A comprehensive presentation about lameness in equine Covering almost all musculoskeletal and metabolic neurological diseases rendering a horse lame. Lameness examination i also explained.
The Importance of Good Handling Skills for Dairy CowsDAIReXNET
Dr. Proudfoot presented this information for DAIReXNET on November 5, 2015. To see the full recorded webinar, please visit http://www.extension.org/pages/15830/archived-dairy-cattle-webinars
A comprehensive presentation about lameness in equine Covering almost all musculoskeletal and metabolic neurological diseases rendering a horse lame. Lameness examination i also explained.
The Importance of Good Handling Skills for Dairy CowsDAIReXNET
Dr. Proudfoot presented this information for DAIReXNET on November 5, 2015. To see the full recorded webinar, please visit http://www.extension.org/pages/15830/archived-dairy-cattle-webinars
Powerpoint complimenting written lecture notes discussing equine and food animal castration, surgical considerations, and complications. Prepared for lecture to 2nd year veterinary students.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
1. Pre-Purchase Exams
for the Horse
Dane Tatarniuk, DVM
Equine Surgery & Sports Medicine
University of Minnesota Equine Center
2. What?
• What is a pre-purchase exam?
• House inspection prior to purchase
• Mechanic check on a car prior to purchase
• Also called ‘soundness exams’, ‘vettings’
3. Why?
• Why perform a pre-purchase exam?
• Horses are rarely purchased just to be ‘pets’
• Most often, athletic use or reproductive function desired by buyer
• Rarely, deals are ‘money back’ guarantees by seller
• Information for buyer to negotiate with seller on the price of the
horse
• Goal:
• Determine if there are any limitations in health or soundness that
preclude the horse from performing its anticipated purpose at
present time
• Gain knowledge of any early disease, previous injuries or preexisting abnormalities that may limit the use of the horse in the
future
4. Why?
• The exam does not involve an assessment or guarantee of the
trainability or behaviour of the horse
• Evaluation for a horse to be ‘serviceable’ for a discipline
• No evaluation of a horses ‘suitability’ for a discipline
5. “The veterinarian’s job is neither to pass or fail an animal.”
“Rather, it is to provide the buyer with information regarding
any existing medical problems and to discuss those problems
with you so that you can make an informed purchase decision.”
“Your veterinarian can advise you about the horse’s current
physical condition, but he or she cannot predict the future. The
decision to buy is the buyers alone to make.”
AAEP Client Handout “Don’t Skip the Purchase Exam”
6. Who?
• Parties involved:
• Buyer / Buyer’s Agent
• Pays for the examination
• Determines which veterinarian will perform the exam
• Seller / Seller’s Agent
• Current owner or agent of the horse involved
• Should provide an honest medical history of the horse, including any
previous diagnostic imaging exams performed prior
• Gives permission for veterinarian to perform examination and
procedures on the animal
• Can deny certain procedures to be performed
• Veterinarian
• Needs to provide disclaimer to buyer if there is a conflict of interest
• Ie, if veterinarian has previously worked on the horse up for sale or has
relationship with the seller
• Additional members present
• Ie, technicians, vet students
• Document as they are witnesses to the examination
7. Where?
• Can be performed in a clinic or on-farm
• Provide yourself with a generous amount of time to perform
the exam
• ie, most exams take at least 1-2 hours to perform
• Important to document any environmental influences that
could interfere with assessment of horse
• ie, uneven surface for trotting, no hard ground, poor lighting,
distractions or background noise
8. Buyer’s Questionnaire
• Before the exam
• Establish the cost of the pre-purchase exam with the buyer
• Questions to consider asking the buyer
• How much do you know about the horse?
• Have you had the chance to ride/work the horse?
• What is your intended use for the horse?
• Short term goals (ie, riding)
• Long term goals (ie, breeding)
• As the veterinarian, you do not need to know / get involved in
the asking price of the horse
• Whether it is a $500 or $500,000 value, treat the exam the same.
9. Seller’s Questionnaire
• Opportunity for seller to fully disclose history of the horse
• Questions:
•
•
•
•
Level of current work / discipline?
How long has seller owned the horse?
Vaccines / Deworming / Coggins?
Previous medical history?
• Ie, respiratory infections, colics, etc.
• Previous surgeries?
• Ie, colic, arthroscopy, upper airway surgery, etc.
• Previous lameness?
• Ie, joint injections, supplements, etc.
• Previous or current medication?
• Stereotypies?
• Cribbing, weaving, head tossing, biting, kicking, etc.
10. Examination
• Be thorough
• Examine any and every aspect of the horse
• This should be the most complete exam you will perform in
veterinary medicine
• Document everything, even if you are unsure of the clinical
significance
11. Basics of the Exam
•
•
•
•
Confirm breed of horse
Document any tattoos or brands present
Document the markings and color of the horse
Attain weight
• Either weight scale or weight tape
• Attain height
• Important in some disciplines for entering specific classes
• Temperature, heart rate, respiratory rate
• Document scars, skin lesions or growths
• ie, Grey horse = melanomas
• Sarcoids
12. Oral Exam
• Variable depending on practitioner
• At a minimum
• Check the incisor teeth to ensure the reported age roughly
matches the teeth
• Open the mouth (unsedated), grab the tongue and evaluate for
sharp points of enamel on the molars, wolf teeth, etc.
• Further examination
• Sedate the horse (with permission, and after lameness
evaluation)
• Open the mouth with a speculum, and fully evaluate all arcades
with dental mirror and probes
• Any significant concerns
• Recommend dental radiographs
13. Ophthalmological Exam
• At minimum,
• Evaluate both eyelids, the third eyelid, sclera, for any abnormal
masses or pigmentation
• Check direct/indirect pupillary light response
• Check menace response
• With ophthalmoscope, evaluate the cornea, anterior chamber,
iris, pupil, lens
• Further examination,
• Dilate the eye and examine the optic nerve, retina
• Tonometry of the globe
14. Auditory Exam
• Evaluate the inner aspect of the ears for any aural plaques or
abnormal skin growths
• Produce noise to determine horse can properly hear
15. Respiratory Exam
• At a minimum,
• Evaluate both nares for normal airflow, any nare pathology,
mucopurulent discharge or odor
• Percussion of the sinuses, evaluate facial bones for any
asymmetrical swelling
• Palpate the larynx, muscular process
• ‘Slap test’ for arytenoid abduction
• Look for ‘tie-back/tie-forward’ scars
• Palpate guttural pouches for swelling, fluid fill
• Palpate submandibular lymph nodes for enlargement
• Auscultate trachea & all areas of both sides of the lungs
• Further examination,
• Rebreathing exam with bag
• Upper airway endoscopy exam
16. Cardiovascular Exam
• At a minimum,
• Fully auscultate the heart, from both sides of the thorax, to
evaluate for any valve murmurs
• Auscultate heart for normal rhythm, normal rate
• ie, atrial fibrillation, 2nd degree AV block
• If 2nd degree AV block, exercise horse & see if block disappears
• Evaluate peripheral artery for pulse quality
• Facial artery on ventral aspect of mandible
• Evaluate both jugular veins for normal fill, patency
• Further evaluation
• ECG
• Cardiac ultrasound exam
17. Abdominal Exam
• At a minimum,
•
•
•
•
•
Palpate ventral midline to feel for previous colic surgery scar
Auscultate all four quadrants for normal gastrointestinal motility
Auscultate ventral abdomen for sand in large colon
Palpate flank for previous standing surgery incisional scars
Palpate for ventral midline, umbilical, abdominal, inguinal hernias
• Further examination,
• Rectal examination
• Get permission!
• Collect feces, add water, and float for sand
• Abdominal ultrasound exam
• Ie, SI/LI wall thickness, motility
• Abdominal radiographs
• Ie, enterolith
18. Urogenital Exam
• At a minimum,
• Examine external genitalia for any abnormalities
• In mares, evaluate perineal/vulvar conformation
• Check for Caslick stitch
• If a stud, palpate for two descended testicles into scrotum
• Further examination,
• Sedate studs & geldings to drop penis, evaluate for any masses or
growths
• Ie, squamous cell carcinoma
• Perform vaginal exam via vaginal speculum
• Uterine ultrasound, cytology, culture, biopsy
• Stallion collection, semen motility & morphology
19. Laboratory Tests
• Not all tests are routinely done, but any test available can be
offered to buyer based on the individual horse examined
• Most common,
• Complete Blood Count
• PCV/TP, RBC, WBC, Platelet, Fibrinogen
• Chemistry
• Muscle, Kidney, Liver, Electrolytes, Protein
• Urine Analysis
• More specific,
• Drug Testing
• Submit serum to a drug testing lab for surveillance of common
equine drugs
• Ie, NSAIDs, sedatives, steroids, etc.
• Genetic Testing
• HYPP, HERDA, Glycogen Branching Enzyme Deficiency, Cerebellar
Abiotrophy, PSSM, etc.
20. Conformation
• Stand the horse square and document any conformational
abnormalities
• ie, varus/valgus joints, cow hocked, sickle hocked, bench knees,
pigeon toes, toed out, etc.
• Document with pictures always beneficial
• Correlate conformational abnormality to any potential predisposition injury (due to abnormal loading)
• Evaluate foot conformation in all four feet
• Shod, unshod?
• Toe length, heel length, club foot, hoof wall defects, etc.
• Apply hoof testers to all four feet
21. Musculoskeletal - Passive
• Systematic palpation of the neck, back and pelvis
• For the neck, use treats to evaluate the range of motion in all
directions
• For the back, palpate the musculature and dorsal spinous
processes for reaction
• For the pelvis, evaluate the tuber coxae, ischii, sacrum for
symmetry
• Systematic palpation of the four limbs
• Proximal (top) to distal (bottom)
• Palpate each joint for effusion
• Palpate each tendon/ligament for thickening, swelling, pain to
palpation
• Palpate each joint for normal range of motion
22. Musculoskeletal - Active
• Walk, trot, canter horse
• In straight line and on lunge line (if possible)
• On soft surface and hard surface
• If abnormal gait is noted, first step is to evaluate whether
horse appears lame or neurological
• If appearing neurological (ataxic), perform basic neurological
examination
• If confirmed, likely a deal-breaker
• Identify the limbs of lameness, and assign appropriate grades
of lameness
• AAEP scale, grade 1 – 5
• Perform flexion tests
• Distal limb, carpus, stifle, upper hindlimb
23. Radiographs
• Based on passive and active musculoskeletal exam, assign
areas of concern & therefore recommended radiographs
• Based on budget, some buyers decline radiographs
• Other buyers elect to radiograph every joint
• Depending on the breed/age, certain joints are commonly
recommended to radiograph for surveillance
• Thoroughbreds
• Fetlocks, Carpus
• Young horses
• Hocks, Stifles (OCD)
• Quarter Horses
• Hocks, Navicular bones
25. Putting it all together…
• Go over the findings with the buyer
• Best to talk about the findings without the seller present
• You do not need to disclose your findings to the seller, unless
your buyer provides permission
• Remember, you work for the buyer!
• Remember, If there is a litigation suit that results later on, the
pre-purchase report is your defense
• Complete, thorough, detailed, etc.
26. Putting it all together…
• Report:
• Make the report organized
• State the location, time, all in attendance of the exam
• Digital advantage
• Take pictures of any external abnormalities
• Attach radiographs / endoscopy exam / ultrasound exam pictures
• Can even consider video of the movement exam, attached to report
• Include every aspect of the exam that you performed (list what is
normal, in addition to abnormalities)
• State the ancillary exams that were offered but declined by buyer
• State that the findings were discussed with the potential buyer
• Include a disclaimer statement