Mycobacterium avium-intracellulare, a member of the M avium complex (MAC), is a ubiquitous, saprophytic, slowgrowing, acid-fast bacillus that is widely distributed in the environment (Greene and Gunn-Moore 2006). Clinical signs associated with MAC infection are typically organ-specific, depending on the route of infection.Dissemination can occur in immunocompromised hosts. The treatment of localised disease consists of surgical removal of the infected tissue, with or without medical therapy (Kaufman and others 1995, Malik and others 1998). The treatment of disseminated MAC infection in cats has recently been reported to be successful with a variety of combination drug regimens, including clofazimine and clarithromycin as essential components (Baral and others 2006). This short communication describes the treatment of a cat with disseminated M avium infection with a multidrug regimen and the associated side effects.A five-year-old, male neutered Abyssinian cat was evaluated by a private veterinarian because of a history of weight loss and anorexia. Physical examination revealed an abdominal mass, which was removed surgically. Pyogranulomatous inflammation was observed on histopathological examination of the mass. Tests for feline leukaemia virus (FeLV) antigen and feline immunodeficiency virus (FIV) antibody were negative. Treatment with prednisone was initiated, but within two weeks the cat became tachypnoeic and was referred to the University of Georgia Veterinary Teaching Hospital.Thoracic radiography revealed a diffuse, nodular interstitial lung pattern. Pyogranulomatous inflammation without visible microorganisms was detected on bronchoalveolar lavage (BAL) and on transthoracic lung aspirates. The results of aerobic bacterial and fungal cultures and tests for cryptococcal antigen (latex agglutination test), toxoplasmosis antibodies (immunoglobulin M [IgM] and immunoglobulin G [IgG] ELISAs) and coronavirus antibody (immunoflourescent antibody test), were negative. On an empirical basis, the cat was discharged on 10 mg/kg clindamycin and 5 mg/kg itraconazole, both administered orally every 12 hours.Two months later, the cat was re-presented because of persisting anorexia and tachypnoea. At that time (day 0) the cat was thin (bodyweight 2·7 kg) and had a normal rectal temperature and a markedly increased respiratory rate, with increased expiratory effort. Thoracic auscultation revealed increased normal breath sounds bilaterally, and abdominal palpation revealed a 6 x 7 cm, irregular, non-painful mass in the mid-abdomen. Laboratory abnormalities included mild neutrophilia (15,768 cells/µl, reference range [RR], 2500 to 12,500 cells/µl) with left shift (bands, 1944 cells/µl, RR 0 to 300 cells/µl), hyperglobulinemia (51 g/l, RR 30 to 34 g/l) and hypercalcemia (total calcium 4·0 mmol/l, RR 2·25 to 2·7 mmol/l; ionised calcium 1·59 mmol/l, RR 1·22 to 1·3 mmol/ l). A severe bronchointerstitial lung pattern was detected on thoracic radiography (Fig 1). Abdominal ultrasonography revealed multiple irregularly marginated h...
Las enfermeras han tenido un papel muy importante a lo largo de la historia, especialmente, en los conflictos bélicos, siendo claves en la atención y cuidados de los pacientes. Las guerras tienen como consecuencia, entre otras, el desarrollo del cuidado y terapéutica, cuya finalidad siempre ha sido ofrecer la mejor atención para la reincorporación de los soldados al campo de batalla [Fragmento de texto].
La alimentación complementaria (AC) se define por la introducción de alimentos líquidos, semilíquidos o sólidos diferentes a la lactancia materna o leche de fórmula en el niño, para satisfacer las necesidades adecuadamente a partir de una determinada edad. La Organización Mundial de la Salud (OMS) entre otras sociedades recomiendan la introducción de la AC a partir de los 6 meses de edad, siempre que sean seguros y adecuados nutricionalmente [Fragmento de texto].
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