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Wells JR, Hillier A, Holland R, Mwacalimba K, Noli C, Panter C, Tatlock S, Wright A. Development and validation of a questionnaire to assess owner and canine quality-of-life and treatment satisfaction in canine allergic dermatitis. Vet Dermatol 2024. [PMID: 38361109 DOI: 10.1111/vde.13242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 12/06/2023] [Accepted: 01/28/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Animal and owner quality-of-life (QoL) is pivotal in treatment decisions. Accurate measurement of owner-reported QoL and treatment satisfaction (TS) supports disease burden and treatment benefit evaluation. OBJECTIVES Develop and evaluate an owner-completed canine dermatitis QoL and TS questionnaire (CDQoL-TSQ) in allergic dogs. MATERIALS AND METHODS The CDQoL-TSQ was drafted following review of existing measures and expert input. Content validity was assessed through interviews with owners of allergic dogs. Psychometric properties of the QoL domains (Canine QoL, Owner QoL) were evaluated. Score interpretation was derived. RESULTS Twenty dog owners were interviewed. Item wording was amended following the first 10 interviews. Data from 211 owners were used in the psychometric evaluation. The Canine QoL domain demonstrated strong internal consistency (α = 0.89), test-retest reliability (ICC2,1 = 0.844), moderate convergent validity (r = 0.41) and moderate-high known-groups validity (effect size 0.37-0.64). The Owner QoL domain demonstrated strong internal consistency (α = 0.73), high convergent validity (r = 0.63) and moderate-high known-groups validity (0.43-0.63). Test-retest reliability approached moderate strength (ICC2,1 = 0.490). Group-level interpretation analysis showed minimal important difference of 7.0-13.6 points for dogs and 13.0-13.6 for owners. For individual dogs a change of 6.3 or 12.5 points for dogs, and 12.5 or 18.8 for owners indicates a response. CONCLUSIONS AND CLINICAL RELEVANCE The CDQOL-TSQ is a two-part assessment to evaluate QoL and TS in canine allergic dermatitis. The QoL questionnaire demonstrated validity and reliability, and interpretation of scores was derived, making it suitable for use in research and practice. The TS module is suitable for clinical setting use to improve owner-veterinarian communication.
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Affiliation(s)
- J R Wells
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, UK
- Clinical Outcomes Assessment Department, Sanofi, UK
| | | | | | | | - C Noli
- Servizi Dermatologici Veterinari, Peveragno, Italy
| | - C Panter
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, UK
| | - S Tatlock
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, UK
| | - A Wright
- Zoetis, Parsippany, New Jersey, USA
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Hunt S, Silk M, Sprinkle J, Nadolski G, Gade T, Hillier A. Geospatial mapping of interventional radiology physician density. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Candelaresi S, Hillier A, Maehara H, Brandenburg A, Shibata K. SUPERFLARE OCCURRENCE AND ENERGIES ON G-, K-, AND M-TYPE DWARFS. ACTA ACUST UNITED AC 2014. [DOI: 10.1088/0004-637x/792/1/67] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Cohen DA, Lapham S, Evenson KR, Williamson S, Golinelli D, Ward P, Hillier A, McKenzie TL. Use of neighbourhood parks: does socio-economic status matter? A four-city study. Public Health 2013; 127:325-32. [PMID: 23515008 DOI: 10.1016/j.puhe.2013.01.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 10/09/2012] [Accepted: 01/02/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To determine if neighbourhood socio-economic status (SES) is associated with park use and park-based physical activity. STUDY DESIGN Cross-sectional study. METHODS The use and characteristics of 24 neighbourhood parks in Albuquerque, Chapel Hill/Durham, Columbus and Philadelphia were observed systematically in three seasons (spring, summer and autumn), with nearly 36,000 park users observed. Twelve parks were in high-poverty neighbourhoods and 12 parks were in low-poverty neighbourhoods. In total, 3559 park users and 3815 local residents were surveyed. Park incivilities were assessed and park administrators were interviewed about management practices. RESULTS The size and number of facilities in parks in high-poverty neighbourhoods were similar to those in parks in low-poverty neighbourhoods, but the former had more hours of programming. Neighbourhood poverty level, perception of safety and the presence of incivilities were not associated with the number of park users observed. However, programmed activities and the number of activity facilities were strongly correlated with park use and energy expended in the park. CONCLUSIONS The finding that park programming is the most important correlate of park use and park-based physical activity suggests that there are considerable opportunities for facilitating physical activity among populations of both high- and low-poverty areas.
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Affiliation(s)
- D A Cohen
- RAND Corporation, Santa Monica, CA 90407, USA.
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Dykstra MJ, Sharp NJH, Olivry T, Hillier A, Murphy KM, Kaufman L, Kunkle GA, Pucheu-Haston C. A description of cutaneous-subcutaneous pythiosis in fifteen dogs. Med Mycol 2008. [DOI: 10.1111/j.1365-280x.1999.00248.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abstract
Blunted facial expressions and diminished expressions of emotional prosody associated with Parkinson's disease (PD) could be attributed to motor rigidity/akinesia. Although impaired recognition of emotional faces and prosody in PD suggests emotional dysfunction is not entirely motor-efferent, comprehension might depend upon imitation with motor feedback. Thus, to learn if patients with PD have an emotional conceptual defect, we examined their ratings for the emotional connotations of words on a 1-9 scale for valence and arousal. When compared to control participants the valence (positive-negative) and arousal (excited-calm) ratings of the PD patients were blunted, but their ratings of the control expense words (expensive-cheap) were not. These blunted emotion ratings suggest that patients with PD have a degradation of their emotional conceptual-semantic system.
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Affiliation(s)
- A Hillier
- Department of Psychology, University of Massachusetts, Lowell, USA
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Affiliation(s)
- L K Cole
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus, OH 43210, USA
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Beversdorf DQ, Manning SE, Hillier A, Anderson SL, Nordgren RE, Walters SE, Nagaraja HN, Cooley WC, Gaelic SE, Bauman ML. Timing of prenatal stressors and autism. J Autism Dev Disord 2005; 35:471-8. [PMID: 16134032 DOI: 10.1007/s10803-005-5037-8] [Citation(s) in RCA: 217] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Recent evidence supports a role for genetics in autism, but other findings are difficult to reconcile with a purely genetic cause. Pathological changes in the cerebellum in autism are thought to correspond to an event before 30-32 weeks gestation. Our purpose was to determine whether there is an increased incidence of stressors in autism before this time period. Surveys regarding incidence and timing of prenatal stressors were distributed to specialized schools and clinics for autism and Down syndrome, and to mothers of children without neurodevelopmental diagnoses in walk-in clinics. Incidence of stressors during each 4-week block of pregnancy was recorded. Incidence of stressors in the blocks prior to and including the predicted time period (21-32 weeks gestation) in each group of surveys was compared to the other prenatal blocks. A higher incidence of prenatal stressors was found in autism at 21-32 weeks gestation, with a peak at 25-28 weeks. This does support the possibility of prenatal stressors as a potential contributor to autism, with the timing of stressors consistent with the embryological age suggested by neuroanatomical findings seen in the cerebellum in autism. Future prospective studies would be needed to confirm this finding.
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Affiliation(s)
- D Q Beversdorf
- Department of Neurology, Ohio State University Medical Center, Columbus, OH 43210, USA.
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Cole LK, Kwochka KW, Hillier A, Kowalski JJ, Smeak DD. FC-46 Methicillin-resistant Staphylococcus intermedius organisms from the vertical ear canal of dogs with end-stage otitis externa. Vet Dermatol 2004. [DOI: 10.1111/j.1365-3164.2004.411_46.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cole LK, Kwochka KW, Hillier A, Kowalski JJ, Smeak DD, Kelbick NT. Comparison of bacterial organisms from otic exudate and ear tissue from the middle ear of untreated and enrofloxacin-treated dogs with chronic end-stage otitis. Vet Dermatol 2004. [DOI: 10.1111/j.1365-3164.2004.00410_2-5.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hillier A, Kwochka KW. Allergen-specific immunotherapy in dogs with atopic dermatitis and house dust mite hypersensitivity: use of symptom/medication scores. Vet Dermatol 2002. [DOI: 10.1046/j.1365-3164.2002.00298_4.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Jose-Cunilleras E, Kohn CW, Hillier A, Saville WJ, Lorch G. Intradermal testing in healthy horses and horses with chronic obstructive pulmonary disease, recurrent urticaria, or allergic dermatitis. J Am Vet Med Assoc 2001; 219:1115-21. [PMID: 11700711 DOI: 10.2460/javma.2001.219.1115] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare responses to a variety of intradermally injected allergens among healthy horses and horses with chronic obstructive pulmonary disease (COPD), recurrent urticaria (RU), and atopic dermatitis-insect hypersensitivity (allergic dermatitis [AD]). DESIGN Case-control study. ANIMALS 86 horses. PROCEDURE Results of intradermal testing for horses with COPD, RU, or AD were compared with results for healthy horses. RESULTS Compared with healthy horses, horses with COPD, RU, and AD were significantly more likely to have positive (> or = 3+) reactions to intradermal allergens (molds, weeds, trees, grasses-crops, and insects) 30 minutes (immediate reaction), 4 hours (late-phase reactions), and 24 hours (delayed-phase reactions) after exposure. In addition, diseased horses reacted to a significantly higher number of allergens in each allergen group than did healthy horses. CONCLUSIONS AND CLINICAL RELEVANCE Reactions to individual allergens should not be used to determine that horses have hypersensitivity. Overall patterns of reactivity to intradermal allergens may be helpful in management when used in conjunction with a compatible history and evidence of potential exposure to allergens in horses with conditions associated with hypersensitivity to environmental allergens.
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MESH Headings
- Allergens
- Animals
- Bronchoalveolar Lavage Fluid
- Case-Control Studies
- Dermatitis, Atopic/diagnosis
- Dermatitis, Atopic/immunology
- Dermatitis, Atopic/veterinary
- Female
- Horse Diseases/diagnosis
- Horse Diseases/immunology
- Horses
- Hypersensitivity, Delayed/diagnosis
- Hypersensitivity, Delayed/veterinary
- Hypersensitivity, Immediate/diagnosis
- Hypersensitivity, Immediate/veterinary
- Intradermal Tests/veterinary
- Male
- Pulmonary Disease, Chronic Obstructive/diagnosis
- Pulmonary Disease, Chronic Obstructive/immunology
- Pulmonary Disease, Chronic Obstructive/veterinary
- Recurrence
- Time Factors
- Urticaria/diagnosis
- Urticaria/immunology
- Urticaria/veterinary
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Affiliation(s)
- E Jose-Cunilleras
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus 43210, USA
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DeBoer DJ, Hillier A. The ACVD task force on canine atopic dermatitis (XVI): laboratory evaluation of dogs with atopic dermatitis with serum-based "allergy" tests. Vet Immunol Immunopathol 2001; 81:277-87. [PMID: 11553390 DOI: 10.1016/s0165-2427(01)00304-x] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Serum-based in vitro "allergy tests" are commercially available to veterinarians, and are widely used in diagnostic evaluation of a canine atopic patient. Following initial clinical diagnosis, panels of allergen-specific IgE measurements may be performed in an attempt to identify to which allergens the atopic dog is hypersensitive. Methodology for these tests varies by laboratory; few critical studies have evaluated performance of these tests, and current inter-laboratory standardization and quality control measures are inadequate. Other areas where information is critically limited include the usefulness of these tests in diagnosis of food allergy, the effect of extrinsic factors such as season of the year on results, and the influence of corticosteroid treatment on test results. Allergen-specific IgE serological tests are never completely sensitive, nor completely specific. There is only partial correlation between the serum tests and intradermal testing; however, the significance of discrepant results is unknown and unstudied. Variation in test methodologies along with the absence of universal standardization and reporting procedures have created confusion, varying study results, and an inability to compare between studies performed by different investigators.
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Affiliation(s)
- D J DeBoer
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Drive Madison, WI 57606, USA.
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Abstract
Intradermal testing has been practiced for decades in human and veterinary medicine. The primary utility of intradermal testing is in the demonstration of IgE-mediated allergen hypersensitivity. The presence of a positive reaction on an intradermal test is not always indicative of allergy, as it may sometimes be an indication of sub-clinical hypersensitivity. Despite its widespread use by veterinary dermatologists, the usefulness of the intradermal test would be greatly enhanced by the use of standardized allergen extracts and homogeneous criteria for the interpretation of results. Irrespective of these shortcomings, intradermal testing is regarded as a valuable tool in the demonstration of allergen-specific hypersensitivity when performed according to accepted guidelines.
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Affiliation(s)
- A Hillier
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH 43017, USA.
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Abstract
The clinical signs of atopic dermatitis (AD) in man and in dogs are variable, and there is no single physical or historical feature that, if present, indicates the presence of AD. The initial diagnosis of AD is made clinically with the fulfillment of a combination of criteria that are strongly associated with the disease. Several schemes have been proposed in an attempt to define uniform clinical criteria for diagnosing canine AD, but no system is perfect. Once AD is considered as a possible diagnosis, other important differential diagnoses must be methodically eliminated from consideration. As a final step, once the clinician is certain that AD is probable, "allergy" tests may be conducted to provide additional evidence to "substantiate" the diagnosis. It is important to understand that allergy testing, in whatever form, is not appropriately used early in the patient evaluation as a screening test. Rather, it should be reserved, after a firm clinical diagnosis of AD has been made, to implement allergen avoidance schemes or to select allergens to be incorporated in immunotherapy formulations.
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Affiliation(s)
- D J DeBoer
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Drive West, Madison, WI 53706, USA.
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Olivry T, DeBoer DJ, Griffin CE, Halliwell RE, Hill PB, Hillier A, Marsella R, Sousa CA. The ACVD task force on canine atopic dermatitis: forewords and lexicon. Vet Immunol Immunopathol 2001; 81:143-6. [PMID: 11553374 DOI: 10.1016/s0165-2427(01)00343-9] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Abstract
There is an increasing incidence of atopic diseases (asthma, allergic rhinitis and atopic dermatitis) in humans, especially in developed countries. Although there is a genetic predisposition to the development of these diseases, the rapid rise in incidence is suspected to be caused by environmental rather than genetic factors. Neither the incidence nor the prevalence of atopic dermatitis in the general canine population has been studied. As many of the environmental factors associated with the increasing incidence of atopic dermatitis in humans are consistently found in the environment of dogs, it would seem likely that a similar increase in the incidence of this disease would be occurring also in dogs. Epidemiological studies of canine atopic dermatitis are needed to characterize the incidence and prevalence of atopic dermatitis, and to further study the factors that contribute to the development of this disease.
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Affiliation(s)
- A Hillier
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp St., Columbus, OH 43017, USA.
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Hill PB, Hillier A, Olivry T. The ACVD task force on canine atopic dermatitis (VI): IgE-induced immediate and late-phase reactions, two inflammatory sequences at sites of intradermal allergen injections. Vet Immunol Immunopathol 2001; 81:199-204. [PMID: 11553380 DOI: 10.1016/s0165-2427(01)00299-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Intradermal testing is a common diagnostic procedure used in the evaluation of dogs with suspected atopic dermatitis (AD). To do this, most investigators assess the appearance of wheals that develop at the sites of intradermal allergen injections. However, wheals are rarely seen in dogs with naturally occurring AD. Furthermore, infiltration of inflammatory cells into the injection sites can occur 6-24h later, a phenomenon known as the late-phase reaction. The histological appearance of these late-phase reactions closely approximates that seen in the natural disease, suggesting that they might be more relevant than the immediate reactions. In this paper, we review the literature on immediate and late-phase reactions and re-assess the evidence for using current intradermal testing procedures as a diagnostic test in dogs.
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Affiliation(s)
- P B Hill
- Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Edinburgh EH25 9RG, Scotland, UK.
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Abstract
Essential fatty acids (EFAs) exhibit the potential to affect allergic inflammation through the modulation of prostaglandin and leukotriene production, the inhibition of cellular activation and cytokine secretion as well as the alteration of the composition and function of the epidermal lipid barrier. Because of these multi-faceted effects, EFA have been proposed for treatment of canine atopic dermatitis (AD) since 1987. To date, more than 20 trials have been performed, reporting the efficacy of either oral EFA supplements or EFA-rich diets. Unfortunately, most of these studies were found to exhibit one or more of the following deficiencies: heterogeneity of diagnoses used as inclusion criteria, short duration of supplementation, lack of randomization of treatment allocation, lack of blinding of investigators and/or owners, lack of placebo or active controls, lack of documentation of plasma or skin EFA profiles during supplementation, as well as lack of standardization of the basal diets or supplements which could have provided additional EFA. Consequently, there is presently insufficient evidence to recommend for or against the use of EFA to control clinical signs of canine AD. Evidence of efficacy must await the performance of blinded, randomized and controlled trials of at least 3 months duration in which diets are identical for all of study subjects. In these trials, clinical efficacy should be evaluated in relation to plasma and cutaneous EFA treatment-induced alterations.
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Affiliation(s)
- T Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough Street, Raleigh, NC 27606, USA.
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Abstract
Allergen-specific immunotherapy (ASIT) has been used for years to treat dogs with atopic dermatitis (AD) and humans with atopic diseases. The efficacy of ASIT has been well documented for humans with respiratory atopic diseases and stinging insect allergy, but its effectiveness seems more controversial for patients with AD. In spite of insufficient evidence derived from randomized controlled trials, multiple open studies and a large body of clinical observations suggest that ASIT is effective in controlling the clinical signs of dogs with AD. As a result of the scarcity of evidence from controlled trials, the true efficacy of ASIT, and the optimal protocols for allergen dose and frequency of injection are currently unknown. Allergen-specific immunotherapy nevertheless may be included in the treatment of canine AD because of its potential advantages and limited disadvantages compared to other forms of therapy. There is no evidence, however, for the preference of any specific treatment protocol. The predictive value of historical, clinical and immunologic features related to the efficacy of ASIT in dogs with AD are discussed in this paper. Adverse reactions, and the requirements for monitoring of patients receiving ASIT, then are reviewed and detailed. Finally, this review highlights aspects of ASIT where further research and controlled studies are needed.
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Affiliation(s)
- C E Griffin
- Animal Dermatology Clinic, San Diego, CA 92111, USA.
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Hillier A, Griffin CE. The ACVD task force on canine atopic dermatitis (X): is there a relationship between canine atopic dermatitis and cutaneous adverse food reactions? Vet Immunol Immunopathol 2001; 81:227-31. [PMID: 11553384 DOI: 10.1016/s0165-2427(01)00302-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In humans, allergies to foods are known to induce skin lesions in some patients with atopic dermatitis. This is particularly evident in infants with severe atopic dermatitis. Food allergy in humans is an IgE-mediated hypersensitivity in most cases, and thus has the same (or very similar) pathogenic mechanism of disease induction as environmental allergen-induced atopic dermatitis. Cutaneous adverse food reactions and atopic dermatitis in dogs are often indistinguishable from each other on historical and clinical grounds alone. Limited current evidence suggests that dogs with cutaneous adverse food reactions may be predisposed to developing atopic dermatitis. However, confirmation of any association between these two diseases in dogs awaits further elucidation of the pathogenic mechanism of cutaneous adverse food reactions, and epidemiological studies of the relative prevalence of these diseases in relation to each other and the general population.
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Affiliation(s)
- A Hillier
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp St., Columbus, OH 43017, USA.
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Abstract
Collaborative practice models using advanced practice nurses have been developed to provide high-quality healthcare in a cost-effective manner. Studies in gastroenterology nursing evaluating effectiveness of advanced practice nurses have been limited to performance of procedures, such as screening flexible sigmoidoscopies, and assisting with percutaneous endoscopic gastrostomy tube placement. Research and literature discussing the potential benefits of using advanced practice nurses as providers of care in a gastroenterology setting is limited. This cross-sectional descriptive study (N = 32) compares the nurse practitioner and clinical nurse specialist roles in gastroenterology.
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Lorch G, Hillier A, Kwochka KW, Saville WA, LeRoy BE. Results of intradermal tests in horses without atopy and horses with atopic dermatitis or recurrent urticaria. Am J Vet Res 2001; 62:1051-9. [PMID: 11453479 DOI: 10.2460/ajvr.2001.62.1051] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare results of intradermal tests (IDT) for environmental allergens at 30 minutes and 4, 6, and 24 hours after injection in horses without atopy and horses with atopic dermatitis (AD) or recurrent urticaria (RU). ANIMALS 22 horses without atopy, 10 horses with RU, and 7 horses with AD. PROCEDURE In all horses, medical history was obtained, and results of physical examination, hematologic examination, serum biochemical analyses, examination of bronchoalveolar lavage fluid, and IDT with 73 allergens were examined. RESULTS Horses with AD or RU had a significantly greater mean number of positive reactions for IDT, compared with horses without atopy. Horses with AD had a significantly greater number of positive reactions than horses without atopy in every allergen group at all time periods, except for molds at 4 and 24 hours. Horses with RU had a significantly greater number of positive reactions than horses without atopy in every allergen group, except for molds at 30 minutes and 4 and 6 hours, trees at 4 and 6 hours, and grasses at 4 hours. CONCLUSIONS AND CLINICAL RELEVANCE A significantly greater number of positive reactions for IDT in horses with AD or RU, compared with horses without atopy, provides evidence of type-I IgE-mediated hypersensitivity for these diseases. Evaluation of results of IDT performed in horses with AD or RU is useful in determining specific allergens for the formulation of immunotherapy along with providing identification of allergens that could be useful when creating avoidance strategies.
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Affiliation(s)
- G Lorch
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus 43210-1089, USA
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Lorch G, Hillier A, Kwochka KW, Saville WJ, Kohn CW, LeRoy BE. Comparison of immediate intradermal test reactivity with serum IgE quantitation by use of a radioallergosorbent test and two ELISA in horses with and without atopy. J Am Vet Med Assoc 2001; 218:1314-22. [PMID: 11330620 DOI: 10.2460/javma.2001.218.1314] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare a radioallergosorbent test and 2 ELISA with intradermal testing for the determination of environmental allergen hypersensitivity in horses with and without atopic diseases. DESIGN Prospective clinical study. ANIMALS 10 horses with recurrent urticaria, 7 with atopic dermatitis, 16 with chronic obstructive pulmonary disease, and 22 without atopy. PROCEDURE History, physical examination, hemogram, serum biochemical analyses, bronchoalveolar lavage, and an intradermal test (used as the criterion standard) with a regional panel of 73 allergens were performed in all horses. Serum was analyzed by use of the 3 in vitro assays of allergen-specific IgE. RESULTS An ELISA based on the alpha chain of the high-affinity IgE receptor, the Fcepsilon receptor immunoglobin epsilon chain (FcepsilonRIalpha) for IgE, had the overall highest kappa statistic (0.238), positive predictive value (49%), and negative predictive value (78%). Overall agreement between the FcepsilonRIalpha-based ELISA and the intradermal test was fair. The highest kappa statistic was obtained by the FcepsilonRIalpha-based ELISA in horses with atopic dermatitis (0.330). Kappa statistics for the radioallergosorbent test and a polyclonal antibody-based ELISA agreed slightly with that of the intradermal test at best. CONCLUSIONS AND CLINICAL RELEVANCE None of the 3 serum allergy tests reliably detected allergen hypersensitivity, compared with the intradermal test. The FcepsilonRIalpha-based ELISA performed significantly better overall than the other 2 tests. Low sensitivity of all 3 assays indicates the need for continued study to elucidate a more sensitive test for the determination of potentially pathogenic allergens in horses.
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Affiliation(s)
- G Lorch
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus 43210-1092, USA
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Lorch G, Hillier A, Kwochka KW, Saville WJ, Kohn CW, Jose-Cunilleras E. Results of intradermal tests in horses without atopy and horses with chronic obstructive pulmonary disease. Am J Vet Res 2001; 62:389-97. [PMID: 11277205 DOI: 10.2460/ajvr.2001.62.389] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare results of intradermal tests (IDT), conducted using environmental allergens, in horses without atopy and horses with chronic obstructive pulmonary disease (COPD). ANIMALS 38 horses (22 horses without atopy and 16 horses with COPD). PROCEDURE All horses were examined (physical examination, hematologic examination, serum biochemical analyses, examination of bronchoalveolar lavage fluid). An IDT was conducted, using a full panel of 73 allergens consisting of grasses, weeds, trees, molds, and insects. Results of the IDT were evaluated 30 minutes and 4, 6, and 24 hours after injection of allergens. Horses without atopy were euthanatized, and gross and histologic changes of lung parenchyma were assessed. RESULTS Horses without atopy had a greater number of positive immediate and late-phase reactions than did horses with COPD. Horses with COPD did not have a significantly greater number of positive reactions than horses without atopy at any time period for any allergen group (grasses, weeds, trees, molds, and insects). CONCLUSIONS AND CLINICAL RELEVANCE Positive results of IDT document allergen-specific hypersensitivity but do not necessarily distinguish clinically relevant reactions from subclinical reactivity in horses with COPD. Interpreting the clinical relevance of results of IDT requires a thorough knowledge of the medical history, physical examination findings, and environment of each animal.
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Affiliation(s)
- G Lorch
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus 43210, USA
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McCall C, Hunter S, Stedman K, Weber E, Hillier A, Bozic C, Rivoire B, Olivry T. Characterization and cloning of a major high molecular weight house dust mite allergen (Der f 15) for dogs. Vet Immunol Immunopathol 2001; 78:231-47. [PMID: 11292526 DOI: 10.1016/s0165-2427(00)00258-0] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Although house dust mites (HDM(s)) are important elicitors of canine allergy, the low molecular weight molecules defined as major allergens for humans do not appear to be major allergens for dogs. Western blotting of Dermatophagoides farinae (D. farinae) extracts with sera from sensitized dogs showed that the majority of animals had IgE antibodies specific for two proteins of apparent molecular weights of 98 and 109kDa (98/109kDa). The N-terminal sequences of these two proteins were identical, suggesting they were very closely related, and sequencing of internal peptides showed the protein(s) to have homology with insect chitinases. A purified preparation of 98/109kDa proteins elicited positive intradermal skin tests (IDST(s)) in a group of well-characterized atopic dogs sensitized to D. farinae, but not in normal dogs. A rabbit polyclonal antiserum raised against the purified proteins was used to immunoscreen a D. farinae cDNA library. The mature coding region of the isolated chitinase cDNA predicts a protein of 63.2kDa; sequence analysis and glycan detection blotting suggest that the molecule is extensively O-glycosylated. Monoclonal antibodies made against the purified native protein were used to localize the chitinase in sections of whole D. farinae mites. The protein displayed an intracellular distribution in the proventriculus and intestine of the mite, suggesting that it has a digestive, rather than a moulting-related, function. The high prevalence of IgE antibodies to this antigen in canine atopic dermatitis makes it a major HDM allergen for dogs, and the protein has been formally designated Der f 15.
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Affiliation(s)
- C McCall
- Heska Corporation, 1825 Sharp Point Drive, Fort Collins, CO 80525, USA.
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Hillier A, Kwochka KW, Pinchbeck LR. Reactivity to intradermal injection of extracts of Dermatophagoides farinae, Dermatophagoides pteronyssinus, house dust mite mix, and house dust in dogs suspected to have atopic dermatitis: 115 cases (1996-1998). J Am Vet Med Assoc 2000; 217:536-40. [PMID: 10953719 DOI: 10.2460/javma.2000.217.536] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To compare reactivities to intradermal injection of extracts of Dermatophagoides farinae, Dermatophagoides pteronyssinus, house dust mite mix, and house dust in dogs suspected to have atopic dermatitis. DESIGN Retrospective study. ANIMALS 115 dogs. PROCEDURES Records of all dogs suspected to have atopic dermatitis that underwent intradermal testing between October 1996 and July 1998 were reviewed. Reactivities to intradermal injection of crude mixed house dust mite (1:25,000 wt/vol) and crude house dust (25 PNU/ml) extracts were compared with reactivities to intradermal injection of individual extracts of D farinae and D pteronyssinus (1:50,000 wt/vol). RESULTS Ninety dogs were confirmed to have atopic dermatitis including 61 of the 69 dogs with positive reactions to either or both of the individual house dust mite extracts. Intradermal testing with the mixed house dust mite extract had sensitivity of 75%, specificity of 96%, and accuracy of 83%. Intradermal testing with the house dust extract had sensitivity of 30%, specificity of 93%, and accuracy of 56%. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that use of crude mixed house dust mite and crude house dust extracts for intradermal testing in dogs is not as accurate a method of determining house dust mite hypersensitivity as is the use of individual D farinae and D pteronyssinus extracts mainly because of the high percentage of false-negative results. Extracts of individual house dust mites are recommended for intradermal testing of dogs suspected to have atopic dermatitis.
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Affiliation(s)
- A Hillier
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus 43210, USA
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Dykstra MJ, Sharp NJ, Olivry T, Hillier A, Murphy KM, Kaufman L, Kunkle GA, Pucheu-Haston C. A description of cutaneous-subcutaneous pythiosis in fifteen dogs. Med Mycol 1999; 37:427-33. [PMID: 10647124 DOI: 10.1046/j.1365-280x.1999.00248.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Information regarding signalment, duration of clinical signs, history of swimming, results of CBC and serum biochemical analyses, biopsy findings and mycological results, together with treatments and outcome, was retrieved from the medical records of 15 dogs with a diagnosis of pythiosis made between 1985 and 1995 at the Colleges of Veterinary Medicine, North Carolina State University and the University of Florida. Most of the dogs were young (median age 22 months) and represented larger breeds (> 20 kg). Lesions were characteristically chronic, ulcerated, and nodular with multiple draining tracts on the limbs, thoracic wall or perineal regions. The median duration of these lesions was 3 months with a range of 2 weeks-6 months. Seven dogs had a history of swimming. Peripheral eosinophilia was observed in 14 of the dogs. Cytological evaluation of discharge, aspirates, or impression smears made from biopsy specimens revealed hyphae in five of 11 dogs (45%). Histopathological evaluation using the Gomori Methenamine-Silver (GMS) stain was the most useful test for providing presumptive evidence of cutaneous pythiosis. Immunotherapy or antifungal therapy using either amphotericin B, liposomal nystatin, itraconazole, or ketoconazole were all unsuccessful. The only dog to survive underwent amputation of the affected limb; thus, the prognosis for cutaneous pythiosis in the dog is poor.
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Affiliation(s)
- M J Dykstra
- Microbiology, Pathology and Parasitology Department, College of Veterinary Medicine, North Carolina State University, Raleigh 27606, USA
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Cole LK, Kwochka KW, Kowalski JJ, Hillier A. Microbial flora and antimicrobial susceptibility patterns of isolated pathogens from the horizontal ear canal and middle ear in dogs with otitis media. J Am Vet Med Assoc 1998; 212:534-8. [PMID: 9491161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To compare microbial flora and antimicrobial susceptibility patterns of isolated pathogens from the horizontal ear canal and middle ear in dogs with otitis media. DESIGN Prospective study. ANIMALS 23 dogs with chronic bilateral otitis externa. PROCEDURES Swab specimens of the horizontal ear canal and middle ear were obtained for cytologic analysis, bacterial culture, and antimicrobial susceptibility testing. Integrity of the tympanic membrane was observed. If the tympanic membrane was intact, myringotomy was performed to collect specimens. RESULTS Otitis media was diagnosed in 38 of 46 (82.6%) ears evaluated. The tympanic membrane was intact in 71.1% of the ears with otitis media. The 3 most common organisms isolated from the horizontal ear canal and middle ear were Staphylococcus intermedius, yeast, and Pseudomonas spp. A difference in total isolates or susceptibility patterns between the horizontal ear canal and middle ear was found in 34 (89.5%) ears. Compared with results of bacterial culture, cytologic examination of swab specimens was not as effective for detection of rods and cocci from the middle ear. CLINICAL IMPLICATIONS In dogs with chronic otitis externa, otitis media often exists even when there is an intact tympanic membrane. In our study, the same isolates were rarely found in the horizontal ear canal and middle ear. Therefore, to choose appropriate antimicrobial agents, in addition to cytologic examination, bacterial culture and susceptibility testing of swab specimens from the horizontal ear canal and middle ear should be performed.
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Affiliation(s)
- L K Cole
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus 43210, USA
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Abstract
Lactococcal phage abortive infection (AbiD1) determined by plasmid pIL105 is active on both prolate- and small-isometric-head phages of the C6A and 936 phage groups, respectively, which are considered two different species. The Abi phenotype was found to be encoded by a single gene, designated abiD1. The abiD1-encoded protein (351 amino acids) does not show homology with any known protein and has a deduced isoelectric point of 10. It also possesses two helix-turn-helix structures and an unusually high content of asparagine, isoleucine, and lysine. A consensual promoter with a TGy extension to the -10 box was mapped 76 bp upstream of the start codon. Transcription initiated at this strong promoter stops at a terminator located 48 bp downstream from the promoter. The termination process is very efficient, and transcripts corresponding to the abiD1 gene were not visible in our experimental conditions with or without phage infection. Expression of abiD1 under the control of a T7 promoter induced a lag phase in Lactococcus lactis cell growth, suggesting that overproduction of AbiD1 could be toxic for the cells. AbiD1 protein was visualized in Escherichia coli by using a tightly controlled expression system.
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Affiliation(s)
- J Anba
- Laboratoire de Génétique Microbienne, Institut National de la Recherche Agronomique, Jouy-en-Josas, France
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Bidnenko E, Valyasevi R, Cluzel PJ, Parreira R, Hillier A, Gautier M, Anba J, Ehrlich SD, Chopin MC. Amélioration de la résistance des lactocoques aux bactériophages. ACTA ACUST UNITED AC 1993. [DOI: 10.1051/lait:1993218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Hillier A. PARLIAMENTARY REPRESENTATION OF THE UNIVERSITIES OF EDINBURGH AND ST. ANDREWS. West J Med 1906. [DOI: 10.1136/bmj.1.2349.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hillier A. Sir Lauder Brunton's Model Sanatorium. West J Med 1902. [DOI: 10.1136/bmj.2.2168.224-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hillier A. Professor Koch and Bovine Tuberculosis. West J Med 1901. [DOI: 10.1136/bmj.2.2138.1843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hillier A. Professor Koch's Address. West J Med 1901. [DOI: 10.1136/bmj.2.2119.380-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hillier A. Mr. Jonathan Hutchinson on Leprosy in South Africa. West J Med 1900. [DOI: 10.1136/bmj.2.2063.125-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hillier A. The Climate of South Africa. West J Med 1900. [DOI: 10.1136/bmj.1.2043.484-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hillier A. The Geography and Climate of South Africa. West J Med 1899. [DOI: 10.1136/bmj.2.2031.1537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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