Airway injury associated with cervical bite wounds in dogs and cats: 56 cases

2013 ◽  
Vol 26 (02) ◽  
pp. 89-93 ◽  
Author(s):  
Z. J. Halfacree ◽  
M. S. Tivers ◽  
C. J. Jordan
Keyword(s):  
Primary Repair ◽  
Electronic Patient Records ◽  
Animal Suffering ◽  
Excellent Outcome ◽  
Airway Injury ◽  
Long Term Follow Up ◽  
Bite Wounds ◽  
Veterinary Hospital

Summary Objective: To investigate the frequency of airway injury and damage to other vital structures associated with cervical bite wounds in dogs and cats and the implications for management and outcome. Methods: A retrospective search of electronic patient records was used to identify dogs and cats suffering cervical bite wounds that were presented to a large multidisciplinary veterinary hospital over a four year period. Results: Complete records were available for 55 animals, with one animal suffering two separate injuries. Fourteen animals (25%) had injuries to vital structures, including airway injury in nine (17%) which was surgically confirmed and treated in six (11%). Airway injuries were associated with either subcutaneous or mediastinal emphysema in all affected animals. Other structures injured included the jugular vein, pharynx, oesophagus and spine. Airway injuries were treated with primary repair in five animals and a fasciomuscular patch in one. Temporary tracheostomy was performed in three animals. Median duration of hospitalisation was one day (0-19) with 53 animals (54 cases) (96%) surviving to discharge. Long-term follow-up (16-114 months) revealed that 43 of 49 animals were alive with six that died due to unrelated reasons. Clinical significance: Cervical bite wounds are associated with significant injury to vital structures. Up to 17% of animals may have injury to their airway. Identification and treatment of airway injury is vital and was associated with an excellent outcome in six animals.

Tetralogy of Fallot

ESC CardioMed ◽  
2018 ◽  
pp. 814-818
Author(s):  
Robert Yates
Keyword(s):  
Tetralogy Of Fallot ◽  
Valve Replacement ◽  
Primary Repair ◽  
Pulmonary Regurgitation ◽  
Pulmonary Valve Replacement ◽  
Management Issue ◽  
Percutaneous Approach ◽  
Long Term Follow Up

Primary repair is now the favoured approach for most patients with tetralogy of Fallot, and has excellent results. Pulmonary regurgitation is the major management issue during long-term follow-up, and late pulmonary valve replacement by surgery or percutaneous approach may be required.

Minimally Invasive, Endoscopic, Internal Thoracoplasty for the Treatment of Scoliotic Rib Hump Deformity: Technical Note

2005 ◽  
Vol 56 (suppl_4) ◽  
pp. ONS-E444-ONS-E444 ◽  
Author(s):  
Praveen V. Mummaneni ◽  
Rick C. Sasso
Keyword(s):  
Minimally Invasive ◽  
Idiopathic Scoliosis ◽  
Technical Note ◽  
Patient Questionnaire ◽  
Grading System ◽  
Rib Hump ◽  
Excellent Outcome ◽  
Long Term Follow Up

Abstract OBJECTIVE: Patients with idiopathic scoliosis often have a noticeable rib deformity that frequently persists after corrective surgery. Open thoracoplasty has been the traditional method of reducing rib deformity. Recently, however, video-assisted thoracoscopy (VATS) has been used to perform thoracoplasty. There have been no long-term follow-up studies on VATS thoracoplasty, nor have there been outcome scores to assess the results of thoracoplasty procedures. We present our experience using VATS thoracoplasty with long-term follow-up and propose an outcome grading system for thoracoplasty. METHODS: Between 1998 and 2000, four patients (age range, 14–53 yr) underwent VATS thoracoplasty for significant rib hump deformity (mean height, 5 cm; range, 4–6 cm) associated with idiopathic scoliosis. All patients had four rib segments resected during the VATS thoracoplasty procedure. Three of the four patients also underwent anterior thoracic release and discectomy during the procedure. RESULTS: Patients were followed for a mean of 40 months after surgery (range, 33–50 mo). There were no intraoperative or postoperative complications. Outcomes were assessed using a patient questionnaire with our new thoracoplasty grading system. All patients were pleased that they had chosen to have VATS internal thoracoplasty. Based on our new grading system, two patients had an excellent outcome and two had a good outcome. CONCLUSION: VATS provides an alternative, minimally invasive route to perform thoracoplasty. VATS incisions are much smaller and more cosmetically appealing than open thoracoplasty incisions. Long-term follow-up indicates good to excellent patient outcomes.

The outcome of tethered cord release in secondary and multiple repeat tethered cord syndrome

2009 ◽  
Vol 4 (1) ◽  
pp. 28-36 ◽  
Author(s):  
Wajd N. Al-Holou ◽  
Karin M. Muraszko ◽  
Hugh J. Garton ◽  
Steven R. Buchman ◽  
Cormac O. Maher
Keyword(s):  
Spinal Cord ◽  
Primary Repair ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Neurological Outcomes ◽  
Younger Age ◽  
Long Term Follow Up ◽  
Multiple Repeat

Object After primary repair of a myelomeningocele or a lipomyelomeningocele, patients can present with symptoms of secondary tethered cord syndrome (TCS). After surgical untethering, a small percentage of these patients can present with multiple repeat TCS. In patients presenting with secondary or multiple repeat TCS, the role as well the expected outcomes of surgical untethering are not well defined. Methods Eighty-four patients who underwent spinal cord untethering after at least 1 primary repair were retrospectively evaluated using scaled and subjective outcome measures at short-term and long-term follow-up visits. Outcomes were analyzed for predictive measures using multivariate logistic regression. Results Surgical untethering was performed in 66 patients with myelomeningoceles and 18 patients with lipomyelomeningoceles. Fourteen patients underwent multiple repeat spinal cord untethering. Patients were followed up for an average of 6.2 years. Most patients had stability of function postoperatively. Motor function and weakness improved in 7 and 16% of patients at 6 months, respectively, and 6 and 19% of patients at long-term follow-up evaluation, respectively. Of the patients who presented with back pain, 75% had improvement in symptoms at 6 months postoperatively. Younger age at untethering was significantly associated with worse long-term neurological outcomes. The number of previous untethering procedures, original diagnosis, sex, anatomical level, and degree of untethering had no effect on surgical outcomes. Conclusions Patients presenting with secondary or multiple repeat TCS may benefit from surgical untethering.

Surgical management of uterine torsion through ventral celiotomy in eleven mares

2019 ◽  
Author(s):  
Jasmeet Singh Khosa ◽  
Arun Anand ◽  
Vandana Sangwan ◽  
Shashi Kant Mahajan ◽  
Jitendra Mohindroo ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Surgical Management ◽  
Surgical Intervention ◽  
Normal Position ◽  
Inhalation Anesthesia ◽  
Uterine Torsion ◽  
Long Term Follow Up ◽  
Veterinary Hospital

This article describes the surgical management of uterine torsion by midline celiotomy for cesarean section in 11 mares presented with signs of colic at a teaching veterinary hospital. The mares were either in full term of gestation (n = 6) or in advanced stage of pregnancy (n = 5). Majority of the mares (44.5%) were in fourth parity. 78% cases of uterine torsion were post cervical and clockwise and (22%) cases were post cervical and anticlockwise. For surgical intervention, mares were anesthetized using a combination of xylazine (1.1 mg/kg) and ketamine (2.2 mg/kg), intravenously and maintained on isoflurane inhalation anesthesia. Midline celiotomy was performed, and foals were delivered by cesarean section. Before closing the abdominal wound, the uterus was detorted manually and confirmed per-vaginally for its normal position. After long-term follow-up, the study reported 90.0% (10/11) survival rate out of which, seven were bred successfully.

Conversion Disorder Masquerading as Severe Progressive Neurological Deterioration in Childhood

1999 ◽  
Vol 4 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Clare B. Nourse ◽  
Imelda Ryan ◽  
Joe McMenamin
Keyword(s):  
Conversion Disorder ◽  
Chronic Fatigue ◽  
Depressive Illness ◽  
Nasogastric Feeding ◽  
Excellent Outcome ◽  
Fatigue Syndrome ◽  
Pervasive Refusal Syndrome ◽  
Long Term Follow Up

Diagnosis of neurological conversion disorder is difficult. Considerable overlap in symptomatology occurs with progressive neurological degenerative disease, pervasive refusal syndrome, depressive illness, chronic fatigue syndrome, and other conditions. Conversion symptoms can also coincide with organic neurological disease. Successful management requires a sensitive, confident, multidisciplinary approach. Multiple or repeated investigations can be counterproductive in resolving symptoms. This report describes three children, one male and two female, aged between 9 and 10 years, who were referred for evaluation of progressive neurological symptoms. Each progressed to a completely dependent state within 8 weeks of referral, requiring nasogastric feeding and total assisted care. A convincing psychosocial trigger was not identified in any case. Improvement occurred only when investigations were ceased and rehabilitation commenced. Long-term follow-up has revealed an excellent outcome for all three children.

scholarly journals Treatment of Stage IA Nodular Lymphocyte-Predominant Hodgkin Lymphoma (NLPHL): An Analysis from the German Hodgkin Study Group (GHSG)

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3058-3058 ◽  
Author(s):  
Dennis A. Eichenauer ◽  
Annette Pluetschow ◽  
Michael Fuchs ◽  
Karolin Behringer ◽  
Boris Böll ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Hodgkin Lymphoma ◽  
Combined Modality Treatment ◽  
Study Group ◽  
Excellent Outcome ◽  
German Hodgkin Study Group ◽  
Long Term Follow Up ◽  
Stage Ia

Abstract Introduction: Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare lymphoma entity accounting for about 5% of all HL cases. As compared with classical HL (cHL), NLPHL is characterized by the absence of CD30 and the consistent expression of CD20 on the malignant lymphocyte predominant (LP) cells. Given a more indolent clinical course, especially early-stage NLPHL is often treated less aggressive than classical HL (cHL). In stage IA patients, radiotherapy (RT) alone is applied at most institutions. However, this clinical practice is not based on data from prospective clinical trials with sufficient follow-up. To shed more light on the optimal treatment of stage IA NLPHL, we performed an analysis including patients with long-term follow-up treated within German Hodgkin Study Group (GHSG) clinical trials. Patients: A total of 256 stage IA NLPHL patients treated within 7 prospective GHSG studies between 1988 and 2009 were included in the analysis. Treatment consisted of combined-modality treatment (CMT) (n=72), extended-field RT (EF-RT) (n=49), involved-field RT (IF-RT) (n=108) or four weekly doses of the anti-CD20 antibody rituximab (n=27). Results: The median age at NLPHL diagnosis was 38.5 years (range: 17-75); 194/256 (75.8%) patients were male and 62/256 (24.2%) patients were female. Median follow-up for the whole patient group was 91 months (98 months for CMT, 118 months for EF-RT, 87 months for IF-RT, 49 months for rituximab). All patients responded to treatment irrespective of the treatment modality applied. At 8 years, progression-free survival (PFS) and overall survival (OS) rates were 88.5% and 94.5% for CMT, 84.3% and 95.7% for EF-RT and 91.9% and 99.0% for IF-RT; 4-year PFS and OS rates for patients treated with rituximab were 81.0% and 100%. Seventeen patients developed a second malignancy in the course of follow-up (8 after CMT, 3 after EF-RT, 4 after IF-RT, 2 after rituxmab). Nine of these second malignancies were solid tumors (4 after CMT, 2 after EF-RT, 1 after IF-RT, 2 after rituximab) and 8 were hematologic malignancies (4 after CMT, 1 after EF-RT, 3 after IF-RT, none after rituximab). A total 12 deaths occurred. The most common cause of death was cardiac failure (n=3). Only one patient died from NLPHL. Conclusion: Based on this large analysis with long-term follow-up, IF-RT should be the standard of care for stage IA NLPHL. Treatment with single agent rituximab is associated with an increased event rate when compared with IF-RT and should therefore not be routinely used in stage IA NLPHL patients. However, given the shorter follow-up in comparison with CMT, EF-RT and IF-RT, final conclusions regarding rituximab especially in terms of treatment-related late sequelae cannot yet be drawn. Addition of chemotherapy does not improve the excellent outcome achieved with RT alone. Disclosures Off Label Use: Rituximab in NLPHL.

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