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Rattka M, Mavrakis E, Vlachopoulou D, Rudolph I, Kohn C, Bohnen J, Yahsaly L, Siebermair J, Wakili R, Jungen C, Rassaf T, Mathew S. Pulsed field ablation and cryoballoon ablation for pulmonary vein isolation: insights on efficacy, safety and cardiac function. J Interv Card Electrophysiol 2024:10.1007/s10840-024-01748-4. [PMID: 38273159 DOI: 10.1007/s10840-024-01748-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/10/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Pulmonary vein isolation (PVI) has become the cornerstone treatment of atrial fibrillation (AF). While in cryoablation cell damage is caused by thermal effects, lately, pulsed field ablation (PFA) has been established as a novel non-thermal tissue-specific ablation modality for PVI. However, data comparing outcomes of patients undergoing either PFA or cryoballoon ablation (CBA) for primary PVI are sparse. METHODS Consecutive patients with AF undergoing PVI by either CBA or PFA were included in the analysis. The primary outcome was the time to AF/AT recurrence. For secondary outcomes, clinical and periprocedural parameters were compared. RESULTS In total, outcomes of 141 AF patients treated by PFA (94 patients) or CBA (47 patients) were compared. After 365 days, 70% of patients in the PFA group and 61% of patients in the CBA group were free from AF/AT (HR 1.35, 95% CI 0.60-3.00; p = 0.470). No deaths occurred. While symptoms alleviated in both groups, only after PFA, we observed significant improvement of left atrial volume index (PFA group baseline: 40 [31;62] ml/m2, PFA group follow-up: 35 [29;49] ml/m2; p = 0.015), NT-pro BNP levels (PFA group baseline: 1106 ± 2479 pg/ml, PFA group follow-up: 1033 ± 1742 pg/ml; p = 0.048), and left ventricular ejection fraction (LVEF) (PFA group baseline: 55 [48;60] %, PFA group follow-up: 58 [54;63] %; p = 0.006). PVI by PFA was the only independent predictor of LVEF improvement. CONCLUSION In our study, we show that CBA and PFA for PVI are of similar efficacy when it comes to AF recurrence. However, our findings suggest that PFA rather than CBA might induce left atrial reverse remodeling thereby contributing to left ventricular systolic function.
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Affiliation(s)
- Manuel Rattka
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Evangelos Mavrakis
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Dimitra Vlachopoulou
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Isabel Rudolph
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Christina Kohn
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Jan Bohnen
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Loubna Yahsaly
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Johannes Siebermair
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
- Krankenhaus Goettlicher Heiland, Vienna, Austria
| | - Reza Wakili
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
- Department of Cardiology and Vascular Medicine, University Hospital Frankfurt, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Christiane Jungen
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Shibu Mathew
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany.
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Shakarchi AF, Assi L, Gami A, Kohn C, Ehrlich JR, Swenor BK, Reed NS. The Association of Vision, Hearing, and Dual-Sensory Loss with Walking Speed and Incident Slow Walking: Longitudinal and Time to Event Analyses in the Health and Retirement Study. Semin Hear 2021; 42:75-84. [PMID: 33883794 DOI: 10.1055/s-0041-1726017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
With the aging of the population, vision (VL), hearing (HL), and dual-sensory (DSL, concurrent VL and HL) loss will likely constitute important public health challenges. Walking speed is an indicator of functional status and is associated with mortality. Using the Health and Retirement Study, a nationally representative U.S. cohort, we analyzed the longitudinal relationship between sensory loss and walking speed. In multivariable mixed effects linear models, baseline walking speed was slower by 0.05 m/s (95% confidence interval [CI] = 0.04-0.07) for VL, 0.02 (95% CI = 0.003-0.03) for HL, and 0.07 (95% CI = 0.05-0.08) for DSL compared with those without sensory loss. Similar annual declines in walking speeds occurred in all groups. In time-to-event analyses, the risk of incident slow walking speed (walking speed < 0.6 m/s) was 43% (95% CI = 25-65%), 29% (95% CI = 13-48%), and 35% (95% CI = 13-61%) higher among those with VL, HL, and DSL respectively, relative to those without sensory loss. The risk of incident very slow walking speed (walking speed < 0.4 m/s) was significantly higher among those with HL and DSL relative to those without sensory loss, and significantly higher among those with DSL relative to those with VL or HL alone. Addressing sensory loss and teaching compensatory strategies may help mitigate the effect of sensory loss on walking speed.
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Affiliation(s)
- Ahmed F Shakarchi
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Lama Assi
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland.,Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Abhishek Gami
- Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Christina Kohn
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Bonnielin K Swenor
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Nicholas S Reed
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Reed NS, Stolnicki W, Gami A, Myers C, Kohn C, Willink A. Association of Self-Reported Trouble Hearing and Patient-Provider Communication with Hospitalizations among Medicare Beneficiaries. Semin Hear 2021; 42:26-36. [PMID: 33883789 PMCID: PMC8050416 DOI: 10.1055/s-0041-1725998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Several studies have recently illuminated the relationship between hearing loss and hospitalizations, but little is understood as to why hearing loss is associated with greater risk for hospitalizations. This study examines the role of patient-provider communication as the mechanism by which those with hearing loss are more likely to be hospitalized, using the self-reported data from 12,654 Medicare beneficiaries from the 2016 Medicare Current Beneficiary Survey (MCBS) Cost and Use File. Multivariable logistic regression was used to model the odds of any hospitalization in the past year and negative binomial regression to model the incident rate ratio of hospitalization based on number of hospitalizations in the past year. It was found that Medicare beneficiaries who experience impaired communication with their physician due to trouble hearing have greater odds of hospitalization and a higher rate of all hospitalization over a 1-year period. Understanding the complex relationship between hearing loss, patient-provider communication, and hospitalizations may provide health care professionals with a better rational to address not only hearing loss but also impaired communication in the care of an individual.
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Affiliation(s)
- Nicholas S. Reed
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland,Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland,Address for correspondence Nicholas S. Reed, Au.D. 2024 E. Monument St, 2-700, Baltimore, MD 21211
| | | | - Abhishek Gami
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Clarice Myers
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Christina Kohn
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Amber Willink
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland,Mcnzies Centre for Health Policy, University of Sydney, Sydney, NSW, Australia
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Schuster M, Moeller M, Bornemann L, Bessen C, Sobczak C, Schmitz S, Witjes L, Kruithoff K, Kohn C, Just O, Kündgen A, Pundt N, Pelzer B, Ampe C, Van Troys M, Nusch A, Haas R, Germing U, Martens L, Jöckel KH, Gunzer M. Surveillance of Myelodysplastic Syndrome via Migration Analyses of Blood Neutrophils: A Potential Prognostic Tool. J Immunol 2018; 201:3546-3557. [PMID: 30446567 DOI: 10.4049/jimmunol.1801071] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 10/16/2018] [Indexed: 11/19/2022]
Abstract
Autonomous migration is a central characteristic of immune cells, and changes in this function have been correlated to the progression and severity of diseases. Hence, the identification of pathologically altered leukocyte migration patterns might be a promising approach for disease surveillance and prognostic scoring. However, because of the lack of standardized and robust assays, migration patterns have not been clinically exploited so far. In this study, we introduce an easy-to-use and cross-laboratory, standardized two-dimensional migration assay for neutrophil granulocytes from peripheral blood. By combining time-lapse video microscopy and automated cell tracking, we calculated the average migration of neutrophils from 111 individual participants of the German Heinz Nixdorf Recall MultiGeneration study under steady-state, formyl-methionyl-leucyl-phenylalanine-, CXCL1-, and CXCL8-stimulated conditions. Comparable values were obtained in an independent laboratory from a cohort in Belgium, demonstrating the robustness and transferability of the assay. In a double-blinded retrospective clinical analysis, we found that neutrophil migration strongly correlated with the Revised International Prognostic Scoring System scoring and risk category of myelodysplastic syndrome (MDS) patients. In fact, patients suffering from high-risk subtypes MDS with excess blasts I or II displayed highly significantly reduced neutrophil migration. Hence, the determination of neutrophil migration patterns might represent a useful tool in the surveillance of MDS. Taken together, we suggest that standardized migration assays of neutrophils and other leukocyte subtypes might be broadly applicable as prognostic and surveillance tools for MDS and potentially for other diseases.
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Affiliation(s)
- Marc Schuster
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, 45147 Essen, Germany
| | - Mischa Moeller
- Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine University Düsseldorf, 40225 Düsseldorf, Germany
| | - Lea Bornemann
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, 45147 Essen, Germany
| | - Clara Bessen
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, 45147 Essen, Germany
| | - Charlyn Sobczak
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, 45147 Essen, Germany
| | - Saskia Schmitz
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, 45147 Essen, Germany
| | - Laura Witjes
- Department of Biochemistry, Ghent University, 9000 Ghent, Belgium
| | - Katja Kruithoff
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, 45147 Essen, Germany
| | - Christina Kohn
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, 45147 Essen, Germany
| | - Olga Just
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, 45147 Essen, Germany
| | - Andrea Kündgen
- Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine University Düsseldorf, 40225 Düsseldorf, Germany
| | - Noreen Pundt
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital, University Duisburg-Essen, 45147 Essen, Germany
| | - Benedikt Pelzer
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, 45147 Essen, Germany
| | - Christophe Ampe
- Department of Biochemistry, Ghent University, 9000 Ghent, Belgium
| | | | - Arnd Nusch
- Onkologische Praxis Velbert, 40822 Mettmann, Germany; and
| | - Rainer Haas
- Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine University Düsseldorf, 40225 Düsseldorf, Germany
| | - Ulrich Germing
- Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine University Düsseldorf, 40225 Düsseldorf, Germany
| | - Lennart Martens
- Department of Biochemistry, Ghent University, 9000 Ghent, Belgium.,VIB-UGent Center for Medical Biotechnology, Ghent University, 9000 Ghent, Belgium
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital, University Duisburg-Essen, 45147 Essen, Germany
| | - Matthias Gunzer
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, 45147 Essen, Germany;
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Kohn C, Klemens JM, Kascholke C, Murthy NS, Kohn J, Brandenburger M, Hacker MC. Dual-component collagenous peptide/reactive oligomer hydrogels as potential nerve guidance materials - from characterization to functionalization. Biomater Sci 2018; 4:1605-1621. [PMID: 27722483 DOI: 10.1039/c6bm00397d] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Toward a new generation of improved nerve guidance conduits (NGCs), novel biomaterials are required to address pressing clinical shortcomings in peripheral nerve regeneration (PNR) and to promote biological performance. A dual-component hydrogel system formed by cross-linking reaction between maleic anhydride groups in an oligomeric building block for cross-linking of free amine functionalities in partially hydrolyzed collagen is formulated for continuous processing and NGC fabrication. The influence of the gelation base is optimized for processing from a double syringe delivery system with a static mixer. A hydrophilic low-concentrated base was introduced to control network formation and to utilize highly reactive macromers for gelation. Cross-linking extent and building block conversion were improved and homogenous monoliths were fabricated. Chemically derivatized hydrogels were obtained by conversion of a fraction of anhydride groups in the oligomeric precursor with monovalent primary amine-containing grafting molecules prior to gelation. Network stability in functionalized hydrogels was maintained and cationic moieties were implement to the gel that promoted in vitro cell attachment and spreading irrespective of mechanical stiffness. A molding strategy was introduced that allowed for fabrication of flexible tubular conduits in tunable dimensions and with chemically patterned structures. These hydrogel-based conduits hold promise for the next generation NGCs with integrated chemical cues for PNR.
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Affiliation(s)
- C Kohn
- Institute of Pharmacy, Pharmaceutical Technology, Leipzig University, 04317 Leipzig, Germany.
| | - J M Klemens
- Fraunhofer Research Institution for Marine Biotechnology EMB, 23562 Lübeck, Germany
| | - C Kascholke
- Institute of Pharmacy, Pharmaceutical Technology, Leipzig University, 04317 Leipzig, Germany.
| | - N S Murthy
- New Jersey Center for Biomaterials, Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854-8066, USA
| | - J Kohn
- New Jersey Center for Biomaterials, Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854-8066, USA
| | - M Brandenburger
- Fraunhofer Research Institution for Marine Biotechnology EMB, 23562 Lübeck, Germany
| | - M C Hacker
- Institute of Pharmacy, Pharmaceutical Technology, Leipzig University, 04317 Leipzig, Germany.
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Richter D, Kohn C, Matuschka FR. Absence of Borrelia spp., Candidatus Neoehrlichia mikurensis, and Anaplasma phagocytophilum in questing adult Dermacentor reticulatus ticks. Parasitol Res 2012; 112:107-11. [PMID: 22955502 DOI: 10.1007/s00436-012-3110-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 08/24/2012] [Indexed: 11/28/2022]
Abstract
To determine whether Dermacentor reticulatus ticks are infected by Borrelia spp., Candidatus Neoehrlichia mikurensis, or Anaplasma phagocytophilum, we collected questing adults in the outskirts of Berlin, Germany, examined them for the presence of DNA of these pathogens, and compared the infection rates to those of sympatric Ixodes ricinus ticks. Questing D. reticulatus adults appeared not to harbor the bacterial pathogens that are prevalent in I. ricinus ticks. Based on our sample size, the estimated prevalence of each of these pathogens in D. reticulatus ticks would be well below three tenth of a percent (<0.3 %). For pathogens which so rarely infect D. reticulatus ticks, this tick likely plays no epidemiologic vector role for either their enzootic transmission cycle in nature or their transmission to people.
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Affiliation(s)
- Dania Richter
- Abteilung Parasitologie, Institut für Pathologie, Charité Universitätsmedizin Berlin, Malteserstraße 74-100, 12249, Berlin, Germany.
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Murphy JE, Frazer G, Munsterman A, Weisbrode S, Kohn C, Beard W. Endometrial stromal hyperplasia and mass formation in a yearling Quarter Horse. EQUINE VET EDUC 2010. [DOI: 10.1111/j.2042-3292.2005.tb00359.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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9
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Kohn C. Crazy therapies: What are they? Do they work? By M. Thaler Singer and J. Lalich. San Francisco, CA: Jossey-Bass Publishers, 1996, 288 pp. $23.00. Clin Psychol Rev 1997. [DOI: 10.1016/s0272-7358(97)00024-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kohn C, Schumann J. Nucleotide sequence and homology comparison of two genes of the sulfate transport operon from the cyanobacterium Synechocystis sp. PCC 6803. Plant Mol Biol 1993; 21:409-412. [PMID: 8425067 DOI: 10.1007/bf00019958] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The genome of Synechocystis sp. PCC 6803 contains an operon with homology to the sulfate permease of other prokaryotes. We used antibodies raised against cytoplasmic membrane protein to find three genes with strong homology to sbpA, orf81 and cysT genes of the cyanobacterium Synechococcus sp. PCC 7942, Escherichia coli, Salmonella typhimurium and Marchantia polymorpha. It is likely that the permease genes are expressed and the proteins are inserted into the cytoplasmic membrane.
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Affiliation(s)
- C Kohn
- Institut für Biochemie der Pflanzen, Heinrich-Heine-Universität Düsseldorf, Germany
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Weiser G, Kohn C, Vachon A. Erythrocyte volume distribution analysis and hematologic changes in two horses with immune-mediated hemolytic anemia. Vet Pathol 1983; 20:424-33. [PMID: 6623846 DOI: 10.1177/030098588302000405] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Immune-mediated hemolytic anemia was diagnosed in two horses on the basis of regenerative anemia, increased erythrocyte fragility in hypotonic saline, autoagglutination, and a positive direct antiglobulin (Coomb's) test. During steroid therapy partial resolution of the anemia was indicated by rising packed cell volume, macrocytosis, and bone marrow erythroid hyperplasia. Using erythrocyte volume distribution histograms (erythrograms), the regenerative response was characterized by analysis of macrocytic and normocytic erythrocyte subpopulations. In both horses, a gradual net increase of about 2 X 10(6) macrocytes/microliter occurred over a four- to five-week period. Over the same interval there was a gradual decrease in the number of normocytes. We suggest that the macrocytes remained large through this period rather than contributing to normocyte population growth. Erythrograms may provide an additional means of evaluating erythrocyte regeneration in horses.
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Beech J, Kohn C, Leitch M, Weinstein AJ, Gallagher M. Therapeutic use of gentamicin in horses: concentrations in serum, urine, and synovial fluid and evaluation of renal function. Am J Vet Res 1977; 38:1085-7. [PMID: 883716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Serum, synovial fluid, and urine concentrations of gentamicin were measured in normal mature horses which had been given a single dose of the drug. Mean peak serum concentration (16.8 microgram/ml) occurred in horses 30 minutes after they were given a single intramuscular dose of 4.4 mg of gentamicin/kg of body weight. In horses given a smaller dose of gentamicin (1.7 mg/kg), mean peak serum concentrations of gentamicin (10.2 microgram/ml) appeared at 1 hour. Synovial fluid concentration was maximum at 2 hours for both doses; in horses given the larger dose, mean peak concentration was 6.4 microgram/ml, and in those given the smaller dose (1.7 mg/kg), 3.4 microgram/ml. Measurable concentrations of gentamicin in serum and synovial fluid persisted 8 hours. During the first 8 hours, percentages of gentamicin excreted in the urine were between 3.9 and 32.8% of the larger dose and between 3.3 and 13.4% of the smaller dose. Serum creatinine concentrations were serially measured in 10 hospitalized horses intramuscularly given 1.7 to 4.4 mg of gentamicin/kg 4 times a day' significant increase in creatinine concentration was not found.
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Carrizosa J, Kohn C, Levison ME. Experimental aspergillus endocarditis in rabbits. J Lab Clin Med 1975; 86:746-53. [PMID: 1102621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Aspergillus endocarditis in man usually occurs on prosthetic cardiac valves and gives rise to large vegetations which embolize easily producing peripheral organ infarction and infection. Blood cultures are usually sterile and the disease is difficult to cure with antimicrobial agents. Aspergillus endocarditis was studied in rabbits to determine the course, degree of fungemia, and response to treatment with amphotericin B (A), 5 flucytosine (5 FC) or A + 5 FC. Polyethylene tubing was introduced into the left ventricle through the carotid artery and 24 hours later animals were inoculated with 10(4) to 10(7) spores of a strain of Aspergillus fumigatus. Large occlusive vegetations developed on the aortic valves. Spontaneous mortality reached 67 per cent after 3 days. Despite large aggregates of mycelia seen beneath a layer of amorphous material on microscopic sections, vegetations contained only 10(3) to 10(5) colony forming units (CFU) of aspergilli per gram, suggesting the aspergilli in tissues were clumped. Disseminated infection involving kidney, lung, liver, spleen, and brain occurred. Animals without intracardiac tubing which received the same inoculum of spores did not develop endocarditis, but showed evidence of disseminated infection. Blood after 24 hours of infection grew aspergilli only when large volumes were cultured and then only a small fraction of the total volume of blood obtained for culture yielded aspergilli, suggesting that the aspergilli in blood were clumped. Sterile vegetations in the absence of an intracardiac catheter were resistant to infection with aspergilli, but once established, infection with aspergilli persisted on vegetations despite removal of the catheter. Treatment of infected animals with A (1 mg. per kilogram), 5 FC (25 or 50 mg. per kilogram) or A + 5 FC daily intraperitoneally, significantly lowered the number of CFU per gram of vegetation.
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