[Enteritis cystica profunda]. / L'entérite kystique profonde.

Enteritis cystica profunda is a rare and benign disease defined as the invagination of the intestinal epithelium into the submucosa and more profound layers of intestinal wall leading to the formation of mucin-filled cystic spaces. We reported the case of a 45-year-old female, suffering from a Crohn's disease, with a Koenig's syndrome, diarrhea, abdominal pain and weight loss. The colonoscopy and the abdominopelvic scan showed a terminal ileal stenosis, with parietal calcifications. A surgical ileocecal resection was decided. Gross examination of the ileocecal resection showed a thickening of the ileal wall, with many mucin-filled cysts measuring 1mm to 2cm, with some calcifications. The ileal mucosa was ulcerated, and showed a stenotic sector extending over 3cm. Histological examination showed acute ulcerated ileitis lesions, with chronic ileitis lesions and stenosis, compatible with the known diagnosis of Crohn's disease. There were also many cysts into the ileal wall. They were lined with a regular ileal epithelium. The cysts contained mucus, with some calcifications. Some cysts were ruptured, with extravasation of mucus within the wall. Cystica profunda can be found anywhere along the digestive tract. The physiopathology is not yet well understood, but it seems to be favored by chronic aggression of the intestinal wall. This pathology most often coexists with Crohn's disease. The main differential diagnosis is mucinous adenocarcinoma. Cystica profunda does not require any specific treatment.

Cuidados de enfermagem ao usuário diagnosticado com doença de Crohn: uma revisão integrativa / Nursing care for users diagnosed with Crohn's disease: an integrative review / Cuidados de enfermería a usuarios diagnosticados de enfermedad de Crohn: una revisión integradora

Objetivo: identificar os cuidados de enfermagem direcionados a usuários diagnosticados com a doença de Crohn. Método: trata-se de uma revisão integrativa da literatura, realizada na Literatura Latino-Americana e do Caribe em Ciências da Saúde, Base de Dados em Enfermagem, Medical Literature Analysis and Retrievel System Online, Scientific Electronic Library Online e Google Acadêmico. A amostra foi composta por sete estudos. Resultados: a análise dos estudos revela uma série de resultados significativos no contexto dos cuidados de enfermagem, podendo citar.: a necessidade de planejar a assistência de enfermagem adaptada às particularidades da doença; a crescente relevância da telessaúde; monitoramento de sintomas, orientação nutricional, administração de medicamentos e apoio emocional, enfatizando a individualização desses cuidados. Considerações finais: os principais resultados do estudo destacam a importância dos cuidados de enfermagem centrados no bem-estar do usuário, controle da doença, apoio emocional e estímulo ao autocuidado.

Objective: to identify the nursing care provided to patients diagnosed with Crohn's disease. Method: this is an integrative literature review carried out in the Latin American and Caribbean Health Sciences Literature, Nursing Database, Medical Literature Analysis and Retrieval System Online, Scientific Electronic Library Online and Google Scholar. The sample consisted of seven studies. Results: the analysis of the studies reveals a series of significant results in the context of nursing care, including: the need to plan nursing care adapted to the particularities of the disease; the growing relevance of telehealth; symptom monitoring, nutritional guidance, medication administration and emotional support, emphasizing the individualization of this care. Final considerations: the main results of the study highlight the importance of nursing care centered on the user's well-being, disease control, emotional support and encouraging self-care.

Objetivos:identificar los cuidados de enfermería prestados a pacientes con diagnóstico de enfermedad de Crohn. Método: se trata de una revisión bibliográfica integradora realizada en la Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Base de Datos de Enfermería, Medical Literature Analysis and Retrieval System Online, Scientific Electronic Library Online y Google Scholar. La muestra estuvo constituida por siete estudios. Resultados: el análisis de los estudios revela una serie de resultados significativos en el contexto de los cuidados de enfermería, entre ellos: la necesidad de planificar cuidados de enfermería adaptados a las particularidades de la enfermedad; la creciente relevancia de la telesalud; la monitorización de síntomas, la orientación nutricional, la administración de medicamentos y el apoyo emocional, destacando la individualización de estos cuidados. Consideraciones finales: los principales resultados del estudio destacan la importancia de los cuidados de enfermería centrados en el bienestar del usuario, el control de la enfermedad, el apoyo emocional y el fomento del autocuidado.

[Severe cytomegalovirus-associated protein losing gastropathy in an immunocompetent adult]. / Entéropathie exsudative sévère compliquant une primo-infection à cytomégalovirus chez un adulte immunocompétent.

INTRODUCTION: Clinical expression of cytomegalovirus (CMV) infection is numerous and depends on the immune status of the host. In immunocompromised patients, CMV disease corresponds to reactivation of the virus with tissue damage responsible for significant morbidity and mortality. In immunocompetent adults, primary CMV infection is usually asymptomatic but may rarely result in severe organ damage. OBSERVATION: We report the case of a 28-year-old man, considered immunocompetent and without medical history, presenting with a primary CMV infection revealed by a severe protein-losing gastroenteropathy (serum albumin level: 18.9g/L). The CT scan showed a gastro-duodeno-jejuno-ileitis pattern. Upper intestinal endoscopy revealed diffuse ulcerated and congestive gastritis predominantly in the fundus. Histological analysis of the biopsies showed no viral inclusion and no immunohistochemical staining reaction, but a high viral load (5.61 log). Treatment was symptomatic associated with anticoagulation due to the major hypoalbuminemia. The patient slowly recovered, and normal clinical examination and blood tests were observed two months after the onset of symptoms. CONCLUSION: Severe CMV organ involvement in the immunocompetent patient is very rare but potentially serious. Digestive involvement complicated by exudative enteropathy is possible. Evolution is usually favorable without the need for antiviral treatment.

Canine coronavirus subtype 2a associated with outbreaks of fatal diarrhoea in bush dog (Speothos venaticus) groups.

INTRODUCTION: Three outbreaks of fatal diarrhoea occurred in bush dog (Speothos venaticus) groups at two zoological collections in the United Kingdom between 2009 and 2017. In all cases, the predominant clinical signs were diarrhoea, anorexia and severe loss of condition. Despite supportive treatment, a number of fatalities occurred during each outbreak. Common gross post mortem findings were emaciation, with erythema, mucosal haemorrhage, and ulceration of the gastrointestinal tract. Histopathological features included villus blunting and fusion, crypt epithelial loss and lymphoid depletion, supporting a viral aetiology and canine coronavirus was suspected. Diagnosis was confirmed on the basis of serology (rising antibody titres) and the detection of viral nucleic acid using polymerase chain reaction. The canine coronavirus was subtyped as type 2a, which is known to cause systemic fatal disease in immature domestic dogs. To the authors' knowledge, these are the first reported cases of fatal diarrhoea associated with canine coronavirus type 2a in bush dogs. These outbreaks suggest that adult bush dogs are highly susceptible to canine coronavirus infection and may succumb to viral enteritis.

INTRODUCTION: Trois foyers de diarrhée mortelle sont survenus dans des groupes de chiens de brousse (Speothos venaticus) dans deux parcs zoologiques au Royaume-Uni entre 2009 et 2017. Dans tous les cas, les signes cliniques prédominants étaient la diarrhée, l'anorexie et une grave perte de condition. Malgré un traitement de soutien, un certain nombre de décès sont survenus au cours de chaque épidémie. Les résultats macroscopiques courants post-mortem étaient l'émaciation, un érythème, des hémorragies des muqueuses et des ulcération du tractus gastro-intestinal. Les caractéristiques histopathologiques comprenaient un émoussement et une fusion des villosités, une perte épithéliale des cryptes et une déplétion lymphoïde, ce qui confortait une étiologie virale. Un coronavirus canin a été suspecté. Le diagnostic a été confirmé sur la base de la sérologie (augmentation des titres d'anticorps) et de la détection d'acide nucléique viral par amplification en chaîne par polymérase. Le coronavirus canin a été sous-typé comme type 2a, qui est connu pour provoquer une maladie systémique mortelle chez les chiens domestiques immatures. À la connaissance des auteurs, il s'agit des premiers cas signalés de diarrhée mortelle associée au coronavirus canin de type 2a chez les chiens des buissons. Ces épidémies suggèrent que les chiens des buissons adultes sont très sensibles à l'infection par le coronavirus canin et peuvent succomber à une entérite virale.

Unrecognized digestive toxicities of radiation therapy.

The aim of this article is to review unrecognized toxicities resulting from radiation therapy of digestive neoplasms. Due to their precocious occurrence, acute toxicities are well-known by radiation oncologist, and their treatment well-established. Thus, acute toxicities will not be described in this review. We will focus on incidence, diagnosis, and management of late and uncommon toxicities occurring in the digestive tract and digestive organs. Prevention, by respecting healthy tissues constraints, is the main tool to reduce incidence of those rare complications. Nonetheless, once installed, late toxicities remain a major burden in terms of quality of life and can even be life threatening. Hence, information and education about their diagnosis and management is important.

Enterite mesentérica como complicação rara do lúpus eritematoso sistêmico / Mesenteric enteritis as a rare complication of systemic lupus erythematosus

A dor abdominal no paciente com lúpus eritematoso sistêmico tem amplo espectro clínico, variando desde condições inespecí- ficas, como diarreia e vômitos, até eventos de importante morbi- mortalidade, como o abdome agudo inflamatório e/ou perfura- tivo. A seguir, descreve-se um caso de paciente do sexo feminino, de 23 anos, internada por dor abdominal associada a vômitos e à diarreia crônica e progressiva. Foi diagnosticada com lúpus eritematoso sistêmico há 2 anos. Durante a internação, evoluiu com quadro de abdome agudo, e foi realizada tomografia compu- tadorizada de abdome, revelando importante edema de parede intestinal difuso. Isso, somado a alterações clínico-laboratoriais, permitiu o diagnóstico de enterite lúpica. Foi realizado tratamen- to conservador, com corticoterapia e terapia de suporte com correção de distúrbios eletrolíticos severos, sendo iniciado ciclo- fosfamida, com resolução dos sintomas gastrintestinais.

Abdominal pain in patients with systemic lupus erythematosus has a broad clinical spectrum, ranging from nonspecific symp- toms, such as diarrhea and vomiting, to events of significant morbidity and mortality, such as acute inflammatory and/or per- forating abdomen. This article describes a case of a 23-year-old female patient hospitalized for abdominal pain, associated with vomiting and progressive chronic diarrhea. She was diagnosed with systemic lupus erythematosus 2 years ago. During hospita- lization, the patient progressed with acute abdomen, and an ab- dominal computed tomography scan was performed, revealing major diffuse intestinal wall edema. This, added to clinical and laboratories alterations, allowed the diagnosis of lupus enteritis. A conservative treatment with corticotherapy and supportive therapy with correction of severe electrolyte disturbances were initiated, as well as the prescription of cyclophosphamide, with resolution of gastrointestinal symptoms.

Epidemiological and pathological aspects of salmonellosis in cattle in southern Brazil / Aspectos epidemiológicos e patológicos de salmonelose em bovinos no Sul do Brasil

ABSTRACT: Salmonellosis is a bacterial disease that affects several domestic animal species, and is commonly diagnosed in cattle, horses, and pigs. This study aimed to describe the epidemiological and pathological findings of eleven cases of enteric salmonellosis and two cases of salmonellosis with pulmonary involvement in cattle in Rio Grande do Sul State, Brazil. Clinical signs included fever, yellow diarrhea, sometimes with blood streaks, and dyspnea, with a clinical course ranging from 1 to 30 days. Eight cases occurred as outbreaks, whereas five cases occurred individually. Risk factors included inadequate handling practices, such as overcrowded facilities and comorbidities, including anaplasmosis. The main gross finding of the enteric presentation was fibrinonecrotic enterocolitis, occasionally associated with button ulcers, mesenteric lymphadenomegaly, splenomegaly, cholecystitis and hepatomegaly. In addition, one steer with a chronic clinical progression presented severe segmental thickening of the ileum, associated with intestinal rupture and peritonitis. In the respiratory system, the main findings were reddened, non-collapsed lungs, with multifocal areas of atelectasis. The main microscopic findings were observed in the small and large intestines, and these were characterized by severe necrosis and mucosal ulceration, associated with marked inflammatory infiltrate of neutrophils and fibrin deposition intermixed by rod-shaped bacterial aggregates, and fibrosis, as well as interstitial pneumonia. Seven cases yielded positive bacterial cultures for Salmonella spp. and three serovars, namely Typhimurium, Dublin, and Panama were identified. All cases exhibited immunolabeling for Salmonella spp. using immunohistochemistry.

RESUMO: Salmonelose é uma doença bacteriana que afeta inúmeras espécies animais, especialmente os bovinos, os equinos e os suínos. O presente estudo teve como objetivo descrever os aspectos epidemiológicos e patológicos de onze casos de salmonelose entérica e dois de salmonelose pulmonar em bovinos no estado do Rio Grande do Sul, Brasil. Os sinais clínicos incluíram febre, diarreia amarelada, por vezes com estrias de sangue, anorexia, perda de peso e dispneia, com curso clínico que variou de um a 30 dias. Em oito casos, a doença ocorreu em forma de surtos e cinco foram individuais. Identificou-se fatores de risco relacionados ao manejo inadequado com os bovinos, como alta lotação, além de comorbidades associadas, como anaplasmose. Os principais achados macroscópicos da forma entérica consistiram em enterocolite fibrinonecrótica, por vezes associada a formação de úlceras botonosas, linfonodos mesentéricos e baço aumentados, colecistite e hepatomegalia. Ainda, um bovino com quadro clínico crônico apresentou acentuado espessamento segmentar da parede do íleo associado a ruptura intestinal e peritonite. Na forma respiratória, os principais achados incluíram pulmões não colabados, avermelhados, com áreas multifocais de atelectasia. Os principais achados microscópicos foram observados no intestino delgado e grosso e foram caracterizados por acentuada necrose e ulceração da mucosa, associada a acentuado infiltrado inflamatório de neutrófilos e deposição de fibrina entremeada por agregados bacterianos cocobacilares e fibrose, além de pneumonia intersticial. Sete casos foram positivos para Salmonella sp. no cultivo bacteriano, com identificação dos sorovares Typhimurium, Dublin e Panama. Ao exame imuno-histoquímico para Salmonella sp. todos os casos apresentaram marcação positiva nos órgãos avaliados.

[Clinicopathologic features and postoperative outcome of the radiation-induced enteritis: a retrospective study of 41 patients]. / Caractéristiques clinicopathologiques et résultats postopératoires de l'entérite radio-induite : une étude rétrospective de 41 patients.

INTRODUCTION: Surgery is required in patients with symptoms of chronic radiation-induced enteritis (CRE) resistant to medical therapy. The study aimed to correlate histopathologic features of CRE to the clinical presentation and the postoperative recurrence. MATERIAL AND METHOD: All patients with small bowel resection performed for CRE between 2006 and 2017 were studied. Histological data were retrospectively correlated to initial clinical data and to postoperative recurrence of CRE (occlusion, need for parenteral nutrition) observed during a median follow-up of 32 months. RESULTS: Forty-one patients were studied (39 women and 2 men, median age 62 yo at time of radiation for pelvic cancer, 80% gynecologic). Median time to surgery after radiation was 3 years. Ileocaecal resections (80% of patients) removed 60cm (median length). Histologically, a diffuse obliterative arteriopathy was present in 24 (59%) patients, highly associated to amyotrophy, villous atrophy and ulceration observed in 66, 63 and 34% of patients respectively (P<.05). Diffuse arteriopathy was uncorrelated with patient's age and vascular risk factor (tobacco, diabetes, hypertension, dyslipidemia). Median time to surgery after radiation was longer in patients presenting with obliterative arteriopathy (13 years vs. 2.6 years, P=0.0002). During follow-up, half of the patients had a recurrence of CRE, uncorrelated to the arteriopathy. CONCLUSION: Radiation-induced enteritis requiring late surgery after radiation presented histologically with a diffuse obliterative arteriopathy and ischemic features. In our center, half of the patients were cured by surgery. The arterial injury was not a risk factor for postoperative recurrence.

Necrohemorrhagic enteritis outbreak in a cattle feedlot in Nova Crixás, Goiás, Brazil / Surto de enterite necro-hemorrágica em um confinamento de bovinos no município de Nova Crixás, Goiás, Brasil

This study described an outbreak of necrohemorrhagic enteritis in a beef cattle feedlot in Nova Crixás, State of Goiás, Brazil, with emphasis on epidemiological, lesional, and laboratory aspects. Visits to the property were carried out and a necroscopic examination was performed on the bovine cadavers (N=57), which presented similar macroscopic alterations. Epidemiological data were collected, mainly referring to the feeding management of animals, and tissue samples were submitted to histopathological examination. Samples of feces and intestinal contents were also collected for bacterial isolation and PCR genotyping to detect the etiological agent, being confirmed Clostridium perfringens type A strains in 100% of the samples. Furthermore, 33.3% of strains isolated from intestinal contents and 40% of those isolated from feces were positive for beta-2 encoding gene. Considering the history, macroscopic and microscopic findings, as well as bacterial isolation and PCR, the diagnosis of bovine necrohemorrhagic enteritis was determined.(AU)

Descreve-se um surto de enterite necro-hemorrágica em um confinamento de bovinos de corte no município de Nova Crixás, Estado de Goiás, Brasil, com ênfase nos aspectos epidemiológicos, lesionais e laboratoriais. Foram realizadas visitas à propriedade e todos os cadáveres bovinos (N=57) foram submetidos ao exame necroscópico, os quais apresentaram alterações macroscópicas semelhantes. Foram compilados dados epidemiológicos, sobretudo referentes ao manejo alimentar dos animais e amostras de tecido foram submetidas a exame histopatológico. Foram colhidas, também, amostras de fezes e conteúdo intestinal para isolamento bacteriano e genotipagem por PCR para detecção do agente etiológico, sendo confirmadas estirpes de Clostridium perfringens tipo A em 100% das amostras. Ainda, 33,3% das cepas de Clostridium perfringens isoladas no conteúdo intestinal e 40% daquelas isoladas nas fezes foram positivas para o gene codificador da toxina beta-2. Considerando o histórico, os achados macroscópicos e microscópicos, o isolamento bacteriano e o PCR, foi estabelecido o diagnóstico de enterite necro-hemorrágica por C. perfringens tipo A.(AU)

[Physiopathology and pharmacological perspectives in the treatment of radiation enteritis]. / Physiopathologie et modulation pharmacologique de l'entérite radique.

The small intestine is an organ frequently exposed in abdominal and pelvic irradiations. Acute and late toxicity can sometimes be difficult to manage and can significantly affect the quality of life of patients. Currently there is no guideline on the management of acute and late side effects induced by therapeutic irradiation. The aim of this review is to summarize available data on the pathophysiology of radiation enteritis, and to highlight potential preventive strategies and principles of treatment of radiation enteritis.

Accidental poisoning by castor bean (Ricinus communis) cake in horses / Intoxicação acidental por torta de mamona (Ricinus communis) em equinos

Ricinus communis is a shrub of the family Euphorbiaceae popularly known in Brazil as "mamona" or "carrapateira". It is an oleaginous plant whose seeds have been used mainly in biodiesel production. Plant seed oil can be extracted mechanically or using solvents, generating castor bean cake and castor bean meal as by-products, respectively. Accidental ingestion of these by-products can cause poisoning in animals and humans, characterized by digestive signs resulting from the presence of a toxalbumin called ricin. Seed toxicity varies among animal species; in horses, the lethal dose of seeds is 0.1 g/kg of body weight. The literature presents plenty of studies addressing poisoning by R. communis in different animal species and in humans; however, reports are scarce and little information is available on the pathological aspects of poisoning regarding equines. Therefore, the present study aimed to describe the epidemiological, clinical and pathological aspects observed in an outbreak of accidental poisoning with castor bean cake in horses. The equines were supplemented with palm kernel (Elaeis guianeesis) cake; however, in the purchase of a new batch, there was an error in the order, and castor bean cake was requested instead. Four horses that received castor bean cake presented clinical signs indicative of colic, which started about 21 hours after administration. Three of these horses died, with clinical evolution from 2 to 4.5 hours; the other animal was treated with intravenous fluid and antibiotic therapy and non-steroidal anti-inflammatory drugs and recovered after five days. In the necropsy of two of these horses, the main lesions were found in the small intestine, where mucosae with pronounced redness and covered with a thin layer of yellow fibrous material were observed. In the intestinal lumen, there was a large amount of bloody liquid. The stomach was full, and dark lumps similar to crushed castor bean seeds were observed in the contents. The adrenal glands of both horses presented congestion and hemorrhage in the cortex. In microscopy, the main lesion was an acute, diffuse and accentuated fibrin-necrotic enteropathy affecting the jejunum. The diagnosis of castor bean cake poisoning was based on the circumstantial evidence of by-product consumption supported by clinical and pathological aspects. The results indicate that castor bean cake commercially available as fertilizer is extremely toxic when ingested, and there is a need for appropriate detoxification or labeling informing of its toxicity.(AU)

Ricinus communis é um arbusto da família Euphorbiaceae conhecido popularmente como "mamona" ou "carrapateira". A planta é considerada oleaginosa e suas sementes têm sido utilizadas, principalmente, na produção de biodiesel. A extração do óleo pode ser mecânica ou com solventes, gerando, como subprodutos, a torta de mamona e a farinha de mamona, respectivamente. A ingestão acidental desses subprodutos pode causar intoxicação em animais e humanos, caracterizada por sinais digestivos devido a toxalbumina ricina. A toxidez das sementes varia entre as espécies animais, em equinos a dose letal de sementes é de 0,1g/kg de peso vivo. Há vasta literatura sobre a intoxicação por R. communis em diferentes espécies animais e humanos. Em relação aos equinos os relatos são escassos e com poucas informações sobre os aspectos patológicos da intoxicação. Assim, os objetivos do presente estudo foram descrever os aspectos epidemiológicos, clínicos e patológicos observados em um surto de intoxicação acidental por torta de mamona em equinos. Os equinos eram suplementados com torta de dendê (Elaeis guianeesis), no entanto, na compra de uma nova partida, houve um erro no pedido sendo solicitada torta de mamona. Os quatro equinos que receberam a torta de mamona apresentaram sinais clínicos indicativos de cólica, que iniciaram cerca de 21 horas após administração. Três destes morreram, com evolução clínica 2 a 4,5 horas, o outro animal foi tratado com fluidoterapia intravenosa, antibioticoterapia e anti-inflamatório não esteroidal, recuperando-se em 5 dias. Na necropsia de dois destes equinos, as principais lesões foram encontradas no intestino delgado, sendo observadas mucosas com avermelhamento acentuado e recobertas por fina camada de material amarelado fibrinoso. No lúmen intestinal, havia grande quantidade de líquido sanguinolento. O estômago estava repleto de grumos escuros semelhantes às sementes trituradas da mamona em meio ao conteúdo. As adrenais de ambos equinos apresentavam congestão e hemorragias corticais. Na microscopia, a principal lesão foi uma enteropatia fibrino-necrótica, aguda, difusa e acentuada, afetando com maior intensidade o jejuno. O diagnóstico de intoxicação por torta de mamona foi baseado na evidência circunstancial de consumo do subproduto, sendo corroborado pelos aspectos clínicos e patológicos. Os resultados indicam que a torta de mamona vendida para fertilização do solo é extremamente tóxica quando ingerida, havendo a necessidade de detoxicação ou rotulagem adequada informando sobre a sua toxicidade.(AU)

Eschechiria coli produtora da toxina shiga em bovinos: revisão / Eschechiria coli producing shiga toxin in cattle: review

Esta revisão apresenta os aspectos epidemiológicos da bactéria Escherichia coli produtora da toxina shiga, (STEC) que é reconhecida no mundo todo como agente causador de toxinfecção. Os produtos de origem animal são frequentemente associados aos surtos da doença, mas os alimentos hortifrutigranjeiros também podem ser contaminados e causar toxinfecção em seus consumidores. A incidência da infecção em humanos no Brasil (STEC) é baixa, foi observada essa prevalência nos rebanhos bovinos, ovinos e aves. Por isso, a importância das boas práticas de manipulação do produtor e do consumidor para evitar possível contaminação dos alimentos. Este trabalho teve por objetivo revisar a literatura sobre a ocorrência de Escherichia coli produtora da toxina shiga. Frente aos limitados estudos realizados sobre os agentes etiológicos, novos estudos fazem-se necessários.

This review presents the aspects of shiga toxin-producing Escherichia coli, which are recognized worldwide as toxinfection agents in the world. Products of animal origin are often associated with outbreaks of disease, but horticultural crops can be contaminated and cause toxinfection as well. This study aims to review the literature on the occurrence of shiga toxin-producing Escherichia coli. The incidence of infection in humans in Brasil by STEC and low, prevalence was observed in cattle, sheep and poultry. Therefore, the importance of good practices of manipulation of the producer and the consumer to avoid possible food contamination. Faced with the limited studies of etiological agents, it is necessary to study the subject.

Intestinal intussusception secondary to enteritis caused by Pythium insidiosum in a bitch: case report / Intussuscepção intestinal secundária à enterite causada por Pythium insidiosum em uma cadela: relato de caso

We report a case of intestinal intussusception secondary to enteritis caused by Pythium insidiosum infection in a 1-year-old mixed breed bitch that died after a 30-day history of bloody diarrhea, anorexia, weight loss, listlessness, dehydration, and pale mucous membranes. Necropsy revealed two areas of intussusception, one jejunum-jejunal and one ileum-cecum-colic. The first intussusception showed slight congestion of the intestinal loop, which was resolved by manual traction, while the second intussusception exhibited thickening, irregular yellow spots, and transmural congestion. Histologically, the jejunum-jejunal segment had ischemic lesions secondary and ileum-cecum-colic intussusception there was also necrotizing, pyogranulomatous enteritis associated with negative images of intralesional fungal hyphae that were well visualized by silver impregnation. Immunohistochemistry identified the hyphae as Pythium insidiosum. The diagnosis was made based on the histological changes and confirmed by immunohistochemistry. We can conclude that enteritis by P. insidiosum in dogs can occasionally cause intestinal intussusception and result in acute death.(AU)

Relata-se um caso de intussuscepção intestinal secundária à enterite causada por Pythium insidiosusm em uma cadela, sem raça definida, com um ano de idade, que morreu após apresentar 30 dias de diarreia sanguinolenta, anorexia, perda de peso, apatia, desidratação e mucosas pálidas. Na necropsia verificaram-se duas áreas de intussuscepções, sendo uma jejuno-jejunal e outra íleo-ceco-cólica. Na primeira havia discreta congestão, que foi desfeita pela tração manual, e na segunda observou-se espessamento segmentar, focos amarelados irregulares e congestão transmural do intestino. Microscopicamente, no segmento jejuno-jejunal observaram-se moderadas lesões isquêmicas secundárias à intussuscepção, e no segmento íleo-ceco-cólica verificou-se enterite piogranulomatosa e necrosante, segmentar, associada a imagens negativas de hifas intralesionais, impregnadas pela prata. Pela imuno-histoquímica, as hifas foram imunomarcadas para Pythium insidiosum. O diagnóstico foi realizado com base nas características microscópicas das lesões e morfotintoriais das hifas e foi confirmado pela imuno-histoquímica. De acordo com esses dados, é possível concluir que a infecção intestinal por P. insidiosum em cães pode causar intussuscepção e morte.(AU)

Ulcerative and granulomatous enteritis associated with Molineus torulosus parasitism in neotropical primates / Enterite ulcerativa e granulomatosa com parasitismo de Molineus torulosus em primatas neotropicais

This paper reports eleven cases of ulcerative and granulomatous enteritis associated with Molineus torulosus parasitism in different species of neotropical primates of the Sapajus genus. All of the affected monkeys had been apprehended by the environmental police and were being treated in a rehabilitation center for wild animals. The clinical history was weight loss and debility. During the necropsy, several nodules were found on the duodenum and proximal jejunum wall, with ulcers on the adjacent intestinal mucosa, including the nodules in the pancreas of four monkeys. Histologically, eosinophilic granulomas were observed in the small intestine, associated with fibrosis, eggs and adult models of Trichostrongylidae, etiology consistent with Molineus torulosus. This study describes the first cases of parasitism in Sapajus flavius, a species previously considered extinct, but recently rediscovered, and presents the occurrence of M. torulosus in two other species, Sapajus libidinosus and Sapajus apella.(AU)

São relatados 11 casos de enterite ulcerativa e granulomatosa associada ao parasitismo por Molineus torulosus em diferentes espécies de primatas neotropicais do gênero Sapajus. Todos os macacos afetados haviam sido apreendidos pela polícia ambiental e estavam sendo tratados em um centro de reabilitação de animais silvestres. O histórico clínico era de emagrecimento e debilidade. Durante a necropsia, foram constatados diversos nódulos na parede do duodeno e jejuno proximal, com úlceras na mucosa intestinal adjacente, além de nódulos no pâncreas de quatro macacos. Histologicamente, observou-se no intestino delgado, granulomas eosinofílicos associados à fibrose, ovos e exemplares adultos de tricostrongilídeos, etiologia consistente com Molineus torulosus. O presente trabalho descreve os primeiros casos de parasitismo em Sapajus flavius, uma espécie antes considerada extinta e recentemente redescoberta, e relata a ocorrência de M. torulosus em outras duas espécies, Sapajus libidinosus e Sapajus apella.(AU)

Detection of serum amyloid-A concentration in the calf clinically diagnosed with pneumonia, enteritis and pneumoenteritis / A detecção de amilóide-A concentração sérica na panturrilha com diagnóstico clínico de pneumonia, enterite e pneumoenterites

ABSTRACT: The aim of this study is to determine serum amyloid-A (SAA) concentration in the cases of pneumonia, pneumoenteritis, and enteritis which are frequently encountered in calves in veterinary medicine. Although a great deal of experimental studies has been conducted in this field, studies on naturally infected calves are quite few. Eighty calves at the age of 0-6 months were used in the study and the calves were divided into four groups. Due to the clinical examination, the calves diagnosed with pneumonia (Group P; n=20), with pneumoenteritis (Group PE; n=20) and with enteritis (Group E; n=20) formed the disease group as the healthy ones formed the control (Group C; n=20) group. After the body temperatures of all calves were taken, blood samples were obtained from Jugular vein for haematological and biochemical measurements. As haematological, white blood cell (WBC), red blood cell (RBC), hemoglobin (Hb) and hematocrit (Hct) measurements were performed in Veterinary Hematology Analyzer. Serum amyloid-A (SAA), interleukin 1 (IL-1β), interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α) concentration measurements were carried out with ELISA reader by using commercial kits. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin (ALB), total bilirubin (T. Bil), total protein (TP), gamma glutamyltransferase (GGT), blood urea nitrogen (BUN) concentration measurements were conducted in autoanalyzer by using commercial kits. In all disease groups (P, PE, and E) body temperature, haematologic parameters (WBC, RBC, Hb and Hct), serum biochemical parameters (AST, ALT, ALB, T. Bil, TP, GGT and BUN), SAA concentration and serum concentrations of cytokines (IL-1β, IL-6 and TNF-α) were determined to be higher in comparison to the control group (P<0.005). According to these findings, routine measurement of serum SAA concentration in veterinary medicine is considered to be beneficial in determining the severity of the disease, in selecting the proper treatment, in monitoring the applied treatment, and detecting subclinical diseases. In the light of these findings we acknowledge that routine measurements of serum SAA concentration from the moment the calves are diagnosed with pneumonia, enteritis and pneumoenteritis in veterinary medicine until the actual cause is determined (bacteria, virus, parasites, etc.) would avail the clinician to, identify the severity of the disease, select the appropriate treatment and monitor the effectiveness of the treatment.

RESUMO: O objetivo deste estudo é determinar amilóide A (SAA) da concentração sérica nos casos de pneumonia, pneumoenterites e enterite, que são frequentemente encontrados em bezerros em medicina veterinária. Apesar de uma grande quantidade de estudos experimentais terem sido realizados neste campo, os estudos sobre animais com infecção natural são muito poucos. 80 vitelos com a idade de 0-6 meses de idade foram utilizados no estudo e os animais foram divididos em quatro grupos. Devido ao exame clínico, os bezerros diagnosticados com pneumonia (Grupo P; n=20), com pneumoenterites (Grupo PE; n=20) e com enterite (Grupo E; n=20) formaram o grupo de doença, como as saudáveis, ​​formando o grupo controle (Grupo C; n=20). Após as temperaturas corporais de todos os bezerros, foram tomadas amostras de sangue que foram obtidas de veia jugular para medições hematológicas e bioquímicas. Como hematológica, glóbulos brancos (WBC), glóbulos vermelhos (RBC), hemoglobina (Hb) e hematócrito (HCT) foram realizados em Hematologia Veterinária Analyzer. O soro amilóide-A (SAA), a interleucina 1 (IL-1β), interleucina 6 (IL-6), fator de necrose tumoral (TNF-α) medidas de concentração foram efectuadas com um leitor de ELISA, utilizando kits comerciais. Aspartato aminotransferase (AST), alanina aminotransferase (ALT), albumina (ALB), bilirrubina total (T. Bil), proteína total (TP), gama glutamiltransferase (GGT), ureia (BUN) às medições das concentrações foram realizadas em auto-analisador por utilizandos kits comerciais. Em todos os grupos de doenças (P, PE, e E), a temperatura corporal, parâmetros hematológicos (WBC, RBC, Hb e Hct), parâmetros bioquímicos de soro (AST, ALT, ALB, T. Bil, TP, GGT e BUN), a concentração SAA e as concentrações séricas de citocinas (IL-1β, IL-6 e TNF-α) foram determinadas a ser mais elevadas em comparação com o grupo controle (P<0,005). De acordo com estas descobertas, a medição rotineira da concentração de soro SAA em medicina veterinária é considerada benéfica para determinar a gravidade da doença, na selecção de um tratamento adequado, no seguimento do tratamento aplicado e para a detecção de doenças subclínicas. À luz desses resultados, reconhecemos que as medições de rotina da concentração SAA soro do momento em que os bezerros são diagnosticadas com pneumonia, enterite e pneumoenterites em medicina veterinária, até que a causa real seja determinada (bactérias, vírus, parasitas, etc.), seria aproveitar o clínico, a fim de identificar a gravidade da doença, além de seleccionar o tratamento adequado e monitorar a eficácia do tratamento.

Epizootic amebiasis outbreak in wild black howler monkeys (Alouatta caraya) in a wildlife facility during captivity prior to translocation - Recommendations to wildlife management programs / Surto epizoótico de amebíase em Bugio preto (Alouatta caraya) provenientes de vida livre durante o cativeiro prévio a translocação - Recomendações a programas de manejo de fauna

The capture and quarantine of non-human primates could be necessary in some circumstances including those required under environmental permit. Mortality is undesirable for wildlife management programs and could be related to opportunistic pathogens, for example, deaths due to intestinal protozoa infection outbreaks as described here. Parasitological, necroscopic, microbiological, and molecular tests were used in the diagnosis of severe necrotic enteritis leading to death of three female and two male black howler monkeys (Alouatta caraya) captured and held in quarantine prior to translocation. Parasitological tests showed the presence of cysts of Entamoeba histolytica/dispar (5/5), Entamoeba coli (5/5) and Giardia duodenalis (1/5). Necroscopic assessment revealed areas of severe multifocal necrosis in the intestinal mucosa and submucosa. Histopathological examination revealed the presence of structures morphologically compatible to Entamoeba spp. in all individuals examined. Furthermore, G. duodenalis (1/5) was demonstrated by the nested PCR technique. During temporary captivity of non-human primates in management programs, proper handling protocols, including fast or immediate destination, are suggested in order to mitigate the negative effects of stress and decrease the risk of infections.(AU)

Óbitos por infecções causadas por protozoários intestinais são indesejáveis para programas de manejo de fauna, exigidos no âmbito do licenciamento ambiental e que demandam a captura e quarentena de primatas não humanos. Exames coproparasitológicos, necroscópicos, microbiológicos e moleculares foram utilizados para a confirmação do diagnóstico de uma severa enterite necrótica que levou a óbito três fêmeas e dois machos de Alouatta (A.) caraya capturados e mantidos em quarentena prévia à translocação. Exames coproparasitológicos revelaram a presença de cistos de Entamoeba (E.) histolytica/dispar (5/5), Entamoeba (E.) coli (5/5) e Giardia (G.) duodenalis (1/5). A avaliação necroscópica revelou áreas de necrose multifocal severa na mucosa e submucosa intestinal. A análise microscópica revelou a presença de estruturas morfologicamente compatíveis com trofozoítos do gênero Entamoeba spp. em todos os indivíduos examinados. Além disso, G. duodenalis (1/5) foi demonstrada pela técnica de Nested PCR. Sugere-se que quando for necessário o cativeiro temporário de primatas, deverão ser adotados protocolos de manejo adequados buscando a destinação imediata dos animais, de moto a mitigar os efeitos negativos do estresse e reduzir o risco da ocorrência de infecções.(AU)

Clostridium perfringens: a review of the disease in pigs, horses and broiler chickens / Clostridium perfringens: uma revisão da doença em suínos, equinos e frangos de corte

Clostridium perfringens is a gram-positive, anaerobic, fermentative, spore-forming bacillus that may be found in the environment but is more commonly found as part of the microbiota of humans and animals. The bacterium is considered a common enteric pathogen; however, the pathogenesis and predisposing factors of the disease can differ among species. Therefore, specific studies are necessary for understanding the role of this pathogen, how to diagnose it and which control measures are applicable. The aim of this paper is to review the current knowledge regarding C. perfringens infections in pigs, horses and broiler chickens.

Clostridium perfringens é um bacilo anaeróbio, Gram positivo, formador de esporos que pode ser encontrado no ambiente e, principalmente, como parte da microbiota de humanos e animais. É considerado um patógeno entérico comum, mas a patogênese e os fatores predisponentes da doença normalmente diferem entre as espécies, sendo necessários estudos específicos para compreender os mecanismos de ação do patógeno, como diagnosticá-lo e apresentar quais as medidas de controle são aplicáveis. O objetivo deste trabalho é revisar as atuais descobertas a respeito da infecção de C. perfringens em suínos, equinos e frango de corte.

Sentinel physician's network in Reunion Island: a tool for infectious diseases surveillance.

UNLABELLED: The surveillance of infectious diseases in Reunion Island is based on a sentinel network of family physicians (FPs) coordinated by the Indian Ocean regional institute for public health surveillance (French acronym OI Cire). The objectives are to identify and monitor outbreaks of influenza, gastroenteritis, and chicken pox, and to characterize circulating influenza viruses. The network can monitor other potentially epidemic diseases. METHOD: The Réunion sentinel network ensures a continuous and permanent surveillance. Physicians send their weekly activity data to the Cire that collects, processes, and interprets it; they also collect samples for biological surveillance of influenza. Statistical thresholds, based on historical data and the estimated numbers of incident cases, are calculated to follow the trend, detect outbreaks, and quantify their impact. RESULTS: The network currently includes 56 FPs and pediatricians, accounting for 6.5% of FPs on the island. The network has clarified the seasonality of influenza during the austral winter and identified the seasonality of acute diarrhea with an epidemic peak when school starts in August. The sentinel FPs's reports allowed monitoring the epidemic trend and estimating the number of cases during the 2005 and 2006 chikungunya outbreaks and 2009 influenza A (H1N1) outbreaks. CONCLUSION: The network has proven its contribution, responsiveness, and reliability for epidemiological surveillance during outbreak. It is an essential tool for infectious diseases surveillance in Reunion Island.