Medical management of esophageal perforation secondary to esophageal foreign bodies in 5 dogs.

OBJECTIVE: To describe 5 cases of conservative management of substantial esophageal perforation in dogs. SERIES SUMMARY: Five dogs presented with an esophageal foreign body (EFB) and resultant esophageal perforation. Clinical signs at presentation included tachycardia, tachypnea, and increased respiratory effort. Thoracic radiography was performed in all cases, and in each case, pleural and mediastinal effusion was present, suggesting esophageal perforation prior to endoscope-guided removal. A full thickness esophageal defect was visualized after foreign body removal in 4/5 cases. Treatment included IV crystalloid fluid therapy, IV antimicrobials, analgesia, and proton pump inhibitors in all cases. Two dogs had a percutaneous endoscopically placed gastrostomy feeding tube placed and 1 dog received prednisolone sodium succinate IV because of marked pharyngeal inflammation. Complications after EFB removal included pneumothorax (n = 2) and pneumomediastinum (n = 4). Four of the 5 dogs survived to discharge and did not have complications 2-4 weeks following discharge. One dog was euthanized as result of aspiration pneumonia following EFB removal. NEW OR UNIQUE INFORMATION PROVIDED: Traditionally, surgical management of esophageal perforations has been recommended. This can be a costly and invasive procedure and requires a high degree of surgical skill. In this report, conservative management of substantial esophageal perforation in 5 dogs is described; medical management may be a viable treatment option in dogs with perforation of the esophagus due to EFB.

Church, place, and crime: Latinos and homicide in new destinations.

Latinos are moving beyond traditional areas and settling in new, potentially disorganized destinations. Without an established immigrant community, new destinations appear to rely more on the local religious ecology to regulate community life and to keep crime low. We examine the link between religious ecology and Latino homicide victimization for traditional and new destination counties. We observe four findings. (1) A Catholic presence has no effect on Latino violence in the old and well-organized traditional settlement areas. But in new Latino settlement areas, a Catholic presence substantially lowers violence against Latinos. In contrast, mainline Protestantism is linked to high levels of violence against Latinos in new destinations. (2) Previous claims that Latino communities are safe do not apply to new destinations, where Latinos are murdered at a high rate. (3) Previous claims that areas with high Latino immigration are safe for Latinos are not true for new destinations. (4) New Latino destinations offer little insulation from the effects of economic deprivation on violence. We discuss the implications of the findings.