Novedades en el tratamiento del conducto arterioso persistente

El conducto arterioso persistente (CAP)es una patología cardíaca congénita frecuentemente, cuyo tratamiento requiere el cierre, bien de forma quirúrgica o de forma percutánea. En este artículo se describe una novedosa técnica de cierre, mediante cardiología intervencionista, que permite el cierre del ductus de tamaño pequeño, mediano y grande, así como de diversas mofologías

Nuevas técnicas en cirugía veterinaria: shunt portosistemico. Ductus arteriosus. Quilotorax = New techniques in veterinary surgery: postosystemic shunt. Ductus arteriosus. Chylothorax

83 p.En este artículo se describe el tratamiento de los shunt portosistémicos (CPSs) (intrahepáticos y extrahepáticos), mediante una técnica de radiología intervencionista de embolizacion percutánea usando coils para el cierre del vaso anómalo. Se introduce un catéter desde la vena cava caudal hasta la desviación portosistémica. Este catéter se utiliza para colocar el stent y los coils. El stent autoexpandible se colocó al lado de la desviación del shunt, para evitar migraciones de los coils. Esta técnica fué utilizada para el tratamiento del CPS en seis perros. Los resultados indican que el embolizacion percutánea de un CPS usando las coils es una técnica menos invasiva que la técnica quirúrgica tradicional, y que da lugar al cierre completo del shunt sin desarrollar hipertensión portal. RESUMEN El cierre del ductus arterioso conlleva una reducción de la carga y a variaciones agudas de la presión en el ventrículo derecho y estos acontecimientos puede producir un alteración en la tasa de la Troponina I cardiaca (cTnI), un proteína cuya determinación y valor se considera como el patrón mejor para valorar el daño del miocárdico. Se estudiaron las concentraciones de cTnI en dos grupos de 10 perros. Ocho perros con edad inferior a 13 meses no tenían sintomatología clínica, dos perros adultos presentaban sintomatología cardiopatía congestiva izquierda. Hemos encontrado que el aumento de los niveles del cTnI era concomitante a las variaciones agudas de la presión en aorta y del ventrículo izquierdo después de cerrar del ductus arteriovenoso. Los valores obtenidos de cTnI sugieren que el daño celular del miocardio se pueda considerar transitorio. RESUMEN Tratamiento convencional de quilotórax idiopático (IC) incluye la ligadura del conducto torácico (TD) (con/sin lymphagiography) combinado con pericardiectomía subfrénica. Se evaluaron en forma retrospectiva nueve perros y cuatro gatos con quilotórax idiopático, a los que se les opero con una técnica de omentalizacion intratorácica, ligadura del conducto torácico (no precedida de linfangiografia ) y pericardiectomia subfrénica Siete de los nueve perros y 3 de los cuatro gatos todavía estaban vivos y libres de enfermedad en el momento de la presentación de informes (rango 10-53 y 19 a 31 meses, respectivamente). Los signos clínicos del quilotórax idiopático no disminuyeron después de la primera cirugía en un gato y en un perro. En otro perro los signos clínicos reaparecieron después de 5 meses. La tasa de eficacia de esta combinación de técnicas quirúrgicas fué de 77% a los 6 meses, de 73%a los 12 meses), y el 57% a lo 24 meses Se presentó un caso de fracaso, y cuando se reoperó la tasa de éxito de los perros subió al 89% (a los 6 meses). En el tratamiento del quilotórax idiopático el realizar una omentalización intratoracica junto a la ligadura en bloque del conducto torácico y pericardiectomía subfrénica no parece mejorar los resultados en comparación con los datos publicados y en la actualidad no parece aconsejable como primera opción

Behaviour Management of the Contemporary Child in Paediatric Dentistry: An Overview of the Research

Objective: To provide an overview of the most relevant studies on non-pharmacological behaviour management techniques for contemporary children, the so-called alpha generation, who undergo dental treatment. Material and Methods: A systematic search was performed on the Medline/PubMed and Google Scholar (grey literature) databases. The articles were read and data collected by two reviewers on an independent basis. Two reviewers collected data from the studies selected in tables structured by using the Rayyan QCRI software. The following data were extracted: year of study, child’s age, child’s gender, technique used. Results: A total of 322 articles were found, remaining only 17 after duplicates were removed and inclusion and exclusion criteria applied. The studies were conducted between 2010 and 2019 in Saudi Arabia, Greece, India, Brazil, USA, Italy, and Switzerland. The samples ranged from 15 to 306 children aged between 3 and 10 years old. The children attended the dental office for different reasons, ranging from simple prevention to endodontic treatment under local anaesthesia. Several behaviour modification methods are known to be used before and during a dental consultation. Conclusion: After reading the articles, we concluded that alpha generation children are inserted in a daily environment of modernization and that conventional non-pharmacological techniques using technology, such as audio-visual glasses, are more interesting and make children distracted and relaxed during dental treatment, thus minimizing their stress, anxiety and fear

Prevalence of and risk factors for degenerative mitral valve disease in dogs attending primary-care veterinary practices in england

Background To date, epidemiological studies on degenerative mitral valve disease (DMVD) in dogs have largely reported referral caseloads or been limited to predisposed breeds. Analysis of primary‐care data to identify factors associated with DMVD would help clinicians identify high‐risk individuals and improve understanding. Objectives To estimate the prevalence of and identify risk factors for DMVD in dogs attending primary‐care veterinary practices in England. Animals Cases were identified within the electronic patient records of 111,967 dogs attending 93 practices. Four hundred and 5 dogs were diagnosed with DMVD (diagnosed cases) and a further 3,557 dogs had a heart murmur (HM) consistent with DMVD (possible cases). Methods Retrospective cross‐sectional study design. Prevalence was adjusted for the sampling approach. Mixed effects logistic regression models identified factors associated with DMVD. Results Prevalence estimates of diagnosed DMVD and HMs consistent with DMVD (both diagnosed and possible cases) were 0.36% (95% confidence interval [CI]: 0.29–0.45) and 3.54% (95% CI: 3.26–3.84) respectively. In the multivariable analysis, males had higher odds of diagnosed DMVD than did females (odds ratio [OR] 1.40, 95% CI: 1.12–1.74). Insured dogs had increased odds of DMVD compared with noninsured dogs (OR 3.56, 95% CI: 2.79–4.55) and dogs ≥20 kg had approximately half the odds of DMVD diagnosis compared with dogs(OR 0.51, 95% CI: 0.36–0.74). Strong associations between a DMVD diagnosis and individual breeds and age were identified. Conclusions and Clinical Importance Degenerative mitral valve disease was a common disorder in practice‐attending dogs. Knowledge of identified risk factors for DMVD could improve clinical diagnosis and direct future research

Collaterali aortico-polmonari associati a cardiopatie congenite

La presenza di comunicazioni anomale a carico della circolazione sistemica-polmonare \ue8 stata riportata nel cane come diagnosi differenziale del dotto arterioso pervio (PDA), in quanto il reperto caratteristico in letteratura \ue8 un soffio continuo ascellare sinistro. La diagnosi definitiva \ue8 stata effettuata in sede intraoperatoria (angiografia o visualizzazione diretta). I report pubblicati hanno sempre presentato questi difetti congeniti come singoli, a differenza della cardiologia pediatrica, dove sono segnalati in associazione a Tetralogia di Fallot (TdF) e atresia della polmonare

Association between halitosis and mouth breathing in children

OBJECTIVE: To determine whether there is a correlation between halitosis and mouth breathing in children. STUDY DESIGN: Fifty-five children between 3 and 14 years of age were divided into two groups (nasal and mouth breathing) for the assessment of halitosis. A descriptive analysis was conducted on the degree of halitosis in each group. The chi-square test was used for comparison between groups, with a 5% level of significance. RESULTS: There was a significantly greater number of boys with the mouth-breathing pattern than girls. A total of 23.6% of the participants had no mouth odor, 12.7% had mild odor, 12.7% had moderate odor and 50.9% had strong odor. There was a statistically significant association between halitosis and mouth breathing. CONCLUSIONS: The occurrence of halitosis was high among the children evaluated, and there was a statistically significant association between halitosis and mouth breathing