Feline herpesvirus-1-related multiple respiratory eosinophilic nodules in an adult cat receiving long-term oral prednisolone.

Case summary: A 10-year-old male castrated domestic shorthair cat was presented for evaluation of a 3-day history of increased inspiratory effort. The cat had received prednisolone 1 mg/kg PO q24h for 1 year due to chronic diarrhea. On physical examination, the patient exhibited severe stridor, intermittent open-mouth breathing and bilateral mucopurulent nasal discharge. Subcutaneous emphysema was palpated over the dorsal cervical region. Mild hypoventilation (PvCO2 55.1 mmHg; approximate reference interval 35-45 mmHg) was identified. Cervicothoracic radiographs showed marked gas tracking within cervical soft tissues with concurrent laryngeal thickening, pulmonary nodules, a bronchial pulmonary pattern, pneumomediastinum and aerophagia. The cat was hospitalized and treated overnight with oxygen and intravenous fluid therapy before anesthesia the next day. On laryngoscopy, a large tracheal mass was observed arising from the right subglottic region and was removed using biopsy forceps. CT revealed an additional mass at the level of the tracheal bifurcation causing marked luminal narrowing of the trachea and proximal main bronchi. The cat made a good initial recovery, although moderate stridor persisted. Five days later, the cat was re-examined due to recurrence of respiratory distress and orthopnea, and the owner elected euthanasia. Histopathology revealed severe nodular obstructive eosinophilic plasmacytic laryngotracheitis with intranuclear inclusion bodies positive for feline herpesvirus-1 on immunohistochemistry. Relevance and novel information: This report describes the presentation and management of a cat with respiratory distress secondary to intratracheal eosinophilic masses caused by feline herpesvirus-1. Although the outcome was ultimately unsatisfactory, to the authors' knowledge, this clinical presentation has not been previously reported.

Integrating physiology into the first two years of a new osteopathic medical school curriculum.

The integrated curriculum is a hot topic in curriculum reform in undergraduate medical education; however, there are varying definitions of the term, and resources guiding the integration of specific disciplines throughout the first 2 years of undergraduate medical education in a learner-centered curriculum are limited. Our first class matriculated into our osteopathic medical school in 2017, and since then we have developed and implemented a learner-centered, integrated curriculum that begins on day one for our learners. This paper will discuss our experience with the development and implementation of the University of the Incarnate Word School of Osteopathic Medicine (UIWSOM) curriculum with specific emphasis on how we incorporate physiology into it.

Radiographic and ultrasonographic appearance of pneumonia in a frog.

A 12-year-old female African Clawed Frog (Xenopus laevis) displayed lethargy and anorexia for 1 week. Radiographs detected a moderately reduced volume of aerated lung with lobulated margins with the left lung predominantly affected. Transcelomic ultrasound revealed marked consolidation of the left lung. Postmortem examination confirmed suppurative and histiocytic pneumonia, worse in the left lung, caused by Mycobacterium chelonae. Given that amphibian pulmonary consolidation and celomic effusion can have similar radiographic findings, ultrasound may be helpful to differentiate.

Almond "Appetizer" Effect on Glucose Tolerance Test (GTT) Results.

BACKGROUND: The extent to which glucose intolerance can be acutely improved with dietary modification is unclear. The purpose of this study was to test the effect of ingesting a low-calorie almond preload ("appetizer") 30 minutes before oral glucose tolerance testing in glucose-intolerant individuals without diabetes. METHODS: Twenty adults with prediabetes or isolated 1-hour glucose ≥160 mg/dL underwent 2 fasting oral glucose tolerance tests (GTTs)-1 standard GTT and 1 GTT 30 minutes after eating a half ounce (12) of dry-roasted almonds. Fourteen participants met 1 or more prediabetes diagnostic criteria; 6 had only elevated 1-hour glucose ≥160 mg/dL. RESULTS: The mean 1-hour plasma glucose after the almond preload was 37.1 mg/dL (19.4%) lower (154.6 vs 191.7; P < .001) than in the standard GTT. The almond preload reduced the area under the glucose curve by 15.5% (P < .001). Eight individuals had a marked hypoglycemic effect (glucose reduced by 45 to 110 mg/dL); 4 had a moderate hypoglycemic effect (22-32 mg/dL). CONCLUSION: A low-calorie almond "appetizer" showed promise as an option for decreasing postprandial hyperglycemia in individuals with prediabetes or isolated 1-hour postprandial hyperglycemia. Further study is needed to confirm and refine the role of such a premeal appetizer in the self-care of prediabetes.