Mediastinal Ectopic Parathyroid Adenoma in a Patient Followed for Colon Cancer and Chronic Renal Failure: A Challenging Case

Colorectal cancer is a significant cause of morbidity and mortality worldwide. The advances in early diagnosis and treatment have increasingly expanded the patient population surviving from colorectal cancer. Herein, we present a case of a patient with mediastinal ectopic parathyroid adenoma who has been followed up for postoperative colon cancer. The patient is a 59-year-old man with postoperative colon cancer and chronic renal failure in whom control positron emission tomography/computed tomography revealed multiple bone metastases. However, on methylenediphosphonate bone scintigraphy, multiple involvement with increased uptake was associated with renal osteodystrophy/hyperparathyroidism; technetium-99m 2-methoxyisobutylisonitrile parathyroid scintigraphy was performed, which revealed mediastinal ectopic parathyroid adenoma. To the best of our knowledge, this is the first case report in the literature reporting the co-occurrence of colon cancer, chronic renal failure, and ectopic parathyroid adenoma

Post weaning diarrhea in pigs: risk factors and non‑colistin‑based control strategies

Post-weaning diarrhea (PWD) is one of the most serious threats for the swine industry worldwide. It is commonly associated with the proliferation of enterotoxigenic Escherichia coli in the pig intestine. Colistin, a cationic antibiotic, is widely used in swine for the oral treatment of intestinal infections caused by E. coli, and particularly of PWD. However, despite the effectiveness of this antibiotic in the treatment of PWD, several studies have reported high rates of colistin resistant E. coli in swine. Furthermore, this antibiotic is considered of very high importance in humans, being used for the treatment of infections due to multidrug-resistant (MDR) Gram-negative bacteria (GNB). Moreover, the recent discovery of the mcr-1 gene encoding for colistin resistance in Enterobacteriaceae on a conjugative stable plasmid has raised great concern about the possible loss of colistin effectiveness for the treatment of MDR-GNB in humans. Consequently, it has been proposed that the use of colistin in animal production should be considered as a last resort treatment only. Thus, to overcome the economic losses, which would result from the restriction of use of colistin, especially for prophylactic purposes in PWD control, we believe that an understanding of the factors contributing to the development of this disease and the putting in place of practical alternative strategies for the control of PWD in swine is crucial. Such alternatives should improve animal gut health and reduce economic losses in pigs without promoting bacterial resistance. The present review begins with an overview of risk factors of PWD and an update of colistin use in PWD control worldwide in terms of quantities and microbiological outcomes. Subsequently, alternative strategies to the use of colistin for the control of this disease are described and discussed. Finally, a practical approach for the control of PWD in its various phases is proposed