Peritoneal fluid collection in healthy cattle and evaluation of changes in cell morphology during storage in refrigerated and non-refrigerated samples / Colheita do fluido peritoneal de bovinos sadios e verificação das alterações na morfologia celular quando mantido refrigerado ou à temperatura ambiente

This study aimed to evaluate the appropriate sites of abdominocentesis for peritoneal fluid collection in cattle and to investigate the time of cell viability in vitro, comparing three methods of sample conservation. Twenty-one healthy cattle (19 females and 2 males) were subjected to a laparocentesis procedure to obtain peritoneal fluid, with punctures in three defined sites: left cranial, right cranial, and right caudal. The total peritoneal fluid collected was divided into three aliquots and maintained under three preservation conditions: room temperature (26°C), refrigeration (4°C), and room temperature (26°C) with the addition of 1µL of 10% formaldehyde per 1mL of peritoneal fluid. The peritoneal fluid analysis performed immediately after collection consisted of: physical examination (color, appearance, volume, and specific gravity), biochemical measures (pH, total protein, fibrinogen, creatinine, and glucose), and cellularity (total and differential counts). The determination of proteins and the examination of cells were repeated in each separate aliquot at two, four, six, and eight hours after harvest. Data were analyzed through repeated measures ANOVA or Friedman test. The harvest was productive in 67% of cattle. The left cranial and the right cranial puncture sites were the most appropriate. Peritoneal fluid analyzed after collection, the total protein concentration ranged from 1.4 to 3.6g/dL, and number of leukocytes ranged from 54 to 1,322 cells/µL; 60 to 95% of leukocytes were lymphocytes. The protein concentration decreased, but the absolute values of leukocytes, lymphocytes, and segmented neutrophils did not change up to eight hours after collection, independent of the maintenance method. Cell lysis was delayed by cooling, and the addition of formaldehyde did not help preserve the integrity of cellular morphology. Laparocentesis is a safe and secure procedure in cattle and maybe more productive when performed in specific sites on the left or right sides of the cranial abdominal wall. Peritoneal fluid samples may be analyzed with reliable results for up to eight hours after collection when kept refrigerated and for up to six hours when kept at room temperature.(AU)

O estudo teve como objetivo avaliar os locais adequados de laparocentese para a colheita de fluido peritoneal de bovinos e estabelecer o tempo de viabilidade celular in vitro, comparando três métodos de conservação. Vinte e um bovinos hígidos (19 fêmeas e 2 machos) foram submetidos ao procedimento de laparocentese para obtenção de fluido peritoneal, com punção em três pontos definidos: cranial esquerdo, cranial direito e caudal direito. O volume total do líquido peritoneal foi dividido em três alíquotas mantidas sob três métodos de conservação: temperatura ambiente (26°C); refrigeração (4°C); e temperatura ambiente (26°C) com adição de 1µL de formol 10% para cada 1mL de líquido peritonial. A análise do líquido peritoneal realizada imediatamente após sua obtenção consistiu em: exames físico (cor, aspecto, volume e densidade); bioquímicos (pH, proteína total, fibrinogênio, creatinina e glicose); e da celularidade (contagens total e diferencial). A determinação de proteínas e o exame da celularidade foram repetidos, em cada alíquota separada, as duas, quatro, seis e oito horas após a colheita. Análise de variâncias de medidas repetidas ou teste de Friedman foram empregados para avaliação ao longo do tempo. A colheita foi produtiva em 67% dos bovinos e os locais de punção craniais esquerdo e direito foram os mais adequados. A concentração de proteína total variou de 1,4 a 3,6g/dL e o número de leucócitos de 54 a 1.322 células/µL, com predomínio de linfócitos (60 a 95% das células) no fluido peritoneal analisado logo após a colheita. A concentração de proteínas diminuiu, mas os valores absolutos de leucócitos, de linfócitos e de neutrófilos segmentados não se modificaram até oito horas após a colheita, independente do método de manutenção das amostras. A lise celular foi retardada pela refrigeração e a adição de formol não contribuiu para preservar a integridade da morfologia celular. A laparocentese é um procedimento seguro e de execução fácil em bovinos sendo mais produtiva quando realizada em locais específicos à esquerda ou à direita craniais da parede abdominal. Amostras de fluido peritoneal podem ser analisadas com resultados confiáveis quando mantidas refrigeradas por até oito horas após a colheita e quando mantidas à temperatura ambiente por até seis horas.(AU)

Abdominal and pelvic actinomycosis due to longstanding intrauterine device: a slow and devastating infection

Actinomycosis is a chronic or subacute bacterial infection characterized by large abscess formation, caused mainly by the gram-positive non-acid-fast, anaerobic, or microaerophilic/capnophilic, obligate parasites bacteria from the genus. Although pelvic inflammatory disease is an entity associated with the longstanding use of intrauterine devices (IUDs), actinomycosis is not one of the most frequent infections associated with IUDs. We present the case of a 43-year-old female patient who was referred to the emergency facility because of a 20-day history of abdominal pain with signs of peritoneal irritation. Imaging exams revealed collections confined to the pelvis, plus the presence of an IUD and evidence of sepsis, which was consistent with diffuse peritonitis. An exploratory laparotomy was undertaken, and a ruptured left tubal abscess was found along with peritonitis, and a huge amount of purulent secretion in the pelvis and abdominal cavity. Extensive lavage of the cavities with saline, a left salpingo-oophorectomy, and drainage of the cavities were performed. The histopathological examination of the surgical specimen revealed an acute salpingitis with abscesses containing sulfur granules. Therefore, the diagnosis of abdominal and pelvic actinomycosis was made. The postoperative outcome was troublesome and complicated with a colocutaneous fistula, which drained through the surgical wound. A second surgical approach was needed, requiring another extensive lavage and drainage of the recto-uterine pouch, plus the performance of a colostomy. Broad-spectrum antibiotics added to ampicillin were the first antimicrobial regimen followed by 4 weeks of amoxicillin during the outpatient follow-up. The patient satisfactorily recovered and is already scheduled for the intestinal transit reconstitution.

Comparación de los modelos pronósticos APACHE II y Score Salvador en sepsis abdominal / Comparison of APACHE II and Score Salvador models of prediction in abdominal sepsis

La evolución y pronóstico de la sepsis abdominal están determinados por la rapidez con que se efectúa el diagnóstico, intervención apropiada y la eficacia y oportunidad del tratamiento antibiótico. Los estudios clínicos han identificado algunos factores de mal pronóstico, entre los cuales se encuentran el puntaje APACHE II elevado. Nosotros realizamos un estudio retrospectivo en la Unidad de Cuidados Intensivos del Hospital del Salvador, comparando el Score Apache II con un Score local, denominado Score del Salvador, en los pacientes con diagnóstico de sepsis abdominal. Resultados: Hubo 2.158 ingresos en la UCI del Hospital del Salvador, correspondiendo a 7,6% (n =164) de los casos a sepsis abdominal. Las principales causas de infección abdominal fueron perforación intestinal, colangitis, obstrucción intestinal y pancreatitis aguda. La comparación de las curvas receptor-operador del Score del Salvador y el índice pronóstico Apache II, evidencia que no existen diferencias significativas en el área bajo la curva de ambos índices pronósticos en pacientes con sepsis abdominal. Conclusión: Ambos índices pronósticos fueron comparables plenamente. Dado el escaso número de pacientes enrolados y la gravedad de ellos el valor predictivo es limitado lo que sugiere necesario aumentar el tamaño de la muestra y diversificar la gravedad.

The evolution and presage of the abdominal sepsis are determined by the speed with which it is made the diagnosis, appropriate intervention and the effectiveness and opportunity of the antibiotic treatment. The clinical studies have identified some factors of bad presage, among which are the high score APACHE II. We carry out a retrospective study in the Intensive Care Unit of the Salvador’s Hospital, comparing the Apache Score II with a local score, denominated Score of the Salvador to the patients with the diagnose of abdominal sepsis. Results: There were 2.158 revenues in the ICU of the Salvador’s Hospital, corresponding 7,6% (n =164) of the cases to abdominal sepsis. The main causes of abdominal infection were intestinal perforation, colangitis, intestinal obstruction, and sharp pancreatitis. The comparison of the curves receiver-operator of the Salvador’s Score and the index Apache II, it evidences that significant differences don’t exist in the area under the curve of both index in patient with abdominal sepsis. Conclusion: Both scores were comparable fully. Given the scarce number of signed up patients and the graveness of them, the predictive value is limited what suggests necessary to increase the size of the sample and to diversify the graveness.

first report of abdominal mesothelioma in a ram in Iran

Primary tumours arising from the mesothelial cells lining the peritoneal cavity, mesothelioma, have been recorded in the abdominal cavity of cattle, horses, dogs and cats. Abdominal tumour masses from a five-year-old male kordi sheep were found during routine inspection at the Mashhad abattoir. At gross examination, the tumour consisted of gray-white multiple firm, sessile nodules, approximately 2.60 kg in weight. Histopathological examination revealed numerous thin papillary projections covered by cuboidal cells with large vesicular nuclei and prominent nucleoli and in some areas the neoplastic cells lined cystic spaces. Mitotic figures were few. Based on histopathological findings, the tumour was diagnosed as abdominal mesothelioma

Absceso esplénico por citrobacter diversus / Splenic abscess citrobacter diversus

Se reporta un inusual caso de absceso esplénico en un paciente pedriátrico. Se trata de una niña de 10 años portadora heterocigoto de Hb S, con bronconeumonía y derrame pericárdico asociado. El diagnóstico incial se realizó por los hallazgos clínicos característicos y se confirmó con estudios ecográficos y de tomografía computada abdominal. El tratamiento incluyó antibióticos de amplio espectro y laparotomía con esplenectomía. Se aisló Citrobacter diversus en el cultivo del material purulento obtenido preoperatoriamente. La evolución ulterior fue satisfactoria.