Ethnic disparities in clinical severity of coronavirus disease 2019 (COVID-19) upon admission

Background

Reports from all over the world have shown great ethnic disparities in COVID-19 morbidity and mortality. Recent European studies have found discrepancies between higher risk of admission and intensive care treatment among ethnic minorities but lower mortality rates compared to the ethnic majority. This study will elucidate the ethnic differences in disease severity upon admission as a possible factor in explaining these discrepancies.

Methods

A retrospective cohort study of 1442 patients admitted with COVID-19 at three hospitals in Copenhagen, Denmark, between 1st February 2020 and 31st May 2022. Clinical, demographic and ethnicity data were extracted from health care records and collected using REDCap. Severity upon admission (< 24 hours) was assessed as 1) oxygen need, 2) oxygen administration and 3) need for intensive care.

Results

Ethnicity was registered on 1341 patients (57,0% Danish, 34,8% non-Western). Over all, preliminary descriptive analyses show patients of non-Western origin had symptoms of COVID-19 for a longer period (8,0 vs 6,7 days, p < 0,0001) and had a higher oxygen need (7,0L vs 5,2L, p = 0,02) upon admission compared to patients of Danish origin. A higher percentage of patients of non-Western origin needed high flow oxygen administration upon admission (30,2% vs 22,9%, p = 0,006) and were transferred to the ICU within the first 24 hours (4,9% vs 2,2 %, p = 0,02) compared to patients of Danish origin. Further analysis will be done, including biochemistry and link to registers in order of obtaining more accurate info on country of birth and migration status. We will do logistic regression regarding ethnic differences in severity of COVID-19 upon admission adjusting for comorbidities, age, sex and BMI.

Conclusions

Preliminary data on disease severity of COVID-19 upon admission show some ethnic disparities. Language barriers, low health literacy or the fear of stigma might explain this. Further analyses are needed.

Key messages

• Preliminary data from this cohort study suggest that patients of non-Western origin had symptoms of COVID-19 for a longer period before being admitted compared to patients of Danish origin.

• Preliminary data on disease severity of COVID-19 upon admission show ethnic disparities with regard to oxygen need, oxygen administration and need for intensive care.

Association of late gadolinium enhancement in cardiac magnetic resonance with heart failure outcomes in patients with non-ischemic cardiomyopathy

Background

Late-gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR) has been found to be associated with increased mortality in patients with non-ischemic cardiomyopathy (NICM). The correlation between LGE and heart failure (HF) hospitalization, referral for heart transplant, and ejection fraction (EF) improvement have not been well established.

Purpose

This meta-analysis assessed the relationship between LGE in CMR with HF hospitalization, referral for heart transplant and EF improvement in patients with NICM.

Methods

We searched the databases for studies reporting the association between LGE in CMR for NICM and HF outcomes including Ovid MEDLINE, EMBASE, Web of Science, and Google Scholar for all studies. The search was not restricted to time or publication status. The minimal follow up duration is one year.

Results

A total of 216 studies resulted from the literature search. A total of 25 studies and 3,039 patients (1,265 with LGE vs 1,774 without LGE) were included; mean follow up is around 33 months (ranging between 13 to 71 months). Our analysis demonstrated that LGE in NICM was associated with increased risk of HF hospitalization (odds ratio 3.38, 95% confidence interval 2.27–5.04; P&lt;0.01), referral for transplant (odds ratio 5.08, 95% confidence interval 2.49–10.35; P&lt;0.01), and lower chance for EF improvement (odds ratio 0.16, 95% confidence interval 0.03–0.85; P 0.03). Heterogeneity is moderate: χ2=49.5, df=21 (P=0.001), I2=57%. (Figures 1 and 2)

Conclusions

Our results suggest that LGE is associated with increased risk of HF hospitalization and referral for heart transplant and lower chance for EF improvement in long-term follow up.

Funding Acknowledgement

Type of funding sources: None.

Effect of Ovariohysterectomy at the Time of Tumor Removal in Dogs with Mammary Carcinomas: A Randomized Controlled Trial

Background

Ovarian hormones play crucial roles in mammary carcinogenesis. However, whether ovarian ablation by ovariohysterectomy (OHE) improves the prognosis in dogs with mammary carcinomas is unclear.

Objectives

Determine if OHE at the time of mastectomy improves the prognosis in dogs with mammary carcinomas and evaluate if hormonal factors influence the effect of OHE.

Animals

Sixty intact dogs with mammary carcinomas.

Methods

Dogs were randomly assigned in a 1 : 1 ratio to undergo OHE (n = 31) or not (n = 29) at the time of tumor removal. Peri‐surgical serum estradiol (E2) and progesterone concentrations were measured, tumor diagnosis was confirmed histologically, and tumor estrogen and progesterone receptor status was immunohistochemically determined. The dogs were monitored for recurrence and metastases every 3‐4 months for at least 2 years. Uni‐ and multivariable survival analyses were performed with relapse and all‐cause death as endpoints in addition to univariable subgroup analyses.

Results

Overall, OHE did not significantly decrease hazard of relapse (hazard ratio [HR], 0.64; P = .18) or all‐cause death (HR, 0.87; P = .64) in univariable analyses. In multivariable analysis OHE did not significantly influence the hazard of relapse (HR, 0.54; P = .12), but an interaction effect was identified between ER status and E2 (P = .037). Subgroup analysis identified decreased hazard of relapse in the OHE group compared to the non‐OHE group in the subsets of dogs with increased E2 (HR, 0.22; P = .012) or grade 2 tumors (HR, 0.26; P = .02).

Conclusion

Dogs with grade 2, ER‐positive tumors, or with increased peri‐surgical serum E2 concentration represent a subset of dogs with mammary carcinomas likely to benefit from OHE.

Classification and grading of canine mammary tumors

Mammary neoplasms are the most common neoplasm in female dogs. Two histologic classification systems for canine mammary tumors and dysplasias have been published: the first in 1974 and a modification in 1999. This article provides a brief overview of the two histologic classification systems. Since the publication of the second system, several new histologic subtypes of canine mammary neoplasms have been described. These have been incorporated into the proposed new classification system. This article also compares the grading systems for canine mammary carcinomas and their use for prognosis, along with the histologic classification.

Immunohistochemical characterization of canine prostatic carcinoma and correlation with castration status and castration time

The purpose of this study was to characterize canine prostate cancer using immunohistochemical staining specific for acinar and urothelial/ductal tissue and correlate these results with the dogs' castration status/castration time. Seventy dogs with prostate cancer were included, 71% were castrated and 29% were intact. Compared with an age-matched control population, castrated dogs were at increased risk of prostate cancer, odds ratio 3.9. Immunohistochemical staining was performed on 58 cases. Forty-six of the 58 stained positive for cytokeratin 7 (CK 7) (ductal/urothelial origin) and one of the 58 stained positive for prostate-specific antigen. Dogs with CK 7-positive tumours were younger when castrated than dogs with CK 7-negative tumours, 2 versus 7 years (P = 0.03); dogs castrated at <or=2 years of age were more likely to be CK 7-positive (P = 0.009). These results show that most canine prostatic carcinomas are of ductal/urothelial, androgen-independent origin. This is consistent with the epidemiological findings, showing increased risk in castrated dogs. Canine prostate cancer may, therefore, not be a realistic model for the human disease.

Nasal and nasopharyngeal lymphoma in cats: 50 cases (1989-2005)

Lymphoma is the most common nasal cavity tumor in cats, yet few reports specifically address the anatomic, immunohistologic, and cytologic features of this neoplasm. Fifty cats were diagnosed with lymphoma at necropsy, via biopsy or by cytology alone. Ten cats displayed multiorgan involvement, and in 2 of these the involvement was limited to the cerebellum and frontal cortex, respectively. Of the tumors, 41 of 50 (82%) were classified as nasal lymphoma, 5 of 50 (10%) were classified as nasopharyngeal lymphoma, and 4 of 50 (8%) involved both nasal and nasopharyngeal tissue. Histologically, all were considered diffuse lymphoid neoplasms and no cats displayed features of follicular lymphoma. Of the 44 cases available for slide review by the pathologist, 40 of 44 (91%) were classified as immunoblastic lymphoma, 2 of 44 (5%) as diffuse large cell, and 1 as diffuse mixed; 1 was unclassified. Of the 45 cats for which immunohistochemical stains were available, 32 were uniformly positive for CD79a, 7 were uniformly CD3 positive, and 6 had a mixed population of CD79a and CD3 cells. Epithelioptropism was exhibited in 4 of 5 (80%) cats in which there was sufficient epithelium present for evaluation. Of those 4, 3 were B-cell and 1 was a granulated T-cell lymphoma. In the 21 cats which nasal cytology was performed, 15 were cytologically diagnosed with lymphoma; the diagnoses in the remaining five cats were inflammatory (n = 4), normal lymphoid tissue (n = 1), or nondiagnostic (n = 1). The most common biochemical abnormalities were panhyperproteinemia in 26/46 (57%) of cats and hypocholesterolemia in 11/46 (24%) of cats.

Can fixation instability improve text perception during eccentric fixation in patients with central scotomas?

BACKGROUND

Oculomotor behaviour was investigated in 14 patients with central scotomas from age related macular degeneration (AMD) or Stargardt's disease. A scanning laser ophthalmoscope (SLO) was used to project letters and words onto the retina and to assess fixation behaviour. Five patients reported while deciphering letters that they needed to "move their eye" to prevent the image from vanishing. The observation of the SLO fundus images revealed that the gradual disappearance of the stimulus did not result from a transient projection of the word in the lesion. This prompted the authors to investigate, in an experimental setting, whether purposeful changes in fixation position could improve the perception of an eccentrically fixated text stimulus.

METHODS

Twenty normal subjects were asked to alternate fixation, every three to four seconds, between two vertically aligned dots, spaced 10 degrees apart, and to report any changes in the perception of a laterally located letter, 1.5 degrees in height, 7 degrees apart and equidistant between the two fixation spots.

RESULTS

Nineteen subjects reported a transient refreshment of the letter image immediately after the realisation of a saccade. Improved perception lasted approximately a second. With persistent fixation, they noted a rapid fading effect that reduced letter recognition.

CONCLUSION

These observations suggest that ocular instability during eccentric viewing can have a functional advantage, probably related to counteracting Troxler's phenomenon. In addition to alternating between PRLs, it appears that saccades related to fixation instability might be valuable and improve text perception in individuals with a central scotoma and eccentric fixation. This possibility should be taken into consideration when conducting visual rehabilitation procedures.

Cutting edge: systemic inhibition of angiogenesis underlies resistance to tumors during acute toxoplasmosis

The ability of various infections to suppress neoplastic growth has been well documented. This phenomenon has been traditionally attributed to infection-induced concomitant, cell-mediated antitumor immunity. We found that infection with Toxoplasma gondii effectively blocked neoplastic growth of a nonimmunogenic B16.F10 melanoma. Moreover, this effect was independent of cytotoxic T or NK cells, production of NO by macrophages, or the function of the cytokines IL-12 and TNF-alpha. These findings suggested that antitumor cytotoxicity was not the primary mechanism of resistance. However, infection was accompanied by strong, systemic suppression of angiogenesis, both in a model system and inside the nascent tumor. This suppression resulted in severe hypoxia and avascular necrosis that are incompatible with progressive neoplastic growth. Our results identify the suppression of tumor neovascularization as a novel mechanism critical for infection-induced resistance to tumors.

Canine hemangiosarcoma treated with standard chemotherapy and minocycline

Standard treatments for canine hemangiosarcoma include surgery and chemotherapy with doxorubicin, but in spite of treatment most dogs with this disease die within 6 months of diagnosis. Tumor growth and metastasis are angiogenesis dependent. Antiangiogenic drugs such as minocycline may provide therapeutic benefits in cancer patients. The purpose of this prospective study was to evaluate the efficacy of chemotherapy with doxorubicin and minocycline, an antiangiogenic agent, in dogs with hemangiosarcoma. Eighteen dogs with histologically confirmed hemangiosarcoma of any stage were treated with doxorubicin, cyclophosphamide, and minocycline. Complete staging was performed before and during the treatment period to assess remission status and response to therapy. No statistically significant difference was found in survival between the dogs treated with chemotherapy and minocycline, and historical controls consisting of dogs that received chemotherapy alone. Postmortem examination revealed widespread metastasis, suggesting that minocycline is ineffective as a single antiangiogenic agent in canine hemangiosarcoma.

[Follow-up of patients suffering from age-related macular degeneration, supplied with visual aids]

BACKGROUND

Age-related macular degeneration (AMD) is at present the major cause of legal blindness in industrialized countries. The results of various treatments are often not satisfactory and follow-up by Low-Vision services is then the only solution for this population. Few studies have been published on this subject. The purpose of this study is to present the use of magnifying systems and the degree of satisfaction obtained for this series of patients 6 months after prescription.

PATIENTS AND METHODS

Forty-four patients were examined, 42 of whom were eligible for the study. Lenses, magnifying glasses, visual systems for intermediate distance, and electronic systems were proposed. A low-vision training was given to every patient.

RESULTS

The highest degree of use and satisfaction was achieved with the electronic systems. In some cases, however, the other systems were well accepted by the patients.

CONCLUSION

The follow-up of patients with age-related macular degeneration is of great social importance. The independence of elderly people can be safeguarded thanks to the help of Low-Vision services with a good equipment and a well-trained team. Sometimes, unsophisticated systems such as magnifying glasses can be proposed, but the best results are mostly obtained through electronic systems (TV).

Caudal vena cava obstruction and ascites in a cat treated by balloon dilation and endovascular stent placement

OBJECTIVE

To present details of an unusual case of caudal vena caval obstruction and its management in a cat.

STUDY DESIGN

Clinical case report.

STUDY POPULATION

A 15 month old male castrated domestic shorthaired cat.

RESULTS

The diagnostic evaluation included the use of digital subtraction angiography and ultrasonography to locate the caudal vena caval obstruction. Treatment initially involved puncture and balloon dilation of the obstructed area of the cava. After reobstruction, the stenotic area was redilated and stented. The cat was euthanatized 4 weeks later because of vomiting, anorexia, and abnormal behavior, presumed to be associated with liver disease.

CONCLUSION AND CLINICAL RELEVANCE

Interventional radiography provided a minimally invasive way to manage this unusual vascular anomaly.

Single-implant segmental osteotomy: a case report

This case report describes the use of a single-implant osteotomy in repositioning a significantly malaligned, osseointegrated endosseous implant. This technique represents a modification of the single-tooth osteotomy that has been used for many years to reposition the natural dental unit. It provides the dental practitioner with a treatment alternative that is safe, cost-effective, and predictable. The goals of the procedure, the surgical technique employed, and the clinical result are presented.

Environmental causes for sinonasal cancers in pet dogs, and their usefulness as sentinels of indoor cancer risk

A case-control study was conducted to investigate the environmental causes of sinonasal cancers among pet dogs. Sinonasal cancer (SNC) cases and digestive cancer controls from the years 1989 through 1993 were obtained from a veterinary histopathology database. Owners were mailed a self-administered survey requesting information on canine factors, owner demographics, household exposures (including environmental tobacco smoke), and local pollution. A total of 129 case owners and 176 control owners returned completed surveys: a response rate of approximately 72%. Only household exposures were associated with increased SNC risk. Use of indoor coal or kerosene heaters represented the strongest risk factors, with significant adjusted odds ratios of 4.2 and 2.2 respectively. Environmental tobacco smoke exposure was not a risk factor and was suggestive of a nonsignificant, mildly protective effect at the lower exposure levels. Increasing nasal length was a significant risk factor, and there was effect modification between nasal length and coal or kerosene combustion. No self-reported measures of local pollution, such as urban status or residence within 1 mile of a factory, were associated with SNC risk. These results suggest that canine SNC has a strong environmental component and highlight the importance of indoor exposures, especially from fossil fuel combustion products. These results also suggest that pet dogs represent excellent sentinels for indoor cancer risk and that canine SNC cases can be used as early markers of household exposure to carcinogenic combustion products.

In vivo inflammatory response to a prototypic B cell superantigen: elicitation of an Arthus reaction by staphylococcal protein A

Staphylococcal protein A (SpA) is representative of a new class of Ags, the B cell superantigens (SAgs). These SAgs, unlike conventional Ags, bind to the Fab regions of Ig molecules outside their complementarity-determining regions. In addition, B cell SAgs can react with a substantial amount of a host's serum Igs by virtue of their ability to interact with many members of an entire variable heavy chain (VH) or variable light chain gene family. For example, SpA reacts with the Fabs of most human Igs using heavy chains from the VH3 gene family (VH3+). Members of this gene family are expressed on 30 to 60% of human peripheral B cells. We sought to determine whether the interaction of a B cell SAg with its reactive Igs can elicit immune complex-mediated tissue injury. Using the Arthus reaction in rabbits as an in vivo model of immune complex-mediated tissue inflammation, we demonstrated that untreated rabbits, which were administered SpA intradermally (i.d.), do not develop a cutaneous inflammatory response. However, when rabbits were pretreated i.v. with human IgG (hIgG), i.d. injections of SpA induced an inflammatory response with the classical histologic features of an Arthus reaction. To determine whether this Arthus-like response occurred via a B cell superantigenic mechanism, the rabbits were pretreated with VH3-depleted hIgG and then were administered SpA i.d. We found that the induction of a prominent inflammatory response by SpA was dependent upon the presence of VH3+ molecules in the hIgG pretreatment. These results provide compelling evidence that an interaction of the B cell SAg, SpA, with its reactive (VH3+) IgGs leads to an immune complex-mediated inflammatory response in vivo.

[Management of children with low vision]

Presentation of the Lausanne school for blind and visually impaired children. 38 children were admitted in the school in 1996-1997. 16 have a visual acuity of less than 3/60. Ocular malformations of various origins are the main reason of the handicap, followed by visual lesions of central origin. Comparing the study with those of 1992 and 1993, it seems that the number of retrolental fibroplasia and cataracts (operated or not) is decreasing. The authors present the educational care of these children. At present, the goal is to maintain the children in their own family. Most of them are day pupils and the transportation organisation is therefore very important. In special cases, it is possible to leave the children in a non-specialized school, provided the children receive a good educational support by one of our specialized low-vision teachers.

Mice lacking the TNF receptor p55 fail to resolve lesions caused by infection with Leishmania major, but control parasite replication

TNF is involved in host resistance to several pathogens. Recently it was found that mice lacking the p55 receptor for TNF (TNFRp55 -/-) do not control growth of the intracellular bacteria, Listeria monocytogenes and Mycobacterium tuberculosis. Here we report that the course of infection in TNFRp55 -/- mice with another intracellular pathogen, the protozoan parasite Leishmania major, is also quite different from normal mice. TNFRp55 -/- mice developed larger lesions than control mice and failed to resolve these lesions. However, they were able to eliminate parasites within the lesions. Histologic analysis indicated that at late stages lesions from TNFRp55 -/- mice appeared similar to lesions associated with cutaneous graft-vs-host disease. Both TNFRp55 -/- and control mice developed a normal Th1-type response during infection. We also found that IFN-gamma-activated macrophages from TNFRp55 -/- mice produced nitric oxide and killed L. major in vitro, which correlated with the ability of TNFRp55 -/- mice to eliminate the parasites in vivo. The production of nitric oxide by macrophages from TNFRp55 -/- mice required the presence of the parasites, however, since in their absence TNF could only synergize with IFN-gamma for nitric oxide production when added to normal, but not TNFRp55 -/-, macrophages. These results indicate that neither macrophage microbicidal activity nor nitric oxide production is absolutely dependent on the p55 receptor for TNF. Furthermore, they uncover a previously undefined role for TNFRp55 in resolution of parasite-induced inflammatory lesions.

Mice lacking the TNF receptor p55 fail to resolve lesions caused by infection with Leishmania major, but control parasite replication

TNF is involved in host resistance to several pathogens. Recently it was found that mice lacking the p55 receptor for TNF (TNFRp55 -/-) do not control growth of the intracellular bacteria, Listeria monocytogenes and Mycobacterium tuberculosis. Here we report that the course of infection in TNFRp55 -/- mice with another intracellular pathogen, the protozoan parasite Leishmania major, is also quite different from normal mice. TNFRp55 -/- mice developed larger lesions than control mice and failed to resolve these lesions. However, they were able to eliminate parasites within the lesions. Histologic analysis indicated that at late stages lesions from TNFRp55 -/- mice appeared similar to lesions associated with cutaneous graft-vs-host disease. Both TNFRp55 -/- and control mice developed a normal Th1-type response during infection. We also found that IFN-gamma-activated macrophages from TNFRp55 -/- mice produced nitric oxide and killed L. major in vitro, which correlated with the ability of TNFRp55 -/- mice to eliminate the parasites in vivo. The production of nitric oxide by macrophages from TNFRp55 -/- mice required the presence of the parasites, however, since in their absence TNF could only synergize with IFN-gamma for nitric oxide production when added to normal, but not TNFRp55 -/-, macrophages. These results indicate that neither macrophage microbicidal activity nor nitric oxide production is absolutely dependent on the p55 receptor for TNF. Furthermore, they uncover a previously undefined role for TNFRp55 in resolution of parasite-induced inflammatory lesions.

Nicorandil: a potassium channel opening drug for treatment of ischemic heart disease

Nicorandil is the first oral potassium channel activating drug to be used for the treatment of symptomatic coronary artery disease. It appears to relax vascular smooth muscle through membrane hyperpolarization via increased transmembrane potassium conductance and, like nitrates, through an increase in intracellular cyclic GMP. In addition, nicorandil, in a nitrate-like manner, dilates normal and stenotic coronary arteries and reduces both ventricular preload and afterload. In contrast to nitrates, however, nicorandil does not appear to cause tolerance with long-term administration. In placebo and comparison clinical trials, nicorandil has demonstrated some efficacy and safety in patients with both stable and vasospastic angina pectoris, and it was found to be a myocardial protective agent in animal studies. The antianginal activity of nicorandil, however, is relatively short lived after dosing, which will necessitate the development of extended-release formulations of the drug.

[Prise en charge of children with poor vision. Example of the pedagogic center for visually handicapped patients in Lausanne]

The taking in charge of visually handicapped children has largely been modified over the past years, encouraging a better integration into society. This is only possible through multidisciplinary collaboration. Presentation of our collective report and various techniques used towards this aim.

Microbial contamination in four commercially available denture adhesives

Four brands of commercially available powder denture adhesives were tested for microbial contamination. Sterile Petri plates that contained either brain-heart infusion (BHI) or Sabouraud's (SAB) agar were inoculated with 0.5 gm samples of each adhesive. The BHI plates were incubated aerobically and anaerobically at 35 degrees C and the SAB plates aerobically at 30 degrees C for 2 weeks. The sterility of these procedures was confirmed by incubating uninoculated control plates. All bottles of powder denture adhesive tested contained microorganisms. Both bacterial and fungal growth were noted. The containers of adhesive were then subjected to 10 minutes of microwave energy (650 W) to sterilize the adhesive material. After retesting, any bottles still contaminated were subjected to additional 10 minutes of microwave exposure and then retested. Seven of 24 bottles still showed evidence of microbial contamination after exposure to microwave energy. Of the seven bottles, five were of one brand. A Fisher's exact test showed significant differences in the percentage of contaminated samples between that and the other brands (p < 0.05). Microwave energy reduced microbial contamination in all samples but failed to completely sterilize seven of 24 samples.

Simultaneous use of microfibrillar collagen hemostat and blood saving devices in a canine kidney perfusion model

Intraoperative autotransfusion and topical microfibrillar collagen hemostats have been increasingly used, often simultaneously, in various surgical procedures to minimize intraoperative blood loss and thus reduce the inherent risks of homologous blood transfusion. As moderate amounts of small particles have been shown to pass through filtering devices during intraoperative autotransfusion, concern has been raised over the amount of heterologous collagen fibrils transfused and their effect on the host. We found that 2% of microfibrillar collagen hemostat particles pass through the 20-microns millipore filter contained in the tested autotransfusion device (William Harvey H-4700 cardiotomy reservoir). Using a canine kidney perfusion model, we found multifocal perivascular inflammatory reactions within the renal parenchyma five days after transfusion of filtered autologous blood containing minute amounts of microfibrillar collagen hemostat. The findings demonstrate a strong inflammatory foreign body response to heterologous collagen particles trapped in the microcirculation of the perfused kidneys. It is concluded that despite using filters with a pore size of 20 microns, using intraoperative autotransfusion and microfibrillar collagen hemostats simultaneously creates a potential risk because adverse reactions can be elicited especially within the microvasculature of tissues containing end-arterial circulation.

Prognostic factors and survival after radiotherapy for intranasal neoplasms in dogs: 70 cases (1974-1985)

Survival time and 31 prognostic factors were analyzed for 70 dogs undergoing radiotherapy for intranasal tumors at the Veterinary Hospital of the University of Pennsylvania between 1974 and 1985. At the time of analysis (January 1987), 14.3% (10 of 70) of the dogs were alive. Of the remaining dogs, 34 died because of tumor recurrence, 14 died because of intercurrent disease, and 12 were lost to follow-up evaluation. Pretreatment prognostic factors that were significantly correlated with disease-free interval or long-term survival could not be identified. Notably, presence of a facial mass was not prognostically significant, suggesting that extensive disease should not preclude treatment. Median survival time of dogs with all tumor types was 16.5 months, with a 1-, 2-, and 3-year survival of 54%, 43%, and 35%, respectively. Median survival time of dogs with carcinoma was 13.5 months, with 1-year survival of 51%, 2-year survival of 37%, and 3-year survival of 31%. Orthovoltage radiation was efficacious in the treatment of canine intranasal tumors.

Long-term renal responses to high dietary protein in dogs with 75% nephrectomy

It has been proposed that ingestion of large amounts of dietary protein leads to sustained renal hyperperfusion and progressive glomerulosclerosis in rats. This hypothesis was tested in dogs, with 75% reduction in renal mass, maintained for 4 years on either 56, 27, or 19% dietary protein. Twelve of 21 dogs survived 4 years, and death due to renal failure was not correlated to diet. Dogs fed 56 and 27% protein had increased GFR and CPAH before and after reduction of renal mass compared to the 19% group. A pattern of deterioration of renal function, including proteinuria, was not found in any diet group. Nine of 11 dogs, fed 56, 27, or 19% protein had minimal glomerular lesions, including mesangial proliferation, GBM irregularities, adhesions, and sclerosis. Two other dogs, fed 56% protein, had more severe glomerular lesions. No significant ultrastructural differences were found in glomeruli among the three diet groups. These results do not support the hypothesis that high protein feeding had a significant adverse effect on either renal function of morphology in dogs with 75% nephrectomy.