Carbon monoxide exposure in hospital accommodation Paratz, Elizabeth D.; Wilkie, Bruce D.
Internal medicine journal,
April 2021, 2021-Apr, 2021-04-00, 20210401, Letnik:
51, Številka:
4
Journal Article
Summary
Reasons for performing study: Neoplasia, for which surgical excision is a frequent treatment, is the most common disease of the equine nictitating membrane. There is little long‐term ...follow‐up information available to the practitioner regarding the long‐term effects of nictitating membrane excision on ocular health. No information is available to compare recurrence of primary neoplasia of the nictitating membrane after excision with local or general anaesthesia.
Objectives: To evaluate the long‐term complications of nictitating membrane resection in horses; recurrence of neoplasia of the nictitating membrane when nictitating membrane resection is performed under local vs. general anaesthesia and if the method of anaesthesia used to permit resection of the affected membrane influences the recurrence of neoplasia of the nictitating membrane after complete nictitating membrane resection.
Methods: Records of 26 horses receiving resection of the nictitating membrane for primary neoplasia of the nictitating membrane 1999–2009 were reviewed. Clinical examination findings, surgical procedure, anaesthesia type, histopathological findings and details of adjunctive treatment were recorded. Owners were contacted via telephone regarding post operative outcomes. Data were analysed using a Fisher's exact test (P<0.05).
Results: The most common long‐term complication of nictitating membrane excision was mild ocular discharge. Squamous cell carcinoma was the most frequent histopathological diagnosis. Recurrence of neoplasia was uncommon (2/26 horses). No significant difference in the number of horses experiencing recurrence of neoplasia was detected between groups receiving general anaesthesia vs. those receiving local anaesthesia.
Conclusions: Resection of the nictitating membrane in horses following local anaesthesia is not associated with increased risk of recurrence of neoplasia compared with excision under general anaesthesia. Resection of the nictitating membrane is not associated with any long‐term ocular side effects and can be an effective modality for cure of primary neoplasia of the nictitating membrane in selected cases.
Because rapidly expanding human populations have devastated gorilla (Gorilla gorilla) and common chimpanzee (Pan troglodytes) habitats in East and West Africa, the relatively intact forests of ...western equatorial Africa have been viewed as the last stronghold of African apes. Gabon and the Republic of Congo alone are thought to hold roughly 80% of the world's gorillas and most of the common chimpanzees. Here we present survey results conservatively indicating that ape populations in Gabon declined by more than half between 1983 and 2000. The primary cause of the decline in ape numbers during this period was commercial hunting, facilitated by the rapid expansion of mechanized logging. Furthermore, Ebola haemorrhagic fever is currently spreading through ape populations in Gabon and Congo and now rivals hunting as a threat to apes. Gorillas and common chimpanzees should be elevated immediately to 'critically endangered' status. Without aggressive investments in law enforcement, protected area management and Ebola prevention, the next decade will see our closest relatives pushed to the brink of extinction.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Patients with mutated TP53 have been identified as having comparatively poor outcomes compared to those retaining wild-type p53 in many cancers, including squamous cell carcinomas of the head and ...neck (SCCHN). We have examined the role of p53 in regulation of metabolism in SCCHN cells and find that loss of p53 function determines the Warburg effect in these cells. Moreover, this metabolic adaptation to loss of p53 function creates an Achilles’ heel for tumour cells that can be exploited for potential therapeutic benefit. Specifically, cells lacking normal wild-type p53 function, whether through mutation or RNAi-mediated downregulation, display a lack of metabolic flexibility, becoming more dependent on glycolysis and losing the ability to increase energy production from oxidative phosphorylation. Thus, cells that have compromised p53 function can be sensitised to ionizing radiation by pre-treatment with a glycolytic inhibitor. These results demonstrate the deterministic role of p53 in regulating energy metabolism and provide proof of principle evidence for an opportunity for patient stratification based on p53 status that can be exploited therapeutically using current standard of care treatment with ionising radiation.
What is already known•TP53 mutations are the most common genetic mutation in many cancers, including head and neck cancers.•Patients with mutated p53 display poor prognosis but no method exists for selectively treating these patients
What this study adds•We identify and confirm that p53 status (mutant or normal) determines tumour cell metabolic profile•Metabolic changes induced by loss of p53 function determine sensitivity to metabolic inhibition in combination with the mainstay of current therapy-radiation, and provide an opportunity to increase radiation sensitivity in p53 mutated cells•The results suggest that a strategy for treating patients with mutations in TP53 could be readily developed combining the current standard of care (radiotherapy) with short term inhibition of a metabolic pathway (glycolysis).
Savides, M. C., Pohland, R. C., Wilkie, D. A., Abbott, J. A., Newbound, G. C., Freise, K. J., Clark, T. P. The margin of safety of a single application of transdermal fentanyl solution when ...administered at multiples of the therapeutic dose to laboratory dogs. J. vet. Pharmacol. Therap.35 (Suppl. 2), 35–43. Previous studies have demonstrated that a single, topical application of a novel, long‐acting transdermal fentanyl solution provides analgesic fentanyl concentrations for at least 4 days. The objective of this study was to describe the margin of safety following application at multiples of the therapeutic dose. Twenty‐four laboratory dogs were administered a single placebo or 1×, 3×, or 5× multiple of the dose of 2.6 mg/kg (50 μL/kg) to the ventral abdominal skin and observed for 14 days. Plasma fentanyl concentrations increased in proportion to dose. Adverse reactions in the 1× group were transient and included a low prevalence (≤33%) of mild sedation, reduced food intake, modest weight loss, and minimal reductions in heart rate and rectal temperature. Moderate to severe sedation emerged in the 3× and 5× groups, which was associated with a dose‐limiting reduction in food and water intake, necessitating maintenance fluid replacement for the first 2 days following application. Also observed in the higher‐dose groups were an increased prevalence of abnormal stools and transient lens opacities. All abnormal health observations were completely resolved prior to necropsy on day 14, and there were no histological abnormalities identified. These data support the safe use of the 1× dose and describe the outcome of an overdose of up to 5× dose in the absence of opioid reversal.
Purpose
Seroma/sialocele and haematoma formations following parotidectomy are common complications. Fibrin-sealant tissue glue (FSTG) applied to the surgical bed prior to closure has been used widely ...to reduce such complications at other surgical sites. We sought to evaluate a potential role in parotidectomy, examining outcomes before and after the use of FSTG was introduced in our department.
Methods
Outcomes were studied retrospectively for 1 year prior to the introduction of FSTG (group A,
n
= 31), and prospectively for 1 year subsequently (group B,
n
= 29). Primary outcome measures were seroma/sialocele and haematoma rates. Secondary outcome measures of interest included the use of a surgical drain and the duration of hospital stay. Chi-squared statistics and Mann–Whitney
U
tests were used to compare the outcomes between groups as appropriate.
Results
Seroma/sialocele rates were significantly lower in group B than in group A (
n
= 2 6.9% versus
n
= 8 25.8%,
p
= 0.01) (Fig.
1
), with an absolute risk reduction of 18.9%, a relative risk reduction of 26.7%, and a number needed to treat of 5.3. Haematoma rates were similar between groups (
n
= 0 0% versus
n
= 1 3.2%,
p
= 0.36) (Fig.
2
). In group A, a surgical drain was used in 24 cases (77.4%), while no cases in group B were drained.
Fig. 1
Seroma rates
Fig. 2
Haematoma rates
Conclusion
The use of FSTG appears to significantly reduce the risk of post-parotidectomy seroma/sialocele formation and facilitates safe, drain-free daycase surgery. We hope this report will prompt other departments to consider using this technique and that our findings will help foster further appraisal in larger, prospective studies going forward.
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