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2.
J Phys Condens Matter ; 33(19)2021 Apr 26.
Article de Anglais | MEDLINE | ID: mdl-33752176

RÉSUMÉ

Oppositely charged bipolar colloids or colloids decorated with complementary deoxyribonucleic acid (DNA) on their surfaces are special kinds of patchy particles where only patch and non-patch parts are attractive. These are classified as inverse patchy colloids (IPCs). In this work, equilibrium self-assembly of IPC in two-dimensions is reported using Monte Carlo simulations. Square (SCs) and triangular crystals (TCs) are found to be stable at 0.5 patch coverage. Upon decreasing the patch coverage to 0.33, the regular SC is destabilized; instead rhombic and TCs are found to be stable. At low patch coverages such as 0.22 and 0.12, only TC is stabilized at high density. Particles of all the patch coverages show kinetically stable cluster phases of different shapes and sizes at low densities, and the average cluster size depends on the patch coverage and particle density. State-diagrams showing all the stable phases for each patch coverage are presented. Ordered phases are characterized by bond order parametersψ4,ψ6and radial distribution function. The effect of polydispersity in patch coverage on the polarization of the stable structures are also studied. The study demonstrates that IPCs can stabilize various ordered two-dimensional structures by tuning the size of the patch, density and interaction strengths.

3.
J Vis Commun Med ; 42(3): 114-119, 2019 Jul.
Article de Anglais | MEDLINE | ID: mdl-31184541

RÉSUMÉ

Intraoperative photography is used to obtain images for both education and research purposes, but poses challenges due concerns regarding aseptic technique. Waterproof digital cameras have sterilisable cases that can be used by the surgeon for intraoperative photography. We compared the quality of still intraoperative images obtained by a non-scrubbed observer using a 35 mm single lens reflex (SLR) camera to images obtained by the surgeon using a GoPro camera in a sterilised case. Image quality was scored using a 4 point Likert scale by 3 groups of end users with differing experience: faculty surgeons, surgical residents, and 3rd year veterinary students. Mean ± SEM overall image quality scores were higher for the traditional 35 mm digital SLR camera when compared to the GoPro (3.25 ± 0.08 vs. 2.0 ± 0.08, p < .0001), as were scores for each image characteristic (brightness, colour, sharpness, and contrast). Image quality scores for each camera also differed significantly between user groups, with expert users (faculty and residents) giving lower quality scores when compared to scores from novices (students). Findings suggest that GoPro cameras provide lower intraoperative image quality than digital SLR cameras, although lower quality images may be more accepted by novices than by experienced users.


Sujet(s)
Blocs opératoires , Photographie (méthode)/instrumentation , Procédures de chirurgie opératoire/méthodes , Humains , Période peropératoire
4.
Phys Chem Chem Phys ; 19(20): 13122-13132, 2017 May 24.
Article de Anglais | MEDLINE | ID: mdl-28489097

RÉSUMÉ

We report a simple and scalable technique for the preparation of patchy particles with tunable patch coverage. These particles are categorized as inverse patchy colloidal particles (IPCs) as the patches repel each other while patch and non-patch surfaces attract. We demonstrate the effect of patch coverage, concentration of electrolyte and concentration of particles on the self-assembly of IPC particles. The study identifies various clustering zones such as (1) finite-sized clusters, (2) chain-like assemblies and (3) irregular amorphous aggregates. The linear assemblies are observed over a wide range of particle concentrations and salt concentrations. The anisotropic electrostatic interaction controls the formation of chain-like assemblies. In an extended study, we use negatively charged isotropic colloidal (NCIC) particles to tune the self-assembly of IPC particles. Interestingly, we observe significant improvement in the clustering efficiency of IPC particles leading to the formation of co-polymeric, flexible branched chains. Depending on the number ratio of NCIC particles with respect to IPC particles, the clustering process is classified into three different phases such as (1) finite-sized, (2) linear and (3) dispersed state. Using a quantitative analysis we show that such evolution of structures is attributed to seeding and crowding effects caused by the addition of NCIC particles. The use of NCIC particles thus control the self-assembly of inverse patchy colloids and tune the number and shape of the self-assembled structures.

5.
J Small Anim Pract ; 58(6): 348-354, 2017 Jun.
Article de Anglais | MEDLINE | ID: mdl-28369956

RÉSUMÉ

OBJECTIVES: To report the outcomes associated with the use of rabbit anti-dog thymocyte serum in dogs with haematological immune-mediated diseases. METHODS: Medical records from 2000 to 2016 of patients diagnosed with immune-mediated haemolytic anaemia, immune-mediated thrombocytopenia, pancytopenia and myelofibrosis were reviewed. All dogs had a severe or refractory disease and received rabbit anti-dog thymocyte serum. Lymphocyte counts were used to monitor the immediate anti-thymocyte effect of therapy; long-term patient outcome was recorded. RESULTS: A total of 10 dogs were included. All dogs except one had a notable decrease in their lymphocyte count after rabbit anti-dog thymocyte serum; four of nine had a decrease to less than 10% of the initial lymphocyte count and one dog reached 10·8%. All dogs were discharged from the hospital following their treatment. The dog with no alteration of lymphocyte count following therapy with rabbit anti-dog thymocyte serum had refractory immune mediated haemolytic anemia and was euthanised within two weeks. All other cases achieved clinical remission with immunosuppressive therapy eventually being tapered (3 of 10) or discontinued (6 of 10). CLINICAL SIGNIFICANCE: Rabbit anti-dog thymocyte serum therapy might be of interest as an adjunctive therapy in refractory immune-mediated diseases and suppressed lymphocyte counts in most dogs.


Sujet(s)
Anémie hémolytique auto-immune/médecine vétérinaire , Sérum antilymphocyte/usage thérapeutique , Maladies des chiens/thérapie , Immunosuppresseurs/usage thérapeutique , Thrombopénie/médecine vétérinaire , Anémie hémolytique auto-immune/thérapie , Animaux , Maladies des chiens/immunologie , Chiens , Femelle , Mâle , Lapins , Thrombopénie/thérapie
6.
J Perinatol ; 36(12): 1055-1060, 2016 12.
Article de Anglais | MEDLINE | ID: mdl-27608296

RÉSUMÉ

OBJECTIVE: To examine racial differences in the association between gestational weight gain and preterm birth subtypes among adolescents. STUDY DESIGN: We conducted a retrospective cohort study of 211 403 adolescents using 2012 United States natality data. The outcome was preterm birth and the primary exposure was gestational weight gain. Multinomial logistic regression analyses were used to estimate adjusted odds ratios, stratified by race and body mass index (BMI). RESULTS: Black and White mothers who gained below the recommendations had increased risks for spontaneous preterm birth in all BMI categories, except obese. All Hispanic mothers who gained below the recommendations had increased risks of spontaneous preterm birth. White normal and overweight mothers and Black, Hispanic and Other normal weight mothers who exceeded the recommendations had decreased risks of spontaneous preterm birth. CONCLUSION: The effect of gestational weight gain on spontaneous and medically indicated preterm birth is modified by race and BMI.


Sujet(s)
Indice de masse corporelle , Disparités de l'état de santé , Naissance prématurée/ethnologie , Prise de poids , Adolescent , /statistiques et données numériques , Femelle , Hispanique ou Latino/statistiques et données numériques , Humains , Nouveau-né , Modèles logistiques , Obésité/épidémiologie , Grossesse , Grossesse de l'adolescente , Naissance prématurée/étiologie , Études rétrospectives , Facteurs de risque , Maigreur/épidémiologie , États-Unis , /statistiques et données numériques
7.
Sci Rep ; 6: 27312, 2016 06 17.
Article de Anglais | MEDLINE | ID: mdl-27311707

RÉSUMÉ

Genomic and pedigree predictions for grain yield and agronomic traits were carried out using high density molecular data on a set of 803 spring wheat lines that were evaluated in 5 sites characterized by several environmental co-variables. Seven statistical models were tested using two random cross-validations schemes. Two other prediction problems were studied, namely predicting the lines' performance at one site with another (pairwise-site) and at untested sites (leave-one-site-out). Grain yield ranged from 3.7 to 9.0 t ha(-1) across sites. The best predictability was observed when genotypic and pedigree data were included in the models and their interaction with sites and the environmental co-variables. The leave-one-site-out increased average prediction accuracy over pairwise-site for all the traits, specifically from 0.27 to 0.36 for grain yield. Days to anthesis, maturity, and plant height predictions had high heritability and gave the highest accuracy for prediction models. Genomic and pedigree models coupled with environmental co-variables gave high prediction accuracy due to high genetic correlation between sites. This study provides an example of model prediction considering climate data along-with genomic and pedigree information. Such comprehensive models can be used to achieve rapid enhancement of wheat yield enhancement in current and future climate change scenario.


Sujet(s)
Agriculture , Grains comestibles/génétique , Triticum/génétique , Pain , Environnement , Variation génétique/génétique , Génome végétal/génétique , Génotype , Modèles statistiques , Saisons , Temps (météorologie)
8.
Burns ; 42(5): 1067-1073, 2016 Aug.
Article de Anglais | MEDLINE | ID: mdl-27215148

RÉSUMÉ

OBJECTIVES: While mortality rates after burn are low, physical and psychosocial impairments are common. Clinical research is focusing on reducing morbidity and optimizing quality of life. This study examines self-reported Satisfaction With Life Scale scores in a longitudinal, multicenter cohort of survivors of major burns. Risk factors associated with Satisfaction With Life Scale scores are identified. METHODS: Data from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Burn Model System (BMS) database for burn survivors greater than 9 years of age, from 1994 to 2014, were analyzed. Demographic and medical data were collected on each subject. The primary outcome measures were the individual items and total Satisfaction With Life Scale (SWLS) scores at time of hospital discharge (pre-burn recall period) and 6, 12, and 24 months after burn. The SWLS is a validated 5-item instrument with items rated on a 1-7 Likert scale. The differences in scores over time were determined and scores for burn survivors were also compared to a non-burn, healthy population. Step-wise regression analysis was performed to determine predictors of SWLS scores at different time intervals. RESULTS: The SWLS was completed at time of discharge (1129 patients), 6 months after burn (1231 patients), 12 months after burn (1123 patients), and 24 months after burn (959 patients). There were no statistically significant differences between these groups in terms of medical or injury demographics. The majority of the population was Caucasian (62.9%) and male (72.6%), with a mean TBSA burned of 22.3%. Mean total SWLS scores for burn survivors were unchanged and significantly below that of a non-burn population at all examined time points after burn. Although the mean SWLS score was unchanged over time, a large number of subjects demonstrated improvement or decrement of at least one SWLS category. Gender, TBSA burned, LOS, and school status were associated with SWLS scores at 6 months; scores at 12 months were associated with LOS, school status, and amputation; scores at 24 months were associated with LOS, school status, and drug abuse. CONCLUSIONS: In this large, longitudinal, multicenter cohort of burn survivors, satisfaction with life after burn was consistently lower than that of non-burn norms. Furthermore mean SWLS scores did not improve over the two-year follow-up period. This study demonstrates the need for continued efforts to improve patient-centered long term satisfaction with life after burn.


Sujet(s)
Brûlures/psychologie , Satisfaction personnelle , Qualité de vie/psychologie , Adolescent , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Enfant , Femelle , Humains , Mâle , Adulte d'âge moyen , Études prospectives , Analyse de régression , Survivants/psychologie , Jeune adulte
9.
J Vet Intern Med ; 29(6): 1464-72, 2015.
Article de Anglais | MEDLINE | ID: mdl-26478445

RÉSUMÉ

BACKGROUND: The cause of gallbladder mucocele (GBM) formation in dogs currently is unknown. Many available drugs represent a newer generation of xenobiotics that may predispose dogs to GBM formation. OBJECTIVE: To determine if there is an association between the histologic diagnosis of GBM in dogs and administration of selected drugs. ANIMALS: Eighty-one dogs with a histologic diagnosis of GBM and 162 breed, age, and admission date-matched control dogs from a single referral institution. METHODS: Medical records of dogs with GBM and control dogs from 2001 to 2011 were reviewed. Owner verification of drug history was sought by a standard questionnaire. Reported use of heartworm, flea, and tick preventatives as well as nonsteroidal anti-inflammatory drugs, analgesics, corticosteroids, or medications for treatment of osteoarthritis was recorded. RESULTS: Dogs with GBM were 2.2 times as likely to have had reported use of thyroxine (as a proxy for the diagnosis of hypothyroidism) as control dogs (95% confidence interval [CI], 0.949-5.051), 3.6 times as likely to have had reported treatment for Cushing's disease (95% CI, 1.228-10.612), and 2.3 times as likely to have had reported use of products containing imidacloprid (95% CI, 1.094-4.723). Analysis of a data subset containing only Shetland sheepdogs (23 GBM and 46 control) indicated that Shetland sheepdogs with GBM formation were 9.3 times as likely to have had reported use of imidacloprid as were control Shetland sheepdogs (95% CI, 1.103-78.239). CONCLUSIONS AND CLINICAL IMPORTANCE: This study provides evidence for an association between selected drug use and GBM formation in dogs. A larger epidemiologic study of Shetland sheepdogs with GBM formation and exposure to imidacloprid is warranted.


Sujet(s)
Maladies des chiens/induit chimiquement , Maladies de la vésicule biliaire/médecine vétérinaire , Imidazoles/effets indésirables , Mucocèle/médecine vétérinaire , Composés nitrés/effets indésirables , Thyroxine/effets indésirables , Animaux , Études cas-témoins , Agents cholinergiques/effets indésirables , Chiens , Femelle , Maladies de la vésicule biliaire/induit chimiquement , Hypothyroïdie/traitement médicamenteux , Mâle , Mucocèle/induit chimiquement , Mucocèle/anatomopathologie , Néonicotinoïdes , Hypersécrétion hypophysaire d'ACTH/traitement médicamenteux , Hypersécrétion hypophysaire d'ACTH/médecine vétérinaire , Facteurs de risque
11.
J Neural Eng ; 11(4): 046027, 2014 Aug.
Article de Anglais | MEDLINE | ID: mdl-25031219

RÉSUMÉ

OBJECTIVE: Before peripheral nerve electrodes can be used for the restoration of sensory and motor functions in patients with neurological disorders, the behavioral and histological consequences of these devices must be investigated. These indices of biocompatibility can be defined in terms of desired functional outcomes; for example, a device may be considered for use as a therapeutic intervention if the implanted subject retains functional neurons post-implantation even in the presence of a foreign body response. The consequences of an indwelling device may remain localized to cellular responses at the device-tissue interface, such as fibrotic encapsulation of the device, or they may affect the animal more globally, such as impacting behavioral or sensorimotor functions. The objective of this study was to investigate the overall consequences of implantation of high-electrode count intrafascicular peripheral nerve arrays, High Density Utah Slanted Electrode Arrays (HD-USEAs; 25 electrodes mm(-2)). APPROACH: HD-USEAs were implanted in rat sciatic nerves for one and two month periods. We monitored wheel running, noxious sensory paw withdrawal reflexes, footprints, nerve morphology and macrophage presence at the tissue-device interface. In addition, we used a novel approach to contain the arrays in actively behaving animals that consisted of an organic nerve wrap. A total of 500 electrodes were implanted across all ten animals. MAIN RESULTS: The results demonstrated that chronic implantation (⩽8 weeks) of HD-USEAs into peripheral nerves can evoke behavioral deficits that recover over time. Morphology of the nerve distal to the implantation site showed variable signs of nerve fiber degeneration and regeneration. Cytology adjacent to the device-tissue interface also showed a variable response, with some electrodes having many macrophages surrounding the electrodes, while other electrodes had few or no macrophages present. This variability was also seen along the length of the electrodes. Axons remained within the proximity of the electrode tips at the distances required for theoretically effective stimulation and recording (⩽100 µm). SIGNIFICANCE: We conclude from these studies that HD-USEAs do not cause overall global effects on the animals, at least up to the two-month period investigated here. These results demonstrate for the first time that the consequences of high-electrode count intrafascicular arrays compare with other peripheral nerve electrodes currently available for clinical or investigational neuromodulation.


Sujet(s)
Électrodes implantées/effets indésirables , Nerf ischiatique/physiologie , Animaux , Axones/physiologie , Comportement animal/physiologie , Pied/innervation , Traitement d'image par ordinateur , Test de matériaux , Neurofibres/physiologie , Régénération nerveuse , Rats , Rats de lignée WKY , Réflexe/physiologie , Course à pied/physiologie
12.
Heredity (Edinb) ; 112(1): 48-60, 2014 Jan.
Article de Anglais | MEDLINE | ID: mdl-23572121

RÉSUMÉ

Genomic selection (GS) has been implemented in animal and plant species, and is regarded as a useful tool for accelerating genetic gains. Varying levels of genomic prediction accuracy have been obtained in plants, depending on the prediction problem assessed and on several other factors, such as trait heritability, the relationship between the individuals to be predicted and those used to train the models for prediction, number of markers, sample size and genotype × environment interaction (GE). The main objective of this article is to describe the results of genomic prediction in International Maize and Wheat Improvement Center's (CIMMYT's) maize and wheat breeding programs, from the initial assessment of the predictive ability of different models using pedigree and marker information to the present, when methods for implementing GS in practical global maize and wheat breeding programs are being studied and investigated. Results show that pedigree (population structure) accounts for a sizeable proportion of the prediction accuracy when a global population is the prediction problem to be assessed. However, when the prediction uses unrelated populations to train the prediction equations, prediction accuracy becomes negligible. When genomic prediction includes modeling GE, an increase in prediction accuracy can be achieved by borrowing information from correlated environments. Several questions on how to incorporate GS into CIMMYT's maize and wheat programs remain unanswered and subject to further investigation, for example, prediction within and between related bi-parental crosses. Further research on the quantification of breeding value components for GS in plant breeding populations is required.


Sujet(s)
Interaction entre gènes et environnement , Caractère quantitatif héréditaire , Triticum/génétique , Zea mays/génétique , Génétique des populations , Génome végétal , Génotype , Modèles génétiques , Phénotype , Sélection génétique
13.
J Neural Eng ; 10(4): 045003, 2013 Aug.
Article de Anglais | MEDLINE | ID: mdl-23723133

RÉSUMÉ

OBJECTIVE: Among the currently available neural interface devices, there has been a need for a penetrating electrode array with a high electrode-count and high electrode-density (the number of electrodes/mm(2)) that can be used for electrophysiological studies of sub-millimeter neuroanatomical structures. We have developed such a penetrating microelectrode array with both a high electrode-density (25 electrodes/mm(2)) and high electrode-count (up to 96 electrodes) for small nervous system structures, based on the existing Utah Slanted Electrode Array (USEA). Such high electrode-density arrays are expected to provide greater access to nerve fibers than the conventionally spaced USEA especially in small diameter nerves. APPROACH: One concern for such high density microelectrode arrays is that they may cause a nerve crush-type injury upon implantation. We evaluated this possibility during acute (<10 h) in vivo experiments with electrode arrays implanted into small diameter peripheral nerves of anesthetized rats (sciatic nerve) and cats (pudendal nerve). MAIN RESULTS: Successful intrafascicular implantation and viable nerve function was demonstrated via microstimulation, single-unit recordings and histological analysis. Measurements of the electrode impedances and quantified electrode dimensions demonstrated fabrication quality. The results of these experiments show that such high density neural interfaces can be implanted acutely into neural tissue without causing a complete nerve crush injury, while mediating intrafascicular access to fibers in small diameter peripheral nerves. SIGNIFICANCE: This new penetrating microelectrode array has characteristics un-matched by other neural interface devices currently available for peripheral nervous system neurophysiological research.


Sujet(s)
Techniques de diagnostic neurologique/instrumentation , Stimulation électrique/instrumentation , Électrodes implantées , Analyse sur microréseau/instrumentation , Microélectrodes , Nanotechnologie/instrumentation , Nerfs périphériques/physiologie , Animaux , Chats , Impédance électrique , Conception d'appareillage , Analyse de panne d'appareillage , Rats , Rat Sprague-Dawley
14.
J Anaesthesiol Clin Pharmacol ; 28(4): 508-9, 2012 Oct.
Article de Anglais | MEDLINE | ID: mdl-23225935

RÉSUMÉ

We report a case of venous air embolism which occurred during intraoperative endoscopy in a five-year-old boy who had undergone Kasai procedure in his infancy. The child had a cardiac arrest during the procedure from which he could not be resuscitated. The awareness about this complication would allow rapid diagnosis, which is vital to provide specific treatment and prevent fatal outcome.

15.
J Small Anim Pract ; 52(8): 433-40, 2011 Aug.
Article de Anglais | MEDLINE | ID: mdl-21797875

RÉSUMÉ

OBJECTIVES: To investigate relationships between central venous oxygen saturation (ScvO(2)) and survival to hospital discharge in dogs. Central venous oxygen saturation is an accessible measure of the balance between systemic oxygen delivery and consumption. METHODS: Prospective observational cohort study, enrolling 126 client-owned dogs with central venous catheters. Central venous oxygen saturation was measured over the 24 hours following intensive care unit admission. Poor outcome was defined as death or euthanasia performed for moribund status. Regression analysis identified independent predictors of non-survival and physiologic parameters associated with central venous oxygen saturation. Area under the receiver operator curve analysis identified a cut-off point of central venous oxygen saturation, below which central venous oxygen saturation decrease was associated with increased mortality risk. RESULTS: Mortality risk was 30·9%. Low central venous oxygen saturation was associated with poor outcome (P<0·05). Area under the receiver operator curve analysis selected a central venous oxygen saturation of 68% as the point below which a fall in central venous oxygen saturation was associated with increased mortality risk. For each 10% drop in central venous oxygen saturation below 68%, odds of non-survival increased by 2·66 times (P=0·0002, 95% confidence interval of odds ratio=1·45 to 4·85). Central venous oxygen saturation was equivalent to lactate in predicting non-survival. Predictors of central venous oxygen saturation (packed cell volume, mean arterial blood pressure, fever, % arterial haemoglobin saturation as measured by pulse oximeter) were consistent with hypothesised physiologic mechanisms. CLINICAL SIGNIFICANCE: Central venous oxygen saturation was a strong mortality predictor. Further work is needed to determine if therapy targeting central venous oxygen saturation can reduce mortality in canine intensive care unit patients.


Sujet(s)
Maladie grave/mortalité , Chiens/sang , Oxymétrie/médecine vétérinaire , Consommation d'oxygène/physiologie , Oxygène/sang , Animaux , Aire sous la courbe , Cathétérisme veineux central/médecine vétérinaire , Études de cohortes , Soins de réanimation , Maladies des chiens/sang , Maladies des chiens/mortalité , Femelle , Mâle , Monitorage physiologique/médecine vétérinaire , Oxygène/analyse , Valeur prédictive des tests , Études prospectives , Courbe ROC
16.
J Exp Bot ; 62(6): 1743-55, 2011 Mar.
Article de Anglais | MEDLINE | ID: mdl-21421705

RÉSUMÉ

Genotype-environment interactions (GEI) limit genetic gain for complex traits such as tolerance to drought. Characterization of the crop environment is an important step in understanding GEI. A modelling approach is proposed here to characterize broadly (large geographic area, long-term period) and locally (field experiment) drought-related environmental stresses, which enables breeders to analyse their experimental trials with regard to the broad population of environments that they target. Water-deficit patterns experienced by wheat crops were determined for drought-prone north-eastern Australia, using the APSIM crop model to account for the interactions of crops with their environment (e.g. feedback of plant growth on water depletion). Simulations based on more than 100 years of historical climate data were conducted for representative locations, soils, and management systems, for a check cultivar, Hartog. The three main environment types identified differed in their patterns of simulated water stress around flowering and during grain-filling. Over the entire region, the terminal drought-stress pattern was most common (50% of production environments) followed by a flowering stress (24%), although the frequencies of occurrence of the three types varied greatly across regions, years, and management. This environment classification was applied to 16 trials relevant to late stages testing of a breeding programme. The incorporation of the independently-determined environment types in a statistical analysis assisted interpretation of the GEI for yield among the 18 representative genotypes by reducing the relative effect of GEI compared with genotypic variance, and helped to identify opportunities to improve breeding and germplasm-testing strategies for this region.


Sujet(s)
Sécheresses , Environnement , Génotype , Modèles biologiques , Triticum/physiologie , Nouvelle-Galles du Sud , Queensland , Eau/physiologie
18.
J Vet Intern Med ; 25(1): 26-38, 2011.
Article de Anglais | MEDLINE | ID: mdl-21143303

RÉSUMÉ

BACKGROUND: Scores allowing objective stratification of illness severity are available for dogs and horses, but not cats. Validated illness severity scores facilitate the risk-adjusted analysis of results in clinical research, and also have applications in triage and therapeutic protocols. OBJECTIVE: To develop and validate an accurate, user-friendly score to stratify illness severity in hospitalized cats. ANIMALS: Six hundred cats admitted consecutively to a teaching hospital intensive care unit. METHODS: This observational cohort study enrolled all cats admitted over a 32-month period. Data on interventional, physiological, and biochemical variables were collected over 24 hours after admission. Patient mortality outcome at hospital discharge was recorded. After random division, 450 cats were used for logistic regression model construction, and data from 150 cats for validation. RESULTS: Patient mortality was 25.8%. Five- and 8-variable scores were developed. The 8-variable score contained mentation score, temperature, mean arterial pressure (MAP), lactate, PCV, urea, chloride, and body cavity fluid score. Area under the receiver operator characteristic curve (AUROC) on the construction cohort was 0.91 (95% CI, 0.87-0.94), and 0.88 (95% CI, 0.84-0.96) on the validation cohort. The 5-variable score contained mentation score, temperature, MAP, lactate, and PCV. AUROC on the construction cohort was 0.83 (95% CI, 0.79-0.86), and 0.76 (95% CI, 0.72-0.84) on the validation cohort. CONCLUSIONS AND CLINICAL IMPORTANCE: Two scores are presented enabling allocation of an accurate and user-friendly illness severity measure to hospitalized cats. Scores are calculated from data obtained over the 1st 24 hours after admission, and are diagnosis-independent. The 8-variable score predicts outcome significantly better than does the 5-variable score.


Sujet(s)
Maladies des chats/diagnostic , Indice de gravité de la maladie , Animaux , Maladies des chats/anatomopathologie , Chats , Études de cohortes , Femelle , Mâle , Courbe ROC
19.
J Vet Intern Med ; 24(5): 1034-47, 2010.
Article de Anglais | MEDLINE | ID: mdl-20629945

RÉSUMÉ

BACKGROUND: Objective risk stratification models are used routinely in human critical care medicine. Applications include quantitative and objective delineation of illness severity for patients enrolled in clinical research, performance benchmarking, and protocol development for triage and therapeutic management. OBJECTIVE: To develop an accurate, validated, and user-friendly model to stratify illness severity by mortality risk in hospitalized dogs. ANIMALS: Eight hundred and ten consecutive intensive care unit (ICU) admissions of dogs at a veterinary teaching hospital. METHODS: Prospective census cohort study. Data on 55 management, physiological, and biochemical variables were collected within 24 hours of admission. Data were randomly divided, with 598 patient records used for logistic regression model construction and 212 for model validation. RESULTS: Patient mortality was 18.4%. Ten-variable and 5-variable models were developed to provide both a high-performance model and model maximizing accessibility, while maintaining good performance. The 10-variable model contained creatinine, WBC count, albumin, SpO(2) , total bilirubin, mentation score, respiratory rate, age, lactate, and presence of free fluid in a body cavity. Area under the receiver operator characteristic (AUROC) on the construction data set was 0.93, and on the validation data set was 0.91. The 5-variable model contained glucose, albumin, mentation score, platelet count, and lactate. AUROC on the construction data set was 0.87, and on the validation data set was 0.85. CONCLUSIONS AND CLINICAL IMPORTANCE: Two models are presented that enable allocation of an accurate and user-friendly illness severity index for dogs admitted to an ICU. These models operate independent of primary diagnosis, and have been independently validated.


Sujet(s)
Maladies des chiens/anatomopathologie , Indice de gravité de la maladie , Maladie aigüe , Animaux , Analyse chimique du sang/médecine vétérinaire , Études de cohortes , Chiens , Femelle , Hôpitaux vétérinaires , Mâle , Modèles biologiques , Valeur prédictive des tests , Reproductibilité des résultats
20.
J Assoc Physicians India ; 58: 15-9, 2010 Jan.
Article de Anglais | MEDLINE | ID: mdl-20649093

RÉSUMÉ

INTRODUCTION: Delirium is common in hospitalized geriatric patients with hip fractures. A number of peri-operative predisposing and postoperative precipitating factors have been identified in Western literature but data regarding this problem within the Indian context is scarce. METHOD: The objectives of the study were to ascertain the incidence of delirium in geriatric patients admitted for the treatment of hip fractures in the Department of Orthopaedics of a tertiary care referral centre in South India, to delineate their clinical profile and identify probable contributing factors for development of delirium in this group of patients. The study was a prospective, cohort study design that was conducted on patients above the age of 60 years, admitted to the orthopaedic ward with hip fracture and who underwent hip surgery. A total of 81 patients were recruited from May 1st 2004 to April 30th 2005 (total duration of one year). RESULTS: Of the 81 patients 17 (21%) of the patients developed post-operative delirium. On multivariate analysis the presence of underlying dementia (OR 16.97), duration of surgery > 2.5 hrs (OR 8.23) and preoperative packed cell volume < 25 (OR 8.07) were found to be independent predisposing risk factors that were associated with the development of postoperative delirium. Postoperative infections, metabolic abnormalities and vascular events were found to be important detected medical causes for precipitating post-operative delirium. Patients who had delirium had longer hospital stays and poor ambulation at discharge. CONCLUSIONS: Delirium in geriatric patients undergoing hip fracture surgery results in poor postoperative outcomes and increased cost. The etiology of delirium is multi-factorial. A number of potentially modifiable factors have been identified as risk factors for delirium. Appropriate intervention strategies involving physicians and geriatricians need to be implemented within the Indian context to reduce the incidence of delirium.


Sujet(s)
Troubles de la cognition/complications , Délire avec confusion/complications , Fractures de la hanche/complications , Complications postopératoires/psychologie , Sujet âgé , Sujet âgé de 80 ans ou plus , Troubles de la cognition/psychologie , Études de cohortes , Délire avec confusion/épidémiologie , Délire avec confusion/étiologie , Femelle , Évaluation gériatrique , Fractures de la hanche/chirurgie , Humains , Incidence , Inde/épidémiologie , Durée du séjour , Mâle , Questionnaire sur l'état mental de Kahn , Adulte d'âge moyen , Procédures orthopédiques/effets indésirables , Complications postopératoires/diagnostic , Complications postopératoires/étiologie , Soins préopératoires , Études prospectives , Facteurs de risque , Résultat thérapeutique
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