scholarly journals The application of a new laminitis scoring method to model the rate and pattern of improvement from equine endocrinopathic laminitis in a clinical setting

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
A. Meier ◽  
J. McGree ◽  
R. Klee ◽  
J. Preuß ◽  
D. Reiche ◽  
...  
Keyword(s):  
Best Practice ◽  
Clinical Status ◽  
Clinical Signs ◽  
Scoring Method ◽  
Pain Medications ◽  
Exponential Decay Model ◽  
History Of ◽  
Consistent Method ◽  
Foot Disease ◽  
New Treatments

Abstract Background Endocrinopathic, or hyperinsulinaemia-associated laminitis (HAL) is a common and debilitating equine foot disease, and although no pharmacological treatments are registered, several are under development. To evaluate the effect of such treatments, an accurate and consistent method is needed to track the clinical signs of laminitis over time, and the natural history of the disease, in terms of a ‘normal’ pattern of improvement, needs to be understood. This study examined the improvement pattern in clinical cases of naturally-occurring HAL subjected to a range of best-practice interventions, using two different scoring methods. Eighty horses and ponies with suspected HAL were enrolled in a study conducted at 16 veterinary practices across Germany. The severity of laminitis was assessed by independent veterinarians using both the traditional Obel method and a modified Obel method developed by Meier and colleagues. Assessments were made on the day of diagnosis (d 0), then on days 4, 9, 14, 25 and 42 during the intervention period. Pain medications were withheld for 24 h prior to clinical examination in all cases. Results Time to marked improvement from laminitis varied between individuals, but was difficult to monitor accurately using the Obel method, with the median grade being 2/4 on days 0 and 4, then 0/4 from d 9 onwards. More subtle changes could be identified using the Meier method, however, and the median scores were seen to follow the form of an exponential decay model in most horses, improving from 8/12 on d 0, to 0/12 on d 25. Within this composite scoring method, considerable variation was observed in the rate of improvement of individual clinical signs, with the average time taken for each sign to reach a median score of 0 ranging from 4 days (foot lift and weight shifting) to 25 days (gait when turned in a circle) across all 80 horses. Conclusions The Meier method provides a reliable and consistent method for monitoring the clinical status of horses with HAL, and despite the variability, the pattern of improvement described here should provide a useful benchmark against which individual cases and new treatments can be assessed.

scholarly journals Dynamic reciprocal relationships between cognitive and functional declines along the Alzheimer’s disease continuum in the prospective COGICARE study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Sophie Carles ◽  
Bachirou O. Taddé ◽  
Claudine Berr ◽  
Catherine Helmer ◽  
Hélène Jacqmin-Gadda ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Cognitive Abilities ◽  
Daily Living ◽  
Preventive Measures ◽  
Clinical Status ◽  
Clinical Signs ◽  
Functional Dependency ◽  
History Of ◽  
Clinically Significant ◽  
Dynamic Causal Model

Abstract Background Thoroughly understanding the temporal associations between cognitive and functional dimensions along the dementia process is fundamental to define preventive measures likely to delay the disease’s onset. This work aimed to finely describe the trajectories of cognitive and functional declines, and assess their dynamic bidirectional relationships among subjects at different stages of the dementia process. Methods We leveraged extensive repeated data of cognition and functional dependency from the French prospective COGICARE study, designed to better characterize the natural history of cognitive and functional declines around dementia diagnosis. Cognition was measured by the Mini-Mental State Examination, the Isaacs Set Test for verbal fluency, the Benton Visual Retention Test for visuo-spatial memory, and Trail Making Test Part B for executive functioning. Functional dependency was measured by basic and instrumental activities of daily living. The study included 102 cognitively normal, 123 mildly cognitively impaired, and 72 dementia cases with a median of 5 repeated visits over up to 57 months. We used a dynamic causal model which addresses the two essential issues in temporal associations assessment: focusing on intra-individual change and accounting for time. Results Better cognitive abilities were associated with lower subsequent decline of the functional level among the three clinical stages with an intensification over time but no reciprocity of the association whatever the clinical status. Conclusion This work confirms that the progressive functional dependency could be induced by cognitive impairment. Subjects identified as early as possible with clinically significant cognitive impairments could benefit from preventive measures before the deterioration of activities of daily living and the appearance of dementia clinical signs.

Intraocular tuberculosis, a challenge in diagnosis and treatment

2020 ◽  
Vol 3 ◽  
pp. 4
Author(s):  
Martina Larroude ◽  
Gustavo Ariel Budmann
Keyword(s):  
Developing Countries ◽  
Clinical Signs ◽  
Steady Increase ◽  
Ocular Tuberculosis ◽  
Industrial Countries ◽  
Choroidal Granuloma ◽  
History Of ◽  
And Migration ◽  
Ocular Tb

Ocular tuberculosis (TB) is an extrapulmonary tuberculous condition and has variable manifestations. The incidence of TB is still high in developing countries, and a steady increase in new cases has been observed in industrial countries as a result of the growing number of immunodeficient patients and migration from developing countries. Choroidal granuloma is a rare and atypical location of TB. We present a case of a presumptive choroidal granuloma. This case exposes that diagnosis can be remarkably challenging when there is no history of pulmonary TB. The recognition of clinical signs of ocular TB is extremely important since it provides a clinical pathway toward tailored investigations and decision making for initiating anti-TB therapy and to ensure a close follow-up to detect the development of any complication.

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 When less is more: a daring conservative approach to postpneumonectomy oesophago-pleural fistula

2019 ◽  
Vol 30 (1) ◽  
pp. 146-148
Author(s):  
Lara Girelli ◽  
Elena Prisciandaro ◽  
Niccolò Filippi ◽  
Lorenzo Spaggiari
Keyword(s):  
Clinical Presentation ◽  
Clinical Status ◽  
High Morbidity ◽  
Conservative Approach ◽  
Chronic Fistula ◽  
Less Is More ◽  
Primary Surgery ◽  
History Of ◽  
Uncommon Complication

Abstract Oesophago-pleural fistula is an uncommon complication after pneumonectomy, usually related to high morbidity and mortality. Due to its rarity and heterogeneous clinical presentation, its diagnosis and management are challenging issues. Here, we report the case of a patient with a history of pneumonectomy for a tracheal tumour, who developed an asymptomatic oesophago-pleural fistula 7 years after primary surgery. In consideration of the patient’s good clinical status and after verifying the preservation of respiratory and digestive functions, a bold conservative approach was adopted. Five-year follow-up computed tomography did not disclose any sign of recurrence of disease and showed a stable, chronic fistula.

scholarly journals L2HGDH Missense Variant in a Cat with L-2-Hydroxyglutaric Aciduria

Genes ◽  
2021 ◽  
Vol 12 (5) ◽  
pp. 682
Author(s):  
Matthias Christen ◽  
Nils Janzen ◽  
Anne Fraser ◽  
Adrian C. Sewell ◽  
Vidhya Jagannathan ◽  
...  
Keyword(s):  
Current Knowledge ◽  
Genetic Defect ◽  
Clinical Signs ◽  
Missense Variant ◽  
Microcytic Anemia ◽  
Abnormal Behavior ◽  
Functional Candidate Gene ◽  
History Of ◽  
The Brain ◽  
Hydroxyglutaric Acid

A 7-month-old, spayed female, domestic longhair cat with L-2-hydroxyglutaric aciduria (L-2-HGA) was investigated. The aim of this study was to investigate the clinical signs, metabolic changes and underlying genetic defect. The owner of the cat reported a 4-month history of multiple paroxysmal seizure-like episodes, characterized by running around the house, often in circles, with abnormal behavior, bumping into obstacles, salivating and often urinating. The episodes were followed by a period of disorientation and inappetence. Neurological examination revealed an absent bilateral menace response. Routine blood work revealed mild microcytic anemia but biochemistry, ammonia, lactate and pre- and post-prandial bile acids were unremarkable. MRI of the brain identified multifocal, bilaterally symmetrical and T2-weighted hyperintensities within the prosencephalon, mesencephalon and metencephalon, primarily affecting the grey matter. Urinary organic acids identified highly increased levels of L-2-hydroxyglutaric acid. The cat was treated with the anticonvulsants levetiracetam and phenobarbitone and has been seizure-free for 16 months. We sequenced the genome of the affected cat and compared the data to 48 control genomes. L2HGDH, coding for L-2-hydroxyglutarate dehydrogenase, was investigated as the top functional candidate gene. This search revealed a single private protein-changing variant in the affected cat. The identified homozygous variant, XM_023255678.1:c.1301A>G, is predicted to result in an amino acid change in the L2HGDH protein, XP_023111446.1:p.His434Arg. The available clinical and biochemical data together with current knowledge about L2HGDH variants and their functional impact in humans and dogs allow us to classify the p.His434Arg variant as a causative variant for the observed neurological signs in this cat.

scholarly journals Towards B-Spline Atomic Structure Calculations

Atoms ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 50
Author(s):  
Charlotte Froese Fischer
Keyword(s):  
Atomic Structure ◽  
Bound States ◽  
Virial Theorem ◽  
B Spline ◽  
B Splines ◽  
Self Consistent ◽  
History Of ◽  
Consistent Method ◽  
Atomic Structure Calculations ◽  
Structure Calculations

The paper reviews the history of B-spline methods for atomic structure calculations for bound states. It highlights various aspects of the variational method, particularly with regard to the orthogonality requirements, the iterative self-consistent method, the eigenvalue problem, and the related sphf, dbsr-hf, and spmchf programs. B-splines facilitate the mapping of solutions from one grid to another. The following paper describes a two-stage approach where the goal of the first stage is to determine parameters of the problem, such as the range and approximate values of the orbitals, after which the level of accuracy is raised. Once convergence has been achieved the Virial Theorem, which is evaluated as a check for accuracy. For exact solutions, the V/T ratio for a non-relativistic calculation is −2.

scholarly journals 289 Detection of Falls in Older Patients by Medical Professionals on Admission to Hospital: An Audit

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Emily Buckley ◽  
Mazen Alalawi
Keyword(s):  
Practice Guidelines ◽  
Older Patients ◽  
Best Practice ◽  
Acute Hospital ◽  
Medical Professionals ◽  
Medical Patients ◽  
Screening Questionnaire ◽  
Best Practice Guidelines ◽  
Audit Data ◽  
History Of

Abstract Background A history of a previous fall is one of the best predictors of future falls, increasing its risk 3-fold. The Health Service Executive (HSE) best practice guidelines recommend that all patients aged over 65 years in contact with healthcare professionals should be asked routinely whether they have fallen in the past year and asked about the fall-frequency, context and characteristics. The aim of this audit was to increase falls recognition by medical professionals following the implementation of a falls screening questionnaire into the admission proforma of an acute hospital. Methods This was a clinical audit. Data was collected on 29 consecutive patients aged > 65 who were admitted via the emergency department of an acute hospital over a 6 day period. Data on falls was collected using the medical admissions hospital proforma during the first 72 hours. Following the initial audit, a new proforma containing a falls screening questionnaire (as per best practice guidelines) was introduced and an information session provided on its use. A re-audit of 17 admitted medical patients was then completed over the next 72 hours. Results The initial audit highlighted poor assessment of falls with only 3 (25%) patients being screened at admission. 1 (33%) had a fall; described as mechanical. Following introduction of a falls screening questionnaire into the admission proforma, a re-audit showed a significant increase, with 58% of admissions now being screened. Of these, 40% had fallen in the last year: 75% of falls were mechanical and 25% due to other causes. Conclusion This audit shows that falls in this patient population was largely unrecognised by medical professionals. Following implementation of a screening questionnaire, significant improvements were made. This audit concludes that implementation of a falls screening questionnaire into the medical admissions proforma is an effective method in identifying falls in older patients admitted to hospital.

Detection of Viruses: insides of antibody-antigen interactions and Multifunctional Lab-On-particle for SARS CoV-2 detection

Coronaviruses ◽  
2021 ◽  
Vol 02 ◽  
Author(s):  
Martin Amé ◽  
Esraa Samy Abu Serea ◽  
Ahmed Esmail Shalan ◽  
A. Guillermo Bracamonte
Keyword(s):  
Fast Response ◽  
Clinical Analysis ◽  
New Drugs ◽  
Detection Systems ◽  
Current State ◽  
History Of ◽  
Non Covalent Interactions ◽  
Genomic Factor ◽  
New Treatments ◽  
Covalent Interactions

: The design of new Drugs, Molecules, Nano-, and Microstructures for targeted applications along the pass of the time within the history of Chemistry and Clinical Analysis showed to be of high impact on Life Sciences. In this context, and mainly for the actual Corona Virus Pandemic status, it should be highlighted the importance of a fast response. Thus, the developments of differents approaches looking for improved and higher sensitive solutions in the Biodetection field accompanied with new treatments of SARS CoV-2 are required. In this way, in this short communication based on the latest Research publications it was afforded and discussed the following topics: i) the importance of non-covalent interactions from antibody-antigen recognition events, ii) the genomic factor, and iii) the use of non-covalent interactions in different Optical detection systems and Lab-On particles. Moreover, it was afforded the theme related with the importance of new treatments in progress, such development of new vaccines; and current state of the pandemic situation. So, it was discussed and stimulated the improvement of innovative Multifunctional Nanophotonic approaches intended for SARS CoV-2 detection accompanied with potential targeted treatments.

Phlegmonous gastritis in 2 yearling horses

2022 ◽  
pp. 104063872110650
Author(s):  
Julie B. Engiles ◽  
Francisco A. Uzal ◽  
Mauricio A. Navarro ◽  
Virginia B. Reef ◽  
Susan J. Bender
Keyword(s):  
Clinical Signs ◽  
Poor Response ◽  
Abdominal Ultrasound ◽  
Mucosal Injury ◽  
Response To Treatment ◽  
Bacterial Populations ◽  
Proliferative Enteropathy ◽  
Mucosal Involvement ◽  
Phlegmonous Gastritis ◽  
History Of

Phlegmonous gastritis was diagnosed in 2 yearling fillies that were presented with a 1-wk history of fever, lethargy, and hypoproteinemia, associated with a previous diagnosis of equine proliferative enteropathy based on clinical signs and PCR assay detection of Lawsonia intracellularis in fecal samples. Abdominal ultrasound revealed enlargement of the stomach and expansion of its submucosal layer with hypoechoic fluid, as well as thickened hypomotile small intestinal segments. Given the poor prognosis and poor response to treatment, both horses were euthanized, one on the day of presentation and the other after 3 wk of intensive medical management including a combination of antimicrobials, analgesics, and intravenous colloids. At autopsy, acute mural gastritis characterized by severe submucosal edema with suppurative inflammation (i.e., phlegmonous gastritis) and necroulcerative enteritis compatible with the necrotizing form of equine proliferative enteropathy were identified in both horses. The gastric inflammation was associated with thrombosis and mixed bacterial populations, including Clostridium perfringens, that were confined to the submucosa without evidence of mucosal involvement; toxin genes compatible with C. perfringens type C were identified in one case. Human phlegmonous gastritis is an uncommon, often-fatal pyogenic infection that is often associated with mucosal injury, bacteremia, or immunocompromise. Our finding of this unusual gastric lesion in 2 horses with similar signalment, clinical disease, and spectrum of postmortem lesions suggests a similar etiopathogenesis that possibly involves local, regional, or distant hematogenous origin, and should be considered a potential complication of gastrointestinal mucosal compromise in horses.

Association Between the Diabetes mellitus Duration and the Severity of Diabetic Foot Disease in Hospitalized Patients in Latin America

2021 ◽  
pp. 153473462110632
Author(s):  
Belissa Bedriñana-Marañón ◽  
Maria Rubio-Rodríguez ◽  
Marlon Yovera-Aldana ◽  
Eilhart Garcia-Villasante ◽  
Isabel Pinedo-Torres
Keyword(s):  
Diabetes Mellitus ◽  
Latin America ◽  
Diabetic Foot ◽  
Poisson Regression ◽  
Hospitalized Patients ◽  
Bivariate Analysis ◽  
Severe Injuries ◽  
History Of ◽  
Diabetic Foot Disease ◽  
Foot Disease

The objective was to determine the association between a diabetes mellitus duration greater than 10 years and the severity of diabetic foot in hospitalized patients in Latin America. Analytical, observational, and retrospective study based in secondary databases. Patients older than 18 years with diagnosis of diabetes mellitus (DM) and hospitalized for any causes were included. The independent and dependent variables were having more than 10 years of diagnosis of DM and the severity of the diabetic foot disease (Wagner> = 2), respectively. A crude Poisson regression analysis was performed to obtain prevalence rates adjusted to confounders. Male gender was 54.8% and the median age was 62 years. In the group with more than10 years of disease (n = 903) 18% (n = 162) had severe injuries. We performed two Poisson regression analyzes, one of which included the entire sample; and in the other, only patients with some degree of ulcer were included at the time of evaluation (Wagner > = 1). In the first analysis the PR was 1.95 ( p < 0.01) adjusted for the significant variables in the bivariate analysis and in the second analysis the PR was 1.18 ( p < 0.01) adding to the adjustment the days of injury prior to hospitalization and the location of the ulcer. We conclude that in patients with more than 10 years of diabetes mellitus, diabetic foot injuries are more severe, regardless type of diabetes, gender, age, history of amputation and days of injury prior to hospitalization for inpatients in Latin America.

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