The laboratory diagnostic approach to thoracic and abdominal effusions in the dog, cat, and horse

Περιστατικά στα οποία διαπιστώνονται υπεζωκοτικές και περιτοναϊκές συλλογές είναι αρκετά συχνά στην κλινική πράξη. Ο καθορισμός της υποκείμενης αιτιολογίας σε αυτές τις περιπτώσεις βασίζεται κυρίως στην ανάλυση του υγρού της συλλογής. Η τεχνική που χρησιμοποιείται για τη λήψη του υγρού της υπεζωκοτικής ή περιτοναϊκής συλλογής μπορεί να επηρεάσει σε μεγάλο βαθμό τα αποτελέσματα της ανάλυσης. Στις πιο συχνά χρησιμοποιούμενες διαγνωστικές εξετάσεις περιλαμβάνονται η αξιολόγηση των φυσικών ιδιοτήτων του υγρού, ο προσδιορισμός του συνολικού αριθμού εμπύρηνων κυττάρων / ολικών πρωτεϊνών (TNCC / TP), ο προσδιορισμός χημικών / βιοχημικών παραμέτρων (γαλακτική αφυδρογονάση και γαλακτικό οξύ, χολοστερόλη, τριγλυκερίδια, γλυκόζη, κρεατινίνη, pH, pO2, pCO2, K), κυτταρολογική εξέταση (διάγνωση σηπτικών και μη σηπτικών φλεγμονών και νεοπλασμάτων), μικροβιολογικές εξετάσεις (επιχρίσματα με χρώση Gram, καλλιέργεια, μοριακές τεχνικές) και ειδικές διαγνωστικές εξετάσεις για ορισμένες παθολογικές καταστάσεις και νοσήματα. Η ταξινόμηση μιας συλλογής ως διίδρωμα, τροποποιημένο διίδρωμα και εξίδρωμα βασίζεται παραδοσιακά στις τιμές των TNCC και ΤΡ. Νέες διαγνωστικές μέθοδοι συνεισφέρουν στην αιτιολογική διάγνωση χωρίς απαραίτητα να ακολουθηθεί αυστηρά η παραδοσιακή ταξινόμηση. Πολλές από τις διαγνωστικές εξετάσεις που περιγράφονται σε αυτήν την ανασκόπηση είναι απλές και μπορούν να πραγματοποιηθούν στο ιατρείο, παρέχοντας γρήγορα πληροφορίες στον κλινικό κτηνίατρο σχετικές με την αιτία της συλλογής. Η γνώση αυτή είναι απαραίτητη για την έγκαιρη και αποτελεσματική θεραπευτική αντιμετώπιση της υποκείμενης παθολογικής κατάστασης.Cases involving pleural and peritoneal effusions occur relatively frequently in clinical practice. Determining the underlying etiology in these cases relies mainly on fluid analysis. The technique used for obtaining the pleural or peritoneal fluid can impact greatly the results of the analysis. Most often used diagnostic tools include evaluation of gross appearance, Total Nucleated Cell Count / Total Protein (TNCC/TP) measurement, chemical/biochemical analysis (Lactate dehydrogenase and lactate, cholesterol, triglycerides, glucose, creatinine, pH, pO2, pCO2, and K measurements), cytology (identification of septic and non-septic inflammation and neoplasia), microbiology (Gram stain, culture, molecular techniques), and specific tests for certain clinical conditions and diseases. Classifying an effusion as transudate, modified transudate and exudate is traditionally based on the TNCC and TP values. New diagnostic methods encourage the clinician to approach the effusion etiologically instead of strictly following this traditional classification. Many of the diagnostic tests described in this review are simple and can be performed in-house, providing the clinician quickly with information about the cause of the effusion, essential for an effective treatment plan without wasting valuable time

Limited Depressive and Anxiety Symptoms Late in Pregnancy Are Not Related to Neonatal Outcomes

Background: Prior studies have reported inconsistent findings regarding the link between antenatal depressive and anxiety symptomatology, with neonatal outcomes. Objectives: The aim of the present study was to assess the possible association of prenatal depressive and anxiety symptoms, in the third trimester of pregnancy, with perinatal outcomes (birth weight of the newborn, Apgar score and the newborn’s admission in neonatal intensive care unit) in a sample of pregnant women, in Greece. Patients and Methods: A total of 117 women from Athens, during the 32nd to 35th week of pregnancy, participated in the study. Demographic and obstetric history data, as well as neonatal outcomes, were recorded. Three self-administered psychometric scales (Beck depression inventory (BDI), Edinburg postnatal depression scale (EPDS) and beck anxiety inventory (BAI)) were used to evaluate in detail the prenatal depressive and anxiety symptoms. Descriptive statistics, Spearman’s Rho coefficients, Mann-Whitney U and Kruskal-Wallis testes were applied to analyze the data. Results: On the basis of BDI, 81.1% of the sample showed minimal, 15.4% mild, 2.6% moderate and 0.9% severe depressive symptoms, respectively. Furthermore, 80.3% of the participants, scored on EPDS below the cut-off point for a likely diagnosis of depression. According to BAI scale, 43.6% showed minimal, 42.7% women mild, 10.3% moderate and 3.4% severe anxiety symptoms. No statistically significant correlations were found between depressive and anxiety symptoms and neonatal outcomes (birth weight, Apgar score and admission in neonatal intensive care unit). Conclusions: Limited levels of prenatal depressive and anxiety symptoms do not seem to be associated with neonatal outcomes. In clinical practice, pregnant women, who suffer from low levels of prenatal depressive and anxiety symptoms, may be reassured, in respect of the adverse outcomes of these mood symptoms on the neonate

A multi-factorial genetic model for prognostic assessment of high risk melanoma patients receiving adjuvant interferon

Purpose: IFNa was the first cytokine to demonstrate anti-tumor activity in advanced melanoma. Despite the ability of high-dose IFNa reducing relapse and mortality by up to 33%, large majority of patients experience side effects and toxicity which outweigh the benefits. The current study attempts to identify genetic markers likely to be associated with benefit from IFN-a2b treatment and predictive for survival. Experimental design: We tested the association of variants in FOXP3 microsatellites, CTLA4 SNPs and HLA genotype in 284 melanoma patients and their association with prognosis and survival of melanoma patients who received IFNa adjuvant therapy. Results: Univariate survival analysis suggested that patients bearing either the DRB1*15 or HLA-Cw7 allele suffered worse OS while patients bearing either HLA-Cw6 or HLA-B44 enjoyed better OS. DRB1*15 positive patients suffered also worse RFS and conversely HLA-Cw6 positive patients had better RFS. Multivariate analysis revealed that a five-marker genotyping signature was prognostic of OS independent of disease stage. In the multivariate Cox regression model, HLA-B38 (p = 0.021), HLA-C15 (p = 0.025), HLA-C3 (p = 0.014), DRB1*15 (p = 0.005) and CT60*G/G (0.081) were significantly associated with OS with risk ratio of 0.097 (95% CI, 0.013-0.709), 0.387 (95% CI, 0.169-0.889), 0.449 (95% CI, 0.237-0.851), 1.948 (95% CI, 1.221-3.109) and 1.484 (95% IC, 0.953-2.312) respectively. Conclusion: These results suggest that gene polymorphisms relevant to a biological occurrence are more likely to be informative when studied in concert to address potential redundant or conflicting functions that may limit each gene individual contribution. The five markers identified here exemplify this concept though prospective validation in independent cohorts is needed

Linking shyness to social anxiety in children through the Clark and Wells cognitive model

This is the author accepted manuscript. The final version is available from Ellinika Grammata via the link in this record.Past research has begun to show that cognitive biases partially mediate the relation between shyness and social anxiety. In addition, it has been showed that the Clark and Wells (1995) cognitive model generalizes to youth. This study investigated the mediating role of the model in the link between shyness and social anxiety. Participants were 306 preadolescents, who completed measures of shyness, social anxiety, and cognitive variables implicated by the model (anticipatory processing, post-event processing, and social attitudes). The results confirmed that shyness, social anxiety and maladaptive cognitive processes were intercorrelated. Further, in a multiple mediator model, social attitudes, but not anticipatory or post-event processing, partially mediated the relation between shyness and social anxiety. Implications for school prevention interventions are briefly discussed

A new mathematical model for the interpretation of translational research evaluating six CTLA-4 polymorphisms in high-risk melanoma patients receiving adjuvant interferon

Adjuvant therapy of stage IIB/III melanoma with interferon reduces relapse and mortality by up to 33% but is accompanied by toxicity-related complications. Polymorphisms of the CTLA-4 gene associated with autoimmune diseases could help in identifying interferon treatment benefits. We previously genotyped 286 melanoma patients and 288 healthy (unrelated) individuals for six CTLA-4 polymorphisms (SNP). Previous analyses found no significant differences between the distributions of CTLA-4 polymorphisms in the melanoma population vs. controls, no significant difference in relapse free and overall survivals among patients and no correlation between autoimmunity and specific alleles. We report new analysis of these CTLA-4 genetic profiles, using Network Phenotyping Strategy (NPS). It is graph-theory based method, analyzing the SNP patterns. Application of NPS on CTLA-4 polymorphism captures allele relationship pattern for every patient into 6-partite mathematical graph P. Graphs P are combined into weighted 6-partite graph S, which subsequently decomposed into reference relationship profiles (RRP). Finally, every individual CTLA-4 genotype pattern is characterized by the graph distances of P from eight identified RRP's. RRP's are subgraphs of S, collecting equally frequent binary allele co-occurrences in all studied loci. If S topology represents the genetic "dominant model", the RRP's and their characteristic frequencies are identical to expectation-maximization derived haplotypes and maximal likelihood estimates of their frequencies. The graphrepresentation allows showing that patient CTLA-4 haplotypes are uniquely different from the controls by absence of specific SNP combinations. New function-related insight is derived when the 6-partite graph reflects allelic state of CTLA-4. We found that we can use differences between individual P and specific RRPs to identify patient subpopulations with clearly different polymorphic patterns relatively to controls as well as to identify patients with significantly different survival. © 2014 Pancoska et al