Impaired growth outcomes in children with congenital colorectal diseases.

BACKGROUND: Cloaca, Hirschsprung disease, and anorectal malformations (CHARM) are congenital anomalies of the hindgut. Small series have suggested that children suffering from one of these anomalies may be at risk for growth impairment. We sought to expand on these findings in a comprehensive cohort, hypothesizing that patients with Medicaid insurance or African-American (AA) race would be at higher risk for poor growth. METHODS: Following Institutional Review Board (IRB) approval, single-institution retrospective review of children with CHARM anomalies was performed (2009-2016). Body mass index (BMI) value Z-scores were obtained using the 2006 World Health Organization (age 0-24 mo) and 2000 Centers for Disease Control (CDC) (age >2 y) growth charts and calculators (statistical analysis system). Patient factors and BMI Z-scores were analyzed with descriptive statistics and Fisher's exact test. RESULTS: One hundred sixty-six patients (Cloaca n = 16, Hirschsprung disease [HD] n = 71, anorectal malformation [ARM] n = 79) were identified. The BMI Z-score distribution for the entire CHARM cohort was lower than controls (P < 0.0001). HD and ARM BMI Z-scores were also lower versus controls (P < 0.0007, P < 0.0037). Requiring more or less than the average number of surgeries did not impact BMI Z-score [P = non-significant (NS)]. Patients with Medicaid had lower Z-scores versus private or commercial insurance (P < 0.0001). AA race BMI Z-score distribution was lower than controls (P < 0.0002), but there was no statistical difference in BMI Z-scores when comparing AA versus non-AA CHARM patients (P = NS). CONCLUSIONS: Patients born with CHARM anomalies are at risk for impaired growth. Furthermore study is warranted to identify modifiable risk factors contributing to this impairment. Longitudinal follow-up should include interventions to mitigate these risks.

A sex-dependent change in behavioral temperature regulation in African house snakes (Lamprophis fuliginosus) challenged with different pathogens.

Behavioral fever in reptiles is often considered an adaptive response used to eliminate pathogens, yet empirical data showing the wide-spread use of this response is mixed. This behavioral change can be beneficial by enhancing the host's immune response and increasing the animal's chance of survival, but it can also be detrimental in terms of host energetic requirements and enzymatic performance. Thus, we examined whether captive-bred African house snakes (Lamprophis fuliginosus) employed behavioral fever in response to pathogen stimulus. Twenty-one African house snakes were injected separately with three different strains of ultraviolet (UV) light-killed bacteria (Escherichia coli, Staphylococcus aureus, Salmonella enterica). We found an increased variance of hourly cloacal temperatures following exposure to pathogens in male but not female house snakes. We did not, however, find a significant febrile response to pathogen exposure as measured via mean cloacal temperature. This research adds critical information to the field of reptilian physiology as this field remains understudied. Reptilian immune function and its relationship with thermal biology is ever more pertinent as new challenges arise, such as novel pathogens and changing climate.

Clinical and risk factor analysis of cloacal defects in the National Birth Defects Prevention Study.

Cloacal exstrophy (CE) and persistent cloaca (PC) (alternatively termed urorectal septum malformation sequence [URSMS]), represent two major cloacal defects (CDs). Clinical characteristics and risk factors often are studied for both defects combined, rather than exploring if these defects have different etiologies. We enumerated clinical features for 47 CE and 54 PC (inclusive of URSMS) cases from the National Birth Defects Prevention Study. Thirty-three CE cases were classified as isolated and 14 as multiple (presence of unassociated major defects); respective totals for PC cases were 26 and 28. We compared selected child and maternal characteristics between 11,829 non-malformed controls and CE and PC cases using chi-square or Fisher's exact tests. Compared to controls, CE and PC cases were statistically more likely (p < 0.05) to be preterm; CE cases were more likely to be multiple births. We conducted logistic regression analysis to estimate odds ratios and 95% confidence intervals for any CD, CE, and PC with selected self-reported maternal prepregnancy and periconceptional (one month prior to 3 months following conception) exposures. In crude and adjusted analyses, we observed significant positive associations for any CD, CE, and PC with use of any fertility medication or assisted reproductive technology procedure. Significant positive associations observed only in crude analyses were any CD with maternal obesity or use of progesterone, any CD and CE with any x-ray, and any CD and PC with use of folate antagonist medications. Our findings provide some of the first insights into potential differing etiologies for CE and PC.

An unusual bladder/cloacal exstrophy with urachal exstrophy.

The authors report a previously unpublished association of bladder exstrophy with cleft lip, exomphalos, Meckel's diverticulum imperforate anus, and a large urachal mass protruding below the umbilicus. The baby underwent surgical repair of the condition and the postoperative recovery was uneventful. None of the theories formulated to explain the embryogenesis of bladder exstrophy can explain these findings. The abnormality is within the bladder exstrophy/cloacal exstrophy spectrum.

Eye surface temperature detects stress response in budgerigars (Melopsittacus undulatus).

Previous studies have suggested that stressors not only increase body core temperature but also body surface temperature in many animals. However, it remains unclear whether surface temperature could be used as an alternative to directly measure body core temperature, particularly in birds. We investigated whether surface temperature is perceived as a stress response in budgerigars. Budgerigars have been used as popular animal models to investigate various neural mechanisms such as visual perception, vocal learning, and imitation. Developing a new technique to understand the basic physiological mechanism would help neuroscience researchers. First, we found that cloacal temperature correlated with eye surface temperature. Second, eye surface temperature increased after handling stress. Our findings suggest that eye surface temperature is closely related to cloacal temperature and that the stress response can be measured by eye surface temperature in budgerigars.

Effects of high and low environmental temperatures on clinical course of fowl cholera in turkeys.

Turkeys inoculated with Pasteurella multocida either in the palatine air spaces or via drinking water were maintained t high (33.4-37.4 C), low (2.6-5.3 C), and moderate (19.8-22.4 C) temperatures in temperature-controlled chambers to determine the influence environmental temperature had on the pathogenesis of fowl cholera. In inoculated turkeys maintained at high temperatures, there was a delay in the onset of depression and, in most instances, in mortality in relation to those at low or moderate temperatures. In turkeys inoculated via drinking water and maintained at low temperatures, there was a higher mortality than in those at high or moderate temperatures. In turkeys maintained at low temperatures during the preinoculation period, the onset of depression was accelerated more after inoculation than in those maintained at moderate temperatures before inoculation. The percentage of leukocytes in the hematocrit was higher in turkeys inoculated int he palatine air spaces and maintained at low temperatures than in turkeys similarly inoculated but maintained at high or moderate temperatures. Cloacal temperatures were higher in all inoculated turkeys maintained at high temperatures than in those at low or moderate temperatures, and decreased markedly when turkeys became moribund. In turkeys inoculated in the palatine air spaces, deaths from pneumonia occurred more frequently at low temperatures and torticollis occurred more frequently at high temperatures than at the other temperatures.

Changes in circulating prostaglandin E and F2 alpha levels, cloacal temperature, and leukocyte counts in turkeys inoculated with Pasteurella multocida.

The inoculation of Pasteurella multocida (P-1059) intravenously into turkeys increased significantly the plasma prostaglandin (PG) F2 alpha levels to 157% of the control values and the plasma PGE levels to 171% of control values at 3 hr after treatment. At 12 hr, the cloacal temperature of the inoculated birds was significantly higher than that of the control. The leukocyte count of inoculated birds remained unchanged from that of the control. However, the differential leukocyte count shifted in favor of significant increases in heterophils and decreases in lymphocytes and monocytes at 6 and 12 hr after inoculation. This study provides evidence that increases in plasma levels of PGF2 alpha and PGE may be partly responsible for the clinicopathological manifestations of acute fowl cholera.

Interaction of aflatoxicosis with heat stress.

An earlier study reported an increased resistance of chickens to an acute lethal heating episode (43 degrees C. and 45% relative humidity) during aflatoxicosis. This varies from other stresses investigated which interact with aflatoxicosis to make chickens more sensitive to the stress factor. The effects of graded doses of dietary aflatoxin (0, 0.625, 2.5, 5.0, and 10.0 mug./g.) on the body temperature, on body fat, on the serum glucose, and on the effect of varying the severity of the heat stress were measured. Both serum glucose and total body fat were decreased significantly (P less than 0.05) by doses of 2.5 mug./g. and above. Cloacal temperature was decreased slightly but significantly (P less than 0.05) in chickens fed 5 or 10 mug./g. for 12 days or longer. The mean survival time of birds exposed to a heat stress of 40 degrees C. and 45% relative humidity did not vary with the dose of aflatoxin while a milder stress of 37 degrees C. and 45% relative humidity caused chickens fed aflatoxin at 2.5 mug./g. or above to show decreased survival times (P less than 0.05) in comparison to the controls. These data can be rationalized by assuming that the lessened burden of body fat during aflatoxicosis accounts for the increased survival time in a severe (43 degrees C. and 45% relative humidity) heat stress but that other parameters related to physiological stress play a dominant role during a less severe but more prolonged heating episode. It seems likely that the hypoglycemia, hypothermia, and lessened body fat also account for the previously reported increased sensitivity to a lethal cold exposure during aflatoxicosis.