Markers of iron metabolism in retired racing Greyhounds with and without osteosarcoma

BACKGROUND

Greyhounds have well-described clinicopathologic idiosyncrasies, including a high prevalence of osteosarcoma (OSA). Hematocrit, HGB, and HGB oxygen affinity are higher than in other dogs, while haptoglobin concentration is lower, so we hypothesized that Greyhounds have a different iron metabolism. To our knowledge, there are no reports on serum iron profiles in Greyhounds.

OBJECTIVES

To elucidate iron metabolism in Greyhounds, we wanted to compare serum iron concentration, total iron-binding capacity (TIBC), and percent transferrin saturation (%SAT) in healthy retired racing Greyhounds (RRGs) with OSA (RRGs - OSA), and also with non-Greyhounds (NGs), without and with OSA (NGs - OSA).

METHODS

Serum iron concentration and unsaturated iron-binding capacity (UIBC) were measured by standard methods, and TIBC and %SAT were calculated in RRGs (n = 25), RRGs - OSA (n = 28), NGs (n = 30), and NGs - OSA (n = 32).

RESULTS

TIBC was lower in RRGs than in NGs (P < .0001), and in RRGs - OSA than in NGs - OSA (P < .0001). NGs - OSA had lower TIBC than healthy NGs (P = .003). Percent SAT was higher in RRGs than in NGs (P < .0001) and in RRGs - OSA (P = .008), and %SAT was also lower in NGs than in NGs - OSA (P = .004). Percent SAT was also higher in RRGs - OSA than in NGs - OSA (P = .001). Both RRGs - OSA (P = .02) and NGs - OSA (P < .0001) had lower serum iron concentrations than their healthy counterparts.

CONCLUSION

Lower TIBC and higher %SAT may constitute another Greyhound idiosyncrasy compared with other dogs. In this study, all dogs with OSA had higher serum iron concentrations and %SAT than healthy dogs.

Consensus on domains, formation objectives and contents in cariology for undergraduate dental students in Colombia

OBJECTIVE

To achieve a consensus for an undergraduate cariology teaching curriculum between Colombian dental schools in line with the 2015 Global Alliance for a Cavity-Free Future goal: '90% of dental schools adopting the current caries paradigm'.

MATERIALS AND METHODS

First phase: Four-regional 2-day workshops were conducted with 4 representative teachers (cariology, clinics, basic-science, public health and specialisations) from each of the 24-ACFO schools (Colombian Dental Schools Association) as follows: Presentations: -Main Colombian cariology teaching barriers, -Caries and public health current paradigms; -Schools' cariology teaching descriptions; -European Cariology Curriculum. Five main-domain subgroup discussions: (i) the knowledge base; (ii) risk assessment, diagnosis and synthesis; (iii) decision-making, preventive non-surgical therapy; (iv) decision-making, surgical therapy; and (v) evidence-based cariology in clinical and public health practice, to adapt domains, objectives and contents to Colombian curriculum, public health and national health system needs. These 4-regional plus 24-school consensuses sent 1 month afterwards were adapted into a preliminary document. 2nd-phase: 10 peer review by national faculty in cariology, and 10 curriculum, basic sciences, research, clinical management and public health experts. School participants and deans reviewed the draft document and suggestions were discussed and adapted into a final consensus document officially presented to the academic community at the ACFO National-Research-Meeting (September, 2012).

RESULTS

24 schools and 92 teachers participated. The Colombian Cariology Curriculum was agreed by 23 schools. It positioned public health into one domain. A general focus on social determination was included, and more relevance was given to fluorosis than erosion.

CONCLUSIONS

A consensus on cariology teaching for undergraduate dental students was achieved in Colombia and work to promote its adoption has commenced.

Is "intra-operating room" thromboelastometry useful in liver transplantation? A case-control study in 303 patients

Coagulation monitoring during liver transplantation (LT) is, even today, fundamental to reduce blood loss during surgery. Thromboelastometry (TEM) is a proven technique for controlling the various parameters that influence coagulation. However, there are no studies linking "intra-operating room" TEM (orTEM) with LT outcomes. We describe a case-control study in 303 liver graft recipients analyzing variables associated with operative complications and long-term LT outcomes. The results showed that orTEM reduced the use of blood products in patients with Model for End-Stage Liver Disease scores of ≥ 21, retransplantation, and high surgical difficulty and important intraoperative bleeding. In addition, results in survival and postoperative complications were better when orTEM was used. In conclusion, we confirm that use of orTEM is associated with less use of blood products and a lower rate of complications after LT.

Donor characteristics that are associated with survival in liver transplant recipients older than 70 years with grafts

INTRODUCTION

The use of grafts from donors older than 70 years of age is increasing due to the decrease in the number of donors and the increase in waiting list patients.

MATERIAL AND METHODS

We undertook a univariate and multivariate analysis of 980 adult recipients of whole liver grafts, 129 of them from donors aged 70 years or older.

RESULTS

No differences were found in patient survival compared with recipients of younger grafts. There were no higher rates of rejection, vascular or biliary complications, postoperative bleeding, or infections, but older grafts were associated with graft dysfunction (P = .01) and a higher frequency of postoperative refractory ascites (P = .007), but without a greater need for retransplantation. As graft-associated factors, the joint presence in the donor of diabetes (P = .00; confidence interval [CI] = 0.04-0.117), hypertension (P = .00; CI = 0.22-0.39), and weight of more than 90 kg (P = .031; CI = 0.05-0.104) were suggestive of poor prognostic factors in recipient survival. Survival in hepatitis C virus (HCV) recipients or recipients aged older than 60 years was worse with donors aged older than 70 years, although not significantly so. With grafts from donors aged older than 80 years (n = 15), although patient survival rate was good (70% at 10 years), there was a higher rate of retransplantation (20%) and the early mortality rate was 13.3%.

CONCLUSIONS

Use of grafts from donors aged older than 70 years is safe, with similar survival to patients with younger grafts. The appearance of initial dysfunction with prolonged ascites may be due to a delay in reaching a correct functionality, but was not associated with increased mortality, complications, or need for retransplantation. It should also be avoided in recipients older than 60 years or with HCV. Grafts older than 80 years were associated with a good long-term patient survival but at the expense of a higher rate of retransplantation. However, it helps to reduce the time on the waiting list and, thus, mortality. We noted decreased survival associated with donor hypertension, diabetes, and obesity, so these donors should be selected more rigorously.

Effects of racing on reticulocyte concentrations in Greyhounds

BACKGROUND

Greyhounds have several hematologic variables that are outside of the respective reference intervals of other dog breeds. In addition, increases in HCT, total protein and HGB concentration, and RBC and WBC counts occur immediately after exercise; these values return to resting values within a few hour after racing.

OBJECTIVE

This study evaluated the effects of exercise on the concentration of reticulocytes in circulating blood in racing Greyhounds. We hypothesized that reticulocyte numbers are significantly increased immediately after a race, and return to baseline within one to 2 h postrace.

METHODS

Fifty actively racing Greyhounds at the Wheeling Island Racetrack and Casino were included in the study. Samples were collected by jugular venipuncture one day prior to racing at the kennel (resting), immediately after racing, and one to 2 h after the race (recovery). Reticulocyte counts were determined with an IDEXX ProCyte Dx Hematology Analyzer (IDEXX Laboratories, Inc., Westbrook, ME, USA). Due to a nonparametric distribution, the results were statistically compared using the Friedman test.

RESULTS

Reticulocyte concentrations were significantly different among the 3 sample collection times (P < .0001). There was a significant increase in reticulocyte concentration immediately after racing (P < .001); one to 2 h after racing, the reticulocyte numbers decreased significantly (P < .001) to counts comparable to resting samples.

CONCLUSION

The increase in reticulocyte concentration is probably related to splenic contraction secondary to the release of catecholamines, although premature bone marrow release could also account for these changes. Thus, it is important to consider a Greyhound's activity and degree of excitement when interpreting selected hematologic data in a clinical setting.

Antitumor efficacy of mammalian target of rapamycin inhibitor therapy in liver transplant recipients with oncological disease: a case-control study

INTRODUCTION

The reported incidences of de novo malignancy following orthotopic liver transplantation (OLT) are significantly greater than those in the general population. We have analyzed the efficacy of mammalian target of rapamycin inhibitor (mTORi) as immunosuppressant therapy in patients with de novo malignancies or those engrafted because of a primary liver cancer.

METHODS

We performed a case-control study of patients with hepatocellular carcinoma (HCC; n = 119), cholangiocarcinoma (n = 1) or de novo malignancies (n = 73). Thirty-seven patients with these tumors were treated with mTORi, and 167, with calcineurin inhibitors (CNI). Switching to mTORi was performed progressively, withdrawing the CNI over 15 days, until obtaining levels of 5-10 ng/dL.

RESULTS

No incidence of rejection, serious adverse events, or death was observed with an overall actuarial survival of 68.5% in the mTORi group versus 45.7% among the CNI group. Overall rates of tumor recurrence were 15.2% and 36.8%, respectively (P < .05). Among patients with HCC, survival was 100% of mTORi with and 61.5% among CNI patients, with tumor recurrence rates of 6.2% and 19.1%, respectively (P < .05).

DISCUSSION

Surprising differences in survival and tumor recurrence rates were observed among the mTORi-treated group compared with controls. Switching from CNI to mTORi immunosuppressant therapy appeared to be safe. It seems to be reasonable to employ this strategy in liver transplant patients with primary hepatic or "de novo" neoplasms.

Liver transplantation in patients with cryptogenic cirrhosis: long-term follow-up

OBJECTIVE

The objective of this study was to evaluate long-term survival, histological diagnoses, and mobility of patients with cryptogenic cirrhosis (CC) treated with orthotopic liver transplantation (OLT).

PATIENTS AND METHODS

We performed a retrospective analysis of 35 patients who underwent transplantation with CC among 800 OLT patients. There were no differences in gender, mean age of 47 years, average MELD (Model for End-stage Liver Disease) of 16, and hepatocellular carcinoma incidence (8%).

RESULTS

In 28.6% of patients, the diagnosis of CC was wrong. There was no incidence of an acute rejection episode and a low incidence of complications, although the postoperative mortality rate was 20%, of chronic rejection was 25%, and recurrence of disease was 4%. Cumulative at 3-, 5-, and 10-year survivals were lower than the other OLT. Survival was lower in patients receiving suboptimal grafts.

CONCLUSIONS

One of 3 patients who underwent transplantation for CC had a specific etiologic diagnosis. The chronic rejection rate and postoperative mortality rate were higher than other etiologies, and survivals at 5, 10, and 15 years were lower than other OLT.

Clinical pathology of Greyhounds and other sighthounds

Owing to the development of Greyhounds as racing sighthounds, these dogs have acquired unique physiologic adaptations that distinguish them from other breeds. Reference intervals for many analytes in retired racing Greyhounds (RRGs) differ from those of other breeds; most of the hematologic differences have also been described in other sighthounds. In this review, we provide a survey of the literature on clinical pathology of Greyhounds and other sighthounds and results of laboratory testing, including analysis of CBCs, biochemical profiles, coagulation tests, and blood gases, in RRGs at The Ohio State University. Major clinicopathologic differences in this breed include higher RBC mass, creatinine concentration, glomerular filtration rate, activities of hepatic enzymes, and concentration of cardiac troponin, as well as lower WBC, neutrophil, and platelet counts, thromboelastographic values, and concentrations of serum haptoglobin, total globulins, and T4.

Effects of time of collection and sample processing on von Willebrand factor concentration in retired racing greyhounds

BACKGROUND

Concentrations of von Willebrand factor (vWF) are less than 30% in approximately 10% of Greyhounds.

HYPOTHESIS

That sample collection, processing, and storage can affect the concentration of vWF in plasma of Greyhounds.

ANIMALS

Nineteen healthy former racing Greyhounds.

METHODS

Prospective study: Blood samples were obtained from the jugular vein of dogs at 4 times during the day. Samples were divided and processed in each of 3 ways. The 1st tube was centrifuged immediately, the 2nd tube was kept in a household refrigerator, and the 3rd tube was kept at room temperature for 3 hours before centrifugation and processing.

RESULTS

There were no significant differences in the vWF concentration between different sample storage and processing (P = 5.31). There was no statistically significant diurnal variation in vWF concentration in the samples evaluated (P = .37).

CONCLUSIONS AND CLINICAL IMPORTANCE

Time of sample collection and short-term storage temperature do not influence the vWF concentration in retired racing Greyhounds.