Diagnostic ultrasound in companion animals.
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Animals↗
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Differential diagnostic test technology: sensitivity and specificity, an OIE validation perspective.
Companion differential diagnostic technology is extremely useful when utilized with marker vaccines for disease control and eradication. Examples of this technology include enzyme-linked immunoassays and particle concentration fluorescence immunoassays. The predictive values of such assays are dependent upon adequate validation of their diagnostic sensitivities and specificities. The World Organization for Animal Health (OIE) has put forth official guidelines for performing complete validation of diagnostic tests. This article presents an overview of these important guidelines.
Animals↗
Comparison of susceptibility to antimicrobials of bacterial isolates from companion animals in a veterinary diagnostic laboratory in Canada between 2 time points 10 years apart.
The susceptibility to antimicrobials of bacterial species most frequently isolated from companion animals in a veterinary teaching diagnostic laboratory was evaluated retrospectively. A significant decrease between 1990-1992 and 2002-2003 was noted in the susceptibility of dog isolates to the following antimicrobials: Escherichia coli to cephalothin (86% to 61%, P < 0.001); E. coli to ampicillin (85% to 67%, P < 0.001); Proteus spp. to ampicillin (92% to 71%, P < 0.01); coagulase-positive staphylococci (Staphylococcus aureus and Staphylococcus intermedius) to enrofloxacin (99% to 95%, P < 0.01). Significantly increased susceptibilities were also noted as follows: coagulase-positive staphylococci to erythromycin (78% to 90%, P < 0.001) and tetracycline (61% to 77%, P < 0.001). Despite a limited number of results available for cats, a significant increase in susceptibility was noted for Pseudomonas spp. to gentamicin (40% to 100%, P < 0.05) and for E. coli to tetracycline (59% to 80%, P < 0.05). Regular updates on the resistance to antimicrobials used in veterinary medicine are required.
Animals↗
Marker vaccine strategies and candidate CSFV marker vaccines.
Classical swine fever (CSF) is an economically important highly contagious disease of swine worldwide. Classical swine fever virus (CSFV) is its etiological agent, and the only natural hosts are domestic pigs and wild boars. Although field CSFV strains vary in the virulence, they all result in serious losses in pig industry. Highly virulent field strains generally cause acute disease and high mortality; moderately virulent field strains raise subacute or chronic infections; postnatal infection by low virulent field strains produces subclinical infection and mortality in the new-born piglets. CSFV can cross the placental barrier, and this transplacental transmission usually results in mortality of fetuses and birth of congenitally infected pigs with a late-onset disease and death. Two main strategies to control CSF epidemic are systematic prophylactic vaccination with live attenuated vaccines (such as C-strain) and non-vaccination stamping-out policy. But neither of them is satisfying enough. Marker vaccine and companion serological diagnostic test is thought to be a promising strategy for future control and eradication of CSF. During the past 15 years, various candidate marker vaccines were constructed and evaluated in the animal experiments, including recombinant chimeric vaccines, recombinant deletion vaccines, DNA vaccines, subunit vaccines and peptide vaccines. Among them, two subunit vaccines entered the large scale marker vaccine trial of EU in 1999. Although they failed to fulfil all the demands of the Scientific Veterinary Committee, they successfully induced solid immunity against CSFV in the vaccinated pigs. It can be expected that new potent marker vaccines might be commercially available and used in systematic prophylactic vaccination campaign or emergency vaccination in the next 15 years. Here, we summarized current strategies and candidate CSFV marker vaccines. These strategies and methods are also helpful for the development of new-generation vaccines against other diseases.
Animals↗
Information seeking during "bad news" oncology interactions: Question asking by patients and their companions.
Previous research has investigated patient question asking in clinical settings as a strategy of information seeking and as an indicator of the level of active patient participation in the interaction. This study investigates questions asked by patients and their companions during stressful encounters in the oncology setting in the USA. We transcribed all questions patients and companions asked the oncologist during 28 outpatient interactions in which "bad news" was discussed (n = 705) and analyzed them for frequency and topic. Additionally, we analyzed the extent to which personal and demographic characteristics and independently obtained ratings of the oncologist-patient/companion relationships were related to question asking. Findings demonstrated that at least one companion was present in 24 (86%) of the 28 interactions and companions asked significantly more questions than patients. The most frequently occurring topics for both patients and companions were treatment, diagnostic testing, diagnosis, and prognosis. In general, personal and demographic characteristics were unrelated to question asking, but older patients asked fewer questions, while more educated patients asked more questions. With regard to ratings of the quality of the dyadic relationships, results showed that "trust" between the physician and companions was positively correlated and "conversational dominance by physician" was negatively correlated with the frequency of companion questions. Additionally, positive ratings of the relationship between physicians and companions were correlated with fewer patient questions. This study demonstrates that companions are active participants in stressful oncology interactions. Future research and physician training in communication would benefit from expanding the focus beyond the patient-physician dyad to the roles and influence of multiple participants in medical interactions.
Aged↗
Laboratory procedures for the diagnosis of gastrointestinal tract diseases of dogs and cats.
An increasing number of laboratory tests are available for diagnosis of gastrointestinal tract diseases in dogs and cats. Use of these tests can lead to more accurate and rapid diagnoses. This review discusses laboratory tests, both new and old, and the role they currently play in the evaluation of animals presented with gastrointestinal problems. A minimum database helps assess the severity of the disorder, detect extra-gastrointestinal causes of problems and assists in formulating diagnostic and therapeutic plans. Faecal examination remains one of the most important diagnostic procedures in the investigation of gastrointestinal problems. Zinc sulphate faecal flotation is an excellent routine screening technique for helminth and protozoal infections, including giardiasis. Rectal cytology can assist in the diagnosis of large bowel disorders. Interpretation of faecal immunodiagnostic tests is hampered by insufficient knowledge of test sensitivities and specificities. Routine faecal cultures are not warranted and faecal occult blood tests are rarely indicated. Serum tests for gastric inflammation are now under development. The serum trypsin-like immunoreactivity test remains the gold standard technique for the diagnosis of exocrine pancreatic insufficiency. Breath hydrogen tests can be helpful in assessing the functional relevance of mild abnormalities in small-bowel biopsy specimens. Subnormal concentrations of serum cobalamin appear to be more specific indicators of gastrointestinal disease in cats than in dogs. Tests for small intestinal bacterial overgrowth remain controversial and assessment of gastrointestinal permeability has yet to prove its value in the diagnostic assessment of companion animals with gastrointestinal problems. Faecal alpha1-protease inhibitor shows promise for the diagnosis of protein-losing enteropathy.
Journal Article↗
Royal Park Multidiagnostic Instrument for Psychosis: Part I. Rationale and review.
The Royal Park Multidiagnostic Instrument for Psychosis (RPMIP) is a validity-oriented assessment procedure developed for the acute psychotic episode using serial interviews and multiple information sources to construct a data base of clinical information. A number of sets of operational criteria, including 11 definitions of schizophrenia and several concepts of atypical, schizoaffective, and affective psychoses, are simultaneously applied to the data base to produce a diagnostic profile for each patient that can be linked to other variables. This article describes the rationale for the development of the RPMIP and contrasts it with other assessment and diagnostic procedures. A companion article (Part II) presents data on interrater reliability and procedural validity, together with an account of the structure and development of the instrument.
Humans↗
Serum protein electrophoresis: potential test for use in geriatric companion animal health programmes.
The electrophoretic patterns of 117 serum samples from 37 clinically healthy old dogs (age: 10.0 +/- 2.5 years, mean +/- SD) 47 old dogs (age: 9.7 +/- 2.0 years) with different diseases, 18 clinically healthy young dogs (age: 2.9 +/- 1.6 years) and 15 young dogs (age: 2.0 +/- 1.0 years) with different diseases were evaluated using agarose as a supporting matrix. Three major electrophoretic patterns were identified after densitometric scanning. The first pattern was a predominant pattern for the young healthy dogs (found in 67% of dogs in that group) and was considered normal for healthy dogs. The second pattern had relatively higher proportions of beta and gamma globulins (polyclonal immunoglobulinaemia) and was a predominant pattern among the old healthy dogs (found in 51% of dogs in that group). The findings regarding the second pattern appear to suggest that they had been exposed to antigens during their lives and that they had a well developed and responsive humoral immune response. The third pattern was characterized by high levels of alpha globulins, it was the most common pattern in the old diseased dogs (found in 70% of the dogs in that group). The third pattern was considered to indicate an inflammatory response among old dogs when compared to young dogs (P < 0.01). These patterns appear to suggest that because of aging and/or accumulated injury geriatric dogs will have high levels of polyclonal gamma-globulinaemia or acute phase reactants. The observed patterns, especially the one showing high levels of alpha-globulins, could be a valuable parameter in the search for individuals requiring special attention and thus for the establishment of health programmes for geriatric dogs. With further effort, serum protein electrophoresis might prove to be a useful test for the evaluation of geriatric companion animals for diagnostic, prognostic and therapeutic reasons.
Aged↗
Biology and medicine of the ferret.
There is still much more to be learned about ferret behavior, nutrition, and physiologic responses associated with aging, disease, and environmental stimuli. The many similarities in the clinical disorders of ferrets and other small companion animals should emphasize the importance of using the same diagnostic methods developed for common companion animals in examinations of ferrets. There is still very little known of the efficacy of a wide spectrum of drugs in ferrets, and judicious use of pharmacodynamic agents that are safe for cats would be a reasonable approach to drug therapy.
Animal Diseases↗
The occurrence of Aeromonas hydrophila in avian diagnostic submissions.
Twenty isolations of Aeromonas hydrophila were made from 15 species of free-living, commercial, and companion birds submitted for routine diagnostic postmortem examination. Seventy percent of the isolations were made from November through March during the 25-month survey period.
Aeromonas↗
Clinical and research application of an enterovirus group-reactive monoclonal antibody.
Diagnostic methods employed in enterovirus laboratories are generally laborious, slow and expensive. This is largely because type-specific neutralization tests still play the major role in identification and diagnostic serology. In the companion paper we describe the derivation of monoclonal antibodies against epitopes of the VPI peptide which are shared by all of the enteroviruses tested to date, with the exception of hepatitis A virus. This study describes the application of one of these monoclonal antibodies in several research and diagnostic procedures, illustrating a special utility in a wide variety of assay systems. This monoclonal antibody has proved particularly useful in the detection of enterovirus antigens in circulating immune complexes, and in identifying field isolates of this group of viruses. Immunohistochemistry, previously almost impossible in enterovirus diagnosis and research due to the large number of serotypes, is now shown to be practical and informative when this monoclonal antibody is used.
Animals↗
A diagnostic marker for speech delay associated with otitis media with effusion: backing of obstruents.
A companion paper in this issue reported diagnostic accuracy findings for a marker (the Intelligibility-Speech Gap) to identify speech delay associated with otitis media with effusion (SD-OME). The present paper reports findings for another possible diagnostic marker for SD-OME--Backing of Obstruents. Conversational speech samples and citation forms from 48 speech-delayed children with positive and negative histories for OME were analysed using both perceptual and acoustic methods. The perceptual findings indicated significant trends for backing to be more prevalent in children with positive compared to negative histories of OME. Among a number of candidate speech error variables, lowered first spectral moments on lingual stops and sibilant fricatives as obtained from moments analysis emerged as a promising acoustic correlate of backing. Positive and negative predictive values, and sensitivity and specificity values for the acoustic marker, were above 75% for each of three stimulus words targeting /k/, /z/ and /f/. Discussion considers alternative explanatory perspectives on the ontogenetic development of backing in children who have experienced the fluctuant hearing loss associated with early recurrent OME.
Child↗
The impact of the 1995 Oklahoma City bombing on the partners of firefighters.
This study explored the impact of the 1995 Oklahoma City, Oklahoma, bombing on the spouses and significant others of a volunteer sample of Oklahoma City firefighters who participated in the bombing rescue effort. Twenty-seven partners of Oklahoma City firefighters participated in this study, conducted 42 to 44 months after the bombing. These partners were assessed using a structured diagnostic interview and a companion interview to examine exposure, rates of psychiatric disorders and symptoms, functioning, health, and relationships. Coping and perception of the firefighter partner's response were also examined. Some of the women were exposed directly; most knew someone who had been involved in the disaster, and all reported exposure through the media. The rate of psychiatric disorders in the women following the disaster was 22%, essentially unchanged from before the incident. One developed bomb-related posttraumatic stress disorder (PTSD). Most were satisfied with their work performance; 15% reported that their health had worsened since the bombing, and more than one third reported permanent changes in relationships as a result of the bombing. Most coped by turning to friends or relatives, with less than 10% seeking professional help. Many described symptoms in their firefighter mate; all reported that their mate had been affected by the experience, and one half said their mate had fully recovered. The mates of these firefighters fared relatively well in terms of psychiatric disorders, symptoms, and ability to function. The prevalence of bomb-related posttraumatic stress disorder was considerably lower in this sample than in samples of individuals more directly exposed to the bombing, although some reported changes in relationships and health. The results suggest the need for further study of the impact of interpersonal exposure in those who provide support for rescue-and-recovery workers in major terrorist incidents.
Adaptation, Psychological↗
Repeatable battery for the assessment of neuropsychological status as a screening test in schizophrenia, II: convergent/discriminant validity and diagnostic group comparisons.
OBJECTIVE: In a companion article in this issue of the Journal, the authors presented data suggesting that the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is sensitive to the types of impairments observed in schizophrenia, correlates highly with standard measures of intelligence and memory, and is related to employment status in a group of patients with schizophrenia drawn from a tertiary care research center. The objectives of the current study were 1) to determine if evidence of the convergent validity of the RBANS could be replicated in a diagnostically heterogeneous sample drawn from a public mental health system, 2) to examine the relationship of the RBANS to a broad neuropsychological battery, and 3) to compare the performance of patients with schizophrenia and patients with bipolar disorder on a neuropsychological battery and the RBANS. METHOD: The RBANS and a standard neuropsychological battery, including the WAIS-III and Wechsler Memory Scale, 3rd ed. (WMS-III), were given to 150 patients drawn from a larger study of vocational rehabilitation. RESULTS: Correlations of RBANS total scores with WAIS-III and WMS-III variables were highly similar across study groups. The RBANS correlated highly with a composite z score derived from 22 standard measures of IQ, memory, language, motor, attention, and executive function. Principal component analyses of the neuropsychological battery resulted in a six-factor solution: the RBANS correlated most highly with a general ability factor and had limited correlations with measures of motor performance, vigilance, and executive function. Patients with schizophrenia demonstrated greater deficits on the neuropsychological battery and the RBANS than patients with bipolar disorder. CONCLUSIONS: These data suggest that the RBANS is a useful screening instrument for assessing the severity of cognitive impairment in psychiatric populations.
Adult↗
Vaccines and vaccinations. The strategic issues.
The rapid proliferation of companion animal vaccines, advances in diagnostic and vaccine technology, and concerns over vaccine safety are clearly among the most important issues practicing veterinarians face as we enter the 21st century. Although many would argue that these are already issues, the future promises to be especially challenging as the vaccines we currently use and the protocols we recommend undergo unprecedented review.
Animals↗
Common diagnostic and clinical techniques for fish.
Fish medicine has common diagnostic and clinical procedures that are essential for disease diagnosis and patient management. With a few modifications for handling of the fish patient, these resemble procedures performed in most veterinary hospitals and clinics in our other companion species. The predictive value of these diagnostic methods is improving with the ever-increasing number of publications in fish medicine. Training in aquatic clinical procedures is offered at most large continuing education conferences and as specialty courses. These basic procedures are the important first steps toward improving the health of our aquatic companion animals.
Animals↗
Respiratory diseases, diagnostics, and treatment of marsupials.
Primary respiratory disease is uncommon in marsupials, but generalized disease often involves the respiratory tract in these animals. Other disease entities may spread to involve the respiratory system secondarily. Treatment is challenging because most animals are severely compromised on presentation. Bacteria, viruses, parasites, fungi and yeasts, trauma, and neoplasia all can affect the respiratory systems of marsupials. Some of these conditions are only incidental findings, whereas others are pathogenic. Many therapies and diagnostic procedures are extrapolated from those in companion animal medicine and surgery. Despite the problems associated with the diagnosis and treatment of respiratory disease in marsupials, new therapeutic agents and diagnostic techniques are making these tasks easier and ultimately more successful.
Animals↗
Hospital visitor-companions as a source of controls for case-control studies in the Philippines.
Hospital visitor-companions are being used as a source of controls in an ongoing case-control study on breast cancer in the Philippines. As a tool for rapid epidemiologic assessment in obtaining research data for case-control studies, visitor-companions may serve as an alternative source of controls. To determine their generalizability and consistency, this proposed group was compared to neighbourhood controls and to hospital-patient controls. Hospital visitor-companions were comparable to neighbourhood controls in terms of cooperation in the interviews, height, weight, marital status, longest residence, education, cigarette smoking, alcohol intake, annual income, proportion with salaried jobs, ownership of house, land, and business, number of people living in the house, number of siblings, medical history, parity, menopausal status, breast feeding practices, and use of oral contraceptives. Neighbourhood controls however had longer interview durations than visitor-companion controls (p less than 0.05). Hospital-patient controls were less likely to breast feed, had lower alcohol intake, and had more exposure to chronic diseases and diagnostic x-ray than visitor-companion or neighbourhood controls (p less than 0.05). It was concluded that visitor-companions may usefully serve as an alternative source of controls for case-control studies when their limitations are taken into consideration during analysis.
Breast Neoplasms↗