[Comparison of the reoperation rates of three techniques for tibial tuberosity transposition in medial patellar dislocation]. / Vergleich der Reoperationsraten von drei Techniken zur Fixation der bei medialer Patellaluxation transponierten Tuberositas tibiae.

INTRODUCTION: A common technique for the treatment of medial patellar luxation is the lateral transposition of the tibial tuberosity. Two variations of a new surgical method with a retention plate and fixation with a wire or a security plate, were tested against each other and against the existing fixation with Kirschner wires and a tension band by the number of reoperations. The new method using a retention plate and security plate showed the lowest rate of reoperations (5 %), followed by the new technique using retention plate and wire (14 %) and the existing fixation with Kirschner wires and a tension band (34 %). A possible explanation for the good result of the new method can be the fixation of the implants on the medial side of the tibia and the non-use of Kirschner wires.

INTRODUCTION: La transposition latérale de la tubérosité tibiale est une technique courante pour le traitement de la luxation rotulienne médiale. Deux variantes d'une nouvelle méthode chirurgicale avec une plaque de rétention et une fixation avec un fil métallique respectivement un étrier en titane ont été testées l'une par rapport à l'autre et par rapport à la fixation usuelle avec des broches de Kirschner et un haubanage en fonction du nombre de réopérations. La nouvelle méthode utilisant une plaque de rétention et un étrier a montré le taux le plus bas de réopérations (5 %), suivie par la nouvelle technique utilisant une plaque de rétention et une broche (14 %) et la fixation usuelle avec des broches de Kirschner et un haubanage (34 %). Le bon résultat de la nouvelle méthode peut s'expliquer par la fixation des implants sur la face médiale du tibia et la non-utilisation de broches de Kirschner.

Comparison of four methods to -determine cage width in tibial tuberosity advancement.

INTRODUCTION: The objective of this study was to test a method for determining the width of the tibial tuberosity advancement (TTA) cage without the need for extension of the stifle joint, while producing preoperative radiographs. TTA cage size was determined by applying 4 different methods using radiograph images in mediolateral direction of fully extended stifles of dogs (n=43), with and without naturally occurring cranial cruciate ligament disease: parallel shift (PS) method, common tangent (CT) method, «2,1¼ method (cage size = 2,1 × tibia plateau length - tibial tuberosity width), and margo cranialis (MC) method (cage size = length of MC/6*1,75). Two new methods, «2,1¼, and MC were compared to the existing CT and PS methods. All 4 methods resulted in reliable cage sizes. Intraclass correlation coefficients showed an excellent reliability of the CT and PS to the «2,1¼ method and a good reliability in regards to the MC method. In conclusion, TTA cage size of the tibia anatomy alone can be determined on radiographs without the need of full extension of the stifle joint. Based on the results, two different methods of cage size measurement are recommended in order to increase diagnostic accuracy and to prevent the insertion of suboptimal cages.

INTRODUCTION: L'objectif de cette étude était de tester une méthode pour déterminer la largeur de la cage d'avancement de la tubérosité tibiale (TTA) sans avoir besoin d'extension du grasset, tout en réalisant des radiographies préopératoires. La taille de la cage TTA a été déterminée en appliquant 4 méthodes différentes, utilisant des images radiographiques dans l'axe médiolatéral des grassets complètement étendus de chiens (n ​​= 43), avec et sans pathologie naturelle du ligament croisé antérieur: méthode du décalage parallèle (PS), méthode de la tangente commune (CT), méthode «2,1¼ (taille de la cage = 2,1 × longueur du plateau du tibia ­ largeur de la tubérosité tibiale) et méthode de la margo cranialis (MC) (taille de la cage = longueur de MC/6*1,75). Deux nouvelles méthodes, «2,1¼ et MC ont été comparées aux méthodes CT et PS existantes. Les 4 méthodes ont abouti à des tailles de cage fiables. Les coefficients de corrélation intra classe ont montré une excellente fiabilité du CT et du PS avec la méthode «2,1¼ et une bonne fiabilité vis-à-vis de la méthode MC. En conclusion, la taille de la cage TTA de l'anatomie du tibia seule peut être déterminée sur des radiographies sans qu'il soit nécessaire d'étendre complètement l'articulation du grasset. Sur la base des résultats, deux méthodes différentes de mesure de la taille des cages sont recommandées afin d'augmenter la précision du diagnostic et d'empêcher la mise en place de cages sous-optimales.

Effect of hyperbaric oxygen therapy and corticosteroid therapy in military personnel with acute acoustic trauma.

INTRODUCTION: Acute acoustic trauma (AAT) is a sensorineural hearing impairment due to exposure to an intense impulse noise which causes cochlear hypoxia. Hyperbaric oxygen therapy (HBO) could provide an adequate oxygen supply. The aim was to investigate the effectiveness of early treatment with combined HBO and corticosteroid therapy in patients with AAT compared with corticosteroid monotherapy. METHODS: A retrospective study was performed on military personnel diagnosed with AAT between November 2012 and December 2017. Inclusion criteria for HBO therapy were hearing loss of 30 dB or greater on at least one, 25 dB or more on at least two, or 20 dB or more on three or more frequencies as compared with the contralateral ear. RESULTS: Absolute hearing improvements showed significant differences (independent t-test) between patients receiving HBO and the control group at 500 Hz (p=0.014), 3000 Hz (p=0.023), 4000 Hz (p=0.001) and 6000 Hz (p=0.01) and at the mean of all frequencies (p=0.002). Relative hearing improvements were significantly different (independent t-test) at 4000 Hz (p=0.046) and 6000 Hz (p=0.013) and at all frequencies combined (p=0.005). Furthermore, the percentage of patients with recovery to the functional level required by the Dutch Armed Forces (clinical outcome score) was higher in the HBO group. CONCLUSIONS: Early-stage combination therapy for patients with AAT was associated with better audiometric results at higher frequencies and better clinical outcome score.

[Characteristic hindlimb lameness presentations in dogs]. / Gangbilder bei Lahmheiten der Hintergliedmasse des Hundes.

INTRODUCTION: Lameness in dogs are caused in about 70% of the cases in the hind limb, whereof about 50% are attributed to the knee joint. The current article shows selected lameness presentations on the basis of typical case studies. The lameness videos can be viewed via the corresponding QR code scanned with your mobile phones and tablets. Supplementary information on the diagnosis and therapy rounds off the cases.

INTRODUCTION: Lors de boiteries chez le chien, la couse est à chercher dans 70% des cas au niveau des postérieurs et pour 50% au niveau du genou. Sur la base de cas typiques choisis, on présente les images de la locomotion qui y sont associées. On peut, en scannant via le QR-Code correspondant sur une téléphone mobile ou une tablette, visualiser les films. Des informations sur la pose de diagnostic et le traitement complètent les cas.

[Simple repair of Monteggia fractures in the cat]. / Einfache Methode zur Stabilisierung von Monteggia Frakturen bei der Katze.

INTRODUCTION: Monteggia fractures are rare traumatic injuries in cats and dogs. Ulna repair is mostly achieved by plates. Stable radial head fixation however is challenging. Temporary position screws have to be removed due to rotation forces in the elbow joint causing screw loosening. We present a novel and simple method using a sling technique, which holds the radial head in its physiological position and allows normal elbow movement.

Combination of Ultrasound-Guided Percutaneous Microwave Ablation and Radioiodine Therapy in Benign Thyroid Disease: A 3-Month Follow-Up Study.

PURPOSE: Pilot studies of combined therapies treating benign nodular goiters reported promising results. The aim of this study was to investigate the effectiveness of combined microwave ablation (MWA) and radioiodine therapy (RIT) with a special focus on thyroid function at the 3-month follow-up. MATERIALS AND METHODS: 15 patients (median age: 55 years) with a large goiter and benign thyroid nodules or Graves' disease were treated with the combined therapy. Serum levels of triiodothyronine (T3), thyroxine (T4), thyrotropin (TSH), thyroglobuline (Tg) and, additionally, antibody levels against thyroglobulin (TgAb), thyrotropin receptors (TRAb) and thyroid peroxidase (TPOAb) were measured at enrollment, post MWA and at the 3-month follow-up (3MFU). Furthermore, the goiter volume, I-131 dose and hospitalization time were analyzed to evaluate effectiveness. MWA was operated under local anesthesia with a system working in a wavelength field of 902 to 928 MHz. RESULTS: TSH, T4, T3 and Tg did not change at 3MFU, except for in two patients in whom the initial TSH levels improved to normal thyroid functioning levels at follow-up. One of the patients developed a high TRAb-level that receded back into the normal range. At 3MFU, the combined therapy showed a mean thyroid volume reduction of 26.4 ml ±â€Š7.9 ml (30.5 % ±â€Š4.6 % (p < 0.05)). By utilizing the combined therapy, administered activity could be reduced by 26.6 % ±â€Š4.8 % (p < 0.05) and hospitalization time by 30.9 % ±â€Š19.9 % (p < 0.05). CONCLUSION: The data confirmed the effectiveness of the combination of MWA with RIT. The combined therapy is an innovative and conservative approach and could become a safe alternative to surgery for the treatment of very large benign nodular goiters. Due to the short follow-up and the limited number of patients, further studies will be necessary. KEY POINTS: • The combined therapy shows a significant volume reduction in benign nodular goiters. • Initial MWA improves the RIT results by reducing the required therapy activity. • Thyroid function is preserved after combined therapy.

Combination of ultrasound guided percutaneous microwave ablation and radioiodine therapy in benign thyroid diseases. A suitable method to reduce the 131I activity and hospitalization time?

AIM: Goiters and thyroid nodules are an ongoing problem in healthcare. There has not been any treatment of goiters and thyroid nodules based on the combined therapy of microwave ablation (MWA) and radioiodine therapy (RIT) until now. In this study the potential benefit of a combined therapy versus single RIT is evaluated in order to achieve improvements concerning ¹³¹I-dose and hospitalization time. PATIENTS, MATERIAL, METHODS: Ten patients with goiter and benign thyroid nodules or Graves' disease were included. Pre-ablation assessments included sonographical imaging, functional imaging with 99mTc and FNAB to collect data of nodules and total thyroid volume and to exclude malignancy. Prior to treatment, radioiodine uptake test was performed. MWA was operated under local anesthesia with a system working in a wavelength field 902-928 MHz. Post-MWA, thyroid volume was recalculated ultrasonically. Due to reduced vital volume, changes of ¹³¹I-dose and hospitalization time could be monitored. RESULTS: Mean absolute thyroid volume reduction by MWA before applying RIT was 22 ± 11 ml, meaning a relative reduction of 24 ± 6% (p < 0.05). Thereby, administered activity could be reduced by 393 ± 188 MBq using the combined therapy, reflecting a relative reduction of 24 ± 6% (p < 0.05). Additionally, mean hospitalization time was decreased by 2.1 ± 0.8 days using MWA prior to RIT, implying a relative reduction of 28 ± 6% (p < 0.05). CONCLUSION: Depending on ablated volume by MWA, RIT-monotherapy requires on average 31.2% more ¹³¹I-activity than the combined therapy. The combined therapy remarkably decreases ¹³¹I-dose and hospitalization time. The combined MWA and RIT therapy is a considerable, effective and safer alternative to surgery for the treatment of very large benign nodular goiters.

Comparative investigations on the upper respiratory tract in Norwich terriers, brachycephalic and mesaticephalic dogs.

For some time Norwich terriers have been known to suffer from respiratory problems. In order to assign this weakness to a pathophysiology, 23 terriers were examined clinically, with laryngoscope and with rhinomanometry. In addition their skulls were dimensioned on radiographs. Widened nostrils, overlong soft palates and the everted laryngeal pouches were consistent with brachycephalic syndrome. Resistance values in the nasal passage corresponded to the appearance in brachycephalic dogs. Skull measurements gave inconsistent results, because length to width ratios and craniofacial angles denoted mesaticephaly, whereas the facial to cranial length ratios (S-index = 0.65) lay in the brachycephalic sector. It can be concluded, that the Norwich terrier breed is in transition towards brachycephaly with some individual dogs already suffering from the brachycephalic syndrome. Breeders are requested to introduce necessary counter measures.

On sait depuis longtemps déjà que le Norwich Terrier souffre de plus en plus de problèmes respiratoires. Afin de pouvoir donner une explication pathophysiologique à ces problèmes, on a examiné 23 Norvich Terriers sur le plan clinique, laryngoscopique, rhino-manométrique ainsi qu'avec des radiographies du crâne. Des narines larges, un voile du palais trop long et des ventricules laryngés éversés, de même que des mesures de résistance augmentées dans les conduits nasaux correspondaient à l'image du syndrome brachycéphale. Les mesures du crâne présentaient un tableau non uniforme. L'index longueur-largeur et l'angle cranio-facial correspondaient à ceux de chiens mésocéphales, alors que l'index splanchnocrâne-neurocrâne (Index S de 0.65) était clairement dans la zone du brachicéphalisme. On peut en déduire que le Norwich Terrier se trouve sur le chemin du brachicéphalisme et que certains chiens souffrent déjà d'un syndrome brachycéphale. Les éleveurs doivent donc prendre des mesures pour lutter contre cette évolution.

Weight gain and lipid-glucose profiles among patients taking antipsychotic medications: comparisons for prescriptions administered using algorithms versus usual care.

The purpose of this study was to determine if treatment strategy had a significant effect on the occurrence of physiological changes consistent with metabolic syndrome and/or type 2 diabetes in patients using atypical antipsychotic medications. The four variables assessed were: weight gain, fasting blood sugar, triglycerides and cholesterol. The two strategies compared were (1) evidence-based practice, derived from the Texas Medication Algorithm Project, and (2) practitioner preference. A retrospective chart review was performed on patients diagnosed with a chronic psychiatric disorder being treated with atypical antipsychotics. The dates of the reviewed records were from 1 January 2008 to 31 December 2008. The sample of patients totaled 113. Statistical analysis included logistic regression for each of the four variables assessed. The use of evidence-based practice guidelines was found to have strong positive effects on two of the four variables assessed. Further studies need to be conducted to include medications being taken to lower lipids and blood sugar. Overall, the use of evidence-based practice guidelines has a positive effect on weight, triglycerides and cholesterol. It is important that patients be closely monitored and changes made in a timely manner to minimize adverse effects of atypical antipsychotics.

[Histological criteria and metastasis of squamous cell carcinoma of the pinna]. / Histologische Kriterien und Metastasierungshäufigkeit von Plattenepithelkarzinomen der Ohrmuschel.

INTRODUCTION: According to the guidelines for cancer of the skin in the head and neck region of the German association of Otolaryngology, Head and Neck surgery squamous cell carcinoma (SCC) of the pinna are classified by using the current TNM system of skin cancer. As soon as cartilage is infiltrated, irrespective of other criteria like tumour size, SCC of the thin skin of the pinna are classified as T4 category. As therapy considerably depends on the TNM stage a review of the prognostic value of cartilage infiltration as well as other histological criteria seems to be justified. METHODS: Medical records of all patients (n = 36) being operated for SCC of the pinna between August 1988 and January 2004 at our department were retrospectively analysed with regard to a statistical correlation of histological criteria, cervical lymph node metastases and prognosis. RESULTS: In 36 cases a histological re-evaluation could be performed on the original tumour samples (34 male symbol : 2 female symbol; average age was 76 years, with an age interval of 54 - 99 years). 26 SCC cases were smaller than 2 cm, 8 cases between 2 and 5 cm and 2 cases bigger than 5 cm of size. 36 % of SCC cases had infiltration of the auricular cartilage. Statistical analysis did not show a statistical correlation of either cartilage infiltration, tumour size bigger than 2 cm or 1 cm, tumour grading and tumour depth with regard to lymph node metastases. DISCUSSION: According to our results, cartilage infiltration as single criterion of inclusion into a T4 category should be analysed cautiously. The anatomical peculiarity of the pinna where cartilage lies directly beneath very thin skin should be taken into account. A survey of a bigger group of patients e. g. as a multicenter study would be desirable for such a rare malignancy.

[Perineal hernia in dogs--colopexy, vasopexy, cystopexy and castration as elective therapies in 32 dogs]. / Perineale Hernie beim Hund--Colopexie, Vasopexie, Cystopexie und Kastration als Therapie der Wahl bei 32 Hunden.

In 32 male dogs colopexy, vasopexy, cystopexy and castration was performed for the treatment of perineal hernia. Recurrence rate in this study is 22%, what is comparable to other studies using different methods. The degree of severity and the number of complications is lower with this technique than with others. Enlargement of the prostate was evident in 59% and bladder retroflexion in 22% of the dogs. A celiotomy allows to recognize, assess, reduce and fix displaced organs which is not possible by using other methods. The aim is to regain the tubular structure of the ampulla recti and to fix prostate and bladder cranioventrally to the pelvic entrance. The castration performed at the same time causes the prostate gland to atrophy within 2-3 weeks, what makes the pelvic entrance even wider and the dogs return to normal defecation.

[A case of sesamoid bone fragmentation in the leg as the cause of lameness in a female Rottweiler]. / Ein Fall von Sesambeinfragmentierung als Lahmheitsursache bei einer Rottweilerhündin.

An eight-month-old female rottweiler was presented with a history of intermittent lameness of the right hindlimb of 4 weeks duration. Radiographs showed a fragmentation in two plantar sesamoid bones of the metatarsophalangeal joint. Based on these clinical and radiographic signs sesamoid disease of the 2nd and 7th sesamoid bone in the right hindpaw was diagnosed. The fragmented sesamoids were surgically removed and histologically examined. The treatment was successful and the dog became lamnessfree. Additional radiographs showed fragmentations of sesamoid bones VII of both the forepaws, but they did not cause any lameness.

[A surgical method for the stabilization of traumatic subluxation, luxation and fractures of the thoracic and lumbar vertebrae in dogs and cats]. / Eine chirurgische Methode zur Stabilisation von traumatischen Subluxationen, Luxationen und Frakturen der Brust- und Lendenwirbelsäule bei Hunden und Katzen.

A dynamic fixation technique, that is technically easy and requires a minimal instrumentarium, is described for the treatment of subluxations, luxations and fractures of the thoracic and lumbar vertebral column in dogs and cats. Results of its application in 34 dogs and three cats are reported.

[The diagnosis of patellar luxation in small animals]. / Die Diagnostik der Patellarluxation des Kleintieres.

A standard diagnostic procedure for patellar luxation is described. It is based upon the patellar luxations grade 1 to 4, which have been published before, and contains additional definitions in terms of the animals positioning toward the examiner.

Effects of preservation methods, parasites, and gut contents of black flies (Diptera: Simuliidae) on polymerase chain reaction products.

Molecular analysis of biological specimens usually requires extraction of high-molecular weight DNA free of foreign DNA contaminants. DNA was extracted from black flies at different life stages that had been preserved by 4 methods: larvae and adults in ethanol, larvae in Carnoy's solution, adults on card-points, and adults hand-swatted and sun-dried. Using specific primers for the mitochondrial ND4 gene, a 257-bp amplicon was obtained from specimens preserved by ethanol, card-point mounting, and sun-drying. Successful amplification often required DNA dilutions > or = 1:20 (< 1-10 ng). DNA from specimens preserved in Carnoy's solution (ethanol: acetic acid, 3:1) yielded degraded DNA, resulting in fewer successful amplications. Parasitic nematodes and, to a lesser extent, gut contents resulted in extra products when amplified with randomly amplified polymorphic DNA (RAPD) primers. Sufficient DNA was extracted from the head of a larva for a successful polymerase chain reaction (PCR), eliminating the need to remove the contaminating gut and parasites.

[Clinical experiences with the therapy for patella luxation of small animals using sulcoplasty and lateral and cranial relocation of the tuberositas tibiae]. / Klinische Erfahrungen bei der Therapie der Patellarluxation des Kleintieres mittels Sulkoplastik und seitlicher und kranialer Verschiebung der Tuberositas tibiae.

Twenty cases with patellar luxation in dogs and cats, in which a sulcoplasty and cranialisation of the tuberositas tibiae were performed, were investigated and reviewed retrospectively. Twelve knees were available for follow-up after a mean period of 15 months. Clinical scoring of patients showed eight with no lameness, three with an occasional weightbearing lameness, and one with a frequent weightbearing lameness. The patella was stable and could not be luxated in ten out of twelve cases. Degenerative joint disease was slightly progressive in the postoperative period. It did not impair the outcome of the procedure.

Behavioral contracting to improve adherence in patients with thalassemia.

Twenty-three patients with thalassemia contracted to improve their adherence with subcutaneous desferrioxamine by increasing their number of days of use. Adherence, as measured by empty vial counts, was positively reinforced by careful monitoring and behavioral reward system. Contingency contracting was successful in 76% of patients over a 6-month period, with 69% maintaining improvement in adherence 2 months after the program. Findings supported the efficacy of behavioral intervention strategies in the care of patients with chronic illness.