Veterinary Medicine In Other Countries and the Role of the American Veterinarian Abroad

What is it like to be a veterinarian in a foreign country? How does a veterinarian's role in society, his education and his working conditions change as one looks to different parts of the world? How are they similar? What position does an American veterinarian assume in a foreign country? Many of the professors in the College of Veterinary Medicine at Iowa State University have had professional experiences abroad. Interviews with nine such veterinarians formed the basis o this article and yielded answers to the above questions.</p

A Genome-Wide Association Study of Diabetic Kidney Disease in Subjects With Type 2 Diabetes

Identification of sequence variants robustly associated with predisposition to diabetic kidney disease (DKD) has the potential to provide insights into the pathophysiological mechanisms responsible. We conducted a genome-wide association study (GWAS) of DKD in type 2 diabetes (T2D) using eight complementary dichotomous and quantitative DKD phenotypes: the principal dichotomous analysis involved 5,717 T2D subjects, 3,345 with DKD. Promising association signals were evaluated in up to 26,827 subjects with T2D (12,710 with DKD). A combined (T1D+T2D) GWAS was performed using complementary data available for subjects with T1D, which, with replication samples, involved up to 40,340 diabetic subjects (and 18,582 DKD cases). Analysis of specific DKD phenotypes identified a novel signal near GABRR1 (rs9942471, p=4.5×10-8) associated with 'microalbuminuria' in European T2D cases. However, no replication of this signal was observed in Asian subjects with T2D, or in the equivalent T1D analysis. There was only limited support, in this substantially enlarged analysis, for association at previously-reported DKD signals, except for those at UMOD and PRKAG2, both associated with 'EGFR'. We conclude that, despite challenges in addressing phenotypic heterogeneity, access to increased sample sizes will continue to provide more robust inference regarding risk-variant discovery for DKD.</p

Veterinary Medicine In Other Countries and the Role of the American Veterinarian Abroad

What is it like to be a veterinarian in a foreign country? How does a veterinarian's role in society, his education and his working conditions change as one looks to different parts of the world? How are they similar? What position does an American veterinarian assume in a foreign country? Many of the professors in the College of Veterinary Medicine at Iowa State University have had professional experiences abroad. Interviews with nine such veterinarians formed the basis o this article and yielded answers to the above questions.</p

Validity and Reliability of the First Distal Metatarsal Articular Angle

A laboratory study was undertaken to quantify the validity, the intra- and interobserver reliability, and the effect of first metatarsal orientation on the distal metatarsal articular angle (DMAA). First metatarsals from six cadavers were isolated by sharp dissection and attached to a custom-made triplanar protractor. This allowed controlled positioning of the first metatarsal in the three cardinal planes. Each specimen was moved through a stepwise sequence of first metatarsal orientation changes. Radiographs were taken at each position. The distal (metatarsophalangeal) articular surface of the first metatarsal was then circumscribed with metallic paint and the radiographic series was repeated. DMAA measurements were made on each radiograph multiple times by two measurers blinded to the parameters of variation. The difference between the standard (clinical) radiographic technique for estimating the DMAA and the metallic paint DMAA averaged −0.9° (SD = 2.4°). Longitudinal rotation ( P &lt; .0001) and varus deviation (P &lt; .02 at 10°) of the first metatarsal had a significant effect on the radiographic determination of the DMAA. Although intraobserver reliability for DMAA measurement was high, interobserver reliability for the clinical technique of measurement was poor (pooled intraclass correlation coefficient = 0.14). </jats:p

Thoracolumbar Injury Classification and Severity Scale Can Help Identify Intra-Abdominal Injury in Children Injured in an MVC

Background: Motor vehicle crashes (MVC) cause variable injury to the thoracolumbar (TL) region of children secondary to rapid deceleration from seatbelts. This mechanism can also predispose a child to intraabdominal injury (IAI), which necessitates early diagnosis to limit morbidity and mortality. While the maximum extent of TL-spine injury can be appreciated shortly after presentation, the severity of IAI may not be appreciated until days later. It is hypothesized that a measure of TL-injury severity will identify patients at risk of concomitant IAI. Methods: Retrospective chart review identified 72 children with MVC-related TL-spine injuries from 2007-2020. Patients were grouped based on the presence of IAI and TL-spine injury (N=33) compared to isolated TL-spine injury (no IAI, N=39). TL-spine injury severity was classified according to the Thoracolumbar Injury Classification and Severity Scale (TLICS). Results: Demographics were similar in both groups. Children with concomitant IAI had primarily lumbar spine injuries, while injuries without associated IAI were more broadly distributed throughout the thoracolumbar spine. Children without concomitant IAI were more likely to sustain compression fractures (n=31, 79%), while children with IAI had more distraction injuries (n=24, 73%). TL injuries associated with IAI were significantly more severe than isolated TL injures (median TLICS=7 [range: 1-9] vs 1 [range: 1-10], p&lt;0.001). As hypothesized, increasing TLICS is associated with an increased risk of concomitant IAI, such that for every point increase in TLICS, the risk of IAI increases 49% (OR: 1.492, [95% CI 1.254-1.817], AROC 0.795) Conclusions: Given the close association between severe spine injury and IAI, this study illustrates the utility of TLICS score at presentation to establish a high index of suspicion for concomitant IAI. While other clinical signs may be suggestive of the presence of IAI, our study provides clinicians with a new datapoint, a severe spine injury as graded by TLICS (i.e., TLICS &gt;5), in their diagnostic toolbox to optimally manage pediatric patients after MVC.</jats:p