Role of three dimensional (3D) printing in endourology: An update from EAU young academic urologists (YAU) urolithiasis and endourology working group.

The management of nephrolithiasis has been complemented well by modern technological advancements like virtual reality, three-dimensional (3D) printing etc. In this review, we discuss the applications of 3D printing in treating stone disease using percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS). PCNL surgeries, when preceded by a training phase using a 3D printed model, aid surgeons to choose the proper course of action, which results in better procedural outcomes. The 3D printed models have also been extensively used to train junior residents and novice surgeons to improve their proficiency in the procedure. Such novel measures include different approaches employed to 3D print a model, from 3D printing the entire pelvicalyceal system with the surrounding tissues to 3D printing simple surgical guides.

Pseudoreticulocytosis by the ADVIA 2120 Hematology Analyzer and Other Hematologic Changes in a Cynomolgus Macaque (Macaca fascicularis) With Malaria.

Important hematologic changes can be observed in nonhuman primates with malaria, including inaccurate reticulocyte counts by the ADVIA 2120 hematology analyzer. A 5-year-old male purpose-bred cynomolgus macaque (Macaca fascicularis) imported from a commercial source in Cambodia was enrolled in a nonclinical toxicity study investigating the effects of an immunomodulatory pharmaceutical agent. On study day 22, an increase in large unstained cells (LUCs), due to increased monocytes (2.20 × 103/µl, reference interval: 0.17-0.76 × 103/µl), was reported by the analyzer during a scheduled hematologic evaluation, which prompted blood smear review and revealed that the macaque had a high burden of Plasmodium spp.. The macaque did not have clinical signs for the infection at this time point. Progressively higher parasite burdens and persistently increased monocytes (markedly increased by study day 56, 10.38 × 103/µl) were observed at subsequent hematologic evaluations. New Methylene Blue stain manual reticulocyte counts were performed on study day 43 and at later time points, and showed that the analyzer reported erroneous higher reticulocyte counts (study day 43: +6.7%, +266.2 × 109/L; study day 50: +18.9%, +409.8 × 109/L) compared with the manual reticulocyte counts (pseudoreticulocytosis). The magnitude of regenerative response was considered inadequate for the severity of anemia at these time points. Atypical reticulocyte scatter plot distributions from the analyzer were also observed at time points with high parasite burdens, and combined with increased LUCs, may suggest high burden parasitemia. Verification of automated reticulocyte counts is important in cases with high malarial parasite burdens and the recognition of pseudoreticulocytosis is prudent in assessing appropriateness of the regenerative response. Increases in monocytes correlated with higher parasite burdens and marked increases may be an indicator of advanced disease.

Mucoid Pseudomonas aeruginosa infection in a cat with severe chronic rhinosinusitis.

A 6-year-old male neutered Bengal cat was presented to the University of Wisconsin Veterinary Care Hospital with a history of severe chronic rhinitis that was unresolved from kittenhood. In weeks prior to presentation, the cat's upper respiratory signs had significantly worsened and a left-sided facial swelling overlying the left frontal sinus was noted. Skull computed tomography, rhinoscopy, bilateral nasal biopsies, bacterial and fungal cultures of fluid from the left frontal sinus, and cryptococcal fungal antigen testing were performed. The cat was diagnosed with severe chronic rhinosinusitis and determined to have an infection with a mucoid variant of Pseudomonas aeruginosa (P aeruginosa). This case highlights an atypical cytomorphologic appearance of the well-known bacterial pathogen, P aeruginosa, an appearance that could be confused cytologically with other microorganisms, such as septate fungi. Mucoid variants of P aeruginosa are often associated with progressive lung or airway disease in people with cystic fibrosis and have not been previously documented in feline respiratory tract disease. This report also presents a brief review of chronic rhinosinusitis (CRS) in cats and describes a novel interventional treatment approach to feline CRS via sinusotomy and sinus flushing for severely affected cats.

Hypercholesterolemia and hypertriglyceridemia as biochemical markers of disease in companion rabbits.

BACKGROUND: Inflammation has important effects on lipid metabolism, but the relationship between hyperlipidemia, inflammation, and disease remains unknown in rabbits. While rabbits are sensitive to dietary hypercholesterolemia, the etiology of hyperlipidemia when fed non-atherogenic diets is uncertain. OBJECTIVES: This study aimed to determine the association between hypercholesterolemia and patient characteristics, diseases, and select CBC and biochemistry analytes in rabbits, and to measure plasma lipoprotein lipid fractions in rabbits with inflammatory and other diseases. METHODS: Complete blood count and plasma biochemistry data, including total cholesterol concentrations, were evaluated in 531 companion rabbits. Lipoprotein cholesterol fractions (non-high-density lipoprotein cholesterol [non-HDLc] and high-density lipoprotein [HDLc]) and triglycerides were measured using a colorimetric enzymatic assay in archived plasma from a subset of 267 rabbits. Rabbits were categorized by age, sex, spay/neuter status, breed, diet status (fed atherogenic dietary components or not), the organ system affected by disease, and the pathologic process. RESULTS: Cholesterol was associated with fibrinogen (P = 0.01), globulins (P < 0.01), and heterophil (P < 0.01) concentrations. Adjusting for diet, rabbits with severe infection or sepsis (odds ratio [OR] = 13.25, 95% CI = 5.83-30.12), renal failure (OR = 14.42, 95% CI = 5.69-36.54), and hepatopathy (OR = 8.55, 95% CI = 3.55-20.62) had increased risks of hypercholesterolemia. Increased non-HDLc and triglyceride concentrations were also associated with these three disease states (P < 0.05). CONCLUSIONS: Hyperlipidemia is associated with biochemical and CBC markers of inflammation, and with severe infection or sepsis, renal failure, and hepatopathy. Independent of diet, increased cholesterol, non-HDLc, and triglycerides are indicators of disease in companion rabbits.

Retrospective evaluation of prognostic indicators in dogs with head trauma: 72 cases (January-March 2011).

OBJECTIVE: To investigate the prognostic value of clinical and laboratory variables and scoring systems in dogs with head trauma. DESIGN: Retrospective study (January-March, 2011). SETTING: University teaching hospital. ANIMALS: Seventy-two client-owned dogs with a history of head trauma occurring ≤5 days prior to hospital admission. Dogs were excluded if they had an unconfirmed history of trauma, preexisting neurologic disease, or insufficient data available in the medical record. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data from hospital admission were collected, including vital signs; blood pressure; pulse oximetry; venous blood gases and electrolyte concentrations; plasma lactate and blood glucose concentrations; PCV; total plasma protein concentration; activated clotting time; WBC count; and serum albumin, creatinine, total bilirubin, and BUN concentrations. Modified Glasgow Coma Scale (MGCS), mentation, and animal trauma triage (ATT) scores were also calculated. Treatment with mannitol, hypertonic saline (HS), corticosteroids, benzodiazepines, or phenobarbital, and requirement for endotracheal intubation were also recorded. Outcome was classified as survival or nonsurvival to hospital discharge. Decreased pulse oximetry, pH, bicarbonate concentration, or base excess, and increased potassium concentration, lactate concentration, BUN concentration, ATT score, or mentation score were risk factors for nonsurvival. Decreased MGCS score was the strongest predictor of nonsurvival; a score ≤ 11 was 84% sensitive and 73% specific for predicting nonsurvival. Dogs were more likely to die before discharge if they required HS or endotracheal intubation. CONCLUSIONS: Dogs that did not survive following head trauma were more likely to have poor perfusion, severe concurrent injuries reflected by increased ATT scores, severe traumatic brain injury as evidenced by decreased MGCS or increased mentation scores, or requirement for HS administration or endotracheal intubation.

Hemangiosarcoma in a geriatric Labrador retriever.

A geriatric Labrador retriever dog was presented for acute collapse. The dog was conscious but lethargic, tachypneic, tachycardic with weak femoral pulses, occasional pulse deficits, and pale mucous membranes. Radiography, ultrasonography, quick assessment tests, and a complete blood (cell) count (CBC)/biochemistry panel indicated internal hemorrhage and potential problems with hemostasis. The dog was euthanized. A necropsy, histopathology, and immunohistochemistry for CD31 and Factor VIII-related antigen cell markers supported a diagnosis of splenic hemangiosarcoma.

RésuméHémangiosarcome chez un Labrador retriever gériatrique. Un chien Labrador retriever gériatrique a été présenté pour un collapsus aigu. Le chien était conscient mais léthargique, tachypnéique, tachycardique avec des pouls fémoraux faibles, des pouls déficitaires occasionnels et des muqueuses pâles. La radiographie, l'échographie, des tests d'évaluation rapide et une numération globulaire complète/évaluation biochimique ont indiqué une hémorragie interne et des problèmes potentiels avec l'hémostase. Le chien a été euthanasié. Une nécropsie, un examen histopathologique et immunohistochimique pour CD31 et les marqueurs des cellules antigènes facteur VIII ont appuyé le diagnostic d'un hémangiosarcome de la rate.(Traduit par Isabelle Vallières).