Periconceptional maternal alcohol consumption leads to behavioural changes in adult and aged offspring and alters the expression of hippocampal genes associated with learning and memory and regulators of the epigenome.

Maternal alcohol consumption throughout pregnancy can result in long term behavioural deficits in offspring. However, less is known about the impact of alcohol during the periconceptional period (PC). The aim of this study was to examine the effect of PC ethanol (PC:EtOH) exposure on long term cognitive function; including memory and anxiety. Rats were exposed to a liquid diet containing ethanol (EtOH) (12.5% vol;vol) or a control diet from 4 days prior to mating until day 4 of pregnancy. Separate cohorts of animals were tested at 6 months (adult) or 15-18 months of age (aged). Offspring underwent a series of behavioural tests to assess anxiety, spatial and recognition memory. The hippocampus was collected, and mRNA expression of epigenetic modifiers and genes implicated in learning and memory were examined. PC:EtOH exposure resulted in a subtle anxiety like behaviour in adult female offspring with a significant reduction in directed exploring/head dipping behaviour during holeboard testing. In aged male offspring, PC:EtOH exposure resulted in a tendency for increased directed exploring/head dipping behaviour during holeboard testing. No differences between treatments were observed in the elevated plus maze. Aged female offspring exposed to PC:EtOH demonstrated short term spatial memory impairment (P < 0.05). PC:EtOH resulted in an upregulation of hippocampal mRNA expression of bdnf, grin2a and grin2b at 18 months of age along with increased expression of epigenetic modifiers (dnmt1, dnmt3a and hdac2). In conclusion, PC:EtOH can lead to sex specific anxiety-like behaviour and impairments in spatial memory and altered hippocampal gene expression.

The impact of periconceptional alcohol exposure on fat preference and gene expression in the mesolimbic reward pathway in adult rat offspring.

Alcohol consumption around the time of conception is highly prevalent in Western countries. Exposure to ethanol levels during gestation has been associated with altered development of the mesolimbic reward pathway in rats and increased propensity to addiction, however the effect of exposure only around the time of conception is unknown. The current study investigated the effects of periconceptional alcohol exposure (PC:EtOH) on alcohol and palatable food preferences and gene expression in the ventral tegmental area (VTA) and the nucleus accumbens of the adult offspring. Rats were exposed to a liquid diet containing ethanol (EtOH) (12.5% vol/vol) or a control diet from 4 days before mating until 4 days after mating. PC:EtOH had no effect on alcohol preference in either sex. At 15 months of age, however, male PC:EtOH offspring consumed more high-fat food when compared with male control offspring, but this preference was not observed in females. Expression of the dopamine receptor type 1 (Drd1a) was lower in the VTA of male PC:EtOH offspring compared with their control counterparts. There was no effect of PC:EtOH on mRNA expression of the µ-opioid receptor, tyrosine hydroxylase (Th), dopamine receptor type 2 (Drd2) or dopamine active transporter (Slc6a3). These data support the hypothesis that periconceptional alcohol exposure can alter expression of key components of the mesolimbic reward pathway and heighten the preference of offspring for palatable foods and may therefore increase their propensity towards diet-induced obesity. These results highlight the importance of alcohol avoidance when planning a pregnancy.

Maternal hypomagnesemia alters hippocampal NMDAR subunit expression and programs anxiety-like behaviour in adult offspring.

It is well established that maternal undernutrition and micronutrient deficiencies can lead to altered development and behaviour in offspring. However, few studies have explored the implications of maternal Mg deficiency and programmed behavioural and neurological outcomes in offspring. We used a model of Mg deficiency (prior to and during pregnancy and lactation) in CD1 mice to investigate if maternal Mg deficiency programmed changes in behaviour and NMDAR subunit expression in offspring. Hippocampal tissue was collected at postnatal day 2 (PN2), PN8, PN21 and 6 months, and protein expression of NMDAR subunits GluN1, GluN2A and GluN2B was determined. At 6 months of age, offspring were subject to behavioural tasks testing aspects of anxiety-like behaviour, memory, and neophobia. Maternal hypomagnesemia was associated with increased GluN1, GluN2A and GluN2B subunit expression in female offspring at 6 months, but decreased GluN1 and GluN2A expression in males. The GluN2B:GluN2A expression ratio was increased in both sexes. Male (but not female) offspring from Mg-deficient dams showed anxiety-like behaviour, with reduced head dips (Suok test), and reduced exploration of open arms (elevated plus maze). Both male and female offspring from Mg-deficient dams also showed impaired recognition memory (novel object test). These findings suggest that maternal Mg deficiency can result in behavioural deficits in adult life, and that these changes may be related to alterations in hippocampal NMDA receptor expression.

Interaction between the socio-demographic variables of physicians and their patients: its impact upon patient satisfaction.

An investigation of resident physician socio-demographic characteristics and how they may interact with patient socio-demographic characteristics to influence satisfaction was done. Physician characteristics of gender, age, marital and parental status, ethnic background, level of training and demonstrated cognitive skills, was compared with similar patient socio-demographics, to ascertain if a patient's preconceived images of who a physician is, rather than what a physician does will impact significantly upon patient satisfaction outcome. Results suggest that patients make these judgments separately from physician socio-demographic variables and support the belief that communication skills are a major determinant of patient satisfaction.

A wellness program model for family practice residency programs.

For some time health promotion and disease prevention have been expected tenets of medical practices with the public. However, the medical profession has only recently emphasized prevention and wellness promotion as required curricula for study at the undergraduate and graduate levels. Family physicians have been at the forefront in accepting this additional responsibility, but actual implementation of such practices has been difficult for the individual physician. To address this needed transitional step from public demand to practice, a wellness program for residents, faculty, staff, and patients was designed for the Family Practice Residency Program at Cheyenne.

Electronic medical records: the family practice resident perspective.

BACKGROUND AND OBJECTIVES: Few studies have included family practice residents' perceptions regarding the use of electronic medical records (EMR) in a residency program. This study determined residents' perceptions of EMR systems and what variables influenced those perceptions. Specifically, we studied how EMR training and previous computer background influenced resident perception of difficulty in EMR implementation, time efficiency, preventive care opportunities, accuracy of medical records, and desired future use of EMR systems. Questions targeted the use of the EMR in the resident continuity clinic. METHODS: Survey questionnaires about the use of EMR systems in the residents' continuity clinic were mailed to residency directors and residents of 219 family practice residency programs. Respondents were given the opportunity to comment on benefits of and concerns about EMR. RESULTS: Resident response rate was 46% in programs using EMR systems. Findings revealed that the length of EMR training a resident received was unrelated to the perceived adequacy of training but was related to the residents' assessment of the difficulty of implementing the EMR in their continuity clinic. Residents who perceived training to be adequate and perceived a relative ease of implementing the EMR were more likely to perceive the EMR to be beneficial and were more likely to choose the EMR over traditional paper records for future use. Computer background/experience was not related to perceived satisfaction with the EMR, nor was it related to perceived difficulty of implementation, adequacy of training, or anticipated future use of an EMR system. CONCLUSIONS: Although residents recognize the benefits of the EMR, our study demonstrates an overall ambivalence and frustration toward EMR systems currently in use in family practice residency continuity clinics. However, the training they receive regarding EMR use in their residency may influence not only the perceived ease of EMR implementation but attitudes regarding the ability of the EMR to assist them with preventive opportunities, time management, and medical record accuracy. This may in turn have influence on the use of EMR systems in their practices after residency.

Ulcerative keratitis associated with qualitative tear film abnormalities in cats.

Three cats with indolent corneal ulcers and one cat with bilateral corneal sequestration and normal aqueous tear production were found to have rapid tear break-up times (BUTs). Tear BUTs in clinically affected cats averaged 2.5 +/- 1.29 s and 2.33 +/- 0.58 s for the right and left eyes, respectively. Palpebral conjunctival biopsies were harvested from consistent sites from each eye of affected cats (n = 7 affected eyes), and age-and breed-matched controls (n = 2 unaffected eyes). Light microscopy revealed a marked decrease to complete absence of conjunctival goblet cells (average goblet cell (GC):epithelial cell (EC) density = 18:50), conjunctival epithelial dysplasia, squamous metaplasia, and neutrophilic and mononuclear cell submucosal infiltration in affected cats. Specimens from the control cats had an average GC:EC density of 34:50, and minimal submucosal inflammatory infiltrate. The corneas (n = 7 eyes) healed following surgical keratectomy with (n = 2 eyes) or without (n = 1 eye) conjunctival pedicle flaps, superficial keratectomy and striate keratotomy with (n = 2 eyes) or without (n = 2 eyes) third eyelid flaps, and mucinomimetic tear supplementation (n = 5 eyes). Goblet cell regeneration was confirmed after 5 months of mucinomimetic supplementation (n = 2 eyes). The etiology for these mucin deficiencies remains unknown.

Anterior chamber to frontal sinus shunt for the diversion of aqueous humor: a pilot study in four normal dogs.

Silicone tubing was used to divert aqueous humor from the anterior chamber of the right eye to the rostral compartment of the right frontal sinus in four clinically normal mixed-breed dogs. Biomicroscopic examination, and pneumoapplanation tonometry and tonography, completed for up to 18 weeks postoperatively, confirmed gonioimplant function in all four cases. The dogs were euthanized at 6, 8, 16 and 18 weeks postoperatively. Gonioimplant patency was further confirmed by postmortem examination of the globes, implants and frontal sinuses. Gross and light microscopic examinations revealed iridal attachments to the implant (n = 4), mild anterior uveitis (n = 3), anterior subcapsular cataracts (n = 4), and focal corneal (n = 3) and scleral (n = 3) scarring in the operated globes. Light microscopic examination of frontal sinus specimens revealed mild lymphocytic proliferation and fibrosis immediately adjacent to the implant entrance site. There were no bacteria detected on aerobic or anaerobic cultures of the frontal sinuses or light microscopic examination of the globes or frontal sinuses. Results indicate that the frontal sinus shunting of aqueous humor is a safe and effective means of extraorbital aqueous diversion with potential applicability in the management of glaucoma.

The use of immunohistochemistry and the polymerase chain reaction for detection of feline leukemia virus and feline sarcoma virus in six cases of feline ocular sarcoma.

Ocular sarcoma was diagnosed by light microscopic examination in enucleated globes (n = 4), orbital tissue biopsy (n = 1) and ocular evisceration contents (n = 1) from six cats. To determine if feline leukemia virus (FeLV) or a replication-defective FeLV, feline sarcoma virus (FeSV), was present in these ocular sarcomas, immunohistochemistry (IHC) and polymerase chain reaction (PCR) for FeLV were utilized. Immunohistochemical staining for FeLV glycoprotein 70 (gp70) was performed on all six formalin-fixed, paraffin-embedded tumors using an avidin-biotin complex technique. DNA was extracted from each specimen and a 166 bp region of the FeLV long-terminal repeat (LTR) was amplified by PCR. All tumors were composed primarily of spindle cells; two neoplasms had PAS-positive basement membrane enveloping areas of spindle cells. All tumors involved the uvea and five of six tumors showed transcleral extension, one of which invaded the optic nerve. Immunohistochemical staining for FeLV gp 70 was negative. PCR to amplify a portion of the FeLV LTR was negative. Based on these findings of these limited number of cases, FeLV/FeSV may not play a role in the tumorigenesis of feline ocular sarcomas. However, additional tumors representing all morphological subtypes should be investigated for the presence of viral antigen and DNA. It is important to determine the etiology and pathogenesis of these malignant ocular sarcomas. If the cell of origin and pathogenesis involve ocular and lenticular injury, and FeLV/FeSV is not present, then the clinical management of cases of feline ocular trauma, uveitis and glaucoma may prevent the development of this tumor.

Multifocal retinopathy of Great Pyrenees dogs.

Forty-four related Great Pyrenees dogs were examined ophthalmoscopically. Focal retinal elevations, multiple gray-tan-pink subretinal patches, and discrete areas of tapetal hyper-reflectivity were seen in 19 dogs, ranging from 13 weeks to 10 years of age. These lesions varied in size from focal spots that were barely visible with the indirect ophthalmoscope to areas that were larger than the optic disc. Complete blood cell counts, serum biochemical profiles, urinalyses, and blood pressure measurements were completed on four affected dogs and all were within normal reference ranges. Photopic and scotopic electroretinography was completed and the a-wave and b-wave amplitudes and latencies were similar for affected and age-matched nonaffected Great Pyrenees and other normal dogs. Electroretinograms that were examined twice during a 3-year period on three affected adult dogs did not reveal significant progressive deterioration of the a or b-wave parameters. Fluorescein angiography was completed on four affected dogs of ages 1 (n = 2), 5, and 6 years. These angiograms were repeated in three of these dogs 1 year later. The blood ocular barrier was intact in these dogs but there was blocked choroidal fluorescence. Postmortem examination, light microscopy, scanning and transmission electron microscopy were performed on three affected puppies and two affected adult dogs. These examinations revealed that the lesions in the puppies were limited to bilateral multiple areas of retinal pigment epithelial vacuolation, hypertrophy, and apparent separation from Bruch's membrane, and multiple serous retinal detachments. The affected adult dogs had focal retinal degeneration and retinal pigment epithelial hypertrophy, hyperplasia and pigmentation. Pedigree analysis and test mating confirm that this condition is inherited, probably as an autosomal recessive trait. This condition develops at approximately 13 weeks of age and the focal areas of retinal detachment and retinal pigment epithelial vacuolation progress to permanent and stable focal areas of retinal degeneration, and retinal pigment epithelial hypertrophy and pigmentation.

Bilateral gemination with talon cusp: report of case.

The extraction of the geminated maxillary central incisors was selected as the preferred treatment in this case because of the impossibility of properly recontouring these teeth. Although the crowns could have been reshaped somewhat to conform to a more normal size and shape, the roots were so wide that approximation of the central and lateral incisor crowns would have been impaired. The use of normally shaped, large lateral incisors in place of abnormal central incisors gives a better occlusion and a more esthetic result at the end of the treatment.

Erythroblastosis fetalis produced by Kell immunization: dental findings.

Erythroblastosis fetalis is a severe hemolytic disease in the newborn that originates in utero because of a maternal-fetal blood incompatibility. An unusual case of erythroblastosis fetalis caused by an irregular antibody of the Kell blood group is presented. The dental findings are compared to those found with Rh(D) incompatibility.

Bilateral mandibular regional odontodysplasia with vascular nevus.

Odontodysplasia is a rare clinicopathologic condition that has a variety of expressions, including a range of tooth coloration, formation of hypoplastic enamel affecting one or multiple teeth, bizarre radiographic appearance, and delayed eruption of teeth. An unusual case is presented of bilateral regional odontodysplasia associated with a vascular nevus of the face and neck. A review of the etiology with emphasis on the "local circulatory disease" theory is presented.

Equine phacoclastic uveitis: the clinical manifestations, light microscopic findings, and therapy of 7 cases.

This retrospective clinical study describes the clinical manifestations, light microscopic findings, and diagnosis and treatment of acute and chronic lens rupture in the horse. Rupture of the lens capsule in the horse usually results in a chronic, blinding inflammation (phacoclastic uveitis) unless prompt surgical and medical therapies are implemented. The clinical manifestations of acute lens capsule rupture included: cataract; intralenticular displacement of iridal pigment; lens cortical fragments attached to the perforated lens capsule, iris, and corneal endothelium; miosis; aqueous flare; and usually a corneal or scleral perforation with ulceration or focal full thickness corneal edema and scarring. The clinical signs of chronic phacoclastic uveitis include blindness, phthisis bulbi, and generalized corneal opacification related to scarring, vascularization, pigmentation, and edema. In one horse, acute phacoclastic uveitis was successfully treated with phacoemulsification to remove the ruptured lens and medical therapy to control the accompanying inflammation. The affected eyes of the horses with chronic phacoclastic uveitis were enucleated because of persistent clinical signs of nonulcerative keratitis and uveitis, despite long-term medical management. The clinical manifestations and lack of improvement with medical therapy are similar in the horse, dog, cat, and rabbit. However, the histologic findings in equine phacoclastic uveitis differ significantly from those in the dog, and rabbit.

Equine glaucoma: a retrospective study of 13 cases presented at the Western College of Veterinary Medicine from 1992 to 1999.

The prevalence of equine glaucoma seen by the ophthalmology service at the Western College of Veterinary Medicine (WCVM) was 6.5%. The majority of cases (11/13) were associated with clinical manifestations of uveitis. Congenital glaucoma was documented in 1 case, and primary glaucoma was diagnosed in a 12-year-old quarter horse. There were no breed or sex predilections evident. Affected horses were middle-aged to old (average age = 9.5 years, ranging from 2 weeks to 23 years). The clinical manifestations of equine glaucoma included blindness, diffuse corneal edema, corneal vascularization, buphthalmia, corneal striae, recurrent secondary ulcerative keratitis, and less commonly, iris bombé, tapetal hyper-reflectivity, complete pupillary occlusion from posterior synechiae, and optic disc cupping. Elevated intraocular pressure confirmed the diagnosis (n = 10), while 3 cases were normotensive with signs of glaucoma including corneal striae and buphthalmia. Affected eyes were treated medically and/or surgically. Regardless of the therapy instituted, the visual outcome was poor. Most affected eyes were blind at presentation or became blind within a few weeks.