Dog Owners Hide Truth from Shelters
Many dog owners who relinquish their pets to animal shelters are not entirely honest about their dogs’ behavioral problems. According to the researchers at Penn and University of California veterinary schools, these behavioral problems may sometimes pose a risk to an adopting family who could unknowingly take in an aggressive animal.
The researchers studied behavioral questionnaires given to owners leaving their dogs at shelters and found that people are less likely to report such behavioral problems as aggression and fear of strangers, if they believed that their responses would be shared with shelter staff. Their findings were published recently in the Journal of the American Veterinary Medical Association.
“Many shelters conduct behavior-based evaluations on animals they take in, but there are few better descriptions of a dog’s temperament than an honest assessment from its owner through a questionnaire,” said Dr. James Serpell, professor of humane ethics and animal welfareand director of Penn’s Center for the Interaction of Animals & Society.
Dr. Serpell comments that, “Shelters could more effectively use their scarce resources to correct behavioral problems or find ways of guiding troubled dogs to more appropriate adopters–if they detect these problems in time.” Dr. Serpell conducted the study with UC Davis colleagues Sheila Sergurson and Benjamin Hart at two shelters in Sacramento. They gave questionnaires to two groups of people. One group was told that the information would be kept confidential and the other was told that the information would be shared with shelter staff. Significantly more shelter dogs in the confidential group were reported to behave aggressively to their owners or fearfully with strangers.
The researchers also compared both groups to questionnaires given to a group of dog-owners, all of whom were clients of Penn’s Matthew J. Ryan Veterinary Hospital. The comparison showed that there were many more instances of behavioral problems in animals being left at shelters.
For animal shelters, however, the lesson that this study provides is more complex. Shelters must identify potentially troubled dogs before making them available for adoption.
Thermal Energy to Reduce Asthmatic Symptoms
Clinical researchers at HUP hope to open up a new avenue to alleviate the debilitating symptoms of asthma through an investigative bronchoscopic procedure where the smooth muscle of the airway, which causes the spasm, is reduced using thermal energy.
Physicians will go into the airways with a bronchoscope, which is a routine procedure, and by generating and applying thermal energy, will reduce areas of underlying smooth muscle in the small to medium size airways with a new medical device. The Alair® System consists of a single-use device and a controller that delivers thermal energy to the bronchial wall during an outpatient bronchoscopic procedure known as Bronchial Thermoplasty(tm).
The system, which has an expandable wire basket at the tip, consists of four arms that come in contact with and fit snugly against the airway wall. The expanded basket then delivers controlled radio frequency energy for about 10 seconds to heat the airway smooth muscle. Once the treatment session is completed, the device and the bronchoscope are removed. The controlled heat is designed to reduce the amount of airway smooth muscle in the airway wall, thus reducing the ability of the airway walls to contract and narrow and spasm in response to irritation, infection or inflammation.
“The procedure itself takes only about an hour to complete and no general anesthesia is used. This is done on an outpatient basis as a bronchoscopic procedure, with conscious sedation (in which a tube is placed through the mouth or nose and positioned into the lungs). There is no incision and no need to stay overnight, ” said Dr. Maureen George, coordinator, Comprehensive Asthma Care Program in the Pulmonary, Allergy and Critical Care Division at HUP.
During the clinical trial, physicians will treat one-third of the lungs in each treatment period for three treatment sessions total. Also, patients who are currently highly medicated will stay on their medication for the duration of the study.
In this country, severe asthmatics are a major health problem. It’s predicted that 40-50 percent of adults suffer from asthma leading to lost days at work. Asthma is a common disease in which the airways in the lung become inflamed, excess airway mucus is produced, and airways narrow when muscles within the airway walls contract. Asthma affects more than 20 million people in the U.S.
“There’s no expectation that this new procedure will cure asthma but we’re hopeful it will be useful in reducing the severity and frequency of asthma symptoms and help to improve the quality of life for asthma sufferers,” comments Dr. Ali Musani, an interventional pulmonologist at Penn and principal investigator of the study.
Hospitalization or Death of Elderly Spouse Substantially Affects Husband or Wife’s Mortality
A new study shows that for people aged 65 and older hospitalization of a spouse can harm the well being of the surviving partner and significantly contribute to that partner’s death. The study appears in the February 16 New England Journal of Medicine.
Dr. Paul Allison, professor and chair of Penn’s sociology department, and Nicholas Christakis, professor in the department of healthcare policy at Harvard Medical School, examined the effect of illness in one spouse on the risk of illness in a partner. They looked at the effect of the death of one spouse on the mortality of the other. By considering these effects together for the first time, the authors were able to assess the implications of specific illnesses or diseases for a partner’s risk of death.
“What surprised us was that diseases that are highly lethal, like lung cancer or pancreatic cancer, had very little impact on the partner’s mortality risk,” Dr. Allison said. “On the other hand, dementia and other psychiatric diseases showed substantial increases–19 to 32 percent–in the risk of death for the partner, for both husbands and wives.”
Researchers found that the period of greatest risk is within 30 days of a spouse’s hospitalization or death, where hospitalization of a spouse can confer to a partner almost as much risk of dying as the actual death of a spouse.
The study also found that specific illnesses impacted the spouse differently. For example, if the wife were hospitalized for colon cancer, there was almost no effect on her husband’s mortality. But, if a wife were hospitalized with heart disease, her husband’s risk of death was 12 percent higher than it would be if the wife were not sick. If a wife were hospitalized with dementia, her husband’s risk was 22 percent higher. Similar effects were seen in women whose husbands were hospitalized.
Further analyses found that the death of a wife in the previous 30 days increased her husband’s risk of death 53 percent, and the death of a husband increased his wife’s risk of death 61 percent. For women, the effect of a husband’s hospitalization increased with age and the level of poverty. For men, the effect of a wife’s hospitalization increased only with age.
For nine years, the authors studied 518,240 couples—more than 1 million people—between the ages of 65 and 98 who were enrolled in Medicare. This study found that the stress effect may last for a few weeks or months, and the support effect may last for several years. Eventually, the healthy partner adapts to the stress effect, so that the health risks of being a caregiver decline; however, the lack of social support that is associated with the illness or death of a partner becomes a problem, and health risks in the partner increase again.
Most At-Risk Patients for Secondary Strokes
Among patients who have suffered a single stroke, researchers at Penn’s School of Medicine, along with colleagues at other institutions, have found that severe stenosis, or narrowing of the arteries in the head, represents a major risk factor for the development of a subsequent stroke. Patients with recent symptoms were also at high risk. Further, women faced a greater risk of subsequent stroke than men. Their work, published in the January 31 issue of Circulation, lays the foundation for further studies into effective therapies to prevent secondary strokes.
The researchers’ findings are part of a larger multi-site clinical investigation—specifically, the Warfarin versus Aspirin for Symptomatic Intracranial Disease (WASID) trial—which found aspirin to be the preferred medical therapy for preventing a secondary stroke. According to the WASID study, warfarin was associated with significantly higher rates of adverse events and provided no benefit over aspirin for preventing stroke and vascular death.
“We need to be more aggressive in the treatment of these high-risk patients,” said Dr. Scott Kasner, lead author of the study and director of Penn’s Stroke Center. “Stenting and angioplasty in the brain are promising treatments for intracranial stenosis, and this study identified the target group for a new trial comparing these treatments with traditional medical therapy.”
Using patient data from the WASID trial, Dr. Kasner, analyzed five probable clinical factors that would contribute to a subsequent stroke in the territory of the initial event—including type of qualifying event (stroke or TIA), location of vessel, percent stenosis, treatment with antithrombotic medications at the time of the preliminary stroke, and time from the qualifying event to enrollment in the study. After adjusting for age, gender, and race, the researchers found that patients with severe stenosis (at or greater than 70% of the affected vessel’s diameter), recent symptoms, and female gender were associated with significantly higher subsequent risk of stroke in the territory of a symptomatic intracrancial stenotic artery than other groups. “Our observations suggest that potential intervention should be considered very soon after clinical presentation, unless early intervention also increases the short-term risk,” says Dr. Kasner.
Almanac, Vol. 52, No. 27, March 28, 2006