Use of poliglecaprone 25 for perineal urethrostomy in cats: 61 cases (2007-2013).

OBJECTIVE To determine frequency of postoperative complications in cats undergoing perineal urethrostomy (PU) in which poliglecaprone 25 was used for closure and identify possible predisposing factors for development of complications. DESIGN Retrospective case series. ANIMALS 61 cats that underwent PU. PROCEDURES Medical records for cats that underwent PU at Gulf Coast Veterinary Specialists between 2007 and 2012 were reviewed. Information regarding signalment, perioperative conditions, surgical procedures, treatments, and postoperative complications were obtained from medical records and by telephone follow-up. RESULTS 11 of 61 (18%) cats developed minor short-term (ie, ≤ 2 months after surgery) complications, 1 of 61 (1.6%) cats developed a major short-term complication requiring surgical revision, and 16 of 38 (42%) cats developed minor long-term complications. No major long-term complications were identified. Preoperative urinary tract infection was significantly associated with development of minor short-term complications, but use of an indwelling urinary catheter after surgery was not significantly associated with development of postoperative complications. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that poliglecaprone 25 may be an acceptable suture for apposition of mucosa to skin in cats undergoing PU. Short- and long-term complication rates and percentage of cats requiring revision surgery were comparable to values reported in previous studies in which slowly absorbable or nonabsorbable sutures were used.

Lessons from the Deployment of the SPIRIT App to Support Collaborative Care for Rural Patients with Complex Psychiatric Conditions.

We report the design and deployment of a mobile health system for patients receiving primary care-based mental health services (Collaborative Care) for post-traumatic stress disorder and/or bipolar disorder in rural health centers. Here we describe the clinical model, our participatory approach to designing and deploying the mobile system, and describe the final system. We focus on the integration of the system into providers' clinical workflow and patient registry system. We present lessons learned about the technical and training requirements for integration into practice that can inform future efforts to incorporate health technologies to improve care for patients with psychiatric conditions.

Reevaluation of the resting time period when preparing whole blood-derived platelet concentrates with the platelet-rich plasma method.

BACKGROUND: The resting of platelet (PLT) pellets during the preparation of whole blood-derived PLT concentrates (PCs) is considered an essential step. A reevaluation of the rest period was conducted because preparation and storage conditions have been modified during the past 20 years. STUDY DESIGN AND METHODS: A two-site in vitro study (Study 1) was conducted with rest times of 0 to 5 minutes, 1 hour, and 4 hours (n = 31-33 per rest period). Leukoreduced PCs were stored for 5 days. A second study (Study 2) measuring in vivo viability was conducted at a third site (14 paired studies). PCs were prepared from 2 units of whole blood on the same day to simultaneously compare viability following storage and radioisotopic labeling. RESULTS: In Study 1, comparable in vitro parameters and swirling were observed with the three rest periods. The mean (+/-1 SD) values after storage for the extent of shape change and hypotonic stress parameters were 0 to 5 minutes, 16.7 +/- 7.2 and 66.0 +/- 15.7%; 1 hour, 19.1 +/- 6.9 and 69.3 +/- 17.9%; and 4 hours, 17.6 +/- 5.5 and 64.1 +/- 11.3%. In Study 2, the in vivo recovery was 49.9 +/- 15.3 and 50.9 +/- 20.2% with 0- to 5-minute and 1-hour rest periods, respectively. The corresponding survival time was 111.2 +/- 50.7 and 114.9 +/- 43.8 hours. CONCLUSION: These studies indicate comparable in vitro and in vivo viability properties with 0- to 5-minute and 1-hour rest periods and at 4 hours (in vitro only).

Sodium nitroprusside-induced deliberate hypotension to facilitate patent ductus arteriosus ligation in dogs.

OBJECTIVE: To report the use of sodium nitroprusside to induce deliberate hypotension to reduce hemorrhage and facilitate surgical ligation of complicated patent ductus arteriosus (PDA) in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Six dogs. METHODS: Hemorrhage occurred during surgical ligation of PDA in 5 dogs. Surgical dissection and isolation of the PDA were very difficult in a sixth dog that was considered to be at increased risk for ductus rupture. Sodium nitroprusside (5 to 25 microg/kg/min intravenously) was administered to these 6 dogs to induce hypotension to reduce blood loss and facilitate surgical ligation of the PDA. RESULTS: Sodium nitroprusside infusion reduced blood pressure (mean arterial pressure, 45 to 60 mm Hg) within 5 to 10 minutes and hemorrhage from the PDA, facilitating its surgical ligation. Recovery from surgery and anesthesia was uneventful in all 6 dogs. CONCLUSIONS: Sodium nitroprusside infusion can be used to induce deliberate hypotension in dogs to facilitate surgical ligation of PDA. CLINICAL RELEVANCE: Sodium nitroprusside infusion produces hypotension within 5 to 10 minutes and is easy to control, rapidly abates, and should help to facilitate surgical ligation of PDA.