RESUMO
Background: Caseous Lymphadenitis (CL) is a chronic infectious disease caused by the bacterium Corynebacteriumpseudotuberculosis, which is considered the main agent responsible for abscess lesions. In the visceral form it can affect theinternal organs of sheep and goats, which could negatively affect animal health and cause large economic losses for producers.Case: This study aims to report a case of intestinal CL in sheep, with suspected diagnosis during physical examinationand identification during the performance of the oophorectomy procedure, adopted as a management approach. It is amixed breed sheep, aged over 5 years; weight 28 kg; emaciated on physical examination; with pale pink and moist eyelidmucosa; heart and respiratory rate: 81 beats/min and 22 movements/min, respectively; body temperature 39.2°C; ruminalmovements at 1 movement/min; without identification of lymphadenomegaly on palpation, however, it was observed thatthe right submandibular lymph node presented tissue retraction compatible with the healing process. For the surgical procedure, an 18-h fast was used and pre-anesthetic medication with 2% xylazine (0.1 mg/kg), 10% ketamine (5 mg/kg) and50 mg/mL tramadol (2 mg/kg) administrated intramuscularly. The animal was placed in the left lateral decubitus position,then was performed trichotomy and epidural administration of 2% lidocaine (4 mg/kg) and maintenance with propofol10 mg/mL intravenous dose-effect and oxygen mask 3 L/min, antibiotic prophylaxis was performed with 10% enrofloxacin(2.5 mg/kg). Flank oophorectomy was performed according to the classic technique and during...(AU)
Assuntos
Animais , Feminino , Ovinos/microbiologia , Linfadenite/veterinária , Corynebacterium pseudotuberculosis , Infecções por Corynebacterium/veterinária , Linfadenite/diagnóstico , Abscesso/veterinária , Ovariectomia/veterinária , Biópsia/veterináriaRESUMO
Background: Caseous Lymphadenitis (CL) is a chronic infectious disease caused by the bacterium Corynebacteriumpseudotuberculosis, which is considered the main agent responsible for abscess lesions. In the visceral form it can affect theinternal organs of sheep and goats, which could negatively affect animal health and cause large economic losses for producers.Case: This study aims to report a case of intestinal CL in sheep, with suspected diagnosis during physical examinationand identification during the performance of the oophorectomy procedure, adopted as a management approach. It is amixed breed sheep, aged over 5 years; weight 28 kg; emaciated on physical examination; with pale pink and moist eyelidmucosa; heart and respiratory rate: 81 beats/min and 22 movements/min, respectively; body temperature 39.2°C; ruminalmovements at 1 movement/min; without identification of lymphadenomegaly on palpation, however, it was observed thatthe right submandibular lymph node presented tissue retraction compatible with the healing process. For the surgical procedure, an 18-h fast was used and pre-anesthetic medication with 2% xylazine (0.1 mg/kg), 10% ketamine (5 mg/kg) and50 mg/mL tramadol (2 mg/kg) administrated intramuscularly. The animal was placed in the left lateral decubitus position,then was performed trichotomy and epidural administration of 2% lidocaine (4 mg/kg) and maintenance with propofol10 mg/mL intravenous dose-effect and oxygen mask 3 L/min, antibiotic prophylaxis was performed with 10% enrofloxacin(2.5 mg/kg). Flank oophorectomy was performed according to the classic technique and during...
Assuntos
Feminino , Animais , Abscesso/veterinária , Corynebacterium pseudotuberculosis , Infecções por Corynebacterium/veterinária , Linfadenite/diagnóstico , Linfadenite/veterinária , Ovinos/microbiologia , Biópsia/veterinária , Ovariectomia/veterináriaRESUMO
BACKGROUND: Mechanisms of resistance have been described during disease progression (PD) for patients under treatment with anti-EGFR plus chemotherapy (CT). The aim of our study was to evaluate efficacy of anti-EGFR rechallenge (ReCH) and reintroduction (ReIn) in metastatic colorectal cancer (mCRC). MATERIALS AND METHODS: This is a retrospective analysis of patients with mCRC that previously received anti-EGFR + CT and interrupted therapy due to PD in the ReCH group and other reasons in the ReIn group. We aimed to describe progression-free survival (PFS), overall survival (OS) and response rate (RR) after re-exposure and to evaluate prognostic factors associated with PFS. RESULTS: Sixty-eight patients met the inclusion criteria. The median follow-up after re-exposure was 39.3 months. ReCH was adopted in 25% and ReIn in 75%. The median anti-EGFR free interval was at 10.5 months. At re-exposure, the main CT regimen was FOLFIRI in 58.8%. Cetuximab and Panitumumab were used in 59 and 9 patients, respectively. mPFS for ReCH and ReIn was 3.3 × 8.4 months, respectively (p 0.001). The objective response rate for ReCH and ReIn was 18% and 52%, respectively. In univariate analysis, adverse prognostic factors related to PFS were: stable disease or PD at first anti-EGFR exposure (HR: 2.12, CI:1.20-3.74; p = 0.009); ReCH (HR: 3.44, CI:1.88-6.29, p < 0.0001); rechallenge at fourth or later lines (HR: 2.51, CI:1.49-4.23, p = 0.001); panitumumab use (HR: 2.26 CI:1.18-5.54, p = 0.017). In the multivariate model, only ReCH remained statistically significant (HR = 2.63, CI: 1.14-6.03, p = 0.022). CONCLUSION: In our analysis, ReCH resulted in short PFS and low RR. However, reintroduction of anti-EGFR plus CT before complete resistance arose resulted in prolonged PFS. These data could be clinically useful to guide a treatment break due to side effects or patient decisions. Our data should be confirmed by larger and prospective trials.