Non-late-onset neutropaenia following treatment of multiple sclerosis with ocrelizumab.

Late-onset neutropaenia is defined as an absolute neutrophil count of <1.5×103cells/µL starting>4 weeks after the last dose of rituximab, in the absence of other identifiable causes. Late-onset neutropaenia is a rare adverse reaction to rituximab (observed in approximately 5% of patients). Rheumatic diseases constitute the main indication for rituximab; in these patients, neutropaenia appears after a mean of>28 days. Ocrelizumab is another monoclonal antibody that binds to CD20 (a glycosylated phosphoprotein mainly expressed on the membranes of B-lymphocytes); in January 2018, it was approved for the treatment of relapsing-remitting and primary progressive multiple sclerosis. We present a case of neutropaenia following intravenous infusion of ocrelizumab in a patient with primary progressive multiple sclerosis who presented with neutropaenic fever, herpetic stomatitis, and ecthyma gangrenosum only 20 days after infusion.

Comparing optic nerve head parameters in two Spanish dog breeds using digital planimetry.

The optic discs of dogs exhibit considerable size, shape, and colour variations, depending on the degree of myelination. This variability makes the interpretation of lesions difficult, owing to the lack of reference patterns. This study aimed to compare optic nerve head (ONH) parameters determined by digital planimetry (DP) in two pure-bred dogs, Spanish Greyhound (SG) and Spanish Water Dog (SWD). The vertical and horizontal diameters, area, circularity, and the proportion of the ONH at the tapetal or non-tapetal zone (top height and bottom height) were calculated using image treatment software and compared between breeds. Significant between-breed differences were detected for all parameters, with SWD exhibiting greater height, width, area, top height, and lower circularity of the ONH than SG. Linear regression revealed that age significantly influenced mean disc height (R2 = 0.310; p = 0.0001), mean disc width (R2 = 0.280; p = 0.0001), mean disc area (R2 = 0.281; p = 0.0001), and circularity (R2 = 0.243; p = 0.0001). The multiple regression model significantly predicted mean disc height, width, and area [(S) (R2 = 0.715; p = 0.001), (R2 = 0.742; p = 0.001), and (S) (R2 = 0.736; p = 0.001), respectively], based on age and breed. Excellent concordance was observed between the measurements of experienced and novice researchers, and there were no differences between the parameters measured by the researcher and those obtained by the software. Planimetric ONH measurements can be easily performed by novice operators using a portable fundus camera and digital computer software. These results may be of considerable clinical value, but further studies are required because of the great variability of the ONH in dogs.

Non-late-onset neutropaenia following treatment of multiple sclerosis with ocrelizumab / Neutropenia de aparición no tardía tras el tratamiento con ocrelizumab para la esclerosis múltiple

Late-onset neutropaenia is defined as an absolute neutrophil count of <1.5 × 103 cells/μL starting > 4 weeks after the last dose of rituximab, in the absence of other identifiable causes.Late-onset neutropaenia is a rare adverse reaction to rituximab (observed in approximately 5% of patients). Rheumatic diseases constitute the main indication for rituximab; in these patients, neutropaenia appears after a mean of > 28 days.Ocrelizumab is another monoclonal antibody that binds to CD20 (a glycosylated phosphoprotein mainly expressed on the membranes of B-lymphocytes); in January 2018, it was approved for the treatment of relapsing-remitting and primary progressive multiple sclerosis.We present a case of neutropaenia following intravenous infusion of ocrelizumab in a patient with primary progressive multiple sclerosis who presented with neutropaenic fever, herpetic stomatitis, and ecthyma gangrenosum only 20 days after infusion.(AU)

La neutropenia de aparición tardía se define como un recuento absoluto de neutrófilos < 1,5 × 103/μl que se produce > 4 semanas después de la última dosis de rituximab, precedido por un recuento de neutrófilos normal y sin otra causa identificable. Es una complicación rara del tratamiento con rituximab, habiéndose observado en aproximadamente el 5% de los pacientes tratados, siendo las enfermedades reumáticas su principal indicación, con un tiempo medio hasta el desarrollo de la neutropenia de al menos 28 días. El ocrelizumab, al igual que el rituximab, es un anticuerpo monoclonal dirigido a CD20, una fosfoproteína glicosilada de membrana que se encuentra predominantemente en los linfocitos B y que se aprobó en enero de 2018 para el tratamiento de la esclerosis múltiple remitente recurrente y la esclerosis múltiple progresiva primaria. Se describe un caso de neutropenia después de la infusión de ocrelizumab en un paciente con esclerosis múltiple progresiva primaria que presentó neutropenia febril, estomatitis herpética y ectima gangrenoso solo 20 días después de la infusión.(AU)

Non-late-onset neutropaenia following treatment of multiple sclerosis with ocrelizumab.

Late-onset neutropaenia is defined as an absolute neutrophil count of <1.5×103cells/µL starting>4 weeks after the last dose of rituximab, in the absence of other identifiable causes. Late-onset neutropaenia is a rare adverse reaction to rituximab (observed in approximately 5% of patients). Rheumatic diseases constitute the main indication for rituximab; in these patients, neutropaenia appears after a mean of>28 days. Ocrelizumab is another monoclonal antibody that binds to CD20 (a glycosylated phosphoprotein mainly expressed on the membranes of B-lymphocytes); in January 2018, it was approved for the treatment of relapsing-remitting and primary progressive multiple sclerosis. We present a case of neutropaenia following intravenous infusion of ocrelizumab in a patient with primary progressive multiple sclerosis who presented with neutropaenic fever, herpetic stomatitis, and ecthyma gangrenosum only 20 days after infusion.

Comparative study of select biochemical markers in cerebrospinal fluid of healthy dogs before and after treatment with nutraceuticals.

BACKGROUND: Several studies indicate that changes in cerebrospinal fluid (CSF) composition depend on the disease stage and reflect modification of brain energy metabolism (BEM). Also, it has been reported that a decline in cognitive functions may be mitigated by incorporating nutraceuticals in the diet. OBJECTIVE: Assuming the beneficial effect of nutraceuticals on BEM and oxidative damage, the aim of this study was to determine if the administration of a nutraceutical compound results in changes of select CSF biomarkers in healthy adult Beagle dogs. METHODS: Two separate CSF and blood samples were obtained from 11 healthy adult Beagle dogs, before and after 50 days of treatment with a veterinary combined nutraceutical. CSF analysis included a total nucleated cell count, total protein, glucose, sodium, chloride, potassium, pyruvate, and lactate concentrations, and calculation of lactate/pyruvate ratio. CBC and serum biochemistry were also performed. The Wilcoxon test was used to analyze the significance of the changes after nutraceutical treatment. RESULTS: All studied variables remained within reference intervals, before and after treatment. A significant increase in CSF sodium and glucose concentration, and a decrease in lactate levels, was observed after treatment (P < .05), and the lactate/pyruvate ratio was decreased after treatment (P = .05). In serum, sodium and chloride concentrations were significantly increased (P < .05), and creatinine concentration was significantly decreased (P < .05) after treatment. CONCLUSIONS: After 50 days of treatment with a nutraceutical compound, CSF glucose, sodium, and lactate concentrations, and L/P ratio were significantly different, suggesting an influence of nutraceuticals' administration on CSF composition.

Oligodendroglial gliomatosis cerebri in a poodle.

Gliomatosis cerebri (GC) is a rare, diffusely infiltrating, glial cell tumour of neuroepithelial origin. This report describes a case of oligodendroglial GC in a 6-year-old male Poodle with central nervous system symptoms. Computed tomography revealed anomalous parenchyma density and ventricular asymmetry. Cerebrospinal fluid showed elevated protein (30 mg dL(-1)) and nucleated cell count (20 µL(-1)). Presumptive diagnosis of necrotizing meningoencephalitis was made. Because of rapid deterioration of the general condition of the animal, the dog was euthanized. Histologically there was an infiltration of round or ovoid neoplastic cells in the white matter of the left cerebral hemisphere and in leptomeninges. Immunohistochemistry showed that 80% of the neoplastic cells expressed Olig2 and some 50% expressed glial fibrilary acidic protein. On the basis of clinical, histological and immunohistochemical features, a diagnosis of oligodendoglial GC was done. This case represents the first report of a case of oligodendroglial GC in the canid.

Presumed primary uveal melanoma with brain extension in a dog.

A 13-year-old, female, mixed, cocker spaniel was examined for a unilateral exophthalmia and protruding mass in episcleral region of the right eye. Mode B ocular ultrasonography revealed a mass extended intraocular from anterior chamber to posterior pole without evidence of extraocular extension. A presumptive diagnosis of melanocytic tumour was made. A complete blood count and chemistry and thoracic radiographs did not show any abnormal changes. The recommended treatment was enucleation, and melanocytic nature of the tumour was confirmed by immunohistochemistry. Three months after surgery, the animal showed a status epilepticus refractory to treatment. Computed tomographic examination of the brain revealed changes compatible with a tumour. Cerebrospinal fluid analysis was normal. Because of the poor clinical prognosis, the owners elected to have the dog euthanased.

Expression of Ol-KIP, a cyclin-dependent kinase inhibitor, in embryonic and adult medaka (Oryzias latipes) central nervous system.

From an expression screen in a fish model, the medaka, we have isolated Ol-KIP (Oryzias latipes-kinase inhibitor protein), a new member of the KIP subfamily of cyclin-dependent kinase (Cdk) inhibitors. We have analysed its expression in the developing and adult brain by in situ hybridization and by double labeling with Ol-KIP mRNA and proliferating cell nuclear antigen (PCNA) antibodies. Ol-KIP presents a complex expression pattern in several areas of the embryonic central nervous system, most often in close vicinity to proliferative neuroepithelia. We studied in great detail its expression in the optic tectum: Ol-KIP is expressed in a ring-shaped domain lying exactly between the proliferative and the postmitotic zones of this structure and is, therefore, potentially involved in cell cycle exit. In the adult CNS, Ol-KIP expression persists in numerous nuclei, both close and distant from proliferative ventricular areas. So, Ol-KIP expression is in part compatible with a sustained "stop signal" role for proliferation, but its expression in postmitotic zones suggests that KIP proteins may have late neuronal function(s), in addition to inhibiting Cdks. This first detailed study of the expression profile of a KIP gene in a nonmammalian vertebrate, thus, opens perspectives for analysing the role of these regulators in brain development and function.

Limited incision cholecystectomy.

Eighty-one consecutive cholecystectomies were retrospectively reviewed; five were dropped because of incomplete data. The remaining 76 were divided into group A, patients who underwent a limited incision cholecystectomy (LIC) defined as less than 10 centimeters, and group B, those who underwent a standard subcostal incision (STD). An STD was used for 18 patients in 1984 and an LIC for subsequent patients unless anatomy dictated extension of the incision for safe surgical exposure. The groups were evaluated for possible benefits and disadvantages of the LIC approach. Multivariate analysis was done to contrast the approaches regarding operative time, operative and postoperative complications, postoperative pain, and hospital stay. The operative time was comparable between the two groups. The LIC approach was superior with less postoperative pain and shorter hospital stay. There were no intraoperative complications or mortality in either group. The postoperative complications were also comparable. No differences were noted in body size, weight, sex, or whether the patient was suffering from acute or chronic disease. The limited incision cholecystectomy can be utilized in the majority of patients with cholecystitis without added operative time or complications when compared to the traditional approach. The benefits of less postoperative pain, shorter hospital stay and better cosmetic results afford a higher degree of patient acceptance. This procedure should be considered when open cholecystectomy is required.

[Diaphragmatic and Erb-Duchenne's paralysis: an infrequent obstetric trauma]. / Parálisis diafragmática y de Erb-Duchenne: un traumatismo obstétrico infrecuente.

The authors report a case of brachial paralysis and paralysis of the right hemidiaphragm which followed a favorable course. Comments are made on the symptomatology and course of the disease.

[The potentially infected newborn infant]. / El recién nacido potencialmente infectado.

In order to establish relationship between premature rupture of membranes (RPM) and neonatal infection, together with the importance of other factors during this process, 50 newborns with history of RPM were studied. In a control group and in groups of newborns with less than and more than 24 hours of plain RPM, related to clinically healthy and vigorous infants, no case of infection was found. On the other hand, 30% and 60% respectively of infections were found in groups less than and more than 24 hours of RPM, but with the presence of other contaminating factors that impair immunological response of the newborn, such as: acute maternal infection, prolonged delivery, unexpected birth, pediatric reanimation procedures, organic immaturity, fetal suffering, immediatie neonatal depression and intercurrent pathology. There were two deaths: a case with RPM of 5 hours and another one with 38 hours, but both with high rating due to the presence and intensity of "aggravating factors" mentioned having internal action mechanism that apparently of restrains to the perpetuation of the hypoxia-acidosis cycle. A provisional sheet is presented to evaluate such "aggravating factors" considering that an RPM associated to them represents a high risk of neonatal infection. In cases of clinically healthy newborns with plain RPM, we advice only to watch over them for 3--5 day, but no antimicrobial treatment at all.