Outcome of 9 dogs treated with stereotactic radiation therapy for primary or metastatic vertebral osteosarcoma.

Primary and metastatic vertebral osteosarcoma (OSA) in the dog carries an overall guarded prognosis. Previously reported definitive treatments in dogs with vertebral OSA have included surgery, radiotherapy, chemotherapy or a combination of those therapies. This retrospective study was completed to determine patterns of failure, duration of local control and survival time in dogs with vertebral OSA treated with stereotactic radiation therapy (SRT). Nine dogs were treated with SRT for vertebral OSA. Protocols ranged from 1 to 5 fractions with total prescription ranging from 13.5 to 36 Gy. Six dogs had primary lesions and 3 had metastatic lesions. Neurologic score improved in 4 patients, remained the same in 4 and worsened in 1. Five of the 6 dogs that presented with assessable spinal pain had reported improvement in pain. Overall median survival time was 139 days and median duration of pain control was 77 days. There was not a statistically significant survival difference between dogs presenting with primary or metastatic disease, or dogs that had improvement in neurologic score following SRT. The data suggests similar survival times to the previously reported definitive treatments in dogs with vertebral OSA and displays continued difficulty in controlling this tumour. The dose limiting structure is the late responding spinal cord, but many of the patients herein died prior to the expected time to development of late radiation side effects.

Fundal height measurement. Part 5--The effect of clinician bias on fundal height measurements.

The purpose of this study was to determine whether clinicians' fundal height measurements were influenced by their ability to see the numeric markings on the tape measure during the measurement procedure, and by their knowledge of gestational weeks. Ten certified nurse-midwives and four student nurse-midwives each obtained measurements from 24 women. Each clinician obtained two fundal height measurements with unmarked paper tape measures and two fundal height measurements with marked paper tape measures. The fundal height measurement obtained and recorded on the prenatal chart by the clinician responsible for the woman's routine prenatal visit at the time of data collection was also recorded by the researchers. Comparison of the differences between the clinician's two marked and two unmarked tape measurements demonstrated that the differences between the two marked tape measurements were smaller (mean absolute difference = 0.61 cm) than the differences between the two unmarked tape measurements (mean absolute difference = 0.97 cm). When the gestational weeks were compared with the unmarked and marked tape measurements and with the fundal height measurements recorded on the prenatal record, the smallest differences were between the fundal height measurements recorded on the prenatal record and gestational weeks (mean absolute difference = 1.51 cm); the next smallest differences were between the marked tape measurements and gestational weeks (mean absolute difference = 1.89 cm); and the largest differences were between the unmarked tape measurements and gestational weeks (mean absolute difference = 2.15 cm). These findings demonstrate that clinicians' fundal height measurements are biased by their ability to see the numeric markings on the tape measure and by their knowledge of gestational weeks. These findings suggest that clinicians should blind themselves to their own fundal height measurements and to the number of gestational weeks to avoid the effects of clinician bias on their fundal height measurements.