human
***task***
the task is to summarize an input biomedical literature in six sentences

***input***
the input is a biomedical literature

***output***
the output is the summary of an input biomedical literature in six sentences

***documentation***

***examples***

input: dogs and other canidae such as foxes serve as definitive hosts , while snails and slugs act as intermediate hosts . it has a worldwide distribution and in europe it is considered enzootic in certain areas in france , denmark , ireland and the uk [ 2 - 4,9 ] . the adult metastrongyle ( 13 - 21 mm ) resides in the pulmonary arteries and the right side of the heart . first - stage ( l1 ) larvae migrate through the respiratory system via the trachea to the gastrointestinal - tract and are excreted in faeces . the migration of the l1 larvae through the blood - air barrier and the subsequent verminous pneumonia and pulmonary thrombosis causes the clinical signs ( i.e. , cough , exercise intolerance , dyspnoea ) that are commonly associated with the pulmonary system . haematological changes such as neutrophilia , thrombocytopaenia and anaemia have been reported whereas the most frequent changes in biochemistry are increased globulin levels and decreased fructosamine . a fatal outcome of infection is often associated with coagulation disorders . suggested echanisms behind the coagulopathy are induced immune - mediated thrombocytopaenia , disseminated intravascular coagulation ( dic ) or secretion of anticoagulants by the adult worms . clinical presentation of associated bleeding disorders may vary between petechial or ecchymotic bleeding on mucosal surfaces , dermis or sclera to intracranial or cns bleeding . to the authors ' knowledge , this is the first reported case of haemoabdomen associated with an a. vasorum infection . a one - year - old intact female danish shorthaired pointer ( body weight 25 kg ) was referred to the emergency service at the department of small animal clinical sciences at the university of coprnhagen with a history of acute collapse and pale mucous membranes . the owner had noted the dog to be less active over the past month , but with no other clinical signs more commonly related to canine angiostrongylosis such as cough , dyspnoea or exercise intolerance . the dog presented with a temperature of 37.1 c , pulse 120 / min , respiration rate of 28 / min and pale pink , dry mucous membranes with a prolonged capillary refill time greater than two seconds . the most predominant changes in haematological and biochemical profiles were neutrophilia , packed cell volume ( pcv ) of 24 % , elevated urea and creatinine and reduced fructosamine ( table 1 ) . haematological , biochemical and coagulation parameters at time of diagnosis * aggregates seen on blood smear at 40 magnification . an ultrasound examination of the abdomen ( figure 1 ) suggested a large amount of free fluid with no obvious cause such as neoplasia or splenic rupture . abdominocentesis was performed and the aspirate had the macroscopic appearance of blood , a pcv of 35 % and no signs of infection or neoplasia on a cytological examination . the coagulation profile showed prolonged prothrombin time ( pt ) and increased d - dimer ( table 1 ) . phytomenadion ( konakion , roche a / s , hvidovre , denmark ) treatment was initiated due to potential coumarin poisoning and for initial stabilisation , the dog received two transfusions ; one unit of full blood ( 18 ml / kg ) and one unit of fresh frozen plasma ( 9 ml / kg ) . however , in the present case , the authors chose to carry out the procedure as a continuing loss of blood could not be ruled out at this stage . urinalysis of a voided sample was unremarkable except that a single a. vasorum l1 larva was detected on microscopy . subsequently , multiple l1 larvae were revealed using a direct faecal smear technique . due to the rapid establishment of the diagnosisthe dog was treated with fenbendazole 25 mg / kg orally once daily for 20 days following a protocol known to be efficient in the treatment of a. vasorum infections . to avoid possible anaphylactic reactions , prednisolone acetate at 1 mg / kg ( prednisolon dak , nycomed , roskilde , denmark ) was administered once daily for 12 days . the dog stabilised on this treatment and was discharged after two days of hospitalisation and monitoring . four weeks later , a complete resolution of clinical signs and normalisation of haematological and coagulation blood parameters were found . haemoabdomen associated with canine angiostrongylosis has not been reported before , although spontaneous bleeding at other sites has been reported . in the present case , neoplasia could not be demonstrated and treatment with phytomenadion was initially started in case of a rodenticide poisoning , although the owner reported it unlikely that the dog had been in contact with such compounds . coumarin poisoning is not usually associated with neutrophilia and decreased fructosamine , as in this case , but could account for the prolonged pt . increased d - dimer indicates formation of thrombi , but is non - specific regarding the underlying cause . prolonged pt and elevated d - dimer could be indicative of disseminated intravascular coagulation ( dic ) as is often reported in cases of canine angiostrongylosis . immune - mediated thrombocytopaenia has been reported in association with a. vasorum infection . however , with a platelet count of 9010 / l and aggregates present on the blood smear , it was considered unlikely to have caused the bleeding , since bleeding caused by low platelet number usually occurs only with platelet count below 4010 / l . the acute onset of clinical signs might also have been caused by a ruptured small vessel . aberrant migration of adult worms probably occurs frequently and rupture of the femoral artery has been reported previously in a case report of an experimentally infected dog . finally , the possible role of the parasites secreting an anticoagulant may contribute to the development of bleeding problems this mechanism , however , needs to be further investigated . the finding of l1 larvae in the urinalysis may be explained by ectopic l1 larvae or faecal contamination of the voided urine sample . however , due to the presumed hypocoagulable state of the dog , sampling by cystocentesis was not performed . abdominal ultrasound of a dog diagnosed with a. vasorum . a large amount of free intraabdominal fluid was observed . haemoabdomen is a clinical sign where surgical intervention is often considered an integral part of the diagnostic investigation ( i.e. , laparotomy ) or treatment . failing to make the diagnosis of canine angiostrongylosis before performing surgeryin conclusion , in areas where a. vasorum is enzootic , a baermann test and a direct faecal smear should be included in the initial diagnostic investigation of all dogs presenting with bleeding disorders of unknown origin .
output:

agent
a one - year - old intact female , danish shorthaired pointer was referred to the emergency service with a history of acute collapse and pale mucous membranes after a month of reduced activity but with no other clinical signs . an ultrasound examination of the abdomen indicated the presence of a large amount of free fluid with no obvious cause such as neoplasia or splenic rupture . fluid analysis had the macroscopic appearance of blood with no signs of infection or neoplasia . multiple angiostrongylus vasorum l1 larvae were revealed on a direct rectal faecal smear . the dog was treated with fenbendazole 25 mg / kg orally once daily for 20 days and given supportive treatment . the dog was stabilised on this treatment . haemoabdomen is a clinical sign where surgical intervention is often considered an integral part of the diagnostic investigation ( i.e. , laparotomy ) or treatment . failing to make the diagnosis of canine angiostrongylosis before performing surgery may have a serious adverse affect on the outcome . consequently , in areas where a. vasorum is enzootic , a baermann test and a direct faecal smear should be included in the initial diagnostic investigation of all dogs presenting with bleeding disorders of unknown origin .
***task***
the task is to summarize an input biomedical literature in six sentences

***input***
the input is a biomedical literature

***output***
the output is the summary of an input biomedical literature in six sentences

***documentation***

***examples***

input: dogs and other canidae such as foxes serve as definitive hosts , while snails and slugs act as intermediate hosts . it has a worldwide distribution and in europe it is considered enzootic in certain areas in france , denmark , ireland and the uk [ 2 - 4,9 ] . the adult metastrongyle ( 13 - 21 mm ) resides in the pulmonary arteries and the right side of the heart . first - stage ( l1 ) larvae migrate through the respiratory system via the trachea to the gastrointestinal - tract and are excreted in faeces . the migration of the l1 larvae through the blood - air barrier and the subsequent verminous pneumonia and pulmonary thrombosis causes the clinical signs ( i.e. , cough , exercise intolerance , dyspnoea ) that are commonly associated with the pulmonary system . haematological changes such as neutrophilia , thrombocytopaenia and anaemia have been reported whereas the most frequent changes in biochemistry are increased globulin levels and decreased fructosamine . a fatal outcome of infection is often associated with coagulation disorders . suggested echanisms behind the coagulopathy are induced immune - mediated thrombocytopaenia , disseminated intravascular coagulation ( dic ) or secretion of anticoagulants by the adult worms . clinical presentation of associated bleeding disorders may vary between petechial or ecchymotic bleeding on mucosal surfaces , dermis or sclera to intracranial or cns bleeding . to the authors ' knowledge , this is the first reported case of haemoabdomen associated with an a. vasorum infection . a one - year - old intact female danish shorthaired pointer ( body weight 25 kg ) was referred to the emergency service at the department of small animal clinical sciences at the university of coprnhagen with a history of acute collapse and pale mucous membranes . the owner had noted the dog to be less active over the past month , but with no other clinical signs more commonly related to canine angiostrongylosis such as cough , dyspnoea or exercise intolerance . the dog presented with a temperature of 37.1 c , pulse 120 / min , respiration rate of 28 / min and pale pink , dry mucous membranes with a prolonged capillary refill time greater than two seconds . the most predominant changes in haematological and biochemical profiles were neutrophilia , packed cell volume ( pcv ) of 24 % , elevated urea and creatinine and reduced fructosamine ( table 1 ) . haematological , biochemical and coagulation parameters at time of diagnosis * aggregates seen on blood smear at 40 magnification . an ultrasound examination of the abdomen ( figure 1 ) suggested a large amount of free fluid with no obvious cause such as neoplasia or splenic rupture . abdominocentesis was performed and the aspirate had the macroscopic appearance of blood , a pcv of 35 % and no signs of infection or neoplasia on a cytological examination . the coagulation profile showed prolonged prothrombin time ( pt ) and increased d - dimer ( table 1 ) . phytomenadion ( konakion , roche a / s , hvidovre , denmark ) treatment was initiated due to potential coumarin poisoning and for initial stabilisation , the dog received two transfusions ; one unit of full blood ( 18 ml / kg ) and one unit of fresh frozen plasma ( 9 ml / kg ) . however , in the present case , the authors chose to carry out the procedure as a continuing loss of blood could not be ruled out at this stage . urinalysis of a voided sample was unremarkable except that a single a. vasorum l1 larva was detected on microscopy . subsequently , multiple l1 larvae were revealed using a direct faecal smear technique . due to the rapid establishment of the diagnosisthe dog was treated with fenbendazole 25 mg / kg orally once daily for 20 days following a protocol known to be efficient in the treatment of a. vasorum infections . to avoid possible anaphylactic reactions , prednisolone acetate at 1 mg / kg ( prednisolon dak , nycomed , roskilde , denmark ) was administered once daily for 12 days . the dog stabilised on this treatment and was discharged after two days of hospitalisation and monitoring . four weeks later , a complete resolution of clinical signs and normalisation of haematological and coagulation blood parameters were found . haemoabdomen associated with canine angiostrongylosis has not been reported before , although spontaneous bleeding at other sites has been reported . in the present case , neoplasia could not be demonstrated and treatment with phytomenadion was initially started in case of a rodenticide poisoning , although the owner reported it unlikely that the dog had been in contact with such compounds . coumarin poisoning is not usually associated with neutrophilia and decreased fructosamine , as in this case , but could account for the prolonged pt . increased d - dimer indicates formation of thrombi , but is non - specific regarding the underlying cause . prolonged pt and elevated d - dimer could be indicative of disseminated intravascular coagulation ( dic ) as is often reported in cases of canine angiostrongylosis . immune - mediated thrombocytopaenia has been reported in association with a. vasorum infection . however , with a platelet count of 9010 / l and aggregates present on the blood smear , it was considered unlikely to have caused the bleeding , since bleeding caused by low platelet number usually occurs only with platelet count below 4010 / l . the acute onset of clinical signs might also have been caused by a ruptured small vessel . aberrant migration of adult worms probably occurs frequently and rupture of the femoral artery has been reported previously in a case report of an experimentally infected dog . finally , the possible role of the parasites secreting an anticoagulant may contribute to the development of bleeding problems this mechanism , however , needs to be further investigated . the finding of l1 larvae in the urinalysis may be explained by ectopic l1 larvae or faecal contamination of the voided urine sample . however , due to the presumed hypocoagulable state of the dog , sampling by cystocentesis was not performed . abdominal ultrasound of a dog diagnosed with a. vasorum . a large amount of free intraabdominal fluid was observed . haemoabdomen is a clinical sign where surgical intervention is often considered an integral part of the diagnostic investigation ( i.e. , laparotomy ) or treatment . failing to make the diagnosis of canine angiostrongylosis before performing surgeryin conclusion , in areas where a. vasorum is enzootic , a baermann test and a direct faecal smear should be included in the initial diagnostic investigation of all dogs presenting with bleeding disorders of unknown origin .
output:
