scholarly journals Right axis deviation in the canine electrocardiogram for predicting severity of pulmonic stenosis: a retrospective cohort analysis

2022 ◽  
pp. 1-5
Author(s):  
Leah H. Ackerman ◽  
Penny S. Reynolds ◽  
Michael Aherne ◽  
Simon T. Swift
Keyword(s):  
Characteristic Curve ◽  
Cohort Analysis ◽  
Clinical Signs ◽  
Small Animal ◽  
Axis Deviation ◽  
University Of Florida ◽  
Pulmonic Stenosis ◽  
Stenosis Severity ◽  
Associated Risk Factors ◽  
Clinic Medical

Abstract OBJECTIVE To investigate the predictive value of right axis deviation of the mean electrical axis (MEA) in assessing the severity of pulmonic stenosis (PS) in dogs. ANIMALS Records for 218 client-owned dogs diagnosed between 2014 and 2020 with PS as determined by Doppler echocardiography. PROCEDURES University of Florida Small Animal Clinic medical records were reviewed, and signalment and clinical risk variables (murmur grade and clinical signs) were extracted. MEA was determined from ECG records by use of leads I and III. Predictive potential of MEA and associated risk factors to diagnose PS severity (mild [< 50 mm Hg], moderate, or severe [> 75 mm Hg]) were assessed by receiver-operating characteristic curve analysis and quantile regression. RESULTS Records for 88 dogs were eligible for analysis. Greater PS severity was associated with smaller breeds presenting with ECG abnormalities, overt clinical signs, and high-category murmur grades (IV and V). Mean MEA increased with stenosis severity category, with an average of 62° for mild, 113° for moderate, and 157° for severe. Each 10° increase in MEA corresponded to an approximately 5–mm Hg increase in PG. Increasing PS severity was associated with MEA right axis deviation > 100° and the more severe cases (PG > 75 mm Hg) with MEA right axis deviation > –180°. CLINICAL RELEVANCE Mean electrical axis right axis deviation may be a useful screening metric for dogs with suspected moderate to severe PS.

scholarly journals Machine Learning Prediction of SARS-CoV-2 Polymerase Chain Reaction Results with Routine Blood Tests

2020 ◽  
Author(s):  
Thomas Tschoellitsch ◽  
Martin Dünser ◽  
Carl Böck ◽  
Karin Schwarzbauer ◽  
Jens Meier
Keyword(s):  
Machine Learning ◽  
Polymerase Chain Reaction ◽  
Characteristic Curve ◽  
Cohort Analysis ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Blood Tests ◽  
Routine Blood ◽  
Machine Learning Model ◽  
Polymerase Chain

Abstract Objective The diagnosis of COVID-19 is based on the detection of SARS-CoV-2 in respiratory secretions, blood, or stool. Currently, reverse transcription polymerase chain reaction (RT-PCR) is the most commonly used method to test for SARS-CoV-2. Methods In this retrospective cohort analysis, we evaluated whether machine learning could exclude SARS-CoV-2 infection using routinely available laboratory values. A Random Forests algorithm with 1353 unique features was trained to predict the RT-PCR results. Results Out of 12,848 patients undergoing SARS-CoV-2 testing, routine blood tests were simultaneously performed in 1528 patients. The machine learning model could predict SARS-CoV-2 test results with an accuracy of 86% and an area under the receiver operating characteristic curve of 0.90. Conclusion Machine learning methods can reliably predict a negative SARS-CoV-2 RT-PCR test result using standard blood tests.

Serum cobalamin concentrations and small intestinal ultrasound changes in 75 cats with clinical signs of gastrointestinal disease: a retrospective study

2016 ◽  
Vol 19 (1) ◽  
pp. 48-56 ◽  
Author(s):  
Maria C Jugan ◽  
John R August
Keyword(s):  
Small Intestine ◽  
Gastrointestinal Disease ◽  
Clinical Signs ◽  
Small Animal ◽  
Abdominal Ultrasound ◽  
Wall Layer ◽  
Normal Serum ◽  
Definitive Diagnosis ◽  
Albumin Concentration ◽  
Small Intestinal

Objectives The aim of the study was to evaluate ultrasonographic changes in the small intestine of cats with clinical signs of gastrointestinal disease and low or low–normal serum cobalamin concentrations. Methods Records for client-owned cats presenting to the small animal hospital with signs of gastrointestinal disease and in which serum cobalamin concentrations were measured from 2000–2013 were reviewed. Inclusion criteria were cobalamin concentrations <500 ng/l, abdominal ultrasound within 1 month of cobalamin testing and definitive diagnosis. Results Of 751 serum cobalamin measurements, hypocobalaminemia or low–normal cobalamin was identified in 270 cats, abdominal ultrasound was performed in 207 of those cats and a diagnosis was available for 75 of them. Small intestinal ultrasound changes were detected in 49/75 (65%) cats. Abnormalities included thickening, loss of wall layer definition, echogenicity alterations and discrete masses. Serum cobalamin concentrations <500 ng/l were observed with diagnoses of inflammatory disease, neoplasia, infectious disease and normal histopathology. Cobalamin concentration was significantly lower in cats with lymphoma or inflammatory bowel disease compared with other gastrointestinal neoplasia ( P = 0.031). No difference was found between cobalamin concentration and the presence of ultrasound abnormalities, specific ultrasound changes or albumin concentration. Conclusions and relevance One-third of symptomatic cats with hypocobalaminemia or low–normal cobalamin concentrations may have an ultrasonographically normal small intestine. For the majority of cats in this study, histopathologic abnormalities were observed in the small intestine, regardless of ultrasound changes. These findings suggest gastrointestinal disease should not be excluded based on low–normal cobalamin concentrations, even with a concurrent normal ultrasound examination. Additional studies are needed in cats with low–normal serum cobalamin concentrations, as a definitive diagnosis was not pursued consistently in those cats. However, data from this study suggest that careful monitoring, histopathologic evaluation and future cobalamin supplementation may be warranted.

scholarly journals Clinical Evidence of Lyme Disease in Dogs and Disease Awareness Among Students and Veterinarians in Veracruz, Mexico

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Blanca Paola Boria-Gamboa ◽  
José Alfredo Villagómez-Cortés ◽  
David Itzcoatl Martínez-Herrera
Keyword(s):  
Differential Diagnosis ◽  
Lyme Disease ◽  
Professional Practice ◽  
Clinical Evidence ◽  
Clinical Signs ◽  
Small Animal ◽  
Apparent Absence ◽  
Veterinary Students ◽  
Disease Awareness ◽  
Veterinary Curriculum

Background: Lyme disease is a relatively new and zoonotic canine pathology mostly unknown by people involved in the management and care of dogs.  Objective: to assess the knowledge about Lyme disease by veterinarians and veterinary students in Veracruz, Mexico. Methodology: three questionnaires were designed and applied to 290 individuals (40 small animal veterinarians, 50 in other professional practice and 200 veterinary students). Results and discussion: in general, the three groups were unaware about the disease, although there is a high interest in learning about this problem. Graduates from seven universities included in this study stated that Lyme disease was not part of the veterinary curriculum in their schools. Five clinical cases suggestive of Lyme disease occurring in dogs in the area were detected at the time of this research. Conclusion: although the presence of the agent causing Lyme disease has not been demonstrated in the studied area due to the lack of laboratory support and the apparent absence of the vector, it cannot be ruled out; furthermore, it is important that veterinary practitioners and student alike be aware of the potential presence of Lyme disease, paying particular attention to differential diagnosis when resembling clinical signs are observed.

scholarly journals Molecular characterization and serodiagnostic potential of two serpin proteins in Psoroptes ovis var. cuniculi

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Xiaobin Gu ◽  
Yuhang Chen ◽  
Chongyang Zhang ◽  
Yue Xie ◽  
Nengxing Shen ◽  
...  
Keyword(s):  
Inflammatory Responses ◽  
Early Stage ◽  
Characteristic Curve ◽  
Clinical Signs ◽  
Serine Proteinase ◽  
Reproductive Development ◽  
Enzyme Linked Immunosorbent Assay ◽  
Diagnostic Efficiency ◽  
Psoroptes Ovis ◽  
Domestic Rabbits

Abstract Background Psoroptes ovis var. cuniculi is a common ectoparasite of wild and domestic rabbits worldwide that causes economically devastating losses in commercial rabbit husbandry and significantly affects the overall health of rabbits. Serine proteinase inhibitor (serpin) is present in almost all organisms that are involved in host–pathogen interactions, inflammatory responses, and reproductive development, among others. However, very little research has been carried out on P. ovis var. cuniculi serpins. Methods Two serpin genes of P. ovis var. cuniculi (Pso c 27 and PsoSP2 cDNAs) were cloned and molecularly characterized. The transcriptional profiles and tissue localization of these two serpins in P. ovis var. cuniculi were investigated by quantitative real-time PCR and immunohistochemistry, respectively. The potential function of recombinant Pso c 27 and PsoSP2 (rPso c 27 and rPsoSP2) in the serodiagnosis of P. ovis var. cuniculi infestation in rabbits was evaluated using a newly devleoped indirect enzyme-linked immunosorbent assay. Results Both the 523-residue Pso c 27 and the 240-residue PsoSP2 proteins contained typical serpin domains and signatures. Both Pso c 27and PsoSP2 cDNAs were expressed throughout the life-cycle; specifically, the cDNAs showed significantly higher expression in female mites than in larva, nymph, and male mites (Pso c 27: F(3, 8) = 1935.953, P < 0.0001; PsoSP2: F(3, 8) = 660.669, P < 0.0001). The native Pso c 27 and PsoSP2 proteins localized in the ovary and mouthparts of adult female mites, respectively. Compared to rPsoSP2, rPso c 27 showed better diagnostic efficiency, with higher values of sensitivity, specificity, and area under the receiver operating characteristic curve (rPso c 27 vs rPsoSP2: 96.0 vs 90.0%; 90.91 vs 78.18%; 0.988 vs 0.964, respectively). Moreover, rPso c 27 showed seropositivity in 80% of the rabbits as early as the 2 weeks post-infestation, prior to visible clinical signs and microscopy-positive of skin scrapings. Conclusions These results suggest that these two serpins may play essential roles in reproductive development, serum-feeding, and pathogenicity of P. ovis var. cuniculi. Compared to PsoSP2, Pso c 27 appears to be a potential antigen for serodiagnosis of P. ovis var. cuniculi infestation in rabbits, especially at the early stage of infestation.

Fever and Leukocytosis in Critically Ill Trauma Patients: It is Not the Blood

2009 ◽  
Vol 75 (5) ◽  
pp. 405-410 ◽  
Author(s):  
Jeffrey A. Claridge ◽  
Joseph F. Golob ◽  
Adam M. A. Fadlalla ◽  
Mark A. Malangoni ◽  
Jeffrey Blatnik ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Injury Severity ◽  
Leukocyte Count ◽  
Cohort Analysis ◽  
Clinical Signs ◽  
Blood Cultures ◽  
Daily Temperature ◽  
Trauma Patients

The diagnosis of bacteremia in critically ill patients is classically based on fever and/or leukocytosis. The objectives of this study were to determine 1) if our intensive care unit obtains blood cultures based on fever and/or leukocytosis over the initial 14 days of hospitalization after trauma; and 2) the efficacy of this diagnostic workup. An 18-month retrospective cohort analysis was performed on consecutively admitted trauma patients. Data collected included demographics, injuries, and the first 14 days maximal daily temperature, leukocyte count, and results of blood and catheter tip cultures. Fever was defined as a maximum daily temperature of 38.5°C or greater and leukocytosis as a leukocyte count 12,000/mm3 or greater of blood. Five hundred ten patients were evaluated for a total of 3,839 patient-days. The mean age and injury severity score were 49 ± 1 years and 19 ± 1, respectively. Four hundred twenty-five blood culture episodes were obtained and 25 (6%) bacteremias were identified in 23 patients (5%). A significant association was found between obtaining blood cultures in patients with fever (relative risk [RR], 7.7), leukocytosis (RR, 1.3), and fever + leukocytosis (RR, 3.2). However, no significant association was found between these clinical signs and the diagnosis of bacteremia. In fact, fever alone was inversely associated with bacteremia. Our intensive care unit follows the common “fever workup” practice and obtains blood cultures based on the presence of fever and leukocytosis. However, fever and leukocytosis were not associated with bacteremia, suggesting inefficiency and that other factors are more important after trauma.

scholarly journals Identifying patients who access musculoskeletal physical therapy: a retrospective cohort analysis

2020 ◽  
Author(s):  
Jason A Sharpe ◽  
Brook I Martin ◽  
Julie M Fritz ◽  
Michael G Newman ◽  
John Magel ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Retrospective Cohort ◽  
Physical Therapist ◽  
Characteristic Curve ◽  
Cohort Analysis ◽  
Past Research ◽  
Urgent Care ◽  
Medical Provider ◽  
Primary Analysis ◽  
Musculoskeletal Conditions

Abstract Background Musculoskeletal conditions are common and cause high levels of disability and costs. Physical therapy is recommended for many musculoskeletal conditions. Past research suggests that referral rates appear to have increased over time, but the rate of accessing a physical therapist appears unchanged. Objective Our retrospective cohort study describes the rate of physical therapy use after referral for a variety of musculoskeletal diagnoses while comparing users and non-users of physical therapy services after referral. Methods The study sample included patients in the University of Utah Health system who received care from a medical provider for a musculoskeletal condition. We included a comprehensive set of variables available in the electronic data warehouse possibly associated with attending physical therapy. Our primary analysis compared differences in patient factors between physical therapy users and non-users using Poisson regression. Results 15 877 (16%) patients had a referral to physical therapy, and 3812 (24%) of these patients accessed physical therapy after referral. Most of the factors included in the model were associated with physical therapy use except for sex and number of comorbidities. The receiver operating characteristic curve was 0.63 suggesting poor predictability of the model but it is likely related to the heterogeneity of the sample. Conclusions We found that obesity, ethnicity, public insurance and urgent care referrals were associated with poor adherence to physical therapy referral. However, the limited predictive power of our model suggests a need for a deeper examination into factors that influence patients access to a physical therapist.

scholarly journals Development and Application of New Mouse Models To Study the Pathogenesis of Clostridium perfringens Type C Enterotoxemias

2009 ◽  
Vol 77 (12) ◽  
pp. 5291-5299 ◽  
Author(s):  
Francisco A. Uzal ◽  
Juliann Saputo ◽  
Sameera Sayeed ◽  
Jorge E. Vidal ◽  
Derek J. Fisher ◽  
...  
Keyword(s):  
Mouse Models ◽  
Clostridium Perfringens ◽  
Clinical Signs ◽  
Passive Immunization ◽  
Small Animal ◽  
Abdominal Distension ◽  
Virulent Type ◽  
Genes Encoding ◽  
Type C ◽  
Beta Toxin

ABSTRACT Clostridium perfringens type C isolates cause enterotoxemias and enteritis in humans and livestock. While the major disease signs and lesions of type C disease are usually attributed to beta toxin (CPB), these bacteria typically produce several different lethal toxins. Since understanding of disease pathogenesis and development of improved vaccines is hindered by the lack of small animal models mimicking the lethality caused by type C isolates, in this study we developed two mouse models of C. perfringens type C-induced lethality. When inoculated into BALB/c mice by intragastric gavage, 7 of 14 type C isolates were lethal, whereas when inoculated intraduodenally, these strains were all lethal in these mice. Clinical signs in intragastrically and intraduodenally challenged mice were similar and included respiratory distress, abdominal distension, and neurological alterations. At necropsy, the small, and occasionally the large, intestine was dilated and gas filled in most mice developing a clinical response. Histological changes in the gut were relatively mild, consisting of attenuation of the mucosa with villus blunting. Inactivation of the CPB-encoding gene rendered the highly virulent type C strain CN3685 avirulent in the intragastric model and nearly nonlethal in the intraduodenal model. In contrast, inactivation of the genes encoding alpha toxin and perfringolysin O only slightly decreased the lethality of CN3685. Mice could be protected against lethality by intravenous passive immunization with a CPB antibody prior to intragastric challenge. This study proves that CPB is a major contributor to the systemic effects of type C infections and provides new mouse models for investigating the pathogenesis of type C-induced lethality.

scholarly journals Taenia multiceps coenurosis in Tanzania: a major and under-recognised livestock disease problem in pastoral communities

2019 ◽  
Vol 184 (6) ◽  
pp. 191-191 ◽  
Author(s):  
Ellen C Hughes ◽  
Tito K Kibona ◽  
William A de Glanville ◽  
Felix Lankester ◽  
Alicia Davis ◽  
...  
Keyword(s):  
Small Ruminant ◽  
Clinical Signs ◽  
Small Ruminants ◽  
Control Measures ◽  
Taenia Multiceps ◽  
Individual Level ◽  
Pastoral Communities ◽  
Associated Risk Factors ◽  
The Individual ◽  
Spinal Cord Cysts

AbstractA neurological syndrome of small ruminants, known locally as ‘ormilo’, has been reported among pastoralist livestock keepers in Tanzania. This study was carried out in four affected pastoral communities to determine the prevalence and associated risk factors, characterise the clinical signs and investigate the aetiology of the syndrome. Questionnaires were administered at all households (n=480) within four study villages. Overall, 94 per cent of households reported at least one case in the previous 12 months. By village, the individual-level 12-month period prevalence ranged from 11 per cent to 34 per cent, equivalent to about 10,000 small ruminants across the four villages. Thirty-eight households were randomly selected for further investigation. Proprioceptive deficits and weakness were the most commonly observed clinical signs in affected animals. Brain and spinal cord cysts consistent with Taenia multiceps infection were detected in 32 (82 per cent) of 39 affected animals selected for postmortem examination. Feeding small ruminant brains to dogs was identified as an important risk factor for the syndrome, even in households that did not own dogs. This study confirms cerebral coenurosis as a major cause of small ruminant neurological disease in northern Tanzania and highlights the urgent need for further investigation to quantify the disease burden and to identify and implement control measures.

scholarly journals A Probabilistic Model for Cushing’s Syndrome Screening in At-Risk Populations: A Prospective Multicenter Study

2016 ◽  
Vol 101 (10) ◽  
pp. 3747-3754 ◽  
Author(s):  
Antonio León-Justel ◽  
Ainara Madrazo-Atutxa ◽  
Ana I. Alvarez-Rios ◽  
Rocio Infantes-Fontán ◽  
Juan A. Garcia-Arnés ◽  
...  
Keyword(s):  
At Risk ◽  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Risk Score ◽  
Scoring System ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Clinical Signs ◽  
At Risk Populations ◽  
Operating Characteristic Curve

Context: Cushing’s syndrome (CS) is challenging to diagnose. Increased prevalence of CS in specific patient populations has been reported, but routine screening for CS remains questionable. To decrease the diagnostic delay and improve disease outcomes, simple new screening methods for CS in at-risk populations are needed. Objective: To develop and validate a simple scoring system to predict CS based on clinical signs and an easy-to-use biochemical test. Design: Observational, prospective, multicenter. Setting: Referral hospital. Patients: A cohort of 353 patients attending endocrinology units for outpatient visits. Interventions: All patients were evaluated with late-night salivary cortisol (LNSC) and a low-dose dexamethasone suppression test for CS. Main Outcome Measures: Diagnosis or exclusion of CS. Results: Twenty-six cases of CS were diagnosed in the cohort. A risk scoring system was developed by logistic regression analysis, and cutoff values were derived from a receiver operating characteristic curve. This risk score included clinical signs and symptoms (muscular atrophy, osteoporosis, and dorsocervical fat pad) and LNSC levels. The estimated area under the receiver operating characteristic curve was 0.93, with a sensitivity of 96.2% and specificity of 82.9%. Conclusions: We developed a risk score to predict CS in an at-risk population. This score may help to identify at-risk patients in non-endocrinological settings such as primary care, but external validation is warranted.

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