Cat scratch disease and lymph node tuberculosis in a colon patient with cancer

A 71-year-old man operated for a sigmoid tumour remained in the surveillance after adjuvant chemotherapy. After 3 years, a left axillary lymph node was visible on CT scan. The biopsy revealed a necrotising and abscessed granulomatous lymphadenitis, suggestive of cat scratch disease. The patient confirmed having been scratched by a cat and the serology for Bartonella henselae was IgM+/IgG-. Direct and culture examinations for tuberculosis were negative. The patient was treated for cat scratch disease. One year later, the CT scan showed increased left axillary lymph nodes and a left pleural effusion. Direct and cultural examinations to exclude tuberculosis were again negative. Interferon-γ release assay testing for tuberculosis was undetermined and then positive. Lymph node and pleural tuberculosis were diagnosed and treated with a good radiological response. This article has provides evidence of the importance of continued search for the right diagnosis and that two diagnoses can happen in the same patient.

Unusual head metastasis of kidney cancer

Renal cell carcinoma (RCC) metastasis can involve any organ. Head metastasis are rare, namely tongue, scalp and nose and only a few cases have been described. The authors describe three cases of unusual presentation of head metastasis of RCC. In case 1, a 50-year-old man with RCC underwent left nephrectomy, and presented 16 months later with nasal metastasis. In case 2, a 64-year-old woman with RCC operated 12 years ago, relapsed at multiple sites including scalp, which was treated surgically. In case 3, a 47-year-old man with RCC developed metastasis in multiple organs including a mass on the tongue that was operated and was compatible with primary tumour metastasis. These cases show the importance of correct diagnosis of rare presentations and local treatment of metastasis of RCC.

In vitro evaluation of the effect of a high plant protein diet and nucleotide supplementation on intestinal integrity in meagre (Argyrosomus regius)

In the present study, the protective effect of nucleotides over damages induced by the consumption of a diet containing a high amount of vegetable ingredients (560 g kg(-1)) in the intestinal epithelia of the meagre (Argyrosomus regius) was assessed by assays performed with an Ussing-type chamber. Two experimental feeds were prepared including or not a commercial mixture of nucleotides (1 g kg(-1)). Nucleotides significantly enhanced fish growth during the experiment. On the other hand, differences in the integrity and functionality of intestinal epithelia were evidenced by a change in the polarity of intestinal trans-epithelial potential. Samples of fish fed on the control diet showed a preferentially secretory short-circuit current, while those of fish receiving the nucleotide-supplemented diet showed a significantly lower and preferentially absorptive negative current. It is concluded that alterations of intestinal physiology juvenile meagre resulting from the intake of high amounts of plant ingredients could be minimized by nucleotide supplementation.

Sarcoma in the thymus of juvenile meagre Argyrosomus regius reared in an intensive system

Juvenile meagre Argyrosomus regius (Asso, 1809) maintained in experimental conditions developed lateral and/or bilateral circular-shaped sarcoma within the opercular cavity. The sarcoma was dense, reddish and its growth from the branchial arch exerted pressure on the operculum forcing it to open. Histologically, the neoplasm exhibited marked proliferation of mesenchymal connective tissue composed largely of fusiform cells, which developed in a solid pattern accompanied by abundant mononuclear cell types. Multifocal areas of discrete necrosis were also observed, compatible with a sarcomatous proliferation. The immunological parameters analysed suggested an inflammatory response. No bacteria were isolated from the hematopoietic organs. However, Vibrio species, components of the normal seawater flora, were isolated from the tumour, which may have had a role in eliciting the immune response. No evidence of viral pathogens was found by electron microscopy. In order to look for cytogenetic alterations often linked to sarcomas, the diploid number and karyotype of this species were determined for the first time. An increase in the aneuploidy level was observed in sarcoma cell metaphase stages compared to other tissues. The aetiology of this tumour remains unknown.

Cyclophosphamide-based in vivo T-cell depletion for HLA-haploidentical transplantation in Fanconi anemia

Allogeneic hematopoietic cell transplantation (HCT) is the only known cure for patients with Fanconi anemia (FA) who develop aplasia or leukemia. However, transplant regimens typically contain high-dose alkylators, which are poorly tolerated in FA patients. Furthermore, as many patients lack human leukocyte antigen (HLA)-matched family donors, alternative donors are used, which can increase the risk of both graft rejection and graft-versus-host disease (GVHD). To improve on these three concerns, we developed a multi-institutional clinical trial using a fludarabine (FLU)-based conditioning regimen with limited alkylators/low-dose radiation, HLA-haploidentical marrow, followed by reduced-dose cyclophosphamide (CY) to treat three FA patients with aplasia. All three patients engrafted with 100% donor CD3 chimerism at 1 month. One patient died early from disseminated toxoplasmosis infection. Of the two survivors, one had significant pretransplant co-morbidities and inadequate immunosuppression, and developed severe acute GVHD. The other patient had only mild acute and no chronic GVHD. With a follow-up of 2 and 3 years, respectively, both patients are doing well, are transfusion-independent, and maintain full donor chimerism. The patient with severe GVHD has resolving oral GVHD and good quality of life. We conclude that using low-intensity conditioning, HLA-haploidentical marrow, and reduced-dose CY for in vivo T-cell depletion can correct life-threatening aplasia in FA patients.

Iodine and selenium supplementation increased survival and changed thyroid hormone status in Senegalese sole (Solea senegalensis) larvae reared in a recirculation system

To test how iodine and both iodine and selenium supplementation affected the thyroid status as well as growth and survival in Senegalese sole, larvae were reared in a recirculation system from 15 to 34 DAH. Sets of three tanks were assigned to each of the following three diets: control (C), iodine (I) and iodine and selenium (I + Se). Samples were collected at 15, 27 and 34 DAH to determine dry weight, iodine and selenium levels, GPx and ORD activities, thyroid hormone levels and thyroid follicles histology. At 34 DAH, fish from the control (C) treatment suffered from hyperplasia of the thyroid follicles (goitre), whereas iodine-treated larvae did not (I and I + Se). Lower survival rates in the C groups were probably a consequence of the hyperplasia. Moreover, there was an improvement in thyroid hormone status in I- and I + Se-treated larvae, showing that further supplementation of live feed with iodine can be crucial for fish at early life stages, as it seems to sustain normal larval development, when reared in a recirculation system. Selenium did not affect the results. Together with previous results, this indicates selenium supplement is more important at younger life stages.

A groundwater perspective on the river basin management plan for central Portugal - developing a methodology to assess the potential impact of N fertilizers on groundwater bodies

The Water Framework Directive establishes that the river basin management plans must have a summary of the pressures and impacts of human activities, such as agriculture, on the chemical and quantitative status of groundwater bodies. In order to identify those areas where a potential impact from agricultural activities on groundwater bodies exists, but currently lacking groundwater monitoring data, a methodology was developed that combines the use of gross nitrogen balance values with the results of a specific vulnerability assessment index. A farm management efficiency parameter is added, to identify the factors that contribute to nitrogen use efficiency and to assess the near-future scenarios. This methodology allows the identification of significant pressures that may be responsible for a groundwater body failing good status where there is no representative monitoring network.

Major issues regarding the efficiency of monitoring programs for nitrate contaminated groundwater

Major issues regarding the efficiency of moni toring programs for nitrate contaminated groundwater are analyzed in this paper: (i) representativeness of monitoring networks; (ii) correct interpretation of the monitoring data and resulting time series and trends; and (iii) differentiation among the different sources of nitrates in groundwater. Following an overview of the nitrate contamination problem and possible solutions, as well as some of the difficulties found, a relatively straightforward method for assessing monitoring network representativity is presented, namely interpolation standard error assessment. It is shown how nitrate-concentration time series resulting from periodic observations can be corrected with a conservative tracer, in order to avoid misinterpretation and confirm or correct apparent trends. Finally, coupled ¹⁵N and ¹⁸O isotope signatures of nitrate (NO₃⁻) in groundwater are used to differentiate among nitrogen (N) sources, to ensure correct targeting of restoration measures. The case study regards a Nitrate Vulnerable Zone in the south of Portugal, designated in compliance with the European Nitrates Directive, where coastal discharge of nutrient-rich groundwater threatens the good qualitative and ecological status of the Ria Formosa coastal lagoon. Results show that mineral fertilizer is the main source of N in groundwater, and that increases in N load can be masked by dilution phenomena.