Sobrevida de los recién nacidos con cardiopatías congénitas diagnosticadas prenatalmente / Survival of newborns with prenatally diagnosed congenital heart disease

Objetivo: Estimar la sobrevida al año de los recién nacidos con cardiopatías congénitas diagnosticadas prenatalmente y el perfil epidemiológico de sus madres. Método: Cohorte dinámica retrospectiva de 825 pacientes, ingresados entre el 1 de abril de 2003 y el 31 de marzo de 2019, con tiempo de seguimiento de 1 año, que se elaboró utilizando la base de datos del Centro de Referencia Perinatal Oriente (CERPO), Facultad de Medicina, Universidad de Chile. Resultados: Se estimó la función de supervivencia global de la muestra, obteniendo una supervivencia del 70% al año de seguimiento (error estándar (ES): 0,0164; intervalo de confianza del 95% [IC95%]: 0,66-0,73). Los recién nacidos con edad gestacional < 30 semanas tuvieron una menor sobrevida (hazard ratio [HR]: 4,17; IC95%: 1,52-11.44; p < 0,01). Los recién nacidos con un peso < 3000 g tuvieron una menor sobrevida (HR: 1,41; IC95%: 1,09-1,84; p < 0,01). La distribución de las cardiopatías congénitas según la gravedad en esta cohorte fue: riesgo vital 64%, clínicamente relevante 34% y clínicamente no relevante 2%. La menor sobrevida fue para la categoría riesgo vital (HR: 6,005; IC95%: 3,97-9,08; p < 0,01). Conclusiones: La prematuridad, el bajo peso al nacer y la gravedad de la cardiopatía se correlacionaron con una menor sobrevida.

Objective: To estimate the survival at one year of newborns with prenatally diagnosed congenital heart diseases and the epidemiological profile of their mothers. Method: Dynamic retrospective cohort of 825 patients, admitted between April 1, 2003 and March 31, 2019, with a follow-up time of 1 year, which was elaborated using the database of the Centro de Referencia Perinatal Oriente (CERPO), Faculty of Medicine, Universidad de Chile. Results: The overall survival function of the sample was estimated, resulting in a survival of 70% at one year follow-up (standard error (SE): 0.0164; 95% confidence interval [95% CI]: 0.66-0.73). Newborns with gestational age < 30 weeks had a lower survival (hazard ratio [HR]: 4.17; 95% CI: 1.52-11.44; p < 0.01). Newborns with a birth weight < 3000 g had a lower survival (HR: 1.41; 95% CI: 1.09-1.84; p < 0.01). The distribution of congenital heart disease according to severity in this cohort was: life-threatening 64%, clinically relevant 34% and clinically not relevant 2%. With a lower survival for the life-threatening category (HR: 6.005; 95% CI: 3.97-9.08; p < 0.01). Conclusions: Prematurity, low birth weight and severity of congenital heart correlated with a lower survival rate.

Evaluating 21-day doxycycline and azithromycin treatments for experimental Chlamydophila psittaci infection in cockatiels (Nymphicus hollandicus).

To determine the efficacy of 21-day therapy with azithromycin and doxycycline in the treatment of experimental infection with Chlamydophila psittaci in cockatiels (Nymphicus hollandicus), 30 birds randomly assigned to 3 treatment groups and 1 control group were inoculated with C psittaci by combined intranasal and ocular routes. Morbidity, mortality, and results of polymerase chain reaction testing confirmed that infection was successful. Birds in group 1 (n = 8) received azithromycin at 40 mg/kg PO q48h for 21 days; in group 2 (n = 8), doxycycline at 35 mg/kg PO q24h for 21 days; in group 3 (n = 8), doxycycline at 35 mg/kg PO q24h for 45 days; and, in group 4 (controls; n = 6), no treatment. Six birds died either before or within 2 days of initiating treatment: 4 in the 3 treatment groups and 2 in the control group. Clinical signs resolved and mortality ceased 2-6 days after treatment was initiated in all treatment groups, whereas birds in the control group exhibited clinical signs for the duration of the study. Plasma doxycycline concentrations were measured during the treatment period and exceeded 1 microg/mL at all time points. The absence of clinical signs and mortality in the treatment groups, even after inducing an immunocompromised state with dexamethasone (3 mg/kg IM q24h for 5 days), starting on day 70 postinoculation, suggested that treatment resulted in elimination of the pathogen. After euthanasia of the remaining 24 birds, 23 of the carcasses were submitted for necropsy. Spleen and liver samples from the birds in all treatment and control groups were polymerase chain reaction negative for C psittaci nucleic acid, and organisms were not detected by Gimenez stain. No gross or histologic differences were observed in the livers and spleens of treated and untreated infected birds. Lesions consistent with avian chlamydiosis (hystiocytosis) were seen in all birds and were considered residual. In this study, a 21-day course of either doxycycline or azithromycin was effective in eliminating C psittaci infection in experimentally inoculated cockatiels. Additional studies are necessary to evaluate the efficacy of these treatments in naturally infected cockatiels as well as other species of birds.

Systemic adenovirus infection in Sulawesi tortoises (Indotestudo forsteni) caused by a novel siadenovirus.

A novel siadenovirus was identified in the Sulawesi tortoise (Indotestudo forsteni). A group of 105 Sulawesi tortoises was obtained by the Turtle Survival Alliance. Many of the tortoises were in poor health. Clinical signs included anorexia, lethargy, mucosal ulcerations and palatine erosions of the oral cavity, nasal and ocular discharge, and diarrhea. Initial diagnostic tests included fecal testing for parasites, complete blood count and plasma biochemical analysis, mycoplasma serology, and polymerase chain reaction (PCR) testing for intranuclear coccidia and chelonian herpesvirus. Treatment included administration of antibiotics, antiparasitic medications, parenteral fluids, and nutritional support. Tissue samples from animals that died were submitted for histopathologic evaluation. Histopathologic examination revealed systemic inflammation and necrosis associated with intranuclear inclusions consistent with a systemic viral infection in 35 tortoises out of 50 examined. Fecal testing results and histopathologic findings revealed intestinal and hepatic amoebiasis and nematodiasis in 31 animals. Two of 5 tortoises tested by PCR were positive for Chlamydophila sp. Aeromonas hydrophila and Escherichia coli were cultured from multiple organs of 2 animals. The mycoplasma serology and PCR results for intranuclear coccidia and chelonian herpesvirus were negative. Polymerase chain reaction testing of tissues, plasma, and choanal/cloacal samples from 41 out of 42 tortoises tested were positive for an adenovirus, which was characterized by sequence analysis and molecular phylogenetic inference as a novel adenovirus of the genus Siadenovirus. The present report details the clinical and anatomic pathologic findings associated with systemic infection of Sulawesi tortoises by this novel Siadenovirus, which extends the known reptilian adenoviruses to the chelonians and extends the known genera of reptilian Adenoviridae beyond Atadenovirus to include the genus Siadenovirus.

Clinical neurology of ferrets.

Neurology represents an important specialty within ferret clinical medicine. Veterinarians should become familiar with the unique anatomic and physiologic differences between ferrets to improve their management of theses cases. In addition, veterinarians should use available diagnostic tests to confirm the presence of neurologic diseases. Recent advances in ferret medicine and veterinary neurology offer new capabilities to investigate and treat neurological disease in ferrets.

Complications associated with conjoined intramedullary pin placement for femorotibial joint luxation in a Solomon Island eclectus parrot (Eclectus roratus solomonensis).

Femorotibial joint-luxation repair with conjoined intramedullary pins has been successfully used in pediatric psittacine birds. However, there are no reports of complications associated with its use in adults. In this report, we describe the clinical presentation, surgical reduction, and postoperative complications associated with stifle-luxation repair in an adult female Solomon Island eclectus parrot (Eclectus roratus solomonensis). The normal perching angle for the eclectus stifle was determined before surgery. Osteomyelitis was treated systemically and locally. Midfemoral amputation was performed as a salvage procedure, without an apparent reduction in the quality of the bird's life.

Wound management in reptiles.

Our understanding into the healing response of reptile wounds is in its infancy. To date, many of the methods we have used have been adopted from human, mammalian, or avian species, with varying success. Future research should focus on the development of methods to improve our management of contaminated wounds, minimize the negative inflammatory responses occurring in a wound, and shorten wound-healing time.

Adolescentes de educación secundaria con cifras tensionales elevadas: seguimiento longitudinal durante 18 meses / High school adolescents with high blood pressure reading: longitudinal following during 18 months

Esta investigación, que forma parte de un estudio de prevalencia de hipertensión arterial, en la ciudad de Mérida Venezuela, comprende el seguimiento durante 18 meses de 24 de 35 adolescentes (74 por ciento ) con cifras tensionales por encima del percentil 95 para la edad y sexo. Las medidas de la presión arterial tanto sistólica como diastólica se realizaron de acuerdo a las recomendaciones del Comite para el Diagnóstico y Control de la Presión Arterial en Niños y Adolescentes. Se realizaron 3 medidas: la inicial o causal y las dos adicionales en reposo. Estas dos ultimas fueron registradas a los 12 y 18 meses. De los 24 adolescentes que se reexaminaron a los 12 y 18 meses, doce (50 por ciento ) tenían lecturas de presión arterial persistentemente elevadas (sistólica y/o diastólica). El análisis de nuestros resultados mostro correlación significativa entre la presión arterial sistólica y el sexo. La presión arterial diastólica no se correlacionó con la edad y con el sexo. Las medida iniciales, y los subsiguientes registros de la presión arterial sistólica y diastólica, se corelacionaron significativamente entre si. El coeficiente de correlación para la presión sistólica fué de r=0.57 (p < 0.004) y de r=0.66 (p < 0.0005) para la presión diastólica. El valor predictivo, para hipertensión arterial futura de los diferentes registros de la arterial sistólica y diastólica, fue muy bajo. Este bajo valor predictivo, posiblemente se debe a los intervalos de confianza al 95 por ciento fueron muy amplios. En consecuencia, nuestros resultados indican que el hallazgo de hipertensión arterial, en una toma casual de presión arterial en los adolescentes no necesariamente indica enfermedad vascular o riesgo de adquirirla. Por consiguiente, estos hallazgos no deberían despertar alarma, pero si deben ser objetos de seguimiento posterior

La inervación parasimpática cardíaca y su posible relación con el aneurisma apical ventricular izquierdo de los pacientes con enfermedad de chagas / Cardiac parasympathetic innervation and the apical left ventricular aneurysms of chagas heart disease

El aneurisma apical ventricular izquierdo es considerado como una anormalidad particular y "específica" de la enfermead cardíaca chagásica. Esta alteración, segmentaria de la motilidad ventricular izquierda, está presente en pacientes chagásicos, con inervación parasimpática cardíaca normal. Las anormalidades parasimpáticas cardíacas se detectan tardíamente, en las fases arritmicas y congestivas de la enfermedad cardíaca chagásica. La región apexiana, del ventrículo izquierdo, está comunmente afectada en enfermedades miocárdicas agudas, no chagásicas. En consecuencia, el aneurisma apical ventricular izquierdo podría ser una secuela inespecífica, no necesariamente relacionada con anormalidades de la inervación parasimpática cardíaca