Proposal of model for personalized early adapted cancer screening in people living with HIV: experience of "Gaetano Martino" Hospital University of Messina.

Human immunodeficiency virus (HIV) infection has historically been related to the development of specific cancers, some of which are so closely linked to the infection, such as Kaposi's Sarcoma (KS), that they have earned the name Acquired Immuno-Deficiency Syndrome (AIDS)-defining cancers (ADCs). While the development of antiretroviral therapy (ART) has decreased the incidence of AIDS-defining cancers, the resulting aging of people living with HIV (PLWH) highlighted an increased occurrence of other forms of cancer. At the "Gaetano Martino" hospital in Messina, we developed a multidisciplinary approach by creating a bridge between the Oncology Unit and the Infectious Diseases Unit to carry out screening and a more rapid diagnostic and therapeutic journey for cancers in PLWH. The goal is to improve the diagnosis of various types of cancer by involving other professionals, such as gastroenterologists and gynecologists, to ensure faster access to treatment and, therefore, a greater chance of survival. In addition, our multidisciplinary approach has also included vaccine screening, offered by the "Gaetano Martino" hospital and useful for preventing the development of specific forms of cancer in the entire population and particularly in PLWH.

Prognostic factors and outcome in cats with thymic epithelial tumours: 64 cases (1999-2021).

OBJECTIVES: To describe the clinical presentation, treatment and outcomes of cats diagnosed with thymic epithelial tumours and to determine prognostic factors for survival and recurrence. MATERIALS AND METHODS: Clinical records of cats diagnosed with a thymic epithelial tumour between 1999 and 2021 at three referral institutions were retrospectively reviewed. RESULTS: Sixty-four cats were included. Paraneoplastic syndromes were present in nine cats and metastatic disease was seen in two cats, one at diagnosis and one at the time of recurrence. Median tumour diameter was 6 cm (range, 2 to 15) and a cystic appearance was described on imaging in 25 cats. Surgical excision was attempted in 54 cats with a perioperative mortality rate of 11%. Median survival time for cats surviving to hospital discharge was 897 days (range, 21 to 3322). The 1-, 2- and 5-year survival rates for surgically treated thymic epithelial tumour were 86%, 70% and 66%, respectively. Survival was longer for cats with Masaoka-Koga stage I and II tumours compared to stages III and IV (1366 days versus 454 days; P=0.002). Masaoka-Koga stage was the only significant prognostic factor detected on multi-variable analysis, with stage III and IV tumours associated with increased risk of death (hazard ratio: 5.67, 95% confidence interval: 1.29 to 24.91, P=.021). Tumour recurrence occurred in 11 cats at a median of 564 days (range, 93 to 1095); no significant prognostic factors for recurrence were identified. CLINICAL SIGNIFICANCE: Cats with thymic epithelial tumours had a good long-term prognosis following surgery. Tumour recurrence can occur late in the disease course and ongoing monitoring should therefore be considered. Masaoka-Koga stage may influence survival time and could be used to predict outcome.

Surgical treatment of canine urethral prolapse via urethropexy or resection and anastomosis.

OBJECTIVES: The objective was to report and compare the complications and recurrence rates of urethral prolapse in dogs when treated with urethropexy, resection and anastomosis or a combined surgical technique. STUDY DESIGN: Retrospective study. MATERIALS AND METHODS: A total of 86 dogs were identified from the medical records of 10 veterinary referral hospitals from February 2012 and October 2022. Dogs were included if they underwent surgery for a urethral prolapse at first presentation. Complications were classified as minor or major based on the necessity of further surgical intervention. Complications leading to death were also considered major complications. RESULTS: Seventy-nine dogs were included, urethropexy (n=44), resection and anastomosis (n=27) and a combined surgical technique (n=8). Minor complications were identified in 41 of 79 dogs (51.9%): urethropexy 19 of 44 (43.2%), resection and anastomosis 18 of 27 (66.6%) and a combined surgical technique four of eight (50%). Major complications occurred in 23 dogs (29.1%), of which 21 were recurrence (26.6%). Recurrence occurred in 17 of 44 dogs following a urethropexy (38.6%), three of 27 dogs following resection and anastomosis (11.1%) and one of eight dogs treated with a combined surgical technique (12.5%). Recurrence of a urethral prolapse was significantly more likely following urethropexy in comparison to resection and anastomosis. CLINICAL SIGNIFICANCE: Resection and anastomosis was associated with a lower recurrence rate in comparison to urethropexy for the surgical treatment of urethral prolapse. Based on these results, we concluded that resection and anastomosis may be preferable to urethropexy for treatment of urethral prolapse at first presentation. Urethropexy, and resection and anastomosis combined surgical technique was associated with low recurrence rate; however, further studies will be needed to clarify if it provides any benefit over resection and anastomosis.

Clinical findings, surgical treatment and outcome in dogs with parotid duct ectasia: 14 cases (2010-2023).

OBJECTIVES: To describe the clinical presentation, diagnostic findings, surgical treatment and outcome of dogs diagnosed with parotid duct ectasia. MATERIALS AND METHODS: Medical records of dogs diagnosed with parotid duct ectasia between 2010 and 2023 at six small animal referral hospitals were retrospectively reviewed. Outcome was assessed by contacting the owners or referring veterinarians. RESULTS: Fourteen dogs were included. Lateral facial swelling was the most common clinical presentation. CT revealed a tortuous cavitary tubular fluid-filled structure consistent with a dilated parotid duct in all dogs. Surgical treatment included marsupialisation of the parotid duct papilla, surgical exploration of the duct alone, parotid duct marsupialisation with surgical exploration of the duct, parotidectomy or en-bloc parotid duct resection. The aetiology of parotid duct ectasia was not established in 13 of 14 dogs. In one case, a foreign body was retrieved from the duct. No recurrence of clinical signs was noted during the follow-up period (range 21 to 2900 days). CLINICAL SIGNIFICANCE: Parotid duct ectasia should be considered for dogs with a lateralised fluctuant non-painful tubular facial swelling. Surgical management was associated with a favourable prognosis without evidence of recurrence in all cases reported in the case series.

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

OBJECTIVE: 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. MATERIALS AND METHODS: 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. RESULTS: 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. CLINICAL SIGNIFICANCE: 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.

Congenital pleuroperitoneal hernia presenting as gastrothorax in five cavalier King Charles spaniel dogs.

Five cavalier King Charles spaniels were examined for acute onset of respiratory distress. Thoracic radiographs demonstrated diaphragmatic hernia and tension gastrothorax, visible as a distended stomach occupying the left caudal thoracic cavity. Exploratory midline coeliotomy confirmed congenital pleuroperitoneal diaphragmatic hernia with herniation and dilatation of the stomach. The hernia configuration was consistent in all cases, with a defect affecting the left diaphragmatic crus. Congenital pleuroperitoneal diaphragmatic hernia is a rare condition caused by a defect in the dorsolateral diaphragm. Defects of the left crus of the diaphragm could result in the herniation of the stomach into the thoracic cavity with possible subsequent tension gastrothorax. Cavalier King Charles spaniels may have a predisposition to this condition. Tension gastrothorax is an acute life-threatening consequence of gastric herniation through a diaphragmatic defect that must be promptly recognised and surgically treated.

Robot-assisted renal surgery: current indications and results.

Robotic technology is the natural evolution and simplification of traditional laparoscopy. Robotic surgery has the same benefits of traditional laparoscopic surgery in terms of cosmetic results, pain control and short in-hospital stay. However, magnified three-dimensional vision and the use of fully articulated wristed-instruments allow to increase the precision control. Recently, robotic surgery has been even more used in urology. In fact, robot-assisted radical prostatectomy (RARP) is currently the most common treatment used for localized prostate cancer in the United States. Perioperative and functional outcomes resulted significantly better after RARP. As a consequence of the diffusion of RARP, other urological procedures were performed using the robotic approach. Particular attention has been paid to the use of robotic surgery for the treatment of benign and malignant renal diseases. In 2002 the first robot-assisted pyeloplasty was performed followed by the first robot-assisted partial nephrectomy. This last procedure had widespread a lot in the last years and it can currently be considered as the main alternative to the traditional open partial nephrectomy. Finally, the evolution of technology and surgeon skills allowed us to consider the less invasive approaches also for renal transplantation surgery and vena cava tumor thrombectomy. The objective of this review was to analyze current indications and outcomes of robot-assisted procedures for the treatment of benign and malignant renal diseases.

Imaging diagnosis and minimally-invasive management of necrotizing fasciitis in a dog.

Necrotising fasciitis is a rapidly progressive, aggressive bacterial infection of the subcutis associated with significant morbidity and mortality in both man and domestic animals. To the best of our knowledge, this is the first veterinary report of magnetic resonance imaging findings in necrotising fasciitis, and the first reported case in a dog to be successfully treated with minimally invasive surgical intervention.

Robot-assisted radical prostatectomy: tips, tricks and pitfalls.

In the last decade, we have assisted to the progressive standardization of the surgical technique of robot-assisted radical prostatectomy (RARP). This article describes in details our current surgical technique to perform nerve-sparing RARP. Specifically, we took in consideration the tips, tricks and pitfalls of each step of RARP according to our experience.