[Acute myocardial infarction in women. Initial characteristics, management and early outcome. The FAST-MI registry]. / L'infarctus du myocarde chez la femme. Caractéristiques spécifiques, prise en charge et pronostic. Données de FAST-MI 2010.

AIM: To assess gender differences in characteristics, management, and hospital outcomes in patients participating in the French FAST-MI 2010 registry. POPULATION: Three thousand and seventy-nine patients hospitalised for ST-elevation (STEMI) or non-ST-elevation (NSTEMI) myocardial infarction in 213 French centres during a 1-month period at the end of 2010. RESULTS: Women account for 27% of the population and more frequently present with NSTEMI. They are 9 years older than men on average, although 25% of women with STEMI are less than 60 years of age. Management of STEMI is similar, after adjustment for baseline characteristics. However, fewer women are treated with primary percutaneous coronary angioplasty. In NSTEMI, although use of coronary angiography is similar, fewer women get treated with angioplasty. Most medications are used in a similar way in men and women, except thienopyridines, with fewer women receive prasugrel. After adjustment, in-hospital mortality is similar for men and women. CONCLUSION: Myocardial infarction is not specific to men: one out of four patients admitted for myocardial infarction is a woman. Initial management is rather similar for men and women, after taking into account differences in baseline characteristics. Percutaneous coronary angioplasty, however, remains less frequently used in women. In-hospital complications have become rarer and do not differ according to sex.

Intestinal haemangiosarcoma in the cat: clinical and pathological features of four cases.

The clinical and pathological features of four cases of feline intestinal haemangiosarcoma are described. All cases were in domestic shorthaired cats and the mean age of the animals (n=3) was 13 years. The tumours originated in the colon, small intestine, ileocaecocolic junction or rectum. The rectal tumour was juxtaposed with an adjacent mast cell neoplasm. Metastasis to mesenteric lymph node occurred in two cases, and in one of these cats there was also abdominal seeding. The histopathological appearance was of a spindle cell neoplasm with vascular differentiation in each case. Immunohistochemical staining for factor VIII-related antigen, an endothelial cell marker, confirmed all four tumours to be of endothelial origin. The neoplastic endothelial cells lining irregular vascular channels were more likely to express the antigen than those forming denser sheets without obvious vascular differentiation.

T-cell-rich B-cell lymphoma in the cat.

The clinical and pathological features of eight cases of feline T-cell-rich B-cell lymphoma are described. The disease occurred in older cats (mean age 11.4 +/- 3.9 years), which on initial examination generally showed enlargement of a single submandibular or cervical lymph node. After excision, there was no recurrence of the lesions at 6 months in three cats. In one further case, however, the lesion had recurred 6 months later; it was again excised but recurred after an additional 6 months. Microscopically, there was effacement of normal lymph node architecture by a nodular (n = 4) or diffuse (n = 4) proliferation of small to blastic lymphocytes, accompanied by a characteristic population of bizarre giant, or multinucleate, cells. The mitotic rate was low and mitoses were restricted to the atypical population. Immunophenotyping revealed the smaller lymphocytes to be a mixture of CD3+ MHC Class II+ T lymphocytes and BLA36+CD79variable MHC Class IIvariable B lymphocytes. The atypical cells were of the B-cell lineage (BLA36+MHC Class IIvariable). Polymerase chain reaction analysis revealed no proviral DNA products of feline leukaemia virus or feline immunodeficiency virus in tissue from any tumour, confirming that these neoplasms were not associated with either virus. The clinical, histological and immunophenotypic findings in these cats were identical with those of "nodular lymphocyte predominance (lymphocytic and histiocytic/L&H) Hodgkin's disease" in man.

Lipomatous infiltration of the canine salivary gland.

Benign connective tumours of the canine salivary glands are rare. This report describes lipomatous infiltration of parotid or submandibular salivary glands in seven dogs in which the glands were enlarged as a result of infiltration by fat cells; they appeared to have been successfully treated by local excision. The precise cause of the lipomatous infiltration in the dogs is unclear but different causes of similar lesions in humans are discussed.

Feline tuberculosis: a literature review and discussion of 19 cases caused by an unusual mycobacterial variant.

The literature relating to feline mycobacterial disease is reviewed and 19 cats with tuberculosis caused by a previously unknown strain of mycobacterium are discussed. The bacteria were found to have characteristics between those of Mycobacterium tuberculosis and M bovis. The paper considers the clinical signs, epidemiology and diagnosis of the cases, and discusses the possible origins of the organism, treatment regimens and zoonotic potential.

Lesions associated with mineral deposition in the lymph node and lung of the dog.

This report includes details of the clinical and pathologic features of 31 dogs with a range of systemic illness and granulomatous lymphadenopathy associated with the presence of birefringent crystalline material within lymph nodes. Similar crystalline material was found in the lymph nodes of dogs with lymphoma (n = 9) and as an incidental finding within the canine lung (n = 9). The mineral content of these crystals was determined by electron microprobe analysis and interpreted in light of the composition of known geological or human-made compounds. A wide range of elements was identified including silicon, sulfur, copper, calcium, and aluminium, with lesser proportions of phosphorus, sodium, potassium, iron, magnesium, titanium, nickel, and chromium. Many of these compounds may have originated from exogenous natural and human-made sources, but some compounds (notably phosphates and sulfates) are uncommon or not found in nature and may have been formed within the tissues of the body (biomineralization). The inflammatory response induced by the presence of these minerals within lymphoid tissue may trigger altered immunoregulation, accounting for the spectrum of disease observed.

A review of pathological diagnoses made from 87 canine splenic biopsies.

The pathological findings in 87 cases of canine splenic abnormality recognised clinically by abdominal palpation or radiography, or at exploratory laparotomy, are presented. The most common diagnosis was of splenic neoplasia (n = 38) and the most frequently recognised canine splenic neoplasm was haemangiosarcoma (17 of 38 cases). Benign splenic enlargement secondary to nodular hyperplasia (n = 6), haematoma (n = 16) or non-specific changes including congestion, haemorrhage, extramedullary haemopoiesis and haemosiderin deposition (n = 14) was also recognised. A diagnosis of non-specific pathology was more frequently recorded when portions of spleen, as opposed to the entire organ, were submitted for assessment. Splenic infarction, with (n = 3) or without (n = 7) torsion, abscessation (n = 2) and focal mast cell proliferation (n = 1) accounted for the remainder of the cases. Clinical follow-up was available for 35 cases and revealed good long-term survival in cases of splenic haematoma or haemangioma, with relatively poor survival with a diagnosis of splenic haemangiosarcoma or anaplastic sarcoma. A range of splenic disorders was recognised in dogs of the labrador breed (16 of 87 cases) and three of 17 cases of haemangiosarcoma occurred in German shepherd dogs. The possible predisposition of dogs of these breeds to splenic disorders is discussed.

Melanocytic neoplasia in the cat.

Clinical features and histopathological details from 13 cases of melanocytic neoplasia in the cat are presented. The series includes cases of intraocular melanoma (n = 5), limbal melanoma (n = 2), dermal melanoma (n = 5) and one case of metastatic melanoma for which a primary site was not identified. In the case of the intraocular tumours, there was apparent correlation between the degree of cellular pleomorphism, the mitotic rate and the extent of local infiltration. Such an association was not identified for the melanomas arising from the limbus or skin.

Flaccid trunk paralysis in free-ranging elephants (Loxodonta africana) in Zimbabwe.

An epizootic of flaccid trunk paralysis began in free-ranging Zimbabwean elephants (Loxodonta africana) on the southern shore of Lake Kariba in 1989. It involved a selective neuropathy of peripheral nerves supplying the trunk, with axon and myelin degeneration, muscle atrophy, compensatory hypertrophy, and fine endomyseal fibrosis, without inflammatory changes.

Variation in clinical disease and species susceptibility to psittacine beak and feather disease in Zimbabwean lovebirds.

While psittacine beak and feather disease has caused 100% mortality in captive flocks of 2 species of native Zimbabwean lovebirds (Agapornis nigrigensis and A. lilianae), other lovebird species in close contact with the sick birds have been only transiently affected or not at all. The clinical course of the disease in affected lovebirds may differ from that reported elsewhere, with recovery in some cases. These differences, along with ultrastructural differences may suggest a different virus or different strain of virus underlying disease in Zimbabwe.

Preliminary studies on congenital hypothyroidism in a family of Abyssinian cats.

Congenital hypothyroidism was diagnosed in related Abyssinian cats. The disease appeared to be inherited as an autosomal recessive trait with affected homozygotes showing signs of reduced growth rate, shorter stature with kitten-like features, constipation and goitre. Hypothyroidism was confirmed by demonstrating low basal serum thyroxine levels which failed to increase after intravenous administration of thyroid stimulating hormone or thyrotropic releasing hormone. The radioiodide uptake of the thyroid glands was normal but a high proportion of the accumulated radioiodide was discharged after the administration of sodium perchlorate. It is concluded that the affected cats had a primary dyshormonogenesis: an organification (peroxidase) defect.

Antibody response and antibody affinity maturation in cats with experimental proliferative immune complex glomerulonephritis.

An experimental model of proliferative glomerulonephritis (GN) in the cat, which closely resembles human proliferative forms of GN, has been used to study the role of antibody and antibody affinity in the development of immune complex-mediated renal disease. The serum IgG and IgM antibody response to antigen, average antibody affinity (avidity) and affinity heterogeneity of the IgG and IgM populations was assessed at varying times after commencement of chronic immunization with the antigen, human serum albumin (HSA), by enzyme immunoassay. Cats could be classified according to whether they were "low", "intermediate" or "high" IgG responders, by quantification of serum IgG values. Cats with the lowest serum IgG values failed to develop glomerulonephritis. However, there was no relationship between actual IgG values and the severity of the induced disease. In contrast to IgG, there was no division of cats into low or high IgM anti-HSA responders. Again, cats with the lowest IgM values failed to develop GN, but, more interestingly, a late, marked increase in serum IgM anti-HSA occurred only in cats that developed clinical signs of GN (anterior uveitis and nephrotic syndrome). Maturation of average, functional IgG affinity (avidity) for HSA following chronic immunization was clearly demonstrated for all cats. At the end of the experiment, all cats had IgG of high affinity for HSA and the average affinity heterogeneity of the IgG populations was less than in measurements taken earlier. Values of IgG affinity at the end of the experiment were very similar both in cats which developed GN and in those which remained clinically, biochemically and pathologically normal. In contrast to IgG antibody, some cats developed IgM of increased affinity, whilst others produced antibody of reduced affinity, following chronic immunization. There was no correlation between the development of disease and the production of either low or high affinity IgM antibody. Data indicated that an alteration in IgM affinity occurred at a late stage, as serum IgM levels increased, in cats which progressed to develop GN. These findings suggested that an increase in both serum IgG and IgM anti-HSA values, in particular IgM, was associated with the development of a more severe immune complex renal disease in these cats. Although there was no evidence that differences in the average affinity of either the IgG or IgM antibody populations for HSA, were associated with the development of disease, the increase in IgM values was also accompanied by a concomitant alteration in IgM affinity for antigen.(ABSTRACT TRUNCATED AT 400 WORDS)

Experimental proliferative glomerulonephritis in the cat.

A model of chronic serum sickness was used to induce immune-complex glomerulonephritis in seven experimental cats, by daily intravenous inoculation of an increasing dose (5 to 35 mg) of human serum albumin (HSA). At week four, two of the seven animals developed anterior uveitis. At week 23, two different animals developed the subcutaneous oedema characteristic of the nephrotic syndrome (NS), whilst the other five cats appeared clinically normal. The kidneys were examined at necropsy by light microscopy and by transmission electron microscopy. The glomeruli of four animals (three with both proteinuria and uraemia, and one with proteinuria only) showed morphological changes under light microscopy. The abnormalities suggested that a diffuse mesangial proliferative glomerulonephritis (GN) had been induced in three cats and diffuse membranoproliferative GN induced in another. Ultrastructural studies revealed electron-dense deposits (immune-complexes) in six of the seven cats. Two cats without glomerular abnormalities by light microscopy had mesangial deposits and three cats with mesangial proliferative GN had deposits at mesangial, subendothelial and/or subepithelial sites. The single cat with membranoproliferative GN had deposits at mesangial, subendothelial, subepithelial and intramembranous sites. Immunohistological examination (peroxidase-antiperoxidase technique) showed that HSA and immunoglobulin (IgG and IgM) were deposited in the glomeruli of these cats. Deposits were the most dense in cats with more severe renal lesions. Deposits of IgM were most abundant. An extensive cellular infiltrate, comprising macrophages, neutrophils and plasma cells, was observed only in the four animals which showed abnormalities in glomerular ultrastructure. The disease induced in these cats thus appears to differ from the membranous nephropathy previously described in the cat and bears a close resemblance to immune complex (IC) disease in man. In view of the relatively few specific animal models of IC-mediated proliferative GN, this model has potential for application to the study of human IC disease.

Atrial septal defect and atrial fibrillation in a foal.

Clinical examination of a four-and-a-half-month old foal revealed evidence of progressive heart failure associated with an atrial septal defect and atrial fibrillation. Atrial septal defects are rarely reported in foals and the foal's growth, development and demeanour were normal until a sudden onset of lethargic behaviour. The value of B-mode echocardiography in identifying the congenital lesion is indicated.

Squamous cell carcinoma of the equine external genitalia: a review and assessment of penile amputation and urethrostomy as a surgical treatment.

A retrospective analysis was performed on 48 cases of suspected neoplasia involving the equine external genitalia. Forty nine squamous cell carcinomata (SCC) and 23 squamous papillomata (SP) were identified. Two cases of epithelial hyperplasia and one case of habronemiasis were also recognised histopathologically. The glans penis was the most common site of tumour development accounting for 53 per cent of cases of SCC and 61 per cent of SP. The urethral diverticulum, urethral process or urethra was involved in 27.6 per cent (8/29) of cases of SCC. Twelve per cent (5/41) of cases of SCC were confirmed to have metastatic involvement of the local lymph nodes. Papillomata showing pre-malignant changes were identified in five cases. Seventy five per cent (36/48) of the animals presented were ponies. All were geldings, mean age 16.5 years. Penile amputation and urethrostomy, preputial ablation and proximal urethrostomy or local excision were used in the surgical management of these animals; three cases were inoperable and destroyed at presentation. Oedema, haemorrhage and stenosis of the urethrostomy site were encountered as post operative complications. Sixty six per cent (6/9) of animals with SCC of the glans penis (without urethral involvement), which had a known history over the follow up period, treated by penile amputation and urethrostomy survived for longer than 18 months. Similarly, of those with urethral involvement only 28.6 per cent (2/7) survived for a similar follow-up period. SCC not uncommonly affects the external genitalia of aged pony geldings and frequently the glans penis. If the lesion is identified before local metastasis occurs, penile amputation and urethrostomy is indicated and the prognosis is favourable.

Plasma and urine biochemical changes in cats with experimental immune complex glomerulonephritis.

Biochemical changes in plasma and urine were monitored in six cats before and during the induction of immune complex-mediated glomerulonephritis (ICGN) by daily intravenous administration of human serum albumin (HSA). The earliest indication of renal dysfunction in the cats was hypoalbuminaemia, which occurred as early as 13 weeks before cats developed clinical signs of renal disease. Proteinuria occurred 2 to 3 weeks before clinical disease, but was sensitive in predicting renal pathology in two cats that did not develop clinical signs of disease. In addition, increased activities of several urinary enzymes were detected in affected cats, with measurement of N-acetyl-beta-D-glucosaminidase and gamma-glutamyl transferase providing the earliest and most sensitive indication of renal damage. These plasma and urine measurements correlated more closely with the renal pathology, observed at postmortem, than clinical assessment of disease. It was concluded that ICGN in the cat could be diagnosed earliest by measurement of plasma protein concentration, whilst disease progress could be effectively monitored by including assays to measure urine protein and urine enzymes.

Hypercalcaemia and soft tissue mineralisation associated with lymphosarcoma in two horses.

Two horses with deposits of lymphosarcoma, one in the spleen, the other in the mediastinum, several lymph nodes and kidneys, lost weight rapidly and became depressed and weak. They were hypercalcaemic and post mortem examination revealed extensive calcification of the heart and major vessels. There was no evidence of bone marrow metastases in the one horse whose marrow was examined, and the thyroid and parathyroid glands of both horses were grossly normal.