Modified tube cystostomy technique for management of obstructive urolithiasis in small ruminants: procedure and outcome in 17 sheep and goats.

OBJECTIVE: To describe the surgical technique and clinical outcome of small ruminants treated for obstructive urolithiasis using a modified tube cystostomy (MTC) technique. ANIMALS: 15 goats and 2 sheep treated with an MTC between March 2018 and February 2023. CLINICAL PRESENTATION: Animals were diagnosed with obstructive urolithiasis on the basis of history, physical examination, and ultrasonographic examination. An MTC was performed with sedation and a local block. Postoperative medical management was instituted to help reestablish urethral patency, and Foley catheters were removed after successful urination. RESULTS: Animals were hospitalized an average of 3 nights (range, 0 to 14 nights). Complications included urine spillage in the abdomen and accidental deflation of the Foley balloon. Six animals were euthanized due to poor prognosis or failure to regain urethral patency. Foley catheters were removed an average of 15.7 days postoperatively in animals that regained urethral patency. Long-term (> 1-month) follow-up was available for 8 animals, with an average postoperative survival time of 19.4 months (range, 1 to 58 months). Four animals were lost to long-term follow-up. CLINICAL RELEVANCE: This MTC technique is an effective means of catheterizing the urinary bladder in small ruminants. It can be performed under field conditions and serve as a standalone procedure for providing temporary urine egress. Patient size is limited by the length of the introducer, and an intact, distended urinary bladder and plan for reestablishing urethral patency are important considerations.

Predictors of sexual involvement among adolescents in rural Jamaica.

Early sexual activity of adolescents is associated with increased risk of teenage pregnancy, sexually transmitted infections including HIV, and higher maternal/perinatal morbidity and mortality. HIV and adolescent pregnancy are among the most serious public health problems in Jamaica. The objective of this study was to identify the potential predictors of adolescent sexual activity in Jamaica. A cross-sectional survey was conducted among 788 students 13-19 years of age in Jamaica. A questionnaire containing items on socio-demographic characteristics such as age and gender, and scales on adolescent values about sexual activity, self-efficacy for abstinence, parental love, and depression were administered to adolescents at secondary schools in the parish of Hanover. Reliability analysis of the scales, descriptive statistics, and logistic regression to determine predictors of sexual activity were conducted. Approximately 62% of adolescents who responded reported previous sexual intercourse and 38% reported never having had sex. The mean age for sexual debut was 13.6 years. Logistic regression revealed delay values (values towards delaying sexual activity) as protective (OR=0.16, CI=0.09-0.26) against involvement in sexual activity. Risk factors for sexual activity included being older (OR=1.9, CI=1.50-2.50), being male (OR=2.26, CI=1.39-3.68) and having grown-up values (OR=1.49, CI=1.05-2.12). Contrary to expectations, having higher self-efficacy skills was predictive (OR=1.47, CI=1.05-2.05) of adolescent sexual involvement. Analyses by gender revealed that delay and grownup values predicted male sexual activity, while self-efficacy, paternal love and delay values predicted female behavior. These findings show the importance of age, gender, self-efficacy, delay and grown-up values in predicting sexual activity in adolescents and indicate the need for gender-specific interventions for Jamaican adolescents.