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A com- bined bioengineering 250mg azithromycin visa antimicrobial testing, cell-based gene therapy strategy may decrease this thrombo- genicity buy 500mg azithromycin fast delivery virus or bacterial infection. Successful isolation of autologous endothelial cells and their seeding onto prosthetic grafts in animal models have been well characterized order azithromycin 100 mg with mastercard antimicrobial 8536. Furthermore order 250mg azithromycin with mastercard antibiotics metronidazole, it has been hypothesized that one can enhance the function of these endothelial cells via the transfer of genes prior to seeding of the cells on the graft surface. The initial report of the use of this strategy achieved successful endothelialization of a pros- thetic vascular graft with autologous endothelial cells transduced with a recombi- nant retrovirus encoding the lacz gene. Successful clinical applications of these concepts, however, have not been reported. The grafts were subsequently implanted into the femoral and carotid circulation of sheep. As seen in noncardiac muscle, measurable levels of gene activity has been found after direct injection of plasmids into myocardial tissue in vivo. Although limited to a few millimeters surrounding the injection site, these observations have laid the basis for consideration of gene transfer as a therapeutic approach to cardiac disease. Additionally, both adenoviral and adenoassociated viral vectors can be delivered to the myocardial and coronary vascular cells via either direct injection or intracoronary infusion of concentrated preparations in rabbits and porcine models respectively. Gene transfer into the myocardium has also been achieved via either the direct injection or intracoronary infusion of myoblast cells that have been genetically engineered in cell culture. This receptor has received significant attention as a target for genetic therapeutic intervention in congestive heart failure. To date, attempts at exploring this exciting possibility have been primarily limited to cell culture systems. But no evaluation of enhanced contractility by transfer of this gene into the ventricle has been reported. These results demonstrate the feasibility of using the bP-adrenergic pathway and its regulators as a means by which to treat the endpoint effect of the variety of cardiac insults. There has also been recent interest in the enhancement of contractility through 2+ the manipulation of intracellular calcium levels. This leads to an increase in the peak (Ca li) release, a decrease in 2+ resting (Ca li) levels, and more importantly to enhanced contraction of the myocar- dial cells as detected by shortening measurements. The success of this approach in improving myocardial contractility has yet to be documented in vivo. But once again, gene therapy approaches provide a novel and potentially exciting means by which to treat the failed heart. Given the terminal differentiation of cardiomyocytes, loss of cell mass due to infarction does not result in the regeneration of myocytes to repopulate the wound. Researchers have, therefore, pursued the possibility of genetically converting cardiac fibroblasts into functional cardiomyocytes. These studies used retroviral-mediated gene transfer for the in vitro conversion of cardiac fibroblasts into cells resembling skeletal myocytes via the forced expression of a skeletal muscle lineage- determining gene, MyoD. At this time, however, functional cardiomyocytes have not yet been identified in regions of myocardial scarring treated with in vivo gene transfer. Ischemia and Reperfusion Coronary artery atherosclerosis, and resulting myocardial ischemia, is a leading cause of death in developed countries. Reperfusion injury has been linked to significant cellular damage and progression of the ischemic insult. In addition to stimulating therapeutic neovascularization, genetic manipulation may be used as a means to limit the degree of injury sustained by the myocardium after ischemia and reperfusion. The process of tissue damage resulting from ischemia and reperfusion has been well characterized. Additionally, increased conversion of xanthine dehydrogenase into xanthine oxidase takes place. Upon exposure to oxygen during the period of reperfusion, hypoxanthine is converted to xanthine. This conversion results in the - cytotoxic oxygen radical, superoxide anion (O2 ). This free radical goes on to form 2+ hydrogen peroxide (H2O2), another oxygen radical species. These free radical species result in cellular injury via lipid peroxidation of the plasma membrane, oxidation of sulfhydryl groups of intracellu- lar and membrane proteins, nucleic acid injury, and breakdown of components of the extracellular matrix such as collagen and hyaluronic acid. The level of oxygen radical formation after ischemia–reperfusion injury in the heart can overwhelm the natural scavenger systems. These findings suggest a role for gene transfer of natural scavengers as a means to protect the myocardium in the event of an ischemia–reperfusion event. However, no studies have investigated the direct antioxidant effect and ensuing improvement in myocardial function of this treatment after ischernia and reperfusion injury. This application of gene therapy technology may offer a novel and exciting approach for prophylaxis against myocardial ischemic injury when incorporated into a system of long-term, regulated transgene expression. In addition to the overexpression of antioxidant genes, some researchers have proposed intervening in the program of gene expression within the myocardium that lead to the downstream deleterious effects of ischemia reperfusion. Genetic manipulation of donor tissues offers the opportunity to design organ- specific immunosuppression during cardiac transplantation. Although transgenic animals are being explored as potential sources for immunologically protected xenografts, the delivery of genes for immunosuppressive proteins, or the blockade of certain genes in human donor grafts, may allow site-specific, localized immuno- suppression. Alternatively, these approaches could result in a reduction or elimina- tion of the need for toxic systemic immunosuppressive regimens. The current state of this technology has pro- vided us with an exciting glimpse of its therapeutic potential. Routine application, however, will require improvement of existing techniques along with the develop- ment of novel methods for gene transfer. More importantly, no one method of gene transfer will serve as the defining approach. Rather, it will be the use of all avail- able techniques, either individually or in combination, that will shape the applica- tion of this therapy. Over the past two decades, as scientists have begun to unlock the genetic code, more insight into the pathogenesis of disease has been gained. With the use of gene manipulation technology, this new information can be used to further improve the understanding and treatment of complex acquired and con- genital diseases previously unresponsive to traditional surgical and pharmacologic therapy. This ideal vector would also have the flexibility to accommodate genes of all sizes, incorporate control of the temporal pattern and degree of gene expression, and to recognize specific cell types for tailored delivery or expression. Recombinant adenoviruses have become the most widely used viral vectors for experimental in vivo cardiovascular gene transfer. Adenoassociated virus has successfully transduced myocardial cells after direct injection of viral suspensions into heart tissue; and these infections have yielded relatively stable expression for greater than 60 days. For nonviral gene delivery, the controlled application of a pressurized en- vironment to vascular tissue in a nondistended manner has recently been found to enhance oligonucleotide uptake and nuclear localization.

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Damage to the feathers of the breast buy azithromycin 500 mg fast delivery infection quality control staff in a sterilization, abdomen and legs during the breeding season may indicate reproductive frustration order azithromycin 100mg treatment for dogs ear mites. Seasonal feather picking associated with breeding activity is usually temporary and no specific therapy is necessary or warranted unless the feather loss is persistent or involves areas other than the lower abdomen order 100mg azithromycin amex antibiotics gonorrhea. Mutilation is a commonly discussed problem in poul- try and has been associated with improper manage- ment 500 mg azithromycin with mastercard antibiotics used for sinus infection, crowding and malnutrition. In humans, hepa- topathies have been associated with pruritus, and many self-mutilating birds have clinical changes suggestive of liver disease. Cockatoos may occasionally over- that were present in the epidermal collar at the time the stress preen a mate, but more commonly a male bird will occurred are improperly formed (courtesy of John Cooper). Feather Picking Feather picking occurs when a bird damages its Examination of the Feather-picking Bird feathers or skin (or the feather and skin of a compan- Feather-picking birds should be approached in a sys- ion). Feather graphs, endoscopy and direct microscopic examina- picking induced by a companion is characterized by tion and biopsies of affected feathers. There is an apparent species’ predilection to feather- Feather picking can become an obsessive behavior picking behavior. African Grey Parrots appear to be with a bird progressively damaging all or part of the particularly prone to feather picking, perhaps as a accessible plumage, leading to abnormalities in nor- result of their sensitive natures or need for a highly mal feather development and molt. Spoiled, improperly social- characterized by over-preening and subsequent dam- ized, hand-raised birds of any species may also be age to the skin or muscle. Cockatoos and conures fre- cause, or occur secondary to, chronic ulcerative der- quently develop feather-picking behavior for which matitis. By Many feather-picking or self-mutilating birds are comparison, idiopathic feather picking in budgeri- considered to be pruritic, which is difficult to docu- gars and cockatiels is rare. Over-preening and scratching an area with the picking associated with ulcerative dermatitis of the nails is suggestive. Chronic feather picking can result in sufficient damage to the follicles to prevent any future feather growth (Figure 24. Therapy for self-mutila- tion of undetermined etiology should be considered effective if the destructive behavior can be reduced. In a retrospective study of 106 feather-picking cases, 31 had no change on follow-up examination; resolu- tion of the problem occurred in 20 cases; 21 showed some improvement; and 34 were lost to follow-up. Some of these birds will stop mu- with behavior modification, drugs may be necessary. Assuming that idi- sants and antihistamines (hydroxyzine hydrochlo- opathic self-mutilation is a result of some undetect- ride,c 2 mg/kg oral). These therapeutic agents are able neurosis, it would be considered unwise for frequently discussed but are rarely effective. Hormo- these birds to be added to a breeding collection where nal therapies including thyroxine, testosterone and they may pass on genes that will predispose their medroxyprogesterone have also been suggested for progeny to the same problem. Any underlying medical problems should be stopping some sexually related behavioral disorders identified and corrected. Various foul-tasting sub- including feather picking, aggressiveness and mas- stances are frequently applied to the feathers in an turbation; however, the drug can have severe side-ef- unsuccessful attempt to modify the picking behavior. Treatment for feather picking should include the correction of organopa- Ongoing studies suggest that haloperidold may be thies, specific therapies for folliculitis (bacterial or effective in some feather-picking cases. It takes two days to stabilize the photoperiod that varies naturally with the seasons, dose. Side-effects include loss of appetite, incoordina- and behavioral modification (see Chapter 4). If there are no side-effects and a therapies are determined to be ineffective over a bird is still picking, the dose can be increased in 0. Where feather picking is determined to be psychologi- Successful treatment is generally reported within cal (a failure in the ability to diagnose a cause for the two to three days when the bird stops over-preening problem), a video recorder may be helpful in document- or self-mutilating and begins to play, sing and inter- ing a bird’s behavior in its normal environment. Dosed at 1-2 mg/kg, the patients unliked child, an abusive adult) can guide the clinician respond for up to 14 to 21 days. Both administration in making specific recommendations to correct the be- forms have to be used continually unless the initiat- havior and resolve the problem (see Chapter 4). With Feather damage can be prevented by beak trimming or, some birds, the addition of new toys or moving an as a last resort, by applying restrictive collars (Figure enclosure to a different location will be a stress factor 24. These procedures only suppress the clinical that induces feather-picking, while with other birds signs and do not address the underlying problem. A bird that is properly social- Endocrine-related Feather Disorders ized and adapted early in life to changes in daily routine is less likely to develop emotional problems In poultry, hypothyroidism causes black, brown and due to separation anxiety when changes occur later yellow feathers to become red, longer and more in life. Hyperestrogenism has been asso- ciated with proliferation of endosteal bone in birds, but has not been associated with feather lesions (see Chapter 23). Up to 60% of the male canaries in some flocks may develop baldness that is responsive to a change in the level of nutrition provided. Persistent generalized inactivity of the feather folli- cles should be considered abnormal. Although no feather measurements were obtained, photographs of this bird suggest that con- Polyfolliculitis tour feathers lacked width and were shorter than normal. This bird responded favorably to treatment Pruritic polyfolliculitis and dermatitis that may be with 0. Lesions appear to be particularly There are no documented cases of feather abnormali- common in the feather tracts of the tail and dorsal ties resulting from hyperadrenocorticism or hypoad- region of the neck. The newly emerging feathers have renocorticism in birds although both conditions short, stout quills with retained sheaths. This bird was on a poor diet and had staphylo- coccal abscesses of the occipital bone, bacteremia and Histologically, polyfolliculitis is characterized by the bilateral pododermatitis. Therapy with broad-spec- trum antibiotics and corticos- teroids is palliative at best. Experimen- tally, developing feathers that are removed can be rotated and rein- serted and will continue to grow. In the clinical setting, it is best to re- move damaged pin feathers (see Chapter 15). An etiologic agent could not be detected by histopathol- failure of the developing feather to ogy in either case. The lesions will usually resolve when the humidity is in- creased (and the affected feathers are removed). Proc Assoc Avian Vet, 1988, pp 263- scientarium bohemoslovacae 8:1-51, nutzung des Vogel Schnabels. British Trust for Ornithology, Tring, (ed): Diseases of Cage and Aviary ing Australian birds. Millam J, Finney H: Leuprolide ace- fleas (Echnidnophaga gallinacea) on mor found on juvenile common loon. In von Tscharner C, Halliwell fungi as the cause of vesicular derma- Avian skin and feather disorders: A Press, 1978. Onderka N, et al: Adrenal degenera- dermatitis in budgerigars (Melopsit- Vet, 1991, pp 50-56. Proc Assoc don, Academic Press, 1971, pp 604- pesvirus infection in a mallard duck integument: A review. Classification of some neoplasms as benign or malignant may require knowledge of the biological behavior of the neoplasm.

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They collected live birds generic azithromycin 500 mg with visa antibiotic shelf life, espe- Bird watching azithromycin 100 mg amex antibiotics mnemonics, photographing and feeding have cially waterfowl azithromycin 100 mg with visa antibiotic resistance ted talk, and established private mini-zoo- minimal effects on bird populations and benefit both logical gardens purchase azithromycin 100mg visa antibiotics kidney disease. Colonialism exposed wealthy Europeans to birds Approximately 34% of Americans either photograph from other continents, and large outdoor aviaries birds or watch birds. Falconers have been successful in breeding and numbers, migratory patterns and other biologi- and reintroducing falcons. Aviculture Aviculturists support avian conservation by using A 1989 survey of non-hunting recreational activities birds already in captivity for their breeding programs revealed that 46% of Americans feed birds either in to decrease the need for importation. Seasonal group bird counts and the knowledge they gain from captive breeding ef- surveys provide demographic data regarding winter- forts is used by field biologists to more effectively ing species. Avian vet- erinarians can bridge the gap between aviculturists, Rehabilitation biologists and conservationists by encouraging the Because of their interest in birds, avian veterinari- sharing of knowledge and experience. Assisting injured wildlife offers an opportunity The success of the Peregrine Falcon, California Con- for the veterinarian to expand the public’s under- dor and Whooping Crane breeding programs is due, standing of avian conservation. Many native birds in part, to the commitment of aviculturists to con- are protected by federal and state laws and permits ducting in-depth studies of a single species. This are required for veterinary care and even short-term focus saves time and money and prevents the dilu- possession of these species. Developing a relationship tion of energies that often occurs with aviculture with a qualified rehabilitator could be helpful to both programs that involve a variety of different species. The care of certain native species, ie, endangered or threatened Some areas of the United States seem to be better species, should be undertaken only by veterinarians suited for the breeding of some species. The concept experienced in the care of these birds and with suit- of focusing avicultural efforts on bird species that able facilities. Wildlife rehabilitation centers are al- breed well in a certain geographic region needs to be ways in need of volunteers. Companion Birds Hunting The recreational use of birds as pets has had a pro- Hunting as a recreational use of birds consists of two found and permanent effect on the population of categories: hunting free-ranging wildlife and hunt- many free-ranging bird species. In terms of conservation ethics, perspective avian veterinarians should encourage hunting stocked wildlife is similar to the consump- clients to continue to buy domestically raised or tive use of birds for food. Contemporary hunting of ranched birds, thereby supporting captive breeding free-ranging birds initially was useful as a conserva- and sustained harvesting, and thus relieving pres- tion management tool. Hunting has conservation value physical and emotional needs of their companion when the hunter appreciates both his prey and the birds, thereby ensuring the health and welfare of the environment of the animal. With the use of high-tech birds and increasing the involvement of the owners equipment, the hunter has become more isolated with their bird. The goal is to change the nature of from his prey; consequently, the experience provides the relationship from one of consumptive ownership less conservation value. Younger animals tend to have an in- Conservation is a science as well as a philosophy. Will domestication Avian populations, especially psittacines, have expe- and the favoring of neotenic traits also lead to an rienced recent dramatic declines. Are more diseases being found in Psittacidae species that are seriously threatened or companion birds than in their free-ranging counter- at risk of extinction, most are a result of habitat loss parts because companion birds are more easily stud- and the pet trade. Figure 1 summarizes the current approaches to par- 14 Infection is difficult to assess in free-ranging birds. Many of these methods are The relationship between parasite and host is care- equally valuable to other species. What effect will domestica- One of the key approaches to conservation of tion have on this relationship? Some species mon, yet flocks of these birds are established only in exist today only in captivity. There are many questions regarding captive breed- Research on White-naped Crane eggs has shown that ing. Are the progeny of these birds releasable in their the microclimate surrounding these large eggs is native habitat or non-native habitats? Incubated netic changes that result from captive breeding that eggs do not have any temperature gradient. Is this might affect the ability of captive-bred birds to sur- microclimate essential for successful hatching of vive in the wild? What are the risks of introducing diseases to native populations or altering the ecology of the habitat with the introduction of captive-bred birds? As a consequence of domestication, there are behavioral and anatomic changes which become evident within the first few generations. The behavioral changes include three major charac- teristics: docility, curiosity and a disrespect of species barriers. Does this thermal gradient have a spe- an endeavor face difficult economic and scientific cific function? Over a century ago, Darwin and Wallace proposed conflicting views about the origin and function of Harvesting prominent male secondary sexual features and their effects on the female’s choice of a mate. Research and Avian veterinarians will need to play a significant debate on this subject is still very intense today. How are genetics, resistance to disease and reproduc- Ranching differs from captive breeding in that the tive strength of avian species being altered when breeder flock is not removed from its native habitat. How large a flock is The number of offspring “harvested” is based on the needed to allow mate selection and adequately pro- local site biological data. Parrots appear to have considerable potential as a Should this practice be discouraged in order to pre- sustainable harvest. Both large Aviculturists who intend to provide birds for reintro- and small landowners can participate, and there is duction programs will need to establish specific considerable potential to increase harvests through flocks for this purpose that are separate from birds existing management techniques. These birds must be maintained and managed differently from compan- Because habitat protection is an integral part of suc- ion birds to minimize the effects of domestication. Some of the problems associated with harvesting To prevent losses, the flock must be divided into include the social and political structures needed to viable groups, managers must be attentive to hus- allow for the lawful export of the harvest, protection bandry and sanitation and movements must be re- of the birds from poaching and over-exploitation, stricted between populations. Avian veterinarians fluctuations in demand for birds, ensuring that im- will be important members of the management portation of these birds does not increase the level of teams. With a decrease in available habitat, all the factors for disease transmission among free-ranging birds Avian veterinarians may play an important role in (eg, nutrition, increased proximity, stress) become the prevention of disease on the ranch and during the more significant. Psittacines have the potential for reintroduction once appropriate criteria have been met. Factors that con- tributed to the decline of the native population must Captive Breeding and Reintroduction be modified sufficiently in order for the newly re- When faced with imminent extinction, captive breed- leased birds to survive. Habitat protection, predator ing with the goal of reintroduction remains the only control, harvest of free-ranging birds and reduction alternative for preservation of a species. The conser- of human activity, both recreational and commercial, vation community is not in full agreement about must also be considered. Until we have a greater captive breeding of endangered and threatened spe- understanding of how these and other factors affect cies because of the many scientific, economic and populations, release of captive-bred psittacine birds political considerations involved. However, before a captive breeding program for a Under some circumstances it may be preferable to species can be established, several questions need to establish new populations in previously non-native be asked.

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Myeloperoxidase is an enzyme within the primary (azurophilic) General Pathology Answers 105 granules of neutrophils generic 500 mg azithromycin visa antibiotic 5897, while alkaline phosphatase is an enzyme in their secondary (specific) granules 250mg azithromycin with visa antibiotic urinary tract infection. In contrast purchase azithromycin 250mg with mastercard antibiotics you can give dogs, chronic inflammatory processes are associ- ated with increased numbers of monocytes and lymphocytes 250 mg azithromycin otc antibiotics for dogs vs humans. Monocytes are mononuclear leukocytes with a “bean-shaped” or “horseshoe-shaped” nucleus. The acti- vated form of macrophages have abundant eosinophilic cytoplasm and are called epithelioid cells. Lymphocytes are smaller mononuclear leuko- cytes that have a round to oval nucleus and little cytoplasm. B lymphocytes (B cells) mature into plasma cells, which have an eccentric nucleus with a “clock-face” appearance of their chromatin. Plasma cells secrete immunoglobulin, while certain T lymphocytes (T cells) secrete lymphokines. Numbers of lympho- cytes are increased in acute viral infections or chronic disease. Eosinophils are bilobed leukocytes that contain abundant eosinophilic granules within their cytoplasm. These granules contain many different types of substances, such as major basic protein (which is toxic to helminthic parasites), arylsulfatase (which neutralizes leukotrienes), and histaminase (which neutralizes histamine). They participate in specific types of inflammatory processes, such as allergic disorders, parasitic infec- tions, and some diseases of the skin. Basophils are a type of leukocyte that have numerous deeply basophilic granules within their cytoplasm that completely hide the nucleus. Basophils participate in certain specific types of immune reactions because they have surface receptors for IgE. Mast cells, although not exactly the same as basophils, are found in tissue and are very similar to basophils. When called upon, the circulating monocyte can enter into an organ or tissue bed as a tissue macrophage (sometimes called a histiocyte). Examples of tissue macrophages are Kupffer cells (liver), alveolar macrophages (lung), osteo- 106 Pathology clasts (bone), Langerhans cells (skin), microglial cells (central nervous sys- tem), and possibly the dendritic immunocytes of the dermis, spleen, and lymph nodes. The entire system, including the peripheral blood mono- cytes, constitutes the mononuclear phagocyte system. In the lung, alveolar macrophages can phagocytize the red blood cells that accumulate in alve- oli in individuals with congestive heart failure. These cells may be surrounded by mononuclear cells, mainly lymphocytes, and multinucleated giant cells, which result from the fusion of several epithe- lioid cells together, may be present. Granulomatous inflammation is a type of chronic inflammation initiated by a variety of infectious and noninfec- tious agents. Indigestible organisms or particles, or T cell–mediated immu- nity to the inciting agent, or both, appear essential for formation of granulomas. Although tuberculosis is the classic infectious granulomatous disease, several other infectious disorders are characterized by formation of granulomas, including deep fungal infections (coccidioidomycosis and histoplasmosis), schistosomiasis, syphilis, brucellosis, lymphogranuloma venereum, and cat-scratch disease. In sarcoidosis, a disease of unknown cause, the granulomas are noncaseating, which may assist in histologic dif- ferentiation from tuberculosis. Tissue repair involves the formation of granulation tissue, which histologically is characterized by a combination of proliferating fibroblasts and proliferating blood vessels. Proliferating cells are cells that are rapidly dividing and usually have prominent nucleoli. It is important not to confuse the term granulation tissue with the similar- sounding term granuloma. The latter refers to a special type of inflamma- tion that is characterized by the presence of activated macrophages (epithelioid cells). Collagen is a triple helix of three polypeptide α chains that is secreted by fibroblasts and has a high content of glycine and hydroxyproline. Fibronectin, secreted by fibroblasts, mono- cytes, and endothelial cells, is also capable of binding many substances, such as collagen, fibrin, proteoglycans, and integrins. Basically, fibronectin links extracellular matrix component and macromolecules to integrins and is chemotactic for fibroblasts and endothelial cells. Instead of being cross- shaped like laminin, fibronectin is a large glycoprotein composed of two chains held together by disulfide bonds. Albumin is secreted by hepato- cytes and is mainly responsible for intravascular oncotic pressure, while immunoglobulins are secreted by plasma cells and are important in medi- ating humoral immunity. Marfan’s syndrome is an autosomal dominant disorder that results from defective synthesis of fibrillin causing connective tissue abnormalities. It is charac- terized by specific changes involving the skeleton, the eyes, and the car- diovascular system. Skeletal changes seen in individuals with Marfan’s syndrome include arachnodactyly (spider fingers) and a large skeleton 108 Pathology causing increase in height. Eyes in patients with Marfan’s syndrome typi- cally have a subluxed lens (ectopia lentis) in which the lens is found in the anterior chamber. The lens dislocation in Marfan’s syndrome is usually upward, in contrast to the downward dislocation seen with homocystin- uria. The skin in these patients is fragile and hyperextensible, while the joints are hypermobile. These patients have “brittle bones” and also typically develop blue scleras and hearing loss. Decreased levels of vitamin D can produce rickets in children or osteomalacia in adults. It may be caused by inflammation (inflammatory edema) or it may be due to abnormalities involving the Starling forces acting at the capillary level (noninflammatory edema or hemodynamic edema). Inflammatory edema is caused by increased capillary permeability, which is the result of vasoactive mediators of acute inflammation. An exudate is inflammatory edema fluid resulting from increased capillary permeability. It is characterized by a high protein content, much cellular debris, and a specific gravity greater than 1. Pus is an inflammatory exudate containing numerous leukocytes and cellular debris. In contrast, transudates result either from increased intravascular hydrostatic pressure or from decreased osmotic pressure. Nonin- flammatory edema is the result of abnormalities of the hemodynamic (Starling) forces acting at the level of the capillaries. Increased hydrostatic pressure may be caused by arteriolar dilation, hypervolemia, or increased venous pressure. Hypervolemia may be caused by sodium retention seen in General Pathology Answers 109 renal disease, and increased venous hydrostatic pressure can be seen in venous thrombosis, congestive heart failure, or cirrhosis.

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