scholarly journals Refractory feline sporotrichosis: a comparative analysis on the clinical, histopathological, and cytopathological aspects

2022 ◽  
Vol 42 ◽  
Author(s):  
Francine S. Silva ◽  
Simone C.S. Cunha ◽  
Vanessa A. Moraes ◽  
Juliana S. Leite ◽  
Ana M.R. Ferreira
Keyword(s):  
General Condition ◽  
Moderate Intensity ◽  
Clinical Aspects ◽  
Fungal Culture ◽  
Poor General Condition ◽  
Cutaneous Lesions ◽  
Good General Condition ◽  
Cutaneous Form ◽  
Itraconazole Treatment

ABSTRACT: Sporotrichosis is a chronic fungal infection caused by Sporothrix species. The occurrence of cases that are resistant to long-term treatment, especially in the nasal planum of cats, emphasizes the importance of studying its pathogenesis. The purpose of this study was to analyze and compare the inflammatory process of cutaneous lesions of feline refractory sporotrichosis to clinical aspects through cytopathological and histopathological examination. Moreover, the study included 13 cats with cutaneous lesions that had been resistant to itraconazole treatment for more than a year. Cutaneous lesions samples were collected for cytopathological, histopathological, and fungal culture analyses. Tissue fragments were processed and stained with hematoxylin-eosin (HE) and Grocott methenamine silver (GMS). Further, two clinical presentations had the highest occurrence: the localized cutaneous form in animals with good general condition and stable disease (n=9, 69.2%) and the disseminated cutaneous form in cats with poor general condition (n=4, 30.8%). In cats with refractory sporotrichosis, the nasal planum (84.6%) was the most common location of lesions. In the cytopathological study, cats with fewer than two lesions and in good general condition (n=9, 69.2%) showed absence or mild yeast intensity (up to 5 yeasts per field), lower intensity of macrophages and neutrophils, and higher intensity of epithelioid cells, lymphocytes, plasma cells, and eosinophils. On the other hand, (n=4, 30.8%) of the cats with disseminated sporotrichosis and a poor general condition had a marked intensity of yeasts, which were mostly phagocytosed by an increased number of macrophages and neutrophils. Of those animals with good general condition, the majority (n=6, 66.7%) had higher eosinophil intensity. In histopathology, malformed suppurative granuloma was the predominant type (n=9, 69.2%) in feline sporotrichosis lesions, followed by well-formed granulomas (n=4, 30.8%). Malformed granulomas showed mild to moderate fungal intensity (55.6%) in animals with good general condition and localized lesions while marked fungal intensity (44.4%) in cats with the disseminated form of the disease and poor general condition. Well-formed granulomas (n=4, 30.7%) had mild to moderate intensity of fungal load, and 75% of the animals with this type of granuloma had only one lesion and were in good general condition. Long-term itraconazole treatment in these cats with refractory sporotrichosis can keep the infection under control and localized lesions stable; however, fungus reactivation can occur, resulting in an exuberant and inefficient immune response.

scholarly journals Temporary above-knee prostheses and training programme during chemotherapy

1985 ◽  
Vol 9 (2) ◽  
pp. 87-91 ◽  
Author(s):  
J. Kawamura ◽  
Y. Hayashi ◽  
T. Yoneda ◽  
K. Minamihara ◽  
H. Tanaka ◽  
...  
Keyword(s):  
Mental State ◽  
General Condition ◽  
Training Programme ◽  
Knee Prostheses ◽  
Poor General Condition ◽  
And Training

A temporary prosthesis has been developed for above-knee amputees who receive long-term post-amputation chemotherapy. The temporary prosthesis has an adjustable laminated quadrilateral socket, the size of which is adjusted by metal screws. Fifteen patients were fitted with the temporary prosthesis. Initial fittings were carried out after a period averaging 46 days from amputation. All of the patients were able to walk with one crutch after about one month from initial fitting. Although patients often had to discontinue their prosthetic training owing to chemotherapy, they could resume wearing their prostheses simply by adjusting the socket. One patient, who was fitted with a cosmetic ultra-light prosthesis initially due to her poor general condition, was later fitted with the temporary prosthesis. She regained the ability to walk 60 days later and still wears it. Early fitting of temporary prostheses for these patients is not only of practical convenience but also improves their mental state.

Chronic Laryngotracheal Granulomatous Disease Secondary to Sporothrix schenckii in an Immunocompromised Patient

2022 ◽  
pp. 000348942110730
Author(s):  
Hannah Kenny ◽  
Michael Dougherty ◽  
Ian Churnin ◽  
Stephen Early ◽  
Akriti Gupta ◽  
...  
Keyword(s):  
Immunocompromised Patient ◽  
Sporothrix Schenckii ◽  
Fungal Culture ◽  
Granulomatous Disease ◽  
Rare Presentation ◽  
Tissue Samples ◽  
History Of ◽  
Itraconazole Treatment ◽  
Inflammatory Changes

Objective: To describe a rare presentation of laryngotracheal granulomatous disease secondary to sporotrichosis. Methods: The authors report a case of laryngeal sporotrichosis in an immunocompromised patient, with accompanying endoscopic images and pathology. Results/case: A 72-year-old immunocompromised female with a history of rose-handling presented with a year of hoarseness and breathy voice. Flexible nasolaryngoscopy showed diffuse nodularity; biopsy of the lesions demonstrated granulomatous inflammatory changes, and fungal culture grew Sporothrix schenkii. Long-term itraconazole treatment was initiated, with improvement in dysphonia and few residual granulomas on follow-up examination. Conclusion: When evaluating granulomatous disease of the airway, a broad differential including infectious or inflammatory etiologies should be considered, especially in immunocompromised patients. Adequate tissue samples should be collected to facilitate special staining. The current recommendations for laryngeal sporotrichosis include treatment with a prolonged course of itraconazole.

The Role of Arthroscopy in the Treatment of Gouty Arthritis of the Knee Case presentation

2018 ◽  
Vol 69 (8) ◽  
pp. 2236-2239
Author(s):  
Marius Moga ◽  
Mark Edward Pogarasteanu ◽  
Dumitru Ferechide ◽  
Antoine Edu ◽  
Chen Feng Ifrim
Keyword(s):  
Gouty Arthritis ◽  
Surgical Techniques ◽  
Term Treatment ◽  
Clinical Aspects ◽  
Associated Lesions ◽  
Number Of Patients ◽  
Long Term Treatment ◽  
Functional Scores ◽  
Urate Crystals

Gout is a metabolic disease involving the impregnation of joints and other tissues with urate crystals. The onset is often brutal, and it manifests itself with pain and inflammation in the affected joint. The treatment usually involves rest, ice, NSAIDs and anti-gout medication. The long-term treatment involves medication and dietary changes. In the joint, urate crystals are deposited in the synovial, in the cartilage and in the menisci. In the arthroscopic practice, the gouty knee is a rare occurrence. We present a relevant case, that of a 57 years old patient without a prior gout diagnosis where we found urate crystal deposits covering the synovium, cartilage and meniscus, and we discuss the current and recent year Pub Med indexed literature in order to evaluate the possibilities for arthroscopic treatment of this pathology. We looked at the number of patients involved, their characteristics, and the surgical techniques used. We also looked at the temporal relation of the arthroscopic intervention to the recent gout attacks, and at the described lesions that were found. Also, we evaluated the papers for joint liquid analysis, gout drug treatment, and description of clinical aspects involved and associated lesions. Finally, we looked at the follow-up, at the functional scores used to monitor the patient�s evolution, at the associated medication and at the long-term outcomes, if described. We have found opinions to vary. In the end, we draw conclusions pertaining to the practical short-term and long-term use of knee arthroscopy in the treatment of gout.

Long-Term Follow-Up of Patients with Sick Sinus Syndrome: A Comparison of Clinical Aspects Among Unpaced, Ventricular Inhibited Paced, and Physiologically Paced Groups

1988 ◽  
Vol 11 (11) ◽  
pp. 1575-1583 ◽  
Author(s):  
YASUYUKI SASAKI ◽  
MASAHIRO SHIMOTORI ◽  
KUNIO AKAHANE ◽  
HIROAKI YONEKURA ◽  
KEN HIRANO ◽  
...  
Keyword(s):  
Sick Sinus Syndrome ◽  
Clinical Aspects ◽  
Long Term Follow Up

scholarly journals Miltefosine Administration in Cats with Refractory Sporotrichosis

2018 ◽  
Vol 46 (1) ◽  
pp. 7
Author(s):  
Francina Dos Santos Silva ◽  
Simone Carvalho dos Santos Cunha ◽  
Andrea Regina de Souza Baptista ◽  
Vivian Dos Santos Baptista ◽  
Kássia Valéria Gomes Coelho da Silva ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sporothrix Schenckii ◽  
Clinical Signs ◽  
Public Health Problem ◽  
Parasite Load ◽  
Small Population ◽  
Fungal Culture ◽  
Cutaneous Lesions

Background: Sporotrichosis is a zoonosis caused by fungi of the Sporothrix schenckii complex. Cats have important zoonotic potential due to the high parasite load found in the cutaneous lesions. Refractory cases to antifungal therapy are increasing, becoming a public health problem. Miltefosine is a drug with high in vitro activity against Sporothrix brasiliensis. However, this efficacy has not been confirmed in vivo yet and administration has not been studied in the feline species. This study aimed to evaluate the effectiveness and safety of miltefosine administration in cats with resistant sporotrichosis.Materials, Methods & Results: Ten cats with refractory sporotrichosis were included in this study. Inclusion criteria were previous diagnosis for sporotrichosis associated with therapy with oral antifungals (itraconazole and/or potassium iodide) for more than one year, followed by one of these conditions: incomplete clinical remission, worsening of disease during treatment or recurrence after conventional treatment. Cats underwent clinical and dermatological examinations. Data on lifestyle and previous treatments were provided by the owners. Fungal culture and histochemical techniques were performed in all cats before miltefosine treatment. Blood samples were collected before and during the study for laboratory tests, such as blood count, blood urea nitrogen (BUN), serum creatinine, alanine aminotransferase (ALT) and alkaline phosphatase, as well as serology for Feline Immunodeficiency (FIV) and Feline Leukemia (FeLV). Miltefosine was prescribed at a dosage of 2 mg/kg orally every 24 h. The animals were monitored by phone during the whole process and reassessed on days 0, 15, 30 and 45 of the treatment. Out of 10 cats, lesions were present on the nose in nine, ears in four, periocular areas in one and limbs in four. One cat received treatment for 45 days, six for 30 days, one for 21 days, one for 15 days and one for 3 days. One cat showed no response to the treatment and nine showed disease progression. Hyporexia and weight loss were the most frequent clinical signs related to miltefosine treatment, followed by sialorrhea, vomiting and diarrhea. Few adverse effects on hematology and biochemistry (mainly renal and hepatic parameters) were observed during the study. Hematocrit decrease was observed in four animals. However, only one cat had hematocrit decrease below normal values (anemia), which was already present before miltefosine administration. Other cats had a decrease of five points. Three cats showed elevation in leucometria and four in plasma protein. In relation to renal and hepatic biochemistry, one animal showed a BUN increase and another one showed a transient increase in ALT. Two animals started the treatment with increased ALT but had no problems during the study and values decreased even during the miltefosine administration.Discussion: Although two cats showed sialorrhea, most owners did not report difficulty in administering the drug orally, representing an advantage of this medication. Weight loss, secondary to gastrointestinal changes, was the most clinically relevant alteration. The most frequent hematological alteration was hematocrit decrease and only the animal that started the study with 20% hematocrit ended the study with anemia. Renal and hepatic parameters were not significant in the cats of this study. Miltefosine did not lead to sporotrichosis remission in this small population of cats, which reveals that, despite its in vitro efficacy against Sporothrix spp., the drug is not effective in vivo in the feline species. Further studies are needed to investigate the efficacy of this drug in a larger number of cats, and possible reasons for its in vivo ineffectiveness.

scholarly journals Microsurgical DREZ lesions for the control of cancer-related pain

2020 ◽  
Vol 3 (2) ◽  
pp. V14 ◽  
Author(s):  
Edoardo Mazzucchi ◽  
Andrei Brinzeu ◽  
Patrick Mertens ◽  
Marc Sindou
Keyword(s):  
General Condition ◽  
Dorsal Root ◽  
Lateral Part ◽  
Entry Zone ◽  
Dorsal Root Entry Zone ◽  
Patients With Cancer ◽  
Root Entry Zone ◽  
Refractory Pain ◽  
Pain Pathways ◽  
Good General Condition

Pain in patients with cancer is a major problem, and sometimes it is necessary to surgically interrupt pain pathways to effectively control refractory pain. Surgical lesion of the dorsal root entry zone (DREZ) was first performed in 1972 for the treatment of pain related to a Pancoast-Tobias tumor. The rationale of DREZotomy is to preferentially interrupt the nociceptive inputs in the lateral part of the DREZ and the ventrolateral (excitatory) part of the dorsal horn. Microsurgical DREZotomy is one technique for DREZ lesioning that is suited for tailored control of pain in patients in good general condition who are experiencing pain in a well-defined territory.The video can be found here: https://youtu.be/JtLQDP7gYSQ

Benign Paroxysmal Vertigo of Childhood: A Long-Term Follow-Up

Cephalalgia ◽  
1994 ◽  
Vol 14 (6) ◽  
pp. 458-460 ◽  
Author(s):  
G Lanzi ◽  
U Balottin ◽  
E Fazzi ◽  
M Tagliasacchi ◽  
M Manfrin ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Age Of Onset ◽  
Clinical Aspects ◽  
Migrainous Vertigo ◽  
Long Term Follow Up

We examined clinical aspects of Benign Paroxysmal Vertigo (BPV) in infancy and its most frequent differential diagnosis, in particular analogies and differences with forms of “migrainous vertigo” (MV) of later onset. During a long-term follow-up of 7 cases of BPV, diagnosed according to the Basser criteria, 5 of 7 BPV cases spontaneously resolved and 6 of 7 patients later developed migraine and other migraine-related symptoms. This course differs from that described for MV only in the age of onset of headache and in the chronological relationship with vertigo. The authors suggest that BPV can be interpreted as a migraine precursor and MV as a migraine equivalent.

Exercise decreases aberrant corticostriatal plasticity in an animal model of L-DOPA-induced dyskinesia

2021 ◽  
Author(s):  
Ana E. Speck ◽  
Aderbal S. Aguiar ◽  
Samira G. Ferreira ◽  
Henrique B. Silva ◽  
Angelo R. Tomé ◽  
...  
Keyword(s):  
Animal Model ◽  
Physical Exercise ◽  
Long Term Potentiation ◽  
Moderate Intensity ◽  
Murine Models ◽  
Long Term Depression ◽  
Term Potentiation ◽  
Corticostriatal Plasticity ◽  
6 Hydroxydopamine

Physical exercise attenuates the development of L-DOPA-induced dyskinesia (LID) in 6-hydroxydopamine-induced hemiparkinsonian mice through unknown mechanisms. We now tested if exercise normalizes the aberrant corticostriatal neuroplasticity associated with experimental murine models of LID. C57BL/6 mice received two unilateral intrastriatal injections of 6-hydroxydopamine (12 μg) and were treated after three weeks with L-DOPA/benserazide (25/12.5 mg/kg) for four weeks, with individualized moderate-intensity running (60-70% V̇O2peak) or not (untrained). L-DOPA converted the pattern of plasticity in corticostriatal synapses from a long-term depression (LTD) into a long-term potentiation (LTP). Exercise reduced LID severity and decreased aberrant LTP. These results suggest that exercise attenuates abnormal corticostriatal plasticity to decrease LID.

scholarly journals Hippocampal Blood Flow Is Increased After 20 min of Moderate-Intensity Exercise

2019 ◽  
Vol 30 (2) ◽  
pp. 525-533 ◽  
Author(s):  
J J Steventon ◽  
C Foster ◽  
H Furby ◽  
D Helme ◽  
R G Wise ◽  
...  
Keyword(s):  
Blood Flow ◽  
Temporal Dynamics ◽  
Therapeutic Potential ◽  
Cerebrovascular Reactivity ◽  
Moderate Intensity ◽  
Moderate Intensity Exercise ◽  
Exercise Interventions ◽  
Before And After ◽  
Exercise Induced

Abstract Long-term exercise interventions have been shown to be a potent trigger for both neurogenesis and vascular plasticity. However, little is known about the underlying temporal dynamics and specifically when exercise-induced vascular adaptations first occur, which is vital for therapeutic applications. In this study, we investigated whether a single session of moderate-intensity exercise was sufficient to induce changes in the cerebral vasculature. We employed arterial spin labeling magnetic resonance imaging to measure global and regional cerebral blood flow (CBF) before and after 20 min of cycling. The blood vessels’ ability to dilate, measured by cerebrovascular reactivity (CVR) to CO2 inhalation, was measured at baseline and 25-min postexercise. Our data showed that CBF was selectively increased by 10–12% in the hippocampus 15, 40, and 60 min after exercise cessation, whereas CVR to CO2 was unchanged in all regions. The absence of a corresponding change in hippocampal CVR suggests that the immediate and transient hippocampal adaptations observed after exercise are not driven by a mechanical vascular change and more likely represents an adaptive metabolic change, providing a framework for exploring the therapeutic potential of exercise-induced plasticity (neural, vascular, or both) in clinical and aged populations.

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