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Diagnosis of canine intestinal parasites: Improved detection of Dipylidium caninum infection through coproantigen testing. Vet Parasitol 2023; 324:110073. [PMID: 37976897 DOI: 10.1016/j.vetpar.2023.110073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
Intestinal parasites, including cestodes like Dipylidium caninum, are common in dogs in the United States of America (USA), but fecal flotation consistently, and, at times, dramatically, fails to identify many of these infections. To determine the extent to which including coproantigen testing for D. caninum would improve the identification of dogs infected with this cestode, we evaluated fecal samples from 877 dogs (589 pet and 288 from municipal shelters) from six USA states using zinc sulfate (specific gravity 1.24) fecal flotation with centrifugation along with coproantigen detection for Giardia sp., hookworms, ascarids, and Trichuris vulpis. For D. caninum, PCR of perianal swabs was included. Intestinal parasite infections were identified, using centrifugal fecal flotation or coproantigen, in 265 dogs (13.2 % pet, 64.9 % shelter). Dipylidium caninum infection was detected in 5.6 % of dogs with the combination of coproantigen and centrifugal fecal flotation, and 7.3 % of dogs when perianal swab results were included; prevalence varied by diagnostic method, population, and geographic region. In pet dogs, D. caninum infection was identified by fecal flotation (0), coproantigen (2.2 %), or perianal swabs (1.2 %). The same methods revealed infection in 0.3 %, 12.5 %, and 11.1 % of shelter dogs, respectively. Frequent use of praziquantel in shelter dogs (116/288; 40.3 %) may have reduced prevalence. Positive and negative agreement of D. caninum coproantigen with perianal swab PCR in pet dogs was 85.7 % and 98.8 %, respectively. Multiple logistic regression analysis accounting for region, population, and age found D. caninum infection to be more common in shelter dogs relative to pet (adjusted OR 4.91 [2.48, 10.24]) and in the Southcentral and Southeast regions relative to North (adjusted OR 9.59 [1.92, 174.13] and 17.69 [3.67, 318.09] respectively). Coproantigen testing also enhanced the detection of other intestinal parasites over fecal flotation alone, including Giardia sp. (14.7 % vs 3.3 %), hookworms (13.8 % vs 8.4 %), ascarids (2.9 % vs 2.2 %), and T. vulpis (2.9 % vs 1.4 %). Together, these data indicate that the coproantigen assay employed increases detection of D. caninum infections several fold, supporting the use of this test in clinical practice, and add to a growing body of research documenting enhanced diagnosis through implementation of multiple laboratory-based methods.
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Differentiation of stable kidney function versus progressive dysfunction in dogs. J Vet Intern Med 2023; 37:2241-2250. [PMID: 37861343 PMCID: PMC10658543 DOI: 10.1111/jvim.16885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/15/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Circulating creatinine and symmetric dimethylarginine (SDMA) are biomarkers of kidney function that have been used variously to define stable vs progressive chronic kidney disease (CKD). Slope monitoring of inverse biomarker values (creatinine-1 or SDMA-1 ) has shown promise, but quantitative criteria to distinguish stable vs progressive CKD using this approach are lacking. OBJECTIVE Assessment of creatinine-1 and SDMA-1 slope cutoffs to distinguish stable vs progressive CKD. ANIMALS One hundred ten clinically healthy university staff-owned dogs and 29 male colony dogs with progressive X-linked hereditary nephropathy (XLHN). METHODS Retrospective analysis combining 2 prospective observational studies, 1 tracking kidney function biomarkers in healthy dogs (HDs) to a maximum of 3 years, and 1 tracking kidney function biomarkers in male colony dogs with progressive XLHN to a maximum of 1 year. The minimum slope of creatinine-1 or SDMA-1 as measured using the IDEXX SDMA test from HD was assigned as the slope cutoff for stable kidney function. RESULTS The stable vs progressive slope cutoff was -0.0119 week × dL/mg for creatinine-1 and -0.0007 week × dL/μg for SDMA-1 . CONCLUSIONS AND CLINICAL IMPORTANCE In the studied CKD population, progressive dysfunction can be distinguished from stable kidney function by using the slope of creatinine-1 or SDMA-1 . These criteria may serve to characterize CKD in other cohorts of dogs and to establish guidelines for degrees of progression rate in dogs with naturally occurring CKD.
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Urinary cystatin B differentiates progressive versus stable IRIS Stage 1 chronic kidney disease in dogs. J Vet Intern Med 2023; 37:2251-2260. [PMID: 37815022 PMCID: PMC10658556 DOI: 10.1111/jvim.16887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/15/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Early identification of dogs with progressive vs stable chronic kidney disease (CKD) might afford opportunity for interventions that would slow progression. However, currently no surrogate biomarker reliably predicts CKD progression. HYPOTHESIS/OBJECTIVES Urinary cystatin B (uCysB), a novel kidney injury biomarker, predicts progressive disease in International Renal Interest Society (IRIS) CKD Stage 1. ANIMALS Seventy-two dogs, including 20 dogs from 4 university centers with IRIS CKD Stage 1, with IDEXX symmetric dimethylarginine (SDMA) concentration up to 17 μg/dL and no systemic comorbidities, and 52 clinically healthy staff-owned dogs from a fifth university center. METHODS A multicenter prospective longitudinal study was conducted between 2016 and 2021 to assess uCysB concentration in IRIS CKD Stage 1 and control dogs. Dogs were followed to a maximum of 3 years (control) or 25 months (CKD). Stage 1 IRIS CKD was classified as stable or progressive using the slope of 1/SDMA, calculated from 3 timepoints during the initial 90-day period. Dogs with slope above or below -0.0007 week × dL/μg were classified as stable or progressive, respectively. Mixed effects modeling was used to assess the association between uCysB and progression rate. RESULTS Estimates of first visit uCysB results predictive of active ongoing kidney injury based on the mixed effects models were 17 ng/mL for control, 24 ng/mL for stable CKD, and 212 ng/mL for progressive CKD (P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE Urinary cystatin B differentiated stable vs progressive IRIS CKD Stage 1. Identification of dogs with progressive CKD may provide an opportunity for clinicians to intervene early and slow progression rate.
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Immunoassay for detection of Dipylidium caninum coproantigen in dogs and cats. J Vet Diagn Invest 2023; 35:671-678. [PMID: 37491878 PMCID: PMC10621563 DOI: 10.1177/10406387231189193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Abstract
Dipylidium caninum infections in dogs and cats are underestimated because of a lack of proglottid observations and poor recovery of parasite elements by centrifugal flotation. We developed an immunoassay that employs a pair of monoclonal antibodies to capture D. caninum-specific coproantigen in fecal extracts from dogs and cats. Real-time PCR for D. caninum DNA in perianal swabs and observation of proglottids were used as reference methods. In 6 experimentally infected dogs, parasite DNA, coproantigen, and proglottid segments were first detected at 22, 23, and 26 d post-infection, respectively. Praziquantel treatment of 3 experimentally infected dogs resulted in the elimination of both coproantigen and proglottid shedding within 1-5 d post-treatment; however, parasite DNA persisted for 14 d. Immunohistochemistry on immature and mature tapeworm segments using an antibody against the coproantigen supports the premise that the antigen is produced in mature segments. We assessed the performance of our coproantigen test in natural infections in 78 dogs from a flea-endemic area. Of the 12 antigen-positive samples, 11 were confirmed with a positive PCR test and/or proglottid observation. Finally, we evaluated a convenience sample set of 730 canine and 163 feline fecal samples obtained from a commercial diagnostic laboratory; D. caninum antigen was detected in 4.1% of the canine and 12.9% of the feline samples, whereas parasite elements were observed in only 0.028% of samples. Our coproantigen immunoassay provides a sensitive method for the detection of D. caninum infection in dogs and cats.
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Use of In-Clinic Diagnostic Kits for the Detection of Seropositivity to Leishmania infantum and Other Major Vector-Borne Pathogens in Healthy Dogs. Pathogens 2023; 12:pathogens12050696. [PMID: 37242366 DOI: 10.3390/pathogens12050696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/07/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Canine Vector-Borne Diseases (CVBDs) are widespread in Europe and enzootic in many other countries. Though severe illnesses may occur, dogs living in enzootic areas often show vague or no clinical signs of CVBDs. Undiagnosed infections/co-infections in subclinically infected animals favor the spread of CVBDs and increase the risk of transmission to other animals and, in some cases, humans. This study has evaluated the exposure of dogs living in key enzootic countries, i.e., Italy and Greece, to major CVBDs via the use of in-clinic diagnostic kits. Overall, 300 privately owned dogs without/with single mild clinical signs living in different regions of Italy (n. 150) and Greece (n. 150) were included in the study. As part of a clinical examination, a blood sample was collected from each dog and subjected to two serological rapid tests, i.e., the SNAP® 4Dx®Plus (IDEXX Laboratories Inc.) for the detection of antibodies against Ehrlichia spp., Anaplasma spp., Borrelia burgdorferi s.l. and Dirofilaria immitis antigen and the SNAP®Leishmania (IDEXX Laboratories Inc.) for the detection of antibodies against Leishmania infantum. In all, 51 dogs (17%; 95% CI 12.9-21.7) were seropositive to at least 1 pathogen, i.e., 4 in Italy (2.7%; 95% CI 1.4-13.1) and 47 in Greece (31.3%; 95% CI 24-39.4). Dirofilaria immitis antigens were found in 39 dogs (13%; 95% CI 9.4-17.3), while antibodies against Ehrlichia, Anaplasma and Leishmania were detected in 25 (8.3%; 95% CI 5.5-12.1), 8 (2.7%; 95% CI 1.2-5.2) and 5 (1.7%; 95% CI 0.5-3.8) dogs, respectively. None of the dogs tested seropositive for B. burgdorferi s.l. Statistical analyses were performed to evaluate associations between exposure to CVBDs and possible risk factors. The present results indicate that dogs living in enzootic areas may be seropositive for one or more CVBDs in absence of clinical signs. Rapid kits are among first line tools for the detection of CVBDs in clinical settings, as they are cost-effective, straightforward and quick to use. Also, in-clinic tests used herein allowed detection of co-exposure to CVBDs investigated.
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Evaluation of barcoded magnetic bead-based immunoassays for the simultaneous detection of feline leukemia virus antigen and antibody against feline immunodeficiency virus. J Vet Diagn Invest 2023; 35:57-61. [PMID: 36307958 DOI: 10.1177/10406387221129259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Testing platforms that leverage automation, require minimal sample volume, and enable various tests to be performed simultaneously on a single sample have the potential to improve workflow and efficiency in veterinary diagnostic laboratories. We evaluated a barcoded magnetic bead (BMB) technology using established immunoassays for detection of feline leukemia virus (FeLV) p27 antigen and antibody against feline immunodeficiency virus (FIV). Analytical sensitivity, limit of blank, and limit of detection were used to establish a functional sensitivity of 1.00 ng/mL of inactivated FeLV antigen and 35.7 ng/mL of anti-FIV monoclonal antibody. Common interferents, such as hemoglobin, lipid, and bilirubin, were not found to interfere with the performance of the assay. Intra- and inter-assay CVs were <13% for both assays using manufactured samples. Using a set of 116 feline samples, the diagnostic accuracy of our multiplex assay was 100% compared to reference assays. Performance in a convenience set of 1,000 feline samples submitted to a commercial diagnostic laboratory revealed a proportion of positive results of 1.3% for FeLV and 3.7% for FIV. BMB technology should enable rapid screening of samples for various markers in a single immunoassay well.
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Vector-borne pathogens of zoonotic concern in hunting dogs of southern Italy. Acta Trop 2022; 232:106502. [PMID: 35523272 DOI: 10.1016/j.actatropica.2022.106502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/30/2022] [Accepted: 05/01/2022] [Indexed: 11/01/2022]
Abstract
Dogs are commonly exposed to vector-borne pathogens (VBPs), yet few data are available on hunting dogs, which are often at high risk of infection due to their involvement in field activities. To investigate the occurrence of VBPs and evaluate the relative performance of different diagnostic tools, blood and serum samples were collected from hunting dogs (n = 1,433) in rural areas of southern Italy. All samples were tested by Knott's technique for filarioids, serologically (SNAP® 4Dx® Plus) for Anaplasma spp., Borrelia burgdorferi sensu lato, Dirofilaria immitis and Ehrlichia spp. and molecularly (qPCR) for all except B. burgdorferi of the above pathogens plus Babesia spp. and Leishmania infantum. Logistic regression was run to evaluate the statistical associations between the risk of VBP infection and independent variables (such as geographic area of provenience, age class and sex) and K-Cohen formula for assessing the concordance among diagnostic tests. Overall, out of 321 dogs (22.4%) positive to at least one VBP, 28 (1.9%) were infected by filarial species at the Knott's technique. In particular, Acanthocheilonema reconditum was the most prevalent (1.6%), followed by D. immitis (0.2%) and Dirofilaria repens (0.1%). One hundred forty (9.8%) and 231 (16.1%) dogs scored positive to VBPs by serological and molecular methods, respectively. The most prevalent pathogens detected were Ehrlichia spp. (7.3%) with SNAP® 4Dx® Plus, and A. reconditum (7.7%) by qPCR. Statistics revealed a significant association (p < 0.001) between A. reconditum infestation and both Ehrlichia spp. seropositivity and geographical origin of dogs. An agreement of 99.9%, 94.0% and 95.7% for Knott - SNAP® 4Dx® Plus, Knott - qPCR and SNAP® 4Dx® Plus - qPCR for D. immitis was found, respectively. Data demonstrate a high prevalence of VBPs in hunting dogs, indicating that this group of animals is largely exposed to several arthropod vector species and suggesting the transmission risk of pathogens to humans in rural areas of southern Italy. A multi-diagnostic approach and a deeper cooperation among healthcare and stakeholders are required to prevent VBP infections to animals and humans.
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Bartonella spp. seroepidemiology and associations with clinicopathologic findings in dogs in the United States. J Vet Intern Med 2021; 36:116-125. [PMID: 34788481 PMCID: PMC8783365 DOI: 10.1111/jvim.16311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 10/28/2021] [Accepted: 11/03/2021] [Indexed: 01/14/2023] Open
Abstract
Background Improved understanding of Bartonella spp. serology in dogs may aid clinical decision making. Objective Describe demographic and geographic patterns of Bartonella spp. seroreactivity in dogs, and describe hematologic and serum biochemical abnormalities in Bartonella spp. seroreactive and nonseroreactive dogs. Animals Serum samples from 5957 dogs in the United States, previously submitted to IDEXX Reference Laboratories. Methods Serum was tested using 3 indirect ELISAs for B. henselae, B. vinsonii subsp. berkhoffii, and B. koehlerae. Complete blood count and serum biochemistry panel results were reviewed retrospectively. Results Overall, 6.1% of dogs were Bartonella spp. seroreactive. Toy breeds were less likely to be seroreactive (3.9%) than mixed breeds (7.5%; adjusted odds ratio [aOR], 0.48; 95% confidence interval [CI], 0.32‐0.72), and dogs <1 year old were less likely to be seroreactive (3.4%) than dogs 1 to 5.5 years of age (7.3%; aOR, 0.42; 95% CI, 0.23‐0.72). Dogs in the West South Central (9.8%) and South Atlantic (8.8%) regions were more likely than dogs elsewhere in the United States to be seroreactive (aOR, 2.22; 95% CI, 1.31‐3.87; aOR, 2.44; 95% CI, 1.38‐4.36). Conclusions and Clinical Importance Demographic and geographic findings for Bartonella spp. exposure were broadly comparable to previously reported patterns.
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Canine infection with Dirofilaria immitis, Borrelia burgdorferi, Anaplasma spp., and Ehrlichia spp. in the United States, 2013-2019. Parasit Vectors 2021; 14:10. [PMID: 33407758 PMCID: PMC7789229 DOI: 10.1186/s13071-020-04514-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 12/01/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Dogs in the US are commonly infected with vector-borne pathogens, including heartworm and tick-borne disease agents. The geographic distribution of both arthropod vectors and the pathogens they transmit continues to expand. METHODS To describe the current geographic distribution and prevalence of antigen of Dirofilaria immitis and antibody to Borrelia burgdorferi, Ehrlichia spp., and Anaplasma spp. in dogs, we summarized over 144 million test results from 2013 to 2019, inclusive, by county, state, and region. Canine seroprevalence by state was compared to population-adjusted human reports of tick-borne diseases. RESULTS Results varied regionally, with D. immitis antigen and Ehrlichia spp. antibodies more frequently detected in the Southeast (2.6% and 5.2%, respectively) and antibody to B. burgdorferi and Anaplasma spp. most common in the Northeast (12.1% and 7.3%, respectively). Overall, percent positive test results to D. immitis decreased in the Southeast by 33.3% when compared to earlier summaries using the same strategy (from 3.9 to 2.6%). Geographic expansion of areas where dogs commonly test positive for Ehrlichia spp. was evident, likely because of a change in the test made in 2012 to allow detection of antibodies to E. ewingii concomitant with expansion of vector tick populations. Percent positive test results to Ehrlichia spp. increased in every region; this shift was particularly pronounced in the Southeast, where percent positive test results increased fourfold (from 1.3 to 5.2%). Continued geographic expansion of B. burgdorferi and A. phagocytophilum was apparent in the Northeast, Midwest, and Upper South, although canine seroprevalence of antibody to B. burgdorferi was much lower than prior surveys in many Lyme-endemic areas. Annual reports of human cases of Lyme disease, ehrlichiosis, and anaplasmosis were associated with percent positive canine results by state for the three tick-borne disease agents (R2 = 0.812, 0.521, and 0.546, respectively). Within endemic areas, percent positive test results for all three tick-borne agents demonstrated evidence of geographic expansion. CONCLUSIONS Large scale analysis of results from screening dogs in practice for evidence of vector-borne infections, including those with zoonotic importance, continues to be a valuable strategy for understanding geographic trends in infection risk over time.
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Distribution and risk factors of canine haemotropic mycoplasmas in hunting dogs from southern Italy. Vet Microbiol 2020; 251:108910. [PMID: 33160194 DOI: 10.1016/j.vetmic.2020.108910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 10/25/2020] [Indexed: 11/28/2022]
Abstract
Mycoplasma haemocanis (Mhc) and "Candidatus Mycoplasma haematoparvum" (CMhp) are the main haemoplasma species known to infect dogs. The aim of this study was to determine the prevalence of haemoplasma species infections in hunting dogs from southern Italy and assess related risk factors. 1,433 hunting dogs living in Campania region were tested by qPCR assay. The prevalence was 19.9 %; 13.1 % for Mhc and 11.4 % for CMhp; 4.6 % showed a coinfection with both haemoplasma species. Statistical analysis revealed living in Salerno province (Mhc: OR 3.72; CMhp: OR 2.74), hound (Mhc: OR 5.26; CMhp: OR 8.46) and mixed breed (Mhc: OR 3.38; CMhp: OR 2.80), rural environment (Mhc: OR 12.58; CMhp: OR 10.38), wild mammal hunting (Mhc: OR 8.73; CMhp: OR 8.32), cohabitation with other animals (Mhc: OR 2.82; CMhp: OR 2.78) and large pack size (Mhc: OR 2.96; CMhp: OR 1.61) as risk factors for haemoplasmas. Male gender (OR 1.44) and tick infestation history (OR 1.40) represented risk factors only for Mhc, while adult age (2-7 years - OR 2.01; > 7 years - OR 1.84) and large body size (OR 1.48) were associated only to CMhp. Mhc infection was significantly associated to Babesia vogeli (p < 0.05) and Hepatozoon canis (p < 0.001), while CMhp with H. canis (p < 0.001). This study adds information on haemoplasma species distribution in hunting dogs in southern Italy. Outdoor lifestyle and contact with wild fauna, through greater exposure to tick infestation, or possibly wounds acquired during hunting or fighting, could be factors contributing to haemoplasma infections.
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Hepatozoon canis in hunting dogs from Southern Italy: distribution and risk factors. Parasitol Res 2020; 119:3023-3031. [PMID: 32725320 PMCID: PMC7431440 DOI: 10.1007/s00436-020-06820-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 07/16/2020] [Indexed: 01/25/2023]
Abstract
Hepatozoon canis is a hemoprotozoan organism that infects domestic and wild carnivores throughout much of Europe. The parasite is mainly transmitted through the ingestion of infected ticks containing mature oocysts. The aims of the present survey were to determine the prevalence of H. canis in hunting dogs living in Southern Italy and to assess potential infection risk factors. DNA extracted from whole blood samples, collected from 1433 apparently healthy dogs living in the Napoli, Avellino, and Salerno provinces of Campania region (Southern Italy), was tested by a quantitative real-time polymerase chain reaction (qPCR) assay to amplify H. canis. Furthermore, the investigated dog population was also screened by qPCR for the presence of Ehrlichia canis, a major tick-borne pathogen in Southern Italy, in order to assess possible co-infections. Two hundred dogs were H. canis PCR-positive, resulting in an overall prevalence of 14.0% (CI 12.2–15.9). Breed category (P < 0.0001), hair coat length (P = 0.015), and province of residence (P < 0.0001) represented significant risk factors for H. canis infection. The presence of H. canis DNA was also significantly associated with E. canis PCR positivity (P < 0.0001). Hunting dogs in Campania region (Southern Italy) are frequently exposed to H. canis, and the infection is potentially associated with close contact with wildlife. Further studies are needed to assess the pathogenic potential of H. canis, as well as the epidemiological relationships between hunting dogs and wild animal populations sharing the same habitats in Southern Italy.
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Trends in canine seroprevalence to Borrelia burgdorferi and Anaplasma spp. in the eastern USA, 2010-2017. Parasit Vectors 2019; 12:476. [PMID: 31610803 PMCID: PMC6791011 DOI: 10.1186/s13071-019-3735-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 09/28/2019] [Indexed: 02/07/2023] Open
Abstract
Background Borrelia burgdorferi and Anaplasma phagocytophilum are tick-borne infections transmitted by Ixodes scapularis in the eastern USA; both agents cause disease in dogs and people. To characterize changes in seroprevalence over time, Cochran Armitage trend tests were used to evaluate percent positive test results for antibodies to B. burgdorferi and Anaplasma spp. in approximately 20 million canine tests from 2010–2017 in 25 states and 905 counties in the eastern USA. Results A significant decreasing trend in seroprevalence to B. burgdorferi was evident in eight states along the mid-Atlantic coast from Virginia to New Hampshire, and in Wisconsin. In contrast, a continued increasing trend was evident in five northeastern and Midwestern states where Lyme borreliosis is endemic or emerging, as well as in three southern states where endemicity has not yet been widely established. Similarly, seroprevalence to Anaplasma spp. showed a significant, although smaller, decreasing trend in five states along the mid-Atlantic coast from Virginia to Connecticut and Rhode Island, as well as in Minnesota and Wisconsin in the Midwest; despite the fact that those trends were significant they were weak. However, a strong increasing trend was evident in Massachusetts and three states in northern New England as well as in Pennsylvania. Conclusions As expected, seroprevalence continued to increase in regions where Lyme borreliosis and anaplasmosis are more newly endemic. However, the declining seroprevalence evident in other areas was not anticipated. Although the reasons for the decreasing trends are not clear, our finding may reflect shifting ecologic factors that have resulted in decreased infection risk or the combined positive influence of canine vaccination, tick control, and routine testing of dogs in regions where these infections have long been endemic. Analysis of trends in canine test results for tick-borne infections continues to be a valuable tool to understand relative geographical and temporal risk for these zoonotic agents.![]()
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Development of a three-wave far-infrared laser interferometry and polarimetry diagnostic system for the C-2W field-reversed configuration plasmas. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2018; 89:10B109. [PMID: 30399682 DOI: 10.1063/1.5036977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 06/27/2018] [Indexed: 06/08/2023]
Abstract
Great advancements in modern field-reversed configuration (FRC) experiments motivated the development of a 14-chord three-wave far infrared (FIR) laser interferometry and polarimetry diagnostic system, which can provide simultaneous high temporal resolution measurements of density and Faraday rotation profiles with high accuracy. The unique challenges facing FIR diagnostics in high beta FRC plasmas are the extremely small (<0.5°) Faraday rotation angles, and severe laser beam refraction effects due to high density gradient and choice of long wavelength. The diagnostic system design and development are described with methods to overcome the challenges, and initial experimental data are also presented.
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First time-resolved electron density measurements in the C-2W advanced field-reversed configuration plasmas from long-path compact second-harmonic interferometer. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2018; 89:10B113. [PMID: 30399974 DOI: 10.1063/1.5037329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 06/19/2018] [Indexed: 06/08/2023]
Abstract
Characterization of the plasma structure and density is critical for the diagnosis and control of C-2W plasma equilibria. To this end, two compact, highly portable, turnkey second harmonic interferometers are used to make measurements with greater flexibility than available from other diagnostics, providing important information in areas otherwise inaccessible to more complicated systems. The systems are based on a fiber-coupled 1064 nm Nd:YAG laser and provide a sensitivity of a few 1018 m-2 with a time resolution of a few microseconds. System upgrades were made to allow for beam paths in excess of 5 m. Initial data from two system configurations are presented, showing plasma translation and merged equilibria.
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Evidence for Clinical Anaplasmosis and Borreliosis in Cats in Maine. Top Companion Anim Med 2018; 33:40-44. [PMID: 30223986 DOI: 10.1053/j.tcam.2018.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/12/2018] [Accepted: 05/15/2018] [Indexed: 11/11/2022]
Abstract
The objectives of this study were to use data from client-owned cats in an Ixodes scapularis endemic area to evaluate for clinical associations with diagnostic test results for Anaplasma phagocytophilum and Borrelia burgdorferi and to provide information from a group of cats with possible borreliosis as the cause of clinical manifestations of disease. All cases were evaluated at one clinic, medical records were evaluated, and sera from all cats were tested using one of two commercially available assays labeled for the use with dog sera (SNAP 4Dx or SNAP 4Dx Plus; IDEXX Laboratories, Westbrook, ME). Of the 159 cats evaluated, 42 cats (26.4%) had clinical signs consistent with A. phagocytophilum or B. burgdorferi infection and 117 cats (73.6%) were apparently healthy. Antibodies against B. burgdorferi or A. phagocytophilum were detected in sera of 18.2% and 6.3% of the 159 cats, respectively. Cats with clinical signs of disease were 4 times more likely to have antibodies against one or both agents than healthy cats (95% confidence interval [CI] 1.7928-8.9246; P = .0007), cats allowed outdoors were 5 times more likely to have antibodies against one or both agents than cats housed exclusively indoors (95% CI 2.0196-12.4497; P = .0005), and cats of owners who purchased acaricides were more likely (odds ratio = .3977) to have antibodies against one or both agents than cats of owners who did not purchase acaricides (95% CI .1659-.9534; P = .0387). The cats in the case series were believed to have B. burgdorferi infection as the most likely cause of illness based on serological testing, select clinical information, and apparent response to administration of doxycycline. The results suggest that both A. phagocytophilum and B. burgdorferi are associated with clinical illness in cats. Owners of cats allowed outdoors should be diligent in the use of acaricides.
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Diagnostic strategies to reveal covert infections with intestinal helminths in dogs. Vet Parasitol 2017; 247:108-112. [PMID: 29080756 DOI: 10.1016/j.vetpar.2017.10.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 09/26/2017] [Accepted: 10/06/2017] [Indexed: 11/18/2022]
Abstract
Intestinal helminths are common in dogs in the United States, particularly non-treated dogs in animal shelters, but surveys by fecal flotation may underestimate their prevalence. To determine the prevalence of intestinal helminths and evaluate the ability of fecal flotation and detection of nematode antigen to identify those infections, contents of the entire gastrointestinal tract of 97 adult (>1year) dogs previously identified for humane euthanasia at two animal control shelters in northeastern Oklahoma, USA, were screened. All helminths recovered were washed in saline and fixed prior to enumeration and identification to genus and species. Fecal samples from each dog were examined by passive sodium nitrate (SG 1.33) and centrifugal sugar solution (SG 1.25) flotation. Fecal antigen detection assays were used to confirm the presence of nematode antigen in frozen fecal samples from 92 dogs. Necropsy examination revealed Ancylostoma caninum in 45/97 (46.4%), Toxocara canis in 11/97 (11.3%), Trichuris vulpis in 38/97 (39.2%), Dipylidium caninum in 48/97 (49.5%), and Taenia sp. in 7/97 (7.2%) dogs. Passive fecal flotation identified 38/45 (84.4%) A. caninum, 6/11 (54.5%) T. canis, 26/38 (68.4%) T. vulpis, 2/48 (4.2%) D. caninum, and 1/7 (14.3%) Taenia sp. infections, while centrifugal flotation combined with antigen detection assays identified A. caninum in 97.7% (43/44), T. canis in 77.8% (7/9), and T. vulpis in 83.3% (30/36) of infected dogs based on necropsy recovery of nematodes. Taken together, these data indicate that detection of nematode antigen is a useful adjunct to microscopic examination of fecal samples for parasite eggs, and that this approach can improve diagnostic sensitivity for intestinal nematode infections in dogs.
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High sensitivity far infrared laser diagnostics for the C-2U advanced beam-driven field-reversed configuration plasmas. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2016; 87:11E125. [PMID: 27910420 DOI: 10.1063/1.4959575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A high sensitivity multi-channel far infrared laser diagnostics with switchable interferometry and polarimetry operation modes for the advanced neutral beam-driven C-2U field-reversed configuration (FRC) plasmas is described. The interferometer achieved superior resolution of 1 × 1016 m-2 at >1.5 MHz bandwidth, illustrated by measurement of small amplitude high frequency fluctuations. The polarimetry achieved 0.04° instrument resolution and 0.1° actual resolution in the challenging high density gradient environment with >0.5 MHz bandwidth, making it suitable for weak internal magnetic field measurements in the C-2U plasmas, where the maximum Faraday rotation angle is less than 1°. The polarimetry resolution data is analyzed, and high resolution Faraday rotation data in C-2U is presented together with direct evidences of field reversal in FRC magnetic structure obtained for the first time by a non-perturbative method.
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Improved density profile measurements in the C-2U advanced beam-driven Field-Reversed Configuration (FRC) plasmas. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2016; 87:11E128. [PMID: 27910311 DOI: 10.1063/1.4962038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In the prior C-2 experiment, electron density was measured using a two-color 6-chord CO2/HeNe interferometer. Analysis shows that high-frequency common mode phase noise can be reduced by a factor of 3 by constructing a reference chord. In the system upgrade from C-2 to C-2U a 4-chord far-infrared laser interferometer was developed, which demonstrated superior sensitivity (1 × 1016 m-2 at >1 MHz bandwidth) and solved the under spatial sampling issue of the C-2 interferometer system. Improved density-profile measurement results are presented in this paper, including evidence of fast-ion modified density profile and stabilization of the n = 1 plasma wobble mode.
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Evaluation of rapid diagnostic test kits for feline leukemia virus infection using samples from naturally infected cats. JFMS Open Rep 2016; 2:2055116916667757. [PMID: 28491433 PMCID: PMC5362870 DOI: 10.1177/2055116916667757] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2016] [Indexed: 12/16/2022] Open
Abstract
Objectives Feline leukemia virus (FeLV) is a potentially life-threatening oncogenic retrovirus. The p27 viral core protein is produced by the virus in infected feline cells, is found in the cytoplasm in several blood cells and can be free in the serum and plasma. ELISA or particle-based immunoassay are commonly used to detect the presence of the p27 core protein in samples obtained from blood. The objective of this study was to compare the performance of several in-clinic tests: the SNAP Feline Triple Test (IDEXX Laboratories), the WITNESS FeLV-FIV Test (Zoetis) and the VetScan Feline FeLV/FIV Rapid Test (Abaxis). Methods The sample population (100 positive, 105 negative samples) consisted of serum and plasma samples submitted to IDEXX’s worldwide reference laboratory for feline retrovirus testing. Virus isolation and reverse transcriptase PCR results were not available and so samples were judged to be positive or negative based on the results of the ViraCHEK FeLV (Zoetis) microtiter plate assay. Results The percentage of samples positive and negative for FeLV p27 antigen using the three in-clinic tests compared with the ViraCHEK method were as follows: IDEXX Feline Triple (positive 98.0%, negative 100%); Zoetis WITNESS (positive 79.0%, negative 97.1%); Abaxis VetScan (positive 73.0%, negative 97.1%). Conclusions and relevance The SNAP Feline Triple Test demonstrated a high level of agreement for FeLV-positive and FeLV-negative samples when assessed in this model. Results of FeLV assays can vary among tests.
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Point prevalence survey for tick-borne pathogens in military working dogs, shelter animals, and pet populations in northern Colombia. JOURNAL OF SPECIAL OPERATIONS MEDICINE : A PEER REVIEWED JOURNAL FOR SOF MEDICAL PROFESSIONALS 2016; 14:81-85. [PMID: 25399372 DOI: 10.55460/1vbk-jxc7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/01/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Based on the high tick-borne pathogen results from a 2011 surveillance study in three Colombian cities, an in-depth point prevalence survey was conducted to determine the seroprevalence of tick-borne pathogens at a specific point in time in 70 working dogs, 101 shelter dogs, and 47 client-owned dogs in Barranquilla, Colombia. RESULTS Of the 218 serum samples, 163 (74%) were positive for Ehrlichia canis and 116 (53%) for Anaplasma platys. Exposure to tick-borne pathogens was highest in shelter and working dogs where more than 90% of the samples were seropositive or positive on polymerase chain reaction for one or more organisms as compared to 51% in client-owned animals. CONCLUSION Surveillance for exposure to tick-borne pathogens provides vital information necessary to protect and conserve the health of local humans and animals, deployed military service members, and working dogs in various parts of the world. This study and resultant data demonstrate the value of following a broad-based surveillance study with a more specific, focused analysis in an area of concern. This area?s high levels of exposure warrant emphasis by medical planners and advisors on precautionary measures for military dogs, Special Operations Forces personnel, and the local public.
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Prevalence of selected infectious disease agents in stray cats in Catalonia, Spain. JFMS Open Rep 2016; 2:2055116916634109. [PMID: 28491415 PMCID: PMC5362887 DOI: 10.1177/2055116916634109] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2016] [Indexed: 11/23/2022] Open
Abstract
Objectives The objective of the current study was to investigate the prevalence rates of the following infectious agents in 116 stray cats in the Barcelona area of Spain: Anaplasma phagocytophilum, Bartonella species, Borrelia burgdorferi, Chlamydia felis, Dirofilaria immitis, Ehrlichia species, feline calicivirus (FCV), feline herpesvirus-1 (FHV-1), feline leukaemia virus (FeLV), feline immunodeficiency virus (FIV), haemoplasmas, Mycoplasma species and Rickettsia species. Methods Serum antibodies were used to estimate the prevalence of exposure to A phagocytophilum, Bartonella species, B burgdorferi, Ehrlichia species and FIV; serum antigens were used to assess for infection by D immitis and FeLV; and molecular assays were used to amplify nucleic acids of Anaplasma species, Bartonella species, C felis, D immitis, Ehrlichia species, FCV, FHV-1, haemoplasmas, Mycoplasma species and Rickettsia species from blood and nasal or oral swabs. Results Of the 116 cats, 63 (54.3%) had evidence of infection by Bartonella species, FeLV, FIV or a haemoplasma. Anaplasma species, Ehrlichia species or Rickettsia species DNA was not amplified from these cats. A total of 18/116 cats (15.5%) were positive for FCV RNA (six cats), Mycoplasma species DNA (six cats), FHV-1 DNA (three cats) or C felis DNA (three cats). Conclusions and relevance This study documents that shelter cats in Catalonia are exposed to many infectious agents with clinical and zoonotic significance, and that flea control is indicated for cats in the region.
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Nitric oxide and the Th2 response combine to prevent severe hepatic damage during Schistosoma mansoni infection. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 1999; 163:4976-84. [PMID: 10528202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
During infection with Schistosoma mansoni, NO production increases following the deposition of parasite eggs in the liver. In wild-type C57BL/6 mice, NO levels peak during the sixth week of infection and are subsequently down-regulated. Inducible NO synthase (iNOS) mRNA was found in diseased liver tissue along with TNF-alpha and IFN-gamma, which are known promoters of iNOS expression. Mice treated with aminoguanidine, a selective inhibitor of iNOS, exhibited cachexia and exacerbated liver pathology, suggesting that NO limits hepatocyte damage when the liver is first exposed to eggs. Hepatic iNOS is up-regulated in SCID mice, indicating that NO production is part of an innate response. Studies with infected highly susceptible IL-4-/- mice revealed that prolonged NO production is in itself deleterious and that a major function of the Th2 response, which is severely compromised in the absence of IL-4, is to regulate NO production. In these animals, plasma NO levels are high compared with those in infected wild-type mice and remain elevated until death. Nevertheless, the underlying importance of NO is illustrated by the finding that aminoguanidine treatment leads to more severe liver disease and reduced time to death in infected IL-4-/- mice.
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Nitric Oxide and the Th2 Response Combine to Prevent Severe Hepatic Damage During Schistosoma mansoni Infection. THE JOURNAL OF IMMUNOLOGY 1999. [DOI: 10.4049/jimmunol.163.9.4976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
During infection with Schistosoma mansoni, NO production increases following the deposition of parasite eggs in the liver. In wild-type C57BL/6 mice, NO levels peak during the sixth week of infection and are subsequently down-regulated. Inducible NO synthase (iNOS) mRNA was found in diseased liver tissue along with TNF-α and IFN-γ, which are known promoters of iNOS expression. Mice treated with aminoguanidine, a selective inhibitor of iNOS, exhibited cachexia and exacerbated liver pathology, suggesting that NO limits hepatocyte damage when the liver is first exposed to eggs. Hepatic iNOS is up-regulated in SCID mice, indicating that NO production is part of an innate response. Studies with infected highly susceptible IL-4−/− mice revealed that prolonged NO production is in itself deleterious and that a major function of the Th2 response, which is severely compromised in the absence of IL-4, is to regulate NO production. In these animals, plasma NO levels are high compared with those in infected wild-type mice and remain elevated until death. Nevertheless, the underlying importance of NO is illustrated by the finding that aminoguanidine treatment leads to more severe liver disease and reduced time to death in infected IL-4−/− mice.
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An objective definition of shoulder dystocia: prolonged head-to-body delivery intervals and/or the use of ancillary obstetric maneuvers. Obstet Gynecol 1995; 86:433-6. [PMID: 7651656 DOI: 10.1016/0029-7844(95)00188-w] [Citation(s) in RCA: 95] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To generate an objective definition of shoulder dystocia by timing the events of the second and third stages of labor, and to define the true incidence of shoulder dystocia. METHODS In 34 arbitrarily selected 24-hour time periods, a nonparticipating observer prospectively timed intervals of the second stage of labor in all vaginal deliveries and recorded the use of obstetric maneuvers (McRoberts, episiotomy after delivery of the fetal head, intentional extension of initial episiotomy after delivery of the fetal head, suprapubic pressure, posterior arm rotation to an oblique angle, rotation of the infant by 180 degrees, delivery of the posterior arm, and general anesthesia) and whether the obstetric attendant identified a delivery with shoulder dystocia. All data are reported as mean +/- standard error of the mean. RESULTS Two hundred fifty deliveries were timed and recorded prospectively. Mean intervals (in seconds) in nonmaneuver patients were as follows: head to anterior shoulder 14.8 +/- 1.0, anterior to posterior shoulder 3.9 +/- 0.6, posterior shoulder to body 5.4 +/- 0.8, and total head-to-body time 24.2 +/- 1.3. Three groups of patients were defined after delivery. The maneuver group consisted of 27 patients requiring any of the aforementioned obstetric maneuvers, although the obstetric attendant identified only 16 of these as shoulder dystocia. The prolonged delivery group included 29 patients with the head-to-body delivery interval exceeding the mean plus two standard deviations (60 seconds) of nonmaneuver patients. Sixteen of the 27 maneuver patients were identified as prolonged. The 210 not identified as maneuver or prolonged were considered to be normal. Normal patients had a significantly lower newborn birth weight (3269 +/- 38 g), and a lower proportion of 1-minute Apgar scores of 7 or less (11%) than did the maneuver (4247 +/- 86 g, 41%) and prolonged groups (3952 +/- 118 g, 34%). Defining shoulder dystocia as a prolonged head-to-body delivery time and/or the use of obstetric maneuvers identified 40 patients who had birth weights and 1-minute Apgar scores significantly different from the normal patients. CONCLUSION The incidence of shoulder dystocia, as defined by the use of ancillary obstetric maneuvers, is higher than that reported previously, and the reporting of shoulder dystocia appears to be unreliable. The interval from head-to-body delivery is delayed significantly in patients with shoulder dystocia, despite the lack of recognition of shoulder dystocia. We propose defining shoulder dystocia as a prolonged head-to-body delivery time (eg, more than 60 seconds) or the need for ancillary obstetric maneuvers.
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Performing cytogenetic studies on ascitic, amniotic and hygroma fluid. THE JOURNAL OF REPRODUCTIVE MEDICINE 1990; 35:1145-6. [PMID: 2283633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The importance of obtaining cytogenetic studies on antenatally diagnosed structural malformations is well recognized. In two cases, three fetal compartments were sampled, each resulting in successful cytogenetic studies. Fluid was obtained under ultrasound guidance from amniotic fluid, fetal ascites and cystic hygroma fluid. Fluid from the hygroma itself may be the easiest compartment to analyze.
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Abstract
Since Saling's work in 1961, many investigators have attempted to perfect methods to detect fetal acidosis during labor. A system for continuous tissue pH monitoring of the fetus is evaluated in this study of 59 patients. There was poor correlation of tissue pH values and capillary scalp pH values in 19 cases (r = 0.487), and no significant correlation of tissue pH values to the outcome measurements of Apgar scores and cord gas levels. The benefits realized were those of monitoring the trend of tissue pH over time. We believe that a continuous pH monitoring system offers several advantages over intermittent fetal scalp sampling. Further refinement of the technology employed may offer such a system in the future.
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Previous cesarean section and trial of labor. Factors related to uterine dehiscence. THE JOURNAL OF REPRODUCTIVE MEDICINE 1984; 29:17-21. [PMID: 6708014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Patients with previous cesarean section generally are subjected to repeat cesarean section for fear of uterine rupture and its subsequent catastrophic complications. Recently, however, since the practice of repeat cesarean section has been challenged, a select group of patients has been permitted a trial of labor (TOL) after they have fulfilled certain selection criteria. These criteria include not more than one previous low segment transverse incision, a nonrecurrent indication and absence of macrosomia with this pregnancy. We performed a retrospective study on 836 patients with previous cesarean sections. Of them, 308 were given a TOL. Factors considered to increase the risk of dehiscence were analyzed. On statistical analysis, none of the factors appeared to have any impact on the rate of uterine dehiscence.
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Effect of indication for previous cesarean section on subsequent delivery outcome in patients undergoing a trial of labor. THE JOURNAL OF REPRODUCTIVE MEDICINE 1984; 29:22-5. [PMID: 6708015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
During the period January 1 through December 31, 1980, 308 patients who had undergone previous cesarean sections (C/Ss) underwent a trial of labor (TOL). Hospital records of these patients were examined retrospectively in an effort to correlate delivery outcome with the indication for the prior C/S. Patients with a previous C/S for breech had the highest incidence of subsequent vaginal delivery (81 of 94, or 86%), and patients with a previous C/S for cephalopelvic disproportion or failure to progress had the lowest (22 of 64, or 64%). However, the lower rate of vaginal delivery in the latter group was found only among the subpopulation who had never delivered vaginally. Fetal distress does not appear to be a significant recurring factor in patients given a TOL. Exclusion of patients from a TOL after a previous C/S for cephalopelvic disproportion/failure to progress does not appear to be justified.
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Vaginal delivery after cesarean section in women with unknown types of uterine scar. THE JOURNAL OF REPRODUCTIVE MEDICINE 1984; 29:31-5. [PMID: 6708018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Documentation of a prior cesarean and the type of uterine scar has been used as one criterion for permitting patients a trial of labor. In a highly mobile patient population such as ours, these medical facts are often difficult or impossible to obtain. As a result, we retrospectively examined the performance of patients with unknown types of cesarean scar and found no difference between them and a similar population with documented low cervical scars. Although obtaining an old record is useful, its absence probably should not interdict a trial of labor in a patient who desires to attempt vaginal delivery.
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Assays for antigen-stimulated lymphocyte-derived migration enhancement and inhibition factors from patients with thyroid diseases and their relatives. ACTA ENDOCRINOLOGICA 1977; 86:733-41. [PMID: 335760 DOI: 10.1530/acta.0.0860733] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cell-mediated immunity to thyroid antigens was studied by means of an assay for antigen-stimulated leukocyte migration inhibition factor (LIF) in 5 groups of subjects: patients with Graves' disease, Hashimoto's thyroiditis, their relatives and normal controls. We also sought evidence for the possibility that the hypothesized migration enhancement factor (MEF) might be produced by lymphocytes from patients with autoimmune disorders. We found little evidence of LIF production and none of MEF production by the leukocytes of patients with autoimmune thyroid diseases upon exposure to thyroid antigens. Similarly, either no or only minimal amounts of LIF were demonstrated in culture supernatants of leukocytes of their immediate relatives.
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