Patent ductus arteriosus in cats (Felis catus): 50 cases (2000-2015).

OBJECTIVES: To describe signalment, clinical characteristics, diagnostic, treatment, and outcome data in a large case series of cats with patent ductus arteriosus (PDA). ANIMALS: Fifty cats with confirmed PDA. METHODS: Retrospective review of medical records from five referral veterinary hospitals for cats with PDA between 2000 and 2015. Cats were included if a PDA was visualized echocardiographically, during surgery, or on post-mortem examination. RESULTS: Median age at presentation was 6 months (range: 36 days-9.7 years; n = 50), and sex distribution was approximately equal (27 male, 23 female). Most cats did not have clinical signs (70.2%; 33/47) at the time of presentation. Murmurs were classified as continuous (55%; 22/40) or systolic (45%; 18/40). Echocardiography confirmed left-to-right shunting in 33 cats (82.5%; 33/40) and right-to-left shunting in 7 (17.5%; 7/40). Concurrent cardiac anomalies were identified in 54.5% (18/33) and pulmonary hypertension in 45.7% (16/35). Closure was pursued in 68% (34/50), and complications associated with the procedure occurred in 14.7% (5/34) of cats, including one intraoperative mortality. Long-term follow up was available in 80% (40/50) of cats. CONCLUSIONS: Cats with PDA often do not display clinical signs and may not have the characteristic physical examination findings typical of PDA in dogs. An increased prevalence of concurrent cardiac anomalies and pulmonary hypertension were found relative to previous reports. Thoracic radiographs and echocardiogram may provide the most comprehensive information for making a diagnosis and treatment recommendations. PDA closure was associated with a favorable long-term outcome in cats included in this study.

High-Grade Myxoid Liposarcoma (Round Cell Variant) in a Dog.

A 10-year-old, neutered male, Basset hound had a 26 × 21 × 21 cm infiltrative mass on the left abdominal wall that did not extend into the peritoneal cavity based on radiographs and abdominal computed tomography. Cytological examination revealed moderate numbers of neoplastic round cells, which frequently contained numerous round, clear, cytoplasmic vacuoles. Histologically, the tumour was composed of two morphologically distinct cell populations forming a continuum of heterogeneously differentiated cells. The primary spindle-shaped population formed streams with abundant, lightly eosinophilic, alcian blue-positive, myxoid matrix. The second population was arranged in sheets and had a round cell appearance. Scattered within both populations were neoplastic cells containing variably sized, intracytoplasmic, osmium tetroxide-positive vacuoles (lipid). Multifocal large pools of mucin formed pseudocysts, and numerous small capillaries were present throughout the neoplasm. According to the current World Health Organization veterinary classification of liposarcomas, this neoplasm had morphological features of both the myxoid and pleomorphic variants of liposarcoma; however, it was analogous to the recently defined high-grade myxoid liposarcoma in man. Myxoid liposarcoma with round cells has not been described previously in dogs. This case highlights the need to potentially re-evaluate the current classification of liposarcomas in animals.

Experiencia: aceptabilidad del uso de simulación clínica en educación médica: la experiencia del curso Síntesis de Conocimientos en Medicina / Experience: acceptability of clinical simulation in medical education: Course experience of Synthesis Medical knowledge

Clinical simulation is a technique with multiple benefits. Supervised professional practice results the best predictor of performance quality of a determined clinical skill. The “Summary of Medical Knowledge” course considers within its objectives enhancing necessary clinical skills before graduating, which is done through clinical simulation. Materials and methods: Voluntary participating activity was developed, considering performance in 5 clinical stations, which were assessed by Objective Structured Clinical Examination (OSCE). This activity was held at the Clinical Skill Centre, Faculty of Medicine, University of Chile. The evaluated skills were chosen based on information provided by graduates 2010-2012 about their own perception of competences. Results: 89 students and 53 teachers participated voluntarily. Over 90 percent of respondents (both teachers and students) stated that the activity was a great contribution to become aware of their own skills and limitations, resulting relevant and essential for medical training. Discussion: Simulation is feasible as a method of training in undergraduates, with a high rate of satisfaction for both students and teachers, encouraging the acquisition of clinical skills.

Complicaciones tardías de la terapia láser como tratamiento de la transfusión feto-fetal: caso clínico / Late complications of laser therapy as a treatment for feto-fetal transfusion: clinical case

Presentamos la descripción del diagnóstico y manejo de una secuencia anemia-policitemia (SAP) que se presenta como complicación de una terapia láser exitosa en un embarazo gemelar monocorial cursando una transfusión feto-fetal (TFF) severa. Describimos la manifestación de esta complicación tardía de la terapia láser de la TFF severa y realizamos una revisión de la literatura internacional al respecto. A pesar del éxito de la introducción de la terapia láser en cuanto a la sobrevida y secuelas neonatales, recientemente se han descrito una serie de complicaciones de presentación tempranas o tardías. Entre las tardías, destacan la muerte de uno o ambos gemelos, recidiva de la TFF, y aparición de una SAP. Varios autores han descrito que la SAP sería secundaria a la presencia, o persistencia, de comunicaciones vasculares extremadamente pequeñas de flujo lento, las cuales llevan a una discordancia en los niveles de hemoglobina entre ambos gemelos, sin diferencias en sus volúmenes sanguíneos.

We describe the diagnosis and management of twin anemia-polycythemia sequence (TAPS), which occurs as a late complication of successful laser therapy in twin monochorionic pregnancies developing severetwin to twin transfusion syndrome (TTTS). We offer a description of this late complication of laser therapy in this condition and a review of the related medical literature. Despite the successful introduction of laser therapy on the survival and neonatal sequelae, various early and late complications related to this procedure have been recently described. Among the late, stands out the death of one or both twins, recurrence of TTTS, and the appearance of TAPS. With regards TAPS, several authors have reported that it would be secondary to the presence, o persistence, of extremely small slow flow vascular communications, which lead to discre-pancies in the hemoglobin levéis between the twins, with no differences in blood volume.