Hiatal hernia controversies - a review of pathophysiology and treatment options

Objective To provide a detailed discussion of the aetiology and pathophysiology of hiatal hernia in both humans and small animals, and review current medical and surgical treatments.
Design Review article.
Summary Hiatal hernia is not completely understood in humans or animals. It has a complex multifactorial aetiology and pathophysiology. A primary disturbance of the lower oesophageal sphincter has not been shown in humans or animals. Knowledge of pathophysiology is necessary to institute appropriate treatment.
Medical and/or surgical therapy is not indicated in asymptomatic cases. Medical treatment should be used for up to 1 month in stable cases of sliding hiatal hernia. Paraoesophageal hiatal hernias and any large sliding hiatal hernia should be considered for prompt surgical treatment. Surgical techniques used depend on the type of hiatal hernia present.
Surgical treatment of hiatal hernia cases should be performed by experienced surgeons, and must include hiatal closure and gastropexy. The Nissen fundoplication procedure has been discontinued in the veterinary field due to poor success rates, coupled with the published view that there is a marked difference in pathophysiology between humans and dogs. Reported complications associated with the original Nissen fundoplication technique are identical in the human and veterinary literature. There have been no complications reported with use of the modified or 'floppy' Nissen fundoplica-tion in dogs. Both oesophagopexy and Nissen fundoplication require further evaluation in small animals.     

Applying animal-based welfare assessments on New Zealand dairy farms: feasibility and a comparison with United Kingdom data

AIMS: To assess the feasibility of applying animal-based welfare assessments developed for use in Europe on New Zealand dairy farms; in particular, to identify measures which could be evaluated during a single visit at milking time alongside whole herd locomotion scoring.

METHODS: A protocol for animal welfare assessment, developed in the United Kingdom (UK), was evaluated. Measures that were suitable for use on pasture-based dairy farms in New Zealand were then assessed for practicability on 59 farms across New Zealand, during and immediately after milking, alongside whole herd locomotion scoring. Where data were collected the results were compared to those from a UK study of 53 dairy farms.

RESULTS: Thirteen observations of the physical condition of cows were considered suitable for measurement, excluding observations related to hock lesions as they are rarely observed on pasture-based farms. Five of these measures were not assessed as there was not time to do so during milking alongside whole herd locomotion scoring. Thus, the prevalence of dirty flanks, hind limbs and udders, dull coat, thick hairy coat, significant hair loss, very fat cows (body condition score (BCS) ≥7 on 1–10 scale) and very thin cows (BCS≤3), were recorded. Three measures of behaviour were considered suitable for measurement on-farm, but only locomotion score was practicable and was measured. Farmer-estimates for the incidence of mastitis, lameness, sudden death, milk fever and other diseases were also obtained.Overall, dirty flanks, dirty udders and estimated milk fever incidence were more prevalent in this study than in the UK. The prevalence of thin and fat cows, lame cows and estimated mastitis incidence were much lower in the present study than on UK farms.

CONCLUSIONS AND CLINICAL RELEVANCE: Animal-based assessments can be used on dairy farms in New Zealand, but need to be modified from those developed for housed cows.Welfare on these farms was generally good compared to those in the UK, but these results need to be confirmed on more farms using a wider range of assessments than proved practicable in this study.     

Clinicopathological features of 11 suspected outbreaks of bovine adenovirus infection and development of a real-time quantitative PCR to detect bovine adenovirus type 10

CASE HISTORY: A retrospective study was conducted to investigate 11 outbreaks of presumptive fatal adenovirus infection diagnosed through two New Zealand diagnostic laboratories during 2014 and 2015. Outbreaks occurred in 6–12-month-old Friesian or Friesian cross cattle during autumn, winter and spring. Individual outbreaks were short in duration, with mortality rates ranging from 3/250 to 20/600 (1.2 to 3.3%).

CLINICAL AND PATHOLOGICAL FINDINGS: Clinical signs included severe diarrhoea, depression, recumbency, and death. Post-mortem examination revealed congestion and oedema of the alimentary tract and fluid to haemorrhagic intestinal contents. Histopathological lesions were characterised by congestion and haemorrhage of the alimentary tract mucosa, oedema of the submucosa, and mild interstitial inflammation in the kidneys. Large basophilic intranuclear inclusion bodies were identified in vascular endothelial cells of the alimentary tract in 11/11 cases and of the kidney in 8/9 cases.

MOLECULAR TESTING: A real-time quantitative PCR (qPCR) assay was designed to detect bovine adenovirus type 10 (BAdV-10) using hexon gene sequences available in GenBank. DNA extracted from a field case and confirmed by sequencing was used as a positive control. The qPCR had a reaction efficiency of 101% (R²=0.99) and the limit of detection was <10 DNA copies/reaction. The qPCR detected BAdV-10 in formalin-fixed paraffin-embedded (FFPE) tissue from 10/11 cases. DNA sequencing of PCR products from nine of these cases showed them to be identical to BAdV-10 sequences in GenBank. For the PCR-negative case, the PCR product had a hexon sequence 99% similar to bovine adenovirus Wic isolate Ma20-1, a close relative of BadV-10.

DIAGNOSIS: Bovine adenovirus type 10 was identified in FFPE tissues from cattle with histopathological evidence of adenovirus infection.

CLINICAL RELEVANCE: Bovine adenoviruses, and especially BAdV-10, should be considered in the differential diagnosis for acute enteric disease and death in young cattle. The qPCR detected BAdV-10 from FFPE tissue of cattle with suspected adenoviral infection diagnosed by histopathology. However results should be interpreted in light of clinical and pathological findings due to the possibility of adenovirus shedding by healthy cattle and the presence of pathogenic adenoviruses other than BAdV-10.     

A retrospective analysis of 25% human serum albumin supplementation in hypoalbuminemic dogs with septic peritonitis

This study describes the influence of 25% human serum albumin (HSA) supplementation on serum albumin level, total protein (TP), colloid osmotic pressure (COP), hospital stay, and survival in dogs with septic peritonitis. Records of 39 dogs with septic peritonitis were evaluated. In the HSA group, initial and post-transfusion TP, albumin, COP, and HSA dose were recorded. In the non-supplemented group, repeated values of TP, albumin, and COP were recorded over their hospitalization. Eighteen dogs survived (53.8% mortality). Repeat albumin values were higher in survivors (mean 23.9 g/L) and elevated repeat albumin values were associated with HSA supplementation. Repeat albumin and TP were higher in the HSA supplemented group (mean 24 g/L and 51.9 g/L, respectively) and their COP increased by 5.8 mmHg. Length of hospitalization was not affected. Twenty-five percent HSA increases albumin, TP, and COP in canine patients with septic peritonitis. Higher postoperative albumin levels are associated with survival.     

Bacterial septic arthritis in 19 dogs

OBJECTIVE: To provide information on the clinical features, diagnosis and treatment of bacterial septic arthritis in dogs. DESIGN: A retrospective study examining case records of all dogs diagnosed with bacterial septic arthritis at Murdoch University Veterinary Hospital between 1988 and 1997. RESULTS: Nineteen dogs were diagnosed with bacterial septic arthritis, which most commonly occurred after surgery involving the stifle joint. Haematogenous infection occurred in only five dogs. Diagnosis was based on clinical signs, joint fluid analysis, radiography, microbiology and/or response to treatment. Chronic lameness was the most common problem at presentation. Analysis of joint fluid invariably revealed large number of nucleated cells, which consisted primarily of neutrophils. In all but one case the neutrophils were nondegenerate. Culture of joint fluid was frequently successful. Staphylococcus spp were the most common bacteria isolated. Treatment involved antimicrobial drugs only in five dogs. Other dogs received antimicrobial drugs in combination with surgical procedures such as joint lavage and removal of nonabsorbable suture material (eight), arthrodesis (two) or amputation (one). Two dogs were euthanased. Most dogs responded well to treatment and were free of signs of septic arthritis at follow-up. CONCLUSION: Bacterial septic arthritis may often be mild and manifest as chronic lameness. Analysis of joint fluid will detect an inflammatory arthropathy but the presence of toxic neutrophils should not be relied on as an indicator of sepsis. Culture of infected joint fluid is likely to be successful if antimicrobials are not given prior to collection and if the sample is inoculated into enrichment broth. Treatment should involve antimicrobial drugs, open-joint lavage and removal of joint prostheses if the infection is associated with previous surgery.     

Nanoengineering of inorganic and hybrid hollow spheres by colloidal templating

Hollow silica and silica-polymer spheres with diameters between 720 and 1000 nanometers were fabricated by consecutively assembling silica nanoparticles and polymer onto colloids and subsequently removing the templated colloid either by calcination or decomposition upon exposure to solvents. Scanning and transmission electron microscopy images demonstrate that the wall thickness of the hollow spheres can be readily controlled by varying the number of nanoparticle-polymer deposition cycles, and the size and shape are determined by the morphology of the templating colloid. The hollow spheres produced are envisioned to have applications in areas ranging from medicine to pharmaceutics to materials science.     

The dry-season diet of freshwater fishes in monsoonal tropical rivers of Cape York Peninsula, Australia

Abstract – Fish assemblages in three rivers of eastern Cape York Peninsula, northern Australia, were sampled during the early part of the monsoonal dry season, and the diet of 23 species was quantified. Spatial variation (between-river) in diet was, in general, not pronounced. Sufficient specimens were collected to enable examination of ontogenetic changes in the diet of four species. Interspecific and ontogenetic variation in diet were most strongly related to differences in body size and mouth gape, with larger species or age classes feeding on fish and large aquatic invertebrates. Other gradients upon which dietary differences were arranged included gradients in detritivory and reliance on terrestrial invertebrates. Significant trophic separation was evident in the fauna despite aquatic invertebrates being the most important food item in most species. Seven, and possibly eight, trophic groups were recognized. Notable features of the trophic organization were the prevalence of omnivory and piscivory and relatively small representation by detritivores. Planktivores were essentially absent. Much of the observed trophic structure within the fishes of Cape York Peninsula could be ascribed to the effects of phylogenetic determinants of body size, morphology and foraging mode. The trophic structure within rivers of eastern Cape York Peninsula is compared to other aquatic systems in tropical northern Australia. ^Note     

Light-directed, spatially addressable parallel chemical synthesis

Solid-phase chemistry, photolabile protecting groups, and photolithography have been combined to achieve light-directed, spatially addressable parallel chemical synthesis to yield a highly diverse set of chemical products. Binary masking, one of many possible combinatorial synthesis strategies, yields 2n compounds in n chemical steps. An array of 1024 peptides was synthesized in ten steps, and its interaction with a monoclonal antibody was assayed by epifluorescence microscopy. High-density arrays formed by light-directed synthesis are potentially rich sources of chemical diversity for discovering new ligands that bind to biological receptors and for elucidating principles governing molecular interactions. The generality of this approach is illustrated by the light-directed synthesis of a dinucleotide. Spatially directed synthesis of complex compounds could also be used for microfabrication of devices.