The study found a high prevalence of vitamin D deficiency in hospitalized cancer patients under active treatment. Many authors have recommended dosing vitamin D levels in this population; normalizing serum levels is difficult.

VALVULAR endocarditis in camelids has not previously been reported in the literature to the authors' knowledge. This short communication describes the clinical signs and methods used in the diagnosis of valvular endocarditis in a dromedary camel on Gran Canaria. An I1-year-old, castrated male dromedary camel with a threeto four-month history of progressive exercise intolerance presented with a reluctance to move, and mild incoordination and weakness with even minimal movement. The camel had received several courses of benzylpenicillinstreptomycin (Espes; Calier) at a dosage 0-01 mg/kg liveweight per day for five days, which produced a mild temporary response. On physical examination, the camel was in a poor body condition, with pale mucous membranes, a rectal temperature of 37-2°C, a respiratory rate of 10 breaths per minute and a heart rate of 48 beats per minute (reference data 36 to 39°C, five to 10 breaths per minute, 35 to 50 beats per minute, respectively) (Higgins and Kock 1986). No respiratory distress, oedema or other clinical signs were evident at the time, except an enlargement of the right cervical superficial dorsal lymph node (10 x 7 cm) which when palpated revealed a soft, doughy mass surrounded by a firm wall. The lymph node was aspirated aseptically and a thick, viscous, creamy-white material was collected. A blood sample was taken for microbiological study. Both samples were cultured on sheep blood agar and MacConkey agar, and incubated at 37°C for 48 hours under aerobic and anaerobic conditions. Cardiac auscultation revealed a moderate grade III pansystolic murmur at the fourth intercostal space, midway between the shoulder and elbow. An electrocardiogram (ECG) was obtained under field conditions with the camel in sternal recumbency. ECG recordings were made using a battery operated one-channel electrocardiograph (Bexline; Bexen), with standardisation of lmV equivalent to 10 mm deflections and the traces recorded at a paper speed of 25 mm/second. ECG recordings were taken using standard bipolar and augmented unipolar limb leads. The alligator clip electrodes were connected to the loose skin at the points of the camel's elbows and stifles. The R-wave voltage in lead II was 0-7 mV (normal range 0-6 mV + 0-379) and the mean electric axis was 136°(normal range 189-68°+ 123-690) (Rezakhani and Szabuniewicz 1977). No alterations in rhythms were recorded. Ultrasound examination could not be conducted under the field conditions. Corynebacterium pseudotuberculosis was isolated from the lymph node aspirate. Forty-eight hours after inoculation on sheep blood agar, the cream, umbonate colonies produced flocculation and sedimentation. The bacteria were positive to catalase and urease tests, but negative for pyrazinamidase and nitrate activity. The bacterial agent fermented maltose and

Neutrophil‐to‐lymphocyte ratio (NLR) has been studied as a prognostic factor for mortality in COVID‐19 patients. Our study aimed to evaluate the association between NLR at COVID‐19 diagnosis and survival during the following 90 days in hospitalized patients with solid cancer. Between May 2020 and June 2021, 120 patients were included in a retrospective cohort study. Univariable analysis showed patients with an NLR > 8.3 were associated with an increased risk of death (HR: 4.34; 95% CI: 1.74–10.84) compared to patients with NLR < 3.82 and with NLR ≥3.82 and ≤8.30 (HR: 2.89; 95% CI: 1.32–6.36). Furthermore, on multivariable analysis, NLR > 8.30 independently correlated with increased mortality. In patients with solid malignancies with COVID‐19, an NLR > 8.3 is associated with an increased risk of death.

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