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1.
JDR Clin Trans Res ; : 23800844221123751, 2022 Oct 07.
Article in English | MEDLINE | ID: mdl-36207813

ABSTRACT

OBJECTIVE: To explore through focus groups (FGs) the perceptions of dental practitioners (DPs) from different countries of the challenges of implementing coronavirus disease 2019 (COVID-19) related biosafety measures, especially personal protection equipment (PPE), during the COVID-19 pandemic period. METHODS: DPs from Colombia, Germany, the United Kingdom, and the United States were invited to participate in country-based FGs. These were facilitated by an experienced moderator who explored the factors that guided the implementation of COVID-19 related biosafety measures and PPE use. Data were analyzed through thematic analysis on the basis of categories defined by the researchers deductively and inductively. RESULTS: A total of 25 DPs participated in 3 FGs (Colombia:n = 8; United Kingdom: n = 7; United States: n = 9) and 1 in an in-depth interview (Germany). DPs described using several processes to judge which guidance document to adopt and which aspects of the guidance were important in their practice. These included making judgments concerning the views of any indemnity organization to which the DPs were responsible, the staff's views in the practice, and the views of patients. In the absence of a single overarching guidance document, DPs filtered the available information through several considerations to find a level of PPE that they deemed "implementable" in local practice. CONCLUSIONS: The findings suggest that the implementation of evidence-based practice is subject to modification through a lens of what is "feasible" in practice. KNOWLEDGE TRANSFER STATEMENT: Clinicians, educators, and policy makers can use the results of this study to understand the process through which guidance is transformed into implementable patient care pathways in the dental practice.

2.
Clin Rheumatol ; 39(10): 2963-2971, 2020 Oct.
Article in English | MEDLINE | ID: mdl-32285259

ABSTRACT

OBJECTIVE: To assess the effectiveness and survival of ustekinumab (UST) among patients with psoriatic arthritis (PsA) treated under routine clinical care. METHODS: Multicenter study. Epidemiological and clinical data was collected through electronic medical records of all patients with PsA who started UST in 15 hospitals of Spain. RESULTS: Two hundred and one patients were included, 130 (64.7%) with 45 mg and 71 (35.3%) with 90 mg. One hundred and thirty one patients (65.2%) had previously received another biological therapy. The median baseline DAS 28 ESR was 3.99, and Psoriasis Area and Severity Index (PASI) was 3. Overall, there was a significant decrease in DAS66/68 CRP, swollen joint count (SJC), tender joint count (TJC), and PASI in the first month of treatment, with earlier improvement in skin (PASI) than joints outcomes. Survival was numerically lower in patients with UST 45 mg (58.1%) than 90 mg (76.1%), although significant differences were not found (p = 0.147). When comparing naïve and < 1 TNF blocker versus > 2 TNF blocker-experienced patients, a significantly earlier response was seen in the former group regarding SJC (p = 0.029) at 1 month. Fifty-one patients (25.3%) stopped UST due to joint inefficacy and 4 patients due to adverse events (1.9%). Drug survival was significantly better in patients with fewer lines of previous biological agents (p = 0.003 for < 1 TNF blocker versus > 2 TNF blocker users). CONCLUSIONS: UST was effective in PsA patients in a routine clinical care setting. Patients with UST 90 mg and fewer lines of previous biologics achieved better and faster responses. Key Points • Largest cohort of patients with PsA in treatment with UST with specific rheumatological indication. • First cohort of patients with PsA comparing effectiveness of UST according to 45/90 mg dose.


Subject(s)
Antirheumatic Agents , Arthritis, Psoriatic , Psoriasis , Antirheumatic Agents/therapeutic use , Arthritis, Psoriatic/drug therapy , Humans , Psoriasis/drug therapy , Severity of Illness Index , Spain , Treatment Outcome , Ustekinumab/therapeutic use
3.
Sci Total Environ ; 723: 138023, 2020 Jun 25.
Article in English | MEDLINE | ID: mdl-32220735

ABSTRACT

There is increasing environmental concern about the constant presence of pharmaceuticals and personal care products (PPCPs) in surface water, generally attributed to water discharge from wastewater treatment plants (WWTPs) that are unable to completely remove these compounds. The slight, but continuous, presence of these contaminants in reclaimed water (RW) poses a risk of chronic and sublethal toxicity, and the thyroid axis can likely be a target of many of these PPCPs. In this work, we addressed the effects of RW on the Xenopus laevis thyroid system. The Amphibian Metamorphosis Assay (AMA test) was used with modifications by exposing X. laevis tadpoles to RW samples, and to RW spiked with carbamazepine (CBZ) at 100 and 1000 higher than the average levels environmentally relevant (RW 100× and RW 1000×, respectively). Carbamazepine was selected because it is considered a marker of anthropogenic pollution and could have a potential effect on the thyroid axis. The morphological endpoints and histological alterations to the thyroid gland were evaluated. The results suggested the stimulation of the thyroid gland from exposures to the RW samples, supported by tadpoles' accelerated development and by the histological alterations observed in the thyroid gland. Developmental acceleration was also seen in the tadpoles exposed to the RW-100× and -1000× samples at comparable levels to those seen in exposures to RW samples alone. Hence CBZ did not seem to increase the effects of RW on the thyroid axis. Overall, our results suggested endocrine effects of these RW samples regardless of the CBZ concentration.


Subject(s)
Thyroid Gland , Water Pollutants, Chemical , Animals , Carbamazepine , Larva , Metamorphosis, Biological , Water , Xenopus laevis
4.
Curr Hypertens Rep ; 21(8): 57, 2019 06 10.
Article in English | MEDLINE | ID: mdl-31183617

ABSTRACT

PURPOSE OF REVIEW: This review seeks to present an overview of the recently found association between refractory hypertension (RfH) and obstructive sleep apnoea (OSA). RECENT FINDINGS: RfH was recently defined as an extreme phenotype of resistant hypertension characterized by the lack of blood pressure control despite using ≥ 5 antihypertensive drugs at optimal doses. Current data support that the pathophysiological pathway of both types of hypertension is different. The main mechanism involved in resistant hypertension is fluid retention whereas in the case of RfH is the sympathetic over-activity. OSA is now recognized as a cause of hypertension (especially in the case of difficult-to-treat hypertension). It seems that the biological mechanism linking OSA and arterial hypertension is the sympathetic over-activity related to the respiratory events (apnoeas and hypopnoeas) during the night. So, it is not surprising that, although the literature is scarce, some studies have found a very high prevalence of OSA and an excess of sympathetic activity in patients with RfH. Finally, a very recent study demonstrated that continuous positive airway pressure (CPAP) treatment, which controls sympathetic activation in OSA patients, achieves very significant reductions in blood pressure levels in RfH patients, even greater than in those with resistant (non-refractory) hypertension. The prevalence of OSA in patients with RfH is very high. CPAP treatment achieves a clinically significant reduction in blood pressure levels in those patients with RfH (especially in night readings). Patients with RfH must be sent to a sleep unit for a study.


Subject(s)
Hypertension/complications , Sleep Apnea, Obstructive/complications , Antihypertensive Agents/therapeutic use , Blood Pressure , Continuous Positive Airway Pressure , Humans
5.
Aust Vet J ; 96(12): 495-501, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30478843

ABSTRACT

BACKGROUND: Metronidazole is an antibacterial, antiprotozoal and anthelmintic medication commonly used in veterinary medicine. We describe cases of neurotoxicity associated with the drug's administration. METHODS: Medical records between 2004 and 2017 from four veterinary referral hospitals were reviewed. Inclusion criteria were the presence of neurological signs compatible with metronidazole toxicity, clinical history supporting recent metronidazole therapy and resolution of clinical signs upon discontinuation of metronidazole administration. RESULTS: A total of 26 dogs were identified with clinical signs supporting a diagnosis of metronidazole toxicity. Median age at presentation was 7.2 years (range, 0.1-12 years); median duration of treatment was 35 days (range, 5-180 days); median treatment dosage was 21 mg/kg BID (range, 13-56 mg/kg every 12 h); median resolution of the clinical signs upon discontinuation of metronidazole was 3 days (range, 1-26 days). Magnetic resonance imaging (MRI) of the brain was performed in 19 cases and only one dog had brain lesions affecting the dentate nuclei, which resembled the MRI appearance of this disease in humans. CONCLUSIONS: We found evidence of neurotoxicity in dogs at much lower doses than previously reported and we suggest caution when administering metronidazole at doses > 40 mg/kg every 24 h, regardless of the duration of the treatment.


Subject(s)
Anti-Infective Agents/adverse effects , Dog Diseases/chemically induced , Metronidazole/adverse effects , Neurotoxicity Syndromes/veterinary , Animals , Anti-Infective Agents/administration & dosage , Brain/diagnostic imaging , Dog Diseases/diagnostic imaging , Dog Diseases/drug therapy , Dogs , Female , Magnetic Resonance Imaging/veterinary , Male , Metronidazole/administration & dosage , Neurotoxicity Syndromes/etiology , Retrospective Studies
7.
Sci Total Environ ; 640-641: 1537-1547, 2018 Nov 01.
Article in English | MEDLINE | ID: mdl-30021319

ABSTRACT

The use of reclaimed water for irrigation and aquaculture purposes is generally considered a reliable alternative for sustainable water management in regions with water scarcity. Many organic compounds, generally called compounds of emerging concern (CECs), have been detected in reclaimed water, which implies continuous exposure for aquatic organisms. To date no quality criteria have been proposed for this group of compounds. This work aims to assess the acute, sublethal and chronic effects of reclaimed water using two representative organisms of the aquatic compartment; the green alga Chlorella vulgaris and the microcrustacean Daphnia magna. The study comprises the 72 h-algal growth inhibition test, the D. magna feeding bioassay and the D. magna reproduction test. The results highlighted, for the selected characterised compounds, no differences in the concentrations between the different tertiary WWTP treatments, except for the particular case of carbamazepine. Considering seasonality, no differences were observed between the two different sample collection campaigns. The sublethal and chronic effects observed for these samples could not be explained by the lower concentrations found in the chemical characterisation. However, in the majority of cases, dilution of raw reclaimed water reduced the toxic effects of these samples. Several interactions among compounds can affect the mixture's toxicity. Canonical correlation analyses (CCA) were included to explore the potential relationships between the physico-chemical characterisation of reclaimed water and effects on aquatic organisms. The results corroborated the toxic effect of some pharmaceuticals, in particular beta-blockers and antibiotics, on the growth and yield of green algae, as well as inhibition of daphnia reproduction. Thus the CCA methods could help to elucidate the potential relationships between the physico-chemical characterisation and toxic effects by considering all the potential interactions.


Subject(s)
Aquatic Organisms/physiology , Water Pollutants, Chemical/toxicity , Animals , Aquatic Organisms/drug effects , Chlorella vulgaris/drug effects , Chlorella vulgaris/physiology , Daphnia , Reproduction , Waste Disposal, Fluid
8.
Neuroscience ; 371: 178-190, 2018 02 10.
Article in English | MEDLINE | ID: mdl-29229559

ABSTRACT

Sensory information stimulates receptors of somatosensory system neurons generating a signal that codifies the characteristics of peripheral stimulation. This information reaches the spinal cord and is relayed to supra-spinal structures through two main systems: the postsynaptic dorsal column-medial lemniscal (DC-ML) and the anterolateral (AL) systems. From the classical point of view, the DC-ML has an ipsilateral ascending pathway to the Gracilis (GRA) or Cuneate (CUN) nuclei and the AL has a contralateral ascending pathway to the ventral posterolateral (VPL) thalamic nucleus. These two systems have been the subject of multiple studies that established their independence and interactions. To analyze the ascending projections of L1-L5 spinal dorsal horn neurons in the rat, two retrograde neuronal tracers were injected into the GRA and the VPL. Additionally, an electrophysiological study was performed by applying electrical stimulation at the GRA or VPL and recording antidromic evoked activity in single unit spinal cord cells. Importantly, a subset of spinal dorsal horn neurons exhibited double staining, indicating that these neurons projected to both the GRA and the VPL. These double-stained neurons were located on both sides of the dorsal horn of the spinal cord. The spinal dorsal horn neurons exhibited antidromic and collision activities in response to both GRA and VPL electrical activation. These results show spinal cord neurons with bifurcated bilateral projections to both the DC-ML and AL systems. Based on these results, we named these neurons bilateral and bifurcated cells.


Subject(s)
Axons/physiology , Posterior Horn Cells/cytology , Posterior Horn Cells/physiology , Animals , Lumbar Vertebrae , Male , Medulla Oblongata/cytology , Medulla Oblongata/physiology , Neural Pathways/cytology , Neural Pathways/physiology , Neuroanatomical Tract-Tracing Techniques , Rats, Sprague-Dawley , Rats, Wistar , Ventral Thalamic Nuclei/cytology , Ventral Thalamic Nuclei/physiology
9.
J Vet Intern Med ; 31(5): 1477-1486, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28833469

ABSTRACT

BACKGROUND: Feline infectious peritonitis (FIP) is the most common infectious central nervous system (CNS) disease in the cat and is invariably fatal. Improved means of antemortem diagnosis is required to facilitate clinical decision making. Information regarding the magnetic resonance imaging (MRI) findings of neurologic FIP currently is limited, resulting in the need for better descriptions to optimize its use as a diagnostic tool. OBJECTIVE: To describe the clinicopathologic features and MRI findings in cases of confirmed neurologic FIP. ANIMALS: Twenty-four client-owned cats with histopathologic confirmation of neurologic FIP. METHODS: Archived records from 5 institutions were retrospectively reviewed to identify cases with confirmed neurologic FIP that had undergone antemortem MRI of the CNS. Signalment, clinicopathologic, MRI, and histopathologic findings were evaluated. RESULTS: Three distinct clinical syndromes were identified: T3-L3 myelopathy (3), central vestibular syndrome (7), and multifocal CNS disease (14). Magnetic resonance imaging abnormalities were detected in all cases, including meningeal contrast enhancement (22), ependymal contrast enhancement (20), ventriculomegaly (20), syringomyelia (17), and foramen magnum herniation (14). Cerebrospinal fluid was analysed in 11 cases; all demonstrated a marked increase in total protein concentration and total nucleated cell count. All 24 cats were euthanized with a median survival time of 14 days (range, 2-115) from onset of clinical signs. Histopathologic analysis identified perivascular pyogranulomatous infiltrates, lymphoplasmacytic infiltrates, or both affecting the leptomeninges (16), choroid plexuses (16), and periventricular parenchyma (13). CONCLUSIONS AND CLINICAL IMPORTANCE: Magnetic resonance imaging is a sensitive means of detecting neurologic FIP, particularly in combination with a compatible signalment, clinical presentation, and CSF analysis.


Subject(s)
Feline Infectious Peritonitis/pathology , Animals , Brain/diagnostic imaging , Brain/pathology , Cats , Feline Infectious Peritonitis/diagnostic imaging , Female , Magnetic Resonance Imaging/veterinary , Male , Neuroimaging/veterinary , Retrospective Studies
10.
Vet Rec ; 179(21): 545, 2016 Nov 26.
Article in English | MEDLINE | ID: mdl-27729589

ABSTRACT

To describe the development of clinical signs (CS) and outcome of L-2-hydroxyglutaric aciduria (L-2-HGA), owners of 119 Staffordshire bull terriers positive for the known L-2-hydroxyglutarate dehydrogenase autosomal-recessive mutations were requested to complete a questionnaire regarding their pet's CS. Questionnaires were returned for 27 dogs, all with neurological abnormalities-not all questions were answered in all cases. The mean age of CS onset was 12 months (range 2.5-60). Gait dysfunction was reported in 26/26 dogs, with stiffness of all four limbs the most common (24/26) and earliest recognised abnormality. Kyphosis (19/26), body and/or head tremors (19/26) and hypermetria (15/26) were frequent. Behavioural changes were present in 24/27 dogs; most commonly staring into space (21/24), signs of dementia (17/24) and loss of training (15/24). Eighteen dogs demonstrated paroxysmal seizure-like/dyskinetic episodes. Nineteen (70 per cent) dogs were alive at a mean survival time of 76.6 months (12-170) after onset of CS. L-2-HGA was the cause of euthanasia in six dogs. Euthanasia occurred at a mean survival time of 44 months (8.5-93) after onset of CS, with 2/8 dogs euthanased within 12 months. L-2-HGA is considered a progressive neurological disease; however, CS can be successfully managed with affected dogs potentially living a normal lifespan.


Subject(s)
Brain Diseases, Metabolic, Inborn/veterinary , Disease Progression , Dog Diseases/diagnosis , Dog Diseases/pathology , Age of Onset , Animals , Brain Diseases, Metabolic, Inborn/diagnosis , Brain Diseases, Metabolic, Inborn/pathology , Brain Diseases, Metabolic, Inborn/therapy , Cohort Studies , Dog Diseases/therapy , Dogs , Severity of Illness Index , Species Specificity , Survival Analysis , Treatment Outcome
12.
Eur Neuropsychopharmacol ; 25(11): 2036-48, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26433268

ABSTRACT

Changes in histone acetylation could contribute to the pathogenesis of depression and antidepressant therapy. Using the chronic social defeat stress (CSDS) model of depression and different antidepressant treatments we studied the regulation of histone deacetylases (Hdac׳s) and synaptic plasticity markers in the prefrontal cortex (PFC). Further, functional implication of identified Hdac׳s in brain plasticity was explored. Mice were exposed to CSDS (10 days) followed by saline or imipramine (4 weeks). PFC Hdac׳s mRNA abundance was studied and compared to human׳s. Further, protein expression of acetylated histones (AcH3 and AcH4), neuroplasticity markers (CREB and pro-BDNF) and selected Hdac׳s were analyzed. Moreover, other antidepressants (fluoxetine and reboxetine) and selective HDAC inhibitors were studied. CSDS increased Hdac5 and Sirt2 mRNA whereas repeated imipramine did the opposite. Accordingly, stress and imipramine induced opposite changes on AcH3, AcH4 and CREB expression. At protein level, CSDS upregulated nuclear fraction of Hdac5 and repeated imipramine and reboxetine increased its phosphorylated form (p-Hdac5), mainly located in the cytoplasm. Moreover, Sirt2 was downregulated by all monoaminergic antidepressants. Further, repeated treatment with the class IIa Hdac inhibitor MC1568 and the Sirt2 inhibitor 33i for three weeks increased synaptic plasticity in the prefrontal cortex. Our results suggest that Hdac5 and Sirt2 upregulation could constitute stable stress-induced neuronal adaptations. Noteworthy, the SIRT2 upregulation in depressed patients supports the interest of this target for therapeutic intervention. On the other hand, cytoplasmic Hdac5 export and Sirt2 downregulation induced by monoaminergic antidepressants could contribute to the well-known beneficial effects of antidepressants on brain plasticity.


Subject(s)
Antidepressive Agents/pharmacology , Histone Deacetylases/metabolism , Neuronal Plasticity/physiology , Sirtuins/metabolism , Stress, Psychological/physiopathology , Adult , Animals , Chronic Disease , Depressive Disorder/metabolism , Fluoxetine/pharmacology , Histone Deacetylase Inhibitors/pharmacology , Humans , Imipramine/pharmacology , Male , Mice, Inbred C57BL , Middle Aged , Morpholines/pharmacology , Neuronal Plasticity/drug effects , Prefrontal Cortex/drug effects , Prefrontal Cortex/metabolism , RNA, Messenger/metabolism , Reboxetine , Stress, Psychological/drug therapy
13.
Acta neurol. colomb ; 31(3): 291-298, jul.-sep. 2015. ilus, tab
Article in Spanish | LILACS | ID: lil-776237

ABSTRACT

La enfermedad de Creutzfeldt-Jakob es la encefalopatía espongiforme más común en el ser humano y prototipode las patologías causadas por priones. Se caracteriza histológicamente por astrogliosis y degeneración dela sustancia gris. Típicamente inicia con síntomas prodrómicos no específicos progresando a demencia conmioclonias y ataxia. Presentamos dos casos de mujeres en edad media con deterioro cognitivo progresivo,dificultades motrices, alteraciones del lenguaje y mioclonias que conducen a la muerte. En electroencefalogramasde ondas trifásicas lentas periódicas así como elevación de proteínas tau y 14-3-3 en LCR por apoyodel The National Prion Disease Pathology Surveillance Center - Cleveland, todos estos hallazgos definen lascondiciones para el diagnóstico clínico de enfermedad por priones. El diagnóstico diferencial en el contextode demencia rápidamente progresiva es amplio, incluyendo infecciones, intoxicaciones, trastornos metabólicos,autoinmunidad, vasculopatías y neoplasias que podrían explicar un posible subregistro en las estadísticasregionales. Existe una posible asociación de riesgo entre enfermedad por priones y médicos patólogos que,aunque discutida, podría limitar el estudio de los especímenes histológicos que son la clave del diagnósticodefinitivo. A pesar de la importancia en salud pública de estas condiciones, el actual modelo de salud limita elmanejo integral de los pacientes.


Creutzfeldt-Jakob is the most common spongiform encephalopathy in humans and the prototype of prions diseases. Astrogliosis and degeneration of the gray matter are the histological features. Typically starts with nonspecific prodromal symptoms that progressing to dementia with myoclonus and ataxia. We present two cases of women in middle age with progressive cognitive impairment, motor difficulties, language disorders and myoclonus that lead to death. EEG slow periodic triphasic waves and elevated protein tau and CSF14-3-3 support for The National Prion Disease Pathology Surveillance Center - Cleveland, all these findings define the conditions for the clinical diagnosis of prion disease. The differential diagnosis in the context of rapidly progressive dementia is broad including infections, poisoning, metabolic disorders, autoimmunity, vascular disease and neoplasms that could explain a possible underreporting in regional statistics. There is a possible risk association between disease and Medical Pathologists that although discussed could limit the study of histological specimens that are key to definitive diagnosis. Despite the public health importance of these conditions the current model of health limits the comprehensive management of patients.


Subject(s)
Humans , Creutzfeldt-Jakob Syndrome , Dementia , Myoclonus , Prions
14.
Pharmacol Biochem Behav ; 135: 227-36, 2015 Aug.
Article in English | MEDLINE | ID: mdl-26051025

ABSTRACT

Many studies suggest that the prefrontal cortex (PFC) is a target limbic region for stress response because a dysfunction here is linked to anhedonia, a decrease in reactivity to rewards, and to anxiety. It is suggested that stress-induced persistent molecular changes in this brain region could bring some light on the mechanisms perpetuating depressive episodes. In order to address this issue, here we have studied the long-term PFC gene expression pattern and behavioral effects induced by a chronic mild stress (CMS) model and antidepressant treatment in mice. CMS was applied to mice for six weeks and imipramine (10mg/kg, i.p.) or saline treatment was administered for five weeks starting from the third week of CMS. Mice were sacrificed one month after CMS and following two weeks after the discontinuation of drug treatment and the PFC was dissected and prepared for gene (mRNA) and protein expression studies. Using the same experimental design, a separate group of mice was tested for anhedonia, recognition memory, social interaction and anxiety. CMS induced a long-term altered gene expression profile in the PFC that was partially reverted by imipramine. Specifically, the circadian rhythm signaling pathway and functions such as gene expression, cell proliferation, survival and apoptosis as well as neurological and psychiatric disorders were affected. Of these, some changes of the circadian rhythm pathway (Hdac5, Per1, and Per2) were validated by RT-PCR and western-blot. Moreover, CMS induced long-lasting anhedonia that was reverted by imipramine treatment. Impaired memory, decreased social interaction and anxiety behavior were also induced by chronic stress. We have identified in the PFC molecular targets oppositely regulated by CMS and imipramine that could be relevant for chronic depression and antidepressant action. Among these, a possible candidate for further investigation could be the circadian rhythm pathway.


Subject(s)
Antidepressive Agents, Tricyclic/pharmacology , Behavior, Animal/drug effects , Gene Expression/drug effects , Imipramine/pharmacology , Prefrontal Cortex/metabolism , Stress, Psychological/genetics , Stress, Psychological/psychology , Anhedonia/drug effects , Animals , Anxiety/psychology , Circadian Rhythm/drug effects , Histone Deacetylases/biosynthesis , Histone Deacetylases/genetics , Interpersonal Relations , Male , Memory/drug effects , Mice , Mice, Inbred C57BL , Prefrontal Cortex/drug effects , RNA, Messenger/biosynthesis , RNA, Messenger/genetics , Recognition, Psychology/drug effects
15.
J Small Anim Pract ; 56(5): 351-4, 2015 May.
Article in English | MEDLINE | ID: mdl-25353637

ABSTRACT

A six-month-old male entire Norfolk terrier was presented with a 3-month history of poor development, reluctance to exercise and progressive and diffuse muscle atrophy. Serum creatine kinase concentration was markedly elevated. Magnetic resonance imaging of the epaxial muscles revealed asymmetrical streaky signal changes aligned within the muscle fibres (hyperintense on T2-weighted images and short-tau inversion recovery with moderate contrast enhancement on T1-weighted images). Electromyography revealed pseudomyotonic discharges and fibrillation potentials localised at the level of the supraspinatus, epaxial muscles and tibial cranialis muscles. Muscle biopsy results were consistent with dystrophin-deficient muscular dystrophy. The dog remained stable 7 months after diagnosis with coenzyme Q10 and l-carnitine; however after that time, there was a marked deterioration and the owners elected euthanasia. This case report describes the clinical presentation, magnetic resonance imaging, electrodiagnostic and histopathological findings with immunohistochemical analysis in a Norfolk terrier with confirmed dystrophin-deficient muscular dystrophy, which has not been previously described in this breed.


Subject(s)
Dog Diseases/diagnosis , Dystrophin/analysis , Muscular Dystrophy, Animal/diagnosis , Animals , Biopsy/veterinary , Dog Diseases/pathology , Dog Diseases/physiopathology , Dogs , Dystrophin/deficiency , Electromyography/veterinary , Magnetic Resonance Imaging/veterinary , Male , Muscle, Skeletal/chemistry , Muscle, Skeletal/pathology , Muscle, Skeletal/physiopathology , Muscular Dystrophy, Animal/pathology , Muscular Dystrophy, Animal/physiopathology
18.
J Vet Intern Med ; 28(4): 1256-62, 2014.
Article in English | MEDLINE | ID: mdl-24814522

ABSTRACT

BACKGROUND: The prognostic value of early magnetic resonance imaging (MRI) in dogs after traumatic brain injury (TBI) remains unclear. OBJECTIVES: Determine whether MRI findings are associated with prognosis after TBI in dogs. ANIMALS: Fifty client-owned dogs. METHODS: Retrospective study of dogs with TBI that underwent 1.5T MRI within 14 days after head trauma. MRI evaluators were blinded to the clinical presentation, and all images were scored based on an MRI grading system (Grade I [normal brain parenchyma] to Grade VI [bilateral lesions affecting the brainstem with or without any lesions of lesser grade]). Skull fractures, percentage of intraparenchymal lesions, degree of midline shift, and type of brain herniation were evaluated. MGCS was assessed at presentation. The presence of seizures was recorded. Outcome was assessed at 48 h (alive or dead) and at 3, 6, 12, and 24 months after TBI. RESULTS: Sixty-six percent of the dogs had abnormal MRI findings. MRI grade was negatively correlated (P < .001) with MGCS. A significant negative correlation of MRI grade, degree of midline shift, and percentage of intraparenchymal lesions with follow-up scores was identified. The MGCS was lower in dogs with brain herniation (P = .0191). Follow-up scores were significantly lower in dogs that had brain herniation or skull fractures. The possibility of having seizures was associated with higher percentage of intraparenchymal lesions (P = 0.0054) and 10% developed PTE. CONCLUSIONS AND CLINICAL IMPORTANCE: Significant associations exist between MRI findings and prognosis in dogs with TBI. MRI can help to predict prognosis in dogs with TBI.


Subject(s)
Brain Injuries/veterinary , Dog Diseases/diagnosis , Animals , Brain Injuries/diagnosis , Dogs , Female , Glasgow Coma Scale/veterinary , Magnetic Resonance Imaging/veterinary , Male , Neuroimaging/veterinary , Prognosis , Retrospective Studies
19.
Vet Pathol ; 50(6): 1091-8, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23528939

ABSTRACT

Matrix metalloproteinases (MMPs) are proteolytic enzymes involved with extracellular matrix degradation. They have been considered to be important for tumor growth and development of peritumoral edema. This retrospective study investigated the expression of MMP subtypes 9 and 2 in canine intracranial meningiomas and their association with peritumoral edema. Twenty-two cases of histologically confirmed grade I meningiomas based on human World Health Organization classification were enrolled. Tumor volume and peritumoral edema were measured by magnetic resonance imaging volumetry. The intratumoral MMP expression was semiquantitatively assessed by immunoreactivity scores and compared with the imaging data. MMP-9 was expressed in all the samples (22/22), whereas proMMP-2 was expressed in 21 of 22 meningiomas, and a/proMMP-2 was expressed in 9 of 22. The immunoreactivity scores were not statistically linked to the severity of peritumoral edema. None of the evaluated MMP expression parameters were statistically linked to the edema index. Although both edema index and MMP-9 expression were highest in meningiomas of the olfactory and frontal region, only the latter mounted up to statistical significance (P = .002) if compared with parafalx and convexity meningiomas of the parietal lobe. In summary, MMP-2 and MMP-9 expression by tumor cells, evaluated through immunohistochemistry, is not predictive of the formation of peritumoral edema in canine rostrotentorial meningiomas.


Subject(s)
Dog Diseases/enzymology , Edema/veterinary , Matrix Metalloproteinase 2/metabolism , Matrix Metalloproteinase 9/metabolism , Meningeal Neoplasms/veterinary , Meningioma/veterinary , Animals , Brain/diagnostic imaging , Brain/pathology , Dog Diseases/pathology , Dogs , Edema/enzymology , Edema/pathology , Female , Immunohistochemistry/veterinary , Magnetic Resonance Imaging/veterinary , Male , Meningeal Neoplasms/enzymology , Meningeal Neoplasms/pathology , Meningioma/enzymology , Meningioma/pathology , Radiography , Retrospective Studies
20.
J Vet Intern Med ; 26(6): 1374-82, 2012.
Article in English | MEDLINE | ID: mdl-22978330

ABSTRACT

OBJECTIVES: To report the clinical presentation, imaging characteristics, treatment results, and histopathological findings of a previously undescribed vertebral malformation in the Basset Hound. ANIMALS AND METHODS: Retrospective case series study. Eighteen Basset Hounds presented for evaluation of a suspected cervical spinal cord problem. All dogs underwent computed tomography myelography or magnetic resonance imaging of the cervical region. RESULTS: Thirteen male and 5 female Basset Hounds between 6 months and 10.8 years of age (median: 1.4 years) were studied. Clinical signs varied from cervical hyperesthesia to nonambulatory tetraparesis. Imaging demonstrated a well-defined and smooth hypertrophy of the dorsal lamina and spinous process of ≥ 2 adjacent vertebrae. Although this bony abnormality could decrease the ventrodorsal vertebral canal diameter, dorsal midline spinal cord compression was predominantly caused by ligamentum flavum hypertrophy. The articulation between C4 and C5 was most commonly affected. Three dogs were lost to follow-up, 10 dogs underwent dorsal laminectomy, and medical management was initiated in 5 dogs. Surgery resulted in a good outcome with short hospitalization times (median: 4.5 days) in all dogs, whereas medical management produced more variable results. Histopathology confirmed ligamentum flavum hypertrophy and demonstrated the fibrocartilaginous nature of this anomaly. CONCLUSIONS AND CLINICAL IMPORTANCE: Dorsal lamina and spinous process hypertrophy leading to ligamentum flavum hypertrophy should be included in the differential diagnosis of Basset Hounds with cervical hyperesthesia or myelopathy. Prognosis after decompressive surgery is favorable. Although a genetic component is suspected, additional studies are needed to determine the specific etiology of this disorder.


Subject(s)
Cervical Vertebrae/pathology , Dog Diseases/pathology , Spinal Cord Compression/veterinary , Aging , Animals , Dogs , Female , Male , Retrospective Studies , Sex Factors , Spinal Cord Compression/pathology
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