Use of a tilapia skin xenograft for management of a large bite wound in a dog.

A 13-year-old neutered male miniature dachshund suffered ~30% total skin loss following an attack by another dog. After numerous failed attempts at wound management and closure, the wound was successfully healed by epithelialization using tilapia skin grafts. At each tilapia skin graft placement, the wound bed appeared pink, clean, and healthy with excellent progression of epithelialization at all edges. With use of the tilapia grafts, epithelialization occurred at a rate of 1.76 mm/day. As a result, the wound reached complete closure by epithelialization with no evidence of wound contracture in 102 days. Key clinical message: Tilapia skin grafts were successfully used for management of a large bite wound in a dog and may promote accelerated epithelialization in full thickness skin wounds.

Utilisation d'une xénogreffe de peau de tilapia pour la prise en charge d'une morsure importante chez un chien. Un teckel miniature mâle castré de 13 ans a subi une perte totale de peau d'environ 30 % à la suite d'une attaque par un autre chien. Après de nombreuses tentatives infructueuses de gestion et de fermeture de la plaie, la plaie a été cicatrisée avec succès par épithélialisation à l'aide de greffes de peau de tilapia. À chaque placement de greffe de peau de tilapia, le lit de la plaie apparaissait rose, propre et sain avec une excellente progression de l'épithélialisation sur tous les bords. Avec l'utilisation des greffes de tilapia, l'épithélialisation s'est produite à un taux de 1,76 mm/jour. En conséquence, la plaie a atteint une fermeture complète par épithélialisation sans signe de contracture de la plaie en 102 jours.Message clinique clé :Les greffes de peau de tilapia ont été utilisées avec succès pour la gestion d'une grande plaie de morsure chez un chien et peuvent favoriser une épithélialisation accélérée dans les plaies cutanées de pleine épaisseur.(Traduit par Dr Serge Messier).

Persistent papilloma treated with cryotherapy in three dogs.

BACKGROUND: Canine papillomaviruses can affect the mucous membranes and skin of young, old and immunocompromised dogs. Most lesions regress spontaneously over a four to eight week interval; however, in some cases the lesions may persist or progress. Cryotherapy is used as a treatment for papillomavirus induced lesions in veterinary practice but there is limited published evidence regarding its use. OBJECTIVES: To describe the history, lesions and treatment outcomes of three dogs with persistent viral papillomas treated with cryotherapy. ANIMALS: Three client owned dogs. METHODS: Canine viral papilloma lesions were treated with five to six freeze-thaw cycles using liquid nitrogen cryotherapy. RESULTS: All lesions in each case resolved with cryotherapy treatment. Two cases required one treatment and one case required two treatment courses. CONCLUSIONS AND CLINICAL IMPORTANCE: The apparent resolution of these papilloma lesions with cryotherapy suggests that this may be a useful treatment intervention for persistent canine papilloma lesions. Spontaneous resolution may still have taken place; consequently, large scale clinical trials are required to demonstrate unequivocally that this mode of therapy, as with other therapeutic modalities, is really effective in the treatment of canine papillomatosis.

Residual antibacterial activity of canine hair treated with topical antimicrobial sprays against Staphylococcus pseudintermedius in vitro.

BACKGROUND: Topical antimicrobial therapy is increasingly important in the treatment of canine pyoderma as the incidence of multidrug resistance has risen. However, little information is reported on the persistence of activity of topical antimicrobial products. OBJECTIVE: To determine the residual antibacterial activity of canine hairs treated with antimicrobial sprays. ANIMALS: Twelve privately owned dogs with no history of dermatological disease. METHODS: Dogs were treated once with four different spray products [(A) 1% chlorhexidine digluconate, (B) 2% miconazole nitrate, 2% chlorhexidine gluconate, tromethamine USP/disodium EDTA (TrizEDTA), (C) 3% chlorhexidine gluconate, phytosphingosine salicyloyl and (D) 4% chlorhexidine gluconate, TrizEDTA] in separate 5 × 5 cm sections on the trunk. Hairs were collected via shaving before, one hour after and 2, 4, 7 and 10 days after treatment. Hairs were incubated on agar plates streaked with Staphylococcus pseudintermedius for 24 h and the bacterial growth inhibition zone around the hairs was measured. RESULTS: There were significant overall treatment and day (P < 0.0001) differences in inhibition zones. The largest zones of inhibition were from hairs treated with spray B, followed by sprays D, C and A, respectively. All sprays demonstrated residual antimicrobial activity for the ten days evaluated. CONCLUSIONS AND CLINICAL SIGNIFICANCE: Results suggest that the efficacy of an antimicrobial spray is dependent on both the concentration and combination of active ingredients. Several ingredient profiles appear to effectively inhibit S. pseudintermedius growth for at least 10 days, which may be beneficial in the treatment of canine pyoderma.

Concurrent and convergent validity of the simple lifestyle indicator questionnaire.

Lifestyle issues including physical activity, diet, smoking, alcohol consumption, and self-reported stress have all been shown to predispose people to higher risk of cardiovascular disease. This study provides further psychometrics on the Simple Lifestyle Indicator Questionnaire (SLIQ), a short, easy-to-use instrument which measures all these lifestyle characteristics as a single construct. One hundred and ninety-three individuals from St. John's, Newfoundland, and Labrador, Canada completed the SLIQ and reference standards for diet, exercise, stress, and alcohol consumption. The reference standards were a detailed Diet History Questionnaire (DHQ), the Social Readjustment Rating Scale (SRRS), the SF36 Health Status Questionnaire, and a survey of eight questions from a cardiovascular risk questionnaire. Physical activity score was compared with number of steps on a pedometer. Correlations between scores on the SLIQ and the reference standards were the SLIQ versus DHQ (r = 0.679, P = 0.001), SLIQ versus pedometer (r = 0.455, P = 0.002), SLIQ versus alcohol consumption (r = 0.665, P = 0.001), SLIQ versus SRRS (r = -0.264, P = 0.001), SLIQ versus eight-question risk score (r = 0.475, P = 0.001), and SLIQ versus Question 1 on SF36 (r = 0.303, P = 0.001). The SLIQ is sufficiently valid when compared to reference standards to be useful as a brief assessment of an individual's cardiovascular lifestyle in research and clinical settings.

Evaluation of otoscope cone disinfection techniques and contamination level in small animal private practice.

The objective of this study was to evaluate the level of bacterial contamination of otoscope cones in veterinary private practice, and to determine the most effective method of disinfection. Fifty small animal practices participated in this study, which included a detailed survey regarding otoscope cleaning, storage and usage and quantitative culture of the cleaned and stored otoscope cones. Using sterile technique, two cones from each of the 50 hospitals were swabbed and submitted for quantitative culture. Contamination was present in 29% of the samples and the following organisms were isolated: Flavobacterium brevis (10%), Pseudomonas aeruginosa (6%), Pseudomonas alcaligenes (4%), Staphylococcus intermedius (4%), Corynebacterium spp. (2%), Bacillus spp. (1%), Enterococcus faecalis (1%) Malassezia spp. (1%). There was no statistically significant difference between storage type (dry versus stored in solution) and for the instrumentation used to clean the cones (brush, cotton-tipped applicator, both versus none). There was a statistically significant difference between the different cleaning solutions (P < 0.001) and between the storage solutions (P = 0.003). A single most effective cleaning solution was unable to be determined due to the large number of solutions utilized. Cetylcide G (Cetylite Industries, Inc., Pennsauken, NJ, USA) was the most effective of the three most commonly used storage solutions (Cetylcide G, Benz-all, and 2% Chlorhexidine gluconate) when used as directed (P < 0.001). The level of contamination had a positive association with the frequency of cone use and a negative association with the frequency of storage solution replacement.

Prehypertension and hypertension in a primary care practice.

OBJECTIVE: To assess the prevalence of prehypertension and the prevalence and treatment of hypertension in a family practice population. DESIGN: Cross-sectional study. SETTING: An academic family practice unit. PARTICIPANTS: Practice patients aged 30 to 80 years who had visited the clinic at least once during the 2 years before the study and had at least 1 blood pressure (BP) measurement recorded on their charts during that time period. MAIN OUTCOME MEASURES: Most recent BP recorded on the chart; presence or absence of a diagnosis of hypertension recorded on the chart; number and class of prescribed antihypertensive medications. RESULTS: Of the 1388 patients who met the inclusion criteria, 389 had a diagnosis of hypertension. Of the 999 who did not have a diagnosis of hypertension, 306 (30.6%) met the criteria for prehypertension used in this study (systolic BP of 130 to 139 mm Hg or diastolic BP of 85 to 89 mm Hg). Men and older patients (60 to 80 years of age) were more likely to have prehypertension than other patients were. Of the patients with hypertension, 254 (65%) had achieved a BP level of < 140/90 mm Hg. The majority of hypertensive patients were prescribed 1 or 2 medications. Only 4.5% were using more than 2 different medications. CONCLUSION: A large proportion of a family practice's patients need close surveillance of BP because of the prevalence of prehypertension. Despite the improvement in the management of hypertension, only 65% of hypertensive patients had achieved the recommended target BP. Family physicians could be treating their hypertensive patients more aggressively with medications; only 4.4% of patients were using more than 2 different antihypertensive medications, despite 35% not being at target. Hypertension surveillance and treatment to achieve target BP levels continue to be important issues in primary care.

Perceived community environment and physical activity involvement in a northern-rural Aboriginal community.

BACKGROUND: Type 2 diabetes disproportionately affects Aboriginal peoples in Canada. Ample evidence shows that regular physical activity (PA) plays an important role in the prevention and treatment of type 2 diabetes. Evidence is beginning to emerge linking PA to the physical environment but little is known about the relationship between remote rural environments and PA involvement in Aboriginal peoples. This study's purpose was to investigate the relationship between perceptions of the environment and PA and walking patterns in Aboriginal adults in order to inform the planning and implementation of community-relevant PA interventions. METHODS: Two hundred and sixty three residents (133 women, mean age = 35.6 years, SD = 12.3 and 130 men, mean age = 37.2 years, SD = 13.1) from Moose Factory, Ontario were asked about environmental factors related to walking and PA involvement. Survey items were drawn from standardized, validated questionnaires. Descriptive statistics (means, standard deviations, percentages) were calculated. A series of hierarchical multiple regressions were performed to determine associations between walking and overall PA with perceived environmental variables. RESULTS: Hierarchical multiple regression to predict walking revealed significant associations between walking and perceived safety and aesthetics. Owning home exercise equipment predicted strenuous PA. Different aspects of the physical environment appear to influence different types of physical activities. The significant amount of variance in behaviour accounted for by perceived environmental variables (5.3% walking) included safety, aesthetics, convenience, owning home exercise equipment and comfortable shoes for walking. CONCLUSION: Results suggest that a supportive physical environment is important for PA involvement and that walking and activities of different intensity appear to be mediated by different perceived environmental variables. Implications for PA promotion in rural environments where Aboriginal people face many unique environmental features (e.g., bears, mosquitoes, extreme cold) are discussed.

Family medicine as a career option: how students' attitudes changed during medical school.

OBJECTIVE: To track and describe career choice decisions of medical students as they progressed through their undergraduate training. DESIGN: Quantitative survey of each class at 5 points during their undergraduate experience. Each survey collected qualitative descriptors of students' current career choices. SETTING: Faculty of Medicine at Memorial University of Newfoundland in St John's. PARTICIPANTS: Undergraduate medical students in each year from 1999 to 2006. MAIN OUTCOME MEASURES: Number of students considering family medicine as a career option at 5 different data-collection points throughout the medical school curriculum. RESULTS: Many students considered family medicine as a career choice early in their undergraduate experience. The number of students considering family medicine dropped significantly during the second year of the curriculum. This trend was consistent across all students surveyed. Although interest in family medicine as a career rebounded later in the curriculum, it never fully recovered. CONCLUSION: A large percentage of medical students considered family medicine as a career choice when they entered medical school. The percentage dropped significantly by the end of the second year of training. Attention should be directed toward understanding how the undergraduate medical curriculum in the first 2 years can protect and cultivate interest in family medicine as a career choice.