Factors influencing contrast enhancement in abdominal CT angiography in dogs: a systematic review

Lo scopo dell’AngioTC è quello di ottenere un’opacizzazione adeguata del comparto vascolare esaminato, sincronizzata all’acquisizione della scansione TC. La distribuzione del mezzo di contrasto (mdc) e l’opacizzazione dei distretti corporei, definita enhancement, è influenzata da diversi fattori: relativi al paziente, al mdc o allo scanner TC. In Medicina Veterinaria sono presenti pochi studi indirizzati a valutare l’influenza di diversi fattori sull’enhancement. La ricerca è stata condotta seguendo le linee guida PRISMA (Preferred Reporting Items for Systematic Reviews, 2020). Il database online di diversi motori di ricerca scientifici (Web of Science, PubMed, Scopus e CABAbstract) è stato esaminato mediante combinazione di diverse parole chiave. Sono stati individuati 20 studi che rispettavano i criteri di inclusione, inseriti nel corpo finale della revisione sistematica e raggruppati sulla base della categoria di appartenenza. Si è visto come la quantità di tessuto adiposo addominale sull’enhancement rappresenti un fattore che permette di ridurre la dose di mezzo di contrasto utilizzato, riducendo effetti avversi o tossicità sull’animale. Per quanto riguarda l’iniezione del mdc, un fattore in grado di influenzare maggiormente l’enhancement sembra essere la velocità di trasporto dello Iodio, piuttosto che la durata di iniezione, soprattutto a livello arterioso ed epatico. Con uno scanner lento o una durata di scansione lunga, è consigliato utilizzare una durata fissa di iniezione del mdc per l’acquisizione delle diverse fasi vascolari. Al contrario, con scanner più performanti la tecnica di bolus tracking garantisce una maggior qualità tra le varie fasi vascolari. È indicato, infine, eseguire un flush con soluzione fisiologica al termine della somministrazione di mdc per incrementare l’enhancement arterioso e ridurre la dose di mdc somministrata. Questa revisione sistematica mette in evidenza alcuni fattori e può fare da base per l’ulteriore approfondimento di alcuni di questi fattori o per la valutazione altri non ancora esaminati in Medicina Veterinaria.The main objective of AngioCT is to obtain adequate opacification of the vascular compartment of interest, synchronized with the CT acquisition. Contrast medium (CM) distribution and opacification of the vascular territory of interest are influenced by different factors: patient-related factors, CM-related factors and MDCT scanner-related factors. In Veterinary Medicine, many aspects regarding the influence of different factors on contrast enhancement remain underdeveloped. Therefore, the aim of our systematic review is to evaluate these factors and their influence on contrast enhancement. The systematic literature review followed the PRISMA (Preferred Reporting Items for Systematic Reviews, 2020) flowchart. Research was conducted on bibliographic online databases (WebofScience, PubMed, Scopus, CABAbstract) using different key words. After screening of the identified studies, 20 studies were included in final corpus of the systematic review. The amount of abdominal adipose tissue on enhancement represents a very interesting and little-considered factor in daily clinical practice, which makes it possible to reduce the dose of CM to the patient and the related adverse effects or toxicity. Regarding CM injection, the speed of transport of iodine seem to be a more influencing factor, rather than the duration of injection, especially at the arterial and hepatic level, with possible clinical implications of great relevance. When a slow scanner or a long scan duration is available, it may be advisable to use a fixed CM injection duration for the acquisition of the different vascular phases. On the contrary, with faster scanners, the bolus tracking technique guarantees a higher quality between the vascular phases. Finally, a saline flush at the end of the administration of CM permits to increase arterial enhancement and reduce the dose of CM to the patient. This systematic review highlights some factors and can form the basis for further study regarding factors influencing enhancement on angioCT in small animals

A Rare Case of Salmonella Spp. Osteomyelitis in a Dog

Osteomyelitis is an inflammatory condition of bone usually caused by infectious agents such as bacteria, fungi or viruses. The disease is characterized by systemic illness, pain and soft tissue swelling with visible radiographic alterations in bone. The most common bacteria isolated in cases of osteomyelitis in dogs and cats are Staphylococcus spp. (60% of cases), followed by Escherichia coli and Streptococcus spp. [1,2]. To our knowledge, this is the first canine case of Salmonella spp. osteomyelitis

A Retrospective Clinico-Pathologic Study of 35 Dogs with Urethral Transitional Cell Carcinoma Undergoing Treatment

: Chemotherapy and cyclooxygenase inhibitors (COXi) are primary treatments for canine urethral transitional cell carcinoma (uTCC), a tumor known for its aggressiveness and poor prognosis. This retrospective study aimed to evaluate the clinico-pathological characteristics, treatment modalities, and prognostic factors of 35 dogs with confirmed uTCC that received chemotherapy and COXi. Upon admission, urethral obstruction (UO) and urinary tract infection (UTI) were observed in seven (20%) dogs each. Gemcitabine (n = 20; 57.1%) and vinblastine (n = 10; 28.6%) were commonly used as first-line therapies, with four dogs also receiving radiation therapy. Based on RECIST, one (2.9%) dog achieved complete remission, nine (25.7%) partial remission, 20 (57.14%) showed stable disease, and five (14.3%) progressed. Among dogs with UO, six (85.7%) showed resolution or improvement after the first chemotherapy dose. The median time to local progression was 171 days (range: 107-235), and the median survival time was 333 days (range: 158-508). Dogs with UO upon admission had a higher risk of local progression, while both UO and UTI were associated with an increased risk of overall disease progression and tumor-related death. Additionally, gemcitabine significantly improved metastatic control. This study identified UO and UTI as negative prognostic factors, highlighting the importance of a multimodal approach in managing uTCC

Spotlight on capecitabine for the treatment of unresectable or metastatic carcinoma of various origin: A retrospective study of 25 dogs

Capecitabine, the oral prodrug of 5-fluorouracil, is indicated in people to treat various malignant epithelial cancers. In dogs, capecitabine has not been extensively evaluated. The aim of this retrospective study was to investigate toxicity and preliminary efficacy of single agent capecitabine in dogs with advanced malignant epithelial cancers of any site, for which no effective therapy existed, conventional treatment failed or was declined. Capecitabine was administered orally at 750 mg/m2 from day 1 to 14, followed by 1-week rest period, given as 3-week cycles. Safety evaluation was performed after 2 cycles, and every 2-3 cycles thereafter. Tumour response was determined every 2-3 cycles. Twenty-five dogs with hepatocellular carcinoma (n = 6), lung papillary carcinoma (n = 4), anal sac adenocarcinoma (n = 3), colic adenocarcinoma (n = 2), and other individually represented epithelial cancers (n = 10) were included. Dogs received a median of 4 cycles (range, 2-43) for a median of 84 days (range, 42-913). Toxicity occurred in 17 (68.0%) dogs; the most frequent adverse events were gastrointestinal, with the majority being self-resolving and of mild grade. Of the 22 dogs with macroscopic disease, 3 (13.6%) achieved partial remission, 16 (72.7%) were stable and 3 (13.6%) progressed; overall clinical benefit rate was 86.4%. Median progression-free interval was 93 days (95% CI 42-154; range, 1-521) and median tumour-specific survival was 273 days (95% CI 116-482; range 45-913). These findings suggest that capecitabine is an attractive option for the treatment of several types of carcinomas in dogs. Prospective studies are warranted to optimize the scheduling of capecitabine and confirm its efficacy

The incidence of different pellet size on growth, gut evacuation, feed digestibility and feed waste in gilthead sea bream (Sparus aurata)

The feeding behaviour of gilthead sea bream (Sparus aurata) consists in cracking and chewing feed. In farming condition, this results in crushing feed pellets with an occasional loss of some fragments which can vary in response to pellet dimension, thus affecting feed waste at the on-growing stage. However, few studies have addressed this issue and even less information on the further effect of different pellet size on growth, gut evacuation and feed efficiency are available on this species. Thus, a 122-day study was undertaken to assess the effects of three pellet size (2 mm, S; 4 mm, M and 6 mm, L) on growth, gut evacuation, feed waste and feed digestibility during the on-growing of gilthead sea bream (initial weight: 215.9 +/- 1.8 g). No significant effects of pellet size on growth (final body weight and SGR) were observed. Pellets diameters had no effects on feed digestibility (protein and dry matter) and feed efficiency parameters (FCR, PER, GPE, GLE) even if differences in the gastric evacuation rate were detected at different pellet size. At this regard, the shape-rate model developed to estimate the gastrointestinal evacuation pattern, evidenced a slower gastric evacuation rate in the 6 mm diet, while no differences in foregut evacuation rate were observed. Data on feed waste, highlighted how feed losses by chewing was practically absent in the S (2 mm) diet while in the M (4 mm) and L (6 mm) diets 24.3 and 17.3% of the entire meal was losses by chewing activity, respectively. The study reinforces previous observation that feeding pellets size of 4 and 6 mm in gilthead sea bream within 200-450 g could induced an excess of feed waste by chewing activity with economic and environmental implication. Despite the reduced feed intake observed, pellets size of 2 mm did not lead to any feed losses by chewing and was able to guarantee similar growth compared to the other diets. Further studies considering intermediate pellets size (3 mm) may be useful in order to further optimize the pellet size choice during the on-growing phase of this species

from a traditional to a digital site 2008 2019 the history of milan cathedral surveys

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Ultrasonographic assessment of early leakage in intestinal sutures in dogs

Intestinal suture dehiscence is one of the most feared complications following gastrointestinal surgery in both human and veterinary medicine, increasing the morbidity and mortality of these patients. Clinical and laboratory early signs of septic peritonitis are not always easily identifiable while prompt treatment should help decrease postoperative morbidity and mortality. The aim of this study is to describe the ultrasonographic (US) features of confirmed leakage of intestinal sutures (LIS) and to evaluate if this imaging technique can be useful as noninvasive tool for the early diagnosis of LIS. Seven dogs developed LIS in a range of three-four days after gastrointestinal surgery and four of these developed a second dehiscence. On B-mode ultrasonography, all intestinal surgical sites were identified and characterized by a bowel focal thickening with reduced or absent wall layering and the presence of hyperechoic, double-walled foci at regular intervals (suture material). Furthermore, hyperechoic linear interfaces associated with dirty acoustic shadowing and comet-tail artifacts crossing the intestinal wall to free-float in peritoneal cavity or in a saccate collection have been documented. On the basis of these preliminary results, canine abdominal ultrasound seems to be a useful diagnostic technique for post-operative monitoring of patients undergoing intestinal surgery, allowing early detection of signs of a LIS, before the patient develops clinical signs of septic peritonitis

Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines

Duodeno-pancreatic and extrahepatic biliary tree injuries are rare in both adult and pediatric trauma patients, and due to their anatomical location, associated injuries are very common. Mortality is primarily related to associated injuries, but morbidity remains high even in isolated injuries. Optimal management of duodeno-bilio-pancreatic injuries is dictated primarily by hemodynamic stability, clinical presentation, and grade of injury. Endoscopic and percutaneous interventions have increased the ability to non-operatively manage these injuries. Late diagnosis and treatment are both associated to increased morbidity and mortality. Sequelae of late presentations of pancreatic injury and complications of severe pancreatic trauma are also increasingly addressed endoscopically and with interventional radiology procedures. However, for moderate and severe extrahepatic biliary and severe duodeno-pancreatic injuries, immediate operative intervention is preferred as associated injuries are frequent and commonly present with hemodynamic instability or peritonitis. The aim of this paper is to present the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) duodenal, pancreatic, and extrahepatic biliary tree trauma management guidelines

Conceptual Design of a Soft X‐ray SASE‐FEL Source

FELs based on SASE are believed to be powerful tools to explore the frontiers of basic sciences, from physics to chemistry to biology. Intense R&D programs have started in the USA and Europe in order to understand the SASE physics and to prove the feasibility of these sources. The allocation of considerable resources in the Italian National Research Plan (PNR) brought about the formation of a CNR‐ENEA‐INFN‐University of Roma "Tor Vergata" study group. A conceptual design study has been developed and possible schemes for linac sources have been investigated, bringing to the SPARX proposal. We report in this paper the results of a preliminary start to end simulation concerning one option we are considering based on an S‐band normal conducting linac with high brightness photoinjector integrated in a RF compressor