Effect of proximity to females on integument damage caused by self-enurination in male goats.

In male goats, self-enurination (SE) is the downward turning of the head and shoulders while urinating onto the face and front legs. Although it provides important chemical cues to females, other males, and even self, it is a costly behavior that can create a range of problems including erythema, irritation, hair loss, and compromised skin. It was hypothesized that the extent of integument damage from SE on bucks' faces and front legs would be increased by housing bucks near females. Four bucks were housed with fence-line contact to females ("Near" bucks), and four bucks were housed without fence-line contact to females ("Far" bucks). Each buck was photographed every other week over an 18-wk period during the breeding season. During each imaging session, seven different photographic views were captured, and burn areas were quantified for each buck. Overall, more Near bucks had urine burn than Far bucks, and Near bucks developed urine burn earlier in the breeding season than did Far bucks. Housing bucks close to females increases the extent of integument damage from SE. These findings may help goat breeders develop management practices to improve animal well-being by minimizing urine burn injury to bucks.

Differential effects of androgens, estrogens and socio-sexual context on sexual behaviors in the castrated male goat.

The behavioral and endocrine activation of sexual behaviors exhibited by male goats, especially self-enurination (SE), is poorly understood. In the first experiment, to assess the influence of socio-sexual context on SE in bucks, the effects of distance from does, the presence of estrous versus non-estrous does and the presence of another buck on SE and courtship frequencies of intact male goats (bucks; n = 12) were tested using a unique behavior test apparatus. For experiments 2 and 3, to test the relative contributions of sex steroid hormones and socio-sexual context on SE, castrated male goats (wethers; n = 20) were randomly divided into five groups and injected for seven weeks with one of the following: 25 mg testosterone propionate (T), 25 mg dihydrotestosterone propionate (DHT), 100 µg estradiol benzoate (E), 100 µg E and 25 mg DHT (E + DHT), or oil (CON). The effects of these treatments on frequency of SE and courtship were assessed using the behavior test apparatus (social scenarios) adapted from the findings in experiment 1. In one scenario, a wether could observe (from 4.6 m) a buck and estrous female (doe) together in a wire mesh holding pen. In a different scenario, the wether could observe (from the same distance) a buck that could only court the estrous doe through a wire mesh barrier. Finally, to observe the effects of steroid treatment on mounting and ejaculation frequencies, in addition to SE and courtship, each wether was placed in a pen with an estrous doe for 10 min. After a five-week, treatment-washout period, wethers were randomly assigned to different treatment groups and retested. In experiment 1, bucks that were distanced from females displayed more SEs than those with fence-line contact, while those with fence-line contact displayed more bouts of courtship (P < 0.05). In experiments 2 and 3, courtship frequencies displayed in all three scenarios were greater than CON only for groups exposed to estrogen directly or via aromatization (T, E + DHT, E; P < 0.05). Frequencies of SE exhibited during behavior tests in which the wether was watching were greater than CON only for androgen-treated groups (T, E + DHT, DHT; P < 0.05). In contrast, when the wether was free to interact with the female, only the DHT group displayed SE at a higher frequency than CON (P < 0.05). Treatment had no effect on mount frequencies in this test scenario, however ejaculation frequencies were highest for T and E + DHT (P < 0.05). These studies suggest that the courtship behaviors of the male goat are estrogen-dependent. However, SE appears to be activated by androgens. It was also demonstrated that social context contributes as much to behavior expression as steroid treatment, as in social scenario 2 some sexual behaviors were displayed in similar frequencies across groups, despite differing sex steroid treatments.

From Death to Health in 30 Days: A Hemochromatosis Case Report.

BACKGROUND: Heredity hemochromatosis (HH) is an underdiagnosed genetic disease that can lead to life-threatening multisystem organ failure. Identifying and treating HH early can prevent the progression of the disease. CASE PRESENTATION: For a 60-year-old white patient without obvious symptoms, it was a revelation to discover that he had HH. This patient, although receiving evidence-based care, ultimately required a liver transplant. As his condition deteriorated, the plan for this patient and his family involved working within an interdisciplinary team that included nurse practitioners and intensive care unit nurses. DISCUSSION: The uniqueness of this case illustrates the crucial role of a health care team that persisted in differentiating the patient's diagnosis and continued to sustain both physical and emotional care throughout his hospitalization despite a poor prognosis. The patient felt support from this team during the course of his illness, from requiring life-supporting care in intensive care unit to returning home and resuming his normal activities of daily living.

A Pilot Study Implementing a Protocol Using Dexmedetomidine as a Safe Alternative to Traditional Sedation to Decrease Ventilator Days for Patients Difficult to Extubate.

BACKGROUND: Traditional sedation for mechanically ventilated patients causes delirium, which increases the patients' length of stay while hospitalized. When extubation is attempted, these medications must be discontinued because of the side effect of respiratory depression, leaving patients anxious and agitated, delaying extubation and prolonging the need for mechanical ventilation. Dexmedetomidine is a safe alternative sedative that does not cause delirium or respiratory depression. During the weaning process, dexmedetomidine can be continued, allowing the patient to remain calm and successfully extubated. OBJECTIVES: The aim of this study is to decrease the length of stay for mechanically ventilated patients by implementing a dexmedetomidine protocol for difficult-to-extubate patients during the weaning process. METHODS: A preintervention/postintervention design pilot study was done comparing the patient mean of length of stay on mechanical ventilation. A Mann-Whitney U test was used because of the small sample size. RESULTS: Over the 3-month implementation period, 15 patients received dexmedetomidine. None of the patients experienced adverse reactions while on dexmedetomidine. There was a trend of decreasing mechanical ventilation length of stay but no significant difference was noted between the preimplementation and postimplementation groups. CONCLUSION: Dexmedetomidine was a safe alternative to traditional sedation for difficult-to-extubate patients when a bolus dose was not given.

The disease with hope: hairy cell leukemia.

Hairy cell leukemia (HCL), comprising 2% of all leukemias, is a chronic disorder characterized by mononuclear cells with prominent cytoplasmic projections. For years, patients with HCL underwent splenectomies and then interferon alpha for treatment, which provided high response rates but low percentages of complete remission. More recent treatments with 2-chlorodeoxyadenosine result in 85%-90% complete remission, minimal toxicity, and lower rates of relapse using a single course of therapy. A second course of therapy can be administered if HCL continues to be resistant or recurs. New research using anti-CD22 recombinant immunotoxin BL22 is proving successful. With these latest chemotherapy options, patients' prognoses are optimistic.