Clinicopathological factors associated with the presence of hypercapnia at admission in hospitalised cats with decompensated chronic kidney disease.

AIMS: To evaluate associations between clinicopathological variables and hypercapnia measured in cats with decompensated chronic kidney disease (CKD) on admission to a veterinary hospital. METHODS: This is a retrospective, cross-sectional study of cats (n = 39) that presented to a tertiary veterinary hospital in Argentina between June 2015 and December 2017 with blood creatinine concentrations >140 µmol/L, and abdominal ultrasound results consistent with CKD. Data recorded included venous partial pressure of CO2 (PvCO2), blood pH, haematocrit and concentrations of glucose, potassium, sodium, corrected sodium (Na+c), and ionised calcium in blood. A logistic regression model was used to assess associations between the presence of hypercapnia (PvCO2 ≥ 44.7 mmHg) and the other clinicopathologic variables. The duration of hospitalisation was compared in cats with and without hypercapnia using the Wilcoxon Rank Sum test. RESULTS: The final study population comprised 39 cats. Eleven cats (28.2%) had hypercapnia. In the logistic regression model, two independent variables were associated with the presence of hypercapnia at admission in cats with CKD: the concentration of creatinine in blood (OR = 1.06 (95% CI = 1.016-1.108); p = 0.007) and Na+c (OR = 1.33 (95% CI = 1.08-1.63); p = 0.005). There were no statistically significant differences in the length of hospital stay between the two groups. CONCLUSIONS AND CLINICAL RELEVANCE: There appears to be an association between elevated concentrations of creatinine and Na+c in blood, and hypercapnia in cats with CKD, suggesting careful assessment of blood gas and electrolyte parameters during hospitalisation is required. Further prospective studies are needed to evaluate the mechanisms behind this association and the association of hypercapnia with disease outcome including mortality.

Long-term follow-up in composite tissue allotransplantation: in-depth study of five (hand and face) recipients.

Composite tissue allotransplantations (CTAs) have clinically shown little, if any, evidence of chronic rejection. Consequently, the effect of chronic rejection on bones, joints, nerves, muscles, tendons and vessels may still have undescribed implications. We thoroughly assessed all allograft structures by histology, magnetic resonance imaging, ultrasonography and high resolution peripheral quantitative computed tomography scan in four bilateral hand-grafted patients (10, 7, 3 and 2 years of follow-up, respectively) and in one facial allotransplantation (5 years of follow-up). All the recipients presented normal skin structure without dermal fibrosis. Vessels were patent, without thrombosis, stenosis or intimal hyperplasia. Tendons and nerves were also normal; muscles showed some changes, such as a variable degree of muscular hypotrophy, particularly of intrinsic muscles, accompanied by fatty degeneration that might be related to denervation. In the majority of hand-grafted patients graft radius and recipient tibia showed a decrease in trabecular density, although in the graft radius the alterations also involved the cortices. No deterioration of graft function was noted. In these cases of CTA no signs of chronic graft rejection have been detected. However, the possibility that chronic rejection may develop in CTA exists, highlighting the necessity of close continuous follow-up of the patients.

Urban development and employment in Abidjan.

PIP: The city of Abidjan in the Ivory Coast has grown physically, economically, and demographically at rates exceeding all reasonable expectation. Yet, as in many other development nations, the employment generated by Abidjan's rapid economic expansion has failed to keep pace with the increase in working population it has attracted. Consequently, economic success has been accompanied by a variety of social strains. Some of these have been discussed in earlier issues of the "International Labour Review" by Louis Roussel. This discussion expands on Roussel's earlier treatment by focusing more specifically on several facets of the urban employment problem created by the rapid growth of Abidjan. Attention is directed to labor supply and employment, factors affecting migration, foreign Africans in the Ivory Coast labor force; the urban informal sector; urban infrastructure and development; social problems of population pressure; employment policy options (current government policies and other policy options); and general issues and policy alternatives (motivations for rural urban migration, smaller urban centers as alternative growth poles, and distributing the gains from development). Several essential features of the employment problem stem from the rural urban distribution of the workforce. The rural labor force, including temporary seasonal workers from the savannah countries to the north, remains more or less in balance with increasing rural employment opportunities, since the migration of Ivory Coast nationals to the cities is balanced by the inflow of foreign workers. In contrast, the influx of migrants into urban areas has led to a more rapid increase in the urban labor force than in urban employment, with a consequent rise in unemployment. In 1970 the Abidjan rate of open unemployment was probably around 20%. At this time, most people's idea of a desirable job is one in the formal sector of the urban economy. If there is to be any hope of an eventual balance between expectations and reality, it must be realized that an increasing share of the urban labor force will have to end up in the informal sector. Different attitudes towards work in the informal sector are needed on the part of both young people entering the labor force and of government policy makers. The latter should be seeking ways to increase productivity and incomes in the informal sector rather than for ways to destroy it. Current government policies include the training and educating of nationals to replace foreign technicians and managers, increasing the attractiveness of the rural milieu by the promotion of cooperatives, attempts to reform the land tenure system, the supply of electricity to villages, and the introduction of educational television; and adapting the educational system and technical training programs to the needs of the economy.^ieng