A challenging hernia: primary venous aneurysm of the proximal saphenous vein

Introduction: Primary venous aneurysm is a rare, but essential consideration in the differential diagnosis of an inguinal and femoral hernia. Methods: We report a case of a 43-year-old man who was referred for evaluation and treatment of a femoral hernia. Results: The patient presented with a 3-month history of an asymptomatic tumor on his right upper inner thigh. Physical examination noted a non-tender, non-indurated tumor. Conclusion: Surgical exploration demonstrated a primary venous aneurysm of the proximal saphenous vei

Ultraschallbefunde und Therapie bei einer Kuh mit einem Hämangiosarkom in der Harnblase

A 4.5-year-old Swiss Braunvieh cow was presented to the Department of Farm Animals, University of Zurich, because of severe haematuria. All other clinical findings were within normal ranges. Transrectal ultrasonography revealed a 1 cm × 1 cm echogenic, irregularly-shaped, raised mass in the wall of the urinary bladder. Endoscopy identified the mass as a proliferation, approximately 0.5 cm in diameter, which was bleeding continuously. Thermocautery of the bleeding site was carried out twice five days apart via endoscopy. Clinical signs resolved for the remainder of the cow’s life; she was slaughtered 15 months later because of infertility. Histological examination of the mass revealed a haemangiosarcoma

Perineal stapled prolapse resection for external rectal prolapse: is it worthwhile in the long-term?

Background: Perineal stapled prolapse (PSP) resection is a novel operation for treating external rectal prolapse. However, no long-term results have been reported in the literature. This study analyses the long-term recurrence rate, functional outcome, and morbidity associated with PSP resection. Methods: Nine consecutive patients undergoing PSP resection between 2007 and 2011 were prospectively followed. Surgery was performed by the same surgeons in a standardised technique. Recurrence rate, functional outcome, and complication grade were prospectively assessed. Results: All 9 patients undergoing PSP resection were investigated. The median age was 72years (range 25-88years). No intraoperative complications occurred. Faecal incontinence, preoperatively present in 2 patients, worsened postoperatively in one patient (Vaizey 18-22). One patient developed new-onset faecal incontinence (Vaizey 18). The median obstructive defecation syndrome score decreased postoperatively significantly from 11 (median; range 8-13) to 5 (median; range 4-8) (p<0.005). At a median follow-up of 40months (range 14-58months), the prolapse recurrence rate was 44% (4/9 patients). Conclusions: The PSP resection is a fast and safe procedure associated with low morbidity. However, the poor long-term functional outcome and the recurrence rate of 44% warrant a cautious patient selectio

Comparison of a continuous glucose monitoring system with a portable blood glucose meter to determine insulin dose in cats with diabetes mellitus.

Background:The continuous glucose monitoring system (CGMS) Guardian REAL‐Time® allows the generation of very detailed glucose profiles in cats. The performance of CGMS to generate short‐term glucose profiles to evaluate treatment response has not been yet evaluated in diabetic cats.Hypothesis:Analysis of glucose profiles generated using the CGMS produces insulin dose recommendations that differ from those of profiles generated using the portable blood glucose meter (PBGM) in diabetic cats.Animals:Thirteen client‐owned diabetic cats.Methods:Prospective, observational study. Simultaneous glucose profiles were generated over an 8‐10 hour period using the CGMS, blood glucose concentration was measured every 2 hours with the PBGM. Profiles were submitted to three internal medicine specialists who used them to determine the insulin dose. Differences between insulin doses deduced from paired profiles were compared. Percentages of nadirs recorded with the CGMS that were lower, higher, or equal to those derived with the PBGM were calculated.Results:Twenty‐one paired glucose profiles were obtained. There was no difference of insulin doses based on CGMS and PBGM profiles (median 0 U; range: −1 to +0.5). Treatment decisions did not differ among investigators. Compared with the observed PBGM nadir, the CGMS nadir was lower, higher, or equal in 17, 2, and 2 of 21 cases, respectively.Conclusions and Clinical Importance:Adjustments in insulin dose based on glucose profiles generated with the CGMS are similar to those based on the PBGM. The common occurrence of lower nadirs recorded with the CGMS suggests that this device detects hypoglycemic periods that are not identified with the PBGM

A challenging hernia: primary venous aneurysm of the proximal saphenous vein

Introduction: Primary venous aneurysm is a rare, but essential consideration in the diVerential diagnosis of an inguinal and femoral hernia. Methods: We report a case of a 43-year-old man who was referred for evaluation and treatment of a femoral hernia. Results: The patient presented with a 3-month history of an asymptomatic tumor on his right upper inner thigh. Physical examination noted a non-tender, non-indurated tumor. Conclusion: Surgical exploration demonstrated a primary venous aneurysm of the proximal saphenous vein

Exercise Improves Outcomes of Surgery on Fatty Liver in Mice: A Novel Effect Mediated by the AMPK Pathway.

OBJECTIVE To investigate whether exercise improves outcomes of surgery on fatty liver, and whether pharmacological approaches can substitute exercising programs. SUMMARY OF BACKGROUND DATA Steatosis is the hepatic manifestation of the metabolic syndrome, and decreases the liver's ability to handle inflammatory stress or to regenerate after tissue loss. Exercise activates adenosine monophosphate-activated kinase (AMPK) and mitigates steatosis; however, its impact on ischemia-reperfusion injury and regeneration is unknown. METHODS We used a mouse model of simple, diet-induced steatosis and assessed the impact of exercise on metabolic parameters, ischemia-reperfusion injury and regeneration after hepatectomy. The same parameters were evaluated after treatment of mice with the AMPK activator 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR). Mice on a control diet served as age-matched controls. RESULTS A 4-week-exercising program reversed steatosis, lowered insulin levels, and improved glucose tolerance. Exercise markedly enhanced the ischemic tolerance and the regenerative capacity of fatty liver. Replacing exercise with AICAR was sufficient to replicate the above benefits. Both exercise and AICAR improved survival after extended hepatectomy in mice challenged with a Western diet, indicating protection from resection-induced liver failure. CONCLUSIONS Exercise efficiently counteracts the metabolic, ischemic, and regenerative deficits of fatty liver. AICAR acts as an exercise mimetic in settings of fatty liver disease, an important finding given the compliance issues associated with exercise. Exercising, or its substitution through AICAR, may provide a feasible strategy to negate the hepatic consequences of energy-rich diet, and has the potential to extend the application of liver surgery if confirmed in humans

Nachhandparese infolge eines malignen Lymphoms bei einer Ziege

Zusammenfassung:In der vorliegenden Arbeit wird ein Fall von Nachhandparese bei einer 4 Jahre alten Ziege durch ein malignes Lymphom beschrieben. Die Ziege wurde wegen einer progredienten Ataxie der Nachhand, welche schliesslich zur Nachhandparese und zum Festliegen geführt hatte, in die Klinik überwiesen. Die Ziege lag in Brustlage fest und konnte sich selbständig in den Hundshock erheben. Bei der neurologischen Untersuchung fielen als wichtigste Befunde eine verminderte Sensibilität der Hintergliedmassen auf Nadelstiche und ein beidseits verminderter Pannikulusreflex auf. Die Liquoruntersuchung ergab einen erhöhten Proteingehalt und einen erhöhten Leukozytengehalt. In der Differenzierung wurden 98 % Lymphozyten, 1 % Monozyten und 1 % neutrophile Granulozyten sowie 3 Mitosen gesehen. Aufgrund der klinischen Befunde wurde die Diagnose zentralnervöse Erkrankung mit Sitz im thorakolumbalen Bereich des Rückenmarks gestellt. Die Ziege wurde euthanasiert und pathologisch-anatomisch untersucht. Die Lymphknoten im Ileosakralbereich waren zu einer knotigen Masse von ca. 15 cm × 12 cm × 5 cm konfluiert, die auch die ventrale Wirbelsäule umschloss und in den Wirbelkanal eingedrungen war. Die histologische Untersuchung ergab ein kleinzelliges malignes Lymphom. Abstract: This report describes a 4-year-old goat with posterior paresis and subsequent paralysis caused by malignant lymphoma. The goat was referred to our clinic because of progressive posterior ataxia, which developed into posterior paresis and paralysis. The goat was presented in sternal recumbency but was able to assume a dog-sitting position. A neurological examination revealed reduced sensitivity to pricking of the skin with a needle, and a bilateral reduced panniculus reflex. The cerebrospinal fluid was slightly cloudy with increases in the protein concentration and leukocyte count, which consisted of 98 % lymphocytes, 1 % monocytes and 1 % neutrophils; three cells had mitotic figures. Based on the clinical findings, a tentative diagnosis of central nervous system disease of the thoracolumbar spinal cord was made, and euthanasia and postmortem examination were carried out. The lymph nodes in the ileosacral region appeared as a 15 × 12 × 5 cm confluent mass, which involved the ventral vertebral column and infiltrated the spinal canal. Histological examination of the tumour yielded a diagnosis of microcytic malignant lymphoma

Hämatologische und klinisch-chemische Referenzwerte für adulte Ziegen und Schafe

Sheep and goat husbandry has always played an important role in swiss agriculture, but in recent years these animals are increasingly appreciated as hobby pets. This opens new diagnostic and therapeutic perspectives for veterinary surgeons, notably in the determination of hematological and clinical biochemical parameters. For the current methods used there are no reference range values available for adult sheep and goats kept under swiss conditions. Therefore, the present study was designed to determine haematological and clinical biochemical parameters in 102 goats and 102 sheep from swiss flocks. Significant differences were found between the two species, especially regarding erythrocyte count, mean erythrocyte volume, hemoglobin content as well as leukocyte count. It is therefore of utmost importance to discriminate between sheep and goats when interpreting laboratory tween findings

The dipeptidyl peptidase IV inhibitor NVP-DPP728 reduces plasma glucagon concentration in cats

Glucagon-like peptide-1 (GLP-1) analogues and inhibitors of its degrading enzyme, dipeptidyl peptidase IV (DPPIV), are interesting therapy options in human diabetics because they increase insulin secretion and reduce postprandial glucagon secretion. Given the similar pathophysiology of human type 2 and feline diabetes mellitus, this study investigated whether the DPPIV inhibitor NVP-DPP728 reduces plasma glucagon levels in cats. Intravenous glucose tolerance tests (ivGTT; 0.5g/kg glucose after 12h fasting) and a meal response test (test meal of 50% of average daily food intake, offered after 24h fasting) were performed in healthy experimental cats. NVP-DPP728 (0.5-2.5mg/kg IV or SC) significantly reduced glucagon output in all tests and increased insulin output in the ivGTT. Follow-up studies will investigate the potential usefulness as therapy in diabetic cats