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Efficient nutritional support plays a pivotal role in the rehabilitation of sea turtles, ensuring a positive, swift, and successful recovery from clinical conditions for their reintroduction into the wild. For sea turtles in severely emaciated and underweight condition, the primary objective is to facilitate weight gain in terms of both muscle mass and fat reserves. Traditionally, many sea turtle rehabilitators have employed the practice of force-feeding, which also involves the daily insertion of an orogastric tube from the mouth to the stomach. However, this technique may be highly stressful for the animals, carrying the risks of regurgitation and potential harm, requiring the removal of the animal from the water, and subjecting it to uncomfortable and potentially dangerous handling. The procedure may also involve risks for operators. In this study, we explore the utilization of a permanent esophago-gastric tube (EG tube) in sea turtles as an alternative to force-feeding, providing a respectful and appropriate approach to meeting the nutritional needs of patients. The administration of food, essential medications, and fluids is performed directly with the turtle in its tank, minimizing the stress associated with handling, while ensuring the safety of operators. The study involves 195 marine turtles that underwent surgery for the placement of a permanent EG tube between 2008 and 2022. Of these, 116 animals were treated at the Sea Turtle Clinic of the Department of Veterinary Medicine at the University of Bari, South Adriatic Sea, Puglia (IT), and 79 patients were admitted to the Sea Turtle Rescue Center of Lampedusa, Central Mediterranean Sea, Sicily (IT). The loggerhead turtles ( Caretta caretta ) required EG tube placement due to their poor condition related to various diseases, which were systematically categorized. The duration of EG tube placement was analyzed regarding the specific condition of the animals and the nature of their injuries, considering any complications or differences between the two facilities. The results of the study will provide valuable information for the ongoing care and treatment of marine turtles in rehabilitation facilities.

Sea turtles are considered endangered species, largely due to anthropogenic activities. Much of the trauma in these species involves the carapace and skull, resulting in several degrees of damage to the pulmonary and nervous systems. Among traumatic injuries, those involving the skull can be complicated by brain exposure, and turtles with severe skull injuries that have nervous system impairment, emaciation, and dehydration can often die. Between July 2014 and February 2022, a total of 1877 loggerhead sea turtles ( Caretta caretta ) were referred for clinical evaluation at the Sea Turtle Clinic (STC) of the Department of Veterinary Medicine of the University of Bari. A retrospective study of 29 consecutive cases of loggerhead sea turtles ( Caretta caretta ) with skull lesions of different degrees of severity is reported. On admission, physical and neurological evaluations were performed to assess and grade the lesions and neurological deficits. In 20 of the 29 sea turtles with more serious head trauma, computed tomography (CT) findings in combination with physical and neurological assessment enabled the evaluation of the potential correlation between deficits and the extent of head injuries. All sea turtles underwent curettage of the skull wounds, and the treatment protocol included the use of the plant-derived dressing 1 Primary Wound Dressing ® (Phytoceutical AG, Endospin Italia) applied on the wound surface as a primary dressing. Out of 29 sea turtles, 21 were released after a time ranging from a few days to 8 months. To the best of our knowledge, the literature lacks specific data on the incidence, correlations with neurological deficits, complications, and survival rate of loggerhead sea turtles with traumatic head injuries.

The aim of this study was to describe the clinical signs, radiographic, endoscopic and CT findings, cytological and microbiological findings and treatments of pulmonary diseases in sea turtles, in order to obtain an accurate diagnosis that avoids unnecessary therapy and antibiotic-resistance phenomena. In total, 14 loggerheads ( Caretta caretta ), with clinical and/or radiographic findings of pulmonary pathology, were assessed through various combinations of clinical, radiological, CT, endoscopic examination and bronchoalveolar lavage, which recovered fluid for cytologic and microbiologic analysis. In all cases, radiographic examination led to a diagnosis of pulmonary disorders-4 unilateral and 10 bilateral. All bacteria cultured were identified as Gram-negative. Antibiotic resistance was greater than 70% for all beta-lactams tested. In addition, all bacterial strains were 100% resistant to colistin sulfate and tetracycline. Specific antibiotic therapies were formulated for seven sea turtles using Enrofloxacin, and for four sea turtles using ceftazidime. In two turtles, antibiotic therapy was not included due to the presence of antibiotic resistance against all the antibiotics evaluated. In both cases, the coupage technique and environmental management allowed the resolution of the lung disease without antibiotics. All 14 sea turtles were released back into the sea. Radiographic examination must be considered the gold standard for screening sea turtles that show respiratory signs or abnormal buoyancy. Susceptibility testing with antimicrobials allowed appropriate therapy, including the reduction of antibiotic-resistance.

A 3-year-old, pregnant, Alpine Brown cow showed a rapidly growing, pedunculated, skin mass located at the umbilical region, reaching 8 kg in weight over a 3-month period after its initial detection. Six days after parturition, the mass was completely surgically excised. During the follow-up period, the cow remained in good health, without signs of recurrence, and showed increased milk production. Histological examination of the mass revealed a loose proliferation of spindle-shaped or stellate cells, immersed in an abundant myxoid matrix with admixed numerous thin-walled blood vessels. Immunohistochemically, the tumour cells were positive for vimentin, α-smooth muscle actin, and desmin. Gross and histopathological features were compatible with superficial angiomyxoma, a subtype of angiomyxoma rarely described in humans, but not in the veterinary literature. The tumour did not infiltrate into the surrounding tissues, and there was no post-excision recurrence after 3 months. The possibility of hormonal dependence of the tumour during pregnancy is discussed based on such findings in some human cases.

Entanglement occurs when a marine turtle becomes trapped within anthropogenic materials such as debris or fishery gear, inducing strangulation of anatomical parts such as flippers or the neck, causing deep lacerations, maiming, amputation, or choking. Often, severely entangled flippers in captured or stranded turtles are removed surgically. Turtles with flipper impairment have difficulty in swimming, diving, and feeding. Our aim was to use color Doppler ultrasound and multi-detector computer tomography to evaluate residual vascularization or neovascularization in severely entangled flippers of loggerhead sea turtles ( Caretta caretta ) to assess viability of flippers, even in the absence of limb sensation. We studied 12 turtles with either unilateral ( n =8) or bilateral ( n =4) involvement. A total of 14 flippers were severely entangled and two flippers were spontaneously amputated. Only two of the 14 entangled flippers had to be removed surgically. For 12 entangled flippers, after surgical curettage, the treatment protocol was based on the use of a plant-derived commercial dressing. The animals were monitored and treated for 1-3 mo, until the soft tissue defects were completely healed by secondary intention. Interestingly, in the treated animals the healing flippers steadily recovered motility and sensation, restoring the complete functionality of the flipper. Vascularization of the limb was found to be critical to prevent amputation of entangled flippers, preserving the flipper and its functionality with conservative therapy and avoiding amputation as much as possible. Our study showed that in cases of entanglement, amputation does not need to be performed immediately but can wait for nonviability to declare itself following conservative therapy and should be reserved as a last-resort treatment.

Multidetector computed tomographic (CT) anatomy was used to evaluate the lungs of 10 loggerhead sea turtle (Caretta caretta) without pulmonary disease, in order to provide a baseline of turtle lung anatomy by CT imaging. In all patients, in this retrospective anatomic study, the CT datasets were carefully evaluated for assessment of the bronchial tree morphology and branching pattern, of the arborization pattern of pulmonary arteries and veins and of the bronchoarterial-bronchovenous diameter ratios. Imaging anatomy was compared with previous published data based on dissection and microscopic anatomy. With the increasing availability of advanced imaging tools for wildlife animal patients, a detailed CT anatomy background is required to decipher correctly the pathologic respiratory conditions of sea turtles. Anat Rec, 302:1658-1665, 2019. © 2018 American Association for Anatomy., (© 2018 American Association for Anatomy.)

Untreated, traumatic, or wound myiases can cause severe consequences to animal health and welfare as well as economic losses to livestock productions. For healing myiasis-caused wounds, disinfectant such as creolin is wrongly but currently used in association with insecticides. Though effective, creolin is highly toxic to the patients, is inadequate with respect to the repellent effect, and may delay the healing of treated wounds. In this uncontrolled study, the efficacy of the patented plant-derived formulation 1 Primary Wound Dressing© (1-PWD), composed of neem oil (Azadirachta indica A. Juss.) and the oily extract of Hypericum perforatum (L.) flowers, has been investigated. Forty-four domestic animals of different species suffering from wound myiasis lasting for up to 25 days, at different parts of the body, were enrolled in the study. No systemic or local antibiotic or disinfectants' treatment was administered. Larvae recovered on open wounds and adults reared from mature larvae were identified as Wohlfahrtia magnifica. All the treated wounds healed in a range of 10 to 32 days without further infestation. None of the recruited animals presented bacterial complications. Data herein presented indicate that the tested natural plant-derived formulation is able to manage the infestation caused by W. magnifica larvae and the healing process of traumatic infested wounds in several domestic animal species, without any side effect on the living tissue and without the need to use local or systemic chemical or other products.

The dorsolateral subluxation index of the femoral head is a good proxy of hip dysplasia in dogs. An exploratory, prospective, descriptive study was carried out in order to assess whether the dorsolateral subluxation index may also be useful to improve diagnosis of hip dysplasia in cats. The dorsolateral subluxation index was determined by CT scans simulating the loading position, and compared with measurements of the Norberg-Olsson angle. A total of 82 cats were subjected to radiographic examination of the pelvis, in the standard ventro-dorsal projection, and to CT scans of the pelvis and hips. The Norberg-Olsson angle of each hip was calculated radiographically, while the dorsolateral subluxation index of the femur was calculated on CT images according to a technique recently developed for evaluation of hip dysplasia in dogs. Using the Norberg-Olsson angle a total of 52 hips (31,7%) were diagnosed as dysplastic, 74 (45,1%) as non-dysplastic, and 38 (23,1%) as borderline. Using the dorsolateral subluxation index, values ranged from a minimum of 34.6% to a maximum of 66.6% and four distribution classes were proposed. Findings indicated that the dorsolateral subluxation index previously described as method for quantifying hip dysplasia in dogs is also a feasible method for quantifying hip dysplasia in cats. Future studies are needed to more definitively determine the diagnostic sensitivity of this method., (© 2019 American College of Veterinary Radiology.)

Loggerhead sea turtles ( Caretta caretta) are among the most frequent victims of bycatch in drifting longlines, and the ingestion of fish hooks and fishing lines is one of the most frequent causes of death of sea turtles. The aim of this study was to evaluate whether coelomic ultrasound (US) can be decisive, not only for diagnosis but also to optimize surgical planning based on preoperative evaluation of the bowel conditions and, in addition, to see if there are characteristic sonographic findings in sea turtles associated with the ingestion of fishing lines. Physical examination, hematology, blood chemistry, radiographs, and US examination were performed in 37 loggerhead sea turtles with suspected or known ingestion of fish hooks or monofilament fishing lines. During the ultrasonographic examinations, the loggerhead sea turtles were placed in dorsal recumbency and the prefemoral left and right acoustic windows were used. Nine wild loggerheads had sonographic findings of intestinal and coelomic abnormalities, and the sonographic images were compared with the surgical findings. Ultrasonography positively identified the foreign body in 89% (8/9) animals. The presence of intestinal plication (in all loggerhead turtles) and ultrasonographic visualization of the linear foreign body was always consistent with the ingestion of a fishing line. In sea turtles, fishing lines cause a corrugated appearance in the small intestine due to increased/unproductive peristalsis. The affected small bowel loops are usually dilated with fluid. In the present study, coelomic US allowed us to make a thorough evaluation of the characteristics, number, and severity of the bowel wall lesions in the animals, thus ensuring the planning of a correct surgical procedure. We suggest that US examination of the coelomic cavity should be complementary to radiographic survey in cases of suspected ingestion of fish hooks and fishing lines by sea turtles.

Background: Cannabis-based drugs have been shown to be effective in inflammatory diseases. A number of endocannabinoids including N- arachidonoylethanolamide (anandamide, AEA) and 2-arachidonyl glycerol (2-AG) with activity at the cannabinoid receptors (CBR) CBR1 and CBR2, have been identified. Other structurally related endogenous fatty acid compounds such as oleoylethanolamide (OEA) and palmitoyl ethanolamide (PEA) have been identified in biological tissues. These compounds do not bind to CBR but might be involved in facilitating the actions of directly acting endocannabinoids and thus are commonly termed "entourage" compounds due to their ability to modulate the endocannabinoid system. The aim of this study was to evaluate the presence of endocannabinoids and entourage compounds in the synovial fluid of dogs with osteoarthritis subjected to arthrotomy of the knee joint. Cytokines and cytology were studied as well., Results: AEA, 2-AG, OEA and PEA were all present in the synovial fluid of arthritic knees and in the contralateral joints; in addition, a significant increase of OEA and 2AG levels were noted in SF from OA knees when compared to the contralateral joints., Conclusion: The identification and quantification of endocannabinoids and entourage compounds levels in synovial fluids from dogs with OA of the knee is reported for the first time. Our data are instrumental for future studies involving a greater number of dogs. Cannabinoids represent an emerging and innovative pharmacological tool for the treatment of OA and further studies are warranted to evaluate the effectiveness of cannabinoids in veterinary medicine.

Introduction: Somatic symptoms are frequently reported by children with significant impairment in functioning. Despite studies on adult populations that suggest somatic symptoms often co-occur with difficulties in identifying and describing feelings, little research has been done in childhood. This study aimed to investigate the prevalence and frequency of somatic symptoms as well as to investigate the functional impairment in children with high number of self reported somatic symptoms versus those with fewer somatic symptoms. Additionally the parental perception of their children's somatic symptoms and functioning was explored. Finally, we explored the direct and indirect effects of difficulties in identifying feelings in predicting somatic symptoms and functional disability among school-aged children., Methods: 356 Italian school-aged children and their mothers participated in this study. Children (mean age = 11.43; SD = 2.41) completed the Children's Somatization Inventory (CSI-24) to assess somatic symptoms, the Functional Disability Inventory (FDI) to assess physical and psychosocial functioning and the Alexithymia Questionnaire for Children (AQC) to evaluate alexithymic features. Mothers completed the parental forms of the CSI and the FDI., Results: Among children, 66.3% did not declare somatic symptoms and 33.7% reported one or more somatic symptoms in the last two weeks. A significant positive correlation emerged between children's and mothers' CSI total scores. Both children's and mothers' FDI total scores were significantly correlated with CSI scores. A significant correlation was observed between somatic symptoms and alexithymic features. Furthermore, the data showed that somatic symptoms mediated the relationship between difficulties in identifying feelings and functional impairment. Finally, it was showed that alexithymia facet of difficulty in identifying feelings contributed in large part to the prediction of the somatic symptomatology (b = 0.978, p < 0.001; R2 = 0.164, F(5, 350) = 10.32, p < 0.001)., Conclusions: Findings from this study provide evidence that a higher frequency of somatic symptoms is associated with functional disabilities and alexithymic facets in school-aged children., Competing Interests: The authors have declared that no competing interests exist.

Objective: The purpose of this cross-sectional study was to determine whether migraine or tension-type headaches are associated with abuse of the internet and/or mobile phones and to explore whether headache and the abuse of the two technologies are associated with sleep disturbances and other self-reported somatic symptoms., Background: In the last several years, estimates indicate the increasing pervasiveness of the internet and other technologies in the lives of young people, highlighting the impact on well-being., Design: A population-based cross-sectional study was conducted between February 2013 and June 2014., Method: The initial sample was composed of 1004 Italian students (aged 10-16 years) recruited within public middle schools not randomly selected in central Italy. The final convenience sample consisted of 841 students (Males = 51.1%; Females = 48.9%) who were included in the analysis. Data were collected using self-reported measures., Results: Headache was reported by 28.0% of the total sample. A significant relationship was determined with gender (χ(2) (1) = 7.78, P < .01), with female students being overrepresented in the headache group. Approximately 39.6% of subjects were non-abusers of both technologies, internet and mobile. Mobile only abusers were approximately 26.0% of the study population; internet only abusers were approximately 14.9%; and abusers of both media were 19.5%. No significant relationship was found between students with and without headache with respect to the abuse of internet and mobile phone categories (headache was, respectively, the 26% in no abusers, the 30% in internet abusers, the 29% in mobile abusers, and the 29% in internet and mobile abusers, P = .86). Additionally, also by excluding the no headache group, the relationship between the two groups of headache (migraine and tension type headache) and the abuse of media (tension type headache was the 31% in no abusers, the 43% in internet abusers, the 49% in mobile abusers, and the 29% in internet and mobile abusers) is not statistically significant (P = .06). No significant relationship emerged between headache and the internet and mobile phone addiction groups (headache was the 28% in no addiction group, the 35% in mobile addiction group, the 25% of internet addiction group, and the 28% in mobile and internet addiction group, P = .57) as well as no significant relationship was found when only the different headache types were considered (tension type headache was the 39% in no addiction group, the 40% in mobile addiction group, the 32% in internet addiction group, and the 31% in mobile and internet addiction group, P = .71). Daily internet users reported higher median scores for somatic symptoms than the occasional internet users in the no-headache group (Kruskal-Wallis χ(2) (1) = 5.44, P = .02) and in the migraine group (Kruskal-Wallis χ(2) (1) = 6.54, P = .01)., Conclusions: Results highlighted the potential impact of excessive internet and mobile use, which ranges from different types of headache to other somatic symptoms. Further studies are needed to confirm these findings and to determine if there is a need for promoting preventive health interventions, especially in school setting., (© 2016 American Headache Society.)

Background: Headache is a common disorder affecting a growing number of children and adolescents. In recent years, there has been an increase in scientific interest in exploring the relationship between migraine and emotional regulation, and in particular, the impact of emotional dysregulation on mental and physical health. The present study aims to explore the relationship between migraine and alexithymia among adolescents and their mothers as well as the impact of this association on mental health. An additional aim is to verify whether alexithymia may be a predictor of psychopathological symptoms in adolescents and mothers with migraines., Methods: A total of 212 subjects were involved in this study. The sample was divided into (a) Experimental Group (EG) consisting of 106 subjects (53 adolescents and 53 mothers) with a diagnosis of migraine according to International Classification of Headache Disorders (ICHD-3) and (b) Control Group (CG) including 106 subjects (53 adolescents and 53 mothers) without a diagnosis of migraine. All participants completed the Toronto Alexithymia Scale to assess alexithymia and the Symptom Checklist-90-R to assess psychopathological symptoms., Results: Higher rates of alexithymia were found in the adolescents and mothers of the EG in comparison to the adolescents and mothers of the CG. Furthermore, adolescents and mothers experiencing both migraine and alexithymia, demonstrated a higher risk of psychopathology., Conclusions: Findings from this study provide evidence that the co-occurrence of migraine and alexithymia increases the risk of psychopathology for both adolescents and their mothers.

Onchocerca lupi, a zoonotic nematode infecting the eyes of carnivores, has been increasingly reported in dogs from Europe and the USA. In order to improve the current status of knowledge on this neglected filarioid, diagnostic imaging tools (i.e., ultrasound scan, computed tomography and magnetic resonance imaging) are herein used to diagnose canine onchocercosis in two dogs, which scored positive for O. lupi microfilariae at the skin snip test and to assess the anatomical location of the nematode within the ocular apparatus. Results indicate that ultrasound tools are useful to address the diagnosis of O. lupi in dogs and to evaluate the localization of nodules or cysts containing the adult nematode., (Copyright © 2014 Elsevier B.V. All rights reserved.)

In this study, the authors describe a simple, nontraumatic procedure for ultrasound-guided placement and maintenance ofjugular and cephalic vein catheterization. The ultrasound scans were performed with a GE Logiq 400 machine connected to a multifrequency (7-11 MHz) linear-array transducer. To find the cephalic vein, longitudinal and transverse color-Doppler ultrasonographic scans were made of the dorsal surface of the flipper. To find the jugular vein, scans of the midline of the lateral surface of the neck were performed. Once the vein had been located, a 16- to 22-gauge 51-mm needle catheter was inserted into the skin beneath the ultrasound probe, inclined at 15-25 degrees to the skin surface. The successful insertion of the catheter inside the vein was monitored by ultrasound. The authors believe that the procedure described offers a good option for fashioning a simple, nontraumatic, and durable vascular access in sea turtles compared with previously described techniques. Caretta caretta, cephalic vein, jugular vein, ultrasonography, vascular catheterization.

Intestinal obstruction by radiolucent foreign bodies is common in sea turtles. The absence of clinical signs and the extended fasting periods in these animals means that intestinal obstructions may not be diagnosed early. Digestive tract radiographic contrast procedures were performed to evaluate the gastrointestinal transit time and intestinal obstructions in loggerhead sea turtles. Barium sulfate and nonionic iodinate contrast medium were used for radiographic contrast procedures. Contrast medium was administered via a gastric tube or into the colon. These procedures are often necessary and are useful to document intestinal obstruction and foreign objects. The diagnostic procedures were not easily performed in some turtles, but often they were adequate for the diagnosis.

Objective: To describe a surgical approach to the coelomic cavity through the axillary and inguinal regions in sea turtles., Design: Descriptive report., Animals: 9 loggerhead sea turtles (Caretta caretta) that had ingested fishhooks or monofilament fishing line., Procedure: Turtles known to have ingested foreign bodies were anesthetized. For the extraction of fish-hooks located in the stomach, an approach to the coelomic cavity through the soft tissues of the left axillary region (along the cranial margin of the plastron) was made. For the removal of fishhooks and long fishing lines in other portions of the intestinal tract, an approach to the coelomic cavity was performed via the inguinal region. Foreign bodies were removed via gastrotomy or enterotomy., Results: Of the 9 loggerhead turtles, 3 had a fish-hook in the stomach, 1 had a fishhook in the stomach and fishing line throughout the intestinal tract, 2 had a fishhook in the ileum and fishing line in the ileum and colon, and 3 had fishing line throughout the intestinal tract. Following surgery, 8 turtles recovered successfully; 1 turtle (in which an enterectomy was performed) died. After approximately 8 weeks, the surviving turtles were well enough to be released from captivity., Conclusions and Clinical Relevance: Results indicated that an axillary approach to the coelomic cavity in sea turtles could be a useful alternative to plastron osteotomy. Moreover, the inguinal approach allows the exteriorization of the intestinal tract from jejunum to colon, which facilitates surgical removal of long linear foreign bodies ingested by turtles.

Single energy X-ray imaging, due to its low cost and flexibility, is one of the most used and common technique to assess bone state and bone remodeling over time. Standardized X-ray images are needed to compare sets of radiographs for semi-quantitative analyses of tissue remodeling. However, useful mathematical modeling for the analysis of high level radiographic images are not easily available. In order to propose a useful evaluation tool to a wide clinical scenario, we present an innovative calibration algorithm for a semi-quantitative analysis of non-standardized digitized X-ray images. For calibration on a unique standardization scale, three time invariant regions (ROI) of radiographs were selected and analyzed. The accuracy of the normalization method for X-ray films was successfully validated by using an aluminum step wedge for routine X-ray exposures as tool to standardize serial radiographs (Pearson correlation test: R(2) = 0.96). This method was applied to investigate the progression of the new bone deposition within ceramic scaffolds used as osteoconductive substitute in large bone defects taking advantage of a large animal model. This innovative image-processing algorithm allowed the identification and semi-quantification of the bone matrix deposited within the implant. The osteo-integration at the bone-implant interface was also investigated. A progressively increasing bone tissue deposition within the porous bioceramic implant and a progressive osteo-integration was observed during the 12 months of the trial., (Copyright 2005 Wiley Periodicals, Inc.)

Congenital elbow luxations are responsible for 17-20% of nontraumatic lameness of the elbow joint. They are not associated with a growth disorder or trauma. Congenital elbow luxation has been observed in dogs, but no data were found about this condition in cats. In this report, we describe congenital bilateral elbow subluxation in a cat.