Evaluation of serum 25-hydroxyvitamin D, C-reactive protein, and haptoglobin as biomarkers in dogs newly diagnosed with histoplasmosis.

BACKGROUND: Serum 25-hydroxyvitamin (OH)D, C-reactive protein (CRP), and haptoglobin are useful biomarkers in various infectious diseases and inflammatory disorders in dogs, but their utility in histoplasmosis is unknown. OBJECTIVE: Determine if serum 25(OH)D, CRP, and haptoglobin concentrations are different in dogs with histoplasmosis compared to healthy controls and whether serum globulin, albumin, CRP, or haptoglobin are associated with 25(OH)D concentration. ANIMALS: Twenty-two client-owned dogs (histoplasmosis, n = 12; controls, n = 10). METHODS: Prospective case-control study. Dogs with histoplasmosis were categorized as pulmonary, disseminated, or gastrointestinal (GI) tract. Serum 25(OH)D was measured using modified high-performance liquid chromatography (HPLC). Serum CRP and haptoglobin were measured with ELISA assays. RESULTS: Dogs with histoplasmosis were grouped as disseminated (n = 8) and GI tract (n = 4). No dogs had pulmonary tract involvement alone. Dogs with histoplasmosis (median, interquartile range [IQR]; 11.6 ng/mL, 16.8) had lower serum 25(OH)D concentrations than controls (35.7 ng/mL, 17.6; P < .001). Serum CRP and haptoglobin concentrations were higher in dogs with histoplasmosis (CRP: median, IQR; 63.5 mg/L, 37.1 and haptoglobin: 459.7 mg/dL, 419.6) than controls (CRP: 1.9 mg/L, 2; P < .001 and haptoglobin: 85.5 mg/dL, 106.7; P = .003). Serum 25(OH)D concentration was positively associated with fold change in serum albumin concentration (ρ = 0.77; P < .001), and negatively associated with fold change in serum globulin (ρ = -0.61; P = .003) and CRP concentrations (ρ = -0.56; P = .01). CONCLUSION AND CLINICAL IMPORTANCE: Assay of serum 25(OH)D, CRP, and haptoglobin could have clinical value in dogs with histoplasmosis.

Nasal colonization by Entamoeba gingivalis in a 13-year-old Italian Greyhound.

A 13-year-old 4.6 kg castrated male Italian Greyhound was presented for evaluation of sneezing, bilateral epistaxis and mucoid nasal discharge of approximately 3 months duration. Severe periodontal disease was noted on physical exam. The patient's CBC was unremarkable. His biochemical profile revealed mild azotemia as well as mild electrolyte abnormalities. Rhinoscopy revealed a tan plaque present in the left dorsal meatus of the nasal cavity. Vigorous flushing yielded granular white particulates suspended in the saline, which were cytologically examined. Marked neutrophilic inflammation, a diverse bacterial population, and organisms consistent with amoebic trophozoites were identified. The remaining fluid was analyzed by PCR and sequencing, and Entamoeba gingivalis was identified. The dog's clinical signs improved dramatically after initiating treatment with clindamycin. Six weeks after diagnosis, a dental cleaning with multiple extractions was performed. Four weeks after the dental procedure, the dog was clinically normal. This report describes the clinical, hematologic, cytologic, and gross findings in a case of Entamoeba gingivalis infection in a dog.

Factores psicológicos relacionados al aislamiento social en estudiantes universitarios

Introducción: durante la pandemia de COVID-19, se han implementado medidas de distanciamiento social en muchos países para interrumpir la transmisión viral y retrasar la propagación de la infección. Las personas que están en aislamiento social, con movilidad restringida y pobre contacto con los demás son vulnerables a presentar complicaciones psiquiátricas que van desde síntomas aislados hasta el desarrollo de un trastorno mental. Objetivo: fundamentar la influencia de los factores psicológicos relacionados al aislamiento social en estudiantes universitarios. Método: se realizó una revisión bibliográfica en las bases de datos Scopus, BASE, Clinical-Key, SciELO y LILACS. De los 46 artículos recuperados se seleccionaron 23 para el desarrollo de la investigación. Desarrollo: en los seres humanos la respuesta fisiológica al estrés está modulada por el nivel psicológico, al estar inmersos en una sociedad cambiante desde lo económico y hasta lo familiar, se es vulnerable a padecerlo, la importancia es la frecuencia con la que se experimenta y el daño que ello va ocasionando al propio organismo. Conclusiones: los estudiantes universitarios se ven expuestos a la influencia de factores psicológicos que van desde síntomas aislados hasta el desarrollo de afectaciones mentales como insomnio, ansiedad, depresión y trastorno por estrés postraumático, los cuales actúan de forma directa e indirecta en el proceso salud-enfermedad. (provisto por Infomedic International)

Introduction: During the COVID-19 pandemic, social distancing measures have been implemented in many countries to interrupt viral transmission and delay the spread of infection. People in social isolation, with restricted mobility and poor contact with others are vulnerable to psychiatric complications ranging from isolated symptoms to the development of a mental disorder. Objective: to substantiate the influence of psychological factors related to social isolation in university students. Method: a bibliographic review was carried out in the Scopus, BASE, Clinical-Key, SciELO and LILACS databases. Of the 46 articles retrieved, 23 were selected for the development of the research. Development: in human beings the physiological response to stress is modulated by the psychological level, being immersed in a changing society from the economic and family level, one is vulnerable to suffer it, the importance is the frequency with which it is experienced and the damage it causes to the organism itself. Conclusions: university students are exposed to the influence of psychological factors ranging from isolated symptoms to the development of mental disorders such as insomnia, anxiety, depression and post-traumatic stress disorder, which act directly and indirectly in the health-disease process. (provided by Infomedic International)

Vasculitis intestinal y hallazgos en la videocápsula endoscópica: reporte de caso y revisión de la literatura / Intestinal Vasculitis and Endoscopic Video Capsule Findings: Case Report and Literature Review

Resumen Las vasculitis sistémicas pueden llegar a afectar los vasos sanguíneos de todos los tamaños, provocando necrosis e inflamación. La granulomatosis con poliangitis (GPA) es una vasculitis de vasos pequeños y medianos. Las presentaciones clínicas pueden ser locales o difusas en el tracto gastrointestinal. Presentamos el caso de un paciente con diagnóstico de vasculitis sistémica asociada a anticuerpos anticitoplasma (ANCA) mieloperoxidasa (MPO) (poliangitis microscópica) confirmada con biopsia renal, con clínica de 15 días consistente en astenia, adinamia, oliguria subjetiva, edema de miembros superiores e inferiores, hiporexia y melenas. En el examen físico, el tacto rectal fue positivo para melenas, posteriormente presentó anemización secundaria a melenas, por lo que se realizó videocápsula endoscópica en la que se evidenciaron hallazgos compatibles con vasculitis entérica. Durante su estancia presentó compromiso multisistémico dado por la afectación renal, pulmonar, neurológica y gastrointestinal, manejada en la unidad de cuidados intensivos (UCI), donde se iniciaron pulsos de esteroide sistémico y hemodiálisis. Conclusión: la vasculitis gastrointestinal es una complicación rara; sin embargo, ocurre y causa una grave amenaza para la vida de los pacientes. El diagnóstico diferencial debe cubrir otras enfermedades inflamatorias, especialmente la enfermedad de Crohn. Su adecuado reconocimiento influencia de forma significativa el pronóstico, pues el inicio rápido de la terapia con esteroides puede cambiar el curso de la enfermedad.

Abstract Systemic vasculitis can affect blood vessels of all sizes, causing necrosis and inflammation. Granulomatosis with polyangiitis (GPA) is a vasculitis of small and medium blood vessels. Clinical manifestations may be local or diffuse in the gastrointestinal tract. We present a patient's case with systemic vasculitis associated with anti-cytoplasmic antibodies (ANCA), myeloperoxidase (MPO) antibodies (microscopic polyangiitis) confirmed through renal biopsy, presenting a 15-day clinical picture consisting of asthenia, adynamia, subjective oliguria, edema of the upper and lower limbs, hyporexia, and melena. The digital rectal examination was positive for melena in the physical examination, later presenting melena with secondary anemization. An endoscopic video capsule was performed, showing findings compatible with enteric vasculitis. During his stay, he presented multisystemic involvement due to renal, pulmonary, neurological, and gastrointestinal involvement, managed in the intensive care unit (ICU), where systemic steroid pulses and hemodialysis started. Conclusion: although gastrointestinal vasculitis is a rare complication, it occurs and threats patients' lives. Differential diagnosis should cover other inflammatory diseases, especially Crohn's disease. Gastrointestinal vasculitis early diagnosis significantly influences prognosis, as prompt steroid therapy can change the course of the disease.

[A comparative study of blood culture conventional method vs. a modified lysis/centrifugation technique for the diagnosis of fungemias]. / Comparación del método de hemocultivo convencional con el de lisis/centrifugación modificado para el diagnóstico de fungemias.

The purpose of this work was to compare the efficacy of blood culture conventional method vs. a modified lysis/centrifugation technique. Out of 450 blood specimens received in one year, 100 where chosen for this comparative study: 60 from patients with AIDS, 15 from leukemic patients, ten from febrile neutropenic patients, five from patients with respiratory infections, five from diabetics and five from septicemic patients. The specimens were processed, simultaneously, according to the above mentioned methodologies with daily inspections searching for fungal growth in order to obtain the final identification of the causative agent. The number (40) of isolates recovered was the same using both methods, which included; 18 Candida albicans (45%), ten Candida spp. (25%), ten Histoplasma capsulatum (25%), and two Cryptococcus neoformans (5%). When the fungal growth time was compared by both methods, growth was more rapid when using the modified lysis/centrifugation technique than when using the conventional method. Statistical analysis revealed a significant difference (p<0.05) between them. The modified lysis/centrifugation technique showed to be more efficacious than the conventional one, and therefore the implementation of this methodology is highly recommended for the isolation of fungi from blood.

Evaluation of a quality improvement intervention for diabetes management.

The purpose of this study was to develop and test two interventions designed to improve provider compliance with diabetes management guidelines: the use of a diabetes management flowsheet inserted into patient charts and the use of a diabetes management flowsheet plus quarterly provider feedback about compliance levels. Diabetic patient charts from six family practice clinics were randomly selected and audited at baseline and at 12 months. The analysis indicated that the use of the flowsheet was associated with improved provider compliance in the completion of foot examinations only. Providers involved in the study believed that the process of the flowsheet plus feedback contributed to their greater awareness of diabetes management guidelines.