Ultrasound-guided lateral pericapsular hip desensitization of the articular branches of the cranial gluteal nerve: A canine cadaveric study and feasibility study in dogs.

OBJECTIVE: To develop and assess the feasibility, as a diagnostic block, of an ultrasound-guided lateral pericapsular hip desensitization (L-PHD) technique in dogs. STUDY DESIGN: Prospective, randomized, anatomical and feasibility study. ANIMALS: A total of 11 canine cadavers and eight adult dogs scheduled for acetabular surgical denervation. METHODS: After studying the ultrasound anatomy of the lateral aspect of the gluteal region and determining an acoustic window to perform an ultrasound-guided L-PHD in three canine cadavers, the right and left hemipelves of eight canine cadavers were injected in the interfascial plane located lateral (LL-PHD group) or medial (LM-PHD group) to the deep gluteal muscle, with 0.05 mL kg-1 of dye per hip on each cadaver. The staining of the pericapsular nerves was assessed by anatomical dissection. Then, the LM-PHD was performed using 2% lidocaine as a diagnostic block in dogs scheduled for acetabular surgical denervation. Positive predictive value (PPV) was calculated for those animals who had favorable outcomes after acetabular surgical denervation. RESULTS: The ultrasound-guided LL-PHD and LM-PHD could be performed by inserting the needle lateral and medial to the deep gluteal muscle. Ultrasound-guided LL-PHD stained the cranial gluteal nerve and its muscular branches in all injections and partially stained the lumbosacral trunk in two out of eight cadavers. The LM-PHD selectively stained the articular branches of the cranial gluteal nerve in all but one cadaver. The PPV for LM-PHD successful test prediction was 85.7% (95% confidence interval: 48.6% to 98.6%). CONCLUSIONS: and clinical significance Ultrasound-guided LM-PHD using 0.05 mL kg-1 of dye selectively stained the articular branches of the cranial gluteal nerve in canine cadavers. The LM-PHD technique is feasible and could be used as a diagnostic block before acetabular surgical denervation in dogs.

Bullfrogs (Lithobates catesbeianus) as a Potential Source of Foodborne Disease.

In Mexico, bullfrogs (Lithobates catesbeianus) are produced as gourmet food. However, bullfrogs can be carriers of pathogens because the frogs' preferred living conditions occur in stagnant water. The present study aimed to identify bacteria that cause foodborne diseases or are associated with human diseases. For molecular identification, based on the sequential analysis by 16S rRNA or rpoD was conducted on all isolates obtained from bullfrog. A total of 91 bacterial isolates were obtained from bullfrogs; 14 genera and 23 species were identified, including Acinetobacter johnsonii 16.5%; Aeromonas media 14.3%; Aeromonas veronii 13.2%; Providencia rettgeri 7.7%; Citrobacter freundii 6.6%; Aeromonas caviae 4.4%; Aeromonas hydrophila and Elizabethkingia ursingii 3.3%; Pseudomonas stutzeri, Raoultella ornithinolytica, and Shewanella putrefaciens 2.2%; Acinetobacter guillouiae, Acinetobacter pseudolwoffii, Citrobacter portucalensis, Citrobacter werkmanii, Edwardsiella anguillarum, Klebsiella michiganensis, Kluyvera intermedia, Kocuria rosea, Myroides odoratimimus, Myroides odoratus, Proteus sp., and Proteus hauseri 1.1%. In this study, 49.4% of the isolates obtained cause foodborne disease, 19.8% are bacteria that play an important role in the spoilage of food, 5.5% of isolates have nosocomial significance, 13.2% of bacteria are considered to be pollutants of the ecosystem, and in the case of A. salmonicida and Edwardsiella anguillarum (12.1%) to have a negative impact on aquaculture. Acinetobacter pseudolwoffii and Citrobacter portucalensis have not been reported to cause disease. Lastly of these isolates, 97.8% (89/91) can cause disease by food consumption or by direct contact for immunocompromised persons. The presence of these bacteria in bullfrogs represents a significant problem for human health. There is evidence that these microorganisms are pathogenic and frogs may also be reservoirs.

Pericapsular hip desensitization in dogs: a cadaveric study and case series.

OBJECTIVE: To develop and assess the efficacy of an ultrasound (US)-guided pericapsular hip desensitization (PHD) technique in dogs. STUDY DESIGN: Prospective, randomized, anatomical study and a case series. ANIMALS: A total of 30 healthy dogs, eight canine cadavers and seven dogs with hip osteoarthritis. METHODS: After studying the US anatomy of the medial aspect of the coxofemoral joint and determining an acoustic window to perform an US-guided PHD in healthy dogs, the US-guided PHD was performed bilaterally in canine cadavers. A low [(LV) 0.1 mL kg-1] and high [(HV) 0.2 mL kg-1] volume of dye was injected per hip on each cadaver. The staining of the pericapsular nerves was assessed by anatomical dissection, and comparison between LV and HV was assessed using Fisher's exact test. Then, the US-guided PHD was performed using a triamcinolone-bupivacaine solution in dogs with hip osteoarthritis. Dynamic pain response was assessed before and after injection. The canine brief pain inventory (CBPI) questionnaire was used to assess treatment efficacy and duration. RESULTS: The US-guided PHD could be performed by inserting the needle between the iliopsoas muscle and the periosteum of the ilium. The articular branches of the femoral and obturator nerves were stained in all cadavers using both volumes. The main femoral nerve was never stained, but the main obturator nerve was stained in 37.5% and 100% of injections using LV and HV, respectively (p = 0.026). Treated animals showed decreased dynamic pain response after the injection. Compared with baseline, CBPI scores were reduced by ≥ 50% for ≥ 12 weeks in all but one dog. CONCLUSIONS AND CLINICAL SIGNIFICANCE: The US-guided PHD with both 0.1 and 0.2 mL kg-1 volumes stained the articular branches of the femoral and obturator nerves in canine cadavers and was associated with clinical improvement in dogs with hip osteoarthritis.

Recommendations for the provision of palliative care to people with COVID-19.

The pandemic of SARS-CoV-2 infection, which causes COVID-19, has deeply affected health systems and has had a significant impact on families, communities and nations. A comprehensive response strategy requires, in addition to epidemiological, scientific and technical considerations, for human suffering associated with disease, vulnerability and death not to be forgotten. Palliative care for people with suspicion or diagnosis of COVID-19 with serious evolution, and their families should also be a key part of organized actions that help alleviate suffering and improve quality of life by controlling symptoms, addressing psychological, emotional, social and spiritual needs, support for advanced care planning and its goals, end-of-life care, as well as support in complex decision-making and ethical problems, among others. Recommendations are provided for offering palliative care in COVID-19 pandemic context.

La pandemia de infección por SARS-CoV-2, la cual es causada por COVID-19, ha afectado profundamente a los sistemas de salud y ha ocasionado un enorme impacto en las familias, las comunidades y las naciones. La estrategia de respuesta integral requiere que además de las consideraciones epidemiológicas, científicas y técnicas, no se olvide el sufrimiento humano asociado a la enfermedad, la vulnerabilidad y la muerte. La atención paliativa a personas con sospecha o diagnóstico de COVID-19 con evolución grave y sus familias debe ser también parte clave de la acción organizada que ayude al alivio del sufrimiento y mejore la calidad de vida mediante el control de los síntomas, el abordaje de las necesidades psicológicas, sociales y espirituales, el apoyo para la planificación de la atención avanzada y la articulación de los objetivos de la misma, el cuidado de la persona en la fase final de la vida, así como el soporte ante la toma de decisiones complejas y problemas éticos, entre otros. Se ofrecen recomendaciones para brindar los cuidados paliativos en el contexto de la pandemia de COVID-19.

Calidad de vida en reconstrucción mamaria postmastectomía. Aplicación del instrumento Breast-Q(R) / Quality of life in breast reconstruction after mastectotmy. Application of the Breast-Q(R) instrument

Introducción y objetivo: A diferencia de los resultados oncológicos, no existen métodos estándar para evaluar los resultados estéticos. Muchos estudios han evaluado resultados cosméticos y calidad de vida después de la cirugía de cáncer de mama; los resultados fueron muy inconsistentes, tal vez debido al uso de evaluaciones subjetivas no confirmadas, al pequeño tamaño poblacional del estudio, al diseño retrospectivo y las diferencias en las medidas de calidad de vida. El objetivo del presente estudio es determinar el estado de calidad de vida con el instrumento Breast-Q(R) (previamente autorizado por 2018 Mapi Research Trust(C) y validado también para su aplicación en español) en mujeres sometidas a reconstrucción mamaria postmastectomía entre 2013-2018. Material y método: Estudio de cohorte que incluye pacientes con diagnóstico de cáncer de mama sometidas a reconstrucción mamaria. Medimos su calidad de vida con el instrumento Breast-Q(R) en su versión en español. Mostramos las variables cuantitativas como promedios y desviación estándar. Los datos cualitativos como frecuencias y porcentajes. El análisis del antes y después de la reconstrucción mamaria con la prueba de Wilcoxon. Tomamos como significativo un valor p <0.05. Para el análisis de los datos utilizamos el paquete estadístico SPSS versión 22. Resultados: La satisfacción en cuanto a sus pezones, tórax, la información referida y en general, fue superior a 75 puntos sobre 100. De manera interesante, también el bienestar psicológico estuvo por encima del 75 de promedio. Al comparar el antes y después de la satisfacción con sus senos y del bienestar sexual encontramos un aumento significativamente estadístico. Conclusiones: La evaluación mediante el instrumento Breast-Q® entre nuestro grupo de estudio demostró que la reconstrucción mamaria mejora la calidad de vida de las pacientes sometidas a este procedimiento

Backgorund and objective: Unlike oncological results there are no standard methods to evaluate aesthetic results. Many studies have evaluated cosmetic results and quality of life after breast cancer surgery with very inconsistent results perhaps due to the use of unconfirmed subjective evaluations, the small size of the population study, the retrospective design of the studies and differences in measures of quality of life. Our objective is to determine the quality of life status with Breast-Q(R) instrument (previously authorized by 2018 Mapi Research Trust(C) and also validated for its application in Spanish), in women with post-mastectomy breast reconstruction in 2013-2018. Methods: Cohort study including patients diagnosed with breast cancer who underwent breast reconstruction. Quality of life was measured by the Breast-Q(R) instrument in its Spanish version. The quantitative variables are shown as averages and standard deviation. Qualitative data such as frequencies and percentages. The analysis of the before and after breast reconstruction with the Wilcoxon test. A value p < 0.05 was taken as significant. The statistical package SPSS version 22 was used to analyze the data. Results: Satisfaction regarding their nipples, their thorax, the referred information, and in general is above 75 points out of 100. Interestingly, psychological well-being is also above 75 on average. When comparing the before and after satisfaction with their breasts and sexual well-being, a statistically significant increase was found. Conclusions: The evaluation using the Breast-Q(C) instrument among our study group showed that breast reconstruction improves the quality of life of patients undergoing this procedure