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Malignant primary bone neoplasms are characterized by high malignancy and metastatic capacity, commonly affecting dogs of large or giant breeds. The prognosis is reserved to unfavorable for the patients. This paper describes a case of osteosarcoma in the left pelvic limb of a Dachshund, diagnosed by fine-needle aspiration cytology and confirmed by histopathological evaluation. The patient underwent limb amputation and doxorubicin chemotherapy; however, the dog died. This report alerts clinicians to the occurrence of osteosarcoma in small animals and demonstrates the importance of fine-needle aspiration cytology as a tool in the diagnosis of bone neoplasms.

The efficacy in 1H Overhauser dynamic nuclear polarization in liquids at ultralow magnetic field (ULF, B0 = 92 ± 0.8 µT) and polarization field ( B p = 1–10 mT) was studied for a broad variety of 26 different spin probes. Among others, piperidine, pyrrolidine, and pyrroline radicals specifically synthesized for this study, along with some well-established commercially available nitroxides, were investigated. Isotope-substituted variants, some sterically shielded reduction-resistant nitroxides, and some biradicals were included in the measurements. The maximal achievable enhancement, Emax, and the radio frequency power, P1/2, needed for reaching Emax/2 were measured. Physico-chemical features such as molecular weight, spectral linewidth, heterocyclic structure, different types of substituents, deuteration, and 15N-labeling as well as the difference between monoradicals and biradicals were investigated. For the unmodified nitroxide radicals, the Emax values correlate with the molecular weight. The P1/2 values correlate with the spectral linewidth and are additionally influenced by the type of substituents neighboring the nitroxide group. The nitroxide biradicals with high intramolecular spin–spin coupling show low performance. Nitroxides enriched with 15N and/or 2H afford significantly higher | Emax| and require lower power to do so, compared to their unmodified counterparts containing at natural abundance predominantly 14N and 1H. The results allow for a correlation of chemical features with physical hyperpolarization-related properties and indicate that small nitroxides with narrow spectral lines have clear advantages for the use in Overhauser dynamic nuclear polarization experiments. Perdeuteration and 15N-labeling can be used to additionally boost the spin probe performance.

Importance: Sodium glucose cotransporter 2 inhibitors reduce morbidity and mortality in patients with heart failure and reduced ejection fraction (HFrEF). Clinicians may find estimates of the projected long-term benefits of sodium glucose cotransporter 2 inhibitors a helpful addition to clinical trial results when communicating the benefits of this class of drug to patients. Objective: To estimate the projected long-term treatment effects of dapagliflozin in patients with HFrEF over the duration of a patient’s lifetime. Design, Setting, and Participants: Exploratory analysis was performed of Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure (DAPA-HF), a phase 3 randomized, placebo-controlled clinical trial conducted at 410 sites in 20 countries. Patients with an ejection fraction less than or equal to 40% in New York Heart Association functional classification II to IV and elevated plasma levels of N-terminal pro B-type natriuretic peptide were enrolled between February 15, 2017, and August 17, 2018, with final follow-up on June 6, 2019. Mean (SD) duration of follow-up was 17.6 (5.2) months. Interventions: Dapagliflozin, 10 mg, once daily vs placebo in addition to standard therapy. Main Outcomes and Measures: The primary composite outcome was time to first hospitalization for heart failure, urgent heart failure visit requiring intravenous therapy, or cardiovascular death. The trial results were extrapolated to estimate the projected long-term treatment effects of dapagliflozin over the duration of a patient’s lifetime for the primary outcome and the secondary outcome of death from any cause. Results: A total of 4744 patients (1109 women [23.4%]; 3635 men [76.6%]) were randomized in DAPA-HF, with a mean (SD) age of 66.3 (10.9) years. The extrapolated mean event-free survival for an individual aged 65 years from a primary composite end point event was 6.2 years for placebo and 8.3 years for dapagliflozin, representing an event-free survival time gain of 2.1 years (95% CI, 0.8-3.3 years; P = .002). When considering death from any cause, mean extrapolated life expectancy for an individual aged 65 years was 9.1 years for placebo and 10.8 years for dapagliflozin, with a gain in survival of 1.7 years (95% CI, 0.1-3.3; P = .03) with dapagliflozin. Similar results were seen when extrapolated across the age range studied. In analyses of subgroups of patients in DAPA-HF, consistent benefits were seen with dapagliflozin on both event-free and overall survival. Conclusions and Relevance: These findings indicate that dapagliflozin provides clinically meaningful gains in extrapolated event-free and overall survival. These findings may be helpful in communicating the benefits of this treatment to patients with HFrEF. Trial registration: ClinicalTrials.gov Identifier: NCT03036124.

Surfactants are widely used as detergents, emulsifiers, wetting agents, foaming agents and dispersants in the cosmetics, hygiene, food and oil industries. Their use in a clinical setting is also common, particularly within the field of wound care. Many wound cleansers contain surfactants and subsequently there is available data that shows the growing potential of these wound cleansers in the enhancement of wound closure. The presence of microorganisms in wounds has been recognised as a significant factor that delay healing. In complex or chronic wounds that are complicated by biofilms, persistent inflammation or the production of non-viable tissue and slough, the use of surfactants has been shown to aid in the removal of these barriers to wound healing. The use of concentrated surfactant(poloxamer) based wound dressings represent an important component of wound management. Consequently, this article will discuss the effect of clinically used surfactants, with specific focus on a concentrated poloxamer for use against wound biofilm.

WOS: 000468732700018, PubMed ID: 31054483, Background and aims: One of the objectives of the ESC-EORP EUROASPIRE V survey is to determine how well European guidelines on the management of dyslipidaemias are implemented in coronary patients. Methods: Standardized methods were used by trained technicians to collect information on 7824 patients from 130 centers in 27 countries, from the medical records and at a visit at least 6 months after hospitalization for a coronary event. All lipid measurements were performed in one central laboratory. Patients were divided into three groups: on high-intensity LDL-C-lowering-drug therapy (LLT), on low or moderate-intensity LLT and on no LLT. Results: At the time of the visit, almost half of the patients were on a high-intensity LLT. Between hospital discharge and the visit, LLT had been reduced in intensity or interrupted in 20.8% of the patients and had been started or increased in intensity in 11.7%. In those who had interrupted LLT or had reduced the intensity, intolerance to LLT and the advice of their physician were reported as the reason why in 15.8 and 36.8% of the cases, respectively. LDL-C control was better in those on a high-intensity LLT compared to those on low or moderate intensity LLT. LDL-C control was better in men than women and in patients with self-reported diabetes. Conclusions: The results of the EUROASPIRE V survey show that most coronary patients have a less than optimal management of LDL-C. More professional strategies are needed, aiming at lifestyle changes and LLT adapted to the need of the individual patient., ESC - EORP; AmgenAmgen; Eli LillyEli Lilly; PfizerPfizer; SanofiSanofi-Aventis; Ferrer; Novo NordiskNovo Nordisk, The EUROASPIRE V survey was carried out under the auspices of the ESC - EORP. Since the start of EORP, the following companies have supported the programme: Amgen, Eli Lilly, Pfizer, Sanofi, Ferrer and Novo Nordisk. The sponsors of the EUROASPIRE surveys had no role in the design, data collection, data analysis, data interpretation, decision to publish, or writing the manuscript.

A biofilm is a community of microorganisms that adhere to each other and to surfaces and secrete extracellular polymeric substances (EPS) encasing themselves in a matrix. Biofilms are a major healthcare concern, as they can form on medical devices leading to infection. Additionally, there is growing evidence to show their ability to form in chronic wounds, which leads to delayed wound healing and inflammation. Due to a number of reasons, such as formation of the EPS resulting in sub-inhibitory concentrations of antimicrobials reaching the bacterial cells, slow growth rate of bacterial cells rendering some antibiotics ineffective, and the presence of persister cells, biofilms show increased tolerance to many antimicrobials and antibiotics. Additionally, studies have started to emerge showing a link between resistance to antimicrobials and antibiotics. Cross-resistance can be attributed to a number of factors, for example, increased expression of multidrug efflux pumps that efflux a wide range of substrates and horizontal gene transfer of genetic material encoding multiple resistance genes between different species within the polymicrobial biofilm. Antimicrobial resistance is an increasing threat caused by multiple factors including cross-resistance, and it is a global health concern. This review focuses on current research on antimicrobial and antibiotic resistance and cross-resistance found between antimicrobials and antibiotics commonly used in woundcare to evaluate the significance of this acquired antibiotic resistance. Furthermore, the review discusses the significance of antimicrobial tolerance and the role biofilms play in enhancing antibiotic resistance.

Juxta-, suprarenale und Abschnitt-IV-Aneurysmen sind im Vergleich zu abdominalen Aneurysmen selten. In einer grosen autoptischen Serie von Patienten mit aortoiliakalen Aneurysmen zeigte sich die folgende relative Haufigkeit nach Lokalisation: abdominale Aorta allein 65 %; thorakale Aorta allein 19 %; abdominale Aorta plus Iliakalarterien 13 %; thorakoabdominale Aorta 2 %; und isolierte Iliakalarterien 1 % (Brunkwall et al. 1989). In einer vergleichenden Studie von 429 Patienten mit abdominalen und juxtarenalen Aortenaneurysmen prasentierten sich 86 % als infrarenal, und 14 % erstreckten sich bis an oder uber die Nierenarterien (Ayari et al. 2001). Abschnitt-IV-Aneurysmen werden in 10–26 % der thorakoabdominalen Aortenaneurysmen beschrieben (Cambria 2000). Juxtarenale Aneurysmen sind etwa 3- bis 4-mal haufiger als suprarenale Aneurysmen (Nypaver et al. 1993). Populationsbasierte Studien schatzen die Inzidenz von klinisch offenkundigen abdominalen Aortenaneurysmen auf 21 pro 100.000 Personenjahre und von thorakalen Aortenaneurysmen auf 6 pro 100.000 Personenjahre (Bickerstaff et al. 1982). Epidemiologisch verhalten sich abdominale (inklusive juxta- und suprarenale) Aneurysmen und Abschnitt-IV-Aneurysmen unterschiedlich. Erstere kommen in einem Verhaltnis Mann zu Frau von 2:1 bis 6:1, letztere in einem Verhaltnis 1:1 bis 4:1 vor. Die Inzidenz von rupturierten abdominalen Aortenaneurysmen in der allgemeinen Bevolkerung wird mit 6,3 pro 100.000, diejenigen bei uber 65-Jahrigen mit 35,5 pro 100.000 angegeben (Heikkinen et al. 2002). Obwohl man annehmen musste, dass die Zunahme der elektiven Versorgung die Anzahl der Rupturen senken sollte, konnte dieser Effekt bisher nicht eindeutig nachgewiesen werden (Heller et al. 2000). Auch konnte nicht klar aufgezeigt werden, dass juxta- und suprarenale Aneurysmen haufiger rupturieren wurden, wie von einigen Autoren vermutet.

Crystal structures of enzymes are indispensable to understanding their mechanisms on a molecular level. It, however, remains challenging to determine which structures are adopted in solution, especially for dynamic complexes. Here, we study the bilobed decapping enzyme Dcp2 that removes the 5′ cap structure from eukaryotic mRNA and thereby efficiently terminates gene expression. The numerous Dcp2 structures can be grouped into six states where the domain orientation between the catalytic and regulatory domains significantly differs. Despite this wealth of structural information it is not possible to correlate these states with the catalytic cycle or the activity of the enzyme. Using methyl transverse relaxation-optimized NMR spectroscopy, we demonstrate that only three of the six domain orientations are present in solution, where Dcp2 adopts an open, a closed, or a catalytically active state. We show how mRNA substrate and the activator proteins Dcp1 and Edc1 influence the dynamic equilibria between these states and how this modulates catalytic activity. Importantly, the active state of the complex is only stably formed in the presence of both activators and the mRNA substrate or the m7GDP decapping product, which we rationalize based on a crystal structure of the Dcp1:Dcp2:Edc1:m7GDP complex. Interestingly, we find that the activating mechanisms in Dcp2 also result in a shift of the substrate specificity from bacterial to eukaryotic mRNA.

Die CO2-Sequestrieung wird von den Vereinten Nationen als Abscheidung von CO2 aus den Emissionen des globalen Energiesystems und sichere Speicherung dieses CO2 definiert. Das Konzept lasst sich in drei aufeinander folgende Schritte unterteilen: den Abscheideprozess im Kraftwerk, den Transport des abgeschiedenen CO2 und die Speicherung im Untergrund. Im Beitrag werden verschiedene Transportkonzepte vorgestellt und anhand ihrer technischen Charakteristika sowie der mit ihnen verbundenen Transportkosten verglichen.

Resume Introduction La borreliose europeenne, connue du public sous le nom de maladie de Lyme par analogie avec la forme americaine dont elle differe par de nombreux points, est endemique en Alsace, posant un probleme de sante publique. Le niveau de connaissance et de prevention de la population vis-a-vis de cette maladie n’a jamais ete evalue en France. Materiel et methodes Une enquete a ete realisee dans tous les centres d’examens de sante de la Securite Sociale d’Alsace a l’aide d’un auto-questionnaire. Les donnees recueillies portaient sur les caracteristiques socio-demographiques, les connaissances sur la maladie, les antecedents de piqures de tiques, la crainte suscitee par cette maladie, la frequence des sejours en foret, les habitudes de prevention lors de sorties en foret et l’attitude adoptee en cas de piqure de tique. Resultats Sur les 600 sujets inclus, 99 (16,5 p. 100) avaient ete piques une ou plusieurs fois par des tiques depuis un an. L’existence de la maladie de Lyme etait connue par 74 p. 100 des consultants, 63 p. 100 disaient en eprouver une crainte et 43 p. 100 savaient que sa premiere manifestation est une rougeur qui s’etend sur la peau. Vingt-sept pour cent s’habillaient d’un pantalon et de manches longues lors de sejours en foret et 19 p. 100 s’inspectaient le corps entier au retour. Les sujets les moins informes etaient egalement ceux qui se premunissaient le moins contre les piqures de tique. Il s’agissait des moins de 30 ans, des moins diplomes et des citadins. Les sujets se rendant frequemment en foret pour leurs loisirs et ceux ayant des antecedents de piqures etaient les mieux informes et avaient de meilleures habitudes de prevention. La crainte suscitee par la maladie etait associee a de meilleures connaissances et a un comportement mieux adapte. Discussion Cette etude montre qu’une proportion elevee de la population alsacienne est exposee aux piqures de tiques. Les borrelioses par piqure de tiques sont assez bien connues mais leur prevention demeure insuffisante. Une meilleure information est associee a une meilleure prevention. Les campagnes d’information et d’education de la population generale pourraient viser particulierement les jeunes, les citadins et les moins diplomes. Des messages specifiques de prevention pourraient egalement etre delivres aux sujets les plus exposes, c’est a dire ceux piques par des tiques ou se rendant souvent en foret, sur leurs lieux de consultation ou de loisirs.

Accumulation of advanced glycation end-products (AGE) has been suggested to be involved in several pathophysiological processes in the vessel wall. Soluble isoform of receptor for AGE (sRAGE) acts as a decoy for capturing circulating AGE, thus preventing them from binding to the cell-surface receptor (RAGE) and protecting against the RAGE-AGE axis-elicited processes. We hypothesized that low sRAGE levels might be associated with increased arterial stiffness. In a cross-sectional design, we analyzed 1077 subjects, aged 25 to 64 years, from the Czech population-based study ("Post-MONICA"). Aortic pulse wave velocity (aPWV) measured by the Sphygmocor device, was used to assess aortic stiffness. sRAGE concentrations were assessed in frozen samples by ELISA methods (R&D Systems). Aortic PWV significantly (p

Lipoprotein associated phospholipase A2 (Lp PLA2) represent new cardiovascular risk factor and potential treatment target. We aimed to analyze the epidemiological situation of this factor in Czech population.The study population consisted from 1 962 subjects, a random samples of general population (postMONICA study), and from patients with manifest coronary or cerebrovascular disease (Czech samples of EUROASPIRE III survey). Lp PLA2 activity was estimated using commercial kits by diaDexus Inc. in frozen samples. Increased activity (by definition, i.e.195 nmol/ min/ ml) was observed in 21.1 % of sample, no apparent difference between subject with and without manifest vascular disease was found. Males showed higher Lp PLA2 activity, than females (179.6 vs 146, resp., p0.0001), while no substantial increase with age was observed. Taking Lp PLA2 activity195 as dependent variable, following independent variables entered the multiple logistic regression: male gender [with odds ratio 4.26 (3.26- 5.58)], low HDL cholesterol (i.e.1.0 mmol/ l in males or1.2 mmol/ l in females) [3.49 (2.62- 4.64)], LDLcholesterol2.5 mmol/ l [6.95 (4.79- 10.07)] and lipid lowering treatment [0.59 (0.44- 0.79)]. In subject without manifest vascular disease, 6.3 % of them showed co incidence of markedly increased Lp PLA2 activity with high conventional risk (SCORE10 %). Expanding this group by intermediate risk subjects (ie. with Lp PLA2 activity 152- 194 and/ or SCORE 5- 9.9 %) leads to increase of this prevalence to 28.9 % of primary prevention subjects.Increased Lp PLA2 activity is in Czech population highly prevalent and with exception of lipid parameters, generally independent from conventional cardiovascular risk. However, up to 29 % of subject in primary prevention amalgamate increased Lp PLA2 activity with high conventional cardiovascular risk.

In wound care research, available high-level evidence according to the evidence pyramid is rare, and is threatened by a poor study design and reporting. Without comprehensive and transparent reporting, readers will not be able to assess the strengths and limitations of the research performed. Randomized clinical trials (RCTs) are universally acknowledged as the study design of choice for comparing treatment effects. To give high-level evidence the appreciation it deserves in wound care, we propose a step-by-step reporting standard for comprehensive and transparent reporting of RCTs in wound care. Critical reporting issues (e.g., wound care terminology, blinding, predefined outcome measures, and a priori sample size calculation) and wound-specific barriers (e.g., large diversity of etiologies and comorbidities of patients with wounds) that may prevent uniform implementation of reporting standards in wound care research are addressed in this article. The proposed reporting standards can be used as guidance for authors who write their RCT, as well as for peer reviewers of journals. Endorsement and application of these reporting standards may help achieve a higher standard of evidence and allow meta-analysis of reported wound care data. The ultimate goal is to help wound care professionals make better decisions for their patients in clinical practice.

Power distribution grids with a high share of photovoltaic (PV) generation can be subject to severe voltage issues. The realistic simulation of such systems is therefore important for planning purposes and the evaluation of technical counter measures. This paper suggests a method to generate realistic power time series for a given set of PV generators within a distribution grid to provide the necessary input data for such simulations.

The objective of this study was to evaluate the impact of a standardized enteral feeding protocol for very low birth weight (VLBW) infants on nutritional, clinical and growth outcomes. Retrospective analysis of VLBW cohorts 9 months before and after initiation of a standardized feeding protocol consisting of 6–8 days of trophic feedings, followed by an increase of 20 ml/kg/day. The primary outcome was days to reach full enteral feeds defined as 160 ml/kg/day. Secondary outcomes included rates of necrotizing enterocolitis and culture-proven sepsis, days of parenteral nutrition and growth end points. Data were analyzed on 147 VLBW infants who received enteral feedings, 83 before (‘Before’) and 64 subsequent to (‘After’) feeding protocol initiation. Extremely low birth weight (ELBW) infants in the After group attained enteral volumes of 120 ml/kg/day (43.9 days Before vs 32.8 days After, P=0.02) and 160 ml/kg/day (48.5 days Before vs 35.8 days After, P=0.02) significantly faster and received significantly fewer days of parenteral nutrition (46.2 days Before vs 31.3 days After, P=0.01). Necrotizing enterocolitis decreased in the After group among VLBW (15/83, 18% Before vs 2/64, 3% After, P=0.005) and ELBW infants (11/31, 35% Before vs 2/26, 8% After, P=0.01). Late-onset sepsis decreased significantly in the After group (26/83, 31% Before vs 6/64, 9% After, P=0.001). Excluding those with weight

The relationship between the plasma magnesium (Mg) concentration and steady-state plasma insulin (SSPI) and glucose (SSPG) concentrations at the end of a 180-minute infusion of octreotide, insulin, and glucose was determined in 98 healthy nondiabetic subjects. For the purposes of data analysis, the population was divided into tertiles on the basis of the plasma Mg concentration: I, plasma Mg 0.83 mmol/L; II, plasma Mg 0.84 to 0.91 mmol/L; and III, plasma Mg 0.92 mmol/L. The three groups were identical in terms of age, gender distribution, and degree of obesity. However, both fasting plasma insulin (P.05) and SSPG (P.05) concentrations were significantly higher in the tertile (I) with the lowest plasma Mg concentration. Furthermore, there was a significant inverse correlation between plasma Mg and SSPG concentrations (r = -.27, P.01) in the entire population. These results indicate that variations in the plasma Mg concentration have a relatively modest but significant effect on insulin-mediated glucose disposal in healthy subjects, with lower plasma Mg concentrations associated with increased insulin resistance.