Multicenter cohort study, with a nested randomized comparison, to examine the cardiovascular impact of preterm preeclampsia

This study evaluated whether planned early delivery would ameliorate cardiovascular dysfunction six months postpartum, compared to usual care with expectant management, in women with late preterm preeclampsia. We conducted a mechanistic observational study in women with preterm preeclampsia between 34+0 and 36+6 weeks’ gestation, nested within a randomised controlled trial of planned early delivery versus expectant management (usual care), in 28 maternity hospitals in England and Wales. Women were followed up six months postpartum with cardiovascular assessments. The primary outcome was a composite of systolic and/or diastolic dysfunction (by 2009 and 2016 definitions of diastolic dysfunction). Between 27 April 2016 and 30 November 2018, 623 women were found to be eligible, of whom 420 (67%) were recruited. 133 women were randomised to planned delivery, 137 women were randomised to expectant management within the trial, while 150 women received expectant management outside of the trial. 321 (76.4%) completed their six month echocardiography assessment. 10% (31/321) had a left ventricular ejection fraction <55% whilst 71% (229/321) remained hypertensive. There were no differences in the primary outcome between the two randomised groups (planned delivery versus expectant management) using either the 2009 (RR 1.06; 95% CI 0.80, 1.40) or 2016 definitions (RR 0.78; 0.33, 1.86). In conclusion, we demonstrated that late preterm preeclampsia results in persistence of hypertension in the majority, and systolic LV dysfunction in 10%, of women six months postpartum. Planned early delivery does not affect these outcomes. Preeclampsia is not a self-limiting disease of pregnancy alone

Aspects of feline dermatophytosis and the immune response to Microsporum canis infection

SIGLEAvailable from British Library Document Supply Centre- DSC:DX181111 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Peritonite infecciosa felina: 13 casos Feline infectious peritonitis: 13 cases

Numa pesquisa realizada em tecidos de 638 gatos necropsiados, foram encontrados 13 casos (2,03%) de peritonite infecciosa felina. Oito desses casos (61,53%) eram da forma efusiva ou úmida, e 5 apresentavam a forma seca ou não-efusiva da doença. A idade dos gatos afetados variou de 2 meses a 3 anos. Doze gatos (92,30%) eram de raças puras, cinco deles (38,47%) eram oriundos de ambientes onde havia mais de um gato e três eram provenientes de um mesmo gatil. A duração da doença clínica foi de 7 a 45 dias e os sinais clínicos incluíram emagrecimento, anorexia, diarréia, icterícia, vômito, linfadenopatia e distúrbios neurológicos. Os achados de necropsia na forma úmida incluíam excesso de líquido viscoso (50ml a 1 litro), translúcido ou levemente opaco na cavidade peritoneal e, em um caso, na cavidade torácica. Exsudato fibrinoso cobria as superfícies serosas dos órgãos abdominais dando-lhes aspecto granular e brancacento. Na forma seca, havia múltiplos focos granulomatosos sob a superfície serosa e para o interior do parênquima de órgãos abdominais; esses achados eram particularmente proeminentes nos rins. Opacidade de córnea foi observada em um gato. Histologicamente, havia graus variáveis de vasculite e perivasculite piogranulomatosa, particularmente em arteríolas. Meningite ou meningoencefalite piogranulomatosa foram observadas em três gatos com a forma seca de peritonite infecciosa felina.<br>In a survey carried out in tissue specimens from 638 necropsied cats, 13 cases (2.03%) of feline infectious peritonitis were found. Eight of those (61.53%) were of the effusive or wet form and five had the dry non-effusive form of the disease. Ages of affected cats varied from 2-months to 3 yeas. Twelve affected cats (92.30%) were purebreds, five of these cats (38.47%) came from households with more than one cat and three of them came from the same comercial cat raising facility. The duration of clinical courses were 7-45 days and clinical signs included loss of weight, anorexia, diarrhea, jaundice, vomiting, swollen lymph nodes, and neurological disturbances. Necropsy findings, in the wet form included excess of yellowish viscous tanslucent or slightly opaque fluid (50ml-1 liter) in the peritoneal cavity and (in one case) thoracic cavity. Fibrinous exudate covered the serosal surfaces of abdominal organs imparting a whitish, granular, frost-like appearance to them. In the dry form there were multiple granulomatous foci underneath the serosal surface, which extended into the parenchyma of abdominal organs; these findings were particularly prominent in the kidneys. Corneal opacity was observed in one cat. Histologically, there were variable degrees of disseminated piogranulomatous vasculitis and perivasculitis particularly in arterioles. Pyogranulomatous meningitis or meningoencephalitis were observed in three cats with the dry form of feline infectious peritonitis