Prognostic markers and assessment of a previously published clinical severity index in 109 hospitalised dogs with acute presentation of pancreatitis

2019 ◽  
Vol 187 (2) ◽  
pp. e13-e13 ◽  
Author(s):  
Sharon Kuzi ◽  
Reut Mazor ◽  
Gilad Segev ◽  
Ran Nivy ◽  
Michal Mazaki-Tovi ◽  
...  
Keyword(s):  
Large Scale ◽  
Prognostic Markers ◽  
Assessment Tool ◽  
Clinical Signs ◽  
Kidney Injury ◽  
Scoring Systems ◽  
Severity Index ◽  
Clinical Severity ◽  
Secondary Complications ◽  
Abdominal Complication

BackgroundAcute pancreatitis (AP) is common in dogs. Nevertheless, validated clinical severity index (CSI) scoring systems to assess severity and guide treatment in current, large-scale studies are unavailable.MethodsThis is a retrospective study including 109 dogs. Pancreatitis was diagnosed based on clinical signs, abdominal sonographic evidence, positive pancreatic lipase assays and experts’ assessment consensus.ResultsThe survival rate was 75 per cent (82 dogs). Azotaemia and presence of local complications (ie, ascites) and secondary complications (ie, acute kidney injury and acute respiratory distress syndrome) were significantly associated with death. In agreement with the previously published CSI, respiratory anomalies were significantly associated with death. However, in disagreement with that study, high scores in the kidney and local abdominal complication categories and the sum of scores of all nine categories, but not high gastrointestinal category score, were also significantly associated with death. A final CSI score of at least 4 was associated with death.ConclusionsThis study has validated a nine-category CSI, proven a useful assessment tool in dogs with AP. Several previously reported and novel prognostic markers were assessed.

Clinical Profile and Outcomes in Patients with Acute Pancreatitis attending a Teaching Hospital at Gandaki Province, Nepal

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Subash Bhattarai ◽  
Merina Gyawali
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Age Groups ◽  
Data Entry ◽  
Kidney Injury ◽  
Severity Index ◽  
Clinical Profile ◽  
Cross Sectional ◽  
Systemic Complications ◽  
Keywords Alcohol

Background: Acute pancreatitis (AP) is inflammatory process of pancreas presenting with acute abdominal pain.The majority of patients have mild disease. Some patients develop local and systemic complications with increased morbidity and mortality. This study was undertaken to describe the clinical profile and outcomes in patients with acute pancreatitis.   Methods:  A cross-sectional hospital based study comprising of 62 consecutive patients with acute pancreatitis were enrolled between Jan 2019 to August 2020. Clinical profile at admission, complications and clinical outcomes including mortality were studied. Patients were classified into mild, moderately severe and severe acute pancreatitis based on revised Atlanta classification and modified CT severity index.  Data entry was done in Statistical Packages for the Social Sciences version 20. Results: The mean age of study subjects was 44±10.87 years with 43 (56%) males and 19 (44%) females (M:F=2.1:1). The commonest etiology of pancreatitis was alcohol (53.2%) followed by biliary pancreatitis (37.1%)  The most common presentation was abdominal pain (100%). The most common complication was pancreatic necrosis (21%) followed by acute kidney injury (19.4%) and pleural effusion (17.3%). Majority( 72.6%) was mild and 17.7% had severe acute pancreatitis. Mortality was seen in 6.5% patients. Mortality was observed in patients with persistent complications, organ failure, low serum calcium and high modified CT severity index.   Conclusions: Alcohol and gallstones were the two main etiologies of acute pancreatitis and were common in males, and in middle age groups. Majority presented with mild severity. Mortality was observed in some patients with severe acute pancreatitis.   Keywords: alcohol; biliary; CT severity index; mortality; outcome; pancreatitis          

Machine-learning algorithm as a prognostic tool in non-obstructive acute-on-chronic kidney disease in the cat

2021 ◽  
pp. 1098612X2110012
Author(s):  
Jade Renard ◽  
Mathieu R Faucher ◽  
Anaïs Combes ◽  
Didier Concordet ◽  
Brice S Reynolds
Keyword(s):  
Machine Learning ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Decision Tree ◽  
Diagnostic Performance ◽  
Clinical Signs ◽  
Learning System ◽  
Clinical Severity ◽  
Medium Term ◽  
Term Survival

Objectives The aim of this study was to develop an algorithm capable of predicting short- and medium-term survival in cases of intrinsic acute-on-chronic kidney disease (ACKD) in cats. Methods The medical record database was searched to identify cats hospitalised for acute clinical signs and azotaemia of at least 48 h duration and diagnosed to have underlying chronic kidney disease based on ultrasonographic renal abnormalities or previously documented azotaemia. Cases with postrenal azotaemia, exposure to nephrotoxicants, feline infectious peritonitis or neoplasia were excluded. Clinical variables were combined in a clinical severity score (CSS). Clinicopathological and ultrasonographic variables were also collected. The following variables were tested as inputs in a machine learning system: age, body weight (BW), CSS, identification of small kidneys or nephroliths by ultrasonography, serum creatinine at 48 h (Crea48), spontaneous feeding at 48 h (SpF48) and aetiology. Outputs were outcomes at 7, 30, 90 and 180 days. The machine-learning system was trained to develop decision tree algorithms capable of predicting outputs from inputs. Finally, the diagnostic performance of the algorithms was calculated. Results Crea48 was the best predictor of survival at 7 days (threshold 1043 µmol/l, sensitivity 0.96, specificity 0.53), 30 days (threshold 566 µmol/l, sensitivity 0.70, specificity 0.89) and 90 days (threshold 566 µmol/l, sensitivity 0.76, specificity 0.80), with fewer cats still alive when their Crea48 was above these thresholds. A short decision tree, including age and Crea48, predicted the 180-day outcome best. When Crea48 was excluded from the analysis, the generated decision trees included CSS, age, BW, SpF48 and identification of small kidneys with an overall diagnostic performance similar to that using Crea48. Conclusions and relevance Crea48 helps predict short- and medium-term survival in cats with ACKD. Secondary variables that helped predict outcomes were age, CSS, BW, SpF48 and identification of small kidneys.

scholarly journals Confocal laser endomicroscopy reveals alterations in duodenal permeability in patients with acute pancreatitis

2019 ◽  
Vol 47 (3) ◽  
pp. 1279-1287
Author(s):  
Lingjia Sun ◽  
Min Yue ◽  
Yining Dai ◽  
Chaohui Yu ◽  
Chunxiao Chen
Keyword(s):  
Acute Pancreatitis ◽  
Large Scale ◽  
Duodenal Bulb ◽  
Severity Index ◽  
Duodenal Mucosa ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Mucosal Permeability ◽  
Reactive Protein ◽  
Severity Index Score

Objective Intestinal permeability increases during the course of acute pancreatitis (AP). We assessed duodenal permeability alterations in patients with AP by confocal laser endomicroscopy (CLE). Methods Thirty patients with AP underwent CLE evaluation of the antral and duodenal mucosa. Images were graded based on the appearance of capillaries and the degree of fluorescein leakage. Results Patients with AP had increased duodenal mucosal permeability that could be detected by CLE. The mucosal permeability progressively increased in the gastric antrum, duodenal bulb, and descending duodenum. The CLE parameters in the antrum and duodenal bulb were not significantly different between patients with mild and severe AP. The CLE grades in the descending duodenum were higher in patients with severe than mild AP. The C-reactive protein level in AP was positively correlated with the permeability in the duodenal bulb and descending duodenum, while the computed tomography severity index score was positively correlated with the mucosal permeability in the duodenal bulb and descending duodenum. Conclusion CLE revealed increased duodenal permeability in patients with AP. Higher permeability in the descending duodenum was observed in severe than mild AP. Further large-scale studies are needed to confirm the relationship between altered duodenal permeability and the severity of AP.

scholarly journals Pulmonary Vessel Obstruction Does Not Correlate with Severity of Pulmonary Embolism

2019 ◽  
Vol 8 (5) ◽  
pp. 584 ◽  
Author(s):  
Marianne Lerche ◽  
Nikolaos Bailis ◽  
Mideia Akritidou ◽  
Hans Jonas Meyer ◽  
Alexey Surov
Keyword(s):  
Pulmonary Embolism ◽  
Statistical Significance ◽  
Pulmonary Arteries ◽  
Severity Index ◽  
Clinical Severity ◽  
Pulmonary Vessel ◽  
Wells Score ◽  
Clot Burden ◽  
Spearman’S Correlation ◽  
D Dimer

The aim of the present study was to analyze possible relationships between pulmonary vessel obstruction and clinically relevant parameters and scores in patients with pulmonary embolism (PE). Overall, 246 patients (48.8% women and 51.2% men) with a mean age of 64.0 ± 17.1 years were involved in the retrospective study. The following clinical scores were calculated in the patients: Wells score, Geneva score, and pulmonary embolism severity index (PESI) score. Levels of D-dimer (µg/mL), lactate, pH, troponin, and N-terminal natriuretic peptide (BNP, pg/mL) were acquired. Thrombotic obstruction of the pulmonary arteries was quantified according to Mastora score. The data collected were evaluated by means of descriptive statistics. Spearman’s correlation coefficient was used to analyze associations between the investigated parameters. P values < 0.05 were taken to indicate statistical significance. Mastora score correlated weakly with lactate level and tended to correlate with D-dimer and BNP levels. No other clinical or serological parameters correlated significantly with clot burden. Thrombotic obstruction of pulmonary vessels did not correlate with clinical severity of PE.

scholarly journals Is Bisphosphonate-Related Osteonecrosis of the Jaw an Infection? A Histological and Microbiological Ten-Year Summary

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
A. M. Hinson ◽  
C. W. Smith ◽  
E. R. Siegel ◽  
B. C. Stack
Keyword(s):  
Systematic Review ◽  
Disease Severity ◽  
Large Scale ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Osteonecrosis Of The Jaw ◽  
Multifactorial Disease ◽  
Clinical Signs And Symptoms ◽  
Surgical Treatments

The role of infection in the etiology of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is poorly understood. Large-scale epidemiological descriptions of the histology and microbiology of BRONJ are not found in the literature. Herein, we present a systematic review of BRONJ histology and microbiology (including demographics, immunocompromised associations, clinical signs and symptoms, disease severity, antibiotic and surgical treatments, and recovery status) validating that infection should still be considered a prime component in the multifactorial disease.

scholarly journals PTU-100 Developing Swansea inflammatory bowel disease clinical severity index (SICSI)

Gut ◽  
2012 ◽  
Vol 61 (Suppl 2) ◽  
pp. A225.1-A225
Author(s):  
L Alrubaiy ◽  
J Williams ◽  
H Hutchings
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Severity Index ◽  
Clinical Severity ◽  
Inflammatory Bowel

scholarly journals Effects of a workplace prevention programme for problem gambling: study protocol for a cluster randomised controlled trial

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e015963 ◽  
Author(s):  
Jonas Rafi ◽  
Ekaterina Ivanova ◽  
Alexander Rozental ◽  
Per Carlbring
Keyword(s):  
Problem Gambling ◽  
Large Scale ◽  
Controlled Trial ◽  
Public Health Problem ◽  
Cluster Randomised Controlled Trial ◽  
Severity Index ◽  
The Body ◽  
Prevention Programme ◽  
Open Access Journals ◽  
Randomised Controlled

IntroductionDespite being considered a public health problem, no prevention programme for problem gambling in workplace settings has been scientifically evaluated. This study aims to fill a critical gap in the field of problem gambling by implementing and evaluating a large-scale prevention programme in organisations.Methods and analysisTen organisations, with a total of n=549 managers and n=8572 employees, will be randomised to either receiving a prevention programme or to a waitlist control condition. Measurements will be collected at the baseline and 3, 12 and 24 months after intervention. The primary outcome of interest is the managers’ inclination to act when worried or suspicious about an employee’s problem gambling or other harmful use. Additional outcomes of interest include the Problem Gambling Severity Index and gambling habits in both managers and employees. Furthermore, qualitative analyses of the responses from semistructured interviews with managers will be performed.Ethics and disseminationThis study has been approved by the regional ethics board of Stockholm, Sweden, and it will contribute to the body of knowledge concerning prevention of problem gambling. The findings will be published in peer-reviewed, open-access journals.Trial registration numberNCT02925286; Pre-results.

scholarly journals Complement Components C3 and C4 Indicate Vasculitis Manifestations to Distinct Renal Compartments in ANCA-Associated Glomerulonephritis

2021 ◽  
Vol 22 (12) ◽  
pp. 6588
Author(s):  
Samy Hakroush ◽  
Désirée Tampe ◽  
Peter Korsten ◽  
Philipp Ströbel ◽  
Björn Tampe
Keyword(s):  
Current Knowledge ◽  
Systemic Disease ◽  
Kidney Injury ◽  
Scoring Systems ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
Glomerular Injury ◽  
Tubulointerstitial Injury ◽  
Complement Components ◽  
Tubulointerstitial Lesions ◽  
Low Levels

Background: Acute kidney injury (AKI) is a common and severe complication of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) causing progressive chronic kidney disease (CKD), end-stage renal disease (ESRD) or death. Pathogenic ANCAs, in particular proteinase 3 (PR3) and myeloperoxidase (MPO), trigger a deleterious immune response resulting in pauci-immune necrotizing and crescentic glomerulonephritis (GN), a common manifestation of glomerular injury in AAV. However, there is growing evidence that activation of the complement pathway contributes to the pathogenesis and progression of AAV. We here aimed to compare glomerular and tubulointerstitial lesions in ANCA GN and extrarenal manifestation of AAV in association with levels of circulating complement components C3c and C4. Methods: Plasma levels of C3c and C4 in a total number of 53 kidney biopsies with ANCA GN were retrospectively included between 2015 and 2020. Glomerular and tubulointerstitial lesions were evaluated according to established scoring systems for ANCA GN and analogous to the Banff classification. Results: We here show that circulating levels of C3c and C4 in ANCA GN were comparable to the majority of other renal pathologies. Furthermore, hypocomplementemia was only detectable in a minor subset of ANCA GN and not correlated with renal or extrarenal AAV manifestations. However, low levels of circulating C3c correlated with AKI severity in ANCA GN independent of systemic disease activity or extrarenal AAV manifestation. By systematic scoring of glomerular and tubulointerstitial lesions, we provide evidence that low levels of circulating C3c and C4 correlated with vasculitis manifestations to distinct renal compartments in ANCA GN. Conclusions: We here expand our current knowledge about distinct complement components in association with vasculitis manifestations to different renal compartments in ANCA GN. While low levels of C4 correlated with glomerulitis, our observation that low levels of circulating complement component C3c is associated with interstitial vasculitis manifestation reflected by intimal arteritis implicates that C3c contributes to tubulointerstitial injury in ANCA GN.

Reducing Nutrient Loads in Northern Irish Catchments: A Modelling Approach Based on Load Apportionment and Flow Pathway Identification

2021 ◽  
Author(s):  
Russell Adams ◽  
Donnacha Doody
Keyword(s):  
Water Quality ◽  
Large Scale ◽  
Agricultural Land ◽  
Assessment Tool ◽  
Ecological Status ◽  
Point Sources ◽  
Load Reduction ◽  
Nutrient Loads ◽  
Flow Pathways ◽  
Flow Pathway

&lt;p&gt;Northern Ireland has been somewhat overlooked in terms of water quality modelling in the past. Many of its catchments have consistently failed to meet Water Framework Directive targets especially due to high levels of dissolved nutrients and poor ecological status. A catchment based modelling study to address this issue has not been undertaken here previously and the approach described here uses two water quality models to achieve this aim. The objectives of the modelling were firstly to identify the total load reductions (in terms of Phosphorus (P)) required to reduce in-stream loadings sufficiently for concentrations of soluble reactive P (SRP) to be reduced to achieve the WFD &amp;#8220;Good&amp;#8221; status levels, and secondly to split these loadings into diffuse and point components. The third objective was to identify the most likely flow pathways for the transport of the diffuse component of P to the watercourses particularly for the agricultural (mostly intensive grassland farming) land use which dominates in almost all NI catchments.&lt;/p&gt;&lt;p&gt;The first model applied is the Source Load Apportionment Model (SLAM) developed by the Irish EPA. This model provides a large-scale assessment of the point and diffuse load components across catchments where multiple pressures are occurring. The second model us the Catchment Runoff Flux Assessment Tool (CRAFT) which is able to back-calculate nutrient loads associated with three major flow pathways. SLAM is a static model which uses averaged loadings from diffuse agriculture and non-agricultural land uses, and point sources (where information can be obtained from various sources) to calculate N and P exports. For P, the agricultural diffuse load component uses an enhanced version of the export coefficient approach based on combining the sources of P from applied nutrients (slurry and fertiliser) and soil P. A modelling tool allows the user to evaluate load reduction scenarios where one or several components of P (both point and diffuse) are adjusted downwards to achieve the catchment&amp;#8217;s required load reduction. The CRAFT model works on a dynamic (daily) modelling scale and has simulated sub-catchments where the SLAM model has identified the need for significant load reductions. It identifies the different reductions (P export) that are required for each flow pathway, which will then inform on the type of additional measures (e.g. sediment traps, riparian buffer strips and wetlands) that may also be required.&lt;/p&gt;&lt;p&gt;The initial aim of this study is to complete a pilot application to the trans-border (UK and ROI) Blackwater catchment (1360 km&lt;sup&gt;2&lt;/sup&gt;). Through a review of alternative modelling options for the whole area of NI, an assessment of whether this approach is suitable for application to the entire territory can be made.&lt;/p&gt;

CHEST X RAY SCORE AND CLINICAL SEVERITY IN COVID-19 PATIENTS

2021 ◽  
pp. 31-32
Author(s):  
Sheeba Rana ◽  
Vicky Bakshi ◽  
Yavini Rawat ◽  
Zaid Bin Afroz
Keyword(s):  
Retrospective Study ◽  
Medical Records ◽  
Scoring Systems ◽  
Clinical Severity ◽  
X Rays ◽  
Antigen Test ◽  
X Ray ◽  
Classi Cation ◽  
Chest X Ray ◽  
Male Subjects

INTRODUCTION: Various chest X-ray scoring systems have been discovered and are employed to correlate with clinical severity, outcome and progression of diseases. With, the coronavirus outbreak, few chest radiograph classication were formulated, like the BSTI classication and the Brixia chest X-ray score. Brixia CXR scoring is used for assessing the clinical severity and outcome of COVID-19. This study aims to compare the Brixia CXR score with clinical severity of COVID-19 patients. MATERIAL& METHODS:This was a retrospective study in which medical records of patients aged 18 years or above, who tested for RTPCR or st st Rapid Antigen Test (RAT) for COVID positive from 1 February 2021 to 31 July 2021 (6 months) were taken. These subjects were stratied into mild, moderate and severe patients according to the ICMR guidelines. Chest X Rays were obtained and lesions were classied according to Brixia scoring system. RESULTS: Out of these 375 patients, 123 (32.8%) were female and 252 (67.2%) were male subjects. The average brixia score was 11.12. Average Brixia CXR score for mild, moderate and severe diseased subjects were 5.23, 11.20, and 14.43 respectively. DISCUSSION:The extent of chest x-ray involvement is proportional to the clinical severity of the patient. Although, a perplexing nding was that the average Brixia score of the female subjects were slightly higher than their male counterparts in the same clinical groups. CONCLUSION: Brixia CXR score correlates well with the clinical severity of the COVID-19.

Sign in / Sign up

Export Citation Format

Share Document