Follicular cystitis in a dog: First case report described in Brazil

ABSTRACT A 2-year-old English bulldog presented history of recurrent lower urinary tract disease, refractory to treatment. The Complete Blood Count revealed lymphopenia, hyperproteinemia, and hyperglobulinemia, while urinalysis indicated leukocyturia and bacteriuria. On the abdominal ultrasound, the bladder had a focal wall thickening in its cranial portion, as well as irregular echogenicity and internal margins. A bladder surgical biopsy was performed, indicating the presence of follicular cystitis. Clinical signs disappeared after treatment with a combination of amoxicillin and clavulanic acid, NSAIDs, supplementation with cranberry extract associated with cat's claw (Uncaria tomentosa). Clinical follow-up 12 months after surgery showed remission at all clinical signs. Follicular cystitis in dogs was reported only once worldwide, this case report is the first in Brazil; thus, it may be considered in the differential diagnosis for patients with refractory and recurrent lower urinary tract disease

Predictors of mortality in critically ill patients with COVID-19 and diabetes

The COVID-19 pandemic has challenged the entire world, and patients with diabetes mellitus (DM) have been particularly affected. We aimed to evaluate predictors of mortality during the first 30 days of hospitalization in critically ill patients with COVID-19 and comorbid DM. This prospective study included 110 critically ill patients admitted with COVID-19 infection. Thirty-two (29%) patients had a previous diagnosis of DM. Clinical variables, laboratory tests, and vascular biomarkers, such as VCAM-1, syndecan-1, ICAM-1, angiopoietin-1, and angiopoeitin-2, were evaluated after intensive care unit (ICU) admission. A comparison was made between patients with and without DM. No difference in mortality was observed between the groups (48.7 vs 46.9%, P=0.861). In the multivariate Cox regression analysis, VCAM-1 levels at ICU admission (HR: 1 [1-1.001], P<0.006) were associated with death in patients with DM. Among patients with DM, advanced age (HR 1.063 [1.031-1.096], P<0.001), increased Ang-2/Ang-1 ratio (HR: 4.515 [1.803-11.308] P=0.001), and need for dialysis (HR: 3.489 [1.409-8.642], P=0.007) were independent predictors of death. Higher levels of VCAM-1 in patients with DM was better at predicting death of patients with severe COVID-19 and comorbid DM, and their cut-off values were useful for stratifying patients with a worse prognosis. Vascular biomarkers VCAM-1 and Ang-2/Ang-1 ratio were predictors of death in patients with severe COVID-19 and comorbid DM and those without DM. Additionally, kidney injury was associated with an increased risk of death