Effects of β-like cell autotransplantation through hepatic arterial intervention on diabetic dogs

Abstract Background Plain balloon angioplasty has traditionally been used to treat lower limb arterial disease but can be limited by significant residual stenosis, vessel recoil, dissection, and by late restenosis. Appropriate vessel preparation may significantly improve short and long-term outcomes. We aim to give an overview of some of the devices currently available, or under investigation, for vessel preparation in the lower limb. Main text Vessel preparation devices include those that remove plaque (atherectomy devices) and those that modify plaque. The four groups of plaque removing atherectomy devices are defined by their plaque removal method: Directional, rotational orbital and excimer laser are categories of devices investigated for plaque modification. Intravascular lithotripsy devices generate sonic pulsatile pressure waves that pass into the vessel wall cracking calcified plaques whilst sparing soft tissue. This enables dilatation of calcified lesions at low pressure by conventional balloons and enables full stent expansion. Other balloon based vessel preparation devices were designed to modify plaque and produce more controlled, lower pressure luminal expansion without major dissections and potentially with less recoil than conventional angioplasty balloons. Scoring balloons have a helical nitinol element attached to the balloon that scores plaque facilitating uniform luminal enlargement. Further specialty balloons have been developed in recent years, including the Chocolate, Phoenix and Serranator balloons. Finally, the temporary Spur self-expanding retrievable nitinol stent has a series of radially aligned spurs that are driven into the vessel wall by post-dilatation, potentially improving drug delivery. Conclusion Lesion specific vessel preparation aims to improve both short and long term outcomes through improved penetration of anti-proliferative drug, maximising luminal gain, reducing the need for stent placement and minimising intimal injury. Some forms of vessel preparation appear to improve short term outcomes; long-term outcomes remain uncertain. An overview of some of the multiple devices available for vessel preparation is presented.

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The Influence of Skin Thickness on Flash Glucose Monitoring System Accuracy in Dogs with Diabetes Mellitus

Animals ◽

10.3390/ani11020408 ◽

2021 ◽

Vol 11 (2) ◽

pp. 408

Author(s):

Francesca Del Baldo ◽

Alessia Diana ◽

Claudia Canton ◽

Nikolina Linta ◽

Roberto Chiocchetti ◽

...

Keyword(s):

Monitoring System ◽

Glucose Monitoring ◽

Skin Thickness ◽

Flash Glucose Monitoring ◽

Thin Skin ◽

Clinical Accuracy ◽

The Mean ◽

Group 2 ◽

Diabetic Dogs ◽

Flash Glucose Monitoring System

A flash glucose monitoring system (FGMS) has been validated for use in diabetic dogs. However, it is unknown whether skin thickness affects FGMS measurements. The aim of this study was to evaluate whether FGMS accuracy is affected by skin thickness. Fourteen client-owned diabetic dogs on insulin treatment were prospectively enrolled in the study. The dogs were divided into two groups according to their ultrasound-measured skin thickness: dogs with skin thickness < 5 mm (Group 1) and dogs with skin thickness > 5 mm (Group 2). On days 1, 7 and 14, glucose curves were obtained simultaneously using the FGMS and a validated portable blood glucose meter. Paired measurements were used to calculate the mean bias and to determine accuracy according to ISO 15197:2013 criteria. The mean bias was significantly inversely correlated (p = 0.02; r = −0.6) with the mean skin thickness. Clinical accuracy was observed only in Group 2, with 99% of the results in zone A + B of the Parkes consensus error grid analysis. In conclusion, skin thickness seems to affect FGMS measurements, and the device is accurate in dogs with thicker skin (>5 mm); in dogs with thin skin (<5 mm), the clinical accuracy is low, and the results should be interpreted with caution.

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Glucagon-like peptide-1 has no insulin-like effects in insulin-dependent diabetic dogs maintained normoglycemic and normoinsulinemic

Metabolism ◽

10.1016/s0026-0495(99)90023-9 ◽

1999 ◽

Vol 48 (1) ◽

pp. 134-137 ◽

Cited By ~ 8

Author(s):

E.-J. Freyse ◽

S. Knospe ◽

T. Becher ◽

O. El Hag ◽

B. Göke ◽

...

Keyword(s):

Insulin Dependent ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1 ◽

Diabetic Dogs ◽

Insulin Dependent Diabetic

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Flash glucose monitoring in diabetic dogs: a feasible method for evaluating glycemic control

Tierärztliche Praxis Ausgabe K Kleintiere / Heimtiere ◽

10.1055/a-1239-4739 ◽

2020 ◽

Vol 48 (05) ◽

pp. 330-338

Author(s):

Florian K. Zeugswetter ◽

Andrea Sellner

Keyword(s):

Diabetes Mellitus ◽

Glycemic Control ◽

Glucose Monitoring ◽

Flash Glucose Monitoring ◽

Feasible Method ◽

Klinische Relevanz ◽

Glykämische Kontrolle ◽

Diabetic Dogs

Zusammenfassung Gegenstand und Ziel Zur Reduktion der klinischen Symptome und zur Verhinderung von lebensbedrohlichen Komplikationen sind bei Hunden mit Diabetes mellitus individualisierte Behandlungsstrategien und regelmäßige Kontrollen notwendig. Sieben bis 14 Tage nach jeder Anpassung der Insulindosierung und danach monatlich wird das Erstellen von Blutglukose-Tagesprofilen empfohlen. Im Jahr 2016 wurde ein herstellerkalibriertes Gerät zur kontinuierlichen Glukosemessung als Alternative zur Messung mittels Glukometer vorgeschlagen. Ziel dieser Arbeit war, die Erfahrungen mit dieser neuen Technologie zusammenzufassen und zu zeigen, dass bereits die erste Messperiode in Kombination mit einfachen Regeln eine Verbesserung der glykämischen Kontrolle ermöglicht. Material und Methoden Das elektronische Datensystem der endokrinen Einheit der Klinik wurde retrospektiv auf diabetische Hunde mit Flash-Glukose-Monitoring durchsucht. Bei multipler Sensorapplikation fand nur der erste Sensor Berücksichtigung. Die Aufzeichnungen von Tag A (1. Tag nach Sensorapplikation) wurden mit den Werten von Tag B (letzter Tag vor dem Sensorversagen) verglichen und alle Besitzer wurden gebeten, einen standardisierten Fragebogen auszufüllen. Ergebnisse In die Studie wurden 24 Hunde mit einem Gewicht von 3,4 bis 36 kg eingeschlossen. Obwohl das Klickgeräusch bei der Platzierung des Sensors die meisten Hunde irritierte, beurteilten Anwender die Applikation als einfach und für die Hunde schmerzlos. Eine kurze Pause nach der lokalen Desinfektion und die Fixierung des Sensors mit einer Pinzette verhinderten ein vorzeitiges Ablösen des Sensors beim Wegziehen des Applikators. Obwohl bei 80 % der Hunde milde bis moderate Hautirritationen beobachtet wurden, waren 95 % der Besitzer mit dieser Form des Monitorings hoch zufrieden. Die mittleren und maximalen Glukosekonzentrationen (p = 0,043, p = 0,003) sowie die Glukosewerte ≥ 11,1 mmol/l (p = 0,032) nahmen von Tag A zu Tag B ab, während die Parameter der glykämischen Variabilität unverändert blieben. Schlussfolgerung und klinische Relevanz Flash-Glukose-Monitoring ist eine praktikable, nebenwirkungsarme Methode mit hoher Besitzerzufriedenheit, mit der sich die glykämische Kontrolle bei diabetischen Hunden verbessern lässt.

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P6: ANTIPLATELET AND ANTICOAGULANT USE IN RANDOMISED TRIALS OF PATIENTS UNDERGOING ENDOVASCULAR INTERVENTION FOR PERIPHERAL ARTERIAL DISEASE: SYSTEMATIC REVIEW

British Journal of Surgery ◽

10.1093/bjs/znab117.091 ◽

2021 ◽

Vol 108 (Supplement_1) ◽

Author(s):

MI Qureshi ◽

HL Li ◽

GK Ambler ◽

KHF Wong ◽

S Dawson ◽

...

Keyword(s):

Systematic Review ◽

Peripheral Arterial Disease ◽

Antiplatelet Therapy ◽

Dual Antiplatelet Therapy ◽

Arterial Intervention ◽

Arterial Disease ◽

Endovascular Intervention ◽

Randomised Trials ◽

Peripheral Arterial ◽

High Level

Abstract Introduction Guideline recommendations for antithrombotic (antiplatelet and anticoagulant) therapy during and after endovascular intervention are patchy and conflicted, in part due to a lack of evidence. The aim of this systematic review was to examine the antithrombotic specifications in randomised trials for peripheral arterial endovascular intervention. Method This review was conducted according to PRISMA guidelines. Randomised trials including participants with peripheral arterial disease undergoing endovascular arterial intervention were included. Trial methods were assessed to determine whether an antithrombotic protocol had been specified, its completeness, and the agent(s) prescribed. Antithrombotic protocols were classed as periprocedural (preceding/during intervention), immediate postprocedural (up to 14 days following intervention) and maintenance postprocedural (therapy continuing beyond 14 days). Trials were stratified according to type of intervention. Result Ninety-four trials were included. Only 29% of trials had complete periprocedural antithrombotic protocols, and 34% had complete post-procedural protocols. In total, 64 different periprocedural protocols, and 51 separate postprocedural protocols were specified. Antiplatelet monotherapy and unfractionated heparin were the most common choices of regimen in the periprocedural setting, and dual antiplatelet therapy (55%) was most commonly utilised postprocedure. There is an increasing tendency to use dual antiplatelet therapy with time or for drug-coated technologies. Conclusion Randomised trials comparing different types of peripheral endovascular arterial intervention have a high level of heterogeneity in their antithrombotic regimens, and there has been an increasing tendency to use dual antiplatelet therapy over time. Antiplatelet regimes need to be standardised in trials comparing endovascular technologies. Take-home message To determine the benefits of any endovascular intervention within a randomised trial, antithrombotic regimens should be standardised to prevent confounding. This systematic review demonstrates a high level of heterogeneity of antithrombotic prescribing in randomised trials of endovascular intervention, and an increasing tendency to utilise dual antiplatelet therapy, despite a lack of evidence of benefit, but an increased risk of harm.

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