Fuzapladib in a randomized controlled multicenter masked study in dogs with presumptive acute onset pancreatitis

We read with interest the article by Steiner et al,1 that claims that administration of fuzapladib is safe and effective in reducing 2 clinical scores in dogs with acute pancreatitis (AP). We commend Steiner et al for their efforts in addressing a critical need in veterinary medicine. This letter, however, raises significant concerns regarding the methodology and interpretation of the study results

Primary extraskeletal osteosarcoma of the post-hepatic caudal vena cava in a dog—Case report

Extraskeletal osteosarcoma (EOSA) in dogs is a rare malignant mesenchymal tumor of somatic soft tissues or more commonly visceral organs with a poor prognosis. In dogs, EOSAs have been described as arising from multiple locations, but differently from humans, never from a main vessel. In this report, we describe the first case of an EOSA arising from the post-hepatic caudal vena cava in a 7-year-old male neutered mix breed dog. This report focuses on the description of the diagnostic challenges to obtain a preoperative diagnosis, highlights the importance of histopathology for a correct diagnosis, and introduces a new differential diagnosis for an animal presenting with a suspected thrombus of the vena cava

Public attitudes to the management of invasive non-native species in Scotland

Invasive non-native species are one of the main threats to biodiversity. Consequently there is a need to control or eradicate those species that are causing problems in order to mitigate their impact. Such management programmes can be controversial and in some cases have been delayed or halted because of opposition from pressure groups. Public support can be critical to the success of such projects, and understanding the underlying attitudes of the public can help inform outreach education activities. To assess attitudes towards invasive species management and investigate socio-demographic factors influencing such attitudes, a questionnaire survey of 600 randomly selected members of the public in Scotland was conducted, and a total of 248 completed questionnaires returned. The level of support for control and eradication programmes was, in general, high and was higher amongst men, older people, and people who had previously heard of control and eradication projects. The species to be managed influenced levels of support, and projects to control birds were the least supported. Respondents with prior knowledge of control and eradication programmes and members of conservation organisations, in general, showed higher levels of support, indicating the important role that awareness and education has in terms of increasing public support for invasive non-native species management projects

Falling behind: life expectancy in US counties from 2000 to 2007 in an international context

<p>Abstract</p> <p>Background</p> <p>The United States health care debate has focused on the nation's uniquely high rates of lack of insurance and poor health outcomes relative to other high-income countries. Large disparities in health outcomes are well-documented in the US, but the most recent assessment of county disparities in mortality is from 1999. It is critical to tracking progress of health reform legislation to have an up-to-date assessment of disparities in life expectancy across counties. US disparities can be seen more clearly in the context of how progress in each county compares to international trends.</p> <p>Methods</p> <p>We use newly released mortality data by age, sex, and county for the US from 2000 to 2007 to compute life tables separately for each sex, for all races combined, for whites, and for blacks. We propose, validate, and apply novel methods to estimate recent life tables for small areas to generate up-to-date estimates. Life expectancy rates and changes in life expectancy for counties are compared to the life expectancies across nations in 2000 and 2007. We calculate the number of calendar years behind each county is in 2000 and 2007 compared to an international life expectancy time series.</p> <p>Results</p> <p>Across US counties, life expectancy in 2007 ranged from 65.9 to 81.1 years for men and 73.5 to 86.0 years for women. When compared against a time series of life expectancy in the 10 nations with the lowest mortality, US counties range from being 15 calendar years ahead to over 50 calendar years behind for men and 16 calendar years ahead to over 50 calendar years behind for women. County life expectancy for black men ranges from 59.4 to 77.2 years, with counties ranging from seven to over 50 calendar years behind the international frontier; for black women, the range is 69.6 to 82.6 years, with counties ranging from eight to over 50 calendar years behind. Between 2000 and 2007, 80% (men) and 91% (women) of American counties fell in standing against this international life expectancy standard.</p> <p>Conclusions</p> <p>The US has extremely large geographic and racial disparities, with some communities having life expectancies already well behind those of the best-performing nations. At the same time, relative performance for most communities continues to drop. Efforts to address these issues will need to tackle the leading preventable causes of death.</p

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Problem-based parasitology -- a heartworm teaching module

A case-based, computerized teaching module has been developed based on a 4 year old spayed female Belgian Malinois presented to Cornell University’s Hospital for Animals cardiology service for heartworm infection. The dog came from a Florida animal shelter. Physical examination and clinicopathologic examination were largely unremarkable. Thoracic radiography revealed mild changes consistent with heartworm disease. Thoracic CT imaging with intravenous contrast enabled the visualization of lesions not apparent radiographically. Treatment with melarsomine was initiated following a six week pre-adulticide regimen consisting of doxycycline and ivermectin. No complications were encountered during the course of treatment. Imaging performed one month after the final melarsomine administration showed sub-total resolution of the pulmonary nodules; the dog was clinically well and antigen testing was negative. This interactive tool made possible by collaboration between Cornell and Texas A&M’s veterinary colleges and Zoetis will provide a thorough overview of the diagnosis, staging, pathophysiology, treatment, and follow-up of canine heartworm disease