RESUMO
BACKGROUND: Feline pancreas-specific lipase (Spec fPL) is considered a useful test for the antemortem diagnosis of pancreatitis in cats. A recent study found good agreement between the results of the Spec fPL and catalytic 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR) lipase assay. Prospective studies evaluating their sensitivity and specificity are lacking. OBJECTIVES: To compare the results of the Spec fPL and the DGGR assays with a standardized histologic assessment of the pancreas. ANIMALS: Sixty client-owned cats presented for necropsy. PROSPECTIVE STUDY: Spec fPL concentrations and serum DGGR lipase activity were measured from the same blood sample. The pancreas was removed within 3 hours after euthanasia; serial transverse sections were made every 0.5 cm throughout the entire pancreas and reviewed using a histologic grading scheme. Sensitivity and specificity for the Spec fPL and DGGR assay results were determined. RESULTS: The sensitivity and specificity for the Spec fPL assay (cutoff value ≥5.4 µg/L) was 42.1 [95% confidence interval (95% CI), 29.4-55.9%] and 100% (95% CI, 31.0-100.0%). The sensitivity and specificity for the DGGR assay (cutoff value >26 U/L) was 36.8 (95% CI, 24.7-50.7%) and 100% (95% CI, 31.0-100.0%). When lymphocytic inflammation up to 10% of a section was considered normal, the sensitivity and specificity for Spec fPL assay (cutoff value ≥5.4 µg/L) was 61.1 (95% CI, 36.1-81.7%) and 69.0% (95% CI, 52.8-81.9%) and the sensitivity and specificity for the DGGR assay (cutoff value >26 U/L) was 66.7 (95% CI, 41.2-85.6%) and 78.6% (95% CI, 62.8-89.2%). CONCLUSIONS AND CLINICAL IMPORTANCE: Both lipase assays performed similarly well, but their agreement with histologic pancreatic inflammation was limited.
Assuntos
Azotemia/veterinária , Doenças do Gato/sangue , Glutaratos , Lipase/sangue , Oxazinas , Pâncreas/patologia , Pancreatite/veterinária , Animais , Azotemia/sangue , Bioensaio/veterinária , Doenças do Gato/diagnóstico , Doenças do Gato/enzimologia , Gatos , Feminino , Masculino , Pâncreas/enzimologia , Pancreatite/diagnóstico , Pancreatite/enzimologia , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: Serum lipase activities measured by catalytic assays are claimed to be of limited utility for diagnosing pancreatitis in cats. The Spec fPL assay currently is believed the most sensitive test; however, studies comparing different lipase assays are lacking. 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR) assay for the determination of lipase activity has been evaluated in dogs, but no information is available in cats. OBJECTIVES: To investigate the agreement of DGGR-lipase activity and Spec fPL concentration in cats with clinical signs consistent with pancreatitis. ANIMALS: Two hundred fifty-one client-owned cats. METHODS: DGGR-lipase activity and Spec fPL concentration measured from the same blood sample in cats undergoing investigation for pancreatitis. The agreement between DGGR-lipase and Spec fPL at different cutoffs was assessed using Cohen's kappa coefficient (κ). Sensitivity and specificity were calculated for 31 cases where pancreatic histopathology was available. RESULTS: DGGR-lipase (cutoff, 26 U/L) and Spec fPL (cutoff, >5.3 µg/L) had a κ of 0.68 (standard error [SE] 0.046). DGGR-lipase (cutoff, 26 U/L) and Spec fPL (cutoff, >3.5 µg/L) had a κ of 0.60 (SE, 0.05). The maximum κ at a Spec fPL cutoff >5.3 µg/L was found when the DGGR-lipase cutoff was set >34 U/L and calculated as 0.755 (SE, 0.042). Sensitivity and specificity were 48% and 63% for DGGR-lipase (cut-off, 26 U/L) and 57% and 63% for Spec fPL (>5.3 µg/L), respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: Both lipase assays agreed substantially. DGGR assay seems a useful and cost-efficient method compared to the Spec fPL test.
Assuntos
Doenças do Gato/sangue , Glutaratos , Lipase/sangue , Oxazinas , Pâncreas/enzimologia , Pancreatite/veterinária , Animais , Azotemia/sangue , Azotemia/metabolismo , Azotemia/veterinária , Doenças do Gato/diagnóstico , Gatos , Feminino , Lipase/metabolismo , Masculino , Pancreatite/diagnóstico , Sensibilidade e EspecificidadeRESUMO
The research that was carried out with comparative groups showed the influence of the work done by a coordinated health group on the prolonged natural lactation. This experience has proved the evident reduction of percentages of malnutrition and diarrhoea in children under 6 months of age.
PIP: The authors present their results of an investigation of breastfeeding on 2 groups of newborns; in the first group mothers were spontaneously breastfeeding; in the second group mothers were encouraged to breastfeed through an educational campaign conducted by doctors and nurses. Breastfeeding went on for 6 months in 37.7% of cases in the first group, but in 70% of cases in the second group. A very positive correlation was found between lactation prolonged for longer than 4 months and multiparity and educational level of the mother. Mothers who used oral contraception tended to breastfeed for a shorter period than mothers using a IUD; mothers who did not use contraception were the ones who breastfed longer. After 6 months of investigation the percentage of malnourished babies was 22% in the first group, but only 6.2% in the second group. Incidence of diarrhea diminished with prolonged lactation.