First report of nephrocutaneous fistula in a cat

Nephrocutaneous fistula (NCF) is a very serious rare renal disorder that had not been recorded in cats. This case report describes - for the first time - the features and treatment of a nephrocutaneous fistula in a 3-year-old female intact Persian cat. The cat was referred with a history of lethargy, anorexia, vomiting and recurrent abscess discharging purulent material at the right flank region. Moreover, the cat had a history of cystitis, urethritis and urethral obstruction since 12 months. Physical, laboratory, radiographic and ultrasonographic examinations were performed. The cat was treated with simple nephrectomy and excision of the fistulous tract. The animal showed dehydration, fever, painful abdominal palpation, right nephromegaly, anaemia, neutrophilic leukocytosis and moderate azotaemia. Abdominal radiographs revealed a large radiodense mass at the mid abdomen displacing the intestine caudally. Ultrasonography revealed a renal abscess with marked enlargement of the right kidney, hyperechoic purulent content and loss of parenchymal details of the right kidney. Complete recovery of the cat without any complications was seen after surgical treatment. In conclusion, nephrocutaneous fistula should be listed as one of renal diseases in cats. Nephrectomy as well as excision of the fistulous tract appear to be successful in the treatment of this disorder in cats.

Histopathologic Findings of Potential Kidney Donors With Asymptomatic Microscopic Hematuria: Impact on Donation

INTRODUCTION

Isolated microscopic hematuria (IMH) is not uncommon in potential kidney donors.

AIM

The aim was to study the kidney biopsy findings of potential kidney donors with IMH and the impact of the histopathologic diagnoses on the decision to accept or decline such donors from kidney donation.

METHODS

In this retrospective study, all the potential kidney donors with IMH were identified from the medical records of patients who underwent kidney biopsies between January 2010 and December 2016.

RESULTS

Forty-five such individuals were identified. The mean age of these potential donors was 32.6 years and 76% were male. All of them had normal blood pressure and no significant proteinuria. Seventeen (38%) biopsies showed histopathologic abnormalities; thin basement membrane disease (n = 13; 28%) was the most common cause followed by immunoglobulin (Ig)A nephropathy (n = 4; 9%). Donors with abnormal biopsy findings were excluded from donation. However, 62% of the potential donors had normal kidney biopsy findings and were accepted for kidney donation.

CONCLUSION

IMH justifies extensive work-up including kidney biopsy to identify donors who may have underlying significant glomerular pathology excluding them from kidney donation. On the other hand, kidney biopsy also helps in accepting the donors if it does not show significant abnormality.

Epidemiology and risk factors of brucellosis in Alexandria governorate

This study aimed to describe the trend and to identify possible risk factors for brucellosis in Alexandria in northern Egypt. We enrolled 72 confirmed cases of brucellosis and 144 age-matched controls in this study. Participants were interviewed at home using a structured questionnaire. Working with animals, breeding goats and eating ice cream bought from street vendors were significantly associated (P < 0.05) with brucellosis by univariate and multivariate analysis. Contact with infected animals and their products was the most important method of transmission.

Infections of the lower female genital tract during childhood and adolescence

PURPOSE

To review the pathogenesis, clinical presentation, diagnosis and treatment of lower female genital tract infections at a young age.

METHODS

Review study.

CONCLUSIONS

Lower female genital tract infections at a young age may involve the vulva, the vagina and, less frequently, the fallopian tubes. Good knowledge of the physiology and anatomy of the respective areas plays an important role in the diagnosis and treatment of vulvovaginitis. Candida albicans is the most frequent cause of infection, while Gardnerella vaginalis, Chlamydia trachomatis, Mycoplasma, and Trichomonas vaginalis are rarer ones. The clinical presentation includes a variety of symptoms and signs, with vaginal discharge being the prominent one. Treatment should be causative after careful investigation while preventive advice is mandatory.

Colposcopically directed biopsy findings in the young female

STUDY OBJECTIVE

To evaluate the colposcopic findings of cervical alterations in the young sexually active female.

DESIGN, SETTING, PARTICIPANTS

Colposcopic examination and follow-up of 51 young sexually active females aged 15-20 yr was conducted due to abnormal cytology or a suspicious abnormality of the cervix. The study was conducted at the Colposcopy Units of the 1(st) and 2(nd) Departments of Obstetrics and Gynecology, University of Athens, Greece. ONTERVENTIONS: Colposcopic examination, LEEP, conization.

MEAN OUTCOME MEASURES

Biopsy, human papillomavirus (HPV) typing.

RESULTS

Colposcopic examinations were within normal limits in 8 of 51 (15.7%) cases. Cervical alterations were related to HPV infection in 14 cases (27.4%), to cervical intraepithelial neoplasia (CIN) I in 15 (29.4%) cases, to CIN II in 13 (25.5%) cases, and to CIN III in 1 (2.0%) case. Of all CIN I cases, 8 of 15 (53.3%) were HPV positive, and HPV type 11, 16, 18, 31, 33, and 11& 16 were found. In CIN II cases, 5 of 13 (38.4%) were HPV positive, and HPV type 11, 16, 18, and 11 & 31 were found. In the CIN III case, only HPV type 16 was found.

CONCLUSIONS

Our findings strongly confirm the necessity of obtaining cervicovaginal smears on all sexually active gynecologic and obstetric teenage patients. Colposcopy plays a major role in the evaluation of the cervix and in the treatment that should be given for any individual CIN lesion.

Laparoscopic treatment of hydrosalpinx: factors affecting pregnancy rate

STUDY OBJECTIVE

To evaluate the efficacy of laparoscopic surgery in a series of women with hydrosalpinx.

DESIGN

Prospective, observational study (Canadian Task Force classification II-2). Setting. University-affiliated hospital.

PATIENTS

Sixty-one women undergoing bilateral neosalpingostomy and restoration of tubal ovarian anatomy laparoscopically, and followed for 24 months.

INTERVENTION

Video-controlled operative laparoscopy using standard four-puncture technique.

MEASUREMENTS AND MAIN RESULTS

During 24-month follow-up, cumulative intrauterine pregnancy rates at 6-month intervals were 6.8%, 13.6%, 20.5%, and 20.5% for patients with only distal tubal obstruction and 12%, 23%, 29%, and 29% for those with mild degree of tubal disease and periadnexal adhesions. Miscarriage rate for intrauterine pregnancies was zero in both groups.

CONCLUSION

Operative laparoscopy seems to be an effective treatment for hydrosalpinx in terms of pregnancy outcome.

Adolescent sexuality: a developmental milestone or risk-taking behavior? The role of health care in the prevention of sexually transmitted diseases

Of the many perspectives from which one can view teenage sexual activity, the most evident are as a normal developmental milestone in the life of the adolescent, or as risk-taking and possibly health-compromising behavior. Since unfortunately, knowledge about sexuality, reproduction, and contraception is often acquired after sexual activity has begun, the prevention of pregnancy and sexually transmitted diseases (STDs) should be given high priority in health care and in education. The role of sex education has been a controversial issue for years and communication within the family vis-à-vis the teenager's decision to use contraception is often difficult both for the parents and for the adolescent. In the areas of adolescent sexual behavior, sex education, contraception, and counseling, it is imperative and of paramount importance that the health-care system focus on this target group.

Effect of octreotide on the pathology of hepatic schistosomiasis

In clinical practice, octreotide (CAS 83150-76-9) has its greatest impact in the management of bleeding varices. The present work is the first one which was undertaken to investigate the possible use of octreotide as an antifibrotic agent and to study its effect on hepatic vasculature in Schistosoma mansoni infection. The material of this investigation consisted of two groups of albino mice (A, B), subdivided each into normal control, infected control, subgroups treated with octreotide, praziquantel (CAS 55268-74-1), and a combination of octreotide and praziquantel. Groups A and B were sacrificed at the 8th week and the 18th week post infection, respectively. By analysis of the obtained results, octreotide induced a reduction of the portal pressure, the weight of the spleen and the liver, the liver egg load (number of eggs) granuloma size and cellularity, and of the degree of hepatic fibrosis quantified by serum N-terminal peptide of type III procollagen in serum, serum laminin and tissue collagen using a Picrosirius red dye assay. Moreover, the biochemical state of hepatocytes has been improved. The subgroups treated with octreotide in association with praziquantel revealed better results than the subgroups treated with praziquantel alone. These obtained data were analysed in terms of histological extent of liver fibrosis in sections stained with Masson trichrome and sirius red, hepatocytic and sinusoidal changes at an ultrastructural level and by immunohistochemical demarcation of endothelial cells of blood vessels through the determination of factor VIII-related antigen. The promising results detected in this study may encourage to further investigate the positive findings of this drug with the intention of its possible application on a clinical level.

Octreotide decreases connective tissue formation and improves vascular changes associated with hepatic schistosomiasis

In clinical practice, Octreotide has its greatest impact in the management of bleeding varices. The present work is the first one which was undertaken to investigate the possible use of Octreotide as an antifibrotic agent and to study its effect on hepatic vasculature in Schistosoma mansoni infection. The material of this investigation consisted of two groups of albino mice (A&B) subdivided each, into normal control, infected control, Octreotide treated, Praziquantel treated and Octreotide with Praziquantel treated subgroups. Groups A & B were sacrificed at the 8th week and the 18th week post infection respectively. By analysis of the obtained results, Octreotide has induced reduction of the portal pressure, the weight of the spleen and the liver, the number of liver egg load, granuloma size and cellularity, and of the degree of hepatic fibrosis quantified by serum PIIINP, serum laminin and tissue collagen using sirius red dye assay. Moreover, the biochemical state of hepatocytes has been improved. The subgroups treated with Octreotide in association with Praziquantel revealed better results than the subgroups treated with Praziquantel alone. Data were analysed in terms of histological extent of liver fibrosis in sections stained with Masson trichrome and sirius red, hepatocytic and sinusoidal changes at an ultrastuctural level and by immunohistochemical demarcation of endothelial cells of blood vessels through the determination of factor VIII related antigen. The promising results detected in this study may encourage to further investigate the positive findings of this drug with the intention of its possible application on a clinical level.

Non-Hodgkin's ovarian lymphoma during adolescence: report of two cases

STUDY OBJECTIVE

To present two cases of non-Hodgkin's ovarian lymphoma during adolescence.

DESIGN

Follow up of the patients. Report of diagnostic and therapeutic approaches.

SETTING

Division of Pediatric and Adolescent Gynecology and Corrective Gynecological Surgery, University of Athens (Athens, Greece).

INTERVENTIONS

Laparotomy and chemotherapy. RESULTS AND MAIN OUTCOME: Three- and five-year survival rates.

CONCLUSIONS

Ovarian lymphoma constitutes a rare entity with guarded prognosis. Selective surgery and chemotherapy constitute the treatment of choice.

Vulvovaginitis during childhood and adolescence

STUDY OBJECTIVE

To evaluate cases of vulvovaginitis treated in our institutions.

DESIGN

Follow-up of 1,778 cases of vulvovaginitis to investigate the prevalence of various pathogens involved in the disease.

SETTING

Divisions of pediatric and adolescent gynecology, university hospitals of Crete and Athens, Greece.

PARTICIPANTS

Girls 1-18 years old seen at the clinics of the above institutions.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Vaginal culture, cytology, and vaginoscopy.

RESULTS

Vulvovaginitis was encountered in 61.8% of the gynecological problems seen during childhood and adolescence. Infections were usually located in both the vulva and the vagina (56.9%). The main symptoms were vaginal discharge (53%), erythema (33%), and pruritus (27%). Candida spp (23.0%), beta-hemolytic Streptococci group B (15.0%), and Enterococci spp (10.0%) were the most frequent pathogens involved in the disease.

CONCLUSIONS

Vulvovaginitis is a common disease during childhood and adolescence. Effective treatment, reassurance, and appropriate consultation based on the prevention of relapses are the most important steps for the management of the disease.

Endothelin plasma levels in primary amenorrheic adolescents before and after estrogen treatment

OBJECTIVE

We evaluated the effect of estrogen administration on endothelin (ET) secretion in primary amenorrheic (PA) adolescent girls.

METHODS

Fifteen PA adolescents (ten hypergonadotropic, group A; five hypogonadotropic, group B) were treated with estrogen and progestogen tablets. A control group of ten healthy adolescents (group C) was included in the study. The ET 1-21, FSH, and LH plasma levels were tested before treatment (PrT) and immediately after the last estrogen tablet but before the progestogen administration (PoT).

RESULTS

A statistically significant difference (P < .01) in ET 1-21 plasma values was found between PrT (9.66 +/- 0.80 pmol/L) and PoT (7.56 +/- 0.89 pmol/L) levels in group A cases. A similar reduction (P < .05) was recorded between PrT (8.06 +/- 0.46 pmol/L) and PoT (5.59 +/- 0.53 pmol/L) ET 1-21 plasma levels in group B cases. Endothelin 1-21 plasma PrT values were higher in both group A and B cases in comparison with controls (6.66 +/- 0.44 pmol/L; P < .01, P < .1, respectively).

CONCLUSIONS

Estrogens administered to PA adolescents reduce ET 1-21 plasma levels in both hyper-and hypogonadotropism.