‘of the veteinary colleges into schools ‘of medicine? Having seen the care and attention given by vets to. animal tiving birth, Te no doubt that some ‘Would make excelent obeteticians eterna tes Oymges Hose, Mergen Corre Beterragh Sea oh Lik Another sniffer dog for the clinic? ‘Sic_Willams and Pembroke’ reported 4 patent whose dog constant sniffed t's mole on her leg. On one occasion, the dog even tried to bite the lesion off ‘Although the patent was not concerned About the lesion, the constant tention from the dog prompted her to seck redial advice. The lesion was excled and histology showed the lesion to bea malignant melanome measuring 1-86 mm in thickness. Since chat time the patent har remained well, with no ‘ga of reeurence "We report a man aged 86 years, who developed a patch of eczema on the ‘outer ide of hit Tet thigh Ie grew slowly, over 18 yeas, to about 1-2 em ig dametr, When dy, the lesa would become scabby, and it caused fceasional itching. I was treated wits several topeal agents, including steroids ‘dancing, without effec ‘A pet labrador called Parker came the home in 1994, About 2 year ago, the dog began to persistently push hit ose against his owner's woser leg, Snuifing’ the lesion beneath it This prompted the patent co return t» hie family physician for’ review. Tn September, 2000, the lesion wat excised, Histological assessment of the lesion showed i 0 be a. bara cell carcinoma that bad been fully excited. ‘Since excision of the lesion, Packer hat town ne further interest inthe are, ‘With these wo patients, the dogs could smell the lesions through Clothing, and showed no frther interest ‘once the lesions hed been eteted, The combination of pets contributing to preventing morbidity and possible ronalty, in their owners hat predictably genersted much media Haung seen Williams and Pembroke's report, Comets, ¢ dermatologist in Florida, USA, texmed up vith 2 reired policedog handler with 33 years” experience in taining dogs, including. service in Vietnam, leading the K9 bomb unit, They ted conventional snilferdog techniguct {0 tain George, a schnauzer, to recognise io malignant melanoma samples Consequently George was introduced to patient with several moles thought to be cancerice. However one mole ‘caused George to go crazy, and excision fof the lesion confirmed early malignant disease, ‘Aitsowgh all these data ave anecdotal, we believe chat the Phenomenon of some doge seeming ble to detect unique odors of certain ‘kin cancers worthy of ivertgaton ia Figorously controled experiments, Whether” they can detect odours associated with other speciic diseases toch as tuberculos or bola virus Should also be investigated to aid cay detection ‘John Church, Hywel ams SISAL UC ca dees ete ornare 2 Jee D.Amaang dog at a ut Sinct Dob Mad OPE Ape 3:95 Standard methods to measure HIV drug concentrations Su—The management of HIV infection is complex and dependent on several factore for a ccersfl clinical utcome, An incressig timber of fudies have identified relations between plasms concentrations and antiviral response or toxic eifees for the HIV-1 proteate inhibitors and the onvaucleoside reverse transcriptase inhibiters."" Consequently, there has been mich incerest in che wee of sssersment of drug concentrations of {hese agents in elinieal practice a the hope of capitaising on this increased interest, many laboratories have expanded their services to inclade mearurement of drug concentrations, falling it therapeutic drug monitoring testing (TDM). However, the use of TDM is limited by a lack of standard assay methods, with resultant wide between-laboratonyvacabiiy ‘A survey of 17 laboratories in the USA and Hurope revealed that only two Jabs accurately reported drug concentrations of ix diferent protense inhibitors and non-aveleoside reverse Uuanseriptase inhibiters within 20% of the ‘rue Value, and one laborstory correctly reported only 38% of the Samples assayed? Tn addition, data suggest diferent drug concentations ‘when serum or plasma is sampled, and Aegradation of sored frozen plasma Sampler over "time Additional Variability may also occur fom dif ferences in sample shipment, pro- cessing, ond drug standards used in the If clinicians elect to ute TDM for the clinical care of their HIV-I- infected patente, the concentrations they reeeve, and the subsequent inter pretation of the data, will oly be as ood as the quality of the laboratory Processing the samples, Standar Uirston of laboratory. methods for ‘TDM between laboratories, as well st for sampling and storage, ave urgently needed. Until these. policies are developed, cliniciene should earefally assess a laboratory for the following factors: what ype of qualty-assusance for quality-contol. programmes docs that laboratory use; and docs the Iaboratory validate “their asaya ceemally before making “them commercially avalable (eg, do they partcipate in between-laboratory Yanabilty sdies? If posible, do they Ik pharmaceutical manufacturers 10 Assist in validating their assays?) ‘Any Jnboratory that does not do these functions should be viewed with ceution, We are not in opposition to the widespread svalabilty of TDM for [HIV drugs, but we are concerned that Timited data are available to guide clinicians about the appropriate procesing, storage, analfsis, and Ierpretation of these” data, which could ultimately lead to inappropriate ‘linia! deeisin making. anarew D Luter, Concepta Merry etc Neestn Jonesy Shout eden Chey 1 hg C¥ Kate, Ander Gb) mid O70, we ee {0 Dopam nd sene vo ‘Siz sd meg Suan 2 bug Dat ger PHL Deve oetag (EDM ofan NEV) Fuca Papo ek + Aamoewe Regs (00) pros for theropetie eve ‘Soles Cron i cea Ey Ss See ae pestle ABS 000 Gort 930