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Kupper J Waidyasekera D Schönenberger W Demuth D Althaus RF Naegeli H 《DTW. Deutsche tier?rztliche Wochenschrift》2004,111(11):433-438
Poisonings can cause reduced performance and severe economic loss in farm animals. A swift and targeted action is required from veterinarians. We have established a computer-based decision support system for poisonings in ruminants and pigs. The system offers access to the most recent information available in clinical toxicology of farm animals. Towards this goal, relevant reports from the peer-reviewed literature were evaluated and organised according to the requirements of a structured database. The information provided for each toxic substance includes a summary of its chemical and physical properties, sources, commercial uses or natural occurrences, toxicokinetic data, mechanisms of action, threshold doses, clinical symptoms with brief case reports, sampling and analytical results, post-mortem abnormalities, differential diagnoses, therapeutic guidelines and references to the literature. This decision support system has been programmed with two user-friendly search functions: a search tool that allows the choice of clinical and pathological findings, and another function that serves to find a substance using its chemical name, the class of compounds to wich it belongs, a possible source or one of its main applications. CliniTox can be accessed directly via our webserver (http://www.clinitox.ch). 相似文献
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Toews L 《Journal of veterinary medical education》2011,38(2):123-134
In human medicine, the information infrastructure that supports the knowledge translation processes of exchange, synthesis, dissemination, and application of the best clinical intervention research has developed significantly in the past 15 years, facilitating the uptake of research evidence by clinicians as well as the practice of evidence-based medicine. Seven of the key elements of this improved information infrastructure are clinical trial registries, research reporting standards, systematic reviews, organizations that support the production of systematic reviews, the indexing of clinical intervention research in MEDLINE, clinical search filters for MEDLINE, and point-of-care decision support information resources. The objective of this paper is to describe why these elements are important for evidence-based medicine, the key developments and issues related to these seven information infrastructure elements in human medicine, how these 7 elements compare with the corresponding infrastructure elements in veterinary medicine, and how all of these factors affect the translation of clinical intervention research into clinical practice. A focused search of the Ovid MEDLINE database was conducted for English language journal literature published between 2000 and 2010. Two bibliographies were consulted and selected national and international Web sites were searched using Google. The literature reviewed indicates that the information infrastructure supporting evidence-based veterinary medicine practice in all of the 7 elements reviewed is significantly underdeveloped in relation to the corresponding information infrastructure in human medicine. This lack of development creates barriers to the timely translation of veterinary medicine research into clinical practice and also to the conduct of both primary clinical intervention research and synthesis research. 相似文献
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Epidemiology in dairy production medicine strives to optimize production through the elimination and control of disease and the implementation of management practices that promote animal health, welfare, productivity, and profitability. Epidemiology in dairy production medicine is a broad discipline that encompasses many inter-related areas of activity. Quantitative epidemiology includes a range of activities, from counting clinical cases to the development of complex hierarchic decision models. Evaluation and interpretation of "tests" applied at various levels of the health management cycle serve as the basis for diagnostic and monitoring systems. Critical evaluation of the published scientific literature in the practice of evidence-based veterinary medicine facilitates the appropriate use of knowledge in support of health management decisions. 相似文献
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Assessment of the hazard associated with residues in food animals must be based on an accurate estimate of the residue levels present in the final food product, as well as animal toxicology studies to determine the potential untoward effects of these residues. Extrapolation of residue levels or toxic effects produced by the administration of a chemical in one species to predict residue levels or toxicology that may be produced by lower doses in the same species or by equivalent or lower doses in another species is associated inextricably with knowledge of the pharmacokinetics of the chemical. There are several factors that may influence the pharmacokinetics of xenobiotics which, if left unconsidered, may introduce uncertainty in the predictions of toxicity following any chemical exposure. Two of these factors are dose level and species differences. Because initial toxicity studies are designed to characterize the type of toxicity and to elucidate target organ effects the use of high doses is the accepted practice. However, because biotransformation and excretion of many chemicals are capacity-limited processes, extrapolation of toxicity to lower doses, without adequate pharmacokinetic information at those lower dose levels may result in overestimation of predicted toxicity. Furthermore, determination of tissue residue levels following administration of doses that saturate these processes may result in an overestimation of residues remaining following lower doses. Finally extrapolation of toxicity results across species may result in an over or underestimation of hazard without adequate information on the pharmacokinetics of the chemical in both species. 相似文献
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Bolon B Barale-Thomas E Bradley A Ettlin RA Franchi CA George C Giusti AM Hall R Jacobsen M Konishi Y Ledieu D Morton D Park JH Scudamore CL Tsuda H Vijayasarathi SK Wijnands MV 《Journal of toxicologic pathology》2010,23(3):171-181
The International Federation of Societies of Toxicologic Pathologists (IFSTP) proposes a common global framework for training future toxicologic pathologists who will support regulatory-type nonclinical toxicology studies. Trainees optimally should undertake a scientific curriculum of at least 5 years at an accredited institution leading to a clinical degree (veterinary medicine or medicine). Trainees should then obtain 4 or more years of intensive pathology practice during a residency and/or on-the-job "apprenticeship," at least 2 years of which must be focused on regulatory-type toxicologic pathology topics. Possession of a recognized pathology qualification (i.e., certification) is highly recommended. A non-clinical pathway (e.g., a graduate degree in medical biology or pathology) may be possible if medically trained pathologists are scarce, but this option is not optimal. Regular, lifelong continuing education (peer review of nonclinical studies, professional meetings, reading, short courses) will be necessary to maintain and enhance one's understanding of current toxicologic pathology knowledge, skills, and tools. This framework should provide a rigorous yet flexible way to reliably train future toxicologic pathologists to generate, interpret, integrate, and communicate data in regulatory-type, nonclinical toxicology studies. 相似文献
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Hirst WM Le Fevre AM Logue DN Offer JE Chaplin SJ Murray RD Ward WR French NP 《Veterinary journal (London, England : 1997)》2002,164(1):7-19
This paper presents the first systematic review of the literature on lameness in cattle. It identifies, tabulates and classifies relevant published work and was conducted using electronic reference databases (BIDS ISI, BIOSIS, MEDLINE and the CAB Abstracts CD-ROM). A total of 1373 unique references were obtained from 1981 to 2000, of which 914 were written in the English language. A written search protocol was designed to ensure transparency and repeatability. Pilot studies were undertaken to create search terms that minimised bias and ensured relevance. Electronic files of the search terms allow the database to be updated in future. A further 93 references were included from the most recent international conference on lameness giving a total of 1007 English language references. The systematic review process is described, including a method of classifying papers according to their study design and statistical analysis, and it is hoped that other veterinary researchers will conduct similar reviews in their fields. The compiled and classified references are available as a searchable database through the web-sitehttp://cattle-lameness.dhs.org/. The review may be used in several ways; to identify practical interventions to reduce lameness in dairy cows and to use the resultant web-site as the basis of a decision support system for farmers, veterinarians and advisors. 相似文献
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Richard da Rocha Filgueiras DVM PhD DCBCAV Christine De Souza Martins DVM MSc Ricardo Miyasaka De Almeida DVM PhD DCBCAV Rosana Marques Silva DVM PhD Martha De Souza Teixeira da Rocha DVM Fernanda De Paula Firmino DVM MSc Samara Maguilnik DVM Luíza Quintão Medeiros DVM 《Journal of Veterinary Emergency and Critical Care》2009,19(6):623-628
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CASE DETAILS: A 14-year-old female cat presented with signs of respiratory distress. Pleural fluid was found on radiographic assessment. Cytologic evaluation of the fluid revealed malignant melanocytosis. The cat had a previous history of a recurrent malignant melanoma near the base of the right ear. Due to declining clinical condition, the cat was euthanized. CLINICAL SIGNIFICANCE: Cutaneous malignant melanomas (or melanosarcomas) are uncommon neoplasms in cats, and knowledge is limited. As far as the authors are aware, there are no previous reports in the veterinary literature of malignant melanocytes being identified in pleural effusion in cats, as they have in dogs. This report suggests that, despite conflicting information in the literature regarding the clinical behavior of cutaneous melanomas in cats, these tumors are capable of recurrence and metastasis. Aggressive treatment may be necessary even, as in this case, if the tumor is well differentiated on histopathology. 相似文献
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Computerised decision support is of emerging and increasing importance in human medicine, but as yet has not been thoroughly applied or evaluated in veterinary medicine. In this essay, the authors report on the first example of a veterinary care pathway, a specific form of computerised decision support, which guides clinicians through a clinical workflow and incorporates individual patient data to inform patient-specific decision recommendations. The veterinary care pathway was designed using consensus statements and specialist neurologist opinion to create a decision support tool concerning canine idiopathic epilepsy. The authors evaluated the care pathway by comparing 35 clinical decisions made by referral clinicians in historical cases of idiopathic epilepsy to decisions recommended by the care pathway when presented with the same clinical case. Their results show that in 77.1% (95% confidence interval [59.9, 89.6]) of cases the care pathway recommended a decision that was the same or similar to a specialist neurologist's decision. Whilst further studies are needed to explore the potential use of such technology in clinical practice, the authors believe this first application provides great promise of a new and alternative method of clinical decision support. 相似文献
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The literature contains about 500 cases of equine leucosis, though the reports are deposited in a great number of journals and vary considerably concerning particular topics. During the last years there has been a remarkable increase of publications about this syndrome in the equine. The clinical leucosis key recommended by us has been confirmed in principle considering the latest literature. In about 70 individual symptoms which can be clinically observed in equine with leucosis 11 can be considered as main symptoms because of their frequency; they are again classified in primary (lymph node tumours including splenomegaly--loss of condition, weakness--cachexia, weight loss, periphery oedema), secondary (anorexia, inappetence--fever--paleness of mucous membrane--anaemia--tachycardia) and accessory (incoordination--tachypnoea, dyspnoea--apathy, lethargy) main symptoms. Furthermore in future it will be necessary to take into more consideration the symptoms "recurrent colic" and "hydrothorax" within differential diagnosis. The main symptom "incoordination" (ataxia, asynergy, paresis, paralysis) is used by us more precisely only in case of impairment of nervous system by neoplastic infiltrations and does not signify as possible symptoms of general physical weakness, for example faltering, staggering, tumbling or lameness. The morphological classification follows further on our previous recommendation. There exist generalized forms with tumour infiltrations in abdominal and in thoracic cavity as well as especially in peripheral lymph nodes. On the other hand there are characteristic manifestations in certain regions of the body, which establish distinctly the clinical symptomatology. They are marked as regional multicentric forms with the main localizations "mediastinal", "splenic", "mesenteric" or "intestinal".(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
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OBJECTIVE: To review the gross, microscopic, and functional anatomy of the cranial cruciate ligament (CCL) in dogs. STUDY DESIGN: Literature review. METHODS: Reports of the anatomy and function of the cruciate ligaments in dogs were retrieved by search of the 1975-2005 PubMed database. RESULTS: The CCL has an important biomechanical function resisting cranial drawer, hyperextension, and internal rotation and acts to fine tune and guide the stifle through its rolling and sliding motion. It has a complex architecture, and distinct geographic regions within the ligament have different functional roles depending on the angle and loading conditions. Collagen type I is the main component of the extracellular matrix; the fibrils have a crimped structure. The cruciate ligaments are almost completely covered by synovium, protecting them from synovial fluid. Cruciate blood supply is mainly of soft tissue origin. The intraligamentous network is relatively limited whereas the core of the middle third of the CCL is even less well vascularized. Neurohistologic studies are very limited in the dog. Various mechanoreceptors and proprioceptive receptors have been identified within the substance of the cruciate ligaments. CONCLUSIONS: CCL structural characteristics play an important part in its complex behaviour with the crimped pattern of the collagen fibrils being an important determinant of its biomechanical properties. In contrast to reports of managing CCL rupture, there are few reports describing the microanatomy and neurovascular morphology of the cruciate ligaments. CLINICAL RELEVANCE: Cruciate disease is likely multi-factorial. Improved understanding of CCL degradation leading to CCL rupture is critical to development of new diagnostic tests for cruciate disease in dogs. Appropriate intervention during the early stages of disease process might preserve CCL structural properties by preventing further collagen degradation. Accurate knowledge of functional and fiber bundle anatomy is imperative for reconstruction and restoration of normal stifle joint physiology. Reconstructive goals should alleviate existing instability and mimic normal kinematics. Knowledge of the exact function of the CCL in the neuromuscular control around the stifle joint could possibly explain osteoarthritis progression after CCL damage. 相似文献
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Objective – To describe and review both traditional and newer diagnostic and therapeutic options for canine and feline ureteral obstructions currently being performed clinically in veterinary medicine. Data Sources – A Medline search with no date restrictions was used for this review. Human Data Synthesis – The human literature would support the use of minimally invasive endourological techniques for the treatment of nearly all causes of ureteral obstructions, whenever possible. This typically includes extracorporeal shockwave lithotripsy, intracorporeal lithotripsy via retrograde ureteroscopy or antegrade percutaneous nephroureterolithotomy, ureteral stenting, percutaneous nephrostomy tube placement, and laparoscopic endopyelotomy. Typically open surgery is only suggested in cases of ureteral or gynecological malignancy when en bloc resection is considered a good option, or when various methods of endourological techniques have failed. Veterinary Data Synthesis – The veterinary literature is scarce on the use of interventional endourological techniques for the treatment of ureteral obstructions and has been growing over the last 5 years. The current literature reports the use of extracorporeal shockwave lithotripsy for ureteral stones, as well as the use of ureteral stents for the treatment of trigonal obstructive transitional cell carcinoma, ureterolithiasis, and ureteral strictures. Traditional surgical interventions, like ureterotomy, ureteronephrectomy, and ureteral reimplantation is more vastly reported and accepted. This review will focus on new clinical data using interventional endourological techniques for ureteral obstructions. Conclusions – Various treatment options for ureteral obstructions are now available for veterinary patients, and the trend away from traditional surgical techniques will hopefully be followed now that they are technically and clinically available for dogs and cats. 相似文献
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Jehn CT Perzak DE Cook JL Johnston SA Todhunter RJ Budsberg SC 《Journal of the American Veterinary Medical Association》2003,223(9):1272-1275
OBJECTIVE: To evaluate the quality of information regarding osteoarthritis (OA) in dogs currently available on the World Wide Web. DESIGN: Survey study. PROCEDURE: 5 search engines were searched with the keywords "dog," "degenerative joint disease," "canine," and "osteoarthritis," and the first 50 sites listed by each search engine were analyzed. Unique Web site addresses were distributed to 3 diplomates of the American College of Veterinary Surgeons, who provided a standardized evaluation of each site. RESULTS: 30 unique Web sites were evaluated. Twenty (66%) provided information consistent with conventional knowledge as outlined in textbooks and peer-reviewed literature, 8 (27%) provided experimental or anecdotal information in addition to conventional knowledge, and 2 (7%) provided misleading information. Mean scores for overall usefulness of the information provided in regard to clinical features of and treatment for OA were 1.3 and 1.5, respectively (1 = information of minimal use; 5 = very useful information). Twenty-three (77%) sites encouraged pet owners to seek the advice of a veterinarian. Twenty-three (77%) sites were given overall quality scores < 2, and 7 (23%) were given scores between 2 and 3 (1 = site was counterproductive; 5 = site was very valuable). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the quality of information currently available on the Web that addresses OA in dogs is questionable. Although most of the sites conveyed some conventional information with reasonable accuracy, the information was incomplete, of minimal use, and often considered counterproductive. 相似文献
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Alberto L. Fernandez DVM Justine A. Lee DVM DACVECC Louisa Rahilly DVM DACVECC Lynn Hovda DVM RPH MS DACVIM Ahna G. Brutlag DVM MS Kristin Engebretsen PharmD DABAT 《Journal of Veterinary Emergency and Critical Care》2011,21(4):309-320
Objective – To review the use of IV lipid emulsion (ILE) for the treatment of toxicities related to fat‐soluble agents; evaluate current human and veterinary literature; and to provide proposed guidelines for the use of this emerging therapy in veterinary medicine and toxicology. Data Sources – Human and veterinary medical literature. Human Data Synthesis – Human data are composed mostly of case reports describing the response to treatment with ILE as variant from mild improvement to complete resolution of clinical signs, which is suspected to be due to the variability of lipid solubility of the drugs. The use of ILE therapy has been advocated as an antidote in cases of local anesthetic and other lipophilic drug toxicoses, particularly in the face of cardiopulmonary arrest and unsuccessful cardiopulmonary cerebral resuscitation. Veterinary Data Synthesis – The use of ILE therapy in veterinary medicine has recently been advocated by animal poison control centers for toxicoses associated with fat‐soluble agents, but there are only few clinical reports documenting successful use of this therapy. Evidence for the use of ILE in both human and veterinary medicine is composed primarily from experimental animal data. Conclusions – The use of ILE appears to be a safe therapy for the poisoned animal patient, but is warranted only with certain toxicoses. Adverse events associated with ILE in veterinary medicine are rare and anecdotal. Standard resuscitation protocols should be exhausted before considering this therapy and the potential side effects should be evaluated before administration of ILE as a potential antidote in cases of lipophilic drug toxicoses. Further research is waranted. 相似文献
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PRACTICAL RELEVANCE: Weakness is a relatively common clinical presentation in feline medicine and can be caused by primary neuromuscular disease or by diseases of other body systems affecting the neuromuscular system secondarily. Successful work-up relies on a thorough clinical and neurological examination, and logical problem solving, based on an understanding of the underlying neuroanatomical and pathophysiological mechanisms. CLINICAL CHALLENGES: Feline neuromuscular diseases can be a diagnostic challenge. On initial inspection, the presenting signs can mimic disorders of other body systems, particularly cardiovascular, pulmonary and orthopaedic disease, or may be confused with systemic illnesses. Additionally, because many different pathologies of the feline neuromuscular system converge to a similar clinical phenotype, further diagnostic steps such as electrodiagnostics, cerebrospinal fluid analysis, and muscle and nerve biopsies must be considered even after neuromuscular dysfunction has been identified. AUDIENCE: This review provides a framework for the clinical approach to the weak cat and gives a practical summary of neuromuscular diseases for the general practitioner and specialist alike. EVIDENCE BASE: Many diseases affecting the feline neuromuscular system have been well described in the veterinary literature, mostly based on retrospective case reports and series. The evidence base for the treatment of feline neuromuscular diseases remains very limited. 相似文献
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Justin D. Derner David J. Augustine James C. Ascough Lajpat R. Ahuja 《Strength and Conditioning Journal》2012,65(6):623-631
A large number of empirical and mechanistic simulation models and decision support tools have been produced for rangelands. Collectively, these models have considerably increased our fundamental knowledge and understanding of the dynamics of ecosystem functions, processes, and structure. We explore three areas where models for rangeland management are often challenging for land managers and enterprise-level decision making: 1) coping with spatiotemporal and climatic variability in implementing scenario forecasting, risk assessments, and adaptive management; 2) addressing outputs of multiple ecosystem goods and services and determining whether they are synergistic or competitive; and 3) integrating experimental and experiential knowledge and observations into decision making. Increasing the utility of models for rangeland management remains a key frontier and a major research need for the modeling community and will be achieved less by further technical advances and model complexity and more by the use of existing topoedaphic databases, the capacity to readily incorporate new experimental and experiential knowledge, and the use of frameworks that facilitate outcome-based, adaptive decision making at the enterprise level with associated economic considerations. Opportunities exist for increasing the utility of models for decision making and adaptive rangeland management through better matching of model complexity with enterprise-level, decision-making goals. This could be accomplished by incorporating a fundamental understanding of herbivory, fire, and spatiotemporal interactions with weather patterns that affect multiple ecosystem functions. Most important, effective models would allow land managers in a changing and variable climate to 1) evaluate trade offs in producing multiple goods and services, 2) optimize the application of conservation practices spatially (comparing costs and benefits accrued across different timescales), and 3) incorporate manager capacity, including experience, skills, and labor input. 相似文献