Enteropathy and intestinal malabsorption in patients treated with antihypertensive drugs. A retrospective cohort study.

OBJECTIVES: To investigate differences in the incidence of enteropathy or intestinal malabsorption in patients taking angiotensin II receptor blockers (ARBs), angiotensin-converting enzyme inhibitor (ACEI), calcium channel blocker (CCB), and beta blockers (BBs) at a single center in Korea. METHODS: In this retrospective study, we utilized data from the Yangsan electronic medical records to identify 129,169 patients. These individuals were prescribed olmesartan, other ARBs, ACEI, CCB, and BBs between November 2008 and February 2021. RESULTS: Of the 44,775 patients, 51 (0.11%) were observed to have enteropathy or intestinal malabsorption. Compared with the ACEI group, the adjusted odds ratios (ORs) for enteropathy and intestinal malabsorption were OR=1.313 (95% confidence interval [CI]: [0.188-6.798], p=0.893) for olmesartan, OR=0.915 (95% CI: [0.525-1.595], p=0.754) for the other ARBs, OR=0.928 (95% CI: [0.200-4.307]; p=0.924) for the CCB, and OR=0.663 (95% CI: [0.151-2.906]; p=0.586) for the BBs group. These findings were adjusted for factors such as age, gender, duration of antihypertensive medication, and comorbidities. CONCLUSION: In a retrospective cohort study of patients on antihypertensive medications, no significant difference was found in the incidence of enteropathy or intestinal malabsorption when ACEI was compared to olmesartan, other ARBs, CCB, and BBs.

Burnout in healthcare workers in COVID-19-dedicated hospitals.

BACKGROUND: Considering the prolongation of the COVID-19 pandemic, the lack of studies on burnout, particularly in healthcare workers, needs to be addressed. This report aimed to identify the risk factors of burnout by comparing the level of burnout between nurses in general wards and those in COVID-19-dedicated wards in a national university hospital. METHODS: A survey based on the Korean version of Burnout Assessment Tool (BAT-K) was conducted on nurses between 10 January and 31 January 2022. The BAT-K consists of exhaustion, mental distance, cognitive impairment, emotional impairment and secondary symptoms. RESULTS: A total of 165 nurses, including 81 nurses from the COVID-19-dedicated ward, completed the questionnaire. The percentage of general-ward nurses with an emotional impairment score above the clinical cutoff was higher than that of COVID-19 ward nurses. General ward compared to the COVID-19 ward increased the risk of presenting with total-core symptoms. Two factors increased the risk regarding mental distance: short career length and underlying disease. CONCLUSIONS: In contrast to previous studies, the risk of burnout in the COVID-19-ward nurses was lower than that of the general ward nurses. The risk regarding mental distance was correlated with short career length and presence of an underlying disease.

Adsorption and Clearance of the Novel Fluorescent Tracer Agent MB-102 During Continuous Renal Replacement Therapy: In Vitro Results.

MB-102 is a novel fluorescent tracer agent that is exclusively removed from the body by glomerular filtration. This agent can be detected transdermally to provide a real-time measurement of glomerular filtration rate at the point-of-care and is currently in clinical studies for such. MB-102 clearance during continuous renal replacement therapy (CRRT) is unknown. Its plasma protein binding (~0%), molecular weight (~372 Da) and volume of distribution (15-20 L) suggest that it may be removed by renal replacement therapies. To determine the disposition of MB-102 during CRRT, an in vitro study assessing the transmembrane clearance (CL TM ) and adsorptive clearance of MB-102 was conducted. A validated in vitro bovine blood continuous hemofiltration (HF) and continuous hemodialysis (HD) models were performed using two types of hemodiafilters to evaluate CL TM of MB-102. For HF, three different ultrafiltration rates were evaluated. For HD, four different dialysate flow rates were evaluated. Urea was used as a control. No MB-102 adsorption to the CRRT apparatus or either of hemodiafilters was observed. MB-102 is readily removed by HF and HD. Dialysate and ultrafiltrate flow rates directly influence MB-102 CLTM. Hence MB-102 CLTM should be measurable for critically ill patients receiving CRRT.

A short review of undergraduate occupational medicine training.

BACKGROUND: Medical schools worldwide allocate little time and utilize varying formats in the teaching of occupational medicine (OM) to undergraduate medical students. AIMS: To identify undergraduate OM teaching formats and highlight key findings in these different methods. METHODS: A limited literature search conducted on PubMed and Scopus identified relevant articles published in English and between the years 2009 and 2018. Our inclusion criteria were papers containing the key words ('occupational medicine' AND ('medical students' OR 'undergraduate medical')) OR ('occupational medicine' AND ('training' OR 'education' OR 'teaching')) in the title or abstract and those that specifically discussed OM education. RESULTS: The literature search yielded 1479 papers. Seven of them fulfilled the inclusion criteria and were reviewed in full. Formats in OM education of undergraduate medical students include, either singly or in combination, the use of case studies, didactic sessions, workplace visits, text-based readings and pro forma. CONCLUSIONS: OM education has a very small footprint in most undergraduate medical curricula. The studies show that different teaching formats are utilized, often in combination. Case-based discussions and workplace visits are frequently used with good qualitative results. Text-based readings will serve well to build good foundational knowledge, though there is no conclusive evidence that students will perform better.

Characterization and validation of multimodal annihilation-gamma/near-infrared/visible laparoscopic system.

Minimally invasive robotic surgery using fluorescence-guided images with a video laparoscope has been widely used because of its advantages of small incision, fast recovery time, and efficiency. However, the penetration depth limitation of fluorescence is a disadvantage caused by the absorption and scattering in tissues and blood cells. If this limitation can be overcome by additional imaging modalities, the surgical procedure can be quite efficient and precise. High-energy annihilation-gamma photons have a stronger penetration capability than visible and fluorescence photons. To characterize and validate a multimodal annihilation-gamma/near-infrared (NIR)/visible laparoscopic imaging system, an internal detector composed of an annihilation-gamma detector and an optical system was assembled inside a surgical stainless pipe with an outer diameter of 15.8 mm and an external detector with a dimension of 100 × 100 mm2 placed at the opposite side of the internal detector. Integrated images of 511-keV gamma rays, NIR fluorescence, and visible light were obtained simultaneously. The 511-keV gamma image could be clearly seen with the acquisition of 5 s, while NIR and visible images could be presented in real time. This multimodal system has the potential for improving the surgery time and the quality of patient care.

Prevalence and Risk Factors for Cardiac and Liver Iron Overload in Adults with Thalassemia in Malaysia.

We explored the severity and risk factors for cardiac and liver iron overload (IOL) in 69 thalassemia patients who underwent T2* magnetic resonance imaging (T2* MRI) in a Malaysian tertiary hospital from 2011 to 2015. Fifty-three patients (76.8%) had transfusion-dependent thalassemia (TDT) and 16 (23.2%) had non transfusion-dependent thalassemia (NTDT). Median serum ferritin prior to T2* MRI was 3848.0 µg/L (TDT) and 3971.0 µg/L (NTDT). Cardiac IOL was present in 16 (30.2%) TDT patients and two (12.5%) NTDT patients, in whom severe cardiac IOL defined as T2* <10 ms affected six (11.3%) TDT patients. Liver IOL was present in 51 (96.2%) TDT and 16 (100%) NTDT patients, 37 (69.8%) TDT and 13 (81.3%) NTDT patients were in the most severe category (>15 mgFe/gm dry weight). Serum ferritin showed a significantly strong negative correlation with liver T2* in both TDT (rs = -0.507, p = 0.001) and NTDT (r = -0.762, p = 0.002) but no correlation to cardiac T2* in TDT (r = -0.252, p = 0.099) as well as NTDT (r = -0.457, p = 0.100). For the TDT group, regression analysis showed that cardiac IOL was more severe in males (p = 0.022) and liver IOL was more severe in the Malay ethnic group (p = 0.028) and those with higher serum ferritin levels (p = 0.030). The high prevalence of IOL in our study and the poor correlation between serum ferritin and cardiac T2* underline the need to routinely screen thalassemia patients using T2* MRI to enable the early detection of cardiac IOL.

Inconsistency in Reporting Variables Related to Intracranial Pressure Measurement in Scientific Literature.

PURPOSE: To assess whether the collection and communication of intracranial pressure (ICP) values were standardized and reproducible. METHODS: Integrative review of clinical trials (n = 357) reporting ICP as a variable. RESULTS: Only 24.1% of studies reported adequate data required for replication. Of the 357 reports, 342 provided information about the design, 274 discussed sampling strategy, 294 identified the ICP device type, 312 provided a unit of measure, 121 provided anatomical localization for measuring ICP, and 83 provided information about patient positioning. CONCLUSIONS: The majority of literature evaluated did not provide enough data for replication of results. Measuring and reporting ICP in the scientific literature is not standardized. A uniform standard would strengthen the quality of the evidence in neurocritical care and neurosurgical literature and better establish clinical guidelines for ICP management in neurologically injured patients.

Provisional heritability estimates of four distraction index traits in a breeding population of German Shepherd dogs.

AIM To obtain provisional estimates of the heritability (h2 ) of passive laxity of the coxofemoral joints of a breeding colony of German Shepherd dogs, measured using the PennHIP distraction index (DI). METHODS Records were obtained of the PennHIP DI of right and left hips of 195 German Shepherd dogs (377 DI records) from the dog breeding colony of the New Zealand Police Dog Breeding Centre between 2003 and 2016, as well as pedigree records of 884 animals over four generations. Estimates of h2 and variance components for the log transformed DI data were obtained using restricted maximum likelihood procedures with a single trait sire model. Four DI traits for each dog were analysed: left hip, right hip, mean and worse-hip DI. The model included the fixed effects of sex and year of birth, with the age at scoring as a covariable, the random sire effect and residual error for each observation. RESULTS The h2 of the DI of the left hip (0.81, SE 0.40) was higher than the h2 of the DI of the right hip (0.35, SE 0.36). The h2 for the worse-hip DI (0.15, SE 0.28) in each dog was lower than the h2 of the individual hip DI, or the h2 for the mean of the two hips (0.53, SE 0.36) in each dog. The low number of generations prevented a meaningful analysis of the genetic trend. CONCLUSIONS AND CLINICAL RELEVANCE The h2 estimates for the left, right and mean DI traits were moderate to high, whereas the h2 estimates for the worse-hip DI (as used by the PennHIP programme for ranking of dogs) was low, but all estimates had large SE due to the small sample size. This provisional estimate of the h2 of four distraction index traits suggests that the mean DI could be useful as a selection tool against canine hip dysplasia in German Shepherd dogs, whereas the worse-hip DI may be less effective. Heritability estimates from a population with a greater number of DI measures is needed to validate this finding given the large SE in our study.

Heritabilities and genetic trends for elbow score as recorded by the New Zealand Veterinary Association Elbow Dysplasia Scheme (1992-2013) in four breeds of dog.

AIM: To estimate the heritability of the New Zealand Veterinary Association (NZVA) elbow phenotype, obtain estimated breeding values (EBV) for the worst-elbow score and estimate the genetic trends for this trait in four populous breeds of dogs, using the records from the NZVA Canine Elbow Dysplasia Scheme database (1992-2013). METHODS: Overall, 4,070 elbow records from a pedigree of 11,311 dogs were available for animals scored between 1992 and 2013. The worst elbow score between the left and right elbows was identified for each dog and used for EBV analysis. Estimates of heritability and EBV for the elbow score of dogs from German Shepherd dog, Labrador Retriever, Golden Retriever and Rottweiler breeds were obtained using restricted maximum likelihood procedures with a within-breed linear animal model. The model included the fixed effects of sex and birth year, with age at scoring as a covariable, and the random effect of animal. Genetic trends for the worst-elbow score were calculated as the regression coefficient of the EBV, weighted by reliabilities, on year of birth. RESULTS: The estimates of heritability for worst-elbow score were 0.25 (SE 0.06) in German Shepherd dogs, 0.46 (SE 0.06) in Labrador Retrievers, 0.18 (SE 0.07) in Golden Retrievers and 0.29 (SE 0.11) in Rottweilers. The genetic trend for German Shepherd dogs was -0.0082 (SE 0.0015), for Labrador Retrievers was -0.0016 (SE 0.0016), for Golden Retrievers was -0.0033 (SE 0.0010) and for Rottweilers was -0.0070 (SE 0.0023) units per annum, which were different from zero (p<0.01) in all breeds except Labrador Retrievers. CONCLUSIONS AND CLINICAL RELEVANCE: A small but favourable response to selection was achieved by three of the four breeds in the study period; during which selection for elbow traits has been largely voluntary. While the magnitude of genetic change in terms of elbow units per annum may appear small, it must be remembered that elbow scoring grades only range from 0-3. Greater improvement may be possible if compulsory screening was a requirement for pedigree breeding stock, and if greater selection pressure were applied on the basis on an individual's EBV, rather than the worst-elbow score alone. The maintenance of an open registry, with transparency of EBV information made available to all breeders, may enhance selection intensity opportunities and potentially assist with the process and progress of breeding selection.

Asian venous thromboembolism guidelines: updated recommendations for the prevention of venous thromboembolism.

The Asian venous thromboembolism (VTE) prophylaxis guidelines were first published in 2012. Since its first edition, the Asian Venous Thrombosis Forum (AVTF) working group have updated the Asian VTE epidemiology and reviewed issues that were not addressed in the previous guidelines. The authors noted that the rising incidence of VTE across Asia may be attributable to aging population, dietary changes, and increasing incidence of obesity and diabetes. The new additions in the guideline include role of thrombophilia in VTE, bleeding risk in Asians, individual risk assessment, updates in the prevention of VTE in medically ill, bariatric surgery, cancer, orthopedic and trauma patients. The influence of primary thrombophilia in perioperative VTE is still unclear. The secondary risk factors, however, are similar between Asians and Caucasians. The group found no evidence of increased risk of bleeding while using pharmacological agents, including the use of novel anti-coagulants. At present, Caprini risk assessment model is widely used for individual risk assessment. Further validation of this model is needed in Asia. In medically ill patients, pharmacological agents are preferred if there is no bleeding risk. Intermittent pneumatic compression device (IPC) is recommended in patients with bleeding risk but we do not recommend using graduated compressive stockings. In bariatric patients, data on VTE is lacking in Asia. We recommend following current international guidelines. A high index of suspicion should be maintained during postbariatric surgery to detect and promptly treat portomesenteric venous thrombosis. Different cancer types have different thrombotic risks and the types of surgery influence to a large extent the overall VTE risk. Cancer patients should receive further risk assessment. In patients with higher thrombotic risk, either due to predisposing risk or concomitant surgery, low molecular weight heparin is indicated. Different countries appear to have different incidence of VTE following trauma and major orthopedic surgery. We recommend mechanical prophylaxis using IPC as the main method and additional pharmacological prophylaxis if the thrombotic risk is high. As for obstetric practice, we propose adherence to the UK Greentop guideline that is widely accepted and utilized across Asia. To improve VTE thromboprophylaxis implementation in the region, we propose that there should be better health education, establishment of hospital-based guidelines and multidisciplinary collaboration.

Growth of Catalyst-Free Epitaxial InAs Nanowires on Si Wafers Using Metallic Masks.

Development of heteroepitaxy growth of catalyst-free vertical III-V nanowires on Si wafers is highly desirable for future nanoscale Si-based electronic and optoelectronic devices. In this study, a proof-of-concept approach is developed for catalyst-free heteroepitaxy growth of InAs nanowires on Si wafers. Before the growth of InAs nanowires, a Si-compatible metallic film with a thickness of several tens of nanometers was predeposited on a Si wafer and then annealed to form nanosize openings so as to obtain a metallic mask. These nano-openings exposed the surface of the Si wafer, which allowed subsequent nucleation and growth of epitaxial InAs nanowires directly on the surface of the Si wafer. The small size of the nano-openings limits the lateral growth of the nanostructures but promotes their axial growth. Through this approach, catalyst-free InAs nanowires were grown on both Si (111) and (001) wafers successfully at different growth temperatures. In particular, ultralong defect-free InAs nanowires with the wurtzite structure were grown the Si (111) wafers at 550 °C using the Ni mask. This study offers a simple, cost-effective, and scalable method to grow catalyst-free III-V nanowires on Si wafers. The simplicity of the approach opens a new avenue for the growth and integration of catalyst-free high-quality heteroepitaxial III-V nanowires on Si wafers.

The Microtubule-Associated Protein Lis1 Regulates T Lymphocyte Homeostasis and Differentiation.

The microtubule-associated protein lissencephaly 1 (Lis1) is a key regulator of cell division during stem cell renewal and differentiation. In this study, we examined the role of Lis1 in T lymphocyte homeostasis and fate diversification in response to microbial infection. T cell-specific deletion of Lis1 resulted in depletion of the peripheral CD4(+) and CD8(+) T lymphocyte pool owing to a loss of homeostatic, cytokine-induced proliferation. In contrast, cognate Ag-triggered proliferation was much less affected, enabling Lis1-deficient CD8(+) T cells to differentiate into terminal effector cells in response to microbial infection. Strikingly, however, the specification of Lis1-deficient long-lived memory CD8(+) T lymphocytes was impaired due, in part, to an apparent failure to differentiate appropriately to IL-15. Taken together, these findings suggest that Lis1 plays an important role in T cell homeostasis and the generation of memory T lymphocytes.

A review of induced pluripotent stem cell, direct conversion by trans-differentiation, direct reprogramming and oligodendrocyte differentiation.

Rapid progress in the field of stem cell therapy and cellular reprogramming provides convincing evidence of its feasibility in treating a wide range of pathologies through autologous cell replacement therapy. This review article describes in detail on three widely used approaches of somatic cell reprogramming: induced pluripotent stem cells, direct conversion and direct reprogramming, in the context of demyelination in the CNS. The potential limitations of each reprogramming technique are reviewed along with their distinct molecular approach to reprogramming. This is followed by an analysis on the scopes and challenges of its translational applications in deriving oligodendrocyte progenitor cells and oligodendrocytes for cell replacement treatment of demyelinating conditions in the CNS.

FGF21 and the late adaptive response to starvation in humans.

In mice, FGF21 is rapidly induced by fasting, mediates critical aspects of the adaptive starvation response, and displays a number of positive metabolic properties when administered pharmacologically. In humans, however, fasting does not consistently increase FGF21, suggesting a possible evolutionary divergence in FGF21 function. Moreover, many key aspects of FGF21 function in mice have been identified in the context of transgenic overexpression or administration of supraphysiologic doses, rather than in a physiologic setting. Here, we explored the dynamics and function of FGF21 in human volunteers during a 10-day fast. Unlike mice, which show an increase in circulating FGF21 after only 6 hours, human subjects did not have a notable surge in FGF21 until 7 to 10 days of fasting. Moreover, we determined that FGF21 induction was associated with decreased thermogenesis and adiponectin, an observation that directly contrasts with previous reports based on supraphysiologic dosing. Additionally, FGF21 levels increased after ketone induction, demonstrating that endogenous FGF21 does not drive starvation-mediated ketogenesis in humans. Instead, a longitudinal analysis of biologically relevant variables identified serum transaminases--markers of tissue breakdown--as predictors of FGF21. These data establish FGF21 as a fasting-induced hormone in humans and indicate that FGF21 contributes to the late stages of adaptive starvation, when it may regulate the utilization of fuel derived from tissue breakdown.

Graphene Quantum Dot Layers with Energy-Down-Shift Effect on Crystalline-Silicon Solar Cells.

Graphene quantum dot (GQD) layers were deposited as an energy-down-shift layer on crystalline-silicon solar cell surfaces by kinetic spraying of GQD suspensions. A supersonic air jet was used to accelerate the GQDs onto the surfaces. Here, we report the coating results on a silicon substrate and the GQDs' application as an energy-down-shift layer in crystalline-silicon solar cells, which enhanced the power conversion efficiency (PCE). GQD layers deposited at nozzle scan speeds of 40, 30, 20, and 10 mm/s were evaluated after they were used to fabricate crystalline-silicon solar cells; the results indicate that GQDs play an important role in increasing the optical absorptivity of the cells. The short-circuit current density was enhanced by about 2.94% (0.9 mA/cm(2)) at 30 mm/s. Compared to a reference device without a GQD energy-down-shift layer, the PCE of p-type silicon solar cells was improved by 2.7% (0.4 percentage points).

Canine hip dysplasia: phenotypic scoring and the role of estimated breeding value analysis.

Canine hip dysplasia (CHD) is a developmental orthopaedic disease of the coxofemoral joints with a multifactorial mode of inheritance. Multiple gene effects are influenced by environmental factors; therefore, it is unlikely that a simple genetic screening test with which to identify susceptible individuals will be developed in the near future. In the absence of feasible methods for objectively quantifying clinical CHD, radiographic techniques have been developed and widely used to identify dogs for breeding which are less affected by the disease. A hip-extended ventrodorsal view of the pelvis has been traditionally used to identify dogs with subluxation and/or osteoarthritis of the coxofemoral joints. More recently, there has been emphasis on the role of coxofemoral joint laxity as a determinant of CHD and methods have been developed to measure passive hip laxity. Though well-established worldwide, the effectiveness of traditional phenotypic scoring schemes in reducing the prevalence of CHD has been variable. The most successful implementation of traditional CHD scoring has occurred in countries or breeding colonies with mandatory scoring and open registries with access to pedigree records. Several commentators have recommended that for quantitative traits like CHD, selection of breeding stock should be based on estimated breeding values (EBV) rather than individual hip score/grade. The EBV is a reflection of the genetic superiority of an animal compared to its counterparts and is calculated from the phenotype of an individual and its relatives and their pedigree relationship. Selecting breeding stock on the basis of a dog's genetic merit, ideally based on a highly predictive phenotype, will confer the breeder with greater selection power, accelerate genetic improvement towards better hip conformation and thus more likely decrease the prevalence of CHD.

Genetic evaluation of the total hip score of four populous breeds of dog, as recorded by the New Zealand Veterinary Association Hip Dysplasia Scheme (1991-2011).

AIM: To use estimated breeding value (EBV) analysis to investigate the genetic trend of the total hip score (to assess canine hip dysplasia) in four populous breeds of dogs using the records from the New Zealand Veterinary Association (NZVA) Canine Hip Dysplasia Scheme database (1991 to 2011). METHODS: Estimates of heritability and EBV for the NZVA total hip score of individual dogs from the German Shepherd, Labrador Retriever, Golden Retriever and Rottweiler breeds were obtained using restricted maximum likelihood procedures with a within-breed linear animal model. The model included the fixed effects of gender, birth year, birth season, age at scoring and the random effect of animal. The pedigree file included animals recorded between 1990 and 2011. A total of 2,983 NZVA hip score records, from a pedigree of 3,172 animals, were available for genetic evaluation. Genetic trends of the NZVA total hip score were calculated as the regression coefficient of the EBV (weighted by reliabilities) on year of birth. RESULTS: The estimates of heritability for hip score were 0.32 (SE 0.08) in German Shepherd, 0.37 (SE 0.08) in Labrador Retriever, 0.29 (SE 0.08) in Golden Retriever and 0.52 (SE 0.18) in Rottweiler breeds. Genetic trend analysis revealed that only the German Shepherd breed exhibited a genetic trend towards better hip conformation over time, with a decline of 0.13 (SE 0.04) NZVA total hip score units per year (p<0.001). The genetic trends of total hip score for the remaining three breeds were not significantly different from zero (p>0.1). CONCLUSIONS: Despite moderate heritability of the NZVA total hip score, there has not been substantial improvement of this trait for the four breeds analysed in the study period. CLINICAL RELEVANCE: Greater improvement in reducing the prevalence of canine hip dysplasia may be possible if screening were to be compulsory as a requirement for registration of pedigree breeding stock, greater selection pressure were to be applied and selection of breeding stock made on the basis on an individual's EBV rather than the NZVA total hip score alone.

Loss of white adipose hyperplastic potential is associated with enhanced susceptibility to insulin resistance.

Fat mass expansion occurs by adipocyte hypertrophy or recruitment of differentiating adipocyte progenitors, the relative balance of which may impact systemic metabolism. We measured adipogenesis in murine subcutaneous (sWAT) and visceral white adipose tissue (vWAT) using stable isotope methodology and then modeled adipocyte turnover. Birth and death rates were similar within depots; however, turnover was higher in vWAT relative to sWAT. In juvenile mice, obesity increased adipogenesis, but in adults, this was only seen in vWAT after prolonged high-fat feeding. Statistical modeling suggests differentiation of adipocyte progenitors without an accompanying self-renewing division step may partially explain the age-dependent decline in hyperplastic potential. Additional metabolic interrogation of obese mice demonstrated an association between adipocyte turnover and insulin sensitivity. These data therefore identify adipocyte hypertrophy as the dominant mechanism of adult fat mass expansion and support the paradoxical concept that metabolic disease ensues due to a failure of adipose tissue plasticity.

A case of feline gastrointestinal eosinophilic sclerosing fibroplasia mimicking metastatic neoplasia.

CASE HISTORY: A 7-year-old cat developed sporadic vomiting, reduced appetite, and weight loss over the previous 3 months. CLINICAL FINDINGS: Palpation revealed a large mid-abdominal mass and the cat had marked eosinophilia. The cat progressively lost weight over the next 7 weeks when euthanasia was performed. PATHOLOGICAL FINDINGS: Necropsy revealed a 3 cm diameter firm white intramural mass in the colon and another in the pylorus. Mesenteric and cranial mediastinal lymph nodes were firm, pale, and enlarged. Histopathological examination revealed foci of necrosis surrounded by thick dense collagen trabeculae and predominantly eosinophilic inflammation within the intestine and lymph nodes. Marked eosinophilic infiltration of the liver was also present. DIAGNOSIS: The lesions were consistent with gastrointestinal eosinophilic sclerosing fibroplasia (FGESF). CLINICAL RELEVANCE: This is the first report of FGESF in a New Zealand cat and the first time lesions of FGESF have been observed in extra-abdominal tissues. Intestinal neoplasia can be clinically identical to FGESF and histopathology is required for differentiation. Evidence suggests that FGESF has a more favourable prognosis than intestinal neoplasia.