Thyroid neoplasia associated with nutritional deficiency in cultured jade perch in Hong Kong.

Non-neoplastic thyroid hyperplasia is common in terrestrial animals, secondary to nutritional imbalances or other goitrogenic compounds. Thyroid hyperplasia is relatively common in teleost fish; however, malignant thyroid neoplasia is rarely reported. We diagnosed cases of thyroid neoplasia in a population of jade perch (Scortum barcoo). The 3,000 affected fish had grossly apparent, bilateral pharyngeal swellings. Histologic examination confirmed proliferative thyroid lesions ranging from hyperplasia to well-differentiated follicular cell carcinoma. In addition, the younger population of animals on the farm also had bacterial septicemia and mild Dactylogyrus sp. gill infections. Feed analysis revealed a severe deficiency of iodine and vitamin C in the homemade fish diet used on the farm. The concentrations of other minerals, such as zinc, were also on the lower end of the recommended requirements for freshwater fish. The farm was using surface water in its recirculating aquaculture system. We recommended a switch to a commercial aquaculture diet, as well as to use well water rather than surface water to avoid any contaminants, and to treat the younger fish with an antibiotic for bacterial septicemia. Our case provides evidence of progression from nutritional-associated thyroid hyperplasia to neoplasia in farmed teleost fish.

Hydrogen peroxide as a mitigation against Microcystis sp. bloom.

Microcystis sp. is a harmful cyanobacterial species commonly seen in earthen ponds. The overgrowth of these algae can lead to fluctuations in water parameters, including DO and pH. Also, the microcystins produced by these algae are toxic to aquatic animals. This study applied hydrogen peroxide (7 mg/L) to treat Microcystis sp. in a laboratory setting and in three earthen pond trials. In the lab we observed a 64.7% decline in Microcystis sp. And in our earthen pond field experiments we measured, on average, 43% reductions in Microcystis sp. cell counts within one hour. The treatment was found to eliminate specifically Microcystis sp. and did not reduce the cell count of the other algae species in the pond. A shift of the algae community towards the beneficial algae was also found post-treatment. Lastly, during the pond trials, the gill status of Tilapia and Giant tiger prawn were not affected by the H2O2 treatment suggesting this may be a good mitigation strategy for reducing cyanobacteria in pond aquaculture.

Perioperative Management of Patients with Craniomaxillofacial Trauma.

Successful surgical management of patients with facial fractures requires a detailed preoperative evaluation and postoperative management that differs from elective surgical patients. This review presents evidence-based recommendations from the surgical and anesthesiology literature that address many of the clinical questions that arise during the perioperative management of this group of patients. Surgeons and anesthesiologists must work together at numerous points and make joint decisions, especially where airway and pain management challenges may arise. The multidisciplinary nature of the decision-making process is emphasized.

Subsidized veterinary extension services may reduce antimicrobial resistance in aquaculture.

Antibiotic use in aquaculture has become very controversial vis-à-vis driving antimicrobial resistance (AMR) in aquatic bacterial populations. The AMR trends in fish pathogens in Hong Kong over a four-year period suggests that providing small stakeholder farmers with free veterinary advice on fish health issues and treatments, as well as subsidized quality-assured medicines, likely reduced AMR. We observed a dramatic reduction in the proportion of bacteria resistant to oxolinic acid, oxytetracycline, and florfenicol on local aquaculture farms between 2018 and 2021. These decreases coincided with either a change in antibiotic use practices on farms (i.e. with oxytetracycline), or the reduction in the use of specific drugs (i.e. oxolinic acid and florfenicol). We did not observe a similar decline in the resistance pattern to commonly used antibiotics in human medicine in the same fish bacteria. Resistance to these products, which were unlikely to be used by the farmers in our study, was very high. Our finding suggests that both human and veterinary use of antibiotics in Hong Kong may have an influence on the AMR of bacteria in the aquatic environment.

Complement C3-α and C3-ß Levels in Synovial Fluid But Not in Blood Correlate With the Severity of Osteoarthritis Research Society International Histopathological Grades in Primary Knee Osteoarthritis.

BACKGROUND: Primary osteoarthritis (OA) is the most common cause of knee arthritis worldwide. The knee synovial fluid complement C3-ß chain levels have been shown to correlate with clinical symptoms of knee OA. It is not known whether the complement C3 in the synovial fluid is derived from the circulation or is produced locally in the knee. METHODS: Fifty primary OA patients undergoing a total knee arthroplasty procedure were evaluated for biochemical analyses of C3-α and C3-ß chains in the synovial fluid and blood plasma. These levels were corelated with the severity of corresponding knee OA based on the Osteoarthritis Research Society International (OARSI) grade. RESULTS: Both synovial C3-α and C3-ß levels correlated significantly with the severity of OA. Neither plasma C3-α levels nor C3-ß levels significantly correlated with OARSI grading. Neither synovial C3-α levels nor C3-ß correlated significantly with plasma C3-α or C3-ß levels, respectively. Synovial C3-α chain and C3-ß chain levels were significantly higher in the grade >6 group. In plasma, neither C3-α chain levels nor C3-ß chain levels were significantly different between the groups. Neither synovial C3-α nor C3-ß levels significantly correlated with plasma erythrocyte sedimentation rate or C-reactive protein levels. CONCLUSION: In knee primary OA, C3 seems to be produced and released locally into the synovial fluid instead of being derived from blood in the circulation. Synovial C3 levels, but not blood plasma C3, correlate with the histopathological severity of primary OA in the knee. Synovial C3 may be an important factor in the pathogenesis of primary OA clinical symptoms and a potential target for therapeutic intervention.

Emamectin Benzoate Treatment of Hybrid Grouper Infected With Sea Lice in Hong Kong.

Sea lice (Copepoda: Caligidae) are ectoparasites which negatively impact marine aquaculture species around the world. There are a limited number of treatments licensed for use against sea lice in tropical and semi-tropical farmed fish species. Emamectin benzoate (EB) was an effective pharmaceutical drug against sea lice infestations in several salmon industries before resistance to the product developed. This drug has not been extensively tested in marine fish within Asia. The objective of this study was to determine whether this drug could be used to treat oral infections with sea lice in hybrid grouper (Mycteroperca tigris × Epinephelus lanceolatus) cultured in saltwater net-pen sites in Hong Kong. We observed an overall reduction in sea lice infections over time, starting on the last day of the treatment up to the end of our study (i.e., 14 days after the last EB treatment). We also observed a large variation in concentrations of EB in fish on the last day of the treatment, which provides an explanation for the variation in response to the treatment. It also suggests that distribution of the medication to fish in saltwater net-pens is difficult, especially when medication is hand-mixed in the feed and possibly unevenly distributed in the daily rations. Overall, this study provides preliminary evidence that EB could be used to treat sea lice found in Hong Kong and potentially in other regions of SE Asia.

Preeclampsia Among African American Pregnant Women: An Update on Prevalence, Complications, Etiology, and Biomarkers.

IMPORTANCE: Preeclampsia is a devastating disease of pregnancy associated with increased risk of fetal and maternal complications. African American pregnant women have a high prevalence of preeclampsia, but there is a need of systemic analyses of this high-risk group regarding complications, etiology, and biomarkers. OBJECTIVE: The aim of this study was to provide a synopsis of current research of preeclampsia specifically related to African American women. EVIDENCE ACQUISITION: A comprehensive search was performed in the bibliographic database PubMed with keywords "preeclampsia" and "African American." RESULTS: African American women with preeclampsia were at an increased risk of preterm birth, which resulted in low-birth-weight infants. Intrauterine fetal death among African American preeclamptic patients occurs at twice the rate as in other races. On the maternal side, African American mothers with preeclampsia have more severe hypertension, antepartum hemorrhage, and increased mortality. Those who survive preeclampsia have a high risk of postpartum cardiometabolic disease. Preexisting conditions (eg, systemic lupus erythematosus) and genetic mutations (eg, sickle cell disease in the mother, FVL or APOL1 mutations in the fetus) may contribute to the higher prevalence and worse outcomes in African American women. Many blood factors, for example, the ratio of proteins sFlt/PlGF, hormones, and inflammatory factors, have been studied as potential biomarkers for preeclampsia, but their specificity needs further investigation. CONCLUSIONS: Further studies of preeclampsia among African American women addressing underlying risk factors and etiologies, coupled with identification of preeclampsia-specific biomarkers allowing early detection and intervention, will significantly improve the clinical management of this devastating disease.

Knee synovial fluid complement C3-ß chain levels correlate with clinical symptoms of knee osteoarthritis.

AIM: Early research found innate immune factor complement C3 in the synovial fluid (SF) and activated in serum of osteoarthritis (OA) patients. Whether synovial C3 comes from circulation, or is produced locally, is still unknown. It is also unclear whether synovial and circulating C3 is responsible to OA symptoms. A native C3 molecule consists of two chains, C3-α and C3-ß. Small fragments breaking down from C3-α chain in serum and SF were reported to be related to OA severity. Little is known if C3-ß chain is involved in the pathogenesis. METHOD: In this study, we evaluated these important areas by biochemical analyses of C3-α and C3-ß chains in both the SF and plasma of OA patients. RESULTS: Our results showed that C3-α and C3-ß levels in SF did not correlate with those in plasma, suggesting that synovial C3 is independently and locally produced, rather than being "leaked" from circulation. Synovial C3-ß but not C3-α levels correlated with pain, other OA symptoms, function in daily living, and sports/recreational activities. Plasma C3-ß levels only marginally correlated with pain, and plasma C3-α levels did not correlate with any of these OA symptoms. CONCLUSION: We present first-hand evidence that the clinical symptoms of OA are mainly associated with C3 in the local SF rather than systemic circulation, suggesting local factors in the etiopathogenesis. Future local targeted therapies for pain management may be more effective and safer.

Circulating Complement C3-Alpha Chain Levels Predict Survival of Septic Shock Patients.

BACKGROUND: Circulating complement C3 fragments released during septic shock might contribute to the development of complications such as profound hypotension and disseminated intravascular coagulation. The role of C3 in the course of septic shock varies in the literature, possibly because circulating C3 exists in different forms indistinguishable via traditional ELISA-based methods. We sought to test the relationship between C3 forms, measured by Western blotting with its associated protein size differentiation feature, and clinical outcomes. METHODS: Secondary analysis of two prospective cohorts of patients with septic shock: a discovery cohort of 24 patents and a validation cohort of 181 patients. C3 levels were measured by Western blotting in both cohorts using blood obtained at enrollment. Differences between survivors and non-survivors were compared, and the independent prognostic values of C3 forms were assessed. RESULTS: In both cohorts there were significantly lower levels of the C3-alpha chain in non-survivors than in survivors, and persisted after controlling for sequential organ failure assessment score. Area under the receiver operating characteristics to predict survival was 0.65 (95% confidence interval: 0.56-0.75). At a best cutoff value (Youden) of 970.6 µg/mL, the test demonstrated a sensitivity of 68.5% and specificity of 61.5%. At this cutoff point, Kaplan-Meier survival analysis showed that patients with lower levels of C3-alpha chain had significantly lower survival than those with higher levels (P < 0.001). CONCLUSION: Circulating C3-alpha chain levels is a significant independent predictor of survival in septic shock patients.