The endothelial glycocalyx (eGlx) is a critically important structure lining the luminal surface of endothelial cells. There is increasing evidence, in human patients and animal models, for its ...crucial role in the maintenance of health. Moreover, its damage is associated with the pathogenesis of multiple disease states. This review provides readers with an overview of the eGlx; summarising its structure, essential functions, and evidence for its role in disease. We highlight the lack of studies regarding the eGlx in cats and dogs, particularly in naturally occurring diseases. Importantly, we discuss techniques to aid its study, which can be applied to veterinary species. Finally, we present targeted therapies aimed at preserving, and in some cases, restoring damaged eGlx.
•The endothelial glycocalyx is critical in maintaining vascular health.•Glycocalyx visualisation and measurement is technically challenging.•There is growing evidence for the role of glycocalyx breakdown in human disease.•Research is needed to understand glycocalyx degradation in disease in dogs and cats.
The endothelial glycocalyx (eGlx) lines the luminal surface of endothelial cells, maintaining vascular health. Glycocalyx damage is pathophysiologically important in many diseases across species ...however few studies have investigated its breakdown in naturally occurring disease in dogs. The aims of the study were to investigate eGlx damage in dogs with myxomatous mitral valve disease (MMVD) diagnosed on echocardiography, and dogs in a hypercoagulable state diagnosed using thromboelastography (TEG), by measuring serum hyaluronan concentrations. Serum hyaluronan was quantified in dogs with MMVD (n = 27), hypercoagulability (n = 21), and in healthy controls dogs (n = 18). Serum hyaluronan concentrations were measured using a commercially-available ELISA validated for use in dogs. Hyaluronan concentrations were compared among groups using Kruskal-Wallis tests, and post-hoc with Dunn’s tests. Serum hyaluronan concentrations (median range) were significantly increased in dogs with MMVD (62.4 22.8–201 ng/mL; P = 0.031) and hypercoagulability (92.40 16.9–247.6 ng/mL; P < 0.001) compared to controls (45.7 8.7–80.2 ng/mL). Measurement of serum hyaluronan concentration offers a clinically applicable marker of eGlx health and suggests the presence of eGlx damage in dogs with MMVD and dogs in a hypercoagulable state.
•Few studies have investigated endothelial glycocalyx breakdown in disease in dogs.•Serum hyaluronan is a clinically applicable marker of endothelial glycocalyx health.•Serum hyaluronan was significantly increased in dogs with mitral valve disease.•Serum hyaluronan was significantly increased in dogs in a hypercoagulable state.•Increased serum hyaluronan may indicate glycocalyx shedding in these diseases.
Primary gastric mucormycosis is a rare but potentially lethal fungal infection due to the invasion of Mucorales into the gastric mucosa. It may result in high mortality due to increased risk of ...complications in immunocompromised patients. Common predisposing risk factors to develop gastric mucormycosis are prolonged uncontrolled diabetes mellitus with or without diabetic ketoacidosis (DKA), solid organ or stem cell transplantation, underlying hematologic malignancy, and major trauma. Abdominal pain, hematemesis, and melena are common presenting symptoms. The diagnosis of gastric mucormycosis can be overlooked due to the rarity of the disease. A high index of suspicion is required for early diagnosis and management of the disease, particularly in immunocompromised patients. Radiological imaging findings are nonspecific to establish the diagnosis, and gastric biopsy is essential for histological confirmation of mucormycosis. Prompt treatment with antifungal therapy is the mainstay of treatment with surgical resection reserved in cases of extensive disease burden or clinical deterioration. We presented a case of acute gastric mucormycosis involving the body of stomach in a patient with poorly controlled diabetes and chronic renal disease, admitted with acute onset of abdominal pain. Complete resolution of lesion was noted with 16 weeks of medical treatment with intravenous amphotericin B and posaconazole.
This is the story of a paradox that both limited and stimulated Hong Kong's post-war economy. The book examines how Hong Kong handled, by negotiation, attempts by developed economies to limit ...international trade through protective measures.
Pemphigus vulgaris (PV) is an autoimmune blistering disorder of the skin and mucosal surfaces characterized by acantholysis (loss of adhesion between epidermal cells). Esophageal involvement of PV is ...an underdiagnosed entity as routine diagnostic endoscopy is not recommended in asymptomatic patients. Dysphagia and odynophagia are common presenting symptoms; however, upper gastrointestinal bleeding (UGIB) associated with esophageal involvement of PV without a history of mucosal blistering is extremely uncommon. We present a case of esophageal involvement of PV associated with active UGIB that was diagnosed on endoscopic evaluation. This case illustrated the importance of early endoscopy to identify the esophageal involvement of PV especially in patients with preexisting disease who present with gastrointestinal symptoms such as dysphagia, odynophagia, and hematemesis. Early recognition of esophageal involvement of PV and initiation of corticosteroid and/or immunosuppressant therapy may improve the outcome of the disease.
Protecting Free Trade is the story of a paradox that both limited and stimulated Hong Kong’s post-war economy. In order to preserve its access to open markets, Hong Kong was obligated by ...international agreements to accept restraints on its exports; and in order to sustain growth, Hong Kong had to subject its largest industry — textiles — to a massive network of restrictions. Protecting Free Trade examines how Hong Kong handled, by negotiation, attempts by developed economies to limit international trade through protective measures. The central argument is that, far from stifling Hong Kong’s industry, restrictive international trade agreements became a stimulus for economic success by creating a sellers’ market in which Hong Kong was the dominant supplier. The book is also a personal memoir by someone who was deeply involved in policy formulation.
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