Ear piercing for individuals with metal hypersensitivity.

OBJECTIVE: To describe and evaluate an ear piercing and earring retention method for individuals with metal hypersensitivity. SETTING: Private facial plastic surgery practice associated with a tertiary care medical center. METHODS: Thirty-one patients with a history of hypersensitivity to metallic jewelry (62 ears) underwent earlobe piercing with an intravenous catheter. RESULTS: None of the patients experienced an infection or hypersensitivity reaction. All patients were able to wear nickel-free earrings for short periods without using the shortened catheter. CONCLUSION: Using the distal shaft of an intravenous catheter as an earring post sheath is a safe and effective technique that allows hypersensitive individuals to wear earrings in pierced ears on a limited basis.

Subnormal concentrations of serum cobalamin (vitamin B12) in cats with gastrointestinal disease.

The present study sought to determine the spectrum of diseases associated with subnormal concentrations of serum cobalamin in cats undergoing investigation of suspected gastrointestinal problems. The solid-phase boil radioassay (RA) for cobalamin employed in the present study was immunologically specific, precise, and accurate, with a sensitivity of 15 pg/mL. The RA yielded results that strongly correlated with those obtained by bioassay (Spearmann rho = .805; P < .0001), although the absolute values were lower for the RA. Forty-nine of 80 serum samples submitted during the period of January 1996-January 1998 had cobalamin concentrations below the reference range for healthy cats (range 900-2,800 pg/mL; mean +/- SD, 1,775 +/- 535 pg/mL; n = 33). Cats with subnormal cobalamin concentrations (mean +/- SD; 384 +/- 272 pg/mL, range 3-883 pg/mL) were middle-aged or older and were presented for weight loss. diarrhea, vomiting, anorexia, and thickened intestines. Definitive diagnoses in 22 cats included inflammatory bowel disease (IBD), intestinal lymphoma, cholangiohepatitis or cholangits, and pancreatic inflammation. Serum concentrations of cobalamin were particularly low in cats with intestinal lymphoma, three-fifths of whom also had subnormal serum concentrations of folate (< 9 ng/mL). The simultaneous presence of disease in the intestines, pancreas, or hepatobiliary system in many cats made it difficult to determine the cause of subnormal cobalamin concentrations. The circulating half-life of parenteral cyanocobalamin was shorter in 2 cats with IBD (5 days) than in 4 healthy cats (12.75 days). The presence of subnormal serum concentrations of cobalamin in 49 of 80 cats evaluated suggests that the measurement of serum cobalamin may be a useful indirect indicator of enteric or pancreatic disease in cats. The rapid depletion of circulating cobalamin in cats suggests that cats may be highly susceptible to cobalamin deficiency. However, the relationship of subnormal serum cobalamin concentrations to cobalamin deficiency and the effect of cobalamin deficiency on cats remain to be determined.

Use of a [13C]urea breath test for detection of gastric infection with Helicobacter spp in dogs.

OBJECTIVE: To evaluate a [13C]urea breath and blood test (UBBT) for detection of gastric infections with Helicobacter spp in dogs. ANIMALS: 8 Beagles with, and 3 Beagles without, gastric Helicobacter spp infection. PROCEDURE: The UBBT was evaluated in dogs of known infection status before and after treatment with amoxicillin, metronidazole, and famotidine (AMF). A standard dose of [13C]urea (4 mg/kg of body weight) was given, and breath and blood samples were obtained at 0, 20, 40, and 60 minutes after administration. Effect of AMF treatment on breath and blood 13CO2 values, gastric urease activity (GUA), and gastric spiral organisms (GSO) was evaluated 3 to 4 and 28 to 29 days after 14 days of AMF treatment. RESULTS: Breath and blood 13CO2 values were higher in infected dogs than uninfected dogs. Endogenous 13CO2 production was minimal. Breath and blood 13CO2 values varied by 10 and 13%, respectively, between test periods. There was a correlation (R2 = 0.985) between breath and blood 13CO2 values. In 6 of 8 infected dogs, these values were decreased 3 days after completion of AMF administration and biopsy specimens lacked GSO and GUA . For these 6 dogs, breath and blood 13CO2 values were variable 28 days after completion of AMF treatment, and were associated with recurrence of GSO in 6 dogs and GUA in 4 dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Results of this study indicate that UBBT may provide a noninvasive procedure for detection of gastric infections with Helicobacter spp in dogs. Treatment with amoxicillin, metronidazole, and famotidine may not be effective in eradicating gastric infections with Helicobacter spp in dogs.

Clinical and clinicopathologic features in 11 cats with Cuterebra larvae myiasis of the central nervous system.

The medical records of 11 cats with histopathologic findings consistent with central nervous system (CNS) Cuterebra larvae myiasis were retrospectively examined to determine if clinical features could identify this disorder antemortem. Young to middle-aged indoor-outdoor domestic shorthaired cats presenting with acute neurologic signs from July through September predominated. Many cats recently had clinical signs consistent with upper respiratory disease. Most cats presented for depression, lethargy, or seizures. Almost all cats had abnormal rectal temperatures, either hypethermia or hypothermia. Peripheral leukocytosis and eosinophilia were not characteristic of cats with CNS cuterebriasis. Cerebrospinal fluid analysis did not consistently disclose evidence of inflammation. Common neurologic deficits included blindness, abnormal mentation, and signs of unilateral prosencephalic disease. No specific clinical or clinicopathologic test was diagnostic for CNS cuterebriasis.

Revision endoscopic sinus surgery: the Thomas Jefferson University experience.

Since its introduction, functional endoscopic sinus surgery (FESS) has demonstrated success rates of 76% to 98%. A small group of the patients in whom initial FESS and optimal medical therapy fail require revision endoscopic sinus surgery (RESS). This group has recently been studied by several authors, and we have evaluated a group of 90 RESS patients selected from 753 consecutive primary FESS patients. Patients were followed for a mean of 22.8 months. Extent of disease, history of polyps, allergy, previous traditional endonasal sinus surgery, male gender, chronic steroid use, and the presence of a deviated septum all appeared to adversely affect RESS outcome. The surgeon's knowledge of the sinus anatomy is critical, especially in revision sinus cases in which landmarks are distorted or absent. In our review, RESS was associated with a 1% major complication rate and was successful in 67% of patients. Computer-assisted endoscopic sinus surgery integrates preoperative imaging with realtime endoscopic visualization, augments the surgeon's knowledge of anatomy, and helps to minimize patient risk.

Comparison of four test procedures to identify Staphylococcus aureus isolated from bovine intramammary infections.

A comparison was made between conventional tube coagulase, macrocupsular coagulase, latex agglutination, and miniaturized biochemical test systems for identification of Staphylococcus aureus of bovine origin. A total of 303 gram-positive, catalase-positive cocci of bovine origin were tested. Agreement between each pair of 4-hour tube coagulase, macrocupsular coagulase, latex agglutination, and miniaturized biochemical test results within isolates was greater than 95.0. Seventeen (5.6%) isolates were test negative for 4-hour tube coagulase, but test positive for 24-hour tube coagulase. Thirteen (76.5%) of these isolates were identified as S hyicus, 3 were S aureus, and 1 was not identified.