Search Results
You are looking at 1 - 5 of 5 items for
- Author or Editor: Jo R. Smith x
- Refine by Access: All Content x
Abstract
Objective—To determine the effect of an intervention (educational campaign) on hand hygiene (HH) and health-care workers' (HCWs') perceptions of HH.
Design—Prospective observational study and cross-sectional survey.
Sample—Observed opportunities for HH performed by HCWs before (n = 222) and after (249) intervention, measures of HH product usage, and surveys distributed to 300 HCWs.
Procedures—Data were collected by means of direct observation, measurement of HH product consumption, and surveys of HCWs.
Results—Adherence rates of HCWs for HH practices before and after the intervention were 27% (61/222 observations) and 29% (73/249 observations), respectively. Combined HH and glove use adherence rates before and after the intervention were 84% (186/222 observations) and 81% (201/249 observations), respectively. Before intervention, the highest combined HH and glove use adherence rate was detected for technicians (90% [57/63 observations]) and for opportunities after exposure to a patient's bodily fluids (100% [5/5 opportunities]). Rate of use of alcohol-based antimicrobial hand rubs (AHRs) and amount of HH products used did not significantly change during the study. Survey response rates were 41% (122) and 21% (62) before and after the intervention, respectively. Availability of AHRs and role modeling of HH (performance of HH each time it is warranted) were considered the factors most likely to increase HH adherence rates by survey respondents.
Conclusions and Clinical Relevance—Results indicated the intervention did not increase HH adherence or use of AHRs. High rates of glove use before the start of the study may have been a confounding factor. Future educational campaigns should indicate that glove use should not supersede HH.
Abstract
Objective—To determine the effects of dexamethasone or synthetic ACTH administration on endogenous ACTH concentrations in healthy dogs.
Animals—10 healthy neutered dogs.
Procedures—Each dog received dexamethasone (0.01 mg/kg), synthetic ACTH (5 μg/kg), or saline (0.9% NaCl) solution (0.5 mL) IV at intervals of ≥ 30 days. Plasma endogenous ACTH concentrations were measured before (baseline; time 0) and 1, 8, 12, and 24 hours after drug administration; serum cortisol concentrations were measured before and 1 hour after synthetic ACTH and saline solution administration and 8 hours after dexamethasone administration.
Results—Analysis of serum cortisol concentrations confirmed effects of drug administration. Dexamethasone significantly decreased the endogenous ACTH concentration from the baseline value at both 8 and 12 hours. Synthetic ACTH administration significantly decreased the endogenous ACTH concentration from the baseline value at 8 hours. Saline solution administration had no significant effect on endogenous ACTH concentration.
Conclusions and Clinical Relevance—Dexamethasone and synthetic ACTH administered IV at doses used routinely during testing for hyperadrenocorticism caused significant but transient reductions of endogenous ACTH concentrations in healthy dogs. Thus, a 2-hour washout period following ACTH stimulation testing before collection of samples for measurement of the endogenous ACTH concentration may be insufficient. Although this effect has not been verified in dogs with hyperadrenocorticism, these data suggested that samples for measurement of endogenous ACTH concentrations should be obtained before or > 8 hours after initiation of an ACTH stimulation test or before or > 12 hours after the start of a low-dose dexamethasone suppression test.
Abstract
OBJECTIVE
To assess the accuracy of automated readings of urine dipstick results for assessment of glucosuria in dogs and cats, compare visual versus automated readings of urine glucose concentration, and determine the utility of the urine glucose-to-creatinine ratio (UGCR) for quantification of glucosuria.
SAMPLE
310 canine and 279 feline urine samples.
PROCEDURES
Glucose concentration was estimated in 271 canine and 254 feline urine samples by visual assessment of urine dipstick results and with an automated dipstick reader. Absolute urine glucose and creatinine concentrations were measured in 39 canine and 25 feline urine samples by colorimetric assay with a clinical chemistry analyzer (reference standard for detection of glucosuria), and UGCRs were determined.
RESULTS
Automated assessment of the urine dipsticks yielded accurate results for 163 (60.1%) canine urine samples and 234 (92.1%) feline urine samples. Sensitivity of the automated dipstick reader for detection of glucosuria was 23% for canine samples and 68% for feline samples; specificity was 99% and 98%, respectively. Visual readings were more accurate than automated readings for both canine and feline urine. The UGCR was significantly correlated with absolute urine glucose concentration for both dogs and cats, yet there was incomplete distinction between dipstick categories for glucose concentration and UGCR.
CONCLUSIONS AND CLINICAL RELEVANCE
Urine dipstick readings for dogs and cats were useful for ruling glucosuria in when the result was positive but not for ruling it out when the result was negative. The evaluated dipsticks were more accurate for detection of glucosuria in cats than in dogs. Visual dipstick readings were more accurate than automated readings. The UGCR did not appear to provide additional useful information.
Abstract
Case Description—An 8-year-old domestic shorthair cat was evaluated because of signs of depression, circling, and visual deficits.
Clinical Findings—The cat had no cutaneous lesions, and results of an ophthalmologic examination and thoracic radiography were within reference limits. Computed tomography of the brain revealed a mass lesion involving the right parietal, temporal, and occipital lobes; the mass was in broad-based contact with the skull and smoothly marginated and had strong homogenous enhancement after contrast agent administration. During craniectomy, samples of the mass were collected for cytologic and histopathologic evaluations and microbial culture. A diagnosis of Blastomyces dermatitidis—associated meningoencephalitis with secondary pyogranulomatous inflammation was made.
Treatment and Outcome—Amphotericin B (0.25 mg/kg [0.11 mg/lb], IV) was administered on alternate days (cumulative dose, 1.75 mg/kg [0.8 mg/lb]). To minimize the risk of nephrotoxicosis, assessments of serum biochemical variables (urea nitrogen and creatinine concentrations) and urinalyses were performed at intervals. The third dose of amphotericin B was postponed 48 hours because the cat became azotemic. The cat subsequently received fluconazole (10 mg/kg [4.5 mg/lb], PO, q 12 h) for 5.5 months. Six months after discontinuation of that treatment, the cat appeared healthy and had no signs of relapse.
Clinical Relevance—Brain infection with B dermatitidis is typically associated with widespread disseminated disease. The cat of this report had no evidence of systemic disease. Blastomycosis of the CNS should be considered as a differential diagnosis for brain lesions in cats from areas in which B dermatitidis is endemic.
