ABSTRACT
O linfoma é uma neoplasia de alta recorrência na rotina oncológica de medicina veterinária. Pode ser classificado em linfoma Hodgking-liked, com raros casos descritos somente em felinos,e não Hodgking, sendo este segundo o mais comum, subdividido em linfomas B ou T. O objetivo deste trabalho foi relatar a conduta clínica, diagnóstica e terapêutica do caso de uma cadela, de 12 anos, sem raça definida, que manifestava disúria, prostração, dor abdominal e ao exame físico a presença de uma massa na região hipogástrica. Esta foi diagnosticada com linfoma de grandes células por meio de exames de citologia e biópsia, com solicitação do exame de imunoistoquímica que confirmou linfoma difuso de grandes células de imunofenótipo B. Sem o envolvimento de nenhum outro sistema, classificou-se como linfoma primário de bexiga extranodal. O animal passou pelo tratamento quimioterápico realizando nove sessões de quimioterapia pelo protocolo de CHOP, contudo devido ao agravamento do caso a paciente veio a óbito cerca de sete meses após o diagnóstico da doença. O caso estudado foi de extrema importância para a compreensão de linfomas primários de bexiga em razão da escassez de informações relacionadas na literatura. Ainda, o cão é um excelente modelo experimental de linfomas não Hodgking em humanos, consequentemente compreender essa doença em cães promove a evolução conjunta da medicina humana.
Lymphoma is a highly recurrent rate neoplasm in the oncology routine of veterinary medicine. It can be classified into Hodgking-like, rarely described just in felines, and non-Hodgking lymphoma, the latter being the most commun, subdivided into B-cell lymphoma and T-cell lymphoma. The objective of this study was to report the clinical and therapeutic conduct within the diagnosis procedures of a 12-years-old female dog, mixed breed, who manifested dysuria, prostation, abdominal pain and on the physical examination a mass in the hypogastric region was noticed. This was diagnosed as a large cell lymphoma by means cytology and biopsy, also immunohistochemistry was required which confirmed the diffuse large cell lymphoma of immunophenotyping B. Without any other sistem envolved, the neoplasm was classified as primary urinary bladder lymphoma extranodal. The animal underwent chemotherapy, performing nine sessions according to the Madison protocol, however, due to the worsening of the case, the patient died about seven months after the diagnosis of the disease. This case was extremely importante for the understanding of primary urinary bladder lymphomas due to the scarcity of informations in the literature. Also, dog is an excellent experi,emtal model of non Hodgking lymphomas in humans, thus understandig this disease in dogs promotes the joint evolution of human medicine.
Subject(s)
Animals , Dogs , Urinary Bladder/abnormalities , Immunohistochemistry/veterinary , Lymphoma, Large B-Cell, Diffuse/veterinary , Dogs/abnormalities , Drug Therapy/veterinary , Extranodal Extension/diagnosisABSTRACT
OBJECTIVES: Given the complex pathology of sickle cell anemia (SCA) and low adherence to hydroxyurea (HU) treatment, there is a need to seek parameters that identify recent changes in patient status. The advanced clinical parameters (ACPs) allow an early analysis of hematopoiesis. We aimed to draw the demographic profile of non-adherent SCA patients and to verify the use of ACPs as a measure of HU treatment adherence. METHOD: In a cross-sectional study, we divided 83 SCA subjects treated with HU into Children (<12 years old) and adolescents/adults (≥12 years old). Their hemogram with the ACPs, electronic medical charts and pharmacy claim data were analyzed. RESULTS: Non-adherent ≥12 years old patients had significantly increased WBC, absolute neutrophil, lymphocyte, monocyte, and basophil counts, RBC, RET, RDW, and PLT, and significantly decreased MCV and MCH. Subjects in the adolescent/adult group with IG ≥0.035 cells/mm3 had the RR for non-adherence increased by 4.6 times (p = .014), and the systemic immune inflammation index (SII) of non-adherent patients was also significantly higher (p = .042). CONCLUSION: IG presents clinical utility in early identification of non-adherence to HU, especially when combined with other parameters, suggesting the evaluation of ACPs in laboratory routine, as they can be easily implemented.
Subject(s)
Anemia, Sickle Cell , Hydroxyurea , Child , Adult , Adolescent , Humans , Hydroxyurea/therapeutic use , Antisickling Agents/therapeutic use , Cross-Sectional Studies , Anemia, Sickle Cell/diagnosis , Anemia, Sickle Cell/drug therapy , Blood Cell CountABSTRACT
Abstract Rhabdomyolysis is defined as the breakdown of skeletal muscle leading to the release of muscle contents into the extracellular fluid. Patients with rhabdomyolysis can be asymptomatic or have myalgia symptoms, weakness, myoglobinuria with dark urine, significant electrolyte imbalance, and acute kidney injury. Here we describe a case on acute kidney injury associated to rhabdomyolysis in a patient with COVID-19.
Resumo A rabdomiólise é definida como a lise da musculatura esquelética levando à liberação do conteúdo muscular para o fluido extracelular. Pacientes com rabdomiólise podem ser assintomáticos ou apresentar sintomas de mialgia, fraqueza, mioglobinúria com urina escura, desequilíbrio eletrolítico significativo e lesão renal aguda. Aqui descrevemos um caso de lesão renal aguda associada à rabdomiólise em um paciente com COVID-19.
ABSTRACT
Rhabdomyolysis is defined as the breakdown of skeletal muscle leading to the release of muscle contents into the extracellular fluid. Patients with rhabdomyolysis can be asymptomatic or have myalgia symptoms, weakness, myoglobinuria with dark urine, significant electrolyte imbalance, and acute kidney injury. Here we describe a case on acute kidney injury associated to rhabdomyolysis in a patient with COVID-19.
Subject(s)
Acute Kidney Injury , COVID-19 , Myoglobinuria , Rhabdomyolysis , Acute Kidney Injury/complications , COVID-19/complications , Electrolytes , Humans , Myoglobinuria/complications , Myoglobinuria/diagnosis , Rhabdomyolysis/complications , Rhabdomyolysis/diagnosisABSTRACT
Apesar de inicialmente terem surgido como agentes etiológicos de resfriados comuns, os coronavírus se tornaram uma ameaça global no século XXI, provocando síndromes respiratórias com alto poder de transmissão e contribuindo para quadros graves que podem levar à morte. Além dos coronavírus que emergiram no século XXI, quatro outros coronavírus humanos são mundialmente endêmicos e atualmente representam até 30% das infecções do trato respiratório superior em adultos. A pandemia atual de Síndrome Respiratória Aguda Grave causada por SARS-CoV-2, denominada COVID-19, vem aumentando sua casuística de forma importante, causando o colapso dos sistemas de saúde. Além dos danos ao sistema respiratório, a insuficiência renal aguda (IRA) é uma importante complicação da COVID-19, ocorrendo em 0,5%-7% dos casos e em 2,9%-23% dos pacientes em Unidade de Terapia Intensiva (UTI). Até o momento não se conhecem os mecanismos relacionados à etiologia da IRA associada à COVID-19. Nesta revisão são apresentadas algumas informações associadas à COVID-19 como histórico, manifestações clínicas e laboratoriais, à IRA (especialmente em pacientes internados em UTI) e enfatizando as alterações evidenciadas no exame de urina em pacientes com COVID-19.
Although they initially emerged as etiologic agents of common colds, coronaviruses became a global threat in the 21st century, causing respiratory syndromes with high transmission power and contributing to serious conditions that can lead to death. In addition to the coronaviruses that emerged in the 21st century, four other human coronaviruses are globally endemic and currently account for up to 30% of upper respiratory tract infections in adults. The current pandemic of Severe Acute Respiratory Syndrome caused by SARS-CoV-2, called COVID-19, has been increasing its casuistry significantly, and causing the collapse of health systems. In addition to damage to the respiratory system, acute kidney injury (AKI) is an important complication of COVID-19, occurring in 0.5-7% of cases and in 2.9-23% of patients in the Intensive Care Unit (ICU). So far, the mechanisms related to the etiology of AKI associated with COVID-19 are not known. In this review, some information associated with COVID-19 is presented, such as history, clinical and laboratory manifestations, AKI (especially in ICU patients), and emphasizing the changes evidenced in the urine test in patients with COVID-19.
