Canine demodicosis: Hematological and biochemical alterations.

BACKGROUND AND AIM: One of the most common cutaneous infections seen in veterinary canine practice is canine demodicosis. Demodicosis is a parasitic skin infection with a possible impact on acute-phase proteins (APPs) and oxidant-antioxidant balance. This study aimed to estimate the possible alterations in hematological, biochemical, oxidant-antioxidant, and APP (C-reactive protein [CRP] and albumin) profiles in naturally infected dogs with demodicosis. MATERIALS AND METHODS: This study enrolled 21 dogs that were divided into two groups: The control group including 7 apparently healthy dogs and the diseased group including 14 dogs with generalized demodicosis. Demodicosis was confirmed through microscopic detection. Blood samples were collected for the estimation of CBC, total protein, albumin, alanine transaminase, aspartate aminotransferase, blood urea nitrogen, creatinine, superoxide dismutase (SOD), glutathione peroxidase (GPx), total antioxidant capacity (TAC), catalase (CAT), malondialdehyde (MDA), and CRP levels. RESULTS: Significant reduction in red blood cells along with significant elevation in white blood cells was recorded in the diseased group compared with the control group. There was also significant elevation in MDA, TAC, SOD, and CRP levels along with significant reduction in GSH-Px and CAT levels in the diseased group. CONCLUSION: Based on these findings, a relationship between canine generalized demodicosis and oxidant-antioxidant disequilibrium could be suggested. Evidence of this relation manifested in the elevation in MDA and SOD levels and reduction in GPx and CAT levels as a consequence to the release of ROS resulting from Demodex infection. CRP elevation is expected in canine demodicosis.

Cardiovascular disease research in the Arab world: a scoping review from seven Arab countries (2000-2018).

OBJECTIVES: The objective of this study is to map cardiovascular disease (CVD) research productivity in Arab countries and identify gaps and opportunities that would inform future research agenda. STUDY DESIGN: This is a scoping review. METHODS: A review of research output between January 2000 and December 2018 in seven Arab countries, selected to represent various economies and epidemiological transitions, was conducted. Data on quantity and quality, study design, setting and focus were extracted and analysed for trends by time and place. RESULTS: Over the study period, a total of 794 articles were published, with an average of 7.3 publications per million population. While time trends showed a 6-fold increase in the number of publications over the study period, a decreasing trend in mean journal impact factor was noted (from 2.3 in 2000 to 1.5 in 2018). Most studies (71%) were observational, 56% were conducted in medical facilities (hospitals or clinics) and most of the experimental studies (10%) were based in laboratory settings. Behavioural risk factors were addressed in 52% of the studies, and there was a dearth of studies examining associations with diet, physical inactivity or family history. CONCLUSIONS: Findings from this review indicate gaps in robust methods and pertinent themes in CVD research in the Arab region. Greater attention should be paid to high-quality evidence and implementation research. Also, there is a need for a more targeted CVD research agenda that is responsive to local and regional health burden and needs.

Active surveillance is superior to radical nephrectomy and equivalent to partial nephrectomy for preserving renal function in patients with small renal masses: Results from the DISSRM registry.

PURPOSE: We compared renal function outcomes among patients in the surveillance and intervention arms of the DISSRM registry. MATERIALS AND METHODS: Patients were grouped into chronic kidney disease stages by estimated glomerular filtration rate range. Cases were considered up staged if a more advanced chronic kidney disease stage was entered during followup. Chronic kidney disease up staging-free survival was compared among groups using Kaplan-Meier analysis and paired comparisons log rank tests. Multivariate Cox regression identified independent predictors of chronic kidney disease up staging-free survival. RESULTS: A total of 162 patients met the study inclusion criteria, with 68 in the surveillance arm, 65 undergoing partial nephrectomy, 15 undergoing radical nephrectomy, and 14 undergoing cryoablation. Median tumor size was 2.2cm. Mean estimated glomerular filtration rate change was significantly larger for radical nephrectomy vs. surveillance (-9.2 vs. -0.5ml/min/1.73m2) and for radical vs. partial nephrectomy (-9.2 vs. -1.9ml/min/1.73m2) (P = 0.001). No other groups differed significantly. On Kaplan-Meier analysis, patients undergoing radical nephrectomy had significantly worse chronic kidney disease up staging-free survival vs. those treated with partial nephrectomy (P = 0.029), surveillance (P = 0.007), and cryoablation (P = 0.019). No other groups differed significantly. On multivariate analysis, radical nephrectomy independently predicted poor chronic kidney disease up staging-free survival (odds ratio vs. surveillance 30.6, P = 0.001). Neither partial nephrectomy (P = 0.985) nor cryoablation (P = 0.976) predicted poor chronic kidney disease up staging-free survival relative to surveillance. CONCLUSIONS: Patients in the surveillance arm had superior estimated glomerular filtration rate preservation compared to those in the radical nephrectomy but not the partial nephrectomy arm. In certain patients with small renal masses, surveillance and partial nephrectomy may offer comparable renal functional outcomes. This could be partly attributable to a modest estimated glomerular filtration rate decrease associated with surveillance itself. A thorough understanding of the renal functional impacts of treatment modalities is critical in the management of small renal masses.

Synergism between metformin and statins in modifying the risk of biochemical recurrence following radical prostatectomy in men with diabetes.

BACKGROUND: To determine the effect of statins and metformin in combination on biochemical recurrence (BCR) among diabetic men undergoing radical prostatectomy (RP). METHODS: Diabetic men undergoing RP at our institution from January 1995 to March 2012 were retrospectively reviewed. Recipients of adjuvant radiation or hormonal therapy were excluded. Statin and/or metformin use was determined through review of electronic records. BCR-free survival was plotted using Kaplan-Meier analysis, and the effect of statins and metformin on BCR was assessed via a multivariate Cox proportional hazards model. RESULTS: Seven hundred and sixty-seven men met the inclusion criteria. Seventy-six (9.9%) were users of statins only, 56 (7.3%) were users of metformin only and 42 (5.5%) were dual users. Median follow-up time was 27 months. Dual users were less likely than nonusers or users of either medication alone to have a biopsy Gleason sum of 8-10 (P=0.033), and tended towards a lower rate of pathological T stage of pT3 or higher (P=0.064). Dual users had the highest 2-year and 5-year BCR-free survival, although this was not statistically significant (P=0.205). On multivariate regression, neither statin nor metformin use alone was significantly associated with BCR-free survival. However, their interaction led to a significantly lower BCR risk than would be expected from each medication's independent effects (hazard ratio=0.2; P=0.037). CONCLUSIONS: The combination of statins and metformin in men undergoing RP for prostate cancer (PCa) may be associated with a lower BCR risk than would be predicted based on the independent effects of both medications. A synergism between these two agents is biologically plausible based on our current understanding of their diverse molecular pathways of action. The results of future clinical trials involving the use of either medication in men with PCa should be carefully assessed for confirmatory evidence of such a relationship.

The intersection of intimate partner violence against women and HIV/AIDS: a review.

The objective of this study was to review original research on the intersection of violence against women by intimate partners and risk for HIV infection and highlight opportunities for new research and programme development. Seventy-one articles presenting original, peer-reviewed research conducted with females aged 12 years and older in heterosexual relationships during the past decade (1998-2007) were reviewed. Studies were eligible for inclusion if they addressed intimate partner violence (IPV) against women and HIV/AIDS as mutual risk factors. The prevalence of IPV and HIV infection among women varies globally, but females remain at elevated risk for both IPV and sexually transmitted/HIV infection, independently and concurrently. Comparisons between sero-negative and -positive women varied by geographic region; African HIV-positive women reported higher rates of victimisation while findings were inconsistent for HIV-positive women in the USA. Studies among various populations support the existence of a temporally and biologically complex relationship between HIV risk, lifetime exposure to violence and substance use, which are further complicated by gender and sexual decision-making norms. A possible link between violence-related post traumatic stress disorder and comorbid depression on immunity to HIV acquisition and HIV disease progression warrants further investigation. Sexual risk related to IPV works through both male and female behaviour, physiological consequences of violence and affects women across the lifespan. Further physiological and qualitative research is needed on the mechanisms of enhanced transmission; prospective studies are critical to address issues of causality and temporality. Prevention efforts should focus on the reduction of male-perpetrated IPV and male HIV risk behaviours in intimate partnerships.