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BACKGROUND: To ameliorate anticipated or ongoing neurological deficits, dogs undergoing brain tumor irradiation often are prescribed lengthy courses of prednisone PO during and after radiotherapy (RT). This practice can contribute to unwanted corticosteroid-associated morbidity and may be unnecessary. OBJECTIVE: Determine whether long-term corticosteroid dependency can be minimized by use of succinct prednisone tapering. ANIMALS: Fifty-five pet dogs undergoing brain tumor irradiation. METHODS: Nineteen dogs were treated using a "rapid-taper" protocol wherein corticosteroid dose reduction began 0 to 20 days after completing RT. Outcomes were compared with a retrospectively studied control group ("slow-taper"; N = 36 dogs) in which corticosteroids were tapered more slowly according to individual clinician recommendations. RESULTS: Patient demographics were similar between groups. Mean time to lowest prednisone dose was 41 days postirradiation in the rapid-taper group and 117 days in the slow-taper group (P = .003). In the rapid-taper group, 15 of 19 dogs (84%) were completely tapered off prednisone, vs 18 of 36 (50%) in the slow-taper group (P = .04). Rates at which corticosteroids had to be reinstituted later were similar for the 2 groups (approximately 1 in 3 dogs). Adverse effect rates were similar for the 2 groups. Although no comparable questionnaire-derived data were available for the "slow-taper" group, overall and neurologic quality of life remained stable after RT in the rapid-taper group. CONCLUSIONS AND CLINICAL IMPORTANCE: For many dogs, lengthy courses of PO prednisone are avoidable after intracranial RT. Future efforts should aim to identify which dogs benefit most from accelerated prednisone tapering.
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In pursuit of developing alternatives for the highly polluting Haber-Bosch process for ammonia synthesis, the electrocatalytic nitrogen reduction reaction (NRR) using transition metal nitrides such as zirconium mononitride (ZrN) has been identified as a potential pathway for ammonia synthesis. In particular, specific facets of ZrN have been theoretically described as potentially active and selective for NRR. Major obstacles that need to be addressed include the synthesis of tailored catalyst materials that can activate the inert dinitrogen bond while suppressing hydrogen evolution reaction (HER) and not degrading during electrocatalysis. To tackle these challenges, a comprehensive understanding of the influence of the catalyst's structure, composition, and morphology on the NRR activity is required. This motivates the use of metal-organic chemical vapor deposition (MOCVD) as the material synthesis route as it enables catalyst nanoengineering by tailoring the process parameters. Herein, we report the fabrication of oriented and facetted crystalline ZrN thin films employing a single source precursor (SSP) MOCVD approach on silicon and glassy carbon (GC) substrates. First principles density functional theory (DFT) simulations elucidated the preferred decomposition pathway of SSP, whereas ab initio molecular dynamics simulations show that ZrN at room temperature undergoes surface oxidation with ambient O2, yielding a Zr-O-N film, which is consistent with compositional analysis using Rutherford backscattering spectrometry (RBS) in combination with nuclear reaction analysis (NRA) and X-ray photoelectron spectroscopy (XPS) depth profiling. Proof-of-principle electrochemical experiments demonstrated the applicability of the developed ZrN films on GC for NRR and qualitatively hint towards a possible activity for the electrochemical NRR in the sulfuric acid electrolyte.
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Images collected during NASA's Double Asteroid Redirection Test (DART) mission provide the first resolved views of the Didymos binary asteroid system. These images reveal that the primary asteroid, Didymos, is flattened and has plausible undulations along its equatorial perimeter. At high elevations, its surface is rough and contains large boulders and craters; at low elevations its surface is smooth and possesses fewer large boulders and craters. Didymos' moon, Dimorphos, possesses an intimate mixture of boulders, several asteroid-wide lineaments, and a handful of craters. The surfaces of both asteroids include boulders that are large relative to their host body, suggesting that both asteroids are rubble piles. Based on these observations, our models indicate that Didymos has a surface cohesion ≤ 1 Pa and an interior cohesion of â¼10 Pa, while Dimorphos has a surface cohesion of <0.9 Pa. Crater size-frequency analyzes indicate the surface age of Didymos is 40-130 times older than Dimorphos, with likely absolute ages of ~ 12.5 Myr and <0.3 Myr, respectively. Solar radiation could have increased Didymos' spin rate leading to internal deformation and surface mass shedding, which likely created Dimorphos.
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Aurivillius structured Bi6Ti3Fe1.5Mn0.5O18 (B6TFMO) has emerged as a rare room temperature multiferroic, exhibiting reversible magnetoelectric switching of ferroelectric domains under cycled magnetic fields. This layered oxide presents exceptional avenues for advancing data storage technologies owing to its distinctive ferroelectric and ferrimagnetic characteristics. Despite its immense potential, a comprehensive understanding of the underlying mechanisms driving multiferroic behavior remains elusive. Herein, we employ atomic resolution electron microscopy to elucidate the interplay of octahedral tilting and atomic-level structural distortions within B6TFMO, associating these phenomena with functional properties. Fundamental electronic features at varying bonding environments within this complex system are scrutinized using electron energy loss spectroscopy (EELS), revealing that the electronic nature of the Ti4+ cations within perovskite BO6 octahedra is influenced by position within the Aurivillius structure. Layer-by-layer EELS analysis shows an ascending crystal field splitting (Δ) trend from outer to center perovskite layers, with an average increase in Δ of 0.13 ± 0.06 eV. Density functional theory calculations, supported by atomic resolution polarization vector mapping of B-site cations, underscore the correlation between the evolving nature of Ti4+ cations, the extent of tetragonal distortion and ferroelectric behavior. Integrated differential phase contrast imaging unveils the position of light oxygen atoms in B6TFMO for the first time, exposing an escalating degree of octahedral tilting toward the center layers, which competes with the magnitude of BO6 tetragonal distortion. The observed octahedral tilting, influenced by B-site cation arrangement, is deemed crucial for juxtaposing magnetic cations and establishing long-range ferrimagnetic order in multiferroic B6TFMO.
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Although canine pituitary masses (PM) are increasingly treated with stereotactic radiotherapy (SRT), historical literature supports superior outcomes with conventional full-course fractionated radiation therapy (FRT). A multi-institutional retrospective study was performed, including dogs with PM treated from 2016 to 2022 with SRT (total dose 30 or 35 Gy in 5 daily fractions) or FRT (total dose 50-54 Gy in 19-20 daily fractions). The influence of potential prognostic/predictive factors was assessed, including pituitary: brain height, pituitary: brain volume, sex, age and endocrine status (functional [F] vs. nonfunctional [NF] PM). Forty-four dogs with PM were included (26 F, 14 NF, 4 unknown). All patients completed protocols as scheduled (SRT = 27, FRT = 17) and two dogs had suspected Grade 1 acute neurotoxicity. During the first 6 months after RT, 5/27 (19%) dogs treated with SRT (4 F, 1 NF) and 3/17 (18%) dogs treated with FRT (all F) died or were euthanised because of progressive neurologic signs. The overall median survival time was 608 days (95% CI, 375-840 days). Young age at the time of treatment was significant for survival (p = 0.0288); the overall median survival time was 753 days for dogs <9 years of age (95% CI, 614-892 days) and 445 days for dogs ≥9 years of age (95% CI, 183-707 days). Survival time was not associated with treatment type or any other factor assessed herein. A prospective study using standardised protocols would further validate the results of the present study and potentially elucidate the predictors of early death.
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Enfermedades de los Perros , Fraccionamiento de la Dosis de Radiación , Neoplasias Hipofisarias , Radiocirugia , Animales , Perros , Enfermedades de los Perros/radioterapia , Estudios Retrospectivos , Masculino , Femenino , Neoplasias Hipofisarias/veterinaria , Neoplasias Hipofisarias/radioterapia , Radiocirugia/veterinaria , Radiocirugia/métodos , Resultado del TratamientoRESUMEN
Fidelity between teaching activities and assessment methods is an important goal of knowledge and performance evaluations in medical education. Ideally, assessment methods provide evidence of learning that reflects the types of knowledge described in the learning objectives of the course. The most reliable assessments involve the same or similar tasks as those used during the instructional components of the course. Our preclinical human anatomy course includes, in addition to traditional lecture and cadaver-based laboratory learning activities, a series of applied human anatomy learning activities intended to emphasize human anatomy as it is encountered in living human individuals. The learning activities involve psychomotor behaviors including inspection, palpation, and auscultation, techniques used in the physical examination, as well as other activities designed to emphasize anatomical structures and tissues as they may be found in patient populations. We describe here our method for measuring student success in learning human anatomy in this manner, highlighting the direct linkage between the learning activities and the assessment tasks. We describe our performance scoring method and how we include this data in the calculation of an anatomy examination grade. As an indicator of our success with this approach, we include performance scores for the applied anatomy questions included on the laboratory component of our unit examinations for two successive academic years. We conclude with summary comments from students regarding the applied anatomy learning activities and assessment approach and offer suggestions for addressing specific challenges associated with the use of these types of assessment methods.
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Anatomía , Educación de Pregrado en Medicina , Evaluación Educacional , Anatomía/educación , Humanos , Evaluación Educacional/métodos , Evaluación Educacional/estadística & datos numéricos , Educación de Pregrado en Medicina/métodos , Estudiantes de Medicina/psicología , Estudiantes de Medicina/estadística & datos numéricos , Curriculum , Cadáver , AprendizajeRESUMEN
Thin films of Al as interconnect materials and those of AlN as wide bandgap semiconductor and piezoelectric material are of great interest for microelectronic applications. For the fabrication of these thin films via chemical vapor deposition (CVD) based routes, the available precursor library is rather limited, mostly comprising aluminium alkyls, chlorides, and few small amine-stabilized aluminium hydrides. Herein, we focused on rational precursor development for Al, their characterization and comparison to existing precursors comprising stabilized aluminium hydrides. We present and compare a series of potentially new and reported aluminium hydride precursors divided into three main groups with respect to their stabilization motive, and their systematic structural variation to evaluate the physicochemical properties. All compounds were comprehensively characterized by means of nuclear magnetic resonance spectroscopy (NMR), Fourier-transform infrared spectroscopy (FTIR), elemental analysis (EA), electron-impact ionization mass spectrometry (EI-MS) and thermogravimetric analysis (TGA). Promising representatives were further evaluated as potential single source precursors for aluminium metal formation in proof-of-concept experiments. Structure and reaction enthalpies with NH3 or H2 as co-reactants were calculated via first principles density functional theory simulations and show the great potential as atomic layer deposition (ALD) precursors for Al and AlN thin films.
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With a focus on Mn based organometallic compounds with suitable physico-chemical properties to serve as precursors for chemical vapor deposition (CVD) and atomic layer deposition (ALD) of Mn-containing materials, systematic synthetic approaches with ligand variation, detailed characterization, and theoretical input from density functional theory (DFT) studies are presented. A series of new homoleptic all-nitrogen and mixed oxygen/nitrogen-coordinated Mn(II) complexes bearing the acetamidinate, formamidinate, guanidinate and ß-ketoiminate ligands have been successfully synthesized for the first time. The specific choice of these ligand classes with changes in structure and coordination sphere and side chain variations result in significant structural differences whereby mononuclear and dinuclear complexes are formed. This was supported by density functional theory (DFT) studies. The compounds were thoroughly characterized by single crystal X-ray diffraction, magnetic measurements, mass spectrometry and elemental analysis. To evaluate their suitability as precursors for deposition of Mn-based materials, the thermal properties were investigated in detail. Mn(II) complexes possessing the most promising thermal properties, namely Bis(N,N'-ditertbutylformamidinato)manganese(II) (IV) and Bis(4-(isopropylamino)pent-3-en-2-onato)manganese(II) (ßIII) were used in reactivity studies with DFT to explore their interaction with oxidizing co-reactants such as oxygen and water which will guide future CVD and ALD process development.
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Surface enhanced Raman spectroscopy (SERS) is a powerful analytical technique that has found application in the trace detection of a wide range of contaminants. In this paper, we report on the fabrication of 2D silver nanodendrites, on silicon chips, synthesized by electrochemical reduction of AgNO3at microelectrodes. The formation of nanodendrites is tentatively explained in terms of electromigration and diffusion of silver ions. Electrochemical characterization suggests that the nanodendrites do not stay electrically connected to the microelectrode. The substrates show SERS activity with an enhancement factor on the order of 106. Density functional theory simulations were carried out to investigate the suitability of the fabricated substrate for pesticide monitoring. These substrates can be functionalized with cyclodextrin macro molecules to help with the detection of molecules with low affinity with silver surfaces. A proof of concept is demonstrated with the detection of the herbicide 2-methyl-4-chlorophenoxyacetic acid (MCPA).
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OBJECTIVES: In this study, the aim was to investigate the medium- to long-term impact of peri-implantitis treatment upon clinical parameters and implant stability quotient values and to ascertain if magnetic resonance frequency analysis can be used as a diagnostic tool to demonstrate postoperative healing following treatment of peri-implantitis. MATERIALS AND METHODS: A total of n = 26 patients (n = 86 implants) diagnosed with peri-implantitis were recruited for this prospective cohort study and four different treatment modalities were used. Baseline measurements of a number of clinical parameters as well as implant stability measurements in the form of ISQ were recorded. These measurements were repeated at 6, 12, and 24-36 months following treatment. Analysis of variance was performed for all implants treated as well as separately for each treatment modality. A regression model was also used to determine factors affecting ISQ measurements over time. RESULTS: Treatment of peri-implantitis resulted in significant improvements of both average PPDs and BOP (p < .0001 and p < .01). ISQ values marginally improved initially for all treatment modalities, but improvement was only maintained for 2-3 years in treatment modalities I (+1.28), III (+1.49), and IV (+2.92). There was a statistically significant negative linear correlation between average PPD and the ISQ values recorded both at baseline (r = -.618, p < 0.0001) and at 2/3 years (r = -.604, p < 0.0001). CONCLUSION: Over the 2-3-year follow-up period, all four treatment modalities led to improved clinical and radiographic peri-implant parameters but implant stability posttreatment, as indicated by the fact that the recorded ISQ scores remained stable. As a result, use of MRFA as an adjunct to the traditionally used periodontal and radiographic tools for the evaluation of postoperative implant stability following the treatment of peri-implant disease cannot be recommended.
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Implantes Dentales , Periimplantitis , Humanos , Periimplantitis/diagnóstico , Periimplantitis/cirugía , Implantes Dentales/efectos adversos , Estudios de Seguimiento , Estudios ProspectivosRESUMEN
Stereotactic radiotherapy (SRT) involves the precise delivery of highly conformal, dose-intense radiation to well-demarcated tumors. Special equipment and expertise are needed, and a unique biological mechanism distinguishes SRT from other forms of external beam radiotherapy. Families find the convenient schedules and minimal acute toxicity of SRT appealing. Common indications in veterinary oncology include nasal, brain, and bone tumors. Many other solid tumors can also be treated, including spinal, oral, lung, heart-base, liver, adrenal, and prostatic malignancies. Accessibility of SRT is improving, and new data are constantly emerging to define parameters for appropriate case selection, radiation dose prescription, and long-term follow-up.
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Neoplasias Encefálicas , Neoplasias , Oncología por Radiación , Radiocirugia , Animales , Radiocirugia/veterinaria , Neoplasias/radioterapia , Neoplasias/veterinaria , Neoplasias Encefálicas/veterinariaRESUMEN
The Nod-like Receptor (NLR) apoptosis inhibitory proteins (NAIPs) are cytosolic receptors that sense cytosolic bacterial proteins. NAIP ligation induces its association with NLRC4, leading to the assembly of the NAIP/NLRC4 inflammasome, which induces the activation of the caspase-1 protease. Caspase-1 then cleaves pro-interleukin (IL)-1ß, pro-IL-18, and gasdermin D and induces a form of pro-inflammatory cell death, pyroptosis. These processes culminate in host defense against bacterial infection. Here we describe methods for activating NAIP/NLRC4 inflammasome signalling in human and murine macrophages and quantifying inflammasome-induced cell death.
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Proteínas de Unión al Calcio , Inflamasomas , Animales , Ratones , Humanos , Inflamasomas/metabolismo , Proteínas de Unión al Calcio/metabolismo , Proteínas Reguladoras de la Apoptosis/metabolismo , Muerte Celular , Caspasas/metabolismo , Caspasa 1/metabolismo , Proteínas Adaptadoras de Señalización CARD/metabolismoRESUMEN
Hexagonal boron nitride (h-BN) is a well-known layered van der Waals (vdW) material that exhibits no spontaneous electric polarization due to its centrosymmetric structure. Extensive density functional theory (DFT) calculations are used to demonstrate that doping through the substitution of B by isovalent Al and Ga breaks the inversion symmetry and induces local dipole moments along the c-axis, which promotes a ferroelectric (FE) alignment over antiferroelectric. For doping concentrations below 25%, a "protruded layered" structure in which the dopant atoms protrude out of the planar h-BN layers is energetically more stable than the flat layered structure of pristine h-BN or a wurtzite structure similar to w-AlN. The computed polarization, between 7.227 and 21.117 µC/cm2, depending on dopant concentration and the switching barrier (16.684 and 45.838 meV/atom) for the FE polarization reversal are comparable to that of other well-known FEs. Interestingly, doping of h-BN also induces a large negative piezoelectric response in otherwise nonpiezoelectric h-BN. For example, we compute d33 of -24.214 pC/N for Ga0.125B0.875N, which is about 5 times larger than that of pure w-AlN (5 pC/N), although the computed e33 (-1.164 C/m2) is about 1.6 times lower than that of pure w-AlN (1.462 C/m2). Because of the layered structure, the rather small elastic constant C33 provides the origin of the large d33. Moreover, doping makes h-BN an electric auxetic piezoelectric. We also show that ferroelectricity in doped h-BN may persist down to its trilayer, which indicates high potential for applications in FE nonvolatile memories.
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Metal oxide semiconductors constitute a vast group of materials whose physical properties are greatly affected by native defects. For decades, x-ray photoelectron spectroscopy (XPS) has been widely used in defect analysis. However, correct interpretation of XPS results remains a difficult task. In this work, we present a detailed first-principles study on the core-level shift of the most stable and commonly cited crystal imperfections in ZnO, including O and -OH species at the surface with different coverages and bulk defects, including O interstitial (Oi), O vacancy in the +2 charge state (Vo2+), and the neutral vacancy (Vo0). The O1s core level spectrum is simulated and compared with experiments to understand the correlation between local atomic structures and features in the O1s spectrum. In particular, our results indicate that the widely adopted assignment in the defect analysis of ZnO, which links the defect peak in XPS to Vo, the most stable defect, is very likely a misinterpretation. Theoretical analysis indicates that there are no distinguishable XPS features arising from the Vo defect. Furthermore, we show that the commonly observed defect-related peak instead arises due to Oi or specific surface configurations. Given the importance of native defects in materials performance, misinterpretation of XPS results may lead to erroneous conclusions regarding materials properties. This work provides a first-principles basis for the analysis of oxide defects through XPS.
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Early transition metals ruthenium (Ru) and cobalt (Co) are of high interest as replacements for Cu in next-generation interconnects. Plasma-enhanced atomic layer deposition (PE-ALD) is used to deposit metal thin films in high-aspect-ratio structures of vias and trenches in nanoelectronic devices. At the initial stage of deposition, the surface reactions between the precursors and the starting substrate are vital to understand the nucleation of the film and optimize the deposition process by minimizing the so-called nucleation delay in which film growth is only observed after tens to hundreds of ALD cycles. The reported nucleation delay of Ru ranges from 10 ALD cycles to 500 ALD cycles, and the growth-per-cycle (GPC) varies from report to report. No systematic studies on nucleation delay of Co PE-ALD are found in the literature. In this study, we use first principles density functional theory (DFT) simulations to investigate the reactions between precursors RuCp2 and CoCp2 with Si substrates that have different surface terminations to reveal the atomic-scale reaction mechanism at the initial stages of metal nucleation. The substrates include (1) H:Si(100), (2) NHx-terminated Si(100), and (3) H:SiNx/Si(100). The ligand exchange reaction via H transfer to form CpH on H:Si(100), NHx-terminated Si(100), and H:SiNx/Si(100) surfaces is simulated and shows that pretreatment with N2/H2 plasma to yield an NHx-terminated Si surface from H:Si(100) can promote the ligand exchange reaction to eliminate the Cp ligand for CoCp2. Our DFT results show that the surface reactivity of CoCp2 is highly dependent on substrate surface terminations, which explains why the reported nucleation delay and GPC vary from report to report. This difference in reactivity at different surface terminations may be useful for selective deposition. For Ru deposition, RuCp2 is not a useful precursor, showing highly endothermic ligand elimination reactions on all studied terminations.
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To counteract excessive effort due to relative income comparison among identical agents, the literature suggests a tax response equal to the negative externality. Assuming a general income distribution, we show that an optimal tax must be higher under a general social welfare function, to not only reduce inefficiency but also inequality. We recommend a practical tax response to stronger comparison - to hold employment constant, which does not require unrealistic information including unobservable comparison. Surprisingly, the tax response will dominate the comparison effect and reduce labour supply or reverse "keeping up with the Joneses" on intensive margins, and also reverse the otherwise rising inequality. Supplementary Information: The online version contains supplementary material available at 10.1007/s00712-023-00821-2.
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Introduction: Patients developing acute radiotherapy induced dermatitis or oral mucositis commonly experience pain. When severe, this radiotherapy-associated pain (RAP) can necessitate treatment breaks; unfortunately, in a variety of cancers, prolongation of the radiotherapy course has been associated with early cancer relapse and/or death. This is often attributed to accelerated repopulation, but it is unknown whether pain or pain signaling constituents might alter tumor behavior and hasten metastatic disease progression. We studied this by testing the hypothesis that severe acute RAP at one site can hasten tumor growth at a distant site. Methods: Mice underwent single fraction tongue irradiation (27 Gy, or 0 Gy "sham" control) to induce severe glossitis. At the time of maximal oral RAP, one of three luciferase-transfected tumor cell lines were injected via tail vein (4T1, B16F10, MOC2; each paired to their syngeneic host: BALB/c or C57BL/6); tumor burden was assessed via in vivo transthoracic bioluminescence imaging and ex vivo pulmonary nodule quantification. Survival was compared using Kaplan-Meier statistics. Results: Tongue irradiation and resultant RAP promoted lung tumor growth of 4T1-Luc2 cells in BALB/c mice. This effect was not a result of off-target radiation, nor an artefact of environmental stress caused by standard (subthermoneutral) housing temperatures. RAP did not affect the growth of B16F10-Luc2 cells, however, C57BL/6 mice undergoing tail vein injection of MOC2-Luc2 cells at the time of maximal RAP experienced early lung tumor-attributable death. Lung tumor growth was normalized when RAP was reduced by treatment with resiniferatoxin (300 µg/kg, subcutaneously, once). Discussion: This research points towards radiation-induced activation of capsaicin-responsive (TRPV1) neurons as the cause for accelerated growth of tumors at distant (unirradiated) sites.
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Student success in basic medical science courses is typically determined by their individual performance on examinations of various types. Previous research both within and outside medical education has shown that the use of educational assessment activities can increase learning as demonstrated by performance on subsequent examinations, a phenomenon known as the testing effect. Activities primarily designed and used for assessment and evaluation purposes can also be used as teaching opportunities. We developed a method for measuring and evaluating student accomplishment in a preclinical basic science course that incorporates both individual and collaborative efforts, encourages and rewards active participation, does not compromise the reliability of the assessment outcome and is perceived by the students as helpful and valuable. The approach involved a two-part assessment activity composed of an individual examination and a small group examination with each component differentially weighted in determining an overall examination score. We found that the method was successful in encouraging collaborative efforts during the group component and provided valid measures of student grasp of the subject matter. We describe the development and implementation of the method, provide data derived from its use in a preclinical basic science course and discuss factors to be addressed when utilizing this approach to ensure fairness and reliability of the outcome. We include brief summary comments from students regarding their impressions of the value of this method.
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Educación Médica , Evaluación Educacional , Humanos , Reproducibilidad de los Resultados , Evaluación Educacional/métodos , Aprendizaje , CurriculumRESUMEN
BACKGROUND: Pituitary apoplexy refers to hemorrhage or infarction within the pituitary gland resulting in acute neurological abnormalities. This condition is poorly described in dogs. OBJECTIVES: To document presenting complaints, examination findings, endocrinopathies, magnetic resonance imaging (MRI), treatments, and outcomes of dogs with pituitary apoplexy. ANIMALS: Twenty-six client-owned dogs with acute onset of neurological dysfunction. METHODS: Retrospective case series. Dogs were diagnosed with pituitary apoplexy if MRI or histopathology documented an intrasellar or suprasellar mass with evidence of hemorrhage or infarction in conjunction with acute neurological dysfunction. Clinical information was obtained from medical records and imaging reports. RESULTS: Common presenting complaints included altered mentation (16/26, 62%) and gastrointestinal dysfunction (14/26, 54%). Gait or posture changes (22/26, 85%), mentation changes (18/26, 69%), cranial neuropathies (17/26, 65%), cervical or head hyperpathia (12/26, 46%), and hyperthermia (8/26, 31%) were the most frequent exam findings. Ten dogs (38%) lacked evidence of an endocrinopathy before presentation. Common MRI findings included T1-weighted hypo- to isointensity of the hemorrhagic lesion (21/25, 84%), peripheral enhancement of the pituitary mass lesion (15/25, 60%), brain herniation (14/25, 56%), and obstructive hydrocephalus (13/25, 52%). Fifteen dogs (58%) survived to hospital discharge. Seven of these dogs received medical management alone (median survival 143 days; range, 7-641 days) and 8 received medications and radiation therapy (median survival 973 days; range, 41-1719 days). CONCLUSIONS AND CLINICAL IMPORTANCE: Dogs with pituitary apoplexy present with a variety of acute signs of neurological disease and inconsistent endocrine dysfunction. Dogs that survive to discharge can have a favorable outcome.
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Enfermedades de los Perros , Hidrocefalia , Apoplejia Hipofisaria , Neoplasias Hipofisarias , Perros , Animales , Apoplejia Hipofisaria/terapia , Apoplejia Hipofisaria/veterinaria , Apoplejia Hipofisaria/diagnóstico , Neoplasias Hipofisarias/complicaciones , Neoplasias Hipofisarias/diagnóstico por imagen , Neoplasias Hipofisarias/terapia , Neoplasias Hipofisarias/veterinaria , Estudios Retrospectivos , Hidrocefalia/veterinaria , Infarto/veterinaria , Imagen por Resonancia Magnética/veterinaria , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/terapiaRESUMEN
The horseshoe kidney (HSK) is the most common congenital abnormality of the upper urinary tract with an incidence of approximately 1 in 500 in the general population. Although individuals with HSK are often asymptomatic, they are at increased risk for neoplasms, infections, ureteropelvic obstruction secondary to lithiasis or vascular compression. Direct injury from trauma is increased in these individuals as is the risk of intraoperative complications secondary to damage involving the typically complex renal or adrenal vascular supply. We briefly review etiological factors including renal and urinary system embryology, genetic mutations, abnormalities related to faulty cell signaling, aberrant cell migration, and other possible causes including environmental exposures and trauma. In addition, we call attention to factors that might influence the success of surgical procedures in patients with HSK. We argue that an understanding of possible etiologies of the HSK and its different subtypes may be useful when planning surgical procedures or considering risk-benefit ratios associated with different surgical options. We briefly present the organization of a HSK in a 100-year-old male demonstrating an unusual vascular supply discovered during a dissection laboratory session in a medical school anatomy course. We describe the structure of the HSK, the position and relationships of the HSK to other structures within the abdomen, and the associated vascular relationships.