Ivermectin is a safe and effective microfilaricide which has been shown to have a beneficial impact on some onchocercal eye lesions. Current requirements for the distribution of ivermectin are that patients be weighed, and that their dose be determined according to their weight. This requirement increases the cost of distributing the drug to communities in need of treatment and, when scales breakdown, may lead to the suspension of distribution. Data are presented on a simple, alternative method of dose assessment based on the physical appearance of the patient. Fifteen assessors achieved an overall level of agreement with the weight-based schedule of 86% on a sample of 6420 patients. The level of agreement varied between assessors, from 73% to 95%. About 6% of the population would have received doses outside the range of the current weight-based schedule. We believe that the current insistence that each individual's dose of ivermectin be determined by weighing will hamper efforts to distribute the drug to those most in need of it and that our data indicate that workers can be trained to distribute ivermectin safely without weighing every individual. We would welcome confirmation of our findings from other populations.

Adult↗

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Flow increases with an enlarging intravenous catheter.

STUDY OBJECTIVE: To determine the increase in flow of a hydratable enlarging intravenous (IV) catheter in anesthetized patients. DESIGN: A randomized, nonblinded study, with standard Teflon IV catheters used as controls. SETTING: Operating room at a university medical center. PATIENTS: Thiry adult patients receiving general anesthesia for lower extremity surgery. INTERVENTIONS: An IV catheter was placed in the upper extremity, and flow measurements were made by measuring the time for infusion of 250 ml of normal saline within 1 minute after placement and at 1 hour after placement. MEASUREMENTS AND MAIN RESULTS: The enlarging catheters had a statistically significant average flow increase of 26% after 1 hour indwelling time. The standard Teflon catheters had no statistically significant change in flow after 1 hour. The percentage increase in flow for the enlarging catheters was not as great as previously seen in vitro. CONCLUSIONS: Flow through enlarging IV catheters placed in anesthetized patients increases after 1 hour. The percentage increase in flow is not as great as previously seen in vitro and may be due to skin, vein, and subcutaneous tissues preventing complete expansion.

Adult↗

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Current and proposed management of ocular herpes simplex.

Current and proposed methods of management of ocular herpetic epithelial disease are reviewed with particular attention to the methods, efficacy and side effects of mechanical debridement, chemotherapy, cryotherapy, and photoinactivation. Special types of herpetic ulceration, including steroid-induced, resistant, indolent, and recurrent ulcers are discussed.

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Gastric carcinoma in a bitch.

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Animals↗

PubMedDate not supplied

Prevalence of mucopolysaccharidosis type VI mutations in Siamese cats.

Mucopolysaccharidosis type VI (MPS VI), a lysosomal storage disease, is one of the more prevalent inherited diseases in cats and is commonly found in cats with Siamese ancestry. The prevalence of 2 known MPS VI mutations in cats was investigated in 101 clinically normal Siamese cats, in 2 cats with clinical signs of MPS VI, and in 202 cats from 4 research colonies. The mutation L476P which causes a severe clinical phenotype, was present on both alleles in the known MPS VI cats from Italy and North America and was present in all research colonies that originated from North America. However, LA76P was not detected in the Siamese population screened. In contrast, the mutation D520N, which causes a mild clinical phenotype, was identified in 23 of 202 (11.4%) alleles tested in Siamese cats from 3 continents, 2 of which were homozygous for D520N. Thus, the D520N mutation was widespread, and it is likely that cats inheriting both mutations (LA76P/D520N compound heterozygotes) would be in the general Siamese population, particularly in North America. Practitioners should note the high incidence of degenerative joint disease in these animals.

Animals↗

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Public agency collaboration: implementation of the behavioral risk factor survey in adjacent Texas communities.

This article describes a collaborative community survey project between two public agencies serving adjacent urban communities. The main purpose of the collaboration was to establish comparable baseline health risk data for each community. To meet this goal, the agencies jointly administered the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System questionnaire in their communities. The collaborative process was manageable and conserved both time and resources. This assessment project exemplifies a collaboration that both public and private healthcare entities can model to help ensure the health of the communities they serve.

Aged↗

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Food sensitivity in cats with chronic idiopathic gastrointestinal problems.

The objectives of this study were to investigate the prevalence of food sensitivity in cats with chronic idiopathic gastrointestinal problems, to identify the food ingredients responsible, and to characterize the clinical features. Seventy cats that presented for chronic gastrointestinal signs underwent diagnostic investigation. Fifty-five cats had idiopathic problems and were entered into the study. Diagnosis of food sensitivity was made by dietary elimination-challenge studies by using commercial selected-protein diets as the elimination diet. Sixteen (29%) of the 55 cats with chronic idiopathic gastrointestinal problems were diagnosed as food sensitive. The clinical signs of another 11 cats (20%) resolved on the elimination diet but did not recur after challenge with their previous diet. The foods or food ingredients responsible for the clinical signs were dietary staples. Fifty percent of affected cats were sensitive to more than 1 food ingredient. The clinical feature most suggestive of food sensitivity was concurrent occurrence of gastrointestinal and dermatological signs. Weight loss occurred in 11 of the affected cats, and large-bowel diarrhea was more common than small-bowel diarrhea. Assay of serum antigen-specific immunoglobulin E (IgE) had limited value as a screening test, and gastroscopic food sensitivity testing was not helpful. In conclusion, adverse reactions to dietary staples were common in this population of cats, and they responded well to selected-protein diets. Diagnosis requires dietary elimination-challenge trials and cannot be made on the basis of clinical signs, routine clinicopathological data, serum antigen-specific IgE assay, gastroscopic food sensitivity testing, or gastrointestinal biopsy.

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