[Patient satisfaction in oncological aftercare--differential results of gender aspects in doctor-patient dyads]. / Patientenzufriedenheit in der onkologischen Nachsorge--differentielle Befunde zur Geschlechtsspezifik in Arzt-Patient-Dyaden.

OBJECTIVE: The aim of this study was to explore the role of gender of the physician and gender of the patient in explaining differences in patient satisfaction. MATERIAL AND METHODS: Overall, 1,130 patients were assigned to one of 4 possible physician-patient sex dyads and were interviewed with a questionnaire about their patient satisfaction. RESULTS: Female patients in a dyad with a female physician were most satisfied with the overall judgment of practice visit and the inclusion of life situation in comparison to all other dyads. Male patients in a dyad with a male physician were least satisfied. CONCLUSION: In the future, the specific role of patient-physician dyads has to be considered more in the assessment of subdimensions of patient satisfaction.

[Palliative home care of cancer patients in the Leipzig region]. / Ambulante Palliativversorgung von Tumorpatienten im Raum Leipzig.

BACKGROUND: In many model regions of Germany, palliative home care can be improved for cancer patients over longer periods so that most of these patients could die at home. However, there is a shortage of ambulatory care for dying patients in regions without special agreements for this type of care. METHODS: The aim of the study was to identify beneficial as well as impedimentary factors of outpatient palliative care. Therefore we interviewed 91 tumour patients and collected medical, psychosocial and sociodemographic data with standardized questionnaires. RESULTS: Nearly half of the patients (43%) had moderate to strong pain during domestic care and felt depressed (44%) and anxious (26%). Home hospice services, social workers, and psychologists were rarely involved in home care. Ambulatory home care was often interrupted because of hospital stays. CONCLUSION: Palliative symptom control in outpatients should be performed by qualified and interdisciplinary palliative-care teams, so that patients can receive more psychosocial support and hospital stays can be prevented.

Morphology and immunohistochemistry of spontaneous chronic corneal epithelial defects (SCCED) in dogs.

PURPOSE: To determine the morphologic features of the epithelium and extracellular matrix in spontaneous chronic corneal epithelial defects (SCCED) in dogs. METHODS: Forty-eight superficial keratectomy specimens were obtained after confirmation of the presence of a superficial corneal erosion for longer than 3 weeks with no discernible underlying cause. Histologic samples were examined by light microscopy, scanning electron microscopy, and transmission electron microscopy. Immunolocalization of laminin, collagen IV, fibronectin, and collagen VII was performed. RESULTS: Epithelial cells adjacent to the defect were poorly attached to the underlying extracellular matrix. A prominent superficial stromal hyaline acellular zone composed of collagen fibrils in the area of the erosion was present in most specimens. Samples exhibited a varying degree of fibroplasia, vascularization, and leukocytic infiltrate. Laminin, collagen IV, and collagen VII were usually either not present or were present only in discontinuous segments on the surface of the erosion. Fibronectin usually coated the surface of the erosion, either as a continuous sheet or in discontinuous segments. Transmission electron microscopy of 15 samples revealed that the basement membrane was either absent in the area of the erosion or was present only in discontinuous segments. Scanning electron microscopy of eight of nine samples confirmed the absence of continuous basement membrane. Epithelial and extracellular matrix components in the peripheral cornea appeared normal. CONCLUSIONS: Most canine patients with spontaneous chronic corneal epithelial defects do not have a normal basement membrane structure in the region of the epithelial defect and have other abnormalities in the subjacent extracellular matrix that may reflect a part of the underlying pathophysiology of chronic and recurrent erosions.

Tear copper and its association with liver copper concentrations in six adult ewes.

Tear and liver copper concentrations from 6 clinically healthy adult mixed-breed ewes were measured by Atomic Absorption Electrothermal Atomization (graphite furnace) Spectrometry and Flame Absorption Spectrometry, respectively, 7 times over 227 d to determine if their tears contained copper and if so, whether tear copper concentrations could reliably predict liver copper concentrations. To produce changes in liver copper concentration, the diet was supplemented with copper at concentrations that increased from 23 mg to 45 mg Cu/kg feed/day/sheep during the study. This regimen raised liver copper for all sheep to potentially toxic hepatic tissue concentration of greater than 500 mg/kg dry (DM) matter (tissue). The results of the study showed that copper was present in the tears of all sheep. The mean tear copper concentration showed a positive correlation with liver copper concentration (P = 0.003), increasing from 0.07 mg/kg DM at the start to 0.44 mg/kg DM at the end of the study, but could not reliably predict liver copper concentration (R2 = 0.222).

Effect of intracameral administration of carbachol on the postoperative increase in intraocular pressure in dogs undergoing cataract extraction.

OBJECTIVE: To determine whether intracameral injection of carbachol at the completion of phacoemulsification in dogs would prevent the increase in intraocular pressure (i.o.p) that can develop during the first 24 hours after surgery. DESIGN: Randomized controlled trial. ANIMALS: 32 adult dogs undergoing elective unilateral or bilateral phacoemulsification. PROCEDURE: Dogs were randomly assigned to 1 of 4 groups with 8 dogs/group: phacoemulsification and intracameral administration of 0.5 ml of 0.01% carbachol at the end of surgery; phacoemulsification, intraocular lens implantation, and intracameral administration of 0.5 ml of 0.01% carbachol; phacoemulsification and intracameral administration of 0.5 ml of balanced salt solution; and phacoemulsification, intraocular lens implantation, and intracameral administration of 0.5 ml of balanced salt solution. Intraocular pressure was measured at 3 and 6 hours and the morning after surgery. Aqueous flare was also measured 6 hours and the morning after surgery. RESULTS: None of the dogs treated with carbachol developed postoperative ocular hypertension (i.e., IOP > 27 mm of Hg), whereas 12 of 16 control dogs had ocular hypertension 3 hours after surgery. Intraocular pressure 3 hours after surgery was not significantly associated with phacoemulsification time or phacoemulsification power or with whether the dog received an intraocular lens implant. Severity of aqueous flare was similar for treated and control dogs. CLINICAL IMPLICATIONS: Results suggested that intracameral administration of 0.01% carbachol at the end of surgery was a safe and efficacious method of preventing the postoperative increase in IOP associated with phacoemulsification in dogs.

Stellate rhytidectomy: superior entropion repair in a dog with excessive facial skin.

A four-year-old Chinese shar pei was presented for entropion repair that had not been corrected adequately with two prior Hotz-Celsus procedures. The primary cause for the failure was the weight of the excessive, superior facial folds often found in this breed. A new technique is presented to measure and remove these folds in a stellate pattern by following natural stress lines, thus effecting surgical repair of the superior lid entropion.