{"id":25862,"date":"2023-01-18T18:08:57","date_gmt":"2023-01-18T17:08:57","guid":{"rendered":"https:\/\/www.mylav.net\/nekategorizirano-sl\/novi-profili-fip-a-kako-ih-mozete-iskoristiti\/"},"modified":"2024-02-08T18:51:43","modified_gmt":"2024-02-08T17:51:43","slug":"novi-profili-fip-kako-jih-koristiti","status":"publish","type":"post","link":"https:\/\/www.mylav.net\/sl\/nekategorizirano-sl\/novi-profili-fip-kako-jih-koristiti\/","title":{"rendered":"NOVI PROFILI FIP: KAKO JIH KORISTITI"},"content":{"rendered":"

Letos smo se odlo\u010dili ustvariti profile, ki bodo zdravnikom v pomo\u010d pri diagnosticiranju, zdravljenju in spremljanju ma\u010djega infekcijskega peritonitisa (FIP). V tem blogu si bomo ogledali, kako jih je mogo\u010de koristno uporabiti.<\/p>\n

Suhi FIP: predlagamo obse\u017een hematolo\u0161ko-biokemi\u010dni profil, ki vklju\u010duje krvno sliko, celotne biokemijske klini\u010dne preiskave in elektroforezo.
\nV to osnovno podatkovno bazo dodajamo test ma\u010djega alfa-1-kislega glikoproteina (fAGP), beljakovine akutne faze, ki je zelo uporabna pri sumu na FIP – glejte tudi na\u0161 nedavni blog: VRNITEV VELIKE KLASIKE: MA\u010cJI AGP (ALFA-1 KISLI GLIKOPROTEIN)<\/a> – in doziranje protiteles proti ma\u010djemu koronavirusu s tehniko IFI (posredna imunofluorescenca).<\/p>\n

Te\u017eava pri pacientih s suhim FIP je nespecifi\u010dnost \u0161tevilnih klini\u010dno-patolo\u0161kih znakov kroni\u010dnega vnetnega tipa: za dokon\u010dno potrditev teh oblik bi bilo treba z imunohistokemijo in\/ali molekularno biologijo (PCR) neposredno dolo\u010diti koronavirus v parenhimatoznih spremembah. Ti postopki so invazivni, saj je treba opraviti biopsijski odvzem vzorca, in jih ni vedno lahko izvesti. <\/p>\n

Prisotnost tipi\u010dnih hematobiokemi\u010dnih\/elektroforeti\u010dnih nepravilnosti, povezanih s srednjim\/visokim titrom IFI v serumu in povi\u0161ano koncentracijo AGP, bi znatno podprla klini\u010dni sum na suhi FIP. Natan\u010dneje, v primeru FIP lahko diferencialni pregled krvi, vklju\u010den v raz\u0161irjeni profil, omogo\u010di odkrivanje normocitne normokromne ali morda mikrocitne neregenerativne anemije, povezane z nevtrofilno levkocitozo in\/ali limfopenijo.<\/p>\n

Biokemi\u010dna slika lahko poka\u017ee spremembe, ki prizadenejo enega ali ve\u010d organov, med katerimi so zlasti pogoste spremembe, ki ka\u017eejo na okvaro ledvic (pove\u010dana kreatinin in se\u010dnina) in jeter (pove\u010dani ALT, ALP in bilirubin), zlasti pa hiperproteinemija, hipoalbuminemija in inverzija razmerja albumin\/globulin.<\/p>\n

Slednje spremembe je mogo\u010de dodatno raziskati z elektroforezo, vklju\u010deno v profil, ki obi\u010dajno v poteku FIP poka\u017ee pove\u010dane alfa2 in gama-globuline, ter z dolo\u010ditvijo fAGP, ki je v primeru FIP obi\u010dajno zelo visok (obi\u010dajno >1500 ug\/mL). <\/p>\n

\"Kapilarna
Kapilarna elektroforeza seruma ma\u010dke s FIP s hipoalbuminemijo in izrazito poliklonsko gamopatijo<\/figcaption><\/figure>\n

Efuzivni FIP<\/strong>: v primerjavi s suhim FIP imajo efuzivne oblike to prednost, da omogo\u010dajo analizo kavitarnega izliva, kar v \u0161tevilnih primerih omogo\u010da potrditev diagnoze. Poleg popolne hematokemije in testa fAGP, s katerima lahko odkrijemo zgoraj opisane tipi\u010dne spremembe, hkrati opravimo citokemi\u010dno analizo kavitarnega izliva in odkrijemo virus v zbirki s PCR.<\/p>\n

Dejansko imajo izlivi bolnikov s FIP kemi\u010dne (visoka vsebnost beljakovin, razmerje albumin\/globulin pogosto < 0,8, visoko razmerje med LDH in skupnimi celicami v izlivu) in citolo\u0161ke (prisotnost asepti\u010dnega eksudata z nizko koncentracijo celic, beljakovinsko ozadje in prevlada nedegeneriranih nevtrofilnih granulocitov) zna\u010dilnosti, ki zelo nakazujejo na FIP.\n\nPozitivna PCR v teko\u010dini 100 % potrdi diagnozo FIP (visoka specifi\u010dnost), \u010deprav ob\u010dutljivost molekularne biologije ni absolutna (ob\u010dutljivost pribli\u017eno 70-80 %).\n \nSpremljanje FIP<\/strong>: Pri ma\u010dkah s potrjeno diagnozo FIP predlagamo profil spremljanja terapije z uporabo osnovnega hematobiokemi\u010dnega profila in odmerka fAGP. Klini\u010dno izbolj\u0161anje mora spremljati tudi izbolj\u0161anje klasi\u010dnih hemato-bio kemi\u010dnih sprememb bolezni in zmanj\u0161anje fAGP.<\/p>\n

Ma\u010dja zaveti\u0161\u010da, kolonije in vzrejne farme<\/strong>: znano je, da koronavirus, ki povzro\u010da FIP, izhaja iz enteri\u010dnega ma\u010djega koronavirusa z genetskimi mutacijami, zaradi katerih lahko oku\u017ei makrofage in vdre v tkiva: ve\u010dji kot sta pretok in razmno\u017eevanje enteri\u010dnega koronavirusa med ma\u010dkami, ve\u010dja je verjetnost pojava odkritega FIP.<\/p>\n

V okoljih s potencialno visokim pretokom ma\u010djega koronavirusa imamo dve mo\u017eni metodi za njegovo spremljanje.<\/p>\n

Serologija z uporabo IFI nam omogo\u010da razumevanje stopnje izpostavljenosti ma\u010dk v tem okolju prej\u0161njim oku\u017ebam.<\/p>\n

Poleg tega nam iskanje koronavirusa v iztrebkih omogo\u010da razumevanje, kateri so lahko izlo\u010ditelji, \u010deprav se je treba zavedati, da je lahko izlo\u010danje virusa z iztrebki neredno in remisijsko, celo pri popolnoma asimptomatskih bolnikih.<\/p>\n

Za pravilno prepre\u010devanje je zato pomembno, da se \u010dim bolj zmanj\u0161a \u0161tevilo ma\u010dk na posamezno okolje in da se uporabijo serolo\u0161ke preiskave in\/ali preiskave PCR na blatu<\/strong>, ki se s\u010dasoma ponavljajo, ki se izvajajo kot \u00bbnaklju\u010dni vzorci\u00ab na vsaki skupini \u017eivali in razli\u010dno pogosto glede na \u0161tevilo prisotnih ma\u010dk (pogosteje, npr. enkrat na mesec, \u010de je ma\u010dk veliko, v ve\u010djem \u010dasovnem razmaku, \u010de je \u0161tevilo ma\u010dk majhno).<\/p>\n

Za ustrezno preventivo je zato pomembno \u010dim bolj zmanj\u0161ati \u0161tevilo ma\u010dk v okolju in uporabljati ponavljajo\u010de se serolo\u0161ke in\/ali PCR teste blata skozi \u010das, ki se izvajajo kot \u00bbnaklju\u010dni vzorci\u00ab na vsaki skupini \u017eivali in z<\/p>\n

\nSaverio Paltrinieri<\/strong>, Med. Vet. EBVS European Specialist in Veterinary Clinical Pathology (Dipl. ECVCP); Universit\u00e0 di Milano
\nWalter Bertazzolo<\/strong>, Med. Vet. EBVS European Specialist in Veterinary Clinical Pathology (Dipl. ECVCP); Direttore Scientifico di MYLAV\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Letos smo se odlo\u010dili ustvariti profile, ki bodo zdravnikom v pomo\u010d pri diagnosticiranju, zdravljenju in […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[],"tags":[],"class_list":["post-25862","post","type-post","status-publish","format-standard","hentry"],"acf":[],"yoast_head":"\nNOVI PROFILI FIP: KAKO JIH KORISTITI - MyLav<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.mylav.net\/sl\/nekategorizirano-sl\/novi-profili-fip-kako-jih-koristiti\/\" \/>\n<meta property=\"og:locale\" content=\"sl_SI\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"NOVI PROFILI FIP: KAKO JIH KORISTITI - MyLav\" \/>\n<meta property=\"og:description\" content=\"Letos smo se odlo\u010dili ustvariti profile, ki bodo zdravnikom v pomo\u010d pri diagnosticiranju, zdravljenju in […]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.mylav.net\/sl\/nekategorizirano-sl\/novi-profili-fip-kako-jih-koristiti\/\" \/>\n<meta property=\"og:site_name\" content=\"MyLav\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/laboratoriolavallonea\/\" \/>\n<meta property=\"article:published_time\" content=\"2023-01-18T17:08:57+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-02-08T17:51:43+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.mylav.net\/wp-content\/uploads\/2019\/02\/social_cover.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"epops\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"epops\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.mylav.net\\\/sl\\\/nekategorizirano-sl\\\/novi-profili-fip-kako-jih-koristiti\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.mylav.net\\\/sl\\\/nekategorizirano-sl\\\/novi-profili-fip-kako-jih-koristiti\\\/\"},\"author\":{\"name\":\"epops\",\"@id\":\"https:\\\/\\\/www.mylav.net\\\/sl\\\/#\\\/schema\\\/person\\\/1f212c868d6970154f91b93e9741dddb\"},\"headline\":\"NOVI PROFILI FIP: KAKO JIH KORISTITI\",\"datePublished\":\"2023-01-18T17:08:57+00:00\",\"dateModified\":\"2024-02-08T17:51:43+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.mylav.net\\\/sl\\\/nekategorizirano-sl\\\/novi-profili-fip-kako-jih-koristiti\\\/\"},\"wordCount\":799,\"publisher\":{\"@id\":\"https:\\\/\\\/www.mylav.net\\\/sl\\\/#organization\"},\"inLanguage\":\"sl-SI\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.mylav.net\\\/sl\\\/nekategorizirano-sl\\\/novi-profili-fip-kako-jih-koristiti\\\/\",\"url\":\"https:\\\/\\\/www.mylav.net\\\/sl\\\/nekategorizirano-sl\\\/novi-profili-fip-kako-jih-koristiti\\\/\",\"name\":\"NOVI PROFILI FIP: KAKO JIH KORISTITI - 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