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Benvenuti E, Ferriani R, Gianella P, Ruggiero P, Cagnasso F, Borrelli A, Benvenuto G, Bertoldi L, Bottero E. The fecal bacterial microbiota is not useful for discriminating between lymphoplasmacytic enteritis and low-grade intestinal T-cell lymphoma in cats nor for predicting therapeutic response. Am J Vet Res 2024; 85:ajvr.23.11.0251. [PMID: 38316105 DOI: 10.2460/ajvr.23.11.0251] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/16/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE To evaluate the fecal bacterial microbiota at the time of diagnosis (T0) and after 1 month of therapy (T1) in cats diagnosed with lymphoplasmacytic enteritis (LPE) or cats with low-grade intestinal T-cell lymphoma (LGITL) and to compare these findings with those of healthy cats. ANIMALS 5 healthy cats, 13 cats with LPE, and 7 cats with LGITL were prospectively enrolled between June 2020 and June 2021. METHODS Fecal samples were collected at T0 and T1, and DNA was extracted for 16S ribosomal amplicon sequencing. Alpha diversity and beta diversity were computed. The taxonomic assignment was performed using sequences from the Silva v138 formatted reference database. Differential abundant taxa were selected in each taxonomic level, with the P value adjusted < .05, as the cut-off. RESULTS No significant differences in alpha and beta diversity were found either at T0 or T1 between healthy and diseased cats or between cats with LPE and LGITL. Beta-diversity analysis showed an increase in the Fusobacteriaceae family in cats with LGITL at T0, compared to cats with LPE. Regardless of histological diagnosis, several microbiota differences were found at T0 based on serum cobalamin levels. CLINICAL RELEVANCE Fecal samples were successfully used to characterize the bacteriome of the intestinal tract in cats by 16S rRNA gene sequencing. However, results highlighted that the metagenomic evaluation was not useful to discriminate between LPE and LGITL nor to predict the therapeutic response in this study population.
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Affiliation(s)
| | - Riccardo Ferriani
- Endovet Italian Professional Association, Rome, Italy
- Ospedale Veterinario San Francesco, Milan, Italy
| | - Paola Gianella
- Department of Veterinary Science, University of Turin, Turin, Italy
| | | | | | - Antonio Borrelli
- Department of Veterinary Science, University of Turin, Turin, Italy
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Pierini A, Criscuolo MC, Caccamo R, Bottero E, Campanile A, Pisani G, Marchetti V, Benvenuti E. A case series of urinary bladder rhabdomyosarcoma in seven dogs. Open Vet J 2023; 13:1498-1503. [PMID: 38107227 PMCID: PMC10725289 DOI: 10.5455/ovj.2023.v13.i11.15] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/24/2023] [Indexed: 12/19/2023] Open
Abstract
Background Juvenile urinary bladder rhabdomyosarcoma (ubRMS) is a known entity; however, literature regarding its clinical behavior and endoscopic features is scarce. The aim of this study was to describe clinical and endoscopic features, and outcomes of ubRMS in dogs. Case Description Dogs undergoing transurethral endoscopy and with a histological diagnosis of ubRMS were retrospectively collected. Seven dogs with a median age of 18 months (range 6-32 months) were included in this retrospective, multicenter, and descriptive study. Median tumor size was 58 mm (range 30-65 mm), and tumor location was bladder neck in three cases, trigone in two cases, and bladder body in two cases. Two dogs had monolateral ureteral obstruction. Two dogs presented with regional lymphadenopathy and one dog had lung lesions suggestive of metastatic disease. A grape-like mass was reported in four cases and solid in two, with variable consistency (two friables, two firms, and two not reported). Tumor treatments included surgery in three cases, surgery, and adjuvant doxorubicin in one case, and palliative therapy in three cases. The overall median survival time (ST) was 45 days. STs were shorter (range 20-45 days) for dogs treated with palliative care than for dogs treated with curative-intent treatment (range 70-120 days). Conclusion ubRMS should be considered as a differential diagnosis in young dogs presenting with bladder masses. In this study, ubRMS confirmed its aggressive clinical behavior. Surgery and chemotherapy seem to increase STs but the prognosis remains poor.
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Affiliation(s)
- Alessio Pierini
- Department of Veterinary Sciences, Veterinary Teaching Hospital “Mario Modenato,” University of Pisa, Pisa, Italy
- Centro Veterinario Dott. Pisani-Carli-Chiodo, Luni Mare-Ortonovo, Italy
| | - Maria Carla Criscuolo
- Department of Veterinary Sciences, Veterinary Teaching Hospital “Mario Modenato,” University of Pisa, Pisa, Italy
- Centro Veterinario Dott. Pisani-Carli-Chiodo, Luni Mare-Ortonovo, Italy
| | - Roberta Caccamo
- Department of Animal Pathology, School of Veterinary Medicine, University of Turin, Torino, Italy
- Endovet Professional Association, Roma, Italy
| | | | | | - Guido Pisani
- Centro Veterinario Dott. Pisani-Carli-Chiodo, Luni Mare-Ortonovo, Italy
| | - Veronica Marchetti
- Department of Veterinary Sciences, Veterinary Teaching Hospital “Mario Modenato,” University of Pisa, Pisa, Italy
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Benvenuti E, Reho GA, Palumbo S, Fraldi M. Mechanics of tensegrity cell units incorporating asymmetry and insights into mollitaxis. J R Soc Interface 2023; 20:20230082. [PMID: 37194274 DOI: 10.1098/rsif.2023.0082] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
The mechanical response of a contractile cell anchored to the substrate through focal adhesions is studied by means of an asymmetric pre-strained tensegrity structure obeying a neo-Hookean stress-strain law. The aim is to assess the influence of overall asymmetric contraction on the cell durotaxis and on the growth of the focal adhesion plaque. The asymmetric kinematics of the system is obtained in two ways, that is by assuming a gradient of the substrate stiffness and through asymmetric buckling. Equivalent springs are purposely considered to represent the stiffness of the ensemble formed by the substrate, the focal adhesion plaque and the integrin ligands. Then, contraction results from elastic strains induced by competing polymerization and actomyosin contraction. The cell mechanical response in terms of durotaxis and its coupling with focal adhesion plaque growth is finally analysed with respect to the effects of asymmetry, gaining some insights into how this asymmetry could participate to redirect cell migration, both in terms of durotaxis and mollitaxis.
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Affiliation(s)
- E Benvenuti
- Engineering Department, University of Ferrara, Ferrara, Italy
| | - G A Reho
- Engineering Department, University of Ferrara, Ferrara, Italy
| | - S Palumbo
- Department of Structures for Engineering and Architecture, University of Napoli Federico II, Napoli, Italy
| | - M Fraldi
- Department of Structures for Engineering and Architecture, University of Napoli Federico II, Napoli, Italy
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Cagnasso F, Borrelli A, Bottero E, Benvenuti E, Ferriani R, Marchetti V, Ruggiero P, Bruno B, Maurella C, Gianella P. Comparative Evaluation of Peripheral Blood Neutrophil to Lymphocyte Ratio, Serum Albumin to Globulin Ratio and Serum C-Reactive Protein to Albumin Ratio in Dogs with Inflammatory Protein-Losing Enteropathy and Healthy Dogs. Animals (Basel) 2023; 13:ani13030484. [PMID: 36766371 PMCID: PMC9913579 DOI: 10.3390/ani13030484] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/23/2023] [Accepted: 01/28/2023] [Indexed: 01/31/2023] Open
Abstract
Few routinely available biomarkers are clinically useful in assessing dogs with inflammatory protein-losing enteropathy caused by immunosuppressive-responsive enteropathy (IRE-PLE). Only the neutrophil to lymphocyte ratio (NLR) has been studied, while no information exists on the use of the albumin to globulin ratio (AGR) and C-reactive protein to albumin ratio (CRP/ALB). We aimed to evaluate the clinical significance of the NLR, AGR and CRP/ALB in a population of dogs with IRE-PLE. The medical records of 53 IRE-PLE dogs were reviewed at the time of diagnosis (T0) and 1 month after the initiation of immunosuppressants (T1). A control group of 68 healthy dogs was used for comparison. At T0, the median values of the NLR and AGR of sick dogs were significantly higher and lower than those of healthy dogs, respectively. With the increase in the chronic enteropathy activity index, AGR and CRP/ALB significantly decreased and increased, respectively. At T1, NLR and AGR significantly increased, while CRP/ALB significantly decreased. NLR, AGR and CRP/ALB did not differ significantly between dogs classified as responders and nonresponders according to the chronic enteropathy activity index. Further studies are needed to provide more information on this subject.
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Affiliation(s)
- Federica Cagnasso
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini 2, 10095 Grugliasco, Italy
| | - Antonio Borrelli
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini 2, 10095 Grugliasco, Italy
| | | | | | | | - Veronica Marchetti
- Department of Veterinary Sciences, University of Pisa, Via Livornese Lato Monte, 56121 Pisa, Italy
| | | | - Barbara Bruno
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini 2, 10095 Grugliasco, Italy
| | - Cristiana Maurella
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d’Aosta, Via Bologna, 220, 10154 Torino, Italy
| | - Paola Gianella
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini 2, 10095 Grugliasco, Italy
- Correspondence:
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Benvenuti E, Reho GA, Palumbo S, Fraldi M. Pre-strains and buckling in mechanosensitivity of contractile cells and focal adhesions: A tensegrity model. J Mech Behav Biomed Mater 2022; 135:105413. [PMID: 36057207 DOI: 10.1016/j.jmbbm.2022.105413] [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] [Received: 06/17/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 10/31/2022]
Abstract
We demonstrate that several key aspects of the contractile activity of a cell interacting with the substrate can be captured by means of a non linear elastic tensegrity mechanical system made of a tensile element in parallel with a buckling-prone component, and exchanging forces with the surroundings through an extracellular matrix-focal adhesion complex. Mechanosensitivity of the focal adhesion plaque is triggered by pre-strain-driven buckling of the system induced either by pre-contraction or pre-polymerization of the constituents. The impact of pre-polymerization on the mechanical force and the implications of using linear and nonlinear elasticity for the focal adhesion plaque are assessed.
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Affiliation(s)
- E Benvenuti
- Engineering Department, University of Ferrara, Italy.
| | - G A Reho
- Engineering Department, University of Ferrara, Italy
| | - S Palumbo
- Department of Structures for Engineering and Architecture, University of Napoli Federico II, Italy
| | - M Fraldi
- Department of Structures for Engineering and Architecture, University of Napoli Federico II, Italy.
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Pierini A, Criscuolo MC, Bonfanti U, Benvenuti E, Marchetti V, Bottero E. Usefulness of squash preparation cytology in the diagnosis of canine urinary bladder carcinomas. Vet Clin Pathol 2022; 51:498-506. [PMID: 35854403 DOI: 10.1111/vcp.13151] [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] [Received: 09/01/2021] [Revised: 04/05/2022] [Accepted: 04/25/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Epithelial cells show varying degrees of cytologic atypia in dogs with nonmalignant lesions (NML) and carcinomas (ubC) of the bladder, making histopathologic examination necessary for a definitive diagnosis. OBJECTIVES This study aimed to investigate the diagnostic performance of squash preparation cytology and identify several cytomorphologic features of ubC to assist in diagnoses. METHODS Squash preparations were made and reviewed in dogs that underwent transurethral cystoscopy. The results were compared with histopathologic diagnoses. Two cytopathologists performed blinded assessments using a scoring system established for 11 cytologic features, including the presence of macronuclei, abnormal nucleoli, atypical mitoses, signet ring cells, multinucleated cells, nuclear molding, anisokaryosis, cytoplasmatic microvacuolization, cell arrangements, and neutrophil and lymphocyte infiltrations. Based on cytologic and histopathologic diagnoses, dogs were divided into ubC and NML groups. Associations between cytologic and histopathologic diagnoses were investigated, and agreement between the cytopathologists was calculated. Cytologic features were analyzed with multivariate logistic regression models. The performance of predictors in the final model was evaluated in terms of Sensitivity (Se), Specificity (Sp), accuracy, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio positive (LR+), and negative (LR-) values, and the diagnostic odds ratio (DOR). RESULTS Forty-four dogs diagnosed with ubC, and 17 with NML were included in the study. Cytologic and histopathologic diagnoses were significantly associated with each cytopathologist. There was an almost perfect agreement between cytopathologists (κ = 0.88). The absence of neutrophilic infiltration, the presence of multinucleated cells, and nuclear molding were associated with ubC; using a combination of these features in parallel testing resulted in Se = 0.98, Sp = 0.65, accuracy = 0.89, PPV = 0.88, NPV = 0.92, LR + =2.77, LR- = 0.04, and DOR = 7.7. CONCLUSIONS Squash preparation cytology could be a reliable technique to diagnose ubC in dogs. The best diagnostic combination was the absence of neutrophilic infiltration, multinucleated cells, and nuclear molding.
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Affiliation(s)
- Alessio Pierini
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | | | - Ugo Bonfanti
- MYLAV La Vallonea, Veterinary Laboratory, Milan, Italy
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Bottero E, Pierini A, Ruggiero P, Cattaneo D, Campanile A, Benvenuti E. Gastroduodenal ulceration detected endoscopically in cats: retrospective study of 61 patients. J Feline Med Surg 2022; 24:e347-e352. [PMID: 35848606 DOI: 10.1177/1098612x221109802] [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: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to describe the endoscopic appearance of gastroduodenal ulcers (GDUs), and to assess the clinical, ultrasonographic and histological data, as well as long-term follow-up, in cats. METHODS The medical record databases of five veterinary endoscopists were evaluated between January 2016 and 2020, in a retrospective study. Cats with at least one gastric or duodenal ulcer detected by endoscopic examination were included. All the medical records of the selected cats were reviewed and information was collected regarding breed, age, sex, neuter status, medical history, clinical signs, and ultrasonographic, endoscopic and histological findings. The cats were evaluated at 6, 12 and 18 months. RESULTS Sixty-one cats with a median age of 9.0 years (range 2.0-16.0) were included in the study. The most common complaints were vomiting (n = 55; 90%) and hyporexia (n = 40; 66%); haematemesis was reported in 12 (20%) cats. Endoscopy showed GDUs in the following locations: gastric body in 28 cats (46%), antropyloric area in 34 cats (56%), fundus in 13 cats (21%) and duodenum in eight cats (13%). A single GDU was found in 42 cats (69%) and multiple GDUs were seen in 19 cats (31%). Histopathological evaluation revealed benign lesions in 33 (54%) cats and malignant lesions in 28 (46%; 24 high-grade lymphoma, one low-grade lymphoma and three carcinoma). High-grade lymphoma was detected only in the stomach. Cats diagnosed with malignant GDUs (median 10.5, range 4-16) were significantly older than cats with benign lesions (P = 0.002). CONCLUSIONS AND RELEVANCE GDUs are common and were detected in 5.1% of cats undergoing an upper gastrointestinal endoscopy. The risk of a malignant ulcer increases proportionally with each year of increasing age. GDU location, number and morphological appearance do not provide any indication of the nature of the ulcer; however, duodenal ulcers are frequently benign. Endoscopic examination facilitates the early and minimally invasive detection of GDUs in cats.
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Affiliation(s)
| | - Alessio Pierini
- Pisani Carli Chiodo Veterinary Centre, Luni Mare, La Spezia, Italy
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Bottero E, Ferriani R, Benvenuti E, Ruggiero P, Astorina S, Giraldi M, Bertoldi L, Benvenuto G, Sattin E, Gianella P, Suchodolski JS. Clinical evaluation and microbiota analysis in 9 dogs with antibiotic-responsive enteropathy: A prospective comparison study. J Vet Intern Med 2022; 36:1220-1228. [PMID: 35621056 PMCID: PMC9308422 DOI: 10.1111/jvim.16443] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 04/27/2022] [Indexed: 12/28/2022] Open
Abstract
Background Antibiotic‐responsive enteropathy (ARE) is diagnosed by excluding other causes of diarrhea and when there is a short‐term response to administration of antibiotics. Objectives To characterize the gut microbiota and clinical trend of dogs with suspected ARE and to evaluate the variation in microbiota before (T0), after 30 days (T30) of tylosin treatment, and 30 days after discontinuation of treatment (T60). A further objective was to evaluate whether changes in gut microbiota are related to relapses of diarrhea when the therapy is tapered. Animals Study sample (group A) was composed of 15 dogs with chronic diarrhea, group B was composed of 15 healthy dogs. Group A was given tylosin for 30 days. Methods A multicentric prospective study. Clinical Indexes, fecal score, and samples for microbiota analysis were collected at T0, T30, and T60 in group A and T0 and T30 in group B. The gut microbiota was analyzed via 16S ribosomal RNA gene. Qiime2 version 2020.2 was used to perform bioinformatic analyses, and Alpha‐ and Beta‐diversity were computed. Results Diarrhea recurred after T30 in 9 of 14 dogs, which were classified as affected by ARE. At T0, a difference was noted in the beta‐diversity between groups (Bray Curtis metric P = .006). A T0‐T30 difference in alpha‐diversity was noted in group A (Shannon index P = .001, Faith PD P = .007). Conclusions and Clinical Importance Although tylosin influences the microbiota of dogs with ARE, we failed to find any specific characteristic in the microbiota of dogs with ARE.
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Affiliation(s)
- Enrico Bottero
- Endovet Group, Rome, Italy.,Ospedale Veterinario San Francesco, Milan, Italy
| | - Riccardo Ferriani
- Endovet Group, Rome, Italy.,Ospedale Veterinario San Francesco, Milan, Italy
| | | | | | - Simona Astorina
- Endovet Group, Rome, Italy.,Clinica Veterinaria Città di Catania, Catania, Italy
| | | | | | | | | | - Paola Gianella
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Science, Texas A&M University, College Station, Texas, USA
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Palumbo S, Benvenuti E, Fraldi M. Actomyosin contractility and buckling of microtubules in nucleation, growth and disassembling of focal adhesions. Biomech Model Mechanobiol 2022; 21:1187-1200. [PMID: 35614374 PMCID: PMC9283365 DOI: 10.1007/s10237-022-01584-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 04/08/2022] [Indexed: 11/24/2022]
Abstract
Building up and maintenance of cytoskeletal structure in living cells are force-dependent processes involving a dynamic chain of polymerization and depolymerization events, which are also at the basis of cells’ remodelling and locomotion. All these phenomena develop by establishing cell–matrix interfaces made of protein complexes, known as focal adhesions, which govern mechanosensing and mechanotransduction mechanisms mediated by stress transmission between cell interior and external environment. Within this framework, by starting from a work by Cao et al. (Biophys J 109:1807–1817, 2015), we here investigate the role played by actomyosin contractility of stress fibres in nucleation, growth and disassembling of focal adhesions. In particular, we propose a tensegrity model of an adherent cell incorporating nonlinear elasticity and unstable behaviours, which provides a new kinematical interpretation of cellular contractile forces and describes how stress fibres, microtubules and adhesion plaques interact mechanobiologically. The results confirm some experimental evidences and suggest how the actomyosin contraction level could be exploited by cells to actively control their adhesion, eventually triggering cytoskeleton reconfigurations and migration processes observed in both physiological conditions and diseases.
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Affiliation(s)
- S Palumbo
- Department of Structures for Engineering and Architecture, University of Napoli "Federico II", Napoli, Italy
| | - E Benvenuti
- Department of Engineering, University of Ferrara, Ferrara, Italy
| | - M Fraldi
- Department of Structures for Engineering and Architecture, University of Napoli "Federico II", Napoli, Italy.
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Bottero E, Ruggiero P, Benvenuti E, Mussi E, Falcioni D, De Lorenzi D, Di Girolamo N. Presence of bronchial nodules, younger age, and heavier body weight are associated with a diagnosis of eosinophilic lung disease in dogs with cough. J Am Vet Med Assoc 2022; 260:414-421. [PMID: 34986119 DOI: 10.2460/javma.20.10.0559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe the association between a diagnosis of eosinophilic lung disease (ELD) in dogs with signalment and bronchoscopic features and evaluate the accuracy of visualization of nodules for the diagnosis of ELD. ANIMALS 781 dogs with cough that underwent bronchoscopy between 2014 and 2016. PROCEDURES Data were extracted from the medical records of each included dog. Multivariable logistic regression was performed to investigate associations between ELD and patient characteristics. RESULTS ELD was diagnosed in 113 (14.5%) dogs. More than 3 nodular lesions of the bronchial mucosa were detected in 64 (8.2%) dogs. The odds of having ELD were greater in dogs with nodules (adjusted OR [aOR], 26.0; 95% CI, 13.0 to 52.0) and static bronchial collapse (aOR, 2.3; 95% CI, 1.1 to 4.6), and lower in dogs having focal versus diffuse inflammation (aOR, 0.05; 95% CI, 0.01 to 0.37). The odds of having ELD decreased for each 1-year increase in age (aOR, 0.86; 95% CI, 0.80 to 0.92), and increased for each 1-kg increase in weight (aOR, 1.04; 95% CI, 1.01 to 1.06). Visualization of nodules during bronchoscopy had a overall accuracy of 89.4% (95% CI, 87.0% to 91.4%), sensitivity of 41.6% (32.4% to 51.2%), and specificity of 97.5% (96.0% to 98.5%) for a diagnosis of ELD. CLINICAL RELEVANCE On the basis of high specificity and negative predictive value, lack of visualization of bronchial nodules during bronchoscopy can be used to preliminarily rule out ELD. However, visualization of bronchial nodules does not imply presence of ELD. This could be especially relevant when results of BAL cytology are available several days after the actual bronchoscopy.
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Affiliation(s)
| | | | | | | | | | | | - Nicola Di Girolamo
- 3College of Veterinary Medicine, Oklahoma State University, Stillwater, OK
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Benvenuti E, Pierini A, Bottero E, Pietra M, Gori E, Salvadori S, Marchetti V. Immunosuppressant-Responsive Enteropathy and Non-Responsive Enteropathy in Dogs: Prognostic Factors, Short- and Long-Term Follow Up. Animals (Basel) 2021; 11:ani11092637. [PMID: 34573603 PMCID: PMC8472317 DOI: 10.3390/ani11092637] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 12/29/2022] Open
Abstract
Simple Summary Chronic intestinal inflammation in dogs is a challenging disease to manage. Most studies about prognostic factors and follow-up data are only available for small populations or with short-term follow-up. The aim of this study of 165 dogs with chronic intestinal inflammation was to identify clinical and haematological factors associated with mortality, clinical response and relapse, with long-term follow-up. Nine per cent of dogs did not respond to therapy at 1 month follow-up. Most dogs with chronic intestinal inflammation had a good clinical course in most cases, and the non-response or relapse rate was 9–11%. A reduction of body condition (loss of weight), lower serum albumin concentration and presence of lacteal dilatation on intestinal histology at diagnosis were identified as factors associated with a decreased response rate, higher mortality and lower chance of achieving long-term remission. Abstract A multicentre prospective study was performed to assess whether clinical, hematobiochemical, endoscopic and histopathological parameters were associated with mortality, clinical response and relapse of disease in short- and long-term follow-up of a total of 165 dogs with chronic inflammatory enteropathy, of which 150 had immunosuppressant responsive enteropathy (IRE), and 15 had non-responsive enteropathy (NRE) dogs. Clinical severity (CCECAI) was evaluated from presentation (T0) to 18 months (T18) from diagnosis. T0 body condition score (BCS), selected haematological parameters and endoscopic and histopathological scores were evaluated. Presence/absence of histopathological duodenal lesions was recorded. Responders were evaluated using CCECAI at T1. Relapse was evaluated from T3 to T18. Long-term responders included dogs who responded at T1 and showed no relapse. Dogs were divided into responders/non-responders, survivors/non-survivors and relapsed/non-relapsed. At T1, 15/165 dogs (9%) were considered NRE. Sixteen dogs (11%) were considered relapsed at T3, 8% at T6 and 10% at T12, and none of 96 dogs relapsed at T18. NREs showed significantly lower BCS than IREs. Non-survivors showed a significantly lower serum albumin concentration and BCS than survivors. Non-responders, relapsed or non-survivors had higher presence of lacteal dilatation compared to long-term responders. Dogs with IRE showed a good clinical course with a low relapse rate, with only a few dogs in the NRE group. Reduction of BCS, albumin and lacteal dilatation at diagnosis may be considered negative prognostic factors for response, mortality and long-term disease remission.
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Affiliation(s)
- Elena Benvenuti
- Department of Veterinary Science, University of Pisa, Via Livornese Lato Monte, 56122 Pisa, Italy; (E.B.); (A.P.); (V.M.)
| | - Alessio Pierini
- Department of Veterinary Science, University of Pisa, Via Livornese Lato Monte, 56122 Pisa, Italy; (E.B.); (A.P.); (V.M.)
| | | | - Marco Pietra
- Department of Veterinary Clinical Sciences, University of Bologna, Via Tolara di Sopra, 50, 40064 Bologna, Italy;
| | - Eleonora Gori
- Department of Veterinary Science, University of Pisa, Via Livornese Lato Monte, 56122 Pisa, Italy; (E.B.); (A.P.); (V.M.)
- Correspondence:
| | - Stefano Salvadori
- Institute of Clinical Physiology, National Research Council (CNR), Via Moruzzi 1, 56124 Pisa, Italy;
| | - Veronica Marchetti
- Department of Veterinary Science, University of Pisa, Via Livornese Lato Monte, 56122 Pisa, Italy; (E.B.); (A.P.); (V.M.)
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Gori E, Pierini A, Nesci M, Benvenuti E, Tasca S, Lubas G, Marchetti V. Detection of Anti-Erythrocyte Antibodies in Dogs with Inflammatory Bowel Disease (IBD). Animals (Basel) 2021; 11:ani11092580. [PMID: 34573547 PMCID: PMC8465133 DOI: 10.3390/ani11092580] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/30/2021] [Accepted: 08/30/2021] [Indexed: 12/14/2022] Open
Abstract
Several extra-intestinal manifestations, including immune-mediated cytopenias, are reported in human inflammatory bowel disease (IBD), whereas they are poorly documented in dogs. Hypothesizing that immune-mediated subclinical anemia can occur in canine IBD, the study aim was to evaluate the erythrogram and the presence of anti-RBC antibodies in dogs with IBD. IBD was diagnosed according to the following criteria: chronic gastrointestinal signs, ruling out of extra-intestinal diseases, no improvement with diet trial, histological evidence of inflammatory infiltration, and improvement after immunosuppressant therapy. Canine Chronic Enteropathy Clinical Activity Index (CCECAI) endoscopic and histopathological scores were assessed for each dog. Twenty-five dogs were enrolled, and each dog had a CBC evaluation prior to endoscopy. The CBC was performed using laser hematology analyzer and blood smears were carefully reviewed for the presence of nucleated RBC, anisocytosis, polychromasia, and Howell-Jolly bodies. IgG and IgM anti-RBC antibodies were evaluated with flow cytometry. A high frequency of positive cases for anti-RBC antibodies in dogs with IBD (17/25 dogs) was ascertained. Approximatively 50% of dogs showed some hematologic features of RBC regeneration in addition to hematologic findings consistent with chronic inflammation. Anti-RBC antibodies and signs of erythroid regeneration may suggest possible subclinical chronic immune-mediated hemolysis that can cause anemia in dogs with IBD, together with the chronic inflammation.
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Affiliation(s)
- Eleonora Gori
- Veterinary Teaching Hospital “Mario Modenato”, Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (E.G.); (M.N.); (E.B.); (G.L.); (V.M.)
| | - Alessio Pierini
- Veterinary Teaching Hospital “Mario Modenato”, Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (E.G.); (M.N.); (E.B.); (G.L.); (V.M.)
- Correspondence: ; Tel.: +39-0502210166
| | - Martina Nesci
- Veterinary Teaching Hospital “Mario Modenato”, Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (E.G.); (M.N.); (E.B.); (G.L.); (V.M.)
| | - Elena Benvenuti
- Veterinary Teaching Hospital “Mario Modenato”, Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (E.G.); (M.N.); (E.B.); (G.L.); (V.M.)
| | - Silvia Tasca
- Clinical Pathology Division, San Marco Veterinary Clinic and Laboratory, 35030 Padova, Italy;
| | - George Lubas
- Veterinary Teaching Hospital “Mario Modenato”, Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (E.G.); (M.N.); (E.B.); (G.L.); (V.M.)
| | - Veronica Marchetti
- Veterinary Teaching Hospital “Mario Modenato”, Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (E.G.); (M.N.); (E.B.); (G.L.); (V.M.)
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Benvenuti E, Pierini A, Benali SL, Gori E, Abramo F, Bottero E, Pietra M, Ruggiero P, Marchetti V. Evaluation of duodenal endoscopic and histologic findings, including counts of forkhead box P3-positive regulatory T cells, in dogs with immunosuppressant-responsive enteropathy. Am J Vet Res 2021; 82:218-224. [PMID: 33629898 DOI: 10.2460/ajvr.82.3.218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To prospectively evaluate the clinical and prognostic importance of duodenal endoscopic and histologic findings, including duodenal mucosal counts of forkhead box P3-positive regulatory T cells (Foxp3+ Tregs), in dogs with immunosuppressant-responsive enteropathy (IRE). ANIMALS 57 client-owned dogs with IRE. PROCEDURES The canine chronic enteropathy clinical activity index (CCECAI) was used to assess each dog when IRE was diagnosed (T0) and 1, 3, 6, and 12 months later. Dogs were grouped on the basis of clinical response (responder group vs nonresponder group) and 12-month long-term outcome (responded to treatment and did not relapse [good outcome group] vs did not respond to treatment or had relapsed [bad outcome group]). At T0, dogs underwent gastrointestinal endoscopy and endoscopic biopsy, with results for variables of duodenal endoscopic and histologic evaluations scored and compared across groups. RESULTS At T0, the overall median CCECAI score was 7; CCECAI score was not associated with clinical response or relapse. Dogs had significantly greater odds of being in the bad outcome group (vs the good outcome group) if they had a histologic score of 3 (OR, 3.5; 95% CI, 1.09 to 11.3). No differences in the counts of Foxp3+ Tregs were detected between groups. CONCLUSIONS AND CLINICAL RELEVANCE In dogs with IRE, results indicated that evaluation of Foxp3+ Tregs did not have prognostic value, whereas a duodenal histologic score of 3 could be a negative prognostic factor for response and relapse, and higher severity scores for intraepithelial lymphocytes and lamina propria lymphocytes and plasma cells in duodenal biopsy samples may be negatively associated with response.
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Pierini A, Esposito G, Gori E, Benvenuti E, Ruggiero P, Lubas G, Marchetti V. Platelet abnormalities and platelet-to-lymphocyte ratios in canine immunosuppressant-responsive and non-responsive enteropathy: A retrospective study in 41 dogs. J Vet Med Sci 2021; 83:248-253. [PMID: 33455958 PMCID: PMC7972876 DOI: 10.1292/jvms.20-0291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Few studies have examined platelet alterations in dogs with chronic enteropathy. Our aim was to investigate platelet count (PLT), mean platelet volume (MPV), and platelet-to-lymphocyte ratio (PLR) in dogs diagnosed with immunosuppressant-responsive enteropathy (IRE). In this retrospective study of 41 dogs, data regarding signalment, canine chronic enteropathy clinical activity index (CCECAI), endoscopic and histopathological scores, PLT, MPV, PLR, total serum protein concentrations, albumin, and iron were collected. Clinical response and relapse were assessed with the evaluation of CCECAI over time. One month after starting therapy, dogs with >25% CCECAI reduction were considered responders. During a three-month CCECAI evaluation as part of a twelve-month follow-up, a CCECAI >3 together with a ≥2 unit increase in responder dogs was considered a relapse. PLT and PLR displayed significant negative correlation with MPV. MPV was positively correlated with total protein and albumin levels and negatively correlated with CCECAI. Three dogs were classified as non-responders, and 14 relapsed within 12 months. No differences were observed in PLT, MPV, or PLR between responding/non-responding and relapsing/non-relapsing groups. PLT, MPV, and PLR correlated with total protein, albumin, and CCECAI, confirming PLT as a potential marker, and suggesting MPV as a new marker of clinical efficacy against canine IRE.
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Affiliation(s)
- Alessio Pierini
- Department of Veterinary Science, University of Pisa, Via Livornese Lato Monte, 56122 Pisa, Italy
| | - Giada Esposito
- Department of Veterinary Science, University of Pisa, Via Livornese Lato Monte, 56122 Pisa, Italy
| | - Eleonora Gori
- Department of Veterinary Science, University of Pisa, Via Livornese Lato Monte, 56122 Pisa, Italy
| | - Elena Benvenuti
- Department of Veterinary Science, University of Pisa, Via Livornese Lato Monte, 56122 Pisa, Italy
| | - Pietro Ruggiero
- Private Professional Association Endovet, Via Antonio Oroboni, 8-00149 Roma, Italy
| | - George Lubas
- Department of Veterinary Science, University of Pisa, Via Livornese Lato Monte, 56122 Pisa, Italy
| | - Veronica Marchetti
- Department of Veterinary Science, University of Pisa, Via Livornese Lato Monte, 56122 Pisa, Italy
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Benvenuti E, Pierini A, Gori E, Bottero E, Pietra M, Lippi I, Meucci V, Marchetti V. Serum homocysteine concentration in dogs with immunosuppressant-responsive enteropathy. J Vet Sci 2020; 21:e47. [PMID: 32735090 PMCID: PMC7402937 DOI: 10.4142/jvs.2020.21.e47] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 03/10/2020] [Accepted: 03/27/2020] [Indexed: 11/24/2022] Open
Abstract
Background Homocysteine (HCY) was evaluated in healthy and chronic enteropathic dogs, however no studies on dogs with immunosuppressant-responsive enteropathy are available. Objectives The aim was to evaluate serum HCY concentrations and its prognostic role in dogs with immunosuppressant-responsive enteropathy compared to healthy dogs. Methods Serum HCY concentration was statistically compared between 24 healthy dogs and 29 dogs with immunosuppressant-responsive enteropathy. Correlation analyses between serum total protein, albumin (ALB), C-reactive protein (CRP), folate and cobalamin, and serum HCY concentration were performed in immunosuppressant-responsive enteropathic dogs. Results The associations between serum HCY concentration and clinical, histological, endoscopic scores and follow-up were evaluated. Mean serum HCY concentration was higher in immunosuppressant-responsive enteropathic dogs compared to control dogs (30.22 ± 8.67 µmol/L vs. 5.26 ± 2.78 µmol/L; p < 0.0001). No association between serum HCY concentration and total protein, ALB, CRP, folate concentration as well as, clinical score, histological and endoscopic scores was found. A negative correlation between serum HCY concentration and cobalamin was noted (p = 0.0025, r = −0.54). No significant difference in HCY was found between responsive and non-responsive dogs or between survivors and non-survivors. Conclusions Although, serum HCY concentration was higher in immunosuppressant-responsive enteropathy, its prognostic value remains unclear. However, further prospective, large-scale studies are warranted to better investigate the possible prognostic role of HCY in immunosuppressant-responsive enteropathic dogs.
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Affiliation(s)
- Elena Benvenuti
- Department of Veterinary Science, University of Pisa, 56122 Pisa, Italy
| | - Alessio Pierini
- Department of Veterinary Science, University of Pisa, 56122 Pisa, Italy.
| | - Eleonora Gori
- Department of Veterinary Science, University of Pisa, 56122 Pisa, Italy
| | | | - Marco Pietra
- Department of Veterinary Clinical Sciences, University of Bologna, 40064 Bologna, Italy
| | - Ilaria Lippi
- Department of Veterinary Science, University of Pisa, 56122 Pisa, Italy
| | - Valentina Meucci
- Department of Veterinary Science, University of Pisa, 56122 Pisa, Italy
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Benvenuti E, Pierini A, Gori E, Lucarelli C, Lubas G, Marchetti V. Neutrophil-to-Lymphocyte Ratio (NLR) in Canine Inflammatory Bowel Disease (IBD). Vet Sci 2020; 7:vetsci7030141. [PMID: 32971945 PMCID: PMC7560079 DOI: 10.3390/vetsci7030141] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/16/2020] [Accepted: 09/19/2020] [Indexed: 12/11/2022] Open
Abstract
Inflammatory bowel disease (IBD) is a multifactorial chronic inflammatory disorder leading to structural changes in the intestinal wall. In humans, the neutrophil-to-lymphocyte ratio (NLR) has been proposed as a promising marker of IBD. This study evaluated the possible clinical and prognostic significance of the NLR in dogs with IBD. This retrospective study enrolled 41 dogs diagnosed with IBD presented to University of Pisa from January 2017 to January 2018. For each dog, age, sex, canine chronic enteropathy clinical activity index (CCECAI), endoscopic and histopathological grading were recorded. Complete blood count, serum total protein, albumin, cholesterol, and C-reactive protein at the time of endoscopy were recorded. A control group (CG) of healthy dogs from a blood donor database was built. NLR was calculated for both IBD and CG as the ratio between absolute neutrophils and lymphocytes. Presence of crypt distension, lacteal dilation (LD), mucosal fibrosis, intraepithelial lymphocytes was recorded. Follow-up information was obtained from electronic medical records and dogs were classified as responders and non-responders based on CCECAI variation between admission and the first recheck. IRE dogs showed higher NLR compared to healthy dogs. NLR correlated negatively with total protein, albumin, and cholesterol and correlated positively with CCECAI. Dogs with LD showed higher NLR than dogs without LD. Non-responders showed higher NLR compared to responders. In conclusion, as in IBD human patients, the NLR acts as an inflammatory marker providing further information on severity of the disease and could be useful in predicting treatment response.
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Bottero E, Benvenuti E, Ferriani R, Manassero E, Re G, Barbero R. Preliminary comparative serological evaluation of Histamine H2 receptors in dogs with an acute onset of vomiting treated with Ranitidine and healthy dogs. Vet Anim Sci 2020; 10:100138. [PMID: 32775765 PMCID: PMC7399163 DOI: 10.1016/j.vas.2020.100138] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 11/30/2022] Open
Abstract
Ranitidine (RT) is an antagonist against H2 histamine receptors (H2R) that weakly suppress acid secretion in patients. Despite that a clinical effect is often achieved. H2 antagonists (H2RA) also called H2 blockers, are a group of medications that block the action of histamine at the H2R of parietal cells in the stomach. Preliminary analysis indicates that the levels of H2 receptors in the serum and gastric walls are the same. Evidence suggests that the level of H2 receptors in dogs with acute vomiting is greater than in healthy dogs, thus probably contributing to a greater efficiency of ranitidine treatment.
Despite the lack of evidence of the ability to suppress gastric acid secretion in dogs, ranitidine (RT) is often used to control clinical signs in dogs with acute vomiting even if the way it happens it is still largely unknown. The aim of this study was thus to evaluate the therapeutic effect of ranitidine on H2 receptors in dogs with acute vomiting. To investigate the RT activity a preliminary study was performed in dogs which underwent gastroscopy analyses, demonstrating that the level of H2R observed in the serum and gastric wall tissue was the same [1.473(1.30; 1.79) ng/ml and 1.498 (1.33; 1.85) ng/ml, respectively]. After that H2R levels in the serum of 22 healthy dogs (Group 1) and in a group of 22 dogs with acute vomiting (Group 2) were compared both before (T0), after 7–10 days (T1) of 2 mg/kg twice a day ranitidine administration and after 11 days since the drug was discontinued (T2). Significant differences (p<0.001) were detected between the level of circulating H2R among Group 1: 0.41 ng/ml (0.28;0.54) and Group 2: 2.27 ng/ml (2.11;2.49) at T0. In Group 2, no difference in the level of H2R was detected in samples collected at T0 compared to those at T1 [T1: 2.32 ng/ml (2.14; 2.49)] and T2 [T2: 2.30 ng/ml (1.99;2.69)]. In Group 2 all patients but one displayed remission of symptoms attributable to inflammatory gastropathy at the first withdrawal (T1: 7–10 days), while at the second withdrawal (T2: after 21 days), remission was detected in all dogs. Our preliminary hypothesis is that the clinical efficacy of ranitidine is related to the greater expression of H2 receptors in patients with acute vomiting. This increased expression may be due to continuous pathological stimulus at the gastric level. Further studies with a wider population are needed to better investigate the activity of RT in dogs with acute onset of vomiting.
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Affiliation(s)
- E Bottero
- Endovet Group, Viale V. Marronaro, 130 - 00128 Roma, RM, Italy
| | - E Benvenuti
- Endovet Group, Viale V. Marronaro, 130 - 00128 Roma, RM, Italy
| | - R Ferriani
- Endovet Group, Viale V. Marronaro, 130 - 00128 Roma, RM, Italy.,San Francesco Veterinary Hospital, Via Newton, 2 - 20148 Milano, MI, Italy
| | - E Manassero
- Albese Veterinary Clinic, Via Vivaro n. 25. - 12051 Alba, CN, Italy
| | - G Re
- Department of Veterinary Sciences, University of Turin, Largo P. Braccini 2, Grugliasco,10095, Turin, Italy
| | - R Barbero
- ASL TO4, Via Regio Parco 64 - 10036, Settimo Torinese, Italy
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Benvenuti E, Pierini A, Gori E, Bartoli F, Erba P, Ruggiero P, Marchetti V. Serum amino acid profile in 51 dogs with immunosuppressant-responsive enteropathy (IRE): a pilot study on clinical aspects and outcomes. BMC Vet Res 2020; 16:117. [PMID: 32321505 PMCID: PMC7178940 DOI: 10.1186/s12917-020-02334-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 04/05/2020] [Indexed: 12/11/2022] Open
Abstract
Background Lower levels of tryptophan (TRP) have been identified in people with inflammatory bowel disease and in dogs with protein-losing enteropathy (PLE). No data on serum amino acids (AAs) but some on plasma in canine immunosuppressant-responsive enteropathy (IRE) are available. The aim of this study is to compare serum AAs between healthy and IRE dogs, considering clinicopathological variables and follow-up. Results Twenty-six healthy control dogs (CD) and 51 IRE dogs were included. IRE was diagnosed after the exclusion of extra-intestinal diseases and food and antibiotic responsive enteropathies. The canine chronic enteropathy clinical activity index (CCECAI) was assessed at presentation and during the clinical follow-up. In CD and IRE dogs, 19 different serum AAs were measured. IRE dogs were classified into responders, partial responders and non-responders, based on CCECAI after 1 month, and divided into PLE and non-PLE, based on albumin level. IRE dogs showed lower L-Tyrosine (TYR), L-Phenylalanine (PHE) and TRP (p < 0.001) and higher L-Serine (SER), L-Glutamic acid (GLU), L-Arginine (p < 0.001), L-Threonine (p = 0.013), Proline (p = 0.044), L-Cysteine (p = 0.003), L-Valine (p = 0.018), L-Lysine (p = 0.01) and L-Isoleucine (p = 0.005) than CDs. PLE dogs showed lower L-Histidine (HIS) (p = 0.008), PHE (p = 0.005) and TRP (p = 0.005) than non-PLE dogs. In IRE dogs, median GLU was significantly lower in dogs with BCS 3/9 than BCS 5/9 category (p = 0.036). Total protein was positively correlated with PHE and TRP (both p = 0.031, r = 0.30) and albumin was positively correlated with HIS (p = 0.025, r = 0.31), PHE and TRP (both p = 0.001, r = 0.46). HIS (p = 0.041), PHE (p = 0.047) and TRP (p = 0.044) concentrations were significantly lower in non-responders than in responders and partial responders. Conclusions This study may suggest further investigation on serum, HIS, PHE, TRP and TYR as markers of intestinal disease and proposed HIS, PHE and TRP as prognostic marker for response to therapy.
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Affiliation(s)
- Elena Benvenuti
- Department of Veterinary Science, University of Pisa, via Livornese, 56122 San Piero a Grado, Pisa, Italy
| | - Alessio Pierini
- Department of Veterinary Science, University of Pisa, via Livornese, 56122 San Piero a Grado, Pisa, Italy.
| | - Eleonora Gori
- Department of Veterinary Science, University of Pisa, via Livornese, 56122 San Piero a Grado, Pisa, Italy
| | - Francesco Bartoli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Savi, 10, Pisa, 56126, Italy
| | - Paola Erba
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Savi, 10, Pisa, 56126, Italy
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Natali M, Campana A, Posati T, Benvenuti E, Prescimone F, Ramirez DOS, Varesano A, Vineis C, Zamboni R, Muccini M, Aluigi A, Toffanin S. Engineering of keratin functionality for the realization of bendable all-biopolymeric micro-electrode array as humidity sensor. Biosens Bioelectron 2019; 141:111480. [PMID: 31272056 DOI: 10.1016/j.bios.2019.111480] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/15/2019] [Accepted: 06/25/2019] [Indexed: 12/22/2022]
Abstract
The technological quest for flexible devices to be interfaced with the biological world has driven the recent reinvention of bioderived polymers as multifunctional active and passive constituent elements for electronic and photonic devices to use in the biomedical field. Keratin is one of the most important structural proteins in nature to be used as biomaterial platform in view of the recently reported advances in the extraction and processing from hair and wool fibers. In this article we report for the first time the simultaneous use of naturally extracted keratin as both active ionic electrolyte for water ions sensing and as bendable and insoluble substrate into the same multielectrode array-based device. We implemented the multifunctional system exclusively made by keratin as a bendable sensor for monitoring the humidity flow. The enhancement of the functional and structural properties of keratin such as bendability and insolubility were obtained by unprecedented selective chemical doping. The mechanisms at the basis of the sensing of humidity in the device were investigated by cyclic voltammetry and rationalized by reversible binding and extraction of water ions from the volume of the keratin active layer, while the figures of merit of the biopolymer such as the ionic conductivity and relaxation time were determined by means of electrical impedance and dielectric relaxation spectroscopy. A reliable linear correlation between the controlled-humidity level and the amperometric output signal together with the assessment on measure variance are demonstrated. Collectively, the fine-tuned ionic-electrical characterization and the validation in controlled conditions of the free-standing insoluble all-keratin made microelectrode array ionic sensor pave the way for the effective use of keratin biopolymer in wearable or edible electronics where conformability, reliability and biocompatibility are key-enabling features.
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Affiliation(s)
- M Natali
- Consiglio Nazionale delle Ricerche (CNR), Istituto per lo Studio dei Materiali Nanostrutturati (ISMN), Via P. Gobetti 101, 40129, Bologna, Italy.
| | - A Campana
- Consiglio Nazionale delle Ricerche (CNR), Istituto per lo Studio dei Materiali Nanostrutturati (ISMN), Via P. Gobetti 101, 40129, Bologna, Italy
| | - T Posati
- Consiglio Nazionale delle Ricerche (CNR), Istituto per la Sintesi Organica e la Fotoreattività (ISOF), Via P. Gobetti 101, 40129, Bologna, Italy
| | - E Benvenuti
- Consiglio Nazionale delle Ricerche (CNR), Istituto per lo Studio dei Materiali Nanostrutturati (ISMN), Via P. Gobetti 101, 40129, Bologna, Italy
| | - F Prescimone
- Consiglio Nazionale delle Ricerche (CNR), Istituto per lo Studio dei Materiali Nanostrutturati (ISMN), Via P. Gobetti 101, 40129, Bologna, Italy
| | - D O Sanchez Ramirez
- Consiglio Nazionale delle Ricerche (CNR), Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato (STIIMA), Corso Giuseppe Pella 16, 13900, Biella, Italy
| | - A Varesano
- Consiglio Nazionale delle Ricerche (CNR), Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato (STIIMA), Corso Giuseppe Pella 16, 13900, Biella, Italy
| | - C Vineis
- Consiglio Nazionale delle Ricerche (CNR), Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato (STIIMA), Corso Giuseppe Pella 16, 13900, Biella, Italy
| | - R Zamboni
- Consiglio Nazionale delle Ricerche (CNR), Istituto per la Sintesi Organica e la Fotoreattività (ISOF), Via P. Gobetti 101, 40129, Bologna, Italy
| | - M Muccini
- Consiglio Nazionale delle Ricerche (CNR), Istituto per lo Studio dei Materiali Nanostrutturati (ISMN), Via P. Gobetti 101, 40129, Bologna, Italy
| | - A Aluigi
- Consiglio Nazionale delle Ricerche (CNR), Istituto per la Sintesi Organica e la Fotoreattività (ISOF), Via P. Gobetti 101, 40129, Bologna, Italy
| | - S Toffanin
- Consiglio Nazionale delle Ricerche (CNR), Istituto per lo Studio dei Materiali Nanostrutturati (ISMN), Via P. Gobetti 101, 40129, Bologna, Italy.
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Ruggiero C, Bonamassa L, Pelini L, Prioletta I, Cianferotti L, Metozzi A, Benvenuti E, Brandi G, Guazzini A, Santoro GC, Mecocci P, Black D, Brandi ML. Early post-surgical cognitive dysfunction is a risk factor for mortality among hip fracture hospitalized older persons. Osteoporos Int 2017; 28:667-675. [PMID: 27717957 DOI: 10.1007/s00198-016-3784-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 09/22/2016] [Indexed: 01/29/2023]
Abstract
UNLABELLED This study investigates the relationship between cognitive dysfunction or delirium detected in the early post-surgical phase and the 1-year mortality among 514 hip fracture hospitalized older persons. Patients with early cognitive dysfunction or delirium experienced a 2-fold increased mortality risk. Early post-operative cognitive dysfunction and delirium are negative prognostic factors for mortality. BACKGROUND AND PURPOSE Premorbid cognitive impairment and dementia in older individuals negatively affect functional recovery after hip fracture. Additionally, post-operative delirium is an established risk factor for negative outcomes among hip fracture patients. While the majority of hip fracture patients experience minor post-surgical cognitive dysfunction, the prognostic value of this phenomenon is unknown. Therefore, we investigated the relationship between minor cognitive dysfunction or delirium detected in the early post-surgical phase and the 1-year mortality after index hip fracture. SUBJECTS AND METHODS We enrolled 514 patients with hip fracture (77.4 % women), aged 65 years or older (mean age 83.1 ± 7.3 years), who underwent surgical hip fracture repair. Patients were assessed daily from the second to the fourth post-operative day and at 3, 6, and 12 months thereafter. All participants underwent comprehensive assessment, including detection of delirium by using the confusion assessment method and evaluation of cognitive function by using mini-mental state examination (MMSE; score range 0 to 30, with lower scores indicating poorer performance). In the absence of delirium, post-surgical cognitive dysfunction was defined as having low performance on MMSE. Vital status of 1 year after the index fracture and date of death were gathered from local registries. RESULTS The observed 1-year mortality rate was 14.8 %. Men were more likely to die than women within 1 year of the index fracture (p < 0.01). Compared to participants with better cognitive performance, those with MMSE < 24, as well as those with delirium in the post-operative phase, showed a significantly higher 1-year mortality rate (23.3 versus 17.9 and 8.1 %, respectively). Independent of age and sex, post-operative cognitive dysfunction as well as delirium was both associated with a 2-fold increased mortality risk. CONCLUSIONS The presence of minor cognitive dysfunction in the early post-surgical phase is a negative prognostic factor for mortality among elderly hip fracture patients. The burden of minor cognitive dysfunction is likely superimposed on that of delirium in subgroups of frail patients.
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Affiliation(s)
- C Ruggiero
- Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - L Bonamassa
- Department of Internal Medicine, University of Florence, Largo Palagi 1, 50139, Florence, Italy
| | - L Pelini
- Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - I Prioletta
- Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - L Cianferotti
- Department of Internal Medicine, University of Florence, Largo Palagi 1, 50139, Florence, Italy
| | - A Metozzi
- Department of Internal Medicine, University of Florence, Largo Palagi 1, 50139, Florence, Italy
| | - E Benvenuti
- Local Health Authority of Florence, Florence, Italy
| | - G Brandi
- Local Health Authority of Florence, Florence, Italy
| | - A Guazzini
- Department of Science of Education and Psychology, University of Florence, Florence, Italy
| | - G C Santoro
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - P Mecocci
- Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - D Black
- University of California, San Francisco, CA, USA
| | - M L Brandi
- Department of Internal Medicine, University of Florence, Largo Palagi 1, 50139, Florence, Italy.
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Malagù M, Lyulin A, Benvenuti E, Simone A. A Molecular-Dynamics Study of Size and Chirality Effects on Glass-Transition Temperature and Ordering in Carbon Nanotube-Polymer Composites. MACROMOL THEOR SIMUL 2016. [DOI: 10.1002/mats.201600041] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Marcello Malagù
- Engineering Department; University of Ferrara; Via Saragat 1 44122 Ferrara Italy
- Faculty of Civil Engineering and Geosciences; Delft University of Technology; P.O. Box 5048 2600 GA Delft The Netherlands
| | - Alexey Lyulin
- Department of Applied Physics; Eindhoven University of Technology; P.O. Box 513 5600 MB Eindhoven The Netherlands
| | - Elena Benvenuti
- Engineering Department; University of Ferrara; Via Saragat 1 44122 Ferrara Italy
| | - Angelo Simone
- Faculty of Civil Engineering and Geosciences; Delft University of Technology; P.O. Box 5048 2600 GA Delft The Netherlands
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Cerulli G, Caraffa A, Ponteggia F, Potalivo G, Rende R, Conti V, Benvenuti E. Injury prevention methods among athletes: how are they really performed? Br J Sports Med 2011. [DOI: 10.1136/bjsm.2011.084038.84] [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: 11/04/2022]
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Cecchi F, Mannoni A, Molino-Lova R, Ceppatelli S, Benvenuti E, Bandinelli S, Lauretani F, Macchi C, Ferrucci L. Epidemiology of hip and knee pain in a community based sample of Italian persons aged 65 and older. Osteoarthritis Cartilage 2008; 16:1039-46. [PMID: 18343164 PMCID: PMC4984840 DOI: 10.1016/j.joca.2008.01.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2007] [Accepted: 01/14/2008] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe prevalence, characteristics and correlates of hip pain (HP) and knee pain (KP) in an Italian community based cohort aged 65 and older (65+). METHOD Baseline survey (1998-2000), population-based study in the Chianti area (Tuscany, Italy); 1299 persons aged 65+ were selected from the city registry of Greve in Chianti and Bagno a Ripoli (multistage sampling method); 1006 participants (564 women and 442 men, age 75.2+/-7.1) provided information for this analysis. Persons reporting HP/KP in the past 4 weeks were recorded and their Western Ontario and McMaster University Osteoarthritis Index pain score (WPS-range 0-20) calculated. Potential correlates of HP/KP, including clinical, lifestyle and psycho-social features and physical measures, were tested in age- and gender-adjusted regression analyses and then entered a multivariate regression model. RESULTS HP was reported by 11.9% participants, while 22.4% reported KP and 7.2% both conditions. Climbing/descending stairs and walking were the activities eliciting more severe pain in either condition. Average WPSs were 5.6+/-3.5 for HP and 5.4+/-10.4 for KP. Both HP and KP were related to back pain, reduced hip abduction, reduced muscle power and increased trunk flexibility. HP was also related to KP and poor self-rated health (SRH), while KP to HP, foot pain, high body mass index, reduced knee passive flexion and knee extension torque, low education. CONCLUSION In a community sample of an Italian persons aged 65+, the prevalence of KP almost doubled that of HP. While both conditions were related to pain in other joints and specific joint impairment, only HP was related to poor SRH, and only KP to mechanical overload.
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Affiliation(s)
- F Cecchi
- Fondazione Don Carlo Gnocchi, Scientific Institute for Recovery and Care, Florence, Italy.
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24
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Benvenuti E, Cecchi F, Colombini A, Gori G. Extradural motor cortex stimulation as a method to treat advanced Parkinson's disease: new perspectives in geriatric medicine. Aging Clin Exp Res 2006; 18:347-8. [PMID: 17063072 DOI: 10.1007/bf03324671] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Motor fluctuations not controlled by pharmacological therapy are often encountered in long-term Parkinson's disease (PD). Neurosurgery treatment represented by deep brain stimulation (DBS) was considered a valid alternative to pharmacological treatment. Unfortunately this method is most effective in patients under age of 70. Recently it has been suggested that extradural motor cortex stimulation (EMCS) could be a valid cost-effective alternative to DBS to control motor symptoms in patients affected by Parkinson's disease. The relevant non-invasive surgical technique makes this treatment particularly indicated in geriatric patients. Brain atrophy, cognitive impairment, psychiatric symptoms are not an absolute contraindication to the treatment. We submitted to EMCS an outpatient afferent to our geriatric department, a woman 68 yrs old. The patient showed an improvement of 35% as measured by the Unified Parkinson Disease Rating Scale (UPDRS) scale after the surgery. If our findings will be confirmed in larger series, a new dimension will be added to the treatment of PD.
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Caronna R, Tamburrano G, Leonetti F, Cardi M, Bonifacino A, Mangioni S, Corelli S, Priore F, Benvenuti E, Marengo M, Layec D, Stipa V, Chirletti P. Pancreatic insulinomas: diagnosis and surgical treatment of 45 patients. Suppl Tumori 2005; 4:S65-7. [PMID: 16437909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
- R Caronna
- Istituto Dipartimentalizzato di Chirurgia d'Urgenza e di Pronto Soccorso
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Abstract
AIM/HYPOTHESIS Previous studies have shown that insulin has an important in vitro role in the regulation of human erythropoiesis. We investigated whether in vivo hyperinsulinaemia/insulin resistance affects haematological parameters. METHODS A total of 608 subjects between 22 and 99 years of age were enrolled in the Chianti study, an epidemiological study of factors affecting mobility in old age. The degree of insulin resistance was assessed using the homeostasis model. RESULTS We found a correlation between insulin resistance and red blood cell count, (r = 0.14 p < 0.001), plasma haemoglobin (r = 0.16 p < 0.001), haematocrit (r = 0.15 p < 0.001) and plasma iron (r = 0.1 p < 0.05) concentrations. Red blood cell count was also associated with the other biological markers of insulin resistance syndrome. Subjects with higher insulin resistance (4 degrees quartile) had higher red blood cell count, plasma triglycerides and low density lipoproteins (LDL) cholesterol concentrations and lower high density lipoproteins (HDL) cholesterol concentrations then subjects at the lowest quartiles of insulin resistance. Insulin resistance and BMI were significant and independent predictors of red blood cell count even when the analysis was adjusted for age, sex, waist-to-hip ratio, plasma iron and drug intake. CONCLUSION/HYPOTHESIS Our findings provide in vivo evidence of a relation between hyperinsulinaemia/insulin resistance, the main variables of insulin resistance syndrome and erythropoiesis. Increased red blood cell count could be considered as a new aspect of the insulin resistance syndrome that could contribute to the increased risk of developing cardiovascular problems.
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Affiliation(s)
- M Barbieri
- Department of Geriatric Medicine and Metabolic Diseases, University of Naples, Italy
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Ferrucci L, Bandinelli S, Benvenuti E, Di Iorio A, Macchi C, Harris TB, Guralnik JM. Subsystems contributing to the decline in ability to walk: bridging the gap between epidemiology and geriatric practice in the InCHIANTI study. J Am Geriatr Soc 2000; 48:1618-25. [PMID: 11129752 DOI: 10.1111/j.1532-5415.2000.tb03873.x] [Citation(s) in RCA: 625] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Older patients are often referred to geriatricians because of complaints of progressive difficulties in walking. The diagnostic and therapeutic approach to these patients is complex. Multiple physiologic subsystems may influence the ability to walk, and no standard criteria are currently available to establish whether these subsystems are functioning within the normal range. To address this lack of knowledge we conducted the InCHIANTI study. OBJECTIVE To identify measures that clinicians can use to understand the causes of walking difficulties in older persons. DESIGN A population-based study of persons living in the Chianti geographic area (Tuscany, Italy). PARTICIPANTS 1,453 persons (age-range 20-102 years; 91.6% of the eligible) selected from city registry of Greve in Chianti and Bagno a Ripoli (Tuscany, Italy), using a multistage sampling method. MEASUREMENTS Factors that influence walking ability were classified into six main physiologic subsystems: central nervous system, perceptual system, peripheral nervous system, muscles, bone/joints, and energy production/delivery. Measures of the integrity and functioning of each of these proposed subsystems were identified and administered to all participants. CONCLUSIONS Data collected in InCHIANTI will be used to identify the main risk factors that influence loss of the ability to walk in older persons, to define physiologic subsystems that are critical for walking, to select the best measures of their integrity, and to establish critical ranges in these measures that are compatible with "normal" walking ability. The final goal is to translate epidemiological research into a geriatric clinical tool that makes possible more precise diagnosis and more effective treatment in patients with walking dysfunction.
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Affiliation(s)
- L Ferrucci
- INRCA Geriatric Department, Florence, Italy
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Ferrucci L, Benvenuti E, Bartali B, Bandinelli S, Di Iorio A, Russo CR, Lauretani F. Preventive health care for older women: life-style recommendations and new directions. Aging (Milano) 2000; 12:113-31. [PMID: 10902053 DOI: 10.1007/bf03339898] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
One of the key paradoxes in gerontology is that, despite a higher longevity, aging women experience worse health and longer disability than men. However, there is growing evidence that changes in life-style, medical interventions and systematic screening for certain diseases may substantially reduce the excess risk of major chronic conditions and disability in aging women, and therefore improve the quality of their late life. The potentials and public health implications of prevention in older women have been recently emphasized, not only by the scientific literature, but also by the media. More and more women are turning to their primary care physicians or other health professionals to seek counselling and help on how to reduce the burden of chronic disease and disability in old age by quitting smoking, eating a healthy diet, increasing physical activity, and coping with stress. Hormone replacement therapy also has a central role in this action of prevention. To maximize compliance, women should be provided a few guidelines that are easy to understand, and can be followed without interfering too much with their daily life activities. This article reviews the current literature on prevention in older women to select preventive strategies that are based on robust scientific evidence. This list of guidelines should be considered as a starting point for all those who are in charge of caring for middle-aged and older women.
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Bandinelli S, Benvenuti E, Del Lungo I, Baccini M, Benvenuti F, Di Iorio A, Ferrucci L. Measuring muscular strength of the lower limbs by hand-held dynamometer: a standard protocol. Aging (Milano) 1999; 11:287-93. [PMID: 10631877 DOI: 10.1007/bf03339802] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The aim of this study is to describe the reliability of measuring maximal strength of eight muscle groups of the lower limb by a hand-held dynamometer, according to a standard assessment protocol. The study population consisted of 26 patients (14 males and 12 females; age range 60-90 years) admitted to a geriatric hospital. Multiple assessments of muscle strength by two different examiners were compared to estimate test-retest and inter-rater reliability. The range of strength evaluated across the eight muscle groups was 2.1-29.8 Kg/force. Overall, short-term (same day) and long-term (one week apart) test-retest and inter-rater reliability were very high, with 60% of the intraclass correlation coefficient values above 0.8, and the majority above 0.7. No significant differences in strength were found comparing the left and the right side of each muscle group. Differences between values collected in the same subject by two different examiners, and by the same examiner at different points in time were similar, not influenced by the average strength of the muscle group, and significantly larger for long-term than for short-term comparisons. By using a standardized measurement protocol, reliable measurements of muscle strength can be obtained by a hand-held dynamometer in frail older persons.
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Affiliation(s)
- S Bandinelli
- Geriatric Department, Ospedale I Fraticini, I.N.R.C.A., Firenze, Italy
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Di Iorio A, Longo A, Mitidieri Costanza A, Palmerio T, Benvenuti E, Giardini S, Bavazzano A, Guizzardi G, Senin U, Bandinelli S, Ferrucci L, Abate G. Factors related to the length of in-hospital stay of geriatric patients. Aging (Milano) 1999; 11:150-4. [PMID: 10476309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
The aim of this study was to evaluate factors predicting length of stay in hospital of geriatric patients. Study participants were 402 patients (183 males and 219 females) consecutively admitted to four geriatric wards located in Chieti, Perugia, Pescara and Prato, Italy. Information on potential predictors of length of stay was collected; in particular, we assessed the presence and severity of specific chronic medical conditions, level of physical function, cognitive status, and depressive symptoms. Moreover, information on family and social support was obtained. In general, participants were old, often cognitively impaired and physically disabled. Average length of stay ranged from 9.4 +/- 3.3 days (Perugia) to 14.1 +/- 7.2 days (Chieti), and was statistically different across centers (p < 0.001). None of the specific medical diagnoses was associated with different length of stay. However, higher comorbidity score (p < 0.001), living alone (p < 0.01), lower MMSE score (p = 0.03), and poor functional status (p = 0.05) were all associated with longer length of stay. When these variables were included in a multivariate model predicting length of stay, differences between centers were no longer statistically significant. Findings of this study show that specific medical diagnoses are not adequate instruments to estimate length of stay in geriatric units. Other assessment systems based on extension of the social network, comorbidity, and the cognitive as well as the functional level need to be developed.
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Affiliation(s)
- A Di Iorio
- Department of Medicine and Aging, University of Chieti, Italy
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Benvenuti F, Mecacci R, Gineprari I, Bandinelli S, Benvenuti E, Ferrucci L, Baroni A, Rabuffetti M, Hallett M, Dambrosia JM, Stanhope SJ. Kinematic characteristics of standing disequilibrium: reliability and validity of a posturographic protocol. Arch Phys Med Rehabil 1999; 80:278-87. [PMID: 10084435 DOI: 10.1016/s0003-9993(99)90138-7] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate retest reliability and concurrent validity of the fundamental measurements made of a posturographic protocol that employs quiet standing to quantify the severity and the nature of patients' postural disturbances. STUDY DESIGN Retrospective complete block design. SETTING Geriatric rehabilitation department. PARTICIPANTS Thirty-six participants (age range, 67 to 86 yrs) having normal, moderate, or severe levels of disequilibrium. METHODS Quiet standing was evaluated on three occasions using a three-dimensional motion analysis system and a force platform. Eight testing conditions, designed to vary task difficulty by controlling the contributions of vision, foot proprioception, and base-of-support width, were administered. MAIN OUTCOME MEASURES Retest reliability of body sway, joint alignment, body position, and motor coordination indicators were evaluated by intraclass correlation coefficients (ICCs). Concurrent validity of protocol measures was evaluated by the prediction of disequilibrium from a stepwise linear discriminant analysis. RESULTS ICCs indicated high level of retest reliability for all variables but those of motor coordination, which was not influenced by testing conditions. Discriminant analysis resulted in a four-factor discriminator that included measures of body sway, position, alignment, and motor coordination. The derived linear discriminate function correctly classified 96% of the patients' level of disequilibrium. CONCLUSIONS The posturographic protocol has the potential to be a useful tool for evaluating severity and nature of postural instability and the effects of pharmacologic and rehabilitative treatment. Results also indicate that combining direct body measurements with force-plate data has the potential to expose the underlying impairments that cause disequilibrium, determine their pathogenesis, and evaluate compensatory strategies.
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Affiliation(s)
- F Benvenuti
- Unita Operativa di Geriatria, Istituto Nazionale Ricovero e Cura Anziani, Florence, Italy
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Ferrucci L, Del Lungo I, Guralnik JM, Bandinelli S, Benvenuti E, Salani B, Lamponi M, Ubezio C, Benvenuti F, Baroni A. Is the telephone interview for cognitive status a valid alternative in persons who cannot be evaluated by the Mini Mental State Examination? Aging (Milano) 1998; 10:332-8. [PMID: 9825025 DOI: 10.1007/bf03339796] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The Mini Mental State Examination (MMSE), a widely used tool for first-line assessment of cognitive function, cannot be fully administered to persons with severe visual or upper extremity impairments. This cross-sectional study, which was performed in a sample of patients admitted to the outpatient clinic of the INRCA Geriatric Department "I Fraticini" (Firenze, Italy) and their relatives, evaluated whether the Telephone Interview for Cognitive Status (TICS), a test originally created for telephone screening of cognitive impairment, is a valid alternative for assessment of cognition in persons who cannot provide valid responses to all the MMSE items. Fifteen subjects in each of seven MMSE strata (9-11, 12-14, 15-17, 18-20, 21-23, 24-26, 27-30) were consecutively selected. Inclusion criteria were: age > or = 60 years; Italian as the main language; education > or = 3 years; medical stability; and ability to complete the MMSE. At admission, participants were examined for dementia by an expert clinician according to the DSM IV criteria. Italian versions of the TICS and the MMSE were administered face-to-face by two trained interviewers. The TICS was readministered face-to-face one week later by the same interviewer that had previously administered the test. The TICS showed good test-retest reproducibility. Assessments taken one week apart differed on average by 0.52 +/- 1.9 points (p < 0.01), indicating a systematic improvement. The TICS explained 96% of the variance in the MMSE, and this association was independent of age, gender and education. More than 90% of the cases "screening positive" (i.e., scoring below a certain cut-off) by the TICS, were also identified as "screening positive" when comparable MMSE cut-off scores were used. Using comparable cut-off scores, the sensitivity and specificity of TICS and MMSE in detecting a standard clinical diagnosis of dementia largely overlapped. In persons who cannot be evaluated with the MMSE in its full form, the face-to-face administration of the TICS is a reliable and valid alternative.
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Affiliation(s)
- L Ferrucci
- Department of Gerontology, University of Firenze, Italy
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Bader AM, Datta S, Arthur GR, Benvenuti E, Courtney M, Hauch M. Maternal and fetal catecholamines and uterine incision-to-delivery interval during elective cesarean. Obstet Gynecol 1990; 75:600-3. [PMID: 2107478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The fetal sympathoadrenal system is activated during periods of intrauterine stress such as inadequate uterine perfusion. During cesarean, the period of interruption of utero-placental blood flow is extended as the time interval from uterine incision to delivery increases. An increasing uterine incision-to-delivery interval with spinal or general anesthesia has been associated with a poorer neonatal outcome. This association has not been demonstrated previously in patients undergoing cesarean delivery under epidural anesthesia. We investigated the correlation between prolonged uterine incision-to-delivery intervals, fetal catecholamine concentrations, and fetal blood gas values at delivery in 25 parturients undergoing cesarean under epidural anesthesia and in 28 under spinal anesthesia. Infants delivered after prolonged uterine incision-to-delivery intervals had significantly lower pH values in both the epidural and spinal groups. With longer uterine incision-to-delivery intervals, umbilical arterial norepinephrine concentrations were increased significantly. Umbilical arterial pH values were significantly lower in infants with higher umbilical arterial catecholamine concentrations. The importance of minimizing the uterine incision-to-delivery interval, regardless of the type of anesthetic selected, is demonstrated.
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Affiliation(s)
- A M Bader
- Department of Anesthesia, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Roux H, Paulin R, Vovan L, Lanza M, Fructus X, Conti V, Blachère C, Benvenuti E, Faugère MC. [Dyslipidemia and hyperbaric osteonecrosis in the rat]. Rev Rhum Mal Osteoartic 1982; 49:615-9. [PMID: 7187127] [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: 01/23/2023]
Abstract
The authors subjected 149 adult Sprague-Dawley rats to repeated experimental dives, simulated to 160 m. Histopathological examination (femurs and tibias) revealed no evidence of osteonecrosis in either normal or dyslipidaemic animals. Study of the calcium metabolism using 45Ca revealed a significant drop in the levels of free and bound calcium and in the rate of exchange between the two compartments, in the dyslipidaemic animal placed in hyperbaric conditions.
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