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1.
Vet Comp Oncol ; 15(3): 829-839, 2017 Sep.
Article in English | MEDLINE | ID: mdl-27198171

ABSTRACT

The aim of this study was to evaluate the relationship between breed and the histopathological grade of canine mast cell tumours (MCTs). A retrospective survey of pathology data of 9375 histopathologically confirmed diagnoses of cutaneous MCTs in the US was evaluated in the context of breed prevalence in over two million registered purebred dogs. Association of histopathological grade with breed, age, sex and spay/neuter status was assessed. The data indicate that the proportion of high-grade tumours increases with advancing age, and that male and intact dogs have increased odds of developing high-grade tumours. A significant difference in the proportion of high-grade tumours between breeds was detected. The Pug was at significantly increased risk of developing low/intermediate-grade tumours, but not high-grade tumours, resulting in preponderance of less aggressive MCTs in this breed. The results of this study suggest a genetic association for the development of high-grade MCTs.


Subject(s)
Dog Diseases/pathology , Mastocytosis, Cutaneous/veterinary , Skin Neoplasms/veterinary , Age Factors , Animals , Dog Diseases/etiology , Dogs , Female , Male , Mastocytosis, Cutaneous/etiology , Mastocytosis, Cutaneous/pathology , Retrospective Studies , Risk Factors , Sex Factors , Skin Neoplasms/etiology , Skin Neoplasms/pathology , Species Specificity
2.
J Vet Intern Med ; 30(1): 164-6, 2016.
Article in English | MEDLINE | ID: mdl-26692461

ABSTRACT

BACKGROUND: Canine adenovirus 2, parainfluenza, and Bordetella bronchiseptica cause respiratory disease in dogs, and each has a modified live intranasal vaccine available. Molecular diagnostic assays to amplify specific nucleic acids are available for each of these agents. If positive molecular diagnostic assay results are common after vaccination, the positive predictive value of the diagnostic assays for disease would be decreased. OBJECTIVE: To determine the impact of administration of commercially available modified live topical adenovirus 2, B. bronchiseptica, and parainfluenza vaccine has on the results of a commercially available PCR panel. ANIMALS: Eight puppies from a research breeding facility negative for these pathogens. METHODS: Blinded prospective pilot study. Puppies were vaccinated with a single dose of modified live topical adenovirus 2, B. bronchiseptica, and parainfluenza and parenteral dose of adenovirus 2, canine distemper virus, and parvovirus. Nasal and pharyngeal swabs were collected on multiple days and submitted for PCR assay. RESULTS: Nucleic acids of all 3 organisms contained in the topical vaccine were detected from both samples multiple times through 28 days after vaccination with higher numbers of positive samples detected between days 3 and 10 after vaccination. CONCLUSIONS AND CLINICAL IMPORTANCE: Vaccine status should be considered when interpreting respiratory agent PCR results if modified live vaccines have been used. Development of quantitative PCR and wild-type sequencing are necessary to improve positive predictive value of these assays by distinguishing vaccinate from natural infection.


Subject(s)
Adenoviridae , Bacterial Vaccines/immunology , Bordetella bronchiseptica , Dog Diseases/prevention & control , Parainfluenza Vaccines/immunology , Viral Vaccines/immunology , Adenoviridae Infections/prevention & control , Adenoviridae Infections/veterinary , Administration, Topical , Animals , Bordetella Infections/prevention & control , DNA, Bacterial/genetics , Distemper Virus, Canine/genetics , Dog Diseases/microbiology , Dog Diseases/virology , Dogs , Parvovirus/genetics , Pilot Projects , Polymerase Chain Reaction/methods , Polymerase Chain Reaction/veterinary , RNA, Viral/genetics , Vaccination , Vaccines, Attenuated
3.
Vet Pathol ; 48(1): 198-211, 2011 Jan.
Article in English | MEDLINE | ID: mdl-20861499

ABSTRACT

A study was carried out to test the accuracy and consistency of veterinary pathologists, not specialists in hematopathology, in applying the World Health Organization (WHO) system of classification of canine lymphomas. This study represents an initiative of the ACVP Oncology Committee, and the classification has been endorsed by the World Small Animal Veterinary Association (WASVA). Tissue biopsies from cases of canine lymphoma were received from veterinary oncologists, and a study by pathologists given only signalment was carried out on 300 cases. Twenty pathologists reviewed these 300 cases with each required to choose a diagnosis from a list of 43 B and T cell lymphomas. Three of the 20 were hematopathologists who determined the consensus diagnosis for each case. The 17 who formed the test group were experienced but not specialists in hematopathology, and most were diplomates of the American or European Colleges of Veterinary Pathology. The overall accuracy of the 17 pathologists on the 300 cases was 83%. When the analysis was limited to the 6 most common diagnoses, containing 80% of all cases, accuracy rose to 87%. In a test of reproducibility enabled by reintroducing 5% of cases entered under a different identity, the overall agreement between the first and second diagnosis ranged from 40 to 87%. The statistical review included 43,000 data points for each of the 20 pathologists.


Subject(s)
Dog Diseases/classification , Lymphoma/veterinary , Animals , Dogs , Lymph Nodes/pathology , Lymphoma/classification , Observer Variation , Pathology, Veterinary/standards , Veterinarians/standards , World Health Organization
4.
Vet Pathol ; 48(1): 147-55, 2011 Jan.
Article in English | MEDLINE | ID: mdl-21062911

ABSTRACT

Currently, prognostic and therapeutic determinations for canine cutaneous mast cell tumors (MCTs) are primarily based on histologic grade. However, the use of different grading systems by veterinary pathologists and institutional modifications make the prognostic value of histologic grading highly questionable. To evaluate the consistency of microscopic grading among veterinary pathologists and the prognostic significance of the Patnaik grading system, 95 cutaneous MCTs from 95 dogs were graded in a blinded study by 28 veterinary pathologists from 16 institutions. Concordance among veterinary pathologists was 75% for the diagnosis of grade 3 MCTs and less than 64% for the diagnosis of grade 1 and 2 MCTs. To improve concordance among pathologists and to provide better prognostic significance, a 2-tier histologic grading system was devised. The diagnosis of high-grade MCTs is based on the presence of any one of the following criteria: at least 7 mitotic figures in 10 high-power fields (hpf); at least 3 multinucleated (3 or more nuclei) cells in 10 hpf; at least 3 bizarre nuclei in 10 hpf; karyomegaly (ie, nuclear diameters of at least 10% of neoplastic cells vary by at least two-fold). Fields with the highest mitotic activity or with the highest degree of anisokaryosis were selected to assess the different parameters. According to the novel grading system, high-grade MCTs were significantly associated with shorter time to metastasis or new tumor development, and with shorter survival time. The median survival time was less than 4 months for high-grade MCTs but more than 2 years for low-grade MCTs.


Subject(s)
Dog Diseases/classification , Mastocytoma/veterinary , Skin Neoplasms/veterinary , Animals , Dog Diseases/pathology , Dogs , Female , Male , Mastocytoma/classification , Mastocytoma/pathology , Neoplasm Staging , Skin Neoplasms/classification , Skin Neoplasms/pathology
5.
Vet Pathol ; 48(1): 19-31, 2011 Jan.
Article in English | MEDLINE | ID: mdl-21123864

ABSTRACT

Neoplastic diseases are typically diagnosed by biopsy and histopathological evaluation. The pathology report is key in determining prognosis, therapeutic decisions, and overall case management and therefore requires diagnostic accuracy, completeness, and clarity. Successful management relies on collaboration between clinical veterinarians, oncologists, and pathologists. To date there has been no standardized approach or guideline for the submission, trimming, margin evaluation, or reporting of neoplastic biopsy specimens in veterinary medicine. To address this issue, a committee consisting of veterinary pathologists and oncologists was established under the auspices of the American College of Veterinary Pathologists Oncology Committee. These consensus guidelines were subsequently reviewed and endorsed by a large international group of veterinary pathologists. These recommended guidelines are not mandated but rather exist to help clinicians and veterinary pathologists optimally handle neoplastic biopsy samples. Many of these guidelines represent the collective experience of the committee members and consensus group when assessing neoplastic lesions from veterinary patients but have not met the rigors of definitive scientific study and investigation. These questions of technique, analysis, and evaluation should be put through formal scrutiny in rigorous clinical studies in the near future so that more definitive guidelines can be derived.


Subject(s)
Biopsy , Neoplasms/veterinary , Pathology, Surgical/standards , Practice Guidelines as Topic , Specimen Handling , Veterinary Medicine/standards , Animals , Biopsy/methods , Biopsy/standards , Biopsy/veterinary , Neoplasms/diagnosis
6.
Vet Pathol ; 48(1): 7-18, 2011 Jan.
Article in English | MEDLINE | ID: mdl-20664014

ABSTRACT

There is an increasing need for more accurate prognostic and predictive markers in veterinary oncology because of an increasing number of treatment options, the increased financial costs associated with treatment, and the emotional stress experienced by owners in association with the disease and its treatment. Numerous studies have evaluated potential prognostic and predictive markers for veterinary neoplastic diseases, but there are no established guidelines or standards for the conduct and reporting of prognostic studies in veterinary medicine. This lack of standardization has made the evaluation and comparison of studies difficult. Most important, translating these results to clinical applications is problematic. To address this issue, the American College of Veterinary Pathologists' Oncology Committee organized an initiative to establish guidelines for the conduct and reporting of prognostic studies in veterinary oncology. The goal of this initiative is to increase the quality and standardization of veterinary prognostic studies to facilitate independent evaluation, validation, comparison, and implementation of study results. This article represents a consensus statement on the conduct and reporting of prognostic studies in veterinary oncology from veterinary pathologists and oncologists from around the world. These guidelines should be considered a recommendation based on the current state of knowledge in the field, and they will need to be continually reevaluated and revised as the field of veterinary oncology continues to progress. As mentioned, these guidelines were developed through an initiative of the American College of Veterinary Pathologists' Oncology Committee, and they have been reviewed and endorsed by the World Small Animal Veterinary Association.


Subject(s)
Medical Oncology/standards , Neoplasms/veterinary , Practice Guidelines as Topic , Veterinary Medicine/standards , Animals , Disease Progression , Neoplasms/pathology , Prognosis
7.
J Small Anim Pract ; 48(3): 145-50, 2007 Mar.
Article in English | MEDLINE | ID: mdl-17355605

ABSTRACT

OBJECTIVES: To determine the ability to obtain diagnostic cytology samples from appendicular bone lesions using ultrasound-guided needle aspirations. Secondary objectives were to compare cytological evaluations with histopathological results and to determine the utility of staining malignant mesenchymal cells for the presence of alkaline phosphatase. METHODS: Aspirations from 36 aggressive appendicular bone lesions with histological diagnoses were included in the study. Ultrasound was used to guide the needle to the medullary cavity or the adjacent soft tissue mass. The smears stained with Wright-Giemsa and nitroblue tetrazolium chloride/5-bromo-4-chloro-3-indoyl phosphate toluidine salt (NBT/BCIP) were examined. RESULTS: A diagnostic sample was obtained in 32 of the 36 cases. Of the 32 diagnostic samples, cytology indicated sarcoma, with a sensitivity of 97 per cent (confidence interval: 83 to 100 per cent) and a specificity of 100 per cent (confidence interval: 16 to 100 per cent). When a diagnosis of sarcoma was made on cytology, alkaline phosphatase staining indicated osteosarcoma, with a sensitivity of 100 per cent (confidence interval: 87 to 100 per cent). CLINICAL SIGNIFICANCE: The results of this study indicate that ultrasound-guided needle aspiration of aggressive bone lesions is a viable technique for identifying malignant mesenchymal cells and for diagnosing sarcomas. It is cost-effective and minimally invasive. Furthermore, identifying alkaline-phosphatase-negative malignant mesenchymal cells from a bone aspiration may rule out osteosarcoma, whereas alkaline-phosphatase-positive malignant mesenchymal cells are suggestive of osteosarcoma.


Subject(s)
Biopsy, Fine-Needle/veterinary , Bone Neoplasms/veterinary , Dog Diseases/diagnosis , Osteosarcoma/veterinary , Ultrasonography, Interventional/veterinary , Animals , Bone Neoplasms/diagnosis , Dog Diseases/diagnostic imaging , Dog Diseases/pathology , Dogs , Female , Forelimb , Hindlimb , Male , Osteosarcoma/diagnosis , Predictive Value of Tests , Sensitivity and Specificity
8.
J Small Anim Pract ; 45(10): 507-14, 2004 Oct.
Article in English | MEDLINE | ID: mdl-15515801

ABSTRACT

Acquired amegakaryocytic thrombocytopenla was diagnosed in four dogs. Initial platelet counts in all four dogs were less than 50,000 x 10(9)/litre and initial bone marrow examinations revealed megakaryocytic hypoplasia with minimal changes in the erythroid and myeloid cell lines. Two dogs had evidence of idiopathic immune-mediated disease and two dogs had evidence of associated infectious disease. One dog had a positive antibody titre to Borrella burgdorferi, and one dog had positive titres to both Ehrlichia canis and B. burgdorferi. Treatment consisted of prednisone and cyclophosphamide for the dogs with presumptive immune-mediated disease, and prednisone and tetracycline for the dogs with positive antibody titres to the Infectious organisms. Both dogs with evidence of associated infectious disease responded to treatment. A postmortem examination did not reveal the underlying aetiology in the two dogs with presumptive idiopathic immune-mediated disease.


Subject(s)
Dog Diseases/etiology , Purpura, Thrombocytopenic, Idiopathic/veterinary , Thrombocytopenia/veterinary , Animals , Borrelia burgdorferi/drug effects , Borrelia burgdorferi/growth & development , Dog Diseases/drug therapy , Dog Diseases/immunology , Dog Diseases/microbiology , Dogs , Ehrlichia canis/drug effects , Ehrlichia canis/growth & development , Ehrlichiosis/complications , Ehrlichiosis/veterinary , Female , Lyme Disease/complications , Lyme Disease/veterinary , Male , Purpura, Thrombocytopenic, Idiopathic/drug therapy , Purpura, Thrombocytopenic, Idiopathic/immunology , Purpura, Thrombocytopenic, Idiopathic/microbiology , Thrombocytopenia/drug therapy , Thrombocytopenia/immunology , Thrombocytopenia/microbiology , Treatment Outcome
9.
J Am Anim Hosp Assoc ; 36(1): 16-8, 2000.
Article in English | MEDLINE | ID: mdl-10667401

ABSTRACT

To determine the accuracy of intraoperative cytopathological diagnosis compared with conventional histopathological diagnosis, the authors obtained 100 specimens from masses of various organ systems chosen randomly from 65 dogs, 30 cats, and five exotic animals. Of the 100 specimens, a specific diagnosis was obtained in 42%, the correct pathological process (i.e., mesenchymal neoplasia, epithelial neoplasia, round cell neoplasia, or inflammation) was identified in 41%, in 1% the diagnosis was deferred, and in 16% an incorrect diagnosis was obtained. The overall accuracy rate of intraoperative cytopathological examination was 83%, which increased to 90% by the exclusion of splenic masses. The accuracy rate of diagnosing neoplasia was 87%, with a sensitivity of 89% and a specificity of 100%. Intraoperative cytopathological examination is an accurate diagnostic method with good sensitivity and specificity for the identification of neoplasia.


Subject(s)
Cat Diseases/pathology , Dog Diseases/pathology , Neoplasms/veterinary , Animals , Biopsy, Needle/standards , Biopsy, Needle/veterinary , Cats , Dogs , Intraoperative Period/veterinary , Neoplasms/pathology , Predictive Value of Tests , Sensitivity and Specificity
10.
J Vet Intern Med ; 14(1): 20-6, 2000.
Article in English | MEDLINE | ID: mdl-10668812

ABSTRACT

Hepatic lipidosis in cats is a commonly diagnosed hepatobiliary disease of unknown cause. The purpose of this prospective study was to characterize the blood hormone and lipid status of cats with hepatic lipidosis, and to compare this status to that of cats with other types of liver disease and to control cats. Twenty-three cats with hepatic disease were assigned to 1 of 2 groups on the basis of cytopathologic or histopathologic examination of the liver: group 1, hepatic lipidosis (n = 18); or group 2, cholangiohepatitis (n = 5). Ten healthy young adult cats were used as controls. Food was withheld from control animals for 24 hours before blood collection. Concentrations of plasma glucagon and serum insulin, cortisol, thyroxine, triglycerides, cholesterol, phospholipids, and nonesterified fatty acids (NEFAs) were determined in all cats, in addition to routine hematologic and serum biochemical testing. Cats with hepatic lipidosis had higher serum NEFA concentrations than cats with cholangiohepatitis or control cats (P < .05). Cats with cholangiohepatitis had higher serum cholesterol and phospholipid concentrations than those of cats with lipidosis or control cats (P < .05); their plasma glucagon concentrations were higher than those of control cats (P < .05), but were not different from those of cats with hepatic lipidosis. Serum insulin concentrations were significantly higher in control cats than in diseased cats (P < .05), but neither serum insulin nor the insulin to glucagon ratio was significantly different among the cats with hepatic disease. The high concentration of NEFAs in cats with hepatic lipidosis suggests that at least 1 factor in the pathogenesis of this syndrome may involve the regulation of hormone-sensitive lipase.


Subject(s)
Cat Diseases/pathology , Fatty Acids, Nonesterified/blood , Lipidoses/veterinary , Lipids/blood , Liver Diseases/veterinary , Animals , Anorexia/etiology , Anorexia/veterinary , Cat Diseases/diagnosis , Cats , Glucagon/metabolism , Insulin/blood , Lipidoses/diagnosis , Lipidoses/pathology , Liver Diseases/diagnosis , Liver Diseases/pathology , Prospective Studies , Reference Values
11.
Acad Med ; 74(9): 1028-32, 1999 Sep.
Article in English | MEDLINE | ID: mdl-10498098

ABSTRACT

PURPOSE: To test whether global ratings of checklists are a viable alternative to global ratings of actual clinical performance for use as a criterion for standardized-patient (SP) assessment. METHOD: Five faculty physicians independently observed and rated videotaped performances of 44 medical students on the seven SP cases that comprise the fourth-year assessment administered at The Morchand Center of Mount Sinai School of Medicine to students in the eight member schools in the New York City Consortium. A year later, the same panel of raters reviewed and rated checklists for the same 44 students on five of the same SP cases. RESULTS: The mean global ratings of clinical competence were higher with videotapes than checklists, whereas the mean global ratings of interpersonal and communication skills were lower with videotapes. The correlations for global ratings of clinical competence showed only moderate agreement between the videotape and checklist ratings; and for interpersonal and communication skills, the correlations were somewhat weaker. CONCLUSION: The results raise serious questions about the viability of global ratings of checklists as an alternative to ratings of observed clinical performance as a criterion for SP assessment.


Subject(s)
Clinical Competence , Documentation , Educational Measurement , Videotape Recording , Adult , Female , Humans , Male , New York City , Schools, Medical , Sensitivity and Specificity
12.
J Vet Intern Med ; 13(3): 187-90, 1999.
Article in English | MEDLINE | ID: mdl-10357106

ABSTRACT

Limited information is available on prognostic factors for cats with lymphoma. The quantity of argyrophilic nucleolar organizer region (AgNOR) proteins can be used as a measurement of cellular proliferative activity. To determine if AgNORs were of prognostic value for feline intestinal lymphoma, the silver staining technique was performed on paraffin-embedded sections of 31 cases. Mean number of AgNORs per nucleus ranged from 1.02 to 4.32. Twenty-four (78%) cats had small AgNORs and 7 (22%) had large AgNORs. All cats were treated identically with a combination chemotherapy protocol. Response to chemotherapy was 87%. Median remission duration and survival times were 120 days and 201 days, respectively. No significant correlation was found between mean number of AgNORs per nucleus or AgNOR size and remission rate, remission duration, or survival time. This study indicates that AgNOR staining is not a useful prognostic factor for cats with intestinal lymphoma.


Subject(s)
Cat Diseases/pathology , Intestinal Neoplasms/veterinary , Lymphoma/veterinary , Nucleolus Organizer Region/pathology , Animals , Biomarkers, Tumor/analysis , Cats , Cell Division , Female , Intestinal Neoplasms/pathology , Lymphoma/pathology , Male , Predictive Value of Tests , Prognosis , Silver Staining , Survival Analysis
13.
Acad Med ; 72(7): 619-26, 1997 Jul.
Article in English | MEDLINE | ID: mdl-9236472

ABSTRACT

PURPOSE: To test the criterion validity of existing standardized-patient (SP)-examination scores using global ratings by a panel of faculty-physician observers as the gold-standard criterion; to determine whether such ratings can provide a reliable gold-standard criterion to be used for validity-related research; and to encourage the use of these gold-standard ratings for validation research and examination development, including scoring and standard setting, and for enhancing understanding of the clinical competence construct. METHOD: Five faculty physicians independently observed and rated videotaped performances of 44 students from one medical school on the seven SP cases that make up the fourth-year assessment administered at The Morchand Center of Mount Sinai School of Medicine to students in the eight member schools in the new York City Consortium. RESULTS: The validity coefficients showed correlations between scores on the examination and the overall ratings ranging from .60 to .70. The reliability coefficients for ratings of overall examination performance reached the commonly recommended .80 level and were very close at the case level, with interrater reliabilities generally in the .70 to .80 range. CONCLUSION: The results are encouraging, with validity coefficients high enough to warrant optimism about the possibility of increasing them to the recommended .80 level, based on further studies to identify those measurable performance characteristics that most reflect the gold-standard ratings. The high interrater reliabilities indicate that faculty-physician ratings of performance on SP cases and examinations can or may be able to provide a reliable gold standard for validating and refining SP assessment.


Subject(s)
Clinical Clerkship/standards , Clinical Competence/standards , Educational Measurement , Physical Examination/standards , Evaluation Studies as Topic , New York City , Physician-Patient Relations , Reproducibility of Results , Video Recording
14.
J Vet Intern Med ; 10(6): 360-4, 1996.
Article in English | MEDLINE | ID: mdl-8947867

ABSTRACT

The purpose of this study was to evaluate fructosamine concentrations in clinically healthy cats, sick cats with stress hyperglycemia, and untreated diabetic cats to determine the usefulness of this test in diagnosing diabetes mellitus in cats, and in differentiating the disease from stress-induced hyperglycemia. In addition, we evaluated if the degree of glycemic control in cats treated for diabetes influenced their serum fructosamine concentrations. In the 14 sick cats with stress hyperglycemia, the median serum fructosamine concentration (269 mumol/L) was not significantly different from the median value in the 26 clinically normal cats (252 mumol/L). Two of the 14 cats with stress hyperglycemia (14.3%) had serum fructosamine concentrations above the upper limit of the reference range (175 to 400 mumol/L); on the basis of these results, the test specificity was calculated as 0.86. In 30 cats with untreated diabetes mellitus, the median serum fructosamine concentration was 624 mumol/L, markedly higher than the value in either the normal cats or the cats with stress hyperglycemia. All but 2 of the 30 untreated diabetic cats (6.7%) had serum fructosamine concentration above the upper limit of the reference range; on the basis of these results, the sensitivity of serum fructosamine concentration as a diagnostic test for diabetes mellitus was 0.93. When 30 diabetic cats receiving treatment were divided into 3 groups according to their response to treatment (i.e., poor, fair, and good), the 16 cats that had a good response to treatment had significantly lower serum concentrations of both glucose and fructosamine compared with cats that had either a fair or poor response to treatment. A significant correlation (rs = .70, n = 100, P < .001) was found between serum concentrations of glucose and fructosamine. Results of this study indicate that quantification of serum fructosamine concentration is a meaningful test for the diagnosis of diabetes, for differentiating diabetes from stress hyperglycemia; and for monitoring the metabolic control in treated diabetic cats.


Subject(s)
Blood Glucose/analysis , Cat Diseases/blood , Diabetes Mellitus/veterinary , Fructosamine/blood , Hyperglycemia/veterinary , Animals , Cat Diseases/diagnosis , Cat Diseases/etiology , Cats , Diabetes Mellitus/blood , Diabetes Mellitus/diagnosis , Diagnosis, Differential , Female , Hyperglycemia/blood , Hyperglycemia/diagnosis , Male , Severity of Illness Index , Stress, Psychological
15.
J Am Vet Med Assoc ; 209(10): 1741-5, 1996 Nov 15.
Article in English | MEDLINE | ID: mdl-8921033

ABSTRACT

OBJECTIVE: To evaluate clinical, laboratory, radiographic, ultrasonographic, surgical, and histologic findings in ferrets with insulinoma and to determine their long-term outcome. DESIGN: Retrospective study. ANIMALS: 57 ferrets with a histopathologic diagnosis of pancreatic islet cell tumor. PROCEDURE: Medical records of ferrets with pancreatic islet cell tumors were reviewed. RESULTS: Lethargy, weakness, and collapse were the most common clinical signs. All ferrets had hypoglycemia, and hyperinsulinemia was documented in 39 of 47 (83%) ferrets. Ultrasonographic examination of the abdomen revealed pancreatic nodules in 5 of 23 ferrets. Surgical treatment was performed in 50 ferrets, 3 were treated by medical management alone, and 4 did not have treatment. At the time of surgery, 1 pancreatic nodule was found in 13 (26%) ferrets and multiple nodules were found in 37 (74%) ferrets. Pancreatic carcinoma alone was found in 34 ferrets. Whereas a combination of carcinoma and either hyperplasia or adenoma was found in 23 ferrets; 4 ferrets had metastasis to regional lymph nodes or liver. In 26 (53%) ferrets, hypoglycemia persisted after surgery, necessitating medical treatment with prednisone, diazoxide, or both. Sixteen (33%) ferrets had redevelopment of hypoglycemia at 1 to 23.5 months (median, 10.6 months) after surgery. Only 7 of the 50 (14%) ferrets remained euglycemic after surgery. CLINICAL IMPLICATIONS: In ferrets, surgical removal of insulin-secreting pancreatic islet cell tumors is recommended as definitive treatment; however, multiple pancreatic nodules are common, making complete excision of all tumor tissue difficult. Persistent hypoglycemia after surgical treatment indicates that lifelong medical management with prednisone or diazoxide or both may be necessary in many ferrets. Finally, because the insulin-secreting tumors are malignant, long-term cure and survival are not likely.


Subject(s)
Ferrets , Insulinoma/veterinary , Pancreatic Neoplasms/veterinary , Animals , Female , Hypoglycemia/etiology , Hypoglycemia/therapy , Hypoglycemia/veterinary , Insulinoma/diagnosis , Insulinoma/therapy , Male , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/therapy , Retrospective Studies , Treatment Outcome
16.
J Am Vet Med Assoc ; 207(6): 726-8, 1995 Sep 15.
Article in English | MEDLINE | ID: mdl-7657570

ABSTRACT

Medical records of 117 dogs with digit masses were reviewed. Of 124 digit masses, 76 (61%) were malignant neoplasms, 25 (20%) were benign neoplasms, and 23 (19%) were pyogranulomatous inflammation. Of 29 digits with radiographic evidence of bone lysis, 24 (83%) were affected by malignant masses, whereas only 5 of 29 (17%) digits with radiographic evidence of bone lysis were affected by benign or pyogranulomatous masses. Only 1 of 19 (5%) dogs with melanoma had radiographic evidence of lysis, but 20 of 25 (80%) dogs with squamous cell carcinoma had radiographic evidence of bone lysis. Thoracic radiographs of 95 dogs were available. Six of 19 (32%) dogs with melanoma had radiographic evidence of pulmonary metastasis at the time of diagnosis, whereas 3 of 24 (13%) dogs with squamous cell carcinoma had radiographic evidence of pulmonary metastasis at the time of diagnosis. Twenty-nine digit neoplasms were squamous cell carcinoma, and 19 of 29 (66%) arose from the subungual epithelium. Of 19 dogs with squamous cell carcinoma originating from the subungual epithelium, 18 (95%) survived for at least 1 year, whereas only 6 of 10 (60%) dogs with squamous cell carcinoma originating in other parts of the digit survived for at least 1 year. Furthermore, of 19 dogs with squamous cell carcinoma originating from the subungual epithelium, 14 (74%) survived at least 2 years, whereas only 4 of 9 (44%) dogs with squamous cell carcinoma originating in other parts of the digit survived for 2 years. Dogs with melanoma of the digits had a median survival time of 12 months, with 10 of 24 (42%) alive at 1 year and 3 of 23 (13%) alive at 2 years.(ABSTRACT TRUNCATED AT 250 WORDS)


Subject(s)
Carcinoma, Squamous Cell/veterinary , Dog Diseases , Foot Diseases/veterinary , Melanoma/veterinary , Toes , Animals , Carcinoma, Squamous Cell/diagnostic imaging , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/surgery , Dog Diseases/diagnostic imaging , Dog Diseases/mortality , Dogs , Female , Foot Diseases/diagnostic imaging , Foot Diseases/mortality , Foot Diseases/surgery , Lung Neoplasms/secondary , Lung Neoplasms/veterinary , Male , Melanoma/diagnostic imaging , Melanoma/mortality , Melanoma/surgery , Radiography , Retrospective Studies , Survival Rate , Treatment Outcome
17.
Acad Med ; 69(4): 310-2, 1994 Apr.
Article in English | MEDLINE | ID: mdl-8155242

ABSTRACT

BACKGROUND: Scoring protocols for most standardized-patient (SP) examinations have not received extensive scrutiny and their validity has not been well established. METHOD: A holistic method (i.e., one based on raters' overall impressions) of scoring performance on an SP examination was pilot-tested in the spring of 1992 by administering an examination to two cohorts of fourth-year students at the Albert Einstein College of Medicine at Yeshiva University. The examination consisted of eight SP stations, representing a range of medical problems. Two to three experienced clinical teachers independently reviewed all the written material for each encounter. In Phase I of the study, holistic ratings of outstanding, competent, marginal, or inadequate were given for overall clinical competence for a cohort of 16 students; in Phase II, holistic ratings were given separately for data-gathering and communication skills for a cohort of 26 students. Intercase and interrater reliability analyses were performed. RESULTS: Adequate reliability coefficients were obtained on a two-hour test; total scores (i.e., students' scores across all eight cases) discriminated between groups of examinees; and, on average, less than two minutes were required to score an encounter. CONCLUSION: Although based on a small sample, the study's results suggest that this holistic method of scoring performance may be useful in some situations. Since experienced clinical teachers know and agree about clinical competence when they see it, developers of scoring protocols for SP examinations need to establish that the results obtained are congruent with the judgments of expert teachers.


Subject(s)
Educational Measurement/methods , Physical Examination , Communication , Educational Measurement/standards , Humans , Pilot Projects , Students, Medical
18.
Skeletal Radiol ; 22(6): 473-5, 1993 Aug.
Article in English | MEDLINE | ID: mdl-8248827

ABSTRACT

In summary, we have reported a most interesting case of synovial sarcoma, epithelial hyperplasia in the air sacs, and formation of medullary bone in the left humerus of a 5-year-old female white pigeon. The tumor showed aggressive features radiologically and caused dysfunction of the left wing. The histologic findings and immunohistochemical reactions in this report were identical in many respects to the manifestation of synovial sarcoma described in human beings and dogs. Formation of medullary bone in female birds during the reproductive phase and hyperplasia of epithelia in the air sacs were also discussed.


Subject(s)
Air Sacs/diagnostic imaging , Bird Diseases/diagnostic imaging , Bone Neoplasms/veterinary , Columbidae , Sarcoma, Synovial/veterinary , Air Sacs/pathology , Animals , Bird Diseases/pathology , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/pathology , Calcinosis/diagnostic imaging , Calcinosis/pathology , Epithelium/pathology , Female , Humerus , Hyperplasia , Radiography , Sarcoma, Synovial/diagnostic imaging , Sarcoma, Synovial/pathology
19.
J Am Vet Med Assoc ; 203(2): 271-5, 1993 Jul 15.
Article in English | MEDLINE | ID: mdl-8407489

ABSTRACT

Adrenocortical adenoma, nodular hyperplasia, or carcinoma was diagnosed in 50 ferrets. Thirty-five (70%) ferrets were female and 15 (30%) were male. The mean age at which clinical signs were first noticed was 3.4 years (range, 1 to 7 years). Clinical signs included large vulva (n = 31; 89% of females), alopecia (n = 43; 86%), pruritus (n = 20; 40%), and increased consumption of water and increased urine output (n = 4; 8%). A mass was palpated at the cranial pole of the kidney during physical examination of 17 (34%) ferrets. Ultrasonography, performed on 39 of 50 ferrets, revealed a unilateral adrenal gland mass in 19 (49%). Four ferrets were anemic, and 2 ferrets were thrombocytopenic. Baseline plasma concentrations of cortisol and corticosterone were within or below the reference range in all 17 ferrets tested, whereas baseline plasma estradiol concentrations were high in 4 of the 11 ferrets (36%) tested. AFter adrenocorticotropic hormone (ACTH) administration, only 1 ferret had a slightly exaggerated response on the basis of plasma cortisol concentrations, and all 17 had normal responses on the basis of plasma corticosterone concentrations. There was little or no increase in plasma estradiol concentrations after ACTH administration. Of the 50 ferrets, 39 were treated by adrenalectomy. Unilateral adrenalectomy was performed in 34 ferrets in which 1 adrenal gland was large, whereas subtotal bilateral adrenalectomy was performed in 5 ferrets with bilateral adrenal disease. Five ferrets died in the immediate postoperative period, and follow-up information was available for the remaining 34, 1 to 34 months after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)


Subject(s)
Adrenal Cortex Neoplasms/veterinary , Adrenal Glands/pathology , Adrenocortical Hyperfunction/veterinary , Ferrets , Adrenal Cortex Neoplasms/complications , Adrenocortical Adenoma/complications , Adrenocortical Adenoma/veterinary , Adrenocortical Carcinoma/complications , Adrenocortical Carcinoma/veterinary , Adrenocortical Hyperfunction/etiology , Alopecia/etiology , Alopecia/veterinary , Animals , Corticosterone/blood , Edema/etiology , Edema/veterinary , Estradiol/blood , Female , Hydrocortisone/blood , Hyperplasia , Male , Pruritus/etiology , Pruritus/veterinary , Retrospective Studies , Vulvar Diseases/etiology , Vulvar Diseases/veterinary
20.
J Am Vet Med Assoc ; 202(4): 647-51, 1993 Feb 15.
Article in English | MEDLINE | ID: mdl-8449811

ABSTRACT

Medical records were reviewed for 18 cats with adenomatous polyps of the proximal portion of the duodenum. Cats of Asian ancestry were over represented (8/18), and male castrated cats were common (15/18). The median age was 11.8 years. Common clinical signs were acute and chronic vomiting and hematemesis. Nine cats were anemic. Contrast radiography was performed in 12 cats, and a mass of the proximal portion of the duodenum was identified in 10 cats. Endoscopy was used to confirm existence of the mass in 3 cats. Complete excision of the duodenal mass was performed in 17 cats. One cat died before abdominal exploratory surgery, and a duodenal adenomatous polyp was identified at necropsy. Fifteen cats survived the immediate postoperative period, with 13 of 15 having complete resolution of clinical signs. Five cats had concurrent disease, which caused 4 of them to die between 3 and 26 months after surgery. Redevelopment of adenomatous polyps was not detected in any cat during the follow-up period of 1 to 49 months. Results of the study indicated that benign, adenomatous polyps of the duodenum in cats can be safely excised and that the prognosis for return to normal function is excellent.


Subject(s)
Cat Diseases , Duodenal Neoplasms/veterinary , Intestinal Polyps/veterinary , Animals , Breeding , Cat Diseases/pathology , Cat Diseases/surgery , Cats , Duodenal Neoplasms/pathology , Duodenal Neoplasms/surgery , Female , Follow-Up Studies , Intestinal Polyps/pathology , Intestinal Polyps/surgery , Male , Retrospective Studies
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