Ultrasound biomicroscopic imaging parameters associated with outcome in equine infectious ulcerative keratitis and stromal abscesses.

OBJECTIVE: To determine the predictive value of corneal ultrasound biomicroscopy (UBM) findings for the outcome of equine corneal disease. ANIMALS: 46 horses with a clinical diagnosis of either infectious ulcerative keratitis or stromal abscess. METHODS: Corneal UBM (VevoMD; UHF70; VisualSonics) of horses with infectious corneal disease presenting to the North Carolina State University Equine Ophthalmology Service from 2019 to 2023 were evaluated. Size and depth of lesion, presence of Descemet membrane disruption (DMD), corneal thickness, and aqueous humor cell counts (AHCC) were assessed. Comparisons of UBM and clinical exam findings, presence of infectious organisms, and outcome (healed or enucleated) were performed. RESULTS: The UBMs from 46 horses were evaluated. Increased AHCC was significantly associated with increased size and depth of corneal lesions on UBM but not with DMD. Deep lesions and DMD were significantly associated with an enucleation outcome. Horses treated with systemic antibiotics had significantly lower AHCC on UBM, but there were no differences in AHCC with the use of other systemic or topical medications. There was no significant correlation between infectious disease results, clinical findings (aqueous flare or cells), outcome, and UBM AHCC. CLINICAL RELEVANCE: Parameters on UBM, such as depth of lesion, DMD, and AHCC, may be useful diagnostic and prognostic tools to augment the ophthalmic exam of horses with corneal disease. The UBM findings of deep corneal lesions and DMD suggest a poor prognosis and warrant aggressive surgical intervention.

Fever phobia: a survey of caregivers of children seen in a pediatric emergency department.

BACKGROUND: Fever continues to be the most common complaint of children seen in a Pediatric Emergency Department (PED). Previous studies have assessed the prevalence of fever phobia in various populations. This study aims to document the incidence of fever phobia in a PED. METHODS: Through convenience sampling, caregivers of children seen in a PED were surveyed using a research-assistant-administered questionnaire. The survey contained 28 questions pertaining to caregivers' perceptions, attitudes, and behaviors regarding fever in children. RESULTS: In all, 230 caregivers were surveyed. The median temperature considered to be a fever was 37.8 degrees C (100.0 degrees F), with a range of 36.1 degrees C (97 degrees F) to 40.6 degrees C (105 degrees F), whereas the median temperature considered to result in harmful consequences was 40.6 degrees C (105 degrees F), with a range of 37.8 degrees C (100 degrees F) to 43.3 degrees C (110 degrees F). The median temperature at which antipyretics would be administered was 37.8 degrees C (100 degrees F), with a range of 36.1 degrees C (97 degrees F) to 39.4 degrees C (103 degrees F). More than one third of caregivers reported that they would administer antipyretics inappropriately. The median temperature at which a child would be taken to the PED was 39.4 degrees C (103 degrees F), with a range of 36.7 degrees C (98 degrees F) to 40.8 degrees C (105.4 degrees F). There was also a relationship between level of education and level of fever concern. CONCLUSION: Fever phobia and inappropriate treatment for febrile children is present among caregivers of patients seen in a PED. Level of education may be a factor in fever knowledge and practices. Overly zealous, potentially harmful home practices and unnecessary PED visits for the assessment and treatment of fever in children is widespread among caregivers surveyed in the PED.

Identification of potent and selective MMP-13 inhibitors.

A potent, selective series of MMP-13 inhibitors has been derived from a weak (3.2 microM) inhibitor that did not bear a zinc chelator. Structure-based drug design strategies were employed to append a Zn-chelating group to one end of the molecule and functionality to enhance selectivity to the other. A compound from this series demonstrated rat oral bioavailability and efficacy in a bovine articular cartilage explant model.