Dipeptidyl peptidase-4 inhibitors do not alter GH/IGF-I axis in adult diabetic patients.

PURPOSE: Incretin-based therapies have been introduced in clinical practice for type 2 diabetes mellitus (T2DM) treatment in the last few years. Current available medications of this class include glucagon-like peptide 1 (GLP-1) receptor agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors. In addition to GLP-1, DPP-4 is able to inactivate many others peptides as hypothalamic growth hormone-releasing hormone (GHRH). The aim of this exploratory study was to evaluate, on adult diabetic patients, the impact of therapy with incretins, particularly DPP-4 inhibitors on GH/IGF-I axis. METHODS: 60 patients with T2DM were included in the study and they were divided into three groups (age and sex comparable) on the basis of their hypoglycemic drugs in the last 4 months: group 1 (17 patients, exenatide or liraglutide + metformin), group 2 (18 patients, sitagliptin or vildagliptin + metformin), group 3 (25 patients, metformin). Anthropometric data, glycemia, glycosylated hemoglobin (HbA1c), IGF-I and acid-labile subunit (ALS) were collected in all patients. RESULTS: Weight, waist circumference and BMI of group 1 were significantly higher (P < 0.05) compared to the other groups. Fasting plasma glucose and HbA1c of the group 1 were similar compared to those of group 3 (P ns) and higher compared to those of group 2 (P < 0.05). IGF-I absolute values, IGF-I SDS were not significantly different in the three groups. CONCLUSIONS: Our data evidence that DPP-4 inhibition does not influence significantly GH/IGF-I system, confirming what was observed in animal models. Further studies are needed to better characterize the properties of these molecules on endocrine system.

Use of a Barbed Knotless Suture for Laparoscopic Ablation of the Nephrosplenic Space in 8 Horses.

OBJECTIVE: To evaluate use of a knotless suture for laparoscopic closure of the equine nephrosplenic space. STUDY DESIGN: Experimental in vivo study. ANIMALS: Normal horses without previous history of abdominal surgery (n=8). METHODS: The nephrosplenic space was closed under laparoscopic visualization using a unidirectional, barbed 0 metric absorbable suture (copolymer of glycolic acid and trimethylene carbonate). Intracorporeal suturing of the nephrosplenic space was performed in a cranial-to-caudal direction in a simple continuous fashion. Repeat evaluation was performed laparoscopically in 2 horses and by necropsy in 6 horses. The length of closure was measured and nature of the healed tissue was evaluate grossly. RESULTS: Total surgery time was 65-167 minutes (mean ± SD, 89.6 ± 22.6). Suturing time was 30-65 minutes (40.4 ± 16.3). Second laparoscopy in 2 horses was performed at days 198 and 227. Necropsy was performed at day 69-229 postoperatively (132.7 ± 63.0) in 6 horses. The closure measured 12-14 cm in length (13 ± 1) and consisted of mature fibrous tissue bridging the splenic capsule and the nephrosplenic ligament. No residual suture material was identified grossly in any horses. The procedure was easily performed; extracorporeal suture management to hold it taut was unnecessary since the barbs had excellent purchase in the apposed tissues, and intracorporeal knot tying was not required. CONCLUSION: The barbed knotless suture appears to be a valid alternative to facilitate laparoscopic closure of the nephrosplenic space in normal horses; however, further work is necessary to investigate its suitability in clinically affected horses.

Surgical technique and short-term outcome for experimental laparoscopic closure of the epiploic foramen in 6 horses.

OBJECTIVE: To describe a laparoscopic technique for, and short-term outcome after, closure of the epiploic foramen (EF) in horses. STUDY DESIGN: Descriptive, experimental study. ANIMALS: Healthy, adult horses (n = 6). METHODS: Laparoscopic portals to approach the EF were identified in standing horses. Under laparoscopic observation, the gastropancreatic fold and right lobe of the pancreas were grasped with Babcock forceps and secured to the caudate hepatic lobe using helical titanium coils to obliterate the EF. Surgical procedure time and intra- and postoperative complications were recorded. Serial analysis of select serum enzymes was used as an indication of involvement of the pancreas and liver. Closure was reevaluated at 4 weeks using repeat laparoscopy, and necropsy was performed immediately after. RESULTS: At initial surgery, EF closure was successful in all 6 horses; median surgical time was 40.5 minutes (range, 22-110 minutes). Serum gamma-glutamyl transferase (GGT) and sorbitol dehydrogenase (SDH) were not significantly altered by the surgical procedure; however, aspartate aminotransferase (AST) and amylase (AMY) were transiently increased. At repeat laparoscopic reevaluation, closure was complete in 5 horses, with partial closure of the EF observed in 1 horse. No complications related to the procedure were noted during or after surgery in any horse. CONCLUSIONS: EF closure in the standing horse can be accomplished without complications to the surrounding organs and vessels.

A model for the noninvasive, habitat-inclusive estimation of upper limit abundance for synanthropes, exemplified by M. fascicularis.

Accurately estimating population sizes for free-ranging animals through noninvasive methods, such as camera trap images, remains particularly limited by small datasets. To overcome this, we developed a flexible model for estimating upper limit populations and exemplified it by studying a group-living synanthrope, the long-tailed macaque (Macaca fascicularis). Habitat preference maps, based on environmental and GPS data, were generated with a maximum entropy model and combined with data obtained from camera traps, line transect distance sampling, and direct sightings to produce an expected number of individuals. The mapping between habitat preference and number of individuals was optimized through a tunable parameter ρ (inquisitiveness) that accounts for repeated observations of individuals. Benchmarking against published data highlights the high accuracy of the model. Overall, this approach combines citizen science with scientific observations and reveals the long-tailed macaque populations to be (up to 80%) smaller than expected. The model's flexibility makes it suitable for many species, providing a scalable, noninvasive tool for wildlife conservation.

Evaluation of intra-abdominal pressure in horses that crib.

OBJECTIVE: To measure intra-abdominal pressure (IAP) in horses that crib and compare it with IAP in horses that do not have this vice. STUDY DESIGN: Cohort study. ANIMALS: Healthy cribbing horses (cribbing cohort, n = 8) and 8 healthy noncribbing horses (noncribbing cohort). METHODS: A microsensor catheter was introduced into the peritoneal cavity through the right paralumbar fossa, using local anesthesia, for measurement of IAP. These pressures were recorded in 1-minute intervals for 2 hours, while the horses were standing tied in a stall. IAPs of cribbing horses were compared to the noncribbing cohort. RESULTS: Baseline IAPs were not significantly different between cribbing and noncribbing cohorts (P = .076); however, IAPs in the cribbing cohort were significantly increased when compared with the noncribbing cohort, during active cribbing behavior (P = .0016). Frequency of cribbing was not associated with increased IAP (P = .35). IAPs in the cribbing cohort remained significantly elevated compared with the noncribbing cohort, even after the behavior had ceased (P = .0002). CONCLUSION: Cribbing is associated with increased IAP in the horse, both during and after the behavior.

Use of Thoracic Catheters to Drain Pelvic Abscesses in Horses: Two Cases.

Pelvic abscesses occur in horses of all ages and breeds. Although conservative management may be successful, surgical drainage may be necessary for larger abscesses or in case of secondary intestinal obstruction. The purpose of this report is to describe two cases of pelvic abscesses that were successfully drained using indwelling chest tubes, repeated lavages and targeted antibiotic treatment.

Cyst of the Guttural Pouch in a Foal: A Case Report.

Although cysts can occur anywhere in the equine upper airway, cysts of the guttural pouch are rare. The purpose of this report is to describe the clinical presentation, diagnostic procedure, and surgical treatment of a guttural pouch cyst in a 16-day-old Warmblood foal presenting with dysphagia. Endoscopic examination revealed a cyst protruding into the pharyngeal vault which was causing dysfunction of the pharynx and subsequent dysphagia. Surgical drainage in the pharynx was established by a transendoscopic fenestration of the cyst using a diode laser. The foal presented resolution of dysphagia and no recurrence 12 months following treatment. Foals with persistent dysphagia should receive a through endoscopic examination of the upper airways including the guttural pouches. In this case, the diagnosis and the surgical treatment of a guttural pouch canal cyst were successfully performed using a minimally invasive endoscopic approach.

When the Going Gets Challenging-Motivational Theories as a Driver for Workplace Health Promotion, Employees Well-Being and Quality of Life.

Being characterized by high numbers of physical and mental health issues, the veterinary sector faces some negative peculiarities compared to other professions. To evaluate and possibly improve employees' well-being and to reward according to individual motivation, managing staff and the profession in general must understand every individual's motivation. Defining the motivation of veterinary professionals in a multidisciplinary way can be the first step in increasing the well-being of employees. To assemble current theories of work motivation and adapt and extend them to serve the veterinary profession, basic knowledge of the classical general psychological motivational theories and work motivational theories is inevitable. The authors aimed to illustrate the different motivational theories' key aspects and historical evolution to provide veterinary personnel with broad knowledge. In addition, the availability of already existing literature should be evaluated. A scoping review was performed. Methodological, empirical, review, and theoretical articles were evaluated. Only a minority of the studies (1.3%) evaluated motivational theories in veterinary health care. This reflects that there is a need for research in this field. Still, it is illustrated that the veterinarian profession would benefit from the implementation of general psychological as well as motivational work theories.

Prevalence of Gastric Ulceration in Horses with Enterolithiasis Compared with Horses with Simple Large Intestinal Obstruction.

Enterolithiasis is a well-documented cause of colic in horses, especially in some geographic areas such as California and Florida. This retrospective case-control study aims at comparing the prevalence of gastric ulcers in horses affected by enterolithiasis to that in horses affected by other types of large intestinal obstruction. Two hundred and ninety-six horses were included in the study sample. Horses that had surgery for the removal of one or more enteroliths were included in the study as cases. Patients that had surgery for large intestinal simple obstructions other than enterolithiasis (large colon displacement, non-strangulating large colon torsion, and large and small colon impactions) were selected to match case horses for age, sex, and breed and included as controls. A total of 101/148 horses with enteroliths (68%) had gastric ulcers diagnosed during hospitalization, compared with 46/148 of matched controls (31%). There was a significant association between enterolithiasis and gastric ulceration (odds ratio 4.76, p < 0.0001), and a greater prevalence in Thoroughbreds as compared with other breeds (odds ratio 22.6, p < 0.0001). We concluded that enterolithiasis is significantly associated with gastric ulceration (p < 0.0001). The association is stronger in Thoroughbreds.

Leadership Theories and the Veterinary Health Care System.

This descriptive review aims to illustrate the different leadership theories as they may apply to the veterinary health care sector, and specifically, to the affection and sports animal subsectors. The increasing and ever-changing challenges veterinary health care operators and investors operating in these subsectors face are briefly described, as well as the most known leadership theories and styles, each with its possible advantages and disadvantages specific to its application to the veterinary health care system. The different theories are illustrated in their key aspects and their historical evolution. Finally, the discussion focuses on transformational leadership as it is seen as the most progressive and promising leadership style to hold up to said challenges in the veterinary health care system.

Mechanisms of expression of object play: A comparative study of stone handling in two captive groups of long-tailed macaques (Macaca fascicularis fascicularis).

Stone handling (SH) is a form of solitary object play that is socially learned and culturally maintained. We studied two captive groups (Modena, N = 20; Padova, N = 20) of common long-tailed macaques housed in a sanctuary in Italy. Our research goal was two-fold: (1) establish the first SH repertoire in captive-raised long-tailed macaques, and (2) explain major differences in the expression of SH between the two study groups. Despite being of identical size and sharing similar environmental conditions, we found that SH was performed by most group members in Modena, whereas SH was absent in Padova. We aimed to explain this inter-group variation by exploring the role of proximate factors that are known to affect the occurrence of SH: demography, dominance, stone availability, activity budget, and food provisioning. The atypical age structure of Padova (i.e., no immature individuals) may have impaired the emergence of SH in this group. In Modena, we found no significant effect of hierarchical rank on SH frequency and duration and no temporal relationship between SH and feeding. Regarding the activity budget, SH filled in for a portion of affiliative and resting behaviours in Modena. Our findings lend support to the cultural nature of SH.

Evaluation of an enrichment programme for a colony of long-tailed macaques (Macaca fascicularis) in a rescue centre.

Long-tailed macaques are highly social primates that are commonly used in biomedical research as animal models. The aim of this study was to evaluate the effects of different kinds of enrichment on the behaviour and faecal cortisol metabolite (FCM) level in a colony of ex-laboratory long-tailed macaques during a programme of rehabilitation. The research was carried out in three periods, divided into two sessions each. Every period was composed of one control session (SC) and one session characterised by one type of enrichment: feeding enrichment (FE), manipulative enrichment (ME), and the last session during which manipulative and feeding enrichment were provided every day but in a mixed way (MIX). The results showed that manipulative and mixed enrichments caused positive changes to the activity budget of the colony, with a decrease in abnormal behaviour rates and an increase in play compared with control sessions. The rate of affiliative behaviours and low rate of aggression were probably because the group was composed mostly of females and it was stable, with a well-defined hierarchy. The research underlines the importance of a well-studied enrichment programme for the welfare of captive animals, which should exploit species-specific motivations.

Evidence for prion protein expression in enteroglial cells of the myenteric plexus of mouse intestine.

Transmissible spongiform encephalopathies (TSEs) are slowly progressive and fatal neurodegenerative diseases affecting man and animals. They are caused by pathological isoforms (PrP(Sc)) of the host-encoded cellular prion protein (PrP(C)). There are two crucial factors for the initiation of infection, namely host cells PrP(C) expression and sufficient sequence homology between the PrP(Sc) to which the animal is exposed and its own PrP(C). In acquired TSEs, the gastrointestinal tract (GIT) is the main prion entry site. Hence, it is of paramount importance to an understanding of the early pathogenesis of prion infections, to characterize the GIT cell types constitutively expressing PrP(C). Twenty-three mice were utilized, including wild-type (WT), Prnp knock-out (KO), and PrP(C)-overexpressing (tga20/tga20) animals, of 20-30 g in weight and of either sex. In all three groups of mice, PrP(C)-immunoreactivity (IR), along with glial fibrillary acidic protein (GFAP)-IR and synaptophysin (Syn)-IR were investigated by means of indirect immunofluorescence in wholemount preparations from several gut regions, from duodenum to rectum. In WT mice, PrP(C)-IR and GFAP-IR co-localization was observed in enteric glial cells (EGCs) from all intestinal segments. PrP(C)-overexpressing mice showed a stronger PrP(C)-IR in EGCs, whereas the same cells exhibited no PrP(C)-IR in Prnp-KO mice. Our findings clearly indicate that EGCs of the mouse intestine constitutively express PrP(C); thus they could be a potential target for infectious prions.

Preclinical and clinical experiences with the role of dopamine receptors in the treatment of pituitary adenomas.

Pituitary tumors can cause symptoms of mass effect and hormonal hypersecretion that can be reversed with surgical resection or debulking of the adenoma, radiotherapy, or medical treatment. Medical treatment is the primary choice for prolactinomas because dopamine agonists are very effective in the treatment of these tumors, with rates of control (tumor size reduction and hormone suppression) as high as 80-90% for microprolactinomas and 60-75% for macroprolactinomas. The function of dopamine receptors in other histotypes of pituitary adenoma is still debated. However, new insights into receptor physiology and the introduction of new clinically available, as well as experimental, compounds have reopened a potential role of dopaminergic drugs in the medical treatment of pituitary tumors. The differences between the effectiveness and the resistance to different dopaminergic agents, the new challenging results from clinical and experimental studies, as well as the future of dopamine agonists in the therapy of pituitary tumors are discussed.

Relationship between echotextural and histomorphometric characteristics of stallion testes.

The goal of this study was to investigate correlations between objective measures of testicular echotexture and histomorphometric attributes related to the histological composition of stallion testes. Fifty-four scrotal testes were obtained from three groups of stallions during routine castrations: colts <1 yr old (n = 18), young stallions 1-5 yrs old (n = 27), mature stallions > 5 yrs old (n = 9). In addition, two scrotal testes with degeneration, 16 retained inguinal and 10 retained abdominal testes were surgically obtained. Cross-sectional and longitudinal ultrasonograms were obtained for each testis. Mean numerical pixel values (NPVs) as well as pixel standard deviations (PSDs) were determined for each image (ImageJ-1.5 software). Histomorphometric attributes of the seminiferous tubules (STs) were derived (three tissue samples per each testis) using image analysis software [relative STs area: RSTA = ST area/total cross-sectional area (TA) x 100%; relative STs lumen: RSTL = ST lumen area/TA x 100%; individual ST area; ISTA; individual ST lumen: ISTL; seminiferous epithelium height: SHE]. Degree of fibrosis was graded semi-quantitatively (0-3) in samples from 17 testes. All measures of testicular echotexture as well as all histomorphometric attributes of STs had highest values when obtained from the scrotal testes of young and mature stallions (P < 0.05). The NPVs and PSDs from the ultrasonographic images of the scrotal testes were significantly correlated with all histomorphometric attributes of STs (P < 0.001). However, there was no correlation between the majority of these measures and attributes if each group of the scrotal testes was analyzed separately. The NPVs from the ultrasonographic images of the retained inguinal testes were correlated with RSTA, RSTL, ISTA, and ISTL, while the NPVs from the retained abdominal testes were not correlated with any of the histomorphometric attributes of the STs. Testes with high degree of fibrosis had variable values of pixel intensity and pixel heterogeneity. Based on the results of this study, we concluded that the pixel intensity and pixel heterogeneity of stallion testes increase during the first year of life and remain stable in young and mature stallions. These changes occur in parallel to the development of the seminiferous tubules. Testicular echogenicity in stallions does not seem to reflect degree of testicular fibrosis. Retained abdominal testes have lower and less heterogeneous echogenicity than scrotal testes from stallions that are more than one year old. While pixel analysis cannot replace biopsy in assessing testicular histomorphology in young and mature stallions, testicular echogenicity is a good indicator of peri-pubertal growth and expansion of the seminiferous tubules.

One-year GH replacement therapy reduces early cardiac target organ damage (TOD) in adult GHD patients.

Hypopituitarism reduces life expectancy and increases the risk of cardiovascular and cerebrovascular diseases, as well as death. Abnormalities in the cardiovascular system may be independently related to GH deficiency (GHD). The aim of this study was to prospectively investigate coronary flow reserve and diastolic function in GHD adult patients at diagnosis and after 1 year of GH replacement therapy. As control group, an age- and sex-matched population was chosen. All patients and controls were non-smokers, non-diabetic, and normotensive, with no history of vascular disease. 14 patients with adult-onset GHD and 17 controls represent the two study groups. Anthropometric data, blood pressure, lipid profile, glycosylated hemoglobin (HbA1c) and IGF-I plasma levels, coronary flow reserve (CFR), and LV diastolic function (evaluated by E/A) were collected in all subjects before and after 12 months of GH replacement therapy. Compared with controls, systolic and diastolic blood pressure and LDL cholesterol levels were significantly higher at baseline and return, comparable to controls after 1 year of GH replacement (GHRT). GHD patients showed a blunted CFR at baseline (P < 0.001) and a significant improvement after GHRT, returning to values comparable with those recorded in the control group. In addition, after therapy a significant (P < 0.001) improvement in E/A was recorded. One year of GH therapy improves CFR and E/A in the patient population analyzed, thereby encouraging the early start of GHRT.

Neuroendocrine-immune interactions: the role of cortistatin/somatostatin system.

Hormones and neuropeptides may influence the activities of lymphoid organs and cells via endocrine and local autocrine/paracrine pathways. A paradigm of the interactions between the neuroendocrine and immune system is sophisticatedly represented in the thymus. Indeed, receptors for these molecules are heterogeneously expressed in all subsets of thymic cells, and the communications are tuned by feedback circuitries. Herein, we focus on somatostatin (SS), a ubiquitous peptide that regulates several physiological cell processes and acts via five specific receptor (SSR) subtypes (sst(1-5)). Neuronal and accessory cells, so-called neuroendocrine cells, and immune cells, heterogeneously express SSRs. The functional characterization of SSRs in vivo by nuclear medicine techniques opened a complex scenario on the significance of SS/SSR pathway in immune system and related diseases. Several studies have established that SSR scintigraphy may benefit patients with chronic inflammatory and granulomatous diseases, as well as lymphoproliferative diseases. The results are sufficiently promising to warrant larger studies aimed at defining the exact role of these techniques. The development of SS analogs with antisecretory and antiproliferative effects has radically changed the management of neuroendocrine tumors. Moreover, very important recent findings, emerging from in vitro studies on SSR physiology in immune cells, will certainly expand the potential applications of SS analogs for in vivo diagnostic and therapeutic options. Indeed, the anti-inflammatory and analgesic effects of these drugs remain incompletely understood, but may prove useful in a number of autoimmune diseases. Because SS expression is absent in different immune tissues where SSRs are present, the existence of another ligand was hypothesized. In fact, it has been recently demonstrated that human lymphoid tissues and immune cells may express cortistatin (CST). CST is known to bind SSRs and shares many pharmacological and functional properties with SS. However, CST has also properties distinct from SS, and the higher expression of CST in immune cells supports the hypothesis that CST rather than SS may act as a potential endogenous ligand for SSRs in the human immune system.

Autonomic nervous system and cardiovascular risk assessment during one year of growth hormone replacement therapy in adults with growth hormone deficiency.

OBJECTIVE: This prospective study aimed to evaluate the impact of growth hormone deficiency (GHD) on cardiac autonomic tone and on cardiovascular risk and the changes after 12 months of GH replacement therapy (GHRT). GHD is associated with increased cardiovascular morbidity and mortality. This has been attributed to increased markers of cardiovascular risk and to abnormalities of both the cardiac and peripheral autonomic nervous systems. The autonomic cardiac nervous system (ACNS) can be indirectly evaluated by analysis of heart rate variability (HRV) in clinostatism and orthostatism. DESIGN: We compared 14 GHD patients at baseline and after 12 months of GHRT and 17 healthy controls. We analyzed a number of cardiovascular risk factors and we used analysis of HRV during the Tilt Test that identified high frequency (HF) and low frequency (LF), representing parasympathetic and sympathetic activity, respectively. RESULTS: Compared with the control group, in either clinostatism or in orthostatism our patients showed a significantly lower value of LF (P=0.047; P=0.004, respectively), whereas HF was significantly reduced in orthostatism (P=0.037), and indicatively in clinostatism (P=0.065). These values remained unchanged after 12 months of GHRT. No statistically significant differences were found between the LF/HF ratio in untreated and treated patients. In GHD patients, there was a significant reduction of cardiovascular risk in 12 months of replacement therapy (P=0.002). CONCLUSIONS: Our study highlights the absence of sympathovagal imbalance in GHD patients; GHRT does not change ACNS during the first year of GH treatment but it reduces the absolute cardiovascular risk in these patients.

Anatomical evidence for ileal Peyer's patches innervation by enteric nervous system: a potential route for prion neuroinvasion?

We have examined the innervation of the gut-associated lymphoid system of the sheep ileum, with a view to identifying potential sites for neuroinvasion by pathogens, such as prions (PrP(Sc)). Special attention has been paid to the follicles of Peyer's patches (PPs), which are major sites of PrP(Sc) accumulation during infection. Evidence exists that the enteric nervous system, together with the parasympathetic and sympathetic pathways projecting to the intestine, are important for PrP(Sc) entry into the central nervous system. Thus, PrP(Sc) might move from PPs to the neurons and nerve fibres that innervate them. We investigated, by immunohistochemistry and retrograde tracing (DiI) from the follicles, the distribution and phenotype of enteric neurons innervating the follicles. Antibodies against protein gene product 9.5, tyrosine hydroxylase, dopamine beta hydroxylase, choline acetyltransferase, calbindin (CALB), calcitonin gene-related peptide (CGRP), and nitric oxide synthase were used to characterise the neurons. Immunoreactivity for each of these was observed in fibres around and inside PP follicles. CGRP-immunoreactive fibres were mainly seen at the follicular dome. Retrograde tracing revealed submucosal neurons that contributed to the innervation of PPs, including Dogiel type II neurons and neurons immunoreactive for CALB and CGRP. The major source of the adrenergic fibres are the sympathetic ganglia. Our results thus suggest that enteric and sympathetic neurons are involved during the first stage of neuroinvasion, with neurons connecting to them acting as potential carriers of PrP(Sc) to the central nervous system.