The MRSA was transmitted among members of a wrestling team. Infection with MRSA should be suspected in outbreaks of boils that are nonresponsive to standard antibiotic therapy among healthy participants of contact sports and their close contacts.

Free-roaming dogs and rabies transmission are integrally linked across many low-income countries, and large unmanaged dog populations can be daunting to rabies control program planners. Dog population management (DPM) is a multifaceted concept that aims to improve the health and well-being of free-roaming dogs, reduce problems they may cause, and may also aim to reduce dog population size. In theory, DPM can facilitate more effective rabies control. Community engagement focused on promoting responsible dog ownership and better veterinary care could improve the health of individual animals and dog vaccination coverage, thus reducing rabies transmission. Humane DPM tools, such as sterilization, could theoretically reduce dog population turnover and size, allowing rabies vaccination coverage to be maintained more easily. However, it is important to understand local dog populations and community attitudes toward them in order to determine whether and how DPM might contribute to rabies control and which DPM tools would be most successful. In practice, there is very limited evidence of DPM tools achieving reductions in the size or turnover of dog populations in canine rabies-endemic areas. Different DPM tools are frequently used together and combined with rabies vaccinations, but full impact assessments of DPM programs are not usually available, and therefore, evaluation of tools is difficult. Surgical sterilization is the most frequently documented tool and has successfully reduced dog population size and turnover in a few low-income settings. However, DPM programs are mostly conducted in urban settings and are usually not government funded, raising concerns about their applicability in rural settings and sustainability over time. Technical demands, costs, and the time necessary to achieve population-level impacts are major barriers. Given their potential value, we urgently need more evidence of the effectiveness of DPM tools in the context of canine rabies control. Cheaper, less labor-intensive tools for dog sterilization will be extremely valuable in realizing the potential benefits of reduced population turnover and size. No one DPM tool will fit all situations, but if DPM objectives are achieved dog populations may be stabilized or even reduced, facilitating higher dog vaccination coverages that will benefit rabies elimination efforts.

OBJECTIVE -To evaluate the performance, in settings typical of opportunistic and community screening programs, of screening tests currently recommended by the American Diabetes Association (ADA) for detecting undiagnosed diabetes.RESEARCH DESIGN AND METHODS -Volunteers aged Ն20 years without previously diagnosed diabetes (n ϭ 1,471) completed a brief questionnaire and underwent recording of postprandial time and measurement of capillary blood glucose (CBG) with a portable sensor. Participants subsequently underwent a 75-g oral glucose tolerance test; fasting serum glucose (FSG) and 2-h postload serum glucose (2-h SG) concentrations were measured. The screening tests we studied included the ADA risk assessment questionnaire, the recommended CBG cut point of 140 mg/dl, and an alternative CBG cut point of 120 mg/dl. Each screening test was evaluated against several diagnostic criteria for diabetes (FSG Ն126 mg/dl, 2-h SG Ն200 mg/dl, or either) and dysglycemia (FSG Ն110 mg/dl, 2-h SG Ն140 mg/dl, or either).RESULTS -Among all participants, 10.7% had undiagnosed diabetes (FSG Ն126 or 2-h SG Ն200 mg/dl), 52.1% had a positive result on the questionnaire, 9.5% had CBG Ն140 mg/dl, and 18.4% had CBG Ն120 mg/dl. The questionnaire was 72-78% sensitive and 50 -51% specific for the three diabetes diagnostic criteria; CBG Ն140 mg/dl was 56 -65% sensitive and 95-96% specific, and CBG Ն120 mg/dl was 75-84% sensitive and 86 -90% specific. CBG Ն120 mg/dl was 44 -62% sensitive and 89 -90% specific for dysglycemia. CONCLUSIONS -Low specificity may limit the usefulness of the ADA questionnaire. Lowering the cut point for a casual CBG test (e.g., to 120 mg/dl) may improve sensitivity and still provide adequate specificity.

Objectives To describe therapeutic antibiotic use patterns in dogs at a small animal teaching hospital. Methods A retrospective case analysis of randomly sampled antibiotic prescriptions in dogs from May 20, 2008 – May 20, 2009, deemed to be for therapeutic use, was performed. Records were reviewed to determine if there was documentation of confirmed, suspected or no evidence of infection. The five most frequently prescribed antibiotics were identified and analyzed for their distribution in these categories. Results In 17% of therapeutic antibiotic prescriptions there was confirmed infection, in 45% suspected infection, and in 38% there was no documented evidence of infection. Amoxicillin-clavulanate was the most frequently prescribed antibiotic, followed by cefazolin/cephalexin, enrofloxacin, ampicillin/amoxicillin and doxycycline. Doxycycline was the most frequently prescribed with no documented evidence of infection, and amoxicillin-clavulanate was the most frequently prescribed with either confirmed or suspected evidence of infection. Discussion Clinicians use a variety of tools when deciding whether or not to prescribe an antibiotic and which antibiotic to use. As in human medicine, there is likely overuse and inappropriate use of antibiotics in veterinary medicine. Veterinarians should engage in discussions regarding clinically applicable guidelines for appropriate antibiotic use.