Massive osteolysis in a dog resembling Gorham’s disease in humans

2011 ◽  
Vol 24 (05) ◽  
pp. 389-397 ◽  
Author(s):  
S. Lindsay ◽  
V. Johnson ◽  
G. Child ◽  
M. Farrell
Keyword(s):  
Sudden Onset ◽  
Human Condition ◽  
Computed Tomographic ◽  
Vitamin D Levels ◽  
Mixed Breed ◽  
25 Hydroxy Vitamin D ◽  
History Of ◽  
Pelvic Limb ◽  
Gorham’S Disease ◽  
Work Up

SummaryAn eight-month-old mixed-breed dog was presented with a history of sudden onset pelvic limb lameness. Radiographic and computed tomographic examinations demonstrated an osteolytic process involving the lumbar spine and pelvis. A comprehensive work-up including serial radiographic skeletal survey, biopsy, routine laboratory investigation and evaluation of parathyroid hormone (PTH) and 25-hydroxy-vitamin D levels failed to reveal any underlying cause for the osteolysis. Conservative treatment using the bisphosphonate drug alendronate and oral analgesic medications resulted in a return to nearly normal long-term function, despite massive lumbar and pelvic osteolysis. The clinical, radiological and histopathological features in this dog are reported, and similarities with the human condition known as Gorham’s disease are discussed.

USING SILDENAFIL TO TREAT A DOG WITH IDIOPATHIC MEGAESOPHAGUS

2020 ◽  
Vol 46 (01) ◽  
pp. 1-6
Author(s):  
Yi-Ju Tu ◽  
Cheng-Shu Chung ◽  
Lee-Shuan Lin
Keyword(s):  
Symptomatic Treatment ◽  
Inhibitory Effect ◽  
Sudden Onset ◽  
Thoracic Radiography ◽  
Computed Tomographic ◽  
Endoscopic Gastrostomy ◽  
Mixed Breed ◽  
Half Dose ◽  
Gastric Emptying Time ◽  
Peg Tube

A 4-month old, male intact, mixed-breed dog was referred for sudden onset of regurgitation for two weeks. Thoracic radiographs revealed severe dilatation of esophagus with barium aspiration pneumonia. Idiopathic megaesophagus (IME) was diagnosed after serial laboratory, endoscopic and computed tomographic examinations. Symptomatic treatment including medication for pneumonia, feeding through percutaneous endoscopic gastrostomy (PEG) tube with upright feeding position was performed at first, but regurgitation persisted. Sildenafil (1[Formula: see text]mg/kg, PO, BID) was then administrated for two weeks and regurgitation remitted one day after. Sildenafil was then tapered to half dose (0.5[Formula: see text]mg/kg, PO, BID) for another two weeks. During following-up thoracic radiography on 10 days after sildenafil administration, the degree of esophagus dilation significantly reduced. The clinical sign was completely resolved without relapse for more than 300 days. Sildenafil was reported having inhibitory effect of canine gastric contraction without affecting gastric emptying time. This effect could ameliorate persisting regurgitation after using PEG feeding directly into the stomach while bypassing the esophagus.

scholarly journals Peripherally Embolizing Aortic Thrombus: The Work-Up, Management, and Outcome of Primary Aortic Thrombus

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Ramy Mando ◽  
Robert Gemayel ◽  
Ashish Chaddha ◽  
Julian J. Barbat ◽  
Elvis Cami
Keyword(s):  
Filling Defect ◽  
Sudden Onset ◽  
Low Grade ◽  
Unique Case ◽  
Descending Aorta ◽  
Aortic Thrombus ◽  
Risk Patients ◽  
History Of ◽  
Work Up

Background. Primary aortic thrombus is an uncommon entity and not frequently reported in the literature. Herein, we discuss the presentation and management of a patient with a primary thoracic mural thrombus. Case Summary. A 46-year-old female with past medical history of tobacco dependence presented for low-grade fever and sudden onset, severe right upper quadrant abdominal pain with associated nausea and vomiting. Computed tomography (CT) revealed an intraluminal polypoid filling defect arising from the isthmus of the aorta projecting into the proximal descending aorta and findings consistent with infarction of the spleen and right kidney. Infectious, autoimmune, hematologic, and oncologic work-up were all unyielding. The patient was started on heparin and later transitioned to apixaban 5 mg twice a day and 81 mg of aspirin daily. She was also counseled regarding smoking cessation. Two months follow-up CT revealed resolution of the thrombus. Patient had no further thromboembolic complications. Discussion. We present a unique case of primary aortic thrombus. To our knowledge, this is the first reported case managed successfully with a NOAC. This diagnosis is one of exclusion and through work-up should be completed. Our aim is to raise awareness of this condition and successful management with apixaban in low-risk patients.

Avulsion fragmentation of the tibial tuberosity apophysis and associated patellar tendon enthesopathy in a skeletally immature dog

2013 ◽  
Vol 26 (03) ◽  
pp. 242-247 ◽  
Author(s):  
S. Kalff ◽  
A. Parry ◽  
M. Whitehead ◽  
W. M. McKee ◽  
G. W. Brown
Keyword(s):  
Patellar Tendon ◽  
Tibial Plateau ◽  
Weight Bearing ◽  
Slope Angle ◽  
Varus Deformity ◽  
Tibial Tuberosity ◽  
Computed Tomographic ◽  
History Of ◽  
Pelvic Limb ◽  
The Right

SummaryA 9.5-month-old, female entire, 31.3 kg crossbred dog was presented with a 12 week history of moderate weight-bearing right pelvic limb lameness. Radiographic, computed tomographic, and ultrasonographic imaging revealed progressive avulsion fragmentation of the right tibial tuberosity apophysis and a patellar tendon insertional enthesopathy without physeal involvement. Conservative management was successful in achieving a good clinical outcome. A progressive avulsion of the contralateral proximal tibial physes that occurred concurrently resulted in development of an excessive tibial plateau slope angle. The additional development of a moderate left distal femoral varus deformity was surgically corrected. This is the first report of a progressive, traction injury to the tibial tuberosity apophysis in a dog that appears clinically and radiographically very similar to Osgood-Schlatter disease in humans.

scholarly journals Sciatic neuropathy caused by an intermuscular lipoma in dogs

2016 ◽  
Vol 85 (2) ◽  
pp. 147-149 ◽  
Author(s):  
Piotr Trębacz ◽  
Marek Galanty
Keyword(s):  
Body Weight ◽  
Magnetic Resonance ◽  
Imaging Method ◽  
German Shepherd ◽  
Mixed Breed ◽  
Operative Planning ◽  
Post Operation ◽  
History Of ◽  
Pelvic Limb ◽  
Benign Tumours

Lipomas are common, usually slow-growing, benign tumours of mesenchymal origin that most commonly occur on the proximal limb and trunk of middle-aged to older dogs. They are rarely associated with either local invasion or malignancy, unlike infiltrative lipomas and liposarcomas, respectively. Three dogs, a 10-year-old mixed-breed female of 35 kg body weight, a 10-year-old mixed-breed male of 30 kg body weight, and an 11-year old female German shepherd of 38 kg body weight, were presented with a 3–6 month (median, 5 months) history of progressive left pelvic limb lameness and thigh swelling. A lesion affecting the soft tissue of the thigh and the left sciatic nerve was suspected in all dogs. A left thigh magnetic resonance (MR) revealed a homogenous, well circumscribed tumour in the mixed-breed dogs and two similar tumours in the German shepherd. The tumours were interposed between the semimembranosus and semitendinosus muscles. The treatment involved surgical extirpation of the tumours. A follow-up examination 12 months post operation showed mild lameness and proprioceptive deficits in the operated limb in all the dogs. The withdrawal reflex and the cranial tibial reflex were normal. Neither mass nor thickening were palpable in the thigh region. Although intermuscular lipoma is rare, it should be suspected in dogs with progressive monoparesis. Magnetic resonance is a valuable imaging method for diagnostic precision and pre-operative planning. Quick diagnosis and decompressive surgery are required to allow recovery.

scholarly journals Vitamin D deficiency is associated with tuberculosis disease in British children

2020 ◽  
Vol 24 (8) ◽  
pp. 782-788
Author(s):  
A. J. McArdle ◽  
D. Keane ◽  
J. A. Seddon ◽  
J. Bernatoniene ◽  
J. Paton ◽  
...  
Keyword(s):  
Vitamin D ◽  
Sputum Smear ◽  
Interferon Gamma Release Assay ◽  
Tuberculous Infection ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
History Of ◽  
Release Assay ◽  
The Difference ◽  
Lower Vitamin

BACKGROUND: Basic science, epidemiological and interventional research supports a link between vitamin D and tuberculosis (TB) immunity, infection and disease. We evaluated the association between vitamin D levels and TB infection and disease in UK children recruited to the National Institute for Health Research IGRA Kids Study (NIKS).METHODS: Children presenting between 2011 and 2014 were eligible if they had history of exposure to an adult case with sputum smear/culture-positive TB, or were referred and diagnosed with TB disease. Children were assessed at baseline and at 6–8 weeks for immunological evidence of TB infection (interferon-gamma release assay and/or tuberculin skin test) and evidence of TB disease. Some centres routinely measured total 25-hydroxy vitamin D (25-OHD) levels.RESULTS: A total of 166 children were included. The median 25-OHD levels were higher in non-infected children (45.5 nmol/l) than in those with tuberculous infection (36.2 nmol/l) and TB disease (20.0 nmol/l). The difference between TB infection and disease was statistically significant (P < 0.001). By logistic regression, lower vitamin D levels were associated with TB disease among participants with infection or disease, with no evidence of confounding by age, sex, bacille Calmette-Guérin vaccination status, ethnicity, non-contact referral, season or centre.CONCLUSION: Children with TB disease had lower vitamin D levels than children with infection. Implications for prevention and treatment remain to be established.

Subacute Diencephalic Necrosis and Dural Arteriovenous Malformation

Neurosurgery ◽  
1985 ◽  
Vol 17 (4) ◽  
pp. 653-656 ◽  
Author(s):  
Tsutomu Nakada ◽  
Ingrid L. Kwee ◽  
William G. Ellis ◽  
James N. St. John
Keyword(s):  
Arteriovenous Malformation ◽  
Pathological Examination ◽  
Gait Ataxia ◽  
Dural Arteriovenous Malformation ◽  
Computed Tomographic ◽  
History Of ◽  
Work Up ◽  
Dural Avm

Abstract We report a case of congestive venous necrosis involving the diencephalon symmetrically, presumably precipitated by a dural arteriovenous malformation (AVM). The patient presented with a 1-month history of intermittent confusion and gait ataxia. The initial radiological work-up revealed a dural AVM. The patient's subsequent deterioration was accompanied by computed tomographic findings of diencephalic congestion. Pathological examination showed subacute necrosis of the diencephalon. We discuss the pathogenesis of this case of subacute diencephalic necorsis and its possible relationship to the entity of subacute diencephalic angioencephalopathy.

scholarly journals A Pediatric Case of Reversible Segmental Cerebral Vasoconstriction

2006 ◽  
Vol 33 (2) ◽  
pp. 250-253 ◽  
Author(s):  
Adam Kirton ◽  
John Diggle ◽  
William Hu ◽  
Elaine Wirrell
Keyword(s):  
Previous History ◽  
Sudden Onset ◽  
Thunderclap Headache ◽  
Deep Dive ◽  
Cerebral Vasoconstriction ◽  
History Of ◽  
Repeat Angiography ◽  
The Right ◽  
Work Up ◽  
The Brain

ABSTRACT:Background:Reversible segmental cerebral vasoconstriction (RSCV) is a recognizable clinical and radiographic syndrome consisting of thunderclap headache with or without focal neurological symptoms combined with reversible segmental vasoconstriction of proximal cerebral blood vessels.Methods:We report a case of reversible segmental cerebral vasoconstriction in a child.Results:A healthy 13-year-old boy experienced the sudden onset of a severe, diffuse headache upon surfacing from a deep dive in a swimming pool. Severity was maximal at the onset and improved over several hours. The same headache recurred three times over the next four days and a low baseline headache persisted throughout. Vomiting occurred once and mild photo/osmophobia were reported but throbbing, aura, or autonomic symptoms were absent. Focal neurological signs or symptoms were absent and he denied previous history of headaches, medications, drugs, or trauma. Two normal CT scans were performed within hours of separate headaches. Cerebrospinal fluid study on day 5 was bloody with no xanthochromia. MRI/MRA/MRV of the brain and vasculitic work-up were normal. Cerebral angiography on day 6 demonstrated smooth narrowing of multiple proximal cerebral vessels including supraclinoid internal carotid artery (ICA), M1, and A1 on the right and M1 on the left. By ten days, the patient's headaches had resolved and repeat angiography was normal.Conclusion:RSCV should be considered in a child with thunderclap headache.

Prevalence of Vitamin-D Deficiency in Patients with Acute Coronary Syndrome in Syria

2016 ◽  
Vol 9 (6) ◽  
pp. 3544-3548
Author(s):  
Aya Hallak ◽  
Malhis Mahmoud ◽  
Yaser Abajy Mohammad
Keyword(s):  
Vitamin D ◽  
Acute Coronary Syndrome ◽  
Vitamin D Deficiency ◽  
Hypovitaminosis D ◽  
Control Group ◽  
Coronary Syndrome ◽  
Normal Individuals ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
Coronary Syndromes

The objectives of this study were to estimate the prevalence of vitamin D deficiency in patients with acute coronary syndrome in comparison with normal individuals and study the correlation between these two conditions. We measured the plasma 25-hydroxy vitamin D (25-OH-D) levels in 60 patients with acute coronary syndromes (ACS) of both gender and in 30 age matched control individuals of both gender without any known cardiovascular or systemic diseases. The levels of 25-OH-D were measured by ELISA method and the results were statically analyzed to find out any possible correlation. We classified the cases according to their plasma 25(OH)D levels. 25(OH)D levels of ≥ 30 ng/ml were considered normal, levels < 30 and > 20 ng/ml were classified as insufficient, while levels of ≤ 20 ng/ml were classified as deficient. In the current study the prevalence of hypovitaminosis D in the patients group was much higher than it was in the control group. Vitamin D deficiency was observed in 80% and insufficiency in 13% of total patients of ACS, there by bringing the total count to 93%. Whereas only 7% of the patients had adequate vitamin D levels. Thus, these results indicate the existence of a significant correlation between the vitamin D deficiency and ACS in comparison to healthy controls

Atonement

2018 ◽  
Author(s):  
Eleonore Stump
Keyword(s):  
Moral Psychology ◽  
Negative Emotions ◽  
Human Condition ◽  
Human Beings ◽  
Central Question ◽  
Mind Reading ◽  
Shared Attention ◽  
History Of Interpretation ◽  
History Of ◽  
Eleonore Stump

The doctrine that Christ has saved human beings from their sins, with all that that salvation entails, is the distinctive doctrine of Christianity. Over the course of many centuries of reflection on the doctrine, highly diverse understandings have been proposed, many of which have also raised strong positive or negative emotions in those who have reflected on them. In this book, in the context of this history of interpretation, Eleonore Stump considers this theological doctrine with philosophical care. The central question of the book is the nature of the atonement. That is, what is it that is accomplished by the passion and death of Christ (or the life, passion, and death, of Christ)? Whatever exactly it is, it is supposed to include a solution to the problem of the post-Fall human condition, with its guilt and shame. This volume canvasses major interpretations of the doctrine of the atonement that attempt to explain this solution, and it argues that all of them have serious shortcomings. In their place, Stump employs an extension of a Thomistic account of love and forgiveness to argue for a relatively novel interpretation of the doctrine, which she calls ‘the Marian interpretation.’ Stump argues that this Marian interpretation makes better sense of the doctrine of the atonement than other interpretations do, including Anselm’s well-known theory. In the process of constructing the Marian interpretation, she also discusses love, union, guilt, shame, forgiveness, retribution, punishment, shared attention, mind-reading, empathy, and various other issues in moral psychology and ethics.

scholarly journals A Narrative Review of the History of Skin Grafting in Burn Care

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 380
Author(s):  
Deepak K. Ozhathil ◽  
Michael W. Tay ◽  
Steven E. Wolf ◽  
Ludwik K. Branski
Keyword(s):  
Donor Site ◽  
Subsequent Development ◽  
Skin Grafting ◽  
Human Condition ◽  
Surgical Instruments ◽  
Wound Management ◽  
Burn Wound ◽  
Medical Progress ◽  
Burn Care ◽  
History Of

Thermal injuries have been a phenomenon intertwined with the human condition since the dawn of our species. Autologous skin translocation, also known as skin grafting, has played an important role in burn wound management and has a rich history of its own. In fact, some of the oldest known medical texts describe ancient methods of skin translocation. In this article, we examine how skin grafting has evolved from its origins of necessity in the ancient world to the well-calibrated tool utilized in modern medicine. The popularity of skin grafting has ebbed and flowed multiple times throughout history, often suppressed for cultural, religious, pseudo-scientific, or anecdotal reasons. It was not until the 1800s, that skin grafting was widely accepted as a safe and effective treatment for wound management, and shortly thereafter for burn injuries. In the nineteenth and twentieth centuries skin grafting advanced considerably, accelerated by exponential medical progress and the occurrence of man-made disasters and global warfare. The introduction of surgical instruments specifically designed for skin grafting gave surgeons more control over the depth and consistency of harvested tissues, vastly improving outcomes. The invention of powered surgical instruments, such as the electric dermatome, reduced technical barriers for many surgeons, allowing the practice of skin grafting to be extended ubiquitously from a small group of technically gifted reconstructive surgeons to nearly all interested sub-specialists. The subsequent development of biologic and synthetic skin substitutes have been spurred onward by the clinical challenges unique to burn care: recurrent graft failure, microbial wound colonization, and limited donor site availability. These improvements have laid the framework for more advanced forms of tissue engineering including micrografts, cultured skin grafts, aerosolized skin cell application, and stem-cell impregnated dermal matrices. In this article, we will explore the convoluted journey that modern skin grafting has taken and potential future directions the procedure may yet go.

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