scholarly journals The Effect of Topical Oxygen Therapy in Horses Affected with Mycosis of the Guttural Pouch: An Experimental Pilot Study and a Case Series

Animals ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 3329
Author(s):  
Olivier M. Lepage ◽  
Paola Di Francesco ◽  
Nicolas Moulin ◽  
Monika Gangl ◽  
Gaëtan Texier ◽  
...  
Keyword(s):  
Pilot Study ◽  
Neurological Disorders ◽  
Oxygen Therapy ◽  
Phase 1 ◽  
Clinical Signs ◽  
Nasal Discharge ◽  
Upper Respiratory Tract ◽  
Phase 2 ◽  
Total Recovery ◽  
Inflammatory Lesions

Background: The management of bleeding originating from the guttural pouch (GP) has a high success rate, but the resolution of the macroscopic inflammatory lesions in the case of mycosis (GPM) is highly variable; the resolution of neurological disorders is inconstant and challenging. Objectives: Our aim was to test the feasibility and safety of topical oxygen therapy (TOT) in horses after induction of GPM and in cases with naturally occurring disease. Study design: This study was an in vivo experimental and retrospective two-phase study. Methods: During phase 1, the pilot study, both GPs were inoculated with Aspergillus fumigatus. One GP was randomly assigned to receive one to four TOT 30 min sessions with 100% medical oxygen at 9 L/min. Follow-up endoscopic images were assessed for scoring macroscopic inflammatory lesions of the pharynx and both GPs. In phase 2, the clinical study, TOT was administered for 45 to 60 min at 15 L/min in six horses presenting with GPM. Results: In phase 1, TOT administration was easy to perform in the standing horse with no adverse effects. After more than two administrations, macroscopic inflammatory lesions decreased more quickly in size in the treated GP. In phase 2, horses were treated with TOT only (n = 1) or combined with a transarterial coil embolization (TACE) procedure (n = 5). After TOT and discharge from the hospital, nasal discharge resolved in three horses, and improvement was noted in the fourth one. Between days 2 and 10 after admission, upper respiratory tract endoscopy (URTE) indicated size reduction and alteration in the appearance of all the macroscopic inflammatory lesions. The partial or total recovery of neurological disorders (2/4 laryngeal hemiparesis, 3/5 dysphagia, 1/2 dorsal displacement of the soft palate (DDSP), and 1/1 Horner’s syndrome) was recorded. Main limitations: In phase 1, the small number of horses did not allow for statistically significant conclusions; in phase 2, clinical signs at admission varied between horses, which made comparison difficult. Conclusions: In adult horses, TOT alone or in combination with TACE is feasible and safe with a propensity to reverse the course and the progression of inflammatory lesions without additional local or systemic treatment.

scholarly journals A transient increase in MHC-IIlow monocytes after experimental infection with Avibacterium paragallinarum (serovar B-1) in SPF chickens

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Karla Lucía F. Alvarez ◽  
Astrid Poma-Acevedo ◽  
Manolo Fernández-Díaz
Keyword(s):  
Immune Response ◽  
Large Body ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Nasal Discharge ◽  
High Morbidity ◽  
Upper Respiratory Tract ◽  
Secondary Infections ◽  
Avibacterium Paragallinarum ◽  
Facial Swelling

Abstract Infectious coryza (IC), an upper respiratory tract disease affecting chickens, is caused by Avibacterium paragallinarum. The clinical manifestations of IC include nasal discharge, facial swelling, and lacrimation. This acute disease results in high morbidity and low mortality, while the course of the disease is prolonged and mortality rates are increased in cases with secondary infections. Studies regarding the immune response in infected chickens are scarce, and the local immune response is the focal point of investigation. However, a large body of work has demonstrated that severe infections can impact the systemic immune response. The objective of this study was to evaluate the systemic effects of Avibacterium paragallinarum (serovar B-1) infection on immune cells in specific pathogen-free (SPF) chickens. The current study revealed the presence of a transient circulating monocyte population endowed with high phagocytic ability and clear downregulation of major histocompatibility complex class II (MHC-II) surface expression. In human and mouse studies, this monocyte population (identified as tolerant monocytes) has been correlated with a dysfunctional immune response, increasing the risk of secondary infections and mortality. Consistent with this dysfunctional immune response, we demonstrate that B cells from infected chickens produced fewer antibodies than those from control chickens. Moreover, T cells isolated from the peripheral blood of infected chickens had a lower ability to proliferate in response to concanavalin A than those isolated from control chickens. These findings could be related to the severe clinical signs observed in complicated IC caused by the presence of secondary infections.

Sinusitis in Infants and Children

1992 ◽  
Vol 101 (1_suppl) ◽  
pp. 37-41 ◽  
Author(s):  
Ellen R. Wald
Keyword(s):  
Respiratory Tract ◽  
Maxillary Sinusitis ◽  
Bacterial Species ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Clinical Problem ◽  
Nasal Discharge ◽  
Upper Respiratory Tract ◽  
Radiographic Findings ◽  
Upper Respiratory

The major clinical problem in considering a diagnosis of sinusitis is differentiating uncomplicated upper respiratory tract infection from a secondary bacterial infection of the paranasal sinuses that may benefit from antimicrobial therapy. A diagnosis of sinusitis is suggested by presentation with protracted upper respiratory tract symptoms or a cold that is more severe than usual with fever and purulent nasal discharge. Confirmatory tests of sinus disease are transillumination (useful in adolescents if interpretation is confined to the extremes — normal or absent); radiographic findings of opacification, mucous membrane thickening, or an air-fluid level; and sinus aspiration (indicated for severe pain, clinical failures, or complicated disease). When clinical signs and symptoms are accompanied by abnormal radiographic findings, bacteria in high colony count are recovered from the maxillary sinus aspirate in 70% of patients. The common bacterial species recovered from children with acute maxillary sinusitis are Streptococcus pneumoniae, Moraxella (Branhamella) catarrhalis, and Hemophilus influenzae.

scholarly journals Cyclooxygenase Inhibitor Associated with Carboplatin in Treatment of Metastatic Nasal Carcinoma in Dog

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Carlos Eduardo Fonseca-Alves ◽  
Aline Gonçalves Corrêa ◽  
Fabiana Elias ◽  
Sabryna Gouveia Calazans
Keyword(s):  
Lymph Node ◽  
Complete Blood Count ◽  
Clinical Signs ◽  
Excisional Biopsy ◽  
Needle Aspiration ◽  
Nasal Discharge ◽  
Upper Respiratory Tract ◽  
Intact Male ◽  
Nasal Sinus ◽  
Nasal Carcinoma

A 10-year-old, intact male, pinscher was presented with unilateral bloodstained nasal discharge, sneezing, dyspnea, zygomatic arch deformity, submandibular lymph node increase, blindness in right eye, and exophthalmia. After clinical examination, it was found that the animal presented with upper respiratory tract dyspnea origin, possibly caused by an obstructive process. Complete blood count (CBC), ocular ultrasonography, thoracic radiographs, mandibular lymph node, and nasal sinus fine needle aspiration were performed. The right mandibular lymph node excisional biopsy was conducted and a tumor sample was obtained through the nasal fistula at hard palate. The material was processed, paraffin embedded, sectioned, and stained with hematoxylin and eosin. Immunohistochemical staining for cytokeratin (AE1/AE3), vimentin, and COX-2 was performed. After histopathological evaluation nasal carcinoma diagnosis was obtained. Chemotherapy was established with carboplatin 300 mg/m2intravenously—four cycles with intervals of 21 days—and firocoxib 5 mg/kg orally every 24 hours for 7 months. After 7 months the treatment started, the animal presented with ataxia, vocalization, hyperesthesia, and anorexia. Due the clinical condition presented, the animal owner opted for performing euthanasia. The chemotherapy protocol was effective causing the disease stagnation, minimizing the clinical signs, and extending patient survival and quality of life.

Oral (Gavage) Combined Developmental and Perinatal/Postnatal Reproduction Toxicity Study of Ammonium Salt of Perfluorinated Hexanoic Acid in Mice

2014 ◽  
Vol 33 (3) ◽  
pp. 219-237 ◽  
Author(s):  
Hiroyuki Iwai ◽  
Alan M. Hoberman
Keyword(s):  
Ammonium Salt ◽  
Phase 1 ◽  
Reproductive Toxicity ◽  
Clinical Signs ◽  
Hexanoic Acid ◽  
Test Substance ◽  
Phase 2 ◽  
Body Weights ◽  
Adverse Effect Level ◽  
Development Levels

The reproductive toxicity potential of Ammonium Salt of Perfluorinated Hexanoic Acid (PFHxA Ammonium Salt) in pregnant Crl: CD1(ICR) mice was investigated. Twenty females/group were administered the test substance or vehicle once daily from gestation day 6 through 18. Phase 1 doses: 0, 100, 350, and 500 mg/kg/d; phase 2: 0, 7, 35, and 175 mg/kg/d. Parameters evaluated include mortality, viability, body weights, clinical signs, abortions, premature deliveries, pregnancy and fertility, litter observations, maternal behavior, and sexual maturity in the F1 generation. The level of PFHxA Ammonium Salt was measured in the liver of F0 and F1 mice. At doses of 350 and 500 mg/kg/d maternal mortalities, excess salivation and changes in body weight gains occurred. Pup body weights were reduced on postpartum day (PPD) 0 in all the dosage groups, but persisted only in the 350 and 500 mg/kg/d groups. Additional effects at 300 and 500 mg/kg/d included stillbirths, reductions in viability indices, and delays in physical development. Levels of PFHxA Ammonium Salt in the livers of the 100 mg/kg/d dams were all below the lower limit of quantization (0.02 µg/mL); in the 350 mg/kg/d group, 3 of the 8 samples had quantifiable analytical results. In phase 2 no PFHxA Ammonium Salt was found in the liver. Adverse effects occurred only in the 175 mg/kg/d group and consisted of increased stillborn pups, pups dying on PPD 1, and reduced pup weights on PPD 1. Based on these data, the maternal and reproductive no observable adverse effect level of PFHxA Ammonium Salt is 100 mg/kg/d.

scholarly journals Anti-microbial Activity of Urine after Ingestion of Cranberry: A Pilot Study

2010 ◽  
Vol 7 (2) ◽  
pp. 227-232 ◽  
Author(s):  
Yee Lean Lee ◽  
Wadie I. Najm ◽  
John Owens ◽  
Laurie Thrupp ◽  
Sheryl Baron ◽  
...  
Keyword(s):  
Pilot Study ◽  
Microbial Activity ◽  
Urinary Infection ◽  
Phase 1 ◽  
Urine Specimen ◽  
Control Specimen ◽  
Phase 2 ◽  
Colony Forming Units ◽  
Two Phases ◽  
Urine Specimens

We explore the anti-microbial activity of urine specimens after the ingestion of a commercial cranberry preparation. Twenty subjects without urinary infection, off antibiotics and all supplements or vitamins were recruited. The study was conducted in two phases: in phase 1, subjects collected the first morning urine prior to ingesting 900 mg of cranberry and then at 2, 4 and 6 h. In phase 2, subjects collected urine on 2 consecutive days: on Day 1 no cranberry was ingested (control specimens), on Day 2, cranberry was ingested. The pH of all urine specimens were adjusted to the same pH as that of the first morning urine specimen. Aliquots of each specimen were independently inoculated withEscherichia coli,Klebsiella pneumoniaeorCandida albicans. After incubation, colony forming units/ml (CFU ml−1) in the control specimen was compared with CFU ml−1in specimens collected 2, 4 and 6 h later. Specimens showing ≥50% reduction in CFU ml−1were considered as having ‘activity’ against the strains tested. In phase 1, 7/20 (35%) subjects had anti-microbial activity againstE.coli, 13/20 (65%) againstK.pneumoniaeand 9/20 (45%) againstC.albicansin specimens collected 2–6 h after ingestion of cranberry. In phase 2, 6/9 (67%) of the subjects had activity againstK.pneumoniae. This pilot study demonstrates weak anti-microbial activity in urine specimens after ingestion of a single dose of commercial cranberry. Anti-microbial activity was noted only againstK.pneumoniae2–6 h after ingestion of the cranberry preparation.

scholarly journals Development and feasibility of a modified Fugl-Meyer lower extremity assessment for telerehabilitation: a pilot study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sue Peters ◽  
Marcela Botero ◽  
Allison Evers ◽  
Brianna Fong ◽  
Botond Jakab ◽  
...  
Keyword(s):  
Pilot Study ◽  
Lower Extremity ◽  
Rural Areas ◽  
Phase 1 ◽  
Motor Impairment ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Phase 2 ◽  
Phase 3 ◽  
Face To Face

Abstract Background The majority of stroke survivors experience motor impairment which benefits from rehabilitation treatment. Telerehabilitation, remote delivery of rehabilitation services, is a possible solution providing access to rehabilitation for stroke survivors living in rural areas or in situations like the COVID-19 pandemic where face-to-face treatment may be risky. However, valid and reliable motor impairment measures have not yet been established over a telerehabilitation platform. The Fugl-Meyer (FM) lower extremity assessment is widely used clinically and in research. Thus, the aim was to develop a modified FM for telerehabilitation (FM-tele) and assess the feasibility and preliminary agreement of FM-tele scores with the FM. Methods Three phases were employed: phase 1 development, phase 2 feasibility, and phase 3 preliminary agreement. Literature review and consultation with clinicians were employed to develop the FM-tele. Community-dwelling individuals with stroke and FM evaluators were consulted to provide feedback via questionnaires on the feasibility of the FM-tele. To assess the preliminary agreement of the FM-tele, individuals with stroke participated in two sessions, one in-person and one via telerehabilitation. The standard version of the FM was administered during the in-person session. The FM-tele was administered in both sessions. Results From phase 1, clinician consultation identified the following key principles: safety of the client, clear lower extremity visualization, and minimization of position changes which guided FM-tele development (n = 7). Feasibility was established in phase 2 where participants with stroke indicated that they felt safe and experienced ease following the standardized instructions, despite some technological concerns (n = 5). FM evaluators agreed that participants were safe and indicated effective standardized instructions. Phase 3 (n = 5) indicated preliminary agreement of the FM-tele compared with the FM. Conclusions Participants with stroke and clinical consultation indicated the FM-tele developed for telerehabilitation is feasible. A lower extremity motor assessment tool for telerehabilitation is urgently needed for stroke survivors living in rural areas or when face-to-face visits are impossible. This pilot study provides preliminary support for a future study.

scholarly journals A pilot study towards long-term thermal comfort research for lower-limb prosthesis wearers

2018 ◽  
Vol 43 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Rhys James Williams ◽  
Atsushi Takashima ◽  
Toru Ogata ◽  
Catherine Holloway
Keyword(s):  
Pilot Study ◽  
Thermal Comfort ◽  
Temperature Change ◽  
Lower Limb ◽  
Phase 1 ◽  
Phase 2 ◽  
Thermal Discomfort ◽  
Lower Limb Prosthesis ◽  
Limb Prosthesis

Background: Thermal discomfort among lower-limb prosthesis wearers is prevalent with social and medical consequences. Objectives: This study aimed to verify the feasibility of out-of-laboratory thermal comfort studies. Study design: Repeated measures pilot study. Methods: Thermistors were placed on participants’ residual limbs during two experimental phases. In phase 1, mean limb temperature was calculated over a controlled 55-min rest-exercise-rest protocol. In phase 2, participants conducted activities of their choosing wherever they wanted away from the lab, while limb temperature data were collected. Descriptive statistics and statistical differences between phases are presented. Results: Five male amputees participated with an average age ±standard deviation of 30 ± 9 years. In phase 1, mean limb temperature change ranged between 1.6°C and 3.7°C. In phase 2, mean limb temperature change ranged between 1.8°C and 5.1°C. Limb temperature was significantly higher in out-of-lab studies (+1.9°C, p = 0.043) compared to in-lab studies. Conclusion: Independent multiple-hour temperature studies are shown to be feasible. Results also indicate that out-of-lab residual limb temperature can be significantly higher than in-lab temperatures. Clinical relevance Thermal discomfort and sweating may lead to skin conditions and reduce quality of life among prosthesis wearers. Out-of-lab, long-term temperature studies are needed to comprehensively characterize thermal discomfort to create preventive solutions.

scholarly journals The Use of Endoscopic Diagnosis in Dogs with Upper Respiratory Diseases with Respect to the Localisation of Pathogens and the Subsequent Therapy

2021 ◽  
Vol 65 (1) ◽  
pp. 75-83
Author(s):  
M. Bajtoš ◽  
M. Kožár
Keyword(s):  
Respiratory Tract ◽  
Clinical Signs ◽  
Small Animal ◽  
Endoscopic Examination ◽  
Resistant Bacteria ◽  
Nasal Discharge ◽  
Upper Respiratory Tract ◽  
Bacterial Diseases ◽  
Systemic Manifestations ◽  
Upper Respiratory

Abstract Bacterial diseases of the upper respiratory tract accompanied with various degrees of clinical signs are relatively frequent in a small animal clinical practice. The clinical signs are usually mild, mostly connected with clinical manifestation of nasal discharge, mild dyspnoea, sneezing, and coughing; however, in some cases they may convert to a chronic stage with serious systemic manifestations. The course and development of complications depends on the etiological agent and the success or failure of the subsequent therapy. An accurate diagnosis is of the upmost importance in order to develop an appropriate therapeutic plan for disease management. The present study focused on: endoscopic visualisation of the upper respiratory tract of the affected animals; localisation of pathological changes, and the targeted collection of the samples. This clinical study involved 26 patients with long-term signs of the affected airways that progressed to chronic stages after the failure of the prescribed therapy. Each patient was clinically examined, sedated and subjected to an endoscopic examination that involved the collection of samples. The samples were examined microbiologically, tested for antibiotic resistance, and a targeted therapy was implemented. The endoscopic and complex microbiological diagnosis enabled: more effective management of the bacterial infection; shortening of the therapy; and a convalescence period that reduced the risk of the development, or the spreading of resistant bacteria.

scholarly journals Implementation of a Pharmacist-Led Transitions of Care Program within a Primary Care Practice: A Two-Phase Pilot Study

Pharmacy ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 4 ◽  
Author(s):  
Erin Slazak ◽  
Amy Shaver ◽  
Collin M. Clark ◽  
Courtney Cardinal ◽  
Merin Panthapattu ◽  
...  
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Primary Care Practice ◽  
Phase 1 ◽  
Transitions Of Care ◽  
Care Practice ◽  
Control Group ◽  
Phase 2 ◽  
Two Phase ◽  
Effective Manner

Pharmacists in primary care settings have unique opportunities to address the causes of ineffective care transitions. The objective of this study is to describe the implementation of a multifaceted pharmacist transitions of care (TOC) intervention integrated into a primary care practice and evaluate the effectiveness of the program. This was a two-phase pilot study describing the development, testing, and evaluation of the TOC program. In Phase 1, the TOC intervention was implemented in a general patient population, while Phase 2 focused the intervention on high-risk patients. The two pilot phases were compared to each other (Phase 1 vs. Phase 2) and to a historical control group of patients who received usual care prior to the intervention (Phase 1 and Phase 2 vs. control). The study included 138 patients in the intervention group (Phase 1: 101 and Phase 2: 37) and 118 controls. At baseline, controls had a significantly lower LACE index, shorter length of stay, and a lower number of medications at discharge, indicating less medical complexity. A total of 344 recommendations were provided over both phases, approximately 80% of which were accepted. In adjusted models, there were no significant differences in 30-day all-cause readmissions between Phase 2 and controls (aOR 0.78; 95% CI 0.21–2.89; p = 0.71) or Phase 1 (aOR 0.99; 95% CI 0.30–3.37; p = 0.99). This study successfully implemented a pharmacist-led TOC intervention within a primary care setting using a two-phase pilot design. More robust studies are needed in order to identify TOC interventions that reduce healthcare utilization in a cost-effective manner.

scholarly journals Feasibility of a Clinical Decision Support Tool to Manage Resistant Hypertension: Team-HTN, a Single-arm Pilot Study

2020 ◽  
Author(s):  
Leilani A Siaki ◽  
Victor LIN ◽  
Robert Marshall ◽  
Robert Highley
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Pilot Study ◽  
Phase 1 ◽  
Decision Support Tool ◽  
Clinical Decision ◽  
Phase 2 ◽  
Support Tool ◽  
Sequencing Algorithm ◽  
Clinical Decision Support Tool

ABSTRACT Introduction Based on defining criteria, hypertension (HTN) affects 31% to 46% of the adult U.S. population and almost 20% of service members. Resistant HTN (rHTN) consumes significant resources, carries substantial morbidity and mortality risk and costs over $350 billion dollars annually. For multiple reasons, only 48.3% of people with HTN are controlled, e.g., undiagnosed secondary HTN, therapeutic or diagnostic inertia, and patient adherence. Our purpose was to determine the feasibility of a web-based clinical decision support tool (CDST) using a renin-aldosterone system (RAS) classification matrix and drug sequencing algorithm to assist providers with the diagnosis and management of uncontrolled HTN (rHTN). Outcomes were blood pressure (BP) rates of control, provider management time, and end-user satisfaction. Methods This two-phase, prospective, non-randomized, single-arm, six-month pilot study was conducted in primary care clinics at a tertiary military medical center. Patients with uncontrolled HTN and primary care providers were recruited. Phase 1 patients checked their BP twice daily (AM and PM), three times weekly using a standardized arm cuff. Patients with rHTN were enrolled in phase 2. Phase 2 patients were managed virtually by providers using the CDST, the RAS classification matrix, and the drug sequencing algorithm which incorporated age, ethnicity, comorbidities, and renin/aldosterone levels. Medications were adjusted every 10 days until BP was at target, using virtual visits. Results In total, 54 patients and 16 providers were consented. One transplant patient was disqualified, 29 met phase 2 criteria for rHTN, and 6 providers completed the study. In phase 1, 45% (n = 24) of patients were identified as having apparent uncontrolled HTN using peak diurnal blood pressure (pdBP) home readings. In phase 2 (n = 29), previously undetected RAS abnormalities were identified in 69% (n = 20) of patients. Blood pressure control rates improved from 0% to 23%, 47%, and 58% at 2, 4, and 6 months, respectively. Provider management time was reduced by 17%. Using home pdBP readings identified masked HTN in almost 20% of patients that would have been missed by a single daily AM or PM home BP measurement. Feasibility and satisfaction trends were favorable. Conclusions Despite significant morbidity, mortality, and existing guidelines, over half of hypertensive patients are uncontrolled. Our results suggest that this CDST used with pdBP monitoring is a feasible option to facilitate improved rates of control in rHTN, aid in overcoming therapeutic/diagnostic inertia, improve identification of secondary HTN, and potentially, access. Further research with this tool in a larger population is recommended.

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