Idiopathic anomalous congenital band causing small intestinal obstruction in a 5-month-old dog

A 5-month-old, intact male, yellow Labrador retriever was presented with a 24-hour history of anorexia and vomiting. Abdominal imaging revealed the presence of a mechanical obstruction in the jejunum and peritoneal effusion. Cytologic evaluation and culture of the effusion prior to surgery identified a suppurative exudate with bacteria consistent with septic peritonitis and suspected to be related to the intestinal lesion. An exploratory laparotomy was performed, and a segment of jejunum was circumferentially severely constricted by an off-white, fibrous band of tissue. Resection and anastomosis of the strangulated segment of jejunum and excision of the constricting band provided resolution of the clinical signs. The dog made a complete recovery. Histologic evaluation revealed the band to be composed of fibrovascular and smooth muscle tissue, consistent with an idiopathic anomalous congenital band. No other gastrointestinal lesions were observed, either grossly at surgery or histologically in the resected segment of intestine. To our knowledge, a similar structure has not been reported in the veterinary literature.Copyright © 2022 Canadian Veterinary Medical Association. All rights reserved.

Prevalence of echocardiographic abnormalities in patients hospitalised with COVID-19

Introduction COVID-19 is a multi-systemic disease and cardiac involvement has been widely recognised. Impaired cardiac function is linked to worse prognosis and has important implications on patient management. Evidence-based recommendations to guide selection of COVID-19 patients for transthoracic echocardiogram (TTE) are lacking, and there are concerns regarding unnecessary exposure of sonographers to infection risks. Purpose 1. To determine the prevalence and nature of abnormal TTE findings in patients who underwent TTE within 6 months of admission to our centre with COVID-19 infection. 2. To determine if specific clinical characteristics were predictors of an abnormal TTE finding. Methods A retrospective cohort study of all patients admitted to a single hospital with confirmed COVID-19 (through PCR) from 27/03/2020 to 21/06/2020, cross matched with the local TTE database.Data on patient demographics, TTE indication, biochemical markers, selected co-morbidities, ITU admission and mortality were collected. Patients with abnormal TTE were defined by the presence of left ventricular systolic dysfunction (LVSD), right ventricular systolic dysfunction (RVSD), regional wall motion abnormalities (RWMA) or pericardial effusion. Where available, patients with abnormal TTE were compared to previous TTE results to determine if findings were new. If LVSD was previously present, any worsening in category of severity was considered significant. Unpaired t test and Fisher's exact test were used for between group statistical analysis. Results We identified 71 (12%) patients who underwent TTE from 597 patients admitted with a diagnosis of COVID-19. The mean age was 71 (42-93) years and 37 (52%) were male. 18 (25%) patients died within the admission and 15 (21%) required ITU care. The most frequent indications for TTE were suspected heart failure (42%), endocarditis (17%), MI (13%), valvular dysfunction (7%) and myopericarditis/effusion (7%).A total of 33 (46%) patients had an abnormal TTE. Of these, 30 (91%) were new findings. LVSD was detected in 26 (37%) cases: 5 (7%) mild, 8 (11%) moderate and 12 (17%) severe. RVSD was detected in 12 (17%), pericardial effusion in 9 (13%) and RWMA in 10 (14%).The only clinical characteristic that predicted an abnormal TTE was raised high sensitivity troponin (table 1). There was a trend towards an abnormal TTE in patients with known ischaemic heart disease (30% Vs 13%, p = 0.09). Increased mortality was observed in the abnormal TTE group (34% Vs 18%) although this did not reach statistical significance. Conclusions There was a high prevalence of significant TTE abnormalities in patients admitted to our hospital with COVID-19 where TTE was clinically indicated. Our cohort had a predominance for LVSD rather than RVSD compared to other studies. Raised high sensitivity troponin level was a predictor of an abnormal TTE and may guide selection of COVID-19 patients for TTE.

Analysis on the housing price relationship network of large and medium-sized cities in china based on gravity model

The relationship among cities is getting closer, so are housing prices. Based on the sale price of stocking houses in thirty-five large and medium-sized cities in China from 2010 to 2021, this study established the modified gravity model and used the method of social network analysis to explore the spatial linkage of urban housing prices. The results show that: (1) from the overall network structure, the integration degree of housing price network in China is still at a low stage, and the influence of housing price is polarized;(2) from the individual network structure, Beijing, Shanghai, Shenzhen, Nanjing, Hangzhou, and Hefei have a higher degree of centrality. Chengdu, Xining, Kunming, Urumqi, and Lanzhou stay in an isolation position every year;(3) from the results of cohesive subgroup analysis, different cities play different roles in the block each year and have different influences on other cities. (4) Emergencies, such as outbreaks of COVID-19, also have an impact on the housing price network. Structural divergence among urban housing prices has become more pronounced, and the diversity of house price network has been somewhat reduced. Based on the above findings, this paper puts forward some recommendations for the healthy development of housing market from the perspective of housing price network. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Implementing remote pharmacy objective structured clinical examination during the COVID-19 pandemic

Objective: This paper describes the development and feasibility evaluation of a formative remote objective structured clinical examination (OSCE) for second-year students in a four-year Bachelor of Pharmacy (B.Pharm.) honours programme. Methods. A five-station remote formative OSCE was developed and implemented using Microsoft Teams. The authors used a post-OSCE evaluation, in combination with the results of a students' survey and comprehensive feedback from faculty. Results: A total of seventy second-year B.Pharm. (Hons.) students participated in the online OSCE. Based on the post-OSCE evaluation, about 80% of students agreed that the OSCE ran smoothly. Respondents agreement on the time allocated to complete each station varied between 63.6% and 81.8%. Time allocation for each station and internet connectivity were raised as the main concerns by both the students and the faculty. Conclusion: A remote online OSCE is a feasible strategy for assessment of various skills based on different tasks, reflecting the scope of practice for future pharmacists, and offers a promising direction towards the assessment of such practical skills. Online OSCE planning, development and evaluation are in themselves useful for clarifying assessment goals, processes, hindrances, and affordances