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Se presenta una revisión de la bibliográfica y se comentan los principales aspectos epidemiológicos y clínicos de la patología preinvasora del cérvix. La historia natural de esta enfermedad revela la presencia de un fenómeno dinámico de progresión persistencia y regresión de lesiones intraepiteliales en las cuales el virus papiloma humano juega un rol preponderante. Se resalta el rol actual de la colposcopia en el manejo de una citología alterada. Se revisa los resultados del manejo colpohistológico de un frotis atípico demostrando un 9% de lesiones de alto grado para los ASCUS y de 25% para los ASC-H. Finalmente se presentan las alternativas terapéuticas y se analizan los resultados de la escisión con asa grande en pacientes portadoras de NIE III demostrando un 89% de curaciónWe present the most important aspects related to the epidemiology and natural history of cervical intraepithelial neoplasia (CIN). CIN natural history is a dynamic process characterized not only by progression but also by persistence and regression. 9% of ASCUS revealed at biopsy confirmed CIN - 2.3 and 25% of ASC-H revealed at biopsy confirmed CIN - 2,3. Treatment of women with biopsy- confirmed CIN-3 with LLETZ showed a 89% healing

Herpes gestationis es una rara enfermedad autoinmune que se presenta en mujeres embarazadas, compromete principalmente la piel y puede manifestarse como lesiones bulosas intensamente pruriginosas que, en ocasiones, son de difícil diagnóstico. Nosotros reportamos dos casos clínicos simultáneos que se presentaron en nuestro Servicio en marzo del año 2002, hecho que no deja de sorprender dado lo infrecuente y poco común de esta patología.Herpes gestationis is an uncommon autoimmune disease seen in pregnant women. The condition involves mainly the skin, and results in bulous lesions with intense pruritus, which can sometimes be very difficult to deal with. We report 2 clinical cases which presented simultaneously at our Service, a surprising fact indeed, if we take into consideration the uncommon and peculiar character of this disease.

Background: Megaesophagus (ME) carries a poor long‐term prognosis in dogs. In people, lower esophageal sphincter (LES) achalasia is a rare cause of ME that may respond to targeted intervention. Dogs with lower esophageal sphincter achalasia‐like syndrome (LES‐AS) have been described recently, warranting investigation of analogous targeted treatment. Hypothesis/Objectives: Evaluate response of dogs with LES‐AS to LES mechanical dilation and botulinum toxin A (BTA) injections, with or without surgical myotomy and fundoplication. We hypothesized that clinical and videofluoroscopic swallow study (VFSS) features of LES‐AS would improve after treatment targeting functional LES obstruction. Animals: Fourteen client‐owned dogs with LES‐AS diagnosed by VFSS. Methods: Retrospective study. Dogs diagnosed with LES‐AS underwent treatment between April 2015 and December 2017. Outcome measures included client perception of clinical severity, body weight (BW), body condition score (BCS), regurgitation frequency, and VFSS parameters (ME, esophageal motility, gastric filling). Dogs with positive responses were considered candidates for LES myotomy with fundoplication. Results: By a median IQR of 21 (IQR, 14‐25) days after mechanical dilation and BTA, clients reported clinical improvement in 100% of dogs, BW increased 20.4% (IQR, 12.7%‐25%), pre‐ and post‐treatment BCS was 3 (IQR, 3‐4) and 5 (IQR, 4‐5), respectively, and frequency of regurgitation decreased by 80% (IQR, 50%‐85%). Duration of effect was 40 (IQR, 17‐53) days. Despite clinical improvement, ME and abnormal esophageal motility persisted in 14 dogs. Six dogs subsequently underwent myotomy and fundoplication and maintained improvement observed after mechanical dilation and BTA. Conclusions and Clinical Importance: Dogs with LES‐AS experienced significant, temporary, clinical improvement after mechanical dilation and BTA. Preliminary results suggest myotomy with fundoplication provide lasting clinical benefit despite persistence of ME. [ABSTRACT FROM AUTHOR]

Background Relapses of immune-mediated hemolytic anemia ( IMHA), thrombocytopenia ( ITP), or polyarthropathy ( IMPA) occur despite normal hematologic and cytologic parameters. Thymidine kinase 1 ( TK1), canine C-reactive protein (c- CRP), haptoglobin ( HPT), and 25-Hydroxyvitamin- D (25( OH)D) might be adjunct to current monitoring strategies. Hypothesis/Objectives Compare serum concentrations of TK1, c- CRP, HPT, and 25( OH)D in dogs with well- and poorly controlled primary IMHA, ITP, or IMPA. Animals Thirty-eight client-owned dogs. Methods Prospective descriptive study. Dogs diagnosed with IMHA, ITP, or IMPA had serum biomarker concentrations measured commercially. Disease control was assessed by hematocrit/ PCV and reticulocyte count, platelet count, and synovial fluid cytology for IMHA, ITP, and IMPA, respectively. Statistical analysis performed by Mann-Whitney rank-sum tests and receiver operating characteristic curves. Results TK1 and c- CRP, but not HPT significantly decreased with well- versus poorly controlled IMHA ( P = 0.047, P = 0.028, P = 0.37). C- CRP, but not TK or HPT was significantly lower with well- versus poorly controlled IMPA ( P = 0.05, P = 0.28, P = 0.84). Sensitivity and specificity of TK and c- CRP (simultaneously) for detecting dogs with poorly controlled IMHA were 88 and 100%, respectively. Sensitivity and specificity of c- CRP for detecting poorly controlled dogs with IMPA were 13 and 100%, respectively. 92% of dogs were vitamin D insufficient (<100 ng/mL) regardless of disease control. Conclusions and Clinical Importance Combining TK1 and c- CRP might act markers of disease control in dogs with IMHA. Canine- CRP cannot be recommended as an independent marker of disease control in IMPA. 25( OH)D insufficiency in immune-mediated disorders might benefit from further study to determine if supplementation could improve therapeutic response or reduce disease risk. [ABSTRACT FROM AUTHOR]

Background: Pulmonary capillary hemangiomatosis is a rare, vascular obstructive disorder that uniformly causes pulmonary arterial hypertension. Clinically, pulmonary capillary hemangiomatosis is indistinguishable from primary pulmonary arterial hypertension and histology is required for definitive diagnosis. The distinctive histologic feature of pulmonary capillary hemangiomatosis is non-malignant extensive proliferation of capillaries in the alveolar septae. Vasodilator treatment of humans with primary arterial hypertension due to pulmonary capillary hemangiomatosis can result in fatal acute pulmonary edema. Computed tomography is thus critical to discern pulmonary capillary hemangiomatosis from other causes of pulmonary arterial hypertension prior to vasodilator therapy. This is the first report of a vasoproliferative process resembling pulmonary capillary hemangiomatosis in the feline species. Case presentation: A 15-year-old, male castrated, domestic shorthair cat presented for persistent labored breathing presumptively due to congestive heart failure despite treatment with diuretics for 7 days. Echocardiography showed evidence of hypertrophic cardiomyopathy with severe pulmonary hypertension; however, a normal sized left atrium was not consistent with congestive heart failure. Thoracic computed tomography was performed and showed evidence of diffuse ill-defined nodular ground glass opacities, enlarged pulmonary arteries, and filling defects consistent with pulmonary thromboembolism. The cat acutely decompensated after a single dose of sildenafil and was euthanized. Histopathology of the lungs showed severe multifocal alveolar capillary proliferation with respiratory bronchiolar infiltration, marked type II pneumocyte hyperplasia and multifocal pulmonary arterial thrombosis. Conclusion: This is the first description in a cat of a vasoproliferative disorder resembling pulmonary capillary hemangiomatosis complicated by multifocal pulmonary arterial thrombosis. Inspiratory and expiratory ventilator-driven breath holds with angiography revealed lesions predominantly characterized by ground glass opacification and vascular filling defects with absence of air trapping. The results from this report suggest that, as in humans, the cat can develop a pulmonary capillary hemangiomatosis-like disease in which vasodilator therapy to address pulmonary hypertension may lead to fatal pulmonary edema. [ABSTRACT FROM AUTHOR]

Background Canine chronic bronchitis (CCB) results in cough lasting ≥2 months and airway inflammation. Adverse effects include risk of secondary infection associated with lifelong corticosteroid administration and prompt investigation into alternative therapies. Neurogenic pathways mediated by tachykinins that bind neurokinin ( NK) 1 receptors may induce cough and airway inflammation. Maropitant, a NK-1 receptor antagonist, has been advocated for treatment of CCB based on anecdotal improvement, but without scientific evidence. Hypothesis/Objectives Maropitant will blunt clinical signs and airway inflammation associated with CCB. Animals Client-owned dogs (n = 8) with cough >2 months, thoracic radiographic evidence of airway disease and sterile airway inflammation (>7% non-degenerate neutrophils, >7% eosinophils or both) on bronchoalveolar lavage ( BAL) enrolled. Methods Maropitant (2 mg/kg) administered q48h for 14 days. Study endpoints included client perception of clinical signs (surveys at baseline and 14 days, and visual analogue scale [ VAS] at baseline, 7, and 14 days), and BAL % neutrophils and eosinophils (baseline and 14 days). One-way repeated measures ANOVA ( VAS) and Wilcoxon-signed rank-sum tests ( BAL cells, cough frequency) used with P < .05 considered significant. Results Maropitant significantly decreased cough frequency ( P < .001) and VAS scores ( P = .005). No differences in BAL % neutrophils or % eosinophils noted with treatment ( P = .279 and P = .382, respectively). Conclusions and Clinical Importance Preliminary results suggest that although maropitant may have antitussive properties leading to perceived clinical improvement, its failure to diminish airway inflammation makes it unsuitable for treatment of CCB. Future studies could evaluate maropitant as a cough suppressant for other respiratory disorders in dogs. [ABSTRACT FROM AUTHOR]

Background: Inhaled glucocorticoids reduce airway inflammation while minimizing systemic effects in several species. Hypothesis: Inhaled fluticasone suppresses the hypothalamic–pituitary–adrenal axis (HPAA), modifies immune function, and induces clinical signs to a lesser extent than PO-administered prednisone in dogs. Animals: Seven healthy adult pet dogs. Methods: Dogs were randomized to 1 of 3 treatment groups in a crossover design: fluticasone propionate (220 μg actuation of a metered dose inhaler delivered via a spacer and mask, q12h), placebo (spacer and mask alone, q12h), or prednisone (1 mg/kg PO q24h). Each treatment was administered for 3 weeks followed by a 4-week washout. Appetite, attitude, and water consumption were recorded during the last week of each treatment period. Urine cortisol : creatinine ratios, ACTH stimulation tests, white blood cell counts, lymphocyte phenotype, and serum IgM and IgA concentrations were recorded at each baseline and after the last day of each treatment. Clinical observations were expressed descriptively. Friedman's test was applied to all data comparisons. Pairwise comparisons were made with a mixed model analysis when data were normally distributed, whereas signed rank tests were used otherwise (significance P-value <.01). Results: Appetite and water consumption increased during prednisone treatment. Peak serum cortisol concentrations post-ACTH were significantly decreased in prednisone- and fluticasone-treated dogs compared with placebo (prednisone > fluticasone). Serum IgM concentrations were significantly decreased in dogs treated with prednisone. Conclusions and Clinical Importance: As used, fluticasone suppresses the HPAA to a lesser extent than prednisone and may avert systemic signs associated with PO-administered glucocorticoids in dogs. [ABSTRACT FROM AUTHOR]

Airway hyperresponsiveness (AHR) is a key feature of asthma and can be measured using bronchoprovo-cation. Direct (methacholine, MCh) or indirect (adenosine-5-monophosphate, AMP: or mannitol) bron-choprovocants are used in human patients, the latter inducing AHR only with pre-existing airway inflammation. The present study compared the responses to direct (MCh) and indirect (mannitol, AMP) bronchoprovocation in healthy and asthmatic cats (n = 6/group). The order of bronchoprovocant was randomized using a published table of random numbers and there was a 1-month washout before cross-over to the next treatment. Pulmonary mechanics were measured in anesthetized and mechanically ventilated cats using a critical care ventilator. Saline at baseline and increasing doses of each broncho-provocant were aerosolized for 30 s, followed by 4 min of data collection between doses. The endpoint for each bronchoprovocant was reached when airway resistance exceeded 200% of baseline values (EC200Raw). There was a significant difference (P < 0.001 ) in the airway response of asthmatic vs. healthy cats over the range of MCh concentrations, despite there being no significant difference in the EC200Raw between the groups. Response to MCh was significantly greater (P < 0.05) in asthmatic than in healthy cats at MCh concentrations as low as 0.0625 mg/mL. For AMP, a small subset of asthmatics (n = 2/6) responded at low concentrations: four asthmatic cats and all healthy cats failed to respond even to the highest concentra-tions of AMP. One asthmatic cat but no healthy cats responded to mannitol. In conclusion, MCh discrim-inated asthmatic from healthy cats but neither AMP nor mannitol was an effective bronchoprovocant in this model. [ABSTRACT FROM AUTHOR]