Doctor of Philosophy / Department of Animal Sciences / Barry Bradford / The transition into lactation is a period of primary concern to dairy producers because of the tremendous incidence of health disorders observed during this time. Two common disorders that lead to decreases in production and retention within the herd include fatty liver disorder (FL) and ketosis. These two disorders have been commonly associated with negative energy balance, yet recently it has been hypothesized that inflammation is a contributor to the etiology of these disorders. Three individual projects were completed for this dissertation, all involving inflammation. The role of endogenous inflammation was determined by administration of sodium salicylate (SS) to cows for 7 d after parturition, and metabolites and production responses were evaluated. Overall it appears that SS induced hypoglycemic conditions and increased triglyceride accumulation in the liver (while administered), increased lipid mobilization and ketones (2 weeks after administration ended), and increased whole lactation milk production in older cows. A sensitive, specific sandwich ELISA for bovine tumor necrosis factor-[alpha] was developed, which provided the ability to measure “normal” circulating levels of this cytokine. The final study involved inducing inflammation by daily injections of the TNF[alpha] to the early lactation dairy cow. In this model, cows receiving TNF[alpha] had a reduction in dry matter intake, water intake, and decreases in milk production and milk components. Overall, it appears that inflammation is involved in the normal biology of the transition dairy cow and disrupting this can lead to interesting negative effects and some improvements of production; however, when inflammation is much greater it can lead to negative production effects.

Introdução: A osteoartrite (OA) é uma doença que comumente afeta os seres humanos, sendo caracterizada como um processo degenerativo que abrange as articulações. A OA afeta a cartilagem articular, osso subcondral, ligamentos, cápsula articular, membrana sinovial e músculos periarticulares. O tratamento para esta desordem se baseia em terapia farmacológica, não farmacológica e cirúrgica, isoladamente ou em combinação, a fim de maximizar os efeitos benéficos e minimizar os efeitos indesejáveis. O presente estudo tem como objetivo avaliar e comparar os efeitos isolados e combinados da terapia farmacológica com anti-inflamatório não-esteroidal (AINE) de uso tópico, aos efeitos da atividade física, e por fim, aos efeitos da laserterapia de baixa potência (LBP), em um modelo experimental de OA. Materiais e Métodos: A OA foi induzida por injeção de papaína intra-articular no joelho direito de ratos Wistar machos. Após 21 dias os animais começaram a ser tratados com AINE de aplicação tópica e/ou com atividade física (natação) e/ou LBP. Os tratamentos foram realizados 03 vezes por semana, durante 08 semanas, perfazendo um total de 24 sessões de terapia. Foram realizadas análises bioquímicas e morfológicas da articulação do joelho, compreendendo análise histológica, contagem total de células, atividade de mieloperoxidase (MPO), RT-PCR (COX-1, COX-2, IL-1β, IL-6, IL-10, TNF-α, MMP-3 e MMP-13), análise de citocinas pelo método de ELISA (TNF-α, IL-1β, IL-6 e IL-10), PGE2 e por fim, a análise de Western-Blot (COX-1 e COX-2). Resultados, discussão e conclusão: Os resultados do presente estudo indicam que o tratamento com laserterapia de baixa potência é o mais eficiente em diminuir os danos à articulação e modular o processo inflamatório induzido pela injeção de papaína na articulação do joelho de ratos. / Introduction: Osteoarthritis (OA) is a disease that commonly affects humans and it is characterized as a degenerative process that reachs joints. OA affects the articular cartilage, subchondral bone, ligaments, joint capsule, synovial membrane and periarticular muscles. The treatment for this disorder is based on pharmacological therapy, non-pharmacological therapy and surgery, alone or in combination, in order to maximize the beneficial effects and minimize side effects. This research project aims to evaluate and compare the isolated and combined effects of pharmacological therapy with non-steroidal anti-inflammatory drug (NSAID) of topical use, to effects of physical activity and finally to effects of low-level laser therapy (LLLT) in an experimental model of osteoarthritis. Materials and Methods: OA was induced by intra-articular injection of papain in the right knee of male Wistar rats. After 21 days animals started to be treated with topical NSAID and/or physical activity (swimming) and/or LBP. Treatments was performed 3 times per week for 8 weeks, a total of 24 therapy sessions. It was performed morphological and biochemical analysis of the knee joint, including histology, counting of total cells, activity of myeloperoxidase (MPO), RT-PCR (COX-1, COX-2, IL-1β, IL-6, IL-10, TNF-α, MMP-3 and MMP-13) cytokines analysis by ELISA (TNF-α, IL-1β, IL-6 and IL-10), PGE2, and finally Western- Blot analysis (COX-1 and COX-2). Results, discussion and conclusion: The results of this project indicate that treatment with low-level laser therapy is more efficient in order to decrease damage in joint and to modulate inflammatory process induced by papain injection in rats knee join.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The aim of this study was to evaluate acute and subacute renal and hepatic toxicity of the oral administration of tepoxalin in cats submitted to hypotension with isoflurane. Eighteen adult male mongrel cats were used in this study, weighing between 3 and 5 kg and clinically healthy. The animals were divided into three groups, which were anesthetized and submitted to hypotension with isoflurane (CON), or which, in addition, tepoxalin was administered two hours prior to the hypotension procedure (PRE) or after the hypotension procedure (POS). The animals from groups PRE and POS also received the same doses of tepoxalin every 24 hours, during the five days following the procedure. In order to achieve a condition of moderate hypotension, animals were induced and maintained with isoflurane in variable concentration, for maintenance of mean arterial pressure (MAP) between 45 and 60 mmHg, during 60 minutes. Complete blood count and serum concentrations of alanine aminotransferase (ALT), alkaline phosphatase (FA) and urea (U) were evaluated at baseline and 24 hours, 48 hours and 7 days after hypotension. Serum concentration of creatinine (Cr), fractional excretion of sodium (FENa) and urinary concentrations of Cr, gamma-glutamyl transferase (GGT), proteinuria and albuminuria were evaluated at baseline and 24 hours, 48 hours and 7 days after hypotension. The model chosen was efficient in maintaining the proposed condition of hypotension. No physiological changes were observed in complete blood count, serum biochemistry profile (ALT, FA, U and Cr), FENa and urinary GGT. An increase in urine protein-creatinine ratio was observed in CON and PRE at 24 and 48 hours after hypotension. Urine albumin-creatinine ratio showed increase in CON at 24 hours and maintained elevated values with regard to the other groups until 7 days after hypotension. The authors conclude that administration of tepoxalin does not cause changes in hepatic parameters, urea, creatinine, fractional excretion of sodium and urinary GGT in cats submitted to anesthetic hypotension. However, there is a risk of mild renal injury by administering the drug prior to the hypotensive procedure. / Este estudo objetivou avaliar a toxicidade renal e hepática, aguda e subaguda, da administração oral da tepoxalina em gatos submetidos à hipotensão com isofluorano. Foram utilizados 18 gatos, machos, adultos, sem raça definida, com peso entre 3 e 5 kg e comprovadamente hígidos. Os animais foram alocados em três grupos, os quais foram anestesiados e submetidos à hipotensão com isofluorano (CON), ou que ainda receberam tepoxalina duas horas antes do procedimento de hipotensão (PRÉ) ou após a recuperação anestésica do procedimento de hipotensão (PÓS). Os animais dos grupos PRÉ e PÓS também receberam as mesmas doses de tepoxalina a cada 24 horas, durante cinco dias pós procedimento. Para a caracterização de um quadro de hipotensão moderada, os animais foram induzidos e mantidos anestesiados com isofluorano em vaporização variável, para a manutenção da pressão arterial média (PAM) entre 45 e 60 mmHg durante 60 minutos. Foram avaliados hemograma e concentrações séricas de alanina amino-transferase (ALT), fosfatase alcalina (FA) e ureia (U) no período basal e 24 horas, 48 horas e 7 dias após a hipotensão. A concentração sérica de creatinina (Cr), a fração de excreção de sódio (FENa) e as concentrações urinárias de Cr, gama-glutamiltransferase (GGT), proteínas totais e albumina foram avaliadas no momento basal e 24 horas, 48 horas e 7 dias após a hipotensão. O modelo escolhido foi eficiente na manutenção do quadro de hipotensão proposto. Não foram observadas alterações fisiológicas no hemograma, bioquímica sérica (ALT, FA, U e Cr), FENa e na GGT urinária. Observou-se elevação estatística na razão proteína-creatinina na urina no CON e no PRÉ em relação ao PÓS às 24 e às 48 horas de avaliação. A razão albumina-creatinina na urina apresentou elevação estatística no CON em relação aos demais à partir das 24 horas de avaliação, mantendo essa elevação até os 7 dias de avaliação. Concluiuse que a administração de tepoxalina não causou alterações de parâmetros hepáticos, ureia, creatinina, FENa e GGT urinária em gatos submetidos à hipotensão anestésica, entretanto há o risco de ocorrência de injúria renal discreta devido à proteinúria observada no grupo em que a tepoxalina foi administrada antes do procedimento hipotensor.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / This study aimed to evaluate the possible renal and hepatic toxicities, acute and subacute, of the administration of tepoxalin in dogs submitted to hypotension with isoflurane. A total of 12 dogs were used, which received 10 mg kg-1 of tepoxalin PO two hours before induction of hypotension (T) or were only submitted to hypotension with isoflurane (C). For the subacute study, animals in T were treated with tepoxalin during 5 days, following the hypotensive procedure. The dogs were submitted to hypotension (MAP= 50-60mmHg) for isoflurane in a circular circuit valve, with adjusted FR for the ETCO2 remained between 35-45mmHg. ToC was maintained between 37 and 38oC. HR, SAP, MAP, DAP, CVP, ETCO2 and ETIso were evaluated at 0, 10 and every 10 min up to 60min of hipotension. pH, PaO2, PaCO2, SaO2, HCO3-, BD, Na+, K+, Ca2+ and bleeding time evaluations were carried out before hypotension and at 30 and 60min of hipotension. For renal and hepatic evaluation, serum levels of U, Cr, ALT, alkaline phosphatase, GGT and urinary levels of GGT, Cr and GGT:Cr ratio were determined at 12h, 24h and seven days after the procedure. During the anesthetic procedure, only CVP presented elevation in relation to 0min in both groups at 50 and 60min of evaluation. In blood gas and electrolyte measurement, only Na+ presented levels below to basal at 60min in T, and this same group showed increased values at all intervals, in comparison between groups. Moreover, bleeding time was shown to be more elevated at 30min of evaluation in animals in T, when compared to the ones in C. The variables corresponding to creatinine depuration, GGT:Cr ratio and UV remained stable during the evaluations; however, urinary GGT levels presented increased values in animals in C when compared to T, at 60min of evaluation. At this same interval, urinary Cr values were elevated in T. Serum levels of ALT, alkaline phosphatase, U and Cr presented minor alterations, remaining within reference values; however, GGT presented increased values at 60min of evaluation, when compared to 0min. On the seventh day of evaluation, a reduction in leukocyte number was observed in animals in T, when compared to C. Side effects were not observed in both groups. The prior administration of tepoxalin in healthy dogs submitted to hypotension did not cause significant effects upon renal and hepatic functions. Moreover, daily administrations during five days, following the anesthetic procedure, did not alter the functions of the organs mentioned. Therefore, tepoxalin showed to be a safe NSAID to be used in healthy dogs, submitted to hypotension during anesthesia with isoflurane. / Objetivou-se avaliar as possíveis toxicidades renal e hepática, aguda e subaguda, da administração de tepoxalina em cães submetidos à hipotensão com isofluorano. Foram utilizados 12 cães, os quais receberam 10mg kg-1 de tepoxalina VO duas horas antes da indução da hipotensão (T) ou somente foram submetidos à hipotensão com isofluorano (C). Para o estudo subagudo, os animais do T foram tratados com tepoxalina, durante cinco dias, seguidos ao procedimento hipotensor. Os cães foram submetidos à hipotensão (PAM = 50-60mmHg) por isofluorano em circuito circular valvular, com FR ajustada para que o ETCO2 permanecesse entre 35-45mmHg. A TºC foi mantida entre 37 e 38ºC. Avaliaram-se FC, PAS, PAM, PAD, PVC, ETCO2, e ETIso em 0, 10 e a cada 10min até 60min da hipotensão. As avaliações de pH, PaO2, PaCO2, SaO2, HCO3-, DB, Na+, K+ e Ca2+ e tempo de sangramento foram realizadas antes da hipotensão e aos 30 e 60min da hipotensão. Para a avaliação renal e hepática foram determinados os níveis séricos de U, Cr, ALT, FA, GGT e os níveis urinários de GGT, Cr e a proporção GGT:Cr em 12h, 24h e sete dias após o procedimento. Durante o procedimento anestésico somente a PVC apresentou elevação em relação aos 0min, em ambos os grupos aos 50 e 60min de avaliação. Na mensuração dos gases sanguíneos e eletrólitos, apenas o Na+ demonstrou níveis menores que o basal aos 60min no T, e este mesmo grupo apresentou valores aumentados em todos os momentos, na comparação entre os grupos. Ainda, o tempo de sangramento foi maior aos 30min de avaliação, nos animais do T, quando comparado aos do C. As variáveis correspondentes à depuração da creatinina, razão GGT:Cr e DU permaneceram estáveis durante as avaliações, porém, os níveis de GGT urinária apresentaram valores aumentados nos animais do C, quando comparados ao T, aos 60min de avaliação. Nesse mesmo momento, os valores de Cr urinária estavam aumentados dentro do T. Os níveis séricos de ALT, FA, U e Cr apresentaram poucas alterações, permanecendo dentro dos limites de referência, porém, a GGT apresentou valores aumentados aos 60min de avaliação, comparando-se com 0min. No sétimo dia de avaliação, observou-se redução do número de leucócitos nos animais do T, quando comparados aos do C. Não foram observados efeitos colaterais em ambos os grupos. A administração prévia de tepoxalina em cães hígidos submetidos à hipotensão, não ocasionou efeitos significativos sobre as funções renal e hepática dos mesmos. Da mesma forma, administrações diárias durante cinco dias, seguidas ao procedimento anestésico, não alteraram as funções dos referidos órgãos. Portanto, a tepoxalina demonstrou ser um AINE seguro para utilização em cães hígidos, submetidos à hipotensão durante anestesia com isofluorano.

Introdução: A osteoartrite (OA) é uma doença que comumente afeta os seres humanos, sendo caracterizada como um processo degenerativo que abrange as articulações. A OA afeta a cartilagem articular, osso subcondral, ligamentos, cápsula articular, membrana sinovial e músculos periarticulares. O tratamento para esta desordem se baseia em terapia farmacológica, não farmacológica e cirúrgica, isoladamente ou em combinação, a fim de maximizar os efeitos benéficos e minimizar os efeitos indesejáveis. O presente estudo tem como objetivo avaliar e comparar os efeitos isolados e combinados da terapia farmacológica com anti-inflamatório não-esteroidal (AINE) de uso tópico, aos efeitos da atividade física, e por fim, aos efeitos da laserterapia de baixa potência (LBP), em um modelo experimental de OA. Materiais e Métodos: A OA foi induzida por injeção de papaína intra-articular no joelho direito de ratos Wistar machos. Após 21 dias os animais começaram a ser tratados com AINE de aplicação tópica e/ou com atividade física (natação) e/ou LBP. Os tratamentos foram realizados 03 vezes por semana, durante 08 semanas, perfazendo um total de 24 sessões de terapia. Foram realizadas análises bioquímicas e morfológicas da articulação do joelho, compreendendo análise histológica, contagem total de células, atividade de mieloperoxidase (MPO), RT-PCR (COX-1, COX-2, IL-1β, IL-6, IL-10, TNF-α, MMP-3 e MMP-13), análise de citocinas pelo método de ELISA (TNF-α, IL-1β, IL-6 e IL-10), PGE2 e por fim, a análise de Western-Blot (COX-1 e COX-2). Resultados, discussão e conclusão: Os resultados do presente estudo indicam que o tratamento com laserterapia de baixa potência é o mais eficiente em diminuir os danos à articulação e modular o processo inflamatório induzido pela injeção de papaína na articulação do joelho de ratos. / Introduction: Osteoarthritis (OA) is a disease that commonly affects humans and it is characterized as a degenerative process that reachs joints. OA affects the articular cartilage, subchondral bone, ligaments, joint capsule, synovial membrane and periarticular muscles. The treatment for this disorder is based on pharmacological therapy, non-pharmacological therapy and surgery, alone or in combination, in order to maximize the beneficial effects and minimize side effects. This research project aims to evaluate and compare the isolated and combined effects of pharmacological therapy with non-steroidal anti-inflammatory drug (NSAID) of topical use, to effects of physical activity and finally to effects of low-level laser therapy (LLLT) in an experimental model of osteoarthritis. Materials and Methods: OA was induced by intra-articular injection of papain in the right knee of male Wistar rats. After 21 days animals started to be treated with topical NSAID and/or physical activity (swimming) and/or LBP. Treatments was performed 3 times per week for 8 weeks, a total of 24 therapy sessions. It was performed morphological and biochemical analysis of the knee joint, including histology, counting of total cells, activity of myeloperoxidase (MPO), RT-PCR (COX-1, COX-2, IL-1β, IL-6, IL-10, TNF-α, MMP-3 and MMP-13) cytokines analysis by ELISA (TNF-α, IL-1β, IL-6 and IL-10), PGE2, and finally Western- Blot analysis (COX-1 and COX-2). Results, discussion and conclusion: The results of this project indicate that treatment with low-level laser therapy is more efficient in order to decrease damage in joint and to modulate inflammatory process induced by papain injection in rats knee join.

Träningsvärk efter fysisk aktivitet är ett välkänt fenomen. Vad som ligger bakomträningsvärkens effekter såsom smärta och nedsatt rörlighet är mindre välkänt. Träningsvärk, eller ”delayed onset muscle soreness” (DOMS), har i forskningenantagits bero på muskelskada och inflammation i skelettmusklerna efter att ovana ellerexcentriska övningar utförts. Försöken att lindra träningsvärkens effekter har varitmånga, t ex genom antiinflammatoriska läkemedel (NSAID). Syftet med dennasystematiska litteraturstudie var att svara på frågeställningen hur ibuprofen påverkarträningsvärk där hypotesen att ibuprofen skulle ha en dämpande effekt på träningsvärkantogs. Nio artiklar granskades för att besvara hypotesen utan att några slutsatser omibuprofens inverkan på träningsvärk kunde dras då resultaten pekade åt olika håll ochinga tendenser kunde observeras. Den slutsats som kunde dras utifrån litteraturstudienvar att ytterligare forskning på området är behövlig. Om studier inte kan visa att NSAIDdämpar träningsvärk så kan det ifrågasättas om inflammation är orsaken tillträningsvärken. Ytterligare studier på området är viktigt då NSAID är vanligtförekommande som smärtlindrande läkemedel samtidigt som det har biverkningar. Det finns också forskning som tyder på att NSAID kan ha negativ inverkan på de positivaeffekter som är av intresse i träningssammanhang.

L'obtention des données a été subventionnée par CIORA (Canadian Initiative for Outcomes in Rheumatology Care). CIORA a aussi financé l'analyse des données effectuées par Justine Zehr. L'Initiative Canadienne Pour Des Resultats En Soins Rhumatologiques (ICORA) a financé l'obtention des données et une partie de l'analyse statistique présentée dans ce mémoire. / La plupart des femmes ayant été atteintes d’arthrite juvénile idiopathique (AJI) continuent de souffrir d’arthrite à l’âge adulte. Certains des médicaments utilisés dans le traitement de l’arthrite tels que les corticostéroïdes et les antiinflammatoires non stéroïdiens (AINS) ne sont pas recommandés durant la grossesse. Le but de ce mémoire est d’estimer l’impact de la prise de ces médicaments sur les événements néfastes à l’accouchement chez ces femmes et leur bébé. Des données administratives sur les prescriptions de médicaments et les hospitalisations d’une cohorte de 1756 femmes ayant souffert d’AJI sont utilisées. Elles ont permis de reconstruire l’historique de consommation de médicaments contre l’arthrite chez les femmes durant la grossesse et l’année précédente. Pour ce faire, deux sous-cohortes de femmes ayant souffert d’AJI ont été formées : une pour la période grossesse et une autre pour la grossesse et l’année précédant celle-ci. Les événements d’intérêt étaient : malformations congénitales, complications néonatales, complications maternelles et petit poids pour l’âge gestationnel. Les proportions de cas présentant l’un de ces événements variaient entre 11,52% et 37,08%. Les médicaments ont été modélisés en terme d’utilisation ou de durée totale de consommation durant la période d’étude. Pour chaque événement, des modèles logistiques ont été estimés pour mesurer l’association entre la prise de médicaments et l’événement, en ajustant pour des variables de confusion potentielles : hypertension avant la grossesse, âge à l’accouchement et obtention du diplôme de secondaire. La consommation de corticostéroïdes semble augmenter statistiquement significativement le risque de présenter des malformations congénitales mais n’avoir aucun impact sur les autres événements. Aucun lien statistiquement significatif n’a été observé entre la consommation de AINS et les événements d’intérêt. / Most women diagnosed with juvenile idiopathic arthritis (JIA) continue to suffer from arthritis in adulthood. Some of the drugs used to treat arthritis such as corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) are not recommended during pregnancy. The objective of this thesis is to estimate the impact of these drugs on adverse birth outcomes in women previously diagnosed with JIA and their baby. Administrative data on drug prescriptions and hospitalizations in a cohort of 1756 women with a history of JIA were used to determine individual histories of drug use for the treatment of arthritis during pregnancy and during the year leading to the pregnancy. Two sub-cohorts of women who suffered from JIA were created : one corresponding to the pregnancy and the other to the pregnancy and the year leading to the pregnancy. The events of interest were : congenital anomalies, neonatal adverse outcomes, maternal adverse outcomes and small for gestational age babies. Proportions of the events ranged between 11,52% and 37,08%. Drugs were modelled in terms of use or duration of use during each of the study periods. Logistic regression models were fitted to measure the association between drugs and each of the events, adjusting for the following potential confounding variables : hypertension before pregnancy, maternal age and graduating from high school. The consumption of corticosteroids was associated with a statistically significant increased risk of congenital anomalies but had no impact on the other adverse events. No statistically significant associations were observed between consumption of NSAIDs and the adverse events of interest.

This research has been undertaken to evaluate factors with an association with the practice of self-medication amongst respondents living within three cities within Kurdistan. The research was designed to be a cross-sectional one by arranging for data collection through the direct interviewing of respondents via the use of a questionnaire that had been prepared previously. In total, the investigation involved 627 pharmacist participants, 647 general participants, and 28 interviewees from various age groups. An explanatory design is a mixed methods approach with two phases, with quantitative data collection in the first phase, and qualitative data collection in a second; data collection was conducted using a non-probability convenience sampling technique. The primary reason for self-medication practice was that participants with previous experience of attending to the same disease. The information source regarding self-medicated drugs were previous prescriptions, community pharmacies and friends. The most common indication for self-medication was the common cold or fever/headache/infection, the drugs used to treat these conditions being most commonly antibiotics, then painkillers and preparations for coughs. From the general public, a sample of 647 participants was taken that consisted of 38.4% females and 61.6% males, with participant ages ranging from 18-70 years. Within the study, 12.4% of the cohort had a degree level of education from a university. Moreover, 243 participants had the belief that it was an acceptable practice to purchase antibiotics without a prescription. Self-medication was practiced by 14/28 of the interviewees, and 28/28 (100%) of the interviewees held the belief that the pharmacy always has someone with knowledge of medicines, and who can advise and provide medication. There were 627 pharmacist participants, of which 28.1% were female and 71.9% were male, and 57.2% of them holding a Diploma in Health Institution, and 39.2% of them having a Bachelors Pharmacy degree. 20.7% of participants disagreed with keeping records for the dispensing of drugs, and approximately 20% of participants had little or no ideas regarding the characteristics of pharmacy practice that are considered professional. It was discovered that, if asked by the customer, advice was provided by 82.5% of community pharmacists. The sale of antibiotics was the most common, followed by pain-killers. A 95.5% proportion of pharmacists sold all of the medicines as OTC medicine without prescription. In conclusion, medicines are used by the people of Kurdistan in an inventive way, with suggestions provided by lay people and members of family or friends, which is acted upon without a qualified healthcare professional being consulted.