CT angiographic changes in dogs with acute pancreatitis: A prospective longitudinal study

Computed tomographic angiography (CTA) has recently been shown to be a useful tool in the diagnosis of acute canine pancreatitis, the identification of pancreatic necrosis, and the detection of sequelae. Evidence of pancreatic necrosis on CTA has been shown to be correlated with a poorer outcome in both humans and dogs and early diagnosis and intervention may improve outcomes. In humans, pancreatic necrosis is typically evident on CTA within 48 h of clinical signs, thus, repeat CTA examinations are often performed to identify pancreatic necrosis that may not have been evident on CTA examinations performed early in the course of disease. Published information investigating the timing of CTA examinations and the use of serial CTA in dogs with acute pancreatitis is lacking. In this prospective, longitudinal study, CTA examinations were performed at the time of hospitalization and repeated 3‐5 days later in 11 dogs suffering from acute canine pancreatitis to determine if pancreatic necrosis or sequelae are under diagnosed on examinations performed at the time of hospitalization. Computed tomographic angiography studies were evaluated for changes in pancreatic size, pancreatic contrast enhancement, and peri‐pancreatic tissues and vessels. The only statistically significant difference between the initial and repeat CTA examinations was the improvement of fat stranding on the repeat CTA examinations (P < .045). Based on these results, CTA performed at the time of admission is likely adequate in the diagnosis and evaluation of dogs with acute pancreatitis. Repeat CTA examinations are unlikely to add additional information in the absence of worsening clinical signs.     

Extravasation injury associated with parenteral nutrition in a cat with presumptive gastrinomas

Objective – To describe the pathologic consequences of parenteral nutrition (PN) extravasation into the mediastinum of a cat. Case Summary – An 8‐year‐old domestic short hair cat with persistent vomiting and anorexia was initiated on PN for nutritional support. PN was being administered at a rate of 12.9 mL/h when inadvertent jugular catheter migration resulted in thrombophlebitis and cellulitis and 40–80 mL of PN extravasated into the SC and mediastinal tissues. The cat was euthanized 36 hours after the extravasation of PN due to poor prognosis related to the gastric complications associated with a presumed primary gastrinoma. Grossly there was excessive mediastinal lymphatic drainage and pronounced edema in the cervical SC and mediastinal tissue. Histopathologic examination of the PN‐extravasated area revealed a severe mixed inflammatory reaction, represented by a severe neutrophilic and mild histiocytic infiltrate with lymphoplasmacytic perivascular cuffing. No bacterial agents were observed or cultured from this area. Unique Information Provided – This is the first case report of a foreign body‐type reaction due to extravasation of PN (extravasation injury) in a cat. Extravasation of PN is not without pathologic consequence, and can result in a severe inflammatory reaction in affected tissues.     

Electron microscopic changes in colon in experimental swine dysentery.

Colonic lesions in experimental swine dysentery were studied electron microscopically. Changes indicative of stasis were commonly observed in the microcirculatory vessels of lamina propria. Early lesions in epithelial cells included sparse, short and irregular microvilli, swollen and degenerated mitochondria, and swelling and vesiculation of endoplasmatic reticulum. Numerous large spirochaetes were observed in these locations: a) in the crypts, b) free (i.e. not membrane bound) in cytoplasm of damaged epithelial cells, and c) in cavities, around vessels of lamina propria. It is suggested that stasis, and resultant disturbances in microcirculation in early developmental stages of swine dysentery, may play a pathogenetic role in the development of the necrotic colonic lesions. Finally, it is discussed whether a mechanism related to Sanarelli-Shwartzman reaction is implicated in the development of colonic lesions in swine dysentery.     

Investigation into the causes of aspirin resistance in healthy dogs

Antiplatelet effects of acetylsalicylic acid (ASA, aspirin) may be poor in some individuals. Additionally, no method exists for predicting poor ASA response (resistance) in individual dogs. This study's main objective was to determine whether poor ASA response results from pharmacodynamic or pharmacokinetic causes. ASA concentrations causing 50% inhibition of platelet aggregation (in vitro IC50) were determined using whole blood collected from 21 drug‐free healthy dogs to evaluate intrinsic sensitivity of platelets to ASA. Dogs were then administered ASA at 4 mg/kg once orally. Percent decrease in platelet aggregation from baseline, and plasma ASA and salicylic acid (SA) concentrations (expressed as AUC values) were measured for up to 3 hr. By 3 hr, 13/21 (62%) dogs showed >50% aggregation inhibition, while 8/21 (38%) dogs showed <50% inhibition. Aggregation inhibition values were negatively correlated with in vitro IC50 values (Rs = ?0.49; p = 0.028) and positively correlated with ASA concentrations (Rs = 0.48; p = 0.03). Furthermore, ASA concentrations were strongly negatively correlated (Rs = ?0.88; p < 0.001) with SA/ASA concentration ratios, an index of ASA metabolism to SA by esterase enzymes. Multiple linear regression analysis indicated that 59% (p < 0.001) of interindividual variability in aggregation inhibition was explained by in vitro IC50 values (29% of variability) and ASA concentrations (29% of variability). Consequently, poor in vivo ASA response in these dogs resulted from both pharmacodynamic (decreased platelet sensitivity) and pharmacokinetic (lower ASA concentrations) causes. Lower ASA concentrations may be explained by reduced bioavailability associated with higher esterase activities.     

妊娠期高血压疾病患者术前应用弹力绷带预防深静脉血栓的护理干预

目的探讨妊娠期高血压疾病患者术前应用弹力绷带对预防深静脉血栓形成（Deep vein thrombo-sis,DVT）的护理效果.方法将1 000例妊娠期高血压疾病患者随机分为对照组和实验组,每组各500例,对照组给予常规护理,实验组在常规护理基础上使用弹力绷带,比较两组术后护理效果.结果经过护理后,实验组2例发生DV...     

2型糖尿病有或无血管合并症患者6种血栓分子标志物的检测与临床意义

目的 :了解 2型糖尿病有或无血管合并症患者 6种血栓分子标志物的检测与临床意义。方法 :2例糖尿病患者 90例分为有血管合并症组 (n =5 1)和无合并症组 (n =39)及 30例健康人 (对照组 )均检测血管性假血友病因子(VWF)、血小板α 颗粒膜糖蛋白 14 0 (GMP 14 0 )、纤维蛋白原 (Fbg)、抗凝血酶Ⅲ (AT Ⅲ )、组织纤溶酶原激活物 (t PA)、纤溶酶原激活物抑制物 (PAI)等 6项血栓分子标志物 ,用ELISA和发色底物法检测。结果 :2型糖尿病无论有或无血管合并症的患者的VWF、GMP 14 0、PAI、Fbg均较健康人组高 (P <0 .0 1) ,而有合并症较无合并症组亦显著增高 (P <0 .0 1) ,但t PA相反 ,对照组与无合并症组显著升高 (P <0 .0 1) ;AT Ⅲ在各组之间差异无显著性 (P >0 .0 5 )。结论 :2型糖尿病患者血栓发生与多种因素有关 ,其血管合并症的发生、发展与高凝状态密切相关。