scholarly journals МІКРОСКОПІЧНІ ЗМІНИ В ЛЕГЕНЯХ І СЕРЦІ СОБАК, ЩО ЗАГИНУЛИ ЗА ДИРОФІЛЯРІОЗУ, СПРИЧИНЕНОГО DIROFILARIA IMMITIS

2016 ◽  
Vol 18 (3(70)) ◽  
pp. 187-191
Author(s):  
N.N. Omeljanenko ◽  
S.E. Garkusha ◽  
Kh.H. Maksymova
Keyword(s):  
Blood Vessels ◽  
Dirofilaria Immitis ◽  
Early Stage ◽  
Subcutaneous Tissue ◽  
Abdominal Cavity ◽  
Fatty Degeneration ◽  
The United States ◽  
Published Data ◽  
Interstitial Tissue ◽  
North Caucasus

Dirofilariosis – invasive parasitic disease which can be fatal. Specific course of the disease is the lack of visible signs of the disease at an early stage and make the complexity of diagnosing the disease is especially dangerous, as pet owners may not be aware of what their favorite animal is ill. Until now, according to statistics, dirofilariosis diagnosed by chance during examination before surgery, or carrying out tests for reasons far from suspected dirofilariosis.Dirofilariosis registered in Africa, Asia and Southern Europe. In the United States established endemic areas where there have been outbreaks of helminthiasis annually. The cases were registered in the UK, Sweden, the Netherlands, Austria, Hungary, Bulgaria, Romania, Germany, Poland, Russia, Kazakhstan, the republics of the North Caucasus. Now dirofilariosis observed in Kiev, Odessa, Kharkiv, Kyiv, Chernihiv, Sumy, Poltava, Kharkiv and other areas. Today dirofilariosis carnivores and man registered on the territory of 37 states.Numerous published data indicate that most dirofilariosis in the countries of the former Soviet Union caused by two pathogen – Dirofilaria immitis and Dirofilaria repens.D. repens parasite in the subcutaneous tissue. Another kind of – D. immitis – in the heart, the lungs, the pulmonary artery and other vessels carnivores. Sometimes these nematodes parasitize in unusual places (the brain, the bronchioles, the abdominal cavity, eyes).Dirofilariosis problem for Ukraine is very urgent, because, firstly, the disease among dogs acquires the character of enzootic, secondly, the increase in the number of different types of vectors of infection, in the third, increasing the area of distribution – from the tropics to temperate regions, in the fourth, the difficulties in diagnosis disease and, fifthly, there is lack of training and educational and propaganda work among the population.The aim of our research was to a deeper and more complete definition of the features of microscopic changes in dog heartworm.We used the results of histological examination of samples of pathological material taken from 6 different breeds of dogs that suffered from heartworm. Autopsy was performed by the method of partial evisceration. Microscopic studies were carried out according to conventional techniques.In carrying out investigations following changes were microscopically established: in the lungs – seen interstitial pneumonia, venous hyperemia, hemorrhage, and also discovered microfilariae in the lumen of blood vessels and interstitial tissue. In the myocardium – granular and fatty degeneration, necrosis and destruction of cardiomyocytes in blood vessels – single microfilariae. 

scholarly journals Pyothorax in Antillean Manatee (Trichechus manatus) in Brazil

2020 ◽  
Vol 48 ◽  
Author(s):  
Fernanda Löffler Niemeyer Attademo ◽  
Fábia De Oliveira Luna ◽  
Glaucia Pereira de Sousa ◽  
Augusto Carlos da Bôaviagem Freire ◽  
Deisi Cristiane Balensiefer ◽  
...  
Keyword(s):  
Bone Fractures ◽  
Subcutaneous Tissue ◽  
Abdominal Cavity ◽  
Left Lung ◽  
Clinical Signs ◽  
Pleural Empyema ◽  
The United States ◽  
Trichechus Manatus ◽  
In Captivity ◽  
The Right

Background: Manatees are the most endangered aquatic mammals in Brazil. The current conservation scenario, together with their biological characteristics, raises concern with the future of this species. Pyothorax, also known as septic pleural effusion or pleural empyema, is characterized by the accumulation of a septic purulent exudate within the pleural space. Although this infection often has a multifactorial etiology, it is most commonly associated with respiratory tract disorders and trauma. Here, we report a case of pyothorax in a Antillean manatee (Trichechus manatus) held in captivity for acclimatization in Brazil.Case: A young, male Antillean manatee, aged 4 years and 11 months, measuring 227 cm in total length, and weighing 258 kg was held in captivity for acclimatization (natural environment) in Porto de Pedras in the State of Alagoas, Brazil. The animal died in February 2013 and was sent for necropsy at the CMA/ICMBio laboratory. The study was developed with authorisation from the Ethics Committee on Animal Use (License number 020/2009) and under the license SISBIO/ICMBio number 20685-1. Externally, the carcass of the animal showed swelling and bulging of the right antimere and purulent secretion from the right nostril. After external examination, a window was opened in the layers of skin, fat, and muscles from the level of the anus to the navel. Subsequently, the abdominal cavity was opened for inspecting the internal organs. The subcutaneous muscles had a slightly friable, swollen, and pale texture, in addition to petechial hemorrhage, suffusions, and marked edema of the subcutaneous tissue. The right hemidiaphragm was elevated, filling the abdominal and thoracic spaces. Depending on the elevation, all organs were moved to the left antimere. After dissecting the surrounding structures and analyzing the causes for the increase in volume, it was observed that the right lung formed a structure containing a large amount of purulent exudate, which was delimited by the right hemidiaphragm. It had a length of 111 cm, width of 40 cm, and wingspan of 137 cm, starting from the first thoracic rib to the last lumbar rib, near the peduncle region. After making an incision in the right hemidiaphragm and visceral pleura, approximately 70 L of purulent exudate and caseous material were removed. Since the right lung was severely damaged, visualizing the pulmonary parenchyma was not possible, and only remains of the main right bronchus could be seen.Discussion: Domestic species, such as dogs and cats, when affected by pleural empyema, usually have a restrictive breathing pattern (shallow and rapid breaths) and fever. Interpreting the clinical signs may be difficult for manatees because of their slow metabolism. In the United States, 44 (6%) cases of pleural empyema were recorded in manatees from a total of 731 animals evaluated, and shock with boats was determined as the primary cause. In the present animal, no signs of bone fractures were found, suggesting that the infection may have been caused by the use of an orogastric tube or even acquired in the environment prepared for acclimation. Based on the pathognomonic macroscopic findings, one can conclude that the animal had a characteristic clinical picture of pleural empyema (pyothorax) associated with an infection of unknown origin. This situation resulted in complete degeneration of the right lung and massive thoracic and abdominal distensions, resulting in decreased expansion capacity of the left lung, making breathing impossible, thus leading to death.

scholarly journals Isolation of adipose tissue derived regenerative cells from human subcutaneous tissue with or without the use of an enzymatic reagent

2018 ◽  
Author(s):  
Glenn E. Winnier ◽  
Nick Valenzuela ◽  
Christopher Alt ◽  
Jennifer Peters-Hall ◽  
Joshua Kellner ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Structural Properties ◽  
Subcutaneous Tissue ◽  
The United States ◽  
Biological Characteristics ◽  
Cell Yield ◽  
Published Data ◽  
Physiological Functions ◽  
Enzymatic Isolation ◽  
Regenerative Cells

ABSTRACTBackgroundFreshly isolated, uncultured autologous adipose derived regenerative cells (ADRCs) have emerged as a promising tool for regenerative cell therapy. The Transpose RT system (InGeneron, Inc., Houston, TX, USA) is a system for isolating ADRCs from adipose tissue, commercially available in Europe as a CE-marked medical device and under clinical evaluation in the United States. This system makes use of the proprietary, enzymatic Matrase Reagent for isolating cells. The present study addressed the question whether the use of Matrase Reagent influences cell yield, cell viability, live cell yield, biological characteristics, physiological functions or structural properties of the ADRCs in final cell suspension.MethodsIdentical samples of subcutaneous adipose tissue from 12 subjects undergoing elective lipoplasty were processed either with or without the use of Matrase Reagent. Then, characteristics of the ADRCs in the respective final cell suspensions were evaluated.ResultsCompared to non-enzymatic isolation, enzymatic isolation resulted in approximately twelve times higher mean cell yield (i.e., numbers of viable cells/ml lipoaspirate) and approximately 16 times more colony forming units. Despite these differences, cells isolated from lipoaspirate both with and without the use of Matrase Reagent were independently able to differentiate into cells of all three germ layers.DiscussionThe data of this study indicate that biological characteristics, physiological functions or structural properties relevant for the intended use were not altered or induced using Matrase Reagent. A comprehensive literature review demonstrated that isolation of ADRCs from lipoaspirate using the Transpose RT system and the Matrase Reagent results in the highest viable cell yield among all published data regarding isolation of ADRCs from lipoaspirate.

Clinical Manifestations and Radiological Characteristics on Rosai-Dorfman Disease: A Retrospective Observational Study

2020 ◽  
Vol 5 (5) ◽  
Keyword(s):  
Blood Vessels ◽  
Abdominal Cavity ◽  
Clinical Manifestations ◽  
Ct Images ◽  
High Signal ◽  
Radiological Features ◽  
Imaging Characteristics ◽  
Rosai Dorfman Disease ◽  
Heterogeneous Enhancement ◽  
The Masses

Background and Objective: Rosai-Dorfman disease (RDD) are usually misdiagnosed because of rarity and nonspecific clinical and radiological features. The aim of our study is to explore the clinical and imaging characteristics of RDD to improve diagnostic accuracy. Methods: Clinical and imaging data in 10 patients with RDD were retrospectively analyzed. 7 patients were underwent CT scanning and 3 patients were underwent MR examination. Results: 8 (8/10) patients presented with painless enlarged lymph nodes (LNs) or mass. 3 cases were involved with LNs, 5 cases were involved with extra-nodal tissues, and the remaining 2 cases were involved with LNs and extra-nodal tissue simultaneously. In enhanced CT images, enlarged LNs displayed mild or moderate enhancement, and 2 cases showed heterogeneous ring-enhancement. MR features of 3 patients with extra-nodal RDD, 2 cases showed a mass located in the subcutaneous and anterior abdominal wall respectively, and 1 case showed an intracranial mass. Besides, all lesions showed high signal foci on DWI images, and were characterized by marked heterogeneous enhancement with blurred edge. The dural/fascia tail sign and dilated blood vessels could be seen around all the lesions on enhanced MRI. Radiological features of 2 cases with LN and extranodal tissue involved, one case presented with the swelling and thickening of pharyngeal lymphoid ring and nasopharynx, meanwhile with enlarged LNs in bilateral submandibular area, neck and abdominal cavity, and also companied with osteolytic lesion in right proximal humerus. All these LNs displayed mild and moderate enhancement on CT images. Another case showed enlarged LNs in bilateral neck accompanied with soft tissue mass in the sinuses. Conclusions: RDD occurred commonly in young and middle-aged men and presented with painless enlarged LNs or mass.RDD had a huge diversity of imaging findings, which varied with different location. The radiological features, such as small patches of high signal foci in the masses on DWI images, heterogeneous enhancement and blood vessels around the masses, are helpful in diagnosis of extranodal RDD.

Review of Various Tasks Performed in the Preprocessing Phase of a Diabetic Retinopathy Diagnosis System

2020 ◽  
Vol 16 (4) ◽  
pp. 397-426
Author(s):  
Muhammad Nadeem Ashraf ◽  
Muhammad Hussain ◽  
Zulfiqar Habib
Keyword(s):  
Diabetic Retinopathy ◽  
Blood Vessels ◽  
Early Stage ◽  
Spherical Shape ◽  
Cost Effective ◽  
Lesion Detection ◽  
Diabetic Patients ◽  
Cad System ◽  
Non Invasive ◽  
Optic Discs

Diabetic Retinopathy (DR) is a major cause of blindness in diabetic patients. The increasing population of diabetic patients and difficulty to diagnose it at an early stage are limiting the screening capabilities of manual diagnosis by ophthalmologists. Color fundus images are widely used to detect DR lesions due to their comfortable, cost-effective and non-invasive acquisition procedure. Computer Aided Diagnosis (CAD) of DR based on these images can assist ophthalmologists and help in saving many sight years of diabetic patients. In a CAD system, preprocessing is a crucial phase, which significantly affects its performance. Commonly used preprocessing operations are the enhancement of poor contrast, balancing the illumination imbalance due to the spherical shape of a retina, noise reduction, image resizing to support multi-resolution, color normalization, extraction of a field of view (FOV), etc. Also, the presence of blood vessels and optic discs makes the lesion detection more challenging because these two artifacts exhibit specific attributes, which are similar to those of DR lesions. Preprocessing operations can be broadly divided into three categories: 1) fixing the native defects, 2) segmentation of blood vessels, and 3) localization and segmentation of optic discs. This paper presents a review of the state-of-the-art preprocessing techniques related to three categories of operations, highlighting their significant aspects and limitations. The survey is concluded with the most effective preprocessing methods, which have been shown to improve the accuracy and efficiency of the CAD systems.

scholarly journals Investigation of an EHV-1 Outbreak in the United States Caused by a New H752 Genotype

Pathogens ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 747
Author(s):  
Nicola Pusterla ◽  
Samantha Barnum ◽  
Julia Miller ◽  
Sarah Varnell ◽  
Barbara Dallap-Schaer ◽  
...  
Keyword(s):  
Early Stage ◽  
Clinical Signs ◽  
Amino Acid Position ◽  
High Viral Load ◽  
The United States ◽  
Neurological Deficits ◽  
Diagnostic Challenge ◽  
Genotype I ◽  
Flunixin Meglumine ◽  
Nasal Secretions

Here we report on an EHV-1 outbreak investigation caused by a novel genotype H752 (histidine in amino acid position 752 of the ORF 30 gene). The outbreak involved 31 performance horses. Horses were monitored over a period of 35 days for clinical signs, therapeutic outcome and qPCR results of EHV-1 in blood and nasal secretions. The morbidity of the EHV-1 outbreak was 84% with 26 clinically infected horses displaying fever and less frequently anorexia and distal limb edema. Four horses showed mild transient neurological deficits. Clinically diseased horses experienced high viral load of EHV-1 in blood and/or nasal secretions via qPCR, while subclinically infected horses had detectable EHV-1 mainly in nasal secretions. The majority of infected horses showed a rise in antibody titers to EHV-1 during the outbreak. All 31 horses were treated with valacyclovir, while clinically infected horses further received flunixin meglumine and sodium heparin. This investigation highlights various relevant aspects of an EHV-1 outbreak caused by a new H752 genotype: (i) importance of early detection of EHV-1 infection; (ii) diagnostic challenge to assess H752 genotype; (iii) apparent benefit of valacyclovir use in the early stage of the outbreak; and (iv) weekly testing of blood and nasal secretions by qPCR in order to monitor individual infection status and lift quarantine.

scholarly journals Learning health systems in primary care: a systematic scoping review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Danielle M. Nash ◽  
Zohra Bhimani ◽  
Jennifer Rayner ◽  
Merrick Zwarenstein
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Health Systems ◽  
Scoping Review ◽  
Early Stage ◽  
Point Of Care ◽  
The United States ◽  
Stage Of Development ◽  
Integrated Health ◽  
Google Search

Abstract Background Learning health systems have been gaining traction over the past decade. The purpose of this study was to understand the spread of learning health systems in primary care, including where they have been implemented, how they are operating, and potential challenges and solutions. Methods We completed a scoping review by systematically searching OVID Medline®, Embase®, IEEE Xplore®, and reviewing specific journals from 2007 to 2020. We also completed a Google search to identify gray literature. Results We reviewed 1924 articles through our database search and 51 articles from other sources, from which we identified 21 unique learning health systems based on 62 data sources. Only one of these learning health systems was implemented exclusively in a primary care setting, where all others were integrated health systems or networks that also included other care settings. Eighteen of the 21 were in the United States. Examples of how these learning health systems were being used included real-time clinical surveillance, quality improvement initiatives, pragmatic trials at the point of care, and decision support. Many challenges and potential solutions were identified regarding data, sustainability, promoting a learning culture, prioritization processes, involvement of community, and balancing quality improvement versus research. Conclusions We identified 21 learning health systems, which all appear at an early stage of development, and only one was primary care only. We summarized and provided examples of integrated health systems and data networks that can be considered early models in the growing global movement to advance learning health systems in primary care.

scholarly journals Public Compliance With Social Distancing Measures and SARS-CoV-2 Spread

2021 ◽  
pp. 003335492110112
Author(s):  
Hongjie Liu ◽  
Chang Chen ◽  
Raul Cruz-Cano ◽  
Jennifer L. Guida ◽  
Minha Lee
Keyword(s):  
Growth Rate ◽  
Reproduction Number ◽  
Early Stage ◽  
Human Mobility ◽  
The United States ◽  
Density Change ◽  
Regression Coefficients ◽  
Daily Growth Rate ◽  
Daily Growth ◽  
Social Distancing

Objective We quantified the association between public compliance with social distancing measures and the spread of SARS-CoV-2 during the first wave of the epidemic (March–May 2020) in 5 states that accounted for half of the total number of COVID-19 cases in the United States. Methods We used data on mobility and number of COVID-19 cases to longitudinally estimate associations between public compliance, as measured by human mobility, and the daily reproduction number and daily growth rate during the first wave of the COVID-19 epidemic in California, Illinois, Massachusetts, New Jersey, and New York. Results The 5 states mandated social distancing directives during March 19-24, 2020, and public compliance with mandates started to decrease in mid-April 2020. As of May 31, 2020, the daily reproduction number decreased from 2.41-5.21 to 0.72-1.19, and the daily growth rate decreased from 0.22-0.77 to –0.04 to 0.05 in the 5 states. The level of public compliance, as measured by the social distancing index (SDI) and daily encounter-density change, was high at the early stage of implementation but decreased in the 5 states. The SDI was negatively associated with the daily reproduction number (regression coefficients range, –0.04 to –0.01) and the daily growth rate (from –0.009 to –0.01). The daily encounter-density change was positively associated with the daily reproduction number (regression coefficients range, 0.24 to 1.02) and the daily growth rate (from 0.05 to 0.26). Conclusions Social distancing is an effective strategy to reduce the incidence of COVID-19 and illustrates the role of public compliance with social distancing measures to achieve public health benefits.

scholarly journals Identification of Vulnerable Populations and Areas at Higher Risk of COVID-19-Related Mortality during the Early Stage of the Epidemic in the United States

2021 ◽  
Vol 18 (8) ◽  
pp. 4021
Author(s):  
Esteban Correa-Agudelo ◽  
Tesfaye B. Mersha ◽  
Adam J. Branscum ◽  
Neil J. MacKinnon ◽  
Diego F. Cuadros
Keyword(s):  
United States ◽  
Vulnerable Populations ◽  
Mortality Risk ◽  
Early Stage ◽  
The United States ◽  
National Average ◽  
Health Determinants ◽  
White Population ◽  
Latino Population ◽  
Related Mortality

We characterized vulnerable populations located in areas at higher risk of COVID-19-related mortality and low critical healthcare capacity during the early stage of the epidemic in the United States. We analyze data obtained from a Johns Hopkins University COVID-19 database to assess the county-level spatial variation of COVID-19-related mortality risk during the early stage of the epidemic in relation to health determinants and health infrastructure. Overall, we identified highly populated and polluted areas, regional air hub areas, race minorities (non-white population), and Hispanic or Latino population with an increased risk of COVID-19-related death during the first phase of the epidemic. The 10 highest COVID-19 mortality risk areas in highly populated counties had on average a lower proportion of white population (48.0%) and higher proportions of black population (18.7%) and other races (33.3%) compared to the national averages of 83.0%, 9.1%, and 7.9%, respectively. The Hispanic and Latino population proportion was higher in these 10 counties (29.3%, compared to the national average of 9.3%). Counties with major air hubs had a 31% increase in mortality risk compared to counties with no airport connectivity. Sixty-eight percent of the counties with high COVID-19-related mortality risk also had lower critical care capacity than the national average. The disparity in health and environmental risk factors might have exacerbated the COVID-19-related mortality risk in vulnerable groups during the early stage of the epidemic.

scholarly journals The Use of External Controls in FDA Regulatory Decision Making

2021 ◽  
Author(s):  
Mahta Jahanshahi ◽  
Keith Gregg ◽  
Gillian Davis ◽  
Adora Ndu ◽  
Veronica Miller ◽  
...  
Keyword(s):  
Decision Making ◽  
Natural History ◽  
Product Development ◽  
Rare Diseases ◽  
The United States ◽  
External Control ◽  
Common Source ◽  
Published Data ◽  
History Data ◽  
Benefit Risk Assessment

AbstractThe regulatory standards of the United States Food and Drug Administration (FDA) require substantial evidence of effectiveness from adequate and well-controlled trials that typically use a valid comparison to an internal concurrent control. However, when it is not feasible or ethical to use an internal control, particularly in rare disease populations, relying on external controls may be acceptable. To better understand the use of external controls to support product development and approval, we reviewed FDA regulatory approval decisions between 2000 and 2019 for drug and biologic products to identify pivotal studies that leveraged external controls, with a focus on select therapeutic areas. Forty-five approvals were identified where FDA accepted external control data in their benefit/risk assessment; they did so for many reasons including the rare nature of the disease, ethical concerns regarding use of a placebo or no-treatment arm, the seriousness of the condition, and the high unmet medical need. Retrospective natural history data, including retrospective reviews of patient records, was the most common source of external control (44%). Other types of external control were baseline control (33%); published data (11%); and data from a previous clinical study (11%). To gain further insights, a comprehensive evaluation of selected approvals utilizing different types of external control is provided to highlight the variety of approaches used by sponsors and the challenges encountered in supporting product development and FDA decision making; particularly, the value and use of retrospective natural history in the development of products for rare diseases. Education on the use of external controls based on FDA regulatory precedent will allow for continued use and broader application of innovative approaches to clinical trial design, while avoiding delays in product development for rare diseases. Learnings from this review also highlight the need to update regulatory guidance to acknowledge the utility of external controls, particularly retrospective natural history data.

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