vector-borne disease

媒介传播疾病
  • 文章类型: Journal Article
    人类丝虫病是一种新兴的疾病,由于人类及其伴侣动物的旅行和气候变化的增加,这种疾病正在上升。我们报告了一例21岁患者阴囊中的Dirofilariarepens,经历了右睾丸疼痛的人。超声检查显示一个管状,成功提取蠕虫样病变,并通过寄生虫学和分子分析确认为未成熟的D.repens。手术后,患者接受驱虫治疗后出院。提高医疗保健专业人员对这种寄生虫病的认识至关重要,鉴于预期的丝虫病病例增加。波兰的气候变化与其说是创纪录的高温,不如说是温暖天数的系统性增加,影响生活的许多方面。由于病媒的存在,外来和寄生虫病的引入和重新引入,以前在温带气候地区罕见或不存在,是可能的。
    Human dirofilariasis is an emerging disease that is rising and driven by increasing travel of both humans and their companion animals and climate change. We report a case of Dirofilaria repens in the scrotum of a 21-year-old patient, who experienced right testicular pain. Ultrasonography revealed a tubular, worm-like lesion extracted successfully and confirmed as an immature D. repens through parasitological and molecular analyses. Post-surgery, the patient underwent anthelmintic treatment and was discharged. Increased awareness of this parasitosis among healthcare professionals is crucial, given the expected rise in dirofilariasis cases. Climate change in Poland, characterized not so much by record high temperatures but by a systematic increase in the number of warm days, affects many aspects of life. Due to the presence of disease vectors, the introduction and reintroduction of exotic and parasitic disease, previously rare or absent in temperate climate zones, is possible.
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  • 文章类型: Journal Article
    背景:淋巴丝虫病(LF)是一种全球性的丝虫病,矢量传播,被忽视的热带病,可导致严重的发病率和残疾。随着世界卫生组织(WHO)全球消除淋巴丝虫病计划在消除LF方面取得进展,更需要制定干预后监测的敏感策略。分子异种监测(MX),载体中病原体DNA的检测,可以为传统的基于人类的监视技术提供敏感的补充,包括循环丝虫抗原和微丝血症(Mf)的检测。本研究旨在探讨人类Mf患病率与使用MX的聚合酶链反应(PCR)阳性蚊子患病率之间的关系。
    方法:本研究比较了在萨摩亚35个初级抽样单位(PSU)中进行的2019年基于社区的调查的Mf和MX结果。这项研究还调查了在PSU水平上存在和不存在PCR阳性蚊子和Mf阳性参与者之间的一致性。并使用人类或PCR阳性蚊子中任何Mf阳性感染的存在作为参考来计算每个指标的灵敏度和阴性预测值。使用混合效应贝叶斯多水平回归分析,在PSU和家庭/陷阱水平上估算了蚊子中丝虫DNA的患病率与人类Mf之间的相关性。
    结果:在存在PCR阳性蚊子池的PSU中,不到一半的PSU中发现了Mf阳性个体(28个PSU中的13个)。在PSU水平上,PCR阳性蚊子(每个物种分别)的患病率与人类Mf患病率呈正相关。在物种层面分析,在PSU(r:0.5,95%CrI0.1-0.8)和陷阱/家庭水平(r:0.6,95%CrI0.2-0.9)下,只有波莉伊蚊显示出与人类Mf患病率呈正相关(r)的有力证据。
    结论:这项研究的结果表明,MX可以作为一种在低Mf患病率环境中识别残留感染的敏感监测方法。MX比Mf测试识别出更多具有传输信号的位置。在小空间尺度下,主要媒介物种中估计的PCR阳性蚊子与人类Mf之间的强相关性表明,MX可作为萨摩亚和类似环境中LF流行的指标。需要进一步调查以制定MX准则,以加强MX为业务决策提供信息的能力。
    BACKGROUND: Lymphatic filariasis (LF) is a globally significant, vector-borne, neglected tropical disease that can result in severe morbidity and disability. As the World Health Organization (WHO) Global Programme to Eliminate Lymphatic Filariasis makes progress towards LF elimination, there is greater need to develop sensitive strategies for post-intervention surveillance. Molecular xenomonitoring (MX), the detection of pathogen DNA in vectors, may provide a sensitive complement to traditional human-based surveillance techniques, including detection of circulating filarial antigen and microfilaraemia (Mf). This study aims to explore the relationship between human Mf prevalence and the prevalence of polymerase chain reaction (PCR)-positive mosquitoes using MX.
    METHODS: This study compared Mf and MX results from a 2019 community-based survey conducted in 35 primary sampling units (PSUs) in Samoa. This study also investigated concordance between presence and absence of PCR-positive mosquitoes and Mf-positive participants at the PSU level, and calculated sensitivity and negative predictive values for each indicator using presence of any Mf-positive infection in humans or PCR-positive mosquitoes as a reference. Correlation between prevalence of filarial DNA in mosquitoes and Mf in humans was estimated at the PSU and household/trap level using mixed-effect Bayesian multilevel regression analysis.
    RESULTS: Mf-positive individuals were identified in less than half of PSUs in which PCR-positive mosquito pools were present (13 of 28 PSUs). Prevalence of PCR-positive mosquitoes (each species separately) was positively correlated with Mf prevalence in humans at the PSU level. Analysed at the species level, only Aedes polynesiensis demonstrated strong evidence of positive correlation (r) with human Mf prevalence at both PSU (r: 0.5, 95% CrI 0.1-0.8) and trap/household levels (r: 0.6, 95% CrI 0.2-0.9).
    CONCLUSIONS: Findings from this study demonstrate that MX can be a sensitive surveillance method for identifying residual infection in low Mf prevalence settings. MX identified more locations with signals of transmission than Mf-testing. Strong correlation between estimated PCR-positive mosquitoes in the primary vector species and Mf in humans at small spatial scales demonstrates the utility of MX as an indicator for LF prevalence in Samoa and similar settings. Further investigation is needed to develop MX guidelines to strengthen the ability of MX to inform operational decisions.
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  • 文章类型: Journal Article
    人类极大地改变了地球的陆地水循环,大部分淡水用于农业。灌溉改变了时空水的可利用性,并改变了蚊子的丰度和物候。先前评估灌溉对蚊子丰度和蚊子传播疾病的影响的研究显示出不一致的结果,并且对灌溉对蚊子丰度变异性的影响知之甚少。我们检查了灌溉的效果,加利福尼亚州蚊子丰度和人类西尼罗河病毒(WNV)疾病病例的气候和土地覆盖。灌溉占总水量的近三分之一,一些地区的降水量超过了。几种虫媒病毒的两个关键载体的丰度,包括WNV,淡色库蚊和淡色库蚊复合体,灌溉增加了17-21倍。灌溉减少了C.tarsalis丰度的季节性变化36.1%。人类WNV发病率随着灌溉而增加,这解释了加利福尼亚州各县之间WNV发病率变化的三分之一(34.2%)以上。这些结果表明,灌溉可以增加蚊子种群并使其与自然降水变化脱钩。导致疾病负担持续增加。气候变化导致的降水变化可能会导致许多干旱地区的灌溉增加,这可能会增加蚊子的数量和疾病。
    Humans have greatly altered earth\'s terrestrial water cycle with the majority of fresh water being used for agriculture. Irrigation changes spatial and temporal water availability and alters mosquito abundance and phenology. Previous studies evaluating the effect of irrigation on mosquito abundance and mosquito-borne disease have shown inconsistent results and little is known about the effect of irrigation on variability in mosquito abundance. We examined the effect of irrigation, climate and land cover on mosquito abundance and human West Nile virus (WNV) disease cases across California. Irrigation made up nearly a third of total water inputs, and exceeded precipitation in some regions. Abundance of two key vectors of several arboviruses, including WNV, Culex tarsalis and the Culex pipiens complex, increased 17-21-fold with irrigation. Irrigation reduced seasonal variability in C. tarsalis abundance by 36.1%. Human WNV incidence increased with irrigation, which explained more than a third (34.2%) of the variation in WNV incidence among California counties. These results suggest that irrigation can increase and decouple mosquito populations from natural precipitation variability, resulting in sustained and increased disease burdens. Shifts in precipitation due to climate change are likely to result in increased irrigation in many arid regions which could increase mosquito populations and disease.
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  • 文章类型: Journal Article
    环境维度,如温度,降水,湿度,湿度和植被类型,影响活动,生存,和蜱种的地理分布。蜱是导致人类疾病的各种病原体的载体,肩capularis和Amblyommaamericanum是在美国中部和东部将病原体传播给人类的蜱物种。尽管它们的潜在地理分布已经通过生态位建模进行了广泛的评估,没有全面的研究比较了蜱和蜱传播病原体之间的生态位信号。我们利用了国家生态观测站网络(NEON)的数据,了解了北美这两种蜱和相关的细菌病原体。我们使用了两个新颖的统计检验,明确考虑抽样和缺席数据来执行这些探索:基于随机化和重抽样的单变量分析,和置换多变量方差分析。基于单变量分析,在amblyommaamericanum,三种病原体(伯氏螺旋体,查菲埃里希氏菌,和E.ewingii)进行了测试;病原体在至少一个环境维度上显示出非随机分布。基于PERMANOVA检验,病原体阳性样品的环境位置和变异与美国A的相同的零假设不能被任何病原体拒绝,除了病原体E.ewingii的最高和最低蒸气压和最低温度。对于肩胛骨,六种病原体(A.吞噬细胞,米蒂巴贝虫,伯氏疏螺旋体,B.马约尼,B.miyamotoi,和Ehrlichiamuris-like)进行了测试;只有B.miyamotoi与所有环境维度的零期望没有区别,基于单变量检验。在PERMANOVA分析中,病原体偏离了对B.microti和B.burgdorferisensulato的预期,在B.microti有较小的壁龛,还有B.BurgdorferisensuLato的更大的生态位,比矢量。更一般地说,这项研究显示了具有一致抽样方法的大规模数据资源的价值,以及特定样本中已知的关键病原体缺失,回答公共卫生问题,例如宿主中病原体的存在和不存在与环境条件的关系。
    Environmental dimensions, such as temperature, precipitation, humidity, and vegetation type, influence the activity, survival, and geographic distribution of tick species. Ticks are vectors of various pathogens that cause disease in humans, and Ixodes scapularis and Amblyomma americanum are among the tick species that transmit pathogens to humans across the central and eastern United States. Although their potential geographic distributions have been assessed broadly via ecological niche modeling, no comprehensive study has compared ecological niche signals between ticks and tick-borne pathogens. We took advantage of National Ecological Observatory Network (NEON) data for these two tick species and associated bacteria pathogens across North America. We used two novel statistical tests that consider sampling and absence data explicitly to perform these explorations: a univariate analysis based on randomization and resampling, and a permutational multivariate analysis of variance. Based on univariate analyses, in Amblyomma americanum, three pathogens (Borrelia lonestari, Ehrlichia chaffeensis, and E. ewingii) were tested; pathogens showed nonrandom distribution in at least one environmental dimension. Based on the PERMANOVA test, the null hypothesis that the environmental position and variation of pathogen-positive samples are equivalent to those of A. americanum could not be rejected for any of the pathogens, except for the pathogen E. ewingii in maximum and minimum vapor pressure and minimum temperature. For Ixodes scapularis, six pathogens (A. phagocytophilum, Babesia microti, Borrelia burgdorferi sensu lato, B. mayonii, B. miyamotoi, and Ehrlichia muris-like) were tested; only B. miyamotoi was not distinct from null expectations in all environmental dimensions, based on univariate tests. In the PERMANOVA analyses, the pathogens departed from null expectations for B. microti and B. burgdorferi sensu lato, with smaller niches in B. microti, and larger niches in B. burgdorferi sensu lato, than the vector. More generally, this study shows the value of large-scale data resources with consistent sampling methods, and known absences of key pathogens in particular samples, for answering public health questions, such as the relationship of presence and absence of pathogens in their hosts respect to environmental conditions.
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  • 文章类型: Journal Article
    蓝舌病毒(BT)是一种引起疾病的媒介传播病毒,叫做蓝舌,这导致了绵羊的重大经济损失和发病率,牛,除南极洲外,世界各大洲的山羊和野生有蹄类动物。尽管其影响地域广泛,大多数BT流行病学模型都来自2006-2009年BTV-8欧洲疫情的参数。这项研究的目的是为BT开发一个高度适应性的模型,可以在世界其他地方使用,以及确定对疫情动态影响最大的参数,以便决策者可以适当地了解最新信息,以帮助制定疾病计划。为未来的疫情建模和反映感染自然变化的更新参数提供框架,一个新开发的参数化的双主机,建立并分析了两向量物种常微分方程模型。该模型旨在适应于在世界任何地区实施,并能够对流行和流行情况进行建模。使用宿主到载体和载体到宿主的传输速率的系统文献综述对其进行了参数化,主机潜伏期,宿主感染期,和疫苗保护因素。使用更新的参数演示了该模型,南非是以西开普省已知的牛羊种群为基础的,当地环境参数,和库利科德斯物种。存在数据。敏感性分析确定,绵羊和奶牛的感染期持续时间对爆发高峰期的爆发长度和感染动物数量的影响最大。从牛和羊到C.imicolamid的传播率极大地影响了爆发高峰发生的那一天,随着潜伏期的持续时间,和奶牛的感染期。最后,疫苗的保护因子对感染动物总数的影响最大。这些知识可以帮助制定控制措施。由于气候和人类学的逐渐变化,导致病媒栖息地适应性发生变化,BT爆发的范围和频率可能会继续增加。因此,这项研究为未来世界各地的疫情提供了一个更新的BT建模框架,以探索传播,疫情动态和控制措施。
    Bluetongue virus (BT) is a vector-borne virus that causes a disease, called bluetongue, which results in significant economic loss and morbidity in sheep, cattle, goats and wild ungulates across all continents of the world except Antarctica. Despite the geographical breadth of its impact, most BT epidemiological models are informed by parameters derived from the 2006-2009 BTV-8 European outbreak. The aim of this study was to develop a highly adaptable model for BT which could be used elsewhere in the world, as well as to identify the parameters which most influence outbreak dynamics, so that policy makers can be properly informed with the most current information to aid in disease planning. To provide a framework for future outbreak modelling and an updated parameterisation that reflects natural variation in infections, a newly developed and parameterised two-host, two-vector species ordinary differential equation model was formulated and analysed. The model was designed to be adaptable to be implemented in any region of the world and able to model both epidemic and endemic scenarios. It was parameterised using a systematic literature review of host-to-vector and vector-to-host transmission rates, host latent periods, host infectious periods, and vaccine protection factors. The model was demonstrated using the updated parameters, with South Africa as a setting based on the Western Cape\'s known cattle and sheep populations, local environmental parameters, and Culicoides spp. presence data. The sensitivity analysis identified that the duration of the infectious period for sheep and cows had the greatest impact on the outbreak length and number of animals infected at the peak of the outbreak. Transmission rates from cows and sheep to C. imicola midges greatly influenced the day on which the peak of the outbreak occurred, along with the duration of incubation period, and infectious period for cows. Finally, the protection factor of the vaccine had the greatest influence on the total number of animals infected. This knowledge could aid in the development of control measures. Due to gradual climate and anthropological change resulting in alterations in vector habitat suitability, BT outbreaks are likely to continue to increase in range and frequency. Therefore, this research provides an updated BT modelling framework for future outbreaks around the world to explore transmission, outbreak dynamics and control measures.
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  • 文章类型: Journal Article
    背景:尽管越南在控制疟疾方面取得了成功,这种疾病仍然是一个重大的健康问题,特别是在越南中部。这项研究旨在评估环境之间的相关性,气候,以及该地区疟疾病例的社会经济因素。
    方法:该研究于2018年1月至2022年12月在越南中部15个省进行。每月疟疾病例来自疟疾研究所,寄生虫学,昆虫学QuyNhon,越南。Environmental,气候,使用GoogleEarthEngine脚本检索社会经济数据。使用具有条件自回归先验结构的空间和时空随机效应的贝叶斯框架进行多变量零膨胀泊松回归。后验随机效应是使用带有吉布斯抽样的贝叶斯马尔可夫链蒙特卡罗模拟来估计的。
    结果:研究期间共有5,985例恶性疟原虫和2,623例间日疟原虫。恶性疟原虫风险增加五倍(95%可信区间[CrI]4.37,6.74),每增加1个单位的归一化差异植被指数(NDVI)无滞后和8%(95%CrI7%,9%)在6个月滞后时,最高温度(TMAX)每增加1ºC。虽然风险降低1%(95%CrI0%,1%)的降水量增加了1毫米,滞后6个月。1个月后NDVI增加1个单位与间日疟原虫风险增加4倍(95%CrI2.95,4.90)相关。此外,风险增加6%(95%CrI5%,7%)和3%(95%CrI1%,5%)白天地表温度每增加1ºC,滞后6个月,滞后4个月,TMAX,分别。空间分析表明,在越南中部高地和中部东南部,这两种物种的平均疟疾风险较高,而在北部和西北部地区的风险较低。
    结论:环境,气候,社会经济风险因素和空间疟疾集群对于设计适应性战略至关重要,以最大限度地发挥有限的公共卫生资源对消除越南疟疾的影响。
    BACKGROUND: Despite the successful efforts in controlling malaria in Vietnam, the disease remains a significant health concern, particularly in Central Vietnam. This study aimed to assess correlations between environmental, climatic, and socio-economic factors in the district with malaria cases.
    METHODS: The study was conducted in 15 provinces in Central Vietnam from January 2018 to December 2022. Monthly malaria cases were obtained from the Institute of Malariology, Parasitology, and Entomology Quy Nhon, Vietnam. Environmental, climatic, and socio-economic data were retrieved using a Google Earth Engine script. A multivariable Zero-inflated Poisson regression was undertaken using a Bayesian framework with spatial and spatiotemporal random effects with a conditional autoregressive prior structure. The posterior random effects were estimated using Bayesian Markov Chain Monte Carlo simulation with Gibbs sampling.
    RESULTS: There was a total of 5,985 Plasmodium falciparum and 2,623 Plasmodium vivax cases during the study period. Plasmodium falciparum risk increased by five times (95% credible interval [CrI] 4.37, 6.74) for each 1-unit increase of normalized difference vegetation index (NDVI) without lag and by 8% (95% CrI 7%, 9%) for every 1ºC increase in maximum temperature (TMAX) at a 6-month lag. While a decrease in risk of 1% (95% CrI 0%, 1%) for a 1 mm increase in precipitation with a 6-month lag was observed. A 1-unit increase in NDVI at a 1-month lag was associated with a four-fold increase (95% CrI 2.95, 4.90) in risk of P. vivax. In addition, the risk increased by 6% (95% CrI 5%, 7%) and 3% (95% CrI 1%, 5%) for each 1ºC increase in land surface temperature during daytime with a 6-month lag and TMAX at a 4-month lag, respectively. Spatial analysis showed a higher mean malaria risk of both species in the Central Highlands and southeast parts of Central Vietnam and a lower risk in the northern and north-western areas.
    CONCLUSIONS: Identification of environmental, climatic, and socio-economic risk factors and spatial malaria clusters are crucial for designing adaptive strategies to maximize the impact of limited public health resources toward eliminating malaria in Vietnam.
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  • 文章类型: Journal Article
    夜间人造光(ALAN)是世界范围内常见的光污染形式,和强度,定时,持续时间,光照射的波长会影响生物节律,这可能导致新陈代谢,生殖,和免疫功能障碍,因此,宿主-病原体相互作用。昆虫媒介传播疾病是一个需要解决的全球性问题,ALAN通过影响病媒生物的习性和生理功能,在疾病传播中起着重要作用。在这项工作中,我们描述了ALAN影响宿主生理和生物化学的机制,宿主-寄生虫相互作用,和媒介传播病毒,并提出相关传染病的预防措施,以最大程度地减少人造光对媒介传播疾病的影响。
    Artificial light at night (ALAN) is a common form of light pollution worldwide, and the intensity, timing, duration, and wavelength of light exposure can affect biological rhythms, which can lead to metabolic, reproductive, and immune dysfunctions and consequently, host-pathogen interactions. Insect vector-borne diseases are a global problem that needs to be addressed, and ALAN plays an important role in disease transmission by affecting the habits and physiological functions of vector organisms. In this work, we describe the mechanisms by which ALAN affects host physiology and biochemistry, host-parasite interactions, and vector-borne viruses and propose preventive measures for related infectious diseases to minimize the effects of artificial light on vector-borne diseases.
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  • 文章类型: Journal Article
    智能技术与数字传感器和深度学习网络相结合,在各个领域都有新兴的领域,包括监测携带病原体的蚊子。已经进行了若干研究以高精度检查这种技术在蚊子的差异识别中的功效。一些智能陷阱使用计算机视觉技术和深度学习网络来实时识别埃及伊蚊和库蚊的特征。实施与可靠捕获机构配对的这种工具可以有益于识别活蚊子而不破坏它们的形态特征。这种智能陷阱可以正确区分Cx。昆克法西塔斯和阿伊。埃及伊蚊,也可能有助于控制蚊媒疾病并预测其可能的爆发。嵌入YOLOV4深度神经网络算法的智能设备设计有差动驱动机构和诱蚊模块,以吸引环境中的蚊子。声学和光学传感器与机器学习技术的结合使用正在加速根据蚊子的飞行特征对蚊子进行自动分类,包括翼拍频率。因此,这种基于人工智能的工具具有监测蚊子以控制媒介传播疾病的潜在范围。然而,这种技术的工作效率需要进一步评估,以便在全球范围内实施。
    Smart technology coupled with digital sensors and deep learning networks have emerging scopes in various fields, including surveillance of mosquitoes. Several studies have been conducted to examine the efficacy of such technologies in the differential identification of mosquitoes with high accuracy. Some smart trap uses computer vision technology and deep learning networks to identify live Aedes aegypti and Culex quinquefasciatus in real time. Implementing such tools integrated with a reliable capture mechanism can be beneficial in identifying live mosquitoes without destroying their morphological features. Such smart traps can correctly differentiates between Cx. quinquefasciatus and Ae. aegypti mosquitoes, and may also help control mosquito-borne diseases and predict their possible outbreak. Smart devices embedded with YOLO V4 Deep Neural Network algorithm has been designed with a differential drive mechanism and a mosquito trapping module to attract mosquitoes in the environment. The use of acoustic and optical sensors in combination with machine learning techniques have escalated the automatic classification of mosquitoes based on their flight characteristics, including wing-beat frequency. Thus, such Artificial Intelligence-based tools have promising scopes for surveillance of mosquitoes to control vector-borne diseases. However working efficiency of such technologies requires further evaluation for implementation on a global scale.
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  • 文章类型: Journal Article
    肺动脉高压(PH)是狗感染Dirofilariaimmitis期间肺动脉内膜炎的结果。超声心动图是首选技术,但并非所有临床医生都能使用。这项研究旨在评估患有心丝虫病的狗的放射学发现与超声心动图表征的PH的存在与否之间的关联。该研究包括62只感染心丝虫的狗,这些狗接受了胸片和超声心动图检查。当右肺动脉扩张性(RPAD)指数<29.5%时,研究的狗显示中度至重度PH。RPAD指数用于与胸片比较。椎体心脏大小(VHS)右颅肺动脉通过第四肋外侧投影(CrPA/R4)的比值,右尾肺动脉至第九肋背腹侧投影(CdPA/R9)比值在有/无PH犬之间显示出显着差异(p<0.001)。获得敏感性(sen)和特异性(sp)临界值:VHS≥9.53(sen93.75%,sp63.33%);CrPA/R4≥1.08(森87.5%,sp70%);CdPA/R9≥1.10(森96.88%,sp76.66%)。CrPA/R4和CdPA/R9的比率显示出潜在的初步筛查工具,用于感染心丝虫的狗的PH。表明它们可以可靠地指示PH的存在,并指导进一步诊断测试的决定。
    Pulmonary hypertension (PH) is a consequence of pulmonary endarteritis during infection with Dirofilaria immitis in dogs. Echocardiography is the technique of choice but is not always accessible to all clinicians. This study aimed to evaluate the association of the radiological findings in dogs with heartworm disease and the presence or absence of echocardiographically characterised PH. The study included 62 heartworm-infected dogs that underwent thoracic radiographs and echocardiography. The studied dogs showed moderate to severe PH when the Right Pulmonary Artery Distensibility (RPAD) Index was <29.5%. The RPAD Index was used for comparison with thoracic radiographs. The Vertebral Heart Size (VHS), right cranial pulmonary artery passing through the fourth rib in the laterolateral projection (CrPA/R4) ratio, and right caudal pulmonary artery to the ninth rib in the dorsoventral projection (CdPA/R9) ratio showed significant differences between dogs with/without PH (p < 0.001). Sensitivity (sen) and specificity (sp) cut-off values were obtained: VHS ≥ 9.53 (sen 93.75%, sp 63.33%); CrPA/R4 ≥ 1.08 (sen 87.5%, sp 70%); and CdPA/R9 ≥ 1.10 (sen 96.88%, sp 76.66%). The CrPA/R4 and CdPA/R9 ratios showed potential as a preliminary screening tool for PH in heartworm-infected dogs, suggesting that they may reliably indicate the presence of PH and guide the decision for further diagnostic testing.
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  • 文章类型: Editorial
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