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We aimed to evaluate the effect of the intravenous (IV) administration of blood cell secretome (BCS) compared to its intra-articular (IA) administration. In this cross-over study, ten dogs with bilateral hip osteoarthritis were initially assigned to an IA group (IAG). After a 180-day follow-up, the same 10 animals were assigned to an IV group (IVG). IAG received a single IA administration of 3 ml of BCS per hip joint, and IVG received a single 6 ml IV administration of BCS. Following each treatment, follow-up was conducted on days 0, 8, 15, 30, 60, 90, 120, 150, and 180. In each follow-up, copies of the Canine Brief Pain Inventory (divided into pain interference score - PIS and Pain Severity Score - PSS), Liverpool Osteoarthritis in Dogs (LOAD), and Canine Orthopedic Index (COI, divided into function, gait, stiffness, and quality of life) were obtained. Results were analyzed with the Mann-Whitney test, and Kaplan-Meier estimators were calculated and compared, p < 0.05. The animals had a mean age of 7.6 ± 2.9 years and bodyweight of 27.8 ± 3.6 kg. Seven hips were classified as moderate osteoarthritis, and three as severe. No differences were found between groups from days 0 to +60d, with both groups showing clinically significant improvements. Improvements in the IAG lasted up to +120d. Kaplan-Meier estimators showed that dogs in IAG took longer to record the considered events. IVG also showed positive clinically significant results with different instruments. IV administration of BCS can improve the overall condition of dogs with hip OA, but the IA administration produces longer-lasting results., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: To evaluate the effect of post-surgical photobiomodulation therapy in dogs., Methods: Twenty dogs were selected for elective gastropexy and randomly divided into a control (CG, n = 10) and a PBMT group (PBMTG, n = 10). Pre‑medication consisted of medetomidine and butorphanol. Meloxicam was administered before the procedure. Induction was performed with propofol and maintained with sevoflurane. Local blocks with lidocaine were used. Incisional gastropexy was performed in all animals. PBMTG received PBMT immediately after surgery. The need for postoperative rescue analgesia, if the animal had eaten by the evaluation momen, and pain scores were collected using the Glasgow Composite Measure Pain Scale - Short Form (CMPS‑SF) at 1, 2, 4, 6, 8, 12, 16, 20, and 24 h post‑endotracheal extubation. CMPS‑SF scores were compared with the Mann-Whitney Test and proportions of animals that required rescue analgesia and had eaten with a χ 2 test. P was set at < 0.05., Results: No rescue analgesia was needed for any animal. Still, significant differences were observed in CMPS-SF scores between CG and PBMTG between 1 and 4 h post-extubation. PBMTG had a significantly higher proportion of animals eating up to the 8 h post-extubation evaluation moment., Conclusion: Adding post-surgical photobiomodulation to a standard anesthesia and analgesia protocol reduced CMPS-SF scores and increased the proportion of animals that resumed eating compared to the standard protocol alone., (© 2024. The Author(s).)

Biological control using edible mushrooms as natural enemies is a sustainable alternative for pest management. Despite the well-established literature on toxins and secondary metabolites produced by these fungi in the biochemical control of nematodes, the nematicidal activity of proteases from different Pleurotus species is yet to be investigated. Therefore, this study aimed to correlate protease to the nematicidal activity of different mushrooms, Pleurotus sp., P. ostreatus (SB), P. ostreatus (Pearl), and P. djamor. For such a purpose, we performed motility assays of Panagrellus sp. at different time intervals, 6, 12, and 24 h for each of the mushrooms. In addition, the protease activity was measured using different pH (5, 7, and 9) and fermentation time intervals (45 and 75 days). Furthermore, we also evaluated the effect of this cell-free extract on Panagrellus sp. In response to these experiments, all edible mushrooms showed a reduction over 82% for the nematode-feeding activity (p < 0.01). The cell-free crude extract of each of the fungi studied showed nematocidal activity (p < 0.01). For the 45-day fermentation, P. djamor exhibited statistical significance (p < 0.01) compared with the others, reaching a reduction percentage of 73%. For the 75-day fermentation, Pleurotus sp. and P. ostreatus (Pearl) showed significant differences compared with the other fungi (p < 0.01), with reduction percentages of 64 and 62%, respectively. Herein, protease activity was associated with the nematicidal action of different Pleurotus species in controlling Panagrellus sp., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Objective: To describe the effect of different substance combinations administered through mesotherapy in dogs with hip osteoarthritis., Animals: 104 dogs., Methods: In this retrospective study, 4 groups (dogs treated with a combination of lidocaine, piroxicam, and thiocolchicoside [MG]; dogs treated with lidocaine, piroxicam, and Traumeel [TG]; dogs treated with lidocaine, piroxicam, and glucosamine [GG]; and dogs treated with the same combination as in MG combined with a photobiomodulation session [MPG]) were set. For all groups, the same treatment frequency was followed. Response to treatment was measured with the Canine Brief Pain Inventory (divided into pain interference score and pain severity score), Liverpool Osteoarthritis in Dogs (LOAD), and Canine Orthopedic Index (divided into function, gait, stiffness, and quality of life) before treatment and 15, 30, 60, 90, and 120 days after treatment. Cox proportional hazard regression analysis was used to investigate the influence of treatment, age, sex, body weight, breed, and Orthopedic Foundation for Animals score., Results: Dogs had a mean age of 7.6 ± 3.1 years and body weight of 28.6 ± 5.5 kg. Hip osteoarthritis was classified as mild (4), moderate (70), or severe (30). Greater improvements were observed in MG and MPG. Kaplan-Meier estimators showed MG and MPG had longer periods with clinically significant results. Treatment was the covariable that contributed more frequently to the outcomes observed., Clinical Relevance: The combination used in MG, particularly combined with photobiomodulation, produced longer-lasting clinically significant results.

Dendritic cells (DCs) capture pathogens and process antigens, playing a crucial role in activating naïve T cells, bridging the gap between innate and acquired immunity. However, little is known about DC activation when facing Leishmania parasites. Thus, this study investigates in vitro activity of canine peripheral blood-derived DCs (moDCs) exposed to L. infantum and L. amazonensis parasites and their extracellular vesicles (EVs). L. infantum increased toll-like receptor 4 gene expression in synergy with nuclear factor κB activation and the generation of pro-inflammatory cytokines. This parasite also induced the expression of class II molecules of major histocompatibility complex (MHC) and upregulated co-stimulatory molecule CD86, which, together with the release of chemokine CXCL16, can attract and help in T lymphocyte activation. In contrast, L. amazonensis induced moDCs to generate a mix of pro- and anti-inflammatory cytokines, indicating that this parasite can establish a different immune relationship with DCs. EVs promoted moDCs to express class I MHC associated with the upregulation of co-stimulatory molecules and the release of CXCL16, suggesting that EVs can modulate moDCs to attract cytotoxic CD8 + T cells. Thus, these parasites and their EVs can shape DC activation. A detailed understanding of DC activation may open new avenues for the development of advanced leishmaniasis control strategies.

Squalius alburnoides (Steindachner, 1866) is an endemic threatened species from the Iberian Peninsula. Here, we report the first observations of intraspecific cleaning behavior in isolated summer pools in the Guadiana River Basin (Portugal). We found that focal S. alburnoides solicited cleaning by adopting an immobile tail-stand position known as "posing," which immediately signaled a response to a few conspecifics that approached and inspect them. Our study expands the list of cleanerfish species in freshwaters, giving emphasis to the importance of mutual positive behavior within an endangered species, particularly when facing seasonal disturbance., (© 2023 Fisheries Society of the British Isles.)

To evaluate the effectiveness of photobiomodulation therapy (PBMT) in reducing gingivitis following professional dental prophylaxis in dogs in a prospective, randomly controlled, double-blind study. The study included 47 dogs (male n = 23, female n = 24), with a mean age of 6.5 ± 2.6 years and a bodyweight of 28.9 ± 5.3 kg. Breeds included: Belgian Malinois Shepherd Dogs (n = 23), German Shepherd Dogs (n = 14), Labrador Retriever (n = 4), and Dutch Shepherd Dogs (n = 3). The left side of the mouth was treated by performing dental prophylaxis (control group). The right side received dental prophylaxis and a single session of PBMT using a Class IV therapeutic laser (treatment group). Each side was graded individually for periodontal disease (PD), gingivitis, and calculus. Follow-up observations were conducted on days 1, 3, 8, and 15 post-treatment. Results were compared using a Mann-Whitney Test. Multiple regression was run to predict PD, gingivitis, and calculus scores using age, sex, and breed. A p < .05 was considered significant. The PBMT group (PG) showed significantly lower gingivitis scores from day 1 to 15 post-treatment. PD had an increasing prevalence with age. Age and breed contributed to the prediction of PD, gingivitis, and calculus grading. This study showed that PBMT significantly reduced the grade of gingivitis following dental prophylaxis, and may be a useful adjuvant procedure following dental prophylaxis.

In this retrospective study to determine the optimal method of evaluating static weight-bearing distribution to assess response to treatment in dogs with osteoarthritis using a weight distribution platform, data from the Clinica Veterinária de Cães (Portuguese Republican National Guard) clinical records were extracted. At baseline and at 15 days post-treatment, follow-up data from 80 dogs treated for bilateral hip osteoarthritis were categorized based on an anchor question. Estimates of minimal clinically important differences were calculated with distribution-based and anchor-based methods for deviation from normal weight-bearing and a symmetry index (SI). For deviation, the anchor-based methods provided a range from -0.3 to -3.1, and the distribution-based methods from 0.16 to 0.29. For SI, the anchor-based methods provided a range from -10.0 to -23.9, and the distribution-based methods from 1.31 to 2.88. Receiver operator characteristic curves provided areas under the curve >0.7, indicating an acceptable cut-off point. We presented estimates of -1 for deviation and -10 for SI in dogs with OA. These estimates can be used for research and patient monitoring. Future studies should include OA from other joints and animals from a broader clinical context.

Background: Chronic diarrhoea is a common clinical sign in dogs with chronic enteropathy, and psyllium husk has been shown to improve clinical signs in affected dogs. The aim of this study was to investigate whether faecal microbiome transplant has a similar effect in alleviating clinical signs in dogs with chronic large bowel diarrhoea., Method: Thirty large-breed working dogs with chronic large bowel diarrhoea were divided into a psyllium group (PG) and a faecal microbiome transplant group (FMTG). To the PG, 16 g/day of psyllium husk was administered for 30 days. The FMTG received faecal microbiome transplantation (FMT) once via enema. A daily log of faecal characteristics was kept, and the dogs' canine inflammatory bowel disease index (CIBDAI) and body condition scores (BCS) were determined. A Wilcoxon-Mann-Whitney test was used to compare group results. In addition, the Kaplan-Meier test was used to evaluate the occurrence rate of 1 day or more of diarrhoea and 2 days or more of diarrhoea by day 30., Results: The sample had a mean age of 3.9 ± 2.1 years and a bodyweight of 25.3 ± 6.8 kg. The FMTG showed a more rapid onset of CIBDAI improvement but no difference in other measures. At 30 days, the FMTG showed a greater improvement in bodyweight and BCS, but no differences were observed in faecal scores, defaecation frequency and time of appearance of episodes of diarrhoea. Time played a significant positive role in the results observed across both groups (p < 0.05)., Limitations: This study did not compare the microbiomes of the dogs before and after treatment, so the role of specific types of bacteria cannot be determined., Conclusion: Psyllium husk and FMT had similar effects in improving clinical signs of chronic large bowel diarrhoea., (© 2023 British Veterinary Association.)

Osteoarthritis (OA) is highly prevalent in the canine population. Due to the multiple dimensions of the disease, a multimodal approach is usually favored by clinicians. To evaluate the combined treatment with intra-articular platelet-rich plasma (PRP) and photobiomodulation in dogs with bilateral hip OA, thirty dogs were assigned to a PRP group (PRPG, n = 10), a photobiomodulation group (PBMTG, n = 10), or a combined therapies group (PRP+PBMTG, n = 10). The PRPG received two intra-articular administrations of platelet-rich plasma 14 days apart. The PBMTG received photobiomodulation with a therapeutic laser, with three sessions every other day in week one; two sessions in week two; a single session in week three; and one session/month on follow-up evaluation days. The PRP+PBMTG received the two combined therapies. The response to treatment was evaluated with weight-bearing distribution and the Canine Brief Pain Inventory, the Liverpool Osteoarthritis in Dogs, and the Canine Orthopedic Index. Evaluations were conducted before treatment and +8, +15, +30, +60, and +90 days after initial treatment. Normality was assessed with a Shapiro-Wilk test, and the groups' results in each evaluation moment were compared using a Mann-Whitney U test. Animals of both sexes (male n = 19, female n = 11) were included in the sample, with a mean age of 7.8 ± 2.5 years and a body weight of 26.5 ± 4.7 kg. Joints were classified as mild (n = 6, three in PRPG, two in PBMTG, and one in PRP+PBMTG), moderate (n = 18, six in PRPG, five in PBMTG, and seven in PRP+PBMTG), and severe (n = 6, one in PRPG, three in PBMTG, and two in PRP+PBMTG). No differences were found between groups at the initial evaluation. All treatments produced clinically significant improvements compared to the assessment on treatment day. The combination of PRP and photobiomodulation produced greater, longer-lasting improvements. PRP and photobiomodulation can improve objective outcomes and client-reported outcome measures in dogs with OA. Their combined use leads to greater, longer-lasting, clinically significant improvements.

Objective: Osteoarthritis is the most common joint disease in companion animals. Several client-report outcome measures (CROMs) have been developed and validated to monitor patients and their response to treatment. However, estimates for minimal clinically-important differences for these CROMs in the context of osteoarthritis have not been published., Patients and Methods: Data from the Clínica Veterinária de Cães (Portuguese Gendarmerie Canine Clinic) clinical records were extracted. Baseline and 30-day post-treatment follow-up data from 296 dogs treated for hip osteoarthritis were categorized based on an anchor question, and estimates of minimal clinically-important differences (MCIDs) using distribution-based and anchor-based methods were performed., Results: For the LOAD, the anchor-based methods provided a MCID estimate range of -2.5 to -9.1 and the distribution-based methods from 1.6 to 4.2. For the COI, the anchor-based methods provided a MCID estimate range of -4.5 to -16.6 and the distribution-based methods from 2.3 to 2.4. For the dimensions of COI, values varied from -0.5 to -4.9 with the anchor-based methods and from 0.6 to 2.7 with the distribution-based methods. Receiver operator characteristic curves provided areas under the curve >0.7 for the COI, indicating an acceptable cut-off point, and >0.8 for the LOAD, indicating an excellent cut-off point., Conclusion: Our estimates of MCIDs for dogs with OA were consistent with previously proposed values of -4 for the LOAD and -14 for the COI in a post-surgical intervention context. ROC curve data suggest that LOAD may more reliably differentiate between anchor groups. We also presented estimates from COI of -4 for Stiffness, Function, and Gait and -3 for quality of life. These estimates can be used for research and patient monitoring., Competing Interests: I have read the journal’s policy, and the authors of this manuscript have the following competing interests: John Innes is co-holder, with the University of Liverpool, of the licence for the LOAD client-reported outcomes measure. LOAD is licensed to Elanco Animal Health., (Copyright: © 2023 Alves, Innes. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective:  The aim of this study was to perform the initial psychometric evaluation of the Portuguese version of the Canine Orthopaedic Index (COI)., Study Design:  In a prospective, randomized study, a group of 50 police working dogs with bilateral hip osteoarthritis was assessed. A copy of the translated Portuguese version of the COI was completed by canine handlers, native Portuguese speakers. This result was compared with that of 50 sound dogs. Construct validity was determined by comparing sound dogs and dogs with osteoarthritis scores with the Mann-Whitney test. Additionally, the Kaiser-Meyer-Olin measure of sampling adequacy, eigenvalue, and scree-plot analysis were performed. Internal consistency was tested with Cronbach's α., Results:  A significant difference was observed between osteoarthritis and sound dogs in all dimensions of the COI ( p  < 0.01 for all), indicating construct validity. Two factors accounted for 87.8% of the total variance. Cronbach's α was 0.98, with a high interitem correlation, accounting for strong internal consistency., Conclusion:  We presented criterion and construct validity of the Portuguese version of the COI. It is a step in providing clinicians with a validated and accessible tool to evaluate orthopaedic patients. Further studies are required., Competing Interests: None declared., (Thieme. All rights reserved.)

Accurate localization is a critical task in underwater navigation. Typical localization methods use a set of acoustic sensors and beacons to estimate relative position, whose geometric configuration has a significant impact on the localization accuracy. Although there is much effort in the literature to define optimal 2D or 3D sensor placement, the optimal sensor placement in irregular and constrained 3D surfaces, such as autonomous underwater vehicles (AUVs) or other structures, is not exploited for improving localization. Additionally, most applications using AUVs employ commercial acoustic modems or compact arrays, therefore the optimization of the placement of spatially independent sensors is not a considered issue. This article tackles acoustic sensor placement optimization in irregular and constrained 3D surfaces, for inverted ultra-short baseline (USBL) approaches, to improve localization accuracy. The implemented multi-objective memetic algorithm combines an evaluation of the geometric sensor's configuration, using the Cramer-Rao Lower Bound (CRLB), with the incidence angle of the received signal. A case study is presented over a simulated homing and docking scenario to demonstrate the proposed optimization algorithm.

Infrared thermography is suggested as a method of medical assistance for evaluating anatomical regions where there may be some inflammatory or painful condition that requires immediate medical attention. For this reason, this study aimed to characterize digital thermography of the lumbar region in police working dogs with hip osteoarthritis, 47 dogs with bilateral hip osteoarthritis were evaluated. A thermographic dorsoventral view of the dogs' backs were obtained, and mean and maximum temperatures were determined. In addition, results from the Canine Brief Pain Inventory, Liverpool Osteoarthritis in Dogs (LOAD), the Canine Orthopedic Index, and weight-bearing distribution evaluation were collected. Results were compared with an Independent Samples T-Test or ANOVA, followed by an LSD post hoc. Multiple regression was run to predict temperatures from age, sex, breed, body weight, and Orthopedic Foundation for Animals hip score and to predict clinical metrology scores and weight-bearing distribution results from temperature results. The sample included 28 males and 19 females, with a mean age of 6.3 ± 2.5 years and bodyweight of 26.9 ± 5.1 kg, with osteoarthritis hip scores of mild (70.2%), moderate (21.3%), and severe (8.5%). Significant differences were observed in mean temperatures between German Shepherd Dogs (GSD) and Labrador Retrievers (LR) (p < 0.01), and LR and Belgian Malinois (BM) (p=0.02). Mean temperature contributed to the prediction of LOAD and stiffness. LR showed significantly higher temperature values than GSD and BM. No differences were observed between osteoarthritis hip scores and mean temperature values contributed to LOAD scores' prediction. This relation needs to be addressed in further studies, involving a larger number of animals, and to determine changes in response to treatment., Competing Interests: Declaration of competing interest The authors have no conflict of interest to state., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

This study aimed to define the profile of hospitalizations of children in public hospitals of 52 municipalities of the state of Rondônia, Brazil. We performed an ecological time series study using secondary data provided by the Hospital Information System. The annual trend of Hospitalizations was presented by age group and health region. Linear regression was performed using the Prais-Winsten technique of the statistical package Stata, version 11.0. Hospitalizations for gastrointestinal diseases were found to be decreasing in all age groups, just as those for vaccine-preventable diseases in children aged between 1 and 9 years. Hospitalizations for skin and subcutaneous tissue diseases were increasing in all ages, as well as those caused by epilepsies in children aged 1 to 9 and those caused by diseases related to childbirth and puerperium. Health regions showed a varied hospitalization profile. A stable trend was found in the Cone Sul, Madeira-Mamoré, Café, Vale do Guaporé, and Vale do Jamari regions, whereas a declining trend was found in the Central and Zona da Mata regions. The high rates of hospitalizations for ambulatory care-sensitive conditions in children show how inefficient strategies and investments in primary care have been in the state of Acre, Brazil.

Congenital Zika syndrome (CZS) is a cluster of malformations induced by Zika virus (ZIKV) infection and the underline mechanisms involved in its occurrence are yet not fully understood. Along with epidemiological and environmental factors, the genetic host factors are suggested as important to the CZS occurrence and development, however, few studies have evaluated this. This study enrolled a total of 245 individuals in a case-control association study compound a cohort of high specific interest constituted by 75 mothers who had delivered CZS infants, their 76 infants, and 47 mothers that had delivered healthy infants, and their 47 infants. Sixteen single-nucleotide polymorphisms on TREM1, CXCL10, IL4, CXCL8, TLR3, TLR7, IFNR1, CXCR1, IL10, CCR2 and CCR5 genes were genotyped to investigate their association as risk factors to CZS. The results show an association between C allele at TREM1 rs2234246 and C allele at IL4 rs224325 in mothers infected with ZIKV during pregnancy, with the increased susceptibility to CZS occurrence in their infants and the SNP CXCL8 rs4073 and the G allele at CXCL10 rs4508917 with presence of CZS microcephaly in the infants. Furthermore, the T allele at CXCL8 rs4073 and TRL7 rs179008 SNPs were associated with the severity of microcephaly in children with CZS. These results suggest that these polymorphisms in genes of innate immune responses addressed here are associated to increased risk of occurrence and severity of CZS in pregnant mothers infected with ZIKV and their CZS infants., (© 2023. The Author(s).)

Osteoarthritis (OA) is a growing welfare problem for dogs and a challenge to manage for the clinician, and most therapeutic options aim to control pain. In a randomized, double-blinded, placebo-controlled, 2-way, 2-period crossover study, we aimed to evaluate the use of Blood Cell Secretome (BCS) administrated intra-articularly, with or without the combination with triamcinolone, in dogs with bilateral hip OA. BCS is an acellular orthobiologic containing anti-inflammatory and anabolic proteins produced from the patient’s own blood through extended coagulation in a defined environment. Fifteen dogs were initially assigned to a BCS group (BCSG, n = 5), a triamcinolone group (TG, n = 5), or a combination group (BCS+TG, n = 5). All had bilateral hip OA. After a 180-day follow-up, the crossover was performed with BCSG (n = 7) and BCS+TG (n = 7). BCSG received a single intra-articular administration of 3 mL of Blood Cell Secretome, and BCS+TG received BCS plus 0.5 mL of triamcinolone acetonide (40 mg/mL). The volume in BCSG was corrected to 3.5 mL with saline. In all patients, both hips were treated. For treatment follow-up, a copy of the Canine Brief Pain Inventory (divided into pain interference score—PIS and Pain Severity Score—PSS), Liverpool Osteoarthritis in Dogs (LOAD), and Canine Orthopedic Index (COI, divided into function, gait, stiffness, and quality of life) was completed on days 0, 8, 15, 30, 60, 90, 120, 150, and 180. Results were analyzed with the Mann−Whitney U test, effect size, and Kaplan−Meier estimators, followed by the log-rank test. p was set at <0.05. Patients of the sample had a mean age of 9.6 ± 2.9 years and a body weight of 29.2 ± 3.9 kg. Seven hips were classified as severe osteoarthritis, and eight were classified as moderate. No differences were found between groups at T0. Significant differences were observed in PSS scores at +8d, with BCS+TG exhibiting better results. PIS, PSS, LOAD, stiffness, and function scores were also lower in BCS+TG from +15 to +60d. The two groups showed similar improvements from +90 to +120d. Kaplan−Meier estimators showed that dogs in BCS+TG showed clinically-important differences for longer, despite a positive result in BCSG. The intra-articular administration of BCS alone was able to improve the overall condition of OA patients. Its combined use with triamcinolone acetonide lead to a faster and longer-lasting improvement in pain scores.

Objective: To perform the initial psychometric evaluation of the Portuguese version of the Canine Brief Pain Inventory (CBPI)., Animals: A total of 100 dogs, 50 with bilateral hip osteoarthritis and 50 unaffected dogs., Procedures: The 2 groups of dogs were assessed using the CBPI. The English version of the CBPI (divided into a pain severity score and a pain interference score) was translated into Portuguese, and a copy of the translated version was completed by native Portuguese speakers' canine handlers. The results from the 2 groups were compared, and psychometric properties were evaluated. Construct validity was evaluated by assessing differences between animals with osteoarthritis and unaffected animals with the Mann-Whitney test. Further evaluation was performed with the Kaiser-Meyer-Olin measure of sampling adequacy, Eigenvalue, and scree-plot analysis. Internal consistency was tested with Cronbach α., Results: A significant difference was observed between dogs with osteoarthritis and unaffected dogs in pain severity and pain interference scores (P < .01 for both), one indication of construct validity. Cronbach α was 0.99, and a high interitem correlation was observed, showing strong internal consistency. One factor accounted for 92.3% of the total variance., Clinical Relevance: We presented the initial validation of the Portuguese version of the CBPI and its validity in the Portuguese language. It is an essential step in providing a valid tool for clinicians to assess pain in dogs with osteoarthritis. Further studies are required to determine if the present results can be replicated across samples with different characteristics and evaluate response to treatment.

Objective: To describe the effect of a mesotherapy protocol in dogs with osteoarthritis., Animals: 30 dogs., Procedures: Dogs were randomly assigned to a control (CG; n = 10) or a mesotherapy group (MG; 20). CG received meloxicam for 70 days. MG was treated with a combination of lidocaine, piroxicam, and thiocolchicoside, injected in intradermal points. Seven treatment sessions were conducted. Response to treatment was measured with different instruments: the Canine Brief Pain Inventory (divided into Pain Interference Score [PIS] and Pain Severity Score [PSS]), Liverpool Osteoarthritis in Dogs (LOAD), and Canine Orthopedic Index (COI; divided into function, gait, stiffness, and quality of life), at time 0 (T0), +15 days, +30 days, +60 days, and +90 days after T0. At each time point, the results of the 2 groups with each instrument were analyzed with the Wilcoxon signed ranks test, P < .05. Kaplan-Meier estimators were compared with the Breslow test., Results: Dogs had a mean age of 6.9 ± 2.7 years and a body weight of 31.0 ± 6.4 kg. Hip osteoarthritis was classified as mild (n = 9), moderate (17), or severe (4). No differences were found at T0. Better results were observed in MG at +15 days (P < .01 for PSS and PIS, P = .03 for function), +30 days (P = .01 for PIS and LOAD, P = .03 for PSS, and P = .04 for function, gait, and COI), +60 days (P < .01 for PSS and PIS, P = .01 for LOAD, and P = .02 for function), and +90 days (P = .01 for PSS and PIS, P = .03 for LOAD, and P = .04 for function). Kaplan-Meier estimators showed MG had longer periods with better results than CG in various scores., Clinical Relevance: This mesotherapy protocol reduced pain scores and other clinical metrology instrument scores lasting for longer periods.

Objective: To propose a stepwise approach to robotic diffuse adenomyosis resection with double flap and concomitant abdominal cerclage., Design: A narrated video footage of the surgical approach of a clinical case with extensive adenomyosis and recurrent abortions. Institutional review board approval was obtained (No 3.725.458)., Setting: A university center., Patient(s): We present a case of a 37-year-old patient, gravida 4 para 0 with a history of 3 first trimester miscarriages after spontaneous pregnancies, and a 20-week spontaneous abortion after an in vitro fertilization pregnancy. She underwent 2 laparoscopic excisions of deeply infiltrative endometriosis and was treated with gonadotropin-releasing hormone for 6 months and dienogest for a year with no improvement of her adenomyosis. Currently, she experiences moderate dysmenorrhea and desires future fertility., Intervention(s): For 3 months, gonadotropin-releasing hormone analogues were used before performing the robotic surgery for adenomyosis resection and abdominal cerclage. (Step 1) Control the blood supply with a tourniquet placed lateral to the uterine arteries at the level of the internal cervical os, and a diluted solution of vasopressin 20% is administered at the area to be excised. (Step 2) Uterine incision: we use a vertical uterine incision with monopolar scissors, extended anteriorly and posteriorly. (Step 3) Resection of adenomyosis: carried with monopolar scissors using pure cut current. It is recommended that 0.5-1 cm of the myometrium is maintained around the uterine cavity as well as the serosa. (Step 4) Flap 1: interrupted sutures with vicryl 2.0 are used to approximate the inner myometrium close to the endometrial cavity, and a 2.0 barbed suture is used to approximate the inner myometrium of the contralateral side of the incision to the ipsilateral outer myometrium. (Step 5) Flap 2: another 2.0 barbed suture is used to approximate the outer myometrium of the contralateral side to the base of the repaired inner myometrial layer. (Step 6) Serosal closure: the serosa is approximated with a barbed suture in a baseball fashion before the tourniquet is released and hemostasis is ensured. (Step 7) Abdominal cerclage: a mersilene tape is placed medial to the uterine arteries at the level of the internal cervical os and a tape is tied anteriorly., Main Outcome Measure(s): Description of a stepwise approach to robotic diffuse adenomyosis resection with double flap and concomitant abdominal cerclage., Result(s): The operating time was 255 min with minimal estimated blood loss (250ml). She was discharged with no complaints. Three months postoperatively, dysmenorrhea significantly improved, and the magnetic resonance imaging showed a good anatomic result. An embryo transfer is planned at 6 months postoperatively., Conclusion(s): A minimally invasive approach to fertility-sparing management of diffuse adenomyosis is safe and feasible with good anatomical results. However, it should be noted that after the removal of uterine adenomyosis, the patient should be advised on the high risk of uterine rupture during pregnancy. Robotic cerclage may also be performed concomitantly in cases of 2nd-trimester recurrent abortions., (Copyright © 2022 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

Osteoarthritis (OA) is the most commonly diagnosed joint disease in companion animals, and proper tools are necessary to assess patients and response to treatment. We aimed to perform the psychometric evaluation of several clinical metrology instruments (CMI), developed to evaluate pain and assess outcome. Fifty police working dogs with bilateral hip OA were assessed in a prospective, randomised, double-blinded study. Patients were evaluated using a stance analyser in six different moments divided over a 180-day period. Pedometer step count, weight-bearing symmetry index and deviation from normal weight-bearing were calculated and used for criterion validity. In each evaluation moment, a copy of the Hudson Visual Analogue Scale (HVAS), Canine Brief Pain Inventory (CBPI), Liverpool Osteoarthritis in Dogs (LOAD) and Canine Orthopaedic Index (COI) were completed by the dogs' handlers. Correlations between CMIs were evaluated as construct validity. Further evaluation was performed with the Kaiser-Meyer-Olin measure of sampling adequacy, Eigenvalue and scree-plot analysis. Internal consistency was tested with Cronbach's α. Significant weak correlation was found between all CMIs and stance analysis symmetry index measure and deviation, indicating criterion validity. Significant weak correlation was also found between pedometer count and LOAD plus COI. Cronbach's α was 0.80 for HVAS, 0.98 for CBPI, 0.97 for LOAD and 0.98 for COI. Significant strong correlation was observed between CMIs, indicating construct validity. We present criterion and construct validity of these CMIs, which are able to capture various dimensions of OA. They can be used for the evaluation of osteoarthritis and response to treatment in dogs.

Background: Osteoarthritis (OA) is the most commonly diagnosed joint disease in companion animals, and proper tools are necessary to assess patients and response to treatment. We aimed to perform an initial psychometric evaluation of the Portuguese version of the Liverpool Osteoarthritis in Dogs (LOAD).Fifty Police working dogs with bilateral hip OA were assessed in a prospective, randomized, double-blinded study. Canine handlers, who were native Portuguese speakers, completed a copy of the translated version of the LOAD. Their results were compared with those of fifty sound dogs. Construct validity was evaluated by assessing differences between OA and sound animals with the Mann-Whitney test. Further evaluation was performed with the Kaiser-Meyer-Olkin measure of sampling adequacy, Eigenvalue, and scree-plot analysis. Internal consistency was tested with Cronbach's α., Results: A significant difference was observed between OA and sound dogs (p < 0.01), indicating construct validity. Two factors accounted for 81.5% of the total variance. Cronbach's α was 0.96, and a high inter-item correlation was observed, raging from 0.76 to 0.95, showing strong internal consistency. We presented criterion and construct validity of the Portuguese version of the LOAD, which is valid for use in the Portuguese language. It is an additional stage in providing a broader number of clinicians with an accessible tool to evaluate dogs with osteoarthritis. Further studies are required., (© 2022. The Author(s).)

Objective: To evaluate IL-1 and C-reactive protein (CRP) levels in the synovial fluid in dogs with bilateral hip osteoarthritis and their relation to animals' clinical, radiographic, and thermographic disease signs., Sample: 100 joints from police working dogs., Procedures: Synovial fluid, IL-1, and CRP levels, weight distribution, joint range of motion, thigh girth, digital thermography, and radiographic signs of the joints were recorded. Data from 4 clinical metrology instruments (CMIs) were collected. Results were compared by age, sex, and Orthopedic Foundation for Animals hip scores with the independent samples t test, ANOVA, and Pearson correlation coefficient (P < .05)., Results: The sample included 100 pelvic limbs, equally distributed between left and right pelvic limbs 30 males and 20 females, with a mean age of 6.5 ± 2.4 years and body weight of 26.7 ± 5.2 kg. IL-1 levels, particularly above 200 pg/mL, may be related to the development of caudolateral curvilinear osteophyte, which then expresses a toll on the patient's levels of pain and activity. It was unclear if the CRP levels were a consequence of inflammatory activity within the joint or a reflection of a better prognosis. Increasing body weight was related to worse CMI scores., Clinical Relevance: We described the relation of IL-1 and CRP synovial concentration levels with several clinical signs, diagnostic imaging, laboratory findings, and CMI results of animals with osteoarthritis. Further studies are required to determine the interest of each parameter for the prognosis and treatment monitoring.

Background: In 2016, the Brazilian state of Minas Gerais (∼20 million people), implemented the ERAF policy ("Regionalization Strategy of Pharmaceutical Services") in an effort to improve medicine procurement and distribution within primary care. We evaluated the impact of the policy on three main goals: price reductions, volume increases, and expansion of therapeutic options. Methods: We analyzed the procurement data from the Integrated System of Management of Pharmaceutical Services database in 2012 and 2018. We estimated the volume, drug mix, and expenditure indicators for all major therapeutic classes, and, in detail, for cardiovascular and nervous system drugs. We evaluated the expenditure drivers using decomposition analyses. Results: Overall, the expenditure increased by 14.5%, drug mix almost doubled, while the volume decreased by a third. Cardiovascular and neurological system drugs followed similar patterns. Decomposition analyses showed that prices and drug mix had positive effects while the volume had negative effects, resulting in an overall increase in expenditure. Conclusion: Our findings suggest that the ERAF policy cannot be considered effective as it has not fulfilled its intended purposes so far. Strategies to address the identified problems and to build a platform for a more sustainable long-lasting policy should be put in place by the government., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Luz, Castro, Marques, Cota, Alves and Law.)

Background: Osteoarthritis represents a significant welfare problem for many dogs, with limited therapeutic options other than palliative pain control. To evaluate the effect of the intra-articular administration of blood cell secretome and triamcinolone, 15 dogs with bilateral hip osteoarthritis were randomly assigned to a blood cell secretome (BCSG, n = 5), triamcinolone (TG) or their combination group (BCS + TG, n = 5). BCSG received a single intra-articular administration of 3 ml of blood cell secretome, TG 0.5 ml of triamcinolone acetonide 40 mg/ml, and BCS + TG received the combined products. The volume to administrate was corrected to 3.5 ml with saline. On days 0, 8, 15, 30, 60, 90, 120, 150, and 180, a copy of the Canine Brief Pain Inventory (divided into pain interference score-PIS and Pain Severity Score-PSS), Liverpool Osteoarthritis in Dogs (LOAD), Hudson Visual Analogue Scale (HVAS), and Canine Orthopedic Index (COI, divided into function, gait, stiffness, and quality of life) was completed. Results were analyzed with the Kruskal-Wallis test and the Kaplan-Meier estimators were conducted and compared with the Log Rank test, p < 0.05., Results: Animals in the sample had a mean age of 9.0 ± 2.9 years and a bodyweight of 28.8 ± 4.1 kg. Hips were classified as moderate (8) and severe (7) osteoarthritis. No differences were found between groups at T0 regarding considered evaluations. Significant differences were observed between groups in pain scores from + 8d- + 150d, with BCS + TG exhibiting better results. The same was observed for HVAS and LOAD, from + 8d- + 120d. Improvements were also observed in several dimensions of the COI. Kaplan-Meier estimators showed that BCS + TG produced longer periods with better results, followed by BCSG and TG., Conclusion: The intra-articular administration of blood cell secretome improved the clinical signs and scores of several clinical metrology instruments in dogs with hip OA, particularly when combined with triamcinolone. Further studies are required., (© 2022. The Author(s).)

To describe the weight-bearing compensation in working dogs with bilateral hip osteoarthritis (OA), 50 police working dogs were evaluated with a weight distribution platform at the initial evaluation and after intra-articular treatment (a negative control - 0.9% sodium chloride (NaCl), a platelet concentrate, Hylan G-F 20, triamcinolone hexacetonide or stanozolol). Six evaluation sessions were performed, over a 180-day period. Results were compared by breed, age, sex, weight and Orthopedic Foundation for Animals hip grade scores with the Independent Samples T-Test, repeated samples Analysis of variance and Pearson correlation coefficient, P < .05. Animals had a mean age of 6.5 ± 2.4 years and a bodyweight of 26.7 ± 5.2kg. No significant differences were observed when comparing weight-bearing for different breeds, sex, hip grades or weight during the initial evaluation. Significant differences were observed in deviation (P < .01) and symmetry index (P < .01) between the control and treatment groups during the follow-up period. A weight shift from pelvic to thoracic limbs was observed, with a weak, although a significant, correlation between a pelvic limb and the opposing contralateral thoracic limb. Labrador Retrievers showed higher symmetry index and deviation from normal values during the follow-up period than German Shepherd Dogs and Dutch Shepherd Dogs. Male dogs also showed higher symmetry index and deviation compared with females. At this period, the symmetry index showed a weak, although significant, correlation with body weight. Weight-bearing of all limbs correlated with the remaining limbs, reflecting a more balanced weight distribution than the initial evaluation. The weight distribution platform can be used to evaluate patients, at the initial presentation and during the assessment of response to treatment., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Objectives: This study aimed to determine the prevalence and associated factors of out-of-pocket pharmaceutical expenditure (OOPPE) among primary healthcare patients., Methods: The study is part of the Prover Project, an exit survey conducted in 2017 in a large city (population 234 937) in Minas Gerais State, Brazil. A representative sample of patients (n = 1219) from pharmaceutical services based on primary healthcare was selected. Three components of OOPPE were assessed: the general prevalence, the types of medicines purchased (medicines for the treatment of chronic diseases, medicines for the treatment of acute diseases, or herbal medicines), and coverage by the National Health System. The factors associated with OOPPE were examined applying a modified Andersen's behavioral model of health services use. Data were analyzed using descriptive statistics and logistic regression., Results: The overall prevalence of OOPPE was 77%. Most patients who had OOPPE purchased medicines to treat chronic diseases (94%). In addition, these patients purchased medicines covered by public insurance but were out of stock (85%). OOPPE was associated with enabling factors, such as higher personal income (odds ratio [OR] 1.92; 95% confidence interval [CI] 1.02-3.62), holding health insurance (OR 1.40; 95% CI 1.01-1.95), and higher neighborhood trust (OR 1.34; 95% CI 1.01-1.79), and with need factors, that is, poorer perception of health (OR 1.63; 95% CI 1.20-2.21), multiple comorbidities (OR 1.70; 95% CI 1.18-2.46), and higher number of prescribed medicines (OR 2.84; 95% CI 1.90-4.26)., Conclusions: We found a high prevalence of OOPPE, identifying individuals more likely to incur these expenses. These findings are useful to inform policy makers from the healthcare system to plan and implement the needed interventions to protect primary care patients from this financial burden., (Copyright © 2022 International Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.)

Objective: To evaluate photobiomodulation therapy in dogs with bilateral hip osteoarthritis., Animals: 20 dogs., Procedures: Forty joints were assigned to a control group (CG; n = 20) or treatment group (photobiomodulation therapy [PBMT]; 20). CG received a 21-day course of meloxicam, and PBMT received treatment with a Class IV therapeutic laser over 3 weeks. Joint range of motion, thigh girth, the Canine Brief Pain Inventory (divided into pain interference score [PIS] and pain severity score [PSS]), Hudson Visual Analogue Scale, Liverpool Osteoarthritis in Dogs, and Canine Orthopedic Index (COI; divided into function, gait, stiffness, and quality of life) were evaluated before treatment, +8, +15, +30, +60, and +90 days after initial treatment. Results were analyzed with repeated measures ANOVA or Wilcoxon signed ranks test, P < 0.05. Kaplan-Meier estimators were compared with the Breslow test., Results: Patients had a mean age of 8.3 ± 1.9 years and body weight of 65.7 ± 12.1lb. Osteoarthritis was classified as moderate (n = 26) and severe (14). No differences were found at time 0. Better results were observed in PBMT at +8 days (P = 0.01 for PSS, P = 0.04 for function and COI), +15 days (P = 0.01 for PSS and function, P = 0.02 for PIS and function, P = 0.03 for COI and P = 0.04 for Liverpool Osteoarthritis in Dogs [LOAD]) and +30 days (P = 0.01 for function and gait, P = 0.02 for COI, and P = 0.04 for PIS, PSS, and LOAD). Joint range of motion improved in PBMT from +15 to 90 days. Kaplan-Meier estimators showed that PBMT produced longer periods with better results., Clinical Relevance: PBMT reduced pain levels and improved clinical findings in dogs with hip osteoarthritis.

Alphaviral arthritides caused by mosquito-borne arboviruses such as chikungunya virus (CHIKV) can persist for months after the initial acute disease. Here, we investigated the contribution of interleukin-17 (IL-17), a cytokine involved in chronic autoimmune arthropathies such as rheumatoid arthritis, to the development of alphaviral arthropathy. Sera from CHIKV-infected patients who displayed both acute and chronic disease showed high levels of IL-17, IL-6, IL-21, IL-22, and IL-23, especially during the chronic phase of disease. We sought to validate these findings using a mouse model of CHIKV infection and disease using wild-type and IL-17A-deficient mice. Mice were infected with CHIKV, and joint and muscle tissues were harvested at designated time points. Tissue infiltrates were examined by immunohistochemistry, and tissue mRNA and protein expression of cytokines was assessed. Joint and muscle pathology was assessed using histology. CHIKV-infected mice lacking IL-17A showed reduced tissue inflammation and neutrophil infiltration, compared to wild-type mice. These investigations showed a role for IL-17 in the acute phase of CHIKV infection and also during the postacute disease resolution phase. IMPORTANCE CHIKV has been prevalent in Africa, Asia, and the Indian Ocean Islands for decades. There are currently no clinically approved vaccines or specific antiviral drugs targeting CHIKV. The upregulation of IL-17 detected in CHIKV disease patients and the reduced disease seen in IL-17-deficient mice suggest a correlation between IL-17 signaling pathways and CHIKV-induced arthritic inflammation. With an established role in contributing to the pathogenesis of immune-mediated diseases, such as psoriatic arthritis and rheumatoid arthritis, IL-17 signaling plays an important role in alphavirus arthritides.

Osteoarthritis (OA) is a disease with a high negative impact on patient's quality of life and a high financial burden. It is a source of chronic pain and affects all mammals, including humans and dogs. As the dog is a common model for translation research of human OA, and exploring spontaneous dog OA can improve the health and well-being of both humans and dogs. To describe the effect of the intra-articular administration of stanozolol in a naturally occurring canine OA model, forty canine (N = 40) hip joints were randomly assigned to receive stanozolol or saline (control). On treatment day and at 8, 15, 30, 90, and 180 days post-treatment, several evaluations were conducted: weight distribution, joint range of motion, thigh girth, digital thermography, and radiographic signs. Also, synovial fluid C-reactive protein and interleukin-1 levels were evaluated. Results from four Clinical Metrology Instruments was also gathered. Results were compared with Repeated Measures ANOVA, with a Huynh-Feldt correction, paired-samples t-test, or Wilcoxon signed-rank test, with p < 0.05. OA was graded as mild (90%), moderate (5%), and severe (5%), including both sexes. They had a mean age of 6.5 ± 2.4 years and a bodyweight of 26.7 ± 5.2 kg. No differences were found between groups at treatment day in all considered evaluations. Weight distribution showed significant improvements with stanozolol from 15 days (p < 0.05) up to 180 days (p < 0.01). Lower values during thermographic evaluation in both views taken and improved joint extension at 90 (p = 0.02) and 180 days (p < 0.01) were observed. Pain and function scores improved up to 180 days. In the control group, radiographic signs progressed, in contrast with stanozolol. The use of stanozolol was safe and produced significant improvements in weight-bearing, pain score, and clinical evaluations in a naturally occurring canine OA model., (© 2022. The Author(s).)

To evaluate photobiomodulation therapy's effectiveness (PBMT) in managing chronic idiopathic large-bowel diarrhea. Thirty dogs were selected and divided into a control (CG) and treatment group (TG). CG received psyllium husk at the dose of 4 tablespoons/day for 30 days. TG received PBMT with a Class IV therapeutic laser, divided into three sessions on week 1, two sessions on week 2, and one session on week 3. A daily log of fecal characteristics was maintained, and on days 0, 8, 15, and 30, a canine inflammatory bowel disease index (CIBDAI) and body condition scores (BCS) were obtained. Results were compared using a Mann-Whitney test. Multiple regression was run to predict CIBDAI, Bristol stool scores, and diarrhea from different parameters. The Kaplan-Meier test was used to compare the occurrence rate of ≥ 1 day of diarrhea and ≥ 2 days of diarrhea by 30 days. Cox regression analysis to investigate interest covariates influences the same outcome. A p < 0.05 was set. The sample included 15 Belgian Malinois Shepherd Dogs, 10 German Shepherd Dogs, and 5 Dutch Shepherd Dog, with a mean age of 3.6 ± 2.3 years and a bodyweight of 24.6 ± 8.0 kg. TG showed an improvement in all scores and clinical signs, increased body weight, and BCS. An increased time of appearance of a second episode of diarrhea was observed in both groups. Activity level contributed to the prediction of defecation frequency and CIBDAI. PBMT significantly improved clinical signs and frequency of diarrhea episodes compared to psyllium husk., (© 2021. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Objective: Breast cancer is the most common cancer among women, both in Brazil and worldwide. Breast cancer can also affects men but this constitutes only 1% of cases and is thus considered rare, and for this reason is little studied. Statistics indicate an increase in its incidence with an estimate of new cases in recent years. This study aims to analyze the knowledge of higher education students in relation to breast cancer in men. the knowledge of higher education students in relation to breast cancer in men., Materials and Methods: Exploratory study with a quantitative approach. 299 male students participated in the study. Data collection took place through semi-structured questionnaires, completed by students from pure science, human sciences and health at a higher education institution., Results: Regardless of the area of undergraduate study, 65.9% of the volunteers reported not knowing about breast cancer in men. Regarding predisposing factors for the development of breast cancer, 77.3% reported not knowing about these while 68.9% reported not knowing about breast self-examination. However, 67.6% believe that breast cancer in men can be prevented. Worryingly, 62.5% reported that they only seek medical assistance when becoming ill., Conclusion: Evidence from this study suggests that higher level undergraduates have limited knowledge about breast cancer in men. Only one third knew that male breast cancer was possible. Even smaller proportions knew of the predisposing factors for breast cancer, how to perform self-examination and about diagnosis. These latter factors, when combined with a tendency to seek medical help only when ill, suggests a short-fall in health knowledge which should be corrected., Competing Interests: Conflict of Interest: The authors declare no conflict of interest., (©Copyright 2021 by Turkish Federation of Breast Diseases Associations.)

Neuropsychiatric drugs are used for a wide variety of neurological and psychiatric conditions. This article aims to analyze the trend and determinants of public expenditure of these medicines in Minas Gerais, from 2010 to 2017. Data from the Integrated Materials and Services Administration System (SIAD) database were used to estimate volumes of acquisition and expenditure. A breakdown analysis was performed, and the list of purchased drugs was reviewed, and the Drug Utilization technique (DU90%) applied concerning anti-Parkinson drugs. Annual expenditure dropped by 36%, from R$ 111.7 million in 2010 to R$ 40.9 million in 2017, and the determinant factors were the falling prices and volume, associated with changes in the drug mix, which favored the acquisition, on average, of more expensive products. Higher levels of expenditure for anti-Parkinson drugs stand out, however, with a significant change in the list purchased. This study contributed to a better understanding of public spending on neuropsychiatric drugs. A reduced volume can increase the risk of shortages. Regarding anti-Parkinson drugs, there is no evidence to suggest an increased supply to the population.

Objective: To investigate the trend of infant mortality from preventable causes in children under one year of age in Rondônia from 2008 to 2018., Method: Epidemiological study of time series with data from the Mortality and Live Birth Information Systems, driven by STATA® version 11.0, trend measured by Prais-Winsten linear regression and autocorrelation with Durbin and Watson test., Results: The infant mortality rate was 14.57 deaths / 1,000 live births, 9.14 / 1,000 due to preventable causes. Deaths decreased by 2.88% annually (95% CI: - 4.67; -1.06). However, causes that can be reduced by running immunization actions, to women during pregnancy and fetal and non-childbirth growth, have stable rates. Deaths from preventable causes in the late neonatal period were declining (-11.69%; 95% CI -19.56; -3.05)., Conclusion: Managers need to qualify maternal and child care, considering the performance of the team of professionals in assisting the pregnant-puerperal cycle as well as improving the quality of infant mortality records in the region.

Background: Diarrhea is considered the most common clinical sign of chronic gastrointestinal disease in dogs and affects a considerable portion of working and sporting dogs. We aimed to determine the prevalence of diarrhea in police working dogs and evaluate the relationship between feeding, activity level, and animal characteristics with clinical signs. In an observational, prospective study, information on 188 dogs was collected. For each patient, age, sex, breed, specific mission, number of animals at the same housing location, and activity level was recorded. A body condition (BCS) and canine inflammatory bowel disease activity index (CIBDAI) scores were determined, and feces classified according to the Bristol Stool Form Scale. The Kruskal-Wallis test was used to compare recorded data between breeds, mission, age, and sex. Multiple regression was run to predict BCS score, increased defecation frequency, diarrhea, CIBDAI scores, Bristol stool scores, diarrhea from activity level, number of animals at the same housing location, breed, and mission. A p < 0.05 was set., Results: Animals in the sample (male n = 96, female n = 92) had a mean age of 5.2 ± 3.2 years and a bodyweight of 24.1 ± 7.2 kg. Four main dog breeds were represented, 80 Belgian Malinois Shepherd Dogs, 52 German Shepherd Dogs, 25 Labrador Retrievers, and 19 Dutch Shepherd Dog. A prevalence of diarrhea of 10.6% was determined, with 4% of dogs having liquid diarrhea. Dogs classified as "extremely active" were more likely to have a low BCS, and the level of activity contributed to diarrhea and BCS prediction., Conclusion: Police working dogs frequently experience diarrhea episodes, which lead to clinical disease and performance loss. Investigation of aetiologies is required.

Background: Osteoarthritis (OA) is the most commonly diagnosed joint disease in companion animals, and hip OA is commonly diagnosed in the canine population. The use of platelet-rich plasma has gained increasing interest for the treatment of musculoskeletal conditions in companion animals. To evaluate the effect of the intra-articular administration of platelet-rich plasma in police working dogs with bilateral hip OA compared to a control group, twenty dogs were assigned to a control group (CG, n = 10) or treatment group (PG, n = 10), using the statistical analysis software. PG received two intra-articular administrations of platelet-rich plasma, 14 days apart, while CG received an intra-articular administration of saline, in the same moments. Response to treatment was determined with the Canine Brief Pain Inventory, Liverpool Osteoarthritis in Dogs, Canine Orthopedic Index, and Hudson Visual Analogue Scale, before treatment, + 8, + 15, + 30, + 60, + 90, + 120, 150, and + 180 days after initial treatment. Kaplan-Meier estimators were conducted and compared with the log-rank test. Cox proportional hazard regression analysis was performed to determine treatment survival, p < 0.05., Results: The sample comprised 20 animals of both sexes (male n = 12, female n = 8), with a mean age of 8.4 ± 2.4 years and a bodyweight of 31.5 ± 5.7 kg. Joints were classified as moderate (13) and severe (7) according to the Orthopedic Foundation for Animals grading scheme. No differences were found between groups at the initial evaluation. Better results with the majority of scores were observed in the PG, in some cases lasting up to the last evaluation moment. Kaplan-Meier estimators showed that PG produced longer periods with better results in all scores compared to CG. Treatment was the covariate influencing all scores in the Cox regression analysis. OFA hip score also influenced two dimensions of the Canine Orthopedic Index., Conclusion: The intra-articular administration of platelet-rich plasma can improve pain and functional scores of police working dogs with bilateral hip OA, compared with a control group. Its effects lasted for significantly longer periods, and treatment was the main covariate affecting the improvements observed.

Background: Osteoarthritis (OA) is a complex joint disease and chronic pain source, affecting a patient's quality of life and posing a financial burden. As the dog is considered a nearly ideal species for translation research of human OA and the most used model for research, exploring spontaneous dog OA under the One Health/One Medicine concept can improve both humans and dogs' health and well-being., Methods: In a clinical treatment experiment, forty (N=40) joints were selected and randomly assigned to a control group (CG), which received 0.9% NaCl or a treatment (HG), which received Hylan G-F 20. Evaluations were performed on treatment day (T0), 8, 15, 30, 90, and 180 days post-treatment. They consisted of four different Clinical Metrology Instruments (CMI), evaluation of weight distribution, joint range of motion, thigh girth, radiographic and digital thermography imaging, synovial fluid interleukin-1 (IL-1), and C-reactive protein concentrations. Results were compared with repeated measures ANOVA, with a Huynh-Feldt correction, Paired samples T-test, or Wilcoxon signed-ranks test, with p<0.05., Results: Patients had a mean age of 6.5±2.4 years and a bodyweight of 26.6±5.2kg, and joints graded as mild (n=28, 70%), moderate (n=6, 15%), and severe OA (n=6, 15%). No differences were found between groups at T0. Symmetry index and deviation showed significant improvements in HG from 30 days (p<0.01) up to 180 days (p=0.01). Several CMI scores, particularly pain scores, improved from 90 to 180 days. Radiographic signs progressed in both groups. In both groups, increasing body weight and age corresponded to worse clinical presentation. IA hyaluronan administration produced increased lameness in six cases, which resolved spontaneously., Conclusions: This study characterizes the response to treatment with Hylan G-F 20, which can produce significant functional and pain level improvements in patients with OA, even those with factors related to worse response to treatment.

Background: In dogs, thermal imaging has been documented only recently, but a growing interest in this modality has led to studies using thermography to assess pathologies in the canine hip, stifle, elbow, intervertebral disc, and bone neoplasia. This study aimed to evaluate the use of digital thermography in assessing and evaluating treatment response in dogs with hip osteoarthritis (OA) and comparing its results with an objective measure and two clinical metrology instruments. In an experimental, randomized, double-blinded study, one hundred hip joints of fifty police working dogs with bilateral hip OA were evaluated. A dorsoventral and lateral thermographic image were obtained on days 0, 8, 15, 30, 90, and 180. Mean and maximal temperatures were determined. Additionally, the animal's weight-bearing distribution and radiographic examination of the hip joint (extended legs ventrodorsal view) were performed. Copies of the Canine Brief Pain Inventory (CBPI) and Canine Orthopaedic Index (COI) were obtained. Results were analyzed by ANOVA, followed by an LSD post-hoc test, and correlations were assessed with Spearman correlation coefficient, with p < 0.05., Results: Values recorded on the lateral view were higher than those on the dorsoventral view. No differences or correlations were found between Orthopedic Foundation for Animals hip grades and temperature. Digital thermographic images showed a weak significant correlation with weight-bearing evaluations (r = 0.13, p < 0.01) and different clinical metrology instruments scores (r = - 0.25, p < 0.01 for pain severity score, and r = - 0.21, p = 0.04 for gait). It also correlated with radiographic findings, specifically the circumferential femoral head osteophyte and caudolateral curvilinear osteophyte., Conclusion: To our knowledge, this is the first study presenting the digital thermography assessment of Police working dogs submitted to treatment for hip OA. Digital thermography, mainly based on a lateral view evaluation, showed a weak significant correlation with stance analysis and clinical metrology instruments scores.

The chromosomes of two freshwater stingrays, Potamotrygon motoro and Potamotrygon sp., from the Amazon River basin in Brazil were investigated using integrated molecular (cytochrome c oxidase subunit 1) and cytogenetic analyses. Potamotrygon motoro presented intraspecific variation in the diploid number, with 2n=66 in the females and 2n=65 in the males, while Potamotrygon sp. had a karyotype with 66 chromosomes, in both sexes. The C-banding revealed the presence of heterochromatic blocks accumulated in the centromeric region of all the chromosomes in both species. The FISH assays with 18S DNA probes highlighted the terminal region of three or four chromosome pairs in P. motoro and seven chromosomes in Potamotrygon sp. The rDNA 5S sequences were found in only one chromosomal pair in both species. The interspecific genetic distance based on the COI sequences, between P. motoro and Potamotrygon sp. from Amazon River was 10.8%, while that between the Amazonian P. motoro and Potamotrygon amandae from the Paraná River was 2.2%, and the genetic distance between Potamotrygon sp. and P. amandae was 11.8%. In addition to the new insights on the cytogenetics of the study species, the results of the present study confirmed the existence of heteromorphic sex-linked chromosomes in P. motoro.

Objective: This study aimed to compare the symmetry of clinical and radiographic signs of right and left pelvic limbs of dogs with bilateral hip osteoarthritis (OA) and evaluate the association of physical findings and radiographic abnormalities., Patients and Methods: One hundred pelvic limbs of police working dogs with bilateral hip OA were evaluated, following a screening program. Weight distribution, joint range of motion at flexion and extension, thigh girth, and radiographic signs were recorded and compared with the results of the contralateral limb and by breed, age, and sex with the Paired Samples T-Test and Pearson correlation coefficient, with p<0.05., Results: The sample mean age was 6.5±2.2 years, and the bodyweight of 26.7±5.3kg. No significant differences were observed when comparing weight distribution, joint range of motion, and thigh girth of left and right limbs. Weight distribution and age showed a statistically significant correlation with joint extension. The right limbs showed a significantly higher frequency of circumferential femoral head osteophyte (CFHO) regarding radiographic signs. Limbs with CFHO or caudolateral curvilinear osteophyte had significantly larger joint flexion angle (p = 0.02) and smaller extension angle (p<0.01), respectively, compared to those that did not. Age showed a significant correlation with the presence of several radiographic findings, as did different breeds., Conclusion: Clinical and radiographic signs occur symmetrically in naturally occurring hip OA in police working dogs. Several correlations were observed between the evaluations performed and differences between breeds, which can be useful in assessing and early diagnosis of hip OA., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: The Stance Analyser used in this study was provided by Companion, LiteCure LLC. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Background: Chronic intermittent or persistent diarrhoea is a common condition in dogs and may be a reflex of gastrointestinal or non-gastrointestinal disorders. Besides diarrhoea, many athletes experience other gastrointestinal symptoms. Dietary fiber can help normalize colonic motility and transit time, support normal gastrointestinal microflora growth and provide fuel for colonocytes. This study aimed to evaluate dietary supplementation effectiveness with psyllium husk in police working dogs with chronic large-bowel diarrhoea. Twenty-two animals were selected. Concurrent conditions were ruled out through complete blood count and serum biochemistry. Fecal Clostridium and Salmonella were also screened. A soluble fiber, psyllium husk, was added to the diet at the dose of 4 tablespoons/day for 1 month. A daily log of fecal characteristics (type, frequency, and color) was maintained during the supplementation month and for an additional month, without supplementation., Results: Response to treatment was classified as "very good" in 50% of animals, "good" in 40% of animals, and "poor" in 10% of cases. During the month of psyllium husk supplementation, defecation frequency decreased from 3.5 to 2.9 times a day, with 90% of animals showing consistent stools regularly and registering a mean increase of 2 kg in body weight. Beneficial effects were still observed during the second month, without psyllium husk supplementation., Conclusion: Psyllium husk can be useful in the management of chronic large-bowel diarrhoea in working dogs, which exhibited lower defecation frequency, improved stool consistency, and gained weight. Effects were felt beyond the supplementation period. Alternative approaches for non-responsive cases need to be evaluated.

Background: There is growing concern about individuals reported to suffer repeat COVID-19 disease episodes, these in a small number of cases characterised as de novo infections with distinct sequences, indicative of insufficient protective immunity even in the short term., Methods: Observational case series and case-control studies reporting 33 cases of recurrent, symptomatic, qRT-PCR positive COVID-19. Recurrent disease was defined as symptomatic recurrence after symptom-free clinical recovery, with release from isolation >14 days from the beginning of symptoms confirmed by qRT-PCR. The case control study-design compared this group of patients with a control group of 62 patients randomly selected from the same COVID-19 database., Results: Of 33 recurrent COVID-19 patients, 26 were female and 30 were HCW. Mean time to recurrence was 50.5 days which was associated with being a HCW (OR 36.4 (p <0.0001)), and blood type A (OR 4.8 (p = 0.002)). SARS-CoV-2 antibodies were signifcantly lower in recurrent patients after initial COVID-19  (2.4 ± 0.610; p<0.0001) and after recurrence (6.4 ± 11.34; p = 0.007).  Virus genome sequencing identified reinfection by a different isolate in one patient., Conclusions: This is the first detailed case series showing COVID-19 recurrence with qRT-PCR positivity. For one individual detection of phylogenetically distinct genomic sequences in the first and second episodes confirmed bona fide renfection, but in most cases the data do not formally distinguish between reinfection and re-emergence of a chronic infection reservoir. These episodes were significantly associated with reduced Ab response during initial disease and argue the need for ongoing vigilance without an assumption of protection after a first episode., Competing Interests: Declaration of Competing Interests All authors report there are no conflicts of interest., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)