Collaborative Care Improves Treatment Outcomes for Dogs with Chronic Otitis Externa: A Collaborative Care Coalition Study

2021 ◽  
Vol 57 (5) ◽  
Author(s):  
Dawn Logas ◽  
Elizabeth A. Maxwell
Keyword(s):  
Primary Care ◽  
Collaborative Care ◽  
Medical Records ◽  
Otitis Externa ◽  
Clinical Signs ◽  
Median Number ◽  
Long Term Outcomes ◽  
Treatment History ◽  
Ear Canals

ABSTRACT The purpose of this retrospective study was to compare outcome measures in dogs treated by a primary care veterinarian (pcDVM) before referral and after seeking collaboration with a board-certified veterinary dermatologist (BCVD) for cases of severe recurrent chronic otitis externa. Medical records of 65 client-owned dogs were retrospectively reviewed, and data were obtained regarding treatment history, referral timeframe, recurrence rate, clinical signs, and resolution of signs. The median number of otitis recurrences while under the care of the pcDVM was 4 (range 1–40) versus collaborative BCVD care of 2 (P < .01). There was a longer median time to otitis recurrence with collaborative care (171 days) compared with dogs managed by the pcDVM before referral (21 days; P > .01). Proliferative changes in the ear canals improved in 41/45 (91%) of cases under BCVD care compared with 6/45 (13%) under care by the pcDVM (P < .01). Dogs with chronic otitis had better long-term outcomes when collaboration with a BCVD was pursued within 6 mo of treatment. Referral or consultation with a BCVD should be considered for cases of chronic canine otitis that are persistent or quickly recurrent (20–30 days) over a 6 mo period.

Enteroplication in cats with intussusception: a retrospective study (2001–2016)

2018 ◽  
Vol 21 (6) ◽  
pp. 488-494 ◽  
Author(s):  
Georg Haider ◽  
Katharina Leschnik ◽  
Nikola Katic ◽  
Gilles Dupré
Keyword(s):  
Medical Records ◽  
Clinical Signs ◽  
Long Term Outcomes ◽  
Short Term ◽  
Recurrence Rates ◽  
Initial Surgery ◽  
Duration Of Surgery ◽  
Previously Treated ◽  
Short And Long Term

Objectives The aim of this study was to report complications, as well as short- and long-term clinical outcomes of cats suffering from surgically reduced intussusception with and without enteroplication. Methods Medical records of cats presented at our institution with intussusception between 2001 and 2016 were reviewed. The following data were retrieved: signalment; history; physical examination; diagnostic imaging, surgical and histological findings; and outcomes. Animals were grouped as with or without enteroplication. Duration of surgery, survival, complication and recurrence rates, duration of hospitalisation, and short- and long-term outcomes were compared. Results Cats with intussusception presented with unspecific type and duration of clinical signs. Male or male castrated cats and Maine Coons were over-represented in both groups. Enteroplication was performed in 48% (10/21) of the cats. Cats in the enteroplication group were significantly younger than those in the non-enteroplication group ( P = 0.023). Duration of surgery, time of hospitalisation, complication rate and outcomes did not differ between the two groups. Two complications in the short term and one complication in the long term were possibly associated with enteroplication. A recurrence of intussusception was seen in 2/17 cats approximately 12 months after initial surgery, both previously treated with enteroplication. Conclusions and relevance Although the number of cases was limited, our results suggest that enteroplication should be cautiously performed in cats with intussusception as it may be associated with major complications in the short and long term, and its efficacy remains unclear. Based on this study, the need for enteroplication in cats following a correction of intussusception could be questioned.

Clinical features, treatment, and outcome of dogs with Coccidioides osteomyelitis

2022 ◽  
pp. 1-8
Author(s):  
Stephanie L. Shaver ◽  
Daniel S. Foy ◽  
Todd D. Carter
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Clinical Signs ◽  
Test Results ◽  
Serologic Test ◽  
Rapid Improvement ◽  
Radiographic Appearance ◽  
One Year ◽  
Positive Results

Abstract OBJECTIVE To describe signalment, clinical signs, serologic test results, treatment, and outcome of dogs with Coccidioides osteomyelitis (COM) and to compare those findings with findings for dogs with osteosarcoma (OSA). ANIMALS 14 dogs with COM and 16 dogs with OSA. PROCEDURES Data were retrospectively gathered from electronic medical records. RESULTS Dogs with COM were younger and weighed less than dogs with OSA. Six dogs with COM had appendicular lesions, 5 had axial lesions, and 3 had both appendicular and axial lesions; 9 had monostotic disease, and 5 had polyostotic disease. Axial lesions and nonadjacent polyostotic disease were more common in dogs with COM than in dogs with OSA, but radiographic appearance was not different between the 2 groups. Median IgG titer at diagnosis of COM was 1:48 and was significantly decreased after 6 and 12 months of treatment. Percentage of dogs with COM that had clinical signs was significantly decreased after 1, 3, 6, and 12 months of treatment. One year after initiation of treatment, 9 of 9 dogs were still receiving fluconazole and 8 of 9 dogs had positive results for serum IgG titer testing. CLINICAL RELEVANCE Dogs with COM typically had a rapid improvement in clinical signs after initiating treatment with fluconazole but required long-term antifungal treatment. Dogs with COM differed from dogs with OSA, but radiographic features had a great degree of overlap between groups, confounding the ability to make a diagnosis on the basis of diagnostic imaging alone.

scholarly journals Screening for language and speech delay in children under five years

2021 ◽  
Vol 21 (S1) ◽  
Author(s):  
Sophie Jullien
Keyword(s):  
Primary Care ◽  
Universal Screening ◽  
Screening Tools ◽  
Supporting Evidence ◽  
Speech Delay ◽  
Speech And Language ◽  
Long Term Outcomes ◽  
Targeted Interventions ◽  
Short And Long Term

AbstractWe looked at existing recommendations and supporting evidence on the effectiveness of universal screening for language and speech delay in children under 5 years of age for short- and long-term outcomes.We conducted a literature search up to the 20th of November 2019 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported on the accuracy of the screening tests for detecting language and speech delay, the efficacy of existing interventions for children with language and speech delay, and the potential harms associated with screening and the associated interventions.Several screening tools are used to assess language and speech delay with a wide variation in their accuracy. Targeted interventions improve some measures of speech and language delay and disorders. However, there is no evidence on the effectiveness of such interventions in children detected by screening with no specific concerns about their speech or language before screening. There is no evidence assessing whether universal screening for language and speech delay in a primary care setting improves short and long-term outcomes (including speech and language outcomes and other outcomes). Finally, there is no evidence on the harms of screening for language and speech delay in primary care settings, and there is limited evidence assessing the potential harms of interventions.

Impact of Ongoing Primary Care Intervention on Long Term Outcomes In Uninsured and Insured Patients With Depression

Medical Care ◽  
2002 ◽  
Vol 40 (12) ◽  
pp. 1210-1222 ◽  
Author(s):  
Jeffrey L. Smith ◽  
Kathryn M. Rost ◽  
Paul A. Nutting ◽  
Carl E. Elliott ◽  
L. Miriam Dickinson
Keyword(s):  
Primary Care ◽  
Long Term Outcomes ◽  
Care Intervention ◽  
Insured Patients

Persistence in the long term of the effects of a collaborative care programme for depression in primary care

2014 ◽  
Vol 166 ◽  
pp. 36-40 ◽  
Author(s):  
Enric Aragonès ◽  
Antonia Caballero ◽  
Josep-Lluís Piñol ◽  
Germán López-Cortacans
Keyword(s):  
Primary Care ◽  
Collaborative Care ◽  
Care Programme

scholarly journals Primary care interventions and current service innovations in modifying long-term outcomes after stroke: a protocol for a scoping review

BMJ Open ◽  
2016 ◽  
Vol 6 (10) ◽  
pp. e012840 ◽  
Author(s):  
Dominika M Pindus ◽  
Lisa Lim ◽  
A Viona Rundell ◽  
Victoria Hobbs ◽  
Noorazah Abd Aziz ◽  
...  
Keyword(s):  
Primary Care ◽  
Scoping Review ◽  
Long Term Outcomes

Extrahepatic biliary tract obstruction: a retrospective study of 45 cases (1983-1993)

1995 ◽  
Vol 31 (6) ◽  
pp. 478-482 ◽  
Author(s):  
MA Fahie ◽  
RA Martin
Keyword(s):  
Biliary Tract ◽  
Medical Records ◽  
Serum Bilirubin ◽  
Necrotizing Pancreatitis ◽  
Elevated Serum ◽  
Clinical Signs ◽  
Pathological Process ◽  
Biliary Tract Surgery ◽  
Long Term Prognosis

The medical records of 41 dogs and four cats with either surgical or postmortem confirmation of extrahepatic biliary tract obstruction were reviewed. Clinical signs of icterus, vomiting, anorexia, or a combination of these signs were exhibited by 100% of cases. Elevated serum bilirubin was documented in 37 of 41 dogs and two of four cats (86.6%). The predominant, underlying, pathological process was extraluminal obstruction of the biliary tract due to pancreatitis (19 of 45 cases; 42.2%) or neoplasia (11 of 45 cases; 24.4%). Biliary tract surgery was performed in 29 cases, of which 12 (41.3%) recovered. Animals diagnosed with extrahepatic biliary tract obstruction had a relatively good long-term prognosis, provided they were not compromised substantially due to severe necrotizing pancreatitis or neoplasia.

Gastric submucosal tumors: Lessons learned from 10-year follow-up

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15631-e15631
Author(s):  
A. Sawaki ◽  
N. Mizuno ◽  
T. Takagi ◽  
K. Hara ◽  
T. Nakamura ◽  
...  
Keyword(s):  
Medical Records ◽  
Surgical Intervention ◽  
Lessons Learned ◽  
Long Term Outcomes ◽  
Submucosal Tumors ◽  
Stromal Tumors ◽  
Gastric Submucosal Tumors ◽  
Simultaneous Surgery

e15631 Background: Gastric Submucosal tumors (SMTs) were incidentally discovered esophagogastroduodenoscopy (EGD). However, they have not been studied in detail of epidemiology. Furthermore, no treatment strategy for SMTs has been established with few studies looking into long-term outcomes. The aim of this study is to clarify the clinical features and long-term outcomes of gastric SMT at a single institute for 10-year period. Methods: We performed a total of 5307 EGDs and detected 188 gastric SMTs during 1998. All clinical data including incidence, size and location in stomach were analyzed for the medical records. A retrospective review was conducted for 10-year period for 109 patients and 79 patients were excluded because of simultaneous surgery (3), disappear in follow- up EGD (27), lost of follow-up (49). Results: Gastric SMTs were detected 188 (81 males, 107 females) of 5307 patients (3.5%). Majority size of SMTs was less than 1cm (64%) and SMTs<2cm were 91%. 56% of SMTs located middle one third of stomach, and half (22%) of the remaining SMTs were detected at upper and lower one third, respectively. In 10-year follow-up, 83 of 109 patients were alive at December 2008. One patient was dead of SMT and the remaining 25 patients were dead of other disease till December 2008. Enlargement of SMT was observed in 2 of 109 SMTs (1.8%). Both of them underwent surgical resection and diagnosed as gastrointestinal stromal tumors (GIST). One patient was annually monitored by endoscopy, from 0.6cm to 1.5cm during 4 years, without recurrence for 6 years after surgical intervention. Another didn't undergo regular endoscopy, from 1.8cm to 8cm during 2 years, with recurrence, and consequently died of SMT. Conclusions: The incidence of SMTs is 3.5%, majority (91%) is small (<2cm), and frequent location is middle one third of stomach. Most of SMTs might be managed conservatively, but regular endoscopy is required. No significant financial relationships to disclose.

scholarly journals Balloon dilation for the treatment of nasopharyngeal stenosis in seven cats

2017 ◽  
Vol 3 (2) ◽  
pp. 205511691772998
Author(s):  
Stefeny Z Pollack ◽  
Peter S Chapman ◽  
Alan Klag
Keyword(s):  
Effective Treatment ◽  
Medical Records ◽  
Balloon Dilation ◽  
Clinical Signs ◽  
Upper Airway ◽  
Short Term ◽  
Effective Treatment Option ◽  
Endoscopic Guidance ◽  
Ocular Discharge

Objectives The objective of this study was to evaluate the effectiveness of balloon dilation for the treatment of nasopharyngeal stenosis in cats. Methods The medical records of seven cats with nasopharyngeal stenosis treated with balloon dilation were reviewed. The most common presenting clinical signs included upper airway noise, sneezing, nasal and/or ocular discharge. All seven cats were confirmed to have nasopharyngeal stenosis via nasopharyngeal endoscopy and were treated with balloon dilation under endoscopic guidance. Results All seven cats had acceptable short-term control (median 14 days) of clinical signs after the procedure. Two of six cats had successful long-term control (median 34 days) of clinical signs after one balloon dilation and an additional 2/6 cats had acceptable long-term control of clinical signs after a second balloon dilation procedure. The most significant complication of balloon dilation was the recurrence of stenosis. Conclusions and relevance The findings of this study indicate that balloon dilation is a safe and effective treatment option for the relief of clinical signs associated with nasopharyngeal stenosis in cats. Multiple procedures may be necessary for the best chance of long-term success.

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