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K W Hinchcliff - One of the best experts on this subject based on the ideXlab platform.
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exercise induced Pulmonary Hemorrhage in horses american college of veterinary internal medicine consensus statement
Journal of Veterinary Internal Medicine, 2015Co-Authors: K W Hinchcliff, N E Robinson, Laurent L Couetil, Peter Knight, Paul S Morley, C R Sweeney, E Van ErckAbstract:Background Published studies of Exercise-Induced Pulmonary Hemorrhage (EIPH), when assessed individually, often provide equivocal or conflicting results. Systematic reviews aggregate evidence from individual studies to provide a global assessment of the quality of evidence and to inform recommendations. Objectives Evaluate evidence to determine: if EIPH adversely affects the health, welfare or both of horses; if EIPH affects the athletic capacity of horses; the efficacy of prophylactic interventions for EIPH; and if furosemide affects the athletic capacity of horses. Animals None. Materials and Methods Systematic review. A panel of 7 experts was formed to assess evidence in the peer reviewed literature addressing each of the 4 objectives. Methodology followed that of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Publications were assessed for quality of evidence by working groups of the panel, and a summary of findings was presented in tables. Recommendations were based on quality of evidence and were determined by a vote of the panel. Results Much of the evidence was of low to very low quality. Experimental studies frequently lacked adequate statistical power. There was moderate to high quality evidence that EIPH is progressive, is associated with lung lesions, that it adversely affects racing performance, that severe EIPH (Grade 4) is associated with a shorter career duration, that furosemide is efficacious in decreasing the incidence and severity of EIPH, and that administration of furosemide is associated with superior race performance. Conclusions and clinical significance Strong recommendation that EIPH be considered a disease and a weak recommendation for use of furosemide in management of racehorses with EIPH.
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update on exercise induced Pulmonary Hemorrhage
Veterinary Clinics of North America-equine Practice, 2015Co-Authors: Stacey Sullivan, K W HinchcliffAbstract:Exercise-Induced Pulmonary Hemorrhage (EIPH) is an important disease of horses that perform high-intensity athletic activity. EIPH is an ongoing concern for the racing industry because of its high prevalence; potential impact on performance; welfare concerns; and use of prophylactic medications, such as furosemide, on race day. During the last 10 years, significant progress has been made in understanding the pathogenesis and risk factors for EIPH and the impact of the disease on performance and career. This article summarizes the most recent advances in EIPH.
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efficacy of furosemide for prevention of exercise induced Pulmonary Hemorrhage in thoroughbred racehorses
Javma-journal of The American Veterinary Medical Association, 2009Co-Authors: K W Hinchcliff, Paul S Morley, Alan John GuthrieAbstract:Objective—To evaluate the efficacy of furosemide for prevention of Exercise-Induced Pulmonary Hemorrhage (EIPH) in Thoroughbred racehorses under typical racing conditions. Design—Randomized, placebo-controlled, blinded, crossover field trial. Animals—167 Thoroughbred racehorses. Procedures—Horses were allocated to race fields of 9 to 16 horses each and raced twice, 1 week apart, with each of the 2 races consisting of the same race field and distance. Each horse received furosemide (500 mg, IV) before one race and a placebo (saline solution) before the other, with the order of treatments randomly determined. Severity of EIPH was scored on a scale from 0 to 4 after each race by means of tracheobronchoscopy. Data were analyzed by means of various methods of multivariable logistic regression. Results—Horses were substantially more likely to develop EIPH (severity score ≥ 1; odds ratio, 3.3 to 4.4) or moderate to severe EIPH (severity score ≥ 2; odds ratio, 6.9 to 11.0) following administration of saline solut...
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tracheobronchoscopic assessment of exercise induced Pulmonary Hemorrhage in horses
American Journal of Veterinary Research, 2005Co-Authors: K W Hinchcliff, Paul S Morley, M A Jackson, James A Brown, Anthony F Dredge, Paul A Ocallaghan, John P Mccaffrey, R F Slocombe, A F ClarkeAbstract:Objective—To determine the interobserver variability of assessment of Exercise-Induced Pulmonary Hemorrhage (EIPH) during tracheobronchoscopic examination in horses. Animals—747 Thoroughbred racehorses. Procedure—850 tracheobronchoscopic examinations were performed within 2 hours of racing for the horses. Examinations were recorded on videotape, and EIPH and its severity were assessed independently by 3 veterinarians. Concordance was determined by calculation of the Cohen weighted κ statistic and tabulation of scores assigned by each observer. Results—Weighted κ statistics ranged from 0.75 to 0.80. In 99.4% of observations, all observers agreed or 2 of 3 agreed and the third differed by ≤ 1 grade. Conclusions and Clinical Relevance—Results indicated that interobserver reliability of tracheobronchoscopic assessment of EIPH in Thoroughbred racehorses is high when the examination is conducted by experienced veterinarians. Concordance among investigators is sufficient to justify use of this grading system for...
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association between exercise induced Pulmonary Hemorrhage and performance in thoroughbred racehorses
Javma-journal of The American Veterinary Medical Association, 2005Co-Authors: K W Hinchcliff, Paul S Morley, M A Jackson, James A Brown, Anthony F Dredge, Paul A Ocallaghan, John P Mccaffrey, R F Slocombe, A F ClarkeAbstract:OBJECTIVE: To determine whether Exercise-Induced Pulmonary Hemorrhage (EIPH) was associated with racing performance inThoroughbred horses not medicated with furosemide and not using nasal dilator strips. DESIGN: Observational cross-sectional study. ANIMALS: 744 two- to 10-year-old Thoroughbred horses racing in Melbourne, Australia. PROCEDURE: Horses were enrolled prior to racing, and a tracheobronchoscopic examination was performed after 1 race. Examinations were recorded on videotape, and presence and severity (grade 0 to 4) of EIPH were subsequently determined by 3 observers blinded to the horses' identity. Race records were abstracted for each horse examined. RESULTS: Overall, 52.1% of horses eligible for participation in the study were examined, and horses that were examined did not differ from horses that were not examined in regard to age, sex distribution, or proportion of horses that won or finished in the first 3 positions. Horses with EIPH grades 2. Horses with EIPH grades > 1 finished significantly farther behind the winner than did horses without EIPH. However, odds that horses with grade 1 EIPH would win or finish in the first 3 positions were not significantly different from odds for horses without EIPH. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that EIPH is associated with impaired performance in Thoroughbred racehorses not medicated with furosemide and not using nasal dilator strips.
Laszlo M Hunyadi - One of the best experts on this subject based on the ideXlab platform.
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a retrospective study of bronchoalveolar lavage fluid analysis in barrel racing horses with exercise induced Pulmonary Hemorrhage and asthma in texas from 2016 to 2018
Research in Veterinary Science, 2020Co-Authors: Emily A Sundman, Munashe Chigerwe, Laszlo M HunyadiAbstract:Exercise-Induced Pulmonary Hemorrhage (EIPH) and asthma in barrel racing horses is a common disease across the United States. Limited information is available on non-infectious respiratory diseases in this population, the interaction between these two diseases, and the occurrence of both EIPH and asthma in the horse. The purpose of this study was to evaluate the bronchoalveolar lavage (BAL) fluid cytological results of barrel racing horses with EIPH, asthma, or both. A retrospective study was conducted using the medical records of horses that presented with cough and decreased athletic performance and BAL results that met the criteria for inclusion. Data from 95 horses were included from a private practice referral hospital in Texas. No statistical difference was found in the frequency of neutrophilia, eosinophilia, or mastocytosis between diagnoses of EIPH, asthma, or concurrent diagnoses of EIPH and asthma. Bronchoalveolar lavage of horses suspected of EIPH is warranted to fully characterize the noninfectious respiratory disease of barrel racing horses.
Paul S Morley - One of the best experts on this subject based on the ideXlab platform.
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exercise induced Pulmonary Hemorrhage in horses american college of veterinary internal medicine consensus statement
Journal of Veterinary Internal Medicine, 2015Co-Authors: K W Hinchcliff, N E Robinson, Laurent L Couetil, Peter Knight, Paul S Morley, C R Sweeney, E Van ErckAbstract:Background Published studies of Exercise-Induced Pulmonary Hemorrhage (EIPH), when assessed individually, often provide equivocal or conflicting results. Systematic reviews aggregate evidence from individual studies to provide a global assessment of the quality of evidence and to inform recommendations. Objectives Evaluate evidence to determine: if EIPH adversely affects the health, welfare or both of horses; if EIPH affects the athletic capacity of horses; the efficacy of prophylactic interventions for EIPH; and if furosemide affects the athletic capacity of horses. Animals None. Materials and Methods Systematic review. A panel of 7 experts was formed to assess evidence in the peer reviewed literature addressing each of the 4 objectives. Methodology followed that of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Publications were assessed for quality of evidence by working groups of the panel, and a summary of findings was presented in tables. Recommendations were based on quality of evidence and were determined by a vote of the panel. Results Much of the evidence was of low to very low quality. Experimental studies frequently lacked adequate statistical power. There was moderate to high quality evidence that EIPH is progressive, is associated with lung lesions, that it adversely affects racing performance, that severe EIPH (Grade 4) is associated with a shorter career duration, that furosemide is efficacious in decreasing the incidence and severity of EIPH, and that administration of furosemide is associated with superior race performance. Conclusions and clinical significance Strong recommendation that EIPH be considered a disease and a weak recommendation for use of furosemide in management of racehorses with EIPH.
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efficacy of furosemide for prevention of exercise induced Pulmonary Hemorrhage in thoroughbred racehorses
Javma-journal of The American Veterinary Medical Association, 2009Co-Authors: K W Hinchcliff, Paul S Morley, Alan John GuthrieAbstract:Objective—To evaluate the efficacy of furosemide for prevention of Exercise-Induced Pulmonary Hemorrhage (EIPH) in Thoroughbred racehorses under typical racing conditions. Design—Randomized, placebo-controlled, blinded, crossover field trial. Animals—167 Thoroughbred racehorses. Procedures—Horses were allocated to race fields of 9 to 16 horses each and raced twice, 1 week apart, with each of the 2 races consisting of the same race field and distance. Each horse received furosemide (500 mg, IV) before one race and a placebo (saline solution) before the other, with the order of treatments randomly determined. Severity of EIPH was scored on a scale from 0 to 4 after each race by means of tracheobronchoscopy. Data were analyzed by means of various methods of multivariable logistic regression. Results—Horses were substantially more likely to develop EIPH (severity score ≥ 1; odds ratio, 3.3 to 4.4) or moderate to severe EIPH (severity score ≥ 2; odds ratio, 6.9 to 11.0) following administration of saline solut...
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tracheobronchoscopic assessment of exercise induced Pulmonary Hemorrhage in horses
American Journal of Veterinary Research, 2005Co-Authors: K W Hinchcliff, Paul S Morley, M A Jackson, James A Brown, Anthony F Dredge, Paul A Ocallaghan, John P Mccaffrey, R F Slocombe, A F ClarkeAbstract:Objective—To determine the interobserver variability of assessment of Exercise-Induced Pulmonary Hemorrhage (EIPH) during tracheobronchoscopic examination in horses. Animals—747 Thoroughbred racehorses. Procedure—850 tracheobronchoscopic examinations were performed within 2 hours of racing for the horses. Examinations were recorded on videotape, and EIPH and its severity were assessed independently by 3 veterinarians. Concordance was determined by calculation of the Cohen weighted κ statistic and tabulation of scores assigned by each observer. Results—Weighted κ statistics ranged from 0.75 to 0.80. In 99.4% of observations, all observers agreed or 2 of 3 agreed and the third differed by ≤ 1 grade. Conclusions and Clinical Relevance—Results indicated that interobserver reliability of tracheobronchoscopic assessment of EIPH in Thoroughbred racehorses is high when the examination is conducted by experienced veterinarians. Concordance among investigators is sufficient to justify use of this grading system for...
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association between exercise induced Pulmonary Hemorrhage and performance in thoroughbred racehorses
Javma-journal of The American Veterinary Medical Association, 2005Co-Authors: K W Hinchcliff, Paul S Morley, M A Jackson, James A Brown, Anthony F Dredge, Paul A Ocallaghan, John P Mccaffrey, R F Slocombe, A F ClarkeAbstract:OBJECTIVE: To determine whether Exercise-Induced Pulmonary Hemorrhage (EIPH) was associated with racing performance inThoroughbred horses not medicated with furosemide and not using nasal dilator strips. DESIGN: Observational cross-sectional study. ANIMALS: 744 two- to 10-year-old Thoroughbred horses racing in Melbourne, Australia. PROCEDURE: Horses were enrolled prior to racing, and a tracheobronchoscopic examination was performed after 1 race. Examinations were recorded on videotape, and presence and severity (grade 0 to 4) of EIPH were subsequently determined by 3 observers blinded to the horses' identity. Race records were abstracted for each horse examined. RESULTS: Overall, 52.1% of horses eligible for participation in the study were examined, and horses that were examined did not differ from horses that were not examined in regard to age, sex distribution, or proportion of horses that won or finished in the first 3 positions. Horses with EIPH grades 2. Horses with EIPH grades > 1 finished significantly farther behind the winner than did horses without EIPH. However, odds that horses with grade 1 EIPH would win or finish in the first 3 positions were not significantly different from odds for horses without EIPH. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that EIPH is associated with impaired performance in Thoroughbred racehorses not medicated with furosemide and not using nasal dilator strips.
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association between exercise induced Pulmonary Hemorrhage and performance in thoroughbred racehorses
Javma-journal of The American Veterinary Medical Association, 2005Co-Authors: K W Hinchcliff, Paul S Morley, M A Jackson, James A Brown, Anthony F Dredge, Paul A Ocallaghan, John P Mccaffrey, R F Slocombe, A F ClarkeAbstract:occurs commonly in Thoroughbred and Standardbredracehorses throughout the world. Although estimates ofthe incidence of EIPH vary depending on the populationof horses examined, the diagnostic method, and the fre-quency of examination, blood can be detected by meansof tracheobronchoscopic examination of the airways in > 50% of Thoroughbred horses after a race.
Laurent Viel - One of the best experts on this subject based on the ideXlab platform.
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alveolar macrophage graded hemosiderin score from bronchoalveolar lavage in horses with exercise induced Pulmonary Hemorrhage and controls
Journal of Veterinary Internal Medicine, 2002Co-Authors: Michele Doucet, Laurent VielAbstract:: The objective of this study was to determine if a quantitative scoring system for evaluation of hemosiderin content of alveolar macrophages obtained by bronchoalevolar lavage provides a more sensitive test for the detection of Exercise-Induced Pulmonary Hemorrhage (EIPH) in horses than does endoscopy of the lower airways. A sample population composed of 74 Standardbred racehorses aged 2-5 years was used. Horses were grouped as either control (EIPH-negative) or EIPH-positive based on history and repeated postexertional endoscopic evaluation of the bronchial airways. Bronchoalveolar lavage was performed and cytocentrifuge slides were stained with Perl's Prussian blue. Alveolar macrophages were scored for hemosiderin content by a method described by Golde and associates to obtain the total hemosiderin score (THS). Test performance criteria were determined with a contingency table. All subjects had some degree of hemosiderin in the alveolar macrophages, regardless of group. The distribution of cells among the different grades followed a significantly different pattern for the control group versus horses with EIPH (P < .05). When using a THS of 75 as a cutoff point, the THS test was found to have a sensitivity of 94% and a specificity of 88%. The level of agreement beyond chance, between the EIPH status and the THS test result was very good (Cohen's kappa = 74%). The conclusion was made that careful assessment and scoring of alveolar macrophages for hemosiderin by means of the Golde scoring system shows promise as a more sensitive approach than repeated postexertional endoscopy alone to detect EIPH.
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clinical radiographic endoscopic bronchoalveolar lavage and lung biopsy findings in horses with exercise induced Pulmonary Hemorrhage
Canadian Veterinary Journal-revue Veterinaire Canadienne, 2002Co-Authors: Michele Y Doucet, Laurent VielAbstract:A clinical study was performed to determine whether clinical, endoscopic, radiographic, bronchoalveolar lavage (BAL) cytological, and Pulmonary biopsy findings could be correlated in horses with Exercise-Induced Pulmonary Hemorrhage (EIPH) compared with controls. Racing standardbred horses were selected as either EIPH (n = 10) or control (n = 10), based on repeated postexertional endoscopy of the lower airways. Complete physical and respiratory examinations were performed and blood samples were submitted for arterial blood gas analysis, hematologic study, and fibrinogen determination. Bilateral chest radiographs were taken with the horse standing, and a BAL sample was obtained for cytological examination. Lung was biopsied transcutaneously. Weighted scores were calculated for clinical, radiographic, and Pulmonary biopsy findings. The conclusion was that only routine physical examination may help the clinician when EIPH is suspected in horses, especially when there are abnormal findings on percussion of the caudodorsal areas of the chest.
Jabari Samir - One of the best experts on this subject based on the ideXlab platform.
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Deep Learning-Based Quantification of Pulmonary Hemosiderophages in Cytology Slides
2020Co-Authors: Marzahl Christian, Aubreville Marc, Bertram, Christof A., Stayt Jason, Jasensky Anne-katherine, Bartenschlager Florian, Fragoso-garcia Marco, Barton, Ann K., Elsemann Svenja, Jabari SamirAbstract:Exercise-Induced Pulmonary Hemorrhage (EIPH) is a common condition in sport horses with negative impact on performance. Cytology of bronchoalveolar lavage fluid by use of a scoring system is considered the most sensitive diagnostic method. Macrophages are classified depending on the degree of cytoplasmic hemosiderin content. The current gold standard is manual grading, which is however monotonous and time-consuming. We evaluated state-of-the-art deep learning-based methods for single cell macrophage classification and compared them against the performance of nine cytology experts and evaluated inter- and intra-observer variability. Additionally, we evaluated object detection methods on a novel data set of 17 completely annotated cytology whole slide images (WSI) containing 78,047 hemosiderophages. Our deep learning-based approach reached a concordance of 0.85, partially exceeding human expert concordance (0.68 to 0.86, mean of 0.73, SD of 0.04). Intra-observer variability was high (0.68 to 0.88) and inter-observer concordance was moderate (Fleiss’ kappa = 0.67). Our object detection approach has a mean average precision of 0.66 over the five classes from the whole slide gigapixel image and a computation time of below two minutes. To mitigate the high inter- and intra-rater variability, we propose our automated object detection pipeline, enabling accurate, reproducible and quick EIPH scoring in WSI
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Deep Learning-Based Quantification of Pulmonary Hemosiderophages in Cytology Slides
'Springer Science and Business Media LLC', 2019Co-Authors: Marzahl Christian, Aubreville Marc, Bertram, Christof A., Stayt Jason, Jasensky Anne-katherine, Bartenschlager Florian, Fragoso-garcia Marco, Barton, Ann K., Elsemann Svenja, Jabari SamirAbstract:Purpose: Exercise-Induced Pulmonary Hemorrhage (EIPH) is a common syndrome in sport horses with negative impact on performance. Cytology of bronchoalveolar lavage fluid by use of a scoring system is considered the most sensitive diagnostic method. Macrophages are classified depending on the degree of cytoplasmic hemosiderin content. The current gold standard is manual grading, which is however monotonous and time-consuming. Methods: We evaluated state-of-the-art deep learning-based methods for single cell macrophage classification and compared them against the performance of nine cytology experts and evaluated inter- and intra-observer variability. Additionally, we evaluated object detection methods on a novel data set of 17 completely annotated cytology whole slide images (WSI) containing 78,047 hemosiderophages. Resultsf: Our deep learning-based approach reached a concordance of 0.85, partially exceeding human expert concordance (0.68 to 0.86, $\mu$=0.73, $\sigma$ =0.04). Intra-observer variability was high (0.68 to 0.88) and inter-observer concordance was moderate (Fleiss kappa = 0.67). Our object detection approach has a mean average precision of 0.66 over the five classes from the whole slide gigapixel image and a computation time of below two minutes. Conclusion: To mitigate the high inter- and intra-rater variability, we propose our automated object detection pipeline, enabling accurate, reproducible and quick EIPH scoring in WSI