Mast cell quantification in the skin of dogs with hormonal dermatosis

The mast cells are important in physiological and pathological skin events. They play an important role in the homeostatic regulatory mechanisms in the skin and thyroid gland. Mast cells present a barrier to difference external environmental stimuli and play a mediating role in the presence of infectious agents under the epidermis. This study aimed to quantify the number of mast cells in histological sections of the skin of healthy dogs and dogs with hypothyroidism and hyperadrenocorticism and to determine the distribution of mast cell numbers in the superficial dermis and deep dermis.  When we compared the total mast cell count per high power field in dogs with hypothyroidism, hyperadrenocorticism and healthy dogs, only dogs with hypothyroidism had a significant difference in the quantification of mast cells per high power field, (p < 0.05). After analyzing our results, it was possible to conclude that animals with hypothyroidism produce greater amount of mast cells in the superficial dermis than patients with hyperadrenocorticism and healthy animals

MECANISMOS INFLAMATÓRIOS DA OBESIDADE: O QUE SABEMOS EM GATOS?

This study aimed to provide an overview of the inflammatory mechanisms involved in the obesity process focusing on pro-inflammatory immune responses and the role of adipokines in inflammatory reactionsm in animals and humans, as well as the correlation with the feline specie. Obesity is considered an increasingly prevalent endocrine disease in feline species, caused by a nutritional disorder with negative energy balance. It is defined as an excessive accumulation of adipose tissue that negatively affects the animal's health and is associated with a decrease in life expectancy and as triggering causes are multifactorial, being linked to several genetic and environmental factors. Adipose tissue is an endocrine organ that actively participates in energy metabolism and concentrates hormonal factors that are secreted by adipocytes, which modulate metabolism and exert the ability to directly involve innate and adaptive immune responses through the activity of the main cell types, including adipocytes and macrophages responsible for the activation and release of cytokines that affect normal physiological function, influencing the development of chronic inflammation. The altered production of adipokines in obesity has been implicated in the pathophysiology of several groups of diseases and their possible contribution to the development of insulin resistance and diabetes mellitus. Despite the incomplete understanding of the triggering factors of inflammation in the adipose tissue of cats, it is suggested that aspects associated with mitochondrial dysfunction, hypoxia, or even intrinsic factors of the adipocyte are involved.O objetivo deste trabalho foi fornecer uma visão geral dos mecanismos inflamatórios envolvidos no processo da obesidade, com enfoque nas respostas imunes pró-inflamatórias e no papel das adipocinas nas reações inflamatórias, em humanos e animais, bem como a correlação com a espécie felina. A obesidade é considerada uma doença endócrina cada vez mais prevalente na espécie felina, causada por uma desordem nutricional de balanço energético negativo. É definida como um acúmulo excessivo de tecido adiposo que afeta negativamente a saúde do animal e está associada à diminuição da expectativa de vida, sendo que as causas que a desencadeiam são multifatoriais, sendo atreladas a diversos fatores genéticos e ambientais. O tecido adiposo é um órgão endócrino que participa ativamente do metabolismo energético e concentra fatores hormonais que são secretados pelos adipócitos, os quais modulam o metabolismo e exercem capacidade de envolver diretamente as respostas imunes inatas e adaptativas por meio da atividade dos principais tipos celulares, incluindo adipócitos e macrófagos responsáveis pela ativação e liberação de citocinas que afetam a função fisiológica normal, influenciando no desenvolvimento da inflamação crônica. A produção alterada de adipocinas na obesidade tem sido envolvida na fisiopatologia de diversos grupos de doenças e tem sido relatada sua possível contribuição para o desenvolvimento de resistência insulínica e diabetes mellitus. Apesar do incompleto compreendimento dos fatores desencadeantes da inflamação no tecido adiposo de gatos, sugere-se que estejam envolvidos aspectos associados à disfunção mitocondrial, hipóxia ou, ainda, que estejam associados fatores intrínsecos do adipócito

Doença Renal Aguda em gatos: conquistas e desafios

A doença renal aguda (DRA) refere-se a uma síndrome clínica associada a alta morbidade e mortalidade, fazendo parte da síndrome de disfunção de múltiplos órgãos. Em medicina veterinária, estudos sobre a incidência de casos com DRA ainda são pouco elucidados, e a fisiopatologia da lesão renal aguda (LRA) é complexa, sendo caracterizada pela rápida diminuição da função excretora renal e consequente acúmulo de produtos do metabolismo de nitrogênio. Nesse contexto, o objetivo desse estudo foi apresentar a DRA com dados atuais sobre etiologia, patogenia, diagnóstico e tratamento

Fatores de risco associados a obesidade em gatos: Cat-releated risk factors for cat obesity

No mundo todo, a obesidade é reconhecida com uma condição de risco para saúde. Esta é caracterizada como uma condição de balanço energético positivo e excessiva formação de tecido adiposo com consequências diretas na qualidade de vida e bem estar dos animais. Neste trabalho foram utilizados 36 gatos obesos da rotina clínica do hospital veterinário Professor Sylvio Barbosa Cardoso, onde obteve-se desses animais prontuário clínico com histórico e anamnese, questionário respondido pelos tutores a respeito da rotina desses animais e exame físico completo. Este trabalho evidencia os principais fatores de risco que levam os gatos a desenvolverem a obesidade e comorbidades

Caracterização Morfológica e Utilização da GGT urinária no diagnóstico da Lesão Renal Aguda em Gatos / Morphological Characterization and Use of Urinary GGT in the Diagnosis of Acute Kidney Injury in Cats

Diante da prevalência da doença renal aguda em gatos com quadros obstrutivos e dos poucos estudos com marcadores moleculares de lesão renal aguda o objetivo deste trabalho foi caracterizar as lesões renais e identificar a precocidade da lesão renal com gama glutamiltransferase urinária. Foram utilizados 20 gatos machos adultos, de diferentes raças, portadores de obstrução urinária causada por uma cistite idiopática felina diagnosticada clinicamente, por exames laboratoriais e de imagem além de um grupo controle de 10 gatos. Foi observado aumento dos valores de creatinina (p=0, 0068), ureia (p=0,0033) e relação proteína/creatinina urinária (p<0,05) comparado ao grupo controle. Os valores de GGTu não apresentaram diferenças estatísticas entre os grupos

ASPECTOS CLÍNICOS E HEMATOLÓGICOS DA DOENÇA DO TRATO URINÁRIO INFERIOR EM FELINOS

Urethral obstruction is a urological condition considered to be common and potentially fatal in lower urinary tract disease (DTUIF). The main clinical signs of urethral obstruction are: pollakiuria, dysuria, hematuria, periuria, urination failure, anguish, anorexia, hypothermia, absence of libido or erection and during the clinical examination a full and firm urinary vesicle is observed, conditions that lead to the need for immediate intervention. Therefore, the objective of the study was to describe and compare clinical and hematological changes in cats with obstructive lower urinary tract disease and healthy cats. In the study, 30 cats were admitted and distributed in two groups: the control group composed of animals without clinical diseases and the obstructed group with animals clinically diagnosed with urinary obstruction. Detailed anamnesis of the animals, history, general physical examination with emphasis on urinary examination, ultrasound and complete hematological examination were performed. The main clinical changes in the obstructed animals were dehydration, bleached mucous membranes and hypothermia. The blood count of the obstructed animals showed a significant difference (p<0.05) to the average found when compared to the control group for erythrocyte count, hemoglobin concentration and globular volume, and the obstructed group presented values lower than the control. It can be concluded that hematological tests can identify important changes in the general inflammatory condition in obstructed animals, presenting neutrophilia, lymphopenia and monocytosis. In addition, longitudinal monitoring allows the progress of the disease and the risk of anemia to be monitored, as well as improvements in the clinical condition.A obstrução uretral é uma condição urológica considerada comum e potencialmente fatal na doença do trato urinário inferior (DTUIF). Os principais sinais clínicos da obstrução uretral são: polaquiúria, disúria, hematúria, periúria, insucesso na micção, angústia, anorexia, hipotermia, ausência de libido ou ereção e durante o exame clínico observa-se a vesícula urinária repleta e firme, condições que conduzem à necessidade de intervenção imediata. Diante disso, o objetivo do trabalho foi descrever e comparar alterações clínicas e hematológicas de gatos com doença do trato urinário inferior obstrutiva e gatos saudáveis. No estudo, foram admitidos 30 gatos e distribuídos em dois grupos: o grupo controle composto por animais sem afecções clínicas notáveis e o grupo obstruído com animais diagnosticados clinicamente com quadro de obstrução urinária. Foi realizada anamnese detalhada dos animais, histórico, realização de exame físico geral com ênfase no trato urinário, ultrassonografia e exame hematológico completo. As principais alterações clínicas dos animais obstruídos foram desidratação, mucosas hipocoradas e hipotermia. O hemograma dos animais obstruídos revelou diferença significativa (p<0,05) para as médias encontradas quando comparados com o grupo controle para contagem de eritrócitos, concentração de hemoglobina e volume globular, tendo o grupo obstruído apresentado valores inferiores ao controle. Pode-se concluir que os exames hematológicos podem identificar alterações importantes do quadro inflamatório geral em animais obstruídos, apresentando neutrofilia, linfopenia e monocitose. Além disso, observou-se que o monitoramento longitudinal possibilita acompanhar a progressão da enfermidade e o risco de anemia bem como a melhora do quadro clínico

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83-7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97-2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14-1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25-1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83–7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97–2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14–1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25–1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable

Association of Country Income Level With the Characteristics and Outcomes of Critically Ill Patients Hospitalized With Acute Kidney Injury and COVID-19

Introduction: Acute kidney injury (AKI) has been identified as one of the most common and significant problems in hospitalized patients with COVID-19. However, studies examining the relationship between COVID-19 and AKI in low- and low-middle income countries (LLMIC) are lacking. Given that AKI is known to carry a higher mortality rate in these countries, it is important to understand differences in this population. Methods: This prospective, observational study examines the AKI incidence and characteristics of 32,210 patients with COVID-19 from 49 countries across all income levels who were admitted to an intensive care unit during their hospital stay. Results: Among patients with COVID-19 admitted to the intensive care unit, AKI incidence was highest in patients in LLMIC, followed by patients in upper-middle income countries (UMIC) and high-income countries (HIC) (53%, 38%, and 30%, respectively), whereas dialysis rates were lowest among patients with AKI from LLMIC and highest among those from HIC (27% vs. 45%). Patients with AKI in LLMIC had the largest proportion of community-acquired AKI (CA-AKI) and highest rate of in-hospital death (79% vs. 54% in HIC and 66% in UMIC). The association between AKI, being from LLMIC and in-hospital death persisted even after adjusting for disease severity. Conclusions: AKI is a particularly devastating complication of COVID-19 among patients from poorer nations where the gaps in accessibility and quality of healthcare delivery have a major impact on patient outcomes