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Background: Steaming hay significantly reduces respirable particles and provides a palatable alternative to dry hay for horses with asthma, but there are few prospective studies demonstrating the clinical efficacy of steamed hay., Objectives: To compare the efficacy of alfalfa pellets and steamed hay in improving lung function and inflammation of horses with severe asthma (SEA)., Study Design: Controlled crossover study., Methods: Ten horses with SEA were enrolled and nine completed the study. Horses were housed indoors and fed hay. Once in exacerbation, they were fed pellets and steamed hay for 4 weeks, in a crossover design. Weighted clinical scores and lung function were recorded weekly. Bronchoalveolar lavage fluid (BALF) cytology and mucus scores were recorded before and after each diet., Results: Based on linear mixed model (LMM) analysis, weighted clinical scores significantly improved over time (p < 0.001, no diet effect or time-diet interactions). With pellets, weighted clinical scores decreased from (median (interquartile range)) 13 (5.5) to 2 (1.5), while with steamed hay, they decreased from 10 (9.5) to 6 (8.5). With pellets, lung resistance decreased significantly from a baseline of (mean (SD)) 2.62 (0.77) cmH 2 O/L/s to 1.17 (0.66), 0.79 (0.54), 0.70 (0.20), 0.62 (0.18) on Weeks 1-4, respectively (LMM with post hoc tests, p < 0.001). With steamed hay, the resistance decreased significantly from a baseline of 2.34 (0.93) cmH 2 O/L/s to 1.38 (0.49) and 1.51 (0.66) on Weeks 1 and 2, respectively (p < 0.03). Neutrophils BALF decreased significantly with both diets (pellets: 40.2 (24.4) to 20.1 (11.0) %; steamed hay 30.9 (20.2) to 25.7 (17.6) %; LMM, p = 0.006)., Main Limitations: A small number of horses in a research setting. Dust was not measured in the stalls., Conclusions: Clinical scores, lung function and BALF inflammation of horses with SEA improved with steamed hay and pellets, but the effect on lung function was more pronounced with pellets., (© 2024 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.)

Background: The care model for supporting elderly people living independently at home relies on the informal and formal assistance of caregivers. Information and communication technology (ICT) offers new approaches for informal care services for this group., Methods: A longitudinal observational pilot study was carried out in home services in France. Employees of the ADMR home services followed 130 elderly people living at home and who were no more than moderately impaired. A single visual analogue scale (VAS) was used on a smartphone to assess global health every time a person was visited. An alert system was devised to inform the elderly person and/or a responsible person of any deterioration in health status. All medical and social events were recorded throughout the 9-month study., Results: 138 people were enrolled and 106 were evaluated. 37 alerts were observed. 21 were confirmed and 16 were false positives. Only employees untrained in the use of the system generated false positive alerts. Six severe medical alerts were observed, including one cancer undetected by the physician, one hospitalization for diabetes, one hospitalization which led to death 6 months later and one hospitalization which resulted in follow-up care., Conclusions: Social workers can participate in the health system with all the ethical criteria of medicine. To our knowledge, this is the first ICT-based alert system that has been found to produce severe medical alerts by employees of home services., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Dialysis patients frequently have anxiety and sleeping disorders and that explains a benzodiazepine treatment. A significant proportion of dialysis patients are long-term users even though it is not recommended to take benzodiazepine for more than 3 months. Risks of such a use are well identified. Nephrologists frequently have to prescribe benzodiazepines. This prescription is complex and there are few studies regarding the factors of benzodiazepine use among this population., Objectives: To determine the prevalence and the factors related to a long-term benzodiazepine use by dialysis patients. To determine the prevalence and the motivation of patients to stop taking medication among the long-term users who got information about the risk of such a use., Method: The study includes 91 dialysis chronic patients. Their characteristics were collected from medical records and interviews with the patients., Results: The average age of patients is 65,8 years. In all, 50.5% take benzodiazepines. Among benzodiazepine users, the prevalence of long-term use is 78.3%. Long-term benzodiazepine users (a) are older, (b) less active, (c) frequently diabetic, (d) depressive, (e) unable to walk, (f) less often registered on the kidney transplant waiting list, and (g) had less kidney transplant previously. Benzodiazepine doses of long-term users were higher than the doses of short-term users. Moreover, 60% of patients who are chronic users want to take action and stop the treatment. Observation of side effects, impression of ineffectiveness and fear of addiction are the most identified motivation to stop treatment., Conclusion: The prevalence of benzodiazepine chronic use by dialysis patients is high. Giving information to the patient about the use of these molecules seems to have a positive impact on the decision to stop., (Copyright © 2015 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.)