Isoflurane anesthesia alters complete blood count values in lilac-crowned parrots (Amazona finschi).

OBJECTIVE: To evaluate the effects of a chemical restraint with isoflurane compared to a physical restraint in hemogram values in psittacines. ANIMALS: 21 adult lilac-crowned parrots (Amazona finschi). METHODS: Subjects were physically restrained for blood sample collection, after this isoflurane anesthesia was administered for 30 minutes at which time a second blood sample was taken. Hemogram values were compared between both samples using a t test in variables with normal distribution and a Wilcoxon test in variables without normal distribution. Statistical significance was established at P < .05. RESULTS: When comparing the analytes of the respective CBCs, a decrease in PCV (P < .001), RBC count (P < .001), WBC count (P = .017), absolute lymphocytes (P = .024), and total proteins (P < .001) was observed in the samples taken under chemical restraint. No significant differences in MCV and absolute values of heterophils, monocytes, or eosinophils were observed. CLINICAL RELEVANCE: Isoflurane causes a decrease in some blood count values in lilac-crowned parrots under isoflurane anesthesia for 30 minutes. Although the magnitude of change could be variable between values, it is important to consider the blood collection method when interpreting the blood count in this species.

Enucleations, Eviscerations, and Exenterations at a Supratertiary-care Hospital in Puerto Rico: A Retrospective Study.

OBJECTIVE: To provide a descriptive analysis of the indications and the intraoperative and postoperative complications of eye enucleations and eviscerations, and orbital exenterations performed at the only academic institution in Puerto Rico providing supratertiary care. METHODS: A retrospective medical record review of patients who underwent enucleations, eviscerations, and exenterations from January 2015 through June 2020 was conducted. The data were analyzed to generate a descriptive profile of the demographic characteristics of the patients, their clinical indications and surgical complications, and a histopathological diagnosis per type of eye-removal procedure. RESULTS: A total of 118 eyes were removed via enucleation, evisceration, or exenteration over the 66-month study period. The average patient age was 64 (±17.5) years and 63.8% of the patients were male. The most frequently performed eye-removal procedure was enucleation (73.7%), followed by evisceration (18.6%) and exenteration (7.6%). The main clinical indications for enucleations and eviscerations were infectious processes, namely panophthalmitis, endophthalmitis, and/or perforated corneal ulcers, that failed medical management. In our sample, squamous cell carcinoma was the most common diagnosis (both clinically and histopathologically) leading to exenteration. Postoperative complications in our patient cohort were minimal. CONCLUSION: At our institution, enucleations predominate over eviscerations. Retrospective reviews published in recent years indicate that the rate of eviscerations at our institution is comparatively low. The results of this study, the first of its kind at our institution, may encourage a re-evaluation of the indications for evisceration versus enucleation in our patient population.

Implant Removal Due to Infection After Open Reduction and Internal Fixation: Trends and Predictors.

Background: Implant removal due to infection is one of the major causes failure following open reduction and internal fixation (ORIF). The aim of this study was to determine trends and predictors of infection-related implant removal following ORIF of extremities using a nationally representative database. Methods: Nationwide Inpatient Sample data from 2006 to 2017 was used to identify cases of ORIF following upper and lower extremity fractures, as well as cases that underwent infection-related implant removal following ORIF. Multivariate analysis was performed to identify independent predictors of infection-related implant removal, controlling for patient demographics and comorbidities, hospital characteristics, site of fracture, and year. Results: For all ORIF procedures, the highest rate of implant removal due to infection was the phalanges/hand (5.61%), phalanges/foot (5.08%), and the radius/ulna (4.85%). Implant removal rates due to infection decreased in all fractures except radial/ulnar fractures. Tarsal/metatarsal fractures (odds ratio (OR)=1.45, 95% confidence interval (CI): 1.02-2.05), and tibial fractures (OR=1.82, 95% CI: 1.45-2.28) were identified as independent predictors of infection-related implant removal. Male gender (OR=1.67, 95% CI: 1.49-1.87), Obesity (OR=1.85, 95% CI: 1.34-2.54), diabetes mellitus with chronic complications (OR=1.69, 95% CI: 1.13-2.54, P<0.05), deficiency anemia (OR=1.59, 95% CI: 1.14-2.22) were patient factors that were associated with increased infection-related removals. Removal of implant due to infection had a higher total charge associated with the episode of care (mean: $166,041) than non-infection related implant removal (mean: $133,110). Conclusion: Implant removal rates due to infection decreased in all fractures except radial/ulnar fractures. Diabetes, liver disease, and rheumatoid arthritis were important predictors of infection-related implant removal. The study identified some risk factors for implant related infection following ORIF, such as diabetes, obesity, and anemia, that should be studied further to implement strategies to reduce rate of infection following ORIF.

Blockade of beta adrenergic receptors protects the blood brain barrier and reduces systemic pathology caused by HIV-1 Nef protein.

Combination antiretroviral therapy (cART) targets viral replication, but early viral protein production by astrocytes may still occur and contribute to the progression of HIV-1 associated neurocognitive disorders and secondary complications seen in patients receiving cART. In prior work with our model, astrocytic HIV-1 Nef expression exhibits neurotoxic effects leading to neurological damage, learning impairment, and immune upregulation that induces inflammation in the lungs and small intestine (SI). In this follow-up study, we focus on the sympathetic nervous system (SNS) as the important branch for peripheral inflammation resulting from astrocytic Nef expression. Male and female Sprague Dawley rats were infused with transfected astrocytes to produce Nef. The rats were divided in four groups: Nef, Nef + propranolol, propranolol and naïve. The beta-adrenergic blocker, propranolol, was administered for 3 consecutive days, starting one day prior to surgery. Two days after the surgery, the rats were sacrificed, and then blood, brain, small intestine (SI), and lung tissues were collected. Levels of IL-1ß were higher in both male and female rats, and treatment with propranolol restored IL-1ß to basal levels. We observed that Nef expression decreased staining of the tight junction protein claudin-5 in brain tissue while animals co-treated with propranolol restored claudin-5 expression. Lungs and SI of rats in the Nef group showed histological signs of damage including larger Peyer's Patches, increased tissue thickness, and infiltration of immune cells; these findings were abrogated by propranolol co-treatment. Results suggest that interruption of the beta adrenergic signaling reduces the peripheral organ inflammation caused after Nef expression in astrocytes of the brain.

Historical Spatial Distribution of Zoonotic Diseases in Domestic, Synanthropic, and Wild Animals in the Mexican Territory of the Yucatan Peninsula.

The Mexican territory of the Yucatan Peninsula has a tropical climate and harbors a wide variety of domestic, synanthropic, and wild animals, as well as disease vectors. To determine the distribution of recorded zoonotic diseases in the Yucatan Peninsula, scientific publications referring to these diseases in animals and containing geographic coordinates of disease occurrence, were studied. The epidemiological bulletins of the national government were also consulted to obtain information on zoonotic diseases reported in humans in the territory. The territory harbors a wide variety of tropical zoonotic pathogens, including Trypanosoma cruzi, Leptospira interrogans, Toxoplasma gondii, Leishmania mexicana, Dirofilaria immitis, and Rickettsia felis. A variety of domestic, synanthropic, and wild animals act as hosts or reservoirs in the transmission cycle of the zoonotic diseases in the Yucatan Peninsula, and some spillover into human populations has also been recorded. There are still zoonotic diseases that have rarely or never been reported in humans, but it is not clear whether this is because these diseases in humans are not common, there is a lack of viable transmission cycle or there is a lack of appropriate diagnosis. It is necessary to continue monitoring vectors, animal hosts, and humans to identify risk factors for zoonotic diseases in the Yucatan Peninsula.

Pólipo fibroepitelial de uretra anterior / Fibroepithelial polyp of the anterior urethra

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Melatonin added to freezing diluent improves canine (Bulldog) sperm cryosurvival.

Cryopreservation compromises the capacity of sperm fertilizing due to a series of alterations in the structure and physiology of the sperm. The use of antioxidants, such as melatonin, added to freezing media, may help to reduce sperm cryoinjury. To test the effect of melatonin on Bulldog (Canis lupus familiaris) sperm cryosurvival, spermatozoa were diluted in a standard freezing medium and cooled to 5°C. Then, more freezing medium was added to obtain 200 × 106 cells/mL, and 5% glycerol. Diluted spermatozoa were treated with melatonin (0.0, 0.0005, 0.002, and 0.0035 mol/L), and packaged in 0.25 mL straws, which were further cooled to -5°C before freezing in liquid nitrogen. Thawing was carried out at 70°C for 5 s, and the progressive motility, viability, plasma membrane integrity, acrosome integrity, capacitation status, and plasma membrane fluidity of the spermatozoa (at 37°C) were assessed. Data were analyzed using ANOVA to detect differences between the melatonin doses. There were statistical differences (P < 0.05) in the percentage of sperm having hyper-fluid membranes, intact acrosome, capacitated acrosome-intact, and acrosome-reacted. The values for the high melatonin doses (0.002 and 0.0035 mol/L) were better than for the low melatonin doses (0.0 and 0.0005 mol/L). In conclusion, 0.002 and 0.0035 mol/L of melatonin improved the cryosurvival of sperm from male bulldogs. LAY SUMMARY: Preservation of sperm by freezing enables breeding of individuals geographically separated; protocols for the dog may be used to preserve the semen from threatened wild canids. To improve fertility of female dogs that become pregnant with frozen and then defrosted sperm, these cells must survive that process which can be damaging whilst keeping their ability to fertilize. Antioxidants are substances capable of retarding or preventing the oxidation of any oxidizing substrate such as lipids, proteins, and DNA, which are structural compounds of the sperm. The use of antioxidants, added to freezing media, may provide the sperm the capacity to neutralize oxidative compounds, such as reactive oxygen species, produced during the freezing and thawing process. In this work we tested different levels of melatonin, a natural antioxidant, on dog (English Bulldog) sperm survival and quality after freezing. We found that adding melatonin to the freezing media improved sperm quality after thawing.

Total knee arthroplasty in patients with multiple hereditary exostoses.

We present a case report of a patient with severe valgus deformity of the right knee due to multiple hereditary exostoses (MHEs) treated with total knee arthroplasty (TKA). The surgical management of MHE affecting the knee encompasses exostoses resection, joint deformity rectification, and limb-length discrepancy alignment. On rare occasions, distraction osteogenesis and TKA have been used to correct valgus deformities of the knee. TKA in MHE patients with knee involvement has only been described in 6 cases. Several considerations, such as extensive knowledge of frequently occurring skeletal aberrations, are required to successfully correct the deformities associated with MHE via TKA. This report describes a case of severe valgus knee deformity with a rotational component in MHE managed with TKA, the surgical technique, and future recommendations.

Asymmetrical distractibility of global and focal visuospatial attention during segmental and total compound line bisections.

BACKGROUND/OBJECTIVES: Compound horizontal lines are composed of 2 segments of unequal length and width. Line bisection requires that the participants attend to the entire line (global attention). The longer segment often distracts participants, suggesting that attention directed to this segment (focal attention) disrupts the allocation of global attention. This study attempted to learn whether the allocation of focal attention to a line segment is distracted by global attention allocated to the entire line and whether there are right-left distraction asymmetries when allocating focal or global attention. METHOD: Twenty-four healthy adults (12 > 65 years old) attempted to bisect horizontal lines composed of 2 segments of unequal length, with the larger segment placed to the right or left. They were also asked to bisect the longer segment of these lines. RESULTS: When allocating focal attention to the larger segment, healthy participants were more distracted when the smaller segment was on the left than on the right. In contrast, when attempting to allocate global attention to the entire line, participants were more distracted when the larger segment was on the right side. There were no significant differences between older and younger participants. CONCLUSIONS: The asymmetrical global distraction during segment bisection might be related to the right hemisphere's dominance in mediating global attention and allocating attention leftward. In contrast, the asymmetrical focal distraction during full-line bisection might be related to the left hemisphere's dominance in mediating focal attention and allocating attention toward the right. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Background distraction during vertical solid and character line bisections.

Background-objectives: When vertical lines are positioned above or below the center of the page, line bisection deviates toward the center of the page, suggesting that the edges of the page distract the allocation of attention to the line. A letter-character line (LCL) bisection requires both global and focal attention, to identify the target letter closest to the line's center. If more focal and less global attention is allocated to a LCL, more global attentional resources may be available and inadvertently allocated to the page. Alternatively, if the allocation of focal attention to a LCL inhibits global attentional processing, there may be less distraction by the page. METHOD: Twenty-four healthy adults (12 older) bisected vertical solid and character lines centered, or positioned closer to the top or bottom of the page. RESULTS: There was no difference between bisection of solid and character lines centered on the page. Page-related deviations were greater with character lines than solid line bisections, and greater for lines positioned toward the top than the bottom of the page. With lines positioned toward the top, the older participants' attempted bisections were higher than those of the younger participants. CONCLUSIONS: These results suggest that the allocation of focal attention increases global attentional distractibility and that global-background attentional distraction is greater when the vertical lines are placed in the upper part of the page. Older participants appeared to be less distracted when lines were placed toward the top of the page, but the reason for this age difference requires further research.

The Use of Bone Morphogenetic Protein in Spinal Transforaminal Lumbar Interbody Fusion: Our Experience.

OBJECTIVE: Since its introduction and FDA approval, rhBMP-2 has been adopted by spine surgeons as a substitute for ICBG in numerous spinal fusion techniques. As broad clinical use increased, reports on potential complications associated with rhBMP-2 also increased. We provide our experience with TLIF using rhBMP-2 or ICBG in an entirely Hispanic population. METHODS: This was a 2-year retrospective study of 67 patients, with 26 in the rhBMP-2 group and 41 in the ICBG group, who underwent TLIF. Pertinent information was obtained through review of the medical records documenting complications, intraoperative times, and EBL, among other things. RESULTS: There were 28 post-operative complications with 15 (53.6%) in the ICBG group and 13 (46.4%) in the rhBMP-2 group. The average EBL was 572.3 mL (SD: 411.8) in the ICBG group and 397.9 mL (SD: 312.2) in the rhBMP-2 group. The average intraoperative time was 243.1 minutes (SD: 79.5) in the ICBG group and 226.5 minutes (SD: 64.7) in the rhBMP-2 group. Fifty-two patients underwent open TLIF and 15 patients underwent MI TLIF. The average EBL was 571.2 mL (SD: 375.3) in the open TLIF group and 228.3 mL (SD: 299.3) in the MI-TLIF group. The average intraoperative time was 241.0 minutes (SD: 76.0) for patients in the open TLIF group and 218.8 minutes (SD: 65.0) for those in the MI-TLIF group. There were no new cancer events at any of the 2-year follow-up visits. RESULTS: Our results suggest that the safety profile of rhBMP-2 may be inferior to that of ICBG, rejecting the possibility of ICBG being replaced by rhBMP-2 as the gold standard for spinal fusion.

The aging brain: Movement speed and spatial control.

BACKGROUND/OBJECTIVES: With aging, people commonly develop motor slowing (bradykinesia). Although this slowness with aging may be entirely related to degradation of the cerebral networks important in motor programing, it is possible that, at least in part, it may be a learned procedure for enhancing the accuracy and/or precision of movements. The goal of this study is to test these contradictory hypotheses. METHODS: Twenty-four healthy adults, 12 younger than age 26 and 12 older than age 65 were asked to make alternative marks with a pen between a card centered in front of them and a series of circles distributed across a page. Performance was timed, and participants were instructed to complete the task as quickly as possible while not sacrificing accuracy for speed. The circle sizes and hand used varied by trial. RESULTS: The older adults performed the task more slowly for all target circle diameters. As the circles decreased in size, the younger adults performed the task more rapidly than did the older participants, but the younger participants also had a greater decline in accuracy. CONCLUSIONS: During this aiming task, healthy older adults were less likely than younger adults to sacrifice accuracy for speed. Thus, at least in part, their slowing may be a learned adaptive strategy.

Metástasis cutánea de carcinoma urotelial de vejiga. Presentación de un caso / Cutaneous metastasis of urothelial carcinoma of the bladder. Case report

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Supramesocolic access to the left renal pedicle: anatomical and surgical description.

OBJECTIVE: To expose and remind the supamesocolic approach to the left renal pedicle, in addition to review its main indications. METHODS/RESULTS: We perform a detailed description of the surgical technique showing its indications, the position, the incision and retraction systems employed, detailing the steps followed during dissection. CONCLUSIONS: Adequate vascular control and complete resection of large renal and adrenal masses require an adequate exposition; the knowledge of surgical techniques such as supramesocolic approach to the left renal pedicle is very useful and may ease the course of retroperitoneal operations avoiding complications and giving comfort in a frequently difficult operation.

La vía supramesocólica de acceso al pedículo renal izquierdo: descripción de anatomía quirúrgica / Supramesocolic approach to the left renal pedicle: Description of the surgical anatomy

OBJETIVO: Exponer y recordar la vía de acceso supramesocólica al pedículo renal izquierdo, además de recordar las principales indicaciones de la misma. MÉTODO/RESULTADOS: Realizamos una descripción detallada de la técnica quirúrgica exponiendo sus indicaciones, la posición, incisión y sistemas de retracción utilizados y detallando los pasos llevados a cabo durante la disección. CONCLUSIÓN: El adecuado control vascular y la resección completa de grandes masas renales y suprarrenales precisan de una adecuada exposición; por lo que el conocimiento de técnicas quirúrgicas como el acceso supramesocólico al pedículo renal izquierdo es de gran utilidad y que puede facilitar el curso de cirugías retroperitoneales evitando complicaciones y aportando comodidad a actuaciones con frecuencia comprometidas

OBJECTIVE: To expose and remind the supamesocolic approach to the left renal pedicle, in addition to review its main indications. METHODS/RESULTS: We perform a detailed description of the surgical technique showing its indications, the position, the incision and retraction systems employed, detailing the steps followed during dissection. CONCLUSIONS: Adequate vascular control and complete resection of large renal and adrenal masses require an adequate exposition; the knowledge of surgical techniques such as supramesocolic approach to the left renal pedicle is very useful and may ease the course of retroperitoneal operations avoiding complications and giving comfort in a frequently difficult operation

Angiomiolipoma de gran tamaño en polo superior de riñón derecho / Giant angiomyolipoma in the upper pole of the right kidney

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Tubulocystic renal carcinoma (low grade collecting duct carcinoma).

OBJECTIVE: To report a case of tubulocystic renal carcinoma diagnosed in an adult, after a work up study for hematuria. METHODS/RESULTS: 59-year-old male, CT scan was performed during a study for self-limited hematuria showing a 4.2 cm solid mass with areas suspicious of pseudocystic malignancy. Due to its debut with hematuria and renal sinus involvement laparoscopic radical nephrectomy was performed, establishing the diagnosis of tubulocystic carcinoma (low grade collecting duct carcinoma). CONCLUSION: Tubulocystic carcinoma presents histological characteristics and a natural history that makes it different from the classic type of Bellini duct carcinoma, the latter being a rapidly growing tumor with poor prognosis which is usually diagnosed in advanced stages.

Carcinoma renal túbulo-quístico / Tubulocystic renal carcinoma (low grade collecting duct carcinoma)

OBJETIVO: Presentar el caso clínico de un carcinoma renal túbulo-quístico diagnosticado, en un adulto, tras estudio por hematuria. MÉTODO/RESULTADO: Varón de 59 años que durante un estudio por hematuria franca autolimitada se realizó un TAC que mostró una tumoración de 4,2 cm sólida con áreas pseudoquísticas sospechosa de malignidad. Debido al debut por hematuria y a la afectación del seno renal se realizó nefrectomía radical laparoscópica, estableciendo el diagnóstico de carcinoma túbulo-quístico (carcinoma de los ductos colectores de bajo grado). CONCLUSIÓN: El carcinoma túbulo-quístico presenta unas características tanto histológicas como de historia natural de la enfermedad que lo diferencia de la variante clásica del carcinoma de los ductos colectores de Bellini, siendo éste último un tumor de rápido crecimiento y mal pronóstico que suele diagnosticarse en estadios avanzados(AU)

OBJECTIVE: To report a case of tubulocystic renal carcinoma diagnosed in an adult, after a work up study for hematuria. METHODS/RESULTS: 59-year-old male, CT scan was performed during a study for self-limited hematuria showing a 4.2 cm solid mass with areas suspicious of pseudocystic malignancy. Due to its debut with hematuria and renal sinus involvement laparoscopic radical nephrectomy was performed, establishing the diagnosis of tubulocystic carcinoma (low grade collecting duct carcinoma). CONCLUSION: Tubulocystic carcinoma presents histological characteristics and a natural history that makes it different from the classic type of Bellini duct carcinoma, the latter being a rapidly growing tumor with poor prognosis which is usually diagnosed in advanced stages