Radiologic Manifestations of Mycobacterium chimaera Infection After Open Heart Surgery.

PURPOSE: The objective of this study is to identify and detail the radiologic manifestations of surgical site and disseminated Mycobacterium chimaera (MC) infection. The aim is to facilitate early identification and diagnosis of MC, considering its indolent nature and the challenges involved in clinically and pathologically establishing the diagnosis. PATIENTS AND METHODS: This was a retrospective cohort study reviewing computed tomography (CT), positron emission tomography (PET)/CT, and magnetic resonance imaging examinations in patients over the age of 18 years with a history of open heart surgery and a clinical or pathologic diagnosis of MC. Two radiology residents, a fellowship-trained nuclear medicine radiologist, and a fellowship-trained cardiothoracic radiologist performed consensus reads to determine the imaging findings seen in MC infection. RESULTS: Twenty-five patients were included. Localized, surgical site infection was more common than disseminated disease. Typical CT findings included peristernal soft tissue thickening, sinus tracts often extending to the cutaneous surface, slowly enlarging fluid collections, and sternal osteolysis. PET/CT findings demonstrated hypermetabolic activity in nearly all patients localized to sites of infection. Imaging findings for disseminated infection included hepatosplenomegaly, lymphadenopathy, involvement of the central nervous system, discitis/osteomyelitis, and distant abscesses. CONCLUSIONS: Imaging plays a vital role in suggesting possible surgical sites and disseminated MC infection acquired from open heart surgery. Radiologists must keep a high index of suspicion given the indolent nature and subtle imaging change over time. PET/CT is most useful in diagnosis and helps in differentiating between a sterile postoperative fluid collection or scarring and active MC infection and helps provide a target for debridement.

Variation in mineral types of uroliths from ferrets (Mustela putorius furo) submitted for analysis in North America, Europe, or Asia over an 8-year period.

OBJECTIVE: To compare mineral types of naturally occurring uroliths in ferrets (Mustela putorius furo) from North America, Europe, and Asia and to identify potential risk factors associated with cystine urolithiasis in ferrets. SAMPLES: 1,054 laboratory submission records of uroliths obtained from ferrets between January 1, 2010, and December 31, 2018. PROCEDURES: For this cross-sectional study, the medical records databases at 4 diagnostic laboratories were searched for records of submissions of uroliths obtained from ferrets. Data collection included submission date; ferret sex, neuter status, and age; receiving laboratory and continent; and urolith mineral type. Regression analyses were performed to identify variables associated with cystine uroliths. RESULTS: Of the 1,054 urolith submissions, 1,013 were from North America, with 92.6% (938/1,013; 95% CI, 90.8% to 94.1%) cystine uroliths, and 41 were from Europe and Asia, with only 26.8% (11/41; 95% CI, 15.7% to 41.9%) cystine uroliths. Median age was 2.0 years for ferrets with cystine urolithiasis versus 4.0 years for those with other types of uroliths. Submissions were more likely cystine uroliths for ferrets in North America versus Europe and Asia (adjusted OR [aOR], 59.5; 95% CI, 21.4 to 165.6), for ferrets that were younger (aOR, 0.67; 95% CI, 0.58 to 0.77), or for submissions in 2018 versus 2010 (aOR, 21.1; 95% CI, 5.1 to 87.9). CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that the proportion of submissions that were cystine uroliths dramatically increased in North America between 2010 and 2018. There is an urgent need to determine underlying causes and mitigate cystine urolithiasis in ferrets.

Analysis of canine urolith submissions to the Canadian Veterinary Urolith Centre, 1998-2014.

Understanding urolith trends and risk factors is important for understanding urolithiasis, which is a common problem in dogs. This study evaluated 75 674 canine cystolith submissions to the Canadian Veterinary Urolith Centre between 1998 and 2014. Struvite and calcium oxalate uroliths comprised 80.8% of all uroliths, with calcium oxalate outnumbering struvite. There were significant increases in the proportions of calcium oxalate, mixed and cystine uroliths, and significant decreases in struvite, urate, silica, and calcium phosphate carbonate over the study period. Breeds associated with increased risk of calcium oxalate urolithiasis tended to be small breeds, while those that were at increased risk of struvite urolith formation were larger breeds. Dalmatians were at increased risk of forming both urate and xanthine uroliths while Scottish deerhounds had a remarkably high association with cystine urolithiasis. Males were more likely to form calcium oxalate and metabolic uroliths and females were more likely to develop struvite and mixed uroliths.

Analyse des soumissions d'urolithes canins au Canadian Veterinary Urolith Centre, 1998­2014. Il est important de comprendre les tendances et les facteurs de risque des urolithes pour comprendre l'urolithiase, qui est un problème fréquent chez les chiens. Cette étude a évalué 75 674 soumissions d'urolithes canins au Canadian Veterinary Urolith Centre entre 1998 et 2014. Les urolithes de struvite et d'oxalate de calcium représentaient 80,8 % de tous les urolithes, et le nombre de soumissions d'oxalate de calcium dépassait celui des soumissions de struvite. Il y avait des hausses importantes dans les proportions d'oxalate de calcium, des urolithes mixtes et de cystine et des baisses importantes de la struvite, de l'urate, de la silice et du carbonate de phosphate de calcium pendant la période à l'étude. Les races associées à un risque accru d'urolithiase d'oxalate de calcium étaient surtout des petites races tandis que celles qui présentaient un risque accru de formation d'urolithes de struvite étaient les grandes races. Les Dalmatiens présentaient un risque accru de formation d'urolithes d'urate et de xanthine tandis que les Deerhounds avaient une association remarquablement élevée avec l'urolithiase de cystine. Il était plus probable que les mâles forment des urolithes d'oxalate de calcium et des urolithes métaboliques et il était plus probable que les femelles développent des urolithes de struvite et mixtes.(Traduit par Isabelle Vallières).

Evaluation of 21 426 feline bladder urolith submissions to the Canadian Veterinary Urolith Centre (1998-2014).

This study reports emerging trends in feline urolithiasis in Canada during the past 16.8 y, evaluates associations of breed and gender with urolith types, and reports on feline submissions from outside of Canada. Struvite and calcium oxalate uroliths comprised > 90% of all uroliths submitted. In cats, oxalate submissions outnumbered struvite submissions from Canada, Hong Kong, Denmark, and the United Arab Emirates, while Australian struvite submissions outnumbered calcium oxalate submissions. In Canada, the majority of urolith submissions were from domestic cats followed by Himalayan, Persian, and Siamese cats. Males were more likely to form calcium oxalate uroliths and females were more likely to develop struvite uroliths. Compared to domestic short-haired cats, Tonkinese, Burmese, Devon rex, Himalayan, Persian, and Siamese cats were significantly associated with calcium oxalate urolith submission. Egyptian mau, Birman, ocicat, and Siamese breeds were over-represented amongst urate submissions.

Évaluation de 21 426 soumissions d'urolithes de vessie au Centre canadien d'urolithes vétérinaires (1998­2014). Cette étude présente un rapport sur les tendances émergentes pour l'urolithiase féline au Canada pendant les 16,8 dernières années, évalue les associations avec la race et le sexe pour les types d'urolithes et établit un rapport sur les soumissions félines provenant de l'extérieur du Canada. Les urolithes de struvite et d'oxalate de calcium représentaient > 90 % de tous les urolithes soumis. Chez les chats, les soumissions d'oxalate étaient supérieures aux soumissions de struvite pour les échantillons provenant du Canada, de Hong Kong, du Danemark et des Émirats arabes unis, tandis que les soumissions de struvite provenant de l'Australie étaient supérieures aux soumissions d'oxalate de calcium. Au Canada, la majorité des soumissions d'urolithes provenaient de chats domestiques suivis des chats himalayens, persans et siamois. Il était plus probable que les mâles aient des urolithes d'oxalate de calcium et il était plus probable que les femelles développent des urolithes de struvite. Comparativement aux chats domestiques à poil court, les chats tonkinois, burmese, Devon rex, himalayens, persans et siamois présentaient une association importante avec une soumission d'urolithes d'oxalate de calcium. Les races de chat Mau égyptien, birman, ocicat et siamois étaient surreprésentées parmi les soumissions d'urate.(Traduit par Isabelle Vallières).

Genetically modified α-amylase inhibitor peas are not specifically allergenic in mice.

Weevils can devastate food legumes in developing countries, but genetically modified peas (Pisum sativum), chickpeas and cowpeas expressing the gene for alpha-amylase inhibitor-1 (αAI) from the common bean (Phaseolus vulgaris) are completely protected from weevil destruction. αAI is seed-specific, accumulated at high levels and undergoes post-translational modification as it traverses the seed endomembrane system. This modification was thought to be responsible for the reported allergenicity in mice of the transgenic pea but not the bean. Here, we observed that transgenic αAI peas, chickpeas and cowpeas as well as non-transgenic beans were all allergenic in BALB/c mice. Even consuming non-transgenic peas lacking αAI led to an anti-αAI response due to a cross-reactive response to pea lectin. Our data demonstrate that αAI transgenic peas are not more allergenic than beans or non-transgenic peas in mice. This study illustrates the importance of repeat experiments in independent laboratories and the potential for unexpected cross-reactive allergic responses upon consumption of plant products in mice.

2,8-Dihydroxyadenine uroliths in a dog.

CASE DESCRIPTION: A 43-kg (95-lb) 4-year-old neutered male mixed-breed dog was evaluated because of a 2-day history of dysuria. CLINICAL FINDINGS: Radiography and ultrasonography revealed hydronephrosis, hydroureter, and radiolucent, hyperechoic uroliths in the right kidney and ureter and the urinary bladder. Serum bile acids concentration was within the reference interval. TREATMENT AND OUTCOME: The uroliths in the bladder and right ureter were surgically removed and submitted for analysis. They were initially identified as urate uroliths; however, results of further analysis indicated uroliths were composed of 2,8-dihydroxyadenine (2,8-DHA), and 2,8-DHA was identified in a urine sample of the dog. Allopurinol was prescribed for the dog, and a purine-restricted diet was recommended. CLINICAL RELEVANCE: 2,8-DHA uroliths are extremely rare in humans and dogs. Such uroliths may be underdiagnosed in humans because of variability of clinical signs and difficulty in differentiating 2,8-DHA and urate uroliths and crystalluria. Uroliths composed of 2,8-DHA may be misdiagnosed as urate uroliths in dogs.

Comparison of the α-amylase inhibitor-1 from common bean (Phaseolus vulgaris) varieties and transgenic expression in other legumes--post-translational modifications and immunogenicity.

The seeds of peas (Pisum sativum) and chickpeas (Cicer arietinum) expressing a gene for α-amylase inhibitor-1 (αAI) from the common bean (Phaseolus vulgaris) are protected from damage by old world bruchids (pea and cowpea weevils). Here, we used electrospray ionization time-of-flight mass spectrometry to compare the post-translational modifications of αAI from transgenic sources with the processed forms of the protein from several bean varieties. All sources showed microheterogeneity with differences in the relative abundance of particular variants due to differences in the frequency of addition of glycans, variable processing of glycans, and differences of C-terminal exopeptidase activity. The structural variation among the transgenics was generally within the range of the bean varieties. Previously, mice showed allergic reactions following ingestion of transgenic pea αAI but not bean αAI. Here, only minor differences were observed following intraperitoneal sensitization. Both of the transgenic pea and bean forms of αAI elicited Th1 and Th2 antibody isotype responses, suggesting that both proteins are immunogenic and could potentially be allergenic.

Risk factors for the incidence of calcium oxalate uroliths or magnesium ammonium phosphate uroliths for dogs in Ontario, Canada, from 1998 to 2006.

OBJECTIVE: To investigate individual- and community-level contextual variables as risk factors for submission of calcium oxalate (CaOx) uroliths or magnesium ammonium phosphate (ie, struvite) uroliths for dogs to a national urolith center, as determined on the basis of urolith submission patterns. SAMPLE POPULATION: Records of 7,297 dogs from Ontario, Canada, with CaOx or struvite uroliths submitted to the Canadian Veterinary Urolith Centre from 1998 through 2006. PROCEDURES: Data were analyzed via multilevel multivariable logistic regression. RESULTS: Individual-level main effects and interactions significantly associated with the risk of submission of CaOx uroliths rather than struvite uroliths included age, sex, breed group, neuter status, body condition, dietary moisture content, diet type, sex-neuter status interaction, sex-age interaction, body condition-age interaction, and breed group-dietary moisture content interaction. In addition, median community family income and being located within a major urban center (ie, Toronto) were significant risk factors for submission of CaOx uroliths, compared with submission of struvite uroliths. CONCLUSIONS AND CLINICAL RELEVANCE: Individual-level and dietary factors for dogs affected the risk of submission of CaOx uroliths, relative to that of struvite uroliths. Interactions among these variables need to be considered when assessing the impact of these risk factors. In addition, community-level or contextual factors (such as community family income and residing in a densely populated area of Ontario) also affected submission patterns, although most of the variance in the risk for submission of CaOx uroliths, compared with the risk for submission of struvite uroliths, was explained by individual-level factors.

Feline urate urolithiasis.

This retrospective case control study describes associations between feline urate urolithiasis and breed, age, gender, and urine composition. Data from cases of feline uroliths submitted to the Canadian Veterinary Urolith Centre (CVUC) between February 2, 1998 and July 7, 2007 were reviewed. There were 10 083 feline uroliths examined, including 385 ammonium urate, 13 uric acid, and 21 mixed struvite/urate uroliths. The Egyptian Mau, Birman, and Siamese breeds were significantly predisposed to urate urolithiasis [odds ratio (OR) = 118, 95% confidence interval (CI) = 38.2 to 510, P < 0.001], (OR = 9.1, 95% CI = 2.0 to 32, P < 0.001) and (OR = 3.9, 95% CI = 2.5 to 5.9, P < 0.001), respectively. Urate urolithiasis was more frequent in younger cats (mean age 6.3 versus 7.1 y in cats with other uroliths, P < 0.0001) and in male cats (P = 0.024). The association between Egyptian Maus and urate urolithiasis was remarkable. The association in Siamese cats is consistent with prior reports, and the association with Birman cats requires further study.

Canine and feline urolithiasis: examination of over 50 000 urolith submissions to the Canadian veterinary urolith centre from 1998 to 2008.

This study reports on trends in canine and feline urolithiasis in Canada during the past 10 years. Age, sex, breed of animals and mineral composition from 40 637 canine and 11 353 feline bladder uroliths submitted to the Canadian Veterinary Urolith Centre between 1998 and 2008 were recorded. Struvite and calcium oxalate uroliths comprised > 85% of all uroliths submitted. In dogs, the number of struvite submissions has declined and the number of calcium oxalate submissions has increased. Struvite uroliths were most common in female dogs and calcium oxalate uroliths in male dogs. The shih tzu, miniature schnauzer, bichon frisé, lhasa apso, and Yorkshire terrier were the breeds most commonly affected for both struvite and calcium oxalate uroliths. Urate uroliths were most common in male dalmatians. In cats, struvite submissions declined and calcium oxalate submissions remained constant. Struvite and calcium oxalate uroliths were common in domestic, Himalayan, Persian, and Siamese cats. Urate uroliths were over-represented in Egyptian maus.

Evaluation of risk factors associated with suture-nidus cystoliths in dogs and cats: 176 cases (1999-2006).

OBJECTIVE: To characterize and evaluate risk factors for suture-associated cystoliths in dogs and cats. DESIGN: Retrospective case-control study. Animals-163 dogs and 13 cats with suture-associated cystoliths and 326 control dogs and 26 control cats with non-suture-associated cystoliths. PROCEDURES: Submissions to the Canadian Veterinary Urolith Centre received from 1999 to 2006 were reviewed. Case dogs and cats had cystoliths associated with visible suture or with hollow, cylindrical channels or suture knot impressions consistent with dissolved suture. Control dogs and cats had at least a single recurrent non-suture-associated cystolith submitted closest in time to the sample case. Associations among cystolith composition, recurrence times, sex, age, and breed were evaluated. RESULTS: Cases consisted of 92 dogs and 7 cats with visible suture and 71 dogs and 6 cats with dissolved suture. Suture-associated cystoliths represented 0.6% of canine cystoliths, 9.4% of recurrent canine cystoliths, 0.17% of feline cystoliths, and 4% of recurrent feline cystoliths. Sexually intact and neutered males were at increased odds of suture-associated cystoliths, relative to spayed female dogs. Shih Tzus, Lhasa Apsos, and Pomeranians were significantly predisposed to form suture-associated cystoliths. In dogs, compound suture-associated cystoliths were significantly more likely than other cystolith types (OR, 8.6). Dogs with suture-associated cystoliths had significantly shorter recurrence times than did control dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Suture remnants in the bladder have an important role in recurrent cystolithiasis in dogs. Identification of risk factors is important for avoiding recurrence of iatrogenic cystoliths.

MRI in the diagnosis of cartilage injury in the wrist.

OBJECTIVE: Our purpose was to evaluate the accuracy of MRI in identifying articular cartilage abnormalities in the distal radius, scaphoid, lunate, and triquetrum of patients with wrist pain. MATERIALS AND METHODS: Eighty-six MRI examinations of the wrist in 85 patients (41 indirect MR arthrograms and 45 unenhanced [nonarthrographic] MR images) were evaluated. The study population consisted of 47 male (54.7%) and 38 female (45.3%) patients with an average age of 37.5 years (range, 7-62 years). Three experienced musculoskeletal radiologists who were unaware of surgical findings retrospectively evaluated the MRI examinations for cartilage abnormalities in the distal radius, scaphoid, lunate, and triquetrum. All patients underwent arthroscopy of the radiocarpal joint with inspection of the articular surfaces of the distal radius, scaphoid, lunate, and triquetrum. The articular cartilage was evaluated on the basis of the 5-point scale of the Outerbridge classification system. RESULTS: When at least two of the three radiologists had concordant interpretations, sensitivity for abnormalities in the distal radius was 27%; the scaphoid, 31%; the lunate, 41%; and the triquetrum, 18%. Specificity for the distal radius was 91%; the scaphoid, 90%; the lunate, 75%; and the triquetrum, 93%. Weighted kappa values among the three observers showed only fair agreement (0.279-0.360). High-grade more extensive cartilage lesions were no more accurately identified than low-grade lesions. Indirect MR arthrograms were not statistically more sensitive, specific, or accurate than unenhanced studies. No bone was more frequently or less frequently graded correctly or incorrectly with statistical significance. The variables of sex, age, and the presence of multiple bones with lesions did not affect accuracy. CONCLUSION: Our findings suggest that MRI of the wrist with the techniques described is not adequately sensitive or accurate for diagnosing cartilage defects in the distal radius, scaphoid, lunate, or triquetrum.

Canine urolithiasis: a look at over 16 000 urolith submissions to the Canadian Veterinary Urolith Centre from February 1998 to April 2003.

The purpose of this study was to report on the age, sex, breed, and mineral composition of 16 647 canine bladder uroliths submitted to the Canadian Veterinary Urolith Centre between February 1998 and April 2003. Each urolith submission was accompanied by a questionnaire. Of the submissions, approximately 43.8% were struvite and 41.5% oxalate. Struvite uroliths were most common in female dogs. Mixed breed dogs predominated, followed by the shih tzu, bichon frise, miniature schnauzer, Lhasa apso, and Yorkshire terrier. Oxalate uroliths were most common in males and in the miniature schnauzer, bichon frise, Lhasa apso, shih tzu, and Yorkshire terrier. Urate uroliths were most common in male Dalmations. Other urolith types, including cystine, xanthine, silica, and calcium phosphate, were less commonly reported. A review of risk factors for the various uroliths is presented, along with some recommendations for treatment and prevention.

Changes in methylation during progressive transcriptional silencing in transgenic subterranean clover.

A transgenic line of subterranean clover (Trifolium subterraneum) containing a gene for a sulphur-rich sunflower seed albumin (ssa gene) and a gene conferring tolerance to the herbicide phosphinothricin (bar gene) was previously shown to stably express these genes as far as the T3 generation. In subsequent generations there was a progressive decline in the level of expression of both of these genes such that, by the T7 generation, the plants were almost completely susceptible to the herbicide and the mean level of sunflower seed albumin was reduced to 10-30% of the level in the T2 and T3 generations. The decline in SSA protein correlated closely with a decline in the level of ssa RNA. In vitro transcription experiments with nuclei isolated from plants of the early and late generations showed that the reduced mRNA level was associated with a reduced level of transcription of the ssa transgene. Transcription of the bar transgene was also reduced in the late generations. Bisulphite sequencing analysis showed that the decline in expression of the ssa gene between T3 and subsequent generations correlated closely with increased CpG methylation in the promoter, but not in the coding region. Analysis of the bar gene promoter showed that high levels of CpG methylation preceded the first detectable decline in expression of the bar gene by one generation, suggesting that methylation was not the direct cause of transgene silencing in these plants.

Feline urethral plugs and bladder uroliths: a review of 5484 submissions 1998-2003.

The results of 5484 submissions from cats to the Canadian Veterinary Urolith Centre between February 1998 and February 2003 are presented. Of the submissions, 618 were urethral plugs and 4866 were bladder uroliths. The majority of the urethral plugs were from male domestic shorthair and longhair cats. Approximately 50% of the urolith submissions were oxalate, 44% were struvite. Oxalate uroliths were the most common mineral type in males and in Himalayan, Persian, and Siamese cats. Struvite uroliths were the most common mineral type in domestic shorthair and longhair cats. Females outnumbered males by 1.4:1 in struvite urolith submissions. A review of risk factors for urethral plugs and bladder uroliths is presented.