Analysis of body condition indices reveals different ecotypes of the Antillean manatee.

Assessing the body condition of wild animals is necessary to monitor the health of the population and is critical to defining a framework for conservation actions. Body condition indices (BCIs) are a non-invasive and relatively simple means to assess the health of individual animals, useful for addressing a wide variety of ecological, behavioral, and management questions. The Antillean manatee (Trichechus manatus manatus) is an endangered subspecies of the West Indian manatee, facing a wide variety of threats from mostly human-related origins. Our objective was to define specific BCIs for the subspecies that, coupled with additional health, genetic and demographic information, can be valuable to guide management decisions. Biometric measurements of 380 wild Antillean manatees captured in seven different locations within their range of distribution were obtained. From this information, we developed three BCIs (BCI1 = UG/SL, BCI2 = W/SL3, BCI3 = W/(SL*UG2)). Linear models and two-way ANCOVA tests showed significant differences of the BCIs among sexes and locations. Although our three BCIs are suitable for Antillean manatees, BCI1 is more practical as it does not require information about weight, which can be a metric logistically difficult to collect under particular circumstances. BCI1 was significantly different among environments, revealing that the phenotypic plasticity of the subspecies have originated at least two ecotypes-coastal marine and riverine-of Antillean manatees.

IgG4-specific responses in patients with Staphylococcus aureus bone infections are not predictive of postoperative complications.

The most prevalent pathogen in bone infections is Staphylococcus aureus; its incidence and severity are partially determined by host factors. Prior studies showed that anti-glucosaminidase (Gmd) antibodies are protective in animals, and 93.3 % of patients with culture-confirmed S. aureus osteomyelitis do not have anti-Gmd levels > 10 ng/mL in serum. Infection in patients with high anti-Gmd remains unexplained. Are anti-Gmd antibodies in osteomyelitis patients of the non-opsonising, non-complement-fixing IgG4 isotype? The relative amounts of IgG4 and total IgG against Gmd and 7 other S. aureus antigens: iron-surface determinants (Isd) IsdA, IsdB, and IsdH, amidase (Amd), α-haemolysin (Hla), chemotaxis inhibitory protein from S. aureus (CHIPS), and staphylococcal-complement inhibitor (SCIN) were determined in sera from healthy controls (Ctrl, n = 92), osteomyelitis patients whose surgical treatment resulted in infection control (IC, n = 95) or an adverse outcome (AD, n = 40), and post-mortem (PM, n = 7) blood samples from S. aureus septic-death patients. Anti-Gmd IgG4 levels were generally lower in infected patients compared to controls; however, levels among the infected were higher in AD than IC patients. Anti-IsdA, IsdB and IsdH IgG4 levels were increased in infected patients versus controls, and Jonckheere-Terpstra tests of levels revealed an increasing order of infection (Ctrl < IC < AD < PM) for anti-Isd IgG4 antibodies and a decreasing order of infection (Ctrl > IC > AD > PM) for anti-autolysin (Atl) IgG4 antibodies. Collectively, this does not support an immunosuppressive role of IgG4 in S. aureus osteomyelitis but is consistent with a paradigm of high anti-Isd and low anti-Atl responses in these patients.

Uso de cânula rígida com rosca e endoscópio flexível para videolaparoscopia de acesso único em equinos em estação / Use of threaded rigid cannula and flexible endoscope for single access video laparoscopy in standing horses

Com o objetivo de promover, por meio de acesso único e com o uso de endoscópio flexível, ampla exploração da cavidade peritoneal de equinos em estação, foi concebida uma cânula laparoscópica para dar sustentação ao endoscópio e possibilitar o acesso sob visualização. O procedimento foi realizado a partir da fossa paralombar. Após pequena incisão cutânea, o endoscópio foi inserido na cânula e os músculos e o peritônio foram divulsionados mediante rotação da cânula. Logo depois da perfuração do peritônio, foi realizada a exploração da cavidade e a identificação das estruturas. Em seguida à exploração do lado ipsilateral ao acesso, realizou-se a transposição do conjunto cânula/endoscópio ventralmente à porção caudal do cólon descendente, seguida de exploração do lado contralateral. Concluída a técnica, foi executado, para fins de comparação, o mesmo procedimento por meio da fossa paralombar contralateral. Foi possível a transposição do conjunto cânula/endoscópio para o lado contralateral ao acesso em todos os procedimentos. Também foi possível a identificação da maioria das estruturas abdominais tanto pelo acesso esquerdo quanto pelo direito. A abordagem por acesso único mostrou-se viável para a exploração ampla da cavidade peritoneal, demonstrando ser uma alternativa à técnica laparoscópica convencional.(AU)

A laparoscopic cannula was designed to support a single access approach with a flexible endoscope for the wide exploration of the peritoneal cavity of standing horses. It provides support to the endoscope and allows access to the peritoneal cavity with a visual aid. This procedure was performed through the paralumbar fossa. After a small cutaneous incision, the endoscope was inserted into the cannula, and the muscles and peritoneum were divulsed through the rotation of the cannula. After the peritoneal perforation, cavity exploration and identification of structures were performed. After the exploration of the ipsilateral side of the access, the cannula/endoscope was transposed ventrally to the caudal portion of the descending colon; this was followed by the exploration of the contralateral side. Once this process was completed, the same procedure was performed through the contralateral paralumbar fossa for comparison. It was possible to transpose the cannula/endoscope set to the contralateral access side in all procedures. Further, it was possible to identify most of the abdominal structures in both the left and right access. This single access approach proved to be feasible for the extensive exploration of the peritoneal cavity, thereby indicating it can be an alternative to the conventional laparoscopic technique.(AU)

Deriving a dose and regimen for anti-glucosaminidase antibody passive-immunisation for patients with Staphylococcus aureus osteomyelitis.

Staphylococcus aureus (S. aureus) osteomyelitis remains a major clinical problem. Anti-glucosaminidase (Gmd) antibodies (1C11) are efficacious in prophylactic and therapeutic murine models. Feasibility, safety and pharmacokinetics of 1C11 passive immunisation in sheep and endogenous anti-Gmd levels were quantified in osteomyelitis patients. 3 sheep received a 500 mg intravenous (i.v.) bolus of 1C11 and its levels in sera were determined by enzyme-linked immunosorbent assay (ELISA) over 52 d. A humanised anti-Gmd monoclonal antibody, made by grafting the antigen-binding fragment (Fab) portion of 1C11 onto the fragment crystallisable region (Fc) of human IgG1, was used to make a standard curve of mean fluorescent intensity versus concentration of anti-Gmd. Anti-Gmd serum levels were determined in 297 patients with culture-confirmed S. aureus osteomyelitis and 40 healthy controls. No complications or adverse events were associated with the sheep 1C11 i.v. infusion and the estimated circulating half-life of 1C11 was 23.7 d. Endogenous anti-Gmd antibody levels in sera of osteomyelitis patients ranged from < 1 ng/mL to 300 µg/mL, with a mean concentration of 21.7 µg/mL. The estimated circulating half-life of endogenous anti-Gmd antibodies in sera of 12 patients with cured osteomyelitis was 120.4 d. A clinically relevant administration of anti-Gmd (500 mg i.v. = 7 mg/kg/70 kg human) was safe in sheep. This dose was 8 times more than the endogenous anti-Gmd levels observed in osteomyelitis patients and was predicted to have a half-life of > 3 weeks. Anti-Gmd passive immunisation has potential to prevent and treat S. aureus osteomyelitis. Further clinical development is warranted.

Estenose ureteral após cistectomia radical associada à ureterostomia cutânea abdominal: relato de caso / Ureteral stricture after radical cystectomy and cutaneous abdominal ureterostomy: case report

O presente trabalho tem como objetivo relatar a realização de cistectomia total associada à ureterostomia abdominal, uma técnica ainda pouco descrita na veterinária, bem como descrever as complicações pós-operatórias observadas. Um canino da raça Akita, macho, 11 anos, castrado, foi atendido com histórico de prostração, hiporexia, disúria, hematúria e incontinência urinária havia aproximadamente 10 dias. No exame clínico, foi observada leve algia abdominal; demais parâmetros estavam dentro da normalidade. Os exames complementares de imagem revelaram presença de massa envolvendo grande parte da vesícula urinária. O paciente foi submetido à cirurgia de cistectomia total associada à implantação cutânea abdominal dos ureteres, e o exame histopatológico chegou ao diagnóstico de carcinoma de células de transicionais (CCT) infiltrativo não papilar. No pós-operatório, o paciente desenvolveu dermatite urêmica leve no local de inserção dos ureteres e estenose ureteral em região distal, de maneira que reintervenções cirúrgicas foram necessárias para a correção. Além disso, observaram-se pielonefrite e hidronefrose secundárias ao quadro obstrutivo. Devido às complicações pós-operatórias, a tutora optou pela eutanásia do cão. Dessa maneira, conclui-se que a estenose ureteral e a pielonefrite são possíveis complicações da técnica de cistectomia associada à implantação abdominal dos ureteres.(AU)

This study aims to report the technique of total cystectomy associated with abdominal ureterostomy, a technique -little described in veterinary medicine, as well as to describe the postoperative complications observed. A male Akita canine, 11 years old, castrated, was attended with a history of prostration, hyporexia, dysuria, hematuria, and urinary incontinence for approximately ten days. The clinical examination revealed mild abdominal pain and other parameters within the normal range. Complementary imaging studies revealed the presence of mass involving a large part of the urinary bladder. The patient underwent total cystectomy surgery associated with abdominal cutaneous implantation of the ureters and histopathological examination led to a diagnosis of non-papillary infiltrative transitional cell carcinoma. In the postoperative period, the patient developed mild uremic dermatitis at the insertion site of the ureters and ureteral stenosis in the distal region, so that surgical reinterventions were necessary for correction. In addition, pyelonephritis and hydronephrosis secondary to the obstructive condition were observed. Due to the postoperative complications, the tutor chose to euthanize the dog. Thus, it is concluded that ureteral stenosis and pyelonephritis are possible complications of the cystectomy technique associated with abdominal implantation of the ureters.(AU)

Transrectal endoscopy with three different techniques of rectal suture associate: NOTES survival study with liver biopsy in a swine model / Endoscopia transretal para biópsia hepática associada com três diferentes técnicas de sutura retal: estudo da NOTES em modelo experimental suíno

A cirurgia endoscópica por orifícios naturais (NOTES) representa um novo conceito de cirurgia, caracterizada por ausência de incisões abdominais. Os acessos mais comumente usados são o transvaginal e o transgástrico. Entretanto, as rotas transcolônica e transretal representam alternativas promissoras. O presente estudo objetiva avaliar três diferentes técnicas de sutura retal em três suínos submetidos a NOTES transretal para biópsia hepática, avaliando-se concomitantemente as repercussões clínicas e hematológicas. Sob anestesia geral, foi realizada uma incisão transversal no reto para a passagem do endoscópio até a cavidade abdominal em todos os animais para a realização da biópsia hepática. Cada animal recebeu um tipo de sutura retal: sutura em dois planos; reforço com tela de polipropileno ou reforço com membrana de pericárdio bovino. A NOTES transretal em modelo experimental suíno não apresentou implicações clínicas e hematológicas importantes, o que demonstra um acesso alternativo para biópsia hepática. Nenhum animal apresentou sinais de peritonite, aderências ou deiscência de pontos. O uso de reforço com pericárdio bovino para a sutura retal apresenta um atraso na cicatrização quando comparado com a sutura convencional ou com o uso de tela de polipropileno.(AU)

Laparoscopic paracostal herniorrhaphy in a dog: case report / Herniorrafia paracostal laparoscópica em um cão: relato de caso

Traumatic paracostal hernia is classified as an abdominal hernia that protrudes from the abdomen to a non physiologic space over the ribs. Treatment requires surgical reconstruction of the disrupted musculature in the thoracoabdominal region. Laparoscopic paracostal herniorrhaphy was performed in an eight-month-old male Teckel, presented after a car accident injury. A three-portal laparoscopic access was used for definitive diagnosis and hernia correction. After traction of the herniated omentum, a thoracoabdominal communication caused a left side pneumothorax, which was successfully drained with a chest tube placement. The herniorrhaphy was accomplished with intracorporeal sutures by a combination of Ford interlocking and cross mattress patterns. The postoperative period was uneventful. The laparoscopic paracostal herniorrhaphy was satisfactory, allowing both diagnosis and correction of the paracostal defect, showing to be a feasible alternative to the open surgery.

A hérnia traumática paracostal é classificada como uma hérnia abdominal com abaulamento do abdômen formando um espaço não fisiológico sobre as costelas. O tratamento consiste em reconstituir cirurgicamente a musculatura rompida da região toracoabdominal. A herniorrafia paracostal laparoscópica foi realizada em um cão da raça Teckel, macho de oito meses de idade, com histórico de trauma automobilístico. Optou-se pela utilização da abordagem laparoscópica tanto para o diagnóstico definitivo quanto para a correção da mesma. Foi utilizado o acesso com três portais, permitindo a tração do omento herniado, momento este em que o animal apresentou pneumotórax devido a uma comunicação toracoabdominal esquerda. O paciente foi submetido à toracocentese e adaptação de dreno no hemitórax esquerdo. A herniorrafia foi realizada com sutura intracorpórea em padrão contínuo de colchoeiro e festonada de Ford com fio monofilamentar náilon zero. O paciente apresentou rápida recuperação pós-operatória, sem ocorrências de recidivas. Assim, a herniorrafia paracostal laparoscópica mostrou-se satisfatória, possibilitando o diagnóstico definitivo e concomitante correção do defeito abdominal e diafragmático, podendo ser indicada como uma alternativa à cirurgia convencional.

Osteossíntese de mandíbula e maxila em equinos adultos: relato de quatro casos / Mandibular and maxillary osteosynthesis in adult horses: a report of four cases

Fraturas da mandíbula secundárias a trauma externo não são raras em equinos, sendo este o osso mais comumente fraturado quando o trauma é na região da cabeça. Na maioria dos casos, são abertas e com dano aos tecidos moles adjacentes. Como os ossos da cabeça não são submetidos às forças de carga do apoio, a exigência para fixação da fratura é menos desafiadora. O presente trabalho descreve o tratamento cirúrgico de quatro fraturas de mandíbula em equinos, sendo que, em um caso, havia também fratura de maxila. Quatro cavalos adultos com histórico de traumatismo na região da cabeça foram atendidos, avaliados clinicamente, radiografados e, após diagnóstico, submetidos a tratamento cirúrgico. No primeiro caso, o equino apresentava fratura rostral da mandíbula, sendo esta tratada com cerclagens. Além disso, o animal apresentava fratura múltipla de maxila, que foi corrigida com uma cerclagem próxima aos dentes incisivos, uma placa com parafusos e duas hemicerclagens na região entre os dentes incisivos e pré-molares. O segundo animal apresentava fratura múltipla dos ramos horizontal e vertical direito da mandíbula e foi tratado com uso de cinco placas de reconstrução e parafusos. No terceiro paciente foi diagnosticada fratura simples no ramo horizontal da mandíbula esquerda, que foi estabilizada com uma placa e parafusos. O quarto paciente apresentava fratura rostral de mandíbula, com avulsão de quatro dentes incisivos, sendo realizada a extração dos dentes incisivos e sutura da mucosa labial. Todos os animais obtiveram consolidação das fraturas em diferentes períodos de pós-operatório, o que permitiu melhora na qualidade de vida.

Secondary mandible fracture due to external trauma is not uncommon in horses, that being the most commonly fractured bone when the injure is on the animal´s head. In most cases, the injuries are open and damaging to surrounding soft tissues. As the bones of the head are not subjected to load forces, the support requirements for fracture fixation are less challenging. This paper describes the surgical treatment of four mandible fractures in horses, and, in one case, the animal had also suffered a fractured jaw. Four horses with a history of trauma to the head region have been examined, clinically and radiographically evaluated, and after being diagnosed, each of them was submitted to surgical treatment. In the first case, the horse showed rostral fracture of the jaw, thus being treated with cerclage. Moreover, the animal had multiple jaw fractures that were fixed with a cerclage next to the incisors, with a plate and two screws and cerclage in the region between the incisors and the premolars. The second animal had multiple fractures of the horizontal and vertical branches of the right jaw and was treated with the use of five reconstruction plates and screws. The third patient was diagnosed with a simple horizontal branch fracture of the left mandible that was stabilized with a plate and screws. The fourth patient had a fracture of the rostral mandible with avulsion of four incisors, and received the extraction of incisors and labial mucosa suture. All animals received fracture treatment in different post surgical periods, allowing improved quality of life.

Corpo estranho traqueal em cão / Tracheal foreign body in dog

The occurrence of a tracheal foreign body in a three-month-old male Poodle referred to a Teaching Veterinary Hospital due to acute coughing, gagging and nausea is reported. A bronchoscopy under general anesthesia was performed in order to obtain a diagnose. During the bronchoscopy a foreign body (maize popcorn) was observed in the intrathoracic trachea. The surgeon attempted to remove it by endoscopy, but no success was achieved. Therefore, an open procedure was performed and the foreign body removed. The patient progressed satisfactorily after the thoracotomy.

Comparison of lyophilization, and freezing in honey as techniques to preserve cortical bone allografts used to repair experimental femoral defects in domestic adult cats / Comparação de enxerto ósseo cortical autógeno e implante ósseo cortical alógeno conservados no mel, congelados ou liofilizados na substituição de segmento diafisário do fêmur de gatos domésticos

Cats with orthopedic conditions are a prominent part of the clinical work of veterinary. Conditions such as comminuted fractures, bone tumors and non-unions are often difficult to repair and may require the use of bone grafts for treatment. This study evaluated cortical bone allografts preserved in honey, frozen or lyophilized for correcting long bone defects created in the diaphysis of the right femur of domestic cats (n=24). In the control group (n=6), the defect was repaired using autogenous cortical bone graft. In the remaining animals (n=6/group), the defect was repaired with cortical bone allografts preserved in honey, frozen or lyophilized. Success of graft incorporation and length of time for consolidation were assessed through clinical, radiographic and histological evaluations performed up to 180 days. In the control, frozen, honey and lyophylized groups, respectively, success of graft incorporation was 91.6%, 83.3%, 75%, and 25%, with corresponding mean length of time for consolidation of 83.1, 78, 105 and 120 days. Incorporation percentage in the lyophilized group was significantly lower than in the frozen and control groups. In conclusion, bone grafts preserved in honey or frozen were effective for repairing cortical defects in the femurs of cats as compared to autogenous cortical bone grafts.

Afecções ortopédicas em gatos são frequentes, podendo-se encontrar fraturas cominutivas, neoplasias ósseas ou não-uniões de fraturas. Uma opção para o tratamento dessas afecções é a utilização de enxerto ou implante ósseo. O objetivo deste trabalho foi avaliar implantes ósseos corticais alógenos conservados em mel, congelados ou liofilizados na substituição de segmento diafisário do fêmur de felinos. Foi confeccionada uma falha óssea na diáfise do fêmur de 24 felinos. Em seis felinos a falha foi preenchida com o próprio osso removido e nos outros 18 animais, com implantes ósseos corticais alógenos conservados em mel, congelados ou liofilizados. Os animais foram avaliados clínica, radiográfica e histologicamente durante 180 dias. A incorporação foi de 91,6% no grupo controle, com tempo médio para consolidação de 83,1 dias; no mel foi de 75%, com tempo médio de 105 dias; no congelado foi de 83,3% com tempo médio de 78 dias e no liofilizado foi de 25%, com tempo médio de 120 dias. A porcentagem de consolidação foi significativamente menor no grupo liofilizado em relação aos grupos congelado e controle. É possível concluir que os implantes ósseos autógenos e os conservados no mel e congelados são eficazes no preenchimento de defeito cortical em fêmur de felinos.

Quantifying physical decline in juvenile neuronal ceroid lipofuscinosis (Batten disease).

OBJECTIVE: To use the Unified Batten Disease Rating Scale (UBDRS) to measure the rate of decline in physical and functional capability domains in patients with juvenile neuronal ceroid lipofuscinosis (JNCL) or Batten disease, a neurodegenerative lysosomal storage disorder. We have evaluated the UBDRS in subjects with JNCL since 2002; during that time, the scale has been refined to improve reliability and validity. Now that therapies are being proposed to prevent, slow, or reverse the course of JNCL, the UBDRS will play an important role in quantitatively assessing clinical outcomes in research trials. METHODS: We administered the UBDRS to 82 subjects with JNCL genetically confirmed by CLN3 mutational analysis. Forty-four subjects were seen for more than one annual visit. From these data, the rate of physical impairment over time was quantified using multivariate linear regression and repeated-measures analysis. RESULTS: The UBDRS Physical Impairment subscale shows worsening over time that proceeds at a quantifiable linear rate in the years following initial onset of clinical symptoms. This deterioration correlates with functional capability and is not influenced by CLN3 genotype. CONCLUSION: The UBDRS is a reliable and valid instrument that measures clinical progression in JNCL. Our data support the use of the UBDRS to quantify the rate of progression of physical impairment in subjects with JNCL in clinical trials.

Videolaparoscopia topográfica de equinos em estação com três diferentes massas corpóreas / Topographic videolaparoscopy in standing equines of three different corporal masses

Descreveu-se a anatomia topográfica, obtida por videolaparoscopia, da cavidade abdominal de 21 equinos hígidos, em estação, distribuídos em três grupos conforme massa corpórea. No grupo A foram incluídos animais com até 250kg; no grupo B, animais entre 251 e 350kg; e no grupo C, animais acima de 351kg. A técnica cirúrgica realizada foi a laparoscopia com acesso pelas fossas paralombares esquerda e direita, utilizando a introdução videoassistida da cânula, iniciando sempre pelo flanco esquerdo. O acesso esquerdo permitiu a observação do diafragma, estômago, lobo hepático esquerdo, baço, área renal, intestino delgado, cólon menor, bexiga, órgãos reprodutivos internos do macho e da fêmea e reto. No acesso paralombar direito, foram observados diafragma, lobo hepático direito, área renal, cólon dorsal, duodeno, ceco, intestino delgado, cólon menor, bexiga, órgãos reprodutivos internos do macho e da fêmea e reto. O procedimento videolaparoscópico para estudo da anatomia abdominal de equinos é viável, não sendo observadas limitações decorrentes do tamanho do animal.

The present study aimed to perform an anatomic description of the abdominal cavity of equines in standing position. Twenty-one healthy equines were allotted into three groups according to their corporal mass. Animals weighing up to 250kg were included in group A, 251 to 350kg in group B and over than 351kg in group C. Laparoscopy was the surgical technique performed, with access through the left and right paralumbar fossas using a video-assisted introduction of cannula, starting from the left flank. This first access allowed the observation of the diaphragm, stomach, left hepatic lobe, spleen, renal area, small intestine, descending colon, bladder, rectum and internal reproductive organs of the male and female. During the right access were observed: diaphragm, right hepatic lobe, renal area, dorsal colon, duodenum, cecum, small intestine, descending colon, bladder, rectum and internal reproductive organs of the male and female. The video-laparoscopic for the study of the abdominal anatomy of equines is feasible, and no limitations due to animal size have been observed.

Osteossíntese de tibiotarso com miniplaca de titânio em Arara Canindé (Ara ararauna) / Tibiotarsus osteosynthesis' in blue-yellow-macaw (Ara ararauna) using titanium miniplate

Among the surgical problems of birds, fractures are the most prevalent, and the long bones of the wings and pelvic limbs are the most frequently affected. The success of orthopedic surgery in birds is directly related to the techniques used to undo the mechanical forces of a fracture. At the veterinary teaching hospital a psitacid from the Ara ararauna (blue-and-yellow-macaw) species with a clinical history of trauma in the cage was treated. Craniocaudal and lateral radiographs of the left limb demonstrated a mid-diaphyseal fracture of the tibiotarsus. The bird was sent to surgery. The patient was anesthetized with isufluorane and for the pre-anesthesic medicacion methadone was administrated. A medial surgical approach to the tibiotarsus was made and fracture reduction was performed. The fracture was stabilized through a titanium miniplate (system 2mm) fixed medially on the tibiotarsus with 6 cortical miniscrews, being 3 proximal and 3 distal to the fracture site. In this case, there was no complication in placing the miniplate and miniscrews, resulting in a satisfactory alignment of the fragments and causing an efficient reduction of the diaphyseal fracture of tibiotarsus with functional return of the limb and bone consolidation.

Group patient visits for Parkinson disease: a randomized feasibility trial.

BACKGROUND: Group patient visits are medical appointments shared among patients with a common medical condition. This care delivery method has demonstrated benefits for individuals with chronic conditions but has not been evaluated for Parkinson disease (PD). METHODS: We conducted a 12-month, randomized trial of group patient visits vs usual (one-on-one) care for patients with PD. Visits were led by one of 3 study physicians, included patients and caregivers, and lasted approximately 90 minutes. Those receiving group visits had 4 sessions over 12 months. The primary outcome measure was feasibility as measured by the ability to recruit participants and by the proportion of participants who completed the study. The primary efficacy outcome was quality of life as measured by the PD Questionnaire-39. RESULTS: Thirty patients and 27 caregivers enrolled in the study. Thirteen of the 15 patients randomized to group patient visits and 14 of the 15 randomized to usual care completed the study. Quality of life measured 12 months after baseline between the 2 groups was not different (25.9 points for group patient visits vs 26.0 points for usual care; p = 0.99). CONCLUSIONS: Group patient visits may be a feasible means of providing care to individuals with PD and may offer an alternative or complementary method of care delivery for some patients and physicians. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that group patient visits did not improve quality of life for individuals with PD over a 1-year period.

Exercise prescription after fragility fracture in older adults: a scoping review.

The purpose of this study is to identify and chart research literature on safety, efficacy, or effectiveness of exercise prescription following fracture in older adults. We conducted a systematic, research-user-informed, scoping review. The population of interest was adults aged ≥45 years with any fracture. "Exercise prescription" included post-fracture therapeutic exercise, physical activity, or rehabilitation interventions. Eligible designs included knowledge synthesis studies, primary interventional studies, and observational studies. Trained reviewers independently evaluated citations for inclusion. A total of 9,415 citations were reviewed with 134 citations (119 unique studies) identified: 13 knowledge syntheses, 95 randomized or controlled clinical trials, and 11 "other" designs, representing 74 articles on lower extremity fractures, 34 on upper extremity, eight on vertebral, and three on mixed body region fractures. Exercise prescription characteristics were often missing or poorly described. Six general categories emerged describing exercise prescription characteristics: timing post-fracture, person prescribing, program design, functional focus, exercise script parameters, and co-interventions. Upper extremity and ankle fracture studies focused on fracture healing or structural impairment outcomes, whereas hip fracture studies focused more on activity limitation outcomes. The variety of different outcome measures used made pooling or comparison of outcomes difficult. There was insufficient information to identify evidence-informed parameters for safe and effective exercise prescription for older adults following fracture. Key gaps in the literature include limited numbers of studies on exercise prescription following vertebral fracture, poor delineation of effectiveness of different strategies for early post-fracture mobilization following upper extremity fracture, and inconsistent details of exercise prescription characteristics after lower extremity fracture.

Ovário-histerectomia laparoscópica em felinos hígidos: estudo comparativo de três métodos de hemostasia / Laparoscopic ovariohysterectomy in healthy felines: comparative study of three hemostatic methods

Foram avaliadas 24 gatas, hígidas, sem raça definida, distribuídas em três grupos de oito animais. Descreveu-se o acesso laparoscópico para ovariossalpingo-histerectomia (OSH) e comparou-se o uso do eletrocautério bipolar (grupo I), do clipe de titânio (grupo II) e da ligadura com fio de sutura (grupo III) para a oclusão dos vasos ovarianos e uterinos. Hemorragia e enfisema subcutâneo foram as principais complicações observadas no transoperatório e hematoma subcutâneo e deiscência de sutura, as do pós-operatório. O procedimento cirúrgico e a técnica operatória mostraram-se viáveis nos três grupos. O uso do eletrocautério bipolar apresentou vantagens na comparação com os outros métodos de hemostasia.

Twenty-four healthy female mongrel cats were submitted to ovaryhisterectomy and distributed into three groups of eight animals each: (I) bipolar electrical cautery, (II) titanium clips, and (III) suture ligature for the occlusion of ovarian and uterine vessels, which were compared. The surgical procedure and the operation technique were viable in all three groups. Hemorrhagia and subcutaneous emphysema were the main intraoperative complications, and hematoma and suture dehiscence in the postoperative. The bipolar electrical cautery procedure is shown to be comparatively successful regarding the other studied methods for hemostasia.

Urethral duplication in a dog: case report / Duplicação uretral em cão: relato de caso

A male Brazilian Fila dog was referred because of a perineal orifice with urine stream during micturition. To determine the extent of the accessory channel, a contrasted retrograde urethrocystography was performed. A surgical correction was undertaken. Histological study showed the presence of the urethral channel lined by multilayer transitional epithelium. The patient recovered well and there was no evidence of complications one year after surgery.

Um cão macho da raça Fila brasileiro foi atendido por apresentar, durante a micção, presença de jato de urina em orifício na região perineal. Uretrocistografia retrógrada contrastada foi realizada para determinar o trajeto do canal acessório. Fez-se a remoção cirúrgica da comunicação uretrocutânea. A avaliação histológica demonstrou a presença de um canal uretral revestido por epitélio de transição composta de várias camadas. O paciente teve boa recuperação, e após um ano, não havia apresentado complicações.

Ectrodactilia em cão: relato de caso / Ectrodactyly in dog: case report

Descreve-se um caso de ectrodactilia em um cão, sem raça definida e dois meses de idade. No exame clínico e radiográfico, foi verificada a separação óssea e de tecidos moles entre o segundo e o terceiro dígitos, estendendo-se proximalmente até a região distal do rádio e da ulna, e luxação do cotovelo ipsilateral. O animal foi submetido a procedimento cirúrgico para redução da luxação do cotovelo e reaproximação óssea e dos tecidos moles. Após 16 meses da cirurgia, o animal apresentava uso parcial do membro

A case of ectrodactyly is described in a 2-month-old male mixed Terrier dog. The defect was a complete osseous and soft tissue separation extending from between digits 2 and 3 proximally to the level of the radius and ulna. Radiography revealed elbow luxation. Treatment consisted of surgical reduction of elbow luxation and soft tissue reconstruction. Sixteen months after surgery, the dog was intermittent nonweight-bearing lameness