Military Adolescent Pandemic Study 2021: MAPS21.

BACKGROUND: Military-connected students move between 6 to 9 times throughout their K-12 experience, creating unique challenges relating to integration, adaptation, identity development, and acceptance. However, when transitions occur during a global pandemic, isolation and disconnect with schools and the community create new challenges that impact health and well-being. The MAPS21 study uncovers the lived experiences of military-connected students who have experienced a transition during the pandemic and gives rise to the need for interdisciplinary care within the public-school setting to promote mental health and academic support during and post-pandemic transitions. METHODS: Military adolescents and their parent(s) were interviewed and data were analyzed following an interpretive phenomenological process. A social-ecological model served as the guide to understand the participants' experiences and to further inform future supportive measures. RESULTS: Seven subthemes surface under Individual, Relationships, Community, and Society and Policy, the levels within the social-ecological model. These subthemes included: anticipatory processes, control, growth and maturity, adapting views, isolation, school support, community support. CONCLUSION: Military-connected students may experience adverse outcomes relating to mental health and academic progression after experiencing a move during the pandemic. This study provides an avenue for teams of interdisciplinary professionals to collaborate within the public-school setting to provide proactive support through engagement and policy development.

The Loss of a Parent to Suicide in Military Families.

In this paper the authors explore the impact of loss of a parent to suicide on adolescents in military families using Marcia's identity status theory and the Roy adaptation model (RAM). After describing a brief case study of a 13-year-old boy in a military family who lost his father in this manner, these two theories are applied to better understand his struggle to develop and maintain a healthy identity and adapt to numerous relocations, deployments, and then loss. The military family stressors are seen as weakening the resilience of children in such families, making them more vulnerable to the impact of parent loss. Implications for nurses and other healthcare professionals are discussed.

Neoplastic melanocytic pleural effusion in a Portuguese water dog.

A 9-year-old castrated male Portuguese water dog was presented following incomplete excision of a malignant melanoma at the left lip commissure by the referring veterinarian. Physical examination was otherwise unremarkable. The patient was staged using thoracic radiographs, abdominal ultrasound, and fine-needle aspirates of the mandibular lymph nodes and spleen. Given the absence of any definitive evidence of metastasis, the malignant melanoma was surgically completely removed. The dog then received four melanoma vaccine doses as an adjuvant therapy and remained clinically healthy for more than 3 months after the last immunization. However, 232 days after the initial discovery of the lip mass, the dog was euthanized due to deterioration and a poor prognosis based on the presence of lung metastases and neoplastic melanocytic pleural effusion. The latter has been rarely reported in dogs, despite the high prevalence of oral malignant melanomas and the tendency of these tumors to metastasize to the lungs.

Successful chemical ablation of an intraorbital cyst caused by an eyelid injury and iatrogenic ankyloblepharon formation in a duck.

CASE DESCRIPTION A client-owned 2-year-old 1.8-kg (4-lb) male pet Rouen duck (Anas platyrhynchos domesticus) was evaluated because of severe swelling around the left eye following traumatic injury to the upper and lower eyelids and 2 associated surgeries that resulted in the removal of the entire upper and lower eyelid margins. CLINICAL FINDINGS At initial evaluation, ankyloblepharon of the left eye was observed, with no upper or lower eyelid margins and a large, round, fluctuant subcutaneous mass over the left orbit. Orbital exploration and histologic examination revealed a benign cyst consisting of fibrous tissue, conjunctiva, and skeletal muscle bundles. Bacterial culture of cystic fluid yielded few Staphylococcus delphini. TREATMENT AND OUTCOME Excision of the cyst and evisceration of the left globe were performed, and once daily treatment with orally administered enrofloxacin suspension (12.6 mg/kg [5.7 mg/lb]) and meloxicam (1 mg/kg [0.45 mg/lb]) was initiated. Over the next 4 days, the cyst redeveloped and progressively enlarged. Accumulated fluid was aspirated from the cyst, and 20 mg of gentamicin was injected intraorbitally with ultrasound guidance. Over the subsequent 27-month period, no recurrence of clinical signs or adverse effects were reported by the owner. CLINICAL RELEVANCE To the authors' knowledge, this is the first report of cyst formation after adnexal injury and evisceration in birds and its successful treatment with intralesional gentamicin injection. Findings emphasized the importance of preserving lacrimal puncta during adnexal or eye removal surgeries in birds. Intralesional injection of gentamicin with the goal of destroying fluid-producing cells may be a safe and effective way to treat intraorbital cysts in birds and other species, although additional research would be required to confirm this.

Effect of semen in urine specimens on urine protein concentration determined by means of dipstick analysis.

OBJECTIVE: To determine the effect of semen in urine specimens on urine protein concentration measured by means of dipstick analysis. SAMPLE POPULATION: 14 urine samples from 3 adult castrated male dogs and 14 semen samples from 7 adult sexually intact male dogs. PROCEDURES: Serial dilutions of the whole ejaculate or spermatozoa-free seminal fluid in urine were created, and unaltered and diluted urine samples were analyzed by means of a commercially available dipstick; pH and specific gravity of the samples were also measured. Spermatozoa and WBC counts of the semen samples and protein concentration of the seminal fluid were determined. RESULTS: Protein concentrations determined by means of dipstick analysis of urine samples to which whole ejaculate (dilutions of 1:1, 1:2, 1:16, 1:64, and 1:256) or seminal fluid (dilutions of 1:1, 1:2, 1:16, and 1:64) had been added were significantly higher than concentrations in unaltered urine samples. All 13 samples to which whole ejaculate was added at a dilution of 1:2 and 10 of 12 samples to which seminal fluid was added at a dilution of 1:2 were positive for blood on dipstick analysis. There was no significant linear correlation between spermatozoa or WBC count of the semen sample and protein concentration of the spermatozoa-free seminal fluid. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that regardless of whether spermatozoa were present, semen contamination could result in false-positive results for protein and blood during dipstick analysis of urine samples from sexually intact male dogs.

What is your diagnosis? Subcutaneous mass fluid from a febrile dog.

A 10-month-old spayed female Doberman Pinscher was presented for lameness. On physical examination, the dog was lethargic and febrile and had a 2-cm raised subcutaneous mass at the base of the left ear. Fluid from the mass was drained. Direct smears of the fluid, stained with modified Wright's and new methylene blue, were highly cellular and contained large numbers of degenerate neutrophils with moderate numbers of macrophages. Large numbers of round yeast organisms, 8-20 mum in diameter, were observed extracellularly. The organisms had a thick blue wall and granular internal contents and broad-based budding was seen frequently. Branching hyphae or pseudohyphae, with parallel sides and 2-4 mum in diameter, appeared to extend from the surface of the yeast. The morphology of the yeast organisms was consistent with Blastomyces dermatitidis, with atypical hyphae formation. Culture results were not definitive because it was not possible to induce transition from the mycelial to the yeast form at 37 degrees C and because the morphology of the mycelial form of B. dermatitidis could not be differentiated from that of Emmonsia parvae. The organism was confirmed as Ajellomyces dermatitidis (the mycelial form of B. dermatitidis) using 18S ribosome RNA gene sequencing and comparison with an available databank. The mycelial form of B. dermatitidis is rarely found in the tissue of dogs, and may have been induced in this case by low environmental temperatures and the time delay between sample collection and slide preparation.

An integrative and case-based approach to the teaching of general and systemic pathology.

Since 1993, the pre-clinical phase of the professional (DVM) curriculum at Michigan State University College of Veterinary Medicine has included two pathology courses in which both anatomic and clinical pathologists collaborate to teach concepts in general and systemic pathology. Topics such as inflammation, circulatory disturbances, and neoplasia are taught in this collaborative manner in the year 1 General Pathology course, and pathology of the digestive system (including liver and pancreas), urinary system, and lymphoid system are "team-taught" in the year 2 Clinical and Systemic Pathology course. We feel that this approach gives students an appreciation of the whole-body dynamics of a disease process as it occurs in bone marrow, peripheral blood, body fluids, and tissues and that it leads to a deep understanding of pathologic processes. In addition, the use of "active learning" instructional strategies grounded in case discussions further enhances students' understanding of important concepts by demonstration of practical applications and serves to generate strong interest in learning the subject matter. Integration of concepts of pathology with those taught concurrently in other courses, such as those in physiology and microbiology, is also an important component of pathology instruction in the pre-clinical curriculum.

Use of the Cell-Dyn 3500 to predict leukemic cell lineage in peripheral blood of dogs and cats.

BACKGROUND: Morphology and cytochemistry are the foundation for classification of leukemias in dogs and cats. Advances in automated hematology instrumentation, immunophenotyping, cytogenetics, and molecular biology are significantly improving our ability to recognize and classify spontaneous myeloproliferative and lymphoproliferative disorders. OBJECTIVE: The purpose of this study was to assess the utility of flow cytometry-based light scatter patterns provided by the Cell-Dyn 3500 (CD3500) automated hematology analyzer to predict the lineage of leukemic cells in peripheral blood of dogs and cats. METHODS: Leukemic cells from 15 dogs and 6 cats were provisionally classified using an algorithm based on the CD3500 CBC output data and were subsequently phenotyped by enzyme cytochemistry, immunocytochemistry, indirect flow cytometry, and analysis of antigen receptor gene rearrangement. RESULTS: The algorithm led to correct predictions regarding the ontogeny of the leukemic cells (erythroid/megakaryocytic potential, myeloid leukemia, monocytic leukemia, chronic granulocytic leukemia, lymphoid leukemia) in 19/21 animals. Mismatches in the WBC impedance count and the WBC optical count in conjunction with microscopic assessment of blasts in the blood were useful for predicting myeloproliferative disorders with erythroid or megakaryocytic potential. The leukocyte light scatter patterns enabled distinction among myeloid leukemias (represented by acute myelomonocytic leukemia, acute monocytic leukemia, chronic granulocytic leukemia) and lymphocytic leukemias (including acute and chronic lymphocytic leukemias). One case of acute lymphocytic leukemia was misidentified as chronic lymphocytic leukemia. CONCLUSIONS: Algorithmic analyses can be applied to data generated by the CD3500 to predict the ontogeny of leukemic cells in the peripheral blood of dogs and cats. This rapid and quantitative technique may be used to improve diagnostic decisions, expand therapeutic choices, and increase prognostic accuracy.

Quantitation of reticulated platelets in healthy dogs and in nonthrombocytopenic dogs with clinical disease.

BACKGROUND: Thrombocytopenia is a common disorder in dogs and development of an objective diagnostic assay to measure platelets newly released from bone marrow into the blood would provide a noninvasive way to predict megakaryocytopoiesis. Reticulated platelets are newly released platelets with increased concentrations of RNA that can be detected by flow cytometric analysis of blood stained with thiazole orange (TO). OBJECTIVE: The goals of this study were to establish a reproducible method to quantitate reticulated platelets in dogs, to establish a reference interval for reticulated platelet percentages in healthy dogs, and to determine whether the percentage of reticulated platelets was nonspecifically increased in nonthrombocytopenic dogs with clinical disease. METHODS: Blood samples were obtained from healthy dogs and from nonthrombocytopenic dogs presented for a variety of disorders. An aliquot of whole blood was stained with TO and a phycoerythrin-labeled monoclonal antibody to platelet CD61, then analyzed by flow cytometry. RESULTS: The coefficients of variation were 7.8% to 15.6% (intra-assay precision) and 6.1% to 19.5% (interassay precision). Overnight storage for 18 to 26 hours, under variable conditions, resulted in an increase in the percentage of platelets staining with TO. The reference interval for reticulated platelets in the healthy control group was 0-4.3% (0-12,095/microL). No significant differences were found in the mean percentage of reticulated platelets or absolute concentration of reticulated platelets between control and affected dogs. CONCLUSIONS: These studies demonstrate a reliable, noninvasive diagnostic assay for measurement of reticulated platelets in whole blood and provide a baseline for assessment of the clinical utility of the assay.

Heinz-body hemolytic anemia associated with ingestion of methylene blue in a river otter.

Heinz-body hemolytic anemia and nephrosis associated with hemoglobinuria were diagnosed in a North American river otter. Fluids were administered, and the signs of renal failure improved immediately. Severe anemia developed, and the otter received a semisynthetic hemoglobin product to maintain the oxygen-carrying capacity of the blood until a blood transfusion could be given. Immediate clinical improvement was observed following hemoglobin administration, and adverse effects were not seen. Six days after admission, the otter began to produce its own RBC and recovered without complications. The Heinz-body anemia was determined to be caused by methylene blue that was in the water of minnows consumed by the otter the night before it became ill. Methylene blue is a common ingredient in products used to extend the life of bait fish. Bait fish kept in water treated with methylene blue should not be used as food for fish-eating animals.

The use of cytochemistry, immunophenotyping, flow cytometry, and in vitro differentiation to determine the ontogeny of a canine monoblastic leukemia.

We evaluated the utility of cytochemistry, immunophenotyping, flow cytometry, and in vitro culture with forced differentiation of leukemic cells as diagnostic aids to identify the malignant cell ontogeny in a dog with leukemia. A tentative diagnosis of monoblastic leukemia was established by microscopic examination of Romanowsky-stained blood smears and bone marrow aspirate smears. This diagnosis also was supported by the light scatter signature that identified the blast cells as large, non-granular monocytic cells using a CellDyn 3500 automated hematology analyzer; as well as by the detection of N-butyrate esterase and the lack of choloroacetate esterase or leukocyte peroxidase by cytochemical staining. Subsequently, leukemic cells were isolated from the dog's peripheral blood and placed into tissue culture or cryopreserved. The leukemic cells grew in suspension cultures and proliferated spontaneously for up to 4 days. By day 7, proliferation was negligible. Upon culture with conditioned supernatant using mitogen-stimulated human T cells as a source of cytokines, an increased proportion of cells entered S phase by day 2 of culture; however, proliferation declined markedly by day 4, at which time the cells had apparently differentiated to adherent, vacuolated macrophages. The cytokine-stimulated leukemic cells were positive for the monocyte/macrophage specific markers alpha-1-antitrypsin, alpha-1-antichymotrypsin, lysozyme, CD14, MHC class II, and calprotectin, an antigen found in differentiated macrophages and granulocytes. Despite the strong tendency of the leukemic cells towards monocytic differentiation, our results suggested that they retained some features of a myelomonocytic precursor. These data show that cytochemistry, immunophenotyping, flow cytometry, and in vitro differentiation of canine leukemia cells are useful tools for confirming the lineage of malignant hematopoietic cells.

Effects of hemolysis on serum chemistry analytes in ratites.

Since hemolysis has been a common problem in submitted ratite serum samples, a study was performed to determine interference by hemolysates. Nine chemistry analytes including glucose, total protein, albumin, creatine kinase (CK), gamma-glutamyl transferase (GGT), aspartate aminotransferase (AS7), calcium (Ca), phosphorus, and uric acid were evaluated on a wet reagent analyzer (Ciba Corning Express 550) and on a dry slide reagent analyzer (VetTest 8008). In emus, increasing hemoglobin concentrations increased total protein, albumin, and CK for both analyzers. With increasing hemoglobin concentrations, the Ciba Corning 550 analyte values were increased for AST, Ca, and uric acid and decreased for glucose and phosphorus, the opposite effect was seen in values from the VetTest 8008. GGT levels were variable or sometimes undetectable. Changes in ostrich analytes with hemolysis were similar to emus using the same analyzer. The effects of serum hemolysis often differed in magnitude and direction between the two chemistry analyzers. Interferographs were constructed to aid in rapid assessment of the effects of hemolysis on submitted serum samples.

Bronchoalveolar lavage in ponies with heaves during disease remission.

Bronchoalveolar ravage (BAL) fluid was collected from control ponies and from affected ponies with heaves which were in clinical remission. Significant differences were not detected between the two groups in total nucleated cell count or relative percentages (relative cell counts) of small lymphocytes, large mononuclear cells, eosinophils, or mast cells. The mean relative neutrophil count of BAL fluid from the affected group was statistically greater than that of controls; however, the difference between the two groups was not sufficient to be of diagnostic significance.