Clinical signs, aetiology and outcome in 30 cats with recurrent seizures (2002-2018)

ΔΕΝ ΔΙΑΤΙΘΕΤΑΙ ΠΕΡΙΛΗΨΗThe purpose of the current study was to describe seizure types, aetiology, treatment response and outcome in 30cats with recurrent seizures. This retrospective case series study included the medical records of client-owned cats, admitted to the Clinic of Companion Animals for seizure disorders, from 2002 to 2018. Recorded data included history, seizure type, physical and neurological examination findings, blood pressure measurements, complete blood counts, serum biochemistry profile and urinalysis, tentative/final diagnosis, treatment, hospitalization and longterm outcome. A total of 298 feline neurology cases were examined during the study period. Of those, 38 cases were admitted for seizure disorders and 30 met the inclusion criteria. Median age on admission was 38,2 months (3,1 years) (range 2 months- 14 years old).Seizure types, as per owner description, were generalized (26 cats), focal with secondary generalization (3 cats), focal (2 cats) and complex (1 cat). Cluster seizures appeared at least once in 18/30 and status epilepticus in 7/30. Different seizure types were also recorded in individual cases. Fifteen cats (15/30) were hospitalized at least once and the duration of hospitalization ranged from 1-10 days. In most cases, in which diagnosis was established, epilepsy wassecondary (25/30), due to previous head trauma(11/30),metabolic (1/30), or inflammatory (4/30) disease, arterial hypertension (3/30), toxicosis (3/30) and intracranial neoplasia (2/30).Congenital hydrocephalus was detected in 1 cat. Tentative diagnosis could not be established in 5cats; however differential diagnosis included inflammatory or neoplastic encephalopathies.Antiepileptic drug monotherapy (phenobarbital or levetiracetam) was sufficient to control the seizures in 14 cases, while administration of combination therapy with 2 or more antiepileptic drugs was required in 5 cases (phenobarbital, levetiracetam, gabapentin). Successful control was achieved in 11/30 animals for 1-5 years. Seven cats required intensive care at least once due to status epilepticus. Until today, eighteen (18/30) cats are still alive and 11 died or were euthanized.Although in most cases epilepsy was secondary, seizure control was adequate and quality of life (QoL) was improved with antiepileptic drugs when metabolic, inflammatory and neoplastic encephalopathies were excluded.

Brainstem phaeohyphomycosis due to Curvularia lunata (Cochliobolus lunatus) in a cat

A 13-year-old female neutered domestic short-hair cat was presented with chronic progressive vestibular ataxia, lethargy and anorexia. Clinical examination revealed bilateral mucopurulent nasal discharge. Neurological examination revealed obtundation, a right head tilt, ambulatory tetraparesis, generalised vestibular ataxia, decreased postural reactions in all limbs, right Horner's syndrome, spontaneous conjugate jerk rotatory nystagmus and right positional ventral strabismus. Neuroanatomical localisation was observed in the right central vestibular system. Computed tomography revealed a solitary ill-defined contrast-enhancing mass lesion at the level of the right cerebellopontine angle. Cerebrospinal fluid (CSF) analysis revealed mild mononuclear pleocytosis and fungal elements. CSF culture was positive for Curvularia spp. Further tests for underlying diseases were all negative. The cat was treated with antibiotic and antifungal treatment, but it deteriorated rapidly and was euthanased. Necropsy of the brainstem mass lesion revealed pyogranulomatous inflammation. Panfungal polymerase chain reaction (PCR) targeting the internal transcribed spacer (ITS) region and subsequent sequencing identified Curvularia lunata in the formalin fixed brain tissue. This is the first report of brainstem phaeohyphomycosis by Curvularia lunata (Pleosporales) in a cat. In addition, this is the first report among animal and humans where fungal elements of Curvularia lunata were found in the CSF cytology. Opportunistic fungal pathogens should be always considered within the differential diagnoses list in cats with neurological signs and advanced imaging findings compatible with solitary mass lesions in the brain. In feline patients with pyogranulomatous meningoencephalitis and a suspicion of a fungal aetiology, panfungal PCR for the ITS region and sequencing should be performed regardless of the absence of fungal elements in histopathology

Recent contributions to the distribution of the freshwater ichthyofauna in Greece

In this paper we supplement Greece’s recent annotated inventory of freshwater fishes per hydrographic basin with recent distributional data and taxa alteration information, based on field sampling and a literature review up to September 2011. We report on newly documented distributional records of 31 fish species plus one unidentified taxon, within 35 hydrographic river basin units in Greece. These new records include 14 native fish species, seven alien and 12 translocated. Translocated taxa are distinguished from aliens, in order to report species non-indigenous to a basin but native within the same ecoregion. Twelve hydrographic basin units are newly added to the roster of ichthyologically explored river basins following a previous basin-scale inventory method (the total is now 117). This review increases the number of Greece’s freshwater fish taxa to 167, since four new species are added to the list (Carassius langsdorfii, Neogobius fluviatilis, Telestes alfiensis, Millerigobius macrocephalus) and two are deleted (Salmo dentex, Barbus rebeli) due to taxonomic changes. Taxonomic changes will probably continue to alter the national list since phylogenetic research is ongoing on several taxa in many parts of the countr

Carbon nanoparticles in lateral flow methods to detect genes encoding virulence factors of Shiga toxin-producing Escherichia coli

The use of carbon nanoparticles is shown for the detection and identification of different Shiga toxin-producing Escherichia coli virulence factors (vt1, vt2, eae and ehxA) and a 16S control (specific for E. coli) based on the use of lateral flow strips (nucleic acid lateral flow immunoassay, NALFIA). Prior to the detection with NALFIA, a rapid amplification method with tagged primers was applied. In the evaluation of the optimised NALFIA strips, no cross-reactivity was found for any of the antibodies used. The limit of detection was higher than for quantitative PCR (q-PCR), in most cases between 104 and 105 colony forming units/mL or 0.1–0.9 ng/μL DNA. NALFIA strips were applied to 48 isolates from cattle faeces, and results were compared to those achieved by q-PCR. E. coli virulence factors identified by NALFIA were in very good agreement with those observed in q-PCR, showing in most cases sensitivity and specificity values of 1.0 and an almost perfect agreement between both methods (kappa coefficient larger than 0.9). The results demonstrate that the screening method developed is reliable, cost-effective and user-friendly, and that the procedure is fast as the total time required is <1 h, which includes amplification

Can nurse-led preoperative education reduce anxiety and postoperative complications of patients undergoing cardiac surgery?

Background: The effect of preoperative education on anxiety and postoperative outcomes of cardiac surgery patients remains unclear. Aim: The aim of the study was to estimate the effectiveness of a nurse-led preoperative education on anxiety and postoperative outcomes. Methods: A randomised controlled study was designed. All the patients who were admitted for elective cardiac surgery in a general hospital in Athens with knowledge of the Greek language were eligible to take part in the study. Patients in the intervention group received preoperative education by specially trained nurses. The control group received the standard information by the ward personnel. Measurements of anxiety were conducted on admission-A, before surgery-B and before discharge-C by the state-trait anxiety inventory. Results: The sample consisted of 395 patients (intervention group: 205, control group: 190). The state anxiety on the day before surgery decreased only in the intervention group (34.0 (8.4) versus 36.9 (10.7); P=0.001). The mean decrease in state score during the follow-up period was greater in the intervention group (P=0.001). No significant difference was found in the length of stay or readmission. Lower proportions of chest infection were found in the intervention group (10 (5.3) versus 1 (0.5); P=0.004). Multivariate linear regression revealed that education and score in trait anxiety scale on admission are independent predictors of a reduction in state anxiety. Conclusion: Preoperative education delivered by nurses reduced anxiety and postoperative complications of patients undergoing cardiac surgery, but it was not effective in reducing readmissions or length of stay. © European Society of Cardiology

Intra-abdominal Aspergillosis due to Aspergillus fumigatus in a Dog

A 3 year-old, spayed female, mixed-breed dog presented with abdominal distension due to a large mass, detected during abdominal palpation and confirmed by abdominal imaging. Cytological examination of the mass was suggestive of pyogranulomatous inflammation. During exploratory laparotomy, extensive peritoneal adhesions and multifocal nodular lesions on the liver, spleen and omentum were revealed. One week later, the dog deteriorated and was euthanized. Numerous firm masses were observed in the liver, spleen, left kidney, stomach, small and large intestine during necropsy. The lungs, heart, and ocular structures were macroscopically normal. Histopathology results (surgery and necropsy) revealed fungal hyphae enclosed in the pyogranulomatous lesions. Polymerase chain reaction (PCR) products showed 100% homology with Aspergillus fumigatus and agar gel double diffusion was positive for IgG antibodies against the same fungus. © 2018 L Kalogianni, N Soubasis, M Saridomichelakis, I Vlemmas, A Velegraki, L Papazoglou, M Kritsepikonstantinou, T Rallis

Information and perioperative education of cardiac surgery patients

Today, in a turbulent and competitive health care environment patients more and more, seek to learn what is happening in their own situation and participate in planning their health care and decision-making. Cardiac surgery patients are discharged earlier and anticipate many problems during the rehabilitation period. Preoperative and postoperative education of the patients is of great importance and patients knowledge of self care after discharge is a main outcome indicator of the quality of the provide services. The aim of this study was to assess cardiac surgery patients’ knowledge of self care after the discharge and explore any correlation with the patient characteristics. The sample consisted of 91 patients who admitted during 3 months in two cardiac surgery wards and had an open-heart operation. A special questionnaire was developed based on four dimensions: general, diet, rest, and drugs. Patients scored higher the diet scale (mean=1,91, SD=0,26, scale 0-2) and lower the drug scale ( mean=0,10, SD=0,4, scale 0-2). The majority of the patients wanted to learn more (98,9%) and nurses had not been involved in the educational process. The analysis of variance revealed an indication of correlation between the educational level and the patients’ knowledge but the small sample does not allow safe conclusions. The results can be used for the planning of the patients’ preoperative and postoperative education