Parasites of sheep herding dogs in central Germany.

This paper reports on endoparasite infections diagnosed in 2012 by standard coproscopical techniques and coproantigen Giardia ELISA in 165 dogs used for sheep herding in 36 farms in central Germany. The overall prevalence of dogs with evidence of endoparasite infections was 27.3% (95% CI 20.6-34.7). The most frequently identified faecal forms were those of ascarids (Toxocara, 6.7%; Toxascaris 3.6%), hookworms (5.5%) and taeniid cestodes (4.2%), followed by those of Trichuris whipworms (3.0%), Capillaria aerophila (1.8%), Angiostrongylus and Crenosoma lungworms (1.2% each) and Cystoisospora canis coccidians (0.6%). Molecular identification demonstrated the seven dogs shedding taeniid eggs positive for Taenia (T.) species tapeworms (five, T. hydatigena; one, T. ovis; one Taenia sp.). Screening of the faeces with the coproantigen ELISA revealed Giardia specific antigen in 5.5% of the samples. The majority of the dogs had evidence of single endoparasite infections (22.4%) while evidence for infection with two or three parasites concurrently was found in six (3.6%) and two (1.2%) of the dogs, respectively. Dogs ≤ 1 year (n = 19) were parasitized more frequently (p < 0.05) with overall gastrointestinal parasites (63.2% vs. 20.5%), ascarids (36.8% vs. 6.8%) and Giardia spp. (21.1% vs. 3.4%) than older dogs (n = 146). Dogs which had been wormed within six months of examination tested less frequently positive for gastrointestinal helminths compared to dogs not wormed (11.1% vs. 25.0%; p = 0.0567). In addition, ear swabs taken from 43 sheep dogs in 2012 were examined, and Otodectes cynotis mites were extracted from one dog. Identification of ectoparasites collected by full body search and combing from 113 sheep dogs in the years 2011 to 2013 revealed infestation of fleas and ticks (each up to five specimens per dog) on 13 and 108 dogs, respectively, with nine dogs carrying both fleas and ticks. Archaeopsylla erinacei, Ctenocephalides (C) canis, C. felis and Pulex irritans fleas were identified from one, three, two and eleven dogs, respectively. Dermacentor reticulatus, Ixodes (I.) hexagonus and I. ricinus ticks were isolated from 16, eight and 95 dogs, respectively.

Human CD8+ memory and EBV-specific T cells show low alloreactivity in vitro and in CD34+ stem cell-engrafted NOD/SCID/IL-2Rγc null mice.

Current strategies in cellular immunotherapy of cancer and viral infections include the adoptive transfer of T cell receptor (TCR) and chimeric antigen receptor engineered T cells. When using transient RNA expression systems in clinical studies, multiple infusions with receptor-redirected T cells appear necessary. However, in allogeneic hematopoietic stem-cell transplantation, repeated transfer of donor-derived T cells increases the risk of alloreactive graft-versus-host disease. We investigated naive-derived (TN), memory-derived (TM), and Epstein Barr virus-specific (TEBV) CD8(+) T cell subsets for alloreactivity upon redirection with RNA encoding a cytomegalovirus-specific model TCR. We observed that alloreactivity to human leukocyte antigen (HLA)-mismatched hematopoietic cells developed at much stronger levels in TN compared with TM or TEBV populations in cytokine-release and cytotoxicity assays. Cytomegalovirus-specific effector function was higher in TCR-transfected TEBV and TM over TN cells. To measure alloreactivity in vivo, we reconstituted NOD/SCID/IL-2Rγc(null) mice with human CD34(+) stem cells and adoptively transferred them with CD8(+) T cell subsets previously stimulated against cells of the HLA-mismatched stem-cell donor. TN cells showed a significant ability to eliminate CD34-derived hematopoietic cells, which was not found with TM and TEBV cells. This reduced alloreactive potential along with strong effector function upon receptor RNA engineering makes CD8(+) memory and EBV-specific T cells advantageous tools in adoptive immunotherapy after allogeneic transplantation.

Individual learning curve reduces the clinical value of urinary cytology.

UNLABELLED: The aim of the study was to define the learning curve of a single cytologist as a limitation of urinary cytology. A total of 1034 cytologic and histologic findings of patients undergoing transurethral resection of the bladder for suspicion of bladder cancer were reviewed, and cytologic evaluations of a single cytologist from the beginning of his learning period were compared with the results of a cytologist at a national reference center. Our results showed that the individual learning curve has a significant impact on the quality of urine cytology. BACKGROUND: To define the learning curve of a single cytologist as a limitation of urinary cytology and to compare his results with a reference center for urinary cytology. PATIENTS AND METHODS: Cytologic and histologic findings of patients undergoing transurethral resection of the bladder for suspicion of bladder cancer were reviewed. Cytologic evaluations from a single local cytologist during his learning period and of a cytologist of a national reference center were compared. Changes of sensitivity and specificity of cytology from the local cytologist over the time period were assessed. Differences were estimated by using kappa statistics. RESULTS: The local cytologist evaluated 1034 cytologic findings. Sensitivity and specificity of cytology estimated by the local cytologist were 86% and 66% at the beginning of the learning period, but 68% and 84% at the end of it (P ≤ .05). In high-grade carcinomas, sensitivity did not decrease over the years (P > .05). In contrast, the sensitivity in the diagnosis of low-grade tumors decreased from 86% to 56% (P ≤ .05). The reference center estimated a constant sensitivity and specificity of 59% and 97%, respectively. Agreement of findings between local and national cytologists increased significantly over the learning period (P < .05). CONCLUSION: The individual learning curve has a significant impact on the quality of urinary cytology. Both specificity of cytology and sensitivity for low-grade tumors changed significantly when done by a local cytologist at the beginning of learning period. These findings emphasize the impact of the individual learning curve on the clinical value of urinary cytology in diagnosis of bladder cancer.

Urinary cytology in era of fluorescence endoscopy: redefining the role of an established method with a new reference standard.

OBJECTIVES: To assess whether the use of fluorescence endoscopy (FE) decreases the clinical value of urinary cytology compared with the use of white light endoscopy (WLE). METHODS: The endoscopic, cytologic, and histologic findings of patients who had undergone transurethral resection of the bladder with or without FE were reviewed. The number and characteristics of the tumors that had been overlooked by WLE or FE but detected by cytology were analyzed. An assessment of whether the sensitivity and specificity of urinary cytology changed according to the use of FE or WLE was conducted. RESULTS: The data from 1705 patients were included. Histologic findings were obtained from 238 patients using WLE and from 1467 patients using FE. Histologically confirmed malignancy was found in 641 patients, and the disease of 1064 was classified as benign. FE was superior to WLE in sensitivity in the detection of bladder cancer (94.3% vs 86.3%, P <.05). Cytology detected 53 of 88 tumors that were not detected by WLE (47 high-grade tumors); 31 tumors were overlooked by FE, of which 20 were detected by cytology (12 were high-grade tumors). The sensitivity and specificity of cytology was 66.0% and 78.4%, respectively. The specificity of cytology using WLE and FE was 75% and 79.1% (P >.05) and the sensitivity was 61.4% and 67.4% (P >.05), respectively. CONCLUSIONS: Although FE demonstrated a great sensitivity, cytology still has a role even when using FE, because a small group of patients with high-grade tumors were detected by urinary cytology only.

Influence of clinical information on the interpretation of urinary cytology in bladder cancer: how suggestible is a cytologist?

OBJECTIVE: to determine the influence of the knowledge of the endoscopic findings and the influence of the patient's history on the cytologist's judgement, as urinary cytology is known to be subjective and has several limitations, in particular a high inter- and intra-observer variability. PATIENTS AND METHODS: we analysed the cytological and histological findings of patients who underwent transurethral resection of a bladder tumour, and determined whether the cytologist was aware of the endoscopic findings or not. The sensitivity and specificity of cytology were calculated with or without this knowledge, and that of the patients' bladder cancer history. RESULTS: the findings of 1705 patients were reviewed; in 641 the histological examination confirmed a malignant tumour and 1046 were classified as benign. The sensitivity of cytology was 66.0% and the specificity was 78.4%. The cytologist was aware of the endoscopic finding and patient history in 742 cases, and unaware of the endoscopic findings in 963. The specificity was higher in the latter group (80.2% vs 73.0%; P= 0.006). The specificity in patients with the endoscopic findings described as 'negative', 'inflammation', 'scar tissue', 'flat lesion', 'suspicious for tumour', and 'exophytic tumour' was 89.8%, 89.9%, 85.0%, 77.1%, 63.2% and 48.6%, respectively (P < 0.001). In 898 patients the history was negative for bladder tumours. Among these patients the sensitivity and specificity of cytology was 67.3% and 79.7%; the sensitivity and specificity was 65.4% and 74.8% for the 807 patients with a positive history of bladder cancer (P= 0.054). CONCLUSION: both being aware of the endoscopic findings and a positive patient history for bladder cancer lowers the specificity of cytology. Consequently, the cytologist should be unaware of the endoscopic findings.

Pseudopuberdade precoce por cisto folicular autonomo: relato de caso / Precocius pseudopuberty caused by autonomous follicular ovarian cyst: a case report

A puberdade precoce (PP) na menina e definida com o surgimento de caracteristicas sexuais secundarias antes dos 8 anos de idade. As causas podem ser dependentes de gonadotrofinas (PP verdadeira), independentes de gonadotrofinas (Pseudo PP) e as variantes da normalidade. O cisto folicular autonomo pode determinar sinais de PP pela producao local de estradiol. O caso relatado revela uma menina de 4 anos que apresentou sangramento vaginal, broto mamario e leucorreia fisiologica associados a presenca de um cisto folicular autonomo. O diagnostico fundamentou-se no exame fisico, grau do conteudo vaginal, determinacao radiologica da idade ossea, dosagens hormonais, ultra-sonografias pelvica e mamaria. O tratamento destes cistos pode ser conservador ou cirurgico. Neste caso, optou-se pelo uso de acetato de medroxiprogesterona que mostrou-se satisfatorio. Alem disso, foi feita uma revisao dos achados ultra-sonograficos relevantes para o diagnostico da PP

Utero didelfo, imperfuracao vaginal unilateral e agenesia renal ipsilateral: descricao de um caso / Uterus didelphys, unilateral imperfurated vagina and ipsilateral renal agenesis: a case report

A combinacao do utero didelfo com imperfuracao vaginal unilateral e agenesia renal ipsilateral e rara e, em geral, e encontrada em mulheres com ciclos menstruais normais. Nestes casos, devido ao acumulo de sangue menstrual na hemivagina obstruida, as pacientes podem apresentar massa pelvica e dismenorreia severa. Neste artigo e descrito um caso de uma paciente de 14 anos, a qual apresentava dor pelvica ha 6 meses. Os autores revisam tambem a embriologia, diagnostico e manejo desta rara associacao