M J Sharman

University of Melbourne, Melbourne, Victoria, Australia

Are you M J Sharman?

Claim your profile

Publications (8)11.73 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Confocal endomicroscopy (CEM) is an endoscopic technology permitting in vivo cellular and subcellular imaging. CEM aids real-time clinical assessment and diagnosis of various gastrointestinal diseases in people. CEM allows in vivo characterization of small intestinal mucosal morphology in dogs. Objective To determine the feasibility of CEM to evaluate gastric mucosal morphology in dogs and to characterize the appearance in healthy dogs. AnimalsFourteen clinically healthy research colony dogs. Methods Experimental study. Under general anesthesia, dogs underwent standard endoscopic evaluation and CEM of the gastric mucosa. In the initial 6 dogs, fluorescent contrast was provided with the fluorophore acriflavine (0.05% solution), applied topically. Subsequently, 8 dogs were assessed using a combination of fluorescein (10% solution, 15 mg/kg IV), followed by acriflavine administered topically. For each fluorophore, a minimum of 5 sites were assessed. ResultsConfocal endomicroscopy provided high quality in vivo histologically equivalent images of the gastric mucosa, but reduced flexibility of the endoscope tip limited imaging of the cranial stomach in some dogs. Intravenous administration of fluorescein allowed assessment of cellular cytoplasmic and microvasculature features. Topical application of acriflavine preferentially stained cellular nucleic acids, allowing additional evaluation of nuclear morphology. Identification of Helicobacter-like organisms was possible in 13 dogs. Conclusion and Clinical ImportanceConfocal endomicroscopy provides in vivo images allowing assessment of gastric mucosal morphology during endoscopy, potentially permitting real-time diagnosis of gastrointestinal disease.
    Journal of Veterinary Internal Medicine 03/2014; · 2.06 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Confocal endomicroscopy (CEM) is an endoscopic technology that permits in vivo cellular and subcellular imaging of the gastrointestinal mucosa. To determine the feasibility of CEM to evaluate small intestinal mucosal topologic morphology in dogs and to characterize the appearance in healthy dogs. Fourteen clinically healthy research colony dogs. Experimental study. Dogs were anesthetized for standard endoscopic evaluation of the small intestine followed by CEM. Two fluorophores were used to provide contrast: fluorescein (10% solution, 15 mg/kg IV) before administration of topical acriflavine (0.05% solution) via an endoscopy spray catheter. A minimum of 5 sites within the small intestine were assessed and at each location, sequential adjustment of imaging depth allowed collection of a three-dimensional volume equivalent to an 'optical biopsy'. CEM-guided pinch biopsies were obtained for histologic examination. CEM provided high-quality in vivo cellular and subcellular images. Intravenous administration of fluorescein provided sufficient contrast to allow assessment of the vasculature, cellular cytoplasmic features and goblet cell numbers, and distribution. Topical application of acriflavine preferentially stained cellular nucleic acids, allowing evaluation of nuclear morphology. Quality of captured images was occasionally affected by motion artifact, but improved with operator experience. CEM provides in vivo images that allow for cellular and subcellular assessment of intestinal mucosal morphology during endoscopy. This has implications for aiding in vivo diagnosis of gastrointestinal disease.
    Journal of Veterinary Internal Medicine 10/2013; · 2.06 Impact Factor
  • Source
    M J Sharman, C S Mansfield, T Whittem
    [Show abstract] [Hide abstract]
    ABSTRACT: This study described the pharmacokinetics of the intravenous fluorophore, fluorescein, and aimed to evaluate its utility for use in upper gastrointestinal confocal endomicroscopy (CEM). Six healthy, mature, mixed-breed dogs were anesthetized and then dosed intravenously with fluorescein at 15 mg/kg. Blood samples were collected at predetermined time-points. Dogs were examined by upper gastrointestinal confocal endomicroscopy and monitored for adverse effects. Plasma fluorescein concentrations were measured using high-performance liquid chromatography (HPLC) with UV/Vis detection. Mean plasma concentration at 5 min was 57.6 ± 18.2 mg/L, and plasma concentrations decreased bi-exponentially thereafter with a mean concentration of 2.5 mg/L ± 1.26 at 120 min. Mean terminal plasma elimination half-life (t(½β) ) was 34.8 ± 8.94 min, and clearance was 9.1 ± 3.0 mL/kg/min. Apparent volume of distribution at steady-state was 0.3 ± 0.06 L/kg. Fluorescein provided optimal fluorescent contrast to enable in vivo histologically equivalent evaluation of topologic mucosal morphology within the first 30 min following intravenous administration. Adverse effects were not observed. Based upon the calculated clearance, a constant rate infusion at a rate of 0.18 mg/kg/min is predicted to be adequate, following an initial loading dose (2 mg/kg), to maintain plasma concentration at 20 mg/L for optimal CEM imaging during the study period.
    Journal of Veterinary Pharmacology and Therapeutics 12/2012; · 1.35 Impact Factor
  • Source
    M J Sharman, C S Mansfield
    [Show abstract] [Hide abstract]
    ABSTRACT: Sinonasal aspergillosis is an uncommon, yet debilitating and often frustrating condition to treat in dogs despite years of research evaluating pathogenesis, diagnosis and treatment. The disease is most commonly caused by non-invasive fungal infection, thought to be secondary to altered innate and/or adaptive immune responses. Attempts to confirm this have however failed. A variety of conflicting opinions regarding the diagnosis and treatment of sinonasal aspergillosis exist. Often the use of a particular treatment protocol is based upon personal or regional preference. Evaluation of the veterinary literature demonstrates that the evidence base in support of individual treatment recommendations is weak. A number of recent publications have helped to expand the current knowledge base and therefore our understanding of important practicalities for both diagnostic options and treatment protocols. The following review examines the current evidence for the pathogenesis of sinonasal aspergillosis in dogs, as well as the various diagnostic options. The available evidence for frequently utilised -therapeutic options and their likely outcomes is also explored.
    Journal of Small Animal Practice 07/2012; 53(8):434-44. · 1.18 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Multiple topical treatments are often required for clinical cure of mycotic rhinosinusitis in dogs. The objective of this study was to describe the distribution and retention of enilconazole and clotrimazole solutions using a temporary trephination protocol. Nine client-owned dogs diagnosed with mycotic rhinosinusitis between March 2008 and December 2009 were prospectively enrolled and were sequentially allocated to receive treatment with either clotrimazole (1% in polyethylene glycol) or enilconazole (10% solution), after imaging and rhinoscopic assessment. Both frontal sinuses were trephined, debrided and flushed with saline. Infusion was administered via frontal sinuses with dogs in sternal recumbency and computed tomography (CT) performed 5 minutes after completion. Distribution was scored 1 to 4 at the canine tooth, premolar 4, cribriform plate and frontal sinus on both sides, for a maximum score of 32. Distribution of antifungal agents to all regions of the nasal cavity and frontal sinuses was achievable, but varied considerably. Retention was poor in 10 of 18 regions assessed. Distribution of antifungal agents within the frontal sinuses is achievable using temporary trephination; however, distribution is variable and retention is often poor.
    Journal of Small Animal Practice 02/2012; 53(3):161-7. · 1.18 Impact Factor
  • The Veterinary record 09/2010; 167(11):421. · 1.80 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To retrospectively review the first treatment response of dogs with mycotic rhinosinusitis to commonly utilised treatment techniques. Medical records of dogs treated for mycotic rhinosinusitis were obtained retrospectively via a manual review of the clinical databases of six veterinary referral centres for the period of January 1998 to June 2008, and first treatment outcome was evaluated. Historical and clinicopathological findings were also reviewed to evaluate their impact on treatment success or failure. There was no significant difference in first treatment outcome between treatment groups (P=0.21). When all topical treatments were considered together (n=85), 39 dogs (45.8%) had a successful first treatment. Initial treatment success was associated with a younger age (56.3 versus 75.8 months; P=0.02) and was 2.7 times more likely in dogs with unilateral disease, although this was not significant (P=0.07). Adjunctive therapy with systemic antifungal agents was associated with treatment failure (P< or =0.01). Fifty-nine dogs (69.4%) responded successfully following multiple treatments. Treatment of mycotic rhinosinusitis remains challenging, and multiple treatments are frequently required for adequate treatment. Reasons for first treatment failure are likely multifactorial in origin, making it difficult to predict those dogs that are likely to have a superior prognosis, regardless of the treatment type used.
    Journal of Small Animal Practice 08/2010; 51(8):423-7. · 1.18 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To establish reference values for activated coagulation time (ACT) in normal cats and dogs, by visual assessment of clot formation using the MAX-ACT(TM) tube. We recruited 43 cats and 50 dogs for the study; 11 cats and 4 dogs were excluded from the statistical analysis because of abnormalities on clinical examination or laboratory testing including anaemia, prolonged prothrombin time (PT) or activated partial thromboplastin time (APTT), or insufficient plasma volume for comprehensive laboratory coagulation testing. Blood samples were collected via direct venipuncture for MAX-ACT, packed cell volume/total solids, manual platelet estimation and PT/APTT measurement. Blood (0.5 mL) was mixed gently in the MAX-ACT tube at 37 degrees C for 30 s, then assessed for clot formation every 5 to 10 s by tipping the tube gently on its side and monitoring for magnet movement. The endpoint was defined as the magnet lodging in the clot. The technique was tested with 10 dogs by collecting two blood samples from the same needle insertion and running a MAX-ACT on each simultaneously. In normal cats the mean MAX-ACT was 66 s (range 55-85 s). In normal dogs the mean was 71 s (range 55-80 s). There was no statistical difference between the first and second samples collected from the same needle insertion. and Clinical Relevance In both cats and dogs, a MAX-ACT result >85 s should be considered abnormal and further coagulation testing should be performed. Additionally, failure to discard the first few drops of the sample does not appear to significantly affect results.
    Australian Veterinary Journal 08/2009; 87(7):292-5. · 0.92 Impact Factor