The autologous chondral platelet-rich plasma matrix implantation. A new therapy in cartilage repair and regeneration: macroscopic and biomechanical study in an experimental sheep model.

Introduction: Articular cartilage injuries are a severe problem, and the treatments for these injuries are complex. The present study investigates a treatment for full-thickness cartilage defects called Autologous Chondral Platelet Rich Plasma Matrix Implantation (PACI) in a sheep model. Methods: Chondral defects 8 mm in diameter were surgically induced in the medial femoral condyles of both stifles in eight healthy sheep. Right stifles were treated with PACI and an intraarticular injection with a plasma rich in growth factors (PRGF) solution [treatment group (TRT)], while an intraarticular injection of Ringer's lactate solution was administered in left stifles [Control group (CT)]. The limbs' function was objectively assessed with a force platform to obtain the symmetry index, comparing both groups. After 9 and 18 months, the lesions were macroscopically evaluated using the International Cartilage Repair Society and Goebel scales. Results: Regarding the symmetry index, the TRT group obtained results similar to those of healthy limbs at 9 and 18 months after treatment. Regarding the macroscopic assessment, the values obtained by the TRT group were very close to those of normal cartilage and superior to those obtained by the CT group at 9 months. Conclusion: This new bioregenerative treatment modality can regenerate hyaline articular cartilage. High functional outcomes have been reported, together with a good quality repair tissue in sheep. Therefore, PACI treatment might be a good therapeutic option for full-thickness chondral lesions.

Evaluation of Paraspinal Musculature in Small Breed Dogs with and without Atlantoaxial Instability Using Computed Tomography.

OBJECTIVE: The aim of this study was to evaluate differences in paraspinal musculature between dogs with and without atlantoaxial instability (AAI) using computed tomography scans. STUDY DESIGN: Retrospective multicentre study evaluating transverse reconstructed computed tomography scans of 83 small breed dogs (34 with and 49 without AAI) for the cross-sectional paraspinal musculature area at three levels (Occiput/C1, mid-C1, mid-C2). Ratio of moments, dorsal-to-ventral muscle-area ratios (d-v-ratio) and ratios of the dorsal and ventral musculature to C2 height (d-C2-ratio and v-C2-ratio) were evaluated for differences between groups using multivariate analysis of variance (p < 0.05) taking the head-neck position into account. RESULTS: Dogs with AAI showed a significantly lower d-v-ratio at levels 2 and 3, d-C2-ratio at level 2 and ratio of moments at all levels. When head-neck positions were analysed separately, ratio of moments was significantly lower in affected dogs at level 1 and 2. Also lower was d-C2-ratio at level 2, but only in flexed positioning. The head-neck position had a significant influence on ratio of moments and d-v-ratio at all three levels and on d-C2-ratio at level 1. CONCLUSION: Significant changes in muscle area were observed only for the hypaxial muscles at the C1 level, indicating a limited role of muscular adaption in AAI patients. Our results confirm an altered ratio of moments in dogs with AAI. The head-neck position has a significant impact and should be taken into account when evaluating spinal musculature.

Changes in Hematological and Biochemical Profiles in Ovariohysterectomized Bitches Using an Alfaxalone-Midazolam-Morphine-Sevoflurane Protocol.

The aim of this study was to monitor hematochemical changes during and after OHE in bitches. Twenty-four females were anesthetized with alfaxalone, midazolam, morphine and sevoflurane. Blood samples were taken before anesthesia (T0), at 30 (T1), and 60 min (T2), at 3 (T3), 6 (T4), 12 (T5), and 24 h (T6), and at 3 (T7) and 7 days (T8) from the start of surgery. Red blood cells (RBC) and packed cell volume (PCV) decreased significantly from T1 to T5 and hemoglobin (HB) concentration from T4 to T6. Both the white blood cell (WBC) and neutrophil (NFS) count increased significantly from T3 to T6, monocyte (MON) from T2 to T5, and eosinophil (EOS) at T5. Platelet (PLT) and plateletcrit (PCT) significantly decreased at T5 and increased from T6 to T8; platelet distribution width (PDW) increased significantly from T3 to T6. Creatine kinase (CK) activity increased significantly from T5 to T7. Glucose (GLU) concentrations increased significantly at T2 and P from T2 to T3. TG levels decreased from T2 to T4 and blood urea nitrogen (BUN) levels from T1 to T7, subsequently increasing until T8. Changes possibly resulting from stress and surgical trauma, as well as hemodilution and splenic storage, are due to anesthesia and surgery. In healthy bitches, these changes tend to gradually stabilize after the ending of OHE. A post-operative follow-up is essential to detect possible post-operative complications.

Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small-breed dogs.

OBJECTIVE: To determine cutoff values for the diagnosis of atlantoaxial instability (AAI) based on cross-sectional imaging in small-breed dogs. STUDY DESIGN: Retrospective multicenter study. SAMPLE POPULATION: Client-owned dogs (n = 123) and 28 cadavers. METHODS: Dogs were assigned to three groups: a control group, a "potentially unstable" group, and an AAI-affected group, according to imaging findings and clinical signs. The ventral compression index (VCI), cranial translation ratio (CTR), C1-C2 overlap, C1-C2 angle, atlantoaxial distance, basion-dens interval, dens-to-axis length ratio (DALR), power ratio, and clivus canal angles were measured on CT or T2-weighted magnetic resonance (MR) images. Receiver operating characteristic (ROC) analysis was performed to define cutoff values in flexed (≥25°) and extended (<25°) head positions. RESULTS: Cutoff values for the VCI of ≥0.16 in extended and ≥0.2 in flexed head positions were diagnostic for AAI (sensitivity of 100% and 100%, specificity of 94.54% and 96.67%, respectively). Cutoff values for the other measurements were defined with a lower sensitivity (75%-96%) and specificity (70%-97%). A combination of the measurements did not increase the sensitivity and specificity compared with the VCI as single measurement. CONCLUSION: Cutoff values for several imaging measurements were established with good sensitivity and specificity. The VCI, defined as the ratio between the ventral and dorsal atlantodental interval, had the highest sensitivity and specificity in both head positions. CLINICAL SIGNIFICANCE: The use of defined cutoff values allows an objective diagnosis of AAI in small-breed dogs. The decision for surgical intervention, however, should remain based on a combination of clinical and imaging findings.

Platelet-Rich Plasma for the Treatment of Degenerative Lumbosacral Stenosis: A Study with Retired Working Dogs.

Traditionally, canine degenerative lumbosacral stenosis (DLS) has been defined as a multifactorial syndrome characterized by lumbosacral pain triggered by the compression of the nerve rootlets of the cauda equina. There is still no consensus on the treatment of this condition, probably because there are a plethora of possible causes. In addition to compression, inflammation is a very important factor in the physiopathology of the disorder. Platelet-rich plasma (PRP) consists of an increased concentration of autologous platelets suspended in a small amount of plasma. Platelets are a source of several growth factors. Growth factors were shown to help in wound healing and biological processes, such as chemotaxis, neovascularization and synthesis of extracellular matrix, and growth factors were used to improve soft tissue healing and bone regeneration. PRP also facilitates the restoration of the structural integrity of the affected anatomy. Fourteen dogs diagnosed with DLS were treated with three epidural injections of PRP on days 0, 15 and 45. All dogs showed clinical improvement 3 months after the initial treatment. Gait was also objectively assessed by means of the use of force platform analysis before and after treatment, showing significant improvement. The results show that PRP may provide a good alternative to other nonsurgical treatments, such as prednisolone epidural injection.

Predictors for early readmission in patients hospitalized with new onset pediatric lupus nephritis.

OBJECTIVE: The objective is to determine the 30-day hospital readmission rate following a hospitalization due to pediatric lupus nephritis of recent onset and characterize the risk factors associated with these early readmissions. METHODS: The study included 76 children hospitalized from 01/01/2008 to 4/30/2017 due to a new diagnosis of lupus nephritis. We calculated the 30-day hospital readmission rate and compared the characteristics of the patients that were readmitted to patients that were not readmitted using univariable and multivariable analysis. RESULTS: The 30-day readmission rate was 17.1%. Factors that predicted hospital readmission in unavailable analysis were male gender (38.5 vs 14.3%, p = 0.04), not receiving pulse steroids (30.8 vs 3.2%, p = < .001), receiving diuretic treatment (69.2 vs 34.9%, p = .02), receiving albumin infusions (46.2 vs 12.7%, p = .004), stage 2 hypertension on day one of admission (76.9 vs 41.3%, p = .02), a higher white blood cell count on discharge (13.7 × 103/mm3 vs 8.8 × 103/mm3, p = .023), need for non-angiotensin converting enzyme (ACE) antihypertensive drugs (76.9 vs 46%, p = .042), and being discharged on nonsteroidal anti-inflammatory drugs (NSAIDs) (23.1 vs 4.8%, p = .025). Multivariable analysis demonstrated an increased risk of readmission for patients not treated with intravenous pulse methylprednisolone (IVMP) (OR = 17.5 (1.81-168.32) p = .013), and for those who required intravenous albumin assisted diuresis for hypervolemia (OR=6.25 (1.29-30.30) p = .022). CONCLUSION: In all, 17% of children hospitalized due to new onset lupus nephritis were readmitted within 30 days of discharge. Absence of IVMP and receiving intravenous albumin assisted diuresis during initial hospitalization increase the risk of early readmission in new onset pediatric lupus nephritis.

Multi-System Inflammatory Syndrome in Children (MIS-C) Following SARS-CoV-2 Infection: Review of Clinical Presentation, Hypothetical Pathogenesis, and Proposed Management.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may result in the multisystem inflammatory syndrome in children (MIS-C). The clinical presentation of MIS-C includes fever, severe illness, and the involvement of two or more organ systems, in combination with laboratory evidence of inflammation and laboratory or epidemiologic evidence of SARS-CoV-2 infection. Some features of MIS-C resemble Kawasaki Disease, toxic shock syndrome, and secondary hemophagocytic lymphohistiocytosis/macrophage activation syndrome. The relationship of MIS-C to SARS-CoV-2 infection suggests that the pathogenesis involves post-infectious immune dysregulation. Patients with MIS-C should ideally be managed in a pediatric intensive care environment since rapid clinical deterioration may occur. Specific immunomodulatory therapy depends on the clinical presentation. The relationship between the immune response to SARS-CoV-2 vaccines in development and MIS-C requires further study.

Craniovertebral Junction Anomalies in Small Breed Dogs with Atlantoaxial Instability: A Multicentre Case-Control Study.

OBJECTIVE: The main purpose of this study was to define criteria to systemically describe craniovertebral junction (CVJ) anomalies and to report the prevalence of CVJ anomalies in small breed dogs with and without atlantoaxial instability (AAI). MATERIALS AND METHODS: Retrospective multicentre matched case-control study evaluating magnetic resonance imaging and computed tomographic images of small breed dogs with and without AAI for the presence of CVJ anomalies. RESULTS: One hundred and twenty-two dogs were enrolled (61 with and 61 without AAI). Only dogs with AAI had dens axis anomalies such as separation (n = 20) or a short-rounded conformation (n = 35). Patients with AAI were more likely to have atlantooccipital overlapping based on transection of McRae's line by the dorsal arch of the atlas (odds ratio [OR] = 5.62, p < 0.01), a transection of Wackenheim's clivus line (OR = 41.62, p < 0.01) and rostral indentation of the occipital bone (OR = 2.79, p < 0.05). Patients with AAI were less likely to have a larger clivus canal angle (OR = 0.94, p < 0.01) and larger occipital bone lengths (OR = 0.89, p < 0.05). CLINICAL SIGNIFICANCE: Small breed dogs with AAI are more likely to have other CVJ anomalies such as atlantooccipital overlapping or dens anomalies. The grade of brachycephaly does not differ between patients with and without AAI. Certain objective criteria from human literature were found useful for the assessment of both AAI and atlantooccipital overlapping such as McRae's line, Wackenheim's clivus line, and clivus canal angle. The classification criteria used can help to evaluate CVJ anomalies in a more systematic way.

Small copepods could channel missing carbon through metazoan predation.

Global ecosystem models are essential tools for predicting climate change impacts on marine systems. Modeled biogenic carbon fluxes in the ocean often match measured data poorly and part of this could be because small copepods (<2 mm) are modeled as unicellular feeders grazing on phytoplankton and microzooplankton. The most abundant copepods from a seasonal upwelling region of the Eastern North Atlantic were sorted, and a molecular method was applied to copepod gut contents to evaluate the extent of metazoan predation under two oceanographic conditions, a trophic pathway not accounted for in global models. Scaling up the results obtained herein, based on published field and laboratory estimates, suggests that small copepods could ingest 1.79-27.20 gigatons C/year globally. This ignored metazoan-copepod link could increase current estimates of biogeochemical fluxes (remineralization, respiration, and the biological pump) and export to higher trophic levels by 15.6%-24.4%. It could also account for global discrepancies between measured daily ingestion and copepod metabolic demand/growth. The inclusion of metazoan predation into global models could provide a more realistic role of the copepods in the ocean and if these preliminary data hold true at larger sample sizes and scales, the implications would be substantial at the global scale.

Retos éticos que plantea el uso de la inteligencia artificial en el diagnóstico y tratamiento clínico / Ethical challenges posed by the use of Artificial Intelligence in the diagnosis and clinical treatment

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New Data on the Systematics of Comb-fin Squids Chtenopteryx spp. (Cephalopoda: Chtenopterygidae) from the Canary Islands.

Alejandro Escánez, Álvaro Roura, Rodrigo Riera, Ángel Francisco González, and Ángel Guerra (2018) The systematics of the comb-fin squid species is problematic and poorly resolved. In total, 53 specimens of comb-fin squids (Chtenopteryx spp.) were caught at depths ranging from 30 to 800 m off the Canary Islands (NE Atlantic Ocean). Mantle lengths of the individuals ranged from 18 to 43 mm and the sample included immature, mature male and mature female specimens. Two species of comb-fin squids, Chtenopteryx canariensis and C. sicula, were identified by combining traditional morphological characters with a molecular analysis of a fragment of the cytochrome c oxidase subunit I (COI) gene. Intra- and interspecific genetic distances and maximum likelihood tree analyses based on COI sequences available from GenBank suggest the existence of at least four species, two from the Pacific and two from the Atlantic Ocean. Our data expand the current geographic range of C. canariensis from the NE to NW Atlantic. In the GenBank database, several sequences of comb-fin squid in different species-specific clades have been attributed only to C. sicula, indicating the possible existence of cryptic species and the need to re-analyse these data.

Adenoma de células de Sertoli bilateral en paciente con síndrome de insensibilidad a los andrógenos / Bilateral Sertoli cell adenoma in a patient with androgen insensitivity syndrome

El síndrome de insensibilidad a los andrógenos se caracteriza por la presencia de fenotipo femenino, gónadas masculinas y cariotipo 46,XY. Es la causa más común de seudohermafroditismo masculino y la tercera causa más frecuente de amenorrea primaria, después de la disgenesia gonadal y la ausencia congénita de vagina. Es una entidad cuya importancia radica en su diagnóstico precoz en la pubertad por el riesgo de desarrollo de tumoraciones testiculares. En este artículo se presenta un caso de diagnóstico tardío de síndrome de insensibilidad a los andrógenos asociado a adenoma de células de Sertoli (AU)

Androgen insensitivity syndrome is characterized by the presence of a female phenotype, masculine gonads, and 46,XY karyotype. This syndrome is the most common cause of masculine pseudohermaphroditism and is the third most frequent cause of primary amenorrhea after gonadal dysgenesis and congenital absence of the vagina. The importance of this entity lies in its early diagnosis in puberty because of the risk of testicular tumors. In this article, we present a case of late diagnosis of androgen insensitivity syndrome related to Sertoli cell adenoma (AU)

Cannibalistic behavior of octopus (Octopus vulgaris) in the wild.

The first description of cannibalism in wild adult Octopus vulgaris is presented from 3 observations made in the Ría de Vigo (NW Spain), which were filmed by scuba divers. These records document common traits in cannibalistic behavior: (a) it was intercohort cannibalism; (b) attacks were made by both males and females; (c) in 2 of the records, the prey were transported to the den, which was covered with stones of different sizes; (d) the predator started to eat the tip of the arms of its prey; (e) predation on conspecifics occurred even if there were other abundant prey available (i.e., mussels); and (f) the prey/predator weight ratio in the 3 cases ranged from 20% to 25% body weight. The relationships between this behavior and sex, defense of territory, energy balance, food shortage, competition and predation, as well as how the attacker kills its victim are discussed.

Transitions during cephalopod life history: the role of habitat, environment, functional morphology and behaviour.

Cephalopod life cycles generally share a set of stages that take place in different habitats and are adapted to specific, though variable, environmental conditions. Throughout the lifespan, individuals undertake a series of brief transitions from one stage to the next. Four transitions were identified: fertilisation of eggs to their release from the female (1), from eggs to paralarvae (2), from paralarvae to subadults (3) and from subadults to adults (4). An analysis of each transition identified that the changes can be radical (i.e. involving a range of morphological, physiological and behavioural phenomena and shifts in habitats) and critical (i.e. depending on environmental conditions essential for cohort survival). This analysis underlines that transitions from eggs to paralarvae (2) and from paralarvae to subadults (3) present major risk of mortality, while changes in the other transitions can have evolutionary significance. This synthesis suggests that more accurate evaluation of the sensitivity of cephalopod populations to environmental variation could be achieved by taking into account the ontogeny of the organisms. The comparison of most described species advocates for studies linking development and ecology in this particular group.

Mitochondrial genome diversity and population structure of the giant squid Architeuthis: genetics sheds new light on one of the most enigmatic marine species.

Despite its charismatic appeal to both scientists and the general public, remarkably little is known about the giant squid Architeuthis, one of the largest of the invertebrates. Although specimens of Architeuthis are becoming more readily available owing to the advancement of deep-sea fishing techniques, considerable controversy exists with regard to topics as varied as their taxonomy, biology and even behaviour. In this study, we have characterized the mitochondrial genome (mitogenome) diversity of 43 Architeuthis samples collected from across the range of the species, in order to use genetic information to provide new and otherwise difficult to obtain insights into the life of this animal. The results show no detectable phylogenetic structure at the mitochondrial level and, furthermore, that the level of nucleotide diversity is exceptionally low. These observations are consistent with the hypotheses that there is only one global species of giant squid, Architeuthis dux (Steenstrup, 1857), and that it is highly vagile, possibly dispersing through both a drifting paralarval stage and migration of larger individuals. Demographic history analyses of the genetic data suggest that there has been a recent population expansion or selective sweep, which may explain the low level of genetic diversity.

Laboratory-Confirmed Rotavirus Disease in Utah Children: Clinical and Economic Impact of Rotavirus Vaccination.

BACKGROUND: Rotavirus is the most common cause of infectious diarrhea in children worldwide. Recent studies have described changes in the burden of all-cause gastroenteritis; however, there are limited data on the clinical and economic impact of rotavirus vaccine on cases of laboratory-confirmed rotavirus disease. METHODS: We performed a retrospective study of laboratory-confirmed rotavirus disease from July 2003 through June 2010 at a children's hospital and a community hospital in Utah. Demographics and hospital costs for children <5 years with rotavirus symptoms and a positive rotavirus enzyme immunoassay test on a stool specimen were abstracted from electronic medical records. We compared the prevaccine period (2003-2007) with the postvaccine period (2008-2010). RESULTS: The overall incidence of rotavirus gastroenteritis declined in the postvaccine period, from 26.6 to 5.2 cases per 10 000 person-years for Salt Lake County residents. The largest decrease in the incidence of rotavirus gastroenteritis was among children <12 months (-87%; 95% confidence interval [CI], 79-93). Older children (12-23 months) also experienced significant decreases (-81%; 95% CI, 72-88), as did those 24-59 months (-61%; 95% CI, 51-71). In 2009, 3 years after rotavirus vaccine introduction, there was a 79% decrease in emergency department visits and a 78% decrease in hospitalizations across both hospitals. The cost of emergency department visits and hospitalizations for rotavirus gastroenteritis decreased by 79% and 72%, respectively, resulting in annual savings of $790 000 at a children's hospital and $140 000 at a community hospital. CONCLUSION: Rotavirus vaccination in infants has dramatically decreased the clinical burden and direct medical costs of rotavirus gastroenteritis in both infants and young children.