Grading of oligodendroglioma in dogs based on magnetic resonance imaging.

BACKGROUND: Oligodendroglioma (OG) accounts for 22% of primary brain tumors in dogs. Oligodendroglioma in dogs is graded as low-grade (II) or high-grade (III), based on the presence of microvascular proliferation and necrosis. OBJECTIVE: To investigate if magnetic resonance imaging (MRI) features differ between OG II and III in dogs. ANIMALS: Thirty-two dogs with histological diagnosis of intracranial OG and MRI. METHODS: Retrospective descriptive study. Histology was reviewed to grade OG according to the revised classification. Brain MRI results were reviewed following criteria including contrast enhancement (CE) pattern, presence of cystic structures, gradient-recalled-echo (GRE) signal voids, and necrosis based on signal intensity, as well as diffusion-weighted imaging characteristics. The MRI features were compared between OG II and III using Fisher's exact tests and logistic regression models. RESULTS: Histology identified 8 dogs with OG II (25%) and 24 with OG III (75%). All OG III showed moderate-to-marked CE including 18/24 (75%) with a ring pattern. These features were not seen in OG II. Heterogeneity, cystic structures, GRE signal voids, and necrosis were associated with OG III. No difference in diffusion characteristics was detected between OG II and III. CONCLUSION AND CLINICAL IMPORTANCE: Moderate-to-marked CE and ring pattern were present in dogs with OG III but not in OG II. The presence of cystic structures, GRE signal voids, and necrosis was strongly associated with OG III. Although the importance of brain tumor grading in dogs with regard to prognosis and treatment options remains unknown, the results indicate that MRI reflects the histological features used for grading OG in dogs.

Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small-breed dogs.

OBJECTIVE: To determine cutoff values for the diagnosis of atlantoaxial instability (AAI) based on cross-sectional imaging in small-breed dogs. STUDY DESIGN: Retrospective multicenter study. SAMPLE POPULATION: Client-owned dogs (n = 123) and 28 cadavers. METHODS: Dogs were assigned to three groups: a control group, a "potentially unstable" group, and an AAI-affected group, according to imaging findings and clinical signs. The ventral compression index (VCI), cranial translation ratio (CTR), C1-C2 overlap, C1-C2 angle, atlantoaxial distance, basion-dens interval, dens-to-axis length ratio (DALR), power ratio, and clivus canal angles were measured on CT or T2-weighted magnetic resonance (MR) images. Receiver operating characteristic (ROC) analysis was performed to define cutoff values in flexed (≥25°) and extended (<25°) head positions. RESULTS: Cutoff values for the VCI of ≥0.16 in extended and ≥0.2 in flexed head positions were diagnostic for AAI (sensitivity of 100% and 100%, specificity of 94.54% and 96.67%, respectively). Cutoff values for the other measurements were defined with a lower sensitivity (75%-96%) and specificity (70%-97%). A combination of the measurements did not increase the sensitivity and specificity compared with the VCI as single measurement. CONCLUSION: Cutoff values for several imaging measurements were established with good sensitivity and specificity. The VCI, defined as the ratio between the ventral and dorsal atlantodental interval, had the highest sensitivity and specificity in both head positions. CLINICAL SIGNIFICANCE: The use of defined cutoff values allows an objective diagnosis of AAI in small-breed dogs. The decision for surgical intervention, however, should remain based on a combination of clinical and imaging findings.

Risk factors for severe outcomes for COVID-19 patients hospitalised in Switzerland during the first pandemic wave, February to August 2020: prospective observational cohort study.

BACKGROUND: As clinical signs of COVID-19 differ widely among individuals, from mild to severe, the definition of risk groups has important consequences for recommendations to the public, control measures and patient management, and needs to be reviewed regularly. AIM: The aim of this study was to explore risk factors for in-hospital mortality and intensive care unit (ICU) admission for hospitalised COVID-19 patients during the first epidemic wave in Switzerland, as an example of a country that coped well during the first wave of the pandemic. METHODS: This study included all (n = 3590) adult polymerase chain reaction (PCR)-confirmed hospitalised patients in 17 hospitals from the hospital-based surveillance of COVID-19 (CH-Sur) by 1 September 2020. We calculated univariable and multivariable (adjusted) (1) proportional hazards (Fine and Gray) survival regression models and (2) logistic regression models for in-hospital mortality and admission to ICU, to evaluate the most common comorbidities as potential risk factors. RESULTS AND DISCUSSION: We found that old age was the strongest factor for in-hospital mortality after having adjusted for gender and the considered comorbidities (hazard ratio [HR] 2.46, 95% confidence interval [CI] 2.33−2.59 and HR 5.6 95% CI 5.23−6 for ages 65 and 80 years, respectively). In addition, male gender remained an important risk factor in the multivariable models (HR 1.47, 95% CI 1.41−1.53). Of all comorbidities, renal disease, oncological pathologies, chronic respiratory disease, cardiovascular disease (but not hypertension) and dementia were also risk factors for in-hospital mortality. With respect to ICU admission risk, the pattern was different, as patients with higher chances of survival might have been admitted more often to ICU. Male gender (OR 1.91, 95% CI 1.58−2.31), hypertension (OR  1.3, 95% CI 1.07−1.59) and age 55–79 years (OR 1.15, 95% CI 1.06−1.26) are risk factors for ICU admission. Patients aged 80+ years, as well as patients with dementia or with liver disease were admitted less often to ICU. CONCLUSION: We conclude that increasing age is the most important risk factor for in-hospital mortality of hospitalised COVID-19 patients in Switzerland, along with male gender and followed by the presence of comorbidities such as renal diseases, chronic respiratory or cardiovascular disease, oncological malignancies and dementia. Male gender, hypertension and age between 55 and 79 years are, however, risk factors for ICU admission. Mortality and ICU admission need to be considered as separate outcomes when investigating risk factors for pandemic control measures and for hospital resources planning.

Influence of the Head Neck Position on Imaging Measurements Used to Assess the Craniovertebral Junction in Small Breed Dogs: A Cadaveric Study.

OBJECTIVE: The study aimed to determine the influence of head neck position on imaging measurements used to assess the craniovertebral junction (CVJ) and to recommend the most appropriate position for the evaluation of the CVJ. STUDY DESIGN: A cross-sectional sample of adult dogs' cadavers was subjected to a computed tomography scan of the cranium and the cranial cervical region in three standardized head positions. Imaging measurements often used to assess the CVJ were measured. The influence of the head neck position, breed, weight and gender on imaging measurements was tested using repeated measures analysis of variance. RESULTS: Twenty-eight cadavers of small breed dogs were enrolled in the study. All cadavers examined had occipital dysplasia. All transarticular imaging measurements were dependent on the head neck position. In addition, the breed, weight and gender had an influence on several measurements. CONCLUSION: We recommend a standardized head neck position of 50 degrees flexion if quantitative imaging measurements of the CVJ are used to diagnose pathologies in this region. Future studies should focus on the definition of cut-off values for quantitative imaging measurements of the CVJ to differentiate between healthy and diseased small breed dogs. Regarding atlantoaxial instability, a combination of six parameters (C1-C2 angle, C1-C2 overlap, atlantoaxial distance, dens-to-axis length ratio, ventral compression index and clivus canal angle) is promising for its diagnosis.

Influence of a purpose-built frame on the accuracy of computer-assisted orthopedic surgery of equine extremities.

OBJECTIVE: To determine the influence of a purpose-built frame on the accuracy of screw placement during computer-assisted orthopedic surgery (CAOS) of the equine extremity. STUDY DESIGN: Experimental cadaveric study. SAMPLE POPULATION: Twenty-four paired equine cadaveric limbs obtained from seven horses. METHODS: Three 4.5-mm cortex screws were inserted in lag technique in three different planes of orientation in the proximal phalanx (P1) by means of CAOS. In the study group (n = 12 limbs), the tracker was anchored on a purpose-built frame designed to stabilize the extremity. In the control group (n = 12 limbs), a conventional tracker array was used that was anchored directly on P1. The stability of both tracker arrays was assessed during the procedure by using fiducial markers. After screw placement, preoperative and postoperative computed tomographic images were assessed to measure surgical accuracy aberrations (SAA) between the planned and achieved screw position. Descriptive statistics and repeated-measures analysis of variance were performed to compare SAA measurements between the study and control group. RESULTS: Both tracker arrays remained consistently stable in all specimens. Mean overall SAA of screw insertion were lower in the study group (0.7 mm; median, 0.5; range 0-3.4) than in the control group (1.2 mm; median, 0.9; range, 0-4.2 mm). CONCLUSION: The mean SAA achieved in cortex screw placement using CAOS lies within the range of approximately 1 mm. The use of a purpose-built frame avoided additional drilling of the target bone and improved surgical accuracy compared with the conventional tracker array. CLINICAL SIGNIFICANCE: The purpose-built frame described in this report can be used to facilitate CAOS in equine orthopedics without compromising surgical accuracy.

Complications associated with closed castration using the Henderson equine castration instrument in 300 standing equids.

OBJECTIVE: To describe a closed castration technique in standing equids, report associated complications, and identify potential risk factors. STUDY DESIGN: Prospective cohort study of 300 standing equids that were castrated with the Henderson Equine Castrating Instrument. METHODS: Thirteen participating veterinarians recorded intraoperative difficulties and postoperative complications. Descriptive statistics, univariate analyses with Fisher's exact tests, and logistic regressions were used to evaluate intraoperative difficulties and postoperative complications and to assess risk factors for postoperative complications. RESULTS: Data were collected on 300 equids (269 horses, 23 ponies, and 8 donkeys). Intraoperative difficulties were experienced in 39 of 300 (13%) procedures. Postoperative complications were reported in 69 of 300 (23%) equids, including excessive swelling (29, 9.67%), surgical site infection (SSI; 27, 9%), severe hemorrhage (3, 1%), and prolapse of the omentum (2, 0.64%). Donkeys were at increased risk of severe hemorrhage (2/8, 25%, P = .0019). Equids that were castrated in a hospital setting (83/300, 27.66%) more frequently developed excessive swelling (P = .0034, odds ratio [OR] = 3.20) and SSI (P = .0047, OR = 3.18) compared with equids that were castrated in a field setting (217/300, 72.33%). Prolonging antimicrobial prophylaxis or age of the equid at the time of castration had no effect on the prevalence of excessive swelling or SSI. CONCLUSION: The method of castration evaluated here resulted in a similar prevalence of postoperative complications to that previously reported for castrations in standing horses but fewer SSI. CLINICAL SIGNIFICANCE: The described method provides a viable option for castrating horses and ponies, but is not recommended in donkeys.

Effect of Facetectomy on the Three-Dimensional Biomechanical Properties of the Fourth Canine Cervical Functional Spinal Unit: A Cadaveric Study.

Objective To study the biomechanical effect of facetectomy in 10 large breed dogs (>24 kg body weight) on the fourth canine cervical functional spinal unit. Methods Canine cervical spines were freed from all muscles. Spines were mounted on a six-degrees-of-freedom spine testing machine for three-dimensional motion analysis. Data were recorded with an optoelectronic motion analysis system. The range of motion was determined in all three primary motions as well as range of motion of coupled motions on the intact specimen, after unilateral and after bilateral facetectomy. Repeated-measures analysis of variance models were used to assess the changes of the biomechanical properties in the three treatment groups considered. Results Facetectomy increased range of motion of primary motions in all directions. Axial rotation was significantly influenced by facetectomy. Coupled motion was not influenced by facetectomy except for lateral bending with coupled motion axial rotation. The coupling factor (coupled motion/primary motion) decreased after facetectomy. Symmetry of motion was influenced by facetectomy in flexion-extension and axial rotation, but not in lateral bending. Clinical Significance Facet joints play a significant role in the stability of the cervical spine and act to maintain spatial integrity. Therefore, cervical spinal treatments requiring a facetectomy should be carefully planned and if an excessive increase in range of motion is expected, complications should be anticipated and reduced via spinal stabilization.

Epitheliocystis Distribution and Characterization in Brown Trout (Salmo trutta) from the Headwaters of Two Major European Rivers, the Rhine and Rhone.

We present a first description of the distribution and characterization of epitheliocystis infections in brown trout (Salmo trutta) from the upper catchments of two major European rivers, the Rhine and the Rhone. Overall, epitheliocystis was widely distributed, with 70% of the Rhine and 67% of the Rhone sites harboring epitheliocystis positive brown trout. The epitheliocystis agents Candidatus Piscichlamydia salmonis and Candidatus Clavichlamydia salmonicola could be identified in both catchments, although their relative proportions differed from site to site. Additionally, in two rivers in the Rhine catchment, a new species of Candidatus Similichlamydia was identified. Based on the histology, infection intensity, and severity of pathological changes were significantly more pronounced in mixed chlamydial infections, whereas single infections showed only low numbers of cysts and mild pathology. Infections could be found over a wide range of temperatures, which showed no correlation to infection prevalence or intensity.

The emergence of epitheliocystis in the upper Rhone region: evidence for Chlamydiae in wild and farmed salmonid populations.

We present the first study comparing epitheliocystis in a wild and farmed salmonid in Europe. Sampling three tributaries to the Lake Geneva, including one from headwaters to river mouth, revealed an unequal distribution of epitheliocystis in brown trout (Salmo trutta). When evaluated histologically and comparing sites grouped as wild versus farm, the probability of finding infected trout is higher on farms. In contrast, the infection intensities, as estimated by the number of cysts per gill arch, were higher on average and showed maximum values in the wild trout. Sequence analysis showed the most common epitheliocystis agents were Candidatus Piscichlamydia salmonis, all clustering into a single clade, whereas Candidatus Clavichlamydia salmonicola sequences cluster in two closely related subspecies, of which one was mostly found in farmed fish and the other exclusively in wild brown trout, indicating that farms are unlikely to be the source of infections in wild trout. A detailed morphological analysis of cysts using transmission electron microscopy revealed unique features illustrating the wide divergence existing between Ca. P. salmonis and Ca. C. salmonicola within the phylum Chlamydiae.

Cheek Tooth Extraction Via a Minimally Invasive Transbuccal Approach and Intradental Screw Placement in 54 Equids.

OBJECTIVE: To describe (1) preoperative findings and surgical technique, (2) intraoperative difficulties, and (3) postoperative complications and long-term outcome of equine cheek tooth extraction using a minimally invasive transbuccal screw extraction (MITSE) technique. STUDY DESIGN: Retrospective case series. ANIMALS: Fifty-four equids; 50 horses, 3 ponies, and 1 mule. METHODS: Fifty-eight MITSE procedures were performed to extract cheek teeth in 54 equids. Peri- and intraoperative difficulties, as well as short- (<1 month) and long-term (>6 months) postoperative complications were recorded. Followup information was obtained through telephone interviews, making specific inquiries about nasal discharge, facial asymmetry, and findings consistent with surgical site infection. RESULTS: Preoperative findings that prompted exodontia included 50 cheek teeth with apical infections, 48 fractures, 4 neoplasia, 2 displacements, and 1 supernumerary tooth. Previous oral extraction was attempted but had failed in 55/58 (95%) animals because of cheek tooth fracture in 28, or insufficient clinical crown for extraction with forceps in 27. MITSE was successful in removing the entire targeted dental structure in 47/58 (81%) procedures. However, MITSE failed to remove the entire targeted dental structure in 11/58 (19%) procedures and was followed by repulsion in 10/11 (91%). Short-term postoperative complications included bleeding (4/58 procedures, 7%) and transient facial nerve paralysis (4/58 procedures, 7%). Owners were satisfied with the functional and cosmetic outcome for 40/41 (98%) animals with followup. CONCLUSION: MITSE offers an alternate for cheek tooth extraction in equids, where conventional oral extraction is not possible or has failed. Overall, there was low morbidity, which compares favorably with invasive buccotomy or repulsion techniques.