PICO question In adult horses with secondary sinusitis caused by dental disease, is computed tomography more accurate than radiography for the identification of apical dental pathology? Clinical bottom line Category of research question Diagnosis The number and type of study designs reviewed The literature search identified four papers that were critically reviewed. The publications consist of two retrospective case-controlled studies, one clinical study and one descriptive study Strength of evidence Weak Outcomes reported Four studies reported the sensitivity of computed tomography (CT) for the diagnosis of apical dental pathology in horses presented for evaluation of clinical signs of sinus disease with histopathological evidence of apical dental pathology. All studies reported the radiographic changes present in these horses or used absence of definitive radiographic changes consistent with apical dental disease as a reason to undertake further CT evaluation. All four papers found that CT identified teeth with apical pathology that radiography had not Conclusion CT is more accurate than radiography for the diagnosis of equine maxillary apical dental pathology; however, clear guidelines on the CT changes associated with apical dental pathology are required. Loss of the lamina dura, infundibular changes or pulpal gas as singular findings on CT imaging can be seen in teeth with no underlying histopathological evidence of apical disease, and in maxillary teeth imaged in horses without clinical signs of maxillary cheek tooth pathology How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
{"title":"In horses with secondary sinusitis caused by dental disease, is computed tomography more accurate than radiography for the identification of apical dental pathology?","authors":"Rebecca Gill-Parsons, E. Shipman, K. Pickles","doi":"10.18849/ve.v7i2.491","DOIUrl":"https://doi.org/10.18849/ve.v7i2.491","url":null,"abstract":"PICO question \u0000In adult horses with secondary sinusitis caused by dental disease, is computed tomography more accurate than radiography for the identification of apical dental pathology? \u0000 \u0000Clinical bottom line \u0000Category of research question \u0000Diagnosis \u0000The number and type of study designs reviewed \u0000The literature search identified four papers that were critically reviewed. The publications consist of two retrospective case-controlled studies, one clinical study and one descriptive study \u0000Strength of evidence \u0000Weak \u0000Outcomes reported \u0000Four studies reported the sensitivity of computed tomography (CT) for the diagnosis of apical dental pathology in horses presented for evaluation of clinical signs of sinus disease with histopathological evidence of apical dental pathology. All studies reported the radiographic changes present in these horses or used absence of definitive radiographic changes consistent with apical dental disease as a reason to undertake further CT evaluation. All four papers found that CT identified teeth with apical pathology that radiography had not \u0000Conclusion \u0000CT is more accurate than radiography for the diagnosis of equine maxillary apical dental pathology; however, clear guidelines on the CT changes associated with apical dental pathology are required. Loss of the lamina dura, infundibular changes or pulpal gas as singular findings on CT imaging can be seen in teeth with no underlying histopathological evidence of apical disease, and in maxillary teeth imaged in horses without clinical signs of maxillary cheek tooth pathology \u0000 \u0000How to apply this evidence in practice \u0000The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. \u0000Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. \u0000 \u0000","PeriodicalId":257905,"journal":{"name":"Veterinary Evidence","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133016192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PICO question In dogs with aural haematomas does draining and injecting corticosteroids versus drainage alone reduce the risk of recurrence? Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Three papers were critically reviewed, a retrospective multi-centre cohort study, a randomised case control trial and an observational survey Strength of evidence Weak Outcomes reported Drainage alone at daily or weekly frequency consistently resulted in aural haematoma (AH) recurrence and lack of resolution. Corticosteroid instillation alongside drainage reduced the risk of rapid recurrence for AHs, across both the cohort and the case control studies, provided drainage was frequent Conclusion The strength of evidence for local steroid instillation was weak given the type of studies reviewed, alongside small sample sizes and variations in treatment protocol. However, consistently drainage alone appears an insufficient means of addressing AHs in dogs. In cases where frequent drainage was the chosen treatment option, the addition of local corticosteroid application appeared to improve the outcome compared to drainage alone. However, as systemic treatment was often employed alongside local corticosteroid instillation, success cannot necessarily be attributed solely to local treatment. Larger, randomised control trials would be required to assess the effect of each individual intervention providing clearer evidence for the most effective medical protocol for treating aural haematomas in dogs How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
{"title":"In dogs with aural haematoma does draining and injecting corticosteroids versus drainage alone reduce the risk of recurrence?","authors":"R. Church","doi":"10.18849/ve.v7i1.438","DOIUrl":"https://doi.org/10.18849/ve.v7i1.438","url":null,"abstract":"PICO question \u0000In dogs with aural haematomas does draining and injecting corticosteroids versus drainage alone reduce the risk of recurrence? \u0000 \u0000Clinical bottom line \u0000Category of research question \u0000Treatment \u0000The number and type of study designs reviewed \u0000Three papers were critically reviewed, a retrospective multi-centre cohort study, a randomised case control trial and an observational survey \u0000Strength of evidence \u0000Weak \u0000Outcomes reported \u0000Drainage alone at daily or weekly frequency consistently resulted in aural haematoma (AH) recurrence and lack of resolution. Corticosteroid instillation alongside drainage reduced the risk of rapid recurrence for AHs, across both the cohort and the case control studies, provided drainage was frequent \u0000Conclusion \u0000The strength of evidence for local steroid instillation was weak given the type of studies reviewed, alongside small sample sizes and variations in treatment protocol. However, consistently drainage alone appears an insufficient means of addressing AHs in dogs. \u0000In cases where frequent drainage was the chosen treatment option, the addition of local corticosteroid application appeared to improve the outcome compared to drainage alone. \u0000However, as systemic treatment was often employed alongside local corticosteroid instillation, success cannot necessarily be attributed solely to local treatment. Larger, randomised control trials would be required to assess the effect of each individual intervention providing clearer evidence for the most effective medical protocol for treating aural haematomas in dogs \u0000 \u0000How to apply this evidence in practice \u0000The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. \u0000Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. \u0000 \u0000","PeriodicalId":257905,"journal":{"name":"Veterinary Evidence","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126837095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PICO question In dogs with B-cell lymphoma, does the use of flow cytometry provide useful prognostic information? Clinical bottom line Category of research question Prognosis The number and type of study designs reviewed Twelve papers were critically reviewed. All were cohort studies Strength of evidence Moderate Outcomes reported There are multiple potential prognostic indicators in canine B-cell lymphoma that flow cytometry can be used to evaluate, including lymphoma stage, survival time and time to progression. There is promising evidence for the use of percentage expression of CD25 and Ki67 cellular markers in providing prognostic information in canine B-cell lymphoma and these should be assessed further in clinical practice. Flow cytometry has also been shown to be useful in assessing bone marrow infiltration and providing prognostic information relating to this. There is also evidence for the prognostic value of measuring expression of class II MHC and CTLA-4 cellular markers, peripheral lymphocyte / monocyte ratio, nodal regulatory T-cell populations and the ratio between T and B lymphocytes in extranodal locations. Peripheral regulatory T-cell populations and cellular size were also assessed, however further investigations are required before confirming their prognostic value Conclusion Flow cytometric analysis offers useful measures of prognosis in canine B-cell lymphoma, although further validation is required before introducing their routine use. Percentage expression of CD25 and Ki67 cellular markers from lymph node aspirates of dogs with B-cell lymphoma appear to be promising prognostic indicators in clinical investigations, however this needs to be translated into clinical practice. While there is evidence for the prognostic value of bone marrow infiltration measured flow cytometrically, expression of class II MHC and CTLA-4, peripheral lymphocyte / monocyte ratio, nodal regulatory T-cell populations and the ratio between T and B lymphocytes in extranodal locations, these need to be further investigated before introducing into clinical practice. As new antibodies against cellular targets in dogs become available, it is likely that flow cytometry will become even more useful in providing prognostic information How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
{"title":"What prognostic information does flow cytometry provide in canine B-cell lymphoma?","authors":"Benjamin Haythornthwaite","doi":"10.18849/ve.v7i1.381","DOIUrl":"https://doi.org/10.18849/ve.v7i1.381","url":null,"abstract":"PICO question \u0000In dogs with B-cell lymphoma, does the use of flow cytometry provide useful prognostic information? \u0000 \u0000Clinical bottom line \u0000Category of research question \u0000Prognosis \u0000The number and type of study designs reviewed \u0000Twelve papers were critically reviewed. All were cohort studies \u0000Strength of evidence \u0000Moderate \u0000Outcomes reported \u0000There are multiple potential prognostic indicators in canine B-cell lymphoma that flow cytometry can be used to evaluate, including lymphoma stage, survival time and time to progression. There is promising evidence for the use of percentage expression of CD25 and Ki67 cellular markers in providing prognostic information in canine B-cell lymphoma and these should be assessed further in clinical practice. Flow cytometry has also been shown to be useful in assessing bone marrow infiltration and providing prognostic information relating to this. There is also evidence for the prognostic value of measuring expression of class II MHC and CTLA-4 cellular markers, peripheral lymphocyte / monocyte ratio, nodal regulatory T-cell populations and the ratio between T and B lymphocytes in extranodal locations. Peripheral regulatory T-cell populations and cellular size were also assessed, however further investigations are required before confirming their prognostic value \u0000Conclusion \u0000Flow cytometric analysis offers useful measures of prognosis in canine B-cell lymphoma, although further validation is required before introducing their routine use. Percentage expression of CD25 and Ki67 cellular markers from lymph node aspirates of dogs with B-cell lymphoma appear to be promising prognostic indicators in clinical investigations, however this needs to be translated into clinical practice. While there is evidence for the prognostic value of bone marrow infiltration measured flow cytometrically, expression of class II MHC and CTLA-4, peripheral lymphocyte / monocyte ratio, nodal regulatory T-cell populations and the ratio between T and B lymphocytes in extranodal locations, these need to be further investigated before introducing into clinical practice. As new antibodies against cellular targets in dogs become available, it is likely that flow cytometry will become even more useful in providing prognostic information \u0000 \u0000How to apply this evidence in practice \u0000The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. \u0000Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. \u0000 \u0000","PeriodicalId":257905,"journal":{"name":"Veterinary Evidence","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123162272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PICO question In neonatal calves with contracted flexor tendons is the use of a 3 day course of oxytetracycline in conjunction with other treatments more effective in returning the hoof to normal full weight bearing on both the toe and heel compared to no oxytetracycline? Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Three papers were critically reviewed. One randomised controlled study, one case series and one case study Strength of evidence Weak Outcomes reported Oxytetracycline as a treatment for contracted flexor tendons in calves was found to be slightly more effective in returning the hoof to normal weight bearing compared to no oxytetracycline. In contrast, oxytetracycline infusions for the treatment of contracted flexor tendons in calves do not have an influence on weight bearing and have no significant clinical effect Conclusion There was limited confidence that the estimated effect reported by the studies were close to the true effect, this is due to the studies having a number of limitations as well as the case series / study having limited evidentiary power. There is currently insufficient evidence from the literature to support or reject the use of oxytetracycline in the treatment of contracted flexor tendons in calves. Further studies, with higher strengths of evidence, are required to provide conclusive evidence How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
{"title":"The effectiveness of oxytetracycline in the treatment of calves with contracted flexor tendons","authors":"A. Leech","doi":"10.18849/ve.v7i1.455","DOIUrl":"https://doi.org/10.18849/ve.v7i1.455","url":null,"abstract":"PICO question \u0000In neonatal calves with contracted flexor tendons is the use of a 3 day course of oxytetracycline in conjunction with other treatments more effective in returning the hoof to normal full weight bearing on both the toe and heel compared to no oxytetracycline? \u0000 \u0000Clinical bottom line \u0000Category of research question \u0000Treatment \u0000The number and type of study designs reviewed \u0000Three papers were critically reviewed. One randomised controlled study, one case series and one case study \u0000Strength of evidence \u0000Weak \u0000Outcomes reported \u0000Oxytetracycline as a treatment for contracted flexor tendons in calves was found to be slightly more effective in returning the hoof to normal weight bearing compared to no oxytetracycline. In contrast, oxytetracycline infusions for the treatment of contracted flexor tendons in calves do not have an influence on weight bearing and have no significant clinical effect \u0000Conclusion \u0000There was limited confidence that the estimated effect reported by the studies were close to the true effect, this is due to the studies having a number of limitations as well as the case series / study having limited evidentiary power. There is currently insufficient evidence from the literature to support or reject the use of oxytetracycline in the treatment of contracted flexor tendons in calves. Further studies, with higher strengths of evidence, are required to provide conclusive evidence \u0000 \u0000How to apply this evidence in practice \u0000The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. \u0000Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. \u0000 \u0000","PeriodicalId":257905,"journal":{"name":"Veterinary Evidence","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121272506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PICO question Does the extent of the surgical margin affect the likelihood of local recurrence in Patnaik grade I or II cutaneous mast cell tumours? Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Eight papers were critically reviewed. Five were retrospective case series, two prospective clinical trials, and one prospective case series Strength of evidence Low Outcomes reported Sequin et al. (2001) reported a local recurrence rate of 5%, but this study is 20 years old. In the studies of Simpson et al. (2004), Fulcher et al. (2006), Pratschke et al. (2013), Saunders et al. (2020), and Itoh et al. (2021), no local recurrence was observed in grade I and II mast cell tumours, while in the Milovancev et al. (2019) study, only 1/30 low-grade cutaneous mast cell tumors developed local recurrence. Therefore, there is some evidence that conservative surgical excision is sufficient to achieve local control with low recurrence rates Conclusion There is increasing evidence in the literature for conservative surgical excision of grade I and II MCTs, but because the quality of evidence is low, no clear recommendations can be made. Further studies are needed to determine recommendations for surgical excision of cutaneous MCTs based on the biological characteristics of the tumour and the completeness of histologic margins How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
PICO问题:手术切缘的范围是否影响帕特奈克I级或II级皮肤肥大细胞瘤局部复发的可能性?临床底线研究问题类别治疗研究设计的数量和类型审查了8篇论文。其中5项为回顾性病例系列，2项为前瞻性临床试验，1项为前瞻性病例系列。证据强度:低结局:Sequin et al.(2001)报道的局部复发率为5%，但该研究已有20年历史。在Simpson等人(2004)、Fulcher等人(2006)、Pratschke等人(2013)、Saunders等人(2020)、Itoh等人(2021)的研究中，I级和II级肥大细胞瘤未见局部复发，而在milovancevv等人(2019)的研究中，只有1/30的低级别皮肤肥大细胞瘤出现局部复发。因此，有证据表明保守性手术切除足以达到局部控制，复发率低。结论对于I级和II级mct保守性手术切除的文献证据越来越多，但由于证据质量较低，无法提出明确的建议。基于肿瘤的生物学特征和组织学边缘的完整性，需要进一步的研究来确定手术切除皮肤mct的建议。如何在实践中应用这些证据。证据在实践中的应用应考虑多种因素，不限于:个人的临床专业知识，病人的情况和业主的价值观，你工作的国家，地点或诊所，你面前的个案，治疗和资源的可用性。知识摘要是帮助加强或告知决策的资源。他们不会凌驾于从业者的责任或判断之上，去做对他们照顾的动物最好的事情。
{"title":"Does the extent of the surgical margin affect the likelihood of local recurrence in Patnaik grade I or II cutaneous mast cell tumours?","authors":"Christos Dorlis","doi":"10.18849/ve.v7i1.508","DOIUrl":"https://doi.org/10.18849/ve.v7i1.508","url":null,"abstract":"PICO question \u0000Does the extent of the surgical margin affect the likelihood of local recurrence in Patnaik grade I or II cutaneous mast cell tumours? \u0000 \u0000Clinical bottom line \u0000Category of research question \u0000Treatment \u0000The number and type of study designs reviewed \u0000Eight papers were critically reviewed. Five were retrospective case series, two prospective clinical trials, and one prospective case series \u0000Strength of evidence \u0000Low \u0000Outcomes reported \u0000Sequin et al. (2001) reported a local recurrence rate of 5%, but this study is 20 years old. In the studies of Simpson et al. (2004), Fulcher et al. (2006), Pratschke et al. (2013), Saunders et al. (2020), and Itoh et al. (2021), no local recurrence was observed in grade I and II mast cell tumours, while in the Milovancev et al. (2019) study, only 1/30 low-grade cutaneous mast cell tumors developed local recurrence. Therefore, there is some evidence that conservative surgical excision is sufficient to achieve local control with low recurrence rates \u0000Conclusion \u0000There is increasing evidence in the literature for conservative surgical excision of grade I and II MCTs, but because the quality of evidence is low, no clear recommendations can be made. Further studies are needed to determine recommendations for surgical excision of cutaneous MCTs based on the biological characteristics of the tumour and the completeness of histologic margins \u0000 \u0000How to apply this evidence in practice \u0000The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. \u0000Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. \u0000 \u0000","PeriodicalId":257905,"journal":{"name":"Veterinary Evidence","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117336455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PICO question In auction market calves at high risk of developing bovine respiratory disease (BRD), does delayed (14–30 days) vaccination with a modified live vaccine (MLV) for viral respiratory pathogens versus administration of MLV on arrival (within 24 hours of arrival) to the stocker operation, result in less calves with BRD morbidity diagnosed based on visual signs and rectal temperature >40°C, or less calves with BRD mortality? Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Four papers were critically reviewed. All were randomised complete block designs Strength of evidence Moderate Outcomes reported In stocker calves, delaying administration of a MLV for respiratory viruses may result in numerically lower initial BRD morbidity rates, while giving at arrival may result in numerically lower BRD retreatments. One study shows statistically lower cases of BRD morbidity after the third antimicrobial treatment in cattle vaccinated on arrival with both a clostridial and MLV for respiratory viruses compared to cattle vaccinated on arrival with clostridial vaccine and delayed MLV for respiratory viruses. No conclusion about mortality can be drawn due to inconsistent numerical conclusions between studies Conclusion Due to conflicting evidence and a general lack of statistically significant differences in morbidity and mortality outcomes, a definite answer regarding the impact of delayed MLV respiratory vaccination in stocker calves cannot be made How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
{"title":"Delayed versus on arrival modified live viral vaccination in stocker cattle on bovine respiratory disease","authors":"A. Ambs, S. Capik, H. Moberly","doi":"10.18849/ve.v7i1.503","DOIUrl":"https://doi.org/10.18849/ve.v7i1.503","url":null,"abstract":"PICO question \u0000In auction market calves at high risk of developing bovine respiratory disease (BRD), does delayed (14–30 days) vaccination with a modified live vaccine (MLV) for viral respiratory pathogens versus administration of MLV on arrival (within 24 hours of arrival) to the stocker operation, result in less calves with BRD morbidity diagnosed based on visual signs and rectal temperature >40°C, or less calves with BRD mortality? \u0000 \u0000Clinical bottom line \u0000Category of research question \u0000Treatment \u0000The number and type of study designs reviewed \u0000Four papers were critically reviewed. All were randomised complete block designs \u0000Strength of evidence \u0000Moderate \u0000Outcomes reported \u0000In stocker calves, delaying administration of a MLV for respiratory viruses may result in numerically lower initial BRD morbidity rates, while giving at arrival may result in numerically lower BRD retreatments. One study shows statistically lower cases of BRD morbidity after the third antimicrobial treatment in cattle vaccinated on arrival with both a clostridial and MLV for respiratory viruses compared to cattle vaccinated on arrival with clostridial vaccine and delayed MLV for respiratory viruses. No conclusion about mortality can be drawn due to inconsistent numerical conclusions between studies \u0000Conclusion \u0000Due to conflicting evidence and a general lack of statistically significant differences in morbidity and mortality outcomes, a definite answer regarding the impact of delayed MLV respiratory vaccination in stocker calves cannot be made \u0000 \u0000How to apply this evidence in practice \u0000The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. \u0000Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. \u0000 \u0000","PeriodicalId":257905,"journal":{"name":"Veterinary Evidence","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121554305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PICO question Can the measurement of blood and peritoneal fluid effusion glucose levels be used to accurately diagnose septic peritonitis in dogs when compared to cytology and bacterial culture? Clinical bottom line Category of research question Diagnosis The number and type of study designs reviewed Three papers were critically reviewed, all of which were diagnostic test evaluation studies Strength of evidence Moderate Outcomes reported Glucose measurements can be used to diagnose septic peritonitis when the blood plasma glucose level is >2.1 mmol/L higher than that of the peritoneal fluid glucose when using a veterinary point of care (POC) glucometer. If using a biochemistry analyser, a whole blood glucose >1.1 mmol/L higher than that of the peritoneal fluid can be used to diagnose septic peritonitis. This is only relevant when the peritoneal fluid is collected by abdominocentesis and not in a postoperative period Conclusion At present, there is moderate evidence that glucose measurements are useful as a patient side test for the diagnosis of septic peritonitis and are especially useful in cases where intracellular bacteria cannot be identified on cytology. However, despite the so far promising accuracy results, the cut-offs reported are quite variable and overall, there is not a single diagnostic test that is 100% sensitive and specific in repeated studies. Therefore, the results of the glucose measurements should be evaluated alongside other biomarker testing, imaging modalities and the clinical presentation of the patient. Glucose measurements cannot currently replace culture / sensitivity and cytology as the gold standard for the diagnosis of septic peritonitis How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
{"title":"Can measurement of glucose levels in blood and peritoneal fluid be used to diagnose septic peritonitis in dogs?","authors":"Nicole D'Mello","doi":"10.18849/ve.v7i1.382","DOIUrl":"https://doi.org/10.18849/ve.v7i1.382","url":null,"abstract":"PICO question \u0000Can the measurement of blood and peritoneal fluid effusion glucose levels be used to accurately diagnose septic peritonitis in dogs when compared to cytology and bacterial culture? \u0000 \u0000Clinical bottom line \u0000Category of research question \u0000Diagnosis \u0000The number and type of study designs reviewed \u0000Three papers were critically reviewed, all of which were diagnostic test evaluation studies \u0000Strength of evidence \u0000Moderate \u0000Outcomes reported \u0000Glucose measurements can be used to diagnose septic peritonitis when the blood plasma glucose level is >2.1 mmol/L higher than that of the peritoneal fluid glucose when using a veterinary point of care (POC) glucometer. If using a biochemistry analyser, a whole blood glucose >1.1 mmol/L higher than that of the peritoneal fluid can be used to diagnose septic peritonitis. This is only relevant when the peritoneal fluid is collected by abdominocentesis and not in a postoperative period \u0000Conclusion \u0000At present, there is moderate evidence that glucose measurements are useful as a patient side test for the diagnosis of septic peritonitis and are especially useful in cases where intracellular bacteria cannot be identified on cytology. However, despite the so far promising accuracy results, the cut-offs reported are quite variable and overall, there is not a single diagnostic test that is 100% sensitive and specific in repeated studies. Therefore, the results of the glucose measurements should be evaluated alongside other biomarker testing, imaging modalities and the clinical presentation of the patient. Glucose measurements cannot currently replace culture / sensitivity and cytology as the gold standard for the diagnosis of septic peritonitis \u0000 \u0000How to apply this evidence in practice \u0000The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. \u0000Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. \u0000 \u0000","PeriodicalId":257905,"journal":{"name":"Veterinary Evidence","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128994932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PICO question Do wild coyotes in the US that are in an urban habitat compared to a rural habitat have a higher prevalence of Borrelia burgdorferi seroconversion? Clinical bottom line Category of research question Prevalence The number and type of study designs reviewed Two papers, both utilising a cross-sectional study design Strength of evidence Zero Outcomes reported The relevant studies provide very limited to no evidence towards answering this PICO question. In one, while the absolute percentage of Borrelia-antibody-positive canines (including dogs in addition to coyotes) is higher in metropolitan areas, the effect was not found to be statistically significant, possibly due to their small sample sizes. In the second study, prevalence of antibodies against Borrelia was compared between different rural habitats, but no urban coyotes were tested as a comparison and thus the PICO question cannot be evaluated Conclusion There is a knowledge gap concerning the prevalence of Borrelia in coyotes and how it differs between urban and rural environments. Wild coyotes could be used as a sentinel species of Lyme disease activity and to assess potential for domestic pet and human infections, which would inform clinical differential diagnoses as well as testing and vaccination recommendations. More studies are needed before this PICO question can be answered in a confident manner How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
{"title":"Borrelia burgdorferi exposure in coyotes: an indicator of B. burgdorferi levels in urban versus rural environments","authors":"L. Shultz, E. Fausak","doi":"10.18849/ve.v7i1.444","DOIUrl":"https://doi.org/10.18849/ve.v7i1.444","url":null,"abstract":"PICO question \u0000Do wild coyotes in the US that are in an urban habitat compared to a rural habitat have a higher prevalence of Borrelia burgdorferi seroconversion? \u0000 \u0000Clinical bottom line \u0000Category of research question \u0000Prevalence \u0000The number and type of study designs reviewed \u0000Two papers, both utilising a cross-sectional study design \u0000Strength of evidence \u0000Zero \u0000Outcomes reported \u0000The relevant studies provide very limited to no evidence towards answering this PICO question. In one, while the absolute percentage of Borrelia-antibody-positive canines (including dogs in addition to coyotes) is higher in metropolitan areas, the effect was not found to be statistically significant, possibly due to their small sample sizes. In the second study, prevalence of antibodies against Borrelia was compared between different rural habitats, but no urban coyotes were tested as a comparison and thus the PICO question cannot be evaluated \u0000Conclusion \u0000There is a knowledge gap concerning the prevalence of Borrelia in coyotes and how it differs between urban and rural environments. Wild coyotes could be used as a sentinel species of Lyme disease activity and to assess potential for domestic pet and human infections, which would inform clinical differential diagnoses as well as testing and vaccination recommendations. More studies are needed before this PICO question can be answered in a confident manner \u0000 \u0000How to apply this evidence in practice \u0000The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. \u0000Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. \u0000 \u0000","PeriodicalId":257905,"journal":{"name":"Veterinary Evidence","volume":"9 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114128462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PICO question In dogs with congenital extrahepatic portosystemic shunts that are treated with surgical attenuation what is the persistency, frequency, severity and outcome of neurological signs when compared to dogs that are treated medically? Clinical bottom line Category of research question Prognosis The number and type of study designs reviewed Ten papers were critically reviewed Strength of evidence Weak Outcomes reported For short-term success, owners reported an overall decrease in neurological signs associated with neurological dysfunction and an increase in quality of life after the initiation of either medical management or surgical management. Surgical management has a weak association with higher mortality or severe neurological signs in the immediate postoperative period Conclusion It is challenging to make a direct comparison between medical and surgical management but, overall, both strategies seemed to decrease neurological signs in the short term. There was a lack of evidence and available data about the efficacy of each for long-term control of neurological signs How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
{"title":"Does surgical or medical management of extrahepatic portosystemic shunts in dogs carry a better prognosis for the resolution and reduction of neurological dysfunction?","authors":"Julia Smachlo, W. Gordon-Evans","doi":"10.18849/ve.v7i1.360","DOIUrl":"https://doi.org/10.18849/ve.v7i1.360","url":null,"abstract":"PICO question \u0000In dogs with congenital extrahepatic portosystemic shunts that are treated with surgical attenuation what is the persistency, frequency, severity and outcome of neurological signs when compared to dogs that are treated medically? \u0000 \u0000Clinical bottom line \u0000Category of research question \u0000Prognosis \u0000The number and type of study designs reviewed \u0000Ten papers were critically reviewed \u0000Strength of evidence \u0000Weak \u0000Outcomes reported \u0000For short-term success, owners reported an overall decrease in neurological signs associated with neurological dysfunction and an increase in quality of life after the initiation of either medical management or surgical management. Surgical management has a weak association with higher mortality or severe neurological signs in the immediate postoperative period \u0000Conclusion \u0000It is challenging to make a direct comparison between medical and surgical management but, overall, both strategies seemed to decrease neurological signs in the short term. There was a lack of evidence and available data about the efficacy of each for long-term control of neurological signs \u0000 \u0000How to apply this evidence in practice \u0000The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. \u0000Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. \u0000 \u0000","PeriodicalId":257905,"journal":{"name":"Veterinary Evidence","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115415790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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