Presence Of Inflammatory Lesions Research Articles

Alterations of Liver Morphology in Senescent Rats.

Age-related liver changes can have important implications for health and metabolic function. This study aimed to describe the morphoquantitative alterations of the liver in senescent rats compared to adult rats. Twelve male rats were used, divided into 6-month-old adults (group A) and 36-month-old senescent rats (group S). Morphometric and histopathological studies, quantification of collagen types I and III, and stereological analyses were performed to determine the volume density of mononucleated (VvhepM) and binucleated (VvhepB) hepatocyte nuclei, surface area density (SvhepM), and number density (NvhepM) of mononucleated hepatocyte nuclei. The findings reveal an alteration of the normal liver tissue architecture in senescent rats and the presence of inflammatory lesions and fibrosis. In addition, there was a decrease in body and liver mass and volume. Group S showed a significant reduction in VvhepM and NvhepM; however, SvhepM was significantly higher. No significant differences were noted in the percentage of binucleated hepatocytes between the two groups. This study reveals substantial morphological changes in the aging liver, with possible functional implications. More research is needed on the underlying mechanisms and their consequences at older ages.

Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: comparison of disease characteristics and treatment requirement

Abstract Objectives To compare clinical characteristics, imaging findings and treatment requirements of patients with immune checkpoint inhibitor-mediated polymyalgia rheumatica (ICI-PMR) and primary PMR. Methods This single centre, retrospective cohort study compared ICI-PMR in patients with cancer (n = 15) to patients with primary PMR (n = 37). A comparison was made between clinical symptoms, laboratory markers, ultrasonography, 18F-FDG-PET/CT findings and treatment requirements related to PMR. Results Patients with ICI-PMR less frequently fulfilled the EULAR/ACR classification criteria for PMR (66.7%) than patients with primary PMR (97.3%). Morning stiffness, weight loss and elevation of the ESR were less frequently seen in patients with ICI-PMR. No differences were observed regarding the presence of inflammatory lesions on ultrasound of the shoulders and hips between the two groups. The Leuven and the Leuven/Groningen 18F-FDG-PET/CT scores were significantly lower in the ICI-PMR group. Finally, the ICI-PMR group could be managed with lower glucocorticoid doses than the primary PMR group, while this treatment could be discontinued more quickly. Conclusion Our findings indicate that ICI-PMR may have a milder course with less intense inflammation than primary PMR. ICI-PMR can be managed with a relatively low glucocorticoid dose. Our study underscores that ICI-PMR should be regarded as a PMR-like syndrome.

Audiometric Variability of the Carhart Effect in Middle Ear Diseases - Pretreatment Analysis.

The assessment of bone conduction thresholds in patients with conductive hearing loss is not a full measure of the function of the inner ear due to the weakening of the influence of middle ear components on bone conduction. This relationship has been called the 'Carhart effect'. The retrospective analysis covered 977 patients diagnosed and treated for middle ear diseases from 2010 to 2020. The Carhart effect was considered to be an increase in the bone conduction threshold by a minimum of 10dB relative to adjacent frequencies. The study was performed with the aim of assessing the presence of the Carhart effect in the course of middle ear diseases in pretreatment analysis. The Carhart effect was observed in 532 cases, most often in patients with chronic otitis media and otosclerosis. It was least often observed in patients with otitis media with effusion. In otitis media with effusion, the Carhart effect was more often noted for the frequency of 4000Hz, in otosclerosis for the frequency of 2000Hz. In patients with chronic otitis media, this effect for the frequency of 4000Hz was correlated with the location of inflammatory changes in the attic area. The presence of inflammatory lesions in the oval window area was associated with the presence of the Carhart effect for the frequency of 2000Hz. 1. The frequency of the Carhart effect observed in diseases of the middle ear does not depend on the disease entity but on the type and location of abnormalities in the middle ear. 2. The Carhart effect observed for the frequency of 4000Hz coexists with the localization of lesions in the range of the malleus and incus, and for the frequency of 2000Hz, it is partially associated with abnormalities in the range of stapes and oval window.

Anatomical variation of the sacroiliac joint carries an increased risk for erosion and bone marrow oedema in axial spondyloarthritis.

To assess the impact of joint shape variations on inflammatory lesions on SI joint MRIs in patients with axial spondyloarthritis (axSpA). A total of 1194 patients from four different prospective cohorts were evaluated, with 684 (57.3%) having sufficient imaging data for inclusion (379 axSpA, 305 controls). All images were evaluated for joint form, erosion, sclerosis, fat metaplasia and bone marrow oedema (BMO) by two independent readers. Logistic regression analyses were used to assess the association of joint form and lesions on imaging for axSpA patients and controls. Atypical joint forms were common in both axSpA (43.5% [154/354]) and control patients (44.2% [134/303]); both intra-articular variants and a crescent joint shape were significantly more common in axSpA patients (18.4% vs 11.6% and 11.0% vs 5.3.%, respectively; P < 0.001). The axSpA patients with intra-articular joint form variants had 2-fold higher odds of exhibiting erosions [odds ratio (OR) 2.09 (95% CI 1.18, 3.69)] and BMO [OR 1.79 (95% CI 1.13, 2.82)]; this association was not observed in controls. Accessory joints increased the odds for sclerosis in axSpA patients [OR 2.54 (95% CI 1.10, 5.84)] and for sclerosis [OR 17.91 (95% CI 6.92, 46.37)] and BMO [OR 2.05 (95% CI 1.03, 4.07)] in controls. Joint form variations are associated with the presence of inflammatory lesions on SI joint MRIs of axSpA patients. This should be taken into consideration in future research on the interplay of mechanical strain and inflammation in axSpA.

Glucocorticoids in myocarditis therapy after COVID-19

Abstract The aim of the study - to evaluate the efficacy of glucocorticoids (GC) in patients with acute myocarditis (AM) after COVID-19 infection. Material and methods We included 60 pts with severe AM and heart failure (HF) with reduced (&amp;lt;40%) left ventricular (LV) ejection fraction (EF) who had COVID-19 infection 1–2 months before the enrollment. According to the results of cardiac magnetic resonance (CMR) included pts had ≥2 Lake Louise criteria for myocarditis. All pts on the background of HF therapy (β-blockers, ACE-inhibitors, MRA antagonists, diuretics) were prescribed GC: 0.25 mg/kg per day methylprednisolone for 3 months, followed by a gradual dose reduction of 1–2 mg per week until complete discontinuation after 6 months. Evaluation before the start of GC therapy and after 6 months included CMR, 2D- and speckle-tracking echocardiography. Results After 6 months according to the results of CMR the number of LV segments with inflammatory lesions decreased to (3,58±0,42) from (6,32±0,77) segments in average (p=0,001). This was followed by improvement of LV systolic function: increase of LV EF in average to (43,5±2,6) from (32,2±2,4) % (p=0,003), longitudinal global systolic strain (LGSS) absolute value to (11,3±1,1) from (7,9±0,5) % (p=0,012) and circumferential global systolic strain (CGSS) to (12,1±1,0) from (8,9±0,6) % (p=0,023). Also we observed LV volume reduction: decrease of LV end-diastolic (from 118,9±8,6 to 95,3±7,2 ml/m2, p=0,033) and LV end-systolic (from 80,1±5,1 to 59,1±4,4 ml/m2, p=0,027) volume indexes. Wherein in 24 of 60 pts (41,6%) on the background of significant decrease in the number of LV segments with inflammatory lesions (to 1,34±0,21 from 6,12±0,73 segments, p=0,0001) after 6 months we observed the recovery of LV EF ≥50%, followed by an improvement of LGSS and CGSS on 42,1 and 39,4% respectively (p=0,001). According to multivariate regression analysis, predictors of LV EF recovery (≥50%) after 6 months of GC treatment were established: presence of inflammatory lesions in ≤5,0 LV segments, values of LGSS and CGSS ≥9.0% and ≥9.5% respectively before the start of GC. Conclusions The use of GC in pts with severe AM after COVID-19 was followed by the decrease of LV segments number affected by inflammation, improvement of LV systolic function and reduction of LV volume indexes. In 41,6% of pts GC therapy was associated with LV EF recovery after 6 months and predictors of its effectiveness were found: presence of inflammatory lesions in ≤5,0 LV segments, values of LGSS and CGSS ≥9.0% and ≥9.5% respectively before the start of GC. Funding Acknowledgement Type of funding sources: None.

Role of myocardial inflammation and fibrosis in the development of ventricular arrythmias in patients with inflammatory cardiomyopathy (results of 1-year follow-up)

Abstract Background Myocardial inflammatory and fibrotic changes are the most frequent and significant causes of ventricular rhythm disorders that could result in development of life threatening arrythmias and increase the risk of sudden cardiac death, especially in young patients with inflammatory cardiomyopathy (ICM). The purpose – to estimate association of myocardial inflammation and fibrosis with development of ventricular arrythmias in patients with ICM during 12-months of follow-up. Material and methods The study was performed on 70 patients with ICM, average age was (35,2±2,7) years. Initially all patients had cardiomegaly with reduced left ventricular (LV) ejection fraction - &amp;lt;40% and absolute value of longitudinal global systolic strain &amp;lt;9,0%. By 24-hour ECG monitoring we studied frequency of ventricular premature beats (VPB) and incidence of non-sustained ventricular tachycardia (NSVT) paroxysms. All patients underwent for cardiac MRI with evaluation of early T1- and T2-weighted images for the detection of inflammatory changes and T1-weighted delayed images for detection of myocardial fibrosis. Results of cardiac MRI were estimated by Lake Louise criteria and also we performed quantification of segments involved according to standard 17-segment LV model. Initial examination was carried out within the 1st month from the clinical onset of disease and subsequent evaluation of studied parameters was performed after 12 months of follow-up. Results After 12 months of follow-up average frequency of VPB reduced to (1,42±0,14) % from (2,32±0,27) % on initial examination (p&amp;lt;0,01), similarly reduced the incidence of NSVT paroxysms – to 11,4% after 12 months from 28,6% initially. Mean quantity of LV segments, affected by inflammatory process and characterized by presence of edema and/or hyperemia, reduced to (2,12±0,22) segm. after 12 months of follow up from (6,12±0,71) segm. on the 1st month (p&amp;lt;0,01). Also we observed increase of LV segments amount with the presence of delayed enhancement which indicates myocardial fibrosis – from (2,04±0,21) segm. on initial examination to (4,79±0,38) segm. after 12 months (p&amp;lt;0,01). Using binary regression analysis we defined that initial presence of inflammatory lesions in ≥5,0 LV segments was associated with frequent VPB (≥1,0%) and NSVT paroxysms. Wherein, after 12 months presence of inflammatory lesions had no association with ventricular rhythm disorders but the same relation was observed between the presence of delayed enhancement in ≥4,0 LV segments and frequent VPB (≥1,0%) as also with NSVT paroxysms. Conclusion At the time of clinical onset of inflammatory cardiomyopathy ventricular rhythm disorders (particularly VPB and NSVT paroxysms) were associated with larger quantity of LV segments involved into inflammatory process. After 12 months of follow-up ventricular rhythm disorders were associated predominantly with the presence of fibrotic lesions in several (≥4,0) segments of LV. Funding Acknowledgement Type of funding source: None

A modified Sydney system for the diagnosis of chronic gastritis in dogs

BackgroundThe Sydney system for assessing inflammatory lesions in the gastric mucosa is based on endoscopic and histological examinations. This study aimed to apply the Sydney system to diagnose gastritis in dogs. The study also compared the results of endoscopic and histological examinations conducted on gastric mucosal biopsy specimens. A total of 56 dogs with chronic vomiting were analyzed in the study. The physical appearance of the gastric mucosa was assessed through endoscopic examination, while the severity of the gastric inflammation, inflammation activity, glandular atrophy, and intestinal metaplasia were assessed by histopathological examination.ResultsThe endoscopic examination confirmed the presence of inflammatory lesions affecting the gastric corpus and pylorus in all the dogs, although the severity of these lesions differed between the individuals. Reflux gastritis was the most commonly observed gastric inflammation. In the histopathological examination of the gastric mucosal samples, inflammatory lesions were found in the gastric corpus of 53 dogs, while 55 dogs had lesions in the pylorus. This corresponds to a 96.4% agreement between the methods.ConclusionsThe Sydney system is a useful tool for macroscopic and microscopic assessment of changes in the gastric mucosa as it enables the determination of inflammation type and severity, which helps the canine gastroenterologists to reliably compare the results of the tests performed in different facilities. Besides, the use of the Sydney system in diagnosing lesions facilitates the selection and effective monitoring of treatment. However, despite a high rate of agreement between the results of endoscopic and histopathological examinations, it is recommended to use both these methods for the assessment of the gastric mucosa in dogs.

Cerebrospinal Fluid Neopterin in Children With Enterovirus-Related Brainstem Encephalitis

BackgroundEnterovirus-A71 causes outbreaks of brainstem encephalitis, ranging from self-limited disease to acute flaccid paralysis. The aim of this study was to assess the role of cerebrospinal fluid (CSF) neopterin as a biomarker of disease severity in children with enterovirus-related brainstem encephalitis. MethodsA descriptive, prospective cohort study was conducted from April 2016 to March 2017 in a tertiary hospital. Pediatric patients with a diagnosis of brainstem encephalitis with or without myelitis due to enterovirus infection were enrolled. The final study group comprised a convenience sample including all patients with sufficient CSF volume for neopterin determination. The major variables considered in estimating the severity were the diagnosis of encephalomyelitis, the presence of lesions and extensive lesions on brain and spinal magnetic resonance imaging (MRI), hospital stay length greater than seven days, and sequelae at day 30. ResultsOf 60 patients, CSF neopterin could be measured in 36. Median age was 26 months (interquartile range: 19 to 32). Thirty-three were diagnosed with brainstem encephalitis and three with encephalomyelitis. Enterovirus-A71 was the only identified genotype (25 of 25). CSF neopterin levels were elevated (>61 nmol/L) in 33 of 36 (92%), with a median of 347 nmol/L (interquartile range: 204 to 525). CSF neopterin was useful to distinguish patients with lesions on MRI (area under the receiver operating characteristic curve = 0.76; P = 0.02) and extensive lesions (area under the receiver operating characteristic curve = 0.76; P = 0.04). ConclusionsThis study suggests an association between CSF neopterin levels and the presence of inflammatory lesions on MRI.

Surgical treatment of rapidly advancing active ulcerative colitis: a case report

Ulcerative colitis is an inflammatory bowel disease with various clinical presentation. Due to an impaired immune response, diffuse inflammation develops in the intestinal tissue, which leads to bleeding and diarrhoea. The basis for diagnosis is the clinical presentation and the result of colonoscopy which confirms the presence of inflammatory lesions in the colon. The authors present the case of a patient admitted to their department following two previous hospitalisations at other centres who was suffering from active ulcerative colitis. After bacterial aetiology of the disease was excluded and conservative treatment was attempted at a gastroenterology ward, the patient was referred to a surgical department. During the previous hospitalisation colonoscopy was performed in which a lesion was observed in the splenic flexure, which precluded the visualisation of the further part of the colon. A colonoscopy performed at the surgical department did not confirm the presence of that lesion; however, it did reveal multiple pseudopolyps. Due to rapidly progressing cachexia and anaemia and a lack of improvement following attempted pharmacological treatment, a decision was made to perform an urgent colectomy with end ileostomy. After a week-long preparation of the patient (parenteral nutrition, packed red blood cells transfusion), pancolectomy was performed. Histopathological examination confirmed acute phase ulcerative colitis. In the postoperative period massive wound infection developed, which was treated for 14 days with vacuum therapy (VAC). The patient was treated for 30 days at the surgical department. He was discharged in a good general condition and instructed to report to his outpatient care centre.

Immunohistochemical Analysis of S100-Positive Langerhans Cells in the Healthy Gingiva and Periodontal Disease

Langerhans cells are antigen presenting cells, located in the stratified squamous epithelium of the skin and oral epithelium. A high density of Langerhans cells in gingival epithelium associated with an inflammatory process has been demonstrated in the literature by numerous studies, although the relationship with inflammation was less investigated.The aim of our study was to evaluate the distribution, density, morphology of Langerhans cells in both gingival epithelium and the associated inflammatory infiltrate in the lamina propria of the gingiva. The relationship between Langerhans cells and inflamatory process was also assesed. The present study included a number of 51 gingival biopsies. 12 of these didn� t show significant changes on routine examination. In all of the other 39 cases the presence of inflammatory lesions was noticed. The inflamatory infiltrate was described by using hematoxylin eosin staining and quantitative score, with values between 0 and 3. Langerhans cells were immunohistochemicaly highlighted by using S100 antibody and quantified with hot spot method.We found an increase of Langerhans cells density in all cases of inflammation as compared with healthy gingival tissue. The highest density was found in the 13 cases with severe inflammation. At these last cases was noticed a migration tendency of Langerhans cells from infiltrate inflamatory area to basal layer of the epithelium. The results of this study indicated that Langerhans cells number is higher in inflamatory gingival tissue comparative with normal tissue, and the density of these cells is in relation with the severity of the inflammatory process.

Maternal Income during Pregnancy is Associated with Chronic Placental Inflammation at Birth.

Objective This study aims to examine whether maternal household income is associated with histological evidence of chronic placental inflammation. Study Design A total of 152 participants completed surveys of household income and consented to placenta collection at delivery and postpartum chart review for birth outcomes. Placental inflammatory lesions were evaluated via histological examination of the membranes, basal plate, and villous parenchyma by a single, experienced pathologist. Associations between household income and the presence of inflammatory lesions were adjusted for known perinatal risk factors. Results Overall, 45% of participants reporting household income below $30,000/y had chronic placental inflammation, compared with 25% of participants reporting income above $100,000 annually (odds ratio [OR] = 4.23, 95% confidence interval [CI] = 1.25, 14.28; p = 0.02). Middle-income groups showed intermediate rates of chronic inflammatory lesions, at 40% for those reporting $30,000 and 50,000 (OR = 3.60, 95% CI = 1.05, 12.53; p = 0.04) and 38% for those reporting $50,000 to 100,000 (OR = 1.57, 95% CI = 0.60, 4.14; p = 0.36). Results remained significant after adjustment for maternal age, race, and marital status. Conclusion Chronic placental inflammation is associated with maternal household income. Greater occurrence of placental lesions in low-income mothers may arise from a systemic inflammatory response to social and physical environmental factors.

Investigation of Different Infection Routes of Parrot Bornavirus in Cockatiels

The aim of this study was to determine the natural infection route of parrot bornavirus (PaBV), the causative agent of proventricular dilatation disease (PDD) in psittacines. For this purpose, nine cockatiels ( Nymphicus hollandicus ) were inoculated orally, and nine cockatiels were inoculated intranasally, with a PaBV-4 isolate. To compare the results of the trials, the same isolate and the same experimental design were used as in a previous study where infection was successful by intravenous as well as intracerebral inoculation. After inoculation, the birds were observed for a period of 6 mo and tested for PaBV RNA shedding, virus replication, presence of inflammatory lesions, and PaBV-4 antigen in tissues, as well as specific antibody production. In contrast to the previous study involving intravenous and intracerebral infections, clinical signs typical for PDD were not observed in this study. Additionally, anti-PaBV antibodies and infectious virus were not detected in any investigated bird during the study. Parrot bornavirus RNA was detected in only four birds early after infection (1-34 days postinfection). Furthermore, histopathologic examination did not reveal lesions typical for PDD, and PaBV antigen was not detected in any organ investigated by immunohistochemistry. In summary, oral or nasal inoculation did not lead to a valid infection with PaBV in these cockatiels. Therefore it seems to be questionable that the formerly proposed fecal-oral transmission is the natural route of infection in immunocompetent adult or subadult cockatiels.

Challenges Faced by Cross-sectional Imaging and Histological Endpoints in Clinical Trials.

In patients with inflammatory bowel disease, a dissociation can occur between symptoms and presence of inflammatory lesions. This dissociation has led to the recognition that objective measures of disease activity together with clinical assessment should be co-primary endpoints in clinical trials. Objective assessment of inflammatory lesions has classically relied on ileocolonoscopy. However, examination with endoscopy cannot always be complete and does not evaluate transmural changes. Furthermore, histological alterations may persist in the presence of mild or even absent endoscopy lesions. For these reasons cross-sectional imaging, particularly magnetic resonance imaging [MRI] and histology, are being considered as potential new tools for objective assessment of lesions.In patients with Crohn's disease, it has been shown that MRI has a high degree of accuracy for the evaluation of presence and severity of inflammation, and that validated indices of activity such as the Magnetic Resonance Index of Activity [MaRIA] are responsive to effective therapeutic interventions. In the context of clinical trials, MRI may help in patient selection by providing always a complete assessment of the small bowel and colon and detecting the presence of complications.A generally accepted definition of histological mucosal healing, to be used in clinical trials on Crohn's disease or ulcerative colitis, does not exist. Several histological scoring systems are available, most of these based on the evaluation the presence of neutrophils, epithelial cell damage, and an increase in lymphocytes and plasma cells. At present, histological remission is not included as primary endpoint for therapeutic trials, but better outcomes associated with achievement of histological healing favours the consideration of histology as an endpoint in the future.

Diagnostic imaging of psoriatic arthritis. Part I: etiopathogenesis, classifications and radiographic features.

Psoriatic arthritis is one of the spondyloarthritis. It is a disease of clinical heterogenicity, which may affect peripheral joints, as well as axial spine, with presence of inflammatory lesions in soft tissue, in a form of dactylitis and enthesopathy. Plain radiography remains the basic imaging modality for PsA diagnosis, although early inflammatory changes affecting soft tissue and bone marrow cannot be detected with its use, or the image is indistinctive. Typical radiographic features of PsA occur in an advanced disease, mainly within the synovial joints, but also in fibrocartilaginous joints, such as sacroiliac joints, and additionally in entheses of tendons and ligaments. Moll and Wright classified PsA into 5 subtypes: asymmetric oligoarthritis, symmetric polyarthritis, arthritis mutilans, distal interphalangeal arthritis of the hands and feet and spinal column involvement. In this part of the paper we discuss radiographic features of the disease. The next one will address magnetic resonance imaging and ultrasonography.

AB1009 Concordance between “A Positive MRI of the Sacroiliac Joints” Based on the Local Reading versus A Centralised Reading: Experience from the Desir-Cohort

BackgroundReading of MRIs of the sacroiliac joints (MRI-SI) in clinical trials is usually performed by ≥1 trained readers while in daily practice this is done by local radiologists/rheumatologists. However, this...

Endoscopic evidence of reflux disease in the larynx

Conclusion: The severity of laryngeal mucosal lesions in patients with gastroesophageal reflux disease (GERD) is significantly greater than in controls. A higher degree of laryngeal mucosal injury is documented in patients in whom GERD is associated with more advanced esophageal lesions. Objectives: (1) To confirm the presence of inflammatory lesions in the laryngopharynx of patients with GERD. (2) To analyze the relationship between the severity of laryngopharyngeal and esophageal lesions on the basis of the reflux finding score (RFS) and the Los Angeles (LA) scale of esophageal mucosal injury. Methods: The study included 92 subjects, among them 46 patients with GERD and 46 individuals without endoscopic evidence of esophageal lesions, qualified for routine endoscopy due to other indications. The endoscopic images of the inferior pharynx, larynx, and esophagus were analyzed during the video-endoscopic examination of the upper gastrointestinal tract. The laryngeal images were assessed according to RFS criteria and the numeric value of RFS was calculated. The degree of esophageal mucosal injury was described according to the LA scale. Results: Both global RFS score and the scores of all RFS parameters except the presence of granulomatous tissue were significantly higher in patients with GERD than in the controls. Patients in whom GERD was associated with more severe esophageal lesions (group B according to the LA scale) had significantly higher global RFS score and scores of all analyzed parameters of laryngeal injury except subglottic edema than individuals in whom the degree of esophageal involvement was classified as group A.

FRI0274 Decrease in lumbar spine bone mineral density in patients with early axial spondyloarthritis is highly associated with spinal inflammation on MRI: Results from the DESIR cohort

Objectivesto assess bone mineral density (BMD) at lumbar spine and hip in a large cohort of patients with early inflammatory back pain suggestive of axial SpA, and to assess systemic...

Resposta clínica e metabólica de potros neonatos em relação aos achados histopatológicos da placenta na égua

Avaliaram-se as respostas clínica e metabólica de potros neonatos em relação aos achados histopatológicos da placenta na égua. Foram avaliados dois grupos de éguas da raça Puro Sangue Inglês - um grupo-problema (n=25) e um grupo-controle (n=25), de acordo com os achados da placenta. O exame dos potros constou de avaliação clínica geral, hematologia e bioquímica sérica. O exame histopatológico da placenta apresentou resultado compatível com a apresentação clínica do potro, sendo que a presença de lesões inflamatórias resultou na produção de potros debilitados. A presença de lesões degenerativas não comprometeu o estado clínico do neonato, mas pode ser responsável pela manifestação de distúrbios subclínicos, evidenciados pelo aumento das taxas de AST e GGT. A ureia pareceu ser um indicador de dano renal decorrente de insuficiência placentária em potros neonatos.

Development of lesions and tissue distribution of parasite in lambs orally infected with sporulated oocysts of Toxoplasma gondii

The host–pathogen interaction is as a key feature during the formation of tissue cysts of Toxoplasma gondii within intermediate hosts. In this study, we investigated whether oral infection of lambs with T. gondii oocysts may be used as an experimental model in sheep to study this interaction, with the main objective being to detect the presence and distribution of lesions and parasite within different organs at different time points after oral infection. Lambs were infected with 5 × 10 3 and 5 × 10 5 sporulated T. gondii oocysts and culled at 2, 3, 5 and 6 weeks post-infection (WPI). During the infection, rectal temperature of the animals and serological antibodies against T. gondii were monitored. The presence of inflammatory lesions and parasite were evaluated through histological and immunohistochemical methods at different organs (brain, liver, lung, heart and lymph nodes). The lambs showed no clinical signs other than fever, and lesions appeared mainly in the brain, characterized by glial foci and perivascular cuffs, and in the heart, denoted by foci of interstitial myositis. Tissue cysts and tachyzoite-like structures were observed at all time points studied in the brain, where together with the glial foci they appeared mainly in the cerebral cortex of the forebrain and in the midbrain, but also in the heart, lung and lymph nodes. This study shows that oral infection with sporulated oocysts in lambs may provide a model for investigating the host–parasite interaction in situ during the development of tissue cysts.

Leukocyte scintigraphy compared to intraoperative small bowel enteroscopy and laparotomy findings in Crohnʼs disease

Leukocyte scintigraphy is a noninvasive investigation to assess inflammation. We evaluated the utility of labeled leukocytes to detect small bowel inflammation and disease complications in Crohn's disease and compared it to whole small bowel enteroscopy and laparotomy findings. Scintigraphy with technetium-99m exametazime-labeled leukocytes was prospectively performed in 48 patients with Crohn's disease a few days before laparotomy; 41 also had an intraoperative small bowel enteroscopy. The same procedures were performed in 8 control patients. Independent grading of scans was compared with the results of enteroscopy and with surgical, histopathologic, and clinical data. In the 8 control patients leukocyte scan, endoscopy, and histopathology were all negative for the small bowel. In patients with Crohn's disease and small bowel inflammation seen at enteroscopy and/or laparotomy (n = 39) the scan was positive in 33. In 8 patients without macroscopic small bowel inflammation, the scan was positive for the small bowel in 3 patients; at histology, 2 of 3 had inflammation. When combining results for patients and controls, the sensitivity of leukocyte scan for macroscopically evident small bowel inflammation was 0.85, specificity 0.81, accuracy 0.84, positive predictive value 0.92, and negative predictive value 0.68. Scintigraphy detected inflammatory lesions not known before laparotomy in 16 of 47 (34%) Crohn's disease patients and showed uptake in 25 of 35 (71%) bowel strictures. It was diagnostic regarding 4 of 8 abscesses and 9 of 15 fistulas. In 6 patients (13%) lesions first demonstrated by leukocyte scintigraphy were treated during the surgery performed. Leukocyte scintigraphy reliably detects small bowel inflammation in Crohn's disease. It gives additional information on the presence of inflammatory lesions in a fraction of patients planned for surgery.