scholarly journals Eversion of the Third Eyelid Cartilage in a Cat

2021 ◽  
Vol 49 ◽  
Author(s):  
Eric Orlando Barbosa Momesso ◽  
Carinne Liessi Brunato ◽  
Adriana Lima Teixeira
Keyword(s):  
General Anesthesia ◽  
Ocular Surface ◽  
Previous History ◽  
Clinical Signs ◽  
Sodium Hyaluronate ◽  
Differential Growth ◽  
Presumptive Diagnosis ◽  
Ophthalmic Examination ◽  
The Third ◽  
History Of

Background: Eversion of the cartilage of the third eyelid is a rare congenital disease in cats. It is caused by the anterior eversion of the cartilage edge of the third eyelid. Clinical signs may be associated with secondary keratoconjunctivitis, third eyelid gland protrusion, and ocular surface irritation. The diagnosis is made by ophthalmic examination, and treatment consists of surgical resection of the everted cartilage portion. The goal of the present study was to report a case of eversion of third eyelid cartilage in a cat, given that it is an unusual abnormality in this animal species, and an important differential diagnosis to be considered in the disorders of the third eyelid.Case: A 6-year-old neutered female Persian cat was presented with a presumptive diagnosis of protrusion of the third eyelid gland, history of ocular irritation, and epiphora in the left eye. The disorder had been intermittently present since the animal was 1-year-old, with spontaneous disappearance after approximately 15 days. The owner related the reappearance of the disorder to stressful situations, with no previous history of trauma or other ocular alteration. During the ophthalmic examination, suspended solute was observed through biomiscroscopic examination in both eyes, as well as an increase in volume of the third eyelid in the left eye, without other changes. A thorough examination, under general anesthesia, indicated the protruding volume of the cartilage of the everted third eyelid. The third eyelid was pleated in its upper portion, demonstrating that the cartilage of the third eyelid was folded instead of following the curvature of the ocular surface. Under general anesthesia, the cartilage was partially removed through two parallel incisions on the bulbar conjunctival surface, divulsioning 5 mm in length in the vertical portion of the cartilage in a ‘T’ shape, and separating the conjunctiva from the underlying cartilage. The everted portion of cartilage, once removed, was in fact considered curved in its most dorsal portion, in a manner similar to what was reported in dogs. The third eyelid returned to its anatomically correct position after removing the deformed portion of the cartilage. The patient was treated postoperatively with topical drops of tobramycin and dexamethasone 3 mg/mL + 1 mg/mL (Tobradex®), and lubricant based on sodium hyaluronate 2 mg/mL (Hylo®-Gel). No complications were observed in the postoperative consultations during a 8 month follow-up.Discussion: It is suspected that the eversion of the third eyelid cartilage occurs due to a differential growth rate between the posterior and anterior portions of the cartilage; even though other theories have been proposed. The cartilage of the third eyelid can commonly be everted in large dog breeds, being classified as a disease of hereditary character. However, it has rarely been reported in cats, which can be explained by the more elastic histological constitution when compared to that of dogs. The surgical procedure performed in the present case of eversion of the third eyelid cartilage in a cat was in accordance with that described in the literature. Complete recovery of the third eyelid function was achieved, and the patient's ocular health was preserved. The reported case showed a favorable prognosis after diagnosis, associated with correct treatment and postoperative management. Although there was an effective recovery of the third eyelid, the issues related to the pathophysiology of cartilage eversion are unknown. This way, further studies are necessary to elucidate its etiology.

Rituximab for Preventing Delayed Hemolytic Transfusion Reaction (DHTR) in Sickle CELL Adult Patients: Outcome of Transfusion and SIDE Effects in 58 CASES

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3687-3687
Author(s):  
Fabian Zanchetta-Balint ◽  
France Pirenne ◽  
Marc Michel ◽  
Armand Mekontso-Dessap ◽  
Matthieu Mahevas ◽  
...  
Keyword(s):  
Board Of Directors ◽  
Sickle Cell ◽  
High Probability ◽  
Previous History ◽  
Clinical Signs ◽  
Adult Patients ◽  
Advisory Committees ◽  
The Third ◽  
History Of ◽  
Low Probability

Background: Transfusion is a major therapeutic of sickle cell disease (SCD); however, DHTR is one of the most feared complications . Prevention of allo immunization, by extended RBC matching is insufficient to prevent all cases of DHTR. Therefore, B cell depletion therapy should be also useful, especially in previously immunized patients to avoid the emergence of new allo-antibodies. Rituximab (RTX) is used for preventing alloimmunization for patients with a history of DHTR. Therefore, secondary prevention with rituximab prior a new exposure to transfused RBCs could be a relevant option. Here, we will report our experiences of RTX use in SCD adult patients with a previous history of DHTR. Methods: In this retrospective observational study, the data from 58 consecutive RTX infusion in 44 SCD patients with history of DHTR in our French referral center for SCD were analysed. Medical, biological and blood bank records of patients, clinical signs, rate of hemoglobin A (HbA) after transfusion (TF) were collected. To evaluate the persistence of transfused RBCs, the DHTR risk probability on days 15 and 30 after TF was evaluated according to Mekontso Dessaps nomogram. We also reported serious adverse events like infections in the year after RTX infusion. In cases of programmed surgery, 1 gramme of RTX was administred at day 1 and 15 few weeks before or one injection in emergency situation, with low dose of steroides. Adjuvant measure to avoid transfusion like EPO, Iron injection and hydroxyurea was decided in some cases. Results: We analyzed 58 cases of RTX administered to 44 adult patients with SCD, 10 of whom received two or more times this drug. A transfusion (TF) was required in 33/58 cases (56%). We distinguished three groups of patients. In the first group of 21 cases (36%), rituximab was used preventively before planned surgery at risk of bleeding, only 8 cases were transfused. In the second group of 30 cases (53%) during an acute event, in 19 cases patients received a transfusion. The third group of 7 patients received RTX during an active DHTR with hyperhemolysis requiring transfusion to protect an imminent transfusion and finally 6 of them was transfused. To evaluate the efficacy of transfusion we analyzed group 1 and 2 together and separately the third group with active DHTR and hyperhemolysis. In the first and second groups, HbA measurements was not available or interpretable in 11,1% of cases. On day 15 after TF, 77,8% of cases were classified as having a low probability of hemolysis, 7.4 % as intermediate probability and 3.7% as high probability. On day 30 after TF: 55,6% were into the low probability of hemolysis subgroup, 11,1% in the intermediate probability and 22,2% in the high probability group. (Figure 1) In group 3, HbA measurement wasn't available in 2 cases. On day 15 after TF, no cases were classified as having a low probability of hemolysis, 33,3 % as intermediate probability and 33.3% as high probability. On day 30 after TF: 33,3% were in the intermediate probability and 50 % in the high probability group. (Figure 2) Infection requiring intravenous antibiotic were observed in 19 cases/58 (32.7%) with a bacterial documentation in 73,7 %. In 63% of these cases, patients have been hospitalized in intensive care unit for acute events before RTX administration and had other risk factors of infection. The median time of apparition of infection was 28 days [11.5-46.5]. We report 4 deaths (6,8%), two patient died due to a hyperhemolysis syndrome with multiorgan failure that started before RTX administration, two other were due to an end stage cancer. These deaths are not related to the use of RTX. Conclusion: This study suggests that RTX can be safely used for preventing DHTR in patients with a previous history of DHTR and detected antibodies. We show that transfusion efficiency at day 15 post TF is better than days 30 postTF. The effectiveness of TF in active DHTR with h yperhemolysis is much lower, as most patients lose the transfused units at day 30 post TF.Beyond the use of RTX, the use of other measures such as hydroxyurea and erythropoietin to avoid the need of transfusion in these patients must be emphasized. Infection risk after RTX therapy is difficult to assess. In most cases an active inflammatory event was in process. Additional prospective studies are needed to improve the management of this challenging clinical situation. Disclosures Michel: Novartis: Consultancy; Amgen: Consultancy; Rigel: Consultancy. Galactéros:Addmedica: Membership on an entity's Board of Directors or advisory committees. Bartolucci:Novartis: Membership on an entity's Board of Directors or advisory committees; AddMedica: Honoraria, Membership on an entity's Board of Directors or advisory committees; Roche: Membership on an entity's Board of Directors or advisory committees; HEMANEXT: Membership on an entity's Board of Directors or advisory committees; Global Blood Therapeutics: Membership on an entity's Board of Directors or advisory committees; Agios: Membership on an entity's Board of Directors or advisory committees.

scholarly journals Enteropathy associated T-cell lymphoma

2007 ◽  
Vol 135 (1-2) ◽  
pp. 80-84
Author(s):  
Milena Bakrac ◽  
Branka Bonaci-Nikolic ◽  
Natasa Colovic ◽  
Sanja Simic-Ogrizovic ◽  
Miodrag Krstic ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Lymphoma ◽  
Previous History ◽  
Lymph Node Biopsy ◽  
Intestinal Wall ◽  
T Cell Lymphoma ◽  
The Third ◽  
History Of ◽  
Small Intestinal ◽  
Mesenterial Lymph Node

Enteropathy associated T-cell lymphoma (EATCL) is a high grade, pleomorphic peripheral T-cell lymphoma with usually cytotoxic phenotype. This is a case report of three patients with EATCL. The first patient was 50 year-old woman with four year history of gluten sensitive enteropathy (GSE). Diagnosis of lymphoma was confirmed after the resection of the jejunum (small intestine obstruction). Pathohistological (PAS, Reticulin, Giemsa) and immunohistochemical (anti-LCA, anti-CD20, anti- CD45RO, anti-CD3) methods revealed the diagnosis of EATCL: CD45RO+, CD3+. After the third cycle of chemotherapy, the disease progressed with massive lung infiltration. Patient died due to complications of bone marrow aplasia. The second patient was 23 year-old woman with long earlier history of GSE. She presented with the acute renal failure. According to established diagnosis of tubulointerstitial nephritis, she was treated with pulse doses of steroid therapy. After temporary improvement, she had dissemination of the disease. On MRI, small intestinal wall was thickened, and abdominal lymph nodes were enlarged with extraluminal compression of common bile duct. Laparotomy with mesenterial lymph node biopsy and consecutive pathohistological and immunohistochemical analyses revealed the diagnosis of EATCL. The patient received chemotherapy, but she died with signs of pulmonary embolization. The third patient was 53 year-old woman without previous history of GSE. Diagnosis of EATCL was revealed after the resection of jejunum because of small intestinal obstruction. She received two cycles of chemotherapy, but she died with signs of disease progression. IgA antiendomysial antibodies were detected in the serum of all patients. The overall survival of patients was 7 months. The possibility of lymphoma rising in patients with clinical progression of GSE despite gluten free diet must be kept in mind.

scholarly journals Xeroderma Pigmentosum: Ocular Findings in an Isolated Brazilian Group with an Identified Genetic Cluster

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Maria Claudia Schelini ◽  
Luis Fernando O. B. Chaves ◽  
Marcia C. Toledo ◽  
Francisco W. Rodrigues ◽  
Tauan de Oliveira ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Xeroderma Pigmentosum ◽  
Genetic Disorder ◽  
Skin Pigmentation ◽  
Previous History ◽  
Case Series ◽  
Corneal Neovascularization ◽  
University Hospital ◽  
Ocular Symptoms ◽  
History Of

Purpose. Xeroderma pigmentosum (XP) is a rare autosomal recessive genetic disorder characterized by increased susceptibility to UV radiation- (UVR-) induced skin pigmentation, skin cancers, ocular surface disease, and, in some patients, sunburn and neurological degeneration. Eight different genes are affected, and the prevalence of the disease differs across the world. The present study describes the main ophthalmologic features and symptoms in patients with XP in this case series. Methods. Patients were examined consecutively at the University Hospital of the Federal University of Goias between January 2016 and June 2018. All patients underwent ophthalmologic examination and were asked about their ophthalmological history and the presence of ocular symptoms. Results. Twenty-one patients with genetic confirmation were evaluated. The genetic variants XPV and XPC were detected in the patients. The most prevalent findings include eyelid changes, observed in 80.9% of the patients, and ocular surface changes as punctate keratopathy, occurring in 16 patients (76.2%), corneal neovascularization, and corneal opacities. Six patients (28.5%) presented corneoconjunctival tumor. More than half of patients had previous history of treatment of ocular neoplasia. Ocular burning was the most reported symptom. Conclusions. The ocular characteristics identified in this study corroborate the existing literature, mainly related to the surface. Concerning the XP variant and the gravity of ocular signs, XPC has earlier and more severe symptoms than XPV. Due to their relative rarity, publications of XP cases are important to understand the possible damages caused by the disease in the eyes and surrounding area.

scholarly journals African horse sickness in The Gambia: circulation of a live-attenuated vaccine-derived strain

2011 ◽  
Vol 140 (3) ◽  
pp. 462-465 ◽  
Author(s):  
C. A. L. OURA ◽  
P. A. S. IVENS ◽  
K. BACHANEK-BANKOWSKA ◽  
A. BIN-TARIF ◽  
D. B. JALLOW ◽  
...  
Keyword(s):  
Neutralizing Antibodies ◽  
Previous History ◽  
Clinical Signs ◽  
The Gambia ◽  
African Horse Sickness ◽  
African Horse Sickness Virus ◽  
Live Attenuated Vaccine ◽  
Virus Serotype ◽  
History Of ◽  
Young Horses

SUMMARYAfrican horse sickness virus serotype 9 (AHSV-9) has been known for some time to be circulating amongst equids in West Africa without causing any clinical disease in indigenous horse populations. Whether this is due to local breeds of horses being resistant to disease or whether the AHSV-9 strains circulating are avirulent is currently unknown. This study shows that the majority (96%) of horses and donkeys sampled across The Gambia were seropositive for AHS, despite most being unvaccinated and having no previous history of showing clinical signs of AHS. Most young horses (<3 years) were seropositive with neutralizing antibodies specific to AHSV-9. Eight young equids (<3 years) were positive for AHSV-9 by serotype-specific RT–PCR and live AHSV-9 was isolated from two of these horses. Sequence analysis revealed the presence of an AHSV-9 strain showing 100% identity to Seg-2 of the AHSV-9 reference strain, indicating that the virus circulating in The Gambia was highly likely to have been derived from a live-attenuated AHSV-9 vaccine strain.

scholarly journals PRIMARY HYPOADRENOCORTICISM IN A DOG

2016 ◽  
Vol 19 (2) ◽  
Author(s):  
Denner Santos dos Anjos ◽  
Veronica Jorge Babo-Terra ◽  
Mariana Isa Poci Palumbo
Keyword(s):  
Previous History ◽  
Clinical Signs ◽  
Sodium Potassium ◽  
Capillary Refill ◽  
Once Daily ◽  
History Of ◽  
Fludrocortisone Acetate ◽  
Loss Of Appetite ◽  
Veterinary Hospital ◽  
Acute Crisis

This report describes the clinical and laboratorial findings as well as the therapeutic protocol performed in a three-year-old mongrel female intact dog, referred to the Veterinary Hospital of FAMEZ/UFMS. The animal had a previous history of recurrent gastrointestinal signs (such as lethargy, vomiting, loss of appetite, melena and abdominal pain), acute crisis episodes, bradycardia, hypotension, hypothermia and increase of capillary refill time, recognized as addisonian crisis due to primary hypoadrenocorticism. Laboratorial findings included anemia, eosinophilia, neutrophilia, lymphocytosis, sodium-potassium ratio of 14,02 mEq/L and prerenal azotemia. Based on that, it was confirmed the diagnosis of primary hypoadrenocorcitism. Thus, it was recommended supplementation therapy with mineralocorticoid (aldosterone) and glucocorticoid (cortisol) corresponding respectively, fludrocortisone acetate of 0.2 mg per kg of BW, by mouth, once daily and prednisone 0.2 mg per kg of BW, by mouth, twice daily until further recommendations. The prognostic was excellent, since the animal significantly improved body condition, andclinical signs disappeared after therapy which lead the sodium-potassium ratio to 35.11 mEq/L. Thus, the clinician must always suspect of primary hypoadrenocorticism in dogs with intermittent nonspecific signs that get better with support therapy. Presumably, hypoarenocorticism must be under diagnosed in veterinary medicine, reinforcing the need to require specific exams in patients that show this wax and wane feature of clinical signs.

scholarly journals Effect of doxycycline on stifle lameness: a preliminary clinical observation in twelve dogs

2011 ◽  
Vol 1 (1) ◽  
pp. 7
Author(s):  
Kei Hayashi ◽  
Joseph D. Frank ◽  
Paul A. Manley ◽  
Peter Muir
Keyword(s):  
Clinical Signs ◽  
Poor Response ◽  
Positive Outcome ◽  
Presumptive Diagnosis ◽  
Once Daily ◽  
Doxycycline Treatment ◽  
History Of ◽  
Group A ◽  
Group B

The clinical efficacy of oral doxycycline was evaluated in twelve dogs with stifle arthritis and a presumptive diagnosis of early cruciate disease. Doxycycline (2.5-4.5 mg/kg once daily) was administered orally for 3 to 8 weeks. Eight dogs, who presented prior to the treatment with clinical signs of 4 weeks or fewer duration (group B), had a good response to doxycycline, whereas four dogs with a longer history of lameness (group A) had a poor response. The follow-up periods ranged from 2 to 12 months after discontinuation of the doxycycline treatment (median=6.5 months, 3 months in group A, and 9.5 months in group B). There was a significant correlation between the duration of lameness and the subjective grading of clinical improvement. In 68% of these cases of dogs with stifle arthritis (8/12), the oral administration of doxycycline resulted in the improvement of lameness, even after discontinuation of doxycycline. Careful selection of patients based on the duration of their lameness appears to be crucial in order to achieve a positive outcome.

scholarly journals Influence of anesthesia type on the wound healing after inguinal hernia surgeries

2013 ◽  
Vol 94 (3) ◽  
pp. 413-417
Author(s):  
L E Slavin ◽  
R R Aliullova ◽  
I U Borisova ◽  
A N Chugunov
Keyword(s):  
Inguinal Hernia ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Epidural Anesthesia ◽  
Two Phase ◽  
The Third ◽  
Duration Of Surgery ◽  
History Of ◽  
Group 2 ◽  
Surgery Duration

Aim. To estimate the influence of anesthesia type on the inguinal hernia rate surgery complication rate, considering the hernia type. Methods. 276 patients aged 35-65 years treated for inguinal hernia (history of hernia from 3 months to 3 years) from 2007 to 2011 were analyzed. The surgery was performed using local anesthesia in 146 patients (first group) and using epidural anesthesia in 102 patients (second group); 28 patients underwent surgery using general anesthesia (third group). A combination of 4 mL 10% lidocaine, 20 mL of 7.5 mg/mL ropivacaine solution and 60 mL 0.9% saline were used for local anesthesia in patients of the first group. 2% solutions of lidocaine and ropivacaine were used for epidural or spinal anesthesia in patients of the second group. Results. Mean surgery duration was shortest at the first group - 50.5±1.2 min. Mean surgery duration at the second group was 73.2±2.2 min, 61.8±5.0 min - at the third group (р1,2 0.001, р1,3=0.003, р2,3=0.017). Mean activation terms were 4.2±0,1 hours for the patients of the first group (local anesthesia), 20.3±0.2 hours - for the patients of the second group (epidural anesthesia), 10.5±0.2 hours - for the patients of the second group (general anesthesia). Postoperative pain measured by visual analogue scale occurred at significantly shorter terms after the surgery and was more intense for the first 3 days in patients of the first group. The pain intensity elevated gradually in patients of the first group starting from the second day after the surgery, pain lasted significantly in the second and third group patients compared to the first group. Complications were registered in 15 (10.3%) of the first group patients, in 12 (11.8%) of the second group patients and in 5 (17.9%) of the third group patients (р1,2=0.836; р1,3=0.237; р2,3=0.525). Conclusion. A combination of analgesics solutions based on their pharmacologic features and two-phase vasoactivity ability has shown good analgesic effect at local anesthesia. The type of anesthesia determines the duration of surgery and the rate of post-surgical complications as a consequence.

scholarly journals Diagnostic challenges in paediatric foreign body aspiration: a case report

2020 ◽  
Vol 49 (2) ◽  
Author(s):  
Inês Morais ◽  
Inês Sousa ◽  
Carolina Terra ◽  
Ana Martins ◽  
Tiago Pereira ◽  
...  
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Previous History ◽  
Bronchial Hyperresponsiveness ◽  
Clinical Signs ◽  
Paediatric Population ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Multidisciplinary Communication ◽  
History Of

Introduction: Foreign body aspiration (FBA) is a potentially fatal paediatric emergency. Our objective was to highlight the importance of a multidisciplinary approach to difficult/doubtful diagnosis. Case Report: 34-month-old girl referred for urgent rigid bronchoscopy after suspected metallic blade ingestion (found chewing on it). She had a previous recurrent history of wheezing. The physical examination revealed face/lip wounds, traces of powder on her teeth but no breathing difficulty. The plain X-Ray revealed radiopaque images of the upper pulmonary field and gastric chamber. In the absence of FBA clinical signs but considering a previous history of bronchial hyperresponsiveness, a direct digital radiographic study was performed. There were no images compatible with foreign bodies: the results were interpreted as artefacts and no bronchoscopy was performed. Conclusions: A careful pre-anaesthetic evaluation, a high level of suspicion and excellent multidisciplinary communication led to the recognition of false radiologic findings. A conservative approach was followed and invasive procedures in a remote location, with high anaesthetic risk for the paediatric population were avoided.

A Sidelight on the ‘Son of Man’

1969 ◽  
Vol 22 (2) ◽  
pp. 189-196 ◽  
Author(s):  
A. Gelston
Keyword(s):  
New Testament ◽  
Previous History ◽  
First Century ◽  
Small Contribution ◽  
The Third ◽  
Son Of Man ◽  
The New Testament ◽  
History Of

The term ‘Son of Man’ is one of the enigmas of the Gospels. G. Vermes has re-examined the Aramaic background of the phrase in Appendix E of the third edition of M. BlacK's Aramaic Approach to the Gospels and Acts. Even if his argument that barnāsh (ā) is in some passages a mere circumlocution for ‘I’ is not wholly convincing,page 2 he has demonstrated beyond doubt that the phrase was not in New Testament times a title with a clear and recognised meaning, whether messianic or other. The phrase in itself merely signifies ‘man’, whether mankind in general, or a particular man. Only the context can determine its meaning more precisely. Apart from Act 7.56 it is used virtually exclusively in the New Testament by Jesus, and the question of the crowd in John 12.34—‘who is this Son of Man?’ —shows clearly that the expression was not immediately intelligible to the first century,page 3 and that we are not at liberty to dismiss it as no more than an elaborate way of saying ‘man’ or ‘I’. This is the justification of the immense activity that has gone into the exploration of the previous history of the expression, and to which this article is a small contribution.page 4

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