Demography, preventative healthcare and reason for relinquishment of donkeys to an equine charity in the UK (2013-2015).

BACKGROUND: In the UK, there are thousands of donkeys being cared for by charities; however, little is known about the reasons for relinquishment or their previous health status, with even less information available in published literature. Such information could help to identify factors contributing to poor equine welfare and guide the development of appropriate educational resources. OBJECTIVES: To describe the characteristics of the relinquished donkeys and to better understand the current preventative healthcare status of donkeys relinquished into The Donkey Sanctuary. STUDY DESIGN: Cross-sectional observational survey. METHODS: A total of 596 donkeys were admitted during a 30-month period. Each had a health check at arrival; and previous management information was provided by the owner. Data were retrieved from The Donkey Sanctuary database, inputted into a specific Microsoft Access 2016 database then exported for analysis in IBM SPSS 19.0 for Windows® . Mules and ponies were excluded from the study. RESULTS: Many donkeys arrived without a valid passport (32.3%) or microchip (49.7%). Only 23.2% were fully protected against influenza and tetanus and 21.0% of the donkeys had no previous anthelmintic treatment history. Geriatric donkeys often suffered from moderate to severe dental disease in need of advanced treatment, and 43.9% had received no dental treatment within the last year. Overall 26.3% of donkeys were classed as overweight and 8.6% were obese. The median time since the last hoof trim was 10 weeks. MAIN LIMITATION: The health status of the studied donkeys may have been affected by the reasons for relinquishment, and associations require further investigation. CONCLUSIONS: This study highlights the need for improving preventative healthcare in donkeys to ensure better welfare within the population.

Carotid artery stenting in a single center, single operator, single type of device and 15 years of follow-up.

BACKGROUND: Revascularization with carotid stent (CAS) is considered the therapeutic alternative to endarterectomy (CEA). However, its role compared to CEA remains questioned, mainly due of the heterogeneity of long-term results. The objective of this study was to report the efficacy and durability of CAS in terms of stroke prevention in a "real world experience". METHOD: This was a single-center retrospective analysis of 344 patients treated with CAS between January 2001 and December 2015.The primary outcome of the trial was stroke, myocardial infarction, or death during a periprocedural period or any stroke event over a 15-year follow-up. The secondary aim was to identify risk factors for 30-day complications, long-term neurological complications, and intra-stent restenosis. RESULTS: The primary composite end point (any stroke, myocardial infarction, or death during the periprocedural period) was 2.3%. The use of an EPD was protective against major complications.Long-term follow-up was achieved in 294 patients (85,5%) with a median of 50 months (range 0-155 months). Fifty-six (16,3%) died within this period, most commonly of nonvascular causes (4 patients had stroke-related deaths). During the follow-up period, 8 strokes and 3 TIAs were diagnosed (3.2%).ISR determined by sequential ultrasound was assessed in 4.4% of the patients and remained asymptomatic in all but 2 patients (0.6%). All patients with restenosis underwent revascularization with balloon angioplasty. CONCLUSION: The long-term follow-up results of our study validate CAS as a safe and durable procedure with which to prevent ipsilateral stroke, with an acceptable rate of restenosis, recurrence and mortality.

Multiple approaches to assess fourteen non-invasive serum indexes for the diagnosis of liver fibrosis in chronic hepatitis C patients.

BACKGROUND: The aim of this study was to compare fourteen non-invasive indexes/scores: AAR, APRI, Fibroindex, MODEL3, Forns index, FIB4, GUCI, FI, FCI, Pohl score, AP index, CDS, HGM-1 and HGM-2, in order to diagnose the hepatic fibrosis stage in a survey of patients with chronic hepatitis C. METHODS: 84 patients with chronic hepatitis C were studied. Liver fibrosis was staged according to the Scheuer scoring system. The diagnostic accuracy of these indexes/scores was evaluated by AUROC, contingency tables and logistic regression analysis. RESULTS: The best AUROCs (>0.9) to discriminate cirrhosis (F=4), were observed for CDS, FI, AAR, MODEL3, FIB4, HGM-2 and FCI. To discriminate at least advance fibrosis (F≥3), the best AUROCs (>0.89) were for CDS, FI, FIB4, HGM2-2, MODEL3 and FCI. To discriminate at least significant fibrosis (F≥2), the best AUROCs (>0.8) were for FIB4, GUCI, APRI, FI, Forns index, HGM-2 and FCI. Contingency tables and logistic regression analysis supported the results obtained by AUROC. CONCLUSIONS: This study compares the diagnostic performance of fourteen indexes for the diagnosis of liver fibrosis stage in the same group of CHC patients. These results allow the selection of the best indexes for further studies in larger populations, in order to build diagnostic algorithms as an alternative to liver biopsy for fibrosis staging in patients with chronic HCV infection. These algorithms would allow to take therapeutical decisions and the continuous follow-up of hepatic fibrosis in these patients.