Evaluation of the Safety of Early Compared to Late Enteral Nutrition in Canine Septic Peritonitis

ABSTRACT Septic peritonitis is a relatively common condition in the veterinary intensive care unit, with a classically high mortality rate. Early enteral nutrition (EEN) in critically ill humans can lead to improved outcome. This study was performed to determine the safety of early postoperative feeding in canine septic peritonitis. In this retrospective case series, 56 dogs were identified. Sixteen dogs received EEN, defined as nutrition within 24 hr of surgery; 27 received late enteral nutrition (LEN) defined as nutrition more than 24 hours following surgery; and 13 dogs had no enteral nutrition in hospital (NEN). Signalment, physical examination findings, and occurrence of pre-admission vomiting, regurgitation, and length of anorexia were the same amongst all groups. There was no significant difference in the number of gastrointestinal complications postoperatively between the EEN, LEN, and NEN groups or in the occurrence of vomiting/regurgitation postoperatively compared to preoperatively. There was no difference in the length of hospitalization between any group, although fewer dogs in the NEN group survived compared to the EEN/LEN combined group (46% [6/13] versus 81% [37/40]). This study indicates it is safe to initiate EEN without additional risk of gastrointestinal complications. Prospective studies are needed to evaluate the potential benefits of EEN in dogs with septic peritonitis.

Download Full-text

Ologen Implantation versus Conjunctival Autograft Transplantation for Treatment of Pterygium

Journal of Ophthalmology ◽

10.1155/2018/1617520 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Xiuping Chen ◽

Fei Yuan

Keyword(s):

Operative Time ◽

Case Series ◽

Retrospective Case ◽

Short Operative Time ◽

Conjunctival Autograft ◽

Primary Surgery ◽

Significant Difference ◽

Autograft Group ◽

Group 1 ◽

Primary Pterygium

Purpose. To evaluate the effectiveness and safety of Ologen implantation versus conjunctival autograft transplantation for primary pterygium. Methods. A retrospective case-series analysis. Thirty-one eyes of 29 patients were included in the Ologen group and 42 eyes of 35 patients in the autograft group. The patients were followed up for 1 year and evaluated for slit-lamp biomicroscopy, intraocular pressure, and adverse events. Recurrence rate, complications, and final appearance of the cases were evaluated prospectively. Result. At 1 year after operation, 2 eyes recurred (6.5%) in the Ologen group and 4 eyes recurred (9.52%) in the autograft group. There was no statistically significant difference between both groups (P=0.157, χ2 = 3.781). There was no occurrence of serious complications. Two eyes among the 31 eyes of the Ologen group were conjunctivitis; the incidence of complications was 6.45% (2 eyes). There was conjunctivitis in 3 eyes of the autograft group, 1 eye complicated with symblepharon, and 1 eye with conjunctival granuloma; the incidence of complications was 11.90% (5 eyes), and there was no statistically significant difference between both groups (P=0.094). The conjuntiva was less vascular and inflamed at 1 month postoperatively in the Ologen group than in the autograft group. Conclusions. Ologen transplantation was technically easier, provided short operative time compared with conjunctival autograft transplantation, and preserved healthy conjunctiva with less complication and less recurrence; it may be a new, safe, and effective alternative for improving the short-term success rate of primary surgery.

Download Full-text

Efficacy and safety of misoprostol vaginal insert vs. oral misoprostol for induction of labor

Journal of Perinatal Medicine ◽

10.1515/jpm-2018-0128 ◽

2019 ◽

Vol 47 (2) ◽

pp. 176-182 ◽

Cited By ~ 3

Author(s):

Katharina Redling ◽

Sabine Schaedelin ◽

Evelyn Annegret Huhn ◽

Irene Hoesli

Keyword(s):

Mode Of Delivery ◽

Case Series ◽

Neonatal Outcomes ◽

Efficacy And Safety ◽

Retrospective Case ◽

Application Form ◽

Oral Misoprostol ◽

Vaginal Deliveries ◽

Significant Difference ◽

Time To Delivery

Abstract Objectives To compare the oral application form of misoprostol with the misoprostol vaginal insert (MVI) in a Swiss cohort with special regards to the efficacy and safety. Methods We performed a retrospective case series including a historical group induced with oral misoprostol (MO, n=101) and an MVI group (n=101). The primary outcome was time to delivery. Secondary outcomes were mode of delivery, occurrence of tachysystole, use of analgesia and neonatal adverse outcome. Results A total of 202 women were included in the analysis (101 in the MVI as well as in the MO group). Time from start of induction to delivery was significantly shorter in the MVI group compared to the MO group (15.91 h vs. 37.68 h, P<0.001). Within the first 24 h, 78.2% of the women in the MVI group had given birth compared to 28.7% in the MO group (P<0.001). Tachysystole occurred more often in the MVI group (22.8% vs. 5.0%, P<0.001). Women in the MVI group more often needed opioid analgesia during the induction before onset of active labor (31.7% vs. 2.0%, P<0.001). There was no significant difference between neonatal outcomes in the two groups. Conclusion Time to delivery was significantly shorter in the MVI group with a higher rate of vaginal deliveries within the first 24 h. However, patients needed more opioids for pain relief during induction with MVI. There was no difference in neonatal outcomes.

Download Full-text

The Association between Preoperative Dry Eye Symptoms and Postoperative Discomfort in Patients Underwent Photorefractive Keratectomy

Journal of Ophthalmology ◽

10.1155/2019/7029858 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Gilad Rabina ◽

Ingibjorg Iris Boguslavsky ◽

Michael Mimouni ◽

Igor Kaiserman

Keyword(s):

Postoperative Pain ◽

Dry Eye ◽

Subjective Evaluation ◽

Case Series ◽

Photorefractive Keratectomy ◽

Ocular Surface Disease Index ◽

Retrospective Case ◽

Significant Difference ◽

Eye Symptoms ◽

Dry Eye Symptoms

Purpose. To investigate the association between preoperative dry eye symptoms on postoperative pain and discomfort after photorefractive keratectomy (PRK). Methods. A retrospective case series of 151 consecutive patients, who underwent myopic PRK in both eyes between 5/2016 and 5/2017. Patients with positive dry eye disease (DED) signs on clinical examination or with known DED were excluded. Patients underwent a subjective evaluation for dry eye symptoms using ocular surface disease index (OSDI) and modified standard patient evaluation of eye dryness (SPEED) questionnaires. One day postoperatively, the patients were evaluated again by a questionnaire of pain, discomfort, photophobia, foreign body sensation, satisfaction with vision, and frequency of usage of anesthetic drops. Results. Fifty-two patients had any preoperative dry eye symptoms (OSDI score > 0) compared to 99 nonsymptomatic patients (OSDI score of 0). Postoperatively, the symptomatic dry eye patients suffered significantly more pain than the nondry eye patients (p=0.02). Thirteen patients had a cumulated modified SPEED score >4 (moderate to severe) in comparison to 138 patients with score of 0–4 (non to mild). Patients with moderate to severe preoperative symptoms suffered more pain (p=0.006), photophobia (p=0.005), and epiphora (p=0.03). No statistically significant difference was seen in postoperative subjective visual quality (p=0.82) between the two groups. Conclusion. Preoperative dry eye symptoms may be associated with postoperative pain, epiphora, and photophobia and thus influence negatively on patient satisfaction with this procedure.

Download Full-text

Outcomes of Single-Institution Retrospective Case Series on Observation Alone Following Atypical Meningioma Resection

Neurosurgery ◽

10.1093/neuros/nyz310_647 ◽

2019 ◽

Vol 66 (Supplement_1) ◽

Author(s):

Lauren Stone ◽

Hugh D Moulding ◽

Nimisha Deb ◽

Charles T Lee

Keyword(s):

Median Time ◽

Tumor Resection ◽

Case Series ◽

Single Institution ◽

Retrospective Case ◽

Who Grade ◽

Entire Cohort ◽

Simpson Grade ◽

Retrospective Case Series ◽

Significant Difference

Abstract INTRODUCTION Observation alone vs adjuvant radiotherapy (RT) following gross total resection (GTR) of WHO Grade II (G2) meningiomas is controversial. Local recurrence (LR) rates have been reported to be similar. We present LR rates in patients who were observed following G2 meningioma resection and correlate with Simpson grades. METHODS Patients from 2005 to 2018 who underwent observation alone following surgical resection of G2 meningiomas at a single institution were analyzed in a retrospective case series. Simpson grades were used to classify extent of tumor resection. Patients were followed with magnetic resonance imaging (MRI) or computed tomography (CT) imaging at 1-mo, 3-mo, 6-mo, and 12-mo postoperatively, then annually thereafter to monitor for recurrence. Descriptive 2-yr, and 5-yr LR rates for our entire cohort and time to recurrence by Simpson grade are reported. RESULTS A total of 28 patients with Simpson 1 to 4 resections for G2 meningiomas did not undergo adjuvant RT and were included. Median follow-up (FU) was 34 mo [Interquartile range (IQR): 18-55 mo]. Median time to LR was 55 mo (IQR: 44-65 mo) across our entire cohort. Of 14 patients with Simpson 1 resection, there was 1 LR at 68 mo. Of 3 patients with Simpson 2 resection, there was 1 LR at 49 mo. Of 9 patients with Simpson 3 resection, there were 5 recurrences; median time to LR was 61 mo. Of 2 patients with Simpson 4 resections, there was 1 LR at 3 mo. Overall, 2-yr LR was 3.6% and 5-yr LR was 10.7%. There was no statistically significant difference in LR rate between Simpson 1 vs Simpson 2 to 4 resections (P = .11). CONCLUSION Our results are consistent with the low recurrence rate of G2 meningiomas undergoing observation along following GTR in current literature. Simpson grade 1 resections have low overall LR rate and larger scale studies are needed to determine if statistical significance exists.

Download Full-text

Moody Mares—Is Ovariectomy a Solution?

Animals ◽

10.3390/ani10071210 ◽

2020 ◽

Vol 10 (7) ◽

pp. 1210

Author(s):

Daniel Taasti Melgaard ◽

Trine Stokbro Korsgaard ◽

Martin Soendergaard Thoefner ◽

Morten Roenn Petersen ◽

Hanne Gervi Pedersen

Keyword(s):

Case Series ◽

Ovarian Neoplasm ◽

Histological Classification ◽

Retrospective Case ◽

Oestrus Cycle ◽

Bilateral Ovariectomy ◽

Histopathologic Diagnosis ◽

Significant Difference ◽

Case Series Report ◽

Series Report

Unwanted behaviour in mares is a commonly presenting problem to the veterinarian. This behaviour may range from the mare being uncooperative or aggressive when handled on the ground, kicking, bucking or rearing when ridden or being aggressive towards other horses. This purpose of the study was to evaluate whether bilateral ovariectomy in mares with unwanted behaviour improved the mare’s behaviour and/or rideability from the owner’s perspective. The mares were grouped and compared statistically based on their histological classification as having either “normal” or neoplastic ovaries. This study is a retrospective case series report of twenty-eight ovariectomized mares. A semi-quantitative value (1–10) pre- and post-ovariectomy for A) behaviour on ground/in stable and B) rideability was given, based on the owner’s observations. The horses were grouped based on their histopathologic diagnosis as “Normal ovaries” or “Neoplasia”. Following ovariectomy, rideability improved, with a score of ≥5 in 80% (8/10) of mares with normal ovaries and in 57% (8/14) of mares with ovarian neoplasm. A behavioural improvement of ≥5 was observed in 40% (4/10) of mares with normal ovaries, and in 43% (6/14) of mares with ovarian neoplasm. A significant difference was observed between the semi-quantitative value pre- and post-ovariectomy in both groups. No difference was observed in change in behaviour and rideability score between the group with normal ovaries and neoplastic ovaries. Mares with unwanted behaviour not obviously related to the oestrus cycle and to painful conditions may benefit from ovariectomy to alter their behaviour and rideability.

Download Full-text

Novel Pulmonary Function Parameter Shifts in High-Grade Upper Airway Stenoses

Ear Nose & Throat Journal ◽

10.1177/0145561319840870 ◽

2019 ◽

Vol 98 (7) ◽

pp. E104-E111

Author(s):

Paul Severin Wiggenhauser ◽

Oliver Adolph ◽

Thomas Karl Hoffmann ◽

Julia Thierauf ◽

Johannes Adrian Veit

Keyword(s):

Lung Function ◽

Case Series ◽

Upper Airway ◽

Neck Surgery ◽

Forced Expiratory Volume ◽

Function Parameter ◽

High Grade ◽

Retrospective Case ◽

Level Of Evidence ◽

Significant Difference

Upper airway stenosis (UAS) is a common problem for anesthesiologists in laryngology as well as head and neck surgery, but it may lead to life-threatening situations if it is undetected. This retrospective case series was performed on patients who had UAS and presented with severe dyspnea or encountered difficulties in airway management. To assess the severity of UAS, the degree of stenosis was calculated using computed tomography scans and direct endoscopy. Lung function test was collected, and measured values were extracted as percentage of predicted reference values. Lower and higher grade stenoses were defined by Cotton-Myer classification and median degree of stenosis. Median of detected stenoses was 73% (64%-85%), with 7 of 10 patients classified as Cotton-Myer grade 3. Lung function tests showed typical parameter shifts as known from obstructive pulmonary diseases (OPDs). Furthermore, statistical analyses showed a significant higher value of residual volume (RV)/total lung capacity (TLC) in patients with higher grade stenosis ( P < .05), whereas forced expiratory volume in 1 second /vital capacity (FEV1/VC) did not show a significant difference in same subgroups. In conclusion, the elevation of RV/TLC with concomitant normal FEV1/VC in symptomatic patients could be used to demarcate rare UAS from common OPD. Moreover, RV–TLC ratio might be used to distinguish between low- and high-grade UAS. But further epidemiological studies will be necessary to validate these findings. Level of evidence: 4.

Download Full-text

Reporting in stapes surgery: are we following the guidelines?

The Journal of Laryngology & Otology ◽

10.1017/s0022215118000397 ◽

2018 ◽

Vol 132 (06) ◽

pp. 479-485 ◽

Cited By ~ 2

Author(s):

G J Watson ◽

M da Cruz

Keyword(s):

Case Series ◽

Neck Surgery ◽

Stapes Surgery ◽

Secondary Outcome ◽

Retrospective Case ◽

Adherence To Guidelines ◽

Gap Closure ◽

Significant Difference ◽

Surgery Outcomes ◽

Incorrect Information

AbstractObjectiveThis paper highlights the importance of reporting air–bone gap closure in stapes surgery according to the American Academy of Otolaryngology – Head and Neck Surgery guidelines and reviews compliance in recent years.MethodsA retrospective case series was conducted and the outcomes were reviewed. Closure of the air–bone gap was calculated in 204 adult patients using the aforementioned guidelines. Results were recalculated ignoring the Carhart phenomenon to determine any significant difference. Adherence to guidelines was also reported as a secondary outcome.ResultsIgnoring the Carhart phenomenon resulted in 75 per cent over-reporting of successful air–bone gap closure (p< 0.001). Over-reporting occurred in 5.9 per cent of papers, and in 11.8 per cent it was difficult to determine how the results were reached.ConclusionDespite the existence of clear guidelines, stapes surgery outcomes are still being over-reported as successful. This can lead to incorrect information being provided to patients during the consent process and makes comparative studies difficult.

Download Full-text

Clinical results of Visian implantable collamer lens implantation according to various sizes and implantation angles

European Journal of Ophthalmology ◽

10.1177/11206721211033468 ◽

2021 ◽

pp. 112067212110334

Author(s):

Bu Ki Kim ◽

Young Taek Chung

Keyword(s):

Case Series ◽

Clinical Results ◽

Implantable Collamer Lens ◽

Retrospective Case ◽

Significant Difference ◽

Lens Implantation ◽

Group A ◽

The Mean ◽

Group B

Purpose: To investigate the clinical outcomes of Visian implantable collamer lens (ICL) implantation according to lens size and implantation angle. Setting: Onnuri Smile Eye Clinic, Seoul, Republic of Korea. Design: Retrospective case series. Methods: This study included 566 eyes of 283 patients treated with ICL implantation. Patients were divided into three groups: horizontally implanted same-sized ICL (group A), horizontally implanted different sized-ICL (group B: large ICL and small ICL) and same sized-ICL implanted with a different implantation angle (group C: horizontal and vertical). Results: At 12-month follow-up, the mean vault was 0.78 ± 17, 0.48 ± 0.13, 0.71 ± 0.18 and 0.44 ± 0.16 mm when large and small sized ICL was used in group B ( p < 0.001), and when ICL was horizontally and vertically implanted in group C ( p = 0.021), respectively. And the mean SE was −0.11 ± 0.30, −0.34 ± 0.42, −0.3 ± 0.56 and −0.64 ± 0.66 dioptres (D), when the large and the small sized ICL was used group B ( p = 0.039), and when the ICL was horizontally and vertically implanted in group C ( p = 0.036), respectively. No significant difference in UDVA, IOP and ECD between both eyes in groups B and C was observed. No statistical difference was found in the vault between both eyes for groups B and C. Conclusions: The vault was significantly higher and the SE was significantly more hyperopic when a larger-sized ICL was used or the ICL was horizontally implanted compared to when the ICL was vertically implanted.

Download Full-text

Inguinal Lymphadenectomy for Squamous Cell Cancer of the Penis—Experience of a UK Supra-Regional Network

British Journal of Medical and Surgical Urology ◽

10.1016/j.bjmsu.2011.12.009 ◽

2012 ◽

Vol 5 (5) ◽

pp. 241-247

Author(s):

Thomas G. Martin ◽

Jonathan C. Goddard ◽

Tim R. Terry ◽

Duncan J. Summerton

Keyword(s):

Squamous Cell ◽

Squamous Cell Cancer ◽

Cell Cancer ◽

Case Series ◽

Morbidity Rate ◽

Prognostic Impact ◽

Regional Network ◽

Retrospective Case ◽

Inguinal Lymphadenectomy ◽

Significant Difference

Objective: To present a case series of patients undergoing inguinal lymphadenectomy (IL) for squamous cell cancer (SCC) of the penis within an UK Supra-Regional Network (SRN). Patients and methods: Retrospective case note analysis was undertaken of all patients who underwent IL following referral from the network units across a wide region. Information was cross-referenced from clinician, pathology and hospital episode databases. Results: A total of 79 modified ILs and 11 radical ILs were performed in 49 patients over 5 years. Metastatic involvement was found in 59.1% of patients. Of these 58.6% were found to have extranodal spread at the time of operation. The finding of extranodal spread significantly impacted upon survival. One year survival rates post IL were 100% for pN0 and pN1, compared with 67% for pN3. Kaplan—Meier curves were plotted and showed a significant difference in survival from primary surgery on log rank comparison between pN0/pN1 and pN3 nodal categories. As in most series, IL has a considerable morbidity rate. No perioperative mortality was seen. Conclusions: This case series emphasizes the negative prognostic impact of finding extranodal spread (pN3) at IL. In those with unilateral intranodal metastases (pN1), IL is curative for the majority of patients.

Download Full-text

Complications following intracranial pressure monitoring in children: a 6-year single-center experience

Journal of Neurosurgery Pediatrics ◽

10.3171/2017.9.peds17360 ◽

2018 ◽

Vol 21 (3) ◽

pp. 278-283 ◽

Cited By ~ 8

Author(s):

Ruichong Ma ◽

David Rowland ◽

Andrew Judge ◽

Amedeo Calisto ◽

Jayaratnam Jayamohan ◽

...

Keyword(s):

Intracranial Pressure ◽

Case Series ◽

Complication Rates ◽

Safe Procedure ◽

Icp Monitoring ◽

Retrospective Case ◽

Wide Range ◽

Neurosurgical Patients ◽

Significant Difference ◽

Csf Leakage

OBJECTIVEIntracranial pressure (ICP) monitoring is an important tool in the neurosurgeon’s armamentarium and is used for a wide range of indications. There are many different ICP monitors available, of which fiber-optic intraparenchymal devices are very popular. Here, the authors document their experience performing ICP monitoring from 2005 to 2015 and specifically complication rates following insertion of the Microsensor ICP monitor.METHODSA retrospective case series review of all patients who underwent ICP monitoring over a 10-year period from 2005 to 2015 was performed.RESULTSThere were 385 separate operations with an overall complication rate of 8.3% (32 of 385 cases). Hardware failure occurred in 4.2% of cases, the CSF leakage rate was 3.6%, the postoperative hemorrhage rate was 0.5%, and there was 1 case of infection (0.3% of cases). Only patients with hardware problems required further surgery as a result of their complications, and no patient had any permanent morbidity or mortality from the procedure. Younger patients (p = 0.001) and patients with pathologically high ICP (13% of patients with high ICP vs 6.5% of patients with normal ICP; p = 0.04) were significantly more likely to have complications. There was no significant difference in the complication rates between general neurosurgical patients and craniofacial patients (7.6% vs 8.8%, respectively; p = 0.67).CONCLUSIONSIntraparenchymal ICP monitoring is a safe procedure associated with low complications and morbidity in the pediatric craniofacial and neurosurgical population and should be offered to appropriate patients to assess ICP with the reassurance of the safety record reported in this study.

Download Full-text