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Summary: Definitive diagnosis of a deep digital flexor tendon insertional lesion within the right fore foot was made by magnetic resonance imaging (MRI) examination and the lesion subsequently treated by injection with platelet‐rich plasma. MRI was used to guide positioning of the needle to achieve highly accurate injection. The volume injected was found to approximate the calculated lesion volume. On the basis of experience with this case, MRI‐guided injection of insertional deep digital flexor tendon lesions of the foot of horses under general anaesthesia is practicable. This technique is likely to be more accurate than the other techniques described (computed tomography, ultrasonography) and carries no risk of exposure to radiation (radiography). [ABSTRACT FROM AUTHOR]

Objective: To determine the influence of breed (cob [CB] and non-cob [NC]), obturator type and surgical experience on the number of attempts, time taken and iatrogenic damage (ID) created when entering the digital flexor tendon sheath (DFTS) tenoscopically., Study Design: Prospective experimental cadaveric study., Animals: A total of 104 cadaver limbs., Methods: An equal number of randomly selected CB and NC limbs were operated using a conical obturator (OB) or a switching stick (SS) by one boarded (BS) and one resident surgeon (RS). Skin measurements, number of attempts and time taken to enter the DFTS were recorded. The DFTS was endoscopically examined and then dissected to record ID and cumulative ID calculated., Results: Mean CB skin thickness (8.4 mm) was nearly twice that of NC limbs (4.5 mm) (p < .001). Mean DFTS entry took longer in CB limbs (133 s) compared to NC limbs (112 s) (p = .02). BS mean entry time in CB limbs was 115 s compared to 46 s in NC limbs (p < .001). Cumulative ID was greater in CB limbs (25 of 52 limbs with ID) compared to NC limbs (14 of 52 limbs with ID) (p = .04). No difference was noted between obturators. Surgical experience reduced attempts and time entering the DFTS., Conclusion: Surgeons take longer to enter DFTS in CB limbs and more cumulative ID is created, regardless of obturator type used., Clinical Significance: Skin thickness is a major determinant of time taken to enter the DFTS and increases the risk of ID. Awareness of the challenges in CB limbs is important., (© 2024 American College of Veterinary Surgeons.)

Objective: To describe the surgical technique for removal of hoof wall masses in horses under standing sedation (SS) and local anesthesia (LA), and to report complications and long-term outcome following surgery., Study Design: Observational retrospective study., Animals: Client-owned horses (n = 30)., Methods: Horses undergoing keratoma removal under SS and LA in a single equine hospital between August 2016 and July 2023 were included in the study. Signalment, affected foot, history of lameness and/or foot abscesses, degree of lameness on admission, imaging findings (radiography and magnetic resonance imaging [MRI] when available), location of the mass, surgical technique, remedial farriery, postoperative care, complications and outcome were recorded. Long-term follow-up information was obtained by telephone questionnaire., Results: A total of 30 horses met the inclusion criteria. Duration of lameness ranged from 1 to 289 days (mean 90 days). The degree of lameness varied from absent to grade 4/5 (AAEP) (mean grade 3/5). All horses underwent preoperative radiographic examination and 14/30 underwent MRI. All horses underwent partial hoof wall resection. The surgery was performed safely in all cases. Postoperative complications included marked lameness in the early postoperative period in 3/30 horses and exuberant granulation tissue formation in 2/30 horses. Long-term (>6 months) follow-up information was available for 28 horses, and 26/28 horses returned to previous levels of exercise. Recurrence was suspected in 1/30 horses., Conclusions: The complication rate was lower than previously reported for keratoma removal under general anesthesia (GA)., Clinical Significance: Removal of hoof wall masses under SS and LA can be considered as an alternative to removal under GA., (© 2024 American College of Veterinary Surgeons.)

A newborn Thoroughbred filly presented with a large mass located on the ventro-rostral aspect of the mandible. The mass was surgically removed under general anaesthesia. Upon gross examination, the mass was well circumscribed with a heterogeneous lobulated appearance. The results of histopathology and immunohistochemistry were consistent with a diagnosis of congenital fetal rhabdomyoma. On follow-up at six months post-surgical excision, no abnormalities were noted on clinical examination., (© 2024 The Author(s). Veterinary Medicine and Science published by John Wiley & Sons Ltd.)

Objective: To determine the outcome of tenoscopically guided palmar/plantar annular ligament (PAL) desmotomy to treat PAL constriction without concurrent intrathecal soft-tissue injury, notably of the digital flexor tendons and manica flexoria., Study Design: Retrospective multicenter cohort study., Animals: Sixty-five horses., Methods: Horses from four UK equine hospitals, with digital flexor tendon sheath (DFTS) tenosynovitis, which underwent tenoscopically guided PAL desmotomy for treatment of PAL constriction between 2017 and 2022 were included. All horses had lameness isolated to the DFTS/PAL, and PAL constriction was diagnosed tenoscopically when there was difficulty maneuvering the endoscope into or through the fetlock canal. Horses with tearing of the digital flexor tendons and/or manica flexoria, or any other intrathecal pathology, were excluded. Follow up was via structured telephone questionnaire., Results: Follow up (median 25 months) was available for 61 horses with cobs and ponies predominating. Forty-two returned to their previous level of work, or a higher level, postoperatively and 50 owners were satisfied with the outcome of surgery. Eleven horses returned to lower level exercise, and six were retired/euthanized as they did not regain soundness. Fifty-two horses achieved soundness (median 3 months postoperatively)., Conclusion: Tenoscopically guided PAL desmotomy for the treatment of PAL constriction in the absence of intrathecal soft tissue injury had a good prognosis for return to previous levels of exercise in a UK horse population., Clinical Significance: The prognosis for horses undergoing tenoscopically guided PAL desmotomy to treat PAL constriction in the absence of intrathecal injury is better than previously described. Cobs and ponies seem to be predisposed to PAL constriction in agreement with the previous literature., (© 2024 The Author(s). Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.)

Background: Peritoneal fluid lactate concentration is an important diagnostic tool in horses with abdominal pain. Information on peritoneal lactate concentrations is lacking following parturition in the mare., Objectives: To compare blood and peritoneal lactate concentrations in a population of mares within 36 h post-partum, report a normal reference range and identify any impact of retained foetal membranes (RFMs)., Methods: This is a retrospective study evaluating healthy mares from which blood and peritoneal samples had been obtained within 36 h of parturition. Exclusion criteria included signs of abdominal pain within this period. Data was interrogated for normality using a Shapiro-Wilk test. Wilcoxon signed-rank test and Bland-Altman analysis were used to compare blood and peritoneal lactate concentrations. Linear regression was used to compare age and breed data with peritoneal lactate concentrations. Significance was defined as p < 0.05., Results: Forty mares met the inclusion criteria. Mean age was 12.6 ± 4.1 years, and most mares were multiparous (65%). Peritoneal lactate ((1.2 (IQR = 0.9-1.6) mmol/L) was increased compared to blood lactate concentration (0.7 (IQR = 0-1.1)mmol/L; p < 0.001). Plasma total protein (TP) concentrations were 68 (IQR = 64-74) g/L and peritoneal protein concentrations 8 (IQR = 4-9.7) g/L. Six mares developed RFM. The median fold-increase in peritoneal lactate concentration compared to blood lactate concentration was 0.9 (IQR: 0.01-1.7; range: 0-2.5). The reference range for peritoneal fluid lactate concentration was 0-2.5 mmol/L., Conclusion: Peritoneal lactate concentrations in healthy post-partum mares remained within the normal reference range and were not influenced by RFM or parturition. Increased peritoneal lactate in this group warrants further investigation., (© 2024 The Authors. Veterinary Medicine and Science published by John Wiley & Sons Ltd.)

Schizophrenia is thought to reflect aberrant connectivity within cortico-cortical and reentrant thalamo-cortical loops, which physiologically integrate and coordinate the function of multiple cortical and subcortical structures. Despite extensive research, reliable biomarkers of such "dys-connectivity" remain to be identified at the onset of psychosis, and before exposure to antipsychotic drugs. Because slow waves travel across the brain during sleep, they represent an ideal paradigm to study pathological conditions affecting brain connectivity. Here, we provide proof-of-concept evidence for a novel approach to investigate slow wave traveling properties in First-Episode Psychosis (FEP) with high-density electroencephalography (EEG). Whole-night sleep recordings of 5 drug-naïve FEP and 5 age- and gender-matched healthy control subjects were obtained with a 256-channel EEG system. One patient was re-recorded after 6 months and 3 years of continuous clozapine treatment. Slow wave detection and traveling properties were obtained with an open-source toolbox. Slow wave density and slow wave traveled distance (measured as the line of longest displacement) were significantly lower in patients (p < 0.05). In the patient who was tested longitudinally during effective clozapine treatment, slow wave density normalized, while traveling distance only partially recovered. These preliminary findings suggest that slow wave traveling could be employed in larger samples to detect cortical "dys-connectivity" at psychosis onset., (© 2024. The Author(s).)

Introduction: Intravenous ketamine (KET-IV) and intranasal esketamine (ESK-NS) are effective in the acute treatment of Treatment-Resistant Depression (TRD). Studies comparing KET-IV and ESK-NS concerning their action, safety, and tolerability are currently lacking., Materials and Methods: We combined patients' data from two unipolar TRD cohorts that received KET-IV (n = 171) at the Canadian Rapid Treatment Center of Excellence in Toronto, Canada, or ESK-NS (n = 140) at several TRD clinics in Italy. The Quick Inventory for Depression Symptomatology-Self-Report-16/QIDS-SR16 in the KET-IV group and Montgomery-Åsberg Depression Rating Scale/MADRS in the ESK-NS group measured depressive symptoms at baseline (T0) and after the acute treatment phase (T1) (i.e., four infusions of KET-IV and eight administrations of ESK-NS). As different scales were used, the primary outcome was to compare the improvement in depression severity in the two cohorts by measuring effect sizes, response and remission rates. Finally, we compare side effects and discontinuation rates., Results: At T1, KET-IV and ESK-NS significantly reduced depressive symptoms (respectively: QIDS-SR16 mean reduction = 5.65, p < 0.001; MADRS mean reduction = 11.41, p = 0.025). KET-IV showed larger effect sizes compared to ESK-NS (1.666 vs. 1.244). KET-IV had higher response rates (36 % vs. 25 %; p = 0.042) but not superior remission rates (13 % vs. 12 %; p = 0.845) than ESK-NS at T1. Despite more reported side effects, KET-IV did not cause more discontinuations for adverse events (4.6 % vs. 2.12 %; p = 0.228) than ESK-NS., Conclusion: KET-IV showed a higher short-term antidepressant effect, whereas ESK-NS exhibited lower side effects. Both were generally well tolerated. Future head-to-head studies should consider the long-term efficacy of these treatments., Competing Interests: Declaration of competing interest Dr. Taeho Greg Rhee was supported in part by the National Institute on Aging (NIA) (#R21AG070666; R21AG078972), National Institute of Mental Health (#R21MH117438), National Institute on Drug Abuse (#R21DA057540) and Institute for Collaboration on Health, Intervention, and Policy (InCHIP) of the University of Connecticut. Dr. Rhee serves as a review committee member for Patient-Centered Outcomes Research Institute (PCORI) and Substance Abuse and Mental Health Services Administration (SAMHSA) and has received honoraria payments from PCORI and SAMHSA. Dr. Rhee has also served as a stakeholder/consultant for PCORI and received consulting fees from PCORI. Dr. Rhee serves as an advisory committee member for International Alliance of Mental Health Research Funders (IAMHRF). Dr. Rhee is currently a co-Editor-in-Chief of Mental Health Science and has received honorarium payments annually from the publisher, John Wiley & Sons, Inc. Dr. Giorgio Di Lorenzo has been a speaker and/or a consultant for Angelini, FB-Health, Janssen-Cilag, Livanova, Lundbeck, Neuraxpharm, Otsuka, and Recordati. Dr. Raffaella Zanardi has been a consultant/speaker for Baldacci and Italfarmaco. Dr. Gianluca Rosso has been a speaker and/or consultant from Angelini, Janssen, Lundbeck, Otsuka, Viatris. Dr. Ileana Andriola was a speaker at Janssen sponsored conference. Dr. Bernardo Maria Dell'Osso has received lecture honoraria from Angelini, Lundbeck, Janssen, Pfizer, Neuraxpharm, Arcapharma, and Livanova. Dr. Rosenblat is the medical director of the Braxia Scientific Corp, which provides ketamine and esketamine treatment for depression; he has received research grant support from the American Psychiatric Association, the American Society of Psychopharmacology, the Canadian Cancer Society, the Canadian Psychiatric Association, the Joseph M. West Family Memorial Fund, the Timeposters Fellowship, the University Health Network Centre for Mental Health, and the University of Toronto and speaking, consultation, or research fees from Allergan, COMPASS, Janssen, Lundbeck, and Sunovion. Dr. Giovanni Martinotti has been a consultant and/or a speaker and/or has received research grants from Angelini, Doc Generici, Janssen-Cilag, Lundbeck, Otsuka, Pfizer, Servier, and Recordati. Dr. Roger McIntyre has received research grant support from CIHR/GACD/National Natural Science Foundation of China (NSFC) and the Milken Institute; speaker/consultation fees from Lundbeck, Janssen, Alkermes, Neumora Therapeutics, Boehringer Ingelheim, Sage, Biogen, Mitsubishi Tanabe, Purdue, Pfizer, Otsuka, Takeda, Neurocrine, Sunovion, Bausch Health, Axsome, Novo Nordisk, Kris, Sanofi, Eisai, Intra-Cellular, NewBridge Pharmaceuticals, Viatris, Abbvie, Atai Life Sciences. Dr. Roger McIntyre is the CEO of Braxia Scientific Corp. The remaining authors declare that the research was conducted without any commercial or financial relationship that could be construed as a potential conflict of interest., (Copyright © 2023. Published by Elsevier B.V.)

Background: The pathophysiology of mental illnesses is not fully understood, leading to insufficient remission, frequent adverse drug reactions, and treatment resistance. Pharmacogenetic (PGx) testing, a personalized approach recently adopted also in psychiatry, can guide effective drug therapy and minimize side effects. The objective of this study was to determine the perspective of Slovak clinicians regarding the integration of PGx testing in psychiatric clinical practice., Methods: Questionnaires covering various aspects such as prior experience with PGx testing, self-perceived competence, perceived utility, potential risks and challenges were distributed directly to attendees at two psychiatric conferences held in Slovakia in 2023 and their responses were statistically analysed., Results: Out of 54 respondents, only 7.4% had previous experience with PGx in clinical practice. The most clinicians felt that they should possess the skills to apply PGx testing in psychiatric clinical practice and were enthusiastic about increasing their expertise. They found PGx useful in medication selection, adverse effect management, and treatment-resistant depression. The primary concerns centered around the lack of well-defined guidelines and the financial considerations linked to the testing., Conclusions: Considering the participants' interest in PGx and its integration into clinical practice, educational programmes based on recommendations, guidelines, and convincing evidence could be organized (Tab. 4, Ref. 30). Text in PDF www.elis.sk Keywords: pharmacogenetics, pharmacogenomics, psychiatry, personalized treatment, Slovakia, perspective.

Treatment-resistant depression (TRD) represents a severe clinical condition with high social and economic costs. Esketamine Nasal Spray (ESK-NS) has recently been approved for TRD by EMA and FDA, but data about predictors of response are still lacking. Thus, a tool that can predict the individual patients' probability of response to ESK-NS is needed. This study investigates sociodemographic and clinical features predicting responses to ESK-NS in TRD patients using machine learning techniques. In a retrospective, multicentric, real-world study involving 149 TRD subjects, psychometric data (Montgomery-Asberg-Depression-Rating-Scale/MADRS, Brief-Psychiatric-Rating-Scale/BPRS, Hamilton-Anxiety-Rating-Scale/HAM-A, Hamilton-Depression-Rating-Scale/HAMD-17) were collected at baseline and at one month/T1 and three months/T2 post-treatment initiation. We trained three different random forest classifiers, able to predict responses to ESK-NS with accuracies of 68.53% at T1 and 66.26% at T2 and remission at T2 with 68.60% of accuracy. Features like severe anhedonia, anxious distress, mixed symptoms as well as bipolarity were found to positively predict response and remission. At the same time, benzodiazepine usage and depression severity were linked to delayed responses. Despite some limitations (i.e., retrospective study, lack of biomarkers, lack of a correct interrater-reliability across the different centers), these findings suggest the potential of machine learning in personalized intervention for TRD., Competing Interests: Declaration of Competing Interest The remaining authors declare that the research was conducted without any commercial or financial relationship that could be construed as a potential conflict of interest., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Obtaining a healthy wound environment that is conductive to healing in horses can be challenging. Negative-pressure wound therapy (NPWT) has been employed in humans to enhance wound healing for decades. The existing evidence for the effectiveness of NPWT remains uncertain in equine medicine. The aim of this review is to investigate NPWT applications and benefits in horses. A scoping review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines for scoping reviews on three databases (PubMed, Web of Science-Thompson Reuters, and Wiley Online Library). Twenty-four manuscripts were considered. After removing duplicates, 17 papers underwent abstract screening. Of these, 16 + 1 (cited by others) were evaluated for eligibility according to PICOs, including no case reports/retrospective studies, four original articles, and three reviews. Fifteen manuscripts met the inclusion criteria. The focus of the articles was wound management; they included three reports of wounds communicating with synovial structures. Traumatic wounds and surgical-site infections are indications for NPWT. NPWT presents several advantages and few complications making it an attractive alternative to conventional wound management. However, randomized controlled trials should be performed to quantify the benefits and establish precise protocols in horses.

COVID-19 pandemic had a great impact on mental health, both in the general population and psychiatric patients. Little is known about the difference between these two populations in perceiving the pandemic as a traumatic event. The aim of the study was to compare psychiatric patients and healthy controls (HC) in terms of change over time of post-traumatic (PTSD) symptoms. Demographic and clinical variables were collected. Impact of Event Scale Revised (IES-R) scores were registered at T1 as lockdown period (March-April 2020) and T2 as restarting (May-June 2020). Descriptive analyses and linear regression models were performed. A total of 166 outpatients and 57 HC were recruited. Time (F = 15.76; p < 0.001) and diagnosis (F = 4.94; p < 0.001) had a significant effect on the change of IES-R scores, which resulted T1 > T2 (p < 0.001), except for subjects affected by Obsessive-Compulsive Disorder (OCD). Overall, IES-R scores were < in patients than in HC (p = 0.02), particularly in the schizophrenia (SKZ) subgroup (p < 0.001). IES-R scores of subjects with personality disorders (PDs) resulted to be > HC, although not statistically significant. The lockdown period was perceived as more traumatic than the reopening phase by both groups, with the exception of OCD patients, probably because of the clinical worsening associated with the urge of control against risks of contamination. Overall, HC reported more PTSD symptoms than psychiatric patients did, particularly SKZ ones. PD patients, in contrast, may be more vulnerable to PTSD symptoms probably as a result of poor coping skills. Together with OCD patients, subjects with PDs may need closer monitoring during the different phases of the pandemic. Trial Registration: ClinicalTrials.gov Identifier: NCT04694482.

Sirtuin 1 (SIRT1) is a sensor of cell energy availability, regulating metabolic homeostasis as well as leptin and ghrelin, and it could be considered as a potential plasmatic marker. The aim of this study was to assess whether circulating SIRT1 varies consistently with leptin, ghrelin, body mass index (BMI), and IgG reactive to hypothalamic antigens in anorexia nervosa (AN). Fifty-four subjects were evaluated: 32 with AN and 22 normal-weight control subjects. Serum levels of SIRT1, leptin, ghrelin, and IgG reactive to hypothalamic antigens were evaluated by ELISA. Results showed that serum SIRT1 is increased in patients with AN, and the amount is decreased in relation to the duration of the illness. SIRT1 concentration approaches the values obtained for the control group, although the difference is still statistically significant. A negative correlation between serum SIRT1 values and leptin or BMI values has been found. On the contrary, a positive correlation between SIRT1 and ghrelin or IgG specific for hypothalamic antigens is reported. These findings suggest that a peripheral evaluation of SIRT1 could be a possible clinical/biochemical parameter related to AN. In addition, we can assume that SIRT1 is related to autoantibody production and may correlate with the intensity/severity of AN. Thus, reducing the production of autoantibodies specific for hypothalamic cells could be a sign of improvement of the clinical condition.