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1.
N Z Vet J ; 71(5): 244-250, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37345417

RESUMO

AIMS: To evaluate the effect of IM administration of three sedative drugs, acepromazine, alfaxalone and dexmedetomidine, in combination with morphine, on the size of the feline spleen using ultrasonography. METHODS: Twenty-four client-owned cats undergoing elective de-sexing or minor procedures were recruited for a focused ultrasonographic examination of the spleen prior to and at 10, 20 and 30 minutes following administration of one of three randomly assigned IM sedation protocols: 0.05 mg/kg acepromazine (ACE group), 3 mg/kg alfaxalone (ALF group), or 10 µg/kg dexmedetomidine (DEX group), in combination with 0.5 mg/kg morphine. B-mode images of the spleen were collected and measured following a standardised protocol. Cardiorespiratory parameters and sedation score were also recorded. Mean thickness of the head, body and tail of the spleen for each group at 10, 20 and 30 minutes after drug administration was compared to baseline. RESULTS: Mean splenic thickness increased over time in the ACE group (thickness of body at T0 = 8.9 (SE 2.1) mm and at T30 = 10.5 (SE 2.0) mm; p = 0.001) and the ALF group (thickness of body at T0 = 8.8 (SE 1.0) mm and at T30 = 10.3 (SE 1.7) mm; p = 0.022) but not in the DEX group (thickness of body at T0 = 8.6 mm (1.2) and at T30 = 8.9 mm (0.6); p = 0.67). Mean arterial blood pressure in the DEX group was significantly higher than in the other groups (p = 0.002). Sedation scores in the DEX group were consistently high for the entire period. However, the sedation score in the ACE group increased over 30 minutes (p = 0.007). Sedation score in the ALF group was highest at 10 minutes but gradually decreased over the following 20 minutes (p = 0.003). CONCLUSIONS: Sedation with IM dexmedetomidine and morphine did not change splenic size, whereas acepromazine or alfaxalone and morphine increased it regardless of the degree of sedation. CLINICAL RELEVANCE: Where splenomegaly is identified in a cat sedated with acepromazine or alfaxalone, the effects of the sedation protocol could be considered as a possible cause.


Assuntos
Dexmedetomidina , Gatos , Animais , Dexmedetomidina/farmacologia , Acepromazina/farmacologia , Baço/diagnóstico por imagem , Hipnóticos e Sedativos/farmacologia , Morfina , Ultrassonografia
2.
N Z Vet J ; 69(5): 294-298, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34013827

RESUMO

AIMS: To compare the force to failure under axial loading of a calcaneotibial screw placed approximately perpendicular to the tibia with that of a screw placed perpendicular to the calcaneus, when used to immobilise the tarsus in an ex vivo canine model. METHODS: Twelve pairs of cadaveric hindlimbs from large breed dogs, without orthopaedic or soft tissue disease, were prepared by transecting the limb at the level of the stifle and stripping the limbs of all musculature from the stifle to mid-metatarsus, including removal of the common calcaneal tendon from all limbs. The limbs in each pair were randomly assigned to receive a calcaneotibial screw placed perpendicular to the long axis of either the calcaneus (C group) or the tibia (T group) with the tarsus in full extension. The distal limb was potted in resin and the proximal tibia was pinned to allow biomechanical testing in compressive loading. Testing was performed to apply an axial load using a material testing machine in a proximodistal direction through the tibia, advancing at a rate of 10 mm/second. The force to failure was recorded in kN and compared between groups. RESULTS: The median force to failure of the C group was 0.86 (min 0.50; max 1.64) kN which was higher than the T group which had a median force to failure of 0.74 (min 0.26, max1.05) kN (p = 0.004). All modes of failure were by screw pull-out. CONCLUSIONS: A calcaneotibial screw placed at an angle approximately perpendicular to the long axis of the calcaneus, has a higher force to failure under axial loading than a calcaneotibial screw that is placed at an angle approximately perpendicular to the tibia, in a canine cadaveric model. CLINICAL RELEVANCE: A temporary calcaneotibial screw is a common method of immobilising the tarsus in extension to protect primary repair of a common calcaneal tendon injury. Placing a calcaneotibial screw perpendicular to the calcaneus may be a more reliable option for immobilisation of the tarsus to protect a common calcaneal tendon repair compared to screws placed perpendicular to the tibia. However extrapolation of these results into a clinical setting requires caution.


Assuntos
Calcâneo , Doenças do Cão , Animais , Fenômenos Biomecânicos , Parafusos Ósseos/veterinária , Cadáver , Calcâneo/cirurgia , Cães , Tíbia/cirurgia
3.
Regul Toxicol Pharmacol ; 117: 104767, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32866543

RESUMO

Skin sensitising substances that induce contact allergy and consequently risk elicitation of allergic contact dermatitis (ACD) remain an important focus regarding the replacement of animal experimentation. Current in vivo methods, notably the local lymph node assay (LLNA) refined and reduced animal usage and led to a marked improvement in hazard identification, characterisation and risk assessment. Since validation, regulatory confidence in the LLNA approach has evolved until it became the first choice assay in most regulated sectors. Currently, hazard identification using the LLNA is being actively replaced by a toolbox of non-animal approaches. However, there remains a need to increase confidence in the use of new approach methodologies (NAMs) as replacements for LLNA sensitiser potency estimation. The EPAA Partners Forum exchanged the current state of knowledge on use of NAMs in various industry sectors and regulatory environments. They then debated current challenges in this area and noted several ongoing needs. These included a requirement for reference standards for potency, better characterisation of applicability domains/technical limitations of NAMs, development of a framework for weight of evidence assessments, and an increased confidence in the characterisation of non-sensitisers. Finally, exploration of an industry/regulator cross-sector user-forum on skin sensitisation was recommended.


Assuntos
Alérgenos/toxicidade , Alternativas aos Testes com Animais/normas , Congressos como Assunto/normas , Ensaio Local de Linfonodo , Relatório de Pesquisa/normas , Pele/efeitos dos fármacos , Alternativas aos Testes com Animais/métodos , Animais , Bélgica/epidemiologia , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Humanos , Medição de Risco/métodos , Medição de Risco/normas
4.
N Z Vet J ; 68(6): 324-330, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32495724

RESUMO

Aims: To evaluate the efficacy of insulating the limbs and thorax of cats with a combination of bubble wrap and an absorbent, plastic-lined pad in reducing heat loss during ovariohysterectomy. Methods: A preliminary study was performed to compare heat loss of 1 L bags of Hartmann's solution heated to 38°C which were either wrapped in two layers of bubble wrap and an absorbent pad (n = 6) or were unwrapped (n = 6). Bags were allowed to cool in a temperature-controlled room and the temperature of the bags was measured every 10 minutes for 60 minutes. The clinical study, included 16 intact female cats undergoing ovariohysterectomy. The cats were premedicated with I/M morphine and either medetomidine or dexmedetomidine, and anaesthesia was induced with I/V propofol and maintained with isoflurane in 100% oxygen. Cats were randomly assigned to either the treatment group (n = 8) whose limbs and thorax wrapped with two layers of bubble wrap and an absorbent pad immediately after induction, or the control group (n = 8) which were unwrapped. Body temperature (measured with an oesophageal temperature probe), heart rate, respiratory rate, mean arterial pressure and partial pressure of end-tidal CO2 were recorded immediately after induction (T start), before surgery started (T surgery), and at the end of isoflurane administration (T end). The times from T end to extubation, from T end to when the cat could maintain sternal recumbency and from T end to when the cat was able to stand, were also recorded. Results: In the preliminary study of heat loss by fluid bags, the mean temperature at 60 minutes was higher in wrapped bags (35.4 (SD 0.2)°C) compared to unwrapped bags (33.0 (SD 0.3)°C; p < 0.01). For cats undergoing ovariohysterectomy, mean body temperature of wrapped cats was higher than that of unwrapped cats both at T surgery (36.0 (SE 0.3) vs. 34.5 (SE 0.3)°C; p = 0.001) and at T end (37.2 (SE 0.5) vs. 36.0 (SE 0.5)°C; p = 0.01). Wrapped cats regained the ability to stand more rapidly that unwrapped cats (26.4 (SE 5.8) vs. 47.0 (SE 5.8) minutes p = 0.01). Conclusions: Wrapping the limbs and thorax of cats undergoing ovariohysterectomy in a combination of bubble wrap and absorbent pads reduced heat loss, which in turn improved recovery time from general anaesthesia. Clinical relevance: This inexpensive and practical method may reduce perioperative hypothermia, in cats undergoing abdominal surgery.


Assuntos
Regulação da Temperatura Corporal , Gatos/fisiologia , Hipotermia/veterinária , Histerectomia/veterinária , Ovariectomia/veterinária , Absorventes Higiênicos , Animais , Temperatura Corporal , Feminino , Hipotermia/prevenção & controle , Histerectomia/métodos , Ovariectomia/métodos
5.
N Z Vet J ; 65(2): 99-104, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27842208

RESUMO

AIMS: To identify and describe culture and antimicrobial resistance (AMR) patterns in bacteria isolated from canine urinary samples submitted to a New Zealand veterinary diagnostic laboratory. METHODS: Records from a veterinary diagnostic laboratory were examined for bacterial isolates cultured from canine urine samples between January 2005 and December 2012. Culture and susceptibility results were compiled with information on the age, sex and breed of dog. Repeat submissions were removed. Susceptibility was assessed using results of the Kirby-Bauer disk diffusion method, for a standard panel including amoxicillin-clavulanic acid (AMC), cefovecin (from 2010-2012), cephalothin, clindamycin, enrofloxacin and trimethoprim-sulphonamide (TMS). RESULTS: A total of 5,786 urine samples were submitted for analysis, and 3,135 bacterial isolates were cultured from 2,184 samples. Of these 3,135 isolates, 1,104 (35.2%) were Escherichia coli, 442 (14.1%) were Staphylococcus spp., 357 (11.4%) Proteus mirabilis and 276 (8.8%) were Enterococcus spp. The frequency of culture-positive samples increased with increasing age in both female and male dogs (p<0.001). The percentage of E. coli isolates resistant to AMC and cephalothin increased between 2005 and 2012 (p<0.001), as did resistance to enrofloxacin (p=0.022), but there was no change in resistance to TMS (p=0.696). Enrofloxacin was the antimicrobial with the least resistance shown by the four most common bacteria isolated during the course of the study. CONCLUSIONS AND CLINICAL RELEVANCE: The results of this study provide important regional information regarding the prevalence of bacterial uropathogens and their susceptibility patterns. There was an increase in resistance to some commonly used antimicrobials in the treatment of urinary tract infections. Having access to regional antimicrobial susceptibility results is crucial when forming guidelines for the use of antimicrobials for the treatment of urinary tract infections. Given changes in practising habits and antimicrobial usage over time, ongoing monitoring and surveillance of resistance in pathogens is needed.


Assuntos
Antibacterianos/farmacologia , Doenças do Cão/microbiologia , Farmacorresistência Bacteriana , Infecções Urinárias/veterinária , Animais , Doenças do Cão/epidemiologia , Doenças do Cão/urina , Cães , Feminino , Laboratórios , Masculino , Nova Zelândia/epidemiologia , Fatores de Tempo , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Medicina Veterinária
6.
J Genet Couns ; 25(2): 305-13, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26289228

RESUMO

Duchenne muscular dystrophy (DMD) is a progressive, fatal pediatric disorder with significant burden on parents. Assessing disease impact can inform clinical interventions. Best-worst scaling (BWS) was used to elicit parental priorities among 16 short-term, DMD-related worries identified through community engagement. Respondents viewed 16 subsets of worries, identified using a balanced, incomplete block design, and identified the most and least worrying items. Priorities were assessed using best-worst scores (spanning +1 to -1) representing the relative number of times items were endorsed as most and least worrying. Independent-sample t-tests compared prioritization of parents with ambulatory and non-ambulatory children. Participants (n = 119) most prioritized worries about weakness progression (BW score = 0.64) and getting the right care over time (BW = 0.25). Compared to parents of non-ambulatory children, parents of ambulatory children more highly prioritized missing treatments (BW = 0.31 vs. 0.13, p < 0.001) and being a good enough parent (BW = 0.06 vs. -0.08, p = 0.010), and less prioritized child feeling like a burden (BW = -0.24 vs. -0.07, p < 0.001). Regardless of child's disease stage, caregiver interventions should address the emotional impact of caring for a child with a progressive, fatal disease. We demonstrate an accessible, clinically-relevant approach to prioritize disease impact using BWS, which offers an alternative to the use of traditional rating/ranking scales.


Assuntos
Ansiedade/diagnóstico , Ansiedade/psicologia , Distrofia Muscular de Duchenne/classificação , Distrofia Muscular de Duchenne/genética , Pais/psicologia , Perfil de Impacto da Doença , Atividades Cotidianas/classificação , Atividades Cotidianas/psicologia , Adulto , Criança , Pré-Escolar , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Limitação da Mobilidade , Distrofia Muscular de Duchenne/diagnóstico , Distrofia Muscular de Duchenne/psicologia , Poder Familiar/psicologia , Prognóstico , Psicometria , Reprodutibilidade dos Testes
7.
Gynecol Oncol ; 125(1): 31-6, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22082991

RESUMO

OBJECTIVE: To describe the outcomes of surgical management of bowel obstruction in relapsed epithelial ovarian cancer (EOC) so as to define the criteria for patient selection for palliative surgery. METHODS: 90 women with relapsed EOC underwent palliative surgery for bowel obstruction between 1992 and 2008. RESULTS: Median age at time of surgery for bowel obstruction was 57 years (range, 26 to 85 years). All patients had received at least one line of platinum-based chemotherapy. Median time from diagnosis of primary disease to documented bowel obstruction requiring surgery was 19.5 months (range, 29 days-14 years). Median interval from date of completed course of chemotherapy preceding surgery for bowel obstruction was 3.8 months (range, 5 days-14 years). Ascites was present in 38/90(42%). 49/90(54%) underwent emergency surgery for bowel obstruction. The operative mortality and morbidity rates were 18% and 27%, respectively. Successful palliation, defined as adequate oral intake at least 60 days postoperative, was achieved in 59/90(66%). Only the absence of ascites was identified as a predictor for successful palliation (p=0.049). The median overall survival (OS) was 90.5 days (range, <1 day-6 years). Optimal debulking, treatment-free interval (TFI) and elective versus emergency surgery did not predict survival or successful palliation from surgery for bowel obstruction (p>0.05). CONCLUSION: Surgery for bowel obstruction in relapsed EOC is associated with a high morbidity and mortality rate especially in emergency cases when compared to other gynaecological oncological procedures. Palliation can be achieved in almost two thirds of cases, is equally likely in elective and emergency cases but is less likely in those with ascites.


Assuntos
Obstrução Intestinal/cirurgia , Intestinos/cirurgia , Neoplasias Epiteliais e Glandulares/complicações , Neoplasias Ovarianas/complicações , Cuidados Paliativos , Adulto , Idoso , Idoso de 80 Anos ou mais , Anastomose Cirúrgica , Ascite/etiologia , Carcinoma Epitelial do Ovário , Terapia Combinada , Feminino , Seguimentos , Humanos , Obstrução Intestinal/etiologia , Obstrução Intestinal/mortalidade , Pessoa de Meia-Idade , Análise Multivariada , Neoplasias Epiteliais e Glandulares/mortalidade , Neoplasias Epiteliais e Glandulares/patologia , Neoplasias Epiteliais e Glandulares/terapia , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/terapia , Complicações Pós-Operatórias/epidemiologia , Recidiva , Análise de Sobrevida , Taxa de Sobrevida , Resultado do Tratamento
8.
Aust Dent J ; 67(1): 55-68, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34706067

RESUMO

BACKGROUND: Understanding factors that influence patients' preferences towards oral cancer (OC) screening is imperative to provide high-quality evidence-based OC screening interventions that can be targeted for population-level uptake. This study determined adult patients' knowledge and awareness of OC, and how health behaviours influenced their preferences towards OC screening. METHODS: This cross-sectional study used a 42-point questionnaire, between February and May 2020 using a combination of in-person and telephone interviews. Chi-square test and multiple logistic regression analysis were applied to confounding factors that returned statistical significance against OC knowledge and awareness. Significance of P < 0.05 was accepted. RESULTS: Sixty-eight (38.6%) participants out of a total 176 had good knowledge of OC and 89 (50.6%) had good awareness. A total of 31.8% reported preference for OC screening by a general dental practitioner (GDP) over a general medical practitioner (GMP). Majority (72.7%) reported acceptance of OC screening at their next GDP visit. Ages 56-70 (OR = 0.357, 95% CI) and previous smokers (OR = 0.336, 95% CI) significantly influenced screening preferences. Knowledge of risk factors did not significantly influence OC screening preferences (χ2 = 3.178, P = 0.075). CONCLUSIONS: Significant gaps in OC knowledge, screening and role of GDPs exist with smoking history and age influencing OC screening preferences.


Assuntos
Odontólogos , Neoplasias Bucais , Adulto , Idoso , Estudos Transversais , Detecção Precoce de Câncer , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pessoa de Meia-Idade , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/prevenção & controle , Saúde Bucal , Papel Profissional , Inquéritos e Questionários , Atenção Terciária à Saúde , Universidades
9.
Nurs Stand ; 25(29): 42-7; quiz 48, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21500689

RESUMO

The quality of care for people with dementia in general hospital settings has attracted widespread concern. While organisation-wide strategies are needed to address many of the issues, the nursing role is critical to articulating and promoting good practice. This article focuses on promoting dignity for older people with dementia and offers a number of strategies to help individual nurses and nursing teams reflect on and promote good practice.


Assuntos
Demência/enfermagem , Empatia , Idoso , Humanos , Relações Enfermeiro-Paciente
10.
Anim Reprod Sci ; 225: 106670, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33338983

RESUMO

Reproductive steroids testosterone (T) and estrone sulfate (E1S) are used as diagnostic markers for cryptorchidism in horses. The human chorionic gonadotropin (hCG) stimulation test is used as a diagnostic aid because administration of this hormone results in greater incremental differences in circulating steroid concentrations. Thoughts regarding optimal sampling times following hCG administration, however, are inconsistent. Additionally, determination of half-life of these steroids is important in postsurgical samples to confirm complete removal of testicular tissue. Objectives of this study, therefore, were to determine optimal sampling periods for peak T and E1S after hCG administration and half-life of these steroids after castration. Eight pony stallions were randomly assigned to control or treatment groups (5000 IU hCG). Blood samples were collected following hCG administration. Subsequently, stallions were castrated and blood samples were collected post-castration. The T concentrations were greatest at 72 h after hCG and were greater (P < 0.02) in samples from hCG-treated than control animals: 9,903.4 ± 384 and 784.0 ± 192 pg/mL, respectively (Mean ± SEM). The T concentrations were also greater at 1, 12, 24, 48 and 96 h. The E1S concentrations did not change after administration of hCG. The T response to hCG administration was biphasic with a maximal response between 48-96 h after administration. Half-lives of T and E1S were 1.1 and 0.7 h, respectively, and concentration of T and E1S was similar to that of geldings at 24 h post-castration, which, therefore, should be considered an optimal time to ensure complete castration has occurred.


Assuntos
Gonadotropina Coriônica/farmacologia , Estrona/análogos & derivados , Cavalos/metabolismo , Orquiectomia/veterinária , Testosterona/sangue , Animais , Estrona/sangue , Cavalos/sangue , Masculino
11.
Int J Tuberc Lung Dis ; 24(4): 396-402, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32317063

RESUMO

BACKGROUND: There has been slow uptake of isoniazid preventive therapy (IPT) among people living with HIV (PLWH).METHODS: We surveyed adults recently diagnosed with HIV in 14 South African primary health clinics. Based on the literature and qualitative interviews, sixteen potential barriers and facilitators related to preventive therapy among PLWH were selected. Best-worst scaling (BWS) was used to quantify the relative importance of the attributes. BWS scores were calculated based on the frequency of participants' selecting each attribute as the best or worst among six options (across multiple choice sets) and rescaled from 0 (always selected as worst) to 100 (always selected as best) and compared by currently receiving IPT or not.RESULTS: Among 342 patients surveyed, 33% (n = 114) were currently taking IPT. Having the same standard of life as someone without HIV was most highly prioritized (BWS score = 67.3, SE = 0.6), followed by trust in healthcare providers (score, 66.3 ± 0.6). Poor standard of care in public clinics (score, 30.6 ± 0.6) and side effects of medications (score, 33.7 ± 0.6) were least prioritized. BWS scores differed by IPT status for few attributes, but overall ranking was similar (spearman's rho = 0.9).CONCLUSION: Perceived benefits of preventive therapy were high among PLWH. IPT prescription by healthcare providers should be encouraged to enhance IPT uptake among PLWH.


Assuntos
Infecções por HIV , Tuberculose , Adulto , Antituberculosos/uso terapêutico , Infecções por HIV/tratamento farmacológico , Pessoal de Saúde , Humanos , Isoniazida/uso terapêutico , Tuberculose/tratamento farmacológico , Tuberculose/prevenção & controle
12.
J Geophys Res Planets ; 125(12): e2020JE006527, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33520561

RESUMO

This paper provides an overview of the Curiosity rover's exploration at Vera Rubin ridge (VRR) and summarizes the science results. VRR is a distinct geomorphic feature on lower Aeolis Mons (informally known as Mount Sharp) that was identified in orbital data based on its distinct texture, topographic expression, and association with a hematite spectral signature. Curiosity conducted extensive remote sensing observations, acquired data on dozens of contact science targets, and drilled three outcrop samples from the ridge, as well as one outcrop sample immediately below the ridge. Our observations indicate that strata composing VRR were deposited in a predominantly lacustrine setting and are part of the Murray formation. The rocks within the ridge are chemically in family with underlying Murray formation strata. Red hematite is dispersed throughout much of the VRR bedrock, and this is the source of the orbital spectral detection. Gray hematite is also present in isolated, gray-colored patches concentrated toward the upper elevations of VRR, and these gray patches also contain small, dark Fe-rich nodules. We propose that VRR formed when diagenetic event(s) preferentially hardened rocks, which were subsequently eroded into a ridge by wind. Diagenesis also led to enhanced crystallization and/or cementation that deepened the ferric-related spectral absorptions on the ridge, which helped make them readily distinguishable from orbit. Results add to existing evidence of protracted aqueous environments at Gale crater and give new insight into how diagenesis shaped Mars' rock record.

13.
Science ; 232(4753): 993-5, 1986 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-17759283

RESUMO

It has been suggested that Thaxteriola species and other minute, nonmycelial fungi associated with arthropods have phylogenetic relationships with the Laboulbeniales. However, direct development of the thallus of Thaxteriola from an ascospore of Pyxidiophora has now been discovered. Thaxteriola is specialized for dispersal by mites carried on pine bark beetles; other fungi dispersed by arthropods in this symbiotic assemblage rely primarily on arthropod specializations.

14.
BJOG ; 115(8): 1015-9, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18503576

RESUMO

OBJECTIVE: To audit glove perforations at laparotomies for gynaecological cancers. SETTING: Gynaecological oncology unit, cancer centre, London. DESIGN: Prospective audit. SAMPLE: Twenty-nine laparotomies for gynaecological cancers over 3 months. METHODS: Gloves used during laparotomies for gynaecological cancer were tested for perforations by the air inflation and water immersion technique. Parameters recorded were: type of procedure, localisation of perforation, type of gloves, seniority of surgeon, operation time and awareness of perforations. MAIN OUTCOME MEASURE: Glove perforation rate. RESULTS: Perforations were found in gloves from 27/29 (93%) laparotomies. The perforation rate was 61/462 (13%) per glove. The perforation rate was three times higher when the duration of surgery was more than 5 hours. The perforation rate was 63% for primary surgeons, 54.5% for first assistant, 4.7% for second assistant and 40.5% for scrub nurses. Clinical fellows were at highest risk of injury (94%). Two-thirds of perforations were on the index finger or thumb. The glove on the nondominant hand had perforations in 54% of cases. In 50% of cases, the participants were not aware of the perforations. There were less inner glove perforations in double gloves compared with single gloves (5/139 versus 26/154; P = 0.0004, OR = 5.4, 95% CI 1.9-16.7). The indicator glove system failed to identify holes in 44% of cases. CONCLUSIONS: Glove perforations were found in most (93%) laparotomies for gynaecological malignancies. They are most common among clinical fellows, are often unnoticed and often not detected by the indicator glove system.


Assuntos
Neoplasias dos Genitais Femininos/cirurgia , Luvas Cirúrgicas/normas , Procedimentos Cirúrgicos em Ginecologia/instrumentação , Laparotomia/instrumentação , Falha de Equipamento , Feminino , Luvas Cirúrgicas/estatística & dados numéricos , Procedimentos Cirúrgicos em Ginecologia/estatística & dados numéricos , Humanos , Laparotomia/estatística & dados numéricos , Auditoria Médica , Estudos Prospectivos , Fatores de Tempo
15.
BJOG ; 115(7): 902-7, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18485170

RESUMO

OBJECTIVE: To evaluate the use of inferior vena caval filters (IVCF) prior to surgery in women with gynaecological cancer and venous thromboembolism (VTE). DESIGN: Retrospective review of medical notes and electronic records. SETTING: Gynaecological oncology cancer centre. POPULATION: Women with gynaecological cancer and VTE requiring major surgery. METHODS: A retrospective analysis was performed on women treated for gynaecological malignancies who had had VTE, and an IVCF placed before major abdominal surgery were reviewed during the period 1996-2006. MAIN OUTCOME MEASURES: Safety of IVCF placement and retrieval, peri-operative morbidity and incidence of further VTE. RESULTS: The median age was 66 years (range 30-84 years). Of the 39 women, 35 (90%) women had a primary cancer diagnosis and 4 (10%) had recurrent disease. Twenty-two women had ovarian cancer, 2 had borderline ovarian tumours, 9 had uterine cancer, 5 had cervical cancer and 1 woman had concurrent ovarian and endometrial cancers. The recurrent cancers were two cervical, one ovarian and one uterine. The IVCF used were either of the permanent or retrievable type, the latter being more commonly used in younger women. All filters were placed without morbidity, and none of these women who then underwent major abdominal surgery had VTE complications. In 43.6% of women (n = 17), surgery was performed within 6 weeks of the diagnosis of VTE. All women received perioperative anticoagulation in the form of subcutaneous low-molecular-weight heparin. Three retrievable filters were uneventfully removed postoperatively. No filter-related problems occurred. CONCLUSIONS: Surgery in women with gynaecological cancer and life-threatening VTE is feasible with preoperative IVCF placement. The use of IVCF was safe with no worsening of the VTE, and without surgical or filter-related problems. A short interval between the diagnosis of VTE and surgery was not associated with increased perioperative morbidity.


Assuntos
Neoplasias dos Genitais Femininos/cirurgia , Embolia Pulmonar/prevenção & controle , Filtros de Veia Cava , Tromboembolia Venosa/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/administração & dosagem , Feminino , Neoplasias dos Genitais Femininos/complicações , Neoplasias dos Genitais Femininos/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Embolia Pulmonar/complicações , Ultrassonografia , Tromboembolia Venosa/complicações
16.
J Vet Intern Med ; 32(1): 135-141, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29197094

RESUMO

BACKGROUND: Plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration is increased in dogs with myocardial dysfunction, and cell-free DNA (cfDNA) increases in numerous disease states. In humans, both of these biomarkers can be altered after endurance exercise. OBJECTIVE: To investigate the effect of prolonged strenuous exercise on circulating NT-proBNP and cfDNA concentrations in working farm dogs. ANIMALS: Six healthy, privately owned working farm dogs (4 Huntaways and 2 heading dogs) from the same hill country farm in New Zealand. METHODS: Prospective, nonrandomised cohort study. Venous blood samples were collected before and after the dogs worked over 4 days. Plasma NT-proBNP concentrations were measured by a commercially available ELISA assay and cfDNA concentrations were determined by fluorometry without prior DNA extraction. RESULTS: The baseline (before work, Day 1) median plasma NT-proBNP concentration was 664 pmol/L. A linear mixed-effects model showed that work increased plasma NT-proBNP concentrations by 101 ± 9% (P < 0.001), but with each consecutive day of work, NT-proBNP concentrations declined by 16 ± 4% (P < 0.001). The baseline median plasma cfDNA concentration was 653 ng/mL, and plasma cfDNA concentrations increased by 138 ± 45 ng/mL after work (P = 0.004). CONCLUSIONS AND CLINICAL IMPORTANCE: The plasma concentration of NT-proBNP in healthy Huntaways and heading dogs after work can exceed the upper limit of the reference range. Results in dogs sampled on the day of prolonged strenuous exercise should be interpreted with caution. Plasma concentrations of cfDNA also increase with exercise, but further studies are needed to establish reference ranges in healthy dogs.


Assuntos
Ácidos Nucleicos Livres/sangue , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Condicionamento Físico Animal/fisiologia , Esforço Físico/fisiologia , Animais , Biomarcadores/sangue , Estudos de Coortes , Cães , Feminino , Masculino , Nova Zelândia , Estudos Prospectivos
17.
BJOG ; 114(9): 1168-71, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17617194

RESUMO

We reviewed 25 cases of gestational trophoblastic tumours referred for surgical management from Charing Cross Hospital (the London centre for gestational trophoblastic disease [GTD]) over a 13-year period. The operation performed was total abdominal hysterectomy, with lymph node sampling in 9/25 (36%) women and bilateral salpingo-oophorectomy in 11/25 (44%) women. Radical hysterectomy and unilateral parametrectomy was required in 3/25 (12%) women. Three of 25 (12%) women failed to survive, i.e. the overall rate of survival was 88%. Management by hysterectomy of primary drug-resistant and relapse cases of GTD is a useful and safe adjunct to chemotherapy.


Assuntos
Doença Trofoblástica Gestacional/cirurgia , Histerectomia/métodos , Adulto , Feminino , Doença Trofoblástica Gestacional/mortalidade , Doença Trofoblástica Gestacional/patologia , Humanos , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/secundário , Excisão de Linfonodo/métodos , Metástase Linfática , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Gravidez
18.
R Soc Open Sci ; 4(10): 170785, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29134081

RESUMO

The 2003 Beagle 2 Mars lander has been identified in Isidis Planitia at 90.43° E, 11.53° N, close to the predicted target of 90.50° E, 11.53° N. Beagle 2 was an exobiology lander designed to look for isotopic and compositional signs of life on Mars, as part of the European Space Agency Mars Express (MEX) mission. The 2004 recalculation of the original landing ellipse from a 3-sigma major axis from 174 km to 57 km, and the acquisition of Mars Reconnaissance Orbiter High Resolution Imaging Science Experiment (HiRISE) imagery at 30 cm per pixel across the target region, led to the initial identification of the lander in 2014. Following this, more HiRISE images, giving a total of 15, including red and blue-green colours, were obtained over the area of interest and searched, which allowed sub-pixel imaging using super high-resolution techniques. The size (approx. 1.5 m), distinctive multilobed shape, high reflectivity relative to the local terrain, specular reflections, and location close to the centre of the planned landing ellipse led to the identification of the Beagle 2 lander. The shape of the imaged lander, although to some extent masked by the specular reflections in the various images, is consistent with deployment of the lander lid and then some or all solar panels. Failure to fully deploy the panels-which may have been caused by damage during landing-would have prohibited communication between the lander and MEX and commencement of science operations. This implies that the main part of the entry, descent and landing sequence, the ejection from MEX, atmospheric entry and parachute deployment, and landing worked as planned with perhaps only the final full panel deployment failing.

19.
Food Chem Toxicol ; 44(10): 1636-50, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16891049

RESUMO

The European Food Safety Authority (EFSA) and the World Health Organization (WHO), with the support of the International Life Sciences Institute, European Branch (ILSI Europe), organized an international conference on 16-18 November 2005 to discuss how regulatory and advisory bodies evaluate the potential risks of the presence in food of substances that are both genotoxic and carcinogenic. The objectives of the conference were to discuss the possible approaches for risk assessment of such substances, how the approaches may be interpreted and whether they meet the needs of risk managers. ALARA (as low as reasonably achievable) provides advice based solely on hazard identification and does not take into account either potency or human exposure. The use of quantitative low-dose extrapolation of dose-response data from an animal bioassay raises numerous scientific uncertainties related to the selection of mathematical models and extrapolation down to levels of human exposure. There was consensus that the margin of exposure (MOE) was the preferred approach because it is based on the available animal dose-response data, without extrapolation, and on human exposures. The MOE can be used for prioritisation of risk management actions but the conference recognised that it is difficult to interpret it in terms of health risk.


Assuntos
Carcinógenos/toxicidade , Alimentos/normas , Mutagênicos/toxicidade , Animais , Testes de Carcinogenicidade , Europa (Continente) , Doenças Transmitidas por Alimentos/etiologia , Doenças Transmitidas por Alimentos/genética , Humanos , Testes de Mutagenicidade , Medição de Risco , Organização Mundial da Saúde
20.
N Z Vet J ; 64(3): 145-53, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26553450

RESUMO

AIMS: To determine current practices and attitudes towards vaccination of dogs and cats of veterinarians in New Zealand; the methods used for informing clients on which vaccines to use, and the preferred site for vaccination of cats. METHODS: A postal questionnaire was sent to all 483 listed veterinary practices in New Zealand during February 2012. Some questions were specific to pet dogs, cats, or working farm dogs. Responses were categorised according to practice type and geographical region of the respondent. Factors associated with respondent recommendation of annual vaccination with modified live viral (MLV) vaccines were examined using logistic regression analysis. Vaccines that were considered to be essential for every animal were defined as core; those that may be recommended for animals whose location or lifestyle placed them at risk, were defined as non-core. RESULTS: There were 204 useable returns, equivalent to a response rate of 42.2%, distributed across the country. Annual vaccination with MLV vaccines of dogs was recommended by 54/198 (27.3%) respondents, and of cats by 107/181 (59.1%) respondents. Factors associated with the recommendation of annual administration of MLV vaccines to dogs included being a companion animal practice, a desire for policies on vaccination to be left to individual clinics, and having one veterinarian in the practice. Administration of the final vaccination for puppies was recommended at ≥14 weeks old by 55/185 (29.7%) respondents, and for kittens at ≥13 weeks old by 42/183 (23%) respondents. Of respondents that administered MLV vaccines annually, 62/103 (60.2%) believed reducing the frequency of vaccination would reduce income, and 52/103 (50.5%) considered it would have a negative effect on animal health. Advice to enable clients to decide which non-core vaccines were administered was given by 181/199 (91%) respondents. Factors considered when recommending a vaccine included consideration of risk to individual patients (190/203; 93.6%), requirements of boarding kennels/catteries (165/203; 81.3%) and clinic vaccination policy (142/203; 70%). The preferred site for administering MLV vaccines to cats was the dorsal neck or inter-scapular region (137/198; 69.2%). Amongst respondents, 18 wanted disease surveillance information to allow for truly informed decisions to be made about vaccination. CONCLUSIONS AND CLINICAL RELEVANCE: Veterinarians can now compare their own vaccination practices and attitudes with those of veterinarians nationally, and internationally. There is a need for national surveillance information and for continued education of the public and commercial kennel and cattery owners for optimal vaccination strategies to be developed.


Assuntos
Doenças do Gato/prevenção & controle , Doenças do Cão/prevenção & controle , Vacinação/veterinária , Medicina Veterinária/normas , Envelhecimento , Animais , Gatos , Coleta de Dados , Cães , Nova Zelândia
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