Limy bile syndrome in a dog.

A 11-year-old spayed female golden retriever was examined because of lethargy, anorexia, vomiting and abdominal pain. Plain abdominal radiography showed a uniform radiopacity of the gallbladder. Ultrasonography demonstrated hyperechoic material in the gallbladder lumen associated with an acoustic shadow and findings consistent with acute pancreatitis. Fine-needle aspiration of the bile revealed bacterial cholecystitis. Following cholecystectomy, it was apparent that the gallbladder was filled with a semi-solid, pasty-like greenish-brown material composed of 80% calcium carbonate, consistent with a diagnosis of 'limy bile'. After surgery and medical treatment, the dog's condition improved. Two months after discharge, the dog had fully recovered a good appetite and no relapse has been observed after 11 months of follow-up. To our knowledge, this is the first report of limy bile syndrome in a dog.

Normal canine prostate gland: repeatability, reproducibility, observer-dependent variability of ultrasonographic measurements of the prostate in healthy intact beagles.

Most prostatic diseases in dogs are associated with prostatomegaly, and transabdominal ultrasonography has become the imaging modality of choice for evaluation of the prostate gland in the dog. The aim of the present study was to assess the reproducibility, the repeatability and interobserver variations of sonographic measurements of prostate and to determine which measurement had the lowest variability. Length and height of prostate gland were measured on longitudinal views, width of the prostate gland and height of left and right lobes of the gland on transversal views. The within-day and between-day variabilities of the prostatic parameters were determined by performing 1350 (270 length, 270 height, 270 width, 270 height of right lobe and 270 height of left lobe) examinations on ten healthy intact beagle dogs on six different days, in a two-week period (three days for the five dogs, three different days for the five others). Three observers with different levels of experience in ultrasonography performed the examinations. The lowest within-day and between-day standard deviation and coefficient of variation values were observed for the width of the prostate. The width of the gland measured on transverse frozen images seems to be the most reliable measurement for evaluating size of prostate glands in healthy dogs, although the shape, position, outline, and echogenicity of the prostate should also be assessed.

Normal feline brain: clinical anatomy using magnetic resonance imaging.

The purpose of this study was to provide a clinical anatomy atlas of the feline brain using magnetic resonance imaging (MRI). Brains of twelve normal cats were imaged using a 1.5 T magnetic resonance unit and an inversion/recovery sequence (T1). Fourteen relevant MRI sections were chosen in transverse, dorsal, median and sagittal planes. Anatomic structures were identified and labelled using anatomical texts and Nomina Anatomica Veterinaria, sectioned specimen heads, and previously published articles. The MRI sections were stained according to the major embryological and anatomical subdivisions of the brain. The relevant anatomical structures seen on MRI will assist clinicians to better understand MR images and to relate this neuro-anatomy to clinical signs.

Renal resistive index in 55 dogs with degenerative mitral valve disease.

BACKGROUND: Azotemia occurs frequently in dogs with degenerative mitral valve disease (DMVD). It could indicate changes in renal hemodynamics. HYPOTHESIS/OBJECTIVES: To assess the renal resistive index (RI) in dogs with DMVD, and the statistical link between heart failure class, azotemia, echo-Doppler parameters, several plasma variables, and RI. ANIMALS: Fifty-five dogs with naturally occurring DVMD were used (ISACHC class 1 [n = 28], 2 [n = 19], and 3 [n = 8]). METHODS: Observational, blinded study, performed under standardized conditions. Physical examination, renal ultrasonography, and echo-Doppler examinations were performed in awake dogs. The RI of the renal, interlobar, and arcuate arteries were measured. Plasma creatinine, urea, and N-terminal pro-B-type natriuretic peptide concentrations (NT-proBNP) were determined. Statistical links between variables and RI were tested by means of a general linear model. RESULTS: Although the RI of renal and arcuate arteries were unaffected by ISACHC class, the left interlobar RI increased (P < .001) from 0.62 ± 0.05 (mean ± SD) in class 1 to 0.76 ± 0.08 in class 3. It was also higher (P < .001) in azotemic (0.74 ± 0.08) than in non-azotemic (0.62 ± 0.05) dogs. Similar findings were observed for right interlobar RI. Univariate analysis showed a positive statistical link between NT-proBNP (P = .002), urea (P < .001), creatinine (P = .002), urea-to-creatinine ratio (P < .001), left atrium-to-aorta ratio (P < .001), regurgitation fraction (P < .001), systolic pulmonary arterial pressure (P < .001), shortening fraction (P = .035), and RI. CONCLUSION AND CLINICAL IMPORTANCE: In dogs with DMVD, interlobar RI increases with heart failure severity and azotemia but a cause and effect relationship remains to be established.

Non-infectious pulmonary complications of myelodysplastic syndromes and chronic myeloproliferative disorders.

INTRODUCTION: Non-infectious pulmonary complications of myelodysplastic syndromes and chronic myeloproliferative disorders are not rare but remain little known to respiratory physicians who may be confronted with various clinical pictures corresponding to different pathophysiological causes. BACKGROUND: The few data in the literature only relate to isolated cases or small series. The non-infectious pulmonary complications of myelodysplastic syndromes and chronic myeloproliferative disorders can be classified into several clinical entities: tumour syndrome, pulmonary fibrosis or diffuse infiltrating pneumonia, autoimmune reactions including vasculitis, Sweet syndrome, organizing pneumonia, pulmonary alveolar proteinosis, pleural effusion and pulmonary arterial hypertension. The diagnosis is provided by the histology and management of these complications depends on the underlying pathology. VIEWPOINTS AND CONCLUSION: Myelodysplastic syndromes and myeloproliferative disorders are entities which are becoming better characterized and understood. Better knowledge of the pathophysiological mechanisms involved in these complications should improve their diagnosis and their management, which still remains complex.

Ultrasonographic evaluation of the adrenal glands in healthy dogs: repeatability, reproducibility, observer-dependent variability, and the effect of bodyweight, age and sex.

Adrenal length and width were determined from two-dimensional ultrasound longitudinal images. In study 1, 540 measurements of adrenal glands were attempted from five healthy beagle dogs by three different observers with different levels of expertise in ultrasonography, to determine the variability of adrenal gland measurements. Of these, 484 measurements were included in the statistical analysis, since 16 measurements of the left adrenal gland and 40 for the right could not be visualised by the observer. In study 2, a single measurement of both adrenal glands was taken from each of 146 dogs by the most trained observer from study 1, and the effects of different health status (healthy dogs v dogs with non-adrenal diseases), bodyweight, age and sex were assessed. A total of 267 measurements were included in the statistical analysis. The lowest intra- and inter-day coefficient of variation values were observed for the left adrenal gland and by the most trained observer. The health status had no statistically significant effect on adrenal gland length or width, whereas age had a significant effect only for the left adrenal gland (the greater the age, the greater the width or length) and sex had a significant effect only for the right adrenal gland (the width was larger in males and the length larger in females). The bodyweight had a significant effect for the length of both adrenal glands (the greater the bodyweight, the greater the length), but not the width. The differences between sd and coefficient of variation values for the width of the left adrenal gland were not statistically significant between the three observers, whereas they were statistically significant for the right adrenal gland.

[Intrahospital mortality during acute exacerbations of COPD. Study EABPCO-CPHG of the College of the Lung specialists of General hospitals (CPHG)]. / Mortalité intrahospitalière au cours des exacerbations aiguës de BPCO. Etude EABPCO-CPHG du Collège des pneumologues des hôpitaux généraux (CPHG).

INTRODUCTION: The objective of the present study was to determine the in-hospital mortality rate in the EAPCO-CPHG cohort and to identify risk factors. METHODS: All patients with COPD acute exacerbation admitted to the pneumology department of 68 French general hospitals between October 2006 and June 2007 were included in the EABPCO-CPHG cohort. RESULTS: At discharge, vital status was known for 1817 patients. Forty-five patients died during their hospital stay, i.e., an in-hospital mortality rate of 2.5%. Mutivariate analysis identified age (OR=1.07 [1.03-1.11]), grade greater than 2 dyspnea in stable state (OR=3.77 [1.68-8.57]), and number of clinical signs of severity during the acute exacerbation (OR=1.36 [1.11-1.55]) as independent risk factors for in-hospital mortality. CONCLUSIONS: In-hospital mortality in patients admitted to a pneumology department of a general hospital is quite low. Simple clinical criteria allow easy identification of at-risk patients and should enable management to be improved.

[Non-infectious pulmonary complications of myelodysplastic syndromes and chronic myeloproliferative disorders]. / Complications pulmonaires non infectieuses des maladies myéloprolifératives et des syndromes myélodysplasiques.

Introduction Non-infectious pulmonary complications of myelodysplasic syndromes and chronic myeloproliferative disorders are not rare but remain little known to the respiratory physician. He may be confronted with various clinical pictures corresponding to different pathophysiological causes. Background There are few data in the literature relating only to isolated cases or small series. The non infectious pulmonary complications of myelodysplasic syndromes and chronic myeloproliferative disorders can be classified into several clinical entities: tumoural syndrome, pulmonary fibrosis or diffuse infiltration, auto-immune reactions including vasculitis, Sweet's syndrome, organizing pneumonia, pulmonary alveolar proteinosis..., pleural effusion and pulmonary arterial hypertension. The diagnosis is provided by the histology and the management depends on the underlying pathology. Viewpoints and conclusion Myelodysplasic syndromes and myeloproliferative disorders are entities which are becoming better characterized and understood. Better knowledge of the pathophysiological mechanisms involved in these complications should improve their diagnosis and their management which still remains complex.

[Obstructive sleep apnoea syndrome (OSAS) in women: a specific entity?]. / Pathologie pulmonaire au féminin: le SAOS de la femme, une entité particulière?

Despite a variable prevalence in the literature, OSAS is characterized by a higher frequency in men. This study involved a review of published data describing the impact of gender on features of OSAS. In women, OSAS seems to be associated with certain anatomical factors such as more significant obesity, a thinner oropharyngeal junction, a shorter uvula and reduced upper airway (UA) collapsibility, in comparison with men. Sleep related breathing disorders observed during pregnancy are more likely UA resistance syndrome than true OSAS, and are associated with severe fetal and maternal complications that could be improved by the use of nasal CPAP. Though OSAS symptoms are underestimated by women, the Epworth score as well as snoring are not influenced by gender. Gender does not seem to be a risk factor for increased mortality. Compliance with nasal CPAP is identical in both sexes, but oral appliance seem to be more effective in women. Further studies are needed to produce the required complementary data to confirm specific sex-related features in the diagnosis and treatment of OSAS.

[Pneumonitis caused by hydrocarbon inhalation]. / Pneumopathies par inhalation d'hydrocarbures volatiles.

INTRODUCTION: Kerosene pneumonitis is rare. It most commonly occurs in children who have ingested a hydrocarbon by accident. In adults, pneumonitis caused by aspiration of incompletely vaporized kerosene may be seen in fire-eaters can cause pneumonitis. CASE REPORTS: We report six cases of fire-eater's pneumonitis, from our region, due to hydrocarbon inhalation. CONCLUSIONS: This inhalational pulmonary insult has classical clinical manifestations. The frequency of cases, particularly in tourist areas that host street festivals, is probably underestimated. Its tendency to spontaneously resolve questions the need for antibiotics and corticosteroids.

[Pulmonary cavitated opacity in immunocompromised patient]. / Opacité pulmonaire excavée chez un patient immunodéprimé.

Lung abscesses are uncommon in legionellosis and usually are observed in immunocompromised patients. The radiographic presentation may lead to misdiagnosis and subsequently to increased mortality.

[Early tubular involvements in lead poisoning in children]. / Atteinte tubulaire précoce dans l'intoxication par le plomb chez l'enfant.

One of the main targets of lead poisoning is the kidney. Chronic poisoning can lead to kidney failure, and acute poisoning to tubulopathy with Toni-Debré-Fanconi syndrome. The primum movens of this tubulopathy is a distortion of mitochondrial energetic metabolism. We studied 27 children presenting with non symptomatic poisoning. Serum creatinine levels were normal. There was neither proteinuria nor glycosuria and only one child presented with hyperaminoaciduria. One third already presented with signs of tubulopathy, as shown by an increase in beta 2 microglobinuria in 36.5% of the cases studied (8 times in 22 samples) and enzymuria in 30.4% of the cases (23.5% if one excludes the children having had a chelation before the study). Kidney is therefore involved early in lead poisoning in children.

[Lead poisoning in children. Apropos of 129 cases]. / Saturnisme de l'enfant. A propos de 129 cas.

One hundred and twenty nine children with chronic lead poisoning were followed from August 1985 to July 1989. Old lead paint was recognized as the contaminant source at home. Pica of paint flakes was the main mode of intoxication. Children were classified according to the Center for Disease Control 1985 as follows: class IV (39 cases), class III (45 cases), class II (30 cases), class I (15 cases). Nineteen of those in class IV had blood lead levels above 700 micrograms/l and received BAL + EDTA followed by EDTA alone for a mean of 4.6 +/- 3.5 courses. With this treatment, blood lead level decreases were 50 +/- 17%. Nine of these class IV children had an evaluation at last 3 months after the last chelation course: 5 became class I or II, and 2 class III with a negative provocative test. The remaining 20 children in class IV were given a mean of 2.7 +/- 1.4 courses of EDTA. Blood lead levels decreased by 52 +/- 15%; 11 children were evaluable at least 3 months after the last chelation course: 4 became class I, and 7 class II. Thus overall 80% of class IV moved under treatment to class I or II. Among those 45 children in class II, 30 underwent a provocative test and 24 one to three courses of EDTA: 8 were further studied: 3 became class I and 5 class II. Combination of screening, medical treatment and sociocultural approach led to avoid acute effects of severe chronic childhood lead poisoning. The efficacy of such an approach in preventing chronic effects has still to be evaluated.

[Mucormycosis and diabetes in acute leukemia]. / Mucormycose et diabète au cours d'une leucémie aiguë.

The authors report the case of 5 1/2 year-old boy with insulin-dependent diabetes mellitus revealed during the induction therapy of an acute leukemia of the mixed type, and who presented with an unusual type of pulmonary fungal infection: mucormycosis. It had a favourable outcome with surgical excision preceded and followed by amphotericin B treatment.

[Bronchiolitis obliterans: technics of exploration and diagnosis]. / La bronchiolite oblitérante: moyens d'exploration et de diagnostic.

Bronchiolitis obliterans is an anatomo-clinical entity which may, in young pediatric patients, follow severe viral infections, especially due to measles virus and adenoviruses. After a transient remission, the disease progresses to chronic respiratory failure with dyspneic paroxysms. Diagnosis is based on different investigations which confirm the absence of proximal bronchiolar obstruction and the presence of bronchiolar obliteration. Deficient pulmonary perfusion due to ventilatory defects are demonstrated by pulmonary scintigraphy and even better by digital subtraction pulmonary angiography. Obliteration of non-cartilaginous bronchioli by granulation tissue produces bronchiolar destruction and explains the permenence of alterations. Dissimilarity of the responses of children to acute respiratory viral infection remains unexplained. The degree of the viral load and of the initial immune deficiency as well as the persistence of the virus within the pulmonary tissue probably account for the chronic pulmonary damage.