Bayesian evaluation of the accuracy of a thoracic auscultation scoring system in dairy calves with bronchopneumonia using a standard lung sound nomenclature

BackgroundAlthough thoracic auscultation (AUSC) in calves is quick and easy to perform, the definition of lung sounds is highly variable and leads to poor to moderate accuracy in diagnosing bronchopneumonia (BP). Hypothesis/ObjectivesEvaluate the diagnostic accuracy of an AUSC scoring system based on a standard lung sound nomenclature at different cut-off values, accounting for the absence of a gold standard test for BP diagnosis. AnimalsThree hundred thirty-one calves. MethodsWe considered the following pathological lung sounds: increased breath sounds (score 1), wheezes and crackles (score 2), increased bronchial sounds (score 3), and pleural friction rubs (score 4). Thoracic auscultation was categorized as AUSC1 (positive calves for scores & GE;1), AUSC2 (positive calves for scores & GE;2), and AUSC3 (positive calves for scores & GE;3). The accuracy of AUSC categorizations was determined using 3 imperfect diagnostic tests with a Bayesian latent class model and sensitivity analysis (informative vs weakly informative vs noninformative priors and with vs without covariance between ultrasound and clinical scoring). ResultsBased on the priors used, the sensitivity (95% Bayesian confidence interval [BCI]) of AUSC1 ranged from 0.89 (0.80-0.97) to 0.95 (0.86-0.99), with a specificity (95% BCI) of 0.54 (0.45-0.71) to 0.60 (0.47-0.94). Removing increased breath sounds from the categorizations resulted in increased specificity (ranging between 0.97 [0.93-0.99] and 0.98 [0.94-0.99] for AUSC3) at the cost of decreased sensitivity (0.66 [0.54-0.78] to 0.81 [0.65-0.97]). Conclusions and Clinical ImportanceA standardized definition of lung sounds improved AUSC accuracy for BP diagnosis in calves

Confronto fra la metodica di esecuzione standard di elettrocardiogrammi (ECG) base apice e con tecnica smartphone in bovine da latte adulte.

Sia nell’uomo che in medicina veterinaria nel cane, nel gatto, nel cavallo e in altre specie è stata dimostrata l’accuratezza diagnostica dell’elettrocardiografia mediante smartphone nella valutazione nella frequenza e ritmo cardiaco e misurazione dei parametri elettrocardiografici. Lo scopo di questo studio è stato quello di valutare la fattibilità dell’esecuzione dell’ECG mediante smartphone. Sono stati reclutate cinquantacinque bovine adulte sane di razza Frisona Italiana. In ciascun soggetto lo smartphone ECG e l’ECG standard base-apice sono stati acquisiti simultaneamente. I tracciati sono stati esaminati da un operatore cieco che aveva il compito di giudicarne l’interpretabilità ed effettuare le misurazioni dei parametri elettrocardiografici. È stata valutata la concordanza tra lo smartphone ECG e l’ECG standard base-apice. I tracciati sono risultati interpretabili in 49 casi su 56 (89%). È stata rilevata una concordanza perfetta tra smartphone ECG ed ECG standard nell’identificazione della frequenza cardiaca. La frequenza cardiaca misurata automaticamente dall’applicazione è risultata inaffidabile. Per quanto riguarda le onde ed i segmenti elettrocardiografici tra le due metodiche sono state evidenziate differenze minime di nessun valore clinico. È stata trovata una concordanza perfetta tra smartphone ECG ed ECG standard nella valutazione della polarità del complesso QRS, mentre nessuna concordanza è stata riportata per quanto riguarda la valutazione della polarità dell’onda P. Gli artefatti della linea di base erano presenti in modo limitato ma il loro numero era significativamente più alto nei tracciati ottenuti con il dispositivo smartphone, rispetto a quelli ottenuti con l’ECG standard base-apice. Concludendo, lo smartphone ECG è in grado di registrare tracciati ECG a singola derivazione di qualità. Risulta affidabile nella valutazione della frequenza cardiaca e nella misurazione di onde e intervalli elettrocardiografici. Questa tecnologia rappresenta quindi un valido mezzo diagnostico supplementare nella valutazione elettrocardiografica del bovino, sebbene non costituisca un metodo alternativo all’ECG base-apice standard. Ulteriori studi sono necessari per valutare l’affidabilità diagnostica dello smartphone ECG nella diagnosi delle aritmie nel bovino. A good diagnostic accuracy of smartphone-based electrocardiography in the evaluation of heart rate, heart rhythm and ECG measurements has been reported in humans, dogs, cats, horses and other species. The aim of this study was to assess the feasibility of smartphone-based electrocardiography in cattle. Fifty-five healthy adult Holstain Freisian dairy cows were enrolled. Standard base-apex ECG and smartphone ECG were simultaneously recorded in each cow. All ECGs were reviewed by one blinded operator, who judged whether tracings were acceptable for interpretation and performed electrocardiographic measurements. Agreement between smartphone and standard base-apex ECG in the analysis of tracings was evaluated. Smartphone ECG tracings were interpretable in 49/55 (89%) cases. A perfect agreement between smartphone and standard ECG tracings was found in the assessment of heart rate. Heart rate automatically measured by the smartphone application was not reliable. In terms of electrocardiographic waves and interval duration, minimal differences of no clinical value were found between smartphone and standard ECG. Agreement was found for QRS complex polarity evaluation, but not for P wave polarity. Baseline artefacts were rare but significantly higher in the smartphone ECG tracings compared to standard ECG. The smartphone ECG can record single-lead ECG tracings of an adequate quality for interpretation in cattle. The smartphone ECG could represent an additional tool for the electrocardiographic screening evaluation of cows but is not a substitute for the standard base-apex ECG

Bayesian evaluation of the accuracy of a thoracic auscultation scoring system in dairy calves with bronchopneumonia using a standard lung sound nomenclature

BackgroundAlthough thoracic auscultation (AUSC) in calves is quick and easy to perform, the definition of lung sounds is highly variable and leads to poor to moderate accuracy in diagnosing bronchopneumonia (BP). Hypothesis/ObjectivesEvaluate the diagnostic accuracy of an AUSC scoring system based on a standard lung sound nomenclature at different cut-off values, accounting for the absence of a gold standard test for BP diagnosis. AnimalsThree hundred thirty-one calves. MethodsWe considered the following pathological lung sounds: increased breath sounds (score 1), wheezes and crackles (score 2), increased bronchial sounds (score 3), and pleural friction rubs (score 4). Thoracic auscultation was categorized as AUSC1 (positive calves for scores & GE;1), AUSC2 (positive calves for scores & GE;2), and AUSC3 (positive calves for scores & GE;3). The accuracy of AUSC categorizations was determined using 3 imperfect diagnostic tests with a Bayesian latent class model and sensitivity analysis (informative vs weakly informative vs noninformative priors and with vs without covariance between ultrasound and clinical scoring). ResultsBased on the priors used, the sensitivity (95% Bayesian confidence interval [BCI]) of AUSC1 ranged from 0.89 (0.80-0.97) to 0.95 (0.86-0.99), with a specificity (95% BCI) of 0.54 (0.45-0.71) to 0.60 (0.47-0.94). Removing increased breath sounds from the categorizations resulted in increased specificity (ranging between 0.97 [0.93-0.99] and 0.98 [0.94-0.99] for AUSC3) at the cost of decreased sensitivity (0.66 [0.54-0.78] to 0.81 [0.65-0.97]). Conclusions and Clinical ImportanceA standardized definition of lung sounds improved AUSC accuracy for BP diagnosis in calves

Blood gases, acid‐base, and metabolic alterations in calves with bronchopneumonia diagnosed via clinical signs and thoracic ultrasonography: A cross‐sectional study

Abstract Background Bronchopneumonia (BP) in calves potentially causes systemic changes. Objectives To describe metabolic, arterial blood gas, and acid‐base disorders in calves with BP diagnosed by thoracic ultrasound (TUS), Wisconsin score (WISC), and combinations of WISC and TUS. Animals Two hundred thirty‐one dairy preweaned dairy calves from 13 dairy farms. Methods Cross‐sectional study. Each calf sequentially underwent arterial blood gas evaluation, WISC score, venous sampling, and TUS. Calves were grouped based on a single diagnostic method and combination of WISC and 2 TUS cutoffs (≥1 cm; ≥3 cm) as healthy, upper respiratory tract infection, subclinical BP, and clinical BP. Results Oxygenation and acid‐base variables were unaffected. Glucose concentration in TUS‐affected calves was significantly lower (P < .001) than in healthy calves (median ≥TUS1cm = 5.2 mmol/L 25%‐75% interquartile range [IQR] 4.5‐6.1, <TUS1cm = 5.9 mmol/L IQR 5.5‐6.6; ≥TUS3cm = 5.1 mmol/L IQR 4.4‐6.2, <TUS3cm = 5.8 mmol/L IQR 5.3‐6.4). Paraoxonase‐1 was significantly lower (P < .001) in TUS‐affected calves (≥TUS1cm = 64.1 U/mL IQR 40.8‐78, <TUS1cm = 77.3 U/mL IQR 61.9‐96.5; ≥TUS3cm = 59.2 U/mL IQR 37.7‐72.4, <TUS3cm = 72.9 U/mL IQR 53.4‐95.5). None of the variables highlighted clear distinctions in WISC‐detected clinical and subclinical BP calves based on the combination of WISC and TUS. Conclusions and Clinical Importance Clinical signs indicate minor systemic disorders compared to TUS. The abnormalities detected by ultrasonographic examination were moderate and did not deviate from normal reference ranges

Early biomarkers of altered renal function and orthostatic intolerance during 10-day bedrest

Exposure to actual or simulated microgravity results in alterations of renal function, fluid redistribution, and bone loss, which is coupled to a rise of urinary calcium excretion. We provided evidence that high calcium delivery to the collecting duct reduces local Aquaporin 2 (AQP2)-mediated water reabsorption under vasopressin action, thus limiting the maximal urinary concentration to reduce calcium saturation. To investigate early renal adaptation into simulated microgravity, we investigated the effects of 10 days of strict bedrest in 10 healthy volunteers. We report here that 10 days of inactivity are associated with a transient, significant decrease (day 5) in vasopressin (copeptin) paralleled by a decrease in AQP2 excretion, consistent with an increased central volume to the heart, resulting in reduced water reabsorption. Moreover, bedrest caused a significant increase in calciuria secondary to bone demineralization paralleled by a decrease in PTH. Urinary osteopontin, a glycoprotein exerting a protective effect on stone formation, was significantly reduced during bedrest. Moreover, a significant increase in adrenomedullin (day 5), a peptide with vasodepressor properties, was observed at day 5, which may contribute to the known reduced orthostatic capacity post-bedrest. We conclude that renal function is altered in simulated microgravity and is associated with an early increase in the risk of stone formation and reduced orthostatic capacity post-bedrest within a few days of inactivity

Comparison of smartphone-based and standard base-apex electrocardiography in healthy dairy cows

Background: There is good diagnostic accuracy of smartphone-based ECG in the evaluation of heart rate (HR), heart rhythm, and ECG values for humans, horses, dogs, and cats. Objectives: Assess feasibility and reliability of a smartphone ECG device to evaluate HR expressed as beats per minute and ECG values in cows. Animals: Fifty-five healthy Holstein Friesian cows. Methods: Prospective observational study. A standard base-apex ECG was acquired for 60 seconds in each cow. A smartphone ECG tracing was recorded simultaneously using a single-lead bipolar ECG recorder. All ECGs were reviewed by 1 blinded investigator. The following ECG variables were assessed: HR, P wave duration, PR interval, QRS complex and QT interval (milliseconds), P wave, and QRS complex polarity. Agreement between standard and smartphone ECG was evaluated by Cohen's k test and the Bland-Altman test. Results: Smartphone ECG tracings were interpretable in 89% of the recordings. Minimal differences of no clinical relevance were found between standard and smartphone ECG tracings regarding HR and duration of ECG waves and interval. Good agreement found in the evaluation of QRS complex polarity (85%) but not for P wave polarity (k = 0.006). Artifacts were rare but of significantly higher frequency in smartphone ECG compared to standard ECG tracings (22% versus 0%; P = .005). Conclusions and Clinical Importance: Good quality single-lead ECG tracings can be recorded by smartphone device in healthy cows. Smartphone tracings are reliable for evaluation of HR and selective ECG variables. Smartphone ECG can represent an additional tool for ECG screening in cows

State and trait anxiety and depression in primary brain tumours before and after surgery: a one-year longitudinal study

OBJECT: The aim in this study was to assess the state and trait types of anxiety as well as current depression before and after surgery in patients affected by brain tumors. The relationships between these affective disorders and the patient's sex, tumor histology, and laterality of the tumor were also evaluated. METHODS: A total of 72 patients affected by a primary brain tumor were enrolled in the study. Histological grades were assigned according to the World Health Organization classification. State and trait anxiety were assessed using the State and Trait Anxiety Inventory; current depression was assessed using the Zung Self-Rating Depression Scale. Cognitive impairment was assessed using the 10-item Short Portable Mental Status Questionnaire. Psychometric evaluation was assessed before surgery and at 1, 3, 6, and 12 months after surgery. RESULTS: Before brain surgery, 62.5% of patients showed state anxiety, 50% of patients showed trait anxiety, and 9.7% of patients showed current depression. During the follow-up period there was no significant variation in the percentage of patients with state anxiety (p=0.416) and trait anxiety (p=0.7), whereas a significant increase in the percentage of those with current depression was found (p<0.0001), in particular at 1 month (p=0.002) and 3 months (p=0.039) after surgical treatment. The tumor's laterality and histology showed no correlation with psychometric variables, whereas a relationship between the presence of trait anxiety at the enrollment and current depression after surgery (p<0.0001) was found. CONCLUSIONS: Patients affected by brain tumors frequently experience affective disorders. After brain surgery, a depressive state can develop. The psychometric assessment could be useful in these patients for quick recognition of psychological disorders

State and trait anxiety and depression in patients with primary brain tumors before and after surgery: 1-year longitudinal study

Object. The aim in this study was to assess the state and trait types of anxiety as well as current depression before and after surgery in patients affected by brain tumors. The relationships between these affective disorders and the patient’s sex, tumor histology, and laterality of the tumor were also evaluated. Methods. A total of 72 patients affected by a primary brain tumor were enrolled in the study. Histological grades were assigned according to the World Health Organization classification. State and trait anxiety were assessed using the State and Trait Anxiety Inventory; current depression was assessed using the Zung Self-Rating Depression Scale. Cognitive impairment was assessed using the 10-item Short Portable Mental Status Questionnaire. Psychometric evaluation was assessed before surgery and at 1, 3, 6, and 12 months after surgery. Results. Before brain surgery, 62.5% of patients showed state anxiety, 50% of patients showed trait anxiety, and 9.7% of patients showed current depression. During the follow-up period there was no significant variation in the percentage of patients with state anxiety (p = 0.416) and trait anxiety (p = 0.7), whereas a significant increase in the percentage of those with current depression was found (p , 0.0001), in particular at 1 month (p = 0.002) and 3 months (p = 0.039) after surgical treatment. The tumor’s laterality and histology showed no correlation with psychometric variables, whereas a relationship between the presence of trait anxiety at the enrollment and current depression after surgery (p , 0.0001) was found. Conclusions. Patients affected by brain tumors frequently experience affective disorders. After brain surgery, a depressive state can develop. The psychometric assessment could be useful in these patients for quick recognition of psychological disorders

State and trait anxiety and depression in patients with primary brain tumors before and after surgery: 1-year longitudinal study

OBJECT: The aim in this study was to assess the state and trait types of anxiety as well as current depression before and after surgery in patients affected by brain tumors. The relationships between these affective disorders and the patient's sex, tumor histology, and laterality of the tumor were also evaluated. METHODS: A total of 72 patients affected by a primary brain tumor were enrolled in the study. Histological grades were assigned according to the World Health Organization classification. State and trait anxiety were assessed using the State and Trait Anxiety Inventory; current depression was assessed using the Zung Self-Rating Depression Scale. Cognitive impairment was assessed using the 10-item Short Portable Mental Status Questionnaire. Psychometric evaluation was assessed before surgery and at 1, 3, 6, and 12 months after surgery. RESULTS: Before brain surgery, 62.5% of patients showed state anxiety, 50% of patients showed trait anxiety, and 9.7% of patients showed current depression. During the follow-up period there was no significant variation in the percentage of patients with state anxiety (p=0.416) and trait anxiety (p=0.7), whereas a significant increase in the percentage of those with current depression was found(p<0.0001), in particular at 1 month (p=0.002) and 3 months (p=0.039) after surgical treatment. The tumor's laterality and histology showed no correlation with psychometric variables, whereas a relationship between the presence of trait anxiety at the enrollment and current depression after surgery (p<0.0001) was found. CONCLUSIONS: Patients affected by brain tumors frequently experience affective disorders. After brain surgery, a depressive state can develop. The psychometric assessment could be useful in these patients for quick recognition of psychological disorders

Effective treatment of sarcoptic mange in an alpaca (Vicugna pacos) using fluralaner: a case report

South American Camelids, including alpacas, have gained popularity in Europe as pets and prized wool sources. Skin health concerns, particularly mite infestations, have emerged as a notable problem in these animals. Sarcoptic mange can lead to severe itching, papules, and chronic symptoms such as alopecia, crusts, and emaciation if left untreated. This case report documents a 2-year-old female alpaca suffering from sarcoptic mange. Despite initial treatment with ivermectin, its condition worsened, leading to severe weight loss, abortion, and a continued presence of mites. Considering the lack of effective treatments for sarcoptic mange in alpacas and the unavailability of registered drugs for this species in Italy, fluralaner, a drug previously used in other animal species, has been administered orally at a dosage of 5 mg/kg. Within a week after the treatment with fluralaner, the patient exhibited significant improvement, including the resolution of itching, healing of skin lesions, and an increase in appetite. Follow-up skin scrapings confirmed the absence of mites, and the patient's condition continued to improve. Fluralaner demonstrated to be a highly effective and fast-acting treatment for sarcoptic mange in alpacas, offering potential economic benefits attributed to its single-dose administration