Incidence, severity and prognosis associated with hypernatremia in dogs and cats.

BackgroundHypernatremia has been associated with substantial morbidity and death in human patients. The incidence and importance of hypernatremia in dogs and cats has not been determined.Hypothesis/objectivesTo describe the incidence of and prognosis associated with hypernatremia in dogs and cats at a university teaching hospital.AnimalsA total of 16,691 dogs and 4,211 cats with measured blood or serum sodium concentration.MethodsRetrospective study. Medical records of animals with a blood or serum sodium concentration measured during a 60-month period were reviewed to determine the severity of hypernatremia and its associated case fatality rate. Cases with moderate (11-15 mmol/L above the reference range) or severe hypernatremia (≥16 mmol/L above the reference range) were further reviewed.ResultsA total of 957 dogs (5.7%) and 338 cats (8.0%) were diagnosed with hypernatremia. Case fatality rates of dogs and cats with hypernatremia was 20.6 and 28.1%, respectively compared to 4.4 and 4.5% with a normal blood or serum sodium concentration (P < .0001). The magnitude of hypernatremia was linearly associated with a higher case fatality rate (P < .0001). Hypernatremia was associated with a higher case fatality rate than hyponatremia. Among the animals with moderate or severe hypernatremia, 50% of dogs and 38.5% of cats presented with community-acquired hypernatremia, and 50% of dogs and 61.5% of cats developed hospital-acquired hypernatremia.Conclusions and clinical importanceHypernatremia was found infrequently in this population but was associated with increased case fatality rates in dogs and cats. Presence and severity of hypernatremia might be useful as a prognostic indicator

Assessment of Canine Pancreas-Specific Lipase and Outcomes in Dogs with Hemodialysis-Dependent Acute Kidney Injury.

BackgroundRenal replacement therapies can be life-saving for dogs with severe acute kidney injury (AKI), however, comorbidities including pancreatitis might affect outcome.Hypothesis/objectivesTo investigate the prevalence of pancreas-specific lipase (Spec cPL) measurements consistent with pancreatitis (≥400 μg/L) in dogs undergoing intermittent hemodialysis (IHD) for treatment of AKI and to determine whether there were associations between 30-days outcomes and Spec cPL measurements.AnimalsFifty-three client-owned dogs presented to teaching hospitals between November 2008 and September 2016 that underwent IHD.MethodsRetrospective medical record review from dogs that received IHD for management of AKI and also had a Spec cPL measurement. Association between survival, dialysis-dependency, and Spec cPL measurements was assessed.ResultsForty of 53 (76%) dogs were alive at 30-days and 33/53(62%) had a Spec cPL result ≥400 μg/L. Spec cPL was not significantly different either between surviving (635.5 μg/L, range 29-1,001) and nonsurviving dogs (860 μg/L, range 56-1,001; P = 0.75) or between dialysis-dependent (1,001 μg/L, range 177-1,001) and nondialysis-dependent dogs (520 μg/L, range 29-1,001; P = 0.08). Spec cPL ≥400 μg/L was not significantly associated either with survival (P = 0.74) or dialysis-dependency (P = 0.33).Conclusions and clinical importanceResults revealed a high prevalence of Spec cPL ≥400 μg/L in dogs with AKI treated with IHD. No significant associations between Spec cPL and survival or dialysis-dependency in dogs with AKI at 30 days were identified in the current study, however, the latter could be due to lack of power in this study

Estimation of COVID-19 spread curves integrating global data and borrowing information

Currently, novel coronavirus disease 2019 (COVID-19) is a big threat to global health. The rapid spread of the virus has created pandemic, and countries all over the world are struggling with a surge in COVID-19 infected cases. There are no drugs or other therapeutics approved by the US Food and Drug Administration to prevent or treat COVID-19: information on the disease is very limited and scattered even if it exists. This motivates the use of data integration, combining data from diverse sources and eliciting useful information with a unified view of them. In this paper, we propose a Bayesian hierarchical model that integrates global data for real-time prediction of infection trajectory for multiple countries. Because the proposed model takes advantage of borrowing information across multiple countries, it outperforms an existing individual country-based model. As fully Bayesian way has been adopted, the model provides a powerful predictive tool endowed with uncertainty quantification. Additionally, a joint variable selection technique has been integrated into the proposed modeling scheme, which aimed to identify possible country-level risk factors for severe disease due to COVID-19

Help seeking for cancer 'alarm' symptoms: a qualitative interview study of primary care patients in the UK.

Delay in help seeking for cancer 'alarm' symptoms has been identified as a contributor to delayed diagnosis

Diagnostic yield of cytologic analysis of pericardial effusion in dogs.

BackgroundPericardial effusion cytology is believed by many to be of limited value, yet few studies have evaluated its diagnostic utility.ObjectivesTo determine the diagnostic utility of cytologic analysis of pericardial effusion in dogs and to determine if consideration of additional data could improve the diagnostic yield.AnimalsTwo hundred and fifty-nine dogs with cytologic analysis of pericardial effusion performed between April 1990 and June 2012.MethodsElectronic medical records from a university teaching hospital were retrospectively reviewed; signalment, complete blood count, serum biochemistry, cytologic analysis of pericardial effusion, and echocardiographic data were recorded. Cytology was classified as diagnostic (infectious or neoplastic) or nondiagnostic (hemorrhagic or other) and groups were compared with multiple Student's t-tests.ResultsCytology was grouped as nondiagnostic (92.3%) or diagnostic (7.7%) and characterized as hemorrhagic (90%), neoplastic (4.6%), infectious (3.1%), or other (2.3%). Overall cytologic analysis of pericardial effusion diagnostic utility was 7.7% and increased to 20.3% if the effusion hematocrit (HCT) <10%; echocardiographic evidence of a mass did not result in a significant increase in the diagnostic utility.Conclusions and clinical importanceThe diagnostic utility of cytologic analysis of canine pericardial effusion is variable depending on the underlying etiology. In this group of dogs, the diagnostic yield of cytologic analysis was greater for pericardial effusion samples in which the HCT was less than 10%

Large-Scale Modelling of the Environmentally-Driven Population Dynamics of Temperate Aedes albopictus (Skuse)

The Asian tiger mosquito, Aedes albopictus, is a highly invasive vector species. It is a proven vector of dengue and chikungunya viruses, with the potential to host a further 24 arboviruses. It has recently expanded its geographical range, threatening many countries in the Middle East, Mediterranean, Europe and North America. Here, we investigate the theoretical limitations of its range expansion by developing an environmentally-driven mathematical model of its population dynamics. We focus on the temperate strain of Ae. albopictus and compile a comprehensive literature-based database of physiological parameters. As a novel approach, we link its population dynamics to globally-available environmental datasets by performing inference on all parameters. We adopt a Bayesian approach using experimental data as prior knowledge and the surveillance dataset of Emilia-Romagna, Italy, as evidence. The model accounts for temperature, precipitation, human population density and photoperiod as the main environmental drivers, and, in addition, incorporates the mechanism of diapause and a simple breeding site model. The model demonstrates high predictive skill over the reference region and beyond, confirming most of the current reports of vector presence in Europe. One of the main hypotheses derived from the model is the survival of Ae. albopictus populations through harsh winter conditions. The model, constrained by the environmental datasets, requires that either diapausing eggs or adult vectors have increased cold resistance. The model also suggests that temperature and photoperiod control diapause initiation and termination differentially. We demonstrate that it is possible to account for unobserved properties and constraints, such as differences between laboratory and field conditions, to derive reliable inferences on the environmental dependence of Ae. albopictus populations

Concentric left ventricular remodeling and aortic stiffness: A comparison of obesity and hypertension

Licensed under the Creative Commons Attribution Non-Commercial No Derivatives Licens

PENGARUH KOMPONEN KECERDASAN EMOSIONAL TERHADAP KINERJA PEGAWAI PADA KANTOR CAMAT SITALASARI

ABSTRAK Tujuan penelitian ini adalah Untuk mengetahui dan menganalisa pengaruh komponen kecerdasan emosional terhadap kinerja pegawai pada kantor camat Siantar Sitalasari. Untuk mengetahui dan menganalisa pengaruh sikap kerja terhadap kinerja pegawai pada kantor camat Siantar Sitalasari. Untuk mengetahui dan menganalisa pengaruh komponen kecerdasan emosional dan sikap kerja terhadap kinerja pegawai pada kantor camat Siantar Sitalasari. Penelitian ini di laksanakan pada Kantor Sitalasari, hal ini bertujuan untuk mengetahui kinerja pegawai negeri pada Kantor Camat Sitalasari. Untuk populasi dan sampel peneliti mengembil keseluruhan Pegawai Sitalasari pada Kantor Camat Sitalasari yang berjumlah 30 orang responden.Kepemimpinan memiliki pengaruh positif terhadap Kinerja Pegawai Kantor Camat Sitalasari. Kenyatan ini dibuktikan dengan hasil uji statistik dimana nilai t tabel sebesar 0.05 yang dibandingkan dengan nilai t hitung untuk variabel kepemimpinan 8,019. Hasil perbandingan tersebut menunjukan bahwa nilai t hitung > t tabel yaitu 8,019 > 0,05 maka Ho ditolak dan Ha diterima. Disiplin kerja memiliki pengaruh negatif terhadap kinerja Pegawai Kantor Camat Sitalasari. Kenyataan ini dibuktikan dengan hasil uji statistic dimana nilai t tabel sebesar 0,05 yang dibandingkan dengan nilai t hitung untuk variabel disiplin kerja -0,174. Hasil perbandingan tersebut menunjukan bahwa nilai t hitung > t tabel yaitu - 0,174 > 0,05 maka Ho ditolak dan Ha diterima.Hasil dari penelitian ini menyimpulkan bahwa secara parsial, variabel kepemimpinan tidak signifikan terhadap kinerja karyawan. Berbeda dengan variabel disiplin kerja yang berpengaruh signifikan terhadap kinerja Pegawai Kantor Camat Sitalasari. Secara simultan, kepemimpinan dan disiplin kerja berpengaruh terhadap Kinerja pegawai. Kata kunci: Kepemimpinan, disiplin kerja, kinerja karyawa