Efficacy of fipronil/(S)-methoprene/eprinomectin/praziquantel (Broadline®) against Thelazia callipaeda in naturally infected cats

Background The present clinical field trial was conducted to assess the efficacy of a broad-spectrum parasiticide spot-on formulation containing eprinomectin (Broadline®) against Thelazia callipaeda eyeworm in naturally infected cats. Methods Fifteen privately owned cats harboring at least one live adult T. callipaeda were included in the study. Cats were randomly allocated to an untreated control group of seven cats or to a Broadline®-treated group of eight cats. Cats were treated on Day 0; ocular examinations were performed at inclusion and on Days 7 and 14; eyeworms were recovered and counted on Day 14. The primary efficacy assessment was based on group comparison of number of T. callipaeda on Day 14. Results Seven days after treatment, six of eight treated cats were negative for eyeworm infection per visual examination, and on Day 14 no eyeworms were found in the treated cats while the seven untreated cats were still infected (geometric mean: 1.97). All cats had inflammatory ocular signs at inclusion; on Day 14, five of eight treated cats had recovered while all untreated control cats were still symptomatic. All collected parasites were confirmed to be T. callipaeda by morphology and molecular characterization. Conclusions A single treatment with Broadline® provided 100% efficacy against feline thelaziosis and improved related ocular inflammation signs. Graphical abstract

A Prospective Study on the Efficacy of Two Different Phlebotonic Therapies as a Bridge to Surgery in Patients with Advanced Hemorrhoidal Disease

The aims of this study were to evaluate the efficacy of two different phlebotonic therapies, preoperatively administered in advanced hemorrhoidal disease (HD) patients with recommendation for surgery, and to assess patient satisfaction after treatment. In this prospective observational study, 100 patients were preoperatively treated either with micronized purified flavonoid fraction (group A) or sublingual nano-emulsion flavonoid (group B). HD symptoms, local inflammation signs and patients’ satisfaction were evaluated at baseline visit (T0), after 4 weeks of therapy (T1) and 8 weeks after its discontinuation (T2). In group A, a significant improvement for all HD symptoms and inflammation signs was observed after therapy (T1), followed by a reduction of efficacy in T2, except for itching and edema. In group B, therapy had a significant benefit on symptoms and local inflammation at T1, which persisted after its discontinuation for all symptoms, and edematous hemorrhoids. In both groups, the satisfaction rate was “good” in 60% of patients and patients were statistically significant more satisfied at T1 compared with T2 (p = 0.0001). No adverse events were recorded. Preoperative treatment was safe and useful to optimize patients’ clinical condition prior to surgery.

Synoviocytogram of horses under conditions of the aseptic arthritis treatment

The article describes the efficiency of aseptic arthritis treatment in horses by means of tiotriazolini and dexamethasone. To substantiate the therapeutic effectiveness of the selected drugs, the research was conducted on 12, 18, 24-month horses in the dynamics of aseptic arthritis development and the disease course. The results of the research indicate that the injection of solutions of tiotriazolini and polyvinylpyrolidone intraarterially to prevent the clinical inflammation signs contributed for the improvement of the animals’ general condition after the 3rd injection. The synoviocytogram was already characterized by positive shifts on the 10th day after the second injection of dexamethasone novocaine-based solution with the addition of laevomycetin, which proves the advisability of treating horses of different age groups with aseptic arthritis by means of tiotriazolin and dexamethasone.

Tocilizumab in a Case of Refractory Idiopathic Orbital Inflammation: 6-Year Follow-Up Outcomes

Idiopathic orbital inflammation (IOI) is a noninfectious inflammatory disease whose etiology remains unknown. Treatment is focused on reducing inflammation, which becomes challenging in nonresponding cases. We report the case of a 59-year-old woman with refractory IOI that showed a positive response to tocilizumab therapy. The patient was diagnosed with a unilateral sclerosing IOI for 9 years and showed a negative control with previous oral steroids, peribulbar steroid injections, radiotherapy, immunosuppressors, and intravenous rituximab. After the initiation of 8 mg/kg intravenous tocilizumab, a complete reduction of the pain and the orbital inflammation signs was observed and her condition remained stable for the following 6 years under a monthly dose of 4 mg/kg. In recalcitrant IOI cases, tocilizumab could be considered a possible treatment to reduce inflammatory signs and symptoms with positive long-term outcomes as in our case.

Efficacy of Bioactive Glass Nanofibers Tested for Oral Mucosal Regeneration in Rabbits with Induced Diabetes

The healing of oral lesions that are associated with diabetes mellitus is a matter of great concern. Bioactive glass is a highly recommended bioceramic scaffold for bone and soft tissue regeneration. In this study, we aimed to assess the efficacy of a novel formula of bioactive glass nanofibers in enhancing oral mucosal wound regeneration in diabetes mellitus. Bioactive glass nanofibres (BGnf) of composition (1–2) mol% of B2O3, (68–69) mol% of SiO2, and (29–30) mol% of CaO were synthesized via the low-temperature sol-gel technique followed by mixing with polymer solution, then electrospinning of the glass sol to produce nanofibers, which were then subjected to heat treatment. X-Ray Diffraction analysis of the prepared nanofibers confirmed its amorphous nature. Microstructure of BGnf simulated that of the fibrin clot with cross-linked nanofibers having a varying range of diameter (500–900 nm). The in-vitro degradation profile of BGnf confirmed its high dissolution rate, which proved the glass bioactivity. Following fibers preparation and characterization, 12 healthy New Zealand male rabbits were successfully subjected to type I diabetic induction using a single dose of intravenous injection of alloxan monohydrate. Two weeks after diabetes confirmation, the rabbits were randomly divided into two groups (control and experimental groups). Bilateral elliptical oral mucosal defects of 10 × 3.5 mm were created in the maxillary mucobuccal fold of both groups. The defects of the experimental group were grafted with BGnf, while the other group of defects considered as a control group. Clinical, histological, and immune-histochemical assessment of both groups of wounds were performed after one, two and three weeks’ time interval. The results of the clinical evaluation of BGnf treated defects showed complete wound closure with the absence of inflammation signs starting from one week postoperative. Control defects, on the other hand, showed an open wound with suppurative exudate. On histological and immunohistochemical level, the BGnf treated defects revealed increasing in cell activity and vascularization with the absence of inflammation signs starting from one week time interval, while the control defects showed signs of suppurative inflammation at one week time interval with diminished vascularization. The results advocated the suitability of BGnf as bioscaffold to be used in a wet environment as the oral cavity that is full of microorganisms and also for an immune-compromised condition as diabetes mellitus.

Intra-abdominal Actinomycosis Imitating Sigmoid Colon Cancer: A Case Report

Actinomycosis is a rare bacterial disease characterized by chronic or subacute suppurative inflammation. Abdominal actinomycosis is rarer and accounts for approximately 20% of all actinomycosis cases. In the literature, patients who underwent surgery for actinomycosis mimicking malignant tumors have been reported. Most of these patients had mucosal trauma and inflammation signs. It is often difficult to diagnose abdominal actinomycosis preoperatively and often impossible to distinguish it from a malignant tumor. We present a case that preoperatively was diagnosed as a malignant tumor but pathological evaluation reported to be diverticulitis and actinomycosis. This case can increase the awareness about this disease, which is possible to be treated non-surgically.

Therapy of patients with congenital epidermolysis bullosa using modern non-adherent wound dressings

Aim. To evaluate the clinical efficacy of modern atraumatic non-adherent wound dressings in patients with congenital epidermolysis bullosa. Materials and methods. The study involved 9 patients diagnosed with congenital epidermolysis bullosa (EB), including 7 women and 2 men aged 21–50 years. All the patients underwent immunofluorescent antigenic mapping of skin biopsies to confirm the clinical diagnosis. External therapy using modern atraumatic non-adherent wound dressings was performed in all the patients. The evaluation of the clinical efficacy of the applied therapy was carried out on the 14th and 30th day in accordance with the following criteria: complete healing of erosions or ulcers; significant improvement (reduction of erosions/ulceration by at least 75 % compared with the baseline data, reduction of exudate, the presence of granulations, reduction of inflammation signs, reduction of pain); improvement (reduction of erosions/ulceration area by less than 75 %, but more than 25 % compared with the baseline data, reduction of exudate, presence of granulations, reduction of inflammation signs, reduction of pain); without change (reduction of erosions/ulceration by less than 25 % or no change compared with the baseline data, a slight decrease in the amount of exudate, no granulations, a slight decrease in inflammation signs, a slight reduction of pain); deterioration (increase in the area of erosions/ulceration, increase in the amount of exudate, the level of inflammation and subjective estimation either increases or remains the same). Results. On the 14th day, 22 out of 58 (37.9 %) erosions were epithelized. The area of 15 erosions was reduced by more than 75 %. The area of 12 erosions (20.6 %) was reduced by more than 25 %, but less than 75 %. The area of 7 (12.25 %) erosions decreased by less than 25 %. The area of 2 erosions in patients with severe generalised recessive dystrophic epidermolysis bullosa (RDEB) increased (3.45 %). Out of 36 erosions that had not been epithelized by the 14th day, 20 (55.5 %) achieved complete healing by the 30th day. The dimensions and characteristics of 5 (13.8 %) nonhealing erosive-ulcerative defects had remained unchanged by the 30th day. The share of reduction in the area of these defects did not exceed 30 %. Conclusion. The obtained results demonstrate the clinical efficacy of external therapy using modern atraumatic nonadherent wound dressings. The dynamic observation of erosive-ulcerative defects, regular documentation of changes in the parameters of erosive and ulcerative defects allows the development of standardised approaches of efficient external therapy in such conditions, including the selection of non-adherent dressings. Objective assessment of the dynamics of erosive-ulcerative skin defects contributes to the development of individualized plans for treating EB patients.

Diaphyseal osteomyelitis of femur with suspected ewing sarcoma in 8 years old children: a case report

Metaphyseal osteomyelitis in children due to direct bone trauma or vascular insufficiency is a frequent problem in orthopaedic surgery. In contrast, diaphyseal osteomyelitis represents a rare entity that almost exclusively affects child with bony infarct in sickle cell anemia. Differentiating neoplasm from musculoskeletal infection can sometimes be very challenging. In particular, Ewing sarcoma can masquerade as osteomyelitis with the presenting symptoms of fever, localized bone pain, and elevated inflammatory markers common to both entities, although osteomyelitis is a totally different type of disease. In this article, we report the case of chronic osteomyelitis of the femur in an immunocompetent and otherwise healthy 8 years old boy with minor inflammation signs and misleading clinical features. The X-ray showed onion skin periosteal reaction. We evacuated about 200 cc of abscess. Biopsy report revealed polimononuclear, mononuclear, and necrotic inflammatory cells. The patient was treated with antibiotic for two weeks and discharged with improved general condition. Six months follow-up shows clinical and radiological improvement. The diagnosis had to be confirmed by surgery which allowed the initiation of a targeted therapy. A case of diaphyseal osteomyelitis of a femur, lacking predisposing factors or trauma, is unique in children and never been reported previously.

Adult-Onset Hepatocyte GH Resistance Promotes NASH in Male Mice, Without Severe Systemic Metabolic Dysfunction

Nonalcoholic fatty liver disease (NAFLD), which includes nonalcoholic steatohepatitis (NASH), is associated with reduced GH input/signaling, and GH therapy is effective in the reduction/resolution of NAFLD/NASH in selected patient populations. Our laboratory has focused on isolating the direct vs indirect effects of GH in preventing NAFLD/NASH. We reported that chow-fed, adult-onset, hepatocyte-specific, GH receptor knockdown (aHepGHRkd) mice rapidly (within 7 days) develop steatosis associated with increased hepatic de novo lipogenesis (DNL), independent of changes in systemic metabolic function. In this study, we report that 6 months after induction of aHepGHRkd early signs of NASH develop, which include hepatocyte ballooning, inflammation, signs of mild fibrosis, and elevated plasma alanine aminotransferase. These changes occur in the presence of enhanced systemic lipid utilization, without evidence of white adipose tissue lipolysis, indicating that the liver injury that develops after aHepGHRkd is due to hepatocyte-specific loss of GH signaling and not due to secondary defects in systemic metabolic function. Specifically, enhanced hepatic DNL is sustained with age in aHepGHRkd mice, associated with increased hepatic markers of lipid uptake/re-esterification. Because hepatic DNL is a hallmark of NAFLD/NASH, these studies suggest that enhancing hepatocyte GH signaling could represent an effective therapeutic target to reduce DNL and treat NASH.