Epithelial gastric polyps

Gastric polyps are lesions projected above the mucosal surface, which are detected in approximately 1–6% of upper gastrointestinal endoscopies. Based to their shape, polyps are classified as pedunculate, semi-pedunculate, sessile and flat. Depending on the histopathological type, some of them have the potential to transform into adenocarcinoma. Polyps can be of epithelial and non-epithelial origin. The first group, which is discussed in greater detail in this paper, includes fundic gland polyps, hyperplastic, adenomatous and hamartomatous polyps. Non-epithelial polyps include stromal tumours, leiomyomas, fibrous inflammatory polyps, fibroids, fibromyomas, lipomas, ectopic pancreas, neuroendocrine tumours, neuromas, and some vascular lesions. Multiple polyps in patients under the age of 40 years require more extensive diagnosis for hereditary polyposis syndromes, which are associated with an increased risk of gastric cancer, as well as other gastrointestinal and extra-gastrointestinal malignancies. In recent years, there has been a clear decrease in the proportion of hyperplastic polyps and an increase in the proportion of fundic gland polyps among all gastric polyps, which is probably related to the increased use of proton pump inhibitors and a reduced incidence of Helicobacter pylori infections. About 90% of gastric polyps are detected accidentally and usually do not cause clinical symptoms, but large polyps may be responsible for anaemia, bloody stools, abdominal pain, and even pyloric obstruction, which may be manifested by vomiting, severe flatulence, lack of appetite or progressive weight loss.

Hepatic sarcoidosis resembling primary sclerosing cholangitis

We report the case of a 29-year-old man who presented with progressive weight loss, night sweats, abdominal pain and pruritus who was found to have obstructive jaundice and cholestatic pattern of liver injury on laboratory workup. Though findings on magnetic resonance cholangiopancreatography were initially concerning primary sclerosing cholangitis, he was ultimately diagnosed with biliary sarcoidosis after a liver biopsy. This case brings attention to the rare phenomenon of hepatic sarcoidosis causing hyperbilirubinemia and highlights the importance of reaching the correct diagnosis early, as the patient’s symptoms improved after initiation of steroids.

Metastatic cholangiocarcinoma mimicking tuberculosis in a cow

Here we describe a metastatic hepatic cholangiocarcinoma (cholangiocellular carcinoma) in a 14-y-old Beefmaster cow that was euthanized because of depression and progressive weight loss. Gross changes included coalescing, white-to-yellow, firm-to-hard nodules with central areas of necrosis and mineralization that effaced much of the hepatic parenchyma, omentum, mesentery, ruminal serosa, and diaphragm. A fresh sample of a hepatic nodule was submitted for a modified acid-fast (MAF) stain during autopsy to rule out tuberculosis. The MAF stain was inconclusive, and the sample was subsequently submitted for a PCR assay for Mycobacterium spp. Histologically, all nodules consisted of a neoplastic proliferation of epithelial cells surrounded by extensive areas of desmoplasia, consistent with a metastatic cholangiocarcinoma. PCR for Mycobacterium spp. was negative. Although the histologic diagnosis in our case was metastatic hepatic cholangiocarcinoma, gross changes were strikingly similar to those described in cases of tuberculosis, highlighting the need to remain vigilant in the identification of zoonotic and suspected foreign animal diseases during autopsy to protect human health.

Association of azathioprine and prednisone in the control of immunomediated hemolytic anemia in dogs / Associação de prednisona e azatioprina na terapêutica de cães portadores de anemia hemolítica imunomediada

Immune-mediated hemolytic anemia (IMHA) is an immunological disease, in which the immune-mediated destruction of erythrocytes occurs, leading to a prominent drop in globular volume (GV). The diagnosis of the disease must be made through the association of clinical manifestations with specific complementary exams, with therapy aimed at inhibiting intravascular hemolysis in the control of GV. The present study aims to report the therapeutic association of prednisone and azathioprine in the control of IMHA in two dogs, demonstrating its evolution and the clinical effects of the pharmacological association. At the Veterinary Hospital of UNIMAR, a canine, female, Blue Heeler breed, seven years old and a canine, male, Border Collie breed, seven months old, both showing apathy, hyporexia, progressive weight loss, regenerative anemia, leukocytosis, and test of positive saline autoagglutination. After IMHA was diagnosed, polytherapy with prednisone (2mg/kg/SID) associated with azathioprine (2/mg/kg/SID) was instituted. Initially, the first animal showed liver damage due to the side effects of the drugs. As for the control of IMHA, the two animals described showed improvement and stabilization of the clinical and hematological condition after the association, making it possible to reduce the dosages of both drugs without worsening the conditions and ceasing the side effects caused by the chronic use of the drugs. Through this report it is possible to conclude that the use of the therapeutic combination of prednisone and azathioprine for the control of IMHA has greater benefits, being possible to use lower doses of both drugs, reducing their side effects and, consequently, resulting in a better survival.

Severe Hydroxyapatite Deposition Disease in Binturongs (Arctictis binturong)

In a collection of 6 young binturongs ( Arctictis binturong), 3 presented with anorexia, lethargy, and footpad swelling diagnosed by surgical biopsy as calcinosis circumscripta. Despite supportive care over the next 4 years, affected binturongs had progressive weight loss, hyperphosphatemia, and hyperkalemia and developed large radiodense deposits in tissues adjacent to appendicular joints, thoracolumbar vertebrae, and the sternum. Two binturongs died and necropsies showed severe periarticular mineral deposition with fibrosis and granulomatous inflammation. Additionally, binturongs had mineralization of distal renal tubules, mineralization of the renal interstitium, and marked mineralization of the pulmonary interstitium and peribronchiolar smooth muscle. Foot biopsies from the surviving binturong were evaluated by spectroscopic microanalysis and were positive for hydroxyapatite, Ca10(PO4)6(OH)2. Periarticular and footpad mineralization in these binturongs is consistent with hydroxyapatite deposition disease, which is rarely described in humans and animals as a primary familial condition or a secondary condition often associated with renal injury.

Weight Evolution of Patients Undergoing Gastroplasty in a Hospital in Pernambuco

Objective: describe the weight evolution of patients undergoing gastroplasty in a hospital in Pernambuco. Methods: A longitudinal, retrospective and descriptive study was carried out through the nutritional monitoring form, obtaining sociodemographic, clinical and nutritional data from patients over 18 years of age who underwent Roux-en-Y gastric bypass for the treatment of obesity and who were followed up during the pre and postoperative period at the IMIP Nutrition outpatient clinic between 2012 and 2017. Results: There was a decrease in BMI from 47.35 ± 7.09 kg / m² in the preoperative period to 29.65 ± 4.46 kg / m² in the 24 postoperative month and there was progressive weight loss in percentage according to the 6 months (45 , 23 ± 12.18), 12 (60.37 ± 13.98), 18 (64.80 ± 15.66), and finally, month 24 reaching 67.24 ± 20.38%. Conclusion: Roux-en-Y gastric bypass proved to be efficient in weight loss and decrease in BMI, helping in the long term in weight loss and, therefore, in a better quality of life. In addition, the nutritional monitoring, which is essential for adherence and maintenance of healthy eating habits in the pre- and postoperative period, is also noteworthy.

Metastatic osteoblastic osteosarcoma in a captive scarlet macaw (Ara macao)

Osteosarcoma is a malignant primary tumor of the bone, which is considered rare in birds. This report describes an osteoblastic osteosarcoma in a scarlet macaw (Ara macao), which was apathetic with progressive weight loss, and had a tumor in the distal portion of the femur and proximal tibiotarsus with ulcerated pododermatitis in the contralateral limb. Euthanasia was elected due to poor diagnosis after radiographic and cytological examination. Histopathology and immunohistochemistry were performed and confirmed the diagnosis of an osteoblastic osteosarcoma with hepatic and pulmonary metastases.

Adult onset pan-neuronal human tau tubulin kinase 1 expression causes severe cerebellar neurodegeneration in mice

The kinase TTBK1 is predominantly expressed in the central nervous system and has been implicated in neurodegenerative diseases including Alzheimer’s disease, frontotemporal lobar degeneration, and amyotrophic lateral sclerosis through its ability to phosphorylate the proteins tau and TDP-43. Mutations in the closely related gene TTBK2 cause spinocerebellar ataxia, type 11. However, it remains unknown whether altered TTBK1 activity alone can drive neurodegeneration. In order to characterize the consequences of neuronal TTBK1 upregulation in adult brains, we have generated a transgenic mouse model with inducible pan-neuronal expression of human TTBK1. We find that these inducible TTBK1 transgenic mice (iTTBK1 Tg) exhibit motor and cognitive phenotypes, including decreased grip strength, hyperactivity, limb-clasping, and spatial memory impairment. These behavioral phenotypes occur in conjunction with progressive weight loss, neuroinflammation, and severe cerebellar degeneration with Purkinje neuron loss. Phenotype onset begins weeks after TTBK1 induction, culminating in average mortality around 7 weeks post induction. The iTTBK1 Tg animals lack any obvious accumulation of pathological tau or TDP-43, indicating that TTBK1 expression drives neurodegeneration in the absence of detectable pathological protein deposition. In exploring TTBK1 functions, we identified the autophagy related protein GABARAP to be a novel interacting partner of TTBK1 and show that GABARAP protein levels increase in the brain following induction of TTBK1. These iTTBK1 Tg mice exhibit phenotypes reminiscent of spinocerebellar ataxia, and represent a new model of cerebellar neurodegeneration.

Prepubic tendon rupture in Santa Inês ewe – case report

Prepubic tendon rupture may lead to the loss of pelvic floorsupport. A four-year-old Santa Inês ewe had been reported suffering fromapathy, progressive weight loss throughout ten days, and prolongedpregnancy. Physical exams showed an excessive pendulous abdomen, amild ventral edema between the udder and the umbilical scar (xiphoidregion). Also, the udder was cranially displaced and with hematomas.Other symptoms noticed were walking reluctance, pelvic asymmetry,tachycardia, and tachypnea. The urinalysis findings indicated the presenceof ketone bodies. The ultrasound examination confirmed the presence offetuses with normal development, and a potential rupture of theabdominal muscles was excluded. Eight days following its hospitalization,labor induction was carried out using dexamethasone (20mg, IM, singleapplication). She went into labor three days after the initial dose ofcorticosteroid. The ewe had difficulty expelling the lambs, making theirtraction necessary. Although the animal has recovered from its injuries,the clinical picture shows prepubic tendon rupture, and in order to preventfuture complications, the ewe is not going to breed anymore. The report ofthis case works as an alert to the possibility of the occurrence of thisaffection in ewes and demonstrates the need of parturition assistance inanimals with this condition, which can be diagnosed through clinicalevaluation and ultrasound examination.