Clinical reasoning in feline vestibular syndrome: which presenting features are the most important?

2020 ◽  
pp. 1098612X2097086
Author(s):  
Nicholas J Grapes ◽  
Frances E Taylor-Brown ◽  
Holger A Volk ◽  
Steven De Decker
Keyword(s):  
Middle Ear ◽  
Clinical Reasoning ◽  
Thiamine Deficiency ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Binary Logistic Regression ◽  
Clinical Progression ◽  
Feline Infectious Peritonitis ◽  
Clinical Variables ◽  
Regression Modelling

Objectives The aim of this study was to evaluate whether clinical variables from the history, clinical presentation, and physical and neurological examinations of cats with vestibular syndrome were statistically predictive of the underlying diagnosis. Methods In total, 174 cats presenting with vestibular syndrome between January 2010 and May 2019 were investigated. Univariate statistical analysis of clinical variables was performed and those statistically associated with a diagnosis were retained for multivariable binary logistic regression modelling. Results The seven most prevalent diagnoses represented 95% of vestibular presentations, which included: otitis media/interna (n = 48), idiopathic vestibular syndrome (n = 39), intracranial neoplasia (n = 24), middle ear polyp (n = 17), feline infectious peritonitis (n = 13), thiamine deficiency (n = 13) and intracranial empyema (n = 11). Idiopathic vestibular syndrome was commonly associated with non-purebred cats and had 17.8 times the odds of an improving clinical progression (95% confidence interval [CI] 1.3–250.0; P = 0.03). Intracranial neoplasia was associated with older age and chronic onset of clinical signs, and was significantly more likely to have a central vestibular neuroanatomical localisation (95% CI 8.5–344349142.0; P = 0.015) with postural deficits on neurological examination. Thiamine deficiency was more common in female cats, with 52.6 times the odds of a waxing and waning clinical progression (95% CI 1.2–1000; P = 0.038) and 6.8 times the odds of presenting with bilateral vestibular signs (95% CI 1.0–45.7; P = 0.047) and wide excursions of the head (95% CI 1.0–45.7; P = 0.047). Middle ear polyps were associated with 8.8 times the odds of presenting with Horner syndrome (95% CI 1.5–50.0; P = 0.015). Conclusions and relevance Although it may be difficult to identify the underlying diagnosis in cats with vestibular syndrome from the presenting features alone, there are instances in which discrete clinical features may help to guide clinical reasoning when evaluating cats with vestibular presentations.

Surgical management of choke through oesophagotomy in a buffalo: A case report

2017 ◽  
Vol 12 (3) ◽  
Author(s):  
Devasee Borakhatariya ◽  
A. B. Gadara
Keyword(s):  
Case Report ◽  
Surgical Management ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Thoracic Inlet ◽  
Cervical Oesophagus ◽  
Foreign Objects ◽  
History Of ◽  
Oesophageal Obstruction ◽  
Large Animals

Oesophageal disorders are relatively uncommon in large animals. Oesophageal obstruction is the most frequently encountered clinical presentation in bovine and it may be intraluminal or extra luminal (Haven, 1990). Intraluminal obstruction or “choke” is the most common abnormality that usually occurs when foreign objects, large feedstuff, medicated boluses, trichobezoars, or oesophageal granuloma lodge in the lumen of the oesophagus. Oesophageal obstructions in bovine commonly occur at the pharynx, the cranial aspect of the cervical oesophagus, the thoracic inlet, or the base of the heart (Choudhary et al., 2010). Diagnosis of such problem depends on the history of eating particular foodstuff and clinical signs as bloat, tenesmus, retching, and salivation

scholarly journals A novel de novo DDX3X missense variant in a female with brachycephaly and intellectual disability: a case report

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Giada Moresco ◽  
Jole Costanza ◽  
Carlo Santaniello ◽  
Ornella Rondinone ◽  
Federico Grilli ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Clinical Presentation ◽  
De Novo ◽  
Clinical Signs ◽  
Missense Variant ◽  
Psychomotor Development ◽  
Helicase Domain ◽  
Protein Activity ◽  
Mrna Metabolism ◽  
Pathogenic Variants

Abstract Background De novo pathogenic variants in the DDX3X gene are reported to account for 1–3% of unexplained intellectual disability (ID) in females, leading to the rare disease known as DDX3X syndrome (MRXSSB, OMIM #300958). Besides ID, these patients manifest a variable clinical presentation, which includes neurological and behavioral defects, and abnormal brain MRIs. Case presentation We report a 10-year-old girl affected by delayed psychomotor development, delayed myelination, and polymicrogyria (PMG). We identified a novel de novo missense mutation in the DDX3X gene (c.625C > G) by whole exome sequencing (WES). The DDX3X gene encodes a DEAD-box ATP-dependent RNA-helicase broadly implicated in gene expression through regulation of mRNA metabolism. The identified mutation is located just upstream the helicase domain and is suggested to impair the protein activity, thus resulting in the altered translation of DDX3X-dependent mRNAs. The proband, presenting with the typical PMG phenotype related to the syndrome, does not show other clinical signs frequently reported in presence of missense DDX3X mutations that are associated with a most severe clinical presentation. In addition, she has brachycephaly, never described in female DDX3X patients, and macroglossia, that has never been associated with the syndrome. Conclusions This case expands the knowledge of DDX3X pathogenic variants and the associated DDX3X syndrome phenotypic spectrum.

scholarly journals Animal Coronavirus Diseases: Parallels with COVID-19 in Humans

Viruses ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1507
Author(s):  
Chao-Nan Lin ◽  
Kuan Rong Chan ◽  
Eng Eong Ooi ◽  
Ming-Tang Chiou ◽  
Minh Hoang ◽  
...  
Keyword(s):  
Genome Organization ◽  
Clinical Signs ◽  
Feline Infectious Peritonitis ◽  
Viral Shedding ◽  
Related Disease ◽  
The Past ◽  
Treatment And Prevention ◽  
Historical Archives ◽  
Huge Impact ◽  
Novel Coronavirus

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus in humans, has expanded globally over the past year. COVID-19 remains an important subject of intensive research owing to its huge impact on economic and public health globally. Based on historical archives, the first coronavirus-related disease recorded was possibly animal-related, a case of feline infectious peritonitis described as early as 1912. Despite over a century of documented coronaviruses in animals, the global animal industry still suffers from outbreaks. Knowledge and experience handling animal coronaviruses provide a valuable tool to complement our understanding of the ongoing COVID-19 pandemic. In this review, we present an overview of coronaviruses, clinical signs, COVID-19 in animals, genome organization and recombination, immunopathogenesis, transmission, viral shedding, diagnosis, treatment, and prevention. By drawing parallels between COVID-19 in animals and humans, we provide perspectives on the pathophysiological mechanisms by which coronaviruses cause diseases in both animals and humans, providing a critical basis for the development of effective vaccines and therapeutics against these deadly viruses.

Haematogenous osteomyelitis: clinical presentation and outcome in three dogs

2011 ◽  
Vol 24 (02) ◽  
pp. 146-150 ◽  
Author(s):  
M. Rabillard ◽  
L. Souchu ◽  
G. W. Niebauer ◽  
O. Gauthier
Keyword(s):  
Clinical Presentation ◽  
Clinical Signs ◽  
Pelvic Abscess ◽  
Sensitivity Testing ◽  
Diagnostic Investigation ◽  
Pathological Fractures ◽  
Surgical Biopsy ◽  
Biopsy Specimens ◽  
Haematogenous Osteomyelitis

SummaryHaematogenous osteomyelitis is a rare form of bone infection in adult dogs. Most commonly the infection is iatrogenic or traumatic in origin. The authors report three different presentations of haematogenous osteomyelitis: a focal pelvic localisation in a growing dog, a vertebral lesion in an adult dog with associated neurological signs and a multifocal affection in another adult dog with concomitant pathological fractures.Clinical signs included pyrexia of undetermined origin, focal pain and lameness. Diagnostic investigation included radiographic imaging, bone scintigraphy, magnetic resonance imaging, surgical biopsy, and bacteriological culture with sensitivity testing of biopsy specimens as well as of peripheral blood samples. Treatment consisted of long-term antimicrobial therapy and surgical debridement with curettage of the pelvic abscess of the young dog and decompressive hemilaminectomy of the second dog, with excellent recovery. The dog affected by polyostotic bone involvement and suffering pathological fractures was euthanatized.Haematogenous osteomyelitis may be a diagnostic and therapeutic challenge and may present as a devastating skeletal condition, even in adult dogs, and should be considered amongst the differential diagnoses early on to allow effective treatment.

Computed tomographic findings in 205 dogs with clinical signs compatible with middle ear disease: a retrospective study

2017 ◽  
Vol 29 (1) ◽  
pp. 45-e20 ◽  
Author(s):  
Audrey Belmudes ◽  
Charline Pressanti ◽  
Paul Y. Barthez ◽  
Eloy Castilla-Castaño ◽  
Lionel Fabries ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Middle Ear ◽  
Clinical Signs ◽  
Computed Tomographic ◽  
Middle Ear Disease

scholarly journals Acute Kidney Injury and Acute Liver Failure in Leptospira Infection and Weil’s Syndrome

2020 ◽  
Vol 4 (2) ◽  
pp. 21-28
Author(s):  
Jonathan S Chávez-Iñiguez ◽  
Jose Said Cabrera-Aguilar ◽  
Guillermo Garcia-Garcia ◽  
Juan Armendáriz-Borunda
Keyword(s):  
Acute Kidney Injury ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Kidney Injury ◽  
Organ Damage ◽  
Multiple Organ ◽  
Serological Tests ◽  
Microbiological Criteria ◽  
Sanitary Conditions ◽  
The Impact

Leptospirosis is considered a zoonosis acquired predominantly from contaminated surfaces and water, more commonly in emerging countries with limited sanitary conditions. Leptospira in the host unleashes an immune response that explains the symptoms and clinical signs; once it reaches the kidney and liver tissue, it can manifest with alterations that lead to acute and chronic diseases in both organs. Weil’s syndrome is the best known clinical manifestation with jaundice and acute kidney injury that could lead to multiple organ failure and death. For its diagnosis, there are simplified scores such as the SPiRO score, the microbiological criteria by microscopy or serological tests; the treatment focuses on antibiotics and, if necessary, provides organic support until the infection is curtailed. The purpose of this review was to address the impact of Lep-tospira infection on the kidney and liver, the mechanisms of organ damage, the clinical presentation, and diagnosis and management of this disease.

scholarly journals Proposal of an Algorithm to Early Detect Attenuated Type I Mucopolysaccharidosis (MPS Ia) among Children with Growth Abnormalities

Medicina ◽  
2022 ◽  
Vol 58 (1) ◽  
pp. 97
Author(s):  
Federico Baronio ◽  
Stefano Zucchini ◽  
Francesco Zulian ◽  
Mariacarolina Salerno ◽  
Rossella Parini ◽  
...  
Keyword(s):  
Short Stature ◽  
Metabolic Disorders ◽  
Clinical Presentation ◽  
Diagnostic Delay ◽  
Clinical Signs ◽  
Clinical Approach ◽  
Type I ◽  
Mucopolysaccharidosis Type I ◽  
Stunted Growth ◽  
Growth Abnormalities

Background and Objectives: Diagnostic delay is common in attenuated Mucopolysaccharidosis Type I (MPS Ia) due to the rarity of the disease and the variability of clinical presentation. Short stature and impaired growth velocity are frequent findings in MPS Ia, but they rarely raise suspicion as paediatric endocrinologists are generally poorly trained to detect earlier and milder clinical signs of this condition. Materials and Methods: Following a consensus-based methodology, a multidisciplinary panel including paediatric endocrinologists, paediatricians with expertise in metabolic disorders, radiologists, and rheumatologists shared their experience on a possible clinical approach to the diagnosis of MPS Ia in children with short stature or stunted growth. Results: The result was the formation of an algorithm that illustrates how to raise the suspicion of MPS Ia in a patient older than 5 years with short stature and suggestive clinical signs. Conclusion: The proposed algorithm may represent a useful tool to improve the awareness of paediatric endocrinologists and reduce the diagnostic delay for patients with MPS Ia.

scholarly journals Study of haematological, biochemical profile and clinical presentation in dengue positive patients: 82 cases

2018 ◽  
Vol 6 (6) ◽  
pp. 2099
Author(s):  
Mubin I. Patel ◽  
Abhishek Patel ◽  
Avani Patel ◽  
Sharmistha Patel ◽  
Suresh Padsala
Keyword(s):  
Dengue Fever ◽  
Clinical Presentation ◽  
Liver Enzymes ◽  
Neglected Tropical Diseases ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Biochemical Profile ◽  
Igg Antibody ◽  
Aedes Mosquitoes ◽  
Clinical Signs And Symptoms

Background: Dengue Fever (DF) is a self-limiting disease caused by arbovirus and transmitted by Aedes mosquitoes (Aedes aegypti and Aedes albopictus). It is one of the 17 neglected tropical diseases by WHO. Diagnosis of dengue depends mainly on the detection of IgM and IgG antibody, and NS1 antigen.Methods: The study was carried out in Department of Pathology, affiliated with a government hospital. It includes 82 dengue patients, admitted from August 2015 to August 2016. Haematological, biochemical profile, clinical signs and symptoms were recorded. The Tourniquet test was performed in all the patients on admission. Grading of dengue: DF/DHFI/DHFII/DHFIII/DHFIV. Grade III and IV were collectively called as Dengue Shock Syndrome.Results: Total 82 Dengue positive cases were studied, 52 (63%) were males and 30 (37%) were females. 24 (29%) patients were recorded in September 22 (27%) in October 19 (23%) in August. 12 (14.60%) had positive tourniquet test. Thrombocytopenia was present in 86.5 % patients. Majority cases were of classical dengue fever 51 (62.20%), 14 (17.07%) were of DHF I, 12 (14.63%) were of DHF II, 3 (3.66%) were of DHF III and 2 (2.44%) were of DHF IV.Conclusions: It is very important to correlate clinical examination with haematological and biochemical profile in dengue patients. Hematocrit value, leucopenia, thrombocytopenia, raised liver enzymes is very important to monitor dengue cases in their initial stages and thus facilitate early treatment. This would minimize morbidity and mortality arising out of serious complications of dengue fever.

EP.TU.533A rare clinical presentation of Goblet Cell Adenocarcinoma of the appendix: Recommendations for safe & effective management

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ganeshan Ramsamy ◽  
Zoe Slack ◽  
Giovanni Tebala
Keyword(s):  
Small Bowel ◽  
Goblet Cell ◽  
Clinical Presentation ◽  
Histopathological Examination ◽  
Clinical Signs ◽  
Operative Management ◽  
Small Bowel Resection ◽  
Right Hemicolectomy ◽  
Bowel Ischaemia ◽  
Operative Recovery

Abstract Background Goblet cell carcinoma (GCC) is a rare mixed neoplasm arising from the appendix, consisting of glandular and neuroendocrine tissue. It typically presents in adults with a mean age of 55-65 years old. Diagnosis is usually incidental via histopathological examination after 0.3% to 0.9% of all appendicectomies. Literature remains sparse on classification and prognosis of GCC, and cases documented in younger patients. Aims To highlight an interesting clinical presentation and intra- and post-operative management of GCC. To increase awareness for future practice when managing patients with GCC. Methods A 37 year-old male presented with left sided abdominal pain, constipation and fresh rectal bleeding. Computed Tomography demonstrated extensive SMV thrombus causing small bowel ischaemia. On the Intensive Care Unit, he underwent thrombolysis through a Transjugular Intrahepatic Porto-Systemic Shunt. A few days later, he developed bowel obstruction, necessitating a small bowel resection secondary to an ischaemic stricture. 9 months later, he presented with clinical signs of appendicitis. After an uneventful appendicectomy, he was diagnosed with GCC upon histopathological examination of the specimen. Results The patient made an uneventful post-operative recovery. A multidisciplinary team (MDT) decision was made to perform a completion right hemicolectomy, with histology confirming pT3N1M0 GCC. Adjuvant chemotherapy with 5-Fluorouracil was started. Conclusion This case highlights GCC with a preceding clinical course not yet published in the literature. It stresses the importance of the MDT in managing GCC. Although primarily diagnosed histologically, a clinical suspicion of GCC of the appendix is worth considering in pro-thrombotic patients.

Clinical presentation of pulmonary hypertension

ESC CardioMed ◽  
2018 ◽  
pp. 2495-2497
Author(s):  
Marion Delcroix
Keyword(s):  
Pulmonary Hypertension ◽  
Congenital Heart ◽  
Clinical Presentation ◽  
Heart Diseases ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Right Heart Failure ◽  
Clinical Feature ◽  
Associated Conditions

No clinical feature is pathognomonic for pulmonary hypertension. Signs and symptoms are quite unspecific and can be observed in other lung or heart diseases. This explains why the diagnosis is usually late. Dyspnoea, fatigue, syncope, and angina are the most frequent symptoms. Late in the disease course, signs of right heart failure may also appear, such as hepatomegaly, peripheral oedema, and jugular distension. The clinical presentation is also influenced by the associated conditions, with signs suggestive for systemic sclerosis, portal hypertension, or congenital heart disease. Evaluation of the clinical signs is an important part of patient risk stratification at diagnosis and in the follow-up of patients with pulmonary hypertension.

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