Variability in non-core vaccination rates of dogs and cats in veterinary clinics across the United States

Vaccination guidelines for dogs and cats indicate that core vaccines (for dogs, rabies, distemper, adenovirus, parvovirus; for cats, feline parvovirus, herpes virus-1, calicivirus) are essential to maintain health, and that non-core vaccines be administered according to a clinician’s assessment of a pet’s risk of exposure and susceptibility to infection. A reliance on individual risk assessment introduces the potential for between-practice inconsistencies in non-core vaccine recommendations. A study was initiated to determine non-core vaccination rates of dogs (Leptospira, Borrelia burgdorferi, Bordetella bronchiseptica, canine influenza virus) and cats (feline leukemia virus) in patients current for core vaccines in veterinary practices across the United States. Transactional data for 5,531,866 dogs (1,670 practices) and 1,914,373 cats (1,661 practices) were retrieved from practice management systems for the period November 1, 2016 through January 1, 2020, deidentified and normalized. Non-core vaccination status was evaluated in 2,798,875 dogs and 788,772 cats that were core-vaccine current. Nationally, median clinic vaccination rates for dogs were highest for leptospirosis (70.5%) and B. bronchiseptica (68.7%), and much lower for canine influenza (4.8%). In Lyme-endemic states, the median clinic borreliosis vaccination rate was 51.8%. Feline leukemia median clinic vaccination rates were low for adult cats (34.6%) and for kittens and 1-year old cats (36.8%). Individual clinic vaccination rates ranged from 0 to 100% for leptospirosis, B. bronchiseptica and feline leukemia, 0–96% for canine influenza, and 0–94% for borreliosis. Wide variation in non-core vaccination rates between clinics in similar geographies indicates that factors other than disease risk are driving the use of non-core vaccines in pet dogs and cats, highlighting a need for veterinary practices to address gaps in patient protection. Failure to implement effective non-core vaccination strategies leaves susceptible dogs and cats unprotected against vaccine-preventable diseases.     

活血化瘀方联合针灸治疗对脑梗后遗症患者脑血管血液流变动力学及神经功能的影响

目的:探讨血化瘀方联合针灸治疗对脑梗后遗症患者脑血管血液流变动力学及神经功能的影响。方法:选取2016年1月至2017年1月沈阳市第二中医医院收治脑梗后遗症患者120例作为研究对象,对照组61例患者接受针灸治疗;观察组59例患者接受活血化瘀方联合针灸治疗。2组连续治疗30 d。比较2组患者脑血流流变学指标、神经功能评分、中医证候积分、临床疗效。结果:治疗前2组患者脑部平均血流速度、左侧椎动脉血流量、右侧椎动脉血流量、基底动脉血流量比较,差异无统计学意义(P 0. 05)。治疗后观察组患者脑部平均血流速度、左侧椎动脉血流量、右侧椎动脉血流量、基底动脉血流量大于对照组(P 0. 05)。治疗前2组患者NIHSS评分、MMSE评分比较,差异无统计学意义(P 0. 05)。治疗后观察组患者NIHSS评分显著低于对照组,MMSE评分高于对照组(P 0. 05)。治疗前2组患者头晕目眩、语言謇涩、半身不遂、患侧麻木、舌苔白腻证候评分比较,差异无统计学意义(P 0. 05)。治疗后研究患者头晕目眩、语言謇涩、半身不遂、患侧麻木、舌苔白腻证候评分显著低于对照组(P 0. 05)。2组患者临床疗效比较,差异有统计学意义(Z=-5. 626,P=0. 000)。结论:活血化瘀方联合针灸能改善脑梗后遗症患者脑血管血液流变动力学指标,保护神经功能。     

Hypofractionated radiation therapy for invasive breast cancer: From moderate to extreme protocols

Adjuvant irradiation is the standard treatment after breast conservative surgery. Normofractionated regimen with an overall treatment time of 5 to 6 weeks is often considered as a limiting factor for irradiation compliance. In order to answer this issue, moderate and more recently extreme hypofractionated protocols appeared. We report here oncological outcomes and toxicity of hypofractionated breast irradiation. After defining the frame of moderate and extreme hypofractionated breast irradiations based on overall treatment time, patient selection criteria were listed. According to their levels of proof, the results of moderate and extreme hypofractionated breast irradiation were analysed. Overall treatment time for moderate hypofractionated breast irradiation ranged from 3 to 4 weeks, while for extreme hypofractionated breast irradiation, it was less than 1 week. For moderate hypofractionated breast irradiation, whole breast irradiation was currently performed with or without lymph node irradiation. Moderate hypofractionated breast irradiation has proven to be as safe and as efficient as normofractionated breast irradiation with level IA evidence. For extreme hypofractionated breast irradiation, phase III randomized trials confirmed that accelerated partial breast irradiation was non-inferior in terms of local control compared to normofractionated whole breast irradiation (with external beam radiation therapy and multicatheter brachytherapy), with similar acute and late toxicity. While the use of intraoperative breast irradiation remains under debate, new very accelerated partial breast irradiation (overall treatment time not exceeding 2 days) protocols emerged with encouraging results. Accelerated partial breast irradiation is warranted for extreme hypofractionated breast irradiation and is indicated for low-risk breast cancers. Moderate and extreme hypofractionated breast irradiation regimens are validated and can be routinely proposed according to patient selection criteria.     

中西医结合治疗对单纯疱疹病毒性角膜炎患者视力恢复及血清微量元素的影响

目的:探讨中西医结合治疗对单纯疱疹病毒性角膜炎(HSK)患者视力恢复及血清微量元素的影响。方法:选取2015年1月至2016年10月内蒙古包钢医院收治的HSK患者86例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组43例。对照组采用更昔洛韦滴眼液及硫酸软骨素滴眼液治疗,观察组在对照组基础上结合清肝明目汤进行治疗,2组均连续治疗4周。比较2组患者临床疗效;比较治疗前后2组患者视力恢复状况、血清微量元素及泪液免疫因子水平。结果:治疗后,观察组治疗有效率显著高于对照组,差异有统计学意义(P0.05);治疗后观察组患者视觉模拟评分及视力均显著高于治疗前与对照组,差异有统计学意义(P0.05);治疗后观察组铁离子、钙离子及铜离子水平低于治疗前与对照组,差异有统计学意义(P0.05);血清锌离子水平明显高于治疗前与对照组(P0.05),差异有统计学意义(P0.05);治疗后观察组患者泪液IgA、IgG及C3水平明显高于治疗前与对照组,差异有统计学意义(P0.05)。结论:中西医结合治疗HSK有效促进患者视力的恢复,调节血清微量元素的同时增强患者泪液免疫因子水平,疗效显著优于单用西药治疗。     

理筋通督手法治疗颈性眩晕临床研究

目的:观察理筋通督手法治疗颈性眩晕的临床疗效。方法:将120例颈性眩晕患者随机分成3组,理筋通督组、传统手法组及安慰剂组。理筋通督组采用理筋通督手法;传统手法组采用传统手法;安慰剂组口服维生素C。结果:理筋通督手法可显著减缓患者基底动脉舒张期最低血流速度(P0.05)。理筋通督组有效率为93.67%,传统手法组有效率为67.5%,安慰剂组有效率为17.5%,3组比较差异有统计学意义(P0.05),理筋通督组明显优于其他两组。结论:理筋通督手法治疗颈性眩晕临床疗效显著。