Kirschner-Ehmer Device Alone to Stabilize Caudal Lumbar Fractures in Small Dogs

SummaryA Kirschner-Ehmer device was used to stabilize caudal lumbar fractures/luxations in three dogs weighing 12 kg or less. A through and through Kirschner-Ehmer device maintained alignment during the healing process using the appropriate sized rods and clamps. Postoperative management included strict cage confinement and oral broad spectrum systemic antibiotics for up to two weeks after removal of the Kirschner-Ehmer device. In all three cases, the fractures/luxations were healed within six to eight weeks. The Kirschner-Ehmer device could then be removed with sedation or general anaesthesia.

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Effects of Ketamine Gargle for Post-operative Sore Throat, Hoarseness of Voice and Cough Under General Anaesthesia- A Randomised Control Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/49126.14956 ◽

2021 ◽

Author(s):

Dinesh Chauhan ◽

Ankit Mankad ◽

Jigisha Mehta ◽

Tejash H Sharma

Keyword(s):

General Anaesthesia ◽

Endotracheal Intubation ◽

Normal Saline ◽

Healing Process ◽

Voice Quality ◽

Controlled Study ◽

P Value ◽

Time Duration ◽

C 30 ◽

Randomised Controlled

Introduction: Majority of the patient undergo endotracheal intubation for various time duration, when given general anaesthesia. Injury in airway mucosa or vocal cords due to endotracheal intubation can be a contributing factor. Ketamine without affecting local healing process has an anti-proinflammatory effect as it limits exacerbation of systemic inflammation. Aim: To study the role of ketamine gargles as a pharmacological measure in order to attenuate POST, HOV and cough followed by endotracheal intubation during surgeries under general anaesthesia. Materials and Methods: A randomised controlled study was carried out for a duration of 22 months from the institutional ethical committee (Study Approval No. SVIEC/ON/MEDI/BNPG18/D19046), on 50 patients of American Society of Anaesthesiologists (ASA) grade I and II. They were allocated into two groups of 25 patients. Group (K): ketamine 50 mg in 29 mL 0.9% normal saline and Group (C): 30 mL 0.9% normal saline. Patients were advised to gargle for 30 seconds just 5 minutes prior to induction of anaesthesia. Patients were intubated with appropriate size of the endotracheal tube and were extubated when fully awake and conscious. Pateints were shifted to postoperative ward and were kept in propped up position with oxygen. Pateints were assessed at 1,2,4,24 hours for incidence of POST, HOV and cough. Assessment was made as per the 4 point scale grading system. The statistical analysis was performed using unpaired t-test, p<0.05 considered statistically significant. Results: In terms of POST grading in both K and C groups p-value was statistically significant (p<0.05) at 1 and at 2 hours postoperatively. In terms of HOV, in group K voice quality issues were reduced till 24 hours, (p<0.05). In terms of cough, in group K there was a significant reduction in complaints of cough till 4 hours postoperatively, (p<0.05). Conclusion: Ketamine gargles is effective in attenuating POST and cough till 2 hours and HOV till 4 hours postoperatively in patients following endotracheal intubation.

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Transoral Exposure of the Atlantoaxial Region

Neurosurgery ◽

10.1227/00006123-197809000-00012 ◽

1978 ◽

Vol 3 (2) ◽

pp. 201-207 ◽

Cited By ~ 85

Author(s):

Michael L. J. Apuzzo ◽

Martin H. Weiss ◽

James S. Heiden

Keyword(s):

Broad Spectrum ◽

Postoperative Management ◽

Transoral Approach ◽

Odontoid Fracture ◽

Preparation Technique ◽

Transoral Odontoidectomy ◽

Disease Entities

Abstract A broad spectrum of disease entities affects the atlantoaxial-clival region. This area is readily accessible through a transoral approach, which offers capabilities for canal decompression and fusion. A case is reported that required transoral odontoidectomy with concurrent excision of an osteophyte from the base of an ununited odontoid fracture. Operative preparation, technique, and postoperative management are described in detail. The advantage and applications of the procedure are discussed.

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Experimental usage of a multicomponent film in treatment of wounds

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2019-2-60-68 ◽

2019 ◽

Vol 18 (2) ◽

pp. 60-68

Author(s):

A. Yu. Grigoryan ◽

A. I. Bezhin ◽

T. A. Pankrusheva ◽

B. S. Sukovatykh ◽

M. S. Chekmareva ◽

...

Keyword(s):

Broad Spectrum ◽

Local Anesthetic ◽

Bacterial Contamination ◽

Statistical Significance ◽

Healing Process ◽

Visual Assessment ◽

Laboratory Animals ◽

Wound Area ◽

Experimental Group

Objectives. To optimize treatment of purulent wounds with the help of a wound coating with a multidirectional action that combines broad-spectrum antimicrobial effect, stimulation of regeneration, sorption activity and local anesthetic action. Materials and methods. The material for the study was a wound covering in the form of a film developed by the authors at Kursk State Medical University (Russian patent No. 2601897). Theexperiment was performed on laboratory animals (Wistar rats), which were divided into 2 groups (comparison and experimental), each group containing 36 animals. Purulent wound was modeled in the animals according to the method of P.I. Tolstykh. To evaluate the effectiveness of the treatment, the following methods were used: microbiological method (determination of areas of growth retardation and bacterial contamination in the wounds), Renier’s method (determination of local anesthetic activity), visual assessment of wounds, planimetric method (measurement of the wound area, percentage of area reduction and healing speed) and measurement of pH in the wounds. The statistical significance of the differences was determined with the nonparametric Mann–Whitney test. The differences were considered statistically significant at p ˂ 0.05. Results. Initially, high efficiency of the film was detected in vitro for the most common strains of test organisms, which werewound infection pathogens. The Renier index was 1.2 times higher in the film with chlorhexidine than in 2% lidocaine ointment, and the duration of general anesthesia was 25% longer. Following visual assessment of the wounds we revealed that purification and regeneration of the wounds first occurred in the animals in the experimental group; however, no statistical significance was detected. The maximal differences in the healing speed (1.6 times) were observed at 3–5 days, and the contamination of the wounds was 1.3 times lower in the experimental group than in the comparison group. According to the results of pH assessment, significant differences between the groups were noted only on day 15. Approximation of pH values to intact skin values also proved the effectiveness of treatment. Conclusion. The developed contact wound covering has high antimicrobial activity against a broad spectrum of wound infection pathogens, creates a fairly good local anesthetic effect, significantly speeds up the healing process and reduces bacterial contamination of the wound area. Thus, the developed wound covering can be recommended for further studies in the clinical setting for treatment of inflammatory processes in soft tissues.

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Prediction of stump healing in lower limb amputation: a narrative review

Journal of Wound Care ◽

10.12968/jowc.2019.28.sup12.s18 ◽

2019 ◽

Vol 28 (Sup12) ◽

pp. S18-S25

Author(s):

Suhel Ashraff ◽

Muhammad A Siddiqui ◽

Derek Santos ◽

Thomas Carline

Keyword(s):

Peripheral Neuropathy ◽

Lower Limb ◽

Healing Process ◽

Postoperative Management ◽

Lower Limb Amputation ◽

Sensory Loss ◽

Limb Amputation ◽

Standard Set ◽

Crucial Part ◽

Large Vessel Disease

Both types of diabetes, as well as different forms of acquired diabetes, are associated with diabetic peripheral neuropathy. Diabetic foot ulcers (DFU) is the condition most commonly related to somatic peripheral neuropathy, often leading to gangrene and limb amputation. Independent from large-vessel disease, sensory loss may result in DFU development and even amputation. The crucial part of any lower limb amputation is the stump healing process, which represents the central goal of postoperative management. Despite the importance attributed to this process, a standard set of guidelines regarding efficient healing methods is yet to be formulated. Health professionals are faced with the challenge of assessing the different risk factors and deciding which has a greater influence on the stump healing rate. There is currently an insufficient number of studies regarding factors effecting lower limb amputation. The main purpose of this review is to discuss the markers that can be helpful in the prediction of stump healing in patients who have undergone lower limb amputation.

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P81 Use of systemic antibiotics in Austrian children and adolescents: a survey

Archives of Disease in Childhood ◽

10.1136/archdischild-2019-esdppp.119 ◽

2019 ◽

Vol 104 (6) ◽

pp. e50.2-e50

Author(s):

E Rauch ◽

FB Lagler ◽

H Herkner ◽

V Strenger ◽

C Male

Keyword(s):

Primary Care ◽

Children And Adolescents ◽

Broad Spectrum ◽

Hospital Care ◽

Care Setting ◽

Prescription Data ◽

Representative Survey ◽

Prescription Patterns ◽

Broad Spectrum Antibiotics ◽

Systemic Antibiotics

BackgroundSeveral surveys that have assessed the use of antibiotic medicines for children and adolescents demonstrate significant heterogeneity in prescription patterns between different countries. The liberal use of antibacterial treatment, particularly unjustified use of broad spectrum antibiotics, is one of the main reasons for increasing rates of antibiotic resistance. We have studied antibiotics prescription frequencies in children and adolescents in Austria covering both primary and hospital care settings, in order to obtain a representative survey for our country.MethodsPrescription data for systemic antibiotics were assessed for the year 2014. For primary care, reimbursement data were obtained from Austrian health insurances. For hospital care, information on medicines dispensed to paediatric wards was obtained from hospital pharmacies. Frequencies of systemic antibiotic use were analyzed by Anatomical Therapeutic Chemical classification system, age groups, care setting, and in relation to all other medicines used. Systemic antibiotics were divided into subgroups, like broad and narrow spectrum penicillins, cephalosporins, tetracyclins, and others.ResultsSystemic antibiotics comprised 24% and 21% of all medicines prescribed to children and adolescents in primary care and hospital care, respectively. The most frequent were broad spectrum antibiotics (32% and 35% of systemic antibiotics prescribed) in both primary and hospital care settings. Macrolides and 2nd generation cephalosporins were more frequently prescribed in primary care setting, whereas ß-lactam antibiotics other than cephalosporins and antibiotics, such as fluorochinolones, aminoglycosides, or linezolid were more frequently used in hospital.ConclusionsThis is the first representative survey investigating the use of systemic antibiotics in children and adolescents in Austria. The study allows comparison of prescription patterns to other European countries: it reveals rather big differences to systemic antibiotics prescription in Italy, the Netherlands and Denmark, whereas prescription patterns are similar in Germany and Austria. Furthermore, this survey provides the basis to assess temporal trends in the future.Disclosure(s)Nothing to disclose

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Abstract 630: Broad-spectrum Inhibition of the CC-Chemokine Class Accelerates Wound Healing.

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.35.suppl_1.630 ◽

2015 ◽

Vol 35 (suppl_1) ◽

Author(s):

Anisyah Ridiandries ◽

Joanne T Tan ◽

Christina A Bursill

Keyword(s):

Wound Healing ◽

Blood Flow ◽

Inflammatory Response ◽

Broad Spectrum ◽

Wound Repair ◽

Healing Process ◽

Scar Formation ◽

Mrna Levels ◽

Wound Site ◽

Cc Chemokine

Introduction: Wound healing is a multistep process involving inflammation, proliferation and remodelling at the wound site. Macrophages are important in the inflammatory stage to remove debris, however excessive macrophage accumulation may prolong the inflammatory response leading to prolonged wound healing, excessive scar formation and loss of function at the injury site. In the wound healing process, the CC-chemokine class is involved in the recruitment of macrophages to the wound site. Inhibition of the CC-chemokine class to reduce macrophage infiltration may present as strategy to increase wound closure and reduce scar formation. Aim: To determine if broad spectrum CC-chemokine inhibitor, 35K, can improve wound healing by reducing the inflammatory response and preventing scar formation. Results: Two full-thickness wounds were created on the dorsum, one each side of the midline, of C57BL6 mice. Wounds were treated topically with PBS or 35K protein daily for 10 days. Wounds treated with 35K closed significantly faster than PBS treated wounds between days 4 - 6 (p<0.05) post-wounding. Laser Doppler measurements revealed 35K significantly increased blood flow at the early (day 3-4) and late stages (day 10) of wound repair. Ten days after wounding, collagen was significantly lower in the 35K treated wounds (25.3% p<0.05). There were also reductions in neovessels (CD31, 39%, p<0.001), arterioles (alpha actin, 48% p<0.01) and macrophages (CD68, 25%), as a percentage of wound area, in 35K treated wounds. In wound tissue collected on day 4 (early stage) post-wounding, 35K treatment had an inhibitory effect on CCL2 and CCL5 protein by 41% (p<0.05) and 36% (p<0.05) respectively, and were reduced by 22% and 66% (p<0.05) respectively at day 10 (late stage) wound healing. Consistent with this, mRNA levels of p65 also decreased in both day 4 (34%, p<0.05) and day 10 (62%, p<0.05) wounds treated with 35K. Conclusion: The CC-chemokine class appears to play a key role in wound repair as topical application of CC-chemokine inhibitor 35K promoted wound healing. This was likely to be via inhibition of inflammation and promotion of blood flow recovery in the early stages of wound repair, thereby resulting in less scar formation.

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A case of Churg–Strauss syndrome undergoing radical mastectomy under general anaesthesia and thoracic epidural analgesia

European Journal of Anaesthesiology ◽

10.1017/s0265021506001839 ◽

2005 ◽

pp. 1

Author(s):

M. Gurjar ◽

S. Bhatnagar ◽

S. Mishra ◽

V. Jain ◽

A. K. Singhal

Keyword(s):

Epidural Analgesia ◽

General Anaesthesia ◽

Radical Mastectomy ◽

Thoracic Epidural Analgesia ◽

Churg Strauss Syndrome ◽

Thoracic Epidural ◽

Strauss Syndrome ◽

Churg Strauss

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A Strengths-Based Approach to Autism: Neurodiversity and Partnering With the Autism Community

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp2.sig1.56 ◽

2017 ◽

Vol 2 (1) ◽

pp. 56-68 ◽

Cited By ~ 8

Author(s):

Amy L. Donaldson ◽

Karen Krejcha ◽

Andy McMillin

Keyword(s):

Broad Spectrum ◽

First Language ◽

Family Members ◽

Community Identity ◽

Speech Language Pathologists

The autism community represents a broad spectrum of individuals, including those experiencing autism, their parents and/or caregivers, friends and family members, professionals serving these individuals, and other allies and advocates. Beliefs, experiences, and values across the community can be quite varied. As such, it is important for the professionals serving the autism community to be well-informed about current discussions occurring within the community related to neurodiversity, a strengths-based approach to partnering with autism community, identity-first language, and concepts such as presumed competence. Given the frequency with which speech-language pathologists (SLPs) serve the autism community, the aim of this article is to introduce and briefly discuss these topics.

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