Different feline leukemia virus (FeLV) infection outcomes are possible in cats following natural exposure, such as progressive infections (persistent viremia), regressive infections (transient or no ...viremia followed by proviral persistence) and abortive infections (presence of only antibodies). Laboratory-based testing is currently required for categorization of infection outcomes in cats. The aim of this study was to evaluate the field performance of a novel, rapid, combination point-of-care (PoC) test kit commercially available in Europe (v-RetroFel
Ag/Ab; 2020-2021 version) to determine different FeLV infection outcomes by concurrent detection of FeLV antigen (p27) and antibodies against FeLV transmembrane envelope protein (p15E). A secondary aim was to evaluate the performance of the same test kit (v-RetroFel
FIV) to determine positive/negative feline immunodeficiency virus (FIV) infection status by the detection of antibodies to FIV capsid protein (p24) and transmembrane glycoprotein (gp40). Two cohorts of domestic cats were recruited and tested with v-RetroFel
using plasma or serum, including cats in Australia (
= 200) and cats in Germany (
= 170). Results from p27 antigen PoC testing, proviral DNA PCR, and neutralizing antibody testing or testing for antibodies against non-glycosylated surface unit envelope protein (p45) were used to assign cats to groups according to different FeLV infection outcomes. Testing with a laboratory-based FeLV p15E antibody ELISA was also performed for comparison. In the first cohort, v-RetroFel
Ag/Ab correctly identified 89% (109/122) FeLV-unexposed cats and 91% (21/23) progressive infections, but no regressive (0/23) or abortive (0/32) infections. In the second cohort, v-RetroFel
Ag/Ab correctly identified 94% (148/158) FeLV-unexposed cats and 100% (4/4) progressive infections, but no regressive (0/2) and only 17% (1/6) abortive infections. There was test agreement between v-RetroFel
Ab and the p15E laboratory ELISA in 58.9% of samples. As a secondary outcome of this study, the sensitivity and specificity of v-RetroFel
FIV testing in cohort 1 were 94.7% (18/19) and 98.3% (178/181), and in cohort 2, 30.0% (3/10) and 100.0% (160/160), respectively. Prior history of FIV vaccination did not produce any false-positive FIV results. In conclusion, v-RetroFel
Ag/Ab (2020-2021 version) was unable to accurately determine different FeLV infection outcomes in the field. Improvements of the test prior to application to field samples are required.
Feline immunodeficiency virus (FIV) is a retrovirus that can cause immunosuppression, co-morbidities, and neoplasia in infected cats, and is commonly tested for in veterinary clinics and animal ...shelters in Australia. FIV diagnosis using point-of-care (PoC) kits to detect FIV antibodies in Australia is complicated by the commercial availability of an inactivated whole-FIV vaccine. The aim of this study was to determine the accuracy of the RapidSTATUS™ FIV antibody test kit in FIV-vaccinated and FIV-unvaccinated cats in Australia. Plasma from pet cats of known FIV vaccination and FIV infection statuses (n = 361), comprised of 57 FIV-uninfected cats annually vaccinated against FIV, 10 FIV-uninfected cats with lapsed FIV vaccination histories, 259 FIV-unvaccinated/FIV-uninfected cats, and 35 FIV-infected cats, was tested. RapidSTATUS™ FIV testing had sensitivity of 97.1% (34/35) and specificity of 100% (326/326), with an overall accuracy of 99.7% (360/361). Additional testing was undertaken using plasma from FIV-uninfected cats recently administered a primary FIV vaccination course (n = 12) or an annual booster FIV vaccination (n = 10). RapidSTATUS™ FIV was 98.8% (81/82) accurate and 100% (32/32) accurate in cats recently administered primary or annual FIV vaccinations, respectively. The high level of accuracy of RapidSTATUS™ FIV (98.8–100%) therefore establishes this PoC kit as a DIVA (differentiating infected from vaccinated animals) test. RapidSTATUS™ FIV is recommended to aid animal shelters, veterinarians, and researchers in Australia to accurately determine FIV infection status, irrespective of FIV vaccination history.
To assess the association of patient and nursing education on sequential compression device compliance in patients who have undergone major obstetric or benign gynecologic procedures.
We performed a ...prospective observational study on all English-speaking patients who underwent cesarean delivery or benign gynecologic surgery and were prescribed to wear sequential compression devices postoperatively at a university medical center. The 4-month study was divided into 1-month segments. The first month consisted of baseline observations of compliance. The second month was comprised of structured patient education, the third month involved nursing education, and the final month included both interventions. Observations were made twice daily. All educational interventions and observations were performed by two coauthors. A patient was noted to be compliant if she was ambulating, sitting, or lying in bed with sequential compression devices applied, tubing attached, and the machine powered on.
A total of 859 observations was recorded for 228 patients. The number of hospitalization days ranged from 1 to 13 (mean 2.40 days, median 2 days). There was no difference in compliance among the months with 141 of 230 (61.3%), 106 of 194 (54.6%), 155 of 277 (56.0%), and 95 of 158 (60.1%) compliance for each consecutive month (P=.44). Noncompliance increased with each successive postoperative day (odds ratio 1.18 per day, 95% confidence interval 1.07-1.30). The most common patient-stated reason for noncompliance was "the nurse said I don't need them anymore" (82/362 observations 22.6%). Overall, cesarean delivery was associated with the lowest rate of compliance when compared with gynecologic surgeries (272/519 52.4% compared with 225/340 66.2%, P<.001).
Compliance with postoperative use of sequential compression devices is approximately 58% and did not improve with patient or nursing educational interventions.
III.
ABSTRACTPostoperative venous thromboembolism occurs in a significant proportion of women undergoing major gynecologic surgery and cesarean delivery. Prophylactic use of sequential compression devices ...(SCDs) is a well-established method for prevention of venous thromboembolism in these and other surgical patients. Medical guidelines recommend continuous use of pneumatic compression devices until ambulation and discontinuation only at the time of discharge. Few studies have assessed compliance to these devices in postoperative benign gynecology surgery and cesarean delivery settings.The aim of this prospective observational study was to assess compliance to SCDs in patients who have undergone major obstetric or benign gynecologic procedures and to determine whether use of nursing and patient education about venous thromboembolism prevention would improve compliance. The study was conducted from October 2012 to April 2013 at a university medical center. Subjects were English-speaking patients who underwent cesarean delivery or benign gynecologic surgery and had been prescribed to wear SCDs throughout hospitalization. The study was divided into four 1-month segments. The first month was a period of baseline observations of compliance by a coauthor. The second month involved structured patient education, the third month involved structured nursing education, and the final month included both interventions. Observations of compliance were made twice daily. Educational interventions and observations were performed by the coauthors. Compliance was defined as ambulation or lying in bed with SCDs applied, tubing attached, and the machine powered on, or sitting in a chair (with or without SCDs applied).During the study period, 859 observations were recorded for 228 patients. The mean number of hospitalization days was 2.4 (range, 1–13 days). There was no significant difference in compliance among the 4 segments. Compliance for each consecutive month was 141 (61.3%) of 230, 106 (54.6%) of 194, 155 (56.0%) of 277, and 95 (60.1%) of 158; P = 0.44. Noncompliance increased with each successive postoperative day; the adjusted odds ratio was 1.18 per day, with a 95% confidence interval of 1.07 to 1.30. The most common reasons given by patients for noncompliance were “the nurse said I don’t need them anymore” (82/362 observations 22.6%), “I just got back in bed, and no one has reapplied them” (n = 59 17.1%), and “I’ve been walking” (n = 63 16.3%). Overall, compliance following cesarean delivery was lower than gynecologic surgery (272/519 52.4% vs 225/340 66.2%, P < 0.001).These findings show that postoperative compliance with use of SCDs is approximately 58% and is not improved with patient or nursing educational interventions.
