Knowledge Of Clinical Signs Research Articles

The Common Marmoset-Biomedical Research Animal Model Applications and Common Spontaneous Diseases.

Marmosets are becoming more utilized in biomedical research due to multiple advantages including (1) a nonhuman primate of a smaller size with less cost for housing, (2) physiologic similarities to humans, (3) translatable hepatic metabolism, (4) higher numbers of litters per year, (5) genome is sequenced, molecular reagents are available, (6) immunologically similar to humans, (7) transgenic marmosets with germline transmission have been produced, and (8) are naturally occurring hematopoietic chimeras. With more use of marmosets, disease surveillance over a wide range of ages of marmosets has been performed. This has led to a better understanding of the disease management of spontaneous diseases that can occur in colonies. Knowledge of clinical signs and histologic lesions can assist in maximizing the colony's health, allowing for improved outcomes in translational studies within biomedical research. Here, we describe some basic husbandry, biology, common spontaneous diseases, and animal model applications for the common marmoset in biomedical research.

Livestock Owners' Perception on the Impact of Ghibe-III Hydroelectric Dam on Bovine Trypanosomosis, Southern Ethiopia.

Background:Trypanosomosis is an endemic livestock disease in Ethiopia. The problem prevails mainly in the South, Southwest, and Northwest regions following main rivers and their tributaries.Methods:A cross-sectional questionnaire survey was conducted in Loma and Kindo Didaye districts near the Ghibe-III hydroelectric dam, to compare dam impact upstream and downstream, from January 2019 to June 2020. Two hundred standardized questionnaire surveys were administered. The questionnaire included biography, livestock population before and after dam construction, knowledge of major livestock diseases, clinical signs, transmission, seasonality, and wildlife population status was assessed. Data were analyzed using Mann–Whitney U Test.Results and discussion:A total of 189 questionnaires were returned out of 200 questionnaires administered. Among the respondents, the majorities were males and had an average age of 39.4 + 10.6. In all herd size levels, there was no significant (P > .05) difference before dam construction between the 2 districts; whereas, statistically significant (P < .05) large and medium herd sizes increased by 16%(95% CI: 0.5, 31.5) after dam construction in Loma district; whereas, the same herd size reduced by 20%(95% CI:0,43.7) after dam construction with statistically significant(P < .05) difference. Bovine trypanosomosis ranked first among major diseases. Knowledge of clinical signs, transmission, and seasonality of trypanosomosis was consistent with the literature. 87.8% of respondents in Loma associated reduction of trypanosomosis and tsetse population, but 77% of Kindo Didaye respondents perceived no change in prevalence after dam construction. More reduction in wildlife population was observed upstream than downstream, health services improved, and disease outbreaks and cattle deaths were reduced. Studies in African countries indicate the reduction in tsetse apparent density and absences of wildlife contributed to the reduction of trypanosomosis.CONCLUSION:An increased herd size, reduced trypanosomosis prevalence, and wildlife population observed upstream, indicate artificial Lake has an impact on tsetse apparent density. Therefore, follow-up of the disease prevalence and investigation of drug resistance is recommended to prove the situation in the study area.

English

Socio-economic and socio-demographic factors have been considered as critical in disease epidemiology and need to be taken into consideration when designing health interventions. It is therefore strongly recommended to investigate population ownership to ensure sustainability of a given intervention. To this end, a household-based cross sectional survey was conducted to assess knowledge and perceptions regarding sleeping sickness and its control among populations of the four epicenter villages (Lambi, Bidjouka, Memel 1, and Ebimimbang) of the Bipindi sleeping sickness focus (South Region, Cameroon). It was found that the population of Bipindi is stable (64.0% of participants having spent on average 22 years in this focus), with high education level (64.8% having reached at least the secondary level). Overall, 92.8% (95% CI: 86.9-96.2) of the participants were aware of sleeping sickness or Human Africa Trypanosomiasis (HAT) and 68.3% (95% CI: 59.6-75.9) have been in contact with people who had suffered from this disease. Males had better knowledge of sleeping sickness clinical signs and mode of transmission than their female counterparts. Knowledge was associated both with gender (males exhibiting better knowledge of clinical signs and mode of transmission than females) and age group (participants aged 30-57 years having heard of HAT more frequently than people of other age groups). These findings suggest that the population of Bipindi exhibit knowledge and perceptions that can be useful for appropriation and sustainability of control interventions. Key words: Sleeping sickness, knowledge, perception, Bipindi, Cameroon.

Poor knowledge of COVID-19 and unfavourable perception of the response to the pandemic by healthcare workers at the Bafoussam Regional Hospital (West Region-Cameroon).

WHO warned against a dramatic impact of COVID-19 in Africa unless adequate response strategies are implemented. Whatever the strategy, the role of health staff is pivotal. Objective: Assess knowledge and perception of the response to COVID-19 among health staff. we used a convenience non probabilistic sample to conduct a survey with a self-administered questionnaire from April 14 - 29, 2020 at the Bafoussam Regional Hospital (BRH). All the staff was invited to participate. Analyses were done with Microsoft Excel 2010 and Epi-Info version 7.1.5.2. response rate was 76.1% (464/610). Mean age (SD) was 35.0 (8.9) years. Sex ratio (M/F) was 101/356. Nursing/midwifery staff (56.8%) and in-patients units (49.94%) were predominant. Origin and transmission of SARS-CoV-2 were poorly known while knowledge of clinical signs and the role of laboratory tests were good. For 53.2% of respondents all therapeutic regimens are supportive and only 31.6% trusted state-recommended drugs. For 169 of respondents (36.9%), herbal remedies prevent/cure COVID-19. Seventy percent (70%) felt they were not knowledgeable enough to handle COVID-19 cases. Eighty-five point six percent (85.6%) thought the BRH had insufficient resources to fight COVID-19 and 55.6% were dissatisfied with its response (weaknesses: medicines/technologies (74.5%), service delivery (28.1%), staff (10.9%)). Sixty-eight percent (68%) reported insufficient protection on duty. Seventy-six point five percent (76.5%) reported a drop in non-COVID-19 services. Eighty-five point five (85.5%) percent said they complied with community preventive measures. For 44% of respondents, regulations on COVID-19 corpses should be made more culture-sensitive. Fifty one point two percent (51.2%) of respondents were against vaccine trial in their community. knowledge was poor and perception of the response to COVID-19 was unfavourable.

Preventing zoonotic influenza H5N1 in human: Pictorial versus literal health communication methods.

Outbreaks of avian influenza H5N1 in poultry occurred in Africa's poultry and 16 countries have reported human infections globally. Intensified human-animal interactions necessitate correct communication of health messages to reduce zoonotic infection. This work was done to determine differences between pictorial and literal health education communication. Cross-sectional survey using literal and pictorial questionnaires in LBMs and poultry farms was carried out among respondents based on matching criteria. Responses were scored and analysed with probability of independence using Chi square test and pairwise correlation. The degree of knowledge of clinical signs in birds, species affected, communication means and biosecurity were good, that of the post-mortem signs was poor with increasing potentials of human exposure to virus-rich visceral tissues from slaughtered sick birds. Marked differences exist for the various items listed within each knowledge field, the odds of having correct responses from pictorial were better than with literal respondents. Risky practices were still practised in the LBMs despite the good degree of knowledge of hygiene and biosecurity. Knowledge and implementation does not always correlate and pictorial representation out surpasses literal method in communicating potential zoonotic H5N1 influenza A infection to the undiscerning public.

Abstract B034: Improving patient-centered care for inflammatory breast cancer: Strategies for addressing barriers faced by patients, researchers, and providers

Abstract Introduction: Inflammatory breast cancer (IBC) is a rare but the most lethal breast cancer often misdiagnosed as mastitis or dermatitis since majority of cases lack a clinically apparent tumor mass and present with progressive breast erythema and skin edema. Further exacerbating this is its incidence, more often, in premenopausal women who have yet to initiate regular screening, and/or its manifestation in women of color, in whom the signs of disease may be more subtle. Thus, the goal of this research is to understand IBC awareness and knowledge of clinical signs related to diagnosis and treatment amongst the general public, patients, and primary care providers in order to design effective interventions to improve patient care. Methods: Responses (500+ unique) were collected from a facilitated session and representative post meeting interviews including researchers, clinicians, patients, and community stakeholders on open-ended questions related to IBC diagnosis, treatment barriers, and strategies to improve patient care. For thematic analysis, responses were subdivided into patient/community, provider, and organizational level using NVivo 12 Pro qualitative software. Grounded theory shaped both design and analysis. Results: Based on participant responses, barriers at the patient/community level (69.4%) were recognized to be the greatest. The primary factor identified was related to living in a rural community/distance to a treatment center (21.1%). At the organizational level, obstacles included limited or no access to an appropriate treatment center (42.2%), lack of IBC-specific standard of care (20.0%), lack of central source of information about IBC (20.0%) and need for trained patient navigators (8.9%). This analysis highlighted that patients often experience multiple misdiagnoses before finding a physician that correctly recognizes IBC - 79.4% responses indicated a lack of education among primary care providers (79.4%), misdiagnoses due to patients not fitting the typical breast cancer profile (13.1%), and a dearth in communication between physicians and patients (7.5%). This study also identified specific strategies, which included developing culturally tailored IBC media campaign and community-facing patient navigation to address barriers such as social support and care for patients in rural or underserved communities. Conclusions: Taken together, three themes in IBC care were identified- a) barriers to timely diagnosis and treatment, b) strategies for community engagement, and c) the need for provider education. These datasets have led to the development of survey instruments to assess gaps of knowledge during diagnosis and treatment in IBC patients and primary care providers including physicians, physician assistants, and nurse practitioners in the community. Supported by Duke SOM Interdisciplinary Colloquium (GRD); DCI Behavioral and Health Survey Research Core Award (GRD, LF, AT); C-REP 1P20-CA202925-01A12 (GRD, HH, LGS, NB); T32 Surgical Oncology training (WL). Citation Format: Larisa Gerahart-Serna, Whitney Lane, Laura Fish, Anh N Tran, Gayathri R Devi, Holly Hough, Kearston L Ingraham. Improving patient-centered care for inflammatory breast cancer: Strategies for addressing barriers faced by patients, researchers, and providers [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B034.

Clinical approach in familial hypophosphatemic rickets: report of three generations.

Familial hypophosphatemic rickets is a hereditary disease characterized by the involvement of several family members, transmitted in most cases as an X-linked dominant trait. Oral manifestations can be the first evidences for an adequate and early diagnosis of X-linked hypophosphatemic rickets (XLHR). The present report describes the main systemic manifestations, oral findings and dental management in three generations of an affected family. Oral exams, laboratorial and histologic evaluations, cone-beam computed tomographies, panoramic and periapical radiographs were performed to properly institute the most adequate treatment strategy. The knowledge of clinical signs and symptoms of XLHR is essential for the correct diagnosis of this disease, and for the establishment of preventive and comprehensive dental care.

Diagnostic of immune-mediated neuropathies

Separate discussion of immune-mediated neuropathies from other neuropathies is justified by the serious consequences of the natural course of these diseases, like disability and sometimes even life threatening conditions. On the other hand nowadays effective treatments already exist, and with timely and correct diagnosis an appropriately chosen treatment may result in significant improvement of quality of life, occasionally even complete recovery. These are rare diseases, and the increasing number of different variants makes it more difficult to recognize them. Their diagnosis is based on the precise knowledge of clinical signs and symptoms, and it is verified by the help of neurophysiologic and laboratory, first of all CSF examinations. Description of clinical features of the classic acute immune-mediated neuropathy, characterized by ascending paresis and demyelination is followed by a summary of characteristics of newly recognized axonal, regional and functional variants. Chronic immune-mediated demyelinating polyneuropathies are not diagnosed in due number even today. This paper does not only present the classic form but it also introduces the ever increasing special variants, like distal acquired demyelinating sensory neuropathy, Lewis-Sumner syndrome, multifocal motor neuropathy and paraproteinemic neuropathies. Vasculitic neuropathies can be divided into two groups: systemic and non-systemic ones. The first sign of a vasculitic neuropathy is a progressive, painful mononeuropathy; the classic clinical presentation is the mononeuritis multiplex. It is characterized by general signs like fever, loss of weight, fatigue. In systemic vasculitis organ specific symptoms are also present. From the paraneoplastic diseases the subacute sensory neuropathy and the sensory neuronopathy are members of the immune-mediated neuropathies, being most frequently associated with small cell lung cancer.

Wissenswertes aus der Neuro-Ophthalmologie

Neuro-Ophthalmology is an interdisciplinary field dealing with afferent and efferent disorders of the visual system caused by nervous system lesions. Modern imaging methods and their broad availability have greatly facilitated our diagnostic capacity. Despite this impressive technological progress thorough knowledge of clinical signs and symptoms still remains crucial in order to achieve a straight forward optimal patient care. Above several relevant neuro-ophthalmic disorders are described. Emphasis is given on correct initial management and indication for referral to a specialized institution.

Assessment of the Technical Competence and Ethical Behaviour of Community-based Animal Health Workers in Mwingi District, Kenya

This paper describes an assessment of the technical competence and ethical behaviour of Community-based Animal Health Workers (CAHWs) in Mwingi District, Kenya. From 99 trained CAHWs, 40 participated in the study. Using a pre-tested semi-structured questionnaire, direct observation of the relevant veterinary drug kits and participatory discussions, the study team found that the CAHWs knowledge of clinical signs of local livestock diseases and notifiable and zoonotic diseases and their ability to use veterinary drugs correctly and safely were adequate. Marks were awarded to the candidates according to an agreed marking scheme between the CAHWs' trainers and study team members. The results showed that, overall, 36 out of 40 (90%) of the sampled CAHWs passed the tests. The existence of a referral system for CAHWs and refresher trainings helped to ensure that CAHW competence and ethical behaviour were maintained. However, it was also found that some areas of the current curriculum required more detailed input based on field experience. The CAHW system could serve as an alternative animal health care system in areas lacking veterinary services.

Eccentric anterior wear facets in the diagnosis of temporomandibular disorders

The present study aimed at testing whether eccentric anterior bruxing facets are associated with clinical signs from the temporomandibular joints and with palpatory tenderness of the muscles of mastication. Wear facets in the canine and incisor areas were assessed by inspecting dental stone casts made at baseline and at the end of a 4-year clinical trial involving 129 adolescents and young adults. The subjects who showed distinct increase in wear were divided into three groups: (i) wear pattern indicating an anterior thrust of the working side mandible, (ii) wear pattern indicating a posterior thrust of the working side mandible and (iii) other wear patterns. The assessment of wear patterns was made without knowledge of clinical signs of temporomandibular disorders (TMD). The eventual change in muscular or joint signs of TMD from baseline to the final examination was then obtained from the records, and the association with wear pattern was calculated. There was no significant evidence of an association between eccentric anterior wear and signs of TMD. The direction of the mandibular thrust generated by bruxing was also unassociated with the presence of TMJ and muscular signs. In conclusion, the predictive value of eccentric anterior wear facets in young subjects is too low to be helpful in the diagnosis of TMD.