Prevalence of Disorders Recorded in Dogs Attending Primary-Care Veterinary Practices in England

Purebred dog health is thought to be compromised by an increasing occurence of inherited diseases but inadequate prevalence data on common disorders have hampered efforts to prioritise health reforms. Analysis of primary veterinary practice clinical data has been proposed for reliable estimation of disorder prevalence in dogs. Electronic patient record (EPR) data were collected on 148,741 dogs attending 93 clinics across central and south-eastern England. Analysis in detail of a random sample of EPRs relating to 3,884 dogs from 89 clinics identified the most frequently recorded disorders as otitis externa (prevalence 10.2%, 95% CI: 9.1-11.3), periodontal disease (9.3%, 95% CI: 8.3-10.3) and anal sac impaction (7.1%, 95% CI: 6.1-8.1). Using syndromic classification, the most prevalent body location affected was the head-and-neck (32.8%, 95% CI: 30.7-34.9), the most prevalent organ system affected was the integument (36.3%, 95% CI: 33.9-38.6) and the most prevalent pathophysiologic process diagnosed was inflammation (32.1%, 95% CI: 29.8-34.3). Among the twenty most-frequently recorded disorders, purebred dogs had a significantly higher prevalence compared with crossbreds for three: otitis externa (P = 0.001), obesity (P = 0.006) and skin mass lesion (P = 0.033), and popular breeds differed significantly from each other in their prevalence for five: periodontal disease (P = 0.002), overgrown nails (P = 0.004), degenerative joint disease (P = 0.005), obesity (P = 0.001) and lipoma (P = 0.003). These results fill a crucial data gap in disorder prevalence information and assist with disorder prioritisation. The results suggest that, for maximal impact, breeding reforms should target commonly-diagnosed complex disorders that are amenable to genetic improvement and should place special focus on at-risk breeds. Future studies evaluating disorder severity and duration will augment the usefulness of the disorder prevalence information reported herein

Screening for type 2 diabetes is feasible, acceptable, but associated with increased short-term anxiety: A randomised controlled trial in British general practice

<p>Abstract</p> <p>Background</p> <p>To assess the feasibility and uptake of a diabetes screening programme; to examine the effects of invitation to diabetes screening on anxiety, self-rated health and illness perceptions.</p> <p>Methods</p> <p>Randomised controlled trial in two general practices in Cambridgeshire. Individuals aged 40–69 without known diabetes were identified as being at high risk of having undiagnosed type 2 diabetes using patient records and a validated risk score (n = 1,280). 355 individuals were randomised in a 2 to 1 ratio into non-invited (n = 238) and invited (n = 116) groups. A stepwise screening programme confirmed the presence or absence of diabetes. Six weeks after the last contact (either test or invitation), a questionnaire was sent to all participants, including non-attenders and those who were not originally invited. Outcome measures included attendance, anxiety (short-form Spielberger State Anxiety Inventory-STAI), self-rated health and diabetes illness perceptions.</p> <p>Results</p> <p>95 people (82% of those invited) attended for the initial capillary blood test. Six individuals were diagnosed with diabetes. Invited participants were more anxious than those not invited (37.6 vs. 34.1 STAI, p-value = 0.015), and those diagnosed with diabetes were considerably more anxious than those classified free of diabetes (46.7 vs. 37.0 STAI, p-value = 0.031). Non-attenders had a higher mean treatment control sub-scale (3.87 vs. 3.56, p-value = 0.016) and a lower mean emotional representation sub-scale (1.81 vs. 2.68, p-value = 0.001) than attenders. No differences in the other five illness perception sub-scales or self-rated health were found.</p> <p>Conclusion</p> <p>Screening for type 2 diabetes in primary care is feasible but may be associated with higher levels of short-term anxiety among invited compared with non-invited participants.</p> <p>Trial registration</p> <p>ISRCTN99175498</p

The rate of manual peripheral blood smear reviews in outpatients

Background: The International Consensus Group for Hematology Review recommends manual blood smears for new findings from automated complete blood cell (CBC) tests. However, in outpatients, the rate of peripheral manual blood smear reviews is uncertain, as is the effect of historical results on this rate. Methods: In a prospective cohort study of 687,955 members of a health maintenance organization, we extracted 39,759 consecutive automated CBC test results and determined the rate of manual peripheral smear reviews that were indicated using different triggering criteria, and historical results. Results: Individual triggering values increased from 10.7% to 19.5% when comparing our criteria to those of the consensus criteria. The proportion of CBC test results with at least one triggering value was 7.2% using our criteria, compared to 13.9% with the inclusion of a mean corpuscular volume &#60;75 and a plus one immature granulocyte flag according to the consensus committee. Availability of historical data decreased our peripheral smear review rate to 2.6%. Conclusions: The peripheral smear review rate in outpatients using the consensus criteria was higher than with our less stringent criteria. If historical data are available and no clinical utility is demonstrated for the additional consensus criteria, an acceptable out-patient review rate might be as low as 2.6%. Clin Chem Lab Med 2009;47:1401–5.Peer Reviewe

Factors associated with microhematuria in asymptomatic young men. Clin Chem

The prevalence of asymptomatic microhematuria (two to four or more erythrocytes per high-power field) in 1341 male Air Force personnel was 5.4%. The most powerful predictor of microhematuna (nearly 15-fold increased prevalence) was a history of recurrent microhematuria during the previous five years. Recurrent microscopic hematuna was present in 14.5 % (8/55) of men with a history of urethritis, accounting for 26 % (8/31) of the cases of recurrent microscopic hematuria. The prevalence of microhematuria was not affected by physical exercise, flight duty, or sexual intercourse during the 24 h preceding the urinalysis. AddItional Keyphrases: erythrocytes ‘ urine urethritis Asymptomatic microhematuria is a common diagnostic problem in clinical practice. The prevalence of two to four erythrocytes per high-power-microscopic field varies fro