We assessed the inter-observer agreement in identification of a range of 24 clinical signs associated with disease presentation in 327 children aged < 5 years admitted to hospital in January-June 1999 in Ifakara, southern Tanzania. Children with diagnoses of malaria, pneumonia, diarrhoea, anaemia and malnutrition were examined independently by 2 clinical officers. Findings were recorded on a standard proforma. The Kappa-statistic was used to assess inter-observer agreement for each sign. Physical signs were more likely to be agreed upon by clinicians if they involved inspection than if they involved auscultation. The signs included in the Integrated Management of Childhood Illness (IMCI) algorithm were found to be largely appropriate (Kappa-scores > 0.41) although there was only fair agreement (Kappa-score 0.21-0.40) in the detection of neck stiffness and chest indrawing and slight agreement in the detection of dehydration (Kappa-score 0.199). All objective neurological signs were less reliably assessed in infants than in older children. The difficulties surrounding the diagnosis of impaired consciousness in young children should increase vigilance in the diagnosis and management of neurological complications of illnesses in infancy.

Age Distribution↗

PubMedDate not supplied

Predisposition to gastric dilatation-volvulus in relation to genetics of thoracic conformation in Irish setters.

Thoracic depth/width ratios (TDWRs) were calculated from measurements of the parents (i.e., common dam and two sires) and puppies in two litters of Irish setters. The TDWRs of the parents, distribution of TDWRs in the litters, and comparisons with earlier population studies suggest that an incompletely dominant major gene and a background of minor genes and environmental factors are responsible for the TDWR. A history of gastric dilatation-volvulus (GDV) (i.e., bloat) was correlated with high TDWRs in this family as it was for Irish setters and certain other breeds studied earlier. It may be possible to reduce the incidence of GDV by selective breeding of dogs with lower TDWRs.

Animals↗

PubMedDate not supplied

Influence of thoracic conformation and genetics on the risk of gastric dilatation-volvulus in Irish setters.

Body measurements, history of gastric dilatation-volvulus (GDV), and other data were obtained for 155 Irish setters at the 1994 National Specialty Show. The dogs ranged in age from 6.5 months to 12.4 years (mean+/-standard deviation [SD], 3.6+/-2.6 years); 11 (7%) of the dogs had histories of GDV. Gastric dilatation-volvulus risk increased 33% for each year of age (p of 0.01). Dogs with the deepest thorax relative to width (ratio range, 1.61 to 1.85) had a significantly greater GDV risk than those with the shallowest thorax (ratio range, 1.20 to 1.50); the odds ratio was 8.45; the 95% confidence limits were 1.44 to 49.57; and the p value equaled 0.02. Having a relative (particularly a parent) with GDV also increased GDV risk. Five-generation pedigrees yielded a significantly higher mean coefficient of relationship for the 11 dogs with GDV than for the 11 dogs without GDV.

Animals↗