Cardiac troponin I levels in canine pyometra

BACKGROUND: Myocardial injury may contribute to unexpected deaths due to pyometra. To detect myocardial damage, measurement of cardiac troponin I (cTnI) is currently the most sensitive and specific method. The aims of the present study were to evaluate presence of myocardial damage in canine pyometra by analysis of cTnI, to explore whether myocardial injury was associated with systemic inflammatory response syndrome (SIRS) and to evaluate whether other clinical or laboratory parameters were associated with cTnI increase. METHODS: Preoperative plasma levels of cTnI were investigated in 58 female dogs with pyometra and 9 controls. The value of physical examination findings, haematological, serum biochemical and pro-inflammatory (CRP and TNF-α) parameters as possible predictors of increased cTnI levels was also evaluated. RESULTS: Seven dogs with pyometra (12%) and one control dog (11%) had increased levels of cTnI. In the pyometra group, the levels ranged between 0.3–0.9 μg l(-1 )and in the control dog the level was 0.3 μg l(-1). The cTnI levels did not differ significantly between the two groups. No cardiac abnormalities were evident on preoperative physical examinations. Four of the pyometra patients died within two weeks of surgery, of which two were examined post mortem. In one of these cases (later diagnosed with myocarditis and disseminated bacterial infection) the cTnI levels increased from 0.9 μg l(-1 )preoperatively to 180 μg l(-1 )the following day when also heart arrhythmia was also detected. The other patient had cTnI levels of 0.7 μg l(-1 )with no detectable heart pathology post mortem. CTnI increase was not associated with presence of SIRS. There was a trend for the association of cTnI increase with increased mortality. No preoperative physical examination findings and few but unspecific laboratory parameters were associated with increased cTnI levels. CONCLUSION: Increased cTnI levels were observed in 12% of the dogs with pyometra. The proportions of dogs with cTnI increase did not differ significantly in the pyometra group compared with the control group. CTnI increase was not associated with presence of SIRS. A trend for association of cTnI increase and mortality was observed. Preoperative physical examination findings and included laboratory parameters were poor predictors of increased cTnI levels

Trends in HIV/AIDS morbidity and mortality in Eastern Mediterranean countries, 1990–2015: findings from the Global Burden of Disease 2015 study

OBJECTIVES: We used the results of the Global Burden of Disease 2015 study to estimate trends of HIV/AIDS burden in Eastern Mediterranean Region (EMR) countries between 1990 and 2015. METHODS: Tailored estimation methods were used to produce final estimates of mortality. Years of life lost (YLLs) were calculated by multiplying the mortality rate by population by age-specific life expectancy. Years lived with disability (YLDs) were computed as the prevalence of a sequela multiplied by its disability weight. RESULTS: In 2015, the rate of HIV/AIDS deaths in the EMR was 1.8 (1.4–2.5) per 100,000 population, a 43% increase from 1990 (0.3; 0.2–0.8). Consequently, the rate of YLLs due to HIV/AIDS increased from 15.3 (7.6–36.2) per 100,000 in 1990 to 81.9 (65.3–114.4) in 2015. The rate of YLDs increased from 1.3 (0.6–3.1) in 1990 to 4.4 (2.7–6.6) in 2015. CONCLUSIONS: HIV/AIDS morbidity and mortality increased in the EMR since 1990. To reverse this trend and achieve epidemic control, EMR countries should strengthen HIV surveillance, and scale up HIV antiretroviral therapy and comprehensive prevention services

Metabolic disturbances due to a high-fat diet in a non-insulin-resistant animal model

OBJECTIVE: Shift workers have metabolic changes more often than day workers. It is also known that night workers prefer foods high in saturated fat. Such data suggest that shift workers are prone to cardiovascular disease. Therefore, the objective of this study was to propose an animal model to test the effect of high-fat diet (HFD) based on shift workers' diet. METHODS: This is an experimental study with 20 Wistar rats. Ten rats were allocated to the control group (CG) and were fed standard diet. Ten rats were allocated to the experimental group (EG) and were fed HFD (45% fat). Serum triglycerides (TG), glucose and high-density lipoprotein-cholesterol (HDL-cho) were measured 5, 10 and 15 weeks after the beginning of the study. The amount of visceral adipose tissue (VAT) was determined. Body weight was assessed weekly, and food and water intake were measured daily. Student's t-test was used for independent samples, and P<0.05 was considered significant. RESULTS: After 15 weeks of intervention, the EG showed increased serum levels of TG (P=0.001) and glucose (P<0.001) and decreased HDL-cho (P<0.001) when compared with the CG. The EG showed increased VAT (P=0.005) and liver weight (P=0.01). Food intake and water intake were higher in the CG (P<0.001 and P<0.001, respectively), whereas energy intake showed no difference (P=0.48). No difference was found in the weight of adrenal glands (P=0.07) and body weight (P=0.63). CONCLUSIONS: The experimental diet was effective to show changes in the serum levels of glucose, TG and HDL-cho and visceral fat in spite of no change in body weight in 15 weeks

Burden of diarrhea in the Eastern Mediterranean Region, 1990–2015: Findings from the Global Burden of Disease 2015 study

Objectives: Diarrheal diseases (DD) are an important cause of disease burden, especially in children in low-income settings. DD can also impact children’s potential livelihood through growth faltering, cognitive impairment, and other sequelae. Methods: As part of the Global Burden of Disease study, we estimated DD burden, and the burden attributable to specific risk factors and etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2015. We calculated disability-adjusted life-years (DALYs)—the sum of years of life lost and years lived with disability—for both sexes and all ages. Results: We estimate that over 103,692 diarrhea deaths occurred in the EMR in 2015 (95% uncertainty interval: 87,018–124,692), and the mortality rate was 16.0 deaths per 100,000 persons (95% UI: 13.4–19.2). The majority of these deaths occurred in children under 5 (63.3%) (65,670 deaths, 95% UI: 53,640–79,486). DALYs per 100,000 ranged from 304 (95% UI 228–400) in Kuwait to 38,900 (95% UI 25,900–54,300) in Somalia. Conclusions: Our findings will guide evidence-based health policy decisions for interventions to achieve the ultimate goal of reducing the DD burden