Comparison of ultrasonography and histopathology for the diagnosis of endometritis in Holstein-Friesian cows
ABSTRACT Reproductive diseases are a great barrier to dairy production, as they diminish fertility and cause economic loss. In this context, endometritis plays an important role. Different diagnostic techniques exist for endometritis that vary in sensitivity and specificity. This work aimed to evaluate and compare ultrasonographic and histopathological examinations, and combinations thereof, for the diagnosis of endometritis by determining their sensitivity, specificity, and kappa agreement coefficients using endometrial cytology as the gold standard. We developed an adaptive reading score to perform histological examination of the uterus. In this study, 76 Holstein-Friesian cows, 21 to 47 d postpartum, without vaginal catarrh were submitted to gynecological examinations, including ultrasonographic examination, an endometrial cytology examination, and a uterine biopsy. Our results indicate that ultrasonography is a practical and effective diagnostic method, and a combination of the determination of intrauterine fluid and cervical diameter was the most efficient ultrasonographic method, with 50% sensitivity and 88% specificity. Histopathological examination was a useful diagnostic method that provided rich detail on endometrial inflammation, and allowed evaluation of different components of the tissue such as the epithelium, lamina propria, endometrial glands, and blood vessels; this method had 44% sensitivity and 92% specificity for diagnosis of endometritis.
SourceAvailable from: Sebastian Arlt
Dataset: de Boer et al 2014 JDS
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ABSTRACT: Subclinical endometritis (SCE) is an important postpartum disease in dairy cows but conventional cytobrush diagnosis often gives imprecise results. The aim of this study was to analyze disease-associated changes in peripheral blood as potential diagnostic parameters. Cellular subpopulations of blood leukocytes from cows with or without SCE (45 to 55 days post partum) were flow cytometrically quantified. Gene expression of whole blood leukocytes was assessed by PAXgene analysis. SCE cows showed significantly higher numbers of blood mononuclear cells (MNC) and neutrophils. Among MNC, numbers of B-cells, NK-cells and CD172a-positive monocytes were significantly elevated. Compared to non-SCE cows, blood leukocytes of SCE cows significantly expressed higher copy numbers of CXCL8, TNF and IL12. In order to test whether circulating plasma factors are responsible for these changes, leukocytes, polymorphonuclear cells (PMN) and monocyte subpopulations (classical, intermediate, non-classical) of healthy cows were stimulated with plasma of SCE and non-SCE cows. Whereas gene expression of whole leukocytes and PMN remained unaltered, plasma from SCE animals significantly elevated expressed mRNA copy numbers of CXCL8, CXCL1 and IL1B in intermediate monocytes. In conclusion, elevated numbers of selected mononuclear subpopulations in peripheral blood and enhanced expression of distinct genes encoding for inflammatory mediators in blood leukocytes reflect the subclinical uterine inflammatory process in cows. Whether the observed changes in the periphery of SCE cows are the consequence of the uterine inflammatory process, or whether they affect the pathogenesis of the disease is currently unknown.Theriogenology 04/2014; DOI:10.1016/j.theriogenology.2014.01.007 · 1.85 Impact Factor
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ABSTRACT: The objective of this study was to conduct a systematic and critical appraisal of the quality of previous publications and describe diagnostic methods, diagnostic criteria and definitions, repeatability, and agreement among methods for diagnosis of vaginitis, cervicitis, endometritis, salpingitis, and oophoritis in dairy cows. Publications (n = 1,600) that included the words "dairy," "cows," and at least one disease of interest were located with online search engines. In total, 51 papers were selected for comprehensive review by pairs of the authors. Only 61% (n = 31) of the 51 reviewed papers provided a definition or citation for the disease or diagnostic methods studied, and only 49% (n = 25) of the papers provided the data or a citation to support the test cut point used for diagnosing disease. Furthermore, a large proportion of the papers did not provide sufficient detail to allow critical assessment of the quality of design or reporting. Of 11 described diagnostic methods, only one complete methodology, i.e., vaginoscopy, was assessed for both within- and between-operator repeatability (κ = 0.55-0.60 and 0.44, respectively). In the absence of a gold standard, comparisons between different tests have been undertaken. Agreement between the various diagnostic methods is at a low level. These discrepancies may indicate that these diagnostic methods assess different aspects of reproductive health and underline the importance of tying diagnostic criteria to objective measures of reproductive performance. Those studies that used a reproductive outcome to select cut points and tests have the greatest clinical utility. This approach has demonstrated, for example, that presence of (muco)purulent discharge in the vagina and an increased proportion of leukocytes in cytological preparations following uterine lavage or cytobrush sampling are associated with poorer reproductive outcomes. The lack of validated, consistent definitions and outcome variables makes comparisons of the different tests difficult. The quality of design and reporting in future publications could be improved by using checklists as a guideline. Further high-quality research based on published standards to improve study design and reporting should improve cow-side diagnostic tests. Specifically, more data on intra- and interobserver agreement are needed to evaluate test variability. Also, more studies are necessary to determine optimal cut points and time postpartum of examination.Journal of Dairy Science 05/2014; 97(7). DOI:10.3168/jds.2013-7450 · 2.55 Impact Factor