506 research outputs found
Complications of percutaneous endoscopic gastrostomy in dogs and cats receiving corticosteroid treatment
BACKGROUND: Corticosteroid treatment is commonly required in veterinary patients for treatment of inflammatory, immuneâmediated, neurologic, and neoplastic diseases, which also may require assisted enteral nutrition via percutaneous endoscopic gastrostomy (PEG). OBJECTIVE: To evaluate complications associated with PEG use in dogs and cats receiving corticosteroid treatment. ANIMALS: Fortyâtwo animals were included in the study: 12 dogs and 2 cats in the steroid group and 26 dogs and 2 cats in the control group. METHODS: Medical records, between January 2006 and March 2015, were reviewed. Patients were included if the PEG tube was in use for at least 24 hours and if complete medical records were available. Patients were assigned to the control group if they were not treated with corticosteroids during PEG use or to the steroid group if they had received corticosteroids during PEG tube use. Complications were classified as minor, moderate, and major in severity. Maximum severity complication rate was compared between groups. RESULTS: The general prevalence of complications was found to be similar between groups (P = .306), but in the steroid group, 43% of the cases developed a major severity complication compared with 18% of the control group (P = .054). CONCLUSION AND CLINICAL IMPORTANCE: Owners of dogs and cats receiving corticosteroids, in which PEG is planned, should be counseled about possible complications beyond those associated with PEG tube usage alone
Liver and Pancreatic Resection in the Elderly
Background: Liver resection, or pancreaticoduodenectomy, has traditionally been thought to have a high morbidity and. mortality rate among the elderly. Recent improvements in surgical and anesthetic techniques, an increasing number of elderly patients, and an increasing need to justify use of limited health care resources prompted an assessment of recent surgical outcomes
Diagnosis of anaplastic large-cell lymphoma in a dog using CD30 immunohistochemistry
Anaplastic large-cell lymphoma or null-cell lymphoma is a clinical entity reported in people, classified according to the unique appearance of large pleomorphic cells that express CD30. Null-cell lymphoma has also been described in dogs when neither CD3 nor CD79α is expressed by the tumor. We describe a case of lymphoma in the dog in which neoplastic cells did not express routine B- or T-lymphocyte markers on flow cytometry or immunohistochemistry; however, cells immunohistochemically labeled for CD30. The dog in our case died 5 mo after initial presentation, confirming a poor prognosis. Identification of further similar cases in dogs would provide additional prognostic information for this subset of lymphomas. CD30 may also serve as a potential therapeutic target in anaplastic large-cell lymphomas
Cholecystobronchocolic Fistula: A Late Complication of Biliary Sepsis
A case of a 48 year old woman presenting with bilioptysis due to a cholecystobronchocolic fistula is
reported. Bilioptysis is a rare complication of biliary fistulae, with a high mortality due to chemical
pneumonitis. Bronchospasm and rapid respiratory failure may ensue if aggressive management is not
adopted. The site of fistulation is established by cholangiography, preferably by the percutaneous
transhepatic route. Continued biliary drainage can lead to closure of these fistulae, or allow sufficient
improvement in clinical condition to allow definitive surgery to be performed electively
Cholangitis and Budd Chiari Syndrome as Complications of Simple Cystic Liver Disease
We report the case of a 63 year old woman who developed the complications of cholangitis and Budd
Chiari syndrome secondary to polycystic disease of the liver. The two complications were not present
simultaneously, and both resolved after decompression of the liver cysts
Serum anti-MĂŒllerian hormone concentrations before and after treatment of an ovarian granulosa cell tumour in a cat
Case summary A 15-year-old female cat was presented for investigation of progressive behavioural changes, polyuria, polydipsia and periuria. An ovarian granulosa cell tumour was identified and the cat underwent therapeutic ovariohysterectomy (OHE). The catâs clinical signs resolved, but 6 months later it was diagnosed as having an anaplastic astrocytoma and was euthanased. Serum anti-MĂŒllerian hormone (AMH) concentration prior to OHE was increased vs a control group of entire and neutered female cats. Following OHE, serum AMH concentration decreased to <1% of the original value. Relevance and novel information Serum AMH measurement may represent a novel diagnostic and monitoring tool for functional ovarian neoplasms in cats
Factors in perioperative care that determine blood loss in liver surgery
AbstractObjectivesExcessive blood loss during liver surgery contributes to postoperative morbidity and mortality and the minimizing of blood loss improves outcomes. This study examines pre- and intraoperative factors contributing to blood loss and identifies areas for improvement.MethodsAll patients who underwent elective hepatic resection between June 2007 and June 2009 were identified. Detailed information on the pre- and perioperative clinical course was analysed. Univariate and multivariate analyses were used to identify factors associated with intraoperative blood loss.ResultsA total of 175 patients were studied, of whom 95 (54%) underwent resection of three or more segments. Median blood loss was 782ml. Greater blood loss occurred during major resections and prolonged surgery and was associated with an increase in postoperative complications (P= 0.026). Peak central venous pressure (CVP) of >10cm H2O was associated with increased blood loss (P= 0.01). Although no differences in case mix were identified, blood loss varied significantly among anaesthetists, as did intraoperative volumes of i.v. fluids and transfusion practices.ConclusionsThis study confirms a relationship between CVP and blood loss in hepatic resection. Intraoperative CVP values were higher than those described in other studies. There was variation in the intraoperative management of patients. Collaboration between surgical and anaesthesia teams is required to minimize blood loss and the standardization of intraoperative anaesthesia practice may improve outcomes following liver surgery
Fibronectin as a Prognostic Indicator in Portal Hypertension
Plasma fibronectin levels were measured in 33 patients with portal hypertension and c6mpared with
modified Childâs grading and a previously described prognostic index. Outcome at one year from blood
sampling was recorded.
Mean plasma fibronectin level was 304.1 mg/ml (sem 24.3) and significantly lower levels were found in
patients who had had a variceal bleed within the previous seven days. Plasma fibronectin levels tended
to be lower in patients with poor liver function as assessed by modified Childâs grading but this did not
achieve statistical significance.
Plasma fibronectin alone was not an accurate predictor of one year survival in these patients but only
one of seven patients who had a plasma fibronectin level below 300mg/l in association with a poor
prognostic index survived for one year
Conformity and controversies in the diagnosis, staging and follow-up evaluation of canine nodal lymphoma: a systematic review of the last 15 years of published literature
Diagnostic methods used in the initial and post-treatment evaluation of canine lymphoma are heterogeneous and can vary within countries and institutions. Accurate reporting of clinical stage and response assessment is crucial in determining the treatment efficacy and predicting prognosis. This study comprises a systematic review of all available canine multicentric lymphoma studies published over 15 years. Data concerning diagnosis, clinical stage evaluation and response assessment procedures were extracted and compared. Sixty-three studies met the eligibility criteria. Fifty-five (87.3%) studies were non-randomized prospective or retrospective studies. The survey results also expose variations in diagnostic criteria and treatment response assessment in canine multicentric lymphoma. Variations in staging procedures performed and recorded led to an unquantifiable heterogeneity among patients in and between studies, making it difficult to compare treatment efficacies. Awareness of this inconsistency of procedure and reporting may help in the design of future clinical trials
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