Retrospective Evaluation of Gastrointestinal Signs in Hypothyroid Dogs

Few observations about gastrointestinal (GI) signs in hypothyroid dogs (hypo-T dogs) are available. We aimed to evaluate the prevalence and characteristics of concurrent GI signs in hypo-T dogs, describe clinicopathological, hepato-intestinal ultrasound findings in hypo-T dogs, investigate changes in GI signs after thyroid replacement therapy (THRT). Medical records of suspected hypo-T dogs from two hospitals were retrospectively reviewed. The inclusion criteria were: (1) having symptoms and clinicopathological abnormalities related to hypothyroidism (i.e., mild anemia, hyperlipemia); (2) not being affected by systemic acute disease; (3) not having received any treatment affecting thyroid axis. Hypothyroidism had to be confirmed using low fT4 or TT4 with high TSH and/or inadequate TSH-stimulation test response; otherwise, dogs were assigned to a euthyroid group. Clinical history, GI signs, hematobiochemical parameters, and abdominal ultrasound findings were recorded. Hypo-T dogs were assigned to the GI group (at least 2 GI signs) and not-GI group (1 or no GI signs). Follow-up information 3-5 weeks after THRT was recorded. In total, 110 medical records were screened: 31 dogs were hypo-T, and 79 were euthyroid. Hypo-T dogs showed a higher prevalence of GI signs (44%), especially constipation and diarrhea (p = 0.03 and p = 0.001), than euthyroid dogs (24%) (p = 0.04). Among hypo-T dogs, no difference in hematological parameters between GI and non-GI groups was found. Hypo-T dogs had a higher prevalence of gallbladder alterations than euthyroid dogs (20/25; 80% and 32/61; 52% p = 0.04). The hypo-T GI group showed a significant improvement in the GI signs after THRT (p < 0.0001). Specific investigation for concurrent GI diseases in hypo-T dogs was lacking; however, improvement in GI signs following THRT supports this association between GI signs and hypothyroidism

Reduction of gross hemolysis in catheter-drawn blood using Greiner Holdex® tube holder

Introduction: Blood collection through intravenous lines frequently causes spurious hemolysis. Due to specific structure, the tube holder Holdex® (Greiner Bio-One GmbH, Kremsmuenster, Austria) is supposed to prevent erythrocyte injury in samples collected from catheters, so that we planned a specific study to support this hypothesis. Materials and methods: Blood was collected from emergency department (ED) patients with 20-gauge catheter. In patients with odd order numbers, first and second tubes were collected with conventional holder (BD Vacutainer One Use Holder, Becton Dickinson, Milan, Italy) and the third with Holdex, whereas in even patients first and second tubes were drawn with Holdex and the third using BD Vacutainer One Use Holder. The first tube was discarded, whereas the second and third were centrifuged and serum was tested for potassium, lactate dehydrogenase (LD) and hemolysis index. Results: The final study population consisted in 60 ED patients. Concentrations of potassium (4.25 vs. 4.16 mmol/L; P = 0.031), LD (498 vs. 459 U/L; P = 0.039) and cell-free hemoglobin (0.42 vs. 0.22 g/L; P = 0.042) were higher in samples collected with BD Vacutainer One Use Holder than with Holdex. The mean bias of cell-free hemoglobin was -0.4 g/L in samples collected with Holdex. Although the frequency of samples with cell-free hemoglobin > 0.5 g/L was identical (17/60 vs. 17/60; P = 1.00), the frequency of those with concentrations >3.0 g/L was higher using BD Vacutainer One Use Holder than Holdex (4/60 vs. 0/60; P = 0.042). Conclusions: The use of Holdex for drawing blood from intravenous lines may be effective for reducing gross hemolysis

Plasma D-dimer concentration in patients with systemic sclerosis

BACKGROUND: Systemic sclerosis (SSc) is an autoimmune disorder of the connective tissue characterized by widespread vascular lesions and fibrosis. Little is known so far on the activation of the hemostatic and fibrinolytic systems in SSc, and most preliminary evidences are discordant. METHODS: To verify whether SSc patients might display a prothrombotic condition, plasma D-dimer was assessed in 28 consecutive SSc patients and in 33 control subjects, matched for age, sex and environmental habit. RESULTS AND DISCUSSION: When compared to healthy controls, geometric mean and 95% confidence interval (IC95%) of plasma D-dimer were significantly increased in SSc patients (362 ng/mL, IC 95%: 361–363 ng/mL vs 229 ng/mL, IC95%: 228–231 ng/mL, p = 0.005). After stratifying SSc patients according to disease subset, no significant differences were observed between those with limited cutaneous pattern and controls, whereas patients with diffuse cutaneous pattern displayed substantially increased values. No correlation was found between plasma D-dimer concentration and age, sex, autoantibody pattern, serum creatinine, erythrosedimentation rate, nailfold videocapillaroscopic pattern and pulmonary involvement. CONCLUSION: We demonstrated that SSc patients with diffuse subset are characterized by increased plasma D-dimer values, reflecting a potential activation of both the hemostatic and fibrinolytic cascades, which might finally predispose these patients to thrombotic complications

Alterations of selected serum biochemical and urinary parameters in dogs with chronic enteropathy

Background: No specific study on concurrent nephropathy has been conducted in dogs with chronic enteropathy (CE), except for soft-coated Wheaten Terriers. Moreover, limited information exists regarding the urinary profile in dogs with CE.Aim: To describe, compare, and discuss the alterations in selected serum biochemical and urinary parameters in dogs with CE.Methods: Multicentric retrospective study on dogs with CE diagnosed after exclusion of extra-gastrointestinal diseases. In addition, dogs with azotemia and lower urinary tract diseases were excluded. Information on canine chronic enteropathy clinical activity index (CCECAI) score, muscular condition score (MCS), presence of glycosuria, proteinuria [urine protein-to-creatinine (UPC) ratio > 0.5], and/or cylindruria (>1–2 casts/hpf) at diagnosis were gleaned from the medical records. Dogs were retrospectively classified as food-responsive enteropathy, immunosuppressant-responsive enteropathy, or nonresponsive enteropathy based on the presence of gastrointestinal histological inflammation and the treatment response. In addition, based on the serum albumin concentration (ALB), dogs were classified as having protein-losing enteropathy (PLE).Results: Ninety CE dogs were included. Fifty-two dogs had mild-to-severely decreased MCS and 38 dogs showed altered urinary parameters. No significant associations were found between CCECAI and altered urinary parameters. No significant association was found between PLE dogs and altered urinary parameters. PLE dogs showed higher prevalence of proteinuria than non-PLE dogs (p = 0.03; OR = 2.8; 95% CI = 1–6.8).Conclusion: Despite the presence of altered urinary profile in dogs with CE, further studies are needed to explore a possible link between gastrointestinal and renal inflammation

Independent directors and governance rating: evidence from Italian listed companies

In last years, the role played by independent directors within the boards is increasing in studies on corporate governance. At the same time a new stream of research deals with the usefulness of commercial corporate governance ratings. FTSE International Limited (FTSE) created the FTSE ECPI Italia SRI Benchmark Index composed of ordinary stocks issued by Italian companies that demonstrate good environmental, social and governance practices. The aim of this paper is to test whether the corporate governance quality variables such as the board diversity and the role of independent directors have an impact on the judgment expressed by the ECPI in the FTSE Index. Based on the 2013 company’s Report on corporate governance, we consider more than 100 Italian listed companies belonging to different industries (financial and no financial sectors) and we collect several information on independent directors and board diversity refers to year-end 2012. The obtained results in this paper show that the board diversity has no impact on the FTSE judgment while the company size, the number of the main shareholders and the number of directors have a positive influence on the FTSE rating while the number of majority shareholders has a negative one. Besides, our paper confirms the important role of independents with reference to the judgment expressed by FTSE. In particular, our study expands the existing literature on the topic because it distinguishes between the independent directors “by code” and those independent “by law” and it reveals a surprising contradictory result: the first one seem to have a positive impact on the composition of the FTSE rating at year-end 2012 while the second one seem to have a negative one

Evaluation of sample hemolysis in blood collected by S-Monovette® using vacuum or aspiration mode

Background: In vitro hemolysis can be induced by several biological and technical sources, and may be worsened by forced aspiration of blood in vacuum tubes. This study was aimed to compare the probability of hemolysis by drawing blood with a commercial evacuated blood collection tube, and S-Monovette used either in the “vacuum” or “aspiration” mode. Materials and methods: The study population consisted in 20 healthy volunteers. A sample was drawn into 4.0 mL BD Vacutainer serum tube from a vein of one upper arm. Two other samples were drawn with a second venipuncture from a vein of the opposite arm, into 4.0 mL S-Monovette serum tubes, by both vacuum an aspiration modes. After separation, serum potassium, lactate dehydrogenase (LD) and hemolysis index (HI) were tested on Beckman Coulter DxC. Results: In no case the HI exceed the limit of significant hemolysis. As compared with BD Vacutainer, no significant differences were observed for potassium and LD using S-Monovette with vacuum method. Significant increased values of both parameters were however found in serum collected into BD Vacutainer and S-Monovette by vacuum mode, compared to serum drawn by S-Monovette in aspiration mode. The mean potassium bias was 2.2% versus BD Vacutainer and 2.4% versus S-Monovette in vacuum mode, that of LD was 2.7% versus BD Vacutainer and 2.1% versus S-Monovette in vacuum mode. None of these variations exceeded the allowable total error. Conclusions: Although no significant macro-hemolysis was observed with any collection system, the less chance of producing micro-hemolysis by S-Monovette in aspiration mode suggest that this device may be used when a difficult venipuncture combined with the vacuum may increase the probability of spurious hemolysis

Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review.

Frailty is a highly prevalent condition in the elderly that has been increasingly considered as a crucial public health issue, due to the strict correlation with a higher risk of fragility fractures, hospitalization, and mortality. Among the age-related diseases, sarcopenia and dysphagia are two common pathological conditions in frail older people and could coexist leading to dehydration and malnutrition in these subjects. "Sarcopenic dysphagia" is a complex condition characterized by deglutition impairment due to the loss of mass and strength of swallowing muscles and might be also related to poor oral health status. Moreover, the aging process is strictly related to poor oral health status due to direct impairment of the immune system and wound healing and physical and cognitive impairment might indirectly influence older people's ability to carry out adequate oral hygiene. Therefore, poor oral health might affect nutrient intake, leading to malnutrition and, consequently, to frailty. In this scenario, sarcopenia, dysphagia, and oral health are closely linked sharing common pathophysiological pathways, disabling sequelae, and frailty. Thus, the aim of the present comprehensive review is to describe the correlation among sarcopenic dysphagia, malnutrition, and oral frailty, characterizing their phenotypically overlapping features, to propose a comprehensive and effective management of elderly frail subjects

Artificial Neural Networks in the Outcome Prediction of Adjustable Gastric Banding in Obese Women

Obesity is unanimously regarded as a global epidemic and a major contributing factor to the development of many common illnesses. Laparoscopic Adjustable Gastric Banding (LAGB) is one of the most popular surgical approaches worldwide. Yet, substantial variability in the results and significant rate of failure can be expected, and it is still debated which categories of patients are better suited to this type of bariatric procedure. The aim of this study was to build a statistical model based on both psychological and physical data to predict weight loss in obese patients treated by LAGB, and to provide a valuable instrument for the selection of patients that may benefit from this procedure.The study population consisted of 172 obese women, with a mean ± SD presurgical and postsurgical Body Mass Index (BMI) of 42.5 ± 5.1 and 32.4 ± 4.8 kg/m(2), respectively. Subjects were administered the comprehensive test of psychopathology Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Main goal of the study was to use presurgical data to predict individual therapeutical outcome in terms of Excess Weight Loss (EWL) after 2 years. Multiple linear regression analysis using the MMPI-2 scores, BMI and age was performed to determine the variables that best predicted the EWL. Based on the selected variables including age, and 3 psychometric scales, Artificial Neural Networks (ANNs) were employed to improve the goodness of prediction. Linear and non linear models were compared in their classification and prediction tasks: non linear model resulted to be better at data fitting (36% vs. 10% variance explained, respectively) and provided more reliable parameters for accuracy and mis-classification rates (70% and 30% vs. 66% and 34%, respectively).ANN models can be successfully applied for prediction of weight loss in obese women treated by LAGB. This approach may constitute a valuable tool for selection of the best candidates for surgery, taking advantage of an integrated multidisciplinary approach

Studies on in vitro hemolysis and utility of corrective formulas for reporting results on hemolyzed specimens

Introduction: Spuriously hemolyzed specimens are the most common preanalytical problems in clini-cal laboratories. Corrective formulas have been proposed to allow the laboratory to release test re-sults on these specimens. This study aimed to assess the influence of spurious hemolysis and reliability of corrective formulas. Materials and methods: Blood collected into lithium heparin vacuum tubes was divided in aliquots and subjected to mechanical injury by aspiration with an insulin syringe equipped with a thin needle (30 gauge). Each aliquot (numbered from “#0” to “#5”) was subjected to a growing number of passa-ges through the needle, from 0 to 5 times. After hematological testing, plasma was separated by cen-trifugation and assayed for lactate dehydrogenase (LD), aspartate aminotransferase (AST), potassi-um and hemolysis index (HI). Results: Cell-free hemoglobin concentration gradually increased from aliquot #0 (HI: 0) to #5 (HI: 76±22, cell-free hemoglobin č 37.0 g/L). A highly significant inverse correlation was observed between HI and red blood cell count (RBC), hematocrit, mean corpuscular volume (MCV), LD, AST, potassium, whereas the correlation was negative with mean corpuscular hemoglobin (MCH). No cor-relation was found with hemoglobin, platelet count and glucose. A trend towards decrease was also observed for white blood cells count. The ANCOVA comparison of analyte-specific regression lines from the five subjects studied revealed significant differences for all parameters except potassium. In all circumstances the sy,x of these equations however exceeded the allowable clinical bias. Conclusions: Mechanical injury of blood, as it might arise from preanalytical problems, occurs dishomogeneously, so that corrective formulas are unreliable and likely misleading

Evidence for the Involvement of Lipid Rafts and Plasma Membrane Sphingolipid Hydrolases in Pseudomonas aeruginosa Infection of Cystic Fibrosis Bronchial Epithelial Cells

Cystic fibrosis (CF) is the most common autosomal genetic recessive disease caused by mutations of gene encoding for the cystic fibrosis transmembrane conductance regulator. Patients with CF display a wide spectrum of symptoms, the most severe being chronic lung infection and inflammation, which lead to onset of cystic fibrosis lung disease. Several studies indicate that sphingolipids play a regulatory role in airway inflammation. The inhibition and downregulation of GBA2, the enzyme catabolizing glucosylceramide to ceramide, are associated with a significant reduction of IL-8 production in CF bronchial epithelial cells. Herein, we demonstrate that GBA2 plays a role in the proinflammatory state characterizing CF cells. We also report for the first time that Pseudomonas aeruginosa infection causes a recruitment of plasma membrane-associated glycosphingolipid hydrolases into lipid rafts of CuFi-1-infected cells. This reorganization of cell membrane may be responsible for activation of a signaling cascade, culminating in aberrant inflammatory response in CF bronchial epithelial cells upon bacterial infection. Taken together, the presented data further support the role of sphingolipids and their metabolic enzymes in controlling the inflammatory response in CF