First-line intra-arterial versus intravenous chemotherapy in unilateral sporadic group D retinoblastoma: evidence of better visual outcomes, ocular survival and shorter time to success with intra-arterial delivery from retrospective review of 20 years of treatment.

The introduction of intra-arterial chemotherapy (IAC) as salvage treatment has improved the prognosis for eye conservation in group D retinoblastoma. The aim of this study was to compare the outcomes of consecutive patients with advanced unilateral disease treated with either first-line intravenous chemotherapy (IVC) or first-line IAC. This is a retrospective mono-centric comparative review of consecutive patients. Sporadic unilateral retinoblastoma group D cases treated conservatively at Jules-Gonin Eye Hospital and CHUV between 1997 and 2014. From January 1997 to August 2008, IVC, combined with focal treatments, was the primary treatment approach. From September 2008 to October 2014, IAC replaced IVC as first-line therapy. 48 patients met the inclusion criteria, receiving only either IAC or IVC as primary treatment modality. Outcomes of 23 patients treated by IVC were compared with those of 25 treated by IAC; mean follow-up was 105.3 months (range 29.2-218.6) and 41.7 months (range 19.6-89.5), respectively. Treatment duration was significantly shorter in the IAC group (p<0.001). Ten eyes in the IVC group underwent enucleation. Recordable visual acuity of the salvaged eyes was significantly better in the IAC group (0.9 vs 1.4 logarithm of the minimum angle of resolution, p<0.01). No extraocular disease, metastases or long-term systemic complications were observed in either group. The difference in the time frame between treatment groups had an impact on the availability of intravitreal chemotherapy treatment. Despite this, the results reported here imply that eyes treated with first-line IAC will have shorter treatment period, better ocular survival and visual acuity than first-line IVC

Radiographic parameters of the digit in a cohort population of amiata donkeys

Background: The most common musculoskeletal conditions reported in donkeys are related to the foot. Radiographic examinations are clinically important in the diagnosis of foot abnormalities and are commonly used. However, few studies have been conducted to establish the normal radiographic appearance of a donkey’s foot. Aim: To determine the radiographic features of the front digit in healthy Amiata donkeys. Methods: Radiographic examinations were performed on 56 forefeet of 28 Amiata donkeys. Three radiographic views of each front foot were taken: lateromedial, dorsopalmar and dorso-65°proximal/palmarodistal oblique. Seventeen angular and linear radiographic parameters and the crena solearis were evaluated in all forefeet, and 18 morphometric parameters were evaluated in 16 out of 56 forefeet. Statistical analysis was carried out on all the measures assessed. Results: The radiographic appearance of the forefoot was ascertained, and data were reported as median ± standard error, minimum and maximum values. No statistical differences were obtained between the right and left forefeet. Conclusion: The normal baseline parameters of the forefeet of Amiata donkeys were recorded and described and compared with other donkey breeds and horses. The findings highlighted that the donkey breed affects the radiographic parameters of the digit

Adherence issues related to sublingual immunotherapy as perceived by allergists

Sublingual immunotherapy (SLIT) is a viable alternative to subcutaneous immunotherapy to treat allergic rhinitis and asthma, and is widely used in clinical practice in many European countries. The clinical efficacy of SLIT has been established in a number of clinical trials and meta-analyses. However, because SLIT is self-administered by patients without medical supervision, the degree of patient adherence with treatment is still a concern. The objective of this study was to evaluate the perception by allergists of issues related to SLIT adherence.We performed a questionnaire-based survey of 296 Italian allergists, based on the adherence issues known from previous studies. The perception of importance of each item was assessed by a VAS scale ranging from 0 to 10.Patient perception of clinical efficacy was considered the most important factor (ranked 1 by 54\% of allergists), followed by the possibility of reimbursement (ranked 1 by 34\%), and by the absence of side effects (ranked 1 by 21\%). Patient education, regular follow-up, and ease of use of SLIT were ranked first by less than 20\% of allergists.These findings indicate that clinical efficacy, cost, and side effects are perceived as the major issues influencing patient adherence to SLIT, and that further improvement of adherence is likely to be achieved by improving the patient information provided by prescribers

Ultrasonographic diagnosis of urachal anomalies in cats and dogs: Retrospective study of 98 cases (2009-2019)

This retrospective study investigated the prevalence of different urachal anomalies (UA) in cats (n = 60) and dogs (n = 38) and their association with clinical symptoms and urinalysis alterations. Among UA, the vesicourachal diverticulum was the most prevalent UA diagnosed in both cats (96.7%) and dogs (89.5%): the intramural vesicourachal diverticulum was diagnosed in 76.7% of cats and 71.1% of dogs, followed by extramural vesicourachal diverticulum (20.0% and 18.4% respectively). In both cats and dogs, bladder wall diffuse or regional thickening was the most prevalent alteration. The most common alterations of the urinary bladder content were urolithiasis sediment in cats (33.3%) and in dogs (31.6%). Dogs with UA were more often asymptomatic (p = 0.01). No difference was found in cats. Stranguria, hematuria, and urethral obstruction were the most frequently reported clinical signs, while hematuria and leukocyturia were the most prevalent abnormalities at urinalysis. In conclusion, our study confirmed UA as uncommon, and often incidental findings, with a high prevalence of animals without clinical signs

Multi-Criteria DEXi Analysis for the Selection of Crop Species for Saltwater Aquaponics

Saltwater aquaponics is a sustainable alternative system for food production. The success of this system largely depends on the selection of both fish and plant species, for which several features and criteria must be considered. This paper aims to identify the most suitable plant species for saltwater aquaponics by using a multi-criteria decision-making method also based on current literature. One simple model that contained one root criterion, four aggregated criteria, and four sub-criteria was created using DEXi software. The same model was evaluated considering two different salinity levels in the recirculating water: 10 (brackish water) and 35 (sea water) g L-1. The relevance of the model structure was evaluated by the sensitivity analysis, through the 'plus/minus-1 ' analysis. Our results suggest that Salicornia europaea L. and Portulaca oleracea L. were suitable species for saltwater aquaponics at 35 g L-1. Moreover, at 10 g L-1, the suitable candidates were: Salicornia bigelovii Torr, S. europaea L., Beta vulgaris ssp. maritima (L.) Arcang, Atriplex hortensis L., and P. oleracea L. The DEXi analysis resulted in being an easy and effective tool to select proper species in similar contexts. DEXi can help to identify the hotspots of production processes, according to our results. Since the selected species are wild edible species or minor crops, the availability of their seeds is one of the main constraints of their cultivation in saltwater aquaponics

Economic evaluation of sublingual immunotherapy vs. symptomatic treatment in allergic asthma

The worldwide increased prevalence of allergic diseases, and especially of respiratory allergy, is paralleled by increased health costs. This requires consideration of the cost to efficacy ratio of the available treatment to identify the optimal choice

Identification of Heart Failure Events in Medicare Claims: The Atherosclerosis Risk in Communities (ARIC) Study

We examined the accuracy of CMS Medicare HF diagnostic codes in the identification of acute decompensated and chronic stable HF (ADHF and CSHF)