[Diagnosis and emergency management of radiological incidents]. / Diagnostic et prise en charge en urgence des incidents radiologiques.

Incidents involving ionizing radiation pose a risk of immediate and long-term clinical consequences for both victims and responders in the event of secondary contamination. Rapid identification of the problem and a coordinated response are crucial. This article summarizes the key challenges related to the emergency management of a single patient or multiple victims, addressing the importance of recognizing such a case, radioprotection measures, decontamination, and available treatments.

Les incidents impliquant des rayonnements ionisants représentent un risque aux conséquences cliniques immédiates et à long terme, tant pour les victimes que pour les intervenants en cas de contamination secondaire. L'identification rapide de la problématique et une réponse coordonnée sont cruciales. Cet article résume les principaux enjeux liés à la prise en charge en urgence d'un patient unique ou de plusieurs victimes, en abordant l'importance de la reconnaissance d'un tel cas, des mesures de radioprotection, de la décontamination et des traitements disponibles.

Bilateral Global Nephrocalcinosis in a Uremic Puppy.

This study explores kidney disease in young dogs, focusing on early diagnosis, management, and the importance of staging for effective treatment. Highlighting mineral metabolism imbalances and complications such as nephrocalcinosis, the study presents a case of severe renal failure with uremic syndrome and bilateral nephrocalcinosis in a 50-day-old puppy. Despite intensive care, the puppy's condition deteriorated rapidly, leading to euthanasia. The study underscores the challenges in diagnosing and managing canine nephrocalcinosis in young animals. It emphasizes the need for further research to improve the understanding and treatment outcomes in such cases, ultimately enhancing the quality of life for animals suffering from this rare condition.

Surgical Site Infiltration with Comfort-in Device and Traditional Syringe in Dogs Undergoing Regional Mastectomy: Evaluation of Intra- and Postoperative Pain and Oxidative Stress.

The surgical site infiltration of a local anesthetic is defined as the direct injection of a drug. This study aimed to compare the effects of surgical site infiltration with 4 mg kg-1 lidocaine using a Comfort-in device and traditional syringe on oxidative status and intra- and postoperative pain in dogs undergoing regional mastectomy. Sixty adult female dogs divided into C (Comfort-in device), S (traditional syringe), and CTR (control) groups received 2 µg kg-1 dexmedetomidine and 4 mg kg-1 tramadol IM, 5 mg kg-1 tiletamine/zolazepam IV, and isoflurane. The physiological and anesthesiological parameters were measured. The assessment of intra- and postoperative responses to the surgical stimulus was performed using a cumulative pain scale (CPS score of 0-4) and the Colorado Pain Scale (CSU-CAPS score of 0-4). The hematological and biochemical parameters and inflammatory oxidative status were measured. The CPS scores showed no significant differences between the C and S groups (p = 0.236), while the comparison between the CTR, C, and S groups, respectively, showed a significant difference (p < 0.001). The postoperative analgesia scores were significantly lower in the C group compared to those of the S and CTR groups (p < 0.001). In the C group, no subject received rescue analgesia during the intra- and postoperative periods. The level of oxidative inflammatory stress was lower in group C than those in S and CTR groups, and no side effects were observed in all the groups.

Patient-Specific 3D-Printed Osteotomy Guides and Titanium Plates for Distal Femoral Deformities in Dogs with Lateral Patellar Luxation.

The aim of this study was to describe the diagnosis and treatment of grade IV lateral patellar luxation (LPL) in two adult large breed dogs with complex femoral deformities using patient-specific three-dimensionally (3D) printed osteotomy guides and implants. Computed tomography (CT) scans were obtained for virtual surgical planning (VSP) using computer-aided design (CAD) software, which allowed for 3D reconstruction and manipulation of the femoral deformities, providing a preoperative view of the correction. Of the two patients, one was affected bilaterally and the other unilaterally, but both dogs were from the same litter. Therefore, the healthy femur of the unilaterally affected patient was used as the physiological reference for the virtual surgical correction. Three distal femoral trapezoid osteotomies (DF-TO) followed by reduction and internal fixation with plates were performed using patient-specific 3D-printed osteotomy guides and implants. This type of osteotomy permitted correction of procurvatum in all the femurs to increase knee extension, raise the dog's lumbar spine and correct the kyphosis. Preoperative, expected and postoperative femoral angles were compared to evaluate the efficacy of virtual surgical planning and the outcome of surgical correction. Radiographic follow-up, passive range of motion and functional recovery were recorded. There were no major complications requiring revision surgery. Significant clinical improvement was observed in both patients. This study suggests that the treatment used represents a viable surgical alternative to restore limb alignment in patients with complex femoral deformities.

Tramadol vs. Lidocaine Administered Intraperitoneally and in Incisional Lines for the Intraoperative and Postoperative Pain Management of Romifidine-Telazol-Anesthetized Swine Undergoing Umbilical Hernia Repair.

The aim of the study was to compare the analgesic efficacy of tramadol and lidocaine for local anesthesia during umbilical hernia repair in swine. The study was performed on 66 large white crossbred swine. The swine received a mixture of tiletamine/zolazepam at 5 mg/kg and romifidine at 80 µg/kg, administered intramuscularly. Then, they were divided into three groups (n = 22) that received different treatments with lidocaine at 4 mg/kg and tramadol at 4 mg/kg. The LL group received lidocaine both by infiltration of the surgical planes and intraperitoneally. The LT group received lidocaine by infiltration of the surgical planes and tramadol intraperitoneally. The TT group received tramadol both by infiltration of the surgical planes and intraperitoneally. In all groups, the infiltration of the surgical planes into the umbilical region involved both the skin and muscle planes. Heart rate, noninvasive arterial blood pressure, and respiratory frequency were recorded during surgery. The response to the surgical stimulus was evaluated using a cumulative pain scale (the cut-off point for rescue analgesia was set to 10). Postoperative pain was assessed using the UNESP-Botucatu pig composite acute pain scale (the cut-off point was set to 4). The trend of physiological variables was adequate for patients under anesthesia. No subject required intraoperative and postoperative rescue analgesia. Tramadol could therefore be used for pain management in livestock.

Inhibiting IL-6 in medicine: a new twist to sustain inhibition of his cytokine tin the therapy of Pulmonary Arterial Hypertension.

Pulmonary arterial hypertension (PAH) is a chronic, progressive disease characterized by an increase in blood pressure in the lungs' arteries. It can occur in a variety of species, including humans, dogs, cats, and horses. To date, PAH has a high mortality rate in both veterinary and human medicine, often due to complications such as heart failure. The complex pathological mechanisms of PAH involve multiple cellular signalling pathways at various levels. IL-6 is a powerful pleiotropic cytokine that regulates several phases of immune response, inflammation, and tissue remodelling. The hypothesis of this study was that the use of an IL-6 antagonist in PAH could interrupt or mitigate the cascade of events that leads to the progression of the disease and the worsening of clinical outcome, as well as tissue remodelling. In this study, we used two pharmacological protocols with an IL-6 receptor antagonist in a monocrotaline-induced PAH model in rats. Our results showed that the use of an IL-6 receptor antagonist had a significant protective effect, ameliorating both haemodynamic parameters, lung and cardiac function, tissue remodelling, and the inflammation associated with PAH. The results of this study suggest that the inhibition IL-6 could be a useful pharmacological strategy in PAH, in both human and veterinary medicine.

Fisetin, a Natural Polyphenol, Ameliorates Endometriosis Modulating Mast Cells Derived NLRP-3 Inflammasome Pathway and Oxidative Stress.

A chronic, painful, and inflammatory condition known as endometriosis is defined by the extra-uterine development of endometrial tissue. The aim of this study was to evaluate the beneficial effects of fisetin, a naturally occurring polyphenol that is frequently present in a variety of fruits and vegetables. Uterine fragments were injected intraperitoneally to cause endometriosis, and fisetin was given orally every day. At 14 days of treatment, laparotomy was performed, and the endometrial implants and peritoneal fluids were collected for histological, biochemical, and molecular analyses. Rats subjected to endometriosis presented important macroscopic and microscopic changes, increased mast cell (MC) infiltration, and fibrosis. Fisetin treatment reduced endometriotic implant area, diameter, and volumes, as well as histological alterations, neutrophil infiltration, cytokines release, the number of MCs together with the expression of chymase and tryptase, and diminished α smooth muscle actin (α-sma) and transforming growth factor beta (TGF ß) expressions. In addition, fisetin was able to reduce markers of oxidative stress as well as nitrotyrosine and Poly ADP ribose expressions and increase apoptosis in endometrial lesions. In conclusion, fisetin could represent a new therapeutic strategy to control endometriosis perhaps by targeting the MC-derived NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome pathway and oxidative stress.

Levobupivacaine Combined with Cisatracurium in Peribulbar Anaesthesia in Cats Undergoing Corneal and Lens Surgery.

The aims of the study included evaluating the effects of levobupivacaine combined with cisatracurium on akinesia and mydriasis when administered by peribulbar injection, and evaluating if the chosen dose of cisatracurium is enough to avoid the use of systemic neuromuscular blockade in cats. The animals were divided into four groups as follows: group L received 1.25 mg kg-1 levobupivacaine administered by peribulbar injection; group LC received the same dose of levobupivacaine combined with 0.01 mg kg-1 of cisatracurium administered by peribulbar injection; group C received 0.01 mg kg-1 of cisatracurium administered by peribulbar injection; group GC received 0.01 mg kg-1 of cisatracurium intravenously. Physiological variables, intraocular pressure, akinesia, and mydriasis were measured before and up to 30 min after peribulbar injection. The onset of akinesia, duration of akinesia, and train of four (TOF) were evaluated. Physiological variables remained in the physiological range in all groups. Effective akinesia and mydriasis were observed in all groups. The (TOF) was 0.9 in all groups. Throughout the study was observed in group LC a shortened onset of akinesia and a prolonging its duration. The peribulbar injection of cisatracurium and levobupivacaine provided effective akinesia and mydriasis, and shortened the onset of akinesia while prolonging its duration.

Uroprotective and pain-relieving effect of dietary supplementation with micronized palmitoyl-glucosamine and hesperidin in a chronic model of cyclophosphamide-induced cystitis.

Introduction: Feline idiopathic cystitis is a common, chronic-relapsing disorder of the lower urinary tract. In addition to environmental modification/enrichment, long-term and safe treatment targeting specific pathophysiological changes may be of help. In this context, effective dietary interventions hold clinical promise. Palmitoyl-glucosamine (PGA) and hesperidin (HSP) are safe and authorized feed ingredients for animal nutrition under European regulations. Methods: The current study aimed to investigate whether a 3:1 mixture of micronized PGA and HSP could represent a novel mechanism-oriented approach to chronic cystitis management. A newly validated rat model of cyclophosphamide (CYP)-induced chronic cystitis was used (40 mg/kg, three intraperitoneal injections every 3rd day). Animals were randomized to orally receive either vehicle or PGA-HSP at a low (72 + 24 mg/kg) or high (doubled) dose for 13 days, starting 3 days before the chronic CYP protocol, with mesna (2-mercaptoethane-sulfonate) being used as a reference drug. Results: Higher PGA-HSP dose was effective at relieving chronic visceral pain, as measured by mechanical allodynia test (von Frey test). The severity of cystitis was also significantly improved, as shown by the reduced sonographic thickening of the bladder wall, as well as the decrease in edema, bleeding and bladder to body weight ratio compared to the vehicle treated group. A significant decrease of MPO activity, MDA level and fibrosis at Masson's trichrome staining was also observed in animals administered PGA-HSP in comparison to vehicle treated ones. The CYP-induced increase in bladder mRNA expression of pro-inflammatory cytokines was also significantly counteracted by the study mixture. Moreover, CYP-induced bladder mast cell accumulation and releasability were significantly decreased by PGA-HSP (even at the low dose), as determined by metachromatic staining, chymase and tryptase immunostaining as well as enzyme-linked immunosorbent assay for histamine and 5-hydoxytriptamine. Discussion: PGA-HSP is able to block CYP-induced decrease of tight junction proteins, claudin-1 and occludin, thus preserving the urothelial bladder function. Finally, neuroinflammatory changes were investigated, showing that dietary supplementation with PGA-HSP prevented the activation of neurons and non-neuronal cells (i.e., microglia, astrocytes and mast cells) at the spinal level, and counteracted CYP-induced increase of spinal mRNA encoding for pro-inflammatory cytokines. Altogether, the present findings confirm the uroprotective and pain-relieving effect of PGA-HSP and pave the way to potential and relevant clinical applications of the study supplement in feline idiopathic cystitis.

Hernioplasty with Peritoneal Flap for the Surgical Treatment of Umbilical Hernia in Swine.

BACKGROUND: Umbilical hernia is one of the most common developmental defects in swine, producing large economic losses for farmers, forced to slaughter animals at a younger age and therefore at a lower weight to prevent fatal complications. This study describes a surgical technique to repair umbilical hernia through the use of autologous prostheses, allowing recovery of the affected animals; Methods: After a general examination of the swine and examination of the lesions, the swine were anesthetized and underwent surgery. The surgery was performed by combining the traditional herniorrhaphy with the inclusion and fixation of a peritoneal flap obtained from the incision of the same hernial sac; Results: Follow-ups were carried out at 7, 30 and 60 days and demonstrated healing in all of the treated subjects; Conclusions: The use of this surgical technique allows for providing resistance to herniorrhaphy performed through the use of a cost-free autologous biomaterial prosthesis, with excellent tissue compatibility. This might allow for reducing significantly the rate of relapses and eliminating the risk of rejection.

Regulation of Apoptosis and Oxidative Stress by Oral Boswellia Serrata Gum Resin Extract in a Rat Model of Endometriosis.

Endometriosis (EMS) is a gynecological disease characterized by inflammation, oxidative stress, and apoptosis dysregulation. This study aims to evaluate the effect of Boswellia serrata gum resin extract (BS) on the endometriotic lesions in a rat model of endometriosis. We divided female rats into three groups, including Sham, EMS, EMS + BS. In the EMS and EMS + BS groups, pathology was induced and after 7 days by the abdominal high-frequency ultrasound (hfUS) analysis the presence of the endometriotic lesions was confirmed. Subsequently, the EMS + BS group was administered with BS (100 mg/Kg) daily for another 7 days. At the end of the experiment, the hfUS analysis was repeated and the animals were sacrificed to evaluate the size and histoarchitecture of the endometriotic implants. Pelvic ultrasound showed increased size of the endometriotic lesions in the Endo group, while BS administration reduced the lesion size. The macroscopic analysis confirmed the reduced area and volume of the endometriotic lesions of the EMS + BS group. The histological analysis showed reduced characteristic of ectopic stroma and glands in the animals treated with BS. Western blot analyses were conducted to evaluate the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway. BS increases the expression of Nfr2 in the nucleus and the expression of its downstream antioxidant proteins NQO-1 and HO-1. Moreover, it reduced lipid peroxidation and increased glutathione (GSH) levels, and glutathione peroxidase (GPx) and superoxide dismutase (SOD) activities. BS administration also restored the impaired apoptotic pathway in the lesions by reducing Bcl-2 expression and increasing Bax and cleaved caspase 9 levels. The BS apoptotic effect was also confirmed by the cleavage of PARP, another specific marker of apoptosis, and by the TUNEL assay. Our results show that BS administration resulted in an effective and coordinated suppression of Endo owing to its antioxidant and antiapoptotic activities.

Effects of Cisatracurium in Sevoflurane and Propofol Requirements in Dog-Undergoing-Mastectomy Surgery.

The purpose of the present study was to test whether the addition of cisatracurium in combination with propofol and sevoflurane would result in a change in doses of used anesthetic drugs. Ten dogs (Group A) undergoing elective unilateral mastectomy surgery were included in the study. To induce and maintain anesthesia, subjects received propofol and sevoflurane at varying doses; analgesia was performed with remifentanil. After three months, the same subjects (Group B) underwent contralateral mastectomy and received the same anesthetic protocol with the addition of cisatracurium at a dosage of 0.2 mg/kg−1. The following parameters were monitored during anesthesia: heart rate, systolic blood pressure, end-tidal CO2, oxygen saturation, halogenate requirement, and rectal temperature at baseline (T0), induction (T1), 5 (T5), 10 (T10), 15 (T15), 20 (T20), 25 (T25), 30 (T30), and 35 (T35) time points. In Group A, halogenate requirement was reduced at all the time points other than T1 (p < 0.001); in Group B, the percentage of halogenate requirement was already reduced at T1 and remained constant during the experimental period, showing no significant intragroup differences. The dose requirements of sevoflurane and propofol varied significantly between the two groups, with significantly lower dosages in the Group B (the cisatracurium-treated group). Moreover, patients treated with cisatracurium showed a stable anesthetic plan. The nondepolarizing-muscle-relaxant cisatracurium besylate could be considered a useful adjunct to anesthetic protocols.

Prevention of recurrent respiratory infections : Inter-society Consensus.

Recurrent respiratory infections (RRIs) are a common clinical condition in children, in fact about 25% of children under 1 year and 6% of children during the first 6 years of life have RRIs. In most cases, infections occur with mild clinical manifestations and the frequency of episodes tends to decrease over time with a complete resolution by 12 years of age. However, RRIs significantly reduce child and family quality of life and lead to significant medical and social costs.Despite the importance of this condition, there is currently no agreed definition of the term RRIs in the literature, especially concerning the frequency and type of infectious episodes to be considered. The aim of this consensus document is to propose an updated definition and provide recommendations with the intent of guiding the physician in the complex process of diagnosis, management and prevention of RRIs.

Locking compression plates versus locking plates for tibial plateau levelling osteotomy in dogs: progression of osteoarthritis, bone healing score and lameness degree.

BACKGROUND: The partial or complete cranial cruciate ligament rupture is a common skeletal disease affecting the stifle joint in dogs. The tibial plateau levelling osteotomy, performed with several synthesis systems, changed the approach to its treatment in dogs. The aim of this study was to compare two types of fixation implants, locking compression system and locking system, evaluating radiographically the progression of osteoarthritis of the stifle joint in dogs with complete cranial cruciate ligament deficiency treated surgically with tibial plateau levelling osteotomy. Moreover, we evaluated bone healing and lameness scores to show biomechanical effects by the implant used. Twenty-eight dogs, who met the inclusion criteria, were divided into two groups. Group A: 14 dogs treated using locking compression plates; Group B: 14 dogs treated using locking plates. Radiographic osteoarthritis scores were evaluated up to 1 year following tibial plateau levelling osteotomy. At each visit, animals were clinically and radiographically assessed. Each dog was evaluated before (T0) and after two (T2) and twelve (T12) months after the surgery. At T2 the stage of bone healing was evaluated. The clinical follow up was performed before the surgery and at 10, 15 and 20 days after the surgery, grading the lameness at walk and trot. RESULTS: An increase in osteoarthritis score at T12 versus T0 in both groups was detected. A decrease of the lameness score was observed in Group A versus Group B. The healing score system at T2 showed a lower score in Group A versus Group B. CONCLUSIONS: The osteoarthritis score following tibial plateau levelling osteotomy did not differ when comparing the two different fixation systems. The locking compression system allowed a more rapid functional recovery of the limb and a quicker bone healing than the locking system. Locking compression system should be carefully considered for dogs subjected to tibial plateau levelling osteotomy surgery, because it may reduce the recovery time.

Protein hydrolysates from anchovy waste: purification and chemical characterization.

The aim of this study is to prompt the recovery of industrial by-products through the production of new functional foods; it takes advantage from new throughput technologies with low environmental impact and high economic sustainability. In the field of fish processing, in order to recover the worthy protein-rich fish waste, residues from the production of Anchovies (Engraulis encrasicolus) have been converted into hydrolysate through enzymatic treatment. The obtained hydrolysate product showed a promising biological and nutritional content made by differently sized peptides and free amino acids endowed with assessed benefic effects. The study showed the possibility to produce a dry powder with an activity water (aw) of 0.3-0.5 and an essential amino acids (EAA) fraction of 42.0% over the total amino acids (TAAs). These results pave the way to the smart recovery of commercial products featured by high nutritional value, either as stand-alone items or as components of functional foods.

Impact of Dual-Energy CT in the Emergency Department: Increased Radiologist Confidence, Reduced Need for Follow-Up Imaging, and Projected Cost Benefit.

OBJECTIVE. The purpose of this study was to analyze the contribution of dual-energy CT (DECT) to radiologist interpretation in the emergency department (ED) to determine whether recommendations for follow-up imaging decrease. MATERIALS AND METHODS. Reports of all DECT studies performed in an ED in 2016 were reviewed. A board-certified radiologist noted the number of times a report indicated that use of DECT techniques contributed to radiologist interpretation. For studies containing DECT findings in the report, the mixed datasets, representing conventional CT images, were read again separately. The difference between the numbers of follow-up studies recommended after conventional CT and DECT was converted into U.S. dollars by use of the Medicare fee schedule to estimate a projected cost benefit due to any reduction in follow-up imaging. RESULTS. The study included 3159 cases. DECT findings potentially altered management in 298 (9.4%) cases, increased diagnostic confidence in 455 (14.4%) cases, provided relevant information in 174 (5.6%) cases, helped characterize an incidental finding in 44 (1.4%) cases, and were mentioned to be noncontributory in three (0.09%) cases. DECT was not mentioned in the report in 2272 cases (71.9%). DECT findings avoided 162-191 recommended follow-up MRI examinations, 21-28 CT examinations, and 2-25 US examinations compared with conventional CT alone. The DECT findings also prompted one additional recommended interventional angiography procedure, one ventilation-perfusion scan, and one imaging-guided biopsy. The projected net cost reduction was $52,991.53-61,598.44. CONCLUSION. DECT added value to routine ED imaging by increasing diagnostic confidence, leading to a reduction in the number of recommended follow-up studies and a projected cost benefit.

Use of contrast-enhanced ultrasound for assessment of nodular lymphoid hyperplasia (NLH) in canine spleen.

BACKGROUND: Nodular lymphoid hyperplasia (NLH) is one of the most common non-neoplastic splenic lesions in dogs, especially in old ones, showing a splenic enlargement. More recent studies have been focused on Contrast Enhanced Ultrasonography (CEUS) analysis of the spleen for establishing normal perfusion patterns and blood pool phase peculiarities of focal lesions. The aim of the study was to evaluate the qualitative and quantitative CEUS analysis of the canine splenic NLH, characterizing the CEUS pattern of this pathology on 20 clinical cases. RESULTS: A prospective, observational study was performed using a system equipped with contrast-tuned imaging technology. Mechanical Index was set from 0.08 to 0.11; the contrast medium was a second generation contrast medium composed of sulphur hexafluoride encapsulated of a shell of phospholipids (SonoVue®). Qualitative and quantitative assessment of the enhancement pattern of splenic NLH were performed. Cytology and histology identified 20 splenic NLH. All of the benign hyperplastic lesions assessed were isoechoic with a homogeneous pattern than the surrounding normal spleen, during the wash-in phase (10-20 s) of the CEUS exam. Before finishing the wash-in phase, 20-45 s from the contrast medium inoculation, 19/20 benign nodules became markedly hypoechoic to the adjacent spleen. Sensitivity of hypoechoic pattern for NLH was 95%. CONCLUSIONS: These findings should prove useful in the evaluation of focal splenic masses in dogs. Since enhancement and perfusion patterns of NLH seem to coincide with some neoplastic lesions of the spleen previously reported, in clinical practice attention must be paid to the final diagnosis of canine splenic lesions using only the CEUS exam.

Quantitative evaluation of canine urinary bladder transitional cell carcinoma using contrast-enhanced ultrasonography.

BACKGROUND: In veterinary medicine, contrast-enhanced ultrasonography allowed the accurate quantification of liver, splenic and kidney vascularization in healthy dogs and the differentiation between malignant and benign hepatic, renal, and splenic nodules in dogs and cats based on perfusion patterns. The utility of contrast-enhanced ultrasonography in other applications is still under study. The aim of this study was to develop diagnostic criteria by contrast-enhanced ultrasonography in 8 client-owned adult dogs affected by urinary bladder transitional cell carcinoma with definitive diagnosis made by cytopathologic evaluation after suction biopsy. The contrast enhancement pattern and the quantification of blood flow parameters of this tumor were reported. RESULTS: Examinations with B-mode, Doppler ultrasonography and contrast-enhanced ultrasonography were performed in all not sedated dogs. Assessments of bladder masses and bladder wall infiltration were performed. Each dog received 2 bolus injections of sulfur hexafluoride during the contrast-enhanced ultrasonography. Quantitative analysis of the contrast-enhanced ultrasonography images were performed. For each dog, one region of interest was manually drawn around the entire tumor. Software analysis of contrast-enhanced time-intensity curves was used to identify peak enhancement, time to peak enhancement, regional blood volume, regional blood flow, and mean transit time. Contrast-enhanced ultrasonography showed an avid enhancement of the tumour tissue, with a heterogeneous or homogeneous pattern. The exam also showed the loss of planes between the lesion and the muscular layer. The presence of vascularized tissue through the bladder wall confirms the infiltrative feature of the tumour. Post-processing quantitative analysis showed a time-intensity curve with a rapid wash-in, a low level of signal intensity and a slow wash-out. CONCLUSIONS: Contrast-enhanced ultrasonography provided useful clinical information and defined a vascular enhancement patterns and calculated parameters associated with TCC. It may be a useful, noninvasive and reproducible tool for detecting these tumors in dogs.

Interventional spine procedures under CT guidance: How to reduce patient radiation dose without compromising the successful outcome of the procedure?

This technical note proposes a method to reduce radiation dose for spine interventions under CT guidance without compromising the successful outcome of the procedure. Two consecutive periods of 14months before and after optimization were investigated with 162 and 440 patients, respectively. By optimizing the acquisition parameters (decreased kV and mAs) and appropriately adjusting the reconstruction (kernels, slice thickness, etc) and visualization parameters, image quality was maintained suitable to perform the procedure. By reducing both kV and mAs, dose was reduced by 72% on fluoroscopy mode (i-fluoro) and sequential mode (i-sequence). Moreover, dose was reduced by 58% on helical mode (i-spiral). Depending on the radiologist, the fluoroscopy time was decreased by between 37% and 56%. Acquisitions with i-sequence were less irradiating than the i-fluoro or the i-spiral modes. Radiation doses were reduced by 65% for infiltrations, 51% for vertebral expansions, and 56% for bone biopsies. Median (1st quartile; 3rd quartile) effective dose were 2.1 (1.3; 3.5)mSv, 10.8 (6.7; 18.3)mSv for and 3.0 (2.4; 4.3)mSv, respectively. Radiologists reported "satisfactory" image quality. During interventional spine procedures under CT scan, reducing kV and mAs associated with the use of i-sequence substantially reduces patient dose.

Outcomes of Recurrent Acute Otitis Media in Children Treated for Dental Malocclusion: A Preliminary Report.

Aim. To investigate the role of dental malocclusion treatment in the outcomes of Recurrent Acute Otitis Media (RAOM). Materials and Methods. The clinical outcome (number of acute recurrences in 12 months) of 61 consecutive children treated medically for RAOM was analysed. Children underwent an odontostomatologic evaluation, a fiberoptic endoscopy, and skin-prick tests. Results. 32 children (group A) were diagnosed with dental malocclusion and treated with a mandibular repositioning plate. Dental malocclusion was ruled out in the other 29 patients with RAOM, and they were used as controls (group B). The two groups were homogeneous in terms of sex, exposure to RAOM risk factors, skin test results, and adenoid hypertrophy, while age was significantly higher in group A. Age, sex, exposure to RAOM risk factors, adenoid hypertrophy, and skin test results were not associated with RAOM outcome. Children in group A treated for dental malocclusion were strongly associated with a lower number of acute episode recurrences at both univariate (p < 0.0001) and multivariate analysis (p = 0.001). Conclusions. RAOM showed better outcomes in children with dental malocclusion wearing a mandibular repositioning device. Dental malocclusion in children with RAOM may play a role in the pathogenesis of Eustachian tube dysfunction.