Visible and Near-Infrared hyperspectral imaging (HSI) can reliably quantify CD3 and CD45 positive inflammatory cells in myocarditis: Pilot study on formalin-fixed paraffin-embedded specimens from myocard obtained during autopsy.

INTRODUCTION: To implement Hyperspectral Imaging (HSI) as a tool for quantifying inflammatory cells in tissue specimens by the example of myocarditis in a collective of forensic patients. MATERIAL AND METHODS: 44 consecutive patients with suspected myocardial inflammation at autopsy, diagnosed between 2013 and 2018 at the Institute of ForensicMedicine, Medical University of Innsbruck, were selected for this study. Using the IMEC SNAPSCAN camera, visible and near infrared hyperspectral images were collected from slides stained with CD3 and CD45 to assess quantity and spatial distribution of positive cells. Results were compared with visual assessment (VA) and conventional digital image analysis (DIA). RESULTS: Finally, specimens of 40 patients were evaluated, of whom 36 patients (90%) suffered from myocarditis, two patients (5%) had suspected healing/healed myocarditis, and two did no have myocarditis (5%). The amount of CD3 and CD45 positive cells did not differ significantly between VA, HSI, and DIA (pVA/HSI/DIA = 0.46 for CD3 and 0.81 for CD45). Cohens Kappa showed a very high correlation between VA versus HSI, VA versus DIA, and HSI versus DIA for CD3 (Cohens Kappa = 0.91, 1.00, and 0.91, respectively). For CD45 an almost as high correlation was seen for VA versus HSI and HSI versus DIA (Cohens Kappa = 0.75 and 0.70) and VA versus DIA (Cohens Kappa = 0.89). CONCLUSION: HSI is a reliable and objective method to count inflammatory cells in tissue slides of suspected myocarditis. Implementation of HSI in digital pathology might further expand the possibility of a sophisticated method.

UK dogs eating raw meat diets have higher risk of Salmonella and antimicrobial-resistant Escherichia coli faecal carriage.

OBJECTIVES: To compare detection of Salmonella species and antimicrobial-resistant Escherichia coli in the faeces of dogs eating raw meat or non-raw diets and examine risk factors for their carriage. MATERIALS AND METHODS: Canine faecal samples (raw fed n=114; non-raw fed n=76) were collected from May to July 2015 from across the UK. Enrichment and selective culture and biochemical and PCR assays were used to identify isolates. Escherichia coli underwent susceptibility testing to a range of antimicrobials, including third-generation cephalosporins; PCR assays were used to detect antimicrobial-resistant genes. Questionnaires were used to collect data on independent variables as risks for antimicrobial-resistant (resistant to ≥1 tested antimicrobial), multi-drug-resistant (resistant to ≥3 antimicrobial classes) and third-generation cephalosporin resistant Escherichia coli. RESULTS: Antimicrobial-resistant, multi-drug-resistant and third-generation cephalosporin resistant Escherichia coli were significantly more likely to be detected in raw fed (54, 25 and 31%, respectively) compared to non-raw fed (17, 4 and 4%, respectively) dogs; Salmonella species were detected in eight (4%) raw fed dogs only. CLINICAL SIGNIFICANCE: Raw fed dogs may be a source of Salmonella species and Escherichia coli, resistant to highest priority critically important antimicrobials, representing a potential animal welfare and public health issue. Owners should be aware of the risks, especially households with members, both human and canine, who are very young, elderly or immunocompromised.

[Dyspepsia. Investigation and treatment]. / Dyspepsi. Udredning og behandling.

Dyspepsia is defined as chronic or recurrent pain or discomfort centred in the upper abdomen. Early satiety, nausea, vomiting, or bloating are often also present. Dyspepsia should be differentiated from gastro-oesophageal reflux disease, whose predominant symptoms are heartburn and acid regurgitation. Prevalence rates vary between 25% and 40%, and dyspepsia is the main reason for consulting GPs: 3-5% of all visits. Older patients and patients presenting with alarm symptoms (weight loss, anaemia, jaundice, dysphagia, bleeding) should undergo endoscopy, but apart from this no other management strategy has been agreed upon. Management strategies based on non-invasive H. pylori testing will probably prove cost-effective and safe. However, the results of clinical trials are awaited before guidelines can be offered. The symptomatic effects of treating patients with functional dyspepsia with either acid inhibitors, prokinetics, or H. pylori eradication therapy are difficult to predict and are usually quite modest.

Evidence for attenuation of myo-inositol uptake, phosphoinositide turnover and inositol phosphate production in aortic vasculature of rats during pregnancy.

We postulated that vascular phosphoinositide metabolism is attenuated during pregnancy, and thereby could contribute to maternal vasodilation and reduced vascular reactivity. The basal rate of incorporation of [3H]myo-inositol and [3H]glycerol into phosphoinositides of aortae from pregnant rats in vitro was significantly reduced, when compared with vessels from virgin animals. After injection of [3H]myo-inositol intravenously into chronically instrumented conscious pregnant and virgin rats, the incorporation of the label by phosphatidylinositol was 66 +/- 4% less in aortae of gravid versus virgin animals (P less than 0.001), despite comparable plasma concentrations of radioactivity. Fold stimulation of total [3H]inositol phosphates by arginine vasopressin, norepinephrine, and angiotensin II over a 15-min period was not different between aortic segments from virgin and gravid rats, although both absolute basal and stimulated levels were significantly less in vessels from pregnant animals. After 45 s of incubation with 10(-7) M arginine vasopressin, however, the fold-stimulation of [3H]inositol trisplus tetrakisphosphate was reduced in aortae from gravid rats, when compared with vessels from virgin animals (P less than 0.005). By HPLC, greater than 90% of the radioactivity in the [3H]inositol trisplus tetrakisphosphate column fraction after 30 and 60 s of agonist stimulation was [3H]inositol-1,4,5-trisphosphate. We further observed that the rate of uptake of [3H]myo-inositol by aortic vasculature obtained from gravid rats was significantly (24%) less than uptake by vessels from virgin animals. Plasma myo-inositol concentrations were not significantly different, but presumably as a consequence of reduced uptake, aortic segments freshly isolated from pregnant rats contained 22 +/- 6% less myo-inositol than vessels from virgin controls as measured by gas chromatography-mass spectrometry (P less than 0.03). We conclude that myo-inositol uptake and content, phosphoinositide turnover, and inositol phosphate production are reduced in aortic vasculature of gravid rats.

[The use of services of the physician-on-call by chronic morphine users]. / Kroniske morfikabrugeres anvendelse af laegevagt.

Employment of the doctor on call for administration of morphine to chronic morphine users in a medical district was registered for a period of two years. The group of chronic morphine users imposes considerable stress on the emergency medical system as up to one third of the visits involve administration of morphine. The special circumstances concerning registration and control of morphine therapy are discussed and the necessity of a therapeutic balance is emphasized. Alteration of the procedure of administration of morphine so that the patient's own general practitioner is responsible for prescription of morphine while the doctor on call undertakes the injection has been demonstrated to reduce the number of visits considerably. In this investigation, based on registration of a representative number of visits to chronic morphine users by one doctor, a decrease in visits of this type of 60% was registered.