The Effect of Metronidazole versus a Synbiotic on Clinical Course and Core Intestinal Microbiota in Dogs with Acute Diarrhea.

The usefulness of antibiotics in dogs with acute diarrhea (AD) is controversial. It is also unclear what effect metronidazole has on potential enteropathogens such as Clostridium perfringens and Escherichia coli. Thus, the aim of this study was to evaluate the effect of metronidazole vs. a synbiotic on the clinical course and core intestinal bacteria of dogs with AD. Twenty-seven dogs with AD were enrolled in this prospective, randomized, blinded clinical trial and treated with either metronidazole (METg) or a synbiotic (SYNg; E. faecium DSM 10663; NCIMB 10415/4b170). The Canine Acute Diarrhea Severity (CADS) index was recorded daily for eleven days. Bacteria were quantified using qPCR. Data were analyzed using mixed models with repeated measures. A higher concentration of E. coli was observed in the METg group vs. the SYNg group on Day 6 (p < 0.0001) and Day 30 (p = 0.01). Metronidazole had no effect on C. perfringens. C. hiranonis was significantly lower in the METg group than in the SYNg group on Days 6 and 30 (p < 0.0001; p = 0.0015). No significant differences were observed in CADS index, fecal consistency, or defecation frequency between treatment groups (except for the CADS index on one single day). In conclusion, metronidazole negatively impacts the microbiome without affecting clinical outcomes. Thus, synbiotics might be a preferred treatment option for dogs with AD.

Evaluation of Intestinal Barrier Dysfunction with Serum Iohexol Concentration in Dogs with Acute Hemorrhagic Diarrhea Syndrome.

Histopathologic examination of intestinal biopsies from dogs with acute hemorrhagic diarrhea syndrome (AHDS) reveals necrotizing enteritis and epithelial integrity loss. Serum iohexol measurement has been utilized to assess intestinal permeability. Our hypothesis is that dogs with AHDS have increased intestinal permeability, which is associated with the severity of clinical signs. In this prospective case-control study, 53 client-owned dogs (28 AHDS, 25 healthy controls) were evaluated. Clinical severity was assessed using the AHDS index and systemic inflammatory response syndrome (SIRS) criteria. Simultaneously, dogs received oral iohexol, and serum iohexol concentrations (SICs) were measured two hours later. Results indicated significantly higher (p = 0.002) SIC in AHDS dogs (median: 51 µg/mL; min-max: 9-246) than in healthy controls (30 µg/mL; 11-57). There was a significant positive correlation between AHDS index and SIC (rS = 0.4; p = 0.03) and a significant negative between SIC and serum albumin concentrations (Pearson r = -0.55; p = 0.01). Dogs with severe AHDS (mean 106 µg/mL; range: 17-246) demonstrated significantly higher (p = 0.002) SIC than those with mild to moderate disease (29 µg/mL; 9-54). These findings underscore the association between intestinal permeability and clinical severity in dogs with AHDS assessed by iohexol.

Provision of Psychotherapy One Year after the Beginning of the COVID-19 Pandemic in Austria.

A previous study revealed that the majority of Austrian psychotherapists switched to remote settings during the first months of the COVID-19 pandemic. The current study investigated whether this change in treatment format was maintained after one year of the COVID-19 pandemic. From 16 February until 2 April 2021, a total of 238 Austrian psychotherapists completed an online survey. They were asked about the number of patients currently treated in-person, via telephone and via the internet. Psychotherapists rated three different aspects of psychotherapy (ability to actively listen to patients, ability to understand what is going on in the patients and ability to support patients emotionally) for three different formats (in-person with facemasks, telephone and internet) separately. The results show that, after one year of the pandemic, the majority (78.4%) of patients were treated in-person (compared to 21.7% during the first months of the COVID-19 pandemic; p < 0.001). This change in the treatment format was accompanied by a strong increase in the total number of patients treated by 77.2% on average (p < 0.001). Psychotherapists reported no differences between in-person psychotherapy with facemasks and psychotherapy via the internet with regard to the three investigated aspects of psychotherapy, while the surveyed aspects were rated less favorably for psychotherapy conducted via telephonic communication (p < 0.05). Further studies are needed to investigate the reasons why most psychotherapists switched back to the in-person format with the continuation of the COVID-19 pandemic.

Therapeutic interventions in in-person and remote psychotherapy: Survey with psychotherapists and patients experiencing in-person and remote psychotherapy during COVID-19.

OBJECTIVE: First, to investigate how psychotherapists and patients experience the change from in-person to remote psychotherapy or vice versa during COVID-19 regarding the therapeutic interventions used. Second, to explore the influence of therapeutic orientations on therapeutic interventions in in-person versus remote psychotherapy. METHOD: Psychotherapists (N = 217) from Austria were recruited, who in turn recruited their patients (N = 133). The therapeutic orientation of the therapists was psychodynamic (22.6%), humanistic (46.1%), systemic (20.7%) or behavioural (10.6%). All the data were collected remotely via online surveys. Therapists and patients completed two versions of the 'Multitheoretical List of Therapeutic Interventions' (MULTI-30) (version 1: in-person; version 2: remote) to investigate differences between in-person and remote psychotherapy in the following therapeutic interventions: psychodynamic, common factors, person-centred, process-experiential, interpersonal, cognitive, behavioural and dialectical-behavioural. RESULTS: Therapists rated all examined therapeutic interventions as more typical for in-person than for remote psychotherapy. For patients, three therapeutic interventions (psychodynamic, process-experiential, cognitive interventions) were more typical for in-person than for remote psychotherapy after correcting for multiple testing. For two therapeutic interventions (behavioural, dialectical-behavioural), differences between the four therapeutic orientations were more consistent for in-person than for remote psychotherapy. CONCLUSIONS: Therapeutic interventions differed between in-person and remote psychotherapy and differences between therapeutic orientations in behavioural-oriented interventions become indistinct in remote psychotherapy.