A survey on Shar Pei autoinflammatory disease in the United Kingdom.

OBJECTIVES: To characterise the fever episodes attributed to Shar Pei autoinflammatory disease and to identify common diagnostic and management strategies in the United Kingdom. A secondary objective was to determine risk factors associated with Shar Pei autoinflammatory disease fever episodes. METHODS: A retrospective survey was performed to characterise episodes of Shar Pei autoinflammatory disease fever and to identify commonly used treatments in affected dogs. Clinical data were collected from owners and veterinarians. Frequencies of previously proposed risk factors (skin thickness and folding, muzzle conformation) and comorbid conditions were compared between dogs that had exhibited fever episodes consistent with Shar Pei autoinflammatory disease and those who had not. RESULTS: At least one episode of fever attributed to Shar Pei autoinflammatory disease was reported in 52 of 106 (49%) Shar Pei. Nine other dogs had fever episodes consistent with Shar Pei autoinflammatory disease reported by their owners but not by veterinarians. Median rectal temperature at presentation for Shar Pei autoinflammatory disease fever was 40.1°C [104.2°F] (39.9 to 41.3°C [103.8 to 106.3°F]) and owners reported associated hyporexia (n=33, 63%) and vomiting (n=8, 15%) more frequently than veterinary records (n=22, 42% and n=0, 0%, respectively). The median number of veterinary appointments for Shar Pei autoinflammatory disease was two per dog (1 to 15) while owners reported a median of four episodes per dog per year. None of the assessed phenotypic variants or comorbidities were significantly associated with exhibiting Shar Pei autoinflammatory disease fever episodes. CLINICAL SIGNIFICANCE: Episodes of Shar Pei autoinflammatory disease fever were reported approximately twice as frequently by owners compared to veterinary records, suggesting the burden of this condition may be underestimated by veterinarians. Specific risk factors for Shar Pei autoinflammatory disease fever were not identified.

Characterisation and outcome of idiopathic pyogranulomatous lymphadenitis in 64 English springer spaniel dogs.

OBJECTIVES: To describe the history, clinicopathological abnormalities, diagnostic imaging findings, lymph node cytological/histological appearance, treatment and outcome of English springer spaniels diagnosed with idiopathic pyogranulomatous lymphadenitis. MATERIALS AND METHODS: In this retrospective UK-based multicentre study, 64 dogs were recruited from 10 referral centres, 32 first-opinion practices and three histopathology/cytology laboratories, between 2010 and 2016. RESULTS: The median age at presentation was 6 years (range: 0.17 to 11.75). Neutered females were frequently affected. Pyrexia (83.8%), peripheral lymphadenomegaly (78.4%), dermatological lesions (72.9%), lethargy (67.6%), hyporexia (54%), diarrhoea (29.7%), coughing (24.3%), epistaxis, sneezing or nasal discharge (21.6%), ocular signs (21.6%) and vomiting (16.2%) were reported in dogs for which the history and physical examination records were available. Popliteal (45.3%), superficial cervical (35.9%) and submandibular (37.5%) lymphadenomegaly were frequently reported. Haematology and serum biochemistry revealed non-specific changes. When undertaken, testing for infectious diseases was negative in all cases. Lymph node cytology, histopathology or both demonstrated mixed inflammatory (27%), pyogranulomatous (24%), neutrophilic (20%) or granulomatous (11%) lymphadenitis. Treatment details were available for 38 dogs, with 34 receiving prednisolone for a median duration of 15 weeks (range: 1 to 28 weeks). A good to excellent clinical response was reported in all but one case. Ten dogs relapsed after discontinuing prednisolone. CLINICAL SIGNIFICANCE: Idiopathic pyogranulomatous lymphadenitis should be considered as a differential diagnosis for lymphadenopathy and pyrexia in English springer spaniels. The characteristics of the disease, absence of identifiable infectious aetiology and response to glucocorticoid therapy suggest an immune-mediated aetiology.

Autoimmune myasthenia gravis and dysautonomia in a dog.

A two-year-old male entire border collie dog was evaluated for a short history of mixed bowel diarrhoea, coughing, vomiting and stranguria. Physical examination revealed dyspnoea with increased ventral lung sounds and a flaccidly distended bladder. Neurological examination revealed poor pupillary light reflexes, an absent gag reflex and a poor anal tone. Thoracic radiography was consistent with megaoesophagus and aspiration pneumonia. Clinicopathological testing revealed an elevated muscular nicotinic acetylcholine receptor antibody titre. The dog was euthanased because of clinical deterioration. Cerebrospinal fluid (CSF) collected immediately post-mortem revealed macrophagic pleocytosis. Post-mortem histopathological examination was consistent with dysautonomia. This is the first report of coexisting autoimmune myasthenia gravis and dysautonomia in a non-human species. The concomitant diseases may suggest a common immunopathological aetiology.

Juvenile nephropathy in 37 boxer dogs.

OBJECTIVES: The purpose of this study was to review and characterise the clinical presentation of young boxer dogs with chronic kidney disease referred to the authors' institutions. METHODS: Records were collected retrospectively from 37 boxer dogs, less than five years of age, which had presented with azotaemia, inappropriately low urine concentrating ability, and ultrasound or radiographic evidence of abnormal kidneys. RESULTS: Clinicopathological findings included azotaemia, hyperphosphataemia, anaemia, isosthenuria and proteinuria. Ultrasonographic findings included hyperechoic renal cortices, loss of corticomedullary junction definition, dilated pelves and irregularly shaped small kidneys. Renal histopathological findings included pericapsular and interstitial fibrosis, inflammatory cell infiltration, dilated tubules, sclerotic glomeruli and dystrophic calcification. Survival time of the dogs varied from zero to over five years after diagnosis. CLINICAL SIGNIFICANCE: This paper documents features of the presentation and progression of juvenile nephropathy in boxer dogs. While juvenile nephropathy has been reported in individual cases of boxer dogs previously, this is the first reported case series.

Why is health relatively poor on Sri Lanka's tea estates?

The mountainous interior of Sri Lanka is one of the world's great tea-producing areas. The labour force on the tea estates consists of a population which has migrated from Tamil Nadu, in southern India, over the last one hundred years. This migrant population is known as 'Indian Tamils' and is largely drawn from the two largest Harijan castes of agricultural labourers in Tamil Nadu. On the now government owned estates, they have formed a kind of industrial proletariat, living in long estate line housing where each family has one or two rooms. The women, who are the tea pickers, work longer hours than do the men. The Indian Tamils have been characterized by markedly higher mortality than the indigenous population (Sinhalese, Sri Lankan Tamils and Moors). This paper reports a research program which was carried out in 1987 and which employed both anthropological and demographic survey techniques in an attempt to explain these higher mortality levels. The research identified the origins of higher mortality, both in limited access to health provision and in the social characteristics and economic circumstances of the community.

Sensitization to illness and the risk of death: an explanation for Sri Lanka's approach to good health for all.

Recent research has shown clearly that levels of mortality are not determined solely by income levels and the provision of modern health services. There appears to be an important sociocultural component so that the same density of health services produces lower mortality in one country than in another. Sri Lanka has achieved an expectation of life at birth of 68 years with an annual per capita income of U.S. $330 and no greater provision of health services than most countries at that income level. This paper records the investigation of how such success has been attained. A collaborative program of the University of Colombo and the Australian National University, beginning in 1985, employed both demographic and anthropological methods to study almost 11,000 persons in seven localities of southwestern Sri Lanka. It was found that the major geographical mortality differentials are no longer urban-rural but between the richer and poor areas of Colombo. The low mortality was found to be based on a great sensitivity to illness and the risk of dying. This is ancient in origin but has been heightened by a nineteenth century religious reform movement and twentieth century mass education. It has been further increased by universal death registration, the carrying out of post-mortems wherever necessary with the informing of the police if the death was unnecessary, and by the erection of a system for examining the circumstances of sudden death. This sensitivity was not sufficient to produce low death rates in conjunction with traditional medicine but only with modern medicine. Traditional medicine is still widely practiced, and exorcism is a major cause of expenditure in many families. Nevertheless, the key findings were two. First, where modern medicine can save a life, the sick person nowadays is nearly always exposed to it while there is still sufficient time for a cure. Modern medicine is now usually obtained at a shorter distance and more cheaply than traditional medicine. Second, and of central importance, is the continuing evaluation of sickness from its first appearance and the quick resort to new treatments if the present treatment does not appear to be efficacious. Because of an apprehension of an unnecessary death occurring during their treatment, healers frequently refer cases, from traditional to modern medicine and from general practitioner to hospital. Nevertheless, most changes of treatment are decided by the sick themselves and their relatives so that unsuccessful treatment is changed on average every 5 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Cessation of childbearing in the absence of contraception in Sri Lanka.

PIP: In data from the Sri Lanka Fertility Survey, 1975, the cessation of childbearing is examined among women who have never used contraception. The sample consisted of 6810 currently or previously married women, 57% of whom reported that they had never used contraception. Cessation of childbearing is studied according to age and marriage duration. The variables analyzed are age at last birth, proportions infertile during the last 5 or 7 years, and the infertile open interval. The duration of breastfeeding is taken into account where necessary, and the contraceptive users and nonusers are compared where appropriate. Non-users tend to cease childbearing early, and therefore are infertile for longer periods during their marriages. It is probably age of the 1st child that influences decisions on future fertility. Among women aged 45-49 who married before age 20 and continued in their 1st marriage, mean age at last live birth in non-users, was 34.5 years, about 2 years earlier than in those who had used contraception. Non-users who married at any age below 30 years cease childbearing well below age 40. The proportion not currently pregnant and infertile over the past 5 years increases with marriage duration among the fertile non-users in each age group. When age at last birth and the duration of breastfeeding in the open interval are taken into account and the reference period is increased to 7 years, the period of infertility increases with marriage duration among nonpregnant non-users below age 45. The proportion of women who were currently not pregnant and had remained infertile over the past 7 years is higher among the older non-users whose 1st child was born more than 10 years ago.^ieng

Infant mortality in Sri Lanka.

PIP: Infant mortality in Sri Lanka declined substantially between 1961 and 1980, the reduction being higher during the post-natal period. 3 distinct phases were identified: 1) a declining trend in the face of several fluctuations; 2) a sharp reversal of the trend and then an increase; and 3) a more consistent decline. Between the periods 1961-65 and 1976-80, deaths from exogenous and endogenous causes were reduced considerably and nearly equally. The probabilities of survival increased in every age group, proportionally more in the 1st week of life. There was no evidence that changes in national income or total food supply were factors, but protein calorie availability appeared to affect the rate. Distribution of free supplementary food, increase in public health personnel, more immunization, and a rise in the number of institutional births appeared to have initiated and sustained the more recent decline in infant mortality. Increasing levels of female education also augmented these developments. Further efforts to improve living conditions, access to safe water and flush or water-seal toilets, and motivating women to deliver in institutions and extend their postnatal stay, would probably result in a further decline, as well as general strategies such as integrating public health and medical services and improving health education programs.^ieng

Population growth and development.

PIP: Development is a complex process that has no universal laws to guide it. However, there is widespread agreement that population growth is a crucial factor in the process of social and economic development. Population growth is not always in itself detrimental to development, especially in some developed countries where there are economies of scale and sufficient human and physical capital for new investments. Developing countries face an environment that is less favorable for economic growth than did the developed countries of the past. The major problem lies in the extended time lag between population increases on the 1 hand and technological advances and adaptations on the other hand. In populations that are not equipped to make the necessary technological and infrastructural changes, even moderate population growth can arrest the development process. The transfer or adaptation of new technologies requires time, money, and other structural changes. Moreover, rapid population growth reduces the proportion of household savings, making less money available for per capita investment in both physical and human capital. At the family level, less time and money are available for child development. At the societal level, it becomes more difficult to finance the physical and human investments necessary for sustained economic growth. Under the best conditions, a developing Asian country can expect to achieve better economic performance in the longterm if the population has moderate growth, doubling over a 50-year period. While a slower rate of growth can accelerate development, it introduces a host of new social problems such as providing security to the elderly.^ieng