RESUMO
BACKGROUND: It is doubtful that any of the treatments proposed for feline leukaemia virus (FeLV) infection are effective, despite the entity being described 60 years ago. METHODS: Eighteen pet cats with progressive FeLV infections were recruited in Australia. One or more antiviral drugs were trialled in 16 cats, while two FeLV-infected cats were not handleable and served as untreated controls. Six cats were administered RetroMAD1™ only (0.5 mg/kg orally twice daily), a commercially available recombinant chimeric protein with proposed antiretroviral activity. Three cats were administered the integrase inhibitor raltegravir only (10-15 mg/kg orally twice daily), a drug used as a component of highly effective antiretroviral therapy for human immunodeficiency virus (HIV-1) infection. Three cats were administered RetroMAD1™ and raltegravir concurrently, and four cats were administered raltegravir and the reverse transcriptase inhibitor zidovudine (AZT, 5 mg/kg orally twice daily) concurrently. FeLV RNA and p27 antigen loads were measured at two timepoints (T1-2 months and T3-5 months) during therapy and compared to baseline (pretreatment) levels, to assess the response to therapy using linear modelling. The median survival time (MST) of the cats from commencement of FeLV treatment to death was also determined and compared between treatments. RESULTS: The MST for the 16 FeLV-positive cats which received antiviral therapy was 634 days, while the MST from FeLV diagnosis to death for the two untreated control cats was 780 days. In cats treated with RetroMAD1™, FeLV viral load decreased from T0 to T1-2 months (median viral load reduced from 1339 × 106 to 705 × 106 copies/mL plasma; P = 0.012), but MST was reduced compared to cats not given RetroMAD1™ (426 days vs 1006 days; P = 0.049). Cats treated with raltegravir and AZT had no significant changes in FeLV viral load over time, but p27 antigen load was decreased from T0 to T3-5 months in cats treated with raltegravir (median p27 antigen level reduced from 50.2% to 42.7%; P = 0.005). All other results were not significantly affected by the treatment provided. Importantly, statistically significant and substantial associations were found between age at FeLV diagnosis and survival time (P = 0.046, R2 = 18.6) and between FeLV viral load at T0 and survival time (P = 0.004, R2 = 44.4). Younger cats, and cats with higher levels of pretreatment FeLV RNA, had reduced survival times. Cats treated with RetroMAD1™ were typically younger (median age 2.0 vs 8.0 years), likely explaining the observed reduction in MST. A significant association was found between FeLV viral load and p27 antigen load at T0 (P = 0.015, R2 = 32.9). CONCLUSIONS: Results from this small case series do not provide convincing support for the use of RetroMAD1™, raltegravir or AZT, alone or in combination, for the treatment of cats progressively infected with FeLV. The changes observed were biologically insignificant. Age and FeLV viral load at diagnosis are useful prognostic markers, and p27 antigen concentration can be used to predict viral load. Larger field trials should be performed examining antiretroviral therapy in FeLV-positive cats with progressive infections, preferably using three or more drugs from at least two classes, as is standard with human antiretroviral therapy. Future studies would be easier in countries with a higher prevalence of FeLV infections than Australia.
Assuntos
Antivirais , Vírus da Leucemia Felina , Leucemia Felina , Raltegravir Potássico , Carga Viral , Animais , Gatos , Vírus da Leucemia Felina/efeitos dos fármacos , Masculino , Austrália , Leucemia Felina/tratamento farmacológico , Leucemia Felina/virologia , Feminino , Raltegravir Potássico/uso terapêutico , Antivirais/uso terapêutico , Carga Viral/veterinária , Zidovudina/uso terapêutico , Doenças do Gato/tratamento farmacológico , Doenças do Gato/virologiaRESUMO
CONTEXT: Multiparametric magnetic resonance imaging (MRI) is now recommended before performing prostate biopsies, looking for suspicious lesions to perform targeted biopsies (TB). However, the association or exclusive performance of systematic biopsies (SB), criticized for its morbidity and for the detection of insignificant cancers, remains debated. OBJECTIVE: To perform a literature review to answer three questions: (1) In the presence of a suspicious MRI lesion, should we always perform SB in addition to TB? (2) Can we avoid SB when considering focal treatment? (3) Is there an increase in adverse events when associating SB with TB? SOURCES: A non-systematic literature review was carried out on Medline in April 2020 using the keywords "MRI", "PROSTATE CANCER", "SYSTEMATIC BIOPSY", "TARGETED BIOPSY", "ADVERSE EVENTS". The references of the selected articles were analyzed for additional articles. Selection of Studies published in the last five years were analyzed and retained if the available data made it possible to answer one of the three questions asked. RESULTS: In biopsy-naive patients, the added value of SB to TB for detection of significative cancer varied from +5 to+7% and was reduced to +1 to +3% in the case of a previous series of negative biopsies. For patients under active surveillance, this added value was higher, ranging from +8% to +17%. MRI has a negative predictive value of 85 to 95%, but this value drops to 55% for the detection of secondary or tertiary foci. The use of SB is necessary if focal treatment is considered. Serious complications from biopsies requiring hospitalization range from 1.4 to 6.9% and are increased by the number of previous biopsy series performed more than by the number of biopsies per series. CONCLUSION: In the presence of a suspicious MRI lesion, SB is indicated in addition to TB but can be discussed in patients with previous negative biopsies. They are necessary if focal treatment is considered to aid surgical planning. Severe complications from biopsies do not seem to increase when SB are associated to TB, but rather with the number of biopsy series performed.
Assuntos
Biópsia Guiada por Imagem/métodos , Imageamento por Ressonância Magnética Multiparamétrica , Próstata/diagnóstico por imagem , Próstata/patologia , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Humanos , MasculinoRESUMO
BACKGROUND: Many guidelines now recommend multiparametric MRI (mpMRI) prior to an initial or repeat prostate biopsy. However, clinical decision making for men with a non-suspicious mpMRI (Likert or PIRADS score 1-2) varies. OBJECTIVES: To review the most recent literature to answer three questions. (1) Should we consider systematic biopsy if mpMRI is not suspicious? (2) Are there additional predictive factors that can help decide which patient should have a biopsy? (3) Can the low visibility of some cancers be explained and what are the implications? SOURCES: A narrative review was performed in Medline databases using two searches with the terms "MRI" and "prostate cancer" and ("diagnosis" or "biopsy") and ("non-suspicious" or "negative" or "invisible"); "prostate cancer MRI visible". References of the selected articles were screened for additional articles. STUDY SELECTION: Studies published in the last 5 years in English language were assessed for eligibility and selected if data was available to answer one of the three study questions. RESULTS: Considering clinically significant cancer as ISUP grade≥2, the negative predictive value (NPV) of mpMRI in various settings and populations ranges from 76% to 99%, depending on cancer prevalence and the type of confirmatory reference test used. NPV is higher among patients with prior negative biopsy (88-96%), and lower for active surveillance patients (85-90%). The PSA density (PSAd) with a threshold of PSAd<0.15ng/ml/ml was the most studied and relevant predictive factor used in combination with mpMRI to rule out clinically significant cancer. Finally, mpMRI-invisible tumours appear to differ from a histopathological and genetic point of view, conferring clinical advantage to invisibility. LIMITATIONS: Most published data come from expert centres and results may not be reproducible in all settings. CONCLUSION: mpMRI has high diagnostic accuracy and in cases of negative mpMRI, PSA density can be used to determine which patient should have a biopsy. Growing knowledge of the mechanisms and genetics underlying MRI visibility will help develop more accurate risk calculators and biomarkers.
Assuntos
Imageamento por Ressonância Magnética Multiparamétrica , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Biópsia , Humanos , Masculino , Valor Preditivo dos Testes , Reprodutibilidade dos TestesRESUMO
With the commercial release in Australia in 2004 of a vaccine against feline immunodeficiency virus (FIV; Fel-O-Vax FIV®), the landscape for FIV diagnostics shifted substantially. Point-of-care (PoC) antibody detection kits, which had been the mainstay for diagnosing FIV infection since the early 1990s, were no longer considered accurate to use in FIV-vaccinated cats, because of the production of vaccine-induced antibodies that were considered indistinguishable from those produced in natural FIV infections. Consequently, attention shifted to alternative diagnostic methods such as nucleic acid detection. However, over the past 5 years we have published a series of studies emphasising that FIV PoC test kits vary in their methodology, resulting in differing accuracy in FIV-vaccinated cats. Importantly, we demonstrated that two commercially available FIV antibody test kits (Witness™ and Anigen Rapid™) were able to accurately distinguish between FIV-vaccinated and FIV-infected cats, concluding that testing with either kit offers an alternative to PCR testing. This review summarises pertinent findings from our work published in a variety of peer-reviewed research journals to inform veterinarians (particularly veterinarians in Australia, New Zealand and Japan, where the FIV vaccine is currently commercially available) about how the approach to the diagnosis of FIV infection has shifted. Included in this review is our work investigating the performance of three commercially available FIV PoC test kits in FIV-vaccinated cats and our recommendations for the diagnosis of FIV infection; the effect of primary FIV vaccination (three FIV vaccines, 4 weeks apart) on PoC test kit performance; our recommendations regarding annual testing of FIV-vaccinated cats to detect 'vaccine breakthroughs'; and the potential off-label use of saliva for the diagnosis of FIV infection using some FIV PoC test kits. We also investigated the accuracy of the same three brands of test kits for feline leukaemia virus (FeLV) diagnosis, using both blood and saliva as diagnostic specimens. Based on these results, we discuss our recommendations for confirmatory testing when veterinarians are presented with a positive FeLV PoC test kit result. Finally, we conclude with our results from the largest and most recent FIV and FeLV seroprevalence study conducted in Australia to date.
Assuntos
Síndrome de Imunodeficiência Adquirida Felina/diagnóstico , Vírus da Imunodeficiência Felina/isolamento & purificação , Vírus da Leucemia Felina/isolamento & purificação , Leucemia Felina/diagnóstico , Animais , Anticorpos Antivirais/análise , Anticorpos Antivirais/sangue , Austrália/epidemiologia , Gatos , Síndrome de Imunodeficiência Adquirida Felina/epidemiologia , Síndrome de Imunodeficiência Adquirida Felina/prevenção & controle , Vírus da Imunodeficiência Felina/imunologia , Vírus da Leucemia Felina/imunologia , Leucemia Felina/epidemiologia , Leucemia Felina/prevenção & controle , Sistemas Automatizados de Assistência Junto ao Leito , Reação em Cadeia da Polimerase , Proteínas Oncogênicas de Retroviridae/imunologia , Saliva/virologia , Sensibilidade e Especificidade , Vacinas Virais/imunologiaRESUMO
BACKGROUND/OBJECTIVES: Vitamin D and probiotics are nutrients of interest in the context of type 1 diabetes (T1D). We assessed the prevalence of and factors associated with vitamin D and probiotic supplementations among young children with genetic risk of T1D. SUBJECTS/METHODS: Use of supplements during the first 2 years of life was collected prospectively from 8674 children in The Environmental Determinants of Diabetes in the Young (TEDDY) study. RESULTS: Single and/or multivitamin/mineral (MVM) supplements were reported by 81% of the children. The majority of participants in Finland, Germany and Sweden (97-99%) and 50% in the United States received vitamin D supplements that were mostly MVMs. Probiotics use varied from 6% in the United States to 60% in Finland and was primarily from probiotics-only preparations. More than 80% of the vitamin D and probiotics supplementation was initiated during infancy, and more than half of the uses lasted longer than a year. Being the first child, longer duration of breastfeeding, born in a later year, older maternal age and higher maternal education level were associated with both vitamin D and probiotics use. Shorter gestational age and mother not smoking during pregnancy were associated with a higher likelihood of probiotics supplementation only. CONCLUSIONS: Vitamin D and probiotics supplementations are popular in children 0-2 years old and are associated with common factors. Data documented here will allow evaluation of the relationship between early childhood dietary intake and the development of islet autoimmunity and progression to T1D.
Assuntos
Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/prevenção & controle , Suplementos Nutricionais , Predisposição Genética para Doença , Probióticos/administração & dosagem , Vitamina D/administração & dosagem , Adulto , Peso ao Nascer , Pré-Escolar , Diabetes Mellitus Tipo 1/sangue , Feminino , Finlândia , Alemanha , Humanos , Lactente , Masculino , Micronutrientes/administração & dosagem , Micronutrientes/sangue , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários , Suécia , Estados Unidos , Vitamina D/sangue , Adulto JovemRESUMO
BACKGROUND/OBJECTIVES: Poor maternal diet in pregnancy can influence fetal growth and development. We tested the hypothesis that poor maternal diet quality during pregnancy would increase neonatal adiposity (percent fat mass (%FM)) at birth by increasing the fat mass (FM) component of neonatal body composition. METHODS: Our analysis was conducted using a prebirth observational cohort of 1079 mother-offspring pairs. Pregnancy diet was assessed via repeated Automated Self-Administered 24-h dietary recalls, from which Healthy Eating Index-2010 (HEI-2010) scores were calculated for each mother. HEI-2010 was dichotomized into scores of ⩽57 and >57, with low scores representing poorer diet quality. Neonatal %FM was assessed within 72 h after birth with air displacement plethysmography. Using univariate and multivariate linear models, we analyzed the relationship between maternal diet quality and neonatal %FM, FM, and fat-free mass (FFM) while adjusting for prepregnancy body mass index (BMI), physical activity, maternal age, smoking, energy intake, preeclampsia, hypertension, infant sex and gestational age. RESULTS: Total HEI-2010 score ranged between 18.2 and 89.5 (mean: 54.2, s.d.: 13.6). An HEI-2010 score of ⩽57 was significantly associated with higher neonatal %FM (ß=0.58, 95% confidence interval (CI) 0.07-1.1, P<0.05) and FM (ß=20.74; 95% CI 1.49-40.0; P<0.05) but no difference in FFM. CONCLUSIONS: Poor diet quality during pregnancy increases neonatal adiposity independent of maternal prepregnancy BMI and total caloric intake. This further implicates maternal diet as a potentially important exposure for fetal adiposity.
Assuntos
Adiposidade/fisiologia , Fenômenos Fisiológicos da Nutrição Materna , Mães , Adulto , Peso ao Nascer/fisiologia , Glicemia , Índice de Massa Corporal , Dieta , Inquéritos sobre Dietas , Ingestão de Energia , Comportamento Alimentar , Feminino , Desenvolvimento Fetal/fisiologia , Humanos , Recém-Nascido , Estudos Longitudinais , Gravidez , Fenômenos Fisiológicos da Nutrição Pré-Natal , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: The objective of this paper is to examine whether smoking is associated with autoantibody production in systemic lupus erythematosus (SLE) patients, unaffected first-degree relatives (FDR) of individuals with SLE--a group at increased risk of developing SLE--or unaffected, unrelated controls. METHODS: Detailed demographic, environmental, clinical, and therapeutic information was collected by questionnaire on 1242 SLE patients, 981 FDRs, and 946 controls in the Lupus Family Registry and Repository; a blood sample was obtained. All sera were tested for multiple lupus autoantibodies by immunofluorescence and luminex bead-based assays. Generalized estimating equations, adjusting for age, gender, and ethnicity and accounting for correlation within families, were used to assess smoking status with the dichotomous outcome variables of positivity for SLE status, positivity of ANA by immunofluorescence (≥1:120), positivity for ≥1 autoantibody by the luminex assay, and positivity for each of the 11 autoantibodies. RESULTS: Current smoking was associated with being positive for ≥1 autoantibody (excluding ANA) (adjusted OR = 1.53, 95% CI 1.04-2.24) in our subjects with SLE. No association was observed in unaffected FDRs or healthy controls. Former smoking was associated with anti-Ro/SS-A60 in our unaffected FDRs. There was an increased association with anti-nRNP A seropositivity, as well as a decreased association with anti-nRNP 68 positivity, in current smokers in SLE subjects. CONCLUSIONS: No clear association between smoking status and individual autoantibodies was detected in SLE patients, unaffected FDRs, nor healthy controls within this collection. The association of smoking with SLE may therefore manifest its risk through mechanisms outside of autoantibody production, at least for the specificities tested.
Assuntos
Família , Lúpus Eritematoso Sistêmico/imunologia , Fumar/imunologia , Adulto , Anticorpos Antinucleares/imunologia , Autoanticorpos/imunologia , Estudos de Casos e Controles , Feminino , Imunofluorescência , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
AIMS: To determine the prevalence of plasma vitamin D (25-dihydroxyvitamin D) insufficiency in individuals with Type 1 diabetes and to determine the cross-sectional and longitudinal associations of plasma vitamin D with insulin resistance. METHODS: Participants from the SEARCH for Diabetes in Youth Study [n = 1426; mean age 11.2 years (sd 3.9)] had physician-diagnosed Type 1 diabetes [diabetes duration mean 10.2 months (sd 6.5)] with data available at baseline and follow-up (approximately 12 and 24 months after baseline). Insulin resistance was estimated using a validated equation. Cross-sectional and longitudinal multivariate logistic regression models were used to determine the association of plasma vitamin D with insulin resistance, adjusting for potential confounders. RESULTS: Forty-nine per cent of individuals had plasma vitamin D < 50 nmol/l and 26% were insulin resistant. In cross-sectional multivariate analyses, participants who had higher plasma vitamin D (65 nmol/l) had lower odds of prevalent insulin resistance than participants with lower plasma vitamin D (25 nmol/l) (odds ratio 0.70, 95% CI 0.57-0.85). This association was attenuated after additional adjustment for BMI z-score, which could be a confounder or a mediator (odds ratio 0.81, 95% CI 0.64-1.03). In longitudinal multivariate analyses, individuals with higher plasma vitamin D at baseline had lower odds of incident insulin resistance, but this was not significant (odds ratio 0.85, 95% CI 0.63-1.14). CONCLUSIONS: Vitamin D insufficiency is common in individuals with Type 1 diabetes and may increase risk for insulin resistance. Additional prospective studies are needed to determine the association between plasma vitamin D and insulin resistance, and to further examine the role of adiposity on this association.
Assuntos
Diabetes Mellitus Tipo 1/etiologia , Deficiência de Vitamina D/complicações , Vitamina D/análogos & derivados , Adolescente , Criança , Métodos Epidemiológicos , Feminino , Humanos , Resistência à Insulina/fisiologia , Masculino , Vitamina D/sangue , Adulto JovemRESUMO
AIMS: Cross-sectional evidence indicates that abdominal adiposity, hypertension, dyslipidaemia and glycaemia are associated with reduced metabolic clearance rate of insulin (MCRI). Little is known about the progression of MCRI and whether components of metabolic syndrome are associated with the change in MCRI. In this study, we examined the association between components of metabolic syndrome and the 5-year change of MCRI. METHODS: At baseline and 5-year follow-up, we measured fasting plasma triglycerides (TG), high-density lipoprotein (HDL) cholesterol, blood pressure (BP), waist circumference (WC) and fasting blood glucose (FBG) in 784 non-diabetic participants in the Insulin Resistance Atherosclerosis Study. MCRI, insulin sensitivity (SI ) and acute insulin response (AIR) were determined from frequently sampled intravenous glucose tolerance tests. RESULTS: We observed a 29% decline of MCRI at follow-up. TG, systolic BP and WC at baseline were inversely associated with a decline of MCRI regression models adjusted for age, sex, ethnicity, smoking, alcohol consumption, energy expenditure, family history of diabetes, BMI, SI and AIR [ß = -0.057 (95% confidence interval, CI: -0.11, -0.0084) for TG, ß = -0.0019 (95% CI: -0.0035, -0.00023) for systolic BP and ß = -0.0084 (95% CI: -0.013, -0.0039) for WC; all p < 0.05]. Higher HDL cholesterol at baseline was associated with an increase in MCRI [multivariable-adjusted ß = 0.0029 (95% CI: 0.0010, 0.0048), p = 0.002]. FBG at baseline was not associated with MCRI at follow-up [multivariable-adjusted ß = 0.0014 (95% CI: -0.0026, 0.0029)]. CONCLUSIONS: MCRI declined progressively over 5 years in a non-diabetic cohort. Components of metabolic syndrome at baseline were associated with a significant change in MCRI.
Assuntos
Aterosclerose/sangue , HDL-Colesterol/sangue , Resistência à Insulina , Insulina/sangue , Síndrome Metabólica/sangue , Triglicerídeos/sangue , Adiposidade , Adulto , Idoso , Aterosclerose/epidemiologia , Aterosclerose/metabolismo , Biomarcadores/sangue , Glicemia/metabolismo , Pressão Sanguínea , Índice de Massa Corporal , Estudos Transversais , Progressão da Doença , Dislipidemias/sangue , Feminino , Seguimentos , Teste de Tolerância a Glucose , Hemoglobinas Glicadas/metabolismo , Humanos , Masculino , Taxa de Depuração Metabólica , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/metabolismo , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Fatores de Risco , Estados Unidos/epidemiologia , Circunferência da CinturaRESUMO
AIMS/HYPOTHESIS: To evaluate whether exposure to maternal gestational diabetes (GDM) is associated with adiposity and fat distribution in a multiethnic population of children. METHODS: Retrospective cohort study of 82 children exposed to maternal GDM and 379 unexposed youths 6-13 years of age with measured BMI, waist circumference, skinfold thickness, and visceral and subcutaneous abdominal fat. RESULTS: Exposure to maternal GDM was associated with higher BMI (p = 0.02), larger waist circumference (p = 0.004), more subcutaneous abdominal fat (p = 0.01) and increased subscapular to triceps skinfold thickness ratio (p = 0.01) in models adjusted for age, sex, race/ethnicity and Tanner stage. Adjustment for socioeconomic factors, birthweight and gestational age, maternal smoking during pregnancy and current diet and physical activity did not influence associations; however, adjustment for maternal pre-pregnancy BMI attenuated all associations. CONCLUSIONS/INTERPRETATION: Exposure to maternal GDM is associated with increased overall and abdominal adiposity, and a more central fat distribution pattern in 6- to 13-year-old youths from a multi-ethnic population, providing further support for the fetal overnutrition hypothesis.
Assuntos
Adiposidade/fisiologia , Diabetes Gestacional/epidemiologia , Obesidade/epidemiologia , Obesidade/fisiopatologia , Adolescente , Negro ou Afro-Americano , Criança , Feminino , Hispânico ou Latino , Humanos , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , População BrancaRESUMO
AIMS: Mutations in the serine protease inhibitor (SPINK1) gene have been associated with all forms of chronic pancreatitis. Recently, an association of SPINK1 mutations with early-onset Type 2 diabetes mellitus has been reported in patients from Bangladesh. Therefore, we determined the frequency of SPINK1 N34S mutations in patients with Type 2 diabetes mellitus from the USA. METHODS: The study population of Hispanic and non-Hispanic white people consisted of 387 patients with Type 2 diabetes and familial clustering of the disease, 232 family members without diabetes, 259 patients with Type 2 diabetes without a family history, and 302 ethnically matched healthy controls as part of the San Luis Valley Diabetes Study. We performed linkage- and association-analysis in 82 multiplex families with Type 2 diabetes mellitus. RESULTS: No significant linkage or allele sharing was detected between Type 2 diabetes mellitus and the SPINK1 locus. The frequency of the N34S mutation was determined by fluorescence polarization and was similar between patients (n = 14/387 patients with familial clustering; n = 2/259 patients without family history) and controls (n = 5/232 family members without diabetes; n = 10/302 individuals). Variables such as ethnicity, age of diabetes onset and percentage of individuals with impaired glucose tolerance did not differ significantly between carriers and homozygous normal individuals. CONCLUSION: The SPINK1 N34S mutation appears not to predispose Hispanic or non-Hispanic white people from the USA to the development of Type 2 diabetes mellitus.
Assuntos
Diabetes Mellitus Tipo 2/genética , Inibidor da Tripsina Pancreática de Kazal/genética , Doença Crônica , Análise Mutacional de DNA , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Ligação Genética , Predisposição Genética para Doença , Testes Genéticos , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatite/genéticaRESUMO
A seven-year-old castrated British shorthair cross cat was presented for coughing of five-weeks duration. Thoracic radiographs and an unguided bronchoalveolar lavage showed changes consistent with inflammatory airway disease. In addition, a soft tissue density was evident in the thoracic films between the heart and the diaphragm. Exploratory thoracotomy demonstrated a diaphragmatic hernia, probably congenital in origin, with incarceration of a portion of the hepatic parenchyma. The herniated portion of liver was resected surgically and the defect in the diaphragm closed. The cat was given a 10-day course of doxycycline post-operatively and the cough did not recur subsequently. In retrospect, the hernia was potentially an incidental problem, the cat's coughing being attributable to inflammatory airway disease.
Assuntos
Doenças do Gato/diagnóstico , Hérnia Diafragmática/veterinária , Animais , Lavagem Broncoalveolar/veterinária , Doenças do Gato/diagnóstico por imagem , Doenças do Gato/patologia , Doenças do Gato/cirurgia , Gatos , Diagnóstico Diferencial , Hérnia Diafragmática/diagnóstico , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/veterinária , Masculino , Radiografia , Toracotomia/veterináriaRESUMO
Autoimmunity causing insulin-dependent diabetes mellitus (IDDM) begins in early childhood due to interactions between genes and unknown environmental factors that may be identified through follow-up of a large cohort of genetically susceptible children. Such a cohort has been established using a simple and rapid cord blood screening for HLA alleles. The DRB1 and DQB1 second exon sequences were co-amplified using the polymerase chain reaction and hybridized with single and pooled sequence-specific oligonucleotide probes. Four individual probes were used to detect the susceptibility alleles DRB1*03, DRB1*04, and DQB1*0302 as well as the usually protective DRB1*15/16 (DR2) alleles. In addition, pooled probes allow the distinction of DR3/3 from the DR3/x genotype (where x is neither DR2, 3, nor 4) and DR4/4 from DR4/x. Among 5000 newborns from the general Denver population, we have found the high-risk genotype (DRB1*03/ DRB1*04, DQB1*0302) to be present in 2.4% of non-Hispanic whites, 2.8% of Hispanics, and 1.6% of African Americans. The moderate-risk genotypes (DRB1*04, DQB1*0302/DRB1*04, DQB1*0302, DRB1*04, DQB1*0302/x, or DRB1*03/DRB1*03) are present in 17% of American non-Hispanic whites, 24% of Hispanics and in 10% of African Americans. These results demonstrate the feasibility of a large-scale newborn screening for genes associated with IDDM. The ultimate role for such a screening in future routine prediction and prevention of IDDM will depend on the availability of an effective and acceptable form of clinical intervention.
Assuntos
Doenças Autoimunes/prevenção & controle , Diabetes Mellitus Tipo 1/prevenção & controle , Antígenos HLA/sangue , Programas de Rastreamento , Povo Asiático , Doenças Autoimunes/epidemiologia , Biomarcadores/sangue , População Negra , Estudos de Coortes , Colorado/epidemiologia , Primers do DNA/química , Diabetes Mellitus Tipo 1/epidemiologia , Sangue Fetal/imunologia , Seguimentos , Humanos , Incidência , Recém-Nascido , Programas de Rastreamento/normas , Cooperação do Paciente , Reação em Cadeia da Polimerase , Estudos Prospectivos , Controle de Qualidade , Fatores de Risco , População BrancaRESUMO
The clustering of premature mortality was investigated in 1,761 insulin-dependent diabetics and their family members from the Children's Hospital of Pittsburgh Insulin-Dependent Diabetes Mellitus Registry from 1950-1981. At follow-up, 5% of the mothers and 13% of the fathers were deceased. Life table analyses revealed that fathers of deceased diabetics were significantly more likely to die prematurely than fathers of living diabetics (18% vs. 8% at age 55 years; p = 0.02). A father-diabetic son concordance of mortality appeared to be responsible for this effect. A similar overall trend was observed for maternal mortality, although the difference was not statistically significant. Cause-specific analyses revealed that the increased paternal mortality was primarily the result of cardiovascular disease. Overall mortality rates of parents of deceased diabetics were higher than those of the general population, reaching statistical significance in the age group 35-44 years (p less than 0.05). Mortality among diabetic siblings was also examined. Diabetic siblings of deceased diabetics had a markedly increased risk of dying compared with diabetic siblings of living diabetics (p = 0.001). These findings indicate that premature mortality among both diabetic and nondiabetic relatives of diabetics clusters in families in which there is a deceased insulin-dependent diabetic, and suggest that the marked increase in mortality among persons with insulin-dependent diabetes may be partly under familial control.
Assuntos
Diabetes Mellitus Tipo 1/mortalidade , Família , Análise Atuarial , Adulto , Doenças Cardiovasculares/mortalidade , Causas de Morte , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Neoplasias/mortalidade , Pais , Fatores de Risco , Fatores Sexuais , Conglomerados Espaço-TemporaisRESUMO
Male and female Sprague-Dawley rats (Spartan substrain) were exposed to vinylidene chloride (VDC) by inhalation for 18 months to assess chronic toxicity and oncogenic potential of the subject test material. Interim sacrifices were performed at 1, 6, and 12 months. Rats were exposed to VDC concentrations of 10 and 40 ppm for 6 hr/day, 5 days/week for the first 5 weeks of the study. Based upon the absence of observable treatment-related effects among rats sacrificed after 1 month of exposure, the exposure concentrations were increased to 25 and 75 ppm VDC. Exposures were continued at these concentrations through the 18th month of the study after which the surviving animals were held until 24 months and then sacrificed. Cytogenetic evaluations were performed on a separate group of animals, four rats/sex, exposed to 0, 25, or 75 ppm VDC for 6 months. There were no exposure-related changes in the following parameters: mortality, appearance and demeanor, body weight data, clinical chemistry determinations, hematologic evaluations, urinalysis, or cytogenetic evaluation of bone marrow preparations. A target organ effect, characterized by hepatocellular fatty change in the midzonal region of the hepatic lobule which was minimal in severity, was observed in both male and female rats of both the 25- and 75-ppm exposure groups as early as the 6-month interim sacrifice. The midzonal fatty change was also observed at the 12-month sacrifice but no indication of progression of this lesion in either severity or incidence was apparent. During the last 6 months of the study, after exposures had been discontinued, this effect was no longer discernible; therefore this alteration was readily reversible. The incidences of several tumors and/or tumor types were statistically increased or decreased in VDC-exposed rats when compared to their respective control groups; none of these differences were judged to be attributable to VDC exposure.
Assuntos
Carcinógenos , Animais , Análise Química do Sangue , Peso Corporal/efeitos dos fármacos , Medula Óssea/ultraestrutura , Aberrações Cromossômicas/efeitos dos fármacos , Dicloroetilenos , Feminino , Masculino , Neoplasias Experimentais/induzido quimicamente , Tamanho do Órgão/efeitos dos fármacos , Ratos , Ratos Endogâmicos , Fatores Sexuais , Fatores de TempoRESUMO
The chronic toxicity and oncogenic potential of ingested vinylidene chloride (VDC) was evaluated in a 2-year study on Sprague-Dawley rats and the subchronic toxicity was evaluated in beagle dogs in a 97-day study. The vinylidene chloride was incorporated in the drinking water of the rats at nominal concentrations of 50, 100 or 200 ppm. The time weighted average mg/kg body weight/day dosages of vinylidene chloride administered to the male and female rats over the 2-year period at the various mean analyzed concentrations were 7, 10 or 20 for the males and 9, 14 or 30 for the females. Dogs were administered vinylidene chloride in peanut oil incorporated in a gelatin capsule at concentrations which provided 6.25, 12.5 or 25 mg vinylidene chloride/kg body weight/day. There were no significant differences between the groups of rats or dogs ingesting vinylidene chloride and their corresponding control groups in the following parameters: appearance and demeanor, mortality, body weight, food consumption, hematology, urinalysis, clinical chemistry determinations, organ weights and organ to body weight ratios. There were no significant differences in water consumption of the groups of rats ingesting vinylidene chloride and the controls. The sole treatment-related observation in the rats, evident only upon microscopic examination, was in the liver. The observation was characterized by a minimal amount of hepatocellular swelling with midzonal fatty change which occurred in the females at all dose levels and in the males only at the 200 ppm level. No exposure-related neoplastic changes occurred in the rats in any of the test groups. No exposure-related gross or histopathological changes were present in the tissues taken from the dogs at the termination of the 97-day study.
Assuntos
Dicloroetilenos/toxicidade , Hidrocarbonetos Clorados/toxicidade , Neoplasias Experimentais/induzido quimicamente , Animais , Sangue/efeitos dos fármacos , Cães , Feminino , Fígado/efeitos dos fármacos , Masculino , Ratos , Ratos EndogâmicosRESUMO
Titanium phosphate, a new manmade fiber, was evaluated by intratracheal and intraperitoneal techniques in rats and hamsters to assess the fibrogenic potential and possible hazard to man. Titanium phosphate fibers structurally resemble asbestos insofar as they are composed of bundles of submicronic fibers. A slight, dose-related fibrogenic response to the fiber was observed subsequent to the intratracheal injection of a 50- and 10-mg/kg but not 2-mg/kg dose in rats or any of these three doses in the hamster. Intraperitoneal administration of 10 or 2 mg/kg of the fibers in rats or hamsters induced no abdominal tumors considered related to treatment. In contrast, approximately 34% of rats given an intraperitoneal injection of 2 mg/kg of asbestos developed abdominal tumors; no tumors developed in hamsters injected with asbestos.