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To determine and report the diagnosis, treatment, and outcome in dogs with persistent right aortic arch (PRAA) with an aberrant left subclavian artery (ALS) that underwent thoracoscopic surgery.

Dogs with PRAA and an ALS (n = 5).

Short case series.

Medical records were reviewed from 2014 to 2019. Dogs that underwent thoracoscopy for PRAA with an ALS at an academic referral hospital were included. Signalment, clinical signs, diagnostic imaging, surgical approach, complications, and short- and long-term outcomes were recorded.

Persistent right aortic arch with an ALS was identified in five dogs. Dogs initially underwent a three-port intercostal thoracoscopic approach, and an intercostal thoracotomy was performed in converted cases. In all five dogs, the ligamentum arteriosum (LA) and ALS were divided; three were performed by a thoracoscopy alone. Two cases were converted because of poor exposure (1) and requirement to temporary occlude an ALS (1). The ALS was ligated and divided in all dogs without apparent negative effects. No intraoperative or postoperative complications occurred. Four dogs had resolution of regurgitation, three of which required diet modification. One dog had reported regurgitation when it was excited. Median follow-up was 188 days (range, 150-1133).

Ligation and division of both the LA and the ALS in all dogs in this case series was safe and allowed for improvement in clinical signs and good to excellent long-term outcomes. In addition, both thoracoscopy and thoracotomy were used safely and successfully for ligation and transection of the LA and ALS in all dogs.

Ligation and division of both the LA and the ALS in all dogs in this case series was safe and allowed for improvement in clinical signs and good to excellent long-term outcomes. In addition, both thoracoscopy and thoracotomy were used safely and successfully for ligation and transection of the LA and ALS in all dogs.

Although laryngopharyngeal reflux (LPR) is a common condition in daily practice, no gold standard exists for its diagnosis. The objective of this study was to establish a simple and reliable scoring system for evaluating LPR consisting of both subjective and objective criteria.

This retrospective study includes 124 patients presenting with symptoms of LPR. In all patients, reflux symptom index (RSI), reflux finding score (RFS), oropharyngeal pH monitoring (PHM) and transnasal oesophagoscopy (TNE) were performed and rated in a special scoring system.

A Horvath Score of 4-5 for severe LPR was found in 76 patients (61%), a score of 2-3 for non-severe LPR in 38 patients (31%) and a score of 0-1 for non-existing LPR in 10 patients (8%) by combining the 4 validated diagnostic methods.

The proposed scoring system qualifies as a simple and reliable tool for evaluating LPR in daily practice, directly impacting patient management.

The proposed scoring system qualifies as a simple and reliable tool for evaluating LPR in daily practice, directly impacting patient management.In order to encourage innovative medicine to address Chinese unmet medical needs, China has changed its drug regulatory landscape to speed up access to new medicines. In order to understand the fast-changing landscape and to enable planning of more global drug development programs and study designs in China, we reviewed 15 published clinical pharmacology-related guidances by the National Medical Products Administration (NMPA), and compared them with reference guidances from the US Food and Drug Administration (FDA), the European Medicines Agency (EMA), or the International Conference on Harmonization (ICH), to understand the similarities and differences, especially any China-specific requirements, such as ethnic sensitivity analysis. Overall, by reviewing these clinical pharmacology-related NMPA guidances, it is clear that NMPA guidances are very similar to FDA, EMA, and ICH guidances. HRO761 datasheet There are no relevant differences in the major principles, but some differences in structure, contents, and focus were noted. The NMPA is adapting flexibility statements into newly published guidances. Ethnic sensitivity analysis needs to be implemented early in drug development plans. The NMPA encourages sponsors to conduct early clinical trials in China or include China early in multiregional clinical trials, and to obtain safety, efficacy, and pharmacokinetic data for ethnic sensitivity analysis. Depending on the stage of development, ethnic sensitivity analysis can be conducted using in vitro or literature data, other Asian clinical data, or Chinese clinical data.

Fiscal constraints, an ageing populations and the increasing burden of chronic conditions are stressing health systems internationally. Nurses are the linchpin of effective healthcare delivery and their success is dependent on adequate staffing models, which must align knowledge, skills and competencies with workload.

To compare measures of nursing workload in adult inpatient settings.

A review of published studies characterising nursing workload measures was undertaken. Databases-PubMed and CINHAL-were used to identify published studies. A description of the psychometric properties of each measure and its use in an inpatient setting was required for inclusion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used to guide and report the review.

Of the 1,422 studies identified, 15 met the inclusion criteria. Nursing workload was measured in the intermediate care unit (n=6), overall hospital (n=7), emergency department (n=1) and burn unit (n=1) settings and also by mailed survey (n=1). Eleven different workload measures were identified. The National Aeronautics and Space Administration Task Load Index (n=3), Therapeutic Intervention Scoring System (n=3) and Nursing Activities Score (n=2) were the most common nursing workload measures identified with reported psychometric properties.

Researchers, clinicians and hospital administrators should carefully identify and assess the psychometric properties of nursing workload measures before using these in routine practice.

Gaining a consensus on effective nursing workload measures is a crucial step in designing appropriate staffing models and policies, improving nurse productivity and well-being, as well as enhancing patient health outcomes in inpatient settings.

Gaining a consensus on effective nursing workload measures is a crucial step in designing appropriate staffing models and policies, improving nurse productivity and well-being, as well as enhancing patient health outcomes in inpatient settings.