Immune thrombocytopenia (ITP): Pathophysiology update and diagnostic dilemmas

Immune thrombocytopenia (ITP) is a common autoimmune bleeding disorder. The understanding of ITP pathogenesis is rapidly evolving. We now recognize ITP as a complex and heterogeneous syndrome that results from a combination of humoral and cell‐mediated attacks on platelets peripherally and megakaryocytes in the bone marrow. Autoantibody‐mediated ITP also varies in the pathway used to clear platelets, which depends on the platelet glycoprotein being targeted. Moreover, ITP patients present with variable bleeding severities and treatment responses that do not closely correlate with platelet count. A gold standard diagnostic test for ITP is lacking, and biomarkers to assess disease severity are in their infancy. This review provides an update on the immunopathogenesis of ITP and summarizes currently available tests for ITP diagnosis, prediction of disease severity, and treatment responses. Given the heterogeneous pathogenesis and clinical presentation of ITP, we highlight the need for the development of diagnostic and prognostic tests that would allow for the individualized management of a complex disease.     

Effect of live yeast (Saccharomyces cerevisiae) supplementation on rumen fermentation and metabolic profile of dairy cows in early lactation

The study evaluated dietary supplementation with live yeast (LY) Saccharomyces cerevisiae (CNCM I‐4407, 10¹⁰ CFU/g, Actisaf; Phileo Lesaffre Animal Care, France) on rumen fermentation and serum metabolic profile in lactating dairy cows. Fifty Holstein cows received a total mixed ration with (Live Yeast Diet, LYD, n = 25) or without (Control Diet, CD, n = 25) 5 × 10¹⁰ CFU/cow/day of LY from 3 to 19 weeks of lactation. Rumen fermentation and serum metabolic profile were measured in eight cows per treatment at 3, 7, 11, 15, 19 weeks post‐partum. LYD showed an increased daily milk yield (+4%) over CD (p < 0.05). Mean rumen pH at 4 hr after morning meal was higher in LYD (6.59) than CD (6.32) (p < 0.01). Total volatile fatty acids (VFA) and acetate molar proportion were higher in LYD (114.24 mM; 25.04%) than CD (106.47 mM; 24.73%) (p < 0.05). Propionate and butyrate molar proportions, acetate to propionate ratio, ammonia levels did not differ between LYD and CD. Ruminal lactate was lower in LYD than CD (9.3 vs. 16.4 mM) (p < 0.001), with a 53% decrease in LYD. During peak lactation, LYD had lower serum NEFA (p < 0.05, 0.40 vs. 0.48 mM) and BHBA (p < 0.01, 0.47 vs. 0.58 mM) than CD, lower liver enzyme activities (AST 1.39 vs. 1.54 ukat/L) (p < 0.05). Serum glucose was higher in LYD at peak lactation (3.22 vs. 3.12 mM, and 3.32 vs. 3.16 mM respectively) (p < 0.05). The results confirmed a reducing effect of LY on lactate accumulation in rumen fluid, associated with an increase in rumen pH. Lower serum levels of lipomobilization markers, liver enzyme activities and higher glucose levels may suggest that live yeast slightly mitigated negative energy balance and had a certain liver protective effect.     

Experience and confidence of final year veterinary students in performing desexing surgeries

AIMS: To describe the level of experience and confidence of veterinary students in performing canine and feline desexing procedures at the end of their final clinical year.

METHOD: A cross-sectional survey was conducted with veterinary students at Massey University in November 2017 after completion of their final clinical year. The questions included career plans after graduation, number of assisted and unassisted desexing procedures performed, approximate time to complete desexing surgeries, level of confidence with different aspects of desexing surgeries, what aspects of their desexing surgery training were most helpful, and what could be done to improve training in desexing surgical skills in veterinary school.

RESULTS: The survey was completed by 70/95 (74%) students in their final clinical year. Among respondents, 55/70 (70%) had performed >2 unassisted feline neuters before graduation. However 38/70 (54%) students had never performed an unassisted feline spay, 31/70 (44%) had never performed an unassisted canine neuter, and 44/70 (63%) students had never performed an unassisted canine spay. The median reported times to complete a feline neuter, feline spay, canine neuter, and canine spay were 9, 40, 30 and 60 minutes, respectively. The median level of confidence for these procedures were 9, 6, 7 and 5 (on a scale from 1=least confident to 10=most confident), respectively. The reported time to complete procedures and the confidence in performing procedures did not change markedly with increasing total number of procedures performed. Students were most concerned about their ability to perform the desexing procedures in a reasonable amount of time and to prevent post-operative bleeding from occurring. Students were least concerned with their ability to manage post-operative pain in patients and to select the appropriate suture material. Free-text comments revealed that 62/70 (89%) students wanted more hands-on surgical experience prior to graduation.

CONCLUSION AND CLINICAL RELEVENCE: Many students are currently completing veterinary school with limited experience and low confidence with performing routine canine and feline desexing procedures. Further research is needed to identify the most effective ways for addressing this issue within the constraints of the veterinary curriculum and teaching hospital resources.     

番鸭下丘脑组织的RNA-Seq特征分析

为筛选番鸭下丘脑组织中的基因组信息,本研究以NCBI数据库中已标注的绿头鸭基因组（登录号：BGI_duck_1.0）为参照,利用RNA-Seq技术对番鸭下丘脑组织基因表达水平,以及可变剪切事件、SNPs及InDel进行筛选。结果显示,共鉴定出14 619个基因表达（FPKM ≥ 1）,占筛选出总基因数的72.7%。共有5 034个基因发生了7 528次可变剪切,其中外显子跳跃占92.76%,第一个外显子可变剪切和内含子滞留所占比例最小,共占总数的0.027%。通过RNA-Seq技术,本研究还筛选到646 423个SNP位点和77 712个InDel位点。对SNPs和InDel所在的基因进行功能注释发现,这些基因主要参与分子功能、生物过程和细胞组成过程。通过KEGG通路分析发现,出现SNPs和InDel所在基因主要富集在内分泌调节和神经行为调节的相关通路上,表明下丘脑既可参与内分泌调节,又参与动物的神经行为调节。本研究筛选出的数据不仅丰富了番鸭的遗传信息,而且也建立了番鸭相关基因的SNPs和InDel的数据库,这为番鸭的遗传育种工作及相关功能基因的具体定位提供了可靠依据,同时也为以后番鸭行为的研究提供了一定的参考价值。