Morphometric measurements and carcass characteristics of Black Australorp, Naked Neck, and Rhode Island Red crossbreds under alternative production systems / Medições morfométricas e características de carcaça de Black Australorp, Naked Neck e Rhode Island Red crossbreds sob sistemas de produção alternativos

The present trial explained the effect of alternative production systems on growth, morphometric and carcass traits of four different chicken genotypes. The second generation of two genotypes RNN (Rhode Island Red × Naked Neck) and BNN (Black Australorp × Naked Neck) obtained by two self-crosses (RNN × RNN = RR and BNN × BNN = BB) and two reciprocal crosses (RNN × BNN = RB and BNN × RNN = BR) were evaluated in three alternative production systems (conventional cages, enriched cages, and aviary). At the 6th week of age after sexing, a total of 600 birds, comprising 150 from each crossbred with a total of 300 pullets and 300 cockerels were divided into conventional cages, enriched cages, and aviary systems having 200 birds in each.Birds were organized into 3×4 factorial arrangements under Completely Randomized Design (3 production systems × 4 genotypes × 2 sexes × 25 birds = 600 birds). Regarding genotypes, RB and BR males showed higher (p < 0.01) carcass yield, drumstick weight, breast weight, and thigh weight than BB and RR genotypes. Females of BR genotype showed higher (p < 0.01) breast weight, thigh weight and drumstick weight. As far as production systems are concerned, higher (p < 0.01) liver weight, heart weight, breast weight, intestinal weight, drumstick weight, and thigh weight were observed in the males reared in enriched cages compared with conventional cages and aviary system. Females reared in enriched cages showed higher (p < 0.01) heart weight, breast weight, intestinal weight, drumstick weight, and thigh weight when compared with those reared in conventional cages and aviary. It is concluded that chickens (both sexes) of BR and RB genotypes had better morphological measurements and carcass traits than those of RR and BB genotype chickens. Among alternative production systems, chickens reared in enriched cages had better traits than those of reared in conventional cages and aviary during the growing phase.

O presente estudo explicou o efeito de sistemas alternativos de produção sobre o crescimento, características morfométricas e carcaças de quatro genótipos de frango diferentes. A segunda geração de dois genótipos RNN (Rhode Island Red × Naked Neck) e BNN (Black Australorp × Naked Neck) obtida por duas autocruzes (RNN × RNN = RR e B ANN × BNN = BB) e duas cruzes recíprocas (RNN × BNN = RB e BNN × RNN = BR) foi avaliada em três sistemas de produção alternativos (gaiolas convencionais, gaiolas enriquecidas e aviário). Na 6ª semana de idade após o sexo, um total de 600 aves, compostas por 150 de cada raça cruzada com um total de 300 pullets e 300 galos, foi dividido em gaiolas convencionais, gaiolas enriquecidas e sistemas aviários com 200 aves em cada. As aves foram organizadas em 3×4 arranjos fatoriais sob projeto completamente randomizado (3 sistemas de produção × 4 genótipos × 2 sexos × 25 aves = 600 aves). Em relação aos genótipos, os machos RB e BR apresentaram maior rendimento de carcaça (p < 0,01), peso da baqueta, peso mamário e peso da coxa do que os genótipos BB e RR. As fêmeas do genótipo BR apresentaram maior (p < 0,01) peso mamário, peso da coxa e peso da baqueta. No que diz respeito aos sistemas de produção, maior (p < 0,01) peso hepático, peso cardíaco, peso mamário, peso intestinal, peso da baqueta e peso da coxa foram observados nos machos criados em gaiolas enriquecidas em comparação com gaiolas convencionais e sistema aviário. As fêmeas criadas em gaiolas enriquecidas apresentaram maior (p < 0,01) peso cardíaco, peso mamário, peso intestinal, peso da baqueta e peso da coxa quando comparadas com as criadas em gaiolas convencionais e aviárias. Conclui-se que as galinhas (ambos os sexos) dos genótipos BR e RB apresentaram melhores medidas morfológicas e traços de carcaça do que os de frangos genótipos RR e BB. Entre os sistemas de produção alternativos, [...].

Morphometric measurements and carcass characteristics of Black Australorp, Naked Neck, and Rhode Island Red crossbreds under alternative production systems

Abstract The present trial explained the effect of alternative production systems on growth, morphometric and carcass traits of four different chicken genotypes. The second generation of two genotypes RNN (Rhode Island Red × Naked Neck) and BNN (Black Australorp × Naked Neck) obtained by two self-crosses (RNN × RNN = RR and BNN × BNN = BB) and two reciprocal crosses (RNN × BNN = RB and BNN × RNN = BR) were evaluated in three alternative production systems (conventional cages, enriched cages, and aviary). At the 6th week of age after sexing, a total of 600 birds, comprising 150 from each crossbred with a total of 300 pullets and 300 cockerels were divided into conventional cages, enriched cages, and aviary systems having 200 birds in each.Birds were organized into 3×4 factorial arrangements under Completely Randomized Design (3 production systems × 4 genotypes × 2 sexes × 25 birds = 600 birds). Regarding genotypes, RB and BR males showed higher (p 0.01) carcass yield, drumstick weight, breast weight, and thigh weight than BB and RR genotypes. Females of BR genotype showed higher (p 0.01) breast weight, thigh weight and drumstick weight. As far as production systems are concerned, higher (p 0.01) liver weight, heart weight, breast weight, intestinal weight, drumstick weight, and thigh weight were observed in the males reared in enriched cages compared with conventional cages and aviary system. Females reared in enriched cages showed higher (p 0.01) heart weight, breast weight, intestinal weight, drumstick weight, and thigh weight when compared with those reared in conventional cages and aviary. It is concluded that chickens (both sexes) of BR and RB genotypes had better morphological measurements and carcass traits than those of RR and BB genotype chickens. Among alternative production systems, chickens reared in enriched cages had better traits than those of reared in conventional cages and aviary during the growing phase.

Resumo O presente estudo explicou o efeito de sistemas alternativos de produção sobre o crescimento, características morfométricas e carcaças de quatro genótipos de frango diferentes. A segunda geração de dois genótipos RNN (Rhode Island Red × Naked Neck) e BNN (Black Australorp × Naked Neck) obtida por duas autocruzes (RNN × RNN = RR e B ANN × BNN = BB) e duas cruzes recíprocas (RNN × BNN = RB e BNN × RNN = BR) foi avaliada em três sistemas de produção alternativos (gaiolas convencionais, gaiolas enriquecidas e aviário). Na 6ª semana de idade após o sexo, um total de 600 aves, compostas por 150 de cada raça cruzada com um total de 300 pullets e 300 galos, foi dividido em gaiolas convencionais, gaiolas enriquecidas e sistemas aviários com 200 aves em cada. As aves foram organizadas em 3×4 arranjos fatoriais sob projeto completamente randomizado (3 sistemas de produção × 4 genótipos × 2 sexos × 25 aves = 600 aves). Em relação aos genótipos, os machos RB e BR apresentaram maior rendimento de carcaça (p 0,01), peso da baqueta, peso mamário e peso da coxa do que os genótipos BB e RR. As fêmeas do genótipo BR apresentaram maior (p 0,01) peso mamário, peso da coxa e peso da baqueta. No que diz respeito aos sistemas de produção, maior (p 0,01) peso hepático, peso cardíaco, peso mamário, peso intestinal, peso da baqueta e peso da coxa foram observados nos machos criados em gaiolas enriquecidas em comparação com gaiolas convencionais e sistema aviário. As fêmeas criadas em gaiolas enriquecidas apresentaram maior (p 0,01) peso cardíaco, peso mamário, peso intestinal, peso da baqueta e peso da coxa quando comparadas com as criadas em gaiolas convencionais e aviárias. Conclui-se que as galinhas (ambos os sexos) dos genótipos BR e RB apresentaram melhores medidas morfológicas e traços de carcaça do que os de frangos genótipos RR e BB. Entre os sistemas de produção alternativos, as galinhas criadas em gaiolas enriquecidas tinham características melhores do que as criadas em gaiolas convencionais e aviárias durante a fase de cultivo.

Morphometric measurements and carcass characteristics of Black Australorp, Naked Neck, and Rhode Island Red crossbreds under alternative production systems / Medições morfométricas e características de carcaça de Black Australorp, Naked Neck e Rhode Island Red crossbreds sob sistemas de produção alternativos

Abstract The present trial explained the effect of alternative production systems on growth, morphometric and carcass traits of four different chicken genotypes. The second generation of two genotypes RNN (Rhode Island Red × Naked Neck) and BNN (Black Australorp × Naked Neck) obtained by two self-crosses (RNN × RNN = RR and BNN × BNN = BB) and two reciprocal crosses (RNN × BNN = RB and BNN × RNN = BR) were evaluated in three alternative production systems (conventional cages, enriched cages, and aviary). At the 6th week of age after sexing, a total of 600 birds, comprising 150 from each crossbred with a total of 300 pullets and 300 cockerels were divided into conventional cages, enriched cages, and aviary systems having 200 birds in each.Birds were organized into 3×4 factorial arrangements under Completely Randomized Design (3 production systems × 4 genotypes × 2 sexes × 25 birds = 600 birds). Regarding genotypes, RB and BR males showed higher (p < 0.01) carcass yield, drumstick weight, breast weight, and thigh weight than BB and RR genotypes. Females of BR genotype showed higher (p < 0.01) breast weight, thigh weight and drumstick weight. As far as production systems are concerned, higher (p < 0.01) liver weight, heart weight, breast weight, intestinal weight, drumstick weight, and thigh weight were observed in the males reared in enriched cages compared with conventional cages and aviary system. Females reared in enriched cages showed higher (p < 0.01) heart weight, breast weight, intestinal weight, drumstick weight, and thigh weight when compared with those reared in conventional cages and aviary. It is concluded that chickens (both sexes) of BR and RB genotypes had better morphological measurements and carcass traits than those of RR and BB genotype chickens. Among alternative production systems, chickens reared in enriched cages had better traits than those of reared in conventional cages and aviary during the growing phase.

Resumo O presente estudo explicou o efeito de sistemas alternativos de produção sobre o crescimento, características morfométricas e carcaças de quatro genótipos de frango diferentes. A segunda geração de dois genótipos RNN (Rhode Island Red × Naked Neck) e BNN (Black Australorp × Naked Neck) obtida por duas autocruzes (RNN × RNN = RR e B ANN × BNN = BB) e duas cruzes recíprocas (RNN × BNN = RB e BNN × RNN = BR) foi avaliada em três sistemas de produção alternativos (gaiolas convencionais, gaiolas enriquecidas e aviário). Na 6ª semana de idade após o sexo, um total de 600 aves, compostas por 150 de cada raça cruzada com um total de 300 pullets e 300 galos, foi dividido em gaiolas convencionais, gaiolas enriquecidas e sistemas aviários com 200 aves em cada. As aves foram organizadas em 3×4 arranjos fatoriais sob projeto completamente randomizado (3 sistemas de produção × 4 genótipos × 2 sexos × 25 aves = 600 aves). Em relação aos genótipos, os machos RB e BR apresentaram maior rendimento de carcaça (p < 0,01), peso da baqueta, peso mamário e peso da coxa do que os genótipos BB e RR. As fêmeas do genótipo BR apresentaram maior (p < 0,01) peso mamário, peso da coxa e peso da baqueta. No que diz respeito aos sistemas de produção, maior (p < 0,01) peso hepático, peso cardíaco, peso mamário, peso intestinal, peso da baqueta e peso da coxa foram observados nos machos criados em gaiolas enriquecidas em comparação com gaiolas convencionais e sistema aviário. As fêmeas criadas em gaiolas enriquecidas apresentaram maior (p < 0,01) peso cardíaco, peso mamário, peso intestinal, peso da baqueta e peso da coxa quando comparadas com as criadas em gaiolas convencionais e aviárias. Conclui-se que as galinhas (ambos os sexos) dos genótipos BR e RB apresentaram melhores medidas morfológicas e traços de carcaça do que os de frangos genótipos RR e BB. Entre os sistemas de produção alternativos, as galinhas criadas em gaiolas enriquecidas tinham características melhores do que as criadas em gaiolas convencionais e aviárias durante a fase de cultivo.

Aldehyde dehydrogenase 3I1 gene is recruited in conferring multiple abiotic stress tolerance in plants.

Plant growth and productivity is restricted by a multitude of abiotic stresses. These stresses negatively affect physiological and metabolic pathways, leading to the production of many harmful substances like ROS, lipid peroxides and aldehydes. This study was conducted to investigate the role of Arabidopsis ALDH3I1 gene in multiple abiotic stress tolerance. Transgenic tobacco plants were generated that overexpress the ALDH3I1 gene driven by the CaMV35S promoter and evaluated under different abiotic stresses, namely salt, drought, cold and oxidative stress. Tolerance to stress was evaluated based on responses of various growth and physiological traits under stress condition. Transgenic plants displayed elevated ALDH3I1 transcript levels compared to WT plants. The constitutive ectopic expression of ALDH3I1 conferred increased tolerance to salt, drought, cold and oxidative stresses in transgenic plants, along with improved plant growth. Transgenic plants overexpressing ALDH3I1 had higher chlorophyll content, photosynthesis rate and proline, and less accumulation of ROS and malondialdehyde compared to the WT, which contributed to stress tolerance in transgenic plants. Our results further revealed that ALDH3I1 had a positive effect on CO2 assimilation rate in plants under abiotic stress conditions. Overall, this study revealed that ALDH3I1 positively regulates abiotic stress tolerance in plants, and has future implications in producing transgenic cereal and horticultural plants tolerant to abiotic stresses.

A Randomized, Placebo-Controlled, Double-Blind Study of Minocycline for Reducing the Symptom Burden Experienced by Patients With Advanced Pancreatic Cancer.

CONTEXT: Although it is well known that patients with advanced pancreatic cancer (PC) experience significant symptom burden, few strategies for effective symptom intervention are available for them. OBJECTIVES: To investigate the efficacy of minocycline, an anti-inflammatory agent, for symptom reduction in patients with advanced PC. METHODS: We conducted Phase II, randomized, and placebo-controlled trial to obtain preliminary estimates of the effects on symptom reduction with 100 mg of minocycline or placebo given twice a day. Eligible patients had diagnosed advanced PC and were scheduled for standard chemotherapy. Patient-reported symptoms were measured weekly during the eight-week trial using the MD Anderson Symptom Inventory (MDASI) module in patients with gastrointestinal cancer. The primary outcome measure was the area under the curve values of the five most severe symptoms in the two arms. RESULTS: Of the 44 patients recruited, 31 (71%) were evaluable for the primary efficacy analysis, with 18 received minocycline and 13 placebo. Fatigue, pain, disturbed sleep, lack of appetite, and drowsiness were the most severe symptoms reported by both groups. No significant differences in area under the curve values over time between the study arms were found for the composite MDASI score or single-item scores of the five most severe MDASI items. No treatment-related deaths were reported, and no Grade 3-4 toxicities were observed. CONCLUSION: Minocycline is safe for use in patients receiving treatment for PC. There is no observed symptom reduction with minocycline on the major symptom burden associated with advanced PC compared with placebo. Attrition because of rapid disease progression impacted the study significantly.

Quality of life impact of EUS in patients at risk for developing pancreatic cancer.

BACKGROUND AND OBJECTIVES: The current knowledge about the psychological impact of pancreatic cancer (PC) screening is limited. We aimed to assess the changes in quality of life (QOL) and level of distress after undergoing EUS in individuals with pancreatic cystic lesions (PCLs) and in patients at high risk for PC based on genetic and familial factors. METHODS: Eighty patients with PCL and/or increased genetic or familial risk for PC who had undergone EUS were contacted. Fifty percent of those patients successfully completed the brief profile of mood states (POMS) and the linear analog scale assessment (LASA) QOL questionnaires to evaluate their pre/post-EUS overall QOL. The effect size (ES) method was used to assess clinically meaningful changes in the scores. RESULTS: There was a significant difference in patients' overall QOL scores before and after the EUS procedure (LASA, mean difference 0.73, standard deviation (SD) 1.76, ES 0.58, P < 0.01; brief POMS, mean difference -5.46, SD -6.72, ES 0.81, P < 0.01). CONCLUSIONS: QOL of patients with PCL or increased risk factors for PC is significantly improved after a EUS/EUS-guided fine-needle aspiration (FNA) negative for malignancy.

Minocycline Reduces Chemoradiation-Related Symptom Burden in Patients with Non-Small Cell Lung Cancer: A Phase 2 Randomized Trial.

PURPOSE: In patients with non-small cell lung cancer (NSCLC), concurrent chemoradiation therapy (CRT) exacerbates a cluster of difficult-to-manage symptoms, especially cancer-related fatigue. Minocycline is a readily available, low-cost antibiotic with antiinflammatory properties. We conducted a phase 2 randomized, double-blinded, placebo-controlled trial to investigate the effect of minocycline in reducing CRT-symptom burden in NSCLC. METHODS AND MATERIALS: Patients with NSCLC scheduled to receive CRT provided consent and were randomized to receive either minocycline (100 mg twice daily) or a matching placebo during 6 to 7 weeks of CRT. Patient-reported fatigue and other symptoms were assessed on MD Anderson Symptom Inventory weekly from the start of CRT for 12 weeks. The primary outcome was 12-week (±2 days) area under the curve for symptom burden, which was compared between treatment groups. RESULTS: Forty of 49 enrolled patients (80%) were evaluable (19 on minocycline and 21 on placebo). There were no grade 3 + adverse events related to the study medication. Fatigue was significantly reduced in the minocycline group compared with placebo group during the 12-week trial period (area under the curve = 31.2 ± 14.2 vs 45.0 ± 20.9, P = .011), with a large effect size (Cohen's d = 0.77). Pain (Cohen's d = 0.54) and shortness of breath (Cohen's d = 0.55) were also significantly reduced in the minocycline group (all P < .05). CONCLUSIONS: Minocycline during CRT for NSCLC was feasible, had a low toxicity profile, and yielded a clinically and statistically significant positive signal in reducing symptom burden related to NSCLC and CRT. This study is a proof of concept so a larger trial in CRT patients is warranted.

Finding Novel Anti-carcinomas Compounds by Targeting SFRP4 Through Molecular Modeling, Docking and Dynamic Simulation Studies.

BACKGROUND: Secreted Frizzled-Related Protein 4 (SFRP4) is a glycoprotein that acts as a competitor of both canonical and non-canonical Wnt pathways. SFRP4 is mostly expressed in ovary and plays a significant role as a target molecule to cure ovarian carcinoma. OBJECTIVE: Multiple chemical agonists are being used to cure ovary melanoma. We are interested in theoretically analyzing the compounds through computational approaches for their potential inhibitory effects against SFRP4. METHODS: Compounds were sketched in Chemsketch drawing tool and minimized through chimera tool. Because the crystal structure of SFRP4 is not available in Protein Data Bank, homology modeling approach was used to predict Three-Dimensional (3D) crystal structure of SFRP4. Moreover, multiple computational approaches such as molecular docking and Molecular Dynamic (MD) simulations along with various online tools were employed to screen the best inhibitor against ovary melanoma. RESULTS: The docking results showed that 1d and 1e compounds revealed significant binding energy values (-9.10 and -9.00 kcal/mol, respectively) compared with the standard drugs such as cis-platin and docetaxel (-3.30, -10.80 kcal/mol), respectively. Moreover, MD simulation results showed that 1d has little fluctuations throughout the simulation period as depicted by the root mean square deviation and root mean square fluctuation graphs. CONCLUSION: The present in-silico study provides a deeper insight into the structural attributes of 1d compound and its overall molecular interactions against SFRP4 and gives a hypothetical gateway to use this compound as a potential inhibitor against ovarian carcinoma.

Bowel preparation prior to percutaneous ilio-sacral screw insertion: is it necessary?

PURPOSE: The aim of this study was to compare the outcomes of ilio-sacral (IS) screw fixation with and without the use of bowel preparation, in terms of obtaining adequate visualisation, malpositioning of screw requiring revision surgery and neurovascular injury. METHODS: A retrospective case control study was performed. We reviewed 74 consecutive cases of IS screw fixation performed at our institution within the last 5 years. We included all patients who had undergone percutaneous IS screw fixation. Two groups, one consisting of patients who underwent bowel preparation prior to surgery (Group 1) and one consisting of patients who had no bowel preparation (Group 2), were compared in terms of the above outcomes. There were 37 patients in each group. The mean age in Group 1 was 41 years (17-63) and in Group 2 was 47 years (12-89). RESULTS: In Group 1 there were two procedures abandoned due to poor visualisation. In Group 2 there were no cases abandoned for poor visualisation. There were two nerve injuries in Group 1 and no nerve injuries in Group 2. Revision surgery was performed in four patients in Group 1-for malposition, persistent buttock pain, sciatic nerve palsy and inadequate fixation while one revision performed in Group 2 for persistent buttock pain. CONCLUSION: Based on these results, we conclude that bowel preparation is not necessary to obtain adequate visualisation for safe and accurate percutaneous IS screw insertion. In fact, in Group 1 two procedures were abandoned and there was higher incidence of complications. Therefore, it would appear that this treatment arm should be abandoned all together. Further studies to prove it conclusively and explain the reasons are required.

Prospective Study of Patient-Reported Symptom Burden in Patients With Non-Small-Cell Lung Cancer Undergoing Proton or Photon Chemoradiation Therapy.

CONTEXT: Intensity-modulated radiation therapy (IMRT), three-dimensional conformal radiation therapy (3DCRT), and proton-beam therapy (PBT) are chemoradiotherapy modalities for treating locally advanced non-small-cell lung cancer. Although therapy is carefully planned to maximize treatment benefit while minimizing risk for adverse side effects, most patients develop radiation-induced symptom burden. OBJECTIVES: To demonstrate the MD Anderson Symptom Inventory's ability to detect fine differences in symptom development among these modalities. METHODS: This was a longitudinal observational study. Patients with unresectable primary or recurrent non-small-cell lung cancer (n = 82) underwent 3DCRT, IMRT, or PBT. Patients rated MD Anderson Symptom Inventory symptoms weekly for up to 12 weeks. We used mixed-effect modeling to estimate development of symptoms and functional interference. RESULTS: The PBT group received a significantly higher radiation target dose than did the IMRT and 3DCRT groups (P < 0.001). Fatigue was the most severe symptom over time for all groups. Controlling for patient and clinical factors (age, sex, race, cancer stage, performance status, body mass index, previous cancer therapy, total radiation dose), we found that pain, as a major esophagitis-related symptom, increased more during therapy (P = 0.019) and decreased more after (P = 0.013) therapy in the 3DCRT and IMRT groups than in the PBT group. Compared with the PBT group, the 3DCRT and IMRT groups reported greater decrease in systemic symptoms (fatigue, drowsiness, lack of appetite, disturbed sleep) after therapy (P = 0.016). CONCLUSION: Patients receiving PBT reported significantly less severe symptoms than did patients receiving IMRT or 3DCRT. These results should be confirmed in a randomized study with comparable tumor burden among therapies.

Comparison of Short vs Long Anti-rotation in Treating Trochanteric Fractures.

Introduction: A comparative evaluation of the surgical treatment and outcome of patients with pertrochanteric fractures treated with short versus long proximal femoral nail antirotation. Materials and methods: A retrospective review was conducted of patients with pertrochanteric fractures treated between January 2011 and June 2012. In all 80 patients were enrolled in the study, of which 40 were treated with short PFNA and the remaining with long PFNA. Comparative analyses of demographic data, peri-operative outcome and complications were carried out. Results: There was no significant difference noted in the two groups with regards to Arbeitsgemeinschaft fur Osteosynthesefragen (AO) fracture classification, time from injury to surgery, blood transfusion post surgery and hospital stay. The surgical duration for a short PFNA procedure was significantly less (58 minutes) when compared to that of a long PFNA (87 minutes). Similarly intra-operative blood loss was significantly higher in the long PFNA group as compared to the short PFNA. Conclusions: A relatively quicker surgical time of just under an hour , lesser blood loss and better learning curve with trainee surgeons make short PFNA a better implant choice in the treatment of pertrochanteric fractures.

Urethrocutaneous fistula following hypospadias repair: regional anesthesia and other factors.

BACKGROUND: Urethrocutaneous fistula is a well-known complication of hypospadias surgery. A recent prospective study by Kundra et al. (Pediatr Anesth 2012) has suggested that caudal anesthesia may increase the risk of fistula formation. We sought to evaluate this possible association and determine if any other novel factors may be associated with fistula formation. METHODS: Children who underwent primary hypospadias repair between January 1, 1994 and March 31, 2013 at our tertiary care center were included in this study. Reviewed surgical data included repair type, duration of procedure, use of local anesthetic infiltration, and subcutaneous epinephrine. Analgesic factors included use of caudal and/or penile block, opioid usage, postoperative pain scores, and nausea/vomiting. Postoperative surgical complications and estimates of family household median income by zip code were also reviewed. RESULTS: Fistula occurrence was not associated with caudal or penile block, severity of postoperative pain, or surgeon experience. A more proximal location of the urethral meatus, longer operating time, and use of subcutaneous epinephrine were significantly more common in patients who developed fistula. As assessed by home address zip code, distance of more than 100 miles and median household income in the bottom 25th percentile of our study population were not associated with fistula, as compared to closer distance or higher income. CONCLUSION: In this series, we found no association between the use of caudal regional anesthesia and fistula formation. Location of the starting urethral meatus, prolonged surgical duration, and subcutaneous epinephrine use were associated with fistula formation. Our findings call into question the routine use of epinephrine in hypospadias repair.