RESUMO
BACKGROUND: Past epidemics, including influenza, have resulted in increased paediatric patient volume in EDs. During the early weeks of the COVID-19 pandemic, it was unclear how ED volume would be impacted in paediatric hospitals. The objective of this study was to examine differences in the international experience of paediatric ED utilisation and disposition at five different children's hospitals. METHODS: We obtained data on ED volume, acuity level and disposition (hospitalisation and intensive care unit (ICU) admission) for the time period 1 December1-10 August for the years 2017-2020 from hospitals in five cities (Boston, Massachusetts, USA; Singapore; Melbourne, Australia; Seattle, Washington, USA; and Paris, France). Per cent change was analysed using paired t-tests or Wilcoxon signed rank test. RESULTS: Overall ED volume dramatically decreased in all five hospitals during the early months of COVID-19 compared with prior years. There was a more varied response of decreases in ED volume by acuity level, hospitalisation and ICU admission among the five hospitals. The one exception was a 2% increase in ICU admissions in Paris. As of August 2020, all hospitals have demonstrated increases in ED volume; however, they are still below baseline. CONCLUSION: Paediatric EDs in these five cities demonstrated differential decreases of ED volume by acuity and disposition during the early months of the COVID-19 pandemic.
Assuntos
COVID-19 , Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitais Pediátricos/estatística & dados numéricos , Austrália , Boston , Criança , Hospitalização , Humanos , Unidades de Terapia Intensiva , Internacionalidade , Paris , Singapura , WashingtonRESUMO
Doxycycline gel is licensed for the treatment of periodontal disease in dogs. Package labeling indicates the product is stable after reconstitution of antibiotic with polymer gel for up to 3-days when stored at room temperature. The purpose of this study was to determine if reconstituted doxycycline gel retained antimicrobial activity for greater than 3-days. The antibiotic activity of reconstituted doxycycline gel was evaluated against antimicrobial testing strains of bacteria and bacteria collected from throat swabs of 2 dogs using a standard disc diffusion assay. Our results showed that reconstituted doxycycline gel retained undiminished antimicrobial activity for a minimum of 8-weeks.
Assuntos
Antibacterianos/química , Antibacterianos/farmacologia , Doxiciclina/química , Doxiciclina/farmacologia , Animais , Antibacterianos/administração & dosagem , Cães , Doxiciclina/administração & dosagem , Farmacorresistência Bacteriana , Enterococcus faecalis/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Géis , Staphylococcus aureus/efeitos dos fármacosRESUMO
This case series describes clinical, radiographic, and histopathological features of mandibular swellings in 5 immature, large breed dogs. The dogs originated from different regions of the United States. In each case, intraoral dental radiography of the jaw swelling revealed a two-layered (double) ventral mandibular cortex. Biopsy was performed in 4 of the 5 puppies, revealing periosteal new bone formation. Resolution of the mandibular swelling was spontaneous in the 4 dogs available for follow-up examination. The authors postulate that the clinical, radiographic, and histopathological presentation of mandibular swelling in these 5 dogs is a distinct pathological entity consistent with an inflammatory condition of the maturing human mandible known as periostitis ossificans.
Assuntos
Doenças do Cão/diagnóstico por imagem , Doenças Mandibulares/veterinária , Ossificação Heterotópica/veterinária , Periostite/veterinária , Animais , Antibacterianos/administração & dosagem , Diagnóstico Diferencial , Doenças do Cão/tratamento farmacológico , Doenças do Cão/patologia , Cães , Masculino , Doenças Mandibulares/diagnóstico por imagem , Doenças Mandibulares/tratamento farmacológico , Doenças Mandibulares/patologia , Ossificação Heterotópica/diagnóstico por imagem , Ossificação Heterotópica/patologia , Periostite/diagnóstico por imagem , Periostite/tratamento farmacológico , Periostite/patologia , Radiografia , Resultado do Tratamento , Estados UnidosRESUMO
A Greyhound presented with eosinophilic granuloma lesions of the soft palate and oronasal fistula. Since other siblings had been known to also have oral eosinophilic granuloma, it was suspected that the dog reported here had a familial predisposition to develop the disease. Preoperative medical management consisting of anti-inflammatory and immunosuppressive therapy was required before surgical repair of the oronasal fistula. Multiple surgical techniques, including a greater palatine island axial pattern flap, were used to repair the oronasal fistula.
Assuntos
Doenças do Cão/cirurgia , Granuloma Eosinófilo/veterinária , Fístula Bucal/veterinária , Retalhos Cirúrgicos/veterinária , Animais , Cães , Granuloma Eosinófilo/complicações , Feminino , Fístula Bucal/etiologia , Fístula Bucal/cirurgia , Procedimentos Cirúrgicos Bucais/veterinária , Resultado do TratamentoRESUMO
A seven-year-old neutered/male Siberian Husky-cross dog was referred for evaluation of a gingival mass. Two years previously, the referring veterinarian had resected an ossifying epulis from the same area between the maxillary left first and second premolars. The neoplasm recurred 4-months after the original surgery. En bloc resection provided tumor-free margins. An oral examination 12-months following surgery indicated no gross signs of recurrence.
Assuntos
Doenças do Cão/diagnóstico , Doenças da Gengiva/veterinária , Neoplasias Gengivais/veterinária , Recidiva Local de Neoplasia/veterinária , Animais , Diagnóstico Diferencial , Doenças do Cão/cirurgia , Cães , Doenças da Gengiva/diagnóstico , Doenças da Gengiva/cirurgia , Neoplasias Gengivais/diagnóstico , Neoplasias Gengivais/cirurgia , Masculino , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/cirurgiaAssuntos
Serviços de Emergência Psiquiátrica , Hipnóticos e Sedativos/uso terapêutico , Agitação Psicomotora/tratamento farmacológico , Doença Aguda , Adolescente , Antipsicóticos/efeitos adversos , Antipsicóticos/uso terapêutico , Benzodiazepinas/efeitos adversos , Benzodiazepinas/uso terapêutico , Criança , Procedimentos Clínicos , Feminino , Antagonistas dos Receptores Histamínicos H1/efeitos adversos , Antagonistas dos Receptores Histamínicos H1/uso terapêutico , Humanos , Hipnóticos e Sedativos/efeitos adversos , Masculino , Agitação Psicomotora/psicologia , Encaminhamento e ConsultaRESUMO
Dental radiology is the core diagnostic modality of veterinary dentistry. Dental radiographs assist in detecting hidden painful pathology, estimating the severity of dental conditions, assessing treatment options, providing intraoperative guidance, and also serve to monitor success of prior treatments. Unfortunately, most professional veterinary training programs provide little or no training in veterinary dentistry in general or dental radiology in particular. Although a technical learning curve does exist, the techniques required for producing diagnostic films are not difficult to master. Regular use of dental x-rays will increase the amount of pathology detected, leading to healthier patients and happier clients who notice a difference in how their pet feels. This article covers equipment and materials needed to produce diagnostic intraoral dental films. A simplified guide for positioning will be presented, including a positioning "cheat sheet" to be placed next to the dental x-ray machine in the operatory. Additionally, digital dental radiograph systems will be described and trends for their future discussed.
Assuntos
Odontologia/veterinária , Radiografia Dentária Digital/veterinária , Radiologia/instrumentação , Radiologia/métodos , Medicina Veterinária/instrumentação , Animais , Gatos , Odontologia/métodos , Cães , Radiografia Dentária Digital/instrumentação , Radiografia Dentária Digital/métodos , Medicina Veterinária/métodos , Filme para Raios X/veterináriaRESUMO
Interpretation of dental radiographs is fairly straightforward, with a handful of common patterns making up the majority of pathology. This article covers normal radiographic anatomy, endodontic disease, periodontal disease, neoplastic changes, tooth resorption, caries, and radiographic signs of oral trauma.
Assuntos
Odontologia/veterinária , Doenças Dentárias/veterinária , Animais , Gatos , Cães , Neoplasias Bucais/diagnóstico por imagem , Neoplasias Bucais/veterinária , Radiografia Dentária/veterinária , Doenças Dentárias/diagnóstico por imagemRESUMO
Dental fractures in veterinary patients are relatively common. Historically, very little treatment has been provided for these fractures. Because of the relatively thin layer of enamel present in canine and feline dentition, most fractures result in exposure of dentin and/or pulp. This article discusses the rationale and procedure for treatment of exposed dentin in vital (live) teeth. Correct case selection and treatment improve patient comfort and help decrease the chance of future endodontic involvement in these teeth. This procedure may be considered an entry-level restorative procedure. Once mastered, the materials and principles will allow the practitioner to branch into more sophisticated restorative procedures, such as composite restorations, auto-incline planes, and restoration of endodontic access sites.
Assuntos
Colagem Dentária/veterinária , Restauração Dentária Permanente/veterinária , Selantes de Fossas e Fissuras/uso terapêutico , Fraturas dos Dentes/veterinária , Animais , Gatos , Colagem Dentária/métodos , Restauração Dentária Permanente/métodos , Cães , Fraturas dos Dentes/terapia , Medicina Veterinária/métodosRESUMO
Current standards of care in veterinary medicine dictate an adequate level of pain control for our patients. Effective pain control uses a proactive, multimode approach that starts with preoperative medications, includes the anesthetic protocol selected, and continues into the postoperative period. A basic understanding of the physiology of pain assists in selecting those agents and modalities best suited for individual patients. Analgesic drug selection and local anesthesia are both integral parts of pain control when performing surgery in the oral cavity. Local (regional) anesthesia plays an important part in the pain control of oral surgical patients. Regional anesthetic techniques are used for many common oral procedures, including extractions, periodontal flap surgery, treatment of traumatic injuries of the oral cavity, tumor removal, palatal surgery, periodontal therapy, and root canal therapy. This presentation will cover strategies for analgesia and the techniques and materials used in local/regional anesthesia in the oral cavity. Anatomic landmarks and guidelines for effective regional blocks will be covered.