Cecal lymphoma in a male Rottweiler dog

A 6-year-old male Rottweiler dog presented with a marked weight loss combined with abdominal pain and diarrhea over 3 month. Hematology revealed lymphocytosis, neutrophilia and eosinophilia. Abdominal ultrasound revealed a heteroechoic mid-abdominal mass with a focal hypoechoic area measuring 6.0 x 5.0 cm but with a confusing origin. The mass was resected and intestinal anastomosis was performed after celiotomy. Histopathology of the mass demonstrated massive lympho-proliferative lesions were diagnosed as low grade lymphoma with diffuse small lymphocytic (DSL-plasmacytoid) pattern. The dog was recovered and a one-month ultra sonography follow-up showed no-recurrence.

Hydroponic Lettuce Cultivation Using Organic Nutrient Solution from Aerobic Digested Aquacultural Sludge

The aim of this study was to demonstrate how aquacultural sludge can be processed and utilized as an organic nutrient solution (ONS) for hydroponic lettuce production. By using a previous developed method, approximately 80% of the processed sludge was reclaimed as a clear, nutrient-rich solution. The performance of the recovered nutrient solution on lettuce growth was assessed in a nutrient film hydroponic system. The results were compared to the results obtained using a conventional nutrient solution (CNS). Yield, fresh weight, water consumption, and nutrient and heavy metal content in leaf tissue were measured. In spite of a 16% lower average fresh weight obtained in ONS compared to the weight obtained in CNS, there was no statistical difference of the yield of lettuce among the two nutrient solutions. After the cultivation period, 90% of the lettuce heads grown in ONS exceeded the marked weight of 150 g. Foliar analysis revealed a similar or higher content of all nutrients, except of magnesium and molybdenum in the leaves of lettuce grown in the ONS compared to lettuce grown in the CNS. This study shows that nutrients recovered from aquacultural sludge can be utilized as fertilizer, thereby reducing the dependency on mineral fertilizer in hydroponic and aquaponic systems.

Risks and Rewards of Bariatric Surgery in Advanced Chronic Liver Diseases

The burden of obesity and metabolic syndrome has determined a sharp increase in bariatric surgery (BS) procedures, which lead to marked weight loss, improved metabolic syndrome, reduced cardiovascular risk, and even improvement in nonalcoholic steatohepatitis (NASH). Despite these promising results, BS in patients with chronic liver disease can rarely lead to worsening of liver function, progression to cirrhosis and its complications, and even liver transplantation. On the other hand, since obesity in patients with cirrhosis is a major cofactor for progression to a decompensated stage of the disease and a risk factor for hepatocellular carcinoma, BS has been used to achieve weight loss in this population. In this review, we critically analyze the existing data on outcomes of BS in patients with cirrhosis and the possible mechanisms leading to fibrosis progression and worsening liver function in patients undergoing BS. Finally, we propose a set of measures that could be taken to improve the multidisciplinary management of liver disease in patients undergoing BS, including early recognition of malnutrition and alcohol misuse.

Nutrition in the Patient with Cancer Clinical Physiological and Therapeutic Aspects

The relationships between nutrition and cancer are as broad as they are conflictive because they encompass the wide spectrum of nuances with which they causally interact. Since times past there has been medical concern about malnutrition in cancer patients, but it is undoubtedly since notable progress has been made about therapeutic options for cancer that nutritional aspects have taken on special importance. This is since when more aggressive therapeutic strategies are applied, there is less tolerance to these treatments and greater morbidity from them, in patients with deterioration of their nutritional status. At present, recent advances in the field of neurobiology have shed light on the participation of neurotransmitters in the mechanisms of anorexia. On the other hand, malnutrition in carriers of neoplasms is closely linked to the negative impact of economic variables, quality of life and survival. De Wys et al., more than 2 decades ago, were among the first to draw attention to this issue, reporting that more than 50% of the 3,000 patients included in the Eastern Cooperative Oncology Group had marked weight loss. Other studies, such as those by Shils et al., show different degrees of nutritional compromise in patients undergoing major surgery for cancer.

Chloroquine and Hydroxychloroquine Myopathy: Clinical Spectrum and Treatment Outcomes

Chloroquine (CQ) and hydroxychloroquine (HCQ) have been associated with muscle toxicity, mostly described as a proximal myopathy with evidence of lysosomal dysfunction on muscle biopsy. In this retrospective study, we aimed to define the clinical phenotype, laboratory features, and treatment outcomes of CQ/HCQ myopathy, as well as the safety profile of these drugs. We identified 13 patients seen between 2000 and 2019, with a median age at presentation of 66 years (range 53–89); 11 were females. At onset of symptoms, patients were on CQ or HCQ for a minimum of 6 months and up to 21 years. Diagnosis was often delayed by a median of 6 months (range 3–48). At presentation, 13 patients reported limb weakness, with five requiring assistance in walking. Ten reported dysphagia, often severe, resulting in marked weight loss or aspiration pneumonia. Nine reported respiratory symptoms, which were multifactorial in four, and four reported severe neck weakness. Myopathy clinical phenotype showed predominant involvement of one or more of the following: proximal limb muscle weakness (12 patients), dysphagia (9), axial weakness (4), and respiratory failure (5). Eleven patients had a cardiac evaluation showing prolonged QT interval in 10 and CQ/HCQ cardiomyopathy (CMP) in four. Ten out of 12 patients markedly improved after discontinuing the medication, but most were left with some residual weakness. Eleven patients had a muscle biopsy showing a myopathy with rimmed vacuoles and marked acid phosphatase reactivity. Nine had elevated creatine kinase level up to 1,199 U/L. Twelve patients had an electromyography (EMG), which showed myopathic motor unit potentials with fibrillation potentials in 11 and myotonic discharges in 3. Higher cumulative dose and longer exposure duration were associated with more severe disability and more common cardiac and swallow involvement, indicating a cumulative dose effect. Herein, we demonstrate that long-term exposure to CQ and HCQ may result in a myopathy with a wide spectrum of clinical presentation and predilection for swallowing, respiratory, and cardiac muscles, often with marked associated morbidity. Once accurately diagnosed and the drug is discontinued, patients usually improve but often fail to return to baseline.

Prevalência da perda de peso em pacientes cardiopatas atendidos pelo SUS de uma instituição filantrópica

Introduction: Weight loss during hospitalization is a prevalent fact in the hospital environment that affects a significant number of hospitalized patients. Marked weight loss can lead to malnutrition and increase the risk of infections, decreased wound healing capacity, increased hospital stay and, consequently, increase hospital costs and even death. The present study assessed the prevalence of weight loss in cardiac patients hospitalized by SUS. Methods: This is a quantitative, cross-sectional, descriptive and analytical study carried out in a philanthropic hospital in the city of Vila Velha, ES, with data obtained through electronic medical records of adult heart disease patients, related to nutritional screening and other variables in the period from January to December 2018. Results: Data from 62 patients were analyzed, 58.1% male and 69.4% elderly. Of the evaluated patients, 41.9% were detected with nutritional risk at admission and 43.5% at hospital discharge. 46.6% of the patients had weight loss during hospitalization and in relation to BMI, 14.5% of patients were malnourished, 32.3% were obese. Conclusion: The frequency of weight loss in hospitalized cardiac patients is worrisome and the fact that a large portion is already entering the hospital environment with nutritional risk highlights the importance of early nutritional assessment and intervention regardless of the type of pathology presented.

Abstract 15939: Neither Moderate Consumption of Sugarcane Liquor (“Cachaca”) Nor of Red Wine Affect Cardiovascular Risk Biomarkers in Healthy Individuals

Introduction: It is well established that moderate consumption of red wine is associated with reduced risk of cardiovascular (CV) events. Many observational studies have shown that this same benefit could be seen with other alcohol beverages different from wine. However, the correlation between the Brazilian sugarcane liquor (“cachaca”) and CV benefit has not been demonstrated in human trials. Hypothesis: Cachaca causes changes in biomarkers of CV risk in the same proportion as wine. Methods: In this crossover randomized study, healthy individuals were initially designated to have daily moderate alcohol consumption (MAC) of either cachaca or red wine for a period of 4 weeks. MAC, for both drinks, was denoted as a daily dose equivalent of 28g of alcohol for men and 14g for women. Then, after an abstinence period of 7 days, drink types were switched for more 4 weeks. Analysis of CV risk biomarkers were determined before and after each intervention, and consisted of C-reactive protein, lipid profile, platelet aggregability and glycid profile. (This research was funded by FAPESP 2018/09675-4). Results: Of the 37 individuals originally enrolled, 2 refused to continue the study. The average age of the individuals was 41.7 (±15.3 years) and 43.2% were men. Adherence to the protocol was considered essentially ideal, with 100% of regular use in both interventions and only 3 individuals reporting abuse during the study period. There was no significant variation in anthropometric measurements during the study, except for a weight gain (0.6kg) with red wine (p = 0.011). As seen in the table, no significant changes were noted in the inflammatory markers, lipid profile, platelet aggregability nor glycid profile before and after each intervention. Conclusions: This study shows that in healthy individuals, neither red wine nor cachaca changed CV biomarkers related to atherosclerotic progression after 4 weeks of MAC. However, there was a marked weight gain with daily wine consumption.

A 65–year–old male with moderate anemia, low-grade fever and weight loss

This article has no abstract. The first 100 words appear below: A 65-year-old male hailing from Lolua, Tangail north bordering district of Dhaka, Bangladesh, reported to the Department of Hematology, Armed Forces Institute of Pathology with the complaints of marked weight loss, generalized weakness, low-grade fever and anorexia. He was referred from Kurmitola General Hospital, Dhaka, Bangladesh for bone marrow aspiration and examination. Before aspirating the bone marrow, a detailed history was taken which revealed that he had been suffering from the above mentioned symptoms for the last 10 months. During this time, he reported to the local physicians who investigated with routine laboratory tests such as complete blood count, peripheral blood film