Successful Long-Term Treatment of Severe Hypertriglyceridemia by Feedback Control with Lipid Self-Monitoring.

Ann Nutr Metab. 2008 Jun 11;52(3):215-220

Authors: Hauenschild A, Ewald N, Schnell-Kretschmer H, Porsch-Oezcueruemez M, Kloer HU, Hardt PD

Background/Aims: Successful treatment of severe hypertriglyceridemia is difficult. Besides therapy with different drugs, dietary intervention is an important approach. However, compliance with dietary recommendations is usually bad. Lipid self-monitoring in patients might improve dietary compliance and control of lipid parameters. Methods: Thirty-two patients with severe hypertriglyceridemia (>750 mg/dl) were primarily treated with a formula diet reducing the triglyceride levels <600 mg/dl. After this acute treatment, self-monitoring of lipid parameters was performed for 48 weeks. Twenty-five patients completed the whole study. The participants measured their lipid parameters with Accutrend(R) GCT dry chemistry strips. Dietary records were taken and measurements of body composition, BMI, triglycerides, total cholesterol and glucose were performed. Results: Triglycerides remained stable in patients with levels <300 mg/dl at the beginning of the protocol. There was a significant decline in triglycerides in those who started with levels >300 mg/dl. No severe hypertriglyceridemia (>750 mg/dl) could be observed. The energy intake decreased in all patients due to a reduction in total fat and carbohydrate consumption. The relation between carbohydrates and protein remained unchanged. Self-measurement was well tolerated and an improvement in controlling the diet was reported. Conclusions: Self-control of lipid parameters can improve the dietary compliance of patients with hypertriglyceridemia and is well tolerated.

PMID: 18544976 [PubMed - as supplied by publisher]

Fighting antibiotic resistance in Sweden - past, present and future.

Wien Klin Wochenschr. 2008 May;120(9-10):268-279

Authors: Struwe J

Sweden has been in the favorable situation of having limited antibiotic resistance and low antibiotic consumption. When pneumococci with reduced susceptibility to penicillin and methicillin-resistant Staphylococcus aureus emerged during the 1990s, professionals and relevant authorities called for extensive action plans to avoid the critical threshold levels of resistance experienced in other countries. The purpose of this paper is to examine Swedish experiences in light of new and future challenges by reviewing Swedish data on antibiotic resistance and antibiotic use, notifications, outbreak control, action plans and scientific papers. The tradition of liberal performance of clinical cultures, together with well functioning diagnostic laboratories, has formed a basis for close collaboration and development of surveillance within quality assurement programs. For more than 20 years the pharmacy monopoly in Sweden has made it possible to collect well defined data on antibiotic sales at the county level with almost 100% coverage. Multisectorial collaboration was set up in regional Strama (Swedish Strategic Programme Against Antibiotic Resistance) groups. Large diagnosis-prescribing surveys have been undertaken, and the concept of basic hygiene precautions was introduced, together with extensive programs for early case finding. However, surveillance has been hampered by inadequate IT systems and some difficulties in collecting relevant data on antibiotic sales at the national level. Also, a decentralized system with 21 counties and regions has resulted in divergence of action plans and rules. The containment of antibiotic resistance thus far may be explained by the early response in human and veterinary medicine and close multisectorial collaboration, supported by the government, before problems got out of hand. Nevertheless, rapidly growing problems with bacteria that produce extended beta-lactamases have recently emerged and antibiotic sales have started to increase again. The outcome of ongoing revision of legislation and surveillance will have great impact on the future possibilities of limiting antibiotic resistance in Sweden.

PMID: 18545950 [PubMed - as supplied by publisher]

Two cases of surgically treated feline patellar fractures.

Vet Comp Orthop Traumatol. 2008;21(2):156-8

Authors: Guillaumot P, Scotti S, Carozzo C, Bouvy B, Genevois JP

A transverse patellar fracture in a six-month-old cat was successfully treated by figure-of-eight dorsal wiring of the patella. A longitudinal patellar fracture with luxation of a large medial fragment in a 2.5-year-old cat was treated by lateral marginal patellectomy with a positive outcome. While adding material to the few veterinary reports in that species, in this brief communication, the authors discuss the aetiology, diagnosis, and the treatment of the presented cases with regards to findings in previously published feline cases. 

Computed tomographic evaluation of the canine intercondylar notch in normal and cruciate deficient stifles.

Vet Comp Orthop Traumatol. 2008;21(2):119-24

Authors: Lewis BA, Allen DA, Henrikson TD, Lehenbauer TW

In the human and veterinary orthopaedic literature it has been implied that intercondylar notch stenosis is a mechanical factor in cranial cruciate ligament rupture and intraarticular graft failure. The patients in this study were classified as normal (32), unilateral cruciate rupture (23), or bilateral cruciate rupture (17). The dogs were placed under general anaesthesia and both stifles were scanned via computed tomography (CT) as previously described. Three CT slices at predetermined levels were evaluated within the notch. Measurements included opening notch angle, notch width and height, condyle width, and notch width index (notch width/condyle width) at two different heights within the notch. Intercondylar notch measurements at the most cranial extent were significantly more narrow in unilateral and bilaterally affected stifles when compared to the normal population. Significant differences were noted in the opening notch angle (ONA), notch width index (NWI), NWI at two thirds notch height (NWI2/3), and tibial slope index (TSI). No significant differences were noted between unilateral and bilateral affected stifles. Increased mechanical contact of the cranial cruciate ligament with a stenotic intercondylar notch may predispose the ligament to mechanical wear and structural weakening. Intercondylar notch measurements have been used as a tool to predict the risk of anterior cruciate ligament injury in young human athletes, and to assess the risk factors for intra-articular graft replacements. Our findings may be useful in developing similar predictive models using stifle CT scans.