Clinical Signs Research Articles

Colonoscopy-assisted removal of an impaction foreign body at the rectosigmoid junction: A case report

BACKGROUND When an anorectal foreign body is found, its composition and shape should be evaluated, and a timely and effective treatment plan should be developed based on the patient's symptoms to avoid serious complications such as intestinal perforation caused by displacement of the foreign body. CASE SUMMARY A 54-year-old male was admitted to our outpatient clinic on June 3, 2023, due to a rectal foreign body that had been embedded for more than 24 h. The patient reported using a glass electrode tube to assist in the recovery of prolapsed hemorrhoids, however, the electrode tube was inadvertently inserted into the anus and could not be removed by the patient. During hospitalization, the patient underwent surgery, and the foreign body was dragged into the rectum with the aid of colonoscopy. The anus was dilated with a comb-type pulling hook and an anal fistula pulling hook to widen the anus and remove the foreign body, and the local anal symptoms were then relieved with topical drugs. The patient was allowed to eat and drink, and an entire abdominal Computed tomography (CT) and colonoscopy were reviewed 3 d after surgery. CT revealed no foreign body residue and colonoscopy showed no metal or other residues in the colon and rectum, and no apparent intestinal tract damage. CONCLUSION The timeliness and rationality of the surgical and therapeutic options for this patient were based on a literature review of the clinical signs and conceivable conditions in such cases. The type, material and the potential risks of rectal foreign bodies should be considered.

Early Neurophysiological Abnormalities in Suspected Acute Canine Polyradiculoneuropathy

Acute canine polyradiculoneuritis (ACP) is a common peripheral neuropathy in dogs, and is generally self-limiting and benign. Electrodiagnostic (EDX) tests are typically performed after 7–10 days. Delaying the definitive diagnosis may hamper the treatment of other causes of acute weakness, which may require specific treatments and may carry different prognoses. This retrospective multicenter study aims to assess whether EDX performed within the first 6 days of clinical signs onset can detect alterations indicative of ACP, and aims to characterize the most prevalent alterations. A total of 71 dogs with suspected ACP were retrospectively analyzed and classified into two groups based on EDX timing: early group (EG, 1–6 days after symptom onset) and late group (LG, 7–15 days after symptom onset). In our study, no significant differences were found between the two groups in motor nerve conduction studies (MNCSs) and F-wave analysis, indicating that EDX is able to demonstrate abnormalities even in the first 6 days from onset. Although the LG showed significantly greater degrees of electromyographic (EMG) alterations compared to the EG, frequent muscle alterations were still observed in the EG group. These findings support the use of EDX in patients with suspected ACP within the first 6 days from the clinical onset. Prompt neurophysiological examinations for suspected ACP patients can be performed effectively and can help allow for early diagnosis and facilitate appropriate treatment.

Cesarean Sectional as a Treatment of Dystocia Caused by Uterine Torsion in Mehsana Buffalo

A case of dystocia due to post-cervical right side uterine torsion with the history of colic and straining since (days) in a pluriparous Mehsana buffalo was presented at the clinics of Veterinary Gynaecology and Obstetrics of Veterinary College, Sardarkrushinagar, Dantiwada, Gujarat, India. Maternal dystocia due to of uterine torsion was diagnosed by history, a clinical sign, per rectal and per vaginal examinations. At first we used modified Schaffer’s method for management of uterine torsion in buffalo. After the three rolls torsion was detorted successfully, but due to insufficient dilated cervix the fetus could not be delivered. Further, the buffalo was treated therapeutically using intravenous administration of 10ml-Dexamethasone®, 75IU-Oxytocin®, 1litre-Normal saline, 1litre-Ringer lactate, 100ml-Calcium borogluconate and 10ml-Valethamate bromide (Epidosin®) was given intramuscularly for treating incomplete cervical dilation(ICD). However, the buffalo could not responded to treatment, therefore finally the caesarean section was performed and a dead male fetus was delivered. Buffalo was post-medicated with various fluids, analgesic, antibiotic and antihistamine parentally apart from intra-uterine pessaries which resulted to recovery of affected Mehsana buffalo within some days.

Repeated-dose toxicity and toxicokinetic study of isobutylparaben in rats subcutaneously treated for 13weeks.

Parabens have historically served as antimicrobial preservatives in a range of consumables such as food, beverages, medications, and personal care products due to their broad-spectrum antibacterial and antifungal properties. Traditionally, these compounds were believed to exhibit low toxicity, causing minimal irritation, and possessing limited sensitization potential. However, recent evidence suggests that parabens might function as endocrine-disrupting chemicals (EDCs). Consequently, extensive research is underway to elucidate potential human health implications arising from exposure to these substances. Among these parabens, particular concerns have been raised regarding the potential adverse effects of iso-butylparaben (IBP). Studies have specifically highlighted its potential for inducing hormonal disruption, significant ocular damage, and allergic skin reactions. This study aimed to evaluate the prolonged systemic toxicity, semen quality, and estrus cycle in relation to endocrine disruption endpoints, alongside assessing the toxicokinetic behavior of IBP in Sprague-Dawley rats following a 13-week repeated subcutaneous administration. The rats were administered either the vehicle (4% Tween 80) or IBP at dosage levels of 2, 10, and 50mg/kg/day for 13weeks. Blood collection for toxicokinetic study was conducted on three specified days: day 1 (1st), day 30 (2nd), and day 91 (3rd). Systemic toxicity assessment and potential endocrine effects were based on various parameters including mortality rates, clinical signs, body weights, food and water consumption, ophthalmological findings, urinalysis, hematological and clinical biochemistry tests, organ weights, necropsy and histopathological findings, estrus cycle regularity, semen quality, and toxicokinetic behavior. The findings revealed that IBP induced local irritation at the injection site in males at doses ≥ 10mg/kg/day and in females at 50mg/kg/day; however, systemic toxicity was not observed. Consequently, the no-observed-adverse-effect level (NOAEL) for IBP was determined to be 50mg/kg/day in rats of both sexes, indicating no impact on the endocrine system. The toxicokinetics of IBP exhibited dose-dependent systemic exposure, reaching a maximum dose of 50mg/kg/day, and repeated administration over 13weeks showed no signs of accumulation.

Clinical findings, treatment and outcome of trapped neutrophil syndrome in Border Collies: 12 cases (2011-2022).

This study aimed to evaluate clinical signs, diagnostic findings, treatment administered and short- (survival to 28 days) and long-term prognosis (survival >6 months) in dogs diagnosed with trapped neutrophil syndrome. Medical records of 12 dogs (10 Border Collies and two Border Collie Crossbreeds) homozygous for VPS13B gene mutation causing trapped neutrophil syndrome from seven veterinary institutions between January 2011 and June 2022 were evaluated retrospectively. The most common clinical signs at the time of diagnosis were pyrexia, abnormal gait and gastrointestinal signs. Concurrent metaphyseal osteopathy and immune-mediated polyarthritis were common. Seven dogs had a segmented neutrophil count below, four dogs within and one dog above the analyser reference interval at presentation. Two dogs had a septic source identified and both were additionally identified to be homozygous mutant positive on DNA testing by polymerase chain reaction (PCR)for canine cyclic neutropenia. All dogs received at least one antimicrobial agent and 10 dogs received treatment with prednisone or prednisolone (median starting dose 1 mg/kg/day; range 0.5 to 2.5 mg/kg/day). Nine dogs were alive at 28 days and six dogs were alive at 6 months post-diagnosis. Trapped neutrophil syndrome should be suspected in young Border Collies with pyrexia, lameness and gastrointestinal signs. Neutropenia may not always be present and long-term survival is possible. A septic focus was not commonly identified in our population; however, our results suggest that if identified, testing for concurrent canine cyclic neutropenia should be considered.

Clinical findings and outcome predictors for multinodular pulmonary fibrosis in horses: 46 cases (2009-2019).

Prognostic indicators for equine multinodular pulmonary fibrosis (EMPF), an interstitial fibrosing lung disease, are poorly described. Describe diagnostic findings and outcome predictors for EMPF. Forty-six adult horses with EMPF. Retrospective multicenter case series from 2009 to 2019. Radiographic (n = 27) and ultrasonographic studies (n = 19) from EMPF horses and bronchoalveolar lavage fluid (BALF) cytology from 6 EMPF and 13 asthma cases were independently reviewed and blinded to diagnosis and outcome. Associations between predictor variables and survival were assessed by predictor screening followed by Fisher's exact and Wilcoxon rank sum tests. Primary clinical findings were weight loss (36/46, 78%), increased respiratory effort (33/46, 72%), tachypnea (32/46, 70%), and fever (18/46, 39%). Macrophage atypia was seen in more EMPF than asthmatic horse BALF (67% vs. 8%; P = .02). Equine herpesvirus 5 (EHV-5) was detected in 24 of 30 (80%) and hyperfibrinogenemia in 25 of 28 (89%) cases. Twenty-seven of 46 horses (59%) and 11 of 45 (24%) survived to discharge and to 3 months, respectively. Three-month survival was associated with lower median (range) respiratory rates (30 [24-36] vs. 41 [30-60] breaths per minute; P = .04), and higher BALF lymphocyte:neutrophil ratios (4.7 [1.4-22] vs. 0.47 [0.11-1.9]; P = .01) and blood lymphocyte counts (1.25 [0.93-2.55] vs. 0.90 [0.70-1.24] × 109/L; P = .03). Imaging findings, EHV-5 detection, and corticosteroid treatment were not associated with survival. Fever is not a sensitive clinical sign of EMPF. Diagnostic testing should be pursued for horses with increased respiratory rate and effort and weight loss. The prognosis for EMPF horses is poor. Corticosteroid treatment does not improve 3-month survival.

Olfactory bulb anomalies in KBG syndrome mouse model and patients.

ANKRD11 (ankyrin repeat domain 11) is a chromatin regulator and the only gene associated with KBG syndrome, a rare neurodevelopmental disorder. We have previously shown that Ankrd11 regulates murine embryonic cortical neurogenesis. Here, we show a novel olfactory bulb phenotype in a KBG syndrome mouse model and two diagnosed patients. Conditional knockout of Ankrd11 in murine embryonic neural stem cells leads to aberrant postnatal olfactory bulb development and reduced size due to reduction of the olfactory bulb granule cell layer. We further show that the rostral migratory stream has incomplete migration of neuroblasts, reduced cell proliferation as well as aberrant differentiation of neurons. This leads to reduced neuroblasts and neurons in the olfactory bulb granule cell layer. In vitro, Ankrd11-deficient neural stem cells from the postnatal subventricular zone display reduced migration, proliferation, and neurogenesis. Finally, we describe two clinically and molecularly confirmed KBG syndrome patients with anosmia and olfactory bulb and groove hypo-dysgenesis/agenesis. Our report provides evidence that Ankrd11 is a novel regulator of olfactory bulb development and neuroblast migration. Moreover, our study highlights a novel clinical sign of KBG syndrome linked to ANKRD11 perturbations in mice and humans.

Investigation of canine parvovirus occurrence in cats with clinical signs of feline panleukopenia in Slovakia – pilot study

Abstract Introduction Feline panleukopenia is a contagious viral disease caused by the feline panleukopenia virus (FPV). A closely related pathogen is canine parvovirus (CPV), and amino acid substitutions in this virus allow it to acquire a feline host range. In feline hosts, the disease induced by CPV manifests with similar symptoms to those caused by FPV or milder ones, leading to its underdiagnosis. The aim of this study was to determine the presence of CPV type 2 (CPV-2) in cats with clinical symptoms of panleukopenia and to assess the use of commercial CPV antigen tests for the clinical diagnosis of FPV. Material and Methods Samples from 59 cats from central Slovakia were included in the study. Rectal swabs were collected and clinically tested for parvovirus infection using a commercial antigen test. Antigen-positive samples were confirmed by PCR targeting the viral VP2 gene. The sequences of the PCR products were established with the Sanger method. Results Of 59 samples, 23 were revealed to be positive for parvovirus infection by both antigen and PCR test (38.9%). Analysis with the National Center for Biotechnology Information BLASTn application showed 99.78–100% pairwise identity with FPV. The mortality rate of parvovirus-infected cats included in this study was 8.69% (2/23). Conclusion Although feline disease with CPV-2 was not confirmed, the CPV antigen test was able to detect FPV infection.

Investigation of neutering status and age of neutering in female Dachshunds with thoracolumbar intervertebral disc extrusion.

To evaluate neutering status and age of neutering in female Dachshunds with thoracolumbar intervertebral disc extrusion. We hypothesised that neutered Dachshunds presented with intervertebral disc extrusion at an earlier age, with a higher grade of neurological deficits and with more extensive extrusion of disc material compared with intact females. Retrospective multi-centre study of client-owned female Dachshunds with surgically confirmed thoracolumbar intervertebral disc extrusion. Dogs were classified as early, late or not neutered (intact). Age, body condition score, duration of clinical signs before presentation, modified Frankel score at presentation, length of extruded disc material, maximum spinal cord compression and whether dogs presented for a subsequent intervertebral disc extrusion were recorded. One hundred and fifty-four dogs were included: 36 early neutered, 69 late neutered and 49 intact. No significant difference was found between early neutered, late neutered and entire female Dachshunds in any of the variables studied. In this cohort of female dogs, neuter status and age of neutering were not found to affect age at onset nor severity of thoracolumbar intervertebral disc extrusion.

Urinalysis and culture results of free-catch urine samples in dogs: a randomised controlled trial.

To evaluate the prevalence of bacterial presence in free-catch urine samples preceded by either a standardised prepped ("clean-catch") protocol versus unprepped (non-cleaned) voiding. The study was a single-centre prospective single-blinded randomised controlled trial. Urine samples were obtained from 100 client-owned dogs presenting for routine evaluation. Dogs were randomly assigned to either the prepped group (preputial or peri-vulvar area cleaned with sterile saline before collection) or the unprepped group (no preliminary cleansing) stratified by sex. Urinalysis and urine culture (blood and MacConkey agar) were performed on all samples. Significant bacterial presence on urine culture was defined as >104 colony forming units (CFU)/mL. There were no statistically significant associations between prepped versus unprepped collection method or sex with a urinalysis positive for bacteriuria. However, on culture, significant bacterial growth was almost five times more likely to be associated with males relative to females (odds ratio 4.59, 95% confidence interval 1.61 to 13.10). The probability of finding a positive culture was not statistically associated with prep method (odds ratio 1.43, 95% confidence interval 0.50 to 4.08). For the majority of dogs without clinical signs of urinary tract infection, free-catch urine collection does not result in significant bacteriuria found on analysis or culture. The presence of bacteria found in free-catch samples may be secondary to sample contamination or subclinical bacteriuria. Sample contamination or subclinical bacteriuria may be more prevalent in male dogs.

Fluctuation of Disease Severity and Quality of Life Applying Intra-lymphatic Immunotherapy for Patients with Seasonal Allergic Rhinitis

Allergen-specific immunotherapy is the only disease-modifying treatment for IgE-mediated allergic disorders. Intra lymphatic immunotherapy (ILIT) is an efficacious and time-saving alternative to subcutaneous immunotherapy (SCIT). This study aimed to evaluate the effects and safety of ILIT in patients with moderate to severe allergic rhinitis. 
 In this clinical trial, patients between 18 and 65 years old with moderate to severe allergic rhinitis were enrolled. They received monthly intra-lymphatic inguinal injections of an active allergen (1000 SQ-U Salsola kali pollen). Their clinical symptoms were assessed before and four weeks after treatments. The clinical signs were also evaluated during two consecutive pollination seasons and the following non-pollination season in April.
 No moderate or severe reactions were recorded following ILIT treatment. Lymph node enlargement, angioedema/urticaria, and local itching were seen instantly after injection. Patients who received ILIT experienced a significant clinical improvement in self-recorded seasonal allergic symptoms after the treatments, compared to themselves before ILIT. Furthermore, their quality of life significantly improved.
 This study suggests ILIT with Salsola-pollen extract may decrease symptoms of allergic rhinitis. It was safe and did not cause any crucial complications.
  

Ossification of Bilateral Sacrotuberous Ligaments: Two Cases Report and Literature Review.

Ossification of the sacrotuberous ligament is a rare occurrence in soft tissue, with only 15 cases reported in the past few decades. We reported two cases of bilateral ossification in sacrotuberous ligaments and provided a concise review of the literature on this pathology. Clinical data, radiographic outcomes, and diagnostic and treatment details were obtained. This study aimed to summarize this disease's characteristics and investigate its pathogenesis through a review of literature from the last thirty years. This condition is often incidentally confirmed in elderly males via imagiological examination or gross anatomy and presents a low morbidity rate. Its pathogenesis may be related to stress concentration, excessive intake of element ions, injury repair, and improper operative technique. The majority of patients may not exhibit any clinical symptoms or signs and typically do not require medical interventions. It may be complicated with pudendal nerve entrapment syndrome. The long-term effects of surgical resection and the most effective treatment approach remain areas for further research.

Selecting potential biomarkers of plasma proteins in mares with endometritis.

Endometritis is a common condition in mares that causes significant economic loss. Lacking obvious clinical signs, the clinical diagnosis of endometritis in mares relies on case-by-case clinical examinations, which can be particularly inefficient in large-scale farms. Therefore, the identification of potential biomarkers can serve as a non-invasive and efficient screening technique for endometritis in mares. To compare the blood proteome between fertile mares and mares with endometritis to identify biomarkers potentially associated with the development of endometritis and validate their predictive potential. Observational and experimental study. Differentially expressed proteins were identified via Data Independent Acquisition (DIA) proteomic profiling in a screening cohort composed of eight healthy mares and eight mares with endometritis. Subsequently, enzyme-linked immunosorbent assay was employed that included a validation cohort of 40 healthy mares and 40 mares with endometritis to verify the accuracy and sensitivity of the identified proteins, thereby establishing a diagnostic threshold. In the screening cohort, 12 proteins were significantly differentially expressed between endometritis mares and healthy controls (p < 0.05, outside the 1/1.2 to 1.2-fold). In the validation experiment, all six screened proteins were assessed with area under the curve (AUC) >0.8. The samples displayed certain levels of individual heterogeneity, and the number of samples analysed was limited. Additionally, the identified biomarkers were primarily associated with generalised inflammation, which potentially limited their specificity for endometritis. Levels of plasma proteins are sensitive indicators of equine endometritis and potential tools for endometritis screening. In plasma, fetuin B, von Willebrand factor, vitamin K-dependent protein C, insulin-like growth factor binding protein 3, interleukin 1 receptor accessory protein, and type II cell cytoskeleton showed great predictive ability, with fetuin B being the best predictor (AUC = 0.93, 95% CI: 0.89-0.98), which performs better when combined with all six detected proteins (AUC = 1, 95% CI: 0.99-1.00).

The Successful Use of an Ultrasound-Guided Mid-Femur Sciatic Nerve Block in a Juvenile Emu (Dromaius novaehollandiae) under General Anaesthesia

The current case report describes a successful ultrasound-guided mid-femur sciatic nerve block in an emu. A 2-month-old emu suffering from acute-onset lameness was referred to the University Clinic of Liège, where he was diagnosed with a lateral luxation of the Achilles tendon on both hind limbs. Two surgical procedures were performed for treatment. Both surgical procedures were performed under general anaesthesia with butorphanol, ketamine, midazolam and isoflurane in oxygen. The anaesthesia was continuously monitored. An ultrasound-guided sciatic nerve block was performed to prevent and treat surgically induced nociception. The technique was adapted from what is already described in other species. Levobupivacaine was injected perineurally under ultrasound-guidance. Intraoperative nociception was assessed based on the heart rate and mean arterial pressure changes. The recovery was uneventful and with no clinical signs of postoperative pain.

Trichoscopic findings in children and adults with alopecia areata: A comparative study.

Alopecia areata is a chronic and relapsing condition that affects individuals of all age groups. Dermoscopy is a popular and non-invasive method for diagnosing alopecia areata. This study aimed to analyze dermoscopic findings and their relationship with age, gender, appearance, and clinical signs in children and adults. This retrospective cross-sectional study was conducted on 124 children and adults diagnosed with alopecia areata who were referred to a Hospital in Iran between 2021 and 2022. After reaching the calculated sample size, trichoscopic findings were examined and the results were recorded. Data analysis was performed by a statistician and presented in relevant tables. The participants in the study comprised 53.2% female children, 46.8% male children, 27.42% adult males, and 72.58% adult females. The median age in the pediatric group was 10 years, while it was 27 years in the adult group. Yellow dots were significantly less observed in children than in adults (29% vs. 48.4%), while exclamation mark hairs were significantly more common in children than adults (38.7% vs. 21%). No significant differences were found in the frequency of other trichoscopic features between children and adults. Specifically, black dots, broken hairs, short vellus hairs, pigtail hairs, and empty follicular openings were observed in 38.7%, 40.3%, 32.3%, 11.3%, and 75.8% of children, respectively, and in 35.5%, 32.3%, 21%, 46.8%, and 12.9% of adults, respectively. The most common trichoscopic findings in alopecia areata in children are empty follicular openings and broken hairs, while exclamation mark hairs are more common in children than adults. In contrast, yellow dots are less frequently observed in children compared to adults. This distinct difference between children's and adults' dermoscopic findings highlights the critical need for age-specific considerations in AA evaluations.

Serological Surveillance and Risk Factor Analysis for Parrot Bornavirus in Taiwan

Parrots are traded globally and pose a substantial risk for disease transmission involving parrot-specific pathogens. Parrot bornavirus (PaBV) belongs to the Bornaviridae family and encompasses two clades: alphapsittaciforme (PaBV-1 to -4, PaBV-7, and -8) and betapsittaciforme (PaBV-5 and PaBV-6). These clades cause proventricular dilatation disease, a chronic disease affecting all parrot species. PaBV infections can persist for varying durations in parrots, but the transmission routes are still not well understood. Therefore, surveillance of PaBV-infected parrots is necessary for disease control and improving psittacine aviculture. This study used isolated PaBV-4 NTUCL7 and PaBV-5 NTUCL54 strains to establish and validate two serological diagnostic methods: immunoblotting (IB) and immunocytochemical staining (ICC). To determine the prevalence of PaBV in parrots in Taiwan, 370 clinical serum samples were collected from 13 collaborative veterinary hospitals during a 1-year surveillance period. Serological surveillance revealed a seropositivity rate of 25.68%. Among the seropositive samples, 91.58% were infected with alphapsittaciforme PaBV, demonstrating the predominance of this viral clade in parrots. An analysis of risk factors also demonstrated an association between seropositivity and parrot genera, age, and clinical signs. Cohen’s kappa coefficient analysis showed a high degree of similarity (kappa value = 0.975) between the IB and ICC results, which shows that these serological diagnostic measures are robust. This study established two reliable serological diagnostic measures that are instrumental in serological surveillance, particularly in one of the major parrot-exporting regions. The surveillance results increase the understanding of PaBV infection and associated risk factors and allow methods to be devised for the conservation and protection of parrot populations.

Pulmonary Tuberculosis in the Elderly: Epidemiological, Clinical, and Evolutionary Aspects

Aims: this study aimed to investigate the epidemiological, clinical, and evolutionary aspects of pulmonary tuberculosis in the elderly and to determine the factors associated with death. &#x0D; Study Design:  This was an exhaustive, descriptive, and analytical retrospective study.&#x0D; Place and Duration of Study: Pneumo-phtisiology department of Fann National Teaching Hospital Center over three years, from January 1, 2019, to December 31, 2021.&#x0D; Methodology: This was a study using medical records of patients aged 60 and over hospitalized in the pneumo-phtisiology department. Data were collected on a pre-established from patient medical records entered with Microsoft Excel 2019 software. Data analysis was performed with Statistical Package for Sciences Socials (SPSS) version 18&#x0D; Results: we collected 620 medical records of hospitalized patients aged 60 and over, 69 of whom were diagnosed with pulmonary tuberculosis, standing for a prevalence of 11.12%. The average age was 67.13 [60;85] years, with a sex ratio of 3.92. The 60 to 65 age group was the most represented (n=36 or 52.17%). Smoking and alcoholism were frequent, 82% and 17.4% respectively. A previous history of TB infection was found in 23.19% of cases and TB contagion in 20.3% of cases. An underlying condition was at least observed in 50.72% of patients, dominated by diabetes (29%) and hypertension (23%). Co-infection with HIV-1 and tuberculosis was found in 2 patients (3%). The time to consultation was 75 days [3-180 days]. Symptomatology was polymorphic, dominated by cough (n=65; 94.20%), altered general condition (n=63; 91.30%), sputum (n=58; 84.06%), fever (n=53; 76.81%) and dyspnea (n=47; 68.12%). 46 patients (66.7%) had a BMI &lt; 18.5 kg/m2. Physical signs were dominated by pulmonary condensation (n=52; 75.36%), and a fold of undernutrition was noted in 21.74% of cases. Microbiological evidence was 92.75% and 64 patients (92.75%) were susceptible to rifampin. A rifampin-resistant strain was detected in 5 patients (7.25%) hospitalized in the MDR-TB unit. CRP (75.36%), anemia (68.18%), hyperleukocytosis (47.7%), and hyponatremia (27.54%) were the most frequent biological signs.&#x0D; Alveolar syndrome (n=48 or 70%) and cavitary images (n=34 or 50%) were most frequently found on lung radiography, and for those who benefited from thoracic CT (n=36 or 52.17%), cavitary images were found in 24 cases (66.66%).&#x0D; Pulmonary embolism (n=9 cases, i.e. 40.9%), superinfection (n=4), and excessive hemoptysis (n=3) were the most frequent complications. The mean length of hospital stay was 17 days [3-58 days]. The 2RHZE/4RH protocol was used for 87%. Two patients were placed on a second-line anti-tuberculosis treatment protocol. Treatment was not specified in 7 patients (10.14%). The progression was favorable in 48 patients (69.56% of cases), with a case fatality rate of 30.44%.  Dyspnea, chest pain, anemia, hyperleukocytosis, and hyponatremia were associated with the risk of death.&#x0D; Conclusion: The elderly are particularly exposed to tuberculosis, due to physiological aging of the immune system and co-morbidities. This study highlighted the diagnostic and evolutionary particularities of pulmonary tuberculosis in the elderly, as well as the associated fatal factors.

Ultrasonographic measurements of the normal adrenal glands in guinea pigs (Cavia Porcellus).

Hyperadrenocorticism is an uncommon but important endocrine disease in guinea pigs, but due to its subtle clinical signs and the limited information in veterinary literature, it can be underdiagnosed or misdiagnosed. Ultrasound of the adrenal glands in patients with suspected hyperadrenocorticism can help in identifying adrenomegaly. The purpose of this prospective study was to identify ultrasonographic adrenal gland dimensions in presumed healthy guinea pigs using the same standardized method described for dogs and cats. A conscious ultrasound scan was conducted on twenty client-owned, presumed healthy guinea pigs, and their adrenal glands were measured. A possible correlation between adrenal dimensions with age, sex, and body weight was investigated. The mean length, cranial and caudal pole thickness for the left and right adrenal glands were, respectively, 12.64±2.11mm and 11.55±1.52mm; 4.83mm±1.03mm and 4.69±1.34mm; 4.8±1.23mm and 4.04±0.75mm. The thickness of the left caudal pole was significantly higher than the right (P=0.02). A significant positive correlation was found between the length of the left adrenal gland and both age (r=0.46; P=.03) and weight (r=0.59; P=.01). Statistical correlation between the thickness of each cranial and caudal pole, with age, sex, or weight, was not found. The dimensions provided could prove a useful tool in the clinical evaluation of guinea pigs with suspected hyperadrenocorticism.

Molecular Biomarkers of Neurodegenerative Disorders: A Practical Guide to Their Appropriate Use and Interpretation in Clinical Practice

Neurodegenerative disorders (NDs) represent a group of different diseases characterized by the progressive degeneration and death of the nervous system’s cells. The diagnosis is challenging, especially in the early stages, due to no specific clinical signs and symptoms. In this context, laboratory medicine could support clinicians in detecting and differentiating NDs. Indeed, biomarkers could indicate the pathological mechanisms underpinning NDs. The ideal biofluid for detecting the biomarkers of NDs is cerebrospinal fluid (CSF), which has limitations, hampering its widespread use in clinical practice. However, intensive efforts are underway to introduce high-sensitivity analytical methods to detect ND biomarkers in alternative nonivasive biofluid, such as blood or saliva. This study presents an overview of the ND molecular biomarkers currently used in clinical practice. For some diseases, such as Alzheimer’s disease or multiple sclerosis, biomarkers are well established and recommended by guidelines. However, for most NDs, intensive research is ongoing to identify reliable and specific biomarkers, and no consensus has yet been achieved.

Leflunomide with prednisone or nonsteroidal anti-inflammatory drug therapy is safe and tolerated for long-term treatment of immune-mediated polyarthritis in 27 dogs.

To retrospectively evaluate safety and tolerance of leflunomide for long-term treatment of canine idiopathic immune-mediated polyarthritis (IMPA). 27 dogs with clinical signs and synovial fluid cytology supportive of IMPA with ≥ 6 months' follow-up after starting leflunomide. Medical records were reviewed to identify dogs prescribed leflunomide for treatment of IMPA from February 2012 to May 2022. Initial leflunomide doses of 2 to 4 mg/kg once daily were prescribed and were titrated to the lowest effective dose with concurrent anti-inflammatory therapy. Complete blood count, serum chemistry, and clinical signs were monitored throughout the course of treatment. Adverse effects potentially attributable to leflunomide noted in 9 of 27 dogs (33%) included vomiting, diarrhea, lethargy, decreased or absent appetite, polyuria and polydipsia, and secondary antibiotic responsive infection and were self-limiting or resolved with outpatient therapy. Alkaline phosphatase (ALP) and alanine aminotransferase (ALT) elevation were documented in all dogs prescribed leflunomide plus prednisone, with persistent liver enzyme elevation in 6 of 9 dogs (67%) and normalization after antibiotic therapy in 3 of 9 dogs (33%). The majority of dogs prescribed leflunomide plus NSAID (11/17 [65%] dogs) did not experience liver enzyme elevation; 2 of 17 (12%) dogs developed transient antibiotic-responsive liver enzyme elevations, and 4 of 17 (23%) dogs had persistent liver enzyme elevation. Leflunomide was well tolerated for long-term management of IMPA. A significant difference in liver enzyme elevation was identified between dogs prescribed prednisone versus NSAID in combination with leflunomide. Leflunomide with NSAID therapy resulted in less hepatotoxicity compared with leflunomide with prednisone.