Vinthersauer3004

Influenza virus infection causes seasonal epidemics and occasional pandemics, leading to huge morbidity and mortality worldwide. Vaccination against influenza is needed annually as protection from constantly mutating strains is required. PF-3644022 Groups at high risk of poor outcomes include the elderly, the very young, pregnant women and those with chronic health conditions. However, vaccine effectiveness in the elderly is generally poor due to immunosenescence and may be altered due to "original antigenic sin". Strategies to overcome these challenges in the elderly include high-dose or adjuvant vaccines. Other options include vaccinating healthcare workers and children as this reduces community-level influenza transmission. Current guidelines in the UK are that young children receive a live attenuated nasal spray vaccine, adults aged >65 years receive an adjuvanted trivalent inactivated vaccine and adults aged less then 65 years with comorbidities receive a quadrivalent inactivated vaccine. The goal of a universal influenza vaccine targeting conserved regions of the virus and avoiding the need for annual vaccination is edging closer with early-phase trials under way.Patients with nonsmall cell lung cancer and limited metastatic disease have been defined as oligometastatic if local ablative therapy of all lesions is amenable. Evidence from different clinical retrospective series suggests that this subgroup harbours better prognosis than other stage IV patients. However, most reports have included patients with inconsistent numbers of metastases in different locations treated by a variety of invasive and noninvasive therapies. As long as further results from randomised clinical trials are awaited, treatment decision follows an interdisciplinary debate in each individual case. Surgery and radiotherapy should capture a dominant role in the treatment course offering the option of a curative-intended local therapy in combination with a systemic therapy based on an interdisciplinary decision. This review summarises the current treatment standard in oligometastatic lung cancer with focus on an ablative therapy for both lung primary and distant metastases in prognostically favourable locations.In recent years, many bronchoscopic techniques have been developed in chronic obstructive airway inflammatory diseases, including asthma, COPD and emphysema. The main techniques with available data from randomised controlled trials are 1) bronchial thermoplasty in asthma; 2) valves, coils and thermal vapor ablation in emphysema; and 3) targeted lung denervation in COPD. The objectives of this article are to describe the levels of evidence for efficacy and safety, long-term follow-up results beyond 1 year, and current recommendations for clinical practice from international guidelines for each technique.Pleural infection and malignancy are among the most common causes of pleural disease and form the mainstay of pleural practice. There has been significant research and increase in scientific understanding in these areas in the past decade. With regard to pleural infection, the rising incidence remains worrying. An increased awareness allowing earlier diagnosis, earlier escalation of therapy and the use of validated risk stratification measures may improve outcomes. In pleural malignancy, research has enabled clinicians to streamline patient pathways with focus on reducing time to diagnosis, definitive management of malignant pleural effusion and achieving these with the minimum number of pleural interventions. Trials comparing treatment modalities of malignant pleural effusion continue to highlight the importance of patient choice in clinical decision-making. This article aims to summarise some of the most recent literature informing current practice in these two areas.

Renal cysts are fluid-filled cavities with an epithelial lining that, depending on their size, can cause clinical symptoms and thus require conservative or surgical therapy. Nephrectomy is primarily used in cattle for simple kidney cysts while sclerotherapy is well established in humans and individual case reports have been published in small animal medicine. This case report describes the first successful treatment of a solitary, perirenal cyst using a right-sided laparotomy and intraluminal instillation of 96% ethanol solution in a Swiss Fleckvieh cow. Diagnostics, surgical procedures and aftercare are descripted and risks are compared to other methods. Sclerotherapy is an organ-preserving alternative to nephrectomy that is suitable for buiatric practice, the methodology should be confirmed in subsequent intervention studies.

Renal cysts are fluid-filled cavities with an epithelial lining that, depending on their size, can cause clinical symptoms and thus require conservative or surgical therapy. Nephrectomy is primarily used in cattle for simple kidney cysts while sclerotherapy is well established in humans and individual case reports have been published in small animal medicine. This case report describes the first successful treatment of a solitary, perirenal cyst using a right-sided laparotomy and intraluminal instillation of 96% ethanol solution in a Swiss Fleckvieh cow. Diagnostics, surgical procedures and aftercare are descripted and risks are compared to other methods. Sclerotherapy is an organ-preserving alternative to nephrectomy that is suitable for buiatric practice, the methodology should be confirmed in subsequent intervention studies.

Monitoring programs and guidelines on the use of antibiotics and antibiotic resistance in human and veterinary medicine have been developed worldwide to promote the prudent use of antibiotics in recent years. However, such information on the use of antibiotics in exotic pets is absent. This fact must be taken into account, since the number of exotic pet patients is constantly increasing and the administration of antibiotics is particular challenging due to the diversity of species and the differences in physiology. The present study reports the results of a survey of frequently used antibiotics and the criteria of antibiotic usage in exotic pets (rabbits, rodents, birds and reptiles) among Swiss veterinarians. These data should form the basis for the development of antibiotic usage guidelines in exotic pets. A total of 61 veterinarians returned the questionnaire. The most important decision-making criteria for antibiotic treatment and antibiotic selection were clinical symptoms (55/59, 93% for antibiotic treatment and 40/59, 68% for antibiotic selection), experience (41/59, 69% and 36/59, 61%, respectively) and textbooks (39/59, 66% and 40/59, 68%).