PubMed · 9340525
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D C Manning, M B Hopwood. 1997-10-23. Corticosteroid injections for sciatica.. https://pubmed.ncbi.nlm.nih.gov/9340525/
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OBJECTIVE: To determine clinical signs of pericarditis in horses and to determine whether there were any relationships among clinical signs, echocardiographic findings, treatment, and outcome. DESIGN: Retrospective study. ANIMALS: 18 horses. RESULTS: Physical examination was performed on 16 horses. Cardiovascular abnormalities included tachycardia (n = 16), pericardial friction rub (10), venous distention (7), murmur (7), muffled heart sounds (6), weak arterial pulse (6), jugular pulse (6), and edema (5). Twelve horses also had respiratory abnormalities; the most common was dull lung sounds, ventrally, suggestive of pleural effusion (10). Echocardiography was the most important tool for diagnosis of pericarditis. Detection of clinical signs of right-sided heart failure was significantly associated with severe accumulation of pericardial effusion and with detection of cardiac compromise. Severe accumulation of pericardial effusion was also significantly associated with echocardiographic detection of cardiac compromise. Pericarditis was idiopathic in 6 horses, and bacterial in 5. Five horses had nonseptic pericarditis associated with bacterial respiratory disease, and 2 had nonseptic pericarditis associated with viral respiratory disease. Fourteen of the 18 horses were treated specifically for pericarditis; 10 received antimicrobials and 6 with suspected immune-mediated pericarditis received corticosteroids. Pericardial drainage and lavage were performed on 6 horses in which pericardial effusion or fibrin accumulation was compromising cardiac function. Pericarditis resolved in all 14 horses that were treated, and all 14 returned to their prior intended use. CLINICAL IMPLICATIONS: With early detection of disease and aggressive treatment, the prognosis for horses with pericarditis is good.
Four cattle had chronic diarrhea and had lost weight but were not anorectic or dehydrated. A diagnosis of eosinophillic enteritis was made on the basis of a combination of clinical and histopathologic findings and exclusion of other diseases. Eosinophilia and hypoalbuminemia were not detected in CBC analyses. Gross and histologic examination of the small intestine revealed edema, diffuse eosinophilic inflammation (> 20 eosinophils/HPF [400 x]), and regional lymphadenopathy. A causative agent was not identified in any of the cattle. Treatment consisting of a 1-month course of systemically administered corticosteroids was attempted in 2 cattle and was apparently successful in both. Diagnostic criteria for eosinophilic enteritis have not been established for cattle and, therefore, the diagnosis was subjective. This disease resembled paratuberculosis (Johne's disease) in clinical appearance but was distinguished on the basis of a lack of a contagious etiologic agent and differences in histologic appearance.
We determined the frequency and clinical nature of severe hyperglycemia in a university clinic for HIV-1-infected patients. The medical records of 1392 adult HIV-infected patients were reviewed for cases of severe hyperglycemia, defined as two or more serum glucose values >250 mg/dl or diabetes treatment during clinic care. Demographic information, family histories of diabetes mellitus, body weights, CD4+ lymphocyte counts, and use of corticosteroids, megestrol acetate, pentamidine, or didanosine were recorded for subjects meeting the case definition. Comparisons were made between preexisting diabetic (group 1) and incident hyperglycemic cases (group 2). Less than 2% of the total clinic population experienced severe hyperglycemia: 12 in group 1 and 13 in group 2. Group 2 had lower body weights (mean, 70.6 kg versus 90.0 kg; p < 0.05) and more advanced HIV disease (mean CD4 count, 79/mm3 versus 550/mm3; p < 0.05) than group 1. Group 2 cases had evidence of drug-associated hyperglycemia; four cases demonstrated hyperglycemia coinciding with large fluctuations in weight during megestrol therapy. Among megestrol recipients, cases did not differ from noncases in demographics, weight, or CD4 count. Severe hyperglycemia is uncommon in adult HIV-infected patients. Approximately one half of these patients have preexisting diabetic conditions; many of the remainder may have drug-induced hyperglycemia, especially as a result of corticosteroids or megestrol acetate.