Comprehensive biomarker analysis of patients with idiopathic pulmonary fibrosis and interstitial lung disease with healthy individuals.

OBJECTIVE: Interstitial lung diseases (ILDs) are a group of diffuse parenchymal lung disorders that can be idiopathic [idiopathic pulmonary fibrosis (IPF)] or associated with other diseases and are characterized by varying degrees of inflammation and fibrosis with poor prognosis. Several indicators are essential in diagnosing these individuals and differentiating between IPF and ILD. PATIENTS AND METHODS: The study involved 44 IPF patients, 22 ILD (non-IPF) patients, and 24 healthy people. We aimed to compare ILD (non-IPF) and IPF patient groups with each other and with healthy people in terms of interleukin (IL)-1, tumor necrosis factor-alpha (TNF-α), matrix metalloproteinase (MMP)-1, MMP-7, galectin (Gal)-3, IL-6, Krebs von den Lungen-6 (KL-6), total antioxidant status (TAS), total oxidant status (TOS), pyruvate kinase (PK), complete blood count (CBC), ferritin, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) features. Furthermore, it was intended to assess the patient groups in terms of visual semi-quantitative score (VSQS) (IPF alone), respiratory function tests (RFT), and 6-minute walk test (6MWT), also potential correlations between these tests and the previously indicated parameters. RESULTS: MMP-1, MMP-7, Gal-3, IL-6, KL-6, forced vital capacity (FVC), % FVC, forced expiratory volume in 1 second (FEV1), % FEV1, TAS, TOS, and PK values significantly elevated in IPF and ILD. Weight, IL-1, MMP-1, MMP-7, Gal-3, IL-6, KL-6, % FVC, FEV1, % FEV1, eosinophil count, and % red blood cell distribution width (RDW) values differed between IPF and ILD. VSQS, 6MWT, and PK were substantially linked with MMP-1, MMP-7, Gal-3, IL-6, and KL-6 in IPF. CONCLUSIONS: The factors investigated can be helpful in the diagnosis and distinction of IPF and ILD. In addition to focusing on the inflammatory environment in IPF and ILD patients, oxidant and antioxidant interactions must be studied.

What outcomes should be measured in feline chronic kidney disease treatment trials? Establishing a core outcome set for research.

Chronic Kidney Disease (CKD) is an important cause of feline morbidity and mortality. There is currently no agreement on which outcomes are most important in CKD treatment trials to assist evidence-based decision making. Core Outcome Sets (COSs) originated in human healthcare and are an agreed set of outcomes to be measured and reported as a minimum in any trial conducted relating to a particular disease. To establish a COS for feline CKD, this study used a systematic review and two consensus methodologies (an electronic Delphi (eDelphi), and an in-person consensus meeting), with an international panel of key stakeholders. The systematic review identified 104 unique published parameters, which were rated by panellists in round 1 of the eDelphi. Panellists were also asked to suggest additional parameters. In round 2 these additional parameters were rated and any parameters not understood by >10 % of panellists in round 1 were redefined and re-rated. Parameters reaching consensus in rounds 1 and 2 were removed from round 3, when all remaining parameters were re-rated by panellists who could view their own previous rating alongside the median rating of the whole panel. To reach inclusion in the COS, parameters had to be rated 8 or 9 on a Likert scale of 1-9 (where 1 was not important and 9 was very important) by more than 80 % of panellists. In the consensus meeting, panellists discussed and re-rated borderline parameters and streamlined the final COS. Borderline parameters were those that had been closest to, but not achieved, the 80 % threshold for inclusion. The eDelphi panel (n = 73) rated 24/104 parameters highly enough for inclusion and proposed an additional 20 parameters, of which 3 reached the inclusion threshold. This totalled 27 parameters for inclusion. The consensus meeting panel (n = 16) rated an additional 6/20 borderline parameters highly enough for inclusion. During the streamlining process, 4 parameters were removed as one was considered not an outcome, and three were already addressed by other parameters. The remaining COS totalled 29 parameters. These were grouped into 9 core themes: clinical examination, quality of life, serum biochemistry, complete blood count, urinalysis, total amount of food eaten, CKD progression, survival time and cause of death. This is the first COS for feline medicine. In future treatment efficacy trials the COS will strengthen the evidence-base for this condition, by facilitating easier comparison of results between studies, and reduce research waste.

A systematic review of the quality of life assessment tools for cats in the published literature.

Quality of life (QoL) is an important parameter to assess in cats, as it can be pivotal to important decision-making. Research reports that owners of cats with heart disease would trade longevity for QoL, and treatment associated improvement in QoL is very important for cats with chronic kidney disease. This systematic review aimed to explore the published literature to identify the number and range of QoL assessment tools available to researchers and veterinary professionals, by discovering tools which have already been used in published studies. Medline and CAB Abstracts were searched in March 2018, using terms relevant to cats and QoL or well-being. Inclusion and exclusion criteria were applied and information on uniqueness, validation and a short description of each tool extracted. A total of 1138 manuscripts were identified, of which 96 met all criteria. Forty of 96 manuscripts contained an assessment of QoL, using one of 32 unique tools identified. Sixteen of the tools identified were structured, making detailed patient assessments. Only eight of the structured tools were validated, and of these, three could be applied to healthy cats; the remainder being specific to a disease or being hospitalised. Some validated tools appeared in more than one manuscript. Overall, 12 manuscripts used a validated tool. In the 16 unstructured tools, five tools assessed QoL by assigning a single word (e.g. 'poor'). Eight tools assessed QoL on a single Likert scale (e.g. a number between 1 and 5). This work identifies the tools that are currently available for the assessment of QoL by researchers and veterinary professionals. Additionally, it demonstrates that many are not validated or lack detailed animal assessment, highlighting that further work in this important area is needed.

Proportion of nonsteroidal anti-inflammatory drug prescription in equine practice.

BACKGROUND: There is little knowledge of the prescription of nonsteroidal anti-inflammatory drugs (NSAIDs) and whether their prescription varies between countries. OBJECTIVE: To describe prescription practices of NSAIDs in equids in the United Kingdom (UK), United States of America (USA) and Canada. STUDY DESIGN: Descriptive observational study. METHODS: Free-text electronic medical records from 141,543 equids from 10 equine practices in the UK, 255,777 equids from 7 equine practices with 20 branches from the USA and 2 practices with 7 branches from Canada were evaluated. A validated text-mining technique was used to describe the proportion of equids prescribed NSAIDs at least once in these countries. The choice of NSAIDs in orthopaedic and colic cases was evaluated. RESULTS: The prescription of NSAIDs is more common in the USA (42.4%) and Canada (34.2%) than in the UK (28.6%). Phenylbutazone and flunixin meglumine were the drugs mostly prescribed in all countries. While flunixin meglumine was most prescribed with colic cases in all countries, a proportion received phenylbutazone despite this drug being licensed for use only with musculoskeletal disease. Phenylbutazone was the most commonly prescribed drug in cases with orthopaedic disease followed by flunixin meglumine in all countries. Only a small proportion of cases received meloxicam, ketoprofen or firocoxib. MAIN LIMITATIONS: The retrospective design might have resulted in an unknown number of incomplete records, particularly in the reporting of colic and orthopaedic disease. Although the data set is large, the relatively small number of practices recruited from each country may introduce bias. CONCLUSIONS: Clinical practice can differ between countries although the influence of individual practitioners and practice-specific policy on apparent intercountry differences requires further research. Despite several other NSAIDs being available and a substantial effort being made to evaluate their efficacy, the prescription of NSAIDs other than phenylbutazone and flunixin meglumine remains rather limited.

Assessment of serum endothelin-1 levels in rat appendicitis model and the effects of bosentan.

OBJECTIVE: In this study, the diagnostic value of serum endothelin-1 (ET-1) levels and the therapeutic effects of bosentan have been investigated in an experimental appendicitis rat model. MATERIALS AND METHODS: Twenty-one male Sprague-Dawley rats were chosen for the study. The rats were allocated into three groups as follows: Group 1 (control, n = 7), Group 2 (appendicitis, n = 7), and Group 3 (bosentan treatment, n = 7). At the 6th hour of the experiment, Groups 1 and 2 received 2 ml saline, and group 3 received 30 mg/kg bosentan intraperitoneally. At the 24th postoperative hour, all rats were sacrificed and evaluated histopathologically to score the severity of appendicitis. The plasma malondialdehyde, reduced and total glutathione levels, serum, and appendiceal tissue ET-1 levels were evaluated. RESULTS: In this study, we found that the ET-1 levels were significantly increased with appendicitis (p = 0.018). The administration of bosentan can statistically significantly both decrease the histopathologic injury in the inflamed appendix and increase the serum total glutathione levels (p = 0.002). CONCLUSIONS: The increase in plasma ET-1 levels may have a diagnostic value of acute appendicitis. We believe that manifestations that occur during the acute phase of appendicitis may be reduced with the administration of bosentan, which may also help prevent complications.

Antimicrobial selection and dosing in the treatment of wounds in the United Kingdom.

REASONS FOR PERFORMING STUDY: Antimicrobial stewardship within the veterinary profession is recognised by governing and professional bodies as being important; the attitudes and behaviour of veterinary surgeons merit investigation. OBJECTIVES: To investigate levels of protected antimicrobial use and accuracy of antimicrobial dosing in a common clinical scenario in equine practice. STUDY DESIGN: Retrospective cohort study. METHODS: Antimicrobial use was evaluated retrospectively in 113 cases subsequently referred to a single referral hospital for the treatment of limb wounds over a 20-month period. Antimicrobial classification (first-line, alternative or protected) was made according to guidelines produced by the British Equine Veterinary Association. These guidelines also served as the reference for recommended dose rates. RESULTS: Systemic antimicrobials were administered prior to referral in 94/113 (83.2%) horses, of which 8 (8.5%) received the protected third or fourth generation cephalosporins or fluoroquinolones. Forty-eight of 87 (55.2%) horses for which complete dosing data were available received antimicrobials at ≤90% of the recommended dose. Practitioners who held a postgraduate clinical qualification or worked in purely equine practice were no more or less likely to use protected antimicrobials (P = 0.06 and P = 0.64, respectively) or administer inadequate doses (P = 0.75 and P = 0.85, respectively). Veterinary surgeons with more experience were less likely to use protected antimicrobials (P<0.001); however, with the small case numbers, this finding should be interpreted with caution. Heavier horses were more likely to be under-dosed (P<0.002). CONCLUSIONS: This study highlights the administration of certain classes of antimicrobials in situations where their use is unlikely to be justified. If these findings reflect more general attitudes and behaviour then greater awareness of, and compliance with, recommendations for responsible antimicrobial use are required among equine practitioners. Bodyweight ought to be measured or estimated using validated objective techniques prior to systemic medications being administered.

Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015.

REASONS FOR PERFORMING STUDY: Triamcinolone is commonly used in equine practice for the treatment of orthopaedic conditions. A serious potential adverse effect of triamcinolone is laminitis. However, evidence for the risk of laminitis associated with triamcinolone use is limited. OBJECTIVES: To determine the risk of laminitis within 90 days of triamcinolone administration and compare with the risk of laminitis in a veterinary-attended horse population. STUDY DESIGN: Retrospective study of clinical records. METHODS: Text mining and data extraction was performed using content analysis software (SimStat-WordStat v.6) on a database of anonymous digital clinical records from a convenience sample of North American equine practices (n = 9). Medical records were retrieved using a dictionary of keywords for 3 groups of horses: 1) treated with triamcinolone, 2) age and practice matched control population (no triamcinolone) and 3) all laminitic horses. Records of horses within Groups 1 and 2 were mined for evidence of laminitis within a 90-day period of treatment or a random date respectively. Data manipulation and analysis was performed using R v3.0.0 (R Development Core Team). The prevalence of laminitis within all groups was determined and relative risk of developing laminitis determined by single logistic regression. RESULTS: The clinical records of 225,777 horses were examined. Overall prevalence of laminitis within the database was 1.1% (n = 2533). Triamcinolone was administered to 12.4% (n = 27,898) horses and 0.07% of treated horses (n = 20) developed laminitis. In the control population (n = 56,695), 0.2% of horses (n = 134) developed laminitis. The risk of developing laminitis was significantly lower in the triamcinolone treatment group than the control population (OR 0.3 95%CI, 0.18-0.48 P<0.001). CONCLUSIONS: Triamcinolone treatment does not increase the overall risk of a horse developing laminitis. However, further investigation of risk factors for laminitis in the 20 horses identified by this preliminary study is warranted to aid development of evidence-based treatment guidelines. Ethical animal research: This study was approved by the Ethics and Welfare Committee of the School of Veterinary Medicine at the University of Glasgow. Owners gave informed consent for their horses' inclusion in the study. Sources of funding: John Crawford Endowment Fund, University of Glasgow. Competing interests: None declared.

Investigation of single and paired measurements of adrenocorticotropic hormone for the diagnosis of pituitary pars intermedia dysfunction in horses.

BACKGROUND: Paired measurement of ACTH concentration may be more reliable than a single measurement. HYPOTHESIS/OBJECTIVES: To determine whether the mean of 2 measurements of ACTH concentration is more reliable in assessing pituitary pars intermedia dysfunction (PPID) than a single measurement. ANIMALS: Paired ACTH measurements were performed on (1) 148 occasions from 124 horses being investigated for PPID, (2) 90 occasions from 76 horses with PPID that were receiving treatment with pergolide, and (3) 63 occasions from 50 horses in which there was no clinical suspicion of PPID. Histologic examination of the pars intermedia was performed in 67 of the untreated horses. METHODS: Outcome of testing using single and the mean of paired samples was compared directly and both methods were compared against histology, which was considered the gold standard. RESULTS: Paired ACTH measurement altered binary classification as healthy or diseased in 6 of 211 cases, all off which had equivocal initial ACTH concentrations between 20 and 39 pg/mL. Using histology as the gold standard, optimal sensitivity and specificity for diagnosing PPID were 69.4 and 80.9%, respectively, for a single measurement and 72.2 and 76.2%, respectively, for paired measurements. The area under the receiver operating characteristic curve was 0.72 and 0.73 for single and paired measurements compared with histopathologic diagnosis, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: Paired measurement of ACTH concentration offers no advantage over a single measurement.

Validation of a digital audio recording method for the objective assessment of cough in the horse.

AIM: To validate the use of digital audio recording and analysis for quantification of coughing in horses. MATERIALS AND METHODS: Part A: Nine simultaneous digital audio and video recordings were collected individually from seven stabled horses over a 1 h period using a digital audio recorder attached to the halter. Audio files were analysed using audio analysis software. Video and audio recordings were analysed for cough count and timing by two blinded operators on two occasions using a randomised study design for determination of intra-operator and inter-operator agreement. Part B: Seventy-eight hours of audio recordings obtained from nine horses were analysed once by two blinded operators to assess inter-operator repeatability on a larger sample. RESULTS AND CONCLUSIONS: Part A: There was complete agreement between audio and video analyses and inter- and intra-operator analyses. Part B: There was >97% agreement between operators on number and timing of 727 coughs recorded over 78 h. The results of this study suggest that the cough monitor methodology used has excellent sensitivity and specificity for the objective assessment of cough in horses and intra- and inter-operator variability of recorded coughs is minimal.

Exhaled breath condensate hydrogen peroxide and pH for the assessment of lower airway inflammation in the horse.

Measurement of hydrogen peroxide (H(2)O(2)) concentration and pH in exhaled breath condensate (EBC) is useful for detection and monitoring of asthma in humans. In contrast, limited information on the use of these parameters for the investigation of lower airway inflammation (LAI) is available for horses. Aims of the current study were to investigate the intra- and inter-day variations of EBC H(2)O(2) concentration and pH in horses and establish any relationship(s) with LAI. Both intra- and inter-day variability of EBC H(2)O(2) concentration were large, while those of pH were small. No significant difference in the intra-day or inter-day H(2)O(2) concentrations or pH measurements were found in control or LAI horses, except for inter-day H(2)O(2) concentration in horses with LAI (p=0.019). There was no significant difference in EBC pH or H(2)O(2) concentration between control and LAI horses, however a trend for a reduced pH in horses with LAI was observed.

Stabling causes a significant increase in the pH of the equine airway.

Regulation of pH homeostasis in the equine lung is poorly understood. Measurement of exhaled breath condensate (EBC) pH provided a simple, highly repeatable and noninvasive method for the longitudinal investigation of changes in airway pH in response to environmental changes. Stabling of horses was found to lead to a small (approximately 100-200 parts/billion) but significant (P < 0.001) increase in ambient ammonia concentration when compared to pasture. This increase in exposure to ambient ammonia concentration was associated with significant (P = 0.002) increases in EBC pH and exhaled ammonia (P = 0.013). Stable feed/bedding management type had no effect on EBC pH or exhaled ammonia concentration, while ambient ammonia concentration was influenced by stable management type.

Transesterified sesame (Sesamum indicum L.) seed oil as a biodiesel fuel.

The sesame (Sesamum indicum L.) oil was extracted from the seeds of the sesame that grows in Diyarbakir, SE Anatolia of Turkey. Sesame seed oil was obtained in 58wt/wt%, by traditional solvent extraction. The methylester of sesame (Sesamum indicum L.) seed oil was prepared by transesterification of the crude oil. Transesterification shows improvement in fuel properties of sesame seed oil. This study supports the production of biodiesel from sesame seed oil as a viable alternative to the diesel fuel.

Diagnostic accuracy of digital photography and image analysis for the measurement of foot conformation in the horse.

REASONS FOR PERFORMING STUDY: Rigorous evaluation of practicable methods for the objective assessment of foot conformation has not been performed. OBJECTIVES: To assess the practicability, precision and accuracy of the process of obtaining measurements of horses' feet using photography and image processing software. METHODS: Precision study: Lateral photographs of horses' feet were obtained twice by 2 veterinary surgeons (image acquisition - IAc). Photographs were analysed by 2 masked veterinary surgeons on 2 occasions (image analysis - IAn). Measurements were compared within and between operators for self and non-self acquired photographs. Agreement indices (AIs) and 95% limits of agreement (LOA) were calculated for the IAn process alone and for the combined IAc + IAn processes. Accuracy study: Measurements obtained from lateral photographs were compared with those obtained from lateromedial radiographs. AIs and 95% LOA were calculated for each measurement. RESULTS: Precision study: Mean intra- and interoperator AIs for the IAn process alone were > or = 0.90 while those for the combined IAc + IAn processes were > or = 0.89 for all measurements. Similar mean AIs and 95% LOA were calculated regardless of image origin. The 95% LOA for hoof angle, heel height/toe height% and coronary band angle for all comparisons were within target values. Accuracy study: Mean AIs were > or = 0.89 for all measurements. The 95% LOA for heel height/toe height% and coronary band angle were within target values. CONCLUSIONS: Excellent precision was identified within and between operators regardless of image origin. High levels of accuracy were also identified, especially for heel height/toe height% and coronary band angle, indicating that photography and radiography may be used interchangeably. POTENTIAL RELEVANCE: Acquisition and analysis of photographic images is an appropriate method for the objective measurement of foot conformation, both in clinical and, research settings.

The preventive effect on bone loss of 50-Hz, 1-mT electromagnetic field in ovariectomized rats.

Osteoporosis is a common health problem, especially in the elderly and in women after menopause. Although there are some treatment methods, they impose serious side effects. Recently, the use of an electromagnetic field (EMF) has been a promising candidate for better treatment of osteoporosis. In the present study, we investigated the preventive effects of low-frequency (50 Hz), low-intensity (1 mT), and long-term (6 weeks) EMF on bone loss in ovariectomized rats. We used 18 female albino Wistar rats (8 unexposed and 10 exposed) to assess the effect of EMF. We examined the mineralization and the morphology of the tibia in control and EMF-exposed rats. The cortical thickness of the tibia was increased in EMF-exposed rats ( P < 0.002). The levels of Na and K in the tibia were significantly increased in rats exposed to EMF ( P < 0.001; P < 0.002, respectively). We also observed an increased blood alkaline phosphatase (ALP) level after EMF exposure ( P < 0.05). No significant differences in the levels of Ca, Mg, Li, or creatine were found between the exposed and unexposed groups. Our data support the notion that an EMF may prove to be an effective treatment method for osteoporosis and other abnormalities related to bone loss.

The role of trace minerals in the pathogenesis of postmenopausal osteoporosis and a new effect of calcitonin.

The physiologic role of calcitonin in mineral and bone homeostasis is not very well understood. Very few longitudinal studies have reported the effects of calcitonin therapy on trace minerals in postmenopausal osteoporosis despite the documented involvement of trace minerals in normal skeletal metabolism. Several trace minerals, particularly magnesium (Mg) and zinc (Zn), essential for organic bone matrix synthesis have been known for at least three decades. The present study was designed to determine whether the mineral profile was different between 70 osteoporotic and 30 nonosteoporotic postmenopausal women and to evaluate the efficacy of calcitonin therapy for 6 months on these trace minerals in postmenopausal osteoporotic women. In our study, the serum values of Mg, copper (Cu), and Zn (P < 0.05) were significantly lower in the patient group than those in the control group. After 3 months of treatment, serum Cu, Zn, and Mg levels did not differ between the patients and controls, and this situation has continued after the end of 6 months of therapy. Serum Cu, Zn, and Mg levels increased consistently during the 6-month treatment period. The higher levels of serum Mg in the 3rd and 6th months of therapy were found to be statistically significant compared to those before treatment (P < 0.05). Serum Cu and Zn levels were found to be significantly higher at all measurements during the treatment period as well as at the end of therapy (P < 0.05). These results suggest that (1) calcitonin therapy regulates Mg, Cu, and Zn levels in postmenopausal osteoporosis; (2) when serum calcium and phosphorus were normal in postmenopausal osteoporosis, serum Mg, Cu, and Zn were more useful for evaluation; and (3) further studies are essential to evaluate the role of dietary composition on the manifestations of osteoporosis.

Sorption behaviour of uranium(VI) with N,N-dibutyl-N'-benzoylthiourea Impregnated in Amberlite XAD-16.

The sorption of U(VI) by N, N-dibutyl, N'-benzoylthiourea (DBBT) impregnated resin has been studied. DBBT impregnated resin was prepared by direct adsorption of chelating ligand onto macroporous support, Amberlite XAD-16. The adsorption of DBBT on the macroporous support is shown by FTIR spectroscopy to be the result of only weak chelating ligand-support interactions. Parameters such as the pH effect on the sorption of uranium, the sorption capacity of the impregnated resin, the stripping of uranium and the effect of coexisting ions were investigated by batch experiments. The results demonstrated that uranium(VI) ions, at pH 4.5-7 could be sorbed completely using 0.1 g Amberlite XAD-16 resin loaded with DBBT. The sorption capacity of the impregnated resin is 0.90 mmol uranium(VI) g(-1). Quantitative recovery of U(VI) is achieved by stripping with 0.1 M HNO(3). The method was applied to the determination of uranium in synthetic samples. The precision of the method was 2.4 RSD% in a concentration of 1.20 mug ml(-1) for ten replicate analysis.