Gross and histopathologic diagnoses from North Atlantic right whale Eubalaena glacialis mortalities between 2003 and 2018.

Seventy mortalities of North Atlantic right whales Eubalaena glacialis (NARW) were documented between 2003 and 2018 from Florida, USA, to the Gulf of St. Lawrence, Canada. These included 29 adults, 14 juveniles, 10 calves, and 17 of unknown age class. Females represented 65.5% (19/29) of known-sex adults. Fourteen cases had photos only; 56 carcasses received external examinations, 44 of which were also necropsied. Cause of death was determined in 43 cases, of which 38 (88.4%) were due to anthropogenic trauma: 22 (57.9%) from entanglement, and 16 (42.1%) from vessel strike. Gross and histopathologic lesions associated with entanglement were often severe and included deep lacerations caused by constricting line wraps around the flippers, flukes, and head/mouth; baleen plate mutilation; chronic extensive bone lesions from impinging line, and traumatic scoliosis resulting in compromised mobility in a calf. Chronically entangled whales were often in poor body condition and had increased cyamid burden, reflecting compromised health. Vessel strike blunt force injuries included skull and vertebral fractures, blubber and muscle contusions, and large blood clots. Propeller-induced wounds often caused extensive damage to blubber, muscle, viscera, and bone. Overall prevalence of NARW entanglement mortalities increased from 21% (1970-2002) to 51% during this study period. This demonstrates that despite mitigation efforts, entanglements and vessel strikes continue to inflict profound physical trauma and suffering on individual NARWs. These cumulative mortalities are also unsustainable at the population level, so urgent and aggressive intervention is needed to end anthropogenic mortality in this critically endangered species.

Genitourinary imaging and procedures by the emergency physician.

Optimal imaging of the urinary tract in the Emergency Department does not require sophisticated or rare equipment. The supervising physician must review each ExU, cystogram, or RUG film as it becomes available and decide upon the proper course of action. Indications for contrast studies in injured patients continue to evolve, with a trend away from investigation of stable patients with microscopic hematuria on the first urine. Urethral catheterization and suprapubic cystostomy are complementary options for bladder drainage. Careful attention to details of anatomy and technique allow for success in the majority of patients. There are substantial pitfalls in the diagnosis and treatment of male genital emergencies. The acute treatment of priapism is rapidly changing as understanding of penile physiology becomes more complete. Acute scrotal pathology can be difficult to categorize without surgical exploration. Urologic consultation, therefore, is mandatory in these conditions.

Malignant melanoma of the renal pelvis presenting as a primary tumor.

We report a case of malignant melanoma of the renal pelvis presenting as a primary tumor and review the relevant literature.