Humeral intracondylar fissures and intracondylar sclerosis are common CT findings in the limb contralateral to a humeral condylar fracture in French bulldogs and spaniel breeds.

French bulldogs (FBD) are reported to be at an increased risk of developing humeral condylar fractures (HCF). Spaniel breeds have been reported to be at increased risk of HCF due to a high prevalence of humeral intracondylar fissures (HIF), which can predispose to fracture. The aims of this retrospective, single center, observational study were twofold. First, to compare the signalment, fracture configuration, and etiology of populations of FBD and spaniel breeds presenting with HCF at a single hospital. Second, to evaluate the computed tomographic (CT) findings of the contralateral elbow joints of FBD and spaniel breeds presenting with HCF for concomitant pathology. FBDs were overrepresented for HCF, most commonly presenting when skeletally immature, with a median age of 3.7 months. Fractures of the lateral condyle were the most common configuration for both breed groups. Sclerosis at the fracture site was identified in 62% of FBD and 95% of spaniels undergoing CT scans. Humeral intracondylar fissures and intracondylar sclerosis were commonly observed in the contralateral elbows of FBD (44% and 50%, respectively) and spaniel breeds (58% and 95%, respectively). Medial coronoid pathology, elbow incongruency, and periarticular osteophytes were not identified in the contralateral elbows of FBD but were identified in 29%, 4%, and 20% of spaniels, respectively. The high prevalence of HIF in the FBD group may be a predisposing factor for HCF in this breed.

Rickettsia typhi infection in a clinically-ill dog from Houston, Texas.

In 2020, Rickettsia typhi was diagnosed in a dog from Houston, Texas, USA based upon R. typhi IFA seroreactivity in both acute and convalescent sera, and PCR with DNA sequencing of 4 different gene regions, all of which were 100% identical to R. typhi. The dog was clinically ill with intermittent fever, lethargy, inappetence, and lymphadenopathy. Clinicopathological abnormalities included a mild nonregenerative anemia, neutrophilia, lymphopenia, thrombocytopenia, hypoalbuminemia, and elevated ALP. The dog rapidly recovered with doxycycline administration.

Heterobilharzia americana infection in dogs: A retrospective study of 60 cases (2010-2019).

BACKGROUND: The trematode Heterobilharzia americana (HA) causes granulomatous gastrointestinal and hepatic disease in dogs. Before 2008, diagnosis relied on saline fecal sedimentation or histopathology, and earlier reports primarily described dogs with advanced disease or cases diagnosed incidentally at necropsy. The advent of a fecal PCR test has facilitated the diagnosis of HA and provided insights into manifestations and response to treatment. OBJECTIVES: Describe the clinical findings, response to treatment, and outcome for dogs infected with HA. ANIMALS: Sixty dogs diagnosed with HA between 2010 and 2019. METHODS: Retrospective study. Medical records were searched for dogs diagnosed with HA by fecal PCR testing, identification of ova in feces, or histopathology. RESULTS: Mean age was 7.5 (±4.1) years and weight was 23.2 (±10.18) kg. Clinical signs included diarrhea (55.8%), vomiting (46.2%), and weight loss with or without anorexia (15.4%). Laboratory abnormalities included hyperglobulinemia (42.6%) and increased liver enzyme activities (30%). More than 40% of dogs had an eosinophil count >500/µL. Hypercalcemia attributable to HA was identified in only 4 dogs. Pinpoint hyperechoic foci were noted in intestines, liver, or mesenteric lymph nodes during transabdominal ultrasonography in 64.4% of dogs. Survival data was available for 34 dogs, of which 73.5% (25) were alive 6 months after diagnosis. CONCLUSIONS AND CLINICAL IMPORTANCE: Hyperglobulinemia, high eosinophil count, and ultrasonographic evidence of visceral mineralization were suggestive of infection. Hypercalcemia was uncommon. Combination treatment with praziquantel and fenbendazole was variably effective, and 17.6% of treated dogs with known outcome died as a result of HA infection.

Partnerships between parents and health care professionals to improve adolescent health.

INTRODUCTION: Research on partnerships between parents and health care professionals (HCPs) to improve adolescent health is limited. In this study, we have developed an empirically derived framework to guide research in this particular area. METHODS: We conducted a qualitative study using focus groups and in-depth semi-structured interviews. A total of 85 participants (51 HCPs, 17 mothers of patients of ages 12-18 years, and 17 adolescents) were recruited from three free-standing adolescent health clinics and five school-based health centers across North Carolina. We independently explored the perceptions of HCPs and mothers regarding the roles of parents, HCPs, and parent-HCP partnerships in preventing and addressing adolescent health problems. We then elicited feedback of adolescents on mother and HCP perceptions. We identified common and informative themes during content analysis using ATLAS.ti, and triangulated perspectives of HCPs, mothers, and adolescents to develop a framework for building parent-HCP partnerships to improve adolescent health. RESULTS: A general framework emerged that conceptualizes both direct and indirect strategies for building parent-HCP partnerships. Direct strategies involve strengthening relationships and/or communication between parents and HCPs in both practice and community settings. Indirect strategies involve opportunities for HCPs to influence parent-adolescent relationships and/or communication within the context of adolescent visits. For example, HCPs can discuss the importance of parental involvement and monitoring with adolescents, encourage and facilitate parent-adolescent communication, and deliver tailored parental guidance while also respecting adolescents' desires for confidential health care when appropriate. CONCLUSIONS: Interventions that directly strengthen parent-HCP relationships and/or communication, and those that indirectly support parent-HCP partnerships within the context of adolescent health care, should be designed targeting health outcomes.

Engaging key stakeholders to assess and improve the professional preparation of MPH health educators.

OBJECTIVES: We described the process of engaging key stakeholders in a systematic review of requirements for a master of public health (MPH) degree within the Department of Health Behavior and Health Education, University of North Carolina Gillings School of Global Public Health, and summarized resulting changes. METHODS: A benchmarking study of 11 peer institutions was completed. Key stakeholders (i.e., current students, alumni, faculty, staff, employers, and practicum preceptors) received online or print surveys. A faculty retreat was convened to process results and reach consensus on program revisions. RESULTS: MPH program changes included (1) improved advising and mentoring program, (2) elimination of research and practice track options, (3) increased elective and decreased required credit hours, (4) replacement of master's paper requirement with "deliverables" (written products such as reports, documents, and forms) produced as part of the required "Capstone" course, (5) extended community field experience to 2 semesters and moved it to year 2 of the program, and (6) allowed practica of either 200, 300, or 400 hours. CONCLUSIONS: Engaging key stakeholders in the program review process yielded important changes to the MPH degree program requirements. Others may consider this approach when undertaking curriculum reviews.

Increasing adolescent vaccination: barriers and strategies in the context of policy, legal, and financial issues.

PURPOSE: To increase understanding of the policy, legal, and financial issues influencing efforts to achieve high rates of adolescent vaccination. METHODS: We conducted semistructured telephone interviews with 49 key informants in nine states, five jurisdictions, and at the national level. We elicited: (a) experiences with human papillomavirus (HPV) and meningococcal vaccine programs; (b) perspectives on policy, legal, and financing issues influencing adolescent vaccine program effectiveness; and (c) strategies to increase rates of adolescent vaccination. Common and informative themes were identified by content analyses. RESULTS: Participants reported that barriers to adolescent vaccination included: public concerns (insufficient knowledge, negative attitudes, safety concerns, controversy); practitioner concerns (insufficient knowledge or ambivalence about recommendations); delivery issues (insufficient access to or use of healthcare, vaccines not at healthcare site or part of routine care); minor consent issues; cost/financing issues; and lack of coordination in timing of vaccine recommendations, supply, and financing. Many barriers and promising strategies for overcoming them vary depending on adolescent age. For example, concerns about providing vaccines to prevent sexually transmitted diseases are less frequent with respect to older adolescents; issues of consent vary widely between 11 and 25 years of age; and financial barriers/potential solutions vary by age. We develop a framework to address policy, legal, and financial issues influencing adolescent vaccination based on adolescent age. CONCLUSIONS: A comprehensive description of factors influencing adolescent vaccination reveals variation based on age. A framework that incorporates this complexity may enhance strategies to increase rates of vaccine delivery to adolescent populations.

Parents and health care professionals working together to improve adolescent health: the perspectives of parents.

One proposed strategy to improve adolescent health and health care is to create working partnerships among adolescent health care professionals (HCPs) and families. In this pilot qualitative study we interviewed 17 mothers to explore their perceptions of the role of parents, HCPs, and parent-HCP partnerships in addressing adolescent health issues.