ObjectiveTo assess the prognostic value of neutrophil-to-lymphocyte ratio (NLR) for cardiac death in cats with hypertrophic cardiomyopathy.Study DesignProspective observation study.AnimalsNinety-six client-owned cats.MethodsComplete blood count samples were collected from 38 healthy and 58 cats with hypertrophic cardiomyopathy (HCM), and the NLR ratios were analyzed. All cats had echocardiographic measurements performed on the same day as blood collection. Spearman rank correlation was used to assess the relationship between echocardiographic measurements and NLR. Long-term outcome data were obtained, and time to cardiac death and variables associated with cardiac death were analyzed using Kaplan–Meier survival curves and Cox proportional hazards models, respectively.ResultsThe NLR was significantly higher in cats with confirmed congestive heart failure. When evaluating HCM patients, cats in the third NLR tertile had a significantly higher risk of cardiac death with a hazard ratio of 10.26 (95% CI: 1.84–57.14; p = 0.0001) when compared with that of patients in the first tertile. NLR was significantly associated with echocardiographic measures of left atrial size, left auricular function, the presence of left atrial spontaneous echo contrast (SEC), and thrombus formation.Conclusions and Clinical RelevanceIncreased NLR is a negative prognostic indicator in cats with HCM.
The high rates of fatalities and injuries in the construction industry highlight the importance of work health and safety (WHS). Building information modelling (BIM) could significantly improve WHS management in construction, but integration has been limited. The chapter explores the application of BIM for WHS management and the rationale for market leaders' role to catalyse a BIM-enabled WHS management ecosystem through procurement strategies and tendering proficiency. An international comparative analysis of BIM WHS is presented along with a BIM drivers and barriers critique, including a clustering into seven areas of market, perceptions and attitudes, leadership, supply chain integration and collaborative practice, procurement strategies and tendering proficiency, decision tools, and technical functionality. A focussed decision framework is outlined. The findings provide insights for researchers and practitioners to understand how a BIM-enabled WHS management system can be facilitated and supported through the project lifecycle.
Background: Diuretic braking during furosemide continuous rate infusion (FCRI) curtails urine production.Hypothesis: Renin-angiotensin-aldosterone system (RAAS) activation mediates braking, and RAAS inhibition will increase urine production.Animals: Ten healthy purpose-bred male dogs. Methods: Dogs received placebo, benazepril, or benazepril and spironolactone PO for 3 days before a 5-hour FCRI (0.66 mg/kg/h) in a 3-way, randomized, blinded, cross-over design. Body weight (BW), serum creatinine concentration (sCr), serum electrolyte concentrations, PCV, and total protein concentration were measured before PO medications, at hours 0 and 5 of FCRI, and at hour 24. During the FCRI, water intake, urine output, urine creatinine concentration, and urine electrolyte concentrations were measured hourly. Selected RAAS components were measured before and after FCRI. Variables were compared among time points and treatments.Results: Diuretic braking and urine production were not different among treatments.Loss of BW, hemoconcentration, and decreased serum chloride concentration occurred during FCRI with incomplete recovery at hour 24 for all treatments.Although unchanged during FCRI, sCr increased and serum sodium concentration decreased at hour 24 for all treatments. Plasma aldosterone and angiotensin-II concentrations increased significantly at hour 5 for all treatments, despite suppressed angiotensin-converting enzyme activity during benazepril background treatment.
Conclusions:The neurohormonal profile during FCRI supports RAAS mediation of diuretic braking in this model. Background treatment with benazepril with or without spironolactone did not mitigate braking, but was well tolerated. Delayed changes in
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