Pharmacokinetics of intravenous and subcutaneous cefovecin in alpacas.

The purpose of this study was to determine the pharmacokinetics of cefovecin after intravenous and subcutaneous dose of 8 mg/kg to alpacas. Bacterial infections requiring long-term antibiotic therapy such as neonatal bacteremia, pneumonia, peritonitis, dental, and uterine infections are a significant cause of morbidity and mortality in this species. However, few antimicrobials have been evaluated and proven to have favorable pharmacokinetics for therapeutic use. Most antimicrobials that are currently used require daily injections for many days. Cefovecin is a long-acting cephalosporin that is formulated for subcutaneous administration, and its long-elimination half-life allows for 14-day dosing intervals in dogs and cats. The properties of cefovecin may be advantageous for medical treatment of camelids due to its broad spectrum, route of administration, and long duration of activity. Pharmacokinetic evaluation of antimicrobial drugs in camelids is essential for the proper treatment and prevention of bacterial disease, and to minimize development of antibiotic resistant bacterial strains due to inadequate antibiotic concentrations. Cefovecin mean half-life, volume of distribution at steady-state, and clearance after intravenous administration were 10.3 h, 86 mL/kg, and 7.07 mL·h/kg. The bioavailability was 143%, while half-life, C(max), and T(max) were 16.9 h, 108 µg/mL, and 2.8 h following subcutaneous administration. In the absence of additional microbial susceptibility data for alpaca pathogens, the current cefovecin dosage regimen prescribed for dogs (8 mg/kg SC every 14 days) may need to be optimized for the treatment of infections in this species.

Multilocus sequence typing for characterization of Staphylococcus pseudintermedius.

Staphylococcus pseudintermedius is an opportunistic pathogen in dogs. Four housekeeping genes with allelic polymorphisms were identified and used to develop an expanded multilocus sequence typing (MLST) scheme. The new seven-locus technique shows S. pseudintermedius to have greater genetic diversity than previous methods and discriminates more isolates based upon host origin.

Harmonization of internal dosimetry procedures in Latin America--ARCAL/IAEA project.

Under the auspices of the Regional Coordination Agreement for Latin America, representatives of the eight member states have participated in a project to improve radiological protection for workers exposed to unsealed sources of radiation. The design of the project was based on information obtained from a questionnaire circulated among the participants, from which the initial status of internal dosimetry services in each country was characterised. The objective of the project is to harmonize internal dosimetry procedures, with reference to International Atomic Energy Agency recommendations. After the implementation of new procedures and personnel training, four intercomparison exercises were carried out: measurement of iodine in thyroid phantoms, measurement of gamma emitters in urine samples, measurement of beta emitters in urine samples and internal dose assessments. This project has resulted in important improvements in internal dosimetry services in the region.

A protocol for the calibration of gamma cameras to estimate internal contamination in emergency situations.

The concern about accidents involving radioactive materials has led to the search of alternative methods to quickly identify and quantify radionuclides in workers and in the population. One of the options to face up an eventual demand for mass monitoring of internal contamination is the use of a nuclear medicine diagnostic equipment known as gamma camera, a device used to scan patients who have been administered specific amounts of radioactive materials for medical purposes. Although the gamma camera is used for image diagnosis, it can be calibrated with anthropomorphic phantoms or point sources for the quantification of radionuclide activities in the human body. This work presents a protocol for the calibration of gamma cameras for such application. In order to evaluate the suitability of this type of equipment, a gamma camera available in a public hospital located in Rio de Janeiro was calibrated for the in vivo measurement of 131I. The calibration includes the determination of detection efficiencies and minimum detectable activities for each radionuclide. The results show that the gamma camera presents enough sensitivity to detect activity levels corresponding to effective doses below 1 mSv. The protocol is the basis to establish a network of Nuclear Medicine Centres, located in public hospitals in eight countries of Latin America (Argentina, Brazil, Colombia, Cuba, Chile, Mexico, Peru and Uruguay) and in Spain that could be requested to collaborate in remediation actions in the event of an accident involving incorporation of radioactive materials. This protocol is one of the most significant outputs of the IAEA-ARCAL Project (RLA/9/049-LXXVIII) aimed to the Harmonization of Internal Dosimetry Procedures.

[Intestinal duplication. Report of 2 cases]. / Duplicación intestinal. Informe de dos casos.

Intestinal duplications are rare and they result from embryological failures in the canalization of the gastrointestinal tract. This paper presents a case of ileal intestinal duplication and its differential diagnosis from Meckel's diverticulum. Besides, a case of rectal duplication in an asymptomatic elder patient is presented.

Effects of intravenously administered esomeprazole sodium on gastric juice pH in adult female horses.

BACKGROUND: Gastric ulcers are common in horses and treatment of horses that cannot be administered oral medication can be problematic. OBJECTIVES: To evaluate the efficacy of esomeprazole sodium administered intravenously on gastric juice pH and gastric ulcer scores in horses. ANIMALS: Twelve adult female Quarter Horses. METHODS: Esomeprazole sodium (0.5 mg/kg IV) was administered once daily to 8 horses (treatment group) and saline (5 mL IV) was administered to 4 horses (control group) for 13 consecutive days. Gastroscopy was performed and gastric juice pH and gastric ulcer score were recorded before and 1 hour after the administration of esomeprazole sodium or saline on days 1 and 5, then on day 14, 23 hours after the 13th daily dose of esomeprazole sodium or saline. RESULTS: When compared with values before treatment, gastric juice pH was higher in esomeprazole sodium-treated horses after treatment (4.25 ± 2.39 versus 6.43 ± 1.18; P = .002). Also, gastric juice pH was higher (P = .001) in esomeprazole sodium-treated horses compared with saline-treated control horses on day 5 and on day 14 values. Gastric ulcers were seen in 5/12 (43%) horses in the study. CONCLUSIONS AND CLINICAL IMPORTANCE: Esomeprazole sodium shows promise for treatment of gastric ulcers in horses with signs of dysphagia, gastric reflux, or other conditions that restrict oral intake of the current Federal Drug Administration-approved omeprazole paste.

Localización y frecuencia de placas ateromatosas intracraneales en pacientes mayores de 40 años / Location and frequency of intracranial atheromatous plaques in patients over 40 years

Si bien la ateromatosis intracraneal (AIC) es una entidad frecuente, está subvalorada en la práctica clínica. Los avances tecnológicos en los diferentes métodos radiológicos y especialmente el advenimiento de la tomografía computada multicorte (TCMC) han mejorado la precisión diagnóstica de esta patología. OBJETIVOS: Demostrar la utilidad de la TCMC en el diagnóstico de la AIC y determinar la frecuencia y localización de las placas ateromatosas, así como su distribución etaria y genérica. MATERIALES Y MÉTODOS: Se estudió retrospectivamente a 280 pacientes (140 mujeres y 140 hombres) entre octubre de 2011 y marzo de 2012. Todos eran mayores de 40 años y contaron con una TCMC de cerebro sin contraste, realizada con un tomógrafo Toshiba Aquilion de 16 filas de detectores. Se evaluaron solamente placas cálcicas (considerándose así a aquellas cuya densidad superaba las 80 unidades Hounsfield). RESULTADOS: Se encontró AIC en un 65% de los pacientes examinados, con una incidencia no significativa en el sexo masculino (relación: 1,16/1). Los vasos más comprometidos, en orden de frecuencia, fueron el sifón carotídeo y la arteria vertebral en su segmento V4. CONCLUSIÓN: La ateromatosis es una de las causas frecuentes de ictus cerebral. La TCMC es el método de elección para determinar la localización y frecuencia de las calcificaciones intracraneales de manera no invasiva. Al igual que el score de calcio, la determinación del calcio a nivel de las arterias permitiría establecer el riesgo que tiene el paciente de desarrollar complicaciones vasculares, en este caso en el territorio cerebral.

Even though intracranial atheromatosis (IA) is a frequent entity, it is undervalued in clinical practice. The technological advances in different radiological methods and especially multislice computed tomography (MSCT) have improved the diagnostic accuracy of this pathology. OBJECTIVES: To prove the multislice computed tomography usefulness in intracranial atheromatosis diagnostic, and establish the frequency and location of atheromatous plaques, and also the age and gender distribution. MATERIALS AND METHODS: Two hundred and eighty patients (140 male and 140 female) were studied retrospectively, between October 2011 and March 2012. All of them were more than 40 years old and counted with a brain MSCT without contrast, made it with a Toshiba Aquilion 16 multidetector computer tomograph. Calcium plaques were only evaluated (considering calcium plaques those whose density was over 80 Hounsfield units). RESULTS: It was showed the presence of IA in 65% of the examined patients, being the male gender the mostly affected in a 1.16:1, non significant relation. The most affected vessels in frequency order were carotid siphon and vertebral artery in their V4 segment. CONCLUSION: The atheromatosis is one of the frequent causes of cerebral stroke. The MSCT is the selected method to determine the location and frequency of the intracranial calcification in a noninvasive way. In the same way as the calcium score, determining the level of calcium in the arteries allows to determine the risk that the patient has of developing vascular complications, in this case in the cerebral territory.

Nuestra experiencia en 4 casos de linfoma colónico / Malignaut lymphoma of the colon and rectum: 4 cases

Recogemos, en nuestra experiencia de tres años en el CEDIG, cuatro linfomas colónicos; tres de ellos en su expresión de linfoma multinodular de colon y uno de linfoma con afectación rectal. Dos casos de linfoma multinodular de colon y el rectal, fueron primarios. Los hallazgos característicos del linfoma multinodular fueron: 1) Nódulos submucosos, sésiles, de suave angulación con la pared, superficie lisa, sin erosiones ni umbilicación, con moderada indentación de sus bases en la observación tangencial, de variado tamaño, con un promedio de 8mm; con afectación de la totalidad del colon en dos de los tres casos, y sin pérdida de la distensibilidad parietal. 2) Masa cecal vegetante, mayor de 4cm, única, de superficie lisa, lobulada, con base amplia, sin ulceración mucosa, y ubicada sobre el borde mesentérico. Los linfomas localizados en ampolla rectal presentaron una imagen vegetante, grande, lobulada, de afectación circunferencial y cercana al esfínter anal. En el diagnóstico diferencial se incluyó: poliposis colónica, enfermedades inflamatorias, hiperplasia linfoidea, colitis pseudo membranosa, adenocarcinoma y SIDA

The utility of percutaneous fine-needle aspiration biopsy in the diagnosis of peripheral pulmonary lesions

A pulmonary lesion usually poses a diagnostic problem requiring a swift solution. Percutaneous fine-needle aspiration biopsy (NAB) technique yields a high percentage of correct diagnosis. However, this procedure is often underestimated and its indication vaguely known. Experience with 185 NAB in 175 patients is reviewed. One hundred and ten procedures were performed in hospitalized patients and 75 in an outpatient setting. Forty-four percent of cases in the whole series have had a previous negative fiberoptic bronchoscopy examination (FOB). Sixty-five percent were peripheral solitary pulmonary nodules, 54 percent of which were less than 2 cm lesions. The majority of NAB were performed under imaging guidance utilizing 20-23 gauge Chiba needles. High resolution fluoroscopic guidance was employed in 86 percent of cases, Computed Tomography (CT) in 11 percent and Ultrasonography in 3 percent. Specific cytologic diagnosis were obtained in 87 percent of the procedures done in hospitalized patients and 86.3 percent in ambulatory cases. In both groups, a 69 percent of neoplastic lesions were obttained. Post-biopsy pneumothorax was detected in 15 percent in each series. Only 3 patients in the whole series required the placement of a chest tube. To date, no needle tract seeding has been observed. A 9.3 percent and 10 percent of false negative results were recorded in both series, respectively. In this report, the complication rate is low and showed no statistical significant differences between the hospitalized and the outpatient groups. The latter resulted in less operative costs. Besides, TC guidance increases about 80 percent the operative expenses without offering a significant diagnostic yield. We conclude that NAB under fluoroscopic guidance in an outpatient basis is a reliable, safe, expeditious and cost effective diagnostic tool in small peripheral pulmonary lesions.

Duplicacion intestinal: informe de dos casos / Intestinal duplication: report of 2 cases

Las duplicaciones intestinales son infrecuentes y resultan de fallos embriológicos en la canalización normal del tubo digestivo. Este trabajo presenta un caso de duplicación intestinal en el ileon y su diagnóstico diferencial con el Divertículo de Meckel. A continuación se presenta un caso de duplicación de recto en un paciente de edad asintomático