Clinical features of spinal cord hemangioblastoma in a dog

A 2-year-old male, intact Yorkshire terrier presented with a one-month history of progressive paraparesis. Neurologic examination revealed paraplegia with absent deep pain perception, decreased right pelvic limb withdrawal reflex, and lumbar pain consistent with an L4-S2 neurolocalization. Magnetic resonance imaging showed a single, well-demarcated, intramedullary mass centered over the L3-4 disc space. A hemilaminectomy was performed, and the mass was removed en bloc. Histopathological evaluation was consistent with a hemangioblastoma. Follow-up magnetic resonance imaging nine months after surgery showed no evidence of tumor recurrence, and the dog was ambulatory paraparetic at that time. This case is consistent with a previous histopathologic report of spinal cord hemangioblastoma in a dog and provides additional clinical information regarding diagnosis, treatment, and outcome associated with this tumor type

Altered responsiveness of the kidney to activation of the renal nerves in fat-fed rabbits

We tested whether mild adiposity alters responsiveness of the kidney to activation of the renal sympathetic nerves. After rabbits were fed a high-fat or control diet for 9 wk, responses to reflex activation of renal sympathetic nerve activity (RSNA) with hypoxia and electrical stimulation of the renal nerves (RNS) were examined under pentobarbital anesthesia. Fat pad mass and body weight were, respectively, 74% and 6% greater in fat-fed rabbits than controls. RNS produced frequency-dependent reductions in renal blood flow, cortical and medullary perfusion, glomerular filtration rate, urine flow, and sodium excretion and increased renal plasma renin activity (PRA) overflow. Responses of sodium excretion and medullary perfusion were significantly enhanced by fat feeding. For example, 1 Hz RNS reduced sodium excretion by 79 ± 4% in fat-fed rabbits and 46 ± 13% in controls. RNS (2 Hz) reduced medullary perfusion by 38 ± 11% in fat-fed rabbits and 9 ± 4% in controls. Hypoxia doubled RSNA, increased renal PRA overflow and medullary perfusion, and reduced urine flow and sodium excretion, without significantly altering mean arterial pressure (MAP) or cortical perfusion. These effects were indistinguishable in fat-fed and control rabbits. Neither MAP nor PRA were significantly greater in conscious fat-fed than control rabbits. These observations suggest that mild excess adiposity can augment the antinatriuretic response to renal nerve activation by RNS, possibly through altered neural control of medullary perfusion. Thus, sodium retention in obesity might be driven not only by increased RSNA, but also by increased responsiveness of the kidney to RSNA

Advancing the Public Interest Through Regulatory Reform

To develop a set of critical regulatory reform recommendations for the president and Congress, OMB Watch convened a steering committee of regulatory experts from the public interest, labor, small business, and other communities. The steering committee worked to put forth a consensus document that reflects what it sees as the most important regulatory process issues for the president-elect and Congress. Ideas raised with President Obama and congressional leaders fall into a number of categories: Improving the quality of regulations; protecting scientific integrity within agencies; ensuring agency accountability; effective implementation and enforcement of regulations; bringing more transparency to the regulatory process; and increasing public participation in federal rulemaking. The steering committee also highlighted those items that should be addressed during Obama's first 100 days in the White House and the first 100 days of the 111th Congress

Medication Errors in Patients With Severe Chronic Kidney Disease and Acute Coronary Syndrome: The Impact of Computer-Assisted Decision Support

OBJECTIVE: To evaluate the impact of computerized physician order entry (CPOE) with decision support on the frequency of antithrombotic medication errors in patients with chronic kidney disease (CKD) admitted with acute coronary syndrome (ACS) and to measure what effect it would have on in-hospital bleeding