Tracheal ultrasonography was performed to measure the width of the tracheal ring shadow and to assess the clinical relevance of these measurements for identifying tracheal collapse. The first tracheal ring width (FTRW) and thoracic inlet tracheal ring width (TITRW) were measured on both expiration and inspiration. The mean of the FTRW width (129 dogs) was greater in expiration (10.97 +/- 1.02 mm, p = 0.001) than that in inspiration (9.86 +/- 1.03 mm). For 51 normal dogs, the mean of the TITRW width was greater in expiration (9.05 +/- 1.52 mm, p = 0.001) than in inspiration (8.02 +/- 1.43 mm). For 78 tracheal collapse dogs, the mean of the TITRW width was greater in expiration (15.89 +/- 1.01 mm, p = 0.001) than in inspiration (14.85 +/- 1.17 mm). The TITRW/FTRW ratio of the normal dogs was higher (p = 0.001) in expiration (0.81 +/- 0.09) than that in inspiration (0.79 +/- 0.10). When compared between the normal and tracheal collapse dogs, the TITRW/FTRW ratio was also increased (p = 0.001) both in expiration (1.54 +/- 0.09) and inspiration (1.47 +/- 0.08), respectively. Based on these results, the cutoff level of the TITRW/FTRW ratio was statistically analyzed according to the receiver operating characteristic curve and it could be set at 1.16 in expiration and at 1.13 in inspiration. We have demonstrated that tracheal ultrasonography is a useful technique for the evaluation of tracheal collapse and it can be a supportive tool together with the radiographic findings for making the correct diagnosis.
Animals ; Dog Diseases/diagnosis/pathology/*ultrasonography ; Dogs ; Female ; Male ; Radiography, Thoracic/*veterinary ; Sensitivity and Specificity ; Trachea/*pathology/radiography ; Tracheal Stenosis/diagnosis/pathology/veterinary

This study was performed to radiographically examine the prevalence of aspiration sites and to evaluate their atomical correlation with the bronchial pattens. Ten healthy beagle dogs were repeatedly radiographed, at weekly intervals, in the left and right lateral, ventrodorsal (VD) and dorsoventral (DV) positions. Three mililiters of iohexol distilled with same volume of saline was infused into the tracheal inlet. Which lung lobe was aspirated was decided upon by the presence of a significant alveolar pattern due to the contrast medium. Alveolar patterns were identified at the left (100%) and right cranial lung lobes (77%) with the dogs in dependant lateral recumbency, at the right caudal lung lobe (71%) with the dogs in VD recumbency and at the right middle lung lobe (59%) with the dogs in DV recumbency, respectively. The anatomical correlation was evaluated by performing computed tomography. The right principal bronchus (165.8 +/- 1.6 degrees) was more straightly bifurcated than was the left principal bronchus (142.7 +/- 1.8 degrees, p < 0.01). In VD position, the right side lung had a greater opertunity to become aspirated. The ventrally positioned right middle lobar bronchial origin was more easily to be aspirated the other laterally positioned ones. We think that these anatomical characteristics can be one of the causes for aspiration pneumonia to occur more frequently in the right side lung.
Animals ; Contrast Media/chemistry ; Dog Diseases/pathology/*radiography ; Dogs ; Female ; Iohexol/chemistry ; Male ; Pneumonia, Aspiration/pathology/radiography/*veterinary ; Tomography, X-Ray Computed/veterinary

Background: Although coronavirus disease 2019 (COVID-19) is a viral infection, antibiotics are often prescribed due to concerns about accompanying bacterial infection. Therefore, we aimed to analyze the number of patients with COVID-19 who received antibiotic prescriptions, as well as factors that influenced antibiotics prescription, using the National Health Insurance System database. Methods: We retrospectively reviewed claims data for adults aged ≥ 19 years hospitalized for COVID-19 from December 1, 2019 to December 31, 2020. According to the National Institutes of Health guidelines for severity classification, we calculated the proportion of patients who received antibiotics and the number of days of therapy per 1,000 patient-days. Factors contributing to antibiotic use were determined using linear regression analysis. In addition, antibiotic prescription data for patients with influenza hospitalized from 2018 to 2021 were compared with those for patients with COVID-19, using an integrated database from Korea Disease Control and Prevention Agency-COVID19-National Health Insurance Service cohort (K-COV-N cohort), which was partially adjusted and obtained from October 2020 to December 2021. Results: Of the 55,228 patients, 46.6% were males, 55.9% were aged ≥ 50 years, and most patients (88.7%) had no underlying diseases. The majority (84.3%; n = 46,576) were classified as having mild-to-moderate illness, with 11.2% (n = 6,168) and 4.5% (n = 2,484) having severe and critical illness, respectively. Antibiotics were prescribed to 27.3% (n = 15,081) of the total study population, and to 73.8%, 87.6%, and 17.9% of patients with severe, critical, and mild-to-moderate illness, respectively. Fluoroquinolones were the most commonly prescribed antibiotics (15.1%; n = 8,348), followed by third-generation cephalosporins (10.4%; n = 5,729) and beta-lactam/beta-lactamase inhibitors (6.9%; n = 3,822). Older age, COVID-19 severity, and underlying medical conditions contributed significantly to antibiotic prescription requirement. The antibiotic use rate was higher in the influenza group (57.1%) than in the total COVID-19 patient group (21.2%), and higher in severe-to-critical COVID-19 cases (66.6%) than in influenza cases. Conclusion Although most patients with COVID-19 had mild to moderate illness, more than a quarter were prescribed antibiotics. Judicious use of antibiotics is necessary for patients with COVID-19, considering the severity of disease and risk of bacterial co-infection.