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IN BRIEF Nonalcoholic fatty liver disease (NAFLD) is an increasingly recognized and common cause of chronic liver disease worldwide. Although most patients with NAFLD are obese, a smaller group of NAFLD patients are lean. This study explored the long-term outcomes of lean patients with NAFLD in the United States. Compared to lean individuals without NAFLD, lean people with NAFLD were significantly more likely to be older and male and had higher comorbidities (i.e., diabetes, hyperlipidemia, hypertension, metabolic syndrome, chronic kidney disease, and cardiovascular disease). The presence of NAFLD in lean individuals was independently associated with increased risk of all-cause and cardiovascular mortality.

Background Flea infestations remain a major issue in veterinary medicine. Highly effective flea control for dogs and cats remains the foundation for eliminating infestations from homes and improving skin conditions associated with flea-feeding. Methods Homes with pet cats were screened by flea-history questionnaire. Qualifying homes were subselected into “high” (≥ 5 fleas on ≥ 1 cat, and ≥ 5 fleas collected in environmental flea traps over a 16–24 h period), “low” (< 5 fleas on all cats, < 5 in traps), and “no” homes (no evidence of fleas on cats or traps). All cats and dogs in a household were treated with a lotilaner oral tablet (Credelio ® CAT and Credelio ® , respectively) in weeks 0, 4, and 8. On-animal and trap counts were performed for: “high” at weeks 0, 1, 2, 4, 6, 8, and 11–12; “low” at week 0 and at approximately 2-week intervals through week 11–12; and “no” only at week 0. During each visit, one owner completed a pruritus assessment (PVAS) and a veterinary dermatologist assessed dermatologic lesions using the feline allergic dermatitis (SCORFAD) scale. Results A total of 46 homes met inclusion criteria and completed the study: 19 “high” (35 cats); 17 “low” (27); and 10 “no” (14). By week 1, relative to pretreatment, there was a 99.3% reduction in flea counts on “high” cats, with 31 of 34 cats (91.2%) flea-free. By week 11–12, flea counts across all study cats and traps were zero. Prior to the first treatment, mean PVAS scores were: “high” 6.6; “low” 5.5; and “no” 1.9. By week 1 there was a significant decrease in mean PVAS score of cats from “high” homes to 2.9 ( P  < 0.0001), and mean week 11–12 scores were 0.5 and 0.8 for “high” and “low” homes, respectively. For SCORFAD, by week 11–12, relative to week 0, there was a significant decline in mean scores of cats from both “high” (8.0 to 1.7) ( P  < 0.0001) and “low” homes (3.3 to 0.9) ( P  < 0.0001). Conclusions Lotilaner was 100% efficacious in eliminating flea infestations from animals and their homes. The monthly lotilaner treatments of cats and dogs in flea-infested homes resulted in clinical resolution of pruritus and dermatologic lesions. Graphical abstract

Background The speed with which acaricides paralyze and kill ticks is relevant to impeding pathogen transmission. The objective of this study was to assess early-onset lotilaner effects on the motility and weights of Amblyomma americanum ticks collected from treated dogs. Methods Twelve healthy dogs were randomized between two groups to receive either lotilaner (Credelio ® ) on Day 0 or to be sham treated. On Day 7, 25 male and 25 female A. americanum were placed under bandages, two on each flank of each dog. After 30 or 45 min, all unattached ticks were removed and T  = 0 was set. At T  = 2, 4, 8 and 24 h post attachment, 5 attached ticks removed from each bandage on each dog were weighed, assessed by blinded observers for righting ability and movement recorded. Results After the infestation period significantly fewer treated than control dogs had 20 ticks attached (50.0% versus 91.7%, P  = 0.0015). At 24 h post attachment, mean weights of ticks from treated dogs (males 1.69 mg; females 2.72) were significantly less than ticks from controls (males 2.66 mg; females 4.67) ( P male  = 0.0002; P female  < 0.0001). Mean tick weights from the treated group were significantly lower at 24 h than at earlier time points ( P male  < 0.0307; P female  = 0.0021). At 4 and 8 h, significantly fewer ticks from treated (14.3%, 0.0%, respectively) than from control dogs could right (73.3%, 70.0%) ( P 4h  < 0.0001; P 8h  = 0.0024) (at 24 h, all ticks from treated dogs were dead), and distance moved was significantly less at all time points ( P 2h  = 0.0413; P 4h , P 8h  < 0.0001). Mean and maximum velocity of ticks from treated dogs were significantly lower, relative to controls, at 4 and 8 h ( P  ≤ 0.0001). Within the treated group, collected ticks had significantly lower mean and maximum velocities at 4 and 8 h compared to 2 h ( P mean  < 0.0042; P max  < 0.0194). Conclusion The observed changes indicate that lotilaner may disrupt tick attachment. In ticks that attached, a progressive impairment of neuromuscular processes began within 2 h. Those irreversible changes could substantially reduce the risk of pathogen transmission from tick to host. Graphical Abstract

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