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ObjectivesTo describe the diagnostic techniques, surgical treatments, and outcomes of two cats with recurrent pleural transudate caused by urinary ultrafiltrate.AnimalsTwo cats without evidence of trauma, urinary tract obstruction, or concurrent perinephric pseudocysts that were evaluated and treated for recurrent pleural transudate caused by urinary ultrafiltrate.Study designShort case series.MethodsMultiphase contrast CT scan revealed leakage of contrast media from the kidneys bilaterally into the retroperitoneal spaces in both cats. Renal scintigraphy performed in one cat revealed progressive accumulation of 99mTc diethylenetriamine penta-acetic acid (Tc-DTPA) in the pleural space. Exploratory laparotomy localized the leakage of fluid to renal capsular defects bilaterally in both cats. The retroperitoneum was incised bilaterally to promote fluid drainage into the peritoneum, and nephropexies were performed.ResultsOne cat had long-term survival with recurrent, though decreasing volumes of, pleural effusion. The second cat was euthanized 16 days postoperatively for progressive renal disease.ConclusionThe diagnosis of spontaneous urinary ultrafiltrate accumulation in the pleural space of cats without evidence of trauma, urinary tract obstruction, or concurrent perinephric pseudocysts has not previously been reported. The surgical correction described reduced but did not completely eliminate the rate of pleural effusion accumulation.

Case summaryA 9-month-old intact female domestic mediumhair cat presented with a 5-month history of obtundation, lethargy, hypernatremia (181 mmol/l; reference interval [RI] 151-158 mmol/l), hyperchloremia (142 mmol/l; RI 117-126 mmol/l), azotemia (blood urea nitrogen 51 mg/dl; RI 18-33 mg/dl), creatinine 3.0 mg/dl (RI 1.1-2.2 mg/dl), hyperphosphatemia (8.3 mg/dl; RI 3.2-6.3 mg/dl) and total hypercalcemia (11.4 mg/dl; RI 9-10.9 mg/dl), with concurrent polyuria with adipsia. Neurologic evaluation revealed proprioceptive deficits, and this finding paired with a history of focal seizure-like activity despite improving sodium concentrations suggested a cerebrothalamic lesion. For this reason, and historical and biochemical findings consistent with adipsic diabetes insipidus (DI), MRI of the brain was performed, which revealed a lesion of the hypophyseal fossa consistent with a pituitary cyst. Given the patient's age and the timeline of clinical signs, a congenital pituitary cyst was strongly suspected. The patient was managed initially with intravenous fluids to correct the hypernatremia, then managed for more than 4 years with topical ocular desmopressin acetate administration and free water administered through a feeding tube. This cat's clinical diagnosis included a congenital pituitary cyst with subsequent central DI and primary adipsia.Relevance and novel informationThe clinical presentations of primary adipsia or central DI are both rare in cats. This is the first report to describe these conditions occurring in a cat owing to a congenital pituitary cyst and describes successful long-term management of this condition.

Kidney transplant recipients may be at a high risk of developing critical coronavirus disease 2019 (COVID-19) illness due to chronic immunosuppression and comorbidities. We identified hospitalized adult kidney transplant recipients at 12 transplant centers in the United States, Italy, and Spain who tested positive for COVID-19. Clinical presentation, laboratory values, immunosuppression, and treatment strategies were reviewed, and predictors of poor clinical outcomes were determined through multivariable analyses. Among 9845 kidney transplant recipients across centers, 144 were hospitalized due to COVID-19 during the 9-week study period. Of the 144 patients, 66% were male with a mean age of 60 (±12) years, and 40% were Hispanic and 25% were African American. Prevalent comorbidities included hypertension (95%), diabetes (52%), obesity (49%), and heart (28%) and lung (19%) disease. Therapeutic management included antimetabolite withdrawal (68%), calcineurin inhibitor withdrawal (23%), hydroxychloroquine (71%), antibiotics (74%), tocilizumab (13%), and antivirals (14%). During a median follow-up period of 52 days (IQR: 16-66 days), acute kidney injury occurred in 52% cases, with respiratory failure requiring intubation in 29%, and the mortality rate was 32%. The 46 patients who died were older, had lower lymphocyte counts and estimated glomerular filtration rate levels, and had higher serum lactate dehydrogenase, procalcitonin, and interleukin-6 levels. In sum, hospitalized kidney transplant recipients with COVID-19 have higher rates of acute kidney injury and mortality.

Kidney transplant recipients may be at a high risk of developing critical coronavirus disease 2019 (COVID-19) illness due to chronic immunosuppression and comorbidities. We identified hospitalized adult kidney transplant recipients at 12 transplant centers in the United States, Italy, and Spain who tested positive for COVID-19. Clinical presentation, laboratory values, immunosuppression, and treatment strategies were reviewed, and predictors of poor clinical outcomes were determined through multivariable analyses. Among 9845 kidney transplant recipients across centers, 144 were hospitalized due to COVID-19 during the 9-week study period. Of the 144 patients, 66% were male with a mean age of 60 (±12) years, and 40% were Hispanic and 25% were African American. Prevalent comorbidities included hypertension (95%), diabetes (52%), obesity (49%), and heart (28%) and lung (19%) disease. Therapeutic management included antimetabolite withdrawal (68%), calcineurin inhibitor withdrawal (23%), hydroxychloroquine (71%), antibiotics (74%), tocilizumab (13%), and antivirals (14%). During a median follow-up period of 52 days (IQR: 16-66 days), acute kidney injury occurred in 52% cases, with respiratory failure requiring intubation in 29%, and the mortality rate was 32%. The 46 patients who died were older, had lower lymphocyte counts and estimated glomerular filtration rate levels, and had higher serum lactate dehydrogenase, procalcitonin, and interleukin-6 levels. In sum, hospitalized kidney transplant recipients with COVID-19 have higher rates of acute kidney injury and mortality.

Modifications of General Relativity leave their imprint both on the cosmic expansion history through a non-trivial dark energy equation of state, and on the evolution of cosmological perturbations in the scalar and in the tensor sectors. In particular, the modification in the tensor sector gives rise to a notion of gravitational-wave (GW) luminosity distance, different from the standard electromagnetic luminosity distance, that can be studied with standard sirens at GW detectors such as LISA or third-generation ground based experiments. We discuss the predictions for modified GW propagation from some of the best studied theories of modified gravity, such as Horndeski or the more general degenerate higher order scalar-tensor (DHOST) theories, non-local infrared modifications of gravity, bigravity theories and the corresponding phenomenon of GW oscillation, as well as theories with extra or varying dimensions. We show that modified GW propagation is a completely generic phenomenon in modified gravity. We then use a simple parametrization of the effect in terms of two parameters (Ξ0,n), that is shown to fit well the results from a large class of models, to study the prospects of observing modified GW propagation using supermassive black hole binaries as standard sirens with LISA. We construct mock source catalogs and perform detailed Markov Chain Monte Carlo studies of the likelihood obtained from LISA standard sirens alone, as well as by combining them with CMB, BAO and SNe data to reduce the degeneracies between cosmological parameters. We find that the combination of LISA with the other cosmological datasets allows one to measure the parameter Ξ0 that characterizes modified GW propagation to the percent level accuracy, sufficient to test several modified gravity theories. LISA standard sirens can also improve constraints on GW oscillations induced by extra field content by about three orders of magnitude relative to the current capability of ground detectors. We also update the forecasts on the accuracy on H0 and on the dark-energy equation of state using more recent estimates for the LISA sensitivity.

Modifications of General Relativity leave their imprint both on the cosmic expansion history through a non-trivial dark energy equation of state, and on the evolution of cosmological perturbations in the scalar and in the tensor sectors. In particular, the modification in the tensor sector gives rise to a notion of gravitational-wave (GW) luminosity distance, different from the standard electromagnetic luminosity distance, that can be studied with standard sirens at GW detectors such as LISA or third-generation ground based experiments. We discuss the predictions for modified GW propagation from some of the best studied theories of modified gravity, such as Horndeski or the more general degenerate higher order scalar-tensor (DHOST) theories, non-local infrared modifications of gravity, bigravity theories and the corresponding phenomenon of GW oscillation, as well as theories with extra or varying dimensions. We show that modified GW propagation is a completely generic phenomenon in modified gravity. We then use a simple parametrization of the effect in terms of two parameters (Ξ0,n), that is shown to fit well the results from a large class of models, to study the prospects of observing modified GW propagation using supermassive black hole binaries as standard sirens with LISA. We construct mock source catalogs and perform detailed Markov Chain Monte Carlo studies of the likelihood obtained from LISA standard sirens alone, as well as by combining them with CMB, BAO and SNe data to reduce the degeneracies between cosmological parameters. We find that the combination of LISA with the other cosmological datasets allows one to measure the parameter Ξ0 that characterizes modified GW propagation to the percent level accuracy, sufficient to test several modified gravity theories. LISA standard sirens can also improve constraints on GW oscillations induced by extra field content by about three orders of magnitude relative to the current capability of ground detectors. We also update the forecasts on the accuracy on H0 and on the dark-energy equation of state using more recent estimates for the LISA sensitivity.

Gastrointestinal (GI) pythiosis is a severe and often fatal disease in dogs that traditionally has been poorly responsive to medical treatment. Although aggressive surgical resection with wide margins is the most consistently effective treatment, lesion location and extent often preclude complete resection. Recently, it has been suggested that the addition of anti-inflammatory doses of corticosteroids may improve outcome in dogs with nonresectable GI pythiosis. This report describes 3 dogs with colonic pythiosis in which complete resolution of clinical signs, regression of colonic masses, and progressive decreases in serological titers were observed after treatment with itraconazole, terbinafine, and corticosteroids. This treatment protocol represents a promising treatment for dogs with GI pythiosis in which surgical intervention is not feasible.

Gastrointestinal (GI) pythiosis is a severe and often fatal disease in dogs that traditionally has been poorly responsive to medical treatment. Although aggressive surgical resection with wide margins is the most consistently effective treatment, lesion location and extent often preclude complete resection. Recently, it has been suggested that the addition of anti-inflammatory doses of corticosteroids may improve outcome in dogs with nonresectable GI pythiosis. This report describes 3 dogs with colonic pythiosis in which complete resolution of clinical signs, regression of colonic masses, and progressive decreases in serological titers were observed after treatment with itraconazole, terbinafine, and corticosteroids. This treatment protocol represents a promising treatment for dogs with GI pythiosis in which surgical intervention is not feasible.

Gastrointestinal (GI) pythiosis is a severe and often fatal disease in dogs that traditionally has been poorly responsive to medical treatment. Although aggressive surgical resection with wide margins is the most consistently effective treatment, lesion location and extent often preclude complete resection. Recently, it has been suggested that the addition of anti-inflammatory doses of corticosteroids may improve outcome in dogs with nonresectable GI pythiosis. This report describes 3 dogs with colonic pythiosis in which complete resolution of clinical signs, regression of colonic masses, and progressive decreases in serological titers were observed after treatment with itraconazole, terbinafine, and corticosteroids. This treatment protocol represents a promising treatment for dogs with GI pythiosis in which surgical intervention is not feasible.

BackgroundGastroesophageal reflux (GER) is poorly characterized in anesthetized cats, but can cause aspiration pneumonia, esophagitis, and esophageal stricture formation.ObjectiveTo determine whether pre-anesthetic orally administered omeprazole increases gastric and esophageal pH and increases serum gastrin concentrations in anesthetized cats, and to determine the prevalence of GER using combined multichannel impedance and pH monitoring.AnimalsTwenty-seven healthy cats undergoing elective dental procedures.MethodsProspective, double-masked, placebo-controlled, randomized clinical trial. Cats were randomized to receive 2 PO doses of omeprazole (1.45-2.20 mg/kg) or an empty gelatin capsule placebo 18-24 hours and 4 hours before anesthetic induction. Blood for measurement of serum gastrin concentration was collected during anesthetic induction. An esophageal pH/impedance catheter was utilized to continuously measure esophageal pH and detect GER throughout anesthesia.ResultsMean gastric pH in the cats that received omeprazole was 7.2 ± 0.4 (range, 6.6-7.8) and was significantly higher than the pH in cats that received the placebo 2.8 ± 1.0 (range, 1.3-4.1; P < .001). Omeprazole administration was not associated with a significant increase in serum gastrin concentration (P = .616). Nine of 27 cats (33.3%) had ≥1 episode of GER during anesthesia.Conclusions and clinical relevancePre-anesthetic administration of 2 PO doses of omeprazole at a dosage of 1.45-2.20 mg/kg in cats was associated with a significant increase in gastric and esophageal pH within 24 hours, but was not associated with a significant increase in serum gastrin concentration. Prevalence of reflux events in cats during anesthesia was similar to that of dogs during anesthesia.

BackgroundDevelopment of hypocalcemia after treatment of hyperparathyroidism results in increased costs and risk of poorer outcomes. Previous studies have shown conflicting data about predictors of hypocalcemia after these procedures.Hypothesis/objectivesThe objective of this study was to investigate whether ionized calcium (iCa) concentrations before treatment are predictive of hypocalcemia or its clinical signs after surgical removal or heat ablation in dogs with primary hyperparathyroidism.AnimalsFifty-four dogs with primary hyperparathyroidism (29 female, 25 male; 49 retrospective, 5 prospective).MethodsDogs were enrolled if they met the inclusion criteria: persistent hypercalcemia (iCa >1.41 mmol/L) due to primary hyperparathyroidism and absence of preemptive calcitriol treatment. All dogs were treated with parathyroidectomy (n = 37) or percutaneous ultrasound-guided heat ablation (n = 17). After treatment, iCa was monitored twice daily until plateau or intervention.ResultsThere was a moderate correlation between before-treatment hypercalcemia and after-treatment hypocalcemia. The prospective study was terminated due to ethical concerns given findings in the retrospective section. All dogs were placed into groups according to their pretreatment iCa: 1.46-1.61 mmol/L, 1.62-1.71 mmol/L, iCa 1.72-1.81 mmol/L, or >1.81 mmol/L. After treatment, the mean lowest iCa for each group, respectively, was 1.19, 1.18, 1.13, and 1.01 mmol/L. There was a significant association between higher group and proportion of dogs with iCa

Viewing a person perform an action activates the observer's motor system. Whether this phenomenon reflects the action's kinematics or its final goal remains a matter of debate. One alternative to this apparent controversy is that the relative influence of goal and kinematics depends on the information available to the observer. Here, we addressed this possibility. For this purpose, we measured corticospinal excitability (CSE) while subjects viewed 3 different grasping actions with 2 goals: a large and a small object. Actions were directed to the large object, the small object, or corrected online in which case the goal switched during the movement. We first determined the kinematics and dynamics of the 3 actions during execution. This information was used in 2 other experiments to measure CSE while observers viewed videos of the same actions. CSE was recorded prior to movement onset and at 3 time points during the observed action. To discern between goal and kinematics, information about the goal was manipulated across experiments. We found that the goal influenced CSE only when its identity was known before movement onset. In contrast, a kinematic modulation of CSE was observed whether or not information regarding the goal was provided.

Neurophysiology and neuroimaging evidence shows that the brain represents multiple environmental and body-related features to compute transformations from sensory input to motor output. However, it is unclear how these features interact during goal-directed movement. To investigate this issue, we examined the representations of sensory and motor features of human hand movements within the left-hemisphere motor network. In a rapid event-related fMRI design, we measured cortical activity as participants performed right-handed movements at the wrist, with either of two postures and two amplitudes, to move a cursor to targets at different locations. Using a multivoxel analysis technique with rigorous generalization tests, we reliably distinguished representations of task-related features (primarily target location, movement direction, and posture) in multiple regions. In particular, we identified an interaction between target location and movement direction in the superior parietal lobule, which may underlie a transformation from the location of the target in space to a movement vector. In addition, we found an influence of posture on primary motor, premotor, and parietal regions. Together, these results reveal the complex interactions between different sensory and motor features that drive the computation of sensorimotor transformations.

It is shown that in the vicinity of 77 K beryllium has a superior specific conductance compared with the nominally excellent metallic conductors aluminum and copper. It is concluded that beryllium should be considered for some conduction applications, despite its well known toxicity problems.

It is shown that in the vicinity of 77 K beryllium has a superior specific conductance compared with the nominally excellent metallic conductors aluminum and copper. It is concluded that beryllium should be considered for some conduction applications, despite its well known toxicity problems.