Lethal cysticercosis in a pet rabbit

A one-year-old neutered female crossbreed rabbit died unexpectedly after initially responding to symptomatic treatment over a three-month period for recurrent gut stasis, inappetence and lethargy. Postmortem examination revealed numerous fibrous tracks within the liver from which flattish ovoid parasites could be extruded. Parasites were also found in large numbers throughout the peritoneal cavity. Histopathology confirmed verminous hepatitis with numerous parasitic granulomas within the parenchyma of the liver containing intact and degenerate parasites. The severity of the parasitic burden and associated liver damage was the presumed cause of death. Intact parasites showed morphological features consistent with Taenia pisiformis at 6–15 days postinfection. Species identification was confirmed by PCR sequence analysis. The rabbit was fed on hay sourced from a local farm, commercially available nuggets and washed vegetables. It did not graze outside. Hay contaminated with dog or fox faeces was the presumed source of infection.</jats:p

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients