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Moskva becomes Moscow Wien becomes Vienna Italia becomes Italy Box 14 continues on next page purchase genuine aurogra online. buy generic aurogra 100mg. discount aurogra online. Standard report written by the performing organization and published by the sponsoring organization 13 generic 100mg aurogra free shipping. Report with authors from both the performing and sponsoring organizations Title for Reports (required) General Rules for Report Title • Enter the title of a report as it appears in the original document, in the original language • Capitalize only the frst word of a title, proper nouns, proper adjectives, acronyms, and initialisms • Use a colon followed by a space to separate a title from a subtitle, unless some other form of punctuation such as a question mark, period, or an exclamation point is already present • Translate titles not in English into English, whenever possible; place the translation in square brackets • End a title with a period unless a question mark or exclamation point already ends it or a Type of Medium follows it Specific Rules for Report Title • Titles not in English • Titles in more than one language • Titles containing a Greek letter, chemical formula, or another special character Box 16. Xianggang chuan ran bing tong ji shu zi 1946-2001 [Statistics on infectious diseases in Hong Kong, 1946-2001]. Tis rule ignores some conventions used in non-English languages to simplify rules for English-language publications. Eidgenossische Volkszahlung 1990: die Wohnbevolkerung der Gemeinden [Federal population census 1990: the population of communities]. Tendances recentes de la mortalite par cause en Russie 1965-1994 = Sovremennye tendentsii smertnosti po prichinam smerti v Rossii 1965-1994 [Recent trends in mortality by cause in Russia, 1965-1994]. Lindane (γ-hexachlorocyclohexane): health-based recommended occupational exposure limit. Report with a title containing a chemical formula, Greek letter, or other special character 18. Report in a microform Scientifc and Technical Reports 407 Type of Medium for Reports (required) General Rules for Type of Medium • Indicate the specifc type of medium (microfche, ultrafche, microflm, microcard, etc. Blood carbon monoxide and hydrogen cyanide concentration in the fatalities of fre and non-fre associated civil aviation accidents, 1991-1998 [microfche]. Report in a microform Edition for Reports (required) General Rules for Edition • Indicate the edition/version being cited afer the title (and type of medium if present) when a report is published in more than one edition or version • Abbreviate common words (see Abbreviation rules for editions below) • Capitalize only the frst word of the edition statement, proper nouns, and proper adjectives • Express numbers representing editions in arabic ordinals. Specific Rules for Edition • Abbreviation rules for editions • Editions with dates • Non-English words for editions Box 22. Report titles are frequently followed by phrases such as "Annual report", "Interim report", and "Final report". Report with an edition Editor and other Secondary Authors for Reports (optional) General Rules for Editor and other Secondary Authors • A secondary author modifes the work of the author. Focus on Children community planning manual: needs assessment and health planning for children, including children with special health care needs. Chicago: University of Illinois at Chicago, Division of Specialized Care for Children; 1996 Oct. Joint publication of the Division of Family Health, Illinois Department of Public Health, Springfeld. Report place of publication with geographic qualifer added for clarity Scientifc and Technical Reports 417 21. Report with place of publication inferred Publisher for Reports (required) General Rules for Publisher • Record the name of the publisher as it appears in the publication, using whatever capitalization and punctuation is found there • When a division or other subsidiary part of a publisher appears in the publication, enter the publisher name frst. If you abbreviate a word in one reference in a list of references, abbreviate the same word in all references. Place all translated publisher names in square brackets unless the translation is given in the publication. Tokyo: Tokyo-to Kenko Anzen Kenkyu Senta; Beijing (China): [Chinese Academy of Social Sciences, Population Research Institute]; Peking (China): Mei tan gong ye bu zhi ye yi xue yan jiu suo; [Note that the concept of capitalization does not exist in Chinese. Terefore in transliterating Chinese publisher names only the frst word and proper nouns are capitalized. Tokyo: Tokyo-to Kenko Anzen Kenkyu Senta [Tokyo Metropolitan Institute of Public Health]; • If the name of a division or other part of an organization is included in the publisher information, give the names in hierarchical order from highest to lowest Valencia (Spain): Universidade de Valencia, Instituto de Historia de la Ciencia y Documentacion Lopez Pinero; Box 33 continues on next page... Place all translated publisher names in square brackets unless the translation is given in the publication. Designate the agency that issued the publication as the publisher and include distributor information as a note, preceded by the phrase "Available from: ". Focus on Children community planning manual: needs assessment and health planning for children, including children with special health care needs. Chicago: University of Illinois at Chicago, Division of Specialized Care for Children; 1996 Oct. Joint publication of the Division of Family Health, Illinois Department of Public Health, Springfeld. For those publications with joint or co-publishers, use the name given frst as the publisher and include the name of the second as a note if desired. Focus on Children community planning manual: needs assessment and health planning for children, including children with special health care needs. Chicago: University of Illinois at Chicago, Division of Specialized Care for Children; 1996 Oct. Joint publication of the Division of Family Health, Illinois Department of Public Health, Springfeld. Report with joint publication Date of Publication for Reports (required) General Rules for Date of Publication • Always give the year of publication • Convert roman numerals to arabic numbers. A copyright date is identifed by the symbol ©, the letter "c", or the word copyright preceding the date. Negotiating the new health system: a nationwide study of Medicaid managed care contracts. 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If a report is published on microfche, microflm, or microcards: • Begin with information on the number and type of physical pieces, followed by a colon and a space Box 46 continues on next page... Report in a microform Series for Reports (optional) General Rules for Series • Begin with the name of the series • Capitalize only the frst word and proper nouns • Follow the name with any numbers provided. Characteristics of emergency departments serving high volumes of safety-net patients: United States, 2000. 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Eidgenossische Volkszahlung 1990: die Wohnbevolkerung der Gemeinden [Federal population census 1990: the population of communities]. Tendances recentes de la mortalite par cause en Russie 1965-1994 = Sovremennye tendentsii smertnosti po prichinam smerti v Rossii 1965-1994 [Recent trends in mortality by cause in Box 52 continues on next page... Add the phrase "Accompanied by:" followed by a space and the number and type of the medium. Tendances recentes de la mortalite par cause en Russie 1965-1994 = Sovremennye tendentsii smertnosti po prichinam smerti v Rossii 1965-1994 [Recent trends in mortality by cause in Russia, 1965-1994]. Te notes element may be used to provide any information that the compiler of the reference feels is useful to the reader. Sponsored by the Turning Point Public Health Statute Modernization National Excellence Collaborative; publication supported by a grant from the Robert Wood Johnson Foundation. Environmental standards: scientifc foundations and rational procedures of regulation with emphasis on radiological risk management. Washington: George Washington University Medical Center, School of Public Health and Health Services, Center for Health Services and Policy; 2003 Oct.

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There is gross enlargement of the tibiometatarsal joint cheap aurogra american express, twist- Sudden collapse or fainting has been associated with ing and bending of the distal tibia and slipping of the hypoglycemia in raptors or in other species when a gastrocnemius muscle from its condyles order 100 mg aurogra amex. Syncope is naceous birds order aurogra 100 mg fast delivery, cranes and ratites are particularly characteristic of advanced hypocalcemia in African susceptible to this condition generic 100mg aurogra fast delivery. In some cases, surgical correction is possible (see Behavioral changes including aggressiveness (bit- Chapter 46). In spite of the absence of complete data for companion birds, anecdotal findings and scientifically supported in- Reproductive Disorders vestigations suggest that general health and repro- Many dietary deficiencies or excesses may result in ductive success will be greater in birds fed “balanced” reduced reproductive performance due to infertility, formulated diets supplemented with limited fresh poor hatchability or nestling deaths. Calcium, vita- fruits and vegetables compared to birds fed seeds min E and selenium deficiencies may be associated supplemented with fresh fruits and vegetables (Fig- ure 31. Research findings and clinical experience suggest General Ill Health or Sudden Death that there is considerable interspecies variation in nutrient requirements and in clinical signs of malnu- Fatty liver infiltration may occur due to high fat trition. For example, some finches may consume up diets, fatty acid or B vitamin deficiencies and high- to 30% of their body weight, budgerigars, 25% of body energy diets in exercise-deprived birds (see Color 20). Ascites may be as- of extrapolating nutrient requirements, particularly sociated with excessive dietary levels of iron in birds of minerals, from poultry data when the level of food susceptible to iron storage disease (hemochroma- consumption varies dramatically. Atherosclerosis may be associated with diets also vary depending on the bird’s age and physiologic high in fat and cholesterol (see Color 14). Aortic rupture has been associated with copper defi- ciency in poultry and is suspected to occur in ratites (see Color 48). Protein and Amino Acids Protein in the diet is broken down into component Immune Response amino acids before being absorbed by the intestine. Adequate levels of both B complex (particularly pan- tothenic acid and riboflavin) and vitamin E have been shown to improve the body’s response to pathogens. In poultry, vitamin C and zinc are involved in T-cell re- sponse, and vitamin C stimulates macrophages and helps to counter the immunosuppressant effects of stress. Low vitamin A levels may result in a sub-opti- mal immune response and have been associated with the occurrence of aspergillosis in psittacines. Over- supplementation with fresh foods, as is the case with this daily vegetable bowl for a cockatoo, can actually cause malnutrition When one considers the array of ecological niches to through insufficient consumption of a formulated diet. For a bird the size of an Umbrella Cockatoo, the formulated diet should be which different species of birds are adapted, it is not supplemented with the equivalent of several slices of carrot (or surprising that there are major species differences in dark squash or sweet potato), one-eighth cup of spinach (or broccoli or endive) and several small slices of favorite fruits as a treat. Excess Dietary Protein Dietary protein requirements vary dramatically be- Diets for Birds with Renal Disease or Gout tween species. Broiler chickens and turkeys have Birds with renal disease or gout should be provided been genetically selected for rapid growth and are fed diets that decrease the workload of the kidneys and high protein levels to achieve maximum growth slow the loss of renal function. These feeding practices are rarely appropriate lower in protein and meet energy needs with non- in other species. Calcium, phosphorus, magnesium, pheasants may contain nearly 30% protein, but sodium and vitamin D3 levels should be reduced to young ratites, waterfowl and psittacine birds require avoid renal mineralization. Using a high-protein diet in these sent in adequate amounts to ensure proper function latter species may result in clinical problems such as of the mucous membranes lining the ureters. B vita- airplane wing in ducks, deformed legs in ratites, poor mins should be increased to compensate for losses growth rates in psittacine birds and increased sus- associated with polyuria. Protein and Amino Acid Deficiencies Inappropriate calcium levels in the diet may com- Protein or specific amino acid deficiencies are occa- pound problems caused by excessive dietary protein. Insectivorous protein baby cereal with added vitamins and calcium birds require higher protein levels than granivores showed suboptimal growth rates. When the protein and generally require live food such as crickets or level in the diet was reduced by adding pureed fruits mealworms. If these insects are reared exclusively on and vegetables, the growth rate and the chick’s gen- bran, their total body protein may be low, and conse- eral health improved dramatically (see Chapter 30). Clinically, insecti- Nutritional data collected in juvenile cockatiels indi- vores receiving low-protein insects will have a his- cated that a protein level of 20% was optimal for this tory of recurrent disease problems. Levels of 10% produced stunting, poor that have been raised on dried dog food or encourag- growth and high mortality; levels over 25% produced ing insectivores to consume artificial diets with ap- transient behavioral changes such as biting, nerv- propriate levels of high quality protein prevents the ousness, rejection of food and regurgitation. In budgerigars, one study showed that a protein level Many seeds are relatively low in total protein and of 17 to 20% was optimal. Birds on low-protein seed may also be deficient in some essential amino acids diets increased their food intake and gained weight such as tryptophan, methionine, arginine or lysine. Those on low pro- Free-ranging, seed-eating birds will frequently eat tein (12%) mash diets lost weight, but some died with insects, particularly during the breeding season and their crops packed with food. Birds fed high-protein diets were very abnormal feathers as well as suboptimal growth and thin. Deficiencies of essential diet with 2% lysine and 10% protein (13 kcal/kg of amino acids are most likely to occur if birds are fed a body weight) is ideal. Gout is the deposition of uric acid crystals on body Serine, glycine and proline are the most abundant organs (visceral gout), in joints (articular gout) or in amino acids in feather keratin while methionine, the ureters (renal constipation) (see Color 21). High histidine, lysine and tryptophan occur at lower lev- dietary levels of protein and calcium, hypervitami- els. Changes ciated with impaired feather pigmentation in poul- in the taste or odor of rancid food stuffs did not occur try, but not in cockatiels. Rice and oats are particularly susceptible to becoming rancid Methionine deficiency has been associated with and are processed for foods through extrusion, rolling stress lines on feathers and fatty liver change. Many commercial diets contain antioxi- tine and methionine act as sources of glutathione, dants (propylene glycol or ethoxyquin) to prevent which has a sparing effect on vitamin E. Fats and Essential Fatty Acids Ventricular erosion may occur in birds fed highly Fats provide a concentrated source of energy. Linoleic polyunsaturated fatty acids (such as those present in and arachidonic acids are essential fatty acids cod liver oil), if the fatty acids are not protected by an needed for the formation of membranes and cell or- adequate dietary level of vitamin E. Deficiencies of linoleic acid may be associ- has been associated with ventricular ulceration in ated with decreased metabolic efficiency, decreased poultry fed heated fish meal. Because of these prob- growth, hepatomegaly, increased fat storage, de- lems, fish liver oils are not recommended as dietary creased reproduction, embryonic mortality and de- components in companion birds. In mammals, lipogenesis occurs good source of fatty acids that is less likely to spoil. T is believed to be associated with Atherosclerosis may be induced by diets high in satu- 3 lipogenesis and calorigenesis, especially during mi- rated fats and cholesterol. This problem is occasion- gration, while T is associated with reproduction and ally seen in aged Psittaciformes and may be associ- 4 molt (see Chapter 23). How- kidney syndrome in young chickens and fatty liver ever, about half of the birds fed a 60% fat diet devel- 33 oped a necrotic crop infection and died. Geese that are force-fed cream and not allowed to exercise in preparation for pate de foie gras may have Carbohydrates a six-fold increase in liver weight with only a two- thirds increase in weight. Exercise- Fatty liver syndromes of undetermined etiologies are deprived birds on high-energy diets may develop common in companion birds (see Color 20). In addi- fatty liver infiltration even though carbohydrates, tion to fatty liver, excessive levels of fat in the diet are rather than fats, form the major component of energy known to cause obesity, diarrhea and oily feather consumed. Paradoxically, lack of fatty Clostridial infections, in which gas fermentation oc- acids can also result in fatty liver infiltration because curs along the gastrointestinal tract, have been asso- ciated with high-sugar diets in nectivorous birds. Poor growth and reduced resistance to disease also Birds have blood glucose levels that are several times occur with essential fatty acid deficiencies. Some species, such as poultry is associated with high carbohydrate, low-fat, penguins and sea birds, are adapted to tolerate long selenium-deficient diets given ad lib. Small companion birds (eg, finches) may destroyed, amino acid availability may be reduced collapse from hypoglycemia if they are deprived of and peroxidases may be produced that interfere with food for even short periods. Food restriction prior to the activities of fat- and water-soluble vitamins (bio- anesthesia should not exceed several hours. Glucagon, rather than insulin, system in embryos, for the production of adrenal is the principal director of carbohydrate metabolism hormones and for the formation of red and orange in birds. It is their derivatives that Diets for Birds with Hypoglycemia are responsible for feather pigmentation. Low vita- Birds prone to hypoglycemia should be fed frequently min A in the diet may result in a suboptimal immune with nutrients that are slowly converted to glucose (a response. In most cases, hypo- glycemia is dietary-induced, and placing the bird on Numerous clinical problems may be associated with a diet appropriate for that species is all that is re- hypovitaminosis A. Hyperkeratosis, a related condition, may affect epi- Vitamins 13 thelial surfaces (Figure 31. Vitamins are a mixed group of organic compounds Small white pustules may be seen in the mouth, that are essential for a variety of metabolic proc- esophagus, crop or nasal passages. Most birds require the same vitamins as mam- metaplasia causes blockage of salivary ducts, small mals with the exception that vitamin D (not vitamin3 swellings (often symmetrical) may be noted dorsally D2, as in mammals) is the active form of this com- around the choana, around the larynx and laterally pound.

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Eosinophil progranulocytes lack the dark ma- cyte (late polychromatic erythroblast) and late genta granules and rings and contain only brightly polychromatic rubricyte (orthochromic erythroblast) cheap aurogra 100mg on-line. Baso- The basophilic rubricyte has a high N:C ratio buy aurogra discount, homo- phil progranulocytes have magenta granules that geneous basophilic cytoplasm and round nucleus appear smaller than those of heterophil progranulo- with distinct chromatin clumping best buy for aurogra. The nucleus of progranulocytes is typically eccentric in its cellular The early polychromatic rubricyte appears smaller position purchase genuine aurogra on line, has a delicate reticular chromatin pattern than the basophilic rubricyte and is the first stage of and often has indistinct margins. The myelocytes are smaller than the progranulocytes The hemoglobin gives the cytoplasm a gray, slightly and contain the specific granules (secondary gran- eosinophilic appearance. Heterophil myelocytes are smaller with increased density, and the cytoplasm is round cells with light blue cytoplasm containing pri- more abundant when compared to the previous stage mary granules, magenta granules and rings and the of development. The de- a round-to-slightly oval cell with an eosinophilic finitive granules occupy less than 50 percent of the gray-to-weakly eosinophilic cytoplasm (Color 9. Eosinophil myelocytes contain This cell appears to have increased cytoplasmic vol- primary and secondary granules. The nucleus of myelocytes is cyte, except the cytoplasm is a pale blue and the round and has coarsely granular chromatin. Metamyelocytes resemble myelocytes, except the cell Lymphopoiesis nucleus is slightly indented and may have distinct chromatin clumping. Heterophil metamyelocytes Lymphocyte development may be seen occasionally have definitive, rod-shaped granules that occupy when evaluating hematopoietic tissue (Color 9. Three distinctive stages can be identified for lympho- The primary granules and magenta spheres and cyte development: lymphoblasts, prolymphocytes rings may be present, but fewer in number than the and mature lymphocytes. The nucleus phil and basophil series also occupy greater than 50 has smooth chromatin, in comparison to the mature percent of the cytoplasmic volume in their respective cell, and contains distinct nucleoli. Prolymphocytes resemble lymphoblasts but are The granulocytic cell series will occasionally reveal a slightly smaller, lack nucleoli and have a less baso- band cell stage similar to that described in mammal- philic cytoplasm. However, the cell nucleus is often oblasts and prolymphocytes represent less than ten hidden by the cytoplasmic granules (especially in percent of the lymphoid cells. Thus, the majority of heterophils), making it difficult to differentiate the the cells should be mature lymphocytes with the band cell from mature cells. Mature avian basophil heavy nuclear chromatin clumping, high N:C ratio nuclei do not segment. Thrombocytopoiesis Other Bone Marrow Cells The developmental stages involved in thrombopoi- Other cells frequently encountered in bone marrow esis are the thromboblast, early-immature thrombo- samples include osteoclasts, osteoblasts, monocytes, cyte, mid-immature thrombocyte, late-immature plasma cells and mitotic figures. The abundant cytoplasm is weakly basophilic decreases, the N:C ratio decreases, the nucleus be- and often contains vacuoles and small red granules comes increasingly pyknotic and cytoplasm becomes of various shapes. The oval-to-round Thromboblasts are large, round-to-ameboid-shaped nucleus is eccentrically positioned in the cell. The cells with a narrow rim of deeply basophilic cyto- abundant, foamy, basophilic cytoplasm contains a plasm surrounding the round nucleus. The nuclear prominent clear space (Golgi) that is located a dis- chromatin often appears punctate, making nucleoli tance from the nucleus. The early-immature thrombocyte is smaller than the Products Mentioned in the Text thromboblast. Coulter Counter, Coulter Electronics, Inc plasmic granules may be seen at this stage. Res Vet Leucocytozoon smithi infection of tur- Proc Assoc Avian Vet, 1984, pp 229- 26. Taylor M: Polycythemia in the blue tally produced hemolytic anemia in cal haematology of captive cranes 54. J Assoc Avian Vet cular and hematologic effects of hem- nal cholesterol, and differential leuco- University Press, 1988, pp 257-336. The basic cytodiagnosis of inflammation, tissue hyperplasia, malignant neoplasia and normal cellu- larity are easily differentiated from each other (see Figures 10. One who is well versed in mammalian cytodiagnosis should have little trouble in the interpretation of avian samples. The goal is to 10 achieve a quick presumptive or definitive diagnosis during the patient’s initial visit to the veterinary clinic in an effort to provide an immediate and spe- cific treatment plan. Cytology can then be used to monitor the success of therapy by evaluating changes in microbial and cell populations within or on the host. Cytology should be considered as a part of the minimum database in birds with discharges, masses or swellings. Cytological samples are of greatest value if they are collected fresh and immediately processed for evaluation. To obtain a cytologic sample and send it to an outside laboratory defeats the purpose and usefulness of cy- Terry W. This will serve to improve understanding of the pathogenesis and cellular effects of a disease process. The needle is moved at different angles in the tissue without releasing the vacuum. It is impor- Sample Collection tant to release the vacuum before withdrawing the needle from the tissue, because the aim of the proce- dure is to obtain a small amount of sample in the lumen of the needle only, not in the syringe itself. A variety of sample collection methods can be used to Once the needle has been withdrawn from the tissue, obtain samples for cytologic examination. Cytologic sample inge, and with the point of the needle lying against collection methods can be divided into two broad the slide surface, the air within the syringe is used to categories: aspiration and contact smears. A second glass microscope slide placed on top of the first allows the sample to spread between the two Sample Collection by Aspiration glass surfaces when the slides are pulled horizontally Fine-needle aspiration biopsy is a simple, inexpen- apart. Two specimens for cytologic examination are sive procedure for obtaining material for cytologic thus created. Using an alcohol swab, the “squash preparation technique” because the sam- the skin overlying the biopsy site is cleansed and ple is compressed between the two slide surfaces. A hypodermic needle (eg, 22 ga, Abdominocentesis is an aspiration biopsy procedure one-inch needle) attached to a syringe (12 ml or used to collect cytologic samples from birds with larger) is inserted into the tissue to be sampled. The abdominal space vacuum is applied to the syringe using the syringe is small in normal birds and contains little fluid. Because the abdominal air sacs occupy a large por- tion of the abdomen, it is difficult to enter the perito- neal cavity of normal birds. However, as peritoneal fluids accumulate, the air sacs are compressed later- ally, increasing the size of the peritoneal cavity and making it easier to sample. Abdominocentesis begins with a surgical preparation of the site along the ventral midline just distal to the point of the keel. The needle (21 to 25 ga, one-inch) is attached to a syringe and is directed through the body wall at the midline, pointing toward the right side of the abdo- men to avoid the ventriculus, which lies to the left of the midline (Figure 10. The abdominal fluid is aspirated into the syringe and prepared for cytologic examination, either by making a direct smear as one would prepare a blood film or by using a concentra- tion method. The goal of abdominocentesis is to collect fluid from the abdominal cavity for diagnostic purposes. The material that is collected (eg, gut contents, unwillingness to fly and depression. The hen had been incubating egg yolk, cells from a mass) should be evaluated with eggs, and it was uncertain how long she had been clinically symp- respect to its potential source. The masses in areas where the skin avian species (macaws) will produce small quantities was thin appeared grossly as small, white-to-yellow nodules. Cy- of fluid in response to egg-related peritonitis, while tologic examination of a fine-needle aspirate from the mass re- others (cockatiels) will produce voluminous fluids. Articular gout is common in birds that become dehydrated or that have primary or secondary renal disease. The fluid is placed in a plastic test tube and centrifuged at 600 G (gravity) for ten minutes. Unlike urine sediments, cytologic sediments from poorly cellular fluids do not have a visible button or pellet at the bottom of a spun tube. Therefore, the concentrated cells are usually obtained by aspirating the fluid at the bottom of the tube into a pipette or syringe. The sample is then placed onto a microscope slide and a smear is made in the manner described for concentrating cells in a smear. Special cytocentri- fuge equipmenta is available for concentrating cells on microscope slides while absorbing the fluid onto filter paper. This equipment is expensive and not practical for the average veterinary laboratory. Because centrifugation distorts the appearance of the cells, a cell concentration method that utilizes gravity provides a concentrated sample with normal appearing cells. A simple, inexpensive sedimentation device can be made for use in the veterinary labora- tory.

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