Characterization of a group of children with eosinophilic esophagitis in Cali, Colombia.

PURPOSE: Eosinophilic esophagitis (EoE) is an immunologically mediated chronic disease of the gastrointestinal tract. The objective of this study was to clinically and demographically describe a child population with EoE diagnosed in a high-complexity hospital in Cali, Colombia. METHODS: A retrospective study was carried out. The clinical histories of patients between 0 and 18 years with clinical suspicion and a histological diagnosis of EoE were analyzed. All patients underwent an allergy study, either by measurement of specific immunoglobulin (Ig) E and/or an intraepidermal skin-prick test. RESULTS: Thirty-five patients were included in the study, of which 21 (60%) women. The median age was 8 years (interquartile range [IQR] 5-12), and the age of onset of symptoms was 5 years (IQR 2-10). Thirty patients (85.7%) reported a history of allergic disease, with rhinitis being the most frequent (n = 25, 71.4%). Only one patient reported with food allergy mediated by IgE. The main symptoms in patients included abdominal pain (17 [48.6%]), refractory gastroesophageal reflux (16 [45.7%]), and choking (9 [25.7%]). Upper gastrointestinal endoscopy was normal in 10 patients (38.5%). The median number of eosinophils in the biopsy was 42 (IQR 31-92). Allergenic sensitization was verified in 25 of 35 patients (71.4%). Of these, dust mite allergy was positive in 21 patients (84%), while the most frequent food allergy was toward cow's milk, in five patients (31.3%). CONCLUSIONS: The majority of patients with EoE were females. The most frequent symptom was abdominal pain. Endoscopic abnormalities were also observed frequently, and the prevalence of other allergic diseases (especially rhinitis) and allergenic sensitization (especially to mites) was high.

Functional constipation symptoms and complementary feeding methods: A randomized clinical trial.

INTRODUCTION: The aim of the study was to investigate the impact of different complementary feeding methods on the prevalence of functional constipation symptoms in infants at 12 months of age. MATERIAL AND METHODS: Randomized clinical trial in mother-infant dyads that underwent the intervention at 5.5 months post birth, randomly allocated to one of three complementary food introduction methods: PLW (parent-led weaning), Baby-led Introduction to SolidS (BLISS) and a mixed approach. The symptoms of constipation were assessed at 12 months with an online questionnaire based on the Rome IV diagnostic criteria and adapted to our sample. The data were summarised as absolute frequencies and percentages and compared by means of the χ2 test. The project was approved by the ethics committee of the Hospital de Clínicas de Porto Alegre under number 2019-0230. RESULTS: We analysed data corresponding to 135 infants, 45 allocated to PLW, 48 to BLISS and 42 to the mixed approach. The prevalence of constipation symptoms was 49.6% in the overall sample (n = 67), 60% (n = 27) in the PLW group, 47.9% (n = 23) in the BLISS group and 40.5% (n = 17) in the mixed approach group. We found no association between functional constipation symptoms and the method used to introduce complementary foods (P = .183). CONCLUSIONS: The prevalence of functional constipation symptoms was high in the study population. The presence of constipation symptoms was not associated with the complementary feeding approach.

Clinical and laboratory indicators predictive of the negative outcome of gastrointestinal emergencies in cattle / Indicadores clínicos e laboratoriais preditivos do desfecho negativo de emergências gastrointestinais em bovino

This study aimed to identify clinical and laboratory variables that could help predict the negative outcome in cattle affected by gastrointestinal emergencies. A retrospective cohort study was carried out using multivariate logistic regression analysis based on data collected from the clinical records of cattle hospitalized at the Garanhuns Bovine Clinic, UFRPE campus. One hundred and twenty-two cattle met the inclusion criteria established for the study. Among the clinical variables, heart rate (HR) and abdominal distension are associated with the outcome in animals with right displaced abomasum (RDA), and anorexia and 10% dehydration in animals with an obstructive intestinal disorder. Among the laboratory variables, plasma fibrinogen (PF) and total leukocyte count were associated with the outcome in animals with RDA, while PF and plasma L-lactate were associated with animals with an obstructive intestinal disorder. HR and the total leukocyte count remained in the final model of the regression adjusted for animals with RDA. On the other hand, plasma L-lactate and PF remained in the final model in the adjusted model for animals with an obstructive intestinal disorder. Cattle with RDA and HR higher than 90 bpm present an increased chance of having a negative outcome whereas cattle with obstructive intestinal disorder and plasma L-lactate higher than 1.84 mmol/L or PF higher than 850 mg/dL have a higher chance of not survive. Therefore, clinical and laboratory variables such as HR, fibrinogen, and plasma L-lactate are useful to predict the negative outcome in cattle with gastrointestinal emergencies, especially RDA and obstructive intestinal disorders.(AU)

Este estudo teve como objetivo identificar variáveis clínicas e laboratoriais que pudessem ajudar a predizer o desfecho negativo em bovinos acometidos por emergências gastrointestinais. Foi realizado um estudo de coorte retrospectivo por meio de análise de regressão logística multivariada com base em dados coletados dos prontuários de bovinos internados na Clínica de Bovinos de Garanhuns, campus da UFRPE. Cento e vinte e dois bovinos atenderam aos critérios de inclusão estabelecidos para o estudo. Dentre as variáveis clínicas, a frequência cardíaca e a distensão abdominal estão associadas ao desfecho em animais com deslocamento de abomaso à direita (DAD), e anorexia e 10% de desidratação em animais com distúrbio intestinal obstrutivo. Entre as variáveis laboratoriais, o fibrinogênio plasmáticao (FP) e a contagem total de leucócitos foram associados ao desfecho em animais com DAD, enquanto o FP e o L-lactato plasmático foram associados a animais com distúrbio intestinal obstrutivo. A frequência cardíaca (FC) e a contagem total de leucócitos permaneceram no modelo final da regressão ajustada para animais com DAD. Por outro lado, o L-lactato plasmático e o FP permaneceram no modelo final ajustado para animais com distúrbio intestinal obstrutivo. Bovinos com DAD e FC maior que 90 bpm apresentam maior chance de ter um desfecho negativo, enquanto bovinos com distúrbio intestinal obstrutivo e L-lactato plasmático maior que 1,84 mmol/L ou FP maior que 850 mg/dL têm maior chance de não sobreviver. Portanto, variáveis clínicas e laboratoriais como FC, FP e L-lactato plasmático são úteis para predizer o desfecho negativo em bovinos com doenças emergências gastrointestinais, especialmente DAD e distúrbios intestinais obstrutivos.(AU)

Molecular mechanisms of multidrug resistance in clinically relevant enteropathogenic bacteria (Review).

Multidrug resistant (MDR) enteropathogenic bacteria are a growing problem within the clinical environment due to their acquired tolerance to a wide range of antibiotics, thus causing severe illnesses and a tremendous economic impact in the healthcare sector. Due to its difficult treatment, knowledge and understanding of the molecular mechanisms that confer this resistance are needed. The aim of the present review is to describe the mechanisms of antibiotic resistance from a genomic perspective observed in bacteria, including naturally acquired resistance. The present review also discusses common pharmacological and alternative treatments used in cases of infection caused by MDR bacteria, thus covering necessary information for the development of novel antimicrobials and adjuvant molecules inhibiting bacterial proliferation.

Diagnosis and management of small bowel neuroendocrine tumors: A state-of-the-art.

This review provides an update on the epidemiology, pathophysiology, symptoms, diagnosis and treatment of neuroendocrine neoplasms (NENs) of the small bowel (SB). These NENs are defined as a group of neoplasms deriving from neuroendocrine cells. NENs are currently the most common primary tumors of the SB, mainly involving the ileum, making the SB the most frequently affected part of the gastrointestinal tract. SB NENs by definition are located between the ligament of Treitz and the ileocecal valve. They are characterized by small size and induce an extensive fibrotic reaction in the small intestine including the mesentery, resulting in narrowing or twisting of the intestine. Clinical manifestations of bowel functionality are related to the precise location of the primary tumor. The majority of them are non-functional NENs and generally asymptomatic; in an advanced stage, NENs present symptoms of mass effect by non-specific abdominal pain or carcinoid syndrome which appears in patients with liver metastasis (around 10%). The main manifestations of the carcinoid syndrome are facial flushing (94%), diarrhea (78%), abdominal cramps (50%), heart valve disease (50%), telangiectasia (25%), wheezing (15%) and edema (19%). Diagnosis is made by imaging or biochemical tests, and the order of request will depend on the initial diagnostic hypothesis, while confirmation will always be histological. All patients with a localized SB NEN with or without near metastasis in the mesentery are recommended for curative resection. Locoregional and distant spread may be susceptible to several therapeutic strategies, such as chemotherapy, somatostatin analogs and palliative resection.

Blenderized formulations in home enteral nutrition: a narrative review about challenges in nutritional security and food safety.

Blenderized formulations (BFs) are prepared by homogenization of food that is normally used in oral nutrition. BFs are mainly used in home enteral nutrition (HEN), although their use has also been reported by hospitals when commercial enteral formulas are not available. HEN is applied when the patient has been discharged from the hospital. This nutritional therapy promotes the patient's reintegration into the family nucleus and promotes humanized care, and decreases treatment costs. However, the patient should continue to receive health and nutritional care, ranging from periodic nutritional re-evaluation to adaptation of the dietary plan. HEN provides the patient a greater contact with the family, whereas BFs promote the adaptation of the diet with food, respecting the food diversity and culture, lower cost, and easier access to food. Disadvantages of BFs include more time spent by the professional to calculate the dietary plan, greater difficulty in adjusting daily needs, and less microbiological and chemical stability. In this review, the nutritional, food security, and safety aspects of BF used in HEN are discussed. Technological quality aspects that are essential knowledge in the preparation of the patient's dietary plan also are presented.

Linfoma alimentar canino: relato de caso / Canine alimentary lymphoma: case report / Linfoma alimentario canino: reporte de caso

O linfoma é a neoplasia linfo-hematopoiética mais frequente em cães. A forma alimentar é pouco comum em cães, representando cerca de 5 a 7% de todos os tipos de linfomas caninos. Apenas 20% dos cães acometidos apresentam idade inferior a quatro anos. Ela caracteriza-se pela localização no trato gastrointestinal e/ou linfonodos mesentéricos e aqueles não tratados vivem entre quatro a seis semanas após o início dos sinais clínicos ou diagnóstico. A quimioterapia é a modalidade terapêutica de escolha para cães com linfoma. Este trabalho tem como objetivo descrever um caso de linfoma alimentar em um cão de três anos de idade, atendido no Hospital Veterinário da Ulbra - Canoas, com quadro de vômito, hematoquezia, polidipsia, anorexia e perda de peso progressiva. Com presença de espessamento grave e difuso de segmentos intestinais e linfonodomegalia de linfonodo pancreático e jejunal ao exame ultrassonográfico. O diagnóstico foi confirmado posteriormente por necropsia e exame histopatológico, após o óbito do paciente.(AU)

Lymphoma is the most frequent lympho-hematopoietic neoplasm in dogs. The alimentary form is uncommon in dogs, representing 5 to 7% of all types of canine lymphomas. Only 20% of affected dogs are under the age of four. This disease is characterized by the location in the gastrointestinal tract and/or mesenteric lymph nodes and those untreated live four to six weeks after the onset of clinical signs or diagnosis. Chemotherapy is the therapeutic modality of choice for dogs with lymphoma. This report aims to describe a case of alimentary lymphoma in a three year old dog treated at the Hospital Veterinário da Ulbra - Canoas, presenting vomiting, hematochezia, polydipsia, anorexia and progressive weight loss. With the presence of severe and diffuse thickening of intestinal segments and lymph node enlargement of pancreatic and jejunal lymph nodes on abdominal ultrasound exam. The diagnosis was later confirmed by necropsy and histopathological examination after the patient's death.(AU)

El linfoma es la neoplasia linfohematopoyética más frecuente en perros, La forma alimentaria es poco común en los perros y representa aproximadamente 5 al 7% de todos los tipos de linfomas caninos. Solo el 20% de los perros afectados tienen menos de cuatro años. Se caracteriza por su localización en el tracto gastrointestinal y/o en los ganglios linfáticos mesentéricos y los que no reciben tratamiento viven entre cuatro y seis semanas después del inicio de los signos clínicos o del diagnóstico. La quimioterapia es la modalidad terapéutica de elección para perros con linfoma. Este artículo tiene como objetivo describir un caso de linfoma alimentario en un perro de tres años atendido en el Hospital Veterinário da Ulbra - Canoas, con vómitos, hematoquecia, polidipsiaa, anorexia y pérdida progresiva de peso. Con la presencia de engrosamiento severo y difuso de los segmentos intestinales y agrandamiento de los ganglios linfáticos pancreáticos y yeyunales en el examen de ultrasonido. El diagnóstico se confirmó posteriormente mediante necropsia y examen histopatológico tras la muerte del paciente.(AU)

Síndrome cólica em equinos induzida por ingestão de cana de açúcar / Equine colic syndrome induced by the ingestion of sugarcane

Background: Equine colic syndrome comprises numerous conditions associated with abdominal pain in horses. Impaction, a common cause of this manifestation, is strongly related to these animals' diet. Highly fibrous diets such as sugarcane can predispose horses to colic. The clinical condition can be worsened by fermentative processes, which lead to dysbiosis, circulatory disorders and even endotoxemia. The aim of this study was to report 4 cases of colic syndrome among 8 horses that underwent an experiment to adapt them to a sugarcane-based diet, and to correlate the animals' clinical conditions to the forage they ingested. Cases: Eight male castrated Mangalarga Marchador horses, between 5.5 and 7 years old, were subjected to an experiment to test the feasibility of sugarcane as forage. Four of these horses were taken to the Large Animal Veterinary Hospital (HVGA) of the Federal Rural University of Rio de Janeiro for treatment of abdominal signs of discomfort a few days after the exclusive consumption of sugarcane, in a proportion of 1.75% of live weight in dry matter. The animals' symptoms ranged from behavioral signs indicative of pain to changes in vital parameters and structure of the feces, as well as changes revealed by transrectal palpation. Three of the 4 cases presented impaction in the small colon, and 1 of the horses also presented impaction in the right dorsal colon and rostral displacement of the pelvic flexure, with accumulation of contents in the right ventral colon and sternal flexure. Two of the cases were treated medically, while the other 2 required surgical intervention. The clinical condition of all the patients evolved favorably and they were discharged between 2 and 18 days. Discussion: Colic originating in the digestive system is a syndrome strongly associated with management, especially with respect to confinement, nutrition, and parasite control. During the experiment, 4 of the 8 horses fed with sugarcane presented with colic syndrome. The low quality of sugarcane fiber is due to the high degree of lignification of the plant cell wall, which favors accumulation of ingesta. The poor digestibility and sweet taste of this roughage favor increased consumption. Furthermore, its high sucrose content, associated with an increased rate of passage in the small intestine, alters the intestinal microbiome, and hence, the fermentation byproducts and pH of the ingesta. High intestinal content, allied to longer retention times in the colon and activation of the renin-angiotensin-aldosterone system, promote greater dryness of the ingesta, predisposing the occurrence of impactions in the most distal portion of the large intestine. Intestinal distension and mesenteric traction caused by the accumulation of contents and gases trigger pain, which can worsen due to displacement of the large colon. Small colon impaction, which is easily identified by transrectal palpation, evolves gradually and its treatment, both clinical and surgical, tends to have a favorable prognosis. The need for alternative food sources for horses is a growing demand; however, sugarcane as an exclusive roughage has been shown to be unsafe for horses. The low quality of the fiber and the high sucrose content of this forage can alter the digestive physiology of horses through changes in the passage rate, microbiome and motility of digesta, predisposing them to intestinal dysfunction, ingesta compaction and displacement of the large colon.

Canine pancreatitis: the development of the pancreatic inflammatory condition and the clinical-therapeutic approach / Pancreatite canina: o desenvolvimento da condição inflamatória pancreática e a abordagem clínico-terapêutica / Pancreatitis canina: el desarrollo de la condición inflamatoria pancreática y el enfoque clínico-terapéutico

La pancreatitis, aguda o crónica, es una enfermedad grave para los perros, debido a su potencial nocivo y a la existencia de infradiagnóstico. La enfermedad sigue siendo objeto de estudios en cuanto a su fisiopatología y mecanismos terapéuticos, debido a que los signos que presentan los animales son inespecíficos y van desde presentaciones leves a severas. Puede provocar cambios morfofuncionales en el páncreas y órganos adyacentes. El diagnóstico puede ser una tarea muy difícil, ya sea por los síntomas variables y la gravedad de la enfermedad, o por los callejones sin salida experimentados en el momento de los exámenes complementarios. El manejo terapéutico se define en base a los síntomas que presentan los animales, que van desde la infusión de líquidos para reposición de volumen, analgésicos, antieméticos, antibióticos, alimentos especiales, entre otros.(AU)

Pancreatitis, acute or chronic, is a serious disease for dogs, due to its harmful potential and the existence of underdiagnosis. The disease is still the target of studies regarding its pathophysiology and therapeutic mechanisms, because the signs presented by the animals are nonspecific, ranging from mild to severe presentations. It can cause morphofunctional changes in the pancreas and adjacent organs. The diagnosis can be a very difficult task, either due to the variable symptoms and severity of the disease, or the impasses experienced at the time of the complementary exams. Therapeutic management is defined based on the symptoms presented by the animals, ranging from fluid infusion for volume replacement, analgesics, antiemetics, antibiotics, special food, among others.(AU)

A pancreatite é uma doença grave para os cães, tanto pelo seu potencial deletério quanto pela existência de subdiagnósticos, e pode ser classificada em aguda ou crônica. A doença ainda é alvo de estudos no que diz respeito a sua patofisiologia e mecanismos terapêuticos, uma vez que os sinais apresentados pelos animais são inespecíficos, variando desde apresentações brandas a graves. Pode causar alteração morfofuncional do pâncreas e órgãos adjacentes. O diagnóstico pode ser uma tarefa bastante difícil, seja pela sintomatologia variável e gravidade da doença como também pelos impasses vivenciados no momento da realização dos exames complementares. O manejo terapêutico é definido com base na sintomatologia apresentada pelos animais, variando desde a infusão de fluidos para reposição volêmica, analgésicos, antieméticos, antibióticos, alimentação especial, entre outros.(AU)

Diabetic gastroenteropathy: An underdiagnosed complication.

This article is an extensive review that provides an update on the pathophysiology, symptoms, diagnosis, and treatment of diabetic gastroenteropathy. There is no reported prevalence, but it has been described that patients with type 1 diabetes have a cumulative incidence at 10 years of 5.2%, and type 2 patients, 1%. Also, in the group of type 1 diabetes, it has been observed that women are more likely to present this condition (5.8% vs 3.5%). Many factors are associate with its development (e.g., hyperglycemia, vagal dysfunction, loss of expression of neural nitric oxide synthase in the myenteric plexus, alterations in the Cajal interstitial cell network, and oxidative stress). Gastrointestinal discomfort could be perceived 70% higher in diabetic patients, describing that 25% of diabetic patients experience gastrointestinal symptoms. Diabetic enteropathy could affect any portion of the gastrointestinal tract, but esophageal alterations were described in more than 60% of diabetic patients, also 60% of them present constipation, and 20%, diarrhea. Gastric emptying scintigraphy is useful to evaluate gastroparesis, therefore, gastric retention of more than 60% at 2 h has a sensitivity of 100% and specificity of 20% for diagnosis; however, other studies such as breath tests, with a sensitivity of 89% and a specificity of 80%, or the endoscopic capsule contribute to the diagnosis. There is no cure; however, management must be multidisciplinary, focused on slowing the progression of diabetic gastroenteropathy, reducing symptoms, and restoring function; that includes nutritional recommendation, maintain glucose levels kept below 180 mg/dL, use of prokinetics, anti-emetics; nowadays, it has been special interest in surgical treatment, such as pyloroplasty, also gastric electrical stimulation appears to be another alternative.

Canine pancreatitis: the development of the pancreatic inflammatory condition and the clinical-therapeutic approach / Pancreatite canina: o desenvolvimento da condição inflamatória pancreática e a abordagem clínico-terapêutica / Pancreatitis canina: el desarrollo de la condición inflamatoria pancreática y el enfoque clínico-terapéutico

La pancreatitis, aguda o crónica, es una enfermedad grave para los perros, debido a su potencial nocivo y a la existencia de infradiagnóstico. La enfermedad sigue siendo objeto de estudios en cuanto a su fisiopatología y mecanismos terapéuticos, debido a que los signos que presentan los animales son inespecíficos y van desde presentaciones leves a severas. Puede provocar cambios morfofuncionales en el páncreas y órganos adyacentes. El diagnóstico puede ser una tarea muy difícil, ya sea por los síntomas variables y la gravedad de la enfermedad, o por los callejones sin salida experimentados en el momento de los exámenes complementarios. El manejo terapéutico se define en base a los síntomas que presentan los animales, que van desde la infusión de líquidos para reposición de volumen, analgésicos, antieméticos, antibióticos, alimentos especiales, entre otros.

Pancreatitis, acute or chronic, is a serious disease for dogs, due to its harmful potential and the existence of underdiagnosis. The disease is still the target of studies regarding its pathophysiology and therapeutic mechanisms, because the signs presented by the animals are nonspecific, ranging from mild to severe presentations. It can cause morphofunctional changes in the pancreas and adjacent organs. The diagnosis can be a very difficult task, either due to the variable symptoms and severity of the disease, or the impasses experienced at the time of the complementary exams. Therapeutic management is defined based on the symptoms presented by the animals, ranging from fluid infusion for volume replacement, analgesics, antiemetics, antibiotics, special food, among others.

A pancreatite é uma doença grave para os cães, tanto pelo seu potencial deletério quanto pela existência de subdiagnósticos, e pode ser classificada em aguda ou crônica. A doença ainda é alvo de estudos no que diz respeito a sua patofisiologia e mecanismos terapêuticos, uma vez que os sinais apresentados pelos animais são inespecíficos, variando desde apresentações brandas a graves. Pode causar alteração morfofuncional do pâncreas e órgãos adjacentes. O diagnóstico pode ser uma tarefa bastante difícil, seja pela sintomatologia variável e gravidade da doença como também pelos impasses vivenciados no momento da realização dos exames complementares. O manejo terapêutico é definido com base na sintomatologia apresentada pelos animais, variando desde a infusão de fluidos para reposição volêmica, analgésicos, antieméticos, antibióticos, alimentação especial, entre outros.

Thrombocytosis: a retrospective study of 573 dogs (2016-2017) / Trombocitose: um estudo retrospectivo em 573 cães (2016-2017)

Thrombocytosis refers to the increase in number of platelets per microliter (µL) of blood. Platelet counts greater than 1,000,000/µL may be associated with clinical signs of bleeding or thrombosis. Previous studies on underlying causes of thrombocytosis have aroused the interest of researchers about its clinical importance in dogs. The objective of this study was to analyze the blood cell counts in dogs in order to define the main diseases or clinical conditions that were associated with thrombocytosis, from 2016 to 2017. This was done to determine the incidence of thrombocytosis, and categorize the increase in platelet count with respect to severity. Of the 12,676 blood samples analyzed, 4.5% presented thrombocytosis (n = 573). Similar mean platelet counts were observed in all diagnosis or different categories of clinical conditions (neoplasms; gastrointestinal, endocrine, and ophthalmological diseases; trauma and surgery; dermatological, cardiac, neurological, infectious, respiratory, genitourinary, idiopathic, and multiple diseases; and pregnancy) with no significant difference (P ≥ 0.05). The disorders most commonly associated with thrombocytosis were gastrointestinal diseases, followed by neoplasms. Furthermore, increased platelet counts were observed in dogs treated with glucocorticoids and vincristine drugs. As for the degree of severity, extreme thrombocytosis occurred more frequently in the presence of gastrointestinal diseases.(AU)

A trombocitose é o aumento do número de plaquetas por microlitro (µL) de sangue e contagens maiores que 1.000.000/µL podem estar associadas a sinais clínicos de sangramento ou trombose. Estudos anteriores sobre as causas subjacentes da trombocitose tem despertado o interesse quanto a sua importância clínica em cães. O presente estudo teve como objetivo analisar hemogramas de cães, com a finalidade de definir as principais doenças ou condições clínicas associadas à trombocitose dentro do período de dois anos, determinar a incidência e ainda categorizar as contagens de acordo com a severidade do aumento de plaquetas. De 12.676 hemogramas analisados, observou-se incidência de trombocitose de 4,5% (n=573). As contagens médias de plaquetas em todas as categorias de diagnósticos ou condições clínica (neoplasias, doenças gastrointestinais, endócrinas, oftalmológicas, traumas e cirurgias, dermatológicas, cardíacas, neurológicas, infecciosas, respiratórias, geniturinárias, idiopáticas, múltiplas e gestação) foram semelhantes, não havendo diferença significativa entre elas (P≥0,05). Os distúrbios mais comumente associados à trombocitose foram as doenças gastrointestinais seguidas de neoplasias. Além disso, os aumentos na contagem de plaquetas foram observados em cães tratados com glicocorticoides e vincristina. Quanto ao grau de severidade, a trombocitose extrema ocorreu mais frequentemente nas doenças gastrointestinais.(AU)

A retrospective study on the influence of siblings' relatedness in Bolivian patients with chronic Chagas disease.

BACKGROUND: Chagas disease is a protozoan infection caused by Trypanosoma cruzi. The disease has a chronic course in which 20-30% of the patients would develop progressive damage to the cardiovascular system and the gastrointestinal tube. We are still unable to predict who will develop end-organ damage but there are some acquired and genetic risk factors already known. RESULTS: We reviewed data from 833 patients with serologically confirmed Chagas disease in this retrospective study. Patients were classified as siblings or non-siblings (controls) and the results of pre-treatment blood PCR assay, end-organ damage (cardiac and/or gastrointestinal), and the presence of delayed type hypersensitivity (DTH) skin involvement in patients treated with benznidazole were analyzed. Siblings were grouped by family and we randomly generated groups of 2 or 3 persons with the remaining controls. We classified the results of each variable as concordant or discordant and compared the concordance in these results among the sibling groups with that among control groups. We identified 71 groups of siblings and randomly generated 299 groups of non-related patients. Pre-treatment blood PCR concordance was significantly higher (19%) among siblings compared to controls (P = 0.02), probably due to a higher frequency in pre-treatment positive results. No other statistically significant differences were found. CONCLUSIONS: A significant difference was found in the concordance of pre-treatment blood PCR for T. cruzi among siblings compared to non-related controls.

Thrombocytosis: a retrospective study of 573 dogs (2016-2017) / Trombocitose: um estudo retrospectivo em 573 cães (2016-2017)

Thrombocytosis refers to the increase in number of platelets per microliter (µL) of blood. Platelet counts greater than 1,000,000/µL may be associated with clinical signs of bleeding or thrombosis. Previous studies on underlying causes of thrombocytosis have aroused the interest of researchers about its clinical importance in dogs. The objective of this study was to analyze the blood cell counts in dogs in order to define the main diseases or clinical conditions that were associated with thrombocytosis, from 2016 to 2017. This was done to determine the incidence of thrombocytosis, and categorize the increase in platelet count with respect to severity. Of the 12,676 blood samples analyzed, 4.5% presented thrombocytosis (n = 573). Similar mean platelet counts were observed in all diagnosis or different categories of clinical conditions (neoplasms; gastrointestinal, endocrine, and ophthalmological diseases; trauma and surgery; dermatological, cardiac, neurological, infectious, respiratory, genitourinary, idiopathic, and multiple diseases; and pregnancy) with no significant difference (P ≥ 0.05). The disorders most commonly associated with thrombocytosis were gastrointestinal diseases, followed by neoplasms. Furthermore, increased platelet counts were observed in dogs treated with glucocorticoids and vincristine drugs. As for the degree of severity, extreme thrombocytosis occurred more frequently in the presence of gastrointestinal diseases.

A trombocitose é o aumento do número de plaquetas por microlitro (µL) de sangue e contagens maiores que 1.000.000/µL podem estar associadas a sinais clínicos de sangramento ou trombose. Estudos anteriores sobre as causas subjacentes da trombocitose tem despertado o interesse quanto a sua importância clínica em cães. O presente estudo teve como objetivo analisar hemogramas de cães, com a finalidade de definir as principais doenças ou condições clínicas associadas à trombocitose dentro do período de dois anos, determinar a incidência e ainda categorizar as contagens de acordo com a severidade do aumento de plaquetas. De 12.676 hemogramas analisados, observou-se incidência de trombocitose de 4,5% (n=573). As contagens médias de plaquetas em todas as categorias de diagnósticos ou condições clínica (neoplasias, doenças gastrointestinais, endócrinas, oftalmológicas, traumas e cirurgias, dermatológicas, cardíacas, neurológicas, infecciosas, respiratórias, geniturinárias, idiopáticas, múltiplas e gestação) foram semelhantes, não havendo diferença significativa entre elas (P≥0,05). Os distúrbios mais comumente associados à trombocitose foram as doenças gastrointestinais seguidas de neoplasias. Além disso, os aumentos na contagem de plaquetas foram observados em cães tratados com glicocorticoides e vincristina. Quanto ao grau de severidade, a trombocitose extrema ocorreu mais frequentemente nas doenças gastrointestinais.

Tromboflebite jugular em equinos submetidos à laparotomia para o tratamento de afecção gastrointestinal / Jugular thrombophlebitis in horses subjected to laparotomy for the treatment of gastrointestinal disease

Afecções do trato gastrointestinal de equinos podem causar distúrbios de coagulação devido à concentração elevada de mediadores inflamatórios que estimulam a hemostasia e inibem a fibrinólise, gerando um estado de hipercoagulação. Equinos submetidos à laparotomia no tratamento da síndrome cólica permanecem com cateter venoso durante vários dias para a administração de fluidos e fármacos no período pós-operatório e, a veia jugular é o principal local para a implantação de cateteres. Assim, o trauma vascular persistente causado pelo cateter, associado ao ambiente pró-trombótico induzido pela afecção gastrointestinal, aumenta o risco para o desenvolvimento de tromboflebite jugular. Objetivou-se avaliar as características físicas e ultrassonográficas da veia jugular canulada com cateter de poliuretano durante o período pós-operatório de equinos submetidos à laparotomia. O cateter foi inserido de forma asséptica à admissão e permaneceu por sete dias. A avaliação ultrassonográfica revelou o desenvolvimento de tromboflebite em um equino, 48 após o procedimento cirúrgico. Os demais equinos demonstraram espessamento da parede vascular no local de punção e pequenos trombos junto ao cateter. A monitoração ultrassonográfica demonstrou que a cateterização prolongada em equinos submetidos à laparotomia, seguindo o protocolo proposto, minimiza a lesão vascular e pode prevenir a tromboflebite jugular.(AU)

Coagulation abnormalities are usually associated with equine gastrointestinal disease due to the increased levels of inflammatory mediators, which promotes hemostasis and inhibit fibrinolysis, creating a hypercoagulable state. Horses underwent laparotomy to treat colic usually require a venous catheter for several days to administrate fluids and drugs during the postoperative period, and the jugular vein is the most frequent site for catheterization. Therefore, the persistent vascular trauma caused by an implanted catheter, associated with the prothrombotic environment induced by the gastrointestinal disorder, increases the risk for the development of jugular thrombophlebitis. The purpose of the present investigation was to evaluate physical and ultrassonographic features of the jugular vein cannulated with a polyurethane catheter during the postoperative period of horses underwent colic surgery. The catheter was inserted aseptically on admission and dwell time was seven days. Upon ultrasound examination, one horse developed thrombophlebitis 48 hours after surgery and the other horses showed thickened venous wall at puncture site and small clots associated to the catheter. Ultrasound monitoration showed that long-term catheterization in horses underwent colic surgery following the present protocol minimizes vascular trauma and could prevent jugular thrombophlebitis.(AU)

Tromboflebite jugular em equinos submetidos à laparotomia para o tratamento de afecção gastrointestinal / Jugular thrombophlebitis in horses subjected to laparotomy for the treatment of gastrointestinal disease

Afecções do trato gastrointestinal de equinos podem causar distúrbios de coagulação devido à concentração elevada de mediadores inflamatórios que estimulam a hemostasia e inibem a fibrinólise, gerando um estado de hipercoagulação. Equinos submetidos à laparotomia no tratamento da síndrome cólica permanecem com cateter venoso durante vários dias para a administração de fluidos e fármacos no período pós-operatório e, a veia jugular é o principal local para a implantação de cateteres. Assim, o trauma vascular persistente causado pelo cateter, associado ao ambiente pró-trombótico induzido pela afecção gastrointestinal, aumenta o risco para o desenvolvimento de tromboflebite jugular. Objetivou-se avaliar as características físicas e ultrassonográficas da veia jugular canulada com cateter de poliuretano durante o período pós-operatório de equinos submetidos à laparotomia. O cateter foi inserido de forma asséptica à admissão e permaneceu por sete dias. A avaliação ultrassonográfica revelou o desenvolvimento de tromboflebite em um equino, 48 após o procedimento cirúrgico. Os demais equinos demonstraram espessamento da parede vascular no local de punção e pequenos trombos junto ao cateter. A monitoração ultrassonográfica demonstrou que a cateterização prolongada em equinos submetidos à laparotomia, seguindo o protocolo proposto, minimiza a lesão vascular e pode prevenir a tromboflebite jugular.(AU)

Coagulation abnormalities are usually associated with equine gastrointestinal disease due to the increased levels of inflammatory mediators, which promotes hemostasis and inhibit fibrinolysis, creating a hypercoagulable state. Horses underwent laparotomy to treat colic usually require a venous catheter for several days to administrate fluids and drugs during the postoperative period, and the jugular vein is the most frequent site for catheterization. Therefore, the persistent vascular trauma caused by an implanted catheter, associated with the prothrombotic environment induced by the gastrointestinal disorder, increases the risk for the development of jugular thrombophlebitis. The purpose of the present investigation was to evaluate physical and ultrassonographic features of the jugular vein cannulated with a polyurethane catheter during the postoperative period of horses underwent colic surgery. The catheter was inserted aseptically on admission and dwell time was seven days. Upon ultrasound examination, one horse developed thrombophlebitis 48 hours after surgery and the other horses showed thickened venous wall at puncture site and small clots associated to the catheter. Ultrasound monitoration showed that long-term catheterization in horses underwent colic surgery following the present protocol minimizes vascular trauma and could prevent jugular thrombophlebitis.(AU)

Epidemiological, clinical and pathological features of canine parvovirus 2c infection in dogs from southern Brazil / Aspectos epidemiológicos, clínicos e patológicos da infecção pelo parvovirus canino 2c em cães do Sul do Brasil

Canine parvovirus type 2c (CPV-2c) emerged in Europe in the early 2000's and rapidly spread out worldwide. Clinical and molecular data have demonstrated its circulation in Brazilian dogs, yet detailed descriptions of cases are still lacking. This article describes the epidemiological, clinical and pathological features of 24 cases of CPV-2c-associated disease in dogs submitted to veterinary clinics and laboratory diagnosis in southern Brazil (2014-2016). Most affected dogs presented signs/lesions suggestive of parvovirus enteritis: diarrhea, vomiting, hyperemia and hemorrhage of the serous membrane of the small intestine, diffuse segmental granulation, atrophy of the villi, necrosis and fusion of crypts, squamous metaplasia and epithelial syncytia. A number of cases presented features divergent from the classical presentations, including a wide variation in the color of feces (reddish and/or yellowish, light-brownish, orange-brown and brownish), involvement of adults (4/24) and vaccinated dogs (12/24), extensive involvement of the small intestine (8/20) and the presence of pulmonary edema (7/24) and convulsions (3/24). Feces and intestinal fragments submitted to PCR for the CPV-2 VP2 gene and to virus isolation in cell culture yielded positive results in 100% and 58.3% (14/24) of the cases, respectively. Nucleotide sequencing revealed a high nucleotide identity in VP2 (99.4 to 100%) and a consistent mutation at amino acid 426 (asparagine to glutamic acid), considered a signature of CPV-2c. These results confirm the involvement of CPV-2c in the described cases and demonstrate the importance of CPV-2c infection among Brazilian dogs, calling attention of veterinarians to correctly diagnose the disease, mainly considering the frequent atypical presentations.(AU)

O parvovírus canino tipo 2c (CPV-2c) surgiu na Europa no início do ano 2000 e rapidamente se espalhou pelas populações de cães ao redor do mundo. Dados clínicos e moleculares demonstraram a sua circulação em cães brasileiros, porém descrições detalhadas desses casos ainda são escassas. Este artigo descreve os aspectos epidemiológicos, clínicos e patológicos de 24 casos de doença gastroentérica associada com a infecção pelo CPV-2c em cães atendidos em clínicas veterinárias e submetidos ao diagnóstico laboratorial no Sul do Brasil (2014-2016). A maioria dos cães afetados apresentaram sinais e/ou lesões sugestivas de enterite por parvovírus: diarreia, vômitos, hiperemia e hemorragia na membrana serosa do intestino delgado, granulação segmentar difusa, atrofia das vilosidades, necrose e fusão de criptas, metaplasia escamosa e sincícios epiteliais. Alguns casos apresentaram características divergentes das apresentações clássicas, incluindo uma grande variação na cor das fezes (avermelhada e/ou amarelada, marrom-claro, marrom-alaranjada ou amarronzada), a participação dos adultos (4/24) e cães vacinados (12/24), um amplo envolvimento do intestino delgado (8/20), a presença de edema pulmonar (7/24) e convulsões (3/24). As fezes e fragmentos intestinais foram submetidos ao teste de PCR para o gene VP2 do CPV-2, e ao isolamento do vírus em cultura de células produziram resultados positivos em 100% e 58,3% (14/24) dos casos, respectivamente. O sequenciamento dos nucleótidos revelou uma alta identidade de nucleótidos na VP2 (99,4-100%) e uma mutação no aminoácido 426 (asparagina para ácido glutâmico), considerada uma assinatura de CPV-2c. Estes resultados confirmam o envolvimento do CPV-2c nos casos descritos e demonstra a importância da infecção pelo CPV-2c entre os cães do Brasil, chamando a atenção de veterinários para diagnosticar corretamente a doença, principalmente considerando-se as apresentações atípicas frequentes.(AU)

Epidemiological, clinical and pathological features of canine parvovirus 2c infection in dogs from southern Brazil / Aspectos epidemiológicos, clínicos e patológicos da infecção pelo parvovirus canino 2c em cães do Sul do Brasil

Canine parvovirus type 2c (CPV-2c) emerged in Europe in the early 2000's and rapidly spread out worldwide. Clinical and molecular data have demonstrated its circulation in Brazilian dogs, yet detailed descriptions of cases are still lacking. This article describes the epidemiological, clinical and pathological features of 24 cases of CPV-2c-associated disease in dogs submitted to veterinary clinics and laboratory diagnosis in southern Brazil (2014-2016). Most affected dogs presented signs/lesions suggestive of parvovirus enteritis: diarrhea, vomiting, hyperemia and hemorrhage of the serous membrane of the small intestine, diffuse segmental granulation, atrophy of the villi, necrosis and fusion of crypts, squamous metaplasia and epithelial syncytia. A number of cases presented features divergent from the classical presentations, including a wide variation in the color of feces (reddish and/or yellowish, light-brownish, orange-brown and brownish), involvement of adults (4/24) and vaccinated dogs (12/24), extensive involvement of the small intestine (8/20) and the presence of pulmonary edema (7/24) and convulsions (3/24). Feces and intestinal fragments submitted to PCR for the CPV-2 VP2 gene and to virus isolation in cell culture yielded positive results in 100% and 58.3% (14/24) of the cases, respectively. Nucleotide sequencing revealed a high nucleotide identity in VP2 (99.4 to 100%) and a consistent mutation at amino acid 426 (asparagine to glutamic acid), considered a signature of CPV-2c. These results confirm the involvement of CPV-2c in the described cases and demonstrate the importance of CPV-2c infection among Brazilian dogs, calling attention of veterinarians to correctly diagnose the disease, mainly considering the frequent atypical presentations.(AU)

O parvovírus canino tipo 2c (CPV-2c) surgiu na Europa no início do ano 2000 e rapidamente se espalhou pelas populações de cães ao redor do mundo. Dados clínicos e moleculares demonstraram a sua circulação em cães brasileiros, porém descrições detalhadas desses casos ainda são escassas. Este artigo descreve os aspectos epidemiológicos, clínicos e patológicos de 24 casos de doença gastroentérica associada com a infecção pelo CPV-2c em cães atendidos em clínicas veterinárias e submetidos ao diagnóstico laboratorial no Sul do Brasil (2014-2016). A maioria dos cães afetados apresentaram sinais e/ou lesões sugestivas de enterite por parvovírus: diarreia, vômitos, hiperemia e hemorragia na membrana serosa do intestino delgado, granulação segmentar difusa, atrofia das vilosidades, necrose e fusão de criptas, metaplasia escamosa e sincícios epiteliais. Alguns casos apresentaram características divergentes das apresentações clássicas, incluindo uma grande variação na cor das fezes (avermelhada e/ou amarelada, marrom-claro, marrom-alaranjada ou amarronzada), a participação dos adultos (4/24) e cães vacinados (12/24), um amplo envolvimento do intestino delgado (8/20), a presença de edema pulmonar (7/24) e convulsões (3/24). As fezes e fragmentos intestinais foram submetidos ao teste de PCR para o gene VP2 do CPV-2, e ao isolamento do vírus em cultura de células produziram resultados positivos em 100% e 58,3% (14/24) dos casos, respectivamente. O sequenciamento dos nucleótidos revelou uma alta identidade de nucleótidos na VP2 (99,4-100%) e uma mutação no aminoácido 426 (asparagina para ácido glutâmico), considerada uma assinatura de CPV-2c. Estes resultados confirmam o envolvimento do CPV-2c nos casos descritos e demonstra a importância da infecção pelo CPV-2c entre os cães do Brasil, chamando a atenção de veterinários para diagnosticar corretamente a doença, principalmente considerando-se as apresentações atípicas frequentes.(AU)