Inflammatory Neutrophil Infiltration Research Articles

Natural Drugs as a Treatment Strategy for Cardiovascular Disease through the Regulation of Oxidative Stress.

Oxidative stress (OS) refers to the physiological imbalance between oxidative and antioxidative processes leading to increased oxidation, which then results in the inflammatory infiltration of neutrophils, increased protease secretion, and the production of a large number of oxidative intermediates. Oxidative stress is considered an important factor in the pathogenesis of cardiovascular disease (CVD). At present, active components of Chinese herbal medicines (CHMs) have been widely used for the treatment of CVD, including coronary heart disease and hypertension. Since the discovery of artemisinin for the treatment of malaria by Nobel laureate Youyou Tu, the therapeutic effects of active components of CHM on various diseases have been widely investigated by the medical community. It has been found that various active CHM components can regulate oxidative stress and the circulatory system, including ginsenoside, astragaloside, and resveratrol. This paper reviews advances in the use of active CHM components that modulate oxidative stress, suggesting potential drugs for the treatment of various CVDs.

Colitis actínica de localización cecal. Serie de casos

Por definición, la colitis actínica incluye cambios inflamatorios de la mucosa colorrectal secundarios a radioterapia en cercanía a la región tratada. La localización más frecuente es el recto y la indicación más común de radioterapia corresponde a neoplasias de la región pélvica incluidos el recto, la próstata y el cérvix. Se estima que hasta la mitad de los pacientes que reciben radiación pélvica llega a desarrollar síntomas gastrointestinales asociados. Se presentan dos pacientes con metástasis óseas sacroilíacas y pélvicas secundarias a adenocarcinoma de próstata que recibieron radiación en la región lumbosacra y pélvica, ambos pacientes presentaron episodios de deposiciones con sangre que iniciaron tempranamente posterior a la radioterapia. La colonoscopia mostró eritema y ulceración. En el estudio histopatológico se observó un patrón de colitis isquémica, con núcleo y citomegalia, estroma fibroso con cambios reactivos y abundante infiltrado inflamatorio neutrofílico. Estos hallazgos son característicos de la colitis actínica aguda; sin embargo, la localización cecal no ha sido frecuentemente reportada. Aunque al ser el ciego y el íleon terminal móviles de localización pélvica, se convierten en un factor de riesgo para que estos segmentos anatómicos sean susceptibles al impacto directo de la radioterapia. Esta condición, en la fase aguda, es autolimitada y se suele resolver con medidas de soporte. Es indispensable que el personal involucrado en el manejo de estos pacientes conozca esta entidad y los posibles diagnósticos diferenciales.

Synbiotics administration leads to attenuated mucosal inflammatory neutrophil infiltration and increased hematocrit in experimental ulcerative colitis.

The objective of the study was to estimate the effects of synbiotics on laboratory, macroscopic, and histopathologic features in dextran sulfate sodium (DSS) experimental colitis. A total of 40 Wistar rats received 5% of DSS in their drinking water for 8 days to induce ulcerative colitis (UC). Eight rats were sacrificed to confirm the presence of UC. The remaining rats were randomly assigned to two groups: the synbiotics group, which received synbiotics once per day and the control group, which received tap water for another 8 days. On the 8th day of DSS administration animals developed UC with bloody diarrhea. In the majority of the hematologic variables studied (hemoglobin [HB], red blood cells, platelets, mean corpuscular volume, and mean corpuscular HB), in bodyweight and histopathologic colitis score there was no significant difference between groups. However, the synbiotics group, compared to control, presented a significantly greater colon length on the 4th day, significantly increased hematocrit (HT) on the 8th day, and a significantly decreased number of myeloperoxidase positive cells on the 8th day. Furthermore, there was a trend toward histopathological and clinical improvement. Administration of synbiotics in the experimental UC results in an attenuation of mucosal inflammatory neutrophil infiltration and an increase in HT.

Liver-derived mitochondria drive CD8 T-cell dysfunction, alter purinergic signaling and impair bacterial clearance in the lung in vivo

Abstract Trauma is the leading cause of death in young adults. The pathogenetic mechanisms resulting in posttraumatic immunosuppression with increased susceptibility to infection remain unclear. Mitochondria (MT) are released by cells after trauma and can generate danger molecules, such as extracellular ATP (eATP). The vascular and immune cell ectonucleotidase CD39 scavenges eATP to generate immunosuppressive derivatives such as adenosine. Here, we examined the role of eATP generated by exogenous mitochondria in modulating the immune response and provoking immunosuppression in the context of experimental pneumonia models. ATP probes and MitoSOX revealed that liver-derived MT generate ATP and ROS ex vivo. When injected into recipient mice, MT isolated from mouse liver induced upregulation of CD39 and CD73 expression on circulating CD8 T cells and promoted immune cell exhaustion. Next, wild-type mice were injected intraperitoneally with liver MT, followed by intratracheal instillation of pathogenic S. aureus. Mice receiving MT were unable to clear bacteria, as demonstrated by elevated CFU counts in the bronchoalveolar lavage, when compared to mice with bacterial instillation alone. Histological analysis confirmed more pronounced lung injury with infiltration of inflammatory neutrophils in mice administered both MT and bacteria, when compared to mice instilled only with bacteria. Lastly, the MT injection with concomitant bacteria administration resulted in loss of lung-derived CD8 T-cells. Our data indicate that ATP generation by exogenous mitochondria boost CD39 expression in circulating CD8 T-cells and drive dysfunctional immune responses in mice that result in increased susceptibility to bacterial infection of the lungs.

Activation of the innate immune response by IL-36 mediated inflammation during active ticks mediated ehrlichial transmission in mice

Abstract Tick borne ehrlichiosis is a life-threatening disease affecting humans and animals worldwide. Early host response to pathogen-tick interaction at the site of transmission has not been well studied due to difficulties associated with natural model of infection. To study the host immune interaction with Ehrlichia muris eauclarensis (EME), a human pathogen, we compare tick transmission of EME in C57Bl/6 mice with needle inoculation. Our objective was to analyze the local and systemic infection to identify the immune pathways involved in the pathogenesis of tick borne ehrlichiosis. As previously reported, our studies show inflammatory infiltration of neutrophils and eosinophils at the site of infection within 24–48h of tick infestation. Further evaluation of the site of tick transmission demonstrated increased expression of IL36α, IL36γ, IL1β and IL18 cytokines during initial ehrlichial infection. Our analysis of the peak of infection identified an increased epidermal thickening, massive inflammatory infiltration at the site of infection and systemically, and increased levels of proinflammatory cytokines in serum. The disease progression is associated with increased bacterial load in lungs, spleen, liver and other tissues tested, with increased liver ANG-2 and apoptosis, suggesting acute vascular dysfunction and liver injury. These results demonstrate that ehrlichial transmission by ticks causes severe inflammation with up-regulation of IL36 group of cytokines, potentially activating innate immune system to facilitate bacterial dissemination and severity of the disease. Understanding the key determinants of tick mediated ehrlichiosis will enable us to identify susceptibility markers and new therapeutic targets.

A localized non-healing ulcer: an unusual clinical presentation of pemphigus vulgaris

<p>Pemphigus vulgaris is an autoimmune blistering disorder commonly involving oral mucosa and skin<strong> </strong>with characteristic acantholysis that results in formation of fluid filled blisters and painful erosions. Herein we report a case distinguished by its unusual clinical presentation.<strong> </strong>A twenty-five year old man, presented to our outpatient department of dermatology, complaining of ulcer on forehead in the last one year. Examination revealed single ulcer covered with crust on right side of forehead. Clinically lupus vulgaris, pyoderma gangrenosum, recurrent herpes simplex, leishmaniasis and pemphigus vulgaris were kept as differential diagnosis. Tzanck smear revealed multiple acantholytic cells and mild neutrophilic inflammatory infiltrate. Histological examination of biopsy sample showed suprabasal clefting, acantholytic cells and mild perivascular dermal lymphocytic infiltrate. Features were suggestive of pemphigus vulgaris. Significant improvement occurred after three months of treatment with oral prednisolone, azathioprine and topical steroid. Although oral and skin involve­ment is common, in the form of flaccid blisters and erosions, but non healing ulcer is unusual. This may represent a period of limited activity during this chronic disease. There is paucity of data in literature regarding this. So, this<strong> </strong>case report highlights a, perhaps unique, clinical presentation of this autoimmune disease.<strong></strong></p>

A ‘crowning’ diagnosis: Fever, neck pain, and diffuse polyarthritis as a fulminant first presentation of pseudogout

Background: Calcium Pyrophosphate Deposition Disease (CPPD) rarely presents as a diffuse polyarthritis with systemic features. Case presentation: A 75-year-old man with no prior history of rheumatic disease presented with acuteonset diffuse polyarthritis and severe neck pain, accompanied by fevers, leucocytosis, and elevated acute phase reactants. After excluding infectious aetiologies, a synovial fluid aspirate revealed a highly neutrophilic inflammatory infiltrate and rare calcium pyrophosphate dihydrate crystals. Cervical CT confirmed periodontoid calcium deposits consistent with the crowned dens syndrome. The patient was diagnosed with acute CPPD, and his joint and neck pain improved rapidly with colchicine and glucocorticoids. Conclusion: In addition to arthrocentesis and microscopic crystal analysis, cervical CT can lend support to a diagnosis of pseudogout complicated by CDS. In patients presenting with fever and neck pain, recognition that CDS can be a prominent or isolated feature of acute CPPD facilitates diagnosis, limits unnecessary procedures, and allows for early initiation of appropriate therapy.

NK cell-derived GM-CSF potentiates inflammatory arthritis and is negatively regulated by CIS.

Despite increasing recognition of the importance of GM-CSF in autoimmune disease, it remains unclear how GM-CSF is regulated at sites of tissue inflammation. Using GM-CSF fate reporter mice, we show that synovial NK cells produce GM-CSF in autoantibody-mediated inflammatory arthritis. Synovial NK cells promote a neutrophilic inflammatory cell infiltrate, and persistent arthritis, via GM-CSF production, as deletion of NK cells, or specific ablation of GM-CSF production in NK cells, abrogated disease. Synovial NK cell production of GM-CSF is IL-18-dependent. Furthermore, we show that cytokine-inducible SH2-containing protein (CIS) is crucial in limiting GM-CSF signaling not only during inflammatory arthritis but also in experimental allergic encephalomyelitis (EAE), a murine model of multiple sclerosis. Thus, a cellular cascade of synovial macrophages, NK cells, and neutrophils mediates persistent joint inflammation via production of IL-18 and GM-CSF. Endogenous CIS provides a key brake on signaling through the GM-CSF receptor. These findings shed new light on GM-CSF biology in sterile tissue inflammation and identify several potential therapeutic targets.

Neoplasia Ablation in the Equine Oral Cavity Vestibule

Background: Oral squamous cell carcinoma is responsible for more than 90% of head and neck neoplasms in humans. Multiple factors are associated with the development of squamous cell carcinomas in humans and animals, such as prolonged exposure to ultraviolet light, lack of pigment in the epidermis, or sparse hair coverage. In horses, oral forms are rare and represent 7% of cases, but sarcoids are the main type of oral neoplasia. In the present case, due to the location and anatomical dimensions of the oral vestibule, it was necessary to adapt it to the natural tumor excision, a fact that aimed to describe this report.Case: One Arabian 2- year-old male horse, treated at the Veterinary Hospital of the Santa Cruz State University (UESC), with signs of severe mouth bleeding and halitosis. Clinical inspection of the face showed elevation in the masseter region and left mandible branch. Clinical examination of the oral cavity revealed soft tissue tumor extending from tooth 308 (PM-1, lower left) to 311 (M-3, lower left) and on the buccal surface of the left mandible branch. Radiographic examination revealed no invasion of bone tissue by the tumor. Biopsy material was collected. The histopathological report was of neoplastic cell proliferation, frequent mitoses, binucleate cells and extensive ulceration area associated with neutrophilic inflammatory infiltrate, indicative of squamous cell carcinoma. The animal was referred to the Surgical Sector who, after evaluation of the animal, opted for the ablation of the neoplasia. Pre-anesthesia performed with intravenous detomidine 30 µg/kg, anesthesia with regional mandibular nerve block with 20 mL of 2% lidocaine and maintenance with continuous infusion of detoxid 0.5 µg/kg/ min. Contention for the operative act in the quadrupedal position. The opening of the oral cavity through the Holborn ratchet opener. The beginning of the surgery was with the scalpel, which allowed the removal of approximately one third of the tumor. Due to the great difficulty of fully accessing the area, due to the location of the tumor in the vestibule of the mouth, as well as the presence of fibrosis and calcification, it was necessary to adapt a 15 cm lambotte rugina to allow manipulation and perfect access to the entire mass. tumor for its complete ablation. The synthesis was not performed due to the anatomy and extension of the bed where the tumor was located, which similarly favored drainage. The surgical specimen was treated and fixed in 10% formaldehyde and sent to the Pathology Department for histopathological diagnosis. Immediate postoperative medication consisted of intravenous tranexamic acid administration 5 mg/kg; flunixin megluminate 2.2 mg/kg intramuscularly for three days; intravenous metronidazole 15 mg/kg for ten days and a diet of easily digestible pasture.Discussion: Exeresis of surrounding lymph nodes is indicated, associated with treatment of electrochemotherapy, as oncologists have obtained excellent prognosis and survival of dogs and cats with oral neoplasms. This therapeutic modality may allow the treatment of cancers in horses, since the electric pulse increases the cytotoxicity of chemotherapeutic drugs. Tumors of the oral cavity of horses, due to the signs and symptoms manifested, must be diagnosed and treated urgently, clinically and surgically, due to the evolutionary characteristics of these diseases.

Effects of pure and ozonated sunflower seed oil (Helianthus annuus) on hypergranulation tissue formation, infection and healing of equine lower limb wounds

This study was undertaken to evaluate the therapeutic effects of topical application of pure sunflower seed oil (oil group) and ozonated sunflower seed oil (ozone group) on acute cutaneous wound healing in eight healthy horses. The control group was treated with 0.9% sodium chloride. Two wounds were surgically produced on each horse on the proximal epiphysis of the metacarpus on the dorsal aspect of each forelimb. Wound area and contraction were measured on days 0, 3, 7, 14 and 21. Biopsy samples were taken to evaluate epithelial hyperplasia, inflammation, exuberant granulation tissue, exudate type, angiogenesis, and fibroplasia. Culture swabs were also collected. Wound contraction at 21 days for the oil group was 52.68%, for the ozone group was 72.16%, and for the control group (0.9% sodium chloride) was 34.80%. The ozone group had a significantly smaller wound size and a residual wound area than the control and the oil groups, on days 14 and 21. The control-wounds and oil-wounds had suppurative exudate and the presence of Streptococcus zooepidemicus. Neutrophilic inflammatory infiltrate was observed in all groups. Granulation tissue was observed on day 7 in all groups, but exuberant granulation tissue was observed only in the control group on days 14 and 21. Reepithelialization was observed on day 14 in the ozone group. In conclusion, these results demonstrate that topical application of ozonated sunflower seed oil accelerates acute cutaneous wound repair in horses, preventing hypergranulation tissue and infection, and that it is superior to treatment with pure sunflower seed oil and 0.9% sodium chloride.

Valvular endocarditis associated with Helcococcus ovis in a cow in Southern Brazil

ABSTRACT: A 4-year-old cow with a history of breathing difficulty, progressive weight loss, and muffled heart sound was treated for a period of two weeks, but died and underwent necropsy examination. Macroscopic examination revealed heart with vegetative proliferative lesion firmly adhered to pulmonary valve, lungs with marked consolidation, and the presence of thrombus in vessels. There were grade II ulcers in abomasal mucosa associated to blood clots. Microscopic examination revealed marked thickening of the pulmonary valve due to the proliferation of fibrous connective tissue, inflammatory neutrophil infiltration, fibrin deposition, and a significant number of coccoid basophilic bacteria. Septic thromboemboli were present in the large and small pulmonary blood vessels suggestive of embolic pneumonia. The bacterial culture of the valve showed growth of small, nonhemolytic colonies that demonstrated satellitism to coagulase-negative staphylococci contaminating colonies, which were subjected to 16S gene sequencing and were compatible with Helcococcus ovis in GenBank. This was the first report of H. ovis endocarditis in cattle in South America.

Arytenoid chondritis in two calves

ABSTRACT: Although, calf diphtheria and necrotic laryngitis are common infections in the oral cavity’s soft tissues, arytenoid chondritis is addressed as a serious but rarely diagnosed complication in cattle. This paper aimed to describe clinical, laboratory, imaging, and pathological findings in two calves with arytenoid chondritis. A 2-month-old Jersey calf and a 3-month-old Girolando calf presented 40-days history of respiratory distress. In the former, oral endoscopy revealed enlarged and immobile arytenoids with major involvement of the left arytenoid, causing severe distortion and partial obstruction of the rima glottidis. In the latter, latero-lateral radiography of the head revealed radiolucent areas and thickening at the level of the larynx to the dorsal trachea. Pathological examination of one calf showed neutrophilic multifocal inflammatory infiltrate and areas of necrosis in the cricoarytenoid cartilage, surrounded by abscessation. Definitive diagnosis of arytenoid chondritis in these two calves was established on the basis of clinical, laboratory, imaging (endoscopy and radiography), and pathological findings. Daily and careful observation of the herds and the use of ancillary diagnostic methods allowed the early diagnosis of the disease, and accurate diagnosis can improve prognosis and increase treatment success rate.

Bovine abortion associated with Staphylococcus aureus infection - characterization of S. aureus strain isolated from fetal tissues

ABSTRACT: Staphylococcus aureus is a gram-positive bacterium, commonly found colonizing the skin and mucous membranes of humans and animals. This report describes a case of fetal loss associated with S. aureus infection in a cow. A six-month old, crossbred male bovine fetus from a beef farm was submitted for necropsy. At gross examination fibrinous pleuropneumonia was observed. Histologically, lesions were restricted to the lungs and consisted of marked multifocal to coalescing areas of inflammatory infiltrate of neutrophils, abundant fibrin exudation, necrosis of bronchiolar epithelium and numerous aggregates of coccoid bacteria. Lung and abomasal fluid bacterial culture yielded pure culture of S. aureus, which was characterized as a multidrug resistant strain. Molecular analysis indicated that the studied strain presented several genes of virulence factors including toxic shock syndrome toxin-1 (tst), staphylococcal enterotoxin type A (sea), Panton-Valentine leukocidin (pvl), alpha-hemolysin (hla) and delta-hemolysin (hld). This report documents an infrequent case of fetal loss in cattle due to infection with a highly virulent S. aureus strain.

Bovine abortion by a vaccine strain of Bacillus anthracis

ABSTRACT: This paper reports the abortion of a male Aberdeen Angus bovine by a vaccine strain of Bacillus anthracis, describing the pathological and microbiological findings and the genome sequence. Necropsy findings included multifocal areas of hemorrhage in different organs. Histologically, various organs showed hemorrhage, fibrin exudation, necrosis associated with countless bacillary bacterial clumps and severe neutrophilic inflammatory infiltrate. In the microbiological examination, numerous rough, nonhemolytic, gray and dry colonies with irregular edges were isolated from liver, lung and abomasum content samples. Gram staining revealed square-ended Gram-positive rods arranged in chains. B. anthracis identification was confirmed by detection of the molecular chromosomal marker Ba813. The genomes from the isolated B. anthracis (named SPV842_15) and from the isolated vaccinal strain (Brazilian vaccinal strain), which was recovered from a commercial vaccine used in the pregnant cow, were sequenced. Genomic comparisons displayed a high level of nucleotide identity in the comparisons between B. anthracis SPV842_15 and the B. anthracis Brazilian vaccinal strain (98,2%). Furthermore, in both strains, only the plasmid pX01 sequence was detected. Although, vaccination against anthrax is characterized by an elevated protective profile and very low residual virulence, immunization with Sterne strains can cause abortion in cattle, presumably by the plasmid pX01 toxins in rare or special situations.

Epidemiologic and Pathologic Aspects of Feline Eosinophilic Granuloma Complex

Background: The feline eosinophilic granuloma complex (FEGC) includes a group of lesions that affect the skin, mucocutaneous junctions, and oral cavity of cats. It comprises three distinct clinical entities: the eosinophilic ulcer (EU), the eosinophilic plaque (EP) and the eosinophilic granuloma (EG). The EU is usually found in the upper lip. Lesions of EP occur most commonly on the abdomen and medial thigh. The EG lesions usually appear on the tongue and hard palate. The aim of this study is to describe the localization and pathological findings of FEGC through a retrospective study and testing by immunohistochemistry if feline herpesvirus type 1 (FHV-1) infection may be associated.Materials, Methods & Results: The records of biopsy specimens from the Department of Veterinary Pathology of the Universidade Federal do Rio Grande do Sul were recovered and cats diagnosed with FEGC were selected since January 2006 to December 2017. General data, such as age, sex, breed and distribution lesions, were analyzed and compiled. The histological slides were reviewed by optical microscopy and the microscopic findings were detailed. Sections of tissue were used in immunohistochemistry to investigate the presence of feline herpesvirus-1 (FHV-1) using anti-FHV-1 antibody. In this study, 30 cats were diagnosed with FEGC. Most part of the cats were mixed breed (27/30), and there were no sex predisposition. The age of the cats ranged from seven months to 13 years old, and the median was three years. The lesion distribution of FEGC was 40% in oral cavity, 33.3% in skin and 26.6% in mucocutaneous junction. Histologically, the main lesion of all distributions was characterized by diffuse dermal/submucosa inflammatory infiltrate composed of eosinophils. Within the inflammation there were large irregular foci of collagen fibers and degranulated and degenerating eosinophil (“flame figures”). Oftentimes these foci were surrounded by macrophages and fewer multinucleated histiocytic giant cells. There were mild to moderate inflammatory infiltrate of mast cells, lymphocytes and plasm cells in dermis and submucosa. Ulceration of epidermis and mucosa were observed in majority of FEGC lesions with inflammatory infiltrate of neutrophils. All cases were negative for FHV-1 in the immunohistochemical evaluation.Discussion: In this study, feline eosinophilic granuloma complex was uncommon, accounting 0.96% of the feline cases diagnosticated in 15 years. Agreeing with the other authors, there was no sex and breed predilection. The median of age were three years old, some authors report higher occurrence in young animals and associated with genetic predisposition. Histologically, the most frequent findings were submucous and dermal inflammatory infiltrate composed primarily of eosinophils associated with areas of “flame figures”. Surrounded these areas, there were intense inflammatory infiltrate composed of macrophages, palisading macrophages and fewer multinucleated histiocytic giant cells as previously described by other authors. The ulceration of epidermis and mucosa was a common finding of eosinophilic granuloma complex lesions especially in cases where the oral cavity was affected. In this study, we could not evaluate the presence of FHV-1 in feline cases of eosinophilic granuloma complex. The area commonly affected in cases of FEGC was the oral mucosa. It may be due to differentiate from other diseases that affect the same area. Feline eosinophilic granuloma complex are important differential diagnosis for other diseases that include neoplasms, especially squamous cell carcinoma.

Neutrophilic Infiltrates in Panniculitis: Comprehensive Review and Diagnostic Algorithm Proposal.

Neutrophilic infiltrates in panniculitis can be seen in different clinical-pathological entities. There are a "mostly neutrophilic inflammatory infiltrate" in some entities classically defined as neutrophilic panniculitis and already included in algorithms, such as enzymatic panniculitis, infective and factitial ones, erythema induratum, or subcutaneous Sweet syndrome, but there are also other panniculitis where neutrophils are frequently observed such as panniculitis associated with inflammatory bowel disease or rheumatoid arthritis, or drug-induced panniculitis associated with BRAF inhibitors, and finally, some panniculitis are better classified in other panniculitides groups but may present with neutrophil-rich variants, such as the neutrophil-rich subcutaneous fat necrosis of the newborn. We review the main clinical and histopathological features of most of these panniculitides and construct a diagnostic algorithm including these diseases.

2658 Henoch-Schonlein Purpura Duodenitis

INTRODUCTION: Henoch-Schonlein Purpura (HSP) is an IgA mediated systemic, small and medium vessel vasculitis that typically presents with palpable purpura, arthralgias, abdominal pain and hematuria. Gastrointestinal manifestations occur in about 20% of patients prior to skin involvement. We report a case of a 51-year-old woman that presented with HSP duodenitis. CASE DESCRIPTION/METHODS: A 51-year-old female presented with a several week history of nausea, vomiting and epigastric abdominal pain. In addition, she had been experiencing dysphagia, arthralgias, fever and, later on, a palpable, petechial and purpuric rash on her face, ears and all extremities. She had no previous medical history. Physical exam showed an extensive palpable, ecchymotic and purpuric rash involving her arms, face, right ear and purpura on plantar surface of her feet (See Figure 1). Her wrist, elbow, knee and ankle joints were tender to palpation, warm and swollen. She had epigastric tenderness to palpation with no rebound or guarding. Laboratory workup was notable for a white blood cell count of 18.32 M/μL (4.20–5.60 M/μL). Computed tomography of the abdomen showed bowel wall thickening at the junction of duodenum and jejunum with fat stranding in the central mesentery. Biopsy of the skin showed features of leukocytoclastic vasculitis with associated perivascular necrotizing inflammation and hemorrhage (See Figure 2). EGD showed diffuse circumferential erythema with boggy mucosa as well as friability with touch bleeding consistent with ischemic type changes from distal bulb to the second portion of the duodenum (See Figure 3). Biopsies of the duodenum showed evidence of intramucosal hemorrhage, a mixed inflammatory infiltrate of neutrophils, lymphocytes and some plasma cells within the lamina propria. There were also fragments of advanced necrosis with evidence of small vessel thrombosis and vasculitis. Her abdominal pain and oral intake improved after treatment with 1 g methylprednisone for three days. The patient was discharged from the hospital with an oral steroid taper. DISCUSSION: HSP is rare in adults with roughly 20-fold fewer cases than in children. The range of endoscopic findings includes gastritis, ulceration, duodenitis, and submucosal hemorrhage with the second portion of the duodenum being involved more than the duodenal bulb. The end capillaries of small intestinal villi are particularly susceptible to ischemic injury. HSP is a self-limiting disease and majority of the patients improve spontaneously.

Spontaneous and experimental poisoning by Merremia macrocalyx (Convolvulaceae) in cattle

ABSTRACT: The aim of this work was to describe the epidemiological, clinical and pathological aspects of spontaneous poisoning by Merremia macrocalyx in cattle in the Pernambuco state, northeastern Brazil, and to experimentally replicate the poisoning by this plant. To determine the occurrence of poisonings, 30 farms were visited in six municipalities at the Forest Zone of Pernambuco. The plant was found in nine farms, in which history of plant poisoning in cattle, and occasionally in sheep were also reported. Three outbreaks of spontaneous poisonings in cattle were studied. To replicate the disease experimentally, two steers received a single dose of 60g/kg and two steers received 80g/kg of the fresh leaves of M. macrocalyx in the trough for spontaneous ingestion. Two steers were also used as a control group. The main clinical signs observed in spontaneous cases consisted of restlessness, bloat, polyuria, diarrhea, and death within 48 to 72 hours after the onset of clinical signs. Cattle experimentally poisoned presented similar clinical signs to those observed in spontaneous cases. Gross lesions consisted of dryness and impaction of the rumen, omasum and reticulum contents. Abomasal content was fluid, the mucosa was hyperemic, with swollen folds and multiple ulcers. Similar lesions were observed in duodenum mucosae. Histologically, lesions observed in the abomasum and duodenum mucosa consisted of necrosis, hemorrhage and inflammatory infiltration of neutrophils and lymphocytes. The wide distribution and palatability of this plant, associated with the high sensitivity of the bovine species verified in this experiment, highlight the importance of this plant in spontaneous cases of poisoning in cattle.

Recognition, Intervention, and Monitoring of Neutrophils in Acute Ischemic Stroke

Neutrophils are implicated in numerous inflammatory diseases, and especially in acute ischemic stroke (AIS). The unchecked migration of neutrophils into cerebral ischemic regions, and their subsequent release of reactive oxygen species, are considered the primary causes of reperfusion injury following AIS. Reducing the infiltration of inflammatory neutrophils may therefore be a useful therapy for AIS. Here, inspired by the specific cell-cell recognition that occurs between platelets and inflammatory neutrophils, we describe platelet-mimetic nanoparticles (PTNPs) that can be used to directly recognize, intervene, and monitor inflammatory neutrophils in the AIS treatment and therapeutic evaluation. We demonstrate that PTNPs, coloaded with piceatannol, a selective spleen tyrosine kinase inhibitor, and superparamagnetic iron oxide (SPIO), a T2 contrast agent, can successfully recognize adherent neutrophils via platelet membrane coating. The loaded piceatannol could then be delivered to adherent neutrophils and detach them into circulation, thus decreasing neutrophil infiltration and reducing infarct size. Moreover, when coupled with magnetic resonance imaging, internalized SPIO could be used to monitor the inflammatory neutrophils, associated with therapeutic effects, in real time. This approach is an innovative method for both the treatment and therapeutic evaluation of AIS, and provides new insights into how to treat and monitor neutrophil-associated diseases.

Obstructive urolithiasis in growing-finishing pigs

ABSTRACT: Obstructive urolithiasis is a disease characterized by the presence of uroliths in the urinary tract, with consequent obstruction of excretion pathways. This paper described the epidemiological and clinical-pathological findings of 22 outbreaks of urolithiasis in growing-finishing pigs in Southern Brazil. All affected pigs were male and clinical presentation consisted of lethargy, dysuria, rectal prolapse, abdominal distention, peripheral cyanosis and reluctance to move. Clinical progression course ranged from 12 hours to one week, and the lethality rate was 100%. Gross changes were characterized by urinary bladder rupture associated with marked amount of yellowish liquid with ammoniacal odor (urine) in the abdominal cavity (uroperitoneum), as well as mild fibrin deposition on the surface of abdominal organs and hydronephrosis. Urinary uroliths ranging from 0.3 to 1cm in diameter were often observed obstructing the lumen of the penile urethra and sometimes those were free in the abdominal cavity. Histopathological findings included diffuse and marked urinary bladder edema and hemorrhage associated with inflammatory infiltrate of lymphocytes, plasma cells, and macrophages. Diffuse and marked necrosis of the mucosal epithelium was observed in the penile urethra. Intense fibrin deposition and inflammatory infiltrate of neutrophils were noted in the peritoneum, as well as in the serosa of the organs in the abdominal cavity. Uroliths were submitted to the method of qualitative determination of the mineral components, and were compatible with calcium carbonate and magnesium ammonium phosphate. Growing pigs ration analysis revealed low levels of calcium in relation to phosphorus, resulting in a Ca:P ratio of approximately 0.35:1. Histological findings and mineral analysis suggest that outbreaks of urolithiasis were related to a nutritional imbalance in the proportions of dietary calcium and phosphorus. The main cause of mortality was related to dehydration and uroperitoneum.