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OBJECTIVE: To examine the personal financial impact of atopic dermatitis (AD) and attempt to correlate cost of AD with emotional impact. STUDY DESIGN: Between March 2011 and December 2013, 82 caretakers of children 6 months to 12 years of age with moderate-to-severe AD were recruited at the time of dermatology clinic visits in Cleveland, Ohio, to complete surveys. The response rate was >95%. Participants were asked questions about direct expenses (medical visits, medications, and other products) and indirect expenses (time missed from work, childcare costs) related to AD in the past 4 weeks. Emotional impact was measured by the Childhood Atopic Dermatitis Impact Scale. RESULTS: The mean monthly personal cost of AD in the month before the office visit was $274 (median $114; IQR $29, $276), with $75 from direct costs (median $45; IQR $20, $110) and $199 from indirect costs (median $0; IQR $0, $208). An average of 34.8% of available monthly money was spent on AD care in the month before the office visit. For patients with Medicaid, there was a significant correlation between monthly adjusted personal cost and Childhood Atopic Dermatitis Impact Scale score (r = 0.548; P < .001); however, this correlation did not exist for patients who had commercial insurance (r = 0.269; P = .166). CONCLUSIONS: Our results illustrate the high emotional and financial burden of childhood AD and provide insight into spending patterns. In addition, our study correlate costs with emotional burden of AD for lower-income patients.

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The structure and composition of fetal and placental tissues vary among different species of placental mammals. Some mammals, including camelids and pigs, possess an epidermal membrane during the fetal stage, called the epithelion, that is absent from other domestic mammals. Because neonatal piglets are a common animal model for many research techniques, it is important that researchers correctly identify this tissue and recognize its lack of pathological consequence when working with fetal and neonatal piglets. Here, the authors describe gross and histological examinations of the epithelion, comparing this tissue with other extra-fetal tissues and coatings.

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Seven goats and one ram presented with clinical signs including regurgitation, obtundation, anorexia, apparent pain, and bloat. The animals had escaped from their barn, and it was discovered that they had ingested leaves of Pieris japonica, Japanese pieris, a grayanotoxin-containing plant. Animals were treated with antibiotics, calcium borogluconate, B vitamins, and activated charcoal within the first 24-h postexposure, which was followed by the recovery of the ram and two goats and the death of two goats. Approximately 36 h after Japanese pieris ingestion, one of the three remaining anorectic goats was dosed with intravenous lipid emulsion (ILE). This goat recovered within a few hours. The remaining two goats were given ILE the next day and appeared to recover, but one died a week later of aspiration pneumonia.

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Borrelia burgdorferi, the etiologic agent of Lyme disease is a tick born spirochetal infection. Clinical signs of Lyme borreliosis are uncommon in horses, but when present they are often vague and nonspecific. In horses, Lyme borreliosis has been implicated in musculoskeletal, neurological, reproductive, and ocular disorders, including uveitis, but definitive diagnosis can be challenging as the causative agent is rarely isolated and serologic tests can be unreliable and do not confirm active disease. Here, we report two cases of equine uveitis associated with B. burgdorferi based on the identification of spirochetes within ocular fluids and confirmed with PCR testing. The two cases illustrate some of the challenges encountered in the recognition and diagnosis of equine Lyme borreliosis. Although only one of many possible causes of equine uveitis, Lyme disease should be considered a differential diagnosis, especially in endemic areas. Given the possibility for false negative results of serum tests during uveitis associated with B. burgdorferi and the failure of such tests to confirm active infection, a combination of cytologic assessment, antibody, and/or PCR testing of ocular fluids may be worthwhile if the clinical suspicion for Lyme uveitis is high.

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This article lists commonly encountered toxic plants that affect ruminants in the Northeastern United States. Livestock are at risk for ingestion of a large variety of toxic plants. Plant poisonings are likely to be underdiagnosed because tests for most plant toxins are not routinely available at veterinary diagnostic laboratories. Prevention of access to poisonous plants is usually more effective and economical than treatment of plant poisonings.

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The emergency treatment of small ruminant patients can be overwhelming for clinicians with limited experience with these species. This article outlines the diseases most frequently encountered in veterinary practice. Each section discusses clinical signs, causes, and treatment and/or procedures associated with small ruminant emergencies. Emphasis is placed on the treatment of critical patients, but practitioners should also be prepared to manage these conditions on a flock or herd level because most small ruminant emergencies stem from poor management.

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This retrospective study describes 68 alpacas with skin diseases investigated from 1997 through 2006 at Cornell University. During this time period, 40 of 715 (5.6%) alpacas presented to the university hospital had dermatological diseases. In addition, skin-biopsy specimens accounted for 86 of 353 (24.4%) of alpaca biopsy specimens submitted to the diagnostic laboratory, and of these 86 specimens, follow-up was available for 28 cases. The following diseases were most common: bacterial infections (22%); neoplasms, cysts and hamartomas (19%); presumed immunological disorders (12%); and ectoparasitisms (10%). Conditions described for the first time included intertrigo, collagen and hair follicle hamartomas, lymphoma, hybrid follicular cysts, melanocytoma, anagen defluxion, telogen defluxion, presumed insect-bite hypersensitivity, ichthyosis, and possible hereditary bilateral aural haematomas and chondritis. The results of the retrospective study are compared and contrasted with the results of a literature review.

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The goal of the current study was to determine the range of blood selenium concentrations in goats in New York State that were fed adequately supplemented diets. Blood samples from mature, juvenile, and neonatal goats from commercial farms, 2 dairy and 2 meat producers, were analyzed via graphite-furnace atomic absorption spectroscopy. Feed samples were analyzed by using inductively coupled argon plasma optical emission spectroscopy to confirm that dietary selenium concentrations were adequate. The ranges of blood selenium concentration obtained were 9.1-49.9 microg/dl for mature goats, 7.6-37.5 microg/dl for juveniles, and 9.7-40.7 microg/dl for neonates.

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OBJECTIVE: To compare agreement between 2 pregnancy tests in dairy cattle. DESIGN: Evaluation study. ANIMALS: 976 and 507 cattle for phases 1 and 2, respectively. PROCEDURES: Blood samples were collected, and palpation per rectum (PPR) was performed on cattle. Blood samples for the pregnancy-specific protein B (PSPB) ELISA were sent by courier to a commercial laboratory with results returned later. Results of PPR were extracted from herd records. Statistical comparison of results was performed by use of a mixed linear model and N analysis. RESULTS: Of 571 cattle classified as pregnant by the PSPB ELISA in phase 1, 30 (5%) were nonpregnant by PPR. Mean +/- SE adjusted optical density (OD) of cattle classified pregnant by both tests was significantly higher (0.31 +/- 0.01), compared with the adjusted OD of cattle classified pregnant by the PSPB ELISA and nonpregnant by PPR (0.22 +/- 0.02). Of 255 cows classified pregnant by the PSPB ELISA in phase 2, 31 (12%) were nonpregnant by PPR. Mean +/- SE adjusted OD of cattle classified pregnant by both tests was significantly higher (0.26 +/- 0.01), compared with the adjusted OD of cattle classified pregnant by the PSPB ELISA and nonpregnant by PPR (0.21 +/- 0.01). The N value was 0.82 and 0.81 for phases 1 and 2, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Good agreement existed between the 2 tests, especially at longer intervals after insemination. Discrepant results appeared to be attributable to a nonviable fetus, embryonic loss, or fetal loss.

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Patient education plays an important role in empowering patients who have allergic contact dermatitis. Having the knowledge about a disease process does not guarantee healthy behaviors. Through careful assessment of educational needs, awareness of stages of change that adults go through, and use of resources available to members of the American Contact Dermatology Society, nurses can provide patient education that completes the patch testing process.

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Hand dermatitis is inflammation characterized by redness, scaling, and fissuring clinically and spongiosis histologically. The three main types of hand dermatitis--irritant contact dermatitis, allergic contact dermatitis, and dyshidrotic eczema--are discussed along with nursing assessment, patch testing, and prognosis and prevention.

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The International Council of Nurses (2007) defines nursing research as a systemic inquiry that seeks to obtain new nursing knowledge for the benefit of patients, families, and communities and includes all aspects of health that are of interest to nursing including health promotion, disease prevention, and care during illness and recovery or towards a peaceful death. There is an increased amount of clinical research available to nurses and now we are challenged to utilize this knowledge to improve patient care. Just like Florence Nightingale, nurses today need to make observations, collect data, and use the analysis of that data to support and guide current nursing care.

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An increasing number of cases of allergic contact dermatitis secondary to formaldehyde resins used for textile finishes have been seen in our office over the last several years. Although previously reported to be more common in women, we have seen almost as many men as we have seen women with this condition, possibly because men are more likely to be occupationally sensitized to formaldehyde. We have found that patch-test reactions of only questionable strength may be clinically relevant. It has been our experience that many of these cases are of long duration before referral for patch testing. A low index of suspicion leads to a delayed diagnosis, and avoidance after diagnosis is difficult owing to the lack of labeling requirements for textile finishes. Patch testing with the textile resins Fixapret AC and Fixapret CPN most often identified patients with textile allergies. We have prepared a handout to give patients more definitive recommendations.

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OBJECTIVE: To determine the prevalence of biofilm formation under long-term cell culture conditions in serum samples of dairy cattle, goats, cats, and dogs, and to determine whether there is an association between nanobacteria and biofilm formation. SAMPLE POPULATION: Serum samples of clinically normal animals (313 dairy cattle, 48 goats, 140 dogs, and 44 cats) and animals with various medical conditions (60 dogs and 116 cats). PROCEDURE: Serum was incubated under cell culture conditions and observed for biofilm formation by use of light microscopy, electron microscopy, and spectroscopy. A polymerase chain reaction assay was developed to identify 16S rRNA gene sequences of nanobacteria. RESULTS: Biofilm formation developed in serum samples of 304 of 313 (97%) cattle, 44 of 48 (92%) goats, 44 of 44 (100%) cats, and 126 of 140 (90%) dogs. Prevalence of serum samples with positive results for biofilm formation was not significantly different between cats or dogs with and without medical conditions associated with pathologic extraskeletal calcification processes. Scanning electron microscopy and spectroscopy of biofilm samples revealed small coccoid particles consisting mainly of calcium and phosphate. Polymerase chain reaction assay failed to amplify sequences of nanobacteria. CONCLUSIONS AND CLINICAL RELEVANCE: Under long-term cell culture conditions, biofilm made up of aggregates of calcium and phosphate crystals does form in serum samples of clinically normal dairy cattle, goats, cats, and dogs. Disease, however, does not predispose to biofilm formation in serum samples of dogs and cats. Our findings did not support the existence of nanobacteria in serum samples of cattle, goats, cats, and dogs.

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