Guttural Pouch Diseases Causing Neurologic Dysfunction in the Horse

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Case for diagnosis

Descreve-se caso clínico de paciente feminina adulta, portadora de doença de Parkinson em uso de amantadina que desenvolveu extenso quadro de livedo reticular nos membros e abdome após o início do medicamento. Discutem-se a semiotécnica diagnóstica do livedo reticular e seus diferenciais. Os autores salientam que a etiologia medicamentosa deva ser considerada no diagnóstico dos livedos reticulares.

Levels of matrix metalloproteinase-2 and metalloproteinase-9 in the cerebrospinal fluid of dogs with visceral leishmaniasis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Toothache referred from auriculotemporal neuralgia: case report

P>AimTo present a 52-year-old male patient who complained of intense pain of short duration in the region of the left external ear and in the ipsilateral maxillary second molar that was relieved by blockade of the auriculotemporal nerve in the infratemporal fossa.SummaryExtra- and intraoral physical examination revealed a trigger point that reproduced the symptoms upon finger pressure in the ipsilateral auriculotemporal nerve and in the outer auricular pavilion. The patient's medical history was unremarkable. The maxillary left second molar tooth was not responsive to pulp sensitivity testing and there was no pain upon percussion or palpation of the buccal sulcus. Periapical radiographs revealed a satisfactory root filling in the maxillary left second molar. on the basis of the clinical signs and symptoms, the auriculotemporal was blocked with 0.5 mL 2% lidocaine and 0.5 mL of a suspension containing dexamethasone acetate (8 mg mL(-1)) and dexamethasone disodium sulfate (2 mg mL(-1)), with full remission of pain 6 months later. The diagnosis was auriculotemporal neuralgia.Key learning pointAuriculotemporal neuralgia should be considered as a possible cause of nonodontogenic toothache and thus included in the differential diagnoses.The blockade of the auriculotemporal nerve in the infratemporal fossa is diagnostic and therapeutic. It can be achieved with a solution of lidocaine and dexamethasone.

A interface entre distúrbio obsessivo-compulsivo e esquizofrenia: Desafios da prática clínica

The article discusses the relationship between obsessive-compulsive disorder (OCD) and schizophrenia, based on the report of eight clinical cases. It describes and discusses cases of OCD with poor insight, obsessions that seem paranoid delusions or auditive hallucinations, OCD with transient psychotic reactions, OCD with schizotypal personality disorder and schizophrenia with obsessive-compulsive symptoms.

Low-grade endometrial stromal sarcoma presenting as vaginal nodule

Endometrial stromal sarcoma is a rare neoplasm of the uterus. Extrauterine locations of this neoplasm, excluding metastases or local extension, are even more unusual and are usually associated with the presence of endometriosis. The authors report a case of endometrial stromal sarcoma presenting as a vaginal wall nodule, without any sign of primary uterine tumor after extensive evaluation or presence of endometriosis. The morphology, immunohistochemical profile, differential diagnoses, and pathogenesis are discussed, as well as a review of the literature on this issue. © 2004 Elsevier Inc. All rights reserved.

Feline cholangitis/ chonlangiohepatitis complex secondary to Platynosomum fastosum infection in a cat.

Platynosomiasis has been associated with cholangitis/cholangiohepatitis complex in domestic cats. Despite being typically asymptomatic, some individuals may develop severe disease resulting in hepatic cirrhosis. Definitive diagnosis by means of parasite eggs direct visualization is not always possible and complementary tests should be associated. This paper reports a case of a three-year-old female cat with anorexia and jaundice. Ultrasound and biochemistry laboratory findings as well as liver biopsy were not conclusive. Definitive diagnosis of intense Platynosomum fastosum infestation was only possible through direct examination of biliary fluid at necropsy, stressing the importance of including platynosomiasis, commonly an underdiagnosed disease, among differential diagnoses of feline liver diseases.

Perfil de abdome agudo cirúrgico em pacientes com HIV/AIDS em um hospital de referência no estado do Pará

A Síndrome da Imunodeficiência Adquirida (Aids) é uma doença do sistema imunológico humano causada pelo vírus da imunodeficiência humana (HIV). O HIV ataca células humanas responsáveis por defender o organismo de doenças, sendo os linfócitos T CD4+ os mais atingidos. A dor abdominal em paciente imunodeprimido evolui com difícil manejo diagnóstico, sendo mandatório ao cirurgião estar familiarizado com os diversos diagnósticos diferenciais e complicações secundárias da Aids. O presente trabalho teve como objetivo descrever os aspectos clínico-epidemiológicos de pacientes com Aids que evoluíram com abdome agudo e receberam tratamento cirúrgico no período de janeiro de 2001 a janeiro de 2011 no Hospital Universitário João de Barros Barreto. Foi um estudo observacional, retrospectivo, do tipo caso-controle, onde o grupo de casos foi constituído por pacientes com Aids que evoluíram com abdome agudo e o grupo controle, por pacientes que também evoluíram com abdome agudo, porém sem condição imunossupressora associada. Houve predominância do sexo masculino na proporção 4,5 homens para cada mulher no grupo com aids, porém com proporção similar nos controles. A maioria dos pacientes (87%) do grupo controle apresentou alguma alteração laboratorial, diferentemente do grupo com Aids, onde 38,5% dos pacientes tiveram resultado normal. A anemia esteve presente em 75% dos pacientes com Aids e a leucocitose em 80% do grupo controle. A causa mais frequente de abdome agudo na população com Aids foi perfuração intestinal (82,1%), enquanto no grupo controle foi obstrução intestinal (39,1%). Somente o quadro clínico de defesa abdominal e diminuição de ruídos hidroaéreos apresentaram diferença estatisticamente significativa (p<0.01). As alterações radiológicas mais frequentes foram distensão de alças em 87,2% dos pacientes com Aids e níveis hidroaéreos em 65,2% dos pacientes do grupo controle. A principal cirurgia realizada no grupo Aids foi a ressecção intestinal com reconstrução primária do trânsito (65,5%). As complicações cirúrgicas foram mais frequentes no grupo com Aids (87,2% com infecção de ferida operatória) e a causa predominante de óbito em ambos os grupos foi sepse a partir de foco abdominal (81% nos casos e 87,5% controles), inclusive nos pacientes ostomizados. A probabilidade de óbito nos casos com Aids foi superior em cerca de 2 vezes em relação aos controles. O tempo de internação e o tempo de pós-operatório até o óbito foi menor nos pacientes com Aids em comparação aos controles. Sendo fundamental a realização do estudo para melhorar o manejo e sobrevida dos pacientes com Aids.

Olfactory reference syndrome: a still open nosological and treatment debate

Objective: The objective was to report a case of olfactory reference syndrome (ORS) with several co-occurring disorders and to discuss ORS differential diagnoses, diagnostic criteria and classification.Method: Case report.Results: A 37-year-old married woman presented overvalued ideas of having bad breath since adolescence. Shemet current diagnostic criteria for social anxiety disorder, specific phobia, obsessive-compulsive disorder, generalized anxiety disorder, body dysmorphic disorder and major depressive disorder. ORS similarities and differences with some related disorders are discussed.Conclusion: Further studies regarding symptoms, biomarkers and outcomes are needed to fully disentangle ORS from existing depressive, anxiety and obsessive-compulsive spectrum disorders. (C) 2014 Elsevier Inc. All rights reserved.

Alterações hematológicas associadas ao hifema em cães

Hyphema is an intraocular hemorrhage that can result from many ocular and/or systemic disorders. It is an important clinical sign, since it may appear in the initial stages of some diseases or haematological disorders, acting as an initial marker for early diagnosis. The hematologic disturbances that predispose animals to present hyphema are: Thrombocytopenia, von Willebrand Disease, Scott Syndrome, Disseminated Intravascular Coagulation and Hyperviscosity Syndrome due to Multiple Myeloma. Each of the differential diagnoses due to hematological changes from the appearance of hyphema in dogs shows clinical relevance and particular ocular signs

Doença cerebelar em cães e gatos

Diseases of the cerebellar system are common in small animals, and result in a clinical syndrome characterized by hypermetria, base-wide stance and intentional tremors of the head and body. All movements of the limbs are spastic and awkward. The neurological examination assists in the localization of lesions restricted to the cerebellum or in the detection of disorders relating to other parts of the nervous system, which characterizes a multifocal disease process. Neurological disorders in dogs and cats may suggest a very extensive list of differential diagnoses, since they may be caused by infectious, degenerative and traumatic processes, among others. The possible etiologies for cerebellar syndrome include: aplasia and hypoplasia, abiotrophy, cancer, vascular stroke and inflammatory disorders. The aim of this paper is to review the clinical signs that aid in the location of the cerebellar lesion and discuss the possible causes of this syndrome in dogs and cats.

Fabry's disease and psychosis: causality or coincidence?

A 21-year-old female with Fabry's disease (FD) presented acute psychotic symptoms such as delusions, auditory hallucinations and formal thought disorders. Since the age of 14, she had suffered from various psychiatric symptoms increasing in frequency and intensity. We considered the differential diagnoses of prodromal symptoms of schizophrenia and organic schizophrenia-like disorder. Routine examinations including cognitive testing, electroencephalography and structural magnetic resonance imaging revealed no pathological findings. Additional structural and functional imaging demonstrated a minor CNS involvement of FD, yet without functional limitations. In summary our examination results support the thesis that in the case of our patient a mere coincidence of FD and psychotic symptoms is more likely than a causal connection.

Serum amino acid profiles and their alterations in colorectal cancer

Mass spectrometry-based serum metabolic profiling is a promising tool to analyse complex cancer associated metabolic alterations, which may broaden our pathophysiological understanding of the disease and may function as a source of new cancer-associated biomarkers. Highly standardized serum samples of patients suffering from colon cancer (n = 59) and controls (n = 58) were collected at the University Hospital Leipzig. We based our investigations on amino acid screening profiles using electrospray tandem-mass spectrometry. Metabolic profiles were evaluated using the Analyst 1.4.2 software. General, comparative and equivalence statistics were performed by R 2.12.2. 11 out of 26 serum amino acid concentrations were significantly different between colorectal cancer patients and healthy controls. We found a model including CEA, glycine, and tyrosine as best discriminating and superior to CEA alone with an AUROC of 0.878 (95% CI 0.815-0.941). Our serum metabolic profiling in colon cancer revealed multiple significant disease-associated alterations in the amino acid profile with promising diagnostic power. Further large-scale studies are necessary to elucidate the potential of our model also to discriminate between cancer and potential differential diagnoses. In conclusion, serum glycine and tyrosine in combination with CEA are superior to CEA for the discrimination between colorectal cancer patients and controls.

[Coumarin-induced necrotic purpura of the skin -- case report and review of the literature]

We report the case of a 28-year old woman with extensive red-black colored lesions of the skin on the left thigh, which appeared without trauma. The disease arrived during longterm coumarin therapy because of a deep vein thrombosis and an antiphospholipid syndrome. After consideration of the differential diagnoses and due to the typical clinical picture we made the diagnosis of coumarin necrosis. We review the clinical and therapeutic features for this rare complication.

Mycobacterium microti infection in the cat: a case report, literature review and recent clinical experience

OVERVIEW: Mycobacterium microti infection is infrequently described in cats in the veterinary literature. It can be one of a large number of possible differential diagnoses in a feline patient with dermal nodules and non-healing draining ulcers, and can occasionally spread to involve the lungs and/or other areas of the body. CASE SUMMARY: This report describes the clinical signs, eventual diagnosis and variable response to treatment in a cat in Switzerland with recurrent cutaneous M microti infection. Only after several diagnostic and therapeutic attempts, over more than 2 years, was the species of Mycobacterium finally identified and targeted therapy given. PRACTICAL RELEVANCE: For any cat in which there is even a low suspicion of mycobacterial infection, the authors recommend that an aggressive diagnostic approach is taken. Tissue specimens should be collected and frozen early on, and, as soon as acid-fast bacilli are detected, samples should be sent to a mycobacterial reference laboratory for definitive identification. LITERATURE REVIEW: A review of the literature relating to the aetiopathogenesis, diagnosis and management of M microti infection in cats and dogs is included. This is supplemented with clinical and therapeutic experience gained from this case and other, unpublished cases managed over the past 15 years by one of the authors (DGM).