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Background Direct oral anticoagulants (DOACs) are effective to prevent strokes; however, bleeding risk of DOACs in very old and frail geriatric patients is poorly known. Purpose : To assess bleeding risk in geriatric patients aged ≥ 80 years with AF newly treated with rivaroxaban. Methods Subjects from 33 centers, with non-valvular AF newly treated with rivaroxaban were enrolled and followed-up every 3 months for 12 months. Clinical and biological data were recorded. Major bleedings were recorded at each visit. The cohort was compared with a cohort treated with vitamin K antagonists (VKA) from the same centers (n = 924). Results In total, 995 subjects had a 1-year follow-up. The mean (standard deviation (SD)) age was 86.0 (4.3) years, 23% were aged 90 years and older. 61% were women and 48% had an estimated glomerular filtration rate (eGFR) Conclusions In this first large-scale prospective study in geriatric population with AF, major bleeding rates were significantly lower with rivaroxaban than with VKAs.

Resume Une chienne Cocker spaniel, âgee de deux ans et demi a ete referee en consultation specialiste suite a l’apparition de lesions suintantes ne retrocedant pas au traitement mis en place. L’examen clinique montrait un syndrome febrile associe a des lesions cutanees ulcerocrouteuses de toute la face dorsale de l’animal sans qu’aucune muqueuse ne soit atteinte. L’examen histopathologique cutane a permis le diagnostic d’erytheme polymorphe avec atteinte majeure des annexes. Aucune prise medicamenteuse precedant la dermatose n’a pu etre mise en evidence et un bilan d’extension s’est avere negatif. La patiente a ete hospitalisee pendant quatre jours et a recu un traitement systemique anti-infectieux, antalgique et de rehydratation, ainsi que des shampooings antiseptiques et des bains quotidiens. Un traitement ambulatoire anti-infectieux systemique et topique identique a suivi. La chienne a gueri en un mois et demi, mais aucune repousse pilaire n’a ete observee dans les zones lesees.

of stroke, bleeding and cardiovascular morbidity. Alongwith conventional risk assessment tools such as CHA2DS2-VASc and HAS-BLED scores, cardiospecific troponinsmay hence provide an important complementary information about the thromboembolic risk and the prognosis of patients with AF [6]. Interestingly, it is conceivable that an increased troponin value in these patients would not invariably mirror the presence of relevant coronary artery stenosis, but may be more commonly associated with tachycardia per se, thus reflecting a cardiac injury (e.g., myocyte necrosis and/or fibrosis) which may be directly attributed to AF [7].

Serum cobalamin concentration [CBL] suggests CBL deficiency in cats but serum methylmalonic acid concentration [MMA] more accurately indicates CBL deficiency.To examine the ability of [CBL] to predict CBL deficiency defined by increased [MMA], and relationships of [CBL] and [MMA] with select clinical and clinicopathological variables.One hundred sixty-three client-owned cats with [CBL] measurements, 114 cats with simultaneous [MMA] measurements; 88 cats with medical information.Prospectively collected [CBL] and [MMA] were compared using scatter plots, receiver operating characteristic and correlative analyses with historical [CBL] thresholds and those identified in the study. [CBL] and [MMA] were compared retrospectively to specific clinical and clinicopathological variables.[CBL] correlated negatively with [MMA] (τ = -0.334, P.0001). [MMA] ≥ 1,343 nmol/L identified CBL deficiency. [CBL] = 209 pg/mL optimized sensitivity (0.51), specificity (0.96), PPV (0.89), and NPV (0.74) for detecting [MMA] ≥ 1,343 nmol/L. Prevalence of CBL deficiency was 42% (48/114) when defined by [MMA] ≥ 1,343 nmol/L versus 23% (27/114) by [CBL] ≤ 209 pg/mL. Unexpectedly, 23 and 45% of 48 cats with [MMA] ≥ 1,343 nmol/L had [CBL]900 pg/mL and 290 pg/mL (historical thresholds). [CBL] correlated with mean corpuscular volume (τ = -0.199, P = .013) and [MMA] with hematocrit (τ = -0.28, P = .006).Cobalamin deficiency ([MMA] ≥ 1,343 nmol/L) occurred in 42% of cats and is predicted with high specificity by [CBL] ≤ 209 pg/mL. CBL status correlates with microcytosis and anemia. Discordance between [CBL] and [MMA] cautions against relying on any single marker for determining CBL status.

Objectives: The aim of this study was to assess the clinical and aetiological aspects of contact dermatitis of the scrotum in dogs. Methods: The medical records of 13 dogs with suspected scrotal contact dermatitis were retrospectively included in the study. For each case, historical findings, results of physical and dermatological examination and of avoidance tests as well as follow-up were included. Results of re-exposure tests and patch tests were also included when available. Results: Avoidance tests to various suspected substances such as floor detergents, bleach, cement, laundry detergent and plastic fabric were performed and led to clinical improvement in all patients. Provocative re-exposure was performed in six cases, with five positive responses. Patch tests were undertaken in three of the five re-exposed cases, with two responding positively. Clinical Significance: Scrotal skin is thin and with few hair follicles, and is therefore very susceptible to contact dermatitis. A range of substances can induce contact dermatitis. The diagnosis of contact dermatitis is made by results of avoidance and/or provocation tests and/or patch tests. Once an aetiological agent has been identified, treatment is straightforward consisting of avoidance of this agent.