Feline primary erythrocytosis: a multicentre case series of 18 cats

A retrospective multicentre case series of feline primary erythrocytosis (PE) was evaluated. The aim was to gain better understanding of disease presentation and progression to guide management and prognostication. Case records were assessed for evidence of increased packed cell volume (PCV; >48%), sufficient investigation to rule out relative and secondary erythrocytosis, and follow-up data for at least 12 months or until death. Eighteen cats were included in the case series. No significant trends in signalment were noted. Seizures and mentation changes were the most common presenting signs (both n = 10). Median PCV was 70% (median total protein concentration of 76 g/l) with no other consistent haematological changes. Sixteen cats survived to discharge. Phlebotomy was performed initially in 15/16 surviving animals and performed after discharge in 10/16. Hydroxyurea was the most common adjunctive therapy, used in 10/16 cats. Of the 16 patients surviving to discharge, 14 patients were still alive at the conclusion of the study (survival time >17 months post-discharge), with the two non-survivors having lived for 5 years or more after diagnosis. PCV, when stabilised, did not correlate with resolution of clinical signs

Tratamento de varizes retais de difícil controlo

Background: Rectal varices are portosystemic collaterals that arise as a complication of portal hypertension. Despite their significant prevalence among cirrhotic patients, clinically important bleeding occurs only in a minority. Various treatment options are available, with endoscopic therapies being widely used, and both interventional radiology and surgery being considered for refractory bleeding rectal varices. Case: We report the case of a 61-year-old male with hepatic cirrhosis and bleedingrectal varices refractory to endoscopic therapy, successfully managed with a combination of transjugular intrahepatic portosystemic shunt (TIPS) and selective variceal embolization. Conclusions: Radiological techniques are effective options for refractory bleeding. Adding embolization to TIPS implantation could represent a valid adjunctive measure for haemostasis of recurrent rectal variceal bleeding.Introdução: As varizes retais são colaterais portossistémicos que se formam como complicação da hipertensão portal. Apesar de serem frequentes em doentes com cirrose hepática, cursam com hemorragia apenas numa minoria dos casos. Entre as opções terapêuticas disponíveis, a endoscópica é a mais amplamente disponível e utilizada, sendo as intervenções da radiologia ou da cirurgia reservadas para casos de hemorragia refratária. Caso: Apresenta-se o caso de um homem de 61 anos com cirrose hepá­tica e hemorragia com ponto de partida em varizes retais. Por refratariedade ao tratamento endoscópico, uma combinação de shunt portossistémico intrahepático transjugu­lar e embolização seletiva das varizes retais foi necessária para uma hemóstase eficaz. Conclusão: A combinação do TIPS com a embolização seletiva das varizes retais é uma alternativa terapêutica na hemorragia por varizes retais refratárias a tratamento endoscópico.info:eu-repo/semantics/publishedVersio

Pathological changes in an Alsatian dog following Amitraz and Sniper (dichlorvos) exposure

Amitraz and Sniper (dichlorvos) are known ectoparasiticides of dogs in Nigeria. Although reports of their toxicosis exist, information on the pathological presentations of their combined toxicosis is scanty hence the present case report. Two dogs both had Amitraz bath with simultaneous fumigation of their immediate environment with Sniper (diclorvos). Excessive salivation, staggering gait, and respiratory distress were observed shortly thereafter with the prompt administration of atropine sulphate which ameliorated it, but a particular dog progressively became weak, inactive and off feed. A vomitus, dark watery stool and blood spots were observed within its kennel before death. The post-mortem examination revealed emaciated, dehydrated and tick infested carcass with pale ocular and oral mucous membranes. There was also ileocolic intestinal intussusception characterized by anal intussusceptum protrusion, congested liver and pulmonary peribronchial haemorrhage with inter-alveoli cellular infiltration including haemorrhagic enteritis. Death might have been due to hypovolemic shock following the observed dehydration, pallor, haematochezia, peritoneal fluid exudation, hepatic congestion, pneumonia characterized by peribronchial haemorrhages, and haemorrhagic enteritis. The observed intussusception was a rare occurrence in a dog following Amitraz and Sniper poisoning in Abuja, Nigeria, which highlighted the need for their cautious and professional use

Massive rectal bleeding from colonic diverticulosis

Objectives: This is to describe a case of colonic diverticulosis causing massive rectal bleeding in an elderly Nigerian man.Case report: We highlight a case of a 79 year old man who presented with massive rectal bleeding due to colonic diverticulosis from our centre. Colonoscopy identified multiple diverticula in the proximal rectum, sigmoid, descending and transverse colon. The diverticula were more in the descending colon and also oozing blood. He was worked up, and had surgery for hemicolectomy due to massive blood loss following failure of initial conservative management.Conclusion: Colonic divericulosis may cause massive rectal bleeding severe enough to require hemicolectomy. Only few similar cases have been reported in this part of the continent.Keywords: Colon, rectal bleeding, diverticulosis, colonoscop

Allergic proctocolitis refractory to maternal hypoallergenic diet in exclusively breast-fed infants: a clinical observation

<p>Abstract</p> <p>Background</p> <p>Allergic proctocolitis (APC) in exclusively breast-fed infants is caused by food proteins, deriving from maternal diet, transferred through lactation. In most cases a maternal cow milk-free diet leads to a prompt resolution of rectal bleeding, while in some patients a multiple food allergy can occur. The aim of this study was to assess whether the atopy patch test (APT) could be helpful to identify this subgroup of patients requiring to discontinue breast-feeding due to polisensitization. Additionally, we assessed the efficacy of an amino acid-based formula (AAF) when multiple food allergy is suspected. amino acid-based formula</p> <p>Methods</p> <p>We have prospectively enrolled 14 exclusively breast-fed infants with APC refractory to maternal allergen avoidance. The diagnosis was confirmed by endoscopy with biopsies. Skin prick tests and serum specific IgE for common foods, together with APTs for common foods plus breast milk, were performed. After a 1 month therapy of an AAF all patients underwent a follow-up rectosigmoidoscopy.</p> <p>Results</p> <p>Prick tests and serum specific IgE were negative. APTs were positive in 100% infants, with a multiple positivity in 50%. Sensitization was found for breast milk in 100%, cow's milk (50%), soy (28%), egg (21%), rice (14%), wheat (7%). Follow-up rectosigmoidoscopy confirmed the remission of APC in all infants.</p> <p>Conclusions</p> <p>These data suggest that APT might become a useful tool to identify subgroups of infants with multiple gastrointestinal food allergy involving a delayed immunogenic mechanism, with the aim to avoid unnecessary maternal dietary restrictions before discontinuing breast-feeding.</p

Short term outcomes of prostate biopsy in men tested for cancer by prostate specific antigen: prospective evaluation within ProtecT study

Objectives To measure the effect of the adverse events within 35 days of transrectal ultrasound guided biopsy from the perspective of asymptomatic men having prostate specific antigen (PSA) testing; to assess early attitude to re-biopsy; to estimate healthcare resource use associated with adverse events due to biopsy; and to develop a classification scheme for reporting adverse events after prostate biopsy

Paediatric Gastrointestinal Endoscopy in a Nigerian Tertiary Hospital

Background: Gastrointestinal endoscopy is a very useful tool in the diagnosis and treatment of gastrointestinal disorders. Gastrointestinal endoscopy in paediatric practice is still evolving in Nigeria. Objective: To determine the common indications for paediatric endoscopy in a Nigerian tertiary hospital. Method: This was a retrospective study of all gastrointestinal endoscopic procedures performed for children aged 0 -18 years between January 2021 and March 2022. The hospital records of the children were retrieved, and data were extracted for analysis. Results: Thirty-seven endoscopic procedures were performed on 32 children with two subjects having repeated procedures while one had both upper and lower gastrointestinal endoscopic studies. The mean age of the children was 11 ± 5.4 years with those aged between 10 and 14 years constituting the majority (40.6%). Most indications were diagnostic and the commonest indication for endoscopy was upper abdominal pain (40.6%) which was followed by upper gastrointestinal bleeding (37.6%). The endoscopic findings were mainly gastritis (56.8%), hiatus hernia (32.4%) and duodenitis (18.9%). The commonest therapeutic indication for gastrointestinal endoscopy was variceal banding. Conclusion: Paediatric gastrointestinal endoscopy is useful for the diagnosis and treatment of paediatric gastrointestinal disorders. Upper abdominal pain and upper gastrointestinal bleeding are the leading indications for paediatric gastrointestinal endoscopy in Nigeria

Upper gastrointestinal tract bleeding in Ilorin, Nigeria - a report of 30 cases

Background: Upper gastrointestinal tract bleeding refers to blood loss within the intraluminal gastrointestinal tract from any location between the upper oesophagus to the duodenum at the ligament of Treitz. The onset and severity of blood loss varies widely.Acute gastrointestinal bleeding is a potentially life-threatening abdominal emergency that remains a common cause of hospitalization. There is no local data on the clinical presentation, endoscopic findings and the risk factors for upper gastrointestinal tract bleeding in Ilorin. This study was therefore to review the cases of upper gastrointestinal tract bleed in Ilorin. Aim: To reviewthe cases of upper gastrointestinal tract bleeding seen in Ilorin. Methodology: A retrospective review of the cases of upper gastrointestinal tract bleeding who had upper gastrointestinal tract endoscopy as part of their workup was undertaken to cover a eighteen month period from June 2006 to November 2007. Their clinical presentation, endoscopic findings, and the risk factors which predisposed themto bleedingwere evaluated.The endoscopy register and the request formswere reviewed. Results: Atotal of thirty patients had upper gastrointestinal tract bleeding for which upper gastrointestinal tract endoscopy was performed during the period under review. Twenty-three of the patients were males (76.7%) while seven were females (23.3%). Sixteen patients (53.3%) presented with malaena only; eleven patients (36.7%) with malaena and haematemesis only; while three patients (10.0%) presented with malaena, haematemesis and haematochexia. However all the patients presented with malaena, haematemesis or haematochexia. The commonest clinical presentation of patients with upper gastrointestinal tract bleeding passage of malaena (53.3%). The commonest endoscopic finding was multiple sources of bleeding (66.7%)while the commonest risk factor for upper gastrointestinal tract  bleeding was NSAIDuse (36.7%). Conclusion: The passage of malaena, multiple source of bleeding, and NSAID use are the commonest clinical presentation, endoscopic findings and risk factors respectively in patients with upper gastrointestinal tract bleeding in Ilorin. The spectrum of clinical presentation, endoscopic findings and risk factors for upper gastrointestinal tract bleed found in this study is similar to that found by other workers.Keywords: Upper, gastrointestinal tract, bleeding, Ilori