How does trauma secondary to unexpected extreme weather affect orthopaedic surgery departments? An epidemiological study on the Filomena snowstorm.

INTRODUCTION: Trauma secondary to extreme weather events may heavily impact the normal activity of orthopaedic surgery departments, especially in places not prepared to deal with them. The Filomena snowstorm, which happened in January 2021, has been one of the greatest snowstorms ever in Spain. During it, the constant influx of trauma patients made the Orthopaedic Emergencies Department (OED) to collapse. The primary objective of this study was to describe the orthopaedic injuries and changes in fracture's epidemiology observed during this exceptional period. Secondary objectives were to analyse the collected variables in order to minimize the future impact of these unexpected extreme weather events. MATERIALS AND METHODS: Retrospective cohort study between patients that came to the OED during the snowstorm (Filomena group) and those who came on the same period of the previous year (Control group). The following data were collected: age, sex, injury location, injury mechanism, diagnosis, AO/OTA fracture classification, treatment type (conservative vs surgical) and delay to surgical treatment. RESULTS: A total of 1237 patients were included in total, 655 patients from the Filomena group and 582 from the Control group. One in two patients in the Filomena group sustained a fracture (50.7% vs 23.2%). The most frequent diagnosis on the Filomena group was distal radius fracture (16.2%), five times more frequent than in the Control group (3.4%). A significant increment was also observed in the incidence of ankle (21.7%) and proximal humerus (33%) fractures. In Filomena, surgically treated fractures increased by 168%, being more severe, as C-type fractures were more prevalent (23% vs 13%). Mean delay to surgery was 6.78 days during the snowstorm. CONCLUSION: Unexpected snowstorms entail an exponential rise in orthopaedic care demand and OED pressures. A significant increment in orthopaedic trauma surgery, up to 168% more, particularly distal radius, proximal humerus and ankle fractures it is to be expected, which will imply elective surgery cancellation, damaging patients and increasing costs.

Congenital bilateral clinical anophthalmia and brachygnathia superior in a fighting bull calf.

This study describes a case of a 20-day-old male fighting bull with bilateral clinical anophthalmia and brachygnathia superior whose dam was 12.5 years old and was mistakenly dewormed with ivermectin intramuscularly in the first third of gestation in a livestock farm. A macroscopic examination of the carcass was performed, with a special focus on the ocular components. Eyeball remains were found in both orbits and a histopathological examination was performed on them. Antibodies by serological study against bovine herpes virus-1, respiratory syncytial virus and bovine viral diarrhea virus for both the cow and the calf were not detected. The calf had small orbits and inside them a white and brown mass of soft consistency. Microscopically, abundant muscular and adipose tissue was observed, alongside nervous structures and vestiges of ocular structures with stratified epithelium and abundant connective tissue with glands. No evidence that this congenital bilateral anophthalmia had infectious or hereditary origin was found. By contrast, the malformation could be related to the treatment with ivermectin during the first month of gestation.

Partial Two-Stage Exchange for Infected Total Hip Arthroplasty: A Treatment to Take into Account.

INTRODUCTION: Two-stage revision is the gold standard for chronic periprosthetic joint infection (PJI). The removal of well-fixed implants, especially the femoral component, can be extremely difficult and additional osteotomies may be needed, which is time-consuming and results in bone stock loss. When the femoral stem is osseointegrated, there is no clear indication for the use of partial two-stage revision. The primary objective was to assess infection eradication after surgery. METHODS: Retrospective study of specific case series. A total of eight patients with a chronic uncemented PJI, in the setting of complex revision surgeries, were treated with partial two-stage revision, which included selective retention of the well-fixed femoral component and complete acetabular removal. Stem retention was carried out regardless of the bacteria or associated comorbidities. RESULTS: All patients were re-revision cases with at least two previous surgeries (range, 2-4). Complex revisions were performed in five cases (non-articulated spacer) and simple revisions in three cases (articulated spacer). The minimum follow-up time was 24 months (range, 24-132 months). The infection eradication rate at final follow-up was 100%. CONCLUSION: Partial two-stage reconstruction is a promising technique for the treatment of chronic PJI in patients with a well-fixed stem and complex re-revision acetabular procedures. Further prospective studies and prolonged follow-ups are required to confirm our results.

Factors associated with mortality in older patients sustaining pelvic or acetabular fractures.

INTRODUCTION: This study aimed to investigate potential factors, including delay to surgical stabilisation, affecting mortality in older patients sustaining pelvic or acetabular (PA) fractures. MATERIALS AND METHODS: A retrospective review of the Trauma Audit and Research Network (TARN) database was performed to identify older patients (aged 65 and over) sustaining PA fractures treated surgically in a UK Major Trauma Centre (MTC) between 2015 and 2019. Chi-squared and Fisher tests were used to compare 1-year mortality rates following operative intervention between patients treated within 72 h and after 72 h. Kaplan-Meier curves were used to visualise survival probability; significant predictors of survival were found using Cox proportional hazard models. RESULTS: Of 564 older patients with PA fractures, 70 met the inclusion criteria. The mean age was 76.1 years. The overall 1-year mortality rate was 20%. When patients were grouped by time to surgery (fracture fixation within or greater than 72 h), there was no statistically significant difference in 1-year mortality. Patients whose surgery was delayed more than 72 h were more likely to have longer hospital stays (p = 0.002) or to have suffered from polytrauma (p = 0.025). Age, Charlson Co-morbidities Index (CCI) and pre-op mobility status were associated with statistically significant differences in overall mortality. The same factors were associated with a significantly increased hazard of death in the multivariate Cox proportional hazards model. Patient gender, mechanism of injury, Injury Severity Score (ISS) > 15 and head injury were not significant predictors of mortality. CONCLUSION: Surgical intervention within 72 h of injury did not result in decreased mortality in older patients with PA fractures. The 1-year mortality rate between older PA fractures and hip fractures was comparable. Consideration should be given to a combined multidisciplinary approach between orthogeriatric and expert PA surgeons for these patients.

Enhancing Preoperative Planning in Orthopedic Trauma Surgery Using a Presentation Software.

Preoperative planning (PP) is critical to ensure a successful outcome in orthopaedic trauma surgery. Since it was first described thirty years ago, no modifications have been made to the original preoperative planning (OPP) technique, which was written by hand using pen and paper. We believe that the use of presentation software (such as Microsoft PowerPoint, Microsoft Corp., Redmond, WA, US) can ease, improve and update the OPP and complement three-dimensional PP. The objective of the present paper is to describe our method for PP using a presentation software (PS).

Enhancing Preoperative Planning in Orthopedic Trauma Surgery Using a Presentation Software / Aprimoramento do planejamento préoperatório na cirurgia de trauma ortopédico usando um software de apresentação

Abstract Preoperative planning (PP) is critical to ensure a successful outcome in orthopaedic trauma surgery. Since it was first described thirty years ago, no modifications have been made to the original preoperative planning (OPP) technique, which was written by hand using pen and paper. We believe that the use of presentation software (such as Microsoft PowerPoint, Microsoft Corp., Redmond, WA, US) can ease, improve and update the OPP and complement three-dimensional PP. The objective of the present paper is to describe our method for PP using a presentation software (PS).

Resumo O planejamento pré-operatório (PP) é fundamental para garantir um resultado bemsucedido na cirurgia de trauma ortopédico. Desde que foi descrita pela primeira vez há trinta anos, não foram feitas modificações na técnica de planejamento pré-operatório original (PPO), que foi escrita à mão usando caneta e papel. Acreditamos que o uso de um software de apresentação (como o Microsoft PowerPoint, Microsoft Corp., Redmond, WA, EUA) pode facilitar, melhorar e atualizar o PPO e complementar o PP tridimensional. O objetivo deste artigo é apresentar nosso método de PP por meio de software de apresentação (SA).

Do Poller screws effect union in tibial shaft fractures treated with intramedullary nailing?

INTRODUCTION: Tibial shaft fractures are a commonly encountered challenge presented to orthopaedic trauma surgeons. Intramedullary nailing (IMN) is often the treatment of choice and whilst effective, complications of delayed and/or non-union can cause significant morbidity and necessitate additional operative procedures. The use of Poller screws during IMN are a recognised way of aiding fracture reduction, however the clinical benefits of this are debated. This study evaluated the outcome of tibial shaft fractures treated with IMN with or without the addition of Poller screws. METHODS: Retrospective cohort study of all patients undergoing IMN following tibial shaft fractures over a 5-year period. 154 operated tibial shaft fractures were identified, with patients divided into 3 groups - Group 1: IM nailing alone, Group 2: IMN + 1 conventional Poller screw, or Group 3: IMN + 2 Poller screws placed Epicentrically across the fracture site. Data collected included demographics, length of stay, fracture type, position and AO classification grade, operative time, and operating surgeons' grade. Primary outcome measure was the incidence of delayed and/or non-union. Secondary outcomes were differences in rates of infection and additional orthopaedic procedures between the 3 groups. RESULTS: Overall 139/154 fractures (90.3%) achieved a timely union. There was a statistically significant difference (p = 0.05) in fracture union between the 3 groups, with 75/88 fractures healing in group 1 (IMN alone) compared to 44/46 in Group 2 (IMN + 1 Poller screw) and 20/20 in group 3 (IMN + 2 Poller screws). There was no statistical difference in the incidence of superficial infection, (p = 0.95) additional procedures (p = 0.23) or deep infection (p = 0.65) between the 3 groups. CONCLUSION: The addition of Poller screws appear to be a safe and effective adjunct in the treatment of tibial shaft fractures via IMN. Further prospective randomised trials are needed to fully elucidate both the role and potential benefits of Poller screw augmentation in acute lower limb fracture management.

Ankle arthrodesis using the Taylor Spatial Frame for the treatment of infection, extruded talus and complex pilon fractures.

INTRODUCTION: The treatment of complex pilon fractures and talus fracture-dislocations present several challenges, like avoiding infection, achieving union, management of bone loss and function preservation. METHODS: Retrospective cohort review of fourteen patients who underwent ankle arthrodesis (AA) using the Taylor Spatial Frame (TSF) after pilon and talus fracture-dislocations. Ten tibiocalcaneal (TC) and four tibiotalar (TT) fusions were performed. Eleven of these cases were Gustilo III open fractures. Seven cases involved an open extruded talus. Four cases had established infections. There was a mean of 2.7 (range 0 - 8) operations prior to AA using TSF. The primary objective was to determine infection and union rates. Patient-reported outcomes (Short Form 36, SF-36) and functional outcomes (Ankle Osteoarthritis Score, AOS) were the secondary measures. RESULTS: Eradication and prevention of deep infection was achieved in all cases. Radiological union was achieved at a mean of 9 months (range 5 - 17). Solid AA was achieved in 12 of 14 cases using the TSF. Two TC fusions required a hindfoot fusion nail to achieve union. Eleven cases had concurrent bone transport, mean of 63 mm (range 33 - 180). Mean time of TSF treatment was 11.1 months (range 6 - 16). One case required delayed amputation. Eight patients were able to fully weight bear unaided after the treatment. Mean SF-36 was 65 (range 35 -100). Mean AOS was 36.5 (range 6.6 - 77.5) with 69.3% of scores graded good to excellent. Mean total number of operations was 5.9 (range 2 - 10). Minimum follow up time was 12 months (range 12 - 56). CONCLUSION: AA using TSF can be considered for complex pilon fractures and extruded talus. It has shown to be effective in achieving a solid fusion and infection eradication. While using the TSF in isolation, non-union must be suspected in TC fusions, absence of radiological signs of healing, massive bone loss, and possibly not using bone graft. Patients must be aware that while treatment of these injuries will be prolonged and carries the risk of many potential complications, it provides a good alternative to amputation.

Arabidopsis RIBOSOMAL RNA PROCESSING7 Is Required for 18S rRNA Maturation.

Ribosome biogenesis is fundamental to growth and development in eukaryotes and is linked to human diseases and cancer. Arabidopsis thaliana MORPHOLOGY OF ARGONAUTE1-52 SUPPRESSED 2 (MAS2) participates in splicing and 45S ribosomal DNA (rDNA) expression. In a screen for MAS2 interactors, we identified RIBOSOMAL RNA PROCESSING 7 (RRP7), an ortholog of yeast rRNA processing protein 7 (Rrp7), which is required for 18S ribosomal RNA (rRNA) maturation. Arabidopsis rrp7 mutants exhibit a pleiotropic phenotype including slow growth, altered shoot phyllotaxy, aberrant venation in lateral organs, partial infertility, and abscisic acid hypersensitivity in seedlings. In Arabidopsis, RRP7 localizes mainly to the nucleolus, the site of the 45S rDNA transcription that produces a 45S pre-rRNA primary transcript, precursor of the 25S, 18S and 5.8S rRNAs. Lack of RRP7 function perturbs 18S rRNA maturation, causes nucleolar hypertrophy, and results in an increased 25S/18S rRNA ratio. Arabidopsis contains hundreds of 45S rDNA genes whose expression is epigenetically regulated, and deregulated, in rrp7 mutants. Double mutant analysis revealed synergistic interactions between RRP7 alleles and alleles of MAS2, NUCLEOLIN1 (NUC1), and HISTONE DEACETYLASE 6 (HDA6), which encode epigenetic regulators of 45S rDNA transcription. Our results reveal the evolutionarily conserved but divergent roles of RRP7 as a ribosome biogenesis factor.

IMAGING DIAGNOSIS-COMPUTED TOMOGRAPHY FINDINGS IN A DOG WITH SPONTANEOUS TRANSMURAL MIGRATION OF A TEXTILOMA INTO THE CECUM.

A 3-year-old spayed female dog was presented with 3-month history of severe bilateral uveitis subsequent to previous ovariohysterectomy. Physical examination revealed moderate abdominal pain. Computed tomography showed a nonobstructive heterogeneous mass-like lesion with a speckled gas pattern (spongiform pattern) within the cecum. Exploratory laparotomy revealed a surgical swab in the lumen of the cecum with severe adhesions. Histopathological examination demonstrated a chronic inflammatory pyogranulomatous reaction to the retained swab embedded within the intestinal wall, consistent with transmural migration of the swab from the peritoneal cavity into the cecum.

Tumor glómico maligno: a propósito de un caso y revisión de la literatura / Malignant glomus tumor: a case report and review of the literatura

Los tumores glómicos malignos son neoplasias poco frecuentes del cuerpo glómico mioarterial. Presentamos un caso de tumor glómico maligno en mano derecha en mujer de 72 años. La resonancia magnética identificó tumoración de partes blandas de predominio subcutáneo, en el segundo dedo de la mano, con áreas más profundas que contactaban con los tendones flexores del dedo, el músculo primer interóseo dorsal y los huesos subyacentes. El estudio de extensión no evidenció enfermedad macroscópica maligna. Histológicamente el tumor tenía arquitectura plexiforme. Las células tumorales estaban en íntima relación con vasos de pequeño calibre, en ocasiones con tinción PAS positiva, con morfología fusiforme y focalmente epitelioide, atipia moderada y tasa mitótica de 4 mitosis en 10 campos de gran aumento, sin identificarse mitosis atípicas ni necrosis tumoral. Con técnicas de inmunohistoquímica se observó positividad difusa para actina de músculo liso y vimentina, con marcaje célula a célula de colágeno tipo IV y negatividad para CD34, caldesmon, desmina, queratinas y S100. Realizamos escisión quirúrgica amplia con márgenes negativos y se administró radioterapia adyuvante sobre la mano, sin evidencia de recidiva tumoral tras 9 meses de seguimiento. Presentamos también una revisión de la literatura sobre tumores glómicos malignos en miembro superior, así como el diagnóstico diferencial de este tipo de lesiones cuando se localizan en la piel y el tejido celular subcutáneo (AU)

Malignant glomus tumors are rare malignancies of the mioarterial glomus body. We report a case of a malignant glomus tumor located in the right hand of a 72 years old patient. Magnetic resonance imaging identified a soft tissue tumor of the second finger, with deeper areas in contact with the flexor tendons, the first dorsal interosseous muscle and underlying bones. The extension study showed no macroscopic malignant disease. Histologically the tumor had a plexiform architecture. Tumor cells were in close relationship with small vessels, sometimes with positive PAS staining, had a fusiform and focally epithelioid morphology with moderate atypia and a mitotic rate of 4 mitosis in 10 high magnification fields, without a typical mitosis and tumor necrosis. Diffuse positivity staining for vimentin and actins mooth muscle was observed immunohistochemically, with cell-to-cell labelty for IV collagen and negative for CD34, caldesmon, desmin, keratins and S100. Wide excision with negative margins was performed and adjuvant radiotherapy was administered on hand, with no evidence of tumor recurrence after 9 months follow up. Additionally, a review of the literature of malignant glomus tumors located in the upper limb, and the differential diagnosis of this type of tumors located in the skin and subcutaneous tissue were presented (AU)

Acute Pectoralis Major Rupture Captured on Video.

Pectoralis major (PM) ruptures are uncommon injuries, although they are becoming more frequent. We report a case of a PM rupture in a young male who presented with axillar pain and absence of the anterior axillary fold after he perceived a snap while lifting 200 kg in the bench press. Diagnosis of PM rupture was suspected clinically and confirmed with imaging studies. The patient was treated surgically, reinserting the tendon to the humerus with suture anchors. One-year follow-up showed excellent results. The patient was recording his training on video, so we can observe in detail the most common mechanism of injury of PM rupture.

Phacoemulsification considerations in nonhuman primates.

PURPOSE: To describe the pre-surgical, surgical, and post-surgical considerations for phacoemulsification in non-human primates. METHODS: Records of non-human primates that underwent phacoemulsification by the Ophthalmology Services of FHCV-UAB and HCV-UM, between 2003 and 2009 were reviewed. RESULTS: Five primates were represented: one gorilla, one chimpanzee, one pygmy marmoset, one orangutan, and one chacma baboon. Three were males and two females, of a median age of 16.8 years. Four primates presented bilateral cataracts and one unilateral (n = 9 eyes). Cataracts were immature in two eyes, mature in four and hypermature in 3. One-handed phacoemulsification was used in seven eyes and a two-handed technique in 2. Intraocular lenses (IOLs), with optic powers between +19.0 and +21.5D, were implanted in the four large-sized primates. All the primates were more active and social after the surgery. CONCLUSION: Phacoemulsification in non-human primates is highly successful and associated with an overall good visual outcome. Nevertheless, specific considerations should be applied in these species.

Morphology of retinal vessels in the optic disk in a Göttingen minipig experimental glaucoma model.

OBJECTIVE: To compare the morphology of normal, healthy Gottingen minipig retinal vessels of the optic disk with experimentally induced glaucomatous optic disks in order to identify the glaucomatous excavation. Present results were compared to human glaucoma findings. PROCEDURE: Sixteen eyes from eight Göttingen minipigs were studied using fundoscopic photography and fluorescein angiography. Experimental glaucoma was then induced in the left eyes over 14 months, and changes in the optic disk vessels were assessed using fundoscopic photography and fluorescein angiography. The changes were compared with those previously reported in humans. RESULTS: Regarding the number of vessels, the location from where they emerge and the sectors of the optic disk that they cross, arterial and retinal vessels in Göttingen minipigs present a more asymmetric layout than in humans. The central excavation is filled by the central venous ring. Changes in the glaucomatous optic disk include arteriolar incurvation, and sometimes, nasal, and peripheral displacement of the arterioles that emerge between the ganglion cell axons of the neuroretinal ring. No angiographic changes were observed in the experimental glaucoma model. CONCLUSIONS: The changes in the glaucomatous optic disk of the minipig imply a predominant involvement of the arterioles. However, in humans with primary open-angle glaucoma (POAG), both the arterioles and the venules are displaced, and the central excavation is easier to distinguish, because of the absence of a central venous ring.

Morbillivirus and pilot whale deaths, Mediterranean Sea.

An outbreak of a lethal morbillivirus infection of long-finned pilot whales occurred in the Mediterranean Sea from the end of October 2006 through April 2007. Sequence analysis of a 426-bp conserved fragment of the morbillivirus phosphoprotein gene indicates that the virus is more closely related to dolphin morbillivirus than to pilot whale morbillivirus.

Broncholithiasis in a cat: clinical findings, long-term evolution and histopathological features.

A 14-year-old neutered male Persian cat was evaluated because of an acute exacerbation of a chronic cough of 2-3 years of duration. Physical examination was normal except for the auscultation of accentuated breath sounds and wheezes cranially on both sides of the chest. Complete blood count, biochemical parameters and urinalysis were normal. Thoracic radiographs showed a generalised nodular pattern with multiple mineral opacities. Oral prednisone and doxycycline were prescribed. Two weeks later, the frequency of the cough was significantly reduced. Terbutaline was recommended for relief of acute exacerbations. Three years later the cat was evaluated again due to a non-related disease that led to the euthanasia of the cat. Concerning its respiratory disease, the cat had experienced nearly asymptomatic periods of 3-6 weeks of duration punctuated by acute exacerbation periods of 7-10 days, during which terbutaline was useful to relieve the cough. Thoracic radiographs showed a mild increase in the size and extent of the pulmonary mineralisation. Histopathologically, mild bronchitis and bronchiectasis were evident, accompanied by calcified bronchial plugs and marked hyperplasia and hypertrophy of the seromucinous glands. Based on clinical and pathoanatomical findings, a final diagnosis of miliary broncholithiasis and bronchiectasis was made. Broncholithiasis should be considered in differential diagnosis of pulmonary mineralisation in cats. When no concomitant diseases are present, this rare disease appears to have a slowly progressive evolution that does not appear to carry a bad prognosis and may be satisfactorily managed with combinations of bronchodilators and corticosteroids.

Pharmacokinetics of danofloxacin after single dose intravenous, intramuscular and subcutaneous administration to loggerhead turtles Caretta caretta.

The single-dose disposition kinetics of the antibiotic danofloxacin were determined in clinically normal loggerhead turtles (n = 6) after intravenous (IV), subcutaneous (SC) and intramuscular (IM) administration of 6 mg kg(-1) bodyweight. Danofloxacin concentrations were determined by high performance liquid chromatography with fluorescence detection. The concentration-time data were analyzed by non-compartmental kinetic methods. Steady-state volume of distribution, and total body clearance of danofloxacin after IV administration were estimated to be 1.02 +/- 0.17 1 kg(-1) and 0.11 +/- 0.01 1 h(-1) kg(-1), respectively. Following IM and SC administration, danofloxacin achieved maximum plasma concentrations of 10.25 +/- 4.59 and 10.35 +/- 4.45 mg l(-1) at 1.20 +/- 0.52 and 1.46 +/- 0.48 h, respectively. The absolute bioavailabilities after SC and IM routes were 98.72 +/- 11.73 and 104.81 +/- 14.97%, respectively. Danofloxacin shows a favourable pharmacokinetic profile in loggerhead turtles reflected by parameters such as a long half-life and a high bioavailability following a single dose of 6 mg kg(-1) by IM and SC routes; thus, it is likely that this treatment will be effective in loggerhead turtles with bacterial infections.

Retinal toxicity of intravitreal triamcinolone acetonide at high doses in the rabbit.

In order to study acute retinal toxicity of intravitreal triamcinolone acetonide (TA) at high doses in an animal model, thirty New Zealand albino rabbits were injected with intravitreal TA. The animals were divided in five groups: Group 1 received an intravitreal injection of 0.1 mL balanced salt solution; Group 2, 0.1 mL of the solvent (0.99 mg of benzyl alcohol); Group 3, received 4 mg/0.1 mL TA; Group 4, 20mg/0.1 mL TA; and Group 5, 30 mg/0.1 mL TA. A standard light and dark adapted electroretinogram (ERG) was obtained prior and 28 days after the injection. The animals were sacrificed 28 days after the injection and the eyes were enucleated and examined by electron (EM) and light microscopy (LM) using hematoxylin-eosin, Nissl fluorescent, and immunohistochemistry (glial fibrillary acidic protein). No statistically significant differences in ERG before and 28 days after the injection were found. LM and EM did not show retinal damage in any animal. One eye developed bacterial endophthalmitis 14 days after the injection. Intravitreal TA up to 30 mg does not seem to have acute toxic effects on the function (ERG) or the structure (LM, EM) of the retina of albino rabbits.

Systemic hypertension in dogs with leishmaniasis: prevalence and clinical consequences.

A prospective study was performed (November 1998 to December 2003) to determine the prevalence of systemic hypertension (SH) in dogs with glomerular disease secondary to leishmaniasis. One hundred and five dogs with leishmaniasis were screened and staged for the presence of renal disease (RD) and SH. For the purpose of the study, RD was defined as serum creatinine concentration > or = 1.4 mg/dL, a urine protein/creatinine ratio > or = 0.5, or both. SH was defined as a systolic blood pressure (SBP) > or =180 mm Hg or an SBP between 150 and 179 mm Hg in the presence of clinical manifestations of SH. Fifty-two (49.5%) of the dogs had some degree of RD, and 32 (61.5%) of these dogs were diagnosed with SH. Moreover, SH also was diagnosed in 3 dogs without RD. Left ventricular hypertrophy (LVH), estimated by echocardiography, was the most frequently observed systemic consequence of hypertension, being present in 32 (91.4%) of the hypertensive dogs. Echocardiographic abnormalities were not detected in any of the 33 dogs with leishmaniasis without RD, which were used as controls. Ocular consequences of SH were observed in only 2 (5.7%) of the dogs with hypertension. We conclude that SH is prevalent in dogs with RD secondary to leishmaniasis, not only in the more severe stages but also in the early course of the illness before azotemia becomes apparent. Canine leishmaniasis may be a useful natural model to study SH secondary to glomerular disease.