Diagnosis and Surgical Treatment of a Renal Cyst Causing Unilateral Lameness in a Golden Eagle (Aquila chrysaetos).

This report describes the diagnosis and treatment of a benign renal cyst in an adult, female golden eagle (Aquila chrysaetos) presented for unilateral leg lameness. A cyst at the cranial division of the left kidney was diagnosed by computed tomography and was suspected of compressing the lumbosacral nerve plexus, resulting in limb lameness. The renal cyst was incompletely excised because the cyst wall was closely adhered to the kidney parenchyma and local blood supply. Fluid analysis and surgical biopsy of the cyst and left kidney confirmed the diagnosis of a benign renal cyst. No evidence of an infectious, inflammatory, or neoplastic etiology was noted. Postoperatively, the eagle's lameness resolved and the bird was ultimately released following recovery. During treatment for the renal cyst, the eagle was concurrently found to have increased serum titers on elementary body agglutination for Chlamydia psittaci and a positive titer for Aspergillus species antibody testing. The bird was administered doxycycline, azithromycin, and voriconazole for treatment of these potential pathogens prior to release. Unfortunately, the eagle was found dead 86 days postrelease due to an unknown cause. To the authors' knowledge, this is the first report of a golden eagle with a benign solitary renal cyst causing unilateral lameness secondary to nerve compression that was resolved with surgical excision.

Four Different Surgical Approaches to Vasectomies in Male Texas Bobwhite Quail (Colinus virginianus texanus) and Northern Bobwhite Quail (Colinus virginianus).

Vasectomies render a male sterile and have been used for various management purposes, including conservation efforts. This report evaluated 4 different surgical approaches (external approach, internal approach with dissection, internal approach with cautery, and internal approach caudally) to perform 177 vasectomies in Texas bobwhite (Colinus virginianus texanus; n = 171) and northern bobwhite quail (Colinus virginianus; n = 6) in a field setting. Birds were not randomized into groups for the different approaches. Survival was recorded in 83% (147/177) of the birds. The most common cause of death was hemorrhage from the common iliac vein due to damage during the surgical procedure. Other causes for death included transection of the ureter, parasitism, euthanasia, and undetermined causes. The approach that had the highest survival rate (89.8%, 132/147) was the internal approach with cautery, and based on these results the authors recommend this approach for vasectomies in Texas and northern bobwhite quail.

(Not) far from home: No sex bias in dispersal, but limited genetic patch size, in an endangered species, the Spotted Turtle (Clemmys guttata).

Sex-biased dispersal is common in many animals, with male-biased dispersal often found in studies of mammals and reptiles, including interpretations of spatial genetic structure, ostensibly as a result of male-male competition and a lack of male parental care. Few studies of sex-biased dispersal have been conducted in turtles, but a handful of studies, in saltwater turtles and in terrestrial turtles, have detected male-biased dispersal as expected. We tested for sex-biased dispersal in the endangered freshwater turtle, the spotted turtle (Clemmys guttata) by investigating fine-scale genetic spatial structure of males and females. We found significant spatial genetic structure in both sexes, but the patterns mimicked each other. Both males and females typically had higher than expected relatedness at distances <25 km, and in many distance classes greater than 25 km, less than expected relatedness. Similar patterns were apparent whether we used only loci in Hardy-Weinberg equilibrium (n = 7) or also included loci with potential null alleles (n = 5). We conclude that, contrary to expectations, sex-biased dispersal is not occurring in this species, possibly related to the reverse sexual dimorphism in this species, with females having brighter colors. We did, however, detect significant spatial genetic structure in males and females, separate and combined, showing philopatry within a genetic patch size of <25 km in C. guttata, which is concerning for an endangered species whose populations are often separated by distances greater than the genetic patch size.

Pathology in Practice.

In collaboration with the American College of Veterinary Pathologists.

Retrospective Review of Mycobacterial Conjunctivitis in Cockatiels (Nymphicus hollandicus).

The etiologic disease organism responsible for causing mycobacteriosis in avian species is an acid-fast gram-positive bacterium. This bacterium causes granulomatous disease in various internal organs, but in cockatiels (Nymphicus hollandicus) it has been commonly identified within the conjunctival tissues. Twenty-six cases of mycobacterial conjunctivitis in cockatiels were diagnosed through histopathologic assessment of diseased tissue samples, Fite acid-fast staining, and polymerase chain reaction in this retrospective study. Clinicians who saw these cases were contacted, and information was obtained regarding recommended treatment protocols prescribed for the patients, the Mycobacterium species identified, and case outcomes. All patients in this retrospective study had a biopsy performed on the affected conjunctival tissue, and because of the small size of the patients, this excisional biopsy removed the affected tissue in its entirety or significantly debulked the lesion. Of the 26 cases, 10 were lost to follow-up, 4 were euthanatized, 7 died, and 5 were alive at the time this information was submitted for publication.

Lead Levels in the Eggs of a Chicken With Lead Toxicosis.

A 1.5-year-old Polish hen was presented with a history of watery droppings and poor vent tone. Results of diagnostic tests revealed blood lead at levels considered to be toxic. Chelation therapy was started with calcium ethylenediaminetetraacetate. The hen was laying eggs before, during, and after chelation therapy. Eggs were tested for the presence of lead by combining yolk and albumen together. Before chelation therapy, the level of lead in the egg tested was 14 µg. Two days after the end of chelation therapy, results of a second blood lead test revealed a drop to nontoxic levels. No lead was detected in the combined yolks and albumen of eggs collected 7-11 days after the end of chelation therapy. Four weeks after the end of chelation therapy, no lead was identified in the shells of tested eggs.

Factors influencing non-participation in an exercise program and attitudes towards physical activity amongst cancer survivors.

PURPOSE: The purposes of this study are to investigate factors influencing non-participation in a structured exercise program for cancer survivors and to explore survivors' experiences and attitudes in relation to physical activity participation. METHODS: Face-to-face or telephone interviews were conducted with individuals who had registered for, or engaged in, the 'Life Now' exercise program run by Cancer Council Western Australia. Participants were 20 cancer survivors (mean age 63.90 years, SD 15.29) who had either cancelled their registration or withdrawn from the exercise program during the preceding 2 years. Interview transcripts were analysed using thematic analysis. RESULTS: Seven main themes emerged: availability of the program; access, time and cost; lack of motivation or confidence; unwell or fatigued; physical activity preferences; knowledge of physical activity guidelines; and lack of referral or advice. The main barriers were contextual and included availability of, and access to, the program. Participants expressed a preference for home-based physical activity. CONCLUSIONS: Interventions aimed at promoting physical activity in cancer survivors should offer home-based programs and include referral and advice from oncologists. IMPLICATIONS FOR CANCER SURVIVORS: Increasing cancer survivors' participation in, and compliance with, exercise programs may require home-based strategies and referrals from oncologists to allied health professionals to individualise care.

Implementing exercise in cancer care: study protocol to evaluate a community-based exercise program for people with cancer.

BACKGROUND: Clinical research has established the efficacy of exercise in reducing treatment-related side-effects and increasing wellbeing in people with cancer. Major oncology organisations have identified the importance of incorporating exercise in comprehensive cancer care but information regarding effective approaches to translating evidence into practice is lacking. This paper describes the implementation of a community-based exercise program for people with cancer and the protocol for program evaluation. METHODS/DESIGN: The Life Now Exercise program is a community-based exercise intervention designed to mitigate and rehabilitate the adverse effects of cancer and its treatment and improve physical and psychosocial wellbeing in people with cancer. Involvement in the program is open to people with any diagnosis of cancer who are currently receiving treatment or within 2 years of completing treatment. The 3-month intervention consists of twice weekly group-based exercise sessions administered in community exercise clinics under the supervision of exercise physiologists trained to deliver the program. Evaluation of the program involves measures of uptake, safety, adherence and effectiveness (including cost effectiveness) as assessed at the completion of the program and 6 months follow-up. DISCUSSION: To bridge the gap between research and practice, the Life Now Exercise program was designed and implemented to provide people with cancer access to evidence-based exercise medicine. The framework for program implementation and evaluation offers insight into the development of feasible, generalizable and sustainable supportive care services involving exercise. Community-based exercise programs specifically designed for people with cancer are necessary to facilitate adherence to international guidelines advising patients to participate in high-quality exercise. TRIAL REGISTRATION: ACTRN12616001669482 (retrospectively registered 5 Dec 2016).

Experience of Primary Care Services Among Early Adolescents in England and Association With Health Outcomes.

PURPOSE: The aim of this study was to investigate adolescents' (11-15 years) experience of their general practitioner (GP), whether poor reported GP experience was associated with worse physical and mental health measures and whether poor previous GP experience was linked to lower utilization of these services. METHODS: We used logistic regression to analyze data from the 2014 Health Behaviour in School-aged Children study. Four aspects of recent care experience were studied: feeling at ease, feeling treated with respect, satisfaction with doctor's explanation, and feeling able to discuss personal matters. Five dichotomized measures of health status were used: ever self-harmed; fair or poor self-reported health; frequent (at least weekly) low mood; sleeping problems; or headaches. RESULTS: Of 5,335 students, 4,149 reported having visiting their GP within the past year. Of these, 91.8% felt treated with respect, 78.7% felt at ease, 85.7% were satisfied with explanation, and 53.9% felt able to discuss personal matters. After adjusting for ethnicity, age, gender, and family affluence score, poor experience on any indicator was strongly associated with increased risk of self-harm (adjusted odds ratio range, 2.01-2.70; all p < .001); feeling low (AOR range, 1.53-2.11; all p < .001); and sleeping problems (AOR range, 1.49-1.91; all p ≤ .001). Poor experience on all indicators, except discussing personal matters, was associated with worse self-reported health. CONCLUSIONS: Nearly half of this large, national study of adolescents did not feel able to discuss personal matters with their doctor. There was a consistent, strong association between reported lack of good GP experience and poor health measures.

Recombinant myxoma virus lacking all poxvirus ankyrin-repeat proteins stimulates multiple cellular anti-viral pathways and exhibits a severe decrease in virulence.

Although the production of single gene knockout viruses is a useful strategy to study viral gene functions, the redundancy of many host interactive genes within a complex viral genome can obscure their collective functions. In this study, a rabbit-specific poxvirus, myxoma virus (MYXV), was genetically altered to disrupt multiple members of the poxviral ankyrin-repeat (ANK-R) protein superfamily, M-T5, M148, M149 and M150. A particularly robust activation of the NF-κB pathway was observed in A549 cells following infection with the complete ANK-R knockout (vMyx-ANKsKO). Also, an increased release of IL-6 was only observed upon infection with vMyx-ANKsKO. In virus-infected rabbit studies, vMyx-ANKsKO was the most extensively attenuated and produced the smallest primary lesion of all ANK-R mutant constructs. This study provides the first insights into the shared functions of the poxviral ANK-R protein superfamily in vitro and in vivo.

Osteosarcoma of the tibiotarsus with possible pulmonary metastasis in a ring-necked dove (Streptopelia risoria).

An unknown-age, adult female ring-necked dove (Streptopelia risoria) was presented with an ulcerated mass on the medial side of the right tibiotarsus. Radiographs revealed severe boney lysis with proliferative periosteal reaction. Surgical amputation was performed at the level of the mid femur and histopathologic examination of the mass identified an osteosarcoma. At the 6-month recheck, the bird was in good condition with no evidence of tumor regrowth or metastasis; however, at 8 months, the dove was found dead. On necropsy, a large mass was present in the coelomic cavity invading the left pulmonary parenchyma. Histopathologic examination indicated a spindle cell sarcoma. Immunohistochemical staining for osteocalcin and osteonectin was performed on the confirmed osteosarcoma in the tibiotarsus and the spindle cell sarcoma mass. Results indicated positive intracytoplasmic immunoreactivity for osteocalcin and osteonectin in the confirmed osteosarcoma neoplasm. Very rare positive cytoplasmic immunoreactivity occurred in the spindle cell sarcoma.

Bacteria Isolated From the Skin of Congo African Grey Parrots ( Psittacus erithacus ), Budgerigars ( Melopsittacus undulatus ), and Cockatiels ( Nymphicus hollandicus ).

Little is known about the normal bacterial flora of the skin of birds. To identify the bacterial organisms that reside on the integument of companion psittacine birds in a normal physiologic state, skin cultures were taken from 75 psittacine birds comprising 25 Congo African grey parrots ( Psittacus erithacus ), 25 budgerigars ( Melopsittacus undulatus ), and 25 cockatiels ( Nymphicus hollandicus ). All birds were adults and in good health with no underlying identifiable diseases, had not been on antibiotics in the preceding 2 months or longer, and had no skin or feather abnormalities. Cultures were taken from the axillary region and incubated on bovine blood agar plates. Positive cultures were identified for 52 out of 75 birds, and a total of 89 bacterial colonies grew. The most frequently identified bacterial organisms belonged to the genus Staphylococcus followed by Corynebacterium. Several other genera of bacteria were also isolated. Of the 89 bacterial colonies, 25 were identified to the species level and 50 to the genus level, and 14 were identified as either a nonfermenter or coliform.

Multidisciplinary management of ornithine transcarbamylase (OTC) deficiency in pregnancy: essential to prevent hyperammonemic complications.

Ornithine transcarbamylase (OTC) deficiency is the most common inborn error in the metabolism of the urea cycle with an incidence of 1 in 14,000 live births. Pregnancy can trigger potentially fatal hyperammonemic crises. We report a successful pregnancy in a 29-year-old primiparous patient with a known diagnosis of OTC deficiency since infancy. Hyperammonemic complications were avoided due to careful multidisciplinary management which included a detailed antenatal, intrapartum and postnatal plan. Management principles include avoidance of triggers, a low-protein diet and medications which promote the removal of nitrogen by alternative pathways. Triggers include metabolic stress such as febrile illness, particularly gastroenteritis, fasting and any protein loading. In our case the patient, in addition to a restricted protein intake, was prescribed sodium benzoate 4 g four times a day, sodium phenylbutyrate 2 g four times a day and arginine 500 mg four times a day to aid excretion of ammonia and reduce flux through the urea cycle.

Screening for chlamydia in general practice.

OBJECTIVE: To determine the prevalence of genital Chlamydia trachomatis infection in young patients presenting to general practitioners and to evaluate selective screening, based on risk factors, including gender. METHODS: A cross sectional survey of 508 consecutive patients aged 18-24, presenting to six general practices and one youth clinic in Mackay, North Queensland. We screened urine for chlamydia using Ligase chain reaction. RESULTS: Of 508 samples, 25 were positive (5%). The only factors with increased risks of infection were attendance at a youth clinic and recent change in sexual partner. It was as high in men as in women. CONCLUSION: Prevalence of chlamydia infection may be high enough to support screening of all patients aged 18-24, depending on cost effectiveness studies.