Prevalence of humeral head osteochondrosis in the Greater Swiss Mountain dog and the Border Collie in Switzerland.

INTRODUCTION: Osteochondrosis (OC) is common in large-breed dogs. According to the breeding guidelines of the Swiss kennel clubs, the shoulder joints are included in the radiographic screening for joint diseases in the Greater Swiss Mountain dog (GSMD) and the Border Collie (BC) since 1993 and 2003, respectively. The aim of this study was to estimate the overall prevalence of humeral head OC in these 2 breeds in Switzerland based on the data of the Swiss National Dysplasia Committees. All radiographs were re-evaluated to assess single radiographic changes. From 1993 and 2003, accordingly, until 2013, the overall prevalence was 14% for the GSMD and 8% for the BC, respectively. Affected joints showed a focally reduced opacity or a flattened/indented contour of the caudal section of the humeral head. Articular flaps were only seen occasionally. Degenerative joint disease was significantly more common in OC affected joints (GSMD: 32%; BC: 20%) than in joints without OC. The present study is the first report on the prevalence of humeral head OC in a large cohort of GSMD and the BC over a long study period. In comparison to other breeds, the herein reported prevalences are in the mid to upper range. Results of the present study should alert veterinarians to the disease in these breeds and may serve as a starting point for further epidemiological and genetic studies.

INTRODUCTION: L'ostéochondrose (OC) est fréquente chez les chiens de grande race. Conformément aux prescriptions d'élevage des clubs cynologiques suisses, l'articulation de l'épaule est incluse dans le dépistage radiologique des affections articulaires chez le Grand bouvier suisse (GBS) et le Border Collie (BC) et ceci depuis 1993 respectivement 2003. Le but de la présente étude était d'estimer la prévalence de l'OC de la tête humérale chez ces deux races en Suisse, sur la base des données des commissions nationales suisses de dysplasie. Toutes les radiographies ont été réévaluées pour repérer des altérations radiologiques isolées. Depuis 1993 respectivement 2003 jusqu'en 2013, la prévalence était de 14% chez le GBC et de 8% chez le BC. Les articulations affectées montraient une opacité localement réduite ou un contour aplati/ dentelé de la partie caudale de la tête humérale. Des souris articulaires n'étaient constatées qu'occasionnellement. Les affections articulaires dégénératives étaient significativement plus fréquentes sur les articulations affectées d'OC que sur les autres (GBS: 32%; BC: 20%). La présente étude rapporte pour la première fois la prévalence de l'OC de la tête humérale sur une large cohorte de GBS et de BC sur une longue période. En comparaison avec d'autres races, les prévalences constatées se situent entre la moyenne et le niveau supérieur. Les résultats de cette étude doivent alerter les vétérinaires au sujet de cette affection chez ces races et peut server de pont de départ pour de futures recherches épidémiologiques et génétiques.

Efficacy of a pulsed oxygen delivery device during exercise in patients with chronic respiratory disease.

The ability of a pulsed oxygen delivery system (Puritan-Bennett Companion Oxygen Saver (COS-5) to track respiratory rate during exercise and the oxygenation achieved during the exercise while oxygen was being delivered by this system was compared to that attained while oxygen was delivered continuously in six patients with chronic obstructive pulmonary disease (COPD) and six patients with idiopathic pulmonary fibrosis (IPF). The COS-5 appeared to respond appropriately at respiratory rates between 15 and 45, even when there were minimal pressure changes at the nose. There was an excellent correlation in PaO2 at equivalent flow settings during the exercise in the patients with COPD and IPF. There were six instances (in four patients) of the 31 comparisons in which the PaO2 differed by more than 5 mm Hg. The PaO2 was higher with continuous oxygen delivery on two occasions in a patient with COPD who utilized pursed-lip breathing during the exercise. The PaO2 was higher with COS-5 delivery on two occasions in a patient with IPF who was breathing at the highest respiratory rates (44 and 45/min) during the exercise.

A note concerning the analysis of an epidemic of Q fever.

Techniques of statistical analysis developed for the analysis of experiments, for which the usual precautions of randomization ensure independence, are not necessarily appropriate to the analysis of epidemics. An outbreak of Q Fever in a Swiss Alpine valley previously reported in the International Journal of Epidemiology is analysed to make this point.

Surveillance of antimicrobial resistance--what, how and whither?

OBJECTIVE: To express the views of a working party held to consider antibiotic resistance surveillance systems, their strengths and weaknesses, and their current and future applications. METHODS: The participants, all of whom were experienced in this field, discussed the development of surveillance systems in relation to the increasing prevalence of resistance to antibacterial agents and the current interest in surveillance systems shown by many official bodies, in both the human and veterinary fields. The problems inherent in surveillance systems were considered together with the applications of different systems. RESULTS: The properties of good antibiotic resistance surveillance systems were defined. Surveillance systems vary widely from those with a narrow base, focusing on few organisms in one disease area, to those covering many diseases, many organisms (including normal flora) and many compounds. Whatever their design, they should be able to detect significant differences and shifts in susceptibility to various antibacterial agents, and the information derived from them should reach as many interested parties as possible in a timely manner. In using this information to decide strategies, criteria for action need to be determined by pragmatic consensus. Funding remains a major problem, with few large studies being supported by official bodies in spite of their professed enthusiasm for surveillance. In consequence, many current systems are funded by the pharmaceutical industry and are of necessity restricted in their focus. CONCLUSIONS: Antibiotic resistance surveillance studies should and can be well planned and well executed. Many current systems suffer from well-recognized but uncorrected biases. Consortium funding will be necessary for large schemes to be successful. There is no "ideal" surveillance system.

Resource allocation. Some problems in applying the national formula to area and district revenue allocations.

The inadequacy of the current national formula in dealing with flows of patients across administrative boundaries is illustrated. In particular, the problems of dealing with varying admission rates for inpatients and in allocating revenues for outpatient services are discussed. We draw attention to an oversight in the recommendations concerning psychiatric services and criticise the general approach to the allocation of revenue under this heading. It is concluded that the national formula should not be applied for revenue allocation at district level in an unmodified form.

Ethical considerations concerning treatment allocation in drug development trials.

It is claimed that much of the opposition to placebos is based on the misunderstanding that their use implies the withholding of effective treatments. It is also argued that the ethical feasibility of a trial must be judged by comparing the likely prognosis of patients in the trial to their expectations outside the trial. Furthermore, a longer-term perspective of the patients needs is necessary; the ethical dilemmas involved cannot be resolved at the point of sickness. Some device such as the 'original position' of the philosopher John Rawls is needed. Finally, it is argued that placebo run-ins involve a violation of consent and should be eliminated from clinical trials.

The AB/BA crossover: past, present and future?

The AB/BA design is reviewed from a historical perspective. Particular attention is paid to the problem of carry-over and various attempts to deal with it. The two-stage procedure, an approach which was popular for many years, is shown to be unsafe. The analysis of AB/BA designs with baseline data is also considered. It is shown that such baselines do not provide a cure for the problem of carry-over; and it is concluded that any rational analysis of such trials will always be dependent on assumptions regarding carry-over, and that it is necessary to pay particular attention to washout periods. Under such circumstances analysis of covariance may be useful. In conclusion, some speculative comments about future lines of research are offered.

Clinical cross-over trials in phase I.

We review the role of cross-over trials in pharmacokinetic and pharmacodynamic studies, in particular as applied in phase I. Design and analysis considerations are covered. We also consider the use of pharmacokinetic and pharmacodynamic theories in planning cross-over trials. Finally some practical considerations are covered.

Statisticians and pharmacokineticists: what they can still learn from each other.

Examples are given of how the practice of statistics could be improved if statisticians showed a greater awareness of pharmacokinetic and pharmacodynamic modeling. Some examples are also given where a wider appreciation of statistical theory would improve current approaches to pharmacometrics. Areas in which the two disciplines are in agreement but have failed to have as much influence on others in drug development as they ought are also considered. It is concluded that there would be much benefit in increasing collaboration between these disciplines.