A Subset of Equine Gastric Squamous Cell Carcinomas Is Associated With Equus Caballus Papillomavirus-2 Infection.

Squamous cell carcinoma (SCC) is the most common neoplasm of the equine stomach. However, the mechanisms underlying malignant transformation are unknown. As Equus caballus papillomavirus-2 (EcPV-2) is a likely cause of some genital SCCs, we hypothesized that EcPV-2 is associated with a subset of equine gastric SCCs. To this aim, we performed polymerase chain reaction (PCR) and in situ hybridization (ISH) for EcPV-2 E6/ E7 oncogenes on 11 gastric SCCs and on gastric samples from 15 control horses with no SCC. PCR for EcPV-2 was positive in 7/11 (64%) gastric SCCs; non-SCC gastric samples were all negative. Intense hybridization signals for EcPV-2 E6/E7 nucleic acid were detected by ISH within tumor cells in 5/11 (45%) gastric SCCs, including distant metastases. No hybridization signals were detected within any of the non-SCC gastric cases. This study provides support for a potential association between EcPV-2 infection and a subset of equine gastric SCC.

Dracunculus infections in domestic dogs and cats in North America; an under-recognized parasite?

We reviewed 62 new cases and 18 published reports of Dracunculus infections in domestic dogs and cats to describe the epidemiology of this parasite in dogs and cats in North America. We collected host and parasite data when available, including age, sex, and breed of dog, nematode location in the host, and any clinical signs at presentation and/or description of the apparent lesion. For dogs, infections were noted in six of the AKC breed groups, but none was reported from the toy group or the miscellaneous breed class. Age of infected dogs ranged from 7 months to 19 years (median 4 years; average 5.3 years), and infection rates were similar in male and female dogs. Most nematodes were associated with the distal extremities, but worms were also found in the chest/thorax, abdomen, head, and flank. Although most infected dogs had a single worm, three dogs had two or more worms that were collected from multiple lesions. Three new cat cases, with similar lesions, presentations and seasonality, were detected in Alabama, North Carolina and Texas. Cases were reported from a wide geographic range throughout eastern North America, during every month of the year, but 72% of infections were diagnosed in the late winter to early spring (December to May). All collected worms were larvigerous females which cannot be identified to species based on morphologic characters. Thus, we attempted to amplify and sequence a portion of the cytochrome c oxidase subunit I (COI) gene for specific identification. Although 13 worms from 12 cases were available, sequences were obtained for only eight worms from seven cases. These eight worms were D. insignis, a common parasite of raccoons (Procyon lotor) and other primarily carnivorous mammals. Female worms are the most likely to be detected in dogs and cats because male worms do not emerge, parasites should be preserved in ethanol for molecular identification. Although this study used convenience sampling of available data, we found that the parasite is widespread throughout the eastern US and Canada and that Dracunculus infections in dogs are more common than is revealed in published literature. However, more research is needed to understand the epidemiology, including transmission route(s), prevalence, and distribution of this parasite.

Scleromyxoedema in a dog.

BACKGROUND: In humans, scleromyxoedema is a chronic progressive skin condition traditionally characterized by deposits of mucin, increased number of fibroblasts and fibrosis in the skin, and by systemic disease. Thyroid disease is typically absent. A monoclonal gammopathy is usually present, as are other comorbidities. Descriptions of scleromyxoedema in the veterinary literature are limited to a single feline case. One dog, previously reported as having papular mucinosis, exhibited features that matched the more current diagnostic criteria of scleromyxoedema. OBJECTIVES: To describe generalized papular mucinosis in a dog with systemic illness and to compare the signs with those of human lichen myxoedematosus conditions, specifically scleromyxoedema. RESULTS: A nine-year-old female, spayed English springer spaniel dog presented with generalized papules and nodules (0.5-5 cm) on the body and proximal fore and hind limbs, sparing the face and distal limbs distal to carpi/tarsi. Larger nodules were erythematous. Nodules occurred in proximal limb muscles. The dog had concurrent osteoarthritis of the elbows and coxofemoral joints, developed generalized weakness, declined in health and was euthanized. Thyroid disease was lacking and a monoclonal gammopathy was not present. Histopathological evaluation revealed the classic triad of mucin, fibroblast proliferation and fibrosis with very mild inflammation, as described for humans. CONCLUSION AND CLINICAL IMPORTANCE: We document scleromyxoedema in a dog with significant morbidity and features of the human disease. Recognizing the typical histopathology is important for identifying cases and to establish a diagnosis. Systemic evaluation is important to identify evidence of internal disease and associated comorbidities, which are common, variable, and impact classification and prognosis in humans.

Near Infrared Light Scattering Changes Following Acute Brain Injury.

Acute brain injury (ABI) is associated with changes in near infrared light absorption reflecting haemodynamic and metabolic status via changes in cerebral oxygenation (haemoglobin oxygenation and cytochrome-c-oxidase oxidation). Light scattering has not been comprehensively investigated following ABI and may be an important confounding factor in the assessment of chromophore concentration changes, and/or a novel non-invasive optical marker of brain tissue morphology, cytostructure, hence metabolic status. The aim of this study is to characterize light scattering following adult ABI. Time resolved spectroscopy was performed as a component of multimodal neuromonitoring in critically ill brain injured patients. The scattering coefficient (µ's), absorption coefficient and cerebral haemoglobin oxygen saturation (SO2) were derived by fitting the time resolved data. Cerebral infarction was subsequently defined on routine clinical imaging. In total, 21 patients with ABI were studied. Ten patients suffered a unilateral frontal infarction, and mean µ' s was lower over infarcted compared to non-infarcted cortex (injured 6.9/cm, non-injured 8.2/cm p=0.002). SO2 did not differ significantly between the two sides (injured 69.3%, non-injured 69.0% p=0.7). Cerebral infarction is associated with changes in µ' s which might be a novel marker of cerebral injury and will interfere with quantification of haemoglobin/cytochrome c oxidase concentration. Although further work combining optical and physiological analysis is required to elucidate the significance of these results, µ' s may be uniquely placed as a non-invasive biomarker of cerebral energy failure as well as gross tissue changes.

Protozoal nodular dermatitis and panniculitis in a Rottweiler puppy caused by Caryospora bigenetica.

BACKGROUND: Caryospora bigenetica is an intracellular protozoan parasite in snakes and raptors (primary hosts) and rodents (secondary host). Experimental infection has been documented in mice, pigs and goats; natural infection in dogs is rare. OBJECTIVES: To describe the clinical presentation, histological features, treatment and outcome of a case of protozoal nodular dermatitis and panniculitis in a Rottweiler puppy caused by C. bigenetica. RESULTS: The puppy presented with generalized subcutaneous nodules measuring up to 2 cm in diameter. Histopathology revealed marked suppurative to pyogranulomatous dermatitis and panniculitis with intralesional protozoal organism. PCR and DNA sequencing confirmed infection with C. bigenetica. Treatment with a combination of oral trimethoprim-sulfamethoxazole (TMS), pyrimethamine and high-dose clindamycin (20 mg/kg twice daily) resulted in resolution of lesions in 6 weeks. Discontinuation of the treatment 2 weeks later was followed by a rapid relapse of skin lesions. Clindamycin and TMS were restarted and all lesions resolved within 2 weeks; TMS was discontinued 4 weeks later due to adverse effects. The lesions remained in remission for 2 months while the puppy received clindamycin monotherapy before a second relapse of skin lesions occurred. CONCLUSION AND CLINICAL IMPORTANCE: To the best of the authors' knowledge, this is the first documentation of the treatment and outcome of C. bigenetica cutaneous infection in a dog. Although remission of clinical signs can be achieved with combination therapy of clindamycin and TMS, long-term management is challenging and relapses should be anticipated.

Preliminary evaluation of a brief mindfulness-based stress reduction intervention for mental health professionals.

OBJECTIVES: Mental health professionals are particularly susceptible to occupational stress; however, there are limited formal programmes to address the problem. This paper discusses the preliminary results of a brief mindfulness-based stress reduction (MBSR) programme for practising professionals in a public hospital mental health unit. METHOD: A mixed-group of nine mental health professionals participated in eight weeks of daily 15-minute MBSR training interspersed with three 30-minute education sessions developed by the authors (AD and AT). Levels of psychological distress and mindfulness skill were measured before and immediately after participation. RESULTS: Following the brief MBSR programme, quantitative and qualitative participant feedback revealed a perceived reduction in psychological distress. CONCLUSIONS: A brief MBSR programme can be incorporated into the full-time workloads of practicing mental health professionals, potentially addressing a significant unmet workplace need.

Evaluating nursing handover: the REED model.

This article describes the REED (record, evidence, enquire, discuss) model of handover. The authors reflect on the history of nursing handover, and discuss the different types of handover and the need for standardisation. The article provides a step-by-step approach to the implementation of a new model of nursing handover on an acute ward.

Improved record-keeping with reading handovers.

Nursing handover has traditionally been performed orally and apart from patients. Results of an audit undertaken at the Royal United Hospital, Bath, suggest that record-keeping standards there were poor. To improve these standards, a method of 'reading handover', in which the main method of communication between nurses on different shifts is written rather than oral, was introduced on one ward. This article discusses the results of this pilot study and suggests that the new handover method has improved standards of record keeping.

Outbreak of rash in children associated with recreational mud exposure.

We conducted an investigation of a rash outbreak in children who attended the "Mud Mania Festival." The mean incubation period of illness was 26 hours, and mean duration was 4.3 days. Time spent in mud was associated with the extent of rash in a dose-response fashion. The cultures from lesions of two unrelated cases yielded Enterobacter cloacae.

Oligodendroglioma in an african lion (Panthera leo).

A 10-yr-old female lion (Panthera leo) presented for acute onset ataxia and weakness with a history of two seizure episodes 6 mo prior to presentation and a persistent head tilt for at least 6 mo. Gross necropsy findings included a gelatinous mass in the right cerebral hemisphere extending from the frontal to the occipital lobes. Histologically, the mass was composed of polygonal cells surrounding lakes of mucinous material. These cells had clear cytoplasm, ovoid basophilic nuclei, and inapparent cell processes. Immunoreactivity was positive for S100 and neuron-specific enolase but negative for glial fibrillary acid protein, myelin basic protein, neurofilament triplet, vimentin, and cytokeratin. All findings were consistent with an oligodendroglioma. A second neoplasm, a pulmonary adenoma, was also iidentified at necropsy.

The enhancement of T cell proliferation by L-dopa is mediated peripherally and does not involve interleukin-2.

Although several recent studies suggest that dopamine may have a significant role in the regulation of immune cell function, the mechanisms involved remain unclear. We undertook this study to clarify the actions of dopamine in vivo on lymphocyte proliferation and to determine whether such effects are mediated by alterations in interleukin-2 (IL-2) production and/or IL-2 receptor (IL-2R) expression. Administration of the dopamine precursor, L-dopa, for 5 days to BALB/c mice significantly increased Concanavalin A (ConA)-induced proliferation of lymphocytes. This effect was blocked by treatment with dopamine receptor antagonists as well as a peripheral dopamine synthesis inhibitor, suggesting a peripheral action of dopamine. L-dopa treatment had no effect on IL-2 production or IL-2R expression, indicating that the effects of dopamine on lymphocyte proliferation are not indirectly mediated by alterations in the IL-2 system.

In vivo administration of L-dopa or dopamine decreases the number of splenic IFN gamma-producing cells.

Although dopamine receptors are present on peripheral immune system cells, relatively little is known about the functional role that dopamine may play in immune responses. The purpose of this study was to determine the effects of chronic treatment with L-dopa and dopamine on murine lymphocyte proliferation and cytokine production/release. In vivo treatment with L-dopa resulted in an increase in the proliferative response of splenic lymphocytes to ConA. Spleen cell supernatant concentrations of IL-4 and IFN gamma were not significantly altered following treatment with L-dopa for 5 days. However, the number of IFN gamma-, but not IL-4-producing cells was significantly inhibited by L-dopa. This effect was blocked by co-treatment with a dopamine antagonist. The effect on IFN gamma was replicated by infusion of dopamine. The results suggest that dopamine may have a direct role in regulating immune responses through down-regulation of IFN gamma.