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Fifty-five healthy conscious dogs were included in a prospective randomised double-blinded clinical study. The dogs allocated to one of four groups received intravenous bolus followed by infusion of fentanyl (FEN-group), or ketamine (KET-group), or lidocaine (LID-group), or saline (SAL-group). The intraocular pressure (IOP), pupil size (PS), heart rate (HR) and mean arterial pressure (MAP) were measured prior to and at 2, 5, 10, 20 and 30 min after initiation of the drug administration. The data were analysed using an analysis of variance and the Steel-Dwass test. No significant difference in the IOP within or between the groups was detected. In the FEN-group, the PS decreased significantly at all the measured times. In the KET-group, the PS increased significantly at 2, 5 and 10 minutes. The PS was significantly smaller in the FEN-group compared to the KET-group at 2, 5, 10 and 20 min, compared to the SAL-group at 5, 10, 20 and 30 minutes. In the FEN-group the HR significantly decreased compared to the baseline and was significantly lower compared to the KET-group and LID-group. Fentanyl, ketamine or lidocaine administered at the doses studied as a bolus followed by a 30-min infusion seem to cause no effect on the IOP in healthy conscious non-painful dogs without ocular abnormalities. Fentanyl decreased and ketamine transiently increased the PS.

The objective of this prospective randomised clinical study was to determine the differences in the tracheal, oesophageal and rectal temperature in spontaneously breathing or mechanically ventilated dogs. A total of thirty dogs were allocated to the SPO-group breathing spontaneously (n = 15) or the MEC-group ventilated mechanically (n = 15). Anaesthesia was established using a medetomidine-butorphanol-propofol-isoflurane combination. The tracheal (T-Tra), oesophageal (T-Oes), rectal (T-Rec), inspired gas (T-Gas), room (T-Room) temperatures, respiratory frequency (fR), heart rate (HR), mean arterial pressure (MAP) and end-tidal carbon dioxide concentration (ETCO2) were measured after connecting to a re-breathing system (baseline) and subsequently in 10-minute intervals for 60 minutes. The data were analysed using ANOVA and Steel-Dwass tests (P < 0.05). In the SPO-group, the T-Tra, was significantly lower at T30, T40, T50, T60, the T-Oes and T-Rec at T40, T50, T60, compared to the baseline. In the MEC-group, the T-Tra and T-Oes was significantly lower at T30, T40, T50, T60, the T-Rec at T40, T50, T60, compared to the baseline. In the SPO-group, the fR was significantly lower for all the times and the ETCO2 higher at T10, T20, T30, T40, T50 compared to the MEC-group. No other differences were detected. During anaesthesia, there is a comparable decrease in body temperatures, regardless of whether the dogs are breathing spontaneously or ventilated mechanically.

Background. To address the increasing demands for gastroenterology specialty care and increasing wait times, centralized access and triage (CAT) systems, telephone support, and clinical care pathways were implemented to streamline referrals and support management of low-risk gastrointestinal (GI) conditions in the primary care medical home. This study aimed to understand primary care providers (PCPs) and GI specialists’ perceptions of these supports, factors that affect support implementation and identify barriers and facilitators for implementing supports from both PCP and GI specialists’ perspectives. Methods. We conducted a mixed method study including surveys and interviews with PCPs and GI specialists. Online surveys and semistructured qualitative interviews were conducted from July 2022 to September 2022. All interviews were transcribed and coded to perform a thematic analysis. Survey data were analyzed in SPSS version 25. Descriptive statistics were employed to summarize and describe the data collected. Inferential statistics were used to identify associations and relationships within the dataset. T-test and chi-square tests were applied at 95% confidence level, with a p value

Background: High-dose proton pump inhibitor (PPI) therapy, given either intermittently or continuously for non-variceal upper gastrointestinal bleeding (NV-UGIB), is efficacious. Using intermittent PPI for low-risk patients may be cost-saving. Our objective was to estimate the annual cost savings if all low-risk NV-UGIB patients received intermittent PPI therapy. Methods: Patients who presented to hospital in Calgary, Alberta, who received a PPI for NV-UGIB from July 2015 to March 2017 were identified using ICD-10 codes. Patients were stratified into no endoscopy, high-risk, and low-risk lesion groups and further subdivided into no PPI, oral PPI, intermittent intravenous (IV), and continuous IV subgroups. Average length of stay (LOS) in each subgroup and costs were calculated. Results: We identified 4141 patients with NV-UGIBs, (median age 61, 57.4% male). One-thousand two-hundred and thirty-one low-risk patients received continuous IV PPI, with an average LOS of 6.8 days (95% CI 6.2–7.3) versus 4.9 days (95% CI 3.9–5.9) for intermittent IV patients. If continuous IV PPI patients instead received intermittent IV PPI, 3852 patient days and CAD 11,714,390 (2017 CAD)/year could be saved. Conclusions: Using real-world administrative data, we demonstrate that a sizable portion of low-risk patients with NV-UGIB who were given continuous IV PPI if switched to intermittent IV therapy could generate significant potential cost savings.

Abstract This case report is of a 35‐week female neonate with a cystic abdominal mass. Physical examination was notable for post‐axial polydactyly, distended abdomen, and abnormal urethral opening. Differential diagnosis includes Bardet–Biedl Syndrome (BBS), an autosomal recessive ciliopathy. Genetic panel revealed she was a carrier for a BBS mutation.

Treatment targets of inflammatory bowel diseases (IBD), ulcerative colitis (UC) and Crohn’s disease (CD) have evolved over the last decade. Goals of therapy consisting of symptom control and steroid sparing have shifted to control of disease activity with endoscopic remission being an important endpoint. Unfortunately, this requires ileocolonoscopy, an invasive procedure. Biomarkers [C-reactive protein (CRP) and fecal calprotectin (FCP)] have emerged as surrogates for endoscopic remission and disease activity, but also have limitations. Despite this evolution, we must not lose sight that CD involves transmural inflammation, not fully appreciated with ileocolonoscopy. Therefore, transmural assessment of disease activity by cross-sectional imaging, in particular with magnetic resonance enterography (MRE) and intestinal ultrasonography (IUS), is vital to fully understand disease control. Bowel-wall thickness (BWT) is the cornerstone in assessment of transmural inflammation and BWT normalization, with or without bloodflow normalization, the key element demonstrating resolution of transmural inflammation, namely transmural healing (TH) or transmural remission (TR). In small studies, achievement of TR has been associated with improved long-term clinical outcomes, including reduced hospitalization, surgery, escalation of treatment, and a decrease in clinical relapse over endoscopic remission alone. This review will focus on the existing literature investigating the concept of TR or residual transmural disease and its relation to other existing treatment targets. Current data suggest that TR may be the next logical step in the evolution of treatment targets.

The purpose of this study was to inform a community-engaged partnership concerned with mental health in their community by exploring factors associated with depression among a sample of residents in a micropolitan city in a rural state. Social and contextual factors are important influences on depression risk, but most research in this area has focused on urban settings. Micropolitan areas (midsize rural communities centered around a population core of 10,000-50,000 people) are home to the majority of rural residents and this specific social and economic context may have unique influences on depression risk. Using a random-digit-dial sampling method, adult residents completed a phone interview that assessed a range of health behaviors and measures of quality of life, social support, neighborhood context, and discrimination (n = 1101). Results indicated that being male, having a partner, and being a high school graduate protected against moderate to severe depression, whereas inadequate social support, perceived unfair treatment, and lower neighborhood cohesion were associated with moderate to severe depression. Increases in poverty were significantly associated with greater odds of reporting moderate to severe depression. This study demonstrated that factors associated with depression are similar factors in rural and urban areas, however, the prevalence of these factors may differ along the rural-urban continuum, and should be considered when developing and implementing mental health prevention and control interventions.

Background: The significant role of lay caregivers has been explored in chronic and acute illnesses. In pregnancy, caregivers’ (eg, the baby’s father, friends, and family) roles in promoting the health of the mother and baby are not well understood. Objective: We characterize the activities and roles of pregnancy caregivers and offer opportunities for engaging this important group. Method: We conducted interviews with 29 pregnancy caregivers. Interview transcripts were analyzed inductively, resulting in a coding scheme of actions and roles that pregnancy caregivers perform. Results: The most common actions and roles included searching for information (97%), accompanying patients to medical appointments (69%), and being a source of emotional support (76%). Identified actions and roles fit a patient work framework, including work types identified by Corbin and Strauss: illness, everyday life, biographical, articulation, and invisible. Conclusion: The patient work framework can be employed to describe the activities and roles of pregnancy caregivers. We have contributed new insights into the experiences of pregnancy caregivers and recommendations for educational and technological interventions.