1
|
Questa M, Weimer BC, Fiehn O, Chow B, Hill SL, Ackermann MR, Lidbury JA, Steiner JM, Suchodolski JS, Marsilio S. Unbiased serum metabolomic analysis in cats with naturally occurring chronic enteropathies before and after medical intervention. Sci Rep 2024; 14:6939. [PMID: 38521833 PMCID: PMC10960826 DOI: 10.1038/s41598-024-57004-2] [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: 10/17/2023] [Accepted: 03/13/2024] [Indexed: 03/25/2024] Open
Abstract
Chronic enteropathies (CE) are common disorders in cats and the differentiation between the two main underlying diseases, inflammatory bowel disease (IBD) and low-grade intestinal T-cell lymphoma (LGITL), can be challenging. Characterization of the serum metabolome could provide further information on alterations of disease-associated metabolic pathways and may identify diagnostic or therapeutic targets. Unbiased metabolomics analysis of serum from 28 cats with CE (14 cats with IBD, 14 cats with LGITL) and 14 healthy controls identified 1,007 named metabolites, of which 129 were significantly different in cats with CE compared to healthy controls at baseline. Random Forest analysis revealed a predictive accuracy of 90% for differentiating controls from cats with chronic enteropathy. Metabolic pathways found to be significantly altered included phospholipids, amino acids, thiamine, and tryptophan metabolism. Several metabolites were found to be significantly different between cats with IBD versus LGITL, including several sphingolipids, phosphatidylcholine 40:7, uridine, pinitol, 3,4-dihydroxybenzoic acid, and glucuronic acid. However, random forest analysis revealed a poor group predictive accuracy of 60% for the differentiation of IBD from LGITL. Of 129 compounds found to be significantly different between healthy cats and cats with CE at baseline, 58 remained different following treatment.
Collapse
Affiliation(s)
- Maria Questa
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, One Shields Avenue, Davis, CA, 95616, USA
| | - Bart C Weimer
- Department of Population Health and Reproduction, 100K Pathogen Genome Project, University of California School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Oliver Fiehn
- West Coast Metabolomics Center, University of California Davis, Davis, CA, USA
| | - Betty Chow
- VCA Animal Specialty & Emergency Center, Los Angeles, CA, USA
| | - Steve L Hill
- Veterinary Specialty Hospital, San Diego, CA, USA
| | - Mark R Ackermann
- US Department of Agriculture, National Animal Disease Center, Ames, IA, USA
| | - Jonathan A Lidbury
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, USA
| | - Joerg M Steiner
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, USA
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, USA
| | - Sina Marsilio
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, One Shields Avenue, Davis, CA, 95616, USA.
| |
Collapse
|
2
|
Forman MA, Steiner JM, Armstrong PJ, Camus MS, Gaschen L, Hill SL, Mansfield CS, Steiger K. Response to letter regarding "ACVIM consensus statement on pancreatitis in cats". J Vet Intern Med 2024; 38:17. [PMID: 38032253 PMCID: PMC10800204 DOI: 10.1111/jvim.16943] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Marnin A Forman
- Cornell University Veterinary Specialists, Stamford, Connecticut, USA
| | - Joerg M Steiner
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - P Jane Armstrong
- College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota, USA
| | - Melinda S Camus
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Lorrie Gaschen
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Steve L Hill
- Flagstaff Veterinary Internal Medicine Consulting, Flagstaff, Arizona, USA
| | - Caroline S Mansfield
- Melbourne Veterinary School, University of Melbourne, Melbourne, Victoria, Australia
| | - Katja Steiger
- Institute of Pathology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| |
Collapse
|
3
|
Sung CH, Pilla R, Marsilio S, Chow B, Zornow KA, Slovak JE, Lidbury JA, Steiner JM, Hill SL, Suchodolski JS. Fecal Concentrations of Long-Chain Fatty Acids, Sterols, and Unconjugated Bile Acids in Cats with Chronic Enteropathy. Animals (Basel) 2023; 13:2753. [PMID: 37685017 PMCID: PMC10486672 DOI: 10.3390/ani13172753] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 07/25/2023] [Revised: 08/17/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Chronic enteropathy (CE) in cats encompasses food-responsive enteropathy, chronic inflammatory enteropathy (or inflammatory bowel disease), and low-grade intestinal T-cell lymphoma. While alterations in the gut metabolome have been extensively studied in humans and dogs with gastrointestinal disorders, little is known about the specific metabolic profile of cats with CE. As lipids take part in energy storage, inflammation, and cellular structure, investigating the lipid profile in cats with CE is crucial. This study aimed to measure fecal concentrations of various fatty acids, sterols, and bile acids. Fecal samples from 56 cats with CE and 77 healthy control cats were analyzed using gas chromatography-mass spectrometry, targeting 12 fatty acids, 10 sterols, and 5 unconjugated bile acids. Fecal concentrations of nine targeted fatty acids and animal-derived sterols were significantly increased in cats with CE. However, fecal concentrations of plant-derived sterols were significantly decreased in cats with CE. Additionally, an increased percentage of primary bile acids was observed in a subset of cats with CE. These findings suggest the presence of lipid maldigestion, malabsorption, and inflammation in the gastrointestinal tract of cats with CE. Understanding the lipid alterations in cats with CE can provide insights into the disease mechanisms and potential future therapeutic strategies.
Collapse
Affiliation(s)
- Chi-Hsuan Sung
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX 77843, USA; (C.-H.S.)
| | - Rachel Pilla
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX 77843, USA; (C.-H.S.)
| | - Sina Marsilio
- UC Davis School of Veterinary Medicine, Department of Veterinary Medicine and Epidemiology, University of California, Davis, CA 95616, USA
| | - Betty Chow
- Veterinary Specialty Hospital, San Diego, CA 92121, USA
- VCA Animal Specialty and Emergency Center, Los Angeles, CA 90025, USA
| | | | | | - Jonathan A. Lidbury
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX 77843, USA; (C.-H.S.)
| | - Joerg M. Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX 77843, USA; (C.-H.S.)
| | - Steve L. Hill
- Veterinary Specialty Hospital, San Diego, CA 92121, USA
- Flagstaff Veterinary Internal Medicine Consulting, Flagstaff, AZ 86004, USA
| | - Jan S. Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX 77843, USA; (C.-H.S.)
| |
Collapse
|
4
|
King A, Hill SL, Pucci M, Bailey G, Keating L, Macfarlane R, Cantle F, Hudson S, Thomas SHL. Clinical features associated with ADB-BUTINACA exposure in patients attending emergency departments in England. Clin Toxicol (Phila) 2022; 60:1094-1098. [PMID: 35943421 DOI: 10.1080/15563650.2022.2101469] [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: 11/03/2022]
Abstract
OBJECTIVE Synthetic cannabinoid receptor agonists (SCRA) are commonly encountered new psychoactive substances. Here we report the recent detection of ADB-BUTINACA in samples from patients attending United Kingdom emergency departments with toxicity after suspected drug misuse and describe the associated clinical features. METHODS Consenting adults (≥16 y) presenting to participating hospitals with toxicity after suspected drug misuse have been included in the Identification Of Novel psychoActive substances (IONA) study since March 2015. Demographic and clinical features are recorded and blood and/or urine samples analysed using high-resolution accurate mass liquid chromatography-mass spectrometry. RESULTS By December 2021, analytical data were available for 1279 IONA participants and ADB-BUTINACA was detected in at least one sample from 10 (9 males, age range 16-51 median 45 years), all presenting since February 2021. Smoking 'spice' was reported by four patients, two had ingested edible "cannabis" gums and four reported heroin use (2 intravenous, 1 smoked, 1 route not known). Co-use of pregabalin (oral) and crack cocaine (smoked) were also reported. In 3 cases ADB-BUTINACA was the only substance detected, while in seven other substances of misuse were also detected including other SCRA, opioids, benzodiazepines cocaine and pregabalin. Clinical features reported in these 2 groups respectively included reduced level of consciousness (3/3, 6/7), agitation (0/3, 4/7), tachycardia (0/3, 3/7), seizures (1/3, 1/7), hallucinations (1/3, 1/7), hypotension (1/3, 1/7). Metabolic acidosis (1/3, 0/7) and respiratory acidosis (1/3, 0/7), All 10 patients recovered with supportive care, including intubation and ventilation for one case. The median length of hospital stay was 19 h (range 2.6-131 h). CONCLUSIONS ADB-BUTINACA has recently emerged as a drug of misuse in England. Clinical features of toxicity are consistent with those of other SCRA and include reduced level of consciousness, respiratory and/or metabolic acidosis, seizures, confusion and hallucinations.
Collapse
Affiliation(s)
- A King
- Newcastle Hospitals NHS Foundation Trust, Newcastle, United Kingdom
| | - S L Hill
- Newcastle Hospitals NHS Foundation Trust, Newcastle, United Kingdom.,Translational and Clinical Research Institute, Newcastle University, Newcastle, United Kingdom
| | - M Pucci
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - G Bailey
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - L Keating
- Royal Berkshire NHS Foundation Trust, Reading, United Kingdom
| | - R Macfarlane
- Epsom and St Helier NHS Trust, Epsom, United Kingdom
| | - F Cantle
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - S Hudson
- Sport and Specialised Analytical Services, Fordham, United Kingdom
| | - S H L Thomas
- Newcastle Hospitals NHS Foundation Trust, Newcastle, United Kingdom.,Translational and Clinical Research Institute, Newcastle University, Newcastle, United Kingdom
| |
Collapse
|
5
|
Sung CH, Marsilio S, Chow B, Zornow KA, Slovak JE, Pilla R, Lidbury JA, Steiner JM, Park SY, Hong MP, Hill SL, Suchodolski JS. Dysbiosis index to evaluate the fecal microbiota in healthy cats and cats with chronic enteropathies. J Feline Med Surg 2022; 24:e1-e12. [PMID: 35266809 PMCID: PMC9160961 DOI: 10.1177/1098612x221077876] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Previous studies have identified various bacterial taxa that are altered in cats with chronic enteropathies (CE) vs healthy cats. Therefore, the aim of this study was to develop a targeted quantitative molecular method to evaluate the fecal microbiota of cats. METHODS Fecal samples from 80 client-owned healthy cats and 68 cats with CE were retrospectively evaluated. A panel of quantitative PCR (qPCR) assays was used to measure the fecal abundance of total bacteria and seven bacterial taxa: Bacteroides, Bifidobacterium, Clostridium hiranonis, Escherichia coli, Faecalibacterium, Streptococcus and Turicibacter. The nearest centroid classifier algorithm was used to calculate a dysbiosis index (DI) based on these qPCR abundances. RESULTS The abundances of total bacteria, Bacteroides, Bifidobacterium, C hiranonis, Faecalibacterium and Turicibacter were significantly decreased, while those of E coli and Streptococcus were significantly increased in cats with CE (P <0.027 for all). The DI in cats with CE was significantly higher compared with healthy cats (P <0.001). When the cut-off value of the DI was set at 0, it provided 77% (95% confidence interval [CI] 66-85) sensitivity and 96% (95% CI 89-99) specificity to differentiate the microbiota of cats with CE from those of healthy cats. Fifty-two of 68 cats with CE had a DI >0. CONCLUSIONS AND RELEVANCE A qPCR-based DI for assessing the fecal microbiota of cats was established. The results showed that a large proportion of cats with CE had an altered fecal microbiota as evidenced by an increased DI. Prospective studies are warranted to evaluate the utility of this assay for clinical assessment of feline CE.
Collapse
Affiliation(s)
- Chi-Hsuan Sung
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| | - Sina Marsilio
- UC Davis School of Veterinary Medicine, Department of Veterinary Medicine and Epidemiology, University of California-Davis, Davis, CA, USA
| | - Betty Chow
- Veterinary Specialty Hospital, San Diego, CA, USA
- VCA Animal Specialty and Emergency Center, Los Angeles, CA, USA
| | | | | | - Rachel Pilla
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| | - Jonathan A Lidbury
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| | - Jörg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| | - So Young Park
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| | - Min-Pyo Hong
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| | - Steve L Hill
- Veterinary Specialty Hospital, San Diego, CA, USA
- Flagstaff Veterinary Internal Medicine Consulting, Flagstaff, AZ, USA
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| |
Collapse
|
6
|
Pucci M, Hudson S, Hill SL, Thomas SHL. Severe toxicity involving N-pyrrolidino etonitazene in the United Kingdom-a case report. Clin Toxicol (Phila) 2021; 60:533-534. [PMID: 34528860 DOI: 10.1080/15563650.2021.1979235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M Pucci
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
| | - S Hudson
- LGC Sport and Specialised Analytical Services, Fordham, UK
| | - S L Hill
- Clinical Toxicology, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.,Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - S H L Thomas
- Clinical Toxicology, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.,Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
7
|
Forman MA, Steiner JM, Armstrong PJ, Camus MS, Gaschen L, Hill SL, Mansfield CS, Steiger K. Response to letter regarding "ACVIM consensus statement on pancreatitis in cats". J Vet Intern Med 2021; 35:1646-1647. [PMID: 34021507 PMCID: PMC8295654 DOI: 10.1111/jvim.16164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/03/2021] [Indexed: 11/27/2022] Open
Affiliation(s)
- Marnin A Forman
- Cornell University Veterinary Specialists, Stamford, Connecticut, USA
| | - Joerg M Steiner
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - P Jane Armstrong
- College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota, USA
| | - Melinda S Camus
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Lorrie Gaschen
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Steve L Hill
- Flagstaff Veterinary Internal Medicine Consulting, Flagstaff, Arizona, USA
| | - Caroline S Mansfield
- Melbourne Veterinary School, University of Melbourne, Melbourne, Victoria, Australia
| | - Katja Steiger
- Institute of Pathology, School of Medicine, Technical University of Munich, Munich, Germany
| |
Collapse
|
8
|
Forman MA, Steiner JM, Armstrong PJ, Camus MS, Gaschen L, Hill SL, Mansfield CS, Steiger K. Response to letter regarding "ACVIM consensus statement on pancreatitis in cats". J Vet Intern Med 2021; 35:1650-1651. [PMID: 34021509 PMCID: PMC8295698 DOI: 10.1111/jvim.16167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/03/2021] [Indexed: 11/27/2022] Open
Affiliation(s)
- Marnin A Forman
- Cornell University Veterinary Specialists, Stamford, Connecticut, USA
| | - Joerg M Steiner
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - P Jane Armstrong
- College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota, USA
| | - Melinda S Camus
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Lorrie Gaschen
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Steve L Hill
- Flagstaff Veterinary Internal Medicine Consulting, Flagstaff, Arizona, USA
| | | | - Katja Steiger
- Institute of Pathology, School of Medicine, Technical University of Munich, Munich, Germany
| |
Collapse
|
9
|
Marsilio S, Chow B, Hill SL, Ackermann MR, Estep JS, Sarawichitr B, Pilla R, Lidbury JA, Steiner JM, Suchodolski JS. Untargeted metabolomic analysis in cats with naturally occurring inflammatory bowel disease and alimentary small cell lymphoma. Sci Rep 2021; 11:9198. [PMID: 33911166 PMCID: PMC8080598 DOI: 10.1038/s41598-021-88707-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/09/2021] [Indexed: 01/07/2023] Open
Abstract
Feline chronic enteropathy (CE) is a common gastrointestinal disorder in cats and mainly comprises inflammatory bowel disease (IBD) and small cell lymphoma (SCL). Differentiation between IBD and SCL can be diagnostically challenging. We characterized the fecal metabolome of 14 healthy cats and 22 cats with naturally occurring CE (11 cats with IBD and 11 cats with SCL). Principal component analysis and heat map analysis showed distinct clustering between cats with CE and healthy controls. Random forest classification revealed good group prediction for healthy cats and cats with CE, with an overall out-of-bag error rate of 16.7%. Univariate analysis indicated that levels of 84 compounds in cats with CE differed from those in healthy cats. Polyunsaturated fatty acids held discriminatory power in differentiating IBD from SCL. Metabolomic profiles of cats with CE resembled those in people with CE with significant alterations of metabolites related to tryptophan, arachidonic acid, and glutathione pathways.
Collapse
Affiliation(s)
- Sina Marsilio
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, One Shields Avenue, Davis, CA, 95616, USA. .,Gastrointestinal Laboratory, Texas A&M University, College Station, TX, USA.
| | - Betty Chow
- Veterinary Specialty Hospital, San Diego, CA, USA.,VCA Animal Specialty and Emergency Center, Los Angeles, CA, USA
| | - Steve L Hill
- Veterinary Specialty Hospital, San Diego, CA, USA.,Flagstaff Veterinary Internal Medicine Consulting, Flagstaff, AZ, USA
| | - Mark R Ackermann
- Oregon Veterinary Diagnostic Laboratory, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
| | - J Scot Estep
- Texas Veterinary Pathology, LLC., San Antonio, TX, USA
| | | | - Rachel Pilla
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, USA
| | - Jonathan A Lidbury
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, USA
| | - Joerg M Steiner
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, USA
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, USA
| |
Collapse
|
10
|
Forman MA, Steiner JM, Armstrong PJ, Camus MS, Gaschen L, Hill SL, Mansfield CS, Steiger K. ACVIM consensus statement on pancreatitis in cats. J Vet Intern Med 2021; 35:703-723. [PMID: 33587762 PMCID: PMC7995362 DOI: 10.1111/jvim.16053] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [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: 01/06/2021] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 12/16/2022] Open
Abstract
Background Pancreatitis in cats, although commonly diagnosed, still presents many diagnostic and management challenges. Objective To summarize the current literature as it relates to etiology, pathogenesis, diagnosis, and management of pancreatitis in cats and to arrive at clinically relevant suggestions for veterinary clinicians that are based on evidence, and where such evidence is lacking, based on consensus of experts in the field. Animals None. Methods A panel of 8 experts in the field (5 internists, 1 radiologist, 1 clinical pathologist, and 1 anatomic pathologist), with support from a librarian, was formed to assess and summarize evidence in the peer reviewed literature and complement it with consensus clinical recommendations. Results There was little literature on the etiology and pathogenesis of spontaneous pancreatitis in cats, but there was much in the literature about the disease in humans, along with some experimental evidence in cats and nonfeline species. Most evidence was in the area of diagnosis of pancreatitis in cats, which was summarized carefully. In contrast, there was little evidence on the management of pancreatitis in cats. Conclusions and Clinical Importance Pancreatitis is amenable to antemortem diagnosis by integrating all clinical and diagnostic information available, and recognizing that acute pancreatitis is far easier to diagnose than chronic pancreatitis. Although both forms of pancreatitis can be managed successfully in many cats, management measures are far less clearly defined for chronic pancreatitis.
Collapse
Affiliation(s)
- Marnin A Forman
- Cornell University Veterinary Specialists, Stamford, Connecticut, USA
| | - Joerg M Steiner
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - P Jane Armstrong
- College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota, USA
| | - Melinda S Camus
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Lorrie Gaschen
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Louisiana, USA
| | - Steve L Hill
- Flagstaff Veterinary Internal Medicine Consulting, Flagstaff, Arizona, USA
| | | | - Katja Steiger
- Institute of Pathology, School of Medicine, Technical University of Munich, Munich, Germany
| |
Collapse
|
11
|
Chow B, Hill SL, Richter KP, Marsilio S, Ackermann MR, Lidbury JA, Suchodolski JS, Cocker S, Steiner JM. Comprehensive comparison of upper and lower endoscopic small intestinal biopsy in cats with chronic enteropathy. J Vet Intern Med 2020; 35:190-198. [PMID: 33345405 PMCID: PMC7848359 DOI: 10.1111/jvim.16000] [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: 08/20/2020] [Revised: 12/01/2020] [Accepted: 12/03/2020] [Indexed: 01/01/2023] Open
Abstract
Background Integrating immunohistochemistry (IHC) and clonality testing with histopathology may improve the ability to differentiate inflammatory bowel disease (IBD) and alimentary small cell lymphoma (LSA) in cats. Hypothesis/Objectives To evaluate the utility of histopathology, IHC, and clonality testing to differentiate between IBD and LSA and agreement of diagnostic results for endoscopic biopsy (EB) samples from the upper (USI) and lower small intestine (LSI). Animals Fifty‐seven cats with IBD or LSA. Methods All cases were categorized as definitive IBD (DefIBD), possible LSA (PossLSA), probable LSA (ProbLSA), or definitive LSA (DefLSA) based on histopathology alone. Results from IHC and clonality testing were integrated. Results Based on histopathology alone, 24/57 (42.1%), 15/57 (26.3%), and 18/57 (31.6%) cats were diagnosed with DefIBD, PossLSA or ProbLSA, and DefLSA, respectively. After integrating IHC and clonality testing, 11/24 cases (45.8%) and 15/15 cases (100%) previously categorized as DefIBD and PossLSA or ProbLSA, respectively, were reclassified as LSA. A final diagnosis of IBD and LSA was reported in 13/57 (22.8%) and 44/57 (77.2%) cats, respectively. Agreement between USI and LSI samples was moderate based on histopathology alone (κ = 0.66) and after integrating IHC and clonality testing (κ = 0.70). However, only 1/44 (2.3%) of the LSA cases was diagnosed based on LSI biopsy alone. Conclusions and Clinical Importance Integrating IHC and clonality testing increased the number of cases diagnosed with LSA, but the consequence for patient outcome is unclear. There was moderate agreement between USI and LSI samples. Samples from the LSI rarely changed the diagnosis.
Collapse
Affiliation(s)
- Betty Chow
- Veterinary Specialty Hospital by Ethos Veterinary Health, San Diego, California, USA.,VCA Animal Specialty & Emergency Center, Los Angeles, California, USA
| | - Steve L Hill
- Veterinary Specialty Hospital by Ethos Veterinary Health, San Diego, California, USA.,Flagstaff Veterinary Internal Medicine Consulting, Flagstaff, Arizona, USA
| | - Keith P Richter
- Veterinary Specialty Hospital by Ethos Veterinary Health, San Diego, California, USA
| | - Sina Marsilio
- Department of Medicine and Epidemiology, University of California, School of Veterinary Medicine, Davis, California, USA.,Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, USA
| | - Mark R Ackermann
- Department of Biomedical Sciences and Oregon Veterinary Diagnostic Laboratory, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA
| | - Jonathan A Lidbury
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, USA
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, USA
| | - Sarah Cocker
- Veterinary Specialty Hospital by Ethos Veterinary Health, San Diego, California, USA
| | - Jörg M Steiner
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, USA
| |
Collapse
|
12
|
Al-Banaa I, Hawkins L, Hill SL, Lupton DJ, Jackson G, Sandilands EA, Bradberry SM, Thompson JP, Rushton S, Thomas SHL. Effect of the UK Psychoactive Substances Act 2016 on episodes of toxicity related to new psychoactive substances as reported to the National Poisons Information Service. A time series analysis. Int J Drug Policy 2020; 77:102672. [PMID: 32032867 DOI: 10.1016/j.drugpo.2020.102672] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 01/13/2020] [Accepted: 01/21/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND There have been recent increases in use of new psychoactive substances (NPS) associated with acute health harms including hospital presentations due to toxicity and increasing numbers of deaths. In response, the UK Government enacted generic legislation on 26th May 2016 (the Psychoactive Substances Act) making it an offence to produce, possess with intent to supply, supply, import or export, or possess within a custodial setting a psychoactive substance. We studied the impact of this Act on monthly frequency of enquiries made by health professionals to the UK National Poisons Information Service (NPIS) about NPS. We also studied five commonly used 'conventional' drugs of misuse that had been controlled prior to January 2009. METHOD Anonymised clinical enquiries to the NPIS and accesses to the poisons information database TOXBASE were reviewed retrospectively from January 2009 to December 2018 to ascertain the trends in reported toxicity for NPS, cocaine, heroin, cannabis, amphetamines and MDMA. Data were analysed using interrupted time series analysis with the date of the PSA used as an independent predictor. RESULTS Over the period of study there were 3,866 NPIS telephone enquiries and 79,271 TOXBASE user accesses made by UK health professionals concerning NPS. There were increases in monthly TOXBASE accesses (t = 7.408, P < 0.0001) and telephone enquiries (t = 4.74, P < 0.001) over the pre-specified period January 2009 to May 2016. Comparing the period after the PSA with that before, there were significant reductions in TOXBASE accesses (t = -3.327, P < 0.001) and telephone enquiries (t = -6.97, P < 0.001), although reductions started before May 2016. There were no significant changes for the five conventional drugs. There were significant reductions in telephone enquiries (t = -3.418, P < 0.001) and non-significant reductions in TOXBASE accesses (t = -1.713, P = 0.089) for NPS between June 2016 and December 2018. Increases in telephone enquiries for cocaine and reductions TOXBASE accesses for MDMA were also observed over that period. CONCLUSIONS There have been significant recent reductions in NPIS enquiry activity relating to NPS; although these began before enactment of the PSA in May 2016.
Collapse
Affiliation(s)
- I Al-Banaa
- Health Protection Research Unit for Chemical and Radiation Threats and Hazards, Newcastle University, Newcastle NE2 4HH, United Kingdom; College of Pharmacy, Department of Pharmacology and Toxicology, University of Mosul, Iraq.
| | - L Hawkins
- National Poisons Information Service (Newcastle Unit), Newcastle upon Tyne Hospitals NHS Foundation Trust, Wolfson Unit, Claremont Place, Newcastle upon Tyne, NE2 4HH, United Kingdom
| | - S L Hill
- National Poisons Information Service (Newcastle Unit), Newcastle upon Tyne Hospitals NHS Foundation Trust, Wolfson Unit, Claremont Place, Newcastle upon Tyne, NE2 4HH, United Kingdom
| | - D J Lupton
- National Poisons Information Service (Edinburgh Unit), Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
| | - G Jackson
- National Poisons Information Service (Edinburgh Unit), Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
| | - E A Sandilands
- National Poisons Information Service (Edinburgh Unit), Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom
| | - S M Bradberry
- National Poisons Information Service (Birmingham Unit), City Hospital, Dudley Road, Birmingham B18 7QH, United Kingdom
| | - J P Thompson
- National Poisons Information Service, Cardiff Unit, University Hospital Llandough, Penlan Road, Penarth, Vale of Glamorgan CF64 2XX, United Kingdom
| | - S Rushton
- School of Natural and Environmental Sciences, Newcastle University, Newcastle NE2 4HH, United Kingdom
| | - S H L Thomas
- Health Protection Research Unit for Chemical and Radiation Threats and Hazards, Newcastle University, Newcastle NE2 4HH, United Kingdom
| |
Collapse
|
13
|
Rogers AD, Frinault BAV, Barnes DKA, Bindoff NL, Downie R, Ducklow HW, Friedlaender AS, Hart T, Hill SL, Hofmann EE, Linse K, McMahon CR, Murphy EJ, Pakhomov EA, Reygondeau G, Staniland IJ, Wolf-Gladrow DA, Wright RM. Antarctic Futures: An Assessment of Climate-Driven Changes in Ecosystem Structure, Function, and Service Provisioning in the Southern Ocean. Ann Rev Mar Sci 2020; 12:87-120. [PMID: 31337252 DOI: 10.1146/annurev-marine-010419-011028] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In this article, we analyze the impacts of climate change on Antarctic marine ecosystems. Observations demonstrate large-scale changes in the physical variables and circulation of the Southern Ocean driven by warming, stratospheric ozone depletion, and a positive Southern Annular Mode. Alterations in the physical environment are driving change through all levels of Antarctic marine food webs, which differ regionally. The distributions of key species, such as Antarctic krill, are also changing. Differential responses among predators reflect differences in species ecology. The impacts of climate change on Antarctic biodiversity will likely vary for different communities and depend on species range. Coastal communities and those of sub-Antarctic islands, especially range-restricted endemic communities, will likely suffer the greatest negative consequences of climate change. Simultaneously, ecosystem services in the Southern Ocean will likely increase. Such decoupling of ecosystem services and endemic species will require consideration in the management of human activities such as fishing in Antarctic marine ecosystems.
Collapse
Affiliation(s)
- A D Rogers
- Department of Zoology, University of Oxford, Oxford OX1 3PS, United Kingdom;
- REV Ocean, 1366 Lysaker, Norway
| | - B A V Frinault
- School of Geography and the Environment, University of Oxford, Oxford OX1 3QY, United Kingdom
| | - D K A Barnes
- British Antarctic Survey, Natural Environment Research Council, Cambridge CB3 0ET, United Kingdom
| | - N L Bindoff
- Antarctic Climate and Ecosystems Cooperative Research Centre and CSIRO Oceans and Atmospheres, University of Tasmania, Hobart, Tasmania 7001, Australia
| | - R Downie
- WWF, Living Planet Centre, Surrey GU21 4LL, United Kingdom
| | - H W Ducklow
- Lamont-Doherty Earth Observatory and Department of Earth and Environmental Sciences, Columbia University, Palisades, New York 10964-8000, USA
| | - A S Friedlaender
- Institute for Marine Sciences, University of California, Santa Cruz, California 95060, USA
| | - T Hart
- Department of Zoology, University of Oxford, Oxford OX1 3PS, United Kingdom;
| | - S L Hill
- British Antarctic Survey, Natural Environment Research Council, Cambridge CB3 0ET, United Kingdom
| | - E E Hofmann
- Center for Coastal Physical Oceanography, Old Dominion University, Norfolk, Virginia 23508, USA
| | - K Linse
- British Antarctic Survey, Natural Environment Research Council, Cambridge CB3 0ET, United Kingdom
| | - C R McMahon
- Integrated Marine Observing System Animal Tracking Facility, Sydney Institute of Marine Science, Sydney, New South Wales 2088, Australia
| | - E J Murphy
- British Antarctic Survey, Natural Environment Research Council, Cambridge CB3 0ET, United Kingdom
| | - E A Pakhomov
- Department of Earth, Ocean, and Atmospheric Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
- Aquatic Ecosystems Research Lab, Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - G Reygondeau
- Aquatic Ecosystems Research Lab, Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - I J Staniland
- British Antarctic Survey, Natural Environment Research Council, Cambridge CB3 0ET, United Kingdom
| | - D A Wolf-Gladrow
- Alfred-Wegener-Institut Helmholtz Zentrum für Polar- und Meeresforschung (AWI), 27570 Bremerhaven, Germany
| | - R M Wright
- Tyndall Centre, School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ, United Kingdom
| |
Collapse
|
14
|
Marsilio S, Pilla R, Sarawichitr B, Chow B, Hill SL, Ackermann MR, Estep JS, Lidbury JA, Steiner JM, Suchodolski JS. Characterization of the fecal microbiome in cats with inflammatory bowel disease or alimentary small cell lymphoma. Sci Rep 2019; 9:19208. [PMID: 31844119 PMCID: PMC6914782 DOI: 10.1038/s41598-019-55691-w] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 11/30/2019] [Indexed: 12/21/2022] Open
Abstract
Feline chronic enteropathy (CE) is a common gastrointestinal disorder in cats and mainly comprises inflammatory bowel disease (IBD) and small cell lymphoma (SCL). Both IBD and SCL in cats share features with chronic enteropathies such as IBD and monomorphic epitheliotropic intestinal T-cell lymphoma in humans. The aim of this study was to characterize the fecal microbiome of 38 healthy cats and 27 cats with CE (13 cats with IBD and 14 cats with SCL). Alpha diversity indices were significantly decreased in cats with CE (OTU p = 0.003, Shannon Index p = 0.008, Phylogenetic Diversity p = 0.019). ANOSIM showed a significant difference in bacterial communities, albeit with a small effect size (P = 0.023, R = 0.073). Univariate analysis and LEfSE showed a lower abundance of facultative anaerobic taxa of the phyla Firmicutes (families Ruminococcaceae and Turicibacteraceae), Actinobacteria (genus Bifidobacterium) and Bacteroidetes (i.a. Bacteroides plebeius) in cats with CE. The facultative anaerobic taxa Enterobacteriaceae and Streptococcaceae were increased in cats with CE. No significant difference between the microbiome of cats with IBD and those with SCL was found. Cats with CE showed patterns of dysbiosis similar to those in found people with IBD.
Collapse
Affiliation(s)
- Sina Marsilio
- Gastrointestinal Laboratory, Department of Small Animal Clinical Science, Texas A&M University, 4474 TAMU, College Station, TX, 77843-4474, USA.
- University of California Davis, School of Veterinary Medicine, Department of Medicine & Epidemiology, Davis, CA, 95616, USA.
| | - Rachel Pilla
- Gastrointestinal Laboratory, Department of Small Animal Clinical Science, Texas A&M University, 4474 TAMU, College Station, TX, 77843-4474, USA
| | - Benjamin Sarawichitr
- Gastrointestinal Laboratory, Department of Small Animal Clinical Science, Texas A&M University, 4474 TAMU, College Station, TX, 77843-4474, USA
| | - Betty Chow
- Veterinary Specialty Hospital, 10435 Sorrento Valley Rd, San Diego, CA, 92121, USA
- VCA Animal Specialty & Emergency Center, 1535 South Sepulveda Blvd, Los Angeles, CA, 90025, USA
| | - Steve L Hill
- Veterinary Specialty Hospital, 10435 Sorrento Valley Rd, San Diego, CA, 92121, USA
- Flagstaff Veterinary Internal Medicine Consulting (FLG VIM-C), 6135 Kaitlin Way, Flagstaff, AZ, 86003, USA
| | - Mark R Ackermann
- Oregon Veterinary Diagnostic Laboratory, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
| | - J Scot Estep
- Texas Veterinary Pathology, LLC, San Antonio, TX, USA
| | - Jonathan A Lidbury
- Gastrointestinal Laboratory, Department of Small Animal Clinical Science, Texas A&M University, 4474 TAMU, College Station, TX, 77843-4474, USA
| | - Joerg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Science, Texas A&M University, 4474 TAMU, College Station, TX, 77843-4474, USA
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Science, Texas A&M University, 4474 TAMU, College Station, TX, 77843-4474, USA
| |
Collapse
|
15
|
Cavan EL, Belcher A, Atkinson A, Hill SL, Kawaguchi S, McCormack S, Meyer B, Nicol S, Ratnarajah L, Schmidt K, Steinberg DK, Tarling GA, Boyd PW. The importance of Antarctic krill in biogeochemical cycles. Nat Commun 2019; 10:4742. [PMID: 31628346 PMCID: PMC6800442 DOI: 10.1038/s41467-019-12668-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [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: 03/07/2019] [Accepted: 09/25/2019] [Indexed: 02/02/2023] Open
Abstract
Antarctic krill (Euphausia superba) are swarming, oceanic crustaceans, up to two inches long, and best known as prey for whales and penguins - but they have another important role. With their large size, high biomass and daily vertical migrations they transport and transform essential nutrients, stimulate primary productivity and influence the carbon sink. Antarctic krill are also fished by the Southern Ocean's largest fishery. Yet how krill fishing impacts nutrient fertilisation and the carbon sink in the Southern Ocean is poorly understood. Our synthesis shows fishery management should consider the influential biogeochemical role of both adult and larval Antarctic krill.
Collapse
Affiliation(s)
- E L Cavan
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS, Australia.
- Department of Life Sciences, Imperial College London, Silwood Park Campus, Buckhurst Road, Ascot, Berkshire, SL5 7PY, UK.
| | - A Belcher
- British Antarctic Survey, Natural Environment Research Council, High Cross, Madingley Rd, Cambridge, CB3 0ET, UK
| | - A Atkinson
- Plymouth Marine Laboratory, Prospect Place, The Hoe, Plymouth, PL1 3DH, UK
| | - S L Hill
- British Antarctic Survey, Natural Environment Research Council, High Cross, Madingley Rd, Cambridge, CB3 0ET, UK
| | - S Kawaguchi
- Australian Antarctic Division, Kingston, TAS, Australia
| | - S McCormack
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS, Australia
- Antarctic Climate and Ecosystems CRC, University of Tasmania, Hobart, TAS, Australia
| | - B Meyer
- Alfred Wegener Institute for Polar and Marine Research, Bremerhaven, Germany
- Institute for Chemistry and Biology of the Marine Environment, University of Oldenburg, Carl-von-Ossietzky-Straße 9-11, 26111, Oldenburg, Germany
- Helmholtz Institute for Functional Marine Biodiversity at the University of Oldenburg, Ammerländer Heerstrasse 231, Oldenburg, 26129, Germany
| | - S Nicol
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS, Australia
| | - L Ratnarajah
- Department of Earth, Ocean and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - K Schmidt
- School of Geography, Earth and Environmental Science, University of Plymouth, Plymouth, UK
| | - D K Steinberg
- Virginia Institute of Marine Science, College of William & Mary, Williamsburg, VA, USA
| | - G A Tarling
- British Antarctic Survey, Natural Environment Research Council, High Cross, Madingley Rd, Cambridge, CB3 0ET, UK
| | - P W Boyd
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, TAS, Australia
- Antarctic Climate and Ecosystems CRC, University of Tasmania, Hobart, TAS, Australia
| |
Collapse
|
16
|
Belcher A, Henson SA, Manno C, Hill SL, Atkinson A, Thorpe SE, Fretwell P, Ireland L, Tarling GA. Krill faecal pellets drive hidden pulses of particulate organic carbon in the marginal ice zone. Nat Commun 2019; 10:889. [PMID: 30792498 PMCID: PMC6385259 DOI: 10.1038/s41467-019-08847-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 02/04/2019] [Indexed: 02/01/2023] Open
Abstract
The biological carbon pump drives a flux of particulate organic carbon (POC) through the ocean and affects atmospheric levels of carbon dioxide. Short term, episodic flux events are hard to capture with current observational techniques and may thus be underrepresented in POC flux estimates. We model the potential hidden flux of POC originating from Antarctic krill, whose swarming behaviour could result in a major conduit of carbon to depth through their rapid exploitation of phytoplankton blooms and bulk egestion of rapidly sinking faecal pellets (FPs). Our model results suggest a seasonal krill FP export flux of 0.039 GT C across the Southern Ocean marginal ice zone, corresponding to 17-61% (mean 35%) of current satellite-derived export estimates for this zone. The magnitude of our conservatively estimated flux highlights the important role of large, swarming macrozooplankton in POC export and, the need to incorporate such processes more mechanistically to improve model projections.
Collapse
Affiliation(s)
- A Belcher
- British Antarctic Survey, Cambridge, CB3 0ET, UK.
| | - S A Henson
- National Oceanography Centre, Southampton, SO14 3ZH, UK
| | - C Manno
- British Antarctic Survey, Cambridge, CB3 0ET, UK
| | - S L Hill
- British Antarctic Survey, Cambridge, CB3 0ET, UK
| | - A Atkinson
- Plymouth Marine Laboratory, Prospect Place, The Hoe, Plymouth, PL1 3DH, UK
| | - S E Thorpe
- British Antarctic Survey, Cambridge, CB3 0ET, UK
| | - P Fretwell
- British Antarctic Survey, Cambridge, CB3 0ET, UK
| | - L Ireland
- British Antarctic Survey, Cambridge, CB3 0ET, UK
| | - G A Tarling
- British Antarctic Survey, Cambridge, CB3 0ET, UK
| |
Collapse
|
17
|
Hill SL, Olson KC, Jaeger JR, Stevenson JS. Serum and plasma metabolites associated with postpartum ovulation and pregnancy risks in suckled beef cows subjected to artificial insemination. J Anim Sci 2018; 96:258-272. [PMID: 29385490 DOI: 10.1093/jas/skx033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 01/17/2018] [Indexed: 01/08/2023] Open
Abstract
Two experiments were conducted to determine relationships of blood metabolite concentrations, BW, BCS, and rump fat depth with postpartum ovulation and pregnancy risks, as well as their utility in predicting those outcomes in suckled beef cows. In experiment 1, plasma glucose collected 10 and 3 d before AI of suckled beef cows at seven locations did not differ between cows that had resumed estrous cycles (ovulated) before AI compared with anovulatory cows, whereas plasma glucose 3 d before AI was greater (P < 0.01) in cows that became pregnant compared with nonpregnant cows. Serum beta-hydroxybutyrate (BHB) tended (P = 0.09) to be less in ovulatory cows compared with anovulatory cows 10 d before AI, but was unrelated to pregnancy status. Receiver-operator derived true-positive (sensitivity) and false-positive (1-specificity) risks were determined for plasma glucose and serum BHB as predictors for postpartum ovulation and pregnancy status. Serum BHB 3 d before AI produced true-positive and false-positive risks of 82% and 37%, respectively, when predicting ovulatory status before AI. Serum BHB 10 d before AI produced a true-positive and false-positive risks of 92% and 25%, respectively, when predicting pregnancy status. In experiment 2, blood was collected weekly for 12 wk from multiparous suckled beef cows to assess blood metabolite concentrations in addition to concurrent weekly assessments of BW, BCS, and rump fat. When blood metabolites and physical measures were normalized to parturition reflecting changes occurring during the first 6 wk after calving, we observed reduced (P < 0.05) concentrations of serum BHB and NEFA, and greater (P < 0.05) rump fat and BCS in cows that ovulated before first AI, whereas reduced (P < 0.05) plasma glucose was characteristic of cows that became pregnant. When blood metabolites and physical measures were normalized to the onset of the AI program reflecting changes during 6 wk before AI, ovulatory cows had increased (P < 0.05) BCS and lower (P < 0.05) NEFA from 3 to 6 wk before the onset of the AI program compared with anovulatory cows. With all predictor variables in regression models, some multiple correlation coefficients (R2) exceeded 50% when predicting postpartum ovulatory status, but those for predicting pregnancy risk were less than 25%. Although measures of BCS and BHB during 6 wk after calving were related to postpartum ovulation risk, rump fat, glucose, BCS, and NEFA were associated with cows that were ovulatory and pregnant.
Collapse
Affiliation(s)
- S L Hill
- Department of Animal Sciences and Industry, Kansas State University, Manhattan, KS
| | - K C Olson
- Department of Animal Sciences and Industry, Kansas State University, Manhattan, KS
| | - J R Jaeger
- Department of Animal Sciences and Industry, Kansas State University, Manhattan, KS
| | | |
Collapse
|
18
|
Minamoto T, Walzem RL, Hamilton AJ, Hill SL, Payne HR, Lidbury JA, Suchodolski JS, Steiner JM. Altered lipoprotein profiles in cats with hepatic lipidosis. J Feline Med Surg 2018; 21:363-372. [PMID: 29860906 DOI: 10.1177/1098612x18780060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The aim of this study was to assess serum lipoprotein profiles using rapid single-spin continuous lipoprotein density profiling (CLPDP) in healthy control cats and cats with hepatic lipidosis (HL). METHODS Analysis of serum lipoprotein profiles using the CLPDP was performed in 23 cats with HL and 20 healthy control cats. The area under the curve for each lipoprotein fraction, triglyceride (TG)-rich lipoproteins (TRLs), low-density lipoproteins (LDLs) and high-density lipoproteins (HDLs), was calculated. Serum cholesterol and TG concentrations were measured using a clinical chemistry analyzer. RESULTS Serum cholesterol and TG concentrations were not significantly different between healthy control cats and cats with HL ( P = 0.5075 and P = 0.2541, respectively). LDL content was significantly higher in cats with HL than in healthy control cats ( P = 0.0001), while HDL content was significantly lower in cats with HL than in healthy control cats ( P = 0.0032). TRL content was not significantly different between the two groups ( P = 0.0699). The specific fraction (1.037-1.043 g/ml) within nominal LDL in serum distinguished healthy control cats from cats with HL with a sensitivity of 87% and a specificity of 90%. CONCLUSIONS AND RELEVANCE Serum lipoprotein profiles were altered in cats with HL, even though serum cholesterol and TG concentrations were not significantly different compared with healthy control cats. The CLPDP might be a useful tool for assessing lipid metabolism in cats with HL.
Collapse
Affiliation(s)
- Tomomi Minamoto
- 1 Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| | - Rosemary L Walzem
- 2 Department of Poultry Science and Faculty of Nutrition, Texas A&M University, College Station, TX, USA
| | | | - Steve L Hill
- 3 Veterinary Specialty Hospital, San Diego, CA, USA
| | - Harold R Payne
- 4 Image Analysis Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Jonathan A Lidbury
- 1 Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| | - Jan S Suchodolski
- 1 Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| | - Jörg M Steiner
- 1 Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| |
Collapse
|
19
|
Stevenson JS, Hill SL, Grieger DM, Olson KC, Jaeger JR, Ahola J, Seidel GE, Kasimanickam RK. Two split-time artificial insemination programs in suckled beef cows. J Anim Sci 2018; 95:5105-5111. [PMID: 29293737 DOI: 10.2527/jas2017.1805] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Our objective was to determine which of 2 split-time AI programs applied to suckled beef cows would result in greater pregnancy risk. Suckled beef cows (n = 1,062) at 12 locations in 4 states (CO, KS, MY, and WA) were enrolled. Cows were treated on d -7 with a progesterone insert concurrent with 100 µg GnRH and on d 0 with 25 mg PGF plus removal of the insert. Estrus-detection patches were affixed to cows at insert removal. The study was designed as a completely randomized experiment of 2 treatment combinations. Within location and balanced for parity (primiparous vs. multiparous), cows were assigned randomly to 2 treatment times (55 vs. 65 h after CIDR insert removal) at which time estrus-detection patches were assessed. Estrus was defined to have occurred when an estrus-detection patch was > 50% colored (activated). Cows determined to be in estrus were inseminated at either 55 or 65 h, whereas the residual nonestrous cows in both treatment times received GnRH at 55 or 65 h but were inseminated 20 h later at 75 or 85 h, respectively. Pregnancy outcomes were determined at 36 d after AI and at the end of the breeding season. Thus, pregnancy outcomes of interest were compared between the 55 + 75-h treatment combination and that of the 65+85-h combination. Expression of estrus was greater ( = 0.001) by 65 h after PGF than by 55 h (62.0% vs. 41.9%), respectively, and this proportion was influenced by parity (time x parity interaction; = 0.006). As a result, proportionally more ( < 0.001) cows received the timed AI at 75 than 85 h (59.4% vs. 40.6%). Similar proportions of cows not in estrus by 55 or 65 h were detected in estrus by 75 or 85 h (40.1% vs. 39.3%), respectively. The cumulative proportion of cows in estrus by 75 h was less ( < 0.001) than that by 85 h (66.7% vs. 76.7%), respectively. Pregnancy risks at 36 d differed among treatments, with cows detected in estrus and inseminated at 55 or 65 h having greater pregnancy risks than their time-inseminated herd mates at 75 or 85 h (62.3% vs.49.7%), respectively. Overall pregnancy risk for cows in the 65+85-h treatment combination was greater at 36 d than for cows in the 55 + 75-h treatment combination (61.0% vs. 51.4%), respectively. We conclude that the 65 + 85-h treatment combination produced more pregnancies than the 55 + 75-h combination, but its implementation may be somewhat less convenient in terms of cow handling times.
Collapse
|
20
|
Dworkin JP, Adelman LA, Ajluni T, Andronikov AV, Aponte JC, Bartels AE, Beshore E, Bierhaus EB, Brucato JR, Bryan BH, Burton AS, Callahan MP, Castro-Wallace SL, Clark BC, Clemett SJ, Connolly HC, Cutlip WE, Daly SM, Elliott VE, Elsila JE, Enos HL, Everett DF, Franchi IA, Glavin DP, Graham HV, Hendershot JE, Harris JW, Hill SL, Hildebrand AR, Jayne GO, Jenkens RW, Johnson KS, Kirsch JS, Lauretta DS, Lewis AS, Loiacono JJ, Lorentson CC, Marshall JR, Martin MG, Matthias LL, McLain HL, Messenger SR, Mink RG, Moore JL, Nakamura-Messenger K, Nuth JA, Owens CV, Parish CL, Perkins BD, Pryzby MS, Reigle CA, Righter K, Rizk B, Russell JF, Sandford SA, Schepis JP, Songer J, Sovinski MF, Stahl SE, Thomas-Keprta K, Vellinga JM, Walker MS. OSIRIS-REx Contamination Control Strategy and Implementation. Space Sci Rev 2018; 214:19. [PMID: 30713357 PMCID: PMC6350808 DOI: 10.1007/s11214-017-0439-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OSIRIS-REx will return pristine samples of carbonaceous asteroid Bennu. This article describes how pristine was defined based on expectations of Bennu and on a realistic understanding of what is achievable with a constrained schedule and budget, and how that definition flowed to requirements and implementation. To return a pristine sample, the OSIRIS-REx spacecraft sampling hardware was maintained at level 100 A/2 and <180 ng/cm2 of amino acids and hydrazine on the sampler head through precision cleaning, control of materials, and vigilance. Contamination is further characterized via witness material exposed to the spacecraft assembly and testing environment as well as in space. This characterization provided knowledge of the expected background and will be used in conjunction with archived spacecraft components for comparison with the samples when they are delivered to Earth for analysis. Most of all, the cleanliness of the OSIRIS-REx spacecraft was achieved through communication among scientists, engineers, managers, and technicians.
Collapse
Affiliation(s)
- J P Dworkin
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - L A Adelman
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
- Arctic Slope Research Corporation, Beltsville, MD USA
| | - T Ajluni
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
- Arctic Slope Research Corporation, Beltsville, MD USA
| | | | - J C Aponte
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
- Catholic University of America, Washington, DC, USA
| | - A E Bartels
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - E Beshore
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ, USA
| | - E B Bierhaus
- Lockheed Martin Space Systems, Littleton, CO, USA
| | - J R Brucato
- INAF Astrophysical Observatory of Arcetri, Florence, Italy
| | - B H Bryan
- Lockheed Martin Space Systems, Littleton, CO, USA
| | - A S Burton
- NASA Johnson Space Center, Houston, TX, USA
| | | | | | - B C Clark
- Space Science Institute, Boulder, CO, USA
| | - S J Clemett
- NASA Johnson Space Center, Houston, TX, USA
- Jacobs Technology, Tullahoma, TN, USA
| | | | - W E Cutlip
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - S M Daly
- NASA Kennedy Space Center, Titusville, FL, USA
| | - V E Elliott
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - J E Elsila
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - H L Enos
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ, USA
| | - D F Everett
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | | | - D P Glavin
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - H V Graham
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
- University of Maryland, College Park, MD, USA
| | - J E Hendershot
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
- Ball Aerospace, Boulder, CO, USA
| | - J W Harris
- Lockheed Martin Space Systems, Littleton, CO, USA
| | - S L Hill
- Jacobs Technology, Tullahoma, TN, USA
- NASA Kennedy Space Center, Titusville, FL, USA
| | | | - G O Jayne
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
- Arctic Slope Research Corporation, Beltsville, MD USA
| | - R W Jenkens
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - K S Johnson
- Lockheed Martin Space Systems, Littleton, CO, USA
| | - J S Kirsch
- Jacobs Technology, Tullahoma, TN, USA
- NASA Kennedy Space Center, Titusville, FL, USA
| | - D S Lauretta
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ, USA
| | - A S Lewis
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - J J Loiacono
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - C C Lorentson
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | | | - M G Martin
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
- Catholic University of America, Washington, DC, USA
| | - L L Matthias
- NASA Kennedy Space Center, Titusville, FL, USA
- Analex, Titusville, FL, USA
| | - H L McLain
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
- Catholic University of America, Washington, DC, USA
| | | | - R G Mink
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - J L Moore
- Lockheed Martin Space Systems, Littleton, CO, USA
| | | | - J A Nuth
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - C V Owens
- NASA Kennedy Space Center, Titusville, FL, USA
| | - C L Parish
- Lockheed Martin Space Systems, Littleton, CO, USA
| | - B D Perkins
- NASA Kennedy Space Center, Titusville, FL, USA
| | - M S Pryzby
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
- ATA Aerospace, Albuquerque, NM, USA
| | - C A Reigle
- Lockheed Martin Space Systems, Littleton, CO, USA
| | - K Righter
- NASA Johnson Space Center, Houston, TX, USA
| | - B Rizk
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ, USA
| | - J F Russell
- Lockheed Martin Space Systems, Littleton, CO, USA
| | - S A Sandford
- NASA Ames Research Center, Moffett Field, CA, USA
| | - J P Schepis
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - J Songer
- Lockheed Martin Space Systems, Littleton, CO, USA
| | - M F Sovinski
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - S E Stahl
- NASA Johnson Space Center, Houston, TX, USA
- JES Tech., Houston, TX, USA
| | - K Thomas-Keprta
- NASA Johnson Space Center, Houston, TX, USA
- Jacobs Technology, Tullahoma, TN, USA
| | - J M Vellinga
- Lockheed Martin Space Systems, Littleton, CO, USA
| | - M S Walker
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| |
Collapse
|
21
|
Hill SL, Grieger DM, Olson KC, Jaeger JR, Dahlen CR, Bridges GA, Dantas F, Larson JE, Muth-Spurlock AM, Ahola JK, Fischer MC, Perry GA, Larimore EL, Steckler TL, Whittier WD, Currin JF, Stevenson JS. Using estrus detection patches to optimally time insemination improved pregnancy risk in suckled beef cows enrolled in a fixed-time artificial insemination program. J Anim Sci 2017; 94:3703-3710. [PMID: 27898921 DOI: 10.2527/jas.2016-0469] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A multilocation study examined pregnancy risk (PR) after delaying AI in suckled beef cows from 60 to 75 h when estrus had not been detected by 60 h in response to a 7-d CO-Synch + progesterone insert (CIDR) timed AI (TAI) program (d -7: CIDR insert concurrent with an injection of GnRH; d 0: PGF injection and removal of CIDR insert; and GnRH injection at TAI [60 or 75 h after CIDR removal]). A total of 1,611 suckled beef cows at 15 locations in 9 states (CO, IL, KS, MN, MS, MT, ND, SD, and VA) were enrolled. Before applying the fixed-time AI program, BCS was assessed, and blood samples were collected. Estrus was defined to have occurred when an estrus detection patch was >50% colored (activated). Pregnancy was determined 35 d after AI via transrectal ultrasound. Cows ( = 746) detected in estrus by 60 h (46.3%) after CIDR removal were inseminated and treated with GnRH at AI (Control). Remaining nonestrous cows were allocated within location to 3 treatments on the basis of parity and days postpartum: 1) GnRH injection and AI at 60 h (early-early = EE; = 292), 2) GnRH injection at 60 h and AI at 75 h (early-delayed = ED; = 282), or 3) GnRH injection and AI at 75 h (delayed-delayed = DD; = 291). Control cows had a greater ( < 0.01) PR (64.2%) than other treatments (EE = 41.7%, ED = 52.8%, DD = 50.0%). Use of estrus detection patches to delay AI in cows not in estrus by 60 h after CIDR insert removal (ED and DD treatments) increased ( < 0.05) PR to TAI when compared with cows in the EE treatment. More ( < 0.001) cows that showed estrus by 60 h conceived to AI at 60 h than those not showing estrus (64.2% vs. 48.1%). Approximately half (49.2%) of the cows not in estrus by 60 h had activated patches by 75 h, resulting in a greater ( < 0.05) PR than their nonestrous herd mates in the EE (46.1% vs. 34.5%), ED (64.2% vs. 39.2%), and DD (64.8% vs. 31.5%) treatments, respectively. Overall, cows showing estrus by 75 h (72.7%) had greater ( < 0.001) PR to AI (61.3% vs. 37.9%) than cows not showing estrus. Use of estrus detection patches to allow for a delayed AI in cows not in estrus by 60 h after removal of the CIDR insert improved PR to TAI by optimizing the timing of the AI in those cows.
Collapse
|
22
|
Walker PP, Thompson E, Hill SL, Holton K, Bodger K, Pearson MG. Commissioning for COPD care: a new, recordable metric that supports the patient interest. J Public Health (Oxf) 2015; 38:396-402. [PMID: 25926524 DOI: 10.1093/pubmed/fdv056] [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: 11/13/2022] Open
Abstract
BACKGROUND Healthcare metrics have been used to drive improvement in outcome and delivery in UK hospital stroke and cardiac care. This model is attractive for chronic obstructive pulmonary disease (COPD) care because of disease frequency and the burden it places on primary, secondary and integrated care services. METHODS Using 'hospital episode statistics' (UK 'coding'), we examined hospital 'bed days/1000 population' in 150 UK Primary Care Trusts (PCTs) during 2006-07 and 2007-08. Data were adjusted for COPD prevalence. We looked at year-on-year consistency and factors which influenced variation. RESULTS There were 248 996 COPD admissions during 2006-08. 'Bed days/1000 PCT population' was consistent between years (r = 0.87; P < 0.001). There was a >2-fold difference in bed days between the best and worst performing PCTs which was primarily a consequence of variation in emergency admission rate (P < 0.001) and proportion of emergency admissions due to COPD (P < 0.001) and to only a lesser extent length of hospital stay (P < 0.001). CONCLUSIONS Bed days/1000 population appears a useful annual metric of COPD care quality. Good COPD care keeps patients active and out of hospital and requires co-ordinated action from both hospital and community services, with an important role for integrated care. This metric demonstrates that current care is highly variable and offers a measurable target to commission against.
Collapse
Affiliation(s)
- Paul Phillip Walker
- Aintree Health Outcomes Partnership, University of Liverpool, University Hospital Aintree, Clinical Science Building, Lower Lane, Liverpool L9 7AL, UK
| | - E Thompson
- Aintree Health Outcomes Partnership, University of Liverpool, University Hospital Aintree, Clinical Science Building, Lower Lane, Liverpool L9 7AL, UK
| | - S L Hill
- Department of Health, Wellington House, Waterloo Road, London, UK
| | - K Holton
- Department of Health, Wellington House, Waterloo Road, London, UK
| | - K Bodger
- Aintree Health Outcomes Partnership, University of Liverpool, University Hospital Aintree, Clinical Science Building, Lower Lane, Liverpool L9 7AL, UK
| | - M G Pearson
- Aintree Health Outcomes Partnership, University of Liverpool, University Hospital Aintree, Clinical Science Building, Lower Lane, Liverpool L9 7AL, UK
| |
Collapse
|
23
|
Chartier MA, Hill SL, Sunico S, Suchodolski JS, Robertson JE, Steiner JM. Pancreas-specific lipase concentrations and amylase and lipase activities in the peritoneal fluid of dogs with suspected pancreatitis. Vet J 2014; 201:385-9. [PMID: 25106805 DOI: 10.1016/j.tvjl.2014.07.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 03/17/2014] [Revised: 06/02/2014] [Accepted: 07/21/2014] [Indexed: 10/25/2022]
Abstract
Diagnosing acute pancreatitis in the dog can be challenging. The aim of this study was to determine the concentrations of pancreas-specific lipase immunoreactivity (cPLI), and the activities of amylase and lipase, in the peritoneal fluid from a population of dogs diagnosed with acute pancreatitis based on clinical signs, ultrasonographic findings and serum cPLI concentrations. In a prospective study, cPLI concentrations, and amylase and lipase activities, were measured in the peritoneal fluid of 14 dogs with pancreatitis and 19 dogs with non-pancreatic disease. The sensitivity and specificity of peritoneal fluid cPLI concentration (cut-off value 500 µg/L) were 100.0% (95% confidence interval, CI, 80.7-100.0%) and 94.7% (95% CI 76.7-99.7%), respectively. The sensitivity and specificity of peritoneal fluid amylase (cut-off value 1050 U/L) and lipase activities (cut-off value 500 U/L) were 71.4% (95% CI 44.5-90.2%) and 84.2% (95% CI 62.8-95.8%) for amylase activity, and 92.9% (95% CI 69.5-99.6%) and 94.7% (95% CI 76.7-99.7%) for lipase activity, respectively. In conclusion, peritoneal fluid cPLI concentration was highly sensitive as a complementary diagnostic tool in a group of dogs with suspected acute pancreatitis. Peritoneal fluid lipase activity was not as sensitive as cPLI concentration, but may also support a diagnosis of acute pancreatitis in dogs.
Collapse
Affiliation(s)
- Marie A Chartier
- Veterinary Specialty Hospital of San Diego, 10435 Sorrento Valley Road, San Diego, CA 92121, USA; IVG MetroWest, 5 Strathmore Road, Natick, MA 01760, USA.
| | - Steve L Hill
- Veterinary Specialty Hospital of San Diego, 10435 Sorrento Valley Road, San Diego, CA 92121, USA
| | - Sarena Sunico
- Veterinary Specialty Hospital of San Diego, 10435 Sorrento Valley Road, San Diego, CA 92121, USA
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843, USA
| | | | - Joerg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843, USA
| |
Collapse
|
24
|
Amunts K, Hawrylycz MJ, Van Essen DC, Van Horn JD, Harel N, Poline JB, De Martino F, Bjaalie JG, Dehaene-Lambertz G, Dehaene S, Valdes-Sosa P, Thirion B, Zilles K, Hill SL, Abrams MB, Tass PA, Vanduffel W, Evans AC, Eickhoff SB. Interoperable atlases of the human brain. Neuroimage 2014; 99:525-32. [PMID: 24936682 DOI: 10.1016/j.neuroimage.2014.06.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 05/05/2014] [Accepted: 06/02/2014] [Indexed: 12/11/2022] Open
Abstract
The last two decades have seen an unprecedented development of human brain mapping approaches at various spatial and temporal scales. Together, these have provided a large fundus of information on many different aspects of the human brain including micro- and macrostructural segregation, regional specialization of function, connectivity, and temporal dynamics. Atlases are central in order to integrate such diverse information in a topographically meaningful way. It is noteworthy, that the brain mapping field has been developed along several major lines such as structure vs. function, postmortem vs. in vivo, individual features of the brain vs. population-based aspects, or slow vs. fast dynamics. In order to understand human brain organization, however, it seems inevitable that these different lines are integrated and combined into a multimodal human brain model. To this aim, we held a workshop to determine the constraints of a multi-modal human brain model that are needed to enable (i) an integration of different spatial and temporal scales and data modalities into a common reference system, and (ii) efficient data exchange and analysis. As detailed in this report, to arrive at fully interoperable atlases of the human brain will still require much work at the frontiers of data acquisition, analysis, and representation. Among them, the latter may provide the most challenging task, in particular when it comes to representing features of vastly different scales of space, time and abstraction. The potential benefits of such endeavor, however, clearly outweigh the problems, as only such kind of multi-modal human brain atlas may provide a starting point from which the complex relationships between structure, function, and connectivity may be explored.
Collapse
Affiliation(s)
- K Amunts
- Institute of Neuroscience and Medicine, INM-1, Research Centre Jülich, Germany; C. and O. Vogt Institute for Brain Research, Heinrich Heine University, Düsseldorf, Germany
| | | | - D C Van Essen
- Department of Anatomy and Neurobiology, Washington University School of Medicine, St. Louis, MO, USA
| | - J D Van Horn
- The Institute for Neuroimaging and Informatics (INI) and Laboratory for Neuro Imaging (LONI), Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - N Harel
- Center for Magnetic Resonance Research, Departments of Radiology & Neurosurgery, University of Minnesota School of Medicine, Minneapolis, MN, USA
| | - J-B Poline
- Hellen Wills Neuroscience Institute, Brain Imaging Center, University of California at Berkeley, CA, USA
| | - F De Martino
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - J G Bjaalie
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | | | - S Dehaene
- INSERM, U992, Cognitive Neuroimaging Unit, F-91191 Gif/Yvette, France
| | - P Valdes-Sosa
- Cuban Neuroscience Center, Havana, Cuba; Key Laboratory for Neuroinformation, Chengudu, China
| | - B Thirion
- Parietal Research Team, French Institute for Research in Computer Science and Automation (INRIA), Gif sur Yvette, France
| | - K Zilles
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH University Aachen, Aachen, Germany; Jülich-Aachen Research Alliance (JARA), Translational Brain Medicine, Jülich, Germany
| | - S L Hill
- International Neuroinformatics Coordinating Facility Secretariat (INCF), Stockholm, Sweden
| | - M B Abrams
- International Neuroinformatics Coordinating Facility Secretariat (INCF), Stockholm, Sweden.
| | - P A Tass
- Institute of Neuroscience and Medicine, INM-1, Research Centre Jülich, Germany; Department of Neuromodulation, University of Cologne, Cologne, Germany; Department of Neurosurgery, Stanford University, Stanford, USA
| | - W Vanduffel
- Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - A C Evans
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - S B Eickhoff
- Institute of Neuroscience and Medicine, INM-1, Research Centre Jülich, Germany; Institute for Clinical Neuroscience and Medical Psychology, Heinrich-Heine University, Düsseldorf, Germany
| |
Collapse
|
25
|
Walker PP, Thompson E, Crone H, Flatt G, Holton K, Hill SL, Pearson MG. Use of mortality within 30 days of a COPD hospitalisation as a measure of COPD care in UK hospitals. Thorax 2013; 68:968-70. [DOI: 10.1136/thoraxjnl-2012-202365] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
26
|
Watters GM, Hill SL, Hinke JT, Matthews J, Reid K. Decision-making for ecosystem-based management: evaluating options for a krill fishery with an ecosystem dynamics model. Ecol Appl 2013; 23:710-25. [PMID: 23865224 DOI: 10.1890/12-1371.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Decision-makers charged with implementing ecosystem-based management (EBM) rely on scientists to predict the consequences of decisions relating to multiple, potentially conflicting, objectives. Such predictions are inherently uncertain, and this can be a barrier to decision-making. The Convention on the Conservation of Antarctic Marine Living Resources requires managers of Southern Ocean fisheries to sustain the productivity of target stocks, the health and resilience of the ecosystem, and the performance of the fisheries themselves. The managers of the Antarctic krill fishery in the Scotia Sea and southern Drake Passage have requested advice on candidate management measures consisting of a regional catch limit and options for subdividing this among smaller areas. We developed a spatially resolved model that simulates krill-predator-fishery interactions and reproduces a plausible representation of past dynamics. We worked with experts and stakeholders to identify (1) key uncertainties affecting our ability to predict ecosystem state; (2) illustrative reference points that represent the management objectives; and (3) a clear and simple way of conveying our results to decision-makers. We developed four scenarios that bracket the key uncertainties and evaluated candidate management measures in each of these scenarios using multiple stochastic simulations. The model emphasizes uncertainty and simulates multiple ecosystem components relating to diverse objectives. We summarize the potentially complex results as estimates of the risk that each illustrative objective will not be achieved (i.e., of the state being outside the range specified by the reference point). This approach allows direct comparisons between objectives. It also demonstrates that a candid appraisal of uncertainty, in the form of risk estimates, can be an aid, rather than a barrier, to understanding and using ecosystem model predictions. Management measures that reduce coastal fishing, relative to oceanic fishing, apparently reduce risks to both the fishery and the ecosystem. However, alternative reference points could alter the perceived risks, so further stakeholder involvement is needed to identify risk metrics that appropriately represent their objectives.
Collapse
Affiliation(s)
- G M Watters
- Antarctic Ecosystem Research Division, Southwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, 8901 La Jolla Shores Drive, La Jolla, California 92037-1023, USA
| | | | | | | | | |
Collapse
|
27
|
Berghoff N, Parnell NK, Hill SL, Suchodolski JS, Steiner JM. Serum cobalamin and methylmalonic acid concentrations in dogs with chronic gastrointestinal disease. Am J Vet Res 2013; 74:84-9. [DOI: 10.2460/ajvr.74.1.84] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
28
|
Abstract
Objectives The purpose of this study was to evaluate the incidence of great saphenous vein (GSV) thrombosis in symptomatic patients and its possible relationship to complications usually attributed to deep venous thrombosis (DVT). Methods To quantitate the frequency of GSV thrombosis and evaluate its possible morbidity, we reviewed all the venous studies, both inpatient and outpatient, at a Level I Trauma Center over one year. The charts of all patients who had a thrombus in the GSV, either alone or in combination with a DVT, were examined. Results A total of 2646 lower extremity venous scans were done in the year studied. In this group, there were 388 (14.5%) positive studies for a DVT. There were 36 (9.3%) patients in this group who had a DVT of the lower extremity and a thrombus in the GSV. In the total group, there were 30 patients (1.1%) with a superficial thrombophlebitis of the GSV alone. In these patients, 22 (73%) either showed cephalad progression of the thrombus, symptoms of shortness of breath, a mobile tip in the thrombus or extension of the thrombus into the common femoral vein. Five patients (16.6%), after failing medical therapy (heparin, bed rest and antibiotics), underwent surgical treatment. Conclusions Thrombophlebitis of the GSV, although not very common, needs to be carefully followed with a repeat duplex scan to determine if there is propagation of the thrombus. This study shows that thrombophlebitis of the GSV can cause many of the complications attributed to deep venous thrombi and, therefore, must be thoroughly evaluated, followed, and, if necessary, treated.
Collapse
Affiliation(s)
- S L Hill
- Department of surgery, Carilion Health Systems,
Roanoke, VA, USA
| | - D H Hancock
- Department of surgery, Carilion Health Systems,
Roanoke, VA, USA
| | - T L Webb
- Department of surgery, Carilion Health Systems,
Roanoke, VA, USA
| |
Collapse
|
29
|
Hill SL, Holt DW. Can vacuum assisted venous drainage be achieved using a roller pump in an emergency? A pilot study using neonatal circuitry. J Extra Corpor Technol 2007; 39:254-256. [PMID: 18293812 PMCID: PMC4680692] [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] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
There has been much advancement in perfusion technology over its 50 years of progression. One of these techniques is vacuum-assisted venous drainage (VAVD). Many perfusionists augment venous drainage using VAVD, typically from a wall vacuum source. This study explores alternates to providing VAVD if the wall vacuum fails. In two porcine laboratories, approximately 36 in. of 3/16-in. tubing was connected to a sucker return port and placed into the roller head next to the arterial pump. The vacuum was monitored with a DLP pressure monitoring system (Medtronic). This system was connected to small-bore tubing and attached to a stopcock on top of the reservoir. The vacuum was regulated using another stopcock connected to a non-filtered luer lock port on top of the reservoir or by a segment of 3 x 0.25-in.-diameter tubing attached to the vent port with a c-clamp. Vacuum drainage was achieved, ranging from -18 mmHg to -71 mmHg by manipulating the stopcock or c-clamp. Changes in venous drainage were seen by volume fluctuations in the venous reservoir. The vacuum was adjusted to account for dramatic changes. Augmented venous drainage using a roller pump can be achieved successfully during cardiopulmonary bypass (CPB). This method of active drainage can be used in lieu of wall suction or during times of emergency if wall suction fails.
Collapse
Affiliation(s)
- S L Hill
- University of Nebraska Medical Center, Omaha, Nebraska 68198-5155, USA.
| | | |
Collapse
|
30
|
Abstract
AIMS The aims of the study were to compare bacterial recovery following storage of sputum samples at 20 degrees C room temperature and 4 degrees C (refrigerated) for 24 h, and to determine the effect of postage on viable bacterial numbers. METHODS A total of 38 individual sputum samples from clinically stable patients with bronchiectasis were split into three equal aliquots and quantitative bacterial culture was performed (i) immediately, (ii) following storage at 4 degrees C for 24 h or (iii) following storage at 20 degrees C for 24 h. A further 42 sputum samples were split into two equal aliquots and quantitative bacterial culture was performed either immediately or following postage back to the laboratory by first-class mail from an outside location. RESULTS The predominant organism could still be recovered following storage at 4 degrees C and 20 degrees C, but viable numbers were significantly reduced following storage at 4 degrees C (p<0.004) by at least an order of magnitude (10-fold) in 24% of samples stored at 4 degrees C compared with only 8% stored at 20 degrees C. Posting samples back to the laboratory did not affect the recovery of bacterial species and there was no difference in viable numbers isolated. CONCLUSIONS The results suggest that storage at room temperature is preferable to refrigeration as it retains the species isolated and the viable number. The data also confirm that sputum samples can be posted to the laboratory from patients in the community without affecting qualitative or quantitative results.
Collapse
Affiliation(s)
- A Pye
- Respiratory Research Laboratory, Department of Medicine, Queen Elizabeth Hospital, and The University of Birmingham, Edgbaston, Birmingham B15 2TH, UK.
| | | | | | | |
Collapse
|
31
|
Murphy EJ, Watkins JL, Trathan PN, Reid K, Meredith MP, Thorpe SE, Johnston NM, Clarke A, Tarling GA, Collins MA, Forcada J, Shreeve RS, Atkinson A, Korb R, Whitehouse MJ, Ward P, Rodhouse PG, Enderlein P, Hirst AG, Martin AR, Hill SL, Staniland IJ, Pond DW, Briggs DR, Cunningham NJ, Fleming AH. Spatial and temporal operation of the Scotia Sea ecosystem: a review of large-scale links in a krill centred food web. Philos Trans R Soc Lond B Biol Sci 2007; 362:113-48. [PMID: 17405210 PMCID: PMC1764830 DOI: 10.1098/rstb.2006.1957] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.4] [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: 02/05/2023] Open
Abstract
The Scotia Sea ecosystem is a major component of the circumpolar Southern Ocean system, where productivity and predator demand for prey are high. The eastward-flowing Antarctic Circumpolar Current (ACC) and waters from the Weddell-Scotia Confluence dominate the physics of the Scotia Sea, leading to a strong advective flow, intense eddy activity and mixing. There is also strong seasonality, manifest by the changing irradiance and sea ice cover, which leads to shorter summers in the south. Summer phytoplankton blooms, which at times can cover an area of more than 0.5 million km2, probably result from the mixing of micronutrients into surface waters through the flow of the ACC over the Scotia Arc. This production is consumed by a range of species including Antarctic krill, which are the major prey item of large seabird and marine mammal populations. The flow of the ACC is steered north by the Scotia Arc, pushing polar water to lower latitudes, carrying with it krill during spring and summer, which subsidize food webs around South Georgia and the northern Scotia Arc. There is also marked interannual variability in winter sea ice distribution and sea surface temperatures that is linked to southern hemisphere-scale climate processes such as the El Niño-Southern Oscillation. This variation affects regional primary and secondary production and influences biogeochemical cycles. It also affects krill population dynamics and dispersal, which in turn impacts higher trophic level predator foraging, breeding performance and population dynamics. The ecosystem has also been highly perturbed as a result of harvesting over the last two centuries and significant ecological changes have also occurred in response to rapid regional warming during the second half of the twentieth century. This combination of historical perturbation and rapid regional change highlights that the Scotia Sea ecosystem is likely to show significant change over the next two to three decades, which may result in major ecological shifts.
Collapse
Affiliation(s)
- E J Murphy
- British Antarctic Survey, Natural Environment Research Council, High Cross, Madingley Road, Cambridge CB3 0ET, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Hill SL, Murphy EJ, Reid K, Trathan PN, Constable AJ. Modelling Southern Ocean ecosystems: krill, the food-web, and the impacts of harvesting. Biol Rev Camb Philos Soc 2006; 81:581-608. [PMID: 16987430 DOI: 10.1017/s1464793106007123] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2005] [Revised: 07/10/2006] [Accepted: 07/11/2006] [Indexed: 11/07/2022]
Abstract
The ecosystem approach to fisheries recognises the interdependence between harvested species and other ecosystem components. It aims to account for the propagation of the effects of harvesting through the food-web. The formulation and evaluation of ecosystem-based management strategies requires reliable models of ecosystem dynamics to predict these effects. The krill-based system in the Southern Ocean was the focus of some of the earliest models exploring such effects. It is also a suitable example for the development of models to support the ecosystem approach to fisheries because it has a relatively simple food-web structure and progress has been made in developing models of the key species and interactions, some of which has been motivated by the need to develop ecosystem-based management. Antarctic krill, Euphausia superba, is the main target species for the fishery and the main prey of many top predators. It is therefore critical to capture the processes affecting the dynamics and distribution of krill in ecosystem dynamics models. These processes include environmental influences on recruitment and the spatially variable influence of advection. Models must also capture the interactions between krill and its consumers, which are mediated by the spatial structure of the environment. Various models have explored predator-prey population dynamics with simplistic representations of these interactions, while others have focused on specific details of the interactions. There is now a pressing need to develop plausible and practical models of ecosystem dynamics that link processes occurring at these different scales. Many studies have highlighted uncertainties in our understanding of the system, which indicates future priorities in terms of both data collection and developing methods to evaluate the effects of these uncertainties on model predictions. We propose a modelling approach that focuses on harvested species and their monitored consumers and that evaluates model uncertainty by using alternative structures and functional forms in a Monte Carlo framework.
Collapse
Affiliation(s)
- S L Hill
- British Antarctic Survey, Natural Environment Research Council, Madingley Road, High Cross, Cambridge CB3 0ET, UK
| | | | | | | | | |
Collapse
|
33
|
Abstract
BACKGROUND Bronchiectasis is a chronic suppurative lung disease often characterised by airflow obstruction and hyperinflation, and leading to decreased exercise tolerance and reduced health status. The role of pulmonary rehabilitation (PR) and inspiratory muscle training (IMT) has not been investigated in this group of patients. METHODS Thirty two patients with idiopathic bronchiectasis were randomly allocated to one of three groups: PR plus sham IMT (PR-SHAM), PR plus targeted IMT (PR-IMT), or control. All patients (except the control group) underwent an 8 week training programme of either PR or PR plus targeted IMT. Exercise training during PR was performed three times weekly at 80% of the peak heart rate. IMT was performed at home for 15 minutes twice daily over the 8 week period. RESULTS PR-SHAM and PR-IMT resulted in significant increases in the incremental shuttle walking test of 96.7 metres (95% confidence interval (CI) 59.6 to 133.7) and 124.5 metres (95% CI 63.2 to 185.9), respectively, and in endurance exercise capacity of 174.9% (95% CI 34.7 to 426.1) and 205.7% (95% CI 31.6 to 310.6). There were no statistically significant differences in the improvements in exercise between the two groups. Significant improvements in inspiratory muscle strength were also observed both in the PR-IMT group (21.4 cm H2O increase, 95% CI 9.3 to 33.4; p = 0.008) and the PR-SHAM group (12.0 cm H2O increase, 95% CI 1.1 to 22.9; p = 0.04), the magnitude of which were also similar (p = 0.220). Improvements in exercise capacity were maintained in the PR-IMT group 3 months after training, but not in the PR-SHAM group. CONCLUSION PR is effective in improving exercise tolerance in bronchiectasis but there is no additional advantage of simultaneous IMT. IMT may, however, be important in the longevity of the training effects.
Collapse
Affiliation(s)
- C Newall
- Department of Respiratory Medicine, Queen Elizabeth Hospital, Birmingham B15 2TH, UK.
| | | | | |
Collapse
|
34
|
Bacha EA, Cao QL, Galantowicz ME, Cheatham JP, Fleishman CE, Weinstein SW, Becker PA, Hill SL, Koenig P, Alboliras E, Abdulla R, Starr JP, Hijazi ZM. Multicenter experience with perventricular device closure of muscular ventricular septal defects. Pediatr Cardiol 2005; 26:169-75. [PMID: 15868323 DOI: 10.1007/s00246-004-0956-2] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Hybrid procedures are becoming increasingly important, especially in the management of congenital heart lesions for which there are no ideal surgical or interventional options. This report describes a multicenter experience with perventricular muscular venticular septal defect (VSD) device closure. Three groups of patients (n = 12) were identified: infants with isolated muscular VSDs (n = 2), neonates with aortic coarctation and muscular VSDs (n = 3) or patients with muscular VSDs and other complex cardiac lesions (n = 2), and patients with muscular VSDs and pulmonary artery bands (n = 5). Via a sternotomy or a subxyphoid approach, the right ventricle (RV) free wall was punctured under transesophageal echocardiography guidance. A guidewire was introduced across the largest defect. A short delivery sheath was positioned in the left ventricle cavity. An Amplatzer muscular VSD occluding device was deployed across the VSD. Cardiopulmonary bypass was needed only for repair of concomitant lesions, such as double-outlet right ventricle, aortic coarctation, or pulmonary artery band removal. No complications were encountered using this technique. Discharge echocardiograms showed either mild or no significant shunting across the ventricular septum. At a median follow-up of 12 months, all patients were asymptomatic and 2 patients had mild residual ventricular level shunts. Perventricular closure of muscular VSDs is safe and effective for a variety of patients with muscular VSDs.
Collapse
Affiliation(s)
- E A Bacha
- The Congenital Heart Center, The University of Chicago Hospitals, Chicago, IL 60637, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Hill SL, Hijazi ZM, Hellenbrand WE, Cheatham JP. Evaluation of the AMPLATZER vascular plug for embolization of peripheral vascular malformations associated with congenital heart disease. Catheter Cardiovasc Interv 2005; 67:113-9. [PMID: 16345050 DOI: 10.1002/ccd.20555] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The purpose of this study is to evaluate the recently FDA-approved AMPLATZER Vascular Plug in the embolization of vascular lesions associated with congenital heart disease (CHD). BACKGROUND Fistulas and arteriovenous malformations have been occluded using various devices. The AMPLATZER Vascular Plug is a self-expandable, cylindrical device, used for embolization in the peripheral vasculature. METHODS A total of 84 vessels in 52 patients with CHD from 11 centers were occluded with 89 AMPLATZER Vascular Plugs, delivered through a coronary guide catheter in various vascular sites, including collaterals, pulmonary arterio-venous and coronary artery fistulas, transhepatic tracts, central shunts, patent ductus arteriosus (PDA), and excluded hepatic vein. Complete vessel occlusion was demonstrated within 10 min in 94% of patients. RESULTS There was no device embolization, vascular disruption, or procedure-related complication. One vascular plug implanted in a large type C PDA required surgical removal followed by PDA ligation, after 5 weeks from successful implant because of significant residual flow through the device. CONCLUSIONS The AMPLATZER Vascular Plug is an effective transcatheter occlusion device in the embolization of a wide variety of vascular lesions associated with CHD. Based on our early experience, caution should be used when considering the Vascular Plug as a closure device for large PDA.
Collapse
Affiliation(s)
- S L Hill
- The Heart Center, Columbus Children's Hospital, Section of Cardiology, Department of Pediatrics, The Ohio State University, USA
| | | | | | | |
Collapse
|
36
|
White AJ, Gompertz S, Bayley DL, Hill SL, O'Brien C, Unsal I, Stockley RA. Resolution of bronchial inflammation is related to bacterial eradication following treatment of exacerbations of chronic bronchitis. Thorax 2003; 58:680-5. [PMID: 12885984 PMCID: PMC1746781 DOI: 10.1136/thorax.58.8.680] [Citation(s) in RCA: 116] [Impact Index Per Article: 5.5] [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: 11/04/2022]
Abstract
BACKGROUND Recent studies of the role of bacteria in chronic bronchitis have shown that bacterial colonisation is associated with enhanced inflammation and that purulent acute exacerbations of chronic bronchitis (AECB) are associated with bacteria and characterised by increased inflammation. Changes in bronchial inflammation in response to the success or failure of bacterial eradication following AECB were therefore studied. METHODS Bacterial quantitative culture and sputum markers of inflammation (myeloperoxidase (MPO), neutrophil elastase, leukotriene B4 (LTB4), sol:serum albumin ratio, and secretory leukoprotease inhibitor) were measured in patients presenting with culture positive purulent AECB and repeated 10 days and 2 months later. 41 patients provided sputum sufficient for both bacteriology and assessment of inflammation at baseline and day 10, and 46 provided sufficient sample for bacteriology, 40 of which could also be analysed for inflammation at 2 months (when clinically stable). RESULTS At day 10, 17 of the 41 patient samples had a positive bacterial culture. In the stable state, 18 of the 46 samples had a positive culture, but with a significantly lower bacterial load than at presentation. Although there was no difference between the groups at presentation, the concentration of MPO was lower (p<0.05) in those in whom bacteria were eradicated by day 10 than in those with persisting bacteria. The LTB4 concentration was similarly lower (p<0.001) in those in whom bacteria were eradicated than in those with persistent bacteria. In the stable clinical state the concentrations of both MPO and LTB4 were lower in those in whom bacteria were eradicated than in patients with persisting bacteria. CONCLUSION Resolution of bronchial inflammation following AECB is related to bacterial eradication. Those in whom bacteria continue to be cultured in their sputum have partial resolution of inflammation which may reflect continued stimulation by the reduced bacterial load.
Collapse
Affiliation(s)
- A J White
- Department of Respiratory Medicine, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
| | | | | | | | | | | | | |
Collapse
|
37
|
Middleton AM, Dowling RB, Mitchell JL, Watanabe S, Rutman A, Pritchard K, Tillotson G, Hill SL, Wilson R. Haemophilus parainfluenzae infection of respiratory mucosa. Respir Med 2003; 97:375-81. [PMID: 12693797 DOI: 10.1053/rmed.2002.1454] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The pathogenicity of Haemophilus parainfluenzae (Hpi) in the respiratory tract is unclear, in contrast to the accepted pathogenicity of its close relative non-typable H. influenzae. We have investigated the interaction of two Hpi isolates with the mucosa of adenoid and bronchial tissue organ cultures. The adherence of bacteria to the mucosa of organ cultures, the effect of broth culture filtrates on human nasal epithelium, and interleukin (IL)-8 production by A549 cell cultures was investigated. Hpi 4846 adhered infrequently in clusters of pleomorphic cocco-bacilli to areas of epithelial damage, mucus and unciliated cells in adenoid organ culture experiments at 24 h, but not bronchial mucosa. Hpi 3698 was seen in only one adenoid and no bronchial organ cultures at 24 h. In separate experiments, Hpi 3698 was cleared more rapidly from the centre of the adenoid organ culture and was not cultured at 24 h. Although not adhering to the mucosa at 24 h, Hpi 3698, but not Hpi 4846, caused an increase in the amount of epithelial damage in both types of organ culture. Broth culture filtrates of both strains caused immediate slowing of ciliary beat frequency that progressed, and disrupted epithelial integrity. Dialysed culture filtrates of both strains stimulated IL-8 production by A549 cells, with the culture filtrate of Hpi 3698 being most potent. We conclude that two strains of Hpi varied in their adherence to adenoid tissue, and neither adhered to bronchial tissue. These results lead us to speculate that Hpi is only likely to be a pathogen in the lower respiratory tract when impaired airway defences delay bacterial clearance.
Collapse
Affiliation(s)
- A M Middleton
- Host Defence Unit, Royal Brompton Hospital, Sydney Street, London UK
| | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Abstract
Myocarditis offers a unique opportunity to study the factors contributing to its transition from a viral infection to an autoimmune disease. In this article, we review recent studies on the role of nitric oxide (NO), gamma interferon (IFN-gamma) and interleukin 12 (IL-12) in the progression from early (viral) to late (autoimmune) phases of myocarditis induced by Coxsackievirus B3 (CB3) in highly susceptible (A.CA) and moderately susceptible (B10.M) mice. NO plays a paradoxical role, being protective in early stages but detrimental later in the course of disease. Treatment with antibody to IFN-gamma reduced early disease, but had little effect on the severity of cardiac lesions at later times. Treatment with recombinant (r) IL-12 significantly reduced the autoimmune cardiac lesions in moderately susceptible B10.M mice, but had no measurable effect in highly susceptible A.CA animals. These studies provide evidence that the profile of inflammatory mediators produced early in the course of viral infection determines the later development of autoimmune disease.
Collapse
Affiliation(s)
- S L Hill
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Medical Institutions, JHU School of Hygiene and Public Health, Baltimore, MD 21205, USA
| | | |
Collapse
|
39
|
Abstract
BACKGROUND There is a concern that comorbidity or frailty in older people could limit the usefulness of currently available exercise tests for chronic lung disease. This study evaluated the feasibility and reproducibility of the incremental shuttle walking test (SWT) in people aged 70 years or over, compared exercise tolerance with other disability markers, and assessed whether the SWT is responsive to change after bronchodilators. METHODS Fifty elderly patients with chronic airflow limitation (CAL) and 32 controls without airflow limitation attempted the SWT before and after combined nebulised salbutamol/ipratropium bromide. Subjects also completed the Nottingham Extended Activities of Daily Living index (NEADL) and the London Handicap score (LHS). RESULTS Forty four subjects with CAL (88%) and 29 controls (84%) completed the SWT, including many with co-morbidities. Two week repeatability was good and the SWT was strongly associated with EADL (r=0.51, p<0.001) and LHS (r=0.43, p<0.004), but only weakly with forced expiratory volume in 1 second (FEV1) (r=0.31, p=0.05). Subjects with CAL walked a mean distance of 177.7 m compared with 243.3 m in controls (p<0.001); following bronchodilator therapy the distance walked increased in the CAL group by 13.2% (p=0.009). CONCLUSION The SWT is a feasible and reproducible measure of exercise tolerance in elderly people with and without airflow obstruction and correlates with other markers of disability. It is sensitive to change following bronchodilation in subjects with CAL, although the change correlates less well with improvements in FEV1. Overall, these results suggest that the SWT might be an appropriate measure to assess interventions in elderly people.
Collapse
Affiliation(s)
- C A E Dyer
- Department of Geriatric Medicine, Royal United Hospital Bath NHS Trust, Bath, UK.
| | | | | | | | | |
Collapse
|
40
|
Woolhouse IS, Hill SL, Stockley RA. Symptom resolution assessed using a patient directed diary card during treatment of acute exacerbations of chronic bronchitis. Thorax 2001; 56:947-53. [PMID: 11713358 PMCID: PMC1745974 DOI: 10.1136/thorax.56.12.947] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [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: 01/15/2023]
Abstract
BACKGROUND Acute exacerbations of chronic bronchitis are common and the presenting symptoms vary, although it is not clear how this should influence management. From a health care perspective, an understanding of the speed of symptom resolution is of importance to determine the success of treatment or when a change is indicated because of treatment failure. METHODS The response of 63 patients treated at home for exacerbations of chronic bronchitis was assessed using a patient directed diary card incorporating sputum characteristics and symptoms. Treatment was given according to the nature of the sputum at presentation; patients with purulent sputum received an antibiotic for 5 or 10 days (randomised, double blind) whereas patients with mucoid sputum received high dose inhaled steroid or placebo for 14 days (randomised, double blind). RESULTS The mean (SE) total diary card score at presentation was significantly higher in the purulent group than in the mucoid group (19.7 (0.9) v 16.3 (0.9); mean difference -3.4 (95% CI -6.1 to -0.7), p<0.05). In the purulent group sputum colour and volume improved rapidly and in both groups the mean (SE) total diary card score had improved by the fifth day of treatment to 13.0 (0.7) in the purulent group (mean difference -6.6 (95% CI -8.8 to -4.4), p<0.001) and 14.6 (0.8) in the mucoid group (mean difference -1.7 (95% CI -4.0 to 0.8), p<0.05), which was no longer significantly different from the stable state. Diary card scores did not differ significantly between patients who received antibiotics for 5 or 10 days in the purulent group or between patients who received inhaled fluticasone or placebo in the mucoid group. CONCLUSIONS Exacerbations of chronic bronchitis associated with purulent sputum have significantly worse symptoms at presentation than those with mucoid sputum. In both groups these symptoms resolve rapidly so that by the fifth day of treatment they are no different from the stable state. No significant effect was found on symptom resolution of antibiotic duration (5 v 10 days) in the purulent group or of inhaled fluticasone in the mucoid group, which resolved without antibiotics. Larger numbers may be required to demonstrate a statistically (if not clinically) significant difference.
Collapse
Affiliation(s)
- I S Woolhouse
- Department of Medicine, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
| | | | | |
Collapse
|
41
|
Abstract
OBJECTIVE To compare the incremental shuttle walk test (ISWT) with treadmill exercise testing (TT) derived measurement of peak oxygen consumption (peak VO(2)) in patients undergoing assessment for cardiac transplantation. DESIGN Prospective comparison. All investigations occurred during a single period of admission for transplant assessment. SETTING Single UK cardiothoracic transplantation unit. PATIENTS 25 patients recruited (21 men). Mean age was 53 years. INTERVENTIONS Patients underwent two TT of peak VO(2) using the modified Naughton protocol and three (one practice) ISWT. Investigations were performed on consecutive days. MAIN OUTCOME MEASURES Main outcome measures were repeatability of TT and ISWT assessments; relation between peak VO(2) and distance walked in the ISWT; and receiver operating characteristic (ROC) analysis to establish a distance walked in the ISWT that predicted which patients would have a peak VO(2) greater than 14 ml/min/kg. RESULTS Both the ISWT and the TT were highly reproducible. Following the first practice walk, mean (SD) ISWT distances were 400.0 (146) m (ISWT2) and 401.3 (129) m (ISWT3), r = 0.90, p < 0.0001. Mean peak VO(2) by TT was 15.2 (4.4) ml/kg/min (TT1) and 15.0 (4.4) ml/kg/min (TT2), r = 0.83, p < 0.0001. The results revealed a strong correlation between distance covered in the ISWT and peak VO(2) obtained during TT (r = 0.73, p = 0.0001). ROC analysis showed that a distance walked of 450 m allowed the selection of patients with a peak VO(2) of over 14 ml/min/kg. CONCLUSIONS This work confirms the utility of the ISWT in the assessment of exercise capacity in patients with severe heart failure undergoing assessment for cardiac transplantation. ISWT may provide a widely applicable surrogate measure for peak VO(2) estimation in this population. Shuttle distance walked may therefore allow the convenient, serial assessment of patients with heart failure before referral for transplantation.
Collapse
Affiliation(s)
- M E Lewis
- Heart and Lung Transplantation Unit, Department of Cardiothoracic Surgery, Queen Elizabeth Hospital, University Hospital NHS Trust, Birmingham B15 2TH, UK
| | | | | | | | | |
Collapse
|
42
|
Lewis ME, Newall C, Townend JN, Hill SL, Bonser RS. Incremental shuttle walk test in the assessment of patients for heart transplantation. Heart 2001. [DOI: 10.1136/hrt.86.2.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVETo compare the incremental shuttle walk test (ISWT) with treadmill exercise testing (TT) derived measurement of peak oxygen consumption (peak Vo2) in patients undergoing assessment for cardiac transplantation.DESIGNProspective comparison. All investigations occurred during a single period of admission for transplant assessment.SETTINGSingle UK cardiothoracic transplantation unit.PATIENTS25 patients recruited (21 men). Mean age was 53 years.INTERVENTIONSPatients underwent two TT of peak Vo2 using the modified Naughton protocol and three (one practice) ISWT. Investigations were performed on consecutive days.MAIN OUTCOME MEASURESMain outcome measures were repeatability of TT and ISWT assessments; relation between peak Vo2 and distance walked in the ISWT; and receiver operating characteristic (ROC) analysis to establish a distance walked in the ISWT that predicted which patients would have a peak Vo2 greater than 14 ml/min/kg.RESULTSBoth the ISWT and the TT were highly reproducible. Following the first practice walk, mean (SD) ISWT distances were 400.0 (146) m (ISWT2) and 401.3 (129) m (ISWT3),r = 0.90, p < 0.0001. Mean peak Vo2 by TT was 15.2 (4.4) ml/kg/min (TT1) and 15.0 (4.4) ml/kg/min (TT2), r = 0.83, p < 0.0001. The results revealed a strong correlation between distance covered in the ISWT and peak Vo2obtained during TT (r = 0.73, p = 0.0001). ROC analysis showed that a distance walked of 450 m allowed the selection of patients with a peak Vo2 of over 14 ml/min/kg.CONCLUSIONSThis work confirms the utility of the ISWT in the assessment of exercise capacity in patients with severe heart failure undergoing assessment for cardiac transplantation. ISWT may provide a widely applicable surrogate measure for peak Vo2 estimation in this population. Shuttle distance walked may therefore allow the convenient, serial assessment of patients with heart failure before referral for transplantation.
Collapse
|
43
|
Afanasyeva M, Wang Y, Kaya Z, Park S, Zilliox MJ, Schofield BH, Hill SL, Rose NR. Experimental autoimmune myocarditis in A/J mice is an interleukin-4-dependent disease with a Th2 phenotype. Am J Pathol 2001; 159:193-203. [PMID: 11438466 PMCID: PMC1850414 DOI: 10.1016/s0002-9440(10)61685-9] [Citation(s) in RCA: 126] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Myocarditis in humans is often associated with an autoimmune process in which cardiac myosin (CM) is a major autoantigen. Experimental autoimmune myocarditis (EAM) is induced in mice by immunization with CM. We found that EAM in A/J mice exhibits a Th2-like phenotype demonstrated by the histological picture of the heart lesions (eosinophils and giant cells) and by the humoral response (association of IgG1 response with disease and up-regulation of total IgE). Blocking interleukin (IL)-4 with anti-IL-4 monoclonal antibody (mAb) reduced the severity of EAM. This reduction in severity was associated with a shift from a Th2-like to a Th1-like phenotype represented by a reduction in CM-specific IgG1; an increase in CM-specific IgG2a; an abrogation of total IgE response; a decrease in IL-4, IL-5, and IL-13; as well as a dramatic increase in interferon (IFN)-gamma production in vitro. Based on the latter finding, we hypothesized that IFN-gamma limits disease. Indeed, IFN-gamma blockade with a mAb exacerbated disease. The ameliorating effect of IL-4 blockade was abrogated by co-administration of anti-IFN-gamma mAb. Thus, EAM represents a model of an organ-specific autoimmune disease associated with a Th2 phenotype, in which IL-4 promotes the disease and IFN-gamma limits it. Suppression of IFN-gamma represents at least one of the mechanisms by which IL-4 promotes EAM.
Collapse
Affiliation(s)
- M Afanasyeva
- Departments of Pathology, the Johns Hopkins Medical Institutions, Baltimore, Maryland 21205, USA
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Abstract
There are little data describing noncellular changes in bronchial inflammation during exacerbations of chronic bronchitis. The relationship between sputum colour and airway inflammation at presentation has been assessed during an exacerbation in patients with chronic bronchitis and a primary care diagnosis of chronic obstructive pulmonary disease. Sputum myeloperoxidase, neutrophil elastase, leukotriene B4 (LTB4), interleukin-8 (IL-8), sol:serum albumin ratio and serum C-reactive protein were measured in patients presenting with an exacerbation and mucoid (n = 27) or purulent sputum (n = 42). Mucoid exacerbations were associated with little bronchial or systemic inflammation at presentation, and sputum bacteriology was similar to that obtained in the stable state. Purulent exacerbations were associated with marked bronchial and systemic inflammation (p < 0.025 for all features) and positive sputum cultures (90%). Resolution was related to a significant reduction in LTB4 (p < 0.01), but no change in IL-8, suggesting that LTB4 may be more important in neutrophil recruitment in these mild, purulent exacerbations. In the stable state, IL-8 remained higher in patients who had experienced a purulent exacerbation (2p < 0.02). The presented results indicate that exacerbations of chronic bronchitis, defined by sputum colour, differ in the degree of bronchial and systemic inflammation. Purulent exacerbations are related to bacterial infection, and are associated with increased neutrophilic inflammation and increased leukotriene B4 concentrations.
Collapse
Affiliation(s)
- S Gompertz
- Dept of Respiratory Medicine, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK
| | | | | | | | | |
Collapse
|
45
|
Dowson LJ, Guest PJ, Hill SL, Holder RL, Stockley RA. High-resolution computed tomography scanning in alpha1-antitrypsin deficiency: relationship to lung function and health status. Eur Respir J 2001; 17:1097-104. [PMID: 11491150 DOI: 10.1183/09031936.01.00056501] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.3] [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: 11/05/2022]
Abstract
The development of computed tomography (CT) has enabled emphysema to be assessed noninvasively. Objective quantification of lung density correlates well with lung function in patients with chronic obstructive pulmonary disease and has been shown to be a sensitive tool for monitoring disease progression. In order to determine the clinical impact of changes seen on high-resolution computed tomography (HRCT), the relationship between the objective quantification of emphysema on HRCT, lung function and health status in 111 patients with alpha1-antitrypsin deficiency was examined (PiZ). The degree of HRCT scan abnormality correlated well (p<0.001 for all comparisons) with forced expiratory volume in one second (r = -0.60- -0.75), specific airway conductance (r = -0.67-0.76), residual volume/total lung capacity (r = 0.46-0.58) and transfer factor of the lung for carbon monoxide (r = -0.64- -0.81). In addition, the CT scans correlated (p<0.001) with health status as assessed by the St. George's Respiratory Questionnaire (SGRQ total: r = -0.38-0.50) and the Short-Form health survey (e.g. physical functioning: r = -0.39-0.54). In summary, other workers have shown high-resolution computed tomography to be a sensitive indicator of disease progression. This study confirms the relationship between high-resolution computed tomography and lung physiology, and suggests the relationship is even stronger in patients with predominantly lower zone pan-lobular emphysema than in usual chronic obstructive pulmonary disease. High-resolution computed tomography also relates to patients disability and impairment as defined by health status questionnaires and, therefore, should be considered as an alternative outcome measure particularly in alpha1-antitrypsin deficiency.
Collapse
Affiliation(s)
- L J Dowson
- Lung Investigation Unit, Queen Elizabeth Hospital, Birmingham, UK
| | | | | | | | | |
Collapse
|
46
|
Abstract
BACKGROUND Airway inflammation, with recruitment of neutrophils to the airway lumen, results in purulent secretions and a variety of potential adverse consequences for patients with chronic bronchitis and bronchiectasis. We hypothesised that gradations of sputum colour would correlate directly with the myeloperoxidase content of sputum and with various other indicators of the activity and consequences of bronchial diseases. METHODS To test this hypothesis, we quantified sputum colour by reference to a sensitive nine point colour chart and correlated this assessment with indices of a number of inflammatory mediators in sputum. RESULTS The results indicate that standardised visual measurements of sputum colour correlated strongly with myeloperoxidase, interleukin 8, leucocyte elastase (both activity and total quantity), sputum volume, protein leak, and secretory leucocyte proteinase inhibitor (p<0.001 for all). In addition, there was a strong direct correlation between leucocyte elastase and both myeloperoxidase (p<0.003) and sputum volume (p<0.001), but a strong negative correlation with secretory leucocyte proteinase inhibitor (p<0.001). CONCLUSIONS These results indicate that sputum colour graded visually relates to the activity of the underlying markers of bronchial inflammation. The results of this simple visual analysis of sputum provides guidance concerning underlying inflammation and its damaging potential. It also provides a useful scientific tool for improving the monitoring of chronic airways diseases and response to treatment.
Collapse
Affiliation(s)
- R A Stockley
- Department of Medicine, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK.
| | | | | | | | | | | |
Collapse
|
47
|
Abstract
Resting lung function is only weakly related to health status in chronic obstructive pulmonary disease, reflecting the multifactorial causes of impairment and the heterogeneous nature of the condition. The current study examined whether density mask analysis of high-resolution computed tomography (HRCT) or exercise capacity were better surrogates for health status in a well-defined, homogeneous group of patients with alpha(1)-antitrypsin deficiency (PiZ). Twenty-nine patients with predominantly lower zone emphysema on HRCT were studied. Exercise was assessed by incremental treadmill (V O(2) peak) and shuttle walking tests (ISWT) and health status by the St. George's Respiratory Questionnaire (SGRQ) and SF-36. Although lower zone expiratory HRCT was related to exercise capacity (rho = -0.64 and -0.63 for V O(2) peak and ISWT, respectively, p < 0.001), multiple regression analysis suggested that FEV(1) was a marginally better predictor (rho = -0.64 and -0.65, p < 0.001). HRCT also related significantly to health status (rho = -0.37 for SGRQ activity, p < 0.05), although again FEV(1) showed a stronger relationship (rho = -0.43, p = 0.01). However, exercise capacity was the best predictor of health status with the ISWT accounting for up to 55% of the variability seen in SGRQ total and up to 53% of the SF-36 domain scores (physical functioning). Although both HRCT and lung function relate to health status, exercise capacity is the best predictor of patients disability in these patients with predominantly lower zone emphysema.
Collapse
Affiliation(s)
- L J Dowson
- Lung Investigation Unit, Nuffield House, Queen Elizabeth University Hospital, Birmingham, United Kingdom
| | | | | | | | | |
Collapse
|
48
|
Abstract
BACKGROUND The purpose of this study was to quantitate the effect of surgeons with added qualifications in general vascular surgery on aortic and peripheral vascular surgery performed in a community hospital. METHODS We performed a retrospective study covering a 22-year period and comparing indications, procedures, and results of surgeons who had added qualifications in general vascular surgery with those of board certified general and thoracic surgeons in a private hospital. In Period I (1975-1982), there were 702 vascular procedures all performed by thoracic (65%) and general (35%) surgeons. In Period II (1982-1997), there were 2590 vascular procedures performed by vascular surgeons (73%), general surgeons (7%), and thoracic surgeons (20%). A further comparison was done to examine the results of surgeons with added qualifications in general vascular surgery with board certified general and thoracic surgeons within Period II. RESULTS The volume and frequency of different types of vascular surgery changed significantly from Period I to Period II with lower extremity prosthetic reconstructions decreasing from 12% to 8.2% and autogenous lower extremity bypasses increasing from 15% to 36%. The percentage of distal reconstructions increased significantly from 27% of the total vascular surgeries in Period I to 44.3% in Period II. In Period II, vascular surgeons operated on older patients, had decreased mortality, decreased length of stay, and performed more distal bypasses than board certified general and thoracic surgeons. CONCLUSIONS The development of vascular surgery as a separate specialty appears to have had a beneficial effect on the types of vascular surgery and the results when compared in a contemporaneous or retrospective fashion.
Collapse
Affiliation(s)
- S L Hill
- Department of Surgery, Carilon Medical Center, Roanoke, Virginia, USA
| | | |
Collapse
|
49
|
Beren J, Hill SL, Diener-West M, Rose NR. Effect of pre-loading oral glucosamine HCl/chondroitin sulfate/manganese ascorbate combination on experimental arthritis in rats. Exp Biol Med (Maywood) 2001; 226:144-51. [PMID: 11446439 DOI: 10.1177/153537020122600213] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [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: 11/15/2022] Open
Abstract
The therapeutic effect of a nutritional supplement consisting of a combination of glucosamine hydrochloride (FCHG49), purified sodium chondroitin sulfate (TRH122), and manganese ascorbate (GCM)3 was investigated in the rat model of collagen-induced autoimmune arthritis (CIA). The GCM compound was mixed with a palatable nutritional paste (Nutri-cal [NC]). Oral administration of the NC/GCM compound was initiated in 26 rats 10 days before immunization and continued until the day of sacrifice. One group of 12 control rats was given no oral agents; a second group of 12 control rats received NC only. Evaluations included arthritis index (AI) scoring by three independent evaluators, histologic index (HI) scoring of lesions, T-cell proliferation, and serological studies for antibody classes and subclasses. Both the AI and HI criteria showed a statistically significant reduction in the prevalence of CIA in rats pretreated with the NC/GCM (54%) compared to the combined control groups (96%, chi2 analysis P = 0.001). Rats fed the NC/GCM also exhibited a significant decrease in the severity of autoimmune arthritis in both the AI and HI compared to control Group 2 (immunized-NC) (chi2 analysis P < 0.05). Histological studies verified the decreased incidence of arthritis in the NC/GCM group compared to control Group 2. GCM treatment failed to alter T-cell proliferation and antibody production to bovine type-II collagen, indicating that its effects are not due to alteration of the antigen-specific immune response.
Collapse
Affiliation(s)
- J Beren
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21205, USA
| | | | | | | |
Collapse
|
50
|
Gompertz S, Bayley DL, Hill SL, Stockley RA. Relationship between airway inflammation and the frequency of exacerbations in patients with smoking related COPD. Thorax 2001; 56:36-41. [PMID: 11120902 PMCID: PMC1745913 DOI: 10.1136/thorax.56.1.36] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.2] [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: 11/04/2022]
Abstract
BACKGROUND Patients with more frequent exacerbations of chronic obstructive pulmonary disease (COPD) may have increased bronchial inflammation. Airway inflammation was measured in patients who had been thoroughly investigated with full pulmonary function testing, thoracic HRCT scanning, and sputum microbiology to examine further the relationship between exacerbation frequency and bronchial inflammation. METHODS Airway inflammation (spontaneous sputum sol phase myeloperoxidase (MPO), elastase, leukotriene (LT)B(4), interleukin (IL)-8, secretory leukoprotenase inhibitor (SLPI), protein leakage) and serum levels of C reactive protein (CRP) were compared in 40 patients with stable, smoking related COPD, divided into those with frequent (> or =3/year) or infrequent (< or =2/year) exacerbations according to the number of primary care consultations during the preceding year. The comparisons were repeated after excluding eight otherwise clinically indistinguishable patients who had tubular bronchiectasis on the HRCT scan. RESULTS Patients with frequent (n=12) and infrequent (n=28) exacerbations were indistinguishable in terms of their clinical, pulmonary function, and sputum characteristics, CRP concentrations, and all of their bronchial inflammatory parameters (p>0.05). The patients without evidence of tubular bronchiectasis (n=32) were equally well matched but the sputum concentrations of SLPI were significantly lower in the frequent exacerbators (n=8) in this subset analysis (p<0.05). CONCLUSIONS There are several clinical features that directly influence bronchial inflammation in COPD. When these were carefully controlled for, patients with more frequent reported exacerbations had lower sputum concentrations of SLPI. This important antiproteinase is also known to possess antibacterial and antiviral activity. Further studies are required into the nature of recurrent exacerbations and, in particular, the regulation and role of SLPI in affected individuals.
Collapse
Affiliation(s)
- S Gompertz
- Department of Respiratory Medicine, Queen Elizabeth Hospital, Birmingham B15 2TH, UK.
| | | | | | | |
Collapse
|