Complications and outcomes associated with unilateral thyroidectomy in dogs with naturally occurring thyroid tumors: 156 cases (2003-2015).

OBJECTIVE: To describe complications and outcomes of dogs undergoing unilateral thyroidectomy for the treatment of thyroid tumors. ANIMALS: 156 dogs undergoing unilateral thyroidectomy for a naturally occurring thyroid tumor. PROCEDURES: Dogs that underwent a unilateral thyroidectomy in 2003 through 2015 were included in a multi-institutional retrospective study. For each dog, information gathered through evaluation of electronic and paper records included perioperative complications, short-term outcome (survival to discharge from the hospital vs nonsurvival), and long-term outcome (survival time). RESULTS: In the perioperative period, complications occurred in 31 of the 156 (19.9%) dogs; hemorrhage was the most common intraoperative complication (12 [7.7%] dogs). Five of 156 (3.2%) dogs received a blood transfusion; these 5 dogs were among the 12 dogs that had hemorrhage listed as an intraoperative complication. Immediately after surgery, the most common complication was aspiration pneumonia (5 [3.2%] dogs). One hundred fifty-three of 156 (98.1%) dogs that underwent unilateral thyroidectomy survived to discharge from the hospital. One hundred-thirteen dogs were lost to follow-up; from the available data, the median survival time was 911 days (95% confidence interval, 704 to 1,466 days). CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that unilateral thyroidectomy in dogs with a naturally occurring thyroid tumor was associated with a perioperative mortality rate of 1.9% and a complication rate of 19.9% and that hemorrhage and aspiration pneumonia were the most common complications. Long-term survival of dogs undergoing unilateral thyroidectomy for the treatment of thyroid tumors was not uncommon.

Evaluation of information presented within mast cell tumour histopathology reports in the United States: 2012-2015.

For canine mast cell tumour (MCT), histopathology reports are one of the main factors considered in the decision-making process regarding need and type of adjunctive therapy. However, considerable variation exists in types of information reported, especially relating to surgical margins. The purpose of this study was to describe and evaluate how information is presented within canine MCT histopathology reports across the United States. The reports were collected from medical and surgical oncologists from 4 geographic regions of the USA: Midwest, Northeast, South and West. All reports were obtained between January 1st 2012 and May 1st 2015. Inclusion criteria required that the final diagnosis was MCT, a microscopic description was present, and it was not a scar revision. Three hundred and sixty-eight reports were collected from 26 contributors. While the majority of the reports contained a clinical history (85.9%), information for certain prognostic indicators such as location and mass size was lacking. Grading with both Patnaik and Kiupel systems were described in 76.5% of reports with a single system being used in 7.1% and 15.2% of reports, respectively. Subcutaneous MCT were assigned a grading scheme in 67.2% of reports with 33.3% stating appropriate limitations. Surgical margins were reported in 92% of the reports with 77.2% describing deep and lateral margins separately. Tissue composing the deep margin was only described in 10.9% of the reports. The present results indicate reporting of MCT has variability across pathologists with inconsistencies present in the reporting of clinical history, margin evaluation and subcutaneous MCT grading.

Convergence of clinical staff ratings and research ratings to assess patients with schizophrenia in nursing homes.

OBJECTIVE: A large number of older patients with serious mental illnesses, including schizophrenia, now reside in nursing homes or similar residences, yet little is known about assessments, services, or outcomes for these patients. The Minimum Data Set (MDS) is a mandatory assessment instrument for nursing care facilities, and although it has been well studied in the general nursing home population, little is known about its validity in assessing schizophrenia, which was the purpose of this study. METHODS: A group of 77 patients with schizophrenia had been recruited as part of a longitudinal study and were evaluated after their referral to nursing homes. Researchers compared ratings from the MDS with ratings of cognition and symptoms using instruments previously validated for the assessment of serious mental illness. RESULTS: The cognitive subscale of the MDS (MDS-COG) was not strongly correlated with the Mini-Mental State Examination and was generally uncorrelated with performance on neuropsychological tasks. Symptoms were underreported on the MDS and were not significantly associated with researchers' ratings. Moreover, the ratings from the MDS, unlike the researchers' ratings, were not predictive of functional status, revealing poor criterion validity. CONCLUSIONS: These findings suggest that the MDS is not a suitable rating instrument to evaluate the symptoms and functional characteristics of older patients with schizophrenia. Future work will be required to develop instruments that would allow nursing home staff to recognize and report symptoms, cognitive impairments, and functional characteristics of these patients, which are important first steps for improving treatment services.