A new method of computing the vertebral heart scale by means of direct standardisation.

OBJECTIVES: The aim of this study was to describe and compare a simplified vertebral heart scale computation method (Objective VHS) with the original Buchanan method (Buchanan VHS). METHODS: The Objective VHS was compared to the Buchanan VHS method in 42 dogs including 14 healthy dogs and 28 dogs with mitral insufficiency. For the Objective VHS, the sum of the length of the long and short axes of the cardiac silhouette obtained in centimetres using a metric ruler was subsequently converted into units of vertebral length by means of a direct standardization method. The Buchanan VHS was obtained as previously described. RESULTS: No significant differences in vertebral heart scale values were found between the two methods in all dogs. There was a strong positive correlation (0·99) between Objective VHS and Buchanan VHS. CLINICAL SIGNIFICANCE: The use of a direct standardization method based on a unit conversion allows -computation of vertebral heart scale values without transposing long and short axes to the cranial edge of T4.

A normalized framework for the design of feature spaces assessing the left ventricular function.

A through description of the left ventricle functionality requires combining complementary regional scores. A main limitation is the lack of multiparametric normality models oriented to the assessment of regional wall motion abnormalities (RWMA). This paper covers two main topics involved in RWMA assessment. We propose a general framework allowing the fusion and comparison across subjects of different regional scores. Our framework is used to explore which combination of regional scores (including 2-D motion and strains) is better suited for RWMA detection. Our statistical analysis indicates that for a proper (within interobserver variability) identification of RWMA, models should consider motion and extreme strains.

Quantification of porcine circovirus type 2 (PCV2) DNA in serum and tonsillar, nasal, tracheo-bronchial, urinary and faecal swabs of pigs with and without postweaning multisystemic wasting syndrome (PMWS).

The present study focused on PCV2 quantification by TaqMan PCR in nasal (n=99), tonsillar (n=108), tracheo-bronchial (n=72), urinary (n=91) and faecal (n=42) swabs, as well as in serum (n=57), from a total of 146 pigs received at the Pathological Diagnostic Service at the Veterinary School of Barcelona (Spain). Animals were classified into three categories based on histopathological and in situ hybridisation (ISH) results: PMWS affected pigs (Group A, n=42), PCV2 subclinically infected pigs (Group B, n=29), and non-PMWS with PCV2 ISH negative pigs (Group C, n=75). Overall, tracheo-bronchial swabs had the higher PCV2 load followed by serum, tonsillar, nasal, faecal and, finally, urinary swabs. PCV2 genome was also detected in different proportions in all three categories of pigs; in all tested sites, viral load means were significantly higher (P0.05) were observed among tested specimens when age-groups (pigs younger than 1.5 months, and equal or older than 1.5 months of age) were compared. In summary, PCV2 is presumably excreted through respiratory (nasal and tracheo-bronchial) and oral (tonsillar) secretions, urine and faeces of both PMWS and non-PMWS affected pigs, with higher viral loads being associated with the presence of PMWS lesions.

The clinical uroselectivity of alfuzosin is not significantly affected by the age of patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.

OBJECTIVE: To assess the effect of the age of patients with benign prostatic hyperplasia (BPH) on the clinical uroselectivity of alfuzosin during general medical practice. PATIENTS AND METHODS: The present national, multicentre, open-labelled, observational study involved 4018 Spanish outpatients with BPH, i.e. showing lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction. The patients received sustained release (SR) alfuzosin, 5 mg twice daily, for 2 months. The primary efficacy criteria were symptomatic improvements, as assessed by the International Prostate Symptom Score (IPSS) and quality of life (QoL) index. Safety was assessed by monitoring cardiovascular data and adverse events. RESULTS: The patients were divided into four age groups, i.e. < 56, 56-65, 66-75 and > 75 years. All groups of patients showed a mean IPSS decrease of 11-12 (55.8-65.4% from baseline) at the end of the study, while the QoL decreased by 2-3 points (55.6-63.6% from baseline). There were no relevant effects of age on the efficacy of the treatment. Moreover, alfuzosin was well tolerated independently of the age of the patient; 1.2% of the patients enrolled withdrew because of adverse events. The qualitative distribution of vasodilatory/nonvasodilatory adverse events was similar in all age groups. The incidence of asymptomatic orthostatic hypotension was low (0.58%) and not affected by the age of the patients. CONCLUSION: This study confirms that the clinical uro-selectivity of SR-alfuzosin, already described in ran-domized controlled studies, is not significantly affected in clinical practice by the age of the patients. This is considered particularly relevant to the characteristics of patients with BPH, as they are mostly elderly men.

Age-stratified analysis of I-PSS and QoL values in spanish patients with symptoms potentially related to BPH.

OBJECTIVE: The main goal of the present study was to determine age-related symptom changes using a validated Spanish International Prostate Symptom Score (I-PSS) and quality of life index (QoL) in Spanish patients with symptomatic benign prostatic hyperplasia (BPH). METHODS: A total of 2,875 patients with the clinical diagnosis of symptomatic BPH were evaluated. Data were collected during current medical practice in a national study. Patients were excluded if they had any previous prostate operation or suspicion of prostate cancer. I-PSS was self-administered and compared with the physician's global impression. RESULTS: I-PSS symptoms, both voiding and storage symptoms, increased significantly with age (p<0.0001) as well as QoL (p<0.0017). A change in the I-PSS categories (minor, moderate and severe) was found with age, increasing severe symptomatic patients in the oldest groups. A significant correlation was found between I-PSS and QoL (r = 0.49, p<0.001), being this relationship linear and not significantly influenced by age. CONCLUSIONS: This study confirms reliable results using a validated Spanish I-PSS in a large national representative sample of Spanish patients with BPH symptoms. The age-stratified analysis showed that the natural progression of BPH with age was related to an increased symptomatology and bothersomeness, well reflected by increases in the I-PSS and QoL values. Nevertheless, the effect of symptomatology on quality of life was not strongly influenced by the age of the patient.

Safety and efficacy of sustained-release alfuzosin on lower urinary tract symptoms suggestive of benign prostatic hyperplasia in 3,095 Spanish patients evaluated during general practice.

OBJECTIVES: This general practitioner-run study assess the security as well as the efficacy and impact on health-related quality of life of a sustained-release (SR) form of alfuzosin in Spanish patients suffering from lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). MATERIAL AND METHODS: 3,095 patients with symptomatic BPH were enrolled into a national, multicentric, open, phase IV observational study. The period of active treatment studied (5 mg, twice daily) was 60 days. Safety was assessed by monitoring blood pressure and spontaneous adverse events. Symptoms were assessed using a validated Spanish International Prostate Symptom Score (I-PSS). Impact of symptoms on health-related quality of life was assessed using the quality of life index (L). RESULTS: 101 adverse events were reported in 82 patients (2.6%). 28 adverse events (2.6%) were classified as severe. 49 patients (1.6%) dropped out of the study due to adverse events but only 17 of these patients (0.5%) showed adverse events related to vasodilation. Incidence of postural events (vertigo, postural hypotension/hypotension, headache and dizziness) was low (55 patients, 1.8%) and effects on sexual function were found not significant: no retrograde ejaculation was reported and only 1 patient (0.03%) showed impotence. Blood pressure or heart rate showed no clinically significant changes. All the I-PSS scores decreased significantly during the treatment with alfuzosin, improvement being excellent in 60% of the patients. Symptomatic improvement was associated with a significant improvement in health-related quality of life. CONCLUSIONS: This large study conducted during general practice on Spanish BPH patients confirms the efficacy on LUTS and good safety profile of SR alfuzosin, especially its low incidence of postural symptoms and no deleterious effect on sexual function.