Purebred dog health is thought to be compromised by an increasing occurence of inherited diseases but inadequate prevalence data on common disorders have hampered efforts to prioritise health ...reforms. Analysis of primary veterinary practice clinical data has been proposed for reliable estimation of disorder prevalence in dogs. Electronic patient record (EPR) data were collected on 148,741 dogs attending 93 clinics across central and south-eastern England. Analysis in detail of a random sample of EPRs relating to 3,884 dogs from 89 clinics identified the most frequently recorded disorders as otitis externa (prevalence 10.2%, 95% CI: 9.1-11.3), periodontal disease (9.3%, 95% CI: 8.3-10.3) and anal sac impaction (7.1%, 95% CI: 6.1-8.1). Using syndromic classification, the most prevalent body location affected was the head-and-neck (32.8%, 95% CI: 30.7-34.9), the most prevalent organ system affected was the integument (36.3%, 95% CI: 33.9-38.6) and the most prevalent pathophysiologic process diagnosed was inflammation (32.1%, 95% CI: 29.8-34.3). Among the twenty most-frequently recorded disorders, purebred dogs had a significantly higher prevalence compared with crossbreds for three: otitis externa (P = 0.001), obesity (P = 0.006) and skin mass lesion (P = 0.033), and popular breeds differed significantly from each other in their prevalence for five: periodontal disease (P = 0.002), overgrown nails (P = 0.004), degenerative joint disease (P = 0.005), obesity (P = 0.001) and lipoma (P = 0.003). These results fill a crucial data gap in disorder prevalence information and assist with disorder prioritisation. The results suggest that, for maximal impact, breeding reforms should target commonly-diagnosed complex disorders that are amenable to genetic improvement and should place special focus on at-risk breeds. Future studies evaluating disorder severity and duration will augment the usefulness of the disorder prevalence information reported herein.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Summary
Objective
Magnetic resonance (MR) thermography–guided laser interstitial thermal therapy, or stereotactic laser ablation (SLA), is a minimally invasive alternative to open surgery for focal ...epilepsy caused by cerebral cavernous malformations (CCMs). We examined the safety and effectiveness of SLA of epileptogenic CCMs.
Methods
We retrospectively analyzed 19 consecutive patients who presented with focal seizures associated with a CCM. Each patient underwent SLA of the CCM and adjacent cortex followed by standard clinical and imaging follow‐up.
Results
All but one patient had chronic medically refractory epilepsy (median duration 8 years, range 0.5‐52 years). Lesions were located in the temporal (13), frontal (five), and parietal (one) lobes. CCMs induced magnetic susceptibility artifacts during thermometry, but perilesional cortex was easily visualized. Fourteen of 17 patients (82%) with >12 months of follow‐up achieved Engel class I outcomes, of which 10 (59%) were Engel class IA. Two patients who were not seizure‐free from SLA alone became so following intracranial electrode‐guided open resection. Delayed postsurgical imaging validated CCM involution (median 83% volume reduction) and ablation of surrounding cortex. Histopathologic examination of one previously ablated CCM following open surgery confirmed obliteration. SLA caused no detectable hemorrhages. Two symptomatic neurologic deficits (visual and motor) were predictable, and neither was permanently disabling.
Significance
In a consecutive retrospective series, MR thermography–guided SLA was an effective alternative to open surgery for epileptogenic CCM. The approach was free of hemorrhagic complications, and clinically significant neurologic deficits were predictable. SLA presents no barrier to subsequent open surgery when needed.
Abstract
Objective
To evaluate the use of 3-D printed models as compared to didactic lectures in the teaching of acetabular fractures for Orthopaedic trainees.
Methods
This was a randomised ...prospective study conducted in a tertiary hospital setting which consisted of 16 Orthopaedic residents. Ten different cases of acetabular fracture patterns were identified and printed as 3-D models. The baseline knowledge of orthopaedic residents regarding acetabular fracture classification and surgical approach was determined by an x-ray based pre-test. Trainees were then randomly assigned into two groups. Group I received only lectures. Group II were additionally provided with 3-D printed models during the lecture. Participants were then assessed for comprehension and retention of teaching.
Results
Sixteen trainees participated in the trial. Both Group 1 and 2 improved post teaching with a mean score of 2.5 and 1.9 to 4.4 and 6 out of 10 respectively. The post test score for fracture classification and surgical approach were significantly higher for 3-D model group (
p
< 0.05). Trainees felt that the physical characteristics of the 3-D models were a good representation of acetabular fracture configuration, and should be used routinely for teaching and surgical planning.
Conclusion
3-D printed model of real clinical cases have significant educational impact compared to lecture-based learning towards improving young trainees’ understanding of complex acetabular fractures.
Intravenous lipid rescue therapy (LRT) may be implemented to attenuate drug toxicity. Little is known about LRT interference with laboratory tests in overdose settings. A 54-year-old man with a ...history of depression consumed unknown amounts of diphenhydramine, amitriptyline, and acetaminophen (APAP). Initial workup showed aspartate aminotransferase (AST) of 138 U/L, APAP of 177 μg/mL, and a QRS interval of 136 milliseconds. N-acetylcysteine, sodium bicarbonate, and 20% intravenous LRT were initiated. Laboratory test results drawn less than 6 hours later showed an APAP level of 44 μg/mL and an undetectable AST (Siemens Vista 1500 analyzer, lower limit of detection: alanine aminotransferase, 6 U/L; AST, 3 U/L). N-acetylcysteine and LRT infusions were stopped. Eight hours later, serum AST was measured at 488 U/L and increased over the next 2 days to a peak of 1600 U/L before recovery. Given a gradually rising course of AST following APAP ingestion, a single undetectable measurement is highly unlikely and probably erroneous. For this Siemens analyzer, serum lipid concentrations greater than 400 mg/dL cause interference with the AST measurement. Because lipid levels greater than 400 mg/dL with other similar analyzers are known to falsely decrease the AST, it is possible that extreme lipemia caused this laboratory result; a triglyceride level of 3648 mg/dL has been reported after LRT infusion. This conclusion is limited by the lack of repeat measurement of liver enzymes or measurement of serum lipid levels. Lipid rescue therapy may cause lipemia that interferes with the assay for liver enzymes. Suspected abnormal laboratory values should be repeated, or other techniques can be used to remove lipemic interference.
Feline hyperthyroidism is a commonly diagnosed endocrinopathy that can have a substantial deleterious impact on the welfare of affected cats. This study aimed to estimate the prevalence, associated ...factors and geographical distribution for feline hyperthyroidism in England, using primary-care veterinary practice clinical data from the VetCompass Animal Surveillance Project. Prevalence was estimated from the overall cat cohort. Associated factor analysis used an age-matched, nested, case-control design with multivariable logistic regression. There were 2,276 cases of feline hyperthyroidism identified from 95,629 cats attending 84 practices from September 2009 to December 2011. Cases were aged 6–25 years. 3.7 per cent of cases and 9.9 per cent of controls were purebred, 56.4 per cent of cases and 56.5 per cent of controls were female, and 88.1 per cent of cases and 86.0 per cent of controls were neutered. The apparent prevalence was 2.4 per cent (95% CI 2.3 to 2.5 per cent) overall, and 8.7 per cent (95% CI 8.3 to 9.0 per cent) in cats aged 10 years or above. Burmese (OR 0.15, 95% CI 0.07 to 0.32, P<0.0001), Persian (OR 0.17, 95% CI 0.08 to 0.33, P<0.0001), Siamese (OR 0.4, 95% CI 0.21 to 0.75, P=0.004) and purebred cats overall (OR 0.33, 95% CI 0.25 to 0.42, P< 0.0001) had lower odds of feline hyperthyroidism than non-purebred cats. Insured cats had increased odds (OR 1.78, 95% CI 1.56 to 2.03, P< 0.001). There was little evidence of spatial variation. This study highlights feline hyperthyroidism as a high-prevalence disease in England, and reports reduced odds of diagnosis in certain breeds and purebred cats overall.
BACKGROUND Fibroepithelial polyps are benign lesions of mesodermal origin, which have been reported in the head and neck area. The aim of this study is to describe the management of an oropharyngeal ...fibroepithelial polyp causing stridor. CASE REPORT A 39-year-old male presented with 24 hours of stridor and dysphagia. Flexible laryngoscopy revealed a pedunculated sessile polyp on the posterior oropharynx. The mass was excised using bipolar diathermy and histopathology revealed a fibroepithelial polyp. The differential diagnoses for stridor are extensive. Although uncommon, a fibroepithelial polyp should be considered. CONCLUSIONS We present a rare case of a fibroepithelial polyp causing stridor and imminent airway obstruction. We recommend the use of SponTaneous Respiration using IntraVEnous anaesthesia and High-flow nasal oxygen (STRIVE Hi) for general anaesthesia and resection of pharyngeal polyps.
Idiopathic thrombotic thrombocytopenic purpura (TTP) is frequently complicated by microinfarcts in cerebral cortex and subcortical white matter. We describe two sisters who suffered massive ...hemispheric infarction due to thrombosis of the middle cerebral artery main stem during exacerbations of TTP. Acute TTP may be associated with intraluminal thrombosis of large-diameter arteries in addition to arterioles and capillaries.
This study demonstrates how hydrodynamics can be used to influence the fishing performance of towed demersal fishing gears. Sea trials are performed in the sea star fishery to show how modifications ...to the gear design alter the hydrodynamics of the turbulent wake and consequently affect the catching performance of trawl gears. The trials are performed on cockle and mussel beds and the effect of the gap between the towing beam and the seabed, and the effect of the size of the beam are investigated. Two different beam sizes are utilized where a large beam reduces the mussel bycatch and increases the sea star catch rate if positioned a suitable distance over the seabed. The catch rate is independent of the distance between the beam and the fishing line within the investigated interval.
•Systematic changes in the hydrodynamics affect the catch rate correspondingly.•Demersal fishing gear can be optimized using hydrodynamics.•Beam size and clearance influence the sea star catch rate significantly.
Guinea pigs are popular as domestic pets but there is limited information on the health of the wider pet population. This study aimed to report demography, commonly diagnosed disorders and mortality ...of guinea pigs under UK primary veterinary care.
Diagnosis and mortality information on guinea pigs was extracted from anonymised UK primary-care clinical records in VetCompass.
From 51,622 guinea pigs under primary veterinary care during 2019, a specific breed was not recorded in 50,098 (97.05%). Of guinea pigs with information recorded, 23,206 (47.33%) were female and 25,828 (52.67%) were male. There were 1,020 (2.08%) neutered and 48,014 (97.92%) entire. Median adult bodyweight overall was 1.05kg (interquartile range IQR 0.90-1.19, range 0.40-2.66). From a random sample of 3,785/51,622 (7.33%) guinea pigs, the most prevalent disorders were overgrown nail(s) (n = 1,005, 26.55%, 95% confidence interval CI 25.15-27.99), dermatophytosis (228, 6.02%, 95% CI 5.29-6.83) and corneal ulceration (189, 4.99%, 95% CI 4.32-5.74). Among the 30 most common disorders, females showed predisposition for 3 disorders and males showed predisposition for 5 disorders. The disorder with the youngest age of affected animals was dermatophytosis (1.11 years) while weight loss had the oldest age of affected animals (4.64 years). From 757 recorded deaths, the median age at death overall was 4.03 years (IQR 2.56-5.44, range 0.17-10.00). Among deaths with a recorded cause, the most common causes of death were anorexia (n = 82, 13.87%, 95% CI 11.19-16.93), collapsed (58, 9.81%, 95% CI 7.54-12.50) and peri-anaesthetic death (20, 3.38%, 95% CI 2.08-5.18).
These results can assist veterinarians and owners by providing demographic, disorder and mortality benchmarks that support improved clinical care and welfare outcomes in guinea pigs. Many common disorders in guinea pigs were husbandry related.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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