Meteorological influence on the occurrence of gastric dilatation-volvulus in military working dogs in Texas

Gastric dilatation-volvulus (GDV) is a life-threatening condition in dogs and other species in which the stomach dilates and rotates on itself. The etiology of the disease is multi-factorial, but explicit precipitating causes are unknown. This study sought to determine if there was a significant association between changes in hourly-measured temperature and/or atmospheric pressure and the occurrence of GDV in the population of high-risk working dogs in Texas. The odds of a day being a GDV day, given certain temperature and atmospheric pressure conditions for that day or the day before, was estimated using logistic regression models. There were 57 days in which GDV(s) occurred, representing 2.60% of the days in the 6-year study period. The months of November, December, and January collectively accounted for almost half (47%) of all cases. Disease risk was negatively associated with daily maximum temperature. An increased risk of GDV was weakly associated with the occurrence of large hourly drops in temperature that day and of higher minimum barometric pressure that day and the day before GDV occurrence, but extreme changes were not predictive of the disease.     

Acute gastric dilatation and volvulus in a free-living polar bear

A large, adult male polar bear (Ursus maritimus) was found dead on a barrier island north of Prudhoe Bay, Alaska (USA), in June 1987. There were no external signs of trauma. A twisted distended stomach, distinctive parenchymal and fascial congestion, and significant difficulty in repositioning the anterior abdominal organs, indicated that gastric dilatation-volvulus (GDV) was the proximate cause of death. Polar bears frequently consume large quantities of food at one time and have large stomachs that are well adapted to periodic gorging. The scarcity of food in winter and early spring, combined with voluntary fasting and protracted vigorous activity during the breeding season in late spring may have predisposed this bear to GDV. The relationship between GDV and postprandial exercise emphasizes the need for a better understanding of how the present human invasion of arctic habitats may influence polar bear activities.     

Outcome analysis of 4 years' follow-up of patients referred for colposcopy with one smear showing mild dyskaryosis

Objective: To assess the 4‐year outcome of patients after one smear showing mild dyskaryosis with respect to smear regression rate, prevalence of cervical intraepithelial neoplasia (CIN) and the effect of age. Methods: Retrospective analysis of patients diagnosed with initial mildly dyskaryotic smear during the year 2000 with a follow‐up period of 48 months. These women had not had any previous abnormal smears. Settings: Cytopathology Department and Colposcopy Unit, King’s College Hospital, London, UK. Results: We identified 524 patients of whom 375 patients with complete follow‐up data are included. The age range was 19–67 years with a median of 29 years. There were 207 patients aged 35 years or less (55%). At 6 months, 258 smears were performed and 47.8% of them were negative (95% CI: 41.6–54.0%). The total number of negative follow‐up smears in the first year was 198 out of a total of 397 smears performed (50%). This proportion has significantly increased between 1 and 4 years’ follow‐up to 67.5% (RR: 1.24; 95% CI: 1.14–1.35). Over the 4‐year period, 791 smears were performed and 477 were negative (60.3%; 95% CI: 56.9–63.7%). Of the 477 negative smears there were only 61 smears (12.8%; 95% CI: 10–16%), in 54 patients (14%; 95% CI: 11–18%) that reverted back to low‐grade cytological abnormality. In only one case the repeat smear showed high‐grade abnormality after initial negative follow‐up; however, on biopsy, histology showed CIN I. Out of the 375 patients, 70 required treatment with excisional biopsy (19%; 95% CI: 15.0–22.9%). Histology confirmed high‐grade CIN in only 41 cases giving a prevalence of 11% (95% CI: 8.1–14.5%). There were no cases of microinvasive or invasive cancer detected. Age (≤35 years versus >35 years) did not significantly affect either cytological or histological outcome. Conclusion: Sixty per cent of follow‐up smears after initial mild dyskaryosis subsequently became negative; of them 87.2% remained negative over the 4 year follow‐up. Treatment was only required in 19% of patients, with 11% prevalence of high‐grade CIN. Age did not affect the outcome. These results are reassuring and indicate that colposcopic referral may not be necessary after only one mildly dyskaryotic smear.     

Results of long-term biguanide therapy as a preventive measure in protodiabetes]

55 patients with pathological glucose tolerance received a long term treatment with buformin (200 mg daily). In 43 of the protodiabetics the duration of treatment was one year, in 29 of them two years and in 11 three years. The age of the patients was 38 years and the mean relative body weight was 118 per cent. The effect of buformin on glucose tolerance and insulin secretion was tested with the glucose infusion test before and after the periods of treatment. After one year we found in 58 per cent, after two years in 69 per cent and after three years in 64 per cent of the protodiabetics an improvement of glucose tolerance. In these groups the results showed a rise of the IRI in the low responder and a decrease of the IRI in the high responder. The good effects on glucose tolerance were not demonstrable in the compared groups with long-term treatment of diet only.     

Subtotal gastric resection; an appraisal of a means of treatment of benign peptic ulceration of the stomach and duodenum

In a series of 400 cases of subtotal gastric resection for the treatment of benign ulceration of the stomach and duodenum, the mortality, morbidity and recurrence rate was acceptably low. Fifty-six per cent of the patients had a perfect result, 38 per cent satisfactory, and 6 per cent unsatisfactory. However, the postoperative nutritional status was sufficiently interfered with in a number of patients whose preoperative weight was subnormal that the routine adoption of 75 per cent gastric resection must be questioned. Vagotomy with either pyloroplasty or partial resection may prove to be the most valuable procedure for patients of this type. In properly selected patients, however, gastric resection is a rewarding procedure for both patient and surgeon.     

Mortality rates in patients with burns; a report of experience at San Francisco City and County Hospital, 1943-1956

A review was made of the cases of 93 patients with burns covering more than 20 per cent of the body surface who were treated at the San Francisco City and County Hospital, University of California Service, between 1943 and 1956. The mortality rate increased from 40 per cent during 1943-1947 to 69 per cent during 1952-1956. A significant change in survival time was noted: During 1943-1947, 69 per cent of the deaths occurred within 48 hours of admission; during 1952-1956, only 19 per cent of the deaths occurred within the first 48 hours. In the period 1943-1947 the majority of deaths resulted from shock in the immediate post-burn period; in the later years of the study the major cause of death was infection. No patient more than 50 years of age who had burns of more than 25 per cent of the body surface survived. Only one patient with burns involving more than 45 per cent survived. No patient who had a blood culture positive for bacteria survived. The use of antibiotics had no effect on the incidence of infection. Elderly patients, children and alcoholics were less able to resist the effects of infection. The lowest mortality rate was in the age group of 15 through 35 years.     

Exploring mechanisms of sex differences in longevity: lifetime ovary exposure and exceptional longevity in dogs

To move closer to understanding the mechanistic underpinnings of sex differences in human longevity, we studied pet dogs to determine whether lifetime duration of ovary exposure was associated with exceptional longevity. This hypothesis was tested by collecting and analyzing lifetime medical histories, age at death, and cause of death for a cohort of canine ‘centenarians’– exceptionally long‐lived Rottweiler dogs that lived more than 30% longer than average life expectancy for the breed. Sex and lifetime ovary exposure in the oldest‐old Rottweilers (age at death, ≥ 13 years) were compared to a cohort of Rottweilers that had usual longevity (age at death, 8.0–10.8 years). Like women, female dogs were more likely than males to achieve exceptional longevity (OR, 95% CI = 2.0, 1.2–3.3; P = 0.006). However, removal of ovaries during the first 4 years of life erased the female survival advantage. In females, a strong positive association between ovaries and longevity persisted in multivariate analysis that considered other factors, such as height, body weight, and mother with exceptional longevity. A beneficial effect of ovaries on longevity in females could not be attributed to resistance against a particular disease or major cause of death. Our results document in dogs a female sex advantage for achieving exceptional longevity and show that lifetime ovary exposure, a factor not previously evaluated in women, is associated with exceptional longevity. This work introduces a conceptual framework for designing additional studies in pet dogs to define the ovary‐sensitive biological processes that promote healthy human longevity.     

SUBTOTAL GASTRIC RESECTION—An Appraisal of a Means of Treatment of Benign Peptic Ulceration of the Stomach and Duodenum

In a series of 400 cases of subtotal gastric resection for the treatment of benign ulceration of the stomach and duodenum, the mortality, morbidity and recurrence rate was acceptably low. Fifty-six per cent of the patients had a perfect result, 38 per cent satisfactory, and 6 per cent unsatisfactory. However, the postoperative nutritional status was sufficiently interfered with in a number of patients whose preoperative weight was subnormal that the routine adoption of 75 per cent gastric resection must be questioned. Vagotomy with either pyloroplasty or partial resection may prove to be the most valuable procedure for patients of this type. In properly selected patients, however, gastric resection is a rewarding procedure for both patient and surgeon.     

Mortality in over 350,000 Insured Swedish dogs from 1995–2000: I. Breed-, Gender-, Age- and Cause-specific Rates

This study presents data on over 350,000 insured Swedish dogs up to 10 years of age contributing to over one million dog-years at risk (DYAR) during 1995–2000. A total of 43,172 dogs died or were euthanised and of these 72% had a claim with a diagnosis for the cause of death. The overall total mortality was 393 deaths per 10,000 DYAR. Mortality rates are calculated for the 10 most common breeds, 10 breeds with high mortality and a group including all other breeds, crudely and for general causes of death. Proportional mortality is presented for several classifications. Five general causes accounted for 62% of the deaths with a diagnosis (i.e. tumour (18%), trauma (17%), locomotor (13%), heart (8%) and neurological (6%)). Mortality rates for the five most common diagnoses within the general causes of death are presented. These detailed statistics on mortality can be used in breed-specific strategies as well as for general health promotion programs. Further details on survival and relative risk by breed and age are presented in the companion paper [14].     

MENTAL DISORDERS OF THE AGED—The Role of the State Hospital in the Treatment; Report of a Pilot Study

The number of patients age 65 and over at the Agnews State Hospital now constitutes over one-third of the resident population. The geriatric population is increasing in all California state hospitals.Because this is a relatively new area of concern for the psychiatric institution, the role of the state hospital in the care of the aged is not yet clearly defined.A pilot study of admissions in this age group committed from one county during a 12-month period was undertaken, with an attempt made to evaluate the suitability of the patient for commitment, as well as special problems in admission, treatment during hospitalization, and release from the hospital. The study indicated 42 per cent of persons admitted were considered unsuitable for commitment. Physical illness was found to be a major factor in precipitating admission and a predominating factor in the treatment program after admission. Almost 40 per cent of the patients died within a year after admission.     

MORTALITY RATES IN PATIENTS WITH BURNS—A Report of Experience at San Francisco City and County Hospital, 1943-1956

A review was made of the cases of 93 patients with burns covering more than 20 per cent of the body surface who were treated at the San Francisco City and County Hospital, University of California Service, between 1943 and 1956.The mortality rate increased from 40 per cent during 1943-1947 to 69 per cent during 1952-1956. A significant change in survival time was noted: During 1943-1947, 69 per cent of the deaths occurred within 48 hours of admission; during 1952-1956, only 19 per cent of the deaths occurred within the first 48 hours. In the period 1943-1947 the majority of deaths resulted from shock in the immediate post-burn period; in the later years of the study the major cause of death was infection.No patient more than 50 years of age who had burns of more than 25 per cent of the body surface survived. Only one patient with burns involving more than 45 per cent survived.No patient who had a blood culture positive for bacteria survived. The use of antibiotics had no effect on the incidence of infection. Elderly patients, children and alcoholics were less able to resist the effects of infection.The lowest mortality rate was in the age group of 15 through 35 years.     

Radiation Therapy in the Treatment of Carcinoma of the Lung

In Ontario in the past 25 years, the death rate from cancer of the lung has shown a substantial increase, ninefold for males and twofold for females. The male:female ratio varied from an average of 8.5:1 to as high as 11.7:1 at the ages 65 to 69. From 1938 to 1958, one-quarter of the total cases (2457) were treated in Ontario Cancer Clinics. Survival rates were: for one year, 20%; three years, 6.5%, and for five years, 3.8%. Fifty-four per cent of surgically treated patients and 63% treated by resection and radiotherapy were alive one year after treatment. Of 821 cases treated with orthovoltage the one-year survival rate was 14%, and of 862 cases treated with cobalt therapy, 23%. It was concluded that this improvement in results may be attributed to the difference in treatment.     

Myasthenia Gravis: Comparative Evaluation of Medical and Surgical Treatment

Sixty-eight patients with myasthenia gravis were evaluated and compared to determine the results of medical and surgical treatment; eight patients with thymoma were evaluated separately. In the group of 30 non-thymoma patients treated medically 50% of patients derived moderate to good improvement over a mean follow-up period of 11 years. Ten per cent of patients in this group died from myasthenia.In the group of 30 non-thymoma patients treated by thymectomy, 83% achieved good to excellent improvement. There was no surgical or myasthenic mortality over a mean follow-up period of nine years.The results of treatment in the eight thymoma patients were decidedly inferior and there was no significant difference between the medically and surgically treated patients. Fifty per cent showed only moderate improvement during a mean follow-up of five years and 50%, after initial improvement, deteriorated later and died from myasthenia between three and four years after thymectomy.Two additional patients had thymoma without myasthenia. Neither of them had developed myasthenia, two years following thymectomy in one case and after 25 years in the other, despite recurrence of the tumour with extensive invasiveness in the very long-standing case.     

High mortality by natural and unnatural causes: a 10 year follow up study of patients admitted to a poisoning treatment centre after suicide attempts.

OBJECTIVE--To describe mortality by suicide and other causes of death in a group of patients who attempted suicide, and to identify predictive factors. DESIGN--10 year follow up study based on records of suicide attempters in 1980. SETTING--Poisoning treatment centre at a general hospital. SUBJECTS--974 patients aged 15 and over referred to the poisoning treatment centre after deliberate self poisoning. MAIN OUTCOME MEASURES--Death by different causes registered in the Danish death cause register. RESULTS--In 10 years of follow up 306 patients died: 103 by suicide, 131 from natural causes, and 31 by accident; five were murdered, and in 36 cases the cause of death was uncertain. The standard mortality ratio was 550. Cause specific standardised mortality rates were 2960 for suicide, 236 for natural causes, 1256 for accidents, and 5459 for uncertain causes. In a Cox regression analysis, high risk factors for subsequent suicide were: more than one previous suicide attempt (relative risk 2.25), living alone (2.28), and age (1.03 per year). Predictors of death by natural causes were receiving a pension (1.69), drug misuse (2.72), more than one previous suicide attempt (2.25), age (1.06 per year), and male sex (2.49). The group of patients fulfilling at least one high risk criterion for later suicide differed significantly from the rest of the patient group in incidence of suicide, but both sensitivity and specificity were low. CONCLUSIONS--Most patients who attempted suicide were at high risk of succeeding because the risk factors, though significant, are not very specific. A strategy to prevent suicide must be directed toward the majority of those who attempt suicide.     

Duration of Last Attack in 998 Fatal Cases of Coronary Artery Disease and its Relation to Possible Cardiac Resuscitation

All the deaths attributed to coronary artery disease and occurring in Belfast during one year were studied.The frequency distributions of the cases by interval of time between onset of the last attack and death are given for those not admitted to hospital, for those admitted to hospital, and for those already in hospital for some other cause of illness.Sixty per cent. of all the deaths occurred outside hospital. This indicates that the problem of cardiac resuscitation in coronary artery disease is to a considerable extent an extra-hospital one.Twenty-seven per cent. of the men and 22% of the women died within 15 minutes, but the median period of survival was 3 hours 30 minutes for men and 6 hours 18 minutes for women.The median time interval from the onset of the attack to sending for medical aid was 1 hour 17 minutes for men and 1 hour 6 minutes for women, and from summoning medical aid to sending for the ambulance 59 minutes for men and 1 hour 26 minutes for women. Ninety-six per cent. of the ambulance journeys to the patient were accomplished in less than 20 minutes.It was found among men, but not among women, that the duration of survival tended to be longer in older patients and in second or subsequent attacks.Of the 596 who did not gain admission to hospital 229 (23% of all the 998 patients) were known to have survived for more than half an hour after the onset of the fatal attack; 182 (18%) survived for more than one hour; and 143 (14%) survived for more than two hours. It is among these that there would appear to be special scope for the cardiac ambulance, providing that medical aid is sought and the ambulance is summoned without delay.     

Myocardial Infarction: A Five-Year Follow-up of Patients

Patients with acute myocardial infarction (2,020) admitted to coronary care units (CCU) in Utah were studied for five years. Of these, 1,641 (81.4 percent) survived to leave the hospital. The male to female ratio was 3.5:1. At four months, one year and yearly thereafter from the date of admission to CCU, patients were mailed follow-up questionnaires. Cause of death was obtained from autopsy reports and death certificates. Patients were grouped yearly by the number of cardiac symptoms reported. Of patients discharged whose cases were followed, 925 (61.9 percent) were alive after five years. Reinfarction was the major cause of death in the hospital; however, during follow-up only 36.8 percent of deaths were attributable to myocardial infarction. At follow-up after a year, fewer cardiac symptoms were reported by patients who survived to the fifth year of follow-up than by patients who did not. Women were older and showed a higher death rate during follow-up. Increasing age was found to be a determining factor in long-term mortality after acute myocardial infarction.     

Acute post-irradiation canine intestinal blood flow

Radiation-induced early transient incapacitation (ETI) is accompanied by severe systemic hypotension, during which arterial blood pressure often decreases to less than 50 per cent of normal. One haemodynamic compensatory mechanism is increased peripheral resistance due to vasoconstriction. This vasoconstriction in the small intestine of dogs is disproportionately increased during haemorrhagic or endotoxic shock, and intestinal ischaemia is frequent. In an attempt to elucidate mechanisms underlying radiation-induced ETI and the gastrointestinal radiation syndrome, canine intestinal submucosal blood flow was measured by the hydrogen polarographic technique, both before and after exposure to gamma radiation. Systemic blood pressures, blood gases and haematocrits were determined simultaneously. Data obtained from 12 sham-irradiated dogs and 12 irradiated dogs indicated that 90 Gy, whole-body, gamma radiation produced a 31 per cent decrease in systemic mean blood pressure beginning within 20 min post-irradiation and lasting for at least 90 min. However, the intestinal submucosal blood flow did not decrease as anticipated, but it exhibited an actual post-irradiation increase. This increase in post-irradiation intestinal submucosal blood flow began within 5 min after irradiation and lasted for at least 90 min. Post-irradiation haematocrits were 10.5 per cent higher than those obtained before irradiation and those obtained from sham-irradiated subjects. Histopathological examination of ileal mucosa revealed significant pathologic lesions in some irradiated animals within two hours after exposure.     

Effects of excess dietary phenylalanine on composition of cerebral lipids

Abstract— Concentrations in whole rat brains of lipids (total lipids, phospholipids, galactolipids, cholesterol, plasmalogens) and of proteolipid protein were not altered after feeding for 2 and 6 weeks of diets containing 5 per cent excess l -phenylalanine. After 2 weeks of diet with 7 per cent excess l -phenylalanine there was a slight reduction (5–10 per cent) in the concentrations in whole brain of cholesterol and galactolipids. No significant effects were noted in cerebral hemispheres after 3 weeks of diets with 7 per cent excess l -phenylalanine. In the 5 and 7 per cent supplemented groups of animals, the total amounts of the various lipids were initially reduced to levels which were within 10 per cent of those in diet-matched controls. The results for rats indicate that after 3 weeks of age only very moderate effects on accumulation of cerebral lipids can be produced by excess dietary l -phenylalanine fed at the most toxic levels of supplementation, while lower levels of dietary supplementation are without effect. The results suggest further that the more mature brain is resistant to alteration of deposition of myelin lipids by high levels of phenylalanine.     

Quantitative assessment of inhalation exposure to various transuranium radionuclide compounds by integral nonstochastic criteria

The comparison of the danger from inhalation of radionuclide transuranium compounds differently transferred within the body was made by the results of an examination of 169 mongrel dogs and 2000 Wistar rats. Effective and ineffective levels of the radionuclide inhaled were determined by integral nonstochastic criteria, that is, 50 per cent death rate, shortening and increase of the average life and reduction of body mass.