1,721,198 research outputs found
Endoscopic Management of Recurrent Acute Pancreatitis
No full textThis review aims to summarize the role of endoscopic therapy in the management and outcomes of recurrent acute pancreatitis (RAP). RAP is a clinical entity characterized by repeated episodes of acute pancreatitis in the setting of a normal gland or chronic pancreatitis (CP). The aetiology of RAP can be identified in about 70% of cases; for the remaining cases, the term “idiopathic” (IRAP) is used. However, advanced diagnostic techniques may reduce the percentage of IRAP to 10%. Recognized causes of RAP are gallstone disease, including microlithiasis and biliary sludge, sphincter of Oddi dysfunction (SOD), pancreatic ductal abnormalities (either congenital or acquired) interfering with pancreatic juice or bile outflow, genetic mutations, and alcohol consumption. SOD, as a clinical entity, was recently revised in the Rome IV consensus, which only recognized type 1 dysfunction as a true pathological condition, while type 2 SOD was defined as a suspected functional biliary sphincter disorder requiring the documentation of elevated basal sphincter pressure to be considered a true clinical entity and type 3 was abandoned as a diagnosis and considered functional pain. Endoscopic therapy by retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) has been proven effective when a mechanical obstruction is found and can be removed. If an obstruction is not documented, few treatment options are available to prevent the recurrence of pancreatitis and progression toward chronic disease. In gallstone disease, endoscopic biliary sphincterotomy (EBS) is effective when a dilated common bile duct or biliary sludge/microlithiasis is documented. In type 1 SOD, biliary or dual sphincterotomy is generally successful, while in type 2 SOD, endotherapy should be reserved for patients with documented sphincter dysfunction. However, in recent years, doubts have been expressed about the real efficacy of sphincterotomy in this setting. When sphincter dysfunction is not confirmed, endotherapy should be discouraged. In pancreas divisum (PD), minor papilla sphincterotomy is effective when there is a dilated dorsal duct, and the success rate is the highest in RAP patients. In the presence of obstructive conditions of the main pancreatic duct, pancreatic endotherapy is generally successful if RAP depends on intraductal hypertension. However, despite the efficacy of endotherapy, progression toward CP has been shown in some of these patients, mainly in the presence of PD, very likely depending on underlying genetic mutations. In patients with IRAP, the real utility of endotherapy still remains unclear; this is because several unknown factors may play a role in the disease, and data on outcomes are few, frequently contradictory or uncontrolled, and, in general, limited to a short period of time
Case study: Ichthyosis in two chianina calves
No full textThe occurrence of Ichthyosis in two Italian Chianina calves is described for the first time. Both animals, affected by Ichthyosis fetalis and Ichthyosis congenita respectively, showed diffuse cutaneous thickening, since birth.
The first patient was a three-month-old female calf; inelastic leather cuirass-like skin associated to generalized hypotrichosis and local alopecia, delay of the physiologic change of the coat colour, stiff movement and growth retardation were the most prominent clinical characteristics. The patient was kept under observation for almost one year.
The second case occurred in a 18-day-old female calf, which was referred already dead; presence of irregular hyperkeratotic plates separated by deep fissures over the entire cutaneous surface, and slight eversion of the mucocutaneous junction (eclabium and ectropion) were the most characteristic alterations.
In both cases, the major histopathological feature was a diffuse lamellar orthokeratotic hyperkeratosis. Although no familial relationship was detected between the two patients, an underlying genetic defect was strongly suspected on the basis of current knowledge
Congenital Pseudomyotonia in Chianina cattle
No full textThe Authors describe a very uncommon skeletal malformation syndrome (so-called “Short Spine Lethal”) observed in two Holstein calves submitted from two different breeders. The two subjects, one female and one male, were delivered still born at the end of pregnancy and weighed only 9.8 and 7.9 kg, respectively. An extremely short trunk associated with normal length of all legs was the main finding in both calves. Mandibular hypoplasia and misaligned teeth resulted in protrusion of the tongue from the oral cavity. The radiographic examination of the vertebral column showed several vertebral anomalies including reduced size of all vertebral bodies and abnormal vertebral shape. The vertebrae and ribs were normal in number. At necropsy additional malformations were found affecting the urogenital, gastrointestinal, and cardiovascular system. Both calves were traced back to the same sire; thus an hereditary cause was strongly suspected. .
Short Spine Lethal is a rare lethal skeletal malformation that has been reported before only in few cattle breeds, in a goat, and in a buffalo calf. It was assigned to a genetic origin
Complex Vertebral Malformation (CVM) in a calf
No full textThe Authors describe the clinical, radiological and anatomo-pathological findings of a case of Complex Vertebral Malformation in a two-day-old Holstein female calf.
The calf, weighing 19.4 kg, was submitted due to bilateral symmetrical flexural contraction of the metacarpo-phalangeal and metatarso-phalangeal joints, and medial rotation of the digits, which hindered the calf from maintaining the quadrupedal stance.
The calf was alert and showed physiologic appetite. Despite repeated attempts to stand up, it was unable to and remained laying down in a frog-like decubitus.
Lateral and ventrodorsal radiographs of the whole vertebral column and mediolateral and dorsopalmar projections of both the distal forelimbs were obtained.
The vertebral column showed multiple vertebral anomalies including hemivertebrae, fused and misshapen vertebrae and ribs, and scoliosis affecting mainly the caudal cervical and the thoracic regions.
At necropsy, besides the skeleton anomalies already described, complex malformations of the heart were observed, and included atrial and interventricular septal defects, and patent ductus arteriosus.
The calf resulted as homozygous for CVM-mutation, based on the results of the DNA-PCR test
Adenosine binding sites in pig ventricular sarcolemma and interaction with calcium channels
No full textB-lymphocytes in the Pathophysiology of Pancreatic Adenocarcinoma
No full textPancreatic adenocarcinoma is highly infiltrated by B lymphocytes but the relevance of these immune cells in tumor development has been surprisingly overlooked until recently. Based on available evidence from other solid tumors, interaction between B lymphocytes and neoplastic cells is probably not uniformly stimulatory or inhibitory. Although presentation of tumor antigens to T cells and production of antitumor immunoglobulins might intuitively suggest a prominent tumor suppressive activity, specific subsets of B lymphocytes can secrete growth factors for neoplastic cells and immunosuppressive cytokines thus promoting escape from immunosurveillance and cancer progression. Because many of these mechanisms might also be implicated in the development of PDAC, and immune-modulation of B-cell activity is nowadays possible at different levels, determining the role of B-lymphocytes in this lethal cancer becomes of utmost importance to design novel therapeutic strategies. This review aims to discuss the emerging role of B cells in PDAC tumorigenesis, progression, and associated stromal reaction
Perosomus Elumbis in calves
No full textThis report presents the most important clinical and morphological aspects of the so-called “Perosomus Elumbis”, a congenital vertebral malformation of calves characterized by the segmental lack of vertebrae caudal to the thoracic spine. The etiology has to be defined, but inheritance is suspected.
The report is based on seven calves (five Holstein, one Brown and 1 cross breed) examined at the Veterinary Clinical Department of the University of Bologna (BO66/04; BO107/04; BO46/06; BO107/06; BO290/08) or at the Department of Veterinary Clinical Sciences of Padua (PD34/04; PD66/04). All animals appeared bright and alert at birth, but were completely unable to stand up or to maintain quadrupedal stance if raised manually. The seven calves, ranging from one to 15 days of age, were euthanized on the first day of hospitalization.
Although having individual clinical presentation, the disorder was morphologically characterized by partial or complete segmental absence of vertebra, mostly of the lumbar and sacral segments. The tail was always missing.
As a consequence of the vertebral malformation, the animals’ trunks were shorter than normal, and the posterior part of the body was clearly underdeveloped. More precisely, the girdle showed a reduction in size and width whereas the hind limbs were shorter with evident muscular hypoplasia. In some cases, due to the lack of vertebrae, the hind limbs were attached to the caudal aspect of the thorax by soft tissue only.
On the contrary, the anterior half of the body - from the caudal part of the thorax - was normal. Radiological examination clearly demonstrated the skeletal malformation including the lack of vertebrae. Internal organ malformations, such as intestinal atresia, hydronephrosis, testicular agenesia, uterine and vaginal malformations as well as concentric cardiac hypertrophy were also observed in some animals.
In the context of general scientific interest in genetic diseases of cattle, the Authors suspect Perosomus Elumbis to be a potential inherited disease. However, the reported cases studies did not provide evidence for this hypothesis.
Identification of clinical cases and reports of malformed calves are necessary to improve the knowledge of this defect
EUS-Guided Crio-thermal Ablation of Pancreatic Neoplasia
No full textPancreatic cancer still presents a dismal prognosis despite recent great efforts in chemoradiotherapy regimens. The development of different devices applied to endoscopic ultrasound (EUS), on the basis of EUS-guided fine needle aspiration (EUS FNA) technique principle, has led this approach to become also an interventional procedure. EUS-guided direct tumor thermal ablation represents a minimally invasive potential antitumor therapeutic alternative to radiological and surgical treatments for patients not amenable to surgical treatments. The EUS-guided approach is well suited to pancreatic cancer because of its superior anatomical access compared with other imaging modalities. Currently, a variety of probes specifically designed for EUS thermal ablation for treatment of pancreatic cancer are available with the aim of providing better local disease control and reduce metastatic tumor spreading, including the Hybrid Therm Probe (ERBE, Elektromedizin GmbH, Tubingen, Germany) that has the peculiar property to combine the bipolar radiofrequency ablation and cryoablation technologies. EUS-guided cryothermal ablation using the Hybrid Therm Probe showed to be feasible and safe for the treatment of patients with unresectable locally advanced pancreatic adenocarcinoma. This chapter provides a description of the EUS-guided ablation technique using the Hybrid Therm Probe and its development and clinical application. The long-term efficacy of EUS-guided cryothermal ablation is under investigation
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