A review of cutaneous hypersensitivity reactions in dogs: A diagnostician's guide to allergy.

Allergic dermatoses are common in people and domestic animals. Resultant lesions are routinely biopsied and submitted for histological examination to confirm a diagnosis or rule out diseases with overlapping or atypical clinical features. Diagnostic pathologists and clinicians are often faced with the difficult task of determining whether an allergic reaction pattern is present on both the microscopic and macroscopic levels and correlating histopathologic findings with clinical and historical data to achieve a precise clinical diagnosis. The bulk of the current veterinary literature on allergic dermatoses focuses on atopic dermatitis in dogs, distantly followed by cats, horses, and other animals. The objectives of this review are to demonstrate the key histopathologic and clinical diagnostic features of the various allergy-mediated reaction patterns, and to provide diagnosticians with a practical guide for clinicopathological correlations. Current concepts in the pathophysiology of immediate hypersensitivity reactions, with a focus on atopic dermatitis, are discussed. Points of potential histopathologic overlap between the "classic" allergic reaction pattern and less common inflammatory, predominately eosinophilic, conditions that may mimic this pattern will be discussed with the goal of highlighting the critical need for collaboration between pathologists and clinicians in furthering patient care.

The epidemiology of antimicrobial resistance and transmission of cutaneous bacterial pathogens in domestic animals.

As the primary agents of skin and soft tissue infections in animals, Staphylococcus spp and Pseudomonas aeruginosa are among the most formidable bacterial pathogens encountered by veterinarians. Staphylococci are commensal inhabitants of the surfaces of healthy skin and mucous membranes, which may gain access to deeper cutaneous tissues by circumventing the stratum corneum's barrier function. Compromised barrier function occurs in highly prevalent conditions such as atopic dermatitis, endocrinopathies, and skin trauma. P aeruginosa is an environmental saprophyte that constitutively expresses virulence and antimicrobial resistance genes that promote its success as an animal pathogen. For both organisms, infections of the urinary tract, respiratory tract, joints, central nervous system, and body cavities may occur through ascension along epithelial tracts, penetrating injuries, or hematogenous spread. When treating infections caused by these pathogens, veterinarians now face greater therapeutic challenges and more guarded outcomes for our animal patients because of high rates of predisposing factors for infection and the broad dissemination of antimicrobial resistance genes within these bacterial species. This review considers the history of the rise and expansion of multidrug resistance in staphylococci and P aeruginosa and the current state of knowledge regarding the epidemiologic factors that underly the dissemination of these pathogens across companion animal populations. Given the potential for cross-species and zoonotic transmission of pathogenic strains of these bacteria, and the clear role played by environmental reservoirs and fomites, a one-health perspective is emphasized.

Exploring health by reproductive status: an epidemiological analysis of preconception health.

BACKGROUND: Recently published preconception health guidelines promote maternal health, yet adherence to those guidelines has not been documented. We hypothesized that pregnant women engaged in a healthier lifestyle than nonpregnant women, although this may vary by pregnancy intention and birth control method. METHODS: We performed secondary analysis of cross-sectional data from the Behavioral Risk Factor Surveillance System (BRFSS) (2002 and 2004 datasets). The data are collected in all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and Guam through a telephone survey of 350,000 adults annually. Subjects were a representative sample of noninstitutionalized, 18-44-year-old, fertile women (n = 66,152). Based on pregnancy risk, women were grouped into one of five categories: pregnant, intending pregnancy (IP), unintended pregnancy high risk (HR), moderate risk (MR), and low risk (LR). Logistic regression was used to estimate adjusted prevalence odds ratios (aPOR) and 95% confidence intervals (CI) for behavioral characteristics using pregnant women as the referent group. RESULTS: IP, HR, MR, and LR women were more likely to drink any alcohol (aPOR 10.85, aPOR 8.39, aPOR 11.90, aPOR 11.98, respectively), binge drink (aPOR 7.07, aPOR 6.24, aPOR 7.27, aPOR 7.17, respectively), heavy drink (aPOR 6.90, aPOR 5.67, aPOR 7.48, aPOR 5.89, respectively), and smoke (aPOR 2.89, aPOR 2.69, aPOR 2.40, aPOR 2.09, respectively). Interestingly, IP, HR, MR, and LR women were more likely to engage in leisure activity (aPOR 1.37, aPOR 1.19, aPOR 1.57, aPOR 1.17, respectively). HR, MR, and LR women were less likely to consume folic acid (aPOR 0.14, aPOR 0.21, aPOR 0.29, respectively), whereas women intending a pregnancy were equally likely to consume folic acid (aPOR 0.77 CI 0.30, 2.0), although the response rate for folic acid was low. CONCLUSIONS: Preconceptional health goals are not being met. Pregnancy risk, as delineated by contraceptive use, can inform interventions designed to prevent adversely exposed pregnancies.