Branham sign in dogs undergoing interventional patent ductus arteriosus occlusion or surgical ligation: a retrospective study

Background: The Branham sign is a baroreceptor response that follows patent ductus arteriosus (PDA) closure. Although described in dogs following both interventional and surgical ductal closure, a direct comparison of the Branham sign elicited by these two techniques has not been made. Aim: Since closure with an Amplatz canine ductal occluder (ACDO) occurs over 10 minutes and surgical ligation (SL) is more rapid, we hypothesised that the Branham sign following occlusion of a PDA with an ACDO would be less severe than following SL. Methods: Clinical records of dogs diagnosed with left-to-right shunting PDA between 2008 and 2018 were retrospectively reviewed. Of 139 dogs undergoing PDA occlusion, only 41 dogs (ACDO n = 32, SL n = 9) were included after applying exclusion criteria. Heart rate and BP from occlusion time (T0) until thirty minutes post occlusion (T30) were recorded. Signalment and anaesthetic protocol were also recorded. The influence of age and weight on the haemodynamic variations was assessed. Haemodynamic variables and calculations were compared between and within groups using a repeated measures general linear model, and post hoc tests were applied if significance was identified. Results: A mild Branham sign was present in both groups, and haemodynamic changes were not significantly different between groups. In both groups, there was a significant decrease in HR (11 bpm, 5.3 – 16.3; p < 0.001) (10.4 %, 5.4 – 15.5; p < 0.001) and increase in diastolic BP (9.5 mmHg, 3 – 16; p = 0.002) (23.5 %, 7.1 – 39.9; p = 0.002), but systolic BP did not change significantly (p = 0.824). Age and weight did not influence Branham sign. Conclusion: The Branham sign in dogs is mild in both groups, lasts for at least 30 minutes, and is independent of the method of PDA closure

Degree of patient dependency in relation to nursing staff: analysis of clinical records

Pretendemos, com este estudo, identificar, na evolução de enfermagem, o grau de dependência do paciente anotado pelo enfermeiro e confrontar com um instrumento de classificação. Fizeram parte do estudo 74 pacientes, 15 enfermeiros e 04 docentes, no período de 22 de setembro a 27 de outubro de 2000. Observamos nos resultados que houve discretas alterações do grau de dependência do paciente, da admissão até a alta, e que os pacientes intermediários apareceram com maior incidência (41,9%). Porém, para a nossa realidade, ainda devemos treinar os enfermeiros e formular um instrumento próprio de acordo com a característica das unidades de internação.Pretendimos con este estudio identificar en la evolución de enfermería el grado de dependencia del paciente anotado por el enfermero y confrontar con un instrumento de clasificación. Hicieron parte del estudio 74 pacientes, 15 enfermeros y 4 docentes durante el periodo de 22 de septiembre a 27 de octubre de 2000. Verificamos que hubo alteraciones discretas del grado de dependencia del paciente desde la admisión hasta el alta médica y que hubo una incidencia más alta de los pacientes intermedios (41.9%). Sin embargo para nuestra realidad todavía es necesario adiestrar los enfermeros y formular un instrumento propio de acuerdo con la característica de las unidades de hospitalización.In this study, we intend to identify in the evolution of nursing the intensity of patient dependency as it is written down by the nurse and confront it with a ranking instrument. 74 patients, 11 nurses and 04 lecturers were part of the study held from September 22 until October 27, 2000. We noticed slight modifications in the degree of patient dependency from hospital admission to discharge. Furthermore, the majority of the patients that needed help were the intermediate ones (41.9%). However, our reality still requires nursing training and the creation of an appropriate classification instrument, in accordance with the features of our internment units

Classification system of patients: application of a validated tool

Las autoras aplicaron un instrumento de clasificación en pacientes del Ala B2 del Hospital de Clínicas de Marília, en dosperiodos distintos durante 1999, con el objetivo de conocer el grado de dependencia de dichos pacientes con relación a los enfermeros. La muestra estuvo constituída de 31 pacientes en el primer periodo y de 35 pacientes en el segundo periodo. Los resultados mostraron que la mayoría de los pacientes fue clasificada como de cuidados mínimos o intermedios, siendopreocupante el número de pacientes clasificados como de cuidados semi-intensivos e intensivos en las unidades de internación. Se sugieren algunas modificaciones en el instrumento utilizado.The authors applied an instrument of patient classification to the patients of Hall B2 of the Hospital das Clínicas deMarilia, intwo distinct periods of 1999, seeking to discover the degree of dependency of the patients in relation tonursing staff. The sample consisted of 31 patients in the first period and 35 in the second. The results showed that mostof the patients had been classified as needing minimum or intermediary care in their units of admission. Some modifications of the procedures were suggested.As autoras aplicaram um instrumento de classificação de pacientes na Ala B2 do Hospital de Clínicas de Marília, em doisperíodos distintos, no ano de 1999, com o intuito de conhecer o grau de dependência dos pacientes em relaçãoàequipe de enfermagem. A amostra foi constituída de 31 pacientes no primeiro período e 35 pacientes no segundo período. Osresultados mostraram que a maioria dos pacientes foi classificada como cuidados mínimos ou intermediários, sendopreocupante o número de pacientes classificados como cuidados semi-intensivos e intensivos nas unidades de internação.São sugeridas algumas modificações no instrumento utilizado

Grado de dependencia del paciente con relación a las(os) enfermeras(os): análisis de historias clínicas

Pretendemos, com este estudo, identificar, na evolução de enfermagem, o grau de dependência do paciente anotado pelo enfermeiro e confrontar com um instrumento de classificação. Fizeram parte do estudo 74 pacientes, 15 enfermeiros e 04 docentes, no período de 22 de setembro a 27 de outubro de 2000. Observamos nos resultados que houve discretas alterações do grau de dependência do paciente, da admissão até a alta, e que os pacientes intermediários apareceram com maior incidência (41,9%). Porém, para a nossa realidade, ainda devemos treinar os enfermeiros e formular um instrumento próprio de acordo com a característica das unidades de internação.In this study, we intend to identify in the evolution of nursing the intensity of patient dependency as it is written down by the nurse and confront it with a ranking instrument. 74 patients, 11 nurses and 04 lecturers were part of the study held from September 22 until October 27, 2000. We noticed slight modifications in the degree of patient dependency from hospital admission to discharge. Furthermore, the majority of the patients that needed help were the intermediate ones (41.9%). However, our reality still requires nursing training and the creation of an appropriate classification instrument, in accordance with the features of our internment units.Pretendimos con este estudio identificar en la evolución de enfermería el grado de dependencia del paciente anotado por el enfermero y confrontar con un instrumento de clasificación. Hicieron parte del estudio 74 pacientes, 15 enfermeros y 4 docentes durante el periodo de 22 de septiembre a 27 de octubre de 2000. Verificamos que hubo alteraciones discretas del grado de dependencia del paciente desde la admisión hasta el alta médica y que hubo una incidencia más alta de los pacientes intermedios (41.9%). Sin embargo para nuestra realidad todavía es necesario adiestrar los enfermeros y formular un instrumento propio de acuerdo con la característica de las unidades de hospitalización

Outcomes of conservatively managed coracoid fractures in wild birds in the United Kingdom

Coracoid fractures are a frequent presentation in wild birds, commonly due to collisions with motor vehicles, windows, or other obstacles such as pylons. Despite this, there are few literature reports of outcomes, and those published consist of small numbers of animals, with conflicting results when comparing conservative management with surgical intervention. Outcomes of 232 adult wild birds in the United Kingdom (UK), surviving more than 48 hours after admission, with only closed unilateral coracoid fractures confirmed on radiography were retrospectively analysed. There was a high success rate for conservative management, with 75% (95% confidence interval of 69-80%, n=174/232) of all birds successfully released back to the wild. The proportion of raptors successfully returned to the wild was even higher at 97% (95% CI 85-99%, n=34/35). A statistically significant difference of 26% (95% CI of 18-34%, Fishers exact test p<0.001, Z=6.08) was demonstrated, when comparing the raptor outcomes (97% success, n=34/35) to the non-raptor outcomes (71%, n=140/198). The median time in captive care until released back to the wild was 30 days (95% CI 27-33 days). Conservative management of coracoid fractures in wild birds in the UK, and in particular in raptors, appears to result in good outcomes. The approach is low cost and non-invasive, in contrast to surgery, and is recommended as the first line approach of choice in these cases