The Intersection of Human and Veterinary Medicine-A Possible Direction towards the Improvement of Cell Therapy Protocols in the Treatment of Perianal Fistulas.

The effective treatment of perianal fistulizing Crohn's disease is still a challenge. Local administration of mesenchymal stromal cells (MSCs) is becoming a part of accepted treatment options. However, as a fledgling technique, it still can be optimized. A new trend in translational research, which is in line with "One Health" approach, bases on exploiting parallels between naturally occurring diseases affecting humans and companion animals. Canine anal furunculosis (AF) has been indicated as condition analogous to human perianal Crohn's disease (pCD). This narrative review provides the first comprehensive comparative analysis of these two diseases based on the published data. The paper also outlines the molecular mechanisms of action of MSCs which are likely to have a role in modulating the perianal fistula niche in humans, and refers them to the current knowledge on the immunomodulatory properties of canine MSCs. Generally, the pathogenesis of both diseases shares main determinants such as the presence of genetic predispositions, dysregulation of immune response and the relation to intestine microbiota. However, we also identified many aspects which should be further specified, such as determining the frequency of true fistulas formation in AF patients, elucidating the role of TNF and Th17 pathway in the pathogenesis of AF, or clarifying the role of epithelial-to-mesenchymal transition phenomenon in the formation of canine fistulae. Nevertheless, the available data support the hypothesis that the results from testing cell therapies in dogs with anal furunculosis have a significant translational value in optimizing MSC transplants procedures in pCD patients.

Screening of differentially expressed genes in pathological scar tissues using expression microarray.

Pathological scar tissues and normal skin tissues were differentiated by screening for differentially expressed genes in pathologic scar tissues via gene expression microarray. The differentially expressed gene data was analyzed by gene ontology and pathway analyses. There were 5001 up- or down-regulated genes in 2-fold differentially expressed genes, 956 up- or down-regulated genes in 5-fold differentially expressed genes, and 114 up- or down-regulated genes in 20-fold differentially expressed genes. Therefore, significant differences were observed in the gene expression in pathological scar tissues and normal foreskin tissues. The development of pathological scar tissues has been correlated to changes in multiple genes and pathways, which are believed to form a dynamic network connection.

Septic cavernous sinus thrombosis with diffuse spread leading to cerebral ischemia.

INTRODUCTION: Septic cavernous sinus thrombosis (CST) is a rare disease with many etiologies and a diffuse array of initial presentation leading to high mortality. CASE: A 25-year-old male with a history of a nasal furuncle presents with an acute onset of fixed and dilated pupils, bilateral exophthalmos, hemorrhagic chemosis, elevated intraocular pressures, restricted extraocular motility, and unresponsiveness. A retinal septic emboli in the left eye is present on dilated fundoscopic exam while an exudative retinal detachment is present in the right eye. MRI/MRV revealed extensive thrombosis of cavernous sinuses, distal sigmoid dural sinuses, and proximal internal jugular veins with associated cerebral edema and multifocal areas of venous infarction. Blood cultures grew Methicillin-resistant Staphylococcus aureus and the patient suffered multi-system organ failure. Despite treatment with full dose systemic anticoagulation and broad spectrum antibiotics the patient suffered a cardiopulmonary arrest and expired. COMMENT: The acuity of onset coupled with the multiple risk factors for septic cavernous sinus thrombosis in this patient led to a fulminant presentation of this disease and ultimate poor outcome.

Thrombotic thrombocytopenic purpura associated with Staphylococcus aureus endocarditis in a diabetic with furunculosis.

Thrombotic thrombocytopenic purpura (TTP) is an uncommon and potentially fatal syndrome which is due to either congenital or acquired deficiency of the ultra large von Willbrand's factor (ULVWF) cleavage protease. It is characterized by mechanical micro angiopathic hemolytic anemia, and organ dysfunctions.

Bilateral ophthalmic vein thrombosis secondary to nasal furunculosis.

We were presented with a teenage female who developed superior ophthalmic vein thrombosis and cavernous sinus thrombophlebitis after a 1-week history of a single acne-like lesion or furuncle at the anterior tip of the nose. She was managed aggressively with heparin and intravenous antibiotic. Signs and symptoms improved after 2 weeks of treatment, and she was discharged with an anticoagulant.

Eruptive furunculosis following the soak and smear regimen.

The 'soak and smear' regimen is a highly effective method for localised topical therapy employed by dermatologists for widespread inflammatory skin conditions. The regimen involves application of topical medication under occlusion after soaking in water. Complications from this treatment method are rare. We present a case of multiple, generalised methicillin-resistant Staphylococcus aureus (MRSA)-positive furuncles arising in a patient as an unexpected consequence of therapy. The case highlights an unanticipated risk of a commonly employed treatment amid an epidemic of MRSA in the community.

Furunculosis in a high school football team.

An outbreak of Staphylococcus aureus furuncles (boils) occurred among 26 members of a central Illinois high school football team. A total of 55 boils were reported with a diameter of induration ranging from 0.25 to 6 inches (mean = 1.25 inches). Eighty-nine percent of the boils were located on the extremities, and 70% were known to have developed following a bruise or break in the skin. The development of boils was associated with prior bruises and open wounds. Use of skin lubricant, elbow and forearm pads, whirlpool bath, and athletic tape were also associated with the development of boils, but were not judged to be causal. Rather, these factors most likely reflected attempts to protect areas of compromised skin which were at high risk of developing boils. Lack of hot water and soap for showering may have facilitated the occurrence of the outbreak by discouraging players from showering. Other variables examined, but excluded as important factors, were the sharing of football pads, the sharing of towels, the laundering of athletic clothes, and the position played on the football team.

Metastatic staphylococcal lung abscess due to a cutaneous furuncle.

A seemingly trivial infection of the skin can lead to fulminant staphylococcal pneumonia and death. This case history describes the evolution of a fatal Staphylococcus aureus sepsis complicated by the development of multiple lung abscesses in a 17-year-old patient. A pre-existing cutaneous furuncle was the only identifiable cause. Early bacteraemic symptoms are described. Multiple cavitory lesions could be seen on a CAT-scan. The authors would like to stress the importance of early and adequate antibiotic treatment.

Multiple bilateral orbital abscesses secondary to nasal furunculosis.

Orbital inflammation secondary to sinus inflammation is a well known entity and has been widely reported. However, nasal furunculosis resulting in orbital inflammation is a rare occurrence. We present a case of a 2-year-old boy who developed multiple bilateral orbital abscesses secondary to nasal furunculosis. To our knowledge such a case has not been reported before.

Association between anal furunculosis and colitis in the dog: preliminary observations.

Treatment of anal furunculosis in dogs is often unsatisfactory and may be associated with significant recurrence and complications. This may be compounded by the simultaneous presence of colitis in affected animals. Clinical signs associated with colitis and anal furunculosis may be similar, including faecal tenesmus, dyschezia and haematochezia. To examine the incidence of concurrent anal furunculosis and colitis, colonic biopsies were collected from 18 dogs referred for treatment of anal furunculosis. Nine dogs (50 per cent) had a histopathological diagnosis of colitis. Clinical signs more indicative of colitis than anal furunculosis (increased frequency of defecation, mucus in faeces and diarrhoea) were not observed more frequently in dogs with confirmed colitis compared with those with furunculosis alone. Therefore, while an association between colitis and anal furunculosis may exist, clinical signs alone cannot be used as an indicator of the presence of colitis in cases of anal furunculosis. The authors recommend that colonic biopsies should be undertaken in all dogs presented with anal furunculosis. Whether specific treatment of colitis in dogs with histopathological evidence of colitis improves the outcome of treatment for anal furunculosis awaits further study.

[Staphylococcus aureus septicemia producing Panton-Valentine leukocidin. 3 cases]. / Septicémies a Staphylococcus aureus producteurs de leucocidine de Panton-Valentine.

BACKGROUND: A strong association has been observed between furuncles and Panton-Valentine leukocidin-producing Staphylococcus aureus. CASE REPORTS: Within one year, we cared for three men at the Cayenne hospital who had Staphylococcus aureus septicemia with severe pleuropulmonary involvement originating from furuncular lesions. The Staphylococcus aureus strains isolated from the skin lesions and from blood cultures produced Panton-Valentine leukocidin. CONCLUSION: These cases demonstrate the gravity of S. aureus septicemia in young patients with furunculosis. These cases are the first reported with severe S. aureus infections associated with Panton-Valentine leukocidin producing strains.

[Clinical trial of domestic drug polyoxidonium in secondary immunodeficiency]. / Klinincheskoe primenenie otechestvennogo preparata polioksidoniia pri vtorichnykh immunodefitsitakh vzroslykh.

AIM: To test clinical efficiency and immunocorrectives characteristics of polyoxidonium in patients with chronic bronchitis (CB) and chronic recurrent furunculosis. MATERIALS AND METHODS: 56 patients entered the trial; 13 with CB in remission, 22 with CB in exacerbation and 21 with chronic recurrent furunculosis. Clinical examinations and tests were made before polyoxidonium therapy and 2-3 days after it. Immunological tests consisted of determination of sub-population composition of peripheral blood lymphocytes, serum immunoglobulins and phagocytic activity of neutrophils. RESULTS: Polyoxidonium is an effective and safe immunocorrector. It has a strong influence on functional activity of blood phagocytic cells. CONCLUSION: Polyoxidonium treatment of CB and chronic recurrent furunculosis results in positive shifts in hematological and immunological indices. This allows to recommend it for treatment of acute and chronic infections.

[Septic metastatic staphylococcal destruction of the lungs in adults]. / Septicheskaia metastaticheskaia stafilokokkovaia destruktsiia legkikh u vzroslykh.

The author analyzes results of diagnostics and treatment of 152 patients with septic metastatic staphylococcal destruction of the lungs. Specific features of the clinical course of the disease are described. Under consideration are questions of the complex pathogenetic treatment of this group of patients by means of using antibiotic and immune therapy, fat emulsions (lipofundin), exchange plasmapheresis, ultraviolet irradiation of blood etc.

[Thromboelastography of blood coagulation in patients with complicated nasal furunculosis]. / Tromboélastograficheskii kontrol koaguliatsionnykh svoistv krovi u bolnykh s oslozhnennym furunkulom nosa.

The study of blood coagulation in 50 patients with complicated nasal furuncle using thromboelastogram indicated that such patients have hypercoagulation correctable by intravascular laser radiation. Thromboelastography proved a reliable objective technique in evaluation of blood coagulation this promoting a valid choice of therapeutic policy in complicated nasal furunculi.

[Metastatic lung abscesses]. / Metastaticheskie abstsessy legkikh.

The metastatic origin of abscesses was established in 10 of 142 patients (7%) with acute pulmonary abscesses. The disease was observed to be of severe course, being accompanied by pleural and other complications in all the cases. Thirteen distinctive signs of metastatic abscesses were revealed which determine the curative methods. The main problem in the treatment of such patients is struggle against sepsis, correction of immune processes in the organism, sanitation of the abscess cavity through the tracheobronchial tree and liquidation of pleural complications.

[Secondary abscessing pneumonia in children]. / Vtorichnaia abstsediruiushchaia pnevmoniia u detei

Among 370 patients with staphylococcic abscessing pneumonia in 55 secondary pulmonary involvement (14.8%) was noted. Acute hematogenic osteomyelitis was the most frequent cause of sepsis. The treatment of patients with secondary staphylociccic abscessing pneumonia is described. The mortality was 40 per cent.

[Changes in the T-cell component in patients with subleukemic myelosis at various stages of the pathologic process]. / Izmeneniia T-kletochnogo zvena immuniteta u bol'nykh subleikemicheskim mielozom na razlichnykh stadiiakh patologicheskogo protsessa.

T-cell immunity was assessed in 111 patients with subleukemic myelosis. In such patients with large tumor mass and leukemia exacerbation the amount of immunocompetent cells and their functional activity were reduced more prominently. Association of infection and inflammation promoted aggravation of initial immune deficiency.

[Clinical picture and complex treatment of septic thromboses of the cavernous sinuses]. / Nekotorye voprosy kliniki i kompleksnogo lecheniia septicheskikh trombozov kavernoznykh sinusov.

Under analysis are etiology, clinical picture and diagnosis of a septic thrombosis of cavernous sinuses in 28 patients. The authors have shown the interrelationship between local manifestations of the disease, injuries of the brain and its sheaths and septic complications (abscessing pneumonia as the most severe of them). A scheme of the complex treatment of patients with thrombosis of the cavernous sinus is proposed. The leading role in this treatment is played by intracarotid infusion of antibiotics in combination with anticoagulant drugs, vasodilatatory agents and novocaine as well as the therapy of septic complications (abscesses of the face and hairy part of the head, meningoencephalitis, pneumonia).