Enteric viruses nucleic acids distribution along the digestive tract of rhesus macaques with idiopathic chronic diarrhea

Idiopathic chronic diarrhea (ICD) is a common clinical condition in captive rhesus macaques, claiming 33% of medical culls (i.e. deaths unrelated to research). Using viral metagenomics we characterized the eukaryotic virome in digestive tract tissues collected at necropsy from nine animals with ICD. We show the presence of multiple viruses in the Parvoviridae and Picornaviridae family. We then compared the distribution of viral reads in the stomach, duodenum, jejunum, ileum, and the proximal, transverse, and distal colons. Tissues and mucosal scraping from the same locations showed closely related results while different gut tissues from the same animal varied widely. Picornavirus reads were generally more abundant in the lower digestive tract, particularly in the descending (distal) colon. Parvoviruses were more abundant in the upper reach particularly in the stomach. In situ hydridization (ISH) of fixed tissues showed punctuated staining for both these RNA and DNA viruses in the distal colon. Parvovirus ISH staining was also detected in the stomach/duodenum/jejunum in distinct oval-shaped structures. Therefore, the location of enteric viral nucleic acid differed widely between different viral families and along the length of the digestive tract.

A Review of Diagnostic Methods and Results for HIV-associated Disseminated Histoplasmosis: Shouldn’t We be Involving Pathologists More Systematically?

Background. Disseminated histoplasmosis is a major killer of HIV-infected persons in Latin America. Antigen detection, fungal culture, or Polymerase Chain Reaction are often not available, but cytology and histology are usually present in most hospitals and may represent an important diagnostic alternative. In this study, we review 34 years of clinical experience to describe the respective place of cytology and histology to diagnose disseminated histoplasmosis.Methods. Between January 1st, 1981 and October 1st, 2014, a retrospective multicentric study was performed on 349 patients with confirmed disseminated histoplasmosis. Results. Whereas bone marrow was by far the most common sample taken, only 14.9% of samples were screened using cytopathology, the second most frequent sample taken was bonchoalveolar lavage for which 9.9% were subjected to cytopathological analysis, and finally spinal fluid for which 16.4% were subjected to cytopathological analysis. The samples most systematically sent to pathology were liver biopsies, lower digestive tract, and lymphnode biopsies and the most contributive in terms of positive results were lower digestive tract (72.9% positives), lymph node (66.1%), and liver (50.7%). 97.2% of bone marrow samples were subjected to direct examination by the mycologist, the second most frequent sample taken was bronchoalveolar lavage for which 97% were subjected to direct examination. Positive direct examination was independently associated with death (aHR=1.5 (95%CI=1-2.2), and positive pathology was associated with less mortality ((aHR=0.66 (95%CI=0.44-1). Conclusions. Opportunities for a rapid diagnosis were regularly missed, notably for bone marrow samples which could have been examined using complementary staining methods to those of mycologist.

Success Rate of Colonoscopies and Reasons That Prevent Procedure Completion - Retrospective Study

Background. Colonoscopy is a common performed procedure in Gastroenterology, and it’s widely used for diagnosis, treatment and surveillance of a wide range of conditions and symptoms. Properly performed, it’s generally safe, more accurate than a virtual colonoscopy and well-tolerated by patients. The completion of a colonoscopy is defined by cecal intubation with the visualization of colonic mucosa and distal terminal ileum when it’s possible.Patients and methods. We reviewed retrospectively all consecutive endoscopies database of the lower digestive tract, done over a period from 2014-2017 in our clinic. The recommended completion based on the latest guidelines ranges from 90-95% completion rate according to the indication.Results. 11214 consecutive colonoscopies were done. Overall cecal intubation was successful in 9456 procedures (87.3%). If we exclude the interventional procedures (414 procedures), where cecal intubation was not necessary, the main reasons of non-intubation were due to intolerance of the patients (388 patients), followed on the second place by patients with obstructive cancer (299 patients). The presence of diverticulosis, poor preparation for colonoscopy and post-surgical adhesions were significant findings in non-successful procedures.Conclusions. In normal daily practice, colonoscopy is completed in 88.01% of the procedures but we think that this result will stimulate the efforts to incorporate more quality measures and time in our endoscopy laboratory.