[Prevalence of Tritrichomonas foetus among Dutch cats]. / Prevalentie van Tritrichomonasfoetus onder Nederlandse katten.

Prevalence of Tritrichomonas foetus among Dutch cats The aim of this study was to determine the prevalence of and risk factors for, Tritrichomonas foetus among cats in the Netherlands. A total of 154 faecal samples were collected from three groups of cats: cats with diarrhoea (n=53), cattery cats (n=47), and healthy pet cats (n=54). Faecal samples were examined with a T. foetus specific real-time PCR. All PCR-positive samples were run on gel electrophoresis for definitive diagnosis. The prevalence of T. foetus was 2% among cats with diarrhoea and 4% among cattery cats; T. foetus was not prevalent among pet cats (none of the samples tested positive). Questionnaires had been distributed to cat and cattery owners to determine risk factors for T. foetus, but the low prevalence precluded statistical analysis of the questionnaire results.

A randomized study comparing epirubicin in a 4-weekly versus a weekly intravenous regimen in patients with metastatic, hormone resistant, prostatic carcinoma: effects on health related quality of life.

The treatment of hormone resistant prostate cancer) with epirubicin 25 mg/m(2)(Epi25) on a weekly intravenous regimen may be better in terms of health related quality of life (HRQOL) than with 100 mg/m(2)(Epi100) on a 4-weekly regimen. A total of 79 patients who filled out the EORTC-QLQ-C30 questionnaire for the assessment of HRQOL could be evaluated. Compared with the baseline, no changes in HRQOL function scales or significant changes in the following HRQOL symptom scales were found. The Epi25 group reported less pain during the first 3 months and the Epi100 group more dyspnoea after 4 weeks and less pain and less insomnia but more loss of appetite after 8 weeks. In both groups, toxicity was comparable, except for World Health Organisation grade II-III alopecia occurring in 82% in the Epi100 versus 31% in the Epi25 group. There were no significant differences between groups in response rates and survival. In this study, HRQOL was not improved which is in line with other studies using only epirubicine. Epirubicin as single agent therapy should not be used in future treatment of patients with HRPC.

Nerve-sparing retroperitoneal lymphadenectomy for low stage testicular cancer.

In order to maintain antegrade ejaculation after retroperitoneal lymphadenectomy (RLND) for low stage non-seminomatous germ cell cancer, we implemented a nerve-sparing technique in which the sympathetic nerves were preserved. Thirty-eight patients were clinically staged: 27 were stage I and 11 were either IIa or IIb. Laparotomy revealed that in 2 patients the nerve-sparing technique was not feasible. Fifteen patients had lymph node metastases at frozen section examination and underwent a bilateral nerve-sparing RLND. In the remaining 21 patients the procedure was unilateral. Clinical understaging occurred in 26% of patients (10/38) and overstaging in 8% (3/38). Patients with lymph node metastases received 2 cycles of adjuvant chemotherapy. Mean follow-up was 17 months. Antegrade ejaculation was preserved after bilateral and unilateral nerve-sparing RLND in 86% (12/14) and 95% (19/20) respectively. No recurrences were seen and so far the good prognosis of these patients has not been affected by this new technique.

Malignant fibrous histiocytoma of the spermatic cord.

We report a case of malignant fibrous histiocytoma of the spermatic cord and review 11 previously reported cases. Radical orchiectomy along with wide local excision is the treatment of choice. The rate of local recurrences and distant metastases is 33 per cent (4 of 12 cases) and the 5-year survival rate is 57 per cent (4 of 7 cases).

[Is surgery of inguinal hernia acceptable in ambulatory care?]. / Is liesbreukoperatie in dagverpleging acceptabel?

A prospective study was performed of 45 selected patients subjected to inguinal hernia repair on an outpatient basis. Forty-two patients (93%) were discharged the same day. In retrospect 37 of the patients (82%) favoured this outpatient procedure. The early complication rate was not higher than that of a comparable group of inpatients with an average hospital stay of 5.8 days.

Reoperation for prosthetic heart valve replacement.

From 1974 to 1984, 847 heart valve replacement operations were performed with 1005 prosthetic valves. Thirty-nine (4.6%) were reoperations with 43 prosthetic valve replacements (PVR), on 38 patients. Thirty-three patients had received their initial valve replacement in our hospital and 5 elsewhere. Twenty additional cardiac procedures were required, concomitantly with the prosthesis replacement. Twenty-three patients underwent replacement of a mechanical prosthesis (61%) an average of 4.3 years after initial implantation and 15 patients a bioprosthesis (39%) after 2.8 years. Indications for PVR were endocarditis in 15 patients (39%), prosthesis failure in 13 (34%), periprosthetic leak in 7 (18%), thrombosis in 2 (5%), and a left ventricle subannular aneurysm in 1 (3%). Preoperatively 4 patients were in NYHA functional class II (11%), 15 in class III (39%) and 19 in class IV (50%). Six patients died early postoperatively (15.8%) Various risk factors were analyzed. The early mortality rate was 22% for mechanical prosthesis replacement and 7% for bioprosthesis; 11% for aortic position, 13% for mitral position and 50% to 100% for double valve replacement; 23% for non-elective and 6% for elective operations; 10% for patients with only an initial valve replacement and 43% with additional previous valve operations; 18% for active endocarditis, 15% for prosthesis failure, 14% for periprosthetic leak, 0% for thrombosis and 100% for subannular aneurysm; 0% for patients in class II, 7% in class III and 26% in class IV; 6% in patients with an aortic cross-clamp time less than 2 hours and 24% with more; 27% prior to 1981 and 9% during the last 4 years; and finally 50% in patients over the age of 60.(ABSTRACT TRUNCATED AT 250 WORDS)