scholarly journals Retrospective analysis of feline intestinal parasites: trends in testing positivity by age, USA geographical region and reason for veterinary visit

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Sarah Sweet ◽  
Donald Szlosek ◽  
Donald McCrann ◽  
Michael Coyne ◽  
David Kincaid ◽  
...  
Keyword(s):  
Intestinal Parasites ◽  
Geographical Region ◽  
Reference Laboratory ◽  
Western Region ◽  
Test Results ◽  
True Prevalence ◽  
Increased Risk ◽  
Parasite Detection ◽  
The Usa ◽  
Fecal Tests

Abstract Background The goals of this retrospective study were to estimate parasite positivity in samples from cats using zinc sulfate fecal flotation by centrifugation (“centrifugation”) and coproantigen and examine trends with age, geographical region and reason for visit to veterinarian. Common methods of parasite detection, such as centrifugal flotation, passive flotation, or direct smear, may underrepresent the true prevalence of intestinal parasites in cats. Coproantigen testing detects more positive samples than traditional methods alone. Methods Feline fecal test results from the continental USA containing results for fecal exams performed using centrifugation paired with coproantigen results for ascarid, hookworm, whipworm and Giardia were obtained from the database of a national commercial reference laboratory comprised of multiple regional sites. Results Parasite positivity was highest in samples from young cats and decreased with cat age. The western region of the USA had lower total parasite positivity than other regions for all parasites except Giardia. Cats receiving fecal tests during veterinary wellness visits had only slightly lower parasite positivity than samples from cats during sick clinical visits. Conclusions This study showed a larger population of cats are at increased risk of parasitism than commonly believed and coproantigen testing produces more positive test results for the four parasites that antigen can detect than centrifugation of feline fecal samples.

scholarly journals Quality Assessment of the Genetic Test for Familial Hypercholesterolemia in The Netherlands

Cholesterol ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Iris Kindt ◽  
Roeland Huijgen ◽  
Marieke Boekel ◽  
Kristiaan J. van der Gaag ◽  
Joep C. Defesche ◽  
...  
Keyword(s):  
The Netherlands ◽  
Familial Hypercholesterolemia ◽  
Screening Program ◽  
Reference Laboratory ◽  
Test Results ◽  
Cascade Screening ◽  
Dna Test ◽  
Increased Risk ◽  
A Prospective Study ◽  
Positive Results

Introduction. Familial hypercholesterolemia (FH) is an inherited disorder associated with a severely increased risk of cardiovascular disease. Although DNA test results in FH are associated with important medical and ethical consequences, data on accuracy of genetic tests is scarce. Methods. Therefore, we performed a prospective study to assess the overall accuracy of the DNA test used in the genetic cascade screening program for FH in The Netherlands. Individuals aged 18 years and older tested for one of the 5 most prevalent FH mutations, were included consecutively. DNA samples were analyzed by the reference and a counter-expertise laboratory following a standardized procedure. Results. 1003 cases were included. In the end, 317 (32%) carried an FH mutation, whereas in 686 (69%) samples no mutation was found. The overall accuracy of the reference laboratory was 99.8%, with two false positive results identified by the counter-expertise laboratory. Conclusion. The currently used mutation analysis is associated with a very low error rate. Therefore, we do not recommend routine use of duplicate testing.

scholarly journals A 3-year retrospective analysis of canine intestinal parasites: fecal testing positivity by age, U.S. geographical region and reason for veterinary visit

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Sarah Sweet ◽  
Evan Hegarty ◽  
Donald J. McCrann ◽  
Michael Coyne ◽  
Dave Kincaid ◽  
...  
Keyword(s):  
Zinc Sulfate ◽  
Intestinal Parasites ◽  
Life Stage ◽  
Clinical Signs ◽  
Parasite Prevalence ◽  
Toxocara Canis ◽  
Geographical Region ◽  
Test Results ◽  
Geographical Regions ◽  
Combined Microscopy

Abstract Background Canine life stage is a key factor in parasite prevalence as clinical signs associated with parasitism are more common in pups. In adult dogs, health status and geographical region may also play a role in parasite prevalence. The purpose of this study was to evaluate fecal test results using zinc sulfate flotation by centrifugation combined with fecal antigen testing for hookworms (Ancylostoma spp. Uncinaria stenocephala), ascarids (Toxocara canis, Toxascaris spp., Baylisascaris spp.) and whipworms (Trichuris vulpis) sorted by age, geographical region and veterinary visit type. Methods A retrospective sample of intestinal parasite panels submitted to IDEXX Laboratories from 1,626,104 individual dogs were selected from the continental USA from 1 January 2017 to 31 December 2019. These data contain results from fecal exams performed using zinc sulfate flotation by centrifugation paired with coproantigen immunoassay results for hookworms, ascarids, whipworms and Giardia (Fecal Dx® with Giardia coproantigen immunoassay plate). For paired testing, if either the coproantigen assay or flotation test was positive, the sample was considered to be positive. Data were summarized by age category, U.S. Census Bureau geographical region (Northeast, South, Midwest, West) and veterinary visit type. Visit types were subdivided into Wellness Visits and Other Clinical Visits in which a fecal sample was submitted. Results In dogs presenting for either Wellness Visits or Other Clinical Visits in which Giardia testing was included, Giardia had the highest positivity (combined results for microscopy and coproantigen: 12.2 and 10.8%, respectively), followed by hookworms (combined microscopy and coproantigen: 4.1 and 4.2%, respectively), ascarids (combined microscopy and coproantigen: 2.5 and 1.7%, respectively) and whipworms (combined microscopy and coproantigen: 1.1 and 1.4%, respectively). When all test results were pooled together, pups aged 2–6 months were observed to have the highest proportion of positive results by either microscopy or coproantigen immunoassay regardless of clinical visit type. Parasite positivity varied by geographical region. Regardless of visit type, age or geographical region, the coproantigen method was observed to find a higher proportion of positive test results than microscopy in Giardia, ascarids, hookworms and whipworms. Conclusions The Fecal Dx® coproantigen immunoassay combined with the zinc sulfate flotation by centrifugation method uncovers a higher number of positive hookworm, ascarid and whipworm infections than zinc sulfate flotation alone in both pups and adult dogs across all geographical regions of the USA regardless of visit type.

scholarly journals The Wild West of Emergency Use Authorizations for SARS-CoV-2 Testing: What Could Be the True Sensitivity?

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S142-S143
Author(s):  
S Dalal ◽  
S Patel ◽  
J M Petersen ◽  
D Jhala
Keyword(s):  
Medical Center ◽  
Initial Result ◽  
Reference Laboratory ◽  
Test Results ◽  
Rt Pcr ◽  
Repeat Testing ◽  
Parallel Testing ◽  
Percent Agreement ◽  
Instructions For Use ◽  
Multiple Reference

Abstract Introduction/Objective SARS-CoV-2 is a pandemic that has required mobilization to meet urgent needs. In this mobilization, emergency use authorizations (EUA) have been issued by the FDA to expedite the deployment of these tests. This has led to a situation whereby sensitivity has not been rigorously studied for any of the assays with EUAs. Estimates can be extrapolated from the limited samples documented by the company in their instructions for use (IFU). Although the nationwide shortage of testing reagents prevent parallel testing of multiple platforms on all specimens, observations of repeat specimens at the Veteran Affairs Medical Center (VAMC) provides the first study in the literature of more complete data for SARS-CoV-2 nucleic acid (RT-PCR) assay on sensitivity on the Abbott (Abbott Park Ill) and Cepheid (Sunnyvale CA) assays. Methods A retrospective search was performed for all test results for SARS-CoV-2 by RT-PCR from 3/1/2020 to 4/14/2020 at Corporal Michael J. Crescenz Medical Center, in order to evaluate the sensitivity on Abbott m2000 and Cepheid platforms. Results across multiple reference laboratories and in-house testing platforms were collated in a table with all patients clinically requiring repeat testing recorded. Results 114/863 patients had repeat testing. The tests were performed initially by outside reference laboratories (25 patients), on the Abbott m2000 (63 patients), and Cepheid Infinity (26 patients). 15/114 (13%) had discordant results on repeat testing. This included 1 test initially done by a reference laboratory. 8 days after the initial result from the reference lab, a positive for the same patient was identified on the Abbott platform. 11 initial Abbott results were discordant on further repeat testing on two platforms - Abbott (6 patients) and Cepheid (5 patients) 1-6 days later. In addition, 3 initial Cepheid were discordant on further repeat testing by the same Cepheid platform (1-16 days later). Conclusion While the instructions for use for both platforms suggest 100% sensitivity and specificity (due to the 100% positive and negative percent agreement in limited specimens), the true sensitivity is less than 100%, particularly early in the course of the infection. In our study, the positive percent agreement (surrogate for sensitivity) was 83% for initial Abbott tests, 88% for initial Cepheid tests, and 95% by Reference laboratory platform.

scholarly journals Haemostatic and thrombo-embolic complications in pregnant women with COVID-19: a systematic review and critical analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Juliette Servante ◽  
Gill Swallow ◽  
Jim G. Thornton ◽  
Bethan Myers ◽  
Sandhya Munireddy ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Pregnant Women ◽  
Clinical Evidence ◽  
Case Reports ◽  
Standard Form ◽  
Test Results ◽  
Maternal Deaths ◽  
High Clinical Suspicion ◽  
Increased Risk ◽  
Definition Of

Abstract Background As pregnancy is a physiological prothrombotic state, pregnant women may be at increased risk of developing coagulopathic and/or thromboembolic complications associated with COVID-19. Methods Two biomedical databases were searched between September 2019 and June 2020 for case reports and series of pregnant women with a diagnosis of COVID-19 based either on a positive swab or high clinical suspicion where no swab had been performed. Additional registry cases known to the authors were included. Steps were taken to minimise duplicate patients. Information on coagulopathy based on abnormal coagulation test results or clinical evidence of disseminated intravascular coagulation (DIC), and on arterial or venous thrombosis, were extracted using a standard form. If available, detailed laboratory results and information on maternal outcomes were analysed. Results One thousand sixty-three women met the inclusion criteria, of which three (0.28, 95% CI 0.0 to 0.6) had arterial and/or venous thrombosis, seven (0.66, 95% CI 0.17 to 1.1) had DIC, and a further three (0.28, 95% CI 0.0 to 0.6) had coagulopathy without meeting the definition of DIC. Five hundred and thirty-seven women (56%) had been reported as having given birth and 426 (40%) as having an ongoing pregnancy. There were 17 (1.6, 95% CI 0.85 to 2.3) maternal deaths in which DIC was reported as a factor in two. Conclusions Our data suggests that coagulopathy and thromboembolism are both increased in pregnancies affected by COVID-19. Detection of the former may be useful in the identification of women at risk of deterioration.

scholarly journals Defining a research agenda for youth sport specialisation in the USA: the AMSSM Youth Early Sport Specialization Summit

2021 ◽  
Vol 55 (3) ◽  
pp. 135-143
Author(s):  
Stephanie A Kliethermes ◽  
Stephen W Marshall ◽  
Cynthia R LaBella ◽  
Andrew M Watson ◽  
Joel S Brenner ◽  
...  
Keyword(s):  
Research Agenda ◽  
Sport Participation ◽  
Youth Sport ◽  
Well Being ◽  
Medical Society ◽  
Current Evidence ◽  
Future Research ◽  
Long Term Effects ◽  
Increased Risk ◽  
The Usa

Sport specialisation is becoming increasingly common among youth and adolescent athletes in the USA and many have raised concern about this trend. Although research on sport specialisation has grown significantly, numerous pressing questions remain pertaining to short-term and long-term effects of specialisation on the health and well-being of youth, including the increased risk of overuse injury and burnout. Many current elite athletes did not specialise at an early age. Methodological and study design limitations impact the quality of current literature, and researchers need to prioritise pressing research questions to promote safe and healthy youth sport participation. The American Medical Society for Sports Medicine hosted a Youth Early Sport Specialization Summit in April 2019 with the goal of synthesising and reviewing current scientific knowledge and developing a research agenda to guide future research in the field based on the identified gaps in knowledge. This statement provides a broad summary of the existing literature, gaps and limitations in current evidence and identifies key research priorities to help guide researchers conducting research on youth sport specialisation. Our goals are to help improve the quality and relevance of research on youth sport specialisation and to ultimately assure that opportunities for healthy and safe sport participation continue for all youth.

scholarly journals 1631. Mycobacterium septicum: A 6-year Clinical Experience from a Tertiary Hospital and Reference Laboratory

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S807-S807
Author(s):  
John Raymond U Go ◽  
Cristina G Corsini Campioli ◽  
Omar Abu Saleh ◽  
John Wilson ◽  
Sharon Deml ◽  
...  
Keyword(s):  
Lung Disease ◽  
Treatment Duration ◽  
Retrospective Chart Review ◽  
Patient Characteristics ◽  
Tertiary Hospital ◽  
High Rate ◽  
Clinical Microbiology Laboratory ◽  
Reference Laboratory ◽  
Peritoneal Dialysis Catheter ◽  
Increased Risk

Abstract Background Mycobacterium septicum is a rapidly growing non-tuberculous mycobacterium. It is a ubiquitous organism capable of causing infections in both healthy and immunocompromised individuals. Only a few cases have been reported to date, and standard therapeutic regimens, and optimal treatment duration have not been defined. Methods We conducted a retrospective chart review of all patients seen at Mayo Clinic in Rochester, MN from July 2014 to March 2020 from whom Mycobacterium septicum was isolated in culture by our clinical microbiology laboratory. Results There were 12 patients identified with M. septicum infection – 7 males and 5 females. The average age was 67 years, with an age range of 48 to 80 years. Seven of 12 isolates obtained were from sputum samples. Only one patient was on immunosuppressive medication. Three cases were considered clinically significant infections for which directed anti-mycobacterial therapy was instituted. In two of these three cases, co-infection with Mycobacterium avium complex (MAC) was seen. Underlying structural lung disease was present in the two cases of pulmonary infections. Peritoneal dialysis catheter-related peritonitis was seen in the third case. All the isolates were susceptible to amikacin, ciprofloxacin, imipenem, linezolid, moxifloxacin, and trimethoprim-sulfamethoxazole (TMP-SMX). The isolates were resistant to clarithromycin and doxycycline. Patient Characteristics, Associated M. septicum Illness, and Therapy Provided Antimicrobial Susceptibility Profiles of the Mycobacterium septicum Isolates, MIC (mcg/mL) and Interpretation Patient Demographics and Specimen Source of Mycobacerium septicum Isolates Conclusion M. septicum is an unusual cause of non-tuberculous mycobacterial infection. The presence of a foreign body may increase the risk of infection. Individuals with underlying structural lung disease are also likely to be at increased risk of developing pulmonary infection. Generalized treatment recommendations are limited by the lack of prospective controlled trials; hence, optimal antibiotic regimen and treatment duration have not been firmly established. Susceptibility testing should be performed to guide treatment selection, but the use of combination therapy with potentially empiric agents like amikacin, ciprofloxacin, imipenem, linezolid, moxifloxacin, and TMP-SMX as demonstrated in this small study, can be considered. A high rate of macrolide resistance was noted in our study. Disclosures All Authors: No reported disclosures

Abstract TP73: Transition of ECASS III Results to Clinical Practice: 90 Day Outcomes in a US Cohort

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Carolyn A Cronin ◽  
Patricia Langenberg ◽  
Tara M Dutta ◽  
Steven J Kittner
Keyword(s):  
Clinical Practice ◽  
Functional Outcome ◽  
Treatment Time ◽  
Small Community ◽  
Time To Treatment ◽  
Select Group ◽  
Symptomatic Intracerebral Hemorrhage ◽  
Increased Risk ◽  
The Usa ◽  
Iv Tpa

Introduction: ECASS III showed benefit of IV tPA for acute ischemic stroke (AIS) 3-4.5 hr from onset in a select group of patients from Europe, with this extended treatment subsequently recommended by the AHA/ASA. We prospectively enrolled AIS patients treated with IV tPA as this recommendation was being applied in clinical practice, to determine safety and efficacy in a representative cohort from the USA. Methods: Consecutive AIS patients treated with IV tPA at 18 primary stroke centers throughout Maryland were approached and informed consent obtained during hospitalization. Sites ranged from small community hospitals to large academic medical centers. In-hospital and demographic data were obtained from each site’s GWTG database or directly from the medical record. Study personnel blinded to the treatment time window obtained 90 day modified Rankin Scale (mRS) by structured phone interview. Patients were grouped by time to treatment (≤ 3hr vs. 3-4.5hr) and compared for presence of additional exclusion criteria from ECASS III that are not standard practice in the USA for ≤ 3hr (age >80, history of stroke and diabetes, oral anticoagulant treatment, and NIHSS>25). Good functional outcome (mRS 0-1 and 0-2), mortality, and symptomatic intracerebral hemorrhage (sICH) were analyzed. Results: Patients treated 3-4.5hr were somewhat younger (mean age 62.6 vs. 66.6, p=0.06), and had smaller infarcts (median NIHSS 5 vs. 8, p=0.04). There was only partial adherence to the additional ECASS exclusions (Table 1). There were no significant differences by time to treatment in sICH, mortality, or 90 day functional outcome (Table 2). Conclusion: For US patients treated with IV tPA 3-4.5 hr from onset in every day practice, there is no evidence for increased risk or worse outcomes compared to standard treatment up to 3 hr.

scholarly journals Laboratory capacity of Greek hospitals for diagnosis of salmonellosis and surveillance systems’ performance in the years of economic crisis, 2010–2016

2018 ◽  
Vol 147 ◽  
Author(s):  
K. Mellou ◽  
E. Saranti-Papasaranti ◽  
G. Mandilara ◽  
T. Georgakopoulou
Keyword(s):  
Public Hospitals ◽  
Geographical Region ◽  
Reference Laboratory ◽  
Laboratory System ◽  
Surveillance Systems ◽  
National Reference Laboratory ◽  
Notification System ◽  
National Reference ◽  
Laboratory Capacity ◽  
Mandatory Notification

AbstractAusterity might have affected the capacity of public hospitals in Greece to diagnose salmonellosis (laboratory capacity) over the period 2010–2016, as well as the performance of the existing surveillance systems. The scope of this paper is to present data on laboratory capacity over these years, as well as the results of a two-source capture-recapture study (data from Mandatory Notification System and National Reference Laboratory System for Salmonella). The main findings were that: (a) laboratory capacity was high and steady besides the financial crisis, (b) the estimated number of laboratory-confirmed cases (n = 6017, 95% CI 5892–6142) resulted in an incidence rate (7.9 cases/100 000 population) almost twice than that reported by the two systems Mandatory Notification System (MNS); 4.1 and National Reference Laboratory System (NRLS); 4.5 cases/100 000 population, (c) underreporting was high for both systems (MNS; 47.5% and NRLS; 42.8%) and (d) differences by geographical region, size and type of hospital were identified. We suggest that (a) specific interventions are needed to increase completeness of the systems by type of hospital and geographical region, (b) record linkage can help in estimating the disease burden in a more valid way than each system separately and (c) a common electronic database in order to feed one system to the other could significantly increase completeness of both systems.

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