Treatment of specific macrovascular beds in patients with diabetes mellitus

In 2007, over 23 million people had diabetes in the United States and death from cardiovascular disease is estimated to occur in 80% of those Americans. Risk factor reduction is the most important therapy for primary and secondary prevention of macrovascular disease in patients with and without diabetes mellitus. Despite this, presentation and response to therapy is often different for patients with diabetes compared to their non-diabetic counterparts. This paper will review the current targets for therapy of cardiovascular disease, peripheral vascular disease, and cerebrovascular disease in patients with diabetes

Contributions of ocular surface components to matrix-metalloproteinases (MMP)-2 and MMP-9 in feline tears following corneal epithelial wounding

Purpose: This study investigated ocular surface components that contribute to matrix-metalloproteinase (MMP)-2 and MMP-9 found in tears following corneal epithelial wounding. Methods: Laboratory short-haired cats underwent corneal epithelial debridement in one randomly chosen eye (n = 18). Eyeflush tears were collected at baseline and during various healing stages. Procedural control eyes (identical experimental protocol as wounded eyes except for wounding, n = 5) served as controls for tear analysis. MMP activity was analyzed in tears using gelatin zymography. MMP staining patterns were evaluated in ocular tissues using immunohistochemistry and used to determine MMP expression sites responsible for tear-derived MMPs. Results: The proMMP-2 and proMMP-9 activity in tears was highest in wounded and procedural control eyes during epithelial migration (8 to 36 hours post-wounding). Wounded eyes showed significantly higher proMMP-9 in tears only during and after epithelial restratification (day 3 to 4 and day 7 to 28 post-wounding, respectively) as compared to procedural controls (p,0.05). Tears from wounded and procedural control eyes showed no statistical differences for pro- MMP-2 and MMP-9 (p.0.05). Immunohistochemistry showed increased MMP-2 and MMP-9 expression in the cornea during epithelial migration and wound closure. The conjunctival epithelium exhibited highest levels of both MMPs during wound closure, while MMP-9 expression was reduced in conjunctival goblet cells during corneal epithelial migration followed by complete absence of the cells during wound closure. The immunostaining for both MMPs was elevated in the lacrimal gland during corneal healing, with little/no change in the meibomian glands. Conjunctival-associated lymphoid tissue (CALT) showed weak MMP-2 and intense MMP-9 staining. Conclusions: Following wounding, migrating corneal epithelium contributed little to the observed MMP levels in tears. The major sources assessed in the present study for tear-derived MMP-2 and MMP-9 following corneal wounding are the lacrimal gland and CALT. Other sources included stromal keratocytes and conjunctiva with goblet cells

Detection and Investigation of Atypical Porcine Pestivirus within a Breed-to-Finish Farm and Off-Site Nursery and Finisher Locations

Atypical porcine pestivirus (APPV) has been associated with congenital tremors (CT) and splay leg (SL) in piglets of infected dams. The major cost of this virus is the increased pre-weaning mortality due to CT or SL interfering with the piglet’s ability to nurse and move around the farrowing stall. A commercial farrow-to-finish farm with replacement gilts coming from an off-site genetic multiplier farm, and semen delivery from a commercial boar stud began to see an increase of CT and SL in the farrowing room in early 2020. Diagnostics on clinically affected pigs’ samples identified APPV RNA and no other suspected pathogen. At this point, the origin of the virus and means of introduction into the farm was unknown since the farm had no previous clinical cases of CT or SL prior to this investigation. The two hypothesized routes were the introduction of replacement gilts or incoming semen doses. Therefore, the objectives of this investigation were to determine the prevalence of clinical APPV cases at the farrow-to-finish farm, understand the route of introduction of APPV into the farrowto- finish farm, and understand the prevalence of APPV viremia within a population of offspring from a gilt multiplication farm through an off-site nursery and finisher barn. Farrowing records from the farm were analyzed for the presence of CT or SL and parities of females with affected litters. Blood samples were collected at two different times from the new group of replacement gilts and maternal barrows at the isolation nursery barn. Serum and oral fluids were collected from the same pigs at an off-site finisher barn to determine APPV persistence. The APPV sequencing was conducted on a serum sample from a gilt housed at the isolation nursery intended as a replacement gilt for the farrow-to-finish farm, semen dose utilized at the farrow-to-finish farm, and serum of a clinically affected piglet in the farrowing room of the farrow-to-finish farm. Overall, the prevalence of affected litters within batch farrowing groups ranged from 0 to 31%. The prevalence of APPV within samples pooled by pens (5 pigs) ranged from 37.5 to 77.5%, while individual prevalence ranged from 20 to 40%. When followed to the finisher, the same group of pigs had an APPV prevalence in serum ranging from 0 to 26%, while oral fluid prevalence was 100%. Sequencing results indicated that the virus circulating in clinically affected piglets was the most similar to an incoming semen dose. In summary, introduction of APPV into a naïve herd is associated with an increase in clinical CT and SL. While APPV is present in herds previously exposed to APPV, the APPV RNA remains detectable in serum and oral fluids with no clinical disease. To decrease the chance of infection to a naïve herd, quarantines should be implemented for all introductions. Additionally, semen should be screened for APPV presence if there is a recent onset of clinically affected piglets with CT or SL with no other explanation. The APPV RNA was detected in group oral fluids, suggesting the technique may be used to screen incoming animals

Application of infrared thermography in computer aided diagnosis

The invention of thermography, in the 1950s, posed a formidable problem to the research community: What is the relationship between disease and heat radiation captured with Infrared (IR) cameras? The research community responded with a continuous effort to find this crucial relationship. This effort was aided by advances in processing techniques, improved sensitivity and spatial resolution of thermal sensors. However, despite this progress fundamental issues with this imaging modality still remain. The main problem is that the link between disease and heat radiation is complex and in many cases even non-linear. Furthermore, the change in heat radiation as well as the change in radiation pattern, which indicate disease, is minute. On a technical level, this poses high requirements on image capturing and processing. On a more abstract level, these problems lead to inter-observer variability and on an even more abstract level they lead to a lack of trust in this imaging modality. In this review, we adopt the position that these problems can only be solved through a strict application of scientific principles and objective performance assessment. Computing machinery is inherently objective; this helps us to apply scientific principles in a transparent way and to assess the performance results. As a consequence, we aim to promote thermography based Computer-Aided Diagnosis (CAD) systems. Another benefit of CAD systems comes from the fact that the diagnostic accuracy is linked to the capability of the computing machinery and, in general, computers become ever more potent. We predict that a pervasive application of computers and networking technology in medicine will help us to overcome the shortcomings of any single imaging modality and this will pave the way for integrated health care systems which maximize the quality of patient care

George Sandeman: an eighteenth-century wright from Perth

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