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Nilsson MK, Toresson L, Ljungvall I, Nyman Lee HT, McEvoy FJ. Sonographic features of the uncomplicated postoperative abdomen in dogs treated for pyometra by ovariohysterectomy. Vet Radiol Ultrasound 2023; 64:1090-1098. [PMID: 37985867 DOI: 10.1111/vru.13310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 10/07/2023] [Accepted: 10/07/2023] [Indexed: 11/22/2023] Open
Abstract
Pyometra is a prevalent disease in intact bitches and the standard treatment is ovariohysterectomy (OHE). Published descriptions of normal sonographic findings after OHE are currently lacking. The aims of this prospective observational study were to describe and compare postoperative abdominal sonographic features for three timepoints following OHE in a group of dogs with pyometra and an uneventful recovery. A total of 22 dogs had sequential focused abdominal ultrasound examinations on days 1, 4-6, and 10-15 postsurgery. Recorded sonographic features for each examination time point and characteristics of the cervical stump and the mesovarium, size, and echogenicity of medial iliac lymph nodes (MILNs), presence of free peritoneal fluid, and pneumoperitoneum. The cervical stump appeared as a heterogenous area with a hypoechoic center surrounded by hyperechogenic tissue in all dogs. The cervical stump transverse-sectional area was larger on day 4-6 compared with day 1 and day 10-15 (P = .0009). Mesovarium ligature reactions were identified as heterogeneous and hyperechoic areas with central and/or edge shadowing in all dogs. The size and echogenicity of MILNs and the mesovarium reactions did not significantly differ among time points. Free peritoneal fluid was detected in 45%, 41%, and 9% and pneumoperitoneum in 95%, 82%, and 14% of dogs at sequential time points. Findings from this sample of dogs with an uneventful recovery following OHE due to pyometra can be used to assist veterinarians in interpreting postoperative abdominal ultrasonographic characteristics in future dogs treated surgically for pyometra.
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Affiliation(s)
- Mia K Nilsson
- IVC Evidensia Specialist Animal Hospital Helsingborg, Helsingborg, Sweden
| | - Linda Toresson
- IVC Evidensia Specialist Animal Hospital Helsingborg, Helsingborg, Sweden
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, Helsinki University, Helsingborg, Finland
| | - Ingrid Ljungvall
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Sciences, University of Agricultural Sciences, Uppsala, Sweden
| | | | - Fintan J McEvoy
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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2
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Ding Z, Wei Y, Peng J, Wang S, Chen G, Sun J. The Potential Role of C-Reactive Protein in Metabolic-Dysfunction-Associated Fatty Liver Disease and Aging. Biomedicines 2023; 11:2711. [PMID: 37893085 PMCID: PMC10603830 DOI: 10.3390/biomedicines11102711] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/27/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD), recently redefined as metabolic-dysfunction-associated fatty liver disease (MASLD), is liver-metabolism-associated steatohepatitis caused by nonalcoholic factors. NAFLD/MASLD is currently the most prevalent liver disease in the world, affecting one-fourth of the global population, and its prevalence increases with age. Current treatments are limited; one important reason hindering drug development is the insufficient understanding of the onset and pathogenesis of NAFLD/MASLD. C-reactive protein (CRP), a marker of inflammation, has been linked to NAFLD and aging in recent studies. As a conserved acute-phase protein, CRP is widely characterized for its host defense functions, but the link between CRP and NAFLD/MASLD remains unclear. Herein, we discuss the currently available evidence for the involvement of CRP in MASLD to identify areas where further research is needed. We hope this review can provide new insights into the development of aging-associated NAFLD biomarkers and suggest that modulation of CRP signaling is a potential therapeutic target.
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Affiliation(s)
- Zheng Ding
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100190, China
| | - Yuqiu Wei
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100190, China
| | - Jing Peng
- College of Biological Sciences, China Agricultural University, Beijing 100193, China
| | - Siyu Wang
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100190, China
| | - Guixi Chen
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100190, China
| | - Jiazeng Sun
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100190, China
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Demeli A, Meyer JC. The assessment of haematologic and serum chemistry parameters in canine pyometra: a systematic review and meta-analysis. J Small Anim Pract 2023; 64:543-551. [PMID: 37691297 DOI: 10.1111/jsap.13641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/27/2023] [Accepted: 05/01/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES Pyometra is common in non-spayed adult female dogs requiring early diagnosis and treatment to increase the survival rate. The diagnosis of pyometra is mainly based on clinical examination and anamnesis. Radiography, ultrasonography and laboratory analyses are recommended to support a diagnosis. The aim of this study was to assess blood parameters associated with pyometra by performing a systematic review and meta-analysis. MATERIALS AND METHODS The review was conducted in accordance with PRISMA guidelines. A search of three databases (PubMed, Google Scholar and CAB abstracts) was performed in July 2022. Studies providing information about laboratory parameters for both the pyometra group and healthy control group dogs were eligible for inclusion. Data extraction included the first author's name, publication year, country, number of participants in both groups, mean values of selected studies, standard deviation values, and blood parameters. The risk of bias for each study was evaluated, and a random-effects meta-analysis was performed. RESULTS We included 44 studies which investigated 12 blood parameters. High heterogeneity was detected in all parameters in these meta-analyses. The following blood parameters were increased in dogs with pyometra: white blood cell (mean=27.75×109 L-1 , mean difference (MD)=17.16, 95% confidence interval (CI) 14.85 to 19.47), monocytes (mean=2.06×1012 /L, MD=1.37, 95% CI 0.99 to 1.74), blood urea nitrogen (mean=41.42 mg/dL MD=18.06, 95% CI 12.26 to 23.85), alkaline phosphatase (mean=212.78 IU/L, MD=137.51, 95% CI 81.81 to 88.62), and aspartate aminotransferase (mean=48.31 IU/L, MD=16.96, 95% CI 10.61 to 23.30). The following parameters were reduced: red blood cell (mean=5.42 1012 /L, MD=-1.37, 95% CI -1.68 to -1.05), haemoglobin (mean=121.20 g/L, MD=-30.57, 95% CI -39.70 to 21.45), albumin (mean=23.71 g/L, MD = -8.16, 95% CI -11.46 to -4.86). Lymphocyte, creatinine, urea, and alanine transaminase parameters were increased in some studies and decreased in others. CLINICAL SIGNIFICANCE In canine pyometra, some blood parameters are consistently increased, some consistently decreased, and some increased or decreased depending on the study.
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Affiliation(s)
- A Demeli
- Genreal Directorate of Food and Control, Ankara, Turkey
| | - J C Meyer
- Equine Sport Science, East Hampton, New York, USA
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Bonder BSA, Teixeira FA, Porsani MYH, Gonçales LA, Nagashima JK, de-Oliveira CM, Balieiro JCC, Pfrimer K, Massoco CDO, Fantoni DT, Pontieri CFF, Brunetto MA. Evaluation of an onco-diet on body composition and inflammatory status of dogs with mammary tumor-Pilot study. PLoS One 2023; 18:e0287797. [PMID: 37410738 PMCID: PMC10325094 DOI: 10.1371/journal.pone.0287797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 05/29/2023] [Indexed: 07/08/2023] Open
Abstract
A high-protein hypercaloric diet enriched with glutamine and omega-3 polyunsaturated fatty acids was called an onco-diet. The goal was to verify the modulation of the inflammatory response and body composition of female dogs with mammary tumor after mastectomy, during onco-diet consumption, using a randomized, double-blinded, clinical trial. Six bitches (average age of 8.6 years) were allocated into Control Group-diet without glutamine, EPA and DHA supplementation; and six bitches (10.0 years) were allocated into Test-diet enriched with glutamine and omega-3. Serum measurements of TNF-α, IL-6, IL-10, IGF-1, C-reactive protein and determination of body composition were performed at pre- and post-surgical times. Statistical tests were used to compare the nutrient intake and dietary effects on inflammatory variables between the diets. No differences in concentrations of different cytokines (p>0.05) and C-reactive protein (CRP) (p = 0.51) were observed between the groups. The test group had a higher concentration of IGF-1 (p<0.05), higher percentage of muscle mass (p<0.01) and lower body fat (p<0.01), but the difference was present from initial and throughout the study. Onco-diet, enriched with glutamine and omega-3, in the amounts evaluated in this study, was not sufficient to modulate the inflammation and body composition of female dogs with mammary tumors submitted to unilateral mastectomy.
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Affiliation(s)
- Brana S. A. Bonder
- School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo/Pirassununga, São Paulo, Brazil
| | - Fabio A. Teixeira
- School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo/Pirassununga, São Paulo, Brazil
| | - Mariana Y. H. Porsani
- School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo/Pirassununga, São Paulo, Brazil
| | - Lucas A. Gonçales
- School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo/Pirassununga, São Paulo, Brazil
| | - Julio K. Nagashima
- School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo/Pirassununga, São Paulo, Brazil
| | - Clair M. de-Oliveira
- School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo/Pirassununga, São Paulo, Brazil
| | - Julio C. C. Balieiro
- School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo/Pirassununga, São Paulo, Brazil
| | - Karina Pfrimer
- Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Cristina de O. Massoco
- School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo/Pirassununga, São Paulo, Brazil
| | - Denise T. Fantoni
- School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo/Pirassununga, São Paulo, Brazil
| | | | - Marcio Antonio Brunetto
- School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo/Pirassununga, São Paulo, Brazil
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Ceron JJ, Pardo-Marin L, Wdowiak A, Zoia A, Wochnik M, Szczubiał M, Bochniarz M, Tecles F, Martinez-Subiela S, Tvarijonaviciute A, Dąbrowski R. Divergences between serum C-reactive protein and ferritin concentrations in canine pyometra. BMC Vet Res 2023; 19:78. [PMID: 37344860 DOI: 10.1186/s12917-023-03630-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 06/05/2023] [Indexed: 06/23/2023] Open
Abstract
The main aim of this report was to investigate and compare the response of serum C-reactive protein (CRP) and ferritin, two positive acute phase proteins (APPs) which usually show an increase in inflammatory processes, in dogs with pyometra. For this purpose, two different studies were made. In the first one , both proteins were measured together in an APPs profile in 25 dogs with pyometra, 25 dogs with pancreatitis (as an example of a positive inflammatory control group), and in 25 healthy dogs. In the second study, to advance the knowledge of the changes and evolution of serum ferritin and CRP in dogs with pyometra after treatment, the concentrations of both APPs were analyzed in 30 dogs with pyometra at diagnosis and after ovariohysterectomy and in 10 clinically healthy female dogs before and after elective spaying. In both studies, bitches with pyometra showed significant increases in serum CRP, indicating an inflammatory condition, but not in serum ferritin despite being a moderate positive APP. This divergence between the dynamics of these APPs could be a useful tool for the suspicion of cases of canine pyometra.
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Affiliation(s)
- Jose J Ceron
- Interdisciplinary Laboratory of Clinical Pathology (Interlab-UMU), Campus of Excellence Mare Nostrum, University of Murcia, Espinardo, Murcia, 30100, Spain
| | - Luis Pardo-Marin
- Interdisciplinary Laboratory of Clinical Pathology (Interlab-UMU), Campus of Excellence Mare Nostrum, University of Murcia, Espinardo, Murcia, 30100, Spain
| | - Anna Wdowiak
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Głeboka 30st, Lublin, 20-612, Poland
| | - Andrea Zoia
- Division of Internal Medicine, San Marco Veterinary Clinic, Viale dell'Industria 3, Veggiano, Padua, 35030, Italy
| | - Marco Wochnik
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Głeboka 30st, Lublin, 20-612, Poland
| | - Marek Szczubiał
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Głeboka 30st, Lublin, 20-612, Poland
| | - Mariola Bochniarz
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Głeboka 30st, Lublin, 20-612, Poland
| | - Fernando Tecles
- Interdisciplinary Laboratory of Clinical Pathology (Interlab-UMU), Campus of Excellence Mare Nostrum, University of Murcia, Espinardo, Murcia, 30100, Spain
| | - Silvia Martinez-Subiela
- Interdisciplinary Laboratory of Clinical Pathology (Interlab-UMU), Campus of Excellence Mare Nostrum, University of Murcia, Espinardo, Murcia, 30100, Spain
| | - Asta Tvarijonaviciute
- Interdisciplinary Laboratory of Clinical Pathology (Interlab-UMU), Campus of Excellence Mare Nostrum, University of Murcia, Espinardo, Murcia, 30100, Spain.
| | - Roman Dąbrowski
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Głeboka 30st, Lublin, 20-612, Poland
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Gültiken N, Yarim M, Yarim GF, Sözmen M, Anadol E, Findik M. Plasma concentration and uterine and ovarian expressions of insulin-like growth factor-2 in dogs with cystic endometrial hyperplasia-pyometra. Acta Vet Hung 2021; 69:73-79. [PMID: 33891559 DOI: 10.1556/004.2021.00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/18/2021] [Indexed: 11/19/2022]
Abstract
The objective of this study was to investigate the plasma concentrations of insulin-like growth factor-2 (IGF-2) as well as its expression in the uterus and ovary of healthy dogs and those with cystic endometrial hyperplasia (CEH)-pyometra complex. Group 1 (n = 10) included bitches with open cervix pyometra, while Group 2 (n = 7) consisted of clinically healthy bitches in dioestrus. The number of IGF-2 immunopositive interstitial cells was significantly higher in Group 1, whereas in Group 2 there were only two cases in which a few cells were IGF-2 immunopositive. IGF-2 immunopositivity was observed in the endometrial glandular epithelium in both groups. Additionally, interstitial fibroblasts and macrophages in the endometrium were also positive in Group 1. The concentration of plasma IGF-2 was higher in Group 1 than in Group 2 (P < 0.05). The concentration was positively correlated with IGF-2 expression in the endometrial glands (r = 0.926; P < 0.001) in Group 1. However, a negative correlation was present between plasma IGF-2 concentration and IGF-2 expression in the interstitial endocrine cells of the ovary in Group 1 (r = -0.652; P < 0.05). The results suggest that IGF-2 plays an important role during the inflammatory process occurring in bitches with CEH-pyometra complex as well as in the endometrium of healthy bitches in dioestrus.
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Affiliation(s)
- Nilgün Gültiken
- 1Department of Obstetrics and Gynaecology, Faculty of Veterinary Medicine, University of Ondokuz Mayis, Samsun, Turkey
| | - Murat Yarim
- 2Department of Pathology, Faculty of Veterinary Medicine, University of Ondokuz Mayis, Samsun, Turkey
| | - Gül Fatma Yarim
- 3Department of Biochemistry, Faculty of Veterinary Medicine, University of Ondokuz Mayis, Samsun, Turkey
| | - Mahmut Sözmen
- 2Department of Pathology, Faculty of Veterinary Medicine, University of Ondokuz Mayis, Samsun, Turkey
| | - Elvan Anadol
- 4Laboratory Animal Breeding and Experimental Research Center, University of Gazi, Ankara, Turkey
| | - Murat Findik
- 1Department of Obstetrics and Gynaecology, Faculty of Veterinary Medicine, University of Ondokuz Mayis, Samsun, Turkey
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Del Romero A, Cuervo B, Peláez P, Miguel L, Torres M, Yeste M, Rivera del Alamo MM, Rubio CP, Rubio M. Changes in Acute Phase Proteins in Bitches after Laparoscopic, Midline, and Flank Ovariectomy Using the Same Method for Hemostasis. Animals (Basel) 2020; 10:ani10122223. [PMID: 33260846 PMCID: PMC7761362 DOI: 10.3390/ani10122223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 02/05/2023] Open
Abstract
Simple Summary Ovariectomy is a common surgical procedure in veterinary medicine, with many techniques involved. The aim of this study is to objectively evaluate the acute phase response by measuring the changes in a panel of acute phase proteins after applying three different ovariectomy techniques. C-reactive protein values showed increases of lower magnitude after laparoscopic ovariectomy compared with other techniques, indicating that this surgical technique induces a reduced inflammatory response and tissue damage. The use of this procedure is in agreement with the current tendency to use minimally invasive procedures for ovariectomy. Abstract Acute phase proteins (APP) are biomarkers of systemic inflammation, which allow monitoring the evolution of diseases, the response to treatments, and post-operative complications. Ovariectomy (OVE) is frequently performed in veterinary medicine and can be a useful model to evaluate surgical trauma and inflammation in the bitch. The objective was to investigate and compare the acute phase response (APR) after applying three different OVE techniques by measuring serum levels of C-reactive protein (CRP), haptoglobin (Hp), albumin (Alb), and paraoxonase-1 (PON-1). Forty-five intact bitches were included in the study, being randomly distributed into three groups: laparoscopic OVE (L), midline OVE (M), and flank OVE (F). Serum CRP, Hp, Alb, and PON-1 were measured before surgery, 1, 24, 72, and 168 h post-intervention. CRP levels increased significantly 24 h post-surgery in the M and F groups, but no significant variation was observed in the L group at any time of the study period. Hp was significantly higher in group L than in group F 72 h post-surgery. Alb and PON-1 showed no statistical difference among groups or among sampling periods. CRP response suggests that the use of laparoscopic procedures produce lower inflammation compared to open conventional approaches when performing OVE in the bitch.
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Affiliation(s)
- Ayla Del Romero
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, University CEU—Cardenal Herrera, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain; (A.D.R.); (P.P.); (L.M.); (M.T.); (M.R.)
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, University CEU-Cardenal Herrera, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain
| | - Belén Cuervo
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, University CEU—Cardenal Herrera, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain; (A.D.R.); (P.P.); (L.M.); (M.T.); (M.R.)
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, University CEU-Cardenal Herrera, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain
- Correspondence: ; Tel.: +34-96-136-9000 (ext. 66017)
| | - Pau Peláez
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, University CEU—Cardenal Herrera, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain; (A.D.R.); (P.P.); (L.M.); (M.T.); (M.R.)
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, University CEU-Cardenal Herrera, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain
| | - Laura Miguel
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, University CEU—Cardenal Herrera, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain; (A.D.R.); (P.P.); (L.M.); (M.T.); (M.R.)
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, University CEU-Cardenal Herrera, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain
| | - Marta Torres
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, University CEU—Cardenal Herrera, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain; (A.D.R.); (P.P.); (L.M.); (M.T.); (M.R.)
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, University CEU-Cardenal Herrera, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain
| | - Marc Yeste
- Biotechnology of Animal and Human Reproduction (TechnoSperm), Institute of Food and Agricultural Technology, University of Girona, E-17003 Girona, Spain;
- Unit of Cell Biology, Department of Biology, Faculty of Sciences, University of Girona, E-17003 Girona, Spain
| | - Maria Montserrat Rivera del Alamo
- Unit of Animal Reproduction, Department of Animal Medicine and Surgery, School of Veterinary Medicine, Autonomous University of Barcelona, E-08193 Bellaterra (Cerdanyola Del Vallès), Spain;
| | - Camila P. Rubio
- Interdisciplinary Laboratory of Clinical Analysis (Interlab-UMU), Veterinary School, Campus of Excellence Mare Nostrum, University of Murcia, Espinardo, 30100 Murcia, Spain;
| | - Mónica Rubio
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, University CEU—Cardenal Herrera, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain; (A.D.R.); (P.P.); (L.M.); (M.T.); (M.R.)
- García Cugat Foundation CEU-UCH Chair of Medicine and Regenerative Surgery, University CEU-Cardenal Herrera, CEU Universities, C/Tirant lo Blanc, 7, Alfara del Patriarca, 46115 Valencia, Spain
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Dąbrowski R, Wdowiak A, Contreras-Aguilar MD, Franco-Martinez L, Muñoz-Prieto A, Szczubiał M, Martinez-Subiela S, Ceron JJ, Tvarijonaviciute A. Serum and salivary adiponectin dynamics in septic and non-septic systemic inflammation in a canine model. Vet Immunol Immunopathol 2019; 219:109961. [PMID: 31710908 DOI: 10.1016/j.vetimm.2019.109961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 10/17/2019] [Accepted: 10/22/2019] [Indexed: 11/28/2022]
Abstract
Adiponectin is a 30 kDa protein hormone that has anti-atherogenic properties, being an insulin-sensitizing and anti-inflammatory molecule. Salivary adiponectin concentrations correlate positively with serum, thus, saliva was indicated as appropriate biofluid for its measurement in different clinical situations. However, inflammation was indicated as main confounding factor when evaluating the usefulness and the reliability of determination of salivary adiponectin. The aim of the present report was to evaluate the dynamics of salivary and serum adiponectin in systemic non-septic and septic inflammation using a dogs as a model. Forty bitches were enrolled. Seventeen dogs were healthy (group I, non-septic) and 23 bitches were diagnosed with pyometra (group II, septic). Ovariohysterectomy was performed for all animals. Saliva and blood samples were collected before (D0) and 3 (D3) and 10 (D10) days after ovariohysterectomy. At D0, Group I showed higher serum and salivary adiponectin than group II, although statistical significance was only detected in salivary adiponectin between the two groups at D0 (P = 0.001). In serum, adiponectin was higher on D0 than on D3 and tended to reach pre-surgery values on D10 in both groups. Salivary adiponectin showed similar behaviour to serum in Group I, while in group II salivary adiponectin concentrations were lowest on D0 and tended to increase on D3 and D10. The data obtained in present study describe for the first time the comparative behavior of salivary adiponectin in non-septic and septic inflammation. Salivary, and not serum, adiponectin seemed to mimic better the inflammatory and general health status.
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Affiliation(s)
- Roman Dąbrowski
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 30 Gleboka St., 20-612, Lublin, Poland.
| | - Anna Wdowiak
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 30 Gleboka St., 20-612, Lublin, Poland
| | - Maria D Contreras-Aguilar
- Interdisciplinary Laboratory of Clinical Pathology, Iterlab-UMU, Campus of Excellence Mare Nostrum, University of Murcia, 30100, Espinardo, Murcia, Spain
| | - Lorena Franco-Martinez
- Interdisciplinary Laboratory of Clinical Pathology, Iterlab-UMU, Campus of Excellence Mare Nostrum, University of Murcia, 30100, Espinardo, Murcia, Spain
| | - Alberto Muñoz-Prieto
- Interdisciplinary Laboratory of Clinical Pathology, Iterlab-UMU, Campus of Excellence Mare Nostrum, University of Murcia, 30100, Espinardo, Murcia, Spain
| | - Marek Szczubiał
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 30 Gleboka St., 20-612, Lublin, Poland
| | - Silvia Martinez-Subiela
- Interdisciplinary Laboratory of Clinical Pathology, Iterlab-UMU, Campus of Excellence Mare Nostrum, University of Murcia, 30100, Espinardo, Murcia, Spain
| | - Jose J Ceron
- Interdisciplinary Laboratory of Clinical Pathology, Iterlab-UMU, Campus of Excellence Mare Nostrum, University of Murcia, 30100, Espinardo, Murcia, Spain
| | - Asta Tvarijonaviciute
- Interdisciplinary Laboratory of Clinical Pathology, Iterlab-UMU, Campus of Excellence Mare Nostrum, University of Murcia, 30100, Espinardo, Murcia, Spain
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Vilhena H, Figueiredo M, Cerón JJ, Pastor J, Miranda S, Craveiro H, Pires MA, Tecles F, Rubio CP, Dabrowski R, Duarte S, Silvestre-Ferreira AC, Tvarijonaviciute A. Acute phase proteins and antioxidant responses in queens with pyometra. Theriogenology 2018; 115:30-37. [PMID: 29705657 DOI: 10.1016/j.theriogenology.2018.04.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 04/04/2018] [Accepted: 04/08/2018] [Indexed: 12/17/2022]
Abstract
Acute phase proteins (APP) and biomarkers of oxidative status have proved to be clinically useful biomarkers of pyometra in different species. Despite pyometra is considered one of the most important feline reproductive diseases, information about the APP response and the oxidative status in queens with pyometra is lacking. This study aimed to evaluate the APP and the antioxidant responses at diagnosis and in the post-operative period in feline pyometra. Serum concentrations of serum amyloid A (SAA), haptoglobin (Hp), albumin, total serum thiols (Thiol) and total antioxidant capacity determined by different assays, including trolox equivalent antioxidant capacity (TEAC) assessed by two different methodologies (TEAC1 and TEAC2), ferric reducing ability of plasma (FRAP), and cupric reducing antioxidant capacity (CUPRAC), were determined in 23 queens with pyometra at diagnosis and in 13 healthy control queens submitted to elective ovariohysterectomy. The APP and antioxidants were also evaluated in 11 queens of the pyometra group at days two and 10 after surgery. At diagnosis, queens with pyometra had serum concentrations of SAA, Hp, and FRAP significantly higher (P < 0.001, P < 0.001 and P < 0.05, respectively), and of albumin, Thiol, CUPRAC and TEAC2 significantly lower (P < 0.001, P < 0.001, P < 0.001 and P < 0.01, respectively) than controls. Moreover, concentrations of APP and antioxidants were significantly different (with a tendency to return to physiologic levels) at day 10 after surgery than before surgery. Significant associations were found between APP and antioxidants. According to these results, an APP response and the development of oxidative stress were detected in queens with pyometra. In addition, APP and antioxidants tended to return to physiologic values after surgery in the queens that recovered from the disease. Therefore, our results suggest that APP and selected antioxidants, such as Thiol and CUPRAC, could be potentially useful biomarkers in diagnosis and assessment of the post-operative period in feline pyometra.
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Affiliation(s)
- Hugo Vilhena
- Center for Investigation Vasco da Gama (CIVG), Department of Veterinary Medicine, Vasco da Gama Universitary School, Av. José R. Sousa Fernandes, 197 Lordemão, 3020-210, Coimbra, Portugal; Baixo Vouga Veterinary Hospital, EN1, 355, 3750-742, Águeda, Portugal; Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal.
| | - Marta Figueiredo
- Center for Investigation Vasco da Gama (CIVG), Department of Veterinary Medicine, Vasco da Gama Universitary School, Av. José R. Sousa Fernandes, 197 Lordemão, 3020-210, Coimbra, Portugal.
| | - José J Cerón
- Interdisciplinary Laboratory of Clinical Analysis Interlab-UMU, University of Murcia, Campus de Espinardo Ed. 16, 30100 Espinardo, Murcia, Spain.
| | - Josep Pastor
- Department of Animal Medicine and Surgery, Autonomous University of Barcelona, Campus de la UAB, Plaça Cívica, s/n, 08193 Bellaterra, Barcelona, Spain.
| | - Sónia Miranda
- Baixo Vouga Veterinary Hospital, EN1, 355, 3750-742, Águeda, Portugal; Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal.
| | - Hélder Craveiro
- Center for Investigation Vasco da Gama (CIVG), Department of Veterinary Medicine, Vasco da Gama Universitary School, Av. José R. Sousa Fernandes, 197 Lordemão, 3020-210, Coimbra, Portugal; Baixo Vouga Veterinary Hospital, EN1, 355, 3750-742, Águeda, Portugal.
| | - Maria A Pires
- Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal; Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal; Laboratory of Histology and Anatomical Pathology (LHAP), University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal.
| | - Fernando Tecles
- Interdisciplinary Laboratory of Clinical Analysis Interlab-UMU, University of Murcia, Campus de Espinardo Ed. 16, 30100 Espinardo, Murcia, Spain.
| | - Camila P Rubio
- Interdisciplinary Laboratory of Clinical Analysis Interlab-UMU, University of Murcia, Campus de Espinardo Ed. 16, 30100 Espinardo, Murcia, Spain.
| | - Roman Dabrowski
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 30 Gleboka St., 20-612, Lublin, Poland.
| | - Sofia Duarte
- Center for Investigation Vasco da Gama (CIVG), Department of Veterinary Medicine, Vasco da Gama Universitary School, Av. José R. Sousa Fernandes, 197 Lordemão, 3020-210, Coimbra, Portugal; LAQV-REQUIMTE, Group of Bromatology, Pharmacognosy and Analytical Sciences, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal.
| | - Ana C Silvestre-Ferreira
- Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal; Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal.
| | - Asta Tvarijonaviciute
- Interdisciplinary Laboratory of Clinical Analysis Interlab-UMU, University of Murcia, Campus de Espinardo Ed. 16, 30100 Espinardo, Murcia, Spain.
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Piñeiro M, Pato R, Soler L, Peña R, García N, Torrente C, Saco Y, Lampreave F, Bassols A, Canalias F. A new automated turbidimetric immunoassay for the measurement of canine C-reactive protein. Vet Clin Pathol 2018; 47:130-137. [PMID: 29377276 DOI: 10.1111/vcp.12576] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In dogs, as in humans, C-reactive protein (CRP) is a major acute phase protein that is rapidly and prominently increased after exposure to inflammatory stimuli. CRP measurements are used in the diagnosis and monitoring of infectious and inflammatory diseases. OBJECTIVES The study aim was to develop and validate a turbidimetric immunoassay for the quantification of canine CRP (cCRP), using canine-specific reagents and standards. METHODS A particle-enhanced turbidimetric immunoassay was developed. The assay was set up in a fully automated analyzer, and studies of imprecision, limits of linearity, limits of detection, prozone effects, and interferences were carried out. The new method was compared with 2 other commercially available automated immunoassays for cCRP: one turbidimetric immunoassay (Gentian CRP) and one point-of-care assay based on magnetic permeability (Life Assays CRP). RESULTS The within-run and between-day imprecision were <1.7% and 4.2%, respectively. The assay quantified CRP proportionally in an analytic range up to 150 mg/L, with a prozone effect appearing at cCRP concentrations >320 mg/L. No interference from hemoglobin (20 g/L), triglycerides (10 g/L), or bilirubin (150 mg/L) was detected. Good agreement was observed between the results obtained with the new method and the Gentian cCRP turbidimetric immunoassay. CONCLUSIONS The new turbidimetric immunoassay (Turbovet canine CRP, Acuvet Biotech) is a rapid, robust, precise, and accurate method for the quantification of cCRP. The method can be easily set up in automated analyzers, providing a suitable tool for routine clinical use.
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Affiliation(s)
- Matilde Piñeiro
- Acuvet Biotech, Zaragoza, Spain.,PigCHAMP Pro Europa, Segovia, Spain
| | - Raquel Pato
- Servei de Bioquímica Clínica Veterinària (SBCV), Departament de Bioquímica i Biologia Molecular, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lourdes Soler
- Departamento de Bioquímica y Biología Molecular y Celular. Facultad de Ciencias, Universidad de Zaragoza, Zaragoza, Spain
| | - Raquel Peña
- Servei de Bioquímica Clínica Veterinària (SBCV), Departament de Bioquímica i Biologia Molecular, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain.,Laboratori de Referència d'Enzimologia Clínica (LREC), Departament de Bioquímica i Biologia Molecular, Unitat de Bioquímica de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Natalia García
- Departamento de Bioquímica y Biología Molecular y Celular. Facultad de Ciencias, Universidad de Zaragoza, Zaragoza, Spain
| | - Carlos Torrente
- Servicio de Urgencias y Cuidados Intensivos, FHCV-UAB, Departament de Medicina i Cirurgia Animal, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Yolanda Saco
- Servei de Bioquímica Clínica Veterinària (SBCV), Departament de Bioquímica i Biologia Molecular, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fermín Lampreave
- Departamento de Bioquímica y Biología Molecular y Celular. Facultad de Ciencias, Universidad de Zaragoza, Zaragoza, Spain
| | - Anna Bassols
- Servei de Bioquímica Clínica Veterinària (SBCV), Departament de Bioquímica i Biologia Molecular, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francesca Canalias
- Laboratori de Referència d'Enzimologia Clínica (LREC), Departament de Bioquímica i Biologia Molecular, Unitat de Bioquímica de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
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11
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Vasiu I, Dąbrowski R, Martinez-Subiela S, Ceron JJ, Wdowiak A, Pop RA, Brudaşcă FG, Pastor J, Tvarijonaviciute A. Milk C-reactive protein in canine mastitis. Vet Immunol Immunopathol 2017; 186:41-44. [PMID: 28413048 DOI: 10.1016/j.vetimm.2017.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 01/26/2017] [Accepted: 02/25/2017] [Indexed: 11/17/2022]
Abstract
Presence of mastitis in lactating bitches can become life threatening for both the bitch and pups. The aim of the present study was to evaluate a possible utility of C-reactive protein (CRP) in both milk and serum for canine mastitis diagnosis. Our study showed that milk CRP levels ranged between 0.1 and 4.9μg/mL and from 0.3 to 40.0μg/mL in healthy and diseased bitches (P<0.01), respectively, while serum CRP levels ranged between 2.0 and 8.6μg/mL and between 0.3 and 162.3μg/mL in healthy and diseased bitches (P<0.01), respectively. Milk and serum CRP levels were higher in both clinical and subclinical mastitis when compared with healthy controls (P<0.05 in all cases). However, no significant differences were recorded in CRP concentrations between clinical and subclinical cases. Based on these results, it could be concluded that serum and milk CRP could be useful in order to diagnose canine mastitis.
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Affiliation(s)
- Iosif Vasiu
- Department and Clinic of Infectious Diseases, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine, 3-5 Calea Mănăştur St, 400372 Cluj-Napoca, Romania.
| | - Roman Dąbrowski
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 30 Gleboka St, 20-612 Lublin, Poland
| | - Silvia Martinez-Subiela
- Interdisciplinary Laboratory of Clinical Analysis Interlab-UMU, Faculty of Veterinary Medicine, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Espinardo, Murcia 30100, Spain
| | - Jose J Ceron
- Interdisciplinary Laboratory of Clinical Analysis Interlab-UMU, Faculty of Veterinary Medicine, Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Espinardo, Murcia 30100, Spain
| | - Anna Wdowiak
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 30 Gleboka St, 20-612 Lublin, Poland
| | - Raul Alexandru Pop
- Department and Clinic of Reproduction, Obstetrics and Gynecology, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine, 3-5 Calea Mănăştur St, 400372 Cluj-Napoca, Romania
| | - Florinel Gheorghe Brudaşcă
- Department and Clinic of Infectious Diseases, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine, 3-5 Calea Mănăştur St, 400372 Cluj-Napoca, Romania
| | - Josep Pastor
- Department of Animal Medicine and Surgery, Veterinary School, University Autonoma of Barcelona, Barcelona, Spain
| | - Asta Tvarijonaviciute
- Department of Animal Medicine and Surgery, Veterinary School, University Autonoma of Barcelona, Barcelona, Spain
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12
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Vilar JM, Damiá E, Rubio M, Santana A, Sopena J, Ceron J, Tvarijonaviciute A, Cugat R, Carrillo JM. Therapeutic doses of plasma rich in growth factors cannot provoke cancer by means of the IGF-1 pathway or inflammation in dogs. JOURNAL OF APPLIED ANIMAL RESEARCH 2016. [DOI: 10.1080/09712119.2016.1218888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Jose M Vilar
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Elena Damiá
- Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, Valencia, Spain
| | - Mónica Rubio
- Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, Valencia, Spain
| | - Angelo Santana
- Department of Mathematics, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Joaquin Sopena
- Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, Valencia, Spain
| | - Joaquin Ceron
- Departamento de Medicina y cirugía animal, Universidad de Murcia, Murcia, Spain
| | | | - Ramón Cugat
- Artroscopia Garcia Cugat. Plaça Alfonso Comín, Barcelona, Spain
| | - Jose Maria Carrillo
- Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, Valencia, Spain
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13
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Christensen MB, Eriksen T, Kjelgaard-Hansen M. C-reactive protein: quantitative marker of surgical trauma and post-surgical complications in dogs: a systematic review. Acta Vet Scand 2015; 57:71. [PMID: 26483038 PMCID: PMC4615867 DOI: 10.1186/s13028-015-0164-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Accepted: 10/11/2015] [Indexed: 01/04/2023] Open
Abstract
C-reactive protein (CRP) is a major acute phase protein showing increasing serum concentrations in dogs with systemic inflammation following e.g., surgery, trauma, infections, or neoplasia. CRP is
a useful diagnostic marker of systemic inflammation in dogs and automated assays have been validated for reliable measurements for routine diagnostic purposes. In the present study available evidence for the use of CRP as a marker of surgery related systemic inflammation in dogs was reviewed and assessed. Two main themes were in focus: (1) canine CRP as a potential marker of postsurgical infectious complications and (2) canine CRP as a marker of the degree of surgical trauma. As outlined in the review several studies suggest that CRP is a useful marker for both purposes. However, the evidence level is limited and studies in the field are all affected by considerable risks of bias. Thus, further studies are needed in order to confirm the assumptions from previous studies and increase the level of evidence for CRP as a useful marker for detecting inflammation after surgery in dogs.
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14
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Dąbrowski R, Pastor J, Szczubiał M, Piech T, Bochniarz M, Wawron W, Tvarijonaviciute A. Serum IL-6 and IL-10 concentrations in bitches with pyometra undergoing ovariohysterectomy. Acta Vet Scand 2015; 57:61. [PMID: 26410584 PMCID: PMC4584008 DOI: 10.1186/s13028-015-0153-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 09/21/2015] [Indexed: 11/29/2022] Open
Abstract
Background Pyometra is a serious bacterial infection of the uterus affecting female dogs and manifests as an accumulation of pus in the uterine lumen. The aim of the study was to assess changes in serum interleukin (IL)-6 and IL-10 concentrations in bitches with pyometra undergoing ovariohysterectomy. Findings Blood samples were collected from healthy bitches (controls) and bitches with pyometra before surgery, and 3 and 10 days after ovariohysterectomy. Before surgery, bitches with pyometra had significantly higher serum concentrations of IL-6 and IL-10 than the controls. After surgery, the serum concentration of IL-6 and IL-10 decreased significantly. In healthy dogs, the concentration of IL-6 and IL-10 showed a significant increase 3 days after surgery followed by a decrease on day 10. Conclusion An increase in serum concentrations of IL-6 and IL-10 was present before surgery in bitches with pyometra and 3 days after ovariohysterectomy in healthy controls. Concentrations decreased after ovariohysterectomy and/or proper healing, suggesting that these cytokines can be useful for assessment of the postoperative period in bitches.
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15
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Dąbrowski R, Hagman R, Tvarijonaviciute A, Pastor J, Kocki T, Turski WA. Serum tryptophan and its metabolites in female dogs undergoing ovariohysterectomy as treatment of pyometra or as elective spay surgery. Theriogenology 2015; 83:1279-86. [DOI: 10.1016/j.theriogenology.2015.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 11/29/2014] [Accepted: 01/09/2015] [Indexed: 10/24/2022]
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