July 12, 2011,
Volume 58, No. 01
Short-Nosed Dogs Can Breathe Easier During Critical Care
Dogs with short noses can develop respiratory distress and disease, hospital visits and sometimes the need to receive mechanical assistance just to breathe. However, a study by researchers at the University of Pennsylvania’s School of Veterinary Medicine shows that these dogs do just as well as their longer-nosed kin during mechanical ventilation procedures.
Published in the Journal of Veterinary Emergency and Critical Care, the study was conducted by Assistant Professor Deborah C. Silverstein and graduate student Guillaume Hoareau, both in the department of clinical studies at Penn Vet, along with Assistant Professor Matthew Mellema of the department of surgical and radiological sciences, University of California, Davis.
Brachycephalic dogs—dogs with skulls that are shorter than they are wide—have tiny nostrils, elongated soft palates, narrow windpipes and other abnormalities of their upper respiratory tracts. This makes it difficult for them to breathe, even in ideal conditions.
With the possibility that their airways could completely collapse while in distress, veterinarians must consider whether to mechanically help such dogs breathe.
One problem is that they need more help breathing when under anesthesia than other dogs, but are more likely to suffer complications due to a combination of the breathing tube irritating the dog’s airways and the sedative drugs that are required may make it more difficult to successfully take them off of the respirator once the lung disease is less severe.
To test if this assumption was true, Dr. Silverstein and her colleagues looked at the medical records for brachycephalic dogs, specifically, French and English bulldogs, pugs and Boston terriers, that came into Penn’s veterinary hospital between 1990 and 2008. They found that brachycephalic dogs survived at the same rate as the general population of dogs.
Future studies based on this work could improve care for brachycephalic dogs by looking at a larger sample size, getting a better sense of their oxygenation levels before and during the procedure and determining whether mechanical ventilation could be avoided in favor of a more benign procedure.
A War Inside: Saving Veterans from Suicide
An estimated 18 American military veterans take their own lives every day and those numbers are steadily increasing. These soldiers find themselves overwhelmed by the transition back into civilian life. Many have already survived one suicide attempt, but never received the extra help and support they needed, with tragic results. A team of researchers from the Perelman School of Medicine and colleagues found that veterans who are repeat suicide attempters suffer significantly greater mortality rates due to suicide compared to both military and civilian peers. The research was published in BMC Public Health.
Study author Dr. Douglas J. Wiebe, assistant professor of epidemiology, said that the findings, “should have us very concerned about current veterans in the more contemporary era.” Dr. Wiebe, along with Janet Weiner of Penn’s Leonard Davis Institute of Health Economics and Dr. Therese S. Richmond, Andrea B. Laporte Endowed Term Associate Professor of Nursing, teamed with Joseph Conigliaro of New York University to conduct a study of military veterans who received inpatient treatment at a Department of Veterans Affairs (VA) medical center for a suicide attempt between 1993 and 1998. The veterans were followed for incidence, rate, and cause of mortality through the end of 2002.
Among the total of 10,163 veterans treated for a suicide attempt between 1993-1998, 1,836 died during the follow-up period through 2002, with heart disease, cancer, accidents, and suicide accounting for over 57% of those deaths. Suicide, however, was the second- leading cause of death among the male veterans, and the leading cause among females. In comparison, suicide accounted for only 1.8% of deaths in the general US population during those years.
Dr. Wiebe and his colleagues discovered that veterans who have attempted suicide also face mortality risks from all causes at a rate three times greater than the general population. The so-called “healthy soldier effect,” that military personnel should be healthier than an average person of the same sex and age because they have passed military fitness requirements, does not protect veterans from death from chronic disease, and does not appear to mitigate their risk of suicide. “The ‘healthy soldier effect’ is no reason to think that veterans should be more emotionally and mentally resilient than anyone else,” said Dr. Wiebe.
The current research emphasizes the increased need for more intensive and vigorous efforts to identify and support veterans who are at risk, especially those who have already actually attempted suicide, say the authors.
ADHD Drug Helps Menopausal Women with Memory
At menopause, many women begin to notice a decline in their attention, organization, and short-term memory. These cognitive symptoms can lead to professional and personal challenges and unwarranted fears of early-onset dementia. A small study by Penn Medicine and Yale researchers, published in the journal Menopause, found that a drug typically given to children and adults with ADHD improved attention and concentration in menopausal women, providing the first potential treatment for menopause-related cognition deficits.
Researchers believe the cognitive issues may be the result of a menopause-related decline in estrogen input to the prefrontal cortex, which interferes with neurotransmission, causing executive function problems.
“Subjective declines in memory, focus and organization are common in mid-life women,” said study author C. Neill Epperson, director of the Center for Women’s Behavioral Wellness and associate professor in Psychiatry and Obstetrics and Gynecology at the Perelman School of Medicine. “We believe that the results of our small randomized clinical trial provides proof-of-concept that atomoxetine may improve subjective memory, attention and concentration.”
Before clinical recommendations can be made, a follow-up clinical trial needs to validate results. A new follow-up study is now underway at the Penn Medicine’s Women’s Behavioral Wellness program and will test whether an FDA-approved ADD medication amends these cognitive deficits in a larger group of menopausal women.
Facebook Users More Trusting & More Politically Engaged
New national survey findings show that use of social networking sites (SNS) is growing and that those who use these sites, especially Facebook users, have higher measures of social well-being. In a national phone survey of 2,255 American adults last fall, the Pew Research Center’s Internet & American Life Project found that Facebook users who use the site multiple times per day:
• are 43% more likely than other internet users and more than three times as likely as non-internet users to feel that most people can be trusted.
• averages 9% more close, core ties in their overall social network compared with other internet users.
• was an additional two and half times more likely to attend a political rally or meeting, 57% more likely to persuade someone on their vote, and 43% more likely to have said they would vote.
• receives more emotional support and companionship. For Facebook users, the additional boost is equivalent to about half the total support that the average American receives as a result of being married or cohabitating with a partner.
“There has been a great deal of speculation about the impact of social networking site use on people’s social lives, and much of it has centered on the possibility that these sites are hurting users’ relationships and pushing them away from participating in the world,” noted Dr. Keith Hampton, assistant professor of communication at the Annenberg School for Communication and the lead author of the new Pew Internet report. “We’ve found the exact opposite – that people who use sites like Facebook actually have more close relationships and are more likely to be involved in civic and political activities.”
This survey also showed that more people are using social networking sites (SNS)—the figure is now 47% of the entire adult population, compared with 26% that was measured in our similar 2008 survey. Among other things, this means the average age of adult-SNS users has shifted from 33 in 2008 to 38 in 2010. Over half of all adult SNS users are now over the age of 35.
“We also found interesting variation in the characteristics of users across different social networking sites. People pick the platforms which best meet their social and professional needs,” noted Annenberg doctoral student Lauren Sessions Goulet, co-author of the report. For instance, the report found:
• Nearly twice as many men (63%) as women (37%) use LinkedIn.
• The average adult MySpace user is younger (32), and the average adult LinkedIn user older (40), than the average Facebook user (38), Twitter user (33), and users of other SNS (35).
• MySpace and Twitter users are the most racially diverse mainstream social network platforms.
• MySpace users tend to have fewer years of formal education.
The authors also found that social networking sites are increasingly used to keep up with close social ties and MySpace users are more likely to be open to opposing points of view.