Clinical pathology Flashcards
Symmetric Dimethylarginine and Renal Function Analysis in Horses with Dehydration
-mod correlation with creatinine at admission in dehydrated horses, seems to be less affected by dehydration/extrarenal factors. (still positive correlation with rehydration= increase in GFR?)
- no association with prognosis
-no info on AKI in this study (1 case)
-serial monitoring likely more helpful
-Changes in SDMA concentrations within 12 h were positively correlated with changes in the concentrations of creatinine (r = .441, P = .001) and the GGT/creatinine ratio (r = .691, P = .02)- ischemia during rehydration?
Plasma Syndecan-1 as a Biomarker for Endothelial Glycocalyx Degradation in Septic adult horses
-Syndecan-1 levels were highest in septic horses (50.73 ± 84.24 μg/ml) compared to healthy (15.69 ± 11.28 μg/ml) and non-septic (16.88 ± 15.30 μg/ml) groups.
- Mild correlation with syndecan 1 and SIRS score (r2= 0.0307). No correlation with age.
-No difference between healthy and non-septic groups.
–> EG degredation occuring. Some evidence that normal is less than for humans- RR not established. Serial monitoring may be more useful.
- is also increased in non septic diseases, particularly ichemia reperfusion and intestinal injury.
-associated with prognosis not assessed
Concentrations of neutrophil gelatinase-associated lipocalin are increased in serum and peritoneal fluid from horses with inflammatory abdominal disease and non-strangulating intestinal infarctions
-Horses with NSII and inflammatory abdominal diseasehad higher serum and peritoneal fluid concentrations of NGAL than the other groups (p < 0.001).
- Peritoneal fluid NGAL concentrations in horses with NSII were higher than in horses with inflammatory abdominal disease (p = 0.03).
- Serum NGAL increased with duration of colic (peritoneal trended but no specific interval differences)
-seruma and peritoneal NGAL moderately correlated (r=.5). serum NGAL corrleated with inflammatory markers, and peritoneal NGAL correlated with peritoneal WCC (r=.6)
- differential expression in peritoneal fluid may differentiate NSII that may need Sx
-Rapid rise and fall pattern
Serum SDMA in Healthy Neonatal Thoroughbreds
-Cut off 168. All above adult normal (14) and limit for renal disease (32).
-Decreased with age- higher than adults at 6 months
- some evidence correlation with spuriouas hypercreatinaemia, but underpowered to investigate this.
- pos causes, increased arginine methylation, reduced liver clearance??
- TB only, small numbers and limited information on subclinical renal disease. Short follow up
Agreement of Stall-Side and Laboratory Crossmatch Tests with Reference Standard
KIT sensitivity: 91.4%, specificity: 73.5%. (100% Se for Aa, Ca). Substantial agreement 0.65
LAB sensitivity: 77.1%, specificity: 77.8%. (100% Se for Qab, Ca. Poor for Aa.). Mod agreement 0.55
Aim 2: KIT vs LAB in untyped, n-156
Fair agreement: 0.26 (0.52 for just TBs, 0.69 for just WBs)
KIT better for TBs where 85% Qa + (poor for SB), lab better for SB.
Se/Sp vary depending on prevalence in population so should repeat measurments on target population before use
Serum Amyloid A in Diagnosing Sepsis in Equine Neonates
Median SAA in septic foals: 114 µg/mL. Significantly greater than for other groups.
- For healthy vs septic: At diagnostic threshold of 100ug/ml, Sensitivity: 52.9%, specificity: 97.5%. High specificity but moderate sensitivity. PPV 75%, NPV 93.7%. AUC ROC curve 0.806
-could not distinguish healthy from SNS
-serial measurements may improve Se
Venous Blood Gas Parameters in Sick Neonatal Foals: Dirtect venepuncture vs push-pull
High agreement for most values,ICC >0.9 for most parameters at both time points.
except haematocrit (bias 3.24- -3.52, ICC 0.669)and PvO2 (bias -5.8 , ICC 0.733)
Not possible to withdraw blood in 3 foals (with otherwise normal IVC)
Did not assess IVC complications as a result (study stopped after 2nd pull at 24h)
Measurement of ANP, BNP, and Endothelin-1 in Jumping Horses with Valvular Regurgitation and their correlation with the dimensions of heart structures.
GENERALLY RUBBISH STUDY
Described an equine specific sandwich ELISA for measurement of ANP, BNP and endothelin-1
Association between BNP and valvular regurgitation, BNP and endothelin-1 and PR
ANP and endothelin-1 were correlated with ventricular width
Effect of Freeze-Thaw Cycles on ACTH Determination in Horses
- Freeze thaw cycles had a significant reduction in ACTH. This was more profound (after 1 cycle vs 3) in horses with PPID
-Resulted in missed diagnosis in 2 (1 93->10) and missing 3 equivocal cases. No FP
-17% drop after 1 cycle, lots after 3. - also occurred after TRH stimulation
-? more vulnerable in PPID- the ACTH forms are slighlty different- different origina and structure? - recommend not freezing, or if necessary then 2 cycles mac
Is Serum Amyloid A Elevated in Horses with Equine Gastric Ulcer Syndrome?
No signinficant increase of SAA with EGUS or type of ulceration. Medians all within rr.
Fibrinogen Heterogeneity in Horses
- 2 types of fibrinogen exist- HMWT and LMWT (LMWT may be ex vivo degredation but regardless will be present in lab sample_
-this may affect measurment, particularly with EDTA samples
-Only 5 horses, and samples pooled
SDMA and Creatinine in Healthy Draft Horses
-cut off 14ug/dl >6mo
-higher in Clydesdales than other Draft horses- not clinically significant
-correlated with creatinine but not BUN
-assay performed well relative to MS. Stable for up to a week in storage.
-no associated with age, weight or sex
-Adult horses only.
-further associations with GFR need more work
SAA as a marker to detect sepsis and predict outcome in hospitalised foals
-SAA can rule out sepis (cut off 1050) Se 30% Sp 90%
-SAA can suggest non survival (cut off 1250). Se22% Sp 98%
- concentrations of SAA increased with increasing sepsis score and differed between septic and nonseptic foals, and survivors and nonsurvivors
-recommend repeated measures, lower cut offs or combining with other biomarkers
-is a more robust study than other one with 34 foals- more representative of a referral centre population
Paraoxonase-1 Activity as a diagnostic and prognostic marker in Horses and Foals with SIRS
- Highly Sp (100%), poor Se (28%)
- association between PON-1 category (high or low) and SIRS score.
- any decreases in PON were generally transient.
- decreased PON -> OR poor PX 2.4-3.9
?different metabolism of paraoxonase-1 in horses, lower magnitude of oxidation associated with SIRS in this species or the sensitivity of the assessment of SIRS status in identifying SIRS-positive horses.
Systemic Serum Amyloid A in Early Diagnosis of Synovial Structure Involvement
SAA is insufficient for the diagnosis of synovial sepsis-> synovial fluid analysis better
similar increases with penetrating injury vs sepsis. (around 200)
