RESUMEN
Adverse neurological outcome is a major cause of long-term morbidity in ex-preterm children. To investigate the effect of parturition and inflammation on the fetal brain, we utilized two in vivo mouse models of preterm birth. To mimic the most common human scenario of preterm birth, we used a mouse model of intrauterine inflammation by intrauterine infusion of lipopolysaccharide (LPS). To investigate the effect of parturition on the immature fetal brain, in the absence of inflammation, we used a non-infectious model of preterm birth by administering RU486. Pro-inflammatory cytokines (IL-10, IL-1beta, IL-6 and TNF-alpha) in amniotic fluid and inflammatory biomarkers in maternal serum and amniotic fluid were compared between the two models using ELISA. Pro-inflammatory cytokine expression was evaluated in the whole fetal brains from the two models. Primary neuronal cultures from the fetal cortex were established from the different models and controls in order to compare the neuronal morphology. Only the intrauterine inflammation model resulted in an elevation of inflammatory biomarkers in the maternal serum and amniotic fluid. Exposure to inflammation-induced preterm birth, but not non-infectious preterm birth, also resulted in an increase in cytokine mRNA in whole fetal brain and in disrupted fetal neuronal morphology. In particular, Microtubule-associated protein 2 (MAP2) staining was decreased and the number of dendrites was reduced (P < 0.001, ANOVA between groups). These results suggest that inflammation-induced preterm birth and not the process of preterm birth may result in neuroinflammation and alter fetal neuronal morphology.
Asunto(s)
Encéfalo/embriología , Encéfalo/patología , Neuronas/patología , Complicaciones Infecciosas del Embarazo , Nacimiento Prematuro/inmunología , Nacimiento Prematuro/patología , Líquido Amniótico/metabolismo , Animales , Encéfalo/metabolismo , Supervivencia Celular , Células Cultivadas , Citocinas/metabolismo , Modelos Animales de Enfermedad , Femenino , Mediadores de Inflamación , Lipopolisacáridos , Ratones , Mifepristona , Embarazo , Complicaciones Infecciosas del Embarazo/sangre , Nacimiento Prematuro/inducido químicamente , ARN Mensajero/metabolismoRESUMEN
Three adult horses were evaluated for signs of musculoskeletal pain, dullness, ataxia, and seizures. A diagnosis of bacterial meningitis was made on the basis of results of CSF analysis. Because primary bacterial meningitis is so rare in adult horses without any history of generalized sepsis or trauma, immune function testing was pursued. Flow cytometric phenotyping of peripheral blood lymphocytes was performed, and proliferation of peripheral blood lymphocytes in response to concanavalin A, phytohemagglutinin, pokeweed mitogen, and lipopolysaccharide was determined. Serum IgA, IgM, and IgG concentrations were measured by means of radial immunodiffusion, and serum concentrations of IgG isotypes were assessed with a capture antibody ELISA. Serum tetanus antibody concentrations were measured before and 1 month after tetanus toxoid administration. Phagocytosis and oxidative burst activity of isolated peripheral blood phagocytes were evaluated by means of simultaneous flow cytometric analysis. Persistent B-cell lymphopenia, hypogammaglobulinemia, and abnormal in vitro responses to mitogens were detected in all 3 horses, and a diagnosis of common variable immunodeficiency was made.
Asunto(s)
Inmunodeficiencia Variable Común/veterinaria , Enfermedades de los Caballos/inmunología , Meningitis Bacterianas/veterinaria , Agammaglobulinemia/veterinaria , Animales , Inmunodeficiencia Variable Común/diagnóstico , Inmunodeficiencia Variable Común/inmunología , Inmunodeficiencia Variable Común/patología , Femenino , Citometría de Flujo/veterinaria , Enfermedades de los Caballos/diagnóstico , Enfermedades de los Caballos/patología , Caballos , Deficiencia de IgA/veterinaria , Deficiencia de IgG/veterinaria , Inmunoglobulina M/deficiencia , Linfocitos/citología , Linfocitos/patología , Masculino , Meningitis Bacterianas/diagnóstico , Meningitis Bacterianas/inmunología , Meningitis Bacterianas/patologíaAsunto(s)
Bacteriemia/veterinaria , Encefalitis/veterinaria , Enfermedades de los Caballos/diagnóstico , Trombocitopenia/veterinaria , Acinetobacter baumannii/aislamiento & purificación , Animales , Animales Recién Nacidos , Antibacterianos/uso terapéutico , Bacteriemia/complicaciones , Bacteriemia/diagnóstico , Cruzamiento , Diagnóstico Diferencial , Encefalitis/complicaciones , Encefalitis/diagnóstico , Enterococcus/aislamiento & purificación , Escherichia coli/aislamiento & purificación , Femenino , Enfermedades de los Caballos/tratamiento farmacológico , Enfermedades de los Caballos/patología , Caballos , Masculino , Índice de Severidad de la Enfermedad , Trombocitopenia/complicaciones , Trombocitopenia/diagnósticoRESUMEN
Pet owners often seek reassurance from their veterinarian after making the decision to have their pet euthanized. The authors present advice on how to communicate with grieving clients as well as how to cope with a personal sense of loss when a patient dies.
Asunto(s)
Vínculo Humano-Animal , Mascotas/psicología , Veterinarios/psicología , Animales , Gatos , Perros , HumanosRESUMEN
OBJECTIVE: To determine if changes in viscoelastic variables are associated with abnormalities observed in the standard coagulation profile and patient outcome in foals with suspected septicemia. DESIGN: Prospective clinical trial during 2003 and 2004 foal season. SETTING: Neonatal intensive care unit at a veterinary teaching hospital. ANIMALS: Thirty critically ill foals <72-hour-old admitted sequentially meeting criteria for systemic inflammatory response associated with infection. INTERVENTIONS: Hemostatic evaluation, using standard coagulation testing and viscoelastic analysis, was performed at admission, 24 hours following admission, and 48 hours following admission in critically ill foals. Standard coagulation tests included platelet count, prothrombin time, activated partial thromboplastin time, fibrinogen, fibrin(ogen) degradation products, and antithrombin. Data collected from viscoelastic analysis included time to initial clot formation (ACT), clot rate, and platelet function. Signalment, blood culture results, clinicopathologic data, and outcome were collected from medical records. Equality of populations test was used to determine associations between coagulation tests and blood culture status/outcome, as well as between viscoelastic parameters and coagulopathy, blood culture status, and outcome. Logistic regression was used to quantify associations. A significance level of P<0.05 was used. MEASUREMENTS AND MAIN RESULTS: Foals with decreasing clot rate (CR) over the sample period were more likely to be euthanized or die (P=0.02). Foals with prolonged ACT (P=0.03), and decreased CR at admission (P=0.047), were more commonly coagulopathic. Identification of coagulopathy on admission (P=0.02), or persistence of hemostatic dysfunction 48 hours later (P=0.04), was associated with death. CONCLUSIONS: Viscoelastic coagulation evaluation could be used in a neonatal intensive care unit setting to further characterize coagulopathy, and identify foals at higher risk for poor outcome.