• Sawyer Groth posted an update 5 hours, 48 minutes ago

    Objectives To formulate practice guidelines on diagnosis and management of Kawasaki disease (KD) for Indian children. Justification KD is a systemic vasculitis that predominantly affects infants and children less than 5 years of age. Coronary artery abnormalities (CAA) develop in around 15-25% of untreated children with KD. Coronary artery involvement can lead to long-term cardiovascular implications such as development of premature coronary artery disease. Diagnosis of KD is essentially clinical based on recognition of a constellation of characteristic symptoms and signs. Timely diagnosis and initiation of intravenous immunoglobulin (IVIg) therapy is known to produce five-fold reduction in the incidence of CAA. As there is no confirmatory laboratory test for KD, the diagnosis may be missed if one is not familiar with the nuances of clinical diagnosis. Process A committee was formed under the auspices of Indian Academy of Pediatrics in early 2018 for preparing guidelines on KD in Indian children. A meeting of the consultative committee was held in Mumbai, and a draft protocol was devised. All members scrutinized the recent publications on the subject and an attempt was made to arrive at a broad consensus. Published guidelines on the subject were also reviewed. Recommendations The diagnosis is clinical and is aided by laboratory and 2D echocardiography. First line of therapy is IVIg, and should be started expeditiously once the diagnosis is made.Background Acute paralysis is a common presentation in small animal emergency clinics, but the aetiological prevalence has not been reported. Knowledge of diagnosis frequency aids prioritisation of differential diagnoses, facilitates resource planning and clinical trial design. L-Kynurenine Methods Medical records from NC State Veterinary Hospital Emergency Room were searched over a five-year period to identify cases presenting with acute non-ambulatory paraparesis or paralysis. Signalment and diagnosis category were extracted. Results Acute paralysis was the presenting problem in 845 of 21,535 (3.9 per cent) dogs and 66 of 4589 (1.4 per cent) cats admitted over this period. Intervertebral disc disease (IVDD) was the most common cause (608 of 845; 72 per cent) in dogs, followed by vascular disease (34 of 845; 4.0 per cent). Other diagnostic categories accounted for the remaining 20 per cent. Dachshunds were the most common breed (263 of 845; 31.1 per cent), then Labrador retrievers (57 of 845; 6.7 per cent). In cats, aortic thromboembolism (ATE) was the most common diagnosis, occurring in 40 of 66 (60.6 per cent), followed by IVDD (7 of 66; 10.6 per cent). Other diagnostic categories accounted for 30.3 per cent. Six of 845 (0.7 per cent) dogs and two of 66 (3 per cent) cats were categorised as pseudoparalysis with a non-neurological diagnosis. Conclusions IVDD and ATE are the overwhelming causes of acute paralysis in dogs and cats, respectively, with approximately 28 per cent of dogs and 40 per cent of cats having a different diagnosis.Background Many challenges are encountered in both teaching and learning veterinary obstetrics. This may be due to outdated teaching materials, as the main model of content transmission remains centred around text and images. Methods Visualisation methods such as three-dimensional (3D) and Graphics Interchange Format (GIF) tools were applied in an attempt to improve obstetrics education outcomes in the third-year class. Traditional teaching methods were utilised in the fourth-year and fifth-year students. Results These supplementary tools significantly increased the third-year students’ final examination results compared with the results of fourth-year and fifth-year students (P less then 0.05). These examinations were designed to evaluate comprehension of the subject matter. Self-assessment questionnaire results further indicated that 3D animation and GIF promoted learning efficiency. Conclusion Incorporation of 3D animation learning tools into the veterinary curriculum is predicted to better prepare students for the management of obstetrical cases after graduation.Background Surgical site infection (SSI) is a leading cause of morbidity in horses undergoing emergency exploratory laparotomy for the treatment of acute colic. The exact mechanism by which SSI develops in these cases is unclear. This prospective observational study investigated whether bacterial translocation occurs in horses with acute colic and if there is an association between bacterial translocation and development of SSI. Methods Peripheral venous blood (PVB) and peritoneal fluid (PF) samples were collected on admission and PF samples were collected at the end of surgery from horses presenting for investigation of acute colic. Any discharge from the laparotomy incision in horses that developed SSI was also collected. All samples were submitted for bacterial culture. Results In total, 7.7 per cent of PVB samples (3/39), 11.8 per cent (4/34) of admission PF samples and 8.7 per cent (2/23) of the PF samples at surgery were culture positive. The prevalence of SSI was 10.2 per cent. No association was identified between a positive PVB or PF culture and development of a SSI or survival to hospital discharge. Conclusion Bacterial translocation can occur in some horses with acute colic. However, we were unable to identify any association between bacterial translocation and the development of SSIs following emergency exploratory laparotomy.Acute myeloid leukemia (AML) is a deadly hematologic malignancy with poor prognosis, particularly in the elderly. Even among individuals with favorable-risk disease, approximately half will relapse with conventional therapy. In this clinical circumstance, the determinants of relapse are unclear, and there are no therapeutic interventions that can prevent recurrent disease. Mutations in the transcription factor CEBPA are associated with favorable risk in AML. However, mutations in the growth factor receptor CSF3R are commonly co-occurrent in CEBPA mutant AML and are associated with an increased risk of relapse. To develop therapeutic strategies for this disease subset, we performed medium-throughput drug screening on CEBPA/CSF3R mutant leukemia cells and identified sensitivity to inhibitors of lysine-specific demethylase 1 (LSD1). Treatment of CSF3R/CEBPA mutant leukemia cells with LSD1 inhibitors reactivates differentiation-associated enhancers driving immunophenotypic and morphologic differentiation. LSD1 inhibition is ineffective as monotherapy but demonstrates synergy with inhibitors of JAK/STAT signaling, doubling median survival in vivo.