Influence of soft tissue thickness on marginal bone level around dental implants: A systematic review with meta-analysis and trial-sequential analysis.

OBJECTIVES: The aim of the present review and meta-analysis was to evaluate the influence of soft tissue thickness on initial bone remodeling after implant installation. MATERIALS AND METHODS: A literature search was conducted by two independent reviewers on electronic databases up to May 2022. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) performed on human subjects were included. The risk of bias was evaluated using Cochrane Collaboration's tool. Meta-analysis and Trial Sequential Analysis (TSA) were performed on the selected articles. The primary outcome was marginal bone loss. RESULTS: After screening, 6 studies were included in the final analysis, with a total of 354 implants, and a follow-up from 10 to 14 months. 194 implants were placed in a ≥ 2 mm soft tissue thickness, while 160 had <2 mm soft tissue thickness before implant placement. The included studies had a high level of heterogeneity (I2  > 50%). The meta-analysis indicated a statistically significant difference between the two groups (0.54; p = .027) and the TSA analysis confirmed the results, despite the limited number of dental implants. Additional analysis showed that age and follow-up parameters were not statistically significant factors influencing the bone loss (p = .22 and p = .16, respectively). CONCLUSIONS: Based on the available RCTS and CCTs, initial soft tissue thickness seems to influence marginal bone loss after a short follow-up period. Based on TSA analysis, further studies are needed to assess the influence of the soft tissue thickness on marginal bone loss. PROSPERO registration number: CRD42021235324.

Follicular conjunctivitis in dogs: A retrospective study (2007-2022).

OBJECTIVE: To evaluate the incidence, clinical features, treatment, and outcome of canine follicular conjunctivitis (CFC). PROCEDURE: Medical records of dogs diagnosed with CFC were reviewed. Data recorded included signalment, duration of clinical signs and treatment details prior to presentation, concurrent ocular/systemic diseases, ocular clinical signs, cytology, treatment, follow-up, and outcome. Blepharospasm, signs of self-trauma, hyperemia, chemosis, ocular discharge, and follicle location and severity (0.5-4) were retrospectively evaluated. Based on severity, treatment consisted of topical 0.1% diclofenac or 0.1% dexamethasone sodium eyedrops. Dogs were classified into young (YD < 18 months) and adult (AD ≥ 18 months). RESULTS: One hundred and fifty-three dogs (276 eyes) were included in the study: 83YD (54%) and 70AD (46%). Males and bilateral disease were over-represented in both groups. Severity was associated with young age (p = .032) and bilaterality (p = .025), and not with dermatological diseases (p > .05). No differences in follicular location were observed except for more frequent involvement of the nictitating membrane (MN) in YD (p = .02). Response to treatment was faster in AD (p = .001), with complete resolution in 80.6% of the eyes (100/124) at 1 month. YD treated with diclofenac showed faster resolution than those treated with 0.1% dexamethasone (p = .009). CONCLUSIONS: Although CFC is a bilateral ocular disease occurring at any age, the clinical presentation is influenced by age. Follicular conjunctivitis in adult dogs is less sever, less commonly affects the NM, and responds more quickly to topical treatment. One month of topical diclofenac may be adequate for mild cases, and 1 month of topical 0.1% dexamethasone is recommended as initial therapy for moderate to severely affected cases.

Ophthalmologic findings associated with Rhodococcus equi bronchopneumonia in foals.

OBJECTIVE: To describe ocular findings associated with Rhodococcus equi bronchopneumonia in foals, and to determine whether severity of the ocular lesions is related with outcome. ANIMALS STUDIED: Foals diagnosed with R equi infection at the VTH-UAB from January 2002 to December 2017. PROCEDURE: Rhodococcus equi infection was diagnosed by means of clinical signs, radiographic/ultrasonographic findings, and/or positive culture. In all the foals, a complete ophthalmic examination by a boarded ophthalmologist was performed and ocular signs were recorded and graded (0-4). RESULTS: Thirty-nine foals were included in the study, from which 12 showed signs of bilateral anterior uveitis (30.8%). Among these, three foals were classified as mildly uveitis-affected (MUA:7.7%) and nine as severely uveitis-affected (SUA:23.1%). Five SUA foals showed green aqueous flare (5/9;55.5%). Despite the systemic treatment, 9/39 sick foals died (23.1%), the fatality rate being different between groups: SUA (4/9;44.4%), MUA (0/3; 0%) and nonuveitis-affected foals (5/27;18.5%). Among SUA foals, only one with green aqueous flare died (1/5;20%). CONCLUSION: Bilateral anterior uveitis is highly prevalent in foals with R equi pneumonia (30.8%). The severity of anterior uveitis might be considered a nonsurvival prognostic factor and, until proven otherwise, green aqueous flare could be taken as a strongly suggestive ocular sign of the disease. Findings of this study remark the clinical relevance of performing a complete ophthalmic examination in sick foals, in order to help in the diagnosis and prognosis of uveal diseases, as well as to guaranteeing visual soundness.

A dose-escalation ex vivo study on the effects of intracameral benzalkonium chloride in rabbits.

BACKGROUND: Rabbits are currently not a good model for studying diseases of the corneal endothelium because their corneal endothelial cells (CECs) maintain a high proliferative capacity throughout almost all their life. Addressing this particular feature might allow the use of this species for such a purpose. The aim of this study was to evaluate the corneal endothelial injury after intracameral benzalkonium chloride (BAC) injection into rabbit eyes ex vivo, and to establish the most suitable starting dose for an in vivo study aimed at developing an animal model of corneal endothelial disease. RESULTS: Forty rabbit eyes obtained postmortem by transconjunctival enucleation were divided into 8 groups according to the injected compound: Control (no injection), BSS, and increasing BAC concentrations (0.005%, 0.01%, 0.025%, 0.05%, 0.1% and 0.2%). At 0, 6, 24 and 48 h, ophthalmologic examination of the anterior segment, pachymetry and specular microscopy were performed, and corneas were finally vital-stained and observed under the light microscope to assess the CECs morphology and mortality rate. When compared to BSS, CECs density started to decrease significantly at 0.025% BAC concentration, while mean cell area, corneal edema and corneal thickness began to increase significantly at 0.05%, 0.005% and 0.1% BAC concentrations, respectively. Concentrations of 0.05% BAC and above caused significant increases in CECs pleomorphism (decreased hexagonality) and mortality, compared to control and BSS. CONCLUSIONS: Ex vivo intracameral BAC injection induces corneal endothelial toxicity in rabbits. However, confirmatory in vivo studies are required to develop the desired model, with 0.05% BAC being a suggested starting point.

Varenicline in smokers with severe or very severe COPD after 24 weeks of treatment. A descriptive analysis: VALUE study.

A large number of COPD patients are smokers. The particular characteristics of this group as well as their need to quit usually require psychological counselling and pharmacological treatment to achieve abstinence and, often, intensively. Little information is available about this issue.  The main objective of the study was to evaluate the effectiveness of varenicline after 24 weeks of treatment, with continuous abstinence between weeks 9 and 24.  This study was a post-authorization, open label, observational study of prospective follow-up. Patients included were smokers with severe or very severe COPD criteria who were treated with varenicline for 24 weeks, i.e. with a 12-week extension over the usual treatment.  The outcomes in the population of subjects completing 24 weeks of follow-up were at week 24: continuous abstinence 36.8%, 7 days point prevalence abstinence 65.7%, and continuous smoking 31.5%.The outcomes in the intention-to-treat population included at baseline were: continuous abstinence 17.7% of patients, 7 days point prevalence abstinence 31.6%, continuous smoking 15.1% and not valid/unknown 51.8%.  The mean CAT score at week 24 was 15 and reduction from the baseline was 3.77 (paired T test, p<0.01). The most common adverse events reported were nausea, vivid dreams, stomach ache, insomnia, headache and vomiting.  Patients included in VALUE were active smokers despite all of them had a severe COPD which suggests a very high degree of dependence. Although the study do not allow to infer the results to the global population of smokers with severe COPD, the outcomes have shown that, at 24 weeks follow up 36.8% of the patients were successful in quitting but from 79 patients enrolled initially only 17.7% quit.

Good Publication Practice for Communicating Company-Sponsored Medical Research: GPP3.

This updated Good Publication Practice (GPP) guideline, known as GPP3, builds on earlier versions and provides recommendations for individuals and organizations that contribute to the publication of research results sponsored or supported by pharmaceutical, medical device, diagnostics, and biotechnology companies. The recommendations are designed to help individuals and organizations maintain ethical and transparent publication practices and comply with legal and regulatory requirements. These recommendations cover publications in peer-reviewed journals and presentations (oral or poster) at scientific congresses. The International Society for Medical Publication Professionals invited more than 3000 professionals worldwide to apply for a position on the steering committee, or as a reviewer, for this guideline. The GPP2 authors reviewed all applications (n = 241) and assembled an 18-member steering committee that represented 7 countries and a diversity of publication professions and institutions. From the 174 selected reviewers, 94 sent comments on the second draft, which steering committee members incorporated after discussion and consensus. The resulting guideline includes new sections (Principles of Good Publication Practice for Company-Sponsored Medical Research, Data Sharing, Studies That Should Be Published, and Plagiarism), expands guidance on the International Committee of Medical Journal Editors' authorship criteria and common authorship issues, improves clarity on appropriate author payment and reimbursement, and expands information on the role of medical writers. By following good publication practices (including GPP3), individuals and organizations will show integrity; accountability; and responsibility for accurate, complete, and transparent reporting in their publications and presentations.

Five-step authorship framework to improve transparency in disclosing contributors to industry-sponsored clinical trial publications.

Authorship guidelines have established criteria to guide author selection based on significance of contribution and helped to define associated responsibilities and accountabilities for the published findings. However, low awareness, variable interpretation, and inconsistent application of these guidelines can lead to confusion and a lack of transparency when recognizing those who merit authorship. This article describes a research project led by the Medical Publishing Insights and Practices (MPIP) Initiative to identify current challenges when determining authorship for industry-sponsored clinical trials and develop an improved approach to facilitate decision-making when recognizing authors from related publications. A total of 498 clinical investigators, journal editors, publication professionals and medical writers were surveyed to understand better how they would adjudicate challenging, real-world authorship case scenarios, determine the perceived frequency of each scenario and rate their confidence in the responses provided. Multiple rounds of discussions about these results with journal editors, clinical investigators and industry representatives led to the development of key recommendations intended to enhance transparency when determining authorship. These included forming a representative group to establish authorship criteria early in a trial, having all trial contributors agree to these criteria and documenting trial contributions to objectively determine who warrants an invitation to participate in the manuscript development process. The resulting Five-step Authorship Framework is designed to create a more standardized approach when determining authorship for clinical trial publications. Overall, these recommendations aim to facilitate more transparent authorship decisions and help readers better assess the credibility of results and perspectives of the authors for medical research more broadly. Please see related article: http://www.biomedcentral.com/1741-7015/12/214.

Surgical treatment of epibulbar melanocytomas by complete excision and homologous corneoscleral grafting in dogs: 11 cases.

OBJECTIVE: The aim of the study was to evaluate the efficacy, outcome, and complications following penetrating sclerokeratoplasty and frozen homologous corneoscleral grafting for the management of extensive canine epibulbar melanocytomas. METHODS: Medical records of canine patients treated at three different veterinary hospitals between 1999 and 2010 were reviewed. Signalment, location and extent of melanocytomas, recurrence rate, and early and late complications were reported. Patients were re-examined postoperatively to provide follow-up information. RESULTS: Patients included one intact male, three castrated males, six intact females, and one spayed female, with a median age of 5 years (range, 3-9). German Shepherds were overrepresented. Tumors extended from 2 to 4 clock hours at the limbus and up to 17 mm from clear cornea to globe equator. One case showed iridocorneal angle invasion; corneal involvement was present in all cases, and lipid keratopathy was present in four cases. In two cases, there was incomplete resection owing to tumor extent. Follow-up time ranged from 3 to 72 months (median, 17 months), with one case of intraocular tumor progression. Early complications included anterior uveitis (11/11), intracameral fibrin (5/11), hyphema (4/11), corneal edema (4/11), exuberant corneal granulation tissue (2/11), focal retinal edema (1/11), dyscoria (1/11), and partial suture dehiscence (1/11). Late complications included corneal fibrosis and/or pigmentation (11/11), faint anterior cortical cataracts (3/11), and lipid keratopathy (1/11). Vision was retained in all cases. CONCLUSIONS: This technique offers a surgically challenging but effective treatment for extensive epibulbar melanocytomas. In this case series, complications were mild and transient, with preservation of ocular anatomy and function.

Aqueous humor fibrinolytic activity in dogs with cataracts.

OBJECTIVE: To investigate fibrinolytic activity in aqueous humor (AH) of healthy and sick dogs, with and without cataracts. PROCEDURE: Prospective observational clinical study. A total of 45 dogs were included in the study. Physical and ophthalmic examinations, complete blood cell count (CBC) and serum biochemistry panel were performed in all animals. According to the ocular and systemic diagnoses, animals were classified into three groups: sick dogs without cataracts (20 dogs; 40 eyes), diabetic dogs with cataracts (11 dogs; 22 eyes), and healthy dogs with cataracts (14 dogs; 25 eyes). Bilateral AH and blood samples were collected during intraocular surgery (25 dogs; 47 eyes), or immediately after euthanasia (20 dogs; 40 eyes). Citrated samples were centrifuged and stored at -81 °C until analysis. Plasma and AH D-dimer concentration were determined using a quantitative immunoturbidimetric latex agglutination assay. RESULTS: A total of 108 canine samples (45 plasma and 87 AH samples) were obtained. D-dimer concentration in log-scale, in AH of eyes with diabetic cataract was significantly higher than AH of eyes with nondiabetic cataract, with a difference of 0.9 ng/mL 95% confidence interval (CI) (0.2; 1.6) P = 0.0116 and higher than that of sick animals with healthy eyes, with a estimated difference of -0.89 ng/mL 95% CI (-1.52; -0.25) P = 0.0061. Plasma D-dimer concentration was significantly higher in the group of animals with systemic disease [median 606 ng/mL, Interquartil Range (IQR) 145-1956 ng/mL] than in healthy dogs (median 47.5 ng/mL, IQR 4-250 ng/mL) (P = 0.002) and diabetic dogs (median 60.5 ng/mL, IQR 0-147.5 ng/mL) (P < 0.001). CONCLUSION: AH fibrinolysis is present in dogs, being significantly higher in animals with diabetic cataracts than in those without cataracts, and those with nondiabetic cataracts.

Benign intraocular teratoid medulloepithelioma causing glaucoma in an 11-year-old Arabian mare.

CASE DESCRIPTION: An 11-year-old Arabian mare was presented for investigation of a visible, pale-colored intraocular mass in the right eye. CLINICAL FINDINGS: An intraocular mass was detected clinically and ultrasonographically as originating from the superior temporal quadrant of the ciliary body and iris and causing secondary glaucoma. The echodense mass was occupying the majority of the vitreous chamber and extended into the anterior chamber. The left eye appeared normal. TREATMENT AND OUTCOME: Enucleation was recommended for therapeutic and diagnostic purposes. No adjuvant treatment was given. Histopathological examination demonstrated a benign intraocular teratoid medulloepithelioma located at the ciliary body. Immunohistochemical studies showed that neoplastic cells were positive for vimentin, S-100 protein, neuron-specific enolase (NSE), and nestin and negative for glial fibrillary acidic protein (GFAP). Electron microscopy revealed abundant cellular matrix and blood vessels surrounding tumor cells, which had indented, round to oval nuclei. There were also apoptotic bodies and cells containing melanosomes of variable shape and size. Eight years later, the horse has had no recurrence and maintains normal vision in the left eye. CLINICAL RELEVANCE: This is the first report of a benign teratoid intraocular medulloepithelioma in an adult horse and the ultrastructural and immunohistochemical characterization of a teratoid medulloepithelioma in this species.

Topical 1% cyclosporine eyedrops for the treatment of crystalline corneal dystrophy in dogs.

Background: Crystalline corneal dystrophy (CCD) is the most common type of corneal lipidic deposition in dogs. CCD is a primary metabolic disorder of the corneal fibroblast featuring an accumulation of extracellular and intracellular lipid deposits. Corneal lipid deposits create a corneal opacity and modify the interfibrillar collagen distance, inducing light scattering. Corneal vascularization is not usually associated with the disease, but, in case of chronicity, cell death may produce inflammation, and new corneal vessels are developed. To the best of the authors' knowledge, this is the first report of a medical approach for CCD treatment in veterinary medicine. Aim: To evaluate the efficacy of topical 1% cyclosporine eyedrops (1% CsA) for the treatment of CCD in dogs. Methods: Medical records of dogs with CCD were retrospectively reviewed (2009-2020). Corneal opacification description (COD) [size (mm), depth, and opacification degree (0-3)] was evaluated at 0, 3, 6, 9, 12, and 15 months postinitial diagnosis. Dogs were classified into three groups: the control group (G0), the group receiving topical 1% CsA once per day (G1), and the group receiving topical 1% CsA twice daily (G2). Results: Ninety-two client-owned dogs (163 eyes) of different breeds, ages, and gender fulfilled the inclusion criteria. When compared to G0, where the eyes significantly increased COD (p < 0.001), G1 and G2 significantly decreased COD (p < 0.001). In fact, the probability of reducing COD was about three times higher in G2 than in G1, being nearly the same for the right [odds ratio (OR) = 2.94; 95% confidence interval (95% CI) = 0.55-15.78] and left eye (OR = 2.92; 95% CI = 0.49-17.26). In addition, for each additional month of treatment in G2, the probability of reducing COD increased significantly (OR = 1.12; 95%CI = 1.00-1.26 for the right eye and OR = 1.16; 95%CI = 1.02-1.32 for the left eye). Conclusion: Long-term treatment with topical 1% CsA eyedrops significantly improved CCD in dogs, being the probability of reducing COD higher when applying the treatment twice daily.

A chromosome-level genome assembly enables the identification of the follicule stimulating hormone receptor as the master sex-determining gene in the flatfish Solea senegalensis.

Sex determination (SD) shows huge variation among fish and a high evolutionary rate, as illustrated by the Pleuronectiformes (flatfishes). This order is characterized by its adaptation to demersal life, compact genomes and diversity of SD mechanisms. Here, we assembled the Solea senegalensis genome, a flatfish of great commercial value, into 82 contigs (614 Mb) combining long- and short-read sequencing, which were next scaffolded using a highly dense genetic map (28,838 markers, 21 linkage groups), representing 98.9% of the assembly. Further, we established the correspondence between the assembly and the 21 chromosomes by using BAC-FISH. Whole genome resequencing of six males and six females enabled the identification of 41 single nucleotide polymorphism variants in the follicle stimulating hormone receptor (fshr) consistent with an XX/XY SD system. The observed sex association was validated in a broader independent sample, providing a novel molecular sexing tool. The fshr gene displayed differential expression between male and female gonads from 86 days post-fertilization, when the gonad is still an undifferentiated primordium, concomitant with the activation of amh and cyp19a1a, testis and ovary marker genes, respectively, in males and females. The Y-linked fshr allele, which included 24 nonsynonymous variants and showed a highly divergent 3D protein structure, was overexpressed in males compared to the X-linked allele at all stages of gonadal differentiation. We hypothesize a mechanism hampering the action of the follicle stimulating hormone driving the undifferentiated gonad toward testis.

Phacoemulsification considerations in nonhuman primates.

PURPOSE: To describe the pre-surgical, surgical, and post-surgical considerations for phacoemulsification in non-human primates. METHODS: Records of non-human primates that underwent phacoemulsification by the Ophthalmology Services of FHCV-UAB and HCV-UM, between 2003 and 2009 were reviewed. RESULTS: Five primates were represented: one gorilla, one chimpanzee, one pygmy marmoset, one orangutan, and one chacma baboon. Three were males and two females, of a median age of 16.8 years. Four primates presented bilateral cataracts and one unilateral (n = 9 eyes). Cataracts were immature in two eyes, mature in four and hypermature in 3. One-handed phacoemulsification was used in seven eyes and a two-handed technique in 2. Intraocular lenses (IOLs), with optic powers between +19.0 and +21.5D, were implanted in the four large-sized primates. All the primates were more active and social after the surgery. CONCLUSION: Phacoemulsification in non-human primates is highly successful and associated with an overall good visual outcome. Nevertheless, specific considerations should be applied in these species.

Ocular consequences of blunt trauma in two species of nocturnal raptors (Athene noctua and Otus scops).

OBJECTIVE: To determine the type, prevalence, and prognosis of ocular and periocular lesions in free-living little owls (LO) and scops owls (SO), injured by blunt trauma. PROCEDURES: Medical records from LO and SO with ocular or periocular lesions secondary to blunt trauma were reviewed. A complete ophthalmic examination was performed in all birds. Short protocol electroretinography (ERG) and ocular ultrasound were performed as dictated by the case. RESULTS: During the study period, a total of 158 LO and 99 SO with blunt trauma were admitted. Among these, 43 LO (27.8%) and 27 SO (27.3%) had ocular or periocular lesions. Bilateral injuries (72.1% LO and 81.5% SO) were more common than unilateral. Common findings in both species were: corneal erosions/superficial ulcers, anterior and posterior uveitis, cataracts, hyphema, posterior synechia, vitreal hemorrhage, and retinal detachment. Electroretinography was performed in 32 LO and eight SO, which had posterior segment lesions or opacity of the transparent media. Normal to nonrecordable b-wave amplitudes were observed. Follow-up was available in 13 LO and 11 SO. Among these, nine LO (14 eyes) and 10 SO (17 eyes) had resolution of the clinical signs following medical treatment. CONCLUSIONS: Ocular lesions are common in LO and SO injured by blunt trauma. Electroretinography is a valuable diagnostic tool to assess the severity of retinal dysfunction secondary to blunt trauma and to determine the response to medical treatment. A complete ophthalmic examination is a determining factor in the early management of trauma in these species.

Uveodermatologic lymphoma in two young related Portuguese water dogs.

PURPOSE: Canine lymphoma (CL) is one of the most common forms of spontaneous canine neoplasia. Improved understanding of the genetic and environmental factors associated with CL may provide benefits for the study of non-Hodgkin's and Hodgkin's lymphoma in humans. Uveodermatologic lymphoma is reported in a single household of Portuguese water dog, and the etiology is discussed. METHODS: A 1-year-old female intact Portuguese water dog was referred to the Ophthalmology Service of the Veterinary Teaching Hospital of the Autonomous University of Barcelona because of acute blepharospasm of the right eye in association with a multinodular dermatosis. Physical and ophthalmological examination and a complete diagnostic work-up, including skin and ocular histopathology and immunohistochemistry, were performed. Three months prior, in Galicia (Spain), 1200 km away from Barcelona, a male dog of the same litter showed very similar oculodermatological clinical signs and skin histopathology, and immunohistochemistry were obtained. RESULTS: The clinical diagnoses were anterior exudative uveitis, iridal masses, and secondary glaucoma. Histopathology and immunohistochemistry revealed a nonepitheliotropic lymphoma rich in B cell in dog 1 and rich in T cell in dog 2. CONCLUSION: It is proposed that an underlying genetic predisposition could have played a role in the development of lymphoma in these two young related dogs.

Urrets-Zavalia syndrome following cataract surgery in dogs: A case series.

Background: In human medicine, Urrets-Zavalia syndrome (UZS) is a well-recognized but uncommon postoperative complication characterized by a fixed dilated pupil, accompanied by iris atrophy and glaucoma. Although it was originally reported in 1963 after penetrating keratoplasty surgery for keratoconus, it has been associated with various ophthalmic procedures such as cataract surgery. The condition has not been previously published in the veterinary literature. Case Description: Three client-owned diabetic dogs that developed UZS´s triad after cataract surgery are described. Despite uneventful phacoemulsification in the six eyes, five developed moderate-to-severe postoperative ocular hypertension. Although intraocular pressure (IOP) spikes were initially controlled, fixed dilated pupils accompanied by iris atrophy and chronic ocular hypertension were seen in the five affected eyes. Aggressive medical and surgical management maintained vision in three of those eyes. In one eye, uncontrolled IOP led to blindness. Conclusion: This is the first published description of UZS in dogs, occurring after phacoemulsification. Although no exact, demonstrable causative element could be determined, we believe that should be considered a triggering condition for this syndrome, as it directly affects the ocular blood flow autoregulation and intrinsic uveal tissue integrity. Until the contrary is proved, diabetes mellitus might be considered as a risk factor for developing this syndrome after cataract surgery in dogs.

Consultations due to suspected child and adolescent sexual abuse at the Department of Gynecology of a children's hospital: pre- and intra-COVID-19 pandemic. / Consultas por sospecha de abuso sexual infantojuvenil en la sección de Ginecología de un hospital pediátrico: variaciones prepandemia e intrapandemia de COVID-19.

INTRODUCTION: It has been suggested that the social isolation due to the coronavirus disease 2019 (COVID-19) may increase the incidence of child and adolescent sexual abuse (CASA). OBJECTIVE: To compare the incidence and characteristics of medical consultations made to the Department of Gynecology due to CASA before and during the COVID-19 pandemic. MATERIAL AND METHODS: Descriptive, observational, and comparative study about suspected CASA events occurred during the COVID-19 pandemic compared to those occurred in the previous year at a tertiary care children's hospital. RESULTS: One hundred and twenty-two medical consultations due to suspected CASA were recorded; 78 before and 44 during the pandemic. In both groups, the most common reason for consultation at the hospital was an account of CASA and, at the Department of Gynecology in particular, the external genitalia examination. Most subjects had a normal physical examination. There was a higher prevalence of STI in the pandemic group. In addition, there were also more hospitalizations and police reports for victims protection in this group. The abuser was known to the victim in almost 90% of cases in both groups. CONCLUSIONS: During the pandemic, the total number of medical consultations to the Department of Gynecology decreased so the percentage of those due to suspected CASA was higher. However, the presence of severe lesions, STIs or pregnancy did not change.

Introducción. Se ha postulado que el aislamiento social debido a la pandemia de la enfermedad por el coronavirus 2019 (COVID-19, por su sigla en inglés) aumentaría la incidencia de abuso sexual infantojuvenil (ASIJ). OBJETIVO: Comparar la incidencia y las características de las consultas realizadas en Ginecología en relación con ASIJ antes y durante la pandemia de COVID-19. Materiales y métodos. Se realizó un estudio descriptivo, observacional y comparativo entre las situaciones de sospecha de ASIJ ocurridas durante la pandemia de COVID-19 en relación con las del mismo período del año previo en un hospital pediátrico de alta complejidad. RESULTADOS: Se consignaron 122 consultas por sospecha de ASIJ, 78 en el período previo a la pandemia y 44 en la pandemia. El motivo de consulta al hospital más frecuente, en ambos grupos, fue el relato de ASIJ y, al Servicio de Ginecología en particular, la evaluación de genitales externos. La mayor parte presentó un examen físico normal. Se observó una mayor prevalencia de infecciones de transmisión sexual (ITS) en el grupo de pandemia. Se realizaron más internaciones y denuncias para protección de víctimas en dicho grupo. Se registró que el agresor era conocido de la víctima en casi el 90 % de las víctimas de ambos grupos. CONCLUSIONES: Durante la pandemia se evidenció una disminución en el número total de consultas a Ginecología, de modo que aquellas por sospecha de ASIJ representaron un mayor porcentaje. Sin embargo, las características en relación con la presencia de lesiones graves, infecciones de transmisión sexual o embarazo no se vieron modificadas.

Cryptococcus gattii chorioretinitis in a ferret.

Bilateral exudative chorioretinitis was diagnosed in an 18-month-old male neutered ferret (Mustela putorius furo) with a generalized Cryptococcus gattii infection confirmed by PCR. The animal was referred to the Ophthalmology Service of the Autonomous University of Barcelona (VTH-UAB) for acute onset blindness. Complete ophthalmic examination revealed absent menace response and dazzle reflex in both eyes (OU), as well as subretinal edema located in the tapetal fundus. At that time, the clinical ophthalmologic diagnosis was bilateral exudative chorioretinitis. Treatment with prednisone (0.5 mg/kg PO q24 h) was instituted in addition to the ongoing treatment with fluconazole (10 mg/kg PO q24 h). The following rechecks revealed secondary cataracts with subsequent lens subluxation and panretinal degeneration OU. Despite being blind and the poor prognosis of disseminate cryptococcosis, the patient remained active and in good body condition during 6 months after the initial diagnosis. At that time, the ferret showed ataxia, incontinence, and generalized pain. A magnetic resonance imaging study revealed a mass affecting the spine. The owners declined further investigations and the ferret was humanely euthanized. The postmortem histopathology confirmed the initial diagnosis of cryptococcosis and the presence of intraretinal Cryptococcus spp. To the authors' knowledge, this is the first report of Cryptococcus spp. induced exudative chorioretinitis in a ferret.

[Primary vaginal yolk sac tumor in a girl. Case report]. / Tumor del saco vitelino primario de vagina en una niña. A propósito de un caso.

Gynecological neoplasms in girls are rare and represent only less than 5 % of all childhood tumors. There are no statistics on the incidence of vaginal tumors at this stage in life. We present a 9-month-old girl evaluated for genital bleeding. Ultrasound reveals a vaginal solid mass and vaginoscopy reports a friable tumor. AFP is elevated. A yolk sac tumor is confirmed by biopsy she receives chemotherapy. Within a year after diagnosis, she remains tumor-free. This is a case of interest, not only because of its rarity, but also because a rapid diagnosis of a yolk sac tumor improves outcomes and patient's survival rates.

Las neoplasias ginecológicas en niñas son raras. Representan menos del 5 % de todos los cánceres en pediatría. No existen estadísticas sobre la incidencia de tumores de vagina en esta etapa de la vida. Se presenta el caso de una niña de 9 meses con sangrado por genitales. La ecografía evidencia una masa sólida en vagina, y la vaginoscopia, un tumor friable. Presenta valores de α-fetoproteína elevados, por lo que se diagnostica tumor de saco vitelino, confirmado por biopsia. Se realiza tratamiento quimioterápico. A menos de 1 año del diagnóstico, se encuentra en remisión completa. Este caso resulta de interés no solo por la rareza, sino también porque el diagnóstico rápido de tumor de saco vitelino permite mejorar los resultados y la sobrevida de las pacientes.

Acute postretinal blindness: ophthalmologic, neurologic, and magnetic resonance imaging findings in dogs and cats (seven cases).

OBJECTIVE: To describe the ophthalmologic, neurologic, and magnetic resonance imaging (MRI) findings of seven animals with acute postretinal blindness as sole neurologic deficit. METHODS: Medical records were reviewed to identify dogs and cats with postretinal blindness of acute presentation, that had a cranial MRI performed as part of the diagnostic workup. Only animals lacking other neurologic signs at presentation were included. Complete physical, ophthalmic, and neurologic examinations, routine laboratory evaluations, thoracic radiographs, abdominal ultrasound, electroretinography, and brain MRI were performed in all animals. Cerebrospinal fluid analysis and postmortem histopathologic results were recorded when available. RESULTS: Four dogs and three cats met the inclusion criteria. Lesions affecting the visual pathways were observed on magnetic resonance (MR) images in six cases. Location, extension, and MRI features were described. Neuroanatomic localization included: olfactory region with involvement of the optic chiasm (n = 4), pituitary fossa with involvement of the optic chiasm and optic tracts (n = 1), and optic nerves (n = 1). Of all lesions detected, five were consistent with intracranial tumors (two meningiomas, one pituitary tumor, two nasal tumors with intracranial extension), and one with bilateral optic neuritis that was confirmed by cerebrospinal fluid analysis. Histologic diagnosis was obtained in four cases and included one meningioma, one pituitary carcinoma, one nasal osteosarcoma, and one nasal carcinoma. CONCLUSIONS: Central nervous system (CNS) disease should be considered in dogs and cats with acute blindness, even when other neurologic deficits are absent. This study emphasizes the relevance of MRI as a diagnostic tool for detection and characterization of CNS lesions affecting the visual pathways.