Animal hoarding cases in England: Implications for public health services.

Hoarding disorder is characterized by an accumulation of possessions due to excessive acquisition of or difficulty discarding possessions, regardless of their actual value and is estimated to affect 2-6% of the population. Animal hoarding, a distinct subset of hoarding disorder, has a significant public health impact on the humans involved, as well as animal welfare. Individuals exhibit self-neglect, apathy, social withdrawal and object hoarding; living within squalid, deteriorated, structurally unsafe and uninhabitable premises, alongside neglected animals. Cases are complex, costly and impact on a range of responding service providers. Effective case management is poorly understood and researched, with published literature in England particularly sparse. Improving understanding of the characteristics of these cases is the first step in informed case management. This research is the first exploration of the characteristics of animal hoarders in England and the areas where cases were located. Information about prosecutions involving large numbers of animals that were reported in the media was systematically obtained. This identified 66 cases between January 2015 and December 2020. Geospatial analysis exploring characteristics of locations where animal hoarding cases are also reported. Findings were broadly consistent with the international literature in that females (64%), those living alone (71%) and those with a mean age of 49 were well represented. Cats (61.5%) and dogs (60%) were the most commonly hoarded species. There was a mean of 44 animals per case and dead or animals requiring euthanasia found in 53% of cases. Key characteristics of the areas where cases were found highlight urban, densely populated, and high levels of deprivation being the most represented. Evidence of recidivism was evident in 39% of cases, suggesting that prosecution is not an effective rehabilitator. Animal hoarding raises serious implications for Public Health Services, and the lack of current effective case management strategies are discussed.

A HPLC method to monitor the occurrence of lipid peroxidation in intravenous lipid emulsions used in parenteral nutrition using in-line UV and charged aerosol detection.

Parenteral Nutrition (PN) provides life sustaining support where gastrointestinal nutrition is inadequate due to disease or prematurity. Intravenous lipid emulsions (IVLEs) form a staple part of PN. Whilst the physical stability of IVLE's is relatively well known and quantified, chemical stability is an area where little testing has occurred. We report a new sensitive method for the monitoring of selected triglycerides present within two IVLEs and the detection and quantification of the peroxidation product 4-hydroxynonenal (HNE) using HPLC with in-line UV and charged aerosol detection (CAD). IVLEs used included the soy-bean oil based emulsion Intralipid® 20% and SMOFlipid® 20% (Fresenius Kabi UK), based on soy-bean, olive, fish oil and medium chain triglycerides. Assay validation gave R2 values of ≥0.99 for all selected triglyceride peaks and 4-hydroxynonenal. Inter and intra-day repeatability gave RSD values < 7.2% for CAD detection, achieving a precise and repeatable method. HNE was confirmed through internal standardisation of the HPLC method. Selected triglycerides were identified using ESI-MS with MicroTOF. This novel method permits the chemical stability of IVLEs to be quantified and monitored in respect to lipid peroxidation during storage prior to delivery to the patient, ensuring the optimal safety of IVLEs in a clinical setting.

CME Paper: Lipid Lowering Therapy is Safe in the Elderly:The LifeHelp 80-80 Analysis.

Little information is available regarding the safety and efficacy of lipid lowering therapy in the elderly. Records of 80 octogenarians, taken from the database of the LifeHelp Lipid Clinic of the Heart Institute of St. Petersburg, FL, were examined, representing 1863 patient months of treatment. Therapy was effective, lowering low density lipoprotein cholesterol (from 140Â+/-4 to 92Â+/-3 mg/dL), raising high density lipoprotein cholesterol (from 44Â+/-1 to 50Â+/-1 mg/dL), and lowering triglycerides (from 199Â+/-21 to 146Â+/-9 mg/dL). Six patients developed myalgias (without significant creatine phosphokinase rise) or gastrointestinal disturbances. Three of these patients restarted therapy without difficulty. No patient developed rhabdomyolysis (including the 11% of patients on combination therapy). One patient developed an elevation of liver (more than 3 times upper limits of normal), but later restarted therapy without sequelae. We conclude that lipid lowering therapy was effective at modifying hyperlipidemia in the elderly without significant adverse effects. (c) 2000 by CVRR, Inc.