Systematic review and meta-analysis: Diagnostic performance of DNA alterations in pancreatic juice for the detection of pancreatic cancer.

BACKGROUND AND AIMS: Pancreatic cancer has a dismal prognosis. So far, imaging has been proven incapable of establishing an early enough diagnosis. Thus, biomarkers are urgently needed for early detection and improved survival. Our aim was to evaluate the pooled diagnostic performance of DNA alterations in pancreatic juice. METHODS: A systematic literature search was performed in EMBASE, MEDLINE Ovid, Cochrane CENTRAL and Web of Science for studies concerning the diagnostic performance of DNA alterations in pancreatic juice to differentiate patients with high-grade dysplasia or pancreatic cancer from controls. Study quality was assessed using QUADAS-2. The pooled prevalence, sensitivity, specificity and diagnostic odds ratio were calculated. RESULTS: Studies mostly concerned cell-free DNA mutations (32 studies: 939 cases, 1678 controls) and methylation patterns (14 studies: 579 cases, 467 controls). KRAS, TP53, CDKN2A, GNAS and SMAD4 mutations were evaluated most. Of these, TP53 had the highest diagnostic performance with a pooled sensitivity of 42% (95% CI: 31-54%), specificity of 98% (95%-CI: 92%-100%) and diagnostic odds ratio of 36 (95% CI: 9-133). Of DNA methylation patterns, hypermethylation of CDKN2A, NPTX2 and ppENK were studied most. Hypermethylation of NPTX2 performed best with a sensitivity of 39-70% and specificity of 94-100% for distinguishing pancreatic cancer from controls. CONCLUSIONS: This meta-analysis shows that, in pancreatic juice, the presence of distinct DNA mutations (TP53, SMAD4 or CDKN2A) and NPTX2 hypermethylation have a high specificity (close to 100%) for the presence of high-grade dysplasia or pancreatic cancer. However, the sensitivity of these DNA alterations is poor to moderate, yet may increase if they are combined in a panel.

Performance of the Emprint and Amica Microwave Ablation Systems in ex vivo Porcine Livers: Sphericity and Reproducibility Versus Size.

PURPOSE: To investigate the performance of two microwave ablation (MWA) systems regarding ablation volume, ablation shape and variability. MATERIALS AND METHODS: In this ex vivo study, the Emprint and Amica MWA systems were used to ablate porcine livers at 4 different settings of time and power (3 and 5 minutes at 60 and 80 Watt). In total, 48 ablations were analysed for ablation size and shape using Vitrea Advanced Visualization software after acquisition of a 7T MRI scan. RESULTS: Emprint ablations were smaller (11,1 vs. 21,1 mL p < 0.001), more spherical (sphericity index of 0.89 vs. 0.59 p < 0.001) and showed less variability than Amica ablations. In both systems, longer ablation time and higher power resulted in significantly larger ablation volumes. CONCLUSION: Emprint ablations were more spherical, and the results showed a lower variability than those of Amica ablations. This comes at the price of smaller ablation volumes.

Multiple strains of Mycobacterium avium subspecies hominissuis infections associated with aborted fetuses and wasting in pigs.

A herd of pigs being reared for breeding and fattening, in which there had been incidences of abortion and wasting, reduced growth rates and an increase in mortality for the past year, were tested for Mycobacterium infection by pathological examinations, skin test, serology and Mycobacterium culture. In one placenta, and also in the lung tissues of fetuses, Ziehl-Neelsen staining revealed acid-fast bacilli in combination with infiltrations of neutrophils, macrophages and multinucleated giant cells. Acid-fast bacilli were also found in the mesenteric lymph nodes, liver and/or spleen and jejunum of pigs with wasting and in slaughtered animals. The specimen cultures were identified as Mycobacterium avium subspecies hominissuis using IS1245-specific PCR and IS1245 restriction fragment length polymorphism (RFLP). IS1245 RFLP revealed that the herd was infected with multiple M avium subspecies hominissuis strains belonging to at least two different clades. It is suggested that this infection may have played a more important role in the economic losses of the pig farm than had been assumed previously.

[Campylobacter as a venereal disease in cattle]. / Campylobacter als dekinfectie bij rundvee.

Since the introduction of AI, venereal diseases caused by Tritrichomonas fetus and Campylobacter fetus subsp. venerealis haved been eradicated in The Netherlands. Campylobacter fetus subsp. fetus can cause sporadic abortion and early embryonic death. When natural breeding is practised, venereal diseases must be included in the list of differential diagnoses of fertility problems. A case study of a Campylobacter fetus subsp. fetus infection is described.

Comparison of clinical and pathological diagnoses in dogs.

Clinical and pathological diagnoses were compared in a prospective study of 145 dogs. A diagnostic work up had been performed on all dogs of which 36 (24.8%) died and 109 (75.2%) were euthanatized. In 119 dogs (82.1%) both a clinical and patholical diagnosis was made, in 20 dogs (13.8%) no pathological diagnosis could be made and in 6 dogs (4.1%) no clinical diagnosis was established. In the 119 dogs the agreement level between clinical and pathological diagnosis was scored by the referring veterinarian together with a pathologist. Total agreement was found in 61 cases (51.3%) and disagreement in 31 cases (26.0%). In the remaining cases (27=22.7%) the pathological diagnosis further specified the clinical diagnosis. Consecutive submission appeared difficult to achieve by the participating veterinarians. However, no major differences in agreement level was present between the veterinarian which succeeded in almost consecutive submissions and the other veterinarians. At necropsy 42 cases were diagnosed as neoplasia, of which 52.4% had been diagnosed clinically. As to infectious diseases 55.0% of these diseases diagnosed at necropsy had been diagnosed clinically. In about 20% of the cases the differences were of clinical significance according to the referring veterinarians. In addition, it was indicated by the clinicians that about 50% of the necropsies revealed findings which could amend future patient care. The results of the study stress the relevance of postmortem examination as crucial part of continuing education and of quality monitoring and assurance in veterinary medicine.

[Infectious bovine keratoconjunctivitis (IBK) in cows, clinical and lab review at four farms]. / Infectieuze keratoconjunctivitis bij runderen, overzicht aan de hand van kliniek- en laboratoriumonderzoek op vier bedrijven.

After several reports to the GD (Dutch Animal Health Service) from practitioners in The Netherlands concerning serious Infectious Bovine Keratoconjunctivitis (IBK) in dairy herds during summer and autumn 2003, the GD has carried out a pilot-study to determine the most responsible agent. This pilot was thought to be important because of the painfulness of the illness and problems like, (for the farmer) an intensive and difficult therapy. Also the report of a Chlamydophilae infection causing IBK in a dairy herd in the UK prompted to this study. The most frequently isolated infectious agent in our study was Moraxella, probably M. bovis. For the presence of Chlamydophila, mycoplasmata or BHV1 viruses were no indications.

[A men with a Salmonella dublin-infected aneurysm of the abdominal aorta]. / Een man met een door Salmonella dublin geïnfecteerd abdominaal aneurysma aortae.

A 71-year-old male was diagnosed with a Salmonella dublin infection. He presented with abdominal pain with no diarrhoea, and sepsis, and was found to have an infected aneurysm of the infrarenal abdominal aorta. He was treated surgically with resection of the aneurysm and implantation of an extra-anatomic axillobifemoral bypass, followed by long-term antibiotic treatment. Nine months after the primary treatment, the patient died as a result of rupture of the aortic stump. S. dublin-infected aneurysm of the abdominal aorta is a rare condition with high mortality. Human S. dublin infections are associated with the consumption of unpasteurised dairy products from infected animals.

[Lambing ewes as a source of severe psittacosis in a pregnant woman]. / Lammerende schapen als bron van ernstige psittacose bij een zwangere.

The first documented Dutch case of an ovine Chlamydia psittaci infection concerned a 20-year-old woman in the 26th week of pregnancy, following contact with lambing sheep. She had a severe sepsis and had to be artificially ventilated. Finally, the patient made a full recovery. The preterm born child died directly after birth. The placenta showed an acute intervillitis in which chlamydial antigen was demonstrated immunohistologically. Infection with an ovine C. psittaci was confirmed by sequence analysis of amplified chlamydial DNA from the placenta. Infections with C. psittaci are typically associated with contact with (sick) birds. However, mammals also may act as a source of human infection, especially sheep in which C. psittaci is an important cause of abortion. Infections with ovine C. psittaci are a particular hazard for pregnant women, in whom there is severe placentitis and frequently foetal loss. Such infections are mainly associated with contact with lambing sheep.

Factors influencing the isolation of Mycobacterium avium subsp. paratuberculosis from bovine fecal samples.

A modified procedure was used for culture of Mycobacterium paratuberculosis (Mptb) from bovine feces. Bovine fecal samples were decontaminated with NaOH, exposed to a mixture of oxalic acid and malachite green, incubated in a mixture of neomycin and amphotericin B. Decontaminated specimens were inoculated onto modified Löwenstein-Jensen medium. Specimens processed by high-speed centrifugation showed growth earlier than specimens prepared by low-speed centrifugation. However, the overall number of positive cultures at 16 weeks was not different for the 2 methods. When infected dairy herds were sampled 4 times at 6-month intervals and culture-positive cows were culled, the prevalence of infected cattle declined over time. After selective culling, the cattle left in the herds shed low numbers of Mptb, which explains why it took longer for cultures to become positive. No heifers younger than 11 months were culture positive, but heifers 13-14 months of age were more frequently culture positive than were heifers of any other age. The 16-week culture period is needed with this method to detect cattle shedding low numbers of Mptb. High-speed centrifugation of samples does not increase the efficiency of identification of animals shedding Mptb.

Failure of antibiotics gentamycin, tylosin, lincomycin and spectinomycin to eliminate Mycoplasma bovis in artificially infected frozen bovine semen.

To study the effect of antibiotics upon Mycoplasma bovis in fresh bovine semen just before freezing, specimens of bovine semen were artificially infected with 1 of 9 different strains of M. bovis. Inocula of each strain were prepared to contain 10(5) to 10(6)/mL colony-forming units of M. bovis at 3 different stages of the growth phase. The infected semen was diluted with a Tris extender by a 3-step procedure using an antibiotic mixture of gentamicin, tylosin, lincomycin and spectinomycin (GTLS). This semen-antibiotic mixture was placed into French straws that were stored at -196 degrees C. The control semen specimens contained no antibiotics Mycoplasmas were counted after 8 d of storage in 3 decimal dilutions of the frozen semen. No evident effect was noticed upon the 9 tested strains of mycoplasmas in the semen frozen with the antibiotics, compared with that of the untreated control samples. It was further shown that this lack of effect was irrespective of the stage of the growth phase of the mycoplasmas. It was concluded that the antibiotic mixture (GTLS) in semen specimens is not capable of total elimination of mycoplasmas in frozen bovine semen.

[Pustular dermatitis in veterinarians following delivery in farm animals; an occupational disease]. / Pustulaire dermatitis bij dierenartsen na verlossingen van landbouwhuisdieren; een beroepsziekte.

OBJECTIVE: To assess the prevalence of contact dermatitis after deliveries in cattle or sheep among veterinarians. DESIGN: Retrospective. SETTING: Provinces of Groningen, Friesland, and Drenthe, The Netherlands. METHODS: By means of a short inquiry 310 veterinarians were asked whether and how often they had experienced pustular dermatitis after deliveries in cattle and sheep and what course the dermatitis had run. They were also asked about details of the deliveries (type of animal, condition of the foetus, course of the partus), about microbiological investigation, preventive measurements and therapy. RESULTS: The response to the questionnaires was 24.5%. One or more episodes of pustular dermatitis on an arm after a delivery in cattle or sheep was noticed by 62 (81.5%) of the 76 respondents. Sometimes it was associated with secondary symptoms like headache, fever and lymphadenitis. Listeria monocytogenes (7 times out of 13) and Salmonella dublin (4/13) were the agents cultured most often. CONCLUSION: Contact dermatitis after deliveries in cattle or sheep occurs frequently as an occupational disease of veterinarians.

Bovine fetal neosporosis: a comparison of epizootic and sporadic abortion cases and different age classes with regard to lesion severity and immunohistochemical identification of organisms in brain, heart, and liver.

Eighty bovine fetuses with confirmed neosporosis were used to score lesion severity and presence of parasites in brain, heart, and liver. A comparison was made between epizootic and sporadic abortion cases. The possible influence of fetal age was also investigated. Histologic lesions of multifocal encephalitis, myocarditis, and periportal hepatitis with or without focal hepatocellular necrosis were almost always observed. Neospora caninum tachyzoites were identified immunohistochemically in 85% of the brains, 14% of the hearts, and 26% of the livers. Tissue cysts were observed in 21% of the brains. Significant differences between epizootic and sporadic abortion cases were found only in the liver. Hepatic lesions were more prominent and N. caninum tachyzoites were observed more frequently and in higher numbers in epizootic cases. Examination by immunohistochemistry of the liver in addition to the brain can be highly contributive diagnostically, particularly in epizootic cases. There were no significant age-related differences except for a higher presence of tachyzoites in the hearts of younger fetuses (3-4 months gestational age).

[Severe watery diarrhea caused by Vibrio cholerae in lambs]. / Ernstige waterige diarree door Vibrio cholerae bij lammeren.

An outbreak of watery diarrhoea in lambs is described. Seventeen lambs died within 24 hours after the start of the diarrhoea. At necropsy Vibrio cholerae was isolated from the organs and intestines of three lambs. The strains did not react with O1 or O139 antisera, the strains responsible for cholera epidemics among humans. It is concluded that the diarrhoea in the lambs was caused by V. cholerae non-01/non-139. This microorganism had not been described before in lambs in the Netherlands.

[Pustular dermatitis in veterinarians following delivery in domestic animals; an occupational disease]. / Pustulaire dermatitis bij dierenartsen na verlossingen van landbouwhuisdieren; een beroepsziekte.

OBJECTIVE: To assess the prevalence of contact dermatitis after deliveries in cattle or sheep among veterinarians. DESIGN: Retrospective. SETTING: Provinces of Groningen, Friesland and Drenthe, The Netherlands. METHODS: By means of a short inquiry 31O veterinarians were asked whether and how often they had experienced pustular dermatitis after deliveries in cattle and sheep and what course the dermatitis had run. They were also asked about details of the deliveries (type of animal, condition of the foetus, course of the partus), about microbiological investigation, preventive measurements and therapy. RESULTS: The response to the questionnaires was 24.5%. One or more episodes of pustular dermatitis on an arm after a delivery in cattle or sheep was noticed by 6(2) (81.5%) of the 7(6) respondents. Sometimes it was associated with secondary symptoms like headache, fever and lymphadenitis. Listeria monocytogenes (7 times out of 13) and Salmonella dublin (4/13) were the agents cultured most often. CONCLUSION: Contact dermatitis after deliveries in cattle or sheep occurs frequently as an occupational disease of veterinarians.

[Salmonella dublin infections on a goat farm]. / Een Salmonella dublin-infectie op een geiten-bedrijf.

A Salmonella Dublin infection in young goats has been described. In a period of two weeks, 16 of 70 female-kids died within one day, because of septicaemia. Bad hygiene and management measures were discussed as the main reason for this outbreak.