Clinical and laboratory findings and PCR results in severe and non-severe COVID19 patients based on CURB-65 and WHO severity indices

Abstract Background The importance of clinicolaboratory characteristics of COVID-19 made us report our findings in the Alborz province according to the latest National Guideline for the diagnosis and treatment of COVID-19 in outpatients and inpatients (trial five versions, 25 March 2020) of Iran by emphasizing rRT-PCR results, clinical features, comorbidities, and other laboratory findings in patients according to the severity of the disease. Methods In this study, 202 patients were included, primarily of whom 164 had fulfilled the inclusion criteria. This cross-sectional, two-center study that involved 164 symptomatic adults hospitalized with the diagnosis of COVID-19 between March 5 and April 5, 2020, was performed to analyze the frequency of rRT-PCR results, distribution of comorbidities, and initial clinicolaboratory data in severe and non-severe cases, comparing the compatibility of two methods for categorizing the severity of the disease. Results According to our findings, 111 patients were rRT-PCR positive (67.6%), and 53 were rRT-PCR negative (32.4%), indicating no significant difference between severity groups that were not related to the date of symptoms' onset before admission. Based on the National Guideline, among vital signs and symptoms, mean oxygen saturation and frequency of nausea showed a significant difference between the two groups (P < 0.05); however, no significant difference was observed in comorbidities. In CURB-65 groups, among vital signs and comorbidities, mean oxygen saturation, diabetes, hypertension (HTN), hyperlipidemia, chronic heart disease (CHD), and asthma showed a significant difference between the two groups (P < 0.05), but no significant difference was seen in symptoms. Conclusion In this study, rRT-PCR results of hospitalized patients with COVID-19 were not related to severity categories. From initial clinical characteristics, decreased oxygen saturation appears to be a more common abnormality in severe and non-severe categories. National Guideline indices seem to be more comprehensive to categorize patients in severity groups than CURB-65, and there was compatibility just in non-severe groups of National Guideline and CURB-65 categories.

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CO-St (COVID 19- study): impact of the management of men versus women in the treatment of Covid 19. A Multi-Centric Observational study

10.20944/preprints202108.0119.v1 ◽

2021 ◽

Author(s):

Tiziana Ciarambino ◽

filomena pietrantonio ◽

Sara Rotunno ◽

Alessandra Fiorentini ◽

Rosalba Cipriani ◽

...

Keyword(s):

Oxygen Therapy ◽

Signs And Symptoms ◽

Epidemiological Data ◽

Cross Sectional Study ◽

Antiviral Drugs ◽

Laboratory Findings ◽

Cross Sectional ◽

Significant Difference ◽

Rehabilitation Ward ◽

Epidemiological Link

Background: from December 2019 and the spreading of syndemics, a lot of medical centers reg-istered data about their patients. In Italy, the most relevant quantity of patients was hospitalized in internal medicine wards. Methods: In this observational, retrospective cross-sectional study, all data of the COVID-19 patients, admitted Latio hospitals, from March 01 to December 31, 2020, were collected and their Epidemiological data, demographics, signs and symptoms on admission, comorbidities, laboratory findings, chest radiography and CT findings, treatment received and mortality rate were analyzed by gender to find any differences of gravity of disease. Clinician details were registered on database (one for every hospital). Cost analysis was performed by length of stay and antiviral drugs use, using point of view of Italian Healthcare System. Results: 2256 patients with mean age of 71.01 ± 28.02 years were included. For men, frequency of hyper-tension, COPD, use of oxygen therapy, Tocilizumab were significantly higher and epidemiolog-ical link was related to rehabilitation ward and community. The gender difference about hospi-talization was one day more for man. No strong significant difference by gender in the death rate was observed. Considering antiviral drugs and hospitalization, a man costs €1000 more than woman. Conclusions: In male patients, hypertension and COPD were observed more frequently and the epidemiological link was related to rehabilitation ward and community. In female sub-jects, the epidemiological link was related to Hospital and we observed significantly higher atypical chest-X ray. Tocilizumab, oxygen therapy and antiviral drugs were prescribed more in male subjects. No differences by gender we report in other treatments and outcomes. Future studies should be analyzed to get a more comprehensive understanding of COVID-19 by gender.

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Retinal microvascular signs in COVID-19

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-318236 ◽

2021 ◽

pp. bjophthalmol-2020-318236

Author(s):

Ralene Sim ◽

Gemmy Cheung ◽

Daniel Ting ◽

Edmund Wong ◽

Tien Yin Wong ◽

...

Keyword(s):

Medical History ◽

Vital Signs ◽

Plexiform Layer ◽

Nasopharyngeal Swab ◽

Inner Plexiform Layer ◽

Cross Sectional ◽

Imaging Device ◽

Asymptomatic Patients ◽

Significant Difference ◽

Retinal Microvascular Signs

Background/aimsTo explore if retinal findings are associated with COVID-19 infection.MethodsIn this prospective cross-sectional study, we recruited participants positive for COVID-19 by nasopharyngeal swab, with no medical history. Subjects underwent retinal imaging with an automated imaging device (3D OCT-1 Maestro, Topcon, Tokyo, Japan) to obtain colour fundus photographs (CFP) and optical coherence tomographic (OCT) scans of the macula. Data on personal biodata, medical history and vital signs were collected from electronic medical records.Results108 patients were recruited. Mean age was 36.0±5.4 years. 41 (38.0%) had symptoms of acute respiratory infection (ARI) at presentation. Of 216 eyes, 25 (11.6%) had retinal signs—eight (3.7%) with microhaemorrhages, six (2.8%) with retinal vascular tortuosity and two (0.93%) with cotton wool spots (CWS). 11 eyes (5.1%) had hyper-reflective plaques in the ganglion cell-inner plexiform layer layer on OCT, of which two also had retinal signs visible on CFP (CWS and microhaemorrhage, respectively). There was no significant difference in the prevalence of retinal signs in symptomatic versus asymptomatic patients (12 (15.0%) vs 13 (9.6%), p=0.227). Patients with retinal signs were significantly more likely to have transiently elevated blood pressure than those without (p=0.03).ConclusionOne in nine had retinal microvascular signs on ocular imaging. These signs were observed even in asymptomatic patients with normal vital signs. These retinal microvascular signs may be related to underlying cardiovascular and thrombotic alternations associated with COVID-19 infection.

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A Cross-Sectional Study to Compare Differences on Clinical and Laboratory Findings in Children with Seropositive and Seronegative Lupus

10.21203/rs.3.rs-1113288/v1 ◽

2021 ◽

Author(s):

Shima Salehi ◽

Rozita Hosseini Shamsabadi ◽

Hassan Otukesh ◽

Reza Shiari ◽

Monir Sharafi

Keyword(s):

Autoimmune Disease ◽

Disease Diagnosis ◽

Cross Sectional Study ◽

Rapid Identification ◽

The Body ◽

Musculoskeletal Symptoms ◽

Laboratory Findings ◽

Cross Sectional ◽

Significant Difference ◽

History Of

Abstract Background: Lupus is an inflammatory and autoimmune disease that involves various tissues and organs of the body. Identification of diagnostic elements to rapid identification of seronegative lupus cases is very important in order to prevent morbidity and progression of disease. This study aimed to compare clinical and laboratory findings of seropositive cases with seronegative lupus patients. Methods: This cross-sectional analytic study was performed on 43 children (17 seronegative and 26 seropositive) with lupus who were admitted to Ali Asghar Hospital during 2007-2017. Seropositive patients had anti-nuclear antibody (ANA) titration >1/80, while seronegative patients had ANA titration <1/80 (at the time of disease diagnosis). Clinical and laboratory findings were compared between two groups.Results: Serositis in patients with ANA- was significantly higher than ANA+ (41.17% vs. 23.07%; p = 0.042). ANA- group had higher autoimmune disease history than ANA+ group (42.85% vs. 15.0%; p = 0.041). The family history of the disease in the ANA- group was greater than ANA+ group (50% vs. 23.52%). The percentage of hypertensive patients in ANA- group was higher than ANA+ group (52.94% vs. 26.92%; p = 0.037). Neurologic symptoms in ANA+ and ANA- groups were 38.46% and 17.64%, respectively (p = 0.043). The frequency of patients with thrombocytopenia in ANA+ group was significantly greater than ANA- group (32% vs. 12.5%; p=0.041). There was no significant difference in other clinical and laboratory findings between two groups. Conclusion: Seronegative lupus patients had higher percentage of musculoskeletal symptoms, autoimmune disease history, familial history of disease, and hypertension, while neurological and thrombocytopenia symptoms were higher in seropositive patients compared to seronegative cases. Therefore, evaluation of these factors can be helpful to diagnosis of seronegative patients.

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Clinical and laboratory findings in elderly with Community-Acquired Pneumonia in Babol, northern Iran – 2017-2019

Current Issues in Pharmacy and Medical Sciences ◽

10.2478/cipms-2021-0027 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Saleh Habibi ◽

Arefeh Babazadeh ◽

Soheil Ebrahimpour ◽

Parisa Sabbagh ◽

Mehran Shokri

Keyword(s):

Older Adults ◽

Age Groups ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Vital Signs ◽

The Elderly ◽

Community Acquired Pneumonia ◽

Northern Iran ◽

Laboratory Findings ◽

Cross Sectional

Abstract Morbidity and mortality are higher in older adults with community-acquired pneumonia (CAP) than in other age groups. Also, CAP in older adults has various clinical manifestations with other. A higher mortality rate in the elderly with CAP may contribute to a delay in management. Consequently, the purpose of this study was to investigate the clinical and laboratory manifestations of CAP in the elderly. This cross-sectional study was conducted on 221 elderly patients with CAP who were admitted to Ayatollah Rouhani Hospital, in Babol, northern of Iran, in 2017-2019. Patient outcomes included 170 cases that recovered from CAP, and 51 cases that died of complications. Patients were evaluated in terms of their clinical and laboratory manifestations. The most common symptoms of pneumonia were cough (79.6%), sputum (73.8%), weakness (72.9%), fever (56%), dyspnea (46.2%). The most frequent underlying disease was ischemic heart disease (43.9%). In our study, clinical and laboratory characteristics in older patients with CAP were evaluated and compared with other studies confirming past findings, but there were differences in some cases, such as vital signs, gastrointestinal symptoms, and disturbance of the level of consciousness. Therefore, it recommends carefully taking the patients’ initial histories and accurately recording their clinical and laboratory symptoms.

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Teething Problems and Parental Beliefs in Nigeria

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-10-4-75 ◽

2009 ◽

Vol 10 (4) ◽

pp. 75-82 ◽

Cited By ~ 3

Author(s):

Foluso J. Owotade ◽

Morenike O. Folayan ◽

Temitope A. Esan ◽

Elizabeth O. Oziegbe ◽

Comfort A. Adekoya-Sofowora

Keyword(s):

Signs And Symptoms ◽

Cross Sectional Study ◽

Parental Beliefs ◽

Cross Sectional ◽

Socioeconomic Class ◽

Low Socioeconomic ◽

Significant Difference ◽

And Gender ◽

Symptoms And Signs ◽

Rule Out

Abstract Aim To determine signs and symptoms associated with teething, parental beliefs about teething, and the effects of socioeconomic status on teething in Nigerian children. Methods and Materials A cross-sectional study consisting of 1,013 mothers of children between the ages four to 36 months who visited the immunization clinics at the Community Health Centres in Ife Central and Ife East Local Government Areas. Data was analyzed using STATA (Intercooled release 9) for Windows. Results A total of 765 mothers (75.5%) reported systemic signs and symptoms in their children. Fever (51.8%), diarrhea (12.5%), and vomiting (2.9%) were the most prevalent symptoms and signs reported. Teething problems were reported by 60% of mothers from a high socioeconomic class, as well as 76.7% and 77.9% from middle and low socioeconomic classes, respectively. Interestingly, 65.5% of mothers believed teething should be accompanied with systemic signs and symptoms such as fever (42.1%), diarrhea (13.9%), and vomiting (0.6%). No significant difference was noted between breastfeeding status, gender of the child, and reported systemic signs and symptoms noticed by the mothers. Conclusion Most mothers in the study reported signs and symptoms adduced to teething in their children irrespective of their beliefs. Fever ranked highest of the signs and symptoms reported. Mothers of children from the high socioeconomic class reported fewer teething symptoms. Breastfeeding status and gender of the child had no effect on teething problems in the children studied. Clinical Significance Most signs and symptoms adduced to teething by parents may actually be due to underlying infections. Thus, there is a need to rule out occult infection during the tooth eruption period. Citation Oziegbe EO, Folayan MO, Adekoya-Sofowora CA, Esan TA, Owotade FJ. Teething Problems and Parental Beliefs in Nigeria. J Contemp Dent Pract 2009 July; (10)4:075-082.

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The Role of Ischemia-modified Albumin as a Biomarker in Preeclampsia

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0040-1709662 ◽

2020 ◽

Vol 42 (03) ◽

pp. 133-139

Author(s):

Süleyman Serkan Karaşin ◽

Tayfur Çift

Keyword(s):

Pregnant Women ◽

Laboratory Data ◽

Cross Sectional Study ◽

Enzyme Linked Immunosorbent Assay ◽

Cross Sectional ◽

Ischemia Modified Albumin ◽

Significant Difference ◽

Gestational Week ◽

Severity Of The Disease

Abstract Objective Ischemia-modified albumin (IMA)is a modified type of albumin protein that is formed under oxidative stress. This study aims to compare the levels of serum IMA between normotensive and preeclamptic pregnancies and to evaluate the relationship between the severity of the disease. Methods A total of 90 pregnant women aged between 18 and 45 years participated in this cross-sectional study. The levels of serum IMA were measured by enzyme-linked immunosorbent assay in 30 preeclamptic pregnant women with the severe signs of the disease, 30 preeclamptic pregnant women, and 30 normotensive pregnant women.. The study was designed as a cross-sectional clinical study. Results When the demographic characteristics were examined, statistically significant differences were found between the groups in terms of age, gestational week at birth and blood pressure. Age was higher in the preeclampsia with signs of severity group than in the normotensive group (p = 0.033). Pregnancy week was significantly the lowest in the preeclampsia with the severity signs group (p = 0.004). In normotensive patients, IMA levels were lower than in the preeclampsia groups (p < 0.001) but there was no significant difference in terms of severity of disease (p = 0.191). According to laboratory data; only the creatinine level was significantly different between the groups. Conclusion The levels of serum IMA were higher in patients with preeclampsia than in healthy pregnancies. However, there was no significant correlation in terms of preeclampsia severity; more extensive, prospective and long-term studies are needed.

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Perbandingan Saturasi Oksigen pada Perokok dan Bukan Perokok di Dataran Tinggi Tomohon dan Dataran Rendah Manado

Jurnal e-Biomedik ◽

10.35790/ebm.5.2.2017.18311 ◽

2017 ◽

Vol 5 (2) ◽

Author(s):

Thalia R. Polii ◽

Jimmy Rumampuk ◽

Fransiska Lintong

Keyword(s):

Cigarette Smoking ◽

Oxygen Saturation ◽

Human Body ◽

Analytical Study ◽

Barometric Pressure ◽

The Other ◽

Cross Sectional ◽

Significant Difference ◽

Negative Impacts ◽

Cross Sectional Design

Abstract: Cigarette smoking has many negative impacts to human body inter alia declined oxygen saturation due to binding of CO to Hb. Aside from smoking, declined barometric pressure on higher surface can also decrease the oxygen saturation. This study was aimed to understand the comparison of oxygen saturation between smokers and non-smokers in highland of Tomohon and lowland of Manado. This was an analytical study with a cross-sectional design. There were 60 subjects, smokers and non-smokers, from highland and lowland. The results showed that there was a significant difference in mean oxygen saturation between smokers of highland and of lowland (P=0.002) but there was no significant difference in mean oxygen saturation between non-smokers of highland and of lowland (P=0.0255). There was a significant difference in mean oxygen saturation between smokers of highland and non-smokers of lowland (P=0.001) but there was no significant difference in mean oxygen saturation between non-smokers of highland and smokers of lowland (P=0.424). There was a significant difference in mean oxygen saturation between smokers and non-smokers of highland (P=0.010) but there was no significant difference in oxygen saturation between smokers of highland and non-smokers of lowland (P=0.714). Conclusion: There were significant differences in oxygen saturation between smokers of highland and of lowland; smokers of highland and non-smokers of lowland; as well as smokers and non-smokers of highland. On the other hand, there were no significant differences in oxygen saturation between non-smokers of highland and of lowland; non-smokers of highland and smokers of lowland; as well as smokers and non-smokers of lowland.Keywords: oxygen saturation, smokers, non-smokers, highland, lowland Abstrak: Rokok memiliki dampak buruk pada kesehatan manusia, salah satunya ialah menurunnya saturasi oksigen akibat ikatan yang terjadi antara CO dengan Hb. Selain merokok, penurunan tekanan barometrik pada ketinggian juga dapat menurunkan kadar saturasi oksigen dalam darah. Penelitian ini bertujuan untuk mengetahui perbedaan saturasi oksigen pada perokok dan bukan perokok di dataran tinggi Tomohon dan di dataran rendah Manado. Jenis penelitian ialah analitik dengan desain potong lintang. Subyek penelitian berjumlah 60 orang yang terdiri dari perokok dan bukan perokok di dataran tinggi dan rendah. Hasil penelitian mendapatkan perbedaan rerata saturasi oksigen yang bermakna antara perokok dataran tinggi dan perokok dataran rendah (P=0,002). Tidak terdapat perbedaan rerata saturasi oksigen yang bermakna antara bukan perokok dataran tinggi dan bukan perokok dataran rendah (P= 0,255). Terdapat perbedaan rerata saturasi oksigen yang bermakna antara perokok dataran tinggi dan bukan perokok dataran rendah (P=0,001). Tidak terdapat perbedaan rerata saturasi oksigen yang bermakna antara bukan perokok dataran tinggi dan perokok dataran rendah (P=0,424). Terdapat perbedaan rerata saturasi oksigen yang bermakna antara perokok dan bukan perokok di dataran tinggi (P=0,010). Tidak terdapat perbedaan rerata saturasi oksigen yang bermakna antara perokok dan bukan perokok di dataran rendah (P= 0,714). Simpulan: Terdapat perbedaan rerata saturasi oksigen yang bermakna antara perokok dataran tinggi dan perokok dataran rendah; perokok dataran tinggi dan bukan perokok dataran rendah; serta perokok dan bukan perokok di dataran tinggi. Tidak terdapat perbedaan rerata saturasi oksigen yang bermakna antara bukan perokok dataran tinggi dan bukan perokok dataran rendah; bukan perokok dataran tinggi dan perokok dataran rendah; serta perokok dan bukan perokok di dataran rendah.Kata kunci: saturasi oksigen, perokok, bukan perokok, dataran tinggi, dataran rendah

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Risk factors associated with COVID-19 Intensive Care Unit hospitalisation in Guyana: A cross-sectional study

Caribbean Medical Journal ◽

10.48107/cmj.2021.10.001 ◽

2021 ◽

Author(s):

Steven A. Seepersaud

Keyword(s):

Risk Factors ◽

Retrospective Chart Review ◽

Binary Logistic Regression ◽

Signs And Symptoms ◽

Cross Sectional Study ◽

Laboratory Findings ◽

Cross Sectional ◽

Factors Associated ◽

Independent Variables ◽

Icu Admission

Objective The purpose of the study was to determine risk factors associated with COVID-19 ICU hospitalisation at Georgetown Public Hospital Corporation (GPHC), Guyana. Methods A retrospective chart-review was conducted on all COVID-19 admissions from March to September 2020. The predictive factors were demographics, comorbidities, signs and symptoms of COVID-19 and laboratory findings on admission. Descriptive frequency analysis was done for all independent variables and the Chi-square test was used to compare differences between groups where suitable. Univariate and multivariate binary logistic regression was used to examine the association between the independent variables and the risk for ICU hospitalisation. Results There were 136 patients with COVID-19 at GPHC during March to September 2020 and after exclusion, 135 patients were used in the study. There were 72 (53.4%) patients who required non-ICU care, while 63 (46.6%) ICU care and average age ± SD (median) was 51 ±16 (n= 49) and 56 ±18 (n= 60), respectively. In the multivariate regression model, the odds of ICU admission for those aged 40-65 was 0.14 (p <.01) compared to those > 65 years. Patients with class 2 and above obesity had higher odds of ICU admission compared to non-obese patients OR 11.09 (p= .006). Patients with 2 and 3 or more comorbidities also had higher odds of ICU admission compared to those with no comorbidities OR 7.83 (p= .03) and 132 (p <.001), respectively. Patients with LDH 228-454 U/L and > 454 U/L on admission had higher odds of ICU admission compared to those with normal LDH OR 19.88 (p= .001) and 23.32 (p= .001), respectively. Patients with albumin < 3.50 mg/dL on admission also had higher odds of ICU admission compared to those with normal albumin OR 5.78 (p= .005). Conclusion Risk factors associated with ICU hospitalisation were advanced age, obesity, multiple comorbidities, elevated LDH and low albumin. Protecting the population at risk for ICU admission and prioritizing them for vaccination is recommended to reduce the risk of running out of ICU capacity.

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Effect of Online Classes on Dry Eye Disease in Children: A Hospital Based Survey

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v37i4.1322 ◽

2021 ◽

Vol 37 (4) ◽

Author(s):

Sangameshwarayya Salimath ◽

Salma Sultana ◽

Brijesh Appasaheb Patil ◽

Kalpana R Kulkarni ◽

Shishir K. Nyamagoudar

Keyword(s):

Dry Eye ◽

Signs And Symptoms ◽

Cross Sectional Study ◽

Dry Eye Disease ◽

Eye Disease ◽

P Value ◽

Online Classes ◽

Cross Sectional ◽

Department Of Ophthalmology ◽

Significant Difference

Purpose: To determine the effect of online classes on dry eye disease in children. Study Design: Cross sectional study. Place and Duration of Study: Department of Ophthalmology HSK hospital, Navanagar, Bagalkot, India, from October 2020 to November 2020. Methods: A total of 454 students attending online classes between the ages of 3 – 18 years were selected. Questionnaire was presented which included name, age, sex, residence, duration of online studies and duration in hours per day along with the various signs and symptoms according to SPEED questionnaire. Statistical analysis was performed using the IBM SPSS version 17. Quantitative variables were presented as mean ± standard deviation, while qualitative data was presented as frequency and percentages and compared by chi square test. P-value of < 0.005 was considered as significant. Results: Of the 454 responses, 316 (69.6%) had symptoms of dry eye disease, of which 159 were girls and 157 boys. There was no significant difference between boys and girls. Children taking online classes for 2 – 3 hours and for 4 to 6 months duration were more affected by the dry eye disease. Based on severity of grading system, 246 (84.2%) had mild symptoms, 42 (9.3%) had moderate symptoms and 28 ([6.2%) had severe symptoms. One hundred and twenty children visited ophthalmologist and 28.5% had their treatment of dry eye started. Conclusion: Online classes have resulted in increase in the frequency of dry eye disease in children. Proper education about the usage of screen time and educating parents about early treatment is essential. Key Words: Dry eye disease, Symptoms, Headache, Online learning.

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A comparison of once and twice daily administration of trilostane to dogs with hyperadrenocorticism

Tierärztliche Praxis Ausgabe K Kleintiere / Heimtiere ◽

10.1055/s-0038-1623672 ◽

2012 ◽

Vol 40 (06) ◽

pp. 415-424 ◽

Cited By ~ 6

Author(s):

A. Burden ◽

R. Neiger ◽

I. Ramsey ◽

M. Augusto

Keyword(s):

Clinical Trials ◽

Daily Administration ◽

Effective Control ◽

Final Visit ◽

Inclusion Criteria ◽

Laboratory Findings ◽

Treatment Groups ◽

Clinical Scores ◽

Significant Difference ◽

Group Post

Summary Objective: This retrospective study describes the use of trilostane given once versus twice daily in dogs with hyperadrenocorticism (SID vs. BIDgroup) in separate clinical trials. Material and methods: The groups were compared over a six month period using laboratory findings, dose required to suppress post-ACTH cortisol, and clinical scores from owner and clinician questionnaires. Results: Ninety-three dogs enrolled the trials but for analysis of the final visit results only 56 dogs filled the inclusion criteria: 30 dogs in the SID-group and 26 dogs in the BID-group. Both treatment groups showed an improvement in clinical scores with time and no significant difference between them. In the BID-group post-ACTH cortisol concentrations went below 250 nmol/l sooner and in a higher proportion of dogs than in the SID-group.Twice-daily administration of trilostane also achieved a faster and more effective control for comparable daily doses. A higher individual tolerability (based on clinical scores) was found in the SID-group but there were no supporting laboratory findings. No dogs developed serious side-effects. Conclusion: This study reveals only small practical differences between once and twice daily trilostane administrations in treating hyperadrenocorticism. And the overall benefits of twice daily dosing have to be considered against the effect on the owners and their compliance with treatment.

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