Search

OBJECTIVE: In this study we describe the management of women with gestational diabetes (GD) and an ongoing Sars-Cov-2 infection. The aim of the study is to evaluate whether the COVID-19 infection can further complicate pregnancies and thus if the protocol we usually use for GDM pregnancies is also applicable to patients who have contracted a Sars-Cov-2 infection. METHODS: This is a retrospective study analysing all pregnant women with gestational diabetes and a concomitant COVID-19 infection admitted to our Institution for antenatal care between March 1st and April 30th 2020. RESULTS: Among pregnant women with GD and a concomitant COVID-19 infection, the mean age was 32,9 (SD 5,6) years. Two patients (33%) were of Caucasian ethnicity while four (67%) were non-Caucasian. All patients were diagnosed with COVID-19 during the third trimester of pregnancy. Two women were asymptomatic while four were symptomatic. Only two patients (33,3%) received treatment with insulin. None of the patients required intensive care or mechanical ventilation. No complications were found among the newborns. CONCLUSION: the COVID-19 infection was not found to worsen the prognosis of GD patients or of their offspring. Glycaemic monitoring, diet therapy and insulin, when needed, are sufficient for a good metabolic control and a favourable maternal and fetal outcome.

Background C‐reactive protein (CRP) and paraoxonase 1 (PON1) might increase and decrease in canine leishmaniasis (CanL), , and both can rapidly normalize after therapy. Recently, supplementation of domperidone with conventional therapy , increasing the activity of cells involved in acute phase responses in vitro. This combined therapy has been recommended to treat mild forms of CanL; however, no studies have investigated the effects of domperidone supplementation on early CRP or PON1 changes in dogs with CanL. Objectives The aim of this study was to evaluate whether domperidone, added to conventional treatments, modifies CRP concentration and PON1 activity kinetics in CanL dogs responsive to conventional therapy. Methods Serum CRP concentrations and PON1 activities were measured in dogs with mild CanL before (t‐0) and 3 (t‐1), 7 (t‐2), 14 (t‐3), and 21 (t‐4) days after treatment with N‐methylglucamine antimoniate and allopurinol alone (n = 18) or combined with domperidone (n = 18). Results C‐reactive protein concentrations increased at t‐1 in the domperidone group, especially when the CRP concentration at t‐0 was normal. However, the concentrations normalized at t‐4 in 18/18 dogs compared with 14/18 dogs not receiving domperidone. The median PON1 activity decreased at t‐1 in the domperidone group, and this decrease was more significant in dogs with normal PON1 activity at t‐0. Conclusions Based on these results, transient increases in CRP concentrations or decreases in PON1 activities after domperidone administration should not be erroneously interpreted as signs of a worsening disease process.

INTRODUCTION The objective of the present study is to compare the sonographic measurement of subcutaneous adipose thickness and visceral adipose thickness during 1st trimester screening for aneuploidies between non-diabetic pregnant women and patients who develop 1st trimester or 2nd trimester gestational diabetes mellitus (GDM). MATERIAL AND METHODS Adipose thickness was measured by transabdominal ultrasound imaging in pregnant women attending our clinic for screening for fetal aneuploidies between 11 and 13 weeks of gestation. During the 1st trimester all patients were evaluated for fasting glycemia in accordance with the International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommendations. Patients with confirmed fasting glycemia (FPG) ≥92 mg/dL were diagnosed as 1st trimester GDM. Patients with FPG

According to a recent article, ‘Instrument museums are mausoleums, places for the display of the musically dead, with organologists acting as morticians, preparing dead instrument bodies for preservation and display’. This view, often repeated since the 1960s, reflects the frustration experienced by most museum visitors facing objects stripped of their function and presented as aestheticized icons. Curatorial debate has led to the development of several alternative proposals to deliver a culturally engaging presentation of musical objects. However, none has managed to efficiently replace the expectation of museums visitors to appreciate the object in its functional state. Moreover, debate over the role of museums in preserving intangible – as well as tangible – heritage stimulated further consideration of the importance of preserving/presenting functionality of music‐related objects. While some authors have developed specific music‐related perspectives (e.g. Barclay R. [2005]. The Preservation and Use of Historic Musical Instruments: Display Case and Concert Hall), little or no cross‐fertilisation has happened with the much broader world of functional objects in museums, which includes at least scientific, technologic and mechanical objects and those pertaining to daily lives. The article will offer an overview of current debate, approaches and policies for the preservation and display of functionality in a variety of non‐music related museums, with a parallel perspective on the current approach to musical instruments.

Background: High molecular weight (MW) synthetic colloids interfere with refractometry. The effect of low MW synthetic colloids on refractometry is unknown. Objectives: To investigate the effect of 6% hydroxyethyl starch 130/0.4 (HES) and 4% succinylated gelatin (GELO) on the refractometric measurement of total plasma protein (TPP) and colloid osmotic pressure (COP) in canine plasma. Methods: Heparinized plasma from 10 dogs was diluted with 0.9% saline (NaCl), HES, and GELO in ratios of plasma:fluid, 9:1, 8:2, 7:3, 6:4, and 5:5. The biuret TPP (TPPb), refractometric TPP (TPPr), and COP assays were performed for all dilutions. Agreement (bias, 95% limits of agreement (LOA)) was tested between the TPPb (NaCl) and the TPPr of the NaCl, HES, and GELO plasma dilutions, and between the TPPb (NaCl) and the TPPb of the HES and GELO plasma dilutions. Results: A small bias (0.06 g/dL, 95% LOA −0.51 to 0.39 g/dL) existed between TPPb (NaCl) and TPPr (NaCl). A large bias was found between TPPb (NaCl) and TPPr (HES) (1.38 g/dL, 95% LOA 0.30 to 3.10 g/dL), and TPPr (GELO) (1.18 g/dL, 95% LOA 0.53 to 2.88 g/dL). A small bias was found between TPPb (NaCl) and TPPb (HES) (0.08 g/dL, 95% LOA −2.04 to 2.20 g/dL), and a large bias was found between TPPb (NaCl) and TPPb (GELO) (1.00 g/dL, 95% LOA −0.59 to 2.60 g/dL). Increasing overestimation of TPPb (NaCl) by TPPr (HES and GELO) and TPPb (GELO) occurred with increasing colloid volumes. Conclusions: HES and GELO interfered with TPPr, and GELO also interfered with TPPb, in vitro. These variables should be interpreted with caution for dogs that have received these synthetic colloids.

A 13-year-old female Domestic Shorthair cat was presented to the Veterinary Teaching Hospital of the University of Milan for an interscapular mass suspected to be a mesenchymal malignant tumor. A preoperative CBC performed with Sysmex XT-2000iV showed leukocytosis with neutrophilia and eosinophilia. The Sysmex WBC/DIFF scattergram showed an additional, well-separated cluster of events between the neutrophil, eosinophil, and lymphocyte clusters. Blood smear evaluation revealed the presence of a significant number of basophils; thus, it was hypothesized that the additional cluster could represent the basophilic population. A second CBC, 24 days later, showed the same pattern on the WBC/DIFF scattergram in the absence of leukocytosis and neutrophilia. After surgical excision of the mass, a definitive diagnosis of feline injection site sarcoma was made. To the author's knowledge, there are no previous reports about the identification of feline basophils in the WBC/DIFF scattergram of Sysmex XT-2000iV.

Background The ΔWBC (the ratio between DIFF and BASO counts of the Sysmex XT‐2000iV), hereafter defined as ΔTNC (total nucleated cells), is high in effusions due to feline infectious peritonitis (FIP), as cells are entrapped in fibrin clots formed in the BASO reagent. Similar clots form in the Rivalta's test, a method with high diagnostic accuracy for FIP. Objectives The objective of this study was to determine the diagnostic accuracy for FIP and the optimal cutoff of ΔTNC. Methods After a retrospective search of our database, DIFF and BASO counts, and the ΔTNC from cats with and without FIP were compared to each other. Sensitivity, specificity, and positive and negative likelihood ratios (LR+, LR−) were calculated. A ROC curve was designed to determine the cutoff for best sensitivity and specificity. Results Effusions from 20 FIP and 31 non‐FIP cats were analyzed. The ΔTNC was higher (P 2.5 had 100% specificity. Conclusions The ΔTNC has a high diagnostic accuracy for FIP‐related effusions by providing an estimate of precipitable proteins, as the Rivalta's test, in addition to the cell count. As fibrin clots result in false lower BASO counts, the ΔTNC is preferable to the WBC count generated by the BASO channel alone in suspected FIP effusions.

The serum concentration of high density lipoproteins (HDLs) is affected by oxidative phenomena that characterize inflammation. The aims of this study were to assess the concentration of HDLs in dogs with leishmaniasis, and to investigate the correlation between HDL, C-reactive protein (CRP), globulin fractions, and activity of the antioxidant enzyme paraoxonase (PON1). The serum concentration of HDLs was also measured during treatment to assess whether it may be a good marker to monitor response to therapy. HDLs were measured in serum from 10 leishmaniotic dogs (7 classified as sick and 3 as severely sick according to the staging system of the Canine Leishmaniasis Working Group), at admission and during the follow up (3, 7, 14, 21, and 28 days after the beginning of treatment with antimonials and allopurinol). Concentrations of total cholesterol, PON1, CRP and globulin fractions were also measured. At admission, the concentration of HDLs did not differ between sick and severely sick dogs. The correlation between HDL, PON1, CRP, and globulin fractions was assessed on the whole set of data. There was a negative correlation (P < .05, r = -0.42) between total cholesterol and c-globulins, and positive correlations between HDL and PON1 (P = .002; r = 0.55), and HDLs and A/G ratio (P = .019, r = 0.44). There was a negative correlation between HDLs and CRP (r = -0.37, P =,058). HDLs increased in sequential samples collected during the follow up after 14 and 28 days (P = .033 and P = .024). These results support an influence of c-globulins on lipid metabolism as reported in people, and suggest that inflammation is associated with a decreased HDLs concentration, likely due to the oxidative phenomena that decrease PON1 activity. Moreover, these results suggest that HDLs may be useful to assess decreased oxidation/inflammation after successful treatments. In conclusion, HDLs may serve as an additional inflammation and oxidation marker, including dogs with leishmaniasis.

Background: Classification of leukemias requires specialized diagnostic techniques. Automated preliminary indicators of neoplastic cells in blood would expedite selection of appropriate tests. Objective: The objective of this study was to assess the capacity of the Sysmex XT-2000iV hematology analyzer to identify neoplastic cells in canine blood samples. Methods: Blood samples (n=160) were grouped into 5 categories: acute leukemia (n=30), chronic leukemia (n=15), neoplasia without blood involvement (n=41), non-neoplastic reactive conditions (n=31), and healthy dogs (n=43). WBC counts, WBC flags, scattergrams, percentages of cells with high fluorescence intensity, and percentages of cells in the lysis-resistant region were evaluated alone or in combination to establish a "leukemic flag." Sensitivity, specificity, negative (LR-) and positive (LR+) likelihood ratios, and the number of false-negative (FN) and false-positive (FP) results were calculated, and receiver operating characteristic curves were designed for numerical values. Results: Among single measurements and parameters, only the evaluation of scattergrams minimized FN and FP results (sensitivity 100%, specificity 94.8%, LR+ 19.17, and LR- 0.00), although their interpretation was subjective. The more objective approach based on the generation of a "leukemic flag" had a sensitivity of 100%, specificity of 87.0%, LR- of 0.00, and LR+ of 7.67. Conclusion: Using a novel gating strategy the Sysmex XT-2000iV may be used effectively to screen canine blood for hematopoietic neoplasia.

Background: The ADVIA 120 is an automated laser cell counter widely used in veterinary medicine. Although specific software for equine samples is available and validated, only a few reports have been published comparing the ADVIA 120 with other methods for equine hemogram evaluation. Objectives: The purpose of this study was to compare the hematologic values and reference intervals obtained on the ADVIA 120 with those obtained on an impedance cell counter and manual differential counts in healthy horses. Methods: EDTA-anticoagulated blood samples were obtained from 114 clinically healthy horses of various breeds, both sexes, and 2–6 years of age. Samples were stored for up to 12 hours at 4 °C and then analyzed on the ADVIA 120 and the Hemat 8. A 100-cell to 200-cell differential leukocyte count was performed by 3 independent observers on May-Grunwald-Giemsa-stained smears. Intra-assay precision of the ADVIA 120 was determined by analyzing 5 replicates each of 10 of the blood samples. Results: Results from the ADVIA were significantly higher than those from the impedance counter for RBC count, total WBC count, hemoglobin concentration, red cell distribution width, MCH, and MCHC, and significantly lower for HCT and platelet count. Significantly higher neutrophil and basophil counts and significantly lower lymphocyte counts were obtained with the ADVIA 120 compared with manual counts. Based on Passing–Bablok regression analysis, RBC and platelet counts were in good agreement between the 2 analyzers; a constant and proportional bias was present for other values. Coefficients of variation for erythrocyte parameters on the ADVIA were

BACKGROUND The authors investigated the clinical role of tumor burden (TB) in patients with Hodgkin lymphoma, relating this parameter to most of the current clinical and prognostic factors and to the best predictive multifactorial models. METHODS The volume of TB at diagnosis was measured directly from the initial staging computed tomography scans in 351 patients who were treated on standard protocols. The mean patient age was 34.0 years ± 16.4 years. Forty-six patients had clinical Stage I disease, 201 patients had Stage II disease, 64 patients had Stage III disease, and 40 patients had Stage IV disease. There were 146 symptomatic patients. Overall survival (OS), disease-free survival (DFS), and time to treatment failure (TTF) were the time parameters evaluated in the multivariate analysis. Logistic regression was applied according to those who achieved or failed complete remission. RESULTS The mean TB normalized to body surface area (rTB) was 137.8 cm3/m2 ± 124.7 cm3/m2 (range, 1.9–694.5 cm3/m2). In multivariate analysis, rTB was the best predictor of TTF, DFS, and complete remission; the second best predictor of OS after patient age; and largely superior to all prognostic models analyzed. For the same stage and treatment, patients who were destined to clinical failure had an initial rTB 60–108% higher compared with the initial rTB in patients who achieved a cure, whereas differences in drug dose intensity were not significant. CONCLUSIONS In the current study, it was found that the rTB, as a prognostic factor, was more effective than and was independent of hitherto used factors and scores. The rTB may be a tool for evaluating the curative potential of treatment combinations, allowing physicians and patients to make better therapeutic choices earlier. Cancer 2004. © 2004 American Cancer Society.

In order to find the conditions under which Tc-99m-methylenediphosphonate (Tc-99m-MDP) and Tc-99m(V)-dimercaptosuccinate (Tc-99m(V)-DMSA) may become tumour-seeking agents, leaving healthy organs free from the radionuclide uptake, the solution chemistry of these radiopharmaceuticals was studied by paper chromatography and paper electrophoresis in distilled water, in physiological saline, in NAHCO3, and ascorbic acid solutions. Both radiopharmaceuticals are anionic in the radiopharmaceutical solution but get easily hydrolysed to form cationic Tc-99m species which concentrates in healthy bone and in some bone metastases. Tc-99m (V)-DMSA being more stable remains long in the blood pool giving undesirable presence of the radionuclide in lung, heart and kidneys, in addition to its reduced uptake in bone metastases and in some primaries. We are trying to eliminate these drawbacks of healthy organ uptake of Tc-99-m(V)-DMSA not only to get a clean scintigraphic image of the tumour with this radiopharmaceutical but to extend its formulation, thus obtained, to prepare radiopharmaceutical with Re-188, which is the higher homologue of Tc-99m, for systemic therapy of cancer. Essentially similar solution chemistry of both radiopharmaceuticals suggests that like Tc-99m-MDP, technetium-99m-dimercaptosuccinate is also a complex of tetravalent Tc-99m and not of pentavalent Tc-99m as so far supposed to be.

Problem: Recent evidence of growth hormone (GH) receptor expression in rat endometrium and human myometrium have focused our attention on the role of the GH in endometrial development. We tested the expression of GH in the human endometrium throughout the menstrual cycle and during pregnancy. Method of study: Immunohistochemical study was performed on endometrial specimens of fertile women in different periods of the menstrual cycle and in decidua of pregnant women. Results: Glandular cells of the human endometrium were positive for GH in the mid and late luteal phase. Furthermore, the glandular cells of decidua showed intense staining for GH, while the stromal cells were negative. No immunostaining was expressed in the proliferative or early luteal phase. The intensity levels of staining for GH in decidual specimens were significantly higher than in glandular cells of secretory endometrium specimens (P

The sections in this article are: 1 Prepregnancy Period 2 First Trimester 2.1 Introduction 2.2 Carbohydrate Metabolism 2.3 Lipid Metabolism 2.4 Protein Metabolism 3 Second and Third Trimesters 4 Counterregulation During Pregnancy

Ultrasound assessment of abdominal circumference early in the third trimester had been proposed to introduce insulin therapy in order to prevent fetal overgrowth in women with mild gestational diabetes mellitus. The purpose of this study was to investigate adequate weeks gestation timing for testing this parameter.One hundred and forty-one women were included in a randomized trial. Seventy-three women were evaluated at both 28 and 32 weeks gestation whereas 68 women were investigated only at 32 weeks gestation. In both groups, insulin therapy was promptly started when abdominal circumference exceeded the 75th percentile. Macrosomic rates were compared using the Fisher's exact test.Twenty-nine women whose fetal abdominal circumference exceeded the 75th percentile were considered eligible for insulin therapy. In this group, we observed a statistically significant increase in the percentage of macrosomic infants born from women whose ultrasound abdominal circumference assessment was performed only at 32 weeks gestation when compared to women evaluated at both 28 and 32 weeks gestation (71.43% vs 33.33%, p0.05).Our results support the need for fetal ultrasound at 28 weeks gestation to direct metabolic therapy since insulin administration introduced after 32 weeks gestation has a poor effect on fetal growth.

CHRONIC monocytic leukaemia (CMoL) is characterised by the proliferation of mature monocytes that predominate in the peripheral blood ([Monteith and Cole 1995][1]). CMoL is frequently indolent, with a persistent monocytosis that is unresponsive to therapeutic agents (Messick 2000). In human beings