Colonic gastrointestinal stromal tumor (GIST) presenting with colocolonic intussusception: A rare case report.

An 8-year-old spayed female British bulldog was presented with vomiting, hyporexia, and large-bowel diarrhea. Abdominal ultrasound revealed a focal colonic mass with an intussusception located immediately oral to the mass. The intussusception encompassed the ascending and transverse colon and was non-reducible. Colonic resection and anastomosis were completed to include the intussusception and colonic mass. Histopathological examination of the mass demonstrated a spindle cell neoplasm arising within the muscular wall of the intussuscepted segment that obliterated normal architecture. Mild-to-moderate cytoplasmic immunoreactivity of the tumor cell population for CD117 and smooth muscle actin was consistent with a diagnosis of a gastrointestinal stromal tumor. The dog described herein remains alive and free of progressive disease at the time of writing. Key clinical message: The entire gastrointestinal tract should be evaluated in any animal with gastrointestinal symptoms. A gastrointestinal stromal tumor remains a plausible differential diagnosis, regardless of the intestinal segment affected, and tumorassociated intussusception is a rare but urgent clinical finding.

Tumeur stromale gastro-intestinale du côlon (GIST) présentant une invagination colocolique : un rapport de cas rare. Une femelle bouledogue anglais stérilisée de 8 ans a présenté des vomissements, une hyporexie et une diarrhée d'origine du gros intestin. L'échographie abdominale a révélé une masse colique focale avec une invagination située immédiatement oralement à la masse. L'intussusception englobait le côlon ascendant et transverse et était non réductible. La résection colique et l'anastomose ont été réalisées pour inclure l'intussusception et la masse colique. L'examen histopathologique de la masse a révélé un néoplasme à cellules fusiformes apparaissant dans la paroi musculaire du segment invaginé qui a oblitéré l'architecture normale. L'immunoréactivité cytoplasmique légère à modérée de la population de cellules tumorales pour le CD117 et l'actine des muscles lisses étaient compatibles avec un diagnostic de tumeur stromale gastro-intestinale. Le chien décrit ici est toujours vivant et exempt de maladie évolutive au moment de la rédaction.Message clinique clé :L'ensemble du tractus gastro-intestinal doit être évalué chez tout animal présentant des symptômes gastrointestinaux. Une tumeur stromale gastro-intestinale reste un diagnostic différentiel plausible, quel que soit le segment intestinal atteint, et l'intussusception associée à la tumeur est une constatation clinique rare mais urgente.(Traduit par Dr Serge Messier).

Rostral spread of lumbosacral epidural volumes of dye and contrast medium calculated using body weight or length of the vertebral column in dog cadavers.

The objective of this study was to compare the rostral spread of lumbosacral epidural volumes of a mixture of dye and contrast medium, calculated using body weight (BW) or vertebral column length (LE), in 22 dog cadavers. The dogs weighed 4.6 to 52.0 kg. Dogs were paired within a < 10% difference for BW and LE and with the same body condition score (BCS). Pairs of dogs were injected while in sternal recumbency through an epidural catheter with a volume mixture of iopamidol and dye, calculated based on BW: 0.2 mL/kg in one of the cadavers and based on LE: 0.05 mL/cm (< 50 cm), 0.07 mL/cm (50 to < 70 cm), 0.08 mL/cm (70 to < 80 cm), and 0.11 mL/cm (≥ 80 cm) in the other cadaver. The extent of rostral spread was determined using computed tomography for iopamidol and anatomical dissection for dye. Comparisons for dye and iopamidol within each dog, and for BW and LE within matched pairs, were completed with mixed linear models (P < 0.05). The number of vertebrae reached by dye was greater than the number reached by iopamidol in both BW and LE, but the rostral spread was not significantly different between BW and LE for all pairs. In conclusion, dye tends to spread further than iopamidol and therefore, these two methods should not be considered interchangeable when used in research studies.

L'objectif de cette étude était de comparer l'étalement rostral des volumes épiduraux lombo-sacrés d'un mélange de colorant et de produit de contraste, calculé en utilisant le poids corporel (PC) ou la longueur de la colonne vertébrale (LE), chez 22 cadavres de chiens. Les chiens pesaient de 4,6 à 52,0 kg. Les chiens ont été appariés avec une différence < 10 % pour PC et LE et avec le même score d'état corporel (PCS). Des paires de chiens ont reçu une injection alors qu'ils étaient en décubitus sternal à travers un cathéter péridural avec un mélange volumique d'iopamidol et de colorant, calculé sur la base du poids corporel : 0,2 mL/kg dans l'un des cadavres et sur la base de la LE : 0,05 mL/cm (< 50 cm), 0,07 mL/cm (50 à < 70 cm), 0,08 mL/cm (70 à < 80 cm) et 0,11 mL/cm (≥ 80 cm) dans l'autre cadavre. L'étendue de la propagation rostrale a été déterminée par tomodensitométrie pour l'iopamidol et dissection anatomique pour le colorant. Les comparaisons pour le colorant et l'iopamidol au sein de chaque chien, et pour PC et LE au sein de paires appariées, ont été complétées avec des modèles linéaires mixtes (P < 0,05). Le nombre de vertèbres atteintes par le colorant était supérieur au nombre atteint par l'iopamidol dans PC et LE, mais la propagation rostrale n'était pas significativement différente entre PC et LE pour toutes les paires. En conclusion, le colorant a tendance à se propager plus loin que l'iopamidol et, par conséquent, ces deux méthodes ne doivent pas être considérées comme interchangeables lorsqu'elles sont utilisées dans des études de recherche.(Traduit par Docteur Serge Messier).

Comparison of rostral spread of lumbosacral epidural volume calculated by body weight or length of the vertebral column in small-sized anesthetized dogs.

The first objective of this prospective, randomized, crossover experimental trial was to compare the rostral spread of lumbosacral epidural volume calculated by body weight (BW) or vertebral column length (LE) in 6 small, isoflurane-anesthetized female beagle dogs (BW: 7.5 to 10.2 kg; LE measured from the occipital crest to the sacrococcygeal space: 46 to 56 cm). The second objective was to assess the response to a noxious stimulus once the dogs recovered from anesthesia and to determine the effects of the injection on cardiopulmonary variables. While in sternal position, dogs were injected through an epidural catheter with a volume mixture of bupivacaine 0.25% and iopamidol 15% based on BW: 0.2 mL/kg or LE: 0.05 mL/cm (< 50 cm) or 0.07 mL/cm (50 to < 70 cm). Rostral spread was determined by counting the number of vertebrae reached by iopamidol using computed tomography. After anesthesia, cardiopulmonary variables, motor function, and responses to nociceptive stimuli were evaluated. Comparisons were completed with mixed linear models and 2-way analysis of variance (ANOVA) (P < 0.05). The volume of injectate (3.29 ± 0.74 versus 1.81 ± 0.21 mL; mean ± SD) and the number of vertebrae (22 ± 2 versus 19 ± 2 vertebrae) reached by iopamidol were significantly greater for LE than for BW. Response to nociception, time to return of pain sensation, motor function, and cardiopulmonary variables were similar between groups. In conclusion, dosing based on LE resulted in larger rostral spread than when based on BW in dogs of small size.

Le premier objectif de cet essai expérimental croisé prospectif randomisé était de comparer la propagation rostrale du volume épidural lombo-sacré calculé en fonction du poids corporel (PC) ou de la longueur de la colonne vertébrale (LE) chez 6 petites chiennes beagle anesthésiées à l'isoflurane (PC : 7,5 à 10,2 kg; LE mesuré de la crête occipitale à l'espace sacro-coccygien : 46 à 56 cm). Le deuxième objectif était d'évaluer la réponse à un stimulus nocif une fois que les chiens se sont remis de l'anesthésie et de déterminer les effets de l'injection sur les variables cardiopulmonaires. En position sternale, les chiens ont reçu une injection via un cathéter péridural d'un mélange volumique de bupivacaïne à 0,25 % et d'iopamidol à 15 % basé sur le poids corporel : 0,2 mL/kg ou LE : 0,05 mL/cm (< 50 cm) ou 0,07 mL/cm (50 à < 70 cm). La propagation rostrale a été déterminée en comptant le nombre de vertèbres atteintes par l'iopamidol en utilisant la tomodensitométrie. Après l'anesthésie, les variables cardiopulmonaires, la fonction motrice et les réponses aux stimuli nociceptifs ont été évaluées. Les comparaisons ont été complétées avec des modèles linéaires mixtes et une analyse de variance à 2 facteurs (ANOVA) (P < 0,05). Le volume d'injectat (3,29 ± 0,74 versus 1,81 ± 0,21 mL; moyenne ± SD) et le nombre de vertèbres (22 ± 2 versus 19 ± 2 vertèbres) atteints par l'iopamidol étaient significativement plus élevés pour LE que pour BW. La réponse à la nociception, le temps de retour de la sensation de douleur, la fonction motrice et les variables cardiopulmonaires étaient similaires entre les groupes. En conclusion, le dosage basé sur LE a entraîné une plus grande propagation rostrale que lorsqu'il était basé sur BW chez les chiens de petite taille.(Traduit par Docteur Serge Messier).

CT features of subcutaneous, intermuscular, and intramuscular mast cell tumors in dogs.

Surgical removal is the treatment of choice for subcutaneous (SC), intermuscular (InterM), and intramuscular (IntraM) mast cell tumors (MCTs). Advanced imaging (CT or MRI) is frequently used for presurgical planning, but InterM and IntraM MCTs can be difficult to identify and delineate on CT. Aims of the current retrospective, diagnostic accuracy, observer agreement study were to describe the imaging features of SC, InterM, and IntraM MCTs on CT and to assess the limitation of CT to identify the full local extent of the MCT. Inclusion criteria for the study were dogs with a cytologically or histologically diagnosed MCTs determined to be SC, InterM, or IntraM MCT based on histology and/or a CT scan performed in the gross disease setting. Two board-certified veterinary radiologists reviewed the CT images and recorded location, contrast enhancement pattern, and delineation between the normal and abnormal tissue. Sensitivity and specificity of CT for determining location (SC/InterM versus IntraM) was 85.71% and 55.56%, respectively, when compared to consensus location based on surgical pathology report/CT/MRI review. There was a low inter-rater agreement for delineation (kappa: 0.150 (-0.070 to 0.370) and measurement had a low/moderate correlation (rho: 0.4667 to 0.5792). Upon review by a surgical oncologist, CT findings were deemed insufficient for curative surgical planning in 13 of 16 due to inadequate definition of tumor depth, compartment boundary (fascial plane) or MCT margins. The use of CT for presurgical planning of SC/InterM/IntraM MCT dogs has limitations, especially when differentiating MCT from the adjacent muscle.

Interrater reliability and experiences of Assessment, Intervention, and Moving-on 3 Assessment Model in a multidisciplinary Norwegian sample.

Background: Assessing minors with harmful sexual behavior (HSB) is a complex and sensitive task. The AIM3 Assessment Model was developed to assist practitioners with information collection and HSB evaluations. Objective: In this study, we explore the interrater reliability and the practitioners' experience with the AIM3. Participants and setting: The multidisciplinary sample (n = 56) was recruited in Norway. The participants' mean age is 43.2 years (SD 9.5). The sample is 79% female and 21% male. Mean years of experience is 17.6 years (SD 9.5). Methods: The participants used the Norwegian version of the AIM3 to score three case vignettes. A survey containing questions about competence and experience was filled out. We used the intraclass correlation coefficient (ICC) to estimate interrater reliability as well as descriptive statistics to show experience. Results: The estimated ICC for overall AIM3 factors is 0.547 (95% CI = 0.471, 0.634); for domain scores, the estimated ICC is 0.697 (95% CI = 0.548, 0.852). Both are in the moderate range. The majority of the participants reported that they will probably use the AIM3 in the future and that their experience with the AIM3 was highly useful with, for example, empirically informed decision-making and for intervention and safety planning. Conclusion: The moderate ICC results and the sample's generally positive experience with the AIM3 may indicate further usefulness in a Norwegian multidisciplinary setting. We provide recommendations on how the AIM3 and similar HSB assessments can be further evaluated and developed.

Pathology in Practice.

In collaboration with the American College of Veterinary Pathologists.

Most students have experience making radiographs prior to veterinary school but have limited radiation safety training.

The use of radiation for the diagnosis of various medical conditions is ubiquitous in veterinary medicine, and manual restraint of a patient during X-ray exposure has become commonplace. Many prospective veterinary students have been involved with radiographs in general practice prior to veterinary school. Their experiences and level of safety training are largely unknown.   This prospective survey study involved two web-based questionnaires that were used to evaluate the experiences, knowledge, and attitudes toward radiation and how these changed following a radiation safety lecture as part of their first-year curriculum. The questionnaires were distributed to 122 first-year veterinary students before and after this lecture. All participating students (100%) had worked in a veterinary hospital prior to admission to veterinary school and 79% were involved in making radiographs; however, only 28% reported receiving radiation safety training. The content of the safety training reported was variable. After the radiation safety lecture, students were more likely to report that the radiation safety training they had received was useful, but fewer students reported feelings of safety when using radiation. Despite most students being involved with radiation in practice, few had received radiation safety training, as hypothesized. Contrary to our second hypothesis, a single lecture did significantly improve knowledge and attitudes in several, but not all, instances. Importantly, once students gained knowledge regarding radiation, they placed more importance on its safe use. These results suggest that in-clinic training of students in radiation safety is insufficient and that lecture-based training is useful for certain concepts.

Characteristics of adolescent boys who have displayed harmful sexual behaviour (HSB) against children of younger or equal age.

BACKGROUND: Adolescents who have displayed harmful sexual behaviour (HSB) are often described as a heterogeneous population, but different offender-, offense-, or victim-based typologies have been proposed. Two common typologies are based on the victim's age and/or on offender-victim age discrepancies. METHODS: Using data from a Norwegian clinical sample, we aimed to investigate the characteristics of two subgroups of adolescents: those with younger/child victims (HSB-C) and peer victims (HSB-P). The sample was collected from a public child and adolescent psychiatry outpatient clinic. N = 54 boys, mean age 14.1 (younger age: HSB-C, n = 30, equal age: HSB-P, n = 24). Based on patient records, all patient registries within the sample were reviewed retrospectively. The data were analysed in R with different statistical tests (e.g. N - 1 chi-square test, Fisher's exact test). RESULTS: After adjusting the p values for multiple comparisons, none of the test statistics showed significant results. Based on the magnitude of the effect-size estimates, the following tendencies and potential meaningful differences emerged: more adolescents in the HSB-C group had experienced their own trauma early (V = 0.42), had more than one victim (V = 0.32), and had displayed repeated HSB (V = 0.27), and their caregivers required extensive interventions (V = 0.20). More adolescents in the HSB-P group had cognitive abilities in the normal/high range (V = 0.32), and their caregivers more often had difficulties acknowledging the need for support and treatment (V = 0.20). CONCLUSIONS: The nonsignificant differences between the subgroups, despite some strong and moderate effects, bring about a discussion on the utility of using "victim age" in combination with the "offender-victim age differences" as the sole classification criterion for adolescents who have displayed HSB. The heterogeneity of the adolescent HSB population and lack of reliable information on more homogenous subgroups dynamics will remain challenges for clinicians and other practitioners needing a broad assessment and intervention focus.

Laparoscopic ureteronephrectomy for the treatment of giant kidney worm infection in 2 dogs.

One male and one female dog were presented with giant kidney worm infection in the right kidney. Infection was identified through visualization of intra-renal Dioctophyme renale on abdominal ultrasound. Both dogs underwent right-sided laparoscopic ureteronephrectomy for treatment of the giant kidney worm infection. Additional adult worms were extirpated from the peritoneal cavity of both dogs. Both dogs recovered without complication from anesthesia and surgery and were discharged within 24 hours after surgery. Laparoscopic ureteronephrectomy has not previously been described for the treatment of giant kidney worm infection in North America.

Urétéro-néphrectomie laparoscopique pour le traitement d'une infection par le ver géant du rein chez deux chiens. Un chien mâle et un chien femelle furent présentés avec une infection par le ver géant du rein dans le rein droit. L'infection fut identifiée par visualisation de Dioctophyme renale intra-rénal par échographie abdominale. Les deux chiens furent soumis à une urétéro-néphrectomie laparoscopique pour le traitement de l'infection par le ver géant du rein. Des vers adultes additionnels furent retirés de la cavité péritonéale des deux chiens. Les deux chiens ont récupéré sans complication de l'anesthésie et de la chirurgie et ont obtenu leur congé en moins de 24 h après la chirurgie. L'urétéro-néphrectomie laparoscopique n'avait pas encore été décrite en Amérique du Nord pour le traitement de l'infection par le ver géant du rein.(Traduit par Dr Serge Messier).

Diagnostic imaging of a basihyoid bone fracture and partial avulsion of the medial pterygoid muscle in a horse.

A 3-year-old gelding was presented for further evaluation and treatment of a swelling over the left mandible and inability to eat and drink. Radiographs of the mandible were unremarkable. Computed tomography (CT) of the head demonstrated a fracture of the basihyoid bone and partial avulsion of the medial pterygoid muscle. Ultrasound examination was performed to establish a baseline and confirmed the fracture. The gelding was managed conservatively, recovered uneventfully, and was able to return to training after 4 months of rest. Key clinical message: Computed tomography and ultrasonography in the horse provided information about injury to the basihyoid bone and insertion of the medial pterygoid muscle.

Diagnostic par imagerie d'une fracture de l'os basihyoïde et avulsion partielle du muscle ptérygoïde médial chez un cheval. Un cheval hongre âgé de 3 ans fut présenté pour évaluation et traitement d'enflure du mandibule gauche et inhabilité à manger et à boire. Des radiographies du mandibule ne montraient rien de particulier. La tomodensitométrie (CT) de la tête a montré une fracture de l'os basihyoïde et une avulsion partielle du muscle ptérygoïde médial. Une échographie fut effectué afin d'établir un seuil de base et confirmer la fracture. L'hongre a été géré de manière conservatrice, a récupéré sans complication, et a pu retourner à l'entraînement après 4 mois de repos.Message clinique important :La tomodensitométrie et l'échographie chez un cheval ont fourni de l'information sur une blessure à l'os basihyoïde et à l'insertion du muscle ptérygoïde médial.(Traduit par Dr Serge Messier).

The Cellular Localization of the p42 and p46 Oligoadenylate Synthetase 1 Isoforms and Their Impact on Mitochondrial Respiration.

The importance of the IFN-induced oligoadenylate synthetase (OAS) proteins and the OAS/RNase L pathway in the innate response against viral pathogens is well-established, however the observed differences in anti-viral activity between the human OAS1 p46 and p42 isoforms are not fully understood. The protein expression of these isoforms is determined by the SNP rs10774671, either being an A or a G allele resulting in expression of either the p42 or the p46 isoform. Using fluorescence microscopy and immunoblot analysis of fractionated cell samples, we show here that the CaaX motif is of key importance to the cellular localization. The OAS1 p42 isoform is mainly located in the cytosol, whereas the p46 isoform with a C-terminal CaaX motif is translocated to membranous organelles, like the mitochondria. We furthermore observed differences between p42 and p46 in their effect on mitochondrial physiology using high resolution respirometry and fluorometry. Overexpression of OAS1 p42 and IFN-ß treatment of HeLa cells (AA genotype) resulted in significantly increased respiration, which was not seen with p46 overexpression. The difference in subcellular localization and mitochondrial effect of these two OAS1 isoforms might help to explain the anti-viral mechanisms that differentiate these proteins.

A nursing brief: emerging best practice in Department of Children and Families nursing.

In 2012, more than 400,000 children in the United States were in the child welfare system because of abuse or neglect. These children are uniquely vulnerable and present multiple health challenges to child welfare and health professionals. According to the most recent Child and Family Services Reviews (CFSR) from the U.S. Department of Health and Human Services Administration for Children and Families' Children's Bureau (2010), none of the 50 states, Puerto Rico, and the District of Columbia were "in substantial conformity" in meeting the well-being outcome for the physical and mental health needs of the children in their care. To address this deficiency, Connecticut nurses caring for children involved with Department of Children and Families (DCF) collaborated to establish nursing standards of practice leading to improved health services for children in care and a mechanism to readily transfer health information. Post-implementation evaluation revealed improved quality of care and the availability of enhanced health information. These endeavors have led to the recognition that nurses working in DCF venues are members of an emerging professional nursing specialty: "nursing in child welfare."

Evaluation of the MagNA pure LC instrument for extraction of hepatitis C virus RNA for the COBAS AMPLICOR Hepatitis C Virus Test, version 2.0.

The COBAS AMPLICOR system has played a major role in the transition of molecular diagnostics from research to routine clinical laboratory use by automating the nucleic acid amplification and detection processes. However, sample preparation remains a labor-intensive portion of the procedure. In this study, we evaluated the performance of the COBAS AMPLICOR Hepatitis C Virus Test, version 2.0 (Roche Molecular Systems, Branchburg, N.J.) following manual hepatitis C virus (HCV) RNA extraction versus automated extraction with the MagNA Pure LC instrument (Roche Applied Science, Indianapolis, Ind.). Parallel replicate testing was performed with standard dilutions of 100, 75, 60, and 0 HCV IU/ml and 153 clinical specimens. An analytical sensitivity of 75 IU/ml was achieved with either the manual or the standard-volume (200 microl) automated extraction methodologies (25 of 26 [96.2%]; 95% confidence interval [95% CI], 80.4 to 99.9), whereas the clinical sensitivity and specificity were both 100% with either extraction method. A large-volume (1 ml) automated extraction method was also evaluated with standard dilutions of 40, 25, 10, and 0 IU/ml and the same 153 clinical specimens. The analytical sensitivity of the COBAS AMPLICOR assay with the large-volume extraction method was 25 HCV IU/ml (26 of 26 [100%]; 95% CI, 86.8 to 100), whereas the clinical sensitivity and specificity were both 100%. The MagNA Pure LC instrument is a versatile, labor-saving platform capable of integration with minimal modification of the existing assay procedure. The increased sensitivity of the COBAS AMPLICOR Hepatitis C Virus Test, version 2.0 performed in conjunction with large-volume HCV RNA extraction may be important in HCV diagnostic testing as new therapeutic strategies evolve.