Longitudinal Evaluation of DCE-MRI as an Early Indicator of Progression after Standard Therapy in Glioblastoma.

Background and Purpose: Distinguishing treatment-induced imaging changes from progressive disease has important implications for avoiding inappropriate discontinuation of a treatment. Our goal in this study is to evaluate the utility of dynamic contrast-enhanced (DCE) perfusion MRI as a biomarker for the early detection of progression. We hypothesize that DCE-MRI may have the potential as an early predictor for the progression of disease in GBM patients when compared to the current standard of conventional MRI. Methods: We identified 26 patients from 2011 to 2023 with newly diagnosed primary glioblastoma by histopathology and gross or subtotal resection of the tumor. Then, we classified them into two groups: patients with progression of disease (POD) confirmed by pathology or change in chemotherapy and patients with stable disease without evidence of progression or need for therapy change. Finally, at least three DCE-MRI scans were performed prior to POD for the progression cohort, and three consecutive DCE-MRI scans were performed for those with stable disease. The volume of interest (VOI) was delineated by a neuroradiologist to measure the maximum values for Ktrans and plasma volume (Vp). A Friedman test was conducted to evaluate the statistical significance of the parameter changes between scans. Results: The mean interval between subsequent scans was 57.94 days, with POD-1 representing the first scan prior to POD and POD-3 representing the third scan. The normalized maximum Vp values for POD-3, POD-2, and POD-1 are 1.40, 1.86, and 3.24, respectively (FS = 18.00, p = 0.0001). It demonstrates that Vp max values are progressively increasing in the three scans prior to POD when measured by routine MRI scans. The normalized maximum Ktrans values for POD-1, POD-2, and POD-3 are 0.51, 0.09, and 0.51, respectively (FS = 1.13, p < 0.57). Conclusions: Our analysis of the longitudinal scans leading up to POD significantly correlated with increasing plasma volume (Vp). A longitudinal study for tumor perfusion change demonstrated that DCE perfusion could be utilized as an early predictor of tumor progression.

Differentiating Low-Grade from High-Grade Intracranial Ependymomas: Comparison of Dynamic Contrast-Enhanced MRI and Diffusion-Weighted Imaging.

BACKGROUND AND PURPOSE: The aim of this study was to determine the diagnostic value of fractional plasma volume derived from dynamic contrast-enhanced perfusion MR imaging versus ADC, obtained from DWI in differentiating between grade 2 (low-grade) and grade 3 (high-grade) intracranial ependymomas. MATERIALS AND METHODS: A hospital database was created for the period from January 2013 through June 2022, including patients with histologically-proved ependymoma diagnosis with available dynamic contrast-enhanced MR imaging. Both dynamic contrast-enhanced perfusion and DWI were performed on each patient using 1.5T and 3T scanners. Fractional plasma volume maps and ADC maps were calculated. ROIs were defined by a senior neuroradiologist manually by including the enhancing tumor on every section and conforming a VOI to obtain the maximum value of fractional plasma volume (Vpmax) and the minimum value of ADC (ADCmin). A Mann-Whitney U test at a significance level of corrected P = .01 was used to evaluate the differences. Additionally, receiver operating characteristic curve analysis was applied to assess the sensitivity and specificity of Vpmax and ADCmin values. RESULTS: A total of 20 patients with ependymomas (10 grade 2 tumors and 10 grade 3 tumors) were included. Vpmax values for grade 3 ependymomas were significantly higher (P < .002) than those for grade 2. ADCmin values were overall lower in high-grade lesions. However, no statistically significant differences were found (P = .12114). CONCLUSIONS: As a dynamic contrast-enhanced perfusion MR imaging metric, fractional plasma volume can be used as an indicator to differentiate grade 2 and grade 3 ependymomas. Dynamic contrast-enhanced perfusion MR imaging plays an important role with high diagnostic value in differentiating low- and high-grade ependymoma.

A shiny app for modeling the lifetime in primary breast cancer patients through phase-type distributions.

Phase-type distributions (PHDs), which are defined as the distribution of the lifetime up to the absorption in an absorbent Markov chain, are an appropriate candidate to model the lifetime of any system, since any non-negative probability distribution can be approximated by a PHD with sufficient precision. Despite PHD potential, friendly statistical programs do not have a module implemented in their interfaces to handle PHD. Thus, researchers must consider others statistical software such as R, Matlab or Python that work with the compilation of code chunks and functions. This fact might be an important handicap for those researchers who do not have sufficient knowledge in programming environments. In this paper, a new interactive web application developed with shiny is introduced in order to adjust PHD to an experimental dataset. This open access app does not require any kind of knowledge about programming or major mathematical concepts. Users can easily compare the graphic fit of several PHDs while estimating their parameters and assess the goodness of fit with just several clicks. All these functionalities are exhibited by means of a numerical simulation and modeling the time to live since the diagnostic in primary breast cancer patients.

Young children contribute to nature stewardship.

Research on young children in environmental education (EE) has focused on unstructured play in, or experiencing, nature. Little attention has been paid to young children's stewardship efforts, or to the relation of such efforts to young children's learning and capacity to contribute to their communities and local nature. This perspectives paper draws on the first author's experience guiding pre-k and kindergarten children (4-6 years old) in outdoor educational projects in Santo Domingo (SD), Dominican Republic, in which the children produced a park guide and a short film. In addition to becoming resources for the local community, these products are an example of children's civic contributions. In "return on investment" language, guiding young children in outdoor experiences and reflecting on the experience represent the investment and the park guide and other products, and importantly, children's recognition of their ability to make contributions to their community, represent the return on investment. Based on our observations that young children can make significant contributions to their communities when given the opportunity, this perspectives paper argues for a research agenda and investment in opportunities for young children to contribute to their socio-ecological communities. To support our perspective, we first review and critique the prevailing and emerging paradigms of early childhood EE, following which we briefly describe the Santo Domingo (SD) project, and close by integrating past work with the first author's experience to argue for the importance of including young children in stewardship efforts.

Evaluation of hair and nail cortisol concentrations and associations with behavioral, physical, and environmental indicators of chronic stress in cats.

BACKGROUND: Chronic stress is implicated in behavioral and health issues in cats, but methods for recognition, evaluation, and measurement of stress are lacking. Cortisol concentration is typically used as an indicator of stress. OBJECTIVES: To evaluate use of an enzyme immunoassay to quantitate hair and nail cortisol concentrations (HCC and NCC) in cats and evaluate associations between HCC and NCC and behavioral, physical, and environmental correlates of chronic stress in cats. ANIMALS: Forty-eight adult, owned or community cats. METHODS: Cross-sectional study. Nail clippings and hair were collected from cats. Medical history and cat daily lifestyle questionnaires were completed by owners or caretakers. A commercial laboratory performed cortisol extraction and quantification using a validated enzyme immunoassay kit. Correlational and regression analyses were used to evaluate associations between HCC and NCC and behavioral, environmental, and medical factors. RESULTS: Hair and nail cortisol concentrations were significantly associated (rs  = 0.70; P < .001), but HCCs varied widely within and among cats. Cats with litterbox issues had significantly increased HCC (P = .02) and NCC (P = .001) as compared to cats without litterbox issues. Cats with groomed coats had lower HCCs (P = .02) as compared to cats without groomed coats, whereas cats with dander and mats had higher NCCs (P = .01) as compared to cats without dander and mats. CONCLUSIONS AND CLINICAL IMPORTANCE: The quantification of NCCs might improve identification and evaluation of chronic stress in cats. The variability of HCCs in individual cats warrants caution using this measurement in chronic stress studies.

Diagnóstico y tratamiento de la etapa aguda del accidente cerebrovascular isquémico: Guía de práctica clínica del Seguro Social del Perú (EsSalud) / Diagnosis and therapy for the acute stage of ischemic cerebrovascular accident: A clinical practice guideline from Peruvian Social Security (EsSalud)

RESUMEN Objetivo: proveer recomendaciones clínicas basadas en evidencia para el diagnóstico y tratamiento de la etapa aguda del ataque cerebrovascular isquémico en EsSalud. Materiales y métodos: se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El GEG formuló 8 preguntas clínicas a ser respondidas por la presente GPC. Se realizó búsquedas sistemáticas de revisiones sistemáticas y -cuando fue considerado pertinente- estudios primarios en Medline y Cochrane Controlled Register of Trials durante el 2018. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG usó la metodología GRADE para revisar la evidencia y formular las recomendaciones, los puntos de buenas prácticas clínicas y el flujograma de diagnóstico y tratamiento. Finalmente, la GPC fue aprobada con Resolución N° 128-IETSI-ESSALUD-2019. Resultados: la presente GPC abordó 8 preguntas clínicas, divididas en cuatro temas: tamizaje, diagnóstico, tratamiento, soporte y rehabilitación. En base a estas preguntas se formularon 28 recomendaciones (8 fuertes y 20 condicionales), 38 puntos de buena práctica clínica, 1 nota de implementación y 2 flujogramas. Conclusión: el presente artículo resume la metodología y las conclusiones basadas en evidencias de la GPC para el diagnóstico y tratamiento de la etapa aguda del ataque cerebrovascular isquémico en EsSalud.

ABSTRACT Objective: to provide evidence based clinical recommendations for the diagnosis and therapy of the acute stage of ischemic cerebrovascular accident in EsSalud. Materials and methods : a group for producing the guideline was conveyed, including specialized physicians and methodologists. The group prepared 8 clinical questions to be answered by the guideline. Systematic searches of previous reviews were performed, and - when it was deemed necessary - primary studies in Medline and the Cochrane Controlled Registry of Trials for 2018 were reviewed. Evidence was selected aiming to respond each one of the proposed clinical questions. Certainty of the evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work sessions, the group used GRADE methodology for reviewing the evidence and generated recommendations, good clinical practice items, and designed flow charts for both diagnosis and therapy. Finally, the guide was approved with the decree N° 128-IETSI-ESSALUD-2019. Results : this clinical practice guideline focused in 8 clinical questions, which were divided into four topics: screening, diagnosis, therapy, support and rehabilitation. On the basis of these questions, 28 recommendations were formulated (8 strong and 20 conditional), 38 items for good clinical practice, 1 implementation note, and 2 flow charts. Conclusion : this paper summarizes both evidence based methodology and conclusions from a new clinical practice guide for diagnosis and therapy of the acute stage of a cerebrovascular accident in EsSalud.

Evaluation of liposome toll-like receptor ligand complexes for non-specific mucosal immunoprotection from feline herpesvirus-1 infection.

BACKGROUND: Feline herpesvirus-1 (FHV-1) infection can result in serious morbidity and mortality, especially in kittens. Immunotherapy using liposome-toll-like receptor (TLR) ligand complexes (LTC) has been shown to activate innate immune responses. OBJECTIVES: To determine in kittens whether mucosal administration of LTC before FHV-1 inoculation would decrease severity of clinical signs and decrease quantities of FHV-1 DNA in materials collected on oropharyngeal swabs. ANIMALS: Nineteen, 14-week-old, purpose-bred kittens. METHODS: Pilot clinical trial with 2 groups of kittens allocated to either an LTC or control group. The LTC were administered into both nares and the oropharynx of the 12 LTC group kittens, and all 19 kittens were inoculated with FHV-1 24 hours later. Clinical scores were determined daily for 28 days, and oropharyngeal mucosal materials were collected every 7 days to assess FHV-1 DNA quantities for comparison between groups. RESULTS: Conjunctivitis was more common in kittens in the control group on Days 15-28 (P = .01) and Days 1-28 (P = .02). Total respiratory scores were higher in the LTC group on days 15-28 (P = .03). The LTC group had significantly decreased FHV-1 DNA on swabs when compared to the control group on some postinoculation days, using 2 methods of calculation. CONCLUSIONS AND CLINICAL IMPORTANCE: Administration of LTC to kittens was shown to decrease FHV-1 DNA and some manifestations of illness in kittens when administrated 24 hours before inoculation, suggesting clinical benefit.

Activation of upper respiratory tract mucosal innate immune responses in cats by liposomal toll-like receptor ligand complexes delivered topically.

BACKGROUND: Nonspecific induction of local innate immune responses by mucosally administered immunotherapy is a new approach to protection from upper respiratory tract infections. Therefore, a new liposome-toll-like receptor complex (LTC) immune stimulant was developed and investigated for its ability to activate innate immune responses in cats, both in vitro and in vivo, as part of an initial evaluation of LTC for use as an immunotherapeutic agent in cats. OBJECTIVES: We hypothesized that LTC could activate innate immune responses in cats after topical application to nasal and oropharyngeal mucosal surfaces. ANIMALS: Mucosal immune responses to topical administration of LTC were assessed in 7 healthy, purpose-bred cats, and in vitro responses were assessed using blood samples from healthy cats. METHODS: Cytokine and cellular immune responses to LTC were evaluated in blood samples, nasal lavage specimens, and pharyngeal swabs from cats, using reverse transcriptase polymerase chain reaction assays, ELISA assays, and flow cytometry. RESULTS: Liposome-TLR complexes rapidly activated leukocytes in vitro, including upregulation of costimulatory molecule expression and cytokine production. Topical administration of LTC in healthy cats triggered rapid recruitment of monocytes to the nasal and oropharyngeal mucosa. CONCLUSIONS AND CLINICAL IMPORTANCE: Liposome-TLR complexes were found to effectively activate innate immune responses in cats after mucosal administration. These findings suggest that LTC have potential for use as a new mucosally administered immunotherapy for nonspecific protection from viral and bacterial respiratory tract infections.

Evaluation of Psychometric Properties of Voice Activity and Participation Profile (VAPP): A Spanish Version.

OBJECTIVES: This study aimed to analyze the psychometric properties of the Spanish version of the Voice Activity and Participation Profile (SVAPP) questionnaire. STUDY DESIGN: A randomized, cross-sectional sampling strategy with controls was used. METHODS: Two samples with a total of 169 participants were analyzed, specifically 61 men (mean age 37.02) and 108 women (mean age 37.78). Of these participants, 112 were patients and 57 were controls. The instrument was submitted to reliability (internal consistency and corrected item-total correlations) and reproducibility analyses. Validation assessment was based on the construct validity, convergent validity, discriminant validity, and concurrent validity. RESULTS: The global internal consistency was excellent (Cronbach's α = 0.976), corrected item-total correlations were satisfactory and ranged 0.63-0.89, and factor loadings were above 0.50. The different subscales showed good internal consistency (alpha coefficients ranged 0.830-0.956) and test-retest values were consistently associated. The exploratory factor analysis evidenced a strongly defined five factors internal structure, with factors loadings ranging 0.51-0.86. Convergent validity demonstrated that all subscales and scores were very strongly correlated (Pearson r above 0.735) and significantly associated. The discriminant validity analysis showed that SVAPP had good specificity to distinguish dysphonic from healthy voice subjects. Concurrent validity with Voice Handicap Index Spanish version (SVHI) showed very strong correlations between total scores, and between SVHI total score and SVAPP Daily and Social Communication subscales; correlations between both tests subscales were strong; only between SVAPP Work and SVHI Physical sections correlations were moderate. CONCLUSIONS: The findings of the present study demonstrated evidence for the SVAPP questionnaire reliability and validity, and provided insightful implications of voice disorders on Spanish patients' quality of life. However, further investigations are required.

Clinical and Laboratory Effects of Doxycycline and Prednisolone in Ixodes scapularis-Exposed Dogs With Chronic Anaplasma phagocytophilum Infection.

Persistent infection of Anaplasma phagocytophilum (AP) after treatment and immunosuppression has not been studied in dogs infected with AP after Ixodes scapularis infestation. This descriptive pilot study evaluated 6 laboratory-reared beagles that were persistently positive for AP antibodies after infestation with wild-caught I. scapularis. After 20 weeks, 3 of 6 dogs were administered doxycycline orally for 28 days, and all 6 dogs were then administered prednisolone at 2.2 mg/kg orally for 14 days. Blood was collected from all 6 dogs and evaluated by complete blood count, AP antibodies, and AP DNA at the beginning of the study and on Week 24 through Week 28. Blood was collected from 5 of the dogs on Week 48. No dogs developed recognizable clinical signs of illness or clinically relevant complete blood count abnormalities. During Week 26 through Week 28, all 6 dogs were negative for AP DNA. On Week 48, the 2 doxycycline treated dogs available for testing were negative for AP DNA and antibodies; the 3 untreated dogs were negative for AP DNA but positive for AP antibodies. In this model, the prednisolone protocol used did not activate AP in dogs with chronic, vector-induced infection. Since PCR evidence of AP infection resolved in both groups of dogs, the effect doxycycline had in eliminating AP infection from I. scapularis-exposed dogs will require further study.

Postamputation Orthopedic Surgery in Canine Amputees: Owner Satisfaction and Outcome.

Surgical management of postamputation orthopedic disease (PAOD) in canine amputees has rarely been documented, and no reports describing outcome of stifle surgery in canine amputees are available. The objective of this multisite retrospective case series was to describe cases and evaluate satisfaction with and outcome of postamputation orthopedic surgery in canine amputees. Data was obtained through medical records and owner survey responses; data included signalment, amputation cause, diagnosis, surgical treatment, timeframes, and outcome assessment. Outcome was categorized as acceptable or unacceptable, and complications were classified as catastrophic, major, or minor. Eleven thoracic limb amputees and 6 pelvic limb amputees with surgically treated PAOD were identified. Surgically treated PAOD was reported at a median of 9.7 months (range 0.5-110 months) after amputation. All 17 amputees were treated for pelvic limb disease, predominantly for cranial cruciate ligament disease that occurred in 11 of 17 dogs. Major complications following orthopedic surgeries performed in 3 thoracic limb amputees consisted of infection (n = 2) and uncontrolled pain (n = 1). No major complications were reported following orthopedic surgeries performed in pelvic limb amputees. Acceptable mid-to-long-term outcome was achieved in 16 of the 17 canine amputees. Surgical treatment of pelvic limb disease did not appear to be associated with a high number of major complications in this case series. These findings suggest that orthopedic surgery, specifically stifle surgery, in canine amputees might be considered a feasible treatment option. Although there are inherent methodological limitations of retrospective studies and owner surveys, our case series provides new information that might help guide surgical treatment decisions in canine amputees suffering from orthopedic disease. Prospective studies using objective outcome measures evaluating surgical management of PAOD are necessary to confirm the provided information.

Intrapancreatic accessory spleen. Report of four cases diagnosed by ultrasound-guided fine-needle aspiration biopsy.

Intrapancreatic accessory spleen (IPAS) is a congenital anomaly usually misdiagnosed as a pancreatic neoplasm. For five years and four months, we collected seven IPASs located in the tail of the pancreas in four patients diagnosed by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). All cases had associated cell block preparations. Each patient underwent endoscopic ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) studies. The patients ranged in age from 57 to 73 years (mean age 65.7 years old). All lesions were well-defined, 1-1.9 cm in size (mean 1.5 cm). To our knowledge, a case with four IPASs in the tail of the gland has not been previously reported. Cytological features of IPAS included a polymorphous population of hematopoietic cells admixed with occasional blood vessels. Cell blocks comprised spleen red pulp. CD8 immunostaining of cell blocks highlighted splenic endothelial cells and confirmed the diagnosis. IPAS presented as an asymptomatic lesion detected on imaging studies. It may mimic a pancreatic neoplasm, mainly a neuroendocrine tumor. The use of EUS-FNA is an essential tool in the diagnosis of the lesion. The endothelial cells of the splenic sinuses characterized by their positivity for CD8 are evident in the sections of the cell blocks. This staining is considered specific and can be used as a confirmatory marker. EUS-FNA biopsy provides a reliable diagnosis that prevents unnecessary surgery.

A retrospective analysis of the use of lokivetmab in the management of allergic pruritus in a referral population of 135 dogs in the western USA.

BACKGROUND: Lokivetmab neutralizes IL-31, a cytokine that plays an important role in the pathogenesis of atopic dermatitis (AD) in dogs. OBJECTIVE: To review experience of one year of treatment with lokivetmab for the control of pruritus in dogs with allergic dermatitis. ANIMALS: Eighty dogs diagnosed with AD, ten with concurrent adverse food reaction and AD and 45 with allergic dermatitis of undetermined cause. Three dogs were lost to follow- up. METHODS AND MATERIALS: Retrospective analysis of medical records of dogs with allergic dermatitis treated with lokivetmab from November 2015 to October 2016. Treatment success for owner-assessed pruritus was empirically defined as ≥2 cm reduction in Visual Analog Scale (pVAS) from baseline. A ≥50% reduction in pVAS also was recorded. RESULTS: Pruritus improvement was achieved in 116 of 132 dogs (87.8%) following initial lokivetmab administration at 1.8 to 3.7 mg/kg (P < 0.001). A pVAS reduction of ≥50% was recorded in 104 dogs (77.0%). Dogs with severe/very severe pruritus prior to treatment and large/giant sized dogs, had 2.7 and 2.8 times higher odds of treatment success, respectively. There were no significant associations between treatment success and age of onset of clinical signs, disease chronicity, lokivetmab dosage or age at initial lokivetmab administration. Dogs that did not previously respond to oclacitinib were less likely to respond to lokivetmab. Adverse effects including lethargy, vomiting, hyperexcitability, pain at injection site and urinary incontinence were reported in 11 of 132 dogs. CONCLUSIONS AND CLINICAL IMPORTANCE: Lokivetmab at labelled dosages was a fast, safe and efficacious therapy for the control of pruritus in dogs with allergic dermatitis.

Evaluation of immunological parameters in pit bull terrier-type dogs with juvenile onset generalized demodicosis and age-matched healthy pit bull terrier-type dogs.

BACKGROUND: Juvenile onset generalized demodicosis (JOGD) is thought to occur due to immunological abnormalities and is over-represented in pit bull terrier-type dogs. ANIMALS: Twelve pit bull terrier-type dogs with JOGD and 12 age-matched healthy pit bull terrier-type dogs. OBJECTIVE: To investigate immunological differences between age-matched healthy and JOGD pit bull terrier-type dogs by flow cytometry, multiplex, molecular and serological assays. METHODS AND MATERIALS: Flow cytometry quantified B cells expressing MHCII or surface-bound IgG, CD4+ T cells expressing MHCII, CD8 T cells expressing MHCII or CD11a, neutrophil and monocyte markers. Surface expression was quantified by calculating the geometric mean fluorescence index. The Wilcoxon rank sum test was used to compare median results for IL-2, IL-4, IL-6, IL-7, IL-8, IL-10, IL-13, IL-18, FOXP3, monocyte chemoattractant protein-1, GM-CSF, KC, IgE, IgA, IgG, IgM, C-reactive protein, lymphocyte, neutrophil and monocyte in the groups. IFN-gamma, IP-10, IL-15, IL-31 and TNF-alpha also were measured; however, insufficient dogs (<5) had values that were in range of the assay to allow for statistical evaluation. Significance was defined as P < 0.05. RESULTS: Serum concentrations of IL-2, IL-18 and MCP-1 were significantly higher (P = 0.01, P = 0.01, P = 0.04) in the JOGD group. Also, IgA median value was significantly higher (P = 0.002) in pit bull terrier-type dogs with JOGD. Flow cytometry revealed that T-cell, neutrophil and monocyte markers were not different between groups. CONCLUSIONS: Results suggest an appropriate compensatory immune response by pit bull terrier-type dogs in the JOGD group and do not support the explanation of global immune deficiency in these dogs.

Effect of a Pheromone on Stress-Associated Reactivation of Feline Herpesvirus-1 in Experimentally Inoculated Kittens.

BACKGROUND: Stress contributes to reactivation of feline herpesvirus-1 (FHV-1). The usage of pheromones to decrease stress in FHV-1 experimentally inoculated kittens has not previously been investigated. HYPOTHESIS/OBJECTIVES: To determine whether a feline pheromone would lessen stress, resulting in decreased recurrence of FHV-1-associated illness in kittens. ANIMALS: Twelve 5-month-old, purpose-bred kittens. METHODS: Randomized, double-blind, placebo-controlled clinical trial. Kittens previously infected with the same dose of FHV-1 were randomized into 2 separate but identical group rooms. After a 2-week equilibration period, a diffuser containing either the pheromone or placebo was placed in each of the rooms, and the kittens acclimated for an additional 2 weeks. Every 2 weeks thereafter, for the 8-week study period, housing was alternated between kennel- and group housing. Blinded observers applied a standardized clinical and behavioral scoring rubric daily. After each 2-week period, serum cortisol concentrations and quantitative PCR for FHV-1 and glyceraldehyde 3-phosphate dehydrogenase (GAPDH) ratios were evaluated. Clinical, behavioral, and laboratory test results were compared between groups within individual and combined study periods. RESULTS: Sneezing occurred more frequently in the placebo group during individual (P = 0.006) and combined study periods (P = 0.001). Sleep at the end of observation periods occurred more frequently in the pheromone group during individual (P = 0.006) and combined study periods (P < 0.001). CONCLUSIONS AND CLINICAL IMPORTANCE: The findings suggest that the pheromone decreased stress, and the decrease in stress response may have resulted in decreased sneezing associated with FHV-1.

Use of Purina Pro Plan Veterinary Diet UR Urinary St/Ox to Dissolve Struvite Cystoliths.

The objective of this study was to determine the efficacy of feeding the commercially available diet, Purina Pro Plan Veterinary Diets UR Urinary St/Ox, for the dissolution of struvite cystoliths in cats with naturally occurring disease. Twelve cats with clinical signs of lower urinary tract disease and cystoliths confirmed via radiographs were enrolled. The cats were fed the study diet ad libitum and assessed by abdominal radiographs weekly. Cats with cystoliths that resolved based on radiographs and confirmatory ultrasound examination were considered diet successes. Cats with no change in cystolith size after 2-6 weeks underwent cystotomy for stone removal, aerobic culture and antimicrobial susceptibility testing, and analysis. All cats accepted the study diet, and weight loss was not noted over the course of the study. Total cystolith dissolution was achieved by week 2 for 5 cats, which were presumed to have struvite cystoliths. All other cats underwent cystotomy for stone removal after radiographic evidence of cystoliths were still present at 2 weeks (1 cat with severe signs), 4 weeks (5 cats), or 6 weeks (1 cat). The cystoliths that were surgically removed were calcium oxalate (5 cats) and mixed (2 cats) and would not be expected to dissolve with this diet. Follow-up radiographs from 6 cats fed the diet long term (3 presumed struvite and 3 with other cystoliths removed surgically) were collected from 1 to 6 months after beginning the study and showed no evidence of cystolith recurrence. While larger case numbers are needed, these results suggest that feeding Purina Pro Plan Veterinary Diets UR Urinary St/Ox can successfully dissolve cystoliths that are likely struvite and may lessen the risk of recurrence of struvite and calcium oxalate cystoliths.

Palatability and Clinical Effects of an Oral Recuperation Fluid During the Recovery of Dogs With Suspected Parvoviral Enteritis.

Dogs infected with canine parvovirus (CPV) can develop severe enteritis that requires supportive care until voluntary food and water consumption return. An oral recuperation fluid (ORF) may assist in the overall recovery from CPV. The hypotheses of the study were that dogs with naturally infected CPV would prefer the ORF to water and that dogs consuming the ORF would have a more rapid return to voluntary appetite and improved caloric intake during the initial recovery period compared with dogs consuming water. A total of 28 dogs with CPV were enrolled. Dogs were excluded if voluntary food or water intake was present at the time of study enrollment. Dogs were randomized to either an ORF or water group. The designated fluid was offered twice daily, followed by offering the opposite fluid 1 hour later if the designated fluid was refused. Dogs also received a standardized supportive treatment protocol. Beginning on day 2, all dogs were offered a gastrointestinal diet q8h, staggered with the fluid intake trials. A total of 40% (6/15) of dogs with CPV consumed the ORF as their designated fluid, and 31% (4/13) of dogs with CPV consumed water as their designated fluid (P = .71). For those dogs who refused their designated fluid, 56% (5/9) of the dogs consuming ORF ultimately consumed water, and 22% (2/9) of the dogs consuming water also consumed the ORF (P = .33). Dogs who consumed the ORF demonstrated a more rapid return to voluntary appetite (median = 1.5 days [range: 1-3]) compared with those that consumed water (median = 4.25 days [range: 1.5-5.5], P = .01) or neither fluid (median = 2 days [range: 1.5-5.5], P = .03). Additionally, those dogs consuming the ORF demonstrated greater caloric intake [median = 100% resting energy requirement (RER), range: 61%-100%] compared with those that consumed water (median = 19% RER; range: 9%-100%; P = .004) or neither fluid (median = 37% RER; range: 3-100; P = .05). This study suggests that some dogs with CPV voluntarily consume an ORF during the recovery phase of their illness and that consumption of the ORF may foster a more rapid return of voluntary appetite as well as improved caloric intake. Additional studies are warranted to further assess additional effects of this ORF during recovery from CPV.

Enfermedades intersticiales pulmonares asociadas a enfermedades del tejido conectivo: Hallazgos en la radiografía de tórax, la tomografía computarizada de alta resolución y test de espirometría / Intermediate pulmonary diseases associated with diseases of the connective fabric: Finds in the X-ray photography of thorax, the tomography computed of high resolution and test of spirometry

Objetivo: La meta de nuestro estudio fue describir los hallazgos de la enfermedad intersticiales pulmonares asociada a colagenopatías, en la radiografía de tórax, la tomografía computarizada de alta resolución (TCAR) y el test de espirometría. Métodos: Se revisó retrospectivamente las historias clínicas, las radiografías de tórax, las TCAR, y los informes del test de espirometría de 30 pacientes con las siguientes enfermedades del tejido conectivo: artritis reumatoidea (AR), lupus eritematoso sistémico (LES), esclerosis sistémica progresiva (ESP), síndrome de Sjõgren (SS) y dermatomiositis/polimiositis (DM/PM); que cumplían con los criterios de diagnóstico de la Asociación Americana de Reumatología (ARA), atendidos en el departamento de Reumatología y Eco-tomografía del Hospital Nacional Guillermo Almenara Irigoyen (HNGAI), durante el período comprendido entre enero del 2001 a enero del 2002. Resultados: Se evaluaron 30 pacientes, con promedio de edad de 52 años y rango de edad de:34 - 75 años; se encontró: 10 casos de AR; 8 casos de ESP; 6 casos de síndrome de sobreposición ESP/SS; 2 casos de síndrome de sobreposición ESP/LES; 2 casos de síndrome de sobreposición AR/SS; I caso de síndrome de sobreposición AR/les. Los hallazgos en la radiografía ...

Perceived psychologicasl stress in diabetes mellitus type 2 / Estrés psicológico percibido en diabetes mellitus tipo 2

Estudiamos los factores asociados al estrés psicosocial en pacientes con diabetes mellitus tipo 2. Se realizó un estudio en sección transversal en 105 pacientes, 27 hombres y 78 mujeres, cuya edad media es de 51.5 años (50.2-52.5, IC 95 por ciento) con 8.6 años desde el diagnóstico (7.3-9.8, IC 95 por ciento). Los pacientes tenían sobrepeso con índice de masa corporal (IMC) de 27.6 y la mayoría tenía descontrol metabólico aunque sin síntomas (media de glucosa 10.6 nmol/L y HbA1c de 9.2 por ciento). La hemoglobina glucosilada se asoció con el IMC (negativamente, p = 0.002). Dentro de los grupos, esta asociación con el IMC se encontró sólo en las mujeres y se explicó porqué la mujer obesa tiene menos años desde el diagnóstico que es un factor relacionado a mejor control metabólico. En el análisis de regresión múltiple el estrés percibido se asoció además con el por ciento de grasa corporal y con la glucosa en el grupo total, en las mujeres con años desde el diagnóstico (p = 0.02), y en los hombres con IMC (p = 0.03). No se encontró asociación entre estrés percibido y adherencia al tratamiento. Concluimos que en nuestro grupo, el estrés percibido se asoció con la obesidad y con el control metabólico.