Untersuchungen zur Reproduzierbarkeit und Variabilität der T4-Messung bei drei deutschen, kommerziellen, veterinärmedizinischen Laboratorien

Diese prospektive, verblindete, multizentrische Studie untersuchte für den Gesamt- Thyroxinwert im Serum von Hunden die Intra- und Inter-Assay-Variabilität bei drei kommerziellen, deutschen, veterinärmedizinischen Laboren. Insgesamt war die Korrelation der Gesamt-Thyroxinwerte bei den drei Laboratorien als sehr gut einzustufen. Die Werte lagen bei über zwei Dritteln der Patienten bei allen drei Laboratorien entweder einheitlich unter- oder innerhalb des Normalbereichs. Der Cohen’s-Kappa-Koeffizient von Labor 2 zeigte eine perfekte Übereinstimmung und daher eine vollständige Korrelation der Intra- und Interassay-Reliabilität. Labor 1 und 3 zeigten bei der Evaluation der Übereinstimmung schlechtere Resultate. Hier ergaben sich bei einigen Proben Werte, welche bei Labor 1 und 3 bei einem der durchgeführten Assays bei einem Labor im Referenzbereich und gleichzeitig am selben Tag oder im selben Assay unterhalb des Referenzbereichs lagen, was zu einer schlechteren Übereinstimmung führte. Schlussfolgernd ließen sich Unterschiede in der Intra- und Interassay-Variabilität bei den drei Laboratorien feststellen. Die Diagnosestellung der caninen Hypothyreose sollte stets aufgrund der zutreffenden klinischen Symptomatik, Laborergebnissen und im Zweifelsfall die Besserung auf Levothyroxin beruhen

Untersuchungen zur Reproduzierbarkeit und Variabilität der T4-Messung bei drei deutschen, kommerziellen, veterinärmedizinischen Laboratorien

Diese prospektive, verblindete, multizentrische Studie untersuchte für den Gesamt- Thyroxinwert im Serum von Hunden die Intra- und Inter-Assay-Variabilität bei drei kommerziellen, deutschen, veterinärmedizinischen Laboren. Insgesamt war die Korrelation der Gesamt-Thyroxinwerte bei den drei Laboratorien als sehr gut einzustufen. Die Werte lagen bei über zwei Dritteln der Patienten bei allen drei Laboratorien entweder einheitlich unter- oder innerhalb des Normalbereichs. Der Cohen’s-Kappa-Koeffizient von Labor 2 zeigte eine perfekte Übereinstimmung und daher eine vollständige Korrelation der Intra- und Interassay-Reliabilität. Labor 1 und 3 zeigten bei der Evaluation der Übereinstimmung schlechtere Resultate. Hier ergaben sich bei einigen Proben Werte, welche bei Labor 1 und 3 bei einem der durchgeführten Assays bei einem Labor im Referenzbereich und gleichzeitig am selben Tag oder im selben Assay unterhalb des Referenzbereichs lagen, was zu einer schlechteren Übereinstimmung führte. Schlussfolgernd ließen sich Unterschiede in der Intra- und Interassay-Variabilität bei den drei Laboratorien feststellen. Die Diagnosestellung der caninen Hypothyreose sollte stets aufgrund der zutreffenden klinischen Symptomatik, Laborergebnissen und im Zweifelsfall die Besserung auf Levothyroxin beruhen

Evaluation of hypochlorous acid as an ear flush in dogs with chronic otitis externa

BackgroundChronic otitis externa (OE) in dogs frequently requires anaesthetised ear flushing. ObjectivesTo evaluate hypochlorous acid as an ear flushing and antimicrobial agent in dogs with chronic OE. AnimalsTwenty dogs with chronic OE caused by the same organisms bilaterally. Materials and MethodsOne ear was flushed under anaesthesia with hypochlorous acid, the other with saline solution. Subsequently, the ear flushed with hypochlorous acid was cleaned with the same solution twice daily for 2 weeks, the other ear with a commercial ear cleaner. An ear medication containing miconazole, polymyxin B and prednisolone was used once daily in both ears. Clinical scores were determined before the flush. Ear cytological results were obtained, a hearing test was conducted before and after the ear flush, and a culture was taken directly after flushing. Ears were evaluated after 2 weeks of therapy. ResultsYeast was present in the ears of 11, cocci in one and a mixed infection in eight dogs. Five ears were negative on culture after flushing with hypochlorous acid, one after the saline flush. Clinical and cytological scores decreased significantly with both solutions after 2 weeks of treatment. There was no difference between treatments in any of the scores at any time point between treatments and in the results of the hearing test before and after the flushing procedure. Adverse effects were not seen. Conclusions and Clinical RelevanceHypochlorous acid is a suitable cleaning solution for canine OE

A randomised, double-blinded comparison between subcutaneous rush and intralympathic allergen immunotherapy induction in atopic dogs

BackgroundAtopic dermatitis (AD) is one of the most common skin diseases in small animal practice. Allergen immunotherapy (AIT) is the only curative treatment for the disease, and oral, subcutaneous and intralymphatic administration of allergens are commonly employed. ObjectivesTo compare the efficacy of AIT following an induction phase with intralymphatic injections (ILIT) or rush immunotherapy (RIT). AnimalsFifty privately owned dogs with AD. Materials and MethodsIn a double-blinded study, dogs were randomly assigned to either four monthly ILIT of allergen extract or RIT with five injections administered subcutaneously at hourly intervals on the first day. They were assessed by validated scores;Canine Atopic Dermatitis Lesion Index (CADLI) and pruritus Visual Analog Scale (PVAS) at the beginning of the study and after 1, 3, 6 and 12 months. The latter were performed daily for 7 days before each revisit. Medication scores and a total clinical score were calculated and compared between each group and time point. ResultsThere was no significant difference in CADLI and PVAS scores, or CADLI and medication scores between groups at any of the time points. A significant improvement with both ILIT and RIT was seen in total and pruritus scores, respectively. An owner global assessment of good-to-excellent treatment efficacy was seen in 40% of the dogs;total scores improved by 27% and 35% in the RIT and ILIT group, respectively. Adverse effects were not seen. Conclusions and Clinical RelevanceInduction of AIT can be conducted either as RIT or ILIT with no loss in efficacy

PATTERNS OF PRECIPITATION VARIABILITY IN THE GREATER ALPINE REGION

A recently set up and homogenised new precipitation dataset for the Greater Alpine Region (GAR) is presented here with some first preliminary analyses. Climate change patterns within the study region are analysed in terms of regionally different evolutions, seasonality, and short to long-term trends. It will be shown that precipitation presents pronouncedly different variability patterns in space as well as in terms of seasonality and at different time scales

Jacobsen syndrome

Jacobsen syndrome is a MCA/MR contiguous gene syndrome caused by partial deletion of the long arm of chromosome 11. To date, over 200 cases have been reported. The prevalence has been estimated at 1/100,000 births, with a female/male ratio 2:1. The most common clinical features include pre- and postnatal physical growth retardation, psychomotor retardation, and characteristic facial dysmorphism (skull deformities, hypertelorism, ptosis, coloboma, downslanting palpebral fissures, epicanthal folds, broad nasal bridge, short nose, v-shaped mouth, small ears, low set posteriorly rotated ears). Abnormal platelet function, thrombocytopenia or pancytopenia are usually present at birth. Patients commonly have malformations of the heart, kidney, gastrointestinal tract, genitalia, central nervous system and skeleton. Ocular, hearing, immunological and hormonal problems may be also present. The deletion size ranges from ~7 to 20 Mb, with the proximal breakpoint within or telomeric to subband 11q23.3 and the deletion extending usually to the telomere. The deletion is de novo in 85% of reported cases, and in 15% of cases it results from an unbalanced segregation of a familial balanced translocation or from other chromosome rearrangements. In a minority of cases the breakpoint is at the FRA11B fragile site. Diagnosis is based on clinical findings (intellectual deficit, facial dysmorphic features and thrombocytopenia) and confirmed by cytogenetics analysis. Differential diagnoses include Turner and Noonan syndromes, and acquired thrombocytopenia due to sepsis. Prenatal diagnosis of 11q deletion is possible by amniocentesis or chorionic villus sampling and cytogenetic analysis. Management is multi-disciplinary and requires evaluation by general pediatrician, pediatric cardiologist, neurologist, ophthalmologist. Auditory tests, blood tests, endocrine and immunological assessment and follow-up should be offered to all patients. Cardiac malformations can be very severe and require heart surgery in the neonatal period. Newborns with Jacobsen syndrome may have difficulties in feeding and tube feeding may be necessary. Special attention should be devoted due to hematological problems. About 20% of children die during the first two years of life, most commonly related to complications from congenital heart disease, and less commonly from bleeding. For patients who survive the neonatal period and infancy, the life expectancy remains unknown

The trans-ancestral genomic architecture of glycemic traits

Glycemic traits are used to diagnose and monitor type 2 diabetes and cardiometabolic health. To date, most genetic studies of glycemic traits have focused on individuals of European ancestry. Here we aggregated genome-wide association studies comprising up to 281,416 individuals without diabetes (30% non-European ancestry) for whom fasting glucose, 2-h glucose after an oral glucose challenge, glycated hemoglobin and fasting insulin data were available. Trans-ancestry and single-ancestry meta-analyses identified 242 loci (99 novel; P < 5 x 10(-8)), 80% of which had no significant evidence of between-ancestry heterogeneity. Analyses restricted to individuals of European ancestry with equivalent sample size would have led to 24 fewer new loci. Compared with single-ancestry analyses, equivalent-sized trans-ancestry fine-mapping reduced the number of estimated variants in 99% credible sets by a median of 37.5%. Genomic-feature, gene-expression and gene-set analyses revealed distinct biological signatures for each trait, highlighting different underlying biological pathways. Our results increase our understanding of diabetes pathophysiology by using trans-ancestry studies for improved power and resolution. A trans-ancestry meta-analysis of GWAS of glycemic traits in up to 281,416 individuals identifies 99 novel loci, of which one quarter was found due to the multi-ancestry approach, which also improves fine-mapping of credible variant sets.Peer reviewe

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation