The Telehealth Skills, Training, and Implementation Project: An evaluation protocol

External stabilization is reported to improve reliability of hand held dynamometry, yet this has not been tested in burns. We aimed to assess the reliability of dynamometry using an external system of stabilization in people with moderate burn injury and explore construct validity of strength assessment using dynamometry. Participants were assessed on muscle and grip strength three times on each side. Assessment occurred three times per week for up to four weeks. Within session reliability was assessed using intraclass correlations calculated for within session data grouped prior to surgery, immediately after surgery and in the sub-acute phase of injury. Minimum detectable differences were also calculated. In the same timeframe categories, construct validity was explored using regression analysis incorporating burn severity and demographic characteristics. Thirty-eight participants with total burn surface area 5 – 40% were recruited. Reliability was determined to be clinically applicable for the assessment method (intraclass correlation coefficient \u3e0.75) at all phases after injury. Muscle strength was associated with sex and burn location during injury and wound healing. Burn size in the immediate period after surgery and age in the sub-acute phase of injury were also associated with muscle strength assessment results. Hand held dynamometry is a reliable assessment tool for evaluating within session muscle strength in the acute and sub-acute phase of injury in burns up to 40% total burn surface area. External stabilization may assist to eliminate reliability issues related to patient and assessor strength

Relationship between haptoglobin and serum amyloid A in milk and milk quality

The objective of this study was to evaluate relationships between the presence in milk of the major bovine acute phase proteins, haptoglobin (Hp) and serum amyloid A (SAA), and milk quality parameters. Composite milk samples were collected from 89 clinically healthy dairy cows and analysed for Hp and SAA, total protein, casein, and whey protein levels, casein number, proteolysis, total fat and lactose levels, and somatic cell count (SCC). Milk samples with detectable levels of Hp showed lower total protein and casein levels, whereas milk samples with detectable levels of SAA had lower casein number and lactose level. Samples with detectable levels of acute phase proteins also showed an elevated SCC. The results suggest that the presence of Hp and SAA in milk might indicate unfavourable changes in milk composition, especially in relation to protein quality

Grip and muscle strength dynamometry in acute burn injury: Evaluation of an updated assessment protocol

External stabilization is reported to improve reliability of hand held dynamometry, yet this has not been tested in burns. We aimed to assess the reliability of dynamometry using an external system of stabilization in people with moderate burn injury and explore construct validity of strength assessment using dynamometry. Participants were assessed on muscle and grip strength three times on each side. Assessment occurred three times per week for up to four weeks. Within session reliability was assessed using intraclass correlations calculated for within session data grouped prior to surgery, immediately after surgery and in the sub-acute phase of injury. Minimum detectable differences were also calculated. In the same timeframe categories, construct validity was explored using regression analysis incorporating burn severity and demographic characteristics. Thirty-eight participants with total burn surface area 5 – 40% were recruited. Reliability was determined to be clinically applicable for the assessment method (intraclass correlation coefficient \u3e0.75) at all phases after injury. Muscle strength was associated with sex and burn location during injury and wound healing. Burn size in the immediate period after surgery and age in the sub-acute phase of injury were also associated with muscle strength assessment results. Hand held dynamometry is a reliable assessment tool for evaluating within session muscle strength in the acute and sub-acute phase of injury in burns up to 40% total burn surface area. External stabilization may assist to eliminate reliability issues related to patient and assessor strength

The acute phase protein, haptoglobin : a potential parameter in welfare assessment?

Physiological parameters are important measures in animal welfare assessment. To assess the amount of stress an animal experiences, stress hormones like cortisol are frequently used. However, measuring cortisol has major disadvantages due to its rapid reactivity and decline and many influencing factors. Other potential alternative markers are acute phase proteins, since stress is known to affect the immune system. A pilot study was conducted to investigate the response of the acute phase protein, plasma haptoglobine (HP), in pigs subjected to a stressor (food deprivation) and to examine the correlation between HP levels and average daily growth (ADG). Forty grower pigs (25.1 ± 4.4 kg, mean ± SD) (sex and former pen mates balanced), were allocated to 4 conventional pens, 2 treatment (T) and 2 control (C) groups (10 pigs per pen). After 10 days of adaptation the experiment started and ran for 3 weeks. In the 2nd week, T groups were repeatedly subjected to an 8-hour food deprivation (day 1, 3, 5 and 7 of week 2), C groups had normal, unrestricted, access to food. Pigs were weighed twice a week and blood was collected once a week (every 5th day). Mean levels of plasma HP of C and T groups showed large variation between individuals (C groups, week 2: 1.84 ± 3.11 mg/ml; T groups, week 2: 1.40 ± 1.16 mg/ml). No significant differences (Kruskal-Wallis test) in HP levels or growth were found between the C and T groups or between the different weeks within the T groups. Significant negative weak to moderate correlations were found between ADG and HP levels (HP week 1 and ADG week 1: rs = -0.47, p=0.005; HP week 2 and ADG total; rs= -0.60, p=0.015; HP week 3 and ADG total: rs = -0.43, p=0.025; average HP total and ADG total: rs= -0.41, p=0.017). Large variations in HP levels between individuals were shown and no effect of treatment on HP levels or growth was found. Possibly, food deprivation had no apparent stress eliciting effect. Despite these results, interesting correlations between the level of HP and ADG were found, corroborating the inverse relationship between the acute phase response and growth. To further investigate the relation of the acute phase response and stress a successive experiment will be conducted in which we apply a stronger stressor (mixing pigs) and combine the physiological data with behavior

Effect of pre-analytical treatments on bovine milk acute phase proteins

Background Samples for diagnostic procedures often require some form of pre-analytical preparation for preservation or safe handling during transportation prior to analysis in the laboratory. This is particularly important for milk samples which frequently need preservatives to retain milk composition as close to that found in freshly collected samples as possible. Methods Milk samples were treated by heating at 56 °C for 30 min or preserved by addition of either potassium dichromate or bronopol respectively. Haptoglobin (Hp), mammary associated serum amyloid A3 (M-SAA3) and C-reactive protein (CRP) were measured in the various treatment groups and in control samples which were not treated, using enzyme linked immunoassays. The concentrations of each APP were compared between treated and non-treated groups using the Wilcoxon signed ranks tests. Results Heat treatment of samples was found to have a significant lowering effect on milk M-SAA3 and CRP but not Hp. The use of potassium dichromate and bronopol as preservatives in milk had no significant effects on milk Hp and M-SAA3 concentration but lowered milk CRP values compared to controls. Conclusions The observed effects of heating and preservative use on milk APP should be taken into consideration when assaying samples which have undergone heat treatment as a result of international transfer regulations involving biological samples or samples needing chemical preservation prior to transport to laboratory

Optimal combinations of acute phase proteins for detecting infectious disease in pigs

Peer reviewedPublisher PD

Diabetes is a Risk Factor for Pulmonary Tuberculosis: A Case-Control Study from Mwanza, Tanzania.

Diabetes and TB are associated, and diabetes is increasingly common in low-income countries where tuberculosis (TB) is highly endemic. However, the role of diabetes for TB has not been assessed in populations where HIV is prevalent. A case-control study was conducted in an urban population in Tanzania among culture-confirmed pulmonary TB patients and non-TB neighbourhood controls. Participants were tested for diabetes according to WHO guidelines and serum concentrations of acute phase reactants were measured. The association between diabetes and TB, and the role of HIV as an effect modifier, were examined using logistic regression. Since blood glucose levels increase during the acute phase response, we adjusted for elevated serum acute phase reactants. Among 803 cases and 350 controls the mean (SD) age was 34.8 (11.9) and 33.8 (12.0) years, and the prevalence of diabetes was 16.7% (95% CI: 14.2; 19.4) and 9.4% (6.6; 13.0), respectively. Diabetes was associated with TB (OR 2.2, 95% CI: 1.5; 3.4, p<0.001). However, the association depended on HIV status (interaction, p = 0.01) due to a stronger association among HIV uninfected (OR 4.2, 95% CI: 1.5; 11.6, p = 0.01) compared to HIV infected (OR 0.1, 95% CI: 0.01; 1.8, p = 0.13) after adjusting for age, sex, demographic factors and elevated serum acute phase reactants. Diabetes is a risk factor for TB in HIV uninfected, whereas the association in HIV infected patients needs further study. The increasing diabetes prevalence may be a threat to TB control