Inclusion Body Disease hos boa- och pytonorm

Inclusion body disease (IBD) affecting boas and pythons is a serious and common disease. Boas can be clinically healthy carriers, which makes control of the disease difficult. The causative agent has not yet been confidently identified, and therefore there are no serodiagnostic tests available. Today, histopathologic examination of tissue biopsies is the recommended antemortem diagnostic method, but there are several disadvantages. The objective of this study was to compare the sensitivity of two diagnostic methods – liver biopsies and blood smears, and to evaluate ultrasoundguided needle biopsy of the liver. Sixteen clinically healthy boas aging from 1,5 months to 4 years or more, and from different collections in Sweden were used in the study. Blood samples for blood smears were collected from all snakes, liver biopsies by celiotomy were performed on fourteen, and ultrasoundguided needle biopsies on five. The blood smears were stained with May-Grünewald-Giemsa, and the tissue samples were after preparation stained with hematoxylin and eosin. They were then examined with light microscopy for intracytoplasmic eosinophilic inclusion bodies in hepatocytes or blood cells. Typical IBD-inclusions were found in liver biopsies from four of the snakes, but no inclusions were found in blood smears from the same animals. Sampling by ultrasoundguided needle biopsy resulted in representative samples. In conclusion, a blood smear is not a reliable diagnostic alternative to identify IBD-positive snakes compared to liver biopsies, as liver biopsy by celiotomy or needle biopsy is a more sensitive method. Ultrasound guided needle biopsy is a less invasive technique, but has less control of procedure complications.Inclusion body disease (IBD) som drabbar boa- och pytonormar är en allvarlig och vanligt förekommande sjukdom. Boaormar kan vara kliniskt friska bärare, vilket medför att spridningen av sjukdomen är svår att kontrollera. Då man än inte har lyckats identifiera det agens som orsakar sjukdomen finns ännu inga serologiska diagnostiska metoder utvecklade. I dagsläget rekommenderas histopatologisk undersökning av vävnadsbiopsier som bästa diagnostiska metod på levande djur, men flera nackdelar finns. Syftet med denna studie var att jämföra sensitiviteten mellan två diagnostiska metoder - leverbiopsier och blodutstryk, samt att utvärdera ultraljudsguidad nålbiopsi från levern. Sexton kliniskt friska boaormar, från 1,5 månader till 4 års ålder eller mer, och från olika samlingar i Sverige ingick i försöket. Blodprov för blodutstryk togs på alla ormarna, leverbiopsier via celiotomi på fjorton och ultraljudsguidade nålbiopsier på fem. Blodutstryken färgades med May-Grünewald-Giemsa, och biopsierna preparerades och färgades med hematoxylin och eosin. De undersöktes därefter i ljusmikroskop efter intracytoplasmatiska eosinofila inklusionskroppar i hepatocyter eller blodceller. Typiska IBD-inklusioner påvisades i leverbiopsier från fyra av ormarna, men inga inklusioner hittades i blodutstryk från samma djur. Slutsatsen är att blodutstryk inte är ett tillförlitligt diagnostiskt alternativ för att identifiera IBD-positiva ormar jämfört med leverbiopsier, eftersom leverbiopsi genom celiotomi eller nålbiopsi är en mer sensitiv metod. Ultraljudsguidad nålbiopsi är en mindre invasiv metod, men medför en sämre kontroll av eventuella komplikationer

Ecoturismo: una quimera para comunidades rurales en áreas naturales protegidas

International institutions promoting “sustainable development” have broadened their scope of action to incorporate ecotourism as a new field to promote capitalist accumulation. As part of the process, they are offering financing and “technical assistance” to incorporate rural and native communities in providing these services, generally in partnership with international promoters of these activities that are organizing the markets. Considering the enormous cultural and economic gap between the groups of service providers and consumers, it is evident that most of the encounters imply a lack of mutual understanding of the situation and an appropriation of the benefits by people outside the communities. In the process, the communities end up sacrificing important parts of their own existence and their social, cultural and productive organization along with their ability to protect their ecosystems. There are, however, hopeful examples of where self-management prevails.Keywords: ecotourism, sustainability, self-management, autonomy, exploitation.Las instituciones internacionales promoviendo el “desarrollo sustentable” han ampliado sus visiones para incorporar el ecoturismo como un nuevo campo para promover la acumulación capitalista. Como parte del proceso están ofreciendo financiamiento y “asistencia técnica”’ para la incorporación de comunidades rurales e indígenas en la provisión de estos servicios, generalmente en sociedad con organizaciones internacionales promotoras de la actividad quienes están organizando de alguna manera los mercados. Considerando la enorme brecha cultural y económica entre los oferentes y los demandantes de los servicios, es evidente que la mayor parte de los encuentros implicarían una incapacidad de comprensión mutua de la situación y una apropiación de los beneficios por personas ajenas a la comunidad. En el proceso, las comunidades terminan sacrificando partes importantes de su propia existencia y de su organización para la reproducción social, cultural y productiva, así como para la protección de sus ecosistemas. Sin embargo, hay ejemplos alentadores donde prevalecen esfuerzos autogestionados.Palabras clave: ecoturismo, sustentable, autogestionado, autonomía, explotación

Evaluation of social interventions based on tourism using the methodological approach of Realistic Assessment

El crecimiento y expansión del turismo a nivel mundial ha hecho de la actividad un elemento relevante para las economías de países en desarrollo que cuentan con importante patrimonio cultural y natural, ya que constituyen activos turísticos valiosos. La combinación de estos elementos llevó a la incorporación del turismo a la agenda internacional como herramienta para el desarrollo y el combate a la pobreza. En consecuencia, particularmente desde principios de los años 2000 se ha incrementado la aplicación de intervenciones sociales basadas en el turismo con el propósito de generar desarrollo sostenible en comunidades marginadas a nivel mundial. Sin embargo, la relación entre abatimiento de la pobreza y turismo todavía no se ha establecido de manera clara, y la información disponible indica un elevado índice de fracaso en estos proyectos. Hasta ahora por un lado, el análisis académico de estos proyectos está generalmente basado en conceptos como turismo pro-pobre y turismo basado en comunidades, y por tanto, se ha enfocado al desempeño de los proyectos turísticos y al beneficio indirecto y relativo a las comunidades receptoras, y por otro, las pocas evaluaciones de estas intervenciones son extremadamente escasas, de difícil acceso y no buscan explicar los mecanismos que detonan en los contextos en los que son aplicadas, sus procesos operativos o los impactos que generan. Para llenar este vacío se propone la evaluación realista de una intervención para el desarrollo sostenible basada en el turismo (IDST) para generar un panorama integral de la misma. Este enfoque metodológico ha sido desarrollado para vincular las teorías que tienen los grupos involucrados con los contextos en los que las intervenciones son llevadas a cabo y evidenciar los mecanismos detonados que generan los resultados de la intervención. Este artículo presenta el caso de la Estación de Campo ‘Modelo’ en Sta. Cruz Tepetotutla, en la región indígena Chinanteca, en Oaxaca, México, proporciona al lector una primera visión de la Evaluación Realista y propone un marco conceptual como guía para la aplicación de este enfoque metodológico en la evaluación de intervenciones sociales para el desarrollo sostenible de las comunidades beneficiadas/receptoras de turismo.The growth and expansion of tourism worldwide has made the activity a relevant element in developing countries’ economies with important cultural and natural features forming valuable tourist assets. The combination of these elements has led to the incorporation of tourism into the international agenda as a tool for development and combating poverty. As a result, particularly since the beginning of the 2000s, there has been an increase in the application of social interventions based on tourism with the aim of generating sustainable development in marginalized communities in the world. However, the relationship between poverty alleviation and tourism has not yet been established. And the information available indicates a high rate of failure in these projects. So far, on the one hand, academic analysis of these projects is generally based on concepts such as pro-poor tourism and community-based tourism, and has therefore focused on project performance and indirect benefit relative to the receiving communities, and on the other, the few evaluations of these interventions are extremely scarce, difficult to access and do not seek to explain the mechanisms triggered in the contexts in which they are applied, their operational processes or the impacts they generate. To fill this gap, we propose a realistic evaluation of an intervention for sustainable development-based tourism (IDST) to generate a comprehensive picture of it. This methodological approach has been developed to link theories held by the groups involved with the contexts in which the interventions are carried out and demonstrate the mechanisms used that generate the results of the intervention. This article presents the case of the ‘Modelo’ Field Station in Sta. Cruz Tepetotutla, in the region of Chinanteca, in Oaxaca, Mexico, to provide a first proposal for a conceptual framework as a guide for the applica‑ tion of this methodological approach in the evaluation of social interventions for the sustainable development of tourism recipient/beneficiary communities

Endothelial Function is Not Changed during Short-Term Withdrawal of Thyroxine in Patients with Differentiated Thyroid Cancer and Low Cardiovascular Risk

PURPOSE: The incidence of differentiated thyroid cancer is increasing in young adults and females in Korea. Some of them experience short-term hypothyroidism in preparation for radioiodine (RAI) therapy, which can have a deleterious effect on the cardiovascular system. However, it is not clear if short-term hypothyroidism induces endothelial dysfunction in patients with low cardiovascular risk. Therefore, the aim of this study was to investigate whether short-term hypothyroidism is associated with endothelial dysfunction in patients with low cardiovascular risk. MATERIALS AND METHODS: To evaluate the effect of short-term hypothyroidism on endothelial function in this group, we recruited fifteen female patients with low cardiovascular risk. We analyzed clinical, biochemical, and cardiovascular parameters at four time points: the last day on levothyroxine (LT4) at their usual thyroid-stimulating hormone (TSH)-suppressive doses (P1), 7 days (P2) and 4 weeks (P3) after withdrawal of LT4, and 8 weeks (P4) after replacement of the previous dose of LT4. A high resolution ultrasound was used to measure brachial artery diameter at rest, after reactive hyperemia, and after sublingual nitroglycerin. RESULTS: During short-term hypothyroidism (P3), serum concentrations of total cholesterol and low-density lipoprotein (LDL)-cholesterol were increased (p < 0.001 for each period). In spite of having worsened lipid states, serum high sensitivity C-reactive protein or flow-mediated vasodilatation, which is one of the surrogate markers of the endothelial function, did not change during short-term hypothyroidism. CONCLUSION: Short-term hypothyroidism induced worsening of metabolic parameters, but not enough to induce the endothelial dysfunction in patients with low cardiovascular riskope

Renal fibrosis

Renal fibrosis, characterized by tubulointerstitial fibrosis and glomerulosclerosis, is the final manifestation of chronic kidney disease. Renal fibrosis is characterized by an excessive accumulation and deposition of extracellular matrix components. This pathologic result usually originates from both underlying complicated cellular activities such as epithelial-to-mesenchymal transition, fibroblast activation, monocyte/macrophage infiltration, and cellular apoptosis and the activation of signaling molecules such as transforming growth factor beta and angiotensin II. However, because the pathogenesis of renal fibrosis is extremely complicated and our knowledge regarding this condition is still limited, further studies are needed

The relation between endothelial dependent flow mediated dilation of the brachial artery and coronary collateral development – a cross sectional study

<p>Abstract</p> <p>Background</p> <p>Endothelial dysfunction is thought to be a potential mechanism for the decreased presence of coronary collaterals. The aim of the study was to investigate the association between systemic endothelial function and the extent of coronary collaterals.</p> <p>Methods</p> <p>We investigated the association between endothelial function assessed via flow mediated dilation (FMD) of the brachial artery following reactive hyperemia and the extent of coronary collaterals graded from 0 to 3 according to Rentrop classification in a cohort of 171 consecutive patients who had high grade coronary stenosis or occlusion on their angiograms.</p> <p>Results</p> <p>Mean age was 61 years and 75% were males. Of the 171 patients 88 (51%) had well developed collaterals (grades of 2 or 3) whereas 83 (49%) had impaired collateral development (grades of 0 or 1). Patients with poor collaterals were significantly more likely to have diabetes (<it>p </it>= 0.001), but less likely to have used statins (<it>p </it>= 0.083). FMD measurements were not significantly different among good and poor collateral groups (11.5 ± 5.6 vs. 10.4 ± 6.2% respectively, <it>p </it>= 0.214). Nitroglycerin mediated dilation was also similar (13.4 ± 5.9 vs. 12.8 ± 6.5%, <it>p </it>= 0.521).</p> <p>Conclusion</p> <p>No significant association was found between the extent of angiographically visible coronary collaterals and systemic endothelial function assessed by FMD of the brachial artery.</p

Effect of clopidogrel discontinuation at 1 year after drug eluting stent placement on soluble CD40L, P-selectin and C-reactive protein levels: DECADES (Discontinuation Effect of Clopidogrel After Drug Eluting Stent): a multicenter, open-label study

Antiplatelet therapy with clopidogrel has been shown to reduce major adverse cardiac events in acute coronary syndromes and after percutaneous interventions. This effect is not only due to its anti-platelet effect but also possibly due to an anti-inflammatory effect. The effect of clopidogrel cessation after one year of therapy on markers of inflammation has been investigated in diabetics and showed an increase in platelet aggregation as well as hsCRP and surface P-selectin levels. This was an exploratory multicenter prospective open-label single arm study of 98 non-diabetic patients who had received one or more drug eluting stents and were coming to the end of their 12 months course of clopidogrel therapy. The effect of clopidogrel cessation on expression of biomarkers: sCD40L, soluble P-selectin and hsCRP was measured right before clopidogrel cessation (day 0), and subsequently at 1, 2, 3 and 4 weeks after drug withdrawal. A median increase in sCD40L expression from 224 to 324.5 pg/ml was observed between baseline and 4 weeks after clopidogrel cessation, which corresponded to a 39% mean percent change based on an ANCOVA model (P < 0.001). Over the 4 weeks observation period the change in sCD40L expression correlated weakly with soluble P-selectin levels (at 4 weeks Spearman’s correlation coefficient = 0.32; P = 0.0024). Increase in P-selectin expression from baseline was statistically significant at week 1 and 2. Conversely, hsCRP level decreased by 21% at 1 week (P = 0.008) and was still reduced by 18% by 4 weeks (P = 0.062). The change in sCD40L expression appeared to vary with the type of drug eluting stent. Patients treated with drug eluting stents at 1 year after implantation display significant increase in sCD40L and decrease in hsCRP after clopidogrel cessation. Further studies should elucidate if this increase in sCD40L levels reflects solely the removal of the inhibitory effects of clopidogrel on platelet activity or rather an increase in pro-inflammatory state. The latter hypothesis may be less likely given decrease in hsCRP levels. Randomized studies are urgently needed to establish potential link of clopidogrel discontinuation and vascular outcomes

Utility of Atherosclerosis Imaging in the Evaluation of High-Density Lipoprotein–Raising Therapies

Decreased level of high density-lipoprotein cholesterol (HDL-C) is a rigorous predictor for future cardiovascular events. Much effort is being made to develop HDL-C–raising pharmacotherapies in the attempt to avert the pandemic of atherosclerotic disease. Important properties by which HDL-C–raising compounds are effective involve improvement of cholesterol uptake from macrophages in plaque for transport back to the liver, improvement of endothelial function, and anti-inflammatory effects. Vascular imaging can aid in the determination which HDL-C–raising compounds are effective. Ultrasound and MRI have proved suitable for assessment of structural changes of the vessel wall. Ultrasound can also be used or assessment of endothelial function. 18F-fluordeoxyglucose positron emission tomography has opened up the possibility to assess vessel wall inflammation. In this article we discuss these various imaging techniques and how they can assess efficacy as well as provide pathophysiologic information on the mechanism of action of novel HDL-C–raising drugs