scholarly journals Clinical validation of the short and long UNESP-Botucatu scales for feline pain assessment

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11225
Author(s):  
Maíra Belli ◽  
Alice R. de Oliveira ◽  
Mayara T. de Lima ◽  
Pedro H.E. Trindade ◽  
Paulo V. Steagall ◽  
...  

Background The UNESP-Botucatu multidimensional feline pain assessment scale (UFEPS) is a valid and reliable instrument for acute pain assessment in cats. However, its limitations are that responsiveness was not tested using a negative control group, it was validated only for ovariohysterectomy, and it can be time-consuming. We aimed to evaluate the construct and criterion validity, reliability, sensitivity, and specificity of the UFEPS and its novel short form (SF) in various clinical or painful surgical conditions. Methods Ten client-owned healthy controls (CG) and 40 client-owned cats requiring pain management for clinical or surgical care (20 clinical and 20 surgery group (12 orthopedic and eight soft tissue surgeries) were recruited. Three evaluators assessed pain, in real-time, in clinical cases before and 20 min after rescue analgesia and in surgical cases before and up to 6.5 hours postoperatively, by using the visual analog, numerical ratio, and a simple descriptive scale, in this order, followed by the UFEPS-SF, UFEPS and Glasgow multidimensional feline pain (Glasgow CMPS-Feline) in random order. For the surgical group, rescue analgesia (methadone 0.2 mg/kg IM or IV and/or dipyrone 12.5 mg/kg IV) was performed when the UFEPS-SF score was ≥4 or exceptionally according to clinical judgement. If a third interventional analgesia was required, methadone (0.1–0.2 mg/kg IM) and ketamine (1 mg/kg IM) were administered. For the clinical group, all cats received rescue analgesia (methadone 0.1–0.2 mg/kg IM or IV or nalbuphine 0.5 mg/kg IM or IV), according to the clinician in charge, regardless of pain scores. Construct (1—comparison of scores in cats undergoing pain vs pain-free control cats by unpaired Wilcoxon-test and 2—responsiveness to analgesia by paired Wilcoxon test) and concurrent criterion validity (Spearman correlation of the total score among scales), inter-rater reliability, specificity and sensitivity were calculated for each scale (α = 0.05). Results Reliability ranged between moderate and good for the UFEPS and UFEPS-SF (confidence intervals of intraclass coefficients = 0.73–0.86 and 0.63–0.82 respectively). The Spearman correlation between UFEPS and UFEPS-SF was 0.85, and their correlation with Glasgow CMPS-Feline was strong (0.79 and 0.78 respectively), confirming criterion validity. All scales showed construct validity or responsiveness (higher scores of cats with clinical and postoperative pain vs healthy controls, and the reduction in scores after rescue analgesia). The sensitivity and specificity of the UFEPS, UFEPS-SF and Glasgow CMPS-Feline were moderate (sensitivity 83.25, 78.60% and 74.28%; specificity 72.00, 84.67 and 70.00%, respectively). Conclusions Both UFEPS and UFEPS–SF showed appropriate concurrent validity, responsiveness, reliability, sensitivity, and specificity for feline acute pain assessment in cats with various clinical and orthopedic and soft tissue surgical conditions.

2021 ◽  
pp. 1-9
Author(s):  
Margarete Delazer ◽  
Laura Zamarian ◽  
Atbin Djamshidian

Background: Agraphia is a typical feature in the clinical course of Alzheimer’s disease (AD). Objective: Assess the differences between AD and normal aging as regards kinematographic features of handwriting and elucidate writing deficits in AD. Methods: The study included 23 patients with AD (78.09 years/SD = 7.12; MMSE 21.39/SD = 3.61) and 34 healthy controls (75.56 years/SD = 5.85; MMSE 29.06/SD = 0.78). Both groups performed alphabetical and non-alphabetical writing tasks. The kinematographic assessment included the average number of inversions per stroke (NIV; number of peaks in the velocity profile in a single up or down stroke), percentage of automated segments, frequency (average number of strokes per second), writing pressure, and writing velocity on paper. Results: A total of 14 patients showed overt writing difficulties reflected by omissions or substitutions of letters. AD patients showed less automated movements (as measured by NIV), lower writing velocity, and lower frequency of up-and-down strokes in non-alphabetical as well as in alphabetical writing. In the patient group, Spearman correlation analysis between overt writing performance and NIV was significant. That means patients who had less errors in writing a sentence showed a higher automaticity in handwriting. The correctness of alphabetical writing and some kinematographic measures in writing non-alphabetical material reached excellent diagnostic values in ROC analyses. There was no difference in the application of pressure on the pen between patients and controls. Conclusion: Writing disorders are multi-componential in AD and not strictly limited to one processing level. The slow and poorly automated execution of motor programs is not bound to alphabetical material.


2021 ◽  
Vol 9 (8) ◽  
pp. 1616
Author(s):  
Natalia S. Rozas ◽  
Gena D. Tribble ◽  
Cameron B. Jeter

Patients with Parkinson’s disease (PD) are at increased risk of aspiration pneumonia, their primary cause of death. Their oral microbiota differs from healthy controls, exacerbating this risk. Our goal was to explore if poor oral health, poor oral hygiene, and dysphagia status affect the oral microbiota composition of these patients. In this cross-sectional case-control study, the oral microbiota from hard and soft tissues of patients with PD (n = 30) and age-, gender-, and education-matched healthy controls (n = 30) was compared using 16S rRNA gene sequencing for bacterial identification. Study participants completed dietary, oral hygiene, drooling, and dysphagia questionnaires, and an oral health screening. Significant differences in soft tissue beta-diversity (p < 0.005) were found, and a higher abundance of opportunistic oral pathogens was detected in patients with PD. Factors that significantly influenced soft tissue beta-diversity and microbiota composition include dysphagia, drooling (both p < 0.05), and salivary pH (p < 0.005). Thus, patients with PD show significant differences in their oral microbiota compared to the controls, which may be due, in part, to dysphagia, drooling, and salivary pH. Understanding factors that alter their oral microbiota could lead to the development of diagnostic and treatment strategies that improve the quality of life and survivability of these patients.


2020 ◽  
Vol 6 (2) ◽  
pp. 00192-2019 ◽  
Author(s):  
Matteo Bradicich ◽  
Macé M. Schuurmans

IntroductionTobacco smoke worsens COPD and asthma. For healthy individuals, quantifying active and second-hand smoke (SHS) exposure clarifies the epidemiology of tobacco consumption and the efficacy of nonsmoking measures. Identifying tobacco exposure biomarkers and cut-offs might allow the creation of sensitive and specific tests.AimWe describe the state-of-the-art serum, urinary cotinine and exhaled carbon monoxide (CO) cut-offs for assessing smoking status and SHS exposure in adult patients with COPD or asthma, and healthy controls.MethodologyAfter a keyword research in the PubMed database, we included papers reporting on the cut-offs of the investigated biomarkers in one of the populations of interest. Papers published before 2000, not in English, or reporting only data on nonadult subjects or on pregnant women were excluded from the analysis. 14 papers were included in the final analysis. We summarised diagnostic cut-offs for smoking status or SHS exposure in COPD, asthmatic and healthy control cohorts, reporting sensitivity and specificity when available.ConclusionSerum and urinary cotinine and exhaled CO are easy-to-standardise, affordable and objective tests for assessing smoking status and SHS exposure. Evidence on cut-offs with good sensitivity and specificity values is available mainly for healthy controls. For COPD and asthmatic patients, most of the currently available evidence focuses on exhaled CO, while studies on the use of cotinine with definite sensitivity and specificity values are still missing. Solid evidence on SHS exposure is available only for healthy controls. An integrated approach with a combination of these markers still needs evaluation.


1992 ◽  
Vol 71 (11) ◽  
pp. 1816-1821 ◽  
Author(s):  
C.A. Bibb ◽  
A.G. Pullinger ◽  
F. Baldioceda

Undifferentiated mesenchymal (UM) cells, the progenitor cells of the cartilage layer, have been assigned a significant role in TMJ articular tissue maintenance. This was based on reports of UM cell reduction with increased soft-tissue thickness for the condyle and temporal component. However, the strength of this inverse relationship was not presented and remained unclear. The purpose of the present study was to assess the strength of the correlation between UM cell presence and soft-tissue thickness in young adult TMJs at autopsy. Sagittal histological sections from the central thirds of 50 joints were evaluated with respect to articular soft-tissue thickness, histological character, and UM cell presence in the condyle and temporal component. The superior sector ofthe condyle and the articular eminence showed the greatest variability in soft-tissue thickness and were the only areas to show localized UM cell absence. The eminence was the only location to show an inverse relationship between soft-tissue thickness and UM cell presence, and this was consistent in both an ANOVA (p = 0.0016) and a Spearman correlation analysis. However, the strength of this correlation was only moderate (rho = -0.52), and no such relationship was observed in any other location. This study suggests that the relationship between UM cell presence and soft-tissue thickness is more complex than previously hypothesized and that the contribution of UM cells to articular tissue maintenance has been overstated, while other biological processes were overlooked.


2009 ◽  
Vol 3 (1) ◽  
pp. 14-16
Author(s):  
Mesbah Uddin Ahmed ◽  
Md Akram Hossain ◽  
AKM Shamsuzzaman ◽  
Md Murshed Alam ◽  
Abdul Hossain Khan ◽  
...  

The study was conducted to evaluate the sensitivity and specificity of Immunochromatographic test (ICT) for antigen, using microscopy as the "gold standard" method for diagnosis of malaria. A total of 98 clinically suspected malaria patients and another 30 age and sex-matched healthy controls were included in this study. Thick and thin films were also prepared and examined under microscope as well as Immunochromatographic test (ICT) was performed for malaria antigen. Sensitivity and specificity of ICT for antigen were 93.22% and 94.87% respectively. Keywords: Detection of malaria antigen, Immunochromatographic test   doi: 10.3329/bjmm.v3i1.2965 Bangladesh J Med Microbiol 2009; 03 (01): 14-16


2017 ◽  
Vol 4 (3) ◽  
pp. 650
Author(s):  
Varinder Saini ◽  
Chikkahonnaiah Prashanth ◽  
Jasbinder Kaur ◽  
Ashok Kumar Janmeja ◽  
Seema Gupta ◽  
...  

Background: Lung cancer screening is a challenge. Sputum cytology, chest X-ray, low dose computed tomography and other screening methods have not proved to be very effective. Serum biomarkers are a new hope in screening of lung cancer. The present study was planned to evaluate sensitivity and specificity of serum levels of amyloid A (SAA), soluble E- selectin (sE-selectin) and soluble E-cadherin (sE-cadherin) as lung cancer biomarkers.Methods: An observational and cross-sectional study comprised of three groups with 20 subjects each of proven lung cancer cases, patients with non-malignant respiratory diseases and healthy controls. Levels of SAA, sE-selectin and sE-cadherin were measured by solid phase sandwich ELISA. Individual and collective sensitivity and specificity of these biomarkers was analysed and cut off values calculated by receiver operating curves.Results: A statistically significant difference was found in the median levels (ng/ml) of SAA in patients of lung cancer, other non-malignant respiratory diseases, and healthy controls, the levels (Mean±SD) being 24980.50±6564.14,9961.10±2000.24 and 580.95±334.94 respectively in the three groups. A sensitivity of 80% and specificity of 55% was found when SAA levels of 1068 ng/ml were taken as cut off for screening of lung cancer. However, no significant difference was found in the serum levels of sE selectin and sE cadherin between the three groups. Moreover, significant association of biomarkers could also not be established with lung cancer when they were used in combination.Conclusions: In this preliminary report from India, SAA has been found to be a promising biomarker in screening for lung cancer.


2021 ◽  
Vol 12 (10) ◽  
pp. 478-482
Author(s):  
Louise Lee ◽  
Evie Yon

Phacoemulsification is the gold standard procedure for cataract removal in veterinary patients. Registered veterinary nurses involved in the care of patients undergoing this surgery should be aware of potential complications postoperatively and tailor their nursing considerations to individual patients. Pain assessment in ophthalmic patients should take a different format to that in traditional soft tissue or orthopaedic surgeries, and monitoring of intraocular pressure is an important part of postoperative care. This report aims to discuss these nursing interventions for a patient nursed in a referral hospital setting.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Alexander Pfeil ◽  
Karl F. Drummer ◽  
Joachim Böttcher ◽  
Christian Jung ◽  
Peter Oelzner ◽  
...  

Objective. The aim of this study was to visualize soft tissue inflammation using FOI on patients with Systemic Sclerosis (SSc) characterized by SSc-related Raynaud’s phenomenon and to detect the therapeutic response to treatment with iloprost or alprostadil.Methods. Twenty-one patients with SSc and Raynaud’s phenomenon and twenty-six healthy controls were prospectively included. The SSc patients were intravenously treated with iloprost or alprostadil over seven days. FOI was performed at baseline and after seven days using an intravenous application of indocyanine green (ICG). The hands were divided into nineteen segments per hand. All segments were quantitatively evaluated to determine changes in ICG.Results. The sensitivity and specificity of FOI in the detection of ICG enhancement in patients with SSc were 95% versus 96%. At baseline, 31.5% hand segments showed ICG enhancement. After seven days of either iloprost or alprostadil therapy a significant reduction in the ICG was observed which ranged from 40.9% to 24.7%.Conclusion. The study demonstrates that the FOI technique is able to visualize soft-tissue inflammation with both high sensitivity and specificity. The anti-inflammatory therapeutic effects of iloprost were slightly stronger than alprostadil. FOI offers promising benefits in the diagnosis and therapy of patients with SSc-associated Raynaud’s phenomenon.


2018 ◽  
Vol 103 (8) ◽  
pp. 732-738 ◽  
Author(s):  
Caroline Crehan ◽  
Tim Colbourn ◽  
Michelle Heys ◽  
Elizabeth Molyneux

BackgroundNon-invasive respiratory support using bubble continuous positive airway pressure (bCPAP) is useful in treating babies with respiratory distress syndrome. Despite its proven clinical and cost-effectiveness, implementation is hampered by the inappropriate administration of bCPAP in low-resource settings. A clinical algorithm—‘TRY’ (based on Tone: good; Respiratory distress; Yes, heart rate above 100 beats/min)—has been developed to correctly identify which newborns would benefit most from bCPAP in a teaching hospital in Malawi.ObjectiveTo evaluate the reliability, sensitivity and specificity of TRY when employed by nurses in a Malawian district hospital.MethodsNursing staff in a Malawian district hospital baby unit were asked, over a 2-month period, to complete TRY assessments for every newly admitted baby with the following inclusion criteria: clinical evidence of respiratory distress and/or birth weight less than 1.3 kg. A visiting paediatrician, blinded to nurses’ assessments, concurrently assessed each baby, providing both a TRY assessment and a clinical decision regarding the need for CPAP administration. Inter-rater reliability was calculated comparing nursing and paediatrician TRY assessment outcomes. Sensitivity and specificity were estimated comparing nurse TRY assessments against the paediatrician’s clinical decision.ResultsTwo hundred and eighty-seven infants were admitted during the study period; 145 (51%) of these met the inclusion criteria, and of these 57 (39%) received joint assessments. The inter-rater reliability was high (kappa 0.822). Sensitivity and specificity were 92% and 96%, respectively.ConclusionsDistrict hospital nurses, using the TRY-CPAP algorithm, reliably identified babies that might benefit from bCPAP and thus improved its effective implementation.


2020 ◽  
Vol 21 (3) ◽  
pp. 1142
Author(s):  
Daniel Missailidis ◽  
Oana Sanislav ◽  
Claire Y. Allan ◽  
Sarah J. Annesley ◽  
Paul R. Fisher

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a devastating illness whose biomedical basis is now beginning to be elucidated. We reported previously that, after recovery from frozen storage, lymphocytes (peripheral blood mononuclear cells, PBMCs) from ME/CFS patients die faster in culture medium than those from healthy controls. We also found that lymphoblastoid cell lines (lymphoblasts) derived from these PBMCs exhibit multiple abnormalities in mitochondrial respiratory function and signalling activity by the cellular stress-sensing kinase Target Of Rapamycin Complex 1 (TORC1). These differences were correlated with disease severity, as measured by the Richardson and Lidbury weighted standing test. The clarity of the differences between these cells derived from ME/CFS patient blood and those from healthy controls suggested that they may provide useful biomarkers for ME/CFS. Here, we report a preliminary investigation into that possibility using a variety of analytical classification tools, including linear discriminant analysis, logistic regression and receiver operating characteristic (ROC) curve analysis. We found that results from three different tests—lymphocyte death rate, mitochondrial respiratory function and TORC1 activity—could each individually serve as a biomarker with better than 90% sensitivity but only modest specificity vís a vís healthy controls. However, in combination, they provided a cell-based biomarker with sensitivity and specificity approaching 100% in our sample. This level of sensitivity and specificity was almost equalled by a suggested protocol in which the frozen lymphocyte death rate was used as a highly sensitive test to triage positive samples to the more time consuming and expensive tests measuring lymphoblast respiratory function and TORC1 activity. This protocol provides a promising biomarker that could assist in more rapid and accurate diagnosis of ME/CFS.


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