In response to concerns regarding numerous complex issues facing the veterinary specialty profession, several organizations, including the American College of Veterinary Internal Medicine, have made ...a clarion call to the American Veterinary Medical Association to begin discussions surrounding the formation of an accrediting body for internships, residencies, and fellowships. A proposed name for such a body is the Accreditation Council on Graduate Veterinary Medical Education, in alignment with the Accreditation Council on Graduate Medical Education (ACGME); the term “graduate” refers to specialty education that occurs after the first 4 years of the MD or DVM degree. Although the structure and financing of graduate education differ between the human medical and veterinary professions, we can nevertheless learn much from the history of evolution of human medical specialization as we navigate the path ahead.
Left-sided breast cancer patients receiving adjuvant radiotherapy are at risk for coronary artery disease, and/or radiation mediated effects on the microvasculature. Previously our laboratory ...demonstrated in canines with hybrid .sup.18 FDG/PET a progressive global inflammatory response during the initial one year following treatment. In this study, the objective is to evaluate corresponding changes in perfusion, in the same cohort, where resting myocardial blood flow (MBF) was quantitatively measured. In five canines, Ammonia PET (.sup.13 NH.sub.3) derived MBF was measured at baseline, 1-week, 1, 3, 6 and 12-months after cardiac external beam irradiation. MBF measurements were correlated with concurrent .sup.18 FDG uptake. Simultaneously MBF was measured using the dual bolus MRI method. MBF was significantly increased at all time points, in comparison to baseline, except at 3-months. This was seen globally throughout the entire myocardium independent of the coronary artery territories. MBF showed a modest significant correlation with .sup.18 FDG activity for the entire myocardium (r = 0.51, p = 0.005) including the LAD (r = 0.49, p = 0.008) and LCX (r = 0.47, p = 0.013) coronary artery territories. In this canine model of radiotherapy for left-sided breast cancer, resting MBF increases as early as 1-week and persists for up to one year except at 3-months. This pattern is similar to that of .sup.18 FDG uptake. A possible interpretation is that the increase in resting MBF is a response to myocardial inflammation.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
•These guidelines provide recommendations for the diagnosis and management of bacterial urinary tract infections in dogs and cats.•Sporadic bacterial cystitis, recurrent bacterial cystitis, ...pyelonephritis, bacterial prostatitis, and subclinical bacteriuria are addressed.•Issues pertaining to urinary catheters, medical dissolution of uroliths and prophylaxis for urological procedures are discussed.
Urinary tract disease is a common clinical presentation in dogs and cats, and a common reason for antimicrobial prescription. This document is a revision and expansion on the 2011 Antimicrobial Use Guidelines for Treatment of Urinary Tract Disease in Dogs and Cats, providing recommendations for diagnosis and management of sporadic bacterial cystitis, recurrent bacterial cystitis, pyelonephritis, bacterial prostatitis, and subclinical bacteriuria. Issues pertaining to urinary catheters, medical dissolution of uroliths and prophylaxis for urological procedures are also addressed.
Case summary An indoor-only 6-year-old spayed female domestic cat was evaluated for a history of stertorous respiration. Skull radiographs revealed increased soft tissue density within the caudal ...aspect of the left nasal cavity. CT and rhinoscopy revealed a mass lesion in the choana, plus a smaller lesion, nearly completely occluding flow through the nasal passages. Rhinoscopy was used to collect a biopsy specimen from a fleshy, tan–yellow mass visualized in the caudal nasopharynx. Histopathology was diagnostic for Cryptococcus species infection and systemic antifungal therapy with fluconazole was initiated. Following a series of discordant results, serum samples were submitted to a veterinary diagnostic laboratory that utilized a cryptococcal antigen latex agglutination system with pretreatment of serum with pronase. Twenty-three months after the initial diagnosis, the cat’s serum cryptococcal antigen titer declined to 1:5 and the cat has responded well to continuing treatment. Relevance and novel information This case illustrates challenges associated with discordant test results for cryptococcal antigen among laboratories. Discordancies may be due to differences in assay design, or the underlying disease state itself, or whether serum is pre-treated with pronase; with some tests relying on the training and experience of the operator if the cryptococcal antigen detection test requires a subjective interpretation. It also resolves some confusion in the literature related to the assay types available and terminology used to describe them, and emphasizes the importance of considering cryptococcosis as an important differential for cats with upper respiratory signs, without nasal discharge, even if the cat is kept exclusively indoors.
Background
Superficial bacterial folliculitis (SBF) is usually caused by Staphylococcus pseudintermedius and routinely treated with systemic antimicrobial agents. Infection is a consequence of ...reduced immunity associated with alterations of the skin barrier and underlying diseases that may be difficult to diagnose and resolve; thus, SBF is frequently recurrent and repeated treatment is necessary. The emergence of multiresistant bacteria, particularly meticillin‐resistant S. pseudintermedius (MRSP), has focused attention on the need for optimal management of SBF.
Objectives
Provision of an internationally available resource guiding practitioners in the diagnosis, treatment and prevention of SBF.
Development of the guidelines
The guidelines were developed by the Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases, with consultation and advice from diplomates of the American and European Colleges of Veterinary Dermatology. They describe optimal methods for the diagnosis and management of SBF, including isolation of the causative organism, antimicrobial susceptibility testing, selection of antimicrobial drugs, therapeutic protocols and advice on infection control. Guidance is given for topical and systemic modalities, including approaches suitable for MRSP. Systemic drugs are classified in three tiers. Tier one drugs are used when diagnosis is clear cut and risk factors for antimicrobial drug resistance are not present. Otherwise, tier two drugs are used and antimicrobial susceptibility tests are mandatory. Tier three includes drugs reserved for highly resistant infections; their use is strongly discouraged and, when necessary, they should be used in consultation with specialists.
Conclusions and clinical importance
Optimal management of SBF will improve antimicrobial use and reduce selection of MRSP and other multidrug‐resistant bacteria affecting animal and human health.
Résumé
Contexte
La folliculite bactérienne superficielle (SBF) est généralement due à Staphylococcus pseudintermedius et traitée avec des agents antimicrobiens systémiques. L'infection est la conséquence d'une baisse de l'immunité associée à des altérations de la barrière cutanée et de maladies sous‐jacentes qui peuvent être difficiles à diagnostiquer et à résoudre; ainsi, la SBF est fréquemment récidivante et des traitements répétés sont nécessaires. L'émergence de bactéries multirésistantes, en particulier S. pseudintermedius résistante à la méticilline (MRSP) a attiré l'attention sur le besoin d'une gestion optimale de la SBF.
Objectifs
Fournir un guide de recommandations international disponible pour les praticiens pour le diagnostic, le traitement et la prévention de la SBF.
Développement des recommandations
Les recommandations ont été développées par le groupe de travail des recommandations antimicrobiennes de l'ISCAID (International Society for Companion Animal Infectious Diseases) avec la collaboration des diplômés des collèges américain et européen de dermatologie vétérinaire. Ils ont décrit les méthodes optimales de diagnostic et de gestion de la SBF, y compris l'isolement de l'organisme incriminé, les tests de sensibilité antimicrobiens, le choix de la molécule antimicrobienne, les protocoles thérapeutiques et les conseils sur le contrôle de l'infection. Une conduite est donnée sur les voies systémiques et topiques ainsi que les approches appropriées pour MRSP. Les molécules systémiques sont classées en trois groupes. Le premier groupe est utilisé quand le diagnostic est évident et les facteurs de risque pour la résistance antimicrobienne est absente. Sinon, les médicaments du deuxième groupe sont utilisés et des tests de sensibilité antimicrobienne sont nécessaires. Le troisième groupe inclus les molécules réservées pour les infections hautement résistantes, leur utilisation est fortement déconseillée et si nécessaire, elles doivent être utilisées en concertation avec des spécialistes.
Conclusions et importance clinique
La gestion optimale e SBF doit améliorer l'usage des antimicrobiens et diminuer la sélection des MRSP et d'autres bactéries multirésistantes affectant l'animal et la santé humaine.
Resumen
Introducción
la foliculitis superficial bacteriana (SBF) esta generalmente causada por Staphylococcus pseudintermedius y de forma rutinaria tratada con antimicrobianos sistémicos. La infección es consecuencia de la reducida inmunidad asociada con alteraciones de la barrera de la piel y debido a enfermedades primarias que pueden dificultar el diagnostico y el tratamiento; así pues SBF es con frecuencia recidivante y se necesitan tratamientos repetidos. La aparición de multiresistencia bacteriana, particularmente S. pseudintermedius resistente a meticilina (MRSP), ha centrado la atención en la necesidad de un manejo optimo de la SBF.
Objetivos
la provisión de un recurso disponible a nivel internacional que guíe a veterinarios en el diagnostico, tratamiento y prevención de SBF.
Desarrollo de las directrices
las directrices fueron desarrolladas por el Grupo de Trabajo de Directrices Antimicrobianas de la Sociedad Internacional de Enfermedades Infecciosas de Pequeños Animales, consultando y recibiendo consejos de diplomados de los colegios Americano y Europeo de Dermatología Veterinaria. Estas directrices describen los métodos óptimos para el diagnostico y manejo de SBF, incluyendo aislamiento del agente causal, pruebas de susceptibilidad antimicrobiana, selección de fármacos antimicrobianos, protocolos terapéuticos y consejos para el control de la infección. Se aportan directrices para las modalidades de tratamiento tópico y sistémico, incluyendo pautas adecuadas para MRSP. Los fármacos sistémicos se clasifican en tres niveles. Los fármacos del nivel uno se usarían cuando el diagnóstico es claro y no existen factores de riesgo para el desarrollo de resistencia antimicrobiana. En caso contrario, se utilizarían fármacos del nivel dos y son obligatorios el cultivo y pruebas de susceptibilidad. En el nivel tres se incluyen fármacos reservados para infecciones altamente resistentes; su uso no es recomendable y cuando sean necesarios, deben utilizarse tras consulta con un especialista.
Conclusiones e importancia clínica
el manejo optimo de SBF mejorará el uso de antimicrobianos y reducirá la selección de MRSP y otras bacterias multiresistentes que pueden afectar a la salud humana y animal.
Zusammenfassung
Hintergrund
Die superfizielle bakterielle Follikulitis (SBF) wird üblicherweise von Staphylococcus pseudintermedius verursacht und routinemäßig mit systemischen Antibiotika behandelt. Eine Infektion ist die Konsequenz einer reduzierten Immunität, die mit Änderungen der Hautbarriere und zugrundeliegender Erkrankungen, deren Diagnose und Heilung manchmal schwierig sind, einhergeht; daher kehrt die SBF häufig wieder und eine Behandlung ist wiederholt nötig. Durch das Aufkommen von multiresistenten Bakterien, vor allem Methicillin‐resistentem S. pseudintermedius (MRSP), konzentriert sich die Aufmerksamkeit auf den Bedarf einer optimalen Behandlung der SBF.
Ziele
Bereitstellung einer international verfügbaren Quelle, die PraktikerInnen bei der Diagnose, der Behandlung und der Vorbeugung einer SBF unterstützt.
Entwicklung der Richtlinien
Die Richtlinien wurden von der Antimicrobial Guidelines Working Group der International Society for Companion Animal Infectious Diseases entwickelt, unter Beratung und mit Empfehlungen durch Diplomates der American und European Colleges für Veterinärdermatologie. Sie beschreiben optimale Methoden zur Diagnose und für das Management der SBF, die Folgendes beinhalten: Isolierung der verursachenden Keime, Kultur und Antibiogramme, Auswahl der antimikrobiellen Wirkstoffe, therapeutische Protokolle und Empfehlungen bezüglich Infektionskontrolle. Es werden Richtlinien erstellt für topische und systemische Modalitäten, die auch eine passende Herangehensweise für einen MRSP beinhalten. Die systemischen Wirkstoffe werden in drei Stufen klassifiziert. Die Wirkstoffe der Klasse eins werden eingesetzt, wenn die Diagnose eindeutig ist und keine Risikofaktoren für eine antimikrobielle Multiresistenz bestehen. Ansonsten werden Wirkstoffe der Stufe zwei verwendet, wobei Kultur und Antibiogramm obligatorisch durchgeführt werden sollten. Die Wirkstoffe der Stufe drei beinhalten Medikamente für hochresistente Infektionen; von ihrer Verwendung wird strengstens abgeraten und wenn nötig, sollte ihr Einsatz mit Spezialisten besprochen werden.
Schlussfolgerungen und klinische Bedeutung
Ein optimales Management von SBF wird die Verwendung von antimikrobiellen Wirkstoffen verbessern und die Selektion von MRSP und anderen multiresistenten Bakterien, die die tierische und die menschliche Gesundheit beeinträchtigen, reduzieren.
Background – Superficial bacterial folliculitis (SBF) is usually caused by Staphylococcus pseudintermedius and routinely treated with systemic antimicrobial agents. Infection is a consequence of reduced immunity associated with alterations of the skin barrier and underlying diseases that may be difficult to diagnose and resolve; thus, SBF is frequently recurrent and repeated treatment is necessary. The emergence of multiresistant bacteria, particularly meticillin‐resistant S. pseudintermedius (MRSP), has focused attention on the need for optimal management of SBF. Objectives – Provision of an internationally available resource guiding practitioners in the diagnosis, treatment and prevention of SBF. Conclusions and clinical importance – Optimal management of SBF will improve antimicrobial use and reduce selection of MRSP and other multidrug‐resistant bacteria affecting animal and human health.
Canine Infectious Respiratory Disease Reagan, Krystle L; Sykes, Jane E
The Veterinary clinics of North America. Small animal practice,
03/2020, Letnik:
50, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Canine infectious respiratory disease complex (CIRDC) refers to a syndrome of diseases that can be caused by several different bacterial and viral pathogens. These pathogens are often highly ...contagious, and coinfections are common. Clinical signs are frequently mild and self-limiting; however, some individual cases progress to severe disease. Clinical diagnosis of CIRDC is often based on history of exposure and physical examination findings; however, determining the etiologic agent requires application of specific diagnostic tests, and results can be difficult to interpret because of widespread subclinical infections.
Coccidioidomycosis is a potentially fatal fungal disease of humans and animals that follows inhalation of Coccidioides spp. arthroconidia in the environment. The disease in dogs resembles that in ...people, and because dogs may be at increased risk of exposure due to their proximity to the ground and digging behavior, they are valuable models for the disease in humans. Dogs have been sentinels for identification of new regions of endemicity in Washington and Texas. Canine serosurveillance has also been used to predict variables associated with environmental presence of Coccidioides spp. Expansion of the endemic region of coccidioidomycosis with climate change-along with predicted population increases and increased development in the southwest United States-may result in 45.4 million additional people at risk of infection by 2090. Here we provide an overview of the value of dogs as sentinels for the disease and encourage the routine reporting of coccidioidomycosis cases in dogs to public health agencies. We also highlight the value of dogs as naturally occurring models for studying novel treatment options and preventatives, such as a novel live avirulent coccidioidomycosis vaccine.
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