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2024 ACVIM Forum Research Report Program 2024 年 ACVIM 论坛研究报告计划。
IF 2.1 2区 农林科学 Q1 VETERINARY SCIENCES Pub Date : 2024-09-23 DOI: 10.1111/jvim.17177

The American College of Veterinary Internal Medicine (ACVIM) Forum and the Journal of Veterinary Internal Medicine (JVIM) are not responsible for the content or dosage recommendations in the abstracts. The abstracts are not peer reviewed before publication. The opinions expressed in the abstracts are those of the author(s) and may not represent the views or position of the ACVIM. The authors are solely responsible for the content of the abstracts.

2024 ACVIM Forum

June 5–October 31, 2024

Research Report Program

Index of Abstracts

美国兽医内科学院(ACVIM)论坛和《兽医内科学杂志》(JVIM)不对摘要中的内容或剂量建议负责。摘要在发表前未经同行评审。摘要中表达的观点仅代表作者本人,可能不代表 ACVIM 的观点或立场。2024 年 ACVIM 论坛2024 年 6 月 5 日至 10 月 31 日研究报告计划摘要索引
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引用次数: 0
Evaluation of the efficacy of a live Escherichia coli biotherapeutic product (asymptomatic bacteriuria E. coli 212) 活大肠杆菌生物治疗产品(无症状菌尿大肠杆菌 212)的疗效评估
IF 2.1 2区 农林科学 Q1 VETERINARY SCIENCES Pub Date : 2024-09-16 DOI: 10.1111/jvim.17167
Gilad Segev, Hilla Chen, Jonathan D. Dear, Beatriz Martínez López, Jully Pires, David J. Klumpp, Anthony J. Schaeffer, Jodi L. Westropp

Background

Recurrent bacterial cystitis, often referred to as recurrent urinary tract infection (UTI), can be difficult to manage and alternative treatments are needed.

Hypothesis/Objective

Intravesicular administration of asymptomatic bacteriuria (ASB) E. coli 212 will not be inferior to antimicrobial treatment for the management of recurrent UTI in dogs.

Animals

Thirty-four dogs with >1 UTI in the 12 months before presentation.

Methods

All dogs were deemed normal otherwise based on absence of abnormalities on physical examination, CBC, serum biochemical panel, and abdominal ultrasonography. Dogs were randomized to 1 of 2 treatment groups: Group 1 antimicrobials for 7 days or group 2 intravesicular administration of ASB E. coli 212. Owners were provided a voiding questionnaire regarding their dogs' clinical signs, which was completed daily for 14 days to assess clinical cure. Dogs were examined on days 7 and 14 to assess clinical cure, and urine specimens were submitted for urinalysis and bacterial culture.

Results

Clinical cure rates for ASB E. coli 212–treated dogs were not inferior to 7 days of antimicrobial treatment with a 12% margin of difference to determine non-inferiority. No significant difference was found between the treatment groups on days 7 and 14 in the proportion of dogs achieving ≥50% or ≥75% reduction in their clinical score compared with baseline.

Conclusions and Clinical Importance

These data suggest that intravesicular administration of ASB E. coli 212 is not inferior to antimicrobials for the treatment of recurrent UTI in dogs. This biotherapeutic agent could help alleviate the need for antimicrobials for some dogs with recurrent UTI, improving antimicrobial stewardship.

背景复发性细菌性膀胱炎通常被称为复发性尿路感染(UTI),很难处理,需要替代疗法。方法根据体格检查、全血细胞计数、血清生化检查和腹部超声波检查无异常,认定所有狗的其他方面均正常。狗狗被随机分为两个治疗组:第 1 组使用抗菌药 7 天,第 2 组膀胱内注射 ASB 大肠杆菌 212。狗的主人会收到一份关于狗的临床症状的排尿问卷,每天填写,持续 14 天,以评估临床治愈情况。第 7 天和第 14 天对狗进行检查以评估临床治愈率,并将尿液标本送去进行尿液分析和细菌培养。结果经 ASB 大肠杆菌 212 治疗的狗的临床治愈率不低于 7 天的抗菌药治疗,差异幅度为 12% 以确定非劣效性。在第 7 天和第 14 天,与基线相比临床评分降低≥50% 或≥75% 的狗的比例在治疗组之间没有发现明显差异。这种生物治疗剂有助于减轻一些复发性 UTI 狗对抗菌药的需求,从而提高抗菌药管理水平。
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引用次数: 0
Endothelial glycocalyx degradation in critically ill foals 重症马驹的内皮糖萼降解
IF 2.1 2区 农林科学 Q1 VETERINARY SCIENCES Pub Date : 2024-09-14 DOI: 10.1111/jvim.17196
Diego E. Gomez, Ahmed Kamr, William F. Gilsenan, Teresa A. Burns, M. C. Mudge, Laura D. Hostnik, Ramiro E. Toribio

Background

Endothelial glycocalyx (EG) degradation occurs in septic humans and EG products can be used as biomarkers of endothelial injury. Information about EG biomarkers and their association with disease severity is lacking in hospitalized foals.

Objectives

Measure serum syndecan-1 (SDC-1), heparan sulfate (HS), angiopoietin-2 (ANG-2), aldosterone (ALD), and plasma atrial natriuretic peptide (ANP) concentrations and to determine their association with disease severity and death in hospitalized foals.

Animals

Ninety foals ≤3 days old.

Methods

Prospective, multicenter, longitudinal study. Foals were categorized into hospitalized (n = 74; 55 septic; 19 sick nonseptic) and 16 healthy foals. Serum ([SDC-1], [HS], [ANG-2], [ALD]) and plasma (ANP) were measured over 72 hours using immunoassays.

Results

Serum ([SDC-1], [HS], [ANG-2], [ALD]) and plasma (ANP) were significantly higher in hospitalized and septic than healthy foals (P < .05). Serum (ANG-2) and plasma (ANP) were significantly higher in hospitalized nonsurvivors than in survivors (P < .05). On admission, hospitalized foals with serum (HS) > 58.7 ng/mL had higher odds of nonsurvival (odds ratio [OR] = 6.1; 95% confidence interval [CI] = 1.02-36.7). Plasma (ANP) >11.5 pg/mL was associated with the likelihood of nonsurvival in hospitalized foals (OR = 7.2; 95% CI = 1.4-37.4; P < .05). Septic foals with serum (ANG-2) >1018 pg/mL on admission had higher odds of nonsurvival (OR = 6.5; 95% CI =1.2-36.6; P < .05).

Conclusion and Clinical Importance

Critical illness in newborn foals is associated with EG degradation and injury, and these biomarkers are related to the severity of disease on admission and the outcome of sick foals.

背景脓毒症患者的内皮糖萼(EG)会发生降解,EG产物可作为内皮损伤的生物标志物。目前还缺乏住院马驹的 EG 生物标志物及其与疾病严重程度的关系的相关信息。目的测量住院小马驹的血清辛迪加-1(SDC-1)、硫酸肝素(HS)、血管生成素-2(ANG-2)、醛固酮(ALD)和血浆心房利钠肽(ANP)浓度,并确定它们与疾病严重程度和死亡的关系。小马驹被分为住院小马驹(n = 74;55 患化脓性疾病;19 患非化脓性疾病)和 16 只健康小马驹。结果住院和败血症小马驹的血清([SDC-1]、[HS]、[ANG-2]、[ALD])和血浆(ANP)显著高于健康小马驹(P <.05)。非存活的住院马驹的血清(ANG-2)和血浆(ANP)明显高于存活马驹(P < .05)。入院时,血清(HS)> 58.7 ng/mL的住院马驹非存活几率更高(几率比 [OR] = 6.1; 95% 置信区间 [CI] = 1.02-36.7)。血浆(ANP)>11.5 pg/mL与住院马驹的非存活几率有关(OR = 7.2;95% CI = 1.4-37.4;P <.05)。入院时血清(ANG-2)>1018 pg/mL的化脓性小马驹非存活几率更高(OR = 6.5; 95% CI = 1.2-36.6; P <.05)。结论和临床意义新生小马驹的危重病与EG降解和损伤有关,这些生物标志物与入院时的疾病严重程度和病驹的预后有关。
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引用次数: 0
Effect of oral or subcutaneous administration of cyanocobalamin in hypocobalaminemic cats with chronic gastrointestinal disease or exocrine pancreatic insufficiency 口服或皮下注射氰钴胺对患有慢性胃肠道疾病或胰腺外分泌功能不全的低钴胺血症猫的影响
IF 2.1 2区 农林科学 Q1 VETERINARY SCIENCES Pub Date : 2024-09-13 DOI: 10.1111/jvim.17195
Chee-Hoon Chang, Jonathan Lidbury, Jan S. Suchodolski, Joerg M. Steiner

Background

No prospective study has evaluated the efficacy of oral supplementation with cobalamin in hypocobalaminemic cats.

Objectives

To investigate the efficacy of oral or SC supplementation with cyanocobalamin in normalizing serum cobalamin and methylmalonic acid (MMA) concentrations in hypocobalaminemic cats with chronic gastrointestinal disease (CGID) or exocrine pancreatic insufficiency (EPI).

Animals

Forty-eight client-owned hypocobalaminemic (<290 ng/L) cats with normal or abnormally high serum MMA concentrations.

Methods

This study was conducted based on the prospective randomized clinical trial method. Cats with CGID or EPI were randomly assigned to 2 groups that received either oral or SC supplementation with cobalamin (250 μg/cat) for 12 and 10 weeks, respectively, in addition to other medical and dietary interventions. Each cat was evaluated 3 times (baseline, 6-week postsupplementation, and 1-week postcompletion) by measuring serum cobalamin and MMA concentrations.

Results

In cats with CGID or EPI, cobalamin concentrations were normalized in all cats that received either oral or SC supplementation (mean 100% [95% CI: 80.6%-100%] in both groups in cats with CGID and 100% [67.6%-100%] in both groups in cats with EPI). Among 37 cats with elevated MMA concentrations at baseline (21 cats with CGID and 16 cats with EPI), MMA concentrations were normalized in most cats with CGID (70% in oral and 82% in SC group) or EPI (88% in both groups).

Conclusions and Clinical Importance

In hypocobalaminemic cats with CGID or EPI, in conjunction with other medical and dietary interventions, both oral and SC supplementation are effective at normalizing serum cobalamin and MMA concentrations.

背景目前还没有前瞻性研究评估口服钴胺素补充剂对低钴胺血症猫的疗效。目的研究口服或SC补充氰钴胺对患有慢性胃肠病(CGID)或胰腺外分泌功能不全(EPI)的低钴胺血症猫的血清钴胺素和甲基丙二酸(MMA)浓度恢复正常的疗效。动物48只客户饲养的低钴胺血症(<290 ng/L)猫,其血清MMA浓度正常或异常高。患有 CGID 或 EPI 的猫被随机分配到两组,除了其他医疗和饮食干预措施外,这两组分别在 12 周和 10 周内接受口服或皮下注射钴胺素补充剂(250 μg/猫)。结果在患有 CGID 或 EPI 的猫中,所有接受口服或皮下注射补充剂的猫的钴胺素浓度均恢复正常(CGID 猫两组的平均值均为 100% [95% CI:80.6%-100%],EPI 猫两组的平均值均为 100% [67.6%-100%])。在基线 MMA 浓度升高的 37 只猫咪中(21 只为 CGID 猫咪,16 只为 EPI 猫咪),大多数 CGID 猫咪(口服组为 70%,静脉注射组为 82%)或 EPI 猫咪(两组均为 88%)的 MMA 浓度已恢复正常。
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引用次数: 0
Response to letter regarding “Prospective randomized trial comparing relapse rates in dogs with steroid-responsive meningitis-arteritis treated with a 6-week or 6-month prednisolone protocol” 对有关 "类固醇反应性脑膜炎-动脉炎犬只接受 6 周或 6 个月泼尼松龙方案治疗后复发率比较的前瞻性随机试验 "信件的回复
IF 2.1 2区 农林科学 Q1 VETERINARY SCIENCES Pub Date : 2024-09-12 DOI: 10.1111/jvim.17189
Jeremy H. Rose, Colin J. Driver, Lorna Arrol, Thomas J. A. Cardy, Joana Tabanez, Anna Tauro, Ricardo Fernandes, Imogen Schofield, Sophie Adamantos, Nicolas Granger, Thomas R. Harcourt-Brown

We thank you for your considered comments.

We believe we have been transparent in our methodology and the limitations of the study, particularly relating to the sample size and therefore certainty of the results.

We credit our readers with the ability to draw their own conclusions on the statistical and clinical relevance of the work based on the study design. We believe this prospective, randomized, multicenter trial offers real-world findings that suggest a possibility that shorter prednisolone courses may be effective in treating SRMA, but agree this is not conclusive. As such, we used the word “could” in our statement, “both a ‘long’ 6-month or ‘short’ 6-week prednisolone protocol could be considered to treat SRMA cases.” It is possible neither prednisolone protocol used in our study is optimal because of the limited evidence on this topic to date. Hopefully this will be one of many studies to allow veterinary surgeons to optimize the medication and duration of the treatment to improve the quality of life for SRMA dogs.

We appreciate there may be a wider discussion concerning the utilization of P-values in veterinary clinical research and appreciate your perspective on this matter. However, beyond noting this, we feel it is not for us to comment further.

Regards,

我们相信我们在研究方法和研究局限性方面已经做到了透明,尤其是在样本量方面,因此结果的确定性也是如此。我们相信读者有能力根据研究设计就这项工作的统计和临床相关性得出自己的结论。我们认为,这项前瞻性、随机、多中心试验提供了真实世界的研究结果,表明较短的泼尼松龙疗程可能对治疗 SRMA 有效,但我们同意这并不是决定性的。因此,我们在声明中使用了 "可能 "一词,"可以考虑采用'长'6 个月或'短'6 周的泼尼松龙方案来治疗 SRMA 病例"。我们的研究中使用的泼尼松龙方案可能都不是最佳方案,因为迄今为止有关该主题的证据有限。希望这将成为众多研究中的一项,让兽医外科医生能够优化药物和疗程,以改善SRMA犬的生活质量。我们知道,关于在兽医临床研究中使用P值的问题可能会有更广泛的讨论,并感谢您对此事的看法。然而,除了注意到这一点之外,我们认为我们不应该发表更多评论、
{"title":"Response to letter regarding “Prospective randomized trial comparing relapse rates in dogs with steroid-responsive meningitis-arteritis treated with a 6-week or 6-month prednisolone protocol”","authors":"Jeremy H. Rose,&nbsp;Colin J. Driver,&nbsp;Lorna Arrol,&nbsp;Thomas J. A. Cardy,&nbsp;Joana Tabanez,&nbsp;Anna Tauro,&nbsp;Ricardo Fernandes,&nbsp;Imogen Schofield,&nbsp;Sophie Adamantos,&nbsp;Nicolas Granger,&nbsp;Thomas R. Harcourt-Brown","doi":"10.1111/jvim.17189","DOIUrl":"10.1111/jvim.17189","url":null,"abstract":"<p>We thank you for your considered comments.</p><p>We believe we have been transparent in our methodology and the limitations of the study, particularly relating to the sample size and therefore certainty of the results.</p><p>We credit our readers with the ability to draw their own conclusions on the statistical and clinical relevance of the work based on the study design. We believe this prospective, randomized, multicenter trial offers real-world findings that suggest a possibility that shorter prednisolone courses may be effective in treating SRMA, but agree this is not conclusive. As such, we used the word “could” in our statement, “both a ‘long’ 6-month or ‘short’ 6-week prednisolone protocol could be considered to treat SRMA cases.” It is possible neither prednisolone protocol used in our study is optimal because of the limited evidence on this topic to date. Hopefully this will be one of many studies to allow veterinary surgeons to optimize the medication and duration of the treatment to improve the quality of life for SRMA dogs.</p><p>We appreciate there may be a wider discussion concerning the utilization of <i>P</i>-values in veterinary clinical research and appreciate your perspective on this matter. However, beyond noting this, we feel it is not for us to comment further.</p><p>Regards,</p>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":"38 5","pages":"2414"},"PeriodicalIF":2.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142222370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of fecal microbiota transplantation on clinical outcomes and fecal microbiota of foals with diarrhea 粪便微生物群移植对腹泻马驹临床结果和粪便微生物群的影响
IF 2.1 2区 农林科学 Q1 VETERINARY SCIENCES Pub Date : 2024-09-12 DOI: 10.1111/jvim.17185
Jillian Bell, Sharanne L. Radial, Rosemary S. Cuming, Gareth Trope, Kristopher J. Hughes

Background

Diarrhea in foals can be associated with disruption of the intestinal microbiota (dysbiosis). Effective management of intestinal dysbiosis in foals has not been demonstrated.

Hypothesis/Objectives

Fecal microbiota transplantation (FMT) in foals with diarrhea influences the intestinal microbiota and improves clinical and clinicopathological outcomes.

Animals

Twenty-five foals <6 months of age with diarrhea and systemic inflammatory response syndrome at 3 veterinary hospitals.

Methods

A prospective randomized placebo-controlled cohort study. Foals in the FMT group (n = 19) or control group (n = 9) received FMT or electrolyte solution once daily for 3 days. Fecal samples were obtained on Day 0 (D0), D1, D2, D3, and D7. Within group and between group data analyses were performed for clinical, clinicopathological, and microbiota variables.

Results

Treatment had no effect on survival (FMT 79%; control 100%, P = .3) or resolution of diarrhea (FMT 68%; control 55%, P = .4). On D3, the white blood cell count of the FMT group was lower than the control group (D3 FMT group median 6.4 g/L [5-8.3 g/L]; D3 control group median 14.3 g/L [6.7-18.9 g/L] P = .04). Heart rate reduced over time in the FMT group (D0 median 80 bpm [60-150 bpm]; D2 median 70 bpm [52-110 bpm] [P = .005]; and D3 median 64, [54-102 bpm] [P < .001]). Phylum Verrucomicrobiota, genus Akkermansia, and family Prevotellaceae were enriched in the FMT group on D1 (linear discriminate analysis > 4).

Conclusions and Clinical Importance

In foals with diarrhea, FMT appears safe and can be associated with some clinical and microbiota changes suggestive of beneficial effect.

背景小马驹腹泻可能与肠道微生物群紊乱(菌群失调)有关。假设/目标对腹泻驹进行粪便微生物群移植(FMT)可影响肠道微生物群,并改善临床和临床病理结果。方法前瞻性随机安慰剂对照队列研究。FMT组(n = 19)或对照组(n = 9)的小马驹接受FMT或电解质溶液治疗,每天一次,连续3天。在第 0 天(D0)、D1、D2、D3 和 D7 天采集粪便样本。结果治疗对存活率(FMT 79%;对照组 100%,P = .3)或腹泻缓解率(FMT 68%;对照组 55%,P = .4)没有影响。D3时,FMT组的白细胞计数低于对照组(D3 FMT组中位数为6.4 g/L [5-8.3 g/L];D3对照组中位数为14.3 g/L [6.7-18.9 g/L] P = .04)。随着时间的推移,FMT 组的心率降低(D0 中位数为 80 bpm [60-150 bpm];D2 中位数为 70 bpm [52-110 bpm] [P = .005];D3 中位数为 64, [54-102 bpm] [P < .001])。在 D1 的 FMT 组中,富集了 Verrucomicrobiota 门、Akkermansia 属和 Prevotellaceae 科(线性判别分析 > 4)。
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引用次数: 0
Effect of repetitive transcranial magnetic stimulation on trigeminal-mediated headshaking in 17 horses 重复经颅磁刺激对 17 匹马三叉神经介导的摇头的影响
IF 2.1 2区 农林科学 Q1 VETERINARY SCIENCES Pub Date : 2024-09-12 DOI: 10.1111/jvim.17194
Vanessa Franzen, Nina Alexandra Gruber, Sven Klußmann, Angelika Schoster, Anna May

Background

Trigeminal-mediated headshaking is a neuropathic facial pain condition in horses. No treatment has been entirely successful. Repetitive transcranial magnetic stimulation (rTMS) is used in human medicine as a treatment for various neuropathic pain conditions, and good results have been achieved in cases of trigeminal neuralgia.

Objectives

Apply rTMS to horses with trigeminal-mediated headshaking (TMHS) and to evaluate tolerability, application of the setting, and success rate.

Animals

Seventeen horses with nonseasonal signs of TMHS.

Methods

Other underlying causes of headshaking were ruled out. The rTMS was performed under standing sedation on 5 consecutive days applying 3 sets of 500 stimulations each, with a stimulation strength of 5 Hz. Horses were evaluated on Day 1 (t0) and Day 5 (t1) of the treatment and 2 (t2) and 4 weeks (t3) afterwards using a special scoring system.

Results

The rTMS was well tolerated. Headshaking signs during exercise were decreased by 70% (Day 5; t1). Four weeks after rTMS, signs were still decreased (mean reduction of 50%) during exercise. Improvement of mean resting and exercise scores was significant (P < .05) and effect sizes between pretreatment and all time points after treatment (t1, t2, t3) were large (>±0.8).

Conclusions and Clinical Importance

Repetitive transcranial magnetic stimulation may be a promising treatment for neuropathic pain and headshaking in affected horses. Pain-free periods after treatment differ individually, and repeated treatment may be necessary. More studies should be performed to determine ideal settings for horses.

背景三叉神经介导的摇头症是马的一种神经性面部疼痛。目前还没有完全成功的治疗方法。目的 对患有三叉神经介导的摇头症(TMHS)的马匹应用经颅磁刺激(rTMS),并评估其耐受性、应用环境和成功率。连续 5 天在站立镇静状态下进行经颅磁刺激,每组 500 次,共 3 组,刺激强度为 5 Hz。在治疗的第 1 天(t0)和第 5 天(t1)以及治疗后的第 2 天(t2)和第 4 周(t3),使用特殊的评分系统对马匹进行评估。运动时的摇头症状减少了 70%(第 5 天;t1)。经颅磁刺激治疗四周后,运动时的摇头症状仍有减少(平均减少50%)。静息和运动时的平均评分改善显著(P <.05),治疗前和治疗后所有时间点(t1、t2、t3)之间的效应大小较大(>±0.8)。治疗后的无痛时间因人而异,可能需要重复治疗。应开展更多研究,以确定适合马匹的理想设置。
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引用次数: 0
Treatment of a urethral stricture by image-guided placement of a custom-made absorbable stent in a standing, sedated horse 在图像引导下为站立的镇静马放置定制的可吸收支架治疗尿道狭窄
IF 2.1 2区 农林科学 Q1 VETERINARY SCIENCES Pub Date : 2024-09-12 DOI: 10.1111/jvim.17181
Milda Baltrimaite, Clodagh Kearney, Anne O'Brien, Michael Duggan, Benoît Cuq

A 10-year-old Irish Sport Horse gelding developed complications from a general anesthesia resulting in sling support and recurrent urinary catheterization. The horse subsequently presented signs of dysuria and pollakiuria, was diagnosed with sabulous cystitis, and developed a urethral stricture from the repeated catheterizations, which was confirmed on urethroscopy. Clinical signs persisted despite conservative management with topical corticosteroids and urethral bougienage with balloon dilators. An image-guided approach was used to treat the stricture with a custom-made polydioxanone stent placed in the urethra after which the horse was able to void normally and fully empty his bladder. Repeat urethroscopy and ultrasonography 6 months after the procedure showed the stent to have completely reabsorbed with urethra remaining patent. Nineten months after the procedure, the owner reports the horse remaining at his intended level of athletic performance with no dysuria.

一匹 10 岁的爱尔兰运动马公马因全身麻醉导致吊带支撑和反复导尿而出现并发症。该马随后出现排尿困难和花粉尿症状,被诊断为剑突性膀胱炎,并因反复导尿而导致尿道狭窄,尿道镜检查证实了这一点。尽管采取了局部皮质类固醇和使用球囊扩张器进行尿道扩张的保守治疗,但临床症状依然存在。在图像引导下,医生在尿道中放置了一个定制的聚二氧酮支架来治疗狭窄,之后这匹马就能正常排尿并完全排空膀胱了。术后 6 个月再次进行尿道镜检查和超声波检查,结果显示支架已完全吸收,尿道仍然通畅。术后 9 个月,马主报告说这匹马的运动表现仍保持在预期水平,没有排尿困难。
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引用次数: 0
Letter regarding “Prospective randomized trial comparing relapse rates in dogs with steroid-responsive meningitis-arteritis treated with a 6-week or 6-month prednisolone protocol” 关于 "类固醇反应性脑膜炎-动脉炎犬只接受 6 周或 6 个月泼尼松龙方案治疗后复发率比较的前瞻性随机试验 "的信件
IF 2.1 2区 农林科学 Q1 VETERINARY SCIENCES Pub Date : 2024-09-12 DOI: 10.1111/jvim.17188
Andrew Woodward
<p>I read with interest the article “Prospective randomized trial comparing relapse rates in dogs with steroid-responsive meningitis-arteritis treated with a 6-week or 6-month prednisolone protocol.”<span><sup>1</sup></span> I am concerned that the article contains substantial misinterpretations of statistical evidence, which undermine the reliability of the authors' conclusions.</p><p>Unfortunately, the phrase “no significant difference” may be deeply misleading unless it is correctly interpreted, under the unintuitive logic of frequentist hypothesis tests, and has led the authors to a mistake; it may be true that the interventions are practically exchangeable, but that conclusion cannot be reached from “not significant.” The <i>P</i>-value resulting from frequentist hypothesis tests represents an approximation of the probability that data more extreme than the data at hand would be observed, if the test hypothesis was true; where “probability” represents the frequency in a hypothetical series of identical repeated trials, and the test hypothesis is some statistical model including its parameters.<span><sup>2</sup></span></p><p>The <i>P</i>-value is calculated under the assumption that the test hypothesis (whatever it is) is true, so never indicates support for the test hypothesis, which would involve circular reasoning. Though the “evidential” meaning of <i>P</i>-values is contested and generally dubious,<span><sup>3</sup></span> in simple terms the <i>P</i>-value can be considered a summary of the evidence provided by the data to <i>refute</i> the test hypothesis,<span><sup>4</sup></span> or equivalently, an expression of how surprising it would be to observe data at least as extreme as these, if the test hypothesis was in fact true.<span><sup>2</sup></span> Though a small <i>P</i>-value may suggest (charitably) that some aspect of the test hypothesis is untrue, the usage advocated by Fisher, a large <i>P</i>-value does not support that it is true, because it says nothing about other test hypotheses (in this case, difference between interventions) with which the data may be compatible. It is, therefore, incorrect to conclude anything substantive from a large <i>P</i>-value. Unfortunately, the incorrect interpretation that a large <i>P</i>-value indicates that an effect or association is absent appears common in clinical trials reporting.<span><sup>5</sup></span></p><p>An emphasis on confidence intervals may mitigate some of the limitations of reasoning based on hypothesis tests, even if their exact meaning is unintuitive. This is a popular view,<span><sup>6</sup></span> and is generally encouraged by relevant reporting guidelines. Considering the authors' estimate of the relative incidence risk (which they express as odds ratio) of at least one relapse, which they state as 1.40 (95% CI: 0.40, 4.96, <i>P</i> = 0.60), the confidence interval represents, in simple terms, the set of values of the parameter of interest (test hypotheses) with which
我饶有兴趣地阅读了《比较类固醇反应性脑膜炎-动脉炎患犬接受 6 周或 6 个月泼尼松龙方案治疗后的复发率的前瞻性随机试验》1 一文,我担心的是,该文对统计证据进行了大量曲解,从而削弱了作者结论的可靠性。不幸的是,根据频繁假设检验的非直觉逻辑,除非正确解释,否则 "无显著差异 "这一短语可能会严重误导读者,并导致作者犯了一个错误;干预措施实际上可以交换可能是真的,但这一结论不能从 "无显著差异 "中得出。频繁假设检验得出的 P 值代表的是,如果检验假设为真,那么观察到比当前数据更极端数据的概率的近似值;其中 "概率 "代表的是假设的一系列相同重复试验中的频率,而检验假设则是某种统计模型,包括其参数2 。虽然 P 值的 "证据 "意义存在争议,而且一般都值得怀疑3 ,但简单地说,P 值可以被视为数据提供的反驳检验假设的证据的总结4 ,或者说,如果检验假设确实成立,那么观察到至少与这些数据一样极端的数据会是多么令人惊讶2。虽然小的 P 值可以(善意地)表明检验假设的某些方面是不真实的,但按照费雪所主张的用法,大的 P 值并不支持检验假设是真实的,因为它对数据可能与之相符的其他检验假设(在本例中为干预之间的差异)只字未提。因此,从大 P 值得出任何实质性结论都是不正确的。不幸的是,临床试验报告中经常出现这样的错误解释,即大 P 值表明不存在效应或关联。5 强调置信区间可以减轻基于假设检验推理的一些局限性,即使其确切含义并不直观。这是一种流行的观点6 ,也是相关报告指南所普遍鼓励的。考虑到作者估计的至少一次复发的相对发病风险(以几率比表示)为 1.40(95% CI:0.40, 4.96,P = 0.60),简单地说,置信区间代表了与数据合理一致的一组相关参数值(检验假设);从某种意义上说,是手头数据无法排除的参数值。虽然我自认不擅长评估神经病学中的干预效果大小,但从表面价值来看,这个区间还是相当宽的;数据显示,每 6 周一次的干预可使复发几率降低约 2.5(1/0.40),或使复发几率增加约 5 倍。这项研究为支持每 6 周一次的干预措施提供了多大程度的证据,这在很大程度上取决于对提名不确定区间内所有效应的背景解释,而作者并没有提供这种解释。8 在大多数情况下,我认为兽医临床研究人员最好将 "显著性"、P 值阈值及相关概念完全搁置一边,将注意力集中在估计值及其不确定性上。
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引用次数: 0
Malignant transformation of an intraparenchymal hemangioma in the cervical spinal cord of a German shepherd dog 德国牧羊犬颈脊髓实质内血管瘤的恶性转化
IF 2.1 2区 农林科学 Q1 VETERINARY SCIENCES Pub Date : 2024-09-11 DOI: 10.1111/jvim.17190
Courtney P. Korff, Sophie Nelissen, Amy B. Todd-Donato, Andrew D. Miller, Emma Davies

An 8-year-old female spayed German shepherd dog was presented for evaluation of a 1-week history of right thoracic limb monoparesis. Magnetic resonance imaging (MRI) identified an intraparenchymal, T2 hypointense and T1 isointense, strongly heterogeneously contrast-enhancing mass with moderate internal susceptibility artifact on T2* images at the level of the cranial extent of the C5 vertebral body. Euthanasia was elected after a rapid neurologic decline in the 24 hours after MRI. Necropsy and histopathology identified an intraparenchymal hemangiosarcoma arising from a hemangioma in the cervical spinal cord, with no evidence of neoplastic disease in any other examined organs. The spectrum of vasoproliferative disorders in the central nervous system in veterinary species has been codified recently, but hemangiosarcoma is considered metastatic to the central nervous system. Herein we describe the clinical, imaging, and histologic findings in a dog with a novel primary location of hemangiosarcoma in the cervical spinal cord.

一只 8 岁的雌性德国牧羊犬因 1 周前出现右侧胸肢单瘫而前来就诊。磁共振成像(MRI)发现,在C5椎体颅内水平,有一个软组织内、T2低密度、T1等密度、强异质对比度增强的肿块,T2*图像上有中度内易感伪影。在核磁共振成像后的 24 小时内,该患者的神经功能迅速衰退,因此选择了安乐死。尸体解剖和组织病理学检查发现,颈脊髓内的血管瘤引发了实质内血管肉瘤,其他检查器官均无肿瘤性疾病的证据。最近,兽类中枢神经系统血管增生性疾病的范围已被明确,但血管肉瘤被认为是中枢神经系统的转移性疾病。在此,我们描述了一只原发部位位于颈脊髓的新型血管肉瘤犬的临床、影像学和组织学检查结果。
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引用次数: 0
期刊
Journal of Veterinary Internal Medicine
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