Variables influencing the prediction of fluid responsiveness: a systematic review and meta-analysis.

INTRODUCTION: Prediction of fluid responsiveness in acutely ill patients might be influenced by a number of clinical and technical factors. We aim to identify variables potentially modifying the operative performance of fluid responsiveness predictors commonly used in clinical practice. METHODS: A sensitive strategy was conducted in the Medline and Embase databases to search for prospective studies assessing the operative performance of pulse pressure variation, stroke volume variation, passive leg raising (PLR), end-expiratory occlusion test (EEOT), mini-fluid challenge, and tidal volume challenge to predict fluid responsiveness in critically ill and acutely ill surgical patients published between January 1999 and February 2023. Adjusted diagnostic odds ratios (DORs) were calculated by subgroup analyses (inverse variance method) and meta-regression (test of moderators). Variables potentially modifying the operative performance of such predictor tests were classified as technical and clinical. RESULTS: A total of 149 studies were included in the analysis. The volume used during fluid loading, the method used to assess variations in macrovascular flow (cardiac output, stroke volume, aortic blood flow, volume‒time integral, etc.) in response to PLR/EEOT, and the apneic time selected during the EEOT were identified as technical variables modifying the operative performance of such fluid responsiveness predictor tests (p < 0.05 for all adjusted vs. unadjusted DORs). In addition, the operative performance of fluid responsiveness predictors was also influenced by clinical variables such as the positive end-expiratory pressure (in the case of EEOT) and the dose of norepinephrine used during the fluid responsiveness assessment for PLR and EEOT (for all adjusted vs. unadjusted DORs). CONCLUSION: Prediction of fluid responsiveness in critically and acutely ill patients is strongly influenced by a number of technical and clinical aspects. Such factors should be considered for individual intervention decisions.

UNVEILING THE SIGNIFICANCE OF DYNAMIC ARTERIAL ELASTANCE: AN INSIGHTFUL APPROACH TO ASSESSING ARTERIAL LOAD IN AN ENDOTOXIN SHOCK MODEL.

ABSTRACT: Background: The aim of this study was to investigate the relationship between dynamic arterial elastance (EaDyn) and the pulsatile and steady components of arterial load in an endotoxin shock model using a two-element Windkessel model and to describe the behavior of EaDyn in this model. Methods : Ten female Yorkshire pigs were administered lipopolysaccharide intravenously to induce endotoxin shock, while three female pigs served as the control group. Measurements of EaDyn (ratio between pulse pressure variation and stroke volume variation), effective arterial elastance, arterial compliance (Cart), and systemic vascular resistance were taken every 30 min in the endotoxin group until shock was induced. In the control group, these variables were measured every 30 min for 3 h. Subsequently, a fluid load was administered to both groups, and measurements were repeated every 30 min. After 1 hour of shock induction, the endotoxin group was divided into two subgroups: one receiving norepinephrine (END-NE) and the other not receiving it (END-F). Results: EaDyn showed an association with Cart, while pulse pressure variation was connected to both pulsatile and steady components, and stroke volume variation was solely associated with steady components. In addition, EaDyn exhibited higher values in the END groups than in the control group when shock was achieved. Furthermore, after the administration of norepinephrine, EaDyn displayed higher values in END-F than in END-NE. Conclusions: The EaDyn variable helps identify changes in the pulsatile component of arterial load, providing valuable guidance for management strategies aimed at improving cardiac performance.

Changes of operative performance of pulse pressure variation as a predictor of fluid responsiveness in endotoxin shock.

Several limitations regarding pulse pressure variation (PPV) use have been reported. Our aim was to describe changes in the PPV operative performance as a predictor of fluid responsiveness during the development of a swine endotoxin shock model and to assess hemodynamic variables associated with PPV changes. A swine porcine endotoxin shock model was established (Escherichia Coli 055:B5 endotoxin) in 7 pigs, and 3 pigs were included in the control group. The endotoxin was infused until the mean arterial pressure (MAP) dropped below 50 mmHg (TH0); then, the model animal was reanimated with fluids and vasopressors. We performed fluid challenges every hour for 6 h. ROC curve analysis and a linear mixed model were performed. The area under the curve of PPV decreased from 0.95 (0.81-1.00) to 0.60 (0.17-1.00) at TH0. Its cutoff increased from 10.5 to 22.00% at TH0. PPV showed an inverse relationship with stroke volume, mean systemic filling pressure, MAP, and systemic vascular resistance (SVR) (p < 0.001, AIC = 111.85). The PPV operative performance as a predictor of fluid responsiveness decreased with the progression of shock. This could lead to an inverse association between PPV and the following variables: MAP and SVR.

Predictors of fluid responsiveness in critically ill patients mechanically ventilated at low tidal volumes: systematic review and meta-analysis.

INTRODUCTION: Dynamic predictors of fluid responsiveness have shown good performance in mechanically ventilated patients at tidal volumes (Vt) > 8 mL kg-1. Nevertheless, most critically ill conditions demand lower Vt. We sought to evaluate the operative performance of several predictors of fluid responsiveness at Vt ≤ 8 mL kg-1 by using meta-regression and subgroup analyses. METHODS: A sensitive search was conducted in the Embase and MEDLINE databases. We searched for studies prospectively assessing the operative performance of pulse pressure variation (PPV), stroke volume variation (SVV), end-expiratory occlusion test (EEOT), passive leg raising (PLR), inferior vena cava respiratory variability (Δ-IVC), mini-fluid challenge (m-FC), and tidal volume challenge (VtC), to predict fluid responsiveness in adult patients mechanically ventilated at Vt ≤ 8 ml kg-1, without respiratory effort and arrhythmias, published between 1999 and 2020. Operative performance was assessed using hierarchical and bivariate analyses, while subgroup analysis was used to evaluate variations in their operative performance and sources of heterogeneity. A sensitivity analysis based on the methodological quality of the studies included (QUADAS-2) was also performed. RESULTS: A total of 33 studies involving 1,352 patients were included for analysis. Areas under the curve (AUC) values for predictors of fluid responsiveness were: for PPV = 0.82, Δ-IVC = 0.86, SVV = 0.90, m-FC = 0.84, PLR = 0.84, EEOT = 0.92, and VtC = 0.92. According to subgroup analyses, variations in methods to measure cardiac output and in turn, to classify patients as responders or non-responders significantly influence the performance of PPV and SVV (p < 0.05). Operative performance of PPV was also significantly affected by the compliance of the respiratory system (p = 0.05), while type of patient (p < 0.01) and thresholds used to determine responsiveness significantly affected the predictability of SVV (p = 0.05). Similarly, volume of fluids infused to determine variation in cardiac output, significantly affected the performance of SVV (p = 0.01) and PLR (p < 0.01). Sensitivity analysis showed no variations in operative performance of PPV (p = 0.39), SVV (p = 0.23) and EEOT (p = 0.15). CONCLUSION: Most predictors of fluid responsiveness reliably predict the response of cardiac output to volume expansion in adult patients mechanically ventilated at tidal volumes ≤ 8 ml kg-1. Nevertheless, technical and clinical variables might clearly influence on their operative performance.

Use of Pulse Pressure Variation as Predictor of Fluid Responsiveness in Patients Ventilated With Low Tidal Volume: A Systematic Review and Meta-Analysis.

INTRODUCTION: Pulse pressure variation (PPV) has been shown to be useful to predict fluid responsiveness in patients ventilated at tidal volume (Vt) >8 mL kg-1. Nevertheless, most conditions in critical care force to use lower Vt. Thus, we sought to evaluate the operative performance of PPV when a Vt ⩽8 mL kg-1 is used during mechanical ventilation support. METHODS: We searched PubMed and Embase databases for articles evaluating the operative performance of PPV as a predictor of fluid responsiveness in critical care and perioperative adult patients ventilated with tidal volume ⩽8 mL kg-1 without respiratory effort and arrhythmias, between January 1990 and January 2019. We included cohort and cross-sectional studies. Two authors performed an Independently selection using predefined terms of search. The fitted data of sensitivity, specificity, and area under the curve (AUC) were assessed by bivariate and hierarchical analyses. RESULTS: We retrieved 19 trials with a total of 777 patients and a total of 935 fluid challenges. The fitted sensitivity of PPV to predict fluid responsiveness during mechanical ventilation at Vt ⩽8 mL kg-1 was 0.65 (95% confidence interval [CI]: 0.57-0.73), the specificity was 0.79 (95% CI: 0.73-0.84), and the AUC was 0.75. The diagnostic odds ratio was 5.5 (95% CI: 3.08-10.01, P < .001) by the random-effects model. CONCLUSIONS: Pulse pressure variation shows a fair operative performance as a predictor of fluid responsiveness in critical care and perioperative patients ventilated with a tidal volume ⩽8 mL kg-1 without respiratory effort and arrhythmias.

Comparative analysis of acid-base balance in patients with severe sepsis and septic shock: traditional approach vs. physicochemical approach / Análisis comparativo del equilibrio ácido-base en pacientes con sepsis severa y choque séptico: enfoque tradicional versus enfoque físico-químico

Abstract Introduction: The evaluation of metabolism and the diagnostic classification of acid-base disorders has generated great controversy. Acid-base balance (ABB) is approached by means of the physicochemical and Henderson's models. Objective: To compare two diagnostic approaches to ABB in patients with severe sepsis. Materials and methods: Prospective, descriptive study conducted in patients with severe sepsis. ABB was analyzed within the first 24 hours. The diagnosis was compared according to each model and the causes of the disorders were compared according to the physicochemical model. Results: 38 patients were included in the study, of which 21 (55%) were women; the mean age was 49 years, the median APACHE II, 13.28, and the mortality at 28 days, 24.3%. The traditional approach identified 8 patients with normal ABB, 20 with metabolic acidosis, and 10 with other disorders. Based on the physicochemical model, all subjects had acidosis and metabolic alkalosis. Increased strong ion difference (SID) was the most frequently observed disorder. Conclusion: The physicochemical model was useful to diagnose more patients with acid-base disorders. According to these results, all cases presented with acidosis and metabolic alkalosis; the most frequent proposed mechanism of acidosis was elevated SID. The nature of these disorders and their clinical relevance is yet to be established.

Resumen Introducción. Existe gran controversia en la evaluación del componente metabólico y en la clasificación diagnóstica de las alteraciones del equilibrio ácido-base (EAB), el cual se aborda mediante los modelos físico-químico y de Henderson. Objetivo. Comparar dos enfoques diagnósticos del EAB en pacientes con sepsis severa. Materiales y métodos. Estudio descriptivo prospectivo realizado en pacientes con sepsis severa. Se analizó el EAB en las primeras 24 horas; el diagnóstico se comparó según cada modelo y las causas de alteraciones, según el modelo físico-químico. Resultados. Se analizaron 38 pacientes (55% mujeres) con edad promedio de 49 años, mediana APACHE II de 13 y mortalidad a 28 días del 24.3%. El enfoque tradicional identificó 8 pacientes con EAB normal, 20 con acidosis metabólica y 10 con otros trastornos. En el modelo físico-químico, los 38 pacientes tuvieron alteraciones denominadas acidosis y alcalosis metabólica; el aumento de la brecha de iones fuertes (SIG, por su sigla en inglés) fue la más frecuente. Conclusión. El modelo físico-químico diagnosticó más pacientes con alteraciones ácido-base. Según este, todos tuvieron acidosis y alcalosis metabólica y el mecanismo propuesto más frecuente de acidosis fue el SIG elevado. La naturaleza de estas alteraciones y su significado clínico está por definirse.

Peridomestic small Indian mongoose: An invasive species posing as potential zoonotic risk for leptospirosis in the Caribbean.

In this study, we investigated Leptospira infection and exposure in small Indian mongoose (Herpestes auropunctatus), an invasive animal species, in two different sites in the Caribbean island of Saint Kitts. Overall a low seroprevalence (12/148; 8.1%: 95%CI: 3.7-12.5) was observed. Agglutinating antibodies to serovars Mankarso (3.4%), Copenhageni (2.7%), Icterohemorrhagiae (1.4%), Bratislava (1.4%), Canicola (1.4%), Autumnalis (0.7%), Alexi (0.7%), Pomona (0.7%) and Grippotyphosa (0.7%) was observed on the microscopic agglutination test. The seroprevalence observed in mongooses trapped from peridomestic sites was significantly higher compared to the arid and less inhabited site (p = 0.0268). The real time PCR targeting lipL32 gene was positive for 9 out of 146 mongooses. Bacterial culture of kidneys resulted in two Leptospira isolates. Whole genome sequencing and analysis suggested that these isolates are closely related to L. interrogans serovar Copenhageni. We observed mild to severe chronic renal lesions in 20.2% of mongooses in the absence of an antibody response or active infection. Our findings emphasize the need to investigate other infectious etiologies or atypical outcomes and potential chronic long-term impact of Leptospira infection in animals and people living in an endemic area. In addition, our data reinforces the need for including locally prevalent Leptospira isolates rather than representative members of a serogroup in the microscopic agglutination test panel in epidemiologic and diagnostic investigations. In conclusion, mongoose inhabiting the island are exposed to and harbor pathogenic Leptospira and hence may play a role in the transmission. The invasive nature of the species highlights their presence as a potential risk factor for this widespread zoonotic disease.

Prevalence of Renal Lesions in the Small Indian Mongoose ( Herpestes auropunctatus) Inhabiting the Caribbean Island of Saint Kitts.

We describe histopathologic abnormalities in the kidneys of small Indian mongoose ( Herpestes auropunctatus) on the Caribbean island of Saint Kitts. The lesions observed in moderate to severe cases were suggestive of a chronic nephropathy. Further investigation is needed to explore the magnitude of the problem, potential causes, and predisposing factors.

Parasites of small Indian mongoose, Herpestes auropunctatus, on St. Kitts, West Indies.

Herpestes auropunctatus, the small Indian mongoose, is an invasive omnivore introduced to the Caribbean, including the island of St. Kitts over 150 years ago. It has played a role in changing native fauna and can carry zoonotic pathogens of public health importance. The aim of the current study was to estimate the prevalence of parasites harbored by mongooses. In total, 87 mongooses trapped from April to July 2015 were examined for parasites using (1) hair plucks (N = 79), ear swabs (N = 79), and general coat and skin examination (N = 87) for mites, ticks, lice, and fleas; (2) dissection of the trachea, bronchi, and lungs for lungworms and flukes (N = 76); (3) a double centrifugation fecal flotation method for parasites of the gastrointestinal tract (N = 75); and (4) PCR of heart homogenates for Toxoplasma gondii (N = 60). The only ectoparasite seen was Ctenocephalides felis (79.3%; 69/87), with most mongooses having > 10 fleas (based on a subjective assessment) but insufficient numbers to result in signs of pruritus or anemia. On fecal flotation, coccidial oocysts were found with a prevalence of 69.3% (52/75). Neither T. gondii, lungworm, nor fluke infections were detected with the methods used. The high number of C. felis-infested mongooses and the infestation level of the individual mongooses suggest that they could serve as a reservoir for these potential vectors of pathogens. No evidence was found to support that mongooses are a component of T. gondii cycles on St. Kitts, although this finding needs to be confirmed with a larger sample size from other geographic locations.

Inhaling Benzene, Toluene, Nitrogen Dioxide, and Sulfur Dioxide, Disrupts Thyroid Function in Captive American Kestrels (Falco sparverius).

Research investigating the effects of air contaminants on biota has been limited to date. Captive adult female American kestrels (Falco sparverius) were exposed to a mixture of benzene (0.6 ppm), toluene (1 ppm), nitrogen dioxide (NO2; 2 ppm) and sulfur dioxide (SO2; 5.6 ppm), in a whole-body inhalation chamber. Thyroid axis responses to meet metabolic demands were examined through thyroid histology, plasma thyroxine (T4), and triiodothyronine (T3), and hepatic outer ring deiodination (T4-ORD). Plasma free (F) T3 and T4 were measured at baseline, and at 9 days and 18 days of exposure, whereas total (T) T3 and TT4, thyroid histology and hepatic T4-ORD were determined at the final 18 day exposure. Inhalation of these contaminants significantly suppressed plasma FT4 and TT4, and depleted follicular colloid and increased epithelial cell height at 18 days, and significantly altered the temporal pattern of plasma FT4. Significant histological changes in the follicular colloid:epithelial cell height ratio indicated sustained T4 production and release by the thyroid glands. There was no effect on plasma FT3, TT3, or hepatic T4-ORD. We hypothesize that contaminant-related activation of the hypothalamus-pituitary-thyroid axis in the kestrels increased elimination of plasma T4 through Phase II enzymes. Further research is required to test this hypothesis in wild birds.

Global Solutions to Regional Challenges: Bridging the One Health Divide in the Caribbean.

Ross University School of Veterinary Medicine, located on the Caribbean island of St. Kitts in the West Indies, hosted a multi-national, transdisciplinary One Health conference in St. Kitts and Nevis. Historically the many countries of the Caribbean carry a high burden of chronic and infectious disease and struggle with complex economic and developmental issues that continuously pressurize inhabitants and their natural environment. Considering these vast regional challenges, presentations covered diverse topics including community-based approaches for zoonotic disease control and prevention and mitigation of problems at the interface of wildlife, domestic animals, and humans. In two workshops the participants suggested a framework for practicing One Health in the Caribbean that emphasized capacity building and sustainability. Four structural components to the One Health paradigm were discussed including: identification of common problems, the necessity of comprehensive needs assessment, regional mobilization of resources, and building trust among all One Health stakeholders and the public.

Stress response, biotransformation effort, and immunotoxicity in captive birds exposed to inhaled benzene, toluene, nitrogen dioxide, and sulfur dioxide.

In the oil sands of Alberta, Canada, toxicology research has largely neglected the effects of air contaminants on biota. Captive Japanese quail (Coturnix c. japonica) and American kestrels (Falco sparverius) were exposed to mixtures of volatile organic compounds and oxidizing agents (benzene, toluene, NO2 and SO2) in a whole-body inhalation chamber, to test for toxicological responses. Hepatic biotransformation measured through 7-ethoxyresorufin-O-dealkylase (EROD) tended to be increased in exposed kestrels (p=0.06) but not in quail (p=0.15). Plasma corticosterone was increased in the low dose group for quail on the final day of exposure (p=0.0001), and midway through the exposure period in exposed kestrels (p=0.04). For both species, there was no alteration of T and B-cell responses, immune organ mass, or histology of immune organs (p>0.05). This study provides baseline information valuable to complement toxicology studies and provides a better understanding of potential health effects on wild avifauna.

Detoxification, endocrine, and immune responses of tree swallow nestlings naturally exposed to air contaminants from the Alberta oil sands.

Changes in environmental and wildlife health from contaminants in tailings water on the Canadian oil sands have been well-studied; however, effects of air contaminants on wildlife health have not. A field study was conducted to assess biological costs of natural exposure to oil sands-related air emissions on birds. Nest boxes for tree swallows (Tachycineta bicolor) were erected at two sites; within 5 km of active oil sands mining and extraction, and ≥ 60 km south, at one reference site. Passive air monitors were deployed at the nest boxes to measure nitrogen dioxide, sulfur dioxide, ozone, volatile organic compounds, and polycyclic aromatic hydrocarbons (PAHs). Nestlings were examined at day 9 post hatching to assess T cell function and morphometry. At day 14 post hatching, a subset of nestlings was euthanized to measure detoxification enzymes, endocrine changes, and histological alterations of immune organs. Except for ozone, all air contaminants were higher at the two oil sands sites than the reference site (up to 5-fold). Adult birds had similar reproductive performance among sites (p>0.05). Nestlings from industrial sites showed higher hepatic ethoxyresorufin O-dealkylase (EROD) induction (p<0.0001) with lower relative hepatic mass (p=0.0001), a smaller T cell response to the phytohemagglutinin skin test (p=0.007), and smaller bursae of Fabricius (p<0.02); a low sample size for one site indicating lower body condition scores (p=0.01) at day 14 warrants cautious interpretation. There were no differences among nestlings for feather corticosterone (p>0.6), and no histological alterations in the spleen or bursa of Fabricius (p>0.05). This is the first report examining toxicological responses in wild birds exposed to air contaminants from industrial activity in the oil sands. It is also the first time that small, individual air contaminant monitors have been used to determine local contaminant levels in ambient air around nest boxes of wild birds.

Maximum Heart Rate during exercise: Reliability of the 220-age and Tanaka formulas in healthy young people at a moderate elevation / Frecuencia cardíaca máxima en ejercicio: confiabilidad de las fórmulas de 220-edad y Tanaka en jóvenes saludables en altitud moderada

Background. The formulas to predict maximum heart rate have been used for many years in different populations. Objective. To verify the significance and the association of formulas of Tanaka and 220-age when compared to real maximum heart rate. Materials and methods. 30 subjects -22 men, 8 women- between 18 and 30 years of age were evaluated on a cycle ergometer and their real MHR values were statistically compared with the values of formulas currently used to predict MHR. Results. The results demonstrate that both Tanaka p=0.0026 and 220-age p=0.000003 do not predict real MHR, nor does a linear association exist between them. Conclusions. Due to the overestimation with respect to real MHR value that these formulas make, we suggest a correction of 6 bpm to the final result. This value represents the median of the difference between the Tanaka value and the real MHR. Both Tanaka (r=0.272) and 220-age (r=0.276) are not adequate predictors of MHR during exercise at the elevation of Bogotá in subjects of 18 to 30 years of age, although more study with a larger sample size is suggested.

Introducción. Las fórmulas que predicen la Frecuencia Cardíaca Máxima (FCM) han sido utilizadas desde hace varios años en diferentes poblaciones. Objetivo. Verificar la precisión de las fórmulas de Tanaka y 220-edad con respecto a la FCM real. Materiales y métodos. Se evaluaron 30 sujetos -22 hombres y 8 mujeres- entre 18 y 30 años de edad en cicloergómetro y se compararon estadísticamente las fórmulas con la FCM real. Resultados. Se demuestra que tanto Tanaka p=0,0026 como 220-edad p=0,000003 no predicen la FCM real ni existe una asociación lineal de estas. Conclusiones. Debido a la sobreestimación que realizan dichas fórmulas con Tanaka se sugiere realizar una corrección de 6 lpm al resultado final. Este valor representa la mediana de la diferencia de Tanaka con respecto a la FCM real: tanto Tanaka r=0,272 como 220-edad r=0,276 no son predictores adecuados entre sujetos de 18 a 30 años de edad de la FCM durante el ejercicio en la altura de Bogotá, aunque se sugiere realizar más estudios con una muestra mayor.

Fisiología cardiovascular aplicada en caninos con insuficiencia cardiaca / Applied cardiovascular physiology in dogs with heart dailure

La insuficiencia cardiaca está relacionada con anormalidades de la contracción y relajación ventricular. Recientes publicaciones han mostrado que la mayoría de los pacientes con enfermedades cardiacas coexiste alteraciones de la función sistólica y diastólica. Actualmente, hay muchas ambigüedades en el uso de términos clínicos y fisiológicos usados cotidianamente con respecto a este tema. Este artículo pretende revisar algunos conceptos fisiológicos del sistema cardiovascular.

Congestive heart failure is related to abnormal ventricular contraction and relaxation. Recent publications show that the alteration of systolic and diastolic function coexists in most patients with heart diseases. There are currently several ambiguities in the daily use of clinical and physiological terms regarding this topic. This paper aims to review certain physiological concepts of the cardiovascular system.

Natural fatal Sarcocystis falcatula infections in free-ranging eagles in North America.

Three bald eagles (Haliaeetus leucocephalus) and 1 golden eagle (Aquila chrysaetos) were admitted to rehabilitation facilities with emaciation, lethargy, and an inability to fly. Intravascular schizonts and merozoites were present in 2 bald eagles, mainly in the lung tissue, whereas the third bald eagle and the golden eagle had lymphohistiocytic encephalitis with intralesional schizonts and merozoites. In all eagles, protozoal tissue cysts were present in skeletal musculature or heart. The protozoal organisms were morphologically compatible with a Sarcocystis sp. By immunohistochemistry, the protozoal merozoites were positive for Sarcocystis falcatula antigen in all cases when using polyclonal antisera. Furthermore, the protozoa were confirmed to be most similar to S. falcatula by polymerase chain reaction in 3 of the 4 cases. To the authors' knowledge, this report presents the first cases of natural infection in eagles with S. falcatula as a cause of mortality.

Modelos de insuficiencia cardiaca en caninos / Heart failure models in canines

Los pequeños animales se han incorporado a las sociedades actuales como miembros de la familia, y una de las afecciones que presentan es la insuficiencia cardiaca. Dada la prevalencia de esta enfermedad, se utilizan caninos para desarrollar el síndrome u utilizarlos como modelos animales para su estudio. La insuficiencia cardiaca se define como un síndrome clínico causado por una enfermedad cardiaca que genera disfunción sistólica-diastólica, que a su vez impide satisfacer las necesidades metabólicas tisulares. Este articulo pretende revisar los diferentes modelos y mecanismos que producen la insuficiencia cardiaca...

Management of select bacterial and parasitic conditions of raptors.

Raptors are susceptible to a broad array of established and emerging bacterial and parasitic diseases, including babesiosis, chlamydiosis, clostridiosis, coccidiosis, cryptosporidiosis, malaria, mycobacteriosis, pasteurellosis, salmonellosis, trichomoniasis, and pododermatitis. Many of these conditions are opportunistic and can be easily managed or averted with proper preventive measures related to captive management, husbandry and diet, and veterinary care. Once infected, treatment must be prompt, appropriate, and judicious. This article examines the significance, diagnosis, management, and prevention of select bacterial and parasitic pathogens of raptors.

Sarcocystis falcatula-associated encephalitis in a free-ranging great horned owl (Bubo virginianus).

A great horned owl (Bubo virginianus) was admitted to a rehabilitation clinic with severe neurologic signs that were unresponsive to supportive care. The animal was euthanatized because of a poor prognosis. Marked granulomatous encephalitis with focal brainstem malacia was detected microscopically. The brainstem was the most severely affected brain location and the only place in which schizonts and merozoites, morphologically compatible with Sarcocystis spp., were detected. Immunohistochemistry with the use of polyclonal antisera indicated the presence of Sarcocystis falcatula. The species identification of the protozoa as S. falcatula was confirmed by polymerase chain reaction. To the author's knowledge, this is the first report of spontaneous S. falcatula-associated encephalitis in a great horned owl.