Discrepancy between Clinical and Postmortem Diagnosis  of Dogs in a Veterinary Medical Teaching Hospital

Background: The postmortem examination offers the opportunity to study the processes involved in disease. Although a portion of veterinary medical professionals and students consider the necropsy as a diagnostic tool of purely academic interest, it can provide valuable assistance in formulating health strategies in order to prevent and control animal diseases. The number of necropsies performed in general is higher in universities where the cost is subsidized. In veterinary medicine, studies intended to assess the frequency of necropsy and the discrepancy between clinical and postmortem diagnosis of dogs are rare. The main purpose of the necropsy is to discover the cause of death of dogs, by defining a possible etiology and pathogenesis in order to reach a diagnosis.Material, Methods & Results: We used medical records and necropsy records to define the clinical and postmortem diagnosis, respectively. Data relating to deaths was recorded as the number of euthanized dogs and natural deaths in 2014. From the information cause of death, these were categorized as infectious disease, cardiac, gastrointestinal, renal, pulmonary, neurological, metabolic or endocrine disease, neoplastic disease, trauma, or systemic disease. We used the Binomial discrepancy in the comparison of the rates between different years and also to verify the association between discrepancy and the correlation between clinical and postmortem diagnosis of dogs with euthanasia and natural death, with statistical significance (P < 0.05). In 2009, 56.81% (25/44) of cases included in the study had a concordance between the clinical and postmortem diagnosis, while 43.19% (19/44) were discordant. In 2014, it was observed that 71.70% (76/106) of the diagnosis was confirmed with the necropsy, while 28.30% (30/106) were discordant. The disagreement rate was higher in 2009 (P < 0.05) and there was a reduction of 14.89% in the disagreement rate between 2009 and 2014. Regarding the cause of death, infectious diseases, gastrointestinal disease, and heart disease were the categories in which the discrepancy was higher. It was found that in the group of dogs euthanized, the discrepancy rate was lower compared with the group of dogs that had anatural death (P < 0.05).Discussion: The disagreement rate can be considered high when compared with a veterinary study and similar to those observed in a human study. Decrease in the discrepancy rate in the years, as observed by other authors, that can be attributed to improvements and expansion of diagnostic services of the hospital and better training of veterinarians. The difficulty in determining the etiology of infectious diseases is associated with lack of specific diagnostic tests and the high cost of available tests, which often is not bank rolled by the tutor. Dogs in this study were rarely submitted to diagnostics tests such as electrocardiogram or echocardiogram which explains the high discordance in the diagnosis of heart disease. Distemper is an infectious disease of great importance regarding euthanized animals, especially in cases that progress to central nervous system injuries with extremely poor prognosis and wind up having euthanasia indication. Another common cause of domestic animals euthanasia indication is the occurrence malignant neoplasms, which depends on the progression of the disease and psychological and social conditions of the owner. The results generated herein suggests that infectious, gastrointestinal and cardiac diseases origin tend to have a greater discordance between clinical and postmortem diagnosis, however this rate is decreasing due to improved infrastructure of veterinary centers with better professionals qualification.

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Improvements in the incidence and survival of cancer and cardiovascular but not infectious disease have driven recent mortality improvements in Scotland: nationwide cohort study of linked hospital admission and death records 2001–2016

10.1101/19003012 ◽

2019 ◽

Author(s):

Paul RHJ Timmers ◽

Joannes J Kerssens ◽

Jon W Minton ◽

Ian Grant ◽

James F Wilson ◽

...

Keyword(s):

Infectious Disease ◽

Heart Disease ◽

Life Expectancy ◽

Infectious Diseases ◽

Hospital Admission ◽

Disease Incidence ◽

Malignant Neoplasm ◽

List Type ◽

Mortality Improvements ◽

Symptoms And Signs

AbstractObjectivesTo identify the causes and future trends underpinning improvements in life expectancy in Scotland and quantify the relative contributions of disease incidence and survival.DesignPopulation-based study.SettingLinked secondary care and mortality records across Scotland.Participants1,967,130 individuals born between 1905 and 1965, and resident in Scotland throughout 2001–2016.Main outcome measuresHospital admission rates and survival in the five years following admission for 28 diseases, stratified by sex and socioeconomic status.ResultsThe five hospital admission diagnoses associated with the greatest burden of death subsequent to admission were “Influenza and pneumonia”, “Symptoms and signs involving the circulatory and respiratory systems”, “Malignant neoplasm of respiratory and intrathoracic organs”, “Symptoms and signs involving the digestive system and abdomen”, and “General symptoms and signs”. Using disease trends, we modelled a mean mortality hazard ratio of 0.737 (95% CI 0.730–0.745) across decades of birth, equivalent to a life extension of ∼3 years per decade. This improvement was 61% (30%–93%) accounted for by improvements in disease survival after hospitalisation (principally cancer) with the remainder accounted for by a fall in hospitalisation incidence (principally heart disease and cancer). In contrast, deteriorations in the incidence and survival of infectious diseases reduced mortality improvements by 9% (∼3.3 months per decade). Overall, health-driven mortality improvements were slightly greater for men than women (due to greater falls in disease incidence), and generally similar across socioeconomic deciles. We project mortality improvements will continue over the next decade but will slow down by 21% because much of the progress in disease survival has already been achieved.ConclusionMorbidity improvements broadly explain observed improvements in overall mortality, with progress on the prevention and treatment of heart disease and cancer making the most significant contributions. The gaps between men and women’s morbidity and mortality are closing, but the gap between socioeconomic groups is not. A slowing trend in improvements in morbidity may explain the stalling in improvements of period life expectancies observed in recent studies in the UK. However, our modelled slowing of improvements could be offset if we achieve even faster improvements in the major diseases contributing to the burden of death, or if we improve prevention and survival of diseases which have deteriorated recently, such as infectious disease, in the future.Summary boxWhat is already known on this topicLong term improvements in Scottish mortality have slowed down recently, while life expectancy inequalities between socioeconomic classes are increasing.Deaths attributed to ischaemic heart disease and stroke in Scotland have declined in the last two decades.What this study addsGains in life expectancy can largely be attributed to improvements in cancer survival and falls in incidence of cancer and cardiovascular disease.The hospitalisation rate and survival of several infectious diseases have deteriorated, and for urinary infections, this decline has been more rapid in more socioeconomically deprived classes.Improvements in morbidity are projected to slow down, with much progress in survival of heart disease and cancer already achieved, and align with the recently observed slow-down in mortality improvements.

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Cardiac rehabilitation

Nepalese Heart Journal ◽

10.3126/njh.v1i0.26018 ◽

2000 ◽

Vol 1 ◽

pp. 9-11

Author(s):

G B Baniya

Keyword(s):

Heart Disease ◽

Infectious Diseases ◽

Cardiac Rehabilitation ◽

Cause Of Death ◽

Third World ◽

Heart Diseases ◽

The Third ◽

The Third World ◽

Developed World

Heart Disease Is the leading cause of death in most of the developed world. Still malnutrition and infectious diseases are the major problem of the third world. Simultaneously with these problem, heart diseases not only of rheumatic origin, even coronary, are also increasing in the third world.

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Sensitivity and Specificity of the National Death Index for Multiple Causes of Death in People With HIV

Public Health Reports ◽

10.1177/0033354920977840 ◽

2021 ◽

pp. 003335492097784

Author(s):

Sandra Schwarcz ◽

Nancy A. Hessol ◽

Matthew A. Spinelli ◽

Ling Chin Hsu ◽

Daniel Wlodarczyk ◽

...

Keyword(s):

Heart Disease ◽

Hepatitis B ◽

Infectious Diseases ◽

Cause Of Death ◽

Causes Of Death ◽

High Specificity ◽

Death Certificates ◽

National Death Index ◽

Expert Review ◽

Sensitivity Specificity

Objectives Inaccuracies in cause-of-death information in death certificates can reduce the validity of national death statistics and result in poor targeting of resources to reduce morbidity and mortality in people with HIV. Our objective was to measure the sensitivity, specificity, and agreement between multiple causes of deaths from death certificates obtained from the National Death Index (NDI) and causes determined by expert physician review. Methods Physician specialists determined the cause of death using information collected from the medical records of 50 randomly selected HIV-infected people who died in San Francisco from July 1, 2016, through May 31, 2017. Using expert review as the gold standard, we measured sensitivity, specificity, and agreement. Results The NDI had a sensitivity of 53.9% and a specificity of 66.7% for HIV deaths. The NDI had a moderate sensitivity for non–AIDS-related infectious diseases and non–AIDS-related cancers (70.6% and 75.0%, respectively) and high specificity for these causes (100.0% and 94.7%, respectively). The NDI had low sensitivity and high specificity for substance abuse (27.3% and 100.0%, respectively), heart disease (58.3% and 86.8%, respectively), hepatitis B/C (33.3% and 97.7%, respectively), and mental illness (50.0% and 97.8%, respectively). The measure of agreement between expert review and the NDI was lowest for HIV (κ = 0.20); moderate for heart disease (κ = 0.45) and hepatitis B/C (κ = 0.40); high for non–AIDS-related infectious diseases (κ = 0.76) and non–AIDS-related cancers (κ = 0.72); and low for all other causes of death (κ < 0.35). Conclusions Our findings support education and training of health care providers to improve the accuracy of cause-of-death information on death certificates.

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The Epidemiologic Transition Theory and Evidence for Cancer Transitions in the US, Select European Nations, and Japan

10.1101/2020.11.25.20238832 ◽

2020 ◽

Author(s):

Omer Gersten ◽

Magali Barbieri

Keyword(s):

Infectious Disease ◽

Infectious Diseases ◽

Cause Of Death ◽

Cancer Mortality ◽

High Income ◽

Transition Theory ◽

Epidemiologic Transition ◽

Death Rates ◽

The Us ◽

Death Data

AbstractDespite cancer being a leading cause of death worldwide, scant research has been carried out on the existence of “cancer transitions,” the idea that as nations develop, they move from a situation where infectious related cancers are prominent, to one where non-infectious related cancers dominate. We use annual cause-of-death data to produce death rates for common types of cancer in select high-income countries. We find that cancer mortality patterns parallel the epidemiologic transition, which states that as countries advance, they move from a regime where infectious diseases are most common to one where non-infectious disease are most common. An implication is that the epidemiologic transition theory as originally formulated continues to be relevant despite some researchers arguing that we need additional stages beyond the original three.

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Geographical patterns of proportionate mortality for the most common causes of death in Brazil

Revista de Saúde Pública ◽

10.1590/s0034-89101992000600008 ◽

1992 ◽

Vol 26 (6) ◽

pp. 424-430 ◽

Cited By ~ 5

Author(s):

Rosely Sichieri ◽

Cecilia A. de Lolio ◽

Valmir R. Correia ◽

James E. Everhart

Keyword(s):

Breast Cancer ◽

Infectious Disease ◽

Heart Disease ◽

Linear Regression ◽

Infectious Diseases ◽

Ischaemic Heart Disease ◽

Chronic Diseases ◽

Heart Diseases ◽

Economic Variables ◽

Socio Economic Variables

Mortality due to chronic diseases has been increasing in all regions of Brazil with corresponding decreases in mortality from infectious diseases. The geographical variation in proportionate mortality for chronic diseases for 17 Brazilian state capitals for the year 1985 and their association with socio-economic variables and infectious disease was studied. Calculations were made of correlation coefficients of proportionate mortality for adults of 30 years or above due to ischaemic heart disease, stroke and cancer of the lung, the breast and stomach with 3 socio-economic variables, race, and mortality due to infectious disease. Linear regression analysis included as independent variables the % of illiteracy, % of whites, % of houses with piped water, mean income, age group, sex, and % of deaths caused by infectious disease. The dependent variables were the % of deaths due to each one of the chronic diseases studied by age-sex group. Chronic diseases were an important cause of death in all regions of Brazil. Ischaemic heart diseases, stroke and malignant neoplasms accounted for more than 34% of the mortality in each of the 17 capitals studied. Proportionate cause-specific mortality varied markedly among state capitals. Ranges were 6.3-19.5% for ischaemic heart diseases, 8.3-25.4% for stroke, 2.3-10.4% for infections and 12.2-21.5% for malignant neoplasm. Infectious disease mortality had the highest (p < 0.001) correlation with all the four socio-economic variables studied and ischaemic heart disease showed the second highest correlation (p < 0.05). Higher socio-economic level was related to a lower % of infectious diseases and a higher % of ischaemic heart diseases. Mortality due to breast cancer and stroke was not associated with socio-economic variables. Multivariate linear regression models explained 59% of the variance among state capitals for mortality due to ischaemic heart disease, 50% for stroke, 28% for lung cancer, 24% for breast cancer and 40% for stomach cancer. There were major differences in the proportionate mortality due to chronic diseases among the capitals which could not be accounted for by the social and environmental factors and by the mortality due to infectious disease.

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HLA and Infectious Diseases

Clinical Microbiology Reviews ◽

10.1128/cmr.00048-08 ◽

2009 ◽

Vol 22 (2) ◽

pp. 370-385 ◽

Cited By ~ 170

Author(s):

Jenefer M. Blackwell ◽

Sarra E. Jamieson ◽

David Burgner

Keyword(s):

Infectious Disease ◽

Infectious Diseases ◽

Human Leukocyte Antigen ◽

Molecular Basis ◽

Selective Pressure ◽

Human Leukocyte ◽

Acquired Immunity ◽

Leukocyte Antigen ◽

Extreme Variability ◽

Classical Human Leukocyte Antigen

SUMMARY Following their discovery in the early 1970s, classical human leukocyte antigen (HLA) loci have been the prototypical candidates for genetic susceptibility to infectious disease. Indeed, the original hypothesis for the extreme variability observed at HLA loci (H-2 in mice) was the major selective pressure from infectious diseases. Now that both the human genome and the molecular basis of innate and acquired immunity are understood in greater detail, do the classical HLA loci still stand out as major genes that determine susceptibility to infectious disease? This review looks afresh at the evidence supporting a role for classical HLA loci in susceptibility to infectious disease, examines the limitations of data reported to date, and discusses current advances in methodology and technology that will potentially lead to greater understanding of their role in infectious diseases in the future.

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Drivers of Infectious Disease Seasonality: Potential Implications for COVID-19

Journal of Biological Rhythms ◽

10.1177/0748730420987322 ◽

2021 ◽

pp. 074873042098732

Author(s):

N. Kronfeld-Schor ◽

T. J. Stevenson ◽

S. Nickbakhsh ◽

E. S. Schernhammer ◽

X. C. Dopico ◽

...

Keyword(s):

Infectious Disease ◽

Infectious Diseases ◽

Multidisciplinary Approach ◽

Preliminary Assessment ◽

Epidemiological Evidence ◽

Wide Range ◽

Human Coronaviruses ◽

Induced Changes ◽

And Behavior ◽

Timing Phase

Not 1 year has passed since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19). Since its emergence, great uncertainty has surrounded the potential for COVID-19 to establish as a seasonally recurrent disease. Many infectious diseases, including endemic human coronaviruses, vary across the year. They show a wide range of seasonal waveforms, timing (phase), and amplitudes, which differ depending on the geographical region. Drivers of such patterns are predominantly studied from an epidemiological perspective with a focus on weather and behavior, but complementary insights emerge from physiological studies of seasonality in animals, including humans. Thus, we take a multidisciplinary approach to integrate knowledge from usually distinct fields. First, we review epidemiological evidence of environmental and behavioral drivers of infectious disease seasonality. Subsequently, we take a chronobiological perspective and discuss within-host changes that may affect susceptibility, morbidity, and mortality from infectious diseases. Based on photoperiodic, circannual, and comparative human data, we not only identify promising future avenues but also highlight the need for further studies in animal models. Our preliminary assessment is that host immune seasonality warrants evaluation alongside weather and human behavior as factors that may contribute to COVID-19 seasonality, and that the relative importance of these drivers requires further investigation. A major challenge to predicting seasonality of infectious diseases are rapid, human-induced changes in the hitherto predictable seasonality of our planet, whose influence we review in a final outlook section. We conclude that a proactive multidisciplinary approach is warranted to predict, mitigate, and prevent seasonal infectious diseases in our complex, changing human-earth system.

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Application of 3D bioprinting in the prevention and the therapy for human diseases

Signal Transduction and Targeted Therapy ◽

10.1038/s41392-021-00566-8 ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Hee-Gyeong Yi ◽

Hyeonji Kim ◽

Junyoung Kwon ◽

Yeong-Jin Choi ◽

Jinah Jang ◽

...

Keyword(s):

Infectious Disease ◽

Infectious Diseases ◽

Rapid Development ◽

In Vitro Models ◽

Delivery Systems ◽

Advanced Technology ◽

3D Bioprinting ◽

Disease Research ◽

Infectious Disease Research

AbstractRapid development of vaccines and therapeutics is necessary to tackle the emergence of new pathogens and infectious diseases. To speed up the drug discovery process, the conventional development pipeline can be retooled by introducing advanced in vitro models as alternatives to conventional infectious disease models and by employing advanced technology for the production of medicine and cell/drug delivery systems. In this regard, layer-by-layer construction with a 3D bioprinting system or other technologies provides a beneficial method for developing highly biomimetic and reliable in vitro models for infectious disease research. In addition, the high flexibility and versatility of 3D bioprinting offer advantages in the effective production of vaccines, therapeutics, and relevant delivery systems. Herein, we discuss the potential of 3D bioprinting technologies for the control of infectious diseases. We also suggest that 3D bioprinting in infectious disease research and drug development could be a significant platform technology for the rapid and automated production of tissue/organ models and medicines in the near future.

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