA, and may be a better options for these cases. This study documented the efficacy of several approaches to relieve OA clinical signs. These approaches varied in intensity and duration. HG and PCG where the groups were more significant improvements were observed throughout the follow-up periods, with lower variation in results.

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NILAI ANKLE BRACHIAL INDEX PADA PENDERITA DIABETES MELITUS TIPE 2 SESUDAH MELAKUKAN BUERGER ALLEN EXERCISE DI PUSKESMAS WILAYAH KECAMATAN NGANJUK

Jurnal Penelitian Keperawatan ◽

10.32660/jurnal.v4i1.318 ◽

2018 ◽

Vol 4 (1) ◽

Author(s):

Supriyadi . ◽

Nurul Makiyah ◽

Novita Kurnia Sari

Keyword(s):

Ankle Brachial Index ◽

Control Group ◽

P Value ◽

Test Design ◽

Purposive Sampling ◽

Paired Samples ◽

Post Test ◽

Diabetes Melitus

Buerger Allen Exercise mampu meningkatkan pemakaian glukosa oleh otot yang aktif sehingga glukosa dalam darah dapat menurun, dapat membantu mencegah terjadinya penyakit arteri perifer, serta meningkatkan aliran darah ke arteri dan berefek positif pada metabolisme glukosa. Penelitian ini bertujuan untuk mengetahui nilai ankle brachial indexpada penderita diabetes melitus tipe 2setelah melakukan Buerger Allen exercise. Jenis penelitian ini adalah quasy-experiment dengan pre-post test design with control group. Jumlah sampel 60 penderita diabetes melitus tipe 2 dengan purposive sampling, dibagi menjadi 2 kelompok yaitu kelompok perlakuan dan kelompok kontrol. Responden kelompok perlakuan diberikan intervensi Buerger Allen exercise sebanyak 12 kali selama 15 hari.Penelitian dilakukan di wilayah Puskesmas Kecamatan Nganjuk.Data hasilpengukuran nilai ankle brachial indexberupa ratio dan diuji statistik dengan Paired Samples Test. Didapatkan p value 0.001 untuk kelompok perlakuan (p value< 0.05) yang menunjukkan bahwa adanya perubahan bermakna secara statistik nilai ankle brachial index sesudah melakukan Buerger Allen exercise. Dapat disimpulkan bahwa nilai ankle brachial indexpada penderita diabetes melitus tipe 2 meningkat sesudah melakukan Buerger Allen exercise. Kata kunci :penderita diabetes melitus tipe2, Buerger Allen Exercise, Ankle brachial index

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Intracisternal BioGlue injection in the fetal lamb: a novel model for creation of obstructive congenital hydrocephalus without additional chemically induced neuroinflammation

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.6.peds19141 ◽

2019 ◽

Vol 24 (6) ◽

pp. 652-662 ◽

Cited By ~ 1

Author(s):

Marc Oria ◽

Soner Duru ◽

Federico Scorletti ◽

Fernando Vuletin ◽

Jose L. Encinas ◽

...

Keyword(s):

Calcium Binding ◽

Repeated Measures ◽

Obstructive Hydrocephalus ◽

Critical Threshold ◽

Control Group ◽

Chronic Obstructive ◽

Fetal Sheep ◽

Cisterna Magna ◽

Lateral Ventricles ◽

Fetal Lamb

OBJECTIVEThe authors hypothesized that new agents such as BioGlue would be as efficacious as kaolin in the induction of hydrocephalus in fetal sheep.METHODSThis study was performed in 34 fetal lambs randomly divided into 2 studies. In the first study, fetuses received kaolin, BioGlue (2.0 mL), or Onyx injected into the cisterna magna, or no injection (control group) between E85 and E90. In the second study, fetuses received 2.0-mL or 2.5-mL injections of BioGlue into the cisterna magna between E85 and E90. Fetuses were monitored using ultrasound to assess lateral ventricle size and progression of hydrocephalus. The fetuses were delivered (E120–E125) and euthanized for histological analysis. Selected brain sections were stained for ionized calcium binding adaptor 1 (Iba1) and glial fibrillary acidic protein (GFAP) to assess the presence and activation of microglia and astroglia, respectively. Statistical comparisons were performed with Student’s t-test for 2 determinations and ANOVA 1-way and 2-way repeated measures for multiple determinations.RESULTSAt 30 days after injection, the lateral ventricles were larger in all 3 groups that had undergone injection than in controls (mean diameter in controls 3.76 ± 0.05 mm, n = 5). However, dilatation was greater in the fetuses injected with 2 mL of BioGlue (11.34 ± 4.76 mm, n = 11) than in those injected with kaolin (6.4 ± 0.98 mm, n = 7) or Onyx (5.7 ± 0.31 mm, n = 6) (ANOVA, *p ≤ 0.0001). Fetuses injected with 2.0 mL or 2.5 mL of BioGlue showed the same ventricle dilatation but it appeared earlier (at 10 days postinjection) in those injected with 2.5 mL. The critical threshold of ventricle dilatation was 0.1 for all the groups, and only the BioGlue 2.0 mL and BioGlue 2.5 mL groups exceeded this critical value (at 30 days and 18 days after injection, respectively) (ANOVA, *p ≤ 0.0001). Moderate to severe hydrocephalus with corpus callosum disruption was observed in all experimental groups. All experimental groups showed ventriculomegaly with significant microgliosis and astrogliosis in the subventricular zone around the lateral ventricles. Only kaolin resulted in significant microgliosis in the fourth ventricle area (ANOVA, *p ≤ 0.005).CONCLUSIONSThe results of these studies demonstrate that BioGlue is more effective than Onyx or kaolin for inducing hydrocephalus in the fetal lamb and results in a volume-related response by obstructive space-occupancy without local neuroinflammatory reaction. This novel use of BioGlue generates a model with potential for new insights into hydrocephalus pathology and the development of therapeutics in obstructive hydrocephalus. In addition, this model allows for the study of acute and chronic obstructive hydrocephalus by using different BioGlue volumes for intracisternal injection.

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