Difluoromethylornithine (DFMO), a specific, irreversible inhibitor of polyamine biosynthesis shown to be curative in animal models inoculated with various Trypanosoma spp., was evaluated in the Southern Sudan in a preliminary open clinical field trial in patients infected with Trypanosoma brucei gambiense. 20 patients were studied including 18 with late-stage disease involving the central nervous system, 16 of whom were refractory to arsenical treatment. In late-stage disease monotherapy with oral DFMO doses of about 400 mg/kg/day for five to six weeks was associated with disappearance of parasites from cerebrospinal fluid (CSF), decreased CSF WBC counts and protein concentrations and reversal of clinical signs. Side effects associated with this dose regimen included diarrhoea, abdominal discomfort and anaemia, but were seldom sufficiently severe to prompt discontinuing therapy. In early-stage patients about 200 mg/kg/day for six weeks appears adequate to eliminate parasites and reverse clinical symptoms and is well tolerated. Three cases of late-stage sleeping sickness and two of early-stage disease followed up for approximately one and a half to two years after treatment indicated that DFMO monotherapy can be curative. Additional studies are needed to define optimal posology. Inhibition of polyamine biosynthesis is a promising new approach to therapy of trypanosomiasis.
A 5‐year‐old cat developed a raised hair coat and adherent crusting lesions involving the skin of the head, dorsal neck and abdomen. Erosions were present on the lips and eyelids. The footpads were dry and scaly. Histopathology revealed infiltrative lymphocytic folliculitis, moderate lymphocytic infiltration into the epidermis and apoptotic epidermal cells. A restricted diet as the only therapy resulted in gradual resolution of the skin lesions. Despite an improvement in the dermatological condition, the cat increasingly lost all appetite and marked weight loss occurred. The cat died 4 months after presentation. Post‐mortem revealed a perforated gastric ulcer and a mild to moderate inflammatory bowel disease. The clinical course of lesion resolution in this cat suggested a diet‐related pathogenesis. The late finding of intestinal disease in a patient with diet‐related skin disease is still interesting and needs to be evaluated by further case studies.
A 7-month-old-intact male domestic shorthair cat was presented with fever, anterior uveitis in the right eye and respiratory distress when handled. These signs along with mild changes in serum protein levels and the exclusion of other potential causes were suggestive of feline infectious peritonitis (FIP). As the disease progressed, more clinical signs consistent with FIP, including renal involvement and later pleural effusion, became evident. Non-pruritic cutaneous lesions, characterized by slightly raised intradermal papules over the dorsal neck and over both lateral thoracic walls, were recognized at the end stage of the disease. The identification of papules in well-haired skin was difficult, and clipping of the fur facilitated their detection. Definitive diagnosis of FIP was made by histopathology and by immunohistochemical demonstration of coronavirus antigen in macrophages within kidney and skin lesions. The case was classified as a mixed form of FIP. Recognition of associated cutaneous lesions may facilitate a diagnosis of FIP in suspicious cases.
Four cases in cattle of omental herniation through an acquired omental rent are described. Clinical signs were indistinguishable from other causes of mechanical ileus and exploratory laparotomy was necessary to establish a diagnosis. In all cases a variably sized portion of jejunal loops was obstructed in an omental rent in the deep layer of the greater omentum. In two cases simple reduction was possible, and in one case incision of the hernial ring was necessary before reduction could be performed. Resection was necessary only in a calf, in which the incarceration was complicated by severe abomasal distension and local peritonitis. In all four cases the omental rent was closed by a serosa-serosa suture. Three cases made an uneventful recovery and returned to normal production, but one of these animals died three months postoperatively from an unknown cause. The calf was euthanased two days postoperatively because of persistent ileus.
Summaryobjectives To test the reproducibility and thermostability of a new format of the Card-Agglutination Test for Trypanosomiasis (CATT) test for Human African Trypanosomiasis (HAT), designed for use at primary health care facility level in endemic countries.methods A population of 4217 from highly endemic villages was screened using the existing format of the CATT test (CATT-R250) on whole blood. All those testing positive (220) and a random sample of negatives (555) were retested in the field with the new format (CATT-D10). Inter-format reproducibility was assessed by calculating kappa. All samples testing positive on whole blood with either method were further evaluated in Belgium by CATT titration of serum by two observers, using both old and new format. CATT-D10 test kits were incubated under four temperature regimens (4, 37, 45°C and fluctuating) with regular assessments of reactivity over 18 months.results Inter-format reproducibility of CATT-D10 vs. CATT-R250 on whole blood performed by laboratory technicians in the field was excellent with kappa values of 0.83-0.89. Both inter-and intra-format reproducibility assessed by CATT titration were excellent, with 96.5-100% of all differences observed falling within the limits of ±1 titration step. After 18 months, reactivity of test kits incubated under all four temperature regimens was still well above the minimum threshold considered acceptable.conclusion The CATT-D10 is thermostable and can be used interchangeably with the old format of the CATT test. It is highly suitable for use in peripheral health facilities in HAT-endemic countries.
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