Comparison of a continuous indwelling glucometer with a point-of-care device in healthy adult horses.

Background: Blood glucose is tightly regulated in horses; however, since hypoglycaemia and hyperglycaemia are associated with poor prognosis, close monitoring is warranted. This study aimed at evaluating a continuous indwelling glucometer (CIG) by comparing performance with a point-of-care glucometer (POC).

Methods: Ten horses were equipped with CIG and an intravenous catheter.

Evaluation of the inflammatory response to two intra-articular hyaluronic acid formulations in normal equine joints.

Intra-articular (IA) hyaluronic acid (HA) is commonly used to treat equine arthritis. Inflammatory response or "joint flare" is a recognized potential side effect. However, the incidence and severity of inflammation following IA HA injection in horses is not well documented.

Genetic epidemiology of sepsis and septic shock.

Sepsis affects more than 750,000 people each year in the United States alone, with a mortality rate of over 35% making it one of the leading causes of death in developed countries. Recent genetic analysis has provided us with several candidate genes, which have become the focus of genetic research in sepsis. The analysis of single nucleotide polymorphisms among various genes, such as those coding for pro- and antiinflammatory mediators, in the septic response has the potential to develop into prediction tools that will permit the clinician to more precisely determine the type of therapy that a particular patient should receive.

Pharmacoeconomic implications of new therapies in sepsis.

Severe sepsis is a major healthcare problem, characterised by a high incidence, mortality and cost. New breakthroughs in treatment are quite diverse, including: (i) more effective regimens for generic, inexpensive broad anti-inflammatory agents (corticosteroids); (ii) a recombinant protein (drotrecogin-alfa [activated]); and (iii) a protocol-based treatment approach (early goal-directed therapy). Economic analyses of new sepsis agents should adopt the societal perspective, which requires prolonging the time horizon beyond that currently typically studied in sepsis trials, so that patient-centred outcomes can be more fully captured.

What does it mean to be critically ill and elderly?

The number of critically ill elderly continues to rise, causing health care workers to be faced with decisions regarding aggressiveness of care, rationing of resources, and optimizing outcome. Although survival rates in the critically ill elderly may be lower than those in the younger critically ill, health care workers must focus on customizing treatment to optimize physiologic recovery, quality of life, and functional status. We advocate better research designs incorporating long-term outcomes and genetic predisposition as a means of improving care in the elderly critically ill.

Improving clinical trial design in acute lung injury.

If future trials of acute lung injury/acute respiratory distress syndrome are to be rigorous, informative, and successful, a number of key design issues need to be considered. First, appropriate sample size and entry criteria must be selected. The present definitions of acute lung injury/acute respiratory distress syndrome are arbitrary and select a broad, heterogeneous patient population in which treatment effects may often be small, requiring much larger sample sizes than those of previous trials.