Successful bilateral phacoemulsification and vitrectomy in a Bennett’s wallaby (Macropus rufogriseus)

2021 ◽  
pp. 1-5
Author(s):  
Anaïs Sailler ◽  
Morgane Prieto ◽  
Frédéric Goulle
Keyword(s):  
Physical Examination ◽  
Serum Biochemistry ◽  
Vitreous Humor ◽  
Clinical Findings ◽  
Case Description ◽  
Detailed Report ◽  
Intraoperative Complication ◽  
Ketamine Hydrochloride ◽  
One Year ◽  
Topical Antimicrobial

Abstract CASE DESCRIPTION A 7-month-old hand-reared female Bennett’s wallaby (Macropus rufogriseus) was evaluated for bilateral ocular opacity of 3 months’ duration. CLINICAL FINDINGS On physical examination, the wallaby was in good overall condition. An ophthalmic examination revealed mature cataracts in both eyes (OU). The cataracts were suspected to have a nutritional origin as it has been described in hand-reared macropods. Results of tonometry were normal OU. Results of CBC and serum biochemistry were unremarkable. The wallaby was premedicated with medetomidine and ketamine hydrochloride. Ocular ultrasonography performed while the wallaby was anesthetized revealed a thickened and opaque lens, mildly heterogeneous vitreous humor, and no sign of retinal detachment OU. An electroretinogram confirmed functional retinae OU. TREATMENT AND OUTCOME Surgery was considered necessary for welfare reasons. Phacoemulsification and vitrectomy were performed without intraoperative complication. The wallaby recovered uneventfully, and systemic NSAID, topical corticosteroid, and systemic and topical antimicrobial therapy were prescribed. One year later, the animal had vision OU. Physical examination did not show any vision-threatening postoperative complications. CLINICAL RELEVANCE The etiology of nutritional cataracts is not fully understood in macropods, but this condition is rather common in these species. To our knowledge, this is the first detailed report of a successful bilateral phacoemulsification and vitrectomy in a Bennett’s wallaby.

scholarly journals Clavicle Pseudarthrosis: A Rare Cause of Thoracic Outlet Syndrome

2010 ◽  
Vol 37 (6) ◽  
pp. 863-865 ◽  
Author(s):  
Kathleen Joy Khu ◽  
Rajiv Midha
Keyword(s):  
Physical Examination ◽  
Shoulder Pain ◽  
Thoracic Outlet Syndrome ◽  
Clinical Findings ◽  
Radial Pulse ◽  
History Of ◽  
Arm Elevation ◽  
One Year ◽  
The Right ◽  
Intrinsic Muscles

A 22-year-old man presented with a one year history of rightsided shoulder pain, hand weakness and tingling, and purplish discoloration of the upper extremity upon abduction. He had congenital pseudarthrosis of the right clavicle since childhood. Aside from an obvious deformity characterized by asymmetry of the shoulders and a palpable bony depression over the right clavicle, the patient had been previously asymptomatic. Physical examination revealed the musculoskeletal deformities as described, as well as prominent veins over his right shoulder, arm, and chest. With arm elevation, his right arm became dusky and his radial pulse diminished. Neurologically, the patient had no deficits except for mild weakness (Grade 4+/5) of the ulnarinnervated intrinsic muscles of the right hand. The clinical findings were consistent with a combined neurogenic and vascular form of thoracic outlet syndrome.

scholarly journals Inter-examinerreliability study of physical examination procedures to assess the cervical spine

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Karthik V. Hariharan ◽  
Michael G. Timko ◽  
Christopher G. Bise ◽  
Meenakshi Sundaram ◽  
Michael J. Schneider
Keyword(s):  
Cervical Spine ◽  
Physical Examination ◽  
Facet Joint ◽  
Physical Therapists ◽  
Clinical Status ◽  
Clinical Findings ◽  
Qualitative Assessment ◽  
Segmental Mobility ◽  
Convenience Sample ◽  
Pain Provocation

Abstract Objective The objective of this study was to establish the level of inter-examiner reliability for six common cervical manual and physical examination procedures used to assess the cervical spine. Materials: Reliability study that used a convenience sample of 51 patients between the ages of 16–70 years presenting with a chief complaint of neck pain. Two physical therapists independently performed the same series of cervical physical examination procedures on each of the participant. The clinicians were blinded to each other’s findings and the clinical status of the patient. Kappa coefficients (κ) were calculated for levels of agreement between the clinicians for each procedure. Results When assessing for asymmetrical motion, excellent levels of reliability (κ range: 0.88–0.96) were observed for the Bilateral Modified Lateral Shear (asymmetry criterion), Bilateral C2 Spinous Kick (asymmetry criterion) and Flexion-Rotation Tests. When pain provocation was used as the indicator of a positive test during palpation of the cervical facet joints, moderate to substantial levels of reliability (κ range: 0.53–0.76) were observed. When patients were instructed not to provide feedback to the clinicians about pain provocation during facet joint palpation and clinicians relied solely on their qualitative assessment of segmental mobility, the level of reliability was lower (κ range: 0.45–0.53). Due to 100 % prevalence of negative findings, Kappa values could not be calculated for the Sharp-Purser test or the Unilateral C2 Spinous Kick Test. Conclusions Most physical examination procedures examined in this study demonstrated moderate to excellent levels of inter-examiner reliability. Palpation for segmental mobility without pain provocation demonstrated a lower level of reliability compared to palpation for pain provocation. Correlation with clinical findings is necessary to establish validity and the applicability of these procedures in clinical practice.

Corneal cross-linking for treatment of progressive keratoconus in a patient with Alport syndrome: A case report

2021 ◽  
pp. 112067212199767
Author(s):  
Iva Krolo ◽  
Aida Kasumović ◽  
Ivana Radman ◽  
Pavao Pavić
Keyword(s):  
Case Report ◽  
Alport Syndrome ◽  
Contact Lenses ◽  
Corneal Dystrophy ◽  
Clinical Findings ◽  
Cross Linking ◽  
Posterior Polymorphous Corneal Dystrophy ◽  
One Year ◽  
Corneal Tomography

Purpose: Ocular features of Alport syndrome include anterior lenticonus, posterior polymorphous corneal dystrophy, and fleck-and-dot retinopathy in most cases. Keratoconus in such patients has been rarely mentioned in previous studies. To our knowledge, this is the first report of corneal cross-linking for halting the progression of keratoconus in a patient with Alport syndrome. Case report: A 22-year-old male was referred for his initial corneal topography, after he was already prescribed with rigid gas-permeable contact lenses. Alport syndrome was diagnosed in his infancy and gene COL4A5 mutation was confirmed. Ophthalmological evaluation confirmed keratoconus. One-year follow-up showed a progression on his right eye and standard corneal cross-linking was performed. Stabilization of the disease marked by normalization in visual function and corneal tomography values was noticed 1 year after the procedure. Conclusions: When diagnosing ocular clinical findings of Alport syndrome, keratoconus should be considered. Standard corneal cross-linking protocol can halt its progression.

Symmetrical brachydactyly in a dog

2017 ◽  
Vol 30 (04) ◽  
pp. 306-309
Author(s):  
Ursula Krotscheck ◽  
Anthony Fischetti ◽  
Kim Tong ◽  
Megan Cray
Keyword(s):  
Case Report ◽  
Physical Examination ◽  
Congenital Malformations ◽  
General Term ◽  
Abnormal Development ◽  
Unaffected Sibling ◽  
Radiographic Imaging ◽  
One Year

SummaryCongenital malformations of the canine manus and pes are infrequently reported in the veterinary literature. This includes brachydactyly which is a general term used to indicate the shortening of digits due to abnormal development of the phalanges, metacarpals, or metatarsals. This case report describes isolated brachydactyly in a one-year-old male Maremma Sheepdog affecting all of the phalanges, metacarpals, and metatarsals of digits two through five. This condition was confirmed by determining the length of each phalanx, metacarpal, and metatarsal of the affected dog as well as an unaffected littermate. The affected dog’s metacarpal, metatarsal, and phalanx lengths ranged from 50% to 77% of that of the unaffected sibling. Other abnormalities found on physical examination as well as on radiographic imaging are discussed.

Arthroscopic shoulder assessment in Turkish amateur boxers

Open Medicine ◽  
2009 ◽  
Vol 4 (3) ◽  
pp. 358-362
Author(s):  
Hüseyin Özkan ◽  
İbrahim Yanmış ◽  
Mustafa Kürklü ◽  
Ali Şehirlioğlu ◽  
Servet Tunay ◽  
...  
Keyword(s):  
Physical Examination ◽  
Clinical Findings ◽  
Subacromial Impingement ◽  
Shoulder Injuries ◽  
Pathological Findings ◽  
Glenoid Labrum ◽  
Arthroscopic Findings ◽  
Shoulder Region ◽  
Grade 3 ◽  
The Brain

AbstractThe most common injuries reported in the literature regarding the sport of boxing are to the brain, eyes, kidneys and hands. Shoulder injuries have not been fully reported in the literature until recently, as a result we aimed to present our arthroscopic findings in amateur boxers. Ten amateur boxers with complaints of pain in the shoulder region and decreased performance during sportsplay were enrolled. They were evaluated by physical examination, radiology and arthroscopy. There were no clinical findings of instability. One patient was found to have subacromial impingement; six had crepitation at various degrees during shoulder movements. At arthroscopy, all patients had a variety of pathological findings. Five patients had Grade 1, three had Grade 2, and two had Grade 3 chondropathy. Various degrees of fraying of the anterosuperior and posterosuperior regions of the glenoid labrum were noted in all cases. Three patients had superior labrum anterior and posterior lesions, one patient had a posterior labroligamentous lesion, and one had chondral erosion in the anterosuperior portion of the humeral head. In conclusions, although the injury mechanism of the shoulder during boxing is unknown, this study shows that shoulder complaints in boxers should be considered as possible indicators of serious intra-articular lesions.

scholarly journals Silk flow-diverter stent for the treatment of complex intracranial aneurysms: A one-year follow-up multicenter study

2018 ◽  
Vol 24 (4) ◽  
pp. 357-362 ◽  
Author(s):  
G Foa Torres ◽  
F Roca ◽  
A Noguera ◽  
J Godes ◽  
S Petrocelli ◽  
...  
Keyword(s):  
Mortality Rates ◽  
Flow Diverter ◽  
Clinical Findings ◽  
Safe Alternative ◽  
Complex Aneurysms ◽  
Flow Diverter Stent ◽  
Class 1 ◽  
One Year ◽  
Therapeutic Alternatives

Background Flow-diverter stents have been successfully used in the treatment of complex aneurysms with limited therapeutic alternatives. We report our experience using the Silk flow diverter (SFD; Balt Extrusion, Montmorency, France) for the treatment of complex aneurysms in four Argentine centers. Methods We conducted a retrospective review of 246 consecutive patients who were treated with the SFD at four Argentine centers between January 2009 and January 2017. The patient and aneurysm characteristics, as well as the details of the procedure, were analyzed. The angiographic and clinical findings were recorded during and immediately after the procedure and at 12-month follow-up. Results Angiography follow-up at 12 months was possible in 235 patients (95.5%) with 282 aneurysms. A total of 265 aneurysms (93.9%) presented with complete occlusion of the aneurysmal sac (class 1) and 17 aneurysms (6.1%) presented with partial occlusion (class 2). The 12-month clinical follow-up showed 11 patients with major events (seven, scale 2; five, scale 3; and two, scale 4). The morbidity and mortality rates were 4.2% (11/289) and 2.1% (5/289), respectively. Conclusions The treatment of aneurysms with the SFD was associated with a low rate of complications and a high percentage of aneurysmal occlusion. These findings suggest that SFD is an effective and safe alternative in the endovascular treatment of complex aneurysms.

Extremity Injuries in Children: Predictive Value of Clinical Findings

PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 803-807
Author(s):  
Frederick P. Rivara ◽  
Ruth Ann Parish ◽  
Beth A. Mueller
Keyword(s):  
Lower Extremity ◽  
Physical Examination ◽  
Clinical Findings ◽  
Clinical Predictors ◽  
Lower Extremity Fracture ◽  
Extremity Fracture ◽  
Extremity Injuries ◽  
Physical Findings ◽  
Upper Extremity Fracture ◽  
Point Tenderness

This study sought to identify clinical predictors of extremity fracture in children with trauma. There were 189 children 1 to 15 years of age with 209 extremity injuries seen during a 9-month period. Gross deformity and point tenderness were the best predictors of upper extremity fracture; these two findings correctly identified 81% of children with fractures and 82% of these without fractures. Gross deformity and pain on motion best predicted lower extremity fracture, with 97% of children with fractures correctly identified. The study showed that physical examination is predictive of fractures in extremity injuries of children, regardless of age. In the absence of the specific physical findings identified by the study, the probability of diagnosing a fracture by roentgenographic findings is low.

scholarly journals Pain drawings, interpreter support and clinical findings among immigrant patients on sick leave in Swedish primary health care

2019 ◽  
Vol 20 ◽  
Author(s):  
Monica Löfvander
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Sick Leave ◽  
Formal Education ◽  
Clinical Findings ◽  
Psychosocial Stressors ◽  
Foreign Born ◽  
Pain Drawing ◽  
Primary Health ◽  
One Year

Abstract Aim: To evaluate the spread of pain and its correlates among immigrant patients on sick leave. Background: Backache, outspread pain and sick-leave questions are problematic to handle primary health care, especially in multicultural settings. Methods: Two hundred and thirty-five patients 20–45 years on paid sick leave (59% women, 93% foreign-born, mostly non-Europeans). Many had little formal education. One-third had professional interpreter support. The patients pointed out on their bodies where they felt pain. This information was transferred on a pain drawing [pain drawing fields (PDFs) 0–18] by a doctor. Major depression and psychosocial stressors were assessed using Diagnostic and Statistical Manual of Mental Disorders. Nociceptive locations for pain were established (pain-sites 0–18). Dependent variable was the number of PDFs. Independent variables were social data, sick leave, interpreter, depression, stress levels and number of pain sites. Calculations were done using descriptive methods and multi-variable linear regression in full models, by gender. Findings: Many patients had depression (51% women versus 32% men). A majority were exposed to psychosocial stressors. Women had more PDFs, in median 5 [inter-quartile ranges (IQR) 4–8] versus men 3 (IQR 2–5), and also more pain sites, in median 3 (IQR 2–5) versus men in median 2 (IQR 1–3). For men, the regression calculations revealed that numbers of PDFs associated only with increasing numbers of pain sites (B 0.871 P < 0.001). For women, this association was weaker (B 0.364, P < 0.001), with significant values also for age (B 0.103) and sick leave > one year (B 0.767, P = 0.010), and a negative predicting value for interpreter support (B −1.198, P < 0.043). To conclude, PDFs associated often with somatic findings but varied much among the women. This implies potential problems regarding cause, function and sick leave questions. However, support by professional interpreters may facilitate a shared understanding with immigrant women having long-standing pain.

Clinical variables related to the diagnostic stability of demential syndromes

2017 ◽  
Vol 29 (10) ◽  
pp. 1735-1741 ◽  
Author(s):  
Fabiano Moulin de Moraes ◽  
Paulo Henrique Ferreira Bertolucci
Keyword(s):  
Physical Examination ◽  
Neuropsychological Tests ◽  
Clinical Information ◽  
Initial Diagnosis ◽  
Long Term Memory ◽  
Neuropsychological Battery ◽  
Clinical Dementia Rating ◽  
Diagnostic Stability ◽  
University Center ◽  
One Year

ABSTRACTBackground:Assigning a diagnosis to a patient with dementia is important for the present treatment of the patient and caregivers, and scientific research. Nowadays, the dementia diagnostic criteria are based on clinical information regarding medical, history, physical examination, neuropsychological tests, and supplementary exams and, therefore, subject to variability through time.Methods:A retrospective observational study to evaluate variables related to clinical diagnostic stability in dementia syndromes in at least one year follow up. From a sample of 432 patients, from a single university center, data were collected regarding sociodemographic aspects, Clinical Dementia Rating, physical examination, neuropsychological tests, and supplementary exams including a depression triage scale.Results:From this sample, 113 (26.6%) patients have their diagnosis changed, most of them adding a vascular component to initial diagnosis or depression as comorbidity or main disease. Our findings show that many factors influence the diagnostic stability including the presence of symmetric Parkinsonism, initial diagnosis of vascular dementia, presence of diabetes and hypertension, the presence of long term memory deficit in the neuropsychological evaluation, and normal neuroimaging. We discuss our findings with previous findings in the literature.Conclusion:Every step of the clinical diagnosis including history, vascular comorbidities and depression, physical examination, neuropsychological battery, and neuroimaging were relevant to diagnosis accuracy.

Hyperaldosteronism and Hyperprogesteronism in a Cat

2009 ◽  
Vol 11 (9) ◽  
pp. 758-762 ◽  
Author(s):  
Katherine Briscoe ◽  
Vanessa R Barrs ◽  
Darren F Foster ◽  
Julia A Beatty
Keyword(s):  
Muscle Wasting ◽  
Clinical Signs ◽  
Plasma Renin ◽  
Abdominal Ultrasound ◽  
Serum Biochemistry ◽  
Zona Glomerulosa ◽  
Clinical Findings ◽  
Neoplastic Cells ◽  
Limb Weakness ◽  
Plasma Aldosterone Concentration

Clinical findings and investigations A 14-year-old female neutered domestic shorthair cat was referred for investigation of progressive hair loss, muscle wasting and hind limb weakness. Diabetes mellitus had been diagnosed 8 months earlier and was well controlled. Abnormalities on serum biochemistry included persistent mild azotaemia, hypochloridaemia, hypokalaemia, metabolic alkalosis and elevated creatine kinase. Physical examination revealed a pot-bellied appearance, with muscle wasting, marked thinning and fragility of the skin, bilaterally symmetrical alopecia, a gallop rhythm and systolic hypertension (173 mmHg). A large, lobulated left adrenal mass was identified using abdominal ultrasound. Confirmation of diagnosis Primary hyperaldosteronism was diagnosed based on an elevated plasma aldosterone concentration and normal plasma renin activity. Hyperprogesteronism was confirmed by adrenocorticotrophic hormone stimulation test. Practical relevance This is only the second reported case of hyperaldosteronism and hyperprogesteronism in the cat. Clinicians should be alert to the possibility of concurrent hyperaldosteronism and hyperprogesteronism in cats with adrenal tumours showing clinical signs referable to both conditions. The putative mechanism is either increased secretion of aldosterone and progesterone from neoplastic cells of the zona glomerulosa and fasciculata/reticularis, respectively, or increased production of progesterone, as an intermediate in the synthesis of aldosterone, from neoplastic cells of the zona glomerulosa alone.

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