Search

The 12-lead electrocardiogram (ECG) is a crucial diagnostic tool. However, the ideal method to assess competency in ECG interpretation remains unclear. We sought to evaluate whether keypad response technology provides a rapid, interactive way to assess ECG knowledge. 75 participants were enrolled [32 (43%) Primary Care Physicians, 24 (32%) Hospital Medical Staff and 19 (25%) Nurse Practitioners]. Nineteen ECGs with 4 possible answers were interpreted. Out of 1425 possible decisions 1054 (73.9%) responses were made. Only 570/1425 (40%) of the responses were correct. Diagnostic accuracy varied (0% to 78%, mean 42%±21%) across the entire cohort. Participation was high, (median 83%, IQR 50%-100%). Hospital Medical Staff had significantly higher diagnostic accuracy than nurse practitioners (50±20% vs. 38±19%, p=0.04) and Primary Care Physicians (50±20% vs. 40±21%, p=0.07) although not significant. Interactive voting systems can be rapidly and successfully used to assess ECG interpretation. Further education is necessary to improve diagnostic accuracy., (Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.)

Monoclonal antibodies (MAbs) obtained from a mouse immunised with Clostridium botulinum type D toxoid were developed into a sandwich ELISA (sELISA) format that was able to detect type D toxin and types C and D toxin complexes. The sELISA was examined for its potential to replace the mouse bioassay as an alternative in vitro assay for the diagnosis of cattle botulism. Its application directly to intestinal samples collected from suspect cattle botulism cases and prepared for testing for the standard mouse bioassay showed poor correlation and sensitivity with the mouse bioassay results. However, anaerobic pre-enrichment of the samples after heat treatment at 80 degrees C for 10 min to activate any residual C. botulinum spores greatly improved the sELISA detection rate of the toxin by increasing the sample toxin levels. All of the mouse bioassay positive cattle cases tested were detected by the sELISA from the heated and pre-enriched samples tested after 24h incubation. Toxin was detected by sELISA and subsequently confirmed by mouse bioassay in samples from an additional 3 cases that had been originally mouse bioassay negative. The results indicate that the application of this procedure for screening intestinal samples for C. botulinum strains that produce types C and D toxins from suspect cattle botulism cases would improve the diagnostic rate as well as significantly reduce the number of mice involved in diagnosis., (Copyright (c) 2010 Elsevier B.V. All rights reserved.)

Tissue culture assays were used to investigate the incidence of cytotoxic necrotising factors (CNFs) 1 and 2 in Escherichia coli strains from cattle. E. coli cultures were obtained from faeces collected from 223 cases of diarrhoea and from 113 healthy animals. In addition, strains cultured from 62 cases of mastitis, 66 cases of septicaemia and 68 cases of abortion were also investigated. E. coli producing CNF 1 or 2 were identified in all sample groups except for the abortion cases. Comparable levels of CNF1 strains were present in E. coli from the faces of diarrhoeic (4%) and healthy faeces (4.4%) whereas lower levels of CNF2 were identified in the faeces from diarrhoeic animals (19.3%) in comparison with healthy animals (30.9%). One CNF1 producing strain was identified among the E. coli isolated from mastitis samples, while 3% and 10.6% of septicaemic strains were positive for CNF1 and 2, respectively. Serogrouping of CNF isolates did not reveal the association of any particular serogroups with the different conditions.