Increased number of tissue factor protein expressing thrombocytes in canine idiopathic immune mediated hemolytic anemia

Dogs suffering from canine idiopathic immune mediated hemolytic anemia (cIIMHA) are at great risk of dying particularly in the first two weeks after the diagnosis is made. This high mortality risk may be associated with the development of thromboembolism (TE) and/or disseminated intravascular coagulation (DIC) resulting in organ failure. The exact mechanism of the development of TE and/or DIC in cIIMHA is still undetermined. Therefore, this study investigates the presence of tissue factor (TF) in thrombocytes of dogs suffering from cIIMHA, using OptiPrep™ for the isolation of blood cells and immunocytochemistry (ICC) to visualize TF on thrombocytes. The normalised TF quantity, acquired with 'colour deconvolution' (ImageJ plug in), revealed that in cIIMHA dogs the fraction TF positive thrombocytes was statistically significant higher (P < 0.001; mean 0.79; n = 7) compared to the fraction TF positive thrombocytes of the healthy dogs (mean 0.43; n = 9). We further have indications that the fraction of TF positive thrombocytes decreases with time and therapy, but that the progression rate differs individually. Since cIIMHA dogs have more thrombocytes that are TF-positive compared to healthy dogs, this may explain the increased risk to develop TE and DIC. Furthermore, it seems that the number of TF-positive thrombocytes in cIIMHA dogs remains high during the first two weeks of the disease, the time when the animals are at greatest health risk

Case Report: Unusual Peritoneopericardial Diaphragmatic Hernia in an 8-Month-Old German Shepherd Dog, Associated With a Pericardial Pseudocyst and Coexisting Severe Pericardial Effusion Resulting in Right-Sided Heart Failure

Objective: This study aims to describe an unusual peritoneopericardial diaphragmatic hernia (PPDH) in an 8-month-old German shepherd dog, associated with a pericardial pseudocyst and coexisting severe pericardial effusion resulting in right-sided heart failure. Case Summary: An 8-month-old, male, intact, German shepherd dog, was referred for ascites. Echocardiography revealed a severe pericardial effusion with a cyst-like structure within the pericardium and consequently decompensated right-sided heart failure. The ascites was secondary to right-sided heart failure (cardiac tamponade). Computed tomography (CT) of the thorax and abdomen was performed and showed PPDH with severe pericardial effusion and presence of a pericardial cyst-like structure; xyphoid cleft and Y-shaped seventh sternebra; and mild thickening along the cranioventral abdominal wall consistent with scar tissue from the previous umbilical hernia surgical repair. During surgery, the PPDH was corrected, and it was revealed that the remnant of the umbilical cord passed through it, into the pericardium. The cyst-like structure was successfully resected and sent for pathology. Histopathology showed signs of a chronic suppurative inflammation, with absence of a mesothelial or endothelial wall layer, thus consistent with a pseudocyst. Based on tomographic and surgical findings, it is suspected that the pseudocyst, together with the pericardial effusion, evolved by an inflammation of the remnant of the umbilical cord during the umbilical hernia surgical repair 1 month prior to presentation. The underlying PPDH most likely favored the development of the pericardial pseudocyst. However, due to prior antibiotic therapy initiated by the private vet, an infectious origin cannot be ruled out completely. New or Unique Information Provided: There are a few case reports describing PPDH and/or pericardial pseudocysts in veterinary patients, but the current case report is unique, since it describes PPDH associated with a pericardial pseudocyst and coexisting severe pericardial effusion resulting in cardiac tamponade. As far as the authors know, such a case has not been described in veterinary medicine before

Self-reported clinical practice of small animal cardiopulmonary resuscitation and compliance with RECOVER guidelines among veterinarians in eight Western European regions

Introduction: The objective of this study was to assess whether small animal veterinarians across Western Europe are compliant with the 2012 cardiopulmonary resuscitation (CPR) guidelines by the Reassessment Campaign on Veterinary Resuscitation (RECOVER). Methods: A previously published online questionnaire from Switzerland was adapted and translated into 7 languages, corresponding to national languages in Austria, France, Germany, Ireland, Italy, Liechtenstein, Netherlands, Portugal, Spain, and the United Kingdom. The survey was distributed via respective national veterinary organizations and social media outlets. A subset of questions was analyzed to evaluate respondent demographics, RECOVER guideline awareness, and to allocate composite compliance scores for CPR preparedness, basic life support (BLS) and advanced life support (ALS). Percentages of group total (95% confidence interval) were calculated. Multivariable logistic regression was used to evaluate the effects of region of practice, gender, age, specialty training, and guideline awareness on compliance. Odds ratios (95% confidence interval) were generated and significance set at P &lt; 0.05. Results: Nine-hundred and thirty respondents were included in analysis. Awareness of and compliance with RECOVER guidelines varied widely across regions. Compliance with all assessed RECOVER guideline recommendations was highest in Germany/Austria [14% (7- 27%)] and lowest in France and Portugal [0% (0–3%)]. CPR preparedness compliance was higher in participants aware of RECOVER guidelines [OR 10.1 (5.2-19.5)], those practicing in Germany/Austria [OR 4.1 (1.9–8.8)] or UK/Ireland [OR 2.2 (1.3–3.7)], and lower in those practicing in Portugal [OR 0.2 (0.1–0.9)]. Specialty training [OR 1.8 (1.1–2.9)], guideline awareness [OR 5.2 (3.2–8.6)], and practice in Germany/Austria [OR 3.1 (1.5–6.5)], UK/Ireland [OR 2.6 (1.7–4.1)], or the Netherlands [OR 5.3 (2.0–14.2)] were associated with increased BLS compliance. ALS compliance was higher in participants with guideline awareness [OR 7.0 (2.9–17.0)], specialty training [OR 6.8 (3.8–12.1)], those practicing in Germany/Austria [OR 3.5 (1.3–9.6)], UK/Ireland [OR 4.0 (1.9–8.3)], or Spain [OR 3.2 (1.2–8.3)] and in younger survey participants [OR 0.9 (0.9–1.0)]. Conclusions: Awareness and compliance with RECOVER guidelines varied widely among countries surveyed, however overall compliance scores in all countries were considered low. Further research may highlight factors surrounding poor guideline awareness and compliance so targeted efforts can be made to improve veterinary CPR in Europe

Increased number of tissue factor protein expressing thrombocytes in canine idiopathic immune mediated hemolytic anemia

Dogs suffering from canine idiopathic immune mediated hemolytic anemia (cIIMHA) are at great risk of dying particularly in the first two weeks after the diagnosis is made. This high mortality risk may be associated with the development of thromboembolism (TE) and/or disseminated intravascular coagulation (DIC) resulting in organ failure. The exact mechanism of the development of TE and/or DIC in cIIMHA is still undetermined. Therefore, this study investigates the presence of tissue factor (TF) in thrombocytes of dogs suffering from cIIMHA, using OptiPrep™ for the isolation of blood cells and immunocytochemistry (ICC) to visualize TF on thrombocytes. The normalised TF quantity, acquired with 'colour deconvolution' (ImageJ plug in), revealed that in cIIMHA dogs the fraction TF positive thrombocytes was statistically significant higher (P < 0.001; mean 0.79; n = 7) compared to the fraction TF positive thrombocytes of the healthy dogs (mean 0.43; n = 9). We further have indications that the fraction of TF positive thrombocytes decreases with time and therapy, but that the progression rate differs individually. Since cIIMHA dogs have more thrombocytes that are TF-positive compared to healthy dogs, this may explain the increased risk to develop TE and DIC. Furthermore, it seems that the number of TF-positive thrombocytes in cIIMHA dogs remains high during the first two weeks of the disease, the time when the animals are at greatest health risk

Tuning size and morphology of mpeg-b-p(Hpma-bz) copolymer self-assemblies using microfluidics

The careful design of nanoparticles, in terms of size and morphology, is of great importance to developing effective drug delivery systems. The ability to precisely tailor nanoparticles in size and morphology during polymer self-assembly was therefore investigated. Four poly(ethylene glycol)-b-poly(N-2-benzoyloxypropyl methacrylamide) mPEG-b-p(HPMA-Bz) block copolymers with a fixed hydrophilic block of mPEG 5 kDa and a varying molecular weight of the hydrophobic p(HPMA-Bz) block (A: 17.1, B: 10.0, C: 5.2 and D: 2.7 kDa) were self-assembled into nanoparticles by nanoprecipitation under well-defined flow conditions, using microfluidics, at different concentrations. The nanoparticles from polymer A, increased in size from 55 to 90 nm using lower polymer concentrations and slower flow rates and even polymer vesicles were formed along with micelles. Similarly, nanoparticles from polymer D increased in size from 35 to 70 nm at slower flow rates and also formed vesicles along with micelles, regardless of the used concentration. Differently, polymers B and C mainly self-assembled into micelles at the different applied flow rates with negligible size difference. In conclusion, this study demonstrates that the self-assembly of mPEG-b-p(HPMA-Bz) block copolymers can be easily tailored in size and morphology using microfluidics and is therefore an attractive option for further scaled-up production activities

Tuning Size and Morphology of mPEG-b-p(HPMA-Bz) Copolymer Self-Assemblies Using Microfluidics

The careful design of nanoparticles, in terms of size and morphology, is of great importance to developing effective drug delivery systems. The ability to precisely tailor nanoparticles in size and morphology during polymer self-assembly was therefore investigated. Four poly(ethylene glycol)-b-poly(N-2-benzoyloxypropyl methacrylamide) mPEG-b-p(HPMA-Bz) block copolymers with a fixed hydrophilic block of mPEG 5 kDa and a varying molecular weight of the hydrophobic p(HPMA-Bz) block (A: 17.1, B: 10.0, C: 5.2 and D: 2.7 kDa) were self-assembled into nanoparticles by nanoprecipitation under well-defined flow conditions, using microfluidics, at different concentrations. The nanoparticles from polymer A, increased in size from 55 to 90 nm using lower polymer concentrations and slower flow rates and even polymer vesicles were formed along with micelles. Similarly, nanoparticles from polymer D increased in size from 35 to 70 nm at slower flow rates and also formed vesicles along with micelles, regardless of the used concentration. Differently, polymers B and C mainly self-assembled into micelles at the different applied flow rates with negligible size difference. In conclusion, this study demonstrates that the self-assembly of mPEG-b-p(HPMA-Bz) block copolymers can be easily tailored in size and morphology using microfluidics and is therefore an attractive option for further scaled-up production activities.Nanomedicine: an integrative approac