On farm factors increasing dark cutting in pasture finished beef cattle.

The on-farm factors increasing the incidence of dark cutting were studied in 3145 pasture raised cattle consigned in 66 lots. Animal, environmental and farm management factors were recorded and pasture quantity, quality and mycotoxin concentrations were measured. The relative risk of dark cutting decreased by 26% in cattle grazing pastures with magnesium concentrations exceeding 0.24%. There was a 50% increase in relative dark cutting risk of cattle drinking from dams compared to drinking from troughs. Feeding supplements (hay/silage) in the last 7 days prior to slaughter reduced the relative risk of dark cutting by 25%. A high prevalence of mycotoxins was detected in pastures across all farms. In this case pasture ergot alkaloid concentrations above 600PPB increased the relative risk of dark cutting by 45%, while the presence of FumonisinB1 increased risk by 58%. In contrast the presence of 3acetyldeoxynivalenol reduced the relative dark cutting risk by 37%. Sex also affected the incidence of dark cutting, with heifers less likely to cut dark than steers by 47%.

Clinical Evaluation of Tavocept to Decrease Diuresis Time and Volume in Dogs with Bladder Cancer Receiving Cisplatin.

BACKGROUND: Transitional cell carcinoma is the most common bladder cancer of dogs. Cisplatin combined with piroxicam provides superior response rates, but unacceptable rates of nephrotoxicity. Tavocept is a chemoprotectant that has mitigated cisplatin toxicity and decreased the required infusion/diuresis volume in clinical trials in humans. HYPOTHESIS/OBJECTIVES: We hypothesized that Tavocept would decrease diuresis volume and time and facilitate safe administration of a cisplatin/piroxicam protocol to dogs with bladder cancer. Secondary objectives were to compare response rate and survival times to an historical comparator group treated without Tavocept. ANIMALS: Fourteen client-owned dogs were prospectively enrolled. METHODS: Tumor volume was measured by computed tomography at days 0, 42, and 84. Dogs received combination Tavocept/cisplatin with a shortened diuresis protocol. A total of 4 doses was planned, with concurrent administration of piroxicam. Serial biochemical analyses were evaluated for azotemia. RESULTS: A 90-minute infusion/diuresis time was used for all dogs. Three dogs (21%) had concurrent increases in serum creatinine (>2.0 mg/dL) and BUN (>42 mg/dL) concentrations; 2 of these dogs were isosthenuric. This frequency of nephrotoxicity is significantly less (P = 0.0406) than that of an historical control group treated without Tavocept. Overall response rate was 27%. Median survival time was comparable to historical controls (253 vs. 246 days). CONCLUSIONS AND CLINICAL IMPORTANCE: Tavocept decreased the required diuresis time with cisplatin from > 6 hours to 90 minutes, while also decreasing occurrence of azotemia. Survival time was comparable, but the response rate was inferior to an historical comparator group. Further evaluation in other tumors susceptible to platinum agents is warranted.

Predictors of self-injurious behaviour exhibited by individuals with autism spectrum disorder.

BACKGROUND: Presence of an autism spectrum disorder is a risk factor for development of self-injurious behaviour (SIB) exhibited by individuals with developmental disorders. The most salient SIB risk factors historically studied within developmental disorders are level of intellectual disability, communication deficits and presence of specific genetic disorders. Recent SIB research has expanded the search for risk factors to include less commonly studied variables for people with developmental disorders: negative affect, hyperactivity and impulsivity. METHOD: A heterogeneous sample of 617 individuals with autism spectrum disorder diagnoses was derived from the National Database of Autism Research. Latent constructs were estimated from items of the community version of the Aberrant Behaviour Checklist. Structural equation modelling was used to assess whether impulsivity, hyperactivity, negative affect, severity of stereotypy, intellectual functioning or severity of autism symptoms predicted severity of SIB. RESULTS: Impulsivity (ß = 0.46), followed by intellectual functioning (ß = -0.39), and stereotypy (ß = 0.23) were the variables most highly predictive of increased SIB; impulsivity and stereotypy remained significant predictors of SIB after severity of autism symptoms and intelligence quotient (IQ) were controlled for. CONCLUSIONS: High levels of impulsivity and stereotypy were significant predictors of SIB in a large and diverse sample of people with confirmed autism diagnoses. Future research is needed on the effects of reducing impulsivity and stereotypy on the outcomes of treatment, early intervention and attempts to prevent the development of SIB.

Reducing medical attrition: the role of the Accession Medical Standards Analysis and Research Activity.

This paper illustrates how adding an epidemiologic perspective to medical accession policy development allows the Department of Defense to address unacceptably high rates of premature attrition, lost duty time, avoidable medical care costs, sick leave, disability, and various wasteful, inefficient practices. The Accession Medical Standards Analysis and Research Activity is a major new epidemiologic entity. Historically, military medical accession policy and waiver deliberations were based heavily on expert opinion. A common limitation of expert opinion is that although experience teaches much about individuals with certain conditions who develop problems, it does not teach about individuals with the same conditions who remain well. The Accession Medical Standards Analysis and Research Activity produces the analyses of epidemiologic data necessary for the joint personnel and medical flag-level Department of Defense Accessions Medical Standards Steering Committee to make evidence-based accession policy decisions.

The challenges of implementing quality improvement in small rural hospitals.

In the five years since launching its QI initiative, Mason General Hospital has dealt with many of the challenges that commonly arise in healthcare organizations during TQM implementation, including involving physicians and training staff. It also had to address a host of issues common to small rural organizations. At first glance, one might suspect that the move toward QI would be easier in a small organization because there are fewer leaders to orient, fewer people involved in work processes, and fewer levels of management. In fact, the small organization presents special challenges, including limited staff and financial resources, high turnover rates in key medical staff leadership positions, and small sample sizes. The strategies used by Mason General Hospital to respond to these and other challenges provide a model for small rural healthcare organizations.

Dietary intakes and adipose tissue levels of linoleic acid in peptic ulcer disease.

Adipose tissue levels of linoleic acid were determined from biopsies of subcutaneous abdominal fat of normal healthy controls (n 40) and from two patient groups with endoscopically evaluated non-ulcer dyspepsia (n 40) or peptic ulcer disease (n 38). The level (g/100 g) of adipose tissue linoleic acid in the normal healthy controls (15.0 (SD 4.1] was significantly (P less than 0.05) greater than that in patients with non-ulcer dyspepsia (12.8 (SD 3.5] and in patients with peptic ulcer disease (11.7 (SD 2.7]. A dietary history revealed a lower intake of linoleic acid and a significantly (P less than 0.05) lower intake of dietary fibre (g/d) for both the non-ulcer dyspepsia (15.9 (SD 6.2] and peptic ulcer disease (15.2 (SD 7.8] patients compared with normal healthy controls (20.2 (SD 11.2]. Adipose tissue linoleic acid tended to increase with indices of increasing socioeconomic status, although the differences between patient and controls were not confounded by socioeconomic status. Patients with dyspepsia reported more foods causing symptoms (onion, fried foods, alcohol, citrus fruits and spices) and more foods giving relief (milk, bread) compared with control orthopaedic patients.