Face validity of a proposed tool for staging canine osteoarthritis: Canine OsteoArthritis Staging Tool (COAST)

Abstract Osteoarthritis (OA) is a common, progressive degenerative disease of synovial joints. It can develop subsequent to an acquired disorder such as joint trauma but is primarily driven by developmental orthopedic disease in young dogs. Therefore, it is essentially characterised as an early onset but lifelong disease that worsens with age. Early intervention using a multi-modal drug and non-drug approach, with or without surgery as required, has the greatest potential for the most effective management of the disease. Timely implementation of a continuing care plan provides an opportunity to slow the rate of deterioration by reducing the negative impacts of OA-associated pain, encouraging appropriate levels of activity and improving strength and posture. Unfortunately, many dogs are presented to veterinary clinics only when marked behavioural changes are observed and substantial deterioration of the musculoskeletal and somatosensory systems has already occurred. To assist veterinarians with early and stage-specific diagnosis of OA in dogs, the authors present a proposed, practical diagnostic aid called 'COAST' (Canine OsteoArthritis Staging Tool) with face validity. As indicated by the successful implementation of staging systems for other companion animal diseases, it is expected that standardized staging of OA in dogs will help guide disease management plans and improve monitoring. The items used to construct COAST have been developed using consensus opinion of international experts from nine countries, who are actively working in the fields of small animal orthopaedics, anaesthesia and pain management. Further validation (test-retest, discriminatory ability, responsiveness, criterion validation) of the tool under field conditions is now required and the authors invite input

Degenerative encephalopathy in Nova Scotia Duck Tolling Retrievers presenting with a rapid eye movement sleep behavior disorder

BACKGROUND: Neurodegenerative diseases are a heterogeneous group of disorders characterized by loss of neurons and are commonly associated with a genetic mutation. HYPOTHESIS/OBJECTIVES: To characterize the clinical and histopathological features of a novel degenerative neurological disease affecting the brain of young adult Nova Scotia Duck Tolling Retrievers (NSDTRs). ANIMALS: Nine, young adult, related NSDTRs were evaluated for neurological dysfunction and rapid eye movement sleep behavior disorder. METHODS: Case series review. RESULTS: Clinical signs of neurological dysfunction began between 2 months and 5 years of age and were progressive in nature. They were characterized by episodes of marked movements during sleep, increased anxiety, noise phobia, and gait abnormalities. Magnetic resonance imaging documented symmetrical, progressively increasing, T2‐weighted image intensity, predominantly within the caudate nuclei, consistent with necrosis secondary to gray matter degeneration. Abnormalities were not detected on clinicopathological analysis of blood and cerebrospinal fluid, infectious disease screening or urine metabolite screening in most cases. Postmortem examination of brain tissue identified symmetrical malacia of the caudate nuclei and axonal dystrophy within the brainstem and spinal cord. Genealogical analysis supports an autosomal recessive mode of inheritance. CONCLUSIONS AND CLINICAL IMPORTANCE: A degenerative encephalopathy was identified in young adult NSDTRs consistent with a hereditary disease. The prognosis is guarded due to the progressive nature of the disease, which is minimally responsive to empirical treatment

Lipofibromatous hamartoma of the median nerve

Lipofibromatous hamartoma is a rare tumour of peripheral nerves which is characterised by an excessive infiltration of the epineurium and perineurium by fibroadipose tissue. To the best of our knowledge, only approximately 88 cases are reported in the literature. We report a rare case of lipofibromatous hamartoma of the median nerve causing secondary carpal tunnel syndrome in a 25 year old patient. This patient was treated conservatively with decompression and biopsy and experienced a complete resolution of symptoms post-operatively. Magnetic resonance imaging may be used to diagnose this lesion as it has very distinctive characteristics. Multiple conditions have been associated with this lesion and a greater understanding of these associations may clarify the pathogenesis. The architecture of the tumour makes excision very challenging and the surgical management remains controversial. A review of the literature regarding the etiology, pathogenesis and surgical management of lipofibromatous hamartoma is included

The Registry of the German Competence NETwork on Atrial Fibrillation: patient characteristics and initial management

The aim of this study was to describe the characteristics of patients with atrial fibrillation (AF) enrolled in the Central Registry of the German Competence NETwork on Atrial Fibrillation (AFNET) and to assess current medical practice in patients treated at various levels of medical care in Germany. Methods From February 2004 to March 2006, 9582 ambulatory and hospitalized patients with ECG-documented AF were and results enrolled by 194 participating study centres from all levels of medical care in Germany. Clinical type of AF was reported as paroxysmal in 2893, persistent in 1873, and permanent in 3134 patients or classified as a first episode in 1035 patients. Predisposing conditions were common and present in 87.6 % of the patients. Most patients were symptomatic with AF (75.1%). Rhythm control in persistent AF was provided to 53.4 % of the symptomati

The barriers and facilitators influencing the sustainability of hospital-based interventions: a systematic review

Acknowledgements University of Stirling for providing financial support for open access costs Funding This review was funded by the Chief Scientist Office, grant number GCA/17/26. JC, PC and EAD are employed by the Nursing, Midwifery and Allied Health Professions Research Unit, which is funded by the Chief Scientist Office in Scotland.Peer reviewedPublisher PD