A case of pyometra and granulosa cell tumour in a sheep

This case report describes the diagnosis and treatment of pyometra and granulosa cell tumour in a pet ewe. It includes the use of simple imaging and blood testing to assist the diagnosis, the use of medical treatment in the control of the pyometra, a description of the surgical treatment in order to remove the granulosa cell tumour and the subsequent management of the wound dehiscence by insertion of a polypropylene mesh. The anaesthetic regimens are described and are techniques which can be used in practice. This particular case was followed to its full conclusion as the ewe was a valued pet; in the commercial breeding ewe the case work up would have ceased at an earlier point. </jats:p

Family preferences for home or hospital care at diagnosis for children with diabetes in the DECIDE study.

This is the final version of the article. Available from Wiley via the DOI in this record.AIMS: A diagnosis of Type 1 diabetes in childhood can be a difficult life event for children and families. For children who are not severely ill, initial home rather than hospital-based care at diagnosis is an option although there is little research on which is preferable. Practice varies widely, with long hospital stays in some countries and predominantly home-based care in others. This article reports on the comparative acceptability and experience of children with Type 1 diabetes and their parents taking part in the DECIDE study evaluating outcomes of home or hospital-based treatment from diagnosis in the UK. METHODS: Semi-structured interviews with 11 (pairs of) parents and seven children were conducted between 15 and 20 months post diagnosis. Interviewees were asked about adaptation to, management and impact of the diabetes diagnosis, and their experience of initial post-diagnosis treatment. RESULTS: There were no differences between trial arms in adaptation to, management of or impact of diabetes. Most interviewees wanted to be randomized to the 'home' arm initially but expressed a retrospective preference for whichever trial arm they had been in, and cited benefits relating to learning about diabetes management. CONCLUSIONS: The setting for early treatment did not appear to have a differential impact on families in the long term. However, the data presented here describe different experiences of early treatment settings from the perspective of children and their families, and factors that influenced how families felt initially about treatment setting. Further research could investigate the short-term benefits of both settings.National Institute for Social Care and Health Research Clinical Research Centr

Rapid Global Expansion of the Fungal Disease Chytridiomycosis into Declining and Healthy Amphibian Populations

Published versio

Ultrashort Echo Time Imaging of the Osteochondral Junction in Subjects with Knee Osteoarthritis and Age-matched Healthy Volunteers

SYNOPSIS We describe in vivo translation of ultrashort TE (UTE) imaging of the osteochondral junction (OCJ) at the knee in 9 subjects with osteoarthritis (OA) and 4 age-matched healthy volunteers. The OCJ plays an important role in onset and progression of OA. Our study demonstrates that UTE imaging of the OCJ is repeatable and demonstrates OCJ defects in OA subjects but not in healthy volunteers. Areas of OCJ damage commonly co-locate to other osteochondral pathology (bone marrow lesions and cartilage defects). UTE imaging of the OCJ may be a helpful tool for assessing OCJ damage in clinical studies of OA. INTRODUCTION Disruption of the osteochondral junction (OCJ) is thought to play an important role in the onset and progression of osteoarthritis (OA). Using conventional MR imaging, direct visualisation of the OCJ is not possible due to inherent short T1 and T2 relaxation times of the OCJ tissues. However, by achieving echo times (TEs) of < 1 ms, ultrashort echo time (UTE) MR imaging allows direct visualisation of the OCJ. The normal OCJ appears as an area of linear high signal intensity (SI) on UTE images at the bone-cartilage interface. In OA it has been shown that this area of linear high SI can become thinned or absent, compatible with histological findings of OCJ defects(1, 2). These findings have been described in a number of cadaveric MR studies, but there are limited in vivo data available(3-5). The aims of this study were to compare the in vivo appearance of the OCJ on UTE MR imaging between subjects with knee OA and age-matched healthy volunteers, to determine the relationship between OCJ defects and other osteochondral pathology, and to assess test-retest repeatability. METHODS We imaged 9 participants with mild-moderate knee osteoarthritis, characterised by radiographs with medial tibiofemoral compartment predominant disease and Kellgren-Lawrence grades 2-3, and 4 age-matched healthy volunteers. Participants were imaged at baseline and 1 month. MR studies were performed on a 3T system (GE 750, GE Healthcare). The MR protocol consisted of standard clinical sequences (coronal and sagittal intermediate-weighted fat-saturated fast spin echo (FSE) sequences plus a coronal T1-weighted FSE sequence) and a sagittal dual-echo UTE gradient echo sequence acquired using a 3D cones trajectory (research prototype; repetition time 15 ms, TE 0.03/4.5 ms, flip angle 13o, field-of-view 18 x 18 cm, matrix 430 x 430, slice thickness 2 mm, number of averages 1, acquisition time ~ 7.5 minutes). To increase conspicuity of short T2 tissues, we performed weighted digital image subtraction of the longer TE (4.5 ms) from the shorter TE images (0.03 ms)(6). The presence or absence of characteristic linear high SI at the OCJ was scored in 12 regions for each knee, corresponding to tibiofemoral subdivisions commonly used for semi-quantitative scoring. The presence of bone marrow lesions (BML) or cartilage defects in the same regions was also recorded. Assessment was performed by a single musculoskeletal radiologist with 5 years' experience in OA research, blinded to group assignment. We used descriptive statistics to compare the number of regions with OCJ defects in subjects with OA and healthy volunteers, and to assess the frequency with which OCJ defects co-located with BMLs or cartilage defects. Test-retest repeatability was evaluated using kappa statistics. RESULTS Participant characteristics are displayed in table 1. Six out of 9 OA participants (67%) had an OCJ defect in at least one region compared to 0 out of 4 controls (0%). The most commonly involved region was the central medial tibia (4 participants). OCJ defects commonly co-located to BMLs (7 out of 10 OCJ defects, 70%) and cartilage defects (6 out of 10 OCJ defects, 60%). Results are displayed in table 2. Sample images are displayed in figures 1 - 3. The kappa value for test-retest repeatability of OCJ assessment using UTE was 0.83 (95% confidence interval 0.64 to 1). DISCUSSION The appearances of OCJ defects in subjects with OA in vivo are in keeping with abnormalities predicted by cadaveric MR and histology studies(1, 3). The biological plausibility of the findings is enhanced by the frequency of co-location of OCJ damage to other osteochondral pathology (BMLs and cartilage defects). Our findings demonstrate in vivo translation of UTE imaging of the OCJ, and suggest that this is a useful tool for future studies of OA onset and progression. This may include predicting response to intervention, as equine studies have demonstrated that the presence or absence of OCJ damage is an important predictor of response to treatment of cartilage defects(7). Our results demonstrate that UTE imaging of the OCJ is repeatable with kappa values in keeping with 'near-perfect' test-retest repeatability for qualitative assessment(8). Previous in vivo studies have not used age-matched control subjects, therefore it has been unclear whether areas of OCJ damage are related to OA or normal ageing(4). The normal appearance of the OCJ in age-matched control subjects in this study suggests that the OCJ defects are not part of normal ageing, although at present the number of healthy volunteers imaged is small. CONCLUSION In vivo UTE MR imaging of the OCJ is repeatable and demonstrates OCJ defects in subjects with OA. OCJ defects commonly co-locate with other osteochondral pathology

From modular to centralized organization of synchronization in functional areas of the cat cerebral cortex

Recent studies have pointed out the importance of transient synchronization between widely distributed neural assemblies to understand conscious perception. These neural assemblies form intricate networks of neurons and synapses whose detailed map for mammals is still unknown and far from our experimental capabilities. Only in a few cases, for example the C. elegans, we know the complete mapping of the neuronal tissue or its mesoscopic level of description provided by cortical areas. Here we study the process of transient and global synchronization using a simple model of phase-coupled oscillators assigned to cortical areas in the cerebral cat cortex. Our results highlight the impact of the topological connectivity in the developing of synchronization, revealing a transition in the synchronization organization that goes from a modular decentralized coherence to a centralized synchronized regime controlled by a few cortical areas forming a Rich-Club connectivity pattern.Comment: 24 pages, 8 figures. Final version published in PLoS On

An evaluation of urinary microRNA reveals a high sensitivity for bladder cancer

Background: Urinary biomarkers are needed to improve the care and reduce the cost of managing bladder cancer. Current biomarkers struggle to identify both high and low-grade cancers due to differing molecular pathways. Changes in microRNA (miR) expression are seen in urothelial carcinogenesis in a phenotype-specific manner. We hypothesised that urinary miRs reflecting low- and high-grade pathways could detect bladder cancers and overcome differences in genetic events seen within the disease. Methods: We investigated urinary samples (n ¼ 121) from patients with bladder cancer (n ¼ 68) and age-matched controls (n ¼ 53). Fifteen miRs were quantified using real-time PCR. Results: We found that miR is stable within urinary cells despite adverse handling and detected differential expression of 10 miRs from patients with cancer and controls (miRs 15a/15b/24-1/27b/100/135b/203/212/328/1224, ANOVA Po0.05). Individually, miR-1224-3p had the best individual performance with specificity, positive and negative predictive values and concordance of 83%, 83%, 75% and 77%, respectively. The combination of miRs-135b/15b/1224-3p detected bladder cancer with a high sensitivity (94.1%), sufficient specificity (51%) and was correct in 86% of patients (concordance). Conclusion: The use of this panel in patients with haematuria would have found 94% of urothelial cell carcinoma, while reducing cystoscopy rates by 26%. However, two invasive cancers (3%) would have been missed

Is metal theft committed by organized crime groups, and why does it matter?

Using the example of metal theft in the United Kingdom, this study used mixed methods to evaluate the accuracy of police estimates of the involvement of organised crime groups (OCGs) in crime. Police estimate that 20-30% of metal theft is committed by OCGs, but this study found that only 0.5% of metal thieves had previous convictions for offences related to OCGs, that only 1.3% were linked to OCGs by intelligence information, that metal thieves typically offended close to their homes and that almost no metal thefts involved sophisticated offence methods. It appears that police may over-estimate the involvement of OCGs in some types of crime. The reasons for and consequences of this over-estimation are discussed

Interplay Between Childhood Physical Abuse and Familial Risk in the Onset of Psychotic Disorders

Background: Childhood abuse is considered one of the main environmental risk factors for the development of psychotic symptoms and disorders. However, this association could be due to genetic factors influencing exposure to such risky environments or increasing sensitivity to the detrimental impact of abuse. Therefore, using a large epidemiological case-control sample, we explored the interplay between a specific form of childhood abuse and family psychiatric history (a proxy for genetic risk) in the onset of psychosis. Methods: Data were available on 172 first presentation psychosis cases and 246 geographically matched controls from the Aetiology and Ethnicity of Schizophrenia and Other Psychoses study. Information on childhood abuse was obtained retrospectively using the Childhood Experience of Care and Abuse Questionnaire and occurrence of psychotic and affective disorders in first degree relatives with the Family Interview for Genetic Studies. Results: Parental psychosis was more common among psychosis cases than unaffected controls (adjusted OR = 5.96, 95% CI: 2.09–17.01, P = .001). Parental psychosis was also associated with physical abuse from mothers in both cases (OR = 3.64, 95% CI: 1.06–12.51, P = .040) and controls (OR = 10.93, 95% CI: 1.03–115.90, P = .047), indicative of a gene-environment correlation. Nevertheless, adjusting for parental psychosis did not measurably impact on the abuse-psychosis association (adjusted OR = 3.31, 95% CI: 1.22–8.95, P= .018). No interactions were found between familial liability and maternal physical abuse in determining psychosis caseness. Conclusions: This study found no evidence that familial risk accounts for associations between childhood physical abuse and psychotic disorder nor that it substantially increases the odds of psychosis among individuals reporting abuse

Telephone survey of private patients' views on continuity of care and registration with general practice in Ireland

BACKGROUND: The desire of patients for personal continuity of care with a General Practitioner (GP) has been well documented, but not within non-registered private patients in Ireland. This study set out to examine the attitudes and reported behaviours of private fee-paying patients towards continuity of GP care and universal registration for patients. METHODS: Cross-sectional telephone survey of 400 randomly chosen fee-paying patients living within County Dublin. There is no formal system of registration with a GP for these patients. Main outcomes were attendance of respondents at primary health care facilities and their attitudes towards continuity of care and registration with a GP. Data was analysed using descriptive statistics and using parametric and non-parametric tests of association. Pearson correlation was used to quantify the association between the described variables and attitudes towards continuity and registration with a GP. Variables showing significance at the 5% level were entered into multiple linear regression models. RESULTS: 97% of respondents had seen a GP in the previous 5 years. The mean number of visits to the GP for respondents was 2.3 per annum. 89% of respondents had a regular GP and the mean length of time with their GP was 15.6 years. 96% preferred their personal medical care to be provided within one general practice. 16% of respondents had consulted a GP outside of their own practice in the previous year. They were more likely to be female, commute a longer distance to work or have poorer health status. 81% considered it important to be officially registered with a GP practice of their choice. CONCLUSION: Both personal and longitudinal continuity of care with a GP are important to private patients. Respondents who chose to visit GPs other than their regular GP were not easily characterised in this study and individual circumstances may lead to this behaviour. There is strong support for a system of universal patient registration within general practice