RESUMO
Although the COVID-19 pandemic has left no country untouched there has been limited research to understand clinical and immunological responses in African populations. Here we comprehensively characterise patients hospitalised with suspected or confirmed COVID-19, and healthy community controls. PCR-confirmed COVID-19 participants were more likely to receive dexamethasone and a beta-lactam antibiotic, and survive to hospital discharge than PCR-/IgG+ and PCR-/IgG-participants. PCR-/IgG+ participants exhibited a nasal and systemic cytokine signature analogous to PCR-confirmed COVID-19 participants, but increased propensity for Staphylococcus aureus and Streptococcus pneumoniae colonisation. We did not find evidence that HIV co-infection in COVID-19 participants was associated with mortality or altered cytokine responses. The nasal immune signature in PCR-/IgG+ and PCR-confirmed COVID-19 participants was distinct and predominated by chemokines and neutrophils. In addition, PCR-/IgG+ individuals with high COVID-19 clinical suspicion had inflammatory profiles analogous to PCR-confirmed disease and potentially represent a target population for COVID-19 treatment strategies.
RESUMO
Multi drug resistant Streptococcus pneumoniae constitute a major public health concern worldwide. In this review we discuss how the transformable nature of the pneumococcus, in parallel with antimicrobial induced stress, contributes to the evolution of antimicrobial resistance; and how the introduction of the pneumococcal conjugate vaccine has affected the situation.
Assuntos
Farmacorresistência Bacteriana Múltipla , Fluoroquinolonas/farmacologia , Macrolídeos/farmacologia , Infecções Pneumocócicas/tratamento farmacológico , Streptococcus pneumoniae/efeitos dos fármacos , beta-Lactamas/farmacologia , Antibacterianos/farmacologia , Anti-Infecciosos/farmacologia , Humanos , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/uso terapêuticoAssuntos
Anestesia por Inalação/veterinária , Febre/veterinária , Doenças dos Cavalos , Hiperpotassemia/veterinária , Paralisia/veterinária , Anestesia por Inalação/efeitos adversos , Animais , Feminino , Febre/etiologia , Cavalos , Hiperpotassemia/sangue , Hiperpotassemia/complicações , Isoflurano/efeitos adversos , Paralisia/sangue , Paralisia/complicaçõesRESUMO
The medical records of 75 horses with duodenitis-proximal jejunitis (DPJ) were reviewed. Ages, physical parameters, laboratory values, and treatment data were compared between horses surviving DPJ and horses not surviving DPJ (Table 1). Fifty of 75 horses (66.6%) survived. Sixty-six horses (88.0%) were managed with medical treatment alone and nine horses (12.0%) were managed with medical treatment plus surgical intervention. Using a logistic regression model, the association of each of the 19 physical and laboratory parameters with death was evaluated retrospectively in the 75 horses. Three parameters (anion gap, abdominal fluid total protein concentration, and volume of gastric fluid for the first 24 hours of hospitalization) were significantly associated with death by univariate analysis. Using a stepwise multiple logistic regression, two parameters remained significantly associated with death (P < 0.05), anion gap and abdominal fluid total protein concentration.
Assuntos
Duodenite/veterinária , Doenças dos Cavalos/terapia , Doenças do Jejuno/veterinária , Animais , Duodenite/mortalidade , Duodenite/terapia , Enterite/terapia , Enterite/veterinária , Doenças dos Cavalos/mortalidade , Cavalos , Doenças do Jejuno/mortalidade , Doenças do Jejuno/terapia , Modelos Logísticos , Razão de Chances , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taxa de SobrevidaRESUMO
Cardiopulmonary and behavioral effects of the following tranquilizer-opioid drug combinations were compared in conscious dogs: acepromazine (0.22 mg/kg of body weight, IV) and butorphanol (0.22 mg/kg, IV); acepromazine (0.22 mg/kg, IM) and butorphanol (0.22 mg/kg, IM); and acepromazine (0.22 mg/kg, IV) and oxymorphone (0.22 mg/kg, IV). Marked sedation and lateral recumbency that required minimal or no restraint was achieved with every drug combination. Analgesia was significantly better in dogs receiving oxymorphone than in dogs receiving butorphanol, as evaluated by response to toe pinch. There were no significant differences between the effects of the 3 drug combinations on heart rate, respiratory rate, arterial blood pressure, body temperature, and arterial pH, PCO2, PO2, and bicarbonate concentration. Heart rate, respiratory rate, and systolic arterial pressure decreased significantly over time with all drug combinations. Total recovery time (minutes from the initial injection to standing) was significantly longer in the dogs given acepromazine and oxymorphone.
Assuntos
Acepromazina/farmacologia , Comportamento Animal/efeitos dos fármacos , Butorfanol/farmacologia , Cães/fisiologia , Hemodinâmica/efeitos dos fármacos , Oximorfona/farmacologia , Animais , Gasometria/veterinária , Pressão Sanguínea/efeitos dos fármacos , Temperatura Corporal/efeitos dos fármacos , Dióxido de Carbono/sangue , Combinação de Medicamentos , Feminino , Frequência Cardíaca/efeitos dos fármacos , Concentração de Íons de Hidrogênio , Masculino , Oxigênio/sangue , Distribuição Aleatória , Respiração/efeitos dos fármacosRESUMO
We evaluated and characterized several anesthetic induction protocols used to facilitate intubation and anesthetic maintenance with isoflurane in 7 adult ostriches and 1 juvenile ostrich. Induction protocols included IV administration of zolazepam/tiletamine, IV administration of diazepam/ketamine with and without xylazine, IV administration of xylazine/ketamine, IM administration of carfentanil or xylazine/carfentanil, and mask induction with isoflurane. General anesthesia was maintained with isoflurane in 100% oxygen for various procedures, including proventriculotomy (6 birds), tibial (1 bird) or mandibular (1 bird) fracture repair, and drainage of an iatrogenic hematoma (1 bird). Heart rate and respiratory rate varied greatly among birds. The arterial blood pressure values recorded from 6 of the birds during maintenance of general anesthesia were higher than values recorded for most mammalian species, but were comparable to values reported for awake chickens and turkeys.
Assuntos
Anestesia Geral/veterinária , Aves/fisiologia , Isoflurano , Animais , Pressão Sanguínea , Diazepam , Estudos de Avaliação como Assunto , Fentanila/análogos & derivados , Frequência Cardíaca , Ketamina , Respiração , Tiletamina , Xilazina , ZolazepamRESUMO
Measurements (n = 126) of end-tidal halothane concentrations were taken from 21 horses anesthetized for routine and emergency surgery. One hundred five paired values allowed comparison of gas samples taken near the oral end of the endotracheal tube (Y1) to samples obtained at the cuffed end of the endotracheal tube (Y2). Twenty-one paired readings were assessed to compare samples taken 25 cm beyond the cuffed end of the tube (Y3) to samples from Y1. Measurements were made at all locations at 15-minute intervals starting 30 minutes after beginning halothane. All measurements were made in triplicate at end-expiration, and both sites were sampled within 1 minute of each other. Halothane concentration was measured by rapid infrared analysis with a gas sampling rate of 150 ml/min and displayed as a digital reading. Calibration of the machine was checked regularly. The difference between readings (Y1-Y2 or Y1-Y3 = Sdif) was tested using general linear models and a significance level of p less than 0.05 was used. The variable Sdif was analyzed with respect to time, mode of ventilation, and type of recumbency; no effects of these variables were detected. The mean values (+/- SD) of 105 readings for Y1 and Y2 were 2.41 vol% (+/- 0.49) and 2.39 vol% (+/- 0.49) respectively, and the Pearson's correlation coefficient (Y1 vs Y2) was 0.96. The mean values (+/- SD) of 21 measurements for Y1 and Y3 were 2.31 vol% (+/- 0.27) and 2.32 vol% (+/- 0.28) respectively and the Pearson's correlation coefficient (Y1 vs Y3) was 0.98.
Assuntos
Anestesia por Inalação/veterinária , Halotano/análise , Cavalos/fisiologia , Intubação Intratraqueal/veterinária , Animais , Feminino , Masculino , Espectrofotometria InfravermelhoRESUMO
A study was conducted to identify the clinical signs associated with impaction of the proventriculus in ostriches, to identify diagnostic aids, and to develop a surgical procedure for management of the disorder. Clinical signs indicating the need for surgical intervention included chronic inappetance, a change in fecal consistency or production, dehydration, weight loss, and failure to respond to laxatives. Diagnosis of impacted proventriculus was by abdominal radiography and external palpation. Impactions were caused by sand and rocks (5 ostriches), hay and sand (1 ostrich), and leaves (1 ostrich). After surgery, 5 of the ostriches were clinically normal within (mean) 1 week. One ostrich failed to regain a normal appetite until 2 weeks after surgery, and one juvenile ostrich died after surgery. Of the 6 ostriches that survived, 1 died 1 week after discharge from the hospital. The remaining birds survived without redevelopment of impaction.
Assuntos
Doenças das Aves/cirurgia , Corpos Estranhos/veterinária , Proventrículo/cirurgia , Músculos Abdominais , Anestesia Geral/veterinária , Animais , Anorexia/veterinária , Doenças das Aves/diagnóstico , Aves , Fezes , Feminino , Corpos Estranhos/diagnóstico , Corpos Estranhos/cirurgia , Hematoma/cirurgia , Hematoma/veterinária , Hemorragia/veterinária , Masculino , Complicações Pós-Operatórias/veterinária , Deiscência da Ferida Operatória/cirurgia , Deiscência da Ferida Operatória/veterináriaRESUMO
Six combinations of injectable anesthetic agents were administered to six adult horses in a Latin square design. The drug combinations were xylazine-ketamine, xylazine-butorphanol-ketamine, xylazine-tiletamine-zolazepam, xylazine-butorphanol-tiletamine-zolazepam, detomidine-ketamine, and detomidine-butorphanol-ketamine. Measured variables were heart rate, respiratory rate, systolic blood pressure, arterial pH (pHa), PaCO2, PaO2, recumbency time, and number of attempts necessary to stand. Quality of induction and recovery, muscle relaxation, and response to stimulus were evaluated subjectively. The horses required significantly more attempts to stand after administration of xylazine-tiletamine-zolazepam, xylazine-butorphanol-tiletamine-zolazepam, and detomidine-ketamine than after xylazine-ketamine, xylazine-butorphanol-ketamine, or detomidine-butorphanol-ketamine. Mean recumbency times varied from 23.0 minutes with xylazine-ketamine to 41.3 minutes with xylazine-butorphanol-tiletamine-zolazepam. There were significant differences in mean heart rates at minute 15, mean respiratory rates at minutes 5, 10 and 15, and mean systolic blood pressures at minute 10 of anesthesia. There were no significant differences in pHa, PaCO2 or PaO2.
Assuntos
Anestesia Intravenosa/veterinária , Anestésicos , Cavalos/fisiologia , Equilíbrio Ácido-Base/efeitos dos fármacos , Anestésicos/administração & dosagem , Animais , Gasometria/veterinária , Pressão Sanguínea/efeitos dos fármacos , Butorfanol , Dióxido de Carbono/sangue , Feminino , Frequência Cardíaca/efeitos dos fármacos , Imidazóis , Ketamina , Relaxamento Muscular/efeitos dos fármacos , Oxigênio/sangue , Respiração/efeitos dos fármacos , Tiletamina , Xilazina , ZolazepamRESUMO
Premature ventricular contractions and apparent hypertension were seen in an adult ostrich anesthetized with isoflurane. The ostrich had septic joints and was anesthetized to allow joint lavage. The premature ventricular contractions occurred at a rate of 1 to 2/min, with a brief period of 12 to 15/min, and were not treated with any antiarrhythmic drugs. Normal blood pressures for awake or anesthetized adult ostriches are not readily available, but blood pressures in this bird were higher than in other ostriches measured with the same technique. Systolic pressures ranged from 199 to 249 mm of Hg, diastolic pressures from 107 to 177 mm of Hg, and mean pressures were from 165 to 220 mm of Hg during isoflurane anesthesia of approximately 45 minutes' duration. Recovery from anesthesia was complicated, although the ostrich died 12 days later from mycotic pneumonia.
Assuntos
Anestesia Geral/veterinária , Doenças das Aves/etiologia , Complexos Cardíacos Prematuros/veterinária , Hipertensão/veterinária , Isoflurano , Anestesia Geral/efeitos adversos , Animais , Artrite Infecciosa/cirurgia , Artrite Infecciosa/veterinária , Doenças das Aves/cirurgia , Aves , Complexos Cardíacos Prematuros/etiologia , Eletrocardiografia/veterinária , Feminino , Hipertensão/etiologiaRESUMO
During a 3 1/2-year period, cardiac arrhythmias were identified in 6 of 67 horses diagnosed with duodenitis/proximal jejunitis (DPJ). Arrhythmias were detected by auscultation of irregular cardiac rhythm and subsequently were characterized by electrocardiographic evaluation. Arrhythmias included frequent second-degree atrioventricular block, ventricular ectopic depolarizations, and atrioventricular conduction disturbance. In 4 horses, arrhythmias resolved with recovery from the primary problem. One horse died suddenly 66 hours after admission, and another was euthanatized at 72 hours after admission. Clinical and laboratory data from horses with DPJ and cardiac arrhythmias (group 1) were compared with findings for horses with DPJ and without arrhythmias (group 2). Group-1 horses had significantly (P less than 0.05) higher serum bicarbonate concentration and serum creatine kinase activity. Normal sinus rhythm returned in all 4 group-1 horses that recovered from DPJ, suggesting a causal relationship between DPJ and the arrhythmias. Two group-1 horses were necropsied, and both had myocarditis. The cause of these lesions was not determined.
Assuntos
Arritmias Cardíacas/veterinária , Duodenite/veterinária , Doenças dos Cavalos/etiologia , Doenças do Jejuno/veterinária , Animais , Arritmias Cardíacas/etiologia , Bicarbonatos/sangue , Creatina Quinase/sangue , Duodenite/complicações , Eletrocardiografia/veterinária , Enterite/complicações , Enterite/veterinária , Feminino , Frequência Cardíaca , Cavalos , Doenças do Jejuno/complicações , Masculino , Miocárdio/patologia , Gravidez , Complicações na Gravidez/veterinária , Estudos RetrospectivosRESUMO
Cardiopulmonary effects of IV administered butorphanol tartrate (BUT) were assessed in 7 yearling steers medicated with atropine and anesthetized with guaifenesin, thiamylal sodium, and isoflurane in O2 for surgical placement of duodenal cannulae. Heart rate, respiratory rate, arterial blood pressures, pHa, PaCO2, PaO2, arterial [HCO3-], esophageal temperature, and end-tidal isoflurane concentrations were measured before and after IV administration of BUT (10 mg). Mean respiratory rate increased significantly (P less than 0.05) only at 45 and 60 minutes after BUT administration. Mean respiratory rate was 26 +/- 6.3 breaths/min before BUT administration and 46 +/- 12.1 breaths/min 60 minutes after BUT administration. Arterial blood pressures were increased significantly (P less than 0.05) at all times, except 5 minutes after BUT administration. The mean value for mean arterial pressure was 76 +/- 9.6 mm of Hg before BUT injection and 117 +/- 12.6 mm of Hg 60 minutes after BUT injection. Mean values for pHa and arterial [HCO3-] were significantly (P less than 0.05) higher at 60 minutes after BUT administration (baseline, pH = 7.25 +/- 0.04 and [HCO3-] = 29.9 +/- 3.5 mEq/L; 60 minutes after BUT, pH = 7.28 +/- 0.03 and [HCO3-] = 33.0 +/- 1.8 mEq/L). Although some statistically significant changes were recorded, IV administration of BUT to these steers did not have a marked effect on the cardiopulmonary variables measured.
Assuntos
Anestesia/veterinária , Pressão Sanguínea/efeitos dos fármacos , Butorfanol/farmacologia , Bovinos , Frequência Cardíaca/efeitos dos fármacos , Isoflurano , Morfinanos/farmacologia , Respiração/efeitos dos fármacos , Animais , Temperatura Corporal , Butorfanol/administração & dosagem , Cateteres de Demora/veterinária , Duodeno , Infusões Intravenosas/veterinária , MasculinoRESUMO
A drug induced equine herpesvirus-1 (EHV-1) mutant lacking thymidine kinase inducing activity was developed and evaluated as a vaccine. The safety and effectiveness of the vaccine to protect against experimentally induced EHV-1 respiratory disease were evaluated in weanling horses free of EHV-1 neutralizing antibody. The vaccine was safe when administered either intramuscularly or intravenously, and EHV-1 was not shed intranasally during the 12 days following administration. Intranasal challenge with virulent EHV-1 was used to evaluate vaccine efficacy. Following challenge, there was a significantly (p less than 0.05) greater increase in peak body temperatures and duration of nasal virus shedding in the nonvaccinates, and a significant (p less than 0.05) increase in serum neutralizing antibody titers in the vaccinates.
Assuntos
Infecções por Herpesviridae/veterinária , Herpesviridae/imunologia , Herpesvirus Equídeo 1/imunologia , Doenças dos Cavalos/prevenção & controle , Timidina Quinase/biossíntese , Vacinas Virais , Animais , Anticorpos Antivirais/biossíntese , Temperatura Corporal , DNA Viral/análise , Eletroforese em Gel de Ágar , Indução Enzimática , Infecções por Herpesviridae/prevenção & controle , Herpesvirus Equídeo 1/enzimologia , Herpesvirus Equídeo 1/genética , Cavalos , Contagem de Leucócitos/veterinária , Mutação , Neutrófilos , Mapeamento por Restrição , Timidina Quinase/genética , Vacinação/veterinária , Vacinas Virais/imunologiaRESUMO
A 2-year-old Trakehner filly with pulmonary histoplasmosis is presented. Clinical signs included weight loss, intermittent fever, dyspnea and depression. Diagnosis was based on thoracic radiography, transtracheal wash cytology and lung aspirate cytology. A 5-week regimen of Amphotercin-B administered intravenously resulted in clinical recovery and return of the animal to normal activity. A brief review of histoplasmosis in man and animal is included.
Assuntos
Anfotericina B/uso terapêutico , Histoplasmose/veterinária , Doenças dos Cavalos/diagnóstico , Pneumopatias Fúngicas/veterinária , Animais , Biópsia por Agulha/veterinária , Feminino , Histoplasma/isolamento & purificação , Histoplasmose/diagnóstico , Histoplasmose/tratamento farmacológico , Doenças dos Cavalos/tratamento farmacológico , Cavalos , Pulmão/microbiologia , Pneumopatias Fúngicas/diagnóstico , Pneumopatias Fúngicas/tratamento farmacológicoRESUMO
An eight-year-old Thoroughbred gelding with dermatographic urticaria is presented. Forelimb edema and generalized urticaria were the presenting clinical signs. All hematologic and serum biochemical values were normal. Immunologic and histologic evaluation failed to reveal specific abnormalities. During hospitalization, an urticarial response to mechanical pressure (dermatographism) was identified. Clinical responses to corticosteroid and antihistaminic (H1) therapy were equivocal. The condition resolved in five weeks and an etiology was not discovered. A discussion of the pathogenesis, diagnosis and treatment of dermatographic urticaria in humans is included with the report.
Assuntos
Doenças dos Cavalos/etiologia , Urticária/veterinária , Animais , Cavalos , Masculino , Urticária/etiologiaRESUMO
Chronic hepatic disease was diagnosed in 6 horses with history of anorexia and weight loss. These horses consistently had abnormally high serum gamma-glutamyltransferase activities, total and direct bilirubin and blood ammonia values, and sulfobromophthalein clearance times, whereas serum iditol dehydrogenase, aspartate transaminase, and alkaline phosphatase activities were variable. In the 6 horses, histologic examination of the liver revealed lesions of chronic hepatitis with varying degrees of fibrosis. All 6 horses had ingested kleingrass (Panicum coloratum) for variable periods. Three healthy horses fed kleingrass hay for 90 days developed hepatic lesions and increases in serum gamma-glutamyltransferase activities similar to those in the 6 horses with chronic hepatitis. Characteristic hepatic lesions in both groups of horses included bridging hepatic fibrosis, cholangitis, and hepatocellular regeneration.
Assuntos
Ração Animal/efeitos adversos , Grão Comestível/efeitos adversos , Doenças dos Cavalos/etiologia , Hepatopatias/veterinária , Panicum/efeitos adversos , Animais , Doença Crônica , Feminino , Doenças dos Cavalos/sangue , Doenças dos Cavalos/patologia , Cavalos , Hepatopatias/sangue , Hepatopatias/etiologia , Hepatopatias/patologia , MasculinoRESUMO
A 5-year-old intact male llama (Llama glama) with gastric squamous cell carcinoma and generalized metastasis is presented. Weight loss, anorexia and cachexia were the presenting clinical signs. Abnormal laboratory findings included neutrophilia, lymphopenia, increased serum activity of hepatic enzymes, mildly increased serum urea nitrogen concentration and elevated protein concentration and nucleated cell count in the peritoneal fluid. Fasciola hepatica ova were identified by fecal sedimentation examination. The presence of flukes, as well as carcinoma metastasis, probably contributed to the increased serum hepatic enzyme activity. Similarities to gastric squamous cell carcinoma in the equine and bovine species are discussed. This case suggests that neoplasia, although rarely reported in the llama, must be considered in the differential diagnostic list for anorexia and weight loss in the llama.
Assuntos
Artiodáctilos/parasitologia , Camelídeos Americanos/parasitologia , Carcinoma de Células Escamosas/veterinária , Fasciolíase/veterinária , Neoplasias Gástricas/veterinária , Animais , Carcinoma de Células Escamosas/complicações , Diagnóstico Diferencial , Fasciola hepatica , Fasciolíase/complicações , Masculino , Neoplasias Gástricas/complicaçõesRESUMO
This study describes the use of behavior management procedures to reduce the occurrence of severe behavioral sequela in a 14-year-old, post-Reye's syndrome male. Prior to intervention the client exhibited severe self-injurious, hyperaggressive, and food refusal behaviors that precluded any opportunities for rehabilitation, placed him at severe medical risk, and made him a candidate for institutional placement. With contingent restraint, in vivo desensitization, and reinforcement contingencies it was possible to control these behaviors and begin intensive rehabilitation. Subsequently, the client returned to his family and community day school for the severely handicapped where he remains five years later.