Prognosis For Recovery Research Articles

OXIDATIVE METABOLISM OF ERYTHROCYTES IN PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA AND ITS SIGNIFICANCE IN DIAGNOSIS AND PROGNOSIS OF THE DISEASE

Community-acquired pneumonia is remaining one of the most common diseases in the world. The high morbidity and mortality rates establish the necessity for further in-depth research into the mechanisms of the development and progression of the disease, finding ways to optimize diagnosis and treatment. The purpose of this study is to investigate indicators of the oxidative metabolism of erythrocytes in patients with community-acquired pneumonia and to evaluate its significance in the pathogenesis of the disease. Participants and methods: the study involved 20 adult patients suffering from community-acquired pneumonia, who took the course of treatment at the therapeutic department of the City Clinical Hospital No. 25, Kharkiv. The diagnosis of community-acquired pneumonia was established on the basis of epidemiological, clinical, laboratory, and radiological findings. All indicators were compared with the findings in the group of healthy individuals. A comparative analysis of the content of carbonyl derivatives, the level of malondialdehyde, and membrane-bound haemoglobin was carried out. We revealed the presence of intracellular oxidative stress in erythrocytes of the patients with community-acquired pneumonia that leads to damage to their membranes and the release of hemoglobin into the blood plasma. Conclusion. Oxidative metabolism provokes an impairment of redox reactions in the blood plasma and contributes to the progression of the disease. Hypoxia, which develops during community-acquired pneumonia, aggravates the course of the disease and worsens the prognosis for recovery. The obtained results allow us to recommend the addition of antihypoxic agents to the traditional antibacterial therapy of community-acquired pneumonia.

An Indo-Pacific humpback dolphin (Sousa chinensis) severely injured by vessel collision: live rescue at sea, clinical care, and postmortem examination using a virtopsy-integrated approach

BackgroundVessel collision induces blunt and sharp force traumas to aquatic animals and is a leading anthropogenic impact affecting cetaceans worldwide. Vessel collision is an important threat affecting vulnerable coastal cetaceans such as the Indo-Pacific humpback dolphins (Sousa chinensis) which reside in coastal waters of Hong Kong amongst heavy marine traffic.Case presentationA severely injured subadult S. chinensis was sighted in the waters off southwestern Hong Kong with four gaping incision wounds on its dorsum. It was in poor body condition and seemed unable to use the fluke effectively. The deepest wound located at the caudal peduncle near the base of the fluke and exposed the underlying fractured caudal vertebrae. The dolphin was monitored in the field over three weeks and eventually captured for medical intervention as veterinary assessment indicated progressive and life-threatening deterioration. During rehabilitation, the dolphin demonstrated initial signs of improvement over the first 36 hours as supported by diagnostic tests but then deteriorated rapidly. It was humanely euthanised after three days of rehabilitation. Postmortem investigation was carried out using virtopsy (postmortem computed tomography and magnetic resonance imaging) and conventional necropsy, with special attention to the traumatic musculoskeletal injuries caused by vessel collision and also revealed acute gastrointestinal compromise and respiratory disease that further hampered the rehabilitation.ConclusionIn cetaceans, the prognosis for recovery from injuries caused by vessel collision depends on the extent, location, and gravity of the injuries (i.e., superficial, deep, penetrating, blunt vs. sharp, fresh vs. septic), as well as the health status of the individual and its ability to respond to the insult. Injuries extending deep into the vertebral column may lead to delayed death and associated welfare issues. The prognosis of this case was likely poor given the severity and location of the injuries, but the attempted rehabilitation and postmortem investigation provided valuable insights for clinical management if similar cases are encountered in the future. Being able to non-invasively assess and document traumatic injuries and other pathologies, diagnostic imaging is particularly useful in the clinical assessment and postmortem investigation (virtopsy) of cases with vessel-induced injuries.

Ocular motility disorders following coronavirus disease-19 vaccination.

To describe clinical manifestations and short-term prognosis of ocular motility disorders following coronavirus disease-2019 (COVID-19) vaccination. Ocular motility disorders were diagnosed by clinical assessment, high-resolution magnetic resonance imaging, and laboratory testing. Clinical manifestations, short-term prognosis, and rate of complete recovery were analyzed. Sixty-three patients (37 males, 26 females) with a mean age of 61.6 ± 13.3years (range, 22-81years) were included in this study. Among 61 applicable patients with sufficient information regarding medical histories, 38 (62.3%) had one or more significant underlying past medical histories including vasculopathic risk factors. The interval between initial symptoms and vaccination was 8.6 ± 8.2 (range, 0-28) days. Forty-two (66.7%), 14 (22.2%), and 7 (11.1%) patients developed symptoms after the first, second, and third vaccinations, respectively. One case of internuclear ophthalmoplegia, 52 cases of cranial nerve palsy, two cases of myasthenia gravis, six cases of orbital diseases (such as myositis, thyroid eye disease, and IgG-related orbital myopathy), and two cases of comitant vertical strabismus with acute onset diplopia were found. Among 42 patients with follow-up data (duration: 62.1 ± 40.3days), complete improvement, partial improvement, no improvement, and exacerbation were shown in 20, 15, 3, and 4 patients, respectively. This study provided various clinical features of ocular motility disorders following COVID-19 vaccination. The majority of cases had a mild clinical course while some cases showed a progressive nature. Close follow-up and further studies are needed to elucidate the underlying mechanisms and long-term prognosis.

Being Physically Active Leads to Better Recovery Prognosis for People Diagnosed with COVID-19: A Cross-Sectional Study.

The regular practice of physical activity helps in the prevention and control of several non-communicable diseases. However, evidence on the role of physical activity in mitigating worsening clinical outcomes in people with COVID-19 is still unclear. The aim of this study was to verify whether different levels of physical activity provide protection for clinical outcomes caused by SARS-CoV-2 infection. A cross-sectional study was conducted with 509 adults (43.8 ± 15.71 years; 61.1% female) with a positive diagnosis of COVID-19 residing in Ribeirão Preto, São Paulo, Brazil. Participants were interviewed by telephone to determine the severity of the infection and the physical activity performed. Binary logistic regression was used to indicate the odds ratio (OR) of active people reporting less harmful clinical outcomes from COVID-19. Active people had a lower chance of hospitalization, fewer hospitalization days, less respiratory difficulty and needed less oxygen support. The results suggest that active people, compared to sedentary people, have a lower frequency of hospitalization, length of stay, breathing difficulty and need for oxygen support. These results corroborate the importance of public policies to promote the practice of physical activity, in order to mitigate the severity of the clinical outcomes of COVID-19.

BIOMARKERS OF CYTOKINE STORM AND INFLAMMATION IN SEPSIS, POST-COVID-19 PATIENTS AND COVID-19 VACCINATED INDIVIDUALS

<h3>Introduction</h3> COVID-19 is associated with changes in biomarkers of inflammation and cytokine storm compared with sepsis. <h3>Methods</h3> 39 patients with sepsis (21 men and 18 women, age 57.2±20.2 years; blood was taken on 3-4 days from the diagnosis sepsis), 20 patients who had undergone the COVID-19 infection (10 men and 10 women, age 37.6±17.0 years, 124.9±27.5 days after the first symptoms) and 22 patients who were vaccinated with Sputnik-V (8 men and 14 women, age 53.3±12.8 years, 38.5±2.6 days after the first vaccination) were assessed. Procalcitonin, sCD14, IL-6, IL-8, IL-10, sTREM-1, sWNT5a, sLBP, sTNFα and sTNFβ were measured in serum in duplicate by ELISA. <h3>Results</h3> A significant increase in the level of procalcitonin, sLBP, sCD14, IL-6, IL-8 and IL-10 was found in patients with bacterial sepsis compared with patients who underwent Covid-19 infection or were Sputnik-V vaccinated (p<0.0001). Levels of sTREM-1, sWnt5a, TNFα and TNFβ in patients with sepsis, demonstrated no significant change in indicators compared with patients who underwent Covid-19 infection or were Sputnik-V vaccinated. There was a decrease in the concentration of sCD14, sLBP and an increase in procalcitonin in the serum of vaccinated individuals compared with those who had had an infection (p <0.05). High levels of sTREM-1 were seen in patients who have undergone COVID-19 and vaccinated individuals. <h3>Conclusions</h3> Levels of sTREM-1 can serve as both a marker of the immune response and a marker of the prognosis of recovery from COVID-19.

Posterior ischemic optic neuropathy following postoperative bleeding and internal jugular vein compression.

Perioperative blindness, especially posterior ischemic optic neuropathy (PION), is an uncommon but potentially devastating complication. We report a case of a 65-year-old male patient who underwent laryngopharyngectomy, bilateral neck dissection, and free jejunum flap reconstruction, but then experienced PION in his right eye following postoperative bleeding and bilateral internal jugular veins (IJVs) compression. Despite systemic corticosteroid therapy, his visual recovery prognosis was poor. The specific mechanism responsible for PION remains unclear, and no therapy has been shown to improve this condition. As such, prevention of perioperative PION remains the only available strategy. Surgeons should be aware of this rare potential complication and its risk factors and strive to avoid it. As postoperative bleeding and IJV compression are one of important risk factors for PION, avoiding these are critical.

Assessment of Hearing Loss in Minor Head Injury: A Prospective Study.

Introduction Hearing loss following a head injury is common and well known. The numbers of road traffic accidents have increased recently, with minor head injuries being very common, and usually go unreported. Hearing loss after a minor head injury is often unnoticed. Available literature is limited in this regard. Objective This study was done to assess hearing loss in patients with minor head injuries and to define its natural history and progression/regression by a serial assessment of hearing. Methods This prospective study was done in the Department of Neurosurgery, AIIMS, Bhubaneshwar, Odisha, India, for a period of 24 months to look at the profile of hearing levels of patients presenting with history suggestive of minor head injury. Results This study has shown that some form of hearing loss is common after a minor head injury and should be evaluated in all patients to detect subclinical hearing loss. A significant number of patients having minimal or a mild degree of hearing loss, if managed properly, improve to preinjury status. Distortion product oto-acoustic emission testing should be used as the screening and follow-up tool. Conclusion This study highlights the importance of hearing assessment in minor-head-injury patients and the prognosis of recovery as per the severity of hearing loss and head injury.

Clinical cases of Darier-White follicular dyskeratosis

Follicular dyskeratosis (Darier-White disease) is a hereditary skin disease that is extremely rare in medical practice, so errors in its diagnosis can occur. It was first described in 1889 by two scientists (independently of each other), Ferdinand-Jean Darier and James White. The disease is inherited in an autosomal dominant pattern with variable gene penetrance. The main cause of this pathological process is a mutation of the ATP2A2 gene, located in the long arm of chromosome 12. Both men and women are affected with the same probability, but clinical manifestations are more severe in males. It appears, as a rule, at the age of 20; children under 10 rarely suffer from DAR; people who are over 30 years have very little chance of contracting this disease. Clinical manifestations slowly progress up to the age of 40-50, and gradually disappear in older age. Typical rashes are follicular papules, 0.2-0.5 cm in size, yellow-brown or dark brown in color, covered with dry or oily layers in the form of horny scales. On the surface layers, black dots are visible which are hair follicle funnels. Papules are rounded, dense, flat or spherical, initially isolated, eventually merging into plaques. They are mostly localized on the skin of the limbs, trunk, chest, in the interscapular area, large folds, less often on the neck, scalp, auricles, and in the ear canals. In 20-30 percent of patients, rashes are localized on the mucous membrane of the oral cavity next to the affected skin. More than 90 percent of patients have nail abnormalities, such as erythro- and leukonychia. Other possible manifestations are fragility, splinter hemor­rhages, marked subungual hyperkeratosis, which can be observed on 2-3 nails or affect all nail plates. The dermatoscopy of skin lesions is characterized by the presence of several polygonal, branched, star-shaped or rounded-oval yellow-orange-brown lumps of various sizes, surrounded by a thin whitish halo and pink small-structured areas. The prognosis for recovery is not favorable, the treatment is ineffective. Two cases of Darier-White disease are described in this article.

Electroencephalography Findings in Traumatic Brain Injury

Traumatic Brain Injury (TBI) or also known as a head injury is one of the leading causes of death among young people and is also one of the health problems defined as impact, penetration, and rapid movement of the brain within the skull that can result in changes in mental status and is often referred to as the silent epidemic. Head injuries can also result in electrophysiological abnormalities seen on electroencephalography (EEG) recordings. Electroencephalography was the first clinical neurodiagnostic assessment to reveal abnormal brain function after a head injury. For detecting brain injury, EEG may be more sensitive than clinical neurologic examination. In general conditions, electroencephalography is performed on patients with moderate to severe head injuries to provide information about the severity of the head injury, and establish a diagnosis of non-convulsive status epilepticus. This diagnosis often follows head injuries because patients with loss of consciousness are difficult to identify without an EEG examination. This also helps determine a prognosis for recovery and the likelihood of post-traumatic seizures. Electroencephalography features in head injuries depend on the severity of the injury and the location of the head itself. Electroencephalography after head injury shows slowing of the posterior dominant rhythm and increasing diffuse theta slowing, which returns to normal within hours or may subside more slowly over several weeks. Electroencephalography changes are not the same in each individual, due to differences in the severity of head injuries. It is important to know that there is no clear or specific EEG for mild traumatic brain injury.

Nerve Palsy following Total Hip Arthroplasty: A Review of the Current Literature

AbstractThe incidence of postoperative nerve palsy following total hip arthroplasty (THA) is reported to be 1 to 2%. The most common injury is to the sciatic nerve, but other nerve palsies including the femoral, obturator, and pudendal nerves, have been implicated. There is also an increased risk of nerve palsy following THA in female patients, those who undergo revision procedures, and those with a previous history of developmental hip dysplasia. The prognosis for recovery for each nerve palsy is directly correlated to the extent of nerve damage. Prevention is always the best form of treatment for these conditions, and one method by which this may be accomplished is through electromyography and other variations of intraoperative observation.

EEG-based methods for recovery prognosis of patients with disorders of consciousness: A systematic review

ObjectiveDisorders of consciousness (DoC) are acquired conditions of severely altered consciousness. Electroencephalography (EEG)-derived biomarkers have been studied as clinical predictors of consciousness recovery. Therefore, this study aimed to systematically review the methods, features, and models used to derive prognostic EEG markers in patients with DoC in a rehabilitation setting. MethodsWe conducted a systematic literature search of EEG-based strategies for consciousness recovery prognosis in five electronic databases. ResultsThe search resulted in 2964 papers. After screening, 15 studies were included in the review. Our analyses revealed that simpler experimental settings and similar filtering cut-off frequencies are preferred. The results of studies were categorised by extracting qualitative and quantitative features. The quantitative features were further classified into evoked/event-related potentials, spectral measures, entropy measures, and graph-theory measures. Despite the variety of methods, features from all categories, including qualitative ones, exhibited significant correlations with DoC prognosis. Moreover, no agreement was found on the optimal set of EEG-based features for the multivariate prognosis of patients with DoC, which limits the computational methods applied for outcome prediction and correlation analysis to classical ones. Nevertheless, alpha power, reactivity, and higher complexity metrics were often found to be predictive of consciousness recovery. ConclusionsThis study’s findings confirm the essential role of qualitative EEG and suggest an important role for quantitative EEG. Their joint use could compensate for their reciprocal limitations. SignificanceThis study emphasises the need for further efforts toward guidelines on standardised EEG analysis pipeline, given the already proven role of EEG markers in the recovery prognosis of patients with DoC.

Analysis of the results of surgical and conservative treatment of humeral condyle fractures

Introduction Fractures of the humeral condyle make up 0.5-5.0 % of all fractures and about 30.0 % of adult elbow fractures. Complications develop in 18.0-85.0 % of cases and 29.9 % of the injured have signs of disability, giving these fractures a reputation of injuries with a poor prognosis for functional recovery. Objective To improve the treatment results of the injured with humeral condyle fractures by developing differential treatment tactics taking into account the biomechanical characteristics of the injured anatomical structures. Material and methods The authors analyzed the results of conservative and surgical treatment of 194 patients with fractures of the humeral condyle. The average age of the patients was 50.2 years (range from 19 to 89 years); there were 75 (38.7 %) males and 119 (61.3 %) females. Based on the method of treatment, the patients were divided into 2 groups, each group included a control subgroup and the results of treatment were analyzed. The main subgroup of the clinical group 1 (surgical treatment) consisted of 99 patients with an average age of 49.1 years (range from 19 to 85 years). There were 49 (49.5 %) men and 50 (50.5 %) women. The control subgroup of the clinical group 1 (surgical treatment) consisted of 41 patients with an average age of 51.4 years (from 21 to 89 years). There were 17 (41.5 %) men and 24 (58.5 %) women. The main subgroup of the clinical group 2 (conservative treatment) consisted of 29 patients with an average age of 51.2 years (from 21 to 88 years). There were 5 (17.2 %) men and 24 (82.8 %) women. The control subgroup of the clinical group 2 (conservative treatment) consisted of 25 patients with an average age of 52.9 years (from 21 to 87 years). There were 4 (16.0 %) men and 21 (84.5 %) women. The fractures were rated according to the AO classification: type 13A – 15 (7.7 %) individuals, type 13B - 40 (20.7 %) subjects and type 13C – 139 (71.6 %) patients. Results The mean duration of follow-up was 39.0 ± 1.0 months (7 to 48 months from injury). The mean range of motion in the elbow joint was 110.5 ± 1.2º (50º to 140º), the mean score on the Mayo clinic scale was 81.7 ± 0.9 (45 to 100), and on the Score Scale was 62.7 ± 0.7 (38 to 76). Excellent functional results were obtained in 95 (49.0 %) patients (p &lt; 0.001), good – in 41 (21.2 %) (p &lt; 0.001), fair – in 28 (14.4 %) (p &lt; 0.001) and poor – in 30 (15.5 %) patients (p &lt; 0.001). Conclusion Differentiated treatment tactics in humeral condyle fractures permitted to obtain positive results in 92.2 % (p &lt; 0.001) of the patients in comparison with 89.4 % (p &lt; 0.001) of the control group and to decrease the number of complications by 20.2 % (p &lt; 0.001).

NECROTIZING PNEUMONIA SECONDARY TO CANDIDA INFECTION IN A PATIENT WITH HISTORY OF ALCOHOL ABUSE REQUIRING LOBECTOMY AND ANTIFUNGAL THERAPY

NECROTIZING PNEUMONIA SECONDARY TO CANDIDA INFECTION IN A PATIENT WITH HISTORY OF ALCOHOL ABUSE REQUIRING LOBECTOMY AND ANTIFUNGAL THERAPY

Thallium Poisoning - A Review

Thallium is one of the most toxic of the heavy metals. Its continued use as a rodenticide in many developing countries and its increasing use in an expanding number of new technologies raise concerns about exposure risk to animals and humans. Thallium is a tasteless, odorless, and water-soluble chemical element for which both accidental intoxication and criminal poisoning have been reported. Thallium poisoning is one of the serious toxicities known to man. The symptomatology of its toxicity is usually nonspecific due to the multi-organ involvement.1 The initial symptoms of thallium poisoning may include fever, gastrointestinal problems, delirium, convulsions and coma. Common symptoms are mild gastrointestinal disturbances, polyneuritis, encephalopathy, tachycardia, skin eruptions, stomatitis, atrophic changes of the skin, nail changes (Mee's lines), and skin hyperesthesia (mainly in the soles of the feet and the tibia).1 The current therapy for thallium poisoning is the use of prussian blue and potassium chloride. Potassium therapy is probably the single most effective agent in the treatment of thallium poisoning. Treatment with prussian blue (or activated charcoal) will interrupt the enterohepatic cycling of Thallium, thus enhancing fecal elimination of the metal. Forced diuresis with potassium loading will increase the renal clearance but should be used cautiously because neurologic and cardiovascular symptom may be exacerbated.2 If recognized and treated early, Thallium poisoning carries a favorable prognosis for full recovery.

Optimal timing of referral for nerve transfer surgery for postoperative C5 palsy.

Cervical nerve 5 palsy can occur following surgery for cervical spine pathology. The prognosis of C5 palsy is generally favorable, and most patients recover useful function. However, some patients do not recover useful strength. Nerve transfers are a potential effective treatment of postoperative severe C5 palsy. This study aimed to further delineate the natural history of recovery from postoperative C5 palsy, determine whether lack of recovery at specific time points predicts poor recovery prognosis, and thereby determine a reasonable time point for referral to a complex peripheral nerve specialist. The authors conducted a retrospective review of 72 patients who underwent surgery for cervical spondylosis and stenosis complicated by C5 palsy. Medical Research Council (MRC) motor strength grades were recorded preoperatively; immediately postoperatively; at discharge; and at 2 weeks, 3 months, 6 months, and 12 months postoperatively. Univariate and multivariate logistic regression models were used to identify demographic and clinical risk factors associated with recovery of useful strength after severe C5 palsy. The mean patient age was 62.5 years, and 36.1% of patients were female. Thirty patients (41.7%) experienced severe C5 palsy with less than antigravity strength (MRC grade 2 or less) at discharge. Twenty-one (70%) of these patients recovered useful strength (MRC grade 3 or greater) at 12 months postoperatively, and 9 patients (30%) did not recover useful strength at 12 months. Of those patients with persistent severe C5 palsy at 3 months postoperatively, 50% recovered useful strength at 12 months. Of those patients with persistent severe C5 palsy at 6 months postoperatively, 25% recovered useful strength at 12 months. No patient with MRC grade 0 or 1 strength at 6 months postoperatively recovered useful strength. A history of diabetes was associated with the occurrence of severe C5 palsy. On multivariate analysis, female sex was associated with recovery of useful strength. Most patients with severe C5 palsy recover useful strength in their C5 myotome within 12 months of onset. However, at 3 months postoperatively, patients with persistent severe C5 palsy had only a 50% chance of recovering useful strength by 12 months. Lack of recovery of useful strength at 3 months postoperatively is a reasonable time point for referral to a complex peripheral nerve center to establish care and to determine candidacy for nerve transfer surgery if severe C5 palsy persists.

Токсоплазмозний хоріоретиніт у підлітка: опис власного клінічного випадку

Toxoplasmosis is a zoonotic protozoal disease caused by the intracellular parasite Toxoplasma gondii and is characterized by a polymorphism of clinical symptoms with predominant involvement of the nervous, lymphatic systems, eyes, skeletal muscles and myocardium. Despite the variety of therapeutic agents, the treatment of toxoplasmosis remains problematic and requires an interdisciplinary approach. Complete the release of toxoplasmas from the body is difficult, although theoretically possible. This process depends on the combination of individual characteristics of local and general immunity of the macroorganism, the amount of the pathogen and its virulence. Purpose - to present a clinical case of the patient with chorioretinitis as an example of a clinical manifestation of toxoplasmosis infection. Clinical case. The girl turned to an ophthalmologist with complaints of worsening vision and red eyes. After a doctor’s examination, an ophthalmoscopy was performed, the presence of two chorioretinal foci in both eyes was confirmed. Examination for TORCH-infection is recommended. An elevated level of IgM and IgG to Toxoplasma gondii was detected. The patient received a course of antibacterial and hormonal therapy with a positive effect. After 8 months, the girl’s complaints resumed, signs of synovitis of the knee joints appeared, and anemic syndrome joined. During repeated ophthalmoscopy, three chorioretinal foci were found. The girl was hospitalized in the ophthalmology department for a more detailed examination and to decide on further observation tactics. Conclusions. A case of chorioretinitis as a clinical manifestation of toxoplasmosis infection in adolescence is described. Timely diagnosis and started therapy of the above-described pathology are the key to a satisfactory prognosis for recovery, prevention of the development of negative consequences of this disease. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.

WE-206. Quantitative electromyography in the prognosis of recovery in traumatic nerve injury

WE-206. Quantitative electromyography in the prognosis of recovery in traumatic nerve injury

We Got Your Back: Evaluating Recovery Following Spinal Cord Injury After High-Voltage Electric Burns.

Delayed spinal cord injury (SCI) is a relatively rare consequence of high voltage electrical burns, but it holds significant implications for patient quality of life. Due to the uncommon nature of delayed SCI and variable time of onset following injury, providers are currently unable to provide a prognosis for functional recovery and optimize a therapy process tailored to treat this patient populace. In this study, we aim to better map the pattern of recovery in these patients to better inform future rehabilitation practices. A retrospective chart review of five patients who experienced delayed SCI secondary to an electrical burn was conducted. The majority of patients displayed an upward trajectory in motor function following acute hospitalization and inpatient rehabilitation, with four of the five patients able to achieve complete motor strength in multiple extremities. In addition, rehabilitation was shown to have a noticeable impact in improving functional independence in tasks related to nursing. In conclusion, the clinical and functional outcomes of these delayed SCI patients point to the need for multidisciplinary management following injury and highlight the importance of early rehabilitation in regaining function.

Long-Term Outcome after Cholecystectomy without Common Bile Duct Catheterization and Flushing in Dogs.

Simple SummaryGall bladder mucocele (GBM) is one of the most common indications for biliary surgery in dogs, and cholecystectomy is considered the treatment of choice. Before cystic duct ligation, catheterization and flushing of the common bile duct (CBD) is commonly performed to ensure patency but is potentially associated with complications. Laparoscopic cholecystectomy (LC) has been described in dogs as a treatment for uncomplicated GBM without evidence of biliary tract rupture or CBD obstruction. In this study, we describe the long-term outcome of dogs undergoing cholecystectomy for GBM without catheterization and flushing of the CBD. The results of the present study suggest that this cohort of dogs had a good-to-excellent long-term prognosis, with a low morbidity and perioperative mortality, with 96% of dogs surviving for more than 6 months. This population could represent ideal candidates for LC in dogs.The aim of this study is to report outcomes of dogs undergoing cholecystectomy for gall bladder mucocele (GBM) without flushing and catheterization of the common bile duct (CBD). This is a retrospective multicentric study from three veterinary referral hospitals and included 82 dogs diagnosed with GBM. Medical records were reviewed for clinical and histopathological findings. Long-term outcome was assessed with an owner questionnaire. The common bile duct was considered normal (<4 mm), mildly dilated (5–6 mm) and moderately dilated (>7 mm) in 88%, 10% and 2.4% of dogs, respectively. Surgery was uncomplicated in 83% of dogs. Intraoperative complications were recorded in 21% of dogs, with hypotension being the most common, whereas postoperative complications were documented in 20% of dogs, with vomiting/regurgitation being the most common. Ninety-six percent of dogs that underwent cholecystectomy in this study survived to discharge. Follow-up ranged from 142 to 3930 days (median: 549 days). Eighty-five percent of dogs were alive at the time of follow-up. Dogs undergoing cholecystectomy for GBM without catheterization and flushing of the CBD have a favourable prognosis for recovery and quality of life.

Clinical findings, surgical treatment and long-term outcome of dogs and cats with double aortic arch: four cases (2005-2022).

To describe the clinical presentation, diagnostic findings, treatment and long-term outcome following surgery of dogs and cats undergoing surgical treatment for a double aortic arch. Medical records of dogs and cats diagnosed with a double aortic arch between 2005 and 2022 at three small animal referral hospitals were retrospectively reviewed. Long-term outcome was assessed by a clinical examination and/or by contacting the owners or referring veterinarians. Two dogs and two cats were included. Regurgitation after eating, stunted growth and poor weight gain were the predominant clinical features. All animals had thoracic radiography and oesophagography; a dilation of the cranial thoracic oesophagus cranial to the heart base, was described in all animals. CT angiography confirmed double aortic arch in three of these and the right aortic arch was larger and appeared more well developed compared with the left aortic arch in all based on CT or surgical findings. Surgery was performed via a left fourth intercostal thoracotomy; ligation and transection of the lesser left aortic arch was performed. Follow-up time ranged from 360 to 1563 days. All animals showed a marked improvement during the postoperative period, and all gained weight gradually. Owners' perception of the surgical procedure outcome and quality of life was described as excellent for all animals. Surgical ligation of the lesser aortic arch in dogs and cats with double aortic arch is associated with a favourable prognosis for recovery, resolution of clinical signs, and quality of life with only minor feeding modifications.