Exploring the use of essential fatty acids in veterinary dermatology.

BACKGROUND: The aim of the study was to discover the extent of use of essential fatty acids (EFAs) in veterinary practice, conditions used in, preparation of EFA supplement used and rationale for their use and to investigate the awareness of the oxidation of some commercial fish oil supplement preparations. METHODS: A web-based questionnaire was distributed via email to a dermatology list server and posted to veterinary Facebook groups with questions relating to the use of EFAs, supplement choice, conditions used in, the level of importance of various factors regarding their use and awareness of their oxidation. RESULTS: There were 309 responses from 32 countries. EFA supplements were used by 92.2 per cent of respondents. The most commonly used preparation of EFA supplementation was veterinary oral supplements (75.1 per cent), followed by veterinary diets (14.4 per cent), shop bought fish oil supplements (7.7 per cent), enhancing the diet with oily fish (2.5 per cent) and finally using a commercial pet food (0.3 per cent). Only 46.3 per cent of respondents who used them were aware of the oxidation of EFAs. Veterinary oral supplements were perceived to be the best preserved, followed by veterinary diets and lastly commercial fish oil supplements. CONCLUSION: A large number of respondents advised the use of EFAs for veterinary dermatological conditions but less than 50 per cent were aware of the potential for EFAs to oxidise.

Ambulatory setting of patients with surgical site infections after a cardiac intervention. / Cenário ambulatorial de pacientes com sítio cirúrgico infectado após intervenção cardíaca.

OBJECTIVE: Verifying the clinical-surgical profile and the results of patients monitored in an surgical wound ambulatory after a cardiac surgeries. METHODS: This is a historical cohort research with patients submitted to cardiac surgery and monitored for a year in an outpatient surgical wound clinic from a hospital specialized in cardiology. The study analyzed the prevalent microorganisms in infections, the products used in the dressings, the time of follow-up, and the type of therapy established in the dressings. RESULTS: Among the 150 patients, most were sexagenarians (61.7 ± 11.4 years), hypertensive patients (75%), and diabetic (44.7%). There were 12 patients with mediastinitis (8%) and 44 with surgical site infection (29.3%). Fatty acids (80%) and calcium alginate (19%) were used for wound healing. The mean follow-up time was 35 ± 71 days. CONCLUSION: Sexagenary, hypertensive, diabetic and revascularized patients constituted the population monitored in the wounds outpatient clinic. The SSI and mediastinitis rates found were acceptable and similar to those in literature.

Nutraceuticals and nutritional supplements for the treatment of bipolar disorder: protocol for a systematic review.

INTRODUCTION: First line pharmacological treatments for bipolar disorder (BD) can leave shortfalls in recovery leading to patients seeking alternative and adjunctive treatments such as nutraceuticals. This protocol for a systematic review and proposed meta-analysis aims to answer the research question: in patients with BD, how does use of nutraceutical treatments compare with placebo in reducing depressive and mania symptoms? METHODS AND ANALYSIS: Clinical trials will be identified through database searches using PubMed via PubMed, EMBASE via embase.com, Cochrane Central Register of Controlled Clinical Trials (CENTRAL) via cochranelibrary.com and CINAHL Complete via EBSCO. Search terms for BD and specific nutraceuticals (75 total search terms) will be used. Double-blind, randomised, controlled, clinical trials of adults with BD will be included in the review. Risk of bias will be assessed using the Cochrane Collaboration's tool for assessing risk of bias in randomised trials. ETHICS AND DISSEMINATION: This review will only look at published data (already reviewed for ethical compliance); therefore, ethical approval is not required. We aim to publish the systematic review in a peer-reviewed journal and present at conferences. PROSPERO REGISTRATION NUMBER: CRD42019100745.

Cenário ambulatorial de pacientes com sítio cirúrgico infectado após intervenção cardíaca / Escenario ambulatorial de pacientes con sitio cirugía infectado después intervención cardíaca / Ambulatory setting of patients with surgical site infections after a cardiac intervention

Resumo OBJETIVO Verificar o perfil clínico-cirúrgico e os resultados de pacientes acompanhados em um ambulatório de ferida operatória após cirurgia cardíaca. MÉTODOS Coorte histórica com pacientes submetidos à cirurgia cardíaca e acompanhados por um ano em um ambulatório de feridas de um hospital especializado em cardiologia. Foram analisados os micro-organismos predominantes nas infecções, os produtos utilizados nos curativos, tempo de acompanhamento e o tipo de terapêutica instituída nos curativos. RESULTADOS Entre os 150 pacientes, predominaram sexagenários (61,7 ± 11,4 anos), hipertensos (75%), diabéticos (44,7%). Evidenciou-se 12 pacientes com mediastinite (8%) e 44 com infecção de sítio cirúrgico (29,3%). Utilizou-se para realização dos curativos os ácidos graxos (80%) e alginato de cálcio (19%). O tempo de acompanhamento foi de 35 ±71 dias. CONCLUSÃO Pacientes sexagenários, hipertensos, diabéticos e revascularizados constituíram a população acompanhada no ambulatório de feridas. As taxas de ISC e mediastinite encontradas foram aceitáveis e semelhantes às da literatura.

Resumen OBJETIVO Verificar el perfil clínico-quirúrgico y los resultados de pacientes acompañados en un ambulatorio de heridas operatorias después de cirugía cardiaca. MÉTODO Cohorte histórica con pacientes sometidos a la cirugía cardiaca y acompañados por un año en el ambulatorio de heridas de un hospital especializado en cardiología. Fueron analizados los microorganismos predominantes en las infecciones, los productos utilizados en las curaciones, el tiempo de seguimiento, o el tipo de tratamiento utilizado en las curaciones. RESULTADOS Entre los 150 pacientes predominaron el sexo masculino (58%), sexagenarios (61,7 ± 11,4 años), hipertensos (75%), diabéticos (44.7%). Se evidenciaron 12 pacientes con mediastinitis (8%) y 44 con infección en el sitio quirúrgico (29.3%). Se utilizó en las curaciones fueron los ácidos grasos (80%) y el alginato de calcio (19%). El tiempo medio de seguimiento fue de 35 ± 71 días. CONCLUSIÓN Los pacientes sexagenarios, hipertensos, diabéticos y revascularizados constituyeron la población acompañada en el ambulatorio de heridas. Las tasas de ISC y mediastinitis encontradas fueron aceptables y similares a las de la literatura.

Abstract OBJECTIVE Verifying the clinical-surgical profile and the results of patients monitored in an surgical wound ambulatory after a cardiac surgeries. METHODS This is a historical cohort research with patients submitted to cardiac surgery and monitored for a year in an outpatient surgical wound clinic from a hospital specialized in cardiology. The study analyzed the prevalent microorganisms in infections, the products used in the dressings, the time of follow-up, and the type of therapy established in the dressings. RESULTS Among the 150 patients, most were sexagenarians (61.7 ± 11.4 years), hypertensive patients (75%), and diabetic (44.7%). There were 12 patients with mediastinitis (8%) and 44 with surgical site infection (29.3%). Fatty acids (80%) and calcium alginate (19%) were used for wound healing. The mean follow-up time was 35 ± 71 days. CONCLUSION Sexagenary, hypertensive, diabetic and revascularized patients constituted the population monitored in the wounds outpatient clinic. The SSI and mediastinitis rates found were acceptable and similar to those in literature.

Novel association of Psychrobacter and Pseudomonas with malodour in bloodhound dogs, and the effects of a topical product composed of essential oils and plant-derived essential fatty acids in a randomized, blinded, placebo-controlled study.

BACKGROUND: The pathogenesis and treatment of cutaneous malodour in dogs have not been investigated previously. Staphylococcus and Corynebacterium spp. are associated with human axillary malodour. HYPOTHESIS: Staphylococcus and Corynebacterium spp. are associated with cutaneous malodour in dogs, and treatment with a topical essential oil-based product will improve malodour and reduce the abundance of odour-causing bacteria. ANIMALS: Twenty seven bloodhound dogs from a south Texas boarding facility were enrolled in this study. METHODS AND MATERIALS: Skin swabs were taken from the axilla and dorsum of 27 dogs at initiation of the study. Mean malodour scores were used to assign dogs to control or malodour groups. The malodourous dogs were randomly assigned to a treatment or placebo group, received four weekly topical applications of the spot-on or placebo, and samples were recollected. Next-generation sequencing (NGS) and real-time quantitative PCR (qPCR) were performed on all swabs. RESULTS: Psychrobacter and Pseudomonas spp. were significantly more abundant (P < 0.001, P = 0.006; respectively), and overall bacterial diversity was reduced (P = 0.0384) on the skin of malodourous dogs. Staphylococcus and Corynebacterium spp. were not associated with malodour. The topical essential oil-based product significantly (P = 0.0078) improved malodour in the treatment group and shifted their bacterial community structure. CONCLUSIONS AND CLINICAL IMPORTANCE: A novel association of bacterial genera with malodour in bloodhound dogs, identified by NGS, highlights future targets for odour control. The topical treatment significantly reduced malodour. The interaction between the topical treatment and cutaneous microbiota should be further investigated and may be useful in other dermatological conditions involving microbiota.

Control of canine idiopathic nasal hyperkeratosis with a natural skin restorative balm: a randomized double-blind placebo-controlled study.

BACKGROUND: Nasal hyperkeratosis may cause discomfort in dogs by predisposing them to fissures and secondary bacterial infection. Approaches to treatment have been described anecdotally; the effectiveness of such therapies remains unproven. HYPOTHESIS/OBJECTIVES: To investigate the efficacy of a balm containing essential oils and essential fatty acids in dogs with idiopathic nasal hyperkeratosis. ANIMALS: Client-owned dogs with noncomplicated nasal hyperkeratosis. METHODS: The study was conducted as a randomized, double-blind, placebo-controlled clinical trial with parallel group design and two month follow-up period. Dogs received daily topical application of a commercial balm product (group DBB) or placebo (aqueous gelling agent with preservatives, group PB). The main outcome variables were lichenification, dryness, suppleness and extent of lesions. Subjective owner satisfaction index score was a secondary variable. Evaluation was performed on days (D)0, 30 and 60. Response to treatment was assessed as the change from baseline to each examination day for each criterion. RESULTS: Forty eight dogs, principally French (26 of 48) and English (seven of 48) bulldogs, were included and 39 completed the study. No major adverse events were reported. On D60, changes from baseline for lichenification, lesion extent, suppleness and total score were -31.2%, -18.3%, -72.8% and -36.8% in group DBB (23 dogs) and -11.9%, 2.3%, -42.1% and -14% in group PB (16 dogs), respectively. The total score was significantly improved on D60 in group DBB compared to PB (Wilcoxon-Mann-Whitney U-test, P = 0.0016). CONCLUSIONS AND CLINICAL IMPORTANCE: The balm proved safe and helpful in managing canine idiopathic noncomplicated nasal hyperkeratosis.

A double-blinded, randomized, controlled, crossover evaluation of a zinc methionine supplement as an adjunctive treatment for canine atopic dermatitis.

BACKGROUND: Zinc is important for skin health and proper immune system function. HYPOTHESIS/OBJECTIVES: A zinc methionine, essential fatty acids (EFA) and biotin product (Zn supplement) was compared to an EFA and biotin product (control) in canine atopic dermatitis (CAD). ANIMALS: Twenty seven client-owned dogs with chronic CAD receiving ciclosporin or glucocorticoids. METHODS: A 24 week, randomized, double-blinded, controlled study with crossover at week 12 and 4 week period of allergy medication reduction at weeks 8 and 20. Evaluations included Canine Atopic Dermatitis Lesion Index (CADLI), pruritus Visual Analog Scale (VAS) and cytology sampling. RESULTS: In dogs receiving the zinc supplement and ciclosporin for eight weeks, 44% (n = 7) had significantly decreased CADLI from 11.9 to 6.0 (P = 0.0002) with no significant change in pruritus VAS (P = 1.0). In dogs receiving the zinc supplement and glucocorticoids for eight weeks, 55% (n = 6) had significantly decreased CADLI from 10.9 to 5.0 (P = 0.0043) and pruritus VAS from 7.4 to 3.2 (P = 0.0166). For dogs receiving either steroids or ciclosporin there was a reduction in use of such medications, for at least four weeks, in 63% of dogs receiving the zinc supplement and 37% of dogs receiving the control. This difference was not significant (P = 0.1027). Seventy eight percent of dogs were diagnosed and treated for superficial skin infections during the study. CONCLUSIONS AND CLINICAL IMPORTANCE: This study supports a potential benefit of adjunctive zinc methionine supplementation in CAD. Dogs receiving glucocorticoids may be more likely to benefit. Further studies are needed to substantiate these initial results.

Randomized, double-blinded, placebo-controlled pilot study on the effects of topical blackcurrant emulsion enriched in essential fatty acids, ceramides and 18-beta glycyrrhetinic acid on clinical signs and skin barrier function in dogs with atopic dermatitis.

BACKGROUND: Lipid-based emulsions can be useful for the management of canine atopic dermatitis (cAD). 18-beta glycyrrhetinic acid (GRA), a component of liquorice root, has anti-inflammatory and anti-pruritic effects. HYPOTHESIS/OBJECTIVES: To evaluate the effects of a topical lipid emulsion containing ceramides, fatty acids and GRA on clinical signs of cAD and skin barrier in a randomized, double-blinded, placebo-controlled trial. METHODS: Client owned (n = 45) dogs with nonseasonal, mild/moderate AD, received either treatment or placebo for three months. Skin lesions, pruritus, transepidermal water loss (TEWL) and global assessment (GA) were evaluated. RESULTS: Fourteen dogs receiving treatment and 14 receiving the placebo completed the study. After one month ≥50% reduction in pruritus was seen in seven of 14 dogs (50%) in the Treatment group, and in two of 14 dogs (14.3%) in the Control group (P = 0.047). After two and three months, significant reduction in pruritus was not seen. For Canine Atopic Dermatitis Extent and Severity Index (CADESI), TEWL and GA, there were no significant findings over time or between groups. CONCLUSIONS AND CLINICAL RELEVANCE: The emulsion had some transient beneficial clinical effects. However, it was not effective in controlling pruritus as a monotherapy. Further studies should examine whether owner compliance was a factor in the steady decline of effect on pruritus scores. Further studies evaluating its role as an adjunctive therapy are indicated.