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1.
Vet Pathol ; 54(1): 178-187, 2017 01.
Artículo en Inglés | MEDLINE | ID: mdl-27507806

RESUMEN

Spontaneous age-related lesions of laboratory rabbits are not well documented in the contemporary scientific literature. A retrospective study of diagnostic necropsies of 36 rabbits >2 years of age found a number of common lung lesions. Fibromuscular intimal hyperplasia affected medium and to a lesser extent large pulmonary arteries and was present to a variable extent in all 36 rabbits >2 years of age. The lesions were characterized by fragmentation and/or reduplication of the internal elastic lamina (IEL), proliferation of smoothelin+/alpha-smooth muscle actin (α-SMA)+/vimentin- smooth muscle cells and fewer smoothelin-/α-SMA+/vimentin+ myofibroblasts, and intimal deposition of collagen without thrombosis, embolism, or evidence of pulmonary hypertension. Pulmonary emphysema, present in 30/36 rabbits, was characterized by the loss of alveolar septa; most affected rabbits did not have clinical signs of respiratory disease. In 8/13 rabbits of the inbred EIII/JC audiogenic strain, we identified a unique syndrome of granulomatous pneumonia containing hyaline brown to gray, globular to ring-like acellular material that was Alcian blue and periodic acid-Schiff positive. The material was immunoreactive for surfactant protein-A and had the ultrastructural appearance of multilamellar vesicles, suggesting a genetic defect in surfactant metabolism. Additionally, we found small benign primary lung tumors (fibropapillomas, 5 rabbits) not previously described. Other findings included heterotopic bone (5 rabbits), subacute to chronic suppurative bronchopneumonia, pyogranulomatous pneumonia with plant material, and pulmonary artifacts from barbiturate euthanasia solution.


Asunto(s)
Pulmón/patología , Conejos/fisiología , Envejecimiento/patología , Animales , Femenino , Masculino , Neumonía/patología , Neumonía/veterinaria , Arteria Pulmonar/patología , Conejos/anatomía & histología , Estudios Retrospectivos
2.
Vet Pathol ; 53(2): 456-67, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26936752

RESUMEN

Inbred mice are a unique model system for studying aging because of the genetic homogeneity within inbred strains, the short life span of mice relative to humans, and the rich array of analytic tools that are available. A large-scale aging study was conducted on 28 inbred strains representing great genetic diversity to determine, via histopathology, the type and diversity of spontaneous diseases that aging mice develop. A total of 20 885 different diagnoses were made, with an average of 12 diagnoses per mouse in the study. Eighteen inbred strains have had their genomes sequenced, and many others have been partially sequenced to provide large repositories of data on genetic variation among the strains. This vast amount of genomic information can be utilized in genome-wide association studies to find candidate genes that are involved in the pathogenesis of spontaneous diseases. As an illustration, this article presents a genome-wide association study of the genetic associations of age-related intestinal amyloidosis, which implicated 3 candidate genes: translocating chain-associated membrane protein 1 (Tram1); splicing factor 3b, subunit 5 (Sf3b5); and syntaxin 11 (Stx11). Representative photomicrographs are available on the Mouse Tumor Biology Database and Pathbase to serve as a reference when evaluating inbred mice used in other genetic or experimental studies to rule out strain background lesions. Many of the age-related mouse diseases are similar, if not identical, to human diseases; therefore, the genetic discoveries have direct translational benefit.


Asunto(s)
Envejecimiento/genética , Amiloidosis/genética , Variación Genética , Estudio de Asociación del Genoma Completo/métodos , Genoma/genética , Ratones Endogámicos , Animales , Causas de Muerte , Estudios de Cohortes , Estudios Transversales , Modelos Animales de Enfermedad , Femenino , Estudios Longitudinales , Masculino , Ratones , Ratones Endogámicos/genética , Fenotipo , Análisis de Secuencia de ADN
3.
Vet Pathol ; 53(2): 504-9, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26169384

RESUMEN

Endocardiosis or myxomatous degeneration of the cardiac valves is a well-described age-related change in humans and dogs. Lesions consist of polypoid nodular proliferations of loose extracellular matrix and valvular interstitial cells, most commonly affecting the mitral valve. This entity has not been previously described in fish. Herein we report the appearance, location, and occurrence of valvular and mural endocardiosis in a retrospective survey of aging laboratory zebrafish. Endocardiosis was present in 59 of 777 fish (7.59%), most commonly affecting the sinoatrial (34 fish; 57.6%) and atrioventricular (33 fish; 55.9%) valves. Lesions were more common in fish raised in recirculating water systems and fed commercial diets (52/230 fish; 22.6%) versus flow-through systems with fish fed semi-purified diets (4/234; 1.71%). Lesions were overrepresented in fish heterozygous for a mutant smoothened allele (34/61 fish, 55.7% vs 17/168, 10.1% wild type). There was no association between endocardiosis and intestinal carcinoids. Valvular endocardiosis is a significant age- and husbandry-related background finding in zebrafish and should be considered in the design and interpretation of research studies.


Asunto(s)
Envejecimiento/patología , Endocarditis/veterinaria , Enfermedades de los Peces/patología , Pez Cebra , Animales , Modelos Animales de Enfermedad , Endocarditis/patología , Matriz Extracelular/patología , Femenino , Masculino , Válvula Mitral/patología , Estudios Retrospectivos
4.
Vet Pathol ; 52(4): 757-9, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25281653

RESUMEN

Seven male Hartley guinea pigs, 3 to 18 months old, died or had to be euthanized because of nonspecific clinical signs unresponsive to supportive treatment. Gross necropsy and histopathology findings in all animals included severe soft tissue calcification affecting the myocardium, kidneys, and occasionally the liver.


Asunto(s)
Calcinosis/veterinaria , Insuficiencia Cardíaca/veterinaria , Animales , Calcinosis/patología , Diagnóstico Diferencial , Cobayas , Insuficiencia Cardíaca/patología , Masculino , Miocardio/patología
5.
Vet Pathol ; 52(2): 388-92, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24913269

RESUMEN

Chordomas are uncommon neoplasms arising from notochord remnants, most commonly occurring in the axial skeleton. Extraskeletal soft tissue chordomas are rare primary tumors, and primary alimentary tract chordomas have not been reported. Herein we report 24 cases of spontaneous primary intestinal chordomas in zebrafish, as well as 9 spontaneous vertebral chordomas. Both intestinal and vertebral tumors showed invasive behavior, although more commonly in the latter. In all cases of primary intestinal chordomas, there was no axial or peripheral skeletal or other nonvisceral involvement. Although uncommon, intestinal chordomas represent a unique background lesion in aged zebrafish.


Asunto(s)
Cordoma/veterinaria , Enfermedades de los Peces/patología , Neoplasias Intestinales/veterinaria , Neoplasias de la Columna Vertebral/veterinaria , Animales , Cordoma/patología , Femenino , Neoplasias Intestinales/patología , Masculino , Neoplasias de la Columna Vertebral/patología , Pez Cebra
6.
Vet Pathol ; 51(3): 659-62, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-23912713

RESUMEN

A 1.4-year-old virgin female brown-hooded fancy rat presented for abdominal distention, jaundice, and dyspnea. At physical examination, a firm mass was palpable in the caudoventral abdomen as well as multiple small nodular masses associated with the abdominal viscera. At necropsy, in addition to a large mass replacing the left ovary and myriad nodules studding the peritoneal surface, there was 31 ml of abdominal effusion. By cytology, the abdominal fluid contained numerous pleomorphic vacuolated tumor cells surrounding globular pale eosinophilic to amphophilic acellular material that was strongly periodic acid-Schiff positive. Histologically, the tumor was biphasic with abundant acellular hyaline matrix that was also periodic acid-Schiff positive.


Asunto(s)
Animales de Laboratorio , Tumor del Seno Endodérmico/veterinaria , Neoplasias Ováricas/veterinaria , Enfermedades de los Roedores/diagnóstico , Enfermedades de los Roedores/patología , Animales , Ascitis/patología , Ascitis/veterinaria , Técnicas Citológicas/veterinaria , Diagnóstico Diferencial , Disnea/patología , Disnea/veterinaria , Tumor del Seno Endodérmico/diagnóstico , Tumor del Seno Endodérmico/patología , Resultado Fatal , Femenino , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/patología , Ratas , Vísceras/patología
7.
J Appl Physiol (1985) ; 115(4): 546-55, 2013 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-23743403

RESUMEN

Lung deposition of >0.5-µm particles is strongly influenced by gravitational sedimentation, with deposition being reduced in microgravity (µG) compared with normal gravity (1G). Gravity not only affects total deposition, but may also alter regional deposition. Using gamma scintigraphy, we measured the distribution of regional deposition and retention of radiolabeled particles ((99m)Tc-labeled sulfur colloid, 5-µm diameter) in five healthy volunteers. Particles were inhaled in a controlled fashion (0.5 l/s, 15 breaths/min) during multiple periods of µG aboard the National Aeronautics and Space Administration Microgravity Research Aircraft and in 1G. In both cases, deposition scans were obtained immediately postinhalation and at 1 h 30 min, 4 h, and 22 h postinhalation. Regional deposition was characterized by the central-to-peripheral ratio and by the skew of the distribution of deposited particles on scans acquired directly postinhalation. Relative distribution of deposition between the airways and the alveolar region was derived from data acquired at the various time points. Compared with inhalation in 1G, subjects show an increase in central-to-peripheral ratio (P = 0.043), skew (P = 0.043), and tracheobronchial deposition (P < 0.001) when particles were inhaled in µG. The absence of gravity caused fewer particles to deposit in the lung periphery than in the central region where deposition occurred mainly in the airways in µG. Furthermore, the increased skew observed in µG likely illustrates the presence of localized areas of deposition, i.e., "hot spots", resulting from inertial impaction. In conclusion, gravity has a significant effect on deposition patterns of coarse particles, with most of deposition occurring in the alveolar region in 1G but in the large airways in µG.


Asunto(s)
Bronquios/fisiología , Alveolos Pulmonares/fisiología , Administración por Inhalación , Gravitación , Voluntarios Sanos , Humanos , Tamaño de la Partícula
8.
Vet Pathol ; 49(3): 528-31, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22262350

RESUMEN

Seventy-four 9-week old female C57BL/6J mice housed in a conventional facility were manipulated to induce experimental autoimmune encephalomyelitis, among which 26 developed clinical signs including lethargy, absence of defecation, and abdominal distension. By gross necropsy examination, there was distension of the cecum and colon with fecal impaction. By histologic examination, there was severe ulcerative and proliferative typhlocolitis. Fecal ELISA confirmed the presence of toxins A and B of Clostridium difficile. Alteration in immune status of the immunocompetent mice, due to stress caused by experimental manipulation or autoimmune disease, may have led to intestinal dysbiosis, followed by opportunistic infections resulting in C. difficile-associated disease. This report brings to light the occurrence of the disease in immunocompetent laboratory mice during experimental manipulations associated with alteration in immune status, and it discusses potential hazards associated with conventional housing within a hospital-associated research institute.


Asunto(s)
Abdomen/patología , Clostridioides difficile/metabolismo , Colitis/veterinaria , Estreñimiento/veterinaria , Brotes de Enfermedades/veterinaria , Ratones Endogámicos C57BL , Enfermedades de los Roedores/microbiología , Enfermedades de los Roedores/patología , Animales , Proteínas Bacterianas/metabolismo , Toxinas Bacterianas/metabolismo , Colitis/microbiología , Colitis/patología , Estreñimiento/patología , Encefalomielitis Autoinmune Experimental/veterinaria , Enterotoxinas/metabolismo , Ensayo de Inmunoadsorción Enzimática/veterinaria , Femenino , Vivienda para Animales , Ratones
9.
Vet Pathol ; 47(6): 1028-39, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-20587693

RESUMEN

Vascular Ehlers-Danlos syndrome is a rare genetic disorder resulting from mutations in the α-1 chain of type III collagen (COL3A1) and manifesting as tissue fragility with spontaneous rupture of the bowel, gravid uterus, or large or medium arteries. The heterozygous Col3a1 knockout mouse was investigated as a model for this disease. The collagen content in the abdominal aorta of heterozygotes was reduced, and functional testing revealed diminishing wall strength of the aorta in these mice. Colons were grossly and histologically normal, but reduced strength and increased compliance of the wall were found in heterozygotes via pressure testing. Although mice demonstrated no life-threatening clinical signs or gross lesions of vascular subtype Ehlers-Danlos syndrome type IV, thorough histological examination of the aorta of heterozygous mice revealed the presence of a spectrum of lesions similar to those observed in human patients. Lesions increased in number and severity with age (0/5 [0%] in 2-month-old males vs 9/9 [100%] in 14-month-old males, P < .05) and were more common in male than female mice (23/26 [88.5%] vs 14/30 [46.7%] in 9- to 21-month-old animals, P < .05). Haploinsufficiency for Col3a1 in mice recapitulates features of vascular Ehlers-Danlos syndrome in humans and can be used as an experimental model.


Asunto(s)
Colágeno Tipo III/genética , Modelos Animales de Enfermedad , Síndrome de Ehlers-Danlos/genética , Haploinsuficiencia/genética , Animales , Aorta/patología , Arterias/patología , Vasos Sanguíneos/patología , Western Blotting , Colágeno Tipo III/metabolismo , Colon/patología , Colon/fisiopatología , Síndrome de Ehlers-Danlos/patología , Femenino , Genotipo , Heterocigoto , Masculino , Ratones , Ratones Noqueados/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
10.
Vet Pathol ; 43(4): 552-6, 2006 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-16846999

RESUMEN

A 10-year-old domestic shorthair cat was spayed to remove bilateral ovarian masses and an enlarged uterus. Both ovaries were effaced by large, irregular, firm, glistening, white cystic masses filled with clear viscous fluid. The uterine lumen was filled with copious amounts of clear viscous fluid, and the uterus contained multiple, firm, glistening, white nodules. Histologic examination revealed an invasive spindle cell neoplasm with features of malignancy, and extensive hypocellular areas containing an alcian blue-positive myxoid matrix. Tumor cells expressed caldesmon, alpha-smooth muscle actin, and estrogen receptor but were negative for desmin. The animal was euthanized 1 month later because of suspected local tumor recurrence. At necropsy, the abdominal cavity contained 120 ml of mucoid ascites; multiple tumor nodules were present in the abdominal and thoracic cavities. The clinical behavior and gross, microscopic, and immunohistochemical findings established a diagnosis of myxoid leiomyosarcoma.


Asunto(s)
Enfermedades de los Gatos/patología , Leiomiosarcoma/veterinaria , Neoplasias Uterinas/veterinaria , Animales , Enfermedades de los Gatos/cirugía , Gatos , Femenino , Histerectomía/veterinaria , Inmunohistoquímica/veterinaria , Leiomiosarcoma/secundario , Metástasis de la Neoplasia , Recurrencia Local de Neoplasia/veterinaria , Neoplasias Uterinas/patología , Neoplasias Uterinas/cirugía
11.
Vet Pathol ; 43(3): 377-80, 2006 May.
Artículo en Inglés | MEDLINE | ID: mdl-16672589

RESUMEN

Deciduosarcoma is a rare, hormonally dependent neoplasm with features of malignancy, previously reported only in rabbits enrolled in chronic toxicology studies involving estrogens with or without progestins. An exploratory laparotomy was performed on a 6-year-old pet Dutch dwarf rabbit following palpation of a 6-cm-diameter abdominal mass. Grossly, the mass was fleshy and nodular, adhered to but not appearing to originate from the small intestine, with a smaller mass of similar appearance involving the uterus, and an effaced mesenteric lymph node. Histologically, the mass was characterized by spindloid cells and large epithelioid cells with abundant pale eosinophilic vacuolated cytoplasm and an infiltrative pattern of growth. Giant cells with large, bizarre, hyperchromatic nuclei were common. Cells were positive by immunohistochemistry for vimentin and progesterone and estrogen receptors and negative for pancytokeratin (AE1/AE3), cytokeratin 18, desmin, alpha-smooth muscle actin (SMA), and CD10. Based on histologic and immunohistochemical findings, a diagnosis of deciduosarcoma was made.


Asunto(s)
Enfermedades de los Animales/diagnóstico , Deciduoma/patología , Conejos , Sarcoma/veterinaria , Neoplasias Uterinas/veterinaria , Enfermedades de los Animales/patología , Animales , Femenino , Sarcoma/diagnóstico , Sarcoma/patología , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/patología
12.
J Wildl Dis ; 42(4): 788-96, 2006 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-17255445

RESUMEN

Eimerioriniid coccidia commonly infect vertebrates and might contribute to morbidity and mortality under captive conditions. The common genus Eimeria typically shows tissue specificity, usually being limited to the epithelium of the gut; disseminated infections are rare in vertebrates. Disseminated visceral coccidiosis was found in two wild-caught adult female Indo-gangetic flap-shelled turtles (Lissemys punctata andersonii) that died while in captivity at a zoo. Sporulated oocysts of Eimeria spp. were found in lung and liver of one turtle and in auditory canal, nasal mucosa, pharynx, lung, liver, kidney, spleen, and intestine of the second. Two distinct species of Eimeria were indicated for the latter case by polymerase chain reaction amplification and sequencing of a portion of the 18S rRNA gene; one species was present in nasal mucosa and liver, with a separate species in lung, spleen, and intestine. Severity of inflammation was correlated with coccidial density. Coccidia were in melanomacrophages in liver and spleen; in the interstitium of auditory canal, nasal mucosa, pharynx, lung, and intestine; and within the interstitium and epithelial cells of the renal tubules in kidney. We suggest these disseminated infections might have been facilitated by a compromised immune system.


Asunto(s)
Coccidiosis/veterinaria , Eimeria/aislamiento & purificación , Tortugas/parasitología , Animales , Animales Salvajes/parasitología , Coccidiosis/patología , Eimeria/clasificación , Resultado Fatal , Femenino , Especificidad de Órganos , Reacción en Cadena de la Polimerasa/veterinaria
13.
J Comp Pathol ; 133(2-3): 218-22, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-16026797

RESUMEN

Epithelioid trophoblastic tumour (ETT), a rare neoplasm of chorionic-type intermediate trophoblastic cells in the human female, was diagnosed in the uterus of a red-tailed guenon, a non-human primate. The animal, having had two live births, had a recent history of heavy vaginal bleeding. Four years after the last known pregnancy, the animal developed a large invasive mass involving the uterus, right ovary and abdominal wall. The tumour was removed surgically, but at necropsy 1.5 years later was found to have a recurrent neoplasm. Histologically, the original mass consisted of nests and cords of mononuclear intermediate trophoblastic cells whose borders were accentuated by intimately associated eosinophilic hyaline extracellular proteinaceous material. Extensive coalescing areas of necrosis with mineralization surrounding islands of viable neoplastic cells created a "geographical" pattern of necrosis. Immunohistochemical examination revealed that neoplastic cells were diffusely strongly positive for cytokeratin 18, and focally positive for human placental lactogen. The histopathological and immunolabelling patterns were consistent with ETT in human beings. This is the first reported case of epithelioid trophoblastic tumour in a non-human species.


Asunto(s)
Cercopithecus , Enfermedades de los Monos/patología , Neoplasias Trofoblásticas/veterinaria , Neoplasias Uterinas/veterinaria , Animales , Biomarcadores de Tumor/metabolismo , ADN de Neoplasias/análisis , Células Epitelioides/patología , Resultado Fatal , Femenino , Técnicas para Inmunoenzimas/veterinaria , Enfermedades de los Monos/cirugía , Recurrencia Local de Neoplasia , Reacción en Cadena de la Polimerasa/veterinaria , Neoplasias Trofoblásticas/patología , Neoplasias Trofoblásticas/cirugía , Neoplasias Uterinas/patología , Neoplasias Uterinas/cirugía
14.
J Am Vet Med Assoc ; 215(2): 212-6, 1999 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-10416474

RESUMEN

OBJECTIVE: To determine whether perioperative antimicrobial prophylaxis would reduce incidence of postoperative infection among dogs undergoing elective orthopedic procedures. DESIGN: Randomized, controlled, blinded, intention clinical trial. ANIMALS: Dogs of any breed, sex, or age undergoing elective orthopedic surgery at a veterinary teaching hospital. PROCEDURES: Dogs were randomly assigned to 1 of 3 groups: treatment with saline solution, treatment with potassium penicillin G, and treatment with cefazolin. Treatments were intended to be administered within 30 minutes prior to surgery; a second dose was administered if surgery lasted > 90 minutes. Dogs were monitored for 10 to 14 days after surgery for evidence of infection. RESULTS: After the first 112 dogs were enrolled in the study, it was found that infection rate for control dogs (5/32 dogs) was significantly higher than the rate for dogs treated with antimicrobials (3/80 dogs). Therefore, no more dogs were enrolled in the study. A total of 126 dogs completed the study. Monte Carlo simulations indicated that compared with dogs that received antimicrobials prophylactically, dogs that received saline solution developed infections significantly more frequently. Difference in efficacy, however, was not observed between the 2 antimicrobial drugs used. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that perioperative antimicrobial prophylaxis decreased postoperative infection rate in dogs undergoing elective orthopedic surgery, compared with infection rate in control dogs. Cefazolin was not more efficacious than potassium penicillin G in these dogs.


Asunto(s)
Profilaxis Antibiótica/veterinaria , Cefazolina/uso terapéutico , Cefalosporinas/uso terapéutico , Enfermedades de los Perros/prevención & control , Penicilina G/uso terapéutico , Penicilinas/uso terapéutico , Infección de la Herida Quirúrgica/veterinaria , Animales , Huesos/cirugía , Enfermedades de los Perros/cirugía , Perros , Femenino , Articulaciones/cirugía , Masculino , Método de Montecarlo , Ortopedia/veterinaria , Infección de la Herida Quirúrgica/prevención & control
15.
J Exp Biol ; 198(Pt 8): 1783-9, 1995 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-7636447

RESUMEN

During exercise, pulmonary gas exchange in reptiles was predicted to differ from that in mammals because of their less complex lung structure, which might reduce ventilation-perfusion heterogeneity (V/QL) at the expense of pulmonary diffusion limitation. To investigate this, the multiple inert gas elimination technique was used in six Varanus exanthematicus at rest and during maximal exercise. Trace amounts of six inert gases were infused into the external jugular vein and blood samples were collected from the pulmonary artery and the left atrium. Mixed expired gas samples and ventilatory and metabolic data were acquired. Indices of V/QL heterogeneity, calculated using a 50-compartment model, were low at rest (log standard deviation of perfusion distribution, logSDQ = 0.39) and increased significantly with exercise (logSDQ = 0.78). Oxygen diffusion limitation was apparent during exercise and was comparable to reported mammalian values. A molecular-mass-dependent limitation, suggesting limited intrapulmonary gas mixing, was evident only at rest. An increase in left atrial PO2 from 82mmHg at rest to 96 mmHg during exercise was associated with a corresponding decrease in PCO2. These data indicate adequacy of pulmonary ventilation and gas exchange for metabolic demands in exercising varanid lizards and suggest that less complex lung structures are not necessarily linked to increased pulmonary diffusion limitation.


Asunto(s)
Lagartos/fisiología , Esfuerzo Físico/fisiología , Intercambio Gaseoso Pulmonar , Respiración , Animales , Dióxido de Carbono/sangre , Oxígeno/sangre
17.
Br J Obstet Gynaecol ; 94(10): 957-62, 1987 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-3689727

RESUMEN

A retrospective population study in Northern Ireland examined the benefits of centralized care in insulin-dependent diabetic pregnancies. In the 5 years 1979-1983, there were 139, 250 deliveries in Northern Ireland and of these 221 pregnancies occurred in 187 insulin-dependent diabetic patients; 100 were managed entirely in peripheral maternity units, 61 were referred from a peripheral unit to the Royal Maternity Hospital, Belfast and 60 were managed entirely in this central referral hospital. The patients referred from the periphery had the worst past obstetric history with a combined perinatal mortality rate of 200 per 1000. During the study period the perinatal mortality rate was 107 for the referred pregnancies, 33 for those managed entirely in the peripheral units and 18 for those managed at the Royal Maternity Hospital. If those pregnancies terminated for fetal abnormality, and deaths beyond the perinatal period are included, the figures for total fetal loss were 15.5%, 5.5% and 7.1% respectively. Overall the major congenital malformation rate was 7.5%, and for the respective groups 6.5%, 3.0% and 13.0%. For the general population during the same period the perinatal mortality rate was 1.4% and the major congenital malformation rate was 2.5%. Thus it is suggested that only peripheral hospitals which can offer combined antenatal/endocrine care and with a neonatal intensive care unit should undertake the management of the pregnant diabetic.


Asunto(s)
Diabetes Mellitus Tipo 1/terapia , Maternidades/normas , Hospitales Especializados/normas , Evaluación de Procesos y Resultados en Atención de Salud , Resultado del Embarazo , Embarazo en Diabéticas/terapia , Adulto , Femenino , Muerte Fetal , Humanos , Mortalidad Infantil , Recién Nacido , Irlanda del Norte , Servicio de Ginecología y Obstetricia en Hospital/normas , Embarazo , Derivación y Consulta , Estudios Retrospectivos
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