Inflammatory and oxidative biomarkers of disease severity in dogs with parvoviral enteritis.

OBJECTIVES: To study changes in serum C-reactive protein, haptoglobin, ceruloplasmin and albumin concentration, total anti-oxidant capacity and paraoxonase-1 and butyrylcholinesterase activity in dogs with parvoviral enteritis of different degrees of clinical severity. METHODS: Prospective study of 9 healthy and 43 dogs with parvoviral enteritis that were classified into mildly, moderately and affected groups. RESULTS: Dogs with parvoviral enteritis had a significant increase in C-reactive protein compared with healthy dogs, with an increase of higher magnitude in animals with more severe clinical signs. All dogs with parvoviral enteritis had a significant increase in haptoglobin concentration compared with healthy dogs, but with no difference according to disease severity. There was a decrease in paraoxonase-1 activity in parvoviral enteritis. CLINICAL SIGNIFICANCE: Major increases of C-reactive protein concentrations in dogs with parvoviral enteritis are a marker of disease severity. In addition, higher values for anti-oxidants in severe cases compared with mild and moderate cases suggest a possible compensatory anti-oxidant mechanism.

Effect of experimental endotoxemia on thrombelastography parameters, secondary and tertiary hemostasis in dogs.

BACKGROUND: Thrombelastography (TEG) and indicators of secondary and tertiary hemostasis might be altered in dogs with endotoxemia. HYPOTHESIS: Endotoxemia influences measures of coagulation in dogs. ANIMALS: Ten healthy cross-bred dogs. MATERIAL AND METHODS: Prospective laboratory study between controls (n = 5) receiving 0.9% saline IV and the study group (n = 5) treated with low-dose lipopolysaccharide (0.02 mg/kg IV). Physical examination and sampling for measurement of leukocytes, platelets, and coagulation variables were performed at time points 0, 1, 4, and 24 hours. Coagulation variables included kaolin-activated TEG, 1-stage prothrombin time (OSPT), activated partial thromboplastin time (aPTT), fibrinogen, factor VIII, antithrombin, protein C, protein S, activated protein C (APC)-ratio calculated from aPTT with and without presence of APC), and D-Dimers. RESULTS: Endotoxemia-induced clinical signs included lethargy (n = 5/5), diarrhea (n = 4/5), emesis (n = 4/5), and abdominal pain (2/5). After 1 hour there was severe leukopenia (2.5 ± 0.7 × 10(9)/L; mean ± SD, P < .0001) and a 2.2-fold increase in D-Dimers (0.81 ± 0.64 mg/L, P < .0001). After 4 hours there was hyperthermia (40.3 ± 0.4°C, P < .0001) and increases in OSPT (10.5 ± 2.7 seconds, P < .0001), aPTT (16.7 ± 5.2 seconds, P = 0.002). A significant decrease in fibrinogen (1.5 ± 1.0 g/L, P = 0.001), protein C (31 ± 33%, P < .0001), protein S (63 ± 47%, P < .0001), TEG α (58 ± 19, P = .007), and TEG maximal amplitude (50 ± 19 mm, P = .003) was seen compared with the controls. APC-ratio rose significantly (2.5 ± 0.2, P < .0001) without exceeding the reference interval (n = 4/5). CONCLUSION AND CLINICAL IMPORTANCE: D-Dimers are the earliest indicator for endotoxemia-associated coagulation abnormalities followed by decreased protein C concentration. APC-ratio and TEG were not good screening variables.

Prognostic value of serum acute-phase proteins in dogs with parvoviral enteritis.

OBJECTIVE: To evaluate the acute-phase protein response in dogs with parvoviral enteritis as predictor of the clinical outcome. METHODS: Canine parvovirus infection was diagnosed based on the compatible clinical findings and confirmed by the canine parvovirus antigen test in 43 dogs of less than six months of age. Blood samples for complete blood cell count and acute-phase proteins (C-reactive protein, haptoglobin, ceruloplasmin and albumin) were collected before treatment. Twenty-three dogs died during or after treatment (non-survival) and the rest recovered (survival). Five healthy dogs were enrolled as control. RESULTS: Serum C-reactive protein, ceruloplasmin and haptoglobin levels in dogs with parvoviral enteritis were higher (P<0·001, P<0·01 and P<0·001, respectively), but serum albumin was lower (P<0·001) than those in controls. Mean C-reactive protein and ceruloplasmin values in non-survival were higher (P<0·01) than those for survival dogs. C-reactive protein was found to be superior to ceruloplasmin, haptoglobin and albumin for distinguishing survival from non-survival dogs. Values higher than 92·4 mg/l for C-reactive protein had a sensitivity of 91% to predict mortality. CLINICAL SIGNIFICANCE: The magnitude of the increase in serum acute-phase proteins in dogs with parvoviral enteritis could be a useful indicator of the prognosis of the disease. In acute-phase proteins, C-reactive protein is a potent predictor of mortality in dogs with parvoviral enteritis.

Effects of iron deficiency anemia on hemoglobin A1c in type 1 diabetes mellitus.

BACKGROUND: The relationship between hemoglobin A1c (HbA1c) and iron status in type 1 diabetes mellitus (DM) has not been adequately studied. In this prospective investigation, we aimed to determine the effect of iron deficiency on HbA1c in diabetic patients who also had insufficient iron stores. METHODS: Thirty-seven patients with type 1 DM were included in the study. Eleven of them were also iron deficient (ID) and the remaining 26 were iron-sufficient (IS). Two non-diabetic control groups were selected for the ID and IS groups. All patients with ID were treated with iron at 6 mg/kg per day for 3 months. Glycemia in diabetic patients was monitored at home before breakfast and supper by a glycometer. Hemoglobin A1c was measured in all subjects at the beginning and the end of the study. RESULTS: Patients with ID DM had higher levels of HbA1c than those in the control group (P < 0.001). There were no significant differences in the weekly average glucose concentration of the patients with ID DM before and after iron supplementation. In contrast, HbA1c decreased from a mean of 10.1 +/- 2.7% to a mean of 8.2 +/- 3.1% (P < 0.05). Additionally, HbA1c in ID non-diabetic patients decreased from a mean of 7.6 +/- 2.6% to 6.2 +/- 1.4% after iron therapy (P < 0.05). CONCLUSIONS: We conclude that among type 1 DM patients with similar level of glycemia, iron deficiency anemia is associated with higher concentrations of HbA1c. In addition, iron replacement therapy leads to a drop in HbA1c in both diabetic and non-diabetic patients. The iron status of the patient must be considered during the interpretation of HbA1c concentrations in type 1 DM.

Serum prolactin in neonatal seizures.

BACKGROUND: Prolactin is the most specific neurohormone that is elevated after seizures. This study was undertaken to determine the clinical usefulness of plasma prolactin as a diagnostic aid in differential diagnosis of neonatal convulsions. METHODS: Forty-five patients followed for seizures were included in the study. Postictal serum prolactin levels were obtained 30 min after the onset of the seizures. A second sample obtained 24 h later was used to measure an unstimulated serum prolactin level. RESULTS: The most common cause of seizure was hypoxic ischemic encephalopathy (HIE) followed by sepsis. In patients with HIE, postictal serum prolactin levels were significantly higher than the unstimulated levels (P < 0.0002). Additionally, postictal prolactin levels were significantly higher than the unstimulated levels in clonic (P < 0.02) and tonic convulsions (P < 0.001). CONCLUSIONS: We conclude that the postictal serum prolactin level may be a marker in the differentiation of seizures as well as providing important information about their etiology. Further studies are needed to assess the normal range of serum prolactin levels in unstressed newborns.

Gastric emptying time in children with progressive muscular dystrophy.

Gastric emptying was evaluated in 11 male children (mean age 8.2 +/- 3.2 years) with progressive muscular dystrophy to detect gastrointestinal smooth muscle involvement. No patient had gastrointestinal symptoms. Gastric emptying studies were performed by using 500 microCi of technetium 99 m sulfur colloid bound to a scrambled egg, and scintigraphic measurements were taken continuously for 60 to 90 minutes. The gastric emptying studies were compared with those of eight male children (mean age 8.2 +/- 2.8 years) without gastrointestinal or muscular disorders. The mean percentage of retention of gastric isotope was significantly greater in the study group than in the control group. These data suggest that dysfunction of the smooth muscle of the upper gastrointestinal tract is detectable in children with progressive muscular dystrophy, even when gastrointestinal symptoms are absent.

Tc-99m HMPAO brain SPECT compared to CT and EEG after seizures in childhood.

Twenty-one children with various seizure disorders were studied using Tc-99m HMPAO brain SPECT, cranial CT, and electroencephalography (EEG). The rates of pathologic findings on SPECT, CT, and EEG were 67%, 38%, and 52%, respectively. SPECT showed congruent, or more extensive, lesions in all eight patient with CT lesions. Six of the 13 children who had normal CT results, had abnormal SPECT study results. In this postictal series, 4 of the 14 abnormalities detected in the first SPECT study that was applied within 24 hours of a seizure, were in the form of hyperperfused areas. Eight of the 14 abnormal first SPECT studies had become normal by the second SPECT. We conclude that, with respect to the depiction of some kind of abnormality, HMPAO brain SPECT is superior to CT and EEG, and considerable changes in brain perfusion are likely to occur over a period of a few weeks.

The prevalence of neurological disorders among children in Gemlik (Turkey).

With a descriptive survey, the authors tried to ascertain the prevalence of certain neurological disorders among children aged up to five years. Questionnaires were administered to mothers and their children were divided into two groups (559 children): neurologically healthy and suspect. Suspect children were examined by a paediatrician, who assigned a diagnosis where appropriate (361 children). A control group was selected from the healthy children (420 children), and they were neurologically examined with the suspect children. Cases and controls were compared for family history, and pregnancy and delivery risks. The most frequent condition found was febrile convulsions (0.45 per cent), followed by epilepsy (0.9 per cent) and cerebral palsy (0.5 per cent).