The use of disposable skin staples for intestinal resection and anastomosis in 63 dogs: 2000 to 2014.

OBJECTIVE: To describe the use of disposable skin staples for intestinal resection and anastomosis in dogs and report associated dehiscence and mortality rates. METHODS: Retrospective evaluation of medical records of dogs that underwent intestinal resection and anastomosis using disposable skin staples between 2000 and 2014. Data regarding patient signalment, indication for surgery, location of the resection and anastomosis, number of procedures performed, evidence of peritonitis at the time of surgery, surgeon qualifications, dehiscence, and mortality were obtained from the medical records. Mortality was defined as failure to survive beyond 10 days following resection and anastomosis. RESULTS: The overall mortality rate of patients undergoing intestinal resection and anastomosis was 12·7% (8/63). The most common indication for resection and anastomosis was neoplasia (20/63 [31·7%]), followed by foreign body removal (19/63 [30·2%]). The overall dehiscence rate was 4·8% (3/63). No difference in mortality associated with indication for surgery, whether multiple procedures were performed, surgeon qualifications, or evidence of peritonitis at the time of surgery was identified. CLINICAL SIGNIFICANCE: In this retrospective study, the overall mortality and dehiscence rates using disposable skin staples were similar to previously reported outcomes following resection and anastomosis.

Kaposi sarcoma: no longer an AIDS-defining illness? A retrospective study of Kaposi sarcoma cases with CD4 counts above 300/mm³ at presentation.

BACKGROUND: Historically, Kaposi sarcoma (KS) has been considered to occur in patients infected with human immunodeficiency virus (HIV) who have low CD4 counts and high viral loads. However, merging data show that KS also occurs in HIV-positive patients with CD4 counts of > 300/mm(3) and undetectable viral loads. AIMS: To investigate the characteristics of HIV-positive patients with CD4 counts of > 300 cells/mm(3) and presence of KS. METHODS: This was a retrospective study of 23 cases of histologically confirmed KS in HIV-positive patients presenting to King's College Hospital between 2005 and 2011. RESULTS: Of the 23 cases, 7 (30%) had a CD4 count of > 300 cells/mm(3) at diagnosis of KS; 2 were being treated with highly active antiretroviral therapy (HAART) at the time of KS diagnosis, while the remaining 5 patients were HAART-naïve. All 7 patients were men, and all had a lower median age, higher recorded CD4 counts and more recent HIV diagnosis than the 16 patients with lower CD4 counts (< 300/mm(3) ) at the time of KS diagnosis. CONCLUSIONS: We report seven cases of KS in patients with CD4 count > 300/mm(3) , most of whom were HAART-naïve at the time of KS diagnosis. Contemporary data indicate that KS presenting with CD4 counts > 300/mm(3) usually occurs in patients established on HAART, which is not borne out by the results of our study.