Novedades en el tratamiento del conducto arterioso persistente

El conducto arterioso persistente (CAP)es una patología cardíaca congénita frecuentemente, cuyo tratamiento requiere el cierre, bien de forma quirúrgica o de forma percutánea. En este artículo se describe una novedosa técnica de cierre, mediante cardiología intervencionista, que permite el cierre del ductus de tamaño pequeño, mediano y grande, así como de diversas mofologías

Collaterali aortico-polmonari associati a cardiopatie congenite

La presenza di comunicazioni anomale a carico della circolazione sistemica-polmonare \ue8 stata riportata nel cane come diagnosi differenziale del dotto arterioso pervio (PDA), in quanto il reperto caratteristico in letteratura \ue8 un soffio continuo ascellare sinistro. La diagnosi definitiva \ue8 stata effettuata in sede intraoperatoria (angiografia o visualizzazione diretta). I report pubblicati hanno sempre presentato questi difetti congeniti come singoli, a differenza della cardiologia pediatrica, dove sono segnalati in associazione a Tetralogia di Fallot (TdF) e atresia della polmonare

Sexual Life And Dysfunction After Maternal Morbidity: A Systematic Review.

Because there is a lack of knowledge on the long-term consequences of maternal morbidity/near miss episodes on women´s sexual life and function we conducted a systematic review with the purpose of identifying the available evidence on any sexual impairment associated with complications from pregnancy and childbirth. Systematic review on aspects of women sexual life after any maternal morbidity and/or maternal near miss, during different time periods after delivery. The search was carried out until May 22(nd), 2015 including studies published from 1995 to 2015. No language or study design restrictions were applied. Maternal morbidity as exposure was split into general or severe/near miss. Female sexual outcomes evaluated were dyspareunia, Female Sexual Function Index (FSFI) scores and time to resume sexual activity after childbirth. Qualitative syntheses for outcomes were provided whenever possible. A total of 2,573 studies were initially identified, and 14 were included for analysis after standard selection procedures for systematic review. General morbidity was mainly related to major perineal injury (3(rd) or 4(th) degree laceration, 12 studies). A clear pattern for severity evaluation of maternal morbidity could not be distinguished, unless when a maternal near miss concept was used. Women experiencing maternal morbidity had more frequently dyspareunia and resumed sexual activity later, when compared to women without morbidity. There were no differences in FSFI scores between groups. Meta-analysis could not be performed, since included studies were too heterogeneous regarding study design, evaluation of exposure and/or outcome and time span. Investigation of long-term repercussions on women's sexual life aspects after maternal morbidity has been scarcely performed, however indicating worse outcomes for those experiencing morbidity. Further standardized evaluation of these conditions among maternal morbidity survivors may provide relevant information for clinical follow-up and reproductive planning for women.1530

Speckle tracking echocardiography in dogs with patent ductus arteriosus : effect of percutaneous closure on cardiac mechanics

Background : patent ductus arteriosus (PDA) is one of the most common congenital heart defects in the dog and percutaneous closure is effective in achieving ductal closure.PDA closure is associated with abrupt hemodynamic changes. Hypothesis: A marked reduction in standard parameters of systolic function as assessed by M/B mode after PDA closure was identified in previous studies. Speckle-tracking echocardiography(STE) can provide further insight into the effect of PDA closure on cardiac mechanics in dogs affected by PDA. Animals: 25 client owned dogs affected by PDA Methods: Prospective study. Complete echocardiographic evaluation was performed before and 24 hours after PDA closure, including standard (EDVIB/M, ESVIB/M, AlloD/S, Qp/Qs, SI, EF and FS) and STE (global longitudinal, radial, transversal and circumferential strain and strain rate). Results: PDA closure was associated with a statistically significant decrease in conventional echocardiographic parameters and a derease in the absolute values of radial, transversal and circumferential S and SR, while longitudinal S and SR did not change significantly. Conclusion and clinical importance: PDA closure by percutaneous approach is associated with a marked decrease of conventional echocardiographic parameters due to the changes in loading conditions, but no evidence of systolic dysfunction was identified by means of STE, as none of the S and SR values were below normal ranges. In the short term, contractility is enhanced in the long axis (as Long S/SR values were not statistically different before and after closure) and normalizes in the short axis (circumferential, radial and transversal S/SR decreased to normal reference range)

A study on the risk of subaortic and pulmonic stenosis and on genetic aspects of echocardiography measurements in the Italian Boxer dog

Subaortic and pulmonic stenosis are congenital cardiac defects affecting several dog breeds (Jacobs, 1990; Buchanan, 1992; Tidholm, 1997). Subaortic stenosis (SAS) is characterized by a fibrous ring of tissue placed immediately below the aortic valve

Cardiovascular-renal axis disorders in the domestic dog and cat: a veterinary consensus statement

OBJECTIVES There is a growing understanding of the complexity of interplay between renal and cardiovascular systems in both health and disease. The medical profession has adopted the term "cardiorenal syndrome" (CRS) to describe the pathophysiological relationship between the kidney and heart in disease. CRS has yet to be formally defined and described by the veterinary profession and its existence and importance in dogs and cats warrant investigation. The CRS Consensus Group, comprising nine veterinary cardiologists and seven nephrologists from Europe and North America, sought to achieve consensus around the definition, pathophysiology, diagnosis and management of dogs and cats with "cardiovascular-renal disorders" (CvRD). To this end, the Delphi formal methodology for defining/building consensus and defining guidelines was utilised. METHODS Following a literature review, 13 candidate statements regarding CvRD in dogs and cats were tested for consensus, using a modified Delphi method. As a new area of interest, well-designed studies, specific to CRS/CvRD, are lacking, particularly in dogs and cats. Hence, while scientific justification of all the recommendations was sought and used when available, recommendations were largely reliant on theory, expert opinion, small clinical studies and extrapolation from data derived from other species. RESULTS Of the 13 statements, 11 achieved consensus and 2 did not. The modified Delphi approach worked well to achieve consensus in an objective manner and to develop initial guidelines for CvRD. DISCUSSION The resultant manuscript describes consensus statements for the definition, classification, diagnosis and management strategies for veterinary patients with CvRD, with an emphasis on the pathological interplay between the two organ systems. By formulating consensus statements regarding CvRD in veterinary medicine, the authors hope to stimulate interest in and advancement of the understanding and management of CvRD in dogs and cats. The use of a formalised method for consensus and guideline development should be considered for other topics in veterinary medicine

Sexual life and dysfunction after maternal morbidity: a systematic review.

BACKGROUND: Because there is a lack of knowledge on the long-term consequences of maternal morbidity/near miss episodes on women's sexual life and function we conducted a systematic review with the purpose of identifying the available evidence on any sexual impairment associated with complications from pregnancy and childbirth. METHODS: Systematic review on aspects of women sexual life after any maternal morbidity and/or maternal near miss, during different time periods after delivery. The search was carried out until May 22(nd), 2015 including studies published from 1995 to 2015. No language or study design restrictions were applied. Maternal morbidity as exposure was split into general or severe/near miss. Female sexual outcomes evaluated were dyspareunia, Female Sexual Function Index (FSFI) scores and time to resume sexual activity after childbirth. Qualitative syntheses for outcomes were provided whenever possible. RESULTS: A total of 2,573 studies were initially identified, and 14 were included for analysis after standard selection procedures for systematic review. General morbidity was mainly related to major perineal injury (3(rd) or 4(th) degree laceration, 12 studies). A clear pattern for severity evaluation of maternal morbidity could not be distinguished, unless when a maternal near miss concept was used. Women experiencing maternal morbidity had more frequently dyspareunia and resumed sexual activity later, when compared to women without morbidity. There were no differences in FSFI scores between groups. Meta-analysis could not be performed, since included studies were too heterogeneous regarding study design, evaluation of exposure and/or outcome and time span. CONCLUSION: Investigation of long-term repercussions on women's sexual life aspects after maternal morbidity has been scarcely performed, however indicating worse outcomes for those experiencing morbidity. Further standardized evaluation of these conditions among maternal morbidity survivors may provide relevant information for clinical follow-up and reproductive planning for women